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c13 Flashcards

1
Q

Phenylephrine (Neo-Synephrine) therapeutic class and pharmacologic class

A

Therapeutic Class: Nasal decongestant; mydriatic drug; antihypotensive

Pharmacologic Class: Adrenergic drug (sympathomimetic)

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2
Q

Prazosin (Minipress) therapeutic class and pharmacologic class

A

Therapeutic Class: Antihypertensive

Pharmacologic Class: Adrenergic-blocking drug

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3
Q

mechanism of action of Phenylephrine (Neo-Synephrine)

A

stimulate the sympathetic nervous system directly/indirectly

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4
Q

uses Phenylephrine (Neo-Synephrine)

A

produces many of the same responses as anticholinergics

  1. constricts blood vessels –> BP goes up and treats nasocongestion
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5
Q

severe reactions of Phenylephrine (Neo-Synephrine)

A
  1. death –> restrict IV use USE SMALL DOSES
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6
Q

MOA Prazosin (Minipress)

A

inhibit sympathetic nervous system

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7
Q

uses of Prazosin (Minipress)

A
  1. hypertension
  2. dysrhytmias
  3. angina
  4. heart failure
  5. benign prostatic hypertrophy BPH
  6. narrow-angle glaucoma
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8
Q

primary use of adrenergic-blocking drugs

A

hypertension

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9
Q

therapetuic and pharmacologic class of ibuprofen (advil, motrin)

A

Therapeutic Class: analgesic, anti-inflammatory drug, antipyretic

Pharmacologic Class: NSAID

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10
Q

ibuprofen (advil, motrin) uses

A
  1. mild to moderate pain
  2. fever
  3. inflammation
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11
Q

ibuprofen (advil, motrin) actions are due to what?

A

inhibition of prostaglandin synthesis

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12
Q

common indications of ibuprofen (advil, motrin)

A
  1. pain associated w/ chronic musculoskeletal disorders
    - RA + osteoarthritis
  2. headache
  3. dental pain
  4. dysmenoorhea
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13
Q

administration alerts of ibuprofen (advil, motrin

A

give the drug on an empty stomach

if nausea, vomiting, or abdominal pain occurs, give w/ food

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14
Q

adverse effects of ibuprofen (advil, motrin)

A
  1. nausea
  2. heartburn
  3. epigastric pain
  4. dizziness
  5. GI ulceration w/ occult or gross bleed MAY occur w/ high doses for prolonged periods
  6. renal impairment due to chronic use
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15
Q

black box warning for ibuprofen (advil, motrin)

A
  1. increased risk of serious thrombotic events
  2. MI
  3. stroke –> fatal
  4. increased risk of GI events including bleeding, ulceration, perforation of the stomach or intestines
    - occurs more frequently in older adults
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16
Q

contraindications of ibuprofen (advil, motrin)

A
  1. pt w/ active peptic ulcers
  2. significant renal or hepatic impairment
  3. HF
  4. serious HTN
  5. stroke or MI
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17
Q

drug-drug interactions of ibuprofen (advil, motrin)

A
  1. anticoagulants and other coagulation modifiers
  2. aspirin –> decreases anti-inflammatory action
  3. antihypertensive action of diuretics, beta blockers, ACE inhibitors
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18
Q

treatment of overdose of ibuprofen (advil, motrin)

A

alkaline drug

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19
Q

therapetuic and pharmacologic class of prednisone

A

therapeutic class: anti-inflammatory drug

pharmacologic class: corticosteroid

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20
Q

uses of prednisone

A
  1. synthetic corticosteroid –> actions are the result of being metabolized to an active form
  2. duration = 4-10 days
  3. acute brochopasm
  4. antineoplastic agent
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21
Q

administration alerts of prednisone

A
  1. do not use if signs of system infection are present

2. slowly decrease dose if using more than 10 days

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22
Q

adverse effects of prednisone

A
  1. long-term therapy –> Cushing’s syndrome
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23
Q

contraindications of prednisone

A

active viral, bacterial, fungal, or protozoan infections

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24
Q

drug-drug interactions of prednisone

A
  1. concurrent use w/ amphotericin B or diuretics increases potassium loss
  2. can raise blood glucose levels –> pt with diabetes need insulin dose adjusted
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25
Q

therapetuic and phamacologic class of acetaminophen (tylenol)

A

therapeutic class: antipyretic and analgesic

pharmacologic class, centrally acting COX inhibitor

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26
Q

uses of acetaminophen (tylenol)

A

has no anti-inflmamtory properties –> ineffective in treating arthritis or pain caused by tissue swelling following injury

  1. TREATS FEVER
  2. relieves mild-moderate pain
  3. severe pain –> combined w/ opioids
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27
Q

action of acetaminophen (tylenol)

A

reduces fever by direct action at the level of hypothalamus and dilation of peripheral blood vessels, which enables sweating and dissipation of heat

does not cause GI bleeding or ulcers, like NSAIDS

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28
Q

administration alert of acetaminophen (tylenol)

A
  1. regular consumption of alcohol –> drug-induced hepatoxicity

destroys liver if overdose –> die

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29
Q

adverse effects of acetaminophen (tylenol)

A

liver + hypothalamus

  1. malnoursihed –> acut toxicity –> renal failure –> fatal
  2. acute toxicity: nausea, vomitting, chills, abdominal discomfort, and fatal hepatic necrosis
  3. liver damage risk
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30
Q

black box warning of acetaminophen (tylenol)

A
  1. potential to cause severe and fatal LIVER INJURY

2. serious allergic reactions w/ symptoms of angioedema, difficulty breathing, itching, or rash

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31
Q

contraindications of acetaminophen (tylenol)

A

chronic alcoholism

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32
Q

drug-drug interactions of acetaminophen (tylenol)

A
  1. inhibits warfarin metabolism

2. high dose or long term use –> elevated warfarin levels + bleeding

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33
Q

hepatitis B vaccine classes

A

vaccine

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34
Q

uses of hepatitis B vaccine

A

ppl at risk for exposre to hepatitis virus

  1. infants born to HBV-positive mothers
  2. HPV-infected blood exposure
  3. High-risk sexual practices (multiple partners)
  4. ppl who contract STIs repeatedly
  5. healthcare workers
  6. dialysis pt
  7. prisoners
  8. HBV areas of travel
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35
Q

how is Hep B vaccine produced and how many injections are needed?

A

recombinant DNA technology using yeast cells

3 IM injections; second dose is given 1 month after first, and third dose 6 months after first dose

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36
Q

contraindications of Hep B vaccine

A

hypersensitivity to yeast or HBV vaccine

  1. fever or active infections
  2. compromised cardiopulmonary status
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37
Q

drug-drug interaction of hep b

A

immunosuppresants will decrease effectiveness

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38
Q

classes of Interferon alfa-2b (intron-A)

A

therapeutic class: immunostimulant

pharmacologic class: interferon, biologic response modifier

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39
Q

actions/uses of Interferon alfa-2b (intron-A)

A

biologic response modifier prepared by recombinant DNA technology –> treat cancers and viral infections

available for IV, IM, and subcutaneous administration

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40
Q

administration alerts of Interferon alfa-2b (intron-A)

A
  1. provider experienced with its use

2. subcutaneous administration is recommended for pt at risk for bleeding

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41
Q

adverse effects of Interferon alfa-2b (intron-A)

A

flulike syndrome of fever, chills, dizziness, fatigue

headache, nausea, vomiting, diarrhea, and anorexia, depression, suicidal ideation

serious toxicity –> immunosuppression, hepatotoxicity, neurotoxicity

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42
Q

black box warning of Interferon alfa-2b (intron-A)

A

cause aggravate fatal or life-threaning neuropsychiatric, autoimmune, ischemic, or infectious disorders

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43
Q

contraindications of Interferon alfa-2b (intron-A)

A

hypersenstivity to IFNs, autoimmune hepatitis, and hepatic decompensation

neonates and infants

44
Q

cyclosporine (gengraf, neoral, sandimmune) classes

A

therapeutic: immunosuppressant
pharmacologic: calcineurin inhibitor

45
Q

actions and uses of cyclosporine (gengraf, neoral, sandimmune)

A
  1. obtained from a soil fungus that inhibits helper T cells
  2. less toxic to bone marrow cells
  3. used in combo w/ high doses of corticosteroid
  4. approved for prophylaxis of kidney, heart, liver transplant reject; psoriasis, xerophthalmia
46
Q

adverse effects of cyclosporine (gengraf, neoral, sandimmune)

A
  1. kidneys
    - reduced urine output
  2. hypertension and tremor
  3. headache, gingival hyperplasia, elevated hepatic enzymes
47
Q

black box warning of cyclosporine (gengraf, neoral, sandimmune)

A

only adminstered by healthcare providers experienced

serious infections and possible malignancies

monitor renal function

48
Q

penicillin G classes

A

therapetuic: antibacterial
pharacologic: cell wall inhibitor, natural penicillin

49
Q

penicillin G uses + actions

A
  1. drug of choice against streptococci, pneumococci, and staphylococci organisms that do not produce penicillinase and are shown to be susceptible by C&S testing
  2. gonorrhea and syphilis
  3. given by IV + IM
  4. pencilin V and amoxicillin –> oral penicillin therapy is desired
50
Q

adverse effects of penicillin G

A

diarrhea, nausea, and vomiting

anaphylaxis

late hypersenetivity

51
Q

contraindications of penicillin G

A

pt with severe renal disease

52
Q

cefazolin (ancef, kefzol) classes

A

therapeutic class: antibacterial

pharmacologic class: cell wall inhibitor: 1st generation cephalosporin

53
Q

actions and uses of cefazolin (ancef, kefzol)

A
  1. beta-lactam antibiotic used for treatment and prophylaxis of bacterial –> susceptible gram-positive organisms
  2. respiratory tract, urinary tract, skin structures, biliary tract, bones, joints

NOT effective against MRSA

longer half-life –> less frequent dosing

54
Q

adverse effects of cefazolin (ancef, kefzol)

A

rash + diarrhea

pain + phlebitis can occur at IM injection sites

seizures are rare

55
Q

contraindications of cefazolin (ancef, kefzol)

A

extensively excreted by kidneys –> pt w/ severe renal disease

56
Q

Tetracycline (sumycin, others) classes

A

therapeutic: antibacterial
pharmacologic: tetracycline; protein synthesis inhibitor

57
Q

actions/uses of Tetracycline (sumycin, others)

A

broad range of gram-positive + gram-negative, including chlmaydia, rickettsiae, mycoplasma

effective aggainst H. pylori

given pO

topical + oral preparations treat acne

58
Q

adverse effects of Tetracycline (sumycin, others)

A

tendency to affect vaginal, oral, and intestinal flora –> superinfection

nausea, vomiting, epigastric burning, diarrhea

teeth discoloration

photosensitivity

59
Q

contraindications of Tetracycline (sumycin, others)

A

severe renal or hepatic impairment

60
Q

Erythromycin (Eryc, Erythrocin, others) classes

A

therapeutic: antibacterial
pharmacologic: macrolide; protein synthesis inhibitor

61
Q

actions/uses of Erythromycin (Eryc, Erythrocin, others)

A
  • inactivated by stomach acid –> coated, acid-resistant tablets or capsules that dissolve in small intestine
  • pt who are unable to tolerate penicillins or have pencillin-resistnat infection
  • effective against most gram-positive bacteria
62
Q

adverse effects of Erythromycin (Eryc, Erythrocin, others)

A

nausea, abdominal cramping, vomitting

hearing loss, vertigo, dizziness

cardiotoxic and pose a risk for potentially fatal dysrhythmias

63
Q

Gentamicin (Garamycin, others) classes

A

therapeutic: antibacteriall
pharmacologic: aminoglycoside; protein synthesis inhibitor

64
Q

uses/actions of Gentamicin (Garamycin, others)

A

broad-specturm bactericidal antibiotic usually prescribed for serious urinary, respiratory, nervous, or GI infections when less toxic antibiotics are contraindicated

not absorbed by the oral route

65
Q

how to monitor therapeutic range of Gentamicin (Garamycin, others)

A

check serum drug levels

66
Q

adverse effects of Gentamicin (Garamycin, others)

A

rash, nausea, vomitting, fatigue

67
Q

black box warnings of Gentamicin (Garamycin, others)

A

neurotoxicity may manifest as ototoxicity and produce a loss of hearing or balance

tinnitus, vertigo, persistant headaches –> signs of ototoxicity

neuromuscluar blockade and respiratory paralysis

severe neuromscular weakness

signs of reduced kidney function include oliguria, proteinuria, and elevated BUN and creatinine levels

68
Q

contraindicaitons of Gentamicin (Garamycin, others)

A

pt w/ impaired renal function or those w/ hearing loss

69
Q

Ciprofloxacin (Cipro) classes

A

therapeutic: antibacterial
pharmacologic: fluoroquinolone; bacterial DNA synthesis inhibitor

70
Q

actions/uses of Ciprofloxacin (Cipro)

A

inhibiting bacterial DNA gyrase, affects bacterial replication and DNA repair

more effective against gram-negative

UTI, sinusitis, pneumonia, skin, bone and joint infections, infectious diarrhea, and certain eye infections

71
Q

adverse effects of Ciprofloxacin (Cipro)

A

nausea, vomitting, diarrhea

dont take w/ antacids or mineral supplements bc drug absorption will be diminshed

72
Q

black box warning of Ciprofloxacin (Cipro)

A

tendinitis and tendon rupture

73
Q

contraindications of Ciprofloxacin (Cipro)

A

pt experiences pain or inflammation of tendon

74
Q

trimethoprim-sulfamethoxazole (bactrim, septra) classes

A

therapeutic: antibacterial
pharmacologic: sulfonamide; folic acid inhibitor

75
Q

actions/uses of trimethoprim-sulfamethoxazole (bactrim, septra)

A

UTIs

inhibits bacterial metabolism of folic acid

both SMZ and TMP are synergestic
-development of resistnace is lower

76
Q

adverse effects of trimethoprim-sulfamethoxazole (bactrim, septra)

A

nausea and vomiting

pt w/ pre-existing kidney disease –> crystalluria, oliguria, renal failure

avoid direct sunlight

77
Q

contraindications of trimethoprim-sulfamethoxazole (bactrim, septra)

A

documented megaloblastic anemia due to folate defiiency should not receive this drug

78
Q

Isoniazid (INH) classes

A

therapetuic: antituberculosis drug
pharmacologic: mycolic acid inhibitor

79
Q

Isoniazid (INH) uses/actions

A

first-line drug for TB

inhibit synthesis of mycolic acids, which are essential components of mycobacterial cell walls

bactericidal for actively growing organsims but bacteriostatic for dorman mycobacteria

may be used alone for chemoprophylaxis, or in combo w/ other antituberculosis drugs for treating active disease

80
Q

adverse effects of Isoniazid (INH)

A

numbness of hands/feet, rash, fever

neurotoxicity, convulsions, optic neuritis, dizziness, coma, memory loss, psychoses

81
Q

black box warning of Isoniazid (INH)

A

hepatoxociity

jaundince, fatigue, elevated hepatic enzymes, loss of appetite

82
Q

contraindications of Isoniazid (INH)

A

severe hepatic impairment

83
Q

mechanism of action of pencillin

A

kill bacteria by disrupting cell walls

most effective on gram-positive bacteria

84
Q

primary use of pencillin

A

meninigtis; skin bone and joint infections; stomach infections; blood and valve infections; gas gangrene; tetanus; anthrax; sickle-cell anemia in infants

staph, strep, pneumonia

85
Q

adverse effects of penicilin

A

safest class of antibiotics

bacteria can become resisitnat

allergy is possible

lowered red/ whtie blood cell and platelet levels

86
Q

cephalosporins action

A

bind to bacterial cell wall, inhibit cell-wall synthesis

act w/ broad-spectrum activity against gram-negative organisms

5 generations w/ increased extent of activity

87
Q

primary use of cephalosporins

A

serious infections of lower respiratory tract, central nervous system genitourinary system, nbones bloods and joints

88
Q

adverse effects of cephalosporins

A

safe drugs

adverse effects similar to penicllins

89
Q

MOA tetracycline

A

effective agianst broad range of gram-positive + gram-negative organisms

90
Q

primary use of tetracycline

A

Rocky Mountain spotted fever

typhus, cholera, Lyme disease, peptic ulcers, and Chlamydia; newer ones for drug-resistnat intra-abdominal infections + complicated skin-structure infections, especially those caused by MRSA

91
Q

adverse effects of tetracycline

A

superinfections, nausea, vomiting, diarrhea, teeth discoloration, photsensitivey; drug resistance

92
Q

MOA macrolides

A

inhibits protein synthesis by binding to bacterial ribosome

effective against most gram-positivie and many gram-negative bacteria

93
Q

primary use of macrolides

A
  1. whooping cough
  2. legionnaire’s disease
  3. streptococcus
  4. H. influenzae
  5. Mycoplasma pneumonia
94
Q

adverse effects of macrolides

A

nausea, abdominal cramping and vomiting, diarrhea, superinfections, concern about resistant bacterial strains

95
Q

aminoglycosides MOA

A

inhibit bacterial protein synthesis

96
Q

primary uses of aminoglycosides

A

serious systemic infections caused by aerobic gram-negative bacteria, myobacteria, and some protozoans

97
Q

adverse effects of aminoglycosides

A

more toxic than other antibacterial classes, with serious systemic adverse effects

98
Q

MOA fluoroquinolones

A

inhibit bacterial DNA synthesis by inhibiting DNA gyrase + topoisomerase IV

99
Q

primary use of fluoroquinolones

A

respiratory infections, GI, and genitourinary tract infections

skin + soft tissue infections

UTIs

prophylaxis of anthrax infection

100
Q

adverse effects of fluroquinolones

A

nausea, vomiting, diarrhea, sleep disturbances, headche, dizziness,

most serious: dysrhythmias, hepatotoxicity

101
Q

MOA sulfonamides

A

suppress bacterial growth by inhibitng bacterial synthesis of folic acid

102
Q

sulfonamides primary use

A

UTI, pneumocystis carinii pneumonia, shigella infections of small bowel

103
Q

adverse effects of sulfonamides

A

formulation of crystals in the urine, hypersnsitivty reacitons, nausea, vomiting,

serious adverse effects: agranulocytoiss, acute hemolytics anemia, and aplastic anemia

104
Q

first-line drugs of TB

A

initial phase: 2months daily therapy with :

  1. isoniazid
  2. rifampin
  3. ethambutol

continuation phase: 2 months isoniazid and rifampin 2-3x per week

105
Q

chemoprophylaxis for TB

A

anti-tubercular drugs used to prevent disease in high-risk populations

  • patients w/ aids
  • close contacts + family members of recently infected tuberculosis patients
  • patients who are HIV positive and are receiving immunosuppressant drugs

drug cards (8 decks)

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