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FUNdamentals > Drug Classification > Flashcards

Drug Classification Flashcards

1
Q

What are the Anti-ulcers?

A

Antacids
Histamine 2 Blockers
Proton Pump Inhibitors (PPI)

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2
Q

What do you need to know for Antacids?
What are 3 examples of it?
What is the Nursing Interventions of Antacids?

A
  • Increases osmotic pressure, Drawing fluid to the colon, Neutralizing hydrochloric acid (stomach’s)
  • Binds phosphates in GI tract
  • Neutralizes gastric acid

used for:
1. Treat peptic ulcers
- Ulcers Occurs w/ hyper-secretion of hydrochloric & pepsin
- causes the erosion/hurting of the GI mucosal lining
2. Treat GERD (gastro-esophageal reflux)
- Reflux of stomach acid into esophagus

EX:
1. Magnesium Hydroxide (Milk of Magnesia)
2. Aluminum hydroxide (Mylanta)
3. Calcium carbonates (Tums)

Nursing Interventions:
- Monitor for constipation & diarrhea (Al and Mag)
- Al –> Constipation
- Mag –> Diarrhea
- Instruct the patient to drink enough water to ensure meds reaches the stomach
- Instruct the patient to not take w/ milk (bc you get hypercalcemia)
- Avoid administering w/ other oral drugs since it can delay absorption
- Monitor labs as applicable

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3
Q

What are the things you need to know about Histamine 2 Blockers (H2 Blockers)?
(how it works, what it treats, 3 drug examples, and nursing implications)

A
  1. Histamine receptor antagonist! (blocks the action of histamine) (histamine works by producing gastric acid; since H2 blockers are histamine receptor ANTAGONIST, then it works by blocking/stopping the secretion of gastric acid)
  2. Inhibits gastric acid secretion
    • by blocking histamine at histamine 2 receptors in the parietal cells
  3. Decrease amount of acid & concentration in the stomach

It works to:
- Treat gastric & duodenal ulcers
- Treat Esophagitis from reflux
- Treat GERD
- GI prophylaxis (inhibit acidity & prevent from getting ulcers)

EX: “dine”
1. Nitzatidine (Axid)
2. Famotidine (Pepcid)
3. Cimetidine (Tagamete)

Nursing Implications:
1. Administer before meals or at bedtime
2. Tell patients to avoid smoking
3. Tell patients to eat food high in VITAMIN B12
4. Instruct patient to avoid gastric irritating foods

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4
Q

What are the things you need to know about Proton Pump Inhibitors (PPIs)?
(how it works, what it treats, 3 drug examples, and nursing implications)

A

You take this if you have tried antacids and it doesn’t work, and you moved on to H2 blockers and it still doesn’t work!! PPI’s are 90% more effective than H2 blockers in inhibiting gastric secretion.

  • H+ (hydrogen ion) is a proton & is an essential part of forming acids. PPI inhibit gastric parietal cells in the final step of acid production
  • Stops gastric acid secretion by inhibiting hydrogen/potassium ATPase enzyme in gastric parietal cells.

Used for:
- Treat ulcers & esopagitis
- treat GERD
- GI prophylaxis

EX: “zole”
- Omeprazole (Prilosec)
- Pantoprazole (Protonix)
- Esmoprazole (Nexium)

Nursing Implications:
1. Increase fluids, dietary bulk, exercise to relieve constipation
2. May be given with or without food
3. Avoid foods that cause gastric irritation
4. Be aware of drug interactions w/ Anticoagulants, Phenytoin, Digoxin, & certain Benzodiazepines

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5
Q

What is included in the drug classification: Anxiolytics/Anti-anxiety? How does it work?

A

Benzodiazepines!!

Anxiolytics/Anti-anxiety enhances the action of an inhibitory neurotransmitter, GABA, within the CNS by binding to Benzodiazepine receptors & preventing GABA neurotransmission!
- GABA works by slowing/calming things down! It prevents the synapses from receiving stimulus. ANDD BENZOS INCREASES THE EFFICIENCY OF GABA so it causes a greater calm :)

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6
Q

What are the things you need to know about Benzodiazepines?
(how it works, what it treats, 3 drug examples, and nursing implications)

A
  • Primarily used to treat “panic attacks”, prolonged anxiety, insomnia
  • ALSO used for: Anticonvulsants (helps ppl not have seizures), Sedative-hypnotics (calms you down), Pre-operative drug, Substance abuse withdrawal agent & anxiety
    • Fewer side effects
    • Less dangerous if overdose
    • Dangerous with ETOH (alcohol) AND OTHER CNS DEPRESSANT
  • Drug tolerance can develop
    • So take short term only!!!

Nursing Implications:
- Instruct patient to avoid alcohol
- Monitor VS especially BP & Pulse, watch for orthostatic hypotension
- Don’t abruptly stop medication
- With liver or renal disease, dosage should be lower
- Smoking & caffeine can decrease effectiveness

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7
Q

What are the things you need to know about Antiemetics?
(how it works, what it treats, 3 drug examples, and nursing implications)

A
  • Antagonists to Dopamine, histamine, serotonin, & acetylcholine which all are neurotransmitters that stimulate the CTZ (chemo receptors trigger zone - or the vomiting center near medulla)
  • Act on vomiting center
  • Decrease stimulation to chemoreceptor trigger zone (CTZ) & vestibular paths
  • Treats nausea & vomiting!!!! (prof. shores’ fav meds)

EX:
1. Promethazine (Phenergan) –> MORE sedating, so it’s best to give Zofran instead!!!!!! This can cause drowsiness & hypotension!! so if they have low BP, don’t give them this. It’s best to give them Zofran instead.!!
2. Ondansetron (Zofran)
3. Dimenhydrinate (Domamine)

Nursing Implications:
1. Monitor Vital signs, watch for hypotension!
2. Monitor hydration status (bc they’re vomiting & losing bunch of fluids from there)
3. Tell patient to avoid alcohol
4. Provide mouth care
5. Avoid driving while on meds due to drowsiness
6. Suggest non pharmacologic methods to alleviate nausea

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8
Q

What amplify/increases the effects of Benzodiazepine??
What’s the ANTAGONIST of Benzo????

A
  • Antihistamine –> Benadryl
  • Antagonist –> Flumazine!!!
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9
Q

What are the 3 drugs of Antiemetics??

A
  1. Promethazine (Phenergan) –> MORE sedating, so it’s best to give Zofran instead!!!!!! This can cause drowsiness & hypotension!! so if they have low BP, don’t give them this. It’s best to give them Zofran instead.!!
  2. Ondansetron (Zofran)
  3. Dimenhydrinate (Dramamine)
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10
Q

What are the things you need to know about Anticoagulants?
(how it works, what it treats, drug examples, and nursing implications)

A
  1. Heparin – binds to antithrombin III, which inhibits thrombin, preventing the conversion of fibrinogen to fibrin –> which means clot is prevented!!!
    - Absorbed poorly in the GI; so it’s given SQ or IV
    - Labs PTT (partial thromboplastin time) –>let’s us know how thin/thick our blood is and how much heparin we should use. it’s important to know while taking anticoagulant to not thin the blood out so much that the patient starts bleeding out..
  2. Oral anticoagulants (COUMADIN)
    – inhibits hepatic synthesis of Vitamin K, AFFECTING clotting factor II, VII, IX, X (2,7,9&10)
    - EX: Coumadine (warfarine)!!
    - Extends the time it takes for blood to clot
    - Labs PT (prothrombin time)
    - INR (International normalized ratio)
    • Normal patients = <2
    • Someone on anticoagulant = 2 - 3 (means that it’s going to take 2-3 times longer for blood to clot)
    • Someone with mechanical heart valve = 3.5 - 4.5

other EX:
- Lovenax (enoxaparia sodium)

Used for:
- Prevent thrombosis
- Hospitalized on bed rest
- Atrial fibrillation (irregular heart rate)
- Artificial heart valves
- Treat PE (pulmonary embolism), DVT
- Prevent stroke

Nursing Implications:
- Monitor bleeding– urine, skin, mouth, nose, etc
- Monitor appropriate labs
- Watch platelet count when on Heparin (bc you have potential for low platelet count)
- Tell patient to let their dentist know (bc they have more risk for bleeding)
- Use soft toothbrush & electric razor
- LIMIT foods high in Vitamin K –> IF COUMADIN (no leafy green veggies)
- herbs can interfere. DO NOT TAKE HERBS THAT STARTS WITH “G”: garlic, ginger, etc!!!!!

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11
Q

What labs do we use to look at Heparin and Oral anticoagulants?

A

Heparin –> PTT
Oral anticoagulants –> PT and INR

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12
Q

Heparin is given by which route?

A

Subcut or IV; NOT orally because it’s absorbed poorly in the GI tract

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13
Q

What is the antidote/antagonist of Heparin? How about Oral anticoagulant?

A

Heparin –> Protamine sulfate
Coumadin –> Vitamin K

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14
Q

What is the nursing interventions for Antacids?

A
  1. Monitor for diarrhea and constipation
  2. Drink lots of fluids so that meds can reach the stomach
  3. Avoid milk (can cause hypercalcemia if ur using calcium carbonate)
  4. Avoid drinking with other medications!!
  5. Monitor lab if applicable
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15
Q

What is the nursing interventions for H2 blockers?

A
  1. Eat before meals or at bedtime
  2. Avoid SMOKING
  3. eat food high in VITAMIN B12
  4. avoid gastric irritating food
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16
Q

What is the nursing interventions for PPI (proton pump inhibitors)?

A
  1. Increase fluid, dietary bulk, & exercise to prevent constipation
  2. Can be eaten with or without food
  3. Avoid gastric irritating food
  4. BE AWARE of interactions with Anticoagulants, Phenytoin, Digoxin, and Benzodiazepines
17
Q

What is the nursing interventions for Benzodiazepines?

A
  1. Avoid alcohol
  2. Monitor VS: BP and Pulse; watch for orthostatic hypotension
  3. Don’t stop abruptly
  4. If they have liver or kidney disease, lower the dose
  5. Smoking and Caffeine can decrease effectiveness
18
Q

What is the nursing interventions for Antiemetics?

A
  1. Monitor VS; watch for hypotension
  2. Check hydration status (bc you lose lots of fluids from throwing up)
  3. Avoid alcohol
  4. Give good oral care
  5. Avoid driving while on meds because they can be drowsy
  6. Suggest non-pharmacological methods to alleviate nausea
19
Q

What are the drug classifications for Antihypertensive??

A
  1. Beta blockers
  2. Ace inhibitors
  3. Calcium Channel blockers
  4. Angiotensin II Receptor blockers (ARBs)
20
Q

What does Antihypertensive drugs given for?

A

given to control: Hypertension, Angina (chest pain), Prophylaxis, myocardial infraction (heart attack), and congestive heart failure (CHF)

21
Q

What is the perfusion equation?

A

CO x SVR = ABP

CO (cardiac output) = HR x SV (stroke volume)

  • SVR = systemic vascular resistance
  • ABP = arterial blood pressure
22
Q

Anytime you think of blood pressure, what are the 3 things that could be the issue for someone who has a problem with it?

A
  1. Pump problem
  2. Volume problem
  3. Resistance problem

So, Antihypertensive is going to work on either the pump, the volume, or the resistance to control the blood pressure

23
Q

What are the things you need to know about Beta blockers?
(how it works, what it treats, drug examples, and nursing implications)

A
  • Reduces CO (cardiac output) by decreasing the SNS stimulation to the heart and its conduction system; blocking the beta-receptors in the heart
  • Preventing adrenalines from attaching to receptors in the heart cells. So the heart rate is going to remain normal
  • RESULTS: Decrease in heart rate, contractility, and Renin release

Treats:
- Tachycardia, Blood pressure, and CHF

EX: “lol”
1. Metoprolol
2. Propranolol
3. Carvedilol

Nursing Implications:
1. Monitor Vital signs: BP and HR. Don’t give if HR is <60 or SBP <100!! (or if they have Bradycardia)
2. Herbs can interfere
3. Change positions slowly
- Watch for dizziness & orthostatic hypotension
4. Do not stop abruptly due to rebound hypertension
5. With pre-existing bronchospasm (lung condition) & pulmonary disease, use with caution (make sure they dont have this prior to administration )

24
Q

What are the things you need to know about ACE inhibitors?
(how it works, what it treats, drug examples, and nursing implications)

A
  1. Angiotensin-Converting Enzyme Inhibitors
    • When ACE is inhibited, the formation of Angiotensin II is also inhibited & blocks the release of aldosterone
      • Aldosterone normally promotes sodium retention & potassium excretion
  2. Since Aldosterone is blocked = sodium is secreted, & potassium is retained
  3. Works on SVR (from the perfusion equation) by DECREASING PERIPHERAL RESISTANCE (relaxes blood vessels) & altering fluid levels

Treats:
- hypertension, acute MI, CHF
- Decreases peripheral resistance without increasing Cardiac output, rate, & contractility

EX: “pril”
1. Captopril
2. Lisinopril
3. Enalapril

Nursing Implications:
1. Monitor BP - don’t give if low
2. Monitor for bleeding & bruises
3. Monitor renal labs & blood glucose
4. Don’t stop abruptly bc it can cause rebound hypertension
5. Avoid foods high in potassium
6. Watch for major side effect of constant IRRITATING COUGH & angioedema
7. Don’t take w/ other potassium sparing diuretics

25
Q

What are the things you need to know about Calcium Channel Blockers???
(how it works, what it treats, drug examples, and nursing implications)

A
  • Blocks calcium in the vascular smooth muscle, promoting vasodilation –> lowering blood pressure
  • Decreases myocardial contractility = less squeeze per beat –> decreases SV (stroke volume) –> decreases BP!!
  • High protein bound, have short-life – sustained release

Treats:
- Hypertension, tachycardia (heart rate over 100)

EX: Very Nice Drugs Aha!
1. Veramapil
2. Amlodipine
3. Diltiazem
4. Nifedipine

Nursing Implications:
1. Monitor BP
2. Watch for reflux tachycardia
3. Teaching patients to change position slowly due to orthostatic hypotension
4. Concurrent use w/ beta blockers increases risk of Congestive Heart Failure
5. Monitor for peripheral edema!!!

26
Q

What is the nursing interventions for Calcium Channel Blockers??

A
  1. Check BP
  2. Watch for reflux tachycardia
  3. Position them slowly due to orthostatic hypotension
  4. Don’t use together with beta blockers bc it can increase the risk of CHF
  5. Monitor for Peripheral EDEMA!!!
27
Q

A patient decided to move from receiving ACE inhibitors to ARBs (angiotensin II receptor blockers) MAINLY because of what??

A

Because they don’t want to have that IRRITATING COUGHING AFFECT that ACE inhibitors give!!!
ARBs work similarly with ACE inhibitors, it’s just that usually people who has that irritating coughs that comes from ACE inhibitors move to ARBs which doesn’t have it!!

28
Q

What are the things you need to know about Angiotensin II Receptors Blockers (ARBs)???
(how it works, what it treats, drug examples, and nursing implications)

A
  • Blocks angiotensin II from binding to angiotensin II receptors.
  • Causes vasodilation & decreased peripheral resistance
  • Doesn’t have irritating cough associated with ACE inhibitors!!!!!!!!!!!!!!
  • Aldosterone blocks = sodium is secreted & potassium is retained!

EX: “tran”
1. Valsartan
2. Valsatran Hydrochlorothiazide –> often combined w/ Diuretic
3. Losartan

(works similar to ACE inhibitors)

29
Q

What are the 2 Antiaginal/VASODILATOR (help w/ chest pain) drugs??

A

Nitrates & Nitroglycerin

30
Q

What are the things you need to know about Antianginal drugs –NITRATES???
(how it works, what it treats)

A
  • Increases blood flow/vasodilation thru the CORONARY veins & HEART cells!
  • Reduces myocardial ischemia (lack of oxygen) BUT can cause hypotension
  • Treats angina/chest pain that was due to inadequate blood flow to the myocardium
31
Q

What are things you need to know about Antianginal drugs –NITROGLYCERIN???
(how it works, what it treats)

A
  • Give Sublingual, Topical, and IV
  • EX: “nitro”
    1. Nitrostat (SL)
    2. Nitro-Bid
    3. Nitro-Dur

Nursing Implications:
1. Monitor VS & ASK IF MEN TAKE ERECTILE DYSFUNCTION MEDS bc its contraindication
2. Avoid alcohol
3. When applying path, avoid hairy areas
4. Remove patch, ointment at night TO AVOID TOLERANCE
5. Expect a headache & treat as needed
6. You should Use gloves if using ointment/topical!!
7. Patients should lie down when receiving a nitrate for the first time!!!

32
Q

What are the 3 Dieuretics??

A
  1. Thiazides
  2. Loop Diuretics
  3. K+ Sparing

FUNdamentals (27 decks)

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