Deck 1 Flashcards
- calci
Calcium and Vitamin D supplements
- Calcifero
- Calcitrol
- ergocalciferol
- ase, plase
Thrombolytics
- alteplace ( Activase)
- streptokinase (streptase)
- reteplase (Retavase)
Antidote for thrombolytics such as alteplase ( activase)
Amicar ( Aminocaproic acid)
What should you watch for when giving Thrombolytics
preventing bleeding & watch for reperfusion arrhythmias if administered for myocardial infarction
When is streptokinase contraindicated?
if strep infections or previous streptoknnase in the last 6 months
What is Alteplase (Activase) used for?
what is an important thing to remember when giving this drug?
used in treatment of acute ischemic stroke in adults
needs to be started within 3 hours of on set
-fenac, -lac
Non-steroidal anti-inflammatory drug
- diclofenac ( Cataflam, Voltaren)
- etodolac ( Lodine)
- nepafenac
- Ketrolac ( Toradol)
Side effects of NSAIDS
GI irritation/ulcers/bleeding, nephrotoxicity.
- profen
Non-steroidal anti-inflammatory drugs
- Fenoprofen (Naprofen)
- Ibuprofen ( Motrin, Advil)
- Ketoprofen ( Actron, Orudis)
What is the difference between -fenac and - lac NSAIDS and -profen NSAIDS
-profen NSAIDS have low to intermediate analgesic potency and fenacs have the most potent analgesic effect, comparable with opioids
-afil
Phosphodiesterase inhibitors- PDE-5 inhibitors
- sildenafil
- tadalafil
- vardenafil
What is the action and results of Phosphodiesterase inhibitors?
block 1 or more of the 5 PD enzyme ( PDE) subtypes, resulting in increased intracellular cAMP
Overall causing increased cardiac contactility, vasodilation and bronchodilation
-afil PDIs that selectively block PDE- 5 found where? What are they used for?
found in the corpus cavernosum in the penis. Can treat erectile dysfunction
-rinone
Phosphodiesterase inhibitors-PDE-3 inhibitors
- amrinone
- milrinone
what is the overall effect of phosphodiesterase inhibitors-PDE 3?
increased cardiac contractility and vasodilation
What are phosphodiesterase inhibitors-PDE 3 useful for?
the treatment of acute congestive heart failure and cardiogenic shock because of the ability to increase contractility and vasodilation
-zepam
sedative/anxiolytics-Benzodiazepine
- clonazepam
- diazepam (Valium)
- lorazepam ( Ativan)
- temazepam
What is the mode of action of sedative/anxiolytics- Benzodiazepine?
Act on BZD receptors on chloride channel- increase chloride influx into neuronal cells to decrease excitability
What are Benzodiazepines used for?
anxiety agent, sedative and anti-convulsant
What drug is the first line for stopping seizure in progress in status epilepticus?
Benzodiazepine
-zolam
Sedatives/Anxiolytics- Benzodiazepine
- alprazolam ( Xanax)
- estazolam
- midazolam ( Versed)
- Oxazepam ( Serax
What is a precaution when giving Midazolam ( Versed)
It can cause Amnesia
-glinide, ide
hypoglycemic agents- secretogues
- glipizide ( glucotrol)
- glyburide ( Micronase, DiaBeta)
- Nateglinide ( Starlix)
- Repaglinide ( Prandin)
What are the therapeutic effects of hypoglycemia agents -glinide, ide
increase insulin secretion by pancreatic beta cells
What re side effects/ adverse effect of sulfonylureas( glyburide, glipizide)
weight gain
glyburide increases sensitivity to sun
-glitazone
Hypoglycemic Agent- Thiazolidinediones
- Pioglitazone* (Actos)
- Rosiglitazone (Avandia)
What is the mode of action for Thiazolidinedione hypoglycemic Agents?
insulin sensitizers- increase insulin uptake and effectiveness by skeletal muscle cells and adipose tissue
- limus
Immunosuppressant
-Pimecrolimus (Elidel)
-Sirolimus ( Rapamune)
Tacrolimus ( Prograf)
-mab, -monab
immuntherapy-Monoclonal Antibody ( MAB)
- adalimumab (Humira)
- alemtuzumab(campath)
- daclizumab (zenapax)
- infliximab (remicade)
What are Immunotherapy- Monoclonial Antibody (-mab, -monab) used for?
treatment or prevention of organ rejection or graft vs host disease: also for management of autoimmune disorders
Which MAB is used to inhibit cell proliferation in some type of cancers?
Alemtuzumab and transtuzumab
Which MAB are anti-necrosis factor? What are they used for?
adalimumab, Etanercept, golimumab. Used for rheumatoid arthritis
What are the possible side effects of MABs
Flu-like symptoms, aches, pain, fever and nausea
- zoline
Nasal Decongestants
- oxymetozoline
- zylometazoline
What type of drugs are Nasal Decongestatns ( -zoline)? How do they work?
Alpha Adrenergic Agonists. Exert their effect by causing vasoconstriction of nasal blood vessels.
What are the possible side effects of Nasal Decongestants?
They can enter systemic circulation and produce CNS effects- tachycardia and hypertension
-nium
Neuromuscular blocking agents
-pancuroium
What are Neuromuscular Blocking agents ( -nium) used for?
skeletal muscle relaxation during surgery or other procedures. Also used for mechanically ventilated patients to avoid “ bucking” or resisting the vent.
-curium
Neuromuscular blocking agents-Muscle-relaxant
- atracurium
- mivacurium
-coxib
Non-Steroidal Anti-inflammatory drug ( NSAID) Cyclooxygenase -2 ( COX-2) selective inhibitor
- valdecoxib ( bextra)
- celecoxib ( celebrex)
- rofecoxib ( Vioxx)
What is unique to the Cylooxygenase-2 ( COX-2) selective NSAIDS (-coxib)? Compared to other NSAIDS
Because this class of NSAIDS does not block the COX-1 pathway, it exerts an anti-inflammatory effect without the common side effects of GI irritation ulcers, bleeding and Nephrotoxicity.
What is a disadvantage of the Cyclooxygenase-2 NSAID group?
They do not have anti-platelet effect so there is an increased risk of thrombi and emboli formation- leading to higher risk of stroke, myocardial infarction, pulmonary embolus and deep vein thrombosis. Contraindicated in pts at high risk for this
pred-
Corticosteroid
- loteprednol
- methylprednisolone* (Medrol, Depo-Medrol)
- Prednicarbate
- Prednisolone ( Orapred, Prelone)
- Prednisone* ( Sterapred)
-sone
Corticosteroid
- betamethasone ( Celestone)
- cortisone ( Cortone Acetate)
- dexamethasone ( Decardron)
- prednisone
-tretin
Dermatogic Agent-Retinoid/Vitamin A
- acitretin
- alitretinoin
- isotretinoin
- tretinoin
What are Dermatogic Agents Retinoid/ Vitamin A (-tretin) used for?
Topically for skin lesions such as acne, psoriasis, kaposi’s sarcome lesions
What is a major contraindiction associated with Acitretin?
Contradicted in pregnancy due to tetratogenic effects. Should also not use if planning pregnancy within the next 3 years
-lamide
Diuretics - Carbonic Anhydrase Inhibitors
- acetazolamide
- brinzolamide
- dorzolamide
- methazolamide
What are Carbonic Anhydrase Inhibitors (-lamide) used for?
glaucoma ( decreases edema in eye) and metabolic alkalosis
-semide
Diuretics-loop diuretic
- furosemide
- torsemide
What is the mode of action in Loop diuretic (-semide)?
They block sodium, potassium, chloride and water reabsorption in ascending Loop of Henle
What are the possible adverse effects of giving Loop Diuretics too quickly?
Ototoxicity and syncope
-thiazide
Diuretics-Potassium losing
- chlorthiazide ( Hygroton, Diuril)
- hydrochlorothiazide(hydodiuril)
-actone
Diuretics-Potassium sparing
- aldactone
- spironolactone
What is the mode of action for potassium losing diuretics (-thiazide) ?
inhibits sodium, chloride, and water re-absorption to end portion of ascending LOH and distal tubule
In addition to diuretics what else can Diuretic -Potassium losing (-thiazide) do?
Vasodilation- #1 drug for hypertension
When should -thiazides not be given?
When a pt has sulfa allergy
What are side effects of thiazides?
hypo- kalemia, magnesemia, natremia, tension, chloremia, academia
hyper- glycemia, uricemia
What is the mode of action for -actone potassium sparing diuretics?
blocks the effects of aldoesterone- decreases sodium/chloride/water reabsorption and increases excretion. Increases potassium reabsorption
What must be watched when taking potassium sparing diuretics
hyperkalemia
-trel
female hormone-progestrin
- desogestrel
- etonogestrel
- levonorgestrel
- norgestrel
What are female hormone progestrin ( -trel ) used for?
hormonal contraception
-stim
Hematopoietic agent-colony stimulating factor
- filgrastim
- pegfilgrastim
- sargramostim
What are hematopoietic agents-colony stimulating facor ( -stim) used for?
used to off-set bone marrow suppressive effects of cancer chemotherapy, radiation and other treatments
What are side effects of hematopoietic agents?
flu-like symptoms, fever, chills, aches, pains, malasie, fatigue, Nausea, Anorexia
-phylline
Bronchodilators- xanthine derivative
- Aminophylline (Phyllocontin)
- dyphylline
- oxytryphylline
- theophylinne ( Theo-Dur, Slo-bid)
What is the mode of action of bronchodilators-xanthine derivative ( -phylline )
Relaxes smooth muscle of bronchi and bronchioles by increasing intracellular cAMP –> increase bronchodilation
What are possible side effects of Bronchodilators-xanthine derivative?
CNS stimulant effect- tachycardia, nervousness, tremors, visual hallucinations and seizures
What is an important nursing consideration when giving Bronchodilators-xanthine derivative ( -phylline )
monitoring blood levels because of the narrow therapeutic window
10-20mcg/blood > 20=toxicity
-tropium
Bronchodilators-anticholinergic
- ipratropium (atrovent)
- tiotropium* (spiriva)
What is the mode of action for Anticholinergc- Bronchodilators ( -tropium )
block the bronchoconstrictive effect of acetylcholine from parasympathetic system, promotes SNS causing bronchodiation
What are Anticholinergic-bronchodilators usuaully used for?
treatment of COPD
-stigmine
cholinergic agonists
- neostigmine
- physostigmine
- pyridostigmine
What are cholinergic used for?
treats myasthenia gravis and overdoes of neuromuscular blocking agents like curare
-ine
CNS stimulants
- amphetamine
- dextroamphetamine (Adderall)
- caffeine (NoDox, Vivarin)
- terbutaline
- theophylline
- epinephrine
- lisdexamfetamine (Vyvanse)
- norepinephrine
- dopamine
What are catecholamines such as epinephrine, norepinephrine and dopamine used for?
to prolong the compensatory phase of shock
-cort
corticosteroid
- clocortolone
- fludrocortisones
- hydrocortisone
What are the general uses for corticosteroids?
treatment of chronic inflammatory disorders ( arthritis, asthma, chronic pain disorders, autoimmune disorders) and prevention or treatment of acute or chronic organ rejection in transplantation
What are the adverse effects of corticosteroids
cushings syndrome-hyperglycemia, hyperlipidemia, sodium and water rentention, hypertension, labile mood, stretch marks, muscle atrophy, increased suseptibility to infections, moon face, buffalp ump, masked signs of infection
What should be avoided when on corticosteroids
avoid grapefruit and juice
When should corticosteroids be taken?
in morning
-onide, -sonide
corticosteroid
-idone
Antipsychotic-atypical
- paliperidone ( Invega)
- resperidone ( Risperdal)
- ziprasidone (geodon)
- lloperidone (fanapt)
What is the mode of action for antipsychotic-atypical drugs ( -idone )
blocks dopamine receptors and serotonin receptor 5HR2A
What are the possible side effects
weight gain and changes in metabolism - risk of diabetes and hyperlipidemia
-pine
antipsychotics-atypical
- clozapine (clozaril)
- olonazapine*
- quetiapine* ( Seroquel)
-prazole
Anti-ulcer- Gastric proton pump inhibitors
- esomeprazole* (Nexium)
- lansoprazole (Prevacid)
- omeprazole* (Prilosec)
- pantoprazole ( Prontonix)
What is the mode of action for Anti-ulcer Gastric Proton Pump Inhibitors ( -prazole ) ?
inhibit gastric acid production by the parietal cells on the surface of the stomach
What drugs could proton pump inhibitors effect and how?
they can increase bioavailability and risk of toxicity of anticoagulants, diazepam and dilantin
-tidine
Anti-Ulcer–H2 receptor antagonists
- Cimetidine ( Tagament)
- Famotidine* (Pepcid)
- Niazatidine ( Axid )
- Ranitidine ( Zantac)
What is the mode of action for Anti-Ulcer- H2 receptor antagonists (-tidine)
prevent histamine-induced gastric acid production
What are possible side effects of H2- receptor antagonist (-tidine)
headache
may causes confusion in severly ill patients > 50 yrs old.
Which H2- receptor antagonist may have more adverse effects? What effects are these?
Cimetidine is more prone to have hepatic/renal toxicity and bone marrow suppression
When should H2 receptor antagonists be taken?
orally and at least 1-2 hours apart from antacids
-dronate
Biphosphonates- Bone resorption inhibitor
What is the mode of action for Biphosphoinates-bone resorption inhibitor? ( -dronate )
inhibits resorption of calcium from bone to blood.
What are possible side effects of biphosphonates
irritating to esophagus and GI tract- if taken orally.
How should Biphosphonates be taken?
should be taken 6-8 ounces of water on empty stomach. it upright or stand for at least 30 minutes after taking
-terol
Bronchodilators- Beta-2 agonist
- short acting: albuerol, levalbuterol, metaproteronolo, pirbuterol
- long acting: Arformoterol, formoterol, salmeterol ( Serevent )
What are the side effects of Bronchodilators-beta- 2 agonists
increase HR, increase SNS stimulation
-adol
Analgesics – Opioid
Tapnetadol (Nucynta), tramadol*(Rybix, Ryzolt, Ultram)
-one ,-done
Analgesics – Opioid
hydrocodone* (Norco,Vicodin), hydromorphone (Dilaudid, Exalgo), oxycodone* (OxyContin, Percocet), methadone
hydrocodone* (Norco,Vicodin), hydromorphone (Dilaudid, Exalgo), oxycodone* (OxyContin, Percocet), methadone
o Depressed respirations o Dizziness o Drowsiness o Decreased peristalsis o Decreased BP o Dependency CNS depressant, everything SLOWS DOWN with opioids
-ane
Anesthetics – General
cyclohexane, ethane, fluorane
-caine
Anesthetics – Local/ Antiarrhythmics – Class I
bupivacaine, cocaine, lidocaine (local anesthetic plus Class I Antiarrhythmic), xylocaine (local anesthetic plus Class I Antiarrhythmic), procainamide (Pronestyl – Class I antiarrhythmic)
All “caine” drugs work by
inhibiting or blocking the sodium channels. Sodium does not rush in as fast during an action potential, decreasing heart rate in the heart; decreased rate of pain transmission from the pain receptors
- CNS depressant effect
-nitrate, nitro-
Antianginals – Nitrates Isorbid dinitrate (Isordil, Sorbitrate); isorbide mononitrate* (Monoket, Imdur); nitroglycerin (Nitro-Dur, Nitro-Bid, Nitrostate)
Antianginals – Nitrates (-nitrate, nitro) work by
prevention or treatment of angina in patients with atherosclerosis
- Vasodilation (arteries) and -Venodilation (veins) effect
Antianginals-Nitrates need replaced ..
Potency of NTG SL lost within 3 mos of opening bottle – needs replaced
Side effects of Antianginals-Nitrates?
Headache, dizziness, hypotension
Pts taken Viagra and Nitrates are at a high risk for what?
dangerous hypotension
