*Also contains Budesonide
**Also contains Fluticasone

Thyroid hormone increases the basal metabolic rate, protein synthesis, and sensitivity to catecholamines.  Thyroid hormone is released primarily at T4 from the thyroid and converted in circulation to the more active T3.  Levothyroixine is synthetic T4, and Liothyronine is synthetic T3.

Serotonin norepinephrine reuptake inhibitors (SNRIs) inhibit the reuptake of serotonin and norepinephrine at the level of the synapse.  This class of antidepressant drugs are used to treat depression, anxiety, obsessive-compulsive disorder (OCD), neuropathic pain, and other conditions.

SNRIs increase the levels of the mood related neurotransmitters serotonin and norepinephrine.  In contrast, the more widely used SSRI antidepressants only increase serotonin levels.

Bisphosphonates inhibit the breakdown of bone by osteoclasts by encouraging osteoclast apoptosis.  The inhibition of osteoclasts shifts the balance of bone creation and breakdown to promote formation of new bone.

Calcium channel blockers inhibit the voltage-gated calcium channels (VGCCs) of cardiac and vascular smooth muscle.  This reduces cardiac contractility and vascular smooth muscle tone.  These two actions result in a decreased blood pressure.

*Also contains Trandolapril
**Also contains Benazepril
***Also includes Atorvastatin

* Also contains Salmeterol
** Also contains Formoterol

*Also contains Ipratropium Bromide

Fluoroquinolones are bactericidal drugs that inhibit DNA replication by blocking the action of bacterial DNA gyrase (topoisomerase IV).  Fluroquinolones have a broad spectrum of action against a variety of bacterial pathogens including Streptococcus pneumoniae, Staphlococcus aureus, and others.

*Also contains hydrochlorothiazide
** Also contains verapamil
*** Also contains felodipine
**** Also contains amlodipine

SSRIs increase serotonin levels by inhibiting the reuptake of serotonin into the presynaptic cell.  This increases the serotonin available to bind to the postsynaptic serotonin receptor.

Bupropion is an atypical antidepressant that inhibits the reuptake of norepinephrine and dopamine.  Bupropion is also a nicotinic antagonist.

Antihistamines (histamine antagonist) block the action of histamine at the H1 and H2 histamine receptors.  Antihistamines that primarily block the H1 receptor are used to treat allergies.

Allergens interact with immune cells to cause the release of histamine, which binds to the H1 receptor on other cells to produce the symptoms of an allergic reaction.

Inhibition of histamine binding to target cells reduces allergic symptoms.

*Also contains Pseudoephedrine

Thiazolidinediones (TZDs) bind to the PPAR gamma (peroxisome proliferator-activated receptors gamma) receptor.  When the PPAR gamma is bound by a TZD, transcription of several genes is activated.  PPAR Gamma activation leads to decreased insulin resistance, modified adipocyte differentiation, decreased leptin levels, and angiogenesis is inhibited.

Recent studies indicate that Thiazolidinedione use may increase the risk of heart failure and myocardial infarction.

*Includes metformin
**Includes glimepiride

Ezetimibe is a cholesterol lowering medication that acts by decreasing cholesterol absorption in the small intestine. Ezetimibe binds to the Niemann-Pick C1-Like 1 (NPC1L1) protein on intestinal epithelial cells and hepatocytes, preventing the absorption of dietary cholesterol.  This leads to lower serum cholesterol levels.

Because Ezetimibe works in a way very different than statins. Combining ezetimibe and a statin can result in even lower cholesterol levels than each drug could acheive if taken alone.

*Also contains simvastatin

Antiplatelet agents decrease platelet aggregation by different methods -

• Aspirin inhibits the COX enzymes, causing decreased production of TXA2
• Dipyridamole (an Aggrenox component) inhibits platelet phosphodiesterase, which increases PGI2 levels.  PGI2 inhibits TXA2.
• Clopidogrel (Plavix) inhibits the ADP-dependent activation of the glycoprotein IIb/IIIa complex

*Also contains aspirin

Statins are effective at lowering LDL cholesterol levels by as much as 60%.

Statins also reduce the risk of heart attack and stroke.

Statins are well-tolerated, but have two rare but significant side effects:  liver and muscle injury.

Three statins are available in generic form.

Proton pump inhibitors irreversibly inhibit the function of the gastric proton pumps (H+/K+ ATPase) on gastric parietal cells.   This inhibition reduces gastric acidity by up to 99%, and allows healing of ulcers and esophagitis.

Omeprazole is available over the counter as Prilosec OTC.

No generic Leukotriene Receptor Antagonists are available.

The patent for Zafirlukast (Accolate) expires in 2011, and the patent for Montelukast (Singulair) expires in 2012.

Leukotriene antagonists block the inflammatory cascade by inhibiting the action of cysteinyl leukotrienes at CysLT1 receptors in bronchial smooth muscle and other tissues.

The action of leukotriene antagonists have been shown to improve asthma and seasonal allergy symptoms, reduce asthma exacerbations, and limit markers of inflammation such as eosinophil counts in the peripheral blood and bronchoalveolar lavage fluid.

No generic ARBs are approved at this time.

In 2010, the patents for Eprosartan, Irbesartan, and Losartan will expire.

*Also contains hydrochlorothiazide