All drugs Flashcards
Rapid acting Insulin
Humalog, Novalog, Aspridia
15 min, 2 hrs, 6 hrs
Humalog
Rapid Insulin
Novalog
Rapid Insulin
Aspridia
Rapid Insulin
Short acting “Regular”
Humulin R, Novolin R
30 min, 3-4 hrs, 12 hrs
Humulin R
Short
Novolin R
Short
Intermediate acting insulin (NPH)
Humulin N, Novolin N
60 min, 6 hrs, 24 hrs
Intermediate acting insulin
Humulin L
Long acting duration
Lasts 26 hrs
Sulfonylureas
Inc insulin secretion
Elevates serum glucose
DO NOT USE if pregnant
Oral
Alpha-glucosidase inhibitors
Dec. absorption of glucose
Delays digestion of complex carbs
Can cause hypoglycemia
Oral
Biguanide (Metformin)
Does it all Dec glucose absorption, Increases glucose by muscles and fat cells For those who are insulin resistant Not for hypoglycemics Oral CAN CAUSE lactic acidosis
Thiazolidinediones (Glitazones)
Dec insulin resistance
Stimulate insulin receptors on muscle, fat and liver cells
Used on insulin resistant people
Meglitinides
Inc. secretion of insulin
Stimulate pancreas to make insulin
For those with elevated serum glucose
Take with FOOD
Amylin Analogs
Suppresses postprandial glucagon secretion, regulates postprandial rise in blood glucose, can cause hypoglycemia
Incretin Mimetics
Stimulate pancreas to secrete insulin based on food eaten
“mimics the insulin needed for the food you eat”
Dipepyidyl peptidase 4 inhibitors
Prolonged action of incretin hormones
Balances release of insulin, limits excess glucose by the liver
Linked to inc, beta cell neogenesis
Hyperglycemia
levels above 126 mg/dL OR above 7 mmol/l
Dry mouth, increased thirst, blurred vision, weakness, headache, frequent urination
Hypoglycemia
Levels below 70 mg/dL OR below 4 mmol/l
Sleepiness, sweating, pallor, lack of coordination, irritability, hunger
Type 1 diabetes
Autoimmune
Destroyed pancreatic beta cells, difficult to control
Type 2 diabetes
Gradual insulin resistance
Hyperglycemia
Obesity = main factor
Hemoglobin A1C normal percent
7%, 5.5% - 7% = pre-diabetic
Reflects amount fo hemoglobin with sugars attached to it (glycated)
Levothyroxine
Inc metabolic rate in body tissue
Can cause hyperthyroid, tachycardia , cardiac dysrhythmias, angina, M.I, heart failure, nervousness, insomnia, diarrhea, cramps, nausea, vomiting, weight loss, fever
Synthroid, Levoxyl, Eltroxin
Types of hypothyroid drugs under “Levothyroxine”
Propylthiouracil
Hyperthyroid drug
Inhibits production of thyroid hormone so T4 cannot convert to active T3
Causes bradycardia, heart failure, anemia, CAD, PVD, slow speech, slow body mvmt, constipation, sleepiness, increased weight gain, constipation
Goiter patho
Iodine deficiency
Enlarged thyroid gland
Propanolol
Treats headaches, migrains, chronic chest pain and heart attacks
Beta Blocker
Helps with palpitations and tremors with hyperthyroidism
Synthroid
Treats hypothyroidism
Adrenal insufficiency leads to…
Addisons disease which is failure to produce adequate cortisol (feedback mechanism doesn’t work)
Prednisone can cause “moon face” when given for hypocortisol
Adrenal cortex destruction can be due to….
Autoimmune, tumor, infection, trauma, hemorrhage
Ketoconazole
Cushings Disease
Excess cortisol
Take with food
Can cause hepatotoxicity, abdominal pain, pruritis, sedation, N & V, Abdominal pain
Antifungal
Monitor blood sugar, Report side effects
Increase calcium intake
What drug prevents conversion of 11-deoxycortisol to cortisol in Cushings Disease
Ketoconazole
Addisonian crisis: patho
Acute insufficiency of cortisol and requires immediate treatment
Rapid osnet
Cushings Disease treatment
Drug, Surgical or Radiation therapy
Buffalo hump, moon face, fragile skin, purple striae, bruises, impaired wound healing, thin hair, Depression, Inc. glucose levels, Osteoporosis, Peptic ulcers
Cushings Disease
Lethargy, Weakness, Fever, Anorexia, N & V, Hyperkalemia, Hypoglycemia, Na+ loss —> Cardiovascular collapse and shock
Addisons Disease
Hydrocortisone
Used for addisons disease
Lifetime hormone replacement needed
mineralcorticoids and adrenocorticoids replaced
No LIVE vaccines
Side effects: BP fluctuation, shock, dysrhythmias, M.I, Vertigo, Fragile skin, Ulcers, Immunosuppression
Anticholinergic
Inhibit involuntary muscle movements and various bodily functions
Only used if intolerant to levodopa
Occupy receptor sites to prevent response to acetycholine
Relieves urinary incontinence
Parkinsons Disease Patho
Imbalance neurotransmitters in basal ganglia which include dopamine and acetylcholine, Loss of substantia nigra due to depletion of dopamine
Resting Tremor with “pill rolling” sign, Mask like face, soft speaking voice, Akinesia, Bradykinesia
Parkinsons Disease
Dopamine receptor agonists
Levodopa-carbidopa
Catechol-O-methyltransferase (COMI) Inhibitors – other drug names
Tolcapone (Tasmar), Entacapone (Stalevo)
COMI
Treats symptoms of parkinsons like tremors
Inhibits metabolism of Levodopa
Can cause liver failure
Discontinue if no progress within 3 weeks
Dopaminergics
Inc. dopamine in the brain
Contraindications: hypersensitivity to meds, narrow angle glaucoma, malignant melanoma,PUD, CVD
Levodopa -Carbidopa
Metabolic precursor of dopamine, so converts dopamine in brain
Hallucinations are common
Dont use with hepatic impaired
Only for severe symptoms
Contraindications: malignant melanoma, narrow angle glaucoma (b/c dilates pupils and inc. pressure)
Atropine
Eye drops Anticholinergic effect Blocks acetylcholine Reduces stress secretions Inc. chances of everything (prostate inc. ulcerative colitis, numbness, thyroid issues, HTN, hernia, reflux, asthma, irregular heartbeat
COMT
Inhibits metabolism of levodopa in the periphery
Ligands
Neurotransmitters like acetylcholine, norepinephrine and binds to receptors int he ANS
Agonists
Bind to receptors and alter the function to trigger pathological response
Antagonists
Bind to receptor but fail to activate the physiologic response
Signal transduction
Cascade of intracellular events that occur when receptors located on target tissues are stimulated by a ligand
GABA
inhibitory, regulated communication between brain and nervous system
Dopamine activates which receptors
Activates Alpha 1 and Beta 1 receptors
They are impacted by norepinephrine or epinephrine
Serotonin
Appetite and Mood regulator
Acetylcholine
Skeletal muscle
ANS
Controls involuntary activities ins smooth muscle, secretory glands and visceral like the heart
Homeostasis, stress response, body tissue repair,
SNS and PNS
SNS
Heart rate, arterial blood pressure, cardiac output, pupil dilation, metabolism, blood flow, respiration depth
CNS
Controls most functions of the body and mind containing the brain and spinal cord
PNS
Nerves and ganglia outside the brian and spinal cord
Fight or Flight
Triggered by SNS
Dilated pupils, dry mouth, tense, heart pounding, sweating, slow digestion
Epinephrine and Norepinephrine
A1,B1,A2,B2 Receptors
A1: contraction of heart
A2: contraction of lungs
B1: dilation of heart
B2: dilation of lungs
Dilantin
Stabilizes neuronal membranes to delay influx of sodium ions into the neurons preventing excitability
Controls different types of seizures
Can cause: Ataxia (poor coordination), drowsiness, lethargy, N & V, gingival hyperplasia, osteoporosis, Steven johnson syndrome
IV NEVER GIVEN IN HAND b/c purple glove syndrome (give over 1 hr min.)
Flexeril
Centrally acting skeletal muscle relaxant given short term ORALLY
Provides relaxation by acting on brainstem and spinal cord to depress motor activity
Can cause: drowsiness, dizziness, anticholinergic effects
Tonic-clonic seizure
Grand Mal seizures
Most common
Stiffening-twitching/jerking
May start with simple/partial seizure
Absence seizure
Alter in consciousness
Myoclonic seizure
Contraction of muscle or group of muscles
Status epilepticus
Life threatening usually due to abrupt cessation of AED
Occurs in intervals of tonic-clonic seizures without regaining consciousness
Permanent brain damage
CharacteristicsL hypotension, hypoxia, cardiac dysrhythmias
Pregnancy risk of AED
Birth defects; neural tube, facial clefts, hypospadias
Benzodiazepines (diazepam, Lorazepam, Midazolam)
Given for status epilepticus
Baclofen (Gablofen)
Alleviates signs and symptoms of spasticityin patients with MS, Spinal cord injuries
Agonist to GABA
If given via intrathecal pump should be given in the spinal canal
DO NOT STOP taking abruptly
Oral acts in an hour
Drug given to treat malignant hyperthermia
Dantrolene sodium (Dantrium, Revonto, Ryanodex)
Diuretic purpose
Treat fluid volume excess, increase urine formation and output and secretion of water, sodium and electrolytes
Loop diuretic
Lasix
Bumetanide, Ethacrynic acid, Torsemide
Lasix
Osmotic diuretic
Mannitol
Lasix (Furosimide)
Oral or IV (given to children often)
Works 30-60 min
Inhibits sodium and chloride reabsorption in the ascending lib of the loop of henle
Use when creatinine clearance lower than 30 mL/min
Can cause fluid/electrolyte imbalance, OTOTOXICITY (plasma drug level is high)
NOT potassium sparing so take potassium
LIMIT sodium intake
DO NOT TAKE IF: Anuria, pregnancy, sensitivity
Potassium normal lab values
3.5 - 5 mEq/L
HCTZ “Hydrochlorothiazide”
Most common diuretic
Long term management of heart failure and hypertension
Use if you have adequate urine output
Decrease reabsorption of sodium, water, chloride and bicarbonate in distal tubules
ONLY THIAZIDE GIVEN IV
Can cause hypo everything
Glomerular filtration
Push water and electrolytes to bowmans capsule to proximal tubules
Tubular reabsorption
Indicates movement of substances from tubule into peritubular capillaries, re absorption in proximal tubules
Tubular secretions
Movement of substances from blood in peritubular capillaries to glomerular filtrate flowing through renal tubules
Secretion occurs in proximal tubules (uric acid, creatinine, hydrogen, ammonia) and distal (potassium, hydrogen, ammonia)
Prevacid
PPI
Lansoprazole is the generic name
Inhibits gastric acid secretions for a longer period of time and provides faster symptom relief
Similar to H2RAs
PUD
Heliobacter pylori and NSAIDS
Anywhere in duodenum, esophagus, GI mucosa
Causes bloating, pain, fullness, intolerance, heartburn, nausea
Antacids
Neutralize gastric acid
H2RA “H2 antagonist”
inhibit both basal secretion of gastric acid and the secretion stimulated by histamine, acetylcholine and gastrin
PPIs
Omeprazole, Esomerazole, Lansoprazole
Non prescription substances used to reduce N & V
Acupuncture, Acupressure, Herbal supplements
Zofran
Prototype of 5-HT3 antagonist “Ondansetron”
Oral or IV
Given for postoperative N & V
Antagonize serotonin receptors preventing their activation by the effects of emetogenic drugs of toxins
What Induces vomiting?
Activation of CTZ
5-HT3
Smells, Foods, Ipecac
Neurotransitters associated with nausea and vomiting
Muscarinic (M1) Dopamine (D1) Histamine ( H1) 5 - Hydroxytryptamine 3 (5 -HT3) Neurokin 1 (NK1)
Vistaril
Antihistamine under class of "Hydroxyzine" Can cause anticholinergic effects including drowsiness, dizziness, confusion
Promethazine
Under class phenothiazines
CNS depressant used for N&V
Can cause blurry vision, urinary retention, dry mouth, photosensitivity , drowsiness, confusion
Small doses
Not for children under 2 or elderly w/ dementia
Given I.M, NEVER subcutaneous
Dronabinol
Active ingredient in “Marinol”
THC
Last resort drug to treat appetite loss and weight loss with HIV patients and N&V in chemo patients
Can cause drowsiness, confusion, “High” feeling, GI issues, V & N
Can be addictive, Do not take if hypersensitive to Dronabinol or sesame oil
