Drugs for Final Flashcards
What class does Alendronate belong to?
Biphosphate
What does Alendronate do?
Blocks bone breakdown and increased BMD.
What are the adverse effects of Alendronate?
Heart attack Nausea, vomiting, diarrhea Metallic taste Esophageal erosion Dental issues Femoral fracture Myalgia Hypocalcemia
What drugs interact with Alendronate?
MVI, iron, antacids, calcium all need to be given separately.
Avoid Aspirin
What do you need to educate you patient on if they are given Alendronate?
Take with a full glass of water on empty stomach in the morning and stay sitting for 30 minutes.
What class does Atorvastatin belong to?
Statin
What is the action of Atorvastatin?
HMG CoA reductase inhibitor
What is Atorvastatin the drug of choice for and why?
Reducing LDL levels
They interfere with the synthesis of cholesterol working at the cellular level
What is the contraindication for Atorvastatin?
Active liver disease or history of alcoholic liver disease
What should you monitor in a patient who is on Atorvastatin?
Liver function tests
What are the adverse effects of Atorvastatin?
Heart attack Dizziness Blurred vision Insomnia Fatigue Cataracts Flatulence Abdominal pain Cramps Nausea Vomiting Constipation
What is the main adverse effect you need to watch for in a patient on Atorvastatin?
Rabdomylosis- muscle pain
What should you educate your patient on if they are taking Atorvastatin?
NO grapefruit juice
Take in the morning
What class does Cholestyramine belong to?
Bile acid sequestrant
What is the method of action for Cholestyramine?
Binds to bile acids in intestine allows excretion in feces instead of reabsorption- causes cholesterol to be iodized in liver and levels to fall
True or false:
Cholestyramine is absorbed systemically.
False:
It is not and is excreted in feces.
What is contraindicated for Cholestyramine?
Complete biliary abstraction, abnormal intestinal function.
What are the adverse effects of Cholestyramine?
Heart attack Fatigue Drowsiness Nausea Constipation INCREASED BLEEDING TIMES Vitamin A and E deficiencies.
What drugs should you not give if the patient is on Chloestyramine?
Thiazide diuretic Digoxin Warfarin thyroid hormones Corticosteroids
What should you educate your patient on if they are on Chloestyramine?
Don’t take with meals.
2 hours before or after meals of other meds.
Do not mix with carbonated beverages.
What class does Hydrochlorothiazide belong to?
Thiazide diuretic
What is the action for Hydrochlorothiazide?
Block the chloride pump. Keeps chloride and sodium in the tubule to be excreted in urine and prevents reabsorption of both into the vascular system.
What is the contraindication for hydrochlorothiazide?
Allergy to sulfonamides and bipolar disorder.
What are the adverse effects for Hydrochlorothiazide?
Decreased calcium excretion Dizzy Vertigo Orthostatic Hypotension Vomiting Anorexia Dry mouth Diarrhea Polyuria Nocturia Muscle cramps or spasms
What can Hydrochlorothiazide cause?
Hyperglycemia
What class does Metoprolol belong to?
Beta blocker
What does Metoprolol do?
Blocks the stimulator effects of the SNS decreasing cardiac output and renin release
What is the use for Metoprolol?
Treatment of stable angina and hypertension, prevents reinfarction in MI patients and treats stable CHF.
What are the contraindications for Metoprolol?
Bradycardia, heart block, cardiogenic shock, asthma, COPD.
What diagnoses should make you use caution when giving Metoprolol?
Diabetes and PVD.
What are the adverse effects of Metoprolol?
Related to the blockage of SNS (CHF, decreased CO, Arrhythmias, dizziness, fatigue, emotional depression, bonchospasm).
What should you not give with Metoprolol?
Clonidine
What may intensify the effect of beta blockers?
Calcium channel blockers like Diltiazem.
What class does Diltiazem belong to?
Calcium channel blocker
What is Diltiazem used for?
Prinzmentals angina
What is the action of Diltiazem?
Inhibits the movement of calcium ions across the membranes of myocardial and arterial muscle cells altering the action potential and blocks contractions.
What diagnoses are contraindicated for use of Diltiazem?
heart block
Sick sinus syndrome
renal or hepatic dysfunction
What are the adverse effects of Diltiazem?
Cardiac arrhthmia
GI upset
Skin reaction
What should you NOT use with Diltiazem?
Grapefruit juice
What class does Exenatide belong to?
Incretin-enhancer GLP-1 Agonist.
What does Exenatide do?
Increases insulin release and decreases glucagon release. Slows gastric emptying and increases satiety.
When should you NOT give Exenatide?
NPO patient Gastroparesis Pregnant or child Renal impairment After a meal
When should you give Exenatide and how?
60minutes of morning and evening meals- SQ
What class does Fluoxetine belong to?
SSRI
What does Fluoxetine do?
Inhibits CNS reuptake of serotonin. Little effect on norepinephrine.
What is Fluoxetine used for?
Depression OCD Panic attacks Bulemia PTSD MCDD Social phobia Anxiety
When is Fluoxetine contraindicated for use?
Impaired renal/hepatic function Cardiac disease Diabetes Severe depression Suicidal patient
What are the adverse effects of Fluoxetine?
Heart attack Drowsiness Insomnia Anxiety Tremor Chest Pain Agitation Sexual Dysfunction Palpitation Increased appetite Hyponatremia
What are the special considerations for Fluoxetine?
Serotonin syndrome and do not stop abruptly
What is serotonin syndrome?
When given with other drugs that increase serotonin. Increased HR and BP, agitation, sweating, hyperthermia, CV collapse, coma, seizures.
What class does Glyburide belong to?
Sulfonylurea
What does Glyburide do?
Stimulates insulin release and improves insulin binding to receptors.
What is contraindicated for Glyburide?
Trauma
Surgery
CV disease
Diabetes type 1
What are the adverse effects of Glyburide?
Hypoglycemia
GI upset
Cardiovascular upset
What interacts with Glyburide?
Beta blockers Garlic Alcohol Anticoagulants Ginseng
What class does Digoxin belong to?
Cardiac glycoside
What does Digoxin do?
Produces an inotropic effect- increasing strength of contraction with increased cardiac output.
Negative chronotropic effect- slowing the heart by decreasing conduction velocity.
What should you check before administering Digoxin?
Apical pulse for 1 full minute
What is Digoxin used for?
CHF, Afib, Atrial flutter, other SVT.
When is Digoxin indicated for use?
Heart block
Renal insufficiency
Hypocalcemia
If you are giving Digoxin via IVP how long should you push it for?
Slowly over 5 minutes
What should you check every 6 months if you are on Digoxin?
Serum levels
What is the reversal drug for Digoxin?
Digoxin immune fab
When should you notify your doctor that something isn’t right when taking Digoxin?
A weight gain of over 2 pounds a day
What class does Escitalopram belong to?
SSRI
What does Escitalopram do?
Increases availability of serotonin at specific postsynaptic receptor sites within the CNS.
What is Escitalopram used for”?
Generalized anxiety and depression
What are the adverse effects for Escitalopram?
Dizziness Nausea Insomnia Somnolence Confusion Seizures
What class does Sertraline belong to?
SSRI
What does Sertraline do?
Inhibits serotonin reuptake
What does Sertraline treat?
Depression OCD Anxiety Panic Social anxiety PMDD PTSD
Do not take Sertraline when?
Taking MAOIs or within 14 days of taking an MAOI
When is the use of Sertraline contraindicated?
Hyponatremia
What are the adverse effects of Sertraline?
Suicidal ideation Seizure Agitation Insomnia Heart attack Dizziness Somnolence Fatigue
What should you monitor when a patient is on Sertraline?
Suicidal ideation and worsening depression
What is Protamine sulfate used for?
antidote for heparin
What class does Furosemide long to?
Loop diuretic
What does Furosemide do?
Blocks the chloride pump in the ascending loop of Henley. Causing reabsorption of sodium and chloride.
What are the adverse effects of Furosemide?
Dizziness Vertigo Paresthesias Orthostatic hypotension Rash Uricaria Nausea Anorexia Vomiting Glycosuria Urinary bladder spasm
What should you report when giving Furosemide?
Tinnitus
Decreased urine output
When can you not take Furosemide?
IF they are allergic to sulfonamide
What does Furosemide mask?
S&S of hypoglycemia
When pushing Furosemide what should you make sure you should do?
PUSH SLOW
What class does Prednisone belong to?
Systemic Corticosteroid
What does Prednisone do?
Suppresses histamine and prostaglandins. Immunosuppressant and anti-inflammatory.
What should you teach your patient when they are prescribed Prednisone?
Take with food
Do NOT stop abruptly
Causes hyperglycemia
Can mask infections
What are the contraindications for use of Prednisone?
Systemic infection Cataracts Peptic ulcer Osteoporosis HTN Renal disease
What are the adverse effects of Prednisone?
Suppresses adrenal gland function Hyperglycemia Cushing syndrome in long term use Mood changes Cataracts Peptic ulcers Hypokalemia Osteoporosis
What class does Nitroglycerin belong to?
Nitrate
What does Nitroglycerin do?
Acts directly on smooth muscle to cause relaxation and depress muscle tone.
What is Nitroglycerin used for?
Prevention and treatment of angina pectoris atacks
When should you NOT give Nitroglycerin?
Cases of severe anemia
Head trauma
Cerebral Hemorrhage
If patient is anemic
When should caution be used after administering Nitroglycerin?
In hypotension, hypovolemia, and any condition limiting CO.
What should you check when administering Nitroglycerin?
BP- if too low do not give
What are the Adverse effects of Nitroglycerin?
Heart attack Dizziness Nausea Vomiting Hypotension Flushing Increased perspiration
What are the drugs that interact with Nitroglycerin?
Ergot derivatives and heparin
What class does Imipramine belong to?
TCA
What is Imipramine used for?
Treatment of depression, enuresis and neuropathic pain
When is Imipramine contraindicated for use?
Cardiovascular disease Recent MI Liver dysfunction Angle closure glaucoma Urinary retention History of seizures Manic depression Pregnancy
What are the adverse effects of Imipramine?
Orthostatic hypotension
Arrythmias
Sedation
Bone marrow suppression
What drugs interact with Imipramine?
St John's Worst CNS depressants Antihypertensives Oral anticoagulants Sympathomimetics SSRIs
What should you educate your patient about with Imipramine?
Slowly change position No alcohol use Do not drive until effect is known. Take at bedtime if sedation occurs Avoid strong sunlight
When does a therapeutic effect occur in Imipramine?
2-6 weeks of use.
What class does Raloxifene belong to?
Selective Estrogen Receptor Modulator
What does Raloxifene do?
- Decrease bone reabsorption.
- Increase bone mass and density in postmenopausal women.
- Reduce vertebral fracture
- Decrease cholesterol and LDL.
What are the adverse effects of Raloxifene?
Hot flashes Migraines Flu like symtoms Endometrial disorder Breast pain Vaginal bleeding
When is Raloxifene contraindicated for use?
Pregnancy
History of DVT
What class does Guaifenesin belong to?
Expectorant
What is Guaifenesin used for?
Relief of dry nonproductive cough and mucous in the respiratory tract.
What does Guaifenesin cause?
Output of respiratory tract fluid.
What are the adverse effects of Guaifenesin?
Nausea Vomiting Heart Attack Dizziness Rash
Prolonged use of Guaifenesin causes what?
Masking of an underlying disorder
What class does Metformin belong to?
Biguanides
What does Metformin do?
Decreased hepatic production of glucose.
When is Metformin used?
For reduced insulin resistance
What does Metformin NOT do?
Promote insulin release and does not often cause hypoglycemia
What are the adverse effects of Metformin?
Nausea and vomiting Metallic taste Anorexia Flatulence Heart Attack Fatigue
What can Metformin cause that is rare but fatal?
Lactic acidosis.
What are the contraindications for use of Metformin?
Alcoholism
Cardiopulmonary insufficiency
Serious infection
Being under 10 years old.
When should you withhold Metformin and how long should you hold it for?
40 hours before and after contrast dye.
What three drugs increase the risk of hypoglycemia when using Metformin?
Catopril
Furosemide
Nifedipine
What three drugs decrease elimination of Metformin?
Digoxin
Morphine
Vancomycin
What class does Warfarin belong to?
Anticoagulant
What is the antidote for Warfarin?
FFP and Vitamin K
What labs need to be tested for Warfarin?
PT/ INR
What is the pregnancy category for warfarin?
X
What is the onset for warfarin?
2-7 days
What is crucial patient education for warfarin?
Consistent diet to maintain therapeutic INR
Be careful with food and drug interactions.
What class does Sitagliptin belong to?
Incretin Enhancer DPP-4 Inhibitor
What does Sitagliptin do?
Slows breakdown of GLP-1 which increases insulin secretion and decreases glucagon secretion and slows GI emptying
When taking Sitagliptin how do meals play in administration?
They do not. If taken orally you can take regardless of meal times.
What are the adverse effects of Sitagliptin?
Pancreatitis Heart Attack Nausea Vomiting Diarrhea URI
What may Sitagliptin increase?
Digoxin levels
What class does Captopril belong to?
ACE inhibitor
When is Captopril contraindicated for use?
With impaired renal function
What are the adverse effects of Captopril?
Related to vasodilation- Heart Attack, MI GI irritation (ulcers) Renal insufficiency Non-productive cough Increase in Potassium levels Fluid loss
What drug does Captopril interact with?
Allopurinol
What class does Heparin belong to?
Anticoagulant
What is the antidote for Heparin?
Protamine Sulfate
What labs are associated with Heparin?
PTT and aPTT
What does Heparin do?
Disrupts the conversion of prothrombin to thrombin
What is Heparin used for?
The prophylaxis and treatment of DVT and PE
What class does Enoxaparin belong to?
Anticoagulant
What is Enoxaparin also known as?
Low Molecular Weight Heparin
What does Enoxaparin do?
Inhibits thrombus and clot formation by blocking factors Xa and Iia.
What is Enoxaparin often used?
It has fewer systematic adverse reactions
Why is Enoxaparin used in conjunction with chemo?
It blocks the process that allows cancer cells to develop new vessels.
What is the antidote for Enoxaparin?
Protamine Sulfate
What class does Omeprazole belong to?
Proton Pump Inhibitor
Omeprazole is the drug of choice for what?
Severe GERD
What does Omeprazole do?
Reduces acid secretion by binding irreversibly to an enzyme H1, K1- ATPase.
What is Omeprazole used for?
Treatment of peptic ulcers and GERD.
How long is Omeprazole used for?
2-6 months
What are the adverse effects of Omeprazole?
Heart attack Nausea Diarrhea Rash Abdominal pain
Long term use of Omeprazole increases what?
Risk of gastric cancer and hip fracture
What class does Aspirin belong to?
Antiplatelet
What does Aspirin do?
Alters formation of platelet plug and reduces inflammation
What are the adverse effects of Aspirin?
Heart burn
Abdominal pain
Ulceration
Tinnitus
What is the contraindication for Aspirin?
Increased intracranial pressure or intracranial bleeding.
Bleeding disorders
Alcoholism
What class does Losartan belong to?
Angiotensin II receptor blocker
What does Losartan do?
Selectively blocks binding of angiotensin II to specific tissue receptors on vascular smooth muscle
What drug does Losartan interact with?
Phenobarbital
What class does Clarithromycin belong to?
Macrolide
Why is Clarithromycin used to treat peptic ulcers?
It is acid resistant and does not dissolve in the stomach so it can treat H. Pylori
For treating a peptic ulcer- When should the patient take Clarithromycin?
BID (twice a day)
For a peptic ulcer- is Clarithromycin the only drug used?
No- it is used in a combination with other drugs
What does Clarithromycin do?
Inhibits protein synthesis by binding bacterial ribosome.
What is Clarithromycin effective at treating?
Gram positive bacteria
What are adverse effects of Clarithromycin?
Nausea Abdominal cramping Vomiting Diarrhea Superinfection Resistance
What class does Amoxicillin belong to?
Penicillin
Amoxicillin is used with what to treat peptic ulcers?
In conjunction with Clarithromycin and tetracycline for H. Pylori
How does Amoxicillin work?
By disrupting bacteria cell walls allowing water to enter.
What type of bacteria is Amoxicillin most effective on?
Gram positive bacteria
What are the adverse effects of Amoxicillin?
Resistance
low RBC, WBC, platelet counts
What class does Tetracycline belong to?
Tetracycline
What is Tetracycline effective against?
Broad range of gram positive and gram negative organisms
How does Tetracycline work?
It inhibits protein synthesis
Why is Tetracycline only a drug of choice for a few bacterium?
Due to increased resistant strains
What are the adverse effects of Tetracycline?
Superinfections Nausea Vomiting Diarrhea Discoloration of teeth Photosensitivty
What class does Metronidazole belong to?
Antiprotozoal drugs
How does Metronidazole work?
With antiprotozoal and antibiotic activity against anaerobic bacteria- specifically amoebas
What are the adverse effects of Metronidazole?
Anorexia Nausea Diarrhea Dizziness Heart attack Dry mouth Metallic taste
What type of reaction may occur due to Metronidazole?
Disulfum reaction
What should you NOT use when taking Metronidazole?
Alcohol
Vitamin K is that antidote for what?
Warfarin
What class does Timolol belong to?
Beta-Adrenergic Antagonist
When using Timolol orally h0w is it prescribed?
As a mono therapy or in combination with thiazide diuretic
What is Timolol used for?
Treatment of GLAUCOMA To prevent reinfarction after MI and to treat mild hypertension
What are the adverse effects of Timolol?
Fatigue Headache Bradycardia Depression Hypotension Dyspepsia Nausea
What is Timolol associated with?
Exacerbation of angina and MI when abruptly discontinued.
What should you assess if a patient is on Timolol?
Heart rate and Blood pressure before administration and at regular intervals after administration.
What class does Methadone belong to?
Narcotic analgesic
What schedule does Methadone belong to?
Schedule II
What is Methadone used for?
Treatment of severe pain
What are the adverse effects of Methadone?
Constipation and respiratory depression
What can Grapefruit cause in a patient who takes Methadone?
Increased serum levels and adverse effects.
What should you not take while on Methadone?
Other CNS depressants
What should you monitor on a patient who has taken Methadone?
Respiratory function
What is Methadone associated with?
Abuse
Respiratory depression
QT prolongation
What class does Thiamine belong to?
Vitamin B1
What is Thiamine used for?
Treatment and prophylaxis of thiamine deficiency
What are the adverse effects of Thiamine?
Anaphylaxis and cardiovascular collapse
What education is important to teach when giving a patient Thiamine?
The pill must be swallowed WHOLE. NEVER crushed.
what class does Disulfiram belong to?
Anti-alcohol agent
What is Disulfiram used in adjunction with?
Treatment of the patient with chronic alcoholism who seriously wants to maintain sobriety.
What are the adverse effects of disulfiram?
Hypotension to shock level arrhythmias Acute congestion failure Respiratory depression Unconsciousness Convulsions Sudden death
Who should Disulfiram not be given to?
Anyone in a state of alcohol intoxication or without a patients full knowledge.
What is Dantrolene used for?
Antidote for malignant hyperthermia
What class does Memantine belong to?
Receptor Antagonist/ Antidementia
What is Memantine used for?
Moderate to severe Alzheimer’s disease
What are the adverse effects of Memantine?
Dizziness Headache Confusion Pain Flu-like symptoms
What class does Donepezil belong to?
Central acting cholinergic- therapeutic antidementia
What is Donepezil used to treat?
Mild, moderate, or severe dementia/Alzheimers.
What are the adverse effects of Donepezil?
Headache Insomnia Nausea Diarrhea Vomiting Muscle cramps Anorexia
What should you monitor for with a patient on Donepezil?
S&S of GI ulceration and bleeding
In patients taking Donepezil what should you monitor for?
Patients with asthma or obstructive pulmonary disease. And monitor cardiovascular status
What class does Lisinopril belong to?
Antihypertensive
What should you monitor for when a patient is taking Lisinopril?
Monitor drug effect for several hours or until BP is stabilized for at least an additional hour after.
What are the adverse effects of Lisinopril?
Dizziness
Hypotension
Chest pain
Nausea
What may Lisinopril increase?
Lithium levels and toxicity
What has Lisinopril been associated with?
Fetal injury and death
If hypotension occurs within the first 1-5 hours after the first administration of Lisinopril what should you do?
Place the patient in a supine position and notify prescriber
What class does Gemfibrozil belong to?
Quinolone antibiotic
What is Gemfibrozil a treatment for?
Acute exacerbations of chronic bronchitis and mild to moderate community acquired pneumonia.
What should you monitor in patients who are talking Gemfibrozil?
Cardiac Status
Gemfibrozil increases the risk of what?
Tendinitis, tendon rupture, and exacerbation of muscle weakness in those with MG
Where is Calcitonin found in?
Salmon
What does Calcitonin from salmon do?
Increases bone density by inhibiting bone resorption and opposing effects of PTH lowering serum calcium.
How is Calcitonin administered?
Nasal Spray or SQ
What is Calcitonin from salmon used for?
Osteoporosis, Paget’s, emergency treatment of hypercalcemia.
What are the adverse effects of Calcitonin?
Nausea
Vomiting
Flushing
Hypocalcemia
Where is Calcitonin secreted from?
Thyroid gland
What does Calcitonin do?
Stimulates bone deposition, removes calcium from blood, and helps control homeostasis.
Where does Calcitonin target?
Bones
Kidneys
GI tract
What two hormones control Calcium homeostasis?
Calcitonin and Parathyroid Hormone
Where is PTH stimulated from?
Parathyroid
What does PTH do?
Stimulates osteoclasts and accelerates bone resorption, increases GI absorption of calcium. Increases calcium in blood
Calcitriol is the active form of what?
Vitamin D
What is Calcitriol used for?
Management of hypocalcemia
What are the adverse effects of Calcitriol?
Heart attack Weakness Nausea Vomiting Constipation
What interacts with Calcitriol?
Cholestyramine
What should you monitor for when a patient is taking Calcitriol?
Liver and renal function
Magnesium levels
Calcium and phosphate levels.
Thiamine is used to treat this disease that causes a deficiency in thiamine.
Alcoholism