drugs with their classes Flashcards
morphine
heroin
hydromorphone
oxymorphone
codeine
hydrocodone
oxycodone
meperidine
fentanyl
methadone
propoxyphene
opioids
What are the three classes of opioids? what drugs are in each class?
Morphine-Like (morphine, heroin, hydromorphone, oxymorphone, codeine, hydrocodone, oxycodone)
Meperidine-Like (meperidine, fentanyl)
Methadone-Like (methadone, propoxyphene)
morphine
morphine like
heroin
morphine like opioid
hydromorphone
oxymorphone
morphine like
codeine
morphine like opioids
hydrocodone
morphine like opioids
oxycodone
morphine like opioids
meperidine
meperidine like opioid
fentanyl
meperidine like opioid
methadone
methadone like opioid
propoxyphene
methadone like opioid
What are the opioid agonists-antagonists
butorphanol
pentazocine
buprenorphine
butorphanol
opioid agonist antagonist
pentazocine
opioid agonist antagonist
buprenorphine
opioid agonist antagonist
Binds to a pain receptor but causes a weaker pain response than a full ____
Mu, Kappa, delta receptors must be receptive to drugs; mu is most important (morphine)
not used as a first line analgesic
can cause respiratory depression but not usually as bad
Headaches, nausea
increased cardiac workload
agonist
agonist antagonist pharmacologic action
Respiratory depression (limited)
Sedation, dizziness, lightheadedness, drowsiness
Headache
Nausea
Increased cardiac workload with butorphanol and pentazocine
Abstinence syndrome – have withdrawal (less severe than opioid dependent)
agonists antagonists adverse effects
Measure baseline vital signs
Ask about opioid usage
Monitor respirations, if < 12 withhold medication and stimulate breathing
Fall precautions
Consider recommending an alternative if N/V doesn’t resolve
Do not administer to patients with myocardial infarction or cardiac insufficiency
agonists-antagonists interventions
IM, IV or intranasally
Pentazocine (Talwin) is only given orally
Measure baseline vital signs before administration and monitor throughout therapy, hold if resp rate < 12
Have naloxone (Narcan) and resuscitation equipment available (hard to reverse respiratory depression)
For intranasal administration, give one spray and repeat every 60-90 minutes as needed
For preop IM administration, give 60-90 minutes before surgery
Monitor therapeutic effects
Do not discontinue abruptly
agonist antagonists administration
only use wen needed and for short a term as possible
don’t want them operating heavy machinery or tasks that require alterneess until we know how the drug works with them
fall precautions
change possibitions gradually when standing us rising
report a worsening headache
tell then to lie down when feeling nauseated
should not use this drug for chest pain because of increased cardiac output that the drug will require
do not add opioids unless the doctor has approved it
agonists-antagonists patient instructions
Analgesic, Antiinflammatory and Antipyretic Activity
Also for headaches, myalgia, neuralgia, arthralgia, postoperative pain
Relief of pain with rheumatoid arthritis, juvenile arthritis, ankylosing spondylitis, osteoarthritis, gout, hyperuricemia
NSAIDS - Indications
What are the NSAIDS?
Aspirin
Ibuprofen
Naproxen
Indomethacin
Ketorolac
GI tract
Heartburn to GI Bleeding
Acute Renal Failure (especially if dehydrated)
Due to disruption of prostaglandin function
NSAIDS block protective effects of COX-1 on the kidneys
Reye’s Syndrome
Salicylism
NSAIDS - Adverse Effects
Monitor for signs of bleeding
Test for and treat Helicobacter pylori infection
Recommend a proton pump inhibitor during NSAID therapy
Monitor I & O, BUN and Creatinine
Monitor for salicylism
With long term use of non-aspirin NSAIDS: Monitor for signs of embolic event
Recommend low dose aspirin to prevent embolic events
NSAIDS -Interventions
Aspirin
nsaid (cox 1)
Ibuprofen
nsaid (cox 1)
Naproxen
nsaid (cox 1)
Indomethacin
nsaid (cox 1)
Ketorolac
nsaid (cox 1)
Celecoxib
nsaid cox 2
What is the centrally acting nonopioid ?
tramadol
tramadol
centrally acting nonopioid prototype
Binds to selected opioid receptors and blocking reuptake of norepinephrine and serotonin in the central nervous system
Centrally Acting Nonopioid – Expected Pharmacologic Actions
Sedation, dizziness
Headache, N/V, constipation
Respiratory depression (rare)
Seizures (rare) – avoid taking if have a history of seizures
Urinary retention
centrally acting nonopioid -adverse effects
Fall precautions
Give lowest effective dose possible; short term
Give with food
Antiemetic if N/V occur frequently
Baseline vitals, monitor respirations
Administer _______ antagonist if needed to restore respiratory rate
Monitor for signs of seizure activity
Monitor for urinary retention
Centrally Acting Nonopioid - Interventions
do not give prior to driving or necessary mental alertness
dizziness: sit or lie down when you feel dizzy
change position gradually
increase fluid and fiber intake, exercise to prevent constipation
take only when needed, and for short term
report urinary retention
Centrally Acting Nonopioid – Patient Instructions
Acute intoxication with alcohol, opioids and psychotropic drugs
Seizure disorders
Respiratory depression
Children younger then 16 years old
Centrally Acting Nonopioid - Contraindications
Treat the hyperuricemia (increased uric in blood) that causes
gout
Treat hyperuricemia that occurs secondary to:
Cancer chemotherapy
Blood dyscrasias
Uricosurics - Indications
What are the uricosurics?
allopurinol
febuxostat
probenecid
febuxostat
uricosurics
allopurinol
uricosurics
probenecid
uricosurics
What are the glucocorticoids?
prednisone
hydrocortisone
methylprednisolone
prednisone
glucocorticoid
hydrocortisone
glucocorticoid
methylprednisolone
glucocorticoid
what are the benzodiazepines?
diazepam
alprazolam
lorazepam
temazepam
What is the nonbenzodiaepine anxiolytics?
buspirone
What is the nonbenzodiazepine anxiolytic?
buspirone
zolpidem
nonbenzodiazepine hypnotic/sedative
buspirone
nonbenzodiazepine anxiolytic
-pam
or alprazolam
benzodiazepines
zaleplon
new class of hypnotic,
benzo like medication
sedative/hypnotics
eszopiclone
benzodiazepine like medication
hypnotic
suvorexant
- sedative hypnotic (non Benzo)
What are the traditional antiepileptics?
phenytoin
carbamazepine
valproic acid
(remember PCV)
phenytoin
traditional antiepileptics
carbamazepine
traditional antiepileptics
valproic acid
traditional antiepileptics
what are the newer antiepileptics (anticonvulsants)?
lamotrigine
oxcarbazepine
topiramate
gabapentin
(remember LOT, G)
lamotrigine
newer antiepileptics
oxcarbazepine
newer antiepileptics
topiramate
newer antiepileptics
gabapentin
newer antiepileptics
What are the SSRI’s?
paroxetine
fluoxetine
sertraline
paroxetine
SSRI
fluoxetine
SSRI
sertraline
SSRI
What are the SNRIs?
Duloxetine
venlafaxine
mirtazapine
tetracycline antidepressant
duloxetine
SNRI
venlafaxine
SNRI
What are the TCA antidepressants?
Imipramine
clomipramine
Amitriptyline
mirtazapine
imipramine
TCA antidepressant
clomipramine
TCA antidepressant
amitriptyline
TCA antidepressant
What are the MAOIs?
phenelzine
phenelzine
MAOI
what are the local anesthetics?
xylocaine
novocaine
xylocaine
local anesthetic
novocaine
local anesthetic
What are the parenteral anesthetics?
Diprivan (propofol)
Diprivan
Parenteral anesthetics
What are the rapid acting insulins?
insulin lispro
glulisine
aspart
insulin lispro
rapid acting insulin
glulisine
rapid acting insulin
What is the short acting insulin?
regular insulin
regular insulin
short acting insulin
What are the intermediate acting insulins?
NPH
What are the long actin insulins?
insulin glargine
insulin detemir
insulin glargine
long acting insulin
insulin detemir
long acting insulin
what are the biguanides?
metformin
metformin
biguanide
what are the sulfonyureas?
glipizide
glyburide
glipizide
sulfonyurea (antidiabetic medication)
glyburide
sulfonyurea (antidiabetic)
what are the glinides?
repaglinide (antidiabetic med)
repaglinide
glinide (antidiabetic med)
what are the thiazolidinediones?
(glitazones)
pioglitazone
pioglitazone
thiazolidinedione or glitizones (antidiabetic med)
what are the alpha-glucosidases?
acarbose
acarbose
alpha-glucosidase
what are the dipeptidyl peptidase IV inhibitors (gliptins)?
sitagliptin
stigaliptin
dipeptidyl peptidase IV inhibitor (gliptins)
glucagon
hyperglycemic agent
What are the hyperglycemic agents?
50% dextrose
glucagon
levothyroxine
medications for hypothyrodisim