Drug List- Analgesics and Anti-inflammatory Drugs – Flashcards

• Trade name: o Tylenol, Vicodin Acetaminophen + Hydrocodone • Pharmacologic class: o analgesic and antipyretic agent • Drug action: o inhibition of prostaglandin synthesis by inhibition of cyclooxygenase (COX) • Drug effects: o indirect cannabinoid-receptor agonistic effect in the CNS. In hypothalamus has an antipyretic(fever reducing) effect • Indications: o headache, earache, influenza, chickenpox, bacterial infections with pain and fever, toothache, osteoarthritis, and musculoskeletal pain. Is considered safe during pregnancy if taken as prescribed • Adverse side effects: o drug usually has no side effects • Adverse drug reaction: o Can cause stomach bleeding or liver damage if alcohol is consumed

• Trade name: o Zyloprim • Pharmacologic class: o Xanthine oxidase inhibitor • Drug action: o inhibitor of the enzyme xanthine oxidase • Drug effects: o reduces the production of uric acid • Indications: o used to treat gout, high levels of uric acid in the body caused by certain cancer medications, and kidney stones • Adverse side effects: o Stomach upset, nausea, diarrhea, or drowsiness may occur, numbness/tingling of arms/legs, easy bleeding/bruising, signs of infection (e.g., fever, persistent sore throat), unusual tiredness, painful/bloody urination, change in the amount of urine, yellowing eyes/skin, severe stomach/abdominal pain, persistent nausea/vomiting, dark urine, unusual weight loss, eye pain, vision changes • Adverse drug reaction: o certain asthma drugs (aminophylline, theophylline), azathioprine, "blood thinners" (e.g., warfarin), chlorpropamide, cyclosporine, mercaptopurine, "water pills" (e.g., thiazide diuretics such as hydrochlorothiazide)

• Trade name: o Excedrin • Pharmacologic class: o salicylate and a nonsteroidal anti-inflammatory drug (NSAID) • Drug action: o inhibit both COX 1 and COX 2 • Drug effects: o reducing substances in the body that cause pain, fever, and inflammation. • Indications: o fever and relieve mild to moderate pain from conditions such as muscle aches, toothaches, common cold, and headaches. It may also be used to reduce pain and swelling in conditions such as arthritis • Adverse side effects: o Upset stomach and heartburn may occur • Adverse drug reaction: o Can cause stomach bleeding or liver damage if alcohol is consumed.

• Trade name: o Celebrex • Pharmacologic class: o anti-inflammatory drug • Drug Action: o used to treat pain, tenderness and swelling of joints in patients with OA, RA and Ankylosing Spondylitis; also used to treat painful menstrual periods • Drug Effects: o second generation COX-2 inhibitor (NSAID) • Indications: o pain and inflammation • Adverse side effects: o diarrhea, gas or bloating, sore throat and cold symptoms. Like other NSAIDS Celebrex, may cause heart attacks and strokes; accumulation of fluid and worsen heart failure; cause or worsen hypertension and kidney failure. • Adverse drug reaction: o Concomitant use of celecoxib with aspirin or other NSAIDs (for example, ibuprofen, naproxen, etc.) may increase the occurrence of stomach and intestinal ulcers; it may be used with low dose aspirin. Fluconazole (Diflucan) increases the concentration of celecoxib in the body by preventing the elimination of celecoxib in the liver; therefore, treatment with celecoxib should be initiated at the lowest recommended doses in patients who are taking fluconazole; celecoxib increases the concentration of lithium (Eskalith) in the blood by 17% and may promote lithium toxicity. Therefore, lithium therapy should be closely monitored during and after therapy with celecoxib

• Trade name: o Mucinex, Robitussin, Benylin, Babee Cof • Pharmacologic class: o antitussive • Drug action: o used to temporarily relieve cough caused by the common cold, the flu, or other conditions; will relieve a cough but will not treat the cause of the cough or speed recovery • Drug effects: o decreases activity in the part of the brain that control coughing • Indications: o common cold and cough • Adverse side effects: o dizziness, lightheadedness, drowsiness, nervousness, restlessness, nausea, vomiting and stomach pain • Adverse drug reaction: o should not be taken with Monoamine oxidase inhibitors (MAOIs) or Serotonin reuptake inhibitors (like SSRIs and SNRIs) due to the potential for serotonin syndrome

Trade name o Duragesic, Actiq, Fentora, Sublimaze • Pharmacologic class o Opiod, narcotic analgesic • Drug action o Strong agonist of μ-opioid receptors • Drug effects o Agonist of opioid receptors in the brain leading to reduced feeling of pain • Indications o used to treat breakthrough pain, used for anesthesia and analgesia in operating rooms and used as a sedative during endoscopy, oral surgery, catheterization • Adverse side effects o diarrhea, sweating, dry mouth, confusion, weakness

• Trade name: o Migra-Lieve, Nomigraine, Migraplex • Pharmacologic class: o dietary herbal supplement • Drug Action: o inhibits platelet aggregation (which can release serotonin which may fuel migraines) and histamine release. It has also been shown to inhibit release of serotonin from platelets. • Drug Effects: o Anti-pyruetic and anti-inflammatory, • Indications: o used to treat fevers, headaches, arthritis and digestive problems • Adverse side effects: o allergic reaction is possible and miscarriage in pregnant women

• Trade name: o Vicodin • Pharmacologic class: o semi-synthetic opioid derived from codeine and thebaine • Drug action: o Narcotic analgesic, always combined with other medications, bind opiod-R • Drug effects: o Relieves pain by binding opiod receptors in the brain and spinal cord • Indications: o cough suppressant, pain relief • Adverse side effects: o nausea, vomitting, constipation

• Trade name: o Advil • Pharmacologic class: o NSAID • Drug action: o inhibit both COX 1 and COX 2 • Drug effects: o pain & inflammatiom releif- prevents formation of prostaglandins • Indications: o arthritis, fever, general pain, dysmenorrhea • Adverse side effects: o photosensitivity, CV risk, blisters, nausea, dyspepsia, GI bleeding, raised liver enzymes, diarrhea, constipation, epistaxis, headache, hypertension • Adverse drug reaction: o stomach bleeding w/ alcohol

• Trade name: o Immodium • Pharmacologic class: o opioid • Drug action: o Mu-opioid receptor agonist • Drug effects: o decreases activity of myenteric plexus, which decreases small intestine motility, allowing more water to be absorbed • Indications: o diarrhea • Adverse side effect: o abdominal pain/bloating, nausea, vomiting and constipation • Adverse drug reaction: o P-glycoprotein inhibitors like quinidine and quinine, PPIS like omeprazole, and black pepper can allow loperamide to cross BBB

• Trade name: o Avinza • Pharmacologic class: o opioid analgesic • Drug action: o Mimics endorphins- binds w/ Mu-opioid receptors • Drug effects: o mimics endorphins- analgesic & pleasure • Indications: o acute and chronic severe pain • Adverse side effects: o constipation, addiction, tolerance, withdrawl, overdose • Adverse drug reaction: o other opioids. May cause dependence. May be harmful to babies/opder people

• Trade name: o Narcan • Pharmacologic class: o opioid antagonist • Drug action: o MU-opioid receptor competitive antagonist • Drug effects: o reverses opiate overdose effects • Indications: o heroine/morphine overdose, congenital insensitivity to pain w/ anhidrosis • Adverse side effects: o change in mood, increased sweating, nausea, nervousness, restlessness, trembling, vomiting, allergic reactions such as rash or swelling, dizziness, fainting, fast or irregular pulse, flushing, headache, heart rhythm changes, seizures, sudden chest pain • Adverse drug reaction: o antagonizes buprenorphine. Blocked by methohexital

• Trade name: o Aleve, Naprosyn • Pharmacologic class: o Nonsalicylate NSAID • Drug action: o inhibit both COX 1 and COX 2 • Drug effects: o stopping the body's production of a substance that causes pain, fever, and inflammation • Indications: o commonly used for the reduction of pain (mild-moderate), fever, inflammation and stiffness caused by conditions such as: osteoarthritis, kidney stones, rheumatoid arthritis, psoriatic arthritis, gout, ankylosing spondylitis, menstrual cramps, tendinitis, bursitis • Adverse side effect: o linked to increases in the number of serious and potentially fatal cardiovascular events such as myocardial infarctions and stroke, may interfere and reduce efficiency of SSRI antidepressants • Adverse drug reaction: o easy bruising/bleeding, difficult/painful swallowing, hearing changes (such as ringing in the ears), mental/mood changes, swelling of the ankles/feet/hands, sudden/unexplained weight gain, change in the amount of urine, unexplained stiff neck, vision changes

• Trade name: o Demerol • Pharmacologic class: o narcotic/opioid analgesic • Drug action: o Kappa-opioid receptor agonist • Drug effects: o analgesic • Indications: o moderate to severe pain • Adverse side effects: o nausea, vomiting, sedation, dizziness, diaphoresis, urinary retention and constipation. NO MIOSIS. • Adverse drug reaction: o Dangerous with MAOIs. Serotonin syndrome w/ SSRIs/MAOIs

• Trade name: o Avinza • Pharmacologic class: o opioid analgesic • Drug action: o Mimics endorphins- binds w/ Mu-opioid receptors • Drug effects: o mimics endorphins- analgesic & pleasure • Indications: o acute and chronic severe pain • Adverse side effects: o constipation, addiction, tolerance, withdrawl, overdose • Adverse drug reaction: o other opioids. May cause dependence. May be harmful to babies/opder people

• Trade name: o Narcan • Pharmacologic class: o opioid antagonist • Drug action: o MU-opioid receptor competitive antagonist • Drug effects: o reverses opiate overdose effects • Indications: o heroine/morphine overdose, congenital insensitivity to pain w/ anhidrosis • Adverse side effects: o change in mood, increased sweating, nausea, nervousness, restlessness, trembling, vomiting, allergic reactions such as rash or swelling, dizziness, fainting, fast or irregular pulse, flushing, headache, heart rhythm changes, seizures, sudden chest pain • Adverse drug reaction: o antagonizes buprenorphine. Blocked by methohexital

• Trade name: o Aleve, Naprosyn • Pharmacologic class: o Nonsalicylate NSAID • Drug action: o Inhibit both COX 1 and COX 2 • Drug effects: o Stopping the body's production of a substance that causes pain, fever, and inflammation • Indications: o Commonly used for the reduction of pain (mild-moderate), fever, inflammation and stiffness caused by conditions such as: osteoarthritis, kidney stones, rheumatoid arthritis, psoriatic arthritis, gout, ankylosing spondylitis, menstrual cramps, tendinitis, bursitis • Adverse side effects: o linked to increases in the number of serious and potentially fatal cardiovascular events such as myocardial infarctions and stroke, may interfere and reduce efficiency of SSRI antidepressants • Adverse drug reaction: o easy bruising/bleeding, difficult/painful swallowing, hearing changes (such as ringing in the ears), mental/mood changes, swelling of the ankles/feet/hands, sudden/unexplained weight gain, change in the amount of urine, unexplained stiff neck, vision changes.

• Trade name: o Krystexxa • Pharmacologic class: o PEGylated uric acid specific enzyme. • Drug action: o uric acid specific enzyme • Drug effects: o catalyzing the oxidation of uric acid to allantoin, thereby lowering serum uric acid • Indications: o chronic gout (hyperuricemia) • Adverse side effects: o gout flare-ups or attacks, infusion reactions, nausea, bruising, sore throat, constipation, chest pain, severe allergic reactions, and vomiting • Adverse drug reaction: o anaphylactic shock