ATI Pharmacology drug list (5-08)
Anti-infective agents ( started in 1940's)
Can be toxic to kidneys, liver, or bone marrow; can cause yeast infections (stomatitis [sore mouth],
vaginitis), clostridium difficile-associated diarrhea (bloody diarrhea, foul odor)
Anaphylactic shock: severe respiratory distress, hypotension, tachycardia, cyanosis,
convulsions, unconsciousness if untreated
Aminoglycosides:
Uses: aerobic gram- ; staph infection when penicillin is contraindicated; septicemia;
SE: renal impairment (elderly) & hearing impairment
Nurs: admin w/ caution to: hearing impaired, kidney disease, receiving other renal toxic agents such
as vancomycin, are receiving anesthetic or muscle relaxant; admin. > 2hrs of extended- spectrum
antibiotic; creatinine, hearing; clt to report ringing ears, change in hearing,
drink 2-3L per day to
maintain kidney fxn.
 Steptomycin
 Amikacin
 Gentamicin
 Neomycin
Antifungal—excreted very slowly by kidneys (detected in urine 8wks later)
SE: fever, chills, renal dysfxn
Nurs: not in pregnancy; monitor for: Chvostek's sign; Trousseau's sign; change in heart rhythm
during tx; ↓K & ↓ Mg;
 Amphotericin B (Fungizone) aka amphoterrible: very toxic—use only for life threatening
infections; side effects referred to as shake & bake; premedicate w/ Tylenol, benadryl,
glucocorticoids; renal dysfxn common; ↓K & ↓Mg (muscle weakness or spasms) ; bone marrow
suppression
 Flucytosine (Ancobon)
 Nystatine (Mycostatin)
 Fluconazole (Diflucan)—used for UTI, peritonitis, pneumonia, cryptococcal meningitis, generally
well tolerated; SE: rash, ↑ liver enzymes
 Ketoconazole (Nizoral)—cutaneous fungal infections; can cause cardiac dysrhythmias
 Miconazole (monistat)---vaginal candidiasis and cutaneous fungal infections
Antiparasitics
 Paromomycin (Humatin) [Amebicide] SE: N/V
 Metronidazole (Flagyl) [Amebicide] tx: giardiasis (feces contaminated food/water); trichomoniasis;
helicobacter pylori; clostridium difficile assoc w/ pseudomembranous colitis; not in 1st trimester
pregnancy; Nurs: inhibits metabolism of anticoagulants by the liver
NURS: avoid alcohol during tx and for 48 hrs after tx (causes intense flushing, ↑HR, N/V,
headache, and/or circulatory collapse); metallic taste; discolor urine
Antimalarial drugs: SE: N/V; blurred vision,

Chloroquine (aralen), Quinine sulfate (Quinamm), Hydroxycholoquine (Plaquenil)
Nurs: take 1-2 weeks before traveling; take with food; have eye exam q 6 mo RT
irreversible blindness
 Mebendazole (vermox) [anthelmintic] tx: roundworms, hookworms, pinworms SE: N/V,
dehydration, rash, anemia



Pentamidine [antiprotozoal] SE when given IV: ↓BP, ↑HR, dysrhythmias, renal dysfxn, diabetes,
↓BG,
Nurs: monitor BP, HR, ECG ; monitor BG (patients can develop diabetes mellitus)
Gamma benzin hexachloride (Kwell): commonly prescribed for scabies
Lindane (Nix) [pediculicides] : to treat pediculosis SE: damage to heart, kidneys, CNS
Antitubercular
Uses: TB, Hansen's disease (leprosy), prevent meningitis (rifampin)
SE: peripheral neuropathy, liver damage, blurred vision, discoloration of bodily fluids
Nurs: caution w/ clts w/ liver disease and chronic alcohol ingestion; >6 mos treatment needed; give on
empty stomach; not w/ antacids; weigh weekly (wt loss assoc w/ TB); avoid alcohol;
Vit B6 to
prevent peripheral neuropathy;
 Isoniazid (INH)—do not use in clt. w/ acute liver disease
 Rifampin—used in combo w/ other drugs to prevent resistance; causes reddish discoloration to
urine, tears, saliva, body fluids, & can stain contact lenses
 Ethambutol—combined w/ INH & rifampin
 Pyrazinamide
2nd line: are effective but very toxic
 Ethionamide (Trecator-SC), Para-aminosalicylic acid (PAS), Cycloserine
Other drugs:
Streptomycin (aminoglycoside used to ↑ activities of ethambutol & isoniazid)
Antiviral --often used w/infection that causes CNS, hepatic, or pulmonary symptoms;
Uses: treat herpes simplex virus (HSV), shingles, hep C, influenza A & B pneumonia
SE: tolerated well
Nurs: caution w/ pregnancy, children & renal disease; take with food; wear gloves for IV dose
 Acyclovir—Herpes simplex type I & II, varicella-zoster virus (VZV)
 Amantadine—respiratory synctial virus
 Foscarnet—cytomegalovirus (CMV) retinitis; causes renal dysfxn
 Ganciclovir—same as foscarnet
 Interferons—treat leukemias, renal cell carcinoma, hepatitis, kaposi's sarcoma
Those used to treat AIDS:
 Azidothymidine (AZT aka zidovudine or retrovir) Nucleoside reverse transcriptase inhibitors
(NRTI)
 Nevirapine (Viramune) Non-nucleoside reverse transcriptase inhibitors (NNRTI)
Saquinavir (Invirase)Protease inhibitors
Cephalosporins
Similar to penicillin but more active against gram- and less active against gram
Uses: UTI from E.coli; surgical prophylaxis; gram - meningitis, abdominal & pelvic infections
SE: relatively safe; nephrotoxicity (esp. in elderly);
Precautions: severe penicillin allergy; hx of renal insufficiency; pregnany/lactation
Nurs : creatinine; take with or w/o food; avoid alcohol (↑ sensitivity to drug);
1st generation:
 Cefazolin Na (Ancef, Kefzol)
 Cephalexin (Keflex)
2nd generation:
 Cefoxitin, Cefprozil, Cefotetan, Cefaclor, Cefuroxime
3rd generation: only drugs that are able to penetrate the blood-brain barrier sufficiently to
treat CNS infections.
 Cefoperazone, Ceftriaxone, Cefotaxime, Ceftazidime, Cefixime
4th generation
 Cefepime (Maxipime)
 Chloramphenicol (chloromycetin) –crosses blood brain barrier (9x higher in brain than plasma)
Uses: typhoid fever, meningitis & other CNS infections
 SE: very toxic to bone marrow → bone marrow suppression (hospitalize during tx); gray-baby
syndrome (cyanosis & circulatory collapse); admin on empty stomach;
Fluoroquinolines—serious drug resistance—use newer fluorinated quinolones
Uses: E.Coli, UTI, enteritis, STD's, bronchitis, anthrax, levofloxin (pneumonia)
SE: photosensitivity, superinfections, renal failure, visual disturbances
Nurs: avoid in children/pregnant women; admin w/ caution in clts w/ renal failure; do not admin
w/ antacids, iron, Ca (dairy products), Zn, Mg supplements; drink 1-2L/day, monitor
renal/liver fxn; admin on empty stomach unless GI symptoms, avoid direct sunlight; avoid
caffeine→ inhibits caffeine metabolism → excessive stimulation (nervousness)
 Norfloxacin—highly effective against urinary tract pathogens
 Ciprofoxacin (Cipro)—good for UTI and most gram +/- bacteria & anthrax
 Enoxacin—same as cipro
 Lomefloxacin-- same as cipro
 Ofloxacin-- same as cipro
Levofloxacin (Levaquin)-- same as cipro and pneumonia
Lincosamides
 Clindamycin—Uses: RTI, skin infection, septicemia, osteomyelitis, gynecologic infections
SE: more toxic than erythromycin; pseudomembranous colitis (s/s: severe diarrhea, fever, stools
containing neutrophils and shreds of mucous membrane and blood)
Nurs: food does not affect absorption; admin w/ full glass water
Macrolides
 Erythromycin—do not give concurrently with fluoroquinolones→ ventricular Dysrhythmias;
Not stable in stomach--tablets are enteric-coated; give with 8oz water; admin on empty
stomach unless GI symptoms are present;
Uses: acute diphtheria, mycoplasma pneumonia, substitute for penicillin for S. pneumonia,
rheumative fever, endocarditis; legionnaires' disease, prep for bowel surgery; prevents
whooping cough, prevents gonorrheal in newborn's eye
SE: tinnitus, transient hearing loss, superinfections, hepatotoxicity
Nurs: considered one of safest antibiotics;; unstable in stomach; hepatotoxicity, can admin w/
food if GI symptoms otherwise admin w/o food; notify MD for s/s of pseudomembranous
colitis (diarrhea, abdominal cramping, fever, bloody stools)
 Azithromycin—uses: Upper RTI and lower RTI; skin infections, gonorrhea, chancroid,
Nurs: more recent macrolides that can be used instead of erythromycin; requires less frequent dosing
(single dose/day therapy)
Penicillins:
Uses—treats: gram+ & some gram- ;
Allergies—s/s: urticarial rash, flushing, diaphoresis, palpitations, fever, arthralgia/;myalgia,
respiratory deistress
Serum Sickness(7-21day post) fever, arthritis, urticaria, generalized edema
SE: neurotoxicity, nephropathy, hematologic, yeast infection, oral thrush, hyperkialemia, GI
Precautions: avoid w/ renal insufficiency, hx of previous hypersensitivity, 5%-10% cross
sensitivity of penicillin to cephalosporins
Interventions: observe for hypersensitivity 1st 5-30 minutes after injection; treat mild rxn with
benadryl
; treat severe rxn w/ epinephrine; admin 1-2 hours before or after meals (empty
stomach); take
with glass of water (not acidic fluids);
 Penicillin G
 Methicillin
 Amoxicillin
 Piperacillin
Sulfonamiudes & Urinary tract antiseptic agents:
Uses: systemic infections, acute uncomplicated UTI, bronchitis, acute otic media, traveler's
diarrhea,
ulcerative colitis, GI infections from shigellae, pneumocystis carinii pneumonia (PCP), burn wound
infections admin topically
SE: N/V, diarrhea; blood dyscrasias, pneumonitis, peripheral neuropathy, hypersensitivity rxns:
stevens-johnson symdrome (erythema/ulceration of mucous membranes), rashes w/ AIDS,
renal damage,
 nitrofurantoin (furadantin) [urinary tract antiseptic agent] se: rust/brown color of urine
(expected), dizziness, drowsiness, chest pain
Nurs: not in pregnancy, newborns, or oliguria; keep UO > 1200mL/day to prevent crystalline
formation; admin w/ food for nausea; avoid driving; avoid direct sunlight; use aspirin
cautiously (↑ toxicity); do not admin within 1 hour of Mg.
 Sulfisoxazole, sulfadiazine, trimethoprim/sulfamethoxazole, sulfadoxine,sulfamylon
 Urinary anti-infective: nitrofurantoin, nitrofurantoin macrocrystals
Tetracyclines
Uses: rarely 1st choice; rocky mountain spotted fever, cholera, typhus, endocervical infections; PID,
acme, traveler's diarrhea, lyme disease, substituted drug for gonorrhea/syphilis;
not for strept throat/rheumatic fever
SE: very irritating to the gastric mucosa toxic to kidneys; highly irritating to the veins →
phlebitis; discoloration of teeth in children < 8yrs; not w/ renal failure or last trimester of
pregnancy;
NURS: Do not give w/ dairy or antacids (Ca, Mg, Al, Fe prevent absorption); best absorption on
an empty stomach; avoid sunlight
 Achromycin (prototype)
 Doxycycline (Vibramycin)—used to treat Gonorrhea, lyme disease, malaria prophylaxis, impaired
kidney function; may be given w/ milk
Urinary Tract antiseptics---see sulfonamides
Vancomycin—
Uses: primarily for MRSA, Clostridum difficile colitis (oral only) septicemia, staph infections
SE: Red-man syndrome (vascular dilation → flushing of head, neck, upper body, ↓BP, ↑HR, chills,
fever); nephrotoxicity; Ototoxicity; superinfection (sore mouth, black furry tongue, diarrhea);
Nurs: caution w/ renal disease, hearing impairment, or intestinal obstruction or inflammation;
admin over 1 hr to prevent red-man syndrome; cloudy or pink urine may indicate
nephrotoxicity; report tinnitus (early intervention prevents permanent hearing loss)
Immune system (pg. 68)
Innate immunity—1st line of defense—present at birth
Active immunity—2nd line of defense—is either active or passive
Active acquired immunity—produced by own immune system in response to a disease or vaccine.
Passive acquired immunity—antibodies from other given to host by immunization
SE: mild to severe (anaphylactic rxn (MMR); convulsions; encephalitis (DTP); paralysis (oral polio
vaccine (OPV); manifestation of the disease;
Precautions: moderate to severe acute illness with or w/o fever; pregnant or breastfeeding (some
vaccines); immunocompromised OKAY with: mild illness; antimicrobial therapy, diarrhea,
mild rxns, premature infants,
Nurs: expiration date, egg allergy, S/S of allergic rxn: tx--subQ epinephrine —adult: 0.5mL/child
0.01mL/kg; Tetanus/diphtheria booster q 10yrs; influenza q 3 yrs;
 Bacterial vaccines—pneumococcal polysaccharide vaccine, Haemophilus B, typoid, anthrax
 Viral vaccines—Hep A/B, poliovirus, influenza, MMR, Varicella, smallpox
 Toxoids---Tetanus, diphtheria, DTP/DtaP (diptheria, tetanus, acellular pertussis)
Passive immunizing agents—antitoxins, antivenins, live virus vaccines, passive immunization
w/injection of immune globulins or serums
 Immune globulins: tetanus, hep B, cytomegalovirus, varicella-zoster, (RhoGAM), rabies,
Uses: Rh- mother, renal transplant, following exposure to viral illnesses
Nurs: take T & VS as baseline as client may develop fever after administration
 Antitoxins—tetanus deptheria
Immunostimulants—most used to treat cancer
NURS: monitor: CBC for bone marrow suppression; Assess: s/s of hepatic failure (jaundice, ascities,
RUQ pain, liver enzymes); s/s of transplant rejection (fever, fatigue, altered VS,
tenderness over
graft site, organ specific s/s); s/s of infection; oral cavity for pallor/bleeding gums; ability to
swallow; report ↑T;
Colony stimulating factors (CSF)—stimulate growth/fxn of hematopoietic cells
SE: blood dyscrasias, bone pain, HTN, edema, cough, dyspnea,
Nurs: caution w/ antineoplastics; monitor: BP, edema, bone marrow failure; clt to report sore throat
or cough to MD
 Epoetin alfa (Epogen)
 Granulocyte colony-stimulating factor—Filgrastim (Neupogen) ↑ neutrophil production
Interferons: interfere w/ ability of virus to spread and replicate
SE: flu-like symptoms, renal/liver dysfxn, alopecia
Nurs: caution w/ hepatic disease, aminophylline, egg/neomycin allergy, neurotoxic; admin by
injection only (they are proteins that would be destroyed if given orally); monitor: BUN, creatinine,
CBC; clt to notify MD for bleeding or infection; take at bedtime to minimize flu-like symptoms;
lowers resistence to infection
 Interferon alpha—commonly used for tx of cancer/viral infections (response in 1-2 months)
 Interferon-beta and gamma
Interleukins: increase leukocytes
SE: Flu-like symptoms, Capillary leak syndrome (proteins that leak out→ excessive weight
gain, edema, pulmonary congestion, CHF, dysrhythmias, acute MI); renal failure, anemia
Nurs: admin in ICU RT adverse SE; monitor: BUN, creatinine, change in mental status; clt may
have temporary visual symptoms; report flu-like symptoms to MD; avoid alcohol, aspirin,
NSAIDs → gastric bleeding; use non-hormonal Birth control
 Interleukin-2 (aldesleukin aka IL-2)
Immunosuppressants—suppress the production and activity of lymphocytes
Uses: treat autoimmune disorders, inflammatory bowel disease; prevent organ rejection
SE: infection, malignancy
Nurs: Do not give w/ live vaccines can → serum sickness (s/s: fever,rash, joint pain, swollen lymph
nodes; not in pregnancy or lactation; take with food/milk; call MD for T> 99; avoid other
drugs; avoid pregnancy; call MD for infection/unusual bleeding
Cytotoxic agents
 Azathioprine—prevent organ/tissue rejection; rheumatoid arthritis
SE: GI distress, hepatotoxicity, bone marrow suppression,
Nurs: monitor: renal, hepatic, and hematologic fxn; if miss dose: taking once a day do not double
up, if taking several time a day then take missed does with next does; take with food
 Methotrexate—treat rheumatoid arthritis, psoriasis, some types of cancer
SE: bone marrow suppression; oral/GI ulcers, N/V; nephrotoxicity, pulmonary infiltrates
Nurs: monitor: respiratory, hepatic, hematologic fxn; Do not double up if miss dose;
do not take alcohol/ NSAIDs; may have alopecia
Conventional antirejection agents
 Cyclosporin—prevent rejection rxns by inhibiting T and B lymphocytes
 Mycophenolate—prevent rejection of cardiac and renal transplant
 Tacrolimus—prevent rejection reactions & treat autoimmune disease
Corticosteroids—decrease formation and fxn of antibodies & T-cells.
Antibody preparations—
 Polyclonal antibodies
 Monoclonal antibodies
 Muromonab-CD3 (Orthoclone OKT3)—used to reverse organ transplant rejection
Others
 Etanercept (Enbrel)
 Leflunomide (Arava)
HIV/AIDS agents
Nurs: monitor: CD4 counts to determine proper response to drug; CBC, renal/liver enzymes;
color/appearance of urine; take on empty stomach; report: bleeding, infections, stomach pain,
tingling or loss of feeling in fingers/toes, pain in hands or feet
**NNRTI (non-nucleoside reverse transcriptase inhibitors) –bind w/reverse transcriptase and inhibit the
enzyme
SE: N/V, diarrhea, skin rash
Nurs: not w/ impaired hepatic fxn; give w/other drugs to ↓resistance;
 Nevirapine (Viramune) —slows progression of HIV & ↓ complications
 Delavirdine mesylate (Rescriptor) —slows progression of HIV & ↓ complications
**NRTI (neucleoside reverse transcriptase inhibitor)—inhibits reverse transcriptase →preventing RNA
conversion into DNA
SE: neurologic problems (insomnia, confusion, peripheral neuropathies, seizures); bone marrow
suppression, pancreatitis
Nurs: not w/ renal insufficiency (drug excreted by kidneys); not w/other drugs that cause peripheral
neuropathy (chloramphenicol, isoniazid, nitrofurantoin)
 Zidovudine (AZT, Retrovir)—most important HIV drug; SE: hematologic toxicities
 Zalcitabine (Hivid)—for advanced HIV & given only in combo with Zidovudine
 Stavudine (Zerit/d4T)—advanced HIV or resistant to Zidovudine
 Didanosine (Videx)—for those intolerant to zidovudine
**Protease inhibitors—block the formation of viral protein
SE: N/V, diarrhea, abdominal cramping, kidney stones, insomnia, headache
Nurs: not w/ pregnancy or lactation; caution w/ liver disease; not w/ didanosine
 Saquinavir (Invirase)—slows progression of HIV & ↓ complications
 Ritonavir (Norvir) —slows progression of HIV & ↓ complications
 Indinavir (Crixivan)—taken after known HIV exposure; used in combo w/ other drugs
Pain & Inflammation pg.87
Narcotic (opiate) Analgesics: kidneys excrete; liver enzymes largely deactivate morphine and reduces
effectivenss;
SE of opiates: respiratory depression, constipation, inhibition of cough reflex, pinpoint pupils, postural
hypotension
S/S of withdrawal: N/V, anorexia, intestional cramps. Fever, syncope/light headedness
Narcotic (Opiate) Agonist—stimulate opiate receptors
SE: resp. depression, inhibition of cough reflex, N/V (stimulation of vomiting center),
constipation,
urgency, urinary retention, ↑H2O absorption, SE RT release of histamine: bronchoconstrition,
postural ↓BP, peripheral vasodilation (flushing), diaphoresis, pruritus
Contraindications: head injury w/ ↑ICP, acute asthma, COPD, cystyic fibrosis, renal disease,
pulmonary disease, CHF, liver disease, hypothyroidism, alcoholism, prostatic hypertrophy
 Morphine Sulfate (standard of analgesic effectiveness) –alleviates pain&alters perception of pain
Causes vasodilation (peaks: IV-10 to20 min; IM 30min; Oral 30-60min; SubQ 60-90min)
 Codeine sulfate—for mild to moderate pain & suppress cough reflex
 Hydromorphone (Dilaudid)—more potent, but shorter acting then morphine
 Oxycodone—more potent then codeine
 Percodan—oxycodone & aspirin
 Percocet—oxycodone & acetaminophen
 Meperidine (Demerol)—shorter duration of action; less smooth muscle spasm; interacts w/ MAOI;
TOXIC to CNS—may cause tremors, hallucinations, & seizures
 Fentanyl (sublimaze)—analgesic adjunct to general anesthesia; used in open heart surgery
 Methadone HCl (Dolophine)—used for severe pain; suppress withdrawal symptoms of opiates
 Brompton's cocktail—morphine, cocaine, dextroamphetamine & alcohol—for severe cancer pain
NURS: hold if RR< 10 or shallow/labored; Hold if SBP <90; assess for constipation; increase
fluids & bulk in diet to prevent constipation; stool softeners/laxatives; change position slowly
RT orthostatic hypotension; avoid alcohol
Narcotic (Opiate) agonist-antagonist—stimulates some opiate receptors while antagonizing others; are
not antitussives; have fewer GI SE than opiate agonist
SE: same as opiates;
Precautions: not w/ liver failure; not with narcotic dependence; do not stop abruptly
 Pentazocine(talwin)—life threatening SE when given to clts addicted to narcotics; used in labor
 Nalbuphine HCl (Nubain)—provides analgesia equivalent to morphine
 Dezocine (Dalgan)
 Butorphanol (Stadoil) 3-5 times more potent than morphine; not w/ MAOI or buprenorphine
 Buprenorphine—30 times stronger than morphine
Nurs: same as opiates; no alcohol
Narcotic (opiate) antagonist—compete w/ receptor sites
SE: severe w/drawal in people dependence on narcotics; ↑HR; ↑BP
 Naloxone (Narcan)—onset in minutes; lasts 1-2 hrs
 Nalmefene HCl (Revex)
Nurs: assess VS q 5 minutes & LOC; call MD for BP>140/90 & HR >120
Non-Narcotic Analgesics
 Acetaminophen—no anti-inflammatory effects; combined w/ opioids for additive effect; inhibits
the formation of prostaglandins mainly in CNS; no anti-platelet effects; admin w/ full glass of
water; avoid alcohol; avoid concurrent use of aspirin or NSAIDS w/tylenol
SE: hepatic failure w/ high doses; nephrotoxicity w/ chronic overdose;
Antidote--administerered < 24hrs (acetylcysteine—mucomyst) ;
Anti-inflammatory drugs—
Nurs: admin w/ full glass of water, food, or antacids for GI irritation; discard tablets that have vinegar
odor; avoid concurrent use of alcohol;
Anti-inflammatory drugs inhibit prostaglandin formation (prostaglandins potentate pain, edema as well as
regulate smooth muscle in BVs, GI, respiratory & reproductive systems; protects GI mucosa;
regulate
renal blood flow; inhibit platelet aggregation; ↑CO; stimulate uterine contractions,
stimulate
erythropoietin production; suppress immune response)
Uses: mild to moderate pain; inflammatory processes; arthritis, dysmenorrheal, CVA, DVT,
antipyretic drugs—inhibit the formation of pyrogens which reset the hypothalamic thermostat→↓fever
SE of Both: GI bleed; ulcer formation; salicylism (SE of toxic doses of aspirin s/s: tinnitus,
confusion, liver/kidney/resp.dyfxn); ↑uric acid production; reye's syndrome (aspirin in young
w/virus→ encephalopathy & fatty infiltration of the liver); bone marrow depression;
hypersensitivity s/s: rash, angioedema, urticaria, dyspnea; stop 1-2 days before surgery;
Contra: no aspirin in < 15yrs old; not with GI dysfxn; not with bleeding DOs; not in pregnancy;
 Acetylsalicylic acid (aspirin)—analgesic, anti-inflammatopry, antiplatelet (1 tab-doubles bleeding
time for about 1 week); food slows absorption but protects stomach; GI irritation is major SE;
Overdose tx—emesis or lavage clt and use diuretics
 Tirofiban HCl (Aggrastate)—super-aspirin for CAD, MI, angina
NSAIDs:
 Ibuprofen (Advil, Motrin)—better tolerated than aspirin
 Naproxen (Naproxyn)—for moderate to severe arthritis
 Ketorolac (Toradol)—for pain; NOT for inflammation; only injectable NSAID
 Piroxicam (Feldene)—for arthritis
 Penylbutazone (Butazolidin)—for arthritis; SE severe bone marrow depression
Selective COX-2 Inhibitors: block production of prostaglandins that cause pain, but not those that
protect gastric mucosa
Valdecoxib (Bextra)—for rheumatoid arthritis, osteoarthritis, dysmenorhhea
Anti-inflammatory Corticosteroids—reduces inflammation of joints and other disease processes
SE: safe for short term; can give every other day to reduce adrenal suppression; cause adrenal
insufficiency; ↑ risk of infection, ↑BG, muscle weakness, cataracts/open-angle glaucoma,
osteoporosis, abnormal fat distribution, ulcers; fluid/electrolyte imbalance (Na, K, H);
Nurs: do not stop abruptly→causes adrenal insufficiency; Not give w/ vaccinations; Not w/ active
untreated infections; caution in pregnancy, lactation, children, immunosupressed, DM,
renal/cardiac failure, HTN, myasthenia gravis, osteoporosis, ulcers; ↑ risk of digitalis toxicity RT
↓K; monitor for DM, assess stools for melena; do not give parenteral corticosteroids IV; In
Addison's take 2/3 dose in AM and 1/3 in afternoon & ↑ dose during times of stress; Not w/
NSAIDs; ↑ protein, Ca, K and ↓ Na, CHO in diet;
 Cortisone –short acting corticosteroid
 Prednisone (Deltasone)—intermediate acting corticosteroid
 Betamethasone (Celestone)—long acting corticosteroid
 Fludrocortisone (Florinef Acetate)—potent mineralcorticoid
 Hydrocortisone—topical

Beclomethasone—inhaled
Antimigraine drugs—migraines assoc w/ dilation of arteries in face and scalp
NURS: assess BP, irregular heartbeat; do not mix triptans/serotonin w/ergot alkaloid w/in 24hrs; clt in
quiet, dark room for 2-3 hrs after admin; avoid smoking and exposure to cold (also cause
vasoconstion); avoid driving for 3-5 hrs; take meds at 1st sign of headache or when aura present
Ergot alkaloids
SE: N/V, cramps, confusion, late s/s: circulatory stasis w/ itching, coldness/numbness in finders, seizures,
rapid pulse, confusion;
Precautions: sepsis, vascular/hepatic/renal disease; HTN, anemia, pregnancy
 Ergotamine tartrate (Ergostat) vasoconstrictor; poorly absorbed orally—give sublingually, rectally,
or inhalation
 Ergotamine w/ Caffeine (Cafergot)—same as above except w/ caffeine
Triptans & serotonin antagonist
SE: malaise, nausea, dizzy, weakness, HTN, palpitaions, dry mouth
Precautions: CV disease, liver/kidney disease
 Sumatriptan (Imitrex) for acute migraine headaches
 Zolmitriptan (Zomig) constricts cranial vessels
 Rizatriptan (Maxalt) constricts cranial vessels
Serotonin antagonist
Methysergide (Sansert)
Anti-gout drugs—type of acute arthritis w/ joint inflammation cause by metabolic disturbance of
purine metabolism that causes ↑uricemia. Symptoms occur when serum uric acid > 6mg/dL
SE: GI symptoms, kidney stones, renal failure, ↓BP; arrhythmias; bone marrow suppression, anemia
Nurs: not w/ kidney disease; give w/ food; 3L/day fluid; rest joint; avoid alcohol & aspirin; eat low
purine diet (avoid red/organ meats, shellfish, sardines)
 Cochicine—for acute attacks (↓ inflammation); not w/aspirin
 Ibuprofen—used more commonly the colchicine
 Allopurinol (Zyloprim)—chronic gout; ↓ uric acid synthesis; clts need to be well hydrated
 Probenecid (Benemid) I--inhibit tubular reabsorption of uric acid & ↑ excretion; not w/aspirin
 Sulfinpyrazone (Anturane) –to prevent gout
Disease-Modifying Antirheumatic Drugs (DMARDs)—slow progression of rheumatoid arthritis; used
to relieve inflammation, pain, stiffness, swelling of joints; take 6wks to 6mos to show improve.
NURS: monitor: Hgb, Hct, leukocyte & platelet count from bone marrow suppression;↑ BUN, liver
enzymes; shake bottle of gold before withdrawing; use 20 gauge needle; inject deep into gluteal
muscle and have pt lie down 30 min. after injection; keep in light-resistant container; do not
administer if darker than pale yellow; call MD for mouth ulcers; prevent from excessive sun
exposure; use soft toothbrush
Gold compounds: not w/ renal/liver disease, CHF, uncontrolled DM, acute hepatitis
SE: common 40%--metallic taste, stomatitis, mouth ulcers, thrombocytopenia, nephritic
syndrome, pruritus & skin changes
 Gold sodium thiomalate (Myochrysine)
 Aurothioglucose (Solganal)
 Auranofin (Ridaura)
Chelating agents: SE: dangerous toxic effects-- GI disturb, bone marrow depression, alopecia, skin
friability; fever is 1st sign of allergic rxn
 D-penicillamine (Cuprimine)—reduce titer of rheumatoid factor
Antimalarial—SE: macular degeneration w/ extended use—schedule eye exams
 Chloroquine HCl (Aralen )
Cytotoxic—SE: GI disturbances, bone marrow depression, risk of infection, liver failure
 Methotrexate (Rheumatrex) also potent immunosupppressive drug at anticancer doses
 Azathioprine (Imuran)—for severe rheumatoid that has not responded to conservative therapy
 Cyclophosphamide (Cytoxan)—for severe active rheumatoid (SE: hemorrhagic cystitis)
 Cyclosporine (Neoral)—severe active rheumatoid (SE: nephrotoxicity)
Nervous System drugs p.115
Sympathetic Nervous system drugs
Adrenergic (sympathomimetic) drugs—effects on heart, lungs, BVs; NE is primary NT for SNS;
Contra: cardiac dysrhythmias; angina, HTN; narrow-angle glaucoma, pregnancy, children
Nurs: avoid smoking or alcohol; 2-3L fluids/day
Catecholamines—can't cross blood-brain barrier; can't be taken orally
SE: nervousness/restlessness; angina; HTN; ↑HR; ↑BG; N/V
 Epinephrine HCl (Adrenaline Cl)—choice for anaphylaxis; stimulates α/ receptors
 Norephinephrine (Lovephed)—potent vasoconstrictor; treat hypotension & cardiac arrest; avoid
infiltration which can cause tissue necrosis and amputation; assess IV q 15min
 Dobutamine HCl (Dobutrex)—acts directly on heart to ↑ force of contraction
 Isoproterenol HCl (Isuprel)—bronchodilator, stimulates α1 & 2 receptors—used for shock and
dysrhythmias; poor absorption oral/sublingual
Non-Catecholamines—can cross blood brain barrier
SE: severe anxiety & insomnia; tachycardia, palpitations, dysrhythmias, muscular weakness & cramps.
 Ephedrine—less potent-longer acting then epinephrine; bronchodilator/ nasal decongestant
 Pseudoephedrine (Sudafedd)—similar action to ephedrine
 Phenylephrine HCl ( Neo-synephrine)—stimulates α receptor→vasoconstriction/nasal
decongestant; acts as bronchgodilator
 Albuterol (Proventil)—bronchodilation
Anti-adrenergic drugs—blocks sympathetic NS
Alpha-Adrenergic blocking agents—blocks α receptors primarily in blood vessels; block
sympathomimetic agents; dilate vessels in smooth muscles; lower peripheral vascular resistance;
α2 blocking agents inhibit release of NE in the brain, decreasing sympathetic stimulation and
blood pressure
Use: mild to moderate HTN; BPH, migranes, pheochromocytoma, CHF, peripheral vascular disorders
SE: Ergotism (early s/s: N/V, abdominal cramps, confusion; late s/s: circulatory stasis w/ itching;
coldness & numbness in fingers/hands leading to gangrene extremities, nose, digits, ears;
seizures, rapid irregular pulse, confusion); N/V; sudden tachycardia, postural hypotension, nasal
congestion
Precautions: of ergot alkaloids—sepsis, vascular disease; hepatic/renal disease, marked atherosclerosis,
HTN, anemia
Nurs: assess for early signs of ergotism; change position slowly to prevent orthostatic hypotension;
notify MD if chest pain occurs; take antimigraine at 1st sign of headache
 Phentolamine mesylate (Regitine)—for HTN; Nurs: Clt to remain supine during IV admin.
 Ergotamine tartrate (Ergostat)—vasoconstrictor—for migraine---give sublingually, rectal, inhale
 Ergotamine tartrate w/ caffeine—common antimigrane
 Doxazosin (Cardura)—peripherally acting; for HTN or BPH—blocks α1
 Prazosin (Minipress)—same as Doxazosin
 Terazosin (Hytrin)—same as Doxazosin

Sumatriptan (Imitrex)—vascular headache suppressant used to treat migraines
Beta-Adrenergic blocking agents→ ↓BP, ↓CO, ↓ contraction
Uses: Angina, dysrhythmias, HTN, MI, Glaucoma, Migraine headache; palpitations; tremors
SE: Bradycardia; SOB; fatigue, orthostatic Hypotension, edema
Precautions: in DM, peripheral vascular insufficiency; kidney/liver disease; Do not stop abruptly;
not with: alcohol, CNS depressants, OTC decongestants; not always affective for AfricanAmer so are combined w/ diuretics.
Nurs: baseline weight; HR before admin; BP, BG; assess breath sounds; avoid: antacids, prolonged
exposure to sun, alcohol; caution w/ driving
 Propranolol HCl (Inderal)—HTN, angina, dysrhythmias, MI
 Metoprolol tartrate (Lopressor)—for HTN dysrhythmias
 Atenolol (Tenormin)—for HTN, angina, MI
 Sotalol (Betapace)—for dysrhythmias
 Timolol Maleate (Timoptic)—eye drop to treat glaucoma
Ganglionic Blocking agents—stops both sympathetic and parasympathetic nerve impales thru
ganglia; compete w/ Ach; decrease arterial pressure and lower BP
Uses: advanced stages of HTN or HTN crisis; treat pulmonary edema
SE: hypotension, bradycardia, dry mouth, dilated pupils decreased GI and urinary tract mobility
Contra: glaucoma and cautiously w/ heart disease
Nurs: monitor BP q 5 minutes; call MD if SBP < 60; provide ice chips to relieve dry mouth
 Mecanylamine HCl (Inversine)
Parasympathetic Nervous system drugs—Cholinergic drugs:75% of PSNS fibers are in Vegas nerves
PSNS involved in Digestion, excretion, cardiac deceleration, anabolism; stimulation of PSNS→
constricted pupils, constriction of smooth muscle of GI tract, constricted bronchioles,
bradycardia, ↑ glandular secretion (except of sweat glands); NT os PSNS is Ach; 2 types of
receptors—nicotinic→ tachycardia, ↑ BP, peripheral vasoconstriction & muscarinic→ ↓ HR,↓
BP, ↑saliva
Direct-acting cholinomimetic agents→↓HR, ↑ GI muscle tone & relaxation of sphincters, ↑ bladder tone
& relaxation of sphincter, ↑ respiratory secretions, constriction of pupils
Uses: glaucoma, GI reflux disease, atrial dysrhythmias, postop atonly, neurogenic bladder, prevent N/V
related to chemotherapy.
SE: bradycardia, hypotension, increased salivation/sweating, sleep disturbances
Contra: DM; CAD; MI; Heart block; Gangrene; intestional obstruction, ulcerative colitis, peptic
ulcer, peptic ulcer; respiratory DOs or asthma
Nurs: Atropine Sulfate counteracts a potential dangerous drug interaction; take w/ food
 Acetylcholine (Ach)
 Bethanechol Chloride (Urecholine)
 Pilocarpine HCl (Pilocar)
 Carbachol intraocular (Miostat)
 Metoclopramide HCl (Reglan)—prevent N/V; treat heartburn
Indirect-Acting Cholinomimetic drugs—inhibit the action of acetylcholinesterase
Uses: Myasthenia gravis, glaucoma, post-op bladder disenion, Post-op paralytic ileus; counteract
neuromuscular blockade
SE: hypotension, miosis, vasodilation, bradycardia, increased salivation, diaphoresis, paralysis of the
diaphragm, respiratory arrest
Precaution: DM, CAD, heart block, ulcerative colitis, hypothyroidism, gangrene; Do not give w/
ganglionic blocking agents→ can result in severe hypotension
Nurs: assess for s/s of Myasthenia crisis (drooping of upper eye lid, double vision, difficulty chewing and
swallowing); assess for neuro toxicity (tremors, restless, confusion, convulsions);
 Neostigmine bromide (Prostigmin)—for urinary retention & paralytic ileus
 Edrophonium Cl (Tensilon)—used to differentiate between myasthenia crisis (not enough
medication) and cholinergic crisis (too much medication)
 Pyridostigmine Bromide (Mestinon)—for myasthenia gravis
 Atropine sulfate—ANTIDOTE
Anticholinergic drugs: block PSNS
Uses: GI Dos w/ ↑ mobility, excessive secretion of gastric acid, abdominal pain; Genital urinary-tx
antispasmodic action; eye—paralysis of ciliary muscles & mydraiasis, respiratory—bronchodilation;
Cardiac—tx bradycardia; parkinson's ; pre-op to prevent vagal stimulation & ↓ secretions.
SE: dry mouth, constipation, blurred vision, difficulty urination, ↑HR, intolerance to heat
Precautions: Glaucoma, lung,renal,hepatic disease; myasthenia gravis, Heart disease, paralytic ileus; not
w/ CNS depressants, anti-dysrhythmics, antiphypertensives
 Atropine sulfate—dry secretions, tx ↓HR; antidote for cholinergic drugs & insecticide poisoning
 Belladonna tincture—GI disorders
 Homatropine—eye drops to produce mydraisis & cycloplegia
 Trihexphenidyl (artane)—parkinsons's
 Oxybutynin Cloride (Ditropan)--↑ bladder capacity & ↓ frequency
 Scopolamine hydrobromide (Hyoscine)—motion signcess & N/V
Skeletal Muscle Relaxants-Central: gives sedation w/o loss of consciousness
Uses: muscle pain & spasticity
Nurs: take w/ food; avoid alcohol & CNS depressants
 Carispoprodol (Soma)—muscular spasms
 Cyclobenzaprine HCl (Fexeril)—spasm & severe pain
 Baclofen (Lioresal)—spasticity from MS, spinal cord injuries
 Orphenadrine (Norflex)—less commonly used
Skeletal Muscle Relaxants—direct acting: interferes w/ release of Ca
Uses: spasticity & malignant hyperthermia crisis
SE: yellow discoloration of skin & eyes;
 Dantrolene—spasticity (caution w/ lactose intolerance as drug contains lactose); place client in
recumbent position for IV admin;
Neuromuscular Blocking agents (NMBA): interrupts transmission at neuromuscular junction; does not
diminish pain; admin parenterally
Nondepolarizing NMBA: blocks depolarization; reverse action w/ anticholinesterase agents & give
atropine w/ reversal agent to ↓ SE of Ach buildup (↓HR, bronchospasm, excessive salivation)
Nurs: train of four (TOF) test: response to 4 consecutive mild electric shocks—1 twitch=90% blockage,
2-3 twitches 75-90%blockage, 0 twitches indicate no blockage. Goal 85-90%
Depolarizing agents: (NMBA) : prevents repolarization—no specific antidote
 Succinylcholine (Anectine)—short acting; not w/ narrow-angle glaucoma, not w/ malignant
hyperthermia (s/s: ↑HR, ↑RR, hypercarbia, jaw muscle spasm, lack of laryngeal relaxation, ↑T)
Central Nervous System stimulates: stimulate heart , respiratory, general metabolism
Analeptic Stimulants: act on cerebral cortex & medullary centers;
 Caffeine--↑ alertness & ↓ fatigue; weak diuretic
 Doxapram HCl (Dopram)—respiratory stimulant
 Theophylline (a methyxanthine) –treat respiratory diseases
Psychomotor stimulants: amphetamines; stimulate cerebral cortex;
Uses: ADHD, narcolepsy; Weight reduction; depression, symptoms of withdrawal from addictive drugs
Nurs: monitor for cardiac symptoms & hyperthyroidism; w/ ADHD admin drugs in morning & at noon
 Methyphenidate (Ritaline): schedule II; tx Narcolepsy & ADHD; needs drug holiday
 Pemoline (Cylert): schedule IV; tx ADHD; monitor liver fxn
 Amphetamine Sulfate: tx narcolepsy & ADHD
 Methamphetamine HCl (Desoxyn): tx ADHD & obesity
 Dextroamphetamine sulfate (Dexedrine): ADHD & narcolepsy
Nonamphetamine Anorexiants: depressed CNS appetite center in the brain
Nurs: monitor for cardiac symptoms & hyperthyroidism
 Phentermine HCl (Fastin) short term mgmt of obesity
 Phenmetrazine (Preludin) same
 Diethylpropion HCl (Tenuate) same
CNS Depressants: sedatives—relaxation; hypnotics—sleep; anxiolytics—control anxiety; have potential
for dependence;
Sedatives & Hypnotics: small doses→sedation; lg doses→drowsiness/sleep; very Lg doses→induce
general anesthesia; 3 classifications: barbiturates, non-barbiturates, benzodiazepines
Barbiturates: depress CNS, respirations, HR, BP, T, & rapid eye mov't sleep; do not relieve pain;
psychological & physical dependence is serious problem; metab. by liver & excret by kidneys
Uses: tx seizures; promote anesthesia; promote sedation & sleep
SE: Bariturate poisioning (s/s disorientation, confusion, memory loss, weight loss)
Mgmt: Do not stop abruptly (taper 2-3wks); not w/ alcohol or other CNS depressants; take in PM to
prevent daytime drowsiness; no smoking (↑risk fire); no not admin if RR>10 or shallow
 Theopental Sodium (Pentothal )—for anesthesia
 Penobarbital Na (Luminal, Nembutal)—for seizures
 Secobarbital Na (Seconal) –pre op sedation; status epilpticus; tetanus convulsions, insomnia
 Amobarbital (Amytal)—produce sleep
NonBarbiturates:
 Buspirone (BuSpar)—anxiety ; admin w/ Food; 2-4wks for full effectiveness; causes dry mouth
Chloral Hydrate (Noctec)—sleep ; preprocedure in pediatrics; interferes w/BG test in DM; give w/ food &
8oz water; avoid driving; not w/ Alcohol or other CNS depressants;
 Zolpidem tartrate (Ambien)—schedule IV; short-term mgmt of insomnia; empty stomach; not w/
alcohol or other CNS depressants
 Paraldehyde (Paral)—sedation; alcohol withdrawals; toxicity s/s: ↓BP, ↓RR, liver failure, bleeding
gastritis, pulmonary hemorrhage; discard soln after 24hrs; dilute w/ juice/milk to mask flavor
 Hydroxyzine (Vistaril)—antihistamine to induce sleep; deep tissue IM only; use Z track method
 Diphenhydramine HCl (Benadryl)—antihistamine used to treat mild insomnia
Benzodiazepines: causes release of GABA which inhibits transmission of impulses in CNS;
Uses: sleep; insomnia; anxiety; muscle relax; alcohol w/drawal; seizures; status epelepticus;
Mgmt: not not D/C abruptly (taper 6-8wks); not w/ alcohol or other CNS depressants; withdrawal s/s
(anxiety, dysphoria, insomnia, irritability, acute psychosis, seizures); no admin if RR<10; take w/ food;
 Temazepam (Restril)—insomnia
 Diazepam (Valium)—short-term anxiety; seizures
 Conazepam (Klonopin)—seizures; panic disorders
 Flurazepam HCl (Dalmane)—insomnia
 Estazolam (ProSom)—insomnia
 Quazepam (Doral)—insomnia
 Triazolam (Halcion)—insomnia
 Flumazenil (Romazicon)—ANTIDOTE
Axniolytics (antianxiety):
Uses: Phobias, Obsessive-compulsive behaviors, generalized anxiety, panic disorders
 Diazeppam (Valium)—drug duration 20-50hrs; tx: anxiety, epilepsy, muscle spasm, panic DO, preop medication; take at bedtime;
 Chlordiazeproxide (Librium) [benzo]: duration 5-30hrs; tx anxiety and anxiety w/ depression
 Halazepam (Paxipam)—anxiety
 Lorazepam (Ativan)—anxiety assoc. w/ depression
 Prazepam (Centrax) –anxiety assoc. w/ depression
 Diphenhydramine HCl (Benadryl)—tx mild insomnia
 Buspirone (BuSpar)—anxiety
 Chloral hydrate (Ambien)—short-term mgmt of insomnia
Mood disorder drugs: one theory: serotonin and/or NE lacking w/ depression & excess NE in mania
Cyclic Antidepressants: tri & tetracyclic (nucleus of drug is composed of 1+ rings); prevent reuptake of
NE and serotonin; therapeutic response takes > 3-4wks; lethal dose 1-3g;
Mgmt: acute poisoning s/s: cardiac arrythmias, hallucinations, bowel//bladder paralysis, resp. depress.; not
w/ alcohol or other CNS depressants; stop drug gradually; single dose at bedtime; labs for
therapeutic levels;
 Imipramine HCl (Tofranil)—oldest tricyclic
 Amitriptyline HCl (Elavil)—deprssion
 Doxepin HCl (Sinequan)—sedation and w/ agitated clients
 Maprotiline (Ludiomil)—tricyclic antidepressant w/ anticholingergic properties
Selective Serotonin Reuptake Inhibitors (SSRI): ↑ serotonin levels; similar to cyclics but w/o
anticholinergic, cardiovascular or sedative SEs;
Uses: Depression; dysthymia, bulimina, obsessive-compulsive behavior
Mgmt: not w/ MAOIs (5 weeks should pass before use of SSRI after MAOI); not w/ kidney/liver disease;
caution w/ anticoagulants (both drugs are protein-bound); w/food; weigh clt weekly; 1-3 wks before
effect; no abrupt stopping of drug;
 Fluoxetine (Prozac)—1st on market
 Sertraline (Zoloft)—depression, panic DO, OCD (obsessive…); Post-traumatic stress DO (PTSD)
 Paroxetine (Paxil)—depression, panic DO, OCD, social anxiety disease
Monoamine Oxidase Inhibitors (MAOI): block MAOs which metabolize epinehphrine, NE, and
serotonin; ↑ levels of NTs; non-addicting; do not develop tolerance; few anticholinergic, CV and
sedative effects compared to other antidepressants;
Nurs: restrict diet of tyramine (cheese, fermented/pickled foods, beer/red wine, chocolate, yogurt,
avocados, raisins, figs, meat extracts; no alcohol ) several days before to 2 weeks after start drug;
drug + tyramine → hypertensive crisis (when MAOs are inhibited tyramine can cause release of
large amts of NE); Toxicity s/s: insomnia, agitation, confusion, convulsions; not w/ Demerol →
HTN crisis; not w/ alcohol; change position slowly RT orthostatic hypotension
 Phenelzine sulfate (Nardil)—neurotic depression assoc. w/ anxiety
 Tranylcypromine sulfate (Parnate)—severe depression
Mood Stabilizing drugs: inhibits release of NE and dopamine and ↑ reuptake of catecholamine NTs;
Direct relationship between Na intake and lithium excretion (↓Na slows excretion of
lithium→toxicity); must have function kidney as body does not metabolize lithium; effect takes 5-7
days; Lithium Therapeutic level 0.6 – 1.2 mEq/L; control symptoms of agitation w/
Haloperidol (Haldol) or Chlorpromazine HCl (Thorazine)
Nurs: monitor levels 2-3 times per week for first 2 months; fluid intake of 2-3L/day; w/food or milk;
avoid changing amount of salt intake;
 Lithium carbonate (Eskalith,k Lithane, Lthonate)
 Litium Citrate syrup (Cibalith-S)
Psychiatric Disorders drugs:
Phenothiazines: believed to block dopamine receptors in limbic system→ ↓dopamine levels
Use: schizophrenia, acute mania, psychotic depressions
SE: Extrapyramidal Rxns: Parkinsonism (mask-like face, muscular tremors/rigidity), Akathisia
(involuntary motor restlessness—moves lips/taps feet), Acute dystonia (jerking, spastic mov'ts,
eye rolling), Tardive dyskinesia (lip smacking, tongue mov'ts, constant chewing), Perioral
tremor (rabbit syndrome—like parkinsoniam), Neuroleptic malignant syndrome (fever, ↑HR,
Resp. distress, diaphoresis, muscle rigidity, erratic BP, catatonia), Anticholingergic (dry mouth,
blurred vision, constipation, urinary retention, edema/weight gain), ↓BP w ↑HR, ↓libido
NURS: therapeutic effect can take 6 months, photosensitivity
 Chlorpromazine (Thorazine, Ormazine)—Phenothiazines—psychiatric disorders
 Fluphenazine (Permitil, Prolixin) —Phenothiazines—psychiatric disorders
 Trifluoperazine (Stelazine, Suprazine) —Phenothiazines—psychiatric disorders
Non-phenothiazines: control negative (flat affect) and positive (hallucinations) symptoms
Uses: schizophrenia, depression/psychosis, psychosis, tourette's syndrome, delirium, dementia
Nurs: recumbent position q 30min after admin.,
 Thiothixene (Navane) —chronic schizophrenia
 Haloperidol (Haldol) —acute/chronic psychoses, tourette's, ↑ extrapyramidal SE, not w/Parkinson's
 Clozapine (Clozaril) —schizophrena, SE life-threatening agranulocytosis, ↓seisure threshold
 Molindone (Moban) —
 Loxapine (Loxitane) —like haloperidol
 Risperidone (Risperdal) —psychotic disorders
 Olanzapine (Zyprexa) — psychotic disorders
Seisures drugs: D/C meds gradually (can cause seizures)
Barbiturates: increases the threshold for seizures , not for absence seizures; half life 60-120hrs
SE: ataxia, dizzy, hangover effect/drowsy, Steven-Johnson Syndrom aka erythema multiforme major
(severe inflammatory disease can lead to death s/s: rash, fever, extreme fatigue, joint pain, vision
abnormalities, resp. infection, N/V)
Nurs: not w/ resp. DOs, hx alcohol/drug abuse, liver/kidney dysfxn; toxic s/s: ↓HR, resp.distress,extreme
weakness, ataxia; assess for confusion/slurred speech; not w/ RR<10
 Phenobarbital Na (Luminal)—generalized/tonic-clonic seizures,status epilepticus, SE:CNS depress
 Primidone (Mysoline) —psychomotor/generalized/tonic-clonic seizures
Hydantoins: reduce seizure focal activity, not for absence seizures; not w/ Liver/kidney/throid/cardiac
dysfxn; alcoholism, DM, blood dyscrasias; can cause osteomalacia
 Phenytoin (Dilantin) —tonic-clonic/some psychomotor; SE gastric irritation; therap.level 10-20
 Fosphenytoin (Cerebyx) —hydantoins—seizures
 Mephenytoin (Mesantoin) —produces higher incidence of blood dyscrasias & skin rash
Benzodiazepines: suppress seizure activity by ↑GABA→↓ nerve transmission
SE: drowiness, fatigue, lethargy, muscular incoordination, ↓BP, dizziness, anorexia, ataxia
Nurs: not w/ RR<10; ANTIDOTE: Flumazenil(Romazicon); monitor liver/renal labs for long-term therapy
W/food; not w/ alcohol/smoke; never D/C abruptly (taper 6-8wks)
 Clonazepam (Klonopin) —absence/myotonic seizures
 Diazepam (Valium) —status epilepticus
 Lorazepam (Ativan, Alzapam) — status epilepticus
 Clorazepate (Tranxene) — absence/myotonic seizures
Anti-convulsants—Other:
 Carbamazepine (Tegretol)— absence/mixed seizures
 Ethosuximide (Zarontin) —absence seizures; common SE: GI irritation
 Felbamate (Felbatol)— partial seizures
 Gabapentin (Neurontin) —partial seizures; excreted entirely by kidneys (↓ dose w/renal dysfxn);
not w/in 2 hours of antiacids (↓ usefulness by 20%)
 Lamotrigine (Lamictal) —partial seizures SE: Stevens-Johnson syndrome
 Phensuximide (Milontin) —absence seizures
 Primidone (Mysoline) —all seizures except absence; can be substituted for phenobarbital
 Trimethadione (Tridione) —absence seizures
 Valproic acid (Depakene) —absence/myoconic;generalized tonic-clonic seizures; migraines
Neurological disorder drugs:
Parkinson's: lack of dopamine in basal ganglia of brain; Parkinsoniam is invol. mov't—four cardinal
features: Tremor at rest; Akinesia (complete/partial loss of muscle mov't), rigidity; disturbance of
posture/equilibrium; goal of drug treatment is to ↑dopaminergic action & ↓ cholinergic action
Dopaminergic drugs: does not control drug induced extrapyramidal rxns
SE: early: orthostatic ↓BP, N/V, dsyrhythmias; Late: involunatary mov't, akinetic spells (immobilized);
psychotic behavior, nightmares, anxiety, memory loss
Nurs: not w/ narrow-angle glaucoma (causes mydraisis which worsens glaucoma); not w/ melanoma;
caution w/GI/heart disease or psychiatric DOs; w/food; expect harmless darkening of sweat/urine
 Levodopa (Dopar, Larodopa)—precursor to dopamine(which can't enter brain in sufficient
quantities); looses effectiveness 3-5 yrs; abrupt D/C →Neuoleptic malignant syndrome (↑T, muscle
rigidity); early sign of Toxicity: twitching of eyelids
 Carbidopa-levodopa (Sinemet) —allows ↑ conversion of levodopa to dopamine in the brain by
inhibiting peripheral conversion; give client "drug holidays" to prevent tolerance (taper off for 3
days then D/C up to 14 days);
Anticholinergics (antimuscarinics): must be centrally active and able to cross blood-brain barrier;
Nurs: not w/narrow angle glaucoma, prostatic hyprtropy, urninary retention; caution w/ antihistamine,
phenothiazines, tricyclic antidepressesant, digoxin;
 Trihexyphenidyl (Artane) —used as intial or adjunct treatment
 Benztropine (Cogentin) —used if can't tolerate Artane
Antiparkinson drugs:
 Amantadine (Symmetrel) —dopamine receptor agonist and synthetic antiviral agent that ↑ release
of dopamine in brain; SE: mottled purple-colored skin, edema, drowsy, confused
 Pergolide (Permax) —dopamine receptor agonist→↓tremor, ↑posture/akinesia, rigidity
 Pramipexole (Mirapex) —nonergot dopamine receptor agonist
 Ropinirole HCl (Requip) —nonergot dopamine receptor agonist
 Bromocriptine (Parlodel) —dopamine receptor agonist


Selegiline HCl (Eldepryl)—MAOI—type B—used as adjunct to levodopa/carbidopa (Sinemet)
Entacapone (Comtan)—inhibits an enzyme that breaks down levodopa
Myasthenia Gravis drugs: muscle weakness and abnormal fatigue that is relieved by rest; drooping of
upper eyelip (Ptosis) and sustained gaze; limb weakness; exacerbations from stress/hormonal
changes/ alcohol/some drugs;
Cholinesterase Inhibitors→ ↑Ach levels; tolerance relieved by "drug holidays"
SE: weakness of resp. muscles, ↓HR, ↓BP, tremor, anxiety, ↑bronchial secretions/sweating/salivation
Nurs: NOT w/ ganglionic blocking agents (severe ↓BP); too low dose → cholinergic crisis (abdominal
cramps, diarrhea, excessive pulmonary secretions); w/food 30-60 prior to meals ↑strength to eat
 Neostigmine Br (Prostigmin)—used in dx and tx
 Edrophonium Cl (Tensilon) —used to dx and to differentiate between myasthenia crisis [↓Ach
levels] and cholinergic crisis [↑Ach levels]
 Pyridostigmine Br (Mestinon) —maintenance drug of choice
 Atropine Sulfate (ANTIDOTE)
Anesthesia-general: anticholinergics are given to prevent vagal stimulation;
Anesthesia-Inhalation: goal to provide analgesia, muscle relaxation, amnesia w/o SEs
SE: Resp depression, malignant hyperthermia (↑T, ↑BP, ↑HR, muscle rigidity); CV depression
Nurs: caution w/ breathing DOs
 Nitrous oxide (N2O)—"laughing gas"; light anesthesia; used alone for dental/minor surgical
 Halothane (Fluothane) —used w/children/adults—narrow safety range→CV & resp. depression
 Methoxyflurane (Penthrane) —most powerful—narrow safety range, many SE
 Enflurance (Ethrane) —adults only; similar to halothane
Anesthesia-IV: most common drugs ultra-short acting barbiturates & neuroleptics; conscious sedation ↓
LOC but allows maintence of airway independently & respond to commands—no effect on pain
SE: bronchospasm, resp./Cardiac depression; ↓BP, apnea
 Fentanyl citrate (Sublimaze) —opioid—reduces awareness & sensory perception
 Thiopental sodium (Pentothal)—barbiturate —rapid onset & duration < 15 minutes
 Methohexital Na (Brevital) —barbiturate —very short acting; 5X as strong as thiopental Na; used
in outpatient procedures , electroconvulsive therapy
 Ketamine (Ketalar) —Non-barbiturate; rapid acting; short dx/surgical procedures; no muscle
relaxation; SE: Hallucinations
 Propofol (Diprivan)—IV sedative-hypnotic; not < 3yrs old;
Anesthesia—local/regional: use esters or amides; for dental, labor/delivery, minor surgical/diagnostic
SE: cardiac/resp. depression, skin irritation, headache (spinal)
 Procaine (Novocaine)—Ester—used for nerve blocks
 Benzocaine—Ester—skin & mucous membrane- topical
 Tetracaine HCl (Pontocaine) —Ester—nerve block; topical ointment for eye
 Lidocaine (Xylocaine) —Amide—nerve block & topical
 Prilocaine (Citanest) —Amide—nerve block (40% fewer toxic effects than lidocaine); not topical
 Mepivacaine (Carbocaine) —Amide—nerve blocks
Cardiovascular Drugs:
Heart failure: cardiotonic-inotropic agents are major drugs used; body tries to compensate by ↑SNS
activity, heart size, RAAS system. Goal aimed at altering/controlling compensatory mechanisms:
Diuretics to ↓blood volume, cardio-inotropic agents to strengthen heart, vasodilate to ↓peripheral
resistance, ACE inhib. to dilate both veins & arteries→↓preload & afterload→↓ workload of heart.
Digitalis Glycosides: a glucose molecule attached to a steroid nucleus; tx heart failure & dysrhythmias
(A-fib/flutter, SVT, Paroxysmal atrial tachy); +inotropic without increasing HR or oxygen
requirement; ↓K→↑risk toxicity; SE: Visual disturbances (hallmark signs: blurred or yellow
vision, halos and colored dots), dysrhythmias; p.200-202 for list:
Caution: w/ quinidine, verapamil, erythromycin, clarithromycin, Heart block, wolf-ParkinsonWhite syndrome (impulse returns to upper chamber to abnormal conduction); electrolyte
imbalances ↑ toxicity (↓K, ↓Mg, ↑Ca)
 Digoxin—caridac glycoside—depresses SNS stimulation; and in higher does depresses AV
conduction (affect A-fib/flutter); check apical pulse-hold drug < 60;
therapeutic level 0.8-2.0ng/mL
 Digitoxin (Crystodigin) —longest duration of action (1-3 weeks)
 Digoxin Immune Fab (Digibind)—ANTIDOTE for digoxin
Cardotonic Inotropic Drug:
 Amrinone (Inocor)—bipyridine derivative—relaxes arteries
 Milrinone (Primacor) —bipyridine derivative—long term use → headaches and angina
 Nesiritide (Natrecor)—vasodilator—brain natriuretic peptide (BNP)—tx decompensated heart
faiure; may cause hypotension
Angina:
Organic Nitrates: relax smooth muscles; dilates veins/arterioles; dilates coronary arteries
SE: pulsating pounding headache, facial flushing
Nurs: not w/↑ICP; monitor pulse & BP; use glass bottles; keep away form light/heat/moisture
 Nitroglycerine (NTG) (Nitro-bid, Nitrostat, Nitrodisc, Nitrogard, Nitro-Dur)—organic nitrate—one
tablet q 5 min x 3; prevent anginal attacks w/use prior to moderate or sexual activity, avoid
stenuous activity/stress/and cold.
 Isosorbide dinitrate (Isordil) —organic nitrate—long term prophylaxis
Beta-adrenergic blockers: 2→vasodilation in skeletal muscle arterioles 1→slow HR; should not be
stopped abruptly; Not w/ alcohol/CNS depressants, OTC decongestants; prior to admin—
check pulse, BP; monitor for hypoglycemia; avoid antacids; avoid being hot
 Propranolol HCl (Inderal)—beta blockers—angina, MI, dysrhythmias
 Atenolol (Tenormin) —beta blockers—angina, HTN, MI
 Pindolol (Visken) —beta blockers—angina, HTN
Calcium channel blockers: relax smooth muscle & ↓contraction of heart, ↓conduction, ↓HR; dilate
coronary and peripheral arteries; D/C gradually
Use: SVT, post MI, HTN, stable/unstable/vasospastic angina
SE: hypotension, bradycardia, dyspnea/wheezing, peripheral edema, heart block, dizziness
Contra: hepatic/renal disease; heart block; hypotenaion, severe bradycardia, aortic stenos; severe left
ventricular dysfxn; pregnancy/lactation; respiratory DOs; W/Digoxin→↑digoxin concentration
 Verapamil HCl (Calan, Covera-HS, Isoptin,k Verelan)—angina
 Nefedipine (Adalat, Nifedical, Procardia) —angina
 Diltiazem HCl (Cardizem) —angina
 Amlodipine (Norvasc) —angina
 Nicardinine HCl (Cardene SR)—angina
Lipid-Lowering Drugs:
Bile Acid Sequestrants: bind w/ bile acids and ↑ excretion with feces; not w/bowel obstruction; report
unusual bleeding, tarry stools, bruising—may need Vit K
SE: constipation, bloating & flatulence
 Colestipol (Colestid)—
 Cholestyramine (Questran, Prevalite Powder)
HMG-CoA Reductase Inhib (Statins): inhibit synthesis of Cholesterol; get liver fxn tests; take in
evening (except Lipitor); report muscle pain & serious GI effects
SE: unexplained liver dyfxn; constipation;
 Atorvastatin (Lipitor) —
 Simvastatin (Zocor)
 Fluvastatin (Lescol) —
 Pravastatin (Pravachol) —
 Lovastatin (Mevacor) —
Fibric Acid Derivatives: helps break down cholesterol; short-term only; not w/ renal/liver dysfxn
SE: abdominal pain/diarrhea; cholelithiasis (esp w/ hx of gallstones);
Nurs: monitor for s/s of Cholelithiasis (intolerance to fatty foods, nausea, URQ abdominal pain; clay
colored stools, low grade fever)
 Gemfibrozil (Lopid) —
 Fenofibrate (Lipidil) —
Dysrhythmias:
Group IA—Sodium channel blockers: decrease in conduction speed
Use: atrial Fib AF; PVCs; VT
SE: tinnitus, visual disturbances, hyptension, dizziness/confusion; dysrhythmias (Torsades de Pointes—
form of V-tach where morphology of QRS varies)
Nurs: caution w/ kidney/liver dysfxn; w/food
 Quinidine sulfate (Cin-Quin, Quinora)—toxicity s/s: GI symptoms; tinnitus & visual SE
 Procainamide HCl (Pronestyl) —caution w/ MI, renal failure
 Disopyramide phosphate (Norpace) —tx atrial/ventricular dysrhythmias
Group 1B: decrease action potential duration
Use: PVCs; vent. tachy
SE: confusion, visual/hearing disturbances, hypotension/ bradycardia, drowiness
Nurs: contra w/ heart block; monitor ECG, HR, BP during/after admission
 Lidocaine HCl (Xylocaine)—PVCs, local heart anesthetic; serious CNS SEs
 Mexiletine HCl (Mexitil) —ventricular dysrhythmias; w/food
 Tocainide HCl (Tonocard) —oral equivalent of lidocaine; w/food
Group 1C: cell membrane stabilizer→ ↓ depolarization
Use: life threatening ventricular arrhythmias
SE: dysrhythmias, visual disturbances; dizzy, fatigue, tremor, exacerbation of symptoms of HF
Nurs: schedule eye exams; w/food; report visual changes; monitor K levels; monitor ECG, HR, BP
during/after admission
 Propafenone HCl (Rythmol) —life-threatening V.dysrhythmias; PSVT
 Flecainide acetate (Tambocor) — life-threatening V.dysrhythmias
Group II: Beta-adrenergic blockers
Use: atrial fib/flutter; tachydysrhythmias; Wolf-Parkinson-white syndrome; V. dysrhythmias
SE: bradycardia, orthostatic hypotension, bronchoconstriction/spasm, hypoglycemia
Nurs: Do not stop abruptly; not w/ Alcohol/CNS depressants/OTC decongestants
 Propranolol HCl (Inderal)—dysrhythmias assoc / excess catecholamines
 Esmolol HCl (Brevibloc)—
 Sotalol (Betapace) –
 Metoprolol (Lopressor) —
 Acebutolol (Monitan) —
Group III: Potassium channel blockers→ ↑action potential duration
Use: ventricular dysrhythmias & some atrial
SE: orthostatic hypotension, ARDS, blue-gray skin discoloration (photosensitivity); torsades de pointes;
visual disturbances
Nurs: asses ECG, BP, Apical pulse before/after/during admin.; monitor liver/kidney fxn; assess thyroid fxn
 Bretylium tosylate (Bretylol) —1st 30 min may have ↑BP, vomiting, dysrhy.RT release of NE
 Amiodarone (Cardarone) -caution w/ liver/pulmonary disease; common SE bluish-gray skin & N/V
 Ibutilide (Covert) —A fib/flutter
Group IV: CCBs—relax smooth muscle & ↓ contraction of heart, ↓conduction, ↓HR; dilate coronary and
peripheral arteries; D/C gradually
Use: prevent & control SVT,
SE: hypotension, bradycardia, dyspnea/wheezing, peripheral edema, heart block, dizziness
Contra: hepatic/renal disease; heart block; hypotenaion, severe bradycardia, aortic stenos; severe left
ventricular dysfxn; pregnancy/lactation; respiratory DOs; W/Digoxin→↑digoxin concentration
Nurs: w/food/milk; not w/ alcohol
 Verapamil HCl (Calan, Isoptin) —SVT
 Diltiazem HCl (Cardizem) –tx: PSVT; Wolf-Parkinson-White syndrome(AV node re-entry tachy)
Hypertension (HTN):
Nurs: Asian may need smaller dose, not as effective w/ Afric-amer
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Captopril (Capoten)—ACE inhibitor—anti-hypertension
Lisinopril (Prinivil) —ACE inhibitor—anti-hypertension
Enalapril maleate (Vasotec) —ACE inhibitor—anti-hypertension
Quinapril HCl (Accupril) —ACE inhibitor—anti-hypertension
Moexipril HCl (Univasc) —ACE inhibitor—anti-hypertension
Ramipril (Altace) —ACE inhibitor—anti-hypertension
Fosinopril (Monopril) —ACE inhibitor—anti-hypertension
Losartan potassium (Cozaar)—angiotensin-II receptor antagonist—anti-hypertension
Propranolol HCl (Inderal)—beta adrenergic blocker—anti-hypertension
Atenolol (Tenormin) —beta adrenergic blocker—anti-hypertension
Acebutolol (Monitan) —beta adrenergic blocker—anti-hypertension
Metoprolol tartrate (Lopressor) —beta adrenergic blocker—anti-hypertension
Labetalol (Normodyne, Trandate) —beta adrenergic blocker—anti-hypertension
Nifedipine (Procardia) —Ca channel blocker—anti-hypertension
Amlodipine besylate (Norvasc) —Ca channel blocker—anti-hypertension
Felodipine (Plendil) —Ca channel blocker—anti-hypertension
Prazosin HCl (Minipress)—alpha-adrenergic blocking agent—anti-HTN
Reserpine (Serpasil, Sandril) —alpha-adrenergic blocking agent—anti-HTN
Clonidine HCl (Catapres)—sympathetic NS inhibitor—anti-HTN
Hydralazine (Apresoline)—direct-acting vasodilator—anti-HTN
Minoxidil (Loniten) —direct-acting vasodilator—anti-HTN
Diazoxide (Hyperstat) —direct-acting vasodilator—anti-HTN
Sodium Nitroprusside (Nipride)—mixed arterial/venous vasodilator—anti-HTN
Epinephrine HCl (Adrenalin)—adrenergic drug—hypotension/shock
Norephinephrine (Levophed) —adrenergic drug—hypotension/shock
Dopamine HCl (Intropin) —adrenergic drug—hypotension/shock
Dobutamine HCl (Dobutrex) —adrenergic drug—hypotension/shock
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Isoproterenol HCl (Isuprel) —adrenergic drug—hypotension/shock
Heparin sodium—anticoagulant –blood DOs
Protamine sulfate—ANTIDOTE for heparin—blood DOs
Enoxaparin (Lovenox) —low molecular weight heparin (LMWH)—anticoagulant –blood DOs
Dalteparin (Fragmin) —low molecular weight heparin (LMWH)—anticoagulant –blood DOs
Danaparoid (Orgaran) —low molecular weight heparin (LMWH)—anticoagulant –blood DOs
Ardeparin (Normiflo) —low molecular weight heparin (LMWH)—anticoagulant –blood DOs
Warfarin (Coumadin) —anticoagulant (ANTIDOTE is Vit K) –blood DOs
Epoetin Alpha (Epogen, EPO, Procrit)—erthropoietin—anti-anemic
Alteplase (Activase)—thrombolytic—blood DOs
Anistreplase (Eminase) —thrombolytic—blood DOs
Streptokinase (Streptase) —thrombolytic—blood DOs
Urokinase (Abbokinase) —thrombolytic—blood DOs
Acetylsalicylic acid (Aspirin)—antiplatelet—blood DOs
Dipyridamole (Persantine) —antiplatelet—blood DOs
Ticlopidine (Ticlid) —antiplatelet—blood DOs
Abciximab (ReoPro) —antiplatelet—blood DOs
Clopidogrel (Plavix) —antiplatelet—blood DOs
Eptifibatide (Integrillin) —antiplatelet—blood DOs
Tirofiban ( Aggrastat) —antiplatelet—blood DOs
Ethylenediaminetetraacetic acid aka Ca disodium edentate [EDTA]—chelating agent—blood DOs
Succimer (Chemet) —chelating agent—blood DOs
Fexofenadine (Allegra)—antihistamine—rhinitis--respiratory
Loratadine (Claritin) —antihistamine—seasonal allergies--respiratory
Cetirizine (Zyrtec) —antihistamine—allergic rhinitis & urticaria--respiratory
Dimenhydrinate (Dramamine) —antihistamine—motion sickness
Meclizine (Antivert) —antihistamine—motion sickness
Promethazine (Phenergan) —antihistamine—N/V, increase CNS depression
Hydroxyzine (Vistaril) —antihistamine—N/V, increase CNS depression
Diphenhydramine HCl (Benadryl) —antihistamine—allergic response, promote sleep
Codeine—opioid—antitussive—respiratory
Dextromethorphan—Non-opioid—antitussive—respiratory
Albuterol (Proventil)—adrenergic bronchodilator—respiratory
Salmeterol (Serevent Diskus) —adrenergic bronchodilator—respiratory
Terbutaline (Berethine) —adrenergic bronchodilator—respiratory
Levalbuterol (Xopenex) —adrenergic bronchodilator—respiratory
Epinephrine—acute bronchoconstriction—respiratory
Theophylline (Theo-Dur)—xanthine bronchodilator—respiratory
Aminophylline (Phyllocontin) —xanthine bronchodilator—respiratory
Ipratropium (Atrovent)—anticholinergic bronchodilator—respiratory
Pseudoephedrine (Sudafed, novafed, Afrinol Repetabs)—decongestant—respiratory
Oxymetazoline (Afrin)—decongestant—respiratory
Phenylephreine (Neo-synephrine)—decongestant—respiratory
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Drugs Affecting the Respiratory system
Antihistamines:
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Fexofenadine (Allegra)—antihistamine—rhinitis--respiratory
Loratadine (Claritin) —antihistamine—seasonal allergies--respiratory
Cetirizine (Zyrtec) —antihistamine—allergic rhinitis & urticaria--respiratory
Dimenhydrinate (Dramamine) —antihistamine—motion sickness
Meclizine (Antivert) —antihistamine—motion sickness
Promethazine (Phenergan) —antihistamine—N/V, increase CNS depression
Hydroxyzine (Vistaril) —antihistamine—N/V, increase CNS depression
Diphenhydramine HCl (Benadryl) —antihistamine—allergic response, promote sleep
Codeine—opioid—antitussive—respiratory
Dextromethorphan—Non-opioid—antitussive—respiratory
Albuterol (Proventil)—adrenergic bronchodilator—respiratory
Salmeterol (Serevent Diskus) —adrenergic bronchodilator—respiratory
Terbutaline (Berethine) —adrenergic bronchodilator—respiratory
Levalbuterol (Xopenex) —adrenergic bronchodilator—respiratory
Epinephrine—acute bronchoconstriction—respiratory
Theophylline (Theo-Dur)—xanthine bronchodilator—respiratory
Aminophylline (Phyllocontin) —xanthine bronchodilator—respiratory
Ipratropium (Atrovent)—anticholinergic bronchodilator—respiratory
Pseudoephedrine (Sudafed, novafed, Afrinol Repetabs)—decongestant—respiratory
Oxymetazoline (Afrin)—decongestant—respiratory
Phenylephreine (Neo-synephrine)—decongestant—respiratory
Guaifenesin (Robitussin)—expectorants—respiratory
Belcomethasone—inhaled corticosteroid—respiratory
Zafirkulast (Accolate)—Leukotriene Modifier—respiratory
Montelukast (Singulair)—Leukotriene Modifier—respiratory
Acetylcysteine (Mucomyst)—Mucolytic—respiratory
Acedtazolamide (Diamox, Daxamide)—Carbonic Anhydrase Inhibitor—diuretic —Renal System
Dorzolamide (Trusopt) —Carbonic Anhydrase Inhibitor—diuretic —Renal System
Brinzolamide (Azopt) —Carbonic Anhydrase Inhibitor—diuretic —Renal System
Furosemide (Lasix)—Loop diuretic —Renal System
Ethacrynic acid (Edecrin) —Loop diuretic —Renal System
Bumetanide (Bumex) —Loop diuretic —Renal System
Torsemide (Demadex) —Loop diuretic —Renal System
Mannitol (Osmitrol) —Osmotic diuretic —Renal System
Spironolactone (Aldactone) —K sparing diuretic —Renal System
Triamterene (Dyrenium) —K sparing diuretic —Renal System
Amiloride (Midamor) —K sparing diuretic —Renal System
Hydrochlorothiazide (HydroDIURIL) —Thiazide diuretic —Renal System
Chlorothiazaide (Diuril) —Thiazide diuretic —Renal System
Bendroflumethiazide (Naturetin) —Thiazide diuretic —Renal System
Methyclothiazide (Enduron) —Thiazide diuretic —Renal System
Chlorthilidone (Hygroton, Thalitone) — diuretic —Renal System
Indapamide (Lozol) — diuretic —Renal System
Metolazone (Zaroxolyn, Mykrox)
Quinethazone (Hydromox)
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Digestive System:
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Aluminum hydroxide—antiacids—digestive system
Magnesium hydroxide—antiacids—digestive system
Calcium Carbonate—antiacids—digestive system
Sodium Bicarbonate—antiacids—digestive system
Lomotil (diphenoxylate)—opiate —antidiarrheal—digestive system
Loperamide (Imodium)-- antidiarrheal—digestive system
Psyllium (Fiberall) aka Metemucil-- antidiarrheal—digestive system
Ondansetron (Zofran)—selective serotonin antagonist—antiemetic—digestive system
Granisetron (Kytril) —selective serotonin antagonist—antiemetic—digestive system
Dolasetron (Anzemet) —selective serotonin antagonist—antiemetic—digestive system
Chlorpromazine (thorazine)—phenothiazine —dopamine antagonist—antiemetic—digestive
system
Prochlorperazine (Compazine) —phenothiazine —dopamine antagonist—antiemetic—digestive
system
Promethazine (Phenergan) —phenothiazine —dopamine antagonist—antiemetic—digestive system
Meclizine (Antivert) —antihistamine—motion sickness/vertigo—digestive system
Dimenhydrinate (Dramine) —antihistamine—motion sickness/vertigo—digestive system
Methylprednisolone (Solu-Medrol) —glucocorticoid—antiemetic—digestive system
Dexamethasone (Decadron) —glucocorticoid—antiemetic—digestive system
Lorazepam (Ativan)—benzodiazepine —antiemetic—digestive system
Simethicone (Mylicon)—antiflatulent—digestive system
Ranitidine (Zantac)—Histamine2-receptor antagonist—antiulcer—digestive system
Ranitidine Bismuth citrate (Tritec) —Histamine2-receptor antagonist—antiulcer—digestive system
Famotidine (Pepcid) —Histamine2-receptor antagonist—antiulcer—digestive system
Nizatidine (Axid Pulvules, Axid AR) —Histamine2-receptor antagonist—antiulcer—digestive
system
Cimetidine (Tagamet) —Histamine2-receptor antagonist—antiulcer—digestive system
Omeprazole (Prilosec) —Proton Pump Inhibitor—antiulcer—digestive system
Lansoprazole (Prevacid) —Proton Pump Inhibitor—antiulcer—digestive system
Rabeprazole (Aciphex) —Proton Pump Inhibitor—antiulcer—digestive system
Pantoprazole (Protonix) —Proton Pump Inhibitor—antiulcer—digestive system
Sucralfate (Carafate) —antiulcer—digestive system
Misoprostol (Cytotec) —prostaglandin—antiulcer—digestive system
Syrup of Ipecac—emetic—digestive system
Metoclopramide (Reglan)—GI stimulant—digestive system
Metamucil—bulk-forming laxative—digestive system
Bran cereals—bulk-forming laxative—digestive system
Docusate Sodium—surfactant laxative—digestive system
Milk of Magnesia (MOM)—saline cathartic—digestive system
Magnesium Citrate—saline cathartic—digestive system
Bisocodyl (Dulcolax)—stimulant laxative--—digestive system
Castor Oil—stimulant laxative—digestive system
Ex-Lax—stimulant laxative—digestive system
Glycerin suppository—hyperosmotic agent—laxative —digestive system
Lactulose (Constulose)—hyperosmotic agent—laxative —digestive system
Mineral oil—Lubricant laxative—digestive system
Polyethylene glycol-electrolyte solution (GlLYTELY, CoLyte)—laxative —digestive system
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Vitamins
Fat soluble: ADEK
Water soluble: C & B1 --Thiamin, B2 Riboflavin, B3 Niacin, B5 Pantothenic acid, B6 Pyridoxine,
o B9 Folic acid, B12 Cyanocobalamin, Biotin
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Metformin (Glucophage)—Biguanides—antiglycemics
Acarbose (Precose) —Alpha-Glucosidase inhibitor—antiglycemics
Miglitol (Glyset)—Alpha-Glucosidase Inhibitor—antiglycemics
Pioglitazone (Actos) —Thiazolidinediones—antiglycemics
Rosiglitazone (Avandia) —Thiazolidinediones—antiglycemics
Thioamides—antithyroid agent
Radioactive iodine 131I—antithyroid agent
Cortisone (Cortone)—systemic—corticosteroid—endocrine
Prednisone (Deltasone) —systemic—corticosteroid—endocrine
Betamethasone (Celestone) —systemic—corticosteroid—endocrine
Fludrocortisone (Florinef Acetate) —systemic—corticosteroid—endocrine
Dexamethasone (Decadron) —systemic—corticosteroid—endocrine
Hydrocortisone—topical—corticosteroid—endocrine
Beclomethasone (Vanceril) —inhaled—corticosteroid—endocrine
Prednisolone (AK-Pred) —opthalmic—corticosteroid—endocrine
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Hormones:
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Estrogens—conjugated (equine, synthetic), DES (diethylstilbestrol), Estradiol, Estrone,
Estropipate, Ethinyl estradiol
Progesterone—progesterone injectable (IM), Prometrium micronized capsules
Norethindrone (w/ estradiol) transdermal—progesterone hormone
Medroxprogesterone acetate (Provera)—progesterone hormone
Crinone micronized vaginal cream—progesterone hormone
Testosterone cypionate (Depo-Testosterone)—androgen hormone
Testosterone enanthate (Andro LA)—androgen hormone
Testosterone ppropionate (Testex) —androgen hormone
Danazol (Danoccrine) —androgen hormone
Nandrolone decanoate (Deca-Durabolin)—anabolic steroid—hormone
Stanozolol (Winstrol)—anabolic steroid—hormone
Flutamide (Eulexin)—antiandrogen—hormone
Bicalutamide (Casodex) —antiandrogen—hormone
Nilutamide (Nilandron) —antiandrogen—hormone
Glucogon—hyperglycemic hormones
Tolbutamide (Orinase), Acetohexamide (Dymelor), Tolazamide (Tolinase), Chlorpropamide
(Diabinese)—1st generation—rarely used—sulfonlureas —hyperglycemic hormones
Glipizide (Glucotrol)—2nd generation—sulfonlureas —hyperglycemic hormones
Glyburide (DiaBeta, Glynase PresTab, Micronase) —2nd generation—sulfonlureas —
hyperglycemic
Glimepiride (Amaryl) —2nd generation—sulfonlureas —hyperglycemic hormones
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Repaglinide (Prandin) —Meglitinides—hyperglycemic hormones
Nateglinide (Starlix) —D-phenylalanine derivative —hyperglycemic hormones
Glyburide/Metformin (Glucovance) —sulfonylurea/biguanide—hyperglycemic hormones
Insulin Lispro (Humalog)—rapid-acting—hypoglycemic
Insulin Aspart (NovoLog) —rapid-acting—hypoglycemic
Regular R —short-acting—hypoglycemic
NPH (Humulin N) —intermediate-acting—hypoglycemic
Lente —intermediate-acting—hypoglycemic
Ultralente —long-acting—hypoglycemic
Glargine (Lantus) —long-acting—hypoglycemic
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Immunosuppressants
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Azathioprine (Rheumatrex, Trexall)—rheumatoid arthritis, antirejection—cytotoxic-immunosuppressant
Methotrexate (Imuran)—rheumatoid arthritis, psoriasis, cancer—cytotoxic agent-immunosuppressant
Cyclosporin (Sandimmune)—antirejection-- conventional antirejection agents
Mycophenolate (CellCept)—antirejection (cardiac/Renal—conventional antirejection agents
Tacrolimus (Prograf)—antirejection—conventional antirejection agents
Polycolon antibody—antibody preparations—immunosuppressant
Monoclonal antibodies—immunosuppressant
Etanercept (Enbrel) —immunosuppressant
Leflunomide (Arava) —immunosuppressant
Levothyroxine (Synthroid, Levoxyl, Levothroid)—thryoid agents
Liothyronine (Cytomel) —thryoid agents
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Ovulation suppressants: Lestrin, Lo-Ovral, Nordette, Ovral, Ortho-Novum, Micronor
Clomiphene citrate (Clomid)—ovulation stimulant
Bromocriptine mesylate (Parlodel) —ovulation stimulant
Leuprolide (Lupron) —ovulation stimulant
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