-
Servent (salmeterol)
Foradil (formoterol)*
Oxese (formoterol)*
*2 uses
Long Acting B2 adrenergics (LABA)
Controller-bronchodilator (asthma)
"2nd line" therapy
*Can also be used as a reliever due to short onset of action
-
Theodur or Uniphyl (theophylline)
Phyllocontin (aminophylline)
Methylxanthine
Controller-bronchodilator (asthma/COPD)
"4th line" therapy
-
Advair (servent + fluticasone)
Combination LABA + ICS
Controller-bronchodilator (asthma/COPD)
-
Symbicort (formoterol + budesonide)
Combination LABA + ICS
Controller- bronchodilator (asthma/COPD)
-
Combivent (salbutamol + ipratropium)
Combination SABA + SAAM
Controller or reliever-bronchodilator (asthma)
-
Deltasone (prednisone)
Cortef or solu-cortef (hydrocortisone)
Solu-medrol (methylprednisolone)
Pediapred (Prednisolone)
Decadron (dexamthasone)
- Systemic corticosteroids (CS)
controller, anti-inflammatory (asthma/COPD)
*used for acute exacerbations or control of refractory asthma or COPD. Used to treat inflammation systemically
-
Flovent (fluticasone)
Qvar (beclomethasone)
Inhaled corticosteroids (ICS)
Controller, anti-inflammatory (Asthma/COPD)
"1st line" therapy
-
Pulmicort (budesonide)
Alvesco (ciclesonide)
Inhaled corticosteroids (ICS)
Controller, anti-inflammatory (Asthma/COPD)
"1st line" therapy
-
Accolate (Zafirlukast)
Singulair (montelukast)
Leukotriene receptor antagonist (LTRA)
controller-leukotriene antagonist (asthma)
"3rd line" therapy
-
Flonase (fluticasone)
intranasal corticosteroid
controller, anti-inflammatory (asthma)
-
Ventolin (salbutamol)
Airomir (salbutamol sulphate)
- Adrenergic (sympathomimietic) "adrenoceptor agonist"
- Direct-acting Non/modified-catecholamine
beta 2: Short-acting B2 Adrenergics (SABA)
Reliever, bronchodilator (acute asthma/COPD)
*bronchodilators are the main Tx for COPD
-
Bricanyl (terbutaline)
Alupent (metoproterenol)
Berotec (Fenoterol)
- Adrenergic (sympathomimetic) "adrenoceptor agonist"
- Direct-acting Non/modified-catecholamine
beta 2: Short-acting B2 Adrenergics (SABA)
Reliever, bronchodilator (acute asthma/COPD)
-
Atrovent (ipratropium bromide)
- Short-acting Anti-muscarinic (SAAM)
- Respiratory-specific (M3) - quaternary
Reliever-bronchodilator (acute asthma) - used in cobination with a SABA (i.e. ventolin or as a combo= combivent)
-
Xolair (Omalizumab)
Anti-IgE
Reliever, stops mast cell sensitization (acute asthma)
pt's > 12 yrs old
-
Intal (cromolyn sodium)
Zaditen (ketotifen)
Tilade (nedocromil)
Anti-allergics
controller (asthma)
-rarely used, mild asthma alternative to ICS
-
MgSO4
Magnesium sulfate (blocks Ca+ influx)
- Reliever, anti-inflammatory (acute asthma) - use in addition to SABA, ICS and LABA
- Used in CPR situations of sustained VFib/flutter or arrest with hypomagnesium
-
Spiriva (tiotropium)
- Long-acting Anti-muscarinic (LAAM)
- Respiratory specific ( M3) - quaternary
Bronchodilator (COPD) - used daily
-
Mucomyst (acetylcysteine)
mucolytic
- breaks disulfide bonds
- may cause bronchospasm so give with a B2 agonist
-
Pulmozyme (dornase alpha)
mucolytic
- breaks DNA in infected secretions
- admin via nebulizer
- for CF patients
-
Prolastin
Alpha-1 protease inhibitor
used in pt's with congenital alpha-1 antitrypsin deficiency
-
Provocholine (methacholine)
Direct-acting cholinergic (agonist)
*mimics ACh
-
Tensilon (endrophonium)
- Indirect-acting cholinergic (ACh receptor agonist)
- Reversible
- "cholinesterase inhibitor"
reverses the effects of a ND-NMB, also used in Dx of MG
-
Prostigmin (Neostigmine)
Mestinon (Pyridostigmine)
- Indirect-acting cholinergic (ACh receptor agonist)
- Reversible
- "cholinesterase inhibitor"
reverses the effects of a ND-NMB, also used to Dx MG
-
Pavulon (Pancuronium)
Zemuron (Rocuronium)
- Non-Depolarizing NMB
- "cholinergic (ACh receptor) antagonist"
Competetive with ACh at the site- keeps Na+ channels closed to prevent EPSP's
-
Tracrium (Atracurium)
Nimbex (Cisatracurium)
- Non-Depolarizing NMB
- "cholinergic (ACh receptor) antagonist"
Competetive with ACh at the site- keeps Na+ channels closed to prevent EPSP's
-
Anectine (Succinylcholine)
- Depolarizing NMB
- "cholinergic (ACh receptor) antagonist"
keeps Na+ channel open for continuous depolarization (flaccid paralysis)
-
Atropine
- Anti-muscarinic
- Anti-cholinergic specific to the heart (M2)
used to reverse NMB's and as a positive chronotrope
At tertiary compound= has systemic and CNS effects
-
Robinul (Glycopyrolate)
- Anti-muscarinic
- Anti-cholinergic
used to reverse NMB's, quarternary compound has less systemic/CNS effects
-
Levophed (Norepinephrine)
- Adrenergic (sympathomimetic) "adrenoceptor agonist"
- direct-acting Catecholamine
- vasopressor (inc BP during shock)
alpha-1: arterial vasoconstriction and increased BP
use: to treat hypotension refractory to epi and/or dopamine, or where SVR is reduced
-
Adrenalin (epinephrine)
- Adrenergic (sympathomimetic) "adrenoceptor agonist"
- Direct-acting Catecholamine
- Vasopressor (inc BP during shock)
use: heart failure/cardiac arrest
- alpha-1: increased BP- arterial vasoconstriction (inc SVR) at higher doses
- beta-1: cardiac stimulation (chronotrope and inotrope)
- beta-2: bronchodilation (lower doses)
-
Inotropin (Dopamine)
- Adrenergic (sympathomimetic) "adrenoceptor agonist"
- Direct-acting catecholamine
- Vasopressor (inc BP during shock)
- use: Heart failure
- alpha-1: increased BP- arterial vasoconstriction (inc SVR) at higher doses
- beta-1: cardiac stimulation (inotrope, chronotrope)
- D1: renal vasodilation
-
Dobutrex (Dobutamine)
- Adrenergic (sympathomimetic) "adrenoceptor agonist"
- Direct-acting catecholamine
- Inotrope
use: Heart failure
- beta-1: cardiac stimulation
- beta-2: vasodilation
-
isuprel (isoproterenol)
- Adrenergic (sympathomimetic) "arenoceptor agonist"
- Direct-acting catecholamine
- beta-1: cardiac stimulation
- beta-2: bronchodilation
-
Neosynephrine (Phenylephrine)
- Adrenergic (sympathomimetic) "adrenoceptor agonist"
- Vasopressor (inc BP during shock)
- Direct-acting Non/modified-catecholamine
pure alpha-1 adrenergic: peripheral vasoconstriction, increased BP and mydriasis
-
Ephedrine
Pseudoephedrine
- Adrenergic (sympathomimetic)
- Mixed-acting (direct and indirect) agent
- Vasopressor
use: nasal decongestant, treats spinal hypotension during spinal anesthesia (stimulates Nor Epi and inhibits MAO)
- alpha-1: arterial vasoconstriction
- non-seective beta effects (side effects)= cardiac stimulation and bronchodilation
-
Inderal (Propanolol)
- Adrenoceptor antagonist (sympatholytic)
- Non-selective Beta blocker (1 and 2)
- use: HTN, angina, migraines, acute MI, pheochromocytoma
- negative (-) inotrope (CO), chronotrope (HR) and dromotrope (AV conduction), also decreases BP and O2 demand
-
Tenormin (atenolol)
Lopressor (metoprolol)
Brevibloc (Esmolol)
- Adrenoceptor antagonist (sympatholytic)
- Selective Beta-1 blocker
- Class II anti-arrhythmic
- use: HTN, angina, acute MI (Esmolol also does acute SVT)
- negative (-) inotrope (CO), chronotrope (HR) and dromotrope (AV conduction), also decreases BP and O2 demand
-
Coreg (Carvedilol)
Normodyne (Labetalol)
- Adrenoceptor antagonists (sympatholytics)
- alpha + beta blockers
- use: HTN
- causes vasodilation, decreases HR and BP, carvedilol increases CO
-
aldomet (methyldopa)
- A sympatholytic that is an adrenoceptor agonist (a sympathomimetic)
- Centrally-acting alpha-2 agonist
- use: HTN, if other Rx has failed (lots of side effects). Used in pregnancy due to no effect on fetus
- Reduce sympathetic outflow and effect imidazoline receptors (medulla) to lower BP via reducing PVR
-
Minipress (Prazosin)
- Adrenoceptor antagonist (sympatholytic)
- selective alpha-1 blocker
- use: HTN and urinary symptoms
- Causes vasodilation and decreases BP, relaxes bladder, urethral and prostate smooth muscle
-
Vasotec (Enalapril)
Altace (Ramapril)
Capoten (captopril)
Agiotensin-converting enzyme (ACE) inhibitors
- use: HTN
- inhibit angiotensin II activation which would stimulate aldosterone release
- are the first line in HTN treatment as they reduce BP without affecting the heart directly
-
Cardiazem (diltiazem)
Isoptin (Verapamil)
Adalat (Nifedipine)
- Calcium channel blockers (CCB)
- Vasodilators
- Class IV Antiarrhythmic
- use: HTN, angina, non life-threatening arrhythmias (not nifedipine) acute SVT, Afib, and pulmonary HTN
- Reduce HR/SV. Promote coronary artery perfusion.
-
Nirostat (nitroglycerine)
Nipride (nitroprusside)
- use: HTN, angina (nitroglycerine)
- reduces BP (HTN) and O2 demand (angina) by reducing afterload and preload via vasodilation
-
Diuril (Chlorothiazide)
Thiazide Diuretic
- use: HTN
- increase Na+ excretion= decreased blood volume. Moderate natriuretic effects, first choice. Can add a KCl tab to prevent hypokalemia
-
Aldactone (spironolactone)
Potassium Sparing diuretic
- use: HTN
- increases Na+ excretion= decreased blood volume. Moderate natriuertic effects, spares K+ to prevent hypokalemia
-
Lanoxin (Digoxin)
- Cardiac Glycoside
- mild inotrope
- use: Afib/flutter. chronic CHF
- increases Ca+ to improve SV
-
Primacor (milrinone)
- c-AMP phosphodiesterase inhibitor (PDI)
- Inodilator (inotrope and vasodilator)
- use: acute heart failure with low CO and high SVR
- increases Ca+ in cardiac cells but decreases Ca+ in vascular cells
-
Xylocaine (lidocaine)
- Sodium channel blocker
- Class IB antiarrhythmic (negative chronotrope)
- Local anesthetic
use: tachycardia, acute Vtach/Vfib, anesthesia
-
Pronestyl (procainamide)
- Sodium channel blocker
- Class IA antiarrhythmic (negative chronotrope)
use: acute situations where lidocaine fails
-
Quinidine
- Sodium channel blocker
- Class IA antiarrhythmic (negative chronotrope)
use: Afib/flutter, SV arrhythmias
-
Rhythmol (Propafenone)
- Sodium channel blocker
- Class IC antiarrhythmic (negative chronotrope)
use: Afib/flutter, SV arrhythmias and some ventricular arrhythmias
-
Cardarone (Amiodarone)
- Potassium channel bloacker
- Class III antiarrhythmic
- use: for atrial and ventricular arrhythmias (tach and fib)
- blocks K+ channels as well as Na+ and Ca+ and beta adrenergic receptors
-
Adenocard (adenosine)
- Nucleoside
- Used to treat arrhythmias, particularly acute PSVT
causes hyperpolarization = slowing AV conduction and increased refraction, can cause asystole
-
Allegra (Fexofenadine)
Claritan (Loratadine)
Benadryl (Diphenhydramine)
- Anti-histamines
- H1 specific: respiratory tracts, smooth muscle and glands
- prevent itchyness, secretions, bronchoconstriction...
- Benadryl also has sedating and anti-cholinergic properties
-
Tagamet (Cimetedine)
Zantac (Ranitidine)
- Anti-histamines
- H2 specific: gastric mucosa
block HCl secretion to control gastric acid
-
Caffeine
Theophylline
ventilatory stimulants (analeptics)
- non-selective= side effects (tachycardia, HTN...)
- used mainly in premature neonates
-
Pitressin (Vasopressin)
Vasopressor
- increases BP during shock
- an anti-diuretic hormone (ADH), increases BP via diuresis and thus, doesn't affect the heart directly
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