406 E2 drugs Flashcards

1
Q

what class is sumatriptan

A

serotonin receptor agonists

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2
Q

sumatriptan MOA

A

-constrict intracranial blood vessels
-suppress release of inflam. neuropeptides
-block brain pathways for pain

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3
Q

sumatriptan routes

A

subq, PO, intranasal

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4
Q

sumatriptan SE

A

injection site rx
chest pressure
flushing
weakness
headache
bad taste (nasal)

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5
Q

sumatriptan nursing considerations

A

avoid w/ ischemic stroke, heart disease & angina

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6
Q

what class is rimegepant

A

CGRP antagonists

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7
Q

rimegepant MOA

A

mediates pain transmission

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8
Q

rimegepant SE

A

GI upset

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9
Q

rimegepant considerations

A

CYP substrate

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10
Q

dopaminergic drugs

A

enhance dopamine

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11
Q

anticholinergic drugs

A

block the effects of ACH

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12
Q

levodopa/carbidopa MOA

A

-levodopa: converts to dopamine in the brain and activates dopamine receptors
-carbidopa: blocks destruction of levodopa

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13
Q

levodopa/carbidopa advantages

A

most effective drug for PD

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14
Q

levodopa/carbidopa disadvantages

A

-several months to see improvement
-does not work long term
-adverse effects

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15
Q

levodopa/carbidopa key teaching points

A

-“on-off” phenomenon
-avoid high proteins meals

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16
Q

levodopa/carbidopa SE

A

-N/v
-dyskinesias
-postural hypotension
-dysrhythmias
-psychosis/hallucinations/nightmares
-paranoia
-darken sweat & urine
-activate malignant melanoma

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17
Q

what decreases the effects of levodopa

A

vitamin B6
antipsychotics
protein

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18
Q

what increases the effects of levodopa

A

carbidopa
anticholinergics
MAOIs (can lead to toxicity)

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19
Q

duopa

A

-G or J tube infusion levodopa/carbidopa
-gel form
-infuse up to 16hr/d

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20
Q

duopa teaching points

A

-do not take within 2 weeks of nonselective MAOI
-avoid high protein foods

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21
Q

duopa SE

A

-falling asleep w/o warning
-orthostatic hypotension
-hallucinations
-unusual urges
-depression
-dyskinesia

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22
Q

what class is pramipexole

A

dopamine receptor agonist

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23
Q

pramipexole MOA

A

binds w/ D2 receptors

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24
Q

pramipexole indications

A

-monotherapy in early PD
-combo w/ sinemet w/ advanced PD
-restless leg syndrome

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25
Q

pramipexole SE

A

-nausea
-sleep attacks
-pathologic gambling & compulsive behaviors

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26
Q

pramipexole + levodopa SE

A

-orhtostatic hypotension
-dyskinesias
-hallucination risk doubles

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27
Q

what class is ropinirole

A

dopamine receptor agonist

28
Q

ropinirole MOA

A

increase in nerve impulses within the substantia nigra

29
Q

ropinirole SE

A

long term use cause increased risk for DM and acromegaly

30
Q

rotigotine

A

-dopamine agonist
-once daily patch

31
Q

apomorphine

A

-dopamine agonist
-short acting subq for fast relief of PD sx during “off phase”

32
Q

how do cholinesterase inhibitors work

A

prevent inactivation of ACH by cholinesterase and intensifies the effect of ACH released from motor neurons which increases muscle strength

33
Q

what class is neostigmine

A

cholinesterase inhibitors

34
Q

neostigmine indication

A

MG

35
Q

neostigmine MOA

A

enhances cholinergic action by facilitating transmission of impulses across neuromuscular junctions

36
Q

neostigmine SE

A

-cholinergic effects
-toxic doses reduce muscle contraction and can lead to cholinergic crisis

37
Q

neostigmine / cholinergic crisis antidote

A

atropine

38
Q

what med can test between MG or Chol crisis

A

edrophonium, a short acting cholinesterase inhibitor

39
Q

another name for interferon beta

A

avonex

40
Q

another name for glatiramer acetate

A

copaxone

41
Q

interferon beta MOA

A

inhibit pro inflammatory WBCs from cross BBB
decrease relapse rate by up to 30%

42
Q

interferon beta SE

A

-flu like rx
-liver toxicity
-bone marrow suppression
-depression
-drug interactions

43
Q

glatiramer acetate MOA

A

increased production of anti inflammatory T cells which cross the BBB and suppress inflammation

44
Q

glatiramer acetate SE

A

-injection site rx
-flushing, palpitaitons, chest pain, rash, laryngeal constriction
do not need to treat, resolves in 15-20 mins

45
Q

glatiramer acetate & interferon beta indication

A

MS

46
Q

fingolimod (oral MS agent)

A

retain lymphocytes in the lymph nodes, preventing them from crossing the BBB which decreases inflammation
good for RRMS

47
Q

dimethyl fumarate (oral MS agent)

A

thought to inhibit immune cells and may have anti oxidant properties

48
Q

natalizumab MOA

A

Prevents circulating T cells from leaving the vasculature and crossing blood-brain barrier

49
Q

natalizumab indications

A

MS
Crohn’s

50
Q

natalizumab nursing considerations

A

monotherapy
only available through TOUCH program

51
Q

natalizumab SE

A

headache & fatigue
-hepatotoxicity
-hypersensitivity
-progressive multifocal leukoencephalopathy (PML)

52
Q

what med do you give for fatigue related to MS

A

amantadine

53
Q

what med do you give for cognitive dysfunction related to MS

A

donepezil

54
Q

what class is riluzole

A

glutamate inhibitor

55
Q

riluzole indication

A

ALS

56
Q

riluzole MOA

A

glutamate antagonist
reduces damage to motor neurons

57
Q

riluzole SE

A

dizziness, GI upset, hepatotoxicity

58
Q

pharm for GBS

A

steroids
high dose immunoglobulin therapy

59
Q

pharm for bacterial meningitis

A

IV ceftriaxone or vancomycin
acyclovir
steroids
prophylaxis vaccine

60
Q

encephalitis pharm

A

acyclovir
anti-seizure meds
treat sx w/ Tylenol & antiemetics

61
Q

TIA pharm

A

ASA
clopidogrel
heparin and warfarin in cardiac related

62
Q

alteplase class

A

thrombolytics / fibrinolytics

63
Q

alteplase MOA

A

promotes conversion of plasminogen to plasmin
remove thrombi after they have formed

64
Q

alteplase indications

A

acute MI
PE
ischemic stroke

65
Q

alteplase SE

A

increased risk of intracranial bleeding

66
Q

alteplase antidote

A

aminocaproic acid