MANUAL OF DRUG CLASSIFICATION A Quick Guide to Drug Classes and Mechanism of Action

Compiled and

Prepared by:

Xavier Ukpong

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Table of Contents

Allergy Agents - - - - - - - - Page 2

Anti-Microbial Agents - - - - - - - - 3

Anti-biotics - - - - - - - - - - 3

Anti-Fungals - - - - - - - - - - 8

Anti-Mycobacterials - - - - - - - - - 10

Anti-Protozoals - - - - - - - - - 10

Anti-Virals - - - - - - - - - - 11

Anti-Retrovirals - - - - - - - - - 12

Anti-neoplastic Agents (Anti-cancer) - - - - - - 12

Cardiovascular (CVS) Agents - - - - - - - 17

Haematologic Agents - - - - - - - - - 25

Central Nervous System (CNS) Agents - - - - - - 26

Dermatologic Agents - - - - - - - - - 31

Dietary Supplements - - - - - - - - - 33

Ear (Otic) Agents - - - - - - - - - 33

Endocrine System Agents - - - - - - - - 34

Obesity Agents - - - - - - - - - 36

Eye (Ophthalmic) Agents - - - - - - - 36

Gastrointestinal Agents - - - - - - - - 38

Immune System Agents - - - - - - - - 42

Musculoskeletal System Agents - - - - - - 43

OB/GYN Agents - - - - - - - - - 45

Pain Medications - - - - - - - - - 46

Respiratory Agents - - - - - - - - - 49

Urinary/Genitourinary Agents - - - - - - - 53

Wound Care - - - - - - - - - - 54

HIV/AIDS Drugs - - - - - - - - - 55

Natural and Herbal Agents - - - - - - - - 57

References - - - - - - - - - - 58

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CLASSIFICATION (Generic and common brand names)

ALLERGY

Class: Anti-histamines (H1 Blockers)

M.O.A: Antagonism of histamine H1- receptors. In the periphery,

their action can inhibit allergic reactions where histamine is the main

mediator involved. The old-style antihistamines (e.g chlorphenamine

and promethazine) are able to cross the blood–brain barrier where both

specific and non-specific actions in the CNS produce sedation and

antiemetic effects. Alcaftadine (Lastakaft)

Azelastine (Astelin, Optivar)

Bepostatine (Bepreve)

Budesonide (Rhinocort, Pulmicort)

Brompheniramine (LO-Hist, Vazol)

Cetirizine (Zyrtec, Zyrtec D)

Chlorpheniramine (Chlor-Trimeton, Piriton)

Clemastine Fumarate (Tavist)

Cromolyn Sodium (Intal, NasalCrom, Opticrom)

Cyclizine (Marezine)

Cyproheptadine (Periactin)

Desloratadine (Clarinex)

Diphenhydramine (Benadryl)

Dimenhydrinate (Dramamine)

Doxylamine (Unisom Sleeptabs)

Emedastine (Emadine)

Fexofenadine (Allegra)

Hydroxyzine (Atarax, Vistaril)

Ketotifen (Alaway, Zaditor)

Levocetirizine (Xyzal)

Loratadine (Claritin, Alavert)

Meclizine (Bonnie, Antivert)

Montelukast (Singulair)

Olopatadine (Patanase, Patanol)

Promethazine (Phenergan)

Effects at histamine receptors

H1 - Responsible for most of the actions of histamine in a type I

hypersensitivity reaction:

- Capillary and venous dilatation (producing ‘flare’ or systemic

hypotension)

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- Increased vascular permeability (producing ‘wheal’ or oedema)

- Contraction of smooth muscle (producing bronchial and gastrointestinal

contraction)

H2 - Regulation of gastric acid secretion:

- H2-receptors respond to histamine secreted from the enterochromaffin-

like cells that are adjacent to the parietal cell

H3 - Involved in neurotransmission:

- Exact physiological role not clear (presynaptic inhibition of

neurotransmitter release in the CNS and autonomic nervous system, Role

in itch and pain perception)

Class: Antidotes Acetylcysteine (Acetadote, Mucomyst)

Activated Charcoal (SuperChar, Actidose, Liqui-Char)

Amifostine (Ethyol)

Atropine (AtroPen)

Deferasirox (Exjade)

Dexrazoxane (Zinecard)

Digoxin Immune Fab (Digibind, DigiFab)

Flumazenil (Romazicon)

Hydroxocobalamin (Cyanokit)

Ipecacuanha Syrup, an over-the counter (OTC) syrup

Mesna (Mesnex)

Naloxone (Narcan, Nalone, Narcanti)

Physostigmine (Antilirium)

Succimer (Chemet)

ANTIMICROBIAL AGENTS

Antibiotics

Sub-Class I: Aminoglycosides

M.O.A: Aminoglycosides are bactericidal. They bind irreversibly to the 30S

portion of the bacterial ribosome. This inhibits the translation of mRNA to protein

and causes more frequent misreading of the prokaryotic genetic code.

Aminoglycosides have a broad spectrum of activity but with low activity against

anaerobes, streptococci and pneumococci.

Amikacin (Amikin)

Gentamicin (Genticyn, Garamycin,G-Mycitin)

Kanamycin (Kanacyn)

Neomycin (Cicatrin)

Paromomycin

Streptomycin

Tobramycin (Nebcin)

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Sub-Class II: Carbapenems

M.O.A: Carbapenems are members of the beta lactam class of antibiotics,

which kill bacteria by binding to penicillin-binding proteins, thus inhibiting

bacterial cell wall synthesis. However, these agents individually exhibit a broader

spectrum of activity compared to most cephalosporins and penicillins.

Furthermore, carbapenems are typically unaffected by emerging antibiotic

resistance, even to other beta-lactams.

Doripenem (Doribax)

Ertapenem (Invanz)

Imipenem-Cilastatin (Primaxin)

Meropenem (Merrem)

Sub-Class III: Cephalosporins

M.O.A: Cephalosporins are bactericidal. They are b-lactam-containing

antibiotics and inhibit bacterial cell wall synthesis in a manner similar to the

penicillins. Structurally cephalosporins possess a dihydrothiazine ring connected

to the b-lactam ring that makes them more resistant to hydrolysis by b-lactamases

than are the penicillins. The cephalosporins are broadspectrum antibiotics that are

second-choice agents for many infections.

Cephalosporins, First Generation Cefadroxil (Duricef, Ultracef)

Cefazolin (Ancef, Kefzol)

Cephalexin (Keflex)

Cephalothin

Cephapirin

Cephradine (Velosef)

Cephalosporins, Second Generation Cefaclor (Ceclor)

Cefonicid (Monocid)

Cefotetan (Cefotan)

Cefoxitin (Mefoxin)

Cefproxil (Cefzil)

Cefprodoxime

Cefuroxime (Ceftin[oral], Zinacef[parenteral])

Loracarbef (Lorabid)

Cephalosporins, Third Generation Cefdinir (Omnicef)

Cefditoren (Spectracef)

Cefixime (Suprax)

Cefoperazone (Cefobid)

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Cefotaxime (Claforan)

Cefpodoxime (Vantin)

Ceftazidime (Fortaz, Tazicef)

Ceftibuten (Cedax)

Ceftizoxime (Cefizox)

Ceftriaxone (Rocephin)

Moxolactum

Cephalosporins, Fourth Generation Cefepime (Maxipime)

Sub-Class IV: Quinolones

M.O.A: Quinolones are bactericidal. They act by inhibiting prokaryotic DNA

gyrase. This enzyme packages DNA into supercoils and is essential for DNA

replication and repair. They are more narrowly active against Gram-negative

organisms.

Cinxacin

Nalidixic Acid (Nalacid)

Sub-Class V: Fluoroquinolones

M.O.A: Fluroquinolones (fluorinated derivatives of quinolones) are

bactericidal. They act by blocking bacterial DNA synthesis by inhibiting bacterial

topoisomerase II (prokaryotic DNA gyrase) and topoisomerase IV. Inhibition of

DNA gyrase prevents the relaxation of positively supercoiled DNA that is

required for normal transcription and replication. Inhibition of topoisomerase IV

interferes with separation of replicated chromosomal DNA into the respective

daughter cells during cell division. They are broad spectrum in action.

Ciprofloxacin (Cipro)

Gemifloxacin (Factive)

Levofloxacin (Levaquin, Quixin Ophthalmic)

Lomefloxacin (Maxaquin)

Moxifloxacin (Avelox)

Nalidixic Acid

Norfloxacin Ophthalmic (Noroxin, Chibroxin)

Ofloxacin Ophthalmic (Floxin, Ocuflox)

Sub-Class VI: Sulphonamides

M.O.A: Folate is an essential co-factor in the synthesis of purines and hence

of DNA. Bacteria, unlike mammals, must synthesize their own folate from para-

aminobenzoic acid. This pathway can be inhibited at two points: the

sulphonamides inhibit dihydrofolate synthetase, and are bacteriostatic while

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trimethoprim inhibits dihydrofolate reductase and are bacteriostatic. The

sulphonamides are used for ‘simple’ urinary tract infections (UTIs).

Sulfamethizole (Proklar)

Sulfisoxazole (Pediazole)

Sulfadiazine (Antrima)

Sulfadoxine (Metafin)

Silver Sulfadiazine

Mefinide

Sulfacetamide

Sub-Class VII: Macrolides

M.O.A: Macrolides are bacteriostatic/bactericidal. They reversibly bind to the

50S subunit of the bacterial ribosome, preventing the translocation movement of

the ribosome along mRNA. It is effective against most Gram-positive bacteria

and spirochaetes.

Azithromycin (Zithromax)

Carbomycine

Clarithromycin (Biaxin)

Dirithromycin (Dynabac)

Erythromycin (E-Mycin, E.E.S., Ery-Tab)

Erythromycin & Sulfisoxazole (Eryzole, Pediazole)

Sub-Class VIII: Lincosamides

M.O.A: Similar to Macrolides. It is active against Gram-positive cocci,

including penicillin-resistant staphylococci, and many anaerobes.

Clindamycin (Cleocin, Cleocin-T)

Sub-Class IX: Ketolides

M.O.A: Ketolides are semisynthetic, 14-membered-ring macrolides, differing

from erythromycin by substitution of a 3-keto group for the neutral sugar l-

cladinose. Similar to Macrolides in action.

Telithromycin (Ketek)

Sub-Class X: Monobactams

M.O.A: The bactericidal action of aztreonam results from the inhibition of

bacterial cell wall synthesis due to a high affinity of aztreonam for penicillin

binding protein 3 (PBP3). By binding to PBP3, aztreonam inhibits the third and

last stage of bacterial cell wall synthesis. Cell lysis is then mediated by bacterial

cell wall autolytic enzymes such as autolysins. It is possible that aztreonam

interferes with an autolysin inhibitor. It’s spectrum of activity covers beta-

lactamases, gram positive and gram-negative bacterias. Aztreonam (Azactam)

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Sub-Class XI: Penicillins

M.O.A: Penicillins are bactericidal. Structurally they possess a thiazolidine

ring connected to a b-lactam ring. The side chain from the b-lactam ring

determines the unique pharmacological properties of the different penicillins.

Penicillins bind to penicillin-binding proteins on susceptible microorganisms.

This interaction results in inhibition of peptide cross-linking within the microbial

cell wall, and indirect activation of autolytic enzymes. The combined result is

lysis. They are broad spectrum antibiotics.

Amoxicillin (Amoxil, Polymox)

Amoxicillin & Clavulanic Acid (Augmentin)

Ampicillin (Amcill, Omnipen)

Ampicillin-Sulbactam (Unasyn)

Bacampicillin (Bacillocid)

Benzathin (Lapen)

Carbenicillin

Cloxacillin & Ampicillin (Ampiclox)

Dicloxacillin (Dynapen, Dycill)

Flucloxacillin (Flucol)

Methicillin

Nafcillin (Nallpen)

Oxacillin (Bactocill, Prostaphlin)

Penicillin G, Aqueous (Potassium or Sodium) - (Pfizerpen, Pentids)

Penicillin G Benzathine (Bicillin)

Penicillin G Procaine (Wycillin)

Penicillin V (Pen-Vee K, Veetids)

Piperacillin (Pipracil)

Piperacillin-Tazobactam (Zosyn)

Procaine Penicillin (Kanacillin)

Sulbactum

Tazobactam (Tazocin)

Ticarcillin (Ticar)

Ticarcillin/Potassium Clavulanate (Timentin)

Sub-Class XII: Tetracyclines

M.O.A: Tetracyclines are bacteriostatic. They work by selective uptake into

bacterial cells due to active bacterial transport systems not possessed by

mammalian cells. The tetracycline then binds reversibly to the 30S subunit of the

bacterial ribosome, interfering with the attachment of tRNA to the mRNA

ribosome complex. Tetracyclines have a broad spectrum activity against Gram-

positive and Gram-negative bacteria, as well as intracellular pathogens.

Democlocycline

Doxycycline (Adoxa, Periostat, Oracea, Vibramycin, Vibra-Tabs)

Methacycline

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Tetracycline (Achromycin V, Sumycin)

Tigecycline (Tygacil)

Sub-Class XIII: Glycopeptides

M.O.A: Inhibits cell-wall biosynthesis; blocks glycopeptide polymerization by

binding tightly to D-alanyl-D-alanine portion of cell wall precursor.

Vancomycin (Vancocin, Firvanq)

Dalbavancin (Dalvance)

Oritavancin (Orbactiv)

Telavancin (Vibativ)

Sub-Class XIV: Nitrobenzene Derivatives

(Chloramphenicol)

M.O.A: Chloramphenicol is both bactericidal and bacteriostatic, depending on

the bacterial species. It reversibly binds to the 50S subunit of the bacterial

ribosome, inhibiting the formation of peptide bonds. Chloramphenicol has a

broad spectrum of activity against many Gram-positive cocci and Gram-negative

organisms. Because of its toxicity, it is reserved for life-threatening infections,

especially typhoid fever and meningitis.

Chloramphenicol

Miscellaneous Antibiotic Agents

Fosfomycin (Monurol)

Linezolid (Zyvox)

Metronidazole (Flagyl, MetroGel)

Quinupristin-Dalfopristin (Synercid)

Rifaximin (Xifaxan)

Sulfamethoxazole & Trimethoprim [5:1 - Cotrimoxazole] - (Bactrim,

Septra)

Trimethoprim

Vancomycin (Vancocin, Vancoled)

Class: Antifungals

Sub-Class I: Polyene Macrolide

M.O.A: Forms pores in fungal membranes (which contain ergosterol) but not

in mammalian (cholesterol-containing) membranes, binding to sterols and

leading to alterations in cell permeability, allowing electrolytes (particularly

potassium) and small molecules to leak from the cell, resulting in cell death.

Amphotericin B (Fungizone)

Amphotericin B Cholesteryl (Amphotec)

Amphotericin B Lipid Complex (Abelcet)

Amphotericin B Liposomal (AmBisome)

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Sub-Class II: Pyrimidine Analog

M.O.A: Interferes with DNA and RNA synthesis selectively in fungi

Flucytosine (Ancobon)

Sub-Class III: Azoles (Imidazoles & Triazoles)

M.O.A: Blocks fungal C-14 α-demethylase (a cytochrome P450 [CYP450]

enzyme) enzyme and thereby blocking the demethylation of lanosterol to

ergosterol, the principal sterol of fungal membranes. The inhibition of

ergosterol biosynthesis disrupts membrane structure and function, which, in

turn, inhibits fungal cell formation and growth.

Butoconazole (Gynazole)

Clotrimazole (Lotrimin, Mycelex)

Clotrimazole & Betamethasone (Lotrisone)

Econazole (Spectazole)

Fluconazole (Diflucan)

Isavuconazole (Cresemba)

Itraconazole (Sporanox)

Ketoconazole (Nizoral)

Miconazole (Monistat)

Oxiconazole (Oxistat)

Posaconazole (Noxafil)

Sertaconazole (Ertaczo)

Terconazole (Terazol)

Tioconazole (Vagistat-1)

Voriconazole (VFEND)

Sub-Class IV: Echinocandins

M.O.A: Blocks 1,2,3 β-D-glucan synthase, an essential component of fungal

cell walls, leading to fungal cell wall death.

Anidulafungin (Eraxis)

Caspofungin (Cancidas)

Micafungin (Mycamine)

Sub-Class V: Allylamine

M.O.A: Inhibits epoxidation of squalence in fungi, thereby reducing cell

membrane ergosterol synthesis, causing inhibition of fungal cell wall synthesis

and subsequently fungal cell death. Increased levels are toxic to fungi

Butenafine (Lotrimin Ultra)

Naftifine (Naftin)

Nystatin (Mycostatin)

Terbinafine (Lamisil)

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Others Antifungals Cicloprox (Penlac)

Griseofulvin (Grifulvin V)

Tolnaftate (Tinactin)

Triamcinolone & Nystatin (Mycolog-II)

Class: Antimycobacterials

M.O.A: Drugs used in treatment of Tuberculosis

Aminisalicyclic acid (Paser)

Bedaquiline (Sirturo)

Dapsone

Ethambutol (Myambutol)

Ethionamide (Trecator)

Isoniazid (INH)

Pyrazinamide Rifabutin (Mycobutin)

Rifampin (Rifadin)

Rifapentine (Priftin)

Streptomycin

Class: Antiprotozoals Amphotericin-B (Ampicil)

Artemether/lumefantrine (Coartem)

Atovaquone-proguanil (Malarone)

Benznidazole (Radanil)

Chloroquine (Aralen)

Dehydroemetine

Diloxamide (Diloxazole)

Eflornithine

Emetine

Fluconazole (Derecon, Flugal)

Flucyptocine

Griseofulvin (Grifulvin V, Gris-PEG)

Iodoquinol (Yodoxin)

Itraconazole

Ketoconazole

Melarsoprol

Metronidazole (Flagyl)

Miltefosine (Impavido)

Natamycin

Nifurtimox

Nitazoxanide (Alinia)

Nystatin (Ninstat)

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Paromomycin (Humatin)

Pentamidine (Nebupent)

Primaquine

Pyrimethamine (Daraprim)

Quinine/Qunindine (Qualaquin, Quinidine Gluconate)

Sodium Stibogluconate

Suramin (Germanin)

Tinidazole (Tindamax)

Trimethoprim (Antrima)

Voriconazole (Vfend)

Class: Antivirals Acyclovir (Zovirax)

Adefovir (Hepsera)

Amantadine (Symmetrel)

Atazanavir (Reyataz)

Boceprevir (Victrelis)

Cidofovir (Vistide)

Cytabarin

Emtricitabine (Emtriva)

Enfuvirtide (Fuzeon)

Entecavir (Baraclude)

Famciclovir (Famvir)

Foscarnet (Foscavir)

Gamma-Globulin

Ganciclovir (Cytovene, Vitrasert)

5-Fluro Uracil (Curacil, Fluracil)

Interferon (Intron, Avonex)

Interferon Alfa-2b & Ribavirin Combo (Rebetron)

Lamivudine (Epivir, Epivir-HBV)

Methesazone

Oseltamivir (Tamiflu)

Palivizumab (Synagis)

Peginterferon Alfa-2a (Pegasys)

Peginterferon Alfa 2b (PEG-Intron)

Penciclovir (Denavir)

Ribavirin (Virazole)

Rimantadine (Flumadine)

Telaprevir (Incivek)

Telbivudine (Tyzeka)

Trifluridine (Viroptic)

Tenofovir (Viread)

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Valacyclovir (Valtrex)

Valganciclovir (Valcyte)

Zanamivir (Relenza)

Miscellaneous Antiviral Agents

Atovaquone (Mepron)

Atovaquone/Proguanil (Malarone)

Daptomycin (Cubicin)

Pentamidine (Pentam 300, NebuPent)

Retapamulin (Altabax)

Trimetrexate (Neutrexin)

Class: Antiretrovirals Agents

M.O.A: Check for drugs used in treating HIV/AIDs below

Abacavir (Ziagen)

Amprenavir (Agenerase)

Delavirdine (Rescriptor)

Didanosine [ddI] - (Videx)

Efavirenz (Sustiva)

Efavirenz/Emtricitabine/Tenofovir (Atripla)

Fosamprenavir (Lexiva)

Indinavir (Crixivan)

Lamivudine (Epivir, Epivir-HBV)

Lopinavir/Ritonavir (Kaletra)

Nelfinavir (Viracept)

Nevirapine (Viramune)

Ritonavir (Norvir)

Saquinavir (Fortovase)

Stavudine (Zerit)

Telbivudine (Tyzeka)

Tenofovir (Viread)

Tenofovir/Emtricitabine (Truvada)

Tipranavir (Aptivus)

Zidovudine (Retrovir)

Zidovudine & Lamivudine (Combivir)

ANTI-NEOPLASTIC AGENTS (ANTI-CANCER DRUGS)

Class: Alkalyting Agents

M.O.A: These compounds exert their cytotoxic effects by producing highly

reactive carbonium ion intermediates which transfer alkyl groups to cellular

macromolecules by covalently binding to nucleophilic groups on various cell

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constituents. They interfere with DNA replication by crosslinking DNA strands,

DNA strand breaking, and abnormal pairing of base pairs. The position 7 of

guanine residues in DNA is especially susceptible, but other molecular sites are

also involved.

Altretamine (Hexalen)

Busulfan (Myleran, Busulfex)

Carboplatin (Paraplatin)

Carmustine (Bicnu)

Chlorambucil (Leukeran)

Cisplatin (Platinol)

Cyclophosphamide (Cytoxan)

Dacarbazine (Dtic-Dome)

Ifosfamide (Ifex)

Lomustine (Ceenu)

Melphalan (Alkeran)

Mustine (Mechlorethamine)

Oxaliplatin (Eloxatin)

Procarbazine (Matulane)

Temozolomide (Temodar)

Triethylenethiophosphoramide (Thiotepa)

Class: Anti-metabolites

M.O.A: These are analogues related to the normal components of DNA or of

coenzymes involved in nucleic acid synthesis. They generally interfere with the

availability of normal purine or pyrimidine nucleotide precursors, either by

inhibiting their synthesis or by competing with them in DNA or RNA synthesis

by inhibiting ribonucleotide reductase and DNA polymerase subtrates or get

themselves incorporated forming dysfunctional macromolecules.. Their maximal

cytotoxic effects are in S-phase and are, therefore, cell cycle specific.

Azacitidine (Vidaza)

Capecitabine (Xeloda)

Cladribine (Leustatin)

Clofarabine (Clolar)

Cytarabine (Cytosine)

Cytarabine Liposome (DepoCyt)

Fludarabine (Fludara)

Floxuridine (FUDR)

5-Flurouracil (Adrucil, Curacil, Fluracil)

Gemcitabine (Gemzar)

6-Mercaptopurine (Purinethol)

6-Thioguanine [6-TG]

Methotrexate (Rheumatrex, Trexall)

Nelarabine (Arranon)

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Pemetrexed (Alimta)

Pralatrexate (Folotyn)

Class: Anti-biotics

M.O.A: Glycopeptide antibiotics; these are products obtained from

microorganisms and have prominent antitumour activity. They act by

intercalating between DNA strands and inhibiting DNA, RNA, protein synthesis

in G2, M-phases.

Bleomycine (Blenoxane)

Dactinomycin (Daflon, Dalacin C, Dalatin T)

Daunorubicin (Cerubidine)

Doxorubicin (Adriamycin)

Epirubicin (Ellence)

Idarubicin (Idamycin)

Mitomycin (Mutamycin)

Mitoxantrone

Plicamycin

Class: Miotic Inhibitors

M.O.A: They inhibit or alter DNA replication, inducing G2-phase arrest and

preferentially kills cells in G2 and late S-Phase.

Etoposide [VP-16] - (VePesid, Toposar)

Teniposide (Vumon)

Class: Microtubule Inhibitors

M.O.A: Vinka Alkaloids. These are mitotic inhibitors, bind to microtubular

protein—‘tubulin’, prevent its polymerization and assembly of microtubules,

cause disruption of mitotic spindle and interfere with cytoskeletal function. The

chromosomes fail to move apart during mitosis: metaphase arrest occurs and

subsequent inhibition of DNA/RNA synthesis. They are cell cycle specific and

act in the mitotic and S-phases inhibiting microtubule formation.

Docetaxel (Taxotere)

Paclitaxel (Taxol)

Vinorelbine (Navelbine)

Vinblastine (Velban, Velbe)

Vincristine (Oncovin, Vincasar PFS)

Vinorelbine (Navelbine)

Class: Monoclonal Antibodies

M.O.A: Monoclonal antibodies (MAbs) are sourced from hybridomas created

by fusing a continuously proliferating cell line from mouse myeloma with

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antibody producing B lymphocytes sensitized to produce antibody against a

particular antigen. These agents bind to the CD20 B-cell antigen expressed on the

surface of B-lymphocytes and B-cell lymphomas. By binding to the antigen

promotes apoptosis through transmembrane signalling as well as by ADCC and

CDC mechanisms.

(ii) Recombinant humanized monoclonal antibodies to VEGF; blocks the

angiogenic molecule VEGF thereby inhibiting tumor angiogenesis. Without new

blood vessels, tumors are starved of blood, oxygen and essential nutrients

necessary for growth and proliferation.

Bevacizumab (Avastin, Mvasi)

Cetuximab (Erbitux)

Erlotinib (Tarceva)

Obinutuzumab (Gazyva)

Ofatumumab (Arzerra)

Panitumumab (Vectibix)

Rituximab (Rituxan, Truxima)

Trastuzumab (Herceptin)

Class: Steroid Hormones and their Antagonists

M.O.A: They are not cytotoxic, but modify the growth of hormone-dependent

tumours. They competitively bind to receptors and inhibit the actions of their

hormones stimulation. All hormones are only palliative. For example, if a breast

carcinoma is oestrogen receptor-positive, oestrogen antagonists can inhibit these

cells.

Anastrozole (Arimidex)

Bicalutamide (Casodex)

Estramustine Phosphate (Estracyt, Emcyt)

Estrogens (Various)

Exemestane (Aromasin)

Fluoxymesterone (Halotestin, Androxy)

Flutamide (Eulexin)

Fulvestrant (Faslodex)

Goserelin (Zoladex)

Letrozole (Femara)

Leuprolide (Lupron, Viadur, Eligard)

Levamisole (Ergamisol)

Megestrol Acetate (Megace)

Nilutamide (Nilandron)

Prednisone

Raloxifene (Evista)

Tamoxifen (Soltamox)

Triptorelin (Trelstar Depot, Trelstar LA)

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Class: Tyrosine Kinase Inhibitors

M.O.A: They inhibit a specific tyrosine protein kinase labelled ‘Bcr-Abl’

tyrosine kinase expressed by chronic myeloid leukaemia (CML) cells and related

receptor tyrosine kinases including platelet derived growth factor (PDGF)

receptor that is constitutively active in dermatofibrosarcoma protuberans, stem

cell receptor and c-kit receptor active in gastrointestinal stromal tumour (GIST)

which is a rare tumour. Imatinib is found to be strickingly successful in chronic

phase of CML (remission in >90% cases) and in metastatic c-kit-positive GIST,

in which it is the drug of choice.

Dasatinib (Sprycel)

Erlotinib (Tarceva)

Imatinib (Gleevec)

Nilotinib (Tasigna)

Sorafenib (Nexavar)

Sunitinib (Sutent)

Class: Nitrosoureas

M.O.A: Sub-group of alkylating agents. They are highly lipid soluble and

readily cross the brain barrier, thereby interfering with DNA replication and

repair. Nitrosoureas also inhibit several key enzymatic processes by

carbamoylation of amino acids in proteins in the targeted cells.

Carmustine[BCNU] - (BiCNU, Gliadel)

Streptozocin (Zanosar)

Class: Nitrogen Mustards

M.O.A: Alkylating agents of nitrogen mustard family. They crosslink DNA

and interferes with DNA replication and RNA transcription; cell cycle

nonspecific.

Chlorambucil (Leukeran)

Cyclophosphamide (Cytoxan, Neosar)

Ifosfamide (Ifex, Holoxan)

Mechlorethamine (Mustargen)

Melphalan [L-PAM] (Alkeran)

Miscellaneous Antineoplastic Agents

Abiraterone (Zytiga)

Aldesleukin [Interleukin-2, IL-2] (Proleukin)

Aminoglutethimide (Cytadren)

Asparaginase (Erwinaze)

L-Asparaginase (Elspar, Oncaspar)

BCG [Bacillus Calmette-Guérin] - (TheraCys, Tice BCG)

Bortezomib (Velcade)

17 | P a g e

Cladribine (Leustatin)

Dacarbazine (DTIC)

Docetaxel (Taxotere)

Enzalutamide (Xtandi)

Etoposide (Toposar, Vapesid)

Gefitinib (Iressa)

Gemtuzumab Ozogamicin (Mylotarg)

Hydroxyurea (Hydrea, Droxia)

Imatinib (Gleevec)

Interferons (Peg-Intron)

Irinotecan (Camptosar)

Letrozole (Femara)

Leucovorin (Wellcovorin)

Mitoxantrone (Novantrone)

Oxaliplatin (Eloxatin)

Paclitaxel (Taxol, Abraxane)

Pemetrexed (Alimta)

Procarbazine (Matulane)

Rasburicase (Elitek)

Sorafenib (Nexavar)

Sunitinib (Sutent)

Temsirolimus (Torisel Kit)

Thalidomide (Thalomid)

Topotecan (Hycamtin)

Tretinoin, Topical [Retinoic Acid] - (Retin-A, Avita, Renova)

CARDIOVASCULAR (CVS) AGENTS

Class: Aldosterone Antagonist

M.O.A: Aldosterone receptor antagonist. Blocks aldosterone binding at the

mineralocorticoid receptor.

Eplerenone (Inspra)

Spironolactone (Aldactone)

Class: Alpha1-Adrenergic Blocker

M.O.A: Blocks postsynaptic Alpha-1 receptors, thereby decreasing

peripheral vascular resistance and lowering arterial blood pressure by causing

relaxation of both arterial and venous smooth muscle. Doxazosin (Cardura)

Prazosin (Minipress)

Terazosin (Hytrin)

18 | P a g e

Class: Renin Inhibitors

M.O.A: Inhibits renin and, thus, acts earlier in the renin–angiotensin–

aldosterone system than ACE inhibitors or ARBs. It lowers blood pressure

about as effectively as ARBs, ACE inhibitors, and thiazides.

Aliskiren (Tekturna)

Acid Protease Inhibitors (Pepstatin)

Class: Angiotensin-Converting Enzyme (ACE) Inhibitors

M.O.A: Blocks the release of the enzyme (ACE) in the lungs, which reduces

the conversion of angiotensin I to angiotensin II (potent vasoconstrictor),

thereby increasing the presence of bradykinin (potent vasodilator) in the blood

which causes dilation and decreased peripheral vascular resistance, thereby

lowering blood pressure.

Benazepril (Lotensin)

Captopril (Capoten)

Enalapril (Vasotec)

Fosinopril (Monopril)

Lisinopril (Prinivil, Zestril)

Moexipril (Univasc)

Perindopril Erbumine (Aceon)

Quinapril (Accupril)

Ramipril (Altace)

Trandolapril (Mavik)

Class: Angiotensinogen II Receptor Antagonists

M.O.A: They decrease total peripheral resistance (afterload) and cardiac

venous return (pre-load) by blocking aldosterone secretion, thus lowering blood

pressure and decreasing salt and water retention.

AzilsartanMedoxomil (Edarbi)

Candesartan (Atacand)

Eprosartan (Teveten)

Irbesartan (Avapro)

Losartan (Cozaar)

Olmesartan (Benicar)

Telmisartan (Micardis)

Valsartan (Diovan)

Class: Beta-Adrenergic Blockers (B1 and B2)

M.O.A: They inhibit the Beta receptors (either B1 or B2 selectively, or non-

selectively) thereby antagonizing the release of catecholamines (adrenaline),

decreasing the sympathetic activities of the CNS on the heart, thereby reducing

cardiac output and subsequently reducing blood volume resulting in decreased

19 | P a g e

blood pressure. They also block release of Renin from the kidney, thereby

reducing angiotensin II formation and further release of aldosterone.

Acebutolol (Sectral)

Atenolol [selective B1 blocker] - (Tenormin)

Atenolol & Chlorthalidone (Tenoretic)

Betaxolol [selective B1 blocker] - (Kerlone)

Bisoprolol [selective B1 blocker] - (Zebeta)

Carteolol (Cartrol, Ocupress Ophthalmic)

Carvedilol (Coreg, Coreg CR)

Labetalol (Trandate, Normodyne)

Esmolol [selective B1 blocker] - (Brevibloc)

Metoprolol [selective B1 blocker] - (Lopressor, Toprol XL)

Nadolol (Corgard)

Nebivolol [selective B1 blocker] - (Bystolic)

Penbutolol (Levatol)

Pindolol (Visken)

Propranolol (Inderal)

Timolol (Blocadren)

Class: Calcium Channel blockers

M.O.A: They bind to the L-receptors of the special voltage-gated calcium

channels on the smooth muscles of the heart and on the coronary and peripheral

blood vessels, thereby inhibiting more calcium ions from entering the

myocardium, gradually causing vascular smooth muscles to relax and dilating

many arterioles, thereby reducing blood pressure.

Sub-Class I: Dihydropyridines Amlodipine (Norvasc)

Clevidipine (Cleviprex)

Felodipine (Plendil)

Isradipine (Dyna Circ)

Nicardipine (Cardene)

Nifedipine (Procardia, Procardia XL, Adalat, Adalat CC)

Nimodipine (Nimotop)

Nisoldipine (Sular)

Sub- Class II: Non-dihydropyridines Diltiazem (Cardizem, Cartia XT, Dilacor, Diltia XT, Taztia XT, Tiamate,

Tiazac)

Verapamil (Calan, Isoptin, Verelan)

Alpha and Beta blockers

beta blockers

20 | P a g e

Class: Centrally Acting Antihypertensive Agents

M.O.A: They act on the CNS and decrease or diminish the adrenergic outflow

of the sympathetic actions from the CNS, resulting in reduced peripheral

resistance and decreased blood pressure.

Clonidine (Catapres)

Methyldopa (Aldomet)

Class: Diuretics

Sub-Class I: Thiazide Diuretics &Thiazide Combos

M.O.A: They reduce glomerular filtration modestly and decrease positive free

water formation by inhibiting Na reabsorption in distal renal tubules resulting in

increased excretion of Na+ and water, also K+ and H+ ions.

Chlorothiazide (Diuril)

Chlorthalidone (Hygroton)

Hydrochlorothiazide (Microzide)

Hydrochlorothiazide & Amiloride (Moduretic)

Hydrochlorothiazide & Spironolactone (Aldactazide)

Hydrochlorothiazide & Triamterene (Dyazide, Maxzide)

Indapamide (Lozol)

Metolazone (Mykrox, Zaroxolyn)

Sub-Class II: Carbonic Ahydrase Inhibitors

M.O.A: They inhibit the enzyme carbonic anhydrase, located intracellularly

and on the apical membrane of the proximal tubular epithelium, thereby

inhibiting ability to exchange Na+ for H+ which results in mild diuresis.

Acetazolamide (Diamox)

Sub-Class III: High ceiling or Loop Diuretics

M.O.A: Their site of action is the thick ascending limb of loop of Henle.

Diuresis is brought about by inhibition of the co-transport mechanism of

Na+/K+/Cl-, thereby decreasing the absorption of these ions and rsulting in

increased urinary output.

Bumetanide (Bumex)

Ethacrynic acid (Edecrin)

Furosemide (Lasix)

Torsemide (Demadex)

Sub-Class IV: Pottasium-sparing Diuretics

M.O.A: They inhibit Na+/K+ exchange site at the distal covulated tubule

(DCT), thereby preventing Na+ reabsorption and loss of K+.

Amiloride (Midamor)

Eplerenone (Inspra)

Spironolactone (Aldactone)

Triamterene (Dyrenium)

21 | P a g e

Sub-Class V: Osmotic Diuretics

M.O.A: They drag water along with them into the tubule during filtration

through the glomerulus. If there is no reabsorption, there is increased urinary

output.

Mannitol (Osmitrol)

Methyl cellulose

Urea

Class: Antiarrhythmic Agents

Sub-Class I: Na+ channel blockers

M.O.A: Drugs with local anesthetic action block sodium channels and reduce

the sodium current, INa. By blocking sodium channels, it slows the stroke of the

action potential, slows conduction, and prolongs the QRS duration of the ECG.

Disopyramide (NAPamide, Norpace, Norpace CR, Rhythmodan)

Flecainide (Tambocor)

Lidocaine (Anestacon Topical, Xylocaine)

Mexiletine (Mexitil)

Morixicine

Procainamide (Pronestyl, Pronestyl SR, Procanbid)

Propafenone (Rythmol)

Quinidine (Quinidex, Quinaglute)

Sub-Class II: Beta Adrenergic Receptor blockers

(Listed above)

Sub-class III: K+ Channel blockers

M.O.A: These drugs prolong action potentials, usually by blocking potassium

channels in cardiac muscle or by enhancing inward current, eg, through sodium

channels.

Amiodarone (Cordarone, Pacerone)

Dofetilide (Tikosyn)

Dronedarone (Multaq)

Ibutilide (Corvert)

Sotalol (Betapace, Betapace AF)

Sub-Class IV: Ca2+ Channel blockers

(Listed above)

Sub-class V: e.g Adenosine (Adenocard)

Its cardiac mechanism of action involves activation of an inward rectifier K+

current and inhibition of calcium current. The results of these actions are marked

hyperpolarization and suppression of calcium dependent action potentials.

22 | P a g e

Miscellaneous Antiarrythmic agents

Atropine (Atreza, Atropine PO)

Digoxin (Digitek, Lanoxin, Lanoxicaps)

Magnesium Sulfate (MgSO4)

Class: Inotropic/Pressor Agents

M.O.A: These are drugs with alpha and beta -adrenergic effects that increase

the contractility of the myocardium of the heart, thereby increasing cardiac

conductivity, heart rate and cardiac output Digoxin (Digitek, Lanoxin, Lanoxicaps)

Dobutamine (Dobutrex)

Dopamine (Intropin)

Epinephrine (Adrenalin, Sus-Phrine, EpiPen)

Inamrinone (Inocor)

Isoproterenol (Isuprel)

Milrinone (Primacor)

Nesiritide (Natrecor)

Norepinephrine (Levophed)

Phenylephrine (Neo-Synephrine)

Class: Vasodilators

M.O.A: These vasodilators act by producing relaxation of vascular smooth

muscle, primarily in arteries and arterioles. This results in decreased peripheral

resistance and, therefore, reduced blood pressure. Vasodilators also increase

plasma renin concentration, resulting in sodium and water retention. These

undesirable side effects can be blocked by concomitant use of a diuretic and a β-

blocker.

Alprostadil [Prostaglandin E1] - (Prostin VR)

Diazoxide (Hyperstat)

Epoprostenol (Flolan)

Fenoldopam (Corlopam)

Hydralazine (Apresoline)

Iloprost (Ventavis)

Isosorbide Dinitrate (Isordil, Sorbitrate, Dilatrate-SR)

Isosorbide Mononitrate (Ismo, Imdur)

Minoxidil (Loniten, Rogaine)

Nitroglycerin (Nitrostat, Nitrolingual, Nitro-Bid Ointment, Nitro-Bid IV,

Nitrodisc)

Sodium Nitroprusside (Nipride, Nitropress)

Tolazoline (Priscoline)

Treprostinil Sodium (Remodulin)

23 | P a g e

Class: Anti-anginal Agents

Sub-Class 1: Beta adrenergic blockers

Sub-Class 2: Ca2+ channel blockers

Sub-Class 3: Organic Nitrates

M.O.A: Organic nitrates relax vascular smooth muscle by their intracellular

conversion to nitrite ions and then to nitric oxide, which activates guanylate

cyclase and increases the cells’ cyclic guanosine monophosphate (cGMP).

Elevated cGMP ultimately leads to dephosphorylation of the myosin light chain,

resulting in coronary vascular smooth muscle relaxation and providing increased

blood supply to the heart muscle.

Nitroglycerin (Glycerin nitrate, Nitro-Bid, Nitrostat)

Isosorbide dinitrate (Isordil)

Isosorbide Mononitrate (Imdur, Ismo)

Sub-Class 4: Non-Nitrates (Sodium channel blocker)

M.O.A: Atianginal effects are not determined but it is shown to inhibit cardiac

late sodium current (INA) at therapeutic levels.

Ranolazine (Ranexa)

Class: Antihypertensive Combination Agents Amlodipine Besylate Benazepril Hydrochloride (Lotrel)

Isosorbide Dinitrate Hydralazine HCL (BiDil)

Class: Lipid-Lowering Agents (Anti-hyperlipidemia)

Sub-Class 1: HMG CoA Reductase Inhibitors (Statins)

M.O.A: 3-Hydroxy-3-methylglutaryl coenzyme A (HMG CoA) reductase

inhibitors (commonly known as statins) lower elevated LDL-C by competitively

inhibiting HMG CoA reductase, the rate-limiting step in cholesterol synthesis. By

inhibiting de-novo cholesterol synthesis, they deplete the intracellular supply of

cholesterol. Depletion of intracellular cholesterol causes the cell to increase the

number of cell surface LDL receptors that can bind and internalize circulating

LDLs. Thus, plasma cholesterol is reduced, by both decreased cholesterol

synthesis and increased LDL catabolism, resulting in a substantial reduction in

coronary events and death from CHD. They are considered first-line treatment

for patients with elevated risk of ASCVD.

Atorvastatin (Lipitor)

Fluvastatin (Lescol)

Lovastatin (Mevacor, Altocor)

Pitavastatin (Livalo)

Pravastatin (Pravachol)

Rosuvastatin (Crestor)

Simvastatin (Zocor)

24 | P a g e

Sub-Class 2: Niacin

M.O.A: At gram doses, niacin strongly inhibits lipolysis in adipose tissue,

thereby reducing production of free fatty acids. The liver normally uses

circulating free fatty acids as a major precursor for triglyceride synthesis.

Reduced liver triglyceride levels decrease hepatic VLDL production, which in

turn reduces LDL-C plasma concentrations.

Niacin (Niaspan, Slo-niacin)

Sub-Class 3: Fibrates

M.O.A: The peroxisome proliferator–activated receptors (PPARs) are members

of the nuclear receptor family that regulates lipid metabolism. PPARs function as

ligand-activated transcription factors. Upon binding to their natural ligands (fatty

acids or eicosanoids) or antihyperlipidemic drugs, PPARs are activated. They

then bind to peroxisome proliferator response elements, which ultimately leads

to decreased triglyceride concentrations through increased expression of

lipoprotein lipase and decreasing apolipoprotein (apo) CII concentration.

Fenofibrate (TriCor, Antara, Lipofen, Triglide)

Gemfibrozil (Lopid)

Sub-Class 4: Blue Acid Sequestrants (Resins)

M.O.A: They are anion-exchange resins that bind negatively charged bile acids

and bile salts in the small intestine. The resin/bile acid complex is excreted in the

feces, thus lowering the bile acid concentration. This causes hepatocytes to

increase conversion of cholesterol to bile acids, which are essential components

of the bile. Consequently, intracellular cholesterol concentrations decrease, which

activates an increased hepatic uptake of cholesterol-containing

LDL particles, leading to a fall in plasma LDL-C.

Cholestyramine (Questran)

Colesevelam (WelChol)

Colestipol (Colestid)

Sub-Class 5: Cholesterol Absorption Inhibitor

M.O.A: It selectively inhibits absorption of dietary and biliary cholesterol in the

small intestine, leading to a decrease in the delivery of intestinal cholesterol to

the liver. This causes a reduction of hepatic cholesterol stores and an increase in

clearance of cholesterol from the blood. Ezetimibe lowers LDL cholesterol by

approximately 17%.

Ezetimibe (Zetia)

Sub-Class 6: Omega-3 Fatty acids

M.O.A: Omega-3 polyunsaturated fatty acids (PUFAs) are essential fatty acids

that are predominately used for triglyceride lowering. Essential fatty acids

inhibit VLDL and triglyceride synthesis in the liver.

Docosahexaenoic and eicosapentaenoic acids (Lovaza)

Icosapent Ethyl (Vascepa)

25 | P a g e

Class: Lipid-Lowering/Antihypertensive Combos Amlodipine/Atorvastatin (Caduet)

Miscellaneous Cardiovascular Agents

Conivaptan (Vaprisol)

HAEMATOLOGIC AGENTS

Class: Anti-Coagulants

M.O.A: The anticoagulant drugs inhibit either the action of the coagulation

factors (for example, heparin) or interfere with the synthesis of the coagulation

factors (for example, vitamin K antagonists such as warfarin).

Ardeparin (Normiflo)

Apixaban (Eliquis)

Argatroban (Argatroban)

Bivaroxaban (Xarelto)

Bivalirudin (Angiomax)

Dabigatran (Pradaxa)

Dalteparin (Fragmin)

Desirudin (Iprivask)

Enoxaparin (Lovenox)

Fondaparinux (Arixtra)

Heparin

Lepirudin (Refludan)

Protamine

Tinzaparin (Innohep)

Warfarin (Coumadin, Jantoven)

Class: Platelet Aggregation Inhibitors

M.O.A: Platelet aggregation inhibitors decrease the formation of a platelet-rich

clot or decrease the action of chemical signals that promote platelet aggregation.

They inhibit cyclooxygenase-1 (COX-1) or block GP IIb/IIIa or ADP receptors,

thereby interfering with the signals that promote platelet aggregation.

Abeiximab (Reopro)

Aspirin (Variolis)

Cilostazol (Pletal)

Clopidogrel (Plavix)

Dipyridamole (Persantine)

Dipyridamole & Aspirin (Aggrenox)

Eptifibatide (Integrilin)

Prasugrel (Effient)

Ticagrelor (Brilinta)

Ticlopidine (Ticlid)

Tirofiban (Aggrastat)

26 | P a g e

Class: Antithrombolytic Agents

M.O.A: They act either directly or indirectly to convert plasminogen to

plasmin, which, in turn, cleaves fibrin, thus lysing thrombi.

Alteplase, Recombinant [tPA] - (Activase)

Aminocaproic Acid (Amicar)

Anistreplase (Eminase)

Aprotinin (Trasylol)

Danaparoid (Orgaran)

Dextran 40 (Gentran 40, Rheomacrodex)

Reteplase (Retavase)

Streptokinase (Streptase, Kabikinase)

Tenecteplase (TNKase)

Urokinase (Abbokinase)

Class: Volume Expanders

M.O.A: They increase intravascular oncotic pressure, mobilizes fluids from

interstitial into intravascular space.

Albumin (Albuminar, Buminate, Albutein)

Dextran 40 (Rheomacrodex)

Hetastarch (Hespan)

Plasma Protein Fraction (Plasmanate)

Class: Hematopoietic Stimulants Antihemophilic Factor VIII (Monoclate)

Decitabine (Dacogen)

Desmopressin (DDAVP, Stimate)

Lenalidomide (Revlimid)

Pentoxifylline (Trental)

CENTRAL NERVOUS SYSTEM AGENTS

Class: Antianxiety Agents (Anxiolytics)

Benzodiazepines: M.O.A: The targets for benzodiazepine actions are the

γ-aminobutyric acid (GABAA) receptors. GABA is the major inhibitory

neurotransmitter in the central nervous system (CNS). Binding of GABA to its

receptor triggers an opening of the central ion channel, allowing chloride through

the pore. The influx of chloride ions causes hyperpolarization of the neuron and

decreases neurotransmission by inhibiting the formation of action potentials.

Alprazolam (Xanax)

Chlordiazepoxide (Libriu, Mitran, Libritabs)

Clonazepam (Klonopin)

Clorazepate (Tranxene)

27 | P a g e

Diazepam (Valium, Diastat)

Doxepin (Sinequan, Adapin)

Estazolam

Flurazepam (Dalmane)

Lorazepam (Ativan)

Midazolam

Oxazepam (Serax)

Quazepam (Doral)

Temazepam (Restoril)

Triazolam (Halcion)

Non-benzodiazepines: Buspirone (BuSpar)

Meprobamate (Equanil, Miltown)

Class: Anticonvulsants (Antiepileptic or Antiseizure

agents)

M.O.A: They block voltage-gated channels of sodium and calcium, thereby

reducing the release of excitatory glutamate; enhancing gamma-aminobutyric

acid (GABA)-mediated inhibition, thereby suppressing excessive rapid firing of

neurons during seizure and spread of the seizure within the brain.

Carbamazepine (Tegretol)

Clonazepam (Klonopin)

Diazepam (Valium)

Ethosuximide (Zarontin)

Fosphenytoin (Cerebyx)

Gabapentin (Neurontin)

Lamotrigine (Lamictal)

Levetiracetam (Keppra)

Lorazepam (Ativan)

Oxcarbazepine (Trileptal)

Pentobarbital (Nembutal)

Phenobarbital

Phenytoin (Dilantin)

Tiagabine (Gabitril)

Topiramate (Topamax)

Valproic Acid (Depakene, Depakote)

Zonisamide (Zonegran)

Class: Antidepressants

M.O.A: They increase the availability of the synaptic concentration of the

Catecol and/or indolamine transmitters by preventing their neuronal reuptake or

metabolic deamination via inhibition of monoamine oxidase (MAO), an enzyme

28 | P a g e

that catalyzes the breakdown of of the monoamine neurotransmitters (Serotonin,

norepinephrine and dopamine).

Amitriptyline (Elavil)

Bupropion (Wellbutrin, Zyban)

Citalopram (Celexa)

Desipramine (Norpramin)

Doxepin (Adapin)

Duloxetine (Cymbalta)

Escitalopram (Lexapro)

Fluoxetine (Prozac, Sarafem)

Fluvoxamine (Luvox)

Imipramine (Tofranil)

Mirtazapine (Remeron)

Nefazodone (Serzone)

Nortriptyline (Aventyl, Pamelor)

Paroxetine (Paxil)

Phenelzine (Nardil)

Selegiline, transdermal (Emsam)

Sertraline (Zoloft)

Trazodone (Desyrel)

Venlafaxine (Effexor, Effexor XR)

Class: Antiparkinson Agents

M.O.A: These agents correct the imbalance between the dopaminergic and

cholinergic systems at the basal ganglia by penetrating the blood-brain barrier.

Two major groups of drugs are used: drugs that increase dopaminergic activity

between the substantia nigra and the corpus striatum (e.g levodopa), and

anticholinergic drugs that inhibit striatal cholinergic activity (e.g procyclidine).

Sub-Class I: Dopamine Precursors

M.O.A: They are immediate precursors of dopamine and are able to penetrate

the blood–brain barrier to replenish the dopamine content of the corpus striatum.

L-dopa is decarboxylated to dopamine in the brain by dopa decarboxylase, and it

has beneficial effects produced through the actions of dopamine on D2 receptors.

Carbidopa (Lodosyn)

Carbidopa/Levodopa (Sinemet)

Levodopa

Sub-Class II: Dopamine Agonists

M.O.A: They are dopamine agonists selective for the D2 receptor. They

facilitate neuronal dopamine release and inhibition of its reuptake into nerves,

and additional muscarinic blocking actions.

Amantadine (Summetrel, Osmolex ER, Gocovri)

Apomorphine (Apokyn)

29 | P a g e

Bromocriptine (Parlodel)

Carbegoline [long-acting]

Lisuride

Pergolide

Pramipexole (Mirapex)

Ropinirole (Requip)

Rotigotine (Neupro)

Sub-Class III: Monoamine Oxidase (MAOb) Inhibitors

M.O.A: Selectively inhibits the MAO type-B enzyme in the brain that is

normally responsible for the degradation of dopamine.

Isocarboxazid (Marplan)

Selegiline (Eldepryl, Zelapar)

Rasagiline mesylate (Azilect)

Tranylcypromine (Surmontil)

Sub-Class IV: Catechol-O-Methyltransferase (COMT) Inhibitors

M.O.A: Entacapone (Comtan)

Tolcapone (Tasmar)

Sub-Class V: Anti-Cholinergic Agents

M.O.A: They are antagonists at the muscarinic receptors that mediate striatal

cholinergic excitation. Their major action in the treatment of Parkinson’s disease

is to reduce the excessive striatal cholinergic activity that characterizes the

disease.

Benzatropine (Cogentin)

Procyclidine (Kemadrin)

Orphenadrine

Trihexyphenidyl (Artane)

Miscellaneous Anti-Parkinson Agents

Biperiden (Akineton)

Deprenyl

Class: Antipsychotics (Neuroleptics)

First generation (Typical Antipsychotics)

M.O.A: They are competitive inhibitors that competitively blocks dopamine D2

receptors, thereby decreasing psychotic tendencies. First-generation

antipsychotics are more likely to be associated with movement disorders known

as extrapyramidal symptoms (EPS), particularly drugs that bind tightly to

dopaminergic neuroreceptors, such as haloperidol.

30 | P a g e

Low-potency Chlorpromazine (Thorazine)

Thioridazine (Mellaril)

High-potency Fluphenazine (Prolixin, Permitil)

Haloperidol (Haldol)

Loxapine (Loxitane)

Perphenazine (Trilafon)

Pimozide (Orap)

Prochlorperazine (Compazine)

Thiothixene (Navane)

Trifluoperazine (Stelazine)

Second generation (Atypical Antipsychotics)

M.O.A: They block dopamine D2 receptors and serotonin receptors

(especially 5-HT2A and 5-HT2C receptors), thereby increasing dopameinergic

activity in the nigrostriatal pathway, leading to a lowered extrapyramidal side

effect.

Aripiprazole (Abilify)

Clozapine (Clozaril, FazaClo)

Lithium Carbonate (Eskalith, Lithobid)

Mesoridazine (Serentil)

Molindone (Moban)

Olanzapine (Zyprexa)

Paliperidone (Invega)

Quetiapine (Seroquel, Seroquel XR)

Risperidone (Risperdal, Risperdal Consta, Risperdal M-Tab)

Ziprasidone (Geodon)

Class: Sedative/Hypnotics

Barbiturates: M.O.A: The sedative–hypnotic action of the barbiturates is

due to their interaction with GABAA receptors, which enhances GABAergic

transmission. Barbiturates potentiate GABA action on chloride entry into the

neuron by prolonging the duration of the chloride channel openings. In addition,

barbiturates can block excitatory glutamate receptors.

Amobarbital (Amutal)

Phenobarbital (Luminal)

Pentobarbital (Nembutal)

Secobarbital (Seconal)

Theopental (Pentothal)

Other Sedative/Hypnotic Agents; Chloral Hydrate (Aquachloral, Supprettes)

31 | P a g e

Estazolam (ProSom)

Eszopiclone (Lunesta)

Flurazepam (Dalmane)

Quazepam (Doral)

Ramelteon (Rozerem)

Temazepam (Restoril)

Triazolam (Halcion)

Zaleplon (Sonata)

Zolpidem (Ambien)

Class: Anti-Alzheimer Drugs

M.O.A: They prevent an enzyme called acetylcholinesterase from breaking

down acetylcholine, which results in higher concentration of acetylcholine

in the brain, leading to better communication between nerve cells.

Donepezil (Aricept)

Galantamine (Razadyne)

Memantine (Namenda)

Rivastigmine (Exelon)

Miscellaneous CNS Agents

Atomoxetine HCL (Strattera)

Interferon beta-1a (Rebif)

Lisdexamfetamine (Vyvanse)

Methylphenidate, Oral (Concerta, Ritalin, Ritalin-SR, others)

Methylphenidate, Transdermal (Daytrana)

Natalizumab (Tysabri)

Nimodipine (Nimotop)

Sodium Oxybate (Xyrem)

Tacrine (Cognex)

DERMATOLOGIC AGENTS Acitretin (Soriatane)

Acyclovir (Zovirax)

Alefacept (Amevive)

Amphotericin B (Fungizone)

Anthralin (Anthra-Derm)

Bacitracin, Topical (Baciguent)

Bacitracin & Polymyxin B, Topical (Polysporin)

Bacitracin, Neomycin, & Polymyxin B, Topical (Neosporin Ointment)

Bacitracin, Neomycin, Polymyxin B, & Hydrocortisone, Topical

(Cortisporin)

Bacitracin, Neomycin, Polymyxin B, & Lidocaine, Topical (Clomycin)

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Botulinum toxin type A (Botox Cosmetic)

Calcipotriene (Dovonex)

Capsaicin (Capsin, Zostrix)

Ciclopirox (Loprox)

Ciprofloxacin (Cipro)

Clindamycin (Cleocin)

Clotrimazole & Betamethasone (Lotrisone)

Dapsone, Topical (Aczone)

Dibucaine (Nupercainal)

Doxepin, Topical (Zonalon, Prudoxin)

Econazole (Spectazole)

Efalizumab (Raptiva)

Erythromycin, Topical (A/T/S, Eryderm, Erycette, T-Stat)

Finasteride (Propecia)

Gentamicin, Topical (Garamycin, G-Mycitin)

Imiquimod Cream, 5% (Aldara)

Isotretinoin [13-cis Retinoic Acid] - (Accutane, Amnesteem, Claravis,

Sotret)

Ketoconazole (Nizoral)

Kunecatechins (Veregen)

Lactic Acid & Ammonium Hydroxide [Ammonium Lactate] - (Lac-

Hydrin)

Lindane (Kwell)

Lisdexamfetamine (Vyvanse)

Metronidazole (Flagyl, MetroGel)

Miconazole (Monistat)

Miconazole/Zinc Oxide/Petrolatum (Vusion)

Minocycline (Solodyn)

Minoxidil (Loniten, Rogaine)

Mupirocin (Bactroban)

Naftifine (Naftin)

Neomycin Sulfate (Myciguent)

Nystatin (Mycostatin)

Oxiconazole (Oxistat)

Penciclovir (Denavir)

Permethrin (Nix, Elimite)

Pimecrolimus (Elidel)

Podophyllin (Podocon-25, Condylox Gel 0.5%, Condylox)

Pramoxine (Anusol Ointment, ProctoFoam-NS)

Pramoxine & Hydrocortisone (Enzone, Proctofoam-HC)

Selenium Sulfide (Exsel Shampoo, Selsun Blue Shampoo, Selsun

Shampoo)

Silver Sulfadiazine (Silvadene)

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Steroids, Topical

Tacrolimus (Prograf, Protopic)

Tazarotene (Tazorac, Avage)

Terbinafine (Lamisil)

Tolnaftate (Tinactin)

Tretinoin, Topical [Retinoic Acid] - (Retin-A, Avita, Renova)

Vorinostat (Zolinza)

DIETARY SUPPLEMENTS Calcium Acetate (Calphron, Phos-Ex, PhosLo)

Calcium Glubionate (Neo-Calglucon)

Calcium Salts [Chloride, Gluconate, Gluceptate]

Cholecalciferol [Vitamin D3] - (Delta D)

Cyanocobalamin [Vitamin B12] - (Nascobal)

Ferric Gluconate Complex (Ferrlecit)

Ferrous Gluconate (Fergon)

Ferrous Sulfate

Fish Oil (Omacor, OTC)

Folic Acid

Iron Dextran (DexFerrum, INFeD)

Iron Sucrose (Venofer)

Magnesium Oxide (Mag-Ox 400)

Magnesium Sulfate

Multivitamins

Phytonadione [Vitamin K] - (Aqua-MEPHYTON)

Potassium Supplements (Kaon, Kaochlor, K-Lor, Slow-K, Micro-K,

Klorvess)

Pyridoxine [Vitamin B6]

Sodium Bicarbonate [NaHCO3]

Thiamine [Vitamin B1]

EAR (OTIC) AGENTS Acetic Acid & Aluminum Acetate (Otic Domeboro)

Benzocaine & Antipyrine (Auralgan)

Ciprofloxacin, Otic (Cipro HC Otic)

Neomycin, Colistin, & Hydrocortisone (Cortisporin-TC Otic Drops)

Neomycin, Colistin, Hydrocortisone, & Thonzonium (Cortisporin-TC

Otic Suspension)

Polymyxin B & Hydrocortisone (Otobiotic Otic)

Sulfacetamide & Prednisolone (Blephamide)

Triethanolamine (Cerumenex)

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ENDOCRINE SYSTEM AGENTS

Hypothalamic and Anterior Pituitary HormonesAND ANTERIOR

Choriogonadotropin alfa (Ovidrel)

Corticotropin (H.P. Acthar)

Cosyntropin (Cortrosyn)

Follitropin alfa (Gonal-f)

Follitropin beta (Follistim)

Goserelin (Zoladex)

Histrelin (Vantas)

Human chorionic gonadotropin (Pregnyl)

Lanreotide (Somatuline)

Leuprolide (Lupron)

Menotropins (Menopur, Repronex)

Nafarelin (Synarel)

Octreotide (Sandostatin)

Pegvisomant (Somavert)

Somatropin (Humatrope)

Urofollitropin (Bravelle)

Class: Thyroid/Antithyroid Levothyroxine (Synthroid, Levoxyl)

Liothyronine (Cytomel)

Liotrix (Thyrolar)

Methimazole (Tapazole)

Potassium iodide [Lugol Solution] - (SSKI, Thyro-Block)

Propylthiouracil [PTU]

Class: Hypercalcemia/Osteoporosis Agents

M.O.A: They inhibit Osteoclast-mediated reabsorption, decrease mineral

release and collagen or matrix breakdown in bone.

Alendronate (Fosamax)

Calcitonin (Fortical, Binosto)

Denosumab (Prolia)

Etidronate Disodium (Didronel)

Gallium Nitrate (Ganite)

Ibandronate Sodium (Boniva)

Pamidronate (Aredia)

Raloxifene (Evista)

Risedronate (Actonel)

Teriparatide (Forteo)

Zoledronic Acid (Zometa)

Zoledronic Acid (Zometa)

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Class: Antidiabetic Agents Acarbose (Precose)

Acetohexamide

Chlorpropamide (Diabinese)

Glimepiride (Amaryl)

Glimepiride/pioglitazone (Duetact)

Glipizide (Glucotrol)

Glyburide (DiaBeta, Micronase, Glynase)

Glyburide/Metformin (Glucovance)

Insulin Zinc Suspension

Insulin Isophene (Humulin-N)

Insulin Protamine Zinc

Insulin Semilente

Insulin Ultralente

Metformin (Glucophage)

Miglitol (Glyset)

Nateglinide (Starlix)

Pioglitazone (Actos)

Pioglitazone HCL/Glimepiride (Duetact)

Pioglitazone/Metformin (Actoplus Met)

Repaglinide (Prandin)

Rosiglitazone (Avandia)

Rosiglitazone/Metformin (Avandamet)

Sitagliptin (Januvia)

Sitagliptin/Metformin (Janumet)

Tolazamide (Tolinase)

Tolbutamide (Orinase)

Hormone and Synthetic substitutes Calcitonin (Cibacalcin, Miacalcin)

Calcitriol (Rocaltrol, Calcijex)

Cortisone Systemic, Topical

Desmopressin (DDAVP, Stimate)

Dexamethasone (Decadron)

Fludrocortisone Acetate (Florinef)

Fluoxymesterone (Halotestin, Androxy)

Glucagon Hydrocortisone Topical & Systemic (Cortef, Solu-Cortef)

Methylprednisolone (Solu-Medrol)

Oxytocin (Pitocin)

Prednisolone

Prednisone

Testosterone (AndroGel, Androderm, Striant, Testim)

Vasopressin [Antidiuretic Hormone, ADH] - (Pitressin)

36 | P a g e

OBESITY AGENTS

Class: Anorexiants (Appetite Suppressants)

M.O.A: They act by increasing the release of norepinephrine and dopamine

from the nerve terminals and by inhibiting reuptake of these neurotransmitters,

thereby increasing levels of neurotransmitters in the brain. The increase in

norepinephrine signals a “fight-or-flight” response by the body, which, in turn,

decreases appetite.

Diethylpropion (Tenuate) Phentermine (Adipex-P)

Phentermine/Topiramate (Qsymia)

Class: Lipase Inhibitors

M.O.A: They act by inhibiting gastric and pancreatic lipases, thus decreasing

the breakdown of dietary fat into smaller molecules that can be absorbed.

Administration of orlistat decreases fat absorption by about 30%. The loss of

calories from decreased absorption of fat is the main cause of weight loss.

Orlistat (Alli, Xenical)

Class: Serotonin Agonists

M.O.A: They decrease food consumption and promote satiety by selectively

activating serotonin (5-HT2C) receptors on anorexigenic pro-opiomelanocortin

neurons located in the hypothalamus.

Lorcaserin (Belviq)

Sibutramine (Meridia)

Miscellaneous Endocrine Agents

Cinacalcet (Sensipar)

Demeclocycline (Declomycin)

Diazoxide (Proglycem)

EYE (OPHTHALMIC) AGENTS

Class: Anti-Glaucoma Agents Acetazolamide (Diamox)

Apraclonidine (Iopidine)

Betaxolol, Ophthalmic (Betopic)

Brimonidine (Alphagan P)

Brinzolamide (Azopt)

Carteolol (Cartrol, Ocupress Ophthalmic)

Ciprofloxacin, Ophthalmic (Ciloxan)

Cyclosporine, Ophthalmic (Restasis)

Dipivefrin (Propine)

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Dorzolamide (Trusopt)

Dorzolamide & Timolol (Cosopt)

Echothiophate Iodine (Phospholine Ophthalmic)

Epinastine (Elestat)

Latanoprost (Xalatan)

Levobunolol (A-K Beta, Betagan)

Levocabastine (Livostin)

Levofloxacin (Levaquin1, Quixin & Iquix Ophthalmic)

Lidocaine (Akten)

Lodoxamide (Alomide)

Moxifloxacin (Vigamox)

Neomycin, Polymyxin, & Hydrocortisone (Cortisporin Ophthalmic & Otic)

Norfloxacin (Chibroxin)

Ofloxacin (Ocuflox Ophthalmic)

Rimexolone (Vexol Ophthalmic)

Timolol, Ophthalmic (Timoptic)

Trifluridine, Ophthalmic (Viroptic)

Class: Ophthalmic Antibiotics Bacitracin, Ophthalmic (AK-Tracin Ophthalmic)

Bacitracin & Polymyxin B, Ophthalmic (AK-Poly-Bac Ophthalmic,

Polysporin Ophthalmic)

Bacitracin, Neomycin, & Polymyxin B (AK Spore Ophthalmic,

Neosporin Ophthalmic)

Bacitracin, Neomycin, Polymyxin B, & Hydrocortisone, Ophthalmic (AK

Spore HC Ophthalmic, Cortisporin Ophthalmic)

Ciprofloxacin, Ophthalmic (Ciloxan)

Erythromycin, Ophthalmic (Ilotycin Ophthalmic)

Gentamicin, Ophthalmic (Garamycin, Genoptic, Gentacidin, Gentak)

Neomycin & Dexamethasone (AKNeo- Dex Ophthalmic, NeoDecadron

Ophthalmic)

Neomycin, Polymyxin B, & Dexamethasone (Maxitrol)

Neomycin, Polymyxin B, & Prednisolone (Poly-Pred Ophthalmic)

Ofloxacin (Floxin, Ocuflox Ophthalmic)

Silver Nitrate (Dey-Drop)

Sulfacetamide (Bleph-10, Cetamide, Sodium Sulamyd)

Sulfacetamide & Prednisolone (Blephamide)

Tobramycin, Ophthalmic (AKTob, Tobrex)

Tobramycin & Dexamethasone (TobraDex)

Trifluridine (Viroptic)

Miscellaneous Ophthalmic Agents

Artificial Tears (Tears Naturale)

38 | P a g e

Atropine

Cromolyn Sodium (Opticrom)

Cyclopentolate (Cyclogyl, Cyclate)

Cyclopentolate with Phenylephrine (Cyclomydril)

Cyclosporine Ophthalmic (Restasis)

Dexamethasone, Ophthalmic (AK-Dex Ophthalmic, Decadron

Ophthalmic)

Emedastine (Emadine)

Ketorolac, Ophthalmic (Acular, Acular LS, Acular PF)

Ketotifen (Zaditor)

Lodoxamide (Alomide)

Naphazoline (Albalon, AK-Con, Naphcon, others)

Naphazoline & Pheniramine Acetate (Naphcon A)

Nepafenac (Nevanac)

Olopatadine (Patanol)

Pemirolast (Alamast)

Proparacaine (Alcaine, Ophthaine)

Rimexolone (Vexol Ophthalmic)

Scopolamine Ophthalmic

GASTROINTESTINAL AGENTS

Class: Antacid

M.O.A: They are weak bases that neutralize or reduce the acidity of the

stomach and duodenal contents by combining with Hydrochloric Acid (HCL) to

produce salt and water.

Alginic Acid (Gaviscon)

Aluminum Hydroxide (Amphojel, ALternaGEL)

Aluminum Hydroxide with Magnesium Carbonate (Gaviscon)

Aluminum Hydroxide with Magnesium Hydroxide (Maalox)

Aluminum Hydroxide with Magnesium Hydroxide & Simethicone

(Mylanta, Mylanta II, Maalox Plus)

Aluminum Hydroxide with Magnesium Trisilicate (Gaviscon, Gaviscon-2)

Calcium Carbonate (Tums, Alka-Mints)

Magaldrate (Riopan, Lowsium)

Simethicone (Mylicon)

Class: Antidiarrheals

M.O.A: They act on smooth muscle of the intestinal tract, inhibiting and

slowing GI motility and excessive GI propulsion (reduced fecal volume) and also

increasing viscosity.

Bismuth Subsalicylate (Pepto-Bismol)

Diphenoxylate with Atropine (Lomotil, Lonox)

39 | P a g e

Kaolin-Pectin (Kaodene, Kao-Spen, Kapectolin, Parepectolin)

Lactobacillus (Lactinex Granules)

Loperamide (Imodium)

Octreotide (Sandostatin, Sandostatin LAR)

Paregoric [Camphorated Tincture of Opium]

Class: Emetics

M.O.A: They act directly on the Chemoreceptor Trigger Zone (CTZ) to

stimulate the emetic centre in the medulla oblongata and also indirectly by

irritating the gastric mucosa, thereby inducing violent upward vomiting of thr

gastric contents throught the contraction of the smooth muscles of the stomach.

Class: Anti-emetics

M.O.A: These are drugs that reduce the GIT motility, as well as suppressing

the vomiting centre in the medulla oblongata.

Aprepitant (Emend)

Belladona Alkaloids (Benadryl)

Chlorpromazine (Thorazine)

Dimenhydrinate (Dramamine)

Dolasetron (Anzemet)

Domperidone (Emidone, Motil, Motilium)

Dronabinol (Marinol)

Droperidol (Inapsine)

Granisetron (Kytril)

Haloperidol (Halothane, Hapro, Harten)

Meclizine (Antivert)

Metoclopramide (Reglan, Clopra, Octamide)

Nabilone (Cesamet)

Ondansetron (Zofran)

Palonosetron (Aloxi)

Prochlorperazine (Compazine)

Promethazine (Phenergan)

Scopolamine (Scopace)

Thiethylperazine (Torecan)

Trimethobenzamide (Tigan)

Class: Anti-Helmentic Agents

M.O.A: These are drugs used in the treatment of parasitic worms. They act by

inhibiting microtubules in the parasite and paralyzing the parasites.

Albendazole (Albenza)

Diethhylcarbamazine (Banocide)

Ivermectin (Stromectol)

40 | P a g e

Mebendazole (Vermox)

Niclosamide

Niridazole

Praziquantel (Biltricide)

Pyrantel pamoate (Pin-X)

Thiabendazole (Mintezol)

Class: Antiulcer

Sub-Class I: H2-Histamine Receptor Blockers

M.O.A: These drugs inhibit the action of histamine selectively at histamine H2

receptor on the cell membrane of the parietal cells of the stomach, which then

reduces the secretion of gastric acid and reduces pepsin output, thereby

encouraging healing of the ulcerated areas.

Cimetidine (Tagamet)

Famotidine (Pepcid, Pepcid AC)

Nizatidine (Axid)

Ranitidine Hydrochloride (Zantac)

Sub-Class II: Proton Pump Inhibitors (PPIs)

M.O.A: These drugs suppress gastric acid secretion by inhibiting Hydrogen-

Potassium Adenosine Triphosphate enzyme system (H+/K+ATPase) at the

secretory surface of the gastric parietal cells. They block the last step of acid

production, i.e the membrane proton pump.

Dexlansoprazole (Dexilant)

Esomeprazole (Nexium)

Lansoprazole (Prevacid)

Omeprazole (Prilosec, Zegerid)

Pantoprazole (Protonix)

Rabeprazole (AcipHex)

Sub-Class III: Mucosal Protective Agents

M.O.A: These compounds bind to positively charged groups in proteins of both

normal and necrotic mucosa thereby forming complex gels with epithelial cells,

thereby creating a physical barrier that impairs diffusion of HCL and prevents

degradation of mucus by pepsin and acid.

Bismuth Subsalicyclate (Pepto-Bismol)

Sucralfate (Carafate)

Class: Cathartics/Laxatives

M.O.A: They loosen the bowel movement, increase peristaltic movement of

the intestinal tract and encourage evacuation of feaces.

Bisacodyl (Dulcolax)

Docusate Calcium (Surfak)

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Docusate Potassium (Dialose) Docusate Sodium (Doss, Colace)

Glycerin Suppository Lactulose (Constulose, Generlac, Chronulac,

Cephulac, Enulose)

Magnesium Citrate

Magnesium Hydroxide (Milk of Magnesia)

Mineral Oil

Polyethylene Glycol-Electrolyte Solution (GoLYTELY, CoLyte)

Psyllium (Metamucil, Serutan, EfferSyllium)

Sodium Phosphate (Visicol)

Sorbitol

Class: Anti-Muscarinic Agents/Anti-cholinergic Agents

M.O.A: They block the muscarinic receptors, thereby inhibiting gastric

motility and decreasing the amount of acid secreted by the stomach and

delaying emptying of stomach contents.

Dicyclomine (Bentyl)

Hyoscyamine (Levbid, Levsin, Anaspaz)

Glycopyrrolate (Cuvposa, glycopyrronium, Robinul)

Methscopolamine (Pamine, Pamine Forte)

Propantheline (Pro Bantine)

Class: Prostaglandins

M.O.A: It is an analogue of Prostaglandins E produced by the gastric mucosa.

It inhibits secretion of HCL and stimulates secretion of mucus and bicarbonate

thereby protecting the gastric mucosa.

Misoprostol (Cytotec)

Class: Enzymes Pancreatin (Pancrease, Cotazym, Creon, Ultrase)

Miscellaneous GI Agents

Alosetron (Lotronex)

Balsalazide (Colazal)

Budesonide (Entocort EC)

Dexpanthenol (Ilopan-Choline Oral, Ilopan)

Dibucaine (Nupercainal)

Hydrocortisone, Rectal (Anusol-HC Suppository, Cortifoam Rectal,

Proctocort)

Hyoscyamine, Atropine, Scopolamine, & Phenobarbital (Donnatal)

Infliximab (Remicade)

Lubiprostone (Amitiza)

Mesalamine (Asacol, Lialda, Pentasa, Rowasa)

42 | P a g e

Neomycin Sulfate (Neo-Fradin, generic)

Olsalazine (Dipentum)

Pramoxine (Anusol Ointment, ProctoFoam-NS)

Pramoxine with Hydrocortisone (Enzone, ProctoFoam-HC)

Sulfasalazine (Azulfidine)

Vasopressin (Pitressin)

IMMUNE SYSTEM AGENTS

Class: Immunodulators

M.O.A: They are agents used to help regulate or normalize the immune system

by increasing transcription and production of Interleukins 2 (IL-2), thereby

inducing T-cell proliferation and activation, and also enhancing the activity of the

innate immune system (NK cells).

Abatacept (Orencia)

Adalimumab (Humira)

Anakinra (Kineret)

Etanercept (Enbrel)

Interferon Alfa (Roferon-A, Intron A)

Interferon Alfacon-1 (Infergen)

Interferon Beta-1b (Betaseron)

Interferon Gamma-1b (Actimmune)

Natalizumab (Tysabri)

Peg Interferon Alfa-2b (PEG-Intron)

Class: Immunosuppresive Agents

M.O.A: They act by suppressing cell-mediated immune reactions by binding

to immunophilins, bringing about inhibition of reactions that are required for the

synthesis of cytokines, including IL-2 and also inhibiting cellular responses to

these cytokines. Decrease in IL-2 (which is the primary chemical stimulus for

proliferation of T-lymphocytes) brings about decrease in the number of T-

lymphocytes.

Azathioprine (Imuran)

Basiliximab (Simulect)

Cyclosporine (Neoral, Sandimmune, NePO)

Daclizumab (Zenapax)

Everolimus (Afinitor, Zortress)

Lymphocyte Immune Globulin [Antithymocyte Globulin, ATG] -

(Atgam)

Muromonab-CD3 (Orthoclone OKT3)

Mycophenolic Acid (Myfortic)

Mycophenolate Mofetil (CellCept)

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Sirolimus (Rapamune)

Steroids, Systemic

Tacrolimus (Prograf, Protopic)

Class: Vaccines/Serums/Toxoids Cytomegalovirus Immune Globulin [CMV-IG IV] - (CytoGam)

Diphtheria, Tetanus Toxoids, & Acellular Pertussis Adsorbed, Hepatitis

B (recombinant), & Inactivated Poliovirus Vaccine (IPV) Combined -

(Pediarix)

Haemophilus B Conjugate Vaccine (ActHIB, HibTITER, PedvaxHIB,

ProHIBIt)

Hepatitis A Vaccine (Havrix, Vaqta)

Hepatitis A (Inactivated) & Hepatitis B Recombinant Vaccine (Twinrix)

Hepatitis B Immune Globulin (HyperHep, H-BIG)

Hepatitis B Vaccine (Engerix-B, Recombivax HB)

Human Papillomav irus (Types 6, 11, 16, 18) Recombinant Vaccine -

(Gardasil)

Immune Globulin, IV (Gamimune N, Sandoglobulin, Gammar IV)

Immune Globulin, Subcutaneous (Vivaglobin)

Influenza Vaccine (Fluarix, Flulaval, Fluzone, Fluvirin)

Influenza Virus Vaccine Live, Intranasal (FluMist)

Measles, Mumps, Rubella, and Varicella Virus Vaccine Live [MMRV] -

(ProQuad)

Meningococcal Conjugate Vaccine (Menactra)

Meningococcal Polysaccharide Vaccine (Menomune A/C/Y/W-135)

Pneumococcal 7-Valent Conjugate Vaccine (Prevnar)

Pneumococcal Vaccine, Polyvalent (Pneumovax-23)

Rotavirus Vaccine, live, oral, pentavalent (RotaTeq)

Tetanus Immune Globulin Tetanus Toxoid

Varicella Virus Vaccine (Varivax)

Zoster Vaccine, live (Zostavax)

MUSCULOSKELETAL AGENTS

Class: Antigout Agents

M.O.A: binds to the tubulin protein of microtubules and impairs their function

thereby inhibiting leukocyte migration and hence reduced inflammation.

Colchicine (Colcrys, Mitigare)

44 | P a g e

Class: Uricosuric

M.O.A: Uricosuric drugs act by decreasing the production of uric acid. This

reduces the concentration of uric acid in extracellular fluid, thereby preventing

precipitation of crystals in joints or elsewhere, and also by inhibiting active

transport of organic acids by renal tubules. Their main effect on the handling of

uric acid by the kidney is to prevent the reabsorption of filtered uric acid by the

proximal tubule, thus greatly increasing uric acid excretion.

Allopurinol (Zyloprim, Lopurin, Aloprim)

Probenecid (Benemid)

Sulfinpyrazone

Class: Muscle Relaxants

M.O.A: Inhibits interneuronal conduction and polysynaptic transmission

through spinal reflex arcs, via hyperpolarization of primary afferent fibre

terminals, which may result in muscle spasticity. This inhibition results in

relaxation of muscles.

Baclofen (Lioresal Intrathecal)

Carisoprodol (Soma)

Chlorzoxazone (Paraflex, Parafon Forte DSC)

Cyclobenzaprine (Flexeril)

Cyclobenzaprine, extended release (Amrix)

Dantrolene (Dantrium)

Diazepam (Valium)

Metaxalone (Skelaxin)

Methocarbamol (Robaxin)

Orphenadrine (Norflex)

Class: Neuromuscular Blockers

M.O.A: Non-depolarizing skeletal muscle relaxant; binds reversibly to

the post-synaptic nicotinic acetylcholine receptors on the motor end-plate,

competing with acetylcholine and thereby preventing end-plate depolarization

and blocking neuromuscular transmission

Atracurium (Tracrium)

Pancuronium (Pavulon)

Rocuronium (Zemuron)

Vecuronium (Norcuron)

Depolarising Skeletal Muscle relaxant; Also binds to the

acetylcholine receptors at the neuromuscular junction, but depolarizes motor

endplate at myoneural junction, which causes sustained flaccid skeletal muscle

paralysis; no effect on consciousness, pain.

Succinylcholine (Anectine, Quelicin, Sucostrin)

45 | P a g e

Miscellaneous Musculoskeletal Agents

Edrophonium (Tensilon, Enlon, Reversol)

Leflunomide (Arava)

Methotrexate (Rheumatrex)

OB/GYN AGENTS

Class: Contraceptives Copper IUD Contraceptive (ParaGard T 380A)

Drospirenone/Ethinyl Estradiol (YAZ)

Estradiol Cypionate & Medroxyprogesterone Acetate (Lunelle)

Etonogestrel Implant (Implanon)

Levonorgestrel intrauterine device (IUD) - (Mirena)

Etonogestrel/Ethinyl Estradiol (NuvaRing)

Levonorgestrel Implant (Norplant)

Levonorgestrel/Ethinyl Estradiol (Seasonale)

Medroxyprogesterone (Provera, Depo- Provera)

Norgestrel (Ovrette)

Oral Contraceptives, Monophasic

Oral Contraceptives, Multiphasic

Oral Contraceptives, Progestin Only

Oral Contraceptives, Extended-Cycle Combination

Emergency Contraceptives

Ethinyl Estradiol & Levonorgestrel (Preven)

Levonorgestrel (Plan B)

Estrogen Supplementation (Estrogen only) Drospirenone/Estradiol (Angelia)

Esterified Estrogens (Estratab, Menest)

Esterified Estrogens with Methyltestosterone (Estratest)

Estradiol (Estrace)

Estradiol gel (Elestrin)

Estradiol, Transdermal (Estraderm, Climara, Vivelle)

Estrogen, Conjugated (Premarin)

Estrogen, Conjugated-Synthetic (Cenestin, Enjuvia)

Esterified Estrogens (Estratab, Menest)

COMBINATION ESTROGEN/PROGESTIN

Esterified Estrogens withMethyltestosterone (Estratest, Estratest HS,

Syntest DS, HS)

Estrogen, Conjugated with Medroxyprogesterone (Prempro, Premphase)

46 | P a g e

Estrogen, Conjugated with Methylprogesterone (Premarin with

Methylprogesterone)

Estrogen, Conjugated with Methyltestosterone (Premarin with

Methyltestosterone)

Estradiol/Levonorgestrel, Transdermal (Climara Pro)

Estradiol/Norethindrone acetate (FemHRT, Activella)

Norethindrone Acetate/Ethinyl Estradiol (Ethinyl

Estradiol/Norethindrone Acetate)

Vaginal Preparations

Amino-Cerv pH 5.5 Cream

Lutrepulse

Miconazole (Monistat)

Nystatin (Mycostatin)

Terconazole (Terazol 7)

Tioconazole (Vagistat)

Miscellaneous Ob/Gyn Agents

Dinoprostone (Cervidil Vaginal Insert, Prepidil Vaginal Gel, Prostin E2)

Gonadorelin (Factrel)

Leuprolide (Lupron)

Lutropin Alfa (Luveris)

Magnesium Sulfate

Medroxyprogesterone (Provera, Depo-Provera)

Methylergonovine (Methergine)

Mifepristone [RU 486] (Mifeprex)

Oxytocin (Pitocin)

Terbutaline (Brethine, Bricanyl)

PAIN MEDICATIONS

Class: Local Anesthetics

M.O.A: They prevent generation/conduction of nerve impulses in peripheral

nerves by blocking sodium channels therby reducing sodium permeability and

increasing action of potential threshold. They depress small unmyelinated fibres

first and larger myelinated fibres last.

Benzocaine & Antipyrine (Auralgan)

Bupivacaine (Marcaine)

Capsaicin (Capsin, Zostrix)

Cocaine

Dibucaine (Nupercainal)

Lidocaine (Anestacon Topical, Xylocaine)

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Lidocaine & Prilocaine (EMLA, LMX)

Pramoxine (Anusol Ointment, Procto-Foam-NS)

Prilocaine (Citanest)

Ropivacaine

Tetracaine (Tetcaine)

Class: General Systemic Anesthetics

M.O.A: Short-acting, lipophilic sedative/hypnotic; causes global CNS

depression through agonist actions on GABAa/Cl- receptors.

Etomidate (Amidate)

Methohexital (Brevital)

Ketamine (Ketalar)

Propofol (Diprivan)

Thiopental

Class: Migraine Headache Medications

M.O.A: Blocks Prostanglandin synthesis and selectively agonizes 5-HT1

receptor, causing vasoconstriction and reducing inflammation associated with

antidronic neuronal transmission associated with Migraine.

Acetaminophen with Butalbital w/and w/o Caffeine (Fioricet, Medigesic,

Repan, Sedapap 10, Two-Dyne, Triapin, Axocet, Phrenilin Forte)

Almotriptan (Axert)

Aspirin & Butalbital Compound (Fiorinal)

Aspirin with Butalbital, Caffeine, & Codeine (Fiorinal with Codeine)

Eletriptan (Relpax)

Frovatriptan (Frova)

Naratriptan (Amerge)

Sumatriptan (Imitrex)

Zolmitriptan (Zomig)

Class: Narcotic Analgesics, Agonists

M.O.A: Opioid analgesic drugs work by agonist action at opioid receptors. The

sense of euphoria produced by strong opioids contributes to their analgesic

activity by helping to reduce the anxiety and stress associated with pain.

Acetaminophen with Codeine (Tylenol No. 3, 4)

Alfentanil (Alfenta)

Aspirin with Codeine (Empirin No. 2, 3, 4)

Buprenorphine (Buprenex)

Butorphanol (Stadol)

Codeine Fentanyl (Sublimaze)

Fentanyl Iontophoretic Transdermal System (Ionsys)

Fentanyl, Transdermal (Duragesic)

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Fentanyl, Transmucosal (Actiq, Fentora)

Heroin (Diacetylmorphine)

Hydrocodone & Acetaminophen (Lorcet, Vicodin, Hycet)

Hydrocodone & Aspirin (Lortab ASA)

Hydrocodone & Ibuprofen (Vicoprofen)

Hydromorphone (Dilaudid)

Levorphanol (Levo-Dromoran)

Meperidine (Demerol)

Methadone (Dolophine)

Morphine (Avinza XR, Duramorph, Infumorph, MS Contin, Kadian SR,

Oramorph SR, Palladone, Roxanol)

Morphine, Liposomal (DepoDur)

Nalbuphine (Nubain)

Oxycodone (OxyContin, OxyIR, Roxicodone)

Oxycodone & Acetaminophen (Percocet, Tylox)

Oxycodone & Aspirin (Percodan, Percodan-Demi)

Oxymorphone HCl (Opana, Opana ER)

Pentazocine (Talwin)

Propoxyphene (Darvon)

Propoxyphene & Acetaminophen (Darvocet)

Propoxyphene & Aspirin (Darvon Compound-65, Darvon-N with

Aspirin)

Class: Narcotic Analgesics, Antagonists

M.O.A: They act as competitive opioid receptor antagonists; congener of

oxymorphone.

Naloxone (Narcan, Evzio)

Naltrexone (ReVia, Vivitrol, Depade)

Nalmefene (Revix)

Class: Non-Narcotic Analgesics

M.O.A: Work peripherally to block pain impulse generation and inhibition of

ascending pain pathways.

Acetaminophen [APAP] - (Tylenol)

Aspirin (Bayer, Ecotrin, St. Joseph’s)

Tramadol (Ultram, Ultram ER)

Tramadol/Acetaminophen (Ultracet)

Class: Non-steroidal Anti-inflammatory Agents

M.O.A: They act by irreversibly inhibition, or competively inhibition or

reversibly-non-competive inhibition of the enzyme cyclooxygenase (COX-1,

COX-2) which is involved in the metabolism of arachidonic acid to form the

49 | P a g e

prostanoids, i.e. the classic prostaglandins, prostacyclin and thromboxane A2,

thereby producing three major clinical actions of analgesia, anti-inflammatory

action and an antipyretic action.

Celecoxib (Celebrex)

Diclofenac (Cataflam, Flector, Voltaren)

Diflunisal (Dolobid)

Etodolac

Fenoprofen (Nalfon)

Flurbiprofen (Ansaid, Ocufen)

Ibuprofen (Motrin, Rufen, Advil)

Indomethacin (Indocin)

Ketoprofen (Orudis, Oruvail)

Ketorolac (Toradol)

Meloxicam (Mobic)

Nabumetone (Relafen)

Naproxen (Aleve,

Naprosyn, Anaprox)

Oxaprozin (Daypro)

Piroxicam (Feldene)

Sulindac (Clinoril)

Tolmetin (Tolectin)

Miscellaneous Pain Medications

Amitriptyline (Elavil)

Imipramine (Tofranil)

Pregabalin (Lyrica)

Ziconotide (Prialt)

RESPIRATORY AGENTS

Class: Antitussives, Narcotic and Non-Narcotic Combos

M.O.A: These are drugs that act in the CNS to raise the threshold or suppress

the cough centre or act peripherally in the respiratory tract to reduce tussal

impulses, or both these actions.

Acetaminophen/doxylamine/dextromethorphan (Contac cold + Night

cooling relief)

Benzonatate (Tessalon Perles) - [Non-opiods]

Chlophedianol - [Non-opiods]

Codeine - [Opiods]

Codeine Dextromethorphan (Mediquell, Benylin DM, PediaCare 1)

Dextromethorphan (Balminil DM) - [Non-opioids]

Diamorphine – [Opiods]

Ethylmorphine - [Opiods]

50 | P a g e

Hydrocodone & Guaifenesin (Hycotuss Expectorant)

Hydrocodone & Homatropine (Hycodan, Hydromet)

Hydrocodone & Pseudoephedrine (Detussin, Histussin-D) Hydrocodone, Chlorpheniramine, Phenylephrine, Acetaminophen, &

Caffeine (Hycomine)

Menthol/Pectin (Sucrets Herbal Dry)

Phlocodeine - [Opiods]

Noscapine (Narcotine) – [Non-opioids]

Class: Decongestants

M.O.A: They are Alpha 1 Adrenergic agonist which stimulates the alpha-

adrenergic receptors in the nasal conjunctiva and arterioles to produce

vasoconstriction that results in decongestion.

Ephedrine (Akovaz, Corphedra)

Guaifenesin/pseudoehidrine (Mucinex D, Guaifenex PSE)

Naphazoline (Privine)

Otrivine

Oxymetazoline, Intranasal (Afrin, Duramist Plus)

Phenylephrine, PO (Contac D)

Phenylephrine, Intranasal (NeoSynephrine Nasal)

Propylhexedrine, Intranasal (Benzedrex)

Pseudoephedrine (Sudafed, Novafed, Afrinol)

Sodium Chloride, Intranasal (Ocean, Ayr Saline, HuMist)

Xylometazoline, Intranasal

Class: Expectorants

M.O.A: Expectorants (Mucokinetics) are drugs believed to increase bronchial

mucus secretion or reduce its viscosity, facilitating its removal by coughing.

Guaifenesin (Robitussin, Mucinex)

Acetylcysteine (Acetadote, Mucomyst)

Guaifenesin & Codeine (Robitussin AC, Brontex)

Guaifenesin & Dextromethorphan

Potassium Iodide (SSKI, Thyro-Block)

Class: Bronchodilators

Sub-Class I: B2 Agonist (β2-sympathomimetics)

M.O.A: They cause bronchodilatation through β2 receptor stimulation →

increased cAMP formation in bronchial muscle cell → relaxation. In addition,

increased cAMP in mast cells and other inflammatory cells decreases mediator

release.

Albuterol (AccuNeb, Proventil, Ventolin, Volmax)

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Albuterol & Ipratropium (Combivent Respimat)

Arformoterol (Brovana)

Celiprolol (Edsivo)

Ephedrine (Akovaz, Corphedra)

Formoterol (Foradil Aerolizer)

Indacaterol, Inhaled (Arcapta Neohaler)

Isoproterenol (Isuprel)

Levalbuterol (Xopenex, Xopenex HFA)

Metaproterenol (Alupent, Metaprel)

Pirbuterol (Maxair)

Salmeterol (Serevent, Serevent Diskus)

Terbutaline (Brethine, Bricanyl)

Vilanterol/Fluticasone Furoate, Inhalant (Breo Ellipta)

Sub-Class II: MethylXanthines

M.O.A: They act by releasing Ca2+ from sarcoplasmic reticulum, especially in

skeletal and cardiac muscle and Inhibition of phosphodiesterase (PDE) which

degrades cyclic nucleotides intracellularly. The concentration of cyclic

nucleotides is increased. Bronchodilatation, cardiac stimulation and

vasodilatation occur when cAMP level rises in the concerned cells.

Allopurinol (Zyloiprim, Aloprim)

Aminophylline (Theophylline derivative)

Dyphylline (Dilor, Lufyllin)

Epinephrine (Adrenalin, Sus-Phrine, EpiPen)

Theophylline (Theo24, TheoChron)

Sub-Class III: Anti-Cholinergics, Respiratory

M.O.A: These drugs cause bronchodilatation by blocking M3 receptor mediated

cholinergic constrictor tone; act primarily in the larger airways which receive

vagal innervation.

Aclidinium (Tudorza Pressair)

Glycopyrrolate (Cuvposa, Glycopyrronium)

Ipratropium (Atrovent, Atovent HFA)

Tiotropium (Spiriva HaniHaler, Spiriva Respimat)

Umeclidinium Bromide/Vilanterol (Anoro Elipta)

Class: Leukotriene Receptor Antagonists

M.O.A: They competitively antagonize cysLT1 receptor mediated

bronchoconstriction, airway mucus secretion, increased vascular permeability

and recruitment of eosinophils.

Montelukast (Singulair)

Zafirlukast (Accolate)

Zileuton (Zyflo)

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Class: Mucolytics

M.O.A: They breakdown acid-mucopolysaccharide fibres thereby making the

sputum thinner and less viscid and therefore more easily removed by coughing.

Acetylcysteine (N-acetylcysteine, Mucomyst)

Bromhexine

Broncholyte

Carbocisteine

Coflin linctus

Class: Glucocorticoids

M.O.A: Glucocorticosteroids are used in the treatment of asthma and in severe

exacerbations of COPD because of their potent anti-inflammatory effect. This

involves interaction with an intracellular glucocorticosteroid receptor that in turn

interacts with nuclear DNA, altering the transcription of many genes and thus the

synthesis of pro-inflammatory cytokines, β2-adrenoceptors, tachykinin-

degrading enzymes and lipocortin (an inhibitor of phospholipase A2, reducing

free arachidonic acid and thus leukotriene synthesis).

Hydrocortisone

Prednisolone

Predsilone

Class: Respiratory Inhalants Acetylcysteine (Acetadote, Mucomyst)

Beclomethasone (Beconase, Vancenase Nasal Inhaler)

Beclomethasone (QVAR)

Beractant (Survanta)

Budesonide (Rhinocort, Pulmicort)

Budesonide/formoterol (Symbicort)

Calfactant (Infasurf)

Cromolyn Sodium (Intal, Nasalcrom, Opticrom)

Dexamethasone, Nasal (Dexasone, Decadron)

Flunisolide (AeroBid, Aerospan, Nasarel)

Fluticasone, Oral, Nasal (Flonase, Flovent)

Fluticasone Propionate & Salmeterol Xinafoate (Advair Diskus, Advair

HFA)

Ipratropium (Atrovent HFA, Atrovent Nasal)

Nedocromil (Tilade)

Tiotropium (Spiriva)

Triamcinolone (Azmacort)

Miscellaneous Respiratory Agents

Alpha1-Protease Inhibitor (Prolastin)

Bennyllin expectorant

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Dornase Alfa (Pulmozyme, Dnase)

Nedocromil

Omalizumab (Xolair)

URINARY/GENITOURINARY AGENTS Alprostadil, Intracavernosal (Caverject, Edex)

Alprostadil, Urethral Suppository (Muse)

Ammonium Aluminum Sulfate [Alum]

Belladonna & Opium Suppositories (B & O Supprettes)

Bethanechol (Urecholine, Duvoid)

Darifenacin (Enablex)

Dimethyl Sulfoxide [DMSO] - (Rimso 50)

Flavoxate (Urispas)

Hyoscyamine (Anaspaz, Cystospaz, Levsin)

Methenamine (Hiprex, Urex)

Neomycin-Polymyxin Bladder Irrigant [Neosporin GU Irrigant]

Nitrofurantoin (Macrodantin, Furadantin, Macrobid)

Oxybutynin (Ditropan, Ditropan XL)

Oxybutynin Transdermal

System (Oxytrol)

Pentosan Polysulfate (Elmiron)

Phenazopyridine (Pyridium)

Potassium Citrate (Urocit-K)

Potassium Citrate & Citric Acid (Polycitra-K)

Solifenacin (VESIcare)

Sodium Citrate/Citric Acid (Bicitra)

Tadalafil (Cialis)

Tolterodine (Detrol, Detrol LA)

Trimethoprim (Trimpex, Proloprim)

Trospium Chloride (Sanctura)

Vardenafil (Levitra)

Drugs for erectile dysfunction Alprostadil (Caverject)

Sildenafil (Viagra)

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BENIGN PROSTATIC HYPERPLASIA MEDICATIONS Alfuzosin (Uroxatral)

Doxazosin (Cardura, Cardura XL)

Dutasteride (Avodart)

Finasteride (Proscar)

Tamsulosin (Flomax)

Terazosin (Hytrin)

WOUND CARE Becaplermin (Regranex Gel)

Silver Nitrate (Dey-Drop)

Miscellaneous Therapeutic Agents

Acamprosate (Campral)

Alglucosidase alfa (Myozyme)

Cilostazol (Pletal)

Drotrecogin Alfa (Xigris)

Eculizumab (Soliris)

Lanthanum Carbonate (Fosrenol)

Mecasermin (Increlex)

Megestrol Acetate (Megace)

Naltrexone (Depade, ReVia, Vivitrol)

Nicotine Gum (Nicorette)

Nicotine Nasal Spray (Nicotrol NS)

Nicotine, Transdermal (Habitrol, Nicoderm, Nicotrol)

Orlistat (Xenical, Alli [OTC])

Palifermin (Kepivance)

Potassium Iodide [Lugol Solution] - (SSKI, Thyro-Block)

Sevelamer (Renagel)

Sodium Polystyrene Sulfonate (Kayexalate)

Talc (Sterile Talc Powder)

Varenicline (Chantix)

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DRUGS USED TO TREAT HIV/AIDS

Class: Entry Inhibitors Enfuvirtide (Fuzeon)

M.O.A: Enfuvirtide is a fusion inhibitor. For HIV to gain entry into the host cell, it

must fuse its membrane with that of the host cell. This is accomplished by changes in

the conformation of the viral transmembrane glycoprotein gp41, which occurs when

HIV binds to the host cell surface. Enfuvirtide is a polypeptide that binds to gp41,

preventing the conformational change.

Maraviroc (Selzentry)

M.O.A: Maraviroc blocks the CCR5 coreceptor that works together with gp41 to

facilitate HIV entry through the membrane into the cell.

Class: Integrase Inhibitors

M.O.A: The integrase strand transfer inhibitors (INSTIs), often called

integrase inhibitors, work by inhibiting the insertion of proviral DNA into the

host cell genome. The active site of the integrase enzyme binds to the host cell

DNA and includes two divalent metal cations that serve as chelation targets for

the INSTIs. As a result, when an INSTI is present, the active site of the enzyme

is occupied and the integration process is halted.

Bictegravir

Dolutegravir (Tivicay)

Elvitegravir (Viteka)

Raltegravir (Isentress)

Dolutegravir/rilpivirine (Juluca)

Class: Reverse Transcriptase Inhibitors

a) Non-Nucleoside Reverse Transcriptase Inhibitors

M.O.A: NNRTIs are highly selective, noncompetitive inhibitors of HIV-1 RT. They

bind to HIV RT at an allosteric hydrophobic site adjacent to the active site, inducing a

conformational change that results in enzyme inhibition, thereby reducing viral DNA

production.

Delavirdine (Rescriptor)

Efavirenz (Sustiva, Stocrin)

Etravirine (Intelence)

Nevirapine (Viramune)

Rilpivirine (Edurant)

b) Nucleoside Reverse Transcriptase Inhibitors

M.O.A: NRTIs are analogs of native ribosides (nucleosides or nucleotides containing

ribose), which all lack a 3′-hydroxyl group. Once they enter cells, they are

phosphorylated by cellular enzymes to the corresponding triphosphate analog, which is

preferentially incorporated into the viral DNA by RT. Because the 3’-hydroxyl group

is not present, a 3’5′-phosphodiester bond between an incoming nucleoside

triphosphate and the growing DNA is diminished thereby reducing HIV-1 viral

replication.

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Abacavir (Ziagen)

Adefovir (Preveon, Hepsera)

Didanosine (Videx)

Emtricitabine (Emtriva)

Lamivudine (Epivir)

Stavudine (Zerit)

Tenofovir (Viread)

Zalcitabine (Hivid)

Zidovudine (Retrovir)

Class: HIV Protease Inhibitors

M.O.A: They are reversible inhibitors of the HIV aspartyl protease

(retropepsin), which is the viral enzyme responsible for cleavage of the viral

polyprotein into a number of essential enzymes (RT, protease, and integrase) and

several structural proteins. The inhibition prevents maturation of the viral

particles and results in the production of non-infectious virions.

Amprenavir (Agenerase)

Darunavir (Prezista)

Fosamprenavir (Lexiva)

Indinavir (Crixivan)

Lopinavir/ritonavir (Kaletra)

Nelfinavir (Viracept)

Ritonavir (Norvir)

Saquinavir (Invirase)

Tipranavir (Aptivus)

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NATURAL AND HERBAL AGENTS Aloe Vera Aloe barbadensis

Arnica (Arnica montana)

Butcher’s Broom (Ruscus aculeatus)

Bilberry Vaccinium myrtillus

Black Cohosh (Cimicifuga racemosa)

Bogbean Menyanthes trifoliate

Borage Borago officinalis

Bugleweed Lycopus virginicus

Capsicum Capsicum frutescens

Cascara Sagrada Rhamnus purshiana

Chamomile (Matricaria recutita)

Chondroitin Sulfate

Comfrey Symphytum officinale

Coriander Coriandrum sativum

Cranberry Vaccinium macrocarpon

Dong Quai (Angelica polymorpha, sinensis)

Echinacea (Echinacea purpurea)

Ephedra/Ma Huang

Evening Primrose Oil Oenothera biennis

Feverfew (Tanacetum parthenium)

Garlic (Allium sativum)

Gentian Gentiana lutea

Ginger (Zingiber officinale)

Ginkgo biloba

Ginseng (Panax quinquefolius)

Glucosamine Sulfate (chitosamine)

Green Tea Camellia sinensis

Guarana Paullinia cupana

Hawthorn (Crataegus laevigata)

Horsetail Equisetum arvense

Kava Kava (Piper methysticum)

Licorice (Glycyrrhiza glabra)

Melatonin (MEL)

Milk thistle (Silybum marianum)

Nettle Urtica dioica

Rue Ruta graveolens

Saw Palmetto (Serenoa repens)

Spirulina (Spirulina spp)

Stevia Stevia rebaudiana

St. John’s Wort (Hypericum perforatum)

Tea Tree (Melaleuca alternifolia)

Valerian (Valeriana officinalis)

Yohimbine (Pausinystalia yohimbe)

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REFERENCES

A Textbook of Clinical Pharmacology and Therapeutics (Fifth

Edition, @ 2008), James M Ritter, Lionel D Lewis,

Timothy GK Mant, Albert Ferro.

Basic and Clinical Pharmacology (14th Edition, @ 2018),

Betram G. Katzung

Clinical Pharmacy and Therapeutics (Sixth Edition, @ 2019),

Cate Whittlesea, Karen Hodson.

Crash Course Pharmacology (4th Edition, @ 2012), Elisabetta

Battista.

Essentials of Medical Pharmacology (Seventh Edition, @

2013), KD Tripathi.

Lippincott illustrated Reviews Pharmacology (Sixth Edition,

@ 2015), Karen Whalen, Richard Finkel, Thomas A.

Panavelil

Pharmacological Classification of Drugs (First Edition), Tariq

Ahmad, Department of Pharmacy, University of Lahore.

Principles of Pharmacology; the Pathophysiologic Basis of

Drug Therapy (Fourth Edition, @ 2017), David E. Golan,

Ehrin J. Armstrong, April W. Armstrong

Rang and Dale’s Pharmacology (Seventh Edition, @ 2012),

H. P. Rang, M. M. Dale, J. M. Ritter, R. J. Flower, G.

Henderson.

www.google.com/wikipedia