CRC Pharm.

The stem of the generic drug name generally identifies which of the following:

Action of the drug

The stem of the generic drug name generally identifies which of the following:

Action of the drug Rational: generic names identify the action chemical substances, the stem in the surfaces of the drug name provided insight into the drug's therapeutic purposes. The stems generally identify the action of the drug and often surfaces defined the class of the drug.

Anticholinergics have been associated with which of the following rare side effects

Acute glaucoma

What are the rare side effects of anticholinergics?

Acute glaucoma, and I disorder that can permanently damage vision and needs immediate treatment.

Of the following which is classified as a Xanthine

Aminophylline, theophylline,Theo-Dur Feedback: commonly prescribed anticholinergics include: Atrovent & Spiniva

Which medication is used to alleviate pain?

Analgesic

The drug stem -sartan indicates the drug belongs to which of the following classes:

Angiotensin receptor antagonists

Amoxicillin belongs to which of the following drug classes?

Antibiotic

The drug-oxetine Indicates the truck belongs to which of the following classes

Antidepressant related to fluoxetine

-oxetine

Antidepressant related to fluoxetine Example: Duloxetine, reboxetine

Which of the following drugs classes are used to treat Aspergillosis?

Antifungal Aspergillosis is a condition in which certain fungi infected tissues. It most commonly affects the lungs, owing to inhalation of spores from moldy hay, and is then informally called farmers lung. Therefore it is treated with anti-fungal drugs.

Acyclovir, valacyclovir and famciclovir belong to which of the following drug classes?

Antivirals

acyclovir, valacyclovir, famciclovir belong to which of the following drug classes?

Antivirals Acyclovir, Val acyclovir and famciclovir belongs to the class of drugs known as antivirals.

The drug -barb indicates the drug belongs to which of the following classes:

Barbiturates

What medication is used to treat angina?

Beta blocker

Which of the following is a major side effect of anticoagulants?

Bleeding

Of the three names available to most drugs, which is copyrighted?

Brand name

Which medication is used to treat asthma?

Bronchodilator

Sympathomimetics, anticholinergics, and xanthines belong to what drug class?

Bronchodilator Bronchodilator drugs are divided into three main groups: sympathomimetics, anticholinergics, and xanthines

C / G

C-with G- Gram

Of the following drugs, which is used commonly used to treat angina:

Calcium channel blockers

Which of the following is the scientific name and is based on the molecular structure of the drug? a. Proprietary name b. Chemical name c. Generic name d. Brand name

Chemical name

Which of the following is the scientific name and is based on the molecule structure of the drug?

Chemical name

The drug stem -ximab indicates the drug belongs to which of the following classes:

Chimeric antibody that responds to more than one antigen

The drug stem -XIMAB indicates the drug belongs to which of the following classes:

Chimeric antibody that responds to more than one antigen. Rational: The stem -XIMAB indicates the drug belongs to the chimeric and if I had a response to more than one antigen drug class.

Stem: -pril

Class - ACE inhibitor Ex: lisinopril

Stem: -itidine

Class - H2 antagonist Ex: ranitidine

Stem: - prazole

Class - Proton-pump inhibitor Ex: Omeprazole

Stem: -tinib

Class - Tyrosine-kinase inhibitors Ex: Erlotinib, crizotinib

Stem: -sartan

Class - angiotensin receptor antagonists Ex: losartan, valsartan

Stem: -oxetine

Class - antidepressant related to fluoxetine Ex: duloxetine, reboxetine

Stem: -vir

Class - antiviral Ex: Acyclovir

Stem: -barb

Class - barbiturates Ex: phenobarbital, secobarbital

Stem: -olol

Class - beta blocker Ex: propanolol

Stem: -ximab

Class - chimeric antibody that responds to more than one antigen Ex: Infliximab

Stem: -axine

Class - dopamine and serotonin-norepinephrine reuptake inhibitor Ex: Venlafaxine

Stem: -zumab

Class - humanized monoclonal antibody Ex: Natalizumab, bevacizumab

Stem: -mab

Class - monoclonal antibodies Ex: Trastuzumab

Stem: -cillin

Class - penicillin-derived antibiotics Ex: Penicillin

Stem: -oxacin

Class - quinolone-derived antibiotics Ex: levofloxacin, moxifloxacin

The suffix of drugs generic name defines what?

Class drug Rational: Generic names identify the active chemical substances, the stem in the suffix six of the drug name provide insight into the drugs therapeutic purposes. The Stamms generally identify the action of the drug in often the suffixes define the class of the drug.

The suffix of a drug's generic name identifies which of the following

Class of drug

Medication lisinopril

Classification ACE (angiotensin converting enzyme) inhibitor Treats: hypertension

Medication: Amoxicillin

Classification: antibiotic Condition is used to treat: bacterial infections

-alol

Combined alpha and beta blockers

Which medication destroys cancer cells as well as healthy cells?

Cytotoxic

beta blockers

* A class of drugs used frequently in the treatment of cardiac conditions. Basically, they work by blocking the action of adrenaline in your body. Why would you want to block your adrenaline? Because it slows down your heartbeat and makes it beat with less force, helping blood vessels relax and open up. Slower heartbeat, opened-up blood vessels=lower blood pressure, right? Absolutely. Beta blockers are effective at lowering blood pressure. * It turns out that they also do a number of other things to protect and heal the body. First, they help your heart in a number of ways. Beta blockers are used to treat arrhythmia (irregular heart beat), heart failure, chest pain, prevent heart attack, and aid healing following a heart attack. * They are also effective in treating glaucoma, migraines, anxiety disorders, and certain kinds of tremors. *Historically, beta blockers have been contraindicated for congestive heart failure. However, recently (September 2007) one called Coreg (carvedilol) has been approved in the United States for treatment of mild to moderate congestive heart failure. Toprol XL (metoprolol succinate) is also approved for congestive heart failure.

The acronym DMARD stands for what drug class?

Disease modifying antirheumatic drugs

The acronym DMARDs stands for what drug class?

Disease-modifying antirheumatic drugs

The drug stem -axine indicates the drug belongs to which of the following classes:

Dopamine and serotonin-norepinephrine reuptake inhibitor

-axine

Dopamine and serotonin-norepinephrine reuptake inhibitor Example-venlafaxine

-ximab

Drug class: Chimeric antibody that responds to more than one antigen Example: infliximab

-Zumab

Drug class: Hamanized monoclonal antibody Example: natalizumab bevacizumab

-mab

Drug class: monoclonal antibodies Example: trastuzumab

-tinib

Drug class: tyrosine kinase inhibitor Example- Erlotinib, crizotinib

Diabetes and hyperthyroidism are diseases of what body system

Endocrine

Which of the following administration routes is NOT parenteral?

Epicutaneous

Tamoxifen, A drug used to slow the progression of certain types of breast cancer does so by blocking the action of which of the following hormones on breast sales?

Estrogen Rational: Tamoxifen is effective in slowing the progression of certain types of breast cancer that are stimulated by the female sex hormones estrogen. The truck blocks the action of estrogen on breast cells.

Medication Augmentin

Generic Amoxicillin Classification: penicillin antibiotics Treats: bacteria

Medication: ability

Generic aripiprazole Classification: antipsychotic Condition used to treat: bipolar disorder, schizophrenia

The international nonproprietary name or INN of a drug is also known as?

Generic name

Medication: Albuterol

Generic name: Albuterol inhalant Classification: bronchodilator Condition used to treat: asthma, COPD, respiratory failure

Medication: Ativan

Generic name: Lorazepam Classification: anti anxiety Treats: anxiety

Medication: Lipitor

Generic name: atorvastatin Treats: Cholesterol management

Medication: Actos

Generic name: pioglitazone Classification: diabetes medication Condition is used to treat: diabetes

Medication: Ambien

Generic name: zolpidem Classification: sedative/hypnotic Conditioners used to treat: insomnia

Medication: Celebrex

Generic: celecoxib Classification: antiarthritic Treats: arthritis

Medication: Cardizem

Generic: diltiazem Classification: Calcium on channel blocker's Treats: hypertension

What is an adverse effect?

Harmful effect of a medication

What is an adverse effect?

Harmful effect of a medication/drug

Which condition is treated with an antiviral medication? a. Candidiasis b. Asthma c. Hepatitis B d. Cancer

Hepatitis B

topical medications

* A common human skin disease is acne vulgaris—you just call this acne. As you may have experienced, this disease most commonly occurs in adolescence, though it often continues on into adulthood. You've already learned that the antibiotic tetracycline is often used to treat acne. One other medication we have also touched on is isotrentinoin, brand name Accutane, which is a capsule dosage form used to treat acne. * Often, the same medications are used to treat eczema and psoriasis, two common skin diseases. Eczema, also referred to as dermatitis, is a hot, itchy, red, oozing condition characteristic of an acute stage of inflammation. Corticosteriods can also be prescribed to treat this. Take a minute to look back at the corticosteroid page. Psoriasis is a chronic noncontagious condition in which skin cells multiply and die at excessive rates, producing patches of red, scaly skin that are slightly raised. * Viral infections can cause several skin disorders, including shingles, cold sores, and warts. In this table you will see some of the more commonly used drugs to fight these infections. * Dandruff is shedding of scales from the scalp that is more rapid than in other parts of the body. When entrapped by hair, these scales become more noticeable. Dandruff is really a cosmetic problem more than a medical one. Selenium sulfide (Head & Shoulders Intensive Treatment, Selsun Blue) has a direct effect on skin cells. If used daily, dandruff should be controlled. * Skin conditions that are caused by an infection are treated by using antifungal and antibiotic creams, ointments, and solutions. We have learned about many of these anti-infectives as oral dosage forms but some of them are also available in topical dosage forms. Two commonly prescribed antibiotic ointments used to treat skin infections are bacitracin-neomycin-polymyxin B (Neosporin, Triple Antibiotic Ointment, Mycitracin) and mupirocin (Bactroban).

alkylating agents and antimetabolites

* Alkylating agents create irreversible cross-links in DNA so that the DNA and cells cannot reproduce. * Antimetabolite cancer drugs inhibit the normal function of a key enzyme and render them nonfunctional. Most of the antimetabolites used in cancer chemotherapy prevent DNA replication or transcription.

antivirals and antifungals

* Also included in the category of anti-infective drugs are drugs that treat fungus or viruses. These are called (appropriately) antivirals and antifungals. * Common fungal infections include athlete's foot, ringworm, jock itch, and thrush (also called candidiasis). A fungus called Malassezia furfur causes dandruff, and antifungals are often used in dandruff shampoos. Yeasts are also treated with antifungal medication. * Drugs used to treat viruses are called antivirals. Like antibiotics, they are often specifically targeted at certain viruses. These are primarily used to treat herpes viruses (cold sores and genital herpes), hepatitis B and C, the flu, and an entire class of them known as antiretrovirals have been developed to treat HIV. Many of these are in development and there will likely be a number of new ones added in the coming years. Several antiviral medications end in "vir," as in acyclovir (Zovirax) and Valtrex's generic valacyclovir.

Alzheimer disease

* Alzheimer disease (also known as Alzheimer's disease) is a degenerative disorder of the brain or in other words, the brain loses its ability to function properly over time. It leads to progressive dementia (loss of memory, intellect, judgment, orientation, and speech) and changes in personality and behavior. * In the early stages of the disease, the patient complains of memory loss, forgetfulness, and/or misplacement of ordinary items. Many patients suffer from depression as well as they begin to experience these symptoms. As the disease progresses, complex tasks become impossible (i.e. managing personal finances) and concentration suffers. In the final stages, patients are incapacitated, disoriented, and fail to thrive even with help. * Doctors frequently prescribe Namenda (memantine) and Aricept (donepezil) to treat Alzheimer disease. While these and other drugs cannot cure or reverse the disease, they can slow its symptoms. Doctors of Alzheimer patients also often recommend an herbal remedy, ginkgo tablets. Ginkgo has shown good results in improving cognitive function and social behavior and is much less expensive than other Alzheimer drugs.

male hormones & impotence

* Androgen is the general term for male testoid hormones. The most common of course being testosterone which promotes development and maintenance of male physical characteristics. This hormone is responsible for initiating sperm production and for male behavioral characteristics. Testosterone is required during adulthood for the maintenance of libido, sexual potency, fertility (sperm production), muscle mass and strength, fat distribution, bone mass, red blood cell production, and prevention of baldness. As you can see, any irregularities in these two hormone levels will affect quite a few things in male life. * Male impotence, which is sometimes referred to as erectile dysfunction (ED), is defined as the failure to initiate or to maintain an erection until ejaculation. ED may have many causes, one of which is testosterone deficiency. Other causes may be alcoholism, cigarette smoking, psychological factors, and medication side effects. * A few of the earlier drugs on the market used to treat ED are Android and Androderm. The newer, and more commonly prescribed drugs to treat ED are Viagra (sildenafil), Cialis (tadalafil), and Levitra (vardenafil). Cialis is sometimes called the "weekender" because it is effective for 36 hours. * These three drugs all work the same, they are phosphodiesterase inhibitors. It is important for you to know the drug class name, and also that this class of drugs interacts with many other drugs. The most important interaction to be aware of, because it is potentially lethal, is the interaction with nitrates (nitroglycerin, isosorbide dinitrate and isosorbide monitrate) used to treat heart disease.

The drug, Trastuzumab, belongs to which of the following drug classes?

Humanized monoclonal antibody

Which of the following test is required for patients prescribed a warfarin regimen?

INR-International normalized ratio Rational: doses of warfarin is complicated by the fact that it's known to interact with many commonly use medications and serve food. These interactionsany enhance or reduce warfarin anticoagulants effect. In order to to optimize the therapeutic effect without risking dangerous side effects such as bleeding, close monitoring of the degree of the anticoagulants ration is required by a blood test measurement and INR.

anesthesia

* Anesthesia is what allows stitches to be put in, bones to be set, and a knife to cut into your skin without pain. The term refers to a loss of pain and sensation through the use of drugs. Anesthetics are the drugs that are used to prevent you from feeling. You are probably already familiar with the term "anesthesia" and have had some experience with it. At some point or another, you may have watched in wonder as a needle repeatedly passed through the jagged edges of a formerly painful wound but you felt nothing. Without anesthesia, many medical procedures would simply not be possible or would be excruciatingly painful. * There are three main types of anesthesia. Local anesthesia Regional anesthesia General anesthesia * Local anesthesia numbs only one specific area of the body. Just like in drug effects, it is used when only a small affected area requires treatment. A laceration requiring stitches would necessitate the use of a local anesthetic. A tooth extraction would use local anesthetic. Skin biopsy or removal of a mole is rendered less painful through local anesthesia. This is usually accomplished using a needle injection, ointment, or spray. * Regional anesthesia is used to numb a larger area, although not the entire body, and is accomplished by injecting the anesthetic near a cluster of nerves. This includes an epidural, which numbs the torso during labor and delivery, an interscalene block for spinal surgery, or a femoral nerve block for leg surgery. Many of the same drugs are used to accomplish both local and regional anesthesia. * General anesthesia is the ultimate in pain relief. That's because it's more or less oblivion. You not only feel no pain but also no sensation whatsoever, and you remember nothing to boot. In fact, patients often are unable to breathe on their own under general anesthesia and require intubation for assistance in respiration. General anesthesia can be administered via IV or inhalation, or some combination of the two. It has three basic components: an analgesic for relief of pain; a paralytic for loss of sensation, muscle tone, and reflex movement; and an amnesic, to prevent the formation of any memory of the event. It is not uncommon for one drug to accomplish more than one of these objectives. Many of the drugs you learned about in Analgesics could be used in combination with anesthetics to achieve the overall result. * General anesthesia is used primarily during surgery, although it can also be used after serious injury or trauma so the patient does not have to feel or remember their pain and discomfort. Surgery would simply not be possible without all of the components of general anesthesia. There are several different drugs and combinations of drugs used to achieve general anesthesia.

Side effects of sulphonylurea drugs:

Increase appetite & weight gain

Which of the following drugs is NOT considered a Nonsteroidal anti-inflammatory?

Infliximab

Which of the following drugs is used to slow the progression of uterine cancer?

Infliximab

antiplatelet drugs

Interfere with the chemical reactions that cause platelets to be sticky. The most common of these include aspirin and Plavix (clopidogrel). Both of these medications are commonly used in cardiovascular patients to prevent clots, or in aspirin's case, to reduce the harm caused due to a heart attack or mycocardial infarction.

Which of the following is considered a drug's official name:

International nonproprietary name

Which of the following administration routes is through a blood vessel?

Intra-arterial

Which of the following describes the administration of a drug into the brain parenchyma?

Intracerebal

Which of the following describes the administration of a drug into the brain parenchyma? a. Intra-muscular b. Intracerebral c. Intracerebroventricular d. Intrathecal

Intracerebral

Of the following routes a administration, which is NOT An enteral route:.

Intrathecal Feedback: intro Ferichal a administration is a parenteral route of a ministration

Type 1 diabetes characterized by:

Lack of insulin Feedback: And type one diabetes, the body does not produce sufficient insulin, and synthetic insulin is needed. In type 2 diabetes, the body tissues have reduced sensitivity to the action of insulin also known as insulin resistance.

Which of the following drugs is used to slow the progression of uterine cancer?

Megestrol Rational: Hormones can haul the progression of cancer. Megestrol is used to slow the progression of uterine cancer.

All of the following drugs belong to the Sulphonylurea class EXCEPT:

Metformin

—————is often used in The treatment of overweight individuals with type two diabetes

Metformin Rational: Met Forman is commonly prescribed in particularly useful for those who are overweight or those of normal weight his diabetes cannot be controlled by dietary changes alone. It can be used together with sulphonylureas or another drug such as one of the glitazones to increase the sensitivity of body tissues to insulin. Metformin also increases the utilization of glucose by the tissues.

Which of the following medication is a beta blocker?

Metoprolol

Which of the following medications is a beta blocker? a. Metoprolol b. Enalapril c. Albuterol d. Epinephrine

Metoprolol

Which of the following Antianginal drugs Reduce the work of the heart?

Metoprolol Rational: metoprolol is a beta blocker. Beta blockers are used in the prophylactically of by reducing the work the heart is allowed to perform a level below one that would provoke an angina attack

The drug stem - mab indicates the drug belongs to which of the following classes:

Monoclonal antibodies

The stem - mab identifies what class of drugs?

Monoclonal antibodies

The drug stem -mab indicates the drug belongs to which of the following classes

Monoclonal antibodies The drug stem -mab indicates it is monclonal antibodies drug class.

What drug class is used to relieve pain and inflammation, particularly in muscles, ligaments, and joints?

NSAIDS

Side effects caused by the long-term use of corticosteroids include which of the following

Osteoporosis

What is the side effect caused by the long term use of corticosteroids.

Osteoporosis, The thinning of bones, which can lead to an increase in fractured wrist, can be a side effect of long-term use of corticosteroids.

Medication: Aspirin

Pain medication Pain, fever, inflammation

-Cillin

Penicillin-derived antibiotics Example: penicillin

Which of the following is defined as the study of how chemical agents affect living process?

Pharmacology

Which of the following is defined as the study of how chemical agents affect living processes? a. Pharmacodynamics b. Pharmacokinetics c. Pharmacotherapeutics d. Pharmacology

Pharmacology

anti-Infectives

* Anti-infective drugs are those capable of either slowing the spread of or killing infectious agents. These would include antibiotics, antifungals, antiparasitics, and antiviral drugs. * You are probably familiar with the term antibiotics. It refers to those drugs that kill or injure bacteria, which are one-celled microorganisms. Bacteria are present all throughout the human body and are mostly harmless. However, some of them cause infectious disease and cause pain, illness, and even death. Drugs that kill bacteria are also sometimes called antibacterials (for obvious reasons). They are one of the most frequently prescribed medications in modern medicine. * The most famous antibiotic is penicillin, which was accidentally discovered in molds and first used to treat infection in the 1940s. Its introduction made a major impact upon our society. Prior to the appearance of antibiotics, many diseases and illnesses had no treatment and could be fatal, including simple wound infections and pneumonia. Treatment used to consist of cutting off the offending limb. * Death via an infection (or blood poison) was commonplace 100 years ago. In fact, in the United States, fatal bacterial infections are 1/20 what they were prior to the discovery of antibiotics. In addition, most surgical procedures performed today would simply not be possible without antibiotics to fight potential infection from opening up the body. * Some antibiotics are effective against only one or a few types of bacteria. Others, called broad-spectrum antibiotics, are effective against many different kinds of bacteria. The truth is that there are lots and lots of antibiotics effective against a huge variety of different bacteria. It will be important for you to be very familiar with all the antibiotics we will discuss in this unit.

anti-tumor antibiotics and plant alkaloids

* Anti-tumor antibiotics inhibit DNA from copying itself and multiplying, thus stopping the growth of the cancer. Two common anti-tumor antibiotics are daunorubicin (Cerubidine) and doxorubicin (Adriamycin). * Plant alkaloids inhibit the formation of spindle fibers, stopping cell division and stopping cell growth. There are quite a few plant alkaloids, some of which are paclitaxel (Abraxane), etoposide (VePesid), and vincristine (Oncovin).

The drug -PRAZOLE indicates the drug belongs to which of the following classes.

Proton pump inhaler Feedback: The drug stem -PRAZOLE indicates it is a proton pump inhibitor drug class

The drug stem -oxacin indicates the drug belongs to which of the following classes:

Quinolone-derived antibiotics

The drug stem-oxacin indicates the drug belongs to which of the following classes/

Quinolone-derived antibiotics

Which of the following is NOT a topical route of administration? a. Epicutaneous b. Inhalational c. Enema d. Rectal

Rectal

In pharmacology the path in which a drug or other substance is taken is known as:

Route of Administration

antianxiety

* Antianxiety medications are just what they sound like—medications to treat anxiety. In our society, we call these types of drugs by many different names: antianxiety medications, sedatives, tranquilizers, muscle relaxants. Different types of antianxiety medications work in slightly different ways to solve slightly different problems. For the most part, though, they have a calming effect and work to reduce certain chemicals in the brain. * A class of antianxiety medications that have been common in the treatment of a variety of anxiety disorders for many years is benzodiazepines. These are used to treat general anxiety disorders, panic disorder, phobias, insomnia, muscle spasm, alcohol withdrawal, and sometimes seizures. These have a tendency to lead to dependency and abuse. * The individual names of generic drugs in this class sound very similar, with a "z" in the middle and an "am" at the end. H2 blockers tend to include "tidi" in the name, and proton pump inhibitors tend to end in "prazole" as well. Recognizing similarities will make it much easier to identify drug categories and help you in your work as a pharmacy technician. Of course, you may have noticed that all bets are off for the brand names. * There is another muscle relaxant which is not related to the benzodiazepines but seems to be as effective in the treatment of anxiety. It has the added benefits of not being prone to dependency and not functioning as a sedative. In its generic form it is known as buspirone and is sold under several different brand names, including BuSpar. * Muscle relaxants are also commonly classed as antianxiety medications. A few common brand name muscle relaxants include Skelaxin (metaxalone), Soma (carisoprodol), and Flexeril (cyclobenzaprine). Baclofen (a generic drug) is considered an antispasmodic, to relax spastic or rigid muscles. It is specifically used either for spine muscles, as in spinal cord injury, or with multiple sclerosis and ALS (Lou Gehrig disease).

antihistamines

* Antihistamines are drugs that act against histamine. What is histamine, and why do we need to go into battle against it? Believe it or not, histamine is actually a good thing. It helps to regulate physiologic function and works as a neurotransmitter in the brain. In fact, it plays an important role in both sleep and orgasm. In addition, low levels of histamine are correlated with schizophrenia. Less and less something that you want to fight, right? * Well, for some people with allergies, normal, innocuous, everyday things like dust or pollen are seen by their bodies as major invaders. So, their "mast cells" send histamine, lots of histamine, to their bodies. Mast cells happen to be particularly numerous at vulnerable places—the nose, mouth, and blood vessels, for example. The histamine creates a chemical response that causes inflammation and smooth muscle constriction. That results in itching, sneezing, runny nose, watery eyes, and asthma. Now you can see the value of diminishing histamine! * Interestingly, because histamine is a neurotransmitter as well, antihistamines work in the "vomiting center" of the brain to control nausea and vomiting. So, in addition to controlling allergy symptoms, antihistamines are also effective antiemetics. Scopolamine, meclizine, and dimenhydrinate (the generic form of the drug Dramamine) are antihistamines that are particularly effective at controlling motion sickness. And the drug promethazine, which you learned about in antiemetics, is technically an antihistamine. * Closely related to dimenhydrinate is diphenhydramine, the generic form of the drug Benadryl. You may have heard of Benadryl. It is a very common over-the-counter allergy medicine used to treat a number of allergic conditions (and colds for that matter). * There are many other over-the-counter antihistamines. These include brompheniramine, which is sold under the brand names Dimetapp and Robitussin (among others); doxylamine, which is a primary ingredient in NyQuil; and loratadine, which is the antihistamine in Alavert and Claritin. * The generic drug hydroxyzine is sold under the names Vistaril and Atarax. Notice that the sound of the drug is similar to "meclizine," which is classified as an antiemetic. Technically an anxiolytic, hydroxyzine tends to be frequently prescribed as an antihistamine. However, it can also be used to treat motion sickness and as an antianxiety medication because of its effectiveness as a tranquilizer. Remember that histamine is also a neurotransmitter, so it has an effect upon the brain. * Other OTC antihistamines include Allegra, which is the brand name of fexofenadine, and Zyrtec, a common brand name for the generic drug cetirizine. * We also need to address nasal corticosteroids. Though they are not antihistamines, these nasal sprays are used to treat allergies and have been proven very effective in doing so. The two most popular are Flonase (fluticasone) and Nasonex (mometasone).

In pharmacology the path in which a drug or other substances is taking is known as:

Route of administration Rational: The route of administration in pharmacology is the pass in which a drug or other substance is taken into the body. The classification of the administration is generally based on the location where the substance is apply.

antipsychotics

* Antipsychotic medications, also called neuroleptics or major tranquilizers, are typically used for the most severe mental disorders. There are a number of drugs prescribed to patients with varying forms of depression and milder mental conditions. Psychosis, on the other hand, tends to describe mental conditions that are more severe, often involving a loss of contact with reality and significant social impairment; specifically, conditions like bipolar disorder, schizophrenia, delusions, and mania. * The idea behind antipsychotic medication is to calm some areas of the brain while allowing most of it to continue to function normally. The types of symptoms that antipsychotics are trying to mitigate or eliminate include hallucinations, tension, hyperactivity, combativeness, or severe antisocial behavior. * In 1951 in France, a physician named Henri Laborit used the new drug chlorpromazine, brand name Thorazine, to reduce anxiety in his patients prior to surgery. It was so calming that he thought it might be effective in patients suffering from mental illness. In fact, it was found to significantly decrease symptoms of agitation without sedation or loss of consciousness. Not only that, but in addition to reducing physical symptoms, patients' thinking became less chaotic. By 1955 it was getting widespread use. As its use increased, the number of mental illness patients living as inpatients in hospitals dramatically decreased. * A number of similar antipsychotic medications have been introduced since Thorazine. In 1957, haloperidol was developed as a very potent neuroleptic. By weight it is 50 times more potent than chlorpromazine, and it works against delusions and hallucinations in the treatment of schizophrenia and delirium. Sold under the brand name Haldol, it didn't actually receive FDA approval until 1988.

osteoporosis

* Bone is a living tissue that is continuously being replaced as a result of balance between osteoclast (a cell that reabsorbs bone) and osteoblast (a cell that forms bone) activity. In normal, healthy bone, the opposing activities of osteoclasts and osteoblasts are balanced. As adults age, however, resorption of bone tissue exceeds the deposit of new bone and newly formed bone is less dense and more fragile than original bone. For adults over age 50, these processes occur at a faster rate for women than men. The condition of reduced bone mineral density, disrupted microarchitecture of bone structure, and increased likelihood of fracture is known as osteoporosis. Osteoporosis occurs as a result of deficiency in estrogen, calcium, and vitamin D. * For the bisphosphates (generics ending in -ate), the patient must take the medication before the first meal of the day, with six to eight ounces of water to prevent esophageal burning, and should remain upright for 30 minutes after taking the drug.

bronchodilators

* Bronchodilators do what their name implies they do: dilate the bronchi. They work by relaxing the smooth muscles surrounding the airways. This causes the airways to dilate or widen, making it easier to breathe. They can be used to dilate already constricted airways or to prevent airways from becoming constricted in the first place. Bronchodilators most commonly treat asthma. * Asthma is a chronic lung disease that causes the airways to become swollen and irritated and the muscles around the airways to tighten. This can seriously limit the ability to take in air. An asthma attack can be painful and frightening. Some have compared it to trying to breathe through a coffee stirrer. If you have ever been trapped underwater just a little too long while swimming, you can probably appreciate the panic that accompanies a need to breathe and the inability to get air. * In addition to treating asthma, bronchodilators are used to treat other pulmonary conditions as well, including bronchitis, COPD (chronic obstructive pulmonary disease), emphysema, and pneumonia. * Frequently, bronchodilators are lumped into three main categories: beta-agonists, anticholinergics, and theophyllines. * Beta-agonists can be either "long acting" or "short acting." When they are short acting, they are often called "rescue" medications. This is because they work very quickly (within a few minutes, up to 15-20 minutes) and can be the difference between life and death. A few short-acting beta-agonists include albuterol, which is sold under the brand names Proventil and Ventolin, and pirbuterol, sold as Maxair. * Long-acting beta-agonists do not work immediately, but their effects last much longer than the short-acting ones. Therefore, they are not used in an emergent situation but are used consistently to open up the airways and keep them open. A common long-acting beta-agonist is Serevent (salmeterol). * The second category of bronchodilators is anticholinergics. These also do not act right away. They are inhaled regularly to keep the airways open. A common anticholinergic is ipratropium, which is sold under the brand name Atrovent. * Sometimes short-acting beta-agonists are combined with anticholinergics to make an even more powerful bronchodilator, as is the case with Combivent. It combines albuterol (the beta-agonist) and ipratropium (the anticholinergic). Patients that are allergic to soybeans, peanuts, or other food products that contain soya lecithin should not take Combivent. * Bronchodilators are often (although not always) administered to patients via inhalers and nebulizers. These allow small doses of the medicine to be released and breathed in using special equipment. You may remember that nebulizers take a liquid form of a medication and turn it into a vapor, allowing it to be easily inhaled. It allows the largest dose to be delivered and thus can provide the fastest relief of symptoms. They are often used in hospitals. * The third and final category of bronchodilators is theophylline. Sold under the brand names Theo-Dur and Slo-bid, it is a long-acting bronchodilator that can be administered via IV or taken in pill form. It is most commonly taken for severe cases of asthma and must be taken daily. * The following drugs do not fit neatly into any of the above categories but they are some of the most commonly prescribed medications to treat asthma: Singulair, generic name montelukast- This drug, administered in pill form, belongs to a class of drugs called leukotrine inhibitors. Singulair has been approved for children over the age of 12 months as a maintenance drug to reduce asthmatic incidences and is not used as a rescue medication during an asthma attack. Advair, generic name fluticasone-salmeterol- You can probably already tell that this is a combination inhaler. As mentioned earlier in this unit, fluticasone is a corticosteroid, and salmeterol is long-acting beta-agonist. The two work together to improve pulmonary function more than either drug used alone.

chemotherapy drugs

* Chemotherapy drugs, also known as cytotoxics, are used to kill cancer cells that remain after surgery or radiation that are not readily detectible. As larger numbers of chemotherapy agents become available as oral medications, it will be more common for them to be dispensed at the retail level. Antineoplastic therapy is a general term for anticancer therapy, derived from the word neoplasm, defined as the growth of abnormal tissue (cancer). * The goal of most chemotherapy regimes is to put the cancer into remission. In remission, the tumor is in an inactive period with no active cell division and growth. Remission does not cure the disease, but it does extend the patient's life. * The increasing availability of chemotherapy agents at pharmacies is placing significant responsibility on pharmacy personnel to be knowledgeable in order to handle and dispense these drugs properly. * Chemotherapy spill kits should be used for the cleanup of accidental spills of antineoplastic agents. These kits include waste disposal bags, respirator, latex gloves, heavy utility gloves, eyeglasses, gowns, shoe covers, toweling, and sealable bags. If the substance comes in contact with the skin, it must be washed immediately with soap and water for at least five minutes. If the substance comes in contact with the eyes, they should be rinsed for 15 minutes.

anticoagulants

* Coagulation is a process whereby liquid blood forms into solid clots. * Platelets and fibrin immediately begin to surround a damaged blood vessel, forming a clot to both stop the bleeding and begin to repair the vessel. * A clot can develop inside an artery that completely blocks the flow of blood. This is called thrombosis. This can happen because of trauma, infection, or even due to long periods of being sedentary (such as sitting on a plane for several hours). In any case, clots that appear and completely obstruct the flow of blood are bad. When blood vessels to the brain are obstructed, it causes stroke, which can be lethal. * Drugs that treat or prevent inappropriate clotting of the blood can be divided into two separate categories: those that prevent the formation of clots, which are called anticoagulants (these are also sometimes called blood thinners), and those that break up, dissolve, and cause clots to disperse, which are called thrombolytics. (Thrombolytics can also prevent clots.) Thrombolytics are usually referred to as "clot busters" and are usually only administered through IV in a hospital setting. * The most commonly prescribed oral anticoagulant is Coumadin (warfarin) * A patient taking warfarin should not take aspirin unless his or her physician and pharmacist are aware that the medications are being taken simultaneously. Taking aspirin while on warfarin increases the risk of bleeding *Two of the most common injectable anticoagulants is: heparin and Lovenox (enoxaparin).

cough suppressants and expectorants

* Cough suppressant medications control coughs. Another name for cough suppressants is antitussives. "Tussive" is just another way to say "cough." You will rarely actually see coughs referred to as tussives, although you will see cough medication referred to as antitussives. * Coughing is actually a reflex—a very good reflex—designed to expel unwanted material (such as mucus) from your breathing passages. In the event that the body has the need of eradicating something from its breathing passages, you don't really want that reflex to be suppressed. In fact, in these instances you want to use an expectorant, a drug to stimulate the production of saliva and induce coughing, making it more likely to eliminate whatever is blocking the airways. Guaifenesin is used in over-the-counter medications targeted at cold-related symptoms. It works by loosening the mucus or phlegm in the lungs, making them easier to cough up. * On the other hand, when the reflex kicks into gear and there is nothing to expel (resulting in a dry, unproductive cough), it can be very irritating. At that point, you want to suppress the natural coughing reflex. This can be done in a variety of ways. One of the most common medications for cough suppression is dextromethorphan, a common ingredient in cold medicines. It works on the brain to suppress the urge to cough. Codeine, which you may remember as a narcotic, also is used as a cough suppressant and works in the same manner. * As opposed to suppressing the cough through drugs that work on the nerves of the brain, coughs can be suppressed by drugs that have a local effect—primarily a local anesthetic on the irritated throat tissues. Examples of antitussives that work locally are Chloraseptic and the menthol in throat lozenges. * Lots of "medicines" get lumped into this category that are not truly cough suppressants in the sense that they contain no actual medication. Many cough drops, for example, fall into this category. They are primarily sugar, honey, or glycerin. These soothe irritation in the throat basically by keeping it wet, thereby preventing a cough, but they contain no drugs that actually suppress coughing. In fact, you may have noticed that when you have a serious cough, the only time you are not coughing is when the drop is actually in your mouth. The moment it dissolves, you begin coughing again.

decongestants

* Decongestants are medications used to relieve nasal congestion or a "stuffy nose." Often a symptom of a cold, congestion occurs when the membranes of the nose become swollen. This is caused by inflamed blood vessels. Anybody who has ever had a stuffy nose is well aware of why medications exist to alleviate this condition! * Drugs to treat congestion work by constricting the blood vessels in the nose and sinuses, thereby opening up those nasal passages. Aaah! They are available in a couple of different forms. Oral decongestants are taken by mouth (often as part of a multi-symptom cold medicine) and are slow acting. They do not, however, interfere with either the production of mucus or the movement of cilia (the "hair" that sweeps debris out of air passages). Topical decongestants, which include nasal sprays and nasal drops, provide virtually immediate relief. However, they do tend to slow down the movement of the cilia. In fact, nasal decongestants should not be used for more than three days. Use beyond that can cause rebound congestion, meaning the congestion will start to get worse instead of getting better. * Decongestants are often confused with antihistamines, but they are different. Remember that antihistamines work on the brain to block the production of histamine and are an effective weapon against allergies. Decongestants, on the other hand, work to constrict the blood vessels that supply the nose. They are much more limited in scope. * There are really only a few decongestants on the market. First, and one that has been used for a long time, is pseudoephedrine, the primary ingredient in Sudafed. However, because pseudoephedrine is an ingredient in the illicit drug methamphetamine, it is largely being replaced as an ingredient by the decongestant phenylephrine. These are ingredients in a number of cold medicines, which tend to also contain fever reducers, cough suppressants, and other categories of drugs. Recently, because of the potential hazards and abuse of pseudoephedrine, medications containing this drug are kept behind the counter and dispensed at the pharmacy, not on the shelf. A prescription is not required to obtain these medications, but the quantity that one patient may buy is restricted and the patient must show government identification to make the purchase. * Additionally, a number of nasal drips and sprays are decongestants. A couple of these include Afrin (oxymetazoline) and Dristan (cerner multum).

otic medications

* Disorders of the ear range from otalgia (ear pain), earache, infection, to buildups of earwax (cerumen). Otalgia is usually treated with a prescription drug. The only OTC medications for the ear are earwax solvents and a product to dry water in the ear canal after swimming. Wax dissolvers are used to emulsify and disperse excessive buildup of earwax. The pain relievers and antibiotics are all prescription medications. In fact, the OTC drugs can be very painful if someone tries to self-medicate an ear infection. * Eardrops come in solutions and suspensions. If the patient has a tube in the ear or a ruptured eardrum, a solution should not be used; only a suspension should be used. The physician may prescribe an ophthalmic agent to be used in the ear—this practice is quite common and is very effective. If an otic agent is accidentally put in the eyes, however, it is very painful. So ophthalmic drops in ears are fine but otic drops in eyes are not. To avoid confusion, as a pharmacy technician you should clearly label all medications intended for application in the ear.

diuretics

* Drugs that assist the body in getting rid of excess fluid, at the same time increasing the quantity of urine. Most diuretics work on the kidneys, stimulating them to release more sodium. The sodium then takes water out of your blood and tissues. It both eliminates excess fluid and lowers blood pressure, as the subsequent decrease in the amount of fluid reduces the pressure in the arteries. It also gets rid of excess sodium, which is one of the primary reasons for the water retention in the first place. * Diuretics get lumped into three or four different categories according to how they actually work on the kidneys.Diuretics get lumped into three or four different categories according to how they actually work on the kidneys.

antihypertensives

* Drugs that lower blood pressure are called antihypertensives. They accomplish this in a couple of different ways, such as interrupting nerve impulses to the brain or causing blood vessels to relax and get bigger. In fact, there are some major classes of medications that are effective antihypertensives. These include beta blockers, calcium channel blockers, and diuretics. In addition to being antihypertensives, these are effective drugs against a number of different problems related to the heart and cardiovascular system. * ACE inhibitors are another class of antihypertensive drugs. They work by stopping a hormone called angiotensin from ever forming. This hormone normally causes blood vessels to narrow. A number of ACE inhibitors are routinely prescribed for the treatment of hypertension. They are also useful in treating congestive heart failure. * Angiotensin II receptor blockers (ARBs), also known as angiotensin II antagonists, seem to work as well as ACE inhibitors in lowering blood pressure. Because of how they control blood pressure, angiotensin II antagonist drugs are usually better tolerated than ACE inhibitors. Sometimes there are conditions in which the combination of the two may provide even greater therapeutic benefit than either drug alone.

antiarrhythmics

* Drugs used to control irregular heartbeats * Normally, the heart beats in a smooth, normal rhythm. When it doesn't, that condition is called arrhythmia. That abnormal rhythm can be too fast or too slow or have some other component that is aberrant, such as skipping beats. In any case, arrhythmia can be the normal baseline heartrate for some people, can be an irritating but basically benign condition, or can be a life-threatening emergency. * Antiarrhythmics that either prevent or treat arrhythmia work by changing the nerve impulses in the heart. They can stimulate the involuntary muscles to speed up the heartbeat. They can block those same muscles to reduce the heart rate, or simply reduce the force of the heart muscle contraction. This also lowers blood pressure and can help with chest pain.

epilepsy

* Epilepsy is a fairly common neurological disorder characterized by sudden and recurring seizures; it is a symptom of brain dysfunction. All epilepsy patients have seizures, but not all patients with seizures have epilepsy. * Seizures are caused by excessive firing of a small number of neurons and the spread of electrical activity to adjacent neurons. These firings can result in a convulsion, an involuntary contraction or series of contractions of the voluntary muscles. Medications used to treat seizures and convulsions are also often referred to as anticonvulsants.

diabetes

* Given the propensity towards diabetes in our society, insulin is one of the most common and significant hormones used in treatment today. So, what is insulin? It is a hormone secreted by the pancreas; it regulates the glucose (sugar) in the blood. It is essential in converting food into energy. Insulin's counterpart, glucagon (also a hormone), stimulates the liver to release stored glucose. The body's inability to produce or properly utilize insulin leads to high levels of sugar (glucose) in the blood and results in a condition called diabetes mellitus, which has reached epidemic proportions in the United States. In the olden days, it used to be called "sugar sickness." * Diabetes can result in all kinds of serious complications. It puts patients at an increased risk for heart disease, stroke, significant damage to the kidneys ultimately causing them to fail, and can lead to blindness—and those are just the major ones. The most common complication of diabetes is called diabetic neuropathy, which refers to the damage caused to nerves throughout the body. Also, foot problems, including poor circulation, swelling, ulcers, and amputation, as well as skin problems can occur. * There are three kinds of diabetes: Type 1 diabetes: Usually diagnosed in children or young adults. Sometimes called "juvenile diabetes" or "insulin-dependent diabetes mellitus" (IDDM). In type 1 diabetes, the body simply does not produce insulin. It requires life-long administration of insulin. Type 2 diabetes: Much more common type of diabetes. Sometimes called "noninsulin-dependent diabetes mellitus" (NIDDM) or "adult-onset diabetes mellitus." This type of diabetes generally occurs in patients who are older and have significant risk factors related to lifestyle, specifically poor nutrition, inactivity, and obesity. Unlike type 1 diabetes, the body generally does produce insulin, but it either cannot produce enough or the body cannot use it appropriately. The cells of the body become resistant to the effects of insulin, so more and more insulin is needed in order to do its job. Gestational diabetes: Of course you know that hormones increase dramatically during pregnancy. These hormonal changes can cause blood sugar elevation resulting in diabetes during the pregnancy. Although it tends to resolve itself after the baby is born, as many as 50% of women who develop gestational diabetes eventually get type 2 diabetes later in life. * Ultimately, the lack of the insulin hormone can best be treated with... brace yourself... insulin! In type 2 diabetes, however, that is the last resort. Patients are strongly encouraged to change their lifestyle, add exercise, closely monitor their blood sugars as well as their sugar intake, and otherwise do whatever they can to avoid having to take insulin. Since insulin is most frequently given as an injection, nobody is excited about having to "shoot" themselves a couple times a day. * One of the first drugs prescribed in the treatment of type 2 diabetes is called metformin. Not only is it the most commonly prescribed antidiabetic medication, it is one of the most commonly prescribed medications in the United States, period. In 2006 nearly 35,000,000 prescriptions were filled for the generic form of metformin alone! It is sold under the brand name Glucophage.

hormone therapy and nitrogen mustards

* Hormones are modified forms of steroid hormones. Hormone therapy adds, blocks, or removes hormones that stimulate the growth of cancer cells such as estrogen and testosterone. These drugs and their targets are: Plenaxis: prostate Cytadren: breast, prostate Casodex: prostate Eulexin: prostate megestrol (Megace): breast, endometrial * Nitrogen mustard drugs cause damage to the DNA of cells so that they cannot reproduce. They have their name because they are chemically related to mustard gas, a chemical weapon used during World War I. The damage to the DNA of the cells is similar to radiation damage. Nitrogen mustards are used on specific tumors and produce the best results when the cell is in a resting phase (not dividing and growing). * Some of the most commonly used nitrogen mustards are Alkeran, Mustargen, and Leukeran.

insulin

* If diet and exercise have not made a difference and drugs like metformin and glyburide fail to work, or don't work as well, it may become necessary for patients with diabetes to use insulin. It is extremely important that, whatever it takes, blood sugar levels be controlled in Type 2 diabetic patients. * For the most part, insulin is injected into the body. It is done so using either a needle and syringe or a pen. With a needle and syringe, the insulin comes in vials and is drawn up into the syringe and injected subcutaneously. A pen is actually a hidden needle with the appropriate amount of medication inside. It has a needle inside and is injected subcutaneously as well. An insulin pump delivers insulin 24 hours a day through a catheter under the skin. Traditionally, insulin pumps have been used by people with type 1 diabetes. However, in recent years individuals with type 2 diabetes have been using insulin pumps as well. * There are a number of different types of insulin. They can be synthetic—man-made in a laboratory but otherwise identical to human insulin—or they can come from animals. They can act quickly or take a long time to go into effect. And a number of different drug companies make a variety of brand name insulins. * Rapid-acting insulin: takes effect in about five minutes, peaks at an hour, lasts for 2-4 hours. Regular or short-acting insulin: takes effect within 30 minutes, peaks in 2-3 hours, and lasts for 3-6 hours. Intermediate-acting insulin: takes effect 2-4 hours after injection, peaks at 4-12 hours, lasts for 12-18 hours. Long-acting insulin: takes effect 6-10 hours after injection, lasts 20-24 hours. There are more than 20 different kinds of insulin. They all contain the same generic name insulin, such as NPH human insulin or insulin aspart. The letters following the names indicate the type of insulin and the numbers indicate the ratio of the insulin mixture. * Humulin R, Novolin R: also known as regular insulin. This is short-acting insulin and is the only insulin that can be administered intravenously. Humalog, NovoLog, Apidra: rapid-acting insulin. Humulin N, Novolin N: intermediate-acting insulin. Lantus, Levemir: long-acting insulin and more closely mimic natural insulin release than the others do. NovoLog Mix 70/30, Humalog Mix 75/25, Humulin 70/30: insulin mixtures. They have a quick onset and longer duration because they are short-acting insulin mixed with intermediate-acting insulin. Mixed insulin is dosed twice daily.

penicillins

* It is still commonly prescribed to treat a variety of infections. It is considered a class of antibiotics; it can be combined with other compounds, and there are different kinds of penicillin. * The brand name of amoxicillin is Amoxil. There are several brand names for the actual generic drug of penicillin, the most common being Penicillin-VK. Also, penicillins are sometimes combined with other drugs to improve the effect, the most common of those being Augmentin, which is amoxicillin combined with clavulanate. * A patient starting a penicillin regimen, or any antibiotic regimen for that matter, should speak with the pharmacist about possible side effects. Female patients will need to be informed that contraceptives can be less effective while taking an antibiotic and backup contraception should be used while taking the antibiotic.

macrolides and tetracycline

* Macrolides are a class of antibiotics commonly prescribed to patients with an allergy to penicillins. They are effective against a wide variety of microorganisms but are primarily prescribed to treat pulmonary infections. These drug types actually reduce production of proteins, which bacteria need to survive, and this slows the growth of or even kills the bacteria. The most common macrolides are Zithromax (azithromycin), Biaxin (clarithromycin), and Ery-Tab (erythromycin). * Cleocin, generic and more commonly used name clindamycin, is an antibiotic that works similar to macrolides and is in the lincosamides class. * Tetracyclines refer to a class of antibiotics, which includes doxycycline (sold commonly under the brand name Vibramycin), that are a broad-spectrum antibiotic. Unfortunately, their effectiveness has diminished somewhat in recent years due to bacterial resistance, although it remains useful against some bacteria. Another common use for tetracyclines is the treatment of acne. The antibiotic tetracycline is sold under a variety of brand names, Sumycin being the most common. The specific drug "tetracycline" is also considered a part of the "tetracyclines" group.

Parkinson Disease

* Michael J. Fox has brought Parkinson disease (also known as Parkinson's disease, abbreviated as PD) to the public's attention, as he has been very open about his struggle to treat his PD. Though many people have heard of PD because of him, few know very much about it. Some people, like Michael J. Fox, begin to suffer from PD at an early age but the majority affected with PD is over age 60. This disease impairs the patient's motor skills, speech, and other functions. With the elderly population significantly increasing, we can expect to see more cases of PD in the upcoming years. * A few common drugs used to treat Parkinson disease are Sinemet (carbidopa and levodopa), Mirapex (pramipexole), and Cogentin (benztropine).

antidepressants

* More than 20 million people in the United States suffer from some form of depression. This is considered to be more than just feeling blue or being sad; depression includes a variety of symptoms that last for weeks, months, and even years. These symptoms include feelings of sadness, worthlessness, inability to sleep, disinterest in any activities, weight fluctuation, and in its most extreme form, thoughts of suicide (suicidal ideation). It is not uncommon for women to experience symptoms of depression following the birth of a baby (postpartum depression) or for people to suffer depressive symptoms throughout the long winter months (seasonal affective disorder), and depression can be a component of a number of different, more severe psychiatric disorders, such as obsessive-compulsive disorder (OCD) and bipolar disorder. * Antidepressants work by increasing the production of certain chemicals within the brain, such as serotonin. A multitude of studies have concluded that there is a correlation between the amount of these chemicals present in an individual and his or her mood. * There are so many drugs used to enhance mood and treat depression that we are going to break them up here by grouping them into some common categories: Tricyclic antidepressants SSRIs (selective serotonin reuptake inhibitors) Monoamine oxidase inhibitors Tetracyclic compounds and other types of antidepressants * First, tricyclic antidepressants. These are the oldest type of antidepressants, developed in the 1950s. Although they have largely been replaced in recent years by newer types of drugs, they are still prescribed and are effective against the symptoms of depression, ADHD, migraine headaches, insomnia, and bulimia (to name just a few). They work by inhibiting certain neurotransmitters (namely norepinephrine, dopamine, and serotonin) from re-entering nerve cells, causing levels to increase. * Selective serotonin reuptake inhibitors (SSRIs) work essentially the same way but on one specific neurotransmitter, namely serotonin. Although nobody seems to know why, the increase of serotonin levels elevates mood and thus treats a number of depression symptoms. * Monoamine oxidase inhibitors are extremely powerful antidepressants, with potentially lethal drug and dietary interactions. They have traditionally been used only after tricyclics and SSRIs have been tried without success. However, in 2006, a patch form of an MAOI was approved by the FDA, and since it does not require passage through the gastrointestinal system, it is a much safer form. These types of drugs can be used in the treatment of agoraphobia (fear of different settings, which can cause sufferers to never leave their homes) and social anxiety. They work by preventing the breakdown of the specific neurotransmitter monoamine, increasing its stores. Because it has such potentially harmful side effects, it is not commonly prescribed. If a patient is taking an MAOI and the physician changes to another class of antidepressant, the patient must wait at least two weeks for the MAOI to clear the system before starting the second drug. * The last category of antidepressants includes tetracyclic compounds and any other antidepressant that does not fit nicely into one of the above categories. It is amazing when reading and learning about the different drugs, some of which have been on the market for 25 years or more, how little is known about how they work or why they work. As a pharmacy technician, you don't need to understand the details of how antidepressants work; just familiarize yourself with some of these more commonly prescribed drugs and know that they will continue to change as more research is completed. * Antidepressants are also sometimes used for other things, such as antihistamines or to help people quit smoking. In addition, other types of drugs, like benzodiazepines, can be used to treat depression.

NSAIDs

* NSAID is an acronym for "nonsteroidal anti-inflammatory drugs. * They fight inflammation. Inflammation is the body's natural response to injury. Basically, it is the body's way of protecting itself and beginning to heal the wound, injury, or foreign body. Inflammation associated with conditions such as arthritis fits this definition perfectly; for example, when cartilage deteriorates and causes bones to rub together, there is inflammation. For a patient, that means swelling, pain, heat or fever, redness, and sometimes itching. You can certainly see the need for an entire class of drugs to relieve these symptoms. NSAIDs help to alleviate all of these symptoms. * Ibuprofen and naproxen are commonly prescribed NSAIDs. Of course, you learned about them under analgesics because they are just as frequently used to address the symptom of pain as to address symptoms of inflammation and redness. A number of common drugs, including Advil, Motrin, Nuprin, Anaprox, and Naprosyn, contain ibuprofen and naproxen and are used to treat inflammation. * A newer NSAID, celecoxib is sold under the brand name Celebrex. Celebrex is a COX-2 inhibitor NSAID. Unlike traditional NSAIDs (the ones in the table) that block the COX-1 enzyme and the COX-2 enzyme, Celebrex only blocks COX-2. Blocking only the one enzyme has been shown to decrease pain with a much lower risk of adverse GI events.

ophthalmic medications

* Ophthalmic medications are used to treat the eyes. The internal structures of the eye are subject to various disorders. * Some of these medications come as an ointment but many of them are solutions intended to be used as eye drops. It is important for the patient and the pharmacy technician to understand the general procedure for applying eyedrops. The first step is to wash the hands thoroughly. If the liquid needs to be mixed, shake the container. Then remove the bottle cap and draw up liquid in the eyedropper. To apply the eyedrops, tilt the head back and pull the lower eyelid down. Hold the tip of the eyedropper directly over the eye but do not allow it to come in contact with the eye or adjacent tissues. Contact between the body and the dropper can transmit infection. With the patient looking up, place a drop in the pocket behind the lower lid. Release the eyelid. Replace the cap on the container and wash hands again. Wait 5 or 10 minutes before applying any other medication to the eye. Ophthalmic ointments are to be placed in the pocket behind the lower eyelid in a similar manner.

sex hormones

* Perhaps the most famous of all hormones are those related to sexuality and reproduction in the human body. Both males and females produce sex hormones, although they are very different and they do very different things in the body. The adrenal glands produce a small amount, but most come from the sex organs themselves (the ovaries and the testes). * A lot of what the sex hormones do you learned about in elementary school sex education: lower the voice, grow hair in new places, induce menstruation, develop breasts, etc. All of this is, of course, in preparation for adulthood and the ultimate goal of propagating the species. It follows, therefore, that most sex hormones used as medication are used in regards to reproduction: infertility, fertility, pregnancy, and lactation. * Because women's bodies actually do all the work when it comes to reproduction, most of the sex hormone medications are comprised of women's hormones and are prescribed to women. However, men also produce sex hormones—most notably testosterone—and its lack or overabundance can cause problems requiring medication. Women also produce testosterone, although typically men produce 8 to 10 times the amount that women do. Testosterone is responsible for libido and protection against osteoporosis. It also reduces the elimination of protein from the body, causing an increase in muscle size. * In women, the primary sex hormones are estrogen and progesterone. Along with a few others, these hormones tell the female body when to ovulate, build up the appropriate uterine lining, and generally prepare the body for pregnancy. Birth control pills combine some form of either estrogen and progesterone or only progesterone and prevent a woman's body from getting pregnant. * In fact, since the FDA approved "the pill" in 1960, it is the most popular and one of the most effective forms of birth control. More than 18 million U.S. women rely on birth control pills for contraception, and they have more than 40 different ones to choose from, including Ortho-Novum, Ortho Tri-Cyclen, and recently FDA-approved Lybrel, which not only prevents pregnancy, but eliminates menstruation as well. Additionally, the hormones traditionally used in the pill can be put in IUDs or injected IM as well, such as with Depo-Provera. * In addition to being used as a contraceptive, some forms of estrogen and progesterone are used to treat endometriosis, uterine bleeding, breast cancer, and a number of symptoms of menopause. * When the sex hormones are ultimately successful in achieving their purpose, a woman becomes pregnant and more hormones become important. Right away after conception, the body starts to produce increasing amounts of both progesterone and estrogen. In addition, the body starts to make the hormone HCG (human chorionic gonadotropin). This one is credited with all the symptoms of early pregnancy. * The hormone oxytocin is released during labor and immediately after a baby is born. It both distends the cervix and induces lactation. Because of its effectiveness, a synthetic form sold under the trade name Pitocin is frequently used to both induce and augment labor. * Another drug used to induce labor is Cytotec, which has the remarkable ability to ripen the cervix. The pill itself can actually be placed directly in the vagina. Because it is so powerful, it can cause uterine rupture and so is usually broken into pieces.

quinolones and other antibiotics

* Quinolones are another class of broad-spectrum antibiotics that work on bacteria by making it difficult or impossible to repair their DNA. They are among the drugs of choice for treating ophthalmic infections, upper respiratory infections, urinary tract infections, and some sexually transmitted diseases. * A common quinolone is Cipro (ciprofloxacin), which is the drug of choice in the treatment of anthrax. Two other common quinolones include Levaquin (levofloxacin) and Avelox (moxifloxacin). * There are many other antibiotics frequently used in the treatment of infection and other microorganism invasion: metronidazole: Brand name Flagyl - This antibiotic is especially effective against infections that do not require oxygen to grow. A "do not drink alcohol" sticker must be affixed to the amber prescription vial when this drug is dispensed. If the patient consumes alcohol while taking metronidazole, the patient will become nauseated, causing vomiting. Additionally, the patient's blood vessels dilate, causing a flushed reaction and headache. gentamicin: Brand name Garamycin - Used in the treatment of serious infections, gentamicin cannot be administered enterally. When the drug passes through the liver, it is rendered completely inactive. nitrofurantoin: brand name Macrobid - An antibiotic used to treat bacterial infections, it is most commonly prescribed for urinary tract infections. sulfamethoxazole-trimethoprim: Brand names Bactrim DS and Septra DS - This is a sulfonamide antibiotic, the oldest antibiotic on the market. This drug should be taken with lots of fluid and patients taking it should avoid sun exposure, which can cause severe skin rashes. Also, any patient with a drug allergy to sulfonamides should not take this drug. vancomycin: Considered a "drug of last resort," vancomycin is a fairly toxic antibiotic used to treat serious infections (usually in the stomach or bowel) that are not responsive to other antibiotics. Neosporin: Many different antibiotics can be used topically to treat and prevent bacterial infections. Neosporin contains the antibiotics neomycin, bacitracin and polymyxin B.

antacids

* Relieve indigestion and heartburn and sometimes heal ulcers. They work by neutralizing the acid in the stomach. There are a couple of different ways that a drug can do this. First, mineral and salt compounds are a quick and easy way to neutralize stomach acid. These are available without a prescription. A variety of medications are available that utilize three main elements. * Magnesium - Magnesium is, of course, an element. In fact, it is the eleventh most common in the human body. Combined with other elements, as in magnesium carbonate, magnesium trisilicate, and magnesium hydroxide, it is effective in neutralizing stomach acid. Magnesium hydroxide is the most common of these and is known as milk of magnesia. Its use can cause diarrhea, so it is also effective at relieving constipation. In this capacity it is referred to as a laxative. You will often see it capitalized because many brand names use it in their name: Phillips' Milk of Magnesia. * Calcium - Calcium is also an element, and combined in calcium carbonate it is a potent and fast-acting antacid. Unlike magnesium hydroxide, calcium carbonate can cause constipation. Calcium also helps to strengthen bones (unless taken to excess). Brand names for calcium carbonate include Tums and Rolaids. * Aluminum - Aluminum is a metal element, and when combined into aluminum hydroxide it also is an effective antacid. Brand names include Amphojel and ALternaGEL. Aluminum hydroxide can cause constipation. It is common to mix it with magnesium hydroxide (which causes diarrhea) to counteract symptoms of constipation. This combination is sold under the brand names Maalox and Mylanta. * Heartburn, indigestion, and even ulcers can be treated in other ways. H2 blockers and proton pump inhibitors are commonly used. These are also useful in treating gastroesophageal reflux disease (GERD). Many of these are sold by prescription only, although in recent years more have become available over the counter. These are stronger than the mineral and salt combinations discussed above. * H2 blockers: Proteins called histamines encourage acid secretion in the stomach. H2 blockers reduce stomach acid by blocking histamines. In lower dosages, they are available over the counter, although higher dosages require a prescription. These are commonly used for severe heartburn and duodenal ulcers. * Proton pump inhibitors (PPIs): These limit stomach acid by shutting down the acid pumps, specifically by blocking an enzyme in the cells themselves. Prescribed and used in treatment of several different kinds of gastric problems, they are especially effective against ulcers. * There is another drug effective against ulcers that is neither an H2 blocker nor a proton pump inhibitor. This drug, sucralfate, works by creating a chemical barrier around an ulcer, protecting it, much the way that a Band-Aid protects a wound. A brand name example of this medication is Carafate.

non-narcotic analgesics

* Simply put, analgesics are drugs used to get rid of pain. * There are two main types of analgesics: Narcotics or opioids. These are derived from the opium poppy, and they go to work on the brain to relieve pain. They also tend to cause drowsiness and a feeling of, for lack of a better word, well-being. Unfortunately, these also tend to be highly addictive. Everything else. This includes aspirin, acetaminophen, ibuprofen, and are often combined with narcotics. * Narcotics tend to be used medically when there is more severe pain. Pain relief for less severe pain has several options. Some of these are nonsteroidal anti-inflammatories (NSAIDs), and they do more than just help with pain. They can also lower fever and reduce swelling. These medicines are probably in one form or another in your own medicine cabinet. * Originally called acetylsalicylic acid (and this is still accurate), Bayer & Co trademarked the name "Aspirin" in 1899. Its own government denied the application because it was not technically a new product. Bayer's patent was upheld in the United States, however, in 1909, making it 10 times more expensive in the U.S. than in other countries. Germany lost World War I, and the Allies seized Bayer's assets. By 1921 the U.S. established "aspirin" as a genericized trademark. In other countries, there is still a trademark on the name, and they use ASA (a shortened form of acetylsalicylic acid) to refer to the generic. Brand names include: Bayer, Bufferin, Ecotrin, Excedrin * Although good at killing pain and lowering fever, acetaminophen is not particularly effective at reducing swelling. Outside of the United States, the most common brand name of this drug is Panadol, and it is marketed under that name in more than 80 countries. It is also the only analgesic that is recommended for use by pregnant women. Brand names include: Tylenol, Anacin-3 * Ibuprofen is a nonsteroidal anti-inflammatory developed in the 1960s. While it is an effective pain reliever and fever reducer, unlike acetaminophen it is also highly useful for reducing redness and swelling. It can be classified as either an analgesic or an NSAID, as it is commonly used both to relieve pain and reduce swelling. Brand names include: Advil, Motrin, Nuprin, PediaCare * This is also a nonsteriodal anti-inflammatory used to alleviate pain, fever, and swelling. It is commonly used for conditions such as arthritis. In the United States, the higher dosages are available by prescription-only, but a lower dose is available OTC under the brand name Aleve. Brand names include: Naprosyn, Anaprox

vasodilators

* Sometimes used interchangeably with antihypertensives and sometimes classified separately. Vasodilators are actually muscle relaxants, but they work directly on the smooth muscles of the blood vessel walls, causing them to widen (or dilate). A primary use is in the treatment of hypertension (thus the classification as antihypertensives), and most vasodilators are prescribed for that purpose. * Hydralazine is a by-the-book vasodilator. It opens up the blood vessels, making it easier for the heart to pump and lowering blood pressure. It is sold under the brand name Apresoline. The generic drugs phentolamine and prazosin both lower blood pressure by relaxing the blood vessels. * A common vasodilator you may have heard of, minoxidil, was initially developed to treat high blood pressure. It was quickly discovered to have an interesting side effect: hair growth. Specifically, it was found to be effective at reversing baldness. Enterprising drug companies reformulated it from a pill form to a topical form and have sold millions of them in the United States under the brand name Rogaine. * Another vasodilator is isosorbide. It is considered a nitrate and works by relaxing blood vessels and allowing blood vessels to dilate. You have already learned that a by-product of dilating the blood vessels is lowering blood pressure. However, isosorbide is prescribed primarily to treat angina or chest pain. Although sold under a number of different brand names, Imdur and Isordil are common ones. *Perhaps the most commonly used vasodilator is nitroglycerin. This is sold under different brand names, but especially NitroQuick and Nitro-Bid. Like other vasodilators, it relaxes the blood vessels. Although it has the effect of lowering blood pressure, it is more frequently used to treat chest pain, at least chest pain caused by the heart. Something unique about nitroglycerin is that the tablet form is sublingual and must be dispensed in its original amber container. As a pharmacy technician, you cannot remove the tablets from the amber container and repackage them into a different vial.

alternative supplements

* The most commonly used herbs are St. John's wort for depression, ginseng for energy, Ginkgo for memory improvement, feverfew for migraines, Saw Palmetto for prostate disease, valerian as a tranquilizer, and echinacea, also called Siberian ginseng, for the common cold. Non-herbal alternative supplements include melatonin for sleep, chromium picolinate for weight loss, and glucosamine for arthritis.

corticosteroids

* The steroids that your doctor may prescribe to fight inflammation (and treat a number of other conditions) are called corticosteroids. * They are so called because they are similar to cortisol, a hormone naturally produced in the adrenal glands. In fact, they are so similar that your body can't tell the difference between a corticosteroid that you take externally and the cortisol that your body naturally produces. It is sometimes called the stress hormone because your body produces cortisol when it's under stress—really any kind of stress, including surgery, emotional strain, infection, trauma. When the stressful situation ends, the adrenals stop producing as much cortisol. The nice thing about corticosteroids is that not only are they good at fighting inflammation, they are effective at treating a number of medical conditions, including preventing organ rejection in transplant recipients. When they were first introduced in the 1950s, they were considered a miracle drug. They virtually eliminated any symptoms of arthritis, and many people thought that they were a permanent cure for the condition. The problem is that prolonged use of corticosteroids causes the body to quit making cortisol on its own. This condition is called "adrenal suppression." It, along with other side effects, causes these drugs to be prescribed in tapering doses. * All of the common generic corticosteroid drugs end in either -sone or -olone, making it another one of those really easy-to-remember drug categories. It makes it easy to look up difficult-to-understand terms a physician may dictate—if it sounds like it ends in either of the above ways, look up corticosteroids and see if you can identify the drug that was dictated that way. * The most commonly prescribed corticosteroid is prednisone. Though the brand is never dispensed, doctors will sometimes use the brand name Deltasone when prescribing. There are a number of other corticosteroids, all of which you will see as a pharmacy technician.

attention-deficit disorders

* The two main disorders are attention-deficit hyperactivity disorder (ADHD) and attention-deficit disorder (ADD). For your purposes as a pharmacy technician, knowing the differences between the two will not be crucial since the same medications are used to treat both disorders. Although ADHD is thought of as a childhood disease, some symptoms can persist into adult life. * Most of the drugs used to treat ADHD and ADD are amphetamines or amphetamine derivatives, which are drugs that produce increased wakefulness and focus. These drugs have a high possibility of abuse and severe dependence and therefore are classified as Schedule II. * Schedule II is a category of drugs in which dispensing is severely restricted. You will learn more about these in a later module. You have probably heard of the two most commonly prescribed Schedule II drugs used to treat ADHD and ADD, Ritalin (methylphenidate) and Adderall (amphetamine). Concerta is another brand name for methylphenidate. * Newer than the amphetamines is the drug Strattera, generic name atomoxetine. It is a non-stimulant, non-controlled substance and the only one of its kind so far for the treatment of ADHD. It has proven to be a reasonable alternative to the amphetamines with a lower risk of abuse. When any ADHD drug is dispensed, it must have a medication guide included, even if it is not a Schedule II drug.

thyroid hormones

* These hormones tell every cell in the body how fast or slow they should be "going." Obviously, these hormones play a significant role in metabolism, which, you remember, means all the chemical processes in the body. The thyroid hormones tell all the chemical processes the rate at which they should be functioning. * When the thyroid is not functioning at all or not functioning enough, it leads to feelings of fatigue, cold, dry skin, hair loss, constipation, brittle fingernails, a slowed heart rate, leg cramps, sore muscles, depression, weight gain, and the list goes on. This condition is called hypothyroidism (hypo- meaning under or slow). *By the same token, when the rate is revved up, it's not good for the body either. Hyperthyroidism is what happens when the thyroid is overactive (hyper- meaning excessive) and producing too much hormone (i.e., the rate is too high). This can lead to rapid heartbeat, tremors, weakness, hot flashes, weight loss, mood swings, frequent bowel movements. Basically, everything on the list for hypothyroidism but in reverse. *To treat low thyroid, synthetic forms of thyroid hormones are administered in prescription form. The most common of these is levothyroxine. It is sold under the brand names Synthroid and Levoxyl. Another brand name drug Cytomel uses a different generic form of the thyroid hormone, which is more potent than levothyroxine. *Administering more of the thyroid hormone is not what you need when your body is already making too much. Hyperthyroidism tends to be treated with beta blockers or drugs like propylthiouracil, which decreases the amount of hormone produced by the thyroid gland.

hormones

* They transmit important messages chemically throughout the body. The word comes from Greek and it means "impulse or 'to stir up'" And pretty much, that is just what hormones do. They travel from one cell to another cell or group of cells, "exciting " those cells into doing what they need to do to keep things running smoothly. Things like growing, sexual function and reproduction, and mood. They work slowly over time. Produced in the endocrine glands, hormones are powerful chemicals. Just a tiny amount can cause big changes. * Hormones are also responsible for metabolism which refers to "all the chemical processes in your body..." Think things like thyroid function and insulin, puberty, infertility; "all chemical processes" is really quite impressive in scope. * When the messages are not getting sent, or new messages need to be sent, synthetic versions of the hormones are prescribed by doctors, and they are used to assist all of the chemical processes of the body.

other chemotherapy agents

* Topoisomerase I inhibitors cause DNA damage when cells attempt to replicate. These drugs are Camptosar and Hycamtin. * Tyrokinase Inhibiting Agents are another type of chemotherapy agent. A tyrokinase is an enzyme that promotes growth and multiplication of a cell in response to growth factors. Tyrokinase inhibiting agents inhibit cellular growth and decrease reproduction of cells. A few of those are Sprycel, Tarceva, and Gleevec. * A number of anticancer drugs do not fit into the previously discussed categories. These miscellaneous agents have different mechanisms of action and destroy malignant cells in a variety of ways. * Panretin is a gel used to treat skin lesions by inhibiting certain cells' growth. * ONTAK was developed for treatment of lymphomas and leukemias and has also shown effectiveness against late-stage melanoma.

infertility and hormones

* Usually, the first drug used in the treatment of infertility is the generic clomiphene, sold under the brand name Clomid. It is used to induce ovulation or fix irregular ovulation and helps increase egg production. It works by tricking the pituitary gland into producing more of the follicle-stimulating hormones. It is very effective with female-factor infertility, specifically when the cause involves ovulation, and it usually works quickly. If it doesn't work in the first six months, chances are good that it won't work at all and more extreme measures will need to be taken. * The most common estrogen is called estradiol. It is measured during and is an important part of infertility diagnosis and treatment. There are a few other hormones that fall into this category: LH (luteinizing hormone) and FSH (follicle-stimulating hormone). All of these hormones are used in IVF and can be purchased under a variety of different brand names. * When an IVF is performed, the first thing that the doctors do is try to gain control of the hormones released naturally. This is so that they can more totally manipulate them. This is accomplished using a drug called Lupron. It is used to decrease the body's production of hormone. At that point, all of the drugs necessary for conception are reintroduced synthetically. This includes progesterone, estradiol, LH, and FSH. The object is to "grow" as many healthy eggs as possible at one time. *Because the entire conception process is being manipulated, it is also necessary to synthetically introduce the hormone HCG to release the eggs from the stalks. The most common brand name for this injectable drug is Pregnyl.

narcotic analgesics

* You are probably already familiar with several narcotics. Because of their addictive nature, they tend to be talked about in the news. Narcotics are prescribed for moderate to severe pain. They are also used during surgery. The following list contains a few of the generic opioids. * hydrocodone codeine oxycodone morphine methadone propoxyphene tramadol meperidine fentanyl * Most narcotic medications are not purely opioid; they're mixtures of opioids and other ingredients, designed to effectively alleviate pain. Most brand-name narcotic medications fall into this category. Narcotic medications are dispensed as tablets, as patches, or intravenously as liquid solutions.

antihyperlipidemics

* anti- against, counteracting hyper- elevated, above lipid- fats -emics in the blood * Hyperlipidemia is the elevation of lipids in the blood. Primarily this refers to cholesterol (hypercholesterolemia), although it can also mean elevated triglycerides. * When there is too much cholesterol or other fat in the blood, it can cause hardening of the arteries (atherosclerosis), because the fats deposit plaque on the walls of the arteries. Too much plaque and the blood has a hard time getting through. That can lead to a heart attack. * These drugs are also called lipid-lowering agents, and they work in a couple of different ways by decreasing the body's production of cholesterol. * There are a few different categories of antihyperlipidemics. First and most common are the "statin" drugs, technically called HMG-CoA reductase inhibitors, which work by slowing down an enzyme that is important in the creation of cholesterol. * Another type of antihyperlipidemics is bile acid sequestrants. They target the bile acids that contain cholesterol when they enter the gut and prevent them from being reabsorbed back into the gut. This includes cholestyramine, which is sold under the brand name Questran, and colestipol, sold as Colestid. * A couple different kinds of antihyperlipidemics work on lowering triglycerides. First is niacin, which is a vitamin also known as vitamin B3. A common prescription drug that has niacin as its main ingredient is Niaspan. Fibrates are also used to lower triglycerides and include the drugs gemfibrozil, sold under the brand name Lopid, and fenofibrate, which is sold under the brand name TriCor. Zetia is another drug that lowers cholesterol by inhibiting the absorption of cholesterol at the brush border of the small intestine, leading to a decreased delivery of cholesterol to the liver. It still does not have a generic available on the market, but its generic name is ezetimibe.

calcium channel blockers

*A class of drugs that are effective as treatment for hypertension. Although similar, they work a little differently than beta blockers. Calcium channel blockers work on certain types of cells, like those found in the muscles of the heart and the smooth muscles of the blood vessel walls. Unlike beta blockers, they don't work by dilating (or relaxing) the blood vessels. They work directly on the heart itself, decreasing the force of contraction of the muscle. They do this by preventing (blocking) calcium from entering the cells. * These drugs are used to treat hypertension, atrial fibrillation, angina, migraines, and Raynaud's disease.

antiemetics

*Medications that reduce the urge to vomit, also referred to as "antinausea" medications. You actually have a "vomiting center" in your brain and many antiemetics work by blocking messages to that part of your brain. That's why some of these drugs are best taken before you actually need them but when you have a sneaking suspicion that you will. (Think going on an airplane or taking the boat out fishing.) Other types of antiemetics work by coating the lining of the stomach. These are generally used for motion sickness or following surgery (and specifically the side effects of general anesthesia) or other treatments (such as chemotherapy). * So, what drugs are considered antiemetics? There are several of what we will call the "setron" (s5HT3 receptor antagonist) drugs. We'll call them that because they all end in -setron. They include dolasetron, granisetron, ondansetron, tropisetron, and palonosetron. All of these drugs work on that "vomiting center" in the brain and are considered the "gold standard" for treatment of nausea and vomiting due to chemotherapy treatment. So if a drug ends in -setron, you can be pretty sure it's an antiemetic. * Other drugs that work on the brain to relieve nausea and vomiting are the generic drugs metoclopramide (sold commonly under the brand name Reglan) and domperidone. Randomly enough, both of these antiemetics have been found to induce lactation in women as well. The generic drug scopolamine is highly effective in the treatment of nausea, vomiting, motion sickness, and intestinal cramping. However, it is also highly toxic and is given only in very small doses. * Effective antiemetics often can be used for treatment of other conditions. I'm sure that by now you are noticing that this is true of many drugs—putting a powerful agent into your body can have a number of different effects. When you are talking about nausea and vomiting, it is either caused by discomfort of the gastrointestinal system or a signal from the brain. It turns out that the brain is rather important in regulating the entire body, and the gastrointestinal system is the means by which many drugs are taken (think enteral administration). * A few antihistamines are particularly good at controlling symptoms of nausea and vomiting. These include the generic drug meclizine, which is the primary ingredient in the over-the-counter brand name Bonine, also called Antivert. If you have ever lived in a seaside community, you have seen this on the shelf in virtually every store. It is often preferable to the over-the-counter brand name drug Dramamine because it does not have as many side effects. Particularly, it does not make one so drowsy that he/she cannot possibly stay awake. * Another antiemetics class, phenothiazines, includes the generic drug promethazine which is a more powerful antiemetic. It is commonly sold under the brand name Phenergan. In the United States, promethazine is sold by prescription only. However, in the United Kingdom and other countries it is an over-the-counter medication. * Doctors commonly prescribe brand name medications Compazine and Tigan to treat nausea and vomiting as well. * Finally, Pepto-Bismol is considered an antiemetic. This is an over-the-counter medication that treats the symptoms of nausea and vomiting by providing a soothing, protective coat to the lining of the stomach.

sedatives and stimulants

*Sleep is fundamental to human health, so when we don't get enough of it, we can start to have some serious life and health problems. Approximately 6% of adults seek a physician's help because of trouble sleeping. * Insomnia is characterized by difficulty falling or staying asleep, or not feeling refreshed on awakening. Insomnia may be a chronic condition or an occasional short-term problem. Commonly prescribed drugs to treat insomnia are Ambien (zolpidem), Lunesta (eszopiclone), and Restoril (temazepam) and all of them are controlled substances. These drugs are also often referred to as sedatives. * Narcolepsy is a sleep disorder involving recurring inappropriate episodes of sleep during the daytime hours. Onset usually occurs in adolescents or young adults, and continues throughout life. It occurs four times more frequently in men than women. * Therapeutic approaches include drug and nondrug therapy. Nondrug therapy includes lifestyle changes to establish a consistent sleep schedule, avoidance of shift work, and especially avoidance of alcohol. Stimulants such as methylphenidate and dextroamphetamine, which are most commonly used for ADD, have been the drug therapy mainstay for sleepiness. Two drugs that have been approved by the FDA for narcolepsy are Provigil and Nuvigil.

Which of the following is a topical route of administration?

1) epicutaneous 2) eye drops 3) ear drops

What hormone antagonist is used in the treatment of breast cancer?

Tamoxifen

Drugs are generally known by ___ names.

3

Pharmacology's broadly defined as:

The Study of how chemical agents affect living processes. Feedback: Biology is the study of living organisms. And psychology is the science of the behavior in the mine. Anthropology is the study of human societies in cultures.

What drug class causes dilatation of blood vessels and is used primarily for the treatment of hypertension and congestive heart failure (CHF)?

ACE inhibitor

Pharmacology is broadly defined as:

The study of how chemical agents affect living processes

cephalosporins

These are a class of broad-spectrum antibiotics that are similar to penicillin but are used on strains of bacteria that have become resistant to penicillin. There are many individual antibiotics which comprise this class.

Which of the following is NOT classified as a statin?

Tricor

DMARDs reduce the level of:

Tumor necrosis factor-alpha (TNF-alpha)

The drug stem -tinib indicates the drug belongs to which of the following classes:

Tyrosine-kinease Inhibitor

Which of the following is the most common prescribe anti-coagulant?

Warfarin Rational: war far in is one of the most commonly prescribed anticoagulants; however, recently newer anticoagulants have been developed.

-andr-

androgens

-profen

anit-inflammatory/analgesic agents (ibuprofen type)

-conazole

anti-fungal (miconazole type)

-butazone

anti-inflammatory analgesics (phenylbutazone type)

-azepam

antianxiety agens (diazepam type)

-mycin

antibiotics

-oxacin

antibiotics (quinolone derivatives)

-sulfa

antibiotics (sulfonamide derivatives)

-cycline

antibiotics (tetracycline type)

-rudin

anticoagulants (hirudin type)

-triptyline

antidepressants

-pramine

antidepressants (imipramine type)

-fibrate

antihyperlipidemics

-vastatin

antihyperlipidemics (HMG-CoA inhibitors)

-pril

antihypertensives (ACE inhibitors)

-dralazine

antihypertensives (hydrazine-phthalazines)

-azosin

antihypertensives (prazosin type)

-trexate

antimetabolites (folic acid derivatives)

-rubicin

antineoplastic antibiotics (daunorubicin type)

-mustine

antineoplastics

-arabine

antineoplastics (arabinofuranosyl derivatives)

-sartan

antiotensin II receptor antagonists

-peridol

antipsychotics (haloperiodol type)

-mantadine

antivirals

Epicutaneous (topical)

application onto skin Ex: allergy testing, typical local anesthesia

PRN

as needed

H.S

at bedtime

-barb

barbituric acid derivatives

chemical name of drugs

based on molecular structure of the drug; long and complex; not generally used

-olol

beta-blockers (propranolol type)

-bactam

beta-lactamase inhibitors

-terol

bronchodilators (phenetylamine derivatives)

Oral (enteral)

by mouth many drugs as tablets, capsules or drops

-tiazem

calcium channel blockers (ditiazem derivatives)

-cef

cephalosporins

three names of drugs

chemical name, generic name, brand/trade name

-pamil

coronary vasodilators

-cort

cortisone derivatives

-pamide

diuretics (sulfamoylbenzoic acid derivatives)

-thiazide

diuretics (thiazide derivatives)

drug classification

drug may be classified by the chemical type of the active ingredient OR by the way it is used to treat a particular condition

-ase

enzymes

-erg-

ergot alkaloid derivatives

-poetin

erythropoietins

estr-

estrogens

Q

every

Q.A.M

every day before noon

q.a.m.

every day before noon

Q.H

every hour

q.h.

every hour

Q.H.S

every night at bedtime

q.d.s.

four times a day

qid

four times a day

Tube (enteral)

gastric feeding tube, duodenal feeding tube or gastrostomy many drugs and enteral nutrition

generic name of drugs

given to the drug at approval by FDA; considered the official name; generally a shortened version of chemical name; MOST OFTEN USED IN DOCUMENTATION.

poisoning

harmful effect caused by improper use of the medication --- wrong dose, wrong medication or wrong patient

adverse effect

harmful or abnormal effect as a result of taking a medication --- right patient receiving the right medication and correct dose

-parin

heparin derivatives

H,HR

hour

generic drug names

identify the active chemical substances, the stem and suffixes provide insight into drug's therapeutic purpose. Stems identify the action of the drug. Suffixes usually define the class of drug

-flurane

inhalation anesthetics

Inhalation (topical)

inhaled using a machine or inhaler Ex: asthma medications

Enema (topical)

inserted into rectum Ex: contrast media for imagine of bowel

type 2 diabetes is characterized by

insulin resistance... In type 2 diabetes, The body tissues have reduce sensitivity to the action of insulin also known as insulin resistance.

-leukin

interleukin-2 derivatives

IV (parenteral)

into a vein Ex: many drugs, TPN

IA (parenteral)

into an artery Ex: vasodilator drugs in treatment of vasospasm and thrombolytic drugs for treatment of embolism

Intraosseous infusion (parenteral)

into bone marrow as indirect IV access because the bone marrow drains directly into the venous system. -- occasionally used for drugs and fluids in emergency medicine and pediatrics when IV access is difficult

Intracerebroventricular (parenteral)

into cerebral ventricular system

Intracerebral (parenteral)

into the brain parenchyma

IM (parenteral)

into the muscle

Intrathecal (parenteral

into the spinal canal

ID

intradermal

IM

intramuscular

IV

intravenous

IVPB

intravenous piggyback

IVP

intravenous push

KG

kilogram

-lukast

leukotriene antagonists

-caine

local anesthetics

MCG

microgram

MG

milligram

ML

milliliter (cc)

-monam

monobactam antibiotics

-mab

monoclonal antibodies

A.M

morning, before noon

-curium

neuromuscular blocking agents

-tocin

oxytocin derivatives

brand / trade name of drugs

patented name of the drug; selected and is property of manufacturer; protected under copyright

-cillin

penicillins

Ear drops (topical)

placed in ear canal Ex: antibiotics and corticosteroids for otitis externa

Eye drops (topical)

placed on conjunctiva Ex: antibiotics for conjunctivits

-pred

prednisone derivatives

-gest-

progestins

-prazole

proton pump inhibitor Example-omeprazole

Which medical prescription abbreviation would a provider use to indicate the patient needs a medication every hour?

q.h.

pharmacology

science of drug action on biological systems; includes knowledge of sources, chemical properties, biological effects and therapeutic uses of drugs

-anserin

serotonin 5-HT2 receptor antagonists

-sertron

serotonin 5-HT3 receptor antagonists

-olone

steroids

basic principles of pharmacology

study of drugs, their respective actions, dosage, and administration, therapeutic uses and adverse effects

pharmacology

study of how chemical agents affect living processes

routes of administration

topical, enteral, parenteral

-bamate

tranquilizers/antiepileptics

Subcutaneous (parenteral)

under the skin

Rectal (enteral)

various drugs in suppository form