The Pharmacy Cheat Sheet: Crack The Code Of The Top 200

At KLR Medical Certification Training School, Pharmacy Career students learn many challenging concepts to ensure they are ready for the NHA exam and eventually a career in pharmacy.  We go over sig codes, DEA and NDC numbers, pharmacy calculations, and laws and regulations, just to name a few. However, there is always one question I hear more than any other, “How can I learn the Top 200 drugs?”   

I’ll let Kevin Hart answer for me.  (Look to your left)

Stop trying to memorize every drug name! In pharmacy, a drug's name is often a code waiting to be cracked. Many medications that belong to the same therapeutic class share a common ending, or suffix. Learning these suffixes is a quick classification trick that instantly reveals a drug's family.

Although it still takes some practice and some note taking, it’s much easier than trying to tackle all 200 drugs at once.

In class, we focus on recognizing these drug clues in the generic name. Most medications are known to the consumer using the brand name of the medication.  The trade or brand name is the proprietary name of the drug given by the manufacturer.

For example, most people have heard of OxyContin (a very powerful pain reliever), but what about its generic equivalent, oxycodone? 

This blog post will show you how you can use the generic name of medications to not only help you know what medications treat what, but to further understand how these medications work.

Drug Clues: Managing the Heart and Blood Pressure

We focus on three major suffixes regarding blood pressure and when you see them, you know the drug is focusing on blood pressure (hypertension) or lowering cholesterol. These are some of the most common suffixes you'll encounter.

The Hypertension Triple Threat

The Prills! Remember, think of “April” or “Ace−pril” (ACE Inhibitors): Think of these as the primary blood pressure controllers. The mechanism is simple: they prevent the body from making Angiotensin II, a potent vessel constrictor. By blocking this conversion, they allow blood vessels to relax and widen, lowering pressure.

Brand Name:	Generic:
Prinivil, Zestril	Lisinopril
Vasotec	Enalapril
Altace	Ramipril

KLR pharmacy students know that certain drugs including the “prils” are contraindicated to pregnancy.  Check out the image from the New England Journal of Medicine below:

*Contraindications are listed in a drug’s monograph and list who should not take the medication due to potential risks to the patient.

The Sartans! Remember, this clue sounds like that guy and don’t forget the “barbs!” −sartan (ARBs): If a patient develops a persistent cough while using a “pril” drug (a common side effect), they often switch to a -sartan. These drugs achieve the same blood-pressure-lowering goal, but they work by blocking Angiotensin II from binding to the receptor, rather than blocking its formation.

Brand Name:	Generic:
Cozaar	Losartan
Diovan	Valsartan
Avapro	Irbesartan

The OLOLs! Remember, this suffix looks like two backwards b’s! −olol (Beta-Blockers): These are the heart rate and rhythm regulators. They block the effects of adrenaline on the heart, essentially slowing it down and reducing the force of each beat, which also lowers blood pressure.

Brand Name:	Generic:
Zebeta	Bisoprolol
Tenormin	Atenolol
Inderal	Propranolol

KLR students know that Beta-2 receptors help relax the muscles in your airways so you can breathe more easily. When a beta blocker blocks those receptors (especially non-selective beta blockers), it can cause the airways to tighten up, making it harder to breathe — which can trigger an asthma attack. Be sure to speak with your doctor prior to taking medications ending in “olol”.

The Cholesterol Fighter

Statins! Remember, our friend Stan has high cholesterol −statin (Statins): This suffix immediately tells you the drug is a lipid-lowering agent. Statins work by blocking the specific enzyme in the liver responsible for cholesterol production. This dramatically lowers the "bad cholesterol" (LDL) and reduces the risk of heart disease.     

Brand Name:	Generic:
Pravachol	Pravastatin
Zocor	Simvastatin
Lipitor	Atorvastatin

Drug Clues: Addressing Pain, Anxiety, and Mood

The central nervous system (CNS) has drugs with distinct suffixes that will help you identify what those medications treat.  The first two categories, benzodiazepines and opioids are controlled substances due to their high potential for abuse and addiction. 

The Comprehensive Drug Abuse Prevention and Control Act of 1970 established the five levels of controlled substances. Each schedule (or level) contains medications that the DEA classifies as having the potential for abuse and addiction with the most addictive medications placed into schedule I and the medications with the lowest potential for abuse are placed into schedule V.

A doctor and patient must weigh the benefits of using these medications and the risks involved. Recognizing these clues is critical for patient safety.

The Calmers and Pain Relievers

Remember, “O-pam, O-lam, Oh man, I have anxiety!”  They end in −pam or −lam and are called the Benzodiazepines: These schedule IV drugs enhance the effects of gamma-aminobutyric acid (GABA), a brain neurotransmitter that acts like a brake on brain activity. This slowing of the central nervous system produces a calming, sedative effect. They are used for anxiety, panic attacks, and muscle spasms.  

Brand Name:	Generic:
Valium	Diazepam
Ativan	Lorazepam
Xanax	Alprazolam

This clue is a class favorite, but don't take my word for it. Here's what Emilio, a returning senior currently in clinical rotations, has to say:

"The clue I remember most often is that the 'oh-pams' are for the anxiety medicines!"

Remember, we don’t condone anyone being in pain.  These medications end in −codone and are opioid analgesics. Opioid analgesics bind to opioid receptors in the brain and spinal cord, blocking pain signals and reducing the perception of pain. They also release endorphins, the body's natural pain relievers. Due to their high risk of dependence (schedule II), this suffix requires your full attention.

Brand Name:	Generic:
Percocet	Oxycodone + Acetaminophen
Vicodin	Hydrocodone
Oxy IR, Oxycontin	Oxycodone

KLR students know that “CII” or Schedule II medications receive zero refills due to their high potential for abuse and addiction.  A Doctor must prescribe a new prescription each time a patient requests more.

Remember, “Don’t be a depressed Ox” −oxetine (SSRIs): SSRI stands for Selective Serotonin Reuptake Inhibitor.  This suffix belongs to a major class of antidepressants. They work by blocking the reabsorption (reuptake) of the neurotransmitter serotonin, allowing more of it to circulate and improve mood. However, these medications require a black box warning indicating these medications have the potential for increasing suicidal thoughts and behaviors for those that take it.

Brand Name:	Generic:
Cymbalta	Duloxetine
Paxil	Paroxetine
Prozac	Fluoxetine

Drug Clues: Stomach Acid, Allergy, and Headache Relief

These suffixes cover common conditions ranging from heartburn and allergies to migraines and fungal infections.  Although some of these medications can treat the same symptoms, they are vastly different in how they work in the body.

The Acid Reducers

Remember, the “prazoles” are the proton pump inhibitors (PPIs). −prazole begins with “pr” just like “proton”: These are the most potent acid reducers that are typically used to treat gastroesophageal reflux disease (GERD). They work by inhibiting the enzyme known as the proton pump, which is responsible for pumping hydrogen ions into the stomach—the final step in acid production.

Brand Name:	Generic:
Nexium	Esomeprazole
Aciphex	Rabeprazole
Protonix	Pantoprazole

Remember, if you “tidine” too much, you might get acid reflux! −tidine (H2 Blockers): These also reduce stomach acid but use a different mechanism: blocking histamine receptors in the stomach. This group of medications is primarily used to reduce stomach acid and treat conditions like heartburn, acid reflux, and stomach ulcers.They are generally less potent than the -prazole drugs.

Brand Name:	Generic:
Zantac	Ranitidine
Pepcid	Famotidine
Tagamet	Cimetidine

Allergy, Infection, and Migraine Fighters

Remember, if you need “a tad” of allergy relief, you might want to try this drug suffix −atadine which are antihistamines: Antihistamines work by blocking the action of histamine, a substance released by the body during an allergic reaction, to relieve allergy symptoms. 

Unlike older, first-generation antihistamines, many of the newer "-atadine" drugs, like loratadine, are known for being non-drowsy. This is because they do not cross the blood-brain barrier as easily.  Yay, science!      

Brand Name:	Generic:
Claritin	Loratadine
Clarinex	Desloratadine
Pataday	Olopatadine

Remember, my friend cona got a worm! −conazole (Antifungals): This suffix means the drug is attacking a fungus, but our clue is based around a ringworm, which sounds like a worm, but is really a fungus! 

These medications work by damaging the fungal cell membrane, which is vital for the fungus's survival. 

Brand Name:	Generic:
Diflucan	Fluconazole
Nizoral	Ketoconazole
Monistat	Miconazole

Remember, if you trip and hit your head, you might get a headache! −triptan (Serotonin Agonists): This specialized class is used specifically for acute migraines. They bind to serotonin receptors to cause blood vessels in the brain to narrow (vasoconstriction), resolving the headache pain.

Brand Name:	Generic:
Imitrex	Sumatriptan
Zomig	Zolmitriptan
Maxalt	Rizatriptan

The Power of Pattern Recognition

The clues built into the generic names of medications can be very helpful in learning about the medications you will see, not only while preparing for the NHA exam, but throughout your future pharmacy career. This approach is far more efficient than straight memorization. It allows you to classify a drug, anticipate its side effects, and understand its purpose instantly. This skill is a trademark of a professional in any pharmacy career.

What other drug name patterns have you started to notice? Tell us about them in the comments!

As always, if you have any questions, we’re here to help.

-Mr & Mrs. Grisham, Pharmacy Department