Moricizine hydrochloride

mor-IS-ih-zeen Pregnancy Category B Ethmozine (Rx) Classification Antiarrhythmic, class I See also Antiarrhythmic Drugs. Action Kinetics Causes a stabilizing effect on the myocardial membranes as well as local anesthetic activity. Shortens phase II and III repolariza-tion leading to a decreased duration of the action potential and an effective refractory period. Also, there is a decrease in the maximum rate of phase zero depolarization and a prolongation of AV conduction in clients with...

Decongestants

See also the following individual entries Ephedrine sulfate Epinephrine hydrochloride Phenylephrine hydrochloride Pseudoephedrine hydrochloride Action Kinetics The most commonly used agents for relief of nasal congestion are the adrenergic drugs. They act by stimulating alpha-adren-ergic receptors, thereby constricting the arterioles in the nasal mucosa this reduces blood flow to the area, decreasing congestion. However, drugs such as ephedrine and pseudo-ephedrine also have beta-adrenergic...

Classification Antibacterial fluoroquinolone

Action Kinetics Effective against a wide range of gram-positive and gram-negative aerobic and anaerobic bacteria. Penicillinase has no effect on the activity of ofloxacin. Widely distributed to body fluids. Maximum serum levels 1-2 hr. tvi, first phase 5-7 hr second phase 20-25 hr. Peak serum levels at steady state, after PO doses 1.5 mcg mL after 200-mg doses, 2.4 mcg mL after 300-mg doses, and 2.9 mcg mL after 400-mg doses. Peak serum levels after IV doses 2.7 mcg mL...

Ketoconazole

kee-toe-KON-ah-zohl Pregnancy Category C Nizoral (Rx), Nizoral AD (OTC) Classification Broad-spectrum anti-fungal Action Kinetics Inhibits synthesis of sterols (e.g., ergosterol), damaging the cell membrane and resulting in loss of essential intracellular material. Also inhibits biosynthesis of triglycerides and phospholipids and inhibits oxidative and peroxidative enzyme activity. When used to treat Candida albicans, it inhibits transformation of blastospores into the invasive mycelial form....

Furosemide

fur-OH-seh-myd Pregnancy Category C Apo-Furosemide M, Furoside M, Lasix, Myrosemide, Novo-Semide M, Uritol M Rx See also Diuretics, Loop. Action Kinetics Inhibits the reabsorption of sodium and chloride in the ascending loop of Henle this results in the excretion of sodium, chloride, and, to a lesser degree, potassium and bicarbonate ions. The resulting urine is more acid. Diuretic action is independent of changes in clients' acid-base balance. Has a slight antihypertensive effect. Onset PO,...

Antianginal Drugs Nitratesnitrites

See also the following individual entries Isosorbide dinitrate Isosorbide mononitrate, oral Nitroglycerin sublingual Nitroglycerin sustained release Nitroglycerin transdermal system Nitroglycerin translingual spray General Statement Three groups of drugs are currently used for the treatment of angina. These agents include the nitrates nitrites, beta-adrenergic blocking agents, and calcium channel blocking drugs. Action Kinetics Nitrates reduce preload and afterload leading to decreased left...

Quinapril hydrochloride

KWIN-ah-prill Pregnancy Category D Accupril Rx Classification Angiotensin-convert-ing enzyme inhibitor See also Angiotensin-Converting Enzyme Inhibitors. Action Kinetics Onset 1 hr. Time to peak serum levels 1 hr. Peak decrease in BP 2-4 hr. Metabolized to quinaprilat, the active metabolite. tV2, quinaprilat 2 hr. Duration 24 hr. Significantly bound to plasma proteins. Metabolized with approximately 60 excreted through the urine and 37 excreted in the feces. Also appears to improve endothelial...

Cetirizine hydrochloride

seh-TIH-rah-zeen Pregnancy Category B Reactine M, Zyrtec Rx Classification Antihistamine See also Antihistamines. Action Kinetics A potent H1-re-ceptor antagonist. A mild bronchod-ilator that protects against histmine-in-duced bronchospasm negligible anticholinergic and sedative activity. Rapidly absorbed after PO administration however, food delays the time to peak serum levels but does not decrease the total amount of drug absorbed. Poorly penetrates the CNS, but high levels are distributed...

Diuretics Thiazides

See also the following individual entries Indapamide Action Kinetics Thiazides promote diuresis by decreasing the rate at which sodium and chloride are reabsorbed by the distal convoluted renal tubules of the kidney. A large fraction is excreted unchanged in urine. Uses Edema, CHF, hypertension, pregnancy, and premenstrual tension. Thiazides are used for edema due to CHF, nephrosis, nephritis, renal failure, PMS, hepatic cirrhosis, corticosteroid or estrogen therapy. Hypertension....

Diphenhydramine hydrochloride

dye-fen-HY-drah-meen Pregnancy Category B Allerdryl M, AllerMax, AllerMax Allergy & Cough Formula, Banophen Ca-plets, Benadryl, Benadryl Allergy, Benadryl Allergy Ultratabs, Benadryl Dye-Free Allergy, Benadryl Dye-Free Allergy Liqui Gels, Diphen AF, Diphen Cough, Diphenhist, Genahist, Hyrex-in-50, Nytol M, Nytol Extra Strength M, PMS-Diphenhydramine M, Schein-pharm Diphenhydramine M, Scot-Tussin DM, Siladryl, Tusstat (OTC and Rx). Sleep-Aids Dormin, Miles Nervine, Nighttime Sleep Aid,...

Angiotensinconverting Enzyme Ace Inhibitors

See also the following individual entries Action Kinetics Believed to act by suppressing the renin-angiotensin-aldosterone system. The ACE inhibitors prevent the conversion of an-giotensin I to angiotensin II. This results in a decrease in plasma angiotensin II and subsequently a decrease in peripheral resistance and decreased aldosterone secretion (leading to sodium and fluid loss) and therefore a decrease in BP. Uses Alone or in combination with other antihypertensive agents (especially...

Phenothiazines

Amantadine hydrochloride Benztropine mesylate See also the following individual entries Chlorpromazine Chlorpromazine hydrochloride Fluphenazine decanoate Fluphenazine enanthate Fluphenazine hydrochloride Thioridazine hydrochloride General Statement Antipsychotic drugs do not cure mental illness, but they calm the intractable client, relieve the despondency of the severely depressed, activate the immobile and withdrawn, and make some more accessible to psychotherapy. Action Kinetics It has been...

Tiagabine hydrochloride

tye-AG-ah-been Pregnancy Category C Gabatril Rx Classification Anticonvulsant, miscellaneous See also Anticonvulsants. Action Kinetics Mechanism not known but activity of GABA, an inhibitory neurotransmitter, may be enhanced. Drug may block uptake of GABA into presynaptic neurons allowing more GABA to bind to post-synaptic cells. This prevents propagation of neural impulses that contribute to seizures due to GABA-ergic action. Peak plasma levels About 45 min when fasting. High fat meals...

Fluconazole

(flew-KON-ah-zohl Pregnancy Category C Diflucan, Difulcan-150 M (Rx) Classification Antifungal agent Action Kinetics Inhibits the enzyme cytochrome P-450 in the organism, which results in a decrease in cell wall integrity and extrusion of intracellular material, leading to death. Apparently does not affect the cytochrome P-450 enzyme in animals or humans. Peak plasma levels 1-2 hr. t1 2 30 hr, which allows for once daily dosing. Penetrates all body fluids at steady state. Bioavail-ability is...

Quetiapine fumarate

kweh-TYE-ah-peen Pregnancy Category C Seroquel Rx Classification Antipsychotic drug Action Kinetics Mechanism unknown but may act as an antagonist at dopamine D2 and serotonin 5HT2 receptors. Side effects may be due to antagonism of other receptors (e.g., histamine H1, dopamine D1, adre-nergic alpha-1 and alpha-2, serotonin 5HT1A). Rapidly absorbed. Peak plasma levels 1.5 hr. Metabolized by liver and excreted through urine and feces. tV2, terminal About 6 hr. Uses Management of psychoses....

Hydralazine hydrochloride

hy-DRAL-ah-zeen Pregnancy Category C Apo-Hydralazine M, Apresoline, Novo-Hylazin M, Nu-Hydral M Rx Classification Antihypertensive, direct action on vascular smooth muscle See also Antihypertensive Agents. Action Kinetics Exerts a direct va-sodilating effect on vascular smooth muscle. Because there is a reflex increase in cardiac function, hydralazine is commonly used with drugs that inhibit sympathetic activity (e.g., beta blockers, clonidine, methyldo-pa). Rapidly absorbed after PO use. Food...

Antineoplastic Agents

See also the following individual entries Cyclophosphamide Etoposide Fluorouracil Flutamide Hydroxyurea Methotrexate Methotrexate sodium Paclitaxel Tamoxifen General Statement The choice of the chemotherapeutic agent(s) depends both on the cell type of the tumor and on its site of growth. All antineoplastic agents are cytotoxic (i.e., cell poisons) and therefore interfere with normal as well as neo-plastic cells. However, neoplastic cells are more active and multiply more rapidly than normal...

Second Generation

Low to no sedation or anticholinergic effects and no antiemetic activity. Example Cetiri-zine. 2. Piperidines. Moderate to high antihistamine activity, low to no sedation and anticholinergic activity, and no antiemetic action. Examples As-temizole, fexofenadine, loratidine, terfenadine. The kinetics of most first-generation antihistamines are similar. Onset 15-30 min peak 1-2 hr duration 4-6 hr (piperidines have a longer duration). Many antihistamines are available as timed-release...

Cabergoline

cah-BER-goh-leen Pregnancy Category B Dostinex (Rx) Classification Drug to treat hyper-prolactinemia Action Kinetics Secretion of prolac-tin occurs through the release of dopamine from tuberofundibular neurons. Cabergoline is a synthetic ergot derivative that is a dopamine receptor agonist at D2 receptors. Inhibits basal and metoclopramide-induced prolactin secretion. Peak plasma levels 2-3 hr. Undergoes a significant first-pass effect. Extensively metabolized in the liver and excreted in both...

Felbamate

FELL-bah-mayt Pregnancy Category C Felbatol (Rx) Classification Anticonvulsant, miscellaneous (second-line therapy) NOTE In August 1994 it was recommended that felbamate treatment be discontinued for epilepsy clients due to several cases of aplastic anemia. Revised labeling states, Felbatol should only be used in patients whose epilepsy is so severe that the risk of aplastic anemia is deemed acceptable in light of the benefits conferred by its use Action Kinetics Mechanism not known. Felbamate...

Ticlopidine hydrochloride

tie-KLOH-pih-deen Pregnancy Category B Ticlid Rx Classification Platelet aggregation inhibitor Action Kinetics Irreversibly inhibits ADP-induced platelet-fibrinogen binding and subsequent platelet-platelet interactions. This results in inhibition of both platelet aggregation and release of platelet granule constituents as well as prolongation of bleeding time. Peak plasma levels 2 hr. Maximum platelet inhibition 8-11 days after 250 mg b.i.d. Steady-state plasma levels 14-21 days. tvi,...

V

val-PROH-ick Pregnancy Category D Alti-Valproic M, Depakene, Gen-Valproic M, Novo-Valproic M Rx Classification Anticonvulsant, miscellaneous See also Anticonvulsants. Action Kinetics The following information also applies to divalproex sodium (Depakote, Epival M). The precise anticonvulsant action is unknown, but activity is believed to be caused by increased brain levels of the neurotransmitter GABA. Absorption from the GI tract is more rapid following administration of the syrup (sodium...

Sucralfate

sue-KRAL-fayt Pregnancy Category B Apo-Sucralfate M, Carafate, Novo-Sucralate M, Nu-Sucralfate M, Sul-crate M, Sulcrate Suspension Plus M Rx Action Kinetics Thought to form an ulcer-adherent complex with albumin and fibrinogen at the site of the ulcer, protecting it from further damage by gastric acid. May also form a viscous, adhesive barrier on the surface of the gastric mucosa and duodenum. It adsorbs pepsin, thus inhibiting its activity. May be used in conjunction with antacids....

Nicardipine hydrochloride

nye-KAR-dih-peen Pregnancy Category C Cardene, Cardene IV, Cardene SR Rx Classification Calcium channel blocking agent (antianginal, antihypertensive) See also Calcium Channel Blocking Agents. Action Kinetics Moderately decreases CO and significantly decreases peripheral vascular resistance. Onset of action 20 min. Maximum plasma levels 30-120 min. Significant first-pass metabolism. Food (especially fats) will decrease the amount of drug absorbed from the GI tract. Steady-state plasma levels...

Amphetamines And Derivatives

See also the following individual entries Dextroamphetamine sulfate Action Kinetics Thought to act on the cerebral cortex and reticular activating system (including the medullary, respiratory, and vasomotor centers) by releasing norepinephrine and dopamine from central adrener-gic neurons. Readily absorbed from the GI tract and distributed throughout most tissues, with the highest concentrations in the brain and CSF. Duration of anorexia (PO) 3-6 hr. Metabolized in liver and excreted by...

Classification Antibiotic macrolide

Action Kinetics Azithromycin is an azalide antibiotic (subclass of macrolides) derived from erythromy-cin. The drug acts by binding to the 50S ribosomal subunit of susceptible organisms, thus interfering with micro-bial protein synthesis. Rapidly absorbed and distributed widely throughout the body. Food decreases the absorption of azithromycin. tV2, terminal 68 hr. A loading dose will achieve steady-state levels more quickly. Elimination is by biliary excretion of unchanged drug with a small...

Hydrocodone bitartrate and Acetaminophen

high-droh-KOH-dohn, ah-seat-ah-MIN-oh-fen Pregnancy Category C Anexia 5 500, Anexia 7.5 650, Anex-sia 10 mg Hydrocodone bitartrate, Anexsia 660 mg Acetaminophen, Lorcet 10 650, Lorcet Plus, Lortab 10 500 10 mg Hydrocodone bitartrate, Lortab 500 mg Acetaminophen, Vicodin, Vicoprofen (Rx) (C-III) Classification Analgesic See also Opioid Analgesics and Acetaminophen. Content Anexia 5 500 Opioidanal-gesic Hydrocodone bitartrate, 5 mg, and Nonopioid analgesic Acetaminophen, 500 mg. Anexia 10 650...

Fluoroquinolones

See also the following individual entries Ciprofloxacin hydrochloride Enoxacin Lomefloxacin hydrochloride Norfloxacin Ofloxacin Sparfloxacin Action Kinetics Synthetic, broad-spectrum antibacterial agents. Are bactericidal agents by interfering with DNA gyrase, an enzyme needed for the synthesis of bacterial DNA. Food may delay the absorption of ciprofloxacin, lomefloxacin, and norfloxacin. Ciprofloxacin, levofloxa-cin, ofloxacin, and trovafloxacin may be given IV all fluoroquino-lones may be...

Metronidazole

meh-troh-NYE-dah-zohl Pregnancy Category B Apo-Metronidazole M, Femazole, Flagyl, Flagyl ER, Flagyl I.V., Flagyl I.V. RTU, Metric 21, Metro-Cream Topical, MetroGel Topical, MetroGel-Vaginal, Metro I.V., Metryl, Metryl-500, Metryl I.V., NidaGel M, Novo-Nidazol M, PMS-Metronidazole M, Protostat, Sa-tric, Satric 500, Trikacide M Rx Classification Systemic trichomon-acide, amebicide See also Anti-Infectives. Action Kinetics Effective against anaerobic bacteria and protozoa. Specifically inhibits...

Buspirone hydrochloride

byou-SPYE-rohn Pregnancy Category B Apo-Buspirone M, BuSpar, Linbus-pirone M, Nu-Buspirone M Rx Classification Nonbenzodiazepine antianxiety agent Action Kinetics The mechanism of action is unknown. Not chemically related to the benzodiazepines no anticonvulsant or muscle relaxant properties. Significant sedation has not been observed. The drug binds to serotonin 5-HT1A and dopamine D2 receptors in the CNS it is thus possible that dopamine-mediated neurologic disorders may occur. These include...

Ranitidine hydrochloride

rah-NIH-tih-deen Pregnancy Category B Alti-Ranitidine HCl M, Apo-Ranitidine M, Novo-Ranidine M, Nu-Ranit M, Zantac, Zantac-C M, Zantac Efferdo-se, Zantac GELdose Capsules Rx , Zantac 75 OTC Classification H2 receptor antagonist See also Histamine H2 Antagonists. Action Kinetics Competitively inhibits gastric acid secretion by blocking the effect of histamine on histamine H2 receptors. Weak inhibitor of cytochrome P-450 drug-metabolizing enzymes thus, drug interactions involving inhibition of...

Dimenhydrinate

dye-men-HY-drih-nayt Pregnancy Category B Oral Liquid, Syrup, Tablets, Chewable Tablets Apo-Dimenhydrinate M, Calm-X, Dimentabs, Dramamine, Gravol M, Marmine, Motion-Aid, PMS-Dimenhydrinate M, Travamine, Travel Tabs M, Traveltabs M, Triptone OTC . Injection Dimenhydrinate Injection M, Dinate, Dramanate, Dram-ilin, Dymenate, Gravol M, Hydrate, Marmine, Reidamine Rx Classification Antihistamine, anti-emetic See also Antihistamines and Anti-emetics. Action Kinetics Contains both diphenhydramine...

Lidocaine hydrochloride

Direct IV or IV Admixtures Lidocaine HCl for Cardiac Arrhythmias, Xylocaine HCl IV for Cardiac Arrhythmias, Xylo-card M Rx . IV Infusion Lidocaine HCl in 5 Dextrose Rx Classification Antiarrhythmic, class IB See also Antiarrhythmic Agents. Action Kinetics Shortens the refractory period and suppresses the automaticity of ectopic foci without affecting conduction of impulses through cardiac tissue. Increases the electrical stimulation threshold of the ventricle...

Tablet Zeedoh Action

zah-FIR-loo-kast Pregnancy Category B Accolate Rx Action Kinetics A selective and competitive antagonist of leuko-triene receptors D4 and E4, inhibits bronchospasm and airway edema. Rapidly absorbed after PO use bio-availabilty may be decreased when taken with food. Peak plasma levels 3 hr. tv2, terminal About 10 hr. Over 99 bound to plasma proteins. Extensively metabolized in the liver, with about 90 excreted in the feces and 10 in the urine. Inhibits certain cytochrome P450 isoenzymes. Uses...

Cephalosporins

See also the following individual entries Loracarbef General Statement Cephalosporins are broad-spectrum antibiotics classified as first-, second-, and third-generation drugs. The difference among generations is based on pharmacokinetics and antibacterial spectra. Generally, third-generation cephalosporins have more activity against gram-negative organisms and resistant organisms and less activity against gram-positive organisms than first-generation drugs. Third-generation cephalosporins are...

Barbiturates

See also the following individual entries Pentobarbital Pentobarbital sodium Phenobarbital Phenobarbital sodium Secobarbital sodium Action Kinetics Barbiturates produce all levels of CNS depression, ranging from mild depression sedation following low doses to hypnotic sleep-inducing effects, and even coma and death, as dosage is increased. Certain barbiturates are also effective anticonvulsants. The depressant and anticonvulsant effects may be related to their ability to increase and or mimic...

Lamotrigine

lah-MAH-trih-jeen Pregnancy Category C Lamictal Rx See also Anticonvulsants. Action Kinetics Mechanism of anticonvulsant action not known. May act to inhibit voltage-sensitive sodium channels. This effect stabiliz es neuronal membranes and modulates presynaptic transmitter release of excitatory amino acids such as glutamate and aspartate. Rapidly and completely absorbed after PO use. Peak plasma levels 1.4-4.8 hr. tV2, after repeated doses About 33 hr. Metabolized by the liver with metabolites...

Fluticasone propionate

flu-TIH-kah-sohn Pregnancy Category C Flonase, Flovent Rx Classification Corticosteroid See also Corticosteroids. Action Kinetics Following intranasal use, a small amount is absorbed into the general circulation. Onset Approximately 12 hr. Maximum effect May take several days. Absorbed drug is metabolized in the liver and excreted in the urine. Uses Maintenance treatment of asthma in adults and children over four years of age. To manage seasonal and perennial allergic rhinitis in adults and...

Antidepressants Tricyclic

See also the following individual entries Amitriptyline hydrochloride Amoxapine Clomipramine hydrochloride Desipramine hydrochloride Doxepin hydrochloride Nortriptyline hydrochloride Trimipramine maleate Action Kinetics It is now believed that antidepressant drugs cause adaptive changes in the serotonin and norepinephrine receptor systems, resulting in changes in the sensitivities of both presynaptic and postsynaptic receptor sites. Well absorbed from the GI tract. All have a long serum...

Prepulsid M Propulsid [Rx Classification GI drug

Action Kinetics Cisapride is a GI prokinetic agent. Acts by enhancing release of acetylcholine at the myen-teric plexus, resulting in increased strength of esophageal peristalsis and an increase in lower esophageal sphincter pressure. Also increases gastric emptying time. Rapidly absorbed. Onset 30-60 min. Peak plasma levels 1-1.5 hr. Terminal tV2 6-12 hr up to 20 hr following IV use . Metabolized in the liver with less than 10 excreted unchanged through the urine and feces. Uses Symptomatic...

Sympathomimetic Drugs

See also the following individual entries Bitolterol mesylate Ephedrine sulfate Epinephrine Epinephrine hydrochloride Phenylephrine hydrochloride Pirbuterol acetate Pseudoephedrine hydrochloride Salmeterol xinafoate Action Kinetics The adrenergic drugs work in two ways 1 by mimicking the action of norepineph-rine or epinephrine by combining with alpha and or beta receptors directly acting sympathomimetics or 2 by causing or regulating the release of the natural neurohormones from their storage...

Classification Expectorant

Action Kinetics May increase the output of fluid of the respiratory tract by reducing the viscosity and surface tension of respiratory secretions, thereby facilitating their expectoration. Data on efficacy are lacking. Uses Dry, nonproductive cough due to colds and minor upper respiratory tract infections when there is mucus in the respiratory tract. Contraindications Chronic cough e.g., due to smoking, asthma, or emphysema , cough accompanied by excess secretions. Use in children under age 12...

Cromolyn sodium Sodium cromoglycate

CROH-moh-lin Pregnancy Category B Crolom, Gastrocrom, Intal, Nalcrom M, Nasalcrom, Novo-Cromolyn M, Opticrom M, PMS-Sodium Chromo-glycate M, Rynacrom M, Vistacrom M OTC Rx Classification Antiasthmatic, antiallergic drug Action Kinetics Acts locally to inhibit the degranulation of sensitized mast cells that occurs after exposure to certain antigens. Prevents the release of histamine, slow-reacting substance of anaphylaxis, and other endogenous substances causing hy-persensitivity reactions....

Sedativehypnotics Antianxiety Antimanic Drugs

See also the following individual entries Flurazepam hydrochloride Lithium carbonate Lithium citrate Lorazepam Midazolam hydrochloride Zolpidem tartrate Action Kinetics Benzodiazepines are the major antianxiety agents. They are thought to affect the limbic system and reticular formation to reduce anxiety by increasing or facilitating the inhibitory neurotransmitter activity of GABA. When used for 3-4 weeks for sleep, certain benzodiaze-pines may cause REM rebound when discontinued. The...

Carbamazepine

kar-bah-MAYZ-eh-peen Pregnancy Category C Apo-Carbamazepine M, Atretol, De-pitol, Epitol, Mazepine M, Novo-Car-bamaz M, Nu-Carbamazepine M, PMS-Carbamazepine M, Taro-Carba-mazepine M, Tegretol, Tegretol Chewtabs M, Tegretol CR M, Tegretol XR Rx Classification Anticonvulsant, miscellaneous See also Anticonvulsants. Action Kinetics The anticonvul-sant action is not known but may involve depressing activity in the nucleus ventralis anterior of the thalamus, resulting in a reduction of...

Bromocriptine mesylate

broh-moh-KRIP-teen Pregnancy Category B Alti-Bromocriptine M, Apo-Bromocrip-tine M, Parlodel Rx Classification Prolactin secretion inhibitor antiparkinson agent Action Kinetics Bromocriptine is a nonhormonal agent that inhibits the release of the hormone prolactin by the pituitary. Should be used only when prolactin production by pituitary tumors has been ruled out. Its effect in parkinsonism is due to a direct stimulating effect on dopamine type 2 receptors in the corpus stria-tum. Use for...

Betaxolol hydrochloride

beh-TAX-oh-lohl Pregnancy Category C Betoptic, Betoptic S, Kerlone Rx Classification Beta-adrenergic blocking agent See also Beta-Adrenergic Blocking Agents. Action Kinetics Inhibits beta-1-adrenergic receptors although beta-2 receptors will be inhibited at high doses. Has some membrane stabilizing activity but no intrinsic sympath-omimetic activity. Low lipid solubility. When used in the eye, betaxolol reduces the production of aqueous humor, thus, reducing intraocular pressure. It has no...