Capstone Pharmacology Flashcards
-caine
Classification
Local Anesthetic
lidocaine (Xylocaine)
tetracaine (Pontocaine)
procaine (Novocain)
-cillin
Classification
Antibiotic
penicillin
amoxicillin
ampicillin
piperacillin tazobactam (Zosyn)
-dine
Classification
H2 Blockers (Anti-Ulcer)
ranitidine hydrochloride (Zantac)
cimetidine (Tagamet)
famotidine (Pepcid)
nizatidine (Axid)
-done
Classification
Opioid Analgesic
-ide
Classification
Oral Hypoglycemics
chlorpropamide (Diabinese)
glipizide (Glucotrol)
tolzamide
glyburide (DiaBeta)
glimepiride (Amaryl)
repaglinide (Prandin)
nateglinide (Starlix)
** Not to be confused with diuretics **
-lam
Classification
Anti-Anxiety Agents
alprazolam (Xanax)
Diazepam (Valium)
Lorazepam (Ativan)
Oxazepam (Serax)
Clonazepam (Klonopin)
-micin / -mycin
Classification
Antibiotic
-mide
Classification
Diuretic
-nium
Classification
Neuromuscular Blocking Agents
-olol
Classification
Beta Blockers
-oxacin
Classification
Antibiotic
-pam
Classification
Anti-Anxiety Agents
-pril
Classification
ACE inhibitors
-sone
Classification
Steroid
Aspirin
Analgesic (Anti-platelet)
Do not give together with other anticoagulants
Stop taking aspirin several (7?) days prior to surgery
Do not give to children with viral infections (possibility of Reye Syndrome)
Ibuprofen
NSAID
Take with food
Contraindicated for people with GI ulcers
Morphine
Opioid Analgesic
Respiratory depressant – should be witheld if respirations are <10
Antidote: Narcan
Dilatin
Anti-Convulsant
May cause gum hyperplasia - advise clients to visit dentist regularly
Prednisone
Anti-Inflammatory
Causes Cushing-like symptoms
Common side effects include immunosuppression (monitor client for infection) and hyperglycemia
Heparin
Anti-Coagulant
Monitor labs: PTT
Antidote: Protamine sulfate
- Heparin helps prevent thrombin from converting fibrinogen to fibrin. Administered IV or SQ.
- Enoxaparin (Lovenox) is a low-molecular weight heparin - same action but longer half-life and administered SQ
- Protamine sulfate is the antidote
- Administer when there is a likelihood of clot formation such as MI or DVT
- Risk for bleeding is major side effect; monitor for bleeding, bruises, hematuria, petechiae
- Instruct clients to avoid corticosteroid use, oral hypoglycemic agents, salicylates, NSAIDs, excessive green leafy veggies and other foods high in vit K
- Normal aPTT is 20-36seconds but to maintain a therapeutic level, aPTT should be 1.5-2x normal (60-80sec)
Coumadin / Warfarin
Anti-Coagulant
Monitor labs: PT & INR
Antidote: Vitamin K
- Coumadin (Warfarin) interferes with coagulation factors by antagonising vitamin K
- Oral admin (IV heparin may be used until therapeutic level of coumadin achieved)
- Use is contraindicated in clients with low platelet counts or uncontrolled bleeding
- Mephyton (vitamin K) is the antidote
- Advise clients to avoid food high in vit K as well as acetaminophen, glucocorticoids, aspirin; wear a medicalert bracelet
- Dose is usually once daily
- INR and PT are monitored (PT should be 1.5-2x control; INR should be 2-3x control)
- No coumadin for pregnant women! Oral anticoagulants are pregnancy category X.
Cogentin
Anti-Parkinson
Used to treat EPS (extrapyramidal symptoms)
Sinemet
Anti-Parkinson
Drug is effective when tremors are not oberved
Theophylline / Aminophylline
Respiratory
Side effects: tachycardia
Digoxin
(Lanoxin)
Cardiovascular
Signs of toxicity: pt may complain of visual changes in colors; loss of appetite
Therapeutic Serum Blood Level: 0.5 - 2.0 ng/mL
Magnesium Sulfate
Anti-Hypertensive (Pre-Eclampsia)
Monitor for deep tendon reflexes and respiratory depression
Hydrochlorothiazide
Diuretic
Monitor potassium levels
Furosemide (Lasix)
Diuretic
Monitor potassium levels
Aldactone (Spironolactone)
Diuretic
Potassium-sparing; still need to monitor potassium levels to watch for hyperkalemia
Lithium
Psychotropic
Therapeutic range: 0.8 - 1.2 mEq
Know symptoms of toxicity - can cause severe CNS, renal, and pulmonary problems that may lead to death.
Serum levels of 1.5-2.0 mEq/L: CNS problems, including lethargy, slurred speech, muscle weakness, and fine tremor; polyuria, which relates to renal toxicity; and beginning of gastric toxicity, with nausea, vomiting, and diarrhea; ECG irregularites may be present
Adequate fluid and salt intake is important
Encourage routine serum levels measured
MAOI Inhibitors
Psychotropic
Have dangerous food-drug interactions – foods with tyramine (such as aged cheeses, aged meats, and wine) should be avoided
Also has many drug-drug interactions
Disulfiram (Antabuse)
Psychotropic
Used for alcohol aversion therapy
Clients must avoid any form of alcohol (including cough medicines and mouthwash) or they will develop a severe reaction
Oxytocin
Maternity (?)
Assess uterus frequently for tetanic contraction
Tegretol
Atropine
Epogen
Acyclovir
Anti-Viral
Used for various viral infections including shingles
Antiemetics
Medications used for the tx and prevention of N/V.
5-HT3 Receptor Antagonists (serotonin antagonists)
Dolasetron
Granisetron
Ondansetron (Zofran)
Tropisetron
Dopamine Antagonists
Promethazine (Phenergan)
Prochlorperazine (Compazine)
Metoclopramide (Reglan) – monitor for EPS!
Antihistamines (H1 histamine receptor antagonists)
Diphenhydramine (Benadryl)
Dimenhydrinate (Dramamine)
Cannabinoids
Cannabis (Medical Marijuana)
*Most antiemetics cause some form of sedation so watch for additive effect with other meds
Proton Pump Inhibitors (PPIs)
Decrease stomach acid by inhibiting gastric proton pumps (which make the acid) – stop the flow of acid at the pump!!
Omeprazole (Prilosec, Omepral)
Lansoprazole (Prevacid)
Esomeprazole (Nexium)
Pantoprazole (Protonix)
“Zole” is the friendly guy who turns of the pump but, if he stays around too long, he can cause b-12 deficiency.
Statins
HMG CoA Reductase Inhibitors - used to treat primary hypercholesterolemia, prevention of coronary events, protection against MI and stroke in pts with diabetes, help increase HDL
HDL should be HIGH and LDL should be LOW
Atorvastatin (Lipitor)
Simvastatin (Zocor)
Lovastatin
Risk of hepatoxicity - monitor liver function; instruct pts to avoid alcohol
Risk of myopathy and peripheral neuropathy - monitor CK levels and instruct pts to report muscle pain, weakness, tingling, etc.
Antiplatelets
Prevent platelet aggregation by inhibiting enzymes and factors that normally allow for arterial clotthing - used to prevent MI and stroke
Aspirin (Ecotrin)
Clopidogrel (Plavix)
Pentoxifyline (Trental)
Low dose therapy often used (81mg aspirin)
Monitor for bleeding - educate pts about “coffee ground” emesis and bloody or tarry stools; watch for bleeding, bruising, and petechiae
Observe for signs of weakness, dizziness, and headache – could indicate hemorrhagic stroke
Avoid concurrent use with NSAIDs, heparin, warfarin, corticosteroids
Thrombolytic Agents
Clot busters - dissolve clots that have already been formed by converting plasminogen to plasmin, which destroys fibrigoen and other clotting factors
Streptokinase (Streptase)
Must be administered within 4 to 6 hours of onset of symptoms
Goal is the restoration of circulation
Risk is of increased bleeding – baseline blood counts should be monitored; venipuncture, SQ, IM should be avoided
Erectile Dysfunction Agents
Act by increasing nitric oxide which opens and relaxes the blood vessels of the penis causing increased blood flow
Sildenafil (Viagra)
Vardenafil (Levitra)
Tadalafil (Cialis)
“Fil” is well tolerated by most clients but adverse effects include headache, flushing, back pain and muscle aches (Levitra), temporary vision changes.
Men who have heart problems, uncontrolled blood pressure, hx of stroke, or another health problem that my exacerbate the likelihood of priapism, should not hang out with “Fil.”
Hypoglycemia
When using insulin, hypoglycemia is most likely to occur at the peak of the insulin’s action – important to know onset, peak, and duration of all insulin formulations
S/S of abrupt-onset hypoglycemia: tachycardia, palpations, diaphoresis, shakiness
S/S of gradual-onset hypoglycemia: headache, tremors, weakness
Lispro (Humalog)
Fastest: rapid-acting insulin
Onset: <15min
Peak: 30min - 1hr
Duration: 3 - 4hrs
Regular (Humulin R)
Fast: short acting insulin
Onset: 30min - 1hr
Peak: 2 - 3hrs
Duration: 5- 7hrs
NPH Insulin (Humulin N)
Slow: intermediate-acting insulin
Onset: 1 - 2hrs
Peak: 4 - 12hrs
Duration: 18 -24hrs
Insulin glargine (Lantus)
Slowest: long-acting insulin
Onset: 1hr
Peak: none
Duration: 10 - 24hrs
Epinephrine
(Adrenaline)
-
Alpha1 Receptors
- Vasoconstriction
- Slows absorption of local anesthetics
- Manages superficial bleeding
- Reduces congestion of nasal mucosa
- Increases blood pressure
- Vasoconstriction
-
Beta1 Receptors
- Increases heart rate
- Strengthens myocardial contractility
- Increases rate of conduction through the AV node
- Treatment of AV block and cardiac arrest
-
Beta2 Receptors
- Bronchodilation
- Tx of Asthma
- Bronchodilation
Dopamine
(Intropin)
- Tx of shock and heart failure
-
Beta1 Receptors
- Low dose (2 to 5 mcg/kg/min)
- Renal blood vessel dilation
- Increases:
- Heart rate
- Myocardial contractility
- Rate of conduction through the AV node
- Blood pressure
-
Beta1 & Alpha1 Receptors
- High dose (>10 mcg/kg/min)
- Renal blood vessel vasoconstriction
- Increases:
- Heart rate
- Myocardial contractility
- Rate of conduction through the AV node
- Blood pressure
- Vasoconstriction
- High dose (>10 mcg/kg/min)
Dobutamine
(Dobutrex)
- Treatment of heart failure
- Beta1 Receptors
- Increases:
- Heart rate
- Myocardial contractility
- Rate of conduction through the AV node
*
- Increases: