A compiled list on  classification of drugs

Objective:

This page enlists the classification of drugs and provide the the reader an idea on different classes of drugs in several diseases.

Key words:

Classification of drugs, antibiotics

Antibiotics

A. According to the type of mechanism of action, antibiotics are classified as follows:

1. Inhibit cell wall synthesis: Penicillin, Cephalosporin’s etc

2. Interfere of Inhibit with intermediary cell metabolism: Sulphonamides, Trimethoprim etc

3. Interactions with the plasma membrane: Polymixin, Tyrothricin etc.

4. Inhibit or disrupt protein synthesis: Erythromycin, Tetracyclines etc.

5. Inhibition of nucleic acid transcription and replication: Nalidixic acid and profalvin etc

6. Interfere with DNA synthesis: Zodovudine, Idoxuridine etc.

7. Interfere with DNA function: Refampicin, Norfloxacin etc.

8. Cause misreading of m-RNA: Aminoglycosides, Neomycin etc.

B. According to the chemical structure:

1.β-lactum antibiotics: penicillin, Cephalosporin etc.

2. Aminoglycoside antibiotics: Gentamycin, Streptomycin etc.

3. Macrolid antibiotics: Erythromycin, Azithromycin etc.

4. 4-Quinolones: Ciprofloxacin, perfloxacin etc.

5. Polymyxin antibiotics: Polymyxin A, Polymyxin B etc.

General Classification of Analgesics:

Narcotic Analgesics can be classified into the following group:

1. Natural (Opium Alkaloids): Morphine, Codeine

2. Semi-synthetic opiates: Oxymorphine, Hydrocodone.

3. Synthetic analgesics:

a)     Mepredine and related phenyl-piperidine: Pethidine, Piminodine.

b)     Methadone and related drugs: Methadone, propoxyphene.

c)     Benzomorphanes: Phenazocine, Pentazocine.

d)     Morphinan derivatives: Levorphanol, Butorphanol.

e) Narcotic antagonists: Nalorphine, Naloxone.

Anti-inflammatory drugs

Non-steroidal anti-inflammatory drugs(NSAID’s) are the dominating  member of these class of drugs:

Classification of NSAID’s:

·       Classification based on their chemical structure:

Ø Carboxilic Acid Groups:

ü  Salicylates: Aspirin, Salicylamide etc.

ü  Arylalkanoic Acids/Aryl acetic acid derivatives: Diclofenac.

ü  2-Arylpropionic acids (profens) or Propionic acids: Carprofen, Ketoprofen.

ü  N-Arylanthranilic acids(fenamic acids): Mefenamic acid

ü  Aminonicotinic acids: Flunixin.

ü  Indole Analogs: Indomethacin, Ketorolac etc.

Ø  Enolic Acids:

ü  Pyrazolidine derivatives: Phenylbutazone

ü  Oxicams: Piroxicam, Meloxicam

Ø  Selective COX-2 inhibitors: Rofecoxib, Valdecoxib etc.

Ø  Aniline and P-aminophenol derivatives: Acetanilide, Acetaminophen.

Ø  Sulphonarilides: Nimesulide.

Ø  Gold Salts: Auranofin, Gold sodium thiomalate etc.

Classification based on their COX selectivity

Ø  COX non selective Inhibitors: Diclofenac , Ibuprofen etc.

Ø  COX1 selective Inhibitors: Aspirin in low dose.

Ø  COX2 selective inhibitors: Celecoxib, Etorocoxib etc.

Ø  COX3 selective inhibitors: Some paracetamol isomers are under investigation under this class.

Anti-Pyretic Drugs

Classification of anti-pyretic drugs

Ø  Central anti-pyretics:

ü  Acetaminophen.

ü  Phenacetin.

ü  Aspirin.

ü  Phenyl butazone.

Ø  Specific anti-pyretics:

ü  Ampicillin

ü  Amoxacillin.

ü  Cotrimoxazole.

ü  Chloramphenicol.

Ø  Diaphoretics:

ü  Pilocarpine.

ü  Nitrites

Ø  Miscellaneous:

ü  Morphine.

ü  Apomorphine.

ü  Chlorpromazine.

Anti-Viral Drugs

Classification based on Sites of action of anti-viral drugs.

Ø  Inhibitors of penetration of host cell by virus

ü  Gamma globulin.

Ø  Blocker of Viral uncoating stage

ü Amantadine.

Ø  Inhibitors of Viral genome Transcription

ü  Acyclovir

ü  Ganciclovir

ü    Zidovudine( inhibits reverse transcriptase of AIDs virus)

Ø  Inhibitors of Translation of viral proteins

ü  Regulatory proteins/early proteins ( fomivirsen)

ü  Structural proteins/late proteins(Methisazone)

Ø   of posttranslational modifications

ü  Protease inhibitors (Ritonnavir, sequinaver)

Ø  Inhibitors of assembly of virion components

ü  Rifampin

Ø  Inhibitors of Viral release

ü  Neuroaminidase inhibitors

Classification based on Chemical Structure.

Ø  Nucleoside analogs

ü  Acyclovir

ü  Famciclovir

ü  Valacyclovir

Ø  Non-nucleoside analogs

ü  Delavirivine

ü  Foscarnet

ü  Neviratine

Ø  Others(Protease inhibitors)

ü  Ritonnaver

ü  Sequinavir

Anti-Cancer Drugs

Classification of Anti-cancer Drugs is given below:

Ø  Anti-Metabolites

ü  Folate  antagonist (Methotrexate, Amethopterin)

ü  Purin  antagonist (6-Mercaptopurine, 6-thioguanine)

ü  Pyrimidine antagonist (5-Fluorouracil, 5- Fluorodeoxyuridine)

ü  Sugar modified analogs

ü  Ribo-nulceotide reductase inhibitor

Ø  Co-valent DNA-binding drugs

ü  Nitrogen Mustards (Mechlorethamine, Cyclophosphamide)

ü  Azeri dines

ü  Aklane Sulfonates

ü  Nitrosourea ( Carmustine, Lomustine)

ü  Platinum Compounds

ü  Mono alkylating agents

Ø  Non-covalent DNA binding drugs

ü  Antracyclins

ü  Mitoxantrone

ü  Dactinomycin

ü  Bleomycin

Ø  Inhibitors of chromatin function

ü  Topo isomerase (topo I ,topo II)

ü  Microtubule inhibitor( Vinblastin, Vincristine)

Ø  Drug affecting endocrine function

ü  Estrogen

ü  Glucocorticoid

Anti-cancer drugs can also be classified by the following way

1.Alkylating Agents

2.Anti-Metabolites

3.Mitotic Inhibitors

4.Antibiotics

5.Others

Busulfan

Fluorouracil,

Floxuridine

Etoposide

Bleomycin

L-asparaginase

Carmustine

Arabinoside,

Cytosine

Teniposide

Dactinomycin

Hydroxyurea

Chlorambucil

Mercaptopurine

Vinblastine

Daunorubicin,

Doxorubicin

Procarbazine

Cisplatin

Methotrexate

Vincristine,

Vindesine

Mitomycin-C,

Mitoxantrone

Cyclophosphamide

Ifosfamide

Taxoids

Plicamycin

Classification of Anti-Hypertensive Drugs:

Mechanism-based classification:

Diuretics:

Thiazide diuretics (they end in "-thiazide" or are "thiazide-like")-Hydrochlorothiazide, methyclothiazide, chlorothiazide.

Thiazide-like diuretics: Chlorthalidone, indapamide, metolazone

Loop diuretics/high-ceiling diuretics- Furosemide, bumetanide, ethacrynic acid, and torasemide. These potent drugs act on the loop of Henle in the kidneys, leading to a substantial loss of sodium and water, which results in increased urine output

Potassium-sparing diuretics– amiloride, spironolactone.

Sympathoplegic agents:

Adrenergic synthesis/ release blockers- reserpine, granethidine.

Central α-adrenergic agonists-α-methodepa, clonidine.

 α- blockers – prazosin, tetrazosin,

 β- blockers- propranolol, Timolol. [mnemonic]

Ganglion blocker- Trimethaphan.

Direct Vasodilators:

Hydralazine, minoxidil

Calcium channel blockers:

Amlodipine, Verapamil

Angiotensin-II and ACE inhibitors:

ACE inhibitors (often end with the suffix "-pril"))- Captopril, Enalapril, Fosinopril, Perinodopril, Ramipril, Lisonopril, Trandolapril, Quinapril etc.

Angiotensin-II receptor antagonists/Angiotensin-II receptor blockers (ARBs-often end with the suffix "-sartan")- losartan (considered protective of the kidneys ), valsartan, candesartan, irbesartan, telmisartan, olmesartan, eprosartan, and azilsartan medoxomil

The primary mnemonic for Angiotensin II Receptor Blockers (ARBs) is to remember their suffix, "sartan", found in drug names like losartan, candesartan, and valsartan, signifying their class and function in blocking angiotensin II receptors to treat conditions such as hypertension and heart failure. Other useful mnemonics focus on their clinical uses (hypertension, CHF, diabetic nephropathy), mechanism (block AT1 receptors, increase renin), and key side effects (hyperkalemia, no cough unlike ACE inhibitors, teratogenic).

What are the best thiazide diuretics?

Experts recommend chlorthalidone as the preferred diuretic for high blood pressure. But in practice, HCTZ is prescribed much more frequently. Chlorthalidone lasts longer in the body, but it may have a higher risk of kidney and electrolyte problems.

For Drug Names 

• -sartan ending: This is the most direct mnemonic for ARBs. When you see or hear a drug name ending in "sartan," such as losartan, valsartan, or candesartan, you know it's an ARB.

For Clinical Use

• "Spartan"
  (from Picmonic): This helps associate ARBs with their benefits, like treating hypertension, heart failure, and diabetic nephropathy. 

-sartan (Angiotensin II Receptor Blockers):
Linking the suffix to the drug class and understanding the renin-angiotensin-aldosterone system (RAAS) helps remember their use in blocking angiotensin II's effects, leading to vasodilation and reduced aldosterone. 

For Mechanism and Side Effects

• Hiker-banana (Hyperkalemia)
  : This mnemonic helps remember the side effect of hyperkalemia, which results from reduced aldosterone, leading to decreased potassium excretion. 

No Cough:
Unlike ACE inhibitors, which cause a dry cough due to increased bradykinin, ARBs block angiotensin II at the receptor, not the enzyme, and do not increase bradykinin levels. 

How to Use the Mnemonics

1. Identify the Drug Class: Recognize the "-sartan" suffix to identify an ARB. 

Understand the Mechanism: Recall that ARBs block the angiotensin II receptor, leading to vasodilation and reduced aldosterone, which treats hypertension and heart failure. 

Remember Key Side Effects: Note the key difference from ACE inhibitors (no cough) and the potential for hyperkalemia. 

Beta blocker (Google AI Overview)

To remember beta blockers, use the "-olol" or "-lol" suffix mnemonic, shared by most beta-blocking medications, making it a useful identifier. 

For selective β1-blockers, use the A-M rule (Atenolol, Metoprolol), linking the "one" heart to β1 receptors. 

For nonselective β1 and β2-blockers, use the N-Z rule (Propranolol, Nadolol), linking "two" lungs to β2 receptors. Common beta blockers include ** atenolol**, metoprolol, carvedilol, and propranolol. 

• Selective Beta-1 Blockers (Cardioselective) [Mnemonic: A-M for 1 heart] 

Explanation: These blockers primarily target beta-1 (β1) receptors, which are found mainly in the heart. The mnemonic helps remember that the drugs starting with letters from A to M target β1 receptors. 

Examples: Atenolol, Metoprolol, Bisoprolol 

• Nonselective Beta Blockers (Nonselective) [Mnemonic: N-Z for 2 lungs]

Explanation: These blockers affect both β1 (heart) and β2 receptors (lungs, peripheral vessels). The mnemonic links the two lungs to the β2 receptors and helps recall that drugs starting with letters from N to Z are nonselective. 

Examples: Propranolol, Nadolol, Sotalol 

Other Notable Beta Blockers 

• Carvedilol: and Labetalol: These are notable nonselective beta-blockers that do not follow the A-M/N-Z rule.

Common Side Effects of Beta Blockers 

• Mnemonic: BETA

  • B: radycardia

  • E: rectile dysfunction

  • T: iredness/fatigue

  • A: sthma worsening (bronchospasm)

Key Points

• Beta blockers block the effects of adrenaline (epinephrine).

• They slow the heart rate and decrease the force of contraction, lowering blood pressure. 

• They are used for hypertension, angina, heart failure, and after a heart attack

Classification of diuretics

Carbonic anhydrase inhibitors (CAIs)

Carbonic anhydrase inhibitors (CAIs) are a class of drugs that block the carbonic anhydrase enzyme, which plays a key role in regulating pH and fluid production in the body. They are used to treat conditions like glaucoma by reducing fluid in the eye, altitude sickness by decreasing fluid in the brain and lungs, and certain forms of epilepsy. Common examples include topical eye drops like dorzolamide (Azopt) and brinzolamide, and oral medications like acetazolamide, methazolamide, dorzolamide, brinzolamide, diclofenamide, ethoxzolamide, and zonisamide 

How They Work

• Enzyme Inhibition:
  CAIs work by inhibiting the carbonic anhydrase enzyme, which catalyzes the conversion of carbon dioxide and water into bicarbonate and protons. 

Glaucoma Treatment:
By inhibiting carbonic anhydrase in the eye, CAIs reduce the production of aqueous humor (eye fluid), thereby lowering intraocular pressure. 

Diuretic Effect:
In the kidneys, inhibiting carbonic anhydrase leads to increased excretion of sodium and bicarbonate, which promotes diuresis (fluid loss) and can alkalize the urine. 

Conditions Treated

• Glaucoma: Reducing fluid production to lower pressure in the eye. 

Altitude Sickness: Reducing pulmonary and cerebral edema (fluid in the lungs and brain) associated with high altitude. 

Epilepsy: Certain CAIs are used as antiepileptic agents. 

Congestive Heart Failure: As part of their diuretic action. 

Idiopathic Intracranial Hypertension: A condition of high pressure within the skull. 

Common Examples

• Dorzolamide (e.g., Azopt): A topical eye drop used for glaucoma. 

Brinzolamide (e.g., Trusopt): Another topical eye drop for glaucoma. 

Acetazolamide: An oral carbonic anhydrase inhibitor used as a diuretic and for altitude sickness. 

Methazolamide: Another oral CAI used for glaucoma. 

Potential Side Effects 

• Paresthesia: Tingling in the fingers and toes.

• Metallic Taste: A common side effect of these medications.

• Increased Urination: A result of the diuretic effect.

• Metabolic Acidosis: Can occur with systemic CAIs due to bicarbonate loss.

Classification of Sedative and Hypnotics:

A. Barbiturates

                             i.          Long Acting Barbiturates (8-12 hours).

Ø           Barbitone.

Ø           Phenobarbitone.

Ø           Mephobarbitone.

                           ii.           Intermediate acting barbiturate.

Ø           Amilo-barbitone.

Ø           Allo-barbitone.

Ø           Buto-barbitone.

                          iii.          Short acting barbiturate.

Ø           Pento-barbitone

Ø           Quinal-barbitone.

                          iv.          Ultra-short acting.

Ø           Thiopental Na+

Ø           Hexobarbitone Na+

B. Non-Barbiturates

                             i.          Organic group:

Ø           Benzodiazepines ( best hypnotic)

ü  Nitrazepam ( most potent)

ü  Diazepam

Ø           Aldehyde derivatives

ü  Paraldehyde

Ø           Alcohol

ü  Ethyl alcohol

ü  Chloral Hydrate.

Ø           Carbamet derivatives

ü  Ethinmate

ü  Urethane

Ø           Piperdine derivatives

ü  Gluthemide

ü  Thalidomide

Ø           Miscellaneous

ü  Antihistamine

ü  Scopolamine

                           ii.           In-organic group:

ü  Na+ bromide.

ü  K+ bromide

Immunosuppressive drugs:

Classification based on specific molecular mode of action:

A. Drugs Inhibit T-cell activation:

                           i.          Cyclosporins

B. Drugs inhibit the synthesis of DNA and RNA:

                           i.          Azathioprines

C. Drugs inhibit the binding of interleukin-2:

                           i.          Basiliximab

                         ii.          Daclizumab.

D. Drugs suppress the inflammation associated with transplant rejection:

                           i.          Prednisolone.

Classification according to the specific organ that is transplanted:

1. Drugs used in Kidney Transplantation:

a.      Basiliximab.

2. Drugs used in Kidney, liver and heart Transplantation:

a.      Muromonab.

3. Drugs used in liver, kidney, bone marrow, heart , pancreas Transplantation:

a. Tacrolimus.

Cholinergic Drugs:

Classification:

A.    Chlonie esters: Carbachol, Bethanechol.

B.    Natural Cholinomimetic agents: Arecholine.

C.    Anti-Cholinesterase agents:

                           i.          Natural: Physostigmine.

                         ii.          Synthetic: Neostigmine, Edrophonium.

a.  Organophosphorus compound; Hexaethyl tetra   phosphate (HETP)

                       iii.          Agro-chemicals: Diazenone, Parathion.

                      iv.          Nerve gas: Sarin, Tabun.

Anti-cholinergic Drugs:

Classification:

A.    Antimuscarinic agents

                           i.          Natural alkaloids: atropine, scopolamine.

                         ii.          Semi synthetic derivatives: Ipratropium Bromide.

                       iii.          Synthetic compounds:

Ø            Mydriatics: Cyclopentolate.

Ø            Antispasmodic:

ü  Tertiary amine derivatives- Telenzepine.

ü  Quaternary amine derivatives- Propenthaline.

Ø            Antiperkinsonism drug: Benzotropine.

B.    Antinicotinic agents:

                           i.          Neuromuscular blocking agents:

Ø            Competitive blockers: d-tubocurarine.

Ø            Non-competitive blockers: Decamethonium.

Ø            Mixed acting compounds: Denzoquinonium.

                         ii.          Ganglionic blocking agents:

Ø            Competitive blockers: Pentolinium, Hexamethonium.

Ø            Non-competitive blockers: Lobeline.

Adrenergic Drugs:

Classification:

A.    According to Mechanism of Action:

                          I.          Direct sympathomimetic: Isoprenaline.

                        II.          Indirect sympathomimetic: Tyramine, Amphetamine.

                      III.          Mixed acting: Ephedrine, Metaraminol.

B.    According to Therapeutic Uses:

                          I.          Vasoconstrictors: Adrenaline.

                        II.          Vasodilators: Isoprenaline.

                      III.          Bronchodilators: Sulbutamol.

                      IV.          CNS stimulator: Amphitamine.

C.    According to Receptor stimulation:

                          I.            α-agonist: Noradrenaline, Phenylephrine.

                        II.           Β- agonist: Isoprenaline, Isoproterenol.

                      III.           Both: Ephedrine, Adrenaline.

D.    According to Chemical Nature:

                          I.          Catecholamines: Dopamine.

                       II.          Non-catecholamines: Tyramine.

Classification of Anti-epileptic drugs:

A. According to the therapeutic utility

1. Major seizures (grand mal epilepsy)

         1st choice:    Phenytoin

         2nd choice:   Carbamazepine 

                            Pheonbarbitone

                            Primidone

                            Na+ valporate

                         Clonazepam

2.Minor seizores (petit mal epilepsy):

          1st choice : Na+ valporate

               Ethosuximide

          2nd choice : clonazepam

                 Troxidone

3. Others  : Methsuximide

                Carbamazepine

                 Clonazepam 

                Phenytoin

B. According to chemical nature

1. Barbiturate and related drugs :

Phenobarbitone

Mephobarbitone

2. Hydatoins:

Phenytoin

Mephenytoin

Ethotoin

3. Oxazolidenediones :

Trimethadione

Paramethadione

4. Succimides:

Phen-suximide

Meth-suximide

Etho-suximide

5. Benzodiazepines :

Diazepam

Nitrazepam

Clobazam

6. Acetyl urea derivatives

Acetazolamide

7. Newer drugs :

Carbamazepine

Na+ valporate

Classification of Anti-Parkinsonism drugs:

A. Anti-cholinergic :

Atropine

Scopolamine

Proclyclidine

B. Anti-histamines

Orphenadrine

Diphenylhydramine

C. Adrenergic or Dopaminergic drugs:

Levodopa

Levodopa+CARBIDOPA

L-DOPA+Benserzide

Amantidine

Bromocriptine

D. Drugs with both anti-cholinergic and anti-histaminic properties : Benzotropine

E. Phenothiazine with anti-cholinergic and   anti-histaminic action : Promazine

F. Mood elevators : Dextroamphetamine ,imiprine

Types of anesthetic:

Local anesthetic (L.A)

General anesthetic (G.A)

Classification of local anesthetics

a.      According to the duration of action

1.     Short acting (30-60 minutes)

Procaine (30 min)

Amethocaine(1 hour) 

                                 2. Intermediate acting(60-120 minutes)

                                           Lidocaine

                                            Articane

                                              PIlocaine

2.     Long acting

Bupivacaine

Tetracaine

Etidocaine

b.     According to the chemical structure

1.     Ester group

Procaine

Coacaine

Tetracaine

2.     Amide group

Lidocaine

Prilocaine

 Etidocaine

Bupivacaine

c.      According to  the clinical use

1.     Surface anesthesia:

Lignocaine

Cocaine

Ethylcloride

2.     Infiltration anesthesia:

Lignocaine

Cocaine

Procaine

3.     Nerve block anesthesia

Lignocaine

Procaine

tetracaine

4.     Spinal anesthesia

Lignocaine

Procaine

Tetracaine

5.     Epidural anesthesia

Lignocaine

Bupivacaine

Tetracaime

Classification of general anesthetics:

A.    Volatile or inhalation anesthetics:

1.     Gasseus:

Nitrous oxide

Cyclopropane

2.     Volatile liquids

Halothen,chloroform

Ethylcloride

B.    Non-volatile or I/v anesthetics;

1.     Steroidal

Na=hydroxyl succinate

Althesin

Etomide

2.     Non-steroidal:

a.      Ultra short acting barbiturate

Thiopental Na+

Hezithal-Na=

b.     Non-barbiturate

Diazepam

Ketamine

Classification of haematinics(according to disease):

A. Drugs used in the iron deficiency anemia

                 i.          Iron preparation

a.      Oral preparation

Ferrous sulphate

Ferrous gluconate

Ferrous fumarate

Ferrous succinate

Ferrous chline acetate

Ferrous carbonate

Ferric amonioum citrate

b.     Parentral preparation

Irondextran

Iron sorbital

Dextraferron

               ii.          Copper,cobalt,pyridoximine,riboflavin

B. Drugs used in the megaloblastic anemia

Vitamine B12

Folic acid

Vitamine C

Classification of anti-coagulant

A.    Anticoagulant acting in vitro:

First group:

Na and K salts of oxalate,citrate and floride

EDTA

Second group:

Heparin

Dextram sulphate

B.    Anticoagulant acting in vivo:

Coumarin derivative

Dicumarol

Warfrin

Cyclocoumerol

Indandione derivative

Phenindione

Diphenindione

Anisidione

C.    Anticoagulant acting  both in vivo and vitro :

Heparin

Dextram sulphate

Ancord

D.    According to mechanism of action

Directly acting:

Heparin

Dextram sulphate

Indirectly acting:                               

Coumarin derivative

Indandione derivative

E.     According to the mechanism of administration:

                  Inject able anti-coagulants:

Heparin

Ancord

                 Oral anti-coagulant:

Warfarin

Dicoumarol

Classification of hypoglycemic agent:
A. Parental hypoglycemic agent:

                                                             Insulin preparation:

1. First acting (5-12 hours)

Crystaline insulin widely used

Zinc insulin crystals

Promt  insulin zinc suspension

2. Intermediate acting(12-24 hours)

Isophen insulin suspension

Insuline zinc suspension

Globin zinc  insulin

3. Long acting(24-36 hours)

Protamine zinc insulin  suspension

Extended zinc insulin suspension

C. Oral hypoglycemic

1.     Sulphonyl urea derivative

  First generation:

                                           Tolbutamide

                                           Clorpropamide

                                           Acetohexa mide

                                           Carbutamide

                                           Tolazamide

          Second generation:

                                                             Glibinclamide

                                                             Gliclazide

                                                             Gilpizide

2.     Biguanide derivatives

Phenformin

Metformin

Buformin

Anticancer drugs

An antimetabolite is a drug that interferes with normal cellular metabolism by mimicking essential metabolites, thereby blocking the synthesis of vital cellular components like DNA. These compounds are primarily used in cancer chemotherapy to disrupt the rapid growth of tumor cells, but also serve as "steroid-sparing" immunosuppressants for autoimmune diseases like rheumatoid arthritis. Examples include methotrexate, 5-fluorouracil, cyrarabine and azathioprine. 

Cell cycle non-specific (CCNS) drugs work against cancer cells at any phase of the cell cycle, including the resting (G0) phase, unlike cell-cycle specific drugs which only work during particular phases of cell division. Major types of CCNS agents include Alkylating Agents (e.g., cyclophosphamide, cisplatin) and Anthracyclines (e.g., doxorubicin), which damage DNA. This broad mechanism makes them active against both rapidly dividing and resting cancer cells. 

Mechanism of Action

CCNS drugs are generally classified by their actions on DNA, either directly or indirectly: 

Alkylating Agents: These agents form covalent bonds with DNA, interfering with DNA replication and cell division. 

Anthracyclines: These drugs inhibit DNA synthesis, disrupt DNA structure, and induce free radical damage. 

Other CCNS Drugs: Some CCNS drugs can also damage the cell's membrane structure or act through different mechanisms to inhibit cancer cell growth. 

Examples of CCNS Drug Categories and Agents

Alkylating Agents

Nitrogen Mustards: cyclophosphamide, chlorambucil, mechlorethamine 

Nitrosoureas: carmustine, lomustine, which can cross the blood-brain barrier to treat brain tumors 

Platinum Coordination Complexes: cisplatin, carboplatin, which damage DNA 

Anthracyclines

Doxorubicin: An example that inhibits DNA synthesis and causes free radical damage. 

Key Characteristics

Broad Activity: Because they are not limited to specific cell cycle phases, CCNS drugs are effective against a wide range of cancer cells. 

Cell Killing: Their ability to act on resting cells makes them particularly useful against non-proliferating cancer cell populations. 

Combination Therapy: CCNS drugs are often used in combination with cell-cycle specific drugs to improve the overall killing of cancer cells. 

Blood cells or corpuscles

Pancytopenia is a condition marked by low levels of all three types of blood cells—red blood cells, white blood cells, and platelets—in the blood, leading to symptoms like fatigue, frequent infections, and easy bruising or bleeding. It isn't a disease itself but a sign of an underlying issue, such as bone marrow problems, autoimmune disorders, or certain nutritional deficiencies. Treatment focuses on identifying and addressing the root cause and may involve blood transfusions or bone marrow stimulation. 

Specific side effects to drugs 

• Pulmonary Fibrosis -Bleomycin, Amiodarone, Busulfan

• Pseudomembranous Colitis-Clindamycin, Ampicillin, Amoxicillin

• Tendonitis-Fluoroquinolones

• Interstitial Nephritis-NSAIDS, Methicillin

• Cholestatic Jaundice-Macrolides

• Coronary Vasospasm-Cocaine, Sumatriptan

• Gout-Thiazides

• Disulfiram-like reactions-  Cefoxitin, Cefamandole, Chlorpropamide, Metronidazole [mnemonic: ডাইসালফিরাম রিএকশনে  ছি ছি ছি  মেট্রো নিও না  ]. Antabuse is alcohol antagonist [see: Disulfiram or Antabuse Reaction Emergency]

• Atropine-like reactions-TCAS

• Cough- ACE Inhibitors

• Aplastic Anemia- Carbamazepine (Carbamazepine, an anticonvulsant medication used in the treatment of epilepsy and neuropathic pain, used as an adjunctive treatment in schizophrenia along with other medications and as a second-line agent in bipolar disorder.), Chloramphenicol, Gold compounds

EPS-Antipsychotics

Fatal Hepatotoxicity-Halothane

Valproic acid

Thiazolidinediones

Acetaminophen

Gray Baby Syndrome-Chloramphenicol

Gynecomastia-Cimetidine

Spironolactone

Alcohol

Hand Foot Syndrome- 5-Fluorouracil, sold under the brand name Adrucil among others, is a cytotoxic chemotherapy medication used to treat cancer. By intravenous injection it is used for treatment of colorectal cancer, oesophageal cancer, stomach cancer, pancreatic cancer, breast cancer, and cervical cancer. Wikipedia

Metabolism: Intracellular and liver (CYP-mediated)

Routes of administration: Intravenous, topical

Hemolytic anemia w/ G6PD deficiency-Primaquine

Dapsone

Sulfa drugs

Nitrofurantoin

Chloramphenicol

Hot Flashes-Niacin

Tamoxifen

Postural Hypotension-alpha -Blockers

Myelosuppression-Alkylating cancer drugs

SLE-like reactions-Procainamide

Hydralazine

Methyldopa

Red Man Syndrome-Vancomycin

Optic Neuritis-Ethambutol

Ototoxicity-Aminoglycosides, Loop diuretics

Pancreatitis-Didanosine

Adrenal Insufficiency-Steroid-withdrawal

Thrombocytopenia- Heparin, Rifampin

Rebound Hypertension-Clonidine-withdrawal, a-Methyldopa

Severe HTN w/Tyramine-MAO inhibitors

Agranulocytosis-Clozapine

Cinchonism-Quinidine

References

1. Antwi, C. A., Amisigo, C. M., Adjimani, J. P., & Gwira, T. M. (2019). In vitro activity and mode of action of phenolic compounds on Leishmania donovani. PLoS neglected tropical diseases, 13(2), e0007206.

2. Yang, D., Huang, Z., Xing, B., Jin, W., Yan, X., Guo, Z., & Liang, Z. (2016). Regulation of folic acid on phenolic acids production in Salvia miltiorrhiza hairy roots. Plant Cell, Tissue and Organ Culture (PCTOC), 127, 175-185.

3. Mykhailenko, O., Kovalyov, V., Kovalyov, S., & Krechun, A. (2017). Isoflavonoids from the rhizomes of Iris hungarica and antibacterial activity of the dry rhizomes extract. Ars Pharmaceutica (Internet), 58(1), 39-45.

Disclaimer

Most of the information in this page are collected from Google AI Overview. These are for informational purposes only. For medical advice or diagnosis, consult a professional. AI responses may include mistakes. Learn more