Autocoids

Front 1

Histamine

Back 1

VSM - vasodilation, edema
NVSM - contraction of bronchial and other NVSMs
Other Effects - Itching; increase gastric acid secretion

Front 2

Serotonin

Back 2

VSM - vasoconstriction in most vascular beds
NVSM - contraction of GI and other NVSMs
Other - CNS neurotransmission; stimulation of platelet aggregation

Front 3

Leukotrienes

Back 3

VSM - vasoconstriction or vasodilation
NVSM - contraction of bronchial muscle and other NVSMs
Other - inflammatory effects; increase in vascular permeability

Front 4

Prostaglandin D2

Back 4

Produces sleep when infused into cerebral ventricles

Front 5

Prostaglandin E

Back 5

VSM - vasodilation
NVSM - relaxation of bronchial muscle and contraction of uterine muscle
Other - inhibition of gastric acid secretion; inhibit release of NE from sympathetic nerve endings
Dinoprostone (PGE2) and Misoprostol (PGE1) used in 2nd trimester abortions

Front 6

Prostaglandin F

Back 6

VSM - vasoconstriction in most vascular beds
NVSM - contraction of bronchial and uterine muscle
Other - increase in aqueous humor outflow; Used for first or second trimester abortion: intra-amniotic, IM, or intravaginal routes used carboprost

Front 7

Prostaglandin I

Back 7

VSM - vasodilation
NVSM - contraction
Other - inhibition of platelet aggregation

Front 8

Thromboxane A2

Back 8

VSM - vasoconstriction
NVSM - contraction (i.e. respiratory)
Other - stimulation of platelet aggregation

Front 9

Scopolamine

Back 9

Muscarinic antagonist
Used for motion sickness and vestibular disturbances

Front 10

1st Generation H-1 Receptor Antagonists

Back 10

Diphenhydramine (Benadryl)
Chlorpheniramine (Chlor-Trimeton)
Pyrilamine (with phenylephrine or other drugs)
Clemastine (Tavist)
Hydroxyzine (Vistaril)
Brompheniramine (Dimatane)
Promethazine (Phenergan)

Front 11

2nd Generation H1 Receptor Antagonists

Back 11

Fexofenadine (Allegra)
Loratadine (Claritin & Alavert)
Desloratadine (Clarinex)
Cetirizine (Zyrtec)

Front 12

Azelastine & Ololpatadine

Back 12

Intranasal antihistamines
Clinical Use: Allergic rhinitis; relieves itching, sneezing, watery discharge
Adverse effects: Drowsiness/sedation, headache, dry mouth, weight gain, nosebleeds

Front 13

Buspirone (Buspar)

Back 13

5-HT1A selective AGONIST
Indicated for anxiety (partial agonist)

Front 14

5-HT1B/D selective AGONIST

Back 14

Sumatriptan (Imitrex)
Amlotriptan (Axert)
Zolmitriptan (Zomig)
Naratriptan (Amerge)
Rizatriptan (Maxalt)
Frovatriptan (Frova)
Indicated for reversing migraines (acute) and cluster headaches
*NOT FOR MIGRAINE PROPHYLAXIS*
Actions:
1. Constriction of intracranial blood vessels
2. Inhibits release of pro-inflammatory vasodilatory neuropeptides in CNS

Front 15

Tegaserod (Zelnorm)

Back 15

5-HT4 selective AGONIST
(Only for crisis and only with FDA approval)

Front 16

Cyproheptadine (Periactin)

Back 16

5-HT2 antagonists
Indicated for anti-peristalsis in carcinoid crisis, urticaria (hives), pruiritis

Front 17

Clozapine (Clozaril)

Back 17

5-HT2 selective antagonist, non selective antagonist at dopamine receptors
Indicated for schizophrenia (secondary choice); class of atypical anti-psychotic with less adverse effects than traditional anti-psychotic agents (agranulocytosis can occur)

Front 18

Ondansetron (Zofran)
Granisetron (Kytril)
Dolasetron (Anzemet)

Back 18

5-HT3 selective antagonist
Indicated for GI disorders, chemotherapy/radiation-induced nausea/vomiting
*May cause QT prolongation*

Front 19

Labor and Delivery

Back 19

PGE2 (Dinoprostone) used prior to oxytocin or ergonovine to stimulate uterine contractions
Postpartum bleeding - Carboprost tromethamine (PGF2a), Dinoprostone (PGE2), Misoprostol (PGE1)

Front 20

Dinoprostone

Back 20

Analog of PGE2
Indications: Abortifacient from 12th to 20th week; non-malignant trophoblastic disease (hydatiform mole); use if incomplete abortion with other means

Vaginal suppository placed high in vagina; used to induce cervical ripening for labor

Adverse effects: pyresis (50%), diarrhea (40%), headache (10%), hypotension (10%)

Front 21

Carboprost tromethamine

Back 21

Analog of PGF2a
MOA: Vasoconstrictor
Indications: Post-partum bleeding and abortifacient
Admin: Deep IM injection
Adverse effects: Diarrhea due to stimulation of GI contractions

Front 22

Alprostadil

Back 22

Analog of PGE1
Keep open fetal ductus arteriosus due to heart defects
IV infusion; maintain lowest rate until surgery
Adverse: Apnea in 10% of neonates under 2 kg

Vasodilator for erectile dysfunction
Intracavernosal injection (titrated in office) or intraurethral delivery via pellet

Front 23

Epoprostenol

Back 23

Same as PGI2 (prostacyclin)
Indications: long-term i.v. teatment of PAH
MOA: Direct vasodilation of pulmonary and systemic arterial vascular beds; inhibition of platelet aggregation
Adverse: high incidence of dizziness, headache, nausea/vomiting, diarrhea, myalgia, flushing, tachycardia

Front 24

Treprostinil

Back 24

Continuous subcutaneous infusion (via pump) and inhalation therapy in PAH
If transitioning from epoprostenol (IV), must be done in gradual steps in hospital

Front 25

Misoprostol

Back 25

PGE1 analog
Indicated: Gastric cytoprotection by PGE1 preventing ulcers and promoting ulcer healing, especially after long-term NSAID use
Used orally with antiprogestins (mifepristone) as abortifacient.
*Contraindicated in pregnancy*
Adverse: diarrhea and uterine contractions

Front 26

Latanoprost, Travoprost, Unoprostone

Back 26

PGF2a analongs
Indicated: Reduction of elevated intraocular pressure in open-angle glaucoma and ocular hypertension in pts resistant to other treatments
MOA: Increase aqueous fluid outflow
Adverse: increased brown color in iris by increasing melanin in melanocytes, may permanently change eye color