Beta blockers that are substrates for CYP2D6

Beta blockers are commonly used drugs. Having an idea about the metabolism comes in handy to avoid drug interactions. 


Beta blockers that are substrates for CYP2D6

•  Metoprolol*
•  Carvedilol
•  Nebivolol
•  Propranolol
•  Labetalol
•  Timolol 

*Highly dependent on CYP2D6 with 70-80% of metabolism occurring through this pathway.

Poor metabolisers may show a five fold increase in metoprolol drug levels and 2-fold higher heart rate reduction than extensive metabolisers

Cardio Vascular System Classification

Anti hypertensive drugs
Anti arrhythmic drugs 
Anti anginal drugs
Drugs for Chronic Heart Failure (CHF)
Drugs for Peripheral Vascular Disease (PVD)
Diuretics
Anti-diuretics
Coagulants 
Anti-coagulants
Anti-platelets
Hypolipidemic drugs
Fibrinolytics and anti-fibrinolytics
Hematinics
Plasma expanders
Sclerosing agents

Sclerosing agents classification

Phenol (5% in vegetable oil)

Polidocanol

Sod. morrhuate

Sod. linoleate

Sod. tetradecyl sulfate

Ethanolamine oleate

Plasma expanders classification

1) Human Serum Albumin

2) Dextran Pentastarch

a)Dextran 70

b)Dextran 40

3) Hetastarch Hydroxyethyl starch

4) Gelatin (Polygeline/Degraded Gelatin Polymer)

5) Polyvinylpyrrolidone 

6) Crystalloid Plasma Expanders:

a) Normal saline (0.9% NaCl)

b) Half normal saline (0.45% NaCl)

c) Ringer lactate

d) Hartmann's solution (Sodium lactate)

e) Plasma Lyte (multiple electrolytes) Dextrose solution

Hematinics classification

1) Iron [Ferrum]

a) Oral preparations

Ferrous gluconate

Ferrous sulphate

Ferrous fumarate

Colloidal ferric hydroxide

Carbonyl iron sulphate

Ferrous succinate

Ferrous glycine

Ferric glycerophosphate

Ferrous ammonium citrate

Ferrous aminoate

Ferric hydroxide polymaltose

b) Parenteral

Iron dextran

lron sorbitol citrate complex

Iron sucrose

Iron dextrin (polymaltose)

2) Maturation Factors

a)Vitamin B12

Cyanocobalamin

Methylcobalamin

Hydroxycobalamin

b) Folic acid

Folinic acid

c) Other vitamins

Pyridoxine

Riboflavin

Ascorbic acid

3) Hematopoietic Growth Factors

Erythropoietin

Darbepoietin

4) Drugs in neutropenias

Filgrastim

Lenograstim

Molgramostim

5) Drugs in ITP

Eltrombopag

Romiplostim

Fibrinolytics and anti-fibrinolytics classification

A) Fibrinolytics

1) Bacterial origin

Streptokinase

Anistreplase

2) Human Urine/Cultured Renal Cells origin

Urokinase

3) Recombinant Tissue-Type Plasminogen Activator

Alteplase

Reteplase

Tenecteplase

Recombinant prourokinase

B) Antifibrinolytics

Epsilon amino caproic acid

Tranexaemic acid

Aprotinin

Hypolipidemic drugs classification

1) HMG CoA Reductase Inhibitors (Statins)

Lovastatin

Simvastatin

Fluvastatin

Rivastatin

Pravastatin

Atorvastatin

Rosuvastatin

2) Bile Acid sequestrants (Anion exchange resins)

Cholestyramine

Colestipol

Colesevalam

3) Inhibitors of Cholesterol Absorption

Ezetimibe

4) Fibric Acid Derivatives (PPAR α agonists)

Bezafibrate

Ciprofibrate

Fenofibrate

5) Dual PPAR agonist

 Saroglitazar

6) Lipolytic

Nicotinic Acid

Acipimox 

7) Proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibitors

Alirocumab

Evolocumab

8) Others

Gugulipid

Anti-platelets classification

1) TXA2 synthesis blockers

Aspirin

Dazoxiben

2) ADP Receptor Antagonists

Ticlopidine

Clopidogrel

Prasugrel

Ticagrelor

3) Phosphodiesterase inhibitor

Dipyridamole

4) Glycoprotein (Gp) IIb/IIIa Receptors Antagonists

Tirofiban

Pentoxyfylline

Abciximab

Eptifibatide

5) Others

Epoprostenol (PGI2)

 

Anti-coagulants classification

a) Directly acting anticoagulants

i) Heparin

ii) Low molecular weight heparins

Enoxaparin

Tinzaparin

Reviparin

Nadroparin

Dalteparin

Ardeparin

Pamparin

iii) Heparinoids

Heparan sulfate

Danaparoid

Lepirudin

Ancrod

iv) Newer indirect factor Xa inhibiting agents

Fondaparinux

Idraparinux

b) Oral anticoagulants

i)Coumarin derivatives

Warfarin sodium

Dicumarol

Ethylbiscoumacetate

Nicoumalone

ii) Indandione derivatives

Anisindione

Phenindione

iii) Direct thrombin inhibitors

Dabigatran

Argatroban

Ximelagatran

iv) Factor Xa inhibitors

Rivaroxaban

Apixaban

Edoxaban

v) Reversal agents

Heparin-Protamine sulfate

Dabigatran-Idarucizumab

Coagulants classification

1) Vitamin K

K1 Phylloquinone

K2 Menaquinone

K3 Menadione

2) Miscellaneous

Fibrinogen

Fresh frozen plasma

Anti-hemophilic globulin (AHG)

Desmopressin

Adrenochrome monosemicarbazone

Ethamsylate

Rutin

3) Local Hemostatics (Styptics)

Thrombin

Thromboplastin

Fibrin glue (Fibrinogen Thrombin)

Oxidised cellulose

Gelatin foam

Microfibrillar collagen

Astringents like tannic acid, Russel viper venom