IP7 Final MOAs

Carbamazepine (Tegretol)

Sodium channel Blocker

Phenytoin sodium (Dilantin)

Sodium channel Blocker

Fosphenytoin sodium (Cerebyx)

Sodium channel Blocker

Clonazepam (Klonopin)

GABA Receptor Allosteric Modulator

Lorazepam (Ativan)

GABA Receptor Allosteric Modulator

Midazolam (Versed)

GABA Receptor Allosteric Modulator

Diazepam (Valium)

GABA Receptor Allosteric Modulator

Ethosuximide (Zarontin)

Voltage Gated Calcium Channel Blocker

Phenobarbital (Luminal)

GABA Receptor Allosteric Modulator + Decrease Glutamate Release

Valproic acid (Depakene, Depakote, Depacon)

Sodium Channel Blocker &

GABA-T, NMDAR, DA, 5HT

Oxcarbazepine (Trileptal)

Sodium channel Blocker

Lamotrigine (Lamictal)

Sodium channel Blocker

& Decreases Glutamate

Levetiracetam (Keppra)

Inhibit SV2A

(Inhibit Glutamate Release)

Topiramate (Topamax)

Carbonic Anhydrase 2 & 4 Inhibitor

Sodium Channel Blocker

CaV, GABA, AMPAR

Zonisamide (Zonegran)

Sodium channel Blocker & Calcium Channel Blocker

Lacosamide (Vimpat)

Sodium channel Blocker

Eslicarbazepine acetate (Aptiom)

Sodium channel Blocker

Brivaracetam (Briviact)

Inhibit SV2A

(Inhibit Glutamate Release)

Cannabidiol (Epidiolex)

TRPv, 5-HT1aR, T-Type CaV, GPR55

Cenobamate (Xcopri)

Sodium Channel Blocker & Allosteric Modulator of GABA Receptors

Felbamate (Felbatol)

Sodium Channel Blocker & Allosteric Modulator of GABA Receptors

Vigabatrin (Sabril)

Irreversible GABA-T Inhibitor

Tiagabine (Gabitril)

GABA-T Inhibitor via GAT1 Inhibition

Perampanel

Inhibit SV2A

(Inhibit Glutamate Release)

Methylprednisolone

Reduces Polymorphonuclear leukocytes / PMN migration & capillary leakage

Interferon Beta

Reduces antigen presentation & T cell infiltration in the CNS

Prevent the "kickoff" event in acute exacerbations of MS

Interferon Beta

Essentially endogenous interferon; reminds the immune system of what it's "supposed to be doing"

Teriflunomide

Pyrimidine Synthesis Inhibitor

Teriflunomide

Inhibits the rate limiting enzyme which causes reduced B and T cell activation

Cladribine

Incorporated into DNA (within dividing cells), which causes reduced T and B cell activation

Glatiramer acetate

A biologic mixture of "random" polypeptides which "distracts" the immune system

Glatiramer acetate

Decreases antigen response to myelin proteins

Fingolimod

Prevents lymphocyte (T & B cell) exit from the lymph nodes

Siponimod

Prevents lymphocyte (T & B cell) exit from the lymph nodes

Ozanimod

Prevents lymphocyte (T & B cell) exit from the lymph nodes

Ponesimod

Prevents lymphocyte (T & B cell) exit from the lymph nodes

Dimethyl Fumarate (DMF)

Activates Nrf2 to decrease oxidative stress & inflammation

Monomethyl Fumarate (MMF)

Activates Nrf2 to decrease oxidative stress & inflammation

Diroximel Fumarate (DRF)

Activates Nrf2 to decrease oxidative stress & inflammation

Natalizumab

Inhibits T cell adhesion and infiltration into the CNS

Modulates T cell permission to enter the CNS

Alemtuzumab

Depletes B and T cells by ADCC

Any cells with CD52 are marked for destruction

Ofatumumab

Complement-dependent cell lysis and antibody-dependent cell-mediated toxicity in cells that overexpress CD20

Ocrelizumab

Complement-dependent cell lysis and antibody-dependent cell-mediated toxicity in cells that overexpress CD20

Ublituximab

Complement-dependent cell lysis and antibody-dependent cell-mediated toxicity in cells that overexpress CD20

Dalfampridine

Improves conduction in long demyelinated axons (to the legs basically) by delaying repolarization and prolonging action potentials

Dalfampridine

Potassium channel blocker

Salicylates / Acetylsalicyclic acid / ASA

Non Competitive & Irreversible COX 1 & COX 2 Inhibitor via Acetylation

Ibuprofen

Ketoprofen

Reversible & Non Selective COX 1 & COX 2 Inhibitor

Diclofenac

Reversible & Non Selective COX 1 & COX 2 Inhibitor

Ketorolac

Reversible & Non Selective COX 1 & COX 2 Inhibitor

Naproxen

Reversible & Non Selective COX 1 & COX 2 Inhibitor

Celecoxib

Reversible & COX 2 Selective (> COX 1) Inhibitor

Acetaminophen / APAP

Central PGE Production / 5HT Modulation

Ketamine

Noncompetitive NMDA Antagonist

Dissociative Anesthetic

Suzetrigine

Selective NaV 1.8 Inhibitor

(AP Inhibitor in the peripheral nociceptive neurons)

Tramadol

MuOR Full Agonist & 5HT / NE Reuptake Inhibitor

Tapentadol

MuOR Full Agonist & 5HT / NE Reuptake Inhibitor

Loperamide

Peripherally-restricted opioid agonist with poor bioavailability

Buprenorphine

MOR Partial Agonist

& KOR Weak Antagonist

Naloxone

Opioid Antagonist with no oral bioavailbility

Naltrexone

Opioid Antagonist

Methylnaltrexone / Naloxegol

Opioid Antagonist Adjuvent used for preventing opioid-induced constipation

Nalmefene

Opioid Antagonist

Gabapentin

Binds to the α2-δ subunit of Voltage Gated Calcium Channels to reduce NTM release

Pregabalin

Binds to the α2-δ subunit of Voltage Gated Calcium Channels to reduce NTM release

Carbamazepine

Inhibit Voltage Gated Sodium Channels

Desipramine

Inhibit NE & 5HT Reuptake Inhibitor

& Blocks Na, Ca Channels

& Blocks NMDA receptors

Nortriptyline

Inhibit NE & 5HT Reuptake Inhibitor

& Blocks Na, Ca Channels

& Blocks NMDA receptors

Duloxetine

Selective NE & 5HT Reuptake Inhibitor

Heroin

Class 1

Full MOR Agonist

Naloxone / Naltrexone

Opioid Overdose Treatment

MOR Competitive Antagonist

Methadone

Opioid Withdrawal Treatment

Full MOR Agonist

Buprenorphine +/- Naloxone

Opioid Withdrawal Treatment

Partial MOR Agonist

Clonidine

Opioid Withdrawal Treatment

Alpha 2 Adrenergic Agonist

Lofexidine

Opioid Withdrawal Treatment

Alpha 2 Adrenergic Agonist

Cannabinoids

Class 1

Agonist at CB1 (CNS) & CB2 (Immune) GPCRs

Kratom / Mitragynine / 7-hydroxymitragynin & synthetic derivatives

Class 1

Nonselective MOR Partial Agonist

LSD / Lysergic acid diethylamide

Class 1

5HT1/2/5/6, DA2 agonist

Mescaline

Class 1

5HT1/2a agonist

GHB / Gamma-hydroxybutyric acid

Class 1

GABA(B) & GHBR agonist

Psilocybin

Class 1

5HT2a agonist

Nicotine

Class 2

nAChR Full Agonist

Ethanol

(Main MOA)

Class 2

Enhancement of GABA(A) receptor-operated channels

Disulfiram

EtOH Use Disorder Treatment

Aldehyde Dehydrogenase Inhibitor

Acamprosate

EtOH Use Disorder Treatment

GABAergic modulator, NMDA antagonist

Benzodiazepines

Class 2

GABA(A) Allosteric Modulation; Prolongs opening

Ketamine

Class 2

Metabolized to Nor_____, an NMDA antagonist

PCP / Phencyclidine

Class 2

NMDA antagonist, DA+NE+5-HT reuptake inhibitor

Amphetamines

Class 3

Increase Cytosolic DA, Reverse DA Transporter, Inhibits MAO

Cocaine

Class 3

Increase Cytosolic DA, Reverse DA Transporter, Inhibits MAO

MDMA / Ectasy

Class 3

Increases 5-HT, DA, NE Release

Reuptake Inhibitor / Reversal

Baclofen

Hyperpolarization via GABA(B) Agonist activity in the spinal cord

Tizanidine

α2 agonist

Presynaptic inhibition in the spinal cord

Diazepam

Increase GABA(A) Opening Frequency Postsynaptically

(Cl- Permeability)

Cyclobenzaprine

Reduces tonic somatic motor activity in the CNS

Dantrolene

Inhibits Ca2+ release from SR

(RyR1 Inhibitor)

Botulinum Toxin / Botox

Blocks Presynaptic Ach release persistently

Succinylcholine

Agonist nAchR depolarization

Metabolized by BCHE in the liver & plasma

Tubocuraine

nAchR Competitive Antagonist

Rocuronium

nAchR Competitive Antagonist