Pharmacy Drugs

Endocrine Drugs

Class: Insulin

• Use: Type 1 and Type 2 Diabetes 
• insulin lispro (Humalog)
• insulin glargine (Lantus)
• MOA: hormone replacement – must be given subcutaneously
• SE: hypoglycemia

Class: Biguanide

• USE: Type 2 diabetes
• metformin (Glucophage)
• MOA: insulin sensitivity
• SE: Anorexia, N/V/D, flatulence, weakness

Class: Sulfonylurea

• USE: Type 2 diabetes
• glipizide (Glucotrol)
• MOA: Increase pancreatic insulin release
• SE: HA, anorexia, N/V/D, constipation, photo-sensitivity

CLASS: Thiazolidinedione

• USE: Type 2 Diabetes
• pioglitazone HCl (Actos)
• MOA: increase insulin sensitivity  CI: CHF, hepatic impair
• SE: Wt. gain, myalgia, URI, HA, hypoglycemia
• edema, increase fracture risk in women

Corticosteroids

• Use: Chronic adrenal insufficiency
• Prednisone (Deltasone)
• SE: G.I. upset
• Take with food or milk
• avoid alcohol, do not stop taking abruptly

Class: Hormone (Estrogen)

• USE: Menopaus,osteoporosis prevention
• conjugated estrogen (Premarin)
• MOA: PO, INJ or VA 
•  SE: nausea, bloating, weight gain, breast tenderness
• CI: Breast cancer, estrogen dependent tumors

Class: Hormone (Thyroid)

• Use: Hypothyroidism
• levothyroxine (Synthroid, Levoxyl)
• Side Effects: insomnia, alopecia, weight loss
• N/V/D, arrhythmias, hyperthyroidism
• CI: Recent MI, many drug interactions, elderly with CV disease

Class: Bone Resorbtion Inhibitor

• Use: treatment and prevention of osteoporosis
• alendronate (Fosamax)
• risedronate (Actonel)
• ibandronate sodium (Boniva)
• MOA: abnormal bone reabsorption, osteoclast action

Cont.

• CI: esophageal abnormalities
• inability to sit/stand upright for 30 minutes

CNS Drugs

Acetylcholinesterase Inhibitor

• Use: Alzheimer’s Disease 
• donepezil (Aricept)
• MOA: enhancing cholinergic function of acetylcholine-producing neurotransmitters
• SE: N,V,D, insomnia, fatigue, muscle cramps and anorexia dose rated
• NOTE: no drugs can reverse the cognitive abnormalities of Alzheimer’s

Anticholinergics

• USE: Parkinson’s disease
• ropinirole (Requip)
• MOA: dopamine agonist
• SE: syncope, postural BP, NV, HA
• NOTE: provides only symptomatic relief; no alcohol

Class: antiepileptic

• Use: Epilepsy
• MOA: blocks firing of neurotransmitters
• lamotrigine (Lamictal)
• SE: photosensitivity, HA, GI upset, dizziness
• W: serious rash, increased suicide risk

Class: anticonvulsant

• topiramate (Topamax)
• SE: wt. loss, memory impairment, fatigue, dizziness

Class: Stimulant

• Use: ADHD
• methylphenidate (Concerta)
• MOA: blocks reuptake of Norepinephrine and Dopamine
• amphetamine-mixed salts (Adderall)
• MOA: not known for ADHA

Cont.

• SE: tachycardia, elevated BP, dizziness, HA, depression
• CI: CV disease, hypertension, pt with dx drug abuse
• NOTE: CII drug with high potential for abuse
• avoid caffeine, should have periodic CBC

Class: Anticonvulsant

• Use: Fibromyalgia
• pregabalin (Lyrica)
• MOA: blocks nerve transmissions  CI: PG
• SE: dizziness, drowsiness, wt. gian
• Warning: increased suicide behavior

Selective Serotonin Receptor Agonists

• Use: Migraine Headache
• sumatriptan (Imitrex)
• MOA: narrows blood vessels in the head
• SE: dizziness, hot flashes
• CI: severe CV or liver Dz

Class: Muscle Relaxants

• Use: Muscle pain/spasm
• cyclobenzaprine (Flexeril)
• MOA: decreased muscle spasms
• SE: Sedation
• CI: avoid alcohol, no MAOI’s or TCA’s, hyperthyroidism, heart failure

Cont.

• carisoprodol (Soma)
• MOA: blocks neuron activity at the CNS level
• SE: CNS depression, dizziness, drowsiness, tachycardia, HA
• Note: take with food

Cont.

• metaxalone (Skelaxin)
• MOA: decreased muscle spasms without loss of muscle function
• SE: Sedation, NV
• CI: liver impairment

Class: Depolarizing Agent

• Succinylcholine
• Use: surgery & intubation

Affective Disorder Drugs

Class: SSRI (Selective Serotonin Reuptake Inhibitor)

• escitalopram (Lexapro)
• fluoxetine HCI (Prozac)
• duloxetine (Cymbalta)
• venlafaxine (Effexor)
• Use: Major depression, anxiety, OCD, eating disorders

Cont.

• (MOA): blocks the reuptake of serotonin
• (SE): nervousness, insomnia, drowsiness, nausea, dizziness
• (CI): Cannot take with MAOI’s or alcohol

Class: TCA (Tricylic Antidepressants)

• trazodone (Desyrel)
• Use: Depression
• MOA: block reuptake of norepinephrine and serotonin
• SE: drowsiness, dizziness, cardiotoxic
• postural hypotension in the elderly

Class: Benzodiazepine

• diazepam (Valium)
• Use: anxiety, panic disorders, insomnia
• Muscle spasms, alcohol withdrawal, pre-op sedation, antiemetic
• MOA: produces calming effect by potentiating the effect of GABA neurotransmitters
• SE: dizziness, drowsiness, fatigue, confusion, sexual dysfunction, depression

Cont.

• CI: severe pain, low BP, respiratory depression, CNS depression, sleep apnea
• WARNINGS: CIV Controlled Substances; should be tapered on discontinuation

Class: Non-Benzoidiazepine

• zolpidem (Ambien)
• eszopiclone (Lunesta)
• Uses: Insomnia, difficulty falling and staying asleep
• MOA: Hypnotic
• SE: dizziness, confusion, impaired reflexes, potential for abuse

Cont.

• CI: Breastfeeding
• Note: CIV Controlled Substance

Class: Antipsychotic

• quetiapine (Seroquel)
• olanzapine (Zyprexa)
• Uses: psychosis, hallucinations, delusions, thought disorders
• MOA: serotonin & dopamine agonist
• SE: sedation, dizziness, hypotension, weight gain, HA

Bipolar Disorder

• Use: depressive psychosis
• lamotrigine (Lamictal)
• SE: GI upset, bloody stools, acne, leucocytosis, tremors
• NOTE: monitor salt, no alcohol, many drug interactions

Class: Aminoketone

• bupropion HCI (Wellbutrin)
• Use: depression & smoking cessation
• MOA: weak inhibitor of uptake of norepinephrine and serotonin
• SE: dizziness, drowsiness, seizures
• CI: seizure disorder

Upper Respiratory Drugs

Antihistamines - H1 Blocker

• Uses: Allergies, nasal congestion, insomnia
• cetirizine Zyrtec
• fexofenadine Allegra 
• MOA: Block the release of histamine (H1) in the respiratory system
• SE: drowsiness, dry up body fluids, hyperactivity in children

Decongestants

• Use: relief of nasal congestion from colds, sinusitis, UR allergies
• MOA: constriction of the arteries in the nasal mucosa 
• SE: CNS stimulation, BP, HR, insomnia, anxiety, tremors, rebound nasal congestion, headache
• CI: avoid if you have diabetes, heart disease
• pseudoephedrine (Sudafed) cetirizine-pseudoephedrine (Zyrtec-D) 

Cont.

• pseudoephedrine (Sudafed) 
• cetirizine-pseudoephedrine (Zyrtec-D)

Expectorants

• Uses: to remove mucus from both lungs and airway passages during coughing;
• MOA: decrease the mucus thickness by decreasing the viscosity of the liquid
• SE: N&V, drowsiness, GI distress
• guaifenesin (Robitussin) guaifenesin-pseudoephedrine (Mucinex D)

Lower Respiratory Drugs

Bronchodilators (Beta2) Antagonist

• Uses: asthma, COPD (bronchospasms from bronchitis and emphysema)
• albuterol (ProAir HFA)
• MOA: relaxes smooth muscles, resulting in decreased bronchospasms
• SE: CNS stimulation

AntiCholinergic

• Uses: COPD, bronchitis, emphysema
• MOA: relax smooth muscles of the bronchioles
•  ipratropium/albuterol (Combivent)
• SE: palpitations, tachycardia, nervousness, dizziness
• CI: peanut or soybean allergy

Cont.

•  tiotropium (Spiriva)
• SE: dry mouth
• Note: do not use with spacer

Leukotriene Inhibitors

• Uses: prophylaxis and long-term Rx of chronic asthma, seasonal allergies
• montelukast (Singulair)
• MOA: blocks tissue inflammatory responses (edema)
• SE: headache

Corticosteroids

• Use: prophylactically Rx for asthma
• fluticasone (Flovent HFA)
• fluticasone-salmeterol (Advair Diskus)
• mometasone (Nasonex)

Smoking Cessation

• Use: bupropion (Wellbutrin)
• SE: suicidal thoughts in children and young adults
• CI: Seizure disorders

G.I. Agent Drugs

Proton Pump Inhibitors

• Uses: GERD, erosive esophagitis
• esomeprazole (Nexium)
• omeprazole (Prilosec)
• lansoprazole (Prevacid)
• MOA: Block gastric acid secretion in the stomach

Cont.

• SE: HA, D, N/V, abdominal pain

H2 Antagonists - Antiulcer

• Uses: GERD, peptic ulcers
• ranitidine (Zantac)
• MOA: Block gastric acid & pepsin secretion;
• SE: Dizziness, drowsiness
• NOTE: Available OTC in lower doses.

Antidiarrheals

• Use: diarrhea, heartburn, upset stomach, nausea, indigestion
• bismuth subsalicylate (Pepto Bismal)
• SE: May turn tongue and stools black
• CI: Influenza, Chicken Pox, ASA allergy

Bowel Evacuant Laxatives

• Uses: OTC - Occasional constipation
• polyethlene glycol (Miralax OTC and GoLYTELY Rx)
• MOA: Increase osmolarity of bowel fluids
• SE: Upset stomach, bloating, cramping

H1 Antagonist - Antiemetic

• Use: treats the side effect of nausea from medications
• promethazine (Phenergan)
• MOA: Inhibit the impulse going from the chemotrigger zone in the stomach
• SE: Drowsiness, decreased BP
• Other Uses: Sedation, motions sickness, antihistamine

Antiflatulants

• Use: flatulence, gastric bloating, postoperative pains
• MOA: reduce surface tension, resulting in gas bubbles being released more easily
• SE: N & D
• Example:  simethicone (Gas-X, Mylicon)

Urinary Drugs

Antibiotic - Cephalosporin

• Use: antibiotic for UTI’s
• cephalexin (Kelfex)
• SE: D, upset stomach
• CI: penicillin allergy

Anti-spasmotic

• USE: Incontinence and OAB
• tolterodine (Detrol)
• MOA: prevent spasms of the bladder muscle
• SE: dizziness, drowsiness, blurred vision

Alpha-blockers

• USE: Benign prostatic disease
• tamsulosin (Flomax)
• MOA: relax smooth muscles, particularly those in the prostate
• SE: headache, hypotension, dizziness.
• CI: female gender

Reproductive System Drugs

PDE5 inhibitor

• USE: erectile dysfunction, impotence
• sildenafil (Viagra)  tadalafil (Cialis)
• MOA:  blood flow to penis
• SE: HA, D, flushing, dizziness, upset stomach
• CI: taking nitrates for cardiac conditions, renal/hepatic impair

Oral Contraceptives - Hormone

• Use/MOA: stop ovulation
• norgestimate (Ortho Tri-Cyclen) ethinyl estradoil & drospirenone (Yasmin, Yaz)
• SE: potential for heart attack, stroke, or thrombosis, nausea
• CI: CV disease, hypertension, blood clots, breast or uterine cancer

Cardiovascular
System

CLASS: ACE Inhibitor

• USE: Hypertension
• lisinopril - Prinivil, Zestril  ramipril - Altace
• MOA: When angiotensin I is converted into angiotensin II it’s general purpose is to increase BP.
• SE: dizziness, HA, hypotension, N&V, cough, angioedema
• NOTE: ACE inhibitors have a potassium-sparing effect which can cause hyperkalemia

Class: Angiotensin II Receptor Antagonists

• Use: hypertension, CHF
• – valsartan - Diovan
• MOA: blocks the action of angiotensin II at its receptors located in vascular muscles BP
• SE: dizziness, HA, fatigue, cough
• CI: severe liver impair

Class: Beta-Blockers

• Use: hypertension, MI, angina
• metoprolol - Toprol  carvediolol - Coreg
• MOA: reduction of heart rate, and force of contraction thereby reducing BP
• SE: heart depression, bronchoconstriction
• Note: taper off when discontinuing

Class: Calcium Channel BlockersClick to Edit

• Use: hypertension, angina, prevention of MI
• amlodipine - Norvasc
• MOA: inhibits calcium from entered vascular smooth muscle
• SE: constipation, drowsiness  
• NOTE: take with food, limit caffeine

Loop Diuretic

• Use: CHF, edema, hypertension
• furosemide – Lasix
• MOA: eliminates water and sodium from the body
• SE: BP, hyperglycemia

Class: Diuretic Combination

• Use: hypertension, edema
• triamterene HCTZ - Dyazide
• MOA: eliminates water and sodium from the body
• SE: photosensitivity, hyperglycemia, hypokalemia

Class: HMG-CoA Reductase Inhibitors

• Use: lowers cholesterol
• ezetimibe simvastatin – Vytorin atorvastatin – Lipitor
• MOA: inhibits cholesterol synthesis
• SE: G.I. upset, headache, muscle pain and fever
• NOTE: liver function test q 6 mo

Class: Lipid Lowering Agent

• Use: lowers triglycerides and cholesterol
• SE: GI disturbances, cholecystitis
• fenofibrate - Tricor
• Note: monitor liver functions

Class: Inotrope

• digoxin - Lanoxin
• Use: CHF
• MOA: increases force of contractions
• SE: N&V&D, arrhythmias, dizziness

Class: Potassium

• Potassium chloride – Klor-Con • 
• Use: Side effect of K is cardiac arrhythmia
• MOA: increases force of contractions 
• SE: GI irritation

Class: anticoagulant

• Use: treat and prevent blood clots 
• warfarin (Coumadin)
• MOA: counter acts Vitamin K in blood plasma
• SE: bleeding, urine may turn red-orange

Class: Platelet inhibitor

• Use: prevent blood clotting, prevent reoccurrence of M.I. and stroke
• clopidogrel - Plavix
• MOA: lessens ability of platelets to stick together
• SE: increased bleeding, nose bleeds, bruising, headaches

Class: Penicillin

•  amoxicillin (Amoxil)
• USE: ear, nose, throat, UTI, RI’s
• MOA: Bactericidal
• SE: Diarrhea, hives, rash, wheezing, anaphylaxis

CLASS: Macrolides

• azithromycin (Zithromax)
• USE: lung infections, ear infection, skin infections, chlamydia
• MOA: Bacteriostatic
• SEs: GI upset, metal taste

CLASS: Cephalosporins

• cefdinir (Omnicef)  cephalexin (Keflex)
• USE: dental work, surgery, pneumonia, URI’s, sinus infections
• MOA: Bacteriocidal
• SE: Diarrhea, hives, rash, wheezing, anaphylaxis

CLASS: Quinolones (fluoroquinolones)

• ciprofloxacin (Cipro)
• USE: bone/joint infections, dental work, diarrhea, URIs, UTIs
• MOA: Bacteriocidal - DNA breakage
• SE: N&V, D, dizziness, joint swelling, tendonitis
• CI: avoid antacids; phototoxicity, peds, pregnancy

CLASS: Tetracyclines

• doxycycline (Vibramycin)
• USE: broad spectrum: acne, bronchitis, Lyme disease, pneumonia, diarrhea
• MOA: Bacteriostatic - inhibit protein synthesis
• SE: N&V, D, photodermatitis
•  CI: avoid antacids or dairy; pregnancy; peds

Class: Antifungal

• fluconazole (Diflucan)
• Use: candidiasis
• Side Effects: HA, GI upset, rash

Class: Antivirals

• valcyclovir (Valtrex)
• Use: herpes zoster; genital herpes 
• SE: HA, GI upset, dizziness
• oseltamivir (Tamiflu)
• Use: influenza SE: N&V, insomnia

Anti-Inflammatories

Class: Narcotic

• oxycodone-acetaminophen (Percocet, Endocet)
•  hydrocodone-acetaminophen (Vicoden)
• MOA: During a normal pain response, brain releases endorphins
• SE: respiratory depression, constipation, mental confusion

Class: Non-Narcotics

• tramadol (Ultram)
• MOA: Centrally acting analgesic
• SE: dizziness. HA, resp. depression, GI upset

Class: non-narcotic +narcotics

• acetaminophen (300 mg) + codeine (CIII)
• TC#2 - 15 mg codeine ◦ TC#3 - 30 mg codeine ◦ TC#4 - 60 mg codeine
• MOA: synergistic analgesic effect
• SE: drowsiness, sedation, shortness of breath, N&V.; liver damage
• CI: alcoholism, liver disease, may increase bleeding in patients taking warfarin

Cont.

• acetylsalicylic acid (Aspirin – ASA)
• Uses: conditions with pain, inflammation
• MOA: reduces fever by increasing blood flow to the skin and inhibiting inflammation synthesis
• SE: stomach ulcers, anemia,, dizziness, HA

Class: NSAID

•  ibuprofen (Motrin, Advil)  naproxen (Aleve)
• MOA: prevents sensitization of the pain receptors
• SE: stomach irritation, drowsiness, abdominal cramps, jaundice, rash

COX-2 Inhibitor

• celecoxib (Celebrex)
• Uses: arthritis, acute pain
• MOA: blocks enzymes produced during inflammation
• SE: GI distress, edema, renal failure