Top200B MOA

acyclovir

Inhibits DNA synthesis and viral replication by competing with deoxyguanosine triphosphate for viral DNA polymerase and being incorporated into viral DNA

amlodipine

Acts on vascular smooth muscle to produce peripheral arterial vasodilation by inhibiting calcium ions from entering select voltage-sensitive areas of vascular smooth muscle

amoxicillin

Binds to penicillin-binding proteins (PBPs) which inhibits peptidoglycan synthesis in bacterial cell walls, thus inhibiting cell wall biosynthesis

apixaban

Inhibits platelet activation and fibrin clot formation via direct, selective, and reversible inhibition of free and clot-bound factor Xa

aspirin

Irreversibly inhibits cyclooxygenase-1 and 2 enzymes, via acetylation, which results in decreased formation of prostaglandin precursors Irreversibly inhibits formation of prostaglandin derivative, thromboxane A2, via acetylation of platelet cyclooxygenase, thus inhibiting platelet aggregation

atenolol

Selectively blocks beta1-receptors

atorvastatin

Inhibits 3-hydroxy-3-methylglutaryl coenzyme A (HMG-CoA) reductase

azithromycin

Inhibits RNA-dependent protein synthesis by binding to the 5S ribosomal subunit

carvedilol

Nonselectively blocks beta-adrenoreceptors and alpha-adrenoreceptors

cefazolin

Inhibits bacterial cell wall synthesis by binding to one or more of the penicillin-binding proteins (PBPs) which in turn inhibits the final transpeptidation step of peptidoglycan synthesis in bacterial cell walls, thus inhibiting cell wall biosynthesis

cefdinir

Binds to penicillin-binding proteins (PBPs) which inhibits peptidoglycan synthesis in bacterial cell walls, thus inhibiting cell wall biosynthesis

cefepime

Inhibits bacterial cell wall synthesis by binding to one or more of the penicillin-binding proteins (PBPs) which in turn inhibits the final transpeptidation step of peptidoglycan synthesis in bacterial cell walls, thus inhibiting cell wall biosynthesis

ceftriaxone

Inhibits bacterial cell wall synthesis by binding to one or more of the penicillin-binding proteins (PBPs) which in turn inhibits the final transpeptidation step of peptidoglycan synthesis in bacterial cell walls, thus inhibiting cell wall biosynthesis

cephalexin

Binds to penicillin-binding proteins (PBPs) which inhibits peptidoglycan synthesis in bacterial cell walls, thus inhibiting cell wall biosynthesis

chlorhexidine

The bactericidal effect is a result of the binding of this cationic molecule to negatively charged bacterial cell walls and extramicrobial complexes. At low concentrations, this causes an alteration of bacterial cell osmotic equilibrium and leakage of potassium and phosphorous resulting in a bacteriostatic effect At high concentrations, the cytoplasmic contents of the drug and bacterial cell precipitate and result in cell death.

chlorthalidone

Sulfonamide-derived diuretic that inhibits sodium and chloride reabsorption in the distal convoluted tubule

ciprofloxacin

Inhibits DNA-gyrase and promotes breakage of double-stranded DNA

clindamycin

Binds to 5S ribosomal subunit resulting in inhibition of protein synthesis

clonidine

Stimulates alpha2-adrenoceptors in the brain stem, thus activating an inhibitory neuron, resulting in reduced sympathetic outflow from the CNS

clopidogrel

Irreversibly blocks the P2Y12 component of ADP receptors on the platelet surface

dabigatran

Specific, reversible, direct thrombin inhibitor that inhibits both free and fibrin-bound thrombin

daptomycin

Binds to components of the cell membrane of susceptible organisms and causes rapid depolarization, inhibiting intracellular synthesis of DNA, RNA, and protein

darunavir

Binds to the site of HIV-1 protease activity and inhibits cleavage of viral Gag-Pol polyprotein precursors into individual functional proteins required for infectious HIV

digoxin

Inhibits the sodium/potassium ATPase pump in myocardial cells leading to increased contractility Directly suppresses AV node conduction to increase effective refractory period and decrease conduction velocity

diltiazem

Inhibits calcium ions from entering select voltage-sensitive areas of vascular smooth muscle and myocardium during depolarization

docusate

Reduces surface tension of the oil-water interface of the stool resulting in enhanced incorporation of water and fat allowing for stool softening

dopamine

Stimulates both adrenergic and dopaminergic receptors, lower doses are mainly dopaminergic stimulating and produce renal and mesenteric vasodilation, higher doses also are both dopaminergic and beta1-adrenergic stimulating and produce cardiac stimulation and renal vasodilation

doxycycline

Inhibits protein synthesis by binding with the 3S ribosomal subunit

dutasteride

Selectively inhibits 5α-reductase, resulting in inhibition of the conversion of testosterone to dihydrotestosterone and markedly suppressed serum dihydrotestosterone levels

emtricitabine, tenofovir, and efavirenz (combination)

Non-nucleoside reverse transcriptase inhibitor of HIV-1, thereby blocking the RNA-dependent and DNA-dependent DNA polymerase resulting in inhibition of viral replication Nucleoside reverse transcriptase inhibitor, which interferes with HIV viral RNA dependent DNA polymerase resulting in inhibition of viral replication Nucleotide reverse transcriptase inhibitor, interferes with the HIV viral RNA dependent DNA polymerase resulting in inhibition of viral replication

enalapril

Inhibits angiotensin converting enzyme, preventing the conversion of angiotensin I to angiotensin II

enoxaparin

Strong inhibitor of factor Xa

epinephrine

Stimulates alpha-, beta1-, and beta2-adrenergic receptors resulting in relaxation of smooth muscle of the bronchial tree, cardiac stimulation (increasing myocardial oxygen consumption), and dilation of skeletal muscle vasculature; Small doses can cause vasodilation via beta2-vascular receptors; large doses may produce constriction of skeletal and vascular smooth muscle

ertapenem

Inhibits bacterial cell wall synthesis by binding to one or more of the penicillin-binding proteins; which in turn inhibits the final transpeptidation step of peptidoglycan synthesis in bacterial cell walls, thus inhibiting cell wall biosynthesis

esomeprazole

Suppresses gastric acid secretion by inhibition of the H+/K+-ATPase in the gastric parietal cell

estradiol

Responsible for the development and maintenance of the female reproductive system and secondary sexual characteristics Modulate the pituitary secretion of gonadotropins, luteinizing hormone, and follicle-stimulating hormone through a negative feedback system

ethinyl estradiol and etonogestrel (combination)

Combination hormonal contraceptives inhibit ovulation via a negative feedback mechanism on the hypothalamus, which alters the normal pattern of gonadotropin secretion of a follicle-stimulating hormone (FSH) and luteinizing hormone by the anterior pituitary

ezetimibe

Inhibits absorption of cholesterol at the brush border of the small intestine via the sterol transporter, Niemann-Pick C1-Like1 (NPC1L1)

famotidine

Competitively inhibits histamine at H2 receptors of the gastric parietal cells, which inhibits gastric acid secretion

fenofibrate and derivatives

Agonist for the nuclear transcription factor peroxisome proliferator-activated receptor-alpha (PPAR-alpha), downregulates apoprotein C-III (an inhibitor of lipoprotein lipase) and upregulates the synthesis of apolipoprotein A-I, fatty acid transport protein, and lipoprotein lipase resulting in an increase in VLDL catabolism, fatty acid oxidation, and elimination of triglyceride-rich particles

finasteride

Selectively inhibits 5α-reductase, resulting in inhibition of the conversion of testosterone to dihydrotestosterone and markedly suppressed serum dihydrotestosterone levels

fluconazole

Interferes with fungal cytochrome P450 activity (lanosterol 14-α-demethylase), and decreases ergosterol synthesis which inhibits cell membrane formation

furosemide

Inhibits reabsorption of sodium and chloride in the ascending loop of Henle and proximal and distal renal tubules, interfering with the chloride-binding cotransport system, thus causing increased excretion of water, sodium, chloride, magnesium, and calcium

gentamicin

Interferes with bacterial protein synthesis by binding to 30S ribosomal subunit resulting in a defective bacterial cell membrane

Group: Oral Contraceptives

Combination hormonal contraceptives inhibit ovulation via a negative feedback mechanism on the hypothalamus, which alters the normal pattern of gonadotropin secretion of a follicle-stimulating hormone (FSH) and luteinizing hormone by the anterior pituitary

heparin

Potentiates the action of antithrombin III and thereby inactivates thrombin (as well as other coagulation factors IXa, Xa, XIa, XIIa, and plasmin) and prevents the conversion of fibrinogen to fibrin; also stimulates release of lipoprotein lipase (lipoprotein lipase hydrolyzes triglycerides to glycerol and free fatty acids)

hydralazine

Direct vasodilation of arterioles

hydrochlorothiazide

Inhibits sodium reabsorption in the distal tubules causing increased excretion of sodium and water as well as potassium and hydrogen ions

imipenem and cilastatin (combination)

Inhibits bacterial cell wall synthesis

isosorbide mononitrate

Activates cGMP leading to dephosphorylation of myosin light chains and smooth muscle relaxation

lansoprazole

Suppresses gastric acid secretion by inhibition of the H+/K+-ATPase in the gastric parietal cell

levofloxacin

Inhibits DNA-gyrase and promotes breakage of double-stranded DNA

levothyroxine

Synthetic form of thyroxine (T4), which is converted to active thyroid hormone

linezolid

Inhibits bacterial protein synthesis by binding to bacterial 23s ribosomal RNA

liothyronine

Active (T3) thyroid hormone

lisinopril

Inhibits angiotensin converting enzyme, preventing the conversion of angiotensin I to angiotensin II

losartan

Antagonizes angiotensin receptors, blocking the vasoconstrictor and aldosterone secreting effects of angiotensin II

meropenem

Inhibits bacterial cell wall synthesis

metoprolol

Selectively blocks beta1-receptors

metronidazole

Interacts with DNA to cause a loss of helical DNA structure and strand breakage resulting in inhibition of protein synthesis and cell death

minocycline

Inhibits protein synthesis by binding with the 30S ribosomal subunit

mupirocin

Binds to bacterial isoleucyl transfer-RNA synthetase resulting in the inhibition of protein synthesis

nifedipine

Acts on vascular smooth muscle to produce peripheral arterial vasodilation by inhibiting calcium ions from entering select voltage-sensitive areas of vascular smooth muscle

nitrofurantoin

Inactivates or alters bacterial ribosomal proteins leading to inhibition of protein synthesis, aerobic energy metabolism, DNA, RNA, and cell wall synthesis

nitroglycerin

Activates cGMP leading to dephosphorylation of myosin light chains and smooth muscle relaxation

norepinephrine

Stimulates beta1-adrenergic receptors and alpha-adrenergic receptors causing increased contractility and heart rate as well as vasoconstriction, thereby increasing systemic blood pressure and coronary blood flow

norethindrone

Suppresses ovulation, thickens cervical mucus, alters follicle-stimulating hormone (FSH) and luteinizing hormone (LH) concentrations, slows the movement of ovum through the fallopian tubes, and alters the endometrium

omega-3 fatty acids

Reduction in hepatic production of VLDL and a reduction in the hepatic synthesis of triglycerides

omeprazole

Suppresses gastric acid secretion by inhibition of the H+/K+-ATPase in the gastric parietal cell

ondansetron

Selective 5-HT3-receptor antagonist

oseltamivir

Inhibits influenza virus neuraminidase

oxybutynin

Direct antispasmodic effect on smooth muscle and inhibits the action of acetylcholine

pantoprazole

Suppresses gastric acid secretion by inhibition of the H+/K+-ATPase in the gastric parietal cell

penicillin v potassium

Interferes with bacterial cell wall synthesis during active multiplication, causing cell wall death and resultant bactericidal activity against susceptible bacteria

phentermine

secondary to CNS effects, including stimulation of the hypothalamus to release norepinephrine

piperacillin and tazobactam (combination)

Interferes with bacterial cell wall synthesis during active multiplication, causing cell wall death and resultant bactericidal activity against susceptible bacteria

polyethylene glycol

osmotic agent, causes water retention in the stool

pravastatin

Inhibits 3-hydroxy-3-methylglutaryl coenzyme A (HMG-CoA) reductase

promethazine

Blocks postsynaptic mesolimbic dopaminergic receptors in the brain; exhibits a strong alpha-adrenergic blocking effect and depresses the release of hypothalamic and hypophyseal hormones; competes with histamine for the H1-receptor

propranolol

Nonselective beta-adrenergic blocker; competitively blocks response to beta1- and beta2-adrenergic receptors

rivaroxaban

Inhibits platelet activation and fibrin clot formation via direct, selective and reversible inhibition of free and clot-bound factor Xa

rosuvastatin

Inhibits 3-hydroxy-3-methylglutaryl coenzyme A (HMG-CoA) reductase

sacubitril and valsartan (combination)

Prodrug that inhibits neprilysin, leading to increased levels of natriuretic peptides that induces vasodilation and natriuresis Produces direct antagonism of the angiotensin II (AT2) receptors.

sildenafil

Inhibits phosphodiesterase type 5 (PDE-5), causing increased levels of cGMP, resulting in smooth muscle relaxation and increased blood flow

simvastatin

Inhibits 3-hydroxy-3-methylglutaryl coenzyme A (HMG-CoA) reductase

sofosbuvir and ledipasvir (combination)

Ledipasvir inhibits the HCV NS5A protein necessary for viral replication sofosbuvir inhibits NS5B RNA-dependent RNA polymerase

solifenacin

Inhibits muscarinic receptors resulting in decreased urinary bladder contraction, increased residual urine volume, and decreased detrusor muscle pressure

spironolactone

Competes with aldosterone for receptor sites in the distal renal tubules, increasing sodium chloride and water excretion while conserving potassium and hydrogen ions Blocks the effect of aldosterone on arteriolar smooth muscle

sulfamethoxazole and trimethoprim (combination)

Interferes with bacterial folic acid synthesis Inhibits bacterial folic acid metabolism

tadalafil

Inhibits phosphodiesterase type 5 (PDE-5), causing increased levels of cGMP, resulting in smooth muscle relaxation and increased blood flow

tamsulosin

Antagonist of alpha1A-adrenoreceptors leading to relaxation of smooth muscle in the bladder and prostate

tenofovir alafenamide and emtricitabine (combination)

Each drug interferes with HIV viral RNA dependent DNA polymerase activities resulting in inhibition of viral replication

testosterone

Principle endogenous androgen responsible for growth and development of male sex organs and maintaining secondary sex characteristics

ticagrelor

Reversibly and noncompetitively binds the adenosine diphosphate (ADP) P2Y12 receptor on the platelet surface which prevents ADP-mediated activation of the GPIIb/IIIa receptor complex thereby reducing platelet aggregation

triamterene

Blocks epithelial sodium channels in the late distal convoluted tubule and collecting duct which inhibits sodium reabsorption from the lumen. This effectively reduces intracellular sodium, decreasing the function of Na+/K+ ATPase, leading to potassium retention and decreased calcium, magnesium, and hydrogen excretion

valacyclovir

Inhibits DNA synthesis and viral replication by competing with deoxyguanosine triphosphate for viral DNA polymerase and being incorporated into viral DNA

vancomycin

Inhibits bacterial cell wall synthesis by blocking glycopeptide polymerization through binding tightly to D-alanyl-D-alanine portion of cell wall precursor

vasopressin

stimulates a family of arginine vasopressin (AVP) receptors, oxytocin receptors, and purinergic receptors stimulates the AVPR1a (or V1) receptor and increases systemic vascular resistance and mean arterial blood pressure. stimulates the AVPR2 (or V2) receptor is then cyclic adenosine monophosphate (cAMP) increases which in turn increases water permeability at the renal tubule resulting in decreased urine volume and increased osmolality also causes smooth muscle contraction in the GI tract by stimulating muscular V1 receptors and release of prolactin and ACTH via AVPR1b (or V3) receptors

verapamil

Inhibits calcium ions from entering select voltage-sensitive areas of vascular smooth muscle and myocardium during depolarization

warfarin

Inhibits subunit 1 of the multi-unit VKOR complex, leading to depletion of factors II, VII, IX, and X, as well as proteins C and S.