What each drug is FOR, and what you tell the patient. 89 entries across all three Exam 1 decks, each citing its slide. The second and third items on Dr. McInnis’s list of what students under-study.
| Drug or class | Tier | Indications | Patient education & practical notes | Source |
|---|---|---|---|---|
| Penicillin G natural penicillin | Drug of choice | DRUG OF CHOICE for syphilis, gas gangrene and meningococcus. Good against gram-positive cocci; no staph coverage; anaerobic activity except Bacteroides; no aerobic gram-negative activity. | Monitor for signs and symptoms of anaphylaxis. | L1 slide 17 |
| Aminopenicillins ampicillin, amoxicillin | Drug of choice | DRUG OF CHOICE for Enterococcus, Listeria, endocarditis prophylaxis, upper respiratory tract infection (sinusitis, otitis, bronchitis) and community-acquired pneumonia (high-dose amoxicillin). | Reduces the effectiveness of oral contraceptives — use backup birth control. Ampicillin is IV or oral; amoxicillin is oral only. | L1 slide 19 |
| Amoxicillin/clavulanate, ampicillin/sulbactam Augmentin, Unasyn | Drug of choice | DRUG OF CHOICE for skin and soft tissue infection, diabetic foot, and animal or human bites. The beta-lactamase inhibitor adds anaerobe coverage (Bacteroides) and MSSA. | The bite indication is the one to remember — it is why Augmentin is the reflex answer for a cat bite. | L1 slide 25 |
| Piperacillin/tazobactam Zosyn | Drug of choice | DRUG OF CHOICE for polymicrobial infections, nosocomial infections (especially pneumonia), intra-abdominal infections and pseudomonal infections. | Broad spectrum with anti-pseudomonal activity; keeps gram-positive cover for MSSA only. | L1 slide 27 |
| Cefazolin, cephalexin 1st generation — Ancef, Keflex | Indication | Cefazolin for surgical prophylaxis, MSSA and urinary tract infection. Cephalexin for skin and soft tissue infection (cellulitis) and urinary tract infection. | Great gram-positive activity but no Enterococcus coverage; some gram-negative cover. | L1 slide 32 |
| Ceftriaxone, cefotaxime 3rd generation | Indication | Ceftriaxone has good Strep coverage and needs no dose adjustment in renal insufficiency. Cefotaxime is preferred in neonatal fever or sepsis. | Ceftriaxone cannot be used in the first 30 days of life — reach for cefotaxime instead. | L1 slide 34 |
| Nafcillin, oxacillin, dicloxacillin penicillinase-resistant | Indication | Designed SOLELY to cover S. aureus (MSSA), with decreased activity against other organisms. | S. aureus is increasingly resistant to this class (MRSA), and vancomycin is the treatment of choice for MRSA. Dosing considerations are hepatic, not renal. | L1 slide 26 |
| Ceftolozane/tazobactam Zerbaxa | Indication | FDA (Food and Drug Administration) approved for complicated intra-abdominal infections (plus metronidazole) and complicated urinary tract infections. | Anti-pseudomonal with some anaerobic activity, but no MRSA and no Enterococcus. The “plus metronidazole” pairing is the detail to carry. | L1 slide 38 |
| Cefepime 4th generation — Maxipime | Drug of choice | DRUG OF CHOICE for neutropenic fever, nosocomial infections (hospital- and ventilator-acquired pneumonia) and pseudomonal infections. | Broad spectrum with anti-pseudomonal activity, but no MRSA, no Enterococcus and no anaerobes. | L1 slide 36 |
| Ceftaroline 5th generation — Teflaro | Indication | FDA approved for community-acquired pneumonia and skin and soft tissue infections. Notable as the cephalosporin with MRSA coverage. | Must be renally adjusted. | L1 slide 37 |
| Aztreonam monobactam | Indication | Gram-negative only — the spectrum resembles the aminoglycosides, with activity against Pseudomonas aeruginosa and Enterobacteriaceae. No gram-positive or anaerobic activity. | The reason it exists on the exam: no cross-reactivity with beta-lactams, so it can be used in a truly penicillin-allergic patient. | L1 slide 40 |
| Carbapenems imipenem, meropenem, ertapenem | Drug of choice | DRUG OF CHOICE for multidrug-resistant gram-negative infections, extended-spectrum beta-lactamase producers, nosocomial infections, and meningitis (they penetrate the central nervous system). | Very broad, but no MRSA, and ertapenem is the one without Pseudomonas coverage. | L1 slide 43 |
| Drug or class | Tier | Indications | Patient education & practical notes | Source |
|---|---|---|---|---|
| Vancomycin | Drug of choice | DRUG OF CHOICE for penicillin-allergy infections, MRSA, C. difficile (oral), endocarditis, osteomyelitis, and surgical prophylaxis in allergy. Gram-positive coverage ONLY. | Oral for C. difficile, intravenous for everything else — the route changes with the indication, which is a favorite question. | L1 slide 47 |
| Vancomycin | Monitoring | Target trough 10–15 or 15–20 mcg/mL depending on the indication. A loading dose of 25–30 mg/kg may be used to reach target quickly. | If the MIC (minimum inhibitory concentration) is 2 mg/L or above, the target is hard to achieve and alternative therapy such as linezolid may be needed. | L1 slide 48 |
| Drug or class | Tier | Indications | Patient education & practical notes | Source |
|---|---|---|---|---|
| Macrolides erythromycin, clarithromycin, azithromycin | Indication | Respiratory tract infections (community-acquired pneumonia, acute otitis media, pharyngitis, sinusitis, chronic bronchitis), skin infections, Mycobacterium avium complex prophylaxis and treatment, Chlamydia trachomatis, and H. pylori. | H. pylori regimen is Prevpac — clarithromycin + amoxicillin + lansoprazole. Erythromycin is the one used for conjunctivitis or pneumonia in an infant. | L1 slide 56 |
| Tetracyclines doxycycline, minocycline | Indication | Acne, atypical pneumonia, animal-borne disease, Rocky Mountain spotted fever, Lyme disease and sexually transmitted disease — doxycycline for chlamydia. | They chelate with cations — counsel the patient to separate doses from iron, calcium and dairy. Warn about photosensitivity. | L1 slide 63 |
| Tigecycline Tygacil | Indication | Complicated skin infections and complicated intra-abdominal infections. Covers MRSA and E. faecalis, but NOT VRE (vancomycin-resistant Enterococcus). | Bacteriostatic. The “not VRE” exclusion is stated twice on the slide. | L1 slide 65 |
| Aminoglycosides gentamicin, tobramycin, amikacin | Drug of choice | DRUG OF CHOICE for febrile neutropenia, sepsis, and enterococcal synergy. Gram-negative activity including Pseudomonas. | Traditionally dosed every 8 hours, now every 24 hours because of the post-antibiotic effect. Renally adjusted, with peak and trough monitoring. | L1 slide 68 |
| Linezolid Zyvox | Drug of choice | DRUG OF CHOICE for hospital-acquired and community-acquired MRSA. Covers resistant gram-positives including multidrug-resistant pneumococcus, MRSA and VRE (vancomycin-resistant Enterococcus). No gram-negative or anaerobic cover. | Counsel on tyramine-containing foods and check for SSRIs and pseudoephedrine — serotonin syndrome risk. | L1 slide 71 |
| Clindamycin Cleocin | Drug of choice | DRUG OF CHOICE for toxin-mediated diseases, skin and soft tissue infection, osteomyelitis, surgical prophylaxis in penicillin allergy, and intra-abdominal combination therapy. | Covers gram-positive aerobes including MRSA and both gram-positive and gram-negative anaerobes, but NO gram-negative aerobic coverage. | L1 slide 80 |
| Drug or class | Tier | Indications | Patient education & practical notes | Source |
|---|---|---|---|---|
| Fluoroquinolones class | Drug of choice | DRUG OF CHOICE for community-acquired pneumonia, sinusitis and otitis, hospital-acquired pneumonia (higher dose), urinary tract infection, infectious diarrheas, skin infection and osteomyelitis. | Separate from iron, antacids, multivitamins, calcium and dairy. The deck flags OVERUSE = RESISTANCE and collateral damage with C. difficile. Watch the QTc and central nervous system effects in the elderly. | L1 slide 75 |
| Levofloxacin, moxifloxacin 3rd generation | Indication | Both are used in community-acquired pneumonia with strep and atypical coverage. Levofloxacin has Pseudomonas coverage; moxifloxacin does not. | Moxifloxacin must not be used for urinary tract infections — the one fluoroquinolone that fails there. Moxifloxacin needs no dosing adjustment; levofloxacin is renally adjusted. | L1 slide 78 |
| Drug or class | Tier | Indications | Patient education & practical notes | Source |
|---|---|---|---|---|
| Trimethoprim/sulfamethoxazole Septra, Bactrim | Indication | Pneumocystis jirovecii pneumonia — treatment AND prophylaxis. Urinary tract infection, bacterial prostatitis, orchitis and epididymitis; respiratory tract infection; and gastrointestinal infection including traveler's diarrhea and Shigella enteritis. | The PJP (Pneumocystis jirovecii pneumonia) indication is the flagship one. Check for warfarin (raises the INR, the international normalized ratio), phenytoin, digoxin and sulfonylureas (hypoglycemia). | L1 slide 84 |
| Metronidazole Flagyl | Drug of choice | DRUG OF CHOICE for Clostridium difficile (intravenous or oral), intra-abdominal combination therapy, and sexually transmitted infections. Covers gram-positive and gram-negative anaerobes and parasites. | Counsel the patient not to drink alcohol — disulfiram-like reaction with ethanol. | L1 slide 86 |
| Polymyxin B and E colistin | Indication | Broad gram-negative coverage. Use is likely to increase because of rising multidrug resistance, after 50 years of disuse. | Optimal dosing regimens have not been thoroughly studied — the deck is explicit that this is a salvage agent with three black box warnings. | L1 slide 88 |
| Drug or class | Tier | Indications | Patient education & practical notes | Source |
|---|---|---|---|---|
| Amphotericin B polyene | Indication | Cryptococcus, Blastomyces, Histoplasma, Candida, Coccidioides and Aspergillus — reserved for invasive infections. | Pre-treat with paracetamol, antihistamines and corticosteroids for the fever and chills, and hydrate with normal saline for the renal tubule damage. Infused over 4 hours. | L1 slide 98 |
| Flucytosine Ancobon | Indication | Cryptococcus neoformans and Candida. Used with amphotericin B in cryptococcal meningitis, and with itraconazole in chromoblastomycosis. | Almost always a combination agent — the slide never gives it alone. | L1 slide 100 |
| Azoles — class | Indication | Candida, Cryptococcus, Blastomyces, Histoplasma, Coccidioides, Aspergillus, plus the tineas: tinea pedis (athlete's foot), tinea corporis (ringworm), tinea cruris (jock itch), tinea unguium (onychomycosis). | The four tinea names and their plain-English equivalents are the most quotable thing on this slide. | L1 slide 102 |
| Fluconazole Diflucan | Indication | Best oral absorption of the azoles. Penetrates the central nervous system — cryptococcal meningitis, and preventative in AIDS. Oral and vaginal candidiasis. | Single dose for vaginal candidiasis — excreted in urine. Available intravenously and orally. | L1 slide 106 |
| Posaconazole Noxafil | Indication | Aspergillus and Candida, and the ONLY azole effective against Zygomycetes (Mucor, Rhizopus). Effective in refractory fungal infection. | The Zygomycetes exclusivity is the fact worth carrying. | L1 slide 105 |
| Voriconazole Vfend | Indication | Systemic Aspergillus and Candida — it replaced amphotericin for systemic aspergillus infections. | Warn about visual effects, which occur in 30%. | L1 slide 107 |
| Echinocandins caspofungin, micafungin, anidulafungin | Indication | Esophageal candidiasis, systemic aspergillus not responding to itraconazole or amphotericin, and febrile neutropenic patients not responding to antibiotics. | Positioned as the salvage option after the azoles and amphotericin fail. | L1 slide 109 |
| Griseofulvin mitotic inhibitor | Education-heavy | Dermatophytes only — not Candida. Deposited in keratin precursor cells of skin, hair and nails. | Absorption increases with a high-fat meal. Treatment is long: scalp 1 month, fingernails 6–9 months, toenails up to 12 months — set that expectation up front. | L1 slide 110 |
| Terbinafine, naftifine allylamines — Lamisil, Naftin | Education-heavy | Superficial dermatophyte infections. Naftifine topical; terbinafine oral or topical. | Duration again: fingernails 6–12 weeks, toenails up to 12 months. | L1 slide 112 |
| Drug or class | Tier | Indications | Patient education & practical notes | Source |
|---|---|---|---|---|
| Benzoyl peroxide | Education-heavy | Acne — converted to benzoic acid in the stratum corneum, active against P. acnes, with peeling and comedolytic effects. Available over the counter. | Start at 2.5% once daily and increase as tolerated. Warn that it bleaches hair, clothes and bedding. | L2 slide 21 |
| Topical retinoids tretinoin, adapalene, tazarotene | Education-heavy | First-line for noninflammatory (comedonal) acne; combined with other agents for inflammatory acne. Also useful for wrinkles and dyspigmentation. | Tretinoin is photolabile — apply at night. Benzoyl peroxide inactivates tretinoin, so do not layer them. Adapalene is stable in sunlight and with benzoyl peroxide, and is less irritating. | L2 slide 25 |
| Isotretinoin Accutane | Education-heavy | Severe acne when topical treatment is not enough — effective in 1 to 3 months. | iPledge enrollment. Contraindicated in pregnancy and breastfeeding, and men should avoid as well. Monitor for signs of developing depression and for raised serum lipids. | L2 slide 27 |
| Topical antibiotics for acne clindamycin, erythromycin | Indication | Clindamycin is the preferred agent. Erythromycin is losing efficacy over time due to P. acnes resistance. | They lack systemic side effects — the advantage of the topical route. | L2 slide 26 |
| Spironolactone, oral contraceptives antiandrogens for acne | Indication | Useful in some women with acne. Ethinyl estradiol with norethindrone. | The deck is explicit that this is a women-only option in the acne algorithm. | L2 slide 29 |
| Topical corticosteroids atopic dermatitis | Education-heavy | The gold standard for atopic dermatitis. Low potency for face, intertriginous areas and infants; medium potency for the body; medium-high for exacerbations. | Use the higher potency for 1 to 2 weeks, then step down. Choice depends on severity and site. | L2 slide 37 |
| Tacrolimus, pimecrolimus Protopic, Elidel | Education-heavy | Second-line agents after topical steroids for atopic dermatitis — they reduce extent, severity and symptoms by inhibiting T cells, mast cells and keratinocytes. | Use a high-SPF (sun protection factor) sunscreen. Expect a burning sensation. Avoid in immunosuppressed patients. | L2 slide 43 |
| Topical azoles clotrimazole, miconazole, sertaconazole | Education-heavy | Topical and vaginal use — vulvovaginal candidiasis. Sometimes combined with corticosteroids for more rapid symptom relief. | Treatment is generally prolonged — 2 to 3 weeks. Tell them to finish the course. | L2 slide 51 |
| Topical acyclovir, penciclovir Zovirax, Denavir | Indication | Recurrent orolabial herpes simplex infection. Active against herpesvirus simplex 1 and 2. | Expect local irritation. | L2 slide 56 |
| Mupirocin Bactroban | Indication | Most gram-positive aerobes, especially MRSA. Used to eliminate nasal carriage of S. aureus. | Not absorbed, but may irritate mucous membranes. | L2 slide 47 |
| Imiquimod Aldara | Education-heavy | External and perianal warts, actinic keratoses, and basal cell carcinoma. An immunomodulator that drives interferon-alpha, tumor necrosis factor and interleukins. | Applied two to five times per week. Skin irritation occurs in virtually all patients — and the degree of inflammation parallels efficacy, so warn them it is expected. | L2 slide 57 |
| Ciclopirox Penlac nail lacquer | Education-heavy | Dermatomycosis, candidiasis and tinea versicolor; marketed as a nail lacquer for onychomycosis. | Set expectations honestly: the nail lacquer is less than 12% effective. | L2 slide 52 |
| Nystatin, tolnaftate topical antifungals | Education-heavy | Nystatin for candidal infections, cutaneous and mucosal. Tolnaftate has NO candida activity. | Tolnaftate must be used long term to prevent recurrence. Nystatin has no oral absorption. | L2 slide 54 |
| Drug or class | Tier | Indications | Patient education & practical notes | Source |
|---|---|---|---|---|
| Bethanechol Urecholine | Indication | Stimulates a postpartum or postoperative atonic bladder. Strong muscarinic activity, no nicotinic activity; increases voiding pressure and decreases bladder capacity. | Not hydrolyzed by acetylcholinesterase, so its action is sustained. | L3 slide 30 |
| Pilocarpine Salagen, Isopto Carpine | Education-heavy | Decreases intraocular pressure — miosis and ciliary muscle contraction. Also stimulates salivation in xerostomia (dry mouth). | Onset within minutes, duration 4 to 8 hours. A potent stimulator of sweat, tears and saliva. | L3 slide 33 |
| Carbachol Miostat | Indication | Decreases intraocular pressure in glaucoma. Has both muscarinic and nicotinic activity. | Causes miosis and spasm of accommodation — warn about the near-vision blur. | L3 slide 32 |
| Edrophonium | Indication | Diagnosing myasthenia gravis, assessing cholinesterase therapy, and reversing nondepolarizing neuromuscular blockers after surgery. | The short-acting prototype — short duration is what makes it a diagnostic rather than a treatment agent. | L3 slide 35 |
| Neostigmine, pyridostigmine Prostigmin, Mestinon | Indication | Neostigmine stimulates the bladder and gastrointestinal tract, is the antidote for competitive neuromuscular blockers, and treats myasthenia gravis symptomatically. Pyridostigmine is for CHRONIC management of myasthenia gravis. | Neostigmine is poorly absorbed from the gut and does not enter the central nervous system — which is why it is safe peripherally. | L3 slide 38 |
| Physostigmine Antilirium | Indication | Treatment of overdoses of anticholinergic drugs — atropine, phenothiazines and tricyclic antidepressants. Also increases intestinal and bladder motility in atony and decreases intraocular pressure. | It is the one that does enter the central nervous system, which is exactly why it works for a central anticholinergic overdose. | L3 slide 36 |
| Donepezil, rivastigmine, galantamine Aricept, Exelon, Razadyne | Indication | Slow the progression of Alzheimer's disease, which is associated with a deficiency of cholinergic neurons in the central nervous system. | Expect gastrointestinal distress — the limiting side effect of the class. | L3 slide 40 |
| Pralidoxime Protopam | Indication | Reactivates inhibited acetylcholinesterase after organophosphate (insecticide) poisoning. | Two limits to know: it does not penetrate the central nervous system, and it cannot overcome reversible inhibitors such as physostigmine. | L3 slide 42 |
| Atropine | Indication | Antisecretory before surgery or in end-of-life care; ophthalmic pupil dilation; gastrointestinal antispasmodic; and the antidote for cholinesterase inhibitor insecticides and some mushroom poisoning. Given during a Code Blue for bradycardia. | Dose-dependent and counterintuitive: bradycardia at LOWER doses, tachycardia at HIGHER doses. | L3 slide 51 |
| Scopolamine Transderm Scop | Education-heavy | Prevention of motion sickness, adjunct in anesthesia, short-term memory blocking, and reducing secretions. | Wash hands thoroughly after placing the patch — touching an eye afterwards causes blurred vision. | L3 slide 54 |
| Ipratropium, tiotropium, glycopyrrolate Atrovent, Spiriva, Robinul | Education-heavy | Inhaled bronchodilators for maintenance treatment of bronchospasm in COPD (chronic obstructive pulmonary disease). Glycopyrrolate also reduces pre-surgical secretions, excessive drooling in cerebral palsy, stomach acid, and hyperhidrosis. | Adverse effects are limited because they cannot enter the systemic circulation or the central nervous system — the reason inhaled antimuscarinics are well tolerated. | L3 slide 55 |
| Oxybutynin, tolterodine, solifenacin bladder antimuscarinics | Education-heavy | Lower intravesicular pressure, increase bladder capacity, and reduce the frequency of bladder contractions in overactive bladder. | Newer agents cause fewer central effects because they are designed not to cross the blood-brain barrier — the reason to switch an older patient off oxybutynin. | L3 slide 56 |
| Succinylcholine | Education-heavy | Endotracheal intubation during induction of anesthesia, and rapid sequence intubation in the emergency department — because of its rapid onset and short duration. | Give a small dose of a nondepolarizing blocker first to reduce the fasciculations that cause muscle soreness. Respiratory muscles are paralyzed LAST. | L3 slide 66 |
| Nondepolarizing blockers pancuronium, vecuronium, rocuronium, cisatracurium | Indication | Adjuvant drugs in anesthesia to relax skeletal muscle, to facilitate intubation, and during orthopedic surgery for fracture alignment and dislocation correction. | Atracurium was replaced by its isomer cisatracurium (Nimbex) because of fewer adverse effects. | L3 slide 63 |
| Drug or class | Tier | Indications | Patient education & practical notes | Source |
|---|---|---|---|---|
| Epinephrine | Indication | ANAPHYLACTIC SHOCK. CARDIAC ARREST. And as an additive to local anesthetic solutions — usually 1:100,000 parts. | In local anesthesia it greatly increases the duration by producing vasoconstriction at the injection site, and applied topically it helps control oozing of capillary blood. | L3 slide 85 |
| Epinephrine respiratory and metabolic | Education-heavy | Bronchospasm — ACUTE reversal. Also drives hyperglycemia: increases hepatic glycogenolysis and glucagon release (beta-2) and decreases insulin release (alpha-1). | Selective beta-2 agonists such as albuterol are used for CHRONIC treatment instead, because of their longer duration and less cardiac stimulation. Acute versus chronic is the whole distinction. | L3 slide 84 |
| Epinephrine the dose-response | Indication | LOW doses: beta effects predominate — vasodilation. HIGH doses: alpha effects predominate — vasoconstriction. Increases cardiac output and systolic pressure while decreasing diastolic pressure. | The low-versus-high reversal is the same trap as atropine's heart rate, and gets asked the same way. | L3 slide 83 |
| Isoproterenol | Indication | Stimulate the heart in an emergency. Predominantly beta-1 and beta-2; a positive inotrope and chronotrope that increases cardiac output. | Inhaled products are no longer available in the United States. | L3 slide 91 |
| Oxymetazoline Afrin | Education-heavy | Nasal decongestant and relief of redness in the eyes. An alpha-1 and alpha-2 agonist producing vasoconstriction. | DO NOT USE LONGER THAN THREE DAYS — rhinitis medicamentosa (rebound congestion) may occur. The single most useful counseling point on any over-the-counter product in this lecture. | L3 slide 95 |
| Phenylephrine Neo-Synephrine | Indication | Nasal decongestant, relief of redness in the eyes, and septic shock. A selective alpha-1 agonist. | It raises systolic and diastolic pressure and induces REFLEX BRADYCARDIA — the heart slows even though the drug is a stimulant. | L3 slide 96 |
| Amphetamine | Indication | Hyperactivity, narcolepsy, and appetite control. Blocks norepinephrine uptake and increases cellular release of stored catecholamines. | Raises blood pressure (alpha-1), stimulates the heart (beta-1) and increases central nervous system activity. | L3 slide 100 |
| Tyramine | Education-heavy | NO therapeutic use. A normal by-product of tyrosine metabolism, found in fermented foods such as cheese and wine. | May cause serious vasopressor effects if the patient is taking a monoamine oxidase inhibitor — normally it is oxidized by MAO (monoamine oxidase) in the gut. This is the food-interaction counseling point. | L3 slide 101 |
| Cocaine | Indication | Local anesthetic — it blocks neuronal sodium channels. It also blocks norepinephrine reuptake, potentiating norepinephrine and epinephrine. | Raises blood pressure, stimulates the heart and increases central nervous system activity — which is why it exaggerates the cardiovascular actions of epinephrine. | L3 slide 102 |
| Norepinephrine | Indication | Shock — it increases vascular resistance. | Given as a continuous intravenous infusion titrated to effect. If it extravasates, treat with phentolamine. | L3 slide 90 |
| Dopamine | Indication | Cardiogenic and septic shock. | Adverse effects to expect: nausea, hypertension and arrhythmias. | L3 slide 93 |
| Dopamine the dose-response | Indication | Dose-dependent across three receptor families: beta-1 inotrope and chronotrope; alpha-1 vasoconstriction only at VERY HIGH doses; and it dilates renal and splanchnic arteries through dopaminergic receptors. | The three-tier dose response is the point of the drug — the same agent does different things as the rate climbs. | L3 slide 92 |
| Dobutamine | Indication | Increase cardiac output in acute heart failure, and inotropic support after cardiac surgery. | Its selling point: it does not significantly increase myocardial oxygen demand the way other sympathomimetics do. Caution in atrial fibrillation — it increases atrioventricular conduction. | L3 slide 94 |
| Albuterol | Indication | Asthma and COPD — a synthetic beta-2 agonist producing bronchodilation. | Expect tremor, restlessness, apprehension and anxiety and warn the patient, or they will think the inhaler is harming them. | L3 slide 98 |
| Clonidine Catapres | Education-heavy | Hypertension, and minimizing withdrawal symptoms from opiates, tobacco and benzodiazepines. | Never stop it abruptly — rebound hypertension. Expect lethargy, sedation, constipation and dry mouth. | L3 slide 97 |
| Pseudoephedrine, ephedrine | Education-heavy | Pseudoephedrine relieves nasal and sinus congestion. Ephedrine was once used to prevent asthma attacks; ephedra-containing herbal products were banned by the FDA in 2004. | Kept behind the pharmacy counter because it can be converted to methamphetamine — the reason a patient needs ID to buy it. | L3 slide 104 |
| Phenoxybenzamine | Indication | Pheochromocytoma (a catecholamine-secreting tumor of adrenal medulla origin) and autonomic hyperreflexia in paraplegic patients. | The block is irreversible — the body must synthesize new receptors, which takes at least 24 hours. | L3 slide 109 |
| Phentolamine | Indication | Short-term management of pheochromocytoma; preventing dermal necrosis from norepinephrine extravasation; hypertensive crisis after abrupt clonidine withdrawal; and impotence. | Actions last about 4 hours and it produces postural hypotension. | L3 slide 110 |
| Prazosin, terazosin, doxazosin alpha-1 blockers | Education-heavy | Hypertension — they decrease peripheral vascular resistance. Tamsulosin and alfuzosin are for benign prostatic hyperplasia, decreasing tone in the bladder neck and prostate. | Warn about first-dose syncope. A bonus worth knowing: they improve lipid profiles and glucose metabolism. | L3 slide 111 |
| Propranolol | Indication | Antihypertensive, migraine prevention, hyperthyroidism, angina pectoris, and myocardial infarction — it prevents a second MI, reduces infarct size, and reduces post-MI sudden death. | In hyperthyroidism it works by blunting the widespread sympathetic stimulation, not by treating the thyroid. | L3 slide 116 |
| Timolol, nadolol | Indication | Timolol reduces production of aqueous humor — used in chronic open-angle glaucoma. Occasionally used for hypertension. | More potent than propranolol, and nonselective. | L3 slide 119 |
| Atenolol, metoprolol, bisoprolol, esmolol selective beta-1 | Indication | Useful to treat hypertension in patients with impaired pulmonary function — the reason cardioselectivity matters clinically. | Cardioselectivity is LOST at higher doses, so it is not a free pass in airway disease. | L3 slide 120 |
| Labetalol, carvedilol | Indication | Labetalol intravenously for hypertensive emergencies. Carvedilol prevents cardiovascular mortality in heart failure and decreases lipid peroxidation and vascular wall thickening. | Both produce peripheral vasodilation and may cause orthostatic hypotension from alpha-1 blockade. | L3 slide 122 |