Drug Classification Flashcards
Analgesic
These medications provide mild to moderate pain relief without interfering with the patient’s level of consciousness; most useful for minor to moderate symptoms of traumatic injury and skeletal muscle aches and pains.
Action: Prostaglandin inhibitors and antagonists, nonsteroidal anti-inflammatories (NSAIDs), and COX-2 inhibitors
Example: Advil, naproxen, Celebrex, aspirin, Tylenol
Anesthetic
Medications in this group vary from topical to intravenous to inhaled preparations. Topical agents may be used to facilitate suturing of traumatic lacerations, with effects lasting for a few hours. Produces a lack of feeling. May be local or general, depending on the type and the route of administration. Most of the drug’s effects resolve with discontinuation of the drug, but some residual effects can remain for several hours following discontinuation.
Action: Anesthetics interfere with the body’s ability to experience pain sensations, blocking conduction of neural impulses or enhancing naturally occurring inhibitory channels
Example: lidocaine HCl (Xylocaine), procaine HCl (Novocaine), Esfluorane
Antacid
Aluminum-containing antacids can cause constipation; those containing magnesium can cause diarrhea; and those containing calcium can increase serum calcium levels and decrease phosphate levels. All these drugs can have significant effects on the metabolism of other medications, which might cause toxicity or prevent absorption.
Action: Neutralize stomach acid by increasing pH
Example: Amphojel, Gelusil, Mylanta, Aludrox, Milk of Magnesia
Antianxiety
Relieve anxiety and muscle tension. They are supplied in oral and injectable forms, and some are available for intravenous injection.
Action: Produces a calming effect or increases a patient’s feelings of well-being by helping balance certain chemicals in the brain, either enhancing some or decreasing the effects of others
Example: benzodiazepines: diazepam (Valium) and chlordiazepoxide HCl (Librium)
Antiarrhythmic
Cardiac electrical rhythm is maintained through a balance of chemical activity
Action: These medications control cardiac arrhythmias by altering chemical activity through suppression of extra electrical impulses or blocking the effects of certain chemicals. Actions are divided into four categories:
Class I drugs act on sodium channels by slowing conduction in fast-channel tissues that are in the atria and ventricles.
Class II drugs are beta-blockers, working on the slow-channel tissues of the sinoatrial and atrioventricular nodes. *These drugs are contraindicated in asthmatic patients.
Class III drugs interfere with potassium channels to prolong the period in which the next heart beat can occur. These drugs work in slow- and fast-channel tissues to reduce automaticity (the capacity of all cardiac tissues to conduct impulses) without interfering with the conduction velocity (speed of impulse conduction) of impulses that are permitted.
Class IV drugs work by blocking calcium channels, reducing automaticity, conduction velocity, and refractoriness (increasing the period in which the next heart beat can occur).
Example: lidocaine HCl (Xylocaine), propranolol HCl (Indera
Antibiotic
Those at increased risk of developing a secondary bacterial infection may be given antibiotics as a preventive measure. “Broad-spectrum” antibiotics may also affect good bacteria that reside in the intestinal tract, causing diarrhea or constipation. Some antibiotics require monitoring of levels to avoid toxicity, especially in patients with liver or kidney disease. Unnecessary use of antibiotics increases the occurrence of antibiotic-resistant bacterial infections, for example, MRSA (Methicillin-resistant Staphylococcus aureus)
Action: Used to cure infections by either killing or injuring bacteria to render them incapable of replication. Antibiotics treat only bacterial infections and have no effect on viral or fungal infections.
Example: penicillins (Pentids, Duracillin, Polycillin, Pipracil, Augmentin), cephalosporins (Keflin, Mandol, Rocephin)
Anticholinergic
Used for stomach and intestinal cramping and reduction of acid secretion
Action: Blocks parasympathetic nerve impulses to slow stomach and intestinal tract activity
Examples: atropine, scopolamine, trihexyphenidyl HCl (Artane)
Anticoagulant
Blood thinners, inhibit the action of blood proteins that form blood clots in response to injury or inflammation.
Used for patients with: genetic trait that causes excessive formation of blood clots, irregular heart rhythm, patients with artificial heart valve, and those at risk of heart attack or stroke from clots.
Actions: Prevents or delays blood clotting and prevents existing clots from extending or getting larger
Examples: heparin sodium, Dicumarol, warfarin sodium (Coumadin), enoxaparin (Lovenox)
- Coumadin requires careful monitoring; Lovenox does not.
Anticonvulsant
Seizures or convulsions are caused by sudden or abnormal amounts of electrical activity in the brain, which can be a result of a chemical imbalance or a traumatic injury.
Actions: Prevents or relieves seizures by halting or delaying transmission of excess electrical impulse; prevents skeletal muscles from responding to the impulses
Examples: carbamazepine (Tegretol), phenytoin (Dilantin), ethosuximide (Zarontin)
Antidepressant
An important note on these drugs is that a side effect may be worsening depression, especially in the initial treatment phase, so careful monitoring is required. MAOIs interact with a number of foods, including wine and fermented cheeses, which can cause a dangerous and sudden increase in blood pressure.
Actions: Prevents or relieves the symptoms of depression by interfering with the brain’s ability to receive certain chemicals that affect mood and feelings of well-being
Examples: monoamine oxidase (MAO) inhibitors: isocarboxazid (Marplan), phenelzine sulfate (Nardil), amitriptyline HCl (Elavil), imipramine HCl (Tofranil)
Antidiarrheal
Diarrhea can quickly lead to dehydration, especially in the very young and very old. Patients should increase fluid intake while taking these medications to avoid constipation. Caution should be advised when using these drugs in children with infections such as chickenpox or the flu because bismuth-containing medications might contribute to Reye’s syndrome.
Actions: Prevents or relieves diarrhea either by causing a thickening of the stools, as in psyllium-containing compounds, or by decreasing intestinal spasms
Examples: Lomotil, Pepto-Bismol, Kaopectate, Imodium
Antidote
The type and form of an antidote administered depends on the poison or overdose taken; there is no universal antidote. One concern regarding administration of Narcan is for patients who have accidentally overdosed on pain medications needed to control the pain of terminal illness. Narcan will remain in the patient’s system for several hours and block the effects of narcotic pain medications; it can also induce withdrawal symptoms. The decision to administer an antidote is not based solely on the compound taken but on the consequences not only of the agent ingested but of that agent’s sudden reversal.
Actions: Counteracts poisons and their effects selectively by binding with the drug or toxin to inhibit further absorption, blocking further effects on target receptor sites or by reversing the actions of the ingested agent.
Examples: naloxone (Narcan), activated charcoal, atropine
Antiematic
In controlling nausea and vomiting, the antiemetic chosen is based on the suspected cause of the symptoms as well as underlying medical problems and other medications the patient might be taking. Pregnancy, motion sickness, chemotherapy, migraines, and postoperative nausea are causes of nausea that can require the use of antiemetics.
Action: Prevents or relieves nausea and vomiting by blocking the effects of dopamine, serotonin, or histamine release
Examples: Tigan, Dramamine, Phenergan, Reglan, Marinol, Scopolamine
Antihistamine
Histamine is a protein released by the body in response to allergens. Its release causes an inflammatory response and constriction of smooth muscles, particularly in the airways of asthmatic patients. In a mild reaction, the effects of histamine release will continue to resolve over several hours even after administration of antihistamines. For more severe reactions, other medications can be used in conjunction with the antihistamine to reverse the allergic reaction’s effects. Patients who are taking certain medications, such as MAO inhibitors or drugs that cause drowsiness, and patients with glaucoma or women who are breastfeeding should avoid taking antihistamines.
Action: Antihistamines act by blocking the effects of histamine at the receptor sites. When administered in response to an allergic reaction, antihistamines prevent further activation of the receptor sites that are causing the response, but they do not reverse what has already occurred.
Example: Dimetane, Benadryl, Seldane
Antihypertensive
Blood pressure control is essential in patients with hypertension to protect them from kidney damage, heart complications, and stroke. Patients often experience fatigue, sexual side effects, or other symptoms that can interfere with their willingness to continue drug therapy. The MA can help the patient anticipate potential side effects and understand that they might resolve after a period of time on the medication.
Action: Prevents or controls high blood pressure through decreasing heart rate, dilating blood vessels, or reducing circulating fluid volume
Example: methyldopa (Aldomet), clonidine HCl (Catapres), metoprolol tartrate (Lopressor)
Anti-inflammatory
Pain and swelling may be treated with anti-inflammatory drugs such as aspirin, ibuprofen, or naproxen. They may be used alone, for milder symptoms, or in conjunction with narcotic pain relievers to reduce the amount of narcotics required for adequate relief. Certain anti-inflammatory drugs, NSAIDs (non-steroidal anti-inflammatory drugs), or COX-2 inhibitors have been known to contribute to heart attack and stroke in patients who are at increased risk of developing blood clots. Although useful for acute inflammation, they can delay healing.
Action: Counteracts inflammation by blocking the release of certain chemicals
Example: naproxen (Naprosyn), aspirin, ibuprofen (Advil, Motrin)
Antimanic
Antimanic drugs can help level patients’ moods in both directions, not just treat the manic episodes. These patients might need encouragement to continue their medication when they are feeling better.
Action: Used for the treatment of the manic episode of bipolar disorder
Example: lithium
Antineoplastic
Although antineoplastic agents are very useful in treating cancers, they have toxic effects on healthy tissues as well and cause a number of unpleasant and sometimes dangerous side effects.
Action: Stops the development, maturation, or spread of a neoplasm or cancer cell
Example: busulfan (Myleran), cyclophosphamide (Cytoxan)
Antiplatelets
Patients who are at increased risk of heart or stroke from blood clots. Antiplatelets do not require the monitor associated with anticoagulants and have less of a bleeding risk. Patients would be advised of increased tendency toward bruising or bleeding.
Action: Interferes with the stickiness of platelets to help prevent blood clot formation.
Example: Plavix (clopidogrel), Ticlid (ticlopidine), aspirin
Antipyretic
Febrile seizures in toddlers have not been shown to be predictive of seizures when the child is older.
Action: Reduces fever by acting on the hypothalamus, the heat-regulating part of the brain
Example: aspirin, acetaminophen (Tylenol)
Antitussive
Antitussives can be narcotic or nonnarcotic preparations.
Action: Decreases the cough reflex by acting on the central and peripheral nervous systems
Example: codeine, dextromethorphan
Bronchodilator
These medications often make patients feel jittery. Some are used as a “rescue” for acute onset of symptoms, whereas others are used for maintenance and prevention.
Action: Dilates the bronchi by relaxing the smooth muscle that lines the air passages
Example: isoproterenol HCl (Isuprel), albuterol (Proventil)
Contraceptive
Women who are overweight, older than 35 years old, or who smoke are at increased risk of heart attack and stroke from blood clots when taking estrogen-containing oral contraceptives. The morning-after pill is a form of emergency contraception containing progestin if a barrier method fails or there is unintended, unprotected sex (regardless of whether consensual). It is not an abortion pill but works the same three ways as ordinary hormonal birth control methods to prevent pregnancy when taken within 120 hours of intercourse.
Action: Oral contraceptives act by preventing release of an ovum, preventing fertilization of an egg, or inhibiting implantation in the uterus of a fertilized egg. Forms of contraception include condoms, diaphragms, intrauterine devices, sponges, and cervical caps.
Example: Enovid-E 21; Ortho-Novum 10/11–21, 10/11–28; Triphasil-21
Decongestant
Because these drugs act through vasoconstriction, patients with heart disease and high blood pressure should not take OTC decongestants without first discussing with their doctor.
Action: Reduces swelling in nasal passages through vasoconstriction to help relieve the pressure sensation in sinuses, improving airflow and making it easier to breathe through the nose
Example: oxymetazoline (Afrin), epinephrine HCl (Adrenalin), phenylephrine HCl (Neo-Synephrine), pseudoephedrine HCl (Sudafed)
Diuretic
Useful either alone or in combination with other drugs to treat hypertension, heart failure, pulmonary edema, edema associated with severe head trauma, and glaucoma.
Action: Increases the production of urine and decreases circulating fluid volume by increasing renal blood flow to improve filtration and by decreasing sodium reabsorption
Example: chlorothiazide (Diuril), furosemide (Lasix), Mannitol (Osmitrol)
Expectorant
Patients should be advised to drink plenty of water when using these medications.
Action: Thins mucus, making it easier to cough it up and clear the airway of secretions
Example: guaifenesin (Robitussin)
Fibrinolytics
Sudden onset (acute) episodes of heart attack or stroke may be caused by a blood clot blocking a critical artery. Used with other anticoagulants, such as Heparin, to prevent smaller clots from forming from the destruction of larger clots.
Action: Clot-buster drugs that dissolve blood clots for emergency treatment of heart attacks and strokes. Destroys existing clots.
Example: TNK, tPA
Hemostatic
May be supplied in an oral form for a genetic clotting deficiency; injectable for surgical bleeding or to reverse the effects of anticoagulant medications; or as a topical dressing containing a hemostatic agent used for external bleeding.
Action: Encourages the formation of a blood clot to control or stop bleeding
Example: Humafac, Amicar, vitamin K, alginate dressings
Hypnotic
Patients may develop dependency when using hypnotics for long periods of time. Not to be taken with alcohol or other sedating medications to avoid respiratory depression.
Action: Acts on brain receptors to induce a sense of calm and reduce tension and anxiety
Example: secobarbital (Seconal), chloral hydrate ethchlorvynol (Placidyl), flurazepam (Dalmane), diazepam (Valium)
Hypoglycemic, oral
Many of these drugs may be used alone or in conjunction with insulin. Careful monitoring of liver and kidney function should be observed. Diabetics need to receive adequate dietary and blood glucose monitoring and control teaching.
Action: Lowers blood glucose levels by causing beta cells of the pancreas to release more insulin; acts on the liver to decrease formation of glycogen; decreases absorption of glucose in the intestines; blocks the breakdown of some sugars; prevents the breakdown of GLP-1, a naturally occurring substance that breaks down sugars; and improves use of glucose by tissues, especially skeletal muscles.
The six types of oral hypoglycemics are sulfonylureas, meglitinides, biguanides, thiazolidinediones, alpha-glucosidase inhibitors, and DPP-4 inhibitors.
Example: (Diabinese), glyburide (Micronase), Amaryl, Glucophage
Insulin
Injectable insulin is given on a routine schedule based on mealtimes to help the body use sugars. In emergencies, the insulin may be given through an IV. To decrease the number of injections a person receives, some insulins may be combined in one injection.
Action: Insulin lowers blood glucose levels to a normal range by allowing the sugar to cross the cell membrane to be used for energy. (This is a decidedly oversimplified explanation; much is still not understood about insulin.) There at least 20 types of insulins, which are divided into four basic categories: rapid-acting, regular or short-acting, intermediate, and long-acting insulins. Some patients require more than one type of insulin to control their diabetes.
Example: Lantus, Humulin, Novolin
Laxative
Lubricants, stimulants, and stool softeners are also effective and may be used in combination for better result. Salts are used for rapid action. Lactulose causes a slower onset of action, is suitable for more prolonged use, and is available only with a prescription. Polyglycol causes water to be retained in stool and is used for short periods of time. Abuse of laxatives is a common issue in anorexic or bulimic patients.
Action: Relieves constipation by absorbing liquid into the intestines to form a soft stool, encourage bowel movements by drawing water into the bowel
Example: Metamucil powder, Dulcolax
Muscle Relaxant
These medications are NOT interchangeable for muscle spasms of different disease processes or injuries.
Action: Muscles spasms are caused by peripheral musculoskeletal problems, such as back or neck pain, and neurological conditions such as multiple sclerosis. The mechanism of action is not well understood. Most appear to act on receptor sites in the central nervous system; a few act directly on striated muscle tissue.
Example: Robaxin, Norflex, Paraflex, Skelaxin, Valium
Sedative/ Tranquilizer
Often considered part of the hypnotics or sedative-hypnotics. Many sedatives are habit-forming or addictive when used improperly. Advise patients to avoid taking sedatives with alcohol because a dangerous decrease in consciousness or breathing can occur.
Action: Produces a calming effect to reduce mental tension and anxiety without causing sleep. They work by suppressing activity in the central nervous system.
Example: amobarbital (Amytal), butabarbital sodium (Buticaps), phenobarbital, zolpidem (Ambien), Haldol, thorazine
Vasodilator
Increases blood supply to tissues, i.e., the heart muscle, to prevent permanent damage and to lower blood pressure. Caution patients beginning a new vasodilator to sit or lie down to avoid an unsafe drop in blood pressure. Use in conjunction with Cialis or Viagra can cause a dangerous and irreversible drop in blood pressure. Relaxes the smooth muscle inside the vessel walls to cause the inner diameter of the vessel wall to widen, lowering blood pressure and allowing for increased circulation to the area supplied by the vessel isosorbide dinitrate (Isordil), nitroglycerin
Vasopressor
Either during or following major surgery, sepsis, or significant blood loss, patients might need chemical blood pressure support in the form of a vasopressor. These are available only in IV form to be used in the hospital setting.
Action: Causes contraction of the smooth muscles that line the walls of blood vessels to increase blood pressure
Example: Neo-Synephrine, norepinephrine (Levophed)
