| Drug Name |
Category |
Comments |
| Cortico steroids
(Prednisone , etc.) |
Chemo therapy; Hormonal Agent
Anti- Inflam matory; Anti-RA
Immunosup pressant |
Actions: (1) They inhibit Phospo lipase-A2,
(2) They inhibit the induction of COX-2
Chemo therapy: They suppress proliferation of lymphocytic cells, thus
they are useful at combating lymphomas. Part of the MOPP group of drugs,
to fight Hodgkin's Disease.
RA: It is a potent anti- inflammatory, but it does nothing to prevent
destruction of bone and cartilege.
Immuno suppres sant: Organ transpla ntation, auto-immune diseases,
asthma. |
| Amsacrine (AMSA) |
Chemo therapy; Miscell aneous |
|
|
| Hydroxyurea |
Chemotherapy; Miscellaneous |
|
| L- Aspara ginase |
Chemo therapy; Miscell aneous |
For Leukemia. Leukemic cells are deficient in
asparagine synthetase and thus cannot replenish asparagine when
it is broken down by this drug. That makes them selectively susceptible
to the drug. Adverse Effects: Allergy, hepatitis, mental depression,
pancreatitis. |
| Erythro poeiten |
Hemopoeitic; Anemia |
Useful for treating the hypopro liferative anemia caused
by end-stage renal disease. Produced by recom binant DNA
techniques. |
| Ferrous Fumarate |
Hemo poeitic; Anemia
Iron- Deficiency Anemia |
Like Ferrous Sulfate |
| Ferrous Sulfate |
Hemopoeitic; Anemia
Iron-Deficiency Anemia |
Take them on an empty stomach. Enteric-coated iron
preparations are not used, because we want to absorb the iron in the
stomach and proximal duodenum. 200-400 mg of iron daily
are required to treat iron deficiency.
Adverse Effects: Black stools, constipation, nausea, epigastric
discomfort, abdominal cramps, diarrhea. |
| Ferrous Gluconate |
Hemopoeitic; Anemia
Iron-Deficiency Anemia |
Like Ferrous Sulfate |
| Iron Dextran |
Hemopoeitic; Anemia
Iron-Deficiency Anemia |
Parenteral iron administration, IM or IV. IM can be
painful.
Indications: Parenteral iron is given for severe iron
deficiency, after a bowel resection or after Inflammatory Bowel
Disease involving the proximal jejunum.
Adverse Effects: Headache, light-headedness. Nausea, vomiting, back
pain, fever, arthralgia, urticaria, anaphylaxis (rare), flushing. |
| Folic Acid |
Hemopoeitic; Anemia
Megaloblastic Anemia |
Folic acid will cure dietary folate deficiency. It will
not cure folate deficiency due to anti-folate drugs (such as
Trimethoprim). For that you use folinic acid.
No adverse effects. |
| Hydroxy cobalamin
(Vitamin B12) |
Hemo poeitic; Anemia
Megaloblastic Anemia |
IM. Highly bound to plasma proteins and remains in
circulation longer than cyanocobalamin. Therapy continues for life. |
| Cyanoco balamin
(Vitamin B12) |
Hemopoeitic; Anemia
Megalo blastic Anemia
Toxicity |
IM. The drug of choice in patients who are
hyper sensitive to the Hydroxy cobalamin- Transco balamin-II Complex.
Therapy continues for life.
Cyanide Toxicity: Co2 EDTA +
Hydroxy cobalamin takes up free cyanide, neutra lizing it and forming
cyanoco balamin (Vit B12). |
| Dextran |
Hemopo eitic; Clotting
Anti- Coagulant |
Used to prevent post-operative thrombosis.
Long chain sugars physically interfere with platelet function and fibrin
polymeri zation. |
| Heparin |
Hemo poeitic; Clotting
Anti-Coagulant |
IV or SQ anti-coagulant. It potentiates
Antithrombin-III and is monitored using the PTT.
It has a fast onset of action and short duration of action. |
| Warfarin
(Coumadin) |
Hemopoeitic; Clotting
Anti-Coagulant |
Oral anti-coagulant. It is an analog of
Vitamin-K and inhibits Vit-K-dependent factors. It is monitored
using the PT. It has a slow onset of action and longer
duration of action. It is eliminated by P450 metabolism and has lots of
drug interactions. |
| Dipyridamole |
Hemopoeitic; Clotting
Platelet Inhibitor |
Inhibits phosphodiesterase ------>
potentiate prostacyclin, which is a cAMP dependent
factor.
In combination with warfarin, it is effective in preventing arterial
embolization in patients with prosthetic heart valves. |
| Ticlopidine |
Hemopoeitic; Clotting
Platelet Inhibitor |
Inhibits ADP-Induced platelet aggregation. Effective in
preventing the recurrence of arterial thrombosis in patients with a
history of MI, Transient Ischemic Attacks (TIA's), stroke, unstable
angina pectoris.
Adverse Effects: GI Disturbances in 20% of patients, Hemorrhage in 5%
of patients, Leukopenia in 1% of patients. |
| Timolol |
Hemopoeitic; Clotting
Platelet Inhibitor
beta-Blocker |
Has been approved for the prophylaxis and prevention of
first MI. It is not known whether the beneficial effects are due to
inhibited platelets, beta-blocking activity, or combination of both. |
| Desmopressin Acetate |
Hemopoeitic; Clotting
Prothrombogenic |
Useful as an adjunct in treatment of mild
Hemophilia A. It potentiates the activity of Factor VIII. |
| Factor VIII |
Hemopoeitic; Clotting
Prothrombogenic |
Given to treat primary Hemophilia A
(Factor VIII Deficiency). Administration of the blood-derived factor
carries a risk of getting viral infections such as Hepatitis-C. |
| Aminocaproic Acid |
Hemopoeitic; Clotting
Prothrombogenic
Toxicity |
They inhibit the conversion of plasminogen to plasmin.
Used as adjunctive therapy in treating hemophilias.
Indicated for tPA, streptokinase toxicity. |
| Factor IX |
Hemopoeitic; Clotting
Prothrombogenic
Toxicity |
Given for treatment of warfarin overdose,
whenever immediate coagulation needs to take effect.
Given to treat primary Hemophilia B (Factor IX
Deficiency). Administration of the blood-derived factor carries a risk
of getting viral infections such as Hepatitis-C. |
| Phytonadione
(Vitamin-K) |
Hemopoeitic; Clotting
Prothrombogenic
Toxicity |
Given for treatment of warfarin overdose,
or whenever the effects of warfarin need to be reversed, such as in
preparation for surgery. The effect is delayed by about 24 hours, the
time required to synthesize new clotting factors.
Given prophylactically before gallbladder surgery. |
| Tranexamic Acid |
Hemopoeitic; Clotting
Prothrombogenic
Toxicity |
Analog of aminocaproic acid. They inhibit the conversion
of plasminogen to plasmin. Used as adjunctive therapy in treating
hemophilias.
Indicated for tPA, streptokinase toxicity. |
| Anistreplase |
Hemopoeitic; Clotting
Thrombolytic Agent |
The acylated form of the Streptokinase-Plasminogen
Activated Complex (APSAC); no risk of systemic
fibrinolysis. Longer lasting than the others. Infused IV for 3-5
minutes. |
| Streptokinase |
Hemopoeitic; Clotting
Thrombolytic Agent |
From Streptococcus. Can cause systemic
fibrinolysis and DIC. May see allergies, in patients who have
anti-streptococcal antibodies. Given as IV loading dose, then 24-48
hours of infusion. |
| Tissue Plasminogen Activator (tPA) |
Hemopoeitic; Clotting
Thrombolytic Agent |
Active only at the site of the clot; no risk of systemic
fibrinolysis. Given as IV loading dose, then 2 hours of infusion.
Particularly efficacious for post-MI treatment, and
that is the only indication currently approved.
Adverse Effect: Higher risk for hemorrhagic stroke
than with the other drugs. |
| Urokinase |
Hemopoeitic; Clotting
Thrombolytic Agent |
Isolated from human kidney. Can cause systemic
fibrinolysis and DIC. Given as IV loading dose, then 12 hours of
infusion. |
| Adjuvants
Bacille Calmette-Guerin (BCG) |
Immuno modulating Agent |
Attenuated M. Bovis strain can be employed as
immunostimulant in cancer therapy. It activates
macrophages, making them more apt at killing tumor cells. |
| Inosiplex |
Immuno modulating Agent |
Enhanced T-Cell and monocyte activities. Potentially
useful in AIDS. |
| Thymosin |
Immuno modulating Agent |
10 kDa protein. Thymic hormone that induces and
stimulates the maturation of lymphoid stem-cells and pre-T-Cells into
T-Cells. Indications: DiGeorge Syndrome, other
conditions of T-Cell Deficiency. |
| Levamisole |
Immuno modulating Agent
Anti- Inflammatory; Anti-RA |
It is an immunostimulatory drug that
has paradoxical effect in treating RA. Treament has not yet been
approved by FDA. Latency period of 3 - 4 months. May also be useful for
Hodgkin's Disease. |
| Tacrolimus (FK-506) |
Immuno suppressant
Anti-Bacterial; Macrolide |
Macrolide antibiotic of fungal origin, similar in use to
Cyclosporin. Used in situations where Cyclosporin is ineffective, toxic,
or cannot otherwise be used. |
| Anti- Lymphocyte Globulin |
Immuno suppressant
Antibody |
It activates complement-mediated destruction of
lymphocytes ------> decreased cellular immunity. There
is little effect on humoral immunity. Indications: Organ
transplantations, GVHD.
Adverse Effects: Pain, erythema, possibly lymphoma at site of
injection. Anaphylactic shock, serum sickness. |
| Anti-T-Cell Antibody OKT3 |
Immuno suppressant
Antibody |
Mouse monoclonal antibody against the CD3 T-Cell
Receptor.It inhibits the interaction between antigen-presenting
cells and T-Cells.
Indications: Kidney transplantation. |
| Anti-Thymocyte Globulin |
Immuno suppressant
Antibody |
Indications: Idiopathic aplastic anemia,
or to counter the auto-immune effects of gamma-Interferon, secondary to
hemopoeitic suppression. |
| Rh0(D) Globulin
(Rhogam) |
Immuno suppressant
Antibody |
For the primary prevention of Erythroblastosis
Fetalis (hemolytic anemia of newborn). It is given to Rh-
mothers, 72 hours after first childbirth of an Rh+
fetus, to prevent formation of anti-Rh antibodies in the mother. |
| Methotrexate |
Immuno suppressant
Chemotherapy; Antimetabolite
Anti-RA |
Inhibits dihydrofolate reductase. Well absorbed orally,
or intrathecal. Polyglutamic-acid conjugates of methotrexate are
retained intracellularly, where they have activity.
Indications: GVHD, Acute Lymphocytic
Lymphoma, Choriocarcinoma, RA, psoriasis.
Adverse Effects: Oral, gastric ulcerations, and
liver cirrhosis with long-term use. High dose
methotrexate may be followed by high-dose folinic acid
in order to "rescue" the anti-folate effects of the
drug. |
| Cyclosporin A |
Immuno suppressant
Chemotherapy; Miscellaneous |
From the fungus, Tolypocladium Inflatum. Binds
to cyclophillins ------> inhibit IL-2
production in T-Cells ------> inhibit T-Cell differentiation and
activation. Extensive Cyt-P450 metabolism.
Indications: Suppress organ rejection after transplantation, IDDM.
Adverse Effects: Viral infections, lymphoma. Nephrotoxicity, but it
can be prevented with mannitol. |
| Azathioprine |
Immuno suppressant
Chemotherapy; Miscellaneous
Anti-RA |
>Pro-drug, it is converted by glutathione S-transferase
to 6-Mercaptopurine, active form of drug. It is toxic
to proliferating T-Cells and B-Cells, after antigen exposure.
Allopurinol, renal disease raise its blood levels.
Indications: kidney transplants, autoimmune diseases
(glomerulonephritis, hemolytic anemia).
Adverse Effects: Nausea, vomiting, diarrhea. Bone marrow suppression.
Fever, skin rashes. Liver dysfunction and jaundice, ocassionally.
Azothioprine or Methotrexate can be used to treat severe RA. |
| 2-PAM
(Pralidoxime) |
Toxicity |
Organophosphate poisoning: Only
effective within the first few minutes of exposure. It is a strong
nucleophile that can bind with the organophosphate, releasing it from
cholinesterase, before the bond has aged. |
| 4- methyl pyrazole |
Toxicity |
A specific inhibitor of alcohol dehydrogenase
that may be used instead of ethanol, for methanol and
ethylene glycol poisoning.
|
| Atropine |
Toxicity |
Treatment of choice after the bond has aged and become
irreversible, in organophosphate poisoning. First-line
treatment for carbamate poisoning. |
| Defero xamine (Desferal) |
Toxicity |
IM or IV to chelate iron in blood, for iron
toxicity. |
| Digoxin- specific antibody fragments. |
Toxicity |
Indicated for Digitalis toxicity. |
| Ethanol |
Toxicity |
It is given to displace the substrates and prevent their
metabolism, in methanol and ethylene glycol
poisoning. Prevent methanol from going to formic acid,
and prevent ethylene glycol from going to oxalic acid. |
| Factor IX |
Toxicity |
Used for immediate coagulation, in the event of
warfarin toxicity. |
| Fluazenil |
Toxicity |
Indicated for Benzodiazepine toxicity. |
| Methy lene Blue |
Toxicity |
Indicated for treatment of methemoglobinemia,
such as that due to nitrite poisoning.
Methylene Blue speeds the conversion of methemoglobin back to
hemoglobin. |
| N- Acetyl cysteine |
Toxicity |
Indicated for Acetominophen toxicity.
It provides reduced sulfhydryl groups and restores glutathione to its
reduced form. |
| Nalorphine |
Toxicity |
Indicated for opioid overdose,
alternative to naloxone. |
| Naloxone |
Toxicity |
Opioid antagonist, indicated for acute opioid
toxicity. |
| Nitrite |
Toxicity |
It causes methemo globinemia which can
then bind up all of the extra cyanide, driving it away from the
cytochrome oxidase. For cyanide poisoning. |
| Phyto nadione (Vitamin-K) |
Toxicity |
>Given to reverse the effects of warfarin
toxicity, but it takes 24 hours to take effect. |
| Protamine Sulfate |
Toxicity |
Given IV for treatment of heparin overdose.
It is a basic peptide that binds to heparin. Must dose it carefully, as
protamine sulfate is itself an anti-coagulant! |
| Prussian Blue |
Toxicity |
Thallium poisoning: It interrupts the
enterohepatic circulation of Thallium, enhancing its excretion. |
| Pyridoxine (Vit B6) |
Toxicity |
Can reverse convulsions and peripheral neuritis
associated with Isoniazid toxicity. |
| Thiosulfate |
Toxicity |
Given to promote the formation of thiocyanate and its
subsequent excretion, in cyanide poisoning. |
| Dimercaprol
(British Anti-Lewisite, BAL) |
Toxicity
Metal Chelator |
Administered in oil by deep IM injection. Fast-acting
and short half-life. Enters tissues more readily than does EDTA.
Forms stable complexes with mercury, arsenic, gold.
It can free the sulfahydral compounds bound by the metals, but it is
better at primary prevention. Adverse Effects: It can cause transient
hypertension.
Used in combination with CaNa2 EDTA for lead poisoning,
particularly when there are signs of Lead Encephalopathy. |
| Edetate Calcium Disodium
(CaNa2 EDTA) |
Toxicity
Metal Chelator |
Poor oral absorption. Usually administered IV or IM.
Half-life 20 - 60 minutes. Urinary excretion. Water soluble; does not
easily enter tissues or get into cells.
Indications: Primarily used for lead poisoning. Not
effective against mercury, arsenic, most other metals. |
| Succimer |
Toxicity
Metal Chelator |
New drug that can be given PO. Both
urinary and biliary excretion, with enterohepatic circulation.
Chemically similar to Dimercaprol.
Indications: Severe Lead Poisoning: Used to treat
children with lead poisoning above 45 �g / dL. It does not metabolize
essential minerals like zinc, copper, iron, making it more attractive.
Has been shown in labs to chelate arsenic, cadmium, mercury. |
