Drugs for Exam 2 Flashcards
antacids
Aluminum hydroxide / Maalox / Milk of Magnesia
indications: peptic ulcer disease, GERD
MOA: Neutralizes stomach acid
side effects: constipation
PT: Take after meals and at bedtime, 1-2 hours before or after other medications
Take Antacids After meals
Histamine 2 Receptor Anatagonists
Famotidine / Pepcid
indications: duodenal and gastric ulcers, GERD, Zollinger-Ellison syndrome
MOA: blocks H2 receptors in the stomach, reducing gastric acid secretion
FamotiDINE helps you stomach feel better when you DINE
side effects: headache, GI upset
Gastrointestinal Prostaglandin
Misoprostol / Cytotec
indications: prevention of gastric ulcers in patients taking NSAIDs (NonSteroidal Anti Inflamatory Drugs - asprin, ibprofun, motrin) Also induces labor by ripening the cervix
MOA: decreases stomach acid secretion, increases production of protective mucus and bicarbonate. Causes uterine contractions
side effects: dysmenorrhea (painful menstrel cramps), GI upset, MISCARRIGAGE, PREMATURE BIRTH, BIRTH DEFECETS
NC: ASSESS WOMEN OF CHILDBEARING AGE FOR PREGNANCY BEFORE ADMINISTRATION FOR ULCER PREVENTION
Misprostol will cause a miscarriage!!!!
Proton Pump Inhibitors
Omeprazole / Prilosec
Pantoprazole / Protonix
indications: duodenal and gastric ulcers, GERD, Zollinger-Ellison syndrome.
I’m going to take omePRAzole and PRAY my ulcer pain goes away.
MOA: decreases gastric acid secretion
side effects: GI upset, C. diff, BONE FRACTURES WITH LONG TERM USE
PT: report diarrhea, abdominal pain, bloody stools
Coating Agents
Sucralfate / Carafate
indications: duodenal ulcers
MOA: forms a thick paste with stomach acid that adheres to ulcers
SUCralfate gets SUCKED down into ulcers
side effects: constipation
PT: TAKE 1 HOUR BEFORE MEALS AND AT BEDTIME (4 times a day), increase fluid and fiber intake
Prokinetic Agents
Metoclopramide / Reglan
indications: nausea, vomitting, gastroparesis, GERD
MOA: accelerates gastric emptying
side effects: drowsiness, GI upset, extrapyramidal symptoms (S/S: rigidity, tremors, restlessness)
TARDIVE DYSKINESIA
PT: take 30 minutes before meals and at bedtime
Dopamine Antagonists
Metoclopramdie / Reglan
Promethazine / Phenergan
indications: nausea and vomiting, motion sickness
MOA: blocks dopamine receptors in the brain
side effects: drowsiness, dry mouth
PT: when used for motion sickness, take 1 hour before conditions that cause motion sickness
Anticholinergic cconsiderations
Serotonin Antagonist
Ondansetron / Zofran
indications: nausea, vomiting
I threw up ON DAN, better get me some ONDANsetron
MOA: Blocks serotonin receptors in the chemoreceptor trigger zone (CTZ)
side effects: headache, constipation, diarrhea, QT prolongation
administer PRIOR to chemotherapy (vs. treating nausea/vomiting that is already occurring).
Anticholinergic
Scopolamine / Transderm-Scop
Diphenhydramine / Benadryl
indications: motion sickness prevention
MOA: corrects imbalance between acetylcholine and norepinephrine in the higher centers in the brain, particularly in the vomiting center
side effects: drowsiness, dry mouth, blurred vision
Using Scopolamine with CNS depressants or alcohol may increase sedation
condtraindications: glaucoma, pyloric stenosis, thyrotoxicosis, fever, urinary tract obstruction and ileus
Corticosteroid (Glucocorticoid)
Dexamethasone / Decadron
indications: inflammation, severe allergies, adrenal problems, arthritis, asthma, blood or bone marrow problems, kidney problems, skin conditions, flare ups of ms
MOA: decreased vasodilation, decreased WBC to sites of inflammation
contraindications: known drug allergy and may include cataracts, glaucoma, peptic ulcer disease, and mental health problems. Use with caution in patients with diabetes mellitus.
side effects: an increase in blood glucose levels, headache, insomnia, mood changes, depression, blurred vision, swelling, abdominal pain
immunosuppressant properties, glucocorticoids are often avoided in the presence of any serious infection, including septicemia, systemic fungal infections, and varicella. One exception is tuberculous meningitis, for which glucocorticoids may be used to prevent inflammatory central nervous system damage. Caution is emphasized in treating any patient with gastritis, reflux disease, or ulcer disease because of the potential of these drugs to cause gastric perforation, as well as any patient with cardiac, renal, and/or liver dysfunction because of the associated alterations in elimination.
glucocorticoid inhalers are never to be used as rescue inhalers for acute bronchospasm.
Benzodiazepines
Lorazepam / Ativan
indications: anxiety, seizures, muscle spasm,s alcohol withdrawal, induction/maintenance of anesthesia
MOA: enhances GABA (Gamma-aminobutyric acid neurotransmitter, an inhibitor) effect in the CNS
side effects: sedation, amnesia, respiratory depression
PAM takes lorazePAM for her anxiety. She doesn’t drive her BENZ anymore because the BENZos cause sedation
Beware: abuse, addiction, dependence, withdrawal (insomnia, irritability, seizures)
PT: do not discontinue abruptly
SHORT TERM USE ONLY! Antidote is flumazenil
Cannabinoid
Dronabinol / Marinol
Tetrahydrocannabinoid
indications: nausea and vomiting caused by cancer chemotherapy
MOA: complex effects on the CNS
side effects: dizziness, seizures, diarrhea, anxiety
