Actions, Interactions
and Indications for
Selected Pharmacologic
Agents
H
CH3
O
O
O
O
OH
O
OH
O
O
OH
O
O
O
O
CH3O
O
CH3O
CH3O
CH3O
CH3O
CH3O
Etoposide:
Synthetic Analog
Podophyllotoxin:
Natural product
Zora DeGrandpre, MS, ND
©2008
ISBN # 978-0-9818002-2-6
Note: In an effort to replace the Trees needed for the publication of this book, a portion of the
proceeds will be donated to maintain the forests. I thank the Trees for their service
1
Table of Contents:
PRINCIPLES OF PHARMACOLOGY ................................................................................... 10
ROUTES OF ADMINISTRATION .................................................................................................... 10
Oral:...................................................................................................................................... 10
Sublingual: ............................................................................................................................ 10
Inhalation .............................................................................................................................. 10
Topical .................................................................................................................................. 10
Transdermal .......................................................................................................................... 11
Parenteral ............................................................................................................................. 11
Other ..................................................................................................................................... 11
PHARMACOKINETICS .................................................................................................................. 11
Absorption ............................................................................................................................. 11
Effect of pH ........................................................................................................................... 11
Physical Variables ...................................................................Error! Bookmark not defined.
Bio-availability ........................................................................Error! Bookmark not defined.
Distribution is dependent on:...................................................Error! Bookmark not defined.
Drug Metabolism .................................................................................................................. 12
UNITED STATES FDA PHARMACEUTICAL PREGNANCY CATEGORIES ............... 12
AUTONOMIC NERVOUS SYSTEM DRUGS ........................................................................ 13
CHOLINERGIC AGONISTS ...................................................... ERROR! BOOKMARK NOT DEFINED.
Donepezil (Aricept®) ...............................................................Error! Bookmark not defined.
ANTI-CHOLINERGICS:MUSCARINIC ANTAGONISTS .............. ERROR! BOOKMARK NOT DEFINED.
Oxybutynin (Oxytrol®, Ditropan®) ........................................Error! Bookmark not defined.
Tolterodine (Detrol®) ..............................................................Error! Bookmark not defined.
NICOTINIC AGONISTS ........................................................... ERROR! BOOKMARK NOT DEFINED.
Nicotine (Nicorette®, Nicotrol®, Nicoderm®) .......................Error! Bookmark not defined.
SYMPATHOMIMETICS ........................................................... ERROR! BOOKMARK NOT DEFINED.
α and β-adrenergic (mixed) agonist ..................................Error! Bookmark not defined.
Epinephrine (Adrenalin®, EpiDri™, Epifrin®, SilTrax®, PrimateneMist®, EpiPen®)
..................................................................................................Error! Bookmark not defined.
α-adrenergic agonists .........................................................Error! Bookmark not defined.
Oxymetazoline (Afrin®, Allerest®, Zicam ®, Mucinex®, Neo-synephrine®, Visine®) Error!
Bookmark not defined.
Pseudoephedrine (Allermed®, Affrinol®, Ridafed®,Sudofed ®, Dimetapp®, Triaminic®
and many other combinations )...............................................Error! Bookmark not defined.
α2 Agonists .........................................................................Error! Bookmark not defined.
Clonidine (Catapress ®, Duraclon®) .....................................Error! Bookmark not defined.
Sympathomimetic amines ..................................................Error! Bookmark not defined.
Amphetamine / Dextroamphetamine (Adderall ®, Dexadrine ®, Dextrostat®) ........... Error!
Bookmark not defined.
2
Methylphenidate (Concerta®, Daytrana®, Metadate®, Ritalin®) ....... Error! Bookmark not
defined.
Adrenergic antagonists...................................................................................................... 14
Tamsulosin (Flomax®) ........................................................................................................ 14
β1Antagonists: ....................................................................Error! Bookmark not defined.
Atenolol (Tenormin®) .............................................................Error! Bookmark not defined.
Metoprolol (Toprol®, Lopressor®) ........................................Error! Bookmark not defined.
Mixed α/ β Antagonist: ......................................................Error! Bookmark not defined.
Carvedilol (Coreg®) ...............................................................Error! Bookmark not defined.
CENTRAL NERVOUS SYSTEM (CNS) DRUGS ... ERROR! BOOKMARK NOT DEFINED.
BENZODIAZEPINES ............................................................... ERROR! BOOKMARK NOT DEFINED.
Alprazolam (Xanax®Niravam®) .............................................Error! Bookmark not defined.
Lorazepam (Ativan®) ..............................................................Error! Bookmark not defined.
Temazepam (Restoril®) ...........................................................Error! Bookmark not defined.
Clonazepam (Cebercon™, Klonopin®) ..................................Error! Bookmark not defined.
IMIDAZOPYRIDINES .............................................................. ERROR! BOOKMARK NOT DEFINED.
Zolpidem (Ambien®) ...............................................................Error! Bookmark not defined.
TRICYCLIC ANTI-DEPRESSANTS (MONOAMINE REUPTAKE INHIBITORS) ...... ERROR! BOOKMARK
NOT DEFINED.
Amitriptyline HCl (Elavil®, Tryptano™, Vanatrip®) ............Error! Bookmark not defined.
ATYPICAL ANTIDEPRESSANTS: AROMATIC AMINOKETONES ERROR! BOOKMARK NOT DEFINED.
Bupropion (Wellbutrin®, Zyban®)..........................................Error! Bookmark not defined.
SELECTIVE SEROTONIN REUPTAKE INHIBITORS ......................................................................... 15
Citalopram (Celexa®) .......................................................................................................... 15
Fluoxetine (Prozac®, Sarafem®) ............................................Error! Bookmark not defined.
Paroxetine (Paxil®, Pexeva®) ................................................Error! Bookmark not defined.
Sertraline (Zoloft®) .................................................................Error! Bookmark not defined.
SEROTONIN AGONISTS ......................................................... ERROR! BOOKMARK NOT DEFINED.
Sumatriptan (Imitrex®) ...........................................................Error! Bookmark not defined.
DOPAMINE AGONISTS .......................................................... ERROR! BOOKMARK NOT DEFINED.
Carbidopa-Levodopa (Sinemet®) ............................................Error! Bookmark not defined.
SELECTIVE SEROTONIN/NOREPINEPHRINE REUPTAKE INHIBITORS (SNERI) ERROR! BOOKMARK
NOT DEFINED.
Trazodone (Desyrel®) .............................................................Error! Bookmark not defined.
MISCELLANEOUS CNS-ACTIVE AGENTS ............................... ERROR! BOOKMARK NOT DEFINED.
Lithium carbonate (Eskalith ®, Lithobid®, Lithonate®) ........Error! Bookmark not defined.
ANTI-CONVULSANTS- MIXED PHARMACOLOGIC CLASSES..... ERROR! BOOKMARK NOT DEFINED.
Phenytoin (Dilantin®) .............................................................Error! Bookmark not defined.
Carbamazapine (Atretol®, Tegretol®, Epitol®, Carbatrol®, Epitol®) ..... Error! Bookmark
not defined.
Divalproex (Depakote®) .........................................................Error! Bookmark not defined.
Valproic acid (Depakene®) .....................................................Error! Bookmark not defined.
Valproate Na (Depacon®) .......................................................Error! Bookmark not defined.
Gabapentin (Neurontin®, Gabarone™)..................................Error! Bookmark not defined.
ANTI-PSYCHOTICS- TYPICAL AND ATYPICAL ....................... ERROR! BOOKMARK NOT DEFINED.
Olanzapine (Zyprexa®, Zydis®)..............................................Error! Bookmark not defined.
3
Quetiapine (Seroquel®) ...........................................................Error! Bookmark not defined.
Risperidone (Risperdal®) ........................................................Error! Bookmark not defined.
MUSCLE-RELAXANTS .......................................................... ERROR! BOOKMARK NOT DEFINED.
Cyclobenzaprine (Flexeril®, Fexmid™, Amrix®) ..................Error! Bookmark not defined.
Carbamic ester derivatives .................................................Error! Bookmark not defined.
Carisoprodol (Soma®, Vanadom®, Soprodal 350™) ............Error! Bookmark not defined.
OPIATES AND OPIATE ANALOGS ........................................... ERROR! BOOKMARK NOT DEFINED.
Hydrocodone bitartrate (Hydromet®, Hydropane®, Mycodone®, Tussigon®) ......... Error!
Bookmark not defined.
Hydrocodone bitartrate +Acetaminophen (Vicodin®, Anexia®, CETA-Plus®, Dolacet®,
Duocet®, Lorcet®, Lortab®, Hydrocet®) ..............................Error! Bookmark not defined.
Hydrocodone bitartrate +Aspirin (Azdone®) ........................Error! Bookmark not defined.
Hydrocodone bitartrate +Ibuprofen (Vicoprofen®) ..............Error! Bookmark not defined.
Fentanyl citrate (Fentora®, Sublimaze®) ...............................Error! Bookmark not defined.
Fentanyl Transdermal (Duragesic®) ......................................Error! Bookmark not defined.
Fentenyl Transmucosal (Actiq®, Fentenyl Oralet®) ..............Error! Bookmark not defined.
Oxycodone HCl (Oxycontin®, OxyFast®, Percolone®, OxyDose™, Endocodone ®,
Roxicodone®) ..........................................................................Error! Bookmark not defined.
Codeine (Phosphate or Sulfate salts).......................................Error! Bookmark not defined.
Methadone (Diskets®, Dolophine®, Methadose®)................Error! Bookmark not defined.
RESPIRATORY SYSTEM AGENTS........................ ERROR! BOOKMARK NOT DEFINED.
ANTI-ASTHMATICS ............................................................... ERROR! BOOKMARK NOT DEFINED.
Sympathomimetics .............................................................Error! Bookmark not defined.
Albuterol (Proventil®, Ventolin®, AccuNeb®, Volmax®, ProAir®, VoSpire®) ......... Error!
Bookmark not defined.
Beclomethasone (Beconase®, QVAR ®, Beclovent®, Vancenase®) .... Error! Bookmark not
defined.
Salmeterol (Serevent Diskus®) ................................................Error! Bookmark not defined.
Anti-Cholinergics ...............................................................Error! Bookmark not defined.
Ipratropium (Atrovent®) .........................................................Error! Bookmark not defined.
Corticosteroids .................................................................................................................. 17
Budesonide (Entocort®, Pulmicort®, Rhinocort®) ................Error! Bookmark not defined.
Fluticasone (Flonase®, Flovent ®, Cutivate ®,Veramyst™) .Error! Bookmark not defined.
Triamcinolone (Aristocort®, Kenacort®, Azmacort®, Flutex™, Oralone ®, Nasacort ®)
..................................................................................................Error! Bookmark not defined.
RESPIRATORY DRUGS: MISCELLANEOUS ............................. ERROR! BOOKMARK NOT DEFINED.
Cromolyn sodium (Crolom®, Gastrocrom ®, Intal ®, Nasalcrom®) .. Error! Bookmark not
defined.
Montelukast (Singulair ®) .......................................................Error! Bookmark not defined.
ANTI-HISTAMINES ................................................................ ERROR! BOOKMARK NOT DEFINED.
Cetirizine (Zyrtec ®) ................................................................Error! Bookmark not defined.
Diphenhydramine (Allermax®, Benedryl®, Compoz®, Diphen®, Hyrexin®, Genahist®,
Nytol®, Sleepinal®, Midol®, Sominex®, Unisom®) ..............Error! Bookmark not defined.
Loratadine (Alavert®, Claritin®, Equate®) ...........................Error! Bookmark not defined.
HEMATOPOIETIC SYSTEM DRUGS .................... ERROR! BOOKMARK NOT DEFINED.
4
ANEMIA ............................................................................... ERROR! BOOKMARK NOT DEFINED.
Vitamin B12, Cyanocobalamin (BigShot B12®, Cyanoject®, Rubramin®, Hydro-Crysti12®, LA-12®, CaloMist™) .....................................................Error! Bookmark not defined.
Folic acid (Folvite ®, FA-8®, Folacin®, Folicet™) ..............Error! Bookmark not defined.
Iron Dextran (DexFerrum ®, InFed®)....................................Error! Bookmark not defined.
Iron sucrose (Venofer®) ..........................................................Error! Bookmark not defined.
COAGULATION DISORDERS................................................... ERROR! BOOKMARK NOT DEFINED.
Acetylsalicylic acid (Aspirin®, Acuprin®, Bayer®, Ecotrin®, EMPIRIN®, Norwich®,
Sureprin®, Zorprin®) ..............................................................Error! Bookmark not defined.
Clopidogrel (Plavix®) .............................................................Error! Bookmark not defined.
Heparin (Hep-Lock®, Hep-Pak®, Uniparin®, Homochron™, Monoject®)................ Error!
Bookmark not defined.
Warfarin (Coumadin®, Jantoven™) .......................................Error! Bookmark not defined.
Vitamin K (AquaMEPHYTON®, Mephyton®) ........................Error! Bookmark not defined.
ANTI-HYPERLIPIDEMIC AGENTS ........................................... ERROR! BOOKMARK NOT DEFINED.
Niacin/ Vitamin B3/ Nicotinic acid/ Niacinamide (Slo-Niacin®, Niacor®, Nicolar®) Error!
Bookmark not defined.
STATIN DRUGS ..................................................................... ERROR! BOOKMARK NOT DEFINED.
Atorvastatin (Lipitor®) ............................................................Error! Bookmark not defined.
Lovastatin (Altocor®, Mevacor®, Altoprev®) ........................Error! Bookmark not defined.
ANTI-INFLAMMATORY AGENTS ........................................... ERROR! BOOKMARK NOT DEFINED.
Anti-Arthritic Agents .........................................................Error! Bookmark not defined.
Hydroxychloroquine (Plaquenil®, Quineprox®) ....................Error! Bookmark not defined.
Methotrexate (Amethopterin®, MTX®, Rheumatrex®, Trexall®) ........ Error! Bookmark not
defined.
ANALGESICS ........................................................................ ERROR! BOOKMARK NOT DEFINED.
Prostaglandin synthesis inhibitors .....................................Error! Bookmark not defined.
Acetylsalicylic acid (Aspirin®, Acuprin®, Bayer®, Ecotrin®, EMPIRIN®, Norwich®,
Sureprin®, Zorprin®) ..............................................................Error! Bookmark not defined.
Acetaminophen (Acephen®, Aceta®, Aminofen® Anacin®, Tylenol ®, Datril®, Feverall®,
Liquiprin®Genapap®, Maranox®, Tempra®) .......................Error! Bookmark not defined.
NSAIDs ..............................................................................Error! Bookmark not defined.
Ibuprofen (Advil®, Motrin®, Genpril®, Medipren®, Menadol®, Midol®, Nuprin ®) Error!
Bookmark not defined.
Naproxen (Aflaxen™, Anaprox®, Aleve®, Mediproxen®, Naprosyn ®, Naprelan®) . Error!
Bookmark not defined.
Celecoxib (Celebrex ®) ...........................................................Error! Bookmark not defined.
Miscellaneous: ...................................................................Error! Bookmark not defined.
Sulfasalazine (Azulfidine ®, Salazopyrn ®, Sulfazine®).........Error! Bookmark not defined.
CARDIOVASCULAR SYSTEM DRUGS ................. ERROR! BOOKMARK NOT DEFINED.
Β1 ANTAGONISTS: ................................................................. ERROR! BOOKMARK NOT DEFINED.
Atenolol (Tenormin®) .............................................................Error! Bookmark not defined.
Metoprolol (Toprol®, Lopressor®) ........................................Error! Bookmark not defined.
MIXED Α/ Β ANTAGONIST: ................................................... ERROR! BOOKMARK NOT DEFINED.
Carvedilol (Coreg®) ...............................................................Error! Bookmark not defined.
α2 Agonists .........................................................................Error! Bookmark not defined.
5
Clonidine (Catapress ®, Duraclon®) .....................................Error! Bookmark not defined.
ACE INHIBITORS.................................................................. ERROR! BOOKMARK NOT DEFINED.
Benazapril (Lotensin®) ..........................................................Error! Bookmark not defined.
Lisinopril (Prinvil®, Zestril®) ...............................................Error! Bookmark not defined.
CA2+ CHANNEL BLOCKERS .................................................. ERROR! BOOKMARK NOT DEFINED.
Verapamil (Calan®, Covera®, Isoptin ®, Verelan®) ...........Error! Bookmark not defined.
Diltiazem (Cardizem®, Cartia ®, Diltia®, Dilacor® Tiazac®, Taztia™) Error! Bookmark
not defined.
NITRATES ............................................................................. ERROR! BOOKMARK NOT DEFINED.
Isosorbide dinitrate (Dilatrate®, Isordil ®) ............................Error! Bookmark not defined.
Isosorbide mononitrate (Imdur®, Imso®, Monoket ®) ...........Error! Bookmark not defined.
Nitroglycerin (Diponit®, Minitran®, Nitro-Dur ®, Nitolingual®, Nitrostat®, Nitrotab™,
Nitrol®)....................................................................................Error! Bookmark not defined.
CARDIAC GLYCOSIDES ......................................................... ERROR! BOOKMARK NOT DEFINED.
Digoxin (Digitek®, Lanoxicaps®, Lanoxin ®)........................Error! Bookmark not defined.
ANTI-ARRHYTHMICS ............................................................ ERROR! BOOKMARK NOT DEFINED.
Amiodorone (Cordorone®, Pacerone ®) ................................Error! Bookmark not defined.
Propafenone (Rythmol ®) ........................................................Error! Bookmark not defined.
DIURETICS ........................................................................... ERROR! BOOKMARK NOT DEFINED.
Furosemide (Lasix®) ...............................................................Error! Bookmark not defined.
Hydrochlorothiazide (HCTZ) (Esidrix®, Ezide ™, HydroDiuril®, Hydro-Par®,
Microzide®, Oretic®) ..............................................................Error! Bookmark not defined.
Spironolactone (Aldactone®, Spirono™)................................Error! Bookmark not defined.
GASTROINTESTINAL SYSTEM AGENTS ........... ERROR! BOOKMARK NOT DEFINED.
ANTACIDS ............................................................................ ERROR! BOOKMARK NOT DEFINED.
Calcium carbonate (Alka-Mints®, Alkets®, Calci-Chew®, Caltrate®, Os-Cal®, OystCal®, Rolaids®, Tums® ..........................................................Error! Bookmark not defined.
+
H PUMP INHIBITORS ............................................................ ERROR! BOOKMARK NOT DEFINED.
Esomeprazole (Nexium®) ........................................................Error! Bookmark not defined.
HISTAMINE2 RECEPTOR ANTAGONISTS ................................. ERROR! BOOKMARK NOT DEFINED.
Ranitidine (Zantac®) ...............................................................Error! Bookmark not defined.
CATHARTICS AND LAXATIVES ............................................. ERROR! BOOKMARK NOT DEFINED.
Irritants ...............................................................................Error! Bookmark not defined.
Stimulants ..........................................................................Error! Bookmark not defined.
Stool softeners....................................................................Error! Bookmark not defined.
Bisacodyl (Bisac-Evac ®, Carter’s Little Pills®, Correctol®, Dacodyl®, Deficol®,
Dulcolax®, Feen-a-Mint®, Fleet®, Theralax® ......................Error! Bookmark not defined.
Docusate Calcium (DC Softgels®, Pro-Cal Sof®, Sulfolax®)Error! Bookmark not defined.
Docusate sodium (Colace®, Correctol®, DOS Softgels®, Modane Soft®, Regulax SS®,
Silace®, Regulax®) .................................................................Error! Bookmark not defined.
Osmotic Agents ..................................................................Error! Bookmark not defined.
Polyethylene glycol (GlycoLax™, MiraLax®) ........................Error! Bookmark not defined.
Magnesium Hydroxide (Milk of Magnesia®, Freelax™) ........Error! Bookmark not defined.
Magnesium Sulfate (Epsom Salts) ...........................................Error! Bookmark not defined.
Bulking Agents ..................................................................Error! Bookmark not defined.
6
Psyllium (Alramucil®, Fiberall®, Genfiber®, Hydrocil®, Konsyl®, Maalox®,
Metamucil®, Modane Bulk®, Reguloid®, Restore®, Serutan®, Sylact®, V-Lax®) .... Error!
Bookmark not defined.
ANTI-DIARRHEAL ................................................................. ERROR! BOOKMARK NOT DEFINED.
Loperamide (Imodium®, Kaopectate®, Diarrhea Control®) .Error! Bookmark not defined.
ANTI-EMETIC ....................................................................... ERROR! BOOKMARK NOT DEFINED.
Prochlorperazine maleate (Compazine®, Compro™) ............Error! Bookmark not defined.
GENITOURINARY SYSTEM DRUGS .................... ERROR! BOOKMARK NOT DEFINED.
MALE GU SYSTEM .............................................................. ERROR! BOOKMARK NOT DEFINED.
Tamsulosin (Flomax®) ............................................................Error! Bookmark not defined.
Sildenafil (Viagra®, Revatio™) ..............................................Error! Bookmark not defined.
ENDOCRINE SYSTEM DRUGS ............................... ERROR! BOOKMARK NOT DEFINED.
THYROID AGENTS ................................................................ ERROR! BOOKMARK NOT DEFINED.
Dessicated Thyroid (Armour Thyroid®, Bio-Throid®, Etwon™, Thyrotab®, Westhroid®)
..................................................................................................Error! Bookmark not defined.
Levothyroxine (Estre™, Synthroid®, Levolet®, Levo-T®, Levothroid®, Levoxyl®, ThyroTabs®, Unithroid®).................................................................Error! Bookmark not defined.
Tri-iodothyronine, ....................................................................Error! Bookmark not defined.
(Cytomel®, Triostat®) .............................................................Error! Bookmark not defined.
CORTICOSTEROIDS ............................................................... ERROR! BOOKMARK NOT DEFINED.
Beclomethasone (Beconase®, Beclovent ®,Vancenase®, Vanceril®,QVAR ®) .......... Error!
Bookmark not defined.
Hydrocortisone (Cortef®, Cortenema®, Hydrocortone ®, Anusol®, Cortizone®,
Dermarest®) ............................................................................Error! Bookmark not defined.
Prednisone (Deltosone®, Predone™, Sterapred®) ................Error! Bookmark not defined.
Triamcinolone (Aristocort®, Kenacort, Azmacort®, Cinalog™, Cinolar™, Flutex™,
Nasacort ®, Kenalog®, Oralone®) ........................................Error! Bookmark not defined.
FEMALE REPRODUCTIVE HORMONES ......................................................................................... 19
SERMs .............................................................................................................................. 19
Clomiphene citrate (Clomid®, Milophene®, Serophene®) ....Error! Bookmark not defined.
Raloxifene (Evista®) ................................................................Error! Bookmark not defined.
Estrogens and estrogen derivatives ....................................Error! Bookmark not defined.
Conjugated Estrogens (Premarin®, Cenestin™, Enjuvia™)..Error! Bookmark not defined.
Estrone (Estra AQ®, Estragyn 5®, Estro-A®, Primestrin®) .Error! Bookmark not defined.
Estriol: .....................................................................................Error! Bookmark not defined.
Estradiol: Estrace®, Estring®, EstroGel®, Gynodiol®, Innofem® ..... Error! Bookmark not
defined.
Estradiol acetate: Femring™ ..................................................Error! Bookmark not defined.
Estradiol cyprionate: Depo-Estradiol® ..................................Error! Bookmark not defined.
Transdermal: Alora®, Climara®, Delestrogen®, Esclim®, Estraderm®, Menostar™,
Vivelle®, Vivelle-Dot® ............................................................Error! Bookmark not defined.
Estradiol hemihydrate: Estrasorb™........................................Error! Bookmark not defined.
Estradiol valerate: Clinagen LA40®, Delestrogen® ..............Error! Bookmark not defined.
Progesterone and progesterone derivatives ........................Error! Bookmark not defined.
7
Medroxyprogesterone (Amen®, Depo-Provera®, Provera®, Prodroxy™, Provera®) Error!
Bookmark not defined.
Progesterone (Crinone®, Progesterone MC 10 ®, First™- ®, First™-Progesterone VGS
100 ® Progesterone VGS 25, 50, 200, 400 ®, Gesterone™, Gestrin™, Prochieve®,
Prometrium®) ..........................................................................Error! Bookmark not defined.
Contraceptives....................................................................Error! Bookmark not defined.
Norgestimate/Ethinyl Estradiol (MonoNessa®, Ortho Tri-Cyclen® Lo Ortho-Cyclen®,
Ortho-Tri-Cyclen®, Previfem®, Sprintec-28®, Tri-Previfem®, Tri-Sprintec®, TriNessa®)
..................................................................................................Error! Bookmark not defined.
Norgestimate/Estradiol (Ortho-Prefest™, Prefest®) ..............Error! Bookmark not defined.
Norelgestromin/ethinyl estradiol (OrthoEvra®) .....................Error! Bookmark not defined.
Male Hormones ..................................................................Error! Bookmark not defined.
Testosterone (Androderm®, AndroGel®, Striant®, Testim®, Testoderm®, Testopel®DepoTestosterone®, TestaSpan™, Testopel®, Tostrelle™, Virilon®Injection) . Error! Bookmark
not defined.
Testosterone cypionate (Depo-Testoserone®) ........................Error! Bookmark not defined.
Testosterone enanthate (Delatestryl®) ....................................Error! Bookmark not defined.
Miscellaneous Hormones ...................................................Error! Bookmark not defined.
Androstenedione ......................................................................Error! Bookmark not defined.
Calcitonin (Fortical®, Miacalcin®, Salmonine®) ..................Error! Bookmark not defined.
Dehydroepiandrosterone: (Prestara™, Vitamist®, DHEA-M for Men, DHEA-W for
Women) ....................................................................................Error! Bookmark not defined.
Pregnenolone ...........................................................................Error! Bookmark not defined.
Insulin, Glucagon and Anti-Hypoglycemic agents ............Error! Bookmark not defined.
Glucagon (GlucaGen®, Glucagon®) ......................................Error! Bookmark not defined.
Insulin ................................................................................................................................... 20
Oral Hypoglycemics ..........................................................Error! Bookmark not defined.
Glyburide (DiaBeta®, Glynase PresTab®, Micronase ®, Glycron™) Error! Bookmark not
defined.
Metformin (Fortamet ™, Glucophage®, Riomet®) ................Error! Bookmark not defined.
Rosiglitazone (Avandia®) ........................................................Error! Bookmark not defined.
ANTI-NEOPLASTICS .............................................................. ERROR! BOOKMARK NOT DEFINED.
Tamoxifen citrate (Sotamox®, Nolvadex®).............................Error! Bookmark not defined.
Anastrozole (Arimidex®) .........................................................Error! Bookmark not defined.
Cyclophosphamide (Cytoxan®, Neosar®) ..............................Error! Bookmark not defined.
Doxorubicin (Adriamycin ®, Rubex®) ....................................Error! Bookmark not defined.
Etoposide (VP16-213) (Toposar®, VePesid®, Etopophos®) .Error! Bookmark not defined.
5-Flurouracil (Adrucil®, Carac™, Efudex ®, Fluroplex®) ...Error! Bookmark not defined.
Cyclosporine (Gengraf®, Neoral®, Sandimmune®, Restasis™, Pulminiq™, SangCya™)
..................................................................................................Error! Bookmark not defined.
Methotrexate, MTX (Amethopterin®,Rheumatrex®, Trexall®) ............ Error! Bookmark not
defined.
Vinblastne (Velban ®) .............................................................Error! Bookmark not defined.
Paclitaxel (Onxol ™, Taxol®) .................................................Error! Bookmark not defined.
DERMATOLOGICAL AGENTS ................................................. ERROR! BOOKMARK NOT DEFINED.
8
Isotretinoin (Accutane®, Amnesteem ™, Claravis®, Sotret®) ............. Error! Bookmark not
defined.
Benzoyl peroxide (Benzac ®, Benzagel®, Clearplex™, Clearskin™, Desquam®, Fostex®,
Lavoclen ™, Loroxide®, Panoxyl®, Zodem®) .......................Error! Bookmark not defined.
TOPICAL ANALGESICS.......................................................... ERROR! BOOKMARK NOT DEFINED.
Benzocaine (Americaine®, Anacaine®, Anbesol®, Boil-Ease®, Cepacol®, Comfort
Caine™, DentiCare™, Dermoplast®, Detane®, Dry Socket™, Freez Eez™, Gingicaine™,
Hurricaine®, Isodettes®, Lanacane®, Numzident®, Orabase ®, Orajel®, Otocain®,
Outgro®, Pro-caine™, Retre Gel™, Rid-A-Pain®, Solarcaine®, Sting-Kill®, Topex™,
Topicale™, Zilactin®) .............................................................Error! Bookmark not defined.
Capsaicin (Analgesic Balm with Capsaicin, ArthriCare®, Arthritis Formula®, Arthritis
Pain Relief Rub®®, Axsain™, Capzasin® HP Arthritis Formula, Dr. S®, Eucalyptamint®
2000, Icy Hot®, Menthac®, Pain-X™, Rid-a-Pain®, RT Capsin®, Salonpas®, Trixaicin®,
Zostrix®) ..................................................................................Error! Bookmark not defined.
Methyl salicylate (Oil of Wintergreen, Sweet Birch Oil, Exocaine®, Gordogesic®, Bengay®
(with menthol)) .........................................................................Error! Bookmark not defined.
MUSCULOSKELETAL AGENTS .............................................. ERROR! BOOKMARK NOT DEFINED.
Bisphosphonates ................................................................Error! Bookmark not defined.
Alendronate (Fosamax®) ........................................................Error! Bookmark not defined.
Calcitonin (Fortical®, Miacalcin®, Salmonine®) ..................Error! Bookmark not defined.
ANTI-MICROBIALS ............................................................... ERROR! BOOKMARK NOT DEFINED.
β-lactams: Cell wall synthesis inhibitors ...........................Error! Bookmark not defined.
Amoxicillin (Amoxil ®, DisperMox™, MOXATAG™, Moxilin™, Sumox ™, Trimox®)
..................................................................................................Error! Bookmark not defined.
Amoxicillin/ Clavulanate (Augmentin®Amoclan) ...................Error! Bookmark not defined.
Cephalosporins ...................................................................Error! Bookmark not defined.
Cephalexin (Keftab®, Bio-Cef™, Keflex®, Keftab®, Panixine DisperDose™)........... Error!
Bookmark not defined.
Protein synthesis inhibitors: Macrolides, Tetracyclines ....Error! Bookmark not defined.
Macrolides:: Azithromycin, Erythromycin ........................Error! Bookmark not defined.
Azithromycin (Azasite™, Zithromax®, Zmax™).....................Error! Bookmark not defined.
Erythromycin (A/T/S®, Akne Mycin®, Akne-Mycin®, E-Mycin®, E.E.S.®, Emcin Clear,
Emgel®, Ery Pads™, Ery-Tab®, ERYC®, Erycette®, EryDerm®, Erygel®, Erymax®,
EryPed®, Erythra-Derm®, Erythrocin®, Ilosone®, Ilotycin®, My-E®, Staticin®, T-Stat®)
..................................................................................................Error! Bookmark not defined.
Tetracyclines: Tetracycline, Doxycycline .........................Error! Bookmark not defined.
Tetracycline (Emtet™, Panmycin™, Sumycin®, Tetra 250™ Error! Bookmark not defined.
Doxycycline (Adoxa®, Alodox™, Atridox™, Bio-Tab™, Doryx®, Doxal™, Doxy™,
Monodox®, Oracea™, Oraxyl™, Periostat®, Vibra-Tabs®, Vibramycin®) .............. Error!
Bookmark not defined.
Aminoglycosides:Tobramycin ...........................................Error! Bookmark not defined.
Tobramycin (AK-Tob®, Nebcin®, TOBI®, Tobrex®) ............Error! Bookmark not defined.
Sulfonamides: Sulfamethoxazole-trimethoprim(SMX-TMP) ......... Error! Bookmark not
defined.
Sulfamethoxazole-trimethoprim (SMX-TMP) (Bacter Aid™, Bactrim™, Septra®,
Sulfatrim®, Sultrex™) .............................................................Error! Bookmark not defined.
9
Fluoroquinolines: Ciprofloxacin ........................................Error! Bookmark not defined.
Ciprofloxacin (Ciloxan®, Cipro®, Ciprofloxacin, ProQuin®) ............ Error! Bookmark not
defined.
ANTI-FUNGALS .................................................................... ERROR! BOOKMARK NOT DEFINED.
Azoles: Clotrimazole, fluconazole .....................................Error! Bookmark not defined.
Clotrimazole (Anti-Fungal™, Clotrimazole, Cruex®, Desenex®, Femcare®, GyneLotrimin®, Gynix™, Jock Itch Relief, Lotrimin®, Mycelex®, Trivagizole 3™) .......... Error!
Bookmark not defined.
Fluconazole (Diflucan®) .........................................................Error! Bookmark not defined.
Polyenes: Nystatin .............................................................Error! Bookmark not defined.
Nystatin (BioStatin™, Mycostatin®, Nyamyc™, Nystex®, Nystop®) .. Error! Bookmark not
defined.
Allylamine: Terbinafine .....................................................Error! Bookmark not defined.
Terbinafine (Desenex Max®, Lamisil®) .................................Error! Bookmark not defined.
ANTI-VIRALS: DNA POLYMERASE INHIBITORS: ACYCLOVIR, PENCICLOVIR, FAMCICLOVIR
............................................................................................. ERROR! BOOKMARK NOT DEFINED.
Acyclovir (Zovirax®) ...............................................................Error! Bookmark not defined.
Famciclovir (Famvir®) ..........................................................Error! Bookmark not defined.
Valcyclovir (Valtrex®) ............................................................Error! Bookmark not defined.
ANTI-VIRALS- MISCELLANEOUS : AMANTADINE ................. ERROR! BOOKMARK NOT DEFINED.
Amantadine (Symmetrel®) ......................................................Error! Bookmark not defined.
ANTI-RETROVIRALS: NRTIS, PROTEASE INHIBITORS ........... ERROR! BOOKMARK NOT DEFINED.
Nucleoside reverse transcriptase inhibitors (NRTIs): Didanosine, Lamivudine,
Zidovudine .........................................................................Error! Bookmark not defined.
Didanosine (ddI, Videx®) ........................................................Error! Bookmark not defined.
Lamivudine, 3TC (Epivir®) ....................................................Error! Bookmark not defined.
Zidovudine, ZDV (Retrovir®) .................................................Error! Bookmark not defined.
Protease inhibitors: Indinavir .............................................Error! Bookmark not defined.
Indinavir, ZDV (Crixivan®) ...................................................Error! Bookmark not defined.
VACCINATION ...................................................................... ERROR! BOOKMARK NOT DEFINED.
HEAVY METAL TOXICITY DRUGS......................................... ERROR! BOOKMARK NOT DEFINED.
: ..........................................................................................Error! Bookmark not defined.
Penicillamine (Cuprimine®, Depen ®) ..................................Error! Bookmark not defined.
DMPS: 2,3-Dimercapto-1-propanesulfonic acid (Unithiol®, Dimaval®) . Error! Bookmark
not defined.
DMSA ™, Succimer (Chemet®) .............................................Error! Bookmark not defined.
Edetate Calcium Disodium, Calcium EDTA ............................Error! Bookmark not defined.
Deferoxamine ...........................................................................Error! Bookmark not defined.
EMERGENCY SITUATIONS: ................................................... ERROR! BOOKMARK NOT DEFINED.
Ringers lactate (VisIV™) .........................................................Error! Bookmark not defined.
Saline (Sodium Chloride) .........................................................Error! Bookmark not defined.
D5W, D10W (5% and 10% Dextrose in water) .......................Error! Bookmark not defined.
D50 (50 g Dextrose/Glucose) ..................................................Error! Bookmark not defined.
Glucose (B-D® Glucose, Dex4® Glutol™, Glutose 15™, Glutose™, Insta-Glucose®)
..................................................................................................Error! Bookmark not defined.
10
Principles of Pharmacology
Routes of Administration
Oral:
Drug must be stable to enzyme degradation (e.g. salivary) and acid hydrolysis/denaturation in the
stomach. Drug must be absorbed by the GI and must also be stable for First-Pass metabolism.
Easy self-administration.
 First Pass Metabolism: Any drug that is absorbed through the GI tract must first pass
through the portal system. Drugs are metabolized by the liver to inactive or less active
derivatives to varying degrees. Many drugs therefore cannot be given by mouth.
Sublingual:
Avoids the problems of oral administration and First Pass metabolism. Absorption is through the
mucosa directly to capillaries and is dependent on the properties of the drug. Easy selfadministration.
Inhalation
Generally is a rapid absorption and easy self-administration. Not suitable for some patients or
conditions.
Topical
Useful for local action and or with agents that can cause systemic problems such as
hypersensitivity or toxicity. Used primarily for dermatologic, otic, ophthalmologic, vaginal,
rectal, and nasal applications. Easy self-administration
Transdermal
Useful for “patch” applications and when sustained drug release is desirable. Drug must be
lipophilic. Easy self-administration.
Parenteral
 Intravenous (IV)
 Intramuscular (IM)
 Subcutaneous (SC, SubQ)
11
Other
Intranasal
Intrathecal /Intraventricular: The drug is delivered directly into the CSF
Pharmacokinetics
 Half-life: (t1/2) amount of time required for the concentration of the drug to decrease by ½
 Therapeutic Index = Toxic Dose/ Effective Dose
Absorption
 Passive diffusion: driven by concentration gradients (from higher to lower drug
concentration). No energy is required. No carrier is necessary (therefore no saturation
effects).
 Lipid-soluble drugs: cross the cell membrane
 Water-soluble drugs: pass through aqueous channels/pores in the membrane
 Active transport: Requires energy and a specific transport system. Saturation kinetics are
present. May be transported against a concentration gradient.
Effect of pH
 Most drugs are weak acids or weak bases
 Weak acids:
 HA⇋H+ + A A charged (anionic) drug, A- will not pass through the cell membrane. The drug must be
in the protonated form to pass into the cell.
 Weak acids (higher pKa) will be absorbed more easily in weakly acidic environments
 pH = pKa+ log [A-]/[HA]
 Weak bases
Drug Metabolism
Kinetics: Most drugs follow first-order Michaelis-Menten kinetics. The rate of
metabolism is directly related to the concentration of the drug and a constant fraction of the total
drug is metabolized per unit of time. Some drugs follow zero-order (non-linear) kinetics and the
rate of metabolism remains constant over time.
Zero order kinetics:
High Dose
Rate of
Metabolism
12
1st order kinetics:
Low Dose
 Hydrophobic drugs cannot generally be eliminated by the kidneys and are handled by the
liver using two sets of reactions to make the drugs more water-soluble. The drug activity
may be increased, decreased or unchanged by Phase I reactions. In general, Phase II
reactions decrease pharmacologic activity.
 Phase I:
 Phase II
 Some drugs undergo Phase II and then Phase I reactions
United States FDA Pharmaceutical Pregnancy Categories
 Pregnancy Category A
o No risk to fetus in the all trimesters of pregnancy. (Animal and human studies)
 Pregnancy Category B
o Animal studies have failed to demonstrate a risk to the fetus. Either there are no
adequate and well-controlled studies in pregnant women or there are no negative
animal studies, but adequate and well-controlled studies in pregnant women have
failed to demonstrate a risk to the fetus in any trimester.
 Pregnancy Category C
o Animal studies have shown an adverse effect on the fetus. There are no adequate
and well-controlled studies in humans. Potential benefits may necessitate use of
the drug in pregnant women despite potential risks.
13
Autonomic Nervous System Drugs
Motor Neuron:
Nicotinic receptor
Neurotransmitter:
ACh
Autonomic, Sympathetic Neuron:
Pre-synaptic Neurotransmitter:
ACh (Nicotinic)
Post-synaptic (Adrenergic)
Neurotransmitter:
NE (α
or β)
Autonomic, Parasympathetic Neuron:
Pre-synaptic Neurotransmitter:
ACh (Nicotinic)
Post-synaptic Neurotransmitter:
ACh (muscarinic)
Cholinergic Responses:

↓ HR, CO, bp⇒


↑ intestinal, salivary secretions and intestinal motility⇒
Diarrhea, nausea, vomiting
↑ Bronchiolar smooth muscle tone

↑ ciliary m. ⇒
↑ miosis

↑ tone of detrusor m⇒
↑ urination

↑ sweat gland activity⇒ diaphoresis
Bradycardia, Dizziness
14
Adrenergic antagonists
 MOA:
 α1 antagonists: Act primarily on the CV system. Vasoconstriction is inhibited,
bringing about a net decrease in bp. Decreases smooth muscle contraction and
increases ease of urine flow.
 Overall clinical effect depends on status and specificity of blockage. If α2receptors are also blocked, there will be an increased sympathetic response
and potentially a smaller drop in bp due to increased NE release and
baroreceptor reflex.
 α2 antagonists: Centrally, these antagonists block either post-synaptic α2adrenergic receptors (↑ sympathetic response) or pre-synaptic α2- adrenergic
receptors, ↑NE release. The net result is an increase in bp, decreased resistance to
urine outflow, increased insulin release and increase smooth muscle tone.
 β1 antagonists: Act primarily on the CV system, decreased heart rate (↓ SA node
rate), decreased contractility and decreased peripheral arteriolar resistance. Renin
secretion is decreased, but it is not known if this is important in the hypotensive
effects.
 β2 antagonists: Act to increase bronchiolar constriction. Generally little effect in
normal individuals, but may induce bronchospasm in patients with asthma or COPD.
Increased CA release may increase serum glucose in diabetics.
 Mixed adrenergic antagonists: The overall effect will be dependent on degree
of selectivity and clinical status. Often difficult to predict.
α1 Antagonists
Tamsulosin (Flomax®)








Canadian Brand Names
 Flomax
Uses:
 BPH
Pharmacologic class: α1-adrenergic blocker
Therapeutic class: Anti-adrenergic
Pregnancy Risk Category B
CI:
 Hypersensitivity
Adverse Reactions
 Dizziness, restlessness, vertigo, headache, insomnia,
 Orthostatic hypotension
 Decreased libido and ejaculation
 Cough
Precautions:
 Hypertension, orthostatic hypotension
15



 Concurrent use of other adrenergic antagonists
 Females
 Elderly
 Pregnancy, lactation
 Renal, hepatic disease
Drug-Lab interactions
 None known
Lab monitoring:
 None necessary
Selected interactions
 Protease inhibitors, anti-hypertensives, concurrent use of adrenergic blockers,
alcohol
 Food
 Grapefruit juice
 Herbal
 α, β agonists: Ephedra, Yohimbe, Hypericum
 Herbs with hypertensive effects:
 Zingiber, Glycyrrhiza
 Anti-hypertensive herbs:
 Allium cepa, Allium sativa, Borago, Capsicum, Centella, Rauwolfia.
Selective Serotonin Reuptake Inhibitors

MOA: Block the re-uptake of 5HT thereby increasing local concentrations of the
neurotransmitter. Reflex decrease of receptors may be the basis of long-term action.
Citalopram (Celexa®)






Uses:
 Depression
Pharmacologic class: Selective Serotonin Re-uptake Inhibitor (SSRI)
Therapeutic class: Anti-depressant
Pregnancy Risk Category C
CI:
 Hypersensitivity
 MAOI use
 Abrupt withdrawal
Adverse Reactions
 Major: Suicide, akathisia, choreoathetosis, coagulopathy, hemolytic anemia,
hepatic necrosis, GI bleed, neuroleptic malignant syndrome, renal failure,
serotonin syndrome, SIADH, toxic epidermal necrolysis, torsade de pointes,
ventricular fibrillation, anaphylaxis
16





Apathy, psychosis, mania, migraine, dizziness, drowsiness, agitation, headache,
insomnia, nervousness, poor concentration, worsening depression
 Tachycardia, orthostatic hypotension
 Blurry vision, nausea, vomiting, diarrhea
 Rash, polyuria, amenorrhea, dysmenorrhea, ED, priapism
 Arthralgia, myalgia, dyspnea
 Erythema multiforme, rash, pruritis, yawning.
Precautions:
 Hepatic, renal, cardiac dysfunction
 History of mania, seizure disorder, suicidal tendencies
 History of addictive behaviors
 Driving, operating machinery
 Electroconvulsive therapy
 Elderly
 Pregnancy, lactation
 Hyponatremia
 Children < 18 yo
Drug Lab interactions
 ↓ Na+
Lab Monitoring
 Liver function tests
 Thyroid function tests
 Serum Na+
Selected interactions
 Adrenergics, protease inhibitors, anti-depressants, anti-histamines, barbiturates,
CNS depressants, H+ pump inhibitors, statins, MOAI’s, other SSRIs, NSAIDs,
sympathomimetics, opiates/opioids, TCAs
 Herbal
 Nervines
 Avena, Humulus, Hypericum, Leonurus, Matricaria, Passiflora, Piper
methysticum, Piscidia, Pulsatilla, Roseminarius, Scutelleria, Verbena,
Viburnum, Viscum.
 Mentha X piperita: activates endogenous opioids
 MAO inhibition in vitro
 Ginkgo, Hypericum, Panax, Eschoscholazia, Piper methysticum
 Cardiac glycosides:
 Hypericum, Crataegus, Digitalis, Convallaria, Selenicereus
 GABA containing herbs: Astragalus
 Herbs that may interfere with serotonin:
 Aspidosperma, Hypericum, Iris versicolor, Mentha X piperita,
Pausinystalia, Tanacetum, Urtica.
 α and β agonist: Ephedra, Hypericum, Pausinystalia
 Herbs containing PA
17
 Borago, Petasites, Eupatorium purpurea and Eupatorium spp, Senecio spp,





Pulmonaria.
Thyroid active herbs:
 Capsella, Lycopus, Lithospermum, Melissa, Leonurus, Thymus serpyllum,
Viscum album, Withania
Herbs with histaminic interactions
 Aloe vera, Hyoscyamus, Phytolacca, Scutelleria, Urtica
Herbs with anti-protease activity
 Curcuma, Ligusticum
Herbs with opiate interactions:
 Hypericum, Piscidia, Silybum
Herbs which induce endorphins
 Viscum album
Corticosteroids
 MOA: Corticosteroids are primarily used clinically as anti-inflammatory agents and
immunosuppressants. Corticosteroids may have glucocorticoid and
mineralocorticoid effects, depending on the particular agent. The effect of
corticosteroids is generally delayed, as the mechanism involves interaction with target
receptors followed by import into the nucleus and eventual alteration of gene
expression and protein synthesis.
Metabolic effects
Carbohydrate
metabolism
↑ gluconeogenesis
↑ glycogen synthesis
Protein metabolism
↑ proteolysis
Lipid metabolism
Electrolyte /water
metabolism
↑ lipolysis
↑ Na+, H2O reabsorption
18
↓ glucose utilization in
periphery⇒ ↑
[glucose]plasma
↑ use of aa for
gluconeogenesis
↑ fat redistribution
↑ K+, H+, Ca2+
excretion
↓ Ca2+ intestinal uptake
Adverse effects
Steroid withdrawal
Prolonged high dose
Systemic effects
Cardiovascular
Skeletal muscle
CNS
Hematopoietic
Exacerbation of underlying disease process
Acute adrenal insufficiency
HPA suppression recovery varies from weeks to > 1 year
HPA suppressive effects
Fluid/Electrolyte/metabolic:
Hypokalemic alkalosis, edema, hypertension, hyperglycemia,
glucosuria
Immune:
↑ susceptibility to infection
Skeletal system:
↑ osteoporosis, osteonecrosis
GI: ↑ PUD, GI bleeds
Muscles: Steroid myopathy
Ophthalmic: cataracts
Psychological:
Mood changes, neuroses, psychoses, suicidal behavior, “steroid rage”
↑ vascular reactivity to
vasoactive substances
↑ vascular permeability
↑ muscle wasting (steroid
Low corticosteroid levels:
myopathy) after high concentrations fatigue, weakness
for prolonged periods
Direct effects: Mixed. Appear to
Indirect effects: depend on bp,
depend on dose, duration and
glucose and electrolyte
endogenous production of
concentrations
neurotransmitters.
Effects include mood elevation,
depression, neuroses, psychoses
↑ hematopoiesis
↑ neutrophils
↓ lymphoid tissue
↓ lymphocytes, eosinophils,
monocytes, basophils
↑ Na+/ H2O⇒ ↑ bp
Inflammation and
↓ Arachidonic acid AA metabolites
Immunosuppression and acute phase reactants
↓ cytokines, lymphokines
↓ Adhesion molecules
↓ Histamine, Leukotrienes
19
Suppression of both humoral and
cellular immune response.
Multiple mechanisms of both
inflammatory and
immunological effects.
Female Reproductive Hormones
SERMs
MOA: Selective estrogen receptor modulators (SERMs) compete with estradiol for
hypothalamic estrogen receptors, blocking the negative feedback control pathways. Treatment
with SERMs therefore increases the release of gonadotropin releasing hormone (GnRH), in turn
increasing the release of both FSH and LH. FSH and LH then stimulate the ovaries to develop
follicles, produce estrogens that then induce the FSH/LH rise from the pituitary. SERMs are
usually given in the follicular phase of the menstrual cycle.
The SERMs also have estrogen agonist effects as well as antagonistic effects in the ovary,
endometrium, cervix, bone and mammary tissues. With Clomiphene, the estrogen agonist effects
on the HP axis are secondary to the antagonist effects, while with raloxifene, the effects on bone
and lipid metabolism are estrogen agonistic and the effects on the uterus and mammary tissue are
antagonistic.
Aldosterone
Cholesterol
Pregnenolone
Corticosterone
Progesterone
17-α-OH- Pregnenolone
17-α-OH- Progesterone
Dehydroepiandrosterone
Androstenedione
Androstenediol
Testosterone
Cortisol
Estrone
Estradiol
Dihydrotestosterone
20
Insulin
Route
SubQ
Onset
15
min
Peak
1 hr
Duration
3-4 hr
Type
Rapid/Aspart
SubQ
15
min.
30-90
min
3-4 hr
Rapid/Lispro
15
min.
10-20
min
30-90
min
2 hr
3-4 hr
Rapid/
Glulisine
Rapid
Insulin glulisine, recombinant: Apidra®
SubQ
30-60
min
2-4 hr Unknown
Short/ Regular
Insulin
IV
10-30
min
1-3 hr
15-30 Unknown
min
6-8 hr 12-16 hr
Short/ Regular
Insulin
Intermediate/
Lente/NPH/
Isophane
Humulin R, Iletin II Regular, Novolin R,
Penfill, Velosulin BR
Canadian names: Insulin-Toronto, Novolin ge
Toronto.
Mixed insulins as needed
Inhalation
SubQ
SubQ
60-60
min
6-10
hr
6 hr
24 hr
Names
Insulin Aspart (rDNA): NovoLog®
Insulin Aspart (rDNA)+ Insulin Aspart
protamine: NovoLogMix 70/30®
Insulin (lispro): Humalog®
Insulin glulisine recombinant: Apidra®
Insulin lispro protamine: Humulog Mix 50/50®
Insulin inhalation (rDNA): Exubera®
Lente: Humulin L, Lente Iletin II
NPH/Isophane: Humulin N, Novolin N, NPHN, NPH Iletin II
Canadian names: Novolin ge Lente
Long/
Humulin U, Novolin ge Ultralente, Novolin U,
Ultralente
Ultralente U
Very
Lantus
Long//Glargine
21