Home Drug Class Flashcards
Narcotic
Opiate derived
Action: works on the MU receptors in the brain. There are also MU receptors in the abdominal.
Analgesic
for pain
narcotic
non-narcotic
Tricyclics (USES)
Used for depression (the OG of antidepressant drugs)
Other uses:
- Anticholinergic effects
- used for sleep, migraines, anti addictive disorders, and fibromyalgia.
Tricyclic (OD)
OD BLOCKS SODIUM SITES, GET WIDE QT AND TACHYCARDIA.
- have 10-15 to treat
- one pill killer
- treat with Sodium Bicarb (1mEq/kg)
MAOIs
monoamine oxidase inhibitors
treats phobias and depression.
Action: monoamine oxidase is an enzyme used in the degradation on catecholamines. when that enzyme is inhibited, catecholamines and serotonin levels increase resulting in a psychostimulation.
what should people who are on MAOIs avoid? what can you uses to treat?
- foods that have tyramine
- any sympathomimetic drugs
(both can send the patient into a hypertensive crisis)
Treat with: nitrates, CCB, and BB.
SSRI
selective serotonin reuptake inhibitor
first choice for antidepressants (the safest)
Action: keeps serotonin in the synapse longer, rather than being reuptake.
SE: headache, GI disturbances, sexual dysfunction (can get serotonin syndrome but usually from something else like St. Johns Wart – NV, tachy, agitated diarrhea, agitated)
Heterocyclic
similar to tricyclics but more stable.
Action: potentiate (increase the power) norepinephrine and block dopamine receptors and have slight anticholinergic effects.
Phenothiazines
antipsychotic medication
action: work to occupy dopamine sites resulting in decreased psychosis and sedative effect.
SE: can cause extrapyramidal side effects (EPSE)
(including tremor, slurred speech, akathesia, anxiety, distress, and can cause Tardive dyskinesia and dystonia.)
Lithium Derivatives
lithium is Greek for stone.
it was initially used as a salt substitute for cardia patients but was removed from the market with lethal side effects..
its a mood stabilizing agent. Action is not fully known but it has to do with the ability to respond to neurotransmitters by replacing the sodium ions.
Class 1a antiarrhythmic
sodium and potassium channel blockers/inhibitors
prolongs duration of action potential and increases absolute refractory period.
extends phase 2 lengthen QT interval
also block the Alpha 2 sites (helping decrease blood pressure)
Class 1b antiarrhythmic
sodium channel inhibitor (affect phase 0, not phase 2)
prophylactic (to prevent disease) use of these drugs is decreasing.
Class 1c antiarrhythmic
works on the fast sodium channels
very rare b/c they cause extreme electrical depression and decrease inotropic function and wide QRS widening
Class 2 antiarrhythmic drugs
Beta Blockers (olol)
beta 1 receptor sites (these sites in cardiac cells trigger cyclic AMP resulting in opening of calcium channels which increase HR and force of contractility)
Beta 1 blockers help to decrease the HR and force of contractility.
SE: SOB and wheezing
OD: hypotensive and Brady
Tx: glucagon, help to stimulate the cAMP and open calcium channel receptor sites
Class 3 antiarrhythmic drugs
Inhibit the potassium channels and alter phase 2
Long term use can cause long QT and TDP. And can cause pulmonary fibrosis (lung tissue will scar)
OD: very bad bc blocks everything (Na, Ca, K)
Class 4 antiarrhythmic
calcium channel blockers
help to slow cardiac conduction decreased force of cardiac contraction and vaso-dilation.
DHP- L-tracks (vascular)
Non-DHP T-Tracks (cardiac)
Cardiac Glycosides
used to increase cardiac output in pts with heart failure, and to slow conduction in the AV node.
Inhibitors Na/K pump to allow the increase in intracellular concentration of Ca.
stimulates parasympathetic system and inhibits sympathetic system.
it attaches to the lean muscle (why it is dosed on peoples lean muscle), if the decrease in lean muscle mass need to change the dose or it is very Lethal.
can be toxic to people on antibiotics cause they kill intestinal flora (it is absorbed through the intestines and are dependent on the intestinal flora)
H2 blockers
(antihistamine medicines)
can slow body from eliminating dig so pt can become toxic from normal dose
OD on cardiac Glycosides
toxic levels will have dysrhythmias, yellowed vision, and ringing in ears.
Tx: chase the rhythm and treat symptoms.
what can help with a OD cardiac glycoside overdose?
Digibind
it will remove dig from system but not off the lean muscle, so anything attached to the muscle can still release and put the pt back into toxic levels.
what do diuretics help with?
HTN
heart failure
what are the concerns of diuretics
dehydration and electrolyte imbalances
potassium sparing diuretics
increase the urine output with out loosing potassium
can cause hyperkalemia
Potassium waisting
increase the urine with out regulating potassium
commonly will take potassium supplement while taking the diuretic
these are easier to regulate than sparing diuretics
ACE inhibitors
stop strong vasoconstrictor Angiotensin II
SE: angioedema (limited to the lips and the tongue) and dry nonproductive cough.
OD: hypotension and tachycardia
Tx: Epi
Alpha 1 antagonist
control the BP by blocking Alpha 1 receptor sites in smooth muscle and blood vessels.
Help to decrease the peripheral vascular resistance (PVR) and preload.
OD: profound hypotension
Tx: fluids
Alpha 2 agonist
stimulates the Alpha 1, which will cause it to shut down the sympathetic nervous system
(1 pill killer)
- can be used for kids with ADD and ADHD b/c shuts off the sympathetic system
Tx: Narcan can reverse. (Clonidine causes endogenous opioid release, which should respond to the use of naloxone.)
ARBs (angiotensin receptor blockers)
used to block angiotensin 2 at the receptor sites.
Nitrates
anti angina, these medications result in the relaxation of smooth muscle tissue.
action: results in venous and arterial dilation, resulting in decreased cardiac oxygen demand. (tolerance can be established)
Antihyperlipidemic (statins)
decrease the LDL cholesterol
No change in prevalence in MIs
should try with diet and exercise first
Major problem is that they can mess with liver enzymes, can cause rhabdomyolysis
Tx: with lots of fluid
anticoagulant
uses vitamin K to stop the clotting factors
OD: can bleed out slowly
What cells are stimulated to release insulin in the pancreas?
Beta cells
insulin preparations
insulin preparations are usually taken by the pt with type 1 diabetes mellitus.
they have no inulin production.
med is usually refrigerated.
Oral anti hyperglycemic meds
usually the pt has some insulin production but they have the inability to use their insulin or insulin production requires stimulation.
Thiazolidinedianes (TZD)
help to allow the cell to use the bodies insulin and allow the glucose to enter the cell.
reduce the bodies resistance to the insulin.
Sulfonylureas
stimulates body’s beta cells in the pancreas to produce more insulin and reduces glucose output by liver
(pt most likely to be acutely hypoglycemic)
Alpha glycosides inhibitors
slows the break down of food into glucose resulting in slower release of glucose into blood.
Biguanides
slows the bodies release stored glucose from the liver
Thyroid hormone
increase metabolism for those with hypothyroidism
anti convulsant / sedative
drugs used to control seizures, calm patients with anxiety disorders and relax patients with chronic pain.
these are usually classed as Class 4 controlled substance Act.
SE: lethargy and unconsciousness, respiratory depression and seizures.
Benzodiazepines
enhance GABA
CNS depressant
skeletal muscle relaxer
cause amnesia
Used also for: anxiety and back spasms
OD: respiratory depression
Barbituates
CNS depression to mild sedation to coma (focus on midbrain reticular formation responsible for alertness)
OD: respiratory depression
bronchodilators
variety of drugs to help dilate bronchioles to help with breathing.
Steroids
anti inflammatory
Laxatives
make you poop your pants
Antibiotics
no prophylactic use, long term affects include nausea, diarrhea, decreased intestinal flora, liver and kidney damage (why are people taking it? I don’t want what they have, can take for acne)
Aminoglycosides
these are broad spectrum antibiotics used against both gram positive and gram negative bacterias.
cause severe kidney and inner ear damage
use is very limited.
Penicillins
used for over 50 years and are very effective against gram positive organisms.
Penicillin remains the number 1 cause of anaphylactic shock
Cephalosporins
they are structurally related to penicillin drugs and are broad spectrum antibiotics effective against gram positive and gram negative organisms.
commonly used in patients with known allergy to penicillin.
Tetracyclines
are used in the treatment and prevention of bacterial diseases. These are drug of choice for bubonic plague, cholera, and Rocky Mountain spotted fever.
Also commonly given to pt with COPD, to help prevent respiratory infections.
Macrolides
for pts with known allergy to penicillin
Used for Group A beta hemolytic streptococcus to prevent damage from rheumatic fever
Can interact with Class 1a anti arrhythmic drugs and exacerbate long QT syndrome
Sulfonamides
first drug for bacterial infections, and drug of choice for UTI, Otitis Media, and Conjunctivitis (sulfa drugs many people with allergy to them)
