Drug Classes Flashcards
Adrenergic Agonists
General effects: incr HR, electrical conduction
bronchodilator, optical dilation, peripheral vasoconstriction
Include:
Epinephrine
Norepinephrine
Isoproterenol
Dobutamine
Albuterol
Adrenergic Antagonists
Betablockers
eg Metoprolol, Carvedilol
Block B1 receptors -> decr HR and contractility, decr RAAS and glycogenolysis
Muscarinic (Cholinergic) Agonists
Relaxation
UO incr and release
decr HR and BP
Incr GI movement and secretions
eg. Bethanechol (Urecholine)
Muscarinic (Cholinergic) Antagonists
Decr secretions and gut motility, UO/urge, peripheral blood flow, eye dilation
eg. Atropine
Tolteradine, Oxybutynin (for overactive bladder)
Diuretics
For HTN, hypervolemia, edema, HF
Effect: Decr Na, Cl, and H2O reabsorption, Decr BP
SdE: hypovolemia and hyperKalemia
NN: monitor weight, I/O, fall rx and voiding urgency! take in AM
e.g. Thiazides (HCTZ), Furosemide (Lasix), Spironolactone, Mannitol
Anti-hypertensives
Block SNS, RAAS, renal fluid retention, decr SVR e.g. ACEi (Lisinopril), ARB (Valsartan), CCB (Nifedipine), BBs (Hydralazine & Metoprolol)
Watch for fluid balance and arrhythmias
Anti-Platelets
For Acute thrombotic events, eg strokes, MI, PE
SdE: GI irritation, bleeding rx, tinnitus (ASA OD) NN: know drug life, appropriate doses for ASA (81-325 vs 650mg)
Block COX/other receptor activation in clotting cascade -> platelet plug won’t form
E.g. Aspirin, Clopidogrel, Ticlopidine
Anti-Coagulants
Inhibit or block clotting cascade or thrombin directly
For acute or chronic use,
SdE: bleeding rx NN: some are teratogens, know normals for aPTT (Hep) and PT/INR (Warf)
Heparin (acute) Enoxaparin Warfarin (chronic) Dabigatran Apixaban
Thrombolytics
Activate plasminogen to dissolve fibrin in clots For acute events and declotting CLs (once you’ve tried everything else)
SdE: bleeding rx
NN: recognize sx of internal bleeding! don’t do any unnecessary procedures that could cause them to start bleeding!
most effective for strokes <3-4.5 hrs after Alteplase (tPA)
Calcium channel blockers
For HTN, esp AA pts, and Angina management SdE: flushing, HA, incr HR (Ca other effect), edema
E.g. Nifedipine, Amlodipine
Beta Blockers
For tachycardia, HTN, HF
SdE: bradycardia, hypoglycemia
Metoprolol
Angiotensin-conversion-enzyme inhibitor (ACEi)
For HTN, HF
SdE: hypovolemia, vasodilation, K RETENTION, decr cardiac remodeling, OH, cough
ASdE: angioedema (swollen tongue, lips - a/w rx!)
Lisinopril, Enalapril (Vasotec), Altace
Angiotensin-receptor blocker (ARB)
For HTN, HF
SdE: same as ACEi’s
Valsartan
Amphetamines
CNS stimulants; Levo- and dextroamphetamine types
For ADHD, narcolepsy, obesity
SdE: irritability, tachycardia, sleep disturbance, drug dependence/tolerance
Eg Adderall (ADHD, combo drug), other “-drine” drugs
Note: be careful of concurrent use w/ antidepressants or mood stabilizing drugs
Anti-Allergy Drugs
Antihistamines- Loratidine (Claratin), Fexophenadine, Diphenhydramine (Benadryl) SdE: drowsiness
Decongestants- Flonase, Pseudephedrine
SdE: sympathomimetic (amp up)
Chronic use (>3 days) -> rebound congestion!
Alzheimer’s Drugs
Incr ACh levels
Eg Aricept (Donepezil), Glantamine (Reminyl)
SdE: anorexia, n/v, dizziness, HA
-slows it, doesn’t cure it
Antibiotics
Aminoglycosides - eg Gentamicin
Cephalosporins - eg Cefazolin (Ancef)
Fluoroquinolones - eg Ciprofloxacin
Macrolides - eg Azithromycin
Penicillins - eg Amoxicillin
Sulfonamides - eg Doxycycline (Vibramycin)
Anti-infectives - eg Metronidazole (Flagyl)
Rx for hepato/nephrotoxicity, sensitivity rxn, interactions with other meds
Anticonvulsants
Carbamazepine (Tegretol)
Gabapentin (Neurontin)
Phenytoin (Dilantin) - SdE: gingival hyperplasia
Phenobarbital (Luminal)
Valproic Acid (Depakote)
Levtiracetam (Keppra)
Topiramate (Topamax)
SdE: n/v, HA, drowsy, RR decr, hypotension
Note: avoid abrupt withdrawals, incr dose slowly
Antidepressants
Tricyclic antidepressants (TCA) - Amitriptyline (Elavil), Nortriptyline (Pamelor)
SSRI - Citalopram (Celexa), Fluoxetine (Prozac), Paroxetine (Paxil), Sertraline (Zoloft)
MAOI - Phenelzine (Nardil) - avoid Tyramine foods (smoked, aged)
-don’t get along with SSRIs
Atypicals - Bupropion, Mirtazapine (Remeron)
SdE: AntiAch, HA, weight gain, sexual dysfunction, appetite incr
Note: no abrupt w/drawals
-SSRIs need minimum 2-6 weeks to avoid Serotonin syndrome
Antidiarrheals
Diphenoxylate HCL (Lomotil) Loperamide (Imodium)
SdE: tachycardia, RR drop, ileus, urinary retention, dry mouth
Watch for F/E imbalances; not suitable for C dif pts (cuz they need to eliminate the bug first)
Antiemetics
Ondansetron (Zofran)
SdE: HA, dizzy, constipation/diarrhea
Give 30-60min before chemo, avoid ETOH
Anti-gout
Reduce uric acid production and inflammation
Allopurinol (Zylo/Alloprim)
Colchicine (Colchrys, Mitigare)
SdE: n/v/d/c, cramps, GERD
Watch out for SJS w/ Allopurinol!
Teach pt to incr fluid intake to avoid renal calculi, etc!
Also used for Behçet’s disease (blood vessel inflammation)
Anti-lipidemics
Atorvastatin (Lipitor), and other statins Cholestyramine (Questran) Ezetimibe (Zetia)
SdE: n/v/c/d, cramps, abd distention, rx for T2DM
No grapefruit juice for HMG-CoA Reductase inhibitors (statins), take in the evening
Watch out for SAMS (incl rhabdomylysis) & Hepatotoxicity*
*Need to have pre-tx liver enzyme labs done.
Anti-neoplastics (CA)
Carboplatin, Cisplatin (Alkylating, DNA acting) Fluororacil, Methotrexate (Antimetabolites)
SdE: renal, GI, skin issues, nephro- or ototoxicity, alopecia (or any fast growing cells)
**top concern is infection prevention!!
Anti-osteoporotic
Alendronic Acid (Fosamax) Usually taken with Vitamin D and Calcium
SdE: GI irritation (CI for esophageal disease)
Note: take 30min before meal, stay upright
Parkinson Drugs
Restore dopamine and Ach balance
Amantadine (Symmetrel), Bromocriptine (Parlodel), Carbidopa-levodopa (Sinemet)
Benztropine (Cogentin) - anticholinergic
SdE: hypotension, incr HR, n/v/c, fatigue, dry mouth
Toxicity: muscle twitching!
AntiPsychotics
Haloperidol (Haldol), Prochlorperazine
Clozapine (Clozaril), Olanzapine (Zyprexa), Quetiapine (Seroquel), Risperidone (Risperdal), Ziprasidone
SdE: EPS (TD, Parkinsonism), sedation, hypotension, anti-ACh effects, sexual dysfunction
QT prolongation for some of them!
May take 2 weeks for effects, avoid caffeine, incr fluids to avoid anti-Ach
EPS management: Clonazepam, Benztropine
AntiSpasmodics
Scopolamine
Chlordiazepoxide (Librium)
Dicyclomine (Bentyl)
For bladder spasms (overactive B),
Anxiolytics
Benzodiazepines
- Alprazolam (Xanax), Lorazepam (Ativan) } short
- Chlordiazepoxide (Librium), Clonazepam, Diazepam } longer-acting
Non-barbiturates
-BuSpar, Benadryl, Zolpidem
SdE: decr mental alertness, euphoria, hypotension, HA, dizzy
Avoid ETOH and caffeine
Bronchodilators
Xanthines - Theophylline
Anticholinergics - Ipratropium (Atrovent)
Leukotriene antag - Montelukast (Singulair)
Inhaled steroid - Budesonide (Pulmicort), Fluticasone (Flovent)
SdE: incr HR, decr BP, HA, weakness, ur retention, dry mouth, dizzy, palpitations
Inhalers: wait 1-5min between, use bronchodilator first
Encourage fluids to avoid dry mouth
Corticosteroids
Anti-inflammatory effect; for allergies, asthma, COPD, RA, MS, IBD/UC, psoriasis, Addison’s (adrenal insufficiency)
Prednisone, Cortisone, Dexamethasone (Decadron)
SdE: decr immune response, insomnia, acne, dizzy, weight gain, slow wound healing, nausea, bloating
Be careful of live vax, NSAIDs, and antifungals
Long-term use: can incr rx for cataracts
Erectile Dysfunction Drugs
Enhance nitric oxide in body, to relax penis, enable erection
Sildenafil (Viagra), other -nafils (Stendra, Levitra)
SdE: flushing, HA, abd discomfort, backache, nasal congestion, visual changes
Don’t take in combo with some cardiac meds (Nitroglycerin) or if hypotensive
H2 Receptor Blockers
Decr histamines -> decr gastric secretions
Famotidine (Pepcid), Ranitidine (Zantac)
SdE: dizzy, HA, drowsy, confusion, nephrotoxic
Watch out for Warfarin effect (may incr), give 1-2hrs before/after antacids
Laxatives
Psyllium (Metamucil) Docusate sodium (Colace) Bisacodyl (Ducolax), Sennakot } stimulant Milk of Mag, Sodium phosphate } saline osmotic
SdE: cramps, F/E imbalance
CI for abd obstruction/pain & for n/v pt
Saline Osmotics are most rapid acting!
Fall-rx prevention/safety!
Muscle Relaxers
Cyclobenzaprine (Flexeril)
Dantrolene
Tizanidine (Zanaflex)
NSAIDs
Ibuprofen (Motrin, Advil), Naproxen (Aleve, Naprosyn)
SdE: tinnitus (Sx of toxicity!), hepatotoxicity, GI irritation/bleeding (melena)
Look out for CI/interactions w/ other meds/procedures Avoid ETOH
Opioids
Codeine, Fentanyl, Hydromorphone, methadone, morphine, oxy/hydro-codone
SdE:
Decr RR, sedation, constipation, nausea, drowsy
Can suppress cough reflex as well, not good for COPD/chronic respiratory pts
Watch for RR depression, have Naloxone on standby!
Tramadol most commonly Px for d/c, d/t lower rx for respiratory depression.
PPIs
Decr H+ ion entry into GI
Omeprazole (Prilosec), Lansoprazole (Prevacid), Pantoprazole (Protonix)
SdE: dizzy, HA, drowsy, confusion, nephrotoxic
Do NOT crush! Watch out for Warfarin effect (may incr), give 1-2hrs before/after antacids
Hypoglycemics
Sulfonylurea - Glimepiride, Glipizide
Biguanides - Metformin (Glucophage)
Meglitinides - Repaglinide (Prandin)
For T2DM
Rx for hypoglycemia (other extreme)
NOT for T1!
