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JDMA NURSING SCHOOL
TABLE OF CONTENTS
SR.NO. TOPICS
1 Drug Suffix , prefix and Root
2 Antibiotics
3 Pain Medications
4 Psychiatric Medication A to Z
5 Cardiac Medications
6 Endocrine Medications
7 Medications For Infection
8 Drug Card
9 Therapeutic drug levels
10 Respiratory Medications
Nursing Process Related to

11
Respiratory Medications
12 Musculoskeletal Meds
13 Vitamins
INDEX
SR.NO. TOPICS
14 Cancer Medications
15 Mood Stabilizing Medications
16 Immunosuppressant Medications
17 Drug Dosage Calculations
18 Medication Administration
Drug Delivery to the

19
Cardiovascular System
20 Antidepressants
21 Principles of Ethics for Nurses
22 Alcohol Withdrawal Medications
23 Antivirals
24 Chemotherapy Medication
25 Antianxiety Medications
26 Tuberculosis Medication
INDEX
SR.NO. TOPICS
27 Oncology Medications
28 Pregnancy Of Medications
29 Trauma Medications
30 Bronchodilators Medication
31 ADHD Medications
32 Renal & Urinary Medications
33 AIDS Medication
34 Antifungals Medications
35 Neuro Medications
36 Insulin
37 Diuretics
38 Spasmolytics
39 Notes
DRUG SUFFIXES CHEAT SHEET
–SORTED ALPHABETICALLY–
A suffix is the ending of a word, placed after the word’s stem, which
often communicates meaning. Drug suffixes are commonly used to
group drugs based on the drug’s action.
Name Drug Classification Examples Action
Increase the fluid

excreted by the
kidneys, while retaining
potassium in the body.
Potassium-Sparing spironolactone reduces cardiovascular
-actone Diuretics aldactone congestion and edema
that results from CHF.
They also lower blood
pressure.
“Clot busters” that
break down clots that
streptokinase lead to heart attacks or
-ase Thrombolytics alteplase (tPA) strokes, to restore
blood flow to the
obstructed area.
Treat and prevent

azine Antiemetics promethazine nausea and vomiting.
Prevent the
transmission of nerve
lidocaine
-caine Local Anesthetics impulses or pain
xylocaine
without causing
unconsciousness.
Broad spectrum antibiotics
tetracycline
-cycline Tetracyclines that treat bacterial
doxycycline
infections.
Relax blood vessels,
therefore increasing blood
-dipine Calcium Channel amlodipine nifedipine supply and oxygen to the
Blockers heart and reducing the
heart’s workload while
lowering blood pressure.
ciprofloxacin Broad spectrum

-floxacin Fluoroquinolones levofloxacin antibiotics that treat
bacterial infections.
Lower blood glucose

repaglinide
Meglitinides levels by triggering the
-ide nateglinide
production of insulin;
glyburide used to treat type 2
glipizide diabetes.
Sulfonylureas
diphenhydramine Treat allergy symptoms,

loratadine such as sneezing, runny
Antihistamines nose, itching, and hives,
brompheniramine
caused by histamine
activation.
-ine Block or delay the
fluoxetine reabsorption of
Selective Serotonin
sertraline serotonin; used to
Reuptake Inhibitors
treat major depressive
(SSRIs)
disorders and anxiety
disorders
Treat anxiety;
prolonged use may
-lam Benzodiazepines alprazolam
lead to physical
dependence.
Increase the fluid excreted

by the kidneys, while
atenolol retaining potassium in the
metoprolol body. reduces
-lol Beta Blockers
propranolol cardiovascular congestion
and edema that results
from CHF. They also lower
blood pressure.
Anti-inflammatory
drugs used to control
Corticosteroids methylprednisolone
-lone many different
inflammation-related
symptoms.
Broad spectrum
-micin - gentamicin
Aminoglycosides antibiotics that treat
mycin tobramycin
bacterial infections.
Treat anxiety;
alprazolam prolonged use may
-pam Benzodiazepines diazepam lead to physical
lorazepam dependence.
Dilate the bronchi and

bronchioles,
theophylline decreasing resistance
-phylline Bronchodilators in the airway and
increasing airflow to
the lungs. Often used
for asthma and COPD.
Block or delay the

reabsorption of
Selective Serotonin citalopram serotonin; used to
-pram Reuptake Inhibitors treat major depressive
(SSRIs) disorders and anxiety
disorders
Anti-ulcer drugs that

Proton Pump lansoprazole
-prazole Inhibitors
reduce gastric acid
omeprazole production.
Reduce blood pressure

captopril by dilating blood
-pril ACE Inhibitors lisinopril vessels, thus reducing
the heart’s workload.
Inhibit blood vessel

Angiotensin-II
losartan constriction, helping
-sartan Receptor
valsartan blood vessels relax,
Blockers
which lowers blood
pressure.
Anti-inflammatory
drugs used to control
-sone Corticosteroids dexamethasone many different
prednisone inflammation-related
symptoms.
Reduce LDL
atorvastatin cholesterol and lower
-statin Antilipidemics simvastatin risks from
cardiovascular disease.
Dilate the bronchi and

bronchioles,
decreasing resistance
albuterol levabutero
-terol Bronchodilators in the airway and
increasing airflow to
the lungs. Often used
for asthma and COPD.
Increase fluid and

potassium excreted by
the kidneys. Reduces
Thiazide Diuretics hydrochlorothiazide cardiovascular
-thiazide
congestion and edema
that results from CHF.
They also lower blood
pressure.
Block the action of

H2-receptor histamine in the
cimetidine
-tidine Antagonists (H2 stomach, decreasing
famotidine the production of
Blockers)
stomach acid.
Treat depression,
Tricyclic amitriptyline bipolar disorder,
-triptyline Antidepressants anxiety, OCD, and
nortriptyline
other mood disorders.
Prefix, Root, and Suffix
–SORTED ALPHABETICALLY–
Generic names tend to follow patterns, with prefixes, Roots, and suffixes
often determining the class of medication. The following table gives a list of
the prefix, root, and suffix for some common medications
prefix, root, suffix examples (generic names) drug class or drug category
betamethasone;
-asone dexamethasone; corticosteroid
diflorasone; fluticasone;
mometasone
avanafil; sildenafil; phosphodiesterase
-afil
tadalafil; vardenafil (PDE) inhibitor
betamethasone;
-asone dexamethasone; corticosteroid
diflorasone; fluticasone;
mometasone
doxorubicin; epirubicin; antineoplastic;
-bicin
idarubicin; valrubicin cytotoxic agent
butabarbital; butalbital;
-bital phenobarbital; barbiturate (sedative)
secobarbital
bupivacaine; lidocaine;
-caine mepivacaine; prilocaine; local anesthetic
proparacaine
cefaclor; cefdinir;
cephalosporin
cef-, ceph- cefixime; cefprozil;
antibiotic
cephalexin
amoxicillin; ampicillin;
-cillin dicloxacillin; nafcillin; penicillin antibiotic
oxacillin
clocortolone;
cort fludrocortisone; corticosteroid
hydrocortisone
demeclocycline;
-cycline doxycycline; minocycline; tetracycline antibiotic
tetracycline
albendazole; anthelmintic;
-dazole mebendazole; antibiotic;
metronidazole; tinidazole antibacterial
amlodipine; felodipine;
calcium channel
-dipine nifedipine; nimodipine;
blocker
nisoldipine
alendronate; etidronate; bisphosphonate; bone

-dronate ibandronate; risedronate resorption inhibitor
esomeprazole; proton pump

-eprazole
omeprazole; rabeprazole inhibitor (PPI)
-fenac bromfenac; diclofenac;

NSAID
nepafenac
besifloxacin; ciprofloxacin;
-floxacin levofloxacin; moxifloxacin; quinolone antibiotic
ofloxacin
saxagliptin; sitagliptin; antidiabetic; inhibitor

-gliptin
linagliptin of the DPP-4 enzyme
pioglitazone; rosiglitazone; antidiabetic;

-glitazone
troglitazone thiazolidinedione
brompheniramine;
-iramine chlorpheniramine; antihistamine
pheniramine
acetazolamide;
carbonic anhydrase
-lamide brinzolamide; dorzolamide;
inhibitor
methazolamide
adalimumab; daclizumab;
-mab monoclonal
infliximab; omalizumab;
antibody
trastuzumab
carmustine;
alkylating agent
-mustine estramustine; lomustine;
(antineoplastic)
bendamustine
azithromycin;
antibiotic;
-mycin clarithromycin; clindamycin;
antibacterial
erythromycin
muscarinic antagonist
-nacin darifenacin; solifenacin
(anticholinergic)
fluconazole; ketoconazole;
-nazole antifungal miconazole; terconazole;
tioconazole
atenolol; metoprolol;
-olol nadolol; pindolol; beta blocker
propranolol; timolol
fluocinolone;
-olone fluorometholone; corticosteroid
prednisolone; triamcinolone
nandrolone; oxandrolone;
-olone anabolic steroid
oxymetholone
budesonide; ciclesonide;
-onide corticosteroid
desonide; fluocinonide;
halcinonide
dexlansoprazole; proton pump

-oprazole
lansoprazole; pantoprazole inhibitor (PPI)
dalteparin; enoxaparin; antithrombotic;

parin; - fondaparinux; heparin; anticoagulant (blood
parin tinzaparin thinner)
aminophylline;
xanthine derivative
-phylline dyphylline; oxtriphylline;
(bronchodilator)
theophylline
clomipramine; tricyclic
-pramine desipramine; imipramine; antidepressant (TCA)
trimipramine
loteprednol;
pred; corticosteroid
prednicarbate;
pred-
prednisolone; prednisone
benazepril; captopril;
-pril enalapril; lisinopril; ACE inhibitor
moexipril; ramipril
fenoprofen; flurbiprofen;
-profen NSAID
ibuprofen; ketoprofen
iloperidone;
-ridone atypical antipsychotic
paliperidone; risperidone
candesartan; irbesartan; angiotensin II receptor
-sartan losartan; olmesartan; antagonist; ARB
valsartan
-semide furosemide; torsemide loop diuretic (water
pill)
alosetron; dolasetron; serotonin 5-HT3
-setron granisetron; ondansetron; receptor antagonist
palonosetron
dolasetron; granisetron; antiemetic and
-setron
ondansetron; palonosetron antinauseant
sulfacetamide; sulfadiazine; antibiotic; anti-
sulfa- sulfamethoxazole; infective; anti-
sulfasalazine inflammatory
alcaftadine;
-tadine cyproheptadine; antihistamine
desloratadine; loratadine;
olopatadine
-tadine amantadine; rimantadine antiviral; anti-
influenza-A
albuterol; arformoterol; beta agonist;
-terol formoterol; levalbuterol; bronchodilator
salmeterol
chlorothiazide; thiazide diuretic
-thiazide hydrochlorothiazide; (water pill)
methyclothiazide
crizotinib; dasatinib;
antineoplastic (kinase
-tinib erlotinib; gefitinib;
inhibitor)
imatinib
desogestrel; etonogestrel; female hormone
-trel levonorgestrel; norgestrel (progestin)
tretin-; tretin; acitretin; alitretinoin; retinoid; dermatologic
- tretin isotretinoin; tretinoin agent; form of vitamin A
almotriptan; eletriptan; antimigraine; selective

-triptan rizatriptan; sumatriptan; 5-HT receptor agonist
zolmitriptan
amitriptyline; tricyclic
-tyline
nortriptyline; protriptyline antidepressant (TCA)
abacavir; efavirenz;
vir; -vir enfuvirtide; nevirapine; antiviral; anti-HIV
ritonavir; tenofovir
-vir acyclovir; famciclovir; antiviral; anti- herpes

penciclovir; valacyclovir
cidofovir; ganciclovir;
-vir antiviral; anti- CMV
valganciclovir
-vir oseltamivir; zanamivir antiviral; anti-flu
lamivudine; stavudine; antiviral; nucleoside

-vudine
telbivudine; zidovudine analogues
clonazepam; diazepam;
-zepam flurazepam; lorazepam; benzodiazepine
temazepam
-zodone nefazodone, trazodone, antidepressant

vilazodone
-zolam alprazolam; estazolam; benzodiazepine

midazolam; triazolam
-zosin alfuzosin; doxazosin; alpha blocker

prazosin; terazosin
Antibiotics
Antibiotics are powerful medications that treat certain infections and can
save lives when used properly. They either stop bacteria from reproducing
or destroy them.
They include a range of powerful drugs used to treat diseases caused by
bacteria.
Antibiotics cannot treat viral infections, such as cold, flu, and most coughs.
The main types of antibiotics include: Penicillins - for example,
phenoxymethylpenicillin, flucloxacillin and amoxicillin. Cephalosporins -
for example, cefaclor, cefadroxil and cefalexin. Tetracyclines - for example,
tetracycline, doxycycline and lymecycline
Fast facts on antibiotics Side effects of Antibiotics

Alexander Fleming Diarrhea
discovered penicillin, the Nausea
first natural antibiotic, in Vomiting
1928. Rash
Antibiotics cannot fight viral Upset stomach
infections. Sensitivity to sunlight, when
Fleming predicted the rise of taking tetracyclines
antibiotic resistance.
Types of antibiotics
Class Examples
Pencillins Amoxicillin (Amoxil)
Macrolides Azithromycin (Zithromax)
Cephalosporins Cephalexin (Keflex)
Fluoroquinolones Ciprofloxacin (Cipro)
Lincosamides Clindamycin (Cleocin)

Allergy
A raised rash, or hives
Swelling of the tongue and face
Coughing
Wheezing
Difficulty breathing
Antibiotics to prevent infection
Antibiotics are sometimes given as a precaution to prevent, rather than treat,

an infection. This is called antibiotic prophylaxis. Situations where antibiotics
are given as a preventive treatment include:
if you're having an operation
after a bite or wound that could get infected
if you have a health problem that means you're at higher risk of infection
such as if you've had your spleen removed or you're having
chemotherapy treatment
When antibiotics are needed?
Antibiotics may be used to treat bacterial infections that:

are unlikely to clear up without antibiotics
could infect others
could take too long to clear without treatment
carry a risk of more serious complications
People at a high risk of infection may also be given antibiotics as a precaution,
known as antibiotic prophylaxis.
Missing a dose of antibiotics
If you forget to take a dose of your antibiotics, take that dose as soon as you
remember and then continue to take your course of antibiotics as
normal.But if it's almost time for the next dose, skip the missed dose and
continue your regular dosing schedule.
Pain Medications
Pain medicines, whether they’re over-the-counter or prescription strength,
can help you manage chronic pain and other kinds of pain. They’re powerful
drugs, so it's important to use them with care. It’s best to start with the
safest drugs at the lowest effective dose for the shortest amount of time and
work up from there as needed.
Over-the-Counter Pain Relievers

Over-the-counter (OTC) pain relievers include:
Acetaminophen (Tylenol)
Nonsteroidal anti-inflammatory drugs (NSAIDs), including ibuprofen,
naproxen, and diclofenac gel
Types of over-the-counter pain relievers
Common OTC pain medications include:

Acetaminophen:
This drug (Tylenol®) dulls pain receptors in the brain. As a result, you feel
less pain.
Nonsteroidal anti-inflammatory drugs (NSAIDs):
NSAIDs lower the production of prostaglandins. These hormone-like
chemicals irritate nerve endings, causing inflammation and pain. NSAIDs
include aspirin compounds (Excedrin®), ibuprofen (Advil® and Motrin®)
and naproxen sodium (Aleve®).
Combination:
Some pain relievers contain both acetaminophen and aspirin (an NSAID).
Certain OTC headache medicines also have caffeine.
Topical:
You apply this pain medication directly to your skin. It comes as a cream,
gel, spray or patch. Topical medicines block pain receptors in the brain.
They may contain aspirin, lidocaine, capsaicin pepper or other medication.
Some topical treatments make the skin feel warmer or cooler.
What do over-the-counter pain relievers treat?
OTC pain medications lower fevers and ease pain from a variety of problems,
including:
Arthritis, bursitis and tendonitis.

Back strains and sprains.
Broken bones.
Burns, including sunburns.
Colds, flu and ear infections.
Headaches and migraines.
Menstrual cramps (dysmenorrhea).
Muscle pain, including neck pain.
Surgeries and minor procedures.
Toothaches.
Prescription Pain Relievers

Prescription medicines to treat pain include:
Corticosteroids
Opioids
Antidepressants
Anticonvulsants (anti-seizure medications)
NSAIDs
What do prescription pain relievers treat?

Prescription pain relievers can alleviate pain brought on by:
Cancer.
Fibromyalgia.
Migraines.
Nerve (neuropathic) pain, including diabetes-related neuropathy.
Postoperative pain.
Severe arthritis pain.
Severe muscle pain, including back pain.
Traumatic injuries, including broken bones and burns.
Types of prescription pain relievers
Prescription pain medications provide stronger pain relief than OTC drugs.
Types of prescription pain relievers include:
Antidepressants:
Antidepressants work on chemicals called neurotransmitters in the brain.
These drugs work best for chronic pain, including migraines. The largest
pain relief comes from tricyclics (Elavil®) and serotonin-norepinephrine
reuptake inhibitors (SNRIs), such as Effexor® and Cymbalta®. Studies
show that selective serotonin reuptake inhibitors (SSRIs) like Prozac®
don’t work as well for pain. SSRIs may make other pain medicines less
effective.
Anti-seizure medications:
Medications for epilepsy interrupt pain messages to the brain. Types
include gabapentin (Gabarone®) and pregabalin (Lyrica®). These
medicines can ease nerve pain and fibromyalgia.
Muscle relaxers:
These medications reduce pain by relaxing tight muscles. They also relieve
muscle spasms.
Opioids:
Opioids are lab-made narcotic pain medicines. They change how your brain
perceives pain messages. Because they can be addictive, healthcare
providers rarely prescribe opioids for chronic pain. You may take opioids
for a short time after a surgery or traumatic injury. Codeine, fentanyl,
hydrocodone and morphine are all opioids.
Steroids:
Corticosteroids are strong anti-inflammatory drugs. Like NSAIDs, they
stop your body from making chemicals that cause irritation and
inflammation. Steroids such as Prednisone® treat migraines and severe
arthritis and back pain.
Topical:
Your provider can choose among prescription-strength skin creams, gels,
sprays and patches. They can ease muscle pain, arthritis and fibromyalgia.
Psychiatric Medication A to Z
A B C D E F
Abilify Benperidol Clozaril Denzapine Ebesque Faverin
Alaquet Biquelle Cipramil Depakote Edronax Fluanxol
Alzain Brancico Clopizol Depefex Efexor Fluoxetine
Anquil Brintellix Clopixol Depixol Epilim Flupentixol
Axalid Buspirone Cipralex Dolmatil Escitalopram Foraven
Alventa H Chloractil I L M
Amphero Haldol Circadin Imipramine Lamictal Majoven
Arpoya Halkid Cariprazine Invega Largactil Manerix
Ativan Haloperidol N Isocarboxazid Latuda Mintreleg
Allegron Heminevrin Nardil O Lecaent Modecate
P Q Nozinan Olena Li-liquid Mogadon

Psytoxil Quetiapine Nortriptyline Orap Librium Molipaxin
Prozep R Nitrazepam Oxactin Lomont S
Prozac Reaglia T Oxazepam V Seroquel
Prothiaden Risperdal Tegretol Olanzapine Valdoxan Seroxat
Priadel Reboxetine Tenprolide W Venaxx Sinepin
Politid Risperidone Tensium Welldorm Venlablue Slenyto
Phenergan X Trevicta Z Venlalic Solian
Parnate Xanax Tropium Zalasta Venlasoz Sominex
Pimozide Xeplion Temazepam Zaluron Vensir Stelazine
Paroxetine -- Trazodone Zaponex Venzip Stemetil
Phenelzine -- Trimipramine Zimovane ViePax Stesolid
-- -- -- Zispin Venlafaxine Stilnoct
-- -- -- Zolpidem Vortioxetine Sulpor

-- Zopiclone Valproate Sunveniz
-- --
-- -- -- ZypAdhera -- Surmontil
-- -- -- Zyprexa -- Sycrest
Cardiac Medications
Sacubitril/valsartan
This is the first in a class of heart Nursing points:
failure medication called angiotensin Sacubitril/valsartan should not be
receptor neprilysin inhibitors. It given with an ACE inhibitor.
combines an angiotensin receptor
blocker (valsartan) with a neprilysin Adverse effects:
enzyme inhibitor (sacubitril). Adverse effects include dizziness,
Neprilysin breaks down natriuretic fatigue, cough, hypotension, and
peptides, which are responsible for hyperkalemia.
sodium and water loss when Indications:
ventricles are overloaded. Delaying Sacubitril/valsartan is indicated
their breakdown lengthens their to reduce the risk of
effects and removes more sodium hospitalization and death in
and water from the body, decreasing patients with chronic heart
intravascular volume and blood failure and reduced ejection
pressure, resulting in decreased fraction.
preload and afterload.
Angiotensin receptor blockers

Similar to ACE inhibitors, ARBs block the Nursing points:
action of angiotensin II. However, they work ARBs and ACE inhibitors
at a different level of interaction with angio shouldn’t be used
ten – sin II, reducing the risk of hyperkalemia interchangeably. ACE
or cough that’s seen with ACE inhibitors. inhibitors are preferred
ARBs block angiotensin II receptors in the over ARBs because they’re
blood vessels and the adrenal glands. In the associated with a decrease
blood vessels, ARBs cause venous and arterial in morbidity and mortality.
dilation to reduce both preload and afterload.
Blocking angiotensin II receptors in the
Adverse effects:
ARBs are well tolerated
adrenal glands decreases the release of
and have minimal side
aldosterone, which in turn increases the
effects.
excretion of sodium and water.
Beta-blockers
Beta-blockers block the effects of Nursing points:
adrenaline, which comes on in Fluid retention may worsen heart
response to stressful situations. failure but can usually be managed
Beta-blockers are prescribed in the with diuretics. If bradycardia or
treatment of these four conditions: hypotension are problematic, the
Angina. provider may reduce the beta
Heart attack. blocker dose. Because of decreased
Congestive heart failure. heart rate and blood pressure
Abnormal heart rhythms. associated with beta blockers, they
Dosage of these medications must shouldn’t be administered at the
be adjusted for the desired response. same time as ACE inhibitors.
Your doctor will monitor you for Adverse effects:
dizziness (due to low heart rate) Adverse effects of beta blockers
kidney and liver problems. include fluid retention, fatigue,
bradycardia, and hypotension.
Examples: Bisoprolol, carvedilol, sustained-release metoprolol.
ACE inhibitors
Angiotensin-converting enzyme (ACE) inhibitors cause vasodilation in both
the venous and arterial systems, so they decrease both preload and afterload,
increasing blood flow to vital organ systems and improving ejection fraction.
These medications also block the enzyme needed to convert angiotensin I to
angiotensin II. Angiotensin II is a strong vasoconstrictor that raises blood
pressure, releases aldosterone, and leads to sodium and water retention. ACE
inhibitors prevent this cascade of effects.
Adverse effects: Nursing points:

Include hyperkalemia, renal failure, Although the cough can be
and a dry, persistent cough associated annoying, explain to the
with increased bradykinin. If the cough patient that it’s a side effect
is intolerable, the provider may of the medication and
discontinue the ACE inhibitors in favor encourage him or her to
of an angiotensin receptor blocker continue its use.
(ARB).
Ivabradine
Ivabradine, the first sinoatrial (SA)- Adverse effects:
node modulator approved to treat include bradycardia and hypotension.
heart failure, decreases normal SA
node activity and lowers heart rate. It Nursing points:
Administer ivabradine as ordered if a
does not affect myocardial
contractility. ≥
patient’s heart rate is 70 bpm.
Diuretics
Diuretics help the body get rid of Adverse effects:
Electrolyte loss.
excess fluid and sodium. This
helps reduce the work the heart Nursing points:
must do. It also decreases fluid Instruct patients to decrease their dietary
buildup in the lungs and intake of sodium, weigh themselves daily,
elsewhere in the body. It is and take the diuretic early in the day to
prescribed to lower blood prevent nocturia. Hypokalemia is a side
pressure and to reduce swelling. effect of loop diuretics, so monitor patients’
serum potassium levels
Some of the common drug names
are amiloride, chlorothiazide,
Examples:
Lasix, Lozol and Aldactone. Furosemide, bumetanide, and torsemide.
Hydralazine/isosorbide dinitrate
The drugs Adverse effects:
isosorbide include headache, dizziness, and orthostatic hypotension.
dinitrate and
hydralazine have Nursing points:
Advise patients to change position slowly to
been combined
prevent falls due to postural changes in blood
into a single pill to
pressure.
reduce both
cardiac preload Indications:
and afterload This medication decreases deaths and hospitalization
through venous in African Americans, who are less responsive to
and arterial angiotensin-converting enzyme inhibitors because of
vasodilation. suspected differences in endothelial function.
Endocrine Medications
Endocrine medications can be broken down into the following
categories:
Diabetic agents
Hormone agonists
Hormone antagonists
Diabetic Agents
Sulfonylureas (1st Generation)
Name Mechanism of Action Key Indication(s) Key Toxicity
Chlorpropamide Inhibits ATP-sensitive K+ Second-line Hypoglycemia
Tolazamide channels resulting in β- treatment for type II Renal failure
Tolbutamide cell depolarization and diabetes Disulfiram effects
insulin release
Sulfonylureas (2nd Generation)

Glipizide Inhibits ATP-sensitive K+ Second-line Hypoglycemia (long-

channels resulting in β- treatment for type II lasting)
Glyburide cell depolarization and diabetes Renal failure
insulin release Disulfiram effects
Biguinides
Exact mechanism First-line Lactic acidosis in

Metformin treatment for patients with poor
unknown
renal function
↓ gluconeogenesis type II diabetes
↑ insulin sensitivity and metabolic
↑ glycolysis syndrome
↓ serum glucose levels
↓ postprandial glucose
levels
Alpha-Glucosidase Inhibitor
Acarbose Prevents breakdown of Refractory type II Osmotic diarrhea

Miglitol carbohydrates into single diabetes mellitus Flatulence
glucose molecules
decreasing rate of
absorption
Thioglitazones
Pioglitazone Stimulates PPAR-γ which Type II diabetes Heart failure

controls insulin-sensitive combination Hepatotoxicity
Troglitazone
genes resulting in increased therapy Weight gain
insulin sensitivity in
Rosiglitazone
peripheral tissues
Hormone Agonists
Progestins
Synthetic progestin Appetite stimulant Weight gain
Megestrol
suppresses leuteinizing Anti-neoplastic Nausea
acetate
hormone by inhibition of agent Vomiting
pituitary function
Anorexic mechanism
Estrogen
Polyestradiol Inhibits actions of Palliative prostate Feminization
dihydrotestosterone cancer therapy Nausea
Blocks LH secretion by Headache
pituitary
Water retention
Decreases testosterone
synthesis
Blocks testosterone uptake
into prostate cells
Diethylstilbestrol Inhibits HPG axis Believed to decrease Clear cell carcinoma

Blocks testosterone synthesis incidence of stillbirth Vaginal adenosis
Induces chemical castration T-shaped uterus
Gonadotropin Releasing Hormones
Leuprorelin Acts as a gonadotropin Hormone Flushing

releasing hormone responsive cancer Sweating
agonist which inhibits (non-pulsatile) Fatigue
gonadotropin secretion Fertility (pulsatile) Edema
Hormone Antagonists
Anti-Estrogens
Tamoxifen Competitively binds to ER/PR positive Endometrial cancer

estrogen receptors breast cancer Growth plate fusion
inhibiting effects of Increased bone
estrogen density
Anti-Androgens
Flutamide Blocks action of Prostate cancer Gynecomastia

testosterone by binding (used prior to GnRH GI disturbance
to adrogen receptors analogues)
Enzyme Inhibitors
Anastrozole Inhibits aromatase ER/PR positive Osteoporosis

breast cancer Bone fracture
Fertility
Medications For Infection
Penicillin Cephalosporin
Penicillin is a medication used to Cephalosporins are beta-lactam
manage and treat a wide range of antimicrobials used to manage a
infections. It is in the beta-lactam wide range of infections from
antibiotic class of drugs. This gram-positive and gram-negative
activity describes penicillin's bacteria. The five generations of
indications, action, and cephalosporins are useful against
contraindications as a valuable skin infection, resistant bacteria,
agent in treating infection. meningitis, and other infections
Carbapenems Tetracycline
Carbapenems exhibit unique Tetracyclines (tetracycline,
pharmacological properties and doxycycline, minocycline,
are typically used to treat tigecycline) are a class of
complicated bacterial infections. A medication used to manage and
carbapenem is often combined treat various bacterial infections.
with an antibiotic that targets Tetracyclines classify as protein
Gram-positive bacteria when used synthesis inhibitor antibiotics and
for the empirical treatment of are considered to be broad-
patients with serious nosocomial spectrum.
infections of unidentified origin.
Macrolides
Lincosamides Macrolides are a class of drugs

used to manage and treat
Lincomycin is the prototype of this various bacterial infections.
class and clindamycin the only Azithromycin, clarithromycin,
member of this group in clinical and erythromycin are
use. Clindamycin is a bacteriostatic commonly used to treat
antibiotic. It is mainly used in the infections like pneumonia,
treatment of infections caused by sinusitis, pharyngitis, and
Gram-positive bacteria. tonsillitis.
Aminoglycoside Sulfonamide
Aminoglycosides are used in the Sulfonamides (SN) or sulfanilamides
treatment of severe infections of belong to an important class of
the abdomen and urinary tract, as synthetic antimicrobial drugs that
well as bacteremia and are pharmacologically used as broad
endocarditis. They are also used for spectrum for the treatment of
prophylaxis, especially against human and animal bacterial
endocarditis. Resistance is rare but infections
increasing in frequency
Antiprotozoal
Antifungal Antiprotozoal agents are a class of
drugs used to treat infections
Antifungal medicines are used to caused by protozoa, which are
treat fungal infections, which most single-cell organisms, belonging to
commonly affect your skin, hair and a group of parasites. Protozoans
nails. typically are microscopic and
Topical Antibacterials similar to plants and animals as
they are eukaryotes, thus having a
Topical antibacterials are clearly defined cell nucleus
commonly used for superficial
pyodermas such as impetigo and Antivirals
treatment or prevention of Antivirals are medications that help
infections following minor cuts, your body fight off certain viruses
abrasions, burns, and surgical that can cause disease. Antiviral
wounds. Several antibiotics and drugs are also preventive. They can
antiseptics are available for use in protect you from getting viral
different indications. One of the infections or spreading a virus to
major uses of topical antibacterials others.
is acne in which benzoyl peroxide
is the drug of the first choice either Antitubercular
singly or in combination with A broad-spectrum antibiotic used in
antibiotics or retinoids. the treatment of tuberculosis and
certain urinary tract infections
(UTI). An aminoglycoside antibiotic
used as an adjunct drug in
tuberculosis.
Drug Card
Drug Class Generic Name Brand Name
Dosage Indications Mechanisms of Action
Adverse Effects Contraindications Interactions
Nursing Considerations Patient Education

Therapeutic drug levels
Therapeutic drug levels are lab tests to look for the amount of a
drug in the blood.
Needle is introduced into

Tourniquet is applied
vein, blood is drawn into
and area is disinfected
vial and analyzed
How the Test is Performed?

A blood sample is needed. Most of the time, blood is drawn from a vein
located on the inside of the elbow or the back of the hand.
How to Prepare for the Test?
You will need to prepare for some drug level tests.
Your health care provider will tell you if you need to change the times
you take any of your medicines.
DO NOT stop or change your medicines without talking to your
provider first.
Why the Test is Performed?
With most medicines, you need a certain level of the drug in your blood to
get the proper effect. Some medicines are harmful if the level rises too high
and do not work if the levels are too low.
Monitoring the amount of the drug found in your blood allows your
provider to make sure the drug levels are in the proper range.
Drug level testing is important in people taking drugs such as:
Flecainide, procainamide or digoxin, which are used to treat abnormal

beating of the heart
Lithium, used to treat bipolar disorder
Phenytoin or valproic acid, which are used to treat seizures or other
conditions
Gentamicin or amikacin, which are antibiotics used to treat infections
Tacrolimus, sirolimus or cyclosporine, which are used to suppress
immune system activity against transplanted organs
Normal Test Results
Acetaminophen: varies with use
Amikacin: 15 to 25 mcg/mL (25.62 to 42.70 micromol/L)
Carbamazepine: 5 to 12 mcg/mL (21.16 to 50.80 micromol/L)

Cyclosporine: 100 to 400 ng/mL (83.20 to 332.80 nmol/L) (12 hours after dose)
Desipramine: 150 to 300 ng/mL (563.10 to 1126.20 nmol/L)

Digoxin: 0.8 to 2.0 ng/mL (1.02 to 2.56 nanomol/L)
Ethosuximide: 40 to 100 mcg/mL (283.36 to 708.40 micromol/L)

Flecainide: 0.2 to 1.0 mcg/mL (0.5 to 2.4 micromol/L)
Gentamicin: 5 to 10 mcg/mL (10.45 to 20.90 micromol/L)
Imipramine: 150 to 300 ng/mL (534.90 to 1069.80 nmol/L)
Kanamycin: 20 to 25 mcg/mL (41.60 to 52.00 micromol/L)
Lidocaine: 1.5 to 5.0 mcg/mL (6.40 to 21.34 micromol/L)

Lithium: 0.8 to 1.2 mEq/L (0.8 to 1.2 mmol/L)
Methotrexate: varies with use
Nortriptyline: 50 to 150 ng/mL (189.85 to 569.55 nmol/L)
Phenobarbital: 10 to 30 mcg/mL (43.10 to 129.30 micromol/L)

Phenytoin: 10 to 20 mcg/mL (39.68 to 79.36 micromol/L)
Quinidine: 2 to 5 mcg/mL (6.16 to 15.41 micromol/L)
Salicylate: varies with use

Sirolimus: 4 to 20 ng/mL (4 to 22 nmol/L)
Tacrolimus: 5 to 15 ng/mL (4 to 25 nmol/L) (12 hours after dose)

Theophylline: 10 to 20 mcg/mL (55.50 to 111.00 micromol/L)
Valproic acid: 50 to 100 mcg/mL (346.70 to 693.40 micromol/L)

AbNormal Test Results
Acetaminophen: greater than 250 mcg/mL (1653.50 micromol/L)
Amikacin: greater than 25 mcg/mL (42.70 micromol/L)
Carbamazepine: greater than 12 mcg/mL (50.80 micromol/L)

Cyclosporine: greater than 400 ng/mL (332.80 micromol/L)
Desipramine: greater than 500 ng/mL (1877.00 nmol/L)

Digoxin: greater than 2.4 ng/mL (3.07 nmol/L)
Ethosuximide: greater than 100 mcg/mL (708.40 micromol/L)

Flecainide: greater than 1.0 mcg/mL (2.4 micromol/L)
Gentamicin: greater than 12 mcg/mL (25.08 micromol/L)
Imipramine: greater than 500 ng/mL (1783.00 nmol/L)
Kanamycin: greater than 35 mcg/mL (72.80 micromol/L)
Lidocaine: greater than 5 mcg/mL (21.34 micromol/L)

Lithium: greater than 2.0 mEq/L (2.00 millimol/L)
Methotrexate: greater than 10 mcmol/L (10,000 nmol/L)
Nortriptyline: greater than 500 ng/mL (1898.50 nmol/L)
Phenobarbital: greater than 40 mcg/mL (172.40 micromol/L)

Phenytoin: greater than 30 mcg/mL (119.04 micromol/L)
Quinidine: greater than 10 mcg/mL (30.82 micromol/L)
Salicylate: greater than 300 mcg/mL (2172.00 micromol/L)
Theophylline: greater than 20 mcg/mL (111.00 micromol/L)

Tobramycin: greater than 12 mcg/mL (25.67 micromol/L)
Valproic acid: greater than 100 mcg/mL (693.40 micromol/L)

Respiratory Medications
Beta2-agonists Methylxanthines
Beta2-agonists (bronchodilators) Methylxanthines are relatively
are a group of drugs prescribed to weak bronchodilators that are
treat asthma. Short-acting beta- administered systemically. They
agonists (SABAs) provide quick have been used for treatment of
relief of asthma symptoms. They acute exacerbations as well as for
can also be prescribed to be taken long-term control of asthma
before exercising in order to symptoms. The most common
prevent exercise-induced methylxanthine used for asthma
bronchoconstriction. treatment is theophylline.
Decongestants Antihistamines
Decongestants are a type of An antihistamine is a prescription
medicine that can provide short- or over-the-counter medication
term relief for a blocked or stuffy that blocks some of what histamine
nose (nasal congestion). does. “Anti” means against, so
They can help ease the symptoms antihistamines are medicines that
of conditions such as colds and flu, work against or block histamine.
hay fever and other allergic
reactions, catarrh and sinusitis. Glucocorticoids
They work by reducing the swelling
Inhaled and intranasal
of the blood vessels in your nose,
glucocorticoids (GCs) are the most
which helps to open the airways.
common and effective drugs for
Examples include pseudoephedrine
controlling symptoms and airway
Types of decongestants
inflammation in respiratory
nasal sprays
diseases such as allergic rhinitis,
Drops
chronic rhinosinusitis
Tablets or capsules
with/without nasal polyps, and
Liquids or syrups
asthma, and the respiratory
Flavoured powders to dissolve
epithelium is a primary target of
in hot water
GC anti-inflammatory actions.
Nursing Process Related to Respiratory
Medications
Implementation of Interventions
Respiratory medications are available in many different formulations,

such as nasal spray, inhalations, oral tablets or liquids, injections, or
intravenous route, so it is always important to verify the correct route and
anticipate the associated side effects. For example, inhalations deliver the
required medicine or medicines directly to the lungs, which means the
medicine(s) can act directly on the lung tissues, minimizing systemic side
effects. On the other hand, intravenous medications are administered to
act quickly, but can cause systemic side effects. Additionally, some
products contain more than one medicine with different dosages (for
example, inhalers that combine a long-acting bronchodilator with a
glucocorticoid).
Respiratory medications are available in many different formulations, such

as nasal spray, inhalations, oral tablets or liquids, injections, or
intravenous route, so it is always important to verify the correct route and
anticipate the associated side effects. For example, inhalations deliver the
required medicine or medicines directly to the lungs, which means the
medicine(s) can act directly on the lung tissues, minimizing systemic side
effects. On the other hand, intravenous medications are administered to
act quickly, but can cause systemic side effects. Additionally, some
products contain more than one medicine with different dosages (for
example, inhalers that combine a long-acting bronchodilator with a
glucocorticoid).
Additionally, the nurse should also ensure the proper use of the inhalers
by the patient. Observe the patient self-administering the medication,
and further instruct the patient in proper use
Nursing Process Related to Respiratory
Medications
Nursing Process: Evaluation
Finally, it is important to always evaluate the patient’s response to a

medication. With respiratory medications, the nurse should assess
decrease in allergy symptoms (cough, runny nose, tearing eyes) and
any decrease in shortness of breath. The nurse should complete a
respiratory assessment (respirations, pulse oximetry, and lung
auscultation) before and after the medications have been administered
and compare the results. If the symptoms are not improving or the
clinical assessment is worsening, prompt intervention is required
(such as notification of the health care provider for further orders) to
prevent further clinical deterioration.
Musculoskeletal Medications
Musculoskeletal Pain
Musculoskeletal pain is pain that affects:
Bones.
Joints.
Ligaments.
Muscles.
Tendons.
Musculoskeletal pain can be acute, meaning it is sudden and severe. Or the
pain can be chronic (long-lasting). You may have localized pain (in one
area of your body), or it may affect your entire body.
Types of musculoskeletal pain

The most common types of musculoskeletal pain include:
Bone pain: Injuries such as bone fractures or other musculoskeletal
injuries cause bone pain. Less commonly, a tumor may cause bone
pain.
Joint pain: Stiffness and inflammation often accompany joint pain. For
many people, joint pain gets better with rest and worsens with
activity.
Muscle pain: Muscle spasms, cramps and injuries can all cause muscle
pain. Some infections or tumors may also lead to muscle pain.
Tendon and ligament pain: Ligaments and tendons are strong bands of
tissue that connect your joints and bones. Sprains, strains and overuse
injuries can lead to tendon or ligament pain.
Types of musculoskeletal pain

Common causes of musculoskeletal pain include:
Bone fractures.
Joint dislocation
Direct blows to muscles, bones or joints.
Overuse injuries.
Poor posture.
Symptoms of musculoskeletal pain
Symptoms may vary depending on the cause of your musculoskeletal
pain. Common symptoms include:
Aching and stiffness.
Burning sensations in the muscles.
Fatigue.
Muscle twitches.
Pain that worsens with movement.
Sleep disturbances.
How is musculoskeletal pain diagnosed?
Your healthcare provider starts a diagnosis by taking a thorough

medical history. Your healthcare provider may ask you questions to
determine:
If you have other symptoms, such as a rash or fever.
Whether your pain is acute or chronic.
Which factors make pain worse or relieve it.
Then, your healthcare provider does a hands-on exam to look for the
pain’s source. Your provider may touch or move the affected area.
How is musculoskeletal pain treated?

Your treatment plan will depend on the underlying cause of your
musculoskeletal pain. Common treatments include:
Acupuncture.
Chiropractic adjustment.
Occupational therapy.
Pain relievers.
Physical therapy.
Splints.
Steroid injections.
Therapeutic massage.
Can musculoskeletal pain treated at home?
Your healthcare provider may guide you to manage

musculoskeletal pain at home. Recommendations may include:
Hot and cold therapy.
Over-the-counter pain relievers.
Strengthening and conditioning exercises.
Stretching exercises.
Stress reduction techniques.
Medications used for musculoskeletal pain

Acetaminophen (Tylenol®).
Nonsteroidal anti-inflammatory drugs (NSAIDs).
Prescription medications, such as opioids.
How to prevent musculoskeletal pain?

Maintaining strong bones and joints is crucial for preventing
musculoskeletal pain. You can work to avoid musculoskeletal pain
if you:
Limit repetitive movements.
Use good posture.
Practice correct lifting techniques.
Stretch regularly.
How to cope with musculoskeletal pain?

To cope with musculoskeletal pain:
Avoid smoking, which increases inflammation.
Eat a healthy, non-inflammatory diet.
Rest the injured muscle, joint or bone.
Stretch daily or as often as your healthcare provider advises.
Take pain medications as prescribed.
Use ice and heat to decrease swelling and inflammation.
Vitamins
Vitamins are organic substances present in minute amounts in
natural foodstuffs. Having too little of any particular vitamin may
increase the risk of developing certain health issues.
A vitamin is an organic compound, which means that it contains
carbon. It is also an essential nutrient that the body may need to get
from food.
Fat-soluble vitamins
Vitamins A, D, E, and K are fat-soluble. The body storesTrusted Source

fat-soluble vitamins in fatty tissue and the liver, and reserves of these
vitamins can stay in the body for days and sometimes months.
Dietary fats help the body absorb fat-soluble vitamins through the
intestinal tract.
Water-soluble vitamins
Water-soluble vitamins do not stay Trusted Source in the body for long
and cannot be stored. They leave the body via the urine. Because of this,
people need a more regular supply of water-soluble vitamins than fat-
soluble ones.
Vitamin C and all the B vitamins are water-soluble.
Vitamin A
It is fat-soluble.
Function: It is essential for eye health.
Deficiency: This may cause night blindness and keratomalacia, which
causes the clear front layer of the eye to grow dry and cloudy.
Good sources: These include liver, cod liver oil, carrots, broccoli, sweet
potatoes, butter, kale, , some cheeses, eggs, apricots, cantaloupe and milk.
Vitamin B1 Vitamin B2
It is water-soluble. It is water-soluble.
Function: It is essential for Function: It is essential for the
producing various enzymes that growth and development of
help break down blood sugar. body cells and helps metabolize
Deficiency: This may cause food.
beriberi and Wernicke-Korsakoff Deficiency: Symptoms include
syndrome. inflammation of the lips and
Good sources: These include fissures in the mouth.
yeast, pork, cereal grains, Good sources: These include
sunflower seeds, brown rice, asparagus, bananas,
whole grain rye, asparagus, kale, persimmons, okra, chard,
cauliflower, potatoes, oranges, cottage cheese, milk, yogurt,
liver, and eggs. meat, eggs, fish, and green beans.
Vitamin B3 Vitamin B6
It is water-soluble. It is water-soluble.
Function: The body needs niacin for the Function: It is vital for
cells to grow and work correctly. the formation of red
Deficiency: Low levels result in a health blood cells.
issue called pellagra, which causes Deficiency: Low levels
diarrhea, skin changes, and intestinal may lead to anemia
upset. and peripheral
Good sources: Examples include chicken, neuropathy.
beef, tuna, salmon, milk, eggs, tomatoes, Good sources: These
leafy vegetables, broccoli, carrots, nuts include chickpeas,
and seeds, tofu, and lentils. beef liver, bananas,
squash, and nuts.
Vitamin B5
It is water-soluble.
Function: It is necessary for producing energy and hormones.
Deficiency: Symptoms include paresthesia, or “pins and needles.”
Vitamin C Vitamin D
It is water-soluble. It is fat-soluble.
Function: It contributes to Function: It is necessary for the
collagen production, wound healthy mineralization of bone.
healing, and bone formation. It Deficiency: This may cause
also strengthens blood vessels, rickets and osteomalacia, or
supports the immune system, softening of the bones.
helps the body absorb iron, and Good sources: Exposure to UVB
acts as an antioxidant. rays from the sun or other
Deficiency: This may result in sources causes the body to
scurvy, which causes bleeding produce vitamin D. Fatty fish,
gums, a loss of teeth, and poor eggs, beef liver, and mushrooms
tissue growth and wound also contain the vitamin.
healing.
Vitamin E Vitamin K
It is fat-soluble. It is fat-soluble.
Function: Its antioxidant activity Function: It is necessary for
helps prevent oxidative stress, an blood clotting.
issue that increases the risk of Deficiency: Low levels may
widespread inflammation and cause an unusual
various diseases. susceptibility to bleeding, or
Deficiency: This is rare, but it may bleeding diathesis.
cause hemolytic anemia in Good sources: These include
newborns. This condition destroys natto, leafy greens,
blood cells. pumpkins, figs, and parsley.
Good sources: These include wheat
germ, kiwis, almonds, eggs, nuts,
leafy greens, and vegetable oils.
Cancer Medications
The most common Trusted Source types of cancer medications include:
Alkylating agents
Nitrosoureas
Antimetabolites
Anti-tumor antibiotics
Plant alkaloids
Corticosteroids
Miscellaneous drugs that do not fall into any of these categories
Alkylating agents
The National Cancer Institute Trusted Source states that alkylating

agents were one of the earliest anticancer drugs and that they
remain among the most common treatments today. They work by
damaging the DNA of cancer cells to prevent them from dividing.
Some examples of alkylating agents include:
Altretamine Dacarbazine
Bendamustine Ifosfamide
Busulfan Mechlorethamine
Carboplatin Melphalan
Chlorambucil Oxaliplatin
Cisplatin Temozolomide
Cyclophosphamide Thiotepa
Trabectedin
Alkylating agents Treat
Doctors primarily use alkylating agents to treat slow-growing cancers,
as they are less effective against cells that divide quickly.
For example, doctors might use these medications to treat:
Breast cancer
Hodgkin disease
Lung cancer
Leukemia
Lymphoma
Multiple myeloma
Ovarian cancer
Sarcoma
Side Effects of Alkylating agents
Some side effects Trusted Source of alkylating agents may include:
Low blood pressure

Fewer periods
Blood disorders
Seizures
Hair loss
Reduced sperm production
Alkylating agents damage DNA in cancer cells, but they may also affect
bone marrow cells, which can cause leukemia.
The risk of developing leukemia is small, but it increases with larger

doses of alkylating agents. The risk of developing leukemia is highest
around 5–10 years Trusted Source after treatment.
Nitrosoureas
Nitrosoureas are a subcategory of alkylating agents that can cross

Trusted Source the blood-brain barrier. This barrier protects the brain
from many substances in the body. However, getting through the blood-
brain barrier is important for treating some cancers, including brain
cancer.
Nitrosoureas work by attaching themselves to DNA strands in cancer
cells. This prevents them from dividing.
Some examples of nitrosoureas include:
Carmustine
Lomustine
Streptozocin
Antimetabolites
Antimetabolites work by convincing cancer cells to consume them Trusted
Source and then preventing their division into new cells.
Some examples of antimetabolites include:
Azacitidin Cladribine Gemcitabine
5-fluorouracil Clofarabine Hydroxyurea
6-mercaptopurine Floxuridine Methotrexate
Capecitabine Fludarabine
Antimetabolites Treat
Antimetabolites are usually effective for treating:
Breast cancer
Leukemia
Ovarian cancer
Head and neck cancers
Anal cancer
Stomach cancer
Colon cancer
Some skin cancers
Side Effects of Antimetabolites
Some side effects Trusted Source of antimetabolites include:
Fatigue Nausea
Fever Pancreatitis
Hair loss Loss of appetite
Kidney damage Ulcers
Liver failure Vomiting
Low white blood cell count
Anti-tumor antibiotics
Anti-tumor antibiotics are chemicals that interfere with enzymes that
support growth in cancer cells.
Anthracyclines are a type of anti-tumor antibiotic. They bind with the DNA
of fast-growing Trusted Source cancer cells to prevent them from
reproducing.
Some examples of anthracyclines Trusted Source include:
Daunorubicin
Doxorubicin
Doxorubicin liposomal
Epirubicin
Idarubicin
Valrubicin
There are also several anti-tumor antibiotics that are not anthracyclines,
including bleomycin, dactinomycin, and mitoxantrone.
Anti-tumor antibiotics Treat

Doctors might use anti-tumor antibiotics to treat:
Colorectal cancer
Lung cancer
Ovarian cancer
Prostate cancer
Side Effect of Anti-tumor antibiotics
One major side effect Trusted Source of anti-tumor antibiotics is :
An increased risk of heart damage.
This side effect is rare, but it can occur with high doses of the drug. For this
reason, doctors typically limit how much of an anti-tumor antibiotic that
someone can take.
Plant Alkaloids
These are drugs that come from plants and have anti-tumor properties
Trusted Source. They have different names depending on the enzyme that
they act on.
Mitotic inhibitors, for example, are a class of plant alkaloids that prevent
cancer cells from replicating or stop enzymes from creating proteins to
support reproduction in cancer cells. Some examples of these drugs include
taxanes and vinca alkaloids.
Topoisomerase inhibitors are a class of plant alkaloids that also have
different names depending on which enzyme they work on.
Topoisomerase I inhibitors, for instance, interrupt DNA replication Trusted
Source in cancer cells. One example is irinotecan. There are also
topoisomerase II inhibitors, one example of which is etoposide.
Plant Alkaloids Treat
Plant alkaloids are useful for treating several cancers, including:
Leukemia
Lung cancer
Ovarian cancer
Gastrointestinal cancer
Colorectal cancer
Pancreatic cancer
Side Effects of Plant Alkaloids
Some possible side effects include:
Nausea
Vomiting
Abdominal pain
Diarrhea
Fatigue
Allergic reactions
Hair loss
Corticosteroids
These are synthetic versions of naturally occurring hormones that
can reduce inflammation and treat cancer.
Some corticosteroids that are useful in cancer treatment include
prednisone, methylprednisolone, and dexamethasone. Their anti-
inflammatory properties can reduce nausea, vomiting, and appetite
problems from chemotherapy.
Side Effects of Corticosteroids
Some possible side effects of corticosteroids include:
An increased risk of infections

Mood changes
Difficulty sleeping
Heartburn
Blood sugar fluctuations
Weight gain
Headaches
High blood pressure
Other Cancer Medications
Some examples of these medications Trusted Source include:
all-trans-retinoic acid mitotane
arsenic trioxide omacetaxine
asparaginase pegaspargase
eribulin procarbazine
hydroxyurea romidepsin
ixabepilone vorinostat
Alternative options for cancer treatment

Targeted therapies Immunotherapy
Cancer cells grow, divide, and spread The body’s immune system
through the body based on typically seeks and kills unusual
instructions they receive from cells around the body. Doctors use
proteins. Targeted therapies attack immunotherapy Trusted Source
those proteins and prevent them to help the body identify
from working effectively. They can cancerous cells and attack them.
help treat cancer in many ways, This can cause side effects such as
depending on the type of cancer flu-like symptoms or skin
reactions at the needle site.
Radiation therapy
Surgery
This uses high doses of radiation to
destroy cancer cells and shrink Doctors sometimes recommend
tumors. Doctors either use a surgery to remove a cancerous
machine to emit radiation from tumor. This is usually when the
outside the body or place a radiation cancer is localized and has not
device inside the body. This option spread to other areas of the body.
can also cause some side effects,
including tiredness and skin
irritation
Mood Stabilizing Medications
The oldest and most studied of mood stabilizers is lithium. However, many
drugs that were first developed as anticonvulsants to treat epilepsy also act
as mood stabilizers. These include carbamazepine, divalproex and
lamotrigine. Gabapentin and topiramate are also anticonvulsants that may
act as mood stabilizers, but they are usually given in addition to other
medications.
Lithium (lithium carbonate or lithium citrate)
Lithium (Carbolith, Duralith, Lithane) is found in nature in some mineral

waters and is also present in small amounts in the human body.
Lithium is used to treat mania and to prevent further episodes of mania and
depression.
Common side-effects of lithium
Common side-effects of lithium include increased thirst and urination,

nausea, weight gain and a fine trembling of the hands. Less common side-
effects can include tiredness, vomiting and diarrhea, blurred vision,
impaired memory, difficulty concentrating, skin changes (e.g., dry skin,
acne) and slight muscle weakness. These effects are generally mild and
fade as treatment continues. If, however, any of these effects are severe,
they should be reported to your doctor immediately. Thyroid and kidney
function can be affected by lithium in some people and must be
monitored regularly by your doctor.
Moods are a natural part of your

emotional rhythm. Understanding
your moods helps you manage them
and feel better faster.
Signs of Lithium Overdose
Lithium blood levels can increase to dangerous levels when a person
becomes severely dehydrated. Remember to drink eight to 12 cups of fluid
per day, especially when it’s hot or when you’re exercising. Severe vomiting,
diarrhea or a fever can also cause dehydration. If you have these symptoms,
stop taking lithium and see your doctor as soon as possible.
Changing the amount of salt you use can also affect lithium levels: avoid
switching to low- or no-salt diets.
Signs that the amount of lithium in the body is higher than it should be
include severe nausea, vomiting and diarrhea, shaking and twitching, loss of
balance, slurred speech, double vision and weakness.
Divalproex, valproic acid or valproate
The differing names for this anticonvulsant medication reflect the various
ways it is formulated. Divalproex (and its various forms) is used for acute
manic episodes. Brand names include Depakene and Epival.
Common side-effects of Divalproex
Common side-effects of divalproex include drowsiness, dizziness, nausea

and blurred vision. Less common side-effects are vomiting or mild cramps,
muscle tremor, mild hair loss, weight gain, bruising or bleeding, liver
problems and, for women, changes in the menstrual cycle.
Carbamazepine
Carbamazepine (Tegretol) is another anticonvulsant. It is used for mania
and mixed states that do not respond to lithium or when the person is
irritable or aggressive
Common side-effects of carbamazepine
include dizziness, drowsiness, blurred vision, confusion, muscle tremor,

nausea, vomiting or mild cramps, increased sensitivity to sun, skin
sensitivity and rashes, and poor co-ordination.
A rare but dangerous side-effect of carbamazepine
A rare but dangerous side-effect of carbamazepine is reduced blood cell

counts. People who take this drug should have their blood monitored
regularly for this effect. Soreness of the mouth, gums or throat, mouth
ulcers or sores, and fever or flu-like symptoms can be a sign of this effect
and should be reported immediately to your doctor. If carbamazepine is the
cause of these symptoms, they will go away when the medication is stopped.
Lamotrigine
Lamotrigine (Lamictal) may be the most effective mood stabilizer for

depression in bipolar disorder, but is not as helpful for mania.
The starting dose of lamotrigine should be very low and increased
very slowly over four weeks or more. This approach decreases the risk
of a severe rash—a potentially dangerous side-effect of this drug.
Common side-effects of lamotrigine
Include fever, dizziness, drowsiness, blurred vision, nausea, vomiting or
mild cramps, headache and skin rash. Although it is rare, a severe skin rash
can occur with lamotrigine. Any rashes that begin in the first few weeks of
treatment should be reported to your doctor.
What does Mood Stabilizing Medication do?

How mood stabilizers work is not fully understood. It is thought that the
drugs work in different ways to bring stability and calm to areas of the
brain that have become overstimulated and overactive, or to prevent this
state from developing.
Side effects of Mood Stabilizing Medication
The side-effects of mood stabilizers vary depending on the type of

medication. With some medications, side-effects are kept to a
minimum through regular monitoring of the level of the drug in the
blood. Some people experience no side-effects. Others may find the
side-effects distressing. Side-effects usually lessen as treatment
continues.
Check the information given to you by your doctor or pharmacist on
the specific effects of any drug you have been prescribed. If side-
effects are not mild and tolerable, let your doctor know as soon as
possible. Your doctor may:
adjust your dose
suggest you take the medication at a different time of day
suggest you take your medication with food
prescribe other medications to help control side-effects
change your medication.
Immunosuppressant Medications
Immunosuppressants are drugs or medicines that lower the body's ability
to reject a transplanted organ.Your immune system recognizes and attacks
anything different from the substances normally present in your body,
even those only slightly different, like your newly transplanted kidney.
The immune system does not discriminate between harmful substances,
like bacteria, fungi and viruses, and transplanted organs — so your
immune system responds to your new kidney as a foreign substance that
needs to be eliminated.
To protect your new kidney, we prescribe a variety of medications to
suppress your body's natural immune response. These medications are
called "immunosuppressants," and they trick the immune system into
believing that your new organ is not foreign, and thus it is not attacked.
After transplantation, you will be taking immunosuppressant medications
for the rest of your life.
The following are a list of common post-transplant medications.
Cyclosporines (Neoral®, Gengraf®, Sandimmune®)
Purpose
Neoral® is an immunosuppressive medicine that helps prevent organ
rejection.
Dosage
The dose we prescribe for you is based on your lab values. The capsules come
in 25mg, 50 mg and 100mg sizes; the liquid in 100mg/cc strength.
When
In the morning, take with breakfast after your lab work is completed.
Repeat the dose in the pm, 12 hours after your am dose. If you are on
Cyclosporin twice a day, your blood level must be measured 12 hours after
your last dose.
Most children and some adults may be on a three times a day schedule, if so,
each dose must be 8 hours apart and blood level must be drawn 8 hours after
the last dose.
Precautions
Cyclosporine blood levels may be altered by some medicines. Before you
take any new drugs please contact the transplant team. New mothers
taking cyclosporine are advised NOT to breast feed.
Common Side Effects
Headache, tremors, fluid retention, decreased kidney function, elevated
potassium levels, high blood pressure, hot flushes, diarrhea,
nausea/vomiting, hair growth, gum swelling, increased risk of infection,
joint discomfort, leg cramping, low magnesium levels.
Tacrolimus (Prograf®, FK506)
Tacrolimus (Prograf®, FK506)
Purpose
Prograf® is an immunosuppressive medicine that helps prevent organ
rejection.
Dosage
The dose we prescribe for you is based on your lab values. The capsules
come in .5mg, 1mg, 5mg, and in a solution of 5mg/ml.
When
In the morning, take with breakfast after your lab work is completed.
Repeat the dose in the pm, 12 hours after your am dose.
Precautions
Prograf® blood levels can be altered by some medicines. Before you take
any new drugs please contact the transplant team. New mothers taking
Prograf are advised NOT to breast feed.
Common Side Effects
Headache, tremors, seizures, change in mental staus,
insomnia/nightmares, high blood sugar, high-blood pressure, anemia,
loss of appetite, diarrhea, decreased kidney function, leg cramping,
elevated potassium levels, lowered magnesium levels, hair loss.
Mycophenolate mofetil (CellCept®)
Purpose
CellCept® is an immunosuppressive medicine that helps prevent organ
rejection.
Dosage
The dose we prescribe for you is based on your lab values. The capsules
come in 250mg and 500mg sizes. Liquid formulation can be made by your
pharmacist in a concentration of 200mg/cc.
When
In the morning, take on an empty stomach. Repeat the dose in the pm, 12
hours after your am dose.
Precautions
Antacids such as Maalox and Mylanta decrease your body's absorption of
CellCept. You should never take antacids at the same time as CellCept.
You will be prescribed other medicines to protect your stomach, such as
Prilosec or Prevacid, while on CellCept.
Common Side Effects
Nausea, vomiting, low white blood cell count, loss of appetite, abdominal
pain, diarrhea, anemia.
Prednisone
Purpose
Prednisone is an immunosuppressive medicine that helps prevent organ
rejection.
Dosage
BE SURE TO READ LABEL INSTRUCTIONS.
Adults: Use only 5mg tablets unless instructed otherwise by the transplant
team.
Children: Prednisone in liquid formulation of 1mg/cc concentration is
recommended.
When
In the morning, take on an empty stomach. Repeat the dose in the pm, 12
hours after your am dose.
Common Side Effects
Mood swings, depression, euphoria, irritability, thrush, increased risk of
infection, joint discomfort, muscle deterioration, osteoporosis, high blood
sugar, "moonface," cataracts, height-ened sun sensitivity, acne, high blood
pressure, increased appetite, vision changes weight gain, fluid retention.
Azathioprine (Imuran®)
Purpose
Imuran® is an immunosuppressive medicine that helps prevent organ
rejection.
Dosage
The dose we prescribe for you is based on your weight and white blood
cell count.
Adults: Tablets are available in 50mg size which can easily be broken in
half.
Children: Imuran can be taken in the same 50mg tablet form, or in a
liquid formulation of 10mg/cc.
When
At bedtime with your other nighttime medications.
Precautions
Certain medications, such as allopurinol, can increase the effects of
Imuran and further deplete your white blood cell count. Remember to
always contact the transplant team before taking any new medication.
Common Side Effects
Decreased white blood cell count, decreased platelet count, hair loss.
Rapamune® (Sirolimus)
Purpose
Rapamune is an immunosuppressive medicine that helps prevent organ
rejection.
Dosage
Available in liquid formulation at a 5mg/ml concentration and 1mg tablets.
When
In the morning, take consistently either before or after breakfast.
Precautions
Rapamune levels can be altered by certain medications. Remember to always
contact the transplant team before taking any new medication. New mothers
taking Rapamune are advised NOT to breast feed.
Common Side Effects
Low white blood cell count, low platelet count, high cholesterol levels, leg
swelling, joint pain, headache, diarrhea, anemia.
Zenapax® (Daclizumab) and Simulect® (Basiliximab)
Purpose
Both are immunosuppressive medicines that help prevent organ rejection.
Dosage
One of these medications, which are administered only by IV, may be given
at the time of your operation, and in the first few days to weeks post-
operatively.
When
The transplant team orders the medication and it will be administered by
the nurse during your hospitalization, or as an out patient in the
Comprehensive Transplant Center.
Common Side Effects
Constipation, nausea, diarrhea, edema, abdominal distention.
OKT3® (Monoclonal Antibody)

Purpose
OKT3 is an immunosuppressive medicine that helps prevent organ
rejection.
Dosage
Administered intravenously only.
Adults:
Usually receive 5 to 10mg per day over 7 to 14 days.
Children:
Usually receive 2.5 to 5mg per day over 7 to 14 days.
When
The transplant team orders the medication and it will be administered
by the physician during your hospitalization, or in the Comprehensive
Transplant Center after your discharge.
Common Side Effects
Fever, chills, flu-like symptoms, shortness of breath, headache,
lowered blood pressure, joint pain, diarrhea.
Guidelines for Taking Medications

1. Always take your medications at the same time every day.
2. Never skip a dose. If you accidentally miss a dose, call the
transplant team.
3. Do not stop taking or change the dose of any medication without
prior knowledge and approval of the transplant team.
4. Call your transplant team if you are experiencing side effects from
your medications, or are having vomiting or diarrhea.
5. Never take medications other than those prescribed by your
transplant team, including over-the-counter medications or those
prescribed by other physicians without first calling the transplant
team.
6. Store your medications out of reach of small children.
7. Store medications in a cool, dry place.
NOTE:
REMEMBER THAT NOT TAKING MEDICATIONS AS PRESCRIBED IS

ONE OF THE MOST COMMON REASONS FOR TRANSPLANT FAILURE.
Therefore, be very careful when taking medications. Call your
transplant team with any questions or concerns no matter how small
they may seem. Some of your immunosuppressive medicines are
dosed by the levels of the drug in your blood. That is why it is
important to have your blood tested at the correct time.
Drug Dosage Calculations
Abbreviations Commonly Used in Dosage
Abbreviation Term Tips for Correct Calculations:
po by mouth (or orally) Make sure that all measurements are in the same units. If necessary,
convert
susp suspension between units.
pm • In most cases, it is best to convert a larger unit to smaller units (e.g.
as needed
convert
tab tablet grams to milligrams). This conversion uses multiplication and most
often keeps the
cap capsule
calculation in whole numbers.
q every • Always check for reasonableness of your answer. Does the drug
dosage make
bid twice a day sense? (Amounts less than half a tablet or greater than 3 tablets are
tid three times a day not common,
but still possible.)
qid four times a day
Formula: D/H * Q=X Desired/Have * Quantity=X
Term Symbol Meaning Example
"Give 500 milligrams" "

Dosage ordered The amount of medication Give grains/v" "
D
or desired dose that the physician prescribed Give 1.2 milliliters"
Dosage strength The amount of drug in a 250 milligrams

or supply on H specific unit of measure Grains/v
hand (what is available; in stock)
Unit of measure The unit of measure for the per 2 milliliters

or quantity of Q specific dosage strength or per capsule
unit supply on hand per tablet
Unknown The dosage you are

S Not applicable
Dosage trying to calculate
Dosage Calculations Conversions
1 kg = 2.2 lb 1 lb = 16 oz 1 mg = 1,000 mcg

1 gallon = 4 quart 1 tbsp = 3 tsp 1 cm = 10 mm
1 tsp = 5 mL 60 minute = 1 hour 1 tbsp = 15 mL
1 inch = 2.54 cm 1 cc = 1 mL 1 cup = 8 fl oz
1 L = 1,000 mL 2 pints = 1 qt 1 pint = 2 cups
1 kg = 1,000 g 8 oz = 240 mL = 1 glass 12 inches = 1 foot
1 oz = 30 mL = 2 tbsp 1 tsp = 60 gtt 1 L = 1.057 qt
1 g = 1,000 mg 1 pt = 500 mL = 16 oz 1 oz = 30 mL
Unit Conversions
Mass: Converting lb to kg and kg to lb
→ → →
mcg mg g kg ( ÷ by 1,000 ) lb = kg × 2.2
← ← ←
mcg mg g kg ( x by 1,000 ) kg = lb ÷ 2.2
→
lb kg ( ÷ by 2.2 ) Converting mL to L and L to mL
←
lb kg ( x by 2.2 ) mL = L × 1,000
Volume: L = mL ÷ 1,000
mcL → mL → L → kL ( ÷ by 1,000 ) Converting mg to g, g to mg, mg to mcg,
mcL ← mL ← L ← kL ( x by 1,000 ) and mcg to mg
Time: mg = g × 1,000
min → hr ( ÷ by 60 ) g = mg ÷ 1,000
min ← hr ( x by 60 ) mcg = mg × 1,000 mg = mcg ÷ 1,000
Figuring IV flow rate, infusion time, and total volume

flow rate (mL/hr) = total volume (mL) ÷ infusion time (hr)
infusion time (hr) = total volume (mL) ÷ flow rate (mL/hr)
total volume (mL) = flow rate (mL/hr) × infusion time (hr)
Example: if you must administer 1 L (1,000 mL) of fluid over 4 hours, use the first
formula to calculate the flow rate, like so:
flow rate (mL/hr) = total volume (mL) ÷ infusion time (hr)
flow rate (mL/hr) = 1,000 ÷ 4
flow rate (mL/hr) = 250

The flow rate is 250 mL/hr.
Drug Dosage Calculations Formula
Dosage By Weight Mass for Mass

Formula: Formula:
Weight in Kg * Dosage Per Kg = Y Ordered \ Have
(Required Dosage) = Y (Tablets Required)
Mass/Liquid For Liquid IV Fluid

Formula: Formula:
Ordered \ Have x Volume Per Have Volume (mL) \ Time (min) x Drop Factor
= Y (Liquid Required) (gtts/mL) = Y (Flow Rate in gtts/min)
Volume/Time - IV mL Volume/Time - IV Drop

Formula: Formula:
Volume (mL) \ Time (hr) Concentration % \ 100 x Volume (mL)
= Y (Flow Rate in mL/hr) = Y (Dosage Amount in g)
Volume/Time - IV mL Volume/Time - IV Drop

Formula: Formula:
Volume (mL) \ Time (hr) Volume (mL) \ Time (min) x Drop Factor
= Y (Flow Rate in mL/hr) (gtts/mL) = Y (Flow Rate in gtts/min)
Fluid Maintenance
Weight Range Required Daily Fluid
0-10 kg 100 mL per kg
10-20 kg 1,000 mL + 50 mL per each kg above 10 kg
20-70 kg 1,500 mL + 20 mL per each kg above 20 kg
Over 70 kg 2,500 mL (adult requirement)

TYPES OF DOSAGE FORMS
Classification
Physical state
Route of Administration
Based on
Site of Application
Uses
Based on Physical state
SOLID SEMI-SOLID LIQUID GAS
1. Monophasic liquid:
1. Unit solid:
Syrup
tablets
solution
capsules
2.Biphasic liquid:
2. Bulk dosage emulsion
form: suspension
powder
Inhaler
dusting powder
aerosols
Cream
paste
gel
suppositories
TYPES OF DOSAGE FORMS
Based on Physical state
Oral Parenteral Rectal Trans dermal
Powders Solutions Suppositories Ointments

Tablets Suspensions Enemas Powders
Capsules Emulsions Ointments Creams
Solutions Vaginal Solutions Pastes
Suspensions Suppositories Intranasal Lotions

Emulsions Tablets Solutions Plasters
Syrups Ointments Sprays Intra ocular
Elixirs Creams Inhalations Solutions
Magmas Douches Intra respiratory Ointments

Gels Sublingual Aerosols Suspensions
Cachets Tablets Conjuntival --
Pills Lozenges Ointments --
Site of Application Uses

1. Skin- Ointments, creams, lotions, liniments 1. Internal – all
2. Eye- Solutions, ointments, creams preparations except
3. Tooth- Tooth powder, tooth paste external
4. Hand- Hand creams, lotions, hand washings 2. External – Ointments,
5. Foot- Creams, ointments, dusting powders lotions, creams,
6. Hair- Hair cream, hair lotions, shampoos, hair powders, solutions,
fixing liniments, paste, hair
7. Nasal- Solutions, sprays, inhalations dyes, hair colorants
Metric System
9 KEY FACTS
Weight VOLUME
Kilogram (kg) Liter (L)
Killo-graham-cracker Liter-of-cola
In the metric system ,the gram (g/gm) is In the metric system, the liter (L) is
used to describe weight. 1 kilogram (kg)= used to describe volume.1 liter =
1,000 grams (g). 1,000 milliliters (mL).
Gram (g/gm)
Graham-cracker Milliliter (mL)
In the metric system, the gram (g/gm) is Millionaire-liter-of-cola
used to describe weight. 1 gram (g) = 1,000 In the metric system, the liter (L) is
milligrams (mg). used to describe volume. 1 liter =
Milligram (mg) 1,000 milliliters (mL).
Millionaire-graham-cracker
In the metric system, the gram (g/gm) is
used to describe weight. 1 milligram (mg) =
LENGTH
1,000 mcg.
Microgram (mcg) Meter (m)
Microphone-graham-cracker Meter-Pan
In the metric system, the gram (g/gm) is In the metric system, the meter is used
used to describe weight. 1,000 microgram to describe length.
(mcg) = 1 milligram (mg).
CONVERTING
Larger to Smaller: Multiply

Large Metro Car Turned into a Small Metro Car by Multiplying
The metric system applies the idea that units within the system get larger or smaller by
a power of 10. Conversions between the units in the metric system can be done by
multiplying or dividing by 1,000. To convert larger to smaller, multiply by 1,000, or
move the decimal point 3 places to the right.
Smaller to Larger: Divide
Small Metro Car Turned into a Large Metro Car by Dividing
The metric system applies the idea that units within the system get larger or smaller by
a power of 10. Conversions between the units in the metric system can be done by
multiplying or dividing by 1,000. To convert smaller to larger, divide by 1,000 or move
the decimal point 3 spaces to the left.
Medication Routes of Administration
Introduction
A medication administration route is often classified by the location at

which the drug is administered, such as oral or intravenous. The choice of
routes in which the medication is given depends not only on convenience
and compliance but also on the drug’s pharmacokinetics and
pharmacodynamic profile. Therefore it is crucial to understand the
characteristics of the various routes and techniques associated with them.
Many interprofessional healthcare team members are involved in the
administration of medications to patients.
Anatomy and Physiology

Enteral Route of Medication
Oral administration of medication is a convenient, cost-effective, and
most commonly used medication administration route. The primary
site of drug absorption is usually the small intestine, and the
bioavailability of the medication is influenced by the amount of drug
absorbed across the intestinal epithelium. The first-pass effect is an
important consideration for orally administered medications. It refers
to the drug metabolism whereby the drug concentration is
significantly diminished before it reaches the systemic circulation,
often due to the metabolism in the liver.
A sublingual or buccal route is another form of the enteral route of

medication administration that offers the benefit of bypassing the
first-pass effect. By applying the drug directly under the tongue
(sublingual) or on the cheek (buccal), the medication undergoes a
passive diffusion through the venous blood in the oral cavity, which
bypasses the hepatic portal vein and flows into the superior vena cava.
Compared to sublingual tissue, which has highly permeable mucosa
with rapid access to the underlying capillaries, buccal tissue is less
permeable and has slower drug absorption
A rectal route is another enteral route of medication administration,
and it allows for rapid and effective absorption of medications via the
highly vascularized rectal mucosa. Similar to sublingual and buccal
routes, rectally administered medications undergo passive diffusion
and partially bypass the first-pass metabolism. Only about half of the
drug absorbed in the rectum directly goes to the liver.
Parenteral Route of Medication

Intravenous injection is the most common parental route of
medication administration and has the benefit of bypassing the first-
pass metabolism by the liver. Given their superficial location on the
skin, peripheral veins provide easy access to the circulatory system
and are often utilized in the parenteral administration of medications.
The upper extremity is usually the preferred site for intravenous
medication as it has a lower incidence of thrombophlebitis and
thrombosis than the lower limbs. The median basilic or cephalic veins
of the arm or the metacarpal veins on the hand's dorsum are
commonly used. In the lower extremity, the dorsal venous plexus of
the foot can be used.
An intramuscular medication route can be administered in different

body muscles, including deltoid, dorsogluteal, ventrogluteal, rectus
femoris, or vastus lateralis muscles. Although the dorsogluteal site, or
the buttock's upper outer quadrant, is a common site chosen
traditionally for intramuscular injections by healthcare professionals,
it poses a potential risk of injury to the superior gluteal artery and
sciatic nerve.[3] On the other hand, the ventrogluteal site, or the
anterior gluteal site, targets the gluteus medius muscle and avoids
these potential complications; thus, it is recommended.
The intraarterial route is not commonly used for drug

administration. Injection of contrast material after an arterial
puncture is done for angiography. The other uses of this route
are for the administration of regional chemotherapeutic
agents and for the treatment of malignant tumors of the brain.
Subcutaneous injections are another form of the parental route of
medication and are administered to the layer of skin referred to as
cutis, just below the dermis and epidermis layers. Subcutaneous tissue
has few blood vessels; therefore, the medications injected undergo
absorption at a slow, sustained rate. Subcutaneous medication can be
administered to various sites, including the upper arm's outer area,
abdomen avoiding a 2-inch circle around the navel, the front of the
thigh, the upper back, or the upper area of the buttock behind the hip
bone.
Other Routes of Medication
A transnasal drug route facilitates drug absorption by passive

diffusion across the single-layered, well-vascularized respiratory
epithelium directly into the systemic circulation.
An inhaled medication is delivered rapidly across the large surface

area of the respiratory tract epithelium. Drugs absorbed into the
pulmonary circulation enter directly into the systemic circulation via
the pulmonary vein, bypassing the first-pass metabolism. The particle
size of the inhaled medication is usually 1 to 10 µm for effective
delivery. The efficacy of drug delivery to the lungs depends not only
on the drug particle size and morphology but also on the patient’s
respiratory physiology, such as tidal volume and tracheal inspiration
velocity.
A vaginal route is an underexplored drug delivery route that is not

commonly used but has the advantage of bypassing the first-pass
effect and can serve as an effective method for local and systemic
therapy. The venous plexuses from the vagina communicate with the
vesical, uterine, and rectal venous plexuses and drain into the internal
iliac veins. The veins from the middle and upper vagina drain directly
into the inferior vena cava and bypass the hepatoportal system.
The transdermal route can deliver drugs through the skin. The
common methods of administration through this route are local
application formulations like transdermal ointments and gels, drug
carriers like nanoparticles and liposomes, and transdermal patches.
The intraosseous route is useful especially in neonates for the

administration of fluids and drugs when both peripheral and central
venous accesses have failed.[6] Clinical trials are now being conducted
on its usefulness in the administration of drugs in out-of-hospital
cardiac arrest.It is also used for the administration of prophylactic
antibiotics for regional surgeries.
Indications
Enteral Route of Medication
1. Oral
This is convenient and is indicated for patients who can ingest and tolerate
an oral form of medication. Some medications with short half-lives are
administered orally as timed-release or sustained-release forms that get
absorbed over several hours.
Advantages:
Ease of administration
Widespread acceptance by the patients.
Disadvantages:
Variable absorption rates
Degradation of some drugs before reaching the site of absorption into the
bloodstream
The inability of many compounds to effectively traverse the intestinal
epithelial membrane cells to reach the bloodstream.
The insolubility of many drugs at low pH levels prevalent in the digestive
tract.
The inactivation of the drug in the liver on its way to the systemic
circulation
Irritation of the mucous lining of the gastrointestinal tract. This can be
prevented to some extent by coating
2. Sublingual and Buccal Routes
These are indicated for medications with high first-pass metabolism that
need to avoid clearance by the liver. For instance, nitroglycerin is cleared
more than 90% during a single pass through the liver; therefore, it is given
in a sublingual form.
Advantages:
Rapid absorption due to the abundant mucosal network of systemic
veins and lymphatics, thereby leading to a rapid onset of action.
If there is any untoward event, the tablet can be removed.
Avoids first-pass hepatic metabolism.
A tablet can be kept for a long duration of time in the buccal cavity
which helps the development of formulations having a sustained-
release effect.
This route is useful in patients having swallowing difficulties.
Low risk of infection
Convenience
Disadvantages:
The tablet has to be kept in place in the buccal cavity and neither
chewed nor swallowed.
Excessive salivation may cause quick dissolution and absorption of the
tablet.
Patients may find it difficult to accept an unpalatable tablet. Hence
some drugs are applied as a patch or a spray.
3. Rectal Route
This route is useful for patients with gastrointestinal motility problems
such as dysphagia or ileus that can interfere with delivering the drug to the
intestinal tract. The rectal route is also often utilized in patients near the
end of life undergoing hospice care.
Advantages:
A relatively big amount of the drug can be administered.
Those drugs that are destroyed by the acidic medium in the stomach
and those metabolized by pancreatic enzymes can be administered
effectively.
Safe and convenient for infants and the elderly.
Can be used in emergency situations such as in infants having seizures
when the intravenous route is unavailable.
The rate of absorption is uninfluenced by the ingestion of food or the
rate of gastric emptying.
Bypasses hepatic metabolism
Less degradation of drugs compared to that in the upper
gastrointestinal tract.
Disadvantages:
Some hydrophilic drugs like antibiotics and peptide drugs are not
suitable for rectal administration as they are not readily absorbed.
Some drugs can cause rectal irritation and proctitis leading to ulceration
and bleeding.
Parenteral Routes of Medication

1. Intravenous Route
This can be utilized in administering nasal decongestants for cold or allergy
treatment. Other uses include desmopressin for the treatment of diabetes
insipidus or intranasal calcitonin for the treatment of osteoporosis.
Factors that affect the rate of absorption of drugs via the nasal route are:
1. The rate of nasal secretion - The rate of secretion is inversely
proportional to the bioavailability of the drug.
2. Ciliary movement - The speed of ciliary movement is inversely
proportional to the bioavailability of the drug.
3. Vascularity of the nose - The volume of blood flow is directly
proportional to the rate of drug absorption.
4. Metabolism of drugs in the nasal cavity - The enzymes present in the
nasal tissues alter the absorption of some compounds especially
peptides that are disintegrated by aminopeptidases.
5. Diseases affecting nasal mucous membrane. Common colds can affect
nasal drug absorption.
Enhancement of nasal drug delivery:
Rapid mucociliary clearance can lead to poor bioavailability of the drug.
This can be overcome by in situ gelling drug delivery.
Chitosan is a natural bioadhesive polysaccharide obtained from
crustacean shells that can be used as an absorption enhancer. Chitosan
binds to the nasal mucosal membrane and facilitates drug absorption
through paracellular transport and other mechanisms.
Advantages:
Increased permeability of the nasal mucosa compared to the
gastrointestinal mucosa.
Highly vascularized subepithelial tissue.
Quick absorption, usually within thirty minutes
Avoids the first-pass effect.
Avoids the effects of gastric stasis and vomiting.
Ease of administration.
Higher bioavailability of the drugs than in the case of the enteral route
or inhalational route.
Disadvantages:
Nasal cavity diseases and conditions may result in impaired absorption.
The dose is limited due to the small area available for absorption.
The time available for absorption is limited.
This route is not applicable to all drugs.
2. Inhalational Route
The alveolar epithelium is approximately 100 square meters in adults and
the alveolar volume is 4000–6000 mL when compared to the airway volume
of 400 ml. This provides a greater surface area for absorption of the inhaled
substances. An inhaled medication route can be utilized to administer
albuterol or corticosteroids such as fluticasone and to deliver inhaled
anesthetics to patients.
Barriers to the absorption of substances in the alveoli are surfactants,
surface lining fluid including the mucus, the epithelial membrane,
extravascular space, and vascular endothelium. The absorption of
macromolecules by the lungs is considered to be by transcytosis (not
significant for macromolecules >40 kDa), paracellular absorption, and drug
transporter proteins.
Advantages:
Large surface area
Proximity to blood flow
Avoids first-pass hepatic metabolism
Only smaller doses are enough to achieve equivalent therapeutic effects
as the oral route
Disadvantages:
The aerodynamic filter of the lungs has to be overcome.
Clearance of particles by the mucus lining the airways.
Only 10–40% of the drug from a conventional inhalation device is
actually deposited in the lungs.
3. Vaginal Route
This is not commonly used but can deliver low, continuous dosing of
medications which can help achieve stable drug levels. A variety of
formulations can be given vaginally, including tablets, creams, gels,
ointments, and pessaries. Common medications given via the vaginal route
include vaginal estrogen therapy for urogenital atrophy, contraceptive
rings, antibiotics, or antifungals.
4. Vaginal Route
Iontophoresis and microneedles are playing an increasing role in
transdermal drug delivery. A technique has been described using hydrogel-
forming microneedle arrays in combination with electro-phoresis for
controlled transdermal delivery of biomacromolecules in a simple, one-step
approach
Drug Delivery to the Cardiovascular System
Methods for local administration of drugs to the cardiovascular system are:
Delivery to the myocardium - direct intramyocardial injection, drug-
eluting implanted devices.
Delivery via the coronary venous system.
Delivery via cardiac catheter into coronary arteries
Intrapericardial delivery
Delivery into the arterial lumen from drug-eluting stents
Drug Delivery to the Central Nervous System (CNS)

The blood-brain barrier is a major obstruction to the delivery of drugs into
the central nervous system.
Some methods to reduce the obstruction by this barrier include:
Systemic administration of drugs for CNS action
Direct administration of drugs to the CNS - Intrathecal[14], into the
cerebral arteries, into the brain parenchyma, and direct positive
pressure infusion
Drug delivery by manipulation of the blood-brain barrier
Drug delivery using novel formulations like conjugates, and
nanocarriers-based delivery systems (including polymeric nanocarriers,
micelles, nanotubes, dendrimers, magnetic nanoparticles, and quantum
dots (QDs))[15]
Drug delivery systems like pumps and catheters
Use of microorganisms like bacteriophages and bacterial vectors
Cell therapy - CNS implants of live cells or genetically engineered cells
Gene transfer - Direct injection into the CNS, intranasal instillation,
retrograde axonal transport, or through vectors.
Antidepressants
Depression is a mental health issue that starts most often in early adulthood.
It’s also more common in women. However, anyone at any age may deal with
depression.
Depression affects your brain, so drugs that work in your brain may prove
beneficial. Common antidepressants may help ease your symptoms, but there
are many other options as well.
Each drug used to treat depression works by balancing certain chemicals in
your brain called neurotransmitters. These drugs work in slightly different
ways to ease your depression symptoms.
Many common drugs for depression fall into the following drug classes
Trusted Source:
Selective serotonin reuptake inhibitors (SSRIs)

Serotonin-norepinephrine reuptake inhibitors (SNRIs)
Tricyclic antidepressants (TCAs)
Tetracyclic antidepressants
Dopamine reuptake blockers
5-HT2 receptor antagonists
5-HT3 receptor antagonists
Monoamine oxidase inhibitors (MAOIs)
Mirtazapine
Selective Serotonin Reuptake Inhibitors (SSRIs)
SSRIs are the most commonly

prescribed class of antidepressants. An
imbalance of serotonin may play a role
in depression. These drugs fight
depression symptoms by decreasing
serotonin reuptake in your brain. This
effect leaves more serotonin available to
work in your brain.
(SSRIs) Include: Common side effects of SSRIs
Sertraline (Zoloft) Nausea

Fluoxetine (Prozac, Sarafem) Trouble sleeping
Citalopram (Celexa) Nervousness
Escitalopram (Lexapro) Tremors
Paroxetine (Paxil, Pexeva, Sexual problems
Brisdelle)
Fluvoxamine (Luvox)
Serotonin-Norepinephrine Reuptake Inhibitors (SNRIs)
SNRIs help improve serotonin and norepinephrine levels in your brain. This
may reduce depression symptoms.
These drugs include:
Desvenlafaxine (Pristiq, Khedezla)
Duloxetine (Cymbalta)
Levomilnacipran (Fetzima)
Venlafaxine (Effexor)
In addition to treating depression, duloxetine may also relieve pain. This is
important because chronic pain can lead to depression or make it worse. In
some cases, people with depression become more aware of aches and pains.
A drug that treats both depression and pain, such as duloxetine, can be
helpful to these people.
Common side effects of SNRIs
Common side effects of SNRIs includeTrusted Source:

Nausea
Drowsiness
Fatigue
Constipation
Dry mouth
Tricyclic Antidepressants (TCAs)
TCAs are often prescribed when TCAs Include

SSRIs or other antidepressants don’t
work. It isn’t fully understood how Amitriptyline (Elavil)
these drugs work to treat Amoxapine (Asendin)
depression. Clomipramine (Anafranil)
Desipramine (Norpramin)
Common side effects of TCAs Doxepin (Silenor)
Imipramine (Tofranil)
Constipation
Nortriptyline (Pamelor)
Dry mouth
Protriptyline (Vivactil)
Fatigue
Trimipramine (Surmontil)
Blurred vision
Tetracyclic antidepressants
Tetracyclic antidepressants, like Common side effects
Maprotiline (Ludiomil), are used to
treat depression and anxiety. They Drowsiness Blurry vision
also work by balancing Weakness Dry mouth
neurotransmitters to ease Lightheadedness
symptoms of depression. Headache
Dopamine Reuptake Blockers

Dopamine reuptake blockers, like Common side effects
Bupropion (Wellbutrin, Forfivo,
Aplenzin), are a mild dopamine Nausea
and norepinephrine reuptake Vomiting
blockers. They are used for Constipation
depression and seasonal affective Dizziness
disorder. They are also used for Dlurry vision
quitting smoking.
5-HT2 Receptor Antagonists
Two 5-HT2 receptor antagonists, Common side effects
nefazodone (Serzone) and trazodone
(Oleptro), are used to treat
Drowsiness
depression. These are older drugs.
Dizziness
They alter chemicals in your brain to
Dry mouth
help depression.
5-HT3 Receptor Antagonist

The 5-HT3 receptor antagonist Common side effects
vortioxetine (Brintellix) treats
depression by affecting the activity Sexual problems
of brain chemicals. Nausea
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
because they interactTrusted Source with prescription drugs,
nonprescription drugs, and some foods. They also can’t be combined with
stimulants or other antidepressants.
MAOIs include: Common side effects
Isocarboxazid (Marplan) Dizziness

Phenelzine (Nardil) Drowsiness
Selegiline (Emsam), which comes Trouble sleeping
as a transdermal patch Restlessness
Tranylcypromine (Parnate)
Mirtazapine
Mirtazapine (Remeron) is used Common side effects
primarily for depression. It alters
certain chemicals in your brain to Drowsiness
ease depression symptoms Dizziness
Weight gain
Uses of Antidepressants
Antidepressants are commonly prescribed for a number of medical
diagnoses, including Trusted Source:
Major depressive disorder
Persistent depressive disorder (dysthymia)
Premenstrual dysphoric disorder
Obsessive-compulsive disorder (OCD)
Social anxiety disorder
Panic disorder
Generalized anxiety disorder (GAD)
Post-traumatic stress disorder (PTSD)
Side effects
Medications to treat depression generally come with side effects. The
specific changes you may experience depend in part on the class of drug
you’re taking.
Common side effects:
Gastrointestinal symptoms: indigestion, diarrhea, constipation, loss of

appetite
Feelings of sickness: headache, dizziness, dry mouth, sweating
Nervousness: agitation, shakiness, nervous feeling
Heart rhythm changes: palpitations, fast heartbeat
Vision changes: blurry vision
Weight changes: unexpected weight loss or weight gain
Sexual dysfunction: low sex drive
Sleep changes: insomnia
Principles of Ethics for Nurses
Autonomy Justice
Autonomy is recognizing each
Justice is that there should be an
individual patient’s right to self-
element of fairness in all medical
determination and decision-making.
and nursing decisions and care.
As patient advocates, it is imperative
Nurses must care for all patients
that nurses ensure that patients
with the same level of fairness
receive all medical information,
despite the individual's financial
education, and options in order to
abilities, race, religion, gender,
choose the option that is best for
and/or sexual orientation.
them. This includes all potential
An example of this is when working
risks, benefits, and complications to
at a free flu clinic or diabetes
make well-informed decisions.
screening clinic. These are open to
Once the patient has all relevant
all individuals in the community
information, the medical and
regardless of the previously
nursing team can make a plan of care
mentioned factors.
in compliance with the medical
wishes of the patient.
It is important that nurses support Nonmaleficence
the patient in their medical wishes
and ensure that the medical team is Nonmaleficence is to do no harm. This
remembering those wishes. is the most well known of the main
Sometimes, nurses will need to principles of nursing ethics. More
continue to advocate for a patient specifically, it is selecting
despite the wishes being verbalized. interventions and care that will cause
the least amount of harm to achieve a
beneficial outcome
Beneficence The principle of nonmaleficence
ensures the safety of the patient and
Beneficence is acting for the good community in all care delivery. Nurses
and welfare of others and including are also responsible to report
such attributes as kindness and treatment options that are causing
charity. The American Nurses significant harm to a patient which
Association defines this as “actions may include suicidal or homicidal
guided by compassion.” ideations.
Principles of Ethics for Nurses
Fidelity Veracity
People want to know they can Working in healthcare is

count on nurses, no matter what. challenging for many reasons, and
Fidelity as an ethical principle in some cases, nurses must
can best be described by keeping communicate unpleasant
your word. Nurses should be information to a patient. Veracity
honest and loyal to each patient, is the ethical principle of being
as this helps the nurse gain trust completely open and honest with
and fulfill their professional patients, even if the truth causes
commitment. Without fidelity, distress. While being completely
more trusting relationships truthful can be daunting, especially
cannot be formed, which leads to in certain patient care
less positive patient outcomes circumstances, it is important for
and less trust in professional establishing trust and
relationships. strengthening the nurse-patient
relationship. Veracity also helps
patients become more
autonomous, making decisions for
their care based on all relevant,
factual information.
Alcohol Withdrawal Medications
Detoxing from alcohol is often the first phase of the rehabilitation process
for those looking to recover from alcohol use disorder (AUD).
When chronic or excessive alcohol use leads to significant physical

dependence, that person may experience withdrawal symptoms when he or
she decides to quit drinking.1
For those at risk of severe alcohol withdrawal, doctors may prescribe

certain medications to alleviate discomfort, stop the progression or
worsening of symptoms, and minimize the likelihood of further withdrawal
complications.2 Read on to learn more about the treatment of alcohol
withdrawal and some of the alcohol withdrawal syndrome medication that
is used to help ease the symptoms felt.
In significantly severe cases of alcohol withdrawal, detoxification

professionals may administer medications to help with the easing of alcohol
withdrawal symptoms. Although some withdrawal episodes may appear to
not need pharmacological intervention, foregoing medications may, in
some cases, have adverse consequences for any future withdrawal
episodes.2
The failure to adequately manage withdrawal with medications with could

result in a type of neurotoxicity which, by way of a phenomenon “kindling”,
could put patients at a greater risk of seizures following repeated
withdrawal episodes.2
Benzodiazepines
Used to treat panic, anxiety, and to control certain types of seizures,

benzodiazepines are a class of sedative medications. These drugs are
physicians’ agents of choice to manage a large portion of the more
problematic alcohol withdrawal symptoms. For example, benzodiazepines
can significantly reduce the risk of seizures in those suffering from alcohol
withdrawal symptoms.
Frequently used benzodiazepine pharmaceutical agents used to treat alcohol

withdrawal symptoms include chlordiazepoxide (Librium) and diazepam
(Valium).
Longer-acting benzodiazepines with active metabolites are common first-

line medications since their use may result in a lower chance of recurrent
withdrawal or seizures.6 Shorter-acting benzodiazepines may play a
relatively more important role for withdrawal mangement in the elderly or
in those with chronic liver issues directly related.2
Benzodiazepines that are specifically FDA-approved to manage acute alcohol

withdrawal syndrome include:7
Chlordiazepoxide (e.g., Librium).

Clorazepate (e.g., Tranxene).
Diazepam (e.g., Valium).
Oxazepam (e.g., Serax).
Anticonvulsants
Besides benzodiazepines, physicians sometimes prescribe other seizure

medications to help manage acute alcohol withdrawal syndrome symptoms
during severe alcohol withdrawal. Some of the additional anticonvulsant
medications that may be utilized to help manage alcohol withdrawal
include:8
Carbamazepine (e.g., Tegretol)
Gabapentin (e.g., Neurontin)
Oxcarbazepine (e.g., Trileptal)
Valproic Acid (e.g., Depakene)
Depending on the specific person suffering from alcohol withdrawal, seizure
medications may either be used as a replacement for benzodiazepines, or
alongside benzodiazepines. One advantage to these types of anticonvulsants
is that they have less potential for abuse than benzos. However, these
medications don’t necessarily prevent DTs or grand-mal seizures.
Barbiturates
Barbiturates are another class of drugs that may be used to treat alcohol
withdrawal symptoms in benzodiazepine-resistant cases of alcohol
withdrawal syndrome. In particular, their use in the emergency department
and in the intensive care unit for severe cases of alcohol withdrawal has
shown immense promise. However, to clarify the distinct role of barbiturates
in alcohol withdrawal syndrome, additional studies are needed.8
Disulfiram (Antabuse)
Disulfiram inhibits an enzyme used to metabolize alcohol. Regular

maintenance use of disulfiram will result in unpleasant effects even when
someone consumes small amounts of alcohol.9
When used as prescribed, to help a person stop drinking, these effects may
begin to be felt as soon as 10 minutes after consuming alcohol and include
anxiety, headache, flushing of the face, sweating, blurred vision, nausea, and
vomiting.9
In turn, these effects may discourage a drinker from drinking and could lead
them to associate drinking with these negative symptoms. Typically, effects
can last for 1 hour or more. Through its aversive reaction with alcohol,
disulfiram is used to discourage continued drinking behavior.9
Naltrexone (Vivitrol,Revia)
Originally used in treating individuals with opioid use disorders, naltrexone

was approved in 1994 by the FDA as treatment for alcohol dependence.11
Although the precise way naltrexone works to decrease drinking behavior
isn’t entirely understood, reports from patients who’ve successfully been
treated with the drug suggest that its effects include reducing the urge or
desire to drink, helping them stay abstinent and interfering with their desire
to continue drinking if they have a sip of alcohol.11
Naltrexone may cause liver damage when taken in large doses and should
not be given to patients with hepatitis or liver disease.13
Acamprosate (campral)
Used alongside counseling and social support, acamprosate is thought to

restore a balance in the central nervous system between the glutamate and
gamma-aminobutyric acid (GABA), excitatory and inhibitory
neurotransmitters, respectively.14
Acamprosate does not prevent symptoms of alcohol withdrawal and may

not be effective in those who have not stopped drinking alcohol, drink it in
large amounts, or abuse other substances.15
In contrast with other FDA-approved treatments for alcohol dependence

(naltrexone and disulfiram), because acamprosate is not metabolized by the
liver and does not adversely interact with alcohol, it can be used in patients
with liver disease or hepatitis, as well as in those who continue to drink.14
However, according to several trials, it doesn’t appear to be more successful
than naltrexone or disulfiram in reducing drinking behavior.14
Acute Alcohol Withdrawal Symptoms
Symptoms of acute alcohol withdrawal may range from mild to physically
dangerous, with some relatively mild symptoms arising within 8 hours after
the last drink.1
Depending on the magnitude of physical dependence, additional symptoms

may continue to arise beyond 24 hours, with some potentially severe effects
emerging 2 to 4 days after abstinence.3
Symptoms of alcohol withdrawal may include: 1,3
Insomnia.
Irritability.
Anxiety.
Agitation.
Mood swings.
Depression.
Fatigue.
Nausea or vomiting.
Sweating.
Increased heart rate.
High blood pressure.
Hand tremor.
Seizures (in rarer cases, severe alcohol withdrawal is associated with a
syndrome known as delirium tremens, or DTs).
The Dangers of Delirium Tremens (DT)
In some instances of pronounced alcohol dependence and severe
accompanying withdrawal, a person may develop a neurological syndrome
called delirium tremens (DTs) that is characterized autonomic nervous
system excitation and significant changes in mental status.5
Though relatively rare, DTs are most commonly seen in those with a history
of alcohol withdrawal and who’ve abused alcohol for more than 10 years, or
drink daily, for months on end.5
Typically, DTs are only present in around 5% of patients experiencing

withdrawal.2 Symptoms may include:5
Hallucinations.
Agitation.
Severe confusion or disorientation.
Seizures.
If you suspect you or someone you know is experiencing this form of
withdrawal, seek medical attention immediately. Delirium tremens may
prove highly dangerous and even life-threatening if left untreated.
Medication for Alcohol Detox

Some medications are useful in managing acute alcohol withdrawal. These
medications include:2
Benzodiazepines.
Phenobarbital and other types of bartbiturates.
Anticonvulsants.
Conlidine and other types of beta-blockers.
Antipsychotics.
Benzodiazepines for Alcohol Withdrawal
Benzodiazepines are a cross-tolerant with alcohol, meaning that they affect
the same parts of the brain.5 As such, many programs consider
benzodiazepines as the primary drug used to help alleviate the symptoms of
alcohol withdrawal.5 Due to the cross-tolerant nature of the drug, benzos can
be used as a substitute for alcohol, potentially mitigating withdrawal
symptoms while the detoxification process continues.2
Other Medications for Alcohol Withdrawal

There are three other types of medications that may be used in alcohol
withdrawal, though their use tends to be less common. Generally, these
medications will be used with specific symptoms appear during the
withdrawal process. Some of these medication types include:
Anticonvulsants: Anticonvulsant medications are still being studies to

determine their usefulness in treating alcohol withdrawal symptoms.2
Early studies show that certain anticonvulsant medications are effective in
treating mild or moderate alcohol withdrawal, but may come with
drawbacks of their own.2 Research still needs to be done to determine the
full effectiveness of anticonvulsants, both old and new, in treating alcohol
withdrawal, but those who are experiencing only mild withdrawal
symptoms may be prescribed some of the medications.
Clonidine and other Beta-Blockers: Clonidine and beta-blockers are
another type of medication that one may experience when receiving
medical treatment for alcohol withdrawal. While beta-blockers are
relatively ineffective at mitigating most withdrawal symptoms, they can
be highly effective at reducing rapid heartbeat or high blood pressure
during the process.2 As such, one may be prescribed clonidine and beta-
blockers as supportive medications to help manage those specific
symptoms.2
Antipsychotics: Antipsychotic medications may be prescribed to help
mitigate certain alcohol withdrawal symptoms like agitation, hallucinations,
delusions, or delirium.2 While these medications can be effective at reducing
these withdrawal symptoms, many antipsychotics could reduce the seizure
threshold, possibly putting the patient at higher risk for experiencing a
seizure.2
Barbiturates for Alcohol Withdrawal

Despite being used for the treatment of alcohol withdrawal symptoms for
many years, barbiturates are gradually falling out of usage.2 Many
barbiturates are questionably effective at treating alcohol withdrawal
symptoms, and the drug’s long half-life (length of time it stays in the body)
and addictive qualities means that taking barbiturates other than prescribed
or for extended periods could lead to addiction, overdose, or death. While a
certain barbiturate, phenobarbital, continues to be used, this is usually done
in highly supervised settings.2
Risk for Severe Alcohol Withdrawal Symptoms
Not everyone who struggles with alcohol abuse will experience severe or
complicated withdrawal. The manifestation of acute alcohol withdrawal
syndrome varies greatly from person to person. Those who are at very high
risk during alcohol withdrawal include:2,3
Those with a history of delirium tremens or withdrawal seizures.

Those who have consumed high amounts of alcohol in the weeks prior to
withdrawal.
Those who have been regular drinkers for two decades or more.
Older adults.
People with co-occurring mental health or physical conditions.
Those in poor general health, such as those with nutritional deficiencies.
Those who’ve suffered head trauma in the past.
Antivirals
Antiviral medications help the body fight off harmful viruses. The drugs can
ease symptoms and shorten the length of a viral infection. Antivirals also
lower the risk of getting or spreading viruses that cause herpes and HIV. One
approved antiviral treats the coronavirus that causes COVID-19.
Antivirals are medications that help your body fight off certain viruses that
can cause disease. Antiviral drugs are also preventive. They can protect you
from getting viral infections or spreading a virus to others.
Viruses
Viruses are tiny (microscopic) infectious agents that grow and multiply only
inside living cells of an organism. Viruses have receptors that allow them to
attach to healthy (host) cells in your body. Once a virus attaches to and enters
a host cell, it can replicate (make copies of itself). The host cell dies, and the
virus infects other healthy cells.
Sometimes, viruses remain in a host cell without replicating or damaging it.

The virus is still there (which means you could be contagious), but you don’t
have symptoms. This latent, or inactive, virus can become active at any time
and cause symptoms or be passed on to others. The way viruses spread
depends on the type of virus.
Viruses can spread through: modes of viral spread (differs by type of virus):
Contaminated bodily products like blood, urine, feces (poop), vomit,

ejaculate (semen) and saliva.
Bug bites (transfer of a virus from a bug’s saliva into a person’s blood).
Skin-on-skin contact, including sex.
How do antiviral medications work?
Antiviral medicines work differently depending on the drug and virus type.
Antivirals can:
Block receptors so viruses can’t bind to and enter healthy cells.

Boost the immune system, helping it fight off a viral infection.
Lower the viral load (amount of active virus) in the body.
What do antivirals treat?
Most viruses clear up without antiviral medications. Healthcare providers

prescribe antivirals to treat chronic or life-threatening viral infections,
including:
Coronaviruses like COVID-19.

Ebola.
Flu, including H1N1 (swine flu).
Genital herpes.
Hepatitis B and hepatitis C.
Human immunodeficiency virus (HIV).
Can antivirals cure viral infections
Antiviral drugs can ease symptoms and shorten how long you are sick with
viral infections like the flu and Ebola. They can rid your body of these
viruses.
Viral infections like HIV, hepatitis and herpes are chronic. Antivirals can’t get
rid of the virus, which stays in your body. However, antiviral medicines can
make the virus latent (inactive) so that you have few, if any, symptoms.
Symptoms that develop while you take antivirals may be less severe or go
away faster.
Can antivirals prevent the spread of viral infections
Yes, antiviral drugs can keep you from getting certain viral infections after a
suspected or known exposure. For instance, taking specific antivirals:
During pregnancy lowers the risk of a mother passing HIV to her newborn
(babies also receive antiviral medicine after delivery).
Daily lowers the risk of giving herpes or HIV to others or getting HIV from
an infected partner.
Within 72 hours of a potential HIV exposure can lower the chances of
getting infected.
Within 48 hours of exposure to the flu virus may keep you from getting sick.
How do you take antiviral medications?

Most antivirals are oral drugs that you swallow. But you may also receive
antiviral medications as:
· Eyedrops.
· Inhaled powder.
· Injection (shot) into a muscle.
· IV into a vein.
· Topical (skin) ointments or creams.

Difference between antibiotics vc antivirals
Antibiotics help the immune system fight off bacterial infections. Bacteria
typically reproduce outside of cells, making it easier for medicines to target
them. An antibiotic can usually treat many different types of bacterial
infections. But the drugs do not affect viruses.
Each antiviral only works against a specific virus. Because viruses inside cells
are harder to target, antiviral drugs are more challenging to develop. There
are more viruses than antiviral drugs to treat them.
Side effects of antivirals
Side effects from antivirals vary depending on the drug type and strength
(dosage). You may experience:
Cough.
Dry mouth.
Diarrhea.
Dizziness.
Fatigue.
Headaches.
Insomnia.
Joint pain or muscle pain.
Nausea and vomiting.
Skin rash.
Most of these side effects happen after the first dose of the medicine, and
most of them will usually stop as treatment continues.
Less common side effects include:
sleeping difficulties
skin reactions
heart rhythm abnormalities
hallucinations
abnormal behaviour
Chemotherapy Medication
Chemotherapy, often called chemo for short, uses medicines to stop or slow
the growth of breast cancer cells. Chemotherapy for breast cancer and other
cancers is considered systemic therapy because it travels through the
bloodstream and affects the whole body.
Breast cancer cells grow and divide faster than healthy, normal cells.
Chemotherapy affects rapidly dividing cells, such as cancer cells, more than it
affects healthy cells. Still, chemotherapy medicines are powerful and can
damage healthy cells, especially cells that grow and divide quickly.
Chemotherapy medicines may be given:

intravenously, which means they’re delivered directly into your
bloodstream through an IV, a port, or a catheter
orally, as a pill or capsule that you take by mouth
There are a number of chemotherapy medicines used to treat breast cancer.

In many cases, a chemotherapy regimen uses a combination of two or more
medicines.
Depending on the breast cancer’s characteristics, chemotherapy medicines

may be combined with other treatments, such as hormonal therapy,
radiation therapy, targeted therapy, or immunotherapy.
Chemotherapy is most often used to treat cancer, since cancer cells grow and
multiply much more quickly than most cells in the body.
Many different chemotherapy drugs are available. Chemotherapy drugs can

be used alone or in combination to treat a wide variety of cancers.
Though chemotherapy is an effective way to treat many types of cancer,

chemotherapy treatment also carries a risk of side effects. Some
chemotherapy side effects are mild and treatable, while others can cause
serious complications.
Chemotherapy Medications works
Chemotherapy medicines stop or slow the growth of breast cancer cells by
destroying the cells or stopping them from dividing.
Breast cancer cells usually grow and divide very quickly in an out-of-control
fashion with no order. Because the cancer cells grow and divide so quickly,
they break away from the original tumor and travel to other places in the
body.
Because chemotherapy travels throughout the body in the bloodstream, it

works on the cancer cells in the original tumor and throughout the body.
Most healthy, normal cells grow and divide in a precise, orderly way, so they
aren’t as affected by chemotherapy as quickly dividing cells, such as cancer
cells. Still, there are some healthy cells that divide quickly, such as cells in:
hair follicles
nails
the mouth
the digestive tract
bone marrow
So chemotherapy can harm these rapidly dividing cells, which can cause side
effects such as hair loss, nail changes, mouth sores, nausea, and vomiting.
Types of chemotherapy Medication
Chemotherapy can be given in several ways. Your doctors will recommend the
best type for you.
The most common types are:
chemotherapy given into a vein (intravenous chemotherapy) – this is

usually done in hospital and involves medicine being given through a tube
in a vein in your hand, arm or chest
chemotherapy tablets (oral chemotherapy) – this usually involves taking a
course of medicine at home, with regular check-ups in hospital
You may be treated with one type of chemotherapy medicine or a
combination of different types.
You'll usually have several treatment sessions, which will typically be spread
over the course of a few months.
Side effects of chemotherapy Medication
As well as killing cancer cells, chemotherapy can damage some healthy cells in
your body, such as blood cells, skin cells and cells in the stomach.
This can cause a range of unpleasant side effects, such as:
feeling tired most of the time

feeling and being sick
hair loss
an increased risk of getting infections
a sore mouth
dry, sore or itchy skin
diarrhoea or constipation
Many of these side effects can be treated or prevented and most, if not all, will
pass after treatment stops.
Paying for chemotherapy Medication
The cost of chemotherapy for breast cancer depends on:
the medicines used and their doses
how long and how often you receive chemotherapy
where you get chemotherapy
where you live
Before you start chemotherapy, someone in your doctor’s office contacts

your insurance company to get your chemotherapy plan approved. Most
insurance plans pay for chemotherapy, but there may be some facility fees
that insurance doesn’t cover. A social worker or nurse navigator can help
you if you have questions.
Chemotherapy Medication treatment
Some chemotherapy medicines for breast cancer can be taken orally as pills.
But most chemotherapy medicines are given as an infusion into a vein
through an IV, a port, or a catheter over a period of time.
Chemotherapy is given in cycles — a period of treatment followed by a period

of recovery. One cycle may include chemotherapy on the first day and then
three weeks of recovery with no treatment.
A chemotherapy treatment regimen is made up of several cycles. The number

of cycles in a regimen and the total time it takes to complete one regimen
depends on the chemotherapy medicines you receive. But most regimens take
three to six months to complete.
In some cases, if the cancer is considered aggressive, doctors may recommend a
dose-dense chemotherapy regimen. Dose-dense chemotherapy means there is
less time between cycles — say every two weeks instead of every three weeks.
How is chemotherapy Medication used?
Sometimes, it treats cancer by itself, but more often it’s used in combination
with:
Surgery: A doctor removes cancerous tumors or tissue, or organs

contaminated with cancerous cells.
Radiation therapy: A doctor uses invisible radioactive particles to kill
cancer cells. It may be delivered by a special machine that bombards parts
of your body from the outside, or by putting radioactive material on, near,
and even inside your body.
Biological therapy: Living material in the form of bacteria, vaccines, or
antibodies are carefully introduced to kill cancer cells.
Chemotherapy may be used to:
Shrink a tumor before radiation therapy or surgery -- called neoadjuvant

chemotherapy
Destroy any remaining cancer cells after surgery or radiation therapy --
called adjuvant chemotherapy
Make other therapies (biological or radiation) more effective
Destroy cancer cells that return or spread to other parts of your body
Staying on track with chemotherapy Medication
Chemotherapy for breast cancer works best when you get the recommended
amount of medicine for the recommended amount of time.
It’s a good idea to not skip a chemotherapy treatment. Still, your doctor may
change your chemotherapy schedule to help you manage any side effects you
may be having and let you know when treatment can start again.
Because chemotherapy can last for a number of months, coordinating a

chemotherapy schedule with work and family activities can get challenging:
Some people may have trouble getting to and from chemotherapy

infusions.
Some people who are taking chemotherapy as a pill or capsule may have
trouble remembering to take the medicine every day.
Here are some steps you can take to stay on track with your chemotherapy
treatment plan.
Ask for scheduling help. In general, it’s not a good idea to skip chemotherapy
to go on vacation or to attend an event. But you can ask your doctor or
treatment center staff to help you plan your treatment cycles so you can go
out when you’re feeling good.
If you’re working, ask if you can schedule your infusions for Thursday or
Friday afternoons. That way, you have all weekend to rest and manage any
side effects.
If you have troubling side effects, talk to your doctor. There are medicines
that can help manage the most common chemotherapy side effects, such as
nausea, constipation, and diarrhea.
Here are some strategies to help you remember to take your
chemotherapy medicine if you take a pill or capsule:
Ask for a written copy of your treatment plan, and ask your doctor to add
what you should do if you miss a dose. Keep the plan where you can look
at it every day.
Keep a medicine diary. Use a calendar or notebook to keep track of when

you take your medicine each day.
Take your medicine at the same time every day. If you take your medicine
right after doing something you do daily — such as brushing your teeth or
eating breakfast — you’re more likely to remember to take it.
Use the alarm or calendar feature in your phone, watch, or computer.
Use a pill caddy so you can see if you’ve taken your medicine each day.
Use a visual cue. Keep your medicine bottles on the bathroom counter and
turn them upside down after you’ve taken the medicine.
Plan ahead if you intend to be away from home. If you’re travelling, take
your medicine
diary and pack extra pills, keeping them in their original bottles. If you plan
to be away from home for more than a week or so, ask your doctor for an
extra prescription. You also can ask your doctor if you can fill a prescription
at your destination, just in case.
How will I feel during chemotherapyMedication?
There’s no way to know for sure. It depends on your overall health, the type
of cancer you have, how far along it is, and the amount and type of
chemotherapy drugs. Your genes may also play a part.
It’s common to feel ill or very tired after chemotherapy. You can prepare for
this by getting someone to drive you back and forth from treatment. You
should also plan to rest on the day of and the day after treatment. During this
time, it may help to get some help with meals and child care, if necessary.
Your doctor may be able to help you manage some of the more severe side
effects of chemotherapy.
Usually, chemo is given in cycles, and depending on the treatment regimen,

your oncologist can give you a general sense of the cycle of recovery.
How long does chemotherapy Medication last?
That depends on:
The type of cancer you have

How far along it is
The goal of treatment: cure, control growth, or ease pain
The type of chemotherapy
The way your body responds to the treatment
You may have chemotherapy in “cycles,” which means a period of treatment
and then a period of rest. For example, a 4-week cycle may be 1 week of
treatment and then 3 weeks of rest. The rest allows your body to make new
healthy cells. Once a cycle has been planned out, it’s better not to skip a
treatment, but your doctor may suggest it if side effects are serious. Then
your medical team will likely plan a new cycle to help you get back on track.
How is chemotherapy Medication given?
Injection: The drugs are delivered with a shot directly into muscle in
your hip, thigh, or arm, or in the fatty part of your arm, leg, or stomach,
just beneath the skin.
Intra-arterial (IA): The drugs go directly into the artery that is feeding the
cancer, through a needle, or soft, thin tube (catheter).
Intraperitoneal (IP): The drugs are delivered to the peritoneal cavity,
which contains organs such as your liver, intestines, stomach, and
ovaries. It is done during surgery or through a tube with a special port
that is put in by your doctor.
Intrathecal (IT) chemotherapy: Medicine is injected into the
cerebrospinal fluid (CSF), which is found in the area surrounding the
spinal cord and the brain.
Intravenous (IV): The chemotherapy goes directly into a vein.
Topical: You rub the drugs in a cream form onto your skin.
Oral: You swallow a pill or liquid that has the drugs.
How much does chemotherapy Medication cost?

It depends on the type of chemotherapy, how much you get, and how often
you get it. It also depends on where you live, and whether you get treatment
at home, in an office clinic, or during a hospital stay. Make sure to read your
health insurance policy to find out exactly what it will and won’t pay for, and
whether you can go to a doctor that you choose for your chemotherapy
treatment.
Can I work during Chemotherapy Medication

It depends on the work that you do and on how you feel. On days you don’t
feel well, you may want to see if you can work fewer hours or work from
home. In some cases, employers are required by law to adjust your schedule
when you have cancer treatment. A social worker may be able to help you
learn about what the law allows.
Antianxiety Medications
A list of anxiety medications includes several types of medication including
antidepressants, antipsychotics, beta blockers, and benzodiazepines. The
anti-anxiety medication list below includes all drugs approved by the FDA for
the treatment of anxiety disorders as well as those commonly prescribed off-
label.1
Only one drug is of the anti-anxiety medication class: Buspirone (BuSpar).

This drug is approved for anxiety disorders (in general).
Antidepressant Drugs for Anxiety
Antidepressants are typically the first choice treatment for anxiety.

Antidepressants are taken long-term. A list of common, modern
antidepressant anxiety medication that works on the brain chemicals
serotonin and norepinephrine includes:2,3,4
Citalopram (Celexa) off label for panic disorder, social phobia and
trichotillomania
Duloxetine (Cymbalta) approved for generalized anxiety disorder (GAD)
Escitalopram (Lexapro) approved for GAD
Fluoxetine (Prozac) approved for OCD and panic disorder
Fluvoxamine (Luvox) approved for OCD in children (8-17 y) and adults
phobia, GAL and posttraumatic stress disorder

Paroxetine (Paxil)
(PTSD)
Sertraline (Zoloft) approved for panic disorder, PTSD, social
phobia and OCD
Trazodone (Desyrel) off label for panic disorders
approved for GAD, panic disorder and social

Venlafaxine (Effexor XR)
anxiety disorder in adults
Tricyclic Antidepressant Drugs for Anxiety
An older type of antidepressant called a tricyclic antidepressant is also

sometimes used to treat depression. Tricyclics act on more chemicals in the
brain and are more likely to cause side effects so they are not typically a first
choice treatment. A list of tricyclic antidepressants used to treat anxiety
includes
Clomipramine (Anafranil) – approved for OCD
Desipramine (Norpramin) – off label for panic disorder
Doxepin (Sinequan) – off label for GAD
Imipramine (Tofranil) - off label for panic disorder
Another powerful, older class of antidepressants is also used to treat anxiety.

These monoamine oxidase inhibitors (moai) are not first choice treatments
but may be useful where other treatments have failed. A list of monoamine
oxidase inhibitors used to treat anxiety includes
Isocarboxazid (Marplan) – off label for social phobia
– off label for panic disorders and social

Phenelzine (Nardil)
phobia
Selegiline (Emsam) – off label for social phobia
Tranylcypromine (Parnate) – off label for social phobia

Benzodiazepines Used to Treat Anxiety
Benzodiazepines are commonly used to treat short-term anxiety or for acute

anxiety episodes. They are not typically used long-term due to concerns
about benzodiazepine tolerance, dependence and abuse. A list of
benzodiazepines includes
approved for GAD, panic disorder; used off-

label for agoraphobia with social phobia
Alprazolam (Xanax)
Chlordiazepoxide (Librium) approved for anxiety (in general)
approved for panic disorder; used off label

Clonazepam (Klonopin)
for anxiety (in general)
Diazepam (Valium) approved for anxiety (in general)
Lorazepam (Ativan) approved for anxiety disorders (in general)
Oxazepam (Serax) approved for anxiety (in general)
Anticonvulsants Used to Treat Anxiety
While considered investigational, some anticonvulsants (antiseizure medication) are

being used to treat anxiety. A list of anticonvulsants used to treat anxiety off label
include:8
Divalproex (Depakote, Depakote ER)

Gabapentin (Neurontin)
Pregabalin (Lyrica)
Beta-Blockers for Anxiety
These drugs are known as an antihypertensive medication because they lower

blood pressure. Beta-blockers and others reduce the physical symptoms of
anxiety. A list of beta-blockers includes
Atenolol (Tenormin) off label for situational/performance anxiety
Nadolol (Corgard) off label for situational/performance anxiety
Betachron E-R, InnoPran XL) – off label for panic

Propranolol (Inderal,
disorder, situational/performance anxiety,
Betachron E-R,
posttraumatic stress disorder and anxiety in
InnoPran XL)
general
Antipsychotic Drugs Used to Treat Anxiety
Antipsychotic drugs are often used in combination with other anxiety

medication. They are a second-line option due to the possibility of severe side
effects. A list of antipsychotic drugs used to treat anxiety includes
Molindone (Moban) – research suggests antianxiety properties
Olanzapine (Zyprexa) –off label use for anxiety (in general)
Quetiapine (Seroquel) – pending FDA-approval for GAD
Risperidone (Risperdal) – off label use for anxiety (in general)

Tuberculosis Medication
Tuberculosis (TB) is considered a “global emergency” by the World Health
Organization (WHO) . Worldwide, about 9.4 million new cases are diagnosed
annually and 1.7 million people die due to the infection. Moreover, over a
third of the population has a latent infection with possibility of a posterior
reactivation. Recently, 440,000 cases of multidrug resistant TB (MDR-TB)
have been reported .
In Peru, around 35,000 cases of active TB are diagnosed every year, with
morbidity and incidence rates of 118 and 103 per 100,000 people, respectively
. MDR-TB cases represent 5.3% of the total cases, and about 200 cases of
extremely drug-resistant TB (XDR TB) have been reported .
Usual treatment, according to the Peruvian National Health Strategy for

Control and Prevention of Tuberculosis, is based upon DOTS strategy . The
anti-TB therapy includes a long-time, wide spectrum of drugs depending on
the characteristics of the TB infection: new cases, re-infection, relapses,
failures, MDR-TB, or XDR-TB. Overall, this situation can predispose patients
to develop adverse drug reactions due to the long-time exposition to the anti-
TB drugs, .
Anti-TB drug side effects are an inherent risk for patients commencing any
type of anti-TB therapy, especially the drug-resistant cases. The Peruvian
Ministry of Health has notified a side-effects prevalence of 3.3% amongst
treated patients. The emergence of side effects may depend on patients'
characteristics but also on concomitant events during therapy , which might
determine adherence and, therefore, therapy success. Thus, an appropriate
determination of risk factors associated with anti-TB medication adverse
reaction is needed. The objective of this study was to assess factors associated
with tuberculosis treatment side effects in Lima, Peru, with special emphasis
on MDR-TB medication, HIV infection, diabetes, age, and tobacco use,
adjusting for potential confounders.
Rayos (predniosne) Kenalog (triamcinolone)
Prednisone is an inexpensive drug Triamcinolone (Kenalog) is an
used to treat asthma, allergies, and inexpensive drug used to reduce
arthritis. It is more popular than swelling and ulcers in the mouth. It
comparable drugs. Prednisone is only helps treat and relieve mouth sores
available as a generic drug; all brands that are not caused by herpes. this
have been discontinued. It is covered drug is slightly more popular than
by most Medicare and insurance comparable drugs. It is available in
plans, but some pharmacy coupons brand and generic forms. It is not
or cash prices may be lower. covered by most Medicare and
insurance plans, but manufacturer
Prednisolone and pharmacy coupons can help
offset the cost.
PREDNISOLONE treats many
conditions such as asthma, allergic Priftin
reactions, arthritis, inflammatory
bowel diseases, adrenal, and blood or RIFAPENTINE is an antibiotic. It is
bone marrow disorders. It works by used to treat of tuberculosis (TB).
decreasing inflammation, slowing This medicine is never used alone for
down an overactive immune system, tuberculosis, but in combination
or replacing cortisol normally made with at least one other agent.
in the body. Cortisol is a hormone
that plays an important role in how
the body responds to stress, illness, Meddol (methylprednisolone)
and injury. It belongs to a group of
medications called steroids. Methylprednisolone (Medrol) is an
inexpensive drug used to treat
inflammation of the skin, joints,
lungs, and other organs. It is available
in generic and brand versions.
Generic methylprednisolone is
covered by most Medicare and
insurance plans, but some pharmacy
coupons or cash prices may be lower.
Taperdex (dexamethasone) Acetylcystenie
Dexamethasone is an inexpensive ACETYLCYSTEINE is a drug that
drug used to treat inflammation of the loosens and thins mucus in the
skin, joints, lungs, and other organs. It lungs. It is used to make breathing
is also used for other conditions, such easier in patients with bronchitis,
as blood disorders and diseases of the cystic fibrosis, emphysema,
adrenal glands. It is slightly more tuberculosis, or other lung
popular than comparable drugs. problems.
Dexamethasone is only available as a
generic drug; all brands have been
Millipred
discontinued. Generic dexamethasone
is covered by most Medicare and
PREDNISOLONE treats many
insurance plans, but some pharmacy
conditions such as asthma, allergic
coupons or cash prices may be lower.
reactions, arthritis, inflammatory
bowel diseases, adrenal, and blood
Cortisone or bone marrow disorders. It works
by decreasing inflammation,
CORTISONE is a corticosteroid. It is slowing down an overactive
commonly used to treat immune system, or replacing
inflammation of the skin, joints, cortisol normally made in the body.
lungs, and other organs. Common Cortisol is a hormone that plays an
conditions treated include asthma, important role in how the body
allergies, and arthritis. It is also used responds to stress, illness, and
for other conditions, such as blood injury. It belongs to a group of
disorders and diseases of the adrenal medications called steroids.
glands.
Cortef (hydrocortisone)
Hydrocortisone (Cortef) is an inexpensive drug used to treat inflammation of
the skin, joints, lungs, and other organs. It is less popular than comparable
drugs. It is available in generic and brand versions. Generic hydrocortisone is
covered by most Medicare and insurance plans, but some pharmacy coupons
or cash prices may be lower.
Orapred (prednisolone sodium phosphate)
PREDNISOLONE treats many conditions such as asthma, allergic reactions,
arthritis, inflammatory bowel diseases, adrenal, and blood or bone marrow
disorders. It works by decreasing inflammation, slowing down an overactive
immune system, or replacing cortisol normally made in the body. Cortisol is a
hormone that plays an important role in how the body responds to stress,
illness, and injury. It belongs to a group of medications called steroids.
Pediapred (prednisolone sodium phosphate)

PREDNISOLONE treats many conditions such as asthma, allergic reactions,
arthritis, inflammatory bowel diseases, adrenal, and blood or bone marrow
disorders. It works by decreasing inflammation, slowing down an overactive
immune system, or replacing cortisol normally made in the body. Cortisol is a
hormone that plays an important role in how the body responds to stress,
illness, and injury. It belongs to a group of medications called steroids.
Rifadin (rifampin) Myambutol (ethambutol)

RIFAMPIN treats infections caused ETHAMBUTOL is used to treat
by bacteria. It belongs to a group of tuberculosis (TB). This medicine is
medications called antibiotics. It never used alone, but always with
will not treat colds, the flu, or another medicine.
infections caused by viruses.
Dexabliss
DEXAMETHASONE is a corticosteroid. It is commonly used to treat
inflammation of the skin, joints, lungs, and other organs. Common conditions
treated include asthma, allergies, and arthritis. It is also used for other
conditions, such as blood disorders and diseases of the adrenal glands.
Dexamethasone (Intensol)
DEXAMETHASONE is a corticosteroid. It is commonly used to treat

inflammation of the skin, joints, lungs, and other organs. Common conditions
treated include asthma, allergies, and arthritis. It is also used for other
conditions, like blood disorders and diseases of the adrenal glands.
Veripred Predniosone (intensol)
PREDNISOLONE treats many PREDNISONE treats many

conditions such as asthma, allergic conditions such as asthma, allergic
reactions, arthritis, inflammatory reactions, arthritis, inflammatory
bowel diseases, adrenal, and blood bowel diseases, adrenal, and blood or
or bone marrow disorders. It works bone marrow disorders. It works by
by decreasing inflammation, decreasing inflammation, slowing
slowing down an overactive down an overactive immune system,
immune system, or replacing or replacing cortisol normally made
cortisol normally made in the body. in the body. Cortisol is a hormone
Cortisol is a hormone that plays an that plays an important role in how
important role in how the body the body responds to stress, illness,
responds to stress, illness, and and injury. It belongs to a group of
injury. It belongs to a group of medications called steroids.
medications called steroids.
Depo-Medrol (methylprednisolone acetate)

METHYLPREDNISOLONE treats many conditions such as asthma, allergic
reactions, arthritis, inflammatory bowel diseases, adrenal, and blood or bone
marrow disorders. It works by decreasing inflammation, slowing down an
overactive immune system, or replacing cortisol normally made in the body.
Cortisol is a hormone that plays an important role in how the body responds
to stress, illness, and injury. It belongs to a group of medications called
steroids.
Oncology Medications
Oncology medications are drugs used to treat cancer. They are an important
part of cancer treatment and can be used alone or in combination with other
therapies, such as surgery, radiation therapy, or stem cell transplantation.
There are several different types of oncology medications, each with its own
mechanisms of action and side effects. The type of medication used will
depend on several factors, including the type of cancer, the stage of the
cancer, the patient's overall health, and any other medical conditions they
may have.
Chemotherapy is one of the most well-known types of oncology medication,

and it works by killing rapidly dividing cancer cells. However, chemotherapy
can also affect healthy cells in the body, leading to side effects such as
nausea, hair loss, and fatigue.
Hormone therapy is used to treat cancers that are hormone-sensitive,

such as breast and prostate cancer. This type of medication blocks the
hormones that promote cancer growth.
Bone-modifying agents are used to treat cancers that have spread to the
bone. These medications help to prevent bone loss and reduce the risk of
fractures.
ONCOLOGY MEDICATION DRUG INTRODUCTION
Oncology medications can be broken down into the following categories

alkylating agents
antimetabolites
microtubule inhibitors
topoisomerase inhibitors
antibiotics
immunomodulators
ONCOLOGY MEDICATION DRUG TABLE
Mechanism of
Name Key Indication Key Toxicity
Action
Pulmonary
CML
Busulfan Cross links DNA fibrosis
Bone marrow
Bone marrow
ablation
suppression
Testicular cancer Ototoxicity

Carboplatin
Ovarian cancer Nephrotoxicity
Cisplatin Cross links DNA
Bladder cancer Peripheral
Oxaliplatin
Lung cancer neuropathy
Myelosuppression
Cyclophos DNA cross Leukemia Hemorrhagic
-phamide linkage at Lymphoma cystitis
guanine Solid tumors (prophylaxis with
residues mesna)
Inhibits DNA
replication Myelosuppression
Chlorambucil CLL
Causes DNA
damage
Antimetabolites
Mechanism of
Action
Leukemia Myelosuppressio
Methotrexate Dihydrofolate
Lymphoma n (reverse with
reductase
Sarcoma leucovorin)
competitive
Ectopic Megaloblastic
inhibitor
pregnancy anemia (prevent
Abortion with folate)
Psoriasis
Rheumatoid Mucositis/stomat
arthritis itis
Pyrimidine Leukemia Pancytopenia

Cytarabine
analogue Lymphoma
Purine analogue Leukemia Lymphopenia

Fludarabine
Lymphoma Infection
6- Purine analogue Immunosuppressant Myelosupppression

Mercaptopurine Inflammatory
bowel disease
SLR
5-Fluorouracil Pyrimidine Colon cancer Myelosupppression

analogue Basal cell
carcinoma
Pancreatic cancer
Microtubule Inhibitors
Name Mechanism of Key Indication Key Toxicity

Action
Microtubule Lymphoma Peripheral

Vinblastine
inhibitor Leukemia neuropathy
Solid tumors Neurotoxic
Microtubule Lymphoma GI problems

Vincristine
inhibitor Leukemia Hair loss
Solid tumors Peripheral
neuropathy
Topoisomerase Inhibitors
Mechanism of Key Indication

Name Key Toxicity
Action
Irinotecan DNA Colon cancer Myelosupppression

topoisomerase Ovarian cancer
inhibitor Small cell lung
cancer
Antibiotics
Mechanism of Key Toxicity

Name Key Indication
Action
Hodgkin Pulmonary
Bleomycin Free radical DNA
lymphoma fibrosis
damage
Testicular Myelosuppression
cancer
Intercalates Ewing sarcoma Myelosuppression

Dactinomycin
between DNA Wilms tumor
(actinomycin D)
base pairs Rhabdomyosar
coma
Free radical damage

Doxorubicin Leukemia Cardiotoxicity
Intercalates
Lymphoma
between DNA base
pairs
Adenocarcinoma Myelosuppression
Mitomycin DNA-cross linkage
of the stomach, Nephrotoxic
pancreas Pulmonary
toxicity
Cardiotoxicity
Immunomodulators
Mechanism of
Action
Cancer Flu-like
Interferon IFN-α analogue
Viral syndromes
infections
(Hep B/C)
Pregnancy Of Medications
Most medicines taken during pregnancy cross the placenta and reach the
baby.
Before taking any medicine when you're pregnant, including painkillers,

check with your pharmacist, midwife or GP that it's suitable.
When deciding whether to take a medicine during pregnancy, it's important

to find out about the possible effects of that medicine on your baby.
This is the case both for medicines prescribed by a doctor and for medicines
you buy from a pharmacy or shop.
It is common to have questions regarding medication use during pregnancy.

You might be trying to get pregnant and wonder how current medication use
could affect your efforts to conceive. Or you may have just discovered that
you are pregnant and wonder if the medication is a risk to your baby.
Contact your health care provider who prescribed the medication. You may
discover that the benefits of taking the medication outweigh potential risks.
You and your healthcare provider can work through these factors and try to
determine what course of action is best for both you and your baby.
Which Preganancy Medications are safe?
They also have advice on what to do if you have already taken a medicine in
pregnancy.
But it's also important to never stop taking a medicine that's been prescribed
to keep you healthy without first checking with your doctor.
Stopping taking your medicine could be harmful to both you and your baby.
If you're trying for a baby or are already pregnant, it's important to always:
talk to your doctor immediately if you take regular medicine, ideally
before you start trying for a baby or as soon as you find out you're
pregnant
check with your doctor, midwife or pharmacist before taking any
prescribed medicines or medicines that you have bought
make sure your doctor, dentist or another healthcare professional knows
you're pregnant before they prescribe anything or give you treatment
Taking Medication During Pregnancy

Please know that many women take prescription medication during
pregnancy for necessary reasons like diabetes, seizures, depression, anxiety,
and other medical conditions. Some pregnant women take medications to
help with common discomforts of pregnancy such as heartburn, morning
sickness, or headaches.
Pregnancy can affect the effectiveness of your medication. When you are
pregnant, your blood volume increases, and your heart and kidneys both
work harder. This means that medications have the potential to pass
through your body more quickly than usual. This may mean that you have
to take more medicine or take it differently.
In most cases, there are different types of medications to address a
particular problem. Your health care provider may switch the type of
medication you are on to take care of your medical needs while lessening
any risk to your developing baby.
Pregnancy Medication Risk Factor Classifications
Each medication has a risk factor classification associated with potential risk
factors during pregnancy. These ratings, along with an evaluation of the risks
and benefits of using a particular medication in your situation, will help you
and your health care provider determines what steps to take.
Pregnancy Medications categories:
Category A: Controlled studies show no risk or find no evidence of harm.

Category B: Animal studies show no risks, but there are no controlled studies
in pregnant women.
Category C: Animal studies have shown risk to the fetus, there are no
controlled studies in women, or studies in women and animals are not
available.
Category D: There is positive evidence of potential fetal risk, but the benefits
from use in pregnant women may be acceptable despite the risk (i.e. life-
threatening condition to mother).
Category X: Studies in animals or human beings have demonstrated fetal
abnormalities, or there is evidence of fetal risk. The drug is contraindicated in
women who are or may become pregnant.
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Category C is the confusing category. A medication gets this classification if

there is insufficient data on its use during pregnancy. It could be safe or
probably safe, or it could be potentially harmful.
Alternatives to Medication During Pregnancy
Your doctor has the best in mind for both you and your developing baby. She
might look to change the course of treatment by incorporating other
methodologies such as acupuncture, herbal medications, or behavioral
techniques. Of course, this depends on what medical conditions you are
dealing with.
You or your health care provider can explore the Natural Medicines Database
to find out information about herbs and their use during pregnancy
Medications Safe for Use During Pregnancy
The medications listed below are safe to take during your pregnancy and
should be taken according to the package directions. If you have any
questions
about using these medications or if you continue to have symptoms that
are
not helped by the medication, call your doctor or midwife.
Constipation
• Polyethylene glycol (Miralax®)
• Docusate sodium (Colace®) stool softener
• Fiber (Metamucil®, Fiber Con®)
Heartburn/Gas
• Calcium (Tums®, Mylanta®, Maalox®) for heartburn
• Simethicone (Mylicon® or GasX®) for gas
• Famotidine (Pepcid®)
Allergy Symptoms
• Cetirizine (Zyrtec®)
• Diphenhydramine (Benadryl®)
• Fexofenadine (Allegra®)
• Fluticasone (Flonase®)
• Loratadine (Claritin®)
• Pseudoephedrine (Sudafed®) for nasal congestion: Avoid taking this
medication during the first trimester (12weeks pregnancy) *Talk with your
health care provider if you have high blood pressure
• Prescription asthma medications
Colds and Flu
• Guafenesin (Mucinex®) for congestion
• Dextromethorphan (Robitussin®) for cough
• Tylenol (Acetaminophen®) for aches and pains and temperature over 100.6°
F (38.1° C)
• Benzocaine(Chloraseptic®/Cepacol®/Halls®) lozenges for sore throat
Diarrhea (continuing longer than 24 hours)

• Loperamide (Immodium)
Headaches
• Acetaminophen (Tylenol®)
• Do not take aspirin, ibuprofen, or naproxen
Hemorrhoids
• Topical phenylephrine hemorrhoidal gel (Preparation H® or Anusol®)
• Witch hazel pads
Nausea and Vomiting
• Vitamin B6 25mg 3 times per day plus doxalamine succinate (Unisom®)
25mg up to three times per day.
Vaginal Yeast Infection
• Miconazole (Monistat®) 1-day, 3-day or 7-day treatment
Trauma Medications
Medications to Treat Post-traumatic Stress Disorder (PTSD)
Post-traumatic stress disorder (PTSD) affected an estimated 3.6% of adults in

the United States in the last year. Although it’s often associated with combat
veterans, children and adults can be diagnosed with PTSD as well.
PTSD is a mental health condition is a severe form of anxiety disorder that

can last for months or years after someone witnesses or experiences trauma.
Triggers can cause the trauma to resurface, resulting in extreme physical
and/or emotional responses. Some common symptoms that can affect your
everyday life include nightmares, flashbacks, anger, irritability, negative
thoughts, sleep disturbance, or hyperarousal symptoms. Those with PTSD
may even find themselves experiencing anxiety or depression in conjunction.
There are many treatment options for post-traumatic stress disorder,

including PTSD medication and various therapy techniques. The most
important thing to keep in mind when considering the right PTSD treatment
medication or therapy is that since no two people have the same experience
and treatment generally isn’t a one-size-fits-all plan.
You might need to try different techniques before something works well for
you and your symptoms. In the end, finding a mental health professional
with experience in treating PTSD is likely going to be your best bet. Whether
this means finding the best medication for PTSD or engaging in short-term
trauma-focused CBT for PTSD, there are treatment options out there for you.
Types of Medications Used to Treat PTSD
Sometimes medication for PTSD nightmares or other symptoms is
prescribed. Typically, medication is used in conjunction with other treatment
techniques like various forms of therapy. Most often, selective serotonin
reuptake inhibitors (SSRIs) — antidepressants — are prescribed. They can
help treat the depression symptoms that often present with PTSD.
While just a couple of medications are approved by the Food and Drug
Administration (FDA) to treat PTSD, many others are also prescribed “off-
label.” “Off-label is when medication is prescribed in a manner that is not
specified by FDA’s packaging. An in-person or online psychiatrist can set up a
treatment plan utilizing a combination of medications to relieve these
troubling PTSD symptoms. For instance, the prescription is used for a
different condition or the dosage is different than what the FDA
recommends.
SSRIs
Selective serotonin reuptake inhibitors (SSRIs) are a class of drugs commonly

known as antidepressants. They can be prescribed to treat major depressive
disorder (MDD) and other psychological conditions like anxiety disorders and
PTSD.
SSRIs work in the brain by increasing serotonin levels — a chemical

messenger or neurotransmitter that carries signals between nerve cells in
the brain. SSRIs inhibit the reabsorption of serotonin, which is also called the
“feel-good” neurotransmitter because it enhances and stabilizes happiness,
mood, and sense of well-being.
Possible side effects of
SSRIs to treat PTSD include: SSRIs to treat PTSD:
Zoloft* (Sertraline) Anxiety
Paxil* (Paroxetine) Insomnia
Prozac (Fluoxetine) Nausea
*Only FDA-approved drugs to treat PTSD Diarrhea
Sexual dysfunction
Anti-anxiety medications
Anti-anxiety medication may be prescribed for adults with PTSD if the
anxiety prevents engagement in normal, daily activities. For example, if
anxiety is so bad, attending work or school becomes problematic, an anti-
anxiety medication might help.
Anti-anxiety medication can reduce symptoms of anxiety such as intense

worry and fear or panic attacks. They can have a physical as well as a mental
effect on anxiety. Anti-anxiety medication works by slowing down the
nervous system, which helps you feel calm.
Anti- Anxiety Medications to treat PTSD include:
Xanax (alprazolam)
Klonopin (clonazepam)
Valium (diazepam)
Ativan (lorazepam)
Possible side effects of anti-anxiety medications to treat

PTSD:
Fatigue
Dizziness
Blurry vision
Loss of memory
Headaches
Confusion
Alpha-1 blockers
Alpha-1 blockers are a class of medication that can be part of PTSD treatment.
They’re primarily known for the ability to help reduce the disruptive sleep
and nightmares that are often associated with PTSD.
Alpha-1 blockers work by blocking alpha-1 receptors in the brain, helping you
achieve better, deeper sleep. Alpha-1 blockers are generally only prescribed
for people who experience PTSD nightmares.
Popular Alpha-1 blockers to treat PTSD include:

Minipress (Prazosin)
Doxazosin
Possible side effects of Alpha-1 blockers to treat PTSD:

Being tired
Headache
Shortness of breath
Swelling of hands, feet, ankles, lower legs
Abnormal vision
Muscle pain or weakness
Joint pain or weakness
Runny nose
Mood stabilizers
Mood stabilizers can be prescribed to adults with PTSD who haven’t
responded to antidepressants. They’re commonly used when primary
symptoms of PTSD include agitation, anger, or irritability.
Mood stabilizers work to treat PTSD by balancing brain chemicals known to

regulate emotions.
Mood stabilizers to treat PTSD include:
Topamax (Topiramate)
Lamictal (Lamotrigine)
Possible side effects of mood stabilizers to treat PTSD:

Headache
Insomnia
Skin rash
Tiredness
Dizziness
Drowsiness
How to Get PTSD Medication?

Finding the right medication for PTSD treatment can take time and patience.
You may find that the first medication you try isn’t the most effective. Also,
most people see a combination of PTSD medication and therapy work best
together to improve symptoms.
As with any medication, reaching out to your doctor is the first thing you
should do. If you’re hoping to get information about a PTSD medication list or
want to find any details about symptoms, options, side effects, or anything
else relating to medication, talking to your doctor is important.
To find the right medication for PTSD, go through the following easy steps:
Get diagnosed
After you’re diagnosed with PTSD, you can begin seriously considering
your treatment — including medication — options.
Begin therapy or treatment
PTSD treatment almost always requires a combination of therapy and
medication. If you haven’t already, it may be time to think about starting
therapy to help you cope with your symptoms.
Consider your options for medication
Learn the different PTSD treatment medication options.
Talk to a prescriber
Your doctor can prescribe the right PTSD medication.
Medications Commonly Prescribed for PTSD
The PTSD medication list below can help you understand more about the
types of medication available to treat PTSD, how they work, and any risks
you should be aware of.
Name Brand Generic Description
Can improve symptoms of PTSD, as well as general

functioning and quality of life. Works by increasing
Zoloft Sertraline
serotonin in the brain. Insomnia can be a side
effect.
A high blood pressure medication that can be used off-label
to treat post-traumatic stress disorder. Typically only
Minipress Prazosin prescribed to patients who have PTSD nightmares. Works
by blocking the Alpha-1 receptor for norepinephrine.
Good for those who have avoidance symptoms

with PTSD. Can be helpful for a full range of
Paxil Paroxetine
PTSD symptoms. Works by increasing the mood-
enhancing chemical serotonin.
Can help improve sleep while reducing
Doxazosin nightmares often associated with PTSD. Works
by blocking the alpha-1 receptors in the brain.
A study by the US Department of Veterans

Topamax Topiramate Affairs showed a reduction in hyperarousal
symptoms of PTSD. Needs further research.
Might be effective as a primary PTSD

Lamictal Lamotrigine medication. Works to decrease core symptoms
of avoidance and re-experiencing trauma.
Talk to your psychiatrist or healthcare professional about the possible

risks and benefits associated with the above medications before starting
treatment.
Should You Treat PTSD with Medication?
Whenever you seriously consider starting a new medication, being informed
is the most important part of the process. Deciding to take medication is a
personal, private decision that you’ll need to make for yourself. Enlist the
help of doctors, friends, psychiatrists, therapists, and family, but ultimately,
you need to be the one to make the decision. If you have questions or
concerns, your doctor can be the first place you turn.
Questions to ask your doctor
Should I consider PTSD medication?

Your doctor can discuss whether medication is something you may want to
consider. Weighing the pros and cons of any medication is step one. Then,
you’ll be better able to come to a decision that makes you feel good about
your choice.
What are the possible side effects of this medication?
You want to know any potential side effects of medications you’re
considering. This will not only help you determine if you really want to take
it, but it’ll also help you monitor how you’re reacting after you start.
Knowing what to look for means you can see potential red flags or
dangerous side effects as soon as possible.
What other treatments should I be considering for my PTSD?
While medication can be one part of your treatment plan, the primary
treatment for PTSD is actually psychotherapy. Combining these two
techniques can help you identify and address your symptoms, learn coping
skills, and treat additional symptoms and problems often related to PTSD.
Should I consider treatment in conjunction with PTSD medication?

Focusing on additional treatments can help enhance your healing.
Whether you’re looking for medication for PTSD nightmares or if you
have problems with avoidance, the more emphasis you can put on an all-
encompassing treatment plan, the better off your healing will ultimately
be.
Are there any holistic or self-help techniques I can try?
Many holistic and self-help techniques have shown efficacy in treating PTSD.
Meditation, activity and exercise, a service dog, and learning to set
boundaries are all things that many people have found helpful. Additionally,
having a PTSD support network can be a critical component of your
treatment plan.
Should I consider therapy in addition to medication?
Many forms of therapy have been found effective in treating and coping with
PTSD. A type of cognitive-behavioral therapy (CBT) known as cognitive
processing therapy is one technique that helps you overcome feelings of self-
blame and any negative thoughts you might be experiencing because of
PTSD. Exposure therapy is another seemingly effective treatment for PTSD.
Group therapy is one more form of treatment that offers support from others
who can relate to your trauma.
Are there any other conditions going on that could be contributing to PTSD?
Substance abuse and major depressive disorder (MDD) are both possible for
people with PTSD. Also, there’s an increased risk of agoraphobia, panic
disorder, obsessive-compulsive disorder (OCD), and social phobia. This
collective set of conditions is yet another reason why a full treatment plan,
typically including therapy, will be so important in managing PTSD.
If you’re ready to seek out medication for treatment of your PTSD, get
connected with a licensed prescriber today.
Bronchodilators Medication
Bronchodilators help open the airways in the lungs by relaxing smooth
muscle around the airways. Bronchodilator medication can be short or long
acting. There are different types of short or long acting bronchodilators that
work in different ways.
SABA (Short-acting inhaled beta-agonists) include:
Proventil HFA®, ProAir®, Ventolin HFA® (albuterol).Take with MDI or

RespiClick®.
Xopenex HFA®, Xopenex® (levalbuterol), Take with MDI or nebulizer.
SABA & SAMA (Short-acting muscarinic antagonist) combination

bronchodilators include:
Combivent® (albuterol and ipratropium), Take with Respimat®.
Duoneb® (albuterol and ipratropium) Take with nebulizer.
They're often used to treat long-term conditions where the airways may
become narrow and inflamed, such as:
asthma, a common lung condition caused by inflammation of the airways

chronic obstructive pulmonary disease (COPD), a group of lung
conditions, usually caused by smoking, that make breathing difficult
Bronchodilators may be either:
short-acting – used as short-term relief from sudden, unexpected attacks

of breathlessness
long-acting – used regularly to help control breathlessness in asthma and
COPD, and increase the effectiveness of corticosteroids in asthma
Long-Acting Bronchodilators Medication
These medications are long-acting. Long-acting bronchodilators are used
regularly to open the airways and keep them open.
Long-acting bronchodilators can be either LABAs (long-acting beta2 agonists)

or LAMAs (long-acting muscarinic antogonists). LABA and LAMA are types of
bronchodilators.
LAMAs include:
Incruse® (umeclidinium), Take once daily using Ellipta®.
Seebri® (glycopyrrolate), Take twice daily using Respimat®
Spiriva® (tiotropium), Take once daily using Respmat® or Handihaler®.
Tudorza® (aclidinium), Take twice daily using Pressair®.
LABAs include:
Arcapta® (indacaterol), Take once daily using Ellipta
Brovana® (arformoterol), Take twice daily using nebulizer.
Perforomist® (formoterol), Take twice daily using nebulizer.
Serevent® (salmeterol), Take twice daily using Discus® or MDI.
Stiverdi® (olodaterol), Take once daily using Respimat®.

LAMA & LABA combinations include:
Anoro® (umeclidinium and vilanterol), Take once daily using Ellipta®.
Stiolto® (olodaterol and tiotropium), Take once daily using Respimat®.
Utibron® (indacaterol and glycopyrrolate), Take twice daily using

Neohaler®.
Bevespi® (glycopyrrolate and formoterol). Take twice daily using

Aerosphere®.
Some bronchodilators work quickly, others work slowly.
Rapid-onset bronchodilators (also called quick-relief medicines) act quickly

and start to relieve shortness of breath within minutes. They are often used
as needed, to help relieve sudden shortness of breath. Quick-relief medicines
usually come in a blue puffer.
Some rescue medicines are short-acting and last for 4-6 hours (like Ventolin
® or Bricanyl ®). Some are long-acting and last for up to 12 hours (like Oxeze
®).
Slow-onset bronchodilators take longer to act. Some last for 4 to 6 hours (like
Atrovent ®), and some last up to 12 hours (like Serevent ®). Some slow-onset
bronchodilator lasts for 24 hours (Spiriva ®).
If you're short of breath and need help right away, take a quick-relief
medicine like Ventolin ®, Bricanyl ®. Quick-relief medicines usually come in
a blue puffer. Keep your quick-relief medicine with you at all times, so it’s
there when you need it.
The bronchodilators listed above come in a spray form (puffers or inhalers),

or in a dry powder form that you suck on. Learn how to use puffers (inhalers)
and other devices.
There’s another kind of bronchodilator that opens your airways. This one is
in pill form:
Xanthines or theophyllines (such as Uniphyl® or Theodur ®)
Xanthines or theophyllines are slow-onset bronchodilator pills. They don’t
work the same way as inhaled bronchodilators. They can have serious side
effects and drug interactions. For these reasons, xanthines/ theophyllines are
not commonly used. When they are used, it’s usually in combination with
other bronchodilators.
Xanthines/theophyllines can interact with food and other medicines. Make

sure your doctor and pharmacist knows all the other medicines you are
taking. If you are taking these pills, your doctor will give you regular blood
tests to monitor how much of the medicine is in your body.
Combination medicines: inhalers that combine two

bronchodilators together
If you have moderate COPD, your health care provider may prescribe two
different types of bronchodilators for you to take as combination medicine.
When they are combined as one inhaler, you won't have to carry around two
different inhalers to use. For example:
AnoroTM (umeclidinium combined with vilanterol)

Ultibro ® (glycopyrronium combined with indacaterol)
Talk to your health care provider or pharmacist about possible side effects
including shaky hands (tremors and a fast heartbeat).
Types
Typesof
of bronchodilator Medication
bronchodilator Medication
The 3 most widely used bronchodilators are:
beta-2 agonists, such as salbutamol, salmeterol, formoterol and vilanterol

anticholinergics, such as ipratropium, tiotropium, aclidinium and
glycopyrronium
theophylline
Beta-2 agonists and anticholinergics are available in both short-acting and
long-acting forms, whereas theophylline is only available in a long-acting
form. Beta-2 agonists
Beta-2 agonists are used for both asthma and COPD, although some types are
only available for COPD.
They're usually inhaled using a small hand-held inhaler, but may also be
available as tablets or syrup.
For sudden, severe symptoms, they can also be injected or nebulised.
A nebuliser is a compressor that turns liquid medication into a fine mist,

allowing a large dose of the medicine to be inhaled through a mouthpiece or
face mask.
Beta-2 agonists work by stimulating receptors called beta-2 receptors in the

muscles that line the airways, which causes them to relax and allows the
airways to dilate (widen).
They should be used with caution in people with:
an overactive thyroid (hyperthyroidism) – a condition that occurs when

there's too much thyroid hormone in the body
cardiovascular disease – conditions that affect the heart or blood vessels
an irregular heartbeat (arrhythmia)
high blood pressure (hypertension)
diabetes – a lifelong condition that causes a person's blood sugar level to
become too high
In rare cases, beta-2 agonists can make some of the symptoms and possible
complications
ADHD Medications
Medication can help reduce symptoms of hyperactivity, inattentiveness, and
impulsivity in children and adults with attention deficit hyperactivity
disorder (ADHD), formerly known as ADD. However, medications come with
side effects and risks—and they’re not the only treatment option. Whether
you’re the parent or the patient, it’s important to learn the facts about ADHD
medication so you can make an informed decision about what’s best for you
or your child.
The first thing to understand is exactly what medications for ADHD can and
can’t do. ADHD medication may help improve the ability to concentrate,
control impulses, plan ahead, and follow through with tasks. However, it isn’t
a magic pill that will fix all of your or your child’s problems. Even when the
medication is working, a child with ADHD might still struggle with
forgetfulness, emotional problems, and social awkwardness, or an adult with
disorganization, distractibility, and relationship difficulties. That’s why it’s so
important to also make lifestyle changes that include regular exercise, a
healthy diet, and sufficient sleep.
Medication doesn’t cure ADHD. It can relieve symptoms while it’s being
taken, but once medication stops, those symptoms come back. Also, ADHD
medication helps some more than others. Some people experience dramatic
improvement while others experience only modest gains. Because each
person responds differently and unpredictably to medication for ADHD, its
use should always be personalized to the individual and closely monitored by
a doctor. When medication for ADHD is not carefully monitored, it is less
effective and more risky.
Stimulant medications for ADHD
Stimulants are the most common type of medication prescribed for attention
deficit disorder. They have the longest track record for treating ADHD and
the most research to back up their effectiveness. The stimulant class of
medication includes widely used drugs such as Ritalin, Adderall, Focalin, and
Dexedrine.
Stimulants are believed to work by increasing dopamine levels in the brain.

Dopamine is a neurotransmitter associated with motivation, pleasure,
attention, and movement. For many people with ADHD, stimulant
medications boost concentration and focus while reducing hyperactive and
impulsive behaviors.
Short-acting vs. long-acting stimulants

Stimulants for ADHD come in both short- and long-acting dosages. Short-
acting stimulants peak after several hours, and must be taken 2-3 times a day.
Long-acting or extended-release stimulants last 8-12 hours, and are usually
taken just once a day.
The long-acting versions of ADHD medication are often preferred, since

people with ADHD often have trouble remembering to take their pills. Taking
just one dose a day is much easier and more convenient.
Common side effects of stimulants include:
Feeling restless and jittery

Stimulant medications may also cause
Difficulty sleeping
personality changes. Some people
Loss of appetite
become withdrawn, listless, rigid, or less
Headaches
spontaneous and talkative. Others
Upset stomach
develop obsessive-compulsive
Irritability, mood swings
symptoms. Since stimulants raise blood
Depression
pressure and heart rate, many experts
Dizziness
worry about the dangers of taking these
Racing heartbeat
ADHD drugs for extended periods.
Tics
Stimulant ADHD medication safety concerns
Beyond the potential side effects, there are a number of safety concerns
associated with the use of stimulant medications for ADHD.
Effect on the developing brain. The long-term impact of ADHD medication on

the youthful, developing brain is not yet known. Some researchers are
concerned that the use of drugs such as Ritalin in children and teens might
interfere with normal brain development.
Heart-related problems. ADHD stimulant medications have been found to

cause sudden death in children and adults with heart conditions. The
American Heart Association recommends that all individuals, including
children, have a cardiac evaluation prior to starting a stimulant. An
electrocardiogram is recommended if the person has a history of heart
problems.
Psychiatric problems. Stimulants for ADHD can trigger or exacerbate

symptoms of hostility, aggression, anxiety, depression, and paranoia. People
with a personal or family history of suicide, depression, or bipolar disorder
are at a particularly high risk, and should be carefully monitored when taking
stimulants.
Potential for abuse. Stimulant abuse is a growing problem, particularly among

teens and young adults. College students take this medication for a boost
when cramming for exams or pulling all-nighters. Others abuse stimulant
meds for their weight-loss properties. If your child is taking stimulants, make
sure he or she isn't sharing the pills or selling them.
ADHD stimulants are not recommended for those with:
Any type of heart defect or disease

High blood pressure
Hyperthyroidism
Glaucoma
High levels of anxiety
A history of drug abuse
Non-stimulant medications for ADHD
Non-stimulant medications can help in some cases of ADHD. They’re used

most often with kids who don’t respond to stimulants or who experience
side effects from them.
Unlike stimulants, non-stimulant medications work by increasing brain

activity of norepinephrine. This is a neurotransmitter that, like dopamine, is
linked to attention. Unlike stimulants, however, it may take four to six
weeks to show results.
Strattera (2002)*
Tenex (1986)*
Intuniv (2009)*
Kapvay (2009)*
Antihypertensive medications are sometimes also used to manage ADHD.
These medications are usually prescribed to treat high blood pressure in
adults but have been found, in some cases, to decrease ADHD symptoms, too
— specifically hyperactivity.
Side effects of ADHD medication
All classes of ADHD medication have possible side effects. These are often
temporary and can be helped by reducing the dose or changing the timing of
the dose. Stimulants can cause loss of appetite, difficulty falling asleep,
weight loss, and irritability or increased anxiety. Strattera can cause nausea,
vomiting, and daytime sleepiness. Tenex, Intuniv, and Kapvay may cause
sleepiness or dizziness.
While there was a fear that stimulants might stunt children’s growth, more
recent research suggests that stimulants typically don’t affect how tall a
child will ultimately be. For some kids, though, stimulants may cause a
slight delay in the rate of growth.
With all of these drugs, side effects tend to occur only when the medication is
active in the body. Very rare or serious side effects of ADHD medications may
include heart problems in children with pre-existing heart defects. The FDA
recommends that parents work with doctors to ensure their child has a
thorough medical exam and health history review before taking ADHD
medications.
Deciding whether or not to take ADHD medication

Even when armed with all the facts, deciding whether or not to take
ADD/ADHD medication isn't always easy. If you're unsure, don't rush the
decision. Take your time to weigh the options. And if the medication is for
your child, be sure to get their input in the decision-making process.
Most importantly, trust your instincts and do what feels right to you. Don't let
anyone—be it your physician or the principal at your child's school—pressure
your child into medication if you're not comfortable with it. Remember:
medication isn't the only treatment option. For young children especially,
medication should be viewed as a last resort, not the first course of treatment
to try.
Drug interactions ADHA Medications

Stimulants can interact with several medications.
Some people have both ADHD and depression or anxiety. For this reason,
doctors may prescribe an antidepressant or antianxiety medication with a
stimulant for ADHD treatment.
Monoamine oxidase inhibitors (MAOIs) are antidepressants that people
should not take with stimulants. In fact, a person must stop taking any MAOI
at least 14 days before starting any stimulant medication.
Other antidepressants that interact with stimulants include:
selective serotonin reuptake inhibitors (SSRIs)
serotonin-norepinephrine reuptake inhibitors (SNRIs)
tricyclic antidepressants
ADHD medication alone is not enough
Treatment for attention deficit disorder isn't just about seeing doctors or
taking medication. There are many ways to help yourself or your child tackle
the challenges of ADHD and lead a calmer, more productive life. With the
right tips and tools, you can manage many of the symptoms of your ADHD on
your own. Even if you choose to take medication, healthy lifestyle habits and
other self-help strategies may enable you to take a lower dose.
Exercise regularly. Exercising is one of the most effective ways to reduce the
symptoms of ADHD. Physical activity boosts the brain's dopamine,
norepinephrine, and serotonin levels—all of which affect focus and attention.
Try walking, skateboarding, hiking, dancing or playing a favorite sport.
Encourage your child to put down the video games and play outside.
Eat a healthy diet. While diet doesn't cause ADHD, it does have an effect on
mood, energy levels, and symptoms. Set regular snack and meal times. Add
more omega-3 fatty acids to your diet and make sure you're getting enough
zinc, iron, and magnesium.
Get plenty of sleep. Regular quality sleep can lead to vast improvement in the
symptoms of ADHD. Simple changes to daytime habits go a long way toward
resting well at night. Have a set bedtime and stick to it. Avoid caffeine later in
the day.
Maintain a positive attitude. A positive attitude and common sense are your
best assets for treating ADHD. When you are in a good frame of mind, you are
more likely to be able to connect with your own needs or your child's.
Try therapy. ADHD professionals can help you or your child learn new skills to
cope with symptoms and change habits that are causing problems. Some
therapies focus on managing stress and anger or controlling impulsive
behaviors, while others teach you how to manage time, improve
organizational skills, and persist toward goals.
Adult ADHD medications
Stimulant and nonstimulant medications are used to treat ADHD. Stimulants
are considered the first-line choice for treatment. They help adjust the levels
of two chemical messengers in your brain called norepinephrine and
dopamine.
Stimulants
Stimulants increase the amounts of norepinephrine and dopamine that are
available to your brain. This allows you to increase your focus. It’s thought
that norepinephrine causes the main action, and dopamine reinforces it.
Stimulants that can be used to treat adult ADHD include methylphenidate

(Ritalin, Concerta) as well as amphetamine compounds like:
amphetamine/dextroamphetamine (Adderall)
dextroamphetamine (Dexedrine)
dexmethylphenidate (Focalin)
lisdexamfetamine (Vyvanse)
Nonstimulants
Atomoxetine (Strattera) is the first nonstimulant drug approved to treat

ADHD in adults. It’s a selective norepinephrine reuptake inhibitor, so it works
to increase levels of norepinephrine only.
Although atomoxetine seems to be less effective than stimulants, it also

seems to be less addictive. It’s still effective and a good option if you can’t
take stimulants. You only have to take it once per day, which also makes it
convenient. It can be used for long-term treatment if necessary.
In 2022, a new nonstimulant option was approved by the FDA for both
adults and children over 6 years of age. Viloxazine (Qelbree) has been used
as an antidepressant in the UK since the 1970s and is available as a once-a-
day pill.
A 2021 clinical trial examining the use of viloxazine in adolescents 13 to 17

years old noted “statistically significant and clinically meaningful
improvement” in both inattention and hyperactivity and noted that the
medication was generally well tolerated.
Renal & Urinary Medications
Renal and urinary medications are a group of drugs that are used to treat
conditions affecting the kidneys and the urinary tract. These medications
may be prescribed to patients with a wide range of conditions, including
kidney disease, urinary tract infections, and urinary incontinence.
Some common types of renal and urinary medications include:
Diuretics: These medications are used to increase urine output and reduce
fluid buildup in the body. They are commonly used to treat conditions such as
edema, high blood pressure, and congestive heart failure. Examples of
diuretics include furosemide, hydrochlorothiazide, and spironolactone.
ACE inhibitors: These medications are used to treat high blood pressure and
some forms of kidney disease. They work by blocking the action of a hormone
called angiotensin II, which can cause blood vessels to narrow and increase
blood pressure. Examples of ACE inhibitors include lisinopril, enalapril, and
ramipril.
ARBs (angiotensin receptor blockers): These medications work similarly to

ACE inhibitors by blocking the action of angiotensin II. They are often used as
an alternative to ACE inhibitors in patients who cannot tolerate the side
effects of ACE inhibitors. Examples of ARBs include losartan, valsartan, and
irbesartan.
Antibiotics: These medications are used to treat bacterial infections in the

urinary tract, such as urinary tract infections (UTIs) and bladder infections.
Examples of antibiotics commonly used to treat UTIs include ciprofloxacin,
trimethoprim-sulfamethoxazole, and nitrofurantoin.
Antimuscarinics: These medications are used to treat overactive bladder,
a condition characterized by frequent and urgent urination.
Antimuscarinics work by relaxing the bladder muscle and reducing
bladder contractions. Examples of antimuscarinics include oxybutynin,
tolterodine, and solifenacin.
Alpha-blockers: These medications are used to treat urinary symptoms
caused by an enlarged prostate, a condition known as benign prostatic
hyperplasia (BPH). Alpha-blockers work by relaxing the muscles in the
prostate and bladder neck, making it easier to urinate. Examples of
alpha-blockers include tamsulosin, alfuzosin, and doxazosin.
Types of renal and urinary medications:
Calcium channel blockers: These medications are used to treat high blood
pressure and can also be used to treat some forms of kidney disease. They
work by relaxing the blood vessels, which reduces blood pressure.
Examples of calcium channel blockers include amlodipine, diltiazem, and
verapamil.
Erythropoietin-stimulating agents (ESAs): These medications are used to

treat anemia in patients with chronic kidney disease. They work by
stimulating the bone marrow to produce more red blood cells. Examples
of ESAs include darbepoetin alfa and epoetin alfa.
Phosphate binders: These medications are used to treat

hyperphosphatemia, a condition in which there is too much phosphate in
the blood. This condition is common in patients with chronic kidney
disease. Phosphate binders work by binding to dietary phosphate in the
digestive tract, preventing its absorption into the bloodstream. Examples
of phosphate binders include calcium acetate and sevelamer.
Loop diuretics: These medications are a type of diuretic that work by

blocking the reabsorption of sodium and chloride in the loop of Henle in
the kidney. This increases the amount of sodium and chloride that is
excreted in the urine, reducing fluid buildup in the body. Examples of
loop diuretics include furosemide, bumetanide, and torsemide.
Steroids: Steroids, such as prednisone, are sometimes used to treat
kidney disease, particularly in cases of glomerulonephritis. They work by
reducing inflammation in the kidneys, which can help to preserve kidney
function.
Antidiuretic hormone (ADH) analogues: These medications are used to

treat conditions such as diabetes insipidus, in which the body produces
too much urine. ADH analogues work by mimicking the action of ADH,
which helps to reduce urine output. An example of an ADH analogue is
desmopressin.
Treatment for Renal and urinary medications
Renal and urinary medications for treatment refer to a group of drugs used to
treat various conditions that affect the kidneys and urinary system. These
medications can be used to manage a wide range of conditions, such as
urinary tract infections, high blood pressure, kidney disease, and urinary
incontinence, among others.
Renal and urinary medications work through different mechanisms of action,

depending on the specific drug and the condition being treated. For example,
antibiotics are used to treat bacterial infections, while diuretics increase urine
output to treat edema and high blood pressure. Other medications, such as
ACE inhibitors, relax blood vessels to reduce blood pressure and improve
blood flow to the kidneys.
Antibiotics Nonsteroidal anti-inflammatory drugs
These medications are used (NSAIDs)
to treat urinary tract These medications, such as
infections (UTIs), which are ibuprofen and naproxen, are used
caused by bacteria. Common to relieve pain and inflammation
antibiotics used to treat caused by conditions such as
UTIs include ciprofloxacin, kidney stones and interstitial
nitrofurantoin, and cystitis.
trimethoprim/sulfamethoxa
zole.
Angiotensin-converting enzyme Diuretics
(ACE) inhibitors These medications are used to
These medications, such as enalapril treat conditions such as edema
and lisinopril, are used to treat high (fluid buildup) and high blood
blood pressure and kidney disease. pressure by increasing urine
They work by relaxing the blood output. Examples of diuretics
vessels, which reduces blood pressure include hydrochlorothiazide,
and improves blood flow to the furosemide, and spironolactone.
kidneys.
Alpha blockers
Antispasmodics
These medications, such as These medications, such as

flavoxate and hyoscyamine, are tamsulosin and alfuzosin, are
used to treat urinary urgency and used to treat urinary symptoms
frequency by relaxing the bladder caused by an enlarged prostate,
muscle. such as difficulty urinating and
frequent urination. They work
by relaxing the muscles in the
prostate and bladder neck,
which allows urine to flow more
easily.
Drugs Used in Renal and Urinary medications
There are several types of drugs used in renal and urinary medications,
including antibiotics, diuretics, angiotensin-converting enzyme (ACE)
inhibitors, angiotensin II receptor blockers (ARBs), nonsteroidal anti-
inflammatory drugs (NSAIDs), immunomodulators, alpha blockers, and
antispasmodics.
Antibiotics are used to treat bacterial infections in the urinary tract, while
diuretics are used to increase urine output and reduce edema or high blood
pressure. ACE inhibitors and ARBs are used to lower blood pressure and treat
kidney disease, while NSAIDs are used to relieve pain and inflammation
caused by conditions such as kidney stones and interstitial cystitis.
AIDS Medication
AIDS (Acquired Immunodeficiency Syndrome) is a condition caused by the
human immunodeficiency virus (HIV) that attacks the immune system,
making individuals vulnerable to infections and other diseases. There are
several medications used to treat HIV and AIDS, which work by targeting
different stages of the virus's life cycle.
AIDS medications are a group of drugs that are used to treat and manage
HIV (human immunodeficiency virus) infection, which can progress to AIDS
(acquired immunodeficiency syndrome) if left untreated. AIDS medications
work by targeting different stages of the virus's life cycle, and they are
typically prescribed in combination to maximize their effectiveness and
minimize the development of drug resistance.
Nucleoside reverse transcriptase inhibitors (NRTIs)
Non-nucleoside reverse transcriptase inhibitors (NNRTIs)
Protease inhibitors (PIs)
Integrase inhibitors
Entry inhibitors
Combination therapies
Each type of AIDS medication works differently, but they all aim to reduce
the amount of virus in the bloodstream, increase the number of CD4 T-cells
(immune cells that are attacked by HIV), and slow the progression of HIV
infection. AIDS medications are not a cure for HIV, but they can help people
with HIV live longer, healthier lives and reduce the risk of transmitting the
virus to others.
It's important to note that AIDS medications can have side effects, and they
can interact with other medications. Therefore, it's crucial to talk to a
healthcare provider before starting or stopping any medication.
Additionally, adherence to medication regimens is critical for effective
treatment and to avoid the development of drug resistance.
Types of AIDS medications
Nucleoside reverse transcriptase inhibitors (NRTIs): These drugs work by

inhibiting the reverse transcriptase enzyme, which is responsible for HIV's
replication. Examples include zidovudine (AZT), lamivudine (3TC), and
emtricitabine (FTC).
Non-nucleoside reverse transcriptase inhibitors (NNRTIs): These drugs

work by binding to the reverse transcriptase enzyme and inhibiting its
activity. Examples include efavirenz, nevirapine, and etravirine.
Protease inhibitors (PIs): These drugs work by inhibiting the protease

enzyme, which is necessary for the production of new HIV particles.
Examples include ritonavir, darunavir, and atazanavir.
Integrase inhibitors: These drugs work by blocking the action of the

integrase enzyme, which is necessary for HIV to integrate its genetic
material into human cells. Examples include raltegravir, elvitegravir, and
dolutegravir.
Entry inhibitors: These drugs work by preventing HIV from entering

human cells. Examples include maraviroc, which blocks the CCR5 co-
receptor, and enfuvirtide, which blocks the fusion of the virus with the cell
membrane.
Combination therapies: Because HIV can quickly develop resistance to a

single drug, antiretroviral therapy typically involves a combination of two
or more drugs from different classes.
AIDS Medications Treatments
At this time, there is no cure for AIDS, but medications are effective in
fighting HIV and its complications. Treatments are designed to reduce HIV
in your body, keep your immune system as healthy as possible and
decrease the complications you may develop.
You and your doctor will work together to develop a treatment plan that
best meets your needs. Three main factors will be considered when
designing your treatment plan:
Your willingness and readiness to begin therapy
The stage of your disease
Other health problems
The U.S. Food and Drug Administration (FDA) has approved a number of drugs
for treating HIV and AIDS. It's important that you take your medications
exactly as prescribed. This is a crucial part of your treatment success. Our
program offers pharmacy services to help you maintain your drug regimen
and to answer any questions you may have.
Most medications have side effects, which your doctor will discuss with you.
Individuals respond differently to medications and side effects may vary. Our
doctors, nurses and pharmacists can help you manage these side effects.
Other AIDS Medications

Fusion Inhibitors
Fusion inhibitors are a new class of drugs that act against HIV by preventing
the virus from fusing with the inside of a cell, preventing it from replicating.
The group of drugs includes Enfuvirtide, also known as Fuzeon or T-20.
Highly Active Antiretroviral Therapy (HAART)
In 1996, highly active antiretroviral therapy (HAART) was introduced for
people with HIV and AIDS. HAART — often referred to as the anti-HIV
"cocktail" — is a combination of three or more drugs, such as protease
inhibitors and other anti-retroviral medications. The treatment is highly
effective in slowing the rate at which the HIV virus replicates itself, which
may slow the spread of HIV in the body. The goal of HAART is to reduce the
amount of virus in your body, or the viral load, to a level that can no longer be
detected with blood tests.
Non-Nucleoside Reverse Transcriptase Inhibitors (NNRTI)

Non-nucleoside reverse transcriptase inhibitors (NNRTIs) block the infection
of new cells by HIV. These drugs may be prescribed in combination with other
anti-retroviral drugs. NNRTs include:
Delvaridine (Rescriptor, DLV)

Efravirenz (Sustiva, EFV)
Nevirapine (Viramune, NVP)
Classes of antiretroviral drugs for ADIS Medications
There are many different classes of antiretroviral drugs used to treat HIV. A
healthcare professional will assess a person living with HIV and decide on the
best medications for their individual case.
This decision will depend on:
the person’s viral load how far the HIV has spread
their T cell count other chronic health
their strain of HIV conditions, also known as
the severity of their case comorbidities
other medications that they’re
taking, as to avoid interactions
between their HIV drugs and
their other drugs
HIV is treated with at least two different medications, although those
medications can sometimes be combined into one pill. This is because
attacking HIV from multiple directions lowers the viral load more quickly,
which has been shown to control HIV the best.
Taking more than one antiretroviral drug also helps prevent resistance to
the drugs being used. This means a person’s medications may work better to
treat HIV.
A person may be prescribed two to four individual antiretroviral drugs, or

they may be prescribed a single combination drug in what’s sometimes
known as a single-tablet regimen (STR). Combination HIV drugs pack
multiple medications into the same pill, tablet, or drug form.
HIV ADIS Medications
Truvada (emtricitabine/tenofovir)
EMTRICITABINE; TENOFOVIR DISOPROXIL FUMARATE helps manage the
symptoms of HIV infection. It may also be used for PrEP (pre-exposure
prophylaxis), which lowers the risk of getting HIV through sex. It works by
limiting the spread of HIV in the body. It is a combination of two
antiretroviral medications. This medication is not a cure for HIV or AIDS and
it may still be possible to spread HIV to others while taking it. It does not
prevent other sexually transmitted infections (STIs).
Genvoya
ELVITEGRAVIR; COBICISTAT; EMTRICITABINE; TENOFOVIR ALAFENAMIDE
is 3 antiretroviral medicines and a medication booster in 1 tablet. It is used to
treat HIV. This medicine is not a cure for HIV. This medicine can lower, but
not fully prevent, the risk of spreading HIV to others.
Tivicay
DOLUTEGRAVIR is an antiretroviral medicine. It is used with other
medicines to treat HIV. This medicine is not a cure for HIV. This medicine
can lower, but not fully prevent, the risk of spreading HIV to others.
Biktarvy
BICTEGRAVIR; EMTRICITABINE: TENOFOVIR ALAFENAMIDE (bik teg' ra
veer; em tri SIT uh bean; ten of' oh vir al" a fen' a mide) is 3 antiretroviral
medicines in 1 tablet. It is used to treat HIV. This medicine is not a cure for
HIV. This medicine can lower, but not fully prevent, the risk of spreading HIV
to others.
Triumeq
ABACAVIR; DOLUTEGRAVIR; LAMIVUDINE is 3 antiretroviral medications in
1 tablet. It helps manage infections caused by HIV. It is not a cure for HIV.
Descovy
Descovy (emtricitabine/tenofovir) is an expensive medication used to treat

HIV and can lower the chances of getting HIV through sex. This drug is more
popular than comparable drugs. There are currently no generic alternatives
to Descovy. It is covered by most Medicare and insurance plans, but
manufacturer and pharmacy coupons can help offset the cost.
viread (tenofovir)
TENOFOVIR is an antiretroviral medicine. It is used with other medicines

to treat hepatitis B virus and HIV. This medicine is not a cure for hepatitis B
or HIV. This medicine can lower, but not fully prevent, the risk of spreading
hepatitis B or HIV to others.
Isentress
Isentress (Raltegravir) is an expensive antiretroviral medicine. It is used
with other medicines to treat HIV. This medicine is not a cure for HIV. This
medicine can lower, but not fully prevent, the risk of spreading HIV to
others. It is more popular than comparable drugs. There is currently no
generic alternative to Isentress. The most common version of Isentress is
covered by 100% of insurance plans at a co-pay of $32.50-$50.00, however,
some pharmacy coupons or cash prices may be lower.
Antifungals Medications
Antifungal medications are drugs that are used to treat fungal infections
caused by various types of fungi. Fungi are microorganisms that can cause
infections in humans, animals, and plants. Fungal infections can affect
different parts of the body, including the skin, hair, nails, lungs, mouth, and
genitals. Antifungal medications work by either killing the fungi or inhibiting
their growth and replication, depending on the type of drug and the specific
fungal infection being treated. There are several different classes of
antifungal medications, including azoles, echinocandins, polyenes,
allylamines, and others. The choice of antifungal medication depends on the
type and severity of the fungal infection, the patient's overall health, and
other factors.
Triazole antifungals: fluconazole, itraconazole, posaconazole,
voriconazole.
Imidazole antifungals: clotrimazole, econazole, miconazole, ketoconazole
and tioconazole.
Polyene antifungals: amphotericin, nystatin.
Echinocandin antifungals: anidulafungin, caspofungin and micafungin.
Other antifungals: these include flucytosine, griseofulvin and terbinafine
and amorolfine.
NB: griseofulvin tablets are still available but have been largely superseded by
other antifungal agents. It is, however, still the drug of choice in trichophyton
infections in children.
Antifungal medication may be used topically or systemically. Most localised

fungal infections are treated with topical preparations, but systemic
treatment may be required for scalp disease, widespread infection, systemic
spread, intractable infection and immunocompromised individuals.
How to use Antifungal Medication?
Candidal vulvovaginitis
Oral fluconazole as a single dose is the first-line treatment.

Topical imidazoles (eg, clotrimazole 1% cream) may be a useful adjunct to
oral fluconazole if there are vulval symptoms.
Intravaginal imidazole drugs (clotrimazole, econazole, fenticonazole, and
miconazole) can be used if fluconazole is contra-indicated or not
tolerated.
Imidazole drugs (clotrimazole, econazole, fenticonazole, and miconazole)
are effective in the treatment of vulvovaginal candidiasis.Oral treatment
with fluconazole or itraconazole is also effective.
Oral antifungal treatment should be avoided during pregnancy;
intravaginal clotrimazole is preferred in this situation.
In recurrent vulvovaginal candidiasis, an induction-and-maintenance
regime may be used: three doses of oral fluconazole 150 mg taken every
three days, and then one dose of oral fluconazole taken every week for up
to six months.
For severe candidal vulvovaginitis, treatment should be repeated at 72
hours; ie fluconazole 150 mg orally on day 1 and day 4, or clotrimazole 500
mg pessaries on day 1 and day 4.
In immunocompromised individuals, oral antifungals for seven days, or
intravaginal preparations for 6-14 days are advised.
Oral candidiasis
First-line therapy is with topical treatment with miconazole gel.

Nystatin suspension is second-line treatment.
For extensive or severe candidiasis, prescribe oral fluconazole 50 mg a
day for 14 days.
In people with HIV and oral candidiasis, prescribe oral fluconazole 200
mg on day one, and oral fluconazole 100-200 mg daily for 14 days.
Children should only receive topical anticandidal treatment. Offer
miconazole oral gel first-line (off-label use in children less than 4 months
of age). Offer nystatin suspension (off-label use in neonates) if
miconazole oral gel is unsuitable.
Nail infections
Fungal Nail Infections.

For mild infections use topical amorolfine nail lacquer first-line. Use for six
months for fingernails and 9-12 months for toenails.
Oral terbinafine is the first-line oral treatment. Treat for between six
weeks and three months for fingernails and for between three and six
months for toenails.
Oral terbinafine can cause drug-induced liver injury, and requires
monitoring of liver function tests during therapy. However, this risk is
relatively small - with an estimated probability of developing elevated
serum aminotransferase levels requiring stopping treatment of 0.44% for
treatment longer than eight weeks, and clinically apparent liver injury
from terbinafine occurring rarely (between 1 in 50,000 to 1 in 120,000
prescriptions).
Oral itraconazole is an alternative. (Terbinafine is most effective against
dermatophyte nail infections. It has fungistatic activity against Candida
albicans. Itraconazole is highly active against Candida spp. but much less
so against dermatophytes.) Prescribe itraconazole as pulsed therapy, 200
mg twice a day for a week, repeating the course after 21 days. Two pulses
should be used for fingernails, and three for toenails.
Griseofulvin can be considered if both terbinafine and itraconazole are
contra-indicated.
Systemic Antifungal infections

See also the separate articles on Aspergillosis, Candidiasis, Cryptococcosis,
Fungal Lung Infections and Systemic Mycoses.
Specialist treatment is required in most forms of systemic or disseminated

fungal infections.
AntiFungal Ear infections

See the separate article on Fungal Ear Infection (Otomycosis).
Skin Infections
See the separate articles on Candidiasis, Tinea Capitis, Pityriasis Versicolor

and Dermatophytosis (Tinea Infections).
Topical antifungals should be prescribed in most cases. Terbinafine and

the imidazoles (clotrimazole, econazole, and miconazole) are all effective.
Systemic treatment is only indicated in severe, extensive skin infection,
or if there is associated systemic infection (eg, in immunosuppressed
people), or in the rare person unresponsive to topical treatment.
Oral treatment is recommended first-line for tinea capitis. This would be
griseofulvin or terbinafine (off-label.) Microbiological sampling should be
performed prior to starting treatment, to guide antifungal choice later. A
topical shampoo can be used alongside oral antifungals, for the first two
to four weeks of oral treatment, to reduce the risk of transmission to
others. Imidazole creams for one week are another option. If the
diagnosis is certain and there is appropriate expertise and experience
available, treatment can be initiated in primary care; otherwise, specialist
advice should be sought.
Fungal eye infections

Most fungi causing orbital infections are ubiquitous aerobic organisms that
are normal commensals of the respiratory, gastrointestinal and female
genital tracts, as well as sometimes being present on normal conjunctiva.
Fungal eye infections are rare in Western countries; they are more frequently
seen in tropical and subtropical regions.
Fungal infections of the eye may cause orbital cellulitis, dacryocystitis,

conjunctivitis, keratitis and endophthalmitis.Thus, they can work at a
superficial level or penetrate deeply into the eye.
Immunocompromised patients
Immunocompromised patients are at increased risk of fungal infections and
may need prophylactic antifungal drugs. Management is a challenge, and a
specialist field, and guidelines differ.
Oral triazole antifungals are the drugs of choice for prophylaxis. Fluconazole
is more reliably absorbed than itraconazole but is not effective against
Aspergillus spp. Therefore, itraconazole is preferred in patients at risk of
invasive aspergillosis. (Voriconazole is the treatment of choice for
established aspergillosis.)
Posaconazole can be used for prophylaxis in patients who are undergoing

haematopoietic stem cell transplantation or receiving chemotherapy for
acute myeloid leukaemia and myelodysplastic syndrome, particularly if the
incidence of invasive mould diseases is high.[11] Micafungin can be used
when fluconazole, itraconazole or posaconazole cannot be used.
Amphotericin by intravenous infusion or caspofungin is used for the

empirical treatment of serious fungal infections. Caspofungin is not effective
against fungal infections of the central nervous system.
Adverse effects
Many antifungal medications have similar adverse effects. They all may
cause gastrointestinal upset, rashes, headaches, etc. In addition:
Amphotericin may cause muscle and joint pain,
hypokalaemia/hypomagnesaemia, hearing loss, diplopia, convulsions or
peripheral neuropathy.
Fluconazole may cause LFT abnormalities, and rash - toxic epidermal
necrolysis and Stevens-Johnson syndrome have been reported.
Griseofulvin may aggravate or precipitate systemic lupus erythematosus
(SLE).
Flucytosine may cause marrow aplasia.
Application of topical imidazoles can be painful in some instances where
there is particularly bad inflammation.
Neuro Medications
Neuro medications are drugs that are used to treat neurological disorders,
which are conditions that affect the nervous system. The nervous system
includes the brain, spinal cord, and nerves throughout the body, and it is
responsible for regulating and coordinating bodily functions and movements.
There are many different types of neurological disorders, including epilepsy,

multiple sclerosis, Parkinson's disease, Alzheimer's disease, and others. Neuro
medications may be used to help manage the symptoms of these disorders or
to slow their progression.
Some common classes of neuro medications include:
Anticonvulsants: These drugs are used to treat epilepsy and other seizure
disorders.
Antidepressants: These drugs are used to treat depression, anxiety, and

other mood disorders.
Antipsychotics: These drugs are used to treat schizophrenia and other

psychotic disorders.
Dopamine agonists: These drugs are used to treat Parkinson's disease and
restless leg syndrome.
Cholinesterase inhibitors: These drugs are used to treat Alzheimer's

disease and other forms of dementia.
Neuro medications can be prescribed by a physician or other healthcare

professional and should always be taken as directed to avoid potential side
effects or complications.
Treatment for Neuro Medications
The treatment of neuro medications depends on the specific neurological

disorder being treated and the severity of the symptoms. Neuro medications
can be used alone or in combination with other treatments, such as physical
therapy, surgery, or behavioral therapy.
The goal of neuro medication treatment is to manage the symptoms of the

neurological disorder and improve the patient's quality of life. The
medication regimen will depend on the patient's individual needs and
response to treatment, and may involve starting with a low dose and
gradually increasing it over time.
It is important for patients to take their neuro medications as prescribed and

not to stop taking them without first consulting with their healthcare
provider. Abruptly stopping neuro medications can cause withdrawal
symptoms or exacerbation of symptoms, so it is important to follow a
healthcare provider's guidance when adjusting or discontinuing medication.
Regular follow-up appointments with a healthcare provider are also

important to monitor the effectiveness of neuro medication treatment and
adjust the medication regimen as needed. Depending on the medication,
blood tests or other monitoring may be required to ensure the medication is
being properly metabolized and to monitor for potential side effects.
Overall, the treatment of neurological disorders with neuro medications can

be an important component of managing symptoms and improving quality of
life for patients. However, it is important to work closely with a healthcare
provider to develop a personalized treatment plan that meets the individual
needs of the patient.
Types of Neuro Medications
There are many different types of neuro medications used to treat a wide
range of neurological disorders. Here are some of the most common types:
Antidepressants: These medications are used to treat depression, anxiety,
and other mood disorders. They work by affecting the levels of certain
neurotransmitters in the brain, such as serotonin and norepinephrine.
Examples of antidepressants include selective serotonin reuptake
inhibitors (SSRIs) such as fluoxetine and sertraline, as well as serotonin-
norepinephrine reuptake inhibitors (SNRIs) such as venlafaxine.
Antipsychotics: These medications are used to treat schizophrenia and

other psychotic disorders. They work by blocking dopamine receptors in
the brain, which can help alleviate symptoms of psychosis such as
delusions and hallucinations. Examples of antipsychotics include
risperidone, olanzapine, and quetiapine.
Anticonvulsants: These medications are used to treat epilepsy and other

seizure disorders. They work by reducing abnormal electrical activity in
the brain that causes seizures. Examples of anticonvulsants include
carbamazepine, valproic acid, and lamotrigine.
Cholinesterase inhibitors: These medications are used to treat Alzheimer's

disease and other forms of dementia. They work by preventing the
breakdown of acetylcholine, a neurotransmitter that is important for
memory and learning. Examples of cholinesterase inhibitors include
donepezil and rivastigmine.
Dopamine agonists: These medications are used to treat Parkinson's disease

and restless leg syndrome. They work by activating dopamine receptors in
the brain, which can help alleviate symptoms of Parkinson's disease such as
tremors and rigidity. Examples of dopamine agonists include pramipexole
and ropinirole.
Side effect of Neuro Medications
Like any medication, neuro medications can have potential side effects. The
specific side effects will depend on the type of medication, the dosage, and the
individual patient's response to the medication. Some common side effects of
neuro medications include:
Drowsiness or sedation
Nausea and vomiting
Dizziness or lightheadedness
Headache
Dry mouth
Constipation or diarrhea
Blurred vision
Tremors or shaking
Weight gain or weight loss
Sexual dysfunction
In addition to these common side effects, some neuro medications can have
more serious or rare side effects. For example, antipsychotic medications can
increase the risk of developing diabetes, while some anticonvulsants can
increase the risk of suicidal thoughts or behaviors.
It is important for patients to talk to their healthcare provider about the

potential side effects of their neuro medications and to report any side effects
that they experience. In some cases, the medication dosage may need to be
adjusted or a different medication may need to be prescribed to manage side
effects.
It is also important for patients not to stop taking their neuro medications
without first consulting with their healthcare provider, as abruptly stopping
some neuro medications can cause withdrawal symptoms or a worsening of
symptoms.
Other Medications for Neuro
In addition to the types of medications I mentioned earlier, there are other

medications used to treat various neurological disorders. Here are a few
examples:
Muscle relaxants: These medications are used to treat muscle spasms and
spasticity that can occur with neurological disorders such as multiple
sclerosis and cerebral palsy. Examples of muscle relaxants include
baclofen and tizanidine.
Beta blockers: These medications are commonly used to treat high blood
pressure and heart conditions, but they can also be used to treat tremors
associated with neurological disorders such as Parkinson's disease.
Examples of beta blockers include propranolol and metoprolol.
Migraine medications: There are several types of medications used to

treat migraines, which are a type of neurological disorder. These
medications include triptans such as sumatriptan, as well as nonsteroidal
anti-inflammatory drugs (NSAIDs) such as naproxen and ibuprofen.
Immunomodulators: These medications are used to treat autoimmune

disorders such as multiple sclerosis and myasthenia gravis, which affect
the nervous system. Examples of immunomodulators include interferon
beta and glatiramer acetate.
Opioids: These medications are sometimes used to treat severe pain

associated with neurological disorders such as neuropathy or spinal cord
injury. However, opioids have a high risk of addiction and other side
effects, so they are generally used only when other pain management
options have not been effective.
It is important to note that all medications, including those used to treat

neurological disorders, can have potential side effects and risks. It is
important for patients to work closely with their healthcare provider to
develop a personalized treatment plan that considers the individual patient's
needs and potential risks.
Insulin
Many types of insulin are
used to treat diabetes.
Although available
choices may seem a bit
overwhelming at first,
this guide can help you
discuss your treatment
with your doctor.
Terms To Know
Onset – How quickly insulin lowers your blood sugar.
Peak Time – When insulin is at maximum strength.
Duration – How long insulin works to lower your blood sugar.
Your doctor will prescribe the best insulin or insulins for you based on
several factors:
How active you are.
The food you eat.
How well you’re able to manage your blood sugar levels.
Your age.
How long it takes your body to absorb insulin and how long it stays
active. (This is different for different people.)
If you have type 1 diabetes, you’ll likely take a combination of insulins.
Some people with type 2 diabetes will also need to take insulin.
Different brands of insulin vary in onset, peak time, and duration, even if
they’re the same type, such as rapid acting. Be sure to check the dosing
information that comes with your insulin and follow your doctor’s
instructions.
Insulin Peak
Onset Duration Method
Type Time
Usually taken right
Rapid 15 1 2 to 4 before a meal. Often
Acting Minutes Hour Hours used with longer-
acting insulin.
Usually taken right

Rapid-
30 3 before a meal. Often
acting 10 to 15
Minutes Hours used with injectable
inhaled Minutes
long-acting insulin.
Regular/s Usually taken 30 to

30 2 to 4 3 to 6
hort 60 minutes before a
Minutes Hours Hours
acting meal.
Covers insulin needs

2 to 4 4 to 12 12 to 18 for half a day or
Intermediate overnight. Often used
Hours Hours Hours
acting with rapid- or short-
acting insulin.
Covers insulin needs

2 for about a full day.
Does not Up to 24
Long acting Hours Often used, when
peak hours
needed, with rapid or
short-acting insulin.
Provides steady
Ultra-long 6 Does not 36 hours insulin for long
acting Hours peak or longer periods.
Combines
intermediate- and
Peaks 10 to 16 short-acting insulin.
5 to 60
Premixed vary hours Usually taken 10 to
Minutes
30 minutes before
breakfast and dinner.
Diuretics
Diuretics, also known as water pills, are medications that increase the
amount of urine produced by the kidneys. They are commonly used to
treat conditions such as high blood pressure, heart failure, and kidney
disease. By increasing urine
output, diuretics
help reduce
the amount
of fluid in the body,
which can help
lower blood pressure
and reduce swelling
in the legs and feet.
TYPES OF DIURETICS
Thiazide diuretics, such as hydrochlorothiazide (Microzide® or Oretic®) or

chlorthalidone (Hygroton® or Thalitone®).
What they do
They make your kidneys pull salt and extra water into your pee.
Selected side effects:
Headache.
Loss of appetite.
Hair loss.
Loop diuretics, such as furosemide or bumetanide
What they do: They affect part of your kidneys (the loop of Henle) to get
salt and excess water out of your body.
Dizziness.
Diarrhea.
Upset stomach.
Potassium-sparing diuretics, such as triamterene or amiloride
What they do
They help your kidneys clear salt and water out of your body, but don’t let
you lose too much potassium in the process.
Gas.
Nausea.
Headache.
A mixture of two types in one pill, like triamterene and hydrochlorothiazide

(Dyazide® or Maxzide®)
What they do: They make your kidneys move salt and extra water out while
keeping you from losing too much potassium.

Headache.
Peeing often.
People usually take diuretics by swallowing diuretic pills, but your provider
can give some diuretics through an IV in your arm during a hospital stay.
Most people can take diuretics without getting serious problems from them.
HOW DO DIURETICS WORK? WHO NEEDS DIURETICS?

Diuretics make your kidneys take People who have high blood pressure
away your body’s extra salt and water or have too much fluid collecting in
by putting them into your urine (pee). their bodies need diuretics.
WHY DO PROVIDERS PRESCRIBE DIURETICS?
Diuretics bring down blood pressure because they help your blood vessels get
wider. Also, there’s a smaller amount of fluid in your blood to pump. Diuretics
also help your body clear out extra fluids.
WHAT DO DIURETICS TREAT?
Diuretic medications can help with:
High blood pressure.
Heart failure.
Cardiomyopathy.
Pulmonary edema.
Ascites.
Renal failure.
Nephrotic syndrome.
Diabetes insipidus.
High intraocular pressure.
High intracranial pressure.
HOW COMMON ARE DIURETICS?

Diuretics are very common. A list of America’s most frequently prescribed
drugs includes two diuretic drugs in the top 15.
RISKS / BENEFITS
ADVANTAGES OF DIURETICS
Diuretics give many people ― even older adults ― good results, especially for
treating high blood pressure. Also, people generally don’t have bad side effects
with diuretics.
RISKS OR COMPLICATIONS OF DIURETICS
Usual side effects of diuretics include:

Peeing more than usual.
Dizziness.
Tiredness.
Headache.
Gout.
Difficulty getting an erection.
Low potassium (unless you’re taking a potassium-sparing type of diuretic).
Muscle cramps.
Heart palpitations.
Higher blood sugar in people with diabetes.
Dehydration.
Unbalanced electrolytes.
Your provider will want to make sure your kidneys are working right and your
potassium level is normal when you’re taking diuretic pills. If you’re pregnant,
breastfeeding, an older adult or have problems with your kidneys or liver,
discuss the risks of diuretics with your provider.
DIURETICS SITES OF ACTION
Diuretics work to enhance sodium and water excretion through 4 main

sites on the nephron.
1– Proximal convoluted tubule: Mannitol and acetazolamide (extends

into the descending loop of Henle)
2– Ascending loop of Henle: loop diuretics
3– Distal convoluted tubule: thiazides
4– Collecting ducts: Potassium-sparing diuretic (e.g., spironolactone and
triamterene)
MECHANISM OF ACTION
Diuretics work by different mechanisms to increase the excretion of
fluid and electrolytes from the body. Loop diuretics act on the ascending
loop of Henle in the kidney, while thiazide diuretics act on the distal
convoluted tubule. Potassium-sparing diuretics work on the collecting
duct in the kidney. Understanding the specific mechanism of action for
each type of diuretic is important in assessing their effectiveness and
potential side effects.
INDICATIONS
Diuretics are commonly used to treat hypertension, edema associated
with heart failure, liver cirrhosis, and kidney disease. It's important to
understand the specific indications for diuretic therapy and how they
are used in the treatment of these conditions.
MONITORING SIDE EFFECTS

Diuretics can have significant effects As mentioned earlier, diuretics
on fluid and electrolyte balance in the can have side effects such as
body. As a nursing student, it's electrolyte imbalances,
important to monitor the patient's fluid dehydration, and low blood
intake and output, serum electrolyte pressure. Nursing students
levels, and blood pressure regularly to should be aware of the potential
assess the effectiveness of treatment side effects of diuretics and
and monitor for potential understand how to manage
complications. them.
PATIENT EDUCATION
Patients receiving diuretic therapy need to be educated about the
medication, its effects, and potential side effects. As a nursing student,
you may be involved in providing patient education about diuretics and
their use.
Spasmolytics
Spasmolytics, also known as antispasmodics, are a class of medications
that act on smooth muscles to relieve muscle spasms or involuntary
contractions. Smooth muscles are found in various parts of the body, such
as the digestive tract, urinary tract, blood vessels, and bronchioles. These
muscles contract and relax involuntarily to perform various functions,
such as moving food through the digestive tract or regulating blood flow.
However, in some cases, smooth muscles may contract excessively,

causing spasms and pain. This can happen due to various reasons such as
inflammation, nerve damage, or abnormal nerve signaling. Spasmolytics
work by relaxing these overactive muscles, reducing the frequency and
intensity of the spasms, and relieving the associated pain.
TYPES OF SPASMOLYTICS
ANTICHOLINERGICS
These medications block the action of acetylcholine, a
neurotransmitter that is involved in muscle contractions.
Acetylcholine binds to muscarinic receptors on smooth
muscle cells, causing them to contract. By blocking these
receptors, anticholinergics prevent the muscles from
contracting, leading to relaxation. Examples of
anticholinergics used as spasmolytics include hyoscine,
dicyclomine, and oxybutynin.
CALCIUM CHANNEL BLOCKERS
These medications block the entry of calcium into muscle cells, which is
necessary for muscle contractions to occur. Calcium ions bind to
calmodulin, a protein in smooth muscle cells, which activates myosin light
chain kinase, leading to muscle contraction. By blocking calcium channels,
calcium channel blockers prevent muscle contraction, leading to relaxation.
Examples of calcium channel blockers used as spasmolytics include
verapamil and nifedipine.
GABA RECEPTOR AGONISTS

These medications enhance the action of gamma-aminobutyric acid
(GABA), a neurotransmitter that has a calming effect on the nervous
system. GABA binds to GABA receptors on smooth muscle cells, leading to
relaxation.
By enhancing GABA activity, GABA receptor agonists promote muscle

relaxation and relieve spasms. Examples of GABA receptor agonists used
as spasmolytics include baclofen and benzodiazepines such as diazepam.
TREATMENT FROM SPASMOLYTICS

Spasmolytics are commonly used to treat conditions such as irritable
bowel syndrome (IBS), urinary incontinence, muscle spasms caused by
multiple sclerosis or cerebral palsy, and menstrual cramps. They may also
be used in surgical procedures to relax muscles and reduce pain. However,
these medications can have side effects such as drowsiness, dry mouth,
blurred vision, and constipation. It is important to use them under the
supervision of a healthcare professional, and to report any side effects
promptly.
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JDMA NURSING SCHOOL

1 Drug Suffix , prefix and Root

7 Medications For Infection

9 Therapeutic drug levels

Nursing Process Related to

15 Mood Stabilizing Medications

17 Drug Dosage Calculations

Drug Delivery to the

21 Principles of Ethics for Nurses

22 Alcohol Withdrawal Medications

32 Renal & Urinary Medications

Name Drug Classification Examples Action

Increase the fluid

Treat and prevent

ciprofloxacin Broad spectrum

Lower blood glucose

diphenhydramine Treat allergy symptoms,

Increase the fluid excreted

Dilate the bronchi and

Block or delay the

Anti-ulcer drugs that

Reduce blood pressure

Inhibit blood vessel

Dilate the bronchi and

Increase fluid and

Block the action of

alendronate; etidronate; bisphosphonate; bone

esomeprazole; proton pump

-fenac bromfenac; diclofenac;

saxagliptin; sitagliptin; antidiabetic; inhibitor

pioglitazone; rosiglitazone; antidiabetic;

dexlansoprazole; proton pump

dalteparin; enoxaparin; antithrombotic;

almotriptan; eletriptan; antimigraine; selective

-vir acyclovir; famciclovir; antiviral; anti- herpes

-vir oseltamivir; zanamivir antiviral; anti-flu

lamivudine; stavudine; antiviral; nucleoside

-zodone nefazodone, trazodone, antidepressant

-zolam alprazolam; estazolam; benzodiazepine

-zosin alfuzosin; doxazosin; alpha blocker

Fast facts on antibiotics Side effects of Antibiotics

Macrolides Azithromycin (Zithromax)

Cephalosporins Cephalexin (Keflex)

Fluoroquinolones Ciprofloxacin (Cipro)

Lincosamides Clindamycin (Cleocin)

Antibiotics to prevent infection

Antibiotics are sometimes given as a precaution to prevent, rather than treat,

When antibiotics are needed?

Antibiotics may be used to treat bacterial infections that:

Missing a dose of antibiotics

Over-the-Counter Pain Relievers

Types of over-the-counter pain relievers

Common OTC pain medications include:

Arthritis, bursitis and tendonitis.

Prescription Pain Relievers

What do prescription pain relievers treat?

P Q Nozinan Olena Li-liquid Mogadon

-- -- -- Zispin Venlafaxine Stilnoct

-- -- -- Zolpidem Vortioxetine Sulpor