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336 Pharmacology > Drug cards > Flashcards

Drug cards Flashcards

1
Q

Morphine

A

class- opioid analgesic- agonist
indications- pain relief, (mod-severe) pre-op sedation, dec anxiety, pulm edema

mech action- mimick opioid peptide, produce endogenous analgesia/gen. cns depression

assessment- b/a bp, rr, o2, LOC, bowl fun, pain location;type; and intensity

adverse e- RESP. DISTRESS, n/v, pupil constric, euphoria, constip, slow motil, bowl spasm, urinary reten, orthostat hypoten, sedation

interactions- mao (monoamine oxidase inhib) w/in 14 days, alcoh/antipsychotics- sedation, resp dep, coma, death
warfarin- inc anticoag effects

patient ed-avoid o/ cns dep and alcoh, abuse pot, drowsy/dizzy (fall precaut), how/when ask for pain meds

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2
Q

HYDROcodone

A

class- opioid analgesic- agonist
indications- pain relif (mod-sev) or (constant/chronic)

mech action- bind opioid recep, alter percep/response pain, gen cns depress

assessment- b/a bp, rr, O2, LOC, bowl funct, brkthru pain- b/@peak, pain location, type, intensity, risk abuse

adverse e- confusion, dizzy, sedation, hypoten, n, constip, ingestion, urinary ret, RESP DEPRESS

interactions- mao inhib, benzodiazepines o/ cns dep- resp dep, sedation and coma
cyp3A4 inducers- dec fentanyl lvl anaelgesia

patient ed- avoid o/ cns dep and alc, abuse pot, drowsy/dizzy (fall precat), sugarl gum dec dry mouth

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3
Q

Codeine

A

class- opioid analgesic-agonist
indications- pain rel (mild-mod) cough reducer

mech action-bind opioid recep, alter percep/response pain, gen cns depress

assessment- b/a bp, rr, O2, LOC, bowl funct, brkthru pain- b/@peak, pain location, type, intensity, risk abuse

adverse e- RESP DEPRES, hypoten, constip, n/v, confusion, sedation

interactions- MAO inhib, alcoh/ benzodiazepines- inc cns depres, CYp3A4 inhib- inc lvl/ risk resp depre, mixed agonist/antagonist- risk withdrawl, dec effects

patient ed-avoid o/ cns dep and alcoh, abuse pot, drowsy/dizzy (fall precaut), s/s respir deprssion

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4
Q

fentaNYL

A

class- opioid analgesic- agonist
indications- pain supp for gen anesth, nerve block, pre/post op pain relief

mech action- bind opioid recep, alter percep/response pain, gen cns depress

assessment- b/a bp, rr, o2, LOC, bowl fun, pain location;type; and intensity, toxic overdose (hypoten, bradycardia, asystole)

adverse e- arrhyth, circ depress, hypoten, n/v, skel rigidty, confusion, APNEA, LARYNGOSPASM, RESP DEPRES

interactions- MAO inhib, alcoh/ benzodiazepines- inc cns depres, CYp3A4 inhib- inc lvl/ risk resp depre, mixed agonist/antagonist- risk withdrawl, dec effects

patient ed- sensations expect b4 surg, how/when ask pain m, dizzy/drowsy, avoid alc o/ cns depres at least 24hrs

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5
Q

HYDROmorphone

A

class- opioid analgesics- agonist
indications- pain rel (mod-severe), suppression cough

mech action- *no active metab, bind opioid recep, alter percep/response pain, gen cns depress

assessment- b/a bp, rr, O2, LOC, bowl funct, brkthru pain- b/@peak, pain location, type, intensity, risk abuse

adverse e- RESPIR DEPRSS, hypoten, confusion, sedation, unusual dreams

interactions- MAO inhib (dc 2wk prior), alcoh/ benzodiazepines- inc cns depres
mixed agonist/antagonist- risk withdrawl, dec effects
antidep, SSRI- inc risk serotonin toxicity

patient ed- pot abuse, how as pain meds, s/s respir depress, drowsy/dizzy (fall precaut), avoid alc/ o/ cns depres

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6
Q

Meperidine

A

class- opioid analgesics- agonist
*active metabolites

indications- pain relief

mech action- bind opioid recep, alter percep/response pain, gen cns depress

assessment- cns stimulation (risk toxicity), b/a bp, rr, o2, LOC, bowl fun, pain location;type; and intensity

adverse e- SEIZURES, RESPIR DEPRES, HYPRSEN RXNS, constip, n/v, hypoten, confusion, sedation

interactions- MAO inhib (dc 2wk prior), alcoh/ benzodiazepines- inc cns depres
mixed agonist/antagonist- risk withdrawl, dec effects
antidep, SSRI- inc risk serotonin toxicity, CYp3A4 inhib- inc lvl/ risk opioid toxicity

patient ed- pot abuse, how/when ask pain m, drowsy/dizzy, avoid alc and o/ cns dep, lying down dec n/v

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7
Q

Methadone

A

class- opioid analgesic- agonist
*long-duration action

indications- pain rel for opioid tol pt (daily), constant and sympt control during drug detox

mech action- bind opioid recep, alter percep/response pain, gen cns depress

assessment- hx heart dis, syncope, arrhyth, order ekg (causes v-tach and cardiac arrest), opioid withdrawl (sweating, loss apetit, runny nose), risk abuse, bowl fun, bp, pulse, rr, sedation lvl, pain type, location and intensity

adverse e- RESPIR DEPRES, constipation, hypotens, VENT TACHY

interactions- MAO inhib, antiarrhyth/ca channel blockers, diuretics (inc risk hypo mg/kalemia and inc risk arrhyth), CYP inhib (inc risk opioid toxicity) CYP inducers (dec effect analge), benzo’s and cns dep (sedation, coma, resp dep, death), agonist/antagonist (inc risk withdrawl)

patient ed- inform abt pot arrhyth, abuse pot, how/when ask pain m

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8
Q

oxyCODONE

A

class- opioid analgesic- agonist
*can be combo w/ acetamin. shrt/long acting

indications- pain rel (mod-sev)(daily, chronic)

mech action-bind opioid recep, alter percep/response pain, gen cns depress

assessment- b/a bp, rr, O2, LOC, bowl funct, brkthru pain- b/@peak, pain location, type, intensity, risk abuse

adverse e- RESPI DEPR, confusion, sedation, constip

interactions-MAO inhib, CYP inhib (inc risk opioid toxicity) CYP inducers (dec effect analge), benzo’s and cns dep (sedation, coma, resp dep, death), partial anagonist (inc risk withdrawl)

patient ed- oxycontin tab can appear stool, avoid o/ cns dep and alcoh, abuse pot, drowsy/dizzy (fall precaut), how/when ask for pain meds

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9
Q

Naloxone

A

class- opioid antagonist

indications-reversal cns dep/resp dep due to overdose

mech action- blocks effects opioids, cns/resp depression, no agonist effects!

assessment- rr, rhythm, depth, pulse, bp, LOC (after peak conc), pain lvl, withdrawl s/s

adverse e- VENTR ARRHY, htn, hypoten, n/v

interactions- withdrawl (if phys dependant)

patient ed- explain purpose

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10
Q

Metoclopramide

A

class- antiemetics (dopamine antagonist)

indications- prevent chemoinduced emesis, trt acute diabet gastroparesis, gastroesoph reflux, prevent postop n/v

mech action- block dopamine recep in chemorecep trigger zone of cns, stim motility upper GI, accel gastric emptying

assessment- b- n/v, abdom disten, during- extrapyram (tremors, shuffling, pill rolling, rigitidy, weakness)
tardive dyskinesia (uncont mvmnt face, mouth, extrem)
hyperthem, alt concious, tachycardia

adverse e- NEUROLEPTIC MALIGNANT SYDROME, anxiety, diarrh, gynecomastia, tremor

interactions- inc absorp , risk toxicity frm cyclosporine, affect gi absorp o/ drugs, exagg hypoten in anesthesia, opioids anatag effects, dec effectivess levodopa (parkinsons)

patient ed- drowsiness, no alco o/ cns depres, risk extrapyramidal/tardive dyskin/ neuro malig synd
not take when preg

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11
Q

dramamine

A

“dimenhyDRINATE”
class- antiemtics/antihistamines

indications- trt n/v, dizzin, vertigo, motion sickness

mech action- inhibi vestibular stim, cns dep properties

assessment- b/a n/v bowl sounds, abdom pain, chart I&O, dehydration s/s

adverse e- drowsiness, anorexia, hypoten, dysuria

interactions- inc cns depress effects, mask s/s ototoxicity, mao inhib inc anticholinergic effect antihistamine

patient ed- dry m, drowsy, no alco o/ cns depress, sunscreem

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12
Q

Scopolamine

A

class- antiemetic, muscarinic, acetylchol. antagonist
*most effective for motion sick.

indications- prevent motion sick and post op n/v

mech action- inhib muscarinic act of acetylcholine, balances norepineph and acetylchol in CNS

assessment- s/s urinary renention

adverse e- dry m, urinary retention, blurred vision, drowsy, tachycard

interactions- inc anticholin effects w/ antidep/antihistam
inc cns dep w/ alc/opioid/ antidep, slow dwn gi tract (inhib absor Po drugs, inc gi mucosal lesions

patient ed- transderm precaut, no underwtr sports, drowsiness, heatstroke when exercising, no alco/cns dep, dry m, dont use if preg

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13
Q

NSAIDS

A

class- nonsteroidal anti-inflam

indications- reduction fever, pain relief (mid to mod)

mech action- analgesic (ihib prostaglan syn), vasodilation

assessment- asthma, allergies (inc risk hypersen rxn), pain, fever, GI blood loss?

adverse e- GI bleeding

interactions- prolong bleeding time, inc effects warfarin/ antiplatelet, dec response diuretics and antihtn drugs

patient ed- take w/ 8 oz h20, no alcoh (gastric irritation/bleeding), do not take before surg

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14
Q

Aspirin

A

class- antiplatelet, nonopioid analgesic

indications- trt RA, OA, mild-mod pain, fever, prophylaxis TIS/MI

mech action- pain/inflamm relief via inhib prostaglandin syn, dec platlet aggregation

assessment- asthma, allergies (inc risk hypersen rxn), pain, fever, s/s DRESS (fever, rash, facial swelling), monit serum uric acid, tsh, serum salicylate lvl, overdose

adverse e- drug rxn w/ EOSINOPHILIA, GI BLEEDING< HYPERSEN RXN (anaphylaxis)(laryngeal edema)

interactions-inc risk bleeding thrombolytic agents, ibuprofen (negate cardioprotect antiplat affects), inc act penicillins, serum salicylate lvl flucutate, blunt response diruects and ace inhib, inc risk gi irr w/ nsaids
inc bleeding w/ ginseng/ginkgo

patient ed- report tarry stool, tinnitus, fever longer 3 days
no alco (inc gi bleeding)
na restrictive diet, no vinegar-like tablets, hold wk b4 surg, not take in 3rd trimester or after 20 wks
*not use in kids (reyes synd)
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15
Q

Acetaminophen

A

class- non-opioid analgesics

indications- mild-mod pain, fever, severe pain (IV)

mech action-inhib syn prostagland in cns
*no GI toxicity

assessment- alc usage, rash, stevens-johnson syndrome, blisters, oral lesions, fatigue, pain, fever, serum bilirubin, can lead false blood gluc lvls

adverse e- ACUTE GEN EXANTHEMATOUS PUSTULOSIS, STEVENS/JOHNSON SYNDROME, TOXIC EPIDERMAL NECROLYSIS, HEPATOTOXICITY, renal failure, hypokalemia

interactions- inc risk bleeding w/ warfarin, hepatotoxicity w/ alc, inc risk liver damage w/ barbiturates, inc risk renal dis w/ nsaids, dec propranolol metab

patient ed- no more 4g/ day, avoid alc (liver dam bc dec lvl glutathione), dc if rash, alters bg lvls

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16
Q

Chondrotinin/ Glucosamine

A

class- nonopioid analgesic

indications- delay brkdwn joint cart., syn new cartilage
trt OA, ischemic heart dis, osteoporosis, hyperlip.

mech action- building block articular cart

assessment- pain, gastric discom, bleeding

adverse e- n, heartburn, edema, bleeding

interactions- inc risk bleeding w/ nsaids/ anticoag

patient ed- take w/ glucosamine, reinforce consistent use, not take during preg

17
Q

Capsicum

A

class- analgesic

indications- dec pain sensation, trt arthritis, dyspepsia (ingestion)

mech action- bind nociorec in skin= heightened sen/ cutaneous vasodil (densensitization by substance P depletion)

assessment- pain, liver/ kid function (can stim circ)

adverse e- buring, sweating, gi irrit, diarr, bleeding

interactions- inc risk bleeding w/ anticoag, inc absorp theophylline (bronchodilator)

patient ed- not during preg
gloves worn, rub in so no cream shows, burning expected (inc by heat ei clothes, exercise
diluted vinegar solution to remove
not apply if shingles lesions 
dc pain contin > 1 month
18
Q

Cimetidine

A

class- antiulcer agent (Tagamet)

indications- shrt trt active duodenal ulcers, management GERD, trt acid indigestion/heartburn

mech action- inhib action histamine at H2 recep site in gastric parietal cells= inhib gastric acid secretion

assessment- abdominal pain, blood in stool/emesis, confusion, CBC blood levels, inc serum creatinine

adverse e- ARRHY, AHRANULOCYTOSIS, APLASTIC ANEMIA, confusion, diarr

interactions- inc risk toxicity as inhib drug-metab enzymes in liver
inc effect succinylcholine (musc relaxant)
inc absorb ketoconazole (skin infections)
dec antacid absorb

patient ed- cessation smoking, drowsy, avoid alc, nsaids and irritating foods, consipation common, report tarry stools, fever, diarr, rash, confusion

19
Q

Famotidine

A

class- antiulcer agent, h2 blocker

indications-shrt trt active duodenal ulcers, management GERD, trt acid indigestion/heartburn

mech action-inhib action histamine at H2 recep site in gastric parietal cells= inhib gastric acid secretion

assessment-abdominal pain, blood in stool/emesis, confusion, CBC blood levels, inc serum creatinine

adverse e-ARRHY, AHRANULOCYTOSIS, APLASTIC ANEMIA, confusion, diarr

interactions- dec absorb ketoconazole (skin infections)

patient ed-cessation smoking, drowsy, avoid alc, nsaids and irritating foods, consipation common, report tarry stools, fever, diarr, rash, confusion

20
Q

Ranitidine

A

class- antiulcer agent
r2 blocker

indications- healing/prevem ulcers, dec gerd sympt, dec secretion gastric acid

mech action-inhib action histamine at H2 recep site in gastric parietal cells= inhib gastric acid secretion

assessment-abdominal pain, blood in stool/emesis, confusion, CBC blood levels, inc serum creatinine

adverse e-ARRHY, AHRANULOCYTOSIS, APLASTIC ANEMIA, confusion, diarr

interactions- dec absorb ketonconazole, inc absor triazolam, inc effects warfarin

patient ed-cessation smoking, drowsy, avoid alc, nsaids and irritating foods, consipation common, report tarry stools, fever, diarr, rash, confusion

21
Q

Omeprazole

A

class- antiulcer agent
PPI

indications- healing duodenal ulcer, gerd maintan, dec accum acid in gastric lumen

mech action-binds enzyme on gastric parietal cells in presence of acid pH, prevent transport H ion into lumen

assessment-bowl fun, abdom pain, Mg lvls

adverse e- CDAD, abdom pain, dizziness, pneumonia, hypomag, inc risk cdiff, rebound acid hypersec

interactions- HIV/AIDS drugs (atazanavir)
antifungal drugs- ketoconazole
enzyme metab- clopidogrel

patient ed- tarry black stools, avoid alc/nsaids, drowsy

22
Q

Clopidogrel

A

class-antiplatelet

indications- reduc risk mI/ stroke

mech action- inhib plate aggre via inhib ATP bind to platelet recep

assessment- stroke, periph vasc dis/ MI
thromboitc thrombocytopenic purpura
platelet count

adverse e- STEVENS-JOHNSON SYNDROME, TOXIC EPIDERMAL NECROLYSIS, DRUG RASH, ACUTE GEN EXANTHEMATOUS PUSTULOSIS, GI BLEEDING, NEUTROPENIA, THROMBOTIC THROMBOCYTOPENIC PURPURA

interactions- aspirin inc risk bleeding, dec metab nsaids, opioids dec absorb/ effect of drug

patient ed- report s/s bleeding, fever, rash, weakness, jaundice
not mix w/ omeprazole
not use neuraxial blockade during preg

23
Q

Sucralfate

A

class- antiulcer agent
gi protectant

indications- management duodenal ulcers

mech action- Al sal reacts w/ acid form protective paste

assessment- abdomin pain/ bloody stool

adverse e- constip, anaphylaxis

interactions- dec absob fat sol vitamins/ phenytoin
h2/ppi dec effectiveness via low pH

patient ed- constip precautions

24
Q

Diphenoxylate/Atropine

A

class- antidiarrheal

indications- antidiarrheal

mech action- activ opioid recep in Gi tract - dec intest motility, reduces fluid in feces

assessment- freq/consis stools, dehydration, fluid bal, liver lvls

adverse e- drowsy, constipation, dry m, blurred vision, urinary retention

interactions- avoid alc, opioids o/ cns depress

patient ed- drowsy, dry m, no alc/ cns dep

25
Q

Bismuth subsalicylate

A

class-antidiarrheal

indications- relief diarrh

mech action- inc intestinal absorp fluid/electrol, dec syn intestinal prostaglandins

assessment- consis/freq stools, n, indigestion, dehydr, fluid bal, ulcers (epigastric pain)

adverse e- constip, black stools

interactions- aspirin- inc risk salicylate toxicity
dec absor tetracycline

patient ed- black color common, dc aspirin if tinnitus occurs, call if diarr contin 2+ days and fever

26
Q

Ondansetron

A

class- antiemetics (Zofran)

indications- prevent/ trt chemo induced n/v

mech action- block serotonin recep in ctz *no extrapydram effects ei dry m

assessment- n/v, abdom disn, bowel sounds, extrapyramidal effects, termor, seizures, rash, fatigue, joint aches, fever

adverse e- headaches, diarrh, dizziness, STEVENS JOHNSON SYN, TORSADE DE POINTES, SEROTONIN SYNDROME

interactions- apomorphine inc risk hypotension and loc
phenytoin dec lvls
maoi’s inc risk serotonin syndrome

patient ed- call if irreg heart beat, seroton syndrome, invol mvmnt eyes, face or limbs

27
Q

Aprepitant

A

class- antiemetic (Emend)

indications- dec n/v w/ chemotherapy

mech action- block neurokinin 1 type recep for sub P in ctz

assessment- n/v, bowel sounds, pain, rash, hydration, I/Os, allergic rxns, infusion site rxn

adverse e- fatigue, hiccups, dizziness, diarrh

interactions- inhib/induce metab liver enzymes

patient ed- call if n/v persist

28
Q

Prochlorperazine

A

dopamine antagonist
class- antiemetic

indications- post op n/v

mech action- block dopamine 2 recep in ctz

assessment-n/v, bowel sounds, pain, rash, hydration, I/Os, allergic rxns, infusion site rxn

adverse e- eps, anticholinergic e, hypotension, sedation, irrit to tissue and veins

interactions- avoid w/ pt with parkinsons
dec effects warfarin
inc lvl cyp3a4 substrates
inc lvl pimozide= inc risk torsade de pointes

patient ed- call if n/v persists

29
Q

Albuterol

A

therap class- bronchodil
beta 2 recep SABA
(Proair)

indications- trt/ prevent bronchospasm asthma/COPD

mech action- bind beta 2 recep in sm musc airway to prevent bronchoconstriction

ae- chest pain, palpations, nervousness, tremor, restlessness, PARADOXICAL BRONCHOSPASM

assessment- lung sounds, bp, pulse, sputum, pulmonary function, wheezing, K+ lvs

interactions- mao- hypertensive crisis, dec digoxin lvl

pt ed- may cause bad taste, inform health care profess if SOB, chest pain etc, prime unit w/ 4 sprays before use- discard after 200 sprays

30
Q

Flovent

A

class- corticosteroid

indications- long term trtmnt asthma

moa- anti-inflamm

ae- headache, CHURG STRAUSS SYNDROME, dry mouth, oral fungal infection

assessment- lung sounds, withdrawal, bone density, thrush

interactions- cyp34 INHIB

pt ed- 5min btw each breath, not used for acute exacerbations, rinse/gargle after use

31
Q

Montelukast

A

(singulair)
class- Leukotriene antagonist

indications- prophylaxis asthma

moa- block inflamm, vasc perm, dec inflamm cell migration/activation, dec bronchoconstriction, prevent leukotrienes attaching to recep on cells in lungs

ae- churg strauss syndrome

assessment- limit alcoh, liver function

interactions- phenytoin- alters metab drungs in liver

pt ed- not used rescue inhaler, important follow routine admin

32
Q

Salmeterol

A

class- bronchodil
beta 2 recep LABA

indications- long term control bronchospasms

moa- bind beta 2 recep in sm musc airway to prevent bronchoconstriction

ae- severe asthma exacerbations (become tolerant) never use alone

assessment- lung sounds, pulse bp, wheezing, K lvls

interactions- beta blockers dec effect, mao/ cyp3a4- cardiovasc effects

pt ed- don’t exhale into disc, use as directed, use w/ ICS

33
Q

theophylline

A

class- methylxanthines (bronchodil)

indications- adjunct maintenance therapy COPD

moa- relaxes sm usc in bronchi

ae- diarrhea, vf, seizures, death, n/v, insomnia

assessment- bp, pulse, rr, monitor for diuresis, pulmonary function

interactions- caffine (inc effects), phenytoin dec effects, h2 recep inc risk toxicity

pt ed- drink 2000mL/day, no smoking, routine serum lvl testing

34
Q

Ipratropium

A

class- anticholinergic (bronchodil)
(atrovent)

indications- therapy for reversible airway obstruction due to COPD

moa- bind acetylcholine recep to prevent ach frm binding, prevents bronchconstriction

ae- inc intraocular p, dry mouth

assessment- rr, pulse, wheezing, rhinorrhea (nasal spray)

interactions- o/ ach drugs inc lvls

pt ed-avoid Combivent if allergic peanuts, rinse mouth after use, do not inhale while spraying

35
Q

Pseudoephedrine

A

Sudafed
class- adrenergic- decongestant

indications- management nasal congestion

moa- stimulates alpha/beta-adrenergic recep, vasoconstriction respir tract mucosa

ae- nervousness, anxiety, SEIZURES, palpations, CARDIOVASC COLLAPSE

assessment- congestion, pulse, bp, lung sounds, maintain fluid intake 1500-2000mL/day

interactions- mao- htn crisis, acidic foods dec effectiveness

pt ed- caution w/ kids < 4 or breastfeeding

36
Q

Phenylephrine

A

Sinex
class- decongestant
(nasal)

indications- shrt term management nasal congestion

moa- stim alpha-adrenergic recep in nasal mucosa producing vasoconstriction

ae- rebound congestion, burning, drying nasal mucosa

assessment- nasal congestion

interactions- inc risk htn w/ antidepress

pt ed- not take w/ lrg amnts caffeine

37
Q

Diphenhydramine

A

Benadryl
class- antihistamine

indications- treat common cold, motion sickness, sleep aid, anaphylaxis, allergic rhinitis

moa- anticholinergic effects-

ae- dry mouth, drowsiness, constipation, changes vision, pupil dilation

assessment- depends on intended use, cold- sneeing, rhinorrhea, nasal stuffiness

interactions-inc risk cns depress w/ opioids/alcoh, mao inhib inc anticholinergic effects

pt ed- not use w/ alcoh and opioids, can cause drowsiness and dry mouth

38
Q

Loratadine

A

Claritin
class- 2nd gen antihistamine

indications- relief seasonal allergies

moa- block effect histamine- dec vasodil, dec respir secretions, dec cap perm

ae- confusion, drowsiness, blurred vision, dry mouth

assessment- allergy symptoms (hives, conjunctivitis (pink eye))

interactions- mao inc effects, inc cns dep w/ opioids/ alcoh

pt ed- sunscreen, avoid alcoh, good oral hygiene avoid dry m, caution while driving

336 Pharmacology (5 decks)

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