Pharm Drugs (Immunopcl, Histamines, Analgesics)

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Cyclophosphamide - Immunosuppressant

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Mechanism: Prodrug - produces alkylating agents (phosphoramide mustard & acrolein) inhibits proliferative response. Use: lupus nephritis, systemic vasculitides (severe autoimmune diseases). SE: myelosuppression, hemorrhagic cystitis, can cause tumors

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Azathioprine - Immunosuppressant

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Mechanism: becomes 6-mercaptopurine, inhibits proliferative response. Use: kidney transplant prophylaxis, moderate to severe SLE (lupus), rheumatoid arthritis (not first-line). SE: bone marrow suppression

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Mycophenolate mofetil - immunosuppressant/anti-inflammatory

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Mechanism: inhibits T and B lymphocyte proliferation through inhibition of purine synthesis

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Methotrexate - immunosuppressant

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Mechanism: inactivates dihydrofolate reductase - this inhibits synthesis of thymidylate & other purine metabolites; stimulates release of adenosine; inhibits stimulated neutrophil function and has potent anti-inflammatory properties. Uses: rheumatoid arthritis, psoriasis, reduce required dosage of GCC's in chronic vasculitis. SE: liver function abnormalities, bone marrow suppression, nausea

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Cyclosporin - immunosuppressant/anti-inflammatory

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Mechanism: inhibits cyclophilin binding protein (which inhibits T-cell activation and cytokine release). Uses: organ transplant prophylaxis. SE: nephrotoxicity, neurotoxicity, hepatotoxicity, hypertension, hypersensitivity to vehicle

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Tacrolimus - immunosuppressant

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Mechanism: inhibits FK binding protein (which inhibits T-cell activation and cytokine release). Uses: liver transplant prophylaxis (when cyclosporin fails). SE: nephrotoxicity, hepatotoxicity, neurotoxicity

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Rapamycin - immunosuppressant

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Mechanism: inhibit FK binding protein (which inhibits T-cell activation and cytokine release). Uses: organ transplant porphylaxis, allow for lower doses of cyclosporine or tacrolimus to be used to decrease toxicity

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Glatiramer - immunosuppressant

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Mechanism: downregulate specific immune response in MS (antigen-specific). Uses: treats MS

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Prednisone (oral), Dexamethaxone, Methylprednisone (injection), Prednisolone (eyedrops), Hydrocortizone - Corticosteroids (Glucocorticoids)

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Mechanism: decrease macrophage IL-1 production; decreases MHC II antigens; decrease phagocytosis of virus infected cells, tumor cells, bacteria, and fungi. Uses: prevent graft rejection and treat autoimmune diseases; can be used topically for poison ivy, atopic dermatitis, and asthma

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Muronomab - biological

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Mechanism: depletes T lymphocytes by binding CD3 receptor. Uses: organ transplant. SE: cytokine release syndrome (hypotension, fever, chills), fluid retention, pulmonary edema

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Omalizumab - biological

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Mechanism: binds circulating IgE. Uses: anti-allergy/asthma

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IFβ1a - biological

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Mechanism: stimulate the immune system to kill bacteria, virally infected cells, and tumor cells. Uses: MS

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IFα2A - biological (immunostimulatory)

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Mechanism: antiproliferative. Uses: leukemia, kaposi's sarcoma, chronic hepatitis C

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Pegfilgrastim - biological

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Mechanism: regulate production and function of neutrophils in the bone marrow. Uses: decrease infection associated with chemotherapy. SE: spleen rupture, acute respiratory distress syndrome

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Chlorpheniramine - 1st generation antihistamine

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Mechanism: H1 receptor antagonists (inhibit mediator release, basophil migration, and eosinophil recruitment). Uses: Anti-allergy. SE: anti-muscarinic actions, sedative effects, CNS depression, paradoxical excitation in children, topical use leads to allergic rxn.

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Diphenhydramine - 1st generation antihistamine

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Mechanism: H1 receptor antagonists (inhibit mediator release, basophil migration, and eosinophil recruitment). Uses: Anti-allergy. SE: anti-muscarinic actions, sedative effects, CNS depression, paradoxical excitation in children, topical use leads to allergic rxn.

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Promethazine - 1st generation antihistamine

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Mechanism: H1 receptor antagonists (inhibit mediator release, basophil migration, and eosinophil recruitment). Uses: Anti-allergy. SE: anti-muscarinic actions, sedative effects, CNS depression, paradoxical excitation in children, topical use leads to allergic rxn.

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Loratadine - 2nd generation antihistamine

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Mechanism: H1 receptor antagonists (inhibit mediator release, basophil migration, and eosinophil recruitment). Uses: Anti-allergy. SE: anti-muscarinic actions, sedative effects, CNS depression, paradoxical excitation in children, topical use leads to allergic rxn.

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Fexofenadine - 2nd generation antihistamine

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Mechanism: H1 receptor antagonists (inhibit mediator release, basophil migration, and eosinophil recruitment). Uses: Anti-allergy. SE: anti-muscarinic actions, sedative effects, CNS depression, paradoxical excitation in children, topical use leads to allergic rxn.

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Cetirizine - 2nd generation antihistamine

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Mechanism: H1 receptor antagonists (inhibit mediator release, basophil migration, and eosinophil recruitment). Uses: Anti-allergy. SE: anti-muscarinic actions, sedative effects, CNS depression, paradoxical excitation in children, topical use leads to allergic rxn.

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Desloratadine - 2nd generation antihistamine

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Mechanism: H1 receptor antagonists (inhibit mediator release, basophil migration, and eosinophil recruitment). Uses: Anti-allergy. SE: anti-muscarinic actions, sedative effects, CNS depression, paradoxical excitation in children, topical use leads to allergic rxn.

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Infliximab - biological

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Mechanism: binds circulation TNF. Uses: rheumatoid arthritis, Crohn's disease

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Aspirin/ASA - NSAID

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Mechanism: inhibits PG synthesis (blocks pain impulses). Uses: relieves fever @ hypothalamic heat-regulating center, prevent platelet aggregation @ low dose (for stroke, heart attack). SE: Reye's syndrome - fat accumulation in brain and elsewhere; dyspepsia; occult bleeding

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Ibuprofen - NSAID

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Mechanism: inhibits PG sythesis; analgesic; anti-inflammatory; antipyretic. Uses: RhA; osteoarthritis; moderate pain; dysmenorrhea; fever. SE: fluid retention, tinnitus

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Indomethacin - NSAID

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Mechanism: inhibits PG synthesis; analgesic; anti-inflammatory; antipyretic. Uses: RhA, osteoarthritis, gouty arthritis, patent ductus arteriosus. SE: blurred vision, rash, GI

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Diclofenac - NSAID

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Mechanism: may block PG synthesis by inhibiting COX. Uses: arthritis, acute injury. SE: GI

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Naproxen - NSAID

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Mechanism: inhibits COX I and II. Uses: RhA, OA, gout

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Piroxicam - NSAID

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Mechanism: non selective COX inhibitor. Uses: RhA, OA, anti gout, etc. SE: GI toxicity, tinnitus, dizziness

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Sulindac - NSAID

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Mechanism: prodrug, possible COX I & II inhibitors (exact mechanism unknown). Uses: acute or chronic inflammatory conditions, anti gout.

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Celecoxib - NSAID

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Mechanism: selective COX II inhibitor. Uses: arthritis (less gastric disturbance than other NSAIDs). SE: dyspepsia, stroke

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Meloxicam - NSAID

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Mechanism: selective COX II inhibitor. Uses: arthritis (less gastric disturbance than other NSAIDs). SE: dyspepsia, stroke

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Acetaminophen - NSAID

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Mechanism: inhibits PG synthesis (NOT an anti-inflammatory). Uses: HA, dysmenorrhea, myalgias, neuralgias, fever, discomfort from cold. SE: skin eruption, hypotension, hepatotoxicity

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Acetylcysteine - NSAID

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Uses: expectorant/mucolytic

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Morphine - natural opioid

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Mechanism: agonist to Mu receptor - works on dorsal horn of the SC/brainstem (respiratory); higher CNS (pain). Uses: moderate to severe pain, cough suppressant. SE: constipation, sedation

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Codeine - natural opioid

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Mechanism: agonist to Mu receptor. Uses: induces sleep in the presence of mild pain; analgesic; sedative; hypnotic; antiperistaltic; antitussive. SE: constipation, miosis, respiratory depression, do not use when breastfeeding

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Heroin - semi synthetic opioid

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Mechanism: agonist to Mu receptor.

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Hydrocodone - semi synthetic opioid

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Mechanism: agonist to Mu receptor. Uses: antitussive, analgesic. SE: constipation, sedation, euphoria

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Oxycodone - semi synthetic opioid

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Mechanism: agonist to Mu receptor. Uses: lowers perception and emotional response to pain. SE: euphoria, sedation, constipation

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Fentanyl - synthetic opioid

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Mechanism: opioid agonist-antagonist. Uses: analgesic, sedative, used with diazepam for anesthesia (neuroleptalanalgesia). SE: euphoria, delerium

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Meperidine - synthetic opioid

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Mechanism: opioid agonist-antagonist. Uses: analgesic, sedative. SE: dizziness, sedation

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Methadone - synthetic opioid

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Mechanism: opioid agonist-antagonist. Uses: detoxification of opioid addiction.

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Pentazoncine - synthetic opioid

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Mechanism: partial opioid agonist. Uses: for moderate to severe pain, preoperative analgesia. SE: constipation, altered taste, vision blurring

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Butorphanol - synthetic opioid

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Mechanism: opioid agonist-antagonist.

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Naloxone - opioid antagonist

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Mechanism: antagonizes Mu receptor. Uses: narcotics overdose, asphyxia neonatorium (respiratory distress in newborns). SE: tremors, hyperventilation, sweating, tachycardia

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Naltrexone - opioid antagonist

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Mechanism: antagonizes Mu receptor. Uses: adjunct for opioid-free state. SE: anorexia, hepatotoxicity

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Vicodin - combination

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hydrocodone + acetaminophen

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Percocet - combination

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oxycodone + acetaminophen

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Percodan - combination

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oxycodone + aspirin

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Empirin - combination

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aspirin + codeine

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Tylenol 3 - combination

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tylenol + codeine