Classifications Of Pharmaceutical Drugs

►All anti-inflammatory drugs are divided into 2 groups: (a) Nonsteroid anti-inflammatory) drugs ; (b) Steroid antiinflammatory drugs Nonsteroid anti-inflammatory drugs are classified according to chemical structure and anti-inflammatory activity. I group – preparations with strong anti-inflammatory activity A. Nonselective inhibitors of cyclooxygenase (COX) I. Acid derivatives

1) Derivatives of salicylic (ortho-oxybenzoic) acid Acetylsalicylic acid (Aspirin) Lysine acetylsalicylate Sodium salicilate Methyl salicylate

2) Pyrazolone derivatives Phenylbutazone

3) Derivatives of indole-acetic acid Indomethacin Sulindac

Derivatives of phenylacetic acid Diclofenac Sodium (Voltaren)

Derivatives of propionic acid Ibuprofen Ketoptofen Naproxen

Derivatives of anthranylic acid Mefenamic acid

Oxicam derivatives Piroxicam Tenoxicam Lornoxicam

II. Non-acidic derivatives B. Preferential inhibitors of COX2 Meloxicam Nimesulide Nabumetone

C. Selective inhibitors of COX2 Celecoxib Rofecoxib

II group

– preparations with poor anti-inflammatory activity

Pyrazolone derivative Metamizol

Paraaminophenol derivatives Paracetamol (Acetaminophen)

Preparations of other chemical structure►

Ketorolac

Antihistaminic drugs – blockers of H1-histaminic

receptors: Drugs of the first generation (”old”): Diphenhydramine (Dimedrol) Promethazine (Diprazine, Pipolphen) Chloropyramine (Suprastin) Clemastine (Tavegyl) Phencarol Mebhydroline (Diazoline) Antihistamines of the second generation: Loratadine (Claritine, Clarotadin) Acrivastine (Semprex) Azelastine Cetirizine (Zyrtec) Ebastine (Kestine) Desloratadine (Aerius) Fexofenadine (Telfast)

Inhibitors of mast cell and basophile degranulation: for internal use – Ketotifen for inhalation: Cromoglicic acid (Intal) Nedocromil (Tilade) combined drugs (cromoglicic acid +fenoterol = Ditec) for local use: Cromoglicic acid (Ifiral) Cromohexal

Others drugs with antiallergic action: glucocorticoids antileukotriene drugs: - lipoxygenase blockers: zileuton - blockers of leukotriene receptors: zafirlukast, montelukast

► FUNCTIONAL ANTAGONISTS OF HISTAMINE:

• •

β2-adrenomimetics – – adrenalin, isadrine, orciprenaline (alupent) muscarinic receptor blocker: Ipratropium bromide (Atrovent) methylxanthines: theophylline, aminophylline (euphylline) antileukotriene drugs: lipoxygenase blockers: zileuton blockers of leukotriene receptors: zafirlukast, montelukast

►Classification of analgesics, Narcotic analgesics Non-narcotic analgesics

I.

II.

1. Narcotic analgesics containing alkaloids of opium. Among these are Morphine and Codeine. Synthetic narcotic analgesics. Trimeperidine (Promedol) • Fentanyl • Piritramide • Pentazocine • Tramadol • Butorphanol Classification of narcotic analgesics according to their action on different types of opioid receptors. 1. •

A.

B.

• • • • • C.

Full agonists of opioid receptors. They stimulate all types of opioid receptors. Among these are Morphine, Trimeperidine, Fentanyl. Partial agonists of opioid receptors. The drugs are also called agonists-antagonists because they stimulate some types of opioid receptors and block others. Among these are: Pentazocine Butorphanol Nalbuphine Buprenorphine Piritramide Narcotic analgesics with a mixed mechanism of action. For example,Tramadol.

2.Non-narcotic analgesics of different chemical groups. The main non-narcotic analgesics are nonsteroidal anti-inflammatory drugs (NSAID). Pyrazolone derivatives: Metamizole sodium 2. Paraaminophenol derivatives: Paracetamol 3. Heteroaryl-acetic acid derivatives: Ketorolac 4. Drugs with a high anti-inflammatory activity can be recommended for the treatment of pain syndrome caused by inflammation of peripheral tissues. Among these are Diclofenac, Indometacin, Acetylsalicylic acid and Meloxicam. 1.

►AGENTS ACTING ON FUNCTIONS OF DIGESTIVE APPARATUS I.

II.

2.

Agents influencing an appetite a) stimulants of an appetite (bitter stuffs) b) preparations inhibiting an appetite (anorectics) • Phepranone • Sibutramine Agents regulating motor (motional) function of GIT 1. Emetics a) emetic drugs of direct action • Apomorphine b) emetic drugs of reflex action • preparations of Thermopsis Antiemetics a) blockers of dopamine receptors of trigger zone of vomiting centre • Tiethylperazine (Turicam) • Bromopride • Metaclopramide (Cerucal, Reglan) • Domperidone (Mothilium) c) Blockers of serotonin 5HT3 receptors • Tropisetrone • Ondansetrone d) drugs of other mechanism of action M-cholinoblockers (Scopalamine, “Aerone”)

Antigistaminic drugs (Diprazine, Dimedrol) 3. Preparations increasing tone of smooth muscles and motility of GIT Anticholinesterase drug (Proserine) 4. Preparations decreasing tone of smooth muscles and motility of GIT Spasmolitics (Papaverine, Drotaverine, Dibazol) M-chlinergic blockers (Atropine) Gaglionic blockers (Pirilen, Benzoxexonium) III. Laxatives A. Preparations causing mechanical irritation of mechanoreceptors of mucous coat of intestine according to nature 1. Salt laxatives • Magnesium sulfate • Sodium sulfate • Mineral salts 2. Preparations swelling in intestine • Laminaria • Bran • Seed of plantain • Linseed • Methylcellulose • Carboxycellulose • Prune 3. Lactulose preparations • Normaze • Duphalac B. Preparations causing chemical irritation of chemoreceptors in intestine 1. Preparations containing anthraglycosides • Rhubarb root • Buckthorn bark • Common [purging] buckthorn

• • • • •

Senna leaves Rhamnil Antrasennin Senade Agiolax

2. Synthetic laxatives • Phenolphtalein • Oxyphenisatine • Bisacodyl (Dulcolax) • Sodium picosulfate (Guttalax) 3. Castor oil C. Preparations softening fecal mass and facilitating their travel through intestine – eccoprotic preparations • sunflower-seed oil • almond-oil • olive oil • liquid paraffin • Poloscalpol D. Carminative agents – stimulate passage of gases. • Fennel seeds • Dill seeds • caraway-seeds • aromatic waters (mint, anise, dill) IV. Antidiareal agents. a) preparations of specific action – acting on pathogenic organisms (antimicrobial and antibacterial agents) b) preparations of non-specific action (for symptomatic therapy) drugs inhibiting intestine peristalsis • Loperamide Immodium) • Attapulgit (Caopectate) • Smecta (Diosmectide) V. Agents influencing on secretion of GIT

a) stimulators of secretion • Histamine • Pentagastrine b) agents inhibiting stomach secretion VI. Antiulcer agents 1. Antacids of systemic action (Sodium hydrocarbonate) of non-systemic action (Magnesium carbonate, Magnesium sulfate, Calcium carbonate, Aluminium hydrate) 2. Preparations decreasing secretion of hydrochloric acid a) b)

histamine H2-receptors blockers: • Ranitidine • Famotidine • Cimetidine b) proton pump inhibitors (blockers Н • Omeprazole • Pantoprazole • Lansoprazole c) muscarinic receptor blockers: • nonselective m-cholinoblockers Atropine a)

•

+

K+ - ATPase):

agents blocking M1-cholinoreceptors mainly Pirenzepine

3. Gastroprotectors – preparations protecting mucous coat of stomach from lesions a) Preparations producing mechanical protection of mucous coat (ulcer surface). • Sucralfat • Bismuth tripotassium dicitrate b) prostaglandin analogues: • Misoprostol • Enprostil

• Rioprostil 4. Preparations stimulating regeneration of mucous coat of stomach a) Preparations received from liquorice Carbenoxolon b) synthetic analogue of enkephalins – Dalargin c) preparations of biostimulants • “Solcoseril” • Methyluracil • Vitamin U 5. Preparation inhibiting chelicobacter pylori • • • VII.

Metronidazole Macrolide antibiotics (Clarythromycin, Roxithromycin) De-nol hepatotropic agents

A. Influencing on liver function: bile-expelling preparations are divided into a) Agents stimulating bile production (choleretica (chole – bile, rheo – flow) or cholesecretica). b) Agents promoting bile excretion (cholagoga (chole – bile, ago – turn out) or cholekinetica). c) Preparations relaxing biliary tracts d) Preparations thining bile (dilutent) B. Hepatoprotectors • Silibinin • Essentiale • Corsil • LIV-52 C. Cholelitolitics • Ursodeoxycholic acid • Ursofalc

• Chenodeoxycholic acid VIII. Agents used in disorders of excretory function of pancreas 1. In deficiency of pancreas function substitute therapy is used Pancreatin – enzyme of pancreas 2. Drugs used in increased function of pancreas (acute pancreatitis) Inhibitors of ptoteolitic enzymes • Aprotinin • Contrical IX. Drugs regulating balance of intestine microflora (socalled “eubiotics”) • Lactobacterine • Bifidumbacterine • Bactisuptil Classification of antianginal drugs: group and preparations I. Drugs decreasing the myocardial oxygen demand 1. Nitrates • Short acting: Glyceryl trinitrate (GTN, Nitroglycerine) • Long acting: Isosorbide dinitrate (short acting by sublingual route), Isosorbide mononitrate, Erythrityl tetranitrate, Penta erythritol tetranitrate 2. Nitrites – closed to nitrates on mechanism of action: Amylnitrite, Sodium nitrite β- adrenoceptor blockers: Propranolol, Metoprolol, Atenolol, Nebivolol etc. 4. Calcium channel blockers. They decrease the myocardium functions and so the myocardial oxygen consumption too. • Phelyl alkylamine: Verapamil • Benzothiazepine: Diltiazem • Dihydropyridines: Nifedepine, Felodipine, Amlodipine, Nitrendipine, Nimodipine, Lacidipine 5. Potassium channel opener - Nicorandil II. Drugs increasing oxygen delivery to the myocardium: 3.

They are less effective and so less popular and used rare. Validol – the drug of reflex action, it is used for relief of angina pectoris symptoms 2. β2- adrenoceptor agonists: Oxyphedrine 3. Inhibitors of phosphodiesterase 4. Coronary vasodilating drugs with adenosine mechanism of action. They increase adenosine concentration in the myocardium, dilate collateral vessels – Dipyridamole 1.

III. Inhibitors of platelet aggregation - Aspirin (acetylsalicylic acid) in small doses – up to 100 mg in a day ►CLASSIFICATION OF ANTIHYPERTENSIVE DRUGS Group I - neurotropic drugs of central action 1)

α2-adrenomimetics Clonidine , Methyldopa , Guanfacine

2)

Agonist of imidazoline receptors Moxonidine , Rilmenadine

Group II - neurotropic drugs of peripheral action 1) Ganglionic blockers Hexamethonium Benzosulfonate Trepirium Iodide (Hygronium) 2) Sympatholytics Reserpine Guanethidine Sulfate Combined preparations: «Adelphan» , «Brinerdin» , «Crystepin» 3)

4)

selective α1adrenoceptor antagonist a) short term acting drug – Prazosin b) long term acting drug – Terazosin, Doxazosin, Bunazosin β-adrenoceptor antagonist 1 generation – β1- β2- adrenoceptor antagonists Propranolol , Pindolol , Bopindolol , Nadolol

2 generation – cardioselective β1- adrenoceptor antagonists Metoprolol , Atenolol , Bisoprolol , Talinolol 3 generation • •

nonselective – Carvedilol, Busindolol selective - adrenoceptor antagonists with vasodilating properties Nebivolol

Group III – drugs of myotropic action 1) Blockers of calcium channel • L-type - Nifedipine, Amlodipine, Diltiazem • T-type - Mibefradil 2) Potassium channel activators • Minoxidil • Diazoxide 3) Nitrosovasodilators • Sodium Nitroprusside • Molsidomine 4) Inhibitors of phosphodiesterase • Dibasol • Papaverine 5) Others • Hydrolazine • Magnesium sulfate Group IV – drugs acting on renin- angiotensin system 1) Angiotensin converting enzyme inhibitors • Captopril • Enalapril • Lisinopril • Benazepril • Ramipril • Perindopril 2) Angiotensin II antagonists • Losartan • Valsartan • Candesartan Group V – diuretics

• Hydrochlorothiazide • Furosemide (Lasix) • Spironolactone CLASSIFICATION OF CALCIUM CHANNEL BLOCKERS A. According to nature 1) Dihydropyridine derivatives • Nifedipine • Nicardipine • Felodipine • Lacidipine • Nimodipine • Nitrendipine • Felodipine • Amlodipine • Isradipine They more influence on artery tone then on myocardium. 2) Benzothiazepine derivatives • Diltiazem Equal influence both artery and myocardium. 3) Phenylalkylamine derivatives • Verapamil Influence on myocardium is greater then on arteries. So it is used in arrhythmia and coronary heart disease. According to generation Generation 1(short term action) • Nifedipine • Nicardipine • Diltiazem • Verapamil Generation 2(prolonged forms of preparations of generation I, retard-forms or new compounds with long time of action) • Isradipine • Nimodipine

Generation III • Amlodipine • Lacidipine Antihypotensive drugs. Hypotension (low blood pressure) can be acute and chronic. Acute hypotension is observed in collapse, shock and faint. Chronic hypotension is characterized by permanent low arterial blood pressure. For the treatment of hypotension depending on its cause the following groups of preparations are used. 1. Vasoconstrictive agents: a) Agonists of angiotensin II Angiotensinamide (synthetic analogue of endogenous angiotensinamide). It is manufactured in the form of powder in vials. It is dissolved ex tempore and administered intravenously. Angiotensinamide has short-time but vigourous action. •

b) Adrenoceptor agonists (mainly α- adrenoceptor agonists) • Epinephrine (Adrenalin) • Norepinephrine (Noradrenaline) They are non-selective α- adrenoceptor agonists. Mesaton –selective ones. c) Sympathomimetics •

• Ephedrine It stimulates noradrenaline release from presynaptic membrane. All the drugs are mainly used in acute hypotension. d) Glucocorticoids • Prednisolone • Dexamethasone • Hydrocortisone

They are used in acute hypotension as they increase adrenoreceptor sensitivity to catecholamines, decreases penetrability of vessels. 2. Agents increasing cardiac output (improving heart function). They are used in case of shocks, in postoperative period. a) Dopamine receptor agonists • Dopamine hydrochloride It stimulates heart function and increases tone of vessels and used in cardiogenic shock, traumatic shock. b) β-adrenomometics • Dobutamine c) Cardiac glycosides 3. Analeptics. They stimulate both tone of vessels and myocardium function. • Caffeine • Cordiamin (Nikethamide) • Camphor preparations 4. General tonic (general stimulants) – they increase a tone of CNS. Ginseng • Aralia • Devil's-club • Schizandra Tinctures from the plants are used in chronic hypotension conditions. •

5. If hypotension is due to loss of blood then preparations increasing volume of blood circulation - plasma-substituting solutions, colloid solutions, crystalloid solutions (salt solutions). Classification of antiarrhythmic drugs, their groups and preparations. I. Drugs blocking ion channels of cardiac hystiocytes (conducting system of heart and contractile myocardium)

1. Drugs blocking sodium channels (membrane stabilizers; group IA) Subgroup IA (quinidine and quinidine like drugs): Quinidine sulfate

Disopyramide

Procainamide

Ajmaline

Subgroup IB: Lidocain

Phenytoin

Subgroup IC: Flecainide

Propafenone

Ethmosine

Ethacizine

2. Drugs blocking L-type of calcium channels (group IV) Verapamil

Diltiazem

3. Drugs blocking potassium channels (drugs increasing repolarization duration and action potential; group III) Amiodaron (Cordaron)

Ornid

Sotalol

II. Drugs mainly influencing on receptors of heart efferent innervation Drugs weakening adrenergic influences: β- adrenergic blockers Anaprilin and etc. Drugs increasing adrenergic influences: β- adrenergic agonists Isoprenaline sympathomimetics Ephedrine Drugs weakening cholinergic influences: muscarinic receptor blocker

Atropine sulfate III. Different drugs having antiarrhythmic activity Potassium and magnesium drugs glycosides Adenosine

Cardiac

Antiarrhythmic drugs are also classified into following groups: A. Drugs used in tachyarrhythmia and extrasystoles • Drugs blocking sodium channels • Drugs blocking calcium channels • Drugs blocking potassium channels • β- adrenergic blockers • Cardiac glycosides (digitalis drugs) • Adenosine • Potassium and magnesium drugs B. Drugs used in bradyarrhythmia and conduction abnormality • Muscarinic receptor blocker • β- adrenergic agonists Classification of antibiotics (groups and drugs) I. β (Beta) - lactam antibiotics • Penicillins • Cephalosporins • Carbapenems • Monobactams II. Macrolides and azalides III. Aminoglycosides IV. Tetracyclines V. Polymyxins VI. Lincosamides VII. Rifampicins

VIII. Glycopeptides IX. Polyene antibiotics X. Others: Chloramphenicol, Fosfomycin, Fusidic acid, Ristomycin, Gramicidin

Biosynthetic penicillins can be classified into: 1. Drugs with a short-term action:  Benzylpenicillin: benzylpenicillin-sodium; benzylpenicillin- potassium  Phenoxymethylpenicillin  Benzathine phenoxymethylpenicillin 2. Drugs with a long-term action:  Benzylpenicillin-procaine  Benzathine benzylpenicillin (bicillin-1, extencillin)  Bicillin-3 (benzylpenicillin-potassium + benzylpenicillinprocaine + benzathine benzylpenicillin in equal quantities)  Bicillin-5 (1 part of benzylpenicillin-procaine, 4 parts of benzathine benzylpenicillin) Semisynthetic penicillins: drugs and their pharmacological features. Semisynthetic penicillins can be classified into: I.

Penicillinase resistant penicillins:  Methicillin  Oxacillin  Cloxacillin  Dicloxacillin  Flucloxacillin  Nafcillin

II. Extended spectrum penicillins  Ampicillin  Amoxicillin  Hetacillin

 Talampicillin  Pivampicillin III.

Penicillins acting on Pseudomonas aeruginosa (blue pus bacillus) a) Carboxypenicillins: Carbenicillin, Ticarcillin, Carfecillin b) Ureidopenicillins: Piperacillin, Azlocillin, Mezlocillin ►Cephalosporins are subdivided into following generations. I. First generation: 1. Parenteral: Cephalothin, Cefazolin 2. Oral: Cephalexin, Cefadroxil II. Second generation: 1. Parenteral: Cefuroxime, Cefoxitin, Cefamandole 2. Oral: Cefaclor, Cefuroxime axetil III. Third generation: 1. Parenteral: Cefotaxime, Ceftriaxone, Cefoperazone, Cefoperazone/sulbactam 2. Oral: Cefixime, Ceftibuten IV. Fourth generation: Parenteral: Cefepime, Cefpirome

Ceftazidime,

► Modes of manufacturing

Fourteenmembered

Natural macrolides

Erythromycin Oleandomycin

Semisynthetic macrolides

Roxithromycin Clarithromycin

Fifteenmembered

Sixteenmembered Spiramycin Josamycin Midecamycin

Azithromycin

Midecamycin acetate

►Classification: 1. 2.

Aminoglycosides of the 1st generation: Streptomycin, Kanamycin, Neomycin Aminoglycosides of the 2nd generation: Gentamycin, Tobramycin, Netilmicin 3. Aminoglycosides of the 3rd generation: Amikacin

►Quinolones and fluoroquinolones: 1.

2.

3.

4.

Drugs of the 1st generation: non-fluorinated quinolones  Nalidixic acid  Oxolinic acid  Pipemidic acid Drugs of the 2nd generation:  Ciprofloxacin  Norfloxacin  Ofloxacin  Pefloxacin  Lomefloxacin (2 F) Drugs of the 3rd generation:  Levofloxacin  Sparfloxacin  Temafloxacin (3F)  Enoxacin  Tosufloxacin  Fleroxacin  Rufloxacin Drugs of the 4th generation:  Moxifloxacin  Clinafloxacin  Gatifloxacin  Trovafloxacin (3F)

1. Classification of antituberculous drugs (groups and medicines). According to their chemical structure antituberculous drugs can be divided into: I.      

Antituberculous antibiotics: Rifampicin Rifabutin Capreomycin Cycloserine Streptomycin Kanamycin

 Amikacin II. Hydrazides of isonicotinic acid:  Isoniazid  Metazide  Opiniazide  Ftivazide III. Derivatives of para-aminosalicylic acid:  Para-aminosalicylic acid IV. Synthetic drugs with other chemical structure:  Pyrazinamide  Ethionamide  Ethambutol  Thiacetazone V. Fluoroquinolones:  Lomefloxacin  Ciprofloxacin  Ofloxacin VI Macrolides :  Clarithromycin  Azithromycin According to their clinical utility antituberculous drugs can be divided into: I. Drugs of first line: These drugs have high antitubercular efficacy as well as low toxicity; are used routinely  Streptomycin  Rifampicin  Isoniazid  Ethambutol  Pyrazinamide II. Drugs of second line: These drugs have either low antitubercular efficacy or high toxicity or both; are used in special circumstances only.    

Capreomycin Cycloserine Kanamycin Amikacin

 Para-aminosalicylic acid  Lomefloxacin Classification of antifungal drugs: According to their chemical structure drugs are divided into following groups: I. Antifungal antibiotics: A. Polyenes: Amphotericin B, Nystatin, Natamycin B. Heterocyclic benzofurans: Griseofulvin II. Synthetic antifungal drugs: A. Azoles: 1. Imidazole derivatives: Clotrimazole, Econazole, Miconazole, Ketoconazole, Oxiconazole 2. Triazole derivatives: Fluconazole, Intraconazole B. Allylamines: Terbinafine, Naftifine C. Thiocarbamates: Tolnaftate D. Nitrophenol derivatives: Nitrofungin E. Derivatives of undecylenic acid: ointment “Zincundan”, ointment “Undecin” F. Antifungal drugs with other chemical structure: 1. Dequalinium chloride (Decamin) 2. Iodine drugs: alcohol solution of Iodine, potassium iodide 3. Drugs of salicylic acid ► I. Synthetic antiviral drugs: 1. Adamantane derivatives:  Amantadine  Rimantadine 2. Nucleoside analogs:  Zidovudine (AZT)  Acyclovir  Valaciclovir  Vidarabine  Ganciclovir

 Idoxuridine 3. Drugs with other chemical structure:  Arbidol  Oxolin  Tebrophen  Bonaphton  Florenal II. Drugs of a biological origin: 1. Interferons:  Interferon alfa (α)  Interferon alfa-2a  Interferon alfa-2b  Interferon beta (β)  Interferon gamma (γ) 2. Drugs of a herbal origin:  Flacosid  Alpisarin  Helepin  Gossypol According to their clinical utility antiviral drugs are classified into: I. Anti-influenza drugs: a) Adamantane derivatives:  Amantadine  Rimantadine b) Inhibitors of viral neuraminidase:  Zanamivir  Ozeltamivir c) Inducers of interferon synthesis:  Arbidol II. Anti-herpes drugs: 1. Nucleoside analogs:  Acyclovir  Valaciclovir  Famciclovir  Idoxuridine

 Ganciclovir 2. Inducers of interferon synthesis:  Cycloferon III. Drugs used for the treatment of HIV:

1. Inhibitors of reverse transcriptase: a) Nucleoside reverse transcriptase inhibitors (NRTIs)  Zidovudine (AZT)  Didanozine  Stavudine  Lamivudine  Zalcitabine b) Non-nucleoside reverse transcriptase inhibitors (NNRTIs)  Nevirapine  Efaverenz 2. Protease inhibitors:  Saquinavir  Indinavir  Amprenavir  Ritonavir IV. Drugs used for the treatment of cytomegalovirus infections: 1. Nucleoside analogs:  Ganciclovir  Valganciclovir 2. Foscarnet V. Antiviral drugs with an extended spectrum of action (nonselective antiviral drugs):  Ribavirin  Lamivudine  Interferons: Interferon α, etc There are drugs which increase resistance of body cells to an action of viruses (nonselective antiviral drugs). Among these are:

 Interferons: Interferon alfa (α), Interferon alfa-2a, Interferon alfa-2b, Interferon beta (β), Interferon gamma (γ)  Inducers of interferon synthesis: Arbidol, Poludan, Neovir (Cridanimod), Cycloferonum (Methylglucamine acridonacetate),  Immunomodulators: Imunofan, Licopid, Levamisole, Polyoxydonium

1. Classification of antiprotozoal drugs. I. Drugs used for the treatment and prevention of malaria.  Chloroquine (chingamin)  Pyrimethamine (chloridin)  Mefloquine  Quinine  Primaquine  Sulfonamides: Sulfadoxine  Tetracyclines: Tetracycline, Doxycycline II. Drugs used for the treatment of amebiasis.  Metronidazole  Emetine  Tetracyclines: Tetracycline, Doxycycline  Chloroquine  Iodoquinol III. Drugs used for the treatment of lambliasis.  Metronidazole  Furazolidone  Aminochinole IV. Drugs used for the treatment of trichomoniasis.  Metronidazole  Tinidazole  Trichomonacide  Furazolidone V. Drugs used for the treatment of toxoplasmosis.  Pyrimethamine (chloridin)  Sulfadimidine (Sulfadimesine) VI. Drugs used for the treatment of balantidiasis.  Tetracyclines

 Monomycin  Chiniofone VII. Drugs used for the treatment of leishmaniasis.     

Solyusurmin Sodium stibogluconate Metronidazole Pentamidine Meglumine antimonite

According to localization of amoebas, antiamoebic drugs can be divided into: A. Antiamoebic drugs (amoebicides) used for the treatment of intestinal and extraintestinal amoebiasis.  Metronidazole  Tinidazole  Ornidazole B. Amoebicides (with direct action) which are effective against amoebas localized within lumen of the large intestine.  Chiniofon  Iodoquinol C. Amoebicides (with indirect action) which are effective against amoebas localized within lumen of the large intestine and in intestinal wall.  Tetracyclines D. Tissue amoebicides acting on amoebas localized in intestinal wall and in the liver.  Emetine  Dehydroemetine E. Tissue amoebicides effective against amoebas localized in the liver.  Chloroquine

Classification of antihelmintic drugs: Antihelmintic drugs can be classified into:

Drugs used for the treatment of intestinal helminthiasises. Drugs used for the treatment of intestinal nematodosises  Levamisole  Pyrantel pamoate  Mebendazole  Albendazole  Piperazine adipate  Pyrvinium embonate  Bephenium hydroxynaphthoas 2. Drugs used for the treatment of intestinal cestodosises.  Mebendazole  Albendazole  Praziquantel  Aminoacrichine  Niclosamide II. Drugs used for the treatment of abenteric helminthiasises. I. 1.

1. Drugs used for the treatment of abenteric nematodosises.  Diethylcarbamazine (ditrazine citrate) 1.

Drugs used for the treatment of abenteric cestodosises

 Albendazole  Praziquantel 2.

Drugs used for the treatment of abenteric trematodosises

 Praziquantel  Chloxyl  Antimonyl Na- tartrate  Emetine  Diethylcarbamazine (ditrazine citrate)

►Classification of antineoplastic drugs: I. Aalkylating agents:  

Chlorethylamines: Cyclophosphamide, Chlorbutin, Dopane, Sarcolysine (merphalan) Ethylenimine: Thiotepa (thiophosphamide)

 Derivatives of methanesulfonic acid: Myelosan  Nitrosoureas: Nitrosourea, Lomustine, Carmustine, Nimustine  Triazines: Dacarbazine, Procarbazine  Drugs containing Platinum: Cisplatin, Carboplatin II. Antimetabolites: Antagonists of folic acid: Methotrexate  Purine antagonists: Mercaptopurine  Pyrimidine antagonists: 5-Fluorouracil, Phthorafur, Cytarabine III. Antineoplastic antibiotics: 

 Actinomycins: Dactinomycin  Anthracyclines: Rubomycin, Doxorubicin, Carminomycin  Phleomycins: Bleomycin  Drugs with other chemical structure: Olivomycin, Mitomycin, Rufocromomycin IV. Vegetable antineoplastic drugs:  Vinca alkaloids: Vincristine, Vinblastine  Taxanes (alkaloids of Western yew tree): Paclitaxel, Docetaxel  Epipodophyllotoxin: Etoposide, Tenyposide  Alkaloids of showy autumn crocus: Colchamine, Colchicine V. Enzymatic drugs: L-Asparaginase VI. Hormones and their antagonists: Androgens: Testosterone propionate, Medrotestrone propionate, Tetrasterone  Estrogens: Ethinylestradiol, Fosfestrol, Diethylstilbestrol  Gestagens: Hydroxyprogesterone, Medroxyprogesterone  Antiestrogens: Tamoxifen, Toremifene 

 Antiandrogens: Flutamide, Cyproterone  Antagonists of hypothalamic hormone stimulating release of gonadotropic hormone: Goserelin, Leiprorelin  Aromatase inhibitors: Letrozole  Glucocorticoids: Prednisolone, Dexamethasone VII. Cytokinins:  Interferons: Interferon alfa  Interleukins: Interleukin-2 Derivatives of purine alkaloids (caffeine, theobromine) increase cerebral blood flow. From this drug group Pentoxyphylline (Agapurin, Trental) is used now for stroke treatment. It takes moderate vasodilating action, decreases platelet aggregation, increases erythrocyte membrane elasticity and improves microcirculation. The vasodilating effect is due to the adenosine receptor block. Besides the drug inhibits phosphodiesterase and increases the cyclic adenosine monophosphate contents in platelets. Pentoxyphylline is also used in peripheral circulation disorders, diabetic angiopathy, eye blood flow disorders. Adverse effects include dyspepsia, dizziness, redness.

Classification of drugs influencing tone and contractions of myometrium A. AGENTS INCREASING STRENGTH AND FREQUENCY OF RHYTHMIC CONTRACTION OF UTERUS (DELIVERY STIMULATING) I. Neurotropic agents 1) M-cholinomimetics • Acetylcholine • Carbachol 2) Anticholinergic drugs • Neostigmine 3) Ganglion-blocking agents • Pachycarpine hydroiodide

• Hexamethonium benzosulfonate • Azamethonium bromide • Pempidine tosylate 4) Dopaminomimetics • Levodopa 5) α-adrenomimetics • Noradrenalin 6) β-adrenoblockers • Propranolol 7) Serotonin receptor agonists • Serotonin adipinate 8) Agonists of histamine receptors • Histamine II. Hormonal preparations 1) Preparations of posterior pituitary • Demoxytocin • Oxytocin • Pituitrin 2) Prostaglandins • Dinoprostone (prostaglandine E2 preparation) • Dinoprost (prostaglandin F2α preparation) 3) Estrogenic hormones Steroid • Esrone • Estradiol • Estradiol dipropionate Nonsteroid synthetic • Hexestrol • Diethylstilbestrol 4) Corticosteroid hormones • Cortisone acetate III. Cyclic nucleotides • cGMP IV. Calcium salts

• Calcium chloride B. AGENTS INCREASING TONE OF MYOMETRIUM Ergot alkaloids • Ergometrine • Ergotamine • Methylergometrine Preparations of other plants • Capsella bursa-pastoris (caseweed) fluid extract (herb) • Polygonum hydropiper (water pepper) fluid extract (herb) • Nettle fluid extract (leaves) • Arnica infusion (flowers) C. AGENTS INHIBITING CONTRACTILITY AND TONE OF MYOMETRIUM (TOCOLYTICS) I. Neurotropic agents 1) M-cholinoblocking agents • Atropine • Platiphylline • Metocinium iodide 2) α-adrenoblocking agents • Phentolamine • Tropodifene hydrochloride 3) β2-adrenomimetics • Orciprenaline • Salbutamol • Fenoterol (Partusisten) • Terbutaline • Hexoprenaline (Gynipral) • Isoxuprine • Ritodrine 4) GABA-ergic agents • Sodium oxybutirate • Gamma aminobutyric acid (Picamolonum) • Hopatenic acid (Pantogam)

5) Inhibitors of prostaglandin synthesis • Indomethacin • Ibuprofen • Mefenamic acid • Diflunisal 6) Hormonal gestagenic preparations • Progesterone • Oxyprogesterone capronate • Allylestrenol (Turinal) 7) Myotropic spasmolitics (inhibitors of phosphodiesterase) • Theophylline • Aminophylline • Papaverine • Drotaverine • Pentoxifylline (trental) 8)Magnesium salts • Magnesium sulphate IV. AGENTS DECREASING TONE OF NECK OF UTERUS • Atropine sulfate • Dinoprost • Dinoprostone