Session III

Classes/ Groups of Drugs Ototoxicity Tinnitus

DRUG GROUPS/CLASSES

Dr. Ghulam SaqulainHead Of Department of ENT

Capital Hospital

DRUG CLASSIFICATION SYSTEM

A drug classification system represents a common language for describing the drug assortment in a country or region and is a prerequisite for national and international comparisons of drug utilization data, which have to be collected and aggregated in a uniform way.

Access to standardized and validated information on drug use is essential to allow audits of patterns of drug utilization, to identify problems in drug use, to initiate educational or other interventions and to monitor the outcomes of these interventions.

Drugs can be classified in different ways according to:

their mode of action; their indications; or their chemical structure.

The ATC classification system

The ATC classification system divides the drugs into different groups according to the organ or system on which they act and according to their chemical, pharmacological and therapeutic properties.

Drugs are classified in groups at five different levels. The drugs are divided into 14 main groups (first level), with two therapeutic/pharmacological subgroups (second and

third levels). The fourth level is a therapeutic/pharmacological/chemical

subgroup and the fifth level is the chemical substance.

The complete classification of glibenclamide illustrates the structure of the code. A Alimentary tract and metabolism (first

level, main anatomical group) A10 Drugs used in diabetes (second level, main

therapeutic group) A10B Oral blood-glucose-lowering drugs (third level,

therapeutic/pharmacological subgroup) A10B B Sulfonamides, urea derivatives(fourth level,

chemical/therapeutic/pharmacological subgroup) A10B B01 Glibenclamide (fifth level, subgroup for

chemical substance)

Thus, in the ATC system all plain glibenclamide preparations are given the code A10B B01.

GROUP FUNCTION DRUGS

ANALGESIC

RELIEVES MILD TO SEVERE PAIN Opioids Analgesics:•Morphine•Pethidine•PentazocineNon-Steroidal Anti-Inflamatory Drugs (NSAID):Acetylsalicylic acidDiclofenacIbuprofenParacetamol

ANTI-INFLAMMA-TORY / ANTI- PYRETIC

REDUCES INFLAMMATION FEVER LOWERING DRUGS

SEDATIVE INDUCES SLEEP OR RELAXATION DiazepamOpioid analgesics

ANESTHETIC

PRODUCE LACK OF FEELING (GENERALLY, LOCALLY, OR TOPICALLY)

Local: Lignocaine, General:•Ehter•Halothane, Enflurane•Nitrous Oxide•Thiopental•Propofol

DRUGS REDUCING SKELETAL MUSCLE CONTRACTION

CENTRALLY ACTING MUSCLE RELAXANT

Depress voluntary muscle activity but also sedate

Benzodizapines e.g., Diazepam

NEURO-MUSCULAR BLOCKING AGENT

Paralyze Voluntary muscles Atracurium Suxamethonium

MUSCLE RELAXANT

Relieve spasticity of voluntary muscles

Baclofen

GASTROINTESTINAL DRUGS:

ANTIACID/ANTI ULCER

NEUTRALIZES STOMACH ACID Ammunium hydroxideMagnesium hydroxideCimetidineSucralfate

ANTI-EMETIC

PREVENTS OR RELIEVES NAUSEA AND VOMITING / VERTIGO

CyclizineMetachlopromideProchlorperazinePromethazine

PURGATIVES/ LAXATIVES

RELIEVE CONSTIPATION/INDUCES DEFECATION

Ispaghula HuskBisacodylLactuloseSenna

ANTIDIARROEALS/ ANTI-CHOLIN-ERGICS

REDUCE G.I MOTILITYprevents or relieves diarrhea; inhibits peristalsis and reduces fecal volume

Atropine SulphateHyosine N ButylbromideKeopectate, Lomotil, Pepto-Bismol

CENTRAL NERVOUS SYSTEMANTI-EPILEPTIC

Relieves tonic clonic, seizures and neuralgiaAbsence seizures

CarbamazepinePhenobarbitonePhenytoinSodium valproateEtosuximide

ANTI-DEPRESSANT

Relieve depression Amitriptiline Chlorpromazine

ANTI SCHIZOPHRENIC

ChlormipramineFluphenazineHalopheridol

SEDATIVES DiazepamChloral hydrate

PARKINSO-NISM Benserazide + Levodopa

BiperidenBenzhexolBromocriptine

DRUGS AFFECTING COAGULA-TION

ANTICOGU-LANTPREVENTS BLOOD FROM CLOTTING OR DELAYS CLOTTING

COAGULANT/HEMOS-TATIC AGENTS

Heparin Warfarin

Transamic acid

HORMONE REPLACE-MENT

REPLACES OR RESOLVES HORMONE DEFICIENCY Thyroid/ Parathyroid DrugsPituitary-Hypothalamic DrugsAdrenocorticoidsDrugs used in infertilitySex Hormones/Hormonal contraception

Pancreatic Hormones and Oral Antidiabetic Agents

ThyroxineAdrenocorticotropic hormoneVasopressiin/ADHClomipheneConjugated EstrogenEthylestradiol-levonorgestrilNonoxinol (spermicidal)Insulin

ANTINEO-PLASTIC

POISONS CANCEROUS CELLS Bleomycin (Carcinomas & lymphomas)VincristineVinblastine

DRUGS ACTING ON RESPIRATORY SYSTEMANTITUSSIVE INHIBITS COUGH REFLEX Dextromethorphan compound

EXPECTO-RANTS/ MUCOLYTICS

HELP EXPECTORATE MUCOUS N acetylcystine

BRONCHO-DILATOR

DILATES BRONCHI (AIRWAYS IN THE LUNGS)

AminophyllneTheophyllineSodium chromoglycateSalbutamolInhalers

ANTIHIS-TAMINE /ANTIPRURI-TICS

CONTERACTACTS EFFECTS OF HISTAMINE AND RELIEVES ALLERGIC SYMPTOMS

ChlorpheniramineCetirizineLoratadineLevocetirizine

ENT PREPARTIONSNASAL SPRAYS/DROPS

RELIEVES NASAL SWELLING AND CONGESTION ANTIALLERGIC

XylometazolineEphedrine nasal dropsAzelastine hydrochloride TriamcinoloneFlunisolideSodium cromoglycate

THROAT SPRAYS/MOUTH WASH

Antiseptics Dequalinium, BenzalkoniumHydrogen peroxideChlorhexidine

EAR DROPS

SOFTEN HARD WAX

ANTIFUNGAL

ANTIBACTERIALS

STEROID/ANTIBIOTICSTEROID/ANTIBIOTIC/ANTIFUNGAL

Soda glycerine, Olive Oil

Clotrimazole, Nystatin

Gentamycin, tobramycin, ciprofloxacin etc.Betamethasone, neomycinNystatin, neomycin, triamcinolone

CARDIOVASCULAR DRUGSANTIARR-HYTHMICS

Reduce arrhythmias AmiodaroneBretylium

INOTROPIC/ VASOCONS-TRICTOR

CONSTRICTS BLOOD VESSELS, INCREASES BLOOD PRESSURE

Digoxin (Inotropic)Dobutamine “

VASODILATOR/ANTIHYPERTENSIVES

DILATES BLOOD VESSELS, DECREASES BLOOD PRESSURE

AtenololMetoprolol (Beta adrenergic blocker)Captopril Enalapril

ANTIANGINAL REDUCE ANGINA Isosorbide nitate (cardiac vasodilator)Glycerl trinitrate

DIURETIC INCREASES URINE OUTPUT, REDUCES BLOOD PRESSURE AND CARDIAC OUTPUT

AmilorideFrusemideManitolSpironolactone

ANTIMICROBIAL DRUGS

ANTIBACTERIALS

PenicillinsCephlosporins

QuinolonesSulphonamidesMacrolidesAminoglycosides

Benzyl penicillin, ampicillinCephradine, cefazoline, cefixime, cefuroxime etcCiprofloxacin, levofloxacin, moxifoxacin, getifloxacinErythromycin, chlarithromycin, azithromycinGentamycin, streptomycin

ANTITUBERCULAR

Used in treatment of tuberculosis; inhibits growth of mycobacteria (INH, Myambutal, Mycobutin, Priftin, PZA, Rifadin, Streptomycin)

EthambutolIsoniazidPyrazinamideRifampicinStreptomycin

ANTILEPROTIC DapsoneClofazimineRifampicin

ANTI FUNGALS Amphotericin BFlucytosineGriseofulvinKetoconazoleNystatin

ANTIVIRALS combats a specific viral disease (e.g. herpes)

AcyclovirZovirax

ANTIMALARIAL

ChloroquineQuininePrimaquinePyrimethamine

ANTIAMOEBIC

MetronidazoleDiloxanide

ANTIHELMITHS

AlbendazoleMebendazolePiperazinePyrantel Palmoate