| Drug Name |
Category |
Comments |
| Allopurinol |
Anti- Inflammatory; Anti-Gout |
It inhibits Xanthine Oxidase. Can cause an attack
of acute gouty arthritis when first administered, caused by resorption
of uric acid from the tissues. Concurrent Colchicine can be given during
the first week of therapy to prevent this side-effect.
|
|
Drug Interactions: Increases blood levels of Mercaptopurines,
Cyclophosphamide.
| Colchicine |
Anti- Inflammatory; Anti- Gout |
Binds to tubulin to prevent polymerization of microtubules ------>
prevent granulocyte migration and phagocytosis of urate crystals
------> prevent foreign-body granulomatous inflammation in joints.
Adverse Effects: Alopecia, agranulocytosis, aplastic anemia. Myopathy,
nausea, and vomiting. |
| Sulfinpyrazone |
Anti- Inflammatory; Anti- Gout
Uricosuric
Platelet Inhibitor |
Promotes the excretion of uric acid in the proximal tubule. Do not
use when urinary uric acid levels are already high, as urate
calculi may result. Adverse Effects: Allergic dermatitis,
GI disturbances.
Platelet Inhibitor: Blocks the chemical mediators of platelet
aggregation. However, it also prolongs platelet survival, limiting its
use in this capacity. |
| Probenecid |
Anti- Inflammatory; Anti- Gout
Uricosuric Agent
Anti- Microbial; Anti- Bacterial
Adjunct |
Promotes the excretion of uric acid in the proximal tubule. Do not
use when urinary uric acid levels are already high, as urate
calculi may result. Adverse Effects: Allergic
dermatitis, GI disturbances.
Penicillin Adjunct: It blocks the urinary secretion
of penicillin, prolonging its half-life. |
| Hydroxy chloroquine |
Anti- Inflammatory; Anti- RA
Anti- Parasitic; Anti- Malarial |
Low dose, long-term treatment for RA refractory to treatment with
NSAID's. Contraindications: Porphyria, Psoriatic Arthritis. |
| Auranofin |
Anti- Inflammatory; Anti- RA
Gold Salts |
29% gold, PO. Mech: Macrophages uptake the drug ------> suppress
phagocytic and lysosomal activity. Gold accumulates in multiple tissues. |
| Aurothioglucose |
Anti- Inflammatory; Anti- RA
Gold Salts |
50% gold, IM. Mech: Macrophages uptake the drug ------> suppress
phagocytic and lysosomal activity. Gold accumulates in multiple tissues. |
| Aurothiomalate |
Anti- Inflammatory; Anti- RA
Gold Salts |
50% gold, IM. Mech: Macrophages uptake the drug ------> suppress
phagocytic and lysosomal activity. Gold accumulates in multiple tissues. |
| D- Penicillamine |
Anti- Inflammatory; Anti- RA
Toxicity
Metal Chelator |
Analog of cysteine. Retards progression of bone and articular
cartilege destruction. 3-4 month latency period required.
Serious adverse effects: Leukopenia, thrombocytopenia, aplastic
anemia. Cancels the effects of gold salts.
Chelator: It chelates copper,
mercury, zinc, lead. Indicated for Wilson's Disease.
Used as adjunct in lead, mercury, gold, arsenic poisoning. Indicated for
gold salt toxicity.
Cystinuria: Forms a soluble penicillamine-cysteine
complex, promoting the excretion of cysteine. |
| Acetominophen
(Tylenol) |
Anti- Inflammatory; Non- Opioid Analgesic |
Lacks anti- inflammatory properties of other NSAID's, but is a good
analgesic and anti -pyretic. Blocks prostagl andins only in the CNS.
Alcohol and starvation can lead to
fatal hepatotoxicity. |
| Phenacetin |
Anti- Inflammatory; Non- Opioid Analgesic |
Pro-drug that is rapidly converted to Acetominophen by
Cyt-P450. Because of severe nephrotoxicity, phenacetin
is not available in the United States. Also, metabolite,
phenetidine causes methemoglobinemia. |
| Bufferin |
Anti- nflammatory; NSAID |
Contains aspirin in enteric-coated granules, which
are intended to prevent absorption of aspirin in the stomach, and
protect the stomach mucosa from aspirin. |
| Diclofenac |
Anti- Inflammatory; NSAID |
Hepatotoxic, due to reactive
carboxy-glucuronidate metabolites. Displaces warfarin from
plasma proteins, and should not be used with warfarin. |
| Diflunisal |
Anti- Inflammatory; NSAID |
|
| Meclofenamate |
Anti- Inflammatory; NSAID |
|
| Sulindac |
Anti- Inflammatory; NSAID |
Pro-Drug must first be metabolized before it inhibits COX. |
| Tolmetin |
Anti- Inflammatory; NSAID |
Does not displace drugs from plasma binding proteins as much as
others. Preferred drug for use with Warfarin. |
| Indomethacin |
Anti- Inflammatory; NSAID
Anti-Gout |
Stronger and more toxic than other NSAID's.Indications:
Osteoarthritis of the hip, acute gouty arthritis,
ankylosing sponylitis, patent ductus arteriosus. |
| Phenylbutazone |
Anti- Inflammatory; NSAID
Anti-Gout |
Potent anti- inflammatory, but weak analgesic and
anti-pyretic. Indications: Acute gouty arthritis,
RA that is refractory to treatment with other NSAID's.
Adverse Effects: GI distress, peptic ulcer; can be worse than
aspirin. Also soar throat, agranulocytosis. |
| Nabumetone
(Relafen) |
Anti- Inflammatory; NSAID
Long- acting |
Can be given only once a day to treat RA. |
| Oxaprozin
(Daypro) |
Anti- Inflammatory; NSAID
Long- acting |
Can be given only once a day to treat RA. |
| Piroxicam |
Anti- Inflammatory; NSAID
Long- acting |
Can be given only once a day to treat RA. Causes GI disturbances in
20% of patients. |
| Acetylsalicylic Acid
(Aspirin) |
Anti- Inflammatory; NSAID
Platelet Inhibitor |
Irreversibly inhibits COX. Can cause GI
disturbances, unlike other NSAID's.
Has anti- platelet activity at low doses via its inhibition of
TXA2. Has anti- inflammatory properties at high doses
via its inhibition of PGE1. |
| Fenoprofen |
Anti- Inflammatory; NSAID
Propionic Acid Derivative |
Short- acting. Must be given 4 times a day for RA. |
| Ibuprofen
(Motrin) |
Anti- Inflammatory; NSAID
Propionic Acid Derivative |
Short- acting. Must be given 4 times a day for RA. Does not displace
drugs from plasma binding proteins as much as others. Preferred drug for
use with Warfarin. |
| Ketoprofen
(Orudis) |
Anti- Inflammatory; NSAID
Propionic Acid Derivative |
Short- acting. Must be given 4 times a day for RA. Unique in that it
inhibits both cyclooxygenase and lipoxygenase. Does not
displace drugs from plasma binding proteins as much as others. Preferred
drug for use with Warfarin. |
| Naproxen |
Anti- Inflammatory; NSAID
Propionic Acid Derivative |
Longer acting than the other propionic-acid derivatives. Half-life
of about 13 hours. Can be given twice a day for RA. |
| Cilastatin |
Anti- Microbial; Anti-Bacterial
Adjunct |
Dihydropeptidase Inhibitor in the kidney. It is
coadministered with the carbapenems (imipenem), in
order to prevent its destruction in the kidney. |
| Clavulanic Acid |
Anti- Microbial; Anti- Bacterial
Adjunct |
beta- Lactamase Inhibitor can be used as an adjunct,
only with penicillins that are not already beta-Lactamase resistant.
It is counterproductive to use Clavulanic Acid with
beta-Lactamase-Resistant penicillins: Naficillin, Oxacillin,
Cloxacillin, Methicillin. |
| Folinic Acid |
Anti- Microbial; Anti- Bacterial
Adjunct |
Given with Trimethoprim, it is the reduced form of
THF. It prevents the anti- folate side- effects of trimethoprim:
Megaloblastic anemia, granulocytopenia, leukopenia. |
| Pyridoxine (Vit. B6) |
Anti- Microbial; Anti- Bacterial
Adjunct |
Given with Isoniazid, it prevents the peripheral
neuritis side-effect that can be seen with this drug. The peripheral
neuritis results from an anti-pyridoxine effect. |
| Sulbactam |
Anti- Microbial; Anti- Bacterial
Adjunct |
beta- Lactamase Inhibitor, similar to Clavulinic
Acid. |
| Dapsone |
Anti- Microbial; Anti- Bacterial
Anti- Mycobac terial |
Indicated for treating Leprosy. Resistance is on
the rise.
Adverse Effects: Hemolytic anemia in people with G6PD deficiency,
Erythema Nodosum, Methemoglobinemia. |
| Ethambutol |
Anti- Microbial; Anti- Bacterial
Anti- Mycobacterial; 1st-line |
First line drug. Mech: probably inhibits polyamine synthesis.
Gets into CNS.
Adverse effect: Optic Neuritis with loss of visual
acuity. |
| Isoniazid |
Anti- Microbial; Anti- Bacterial
Anti- Mycobacterial; 1st-line |
First line drug, and used for chemoprophylaxis. Mech: it blocks
mycolic acid synthesis. Gets into CNS.
Adverse Effects: Hepatotoxicity in elderly,
peripheral neuritis in slow acetylators. Optic neuritis,
teratogenic. |
| Pyrazinamide |
Anti- Microbial; Anti- Bacterial
Anti- Mycobacterial; 1st-line |
First-line drug. Adverse Effects: Hepatotoxicity, Hyperuricemia. |
| Rifampin |
Anti- Microbial; Anti- Bacterial
Anti- Mycobacterial; 1st-line |
First line drug. Mech: It inhibits RNA synthesis by binding to the
beta-subunit of bacterial RNA-Polymerase. Gets into
CNS. Adverse Effects: Hepatotoxicity. |
| Capreomycin |
Anti- Microbial; Anti -Bacterial
Anti- Mycobacterial; 2nd-line |
|
| Ethionamide |
Anti- Microbial; Anti- Bacterial
Anti- Mycobacterial; 2nd-line |
Second- line drug. Mech: Analog of Isioniazid that also inhibits
mycolic acid synthesis.
Adverse Effects: Intense gastric pain, may be
neurotoxic. |
| Para aminosalicylic acid (PAS) |
Anti- Microbial; Anti- Bacterial
Anti-Mycobacterial; 2nd-line |
Second- line drug. PO. Mech: It blocks dihydropteroate
synthesis in mycobacteria but not in other bacteria. This is
same mode of action as the sulfonamides, but on different bugs.
Adverse Effects: Severe GI disturbances and pain;
hypersensitivity. Impaired liver function. |
| Cycloserine |
Anti- Microbial; Anti- Bacterial
Anti- Mycobacterial; 2nd-line
ICWS |
Second- line anti- mycobacterial drug. Mech: It inhibits
alanine racemase.
Adverse Effects: CNS Toxicity, drug- induced psychosis
greatly limit its use. |
| Ciprofloxacin |
Anti- Microbial; Anti- Bacterial
DNA Gyrase Inhibitor |
Fluoro quinolone. PO or IV. |
| Nalid ixic Acid |
Anti- Microbial; Anti- Bacterial
DNA Gyrase Inhibitor |
Quinolone that blocks Topoiso merase II. Effec tive
against gram-negatives. |
| Norfloxacin |
Anti-Microbial; Anti-Bacterial
DNA Gyrase Inhibitor |
Fluoro quinolone. PO. |
| Ofloxacin |
Anti- Microbial; Anti- Bacterial
DNA Gyrase Inhibitor |
Fluoro quinolone. |
| Imipenam |
Anti- Microbial; Anti- Bacterial
ICWS; Carbopenem |
Broad- spectrum antibiotic. Pseudomonas
can develop resistance, so give this drug with an aminoglycoside.
Must be coadministered with cilistatin, to prevent
its degradation (by dihydropeptidase) in the kidney. |
| Meropenem |
Anti- Microbial; Anti- Bacterial
ICWS; Carbopenem |
|
| Primaxin
(Imipenam + Cilistatin) |
Anti- Microbial; Anti- Bacterial
ICWS; Carbopenem |
Combination of imipenam and cilistatin is called
primaxin. |
| Cefadroxil |
Anti- Microbial; Anti- Bacterial
ICWS; Cephalosporin
1st generation |
PO administration. |
| Cefazolin |
Anti- Microbial; Anti- Bacterial
ICWS; Cephalosporin
1st generation |
IV. Excreted mainly by glomerular filtration (rather
than active tubular secretion), thus it has a longer half-life. |
| Cephalexin |
Anti- Microbial; Anti- Bacterial
ICWS; Cephalosporin
1st generation |
PO administration. |
| Cephalothin |
Anti- Microbial; Anti- Bacterial
ICWS; Cephalosporin
1st generation |
IV. Short- half life, due to active
(probenecid-sensitive) tubular secretion. |
| Cefaclor |
Anti- Microbial; Anti- Bacterial
ICWS; Cephalosporin
2nd generation |
PO administration. |
