B&b Drugs I

Front 1

morphine

Back 1

Class: Naturally occuring Opioid agonist
Tx: pain
Side effects: histamine release significant.
Remarks: low lipid solubility, poor bioavailability, metabolites are morphine 3- and morphine-6-gulcuronide (the latter 10-100x more potent)

Front 2

codeine

Back 2

Class: Weak opioid agonist
Remarks: prodrug that is metabolised to morphine.
Tx: pain; good antitussive effect (but so do all opioids)

Front 3

oxycodone

Back 3

Class: Semisynthetic opioid agonist.
Remarks: available as sustained release pill OxyContin, should not be chewed (will cause overdose)

Front 4

propoxyphene

Back 4

Class: Synthetic opioid agonist
Remarks: very weak analgesic, but not naloxone reversible. Tx: this short-acting oral opioid can be used with NSAIDs and anti-emetics in opioid withdrawal.

Front 5

heroin

Back 5

Class: semisynthetic opioid agonist
Remarks: Heroin and metabolites are more lipophilic than morphine. Better entry across BBB.

Front 6

meperidine

Back 6

Class: synthetic opioid agonist
Sides: seizures.
Contra: renal failure

Front 7

hydromorphone (Dilaudid)

Back 7

Class: semi-synthetic opioid agonist
Remarks: unlike morphine, no significant histamine release. Safe for renal failure.
Sides: seizures

Front 8

fentanyl

Back 8

Class: synthetic opioid agonist
Remarks: no active metabolites.
PK: Very lipophilic, can be made into lollipop for cancer pts.
Contra: acute pain.

Front 9

methadone

Back 9

Class: synthetic opioid agonist
Pharm: Very high bioavailability (0.0), long half life of 24hrs. No active metabolites
Remarks: must be given at doses more freq. than half life for pain control, causes accumulation.
Tx: opioid withdrawal; taper over 1 week.

Front 10

tramadol

Back 10

Class: synthetic opioid agonist
MAO: blocks 5-HT reuptake, μ-R agonist.
Tx: mild-mod pain
Remarks: not reversed by naloxone. Often abused due to schedule I status.

Front 11

naloxone

Back 11

Class: Opioid antagonist
MAO: comptetitive antagonist at μ-R. Very poor oral (F).
Pharm: short half-life 1hr.
Remarks: cannot reverse tramadol or propoxyphene

Front 12

Nalmefene

Back 12

Class: Opioid antagonist
MAO: comptetitive antagonist at μ-R. Exactly like naloxone, but with longer 8-9hr half life.

Front 13

pentazocine

Back 13

Class: Opioid agonist/antagonist
MAO: antagonises μ, agonises κ-R. Makes pt. drowsy and psychotic, not often used.

Front 14

nalbuphine

Back 14

Class: Opioid agonist/antagonist
MAO: antagonises μ, agonises κ-R. Makes pt. drowsy and psychotic, not often used.

Front 15

butorphanol

Back 15

Class: Opioid agonist/antagonist
MAO: antagonises μ, agonises κ-R. Makes pt. drowsy and psychotic, not often used.

Front 16

buprenorphine

Back 16

Class: Opioid partial agonist
MAO: only available μ partial agonist.
Pharm: Slow dissociation makes it difficult ot reverse with naloxone.
Tx: opioid dependence.

Front 17

loperamide (Imodium)

Back 17

Class: Opioid anti-diarrhoea
Pharm: poorly absorbed orally, don't enter CNS well (little risk of abuse).

Front 18

dephenoxylate

Back 18

Class: Opioid anti-diarrhoea
Pharm: poorly absorbed orally, don't enter CNS well (little risk of abuse).

Front 19

dextromethorphan (Robitussin)

Back 19

Class: antitussive
Remarks: no analgesic or habituating properties. Not an opioid.

Front 20

ibuprofen (Motrin)

Back 20

Class: NSAID

Front 21

naprosyn (naproxen)

Back 21

Class: NSAID

Front 22

indomethacin

Back 22

Class: NSAID
Remarks: very gastrically irritating

Front 23

diclofenac

Back 23

Class: NSAID
Remarks: jacks up BP

Front 24

nabumetone

Back 24

Class: NSAID

Front 25

ketorolac

Back 25

Class: NSAID
Remark: only I.V. NSAID available in the U.S.
Tx: combine with opioids for perioperative pain.

Front 26

acetylsalicylic acid (aspirin)

Back 26

Class: NSAID
MAO: covalently acetylates COX; irreversible inhibition, new platelets must be made.
Remarks: can cause Reye's Syndrome in children after viral illness.

Front 27

celecoxib

Back 27

Class: NSAID
Pharm: COX-2 selective inhibitor; does not fuck up platelets.

Front 28

rofecoxib

Back 28

Class: NSAID
Pharm: COX-2 selective inhibitor; does not fuck up platelets.

Front 29

acetominophen

Back 29

Class: NSAID
Sides: possible fatal hepatic necrosis in overdose. Covalently binding to hepatocytes.
Tx: radiculopathies

Front 30

amitriptyline

Back 30

Tx: pain associated with common peripheral neuropathies, such as diabetic sensorimotor ones.
Remarks: comparatively inexpensive.

Front 31

desipramine

Back 31

Tx: pain associated with common peripheral neuropathies, such as diabetic sensorimotor ones.

Front 32

gabapentin

Back 32

Tx: pain associated with common peripheral neuropathies, such as diabetic sensorimotor ones.
Remarks: relatively more expensive than amitriptyline.

Front 33

pyridostigmine

Back 33

Class: AChE inhibitor
Tx: first-line against myasthenia gravis.

Front 34

prednisone

Back 34

Class: steroidal anti-inflammatory.
Tx: chronic inflammatory demyelinating polyneuropathy (CIPD), dermatomyositis, polymyositis. Risky for MG. Helps little with DMD.
Contra: Guillain-Barre, Inclusion-body Myositis.

Front 35

IVIG

Back 35

Class: Intravenous Immunoglobulin
Tv: Guillain-Barre; use after plasmophoresis.

Front 36

methylphenidate (Ritalin)

Back 36

Class: psychostimulant
Tx: ADHD, AIDS encephalopathy.
Remarks: comes in ≥10 formulations.
Sides: anorexia, insomnia, possible exacerbation of tics

Front 37

dextroamphetamine (Dexedrine)

Back 37

Class: psychostimulant
Tx: ADHD
Sides: anorexia, insomnia, possible exacerbation of tics

Front 38

Concerta

Back 38

Class: psychostimulant
Long-acting form of Ritalin
Tx: ADHD
Sides: anorexia, insomnia, possible exacerbation of tics

Front 39

Amphetamine (Adderall)

Back 39

Class: psychostimulant
Tx: ADHD
Sides: high potential for abuse, being replaced by lisdexamfetamine (Vyvanse); anorexia, insomnia, possible exacerbation of tics

Front 40

olanzapine (Zyprexia)

Back 40

Class: anti-psychotic
Tx: schizotypal PD (in low dose); borderline PD to improve mood lability.

Front 41

lithium

Back 41

Class: mood-stabiliser
Tx: Antisocial PD to improve violent, aggressive behaviour. Promising for BPD.

Front 42

propranolol

Back 42

Class: nonselective β-blocker
Tx: HTN, antisocial PD to improve violent, aggressive behaviour.

Front 43

carbamazepine

Back 43

Class: anticonvulsant, mood-stabiliser
Tx: antisocial PD to improve violent, aggressive behaviour, ADHD, epilepsy

Front 44

phenelzine (Nardil)

Back 44

Class: MAOI
Tx: BPD; may improve mood reactivity

Front 45

fluoxetine (Prozac)

Back 45

Class: anti-depressant
Tx: promising for BPD

Front 46

valproate (valporic acid)

Back 46

Class: anti-convulsant, mood-stabiliser
Tx: promising for BPD.