EAMC 5E: Mrs. Harriet P.

. Valeros GENERIC NAME Metoprolol tartrate BRAND NAME Neobloc CLASSIFICATION/ACTION Beta1-selective adrenergic blocker Antihypertensive Completely blocks beta-adrenergic receptors in the heart and juxtaglomerular apparatus, decreasing the influence of the sympathetic nervous system on these tissues and the excitability of the heart, decreasing cardiac output and the release of rennin, and lowering BO: acts in the CNS to reduce sympathetic output and vasoconstrictor tone Calcuim channel-blocker Antianginal Antihypertensive Inhibits the movement of calciumions across the membranes of cardiac and arterial muscle cells; inhibition of transmembrane calcium flow results in the depression of impulse formation in specialized cardiac pacemaker cells; in slowing of the velocity of conduction of the cardiac impulse, in the depression of myocardial contractility, and in the dilation of coronary arteries and arterioles and peripheral arterioles; these effects lead to decreased cardiac work, decreased cardiac energy consumption, and increased delivery of oxygen to myocardial cells. Cardiovascular system drug/Anticoagulant Antiplatelet Fibrinolytics (Thrombolytics) Coronary vasodilator and platelet aggregation inhibitor Gabapentin Neurotin Antiepileptic Mechanism of action not understood; antiepileptic activity may be related to its ability to inhibit polysynaptic responses and block posttetanic potentation INDICATION Hypertension, alone or with other drugs, especially diuretics Immediate-release tablets and injection: prevention of reinfarction in MI patients who are hemodynamically stable or within 3-10 days of the acute MI Treatment of angina pectoris Toprol-XL only: treatment of stable symptomatic CHF of ischemic, hypertensive, or cardiomyopathic origin Angina pectoris due to coronary artery spasm (Prinzmetals variant angina) Chronic stable angina (effort-associated angina) SR preparation only: treatment of hypertension Orphan drug use: treatment of intestinal cystitis

Nifedipine

Adalat, Adalat CC, Adalat XL, Apo-Nifed, Nifedical XL, novoNifedin, Procardia, Procardia XL, Calcheck, Calcibloc, Calcibloc OD, Calcigard, Cardicap, Darat, Heblopin, Nelapine, Nifestad, Normadil, Odipin, Tensibloc Aggrenox

Dipyridamole 200mg, Aspirin 25mg

Secondary stroke prevention

With warfarin to prevent thromboembolism in patients with prosthetic heart valves Adjunctive therapy in the treatment of partial seizures with and without secondary generalization in adults and children 3-12 yr with epilepsy Orphan drug use: treatment of amyotrophic lateral sclerosis Management of postherpetic neuralgia or pain in the area affected by herpes zoster after the disease has been treated

Clopidogrel

Plavix

Adenosine Diphosphate (ADP) receptor antagonist Antiplatelet Inhibits platelet aggregation by blocking ADP receptors on platelets, preventing clumping of platelets Central nervous system drug/CNS stimulant Agents for ADHD Takes part in the biosynthesis of phospholipids which integrates into the structures of the nervous system, especially in the membranes of neurons. The formation of phospholipids is needed by the restructuring of the cell membrane by the damaged neurons. ACE inhibitor Antihypertensive Blocks ACE from converting Angiotensin I to angiotensin II, a powerful vasoconstrictor, leading to decreased BP, decreased aldosterone secretion, a small increase in serum potassium levels, and sodium and fluid loss; increased prostaglandin synthesis also may be involved in the antihypertensive action

Unlabeled uses: tremors of MS, neuropathic pain, bipolar disorder, migraine prophylaxis Treatment of patients at risk for ischemic events recent MI, recent ischemic stroke, peripheral artery disease Treatment of patients with acute coronary syndrome CVD in acute and recovery phase, symptoms and signs of derebral insufficiency eg. Dizziness, memory loss, poor concentration, disorientation, recent cranial trauma.

Citicholine

Somazine

Captopril

Capoten,

Tranexomic acid Acetylcysteine

Hemostan Fluimucil,

Cardiovascular Drug/hemostatics Arresting the flow of blood in the vessels Mucolytic Antidote Mucolytic Activity: Splits links in the mucoproteins contained in respiratory mucous secretions, decreasing the viscosity of the mucous Antidote to acetaminophen hepatotoxicity: protects liver cells by maintaining cell function and detoxifying acetaminophen metabolites.

Treatment of hypertension alone or in combination with thiazide-type diuretics Treatment of CHF in patients unresponsive to conventional therapy; used with diuretics and digitalis Treatment of diabetic neuropathy Treatment of left ventricular dysfunction after MI Unlabeled uses: management of hypertensive crises; treatment of rheumatoid arthritis; hypertension related to scleroderma renal crisis; diagnosis of primary aldosteronism, idiopathic edema; Bartters syndrome; Raynauds syndrome Antihemorrhagic and antifibrinolytic for effective hemostatis in various surgical and clinical cases, in traumatic injuries, post-tooth extraction and other dental procedures Mucolytic adjuvant theraphy for abnormal, viscid, or inspissated mucous secretions in acute and chronic bronchopulmonary disease (emphysema with bronchitis, asthmatic bronchitis, tuberculosis, pneumonia), in pulmonary complications of cystic fibrosis, and in tracheostomy care; pulmonary complications associated with surgery, anesthesia, posttraumatic chest conditions; diagnostic bronchial studies (oral solution only) To prevent or lessen hepatic injury that may occur after ingestion of a potentially hepatotoxic dose of acetaminophen; treatment must start as soon as possible,

Ethambutol HCl 275 mg, Rifampicin 150 mg, INH 75 mg, Pyrazinamide 400 mg Ciprofloxacin

Myrin P Forte

Chemotherapeutic/antituberculous drug Effective against actively growing microorganisms of the genus Mycobacterium including M. tuberculosis Antibacterial Fluoroquinolone Bactericidal; interferes with DNA replication in susceptible bacteria preventing cell reproduction

at least within 24 hours of ingestion; IV use approved for this indication Unlabeled uses: As ophthalmic solution to treat keratoconjuctivitis sicca (dry eye); as an enema to treat bowel obstruction due to meconium ileus or its equivalent; prevention of radiocontrast-induced nephrotoxicity Intial phase treatment and re-treatment of all forms of TBin category I and II patients caused by susceptible strains of mycobacteria For the treatment of infections caused by susceptible gramnegative bacteria Treatment o uncomplicated UTIs caused by E.coli, K. pneumoniae as a one0time dose in patients at low risk of nausea, diarrhea Otic: treatment of acute otitis externa Treatment of chronic bacterial prostatis IV: treatment of nosocomial pneumonia Oral: typhoid fever Oral: STDs caused by N. gonorrheae Prevention of anthrax following exposure to anthrax bacilla (prophylactic use in regions suspected of using germ warfare) Acute sinusitis LRTIs Unlabeled Use: effective in patients with cystic fibrosis who have pulmonary exacerbations Systematic administration: serious infections caused by susceptible strains of anaerobes, streptococci, staphtlococci, pneumococci; reserve use for penicillinallergic patients or when penicillin is inappropriate; less toxic antibiotics (erythromycin) should be considered Parenteral: treatment of septicemia caused by staphylococci, streptococci; acute hematogenous osteomyelitis; adjunct to surgical treatment of chronic bone and joint infections due to susceptible organisms; to not use to treat meningitis; does not cross the BBB Topical dermatologic solution: treatment of acne vulgaris Vaginal preparation: treatment of bacterial vaginosis Prevention and correction of potassium deficiency; when

Baxolyn, Brelcip, Ciclodin, Cidroxal, Cloxan, Ciprobay, Ciproglen, Cipromax, Cipromet, Ciprotor, Cirok, Danlex Ciprofloxacin, Floroc, Holdestin, Hyprocel, Iprolan, Ipromax, Kinoves, Laitun, Nexproxyn, Pharex ciprofloxacin, Proxazin, Proxivex, Quilox, Quinoryl, Quiprime, Rapiqure, Xipro, Zalvos, Zyflox Anerocin, Clindal, Clindatech, Cliz, Dalacin C, InprosynHP, Lincyn, Myclin, Tidact, Zindal 300

Clindamycin

Lincosamide antibiotic Inhibits protein synthesis in susceptible bacteria by binding to the 50S subunit of the ribosome, causing cell death

Potassium chloride

Kalium Durule

Electrolyte

(9.8 mEq) 0.75g Principal intracellular cation of most body tissues, participates in a number of physiologic processes maintaining intracellular tonicity, transmission of nerve impulses, contraction of cardiac, skeletal, and smooth muscle, maintenance of normal renal function; also plays a role in carbohydrate metabolism and various enzymatic reactions Hormonal Drug/Coritcosteroid Decreases inflammation, mainly by stabilizing leukocyte lysosomal membranes; suppresses immune response; stimulates bone marrow and influences protein, fat, and carbohydrate metabolism Corticosteroid (immediate acting) Glucocorticoid Hormone Enters target cells and binds to intracellular corticosteroid receptors, initiating many complex reactions that are responsible for its anti-inflammatory and immunosuppressive effects

associated with alkalosis, use potassium chloride; when associated with acidosis, use potassium acetate, bicarbonate, citrate, or gluconate IV: treatment of cardiac arrythmias due to cardiac glycosides Severe inflammation, immunosuppression, acute exacerbations of multiple sclerosis

Tramadol HCl 37.5mg, Paracetamol 325 mg

Dolcet

Prednisone

Bloster, Oracort, Orasone 20, Orasone 5, Pred 1/5/10/20/30/50, Prednisone Organon, Prolix, Qualisone

Allopurinol

Allomaron, Allurase, Alpurase, Elavil, Llanol, Lopric, Loricid, Purinase, Purispec, Puristen, Synol, Trianol, Xanurace, Zyloprim

Antigout Drug Inhibits the enzyme responsible for the conversion of purines to uric acid, thus reducing the production of uric acid with a decrease in serum and sometimes in urinary uric acid levels, relieving the signs and symptoms of gout

5 FU

Biomedis fluorouracil, Fivoflu, Fluracedyl, Fluroblastin, Uflahex, Utoral

Antineoplastic/Antimetabolite May inhibit DNA and RNA synthesis

Replacement therapy in adrenal cortical in sufficiency Hypercalcemia associated with cancer Short term management of various inflammatory and allergic disorders, such as rheumatoid arthritis, collagen diseases, dermatologic diseases, status asthmaticus, and autoimmune disorders Hematologic disorders: Thrombocytopenia purpura, erythrobastopenis Ulcerative colitis, acute exacerbations of MS and palliations in some leukemias and lymphomas Trichinosis with neurologic or myocardial involvement Management of the signs and symptoms of primary and secondary gout Management of patients with malignancies that result in elevations of serum and urinary uric acid Management of patients with recurrent calcium oxalate calculi whose daily uric acid excretion exceeds 800mg/day (males) or 750mg/day (females) Orphan drug use: treatment of Chagas disease; cutaneous and visceral leismaniasis Unlabeled uses: ameliorationof granulocyte suppression with fluorouracil; as a mouth wash to prevent fluorouracilinduces stomatitis Colon, rectal, breast, stomach, and pancreatic cancers; palliative treatment of advanced colorectal cancer; early breast cancer; multiple actinic (solar) keratoses, superficial basal cell carcinoma

Sucralfate

Iselpin

Antiulcer drug/Pepsin Inhibitor Forms an ulcer-adherent complex at duodenal ulcer sites, protecting the ulcer against acid, pepsin, and bile salts, thereby promoting ulcer healing; also inhibits pepsin activity in gastric juices

Ranitidine HCl

Zantac, Zantac EFFERdose, Zantac GELdose, Zantac 75, Zantac 150

Histamine2 Antagonist Completely inhibits the action of histamine at the H2 receptors of the parietal cells of the stomach, inhibiting basal gastric acid secretion and gastric acid secretion that is stimulated by food, insulin, histamine, cholinergic antagonists, gastrin, and pentagastrin GIT Drug/Antacid Antiulcer Promotes healing of gastric ulcers and suppress recurrence/relapse of ulcers; increases mucous; promotes alkaline secretions in the stomach Antisecretory drug Proton pump inhibitor Gastric acid-pump inhibitor: suppresses gastric acid secretion by specific inhibition of the hydrogen-potassium ATPase enzyme system at the secretory surface of the gastric parietal cells; blocks the final step of acid production

Rebamipide

Mucosta

Short term treatment of duodenal ulcers, up 8 wk Maintenance therapy for duodenal ulcers at reduced dosage after healing Orphan drug use: treatment of oral and esophageal ulcers due to radiation, chemotherapy, and sclerotherapy Unlabeled uses: accelerates healing of gastric ulcers, longterm treatment of gastric ulcers, treatment of reflux and peptic esophagitis, treatment of NSAID or aspirin-induced GI symptoms and GI damage, prevention of stress ulcers in critically ill patients Short-term treatment of active duodenal ulcers Maintenance therapy for duodenal ulcers at reduced dosage Short-term treatment of active, benign gastric ulcer Short-term treatment of GERD Pathologic hypersecretory conditions Treatment of erosive esophagitis Treatment of heartburn, acid indigestion, sour stomach Acute gastritis and acute exacerbation of chronic gastritis Gastric ulcer

Omeprazole

Losec, Prilosec, Zegerid

Calcuim Carbonate

Esvical Forte, Exofat Forte, Mylanta Rolltabs

Electrolyte Antacid Essential element of the body; helps maintain the functional

Short-term treatment of active duodenal ulcers First-line therapy in the treatment of heartburn of symptoms of GERD Short-term treatment of active benign gastric ulcer GERD, severe erosive esophagitis, poorly responsive symptomatic GERD Long-term therapy: treatment of pathologic hypersecretory conditions Eradication of Helicobacter pylori with amoxicillin or metronidazole and clarithromycin Unlabeled use: posterior laryngitis; enhance efficacy of pancreatin for treatment of steatorrhea in cystic fibrosis Symptomatic relief of upset stomach associated with hyper acidity; hyperacidity associated with peptic ulcer, gastritis, peptic esophagitis, gastric hyperacidity, hiatal hernia Prophylaxis of GI bleeding, stress ulcers, and aspiration of

5-oxtanthranilic acid0.2 mg, Ca pantothenate 5 mg, folic acid 02 mg, Iisoleucine5.9 mg, Iacetyltryptophan 5 mg, I-leucine 18.3 mg, Ilysine HCl 25 mg, Imethionine 18.4 mg, Nicotinamide 20 mg, Iphenylalamine 5 mg, Ithreonine 4.2 mg, Ivaline 6.7 mg, Vit A 2000IU, Vit B1 5 mg, Vit B12 1mcg, Vit B2 3 mg, Vit B6 2.5mg, Vit C 20 mg, Vit D 200 IU,VIt E 1 mg Human Insulin (Isophane insulin suspension)

Morlamin Forte

integrity of the nervous and muscular systems; helps maintain cardiac function, blood coagulation; is an enzyme cofactor and affects the secretory activity of endocrine and exocrine glands; neutralizes or reduces gastric acidity (oral use) Multivitamins and Minerals

pneumonis; possibly useful Dietary supplement when calcium intake is inadequate Malnutrition, protein and vitamin deficiencies, anemia, convalescence, restoration and maintenance of body resistance; pregnancy and lactation, adjuvant in the therapy of peptic ulcer and tuberculosis

Humulin N, Novolin N, Novoline N PenFil

Antidiabetic Hormone Insulin is a hormone secreted by beta cells of the pancreas that, by receptor-mediated effects, promotes the storage of the bodys fuels, facilitating the transport of metabolites and ions (potassium) through cell membranes and stimulating the synthesis of glycogen from glucose, of fats from lipids, and proteins from amino acids Respiratory drug/antiasthmatic COPD preparations Bronchodilator, relaxes smooth muscle airways and pulmonary blood vessels by inhibiting phosphodiesterases, the enzyme that degrades cAMP Laxative Ammonia reduction drug

Treatment of type 1 (insulin-dependent) DM Treatment of type 2 (non-insulin dependent) DM that cannot be controlled by diet or oral drugs Highly purified and human insulins promoted for short courses of therapy (surgery, intercurrent disease), newly diagnosed patients, patients with poor metabolic control, and patients with gestational diabetes Bronchial asthma and pulmonary disease with spastic bronchial component

Doxofylline

Anslmar

Lactulose

Duphalac, Lilac

Treatment of constipation Prevention and treatment of portal-systemic encephalopathy

The drug passes unchanged into the colon where bacteria break it down to organic acids that increase the osmotic pressure in the colon and slightly acidify the colonic contents, resulting in an increase in a stool water content, stool softening, laxative action, this also results in migration of blood ammonia into the colon contents with subsequent trapping and expulsion in the feces