![1. Adrenergic Drugs
I] Adrenergic Agonists
• Directly acting agonists –
i) - agonists
ii) - agonists
• Indirectly acting agonists
• Agonists with mixed MOA
II] Adrenergic Antagonists
• α – antagonists
• - antagonists
• Phenylephrine, clonidine
• Isoprenaline, salbutamol
• Pseudoephedrine
• Ephedrine, phenylpropanolamine
• Phenoxybenzamine, prazosin
• Propranolol, metoprolol
2](data:image/gif;base64,R0lGODlhAQABAIAAAAAAAP///yH5BAEAAAAALAAAAAABAAEAAAIBRAA7)
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- 1. Drugs For Noncontagious Diseases Prof. A. S. Dhake Department of Pharm. Chemistry SMBT College of Pharmacy, Dhamangaon, Nashik (Maharashtra) 1
- 2. 1. Adrenergic Drugs I] Adrenergic Agonists • Directly acting agonists – i) - agonists ii) - agonists • Indirectly acting agonists • Agonists with mixed MOA II] Adrenergic Antagonists • α – antagonists • - antagonists • Phenylephrine, clonidine • Isoprenaline, salbutamol • Pseudoephedrine • Ephedrine, phenylpropanolamine • Phenoxybenzamine, prazosin • Propranolol, metoprolol 2
- 3. III] Inhibitors of NE biosynthesis IV] Inhibitors of NE storage/release V]Inhibitors of NE reuptake into nerve cells VI] Inhibitors of NE metabolism (MAO inhibitors) • - methyldopa, tyrosine • Reserpine, guanethidine • Tricyclic antidepressants – Imipramine, amitriptyline • Phenelzine, iproniazid Norepinephrine Salbutamol Propranolol 3
- 4. 2. Cholinergic Drugs I] Cholinergic agonists II] Acetylcholinesterase inhibitors a)Reversible b) Irreversible III] Cholinergic antagonists a) Muscarinic antagonists • Acetylcholine, carbachol • Physostigmine, neostigmine • Organophosphate poisons – Isofluorophate, echothiophate • Atropine, cyclopentolate, dicyclomine 4
- 5. b) Nicotinic antagonists • Neuromuscular blocking agents • Ganglion blocking agents • Tubocurarine, decamethonium • Hexamethonium, mecamylamine, trimethaphan Acetylcholine 5
- 6. 3. Anxiolytics and Sedative- hypnotics I] Benzodiazepines* II] Barbiturates III] Azaspirodecanediones* (Azaspirones) IV] Imidazopyridines* V]Pyrazolopyrimidines VI] Piperidinediones VII] Miscellaneous (* Used as anxiolytics) • Chlordiazepoxide,diazepam • Phenobarbital, amobarbital • Buspirone, gepirone • Zolpidem, alpidem* • Zaleplon • Glutethimide, methyprylon • Carbamates – Meprobamate Diazepa m 6
- 7. 4. Antipsychotic Agents A]Typical antipsychotics I] Phenothiazines II]Thioxanthenes III] Butyrophenones IV] Miscellaneous • Chlorpromazine, promazine • Thiothixene, flupenthixol • Haloperidol • Molindone, sulpiride Chlorpromazine 7
- 8. B] Atypical antipsyhotics – I] Benzazepines & related systems II] Benzisoxazoles & benzisothiazoles • Clozapine, olanzapine, quetiapine • Risperidone & ziprasidone Clozapine Risperidone 8
- 9. 5. Anticonvulsants (Antiepileptics) I] Barbiturates and analogs II] Hydantoins III] Oxazolidinediones IV] Succinimides V] Benzodiazepines • Phenobarbital, mephobarbital, primidone • Phenytoin, mephenytoin, ethotoin • Trimethadione • Phensuximide, methsuximide, ethosuximide • Clonazepam, diazepam 9
- 10. VI] Miscellaneous older drugs VII] Newer drugs • Carbamazepine, valproic acid • Gabapentin, tiagabine, felbamate, lamotrigine,zonisamide, topiramate Phenytoin 10
- 11. 6. General Anesthetics I] Inhalation anesthetics II] Intravenous anesthetics • Halothane, isoflurane, nitrous oxide • Thiopental, methohexital, ketamine, propofol, etomidate Halothane Thiopental sodium 11
- 12. 7. Local Anesthetics I] Benzoic acid derivatives (Cocaine analogs) II] Anilides – (Isogramine analogs) • Benzocaine, procaine, chloroprocaine, tetracaine • Lignocaine(lidocaine), bupivacaine, prilocaine, etidocaine Procaine Lidocaine 12
- 13. 8. Opioid Analgesics I] Morphine and derivatives II] Morphinans III] Benzomorphans IV] 4- Phenylpiperidines V] Diphenylheptanes VI] Misc. • Morphine, codeine • Levorphanol, dextromethorphan • Pentazocine, bremazocine • Meperidine, fentanyl • Methadone, dextropropoxyphene • Tramadol, tapentadol Morphine Naloxone 13
- 14. VII] Related drugs – A] Partial agonists B] Opioid antagonists • Nalbuphine, buprenorphine • Naltrexone, naloxone 14
- 15. 9. Nonsteroidal Anti-inflammatory Drugs(NSAIDs) I] Salicylic acid derivatives II] Aryl acetic acids III] Aryl propionic acids IV] N-Arylanthranilic acids (Fenamates) V] Oxicams VI] Misc. • Aspirin, sodium salicylate • Indomethacin, diclofenac • Ibuprofen, naproxen • Mefenamic acid, meclofenamic acid • Piroxicam, meloxicam • Sel. COX-2 inhibitors- celecoxib • Antipyretic analgesics- paracetamol Indomethacin Ibuprofen 15
- 16. 10. Antihistamines( H1 antagonists) • First generation drugs I] Aminoalkyl ethers II] Ethylenediamines III] Piperazines IV] Propylamines V] Phenothiazines VI] Dibenzocycloheptanes • Second generation drugs • Diphenhydramine, doxylamine • Tripelennamine, pyrilamine • Cyclizine, chlorcyclizine • Pheniramine, chlorpheniramine • Promethazine, trimeprazine • Cyproheptadine, azatadine • Fexofenadine, loratadine, cetirizine, acrivastine Diphenhydramine Cetirizine 16
- 17. 10. Antiulcer agents I] H2 Antagonists II] Proton Pump Inhibitors III] Prokinetic agents IV] Insoluble GI protectants • Cimetidine, ranitidine, famotidine, nizatidine • Omeprazole, esomeprazole, pantoprazole, rabeprazole • Metoclopramide, dexpanthenol • Sucralfate, bismuth subsalicylate Ranitidine Omeprazole 17
- 18. 11. Oral Antidiabetic Agents ( For type -2 diabetes mellitus) • I] Phenylsulphonylureas • II] Biguanides • III] Metaglinides • IV]Thiazolidinediones • V] α- Glucosidase inhibitors • VI] DPP- IV inhibitors • VII] SGLT-2 inhibitors 1G-Tolbutamide, chlorpropamide 2G- Glyburide, glipizide,glimepiride Metformin, phenformin Repaglinide, nateglinide Rosiglitazone, pioglitazone Acarbose, miglitol Sitagliptin, linagliptin Canagliflozin, dapagliflozin Tolbutamide 18
- 19. 12. Drugs for Asthma and COPD • I] 2 Adrenergic agonists • II] Antimuscarinics • III] Methylxanthines • IV] Glucocorticoids- Systemic -Inhalatory • V]Mast cell degranuln inhibitors • Epinphrine, terbutaline, salbutamol • Ipratropium, tiotropium • Theophylline, dyphylline • Hydrocortisone, prednisolone • Beclomethasone, triamcinolone • Cromolyn, nedocromil 19
- 20. • VI] Leukotriene modifiers – -LT biosynthesis inhibitors -LT antagonists • VII] Monoclonal antibodies • (anti- Ig E) • VIII] Phosphodiesterase (PDE-4) inhibitors • Zileuton • Zafirlukast, montelukast • Omalizumab • Cilomilast, roflumilast 20
- 21. 13. Diuretics I]Osmotic diuretics II]Carbonic anhydrase inhibitors III]Thiazide diuretics ( incl. thiazide-like) IV] Potassium sparing diuretics V] Aldosterone antagonists VI] Loop/high ceiling diuretics • Mannitol • Acetazolamide, dorzolamide • Chlorothiazide, hydrochlorothiazide, indapamide • Amiloride, triamterene • Spironolactone, eplerenone • Furosemide, torsemide, bumetanide hydrochlorthiazide 21
- 22. 14. Antihypertensives I] Diuretics II] - Adrenergic blockers • Nonselective blockers • Selective 1 blockers • Nonselective blockers(α1+ 1bl.) III] α1- Adrenergic blockers IV]Centrally acting sympatholytics (2 agonists) • Propranolol, nadolol, penbutolol • Atenolol, metoprolol,esmolol • Carvedilol, labetalol • Prazosin, doxazosin, terazosin • Methyldopa, clonidine Nifedipine 22
- 23. V] Calcium channel blockers (1,4- Dihydropyridines) VI] ACE inhibitors VII] Angiotensin- II receptor blockers VIII] Renin inhibitors • Nifedipine, nicardipine, amlodipine,clevidipine • Captopril, enalapril, Lisinopril • Losartan, valsartan, telmisartan • Aliskiren 23
- 24. 15. Antiarrhythmics • Class I- Na+ channel blockers-IA - IB -IC • Class II- - adrenergic blockers • Class III- K+ channel blockers • Class IV – Ca++ channel blockers • Quinidine, procainamide • Lidocaine, mexiletine • Flecainide, propafenone • Propranolol, atenolol, esmolol • Amiodarone, dronedarone, dofetilide, ibutilide • Diltiazem, verapamil 24
- 25. 16. Drugs for CHF I] Cardiac glycosides II] PhosphodiesterasePDE3 inhibitors III] - Adrenergic agonists • Digoxin • Milrinone, inamrinone • Dobutamine Digoxin Dobutamine 25
- 26. 17. Antianginal Drugs I] Organic nitrates II] Sodium channel blockers III] Calcium channel blockers IV]- Adrenergic blockers • Nitroglycerin, isosorbide dinitrate/mononitrate • Ranolazine • Nifedipine, amlodipine, diltiazem, verapamil • Propranolol, metoprolol, atenolol Nitroglycerine 26
- 27. 18. Steroidal hormones Adrenal Hormones(Adrenocorticoids) • Minerlocorticoids • Glucocorticoids- • I] Systemic • II]Topical • III] Inhaled & intranasal • IV] Ocular • Aldosterone, fludrocortisone • Cortisone, hydrocortisone, prednisone, prednisolone, dexamethasone,betamethasone • Beclomethasone dipropionate, amcinonide, desonide • Budesonide, ciclesonide, flunisolide, mometasone furoate • Medrysone, fluorometholone, rimexolone 27
- 28. 19. Sex Hormones • Estrogens • I] Steroidal estrogens • II] Nonsteroidal estrogens • Antiestrogens and SERMs • Aromatase inhibitors • Estradiol, estrone, estriol, ethinylestradiol • Diethylstilbestrol, hexestrol • Fulvestrant, tamoxifen, toremifene, clomiphene • Anastrozole, letrozole, exemestane 28
- 29. • Progestins I] Progesterone derivatives II]Testosterone & 19- nortestosterone derivatives III] Misc. • Progestin Antagonists • Progesterone, hydroxyprogestrone • Ethisterone, dimethisterone • Trimegestone, drospirenone • Mifepristone, ulipristal 29
- 30. • Androgens I] Androgenic steroids II] Anabolic steroids • Antiandrogens I] Steroidal antiandrogens II] Nonsteroidal antiandrogens • Testosterone, 17-methyltestosterone • Oxymetholone, oxandrolone, nandrolone • Cyproterone, abiraterone • Finasteride, dutasteride* • Flutamide, bicalutamide, nilutamide *5-Reductase inhibitors, use-BPH 30
- 31. 31