MT3 Medications

Fludrocortisone

Adrenocorticosteroid, mineralocorticoid

MOA: Increase Na retention and K+ loss, emulates ADH activity

Use: Mineralocorticoid replacement

SE: Increased risk of infection

Prednisone

Adrenocorticosteroids, glucocorticoid

MOA: Short-acting, increase metabolic activity, anti-inflammatory effects, and inhibit immune response

Use: Addison’s disease, RA, severe allergies

SE: Increased risk of infection, Cushing’s

Methylprednisolone

Adrenocorticosteroids, glucocorticoid

MOA: Short-acting, increase metabolic activity, anti-inflammatory effects, and inhibit immune response

Use: Addison’s disease, RA, severe allergies

SE: Increased risk of infection, Cushing’s

Triamcinolone

Adrenocorticosteroids, glucocorticoid

MOA: Short-acting, increase metabolic activity, anti-inflammatory effects, and inhibit immune response

Use: Addison’s disease, RA, severe allergies

SE: Increased risk of infection, Cushing’s

Hydrocortisone

Adrenocorticosteroids, glucocorticoid

MOA: Short-acting, increase metabolic activity, anti-inflammatory effects, and inhibit immune response

Use: Addison’s disease, RA, severe allergies

SE: Increased risk of infection, Cushing’s

Prednisolone

Adrenocorticosteroids, glucocorticoid

MOA: Short-acting, increase metabolic activity, anti-inflammatory effects, and inhibit immune response

Use: Addison’s disease, RA, severe allergies

SE: Increased risk of infection, Cushing’s

Dexamethasone

Adrenocorticosteroids, glucocorticoid

MOA: Long-acting, increase metabolic activity, anti-inflammatory effects, and inhibit immune response

Use: Addison’s disease, RA, severe allergies

SE: Increased risk of infection, Cushing’s

Clomiphene

Gonadal hormones

MOA: ER-alpha/beta antagonist, increase amplitude of LH and FSH pulses

Use: Induction of ovulation in women with intact HPO axis

SE: Hot flashes, bloating

Fluvestrant

Gonadal hormones

MOA: Pure estrogen antagonist

Use: ER positive breast cancer

SE: Hot flashes, bloating

Tamoxifen

Gonadal hormones, SERM

MOA: Estrogen agonist and antagonist in different areas

Use: Breast cancer

SE: Uterine cancer

Raloxifene

Gonadal hormones, SERM

MOA: Estrogen antagonist in the uterus

Use: Breast cancer

SE: Hot flashes, NV

Progesterone

Gonadal hormones

MOA: Produce thick mucus to block sperm

Use: Contraceptive

SE: Period irregularities

Mifepristone

Gonadal hormones

MOA: Progesterone receptor antagonist → Zygote detachment from uterus and shedding of uterine lining

Use: Medical abortion

SE: Bleeding, NV, cramping

Ethinyl estradiol/Norethindrone

Gonadal hormones

MOA: Semi-synthetic estrogen, oral

Use: Contraceptive

SE: Blood clots

Bazedoxifene

Gonadal hormones, SERM

MOA: Conjugated estrogen

Use: Menopause

SE: Hot flashes, NV

Norethidrone/Ethinyl estradiol

Gonadal hormones, Combination

MOA: Dose estrogen 21 days followed by 7 day placebo, progestin dose can vary or stay constant

Use: Contraceptive

SE: Blood clots

Norgestimate/Ethinyl estradiol

Gonadal hormones, Combination

MOA: Dose estrogen 21 days followed by 7 day placebo, progestin dose can vary or stay constant

Use: Contraceptive

SE: Blood clots

Norethindrone

Gonadal hormones, Progestin only

MOA: Produce thick mucus to block sperm

Use: Contraceptive

SE: Menstrual irregularities

Estradiol

Gonadal hormones

MOA: Main estrogen in premenopausal women, topical/patch/IM delivery, also the fixed estrogen in contraceptives

Use: Menopause, contraceptive

SE: Hot flashes, NV

Desogestrel/Ethinyl Estradiol

Gonadal hormones, Combination

MOA: Dose estrogen 21 days followed by 7 day placebo, progestin dose can vary or stay constant

Use: Contraceptive

SE: Blood clots

Levonorgestrel/Ethinyl estradiol

Gonadal hormones, Combination

MOA: Dose estrogen 21 days followed by 7 day placebo, progestin dose can vary or stay constant

Use: Contraceptive

SE: Blood clots

Testosterone

Gonadal hormones

MOA: Avoids 1st pass effect due to transdermal application

Use: Male hypogonadism, andropause

SE: Acne, reduced spermatogenesis, virilization

Finasteride

Gonadal hormones

MOA: 5-alpha-reducetase inhibitor → Reduce testosterone signaling

Use: BPH and baldness

SE: Acne, reduced spermatogenesis, virilization

Levothyroxine

Thyroid

MOA: DOC for hypothyroidism, synthetic T4

Use: Hypothyroidism

SE: Hyperthyroidism

Methimazole

Thyroid, Thioamide

MOA: Inhibits thyroid peroxidase → No iodination of tyrosine

Use: Hyperthyroidism

SE: Rash, NV

Propylthiouracil

Thyroid, Thioamide

MOA: 10x less potent than methimazole, inhibits thyroid peroxidase

Use: Thyroid storm

SE: Hepatotoxicity

Alendronate

Osteoporosis, Bisphosphonate

MOA: Suppress activity of clasts → Inhibit bone resorption

Use: Osteoporosis

SE: Bone, join, or muscle pain, GI upset

Ibandronate

Osteoporosis, Bisphosphonate

MOA: Suppress activity of clasts → Inhibit bone resorption

Use: Osteoporosis

SE: Bone, join, or muscle pain, GI upset

Raloxifene

Osteoporosis, SERM

MOA: Estrogen agonist in bone → Inhibit bone resorption

Use: Osteoporosis

SE: Fatigue, hot flashes

Teriparatide

Osteoporosis

MOA: Synthetic PTH, pulse to stimulate blast activity

Use: Osteoporosis

SE: Hypercalcemia

Denosumab

Osteoporosis

MOA: Monoclonal antibody, prevents clast differentiation and function

Use: Osteoporosis

SE: Increased risk of infection

Cinacalcet

Osteoporosis

MOA: Binds CaSR, promotes negative PTH feedback loop

Use: Hyperparathyroidism in pts with chronic renal failure

SE: Hypocalcemia

Insulin aspart

Antidiabetic

MOA: Rapid onset, early peak action, mimics normal insulin secretion, taken right before a meal or used in SC device

Use: Diabetes

SE: Hypoglycemia

Insulin lispro

Antidiabetic

MOA: Rapid onset, early peak action, mimics normal insulin secretion, taken right before a meal or used in SC device

Use: Diabetes

SE: Hypoglycemia

Insulin detemir

Antidiabetic

MOA: Long acting, mimics basal insulin secretion

Use: Diabetes

SE: Hypoglycemia

Insulin human

Antidiabetic

MOA: Short acting, only IV/IM

Use: Diabetes

SE: Hypoglycemia

GLP-1

Antidiabetic, Incretin mimic

MOA: Stimulates insulin and suppresses glucagon, delays gastric emptying

Use: Diabetes

SE: GI distress, weight loss, acute pancreatitis, thyroid tumors

Liraglutide

Antidiabetic, Incretin mimic

MOA: Stimulates insulin and suppresses glucagon, delays gastric emptying

Use: Diabetes

SE: GI distress, weight loss, acute pancreatitis, thyroid tumors

Sitagliptin

Antidiabetic, DDP-4 inhibitor

MOA: GLP-1 not degraded → Potentiates insulin synthesis and decreases glucagon production

Use: Diabetes

SE: Upper respiratory infections, headaches, pancreatitis

Linagliptin

Antidiabetic, DDP-4 inhibitor

MOA: GLP-1 not degraded → Potentiates insulin synthesis and decreases glucagon production

Use: Diabetes

SE: Upper respiratory infections, headaches, pancreatitis

Metformin

Antidiabetic, Biguanide

MOA: Increase insulin sensitivity, decrease glucose production in liver, decrease glucose absorption in intestines, increase glucose uptake into tissue

Use: Diabetes

SE: GI distress, lactic acidosis

Glyburide

Antidiabetic, Sulfonylurea agent (2nd gen)

MOA: Stimulate insulin secretion from beta cells through K+ channels

Use: Diabetes

SE: Hypoglycemia, weight gain, caution in pts with sulfa allergy

Glipzide

Antidiabetic, Sulfonylurea agent (2nd gen)

MOA: Stimulate insulin secretion from beta cells through K+ channels

Use: Diabetes

SE: Hypoglycemia, weight gain, caution in pts with sulfa allergy

Glimepiride

Antidiabetic, Sulfonylurea agent (3rd gen)

MOA: Stimulate insulin secretion from beta cells through K+ channels

Use: Diabetes

SE: Hypoglycemia, weight gain, caution in pts with sulfa allergy

Glyburide/Metformin

Antidiabetic

MOA: Combo sulfonylurea/biguanide

Use: Diabetes

SE: Upper respiratory infection, headaches, pancreatitis, caution in pts with sulfa allergy

Pioglitazone

Antidiabetic, Thiazolidinediones

MOA: Sensitizes cells to insulin, esp adipose

Use: Diabetes

SE: Edema, weight gain, exacerbation of CHF

Canagliflozin

Antidiabetic, SLGT2 inhibitor

MOA: Increase glucose secretion, increase in Na+ excretion

Use: Diabetes, HTN

SE: GU infections

Azathioprine

Immunopharmacology

MOA: Inhibits new purine synthesis needed for lymphocyte proliferation, 1st drug used for organ transplant

Use: Prevent transplant rejection

SE: Increased risk of infection

Mycophenolate

Immunopharmacology

MOA: Inhibits inosine monophosphate dehydrogenase

Use: Prevent transplant rejection

SE: Increased risk of infection

Leflunomide

Immunopharmacology

MOA: Pyrimidine synthesis inhibitor → Prevent lymphocyte replication

Use: RA

SE: Increased risk of infection

Cyclosporine

Immunopharmacology, Calcineurin inhibitor

MOA: Inhibits IL-2 production/action

Use: RA

SE: Irreversible nephrotoxicity

Tacrolimus

Immunopharmacology, Calcineurin inhibitor

MOA: Inhibits IL-2 release, more potent than cyclosporine

Use: RA, prevents transplant rejection

SE: Irreversible nephrotoxicity

Sirolimus

Immunopharmacology

MOA: mTOR inhibitor → Blocks T cell activation by IL-2

Use: Prevent transplant rejection

SE: Black box warning for liver and lung transplant, increased risk to develop lymphoma and other malignancies

Adalimumab

Immunopharmacology

MOA: Fully humanized anti-TNF-alpha Ab

Use: RA, psoriatic + osteoarthritis

Alemtuzumab

Immunopharmacology

MOA: Humanized mAb, anti-CD52 → powerful lymphocyte depleting agent

Use: Relapse and remitting MS

Basiliximab

Immunopharmacology

MOA: Chimeric mouse-human mAb, anti-CD25 → Prevent T cell activation

Use: Prevent renal transplant rejection

Abatacept

Immunopharmacology

MOA: Prevents APCs from activating T cells

Use: RA if no response to anti-TNF-alpha

Interferons

Immunopharmacology

Immunostimulant

Interleukins

Immunopharmacology

Immunostimulant