Drug Classifications
 Drugs are a diverse and fall into many categories
 The most common categories of medications will be
covered here
 There are others but in the interest of importance and
simplicity the following lecture should provide a
general starting point
Analgesics
 Drug used to suppress pain. Drugs can work via
different mechanisms to suppress pain.
 Opiate Analgesics stop pain by opiate receptor activation
in the brain and spinal cord interrupting the pain signal
 Nonopiate Analgesics work by different mechanisms
include drugs called nonsteroidal anti inflammatory
drugs (NSAIDs)
 For example see table 20-1, pg 373 in the The Pharmacy
Technician Foundations and Practices text
Anti-Infectives
 Agents that are used to treat microrganism infection in the
body
 The class include:
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Antibiotics : Penicillins and cephalosporins
Antivirals: Acyclovir, ganciclovir,
Antituberculosis-isoniazid, ethambutol, pyrazinamide
Antiretrovals: NRTI: Zidovudine, NNRTI-efavirenz, PIritonavir
Fluoroquinolones: ciprofloxacin, levofloxacin
Antimalarial: (treat miliaria): quinine sulfate
Antifungals: Fluconazole (Diflucan®), amphotericin
(Amphocin®)
Please see table 20-2 in the textbook for a complete list
Antibiotic mechanism of action
 Penicillin and Cephalosporins: drugs inhibit the formation
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of the bacterial cell wall. Bacteria swell and die. Drugs are
bactericidal
Macrolides: inhibits bacterial ribosomes and protein
synthesis. Example includes erythromycin (E-Mycin®) and
azithromycin (Zithromax®). Bactericidal or Bacteriostatic.
Tetracyclines: Bacteriostatic by inhibiting protein
sysnthesis.
Fluroquinolones: Bactericidal. Binds to DNA
Aminoglycosides: (Gentamicin) Bactericidal by several
mechanisms
Antineoplastics
 Cancer chemotherapy agents
 Alkylating agents: chemical modify RNA so it is no longer able to be
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translated. Example: cyclophosphamide. Cyclophosphamide is
sometimes used to treat autoimmune disorder as well (Lupus
nephritis)
Antimetabolites: agent that acts as chemical decoy to block the cell
from dividing. Example: methothexate which is a folic antagonist.
Sometimes seen as MTX and is used to treat some autoimmune
disorders as well as RA
Antineoplastic antibiotics: inhibits RNA and DNA synthesis. Example
is epirubicin (Ellence®)
Anti hormones: inhibits the growth of cancer cells that are hormone
sensitive. Example is Tamoxifen which is used to treat breast cancer
post surgery
See page 377 table 20-3 for a complete list
Cardiovascular Drugs
 Beta Blockers: drugs that block the beta receptors in the heart
which blocks attachment of norepinephrine and results in
bradycardia and reduced blood pressure. Examples are
propranolol(Inderal®), metoprolol (Toprol XL, lopressor ®),
atenolol (tenormin®) This is an important drug used in heart
failure patients, patient that have had an MI, and hypertensive
patients.
 ACE inhibitors (angiotensin converting enzyme inhibitor) blocks
the enzyme (ACE) responsible to converting angiotensin I to
angiotensin II (ATII). ATII is a potent vasoconstrictor in
humans. ATII is also important in kidney function. ATII also
increases aldosterone secretion. This drug is important in
hypertensive patients and patients with CHF and MI. ACEI are
also important in preservation of kidney function in diabetics.
Examples are enalapril( Vasotec®) and Ramipril (Altace®)
 Antianginal agents: used to widen coronary arteries to
increase myocardial oxygen delivery and reduce chest pain.
Examples: nitroglycerin (NTG), and isosorbide (Imdur®,
Isordil®)
 Calcium channel blockers: blocks the entry of calcium ions
in the heart muscle and in the muscle that control blood
vessel diameter. Reduced heart rate and reduces blood
pressure. Some are used to control a type of cardiac
arrhythmia called atrial fibrillation. Examples: Diltiazem
(Tiazac®, Cardizem®), amlodipine (Norvasc®)
 Antiarrhythmial agents: block the entry of sodium into the
heart. The drugs in this class have several mechanisms of
action. Examples: Lidocaine, amiodarone (Cordarone®),
Procainamide (Procanbid®)
 Angiotensin 2 Receptor blockers (ARB’s): similar to
ACEI except these drug works on a receptor for ATII.
Examples are Losartan (Cozaar®), valsartan (Diovan®)
 Anticoagulation agents: drugs that block the
formation of blood clots. Different mechanisms of
action. Examples: warfarin (coumadin®), dibigatran
(Pradaxa®)
 Antiplatelet agents: drugs that block the action of
platelets in the formation of a blood clot. Used in the
prevention of stroke or MI. Examples: Clopidegrel
(Plavix®) and Aspirin (Ecotrin®)
 Antihyperlipidemics: drugs used to treat high blood
lipid levels (cholesterol, triglycerides) Examples are
the statin drugs, Niacin (Niaspan®), Omega 3 fatty acid
(Lovaza®)
 Cardiac glycosides: drugs used to boost the strenght of
the heart’s contraction. Example: Digoxin (Lanoxin®)
Diuretics
 Drugs that work at the kidney to help remove sodium,
water, calcium, and potassium from the body. Each class of
diuretic is named for the most part according to its
mechanism of action or the site of action in the kidney.
 Loop Diuretics work in a section of the kidney called the
loop of henle. This is where most of the water and sodium
and potassium is lost from the body. These drugs are used
to treat edema in CHF patients and other patient that hold
on the water.
 Example(s): Furosemide (Lasix®), Torsemide (Demadex®)
 Carbonic anhydrase inhibitors act on the proximal
tubule of the kidney by blocking the enzyme, carbonic
anhydrase which cause sodium retention and acid loss.
 Example: acetazolamide (Diamox®)
 Carbonic anhydrase inhibitor are pretty much weak
diuretics and can produce profound lose of potassium
Thiazide Diuretics
 Thiazide diuretics act on the distal convoluted tubule
to block the NaCL cotransporter in the kidney.
 Generally good diuretics
 Produce a sodium rich urine
 Example: Hydrochlorothiazide (HydroDiuril®)
Potassium Sparing diuretics
 Most of the above diuretics cause profound lose of
potassium. To circumvent this, these diuretic are
usually taken with potassium supplements.
 A class of diuretic that “spares” potassium in the body
are know and are used for many indications
 Examples are: spironolactone (aldactone®), Amiloride
(Midamor®), and the ACE inhibitors with ARB’s.
 These diuretics unlike the ones mentioned before
should not be used with a potassium supplement.
Central Nervous System Drugs
 Sedatives and Tranquiller: Drugs that cause depression of the
reticular activating system in the brain. Differences in
mechanisms of action.
 Examples are
 barbiturates: Phenobarbital (Luminal®)
 Benziodiazepines: Chlordiazepoxide (Librium®), Diazepam
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(Valium®), Lorazepam (Ativan®), Alprazolam (Xanax®)
BDZ were developed in the 1960’s with the advent of librium®. BDZ
are safer than barbiturates. Both dangerous with alcohol
consumption.
Used in anxiety disorder, panic disorder, GAD, sleep disorders
Control Substance: CIV
Miscellanous agents in the class are zolpidem (Ambien®), zaleplon
(Sonata®)
 Neuroleptic agents: drug used in the treatment of
schizophrenia and other personality disorders.
Examples include:
 Dopamine block agents: Haloperidol (Haldol®),
Chlorpromazine (Thorazine®), Fluphenazine (Prolixin®)
 Dopamine and serotonin blocking agents: Olanzapine
(Zyprexa®) and Quetiapine (Seroquel®)
 Drugs used to treat ADHD in children and adults
 Mixed amphetamine salts: Adderall® XR
 Other agents: Methylphenidate (Ritalin® Concerta ®,
Focalin ®)
Antiepileptics
 Drugs used to treat seizures. Many of the drugs block
the sodium ion channel in nerves.
 Examples include:
 Phenytoin (Dilantin®)
 Valproic acid (Depakene®), Divalproex (Depakote®)
 Carbamazepine (Tegretol®)
 Drugs in this group are known to cause birth defects and
are in category D
Drugs used to treat depression
 Drugs that block the reuptake of dopamine, serotonin
and norepinephrine in the brain are called Tricyclic
antidepressants. Drugs in this class include :
amitriptyline, nortriptyline. These drugs have fallen
into disuse over the decades due to their toxicity in
overdose. As little as 1,000 mg of nortriptyline has
resulted in fatal overdoses
 SSRI or selective serotonin reuptake inhibitors are now
most commonly used. Examples include: Fluoxetine
(Prozac®), Paroxetine (Paxil®)
 SSRIs have been used for other indications
Drugs used to treat Diabetes
 Insulin: the nature human hormone needed to clear blood
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glucose. Examples: Ultrafast: Novolog®, Humalog®,
Regular insulin (Humulin®), Basal insulin: Lantus®
Sulfonylureas: drugs that increase the release of insulin in
the body. Examples include: Glipizide (Glucotrol®),
Glyburide. Sulfonylurea should be taken with food
Meglitinides: drugs similar to sulfonylurea by faster acting.
Examples: Repaglinide (Prandin®, Nateglinide (Starlix®)
Thiazolidinediones: drugs that increase the body
sensitivity to insulin. Example includes: pioglitazone
(actos®)
Other agents include: exenatide (Byetta®), sitagliptin
(Januvia®) and metformin (Glucophage®)