Drug Recognition Guide. As a student nurse it can be difficult getting to know particular drugs and distinguishing between the various drug categories that you may be asked (under supervision) to administer. This is a quick reference guide that can make it easier to recognise and remember drug names. Note: this is for general guidance only - it is not intended as a ‘‘fool proof’’ way to identify each and every drug in each and every drug category. Remember that there will always be exceptions to the rule. Nevertheless, the guide will be very useful while you are getting to know your drugs more thoroughly. The drug names used in this guide refer to the drug’s generic name as listed on the prescription sheet (and not to the drug’s ‘‘brand name’’). The colour coding used in this guide is for ease of recognition purposes only and has no clinical significance. The guide lists more than 130 drugs subdivided into 17 different categories. One relatively easy way that can be used to help identify what group a particular drug belongs to is to look at the letters at the beginning (the prefix) or, more commonly, at the end (the suffix) of a generic drug’s name. For example… ACE Inhibitors (drugs used to treat hypertension, heart failure, diabetic nephropathy or to reduce the likelihood of myocardial infarction). ACE (angiotensin-converting enzyme) inhibitors can be recognised by names that end with the letters ‘‘pril’’: - Captopril Cilazapril Enalapril Fosinopril Lisinopril Moexipril Perindopril Quinapril Ramipril Trandolapril Alpha-blockers (drugs used to treat hypertension or urinary obstruction due to benign prostatic hyperplasia). Most (but not all) alphablockers have names ending in ‘‘osin’’: - Alfuzosin Doxazosin Prazosin Tamsulosin Terazosin Note three exceptions: three alpha-blockers that do not end in ‘‘osin’’: - Indoramin Phenoxybenzamine Phentolamine This guide is intended for information purposes only and not as an aid to unsupervised drug administration by nursing students [MFCurrivan/WirralRenalUnit/2011]. 1 Drug Recognition Guide. Angiotensin-II Receptor Antagonists (drugs used to treat hypertension, heart failure or diabetic nephropathy) end with ‘‘sartan’’: - Candesartan Irbesartan Losartan Telmisartan Valsartan Antibiotics (drugs used to treat bacterial infections: with different kinds of antibiotic used to treat particular kinds of bacteria). Many antibiotics (including most antibiotics of the aminoglycoside, macrolide and glycopeptide class) have names ending in ‘‘cin’’. More specifically: antibiotics of the quinolone class end with ‘‘floxacin’’; penicillins can be identified by the suffix ‘‘cillin’’; antibiotics of the cephalosporin class have names beginning with ‘‘cef’’; carbapenem antibiotics end with ‘‘penem’’; tetracycline antibiotics end with ‘‘cycline’’ and rifamycin antibiotics have names beginning with ‘‘rif’’. For example: - Amikacin Amoxicillin Ampicillin Cefalexin Ceftazidime Ceftriaxone Ciprofloxacin Clarithromycin Doripenem Doxycycline Erythromycin Flucloxacillin Gentamicin Imipenem (given with the enzyme inhibitor cilastatin). Levofloxacin Lymecycline Meropenem Penicillin Rifabutin Rifampicin Tigecycline Vancomycin Note a few exceptions: despite ending in ‘‘cin’’ do not mistake acemetacin and indometacin (NSAIDs), darifenacin and solifenacin (antimuscarinic drugs) or oxytocin (a drug used in obstetrics) for antibiotics. This guide is intended for information purposes only and not as an aid to unsupervised drug administration by nursing students [MFCurrivan/WirralRenalUnit/2011]. 2 Drug Recognition Guide. Benzodiazepines (sedatives given to treat insomnia, reduce anxiety or to prevent or treat seizures). Most benzodiazepines have names ending with either ‘‘azepam’’ or ‘‘azolam’’: - Alprazolam Clonazepam Diazepam Flurazepam Loprazolam Lorazepam Lormetazepam Midazolam Nitrazepam Oxazepam Temazepam Note an important benzodiazepine with a different suffix: - Chlordiazepoxide (a benzodiazepine often used to help manage the symptoms of alcohol withdrawal). Beta-blockers (drugs used to treat conditions such as hypertension, angina, heart failure or cardiac arrhythmia) end with ‘‘lol’’ or ‘‘olol’’: - Atenolol Bisoprolol Esmolol Metoprolol Nebivolol Propranolol Sotalol Beta-blockers ending in ‘‘lol’’ should not to be mistaken for drugs that end with ‘‘amol’’. A drug name ending in ‘‘amol’’ is often an indication that it contains paracetamol as a constituent part (see paracetamols, page 5). Bisphosphonates (drugs used to treat osteoporosis or hypercalcaemia: abnormally high levels of calcium in the blood). The drug inhibits bone re-absorption and so helps preserve bone density and prevent the release of excess calcium into the bloodstream. Bisphosphonates have names that end with ‘‘dronate’’ or ‘‘dronic acid’’: - Alendronic acid Clodronate Pamidronate Risedronate Zoledronic acid This guide is intended for information purposes only and not as an aid to unsupervised drug administration by nursing students [MFCurrivan/WirralRenalUnit/2011]. 3 Drug Recognition Guide. Class II Calcium Channel Blockers (drugs used to treat hypertension or angina) have names ending in ‘‘dipine’’: - Amlodipine Felodipine Isradipine Lacidipine Nicardipine Nifedipine Corticosteroids (drugs given to reduce inflammation or to treat allergic, asthmatic or rheumatic disorders). Most corticosteroids have names ending in ‘‘sone’’, ‘‘solone’’, ‘‘olone’’ or ‘‘sonide’’: - Beclometasone Betamethasone Budesonide Ciclesonide Dexamethasone Diflucortolone Fludrocortisone Flumetasone Fluticasone Hydrocortisone Methylprednisolone Mometasone Prednisolone 5HT3 Antagonists (antiemetics used to treat severe nausea and vomiting) end with ‘‘setron’’: - Dolasetron Granisetron Ondansetron Palonosetron H2 Blockers (drugs used to treat oesophageal reflux, dyspepsia and gastric ulcers) end with the suffix ‘‘tidine’’: - Cimetidine Famotidine Nizatidine Ranitidine Note an exception to the rule: a drug with a name ending in ‘‘tidine’’ that is not a H2 blocker: azacitidine (a chemotherapy drug). This guide is intended for information purposes only and not as an aid to unsupervised drug administration by nursing students [MFCurrivan/WirralRenalUnit/2011]. 4 Drug Recognition Guide. Non-Steroidal Anti-Inflammatory Drugs (NSAIDs) (anti-inflammatory painkillers that work by reducing prostaglandin levels). Many NSAIDs are derived from acetic acid, fenamic acid or propionic acid and so tend to have names that end with ‘‘ac’’, ‘‘fenac’’ or ‘‘profen’’: - Aceclofenac Dexibuprofen Dexketoprofen Diclofenac Etodolac Fenbufen Fenoprofen Flurbiprofen Ibuprofen Ketoprofen Ketorolac Paracetamol (a painkiller that also has an antipyretic effect). Paracetamol-containing compounds end with ‘‘amol’’. The prefix ‘‘co-’’ at the beginning of drug name is an indication that it is a mixture or compound of two different drugs combined. For example: - Co-codamol Co-dydramol = = (codeine & paracetamol). (dihydrocodeine & paracetamol). Note an exception to the rule: salbutamol (a beta2 agonist bronchodilator used to relieve breathlessness, which - despite ending in ‘‘amol’’ - should not be mistaken for a paracetamol-containing compound). Phenothiazines (antipsychotic drugs developed in the 1950s to treat schizophrenia but some of which are now also used as antiemetics: drugs to treat nausea and vomiting) end with either ‘‘promazine’’ or ‘‘perazine’’: - Chlorpromazine Levomepromazine Prochlorperazine Trifluoperazine Proton Pump Inhibitors (PPIs) (drugs used to prevent or treat gastric or duodenal ulcers) have names ending in ‘‘prazole’’: - Esomeprazole Lansoprazole Omeprazole Pantoprazole Rabeprazole An exception to the rule - a drug ending in ‘‘prazole’’ that is not a PPI: aripiprazole (an antipsychotic drug used to treat schizophrenia). This guide is intended for information purposes only and not as an aid to unsupervised drug administration by nursing students [MFCurrivan/WirralRenalUnit/2011]. 5 Drug Recognition Guide. Statins (hypolipidaemic agents: drugs used to lower abnormally high levels of cholesterol in the blood). Statins end with the suffix ‘‘vastatin’’: - Atorvastatin Fluvastatin Pravastatin Rosuvastatin Simvastatin Despite having names ending in ‘‘statin’’ (although not ‘‘vastatin’’) do not mistake the following drugs for cholesterol-lowering agents: nystatin (an antifungal drug), pentostatin (an anticancer drug) and cilastatin (an enzyme inhibitor given with the antibiotic imipenem, see page 2). Sulphonylureas (drugs given to help treat type II diabetes). Most sulphonylureas can be recognised by names that begin with the prefix ‘‘gli’’: - Glibenclamide Gliclazide Glimepiride Glipizide Tolbutamide Summary of Drug Prefixes and Suffixes. ACE inhibitors end with… pril Alpha-blockers (most) end with… osin Antibiotics (many) end with… cin Antibiotics (carbapenems) end with… penem Antibiotics (cephalosporins) begin with… cef Antibiotics (penicillins) end with… cillin Antibiotics (quinolones) end with… floxacin Antibiotics (rifamycins) begin with… rif Antibiotics (tetracyclines) end with… cycline Angiotensin-II receptor antagonists end with sartan Benzodiazepines end with… azepam or azolam Beta-blockers end with… olol or lol Bisphosphonates end with… dronate or dronic acid Class II calcium channel blockers end with dipine Corticosteroids end with… sone, solone, olone or sonide 5HT3 antagonists end with… setron H2 blockers end with… tidine NSAIDs (most) end with… ac, fenac or profen Paracetamol compounds end with… amol Phenothiazines end with… promazine or perazine Proton pump inhibitors end with… prazole Statins end with… vastatin Sulphonylureas begin with… gli This guide is intended for information purposes only and not as an aid to unsupervised drug administration by nursing students [MFCurrivan/WirralRenalUnit/2011]. 6