amanda pharmd

thiazide diuretics “water pills”

high blood pressure swelling

ACE Inhibitors (Angiotensin Converting Enzyme Blockers)

High Blood Pressure and Heart Failure

ARBs (Angiotensin II Receptor Blockers)

High Blood Pressure and Heart Failure

Beta Blockers

High Blood Pressure and Irregular Heartbeat

Calcium Channel Blockers (Dihydropyridine Type)

High Blood Pressure

Calcium Channel Blockers (Nondihydropyridine Type)

High Blood Pressure

Alpha Blockers

High Blood Pressure

Alpha - 2 Agonists

High Blood Pressure

Vasodilators

High Blood Pressure and Heart Failure

Other Diuretics “water pills”

-loop Diuretics - swelling from various diseases

-potassium-sparing diuretics = high blood pressure and heart failure

Other Cardiovasular Drugs

-Antiarrhythmics = Irregular Heartbeat

-cardiac glycoside = heart failure and irregular heartbeat

Vitamin K Antagonist Anticoagulants

-block vitamin k, which is involved in clotting process

-inconsistent dietary intake of vitamin k can interfere with effectiveness

-INR blood test required to make sure blood clotting is kept at a safe and effective level

Direct Oral Anticoagulants (DOACs)

-Direct Factor Xa Inhibitors

-not affected by diet and no INR blood testing required for monitoring

Antiplatelets (Platelet Aggregation Inhibitors)

-not technically anticoagulants because they don’t affect the clotting process

-work by preventing platelets from sticking together to decrease the risk of heart attack or stroke

HMG CoA Reductase Inhibtors “Statins”

-reduce production of cholesterol made by the liver

Other Cholesterol Medications

-reduce cholesterol medications

-inhibit intestinal absorption of dietary cholesterol

sulfonylureas

-taken by mouth; oldest diabetes meds available

-increase insulin release from beta cells of the pancreas

biguanides

-taken by mouth

-reduce the amount of sugar produced in the liver, reduce the amount of sugar absorbed in the intestines, and increase insulin sensitivity

DPP-4 Inhibitors (dipeptidyl peptidase 4 inhibitors)

-taken by mouth

-slow the inactivation/degradation of GLP-1, an incretin hormone which triggers insulin release to lower blood sugar

TZDs (Thiazolidinediones)

-taken by mouth; known as “glitazones”

-increase the sensitivity of cells to insulin (decreases insulin resistance)

SGLT-2 Inhibitors (sodium-glucose cotransporter-2 inhibitors)

-taken by mouth; known as “gliflozins”

-cause more glucose to be excreted into the urine instead of reabsorbed into the body

GLP-1 Analogs (Glucagon-like Peptide 1 Agonists)

-injectables; also known as “incretin mimetics”

-mimic incretin hormone GLP-1 produced in GI tract after a meal, causing increased release of insulin from the pancreas

insulins

-injectables

-take the place of insulin that is normally produced by the body to move glucose out of the blood into other body tissues where it is used for energy

-different types: rapid, short, intermediate, and long acting

insulins - rapid acting

-onset within 30 minutes; duration 3-5 hours

insulins - long acting

-onset within 2 hours; duration up to 24 hours (up to 45 hours within insulin Degludec)

stomach medications (acid reflux/ulcers)

-h2 antagonists (h2 blockers)

-work by blocking the action of histamine at the Histamine 2 receptors of the parietal cells of the stomach to reduce acid

-used for treatment/prevention of ulcers and GERD/acid reflux symptoms including heartburn

proton pump inhibitors (PPIs)

-work by blocking the final step in stomach acid production by irreversibly binding to the proton pump of the gastric parietal cells

-used for treatment/prevention of ulcers and GERD

antiemetic medications (nausea/vomiting/motion sickness)

-work by blocking histamine (H1) receptors in the brain that can cause nausea and vomiting and motion sickness

5-HT3 antagonists

-work by blocking serotonin receptors in the brain that can cause nausea and vomiting

medications for constipation

-increase the amount of water the stool absorbs in the gut

-laxative type may also be used as bowel prep prior to GI procedures

medications for irritable bowel/cramping

-work by slowing the natural movements of the gut and by relaxing the muscles of the stomach and small intestines

seizure medications

-antiepileptic or anticonvulsants

-used to treat seizure disorders (aka epilepsy), other indications; migraine headache prevent and bipolar disorder treatment

-work by changing the way brain cells (neurons) send messages with substances called neurotransmitters and how signals move in and out of the brain cells

mild pain medications

-used to reduce fever

-how it works is not completely understood

moderate to severe pain (opioid analgesics)

-bind to opioid receptors in the brain and spinal cord to reduce the sending of pain messages and the feeling of pain

NSAIDS (non-steroidal anti-inflammatory drugs)

-for pain AND inflammation (larger doses)

-work by reducing the production of prostaglandins by blocking the enzymes cyclooxygenase (COX)

-some NSAIDS are more selective for COX-2 enzyme which reduces GI side effects that are commonly seen with NSAID use

Muscle Relaxants

-not technically “pain meds” but for muscle spasms

-exact mechanism of some is unknown, but generally thought to work by blocking nerve impulses from muscles to the brain and spinal cord

5-HT 1B/1D receptor agonists

-for migraine headaches

-work by binding to serotonin 1B/1D receptors on blood vessels in the brain to cause vasoconstriction

tension headache

-combination product that helps headache pain with different mechanisms, such as;

-acetaminophen = pain

-caffeine - vasoconstrictive and enhances acetaminophen’s pain relieving effect

-butalbital = promotes relaxation

antihistamines (h1 receptor blockers)

-work by blocking the effect of histamine (h1) which is made by the body during an allergic reaction

-used to reduce allergy/allergic reaction symptoms including itching, runny nose, watery eyes

corticosteroids “steroids”

-used to treat a wide range of inflammatory, allergic, and autoimmune conditions; use is not limited to asthma and allergies

-work by decreasing inflammation and reducing the activity of the immune system: resemble cortisol, a hormone made by the adrenal glands

-different dosage forms; intranasal, oral, topical, inhaled, injectable

intranasal steroids (nasal spray)

-for symptoms of nonallergic and allergic rhinitis (“hay fever”) which includes sneezing, runny nose, and itchy/watery eyest

topical steroids (cream, ointment, lotion, etc.)

-for a wide variety of allergic reactions/inflammation of the skin such as hives and rashes

-some examples: insect bites/stings, poison ivy, rash from an allergic reaction

oral steroids (tablets/liquid taken by mouth)

-for a wide variety of allergic reactions/inflammation of the body to decrease the immune response

-some examples: lung disease flare up, acute bronchitis, widespread rashes, prevention of organ transplant rejection

inhaled steroids (inhaler/nebulizer)

-maintenance therapy for asthma, COPD, and other chronic lung disease

leukotriene receptor antagonists

-work by blocking leukotrienes, which are released by the body when an allergen enters the airway which causes swelling in the lungs/tightening of muscles around the airway

beta 2 agonist bronchodilators

-work by binding beta 2 receptors in the lungs which promotes bronchial smooth muscle relaxation

-used in the treatment of asthma and other lung disease to increase airflow to the lungs

-formulations; inhaler and nebulizer

anticholinergic/antimuscarinic bronchodilators

-work by inhibiting muscarinic (m3) receptors in the smooth muscle of the airway which leads to bronchodilation

-used to prevent bronchospasm in people with chronic bronchitis, emphysema, COPD

-long-acting inhaler formulation in Top 200 Drugs

steroid/beta 2 bronchodilator combinations

-maintenance therapy used to control and prevent symptoms caused by asthma and COPD

-include steroid plus long-acting beta 2 agonist

antimuscarinic and beat 2 bronchodilator combos

-used to treat and prevent wheezing and shortness of breath from chronic lung diseases including COPD, emphysema, chronic bronchitis

-includes both types of bronchodilators (antimuscarinic m3 and beta 2)

penicillins (beta-lactam antibiotics)

-work by damaging the cell wall of the bacteria (bactericidal); treat wide range of infections

-penicillin was the first antibiotic used by doctors

cephalosporins (beta-lactam antibiotics)

-work by damaging the cell wall of the bacteria (bactericidal); treat wide range of infections

-some examples: ear and sinus infections urinary tract infections (UTIs) infections of the GI tract

fluoroquinolones “quinolones”

-work by inhibiting bacterial enzymes responsible for DNA replication of the bacteria (bactericidal)

-treat a wide range of infections, including UTIs and respiratory infections

-strong antibiotics generally used for resistant infections

sulfonamides “sulfa drugs”

-work by inhibiting bacteria’s ability to make folic acid which is needed for their reproduction (bacteriostatic)

-treat a wide range of infections including UTIs, bronchitis, and prostate infections

macrolides (erythromycin antibiotics)

-work by inhibiting bacterial protein synthesis needed for replication in a reversible manner (bacteriostatic)

-treat a wide range of infections including UTIs, ear infections, upper and lower tract infections, stomach infections, skin infections, STDs

lincosamides (lincomycin antibiotics)

-work by inhibiting bacterial protein synthesis needed for replication in reversible manner (bacteriostatic)

-treat a wide range of anaerobic infections (bacteria not requiring oxygen for growth) including dental, respiratory, skin, bone, and soft tissue infections

nitroimidazoles

-work by inhibiting bacterial nucleic acid synthesis which disrupts the DNA (bactericidal)

-treat a wide range of anaerobic infections including infections of the GI tract, skin, urinary tract, bone, blood, CNS, heart and lower respiratory tract

-also have antiprotozoal activity against certain parasites and single cell organisms like trichomonas and amoeba

nitrofurans

-work by several mechanisms; disrupts bacterial protein, cell wall, RNA, and DNA synthesis

tetracyclines

-work by disrupting bacterial protein synthesis (bactericidal)

-treat a wide range of infections including infections of the intestine, respiratory tract, urinary tract, and eyes

-also used in the treatment of anthrax, various STDs, gum disease, and acne

topical antibiotics

-mupirocin is a mixture of several pseudomonic acids, which inhibit bacterial RNA and protein synthesis (bacteriostatic)

-treats a wide range of skin infections typically due to Staph or Strep (impetigo, open wounds, MRSA)

-inactive for most anaerobic bacteria

antifungals

-for the treatment of infections caused by a fungus including yeast infections

-different types of antifungals, but “azoles” are the only ones in the Top 200 Drugs

-azoles work by interfering with fungal cell membrane synthesis; treat a wide range of infections

antivirals

-for the treatment of infections caused by a virus; only effective while the virus is replicating

-different antivirals work against different viruses; herpes/varicella and influenza

antidepressants

-medications used primarily for the treatment of depression, but may have other indications

-work by increasing certain neurotransmitter levels (chemical messengers between nerve cells) to improve communication between nerve cells in order to strengthen the circuits which regulate mood

-different mechanisms for doing this and different neurotransmitters targeted (serotonin, norepinephrine, dopamine)

tricyclic antidepressants (TCAs)

-older class of antidepressants

-work by blocking the reabsorption of serotonin and norepinephrine

-also affect acetylcholine and histamine levels; responsible for certain side effects and why TCAs may be used for conditions other than depression

tetracyclic antidepressants (TeCAs)

-older class of antidepressants; similar in structure and action to the Tricyclic Antidepressants (TCAs)

-exact mechanism is unknown; increase serotonin and norepinephrine

-affect other neurotransmitters → side effects

serotonin antagonist and reuptake inhibitors (SARIs)

-work by blocking the binding of serotonin at certain undesired receptors (serotonin antagonist) and blocking serotonin reabsorption (reuptake inhibitor); mechanism is not completely understood

-older class of antidepressants with less selectivity; affect other neurotransmitters (side effects, other use)

-often used for treatment of insomnia (off-label use)

selective serotonin reuptake inhibitors (SSRIs)

-work by selectively blocking the reabsorption of serotonin; less side effects = most popular class

-also used for a variety of anxiety-related disorders

serotonin norepinephrine reuptake inhibitors (SNRIs)

-work by selectively blocking the reabsorption of serotonin and norepinephrine

-in addition to depression, also used for anxiety disorders, nerve pain, and fibromyalgia

norepinephrine dopamine reuptake inhibitors (NDRIs)

-work by selectively blocking the reabsorption of norepinephrine and dopamine

-in addition to depression, also used to help with smoking cessation

antipsychotics

-used to treat schizophrenia, severe depression, severe anxiety, and symptoms of psychosis such as delusions, hallucinations, and paranoia

-exact mechanism is unknown; work by blocking dopamine and serotonin receptors

-two categories; typical and atypical antipsychotics

typical antipsychotics (first generation)

-more likely to cause Extrapyramidal symptoms (EPS), which are drug induced movement disorders affecting various parts of the body

atypical antipsychotics (second generation, SGAs)

-block dopamine receptors more selectively, which causes less EPS side effects

-cause more weight gain than typical antipsychotics

-only atypical antipsychotics in Top 200 drugs

benzodiazepines

-work by enhancing the inhibitory neurotransmitter gamma-aminobutyric acid (GABA)

-also used in the treatment of seizure disorders due to their GABA enhancing effect

-addition/dependence potential (DEA Schedule IV)

-use as an anxiolytic or sleep aid depends on each benzo’s pharmacokinetic profile (onset of action, duration, etc.)

-indicated for two disorders; anxiety and insomnia

other anxiolytics/sedatives

-non-benzodiazepines sleep aid that works by enhancing GABA (DEA Schedule IV)

-zolpidem/ambien; anxiolytic that binds at certain serotonin and dopamine receptors but its exact mechanism for reducing anxiety is unknown

-buspirone/buspar; anxiolytic that binds at certain serotonin and dopamine receptors but its exact mechanism for reducing anxiety is unknown

ADHD medications

-ADHD = attention deficit hyperactivity disorder

-goal is decrease the symptoms of ADHD (improve focus and impulse control)

-work by increasing neurotransmitters that affect focus and impulse control (norepinephrine, dopamine)

Central nervous system stimulants for ADHD

-most commonly prescribed meds for ADHD; abuse potential (DEA Schedule II)

-work by increasing the amounts of dopamine and norepinephrine in the brain

non-stimulants for ADHD

-works by selectively inhibiting norepinephrine, causing increased levels; not a controlled substance

gout medications

-xanthine oxidase inhibitor; reduces the production of uric acid in the body; used in PREVENTION of gout

-tubulin disruptor; blocks neutrophil-mediated inflammatory response caused by uric acid; used in the PREVENTION and TREATMENT of gout

glaucoma eye drops

-goal = lower pressure in the eye to prevent blindness

-3 different classes of medications; beta blocker, prostaglandin analog, and alpha 2 agonist

parkinson’s disease medications

-goal = symptom reduction (tremor, rigidity, etc.) by increasing dopamine in the brain

-2 classes of medication; dopamine precursor/decarboxylase inhibitor combination and dopamine agonist (used for RLS)

dementia medications

-target is to help improve mental function in people with alzheimer’s disease

-cholinesterase inhibitors → increase acetylcholine levels in brain; important in the processes of memory, thinking, and reasoning

-NMDA receptors antagonists → glutamate → calcium → slows damage to brain cells that is seen in alzheimer’s disease

hormones

-hormones are the chemical messengers of the body produced by the endocrine glands

-small amounts of hormones can cause big changes in the body; why hormone imbalances can cause serious problems

-lab tests are used to check various hormone levels

-hormone drugs are used for correcting imbalances for modifying various chemical responses or functions

-several hormone types; estrogen, progesterone, estrogen/progesterone, testosterone, thyroid

miscellaneous drugs

-DMARDs (disease modifying antirheumatic drugs)

-congestion/cough medications

cardiovascular drugs

-thiazide diuretics “water pills”

-ACE inhibitors (Angiotensin converting enzyme blockers)

-ARBs (angiotensin II receptor blockers)

-beta blockers

-calcium channel blockers (dihydropyridine type)

-calcium channel blockers (nondihydropyridine type)

-alpha blockers

-vasodilators

anticoagulants “blood thinners”

-vitamin k antagonist anticoagulants

-direct oral anticoagulants (DOACs)

-antiplatelets (platelet aggregation inhibitors)

cholesterol medications

-HMG CoA reductase inhibitors “statins”

diabetes medications

-sulfonylureas

-biguanides

-dpp-4 inhibitors (dipeptidyl peptidase 4 inhibitors)

-TZDs (thiazolidinesdiones)

-SGLT-2 inhibitors (sodium-glucose cotransporter-2 inhibitors

-GLP-1 analogs (glucagon-like peptide 1 agonists)

insulins

-insulin-rapid acting

-insulin-long acting

GI medications

-stomach medications (acid reflux/ulcers)

-proton pump inhibitors (PPIs)

-antiemetic medications (nausea/vomiting/motion sickness)

-5-HT3 antagonists

-constipation

-irritable bowel/cramping

seizure medications

-also known as antiepileptic or anticonvulsants

-used to treat seizure disorders (known as epilespy)

-some of the seizure medications have other indications, including migraine headache prevention and bipolar disorder treatment

pain medications

-mild pain

-moderate to severe pain (opioid analgesics)

-NSAIDS (Non-steroidal anti-inflammatory drugs)

-muscle relaxants

-5-HT 1b/1d receptor agonists

-tension headache

asthma and allergy medications

-antihistamines (h1 receptor blockers)

-corticosteroids “steroids”

-intranasal steroids (nasal spray)

-topical steroids (cream, ointment, lotion, etc.)

-oral steroids (tablets/liquid taken by mouth)

-inhaled steroids (inhaler/nebulizer)

-leukotriene receptor antagonists

-beta 2 agonist bronchodilators

-anticholinergic/antimuscarinic bronchodilators

-steroid/beta 2 bronchodilator combinations

-antimuscarinic and beta 2 bronchodilator combos

antibiotics

-penicillins (beta-Lactam antibiotics)

-cephalosporins (beta-Lactam antibiotics)

-fluoroquinolones “quinolones”

-sulfonamides “sulfa drugs”

-macrolides (erythromycin antibiotics)

-lincosamides (lincomycin antibiotics)

-nitroimidazoles

-nitrofurans

-tetracyclines

-topical antibiotics

antifungals

-for the treatment of infections caused by a fungus including yeast infections

-different types of antifungals, but “azoles” are the only ones in Top 200 drugs

-azoles work by interfering with fungal cell membrane synthesis; treat a wide range of fungal infections

antivirals

-for the treatment of infections caused by a virus; only effective while the virus is replicating

-different antivirals work against different viruses; herpes/varicella and influenza

antidepressants (use)

-medications used primarily for the treatment of depression, but may have other indications

-work by increasing certain neurotransmitter levels (chemical messengers between nerve cells) to improve communication between nerve cells in order to strengthen the circuits which regulate mood

-different mechanisms for doing this and different neurotransmitters targeted

antidepressants (classes)

-tricyclic antidepressants (TCAs)

-tetracyclic antidepressants (TeCAs)

-Serotonin Antagonist and Reuptake inhibitors (SARIs)

-selective serotonin reuptake inhibitors (SSRIs)

-serotonin norepinephrine reuptake inhibitors (SNRIs)

-norepinephrine dopamine reuptake inhibitors (NDRIs)

antipsychotics (use)

-used to treat schizophrenia, severe depression, severe anxiety, and symptoms of psychosis such as delusions, hallucinations, and paranoia

-exact mechanism is unknown; work by blocking dopamine and serotonin receptors

-two categories: typical and atypical antipsychotics

anxiolytics and sedatives (use)

-medications that work on the central nervous system to relieve anxiety, have a calming effect, or help with sleep

-anxiolytics → reduce anxiety

-sedatives → cause sleep

-often grouped together because many drugs have both anxiolytic and sedative properties

-many antidepressants have anxiolytic effects as well

anxiolytics and sedatives (classes)

-benzodiazepines

-non-benzodiazepine sleep aid that works by enhancing GABA (DEA Schedule IV)

-anxiolytic that binds at certain serotonin and dopamine receptors but its exact mechanism for reducing anxiety is unknown

ADHD (use)

-ADHD= Attention deficit hyperactivity disorder

-goal is decrease the symptoms of ADHD (improve focus and impulse control)

-work by increasing neurotransmitters that affect focus and impulse control (norepinephrine, dopamine)

-stimulant and non-stimulant medications