PHARMACOLOGY
DRUGS CONTROL INFECTION
1st SEMESTER MIDTERM S.Y. 2023-2024
ANTI INFLAMMATORY
Inflammation Basics
⋆Inflammation is a complex biological
response to injury or infection.
⋆ It includes redness, heat, swelling, pain, and
loss of function.
⋆Key players: cytokines, prostaglandins,
leukotrienes, and histamines
TYPES OF INFLAMMATION
⋆ Acute Inflammation: - Immediate response
to injury or infection.
⋆ Chronic Inflammation- Prolonged, often
low-grade inflammation seen in conditions
like arthritis.
INFLAMMATORY MEDIATORS
⋆ Cytokines- Signaling proteins involved in
inflammation.
⋆Prostaglandins- Lipid compounds that
mediate inflammation and pain.
⋆Leukotriene- Lipid compounds that promote
inflammation and bronchoconstriction.
⋆Histamines-Released during allergic
reactions and contribute to inflammation.
TYPES OF ANTI-INFLAMMATION
DRUGS
⋆ Nonsteroidal Anti-Inflammatory Drugs
(NSAIDs)
⋆ Corticosteroids
⋆ Disease-Modifying Anti-Rheumatic Drugs
(DMARDs)
⋆Biologic Response Modifiers (Biologics)
NONSTEROIDAL ANTI-
INFLAMMATORY DRUGS (NSAIDS)
⋆ Common examples: Ibuprofen, aspirin,
and naproxen.
⋆ Mechanism: Inhibit cyclooxygenase (COX)
enzymes, reducing prostaglandin production.
⋆ Indications: Pain, inflammation, fever.
⋆ Side effects: GI irritation, renal dysfunction,
bleeding risk
DRUGS TO TO
CONTROL INFECTION
PROFESSOR: MS. ADA MAGNAYON
CORTICOSTEROIDS
⋆ Common examples: Prednisone,
Dexamethasone.
⋆Mechanism: Suppress inflammation by
inhibiting cytokines and immune response.
⋆ Indications: Various inflammatory
conditions.
⋆ Side effects: Immunosuppression, weight
gain, mood changes
DISEASE-MODIFYING ANTI -
RHEUMATIC DRUGS (DMARDs)
⋆ Common examples: methotrexate,
hydroxychloroquine.
⋆Mechanism: Modulate the immune
response, slow disease progression.
⋆ Indications: Rheumatoid arthritis,
autoimmune diseases.
⋆ Side effects: Bone marrow suppression,
liver toxicity.
BIOLOGIC RESPONSE MODIFIERS
(Biologics)
⋆ Common examples: Adalimumab,
Infliximab.
⋆Mechanism: Target specific molecules
involved in inflammation
⋆ Indications: Rheumatoid arthritis, Crohn's
disease, psoriasis.
⋆ Side effects: Risk of infections, injection
site reactions
C LIN IC A L A PPLIC A TION S
⋆ Anti-inflammatory drugs are used in a wide
range of conditions, from arthritis to asthma,
and even post-surgery pain management.
⋆ Always consider the specific patient and
condition when choosing a drug
CLINICAL APPLICATIONS
⋆ Assess patient's medical history, allergies,
and current medications.
⋆ Monitor for side effects, especially
gastrointestinal issues, renal function, and
signs of infection.
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⋆ Educate patients on medication use, potential
side effects, and the importance of compliance
DRUGS TO CONTROL INFECTION:
ANTIBIOTICS
DEFINITION AND HISTORICAL
OVERVIEW
⋆ Antibiotics are medications that inhibit the
growth or destroy bacteria.
⋆ The discovery of antibiotics revolutionized
medicine, with Alexander Fleming's discovery
of penicillin in 1928 being a landmark event.
⋆ They have saved countless lives and continue
to be a cornerstone of modern medicine
MECHANISMS OF ACTION
♥︎ Inhibition of Cell Wall Synthesis: Drugs
like penicillins and cephalosporins weaken
bacterial cell walls, leading to cell lysis.
♥︎ Inhibition of Protein Synthesis: Antibiotics
such as tetracyclines and macrolides interfere
with bacterial protein synthesis, halting their
growth.
♥︎ Disruption of Cell Membranes:
Polymyxins disrupt bacterial cell membranes,
causing leakage and cell death.
♥︎ Inhibition of Nucleic Acid Synthesis:
Fluoroquinolones block DNA replication in
bacteria.
♥︎ Interference with Metabolism:
Sulfonamides act as antimetabolites,
impeding bacterial metabolic pathways
C OMMON C LA SSES OF A N TIBIOTIC S
A N D USES
1. Penicillins: Effective against a wide range
of bacteria, they are used for respiratory, skin,
and urinary tract infections.
2. Cephalosporins: Broad-spectrum
antibiotics used for surgical prophylaxis and
infections involving Gram-negative bacteria.
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3. Tetracyclines: Used for acne and various
infections but not suitable for children and
pregnant women.
4. Macrolides: Effective against respiratory
tract infections and atypical pathogens.
5. Fluoroquinolones: Broad-spectrum
antibiotics used for urinary and respiratory
tract infections.
6. Aminoglycosides: Reserved for severe
infections due to their potential for
nephrotoxicity and ototoxicity.
7. Sulfonamides: Historically used for urinary
tract infections and some systemic infections.
8. Metronidazole: Effective against anaerobic
bacteria and used for certain GI and
gynecological infections
PENICILLINS
⋆ Suffix: "-cillin“
⋆ Mechanism of Action: Inhibit bacterial cell
wall synthesis by targeting enzymes involved
in peptidoglycan formation.
⋆ Side Effects: Allergic reactions (ranging
from rash to anaphylaxis), diarrhea, nausea.
⋆ Adverse Reactions: Anaphylactic shock
(rare but severe).
⋆ Examples: Amoxicillin, Ampicillin,
Penicillin G
PENICILLINS- NURSING CONSIDERATIONS
⋆ Assess for allergies before administration.
⋆ Monitor for signs of anaphylaxis (e.g.,
difficulty breathing, swelling, hives).
⋆ Administer with or after meals to minimize
GI upset.
CEPHALOSPORINS
⋆ Prefix: “Ceph" or “Cef“
⋆ Mechanism of Action: Inhibit cell wall
synthesis, similar to penicillins.
⋆ Side Effects: Nausea, diarrhea, rash.
⋆ Adverse Reactions: Cross-allergenicity
with penicillins (caution in penicillin-allergic
patients).
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⋆ Examples: Cephalexin, Ceftriaxone, MACROLIDES–NURSING

Cefuroxime
CEPHALOSPORINS – NURSING
CONSIDERATIONS
⋆ Monitor for allergic reactions.
⋆Encourage adequate fluid intake to
prevent crystalluria (especially with
cephalosporins like Ceftriaxone)
TETRACYCLINES
⋆ Suffix: "-cycline"
⋆ Mechanism of Action: Inhibit bacterial
protein synthesis by binding to ribosomes.
⋆ Side Effects: Photosensitivity,
gastrointestinal upset, tooth discoloration (in
children).
⋆ Adverse Reactions: Rarely, severe skin
reactions and hepatotoxicity.
⋆ Examples: Doxycycline, Minocycline,
Tetracycline.
TETRACYCLINES – NURSING
CONSIDERATIONS
⋆ Advise patients to avoid sun exposure and
use sunscreen.
⋆ Administer on an empty stomach (except
Doxycycline can be taken with food to reduce
GI irritation)
⋆ Avoid administering with dairy products or
antacids (decreases absorption)
MACROLIDES
⋆ Suffix: "-mycin" or "-thromycin"
⋆ Mechanism of Action: Inhibit bacterial
protein synthesis.
⋆ Side Effects: Nausea, diarrhea, abdominal
pain.
⋆ Adverse Reactions: Prolonged QT interval
(caution with patients at risk for arrhythmias).
⋆ Examples: Azithromycin, Clarithromycin,
Erythromycin
CONSIDERATIONS
⋆ Monitor cardiac status, especially in patients
with pre-existing heart conditions.
⋆ Administer as prescribed to maintain
therapeutic levels.
FLUOROQUINOLONES
⋆ Suffix: "-floxacin"
⋆ Mechanism of Action: Inhibit bacterial
DNA synthesis.
⋆ Side Effects: Nausea, vomiting, diarrhea,
headache.
⋆ Adverse Reactions: Tendon rupture (rare
but serious)
⋆ Examples: Ciprofloxacin, Levofloxacin,
Ofloxacin
FLUOROQUINOLONES – NURSING
CONSIDERATIONS
⋆ Assess for tendon pain or swelling, and
advise patients to stop the medication if
experienced.
⋆ Caution in children and adolescents due to
potential risk of musculoskeletal adverse
effects.
AMINOGLYCOSIDES
⋆ Suffix: "-micin" or "-mycin"
⋆ Mechanism of Action: Inhibit bacterial
protein synthesis by binding to ribosomes.
⋆ Side Effects: Nephrotoxicity, ototoxicity,
neuromuscular blockade.
⋆ Adverse Reactions: Renal impairment,
hearing loss.
⋆ Examples: Gentamicin, Tobramycin,
Amikacin
AMINOGLYCOSIDES–NURSING
CONSIDERATIONS
⋆ Monitor renal function and hearing regularly.
⋆Administer doses based on therapeutic
drug monitoring (TDM)

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SULFONAMIDES
⋆ Suffix: "-sulf" or "-sulfa"
⋆ Mechanism of Action: Interfere with
bacterial metabolism.
⋆ Side Effects: Nausea, vomiting, skin rash.
⋆ Adverse Reactions: Hypersensitivity
reactions, hematologic abnormalities
⋆ Examples: Trimethoprim-
Sulfamethoxazole (TMP-SMX),
Sulfamethoxazole, Sulfadiazine
SULFONAMIDES–NURSING
CONSIDERATIONS
⋆Monitor for skin reactions and signs of blood
dyscrasias.
⋆Encourage adequate fluid intake to prevent
crystalluria
METRONIDAZOLE
⋆ Mechanism of Action: Disrupts DNA
synthesis in anaerobic bacteria.
⋆ Side Effects: Metallic taste, nausea,
headache.
⋆ Adverse Reactions: Peripheral neuropathy
(rare with high doses or prolonged use).
METRONIDAZOLE–NURSING
CONSIDERATIONS
⋆ Advise patients to avoid alcohol due to
potential disulfiram-like reaction.
⋆ Monitor for neurologic symptoms,
especially in long-term use.
DRUGS TO CONTROL INFECTION:
ANTIVIRAL
ANTIVIRAL DRUGS OVERVIEW
⋆ Antiviral drugs are medications used to treat
viral infections by inhibiting the replication of
viruses.
⋆ They differ from antibiotics, which are used
to treat bacterial infections.
⋆ Antiviral drugs are important in the
management of diseases like HIV, hepatitis,
influenza, and herpes.
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MECHANISMS OF ACTION
♥︎ Antiviral drugs target specific steps in the
viral life
cycle.
Common mechanisms of action include:
♥︎ Inhibition of viral entry into host cells
♥︎ Inhibition of viral replication.
♥︎ Inhibition of viral release from host cells.
EXA MPLES OF A N TIV IR A L D R UGS
1. Antiretroviral Drugs: Used to treat
HIV/AIDS.
•Examples: Tenofovir, Lamivudine, Ritonavir.
2. Antiviral Influenza Medications:
•Examples: Oseltamivir (Tamiflu), Zanamivir
(Relenza).
3. Antiviral Herpes Medications:
•Examples: Acyclovir, Valacyclovir,
Famciclovir.
ANTIRETROVIRAL DRUGS
⋆ Side Effects: Nausea and vomiting,
Diarrhea, Fatigue, Headache, Rash
⋆ Adverse Reactions:
• Hepatotoxicity (especially with Ritonavir)
• Renal impairment (especially with
Tenofovir)
• Lipodystrophy syndrome (changes in body
fat distribution)
ANTIRETROVIRAL DRUGS –NURSING
CONSIDERATIONS
⋆Monitor liver and kidney function regularly.
⋆Educate patients on the importance of
adherence to the medication regimen.
⋆Assess for signs of lipodystrophy and provide
supportive care.
ANTIVIRAL INFLUENZA
⋆ Side Effects: Nausea and vomiting (more
common with Oseltamivir), diarrhea,
headache, dizziness
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⋆ Adverse Reactions: Neuropsychiatric
events (rare, but possible with Oseltamivir),
Allergic reactions (rare)
ANTIVIRAL INFLUENZA –NURSING
CONSIDERATIONS
⋆ Administer with food to reduce
gastrointestinal side effects.
⋆ Monitor for signs of neuropsychiatric
events, especially in pediatric patients.
⋆ Educate patients about the importance of
starting treatment within 48 hours of
symptom onset.
ANTIVIRAL HERPES
⋆ Side Effects: Nausea and vomiting,
Diarrhea, Headache, Dizziness
⋆ Adverse Reactions: Renal toxicity
(especially with Acyclovir at high doses),
Neurological side effects (rare)
ANTIVIRAL HERPES –NURSING
CONSIDERATIONS
⋆ Ensure adequate hydration to reduce the risk
of renal toxicity.
⋆ Monitor renal function, especially in
patients with pre-existing renal issues.
⋆ Educate patients on the importance of
completing the full course of treatment.
DRUGS TO CONTROL INFECTION:
ANTIFUNGAL
ANTIFUNGAL DRUGS
⋆ Antifungal drugs are medications used to
treat fungal infections, which can affect
various parts of the body, including the skin,
nails, respiratory system, and internal organs.
MECHANISMS OF ACTION
♥︎ Inhibition of Cell Wall Synthesis: Some
antifungals, such as echinocandins (e.g.,
caspofungin), target the fungal cell wall,
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disrupting its integrity and leading to cell
lysis.
♥︎ Disruption of Cell Membrane: Polyenes
(e.g., amphotericin B) bind to fungal cell
membranes, causing increased permeability
and cell death.
♥︎ Inhibition of Ergosterol Synthesis: Azoles
(e.g., fluconazole, itraconazole) block the
synthesis of ergosterol, a crucial component
of fungal cell membranes, leading to
membrane instability and fungal cell death.
♥︎ Interference with Fungal Nucleic Acid
Synthesis: Nucleoside analogs (e.g.,
flucytosine) disrupt fungal nucleic acid
synthesis, inhibiting DNA replication and
RNA transcription.
EXA MPLES OF A N TIFUN GA L D R UGS
1. Fluconazole (Diflucan)
2. Amphotericin B
3. Caspofungin (Cancidas)
4. Flucytosine (Ancobon)
FLUCONAZOLE (Diflucan)
⋆ Mechanism of Action: Inhibits ergosterol
synthesis.
⋆ Indications: Candidiasis, cryptococcosis.
⋆ Side Effects: Nausea, headache, rash.
⋆ Adverse Reactions: Hepatotoxicity,
Stevens-Johnson syndrome.
⋆ Nursing Considerations: Monitor liver
function, educate patients about potential
adverse reactions.
AMPHOTERICIN B
⋆ Mechanism of Action: Binds to fungal cell
membranes.
⋆ Indications: Severe systemic fungal
infections.
⋆ Side Effects: Fever, chills, nephrotoxicity.
⋆ Adverse Reactions: Anaphylaxis,
hypokalemia.
⋆ Nursing Considerations: Administer
slowly to minimize infusion reactions,
monitor renal function
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CASPOFUNGIN (Cancidas)
⋆ Mechanism of Action: Inhibits cell wall
synthesis.
⋆ Indications: Invasive aspergillosis,
candidemia.
⋆ Side Effects: Flushing, phlebitis at the
infusion site.
⋆ Adverse Reactions: Liver enzyme
elevations, hypotension
⋆ Nursing Considerations: Monitor liver
function, assess for infusion site reactions
FLUCYTOSINE (Ancobon)
⋆ Mechanism of Action: Inhibits nucleic acid
synthesis.
⋆ Indications: Cryptococcal infections.
⋆ Side Effects: Nausea, vomiting, bone
marrow suppression.
⋆ Adverse Reactions: Leukopenia,
thrombocytopenia.
⋆ Nursing Considerations: Monitor blood
counts, and educate patients about potential
adverse effects.
DRUGS TO CONTROL INFECTION:
ANTIPROTOZOAL
ANTIPROTOZOAL DRUGS
⋆ Refers to a class of drugs or medications that
are specifically designed to target and combat
protozoa, which are single-celled
microorganisms that can cause various
infections in humans and animals.
⋆ These drugs work by inhibiting the growth,
reproduction, or survival of protozoa,
ultimately helping to treat and control
protozoal infections.
MECHANISMS OF ACTION
♥︎ Inhibition of DNA Synthesis: Some drugs
interfere with protozoal DNA synthesis,
preventing the parasites from replicating. An
example is metronidazole, which is effective
against Giardia and Trichomonas.
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♥︎ Disruption of Cell Membrane Function:
Other drugs disrupt the integrity of protozoal
cell membranes, leading to cell death. One
such drug is amphotericin B, used to treat
severe fungal and protozoal infections.
EXA MPLES OF A N TIFUN GA L D R UGS
1. Metronidazole: Used for amoebic
dysentery, trichomoniasis, and giardiasis.
2. Chloroquine: Used for malaria.
3. Atovaquone/Proguanil: Also used for
malaria.
4. Artemisinin and its derivatives: Effective
against malaria.
5. Pentamidine: Used for Trypanosoma and
Leishmania infections.
C OMMON SID E EFFEC TS
⋆ Gastrointestinal Disturbances: Nausea,
vomiting, diarrhea.
⋆ Neurological Symptoms: Headache,
dizziness.
⋆ Allergic Reactions: Rash, itching,
swelling.
⋆ Hematological Effects: Blood dyscrasias,
such as leukopenia or thrombocytopenia.
⋆ Cardiac Effects: Some drugs may cause
QT interval prolongation.
DRUGS TO CONTROL INFECTION:
ANTHELMINTIC/ ANTIHELMINTHIC
A N TH ELMIN TIC/ AN TIH ELMIN TH IC
⋆ Antihelminthic drugs, also known as
anthelmintic drugs, are a class of medications
used to treat infections caused by parasitic
worms or helminths.
⋆These parasites can infect various parts of
the body, such as the intestinal tract, blood
vessels, or tissues.
TH R EE MA IN C LA SSES
1. Vermicides: These drugs kill adult worms.
2. Vermifuges: These drugs expel or paralyze
worms, making them easier to eliminate from
the body.
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3. Antiparasitic drugs: These drugs are used
for broader parasitic infections.
ALBENDAZOLE (Albenza)
⋆ Mechanism of Action: Inhibits microtubule
formation in parasites, disrupting their
structure and function.
⋆ Common Uses: Treating a variety of
helminthic infections, including tapeworm and
roundworm infections.
⋆ Side Effects: Nausea, vomiting, abdominal
pain, headache.
⋆ Adverse Reactions: Rare cases of liver
toxicity; monitor liver function.
⋆ Nursing Considerations: Administer with
food to enhance absorption. Monitor for signs
of liver dysfunction.
MEBENDAZOLE (Vermox)
⋆ Mechanism of Action: Inhibits glucose
uptake in helminths, leading to their depletion
of energy stores.
⋆ Common Uses: pinworm, roundworm, and
whipworm infections.
⋆ Side Effects: Abdominal pain, diarrhea,
dizziness.
⋆ Adverse Reactions: Rare bone marrow
suppression; monitor complete blood counts.
⋆ Nursing Considerations: Administer with
or without food. Encourage good hygiene to
prevent reinfection.
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DRUGS ACTING ON THE CENTRAL
AND PERIPHERAL NERVOUS
SYSTEMS
PSYCHOTHERA PEUTIC AGENTS
PSYCHOTHERA PEUTIC DRUGS
⋆ Also known as psychotropic medications or
psychiatric drugs, are a category of
medications designed to treat mental health
and psychological disorders.
⋆These drugs are prescribed by healthcare
professionals, such as psychiatrists, to help
individuals manage and alleviate the
symptoms of conditions like depression,
anxiety, bipolar disorder, schizophrenia, and
other mental health disorders.
⋆The primary goal of psychotherapeutic drugs
is to affect the chemical balance of
neurotransmitters (such as serotonin,
norepinephrine, dopamine, and others) in the
brain to improve mood, reduce anxiety,
stabilize mood swings, or alleviate psychotic
symptoms.
⋆They can play a vital role in mental health
treatment and are often used in combination
with psychotherapy, counseling, or other
therapeutic interventions.
ANTIDEPRESSANTS
⋆ These drugs are primarily used to treat
depression, but they are also effective in
treating other mood disorders and some
anxiety disorders. They work by affecting
neurotransmitters in the
brain.
MA JOR C LA SSES OF
A N TID EPR ESSA N T
1. Selective Serotonin Reuptake Inhibitors
(SSRIs): These drugs increase the levels of
serotonin in the brain, improving
mood. Examples include fluoxetine (Prozac),
sertraline (Zoloft).
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2. Tricyclic Antidepressants (TCAs): Older • Assess for signs of serotonin syndrome,

antidepressants that work on multiple
neurotransmitters. Examples include
imipramine.
3. Monoamine Oxidase Inhibitors
(MAOIs): These drugs inhibit the action of
an enzyme that breaks down
neurotransmitters. Examples include
phenelzine.
SELECTIVE SEROTONIN
REUPTAKE INHIBITORS (SSRIS)
⋆ Examples: Fluoxetine (Prozac), Sertraline
(Zoloft)
⋆ Mechanism of Action: SSRI medications
block the reuptake of serotonin in the brain,
increasing its availability. This, in turn, helps
improve mood and reduce symptoms of
depression and anxiety.
⋆ Indications: SSRIs are commonly used to
treat major depressive disorder, generalized
anxiety disorder, panic disorder, obsessive-
compulsive disorder (OCD), and social
anxiety disorder
⋆ Contradictions: Patients who are taking or
have recently taken monoamine oxidase
inhibitors (MAOIs), have a history of allergic
reactions to SSRIs, or are experiencing acute
angle-closure glaucoma should avoid SSRIs.
⋆ Side Effects:
• Gastrointestinal issues (nausea, diarrhea)
•Sexual dysfunction (decreased libido,
difficulty achieving orgasm)
• Insomnia
⋆ Adverse Effects: Increased risk of suicidal
thoughts, particularly in younger
patients,Serotonin syndrome (rare but serious)
⋆ Nursing Considerations:
• Monitor the patient's mood, especially
during the initial weeks of treatment when the
risk of suicidal thoughts may be increased.
• Educate patients on potential side effects
and the importance of reporting any unusual
or severe symptoms.
such as agitation, confusion, rapid heart rate,
and elevated body temperature.
TRICYCLIC ANTIDEPRESSANT
(TCAs)
⋆ Examples: Imipramine
⋆ Mechanism of Action: TCAs block the
reuptake of norepinephrine and serotonin in
the brain. They also affect other
neurotransmitter systems, which can
contribute to their therapeutic and side effects
⋆ Indications: TCAs are used for major
depressive disorder, particularly when other
treatments have been ineffective. They are also
used for various anxiety disorders and
neuropathic pain
⋆ Contradictions: Patients with a history of
heart disease, glaucoma, or hypersensitivity to
TCAs should avoid them.
⋆ Side Effects:
• Dry mouth
• Constipation
• Drowsiness
⋆ Adverse Effects:
• Cardiac issues (arrhythmias)
• Orthostatic hypotension
•Anticholinergic effects (blurred vision,
urinary retention)
⋆ Nursing Considerations:
• Monitor vital signs regularly, particularly
blood pressure and heart rate due to the risk of
orthostatic hypotension.
• Assess for cardiac symptoms or irregular
heartbeats.
• Provide oral care and encourage fluid intake
to alleviate dry mouth.
MON OA MIN E OXIDA SE IN H IBITOR S
(MA OI s)
⋆ Examples: Phenelzine
⋆ Mechanism of Action: MAOIs block the
enzyme monoamine oxidase, which breaks
down neurotransmitters such as serotonin,

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norepinephrine, and dopamine. By inhibiting
this breakdown, MAOIs increase the
availability of these neurotransmitters.
⋆ Indications: MAOIs are typically used
when other antidepressants have been
ineffective. They are also used to treat certain
anxiety disorders and atypical depression.
⋆ Contradictions: MAOIs have several
dietary and drug interactions. Patients should
avoid foods high in tyramine (e.g., aged
cheeses, and cured meats) and notify
healthcare providers about any medications
they are taking.
⋆ Side Effects:
• Orthostatic hypotension
• Dizziness
• Weight gain
⋆ Adverse Effects:
• Hypertensive crisis (severe reaction if
patients consume foods/drinks
high in tyramine or take specific medications)
• Serotonin syndrome
⋆ Nursing Considerations:
• Instruct the patient about dietary restrictions,
particularly avoiding foods high in tyramine
(e.g., aged cheeses, cured meats) as well as
certain beverages (e.g., red wine). Consuming
these foods can lead to a hypertensive crisis.
• Monitor blood pressure and watch for signs
of hypertensive crisis.
• Be vigilant for signs of serotonin syndrome.
ANTIANXIETY MEDICATIONS
A N XIOLYTIC A N D AN TIA N XIETY
MED IC A TION S
⋆ These drugs are used to reduce anxiety and
treat anxiety disorders. They often work on the
brain's GABA system to calm
the nervous system
MA JOR C LA SSES INC LUD E
⋆ Benzodiazepines: These drugs act quickly to
reduce anxiety but may have a potential for
dependence. Examples include
alprazolam (Xanax).
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⋆ Buspirone: A non-habit-forming anxiolytic
used to treat generalized anxiety.
⋆ Selective Serotonin-Norepinephrine
Reuptake Inhibitors (SNRIs): Some
antidepressants in this class can also help with
anxiety
BENZODIAZEPINES
⋆ Examples: Alprazolam (Xanax)
⋆ Mechanism of Action: Benzodiazepines
enhance the effects of GABA, an inhibitory
neurotransmitter, which reduces anxiety and
promotes relaxation.
⋆ Indications: Benzodiazepines enhance the
effects of GABA, an inhibitory
neurotransmitter, which reduces anxiety and
promotes relaxation.
⋆Contradictions: Hypersensitivity to
benzodiazepines, history of substance abuse,
and pregnancy (especially in the first
trimester).
⋆ Side Effects: Common side effects include
drowsiness, dizziness, and potential for
dependence and withdrawal.
⋆ Adverse Reactions: Rare but serious side
effects include paradoxical reactions
(increased anxiety, aggression), respiratory
depression (with overdose), and cognitive
impairment.
⋆ Nursing Considerations: Monitor patients
for signs of dependence and withdrawal.
Educate patients on the risks of combining
benzodiazepines with alcohol and other central
nervous system depressants.
MOOD STABILIZER S
⋆These drugs are used to stabilize mood and
are primarily used in the treatment of bipolar
disorder.
MA JOR C LA SSES INC LUD E
Lithium: A classic mood stabilizer that helps
prevent manic and depressive episodes in
bipolar disorder.
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Anticonvulsants: Some anticonvulsant
medications like valproic acid (Depakote) are
also used as mood stabilizers.
Atypical Antipsychotics: Some atypical
antipsychotic drugs like quetiapine are used to
stabilize mood in bipolar disorder.
LITHIUM
⋆ Mechanism of Action: Lithium helps
stabilize mood by regulating
neurotransmitters, especially serotonin and
norepinephrine.
⋆ Indications: Bipolar disorder (both acute
manic and depressive episodes) and
maintenance therapy
⋆ Contradictions: Severe renal or
cardiovascular disease, and
pregnancy (especially in the first trimester).
⋆ Side Effects: Common side effects include
weight gain, hand
tremors, and increased thirst/urination.
⋆ Adverse Effects: Lithium toxicity can
occur, leading to symptoms such as vomiting,
diarrhea, confusion, and even
seizures or coma
⋆ Nursing Considerations: Monitor serum
lithium levels (0.6 to 1 mEq/L) (Burchum &
Rosenthal, 2019), renal function, and thyroid
function. Advise patients to maintain
consistent salt and fluid intake to avoid
lithium toxicity.
ANTIPSYCHOTIC MEDICATIONS
⋆These drugs are used to manage
symptoms of psychotic disorders, primarily
schizophrenia.
TWO MA IN C LA SSES
Typical Antipsychotics: These are the older
generation of antipsychotic drugs, such as
haloperidol.
Atypical Antipsychotics: These newer drugs,
like risperidone, are often preferred due to their
effectiveness in treating both positive and
negative symptoms of schizophrenia.
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ATYPICAL ANTIPSYCHOTIC
⋆ Examples: Risperidone (Risperdal)
⋆ Mechanism of Action: Atypical
antipsychotics work by blocking dopamine
receptors, particularly the D2 receptor, in the
brain, reducing positive and negative
symptoms of schizophrenia.
⋆ Indications: Schizophrenia, bipolar
disorder, and adjunctive therapy for
depression.
⋆ Contradictions: Hypersensitivity to the
medication, known QTc prolongation, and
certain medical conditions.
⋆ Side Effects: Common side effects include
weight gain, sedation, and metabolic effects
like hyperglycemia and dyslipidemia.
⋆ Adverse Effects: Serious adverse effects
may include extrapyramidal symptoms,
tardive dyskinesia, and neuroleptic
malignant syndrome.
⋆ Nursing Considerations: Monitor patients
for signs of movement disorders and metabolic
changes. Provide education on medication
adherence and the importance of regular
follow-up
ANTISEIZURE AGENTS
⋆ Also known as antiepileptic drugs (AEDs) or
anticonvulsants, are a class of medications
primarily used to prevent and manage seizures
in individuals with epilepsy, a neurological
disorder characterized by recurrent,
unprovoked seizures.
⋆These drugs help stabilize the electrical
activity in the brain, reduce the likelihood of
abnormal discharges, and control the
symptoms associated with seizures.
MECHANISMS OF ACTION
♥︎ Enhancing GABA (gamma-aminobutyric
acid) activity, which is an inhibitory
neurotransmitter that helps to calm excessive
brain activity.
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♥︎ Reducing the activity of excitatory
neurotransmitters such as glutamate.
♥︎ Stabilizing sodium and calcium channels in
neurons, preventing abnormal electrical firing.
♥︎ Modulating neurotransmitter release and
receptor binding to control neuronal
excitability.
INDICATIONS
♥︎ Antiseizure agents are primarily used to treat
epilepsy, which encompasses various seizure
disorders. They are chosen based on the type
of seizures and the patient's individual
needs.
♥︎ AEDs may also be used for other conditions,
such as bipolar disorder, neuropathic pain, and
migraine prevention
PHENYTOIN (DILANTIN)
⋆ Mechanism of Action: Stabilizes sodium
channels, reducing neuron
excitability.
⋆ Indications: Treats complex partial seizures,
tonic-clonic seizures, and status epilepticus.
⋆ Side Effects: Dizziness, drowsiness, nausea.
⋆ Adverse Effects: Gingival hyperplasia, rash,
bone marrow suppression.
⋆ Nursing Considerations: Monitor blood
levels, assess for rash, and educate on oral
hygiene.
CARBAMAZEPINE (TEGRETOL)
⋆ Mechanism of Action: Reduces sodium
channel activity in neurons.
⋆ Indications: Effective for partial seizures,
generalized tonic-clonic seizures, and
neuropathic pain.
⋆ Side Effects: Dizziness, drowsiness, upset
stomach.
⋆ Adverse Effects: Skin rashes, bone marrow
suppression, hyponatremia.
⋆ Nursing Considerations: Monitor sodium
levels, assess for rash, and inform about bone
marrow risks.
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VALPROIC ACID (DEPAKOTE)
⋆ Mechanism of Action: Enhances GABA
and inhibits glutamate activity.
⋆ Indications: Used for absence seizures,
myoclonic seizures, bipolar disorder, and
migraine prevention.
⋆ Side Effects: Nausea, dizziness, weight
gain.
⋆ Adverse Effects: Liver toxicity, pancreatitis,
birth defects.
⋆ Nursing Considerations: Monitor liver
function, educate on (if needed), and warn
about potential birth defects.
ANTIPARKINSONI SM AGENTS
⋆ Also known as Parkinson's disease
medications or antiparkinsonian drugs, are a
class of medications used to manage the
symptoms of Parkinson's disease.
⋆ Parkinson's disease is a neurodegenerative
disorder characterized by a loss of dopamine-
producing cells in the brain, leading to motor
and non-motor symptoms such as tremors,
bradykinesia (slowness of movement),
rigidity, and postural instability.
⋆ These medications aim to alleviate these
symptoms and improve the quality of life for
individuals with Parkinson's disease.
LEVODOPA
⋆ Indications: Used to alleviate motor
symptoms in Parkinson's
disease.
⋆ Side Effects: Nausea, vomiting, orthostatic
hypotension, dyskinesias (involuntary
movements).
⋆ Adverse Effects: Hallucinations, psychosis,
motor fluctuations, and on-off phenomenon.
⋆ Nursing Considerations: Administer with
food to reduce gastrointestinal side effects.
Monitor for changes in mental status.
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DOPAMINE AGONISTS
⋆ Examples: Pramipexole, Ropinirole
⋆ Indications: Used to stimulate dopamine
receptors in the brain to alleviate motor
symptoms.
⋆ Side Effects: Nausea, dizziness, orthostatic
hypotension, sleep disturbances.
⋆ Adverse Effects: Impulse control disorders,
hallucinations, and daytime sleepiness.
⋆ Nursing Considerations: Monitor for any
unusual behaviors, especially related to
impulse control.
OPIOID ANALGESICS
⋆ Commonly known as opioids or narcotics,
are a class of medications primarily used to
manage and relieve pain.
⋆They are some of the most potent pain-
relieving drugs available, and they work by
binding to specific receptors in the central
nervous system, particularly the mu-opioid
receptors.
⋆ This binding leads to various physiological
and psychological effects, including pain
relief, altered perception of pain, and
potential side effects.
C LA SSIFIC A TION OF D R UGS TH A T
A C T A T OPIOID R EC EPTOR S
1. Pure Opioid Agonists: Activate opioid
receptors for pain relief. Examples include
morphine and oxycodone.
2. Agonist-Antagonist Opioids: Have mixed
properties, providing pain relief with reduced
respiratory depression risk. An example is
pentazocine.
3. Pure Opioid Antagonists: Block opioid
receptors, used to reverse opioid effects and
treat opioid use disorder. Naloxone is a
common example
MECHANISMS OF ACTION
♥︎ Opioid analgesics work by binding to mu-
opioid receptors in the brain and spinal cord.
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♥︎ This binding leads to the modulation of pain
perception, reduced pain intensity, and a sense
of euphoria.
♥︎ Opioid analgesics can also affect other
systems, leading to side effects like respiratory
depression, constipation, and sedation.
INDICATIONS
♥︎ Opioid analgesics are primarily used for the
management of moderate to severe pain. They
are particularly effective in situations where
other forms of pain relief are inadequate.
♥︎ Common indications include postoperative
pain, trauma-related pain, cancer pain, and
severe chronic pain conditions.
♥︎ Opioids can also be used in palliative care to
alleviate pain in individuals with terminal
illnesses.
T YPES OF OPIOID S
• Opioid analgesics come in various forms,
including natural and synthetic opioids.
• Examples of natural opioids include
morphine and codeine, which are derived from
the opium poppy plant.
• Synthetic opioids, like oxycodone, fentanyl,
and methadone, are created in a laboratory.
SIDE EFFECTS AND ADVERSE
EFFECTS
• Opioid analgesics can have a range of side
effects, including drowsiness, constipation,
nausea, vomiting, and itching.
• More serious side effects can include
respiratory depression, hypotension, and a risk
of dependence and addiction.
• Opioid overdose can result in life-threatening
adverse effects, including severe respiratory
depression, circulatory depression, and even
coma or death
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CONTRAINDICATIONS
• Opioid analgesics are contraindicated in
individuals with a known hypersensitivity to
opioids.
• They should be used with caution in patients
with a history of substance abuse, respiratory
conditions, or gastrointestinal disorders
NURSING CONSIDERATION
• When administering opioid analgesics,
nurses should carefully
monitor vital signs, especially respiratory rate
and blood pressure.
• The level of sedation, pain relief, and side
effects should be assessed and documented.
• Education for patients is crucial, including
the potential side effects, safe use, and the
importance of seeking medical care in
case of opioid overdose.
• Nurses should be prepared to administer
opioid antagonists, such as naloxone, in cases
of severe respiratory depression or overdose.
EXAMPLES
MORPHINE
⋆ Type: Pure Opioid Agonist
⋆ Indication: Management of moderate to
severe pain, particularly after surgery, trauma,
or in cases of chronic pain. Also
used in palliative care.
⋆ Nursing Consideration:
• Monitor vital signs and assess pain relief.
• Educate patients on side effects and potential
overdose.
• Be prepared to administer naloxone in cases
of severe respiratory depression.
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OXYCODONE
⋆ Type: Pure Opioid Agonist
⋆ Indication: Management of moderate to
severe pain, often in postoperative and chronic
pain scenarios.
⋆ Nursing Consideration:
• Monitor pain relief and side effects.
• Educate patients on proper medication use
and potential adverse effects.
• Encourage reporting of unusual or severe side
effects.
FENTANYL
⋆ Type: Pure Opioid Agonist
⋆ Indication: Often used for severe pain
management and during surgical procedures. It
comes in various forms, including transdermal
patches.
⋆ Nursing Consideration:
• Exercise caution due to its potency and
monitor for respiratory
depression.
• Ensure correct application and disposal of
transdermal patches.
• Educate patients on patch use and safety
precautions
CODEINE
⋆ Type: Pure Opioid Agonist
⋆ Mechanism of Action: Less potent than
morphine, it also binds to mu-opioid receptors.
⋆ Indication: Used for mild to moderate pain
and as a cough suppressant
⋆ Common Brand Names: Tylenol with
Codeine, Robitussin AC
⋆ Nursing Consideration:
•Assess pain relief and signs of opioid
dependence.
• Educate patients about potential constipation
and side effects.
• Encourage reporting of adverse effects.
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NALOXONE
⋆ Type: Pure Opioid Antagonist
Mechanism of Action: Rapidly binds to
opioid receptors, displacing opioids and
reversing their effects.
⋆ Indication: Used in emergency situations to
rapidly reverse opioid overdoses, particularly
from narcotics like heroin or prescription
opioids.
Common Brand Names: Narcan
Route of Administration: Intranasal,
intramuscular, intravenous
⋆ Nursing Consideration:
• Be prepared to administer naloxone promptly
in cases of suspected opioid overdose.
• Monitor the patient's response to naloxone,
ensuring they achieve adequate respiratory
function.
• Educate patients and caregivers about the
importance of seeking emergency medical care
after naloxone administration
to address the underlying opioid overdose and
prevent its recurrence.
• Collaborate with healthcare providers and
addiction specialists
to ensure appropriate treatment and support for
patients with opioid use disorder

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