DRUG CLASSIFICATIONS

DRUG CLASSIFICATION PART 1

Drug Classification Drugs are classified into groups based on their similar properties. There are various systems for classifying drugs: By disorder, body system affected, type of receptor acted on, type of action, etc. We are going to be focusing on common classifications – based on what they treat (the indications).

Analgesics Action: blocks pain signals going to the brain or interferes with the brain's ability to interpret the signals Indications: Treats mild to severe pain Two Kinds: Non-narcotics Salicylates NSAIDs Acetaminophen Narcotics Opioids Opiates

Anti-infectives Action: acts against infection by killing or inhibiting the spread of the infectious agent Indications: Treats infections Sub Types: Antibiotics Antiviral Antifungal Antiprotazoal

Antineoplastic Agents Action: prevents the development, maturation, or spread of neoplastic (“cancer”) cells Works on cells that are constantly dividing, therefore affects healthy cells as well Different types work on different stages of cell division, so therapy usually involves combination of drugs Indications: Primarily used to treat cancer Sub Types: Antimetabolites: interfere with the production of DNA. Alkylating Agents: acts on DNA in cell nucleus Plant Alkaloids: blocks cell division Hormonal: interferes with an endogenous hormone required for tumor growth

Cardiovascular Agents This is a broad classification that incorporates different drugs that treat multiple conditions. Sub Types: Antianginal Antiarrhythmic Antihypertensive Diuretics Vasopressors Antihyperlipidemic Thrombolytic Anticoagulant

Cardiovascular Agents Antianginal Drugs Indications: treats angina pectoris (chest pain) Examples: Nitrates Beta-Blockers: block the effect of norepinephrine and epinephrine, to reduce the heart rate and dilate blood vessels Calcium Channel Blockers: block the entry of calcium into the muscle cells of the heart and arteries. (Calcium is needed for conduction of electrical signal that passes from muscle cell to muscle cell of the heart, signaling the heart to contract.)

Cardiovascular Agents Antiarrhythmic Drugs Action: Multiple mechanisms of action Indications: treats cardiac arrhythmias (i.e. tachycardia, bradycardia, atrial fibrillation, ventricular tachycardia) Examples: Beta-Blockers: block impulses that may cause irregular heart beat Calcium Channel Blockers: decrease conduction velocity to allow normal rhythm to be reestablished Sodium Channel Blockers: block sodium channel to decrease speed of action potential, so normal rhythm can be reestablished Potassium Channel Blockers: slows conduction of electrical impulses, so normal rhythm can be reestablished

Cardiovascular Agents Antihypertensives Indications: Hypertension (high blood pressure) Examples: Beta-blockers: blocks the action of epinephrine (adrenaline), allowing the cardiac muscles to relax. Commonly ends in “-olol” Alpha-blockers: blocks receptors in arteries and smooth muscles. This action relaxes the blood vessels and leads to an increase in blood flow and a lower pressure. Calcium Channel Blockers: decrease the force of contraction of the myocardium (muscle of the heart). Commonly ends in “-dipine” ACE Inhibitors: inhibits activity of Angiotensin Converting Enzyme (ACE), decreasing the production of angiotensin II. This causes vasodilation, which reduces blood pressure Commonly ends in “-pril”

Cardiovascular Agents Diuretics Action: lowers BP through diuresis; lowers fluid volume in the vascular system. Indications: Treats hypertension and edema Sub Types: Loop Diuretic: inhibit the body's ability to reabsorb sodium at the ascending loop in the kidney which leads to a retention of water in the urine – non potassium sparing Thiazide Diuretic: act on the distal convoluted tubule and inhibits the re-absorption of sodium and chloride leading to a retention of water in the urine – non potassium sparing Potassium-sparing diuretics: prevents sodium re-absorption and the secretion of potassium.

Cardiovascular Agents Vasopressors Action: causes vasoconstriction, resulting in increased blood pressure Indications: treats shock, dangerous drops in blood pressure, and used to manage patients in the operating room. (Commonly end in “-ine”)

Cardiovascular Agents Antihyperlipidemics Action: lowers the blood lipid levels Indications: Hyperlipidemia (high cholesterol) Subcategories: Act within GI system to lower bile (thus cholesterol): Example: Questran Acts to lower triglycerides and lipoproteins Examples: (commonly end in “-statin”) Lipitor (atorvastatin) Pravachol (pravastatin) Zocor (simvastatin) Niaspan (Niacin): Vitamin B3 – not a statin

Cardiovascular Agents Thrombolytics and Anticoagulants Action: dissolves blood clots Indications: myocardial infarction, thromboembolic CVA’s, deep vein thrombosis and pulmonary embolism Examples: tPA, streptokinase Anticoagulants Action: prevents coagulation; it stops blood from clotting Indications: to prevent new clots from forming; given to people at risk for forming blood clots Examples: heparin, coumadin

Dermatologicals Drugs in this class are used to treat disorders of the skin. Indications: Trauma (burns, cuts, abrasions, bruises), pigmentation disorders, dry skin or scaling (dandruff), cancers, non-malignant growths (keratoses). Dermatological disorders: eczema, psoriasis, acne, fungal infections (athlete’s foot, ringworm), viral infections (herpes simplex), general dermatitis, hives or other allergic reactions caused by food, plants, insects. Examples: Steroids, antihistamines, and anti-infectives

Electrolytes Action: replaces the electrolyte levels Indications: electrolyte imbalances Sub Types: Sodium: helps regulate fluid balance and plays a role in critical body functions. Potassium: regulates heartbeat and muscle function Calcium: responsible for construction, formation and maintenance of bone and teeth; blood clotting; muscle contraction Chloride: helps regulate fluid balance

DRUG CLASSIFICATION PART 2

Gastrointestinal Agents Action: control gastric acidity, regulate GI motility and water flow, and improve digestion. Indications: GERD, ulcers, diarrhea, nausea, vomiting, constipation Sub Types: Antidiarrheals Antiemetics Antacid/Antiulcer Laxatives and Stool Softeners

Gastrointestinal Agents Antidiarrheals and Antiemetics Action: multiple mechanisms of actions Indications: Treats diarrhea Antiemetics: Indications: Treats nausea, vomiting, and motion sickness

Gastrointestinal Agents Antacid and Antiulcer Action: neutralize existing stomach acid (antacid) OR reduce the amount of acid that the stomach produces, block the production of stomach acid, create a protective barrier allowing the ulcer to heal (antiulcer) Indications: Treats GERD and ulcers in the stomach and duodenum Examples: Anticholinergic drugs Histamine2 (H2)-blockers Proton Pump Inhibitors Pepsin inhibitors Sodium bicarbonate Calcium carbonate Antibiotic

Gastrointestinal Agents Laxatives / Stool Softeners Indications: treats constipation Types: Bulk forming: swell as they mix with intestinal contents Stimulants: irritate the lining and nerves of the intestine Saline: draws water into intestine to ease evacuation Osmotic: increase the stool’s water content using osmosis Stool Softeners: Action: promotes mixing of fatty and watery intestinal substances to soften the stool’s contents and ease fecal evacuation Indication: treats constipation Suppositories Oral preparations

Hematological Agents Definition: drugs that treat various forms of blood disorders Indications: coagulation disorders and anemia's Examples: Vitamin K Ferrous Sulfate: for iron deficiency anemia Cyanocobalmin: for vitamin B12 deficiency anemia

Hormones and Endocrine System Modifiers Def: drugs given to stimulate or inhibit hormone secretion. Organs and glands affected: Pituitary gland – the “master gland” Thyroid and parathyroid glands Pancreas Adrenal glands Gonads

Thyroid Hormones Parathyroid Hormones Action: replacement of thyroid hormone Indications: Treats hypothyroidism or goiter (enlarged thyroid gland) Parathyroid Hormones Action: replacement of parathyroid hormone and calcitonin Indications: Treats hypocalcemia and osteoporosis

Pancreas: Antidiabetic Agents Action: controls the body’s use of glucose Indications: Treats Type 1 Diabetes (insulin dependent) and Type 2 Diabetes (non-insulin dependent) Sub Types: Insulin Oral antihyperglycemic agents

Adrenal Glands: Corticosteroids Action: multiple actions: Anti-inflammatory affect Suppresses immune system Maintain adequate supply of serum sodium Indications: Treats inflammatory conditions – rheumatoid arthritis, colitis, lupus, allergic conditions (asthma, bronchitis, certain skin rashes) Sub Types: Glucocorticoids: influence the immune system (inflammation) Mineralocorticoids: influence salt and water balances

Estrogen and Progesterone Hormones Action: hormone replacements Indications: used to treat post-menopausal symptoms, prevent pregnancy Examples: Oral contraceptives, Premarin Testosterone Hormones (androgens) Action: hormone replacements Indications: used to treat male hypogonadism or breast cancers or engorgement.

Musculoskeletal Agents Action: multiple actions Indications: osteoporosis, osteoarthritis, and muscle pain Sub Types: Anti-osteoporosis (Fosamax) Osteoarthritis medications Muscle Relaxants (Flexeril) *Drug therapy also consists of: analgesics, NSAID’s and corticosteroids.

Neurological Agents Broad classification used to treat multiple neurological conditions. Major Neurological Disorders: Parkinson’s Disease Alzheimer’s Disease Epilepsy Migraine Headaches

Ophthalmic Agents Indications: various conditions or disorders of the eye Due to special requirements for ophthalmic formulations, often many ingredients in a product besides the active ingredient. Common Disorders: Glaucoma Infection Pain Inflammation

Psychotropic Agents Drugs in this class affect behavior, psychiatric state and sleep. Action: They act on specialized areas of the brain to suppress or control the symptoms of common psychological disorders. Indications: bipolar disorders, anxiety, depression, schizophrenia, insomnia, and drug abuse. Sub Types: Mood Stabilizers Antidepressants Antianxiety Hypnotics

Mood Stabilizers Action: multiple mechanisms of action used to suppress swings between mania and depression Indications: Treats Bipolar disorder, Borderline Personality Disorder and Schizoaffective Disorder. Sub Types: Lithium (naturally occurring mineral – an actual medication) Anticonvulsants (Antiepileptics)

Antidepressants Action: increases the levels of neurotransmitters in the brain Indications: Treats mood disorders such as major depression, anxiety disorders and social anxiety disorder. Sub Types: Selective serotonin reuptake inhibitor (SSRI’s) Tricyclic antidepressant (TCAs) Serotonin–norepinephrine reuptake inhibitors (SNRIs) Monoamine oxidase inhibitor (MAOI’s)

Antianxiety Drugs: (anxiolytics) Action: different classes of anti-anxiety drugs have different mechanisms of action. Indications: Treats anxiety and panic disorders Sub Types: Benzodiazepines (Valium, Xanax) SSRIs Barbiturates (Phenobarbitol) Pregabalin (Lyrica)

Hypnotics Action: induce sleep Indications: Treats insomnia and other sleep disorders Sub Types: Barbiturates Opioids Benzodiazepines Nonbenzodiazepines Antihistamines Melatonin Agonists (hormone)

Respiratory Agents Actions: variety of ways to clear the airways and restore normal respiration. Indications: asthma, allergies, bronchitis, emphysema, COPD, and pneumonia. Sub Types: Antihistamines Decongestants Antitussives Bronchodilators

Respiratory Agents Antihistamines Action: replace histamine at the inflammation receptor sites to reduce inflammation (prevents allergic symptoms). Additional properties include: anti-itching, antiemetic, and sedative effects. Indications: allergy symptoms, insomnia, motion sickness

Respiratory Agents Decongestants Action: cause mucous membrane vasoconstriction to reduce stuffiness & drainage Indications: common cold, seasonal allergies, or the flu Antitussives Action: acts on the central and peripheral nervous systems to suppress the cough reflex Indications: coughs

Respiratory Agents Bronchodilators Action: dilates the bronchi and bronchioles, decreasing airway resistance to improve airflow Indications: asthma, emphysema, bronchitis, and COPD Examples: Albuterol