Indication: allergic rhinitis, persistent asthma, exercise induced bronchoconstriction

Target: CysLT Type 1 Receptor

MOA: Selective leukotriene receptor antagonist that inhibits cysteinyl leukotriene receptor. Prevents airway edema and smooth muscle contraction

Role: Antagonist

Common side effects include: Gastrointestinal (abdominal pain, diarrhea), Neurologic (headache), Otic (otitis, otitis media), Respiratory (cough, nasal discharge, pharyngitis, sinusitis, upper respiratory infection), Other (fever, influenza)

Serious Side Effects: Cardiovascular (eosinophilic granulomatosis with polyangitis), Neurologic (disoriented, disturbance of attention, insomnia, memory impairment, stuttering, tic, tremor) Psychiatric (aggressive behavior, agitation, anxiety, depression, hallucinations, irritability, nightmares, Obsessive-compulsive disorder, restlessness, sleep walking disorder, suicidal behavior, suicidal thoughts)

Side effects: 

Less Common Side Effects: 

Serious but Unlikely Side Effects

Indication: 

-Fibromyalgia 

-Neuralgia 

-Seizures

Side Effects:

-CNS depression 

-Respiratory depression

-Delayed hypersensitivity reactions 

-Peripheral edema

-Suicidal ideation 

-Visual disturbances 

-Weight gain

>10%: Genitourinary: Impotence (5% to 19%)

1% to 10%:

Cardiovascular: Hypotension (1%), orthostatic hypotension (9%), peripheral edema (1%)

Endocrine & metabolic: Decreased libido (2% to 10%), gynecomastia (1% to 2%)

Genitourinary: Breast tenderness (≤1%), decreased 🤬 volume (2% to 4%), ejaculatory disorder (≤7%), prostate cancer - high grade (2%), sexual disorder (3%)

Source: Lexicomp https://online.lexi.com/lco/action/doc/retrieve/docid/patch_f/6913?cesid=0aUYqwO57tF&searchUrl=%2Flco%2Faction%2Fsearch%3Fq%3Dfinasteride%26t%3Dname%26acs%3Dtrue%26acq%3Dfin#

Target: Serotonin and Norepinephrine Reuptake

Mechanism of Action: The active metabolite of venlafaxine, O-desmethylvenlafaxine, inhibits serotonin and norepinephrine reuptake
Role: Inhibitor 

Side Effects (Common): Hypertension, Sweating, Weight loss, Constipation, Nausea, Dizziness, Headache, Insomnia Somnolence, Tremor, Abnormal 🤬, erectile dysfunction, reduced libido

Side effects (serious): Hyponatremia, Hemorrhage, Hepatitis, Rhabdomyolysis, Seizure, Depression, Exacerbation, Mania, Suicidal thoughts, Interstitial Lung disease, Pulmonary eosinophilia, Neuroleptic malignant syndrome, Serotonin syndrome 

MOA: atenolol competitively blocks beta-1 receptors, blocking beta-1 stimulation. Has little to no effect on beta-2 receptors. 

Common Side Effects: Bradyarrhythmia, cold extremities, hypotension, dizziness, depression, and fatigue

Serious Effects: Heart failure, myocardial infarction, ventricular arrhythmia, thyrotoxicosis, anaphylaxis, systemic lupus erythematosus, pulmonary embolism, withdrawal symptoms.

Target: voltage sensitive sodium channels

MOA: triazine inhibits the release of glutamate and inhibits voltage sensitive sodium-channels which stabilizes the neuronal membrane. Lamotrigine has weak inhibitory effect of the 5-HT3 receptor, in vitro inhibits dihydrofolate reductase.

Common Side Effects: rash, abdominal pain, diarrhea, nausea, heart burn, back pain, dizziness, insomnia, somnolence, tremor, blurred vision, dysmenorrhea, rhinitis, pain in throat, fever

Serious Side Effects: Skin rashes (Steven-Johnson Syndrome), Aseptic meningitis, blood dycrasias, hypersensitivity reactions, hemophagocytic lymphohistiocytosis, suicidcal ideation/tendencies, liver failure

Target: 5- Hydroxytryptamine receptors, Dopamine receptors, Histamine receptors, Monomine transport subfamily (GPCRs)

Mechanism of action:  Although the mechanism of action of quetiapine is not fully understood, several proposed mechanisms could occur. in schizophrenia, its action could occur from the antagonism of dopamine type 2 and serotonin 2A receptors. in bipolar depression, its action must be attributed to the binding of the drugs or its metabolite to the norepinephrine receptor. 

Role : Antagonist 

Common side effects: feeling fatigue, headache, constipation, dry mouth, gain of appetite, weight gain, upset stomach, stomach pain, back pain, stuffy nose, feeling nervous and excitable

Serious side effects: depression , high blood sugar, infection like fevers, chills, or sore throat, low thyroid levels, neuroleptic malignant syndrome, seizures , trouble passing urine 

Mechanism of Action: PDE5 is a key enzyme involved in the regulation of cGMP-specific signaling pathways in normal physiological processes such as smooth muscle contraction and relaxation. For this reason, inhibition of the enzyme can alter those pathophysiological conditions associated with a lowering cGMP level in tissues.

Role: Inhibitor

 
Common Side Effects:                                

Dermatologic: , Flushing 
Gastrointestinal: Indigestion
Neurologic:  Insomnia
Ophthalmic: Visual disturbance 
Respiratory: Bleeding from nose, Nasal congestion ,Rhinitis 

Serious Side Effects

Cardiovascular: Cardiovascular morbidity, Myocardial infarction, Sickle cell anemia with Vaso occlusive crisis
Ophthalmic: Non-arteritic ischemic optic neuropathy, Retinal hemorrhage 
Otic: Decreased hearing, Sudden onset, Sudden hearing loss 
Reproductive: Priapism, Prolonged erection of 🤬

 

Nervous system-  Headache including migraine; tension headache), insomnia (including initial insomnia), irritability

Serious Side Effects:

Cardiovascular events- acute myocardial infarctions [MI], sudden cardiac death, stroke, increased heart rate, and increased blood pressure
Growth suppression (pediatric) and Priapism Psychiatric/behavioral effects- pyschosis, mania symptoms

Sources: Lexicomp and Drug Bank

Heterocycles: Pyrazole, Pyrimidine
Indications: Gout, Nephrolithiasis, Recurrent calcium or uric acid stones, Tumor lysis syndrome
Target: xanthine dehydrogenase
MOA: By metabolizing into oxypurinol, allopurinol inhibits xanthine oxidase and essentially stops the production of uric acid.
Side Effects:
- Common: Maculopapular eruption, Pruritus (less than 1%)

- Serious: Drug reaction with eosinophilia and systemic symptoms, Rash (up to 3% ), Stevens-Johnson syndrome (less than 1% ), Toxic epidermal necrolysis (less than 1% ); Agranulocytosis, Aplastic anemia, Eosinophil count raised, Myelosuppression, Thrombocytopenia (0.6% ); Granulomatous hepatitis (less than 1% ), Hepatic necrosis (less than 1% ), Hepatotoxicity; Hypersensitivity reaction; Renal failure (less than 1% )

-Side effects:
• Headache

• Signs of a common cold

• Nose or throat irritation
• Kidney problems like unable to pass urine

• Low blood sugar
• Pancreas problems (pancreatitis) like severe stomach pain
• A severe skin reaction

2) Structure: Posted 
3) Functional Groups: Circled
4) Heterocycles: Circled
5) Target: ADP Receptor -- P2Y12
6) Mechanism of Action:
While active, Clopidogrel irreversibly blocks P2Y12 component of ADP receptors on platelet surface -- prevents activation of GPIIIb/IIIa receptor complex (decrease platelet aggregation). 
7) Interaction Role: P2Y12 Antagonist
8) Indication: Acute Coronary Syndrome (myocardial infarction)
9) Side Effects: Vomiting up Blood, Blood in urine, Bleeding from gums, abnormal vaginal bleeding, random bruising, Fatigue, tachycardia, confusion, hunger, sweating

Allergic Side effects:
Rash
Hives
Itching
Red
Swollen
Blistered
Peeling skin with or without fever
Wheezing
Tightness in the chest or throat
Trouble breathing
Swallowing or talking
Unusual hoarseness
Swelling of the mouth, face, lips, tongue, or throat.

Functional groups: Phenolic –OH group, halide, ether, primary amine, carboxylic acid

Heterocycles: phenol

Indications: primary, secondary, and tertiary hypothyroidism , Myxedema coma and Thyroid stimulating hormone suppression therapy-Pituitary

Targets: TRα1, TRβ1

MOA: “Triiodothyronine (T3) and levothyroxine (T4) diffuse into the cell nucleus and bind to thyroid receptor proteins attached to DNA. This hormone nuclear receptor complex activates gene transcription and synthesis of messenger RNA and cytoplasmic proteins. The physiological actions of thyroid hormones are produced predominantly by T3, the majority of which (approximately 80%) is derived from T4 by deiodination in peripheral tissues” (Micromedex)

Interaction: It is the agonist of Thyroid hormone receptor alpha and beta.

Indications: Levothyroxine is indicated as replacement therapy in primary (thyroidal), secondary (pituitary) and tertiary (hypothalamic) congenital or acquired hypothyroidism. It is also indicated as an adjunct to surgery and radioiodine therapy in the management of thyrotropin-dependent well-differentiated thyroid cancer.

Side effects:

-Enteric infections

-Fractures

-Fundic gland polyps

-Hypersensitivity

-Hypomagnesemia

-Interstitial nephritis

-Vitamin B12 deficiency

​

• Constipation, diarrhea, throwing up, or upset stomach

• Dry mouth

• Headache

• Itching

• Trouble sleeping

• Flushing

• Sweating a lot