MG: Endocrine, respiratory and digestive system

VIP

iNANC - (ihibitory nonadrenergic non cholinergic), causes relaxation due to cAMP production (inhibited in astmha due to inflammatory interferance)..

NO

Causes bronchodilation via CGMP, in asthma reduced due to inhibition of producer (overexpression of arginase which breaks down arginine).

Adrenaline

Beta and alpha agonist, used during anaphylactic shock, but not as asthma treatment because it is injectable and not selective enough.

Isoprenaline

Beta receptor agonist, selective to only beta, but not oral

Orciprenaline

Beta agonist, the first oral variant, not used because still not selective enough

Terbutaline

Beta 2 receptor agonist, still used because of specificity and oral, however an inhalor is preffered.

Salbutamol

Short acting beta agonist inhalor (reliever)

Fenoterol

Short acting beta agonist inhalor (reliever)

Folmeterol

Long acting beta agonist inhalor (maintenance therapy)

Salmetarol

Long acting beta agonist inhalor (maintenance therapy)

Theophylline

Inhibits PDE, which normally breaks down CAMP, however not selective enough, so other problems throughout the body and narrow therapeautic window.

Atropine

Anticholinergic, is not selective enough and can go through the BBB, therefore not used.

Ipatropium

Anticholinergic, but blocks not only M3, but also M2 which is the autoinhibitor, therefore still bronchoconstriction. Also short acting

Tiotropium

Anticholinergic, binds more specifically to M3 and is longer lasting. Treatment is as good as an beta2 agonist. Especially for COPD.

Budesonine

Corticosteroid, effective for late phase. induction of lipocortin resulting in inhibition of leukotrien and prostaglandin mediated inflammation by the inhibition of phopspholipase A, also locally used for IBD

Fluticasone

Corticosteroid, effective for late phase. induction of lipocortin resulting in inhibition of leukotrien and prostaglandin mediated inflammation by the inhibition of phopspholipase A

Beclomethasone

Corticosteroid, effective for late phase. induction of lipocortin resulting in inhibition of leukotrien and prostaglandin mediated inflammation by the inhibition of phopspholipase A

prednisolone

oral corticoidsteroid, a lot of side effects, only given during hospiltalization for a small period of time. (possibly for IBD)

sodium cromoglycate

cromone, mast cell stabilizer, preventing Ca2 of entering, bad complaince due to multiple dosages, still used for eye drops in hay fever.

nedocromil

cromone, mast cell stabilizer, preventing Ca2 of entering, bad complaince due to multiple dosages, still used for eye drops in hay fever.

Montelukast

Targets leukotriene receptors, only used when ICS is no option, so in patients who prefer oral over inhalation (childern)

Omalizumab

anti IgE, expensive, only makes a difference in severe allergic asthma.

Mepolizumab

anti IL 5 which represses eosinophills, only in severe asthma, or when most complementary after taking a biomarker test.

Benralizumab

anti IL 5 receptor which represses eosinophills, only in severe asthma, or when most complementary after taking a biomarker test.

Dupilumab

Anti IL4R, no IL4 and IL13, no IgE production (COPD exacerbation)

Tezepelumab

anti TSLP (alarmin), works great for non allergic asthma, anti inflammatory because ILC2 cant start a response.

xylomethazoline

nasal spray, causing vasoconstriction through alpha2 agonist, not for chronic use.

oxymethazoline

nasal spray, causing vasoconstriction through alpha2 agonist, not for chronic use.

mometasone

Corticosteroid, effective for late phase. induction of lipocortin resulting in inhibition of leukotrien and prostaglandin mediated inflammation by the inhibition of phopspholipase A

chloorpheniramine

first generation antihistamine, enters BBB, sedative

clemastine

first generation antihistamine, enters BBB, sedative

cetrizine

second generation antihistamine

loratidine

second generation antihistamine

Gefapixant

only real working cough medicine, through inhibiting p2×3 which starts the cough reflex, total loss of taste

ACE inhibitors

inhibit the degradation of bradykinin resulting in dry cough

Emollienta (thyme syrup)

short acting protection of mucosal surfaces

Expectorantia (volatile oils)

increased bronchial secretions resulting in the dilution of mucus.

Acetylcystiene

mucolytic, dilution of mucus, by breaking disulfide bonds

Bromohexine

mucolytic, dilution of mucus, by cleavage of mucopolysaccharides

Bupropion

Smoking cessation, reduces withdrawel by affecting dopamine and adrenaline.

Aclidinium

Long acting Anticholinergic, binds more specifically to M3 and is longer lasting. Treatment is as good as an beta2 agonist. Especially for COPD.

Glycopyrronium

Anticholinergic, binds more specifically to M3 and is longer lasting. Treatment is as good as an beta2 agonist. Especially for COPD.

Umeclidinium

Anticholinergic, binds more specifically to M3 and is longer lasting. Treatment is as good as an beta2 agonist. Especially for COPD.

indacaterol

Long acting beta agonist inhalor (maintenance therapy)

olodaterol

Long acting beta agonist inhalor (maintenance therapy)

Rofluminast

PDE4 inhibitor (COPD excerbation)

Ensifentrine

PDE 3 en 4 inhibitor (COPD exacerbation)

Azithromycin

Antibiotic, used with COPD exacerbation as pneumonia prevention.

Nintedanib

Inhibits growth factors, against pulmonary fibrosis.

Pirfedonine

Inhibits fibroblast through an unknown mechanism, against pulmonary fibrosis.

Nerandomilast

inhibits ECM formation through PDE4B inhibition. against pulmonary fibrosis.

Cimetidine

H2 antagonist, blocking the histamine signal from the ECL towards the parietal cells, resulting in no acid production.

Famotidine

H2 antagonist, blocking the histamine signal from the ECL towards the parietal cells, resulting in no acid production.

Omeprazole (prazoles)

Bind the protonpump, resulting in less stomach acid. From the cytoplasmic side, so short duration.

vonoprazan

protonpump inhibitor with longer activation, because gets trapped in lumen due to charge. Less stomach acid.

Sucralfate

Mucosal protective agent, protein complex on ulcer, less pepsin, more PG.

Bismuth subcitrate

Mucosal protective agent, protein complex on ulcer, less pepsin, more PG. anti helicobactor and pepsin reuptake

Sodiumbicarbonate

Fast acting antacid (neutralization acid and pepsin inhibition)

Alluminiumhydroxide

non resorbing antacid (neutralization acid and pepsin inhibition)

magnesiumhydroxide

non resorbing antacid (neutralization acid and pepsin inhibition)

magnesiumtrisillicate

non resorbing antacid (neutralization acid and pepsin inhibition)

Misoprostol

Prostaglandin anaglogue, oral, stimulates uterine contraction (abortion with Mifepristine), works on prostaglandin receptor of the ECL cell, less acid secretion, more mucus and HCO3 secretion. Often used in combination with NSAIDs (as they have the opposite effect)

Domperidone

prokinetic drug, used in reflux disease, D2 antagonist, causing more Ach release, resulting in contraction of the sphincter.

Metclopramide

prokinetic drug, used in reflux disease, D2 antagonist, causing more Ach release, resulting in contraction of the sphincter.

5HT-antagonist

as alternative treatment in reflux disease, against diarrhea as well

Ivacaftor

binds , CFTR receptor, in specific cases it goes back to function, different variances and combinations possible.

ORS

oral rehydration salts, used as treatment for diarhea

Activated carbon, pectin and Al-silicate

absorbent drugs, diarrhea treatment

hyoscine (and atropine)

anticholinergics, anti motillity in diarrhea, hyoscine is also usefull against motion sickness.

loperamide (codeine, difenoxylate)

opioid, against motillity in diarrhea, by repressing Ach secretion, not with infection!

NKA

eNANC (excitatory non-adrenergic non-cholinergic), tachykinin, works on NK2 receptor and causes smooth muscle broncho constriction.

Substance P

eNANC (excitatory non-adrenergic non-cholinergic), tachykinin, works on NK1 receptor, causing oedema and mucosal gland stimulation.

Sulfalazine

pro-drug for mesalazine, so ideal treatment for uclerative colitis as it is made active in the colon. Mechanism of action: decreased arachidonic acid metabolism (less PG and LT), less O2 and less neutrophil chemotaxis.

Mesalazine

Already active in small intestine, so ideal for Crohns, Mechanism of action: decreased arachidonic acid metabolism (less PG and LT), less O2 and less neutrophil chemotaxis.

Methotrexate

immunosuppresive agent, work against IBD (inflammatory bowel disease), but also psoriasis

Infliximab

Anti TNFalpha, in severe IBD, and for psoriasis

Adalimumab

Anti TNFalpha, in severe IBD, and for psoriasis

Certolizumab

Anti TNFalpha, in severe IBD

Lactulose and Mg salts

Osmotic laxatives, Most commonly used, attracts water through osmosis.

methylcellulose and stereulia

Bulk laxatives, Dietary fiber, swell and causes pressure in the colon

Sodium docusate

Fecal softener, Laxative, Increases intestinal fluid secretion

Senna, Danthron and bisacodyl

Stimulant laxatives, Stimulates ENS causing more peristalsis and mucosal effects.

Secretagogues

Laxative, push the secretion of water.

5HT-agonist

Against constipation, by promoting motility and secretion

Benzylperoxide

Local keratolytic (kills keratinocyte), bacterialcidal, anti-inflammatory, cannot combine with tretinoine (due to chemical stability).

Tretinoine

Oral keratolytic, teratogenic (cannot use when pregnant), often combined with local bacterial agents.

Minoxidil

Local vasodilator, works by opening potassium channels, prescribed against baldness.

Finasteride

Inhibits the conversion of testosterone to DHT (which causes local vasoconstriction leading to baldness).

Topical steroids

Immunosuppressant, which also causes vasoconstriction, used for eczema treatment.

topical, T-cell repressor (causing no/less transcription), also against psoriasis

Topical corticosteroids/ antihistamines

used against urticarcia

Phototherapy

Against psoriasis, only light where active PVVA

Cyclosporine

Calcineurin inhibitor, represses T cells, reduction in inflammatory cytokines.

Secukinumab

anti-il17, against psoriasis.

Insulin

Promotes glucose storage and uptake.

Amylin

Lowers glucagon, gastric emptying and gives satiety feeling

Glucagon

Stimulates glycogen breakdown and glucogenesis.

Somatostatin

inhibits glucagon, insulin and other GI secretions, decreased growth signal pituitary gland.

Pancreatic polypeptide (PP)

it causes less pancreatic secretion, gallbladder contraction and regulates GI function.

Lispro

Fast working insuline injection