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Important Points

 

  1. Loperamide   
    1. Synthetic opioid                                    
    2. Mu agonist                  
    3. Structurally related to atropine                       
    4. Does not enter blood brain barrier
    5. No analgesic property, no abuse potential              
    6. DOC-functional diarrheas
  2. Diphenoxylate
    1. Synthetic opioid                                       
    2. Combined with atropine`
    3. Atropine is given with diphenoxylate to reduce its abuse potential
  3. Drotavarine
    1. PD-IV inhibitor        
    2. Not an anticholinergic drug             
    3. Commonly used as antispasmodic

 Phospodiestrase (Pd) Inhibitors

NON SELECTIVE

SELECTIVE

Methylxanthines
Aminophylline
Pentoxiphylline

i.   Vinpocetine

ii.  Bay Gas

iii.  Imrinone/Milrinone
      Cilastazole
      Pimobendan/Levosimendan

iv.  Roflumilast/Ibudilast/Cilomilast
      Drotaverine

v.   Sildenafil/Tadanafil
      Drotaverine

vi.  Papaverine

                    

New PD-IV inhibitors - Cilomilast, Roflumilast- Antiasthma drugs

    

PD V inhibitors

  1. Sildenafil, verdenafil, tadalafil                            
  2. Well absorbed; metabolism by CYP 3A4
  3. Tadalafil is most potent                            
  4. All are equally effective
  5. DOC-erectile dysfunction                             
  6. Contraindicated with nitrates
  7. S/e-hypotension, priapism, blue green vision disturbance
  8. C/i-sickle cell anemia, leukemia, lymphomas

List of Selected classical neurotransmitters

 

System

Transmitter

Precursor

Cholinergic

Acetylcholine

Choline+acetylcoenzyme a

Aminoacidergic

GABA

Glucose glutamate

Aspartic acid

Glucose+glutamine; glutamate

Glutamic acid

Glucose+glutamine; aspartate

Glycine

Serine

Homocysteine

Cysteinecystine

Monoaminergic

 

 

Catecholamines

Dopamine

Tyrosinedopadopamine

Norepinephrine

norepinephrineepinephrine

Epinephrine

 

Indolamines

Tryptamine

 

Serotonin

Tryptophan5-hydroxytryptophan

Others, related to aa

Histamine

Histidine

Taurine

Cysteinecysteamine

Purinergic

Adenosine

 

ADP

 

AMP

 

ATP

 





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