# Most Common Medications



## cauchiad (Mar 29, 2013)

Hey guys
Next monday I have my first ride-along for my EMT classes. I'm going to brush up a bit extra beforehand.
One area I feel I could really use some improvement in is common medications patients use, and how they refer to them.
What medications do you commonly see in the field? Input would be greatly appreciated. Thanks


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## Milla3P (Mar 29, 2013)

My patients commonly refer to their medications as:

My water pill, my sugar pill, my pressure pill, the yellow one. You don't need to worry, they have a list at the hospital. 

It's your job to find/figure out what these are. Sometimes it takes years of practice, don't feel bad if it gets confusing.


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## WuLabsWuTecH (Mar 30, 2013)

I'll post a cheat sheet here that we use for medical school.  Remember that only the generic names follow the pattern, but most meds (on their med list or on their bottle) have the generic names.



```
Suffix                    Class                                    Example
AFIL                    erectile dysfunction            sildenafil
ARTRAN          angiotensin receptor blocker    losartan
AZOSIN           alpha 1 blocker                    prazosin
CAINE            local anesthetic                    lidocaine
CILLIN             penicillin-like antibacterial    amoxicillin
CONAZOLE      antifungal                            ketoconazole
CYCLINE          tetracycline-like antibiotic    tetracycline
DRONATE         bisphosphonate                    etidronate
FLOXACIN        fluoroquinolone                    ciprofloxacin
FUNGIN           antifungal                            caspofungin
IDE                sulfonylureas                    tolbutamide
INE                 antihistamine                    fexofenadine
IPINE              calcium channel blocker      nifedipine
MYCIN or MICIN    antibacterial or anticancer    erythromycin
NAVIR            protease inhibitor antiviral    ritonavir
OLOL              beta blocker                    propranolol
ONE               glucocorticoids                  corticosterone
PAM or LAM      benzodiazepine                diazepam or midazolam
PARIN                    heparin-like anticoagulant    heparin
PRAZOLE           proton pump inhibitor         omeprazole
PRIL               ACE inhibitor                      captopril
QUINE              antimalarial                       primaquine
RUDIN              lepirudin-like anticoagulant    lepirudin
SETRON           serotonin blocker              alosetron
STATIN           HMG coA reductase inhibitor    atorvastatin
TRIPTAN          serotonin agonist              sumatriptan


Also, here's a common classification scheme for drugs and virtually any drug you find is one of these:

Autonomic Drugs
    Cholinoceptor-Activating and Cholinesterase-Inhibiting Drugs
        Cholinoceptor-Blocking Drugs
        Adrenoceptor-Acivating and Other Sympathomimetic Drugs
        Adrenoceptor Antagonist Drugs
Cardiovascular-Renal drugs
    Antihypertensive Agents
    Vasodilators and Drugs for Treatment of Angina Pectoris
    Drugs Used in Heart Failure
    Antiarrhythmics
    Diuretic Agents
Drugs Acting on Smooth Muscle
    Histamine, Serotonin and the Ergot Alkaloids
    Vasoactive Peptides
    The Eicosanoids: Prostaglandins, Thromboxanes, Leukotrienes, and Related     Compounds
    Nitric Oxide, Donor, and Inhibitors
    Drugs Used in Asthma
Drugs Acting in the Central Nervous System
    Sedative-Hypnotic Drugs
    The Alcohols
    Antiseizure Drugs
    General Anesthetics
    Local Anesthetics
    Pharmacologic Management of Parkinsonism and Other Movement Disorders
    Antipsychotic Agents and Lithium
Antidepressant Agents
Opioid Analgesics and Antagonists
Drugs of Abuse
Drugs used to Treat Diseases of the Blood, Inflammation and Gout
    Agents Used in Anemias; Hematopoetic Growth Factors
    Drugs Used in Disorders of Coagulation
    Agents Used in Hyperlipidemia
NSAIDs, DMARDs, Nonopioid Analgesics, and Drugs Used in Gout
Endocrine Drugs
    Hypothalamic and Pituitary Hormones
    Thyroid and Antithyroid Drugs
    Adrenocorticoids and Adrenocortical Antagonists
    The Gonadal Hormones and inhibitors
    Pancreatic Hormones and Antidiabetic Drugs
Agents That Affect Bone Mineral Homeostasis  
Chemotherapeutic Drugs
    Antibacterials
    Disinfectants, Antiseptics, and Sterilants
    Antimycobacterials
    Antifungals
    Antiprotozoals
Anthelmintics
Antivirals
Anticancer drugs
Immunosuppressants
 Drugs Affecting Other Systems
    Gastrointestinal and Antiemetic  Drugs
    Botanicals and Nutritional Supplements
    Toxic  Compounds
```


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## WuLabsWuTecH (Mar 30, 2013)

Hmmm... no idea why it's not liking my tabs to align things.  Anyone got any ideas as to how to post this in a more readable form?


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## MMiz (Mar 30, 2013)

WuLabsWuTecH said:


> Hmmm... no idea why it's not liking my tabs to align things.  Anyone got any ideas as to how to post this in a more readable form?


I used the code tag to make it a little better.


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## cauchiad (Mar 30, 2013)

thanks for all the help guys


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## Handsome Robb (Mar 30, 2013)

Milla3P said:


> You don't need to worry, they have a list at the hospital.




This is my BIGGEST pet peeve for some reason.

I don't care if the hospital has your list, I need it. It's not uncommon to be able to determine your patients medical history by their medications better than the patient can tell you.

I second suffixes. Learn those and you're golden.

Epocrates is a fantastic tool, I use it daily at work to look medications up. Have done it in front of patients during transport once I've gotten everything done or on scene of an OD on a medication I don't know much or anything about, just be sure to explain to the patient and family members what you're doing on your phone...

Seems like everyone and their brother is on omeprazole (Prilosec), simvastatin and lisinopril and they're all allergic to penicillin.


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## usalsfyre (Mar 30, 2013)

Another tip, find out why their "allergic". Undesirable side effects are not the same thing as an allergy, the med can still be used. The strangest "allergy" I've had was "Ambien makes me drowsy" :blink:.


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## STXmedic (Mar 30, 2013)

Nitro gives me a headache

Adenosine makes my chest hurt

Morphine makes me feel funny

+1 on clarifying allergies.


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## Carlos Danger (Mar 30, 2013)

My favorite, which I've heard more than once:

Pt: "I'd rather have Dilaudid, because I'm allergic to morphine". 

Me: "OK. What happens when you have morphine?"

Pt: "It makes me sleepy."

In all seriousness, I would not try to memorize medications. There are just too many.

Instead, ask your patients what conditions they take medicine for. Knowing that they are on medication for blood pressure, or for anxiety, or for chest pain, or for "high sugar", is 75% of the battle.

The rest will come with experience.


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## JPINFV (Mar 30, 2013)

OP: Learn the suffix for the generic names and download Epocrates. Problem solved. 



usalsfyre said:


> Another tip, find out why their "allergic". Undesirable side effects are not the same thing as an allergy, the med can still be used. The strangest "allergy" I've had was "Ambien makes me drowsy" :blink:.




I had a double take earlier this week. I don't remember what it was, but the patient had an "allergy" to a medication (probably an antibiotic, but I can't remember) that caused "itching." Solution: Give with benadryl. It was just strange seeing the medication both on the med list and the allergy list.


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## CritterNurse (Mar 30, 2013)

PoeticInjustice said:


> Nitro gives me a headache
> 
> Adenosine makes my chest hurt
> 
> ...



My favorite one so far is "Narcotics make me break out in handcuffs" when asked why the patient was 'allergic to narcotics'


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## 9D4 (Mar 31, 2013)

Halothane said:


> patients what conditions they take medicine for. Knowing that they are on medication for blood pressure, or for anxiety, or for chest pain, or for "high sugar", is 75% of the battle.
> 
> The rest will come with experience.


Problem with that is the polypharm pts that don't know why they're taking a certain med. They just take it in faith based off their faith in their doc. I've seen that a few times out here in the retirement community during rides.


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## Handsome Robb (Mar 31, 2013)

blittle said:


> Problem with that is the polypharm pts that don't know why they're taking a certain med. They just take it in faith based off their faith in their doc. I've seen that a few times out here in the retirement community during rides.



Only a few?  We see that multiple times a day lol. People are idiots and will blindly follow whatever their doctor tells them. It can go the other way too and they refuse to listen to anything a doc has to say.


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## WuLabsWuTecH (Apr 1, 2013)

MMiz said:


> I used the code tag to make it a little better.




Thanks!




Robb said:


> This is my BIGGEST pet peeve for some reason.
> 
> I don't care if the hospital has your list, I need it. It's not uncommon to be able to determine your patients medical history by their medications better than the patient can tell you.
> 
> ...



A med hx is critical to the patient history.  That being said, I will use the "List given to ER" button on the ePCR.  No need for me to type in an essay as long as I know whats on that sheet.

I also like lexicomp--i find it more intuitive to use than epocrates and a bit faster.



usalsfyre said:


> Another tip, find out why their "allergic". Undesirable side effects are not the same thing as an allergy, the med can still be used. The strangest "allergy" I've had was "Ambien makes me drowsy" :blink:.



Excellent point.  An allergy is not the same as an adverse reaction.


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## jpregulman (Apr 8, 2013)

It really depends on the pt population that you are working with. If they are older, be prepared to write a lot. The most common I come across are Adderall ( ), Lexapro ( ), Xanax ( ), Zoloft ( ), Birth Control ( ), Aspirin ( ), Albuterol ( ). I took this off our run sheet. I work on a college campus btw  Good Luck in school!


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## Dan216 (Apr 8, 2013)

Oxygen


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## NomadicMedic (Apr 8, 2013)

It seems like almost every patient is on a beta blocker and/or an ACE inhibitor, ASA, anticoagulant, statin, PPI, benzo, oral antihypoglycemic, SSRI, opiate pain med and an antibiotic! Ugh. 

We're an over medicated society. Easier to prescribe a med than a lifestyle change. 

To the OP, you'll learn them as you see them. Make it a point to look up the ones you don't know and jot them down. Before you know it, you'll be able to tell a patients medical history by the bottles on the kitchen table.


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## hogdweeb (Apr 9, 2013)

DEmedic said:


> It seems like almost every patient is on a beta blocker and/or an ACE inhibitor, ASA, anticoagulant, statin, PPI, benzo, oral antihypoglycemic, SSRI, opiate pain med and an antibiotic! Ugh.
> 
> We're an over medicated society. Easier to prescribe a med than a lifestyle change.
> 
> To the OP, you'll learn them as you see them. Make it a point to look up the ones you don't know and jot them down. Before you know it, you'll be able to tell a patients medical history by the bottles on the kitchen table.


+1. bout 6 months ago had a call, late 20's, 6 or 7 med bottles.....and heavy etoh on board..:blink:


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## Clipper1 (Apr 9, 2013)

Robb said:


> Only a few?  We see that multiple times a day lol. People are idiots and will blindly follow whatever their doctor tells them. It can go the other way too and they refuse to listen to anything a doc has to say.



Isn't idiot a strong word for the elderly or those suffering from dementia or who were just sick and wanted to go home when they were released from the hospital?  Some just want to feel better and trust their doctors to help them get to that point. Don't your patients blindly allow you to give them meds without asking how much? Isn't this true for the elderly? Are they idiots because they trust you? 

The advice here for EMTs and Paramedics is to not get too concerned about knowing everything and only know a few.  A doctor or nurse might go over the medications listed but then when the scripts are filled by pharmacy, they don't give the brand names.  For Lasix the pharmacy will probably put furosemide on the label which might not be on the discharge instructions. How many know that there is currently no generic albuterol available in MDI form  and that it will probably be ProAir?  How many here know the difference between an SABA and a LABA? How many have told their patients to take extra puffs of the LABA believing it is the same an "albuterol"?  These are the easy and common drugs which some in EMS and even nursing still have a problem with.  Probably some here do not know the generic med for Tylenol. We also still see EMTs and Paramedics laugh at people who OD on Tylenol and call it a worthless waste of a call.


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## Aidey (Apr 9, 2013)

He said "people" and not "the elderly". There are plenty of people that are, to put it simply, idiots when it comes to their health. People _without _mental illness, dementia, memory problems, traumatic brain injury, neurological impairment, developmental delay, or any other organic excuse you can come up with. 

If people weren't idiots someone would never have had to create this website.


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## Clipper1 (Apr 9, 2013)

Aidey said:


> He said "people" and not "the elderly". There are plenty of people that are, to put it simply, idiots when it comes to their health. People _without _mental illness, dementia, memory problems, traumatic brain injury, neurological impairment, developmental delay, or any other organic excuse you can come up with.
> 
> If people weren't idiots someone would never have had to create this website.



The other person made a broad blanket statement. He did not exclude any specific group.  I believe the elderly are people also and deserve some respect.

What exactly is your point about the vaccine website? Thimerosal has been controversial for years. The flu vaccine has been controversial for several decades. In fact, EMS providers raised a big voice of objection to the flu vaccine when some counties made it mandatory.  Just doing a quick search on this website also shows a few discussions about being opposed to vaccines such as those which might be required to work in health care or to enroll in an EMT class. Are you including them in your idiot list?


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## Aidey (Apr 9, 2013)

So because the other person makes a blanket statement you go after Rob because he failed to include an extensive list of the exceptions to his statement? 

My point is that people are idiots. And they believe other idiots. And that it is not necessary to include a list of all those exempted from your list of idiots every time you call someone an idiot.


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## Clipper1 (Apr 9, 2013)

Aidey said:


> So because the other person makes a blanket statement you go after Rob because he failed to include an extensive list of the exceptions to his statement?
> 
> My point is that people are idiots. And they believe other idiots. And that it is not necessary to include a list of all those exempted from your list of idiots every time you call someone an idiot.



Looks like you just want to start an argument or a personal attack because I clarified something your fellow EMTLifer stated.  There are more people reading this than just the two of you. Young people entering the EMT profession can be influenced by some comments made here to think all people are idiots and that is not a good learning point. 

Not all people are idiots and sometimes there is a reason why they may not know what everyone of their medications is all about or even how to say the name properly.   Your patients need to at least be given the benefit of the doubt before making a quick judgment that they are idiots.  You will have already closed off your mind to anything they have to say which then influences your ability to assess. Believe it or not but it might also be the meds or a new acute illness which causes them to not remember all their meds.


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## DesertMedic66 (Apr 9, 2013)

Robb said:


> Only a few?  We see that multiple times a day lol. People are idiots and will blindly follow whatever their doctor tells them. It can go the other way too and they refuse to listen to anything a doc has to say.



Yep. Had that happen today. According to the patient her doctor told her she could only go to 1 hospital about 3 hours away from where she lives. Yeah, not gonna happen when you call 911 in my area.


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## DesertMedic66 (Apr 9, 2013)

Clipper1 said:


> Looks like you just want to start an argument or a personal attack because I clarified something your fellow EMTLifer stated.  There are more people reading this than just the two of you. Young people entering the EMT profession can be influenced by some comments made here to think all people are idiots and that is not a good learning point.
> 
> Not all people are idiots and sometimes there is a reason why they may not know what everyone of their medications is all about or even how to say the name properly.   Your patients need to at least be given the benefit of the doubt before making a quick judgment that they are idiots.  You will have already closed off your mind to anything they have to say which then influences your ability to assess. Believe it or not but it might also be the meds or a new acute illness which causes them to not remember all their meds.



Yep. I was influenced by Robb's post so now I believe the elderly are idiots. (Truely some are and some aren't BUT that goes for all age groups, genders, races, religions, etc). 

#troll

And now I'm probably gonna get my first warning from the CLs haha.


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## Aidey (Apr 9, 2013)

Clipper1 said:


> Looks like you just want to start an argument or a  personal attack because I clarified something your fellow EMTLifer  stated.  There are more people reading this than just the two of you.  Young people entering the EMT profession can be influenced by some  comments made here to think all people are idiots and that is not a good  learning point.
> 
> Not all people are idiots and sometimes there is a reason why they may  not know what everyone of their medications is all about or even how to  say the name properly.   Your patients need to at least be given the  benefit of the doubt before making a quick judgment that they are  idiots.  You will have already closed off your mind to anything they  have to say which then influences your ability to assess. Believe it or  not but it might also be the meds or a new acute illness which causes  them to not remember all their meds.


You didn't clarify, you berated. 

Unlike you, I'm giving the other people reading this the benefit of the doubt that they aren't going to assume that "people are idiots" means "all people everywhere are idiots". You can come up with explanations and veiled insults all day long, but what it boils down to is that there will always people people who are utterly clueless. It is important to acknowledge this and learn how to deal with those people just like dealing with any other type of patient.


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## Clipper1 (Apr 9, 2013)

Aidey said:


> You didn't clarify, you berated.






> Originally Posted by Aidey View Post
> So because the other person makes a blanket statement you go after Rob because he failed to include an extensive list of the exceptions to his statement?



You made an accusation that "I went after Rob" and I replied.  

I can't stop you from feeling like you are being berated.  What about patients who are judged to quickly? I do not see how standing by all people are idiots as giving someone the benefit of the doubt.

I stand by my comments that not all people are idiots. If the other person did not mean it to be a blanket statement he could have given some other clues. Not everyone is a mind reader or knows exactly what someone else means just by their words.  

My point is not to assume everyone is an idiot. You apparently are taking this to be insulting but it is not meant to be.  When someone is starting out, assumptions in the negative influence one's assessment. Maybe you think you are past that but sometimes some need to be reminded of this when dealing with patients.


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## Clipper1 (Apr 9, 2013)

DesertEMT66 said:


> Yep. Had that happen today. According to the patient her doctor told her she could only go to 1 hospital about 3 hours away from where she lives. Yeah, not gonna happen when you call 911 in my area.



Do you have any alternative medical transportation in your area which you could recommend or assist in arranging?  What if the patient required specialized services of a specific hospital?  Would you at least listen to why they wanted to go to another hospital?  Did you try explaining about interfacility transport? Yes it is difficult for some to get charged for your service, an ED visit which probably will be of no benefit and a CCT. But, if you explained the process they might not make the same mistake of bothering you if they need a hospital again.


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## Aidey (Apr 9, 2013)

How about we keep this on the topic of patient medications?


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## TheLocalMedic (Apr 10, 2013)

Wow...  anyhow...  As far as the OP is concerned, learning home meds was one of the hardest things for me.  I'm a big fan of looking things up if I have the time during transport, and I use either the epocrates app or a nursing drug handbook that I stash in my ambulance.  

Before long you'll be able to look at a med list and be able to tell what most of your patient's history is and probably have a better idea of what is most likely to be wrong with them on any given day.


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## TheLocalMedic (Apr 10, 2013)




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