types of drugs Flashcards
Analgesics
Analgesics are medicines that relieve pain. Pain is any type
of noxious feeling that results in discomfort or a “hurting”
sensation. Pain may by acute, lasting for a short period of
time, or chronic, meaning that it never subsides. A wide variety
of drugs may be prescribed to relieve pain. Some work better
than others, depending on the intensity of the pain response.
Also, many pain relievers can be purchased without a prescription.
These nonprescription products are presented in a
separate study unit. There are two main classes of pain
relievers: narcotic analgesics and non-narcotic analgesics.
Narcotic analgesics include drugs such as codeine and
morphine. Non-narcotic analgesics include the nonsteroidal
anti-inflammatory drugs, or NSAIDS, such as aspirin and
Motrin. Tylenol, which is a brand name for acetaminophen,
is also a non-narcotic analgesic.
Narcotic analgesics
Narcotic analgesics are so named because they’re related to
the opium family of drugs. Opiates cause narcosis (sleep).
Today we associate narcotic drugs with codeine and morphine,
or drugs that contain derivatives of codeine or morphine.
Narcotic analgesics are extremely effective in reducing pain.
In fact, they’re more effective in treating severe pain than any
other analgesic drug, and they’re the only pain relievers that
effectively treat pain associated with terminal cancer and the
passage of kidney stones.
Nonsteroidal anti-inflammatory drugs (NSAIDs)
Nonsteroidal anti-inflammatory drugs (NSAIDs) are very
effective in relieving pain of varying intensities ranging from
mild to moderate to moderately severe. Many drugs in this
class are available both by prescription and over the counter.
NSAIDs are more effective than codeine products in relieving
pain associated with inflammation such as arthritic pain.
These drugs don’t contain the chemically functional steroid
nucleus in their molecule (nonsteroidal), but they reduce
inflammation just as the corticosteroids do. Ibuprofen
(Motrin) is considered the prototype drug of the NSAID class
of analgesics. It’s one of the most commonly prescribed drugs
in this group because it treats pain of skeletal-muscular origin,
arthritic origin, headache, premenstrual cramps, and even
fever. Other popular drugs in this family are naproxen
sodium (Anaprox DS, Aleve), naproxen (Naprosyn), flurbiprofen
(Ansaid), diflunisal (Dolobid), ketoprofen (Orudis),
diclofenac (Voltaren), and piroxicam (Feldene).
The greatest use of NSAIDs is in the treatment of pain and
inflammation caused by rheumatoid arthritis and osteoarthritis
(Figure 1). Unfortunately, these drugs have a high
incidence of stomach upset and gastric erosion within the
lining of the stomach when taken for long periods of time.
This led to the development of the COX-2 inhibitors. The COX-
2 inhibitors got their name from the enzyme that they inhibit,
which is cyclooxygenase-2. The COX-2 inhibitors are a type
of NSAID that have a lower tendency to cause stomach
ulcers. The COX-2 inhibitors include drugs such as Celebrex
and Mobic.
Acetaminophen
Acetaminophen is classified in a separate category from
NSAIDs and aspirin because it doesn’t have anti-inflammatory
properties, and it seems to work somewhat differently from
other analgesics. Acetaminophen reduces fever, doesn’t irritate
the stomach, and doesn’t cause anticoagulant effects.
It’s an excellent analgesic when used in combination with
narcotic pain relievers such as codeine. Acetaminophen has
always been available without a prescription either alone or
in combination with aspirin or other over-the-counter drugs
such as antihistamines. A warning on the acetaminophen
label states that it causes liver toxicity in high doses or if
taken with alcohol.
tramadol (Ultram)
Tramadol is a
synthetic opioid analgesic. It binds to some of the same
receptors as morphine to relieve pain. Although tramadol
isn’t currently classified as a controlled substance, there are
reports of abuse of this drug. It’s effective in treating moderate
to moderately severe pain, doesn’t have anti-inflammatory
properties, and doesn’t cause stomach damage.
ANTIHYPERTENSIVES
Antihypertensive drugs work in several ways to lower high
blood pressure. They dilate (open up) the arteries, which
results in a lowering of the blood pressure. This occurs
because arteries are often constricted, causing the pressure
inside them to rise. Antihypertensives open up the constricted
arteries, thus decreasing the pressure within the arteries.
The drugs that dilate constricted arteries are angiotensinconverting
enzyme (ACE) inhibitors, angiotensin II receptor
blockers (ARBs), calcium channel blockers (CCBs), and others
such as alpha 1 receptor blockers.
Secondly, some antihypertensives act on the heart to reduce
the amount of blood volume that’s pumped into the arteries.
Less fluid volume within the arteries usually results in less
pressure within the cardiovascular system. Drugs that act on
the heart to reduce blood outflow are called beta adrenergic
blocking agents (beta blockers).
diuretics
, help to reduce blood pressure
by decreasing the volume of fluid in the plasma. These drugs
are often combined with antihypertensives to increase the
antihypertensive effect
ANGIOTENSIN-CONVERTING ENZYME (ACE) INHIBITORS
Drug Brand Name
enalapril = Vasotec
lisinopril = Prinivil, Zestril
benazepril = Lotensin
ANGIOTENSIN II RECEPTOR BLOCKERS (ARBs)
Drug Brand Name candesartan = Atacand eprosartan =Tevetan irbesartan =Avapro telmisartan =Micardis valsartan =Diovan losartan =Cozaar
CALCIUM CHANNEL BLOCKERS (CCBs)
Drug Brand Name
nifedipine =Adalat, Procardia
diltiazem =Cardizem, Tiazac
amlodipine= Norvasc
BETA BLOCKERS
Drug Brand Name
atenolol =Tenormin
metoprolol= Lopressor, Toprol
propranolol =Inderal
Angiotensin-Converting Enzyme (ACE)
Inhibitors
Angiotensin-converting enzyme (ACE) is present in the blood.
It ordinarily causes production of a very powerful constricting
substance that contributes to high blood pressure. ACE
inhibitors block the actions of this enzyme, causing dilation
of the blood vessels and reduction of blood pressure.
The names of ACE inhibitors end in “pril.” For example,
enalapril, lisinopril, and benazepril are the generic names for
three popular ACE inhibitors.
angiotensin-2 receptor
blockers, or ARBs
Related to the ACE inhibitors are the angiotensin-2 receptor
blockers, or ARBs. These drugs prevent angiotensin-2 from
binding to receptors, and therefore reduce blood pressure by
preventing vasoconstriction. Although it’s possible, ARBs
aren’t as likely to produce the dry cough that many ACEinhibitors
do. Some popular drugs in this class include
Diovan (valsartan), Avapro (irbesartan), and Cozaar (losartan).
Notice that the generic names of all of the ARBs end in
“sartan.”
Calcium Channel Blockers (CCBs)
Calcium channel blockers (CCBs) lower blood pressure by
causing constricted blood vessels to dilate. These drugs cause
dilation by blocking the uptake of calcium through channels
in cell membranes. The smooth muscle cells that line the
arteries utilize calcium to cause tightening within the blood
vessels. The blockade of calcium by CCBs eases this tightening
effect and leads to dilated blood vessels and lower blood
pressure. Three popular CCBs used to treat hypertension are
nifedipine (Procardia), diltiazem (Cardizem), and amlodipine
(Norvasc).
Beta Adrenergic Receptor Blockers
Beta adrenergic receptors work in the heart to force large
volumes of blood into circulation. The blockade of these
receptors by “beta-blocking” drugs prevents the outflow of
large volumes of blood, and blood pressure is reduced. The
names of beta adrenergic receptor blockers end in “olol.”
Three popular beta blockers are atenolol, metoprolol, and
propranolol.
