The Most Prescribed Medications by Class http://pharma.about.com/od/Sales_and_Marketing/a/The-Most-Prescribed-Medications-By-Drug-Class.htm

Lipid Regulators Lipid regulators, mainly statin drugs, are used to prevent dyslipidemia (high blood cholesterol) and other cardiovascular problems and have been prescribed for the prevention and treatment of many other illnesses including osteoporosis and post-menopause complications. More than 255.4 million prescriptions for statins and other lipid lowering drugs were filled in 2010.

Lipid Regulators Pfizer's Lipitor (atorvastatin calcium) was the highest selling branded statin, followed by Crestor (rosuvastatin calcium) by AstraZeneca, Other branded statins included Mevacor (lovastatin), Pravachol (pravastatin sodium), Zocor (simvastatin), Lescol (fluvastatin sodium), Vytorin (Ezetimibe/Simvastatin), and Pitavastatin. Awareness campaigns directed at physicians and directly to consumers have contributed to the growth in this class of drugs.

Lipid Regulators Inhibiting cholesterol synthesis Increasing LDL uptake Decreasing of specific protein prenylation Improve endothelial function Modulate inflammatory responses Maintain plaque stability Prevent thrombus formation

Antidepressants Antidepressants are one of the fastest growing classes of prescribed drugs. In 2010, more than 253.6 million prescriptions were filled for antidepressants, according to the IMS report. One of the main factors driving the increase in scripts for antidepressants is that a growing number of primary care providers and others practicing outside the field of psychiatry are writing the prescriptions for patients who have not received a clinical psychiatric diagnosis, according to a study published in Health Affairs journal in August 2011

Antidepressants Selective serotonin reuptake inhibitors (SSRIs) sertraline (Zoloft) fluoxetine (Prozac, Sarafem) citalopram (Celexa) escitalopram (Lexapro) paroxetine (Paxil, Pexeva, Brisdelle) fluvoxamine (Luvox) trazodone (Oleptro)

Antidepressants Serotonin and norepinephrine reuptake inhibitors (SNRIs) SNRIs help improve serotonin and norepinephrine levels in the brain. This may reduce depression symptoms. These drugs include: duloxetine (Cymbalta) levomilnacipran (Fetzima) venlafaxine (Effexor XR) In addition to treating depression, duloxetine (Cymbalta) may also relieve pain. This is important because chronic pain can lead to depression or make it worse.

Antidepressants Tricyclic antidepressants (TCAs) TCAs are often prescribed when SSRIs or other antidepressants don’t work. It isn’t fully understood how these drugs work to treat depression. amitriptyline amoxapine clomipramine (Anafranil) desipramine (Norpramin)

Antidepressants Other medications for depression - Tetracyclic antidepressant Maprotiline is used to treat depression and anxiety. It also works by balancing neurotransmitters to ease symptoms of depression.

Antidepressants Dopamine reuptake blocker Bupropion (Wellbutrin, Forfivo, Aplenzin) is a mild dopamine and norepinephrine reuptake blocker. It’s used for depression and seasonal affective disorder (SAD). It’s also used in smoking cessation.

Antidepressants 5-HT2 receptor antagonists Two 5-HT2 receptor antagonists, nefazodone and trazodone, are used to treat depression. These are older drugs. They alter chemicals in your brain to help depression. 5-HT3 receptor antagonists One 5-HT3 receptor antagonist, vortioxetine (Brintellix), treats depression by affecting the activity of brain chemicals.

Antidepressants Monoamine oxidase inhibitors (MAOIs) MAOIs are older drugs that treat depression. They work by stopping the breakdown of norepinephrine, dopamine, and serotonin. They’re more difficult for people to take than most other antidepressants. This is because they interact with prescription drugs, nonprescription drugs, and some foods. They also can’t be combined with stimulants or other antidepressants.

Antidepressants isocarboxazid (Marplan) phenelzine (Nardil) selegiline (Emsam), which comes as a transdermal patch tranylcypromine (Parnate)

Narcotic Analgesics Narcotic analgesics are prescribed for the relief of severe pain. In 2010, more than 244,300,000 prescriptions were filled for these types of pain killers. Examples of narcotic analgesics are: codeine, hydrocodone (Zohydro ER), oxycodone (OxyContin, Roxicodone), methadone, hydromorphone (Dilaudid, Exalgo), morphine (Avinza, Kadian, MSIR, MS Contin), and fentanyl (Actiq, Duragesic).

Narcotic Analgesics Big problems!!! Significant abuse potential. Addiction and overdose Narcan: Opiate antagonist http://www.dailymail.co.uk/news/article-3444210/New-Jersey-mother-dying-heroin-overdose-saved-Narcan-antidote.html#v-7343188617160245960

Narcotic Analgesics Mode of action - All opioid analgesics mimic endogenous (meaning produced by the human body) endorphins by stimulating opioid receptors in the central and peripheral nervous systems which results in relief of pain. Opioids are particularly useful in pain management as they: Can be given by a variety of routes including oral, transmucosal, rectal, intravenous, subcutaneous, intramuscular, transdermal, epidural and intrathecal; Are easily titrated to the correct dose; Are highly effective; Have a favorable risk benefit ratio.

Narcotic Analgesics

Beta Blockers Beta-adrenergic blocking agents or beta blockers (plain and in combination with other drugs, are prescribed for the treatment of heart disease, particularly high blood pressure, as well as glaucoma, hyperthyroidism and migraines. More than 191.5 million prescriptions for beta blockers were filled in 2010

Beta Blockers Commonly prescribed beta blockers include Brevibloc (esmolol), Coreg (carvedilol), Inderal (propranolol), Lopressor, Toprol-XL (metoprolol), Normodyne, Trandate (labetalol), Sectral (acebutolol), Tenormin (atenolol) and Zebeta (bisoprolol).

Beta Blockers

Ace Inhibitors Angiotensin-converting enzyme (ACE) inhibitors are used in the treatment of high blood pressure, scleroderma, migraines and other conditions. In 2010, pharmacies dispensed more than 168.7 million prescriptions for ACE inhibitors. Angiotensin-converting enzyme (ACE) inhibitors help relax blood vessels. ACE inhibitors prevent an enzyme in your body from producing angiotensin II, a substance in your body that narrows your blood vessels and releases hormones that can raise your blood pressure.

Antidiabetes Let’s talk about diabetes – huge healthcare costs 2 types Common drugs? Insulin – what does it do?

Respiratory agents Respiratory agents are drugs or a combination of drugs used to prevent, relieve or treat respiratory diseases. They can be taken as pills or liquid, for the drugs to work systemically. Or they can be available as inhalers or other forms or inhalation devices, where the medicine is delivered directly into the lungs

Respiratory agents antiasthmatic combinations - asthma Antihistamines – allergies/sensitivities Antitussives – Coughing Bronchodilators Decongestants Expectorants - gets the phlegm out leukotriene modifiers - manage allergic rhinitis or allergies, as well as prevent asthma lung surfactants miscellaneous respiratory agents respiratory inhalant products inhaled anti-infectives inhaled corticosteroids mast cell stabilizers mucolytics

Antacids, Antireflux Agents & Antiulcerants Antacids are salts of magnesium, aluminium and calcium used to neutralize the gastric acid and raise the gastric pH to treat dyspepsia and also provide symptomatic relief for peptic ulcer disease and gastro-esophageal reflux disease (GERD). Anti-reflux and Anti-ulcerant drugs are a class of drugs called proton pump inhibitors and histamine receptor blockers that stop acid secretion at the source of production and are used to treat ulcers in the stomach and the upper part of the small intestine and GERD.

High Blood Pressure and Diuretics (Water Pills) For high blood pressure, diuretics, commonly known as "water pills," help your body get rid of unneeded water and salt through the urine. Getting rid of excess salt and fluid helps lower blood pressure and can make it easier for your heart to pump. Diuretics may be used to treat a number of heart-related conditions, including high blood pressure, heart failure, kidney and liver problems, and glaucoma.

High Blood Pressure and Diuretics Thiazide diuretics, such as Esidrix or Zaroxolyn, can be used to lower blood pressure, or to treat edema in heart failure. Loop diuretics (Lasix, Bumex) are often used when people have congestive heart failure symptoms and are especially useful in emergencies. However, they do not significantly lower blood pressure. Potassium-sparing diuretics (like Aldactone, Dyrenium) help your body retain potassium and are used more often in congestive heart failure patients. They are often prescribed in conjunction with the other two types of diuretics, but also do not significantly lower blood pressure.

Anti-Epileptics Anti-epileptic drugs (AEDs) are the main form of treatment for people with epilepsy. https://www.epilepsysociety.org.uk/list-anti-epileptic-drugs#.V6QUeNIrI-k Life altering!!!!

Tranquilizers Medically, barbiturates are prescribed for acute anxiety, tension and sleep disorders. Benzodiazepines are prescribed for anxiety, acute stress reactions, and panic attacks. Some potential for abuse!

Antirheumatics Antirheumatics include drugs, which are used to treat the symptoms of rheumatoid arthritis and those that can modify the course of the disease. The drugs that help treat the symptoms such as pain and inflammation are aspirin, non-steroidal anti-inflammatory drugs (NSAIDs) and steroids. Drugs that can slow the progression of rheumatoid arthritis and help with pain, inflammation and stiffness are called disease modifying rheumatoid arthritis drugs (DMARDs).

Antirheumatics These drugs frequently modify the bodies’ own immune response: the list of possible side effects are shocking https://www.youtube.com/watch?v=IFrl-Kbe6wI

Antibiotics Taken for bacterial infection Do you take an antibiotic for the flu? Do you take an antibiotic for a cold? Do you take an antibiotic for pneumonia?

Antibiotics

Bringing a new drug to market $2.6 billion A new report published by the Tufts Center for the Study of Drug Development (CSDD) pegs the cost of developing a prescription drug that gains market approval at$2.6 billion, a 145% increase, correcting for inflation, over the estimate the center made in 2003. http://www.scientificamerican.com/article/cost-to-develop-new-pharmaceutical-drug-now-exceeds-2-5b/

Bringing a new drug to market

Process for bringing a drug to market www.fda.gov/ohrms/.../ac/.../3996S1_08_Rosario.PPT

Accidental Drug discoveries http://io9.gizmodo.com/5871300/10-happy-accidents-from-the-annals-of-drug-discovery