Nurs304 - Module 7 Drugs/Prototypes

Prazosin

• Brand name: Minipress

• Therapeutic class: Antihypertensives

• Pharm class: Adrenergic blocking agent

• Primary use: HTN, dysrhythmias, angina, heart failure, benign prostatic hypertrophy, narrow-angle glaucoma

• MOA: To inhibit the sympathetic nervous system; Affects norepinephrine at the receptors on the vascular smooth muscle in the arterioles and veins (the lining of veins and arteries have smooth muscle helping constrict and relax)

• Adverse side effects: Dizziness, drowsiness, HA, loss of energy & strength, palpitations, and dry mouth

Metoprolol

• Brand name: Lopressor

• Therapeutic class: Antianginals, antihypertensive

• Pharm class: Beta-blockers

• Primary use: First line of defense for HTN, prevention of MI

• MOA: Decrease heart rate and contractility; blockage beta 1 receptors in juxtaglomerular apparatus which inhibits the secretion of renin and the formation of angiotensin II

• Adverse effects: Bradycardia, heart failure, pulmonary edema

Bethanechol

• Brand name: Urecholine

• Therapeutic class: Urinary tract stimulant

• Pharm class: Cholinergic

• Primary use: Glaucoma, urinary retention, myasthenia gravis, alzheimer’s disease

• MOA: To activate the parasympathetic NS directly/indirectly, induce rest/digest response, works on muscarinic receptors helps to cause muscular contraction in the GI tract and helps those who have lost their tone in their bladder

• Adverse side effects: profuse salivation, sweating in case muscle tone, urinary frequency, bradycardia

Atropine

• Brand name: Atropair

• Therapeutic class: Antiarrhythmics

• Pharm class: Cholinergic blocking agent

• Primary use: Peptic ulcers, irritable bowel syndrome, mydriasis, cycloplegia during eye examination, bradycardia, preanesthetic, asthma

• MOA: To inhibit the parasympathetic nervous system

• Adverse side effects: tachycardia, CNS stimulation, urinary retention, dry mouth, dry eyes, decreased sweating, photophobia (pupil is left dilated), seizures, hypothermia/hyperthermia

Ipratropium

• Brand name: Atrovent

• Therapeutic class: Bronchodilator

• Pharm class: Anticholinergic

• Primary use: Maintenance therapy of reversible airway obstruction due to COPD, including chronic bronchitis and emphysema; intranasal rhinorrhea

• MOA: Block the parasympathetic nervous system with the bronchodilator effect

• Adverse side effects: palpitations, headaches, tremors, restlessness, chest pain, allergic reactions

Albuterol

• Brand name: Ventolin

• Therapeutic class: Bronchodilator

• Pharm class: Beta 2 adrenergic agonist

• Primary use: Treatment or prevention of bronchospasm in asthma or COPD

• MOA: Beta 2 adrenergic agonists work by activating beta 2 receptors and bronchial smooth muscle, leading to bronchodilation and relaxation of the airway smooth

• Adverse side effects: Chest pain, palpitations, nervousness, restlessness, tremor, paradoxical bronchospasm

Oxymetazoline

• Brand name: Afrin

• Therapeutic class: Nasal decongestant

• Pharm class: Sympathomimetic

• Primary use: Alleviate nasal congestion of allergic rhinitis and common cold

• MOA: Stimulates the alpha-adrenergic receptors in the sympathetic nervous system and causes arterioles and nasal passages to constrict. It also dries mucous membranes so nose bleeds are common with this medication.

• Adverse side effects: PO adverse effects: Nervousness, insomnia, headache, dry mouth; Intranasal adverse effects: Rebound congestion CNS excitation, tremors, dysrhythmias, tachycardia, difficulty in voiding, severe vasoconstriction

Guaifenesin

• Brand name: Robitussin

• Therapeutic class: Allergy, cold, and cough remedies

• Pharm class: Expectorants

• Primary use: Coughs associated with viral upper respiratory tract infections

• MOA: Helps with mucus secretion and excretion

  • It can make the mucus thinner and easier for it to move out of the respiratory tract so coughing is more effective

• Adverse side effects: Dizziness, headache. rash, nausea, diarrhea, vomiting

Acetylcysteine

• Brand name: Mucomyst

• Therapeutic class: Antidotes

• Pharm class: Mucolytics

• Primary use: Used on cystic fibrosis, bronchitis, or other diseases that produce a thick mucus

• MOA: Directly break down or liquefy mucus molecules

• Adverse side effects: rash. nausea, vomiting, bronchospasm, anaphylaxis, angioedema

Diphenhydramine

• Brand name: Benadryl

• Therapeutic class: Allergy, cold, and cough remedies

• Pharm class: H1 Receptor Antagonists (Antihistamines)

• Primary use: To read minor symptoms of allergy and common colds

• MOA: Histamine (H1) receptor blocker

• Adverse side effects: Anticholinergic effects (dry mouth, hypertension, tachycardia, and photosensitivity)

Loratidine

• Brand name: Claritin

• Therapeutic class: Allergy, cold, and cough remedies

• Pharm class: H1 Receptor Antagonists (Antihistamines)

• Primary use: To read minor symptoms of allergy and common colds

• MOA: Histamine (H1) receptor blocker

• Adverse side effects: Anticholinergic effects (dry mouth, hypertension, tachycardia, and photosensitivity)

Dextromethorphan w/ Codeine

• Brand name: Robitussin with Codeine

• Therapeutic class: Allergy, cold, and cough remedies

• Pharm class: Opioids

• Primary use: Symptomatic relief of coughs caused by minor viral upper respiratory tract infections or inhaled irritants

• MOA: Suppresses the cough reflex with a direct effect on the cough center in the medulla

• Adverse side effects: nausea, dizziness, and sedation (high dose)

Theophylline

• Brand name: Theo-24

• Therapeutic class: Bronchodilators

• Pharm class: Methylxanthine

• Primary use: Long-term control of reversible airway obstruction caused by asthma or COPD.

• MOA: Inhibits phosphodiesterase, producing increased tissue conventions of cAMP; leads to bronchodilation, CNS stimulation, and diuresis

• Adverse side effects: Arrhythmias, tachycardia, nausea, vomiting, seizures, anxiety

Aminophylline

• Brand name: Phyllocontin

• Therapeutic class: Bronchodilators

• Pharm class: Methylxanthine

• Primary use: Long-term control of reversible airway obstruction caused by asthma or COPD.

• MOA: Inhibits phosphodiesterase, producing increased tissue conventions of cAMP; leads to bronchodilation, CNS stimulation, and diuresis

• Adverse side effects: Arrhythmias, tachycardia, nausea, vomiting, seizures, anxiety

Zafirlukast

• brand name: Accolate

• Therapeutic class: Anti-inflammatory drug for asthma prophylaxis

• Pharm class: Leukotriene modifier

• Primary use: Used for asthma prophylaxis and reduced inflammation caused by asthma

• MOA: Antagonizes the effects of leukotrienes; mediates airway edema, smooth muscle constriction, and altered cellular activity

• Adverse side effects: Suicidal thoughts, headache, hepatotoxicity, Churg-Strauss Syndrome

Beclomethasone

• Brand name: Beconase

• Therapeutic class: Anti-inflammatories (steroidal)

• Pharm class: Nasal glucocorticoids

• Primary use: Used to control an acute inflammatory event and asthma; perennial rhinitis

• MOA: Potent, locally acting anti-inflammatory and immune modifier

• Adverse side effects: Sore throat, nausea, dizziness, nasal irritation

Cromolyn

• Brand name: Naslacrom

• Therapeutic class: Antiasthmatics; Allergy, cold, and cough remedies

• Pharm class: Mast cell stabilizer

• Primary use: Treat allergic rhinitis and are used as prophylactic agents to prevent asthma

• MOA: Inhibit mast cells from releasing histamine and other chemical mediators and they are safe for prophylaxis of asthma.

• Adverse side effects: Nasal irritation, nausea, unpleasant taste, cough, wheezing

Hydrochlorothiazide

• Brand name: Microzide

• Therapeutic class: Diuretic

• Pharm class: Thiazide diuretic

• Primary use: Mild to moderate hypertension

• MOA: To increase the amount of urine produced and excreted

  • Acts on the distal tubule to decrease the reabsorption of sodium and it is given orally

• Adverse side effects: Dizziness (check orthostatic BP), headache, electrolyte imbalances, especially loss of potassium (hypocalcemia, hypomagnesemia, hypokalemia, and hyponatremia)

Furosemide

• Brand name: Lasix

• Therapeutic class: Diuretics; Drugs for heart failure and HTN

• Pharm class: Loop diuretics

• Primary use: Treatment of acute heart failure

• MOA: It prevents the reabsorption of sodium and chloride in the loop of Henle. This creates increased excretion of sodium via the urine as well as the excretion of hydrogen, chloride, potassium

• Adverse side effects: Dehydration, electrolyte imbalances, decreased blood pressure, orthostatic hypotension, hearing loss, falls, anemia

Spironolactone

• Brand name: Aldactone

• Therapeutic class: Antihypertensive, a drug for reducing edema

• Pharm class: Potassium-sparing diuretic, aldosterone antagonist

• Primary use: Can treat mild hypertension and is often used in combination with other antihypertensives or diuretics. It is also very useful in kidney and liver disease and it is effective in slowing the progression of heart failure

• MOA: By blocking the actions of Aldosterone, it enhances the excretion of sodium and retention of potassium and produces a weak diuresis for patients that have hypertension and edema.

  • Target receptors for aldosterone are in the distal tubule and collecting ducts of the

• Adverse side effects: Can cause gynecomastia, menstrual abnormalities, male sexual dysfunction, dysrhythmias, dehydration, hyponatremia, and agranulocytosis

Triamterene

• Brand name: Dyrenium

• Therapeutic class: Antihypertensive, a drug for reducing edema

• Pharm class: Potassium-sparing diuretic

• Primary use: Edema associated with HF, cirrhosis, and nephrotic syndrome

• MOA: Inhibition of sodium resorption in the kidney, while saving potassium and hydrogen ions

• Adverse side effects: Can cause gynecomastia, menstrual abnormalities, male sexual dysfunction, dysrhythmias, dehydration, hyponatremia, and agranulocytosis

Amiloride

• Brand name: Midamor

• Therapeutic class: Antihypertensive, a drug for reducing edema

• Pharm class: Potassium-sparing diuretic

• Primary use: Counteracts potassium loss caused by other diuretics

  • Used with other agents to treat edema and HTN

• MOA: Inhibition of sodium resorption in the kidney, while saving potassium and hydrogen ions

• Adverse side effects: Can cause gynecomastia, menstrual abnormalities, male sexual dysfunction, dysrhythmias, dehydration, hyponatremia, and agranulocytosis

Acetazolamide

• Brand name: Diamox

• Therapeutic class: Diuretic

• Pharm class: Carbonic anhydrase inhibitors

• Primary use: Used mainly for glaucoma and for other symptoms

• MOA: Blocking carbonic anhydrase prevents bicarbonate formation and reabsorption in the renal tubule.

• Adverse side effects: Acid-base imbalance (metabolic acidosis)

  • Monitor patients for orthostatic hypotension and electrolyte imbalances

Mannitol

• Brand name: Osmitrol

• Therapeutic class: Diuretic

• Pharm class: Osmotic Diuretic

• Primary use: IV: Reduction of intracranial pressure and treatment of cerebral edema

• MOA: Work by raising the serum osmolality of our blood which is a measure of the amount of the dissolved particles or solutes in a solution and osmotic pressure results, which shifts fluid from one body compartment to another

  • Mainly used to increase urine output in patients experiencing oliguria from acute kidney failure

• Adverse side effects: Hyponatremia, edema, convulsions, and tachycardia