Drug/Medication
Pharmacologic agent capable of interacting, producing and effect. Treatment, cure, or relief of symptoms.
Prescription drug
A drug prescribed by an MD, PA, NP or Dentist (Must be licensed.
Over the counter drug (OTC)
Non prescription medications, used safely without supervision
Controlled substances
can lead to dependacy or abuse
Pharmacology
The study or science of drugs
Pharmacokinetics
The rate of drug distribution among various body compartments after a drug has entered the body. (what happens to a drug from the time it enters the body until is leaves) AMDE Absorption, Distribution, Metabolism, Excretion
Pharmacodynamics
Study of biochemical and physiologic interactions of drugs at their sites of activities.
Pharmacotherapeutics
Treatments of pathologic conditions through use of drugs. Nursing functions are related.
Toxicology
Study of poisons, including toxic drug effects and treatments.
Pharmacognosy
Study of drugs obtained from natural sources. Plants, foxglove, animal
Chemical name
The name that describes the chemical composition and molecular structure of a drug.
Generic name
Given by the US Adoptive Names council (USAN) before the drug is approved.
Official name
Starts with a small leterr, the name listed on the official publications.
Trade name (brand name or proprietary name)
Given by manufacturer. Starts with a capital letter. (ex. Motril, Advil)
Drug Standards
Drugs must be pure and uniform. Federal Food and Cosmetic Act.
Pharmacopeia
Official Information source
The United States Pharmacopeia (USP)
Guarantees safety
National Formulary (NF)
Official source of info on medications, lists drugs and their therapuetic values
Sources of drug information
American Hospital Formulary (AHF)
Physicians' Desk Reference (PDR)
Package insert
Nursing Drug Reference
Food and Drug Administration (FDA)
Responsible for administering Federal Food Drug and Cosmetic Act of 1938
Federal Food, Drug and Cosmetic Act 1906/1912
To protect against mislabeled drugs
Harrison Narcotic Act 1914
Classified habit forming drugs as narcotics
Food, Drug and Cosmetic Act 1938
Monitors safety of drugs
Durham-Humphrey Amendment 1952
Distinguished between which drugs need a prescription or not and if you need a new prescription for refills
Kefauver-Harris Amendment 1962
Assured safety and effectiveness of medications
Comprehensive Drug Abuse Prevention & Control Act 1970
In response to the use and misuse of drugs, control of habit forming drugs
Schedule I
NO Medical use in US, high abuse potential (ex. LSD,pot)
Schedule II
Accepted medical use, high abuse potential, need written prescription, no refills, warning label on II (ex. morphine, cocaine)
Schedule III
Medically accepted, Less abusive than II, 5 refills in 6 months (opiodes)
Schedule IV
Medically accepted, Less abusive than III, 5 refills in 6 months
Schedule V
Less abusive than IV, OTC (over the counter)
Pregnancy Category A
No risk to fetus in any trimester
Pregnancy Category B
No adverse effects in animals
Pregnancy Category C
Must consider risks to fetus, animal studies show adverse effects
Pregnancy Category D
Definate fetal risks, ? Life threatening use
Pregnancy Category X
Absolute fetal abnormalities, not to be used
Three phases of Drug Action
Pharmaceutical
Pharmacokinetic
Pharmacodynamic
Pharmaceutical Phase
Medication enters body in one form and changes into another form that the body can utilize.
Dissolution
Ability of drug to move into solution
Pharmacokinetics
describes what happens to a drug from the time it is put into body until all of it and its metabolites have left the body. Four processess ADME (Absorption, Distribution, Metabolism, Excretion)
Absorption
is the process by which a drug passess into the bloodstream, where the drug molecules travel to their sites of action. Many factors affect drug absorption
Bioavailability
% of the drug that is absorbed. Depends on solubility of outer covering, dosage form, pharmaceutical processing, ph of medication, presence or absence of food in the GI tract
Drug Solubility
Ability of drug to dissolve and form a solution.
* Lipid-soluble drugs enter bloodstream more readily than other substances and cross into the brain.
* Meds may react with other drugs or substances to form insoluble precipitates that can not be absorbed.
Pharmaceutical Processing
Binders used to produce and stabilize a drug and the dosage form (liquid, tablet, etc) can enhance or delay absorption.
PH
Acid drugs (ASA, barbiturates) should be more readily absorbed in acid medium (stomache), basic drugs (quinindine, digoxin) aer more readily absorbed in the less acidic small intestine.
Presense or absence of food
In general, empty stomache enhances absorption and presence of food delays absorption. Some foods may bind with drugs and decrease absorption.
Concentration of drugs
High concentration increases absorption, when it moves to an area of high concentration to low.
Circulation to absorption site
Reduced blood flow decreases absorption (PVD, shock, vasoconstrictor drugs). Increased blood flow increases absorption (heat, message, vasodilators, exercise, metabolic disease)
Absorbing surface
More drug absorption with larger surface area (intestinal mucosa) Avoid scar tissue or broken skin.
Routes of Administration
Parenteral, Enteral, Topical
Parenteral Route
Fastest absorption - by- passing First-Pass Effect
Intravenous - IV
Intramuscular - IM
Subcutaneous - SC
Intradermal - ID
Enteral Route
Oral (absorption may be affected by many factors)
Sublingual
Buccal
Topical Route
Skin, eyes, ears, nose, lungs, rectum, or vagina
Distribution
Transportation of drug from the absorption site to the site of action. Rate and extent of distribution is affected by Cardiac Output & regional blood flow, Plasma Protein Binding
Cardiac output & Regional Blood Flow
Carried to most vascular organs first (liver, kidney, brain) then slower distribution to less vascular organs (muscle, skin, bone, fat)
Plasma Protein Binding
Drugs bind with plasma proteins (usually Albumin) for transport through the blood stream. Only free drug is available for distribution to body tissues. Hypoalbuminemia may cause excess free drug with potenial toxicity.
Distribution is affected by
Drug solubility, ratio of drug within body compartments, manner drug is stored in the body, plasma drug levels, the volume of distribution and the drug's ability to cross central nervous system and placental barriers.
Metabolism (Biotransformation or detoxification)
Refers to the enzymatic alteration of the drug into an active or inactive metabolite. Most drugs are metabolized in the liver, also kidney, lungs, plasma & intestinal mucosa.
Factors affecting metabolism include
Extent of plasma protein binding, drug storage reservoirs, liver function, blood flow to the liver, presense of other substances that induce or inhibit liver function and age.
With decreased metabolism
Monitor carefully for accumulation of drug, prolonged action of the drug and potential toxicity: very young, elderly, liver failure, renal insufficiency, cardiovascular disease and malnutrition.
With increase metabolism
may reduce the parmacologic effects - higher doses required. (cigarette smoke and some drug interations may increase liver enzymes activity.
Excretion
Refers to elimination of drug from the body. Primary organ: KIDNEYS. Also eliminated by liver, bowel, salivary, sweat and mammary glands.
Half - Life
Time it takes for one half the original concentration of the drug to be eliminated from the body. After five half lives most drugs are considered removed from the body. Determines how ofter a drug is administered.
Onset of Action
Time it takes for drug to elicit a therapeuic response
Peak effect
Time it takes to reach its maximum therapeuic response
Duration of action
The time that drug concentration is sufficient to elicit a therapuetic response
Monitoring serum plasma concentrations
Peak Level & Trough Level
Peak Level
Usually drawn 1/2 hour after drug is totally administered to monitor for toxic drug levels
Trough Level
Usually drawn immediately to 1/2 hour before next dose to monitor levels remain within therapeutic range.
Therapeutic Index
(margin of safety) describes relative safety of a drug.
Plateau Principle or Steady State
Occurs when rate of drug administration equals its rate of excretion (takes 4-5 half lives)
Loading Dose
Higher initial dose may be given to reach therapeutic levels.
Maintenance Dose
Repeated smaller doses to maintain therapeutic blood level.
Pharmacodynamic Phase
Describes the biochemical and physiologic action and effects of drugs in the body. Occurs when the drug reaches the target cell, tissue of organ and a therapeutic effect results.
Mechanism of Drug Action
Three major mechanisms:
1) Drug-Receptor Interactions
2) Drug-Enzyme Interactions
3) Other Drug-Receptor Interactions
Drug-Receptor Interactions
The drug binds with receptor sites on the cell or tissue surface. The drug alters the rate (increase or decrease) at which the cell/tissue functions or it can modify a function. It can NOT make the cell or tissue do a function it is not intended to do. Th
Agonist (drug effect)
Drug binds to receptor, there is a response
Antagonist (drug effect)
Drug binds to receptor, there is NO response
Partial Agonist (drug effect)
Drug binds, diminished response
Competitive Antagonist (drug effect)
Drug competes with agonist for binding to receptor. It is binds there is no response.
Noncompetitive Anatagonist (drug effect)
Drug combines with different parts of receptor and inactivates it, agonist has no response.
Drug-Enzyme Interactions
Drugs may bind with enzyme systems to inhibit the action of the enzymes. (ACE inhibitors)
Other Drug-Receptor Interactions
Drugs physically interfere with or chemically alter cell membranes or cellular processess. (cancer drugs, antibiotics)
Pharmacotherapeutics
The use of drugs and the clinical indications for drugs to prevent and treat disease. This continuous process involves assessment, Implementation, monitoring, therapeutic effect, side effects, drug toxicity
Assessment
nurses help collect data about the disease
Acute therapy
Intensive drug therapy, critically ill, emergency
Maintenance therapy
Doesn't eraticate the problem, prevents progression
Supplemental therapy
Replacement therapy
Palliative therapy
Removes symptoms (ex pain meds for end stage cancer) doesn't stop disease.
Supportive therapy
Maintains body function, fluids or electrolytes
Prophylactic therapy
Provided based on past experience and scientific knowledge (antibiotics before surgery)
Empiric therapy
Used when a disease is suspected (pt. has fever so you give them Tylenol)
Therapeutic Effect
Intended, beneficial effects, desired effect, the reason the drug is being given.
Side Effect (secondary effect)
Unintended but potential effects. They are usually predictable and my range from harmless to potentially harmful. Nurses are the ones that are always there to witness any side effects.
Drug Toxicity
Deleterious effects of a drug. Results from overdose, ingestion of a drug intended for external use only or cumulative effects of a drug d/t impaired metabolism or excretion.
Factors affecting drug response
Physiologic factors
Psychological factors
Pharmacologic factors
Physiologic factors
Body wt. & composition, age, diet & nutrition, ethnic origin, genetics, pathophysiology (renal disease, hepatic disease, cardiovascular disease, gastrointestinal disease), immunity, environment.
Psychological factors
Stress, anxiety and depression can alter the therapeutic response
Pharmacological factors
Include drug interactions, cumulative effects, drug tolerance
Drug interactions
Can interact with drug and food and other agents.
Cumulative effects
Increasing response to repeated doses (a build up) rate of absorption excedes the rate of metabolism.
Drug tolerance
Need more of the drug to maintain therapeutic effect.
Drug interactions
Result when the action of a drug is modified by another pharmacologically acting chemical substance (another OTC or prescription drug, diet or environmental factors). Pharmacokinetic interactions affect the absorption, distribution, metabolism or excretio
Additive effect
(1+1=2) Two or more drugs with the same effects that results in a combined effect (Asprin & codine)
Synergistic effect
(1+1=5) Two or more drugs with or without the same effect that yield a combined effect greater than the sum of given each drug alone.
Potentiation effect
A synergistic effect, one drug exerts a greater action because another drug is present.
Antagonistic effect
(1+1=0) One drug deminishes or eliminates the effects of another one (Narcan)
Combined toxicity
Occurs when two drugs with toxic effects on the same organ are combined for therapy, results in permanent dame to organ. (furosemide & aminoglycoside antibiotics)
Adverse drug reactions (ADR), adverse effect, side effect
Any unintended or undesired response to a standard drug dose. Two major catagories: Type A Reaction & Type B Reaction
Type A Reactions
Usually dose related and are an extension of the pharmacologic effects of the drug; predictable and preventable; accounts for 70-80% of all drug reactions.
Type B Reactions
Allergic or idiosyncratic reactions that are NOT dose related, they are not preventable or predictable. Pt must be made aware about allergy and not to take the drug again.
Drug allergies or hypersensitivity reactions
Involves an immunologic reaction to the drug. Body may produce antibodies when exposed to a foreign substance (antigen) and develop signs of an allergic reaction. May be acute or delayed, mild to life threatening.
Mild reactions
Variety of symptoms from skin rashes to diarrhea, nausea and vomiting.
Anaphylactic reaction
Is a severe allergic reaction, usually occurs immediately after administration and can be fatal if not detected and treated. Earliest symptoms: SOB, acute hypotension, tachycardia
Idiosyncratic reation
Is a genetically determined abnormal response to ordinary doses of a drug, usually due to abnormal levels (absence, deficiency or overabundance) of drug metabolozing enzymes.
Patient education
Teach the pt the names of drugs, dose, route, about side effects, verbal and written.
Responsible Drug Administration
8 Rights (right Pt, medication, dose, route, time, refuse, documentation, educate)
Careful Assessment & Monitoring for ADR's
Complete drug history, including use of OTC drugs, drug allergies or previous hypersensitivity. Including assessing the skin, blood dyscrasis, ocular toxicity, nephrotoxicity, hepatotoxicity, ototoxocity, lung toxicity, sexual dysfunction, CNS, cardiovasc
Mutagenic effects
Causes changes in genetic composition, changes chromosomes & DNA structures
Carcinogenic effects
Causes cancer, lengthy exposure over a long period of time
Teratogenic effects
Fetal abnormalities, especially in the 1st trimester, causes structural defects in the unborn fetus.
Reporting Adverse Drug Reactions
Most agencies require you to fill out an incident report. (required by TJC & FDA)
Analgesics
(drug effecting the CNS) Relieve/prevent pain without loss of consciousness.
Opiod Analgesics
(drug effecting the CNS) Very strong pain relievers used to alleviate moderate to severe pain. Classified by chemical structure or their action at receptor sites (mechanism of action). Very addictive.
Opiates - morphine sulfate
(drug effecting the CNS) Most potent of the natural opiates, addictive, given PO, rectally, IM, SC, or IV
Opiates - codeine sulfate
(drug effecting the CNS) Less powerful, fewer side effects (antitussive agent, cough suppresant)
Synthetic opiod - meperidine HCL (Demerol)
(drug effecting the CNS) 1/10 as powerful as morphine
Synthetic opiod - oxycodone
(drug effecting the CNS) Combined with ASA = Percodan
Combined with acetaminophen = Percocet
Propoxyphene HCL (Darvon)
(drug effecting the CNS) Not a true narcotic, it binds to the opiate receptor in the CNS. Used for mild to moderate pain. Combined with acetaminophen = (Darvocet-N) with ASA/caffeine = (Darvon N compound)
Nonsteriodal Antiinflammatory Drugs (NSAIDs)
Used to control mild to moderate pain, fever, and various inflammatory conditions. (very common analgesic class)
Side effects and Nursing implications with opiod analgesics
Most serious is respiratory depression, CNS depression (sedation and confusion), psychological dependence, histamine release, N/V & constipation, and urinary retention.
Hypnotics
(drug effecting the CNS) Causes sleep. Used to treat insomnia.
Sedatives
(drug effecting the CNS) Reduces nervousness, excitability and irritability without causing sleep. AKA anxiolytics, tranquilizers.
Barbiturates
(drug effecting the CNS) Secobarbital (Seconal) phenobarbital (Luminal). Many side effects - drowsiness, lethargy, dizziness, hangover and paradoxical restlessness & excitement. Overdose = respiratory depression & arrest. Habit forming, tapering to avoid
Benzodiazepines
(drug effecting the CNS) flurazepam (Delmane) diazepam (Valium) Preferred over barbiturates: safety, low abuse potential and rare side effects beyond drowsiness and ataxia. Elderly and children are more at risk for falls.
Antiepileptic Agent (Anticonvulsants)
(drug effecting the CNS) Used to prevent seizures associated with epilepsy. Many classes of drugs, often in combination. Many side effects and must monitor closely. (phenytoin - Dilantin)
Antiparkinsonian Agent
(drug effecting the CNS) Used to treat Parkinson's disease, aimed at restoring the natural balance of two neurotransmitters in the CNS (acetylcholine and dopamine). Three classess of drugs used include: anticholinergics, dopamine agonists and MAO inhibito
Psychotherapeutic Agents
(drug effecting the CNS) To treat emotional disorders
Antianxiety
(drug effecting the CNS) By reducing over activity in the CNS
Benzodiazepines
(drug effecting the CNS) Used as a muscle relaxer, sedatives (diazepam - Valium, lorazepam - Ativan, chlordiazepoxide - librium
Barbiturates and carbamates
(drug effecting the CNS) Depress CNS activity and cause sedation, many side effects
Antihistamines
(drug effecting the CNS) Used to treat anxiety because of their sedative side effects.
Antidepressants
(drug effecting the CNS) Used to treat depression and elevate mood. (fluoxetine - Prozac)
Antimanic Agents
(drug effecting the CNS) Used to treat mania (abnormally pronounced emotions) Lithium
Antipsychotics (AKA tranquilizers or neuroleptics)
(drug effecting the CNS) Used to treat major emotional disorders that impair mental function. MANY undesirable side effects: dyskinesia. 6 catagories of drugs used. (chlorproMAZINE - Thorazine, haloperidol - Haldol)
CNA Stimulant Agents
Stimulate a specific area of the brain or spinal cord, to elevate mood, produce a sense of increased energy and alertness, decreased appetite. Used as analeptics (stimulate respirations), anorexiants, and for treatment of ADD or narcolepsy.
Caffeine
Found in many OTC and combination prescription drugs, as well as food and bevereages.
Usual dose: 100-200 mg (Coffee: 80-150 mg/cup)
Uses and side effects: Anxiety, shakey, palpations, increased heart rate.
Amphetamines
(drug effecting the CNS) Used to treat ADD, narcolepsy and obesity. Very potent CNS stimulators with very high abuse potential.
Autonomic Nervous System
involuntary, controls BP, body temp, and GI secretions, used to react in emergencies.
Adrenergic Agents: Sympathomimetics or adrenergic agonists
(drug effecting the ANS) Mimics the effects of neurotransmitter norepinephrine, epinephrine and dopamine. Produces "Fight or Flight" response - results in vasoconstriction (increased BP), broncodilation & cardiac stimulation. Uses: anorexiants, bronchodia
Vasoactive sympathomimetics, AKA vasopressors, inotropes
(drug effecting the ANS) Used to support the heart during cardiac failure or shock. Ex: DOPamine, DOBUTamine
Andrenergic-blocking agents
(drug effecting the ANS) Sympatholytics; these antagonists inhibit sympathetic stimulation, resulting in vasodialtion (decreased BP), decreased heart rate, conduction and force of contraction. Some constrict bronchioles and blood vessels
Alpha-blockers
(drug effecting the ANS) Leads to vasodilation, decreased BP, pupil constriction. Ex: prazosin (Minipress) - antihypertensive.
Beta-blockers
(drug effecting the ANS) Decreased heart rate, conduction and myocardial contractility. May constrict bronchioles and blood vessels. Used to treat hypertension, angina and cardiac arrhythmias. Lipid soluble beta blockers can cross the blood-brain barrier
Cholinergic Agent (parasympathomimetics)
(drug effecting the ANS) Mimic effects of acetylcholine to stimulate the parasympathetic nervous system "Rest system". Used to reduce intraoclular pressure, treat GI and bladder disorders and to diagnose and treat myasthenia gravis.
Cholinergic Blocking Agent (Parasympatholytics, anticholinergics)
(drug effecting the ANS) Competitively inhibits the action of acetylcholine in the parasympathetic nervous system, allows sypathetic nervous system to dominate. Dialates pupils & increases intraocular pressure, decrease GI mobility, secretions and salivat
Cardiac Glycosides
(drugs effecting the cardiovascular system) Used to treat CHF and supraventricular arrhythmias. Positive intotropic (increased force of contraction), negative chronotropic (reduces HR), slows electrical conduction thru the heart. Many potentially dangerou
Antidysrhythmic Agents
(drugs effecting the cardiovascular system) Used to suppress cardiac arrhythmias by a variety of mechanisms depending on group used. Used to control rate, thythm & conduction of heart. Check AP for 1 min notify MD <50
Antianginal Agents
(drugs effecting the cardiovascular system) Used to treat and prevent attacks of angina pectoris by reducing heart's O2 demand or increasing O2 supply.
Nitrates/Nitrites
(drugs effecting the cardiovascular system) Dilate all blood vessels, esp. coronary arteries. Administration - PO, sublingua, IV, topical. SE - headache, postural hypotension
Calcium channel blockers
(drugs effecting the cardiovascular system) Dilate coronary arteries. EX- verapamil, diltiazem
Beta Blockers
(drugs effecting the cardiovascular system) Decrease myocardial O2 consumption by decreasing heart rate. EX-atenolol & Lopressor
Antihypertensive agent
(drugs effecting the cardiovascular system) A veriety of drugs used alone or in combination to treat hypertension. Classified into groupls based on their action.
Adrenergic agents
(drugs effecting the cardiovascular system) vasodialation/vasocontriction & decrease HR.SE- orthostatic hypotension
ACE (angiotensin-converting enzyme inhibitors)
(drugs effecting the cardiovascular system) Prevents production of angiotensin II (potent vasoconstrictor) EX- captopril, Zestril SE- Orthostatic hypotension
Calcium channel blocker
(drugs effecting the cardiovascular system) Dilates arteries
Diuretics
(drugs effecting the cardiovascular system) Gets rid of fluid SE- orthostatic hypotension
Vasodilators
(drugs effecting the cardiovascular system) Dialates the blood vessels. SE- orthostatic hypotension
Coagulation Modifiers (Anticoagulants)
(drugs effecting the cardiovascular system) Prevent clot formation by inhibiting certain clotting factors.
Anticoaglulants
(drugs effecting the cardiovascular system) Inhibit certain clotting factors to prevent clot formation. EX- heparin (IV, sq) protamine(antidote), warfarin (coumadin), vitamin K (antidote)
Antiplatelets
(drugs effecting the cardiovascular system) Prevent platelets from aggregating. Used to prevent stroke or MI. EX - Asprin 81mg baby dose up to 325mg once a day.
Thrombolytics
(drugs effecting the cardiovascular system) Breaks down clot, Used in treatment of MI, pulmonary embolism and stroke to lyse a jperformed blood clot (thrombus) EX- streptokinase, TPA
Antilipemic Agents
(drugs effecting the cardiovascular system) Drugs used to lower high livels of lipids which may lead to artherosclerosis & coronary heart disease. EX- lovastatin (Mevacor)
Diuretic Agent
(drugs that effect the renal/genitourinary system) Drugs that accelerate the rate of urine formation, thru a variety of mechanisms. They remove sodium and water from the body and help decrease blood pressure and decrease edema.
Carbonic anhydrase inhibitors
(drugs that effect the renal/genitourinary system) Relieves glocoma pressure
Loop diuretics
(drugs that effect the renal/genitourinary system) Most potent EX- furosemide (Lasix)
Osmotic diuretics
(drugs that effect the renal/genitourinary system) Cerebrak edema treatment (brain)
Potassium-sparing diuretics
(drugs that effect the renal/genitourinary system) Weak, retains potassium EX-Aldactone
Thiazides
(drugs that effect the renal/genitourinary system) Increase sodium and water excretion. EX- chlorothiazide (Diuril)
Hormones
(drugs that effect the renal/genitourinary system) Natural or synthetic substances that have specific actions on target tissue. Used to treat definciency states.
Female Reproduction Agents
(drugs that effect the renal/genitourinary system) EX - Estrogens, Progestins, oral contraceptives
Male Reproductive Agents
(drugs that effect the renal/genitourinary system) EX - Testosterones
Pituitary
(drugs that effect the renal/genitourinary system) Corticotropin (ACTH) Used to treat deficiency states, may be given in higher doses as anti-inflammatory agent.
Thyroid Agent
(drugs that effect the renal/genitourinary system) levothyroxine (Synthroid) Replacement therapy for hypothyroid.
Antithyroid Agents
(drugs that effect the renal/genitourinary system) propylthioracil (PTU) Reduces thyroid production.
Antidiabetic & Hypoglycemic Agents
(drugs that effect the renal/genitourinary system) Used in the treatment of Deabetes Mellitus, which is insufficient insulin production by the beta cells of the pancreas. Type I or juvenille - body produces NO insulin, Type II - body produces insufficient
Insulin
(drugs that effect the renal/genitourinary system) Used for the treatment of IDDM as replacement therapy to lower blood sugar level. EX- Regular Insulin, NPH Insulin
Oral antidiabetic agents (hypoglycemic agents)
(drugs that effect the renal/genitourinary system) Use- NIDD: stimulates insulin production to lower BS. EX-GlyURIDE (Micronase), GlipZIDE (Glucotrol)
Adrenal Agents
(drugs that effect the renal/genitourinary system) Corticosteriods
Glucocorticoids
(drugs that effect the renal/genitourinary system) Replacement doses to Rx Adrenal insufficiency, larger doses for antiimflammatory, immunosupressive & antineoplastic effect. Serious SE. EX=PredniSONE, Hydrocortisone
Antihistamines
(drug that effects the respiratory system) Block effects of Histamine. USE- to treat cold symptoms, nasal allergies, allergic rxns, motion sickness, Parkinson's disease & vertigo. EX- diphenhydrAMINE (Benadryl) fexofenadine (Allegra)
Decongestants
(drug that effects the respiratory system) Used to shrink swollen nasal mucous membranes and relieve nasasl stuffiness. EX- Phenylephrine, pseudoephendrine (Afrin, Sudafed)
Antitussives
(drug that effects the respiratory system) Suppresses the cough reflex EX-codeine, dextromethorphan (DM)
Expectorants
(drug that effects the respiratory system) Disintegrate and thin mucous secrections to aid in removal (expectoration) EX- guaifenesin (Robitussin)
Bronchodilators
(drug that effects the respiratory system) Dilate bronchi and bronchioles. Used to relieve shortness of breath, wheezing & dyspnea of asthma & COPD. SE- Nausea, anorexia, H/A, dizziness, nervousness & cardiac dysrrhythmias. EX-Theophylline, Epinephrine
Anticholinergics
(drug that effects the respiratory system) ipratropium bromide (Atrovent)
Corticosteriods
(drug that effects the respiratory system) Antiinflammatory effects. Routes of administration - Inhalers & nebulizers, nose drops or sprays, Oral, Parenteral
Antibiotics
(Antiinfective agents) help the body combat infection by inhibiting growth of bacteria (bacteriostatic) or by killy bacteria (bacteriocidal). Not effective against viruses or fungi. Monitor for hypersensitivity & allergic reactions.
Sufonamides
(Antiinfective agents) Bacteriostatic antibiotic used mainly to treat UTI's. EX-Bactrum
Penicillins
(Antiinfective agents) Inhibit bacterial cell wall synthesis, used to combat gram-positive bacteria. EX-penicillin V, amipicillin
Cephalosporins
(Antiinfective agents) Bactericidal, interfere with cell wall synthesis. Broad spectrum antibiotics used agains gm- & gm+ bacteria, fungi and viruses. EX- cephalexin (Keflex)
Tetracyclines
(Antiinfective agents) Bacteriostatic, inhibit protein synthesis in bacteria and some protozoa. Administration with milk, antacids or iron salts cause reduction in absorption. EX- doxycycline
Aminoglycosides
(Antiinfective agents) Bactericidal. Very potent & capable of serious toxicities: renal failure and hearling loss. Monitor peak and trough levels. EX- gentamicin
Quinolones
(Antiinfective agents) Bactericidal by altering DNA, broad spectrum EX- ciprofloxin
Macrolides
(Antiinfective agents) Bacteriostatic, inhibiting protien synthesis. EX- erythromycin
Vancomycin
(Antiinfective agents) Bactericidal antibiotic unrelated to others. Antibiotic of choice for MRSA & C. Difficile. Monitor for nephrotoxicity and ototoxicity.
Antiviral Agents
(Antiinfective agents) Kill viruses by inhibiting ability to replicate. EX- zidovudine (Retrovir)
Antitubercular
(Antiinfective agents) Used to treat infections caused by ycobacterium which is responsible for tuberculosis. EX- isoniazid (INH)
Antifungal
(Antiinfective agents) Kill or inhibit growth of fungi, yeast & molds EX- Monistat
Antiparasitics
(Antiinfective agents) Ex- metronidazole (Flagyl), antibacterial, antiprotozoal & antihelmintic.
NSAIDs - Nonsteriodal Antiinflammatory Drugs
Analgesic, antipyretic, antiimflammatory effects by inhibiting the effects of prostaglandins. EX- ibuprofen (Advil, Midol, Motrin)
Apirin (ASA) Salicylate family
(NSAID) Analgesic, Antiinflammatory, Antipyretic, Anticoagulant SE- GI intolerance, bleeding, renal impairment
Acetaminophen (Tylenol)
(NSAID) Synthetic, nonopiod drug (not to exceed 4g in 24 hrs), Analgesic, Antipyretic. Toxicity - Hepatic necrosis
Immunosuppressant Agents
(drugs that effect Immune system) Agents that decrease or prevent immune response. Unsed int treatment of organ rejection. EX- CycloSPORINE
Antineoplastic Agent
(drugs that effect Immune system) Act by variety of mechanisms to control or kill cancer cells. Often used in combination to minimize toxicities and increase response. Cytotoxic
Antacids
(GI & Nutritional agents) Used to correct too much acid production and hyperacidity of the stomache. Many prescription and OTC preps contain Mg (cause constipation)
H2 Antagonists
(GI & Nutritional agents) Acid secretory antagonists, used to reduce production of hydrogen ion and ultimately hydrochloric acid. EX- cimetidine (Tagamet)
Antidiarrheals
(GI & Nutritional agents) agents used to treat diarrhea, include absorbants, anticholinergics, intestinal flora modifiers and opiates. EX- (Kaipectate, Lomotil, Imodium)
Laxatives
(GI & Nutritional agents) Used to treat constipation
1. Bulk-forming: methylcellulose
2. Emollient or lubricants: Mineral oil
3. Stool softeners: (Colace)
4. Saline: (MOM)
5. Stimulants: (Ducolax)
Antiemetic (Antinausea) Agents
(GI & Nutritional agents) Drugs used to relieve nausea and vomiting, EX- hydrOXYzine (Vistaril), Marinol
Blood-Forming Agents
(GI & Nutritional agents) Iron: Used to correct iron deficiency states such as anemia. SE- nausea & vomiting, stomache cramps & Pain. Drug can accumulate and lea to toxicity. MOST COMMON CAUSE OF PEDIATRIC POISONING DEATHS.