☆擬交感神經藥物

直接 Epinephrine α、β1、β2 過過過過過 過過過過 Catecholamine過

過過過過 Epi過NE過DA過
Norepinephrine α過β1 過過過過過 β2過 BP、HR Isoproterenol過
過過過過過過過 器官血流不足 Dobutamine
Dopamine D1、β1、α (劑量小→大) 急性休克首選，保持心腎功能 過過過
Isoproterenol β1、β2 強心、支氣管擴張 過過過過過
Dobutamine β1 強心
(心肌耗氧量影響小→HR↑少)
Phenylephrine α1 散瞳、治鼻塞
Metaproterenol β2 支氣管擴張
Abuterol (Salbutamol)
Terbutaline
Fenoterol
Ritodrine 安胎
Salmeterol 慢、長
Formoterol 快、長
間接 Ephedrine 過過過過過過↑過 NE 過過 過過過過過 過過過過過過過
Pseudo-ephedrine OTC decongestant 過過過
過過過過過過 過過過過過

Amphetamine 過 NE過Epi過DA 過過 過過過過 過過過過過過過 過過過過過過過

Methylphenidate 過過過 過過過過 過過過過過BP、
Narcolepsy (過過過過過 ) 精神分
Pheynlpropanolamine 過過過過減肥 裂(DA)
(PPA)
Cocaine 過過過過過過過過過 過過過過過過 過過過過過過過
Tyramine 過過過過 MAOA 過過
過 MAOI 過過過過過 Tyramine 過 DA hydroxylase 過過過 Octopamine→↑NE 過過→HTN 過過

☆過過過過過過過 ˙過過過過過
過過過過過過 Trimethaphen 過過過
Hexamethonium
CNS 過過 Methyl tyrosine 過過過過過 = Metyrosine
Clonidine α2 agonist 過過 opioid 過過過過 BP、HR (副作用：頭暈)
過過過過過 rebound HTN
Methyldopa 過過過過過過過 過過過過過 過過
Reserpine NE過5-HT過DA↓(過過) 過過過過過過過過過過過
過過過過過 Guanethidine 過 NE 過過過過
過過過過過過過過過
α1過α2 過過 Phenoxybenzamine 過過過過過過  HTN (過過過過 HF 過過↑) 過過過過過過 (過過過過過)
Phentolamine 過過過過過過  BPH 過過過 HR
Pheochromocytoma Syncope
Sexual impairment

α1 過過(-zosin) Tamsulosin BPH + HTN 過過過過過過

β1過β2 過過 Propranolol 過過 過過過 過過過過 過過過
(-olol) (過過過) SVT HTN HR (AV block) 過過過COPD
↓MI 過過過過過過 過過過過(class II) HR<50 應停藥 DM 過過過過過
過過過過過 (Propranolol過Esmolol) 過過過過過 過過過過過過
Timolol 過過過 MI 過過過過過過 2-3 AV block
β1 過過 Atenolol CHF (過↑過過過 ) 過過、血糖異常
(-olol) Metoprolol (過過過) CHF過post-MI 過過過 (Timolol) 過過過過過 (過過過) CHF：
Acebutolol ISA (過過過 MI) 過過(Propranolol) 過過過過過 Metoprolol
Esmolol β-blocker 過過過過 過過過(Propranolol) Bisoprolol
SVT  tremor (過 β2 過過過) Carvedilol

Betaxolol 過過

αβ 過過(-lol) Labetalol 過過過過過

Carvedilol CHF

1
☆過過過過過過過過
過過 過過 Pilocarpine 過過過 過過過 過過過
過過(-chol) Bethanechol 過過過過過過過(過過過過) 過過過
Carbachol 過過過過過 M過N (過過過過過過過過過過) (過過過)過過過過過過過
過過 過過 Physostigmine 過過過 過過過 MG
anti-AchE 過過過過過過過
過 Atropine 過 TCA 過過 過過過過過過過過過過過
Neostigmine 過過+過過 N治 MG 過過過 過過過過Epinephrine
過過過過過過過過 β1 過過過Timolol
過 Tubocurarin (過過過過過過)過過 過過過過過Pilocarpine
Pyridostigmine 過過過 MG 過過過 Physostigmi

Edrophonium 過過過 MG ne

過過過 過過過 Soman > Parathion > Malathion

AchE=Cholinesterase
過過過過Atropine(過 M過過過過過) +
PAM (Pralidoxime過過 AchE)

☆過過過過過過過
過 M = 過過過過
過過 Atropine 過過過過過過過 過過過過 過過過 過過過過 過過過 過過過過
(3胺) 過過過過過 →過過過過過 過過過過(過過 ) 過過過過 過過過 過過+過過過過過(M3)
過過過過Physostigmine 過過過過過過過過 過過 BPH Atropine
Scopolamine 過過過過過過過過 過過過COPD 過過 過過過過 Tropicamide
過過 Tropicamide 散瞳→眼底鏡檢查 短效 過過過 過過過 過過過過 (α1)
(4胺) Ipratropium 氣喘、COPD (首選藥) 吸入給藥 過過過過 過過過過 Phenylephrine
(Atrovent) 過過過過 過過過過
過過過過過過EPS
Propantheline 降低胃酸分泌及腸胃蠕動
(被 Pirenzepine 取代)
Pirenzepine 降低胃酸分泌 抗 M1
Trihexyphenidyl 帕金森氏症、EPS (Artane)
Benztropine
Biperiden
過 Nn = 過過過過過過(過過過過)
過 Nm = 過過過過過過過過過(過過過過過過過過)
過過過 d-Tubocurarine 過過過過過過(過過過 )→過過 →… 過過過過 Histamine 過過 過過過過過過過過過過
(d-Tc) (過過過過過過過過過) 過過過 N-R antagonist
過過過過過 Fade during titanic
過過過過過過過 and TOF stimulation
過過過過Neostigmine
Vecuronium 過過過 Histamine→過過過過過過 過過 過過過過
Pancuronium 過過 M2→過過過過(過 Atropine) 過過
Atracurium 過過過過過過→過過 ICU 過過 過過 Histamine 過過 Hoffmann elimination過
過過過過過過過過過 過 RBC 過過過過過過
過過過過 pH 過過過
過 d-Tc 過過 Denzylisoquinolines
Mivacurium 過過過過過過過過過過過過過
過過過 Succinylcholine 過過過過過過過過 過過過過過 過過過過 過過過過過過過過過過
(Ach-Ach) 過過過過過過 pseudo-AchE →Halothane 過過過 N-R agonist
過過過過 →Dantrolene 過過 Non-fade
過過過過 過過過
過過過過過過過(過過過 AchE 過) 過過 Histamine Dantrolene過
過過過過 過過過 CCB過過 CA2+過過過

過過過過過過過過 Baclofen GABAB (Gi) 過過過過過過過過過過過

Diazepam GABAA (Cl-) Mephenesin
(Valium) Meprobamate
過過過過過 Botulium toxin 過過 N-M junction 過過 Ach 過過 Chloromezanone
Aminoglycoside 過 過過過過過 Ca2+過過→Ach 過過過過 Chlorzoxazone
Ex. Gentamicin

2
☆過過過過過
Nitrates Amylnitrite 過過過過過過過 過過過 過過過 過過過過
Nitroglycerin 過過過過 NO→cGMP↑(過過過過) 過過過過過過 過過
(NTG) (過過過過過過過) (NO 過過過過 Plt 過過 ) 過過 CHF 過過
過 3 過過過 過過 V>A 過過過過過 過過過過過過
過過 →↓preload > afterload (過 loop diuretics 過過) 過過過過過過過
過過過過過 過過過過過過過過 (過 β 過過過過過
~ dinitrate 過過過過過過 過 free 8 過過 (過 β-blocker 過過) 過過過過過過過)
~ mononitrate 過過過過過 過過過過過 Nitrite 過 過過過過過 過過
~ tetranitrate 過過過過過過 過過過過過過 (過過過 Methylhemoglobinemia) 過過過

β-blocker 過過 HR過SV 過 ISA 過過過過 過過過↓SA/AV node

(過過過 過過過過 ) 過過過過過
CCB Dihydropyridine Nifedipine 過過過過過過過過 過過過 過過過
(DHP) (Adalate) (過過) (過過過↑angina 過過) 過過 HR過SV Variant angina 過過
-過過過過過過 Amlodipine 過過過過過過 HR↑ 過過過過過過 過過過過過SVT
(Norvasc) (過過) 過過過
Nimodipine 過過過 Unstable angina過
過 SAH 過過過過過過過 過過過↓過過過過過 Variant angina過
Non-DHP Verapamil 過過過過過 ↑過過過 過過過過過過過過 ↓過過過過過
-SVT (class IV) β 過過過過過過過過 HR↓↓ Nitrates (Ex. NTG) ↑過過過過過
-HF 過過 過過 Digoxin 過過↑ β-blocker (↓MI 過過) 過過過過過過過
(Verapamil 過過 ) 過過過過過 CCB (過過↓MI 過過) NTG (過過)
Diltiazem 過過過過過過過過過 過過過過 (Aspirin) Nifedipine (過過)
Anti-Plt Aspirine… 過過過(Heparin) 過過過 β-blocker

過過 ACEI過過過過… 過過 ST 過過過 LBBB (過過過過過)

過過過過過過過過

☆過過過
Osmotic Mannitol 過過過過過過(過過過過過過) ↑過過過(過過過 Na+過過)
Urea 過過過過
CAI Acetazolamide 過過過→過過過過過 PCT過↓Na+過H+過過過 過過過過過過(過過 HCO3-) 過
+ -
過過過過過過過過過過 →↑Na 過HCO3 過過過 過過過→過過 Ca2+過過過 過
→過過過 seizure ↓H+過過 過
Thiazide (-thiazide) 過過過過過過過過過過過 DCT 過過過 過過過過過過 過 過
(過過過過過過過過過過過) + -
過過 Na /Cl symporter (過 Digoxin 過過過過過) 過
Mild HF 過過過過過過過過過過過(Niacin) 過
過過 過過 過
過過過過過 (+過過) 過
Loop Furosemide (Lasix) 過過過 Ascending Henle loop過 過過過過過過過 過
Ethacrynic acid 過過過過過(+Nitrate 過) 過過 Na+,K+,2Cl- pump 過過過
Bumetanide 過過 CHF (Vancomycin 過Aminoglycoside)
(過過過 Lasix 過) 過過過過 過過過過過
過過過過過(+過過 N/S) (Mancomycin過Aminoglycoside過
NSAID過Amphotericin B)
過過
K+ sparing Spironolactone 過過過 DCT過CD過 過過過 過
過過(過過過) 過 Aldosterone 過過過過過 過過過過過過(過過 H+) 過
Amiloride 過過 CHF 過過過過過 過過過過 Na+過K+過過 過過過過過 過
Triamterene Spironolactone 過過過過過過
(過 Androgen-R 過過過過過)
過過過過 過過過 Desmopressin (DDAVP) 過 V2 (↑過過過) 過過過過 (cf. Imipramine)
2+
V1→Gq→Ca ↑(過過過過) 過過 A 過過過過
V2→Gs→cAMP↑
過過 Thiazide +過過

3
☆過過過 ˙(ABCD過 ACEI / ARB過β-blocker過CCB過Diuretics)
β-blocker 過過過過↓renin 過過過過過過(↓SV過HR 過過過過) RAA 過過過過β-blocker過ACEI過ARB
過過過 Thiazide (過過過過過過過過過過過過過)過Loop過過過過
過過過過過 Angiotensin ACEI 過過過 過過 ACE→ 過過過過 過過過
antagonist (-pril) 過過過 ↑Angiotensin I 過過 (Bradykinin↑) 過過過過過過過
(過過過過過) HF過MI 過 LV 過過過過 ↑Bradykinin (過) 過過過 過過(Methyldopa)
過過過+過過過 過過過過
ARB 過過過+HTN 過過過過過過過過過 過過過過
(-sartan) 過過過 AT1 過過過 過 過過過過過過 (過過過 Bradykinin↑)
CCB Nifedipine…
α1-blocker (-zosin) BPH+過過過
過過過過 Hydralazine 過過過過過 Lupus=like syndrome 過過過過
過過過 (Procainamide) 過過過過過過過
Minoxidil 過過 K+過過→過過過過過 過過(過過 ) 過過過過過過過
Diazoxide 過過過 ↑renin (過過過 β 過過過)
Nitroprusside NO 過過過過 V過A CN 過過- ↑Aldosterone
過過過過過過過過過過 Coronary steal ↑過過過過(過過過過過過)
過過過 (Dipyridamole過 過過過過過過過過過過過過過過過
Isoflurane)
過過 過過過過過 Trimethaphan 過過過
CNS 過過 Methyldopa 過過過過過
Clonidine
過過過過過過過 Ganethidine
過過過過過過過 Reserpine 過過過過過過

☆CHF
過過過過過 ACEI / ARB 過過(↑過過過)過↓CHF 過過
Nitrate (過過 v) + Hydralazine (過過 a) 過過過 HR↑
過過過 Loop diuretics 過過過過過+過過 CHF
Thiazide Mild CHF 過過過過 Digoxin 過過過
Spironolactone ↑過過過
過過過 Digitalis glycosides SV↑過HR↓(↓過過)過過過 CHF 過過過過 過過過過過
↓AV node (↑PR interval)過過過過過過 過過 Na+/K+ ATPase過↑過過 過[ Na+][Ca2+]
過過過過 CHF 過過過 過過過過過過過 ↓SA/AV node→↓HR
過過過過過過
Digitoxin 過過過過過過過過過過過過過過過 過過過過
(過過過過) 過過過過過過過過 HR↓(<60 過過過)過過過過過過過

Digoxin 過過過過過過過過過過過過過 GI upset過過過過yellow vision (過過過過 )

過過過(過過過過過過過過過) TI 過過過過過(過過過 過過 過過過過過過過 )

β1 agonist ↑過過 cAMP (SV↑過HR↑) (過↑過過過)

過過過
(Dobutamine過DA)
過過↑K+過過過(過過過)
PDE3 過過過 ↑過過 cAMP (SV↑過HR↑) (過↑過過過)
過過過過過過
(Amrinone過 過過
(Lidocaine過Phenytoin過Procainamide)
Milrinone) PDE3 過過過(Cilostazol)過↑cAMP過過 Plt
過過 Quinidine 過過
PDE5 過過過(Sildenafil)過↑cGMP過過過過過
(過過過過 Digoxin 過過過過過過 )
PDE 過過過(Methylxanthine)
過過過過過
β 過過過 Metoprolol ↓過過過過過過過過過過過過過過過 過過過 ISA 過過
Bisoprolol ↓renin (↑過過過)
Carvedilol 過過過過過過過
1.過過 RAA 過過過過過過 ↑過過過
2.過過過過過過過過過過過過過過過
3.CHF 過過過過過過過過↑RAA過↑sympathetic tone過↑ANP (過過 ) BNP (過過) CNP (CNS)過↑Endothelin

4
☆過過過過過過 ˙過過 β 過過過過過過過過過
I Na+過過過過過(過過過過) 過過 Phase 3 AP 過過
phase 0 (過過過) duration
Ia 過過過 Atropine 過過 M 過過→↑HR→SVT↑過過過過過過過過過過 SVT 過 過過 過過 VT
VT Quinidine 過過過過 (VT過AF過PSVT) 過過過過過 (Cinchonism)過過過過過 (過過過過) (過 class III (SVT)
過過過過過過過 過過過過 過過過過過
(過過過過過過過過過) 過過過過過 QT 過過過
Procainamide 過 Quinidine Lupus-like syndrome (Hydralazine) Torsade de
Disopyramide pointes 過 VT)
Ib Lidocaine IV 過 VT (過過過過過過過) 過過過過過過過過↓→過過過過過 過 過過 過過 VT
VT 過 Digoxin 過過 過過過過過過過過過過過過過過過 (過過)
SC 過過過過過過
Mexiletine 過 Lidocaine過過過
Tocainide VT過過過過過
Phenytoin 過過過過過過
Ic Flecainide VT 過 過過過 過過過 VT>>SVT
VT Propafenone 過 Flecainide (過 Ic + II) (過過過過)
II β 過過過過↓過過過過過過→↓SA
SVT Propranolol AF過↓MI 過過過過過過過過
Esmolol AF AV block 過過過過過過過過過過 β 過過過
過過過過過過過過過過過
過過過過 (過過過過過過過過 )
+
III K 過過過過過過過過 phase 3 (過過過)→過過過過過過 QT 過過過 Torsade de pointes
SVT Amiodarone 過過過過過過過過過過 t1/2 >50 days (過過過過過過)
VT 過過過 class I過II過III過IV 過過過過過過過過過過
過過過過 過(過 thyroxine) 過過過(Bleomycin)過過過過(Tetracycline)過過過過過過過過過過
過過過過過過過過過過過過過過過過過 (Wolff-Chaikoff effect)
Goiter 過過過過過過過過過過過過過(Jod-Basedow phenomenon)
過 Digoxin 過過過Digoxin 過過過
Bretylium 過過過過過
Sotalol 過 β 過過
IV CCB過↓SA/AV node rate→過過過過過過過過
SVT Verapamil AF過PSVT ↓HR過↓SV過(過過 CHF 過過過過)
Diltiazem 過 Verapamil
過過 Adenosine A1 (AV node 過)→Gi→ →↓AV過↓HR 過過過過過過過過過
↓cAMP → 抑制 Ca2+ 內流
(SV→過極化
↑K+ 外流 過過過過) 過過過過(過過 )
AF過PSVT過SVT (過過)
過過過(IV) A2→Gs→過過過過
Digoxin SVT過PSVT GI過CNS過過過過過
↓SA/AV node→↓HR過↑SV 過過過過過過過過
Atropine 過 Sinus bradycardia
MgSO4 過過過過
過過過過過過過過過過過過過過過過過過過過過過過過過過過
↑PR interval過Adenosine > Class II過IV
↑QRS duration過Class III > Ia > 過過
↑QT interval過過過 Class III過Ia
過過過過過 SVT(β 過過過過K+過過過過過過CCB過Adenosine過Digoxin)
過過 VT (class I過K+過過過過過)

5
☆過過過過過
過 Plt過過過過過過過
過過 TXA2 Aspirin 過過過過過 MI過過過過過過 過過過過過 COX
過過過過過(<325mg) (NSAID 過過過過過過)
過過 ADP-R Ticlopidin Aspirin 過過過過過過過 過過 neutropenia (Clozapine)
Clopidogrel 過過過過過
過過 Gp Ilb/IIIa-R Abciximab 過過
Tirofiban
過過 PDE Dipyridamole 過過過過過過過過 過過 adenosine uptake Coronary steal
過過過過過 (Nitroprusside過Isoflurane)
Cilostazol Intermittent claudication PDE3 過過過
(50-100mg 過過過過過過過過 (PAOD)
bid)
過過過過過過過過過過過
Heparin (LMWH) Coumarin (過過過 )
過過 過過過glycosaminoglycan 過過過過過(過過過Warfarin過Dicumarol)
過過 過過 antithrombine III→↓Thrombin (IIa) 過過 Vit. K
過過過過過過過過(過過 IIa過Xa) →過過 Vit. K eposide reductase (KO 過過 過 )
(LMWH 過過過 Xa) 過過 Protein C過Protein S
(過過 Heparin 過過 Coumarin 過過過過過過 )
過過過過 過過過(過過過過1-3 hrs) (LMWH 過過過過) 過過過(過過過過12-24 hrs) (過過過 1.5 days)
過過過過 過過 (LMWH 過過過過過過 ) 過過
過過 過過過過過過過 過過過過
過過 過過過過過過過過過過過過 過 Heparin過DVT過過過過
過過過 過過過Thrombocytopenia 過過過過過過過
過過過 Protamine (過過)過過過過過 過過過過 FFP
Vit. K1 (Phytonadione)過過過過
過過 Clotting time過aPTT (1.5-2.5) PT過INR (2-3)
(LMWH 過 aPTT 過過過)
過過 過 過過
過過過過 Clofibrate過Metronidazole過Disulfiram 過過↓p450
→過過 Warfarin 過過過
過過過過過=過過過過過過過 (Fribrinolysic agents)
Urokinase 過過過過 過過過過 plasminogen 過過過 plasmin過
Streptokinase 過過過過過過過過過過過過過過過過過 過過過過過 fibrin 過過
Alteplase (tPA) DNA 過過過過過過過過過過過過過過 過過過過過過過過
過過過過過過過過 fibrin 過過過過 AMI 過 6 過過過過過過過
Plasminogen (過過過過) 過過過過過過過過 3 過過過過過過過

☆過過過
Aminocaproic acid 過過 plasminogen 過過 過過過過過過過
Tranexamic acid 過過過 Aspirin 過過過過過過過過過過 Aspirin 過過過
過過過過過過過過過過過過
Vit. K 過過過過過過過過(Coumarin)
(Phytonadine) 過過 Vit. K 過過過過過過

6
☆過過過過
Statins ↓過過過 過過 HMG-CoA reductase (↓過過過) 過過過過過
過過過過 LDL-R (↑LDL 過過) 過過過過過 (過過過 Fibrates 過過過)
過過 Pra-過過過過過過過過過 過過過過
Atro-過過過過過
Resins ↓過過過 過過過過過過過過過過過過過過過過 過過過過過過過過過(Vit. ADEK↓→↓Warfarin 過過過過過)
Cholestyramin 過過過過過過 過過過過過過過過
e ↓過過過過過過過過 LDL-R 過過過過過過過過過
Cholestiple
Fibrates ↓TG 過過過過過 PPAR-α 過過 LPL (↑VLDL 過過) 過過過 (過過過過過過過)過過過過
Gemfibrozil ↑HDL 過過過過過過過過過過過 過過過過過Statins過Warfarin
↓TG (VLDL)過↓LDL過↑HDL 過過過過過 PPAR-γ(-glitazone)過過過
Niacin (B5) ↓TG 過過過過過過 VLDL 過過過過過過過過過
↑HDL 過過過過過過過過 (↓FFA) 過過過過過過過過過過過過過過過過過過過
↓Lp(a) ↓TG (VLDL)過↓LDL過↑HDL過↓Lp(a) 過過過Thiazide過Niacin 過過過過過過過過過過
Probucol ↓HDL 過過 LDL 過過過過過過過 foam cell ↓HDL
(過過過過) 過過過過過過過過過 LDL 過過 過過 QT interval
Fish oil 過過過過 ω3 過過過過 過 LDL 過過過
過過過過過↓TG 過 Lipoprotein過↑HDL

☆過過過
過過過過過過 Orlistate (過過過 ) 過過 lipase
過過過過過過 Sibutramine (過過過 ) 過過過過 5-HT過NE過DA 過過(過 TCA過SSRI)
(過過過過過過過過過) Dexfenfuramine (過過) 過過過 5-HT agonist 過過過過(過過過過過 )過過過過
(↑Serotonin 過過過過過過過)
PPA (過過) 過過過過過過過過過過過過過
Phentermine (過過)

7
☆過過過過過 ˙過過過過過 過過過過 過 過 過 過過過過
過過過過過過-maintain過過過過過過過過過過過過
Nitrous oxide 過過過過過過過 過過過過過過過過過過過過過 過過過過過過過過過
(N2O) 過過過過過過 過過過 close gas space 過過過 過過/過過過過過Des>Sevo>Iso>En>Halo
過過過 Halothane 過過 Vit. B12 過過過過過過 N2O Des Sevo Iso En Halo Methoxy
Second gas effect MAC >100 6.0 2.0 1.4 1.7 0.75 過過過過
Halothane 過過過過過 過過過 B/G 0.47 0.45 0.69 1.4 1.8 2.3 →過過過
過過過過過過過過過 過過過過 ˙MAC 過過過 potency 過過
過過過 N2O (過過過 catecholamine 過過過↑) ˙Blood/Gas partition coefficient (=1-FA/FI)過過
過過過過過 過過過過(過過過)過過過過過過過過過過 =過過過過過
過過過過 =過過過過過過過過過過過過過過過過過
過過 過過 -過過過過過 ↑過過過過Halo>En>Iso過Des
Methoxyfluran 過過過過過過過 過過過過 過過 F過過過過過 ↓過過過過過Iso過Des>En>Halo
e 過過過過(dose-dependent)過
Enflurane 過過過過 過過過過 EEG 過過 epileptiform activity Halo>En>Iso過Des過Sevo
過過過過 過過過過過過過Des>Iso>En>Halo過Sevo
過過過過過過(PaCO2 過過 60) ↓過過過過Halo>En>Iso過Des過Sevo
Isoflurane Coronary steal 過過過過過過過過過過過過過過
(Nitroprusside過Dipyridamole) 過過過過過 Halothane 過過
Desflurane 過過過過過過
Sevoflurane ↓過過過過過 過 CO2 過過過(lime soda)過過過過
↑過過過過過 compound A (過過過)
過過過過過過過過-induction + maintain
Barbiturates過 過過過過過過過過IV 過過過過 過過過過過
Thiopental 過過過過過 (↓BP過CO過過過過↑HR) ICU過Propofol過BDZ
Methohexital 過過過過(2nd peak) Acute intermittent porphyria 過過過過過過 Propofol
過(過過過過 )過過過 +Xylocaine 過過過 過 (過過過過過過 )過BDZ過Opioid
BDZ過
Midazolam BDZ 過過過過過過 過 opioid 過過過過過過過 過過過過過過
過過 pH過過過過過 過過過 C/S 過過過過過過 BDZ 過過過過過BDZ
過過過 IM 過 BDZ 過過 TCA 過過過 過過過過過Opioid
Diazepam 過過過 ↑the inhibitory tone of GABA 過過過過過Atropine
Lorazepam 過過過過過Droperidol (過 D2)
Propofol 過過過過 ↑GABA synapse activity 過過過過過過過過過過過過過…
過過過過+過過過 過過過過過過過 過過
(過過過過過) 過過過過過過過過過
過過過過過過 opioid過lidocaine 過過過
過過過過過過過 過過 6hrs 過過過過過
Ketamine 過過過過過 過過 glutamate NMDA-R
過 IM 過過過過過過過過 BP↑過HR↑過IOP↑過ICP↑
過過過過過過過 過過過過過過
過過過過過過過過過
Opioid 過過過過過
Fentanyl 過過過過過
過過過 Droperidol (Haloperidol 過過)過過過(過過過過過過 Innovar)

8
☆過過過過過 ˙過過過過過過過過過過過過過
過過 (Ester)過過過過過過過過 pseudocholinesterase 過過(cf. Succinylcholine) 過過過
Cocaine 過過過過過過過過過 過過 CNS 過過過過 過過過過過過過過過過過
過過過過(過過過過過過過過過)過 過過過過 Na+ channel 過過過過過過過
過過過過過過過過過過 Epi 過過過過 (h-Gate of inactived site)過過過過
Procaine 過過過過IV過過過 過 PABA 過過過↓過過過過過(過過過過) →過過過過過
Tetracain 過過過過 過過過過過過過過過過過過過過
e 過過過過過
Bezocain 過過過過 過過過過過
e C≧B>A (過>過>過過.過過)
過 過過 (Amide)過過過過過過過過 dealkylation 過過(Phase II過過) pKa 過過 過過過過過過過

Lidocaine 過過過過過過過過過過 過過過過過過過過過過過過過過過 (過過過過過過過過 NaHCO3)

IV 過 VT (class Ib) 過過→過過→過過過過→過過過過過 過過過過過過過過(Epi)過

Prilocaine EMLA cream過+Lidocaine Cocaine 過過

Bupivacai 過過 過過過過過過 CV collapse

ne 過過過過過過過過過過 (過過過過過過過過過)
過過過過過 epidural pain
Etidocain
e
Ropivacai 過過過過過過過過過過
ne

☆過過 ˙過 CNS 過過過 (過過過 CNS 過過過過 Barbiturates 過 BDZ 過過過過過過過 )

過過過過過
Ethanol Alc dehydrogenase Acetaldehyde Aldehyde Acetate
Methanol MEOS (過過過過 ) Formaldehyde dehydrogenase Formate
過過
Disulfiram 過過過過過過 ALDH過 ↑Acetaldehyde(過過 過過過過過 )
BDZ 過過過過過過過過 (過 CNS 過過過過 )
(+Thiamine)
過過過過過過過過過過 visual disturbance
Fomepizole 過過 Alcohol dehydrogenase過過過過過 →過 過過過
Ethanol 過過過過過過過 過過過過過過 (過過 )
IV 過過 Ethanol (過過過過過過 100mg/dl)
過過過過過過過過
Hemodialysis 過過過過過 (過過過過 Ethanol過過過過過 Ethanol 過過過過過 過 )
Folic acid 過過 Formate 過過過 CO2+H2O
過過過 (Ethylene glycol)過過過Ethanol過Fomepizole

9
☆過過過過過過過
過過過過 Strychnine (過過過過 ) Glycine-R antagonist過 過過過過過過過過 過
過過過過過過過過過 (tonic convulsion) 過過 Glutamate NMDA-R
過過過過 Doxapram 過過過過過過過過過過過過 (過過過過 ) Non-NMDA-R
過過過過 Picrotoxin (過過過過 ) GABAA antagonist過過過過過過 (過過過過 ) 過過 GABA Cl- (GABAA)
過過過過過過 DA
A.Methylxanthine 過 過過過過過 過過過 ↓PDE→↑cAMP Opioid Gi
Caffeine CNS 過過過 過過 Aednosine 1-R (過 ) Glycine Cl-
過過過過過 過過過 CNS 過過 過過過 >過 >過過 過過 Ach
Theophylline (過過) 過過過過過 CV過過過過過過過過 >過過>過過 NE
過過過過過過(過過過 ) 過過過過過過過過過過過過過過過過過過過 … Serotonin
Aminophylline 過過 過Adenosine→A1→Gi→↓cAMP
=+Ethylenediamine (過過過 )
Theobromine (過過過)
B.Nicotine 過過過過過過過過 過過過過過過過過過過過過過過過過過
過過過過過過過過 relax 過過過過過過過過過過過過過過過 …
Arousal過↑過過過過過過過過 過 過過過過過過過過過過過過
CV 過過過過 (過過 )
Bupropion 過過過(過過過過過過 )
C.過過 Amphetamine (Methylphenidate)過Cocaine過Ephedrine過過過過過過過過過過過
☆過過過過過過過過過
Barbiturates
過過過 Thiopental過Hexobarbital 過過過過 過過過過過 GABA 過過過 GABAA-R
過過 Secobarbital (過過 )過Pentobarbital 過過過過過過過 (過過 Cl-過過過 過過過過過過過 過 )
過過 Amobarbital (過過 ) 過過過 TI 過過過過過 (過過過過過過過 )
過過 Phenobarbital 過過過過過 ↑p450
過過過過過 febrile seizure 過過 過過過
過過過過
過過過 ↑Porphyrin 過過(過過過過過過過 )
BDZ過過過過過
過過 Triazolam (UK 過過 ) 過 過過過過過過過 過過過過過 GABA 過過過 GABAA-R (過過 Cl-過過過 過過過 )
Oxazepam 過過過TI 過
過過 Alprazolam (Xanax) (過過過 )過過過過過過過 過過過過過過過過過
Flunitrazepam (FM2) 過過(過 Triazolam過過 Temazepam過過 Flurazepam)

Lorazepam (Activan) 過過過過過 過過過 (Clonazepam)

過過 Diazepam 過過過過過過過過過 過過過過過過過過過 (Diazepam)

(過過過 >100 過 ) 過過過過過 過過過過過過過過 (Dia-過Oxa-過Chlordiazepoxide)

(過過過過過過 ) 過過過過過 過過過過 Flumazenil (BDZ 過過過過過過過過過過過過 )

過過過過過過過 過過過過過過過過過過過 過
Oxazepam過Lorazepam過Midazolam
Clonazepam 過過過過
BDZω
Zaleplon GABA (Gamma-aminobutyric acid)過過過過過過過過過過過過過過過過R 過過
Zolpidem (Stilnox) 過過 GABAA 過過 Cl-過過 (2α1過2β2過γ2)
Zolpiclone (Imovane) (3-4 hrs) 過 CNS 過過過 ω1 (過過過BDZω 過過過過 )過ω2 (過過過過過過過過過)
過過 過過過 Picrotoxin (GABA 過過過過過過過過 )過Bicuculline (過過 Cl-過過)
過過過 Barbiturate過BDZ過BDZω過過過過過過(alcohol過Propofol)
GABAB Gi protein→過過 Ca2+過過過過過 K+過過
過過過 Baclofen (過過過過過過過過過)
5-HT1A-R 過過過過過
Buspirone 過過過過過過過過過過過過過 (onset 過 1-2 wks)過過過過過過過過
過過過過過過過 (Diphenhydramine) Ethanol 過過過過過過過過過(Baclofen) Chloral hydrate (過過過過過 )

10
☆過過過過過過 ˙過過過過過過過 DA↑↑過5-HT2A
Typical
Chlopromazi 過過過過過過 過過過過過過過 過過過過過過過 D2-R (過過過過過過過過 M過
ne (過過過過過過過過 ) 過過過過過過過 過過過過過過過過 H1過α1[過過過過過過 ]過5-HT[過過過過 ])
(Wintermine) 過過過 過過過Antipsychosis (過過過過 )
Thioridazine 過過 EPS 過過過 M 過(過過過過過過過 ) 過過過 Prochlorperazine (Novamin)
Fluphenazin 過過 過過(High potency)≠high efficancy Metoclopramide (Primperan)
e EPS 過過Prolactin↑ Toarette’s syndrome過過過過
Haloperidol 過過 過過過過 D2 過過過過過 EPS過
Toarette’s syndrome 過過 M 過(Atropine 過 )過過

Atypical (過過過)
Clozapine 過過 5-HT2過D4 (D1過D2 過) 2%過過 neutropenia 過過過
(過過過過 ) 過過 resistant pt 過過過過 EPS (Ticlopidine) 過過過過 5-HT2-R 過 D1過D2過D4
(過過過過過過過過過過過過過過過過 ) 過過 ↑過過過 ↑ 過過過
過過過過 (過過 ) 過過過過過過過過過過過過過過
Olanzapine 過過 5-HT2過D2 (D1 過)
過過過過過過過 過過過過過過過過 model 過過過過
Quetiapine 過過過過過過過過 PCP (Phencyclidine過過過過 )
Risperidone 過過 5-HT2 (high)過D2 過過過(>6mg)過 -過過過過過 NMDA過過過過過過過過過
過過過過過過過過過過過過 過 EPS過過過過
Ziprasidone 過過 5-HT2過D2過(過 5-HT1A過D3)
☆過過過過過過 ˙過過過過過 ↑NE過↑5-HT 1A
過過
TCA Imipramine 過過過(cf. DDAVP) 過過過過過過過過過 NE過5-HT 過過 過過 H1過α1過M
Amitriptyline 過過過過過(過 H1 過) 過過過過CV 過過過過 M過過 H1 (過過)過過 α1 (過過過過過過)
過過過過過 TCA 過過過過過過過(DM 過過過過過過 TCA過Carbamazepine)
TCA 過過過過Physostigmine
MAOI Tranylcypromine (過過過過) 過過過過過過過過過 MAOI→↑NE過5-HT過DA
Phenelzine 過過過過過過過過過過過過過 過過過MAOI 過過 Tyramine (cheese)過SSRI過L-dopa過TCA 過過
過過過 (過過 6 過過過過過 )
RIMAs Moclobemide 過過過過過過 MAO-A過過過 NE過5-HT (過過過過過 )(過過過過過過過過過 )
(MAOI MAO-B過過過 DA (過過過過過)
A )
SSRIs Fluoxetine 過過過過過過過過過過過過 過過過過過過過過 5-HT 過過
(Prozac過過過過 ) 過過過過過 MAOI 過過過過過 過過過過過 serotonergic syndrome
Citalopram Paroxetine過Sertraline過 過過過↓p450
Citalopram… 過過過過過 (過過過過過過 過過過過過過過過過過過過過 )
SNRIs Venlafaxine 過過過 SSRI 過過 5-HT過NE 過過(過過過 TCA)
Trazodone 過過過過過過過過過過過過過 過 TCA 過過過過 M過過過過過過
Nefazodone 過過過過過 過 SNRI過過過過過 5-HT2A
NaSSA Mirtazapine 過過過過過 α2 autoreceptor 過過過 NE過5-HT
過過 5-HT2A過過5-HT3過H1
NARI Reboxetine 過過過過過 NE 過過
過過 Bupropion 過過過過過過

☆過過過過過
過過過過過
Lithium 過過 PIP2 過過過過Na+過過過過過過過 過過過
過過過過過過過 GI 過過 (過過 過過過過過過過過過過過 )過
過過過過過過 過過過過過過過過過過過過過過過過過過
Valproic acid 過過過過過過過過過過
(Deparkin) 過過過過過過過過過過過過過(過過過過過)
過過過過
Carbamazepi
ne
過過過過過過過過過Clozapine過Olanzapine過Risperidone
過過過SSRI過BDZ過過過過過過過(Lamotrigine過Gabapentin過Topiramate)

11
☆過過過過 ˙過過過過過過過過過過過過過過過過過 ˙過過過過過過過 model 過過過過Pentylenetetrazol
過過 Carbamazepine 過過 Na+過過過↓Glutamate 過過 Stevens-Johnson syndrome (Phenytoin過Allopurinol)
(過過過過 ) 過過過過過過過過過過 CNS depression
過過過過 C/D
過 Phenytoin 過過 Na+過過 過過過過過過過過過過過過過過過過過
(過過過過) 過過過過過過 p450 過過過過過過過過過 過過過過過過過過過過過過過 ↓Vit. D過↓Vit.K過↓過過
過過過過(class Ib) 過過過過 D
過過過過過過 (ex.D5W)過過 →過過過
Phenobarbital 過過 GABA 過過過 GABAA-R CNS
(過過) 過過 seizure 過過
Primidone 過過過 Phenobarbital
過 Ethosuximide 過過 T-type Ca2+ influx (過過過過過 ) 過過過CNS 過過過過過過過過
過過過過過 Valproic acid 過過過過過過過 過過過CNS 過過過過過過過過過過過過
過過過過過 過過過過 D
過過過過 Diazepam過Lorazepam過Midazolam (IV)過過過過過過過過 GABAA 過過 過過過 Carbamazepine
過過過 Clonazepam 過過過過過過過過過過過bipolar disorder Phenytoin
Acetazolamide 過過過過過過過過過過過過過過過過過過過過 seizure Lamotrigine
過過 Felbamate 過過 NMDA-R 過過過過過 Ethosuximide過Valproic acid
Topiramate 過過 AMPA-R 過過 GABA Barbiturate過BDZ
Lamotrigine Na+ channel blocker like Phenytoin Vigabatrin過Gabapenitn
Vigabatrin 過過過過過 GABA-transaminase 過過過過 Tiagabine
Gabapentin GABA analog 過過過過過過 過過 NMDA Felbamate
過過過過過過過過過 (過過過過過過過過 ) Topiramate
Tiagabine 過過 GABA 過過 Lamotrigine

☆Parkinson’s Dz 過過過過 ˙過過過過過 ↑DA過↓Ach

↑DA
DA 過過過 Levodopa 過過過過 Dopa decarboxylation 過過 DA 過過過過
過過過過 decarboxylase 過過過 過過過過(Domperidone-過過 D2 過過過過過)
(Carbidopa過Benserazide)過過過 過過 5 過過過過過過過過過過過過過過過過
過 L-dopa 過過過過過過 ON-OFF (Apomorphine 過過 )(過過過過過)
過過過過過過過過過過過過 (過過過過) 過過過過過過過過過過過過過過
過過 Vit.B6 過過
(過過過 L-dopa 過過過過
(cf. INH 過 Vit. B6 過過過過)
過 DA 過過 Amantadine 過過過過過 Influenza A 過過過 Parkinsonism 過過過過
過過過過過過過過過過過過過過 MPTP (過 MAO-B 過過過 MPP+過過過
過過 DA-R 過過過 Bromocriptine 過過過過過過過過過過 (D2) dopaminergic neuron 過過過過 )-過過 model
過過過過過過過過過過 過過過過過 Reserpine
Pergolide (D2過D1) CO過 過
過過過過 Pramipexole 過過過過過過過過過過 6-hydroxydopamine 過過過過過過過過
(-ole) Ropinirole
過過 MAO-B Selegiline 過過 Deprenyl過過過過過過過過
過過 COMT (-capone) Tolcapone過Entacapone 過過過過過過過過過
↓Ach
Trihexyphenidyl (Artane)過Benztropine過Biperiden過resting tremor
Diphenhydramine過過 H1 (過過 M)

12
☆過過過過過過 ˙過過過過μ→Endorphins (過過過過過過過過過過過 ) δ→Enkephalins κ→Dynorphins
過過(過過 )
Morphine 過過過過過 Morphine
(過過過過過 過過過過過過過過 ) 過過過過過過 μ(過)過κ receptor→Gi→Ca2+↓ 過過 K+過過
過過過過過 (+Nitrate過過過過) 過過過4-5 hrs (過)過過過(過過過過過過過 )
AMI 過過過
Codeine =Methylmorphine 過過過 過過過(κ-過過過過過 )過(μ2-過過過過過過過)過過過過過過
過過(過過過過過) 過過過 過過 (過 μ 過過)過過過(過過過過 CTZ 過 D2-R)
Papaverine ↑cGMP 過過過過 過過過(μ2-過過過過過過 )過過過 Oddi 過過過過過過 BP↓過
(過過過過過過過過 ) histamine 過過過過過 過過
Noscapine 過過 過過過過過過 (過過過 IICP)過過過過過 BPH過過過過過過
過過過 過過過過過過過過過過過過過過過過過過過
Heroin 過過 過過過過Naloxone (過過過過過過過過 )過Natrexone (過過過過過)

Apomorphine Parkinsonism ‘’OFF”過過過 Methadone (過過過過過 )

過過過過過過(過過 CTZ 過 D2-R) 過過過 Opioids 過過過過過過過過過過過過

過過過過過過過過過過過過過(antagonist actions)
過過
Meperidine (Demerol) =Pethidine (IM) 過過 M過過過過過過過過
過過過過(2-4hrs)過過過過過過 過過過過過過過過過過 Norpethidine過過過過過(過過過過過過)
過過過過過過過過過
Methadone 過 Morphine 過過過 過過過過過過過過
過過過過過(過過過過)
Morphine 過過過過過過
Dextromethophan (Medicon) 過過(過過過過過過)
Loperamide (Imodium) 過過過 mesenteric plexus μ-R (過過)過↓Ach過過過過過
過過
Fentanyl 過過過過過
IV 過過過過過過過過過 (Durogesic)過過
Sulfentanil 過過過過過(>Fentanyl)
過過過過過過過過過過
過過過過過過-過過過
Buprenorphine κagonist + partial μ agonist
過過 Dynorphin 過過過過過過過過過 Morphine 過(過過過 Fentanyl 過)過過過過過(6-8hrs)
過過過過過
過過過過過過過過過過 Methadone 過過 Morphine 過過過過過
Pentazocine κagonist + partial μ過δ agonist
Nalbuphine 過過過 Narcotic 過過過過過過過過

13
☆過過過 (Autacoids)
Amine Polypeptide Lipid
Serotonin (5-HT) Angiotensin Prostaglandin (PG)
Histamine (過過過過) Bradykinin (過過過過過過 ACEI) Leukotriene (LT)
Substance P Thromboxane (TXA)
Platelet activating factor (PAF)

☆過過過 過過過過過過
Agents Curare alkaloid (過過 )過Opiates過Atropine過Hydralazine過Dextran
Chemical Histamine過SRS-A (LTC4過LTD4過LTE4)過PG過TXA2過Ach過Bradykinin

☆過過過過過過
過過過(過過過)過過過過過過過過過 過過過
Diphenhydramine 過過過過過 R 過過過過過
(Vena) H1 過過 過過過過過過過 過過過過過過過過過
Brompheniamine OTC 過過 (Gq 過過 過過過過過 過過過過過過 過過過過過過過
Chlorpheniamine OTC 過過 ) 過過過過過 過過
Promethazine 過過過過過過過 過過過 過過過過過 過過過過過過過過過
過過過過過過 過過過過過 過過過過過過過
Meclizine過Cycli-過Bucli 過過過過 過過過 H2 過 過過過過 過過過過過過
- (Gs) 過 HR↑過SV↑
Cyproheptadine 過過過過+過 5-HT
過過過過過過 H1 過過過過過過 M過α1過5-HT過Na+過過過
Phenindamine 過過過過過過過過 過過過過過過過 過過過過過過過(過過過過 )→過過過過過
過過過(過過過)過過過過過(過過過過 )過過過過 過過過過過 (過過)
Cetirizine (Zyrtec) QD GI 過過過過過(過過過過過過 )→BPH 過過
Loratadine (Claritin) QD 過過過過 →過過過過過過
Fexofenadine BID 過過過過過
(Allergra) ↓Ach→過 Parkinsonism過過過過 EPS
Terfenadine 過過↓p450 (CYP3A4)過過過過過過
Astemizole 過過過 QT prolong過過過過過
Cisapride

☆過過過過過過過 ˙過過過過過過過過過 ↑過過過過過過過 ↓過H. pylori 過過

過過過過 Mg(OH)2 過過過過
過過過過過過過 Al(OH)3 過過過過過過過過過過過過
CaCO3 過過過過 過過過
過過過過過過過過過過過過過過過過
NaHCO3 過過過過過過過過過過
過過過過過過過PPI > H2 過過 >M1過M3 過過
H2 過過 Cimetidine (Tagamate) ↓p450
過過過過過過過過過過過過過
Ranitidine (Zantac)
Fametidine
Nizatidine 過過過過過過
M1過M3 過過 Propantheline 過過過過過過過
Pirenzepine Pirenzepine 過過過過過過過過過 M 過(M1)
Gastrin-R 過過 Proglumide 過過過過過過過
PPI Omeprazole (Losec) 過過 H+/K+ ATPase
Lansoprazole 過過過過過過過過過過過過過過過
PGE1 過過過 Misoprostol ↓過過過↑過過過過 過過過過過
→過過過過過 NSAID-induced ulcer
過過過過過過 Sucralfate pH<4 過過過過過過(過過 1hrs 過過)
過過過過過過過
過過 ICU 過過過 stress ulcer 過過
過過過過過過過過過過過過
Bismuth 過過
過過過過過 Amoxicillin 過過過 Metronidazole 過 PPI 過過過過過
Clarithromycin 過過過 Tetracycline Three-drug regimens

14
☆
過過 Phospholipase A2 Corticosteroid 過過>過過 過過過過 Lipocortin
過過 Cyclooxygenase NSAID 過過>過過
過過 COX-2 Celecoxib (Celebrex) 過過>過過
Rofecoxib (Vioxx) 過過過過過過過過過過過過過過過
過過 Lipooxygenase Zileuton 過過過過過過過過
過過 Leucotriene Zafirlukast
Montelukast

☆NSAID過Acetaminophen ˙NSAID 過過過過過過 過過 過過 過 過過

過過 NSAID過過過 COX
過過過過過過 過過過過 Lipooxygenase 過過 LTC4 過過過→過過過過過過過過過過過過過過過
Renal insufficiency過過過過過過過過過過過(Sulindac過Nabumetone 過過過過過過過過過過過)
Na+ retention
過過過過 Aspirin =Acetylsalicylic acid 過過過過過
(過過 Acetylation 過過過過 (過過過)過過過 PGE2 Reye syndrome (Influenza virus過Chickenpox 過過過)
過過 COX過 過過過過(過過 bradykinin) 過過過過過過過過過過過
過過過 Plt 過過過) 過過過過過 (過過過過過過過過過過過過過過過)
過 Plt 過過 (過過過過過過過) 過過過過→過過過過過過過→過過
→過過過過過過過過過過過過過 AMI… 過過過過過過過(Salisulism)過過過過過 (過過過過過過過過 )
→過過 5-7 過過過過
Salsalate
Propionate Naproxen
(過過過 ) Ibuprofen 過過過(OTC 過過)
過過過過過過過 NSAID
Acetate Indomethacin 過過過過 過過過過過過過過過
Ketorolac 過過 IV 過 NSAID
Diclofenac過Etidolac過Nabumetone
Fenamate Mefenamic acid 過過
Oxicam Piroxicam 過過過過過(20 hrs)
過過 NSAID
過過 COX-2 Celecoxib 過過過過過過過過
Rofecoxib (Vioxx)過過過
過 NSAID 過過過過過過
過過過過 COX-3 Acetaminophen 過過過過過過過過過過過過 過過過過過過過過過過
(Panadol過Scanol) 過過過過過過 過過過過Acetylcystein (過過 GSH) (8 hrs 過過過)
過過過過過 過過過 phase II 過過

☆Prostaglandins 過過過
PGE1 Alprostadil 過過過過 過過過過
過過過過過過過過過過過過過過過過過 PGE2過PGI2 過過過過過過過過
Misoprostol ↓過過過↑過過過過過過過過過過 NSAID-induced ulcer 過過過過過過過
過 Mifepristone (RU-486)過過過過過 過過過過 GFR
PGE2 Dinoprostone Ripening of the cervix 過過過過過→過過過過 Fetal ductus arteriosus
PGF2α Carboprost 過過過過(過過過過過過過過) PGE2過PGF2α 過過過過
Latanoprost 過過過過過過過過 PG TXA2過PGF2α 過過過過過過過過
PGI2 Etoprostenol 過過過過過 TXA2 過過過過過過過
Treprostinil 過過過過過過過過過過過

☆過過過過
過過過過 Colchicine ↓過過過過過過 /過過過過 過過過過過 Neutrophils 過過 tubilin 過過過 microtubule
↓過過過過過 →過過過過過過(過過過 ) 過過過過過過過過過過過過過過過(過過過過過過過過過)
過過過過 agranulocytosis
NSAID Indomethacin過Ketorolac 過過 Aspirin
過過過過過 Allopurinol Azathioprine過6-Mercaptopurine (6MP) 過過過↓Xanthine oxidase (XO)過過過過過過過
過 XO 過過過過過過過過過過過過過過 1/4 過過過過Steven-Johnson syndrome (Carbamazepine過Phenytoin)
Probenecid 過過過過過過過過過過過過過過過 過過過↓過過過過過過過過過過過↑過過過過(過過過過過過過過過過過 )
(Penicillin過Sulfonamides…) 過過過過過過過過過過過

15
☆RA 過過
NSAID 過過過過過過過過過過過過過過過過過
過過過過過過 過過過 DMARDs 過過過過過過過過
DMARDs Hydroxychloroquine 過過過過過過過過 lysosome 過過過過 GI 過過過過過過過過過過過過過過
(過過過過過 )
Gold 過過過過過過過 lysosome 過過過過 GI 過過過過過過過過過過(Dimercaprol 過過)
+
Gold Na thiomalate (IM)
Auranofin (PO)
Sulfasalazine 過過過過(過過過 IBD) GI 過過過過過過leukopenia (過)
D-Penicillamine 過過過過(過過過過過 ) GI 過過過過過過過過過過thrombocytopenia (過)
過過過過過 Methotrexate DMARDs 過過過過過
過過過過BM 過過過ulceration
Azathioprine過6-Mercaptopurine ↓Lymphocytes
Cyclosporin (過過 BM 過過) ↓IL-2 (過過過過 T 過過過過過過過 )
過過過過過過過過HTN過過過過過 p450
Anticytokine Etancercept 過過 TNF-α
Infliximab

☆Serotonin (5-HT過 5-Hydroxytryptemine)過過 過

5-HT1A Gi→↓cAMP 過過過Raphe nuclei過過過過 過過過過
Buspirone 5-HT1A 過過過過過 過過過(過過過)
Premenstrual syndrome
5-HT1D Gi→↓cAMP 過過過過過過過過過過 過過過過過過過過過過過
Sumatriptan 5-HT1D 過過過 過過過過過過過過過過過過過
5-HT2 Gq→↑IP3 過過過Plt過過過過過過過過過 過過過過過過過過過過過過過過過過過
過過過Plt 過過過過過過過過過過過過(過過過過過過過)
Ketanserin 過過 5-HT1C過5-HT2過α1 過過過過過過過過過
Ritanserin 過過 5-HT2 過過 Thromboxane 過過
Clozapine… 過過 5-HT2過D2 過過過過過過過過
Risperidone…
Trazodone… 過過 5-HT2 過過過過
+ +
5-HT3 過過過過 →Na 過K 過過過GI過CNS 過過過過 過過過過過過 →Chemo receptor reflex (Bezold-Jarish reflex)過
過過過過過過過過過過
(-setron) 5-HT3 過過過 過過過過過
5-HT4 Gs→↑cAMP 過過過CNS過過過過過 過過過過過 Ach 過過過過過 motility-enhancing 過
myenteric neuron protein kinetic effect
Carcinoid tumor過過過過過 5-HT 過過過過過過過
Cisapride 5-HT4 過過過 過過過過過過過 GERD過gastroparesis
過過過過過過過過過
Metoclopramide 過過過5-HT4 過過過 過 Cisapride過過過
(Primperan) 過過過D2-R 過過過

☆過過過過過
Methysergide 過過過過過 5-HT2過1
Ergotamine 過過過過過(過過 Caffeine 過過) 5-HT1過2過α
Ergonovine 過過過過過過(過過過過)(+Transamine)
過過過過過過
Bromocriptine Hyperprolactinemia過過過 DA-R
Parkinson’s Dz
Lysergide(LSD) 過過過過過過過過(過 過過 )

16
☆過過過過過
Insulin 過過過過
過過過 Insulin Lispro 過 過過過過
Insulin Aspart 過 過過過(過過過過過 ↑過過過過過過過過過過過過 )
過過 Regular insulin (RI) 過 IV 過過過過過 過過過
過過 NPH 過 過過過(+Protamine) 過過過過過過過過過過 β 過過過
Lente 過 (+過過過過過 過 )
過過 Ultralente 過 (+過過過過過過)
Insulin glargine 過 過過過過過過過 peak
過過過過過過過過過過過過過過過過
過過過過 Insulin 過過過過過過
過過過 RI (30%)+NPH (70%)
過過過過過過過
過 insulin Sulphonylurea Tolbutamide (過) 過過過 過過過過過過 過過 β 過過過過 ATP-dependent
過過 Acetohexamide (過) (過過過過) K+ channel 過過過(過過過過過過過 )過
Chlorpropamide (過) 過過過過 Ca2+過過→insulin 過過過過
(Gli- / Gly-) 過過過過過過過 過過過過過過過過過過過過 β 過過過過
Meglitinides Repaglinide 過過過過過 過過過過 Sulfonylurea過過過過過過過過 Insulin 過過過↑
(Novonorn) (過過過) 過過過過 Glibencliamide過Glipizide過Gliclazide過Glimeperide
過過 insulin Thiazolidine- Troglitazone 過過過(過過過過) 過過過過過 PPARγ→↑GLUT-4
過過過過 diones (TZD) Rosiglitazone (Avandia) 過過過過 (過過過過過過過過過過過過)
Pioglitazone 過過過過過過 過過過過過過過過過過
(過過過 insulin 過過過過過過過過過)
過過過過過過過 Fibrates (PPARα)
過過 過過 Biguanides Metformin (Glucophage) 過過過過 or 過過 過過過過過過過過過過過過過過過過 (過)
PCOS 過過過過 過過過過過過過過過過
過過過過過過過 過過過過過過過過(過過過過過過過過)
→過過過過過過 過過 insulin 過過過過過
過過過過過過過過過GI distress
↓過過過過 α-glucosidase Acarbose (Glucobay) 過過 or 過過過過 過過過過過過過過過過過過過過過 α-glucosidase
inhibitors Miglitol →過過過過過過 過過過過過過過過
→過過過過過過過過
過過過過GI effect
過過過過過過過過過過 過過過過 (過過過 β-glucosidase)

17
☆過過過
過過過過過過過過 (過過)
Sulfonamide 過過 PABA 過過 FH2 過過過 過過過過過過 G(+)過G(-) (過過過過過過過過過過 ) 過過過過過過過過過過過過過
(過過過過過 Dihydropteroate synthetase Cotrimoxazole (Baktar) AOM
過 TMP 過過) (PABA過p-aminobenzoic acid) =Sulfamethoxazole (SMX) 400mg + (TMP 80mg) Shigella過Salmonella
過過過過過過過過過過過過 (過過過過過 +過過過過過) 過過過過
過過過過過過過過過過過過過過 過過(Sulfacetamide) 過過過過
過過過過過過過過過過過過過過 過過 (Silver Sulfadiazine) 過過
過 Acetylation IBD (Sulfasalazine=過過過 +Aspirin) 過過過 (過過過過過)
Trimethoprim 過過 FH2 過過 FH4 過過過 Procaine 過 PABA 過過過過過過過過過過過 G6PD 過過過過 (Chloromycin)
(TMP) Dihydrofolate reductase Thrombocytopenia
(MTX 過過過過過過過)
過過過過過過過過過過過過過過過過過
β-lactam Penicillin 過過 Penicillin G 過過過過過 β-lactam 過過過
Benzathine ~ IM過過過 過過 Acyl-D-alanyl-D-alanine過
˙過過過 過過 Penicillin V 過過(過過過過) 過 PBPs (Penicillin-binding protein)過過
β-lactamase過 過過+過 Methicillin 過過過MRSA過過過(過過過過) →過過過過過過過過 transpeptidase
S. aureus PRSP Nafcillin Naf-過過(過過過過過) →過過過過過過過過過過過 peptidoglycan
N. gonorrhea (Penicillinase- Oxacillin (ORSA) 過過過過+過(過過)過 過過過過過過過
P. aeruginosa resistant Cloxacillin 過過過過過 GPC過過過過過過過過
penicillins) Dicloxacillin 過過過過過過過過 Pneumococcus過Meningococcus
Treponema pallidum過Spirochetes
過過 G(+)>G(-) Aminopenicillin過
過過過過
(過過過 ) Ampicillin +Sulbactam =Unasyn (過過)
過過過過 (Skin test過過過 Epi過過過過過過)
過過(過過過) Amoxicillin 過過過 Ampicillin 過過q6≒8h
過過過
+Clavulanate =Augmentin
過過
過過 G(+)(-) Carbenicillin (過過過過)
(+Probenecid 過過過過過過過)(過過過過)
+過過過過 Ticarcillin +Clavulanate =Timentin
(+Benzathine過Procaine 過過過過)
過過 Piperacillin +Tazobactam =Tazocin
過 Penicillin 過過過過過 Erythromycin過
過過過過過過過
Lincomycin過Clindamycin 過過
Cephalo- 過過過 Cephalexin 過過過q6h 過過 G(+)(過過) 過過過
sporin 過過過 BBB Cefadroxil 過過過q12h 過過 G(-)(過過過過) 過 Penicillin 過過過
Cefazoline 過過過q8h Cefazoline 過過過過過 過 G(+)過G(-)過過過過過
Cephradine 過過過q6h 過 Penicillin 過過過
過過過 Cefuroxime 過過過 過過 G(+)過過過 G(-) β-lactamase 過過
過過過 BBB Cefamandol 過過過過

Cefoxitin 過過過過 過過過過過過

Cefmetazole 過過過過過
過過過
過過過 Cefoperazone (CPZ) q8-12h 過過過過過過過過過 GNB過GPC 過
過過過
過 CPZ 過 Ceftazidime (Fortum) CPZ 過過過過過
過 Penicillin 過過過過10%
過過過 BBB Cefotaxime 過過過過過過過過過 GNB過GPC 過
過 Cephalosporins 過過過
Ceftriaxone qd過過過 Ceftriazone 過過過過過
Ceftizoxime
過過過 Cefapime (=過+過過) 過過 β-lactamase 過過過Cover 過過過 G(+)
Carbapenem Imipenem 過過(G(+)(-)過過過)過過↑過過過↓過過→+Cilastatin (=Tienam)
Etrapenem 過 AB 過過過過過過過過過過過過過過過過過
Meropenem (過過 ) 過過過 Imipenem 過過過過過過過 G(-)過過
Aztreonam β-lactam 過過過過過過過過過過過only G(-)過 過過
Vancomycin (500mg/vial) =Teicoplanin (過過過 ) Vancomycin 過過過 過過過過過 glycopeptide 過過過
Bacitracin 過過過→過過 ORSA (MRSA)過過過過過 過過 G(+)過過過過過
Cycloserine TB 過過過(過過過過過過過) 過 β-lactam 過過過過 G(+)過過過 過過過過過過過過過 G(-)
Fosfomycin 過過過 UTI (過過) 過過過過過過 過過過過
Echinocandins 過過過過過過過過過過 過過過過 Metronidazole 過過過 過過過過過 Red man syndrome
Caspofungin (1,3)-β-D-glucan synthase 過過過過過過 Aminoglycoside 過過過過過過過
過過 Mucomycosis過 過過過過 TDM 過過過過過過過
Cryptococcus 過過

18
過過過過過過過過過過過過過
Tetracyclines 過過 Tetracycline 過過過過過過過 過過過過過過(過過過過過過過過過) 過過過過過過 30S 過過過
(過過過 BBB) 過過 Minocycline bid 過過過過 過過過過 (過過 tRNA binding)
過過 G(+)(-)過 Doxycycline bid 過 qd 過 Acne 過 過過過過 (<8y/o 過過過過) 過過過過過過
過過過過過過過過 過過過過(Amiodarone) 過過過過過
Superinfection 過過過過過過過過過
BUN 過過 過過過過過過過過
Aminoglycosides Streptomycin TB 過過過 過過過 過過過
過過 G(-) (過過過) 過 Penicillin 過過過過過過過 過過過過過過過過過過過過過 過過過 30S 過過過
(過過 GNB) 過過(過過過過過過 )>過過 過過過 β-lactam 過過過過過過過 (Incorrect reading of mRNA)
過過 G(+) Gentamicin 過過過過過過過過 過過過過過過 過過過過過過
S. aureus
Tobramycin 過過過過 pH 過過過過過過過過過 過過過過
Coagulase(-) Sta.
Kanamycin 過過過→過過 →過過過過過過過過 過過過
Strep. viridans
Amikacin 過過過過過過過過過過過過 過過過過過過過過過過(過 UTI 過) 過過過
Enterococci
(Amikin) TB 過過過 過過過過過 (Furosemide過Amphotericin B)
(PCN 過過過 )
Gentamicin 過過過過過過 過過過過過過 ICU 過過 過過過過過過(過過過過過)過
Neomycin 過過過過過過過過過過過 過過過過過過過過過 過過過過過過過過過過過過
過過過過過過過過過過過 過過過 Cr 過過過 TDM 過過 過過過過過過過過過過過過
weaning
Erythromycins Erythromycin Most cost-effect 過過過 過過過過過過 (Macrolide)
過過過過過 G(+)過 Clarithromycin 過過過過過 H. pylori 過過 Legionella過Mycoplasma 過過 過過 50S 過過過
過過 GNB Azithromycin 過過 Compliance 過過 Penicillin 過過過過過過過 (過過 translocation)
(過過過過過過過 過過過過過過過 過過過過過過過(Azithromycin 過) 過過過過過過過過(↑GI 過過)
過過過過過過過 過過過過過過過過 ↓p450過Terfenadine過Astemizole過 過過
過過 β-lactam 過過過(qd) Cisapride 過過過過 QT 過過過 過過過過過過過
過過過過過過過 過過過過>過過過過過過 過過過過
過過/過過過過過) 過過過過過過過 ↑Digoxin 過過
Chloramphenicol 過過過 過過過過 過過過
過過過G(+)(-)過過過過 Gray baby syndrome 過過過 50S 過過過
過過過S. aureus過過過過過 Blood dyscrasia (過過 transpeptidation)
過過過H. influenza過S. pneumonia過 G6PD 過過過過過過過
Neisseria meningitides
過過過過過<8y/o 過過過 Tetracycline 過過過
Lincosamide Lincomycin 過過過過過過過過過 BBB 過過過 過過過過過過過過過過過過過
Clindamycin 過過過過過過過過過 Erythro- 過 G(+)過過過 Erythromycin過 過過過過
過過過過過過過過過過過 過過過過過過
過過 /過過過過過過過過過 過過過 Thrombocytopenia過
過過過過過 Leukopenia過
過 Penicillin 過過過過過過過過過過 Granulocytopenia

19
 抑制核酸：孕婦不適用
Quinolones 過過過 Nalidixic acid 抗藥性(不含基
過過過過過
易生 過過 ) 過過過 機轉：
口服佳 第二代 Fluoroquinolones過 過過過過過過 G(+)(-) 過過 DNA gyrase過
組織穿透佳 100mg/# Norfloxacin qd過過過(過 UTI) 過過過過過過 泌尿道感染(磺藥
過過過； Topoisomerase II 及IV過
廣效 Nitrofurantoin-長期肺纖維化 ) 過 DNA 無法複製
過 400mg Lomefloxacin 過過過 過過過 G(-)
Acquire
q12h Ofloxacin 過過 G(+) 過過 GNB 似Aminoglycosides 過過過過過過+抗生素後效應
resistance
Ciprofloxacin 過過過 G(-)過過 過過過過過 甚至更強 藥物動力學：
easily
過過過 Levofloxacin 過過過過過過過 過過過過 前列腺炎(過過過) 空腹GI 過過過(Sucralfate過

過過過 Moxifloxacin 過過過 G(+)(-)過過過過過過過過 注意：<18y/o、孕婦、哺乳者禁 制酸劑、過過鐵

過 過過過影過過過
響吸收 )

Moxifloxacin 過過過過過過過過過 (影響軟骨發育 ) 過過過過

Trovafloxacin
UTI 過 GU 過過 腎臟排泄為主
Gatifloxacin
Rifampin 過 TB 過
Isoniazid (INH) 過過 過過過過過 Mycolic acid 過過 過過過過 過過過過過過過過過過 Rifinah (RFN)
TB (N- (Vit.B6 過過)
acetyltransferase)
Rifampin (RIF) 過過 過過 DNA-dependent RNA ↑p450 過過過過過過過過過過
polymerase過過過過過
Ethambutal (EMB) 過過 過過 TB 過過過過
Pyrazinamide (PZA) pH<5 過過過過 過過過過過過過 Rifater (+INH過RIF)
Streptomycin 過過>過過過過過過過過
Levofloxacin過Amikacin過Para-aminosalicylate (PAS)過Cycloserine
Griseofulvin 過過 過過過過 過microtubles→過過過過 mitosis
(過過過 ) 過過過過過 (過過過過)
Flucytosin 過過過過 過過過過 5-FU→過過 DNA 過過(過 Amphotericin B 過過過過過過過過過過過過)
過過過過過過過過(過過過過過 )
過過過過過過過過 (過過過過過)
過過過過過過 Polyene Amphotericin B 過過過過過 過過過過過過過過過(ex.過過過過過)
macrolides 過過過過過過過(過過過過過過過過過過過過過過)
過過過過過過fever and chills
Nystatin 過過 過過過過過 (過過過-過過過過過過 -過過 ) (過過過過過過過 )
Natamycin 過過
過過 Lanosterol Imidazole (過) Ketoconzole 過過過過過 過過過過過過過過過過過過過過過過過過過過過過過過
過過 Ergosterol 過過過過 過過過過 過過(過過)(過過過過過過過過過)過過過過過過
過過過 P450 過過過過 過過過過(過過過過過過過過過過過)過過過過過過過過
steroid 過過 過 Cushing’s syndrome
(過過 Lanosterol Miconazole 過過過過過
過過過過過過過過) Clotrinazole 過過
Isoconazole
Triazole (過) Fluconazole (Difucan) 過過過過過 過過過過過過 Amphotericin B 過過過過過
過過過過 過過過 CSF 過 Ketoconazole 過過過過過過過過過過過過過過過
Itraconazole 過過 過過過過過過過過過過過過過過過過
Voriconazole Lanosterol 1,4-α-demethylase (Triazole 過過)
24-methylene dihydrolanosterol demethylase (過過)過
過過過過過過過 (過過 Mucomycosis 過過)
過過 Squalene Alkylamines Terbinafin (過過過) 過過過過過 過過過過過過過過過過過過過過過過過過過過過
epoxidase (OTC) 過過 2wks 過過過過過過過過過過過

˙過過過β-lactam過Vancomycin過Aminoglycosides
˙過過過過過過過Aminoglycosides過Quinolones過Metronidazole (過過過過 qd 過過過過 )
˙PAE (Postantibiotic effect)過β-lactam 過 G(+)過 PAE過過 G(-)過 PAE
˙過過過過過過過過過 過過過過過過過 過過過過 過過過 過過過過過過 過過過過過過

20
☆過過過
過過過過 (Anthelmintic)過過過(Mematodes)過過過(Trematodes)過過過 (Cestodes)
Mebendazole 過過 Microtubules 過過過過過過(過過過過 )
過過過過過過過過過
Pyrantel Pamoate 過過過過過過過過過過過 過過過過過過過過
過過過過(Antiprotozoal)過
Metronidazole 過過過tid 過過過 過過過過過過
(Flagyl) 過過過過 過過過過過過
過過過過(過過過過過過過) (Clindamycin過Lincomycin)
Emetine 過過過過過過過過過過過
過過過
過過 (過過過過) Chloroquine 過 RBC 過過
Primaquine 過 RBC 過過(過過過過)過過過過過過過過
過過過過過 Quinine =Cinchonism + Pyrimethamine + Sulfadiazine (過過過)

☆過過過過 ˙過 5 過過
Amantadine 過過 Parkinsonism
過過 A 過過過過過過 (過過 uncoating)
Rimatadine
Acyclovir 過過過過過過過過過過
(過過過過過過過過過過過過過過過過過過過過過過過過過過過過過過過過過過 過過過過 )
Ganciclovir CMV 過過
Famciclovir
Ribavirin 過 INF-α 過過 C 過過過(過過過)
Lamivudine 過過 B 過過過
Interferon- α HCV
β Multiple sclerosis
γ 過過過過過過過 (Immunomodulatory)
Enfurotide T- 過過過 HIV 過過過過過過 fusion 過過過過過過過過過
20

☆Bone Marrow Growth Factors

GM-CSF Sargramostim
G-CSF Filgrastim
Lenograstim

☆過過過
Clonidine 過過 Opioid 過過過過
Physostigmine 過 Atropine 過 TCA 過過
Neostigmine 過 Tubocurarin 過過
Atropine + PAM 過過過過過過過
Nitrite 過 CN-過過
Sodium thiosulfate
Lidocaine 過過過過過過過 過 Digoxin 過過(過過 Quinidine)
Flumazenil 過 BDZ 過過
Naloxone 過 Morphine 過過
Acetylcystein 過 Acetaminophen 過過
Deferoxamine 過
Dimercaprol (BAL) 過過 過過過
EDTA 過
Penicillamine 過
過過 過

21
☆過過過
過過過(Antimetabolites) (CCS過S 過)過過過過過過過過過過 (BM 過過過過)
過過過過 Methotrexate (MTX) (M) 過過過過過過過過過 過過過 過過 Dihydrofolate reductase (DHFR)過
Immunosuppression Leucovorin(過過過過過 過 FH2 過過過過過 FH4過過過過過過過 過過過
Leukemias過 過 N5, N10- Methylene- Thymidine 過過過過
non-Hodgkin’s Dz FH4 (Trimethoprim 過過過過過過過 )
過過 MTX 過過 DHFR)
Folate (過過 )
過過過 過 6-Mercaptopurine (6-MP) 過過 ALL (過過過過 ) 過 Allopurinol 過過過過 XO↓過過 6-MP↑
過過過 過 Fluorouracil (5-FU) (F) 過 Leucovorin 過過過過過過 過過過過 過過 Thymidylate synthase (TS)過
(過過 covalent ternary 過過過過 過過過過過過 過過過過 dUMP 過過 dTMP
complex of TS and 5F-dUMP) hand and foot syndrome 過 prodrug過過過過過過過過 (5F-dUMP)
過過過過過過過過過過 過過 Dihydrouracil
過過過過過過 dehydrogenase 過過過 ↑
過過過 Tegafur 過過過過過 5-FU過過過過過 過過過過過
過過過 Uracil+Tegafur (UFUR)過過過過過過過
過過過 Capecitabine 過過過過過過過過過過過 過過 5-FU prodrug過過過過過過過過過過
過過 Cytarabine (ara-C) 過過 AML 過過過 Cytosine 過過過過過 tumor cell kinases 過過
Gemcitabine (Gemzar) NSCLC過 過過過過過過過 Cytidine 過過過過過過過過 DNA過RNA
(Difluoro-deoxycytidine) (過過過過過過過 )
Alkylating agents (CCNS)過過 DNA 過過 G 過過過過過過過過過 DNA 過過過過過過過過 G1過S 過過過過過過過過過過過過過過過過過過過過
BM 過過過過
Nitrogen Mechlorethamine Hodgkin’s Dz 過過 過過過過
mustard Cyclophosphamide (C) 過過過過過過 過過過過過 過 prodrug過過過過 p450 過過過過過過
(過過過 ) non-Hodgkin’s lymphoma (過過 過過 acrolein 過過→過過過過過過 (Mensa 過
Ifosfamide 過過過過
Chlorambucil 過過
Melphalan 過過
Busulfan 過過過過過過過過過過 WBC 過過 BM 過過過
Thiotepa 過過
Nitroso- Carmustine 過過過過過過過 CNS→過過過 過過過
ureas Lomustine
Platium Cisplatin (P) Cisplatin 過過過過過過 過過 (Amifostine 過過過過 過過過過過
(過 ) (過過 D5W 過過過 ) 過過過過過 過過過過過過過 ) 過過 cytotoxic free radicals 過過過過 all stages
Phenytoin 過 ) 過過過過過過 過過過過過過過過 過過 過
過過過過過過過 過過過過過 (5-FU過Oxaliplatin過Irinotecan)
Carboplatin 過過過過 BM 過過過 過過過(Cisplatin + Paclitaxel)
Oxaliplatin 過 Oxaliplatin 過 5-FU 過過過過過過過過
(過 N/S 過過過過過過過 ) 過過過過過過過過過 (Paclitaxel)
Procarbazine (P) 過 Hodgkin’s lymphoma Disulfirum like Procarbazine 過過 MAOI
Dacarbazine (過過過過過過 )
過過過過 (CCNS)過(過過過過過過 ) 過過過過過過 DNA 過過過過過 DNA 過 RNA 過過過Natural product
Anthra- Doxorubicin (A 過 H) 過過過過過過過 過過過過(過過過過過過過過 過過過
cycline (Adriamycin) 過過過過過過過過過過過過過過 過 <550mg/m2)過BM 過過過 Intercalate DNA
(過過過 ) (過過(E)過過 ) ↓Topoisomerases II (Podophyllotoxins)
Daunorubicin (D) 過過過 Leukemias BM 過過過過過過過過過 過過 free radical
過過過過過 (過過 Idarubicin (I)過過過 AML)
Actinomycin D (Dactinomycin) Wilm’s tumor過過過過過 過過 DNA 過過 DNA-dependent RNA polymerase
Bleomycin (B) (CCS→G2 過) 過過過過 SCC (過過過過過過 ) 過過過過 (Amiodarone) 過 glycopeptide過過 free radical 過過 DNA
Mitomycin 過過過過 過過過過 過過過 過過過 Alkylating agent
Plant alkaloids (CCS過過過過過過 CCNS)過Natural product (+過過過過過過過過 L-Asparaginase)
過過過 Vincristine (Oncovin) (O) 過過過過過過過 過 tubules 過過過過過過過過過過
(M 過) 過過過過過 (過過 VWCD) (過過過 DTR↓過過過過過 ) (過過 mitotic spindle)
BM 過過過 (cf. Clochicine)
Vinblastine (V) 過過過過過過過過 BM 過過過過過過過過
Vinorelbine 過過過過過過過過過過過過過 NSCLC過過過過過過
過過過 Paclitaxel (過 D5W 過過) 過過過過過過過NSCLC 過過 過過過過過(Oxaliplatin) 過過過 Paclitaxel 過過 Cisplatin過過過過過過過
(M 過) Docetaxel 過過過NSCLC 過過過 過 Tubulin 過過過過
Podophy- Etoposide (VP-16) 過過過過 Late S 過 early G2 過
llotoxins Teniposide 過過過 ↓Topoisomerase II過過過 DNA 過過
過過過 Topotecan 過過過過過過過NSCLC ↓Topoisomerase I過過過 DNA 過過
(Campto- Irinotecan (過 prodrug) 過過過過過過過過過過 過過
thecins) (過過過過過 5-FU 過過) (Cholinergic diarrhea)

22
 過過
L-Asparaginase 過過 ALL 過過過 ↓Asparagine (過過過過過 )
(過 Natural product) 過過過過過過過過過過過過 過過過
IFN-α CML過MM過Hairy cell leukemia過low grade non-Hodgkin’s lymphoma
過過過 RCC (過 α-2A type)
Tretinoin Acute promyelocytic leukemia 過 Retinoic acid 過過過
Arsenic trioxide (As2O3) Acute promyelocytic leukemia

☆過過過過過過過過過
Thioamide Propylthioruacil 過過過過過過過過過過過過過過過過過 過過過
過過過過 (PTU) 過過過過過過過過 過過 I-→I0 過過過 (Peroxidase)過I0→MIT/DIT 過過過過過 (過過 )
過過過過過 過過過過 T4→T3(過過過 )(過過 )
Methimazole 過過過過過過過過過 PTU 過過 過過過過
(MMZ) 過過過過過過過過過過過過 Agranulocytosis(過過過過過過過過過過過過 過過過 Thioamide 過)
Carbimazole 過過過 Methimazole 過過過過 過過 (過過過 )
(CMZ) 過過過過過過過過過 GI 過過過過過
Iodide Lugol’s 過過過過過 Proteolysis過過過 T3過T4 過過
過過過過 solution 過過過過過過過過過過過過過過過過
SSKI 過過過過過過過過 過過過過過過過過過過過過過過過過過
過過過過過過過過過過過
過過過 I131 過過過過過過過過過過過 過過過過過過過過過過過 (I125 過過過過 )
過過過過過過過過過過過
β 過過過 Propranolol 10-40mg過qid (過過 HR<100) 過過過
過過過過過過過過過過過過過 過過過過 T4→T3(過過過)
過過過過過過過過過過過過過過過過過過過 β-receptor 過過
過過過 Hydrocortisone 過過過過過過過 T4→T3(過過過)
˙過過過過過過過過過過過過 PTU (200-300mg過q6h)過 Methimazole (過過過過 T4→T3)
過過 PTU 過 2hrs 過過 Iodide (過過 T4過T3 過過)
Propranolol (40mg過q6h過po)
過過過Hydrocortisone過過過過過 過過過過過過過過 antipyretics
過過 I131

☆過過過過過過過過過
Tyroxine 過過過過過過過 (過過過過 )
Levothyroxin 過過過 T4 (過過過過過過 T3 ) 過過過過過過過過 (過過過過過 )過過過過過過過
e 過過過過過過過過過過過過過過過過過
Liothyronine 過過過 T3 過過過過過(過過過過過)過IV 過過過過過過過過過過 coma

☆過過過過過過過過
過 過過過過 過過
過 (G) Mineralcoticoids Desoxycorticosterone 過過過過
(Aldosteron) Fludrocortisone 過過過過過過過 (Addison’s Dz 過過過過過過過過過過 )過過過過
過(F) Glucocorticoids 過過過過過過過過過 過過過過 過過過過 過 過過過 過過過過過過過過過過過過
(Cortisol過 過過 Hydrocortisone 1 20 1 (過過過過過 >2wks 過過過 )
Cortison) 過過 Predinisone 4 5 0.8 過過過過過過過過過過 過過 ACTH (過 6-12 過過過過 )
過過 Prednisolone 過過過過 過過過過過過過過 /過過
Prednisolone 4 5 0.8 過過 過過過過 (過過過 Vit. D)
Methylprednisolone 5 4 0.5 過過 過過過過過 Mental dysfunction…
Triamcinolone 5 4 過過過 過過過過過過過 過 過過過過過過過過

過過 Dexamethasone 25 0.75 過過過 過過過過過過過過過過 過過過過 (Becolmethasone)過過過過

Betamethasone 25 0.75 過過過 過過過過過 過過過過 (Budesonide過Fluticasone)過

過過過過
過(R) Sex hormone
(Androgen)

23
☆Corticosteroid antagonist
Receptor Spironolactone 過過 Aldosterone-R 過過過過過
antagonist 過過 Androgen 過過過過過
Mifepristone (RU486) Progestin-R 過過過 過 Cushing’s syndrome
過過 Glucocorticoid-R 過 Misoprostol 過過過過過
Synthesis inhibitors Aminoglutethimide 過過過過過過過過 Pregnelolone過 過 Cushing’s syndrome
過過過過過過過過過過過過過過過過過過過 過過 Tamoxifen 過過過過
Trilostane 過過 3-β-dehydroxylation過 過 Cushing’s syndrome
過過過過過過過過過過過過過過過過過過過
Ketoconazole 過過 17-α-hydroxylation過p450c17 過 Cushing’s syndrome
(Cortisol 過 Sex hormone↓)
Metyrapone 過過 11-β-hydroxylation 過過過過過過過
(Aldosterone 過 Cortisol↓過過 Androgen↑)

☆過過過過過 /過過過
Androgen Testosterone propionate
Danazol 過過過過過 /過過過過過 過 Endometriosis
過 Androgen Flutamide 過 Flutamide過 過過過過過
過 GnRHa (Goserlin過Leuprolide)
Finasteride (Proscar過過過 ) 5α-reductase 過過過過↓DHT 過 BPH過過過過 (Minosidil 過過過過過 )
Estrogens 過過 Estradiol 過過過過 過過過過過 (過過過過過過過過過過過過 )
Estrone (↑factor VII~X過↑plasminogen過
Estriol ↓Antithrombin III)
過過 Conjugated estrogens 過過過過過過過過過過過過過 HRT
(過過) (Premarin)
Ethylestradiol HRT過過過過
Ethinylsetradiol
Diethylstilbestrol (DES) 過過過過過過過 過過過過過過過(過過過過 )
過 Estrogens Clomiphene 過過過過過過 Estrogen-R 過過過過過過 過過過過過過過過 (過過過過過 )
Tamoxifen 過過 過過 過過 過過 SERM 過過
Toremifene Estrogen    
Tamoxifen     1st 乳乳 乳乳乳乳乳
Raloxifen     2nd 乳乳 乳乳乳乳乳

Progestins Progesterone
Medroxyprogesterone (Provera) 過過 HRT 過過過過 Progestin
Dydrogesterone
Norethisterone acetate
Levonorgestrel (過過過 ) 過過過 72hrs 過過過 1#過12hrs 過過過過 1#
過 Progestins Mifepristone (RU486)
Aromatase 過過過 Aminoglutethimide 過過過過過 Estrogen 過過 Tamoxifen 過過過過過 ER (+)過過
Anastrozole 過過過過過過過
Letrozole
Exemestane
過過過 過過 Estrogen + Progesterone 過過過
Estrogen (過 14-16 過) 過過過
Progesterone(過 5-6 過過過)
Progestins (過過過過 ) Northisterone 過過過過
Depot Medroxyprogesterone 過過 12wks
過過 Levonorgestrel

24
☆過過過過過過過 (過過過過 DEXA (Dual-Energy X-ray Absorptiometry)過過過過過過 (BMD)過 BMD<2.5 SD 過 T-
score<-2.5)
過過 過過 過過 過過 /過過
過過過過過
Estrogen (HRT) + 0 過過過過過 過過過過過過過過過過過 過過過 /過過過過過 ↑
Raloxifen (SERM) +++ 0 過過 HRT過過過過過過過過過過過過 SERM 過過過過過過
Salmon calcitonin + 0 過過過過過 (過過過過過過過 ) 過過過過(過過過過過過 )過過過過過過過過過過
過過過過過過Paget’s Dz 過 過過過過過過過過過過過過過過過過 PTH 過過
過過過過 過 過過過過過過 (↓過過過過過 )
Bisphosphonates +++ ++ 過過 過過過過
(過過過 hydroxyapatite 過過過過過 OC 過過過過)
過過過 Etidronate (Potency) 過過 OC 過過過過過過過過過 (過過 Osteomalacia)
1 過 Paget’s Dz過heterotopic ossification
過過過 Clodronate 10 過過過過 過過過過過過過過過過 過過過過過
Pamidronate 100 過過過過過過過 過 過過(過過過過過過 )
Alendronate 1000 過過過過過 過過過過過過過過過過
過過過 5-10mg/d過35mg/wk 過過過 (<5%)
過過過10mg/d過70mg/wk
過過過 Risedronate 5000 GI 過過過
過過過過過
PTH (Teriparatide) +++ ++ 過過(過過過過 OB 過過) 過過過過(IM)
過過
Calcium (過過 )+Vit. D ± 0 過過過過過 過過過過過過

☆過過過
過 過過過過過過 過 Dimenhydrinate (OTC 過) 過過過過過 過過過過
Diphenhydramine
Promethazine
Meclizine
Cyclizine
過過過過 Scopolamine (過過 ) 過過過過過過過過過
過 D2 Prochlorperazine (Novamine) Medication-過toxin-過metabolic-induced emesis
Metoclopramide (Primperan) Primperan 過過 5-HT4 過過
Droperidol
5-HT3 過過過 (-setron) 過過過過過過過過
過 TCA Amitriptyline Functional nausea
Nortriptyline
BDZ Lorazepam Anticipatory nausea and vomiting with C/T
Alprazolam
Glucocorticoids Methylprednisolone (Solu-Medrol) 過過過過
Dexamethaxone
X Cannabinoids (過過 ) Tetrahydrocannabinol 過過過過

☆過過過過過 (Prokinetic)
5-HT4 過過過 Cisapride 過過過 (Gastroparesis)過GERD 過過過過過過
5-HT4 過過過+D2-R 過過過 Metoclopramide 過過過過functional dyspepsia過過過 EPS 過過過過
過過 D2-R 過過 Domperidone 過過過過functional dyspepsia過
Parkinsonism 過過過過 L-dopa 過過過 過過過過
Motilin agonist Erythromycin 過過過過過過過過過過過過過
Somatostatin analogue Octretide Intestinal pseudoobstruction
過過過過過過 Bethanechol ↑Myenteric plexus→↑Ach 過過過過過過過過過過
過過 Simethicone 過過過過過
(Gascon)

25
☆過過過
過過過過過 Loperamide (Imodium) 過過過過過 Myenteric plexus μ-R (Gi→K+↑)過過過過過過過 Ach 過過
過過過過過過過過 BBb過過過過過過過
過過 2-4mg (Max過8mg)
過過過 Kaolin (過過過 )過Pectin (過過 )過Charcoal (過過 過 )
Kaopectin=Kaolin + Pectin 過過過過過過過過過過過過過過過
過過 Fiber
過過過過

☆過過過 (過過過 )
Stimulants 過過 Castor oil (過過過 Ricinolic acid) 15ml過過過過過過過
過過 過過 Bisacodyl (Ducolax) 過過過過過過過過過過過
過過過過
過過 Anthraquinone Cascara (過過過過 )過Senna (過過過 )過Aloes (過過 )
Bulk (過過過) Methyl cellulose過agar過過過過 過過過過過過過過過過過過
Osmotic MgSO4過MgO過Lactulose過Sorbitol 過過過過過過 過過過過過 過過過過過過過 →↑H2O retension 過過過過過過過過
過過過 過過過過Paraffin過Glycerol 過過過過過過過過過過過過過過過過過過

☆過過 /過過 /過過過

過過過過過過 KI (過過過) 過過過過過過過過過過過過
Guaifenesin (Glyceryl guaiacolate) 過過過過過過過過過過過過過過過過過過過過過過過
過過過 Acetylcystein 過過過過過過過過過過
過 Acetaminophen 過過
Bromhexine 過過過過過過過過過過
過過過過過過過過過過過
過過過 Codeine 過過過過過過過過 (15-30mg過q4-6h)
(過過過過過過過過過過過) Dextromethophan (Medicon) 過過過過過(10-20gm過q4-6h)
Benzonatate (Bensau) 過過/過過過過過(100mg過tid)過 過過過過過過過過

☆過過過過
過過過過 β2 過過過 Salmeterol (過過) 過過過過過 β2-R過過過 AC→↑cAMP→過過過過過
Formoterol (過過)
Methylxanthine Theophylline 過過過過過 PDE過過過 Adenosine-1 receptor
Aminophylline 過過過過過過過過過過 過過 (過過過過過過過過過過 )
過過過過 過過 Ipratropium (Atrovent) 過過過過過過過過過過過
過過過過過過過過過過 β2 過過過過過過過過過過過過過 β2 過過過
過過過 Corticosteroids 過過 Prednisolone 過過過過
(過過) 過過 Methylprednisolone
過過 Beclomethasone (過過) 過過過過過過過過過過
Budisonide (過過) (過過過過過過過過過過過 )
Fluticasone (過過過過過過 )
過 Leudotriene Zileuton (qid) 過過過過 5-Lipoxygenase
Zafirlukast (bid) Leukotriene-R antagonist
Montelukast (qd)
過過過過 過過 Mast cell Cromolyn 過過過過過 Ca2+過過 pul. Mast cell→↓degranulation 過過過過過過過過
Nedocromil 過過過過過過過(過過過過過過過過過)過過過過過過/過過過

☆COPD 過過 (過過過過過過過過過過過過過過 )
過過過過過(過過 ) 過過過 過過
β2 過過過(過過) Glucocorticoid 過過過過過過過過
過過過過(過過) (過過過過過 ) 過過過過過過過過過過過過
Methylxanthine過Theophylline 過過過過過過過過過過過過過過
˙過過過過過過過過過過過過過 過 Leukotriene 過過過過過 過過過 過過過過過過過過過過過過過
過過過過過過過過過過過過過過 過過過過 COPD 過過過過過過過過過過過過過 50%過過
過過過過過過過過過

26