Musculoskeletal Module Drug Lists

• Salicylates
• Propionic Acid Derivatives
• Acetic Acid Derivatives
• Indole Derivatives
• Oxicams
• Coxibs

• Aspirin: irreversible COX inhibition
• Sulfasalazine: COX inhibition, esp. ulcerative colitis and Crohn's disease

• Flurbiprofen: nonselective COX, TNF-α, NO
• Ibuprofen: nonselective COX, close ductus arteriosus; dental
• Naproxen: nonselective COX
• Oxaprozin: more useful in gout
• (all end in -en/-in)

• Diclofenac: nonselective COX, low level LOX; pre/post op use
• Ketorolac: nonselective COX; analgesic to replace/reduce opioids
• Sulindac: sulfoxide pro-drug/sulfide metabolite
• (ACetic ACid - "-ac" suffix)

Indomethacin: potent nonselective COX; gout, postlaminectomy syndrome, close ductus arteriosus

• Meloxicam: highly selective COX-2, TXA₂
• Piroxicam: nonselective COX; high peptic ulcer bleed risk

Celecoxib: Highly selective COX-2; black box for cardiovascular

Acetominophen: potent CNS COX with little peripheral effect; NAPQI buildup

• Short to medium acting
• Intermediate acting
• Long acting

• Cortisone
• Hydrocortisone
• Methylprednisolone
• Prednisolone
• Prednisone

Triamcinolone (acetonide/hexacetonide)

• Betamethasone
• Dexamethasone

• Against circulating antibodies
• Miscellaneous
• Cytotoxic Drugs

• Infliximab: human/mouse TNF-α IgG
• Adalimumab: human TNF-α IgG; black box for opportunistic infection
• Etanercept: human recomb TNF receptor
• Anakinra: human recomb IL-1 receptor antagonist

• Penecillamine: unknown MOA; marrow suppression
• Hydroxychloriquine: stops WBC action
• Sulfasalazine: COX block, PG downreg for Crohn's, ulcerative colitis

• Methyltrexate: mimics folate
• Azathioprine: PPRP synthetase/aminotransferase block
• Leflunomide: dihydroorate dehydrogenase (rate-limiting enzyme)
• Cyclosporine: calcineurin blockade (no IL-2)

• Acute gout
• Acute gouty attack
• Chronic gout

• NSAIDs: ibuprofen, indomethacine
• Glucocorticoids: prednisone

• Cochicine: inhibition of leuk migration (binds microtubules)
• Indomethacine: potent NSAID

• Uricosurics: probenecid, sulphinpyrazone (both inhibit PCT reabs of urate)
• Xanthine Oxidase Inhibitors: allopurinol

• Motor end plate activity (depolarizing and non-depolarizing)
• Spasmolytics (hit CNS synapses in spinal cord, cortex)
• Other relaxants

• Tubocurarine: slow on, long off; no metab; high dose Nn block; drop BP; raise HR, histamine
• Pancuronium: quick on, long off; 25% liver metab; moderate M2 block; raise BP, HR
• Rocuronium: quick on, medium/long off; liver metab
• Vecuronium: slow on, medium off; liver metab; good for hypertension (only endplate activity)
• Atracurium: medium on, medium off; esterase metab; drop BP; slight histamine
• Mivacarium: quick on, quick off; cholinesterase metab; drop BP; slight histamine
• Cisatracurium

Succinyl choline: very quick on, very quick off; cholinesterase metab; Nn and M2 stim; Raise BP, HR; slight histamine

• Diaz-/lorazepam: increase Gaba-A aff to receptor, increasing Cl^- channel opening λ (peripheral)
• Baclofen: Gaba-B receptor (G_i) agonist, blocks neurotransmitter release (central)
• Tizanidine: α2 agonist for cerebral/spinal disorders
• Gabapentin: decreases presynaptic excitatory AP; tonic-clonic seizures

• Dantrolene: blocks RyR, good for cerebral palsy, paralytics, malig hyperthermia, neuroleptic malignant syndrome, and serotonin syndrome
• Botulinum toxin: blocks Ach release from pre-synaptic neuron