5-HETE

lipoxygenase pathway product

inhibit platelet aggregation

serve as chemotactic factor to attract leukocyte to site of injury

5-HPETE

lipoxygenase pathway product

no physiological function

Acarbose

alpha-glucosidase inhibitor

fungal metabolite derived from actinomyces

Acetaminophen

p-aminophenol

useful for pain and fever NOT inflammation

do not inhibit COX

overdose can lead to hepatic necrosis

Acetanilide

p-aminophenol

useful for pain and fever NOT inflammation

do not inhibit COX

overdose can lead to hepatic necrosis

Acetohexamide

1st Gen Sulfonylurea

Alprostadil

PGE1 analog

Maintain patency of ductus arteriosis after birth

Erectile dysfunction

Amylin

37 amino acid peptide hormone secreted by pancreatic beta cells at same time as insulin

Contributes to glycemic control

Slow gastric emptying

Inhibition of digestive secretion

Inhibiting secretion of glucagon

Anthranilic Acid

NSAID

Reversible competitive inhibitor of COX

Analog of salicylic acid

Arachidonic Acid

Fatty Acid Precursor to Eicosanoids

Released from cell membrane via PLA2

Insulin Aspart

Rapid Acting Insulin

Eliminates ability to dimerize/hexamerize and results in faster absorption rate

Aspirin 

Type 2 salicylate ester

Analgesic, antipyretic, anti-inflammatory

Irreversible COX inhibitor. After acetylation of COX, salicylic acid acts as a reversible inhibitor.

Aspirin Salt

NSAID

Type 2 salicylic acid ester

Irreversible COX inhibitor

Bimatoprost

Synthetic PGF agent

Used as eye drops for ocular hypertension and glaucoma

Canagiflozen

SGLT-2 Inhibitor

Carboprost

PGF analog

Used in combination with mifepristone as abortifacient

Used to stimulate uterine contractions

Carprofen

NSAID

Propionic Acid
veterinary analgesic

both rings are COPLANAR--does not bind site 3 

Celecoxib

NSAID

COX 2 inhibitor

Inhibit production of PGI2, may increase risk of vascular disease

Chlorpropamide

Sulfonylurea

Extremely long half life/duration of action

Potentially prolong hypoglycemia

Potentially potentiate ADH sensitivity (H2O retention)

Choline Salicylate

NSAID

Type 1 salicylic acid ester

Dapagliflozin

SGLT-2 Inhibitor

Detemir Insulin

Long acting insulin

Forms hexamer, slowly resleasing

Monomer is more lipophilic--bound to albumin in circulation

Diclofenac

NSAID

Anthranilic Acid Analog

Inhibits COX and lipoxygenase

Inhibits release and reuptake of arachidonic acid

optimal spacing of atoms between site 1 & 2 increases potency

Dinoprostone

PGE2 analog

Used in combination with mifepristone as abortifacient

Stimulates uterine contraction

Used as a vaginal suppository for induction of labor

Empagliflozin

SGLT-2 Inhibitor

Fenoprofen

NSAID

Propionic Acid Derivative

Inhibits COX & lipoxygenase

Flubiprofen

NSAID

Propionic Acid Derivative

Opthalmic and oral systemic use

Glargine Insulin

Long acting insulin

Isoelectric point neutral at physiological pH

Microcrystal precipitate forms--slowly releases insulin

Glimepiride

3rd Generation Sulfonylurea

Stimulate insulin secretion

Stimulate translocation of GLUT4 from cytoplasm to cell membrane

Glipizide

2nd Gen Sulfonylurea

Glulisine Insulin

Rapid Acting Insulin

Eliminates ability to dimerize/hexamerize

Glyburide

2nd Gen Sulfonylurea

Human GLP-1

Incretin 

Secreted by L cells located in small intestine

Closes ATP-linked K+ channel

Inhibits glucagon secretion & hepatic glucose secretion

Stimulates insulin secretion

Slows gastric emptying

Promotes satiety

Restores beta cell function 

Promotes beta cell differentiation

Regular Human Insulin

Onset 30 min-1 hr, duration 6-8 hr

Ibuprofen

NSAID

Propionic Acid Derivative

Lacks 2nd aromatic ring ut possesss sec-butyl substituent that presumably renders drug slightly less potent

Iloprost

PGI2 analog

Lowers peripheral, pulmonary, and coronary resistance

Used for primary pulmonary hypertension

Inactive PGE2

ketone group eliminates activity

Indomethacin

NSAID

Indolacetic Acid Derivative

More potent than aspirin as anti-inflammatory and anti-pyretic agent

One of the most potent inhibitors of COX

Side effects: GI and CNS (severe frontal headache)

Ketoprofen

NSAID

Propionic Acid Derivative

Inhibitis COX and lipoxygenase

Ketorolac tromethamine

NSAID
Pyrrolacetic Acid Derivative

 As active as indomethacin--very potent COX inhibitor

Latanoprost

Synthetic PGF derivative

Eye drop for ocular hypertension and glaucoma

Linagliptin

DPP4 Inhibitor

Side effects: Nasopharyngitis, hypoglycemia, pancreatitis

Liraglutide

97% homology to human GLP-1

long acting

slow absorption from subcutis

Lispro Insulin

Rapid Acting Insulin

Eliminates ability to dimerize

LTA4

Leukotriene (Lipoxygenase Pathway)

No physiological function

LTB4

Leukotriene (Lipoxygenase Pathway)

Increase leukocyte chemotaxis

Magnesium salicylate

NSAID

Type 1 salicylate ester

Useful for patients with restricted sodium diet

Meclofenamate

Anthranilic Acid Analog

disubstitution makes 10x more potent

Mefenamic Acid

Anthranilic Acid Derivative

Meloxicam

NSAID
Oxicam

More selective as COX 2 inhibitor

Metformin

Biguanide

Rarely causes hypoglycemia

Can cause weight loss and decrease insulin resistance in obese patients

Reported to have beneficial effects on serum lipids

Side effects: Metallic taste, epigastric distress, lactic acidosis

Methyl Salicylate

NSAID

Type 1 salicylate ester

Prodrug

Miglitol

Alpha-glucosidase inhibitor

Misoprostol

Stable analog of PGE1

Used as GI protectant on long term NSAID usage

Orally active prodrug

Drug of choice for use with mifepristone as abortifacient

Montelukast

Leukotriene Receptor Antagonist

Prophylatic and chronic use for asthma

N-arylanthranilic Acid

NSAID

Anthranilic Acid Analog

SAR: Monosub at 2 or disub at 2,6 to enhance activity

Naproxen

NSAID

Propionic Acid Derivative

Does not possess 2nd non-coplanar ring

Only drug marketed in optically pure form

Nateglinide

Phenylalanine Analog of sulfonylurea

Stimulates insulin secretion

Oxaprozin

NSAID
Propionic Acid Derivative (aryl propionic acid)

Less potent because 3 carbons between site 1 and 2 

PGD2

weak inhibitor of platelet aggregation

mediates inflammation by causing vasodilation and increasing vascular permeability

PGE1

mediates inflammation by causing vasodilaiton

PGE2

Increases thermoregulatory set point

GI Protective effect

Stimulates hyperalgesia (increase sensitivity to pain)

Uterine contraction

Mediates inflammation by causing vasodilation and increasing vascular permeability

Inhibits reabsorption of sodium and water in collecting duct

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PGE3

PGF2a

Stimulate uterine muscle contraction

Increase thermoregulatory set point 

PGG2

No specific physiological function

PGH2

No specific physiological function

PGI2

ProstaCYLCIN

Inhibit platelet aggregation

Potent vasodilator of smooth muscle

Mediate inflammation by causing vasodilation and increasing vascular permeabilty 

Phenacetin

p-aminophenol

Useful for pain and fever but NOT inflammation

Does not inhibit COX

Phenformin

Biguanides

Removed from market due to fatal lactic acidosis

Rarely causes hypoglycemia

Can cause weight loss and decrease insulin resistance in obese patients

Reported to have beneficial effects on serum lipids

Side effects: Metallic taste, epigastric distress, lactic acidosis

Pioglitazone

Thiazolidinedione

Insulin Sensitizers

Increased risk of fracture in female patients

Pramlintide

Synthetic amylin analog

Use in conjunction with insulin before meal

Piroxicam

NSAID

Oxicam

Repaglinide

Stimulates insulin secretion

Related to sulfonylureas, but NOT in this class

Rofecoxib

NSAID

COX-2 inhibitor

Discontinued due to CV side effects

Rosiglitazone

Thiazolidinedione

Insulin sensitizer

Safety alert: increased risk of heart attack

Salicylamide

NSAID

Salicylate analog

Weak analgesic and antipyretic

NOT anti-inflammatory

Does not cause GI ulceration, absorbed only in intestine

Does NOT inhibit COX

Salsalate
NSAID
NOT irreversible, but competitive inhibitor

Less GI irritation

Transported to SI and metabolized to 2 salicylic acids 

Saxagliptin

DPP4 Inhibitor

Adverse effect: lymphocytopenia

Sitagliptin

DPP4 Inhibitor

Sodium salicylate

NSAID
Type 1 salicylic acid ester

Sodium thiosalicylate

NSAID

weak analgesic and anti-pyretic, also anti-inflammatory

Sulindac

NSAID

Indolacetic acid derivative

Prodrug

Only Z isomer active

Fever GI disturbances because absorbed as inactive sulfoxide

Suprofen

NSAID
Propionic acid derivative

Withdrawn due to renal toxicity

Reintroduced for opthalmic use 

Tolazamide

1st Gen Sulfonylurea

Slow absorption, slow onset

Tolbutamide

1st Gen Sulfonylurea

Rapid onset, shortest DOA

Diagnostic tool for pancreatic function

Tolmetin

NSAID

Pyrrolacetic Acid Derivative

Travoprost

Synthetic PGF analog

Available as eye drop for ocular hypertension and glaucoma

Treprostinil Sodium

PGI2 analog

Lowers peripheral, pulmonary, and coronary resistance

Used for primary pulmonary hypertension

TXA2

Induce platelet aggregation, produced by plateletswhen there is tissue injury

Causes vasoconstriction

Unoprostone isopropyl

Synthetic PGF analog

Available as eye drop for ocular hypertension and glaucoma

Valdecoxib

NSAID

COX-2 inhibitor

Discontinued due to severe skin reaction

Zafirlukast

Leukotriene receptor antagonist

Prophylactic and chronic use to treat asthma

Zileuton

5-lipoxygenase inhibitor

Indicated for prophylaxis and chronic treatment of asthma

Contraindicated in patients with active liver disease or persistant hepatic function enzyme elevation

Zomepirac

NSAID

Pyrrolacetic Acid derivative

Removed from market for anaphylactic reaction