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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
pramipexole SE
-nausea -sleep attacks -pathologic gambling & compulsive behaviors
26
pramipexole + levodopa SE
-orhtostatic hypotension -dyskinesias -hallucination risk doubles
27
what class is ropinirole
dopamine receptor agonist
28
ropinirole MOA
increase in nerve impulses within the substantia nigra
29
ropinirole SE
long term use cause increased risk for DM and acromegaly
30
rotigotine
-dopamine agonist -once daily patch
31
apomorphine
-dopamine agonist -short acting subq for fast relief of PD sx during "off phase"
32
how do cholinesterase inhibitors work
prevent inactivation of ACH by cholinesterase and intensifies the effect of ACH released from motor neurons which increases muscle strength
33
what class is neostigmine
cholinesterase inhibitors
34
neostigmine indication
MG
35
neostigmine MOA
enhances cholinergic action by facilitating transmission of impulses across neuromuscular junctions
36
neostigmine SE
-cholinergic effects -toxic doses reduce muscle contraction and can lead to cholinergic crisis
37
neostigmine / cholinergic crisis antidote
atropine
38
what med can test between MG or Chol crisis
edrophonium, a short acting cholinesterase inhibitor
39
another name for interferon beta
avonex
40
another name for glatiramer acetate
copaxone
41
interferon beta MOA
inhibit pro inflammatory WBCs from cross BBB **decrease relapse rate by up to 30%**
42
interferon beta SE
-flu like rx -liver toxicity -bone marrow suppression -depression -drug interactions
43
glatiramer acetate MOA
increased production of anti inflammatory T cells which cross the BBB and suppress inflammation
44
glatiramer acetate SE
-injection site rx -flushing, palpitaitons, chest pain, rash, laryngeal constriction **do not need to treat, resolves in 15-20 mins**
45
glatiramer acetate & interferon beta indication
MS
46
fingolimod (oral MS agent)
retain lymphocytes in the lymph nodes, preventing them from crossing the BBB which decreases inflammation **good for RRMS**
47
dimethyl fumarate (oral MS agent)
thought to inhibit immune cells and may have anti oxidant properties
48
natalizumab MOA
Prevents circulating T cells from leaving the vasculature and crossing blood-brain barrier
49
natalizumab indications
MS Crohn's
50
natalizumab nursing considerations
monotherapy only available through TOUCH program
51
natalizumab SE
**headache & fatigue** -hepatotoxicity -hypersensitivity -progressive multifocal leukoencephalopathy (PML)
52
what med do you give for fatigue related to MS
amantadine
53
what med do you give for cognitive dysfunction related to MS
donepezil
54
what class is riluzole
glutamate inhibitor
55
riluzole indication
ALS
56
riluzole MOA
glutamate antagonist reduces damage to motor neurons
57
riluzole SE
dizziness, GI upset, hepatotoxicity
58
pharm for GBS
steroids high dose immunoglobulin therapy
59
pharm for bacterial meningitis
IV ceftriaxone or vancomycin acyclovir steroids prophylaxis vaccine
60
encephalitis pharm
acyclovir anti-seizure meds treat sx w/ Tylenol & antiemetics
61
TIA pharm
ASA clopidogrel heparin and warfarin in cardiac related
62
alteplase class
thrombolytics / fibrinolytics
63
alteplase MOA
promotes conversion of plasminogen to plasmin **remove thrombi after they have formed**
64
alteplase indications
acute MI PE ischemic stroke
65
alteplase SE
increased risk of intracranial bleeding
66
alteplase antidote
aminocaproic acid

ABSN (210 decks)

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