Drug Classifications

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Rosibel
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122105
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Drug Classifications
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2011-12-09 16:16:36
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drugs class treats considerations examples
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Includes drug classes: -what the drug treats -adverse reactions -considerations -examples
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  1. Sulfonamides
    • TR: UTIs, otits media, ulcerative colitis, lower respiratory infections
    • A: photosensitivity, jaundice, blood complications, kidney damage
    • C: avoid direct sun, use sunscreens, drink lots of water
    • E: -Sulfamethoxazole-trimethroprim (Bactrim) oral susp, tab, IV
    • -Sulfasalazine (Azulfidine) tab, EC tab, oral susp
    • -Sulfisoxazole (Gantrisin) tab, oral susp, opth oint
  2. Penicillins
    • TR: abscesses, meningitis, otits media, pneumonia, resp. infections, prophylaxis
    • A: diarrhea, hives, rash, wheezing, anaphylaxis
    • C: take on an empty stomach with water, no water or colas
    • E: -Amoxicillin (Amoxil or Polymox) cap, oral susp
    • -Ampicillin (Omnipen) cap, oral susp
    • -Amoxicillin-clavulanate (Augmentin) caps, oral susp
    • -Penicillin (Veetids) tab, oral susp
  3. Cephalosporins
    • TR: dental work, heart and pacemaker procedures, orthopedic surgery, pneumonia, upper respiratory and sinus infection, UTIs
    • A: diarrhea, hives, rash, wheezing, anaphylaxis
    • C: 10% of population may have cross-sensitivity to pcn
    • E: -Ceflacor (Ceclor) caps, oral susp, ER tab
    • -Cefixim (Suprax) oral susp, tab
    • -Cefpodixime (Vantin) oral susp
    • -Cephalexin (Keflex or Keftab) cap, oral susp, tab
  4. Tetracyclines
    • TR: acne, chronic bronchitis, lyme disease, walking pneumonia, prophylaxis for traveler's diarrhea, neuropathy
    • A: GI, such as nausea and vomiting, photosensitivity
    • C: no dairy, no antacids, no kids under age 9, NO EXPIRED DRUGS= toxicity, death
    • E: -Doxycycline (Vibramycin) cap, IV, oral susp, tab
    • -Minocycline (Minocin) cap, IV, oral susp, tab
    • -Tetracyline (Achromycin, Sumycin) cap, oral susp, top
    • -Chlortetracycline (Aureomycin) top, IV, cap
  5. Macrolides
    • TR: pulmonary infections, chlamydia, Haemophilus infuenza
    • A: GI distress [gram-]
    • C: take with food
    • E: -Azithromycin (Zithromax) caps, oral susp [double-strength loading dose]
    • -Clarithromycin (Biaxin) granules for oral susp, film-coated tab [leaves a metallic taste]
    • -Erythromycin (Eryc, E-mycin, Ery-tab) cap, tab, EC tab, film-coated tab
  6. Quinolones
    • TR: bone and joint infections, dental work, infectious diarrhea, upper respiratory infections (URIs), and UTIs
    • A: nausea and vomiting, joint swelling, dizziness
    • C: antacids interfere with absorption; theophylline products may cause toxicity; phototoxicity, no pts <18y/o due to possible tendon damage; no preggos; protect ciprofloxacin and ofloxacin from light
    • E: -Ciprofloxacin (Cipro) tab, oral susp, opth, IM, IV
    • -Levofloxacin (Levaquin) IV, tab
    • -Moxifloxacin (Avelox, Vigamox) tab
    • -Ofloxacin (Floxin, Ocuflox) tab, IV, opth
  7. Aminoglycosides
    • TR: life-threatening infections, sepsis, immunocompromised pts
    • A: nephrotoxicity, ototoxicity, tinnitus, permanent deafness
    • C: dosages need to be adjusted for each patient after first dose. Once per day dosing has tendency to reduce toxicities
    • E: -Gentamicin (Garamycin) cream, IM, IV, ophthalmic
    • -Neomycin (Mycifradin) tab, soln, IM, cream, oint
    • -Streptomycin (Streptomycin) IM, IV
    • -Tobramycin (Nebcin) IV, ophthalmic
  8. Antifungals
    • TR: fungal infections
    • A: liver toxicities (liver function tests are recommended), GI distress, photosensitivity, rashes, and nausea are common
    • C: pulse dosing is recommended for nail fungal infections. Consuming a cola before taking itraconazole is recommended. Fluconazole suspension should be refrigerated and will expire in 14days.
    • E: -Amphotericin B (Fungizone) oral susp, IV, top
    • -Clotrimazole (Lotrimin) oral troche, top, vag
    • -Fluconazole (Diflucan) IV, oral susp, tab
    • -Ketoconazole (Nizoral) tab, top cream, shampoo
    • -Itraconazole (Sporanox) cap, oral susp
    • -Miconazole (Monistat) top, vag
    • -Nystatin (Nilstat) tab, oral susp, top, vag
    • -Terbinafine (Lamisil) tab, top cream, solution
  9. Antivirals
    • TR: cytomegalovirus retinitis, all kinds of herpes, influenza prophylaxis, organ transplants, varicella, chicken pox
    • A: headaches, nausea, vomiting, diarrhea, constipation, renal disorders
    • C: oral products should be taken with plenty of water. Use reconstituted acyclovir withing 12hrs
    • E: -Acyclovir (Zovirax) cap, tab, oral susp, IV, oint
    • -Famciclovir (Famvir) tab
    • -Valacyclovir (Valtrex) caplet
  10. Anti-Helminths
    • TR: parasitic worms (helminths) by stunning or killing them
    • A: various
    • C: use while pregnant or breastfeeding can sometimes cause fetal abnormalities
    • E: -Albendazole (Albenza) tab, susp
    • -Mendazole (Vermox) tab, susp
  11. Miscellaneous Antibiotic: Clindamycin
    • TR: acne, dental prophylaxis for pcn-allergic pts, anaerobic pneumonia, bone infections, female genital infections
    • A: bloody diarrhea
    • C: none
    • E: -Clindamycin (Cleocin) susp, cap, IV
  12. Miscellaneous Antibiotics: Metronidazole
    • TR: trichomonas infections of vaginal canal, cervix, and male urethra; amebic dysentry, intestinal infectins
    • A: metallic taste, diarrhea, rash, and 'antabuse-like rxn' when alcohol is consumed
    • C: take with food and avoid alcohol 1day before and 2days after
    • E: - Metronidazole (Flagyl) tab, IV
  13. Miscellaneous Antibiotics: Vancomycin
    • TR: dialysis pts, endocarditits, and staph infections
    • A: red man syndrome, ototoxicity, nephrotoxicity, and neutropenia
    • C: pts need to keep hydrated
    • E: -Vancomycin (Vancocin) IV, cap
  14. Antihistamines
    • TR: allergies, insomnia, rashes, hay fever, and dizziness. It's also for drug reactions and allergies b/c it block the release of histamine #1 in the respiratory system
    • A: drowsiness, anticholinergic reactions such as the drying up of bodily fluids, hyperactivity in children
    • C: antihistamines have a synergistic effect with alcohol
    • E: -Azelastine (Astelin) nasal spray
    • -Cetirizine (Zyrtec) tab
    • -Diphenhydramine (Benadryl) cap, tab, top, elix, IV
    • -Fexofenadine (Allegra) tab
    • -Hydroxyzine (Atarax, Vistaril) tab, cap, syrup, IM, IV
    • -Loratadine (Claritin) tab, syrup
    • -Promethazine (Phenergan) tab, syrup, supp, IM, IV
  15. Antitussives
    • TR: cough (by suppression)
    • A: CNS depression, nausea, light-headedness
    • C: dextromethorphan interacts with MAOIs; benzonatate should be swallowed, not chewed
    • E: -Benzonatate (Tessalon Perles) cap
    • -Codeine (Codeine) tab, elix
    • -Dextromethorphan (Delsym, Robitussin DM) syrup, lozange
    • -Diphenhydramine (Benadryl) cap, tab, syrup
  16. Corticosteroids
    • TR: inflammation
    • -addison's disease: a deficiency of glucocorticoids and mineralcorticoids
    • -cushing's disease: overproduction of steroids or caused by excessive administration of corticosteroids over an extended period
    • A: stomach irritation, hypertension from sodium retention, slow wound healing, thinning of skin, peptic ulcer disease, increased infections, reduced white blood cells function, truncal obesity, moon face, buffalo hump, hyperglycemia, hypokalemia, osteoporosis, alterations in mood, mainc-depressive behavior, and cataracts
    • C: Note that the adrenal cortex naturally secretes about 20mg of hydrocosrtisone daily
    • E: -Betamethasone (Diprolene) IV
    • -Hydrocortisone (Hydrocortisone) IV, tab, cream
    • -Prednisolone (Pediapred) oral solution
    • -Prednisone (Deltasone) oral solution, tab
  17. Decongestants
    • TR: temporary relief of nasal congestion from the common cold, sinusitis, and upper respiratory allergies
    • A: CNS stimulation, increased blood pressure, increased heart rate, insomnia, anxiety, tremor, rhinitis medicamentosa (to nasal sprays and drops) and headache
    • C: decongestants should be avoided if patient has diabetes, heart disease, hypertension, hyperthyroidism, prostatic hypertrophy
    • E: -Oxymetolazone (Afrin) nasal drops/spray
    • -Phenylephrine (Neo-Synephrine) nasal drops/spray,IV
    • -Pseudoephedrine (Sudafed) cap, oral, tab, oral sol
  18. Expecorants
    • TR: removes mucus from both lungs and airway passages when coughing
    • A: nausea and vomiting, drowsiness, and GI distress
    • C: patient should consume plenty of water while taking medication
    • E: -guaifenesin (Robitussin, Humibid, Mucinex) cap, tab, liquid
  19. Selective Serotonin Reuptake Inhibitors (SSRIs)
    • TR: major depression, obsessive-compulsive behavior, anxiety
    • A: nervousness, insomnia, nausea, diarrhea, loss of weight, decreased libido, and ejaculatory disturbances
    • C: delay of onset for SSRIs is 10-21days; alcohol should be avoided. SSRIs interact w/ phenytoin
    • E: -Citalopram (Celexa) tab, liquid
    • -Duloxetine (Cymbalta) cap
    • -Escitalopram (Lexapro) tab
    • -Fluoxetine (Prozac) cap, liquid
    • -Paroxetine (Paxil) tab
    • -Sertraline (Zoloft) tab
    • -Venlafaxine (Effexor) tab, ER tab
  20. Tricyclic Antideppresants (TCAs)
    • TR: depression, nocturia (bedwetting) in children
    • A: cardiotoxic in high doses postural hypertension in the elderly, drowsiness and anticholinergic effects
    • C: noticeable results may not occur for serveral weeks
    • E: -Amitriptyline (Elavil) tab, inj
    • -Doxepin (Sinequan, Zonalon) cap, oral liquid, cream
    • -Nortriptyline (Pamelor, Aventyl) cap, oral solution
  21. Monoamine Oxidase Inhibitors (MAOIs)
    • TR: atypical depression
    • A: possible hypertension
    • C: if physician changes therapy, MAOI should be discontinued for 2wks before new therapy begins. Patient should avoid foods containing tyramine (aged cheeses, certain wines, and certain yeast products); MAOIs shuld not be taken if the patient is taking ephederine, amphetamine, methylphenidate, levodopa, or meperidine
    • E: -Selegiline (Eldepryl) tab
    • -Tranylcypromine (Parnate) tab
  22. Thyroid Hormones
    • TR: missing thyroid
    • A: cardiotoxicity and hyperthyroidism
    • C: pts should undergo TSH tests. Levothyroxine injection needs to be used promptly after reconstitution
    • E: -Levothyroxine (Synthroid, Levothroid) tab, inj
    • -Liothyronine (Cytomel) tab
    • -Liotrix (Thyrolar) tab
    • -Thyroid (Armour thyroid) tab
  23. AntiParkinson Agents
    • TR: Parkinson's Disease- a group of disorders resulting from pathologic alterations of the basal ganglia
    • A: nausea, vomiting, cardiac arrhythmias, drowsiness, postural hypotension, insomnia, constipation, diarrhea
    • C: therapy is aimed at symptomatic relief. Numerous side effects may occur, resulting in a continual change of therapy. Avoid alcohol.
    • E: -Amantadine (Symmetrel) cap, syrup
    • -Benztropine (Cogentin) tab, IM, IV
    • -Levodopa-carbidopa (Sinemet) tab
    • -Ropinirole (ReQuip) tab
    • -Selegiline (Eldepryl) tab
  24. Drugs for Attention Deficit Disorder (ADD)
    • TR: ADD
    • A: various according to the drug, but common reactions include dry mouth, depression, and weight loss or gain
    • C: schedule II drugs w/ high potential for abuse. Pts taking methylphenidate should have complete blood counts performed periodically. Caffeine should be avoided b/c of its ability to decrease drugs' effectiveness.
    • E: -Amphetamine-dextroamphetamine (Adderall) tab
    • -Atomexetine (Strattera) cap
    • -Imipramine (Tofranil) cap
    • -Methylphenidate (Ritalin, Concerta) tab, timed-release tab
  25. Anticonvulsants
    • TR: Convulsions/epilepsy
    • A: sedation and loss of cognitive processes
    • C: monotherapy is preferred over polytherapy unless the pt isn't responding to monotherapy. A large # fo drug interactions may occur w/anticonvulsants. Divalproex should be taken w/ water, not w/ carbonated drinks
    • E: -Hydantoin anticonvulsants
    • --Phenytoin (Dilantin) tab, cap, susp, IV
    • --Fosphenytoin (Cerebryx) IV
    • -CNS Anticonvulsants
    • --Carbamazepine (Tegretol) tab, chew tab, susp
    • --Valproic Acid and Divalproex Sodium, which is the EC form (Depakote) cap, syrup, IV, tab
    • -Barbituate Anticonvulsants
    • --Phenobarbital (Luminal) tab, solution, IM, IV
    • -Benzodiazepines
    • --Diazepam (Valium) tab, cap, IM, IV, supp, inh
  26. MS Agents
    • TR: Multiple-sclerosis= an autoimmune disease in which the myelin sheaths around the nerves degenerate. Leads to loss of muscles and eyesight
    • A: photosensitivity
    • C: products require special storage
    • -Avonex is administered q7d
    • -Betaseron is administered qod
    • -Copaxone is given qd
    • E: -Interferon beta-1a (Avonex) inj, SC
    • -Interferon beta-1b (Betaseron) inj, SC
    • -Glatiramer acetate (Copaxone) inj, SC
    • -Tizanidine (Zanaflex) tab
  27. Alzheimer's disease agents
    • TR: Alzheimer's disease- a degenerative disease of the brain leading to dementia; depression and agitation may occur during the course of the disease.
    • A: nausea, vomiting, and diarrhea
    • C: there are no drugs that can reverse the cognitive abnormalities of Alzheimer's disease
    • E: -Donepezil (Aricept) tab
    • -Memantine (Namenda) tab
    • -Rivastigmine (Exelon) cap, oral liquid
  28. Brochodilators
    • TR: asthma and other conditions that can cause the airways to constrict, causing wheezing, dyspnea, and cough
    • A: these are sympathomimetics. They can cause nervousness, tremors, anxiety, nause, palpitations, tachycardia, or arrhythmias
    • C: pts may overmedicate themselves to control their asthma; Ipratropium solution needs to be protected from light; Salmeterol needs to be stored at room temperature; protected from freezing and direct sunlight, store this drug w/ nozzle end down
    • E: -Albuterol (Proventil, Ventolin) cap, solution, syr, tab, inh
    • - Ipratropium (Atrovent) inh, nasal spray
    • -Salmeterol (Serevent) inh
    • -Epinephrine (Bronkaid Mist, Adrenalin) inh, SC, IM, IV
    • -Ipratropium-Albuterol (Combivent) inh
    • -Tiotropium (Spiriva) inh; powdered capsule placed in a handihaler
  29. Xanthine Derivatives
    • TR: lung disease that is unresponsive to other medications (as in asthma, chronic bronchitis, or emphysema)
    • A: none
    • C: blood levels need to be maintained at 8mcg/ml to 20mcg/ml. Theophylline may interact w/ macrolide and fluroquinolones antibiotics
    • E: -Aminophylline (Truphylline) tab, liquid, IM, IV
    • -Theophylline (Theo-Dur, Slo-Phyllin [in extended-release tab]) cap, tab, soln
  30. Leukotriene Inhibitors
    • TR: these block the effects of leukotriencs, resulting in blocking of tissue inflammatory responses such as edema
    • A: headache
    • C: pts using Singulair must be older than 6yrs of age
    • E: -Montekulast (Singulair) tab
    • -Zafirlukast (Accolate) tab
  31. Mast Cell Stabilizers
    • TR: these drug are used as prophylaxis (useless in an acute attack). They inhibit inflammatory cells associated w/ bronchospasms
    • A: pts using cromolyn may experience an unpleasant taste after inhalation, hoarseness, dry mouth, and stuffy nose
    • C: airway passages must be open before use, therefore, a bronchodilator is used first in conjuction w/ mast cell stabilizers. Pt compliance is an obstacle b/c of qid dosing
    • E: -Cromolyn (Intal, Nasal Crom) inh
    • -Nedocromil (Tilade) inh
  32. Mucolytic Agents
    • TR: emphysema, bronchitis, cystic fibrosis, and TB. Mucolyctic agents break apart glycoprotein, resulting in a reduction of viscosity, easier movement and removal of secretions
    • A: none
    • C: mucomyst hass an unpleasant taste and odor, resulting in pt noncompliance
    • E: -Acetylcysteine (Mucomyst) soln
    • -Dornase Alfa (Pulmozyme) soln
  33. Tuberculosis Agents
    • TR: Tuberculosis
    • -slow, progressive respiratory disease w/ symptoms of weight loss, fever, night sweats, malaise and loss of appetite
    • -major issue w/ TB is pt compliance b/c of the length of therapy and # of meds a pt may be taking
    • -asymptomatic pts will receive isoniazid for 6-12mo pts w/ clinical symptoms are treated w/ at least 2 medications
    • A: none
    • C: pt should avoid alcohol
    • E: -Isoniazid (Laniazid, Nydrazid) tab
    • -Rifampin (Rifadin) cap, IV
    • -Ethamutol (Myambutol) tab
  34. Smoking Cessation Agents
    • TR: addictive smoking
    • A: none
    • C: none
    • E: -Buproprion (Zyban) tab
    • -Nicotine (Habitrol, Nicoderm, Nicotrol, Nicorette, Nicotrol NS) patch, gum, inh, nasal spray
  35. Antacids
    • TR: acid reflex and indigestion by neutralizing stomach acid
    • A: constipation and diarrhea
    • C: -increased frequency of dosing results in poor pt compliance
    • -reduces the effectiveness of tetracycline
    • -available as OTC
    • E: -Aluminum hydroxide (Amphojel) tab, liquid
    • -Aluminum hydroxide-magnesium hydroxide (Maalox, Mylanta) tab, liquid
    • -Magnesium hydroxide (Milk of Magnesia or MOM) tab, liquid
  36. H2 Antagonists
    • TR: Acid reflex and indigestion by blocking gastric acid and pepsin secretion from histamine, gastrin, certain foods, caffeine, and cholinergic stimulation through competitive inhibition of H2 receptors of the gastric parietal cells
    • A: constipation and drowsiness
    • C: -bedtime dose is extremely important in therapy
    • -drug interactions include ASA, alcohol, caffeine, and cough/cold preparations
    • -available as OTC in lower doses
    • -famotidine IV should be stored at room temp. reconstituted oral suspension can be stored at room temp and will expire in 30 days
    • E: -Cimetidine (Tagamet) tab, liquid, IM, IV
    • -Ranitidine (Zantac) tab, liquid, IM, IV, oral soln
    • -Famotidine (Pepcid) tab, susp, IM, IV
  37. Proton Pump Inhibitors
    • TR: GERD, erosive esophagitis, taken w/ other agents in treatment of Helicobacter pylori
    • A: diarrhea, dehydration
    • C: capsules may be opened up and placed in apple sauce if pt has difficulty swallowing
    • E: -Esomeprazole (Nexium) cap
    • -Lansoprazole (Prevacid) cap, oral powder packets
    • -Omeprazole (Prilosec) cap
    • -Pantoprazole (Protonix) tab, IV
  38. Coating Agents
    • TR: ulcers
    • A: none
    • C: none
    • E: -Alginic Acid (Gaviscan) tab, chew tab, liq
    • -Sucralfate (Carafate) tab, oral susp
  39. Anit-Inflammatory Agents
    • TR: Crohn's disease and ulcerative colitis
    • A: nausea, vomiting, and headache
    • C: sulfasalazine is contraindicated in pts allergic to sulfonamides and ASA.
    • -will bind to iron tabs
    • -pt needs to keep hydrated
    • -take this medicine after meals
    • -will stain urine orange-yellow and permanently stain soft contact lenses yellow
    • E: -Mesalamine (Rowasa, Asacol, Pentasa) supp, enema, tab, cap
    • -Sulfasalazine (Azulfidine) tab, liq
  40. Antidiarrheals
    • TR: diarrhea
    • A: constipation, respiratory depression, drowsiness
    • C: diarrhea can cause dehydration. It can also make more serious conditions, including malabsorption of drugs and nutrients
    • E: -Attapulgite (Kaopectate) liq, tab
    • -Bismuth Subsalicylate (Pepto Bismol) tab, caplet, liq
    • -Diphenoxylate w/atropine (Lomotil) tab, liq
    • -Loperamide (Imodium) caplet, cap, liq
  41. Emmolients/Lubricants/Saline Laxatives
    • TR: constipation
    • A: nausea, vomiting, diarrhea
    • C: emmolient laxatives draw water into the colon, resulting in bowel evacuation
    • E: -Docusate calcium (Surfak) tab, cap, liq
    • -Lactulose (Cephulac) soln
    • -Mineral Oil (Mineral Oil) soln
    • -Magnesium Hydroxide (MOM) liq
    • -Sodium Phosphate (Fleet Phospha-soda) liq
  42. Stimulant Laxatives
    • TR: constipation
    • A: diarrhea, allergic reactions such as hives and peripheral swelling
    • C: stimulant laxative increases gut activitiy from mucosal stimulation
    • E: -Bisacodyl (Dulcolax) tab, supp
    • -Senna (Senokot) tab, syr, granules
  43. Bulk-Forming Laxatives
    • TR: constipation
    • A: diarrhea, allergic reactions such as hives and peripheral swelling
    • C: bulk-forming laxatives work by increasing fiber in the diet, resulting in intestinal peristalsis
    • E: -Methylcellulose (Citucel, Fibertrim) tab, powder
    • -Psyllium Hydrophilic Mucilloid (Metamucil) powder
  44. Bowel Evacuant Laxatives
    • TR: bowel evacuants are used to cleanse the bowel before GI examination
    • A: none
    • C: -bowel evacuants work by increasing the osmolarity of bowel fluids
    • -8oz should be taken every 10min until 4L is consumed
    • E: -polyethylene glycol-electrolyte solution (PEG,GoLYTELY or NuLYTELY)
  45. Antiemetics
    • TR: vomiting (most consistently used prophylactically for pts on chemotherapy)
    • A: drowsiness
    • C: -antiemetics work by inhibiting the impulse going from the chemo trigger some zone to the stomach
    • -phenothiazines may cause hypotension and must be used cautiously in children b/c of potential of overdosage resulting seizures
    • -promethazine suppositories need to be refrigerated and protected from light
    • E: -Chlorpromazine (Thorazine) tab, cap
    • -Dimehydrinate (Dramamine) tab, chew tab, oral soln
    • -Granisetron (Kytril) tab, IV
    • -Hydroxyzine (Atarax) tab, syr, IM, IV
    • -Meclizine (Antivert, Bonine [OTC]) tab
    • -Metoclopramide (Reglan) tab, syr, IM, IV
    • -Ondansetron (Zofran) tab, IV
    • -Prochlorperazine (Compazine) tab, cap, syr, IV, supp
    • -Promethazine (Phenergan) tab, syr, IM, IV, supp
    • -Trimethobenzamide (Tigan) cap, IM, supp
  46. Antiflatulents
    • TR: flatulance, gastric bloating, and postoperative gas pains
    • A: none
    • C: -decrease tension in bubbles which can be released more easily
    • -bloating and constipation not adverse reaction per se, but are common effects when simethicone is used
    • E: Simethicone (Gas X, Mylicon, Phazyme) tab
  47. Obesity Drugs
    • TR: obesity
    • A: CNS stimulation, dizziness, fatigue, dry mouth, insomnia, nausea, abdominal discomfort, constipation, hypertension, palpitations and arrhythmias
    • C: all are controlled substances, except Xenical
    • E: -Diethylproprion (Tenuate) tab [appetite suppresant]
    • -Phentermine (Fastin, Ionamin) cap ['' '']
    • -Orlistat (Xenical) cap [prevents absorption of fats]
    • -Sibutramine (Meridia) cap [appetite suppresant]
  48. Thiazide Diuretics
    • TR: hypertension and other cardiovascular diseases. Diuretics maintain balance of water, electrolytes, acids and bases in the body
    • A: hypokalemia, hypomagnesemia, hyperuricemia, hyperglacemia, hypercalcemia, photosensitivity
    • C: -thiazide diuretics promote sodium and water excretion, decrease Na levels in blood vessels and decrease vasoconstriction
    • -pts may be advised to take potassium supplements or add bananas or oranges to their diet
    • E: -Hydrochlorothiazide (Hydrodiuril, Esidrix) tab
  49. Loop Diuretics
    • TR: hypertension and other cardiovascular diseases. Diuretics maintain balance of water, electrolytes, acids and bases in the body
    • A: low levels of sodium, chloride, magnesium, calcium, and potassium
    • C: -loop diuretics inhibit reabsorption of sodium and chloride in the ascending loop of Henle and distal renal tubules resulting in urinary excretion of water
    • - pts may be advised to take potassium supplements or add bananas or oranges to diet
    • -diuretics should be taken early in day to avoid nocturia
    • -discolored furosemide or soln should be discarded
    • E: -Bumetanide (Bumex) tab, inj
    • -Furosemide (Lasix) tab, oral soln, IM, IV
    • -Torsemide (Demadex) tab, IV
  50. Potassium-Sparing Diuretics
    • TR: hypertension and other cardiovascular diseases. Diuretics maintain balance of water, electolytes, acids, and bases in the body
    • A: hyperkalemia, arrhythmias, gynecomastia in males
    • C: Contraindicated w/ ACE inhibitors
    • E: -Amiloride (Midamor) tab
    • -Spironolactone (Aldactone) tab
    • -Triamterene (Dyrenium) cap
  51. Combination Diuretic Products
    • TR: hypertension and other cardiovascular diseases
    • A: hyperkalemia, pt taking maxzide may experience a change in urine color (blue-green)
    • C: contraindicated w/ ACE inhibitors
    • E: -Bisoprolol-hydrochlorothiazide (Ziac) tab
    • -Triamterene-hydrochlorothiazide (Dyazide, Maxzide) tab, cap
    • *hydrochlorothiazide= HCTZ
  52. Membrane-Stabilizing Agents
    • TR: arrhythmias (contraindications of ventricle and atria are not synchronized) works by slowing the movement of ions into the cardiac cells, reducing action potential
    • A: nausea, vomiting, dizziness
    • C: -Procainamide and quinolone are extremely similar and have been interchanged in therapy
    • -Lidocaine is the drug of choice for emergency IV therapy
    • E: -Disopyramide (Norpace) cap
    • -Flecainide (Tombocor) tab
    • -Lidocaine (Xylocaine) IV
    • -Procainamide (Pronestyl) tab, cap, IM, IV
    • -Mexiletine (Mextil) tab
    • -Propafenone (Rythmol) tab
    • -Quinidine (Quinaglute) tab, IM, IV
  53. Inhibitors of Nuerostransmitter Release & Uptake
    • TR: arrhythmias (works by preventing the release of various transmitters and prolong the action potential)
    • A: hypotension, bradycardia [decrease heart rate], mental depression and decreases sexual ability
    • C: IV amiodarone must be mixed in a glass or DEHP-free container w/ D5W
    • E: -Amiodarone (Cordarone) tab, IV
    • -Sotalol (Betapace)tab
  54. Calcium Channel Blockers
    • TR: arrhythmias (prevents movement of calcium ions through slow channels, resulting in a reduction through the AV node, SA node action, and relax coronary artery smooth musle
    • A: bradycardia, hypotension, heart block, cardiac failure, constipation, headache, and dizziness
    • C: Diltiazem must be kept in a light-resistent container
    • E: -Diltiazem (Cardizem) cap, tab, IM, IV
    • -Verapamil (Isoptin, Calan, Verelon) tab, cap, IV
  55. Beta-Blockers
    • TR: Angina (beta-blockers slow the heart rate, resulting in decreased myocardial contractility and lowered blood pressure, resulting in a decrease in oxygen demand)
    • A: bradycardia
    • C: -may mask symptoms of hypokalemia and hyperthyroidism
    • -medication should be tapered off when discontinuing therapy
    • E: -Atenolol (Tenormin) tab, IV
    • -Metoprolol (Lopressor, Toprol XL) tab, IV
    • -Nadolol (Corgard) tab
    • -Propranolol (Inderal) cap, tab, soln, IV
  56. ACE inhibitors
    • TR: hypertension (they block angiotensin-converting enzymes to prevent the conversion of angiotensin I to angiotensin II, resulting in a reduction in total peripheral resistance and improving elasticity of arteries)
    • A: dry, unproductive cough; dizziness in the 1st few days of therapy, angioedema, postural hypotension
    • C: ACE inhibitors have a potassium-sparing effect, so be aware of possible hyperkalemia
    • -avoid in pts receiving lithium
    • E: -Benazepril (Lotensin) tab
    • -Captopril (Capoten) tab
    • -Enalapril (Vasotec) tab, IV
    • -Lisinopril (Prinivil, Zestril) tab
    • -Quinapril (Accupril) tab
    • -Ramipril (Altace) cap
  57. ACE-II Antagonists
    • TR: hypertension (ACE-II antagonists block the action of angiotensin II at its receptors)
    • A: angioedema and cough
    • C: none
    • E: -Candesartan (Altacand) tab
    • -Irbesartan (Avapro) tab
    • -Losartan (Cozaar) tab
    • -Telmisartan (Micardis) tab
    • -Valsartan (Diovan) cap
  58. CNS Hypertensives
    • TR: hypertension (they reduce the sypathetic outflow from the vasomotor center in the brain, which decrease heart rate, cardiac output, and total peripheral resistance)
    • A: drowsiness, fatigue, depression, fluid retention
    • C: none
    • E: -Clonidine (Catapres) tab, patch, IV
    • -Guanfacine (Tenex) tab, liq
    • -Methyldopa (Aldomet) tab, susp, IV
  59. Peripheral Antihypertensives
    • TR: hypertension (they block alpha stimulation to peripheral nerves, resulting in vasodilation and hypotension)
    • A: hypotension
    • C: none
    • E: -Doxazosin (Cardura) tab
    • -Prazosin (Minipres) cap
    • -Terazosin (Hytrin) cap
  60. Vasodilator
    • TR: hypertension (work by reducing arteriole smooth muscle, resulting in lower peripheral resistance)
    • A: tachycardia, palpitations, flushing and headache
    • C: none
    • E: -Fonoldopam (Corlopam) IV
    • -Hydralazine (Apresoline) tab
    • -Minoxidil (Loniten) tab
  61. Anticoagulants
    • TR: improper/excessive blood coagulation leading to blood clots
    • A: bleeding, urine may turn red-orange, and feces may turn red or black
    • C: -pts on warfarin should avoid food rich in vitamin K
    • -blood clotting is monitored through prothrombin or INR testing
    • -heparin is given IV or SC, but never IM
    • - overdose of warfarin is treated w/ mephyton
    • -overdose of heparin is treated w/ protamine sulfate
    • E: -Dalteparin (Fragmin) SC
    • -Enoxaparin (Lovenox) SC
    • -Fondaparinux (Arixtra) inj
    • -Heparin (Heparin) IV, SC
    • -Lepirudin (Refludan) IV
    • -Warfarin (Coumadin) tab, IV
  62. HMG-CoA Reductase Inhibitors
    • TR: hyperlipidemia (by decreasing the rate at which the body produces lipids)
    • A: GI upset, headache, muscle pain and fever
    • C: liver function tests should be conducted every 6months
    • E: -Atorvastatin (Lipitor) tab
    • -Fluvastatin (Lescol) cap
    • -Pravastatin (Pravachol) tab
    • -Rosuvastatin (Crestor) tab
    • -Simvastatin (Zocor) tab
  63. Fibric Acid Derivatives
    • TR: hyperlipidemia (unknown method of action)
    • A: headache, nausea, vomiting, diarrhea, skin rash, alteration in liver and kidney function
    • C: none
    • E: -Clofibrate (Atromid S) cap
    • -Fenofibrate (TriCor) cap
    • -Gemfibrozil (Lopid) tab, cap
  64. Bile Acid Sequestrants
    • TR: hyperlipidemia (by forming a complex w/ bile acids in the intestine)
    • A: nausea and vomiting
    • C: none
    • E: -Cholestyramine (Questran) powder
    • -Colesevelam (Welchol) tab
    • -Colestipol (Colestid) tab, granule
  65. Narcotic/Opioid Analgesics, schedule II
    • TR: pain
    • A: respiratory depression, constipation, mental confusion, nausea and vomiting
    • C: -pts can become tolerant or addicted
    • -all opiates are controlled substances
    • -pts should increase fluid intake and use stool softeners
    • E: -Codeine (Codeine) tab, IM, oral soln
    • -Fentanyl (Duragesic) td patch, IV
    • -Hydromorphone (Dilaudid) tab, syrup, liq, IM, IV, SC, supp
    • -Meperidine (Demerol) tab, syrup, IM, IV, SC
    • -Methadone (Dolophine) liq, tab, IV
    • -Morphine (MS Contin) tab
    • -Oxycodone-APAP (Percocet, Tylox) tab, cap
    • -Oxycodone-ASA (Percodan) tab
  66. Narcotic/Opioid Analgesics, schedule III
    • TR: pain
    • A: respiratory depression, constipation, mental confusion, nausea, and vomiting
    • C: -pts can become tolerant or addicted
    • -all opiates are controlled substances
    • - pts should increase fluid intake and use stool softeners
    • E: -APAP w/Codeine (Tylenol w/Codeine) cap, tab, IM, IV, SC, elix
    • -Hydrocodone (Hycodan) tab, syr
    • -Hydrocodone- APAP (Lortab, Vicodin) tab, elix
  67. Narcotics/Opioid Analgesics, schedule IV
    • TR: pain
    • A: respiratory depression, constipation, mental confusion, nausea, and vomiting
    • C: -pts can become tolerant or addicted
    • -all opiates are controlled substances
    • -pts should increase fluid intake and use stool softeners
    • E: -Butophanol (Stadol, Stadol NS) nasal spray, IM
    • -Pentazocine-Naloxone (Talwin NX) tab
    • -Propoxyphene-APAP (Darvocet N) tab
    • -Propoxyphene-HCI (Darvon) cap

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