For Pharmacology we had to do a presentation on the top 20 prescribed drugs for 2013.  This information helps in communicating with patients in regards to the medications they are taking and we are able to recognize the side effects associated with the medications.

 

Top 20 Prescribed Drugs 2013

Group member:

Yineeta Chitlall, Fannyeu Liou, Qing Huang, Olha Vashkevych.

 

1. Abilify (ARIPiprazole):

• Pharmacologic category: Antipsychotic agent, Atypical
• Drug use: bipolar, irritability associated with autistic disorder, major depressive disorder, and schizophrenia.
• MOA: quinolinon antipsychotic which exhibits high affinity for D2 and D3 receptors. Moderate affinity for the serotonin reuptake transporter.
• Adverse Effects: >10% Headache 27%, extrapyramidal reaction (does related) 8-26%, sedation 13% insomnia 18%anxity 17% chest pain 10%
• Drug Interactions: may increase the level/ effect of alcohol; CNS depressant; thalidomide; Zolpidem.

• Nexium ( Esomeprazole):

 

• Pharmacologic category: Proton pump inhibitor; substituted Benzimidazole.
• Drug use: treatment for erosive esophagitis, gastroesophageal reflux disease GERD.
• MOA: proton pump inhibitor suppresses gastric acid secretion by inhibition of the H+/K+ ATPase in the gastric parietal cell.
• Adverse Effects: Headach I.v. 11%
• Drug Interactions: may increase the level; effect of Vitamin K antagonists, Voriconazole.

• Humira ( Adalimumab):

 

• Pharmacologic category: Antirheumatic, Gastriubtetinal agent, Monoclonal antibody, Tumor Necrosis Factor Blocking Agent.
• Drug use: Ankylosing spondylitis. Crohn’s disease, plaque psoriasis. Psoriatic arthritis, rheumatoid arthritis and ulcerative colitis.
• MOA: recombinant monoclonal antibody that bind to human tumor necrosis factor alpha (TNF-alpha), thereby interfering with binding to TNFa receptor sites and subsequent cytokine driven inflammatory processes.
• Adverse Effects: Headache 12%, skin rash 12%, antibody development 26%, upper respiratory tract infection 17%.
• Drug Interactions: Not listed

• Crestor(Rosuvastatin):

 

• Pharmacologic category: antilipemic agent, HMG CoA reeducates inhibitor
• Drug use: Treatment for hypercholesterolemia, hyperlipidemia and mixed dyslipidemia and hypertriglyceridemia.
• MOA: increase in the expression of LDL receptors on hepatocyte membranes and a stimulation of LDL catabolism.
• Adverse Effects: Myalgia 13% headache 6%
• Drug Interactions: Not listed

• Cymbalta(Duloxetine):

 

• Pharmacologic category: Antidepressant, Serotinin/ Norepinephrine reuptake inhibitor
• Drug use: Treatment for hypercholesterolemia, hyperlipidemia and mixed dyslipidemia and hypertriglyceridemia.
• MOA: potent inhibitor of neuronal serotonin and norepinephrine reuptake and a weak inhibitor of dopamine reuptake.
• Adverse Effects: Headache 14% fatigue 11% nausea 25% xerostomia 15%
• Drug Interactions: Not listed

• Advair Diskus (Fluticasone & Salmeterol)

 

• Pharmacologic category: Beta2 Agonist
• Drug use: maintenance treatment of asthma and COPD
• MOA:

• Fluticasone: anti-inflammatory activity, immunosuppressive properties, and antiproliferative actions; extremely potent vasoconstrictive and anti-inflammatory activity.
• Salmeterol: relaxes bronchial smooth muscle by selective action on Beta 2 receptors with little effect on heart rate.

• Adverse effects: upper respiratory tract infection (16%-27%), headache (12%-21%)
• Drug interaction: may increase levels/toxicity of long acting Beta2 agonists, loop diurectics, sympathomimetics, and thiazide diuretics; may decrease levels/effects of antidiabetic agents.

• Remicade (infliximab)

 

• Pharmacologic category: antirheumatic, GI tract, immunosuppressant agent, tumor necrosis factor (TNF) blocking agent.
• Drug use: treatment of moderately-to-severely active rheumatoid arthritis and Crohn’s disease with inadequate response to conventional therapy.
• MOA: infliximab is a chimeric monoclonal antibody that binds to human tumor necrosis factor alpha, thereby interfering with endogenous tumor necrosis factor alpha activity.
• Adverse effects: infection (36%), upper respiratory tract infection (32%), nausea (21%), headache (18%), abscess (15%), sinusitis (14%), cough (12%), pharyngitis (12%).
• Drug interaction: because infliximab may decrease response of immune system, do not administer with vaccines containing live bacteria or viruses; combining with anakinra (kineret), abatacept (orencia) or tocilizumab (actemra) may increase risk of serious infections.

• Spiriva (Tiotropium)

 

• Pharmacologic category: anticholinergic agent.
• Drug use: maintenance treatment of bronchospasm associated with COPD.
• MOA: inhibit actions of acetycholine at type 3 muscarinic receptors in bronchial smooth muscle causing bronchodilation.
• Adverse effects: upper respiratory tract infection (41%), xerostomia (5%-16%).
• Drug interaction: not listed

• Lantus solostar/Lantus (insulin glargine)

 

• Pharmacologic category: insulin
• Drug use: treatment of type 1 diabetes mellitus and type 2 diabetes mellitus to improve glycemic control.
• MOA: insulin acts via specific membrane-bound receptors on target tissues to regulate metabolism of carbohydrate, protein, and fats. Target organs for insulin include liver, skeletal muscle and adipose tissue.
• Adverse effects: hypoglycemia, tachycardia, fatigue, headache, mental confusion.
• Drug interaction: not listed

• Januvia (Sitagliptin)

 

• Pharmacologic category: antidiabetic agent, dipeptidyl peptidase IV inhibitor
• Drug use: management of type 2 diabetes mellitus
• MOA: inhibits dipeptidyl peptidase enzyme resulting in prolonged active incretin levels.
• Adverse effects: diarrhea, constipation.
• Drug interaction: may increase levels/effects of ACE inhibitor, hypoglycemic agents; may be increased by herbs, MAO inhibitors, selective serotonin reuptake inhibitor; may be decreased by corticosteroids (orally inhaled and systemic), loop diuretics.

• Zetia (Ezetimibe)

 

• Pharmacologic category: Atilipemic agent
• Drug use: Treatment of primary hypercholesterolemia
• MOA: Inhibits absorption of cholesterol at the brush border of the small intestines.
• Decreased delivery of cholesterol to the liver.
• Adverse effects: fatigue, diarrhea.
• Drug interaction: may decrease the effect/levels of Cyclosporine, levels of Ezetimibe may be increased by Cyclosporine, levels/effects of Ezetimibe may be decreased by bile acid sequestrants.

• Methylphenidate (Concerta, Daytrana, Metadate CD, Ritalin)

 

• Pharmacological Category: Central nervous system stimulant
• Drug use: treatment of ADHD; symptomatic management of narcolepsy (except Concerta, Daytrana, Metadate CD, Ritalin LA, and Quillivant XR).
• MOA: Blocks the reuptake of norepinephrine and dopamine into presynaptic neurons.
• Adverse effects: hypertension (monitor blood pressure prior to using local anesthetic with vasoconstrictors), insomnia (6-13%), irritability (7%-11%), nausea 10-12%).
• Drug interactions: Avoid concomitant use with alcohol (may increase levels), inhalational anesthetics, MAO inhibitors (increase levels). Methylphenidate may increase effects of Anti-Parkinson’s agent, antipsychotics.

• Symbicort (Budesonide and Formoterol)

 

• Pharmacologic Category: Beta2 Agonist, corticosteroid, inhalant
• Drug use: treatment of asthma in patient ≥12 years of age, maintenance treatment of airflow obstruction associated with COPD, bronchitis and emphysema.
• MOA: Formoterol relaxes bronchial smooth muscle by selective action on beta2 receptors.
• Adverse effects: headache (7%-11%), nasopharyngitis (7%-11%), upper respiratory infections (4%-11%), xerostomia.
• Drug interactions: not listed

• Albuterol (ProAir HFA)

 

• Beta2 agonist
• Drug use: treatment or prevention of bronchospasm in patients with reversible obstructive airway disease; prevention of exercise induced bronchospasm.
• Pharmacologic Category: Androgen
• Use: replacement therapy in the treatment of delayed male puberty.
• MOA: endogenous androgen responsible for promoting the growth and development of the male sex organs and maintaining secondary sex characteristics in androgen-deficient males.
• Adverse effects: prostate specific antigen increase (5%-11%), application site pruritus (17%-37%).

• Viagra (Sildenafil)

 

• Pharmacolgic Category: Phosphodiesterase-5 Enzyme inhibitor.
• Drug use: Revatio: treatment of pulmonary arterial hypertension in adults to improve exercise ability and delay clinical worsening.
• Viagra: treatment of erectile dysfunction.
• Unlabeled use: persistent pulmonary hypertension after recent left ventricular assist device placement.
• MOA: Erectile dysfunction: does not directly cause penile erections, but affects the response to sexual stimulation.
• Pulmonary arterial hypertension: inhibits PDE-5 in smooth muscle of pulmonary vasculature where PDE-5 is responsible for the adaptation of cyclic guanosine monophosphate (cGMP). Increased cGMP concentration results in pulmonary vasculature relaxation.
• Adverse effects: headache (16%-46%), dyspepsia (7%-17%), flushing (10%).
• Drug interaction: avoid concomitant use with Alprostadil, Amyl Nitrite, Boceprevir, Cobicistat, Fusidic acid, Phosphodiesterase 5 inhibitors, Pimozide, Rioclgust, Telaprevir, Vasodilators.

• Cialis (Tadafil)

 

• Pharmacologic category: Phosphodiesterase-5 ezyme inhibitor.
• Drug use: signs and symptoms of benign prostatic hyplerplasia, erectile dysfunction, pulmonary arterial hypertension.
• MOA: likely due to PDE-5 mediated reduction in smooth muscle and endothelial cell proliferation, decreased nerve activity, and increased smooth muscle relaxation. PAH: pulmonary vasculature relaxation.
• Adverse effects: flushing (1-13%), headache (3%-42%), nausea (10%-11%).
• Drug interaction: Avoid concomitant use with Alprostadil, Amyl Nitrite, Fusidic acid.

• AndroGel (testosterone)

 

• Pharmacologic Category: Androgen
• Drug use: Replacement therapy in the treatment of delayed male puberty.
• MOA: Endogenous androgen responsible for promoting the growth and development of the male sex organs and maintaining secondary sex characteristics in androgen-deficient males.
• Adverse effects: prostate specific antigen increase (5%-11%), application site pruritus (17%-37%).

• Avastin ( Bevacizumab)

 

• Pharmacologic category: Antineoplastic agent.
• Drug use: Treatment of metastatic colon or rectal cancer, non-squamous, non-small cell lung cancer, metastatic breast cancer used as part of a combination chemotherapy regimen, glioblastoma (GBM), metastatic renal cell carcinoma.
• MOA: inhibits the biologic activity of human vascular endothelial growth factor (VEGF) in in vitro and in vivo assay systems.
• Adverse effects: hypertension, thromboembolism,pain,fatigue, headache, dizziness, abdominal pain, vomiting, stomatitis, upper respiratory infection.
• Drug interaction: No significant effects

• Oxycontin (Oxycodone)

 

• Pharmacologic category: Analgesic, opioid.
• Drug use: relief of moderate to severe pain, for acute pain and in some instances of chronic cancer pain.
• MOA: Binds to opiate receptors in the CNS, causing inhibition of ascending pain pathways, altering the perception of and response to pain, produces generalized CNS depression.
• Adverse effects: euphoria, constipation, fatigue, dizziness, nausea, vomiting, dry mouth, anxiety, itching, and sweating.
• Drug interactions: Avoid taking Oxycodone with sleeping pill, muscle relaxer, other pain medicine, or medicine for anxiety, depression, or seizures.

• LYRICA( Pregamblin)

 

• Pharmacologic category: Analgesic, Anticonvulsant
• Drug use: Neuropathic pain associated with diabetic peripheral neuropathy, Postherpetic neuralgia, adjunctive therapy for adult patients with partial onset seizures, fibromyalgia, neuropathic pain associated with spinal cord injury.
• MOA: inhibit excitatory neurotransmitter release including glutamate, norepinephrine, serotonin, and dopamine.
• Adverse effects: Serious, even life-threatening, allergic reaction, suicidal thoughts or actions, swelling of your hands, legs and feet, dizziness and sleepiness.
• DRUG INTERACTIONS: Avoid use with Azelastine,Thalidomide, Pregablin may increase levels/effects of : Alcohol, Azelastine(nasal), CNS depressants, Hydrocodone, Selective Serotonin Reuptake Inhibitors, Zolpidem

Below is the link to Powerpoint presentation

Top 20 Prescribed Drugs 2013 FINAL (2)