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Transcript
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Drug Classifications
The following is a list of the major drug classifications with “Memory tricks".
A
o Antianemics: prevention and treatment of anemias
o Antianginals
 nitrates: used to treat and prevent attacks of angina; acute treatment
 calcium channel blockers and beta blockers are used prophylactically for longer-term management
o Antianxiety agents
 benzodiazepines: better for intermittent or short-term use in the management of anxiety
 buspirone, paroxetine, venlafaxine: better for long-term use
o Antiarrhythmics: suppression of cardiac arrhythmias
 generally classified by their effects on cardiac conduction tissue (Class IA, IB, IC, II, III & IV)
 atropine and digoxin: also used as antiarrhymics
o Antiasthmatics: management of acute and chronic episodes of reversible bronchoconstriction
o Anticholinergics
 atropine: bradyarrhythmias
 ipratropium: bronchospasm
 atropine: also used as ophthalmic mydriatic
 benztropine: management of Parkinson's disease
o Anticoagulants: prevention and treatment of thromboembolic disorders
o Anticonvulsants: decrease the incidence and severity of seizures due to different etiologies
o Antidepressants
o Antidiabetics
 insulin: type 1 diabetes mellitus
 oral agents used primarily in type 2 diabetes mellitus
o Antidiarrheals: for control and symptomatic relief of acute and chronic nonspecific diarrhea
o Antiemetics: used to manage nausea and vomiting due to many causes, including surgery, anesthesia,
and antineoplastic and radiation therapies
o Antifungals: memory trick - most end with "AZOLE"
o Antihistamines
 used for relief of symptoms associated with allergies and as adjunctive therapy in anaphylactic
reactions
 some are used to treat insomnia and Parkinson-like reactions
o Antihypertensives: including, but not limited to, the following
 ACE inhibitors: treatment of choice for hypertension; memory trick - most end with "PRIL"
 angiotension receptor blockers: memory trick - most end with "SARTAN", including losartan
(Cozaar), valsartan (Diovan)
 beta blockers (see below)
 calcium channel blockers (see below)
o Anti-infectives: treatment and prophylaxis of various bacterial infections
o Antineoplastics: used in the treatment of various solid tumors, lymphomas, and leukemias
o Antiplatelet agents: used to treat and prevent thromboembolic events, e.g., stroke, myocardial infarction
o Antipsychotics
o Antipyretics: used to lower fever of many causes, including infection, inflammation, and neoplasms
o Antirheumatics: used to manage symptoms of rheumatoid arthritis and slow down joint destruction and
preserve joint function
o Antituberculars: used in the treatment and prevention of tuberculosis
o Antiulcer agents
 used in the treatment and prophylaxis of peptic ulcer and gastric hypersecretory conditions, e.g.,
Zollinger-Ellison syndrome
 memory trick - most end with "PRAZOLE", including omeprazole (Prilosec), pantoprazole
(Protonix), esomeprazole (Nexium)
o Antivirals: memory trick - many end with "CY[I]CLOVIR", including acyclovir (Zovirax), valacyclovir
(Valtrex)
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B
o
o
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C
o
o
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Calcium channel blockers
 used in the treatment of hypertension (amlodipine, diltiazem, felodipine, isradipine, nicardipine,
nifedipine, nisoldipine, verapamil)
 also used in the treatment and prophylaxis of angina pectoris or coronary artery spasm
(amlodipine, diltiazem, felodipine, nicardipine, verapamil)
 memory trick - most end with "DIPINE"
Corticosteriods:
 used in replacement doses (20 mg of hydrocortisone or equivalent) systematically to treat
adrenocortical insufficiency
 larger doses are usually used for their antiiinflammatory, immunosuppressive, or antineoplastic
activity
D
o
Diuretics
 thiazide diuretics and loop diuretics are used alone or in combination in the treatment of
hypertension or edema due to CHF or other causes
 potassium-sparing diuretics have weak diuretic and antihypertensive properties and are used to
conserve potassium in clients receiving thiazide or loop diuretics
 osmotic diuretics are often used in the management of cerebral edema
o
Hormones
 used in the treatment of deficiency states including diabetes (insulin), diabetes insipidus
(desmopressin), hypothyroidism (thyroid hormones), and menopause (estrogens or
estrogens/progestins)
 hormones may be used to treat hormonally sensitive tumors (androgens, estrogens)
o
Immunosuppressants:
 most are used in the prevention of transplantation rejection reactions
 others are used in the management of selected autoimmune diseases (nephrotic syndrome of
childhood and severe rheumatoid arthritis)
o
Laxatives: used to treat or prevent constipation or to prepare the bowel for radiologic or endoscopic
procedures
Lipid-lowering agents:
 used as a part of a total plan, including diet and exercise, to reduce blood lipids in an effort to
reduce the morbidity and mortality of atherosclerotic cardiovascular disease and its sequelae
 memory trick - many end with "STATIN", e.g., atorvastatin (Lipitor), simvastatin (Zocor),
rosuvastatin (Crestor)
H
I
L
o
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Beta blockers:
 used in the management of hypertension, angina pectoris, tachyarrhythmias, migraine headache
(prophylaxis), MI (prevention), glaucoma (opthlalmic use), CHF (carvedilol and sustained-release
metoprolol only), hyperthyroidism (management of symptoms only)
 memory trick - most end with 'OLOL", "ALOL" or "ILOL"
Bone resorption inhibitors
 used to treat and prevent osteoporosis in postmenopausal women
 also used to treat osteoporosis due to corticosteriod therapy, treatment of Paget's disease of the
bone, and management of hypercalcemia
M
o
Minerals/electrolytes/pH modifiers
 used in the prevention and treatment of deficiencies or excesses of electrolytes and maintenance
of optimal acid/base balance for homeostasis
 acidifiers and alkalinizers are also used to promote urinary excretion of substances that
accumulate in some disease states, e.g., kidney stones
o
o
Nonopioid analgesics: used to control mild to moderate pain and/or fever
Nonsteroidal anti-inflammatory agents: used to control mild to moderate pain, fever, and various
inflammatory conditions, e.g., rheumatoid arthritis and osteoarthritis
o
Opioid analgesics: used in the management of moderate to severe pain
N
O
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S
o
o
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Sedative/hypnotics
 used to provide sedation, usually prior to procedures
 selected agents are useful as anticonvulsants, skeletal muscle relaxants, adjuncts in general
surgery and adjuncts for the treatment of alcohol withdrawal syndrome
Skeletal muscle relaxants
 used to treat spasticity (associated with spinal cord diseases or lesions)
 used as adjunctive therapy in the symptomatic relief of acute painful musculoskeletal conditions
 IV dantrolene is also used to treat and prevent malignant hyperthermia
T
o
Thrombolytics: used for the acute management of coronary thrombosis (MI), massive pulmonary emboli,
deep vein thrombosis, and arterial thromboembolism
o
Vascular headache suppressants
 used for the treatment of vascular headaches, e.g., migraine and cluster headaches; memory trick
- many end with "TRIPTAN", including sumatriptan (Imitrex)
 other agents are used for suppression of frequently occurring vascular headaches, e.g., some beta
blockers and calcium channel blockers
V
Adverse Effects of a Drug Class or Type
Antihypertensives: orthostatic hypotension, fluid/electrolyte imbalance
assist with activity; eliminate drug interactions, vasodilators, central nervous system depressants
monitor blood pressure, pulse, respirations; serum electrolyte levels
assess breath sounds, development of edema, dizziness
teaching: get help to stand, report dizziness; avoid alcohol, sedatives, over-the-counter agents, caffeine
Anticholinergic agents: dry mouth, constipation, blurred vision
provide sips of water, oral care; assist with activity; remove environmental hazards
monitor bowel pattern of elimination, assess vision and oral mucous membranes
teaching: frequent oral care; avoid dangerous activity; ask for help to stand
Anticoagulants and antiplatelet agents: bleeding
minimize invasive procedures, shaving; provide gentle oral care; assist with activity
monitor coagulation tests, complete blood count, assess for bleeding and observe for bruising
teaching: avoid dangerous activity; avoid shaving with straight edge razor; wear MedicAlert® identification,
avoid NSAIDs, alcohol, many herbal remedies
Anticonvulsants: central nervous system depression, myelosuppression (infection and bleeding)
assist with activity; protect airway, breathing; minimize invasive procedures
monitor complete blood count with differential; seizure activity
assess temperature; change in skin color (redness), swelling or drainage
teaching: wear MedicAlert® identification, avoid dangerous activity, wash hands, avoid crowds; need for
follow-up care and testing
Antidysrhythmic agents: new or more dangerous dysrhythmias, changes in blood pressure
maintain fluid and electrolytes balance; sinus rhythm; assist with position changes
monitor pulmonary function tests, EKG, serum electrolytes
assess blood pressure, pulse; SaO2 (SaO2 should be greater than 95%); level of consciousness
teaching: ask for help to stand; technique for counting pulse (and to report irregular pulse)
Anti-infective agents: renal and hepatic dysfunction
obtain cultures before administration; verify administration guidelines; screen for renal and hepatic
dysfunction, allergy, nephrotoxic or hepatotoxic drugs
monitor renal and liver function tests
assess for jaundice, dark stool or urine, nausea and vomiting
report nausea, vomiting, dark stool or urine, jaundice; need for follow-up care and testing
Loop, thiazide diuretics: circulatory collapse, myelosuppression, fluid and electrolyte imbalance, ototoxicity
verify infusion guidelines, blood, serum electrolytes, and urinary output before giving
monitor serum electrolytes (sodium and potassium); urinary output
assess breath sounds, edema, blood pressure
teaching: report palpitations, weakness, irregular pulse, decreased urinary output, temperature
Female hormones: thromboembolic disorders, increased risk of breast and endometrial cancer, hyperglycemia,
hypercalcemia, depression, seizures
monitor peripheral perfusion; serum calcium, glucose
assess for edema, leg pain or tenderness
teaching: report lumps, abnormal bleeding; muscle twitching