D398 Intro to Pharmacology WGU

Heart failure: occurs when the heart muscle does not pump blood as well as it should.

Cardiac glycosides: In individuals with heart failure, cardiac glycosides improve cardiac output by increasing the power of ventricular contractions.

digoxin (Lanoxin – heart failure med) side effects: irritability, tremors, seizures, double vision, visual halos, and inability to sleep.

digoxin (Lanoxin – heart failure med) cautions: severe kidney or lung damage (doses may need to be adjusted), sudden heart attacks.

digoxin (Lanoxin – heart failure med) drug interactions: this medication may interact with several drugs. It is important to note this and alert the patient to follow up with their doctors or pharmacists for any new additions of medications.

Arrhythmia: an irregular heartbeat. This occurs when the electrical signals that coordinate heartbeats malfunction. Incorrect signaling causes the heart to beat excessively or quickly (tachycardia), too slowly (bradycardia), or erratically (fibrillation).

amiodarone (Cordarone – arrhythmia med) is an oral and injectable antiarrhythmic agent approved for treating arrhythmias.

amiodarone (Cordarone – arrhythmia med) side effects: tremors, numbness, visual disturbances, lung scarring, or thickness (known as pulmonary fibrosis).

amiodarone (Cordarone – arrhythmia med) cautions: patients with underlying heart block diseases; patients with thyroid disease; patients with allergic reactions to iodine (because of the large amount of iodine contained in amiodarone).

Hypertension (high blood pressure): is a frequent disorder affecting the body's arteries. When a person has high blood pressure, the force exerted by the blood on the arterial walls is consistently excessive; the heart must exert more effort to pump blood.

Hypertension (high blood pressure): systolic blood pressure (SBP) of 130 or higher or diastolic blood pressure (DBP) of 90 or higher at rest.

Hypertension meds: Beta Blockers; calcium channel blockers; diuretics; Angiotensin-converting enzyme (ACE) inhibitors; Angiotensin Receptor Blockers (ARBs).

Beta-blockers (Hypertension meds) are blood pressure-lowering medicines and function by blocking the beta receptor in the body. The class of selective beta1-blockers would reduce the pace and power of cardiac contraction and lower blood pressure; may also be used for other diseases as well .

metoprolol (Tropol – Beta Blocker - Hypertension).

metoprolol (Tropol – Beta Blocker - Hypertension) side effects: dizziness, fatigue, confusion, low blood sugar.

metoprolol (Tropol – Beta Blocker - Hypertension) cautions: Never stop the drug without speaking to a doctor (may have withdrawal symptoms). Inform the doctor of medication and disease history. Some beta-blockers may interfere with diseases such as asthma or chronic obstructive pulmonary disease and can worsen symptoms.

Calcium channel blockers (Hypertension Meds): reduce blood pressure. They act by preventing calcium from entering the cells of the heart and arteries. The calcium blockage reduces heart rate, hence lowering blood pressure further. In addition, this class of drugs may alleviate chest discomfort (angina) and regulate an irregular heartbeat.

amlodipine (Norvasc – Calcium Channel Blockers- Hypertension Meds) .

amlodipine (Norvasc – Calcium Channel Blockers- Hypertension Meds) side effects: edema (swelling), abdominal discomfort, and headache.

Diuretics (Hypertension Meds): used to decrease blood pressure by helping rid the body of salt (sodium) and water through increased urine. Most patients who fit requirements for medication therapy should begin treatment with thiazide diuretics, either alone or in combination with; ACE inhibitors, ARBs, beta-blockers, or calcium channel blockers.

hydrochlorothiazide (Microzide - Diuretics - Hypertension Meds).

hydrochlorothiazide (Microzide - Diuretics - Hypertension Meds) side effects: diuretics commonly cause frequent urination, so many patients prefer taking this medication early in the day and not late at night to prevent frequent urination throughout the night, low potassium, and low magnesium (supplements are sometimes given to maintain electrolyte levels).

Angiotensin-converting enzyme (ACE) inhibitors (Hypertension Meds): drugs that relax veins and arteries to reduce blood pressure. ACE inhibitors are medications that work by blocking an enzyme called ACE in the body, which leads to a decrease in angiotensin II, a chemical that narrows blood vessels. Reducing the levels of angiotensin II can help to relax and widen blood vessels, which can improve blood flow and lower blood pressure.

ACE inhibitors (hypertension meds): first- or second-line medications in the treatment of hypertension. They are good alone but very effective and synergistic in conjunction with other antihypertensives, including diuretics and calcium channel blockers.

lisinopril (Zestril – ACE Inhibitor – Hypertension Med).

lisinopril (Zestril – ACE Inhibitor – Hypertension Med) side effects: The most frequent side effect of ACE inhibitors is a dry cough, rash, and high potassium.

lisinopril (Zestril – ACE Inhibitor – Hypertension Med) cautions: A serious, potentially life-threatening adverse effect is angioedema (swelling under the skin). Use caution in pregnancy and lactation (can cause birth defects).

Angiotensin receptor blockers (ARBs – Hypertension Med): comparable to ACE inhibitors and are often used as alternatives. They inhibit the angiotensin receptor directly. ARBs such as losartan (Cozaar) and valsartan (Diovan) block the effects of angiotensin II, decreasing blood pressure without a marked change in heart rate. ARBs are associated with a lower incidence of drug-induced cough, rash, or taste disturbances and are used in those patients who cannot tolerate ACE inhibitors.

losartan (Cozaar - ARBs – Hypertension Med).

losartan (Cozaar - ARBs – Hypertension Med) Side effects: dizziness, high potassium levels.

losartan (Cozaar - ARBs – Hypertension Med) Cautions: caution in pregnancy and lactation (can cause birth defects).

Angina: describes chest discomfort or pain. The most prevalent kind of angina is angina pectoris, which is caused by obstruction of the coronary arteries, which deliver oxygenated blood to the heart muscle, resulting in severe chest pains and inability to breathe.

Vasodilators (Angina Med): provided to widen the blood arteries (thereby improving oxygen flow) and halt or minimize the frequency of bouts of chest discomfort.

nitroglycerin (Nitrostat - Vasodilator – Angina Med).

nitroglycerin (Nitrostat - Vasodilator – Angina Med) side effects: headaches, flushing (redness and warmth to the face), blurred vision, and dry mouth.

nitroglycerin (Nitrostat - Vasodilator – Angina Med) Cautions: Alcohol may interact with nitrates, intensifying their hypotensive effects. Phosphodiesterase (PDE) inhibitors for erectile dysfunction, such as sildenafil (Viagra), are contraindicated in males taking nitrates. The interaction between the two medicines causes a massive, rapid, and harmful decrease in blood pressure.

Cholesterol: waxy material in blood. Body needs cholesterol to construct healthy cells, but excessive cholesterol levels may raise your risk of heart disease. With elevated cholesterol, fatty deposits may form in the blood arteries. Eventually, the accumulation of these deposits makes it impossible for sufficient blood to flow through the arteries. Occasionally, these deposits might rupture unexpectedly and form a clot, resulting in a heart attack or stroke.

Antilipemic medicines (high cholesterol meds): used for controlling high cholesterol and triglyceride levels in the blood. Cholesterol-lowering medication either inhibits how cholesterol is synthesized in the liver or how it is absorbed in the intestines. Six classes of antilipemic medicines, but only two are covered, statins and fibrates.

Statins (Antilipemic meds - High Cholesterol Meds): First-line treatment; suppress enzyme responsible for cholesterol production.

atorvastatin (Lipitor – Statins - Antilipemic meds - High Cholesterol Meds).

atorvastatin (Lipitor – Statins - Antilipemic meds - High Cholesterol Meds) Side effects: muscle weakness, rhabdomyolysis (severe injury to the muscle tissue), and an increase in liver enzyme markers.

atorvastatin (Lipitor – Statins - Antilipemic meds - High Cholesterol Meds) Cautions: liver or kidney disease, existing muscle weakness, pregnancy, and breastfeeding.

Fibrate (antilipemic med - high cholesterol med): modest LDL-lowering potential but are particularly helpful in individuals with severely excessive triglyceride and cholesterol levels. Excellent option for diabetics because they boost glucose tolerance.

fenofibrate (Tricor – fribrate – antilipemic med – high cholesterol).

fenofibrate (Tricor – fibrate – antilipemic med – high cholesterol) Side effects: GI complaints (diarrhea, dyspepsia, nausea and vomiting, and abdominal pain), stones in the gallbladder, and muscle pain.

fenofibrate (Tricor – fibrate – antilipemic med – high cholesterol) Cautions: gallbladder disease, liver disease.

fenofibrate (Tricor – fibrate – antilipemic med – high cholesterol) Interactions: fibrates interact when taken with statins, which may increase the risk of serious muscle problems and elevated liver enzymes. Only use together if directed by the prescribing healthcare provider.

Blood clots (thrombosis): blood coagulates - unstable, deformed clots may develop, detach, and move through the circulation, obstructing blood flow and causing tissue injury.

Anticoagulants: impede the development of clots; two broad categories, oral anticoagulants and injectable anticoagulants.

warfarin (Jantoven – oral anticoagulant – Blood Clots meds).

warfarin (Jantoven – oral anticoagulant – Blood Clots meds) Side effects: bleeding complications, bloody stool, and red urine.

warfarin (Jantoven – oral anticoagulant – Blood Clots meds) Cautions: There are interactions with several medications and several food groups; patients must follow up with the prescribing healthcare provider for routine level checks. Some patients follow Coumadin clinics, where specific dosing is tailored to each patient, and lifestyle and nutritional information is provided to prevent any interactions.

Bronchoconstriction: occurs in individuals with asthma or chronic obstructive pulmonary disease (COPD).

Bronchodilators (beta-agonists): medicines that make breathing easier by relaxing the muscles in the lungs and widening the airways; SABAs and LABAs.

SABAs (bronchodilator – beta agonist – bronchoconstriction med): short acting beta agonists, acute asthma attack, albuterol (ProAir).

LABAs (bronchodilator – beta agonist – bronchoconstriction med): long-acting beta-agonists (LABA), preventative/maintenance NOT for acute, formoterol (Foradil).

formoterol (Foradil – LABAs – bronchodilator)

formoterol (Foradil – LABAs – bronchodilator) side effects: throat irritation, hoarseness, and sinusitis; nervousness, tremors, dizziness, and headache.

formoterol (Foradil – LABAs – bronchodilator) Caution: may cause or worsen cardiac irregularities (tachycardia, palpitations, arrhythmias, and angina).

Anticholinergics: block receptors in the smooth muscle of the airway. These medications induce bronchodilation by preventing bronchospasms.

ipratropium (Atrovent – anticholinergic – bronchoconstriction med)

ipratropium (Atrovent – anticholinergic – bronchoconstriction med) Side effects: cardiac effects (changes in heart rate and palpitations), CNS stimulation (headache, drowsiness, dizziness, confusion, and agitation), thickened secretions and mucus plugging, dry mouth and metallic taste, constipation and abdominal pain

ipratropium (Atrovent – anticholinergic – bronchoconstriction med) Cautions: anticholinergics are not indicated for patients with unstable cardiac status, history of heart attacks, glaucoma, drug sensitivity, or prostatic hypertrophy

Xanthine derivatives (theophylline Theo 24 – bronchoconstriction med): prevent and treat wheezing, shortness of breath, and chest tightness in the lungs and respiratory passages.

theophylline (Theo 24 – xanthine derivative – bronchoconstriction med)

theophylline (Theo 24 – xanthine derivative – bronchoconstriction med) Side effects: nervousness, insomnia, irritability, headache, tremors, seizures, cardiac effects (palpitation, tachycardia, arrhythmias), and urinary frequency

theophylline (Theo 24 – xanthine derivative – bronchoconstriction med) Cautions: sudden cessation of tobacco smoking (may result in reduced clearance of theophylline and increased serum theophylline concentrations)

Corticosteroids (respiratory inflammation meds): alleviate inflammation, reduce edema (swelling), diminish bronchial hyper-reactivity to triggers, and suppress symptoms. Reduce frequency and severity of asthma attacks.

fluticasone (Flovent – corticosteroid – respiratory med)

fluticasone (Flovent – corticosteroid – respiratory med) Side effects: throat irritation and dry mouth, oral fungal infections (patient should be encouraged to rinse mouth with mouthwash or water after administration), and increased susceptibility to pneumonia.

fluticasone (Flovent – corticosteroid – respiratory med) Cautions: with corticosteroids applied to viral, bacterial, or fungal infections, hypertension or congestive heart failure, diabetes hypothyroidism or cirrhosis renal failure.

Expectorants (over-the-counter – respiratory med): decrease thickness and aid in the expulsion of sputum and phlegm.

guaifenesin (Mucinex - expectorant – over-the-counter respiratory med)

Antitussives (over-the-counter – respiratory med): drugs used to stop coughing in people who do not have a wet congested cough but have a dry, consistent, and hacking cough; Cough suppressant.

dextromethorphan (Delsym – antitussive – over-the-counter respiratory med)

Antihistamines (over-the-counter – respiratory med): treat allergy symptoms such as itching and rash; also taken to reduce nasal secretions, reduce post-nasal drip, and dry out the throat; Two groups of antihistamines, first-generation (diphenhydramine – Benadryl – more drowsy) and second-generation (loratadine - Claritin – less drowsy).

diphenhydramine (Benadryl – 1^st generation antihistamine)

diphenhydramine (Benadryl – 1st generation antihistamine) Side effects: drowsiness, dry eyes, and dry nose

loratadine (Claritin – 2^nd generation antihistamine – respiratory med)

loratadine (Claritin – 2nd generation antihistamine – respiratory med) Side effects: headache, dizziness, fatigue, drowsiness (especially cetirizine), dry mouth, and pharyngitis

Decongestants (over-the-counter respiratory meds): used to alleviate nasal congestion or the feeling of a stuffy nose. They constrict the blood vessels in the nasal lining, which reduces swelling and facilitates breathing.

pseudoephedrine (Sudafed – decongestant – over-the-counter respiratory med)

oxymetazoline (Afrin- nasal decongestant spray – over-the-counter respiratory med)

Acid reflux: manifests with heartburn and a sharp feeling in the center of the chest produced by irritation of the esophageal lining induced by stomach acid. Pyrosis; heartburn.

calcium carbonate (Tums/Rolaids – antacids – acid reflux/gastrointestinal meds); Cautions: chronic kidney disease.

aluminum hydroxide + magnesium hydroxide (Maalox - antacids – acid reflux/gastrointestinal meds) Side effects: constipation (with aluminum or calcium carbonate antacids) or diarrhea (with magnesium antacids); Cautions: chronic kidney disease

Antihistamines: for GI issues, lower stomach acid output.

famotidine (Pepcid – over-the-counter antihistamine – acid reflux/gastrointestinal meds); Side effects: diarrhea, dizziness, or mental confusion (especially in older or debilitated adults; less with Pepcid).

cimetidine (Tagamet – over-the-counter -antihistamine – acid reflux/gastrointestinal meds); Side effects: diarrhea, dizziness, or mental confusion (especially in older or debilitated adults; less with Pepcid).

GERD: disorder in which acid-containing stomach contents continuously seep back into the esophagus, the tube connecting the neck to the stomach.

Proton pump inhibitors (PPIs): category of medications used to reduce stomach acid production by inhibiting the action of pumps that transfer hydrogen ions across cell membranes, thus leading to decreased hydrochloric acid secretion.

omeprazole (Prilosec - Proton pump inhibitors PPI – GERD med) esomeprazole (Nexium - Proton pump inhibitors PPI - GERD med): Side effects, abdominal pain, constipation, and nausea; Cautions, There is an increased risk for bacterial infections and vitamin B12 deficiency. Long-term PPI medication (at least one year), especially at high dosages, can be associated with fractures due to interference with calcium absorption.

Antidiarrheal medicines: lower the frequency of loose stools via a variety of mechanisms.

bismuth subsalicylate (Pepto-Bismol – antidiarrhea med), Side effects, Side effects with bismuth subsalicylate are minimal since it is well tolerated. However, there have been some rare reports of discoloration of the tongue and stool (black color), and it can cause ringing in the ears. Bismuth subsalicylate may interact with antibiotics; Cautions, history of salicylate (including aspirin) allergic reactions Do NOT administer to children (under 12 years of age) or teenagers recovering from chickenpox or influenza due to the risk of Reye syndrome, a severe, life-threatening illness that causes an increase in brain pressure.

Opiate agonists: medications that work by delaying the action of the digestive tract. This lessens the frequency of bowel motions and decreases the number of watery stools (diarrhea).

diphenoxylate with atropine (Lomotil – Opiate agonist - antidiarrheal): it is a Schedule C-V controlled substance. Side effects, drying of secretions, blurred vision, and confusion. Cautions, caution in young children (under 3 years of age) and pregnant women.

loperamide (Imodium – Over the counter - antidiarrheal): Side effects, drying of secretions, blurred vision, and confusion. Cautions, caution in young children (under 3 years of age) and pregnant women.

Laxatives: relieve constipation by facilitating intestinal emptying (defecation). Seven categories: bulk-forming laxatives, stool softeners, emollients, saline laxatives, stimulant laxatives, osmotic laxatives, and chloride channel activators.

Bulk-forming laxatives: fiber supplements, soften the stool by absorbing water and increase fecal mass to facilitate defecation.

psyllium, polycarbophil (constipation med): bulk-forming laxative; Cautions, Do not administer for patients with acute abdominal pain, partial bowel obstruction, dysphagia (difficulty in swallowing), or esophageal obstruction. Contact a healthcare provider.

Stool softeners (constipation med): surface-acting agents that moisten stool through a detergent action and are administered orally. Stool softeners are the choice for pregnant or nursing women and children with hard, dry stools.

docusate sodium (Colace – stool softener – constipation med); Side effects, well tolerated; however, they may sometimes be associated with cramping or rashes. Limit use to no more than one week unless recommended by a healthcare provider.

dimenhydrinate (Dramamine – nausea med) and meclizine (Antivert – nausea med); Side effects, drowsiness, constipation, or blurred vision.

Antidopaminergics: dopamine-receptor antagonists, stop the chemoreceptors (responsible for detecting taste and smell) in the brain from being stimulated, which stops messages from going to the GI tract.

promethazine (Phenergan – antidopaminergic – nausea med); Side effects: tremors, muscular rigidity, difficulty walking.

Endocrine Drugs

Adrenal Corticosteroids: synthetic versions of cortisol used to treat a wide variety of inflammatory conditions. Steroids function by lowering inflammation and the immune system's activity.

prednisone (Deltasone – adrenal corticosteroid – endocrine med), Side effects: mood changes, weight gain, swollen face, acne, or stunted growth in children. Cautions: For patients taking these medications long term, avoid stopping abruptly and consult with a healthcare provider prior to stopping. Caution for patients with diabetes or glaucoma (may worsen these conditions).

methylprednisolone (MEDROL dose pack – adrenal corticosteroid – endocrine med), Side effects: mood changes, weight gain, swollen face, acne, or stunted growth in children. Cautions: For patients taking these medications long term, avoid stopping abruptly and consult with a healthcare provider prior to stopping. Caution for patients with diabetes or glaucoma (may worsen these conditions).

thyroid disorder: occurs when the thyroid produces too much or too little vital hormone. Triiodothyronine (T3) and thyroxine (T4) are the major hormones generated by your thyroid gland. Low levels of T4 could indicate an underactive thyroid (hypothyroidism), while high levels of T4 could indicate an overactive thyroid (hyperthyroidism).

Hypothyroidism: disorder characterized by insufficient production and release of thyroid hormone into circulation. This slows down metabolism. Symptoms of hypothyroidism may include fatigue, weight gain, and an inability to tolerate certain temperatures.

levothyroxine (Synthroid - hypothyroidism), Side effects: muscle weakness, leg cramps, nervousness, and weight loss. Caution: drug interactions, such as a major drug interaction with warfarin

Hyperthyroidism is a condition characterized by an overproduction of the thyroid hormone by the thyroid gland. This condition may increase metabolic rate. Symptoms of hyperthyroidism include weight loss, rapid heartbeat, and sleep problems.

methimazole (Tapazole - hyperthyroidism), Side effects: rash, itching, an abnormal taste of blood in the mouth. Cautions: Caution with patients with liver disease or who are pregnant. Speak to a healthcare provider prior to use.

propylthiouracil (PTU – hyperthyroidism), Side effects: rash, itching, an abnormal taste of blood in the mouth. Cautions: Caution with patients with liver disease or who are pregnant. Speak to a healthcare provider prior to use.

Diabetes Mellitus and Medications

Diabetes mellitus: collection of hormonal disorders defined by poor metabolism of carbohydrates, lipids, and proteins, leading to increased blood glucose levels (sugar components of carbohydrates).

Diabetes: when your cells cannot absorb and use glucose (sugar) for energy; instead, the glucose may remain in the blood and not be utilized, causing long-term side effects.

insulin aspart (NovoLog – diabetes med): rapid-acting diabetes med

insulin isophane (Humulin N – diabetes med): intermediate-acting diabetes med

insulin glargine (Lantus – diabetes med): long-acting diabetes med

Biguanides work by decreasing glucose production in the liver and enhancing insulin uptake in muscle tissue. Metformin is the preferred initial first-line monotherapy, or it can be used in combination with other oral antidiabetic medications or insulin to treat type 2 diabetes or prediabetes.

metformin (Glucophage – biguanides – diabetes med), Side effects: diarrhea, upset stomach, metallic taste in the mouth, weight loss. Cautions: increased risk of lactic acidosis (increased buildup of lactic acid)

Sulfonylureas: work by increasing insulin production from the pancreas and improving peripheral insulin activity.

glipizide (Glucotrol – sulfonylureas – diabetes med) Side effects: weight gain, water retention. Cautions: Caution for patients with impaired kidney function.

Urinary Drugs

Diuretics: medications that accelerate urine elimination and are frequently used in several disease states. Their primary responsibility is to lower the amount of fluid in circulation when patients have excessive fluid and pressure.

Diuretics, or water tablets: assist the kidneys in excreting surplus salt and water via urine. These diuretics impede salt and chloride reabsorption by acting directly on the kidney, which in turn slows water reabsorption back into the circulation, resulting in increased urine production.

hydrochlorothiazide (Microzide – thiazide diuretic – urinary med) Side effects: electrolyte depletion such as hypokalemia (decreased potassium), low sodium levels (hyponatremia), and low magnesium levels (hypomagnesemia); however, it can cause high calcium levels (hypercalcemia). Potassium or magnesium supplements are often given concurrently with diuretics to offset this side effect. Cautions: Caution using hydrochlorothiazide in severe renal diseases—another class of diuretics known as loop diuretics are often used in patients with severe renal disease.

Gout: painful type of arthritis, occurs when the body produces too much uric acid, a waste product found in blood.

Nonsteroidal anti-inflammatory drugs (NSAIDs): ibuprofen or naproxen and anti-gout agents.

colchicine (Colcrys - Nonsteroidal anti-inflammatory drugs NSAIDs – anti-gout) Side effects: gastrointestinal side effects (nausea, vomiting, and diarrhea), bone marrow suppression.

Benign prostatic hyperplasia (BPH): is characterized by an increase in the reproduction of cells (hyperplasia) that causes prostate enlargement and impedes urine flow. The prostate encircles the urethra in males, and urethral obstruction might occur when BPH causes prostate enlargement.

Antiandrogens: drugs used to treat the symptoms of Benign prostatic hyperplasia (BPH)

finasteride (Proscar – antiandrogen - Benign prostatic hyperplasia (BPH) - urinary med) and dutasteride (Avodart – antiandrogen - Benign prostatic hyperplasia (BPH) – urinary med) Side effects: decreased sex drive, breast enlargement in males, inability to maintain erection, increased hair growth..

Alpha-blockers: medications that relax smooth muscle in the bladder, neck, and prostate, causing them to decrease pressure.

tamsulosin (Flomax – alpha-blocker - Benign prostatic hyperplasia (BPH) – urinary med) and doxazosin (Cardura – alpha-blocker - Benign prostatic hyperplasia (BPH) – urinary med) Side effects: dizziness, headache, and nasal congestion. Cautions: Notify ophthalmologists of being on this class of medications before any surgeries. These drugs may put a patient at risk for "floppy iris syndrome," where the iris does not stay dilated during surgery.

Urinary tract infections (UTIs): frequent illnesses when bacteria or fungi enter the urethra and infect the urinary system. The infections may affect numerous regions of the urinary system, but bladder infections (cystitis) are the most prevalent.

phenazopyridine (AZO – over the counter – UTI med – urinary med) Side effects: headache, discoloration of body fluid, and red or orange urine.

Antibiotics: Penicillins (amoxicillin and piperacillin) and cephalosporins; most commonly prescribed antibiotics. Macrolides (azithromycin, clarithromycin, and erythromycin). Fluoroquinolones, also called quinolones. Aminoglycosides (gentamicin and amikacin); potent and reserved for more serious infections. Tetracyclines; side effect discoloration of developing teeth. Carbapenems; reserved for treating life-threatening, complex, hospital-acquired infections or for treating immunocompromised patients.

Antivirals: Acyclovir; one of the most prescribed medications for treating herpes simplex, zoster (shingles), and varicella zoster (chickenpox) infections. Shingrix; vaccine for herpes zoster (shingles). Neuraminidase inhibitors; Tamiflu and Relenza, provides the best protection against illness due to influenza. Ribavirin; RSV, for children - used as a spray either through the nose or the mouth, for adults - orally or through an IV.

Antifungal: two most common antifungal agents are fluconazole and nystatin; fluconazole is often prescribed because a single oral dose effectively treats vaginal candidiasis; nystatin, is given to treat oral thrush (infection inside the mouth).

Antibiotics: used to treat infections caused by bacteria; antibiotic that kills bacteria is called a bactericidal antibiotic; antibiotic that stops the growth of bacteria is called a bacteriostatic antibiotic.

Antivirals: do not kill the infecting virus; instead, the antiviral medication stops the virus's replication and development.

Antifungals: antimycotic medications, work by inhibiting the reproduction of cells and ultimately killing the fungus cells.

Antineoplastic drugs: medications used to treat cancer; also referred to as anticancer, chemotherapy, chemo, cytotoxic, or hazardous drugs. Nine major groups; antimetabolites, alkylating agents, mitotic inhibitors, antitumor antibiotics, hormones and hormone blockers, biologics, targeted cancer therapies, vaccines, radioactive isotopes.

Antimetabolites (antineoplastic): drugs that kill cells and are therefore called cytotoxic; methotrexate (oral/injectable) and fluorouracil (injectable/topical).

Alkylating agents (neoplastic drugs): include cisplatin and cyclophosphamide; used to treat several cancers. As with many antineoplastic agents, their purpose is to prevent cell growth; concern with alkylating agents is the long-term damage associated with these medications, specifically to bone marrow. Other major concerns include damage to the nervous system, ulcers, and pulmonary fibrosis.

Mitotic inhibitors (neoplastic drugs): work to inhibit the process of mitosis, a cellular process necessary for a cell to divide, which is required for all cells in the body; major concerns with mitotic inhibitors, such as vinblastine and vincristine, are their likelihood of causing peripheral nerve damage and myelosuppression, which can lead to anemia and decreased immune function.

Extravasation: many neoplastic drugs can cause this; leaking of drugs intended for intravenous (IV) administration—which leads to the destruction of the surrounding skin and tissue.

Antitumor antibiotics (neoplastic drugs): specifically target and kill cancer cells; they do this through interactions with the genetic material inside the cancer cell; most well-known antitumor antibiotic is doxorubicin, which has a maximum lifetime dose limit and can only be used for a specific period due to heart damage (cardiotoxicity). Doxorubicin plays a major role in the treatment of a wide variety of cancers, including lung, breast, gastric, and ovarian.

Hormones/Hormone Blockers (neoplastic drugs): Some cancers, such as breast, ovarian, and prostate cancer, are hormone-sensitive or hormone-dependent because they depend on hormones—chemical messengers made naturally in the body—to grow and spread. Common cancers that can be treated with drugs that target hormones include breast cancer, uterine cancer, thyroid cancer, prostate cancer, and adrenal cancer.

hormone blockers (neoplastic drugs): Antiestrogens (typically for women- Breast, uterine, and ovarian cancers); drugs to prevent the production or action of estrogen by blocking estrogen receptors. Antiandrogens(for men- prostate cancer); drugs to prevent the production or action of testosterone and dihydrotestosterone.

Hormone-related drugs for cancer: Prednisone(prevents severe allergic reaction, decreases nausea and vomiting), Tamoxifen (suppress estrogen production), Lupron Depot (suppress androgen production).

Biologics (neoplastic drug: to give the immune system a boost to be able to fight off cancerous cells more effectively. Biologics can be considered active (direct) or passive (indirect); active biologics use the body’s natural immune system, while passive biologics use components created outside the body; active biologics include interferons, and passive biologics include monoclonal antibodies.

Active/direct biologics (neoplastic drug): interferons; most frequently used interferon is called interferon alfa, which treats a wide variety of cancers and other conditions, such as hepatitis and multiple sclerosis. Interferons have many uncomfortable side effects, which include flu-like symptoms, stomach issues, sleep disturbances, and anemia.

Passive/indirect biologics (neoplastic drug): Monoclonal antibodies; given intravenously; include Avastin and Herceptin. Avastin treats carcinoma of the colon, kidney, or lungs, while Herceptin is used for breast cancer.

Targeted Cancer Therapy (neoplastic drug): Gleevec, which is considered a signal transduction inhibitor (STI). An STI is a medication that can block signals inside a cell that are being passed from one molecule to another; approved for chronic myelogenous leukemia and, unlike other antineoplastic agents, is given orally.

Vaccines (neoplastic drug): can either be preventative or used as treatments, both of which help the immune system against disease, in this case, cancer; there are two FDA-approved vaccines to protect against the human papillomavirus (HPV), which can cause cervical cancer, Gardasil and Cervarix; Provenge, the first vaccine approved to treat cancer, is uniquely created for each individual patient to help treat prostate cancer.

Radioactive isotopes: targeted cancer treatment by using a radioactive drug that interacts with cancer cells but has minimal impact on nearby healthy cells; common treatment is radioactive sodium iodine, which is administered by mouth to treat thyroid cancer.

Medical Abbreviations: Po / Per os = By mouth; Bid/Bis in die = twice daily; C/Cum = with; Rx/Recipere = Take

1906 Pure Food and Drug Act: established drug standards for strength, purity, and quality. This act also mandated that drugs with dangerous ingredients be labeled as such.

1938 Federal Food, Drug, and Cosmetic Act: established the Food and Drug Administration (FDA), which is meant to enforce rules such as labeling, drug approval before release, and warning labels (such as "may cause drowsiness").

1970 Controlled Substances Act: established the Drug Enforcement Agency (DEA). This act set strict standards for abused drugs and required prescribers to register with the DEA. The DEA enforces the laws included in this act.

Fat-soluble vitamins: Higher risk of overdose; A D E K; Vitamin A helps the body fight infections and heal wounds; Vitamin D is essential for healthy skin, bones, nerves, and muscles; Vitamin E is necessary for the breakdown and use of food and the protection of body organs, tissues, and blood; Vitamin K is necessary for blood clotting.

Water-soluble Vitamins: Lower/No risk of overdose; B complex, C; Vitamin B1 is necessary for a healthy brain, nerves, heart, and blood vessels; Vitamin B2 is necessary to turn carbohydrates in food into energy and to create red blood cells; Vitamin B12 is essential for red blood cell development and a healthy nervous system; Vitamin B9, also known as folic acid, is necessary for cell growth, including red blood cells; Vitamin B3 is essential for the breakdown of fats from food; Vitamin C is essential for wound healing, teeth and bone health, and the absorption of iron.

Essential Minerals: Sodium, chloride, potassium, calcium, iron, and zinc; sodium and chloride help maintain the right amount of body fluids for normal blood pressure and nerve function; Potassium helps with body fluid balance, muscle contraction, and nerve function; Calcium helps the body develop and maintain strong bones and teeth, especially in growing children and adults; Iron is vital to blood as it transports essential oxygen to cells throughout the body; Zinc is essential to the breakdown and conversion of food into usable energy for body functions.

Narcolepsy (psychotropic med): Modafinil (Provigil) and armodafinil (Nuvigil) are two stimulant medications

Narcolepsy: chronic daytime drowsiness, which may result in sudden attacks of sleep.

ADHD: Attention deficit hyperactivity disorder, common development impairment of executive function, or mental skills, that affects the following areas: Activation - organizing and prioritizing; Focus - focusing, sustaining, and shifting focus to tasks; Effort - regulating alertness and processing speed; Emotion - managing frustration and modulating emotions; Memory - utilizing working memory and accessing recall; Action - monitoring and self-regulating action.

ADHD (psychotropic med): first choice of medications to treat ADHD are amphetamines and methylphenidate; Daytrana patch for children who don’t take pills; Non stimulant selective norepinephrine reuptake inhibitor (SNRI), Strattera.

Depression/Anxiety (psychotropic meds): first choice of treatment for depression and anxiety is typically selective serotonin reuptake inhibitors (SSRIs) - fluoxetine (Prozac) and sertraline (Zoloft); tricyclic antidepressants (TCAs); Bupropion, also used to help individuals quit smoking, affects all three neurotransmitters - serotonin, norepinephrine, and dopamine; Mirtazapine is commonly used in depressed patients with poor appetites, given the side effect of weight gain; Trazodone causes more drowsiness at lower doses, and at higher doses helps more with depression; benzodiazepines (BZDs) for acute anxiety - clonazepam, diazepam, and alprazolam.

Antipsychotic meds (psychotropic med): first-generation (typical) and second-generation (atypical) antipsychotics; first-generation antipsychotics are older agents, while second-generation antipsychotics are newer with fewer side effects;1^st generation commonly used typical antipsychotic agents are haloperidol (Haldol), chlorpromazine (Thorazine), and prochlorperazine; 2^nd generation - atypical antipsychotics (Abilify), quetiapine (Seroquel), and risperidone (Risperdal).

Alcoholism meds (psychotropic med): Medication options include vitamin supplements, disulfiram (Antabuse), and naltrexone (ReVia). Disulfiram causes nausea and vomiting if the person drinks even a small amount of alcohol. Naltrexone interferes with the chemical reaction in the brain that makes drinking alcohol enjoyable; benzodiazepines to reduce the impact of alcohol withdrawal symptoms.