Drug Classifications
Major drug classes with generic name suffixes, mechanisms of action, common side effects, and nursing implications.
Drug Classification Quick Reference
Recognizing drug suffixes helps identify the class, mechanism, and expected side effects of unfamiliar medications.
Cardiovascular Medications
| Class | Suffix/Examples | Mechanism of Action | Key Side Effects | Nursing Implications |
|---|---|---|---|---|
| ACE Inhibitors | -pril (lisinopril, enalapril, captopril, ramipril) | Block conversion of angiotensin I to II; reduce preload/afterload | Dry cough (most common), hyperkalemia, angioedema (rare but serious), hypotension | Monitor K+ and renal function; hold for hyperkalemia; contraindicated in pregnancy; report persistent cough |
| ARBs | -sartan (losartan, valsartan, irbesartan) | Block angiotensin II receptors; similar effect to ACE inhibitors | Hyperkalemia, hypotension, dizziness | Alternative if ACE inhibitor cough; still monitor K+ and BUN/Cr; contraindicated in pregnancy |
| Beta-Blockers | -olol (metoprolol, atenolol, propranolol, carvedilol) | Block beta-adrenergic receptors; decrease HR, BP, myocardial O2 demand | Bradycardia, hypotension, fatigue, bronchospasm, masks hypoglycemia | Hold if HR < 60 or SBP < 90; do NOT stop abruptly; avoid in asthma (non-selective); monitor glucose in diabetics |
| Calcium Channel Blockers | -dipine (amlodipine, nifedipine) and diltiazem, verapamil | Block calcium entry into vascular smooth muscle and cardiac cells; vasodilation | Peripheral edema, constipation (verapamil), headache, dizziness, bradycardia | Monitor HR and BP; avoid grapefruit juice; assess for peripheral edema |
| Statins | -statin (atorvastatin, simvastatin, rosuvastatin, pravastatin) | Inhibit HMG-CoA reductase; lower LDL cholesterol | Myalgia/myopathy (report muscle pain), rhabdomyolysis (rare), hepatotoxicity | Monitor LFTs, CK if muscle complaints; take in evening (most production at night); avoid grapefruit with some statins |
| Anticoagulants | Heparin, enoxaparin (-parin), warfarin, rivaroxaban (-xaban), apixaban, dabigatran | Prevent clot formation through various pathways | Bleeding (all); HIT (heparin); see medication cheat sheet | Monitor aPTT (heparin), INR (warfarin); teach bleeding precautions; DOACs have fewer monitoring requirements |
| Loop Diuretics | -semide (furosemide/Lasix, bumetanide) | Block Na/K/Cl transport in Loop of Henle; potent diuresis | Hypokalemia, hyponatremia, hypotension, ototoxicity, dehydration | Monitor K+ (supplement PRN); I&O, daily weights; give in AM to prevent nocturia; monitor hearing |
| Thiazide Diuretics | -thiazide (hydrochlorothiazide, chlorthalidone) | Inhibit Na reabsorption in distal tubule | Hypokalemia, hyperglycemia, hyperuricemia, hypercalcemia | Monitor electrolytes; may worsen gout; mild diuretic; often combined with other antihypertensives |
| K-Sparing Diuretics | Spironolactone, triamterene, amiloride | Block aldosterone or Na channels in collecting duct; retain K | Hyperkalemia, gynecomastia (spironolactone) | Do NOT give with K supplements or ACE inhibitors/ARBs without close monitoring; monitor K+ |
CNS Medications
| Class | Suffix/Examples | MOA | Key Side Effects | Nursing Implications |
|---|---|---|---|---|
| Benzodiazepines | -pam, -lam (diazepam, lorazepam, midazolam, alprazolam) | Enhance GABA activity; CNS depression | Sedation, respiratory depression, dependence, paradoxical excitation (elderly) | Antidote: flumazenil; avoid alcohol; fall precautions; taper to discontinue; short-term use preferred |
| Opioid Analgesics | -one, -ine, -ol (morphine, hydrocodone, oxycodone, fentanyl, codeine) | Bind opioid receptors; pain relief, CNS depression | Respiratory depression, constipation, sedation, nausea, urinary retention, hypotension | Antidote: naloxone (Narcan); assess RR before giving (hold if < 12); bowel regimen; assess pain scale; monitor sedation level |
| Anticonvulsants | Phenytoin (Dilantin), levetiracetam, valproic acid, carbamazepine | Stabilize neuronal membranes; reduce seizure activity | Vary by drug: gingival hyperplasia (phenytoin), hepatotoxicity (valproic acid), Stevens-Johnson (lamotrigine, carbamazepine) | Monitor therapeutic levels; phenytoin: IV rate ≤ 50 mg/min (cardiac monitoring); never mix with dextrose; oral care for gingival hyperplasia |
Anti-Infective Medications
| Class | Suffix/Examples | Key Considerations |
|---|---|---|
| Penicillins | -cillin (amoxicillin, ampicillin, piperacillin) | Ask about allergy (cross-reactivity with cephalosporins ~1–2%); take full course; monitor for anaphylaxis |
| Cephalosporins | cef-, ceph- (cephalexin, ceftriaxone, cefazolin) | Cross-allergy with penicillin possible; avoid alcohol with some (disulfiram-like reaction); monitor renal function |
| Fluoroquinolones | -floxacin (ciprofloxacin, levofloxacin, moxifloxacin) | Risk of tendon rupture (especially Achilles); avoid in children < 18; photosensitivity; do not take with antacids, dairy, or iron (chelation) |
| Aminoglycosides | -mycin, -micin (gentamicin, tobramycin, amikacin) | Ototoxicity (hearing loss, tinnitus) and nephrotoxicity; monitor peak/trough levels, BUN/Cr, hearing; adequate hydration |
| Macrolides | -thromycin (azithromycin, erythromycin, clarithromycin) | GI upset common; QT prolongation risk; many drug interactions (CYP3A4); alternative for penicillin allergy |
| Vancomycin | Vancomycin | Trough level: 15–20 mcg/mL; Red Man Syndrome (histamine reaction — slow infusion over 60+ min); ototoxic, nephrotoxic; monitor levels, renal function |
Endocrine Medications
| Class | Examples | Key Nursing Points |
|---|---|---|
| Biguanides | Metformin (Glucophage) | First-line for Type 2 DM; hold 48 hrs before/after contrast dye; risk of lactic acidosis; do not use in renal impairment; GI side effects common |
| Sulfonylureas | -ide (glipizide, glyburide, glimepiride) | Stimulate insulin secretion; risk of hypoglycemia; take 30 min before meals; weight gain |
| Corticosteroids | -sone, -olone (prednisone, prednisolone, methylprednisolone, dexamethasone, hydrocortisone) | Never stop abruptly (adrenal crisis); immunosuppression; hyperglycemia; osteoporosis; GI irritation; Cushing features with long-term use; take with food; give in AM to mimic natural cortisol |
| Thyroid Hormones | Levothyroxine (Synthroid) | Take on empty stomach, 30–60 min before breakfast; lifelong therapy for hypothyroidism; monitor TSH; separate from calcium, iron, antacids by 4 hours |
Suffix Quick Reference
| Suffix | Drug Class |
|---|---|
| -pril | ACE Inhibitors |
| -sartan | ARBs |
| -olol | Beta-Blockers |
| -dipine | Calcium Channel Blockers (dihydropyridine) |
| -statin | HMG-CoA Reductase Inhibitors |
| -pam / -lam | Benzodiazepines |
| -prazole | Proton Pump Inhibitors |
| -tidine | H2 Receptor Blockers |
| -cillin | Penicillins |
| -floxacin | Fluoroquinolones |
| -mycin / -micin | Aminoglycosides |
| -thromycin | Macrolides |
| -cycline | Tetracyclines |
| -mab | Monoclonal Antibodies |
| -nib | Kinase Inhibitors |
| -sone / -olone | Corticosteroids |
| -xaban | Factor Xa Inhibitors (DOACs) |
| -parin | Heparins (LMWH) |
| -setron | 5-HT3 Antagonists (antiemetics) |
| -triptan | Serotonin Agonists (migraine) |
| -gliptin | DPP-4 Inhibitors (diabetes) |
| -glutide | GLP-1 Receptor Agonists (diabetes/weight loss) |
| -gliflozin | SGLT2 Inhibitors (diabetes) |