Drug By Class
This Book
based on drugs.com site
prepared by
Dr Mahmoud Alwasify
Tanta Pharmacy
What are 5-alpha-reductase inhibitors? mesalamine
sulfasalazine
balsalazide
5-alpha-reductase inhibitors are a group of medi- olsasalazine
cines that block the action of 5-alpha-reductase, the
enzyme that converts testosterone into dihydrotes- What are 5HT3 receptor antagonists?
tosterone. This results in increased levels of testos- 5-HT3 receptor antagonists (also called serotonin
terone and decreased levels of dihydrotestosterone;
receptor antagonists or serotonin blockers) are a
an overabundance of dihydrotestosterone has been class of medicines that are used for the prevention
implicated in benign prostatic hyperplasia (BPH) and treatment of nausea and vomiting, particularly
and prostate cancer. The scalp of men with androge- that caused by chemotherapy, radiation therapy, or
netic alopecia (male-pattern baldness) has also been postoperatively. 5-HT3 is an abbreviation for sero-
found to contain increased amounts of dihydrotes-
tonin that may also be written as 5-hydroxytrypt-
tosterone and miniaturized hair follicles compared amine.
with men who have a lot of hair.
Cells lining the gastrointestinal tract release sero-
Currently, two 5-alpha-reductase inhibitors are
tonin when damaged by chemotherapy and radi-
available, finasteride and dutasteride. The 5-al- ation therapy. This serotonin binds to serotonin
pha-reductase enzyme exists in two forms: type 1 receptors on nerves that transmit impulses to the
and type 2. Finasteride inhibits type 2 only, whereas
vomiting center within the brain, which in turn
dutasteride inhibits both. Although dutasteride pro-
stimulates other nerves involved in the vomit reflex.
vides greater suppression of dihydrotestosterone, it 5-HT3 receptor antagonists prevent serotonin from
is not known if this provides a significant advantage binding to 5-HT3 receptors in the small intestine
clinically. Rates of side effects such as impotence, thereby reducing the likelihood of nausea and vom-
decreased libido, ejaculation disorder, and gyneco-
iting. The way 5-HT3 receptor antagonists work to
mastia are similar.
prevent postoperative nausea and vomiting is less
well understood.
5-alpha-reductase inhibitors may be used in the
treatment of benign prostatic hyperplasia (enlarged The first generation 5-HT3 receptor antagonists
prostate gland) and male-pattern hair loss (an-
include dolasetron, granisetron, and ondansetron.
drogenic alopecia). They are not approved for the
Despite variations in their chemical structures and
prevention of prostate cancer. absorption rates, they all work in the same way and
are well tolerated. The oral formulations are just as
What are 5-aminosalicylates? effective at preventing nausea and vomiting as the
intravenous forms.
Aminosalicylates are anti-inflammatory agents used
to treat inflammatory bowel disease and some forms
Palonosetron is a second-generation serotonin
of arthritis. They work by inhibiting the production
blocker. It has a greater affinity for serotonin recep-
of cyclo-oxygenase and prostaglandin, thromboxane
tors than first generation agents, which increases its
synthetase, platelet activating factor synthetase, and
duration of effect. Palonosetron is also thought to
interleukin-1 by macrophages so reduces the acute
have an effect on 5-HT3 receptors in the vomiting
inflammatory response in inflammatory bowel
center and chemoreceptor trigger zone as well, not
disease.
just the small intestine. It is approved for both acute
and delayed chemotherapy-induced nausea and
Production of immunoglobulin by plasma cells is
vomiting.
also decreased.
Aminosalicylates are used to treat ulcerative colitis, palonosetron
proctitis and Crohn’s disease. dolasetron granisetron ondansetron
What are ACE inhibitors with calcium channel hydrochlorothiazide / lisinopril
blocking agents? hydrochlorothiazide / moexipril
hydrochlorothiazide / quinapril
ACE inhibitors with calcium channel blocking captopril / hydrochlorothiazide
agents is a combination medicine containing both benazepril / hydrochlorothiazide
an angiotensin-converting-enzyme inhibitor (ACE fosinopril / hydrochlorothiazide
inhibitor) and a calcium channel blocker.This com- enalapril / hydrochlorothiazide
bination is often used to treat hypertension.
An ACE inhibitor blocks the angiotensin-con- What are Adamantane antivirals?
verting-enzyme from converting angiotensin I to
angiotensin II. This results in a decrease in an- Adamantane antivirals are only active against
giotensin II causing vasodilation and therefore a influenza A virus, an RNA virus, but has no action
reduction in blood pressure. against influenza B virus. A viral membrane pro-
tein, M2, functions as an ion channel at two stages
Calcium channel blockers block calcium from of the viral replication within the host cell. These
entering cells of the heart and smooth muscle in stages are the fusion of viral membrane and endo-
the walls of blood vessels. This results in vasodila- some membrane, and the assembly and release of
tion of the arteries, a reduction in heart contrac- new virions. Adamantane antivirals block this ion
tion force, a slowing of heart rate and a reduction channel.
in aldosterone production. These effects cause a
decrease in blood pressure in the hypertensive pa-
tient and a decrease in symptoms in patients with amantadine
angina or ischemic heart disease. rimantadine
What are Adrenal cortical steroids?
trandolapril / verapamil
amlodipine / benazepril
Corticosteroids (adrenal cortical steroids) are nat-
enalapril/felodipine
ural hormones made by the adrenal cortex which
amlodipine / perindopril
are important in maintaining good health. There are
two types of corticosteroids, the glucocorticoids and
What are ACE inhibitors with thiazides? the mineralocorticoids.
ACE inhibitors with thiazides is a combination Glucocorticoids e.g. cortisol and cortisone, are
medicine containing both an angiotensin-convert- important for how the body responds to stress and
ing-enzyme inhibitor (ACE inhibitor) and a thia- also how it uses carbohydrate, fat and protein. Nat-
zide. urally occurring and synthetic glucocorticoids have
An ACE inhibitor blocks the angiotensin con- very powerful anti-inflammatory effects and are
verting enzyme from converting angiotensin I to used to treat conditions that involve inflammation.
angiotensin II. This results in a decrease in an- Glucocorticoids also decrease the body’s immune
giotensin II causing vasodilation and therefore a response so are used to treat conditions when the
reduction in blood pressure. immune system is over-reacting.
Thiazide diuretics decrease active re-absorption of
sodium and chloride ions by inhibiting the sodi- Mineralocorticoids e.g. aldosterone are necessary
um/chloride co-transporter in the distal convolut- for regulation of salt and water in the body.
ed tubule. This causes an increase in urine produc-
tion (diuresis) and results in a decrease in blood corticotropin
volume and a reduction in blood pressure. glucocorticoids , mineralocorticoids
