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Bupropion (also known as Wellbutrin, Zyban, Voxra, Budeprion, or Aplenzin; formerly known as amfebutamone) is an atypical antidepressant and smoking cessation aid. The drug is a non-tricyclic antidepressant that differs from most commonly prescribed ones (SSRIs), as its primary pharmacological action is norepinephrine-dopamine reuptake inhibition. It binds selectively to the dopamine transporter, but its behavioural effects have often been attributed to its inhibition of norepinephrine reuptake. It also acts as a nicotinic acetylcholine receptor antagonist. Bupropion belongs to the chemical class of aminoketones and is similar in structure to stimulants cathinone and diethylpropion, and to phenethylamines in general. Initially researched and marketed as an antidepressant, bupropion was subsequently found to be effective as a smoking cessation aid. With over 20 million retail prescriptions in 2007, it was the fourth-most prescribed antidepressant in the United States retail market after sertraline, escitalopram, and fluoxetine. Bupropion lowers seizure threshold, and its potential to cause seizures has been widely publicized. However, at the recommended dose the risk of seizures is comparable to that observed for other antidepressants. Bupropion is an effective antidepressant on its own but it is particularly popular as an add-on medication in the cases of incomplete response to the first-line selective serotonin reuptake inhibitor (SSRI) antidepressant. In contrast to many other antidepressants, bupropion does not cause weight gain or sexual dysfunction; in fact, in most studies, groups placed on bupropion showed statistically significant increases in libido, and mild to moderate weight loss.


Caffeine is a bitter, white crystalline xanthine alkaloid that is a psychoactive stimulant. Caffeine was isolated from coffee in 1820 by a German chemist, Friedlieb Ferdinand Runge, and in 1821 by French chemists working independently; namely, by Robiquet and by Pelletier and Caventou. It was Pelletier, noting that the drug had been isolated from coffee (French: café), who coined the word "cafeine", which became the English word "caffeine". Caffeine is found in varying quantities in the beans, leaves, and fruit of some plants, where it acts as a natural pesticide that paralyzes and kills certain insects feeding on the plants. It is most commonly consumed by humans in infusions extracted from the bean of the coffee plant and the leaves of the tea bush, as well as from various foods and drinks containing products derived from the kola nut. Other sources include yerba mate, guarana berries, and the Yaupon Holly. In humans, caffeine acts as a central nervous system (CNS) stimulant, temporarily warding off drowsiness and restoring alertness. Caffeine is the world's most widely consumed psychoactive substance, but, unlike many other psychoactive substances, is legal and unregulated in nearly all jurisdictions.[clarification needed] Beverages containing caffeine, such as coffee, tea, soft drinks, and energy drinks, enjoy great popularity; in North America, 90% of adults consume caffeine daily. The U.S. Food and Drug Administration (FDA) lists caffeine as a "multiple purpose generally recognized as safe food substance". Caffeine has diuretic properties when administered in sufficient doses to subjects that do not have a tolerance for it. Regular users, however, develop a strong tolerance to this effect, and studies have generally failed to support the common notion that ordinary consumption of caffeinated beverages contributes significantly to dehydration.















Cholic Acid







Clonazepam is a benzodiazepine derivative having anticonvulsant, muscle relaxant, and very potent anxiolytic properties. It is marketed by Roche under the trade-names Klonopin in the United States, and Ravotril in Chile. Other names like Rivotril or Rivatril are known throughout the large majority of the rest of the world. Clonazepam is marketed as Paxam in Australia. Clonazepam has an unusually long half-life of 18–50 hours, making it generally considered to be among the long-acting benzodiazepines. Clonazepam is a chlorinated derivative of nitrazepam and therefore a nitrobenzodiazepine. Benzodiazepines such as clonazepam have a fast onset of action and high effectiveness rate and low toxicity in overdose but have drawbacks due to adverse reactions including paradoxical effects, drowsiness, and cognitive impairment. Cognitive impairments can persist for at least 6 months after withdrawal of clonazepam; it is unclear whether full recovery of memory functions occurs. Other long-term effects of benzodiazepines include tolerance, a benzodiazepine dependence as well as a benzodiazepine withdrawal syndrome occurs in a third of people treated with clonazepam for longer than 4 weeks. Clonazepam is classified as a high potency benzodiazepine and is sometimes used as a second line treatment of epilepsy. Clonazepam, like other benzodiazepines, while being first line treatments for acute seizures, are not first line for the long-term treatment of seizures due to the development of tolerance to the anticonvulsant effects. The benzodiazepine clorazepate may be preferred over clonazepam due to a slower onset of tolerance and availability in slow release formulation to counter fluctuations in blood levels. Clonazepam is also used for the treatment of panic disorder. The pharmacological properties of clonazepam as with other benzodiazepines is the enhancement of the neurotransmitter GABA via modulation of the GABAA receptor.




Clozapine (sold as Clozaril, Azaleptin, Leponex, Fazaclo, Froidir; Denzapine, Zaponex in the UK; Klozapol in Poland, Clopine in NZ/Aus) is an antipsychotic medication used in the treatment of schizophrenia, and is also used off-label in the treatment of bipolar disorder. Wyatt. R and Chew. R (2005) tells us there are three pharmaceutical companies that market this drug at present: Novartis Pharmaceuticals (manufacturer), Mylan Laboratories and Ivax Pharmaceuticals (market generic clozapine). The first of the atypical antipsychotics to be developed, it was first introduced in Europe in 1971, but was voluntarily withdrawn by the manufacturer in 1975 after it was shown to cause agranulocytosis, a condition involving a dangerous decrease in the number of white blood cells, that led to death in some patients. In 1989, after studies demonstrated that it was more effective than any other antipsychotic for treating schizophrenia[citation needed], the U.S. Food and Drug Administration (FDA) approved clozapine's use but only for treatment-resistant schizophrenia. The FDA requires blood testing for patients taking clozapine. The FDA also requires clozapine to carry five black box warnings for agranulocytosis, seizures, myocarditis, for "other adverse cardiovascular and respiratory effects", and for "increased mortality in elderly patients with dementia-related psychosis." In 2002 the FDA approved clozapine for reducing the risk of suicidal behavior for patients with schizophrenia. Clozapine is usually used as a last resort in patients that have not responded to other anti-psychotic treatments due to its danger of causing agranulocytosis as well as the costs of having to have blood tests continually during treatment. It is, however, one of the very effective anti-psychotic treatment choices. Patients are monitored weekly for the first six months. If there are no low counts the patient can be monitored every two weeks for an additional six months. Afterwards, the patient may qualify for every 4 week monitoring.
















Darunavir (brand name Prezista, formerly known as TMC114) is a drug used to treat HIV infection. It is in the protease inhibitor class. Prezista is an OARAC recommended treatment option for treatment-naïve and treatment-experienced adults and adolescents. Developed by pharmaceutical company Tibotec, darunavir is named after Arun K. Ghosh, the chemist who discovered the molecule at the University of Illinois at Chicago. It was approved by the Food and Drug Administration (FDA) on June 23, 2006. Darunavir is a second-generation protease inhibitor (PIs), designed specifically to overcome problems with the older agents in this class, such as indinavir. Early PIs often have severe side effects and drug toxicities, require a high therapeutic dose, are costly to manufacture, and show a disturbing susceptibility to drug resistant mutations. Such mutations can develop in as little as a year of use, and effectively render the drugs useless. Darunavir was designed to form robust interactions with the protease enzyme from many strains of HIV, including strains from treatment-experienced patients with multiple resistance mutations to PIs. Darunavir received much attention at the time of its release, as it represents an important treatment option for patients with drug-resistant HIV. Patient advocacy groups pressured developer Tibotec not to follow the previous trend of releasing new drugs at prices higher than existing drugs in the same class. Darunavir was priced to match other common PIs already in use, such as kaletra. The drug costs around $9000 for a one year supply.






















































































Midazolam, marketed in English-speaking countries under brand names Dormicum, Hypnovel, and Versed, is a short-acting drug in the benzodiazepine class that is used for treatment of acute seizures, moderate to severe insomnia, and for inducing sedation and amnesia before medical procedures. It has extremely potent anxiolytic, amnestic, hypnotic, anticonvulsant, skeletal muscle relaxant, and sedative properties. Midazolam has a fast recovery time and is the most commonly used benzodiazepine as a premedication for sedation; less commonly it is used for induction and maintenance of anesthesia. Flumazenil is a benzodiazepine antagonist drug that can be used to treat an overdose of midazolam as well as to reverse sedation. However, flumazenil can trigger seizures in mixed overdoses and in benzodiazepine dependent individuals so is not used in most cases. Administration of midazolam by nose or the buccal route (absorption via the gums and cheek) as an alternative to rectally administered diazepam is becoming increasingly popular for the emergency treatment of seizures in children. Midazolam is also used for endoscopy procedural sedation and sedation in intensive care. The anterograde amnesia property of midazolam is useful for premedication before surgery to inhibit unpleasant memories. Midazolam, like many other benzodiazepines, has a rapid onset of action, high effectiveness and low toxicity level. Drawbacks of midazolam include drug interactions, tolerance, withdrawal syndrome as well as adverse events including cognitive impairment and sedation. Paradoxical effects occasionally occur and are most common in children, the elderly, and particularly after intravenous administration.










Mycophenolate mofetil is a immunosuppressant and prodrug of mycophenolic acid, used extensively in transplant medicine. Its mode of action is as a reversible inhibitor of inosine monophosphate dehydrogenase in purine biosynthesis. MMF is selective for the de novo pathway critical to lymphocytic proliferation and activation. Other cells are able to recover purines via a separate, scavenger, pathway and are thus able to escape the effect. It is a useful alternative to azathioprine when Aza toxicity precludes use. The chemical name for mycophenolate mofetil is 2-morpholinoethyl (E)-6-(1,3-dihydro-4-hydroxy-6-methoxy-7-methyl-3-oxo-5-isobenzofuranyl)-4-methyl-4-hexenoate. Its empirical formula is C23H31NO7 and molecular weight 433.50. Mycophenolate mofetil is morpholinoethyl ester of mycophenolic acid, which is used to mask the carboxyl group. Mycophenolate mofetil is reported to have pKa values 5.6 for the morpholino moiety and 8.5 for the phenolic group. CellCept is also used in the treatment of autoimmune disorders in which the immune system is overactive - such as Behçet's Disease. Suppressing the immune system inhibits the body from attacking healthy cells (which a faulty immune system has labeled as a pathogen,) thus preventing flares and complications from the disease. As with all immunosuppressants, a negative side effect of CellCept is that it weakens or eliminates the body's ability to defend itself against genuine pathogens, leaving the patient susceptible to infection.























P450 (CYP) metabolite

















Quercetin, a flavonol, is a plant-derived flavonoid found in fruits, vegetables, leaves and grains. It also may be used as an ingredient in supplements, beverages or foods. Several laboratory studies show quercetin may have anti-inflammatory and antioxidant properties,[1][2] and it is being investigated for a wide range of potential health benefits.[2][3] Quercetin has been shown to increase energy expenditure in rats, but only for short periods (fewer than 8 weeks). Effects of quercetin on exercise tolerance in mice have been associated with increased mitochondrial biogenesis. The American Cancer Society says while quercetin "has been promoted as being effective against a wide variety of diseases, including cancer," and "some early lab results appear promising, as of yet there is no reliable clinical evidence that quercetin can prevent or treat cancer in humans." In the amounts consumed in a healthy diet, quercetin "is unlikely to cause any major problems or benefits." Adequate dietary intake of fruits and vegetables may reduce the risk of cancer. Research shows quercetin influences cellular mechanisms in vitro[specify] and, in animal studies, there is evidence from human population studies that quercetin may, in a very limited fashion, reduce the risk of certain cancers. In laboratory studies of cells in vitro, quercetin produces changes that are also produced by compounds that cause cancer (carcinogens), but these studies do not report increased cancer in animals or humans. The U.S. Food and Drug Administration has not approved any health claims for quercetin. There is current early-stage clinical research on quercetin addressing safety and efficacy against sarcoidosis, asthma and glucose absorption in obesity and diabetes (February 2009). Quercetin is the aglycone form of a number of other flavonoid glycosides, such as rutin and quercitrin, found in citrus fruit, buckwheat and onions. Quercetin forms the glycosides quercitrin and rutin together with rhamnose and rutinose, respectively. Quercetin is classified as IARC group 3 (no evidence of carcinogenicity in humans).
















Rosiglitazone is an antidiabetic drug in the thiazolidinedione class of drugs. It works as an insulin sensitizer, by binding to the PPAR receptors in fat cells and making the cells more responsive to insulin. It is marketed by the pharmaceutical company GlaxoSmithKline as a stand-alone drug (Avandia) and in combination with metformin (Avandamet) or with glimepiride (Avandaryl). Annual sales peaked at approx $2.5bn in 2006, but declined after reports of adverse effects. The drug's patent expires in 2012. Some reports have found rosiglitazone is associated with an increased risk of heart attacks, but other reports have not found a statistically significant increase. Concern about adverse effects has reduced the use of rosiglitazone despite its sustained effects on glycemic control. The drug is currently the subject of over 13,000 lawsuits against GSK. As of July 2010, GSK has agreed to settlements on more than 11,500 of these suits. The drug is controversial in the U.S. Food and Drug Administration (FDA). Some reviewers concluded rosiglitazone caused more deaths than pioglitazone (Actos), and recommended rosiglitazone be taken off the market, but an F.D.A. panel disagreed, and it remains on the market in the U.S., subject to significant restrictions. In Europe, the European Medicines Agency (EMA) recommended in September 2010 that the drug be suspended from the European market. However, patients currently taking rosiglitazone are advised to discuss alternative options during their next physician appointment. In the UK, Diabetes UK announced, "People currently taking all forms of the recently suspended drug Avandia (Rosiglitazone) have until 21 October to be reviewed and transferred onto an alternative treatment". In New Zealand, rosiglitazone (Avandia) is to be withdrawn from the market before April 29, 2011 after concern about its make an elevated risk of cardiovascular events. Patients should discuss alternative treatments with their doctor as soon as possible, but to continue taking the drug in the meantime. As reported by Medscape/Heartwire 23 September 2010,medscape the EMA has recommended the suspension of the marketing authorizations for all rosiglitazone-containing antidiabetes medications licensed in the EU--Avandia, Avandamet, and Avaglim.




























Zopiclone, (brand name Imovane in Canada, and Zimovane in the UK) is a non-benzodiazepine hypnotic agent used in the treatment of insomnia. In the United States, zopiclone is not commercially available, although its active stereoisomer, eszopiclone, is sold under the names Lunesta (see History). Zopiclone is a controlled substance in the United States, Canada, Japan, Brazil and some European countries, and may be illegal to possess without a prescription. Zopiclone is known colloquially as a "Z-drug". Other Z-drugs include zaleplon (Sonata) and zolpidem (Ambien and AmbienCR) and were initially thought to be less addictive and/or habit-forming than benzodiazepines. However, this appraisal has shifted somewhat in the last few years as cases of addiction and habituation have been presented. It is recommended that zopiclone be taken on an "as needed" basis. Daily or continuous use of the drug is not usually advised. Zopiclone is a tranquilliser drug. It works by causing a depression or tranquillisation of the Central Nervous System. As Zopiclone is sedating it is marketed as a sleeping pill. After regular dampening down of the Central Nervous System the body becomes accustomed to functioning under the influence of Zopiclone. When the dose is reduced or the drug is stopped these adaptions which have occurred when a persons body has become addicted to a drug are revealed. The result is rebound withdrawal symptoms which can include a whole host of withdrawal symptoms which are seen in benzodiazepine withdrawal. To withdraw from Zopiclone sleeping tablets cross over to an equivalent dose of diazepam. The equivalency table by Professor Heather Ashton has been noted to be the most reliable and accurate. View her EQUIVALENCY TABLE to locate the approximate equivalent dose of zopiclone to diazepam. To withdraw and reduce the intensity of withdrawal symptoms, including interdose withdrawal symptoms, it is important that the blood levels of a drug remain constant throughout a 24 hour period. This is not possible with zopiclone as it is a short acting drug, therefore users of Zopiclone should cross over to an equivalent dose of diazepam to begin their dose taper. See the explanation by Dr JG McConnell in his article called The Clinicopharmacotherapeutics of Benzodiazepine and Z drug dose Tapering Using Diazepam, While it acts on the same benzodiazepine receptors as the benzodiazepine family of drugs it is not classed as a benzodiazepine (with which it shares a number of characteristics and effects) due to its differing molecular structure. Zopiclone is classed as a cyclopyrrolone derivative.

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