Appendix D Class Analgesics Description Relief of pain Note/s Type and degree of pain determine the type of analgesic

used: Acute pain (headache) mild ASPIRIN, ACETAMINOPHEN OR DEXTPROPOXYPHENE Severe pain (dental surgery or trauma) potent narcotic analgesics CODEINE, OXYCODONE More potent meperidine and morphine administered intermittently throughout the day Excruciating chronic pain (arthritis and cancer) MORPHINE can be administered by constant intravenous infusion to assure pain relief General anesthetics (surgical procedure) depressing cerebral nerves that carry sensory pain signals to the brain causes a loss of pain and consciousness gases or volatile liquids administered by inhalation Local anesthetics (dental extractions) for local nerve block in relieving pain for topical application to the skin and mucous membranes relieve pain of minor trauma, sunburns or painful canker sores Representative drugs LIDOCAINE (used as a cardiac membrane depressant to treat cardiac arrhythmias), PROCAINE, COCAINE By lowering the hydrochloric acid content of the stomach by neutralizing or buffering these agents reduce acid irritation Permits the ulcer to heal SODIUM BICARBONATE, SODIUM CARBONATE, ALUMINUM HYDROXIDE, MILK OF MAGNESIA, MAGNESIUM TRISILICATE Source: contaminated food or animal saliva PYRVINIUM PAMOATE, PIPERAZINE CITRATE, DIETHYLCARBAMAZINE CITRATE Primarily vasodilators and agents (beta-adrenergic blocking agents) Decrease heart rate, oxygen demand by the heart and subsequently relieve chest pain PROPANOLOL, NADOLOL, LABETALOL VASODILATORS- NITROGLYCERIN, ISOSORBIDE DINITRATE, PENTAERYTHRITOL TETRANITRATE Used as gastrointestinal antispasmodics PROPANTHELINE, BELLADONNA ALKALOIDS, ADIPHENINE, DICYCLOMINE Clot can serve as the physical barrier to blood flow resulting in a stroke or heart attack Also used as a prophylaxis to prevent possible clotting during hemodialysis and surgery HEPARIN, WARFARIN PHENYTOIN, TRIMETHADIONE, DIAZEPAM

Anesthetics

To relieve pain by interfering with nerve transmission

Antacids

Relieve gastric hyperacidity and the pain associated with duodenal or gastric ulcers

Anthelmintics

Antianginals

Anticholinergics

Anticoagulants

Anticonvulsants

To get rid of worm infestation that have gained entry to the body through the gastrointestinal tract Used to relieve the chest pain associated with increased oxygen demand by the heart muscle due to physical exertion Inhibit nerves that are primarily responsible for gastrointestinal hypersecretions and motility Inhibit the clotting mechanism in patients who have a propensity for clotting Used to depress brain nerve firing to control convulsive seizures in epilepsy Prevent or reduce convulsions in electroshock therapy, brain damage and ingestion of certain poisons

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Antidiarrheals

Act to decrease gastrointestinal activity, absorb toxins, and replace the bacteria flora

Antiemetics

Antihistamines

Antihypertensives

Anti-infectives and Sulfonamides

To antagonize the pathological effects of histamine that is released as a consequence of various disease states To lower blood pressure by: 1. Reducing vascular volume 2. Using diuretics 3. Relaxing blood vessels using vasodilators 4. Inhibiting the sympathetic nervous system 5. Using nerve ending blocking agents Natural or synthetic agents that are able to inhibit the growth (bacteriostatic) or destroy (bactericidal) microorganisms

Diarrhea Liquefaction of fecal discharges due to bacteria viruses, inflammatory processes or irritation of the bowel LACTOBACILLUS ACIDOLPHILUS bacterial culture that is used to replace bacterial flora of the lower gastrointestinal tract frequently depressed during prolong antibiotic therapy (ex. Ampicillin) that can cause diarrhea OPIUM TINCTURE (PAREGORIC), LOPERAMIDE, DIPHENOXYLATE, KAOLIN-PECTIN MIXTURE Phenothiazines Block the brain centers associated with vomiting PROCHLORPERAZINE, CHLORPROMAZINE, THIETHYLPERAZINE, TRIMETHOBENZAMIDE Antagonist to the emetic effect of anticancer drugs METOCLOPRAMIDE used before and after treatment Emesis is associated with motion sickness MECLIZINE and CYCLIZINE prevent the disturbance Used in: allergy, hayfever, common cold, asthma, etc Common effects: itching, rash and reddening, and inflammation of the skin Leading side effect: drowsiness DIPHENHYDRAMINE, CHLORPHENIRAMINE, BROMPHENIRAMINE, PROMETHAZINE, TRIPELENNAMINE Angiotensin-converting enzyme (ACE) inhibitors May also be used to lower blood pressure elevation Drugs that inhibit the renal mechanism for blood elevation DIURETICS (THUAZIDES), BETA-ADRENERGIC BLOCKING AGENTS (PROPANOLOL), NERVE ENDING BLOCKERS (RESERPINE, METHYLDOPA, GUANETHIDINE), CENTRAL NERVOUS SYSTEM BLOCKERS (CLONIDINE), VASODILATORS (HYDRALAZINE, PRAZOCIN), ACE INHIBITOR CAPTOPRIL, ENALAPRIL (VASOTEC)

Antineoplastics

Cellular toxins that function by destroying rapidly multiplying cells associated with cancer

Can be used topically on the skin in the form of ointments, creams, irrigating solutions BACITRACIN, NEOMYCIN, POLYMIXIN Can be used systematically by oral, intramuscular or intravenous administration PENICILLINS, CEPHALOSPORINS, CHLORAMPHENICOL, TETRACYCLINES, ERYTHROMYCIN, SULFONAMIDES Disinfectants ALCOHOL, ACETIC ACID, BORIC ACID, IODINE, HYDROGEN PEROXIDE, MERBROMIN (MERCUROCHROME), THIMEROSOL, GENTIAN VIOLET, ZINC OXIDE, HEXACHLOROPHENE, BENZALKONIUM CHLORIDE They also destroy normal cells that rapidly growing hair cells resulting in hair loss, gastrointestinal epithelium cells resulting in gastrointestinal ulcers, bone marrow cells resulting in blooding dyscrasias Ability to stimulat the chemereceptor trigger zone of the brain and vomiting center causing emesis, antiemetic drugs such as ASPROCHLORPERAZINE or METOCLOPRAMIDE CISPLATIN, VINSBLASTINE, VINSCRISTINE, CYCLOPHOSPHAMIDE, FLUOROURACIL

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Antitussives

Depress the central nervous system cough trigger

Antivirals

Newest drugs used for the treatment of viral infections

Bronchodilators/ antiasthmatics

Cardiac stimulants and depressant

Relax bronchial smooth muscle which dilates the airway that is usually constricted in pulmonary disease states For cardiac depression with a slow heart rate and impulse conduction through the heart

Belong to the narcotic category of drugs CODEINE, HYDROCODONE, DEXTROMETHORPHAN Can also be found in combination with antihistaminic cough preparations (GLYCERYL GUAIACOLATE WITH CODEINE) Viral infections such as Herpes simplex, Group A influenza, HIV infection ACYCLOVIR (ZOVIRAX) are used for Herpes simplex infections AMANTADINE (SYMMETREL) for Group A influenza ZIDOVUDINE (AZT) for HIV or AIDS infections Permits normal respiratory air breathing EPINEPHRINE, ISOPROTERENOL, PSEUDOEPINEPHRINE, THEOPHYLLINE

Decongestants

Cause the shrinking of mucous membranes

Digestants

Drugs that promote digestion of food in the gastrointestinal tract

Diuretics Emetics

Act on kidney to increase the output of urine To induce vomiting

Hormones

Organic compounds that are normally produced endogenously by the endocrine glands of the body

Cardiac disease Common malady of our civilization Exhibit by cardiac depression, arrhythmias Cardiac stimulants : EPINEPHRINE or ISOPROTERENOL DIGOXIN For heart failure with compromise heart muscle function Antiarrhythmic agents : QUINIDINE, PROCAINAMIDE, PROPANOLOL For overexcitability of the heart resulting in rhythm disturbances and rapid heart rates with depressed cardiac output of blood Frequently used by injection Overdosing liability is present with subsequent cardiac arrest or arrhythmia or death Vasoconstrictors Also used in cold medication combination products Should not be used with patients with hypertension PSEUDOEPHEDRINE, EPHEDRINE, PHENYLEPHRINE, DISOPYRAMIDE Gastrointestinal replacement products for normal digestion HYDROCHLORIC ACID, BILE ACIDS, PANCREATIN, PEPSIN DIASTASE SIMETHICONE is frequently used in conjunction with these agents to alleviate trapped gas (flatulence) in the gastrointestinal tract Reducing edema fluid accumulation HYDROCHLOROTHIAZIDE, FUROSEMIDE, ETHACRYNIC ACID, BUMETANIDE To eliminate poisonous substances that have been ingested IPECAC SYRUP is the most popular drug Induces vomiting within a half hour APOMORPHINE is less frequently used Pituitary hormones regulate the release of glandular hormones (releasing factors) Growth hormones regulate growth Thyroid hormones regulates the activity of all body cells Follicle-stimulating hormone and luteinizing hormone control sexual growth and development Corticotropin regulates corticosteroid release from the adrenal glands which influences the ability of the body to maintain blood pressure and withstand environmental stress. Releases vasopressin used to maintain blood pressure in uterine contractility during labor Pancreatic hormones replaces deficiencies seen in diabetes mellitus (ex. INSULIN) Ovarian hormones replace a lack of substances during menopause and ovarian dysfunction (ESTROGENS and PROGESTERONES)

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 Hypnotics and sedatives Drugs that produce and maintain sleep

Laxatives and cathartics

Tranquilizers

Miscellaneous drugs

Promote defecation in patients who are constipated or unable to empty the gastrointestinal tract of its waste materials Drugs that produce a detach calmness without depression of mental faculties or clouding of consciousness Diagnostics aids, radioisotopes

Male ANDROGENS are used to prevent negative nitrogen balance in debilitating disease to promote normal sexual function and to treat osteoporosis and inoperable breast cancer Andrenal cortical hormones are anti-inflammatory, regulate water balance together with EPINEPHRINE and NOREPINEPHRINE and maintain blood pressure Useful for the treatment of patients with sleep disturbances (insomnia) Used in lower doses as anticonvulsants to treat epilepsy BARBITURATES-SECOBARBITAL, PHENPBARBITAL, BENZODIAZEPINE BENZODIAZEPINE-FLURAZEPAM, TEMAZEPAM, TRIAZOLAM Danger of continued used of these agents are habituation with undesirable side effects Accomplish this by irritating the gastrointestinal tract, retaining water in the bowel, forming bulk, lubricating the bowel or reducing the surface tension of fecal material CASTOR OIL, PRUNES, MAGNESIUM SALTS, PHENOLPHTHALEIN, PSYLLIUM SEED, MINERAL OIL, DIOCTYLDODIUMSULFOSUCCINATE, SENNA Used for the treatment of mental and emotional disorders Also used for secondary problems such as emotional distress or agitation due to surgery or cancer PHENOTHIAZINES-CHLORPROMAZINE, TRIFLUOPERAZINE, DIAZEPAM, CHLORDIAZEPOXIDE, MEPROBAMATE

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