KC's Top 200 Generic / MOA Flashcards
(200 cards)
1
Q
Acyclovir
A
Competitive inhibition of viral DNA synthesis and replication - converted to acyclovir monophosphate by thymidine kinase, then to acyclovir triphosphate, which competes with deoxyguanosine triphosphate for viral DNA polymerase and incorporation into viral DNA
2
Q
Adalimumab
A
Recombinant human monoclonal antibodies bind to TNF with high affinity. Inhibits subsequent cytokine-driven inflammatory processes. Elevated TNF levels in the synovial fluid are involved in the pathologic pain and joint destruction in immune-mediated arthritis. Decreases s/s of psoriatic arthritis, RA, and ankylosing spondylitis. Inhibits progression of structural damage of RA and PA. Reduces s/s and maintains clinical remission in Crohn’s and UC; reduces epidermal thickness and inflammatory cell infiltration in plaque psoriasis.
3
Q
Albuterol (inhalation)
A
Albuterol is a short-acting beta-2 selective agonist - it activates beta-2 receptors resulting in increase of cyclic AMP, stimulating relaxation of smooth muscle; and produce bronchodilation by inhibiting the release of inflammatory mediators from mast cells and preventing microvascular leakage into the bronchial mucosa
4
Q
Albuterol / ipratropium
A
Synergistic bronchodilator effect: Beta-2 agonist - relaxes bronchial smooth muscle by action on beta-2 receptors with little effect on heart. Anti-cholinergic - blocks the action of acetylcholine at muscarinic receptors (M1-5) blocking the direct constrictor effects of ACh in bronchial smooth muscle causing bronchodilation (in airways-inhibition of M3 receptors)
5
Q
Alendronate
A
Inhibits osteoclast activity - decreases bone resorption, leading to an indirect increase in bone density; incorporates into the bone
6
Q
Allopurinol
A
Inhibits enzyme xanthine oxidase, which catalyzes final steps in uric acid synthesis
7
Q
Alprazolam
A
Benzodiazepines potentiate the actions of GABA by increasing the influx of chloride ions into neurons.
8
Q
Amitriptyline
A
Inhibits presynaptic reuptake of serotonin and norepinephrine
9
Q
Amlodipine
A
Dihydropyridine CCB - inhibits calcium from entering calcium channels leading to myocardial smooth muscle relaxation and vasodilation
10
Q
Amoxicillin
A
Inhibits bacterial cell wall synthesis by inhibiting transpeptidases (PBP)
11
Q
Amoxicillin / clavulanate potassium
A
Amoxicillin - inhibits bacterial cell wall synthesis by inhibiting transpeptidases (PBP); Clavulanate - binds and inhibits beta-lactamases
12
Q
Amphetamine / dextroamphetamine
A
Promotes the release of catecholamines DA and NE from presynaptic terminals; inhibits reuptake of DA and NE resulting in CNS stimulation
13
Q
Aripiprazole
A
Quinolone antipsychotic is a partial agonist at D2 and 5-HT1a receptors and an antagonist at 5-HT2a
14
Q
Aspirin/dipyridamole
A
Additive antiplatelet efffect: ASA irreversibly inhibits thromboxane A2 synthesis; Dipyridamole decrease platelet aggregation and activation by increasing endogenous concentrations of adenosine and cAMP, reducing the risk of arterial thrombus formation to prevent stroke
15
Q
Atenolol
A
Selective B-1 adrenergic agonist - competes with NE for binding to beta-1 receptors in the heart and kidneys, leading to decreased heart rate and blood pressure (_chronotropy, dromotropy, ionotropy in the heart)
16
Q
Atomoxetine
A
Selectively inhibits the reuptake of NE with little to no activity at the other neuronal reuptake pumps or receptor sites
17
Q
Atorvastatin
A
Competitively inhibit Hydroxymethylglutaryl-coenzyme A reductase to mevalonate, the rate-limiting step in cholesterol synthesis. LDL-receptors are upregulated, reducing plasma LDL.
18
Q
Azithromycin
A
Binds 50S ribosomal subunit impairing bacterial protein synthesis
19
Q
Beclomethasone (inhalation)
A
Inhaled corticosteroid: decrease number of inflammatory cells leading to decreased airway edema and hyper-responsiveness of smooth muscle, also inhibit mucus secretion in the airways.
20
Q
Benazapril
A
Angiotensin-converting enzyme inhibitor (ACE-i) - Suppresses the renin-angiotensin-aldosterone system. Inhibits the conversion of angiotensin I to angiotensin II, a potent vasoconstrictor. ACE-is indirectly inhibit fluid volume increases by inhibiting angiotensin II stimulated release of aldosterone.
21
Q
Bimatoprost (ophthalmic solution)
A
Prostaglandin analog - effectively reduces intraocular pressure by increasing aqueous humor outflow from the eye
22
Q
Brimonidine (ophthalmic solution)
A
Alpha-2 adrenergic agonist - effectively reduces intraocular pressure by increasing aqueous humor outflow from the eye, while decreasing aqueous humor formation
23
Q
Budesonide
A
Controls the rate of protein synthesis; depresses the migration of polymorphonuclear leukocytes, fibroblasts; reverses capillary permeability and lysosomal stabilization at the cellular level to prevent or control inflammation; potent glucocorticoid and weak mineralocorticoid activity
24
Q
Budesonide/ formoterol (inhalation)
A
Inhaled corticosteroid: decrease number of inflammatory cells leading to decreased airway edema and hyper-responsiveness of smooth muscle, also inhibit mucus secretion in the airways. Beta-2 agonist: binds beta-2 receptors on bronchial smooth muscle causing relaxation
25
Buprenorphine/ naloxone
\_Buprenorphine - partial agonist of mu-opioid receptors affecting ascending pain pathway \_Naloxone - opioid antagonist, displaces opioid analgesics from opioid receptors
26
Bupropion
Inhibits presynaptic reuptake of serotonin; also blocks histamine (H1) and alpha-1 adrenergic receptors
27
Buspirone
MOA is primarily unknown - has a high affinity for serotonin receptors and moderate affinity for dopamine type-2 receptors; this is thought to potentiate its anxiolytic and antidepressant effects
28
Carisoprodol
Exact mechanism is unknown - appears to promote release and/or inhibit reuptake of NE and serotonin, promoting inhibitory effects on alphs motor neurons in the spinal cord
29
Carvedilol
Nonselective beta-blocker with alpha-1 blockade
30
Celecoxib
Inhibits prostaglandin synthesis by decreasing activity of COX-2 enzymes, results in decreased formation of prostaglandin precursors associated with inflammation, fever and pain
31
Cephalexin
1st generation - inhibits bacterial cell wall syntesis by inhibiting transpeptidase (PBP)
32
Cetirizine
Reversibly and competitively antagonize H1 receptors peripherally, blocking the increased capillary permeability (edema/wheel formation) and itching caused by histamine release
33
Ciprofloxacin
Inhibits DNA gyrase, preventing DNA replication and transcription
34
Citalopram
Inhibits presynaptic reuptake of serotonin, increasing the concentration of serotonin in the synapse
35
Clindamycin
Binds to the 50S subunit of bacterial ribosomes, suppressing protein synthesis
36
Clonazepam
Benzodiazepines potentiate the actions of GABA by increasing the influx of chloride ions into neurons; clonazepam suppresses the spike-and-wave discharge in absence seizures by depressing nerve transmission in the motor cortex.
37
Clonidine
Stimulation of alpha-2 adrenergic receptors in the brain activates inhibitory neuron resulting in reduced sympathetic outflow from the CNS, producing a decrease in peripheral resistance, renal vascular resistance, heart rate, and blood pressure
38
Clopidogrel
Irreversibly inhibits ADP (P2Y12 component) receptors on platelet preventing GPIIb/IIIa activation and platelet aggregation
39
Colchicine
Unknown, but thought that colchicine bind to beta-tubulin causing depolymerization and preventing activation and migration of neutrophils associated with mediating some gout symptoms. Antiinflammatory props due to ability to decreae leukocyte motility, phagocytosis, and lactic acid production
40
Cyclobenzaprine
Exact mechanism is unknown - appears to promote release and/or inhibit reuptake of NE and serotonin, promoting inhibitory effects on alphs motor neurons in the spinal cord
41
Dabigatran
Reversibly inhibit coagulation by preventing thrombin-mediated effects such as cleavage of fibrinogen to fibrin monomers and thrombin-induces platelet aggregation
42
Desvenlafaxine
Inhibits presynaptic reuptake of serotonin and norepinephrine in the synaptic cleft; action on NE results in efficacy in neuropathic pain syndromes
43
Dexmethylphenidate
Promotes the release of catecholamines DA and NE from presynaptic terminals; inhibits reuptake of DA and NE resulting in CNS stimulation
44
Diazepam
Benzodiazepines potentiate the actions of GABA by increasing the influx of chloride ions into neurons.
45
Diclofenac
Inhibits prostaglandin synthesis by decreasing activity of COX-1 and COX-2 enzymes, results in decreased formation of prostaglandin precursors associated with inflammation and pain
46
Digoxin
Inhibits Na+/K+ ATPase, leading to an increase in the intracellular concentration of Na, this stimulating the Na+/Ca2+ exchange - increasing Ca2+ conc. leading to increased contractility; Enhances vagal tone to directly suppress AV node, which increases effective refractory period and decreases conduction velocity, resulting in decreased ventricular rate
47
Diltiazem
Inhibits the movement of calcium ions across the cell membranes, resulting in relaxation of coronary vascular smooth muscle, coronary vasodilation and decreased myocardial contractility.
48
Divalproex sodium
Structurally similar to GABA, but does not bind GABA receptors; binds presynaptic binding sites near voltage gated Ca channels affecting release of excitatory neurotransmitters
49
Donepezil
Reversibly and noncompetitively inhibits centrally-active acetylcholinesterase, resulting in increased concentrations of ACh available for synaptic transmission in the CNS
50
Dorzolamide/timolol (ophthalmic)
Dorzolamide: carbonic anhydrase inhibitor; timolol: non-selective beta antagonist
51
Doxazosin
Selectivey inhibit postsynaptic alpha-1 receptors resulting in dilation of both peripheral arterioles and veins
52
Doxycycline
Inhibit bacterial protein synthesis by reversibly binding to the 30S ribosomal subunit, resulting in bacteriostatic effect
53
Duloxetine
Inhibits presynaptic reuptake of serotonin and norepinephrine in the synaptic cleft; action on NE results in efficacy in neuropathic pain syndromes
54
Dutasteride
Competitively inhibit 5-alpha reductase in the prostate, liver, and skin, blocking the conversion of testosterone to dihydrotestosterone (DHT).
55
Efavirenz/ emtricitabine/ tenofovir
\_Efavirenz: NNRTI blocks the RNA-dep and DNA-dep DNA polymerase activities including HIV-1 replication. \_Emtricitabine and Tenofovir (TDF): NRTI interferes with HIV viral RNA-dep DNA polymerase resulting in viral replication inhibition.
56
Enalapril
Angiotensin-converting enzyme inhibitor (ACE-i) - Suppresses the renin-angiotensin-aldosterone system. Inhibits the conversion of angiotensin I to angiotensin II, a potent vasoconstrictor. ACE-is indirectly inhibit fluid volume increases by inhibiting angiotensin II stimulated release of aldosterone.
57
Enoxaparin
LMWH binds to antithrombin and accelerates antithrombin's ability to inhibit active clotting factor Xa and Iia
58
Ergocalciferol
Stimulates calcium and phosphate absorption from the small intestine and promotes secretion of calcium from bone to blood; also promotes renal tubule resorption of phosphorus
59
Escitalopram
Inhibits presynaptic reuptake of serotonin, increasing the concentration of serotonin in the synapse
60
Esomeprazole
Inhibits H+/K+ ATPase in gastic parietal cells suppressing gastric acid secretion
61
Estradiol (transdermal)
Controls pituitary release of gonadotropin, FSH, LH via negative feedback in postmenopausal women
62
Estrogens, conjugated/medroxyprogesterone
Controls pituitary release of gonadotropin, FSH, LH via negative feedback in postmenopausal women
63
Estrogens, conjugated
Controls pituitary release of gonadotropin, FSH, LH via negative feedback in postmenopausal women
64
Eszopiclone
Enhances activity of inhibitory neurotransmitter GABA via binding of benzodiazepine receptor, resulting in sedation
65
Etanercept
Etanercept is a recombinant DNA-derived protein composed of tumor necrosis factor receptor (TNFR) linked to the Fc portion of human IgG1. TNF blockers bind TNF-\_ and inhibits its interaction with cell surface receptors
66
Ethinyl estradiol/ drosperinone
Estrogen inhibits ovulation by inhibiting FSH and LH; progestin causes an inhospitable environment by inhibiting LH, which decreases the likelihood of sperm penetration and implantation
67
Ethinyl estradiol/ desogestrel
Estrogen inhibits ovulation by inhibiting FSH and LH; progestin causes an inhospitable environment by inhibiting LH, which decreases the likelihood of sperm penetration and implantation
68
Ethinyl estradiol/ norethindrone
Estrogen inhibits ovulation by inhibiting FSH and LH; progestin causes an inhospitable environment by inhibiting LH, which decreases the likelihood of sperm penetration and implantation
69
Ethinyl estradiol/ norgestimate
Estrogen inhibits ovulation by inhibiting FSH and LH; progestin causes an inhospitable environment by inhibiting LH, which decreases the likelihood of sperm penetration and implantation
70
Exenatide
Enhances glucose-dependent insulin secretion and decreases levels of circulating glucagon and hepatic glucose production
71
Ezetimibe
Inhibits cholesterol absorption at the brush border of the small intestine, leads to increased removal of cholesterol from blood
72
Ezetimibe/ simvastatin
\_See individual agents
73
Famotidine
Competitive inhibition of histamine at H2 receptors of the gastric parietal cells, which ultimately reduce gastric acid secretion
74
Fenofibrate
Fibrates lower TG by reduction of apolipoproteins B, C-III and E. They increase HDL cholesterol by increasing apolipoproteins A-I and A-II.
75
Fentanyl
Opioid analgesic - binds with stereospecific receptors at many sites within the CNS, increases pain threshhold, alters pain reception, inhibiting ascending pain pathways
76
Finasteride
Competitively inhibit 5-alpha reductase in the prostate, liver, and skin, blocking the conversion of testosterone to dihydrotestosterone (DHT).
77
Fluoxetine
Inhibits presynaptic reuptake of serotonin, increasing the concentration of serotonin in the synapse
78
Fluticasone (inhalation)
Inhaled corticosteroid: decrease number of inflammatory cells leading to decreased airway edema and hyper-responsiveness of smooth muscle, also inhibit mucus secretion in the airways.
79
Fluticasone (nasal)
Decreases number of inflammatory mediators, reverse dilatation and increase vessel permeability in the area, resulting iin decreased entry of cells to the sites of damage to reduce or control inflammation
80
Fluticasone/ salmeterol
Inhaled corticosteroid: decrease number of inflammatory cells leading to decreased airway edema and hyper-responsiveness of smooth muscle, also inhibit mucus secretion in the airways. Beta-2 agonist: binds beta-2 receptors on bronchial smooth muscle causing relaxation
81
Furosemide
Inhibits Na reabsorption at the Na+/K+ 2Cl- symporter in the ascending loop of Henle, leading to diuresis; can reduce preload
82
Gabapentin
Structurally similar to GABA, but does not bind GABA receptors; binds presynaptic binding sites near voltage gated Ca channels affecting release of excitatory neurotransmitters
83
Glimeperide
Binds to sulfonylurea receptor on pancreatic beta cells, stimulating glucose-independent insulin release
84
Glipizide
Binds to sulfonylurea receptor on pancreatic beta cells, stimulating glucose-independent insulin release
85
Guaifenesin
Stimulates respiratory tract secretions, reducing the viscosity and surface tension of mucus. Guaifenesin inhibits cough reflex sensitivity in those with upper respiratory infections.
86
Hydralazine
Causes direct vasodilation of arterioles (with little effect on veins), resulting in decreased systemic vascular resistance
87
Hydrochlorothiazide
Thiazide diuretic - inhibits reabsoprtion of Na+/Cl- symporter in the distal tubules resulting in increased urinary excretion of Na+ and Cl-
88
Hydrochlorothiazide/triamterene
\_Thiazide diuretic - inhibits reabsoprtion of Na+/Cl- symporter in the distal tubules resulting in increased urinary excretion of Na+ and Cl- \_Triamterene blocks epithelial Na+ channels in the late distal convoluted tubule and collecting duct, inhibiting Na+ reabsorption from the lumen - reduces intracellular Na+, decreasing function of Na+/K+ ATPase, leading to potassium retention and decreased Ca, Mg and H+ excretion.
89
Hydrochlorothiazide/ valsartan
Thiazide diuretic/angiotensin II receptor blocker (ARB) \_See individual agents
90
Hydrocodone/ acetaminophen
Narcotic binds mu-opioid receptor (agonist), altering the perception and response to pain centrally and peripherally
91
Hydroxyzine
Reversibly and competitively antagonize H1 receptors peripherally and centrally, blocking the increased capillary permeability (edema/wheel formation) and itching caused by histamine release
92
Ibandronate
Inhibits osteoclast activity - decreases bone resorption, leading to an indirect increase in bone density; incorporates into the bone
93
Ibuprofen
Inhibits prostaglandin synthesis by decreasing activity of COX-1 and COX-2 enzymes, results in decreased formation of prostaglandin precursors associated with inflammation and pain
94
Insulin, aspart
Mimics action of endogenous insulin by stimulating peripheral glucose uptake, inhibiting hepatic glucose production and regulating glucose metabolism
95
Insulin, detemir
Mimics action of endogenous insulin by stimulating peripheral glucose uptake, inhibiting hepatic glucose production and regulating glucose metabolism
96
Insulin, glargine
Mimics action of endogenous insulin by stimulating peripheral glucose uptake, inhibiting hepatic glucose production and regulating glucose metabolism
97
Insulin, lispro
Mimics action of endogenous insulin by stimulating peripheral glucose uptake, inhibiting hepatic glucose production and regulating glucose metabolism
98
Insulin, regular
Mimics action of endogenous insulin by stimulating peripheral glucose uptake, inhibiting hepatic glucose production and regulating glucose metabolism
99
Irbesartan
Angiotensin II receptor blocker (ARB) - Suppresses the renin-angiotensin-aldosterone system. Inhibits binding of angiotensin II to the AT1 receptor, therefore inhibiting the effects of angiotensin II (a potent vasoconstrictor that promotes the release of aldosterone, and causes sodium and water retention)
100
Isosorbide mononitrate
Relax vascular smooth muscle by stimulating intracellular cyclic guanosine monophosphate production causing predominantly venous dilation with some dose-dependent arterial effects
101
Lamotrigine
Structurally similar to GABA, but does not bind GABA receptors; binds presynaptic binding sites near voltage gated Ca channels affecting release of excitatory neurotransmitters
102
Lansoprazole
Inhibits H+/K+ ATPase in gastic parietal cells suppressing gastric acid secretion
103
Latanoprost (ophthalmic solution)
Prostaglandin analog - effectively reduces intraocular pressure by increasing aqueous humor outflow from the eye
104
Levalbuterol (inhalation)
Levalbuterol is the active R-isomer of albuterol - a short-acting beta-2 selective agonist - it activates beta-2 receptors resulting in increase of cyclic AMP, stimulating relaxation of smooth muscle; and produce bronchodilation by inhibiting the release of inflammatory mediators from mast cells and preventing microvascular leakage into the bronchial mucosa
105
Levetiracetam
Structurally similar to GABA, but does not bind GABA receptors; binds presynaptic binding sites near voltage gated Ca channels affecting release of excitatory neurotransmitters
106
Levofloxacin
Inhibits DNA gyrase, preventing DNA replication and transcription
107
Levothyroxine
Levothyroxine (T4) is the synthetic form of thyroxine, an endogenous hormone secreted by the thyroid gland. T4 is converted to T3, its active metabolite. T3 and T4 bind to thyroid receptor proteins in the cell nucleus and exert metabolic effects through control of DNA transcription and protein synthesis, involved in normal metabolism, growth and development, promotes gluconeogenesis, increases utilization and mobilization of glycogen stores, and stimulates protein synthesis, increases basal metabolic rate
108
Liraglutide
Enhances glucose-dependent insulin secretion and decreases levels of circulating glucagon and hepatic glucose production
109
Lisdexamfetamine
Promotes the release of catecholamines DA and NE from presynaptic terminals; inhibits reuptake of DA and NE resulting in CNS stimulation
110
Lisinopril
Angiotensin-converting enzyme inhibitor (ACE-i) - Suppresses the renin-angiotensin-aldosterone system. Inhibits the conversion of angiotensin I to angiotensin II, a potent vasoconstrictor. ACE-is indirectly inhibit fluid volume increases by inhibiting angiotensin II stimulated release of aldosterone.
111
Lisinopril/ hydrochlorothiazide
Angiotensin-converting enzyme inhibitor (ACE-i) / thiazide diuretic \_See individual agents
112
Lorazepam
Benzodiazepines potentiate the actions of GABA by increasing the influx of chloride ions into neurons.
113
Losartan
Angiotensin II receptor blocker (ARB) - Suppresses the renin-angiotensin-aldosterone system. Inhibits binding of angiotensin II to the AT1 receptor, therefore inhibiting the effects of angiotensin II (a potent vasoconstrictor that promotes the release of aldosterone, and causes sodium and water retention)
114
Losartan/ hydrochlorothiazide
Angiotensin II receptor blocker (ARB)/thiazide diuretic \_See individual agents
115
Lovastatin
Competitively inhibit Hydroxymethylglutaryl-coenzyme A reductase to mevalonate, the rate-limiting step in cholesterol synthesis. LDL-receptors are upregulated, reducing plasma LDL.
116
Meloxicam
Inhibits prostaglandin synthesis by decreasing activity of COX-1 and COX-2 enzymes, results in decreased formation of prostaglandin precursors associated with inflammation and pain
117
Memantine
Blocks NMDA receptors by preventing excessive excitation by glutamate-induced Ca influx
118
Mesalamine
The active component of sulfasalazine; specific MOA is unknown; it is thought that mesalamine modulates local chemical mediators of the inflammatory response, especially leukotrienes, and is also postulated to be a free radical scavenger or an inhibitor of tumor necrosis factor (TNF); action appears topical rather than systemic
119
Metformin
Biguanide - inhibits hepatic glucose production, decreases intestinal glucose absorption and improves insulin sensitivity
120
Methocarbamol
Exact mechanism is unknown - appears to promote release and/or inhibit reuptake of NE and serotonin, promoting inhibitory effects on alphs motor neurons in the spinal cord
121
Methotrexate
Inhibits DNA synthesis, repair and cellular replication by irreversibly binding to and inhibiting dihydrofolate reductase, inhibiting the formation of reduced folates, and thymidylate synthetase, resulting in inhibition of purine and thymidylic acid synthesis
122
Methylphenidate
Promotes the release of catecholamines DA and NE from presynaptic terminals; inhibits reuptake of DA and NE resulting in CNS stimulation
123
Methylprednisolone
Binds to nuclear glucocorticoid receptors leading to gene transcription of factors responsible for antiinflammatory, antitumor, antiemetic, immunosuppressive effects, also adrenal suppression at high doses
124
Metoprolol
Selective B-1 adrenergic agonist - competes with NE for binding to beta-1 receptors in the heart and kidneys, leading to decreased heart rate and blood pressure (\_chronotropy, dromotropy, ionotropy in the heart)
125
Metronidazole
After diffusing into organism, metronidazole interacts with DNA to cause a loss of helical DNA structure and strand breakage, resulting in the inhibition of protein synthesis and cell death in susceptible organisms
126
Mirtazapine
Tetracyclic antidepressant has alpha-2 antagonist effects resulting in increased release of NE and serotonin; also potent 5HT-2, 5HT-3 and H1 receptor antage and moderate alpha-1 and muscarinic antag. It does not inhibit reuptake of NE or serotonin
127
Modafinil
Promotes the release of catecholamines DA and NE from presynaptic terminals; inhibits reuptake of DA and NE resulting in CNS stimulation
128
Mometasone (inhalation)
Inhaled corticosteroid: decrease number of inflammatory cells leading to decreased airway edema and hyper-responsiveness of smooth muscle, also inhibit mucus secretion in the airways.
129
Mometasone (nasal)
Decreases number of inflammatory mediators, reverse dilatation and increase vessel permeability in the area, resulting iin decreased entry of cells to the sites of damage to reduce or control inflammation
130
Montelukast
Selectively block leukotriene receptors in airways, decreasing airway edema, relaxing smooth muscles and inhibiting inflammatory responses
131
Morphine
Narcotic binds mu-opioid receptor (agonist), altering the perception and response to pain centrally and peripherally
132
Moxifloxacin
Inhibits DNA gyrase, preventing DNA replication and transcription
133
Mupirocin (topical)
Reversibly and specifically binds to the bacterial isoleucine transfer RNA synthetase, inhibiting bacterial protein and RNA synthesis. Bacteriostatic at low concentrations and bactericidal at high concentrations
134
Naproxen
Inhibits prostaglandin synthesis by decreasing activity of COX-1 and COX-2 enzymes, results in decreased formation of prostaglandin precursors associated with inflammation and pain
135
Nebivolol
Selective B-1 adrenergic agonist - competes with NE for binding to beta-1 receptors in the heart and kidneys, leading to decreased heart rate and blood pressure (\_chronotropy, dromotropy, ionotropy in the heart) Nebivolol also produces an endothelium-derived nitric oxide-dependent vasodilation resulting in a reduction of systemic vascular resistance.
136
Nifedipine
Dihydropyridine CCB - inhibits calcium from entering calcium channels leading to myocardial smooth muscle relaxation and vasodilation
137
Nitroglycerin (sublingual)
Relax vascular smooth muscle by stimulating intracellular cyclic guanosine monophosphate production causing predominantly venous dilation with some dose-dependent arterial effects
138
Olanzapine
2nd gen thienobenzodiazepine antipsychotic inhibits DA, serotonin, histamine and alpha-ad receptors
139
Olmesartan
Angiotensin II receptor blocker (ARB) - Suppresses the renin-angiotensin-aldosterone system. Inhibits binding of angiotensin II to the AT1 receptor, therefore inhibiting the effects of angiotensin II (a potent vasoconstrictor that promotes the release of aldosterone, and causes sodium and water retention)
140
Olmesartan/ hydrochlorothiazide
Angiotensin II receptor blocker (ARB)/ thiazide diuretic \_See individual agents
141
Olopatadine (ophthalmic solution)
Block the effects of histamine by selectively blocking H1 receptors; also exhibit mast cell-stabilizing properties, preventing mast cell degranulation, which is the first step in the allergy cascade
142
Omega-3-acid ethyl esters
Decreases fatty acid esterification in TG synthesis; increases lipoprotein lipase to enhance clearance of VLDL/TG. Other possible mechanisms include inhibition of Acyl CoA:1,2-diacyl-glycerol acyltransferase, increased hepatic beta-oxidation, a reduction in the hepatic synthesis of triglycerides, or an increase in plasma lipoprotein lipase activity
143
Omeprazole
Inhibits H+/K+ ATPase in gastic parietal cells suppressing gastric acid secretion
144
Ondansetron
Blocks serotonin, both peripherally on vagal nerve terminals and centrally in the chemoreceptor trigger zone
145
Oxcarbazepine
Structurally similar to GABA, but does not bind GABA receptors; binds presynaptic binding sites near voltage gated Ca channels affecting release of excitatory neurotransmitters
146
Oxybutynin
Inhibit the action of Ach on muscarinic receptors in the detrusor smooth muscle of the overactive bladder, resulting in increased bladder capacity, decreased bladder contractions, decreased detrusor muscle pressure and decreased bladder irritability
147
Oxycodone
Narcotic binds mu-opioid receptor (agonist), altering the perception and response to pain centrally and peripherally
148
Oxycodone/ acetaminophen
Narcotic binds mu-opioid receptor (agonist), altering the perception and response to pain centrally and peripherally
149
Pantoprazole
Inhibits H+/K+ ATPase in gastic parietal cells suppressing gastric acid secretion
150
Paroxetine
Inhibits presynaptic reuptake of serotonin, increasing the concentration of serotonin in the synapse
151
Phentermine
Stimulates CNS and elevates blood pressure. (structurally related to the amphetamines) Mechanism for treating obesity is unknown.
152
Pioglitazone
Increase insulin sensitivity by agonist of nuclear PPAR-gamma receptors which decrease insulin resistance in adipose tissue, skeletal muscle and the iiver
153
Potassium chloride
Major intracellular cation required for nerve conduction, muscle contraction, acid-base balance, gastric acid formation and renal exchange
154
Pravastatin
Competitively inhibit Hydroxymethylglutaryl-coenzyme A reductase to mevalonate, the rate-limiting step in cholesterol synthesis. LDL-receptors are upregulated, reducing plasma LDL.
155
Prednisone
Binds to nuclear glucocorticoid receptors leading to gene transcription of factors responsible for antiinflammatory, antitumor, antiemetic, immunosuppressive effects, also adrenal suppression at high doses
156
Pregabalin
Structurally similar to GABA, but does not bind GABA receptors; binds presynaptic binding sites near voltage gated Ca channels affecting release of excitatory neurotransmitters
157
Promethazine
Non-selectively antagonizes H1 receptors and block vasodepressor response to histamine.
158
Propranolol
Nonselective beta-blocker - competitively blocks response to beta-1 and beta-2 ad stimulation, which results in decreases in heart rate, myocardial contractility, blood pressure, and myocardial oxygen demand. Also reduce portal pressure by producing splanchnic vasoconstriction (beta2 effect) thereby reducing portal blood flow.
159
Quetiapine
Antagonist of serotonin and dopamine, as well as histamine and other alpha-ad receptors
160
Quinapril
Angiotensin-converting enzyme inhibitor (ACE-i) - Suppresses the renin-angiotensin-aldosterone system. Inhibits the conversion of angiotensin I to angiotensin II, a potent vasoconstrictor. ACE-is indirectly inhibit fluid volume increases by inhibiting angiotensin II stimulated release of aldosterone.
161
Rabeprazole
Inhibits H+/K+ ATPase in gastic parietal cells suppressing gastric acid secretion
162
Ramipril
Angiotensin-converting enzyme inhibitor (ACE-i) - Suppresses the renin-angiotensin-aldosterone system. Inhibits the conversion of angiotensin I to angiotensin II, a potent vasoconstrictor. ACE-is indirectly inhibit fluid volume increases by inhibiting angiotensin II stimulated release of aldosterone.
163
Ranitidine
Competitive inhibition of histamine at H2 receptors of the gastric parietal cells, which ultimately reduce gastric acid secretion
164
Ranolazine
MOA is not clearly understood, but appears to inhibit the late Na+ current, preventing Ca2+ overload and ultimately blunting the effects of ischemia by improving myocardial function and perfusion
165
Risperidone
Benzisoxasole atypical antipsychotic - Antagonist of serotonin and dopamine, as well as histamine and other alpha-ad receptors
166
Rituximab
Causes a transient depletion of B-cell lymphocytes by binding to the CD20 surface antigens on tumor cells
167
Rivaroxaban
Selectively and reversibly inhibit active clotting factor Xa without the use of antithrombin
168
Rivastigmine
Increases acetylcholine in the central nervous system through reversible inhibition of its hydrolysis by cholinesterase
169
Rizatriptan
Selective agonist for serotonin in cranial arteries; causes vasoconstriction and reduces sterile inflammation associated with antidromic neuronal transmission correlating with relief of migraine
170
Ropinirole
Stimulation of post-synaptic D2-receptors in the caudate putamen in the brain. Ropinirole causes decreases in systolic and diastolic pressures.
171
Rosuvastatin
Competitively inhibit Hydroxymethylglutaryl-coenzyme A reductase to mevalonate, the rate-limiting step in cholesterol synthesis. LDL-receptors are upregulated, reducing plasma LDL.
172
Saxagliptin
Dipeptidyl Peptidase 4 (DPP-4) inhibitor
173
Sertraline
Inhibits presynaptic reuptake of serotonin, increasing the concentration of serotonin in the synapse
174
Sildenafil
PDE-5 inhibitor - breaks down cGMP, which is responsible for smooth muscle relaxation and influx of blood in the corpus cavernosum
175
Simvastatin
Competitively inhibit Hydroxymethylglutaryl-coenzyme A reductase to mevalonate, the rate-limiting step in cholesterol synthesis. LDL-receptors are upregulated, reducing plasma LDL.
176
Sitagliptin
Dipeptidyl Peptidase 4 (DPP-4) inhibitor
177
Sitagliptin/ metformin
Dipeptidyl Peptidase 4 (DPP-4) inhibitor/biguanide \_See individual agents
178
Solifenacin
Inhibit the action of Ach on muscarinic receptors in the detrusor smooth muscle of the overactive bladder, resulting in increased bladder capacity, decreased bladder contractions, decreased detrusor muscle pressure and decreased bladder irritability
179
Spironolactone
Competitively inhibits aldosterone receptor sites in the distal tubule, increasing sodium chloride and water excretion while conserving potassium and hydrogen ions; may also block the effect of aldosterone on arteriolar smooth muscle
180
Sulfamethoxazole/ trimethoprim
\_SMX impairs folic acid synthesis via inhibiting PABA. \_TMP inhibits folic acid synthesis by inhibiting DHFR
181
Tadalafil
PDE-5 inhibitor - breaks down cGMP, which is responsible for smooth muscle relaxation and influx of blood in the corpus cavernosum
182
Tamsulosin
Blocks alpha-1a receptors in the prostate leading to relaxation of smooth muscle in bladder neck and prostate, which improves urinary flow and symptoms of BPH
183
Temazepam
Benzodiazepines potentiate the actions of GABA by increasing the influx of chloride ions into neurons.
184
Testosterone
Principal endogenous androgen responsible for promoting the growth and development of the male sex organs and maintaining secondary sex characteristics in androgen-deficient males
185
Thyroid
Levothyroxine (T4) is the synthetic form of thyroxine, an endogenous hormone secreted by the thyroid gland. T4 is converted to T3, its active metabolite. T3 and T4 bind to thyroid receptor proteins in the cell nucleus and exert metabolic effects through control of DNA transcription and protein synthesis, involved in normal metabolism, growth and development, promotes gluconeogenesis, increases utilization and mobilization of glycogen stores, and stimulates protein synthesis, increases basal metabolic rate
186
Tiotropium
Inhibits the action of acetylchloine in bronchial smooth muscle, causing bronchodilation
187
Tizanidine
Exact mechanism is unknown - appears to promote release and/or inhibit reuptake of NE and serotonin, promoting inhibitory effects on alphs motor neurons in the spinal cord
188
Tolterodine
Inhibit the action of Ach on muscarinic receptors in the detrusor smooth muscle of the overactive bladder, resulting in increased bladder capacity, decreased bladder contractions, decreased detrusor muscle pressure and decreased bladder irritability
189
Topiramate
Structurally similar to GABA, but does not bind GABA receptors; binds presynaptic binding sites near voltage gated Ca channels affecting release of excitatory neurotransmitters
190
Tramadol
Narcotic binds mu-opioid receptor (agonist) inhibiting the ascending pain pathways and altering the perception and response to pain; also inhibits the reuptake of NE and 5-HT in the descending inhibitory pain pathway
191
Travoprost (ophthalmic)
Prostaglandin analog - effectively reduces intraocular pressure by increasing aqueous humor outflow from the eye
192
Trazodone
Inhibits presynaptic reuptake of serotonin; also blocks histamine (H1) and alpha-1 adrenergic receptors
193
Triamcinolone
Binds to nuclear glucocorticoid receptors leading to gene transcription of factors responsible for antiinflammatory and immunosuppressive effects
194
Valacyclovir
Competitive inhibition of viral DNA synthesis and viral replication - Valacyclovir is rapidly converted to acyclovir by intestinal and hepatic metabolism -\> acyclovir monophosphate by thymidine kinase -\> acyclovir triphosphate, competes with deoxyguanosine triphosphate for viral DNA polymerase and being incorporated into viral DNA
195
Valsartan
Angiotensin II receptor blocker (ARB) - Suppresses the renin-angiotensin-aldosterone system. Inhibits binding of angiotensin II to the AT1 receptor, therefore inhibiting the effects of angiotensin II (a potent vasoconstrictor that promotes the release of aldosterone, and causes sodium and water retention)
196
Vardenafil
PDE-5 inhibitor - breaks down cGMP, which is responsible for smooth muscle relaxation and influx of blood in the corpus cavernosum
197
Venlafaxine
Inhibits presynaptic reuptake of serotonin and norepinephrine in the synaptic cleft; action on NE results in efficacy in neuropathic pain syndromes
198
Verapamil
Inhibits the movement of calcium ions across the cell membranes, resulting in relaxation of coronary vascular smooth muscle, coronary vasodilation and decreased myocardial contractility.
199
Warfarin
Inhibits the activation of vitamin K-dependent clotting factors II, VII, IX and X, thereby increasing the time it takes for blood to clot
200
Zolpidem
Enhances activity of inhibitory neurotransmitter GABA via binding of benzodiazepine receptor, resulting in sedation
