Workshop on Pharmacology of hearing and speech sciences

1. Session III
 Classes/ Groups of Drugs
 Ototoxicity
 Tinnitus

2. DRUG GROUPS/CLASSES
Dr. Ghulam Saqulain
Head Of Department of ENT
Capital Hospital

3. 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.

4.  Drugs can be classified in different ways according to:
 their mode of action;
 their indications; or
 their chemical structure.

5. 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.

6.  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.

7. GROUP FUNCTION DRUGS
ANALGESIC RELIEVES MILD TO SEVERE PAIN Opioids Analgesics:
•Morphine
•Pethidine
•Pentazocine
Non-Steroidal Anti-Inflamatory Drugs
(NSAID):
Acetylsalicylic acid
Diclofenac
Ibuprofen
Paracetamol
ANTI-
INFLAMMA-
TORY /
ANTI-
PYRETIC
REDUCES INFLAMMATION
FEVER LOWERING DRUGS
SEDATIVE INDUCES SLEEP OR RELAXATION Diazepam
Opioid analgesics
ANESTHET
IC
PRODUCE LACK OF FEELING
(GENERALLY, LOCALLY, OR
TOPICALLY)
Local: Lignocaine,
General:
•Ehter
•Halothane, Enflurane
•Nitrous Oxide
•Thiopental
•Propofol

8. 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

9. GASTROINTESTINAL DRUGS:
ANTIACID/
ANTI
ULCER
NEUTRALIZES STOMACH ACID Ammunium hydroxide
Magnesium hydroxide
Cimetidine
Sucralfate
ANTI-
EMETIC
PREVENTS OR RELIEVES
NAUSEA AND VOMITING /
VERTIGO
Cyclizine
Metachlopromide
Prochlorperazine
Promethazine
PURGATIV
ES/
LAXATIVE
S
RELIEVE
CONSTIPATION/INDUCES
DEFECATION
Ispaghula Husk
Bisacodyl
Lactulose
Senna
ANTIDIARR
OEALS/
ANTI-
CHOLIN-
ERGICS
REDUCE G.I MOTILITY
prevents or relieves diarrhea;
inhibits peristalsis and reduces fecal
volume
Atropine Sulphate
Hyosine N Butylbromide
Keopectate, Lomotil, Pepto-Bismol

10. CENTRAL NERVOUS SYSTEM
ANTI-
EPILEPTIC
Relieves tonic clonic, seizures and
neuralgia
Absence seizures
Carbamazepine
Phenobarbitone
Phenytoin
Sodium valproate
Etosuximide
ANTI-
DEPRESSA
NT
Relieve depression Amitriptiline
Chlorpromazine
ANTI
SCHIZOPHR
ENIC
Chlormipramine
Fluphenazine
Halopheridol
SEDATIVES Diazepam
Chloral hydrate
PARKINSO-
NISM Benserazide + Levodopa
Biperiden
Benzhexol
Bromocriptine

11. DRUGS
AFFECTING
COAGULA-
TION
ANTICOGU-LANT
PREVENTS BLOOD FROM
CLOTTING OR DELAYS
CLOTTING
COAGULANT/HEMOS-TATIC
AGENTS
Heparin
Warfarin
Transamic acid
HORMONE
REPLACE-
MENT
REPLACES OR RESOLVES
HORMONE DEFICIENCY
Thyroid/ Parathyroid Drugs
Pituitary-Hypothalamic Drugs
Adrenocorticoids
Drugs used in infertility
Sex Hormones/Hormonal
contraception
Pancreatic Hormones and Oral
Antidiabetic Agents
Thyroxine
Adrenocorticotropic hormone
Vasopressiin/ADH
Clomiphene
Conjugated Estrogen
Ethylestradiol-levonorgestril
Nonoxinol (spermicidal)
Insulin
ANTINEO-
PLASTIC
POISONS CANCEROUS CELLS Bleomycin (Carcinomas &
lymphomas)
Vincristine
Vinblastine

12. DRUGS ACTING ON RESPIRATORY SYSTEM
ANTITUSSIVE INHIBITS COUGH REFLEX Dextromethorphan compound
EXPECTO-
RANTS/
MUCOLYTICS
HELP EXPECTORATE MUCOUS N acetylcystine
BRONCHO-
DILATOR
DILATES BRONCHI (AIRWAYS IN
THE LUNGS)
Aminophyllne
Theophylline
Sodium chromoglycate
Salbutamol
Inhalers
ANTIHIS-
TAMINE
/ANTIPRURI-
TICS
CONTERACTACTS EFFECTS OF
HISTAMINE AND RELIEVES
ALLERGIC SYMPTOMS
Chlorpheniramine
Cetirizine
Loratadine
Levocetirizine

13. ENT PREPARTIONS
NASAL
SPRAYS/
DROPS
RELIEVES NASAL SWELLING AND
CONGESTION
ANTIALLERGIC
Xylometazoline
Ephedrine nasal drops
Azelastine hydrochloride
Triamcinolone
Flunisolide
Sodium cromoglycate
THROAT
SPRAYS/M
OUTH
WASH
Antiseptics Dequalinium, Benzalkonium
Hydrogen peroxide
Chlorhexidine
EAR
DROPS
SOFTEN HARD WAX
ANTIFUNGAL
ANTIBACTERIALS
STEROID/ANTIBIOTIC
STEROID/ANTIBIOTIC/ANTIFUNGAL
Soda glycerine, Olive Oil
Clotrimazole, Nystatin
Gentamycin, tobramycin,
ciprofloxacin etc.
Betamethasone, neomycin
Nystatin, neomycin, triamcinolone

14. CARDIOVASCULAR DRUGS
ANTIARR-
HYTHMICS
Reduce arrhythmias Amiodarone
Bretylium
INOTROPIC/
VASOCONS-
TRICTOR
CONSTRICTS BLOOD VESSELS,
INCREASES BLOOD PRESSURE
Digoxin (Inotropic)
Dobutamine “
VASODILATO
R/ANTIHYPER
TENSIVES
DILATES BLOOD VESSELS,
DECREASES BLOOD PRESSURE
Atenolol
Metoprolol (Beta adrenergic blocker)
Captopril
Enalapril
ANTIANGINAL REDUCE ANGINA Isosorbide nitate (cardiac
vasodilator)
Glycerl trinitrate
DIURETIC INCREASES URINE OUTPUT,
REDUCES BLOOD PRESSURE AND
CARDIAC OUTPUT
Amiloride
Frusemide
Manitol
Spironolactone

15. ANTIMICROBIAL DRUGS
ANTIBACTERIAL
S
Penicillins
Cephlosporins
Quinolones
Sulphonamides
Macrolides
Aminoglycosides
Benzyl penicillin, ampicillin
Cephradine, cefazoline, cefixime,
cefuroxime etc
Ciprofloxacin, levofloxacin, moxifoxacin,
getifloxacin
Erythromycin, chlarithromycin,
azithromycin
Gentamycin, streptomycin
ANTITUBERCUL
AR
Used in treatment of tuberculosis; inhibits
growth of mycobacteria (INH,
Myambutal, Mycobutin, Priftin, PZA,
Rifadin, Streptomycin)
Ethambutol
Isoniazid
Pyrazinamide
Rifampicin
Streptomycin
ANTILEPROTIC Dapsone
Clofazimine
Rifampicin
ANTI FUNGALS Amphotericin B
Flucytosine
Griseofulvin
Ketoconazole
Nystatin
ANTIVIRALS combats a specific viral disease
(e.g. herpes)
Acyclovir
Zovirax

16. ANTIMALARIA
L
Chloroquine
Quinine
Primaquine
Pyrimethamine
ANTIAMOEBI
C
Metronidazole
Diloxanide
ANTIHELMITH
S
Albendazole
Mebendazole
Piperazine
Pyrantel Palmoate