Introduction Drugs medicinessubstances used to prevent or treat a condition or disease Obtained from various sources Plants example digitalis Animals example hormones Synthesized in ID: 738302
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Slide1
Pharmacology
Chapter 21
Pages 881 – 920Slide2
Introduction
Drugs: medicines/substances used to prevent or treat a condition or
disease
Obtained from various sources:Plants – example: digitalisAnimals – example: hormonesSynthesized in lab – example: methotrexatePharmacology = the study of the discovery, properties, and uses of drugs.
Page 882Slide3
Pharmacology Professional
Pharmacist (
PharmD
)Pharmacologist (MD or PhD)Subspecialties include:Page 882Slide4
Drug
Names
Drugs
can have three different names:Chemical name: exact chemical makeupGeneric name: legal and scientific name. Brand name: private
property of the individual drug
manufacturer.
Page 883
Chemical Name
Generic Name
Brand Names
[2
S
,5
R
,6
R
]-6-[(
R
)-(–)-2-amino-2-(
p
-
hydroxyphenyl
)
acetamido
]-3,3-dimethyl-7-oxo-4-thia-1-azabicyclo[3.2.0] heptane-2-carboxylic acid
Amoxicillin
Amoxil
Polymox
TrimoxSlide5
Standards and References
Food and Drug
Administration (FDA)
responsible for deciding whether a drug may be distributed and sold. Untied States Pharmacopeia (USP) an independent committee of physicians, pharmacologists, pharmacists, and manufactures that review the available commercial drugs.Hospital formulary is the most complete and up-to-date listing of drugs.
Physician’s Desk Reference (
PDR)
is
published by a private firm,
and
drug manufacturers pay to have their products listed.
Page 883Slide6
Administration of Drugs
Page 884Slide7
Drug Actions & Interactions
When a drug enters the body, it produces its effect by interacting with a specific target, or
receptor
. Dose = the amount of drug administered, usually measured in milligrams or grams. Schedule = the exact timing and frequency of drug administration.Response = a desired and beneficial effect of a drug. Tolerance = For some drugs, the effects of a given dose diminish as treatment continues, and increasing amounts are needed to produce the same effect.Page 886Slide8
Drug Actions & Interactions: Cont.
Various actions
and
interactions of drugs in the body can occur after they have been absorbed into the blood stream.Additive action = the combination of two similar drugs is equal to the sum of the effects of each. Antagonistic = two drugs give less than an additive effect. Synergistic = two drugs cause an effect that is greater than the sum of the individual effects of each drug given alone.Page 886Slide9
Drug Toxicity
Side effects
= unpleasant effects that routinely result from the use of a drug.
Contraindications = factors in a patient’s condition that make the use of a particular drug dangerous and ill-advised. Drug resistance = the reduction in effectiveness of a drug. Drug toxicity = an unpleasant and potentially dangerous effect of a drug.Idiosyncrasy = unexpected and uncommon side effectIatrogenic disorders that occur
as a result of
treatment.
Pages 886 – 887Slide10
Classes of Drugs
Analgesics
Anesthetics
Antibiotics and antiviralsAnticoagulantsAnticonvulsantsAntidepressantsAntidiabeticsAntihistaminesAntiosteoporosisCardiovascularEndocrine
Gastrointestinal
Respiratory
Sedative-hypnotics
Stimulants
Tranquilizers
Pages 887 – 896Slide11
Analgesics
Pages 887 – 896
Mild
acetaminophen (Tylenol)aspirinNonsteroidal Anti-inflammatory Drugs (NSAIDs)aspirin (Anacin, Ascriptin, Excedrin)celecoxib (Celebrex)diclofenac sodium (Voltaren)
ibuprofen (Motrin, Advil)
ketorolac (
Toradol
)
naproxen (Aleve)
valdecoxib
(
Bextra
)
Narcotic (Opioid)
codeine
fentanyl patch (
Duragesic
)
hydrocodone w/APAP
*
(Lortab, Vicodin)
hydromorphone (
Dilaudid
)
meperidine (Demerol)
morphine
oxycodone (OxyContin, Roxicodone)
oxycodone with APAP
*
(Percocet,
Roxicet
,
Endocet
)
tramadol (Ultram)Slide12
Anesthetics
Pages 887 – 896
General
ketamine (Ketalar)nitrous oxidepropofol (Diprivan)thiopental (Pentothal)Locallidocaine (Xylocaine)lidocaine-
prilocaine
(EMLA—eutectic mixture of local anesthetics)
procaine (Novocain)Slide13
Antibiotics and Antivirals
Pages 887 – 896
ANTIBIOTICS
Antifungal Drugsamphotericin B (Fungilin)clotrimazole (Lotrimin, Mycelex)econazole topical (Spectazole)fluconazole (Diflucan)
itraconazole
(
Sporanox
)
miconazole (Monistat)
nystatin (
Nilstat
)
terbinafine (Lamisil)
Antiturburcular Drugs
ethambutol (Myambutol)
isoniazid [INH] (Nydrazid)
p
-aminosalicylic acid granules (PASER)
rifampin (Rifadin)
Cephalosporins
—bactericidal and similar to
penicillins
ceftazidime (Fortaz)
cefuroxime axetil (Ceftin)
Macrolides
—bacteriostatic
azithromycin (Zithromax)
clarithromycin (Biaxin)
erythromycin (
Ery
-Tab)
ANTIVIRAL DRUGS
acyclovir (
Zovirax
)
efavirenz
+
tenofovirt
+
emtricitabine
(
Atripla
)
*entecavir (Baraclude)**indinavir (Crixivan)†lamivudine (Epivir)‡ribavirin (Copegus, Rebetol)simeprevir (Olysio)sofosbuvir (Sovaldi)
ANTIBIOTICS (Cont’d)
Penicillins
—bactericidal
amoxicillin trihydrate (Amoxil, Trimox)
amoxicillin with clavulanate (Augmentin)
oxacillin (Bactocill)
Quinolones
—bactericidal and wide-spectrum
ciprofloxacin (Cipro)
levofloxacin (Levaquin)
ofloxacin
(
Floxin
)
Sulfonamides
or Sulfa Drugs
—bactericidal
sulfamethoxazole with trimethoprim (Bactrim)
Tetracyclines
—bacteriostatic
doxycycline
tetracyclineSlide14
Anticoagulants and Antiplatelet Drugs
Pages 887 – 896
apixaban
(Eliquis)aspirinclopidogrel (Plavix)dabigatran (Pradaxa)dalteparin (Fragmin)*enoxaparin sodium (Lovenox
)
*
lepirudin
(
Refludan
)
†
prasugrel
(
Effient
)
rivaroxaban (
Xarelto
)
ticagrelor
(
Brilinta
)
tissue plasminogen activator [
tPA
]
warfarin (Coumadin)Slide15
Anticonvulsants
Pages 887 – 896
carbamazepine (
Tegretol)felbamate (Felbatol)gabapentin (Neurontin)levetiracetam (Keppra)phenytoin sodium (Dilantin)pregabalin (Lyrica)valproic acid (Depakote)Slide16
Antidepressants and
Anti-Alzheimer Drugs
Pages 887 – 896
ANTIDEPRESSANTSamitriptyline (Elavil)‡bupropion (Wellbutrin SR)citalopram hydrobromide (Celexa)§duloxetine (Cymbalta)escitalopram (Lexapro)
§
fluoxetine (Prozac)
§
paroxetine (Paxil)
§
sertraline (Zoloft)
§
trazodone (
Desyrel
)
§
ANTI-ALZHEIMER
donepezil (Aricept)
memantine
(Namenda)Slide17
Antidiabetics
Pages 887 – 896
Insulins
Rapid-actinginsulin aspart (NovoLog)insulin glulisine (Apidra)insulin lispro (Humalog)Short-actinginsulin regulator (Humulin R)Intermediate-actinginsulin NPH (Humulin N)
Long-acting
insulin
detemir
(
Levemir
)
insulin glargine (Lantus)
insulin zinc suspension (
Ultralente
)
Other Diabetes Drugs—Oral
acarbose
(
Precose
)—alpha-glucosidase inhibitor
glipizide (Glucotrol XL)—sulfonylurea
glyburide (
Diabeta
, Micronase)—sulfonylurea
metformin (Glucophage)—
biguanide
pioglitazone (Actos)—thiazolidinedione
repaglinide
(
Prandin
)—
meglitinide
rosiglitazone (Avandia)—thiazolidinedioneSlide18
Antihistamines
Pages 887 – 896
cetirizine (Zyrtec)
chlorpheniramine maleate (Chlor-Trimeton)diphenhydramine (Benadryl)fexofenadine (Allegra)loratadine (Claritin)meclizine (Antivert)promethazine (Phenergan)Slide19
Antiosteoporosis
Drugs
Pages 887 – 896
Bisphosphonates—prevent bone lossalendronate (Fosamax)ibandronate sodium (Boniva)zoledronic acid (Zometa)Selective Estrogen Receptor Modulators (SERMs)raloxifene (Evista)tamoxifen (Nolvadex)
Other Antiosteoporosis Drugs
denosumab
(
Prolia
)
*
teriparatide
(
Forteo
)
†Slide20
Cardiovascular Drugs
Page 892
ANGIOTENSIN-CONVERTING ENZYME (ACE) INHIBITORS
enalapril maleate (Vasotec)lisinopril (Prinivil, Zestril)quinapril (Accupril)ramipril (Altace)ANGIOTENSIN II RECEPTOR BLOCKERS
irbesartan (Avapro)
losartan (Cozaar)
valsartan (Diovan)
(Entresto; formerly LCZ696)
ANTIARRHYTHMICS
amiodarone (Cordarone)
ibutilide (Corvert)
sotalol (Betapace)
BETA BLOCKERS
atenolol (Tenormin)
carvedilol (Coreg)
metoprolol (Lopressor, Toprol-XL)
propranolol (Inderal)
CALCIUM CHANNEL BLOCKERS
amlodipine
amlodipine
besylate
(Norvasc)
diltiazem (Cardizem CD)
nifedipine
(
Adalat
CC, Procardia)
CARDIAC GLYCOSIDES
digoxin (Lanoxin)
CHOLESTEROL-BINDING DRUGS (RESINS)
cholestyramine (Questran)
colestipol (Colestid)
CHOLESTEROL-LOWERING DRUGS (STATINS)
atorvastatin (Lipitor)
pravastatin (Pravachol)
rosuvastatin (Crestor)
simvastatin (Zocor)
DIURETICS
bumetanide (
Bumex
)
furosemide (Lasix)
hydrochlorothiazide (
HydroDiuril)spironolactone (Aldactone)triamterene (Dyazide)Slide21
Endocrine Drugs
Page 893
ANDROGENS
fluoxymesterone (Halotestin)methyltestosterone (Virilon)ANTIANDROGENSabiraterone (Zytiga)enzalutamide (XTANDI)flutamide (Eulexin)goserelin (Zoladex)leuprolide (Lupron)nilutamide (Casodex)AROMATASE INHIBITORSanastrozole (Arimidex)
exemestane (Aromasin)
fulvestrant (Faslodex)
letrozole (Femara)
ESTROGENS
estrogens (
Premarin
,
Prempro
)
GLUCOCORTICOIDS
dexamethasone (Decadron)
hydrocortisone
prednisone (Deltasone)
triamcinolone (Aristocort)
GROWTH HORMONE–RELEASE INHIBITING FACTOR
octreotide (Sandostatin)
PARATHYROID HORMONE FRAGMENT
teriparatide (Forteo)
PROGESTINS
medroxyprogesterone acetate (Cycrin, Provera)
megestrol (Megace)
SELECTIVE ESTROGEN RECEPTOR MODULATORS (SERMS)
raloxifene (Evista)
tamoxifen (Nolvadex)
THYROID HORMONES
calcitonin (
Cibacalcin
)
levothyroxine (
Levoxyl
,
Synthroid
)
liothyronine
(
Cytomel
)
thyroid ISP (
Armour
Thyroid)Slide22
Gastrointestinal Drugs
Page 894
ANTACIDS
aluminum and magnesium antacid (Gaviscon)magnesium antacid (milk of magnesia)aluminum antacid (Rolaids)ANTIDIARRHEALSdiphenoxylate + atropine (Lomotil)loperamide (Imodium)paregoricANTINAUSEANTS (ANTIEMETICS)metoclopramide (Reglan)ondansetron (Zofran)promethazine (Phenergan)
prochlorperazine
maleate (Compazine)
ANTI–TUMOR NECROSIS FACTOR (TNF) DRUGS
adalimumab (Humira)
certolizumab pegol (Cimzia)
etanercept (Enbrel)
golimumab (Simponi)
infliximab (Remicade)
ANTIULCER AND ANTI–GASTROINTESTINAL REFLUX DISEASE (GERD) DRUGS
cimetidine (Tagamet)
esomeprazole (Nexium)
famotidine (Pepcid)
lansoprazole (
Prevacid
)
omeprazole (Prilosec)
ranitidine (Zantac)
CATHARTICS
casanthranol
+ docusate sodium (
Peri
-Colace)Slide23
Respiratory Drugs
Pages 887 – 896
BRONCHODILATORS
albuterol (Proventil, Ventolin HFA)*formoterol + budesonide (Symbicort)†ipratropium + albuterol (Combivent)*salmeterol + fluticasone (Advair Diskus
)
†
tiotropium bromide (Spiriva)
‡
LEUKOTRIENE MODIFIERS
montelukast
(
Singulair
)
zafirlukast
(
Accolate
)
zileuton
(
Zyflo
)
STEROIDS: INHALERS
fluticasone (Flovent)
mometasone (Asmanex)
triamcinolone (Azmacort)
STEROIDS: INTRAVENOUS OR ORAL
dexamethasone (
Decadron
)
methylprednisolone (Medrol)
prednisoneSlide24
Sedative-Hypnotics
Pages 887 – 896
methaqualone (Quaalude)
temazepam (Restoril)*triazolam (Halcion)*zolpidem tartrate (Ambien)Slide25
Stimulants
Pages 887 – 896
caffeine
dextroamphetamine sulfate (Dexedrine)dextroamphetamine and amphetamine (Adderall)lisdexamfetamine (Vyvanse)methylphenidate (Ritalin)modafinil (Provigil)Slide26
Tranquilizers
Pages 887 – 896
Minor
alprazolam (Xanax)*buspirone (BuSpar)diazepam (Valium)*lorazepam (Ativan)*Majoraripiprazole (Abilify
)
chlorpromazine (
Thorazine
)
†
haloperidol (Haldol)
lithium carbonate (
Eskalith
)
olanzapine (Zyprexa)
risperidone (Risperdal)
thioridazine
(
Mellaril
)
†
trifluoperazine
(
Stelazine
)
†