Pharmacology Drug List

Name Effects MOA Notes

Atropine SA firing|AV conduction
bronchial secretion|
Paralyze accommodation
Dilate pupils
Opp vagus n action
Anticholinergic|Parasymp
AChR
CAntg of M1-5


Metformin
Omeprazole
(Prilosec)
acid secretion in stomach
heartburn|esophagitis|peptic
ulcer
CYP2C19Rx
DDI: Omep2C19Clop
Clopidogrel
(Plavix)
Antiplatelet
arterial thrombi formation
Prev stroke or heart attack
CYP2C19Rx
Codeine CYP2D6Rx to morphine
Warfarin Anticoagulant CYP2C9Rx
Tamoxifen Antineoplastic CYP2D6Rx
Hydralazine Anti-HTN Slow NAT2SLE like Sx
Isoniozid TB mycolic acid formation Slow NAT2t
1/2

periph neuropathy
Industrial carcinogenic
arylamines
Slow NAT2CA risk after
prolonged exposure
Rosuvastatin HMG-CoA reductase
chol syn
BCRP activity|eff & tox
Simvastatin OATP1A1[simva acid]
tox (myopathy)
efficacy[Rx]
p

Cimetidine
(Tagamet)
H2 histamine Antg
acid secretion
Irrev binding several CYP
Rx Elim|[Rx]
p
OTC
Name Mechanism Administration Complications Contraindications
Minimize GI Absorption
Syrup of Ipecac
(Emetine)
Act directly in Sm
intestine
After absorption, act on
Chemoreceptor trigger
zone (CTZ) in brain
PO w/6-8oz liquid Drowsiness
Diarrhea
Protracted vomiting
Mallory-Weiss tear
Stom rupture
Esoph hiatus
High risk of aspiration
Unconscious|Coma
Convulsion
Regurgitation toxicity
Strong A/B|petroleum
Chemical pneumonitis
(Hydrocarbons|HC)
Gastric Lavage Getting Rx out Sm volume of saline infused into
stomach & rmv by suction|
Orogastric/nasogastric tube|
Unconscious pt: protect airway
Lg volume can push Rx
into sm int
Aspiration pneumonitis
Laryngospasm
Inj to throat/eso/stom
Hypothermia
Electrolyte imbalance
High risk of pulm aspiration (unless
airway protected)
Corrosive agent/low viscous HC
Risk for hemorrhage or GI perforation
SDAC
Activated
charcoal
Insoluble fine powder
with Lg SA ADSORB
organic mlcfree [Rx]
in GIRx Abs
Slurry PO or Oro/nasogastric
tube
PO more palatable w/sorbitol

***Recommended for poison
known to bind to charcoal, w/in
1hr of ingestion***
adsorb:
Li
+
/Fe2
+
/Pb2
+
/CN
-
Methanol/EtOH/Sorbitol
Strong A/B
Serious SE rare
Emesis/aspiration
Combine w/sorbitol risk
of V (use w/ipecac)
High risk of pulm aspiration (unless
airway protected)
Corrosive agents
petroleum distillate (unless coingested
with systemic poisons)concern is
chemical pneumonitis due to
aspiration
Risk for hemorrhage or GI perforation
Cathartics
Laxatives



Promote defecation/D
GI motility
contact time with
poison
H2O in gut to dilute
toxic=Abs rate
PO

***Sorbitol combined with
charcoal; rarely used w/o
charcoal***
N|V|Abd cramp
Transient hypotension
(plasma volume)
Dehydration
(hypotonic soln)
Hypernatremia
Hypermagnesemia
Corrosive agents
Ileus (GI motility or intestinal
obstruction)| bowel sounds
GI tract damaged
Volume depletion|Hypotension
Severe electrolyte imbalance
Classes Mechanism Examples
Osmotic laxatives Work quickly|1-3hr|
Act in sm int & colon|pull water into GI
Adsorbed by charcoal
Mg citrate
Sorbitol
Adults 1-2ml/kg 70% sorbitol
Kids 4ml/kg 35% sorbitol
Stimulant laxatives Not useful|adsorbed by charcoal Bisacodyl (Dulcolax)
Stool softener Not useful|too slow|adsorbed by charcoal Docusate (Colace)
Whole-Bowel
Irrigation
(WBI)
Infuse Lg volume of
isotonic fluid thats NOT
abs & promote
secretion (CoLYTE,
GoLYTELY)
Nasogastric tube 4-12hr
Infuse until clear rectal
effluent
Decontaminate entire GI
N|V|Abd cramp|bloating High risk of pulm aspiration (unless
airway protected)
Corrosive agent/low viscous HC
Mechanical dmg due to WBI

Name Mechanism Administration Complications Notes
Enhance Elimination Rate of Absorbed Rx
MDAC
**Exorption**
Works best if Rx:
reabs|long t1/2 so can
undergo EH cycling
Rx in the blood
Enough Rx is free
Admin 15-25g of AC every 2-6hr until
Sx abate
Prolong Tx if:
Rx adsorbs to charcoal
Rx diffuses back into gut
AFTER being absorbed
Rx enterohepatic cycle
adsorb:
Li
+
/Fe2
+
/Pb2
+
/CN
-
Methanol/EtOH/Sorbitol
Strong A/B
Serious SE rare
Emesis/aspiration
Combine w/sorbitol risk of V
(use w/ipecac)

Biotransform Stimulate biotrans|not
usually feasible
transformation is effective
if metabolite is toxic

Hemodialysis Diffusion of mlc b/w both
sides of the semi-perm mem
in dialyzer
Pts blood pumped across one side
of semi-perm mem in dialyzer &
then back into body
Dialysate is pumped across the
other side of the mem
Allows correction of electrolyte
imbalance (ie. ASA toxicity) &
blood volume
Anticoagulant needed to prevent
clotting
Indications:
Low MW|H
2
O soluble|low V
d
Mostly unbound
ASA|metformin|valproic acid
Methanol|ethylene glycol
Ethanol|Theophylline|Li
+

Expensive|Invasive|Risky
low V
d
means large
portion of Rx is in the
blood
Hemoperfusion Indications:
Use if hemodialysis is not
effective
High MW|H
2
O insoluble|Hi V
d
Mostly bound
Phenobarbital|Phenytoin
Carbamazepine|Salicylates
Theophylline (?)
Pts blood passed thru column of
adsorbent charcoal
Heparin needed to prevent
clotting
Thrombocytopenia
Platelets depleted
Plasma protein removed
Steroid hormones removed
correct electrolyte
imbalance
Rarely used