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Pharm 2 > E2 Medications > Flashcards

E2 Medications Flashcards

1
Q

Carbidopa-levodopa (Sinemet)

A

Dopaminergic - prevents dopamine enzymes from being destroyed
Decreased effect when taken with 1st gen antipsychotics, MOA inhibitors

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2
Q

Pramipexole dihydrochloride (Mirapex)

A

Dopamine agonist (activation of dopamine receptors in striatum - basal ganglia) Nonergot derivative (…) Can be combination with carb/levo
SE: postural hypotension, hallucinations, IMPULSIVE behaviors, fatigue (can make intolerable)

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3
Q

Bromocriptine (Parlodel)

A

Dopamine agonist (activation of dopamine receptors in stratum - basal ganglia) Ergot derivative (…)
SE: n/v, hallucinations, delusions, postural hypotension
Nursing: Monitor liver functions
Can be used with carb/levo or on its own

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4
Q

Entacapone (Comtan)

A

COMT inhibitor (stops COMT enzyme from inactivating dopamine)
Used in combo with carb/levo MAY increase the half life (needs a lower dose)
Does NOT affect the liver function (safer than tolcopone (comtan))
SE: turn urine orange (harmless)

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5
Q

Selegiline (Eldepryl) + Rasagiline (Azilect)

A

MOA-B inhibitor (stops the MOAB enzyme from destroying dopamine) used as an early onset medication, may be used in combination with carb/levo (monitor for increase SE of carb/levo)
Adverse: Tyramine metabolism and hypertensive crisis possible

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6
Q

Amantadine (Symmetrel)

A

Antiviral also used for Influenza A - stimulates dopamine receptors
Not first line r/t loss of effectiveness
Improves rigidity and bradykinesia, less effective for tremors

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7
Q

Benztropine (Cogentin) + Trihexphenidyl HCL (Artane)

A

Anticholinergics - parasympatholytic; inhibits the release of acetylcholine
Reduces rigidity and some tremors, minimal change in bradykinesia (slow movement)
Fits BEERS criteria - not ideal for elderly

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8
Q

Anticholinergics Nursing Interventions

A

Monitor vitals, urine output (for retention) increase fluid, fiber and exercise to avoid constipation, AVOID alcohol, cigarettes, caffeine, and aspirin r/t decrease in gastric acidity, wear sunglasses, relieve dry mouth with ice chips, hard candy or sugarless chewing gum

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9
Q

Donepezil (Aricept) + Rivastigmine (Exelon) + Galantamine (Razadyne)

A

AChE inhibitors - Donepezil can be used for more severe dementia

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10
Q

Memantine (Namenda)

A

NMDA receptor antagonist - moderate to severe dementia symptoms, may be taken without regard to food, no known severe side effects

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11
Q

Glatiramer acetate (Copaxone)

A

Remission-exacerbation treatment of MS. Relives spasticity
SE: chest pain (scary but benign), injection site reaction

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12
Q

Fingolimod (Gilenya)

A

SPECIAL handling precautions; MS treatment
SE: bradycardia, infection, macular edema, liver injury
Need to test for varicella-zoster (chicken pox) if no history of disease or vaccine

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13
Q

Natalizumab (Tysabril)

A

DMT MS
Decreases immunity over time, not to be given with other immunosuppressants/HIV AIDS
Risk for progressive multifocal leukoencephalopathy (PML)
Monitor: Liver toxicity and opportunistic infections

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14
Q

Mitoxantrone

A

MS treatment used for CHRONIC and when disease is unresponsive other treatment
TOXIC - used to treat cancer, lifetime dose limit
Monitor: signs of infection (CBC), hold if neutrophils below 1500, reduces left ejection fraction

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15
Q

Baclofen (Lioresal) + Diazapam (Valium) + Tizanidine (Zanaflex)

A

Central acting muscle relaxants

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16
Q

Cyclobenzaprine (Flexeril)

A

Central acting muscle relaxant - Does not cause drug dependence
Alleviates muscle spasms associated with acute pain
SE: drowsiness, dizziness, ANTIcholinergic (dry mouth, blurry vision, urinary retention) dysrhythmias

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17
Q

Muscle Relaxants Nursing Interventions

A

Take with food, monitor liver, check vital signs, do not drive, most central are for ACUTE and no longer than 3 weeks, avoid alcohol
Those in adjunct with anesthesia remember patient is conscious and HEARING could be intact

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18
Q

Amphetamines

A

Stimulate release of norepinephrine and dopamine, increase alertness, may cause euphoria
SE: tachycardia, palpitations, hypertension, sleplessness, irritability, anorexia, dry mouth, diarrhea, constipation, weight loss

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19
Q

Anorexiants

A

Appetite suppressions
Risk for hemorrhagic stroke, potential for abuse
Not for children under 12
SE: nervousness, restlessness, irritability, insomnia, heart palpitations, hypertension

20
Q

Analeptics

A

Used to stimulate respiratory system
Ex: caffeine + theophylline
SE: restlessness, tremors, twitching’s, diuresis, tinnitus, dependence, arrhythmias

21
Q

Doxapram (Dopram)

A

Respiratory stimulant
Onset 20-40 sec (IV), peak 2 minutes SHORT
SE: hypertension, tachycardia, trembling, convulsions

22
Q

Echinacea

A

Herb used for colds, flu or UTI - probable antiviral/antibacterial, increases lymphocytes and granulocytes in circulation at site of infection
Toxic with long term use (more than 3 months) can cause disruption in GI flora (possible C-diff)

23
Q

Ginger

A

Root used for Gi upset in pregnacy, chemo, motion sickness and post op; should be used short term (up to 4 days)

24
Q

Ginkgo Biloba

A

Antioxidant, peripheral vasodilator that increased blood flow to CNS
Some patients use for prevention/treatment of Alzheimers, CVA, dementia
Causes decreased platelet aggregation - discontinue 2 weeks before surgery do not use during pregnancy

25
Q

St. Johns wort

A

Antidepressant (effects 4-6 wks.) and antiviral
Many drug interactions, can cause serotonin syndrome when taken with other antidepressants
Should not take while on Antabuse
Interferes is digoxin making it less bioavailable
Reduces effectiveness of birth control, warfarin and some HIV meds

26
Q

Lantanoprost (Xalantan)

A

Antiglaucoma agent - prostaglandin analogue
Lowers IOP and improves outflow of aqueous humor

27
Q

Brimonidine (Alphagan P)

A

Alpha-Adrenergic Agonists - decrease IOP by decreasing production of aqueous humor
SE: can cause pupil mydriasis, dry mouth, burning/stinging, blurred vision, crosses BBB (drowsiness, fatigue, hypotension)
TEACHING: contact lenses should be removed and not reinserted for 15 minutes after admin

28
Q

Carbonic Anhydrase Inhibitors

A

Brinzolamide ophthalmic (Azopt) Topical + Acetazolamide (Diamox) Systemic decrease IOP by decreasing production of aqueous humor
SE: risk of cross-reactivity with sulfa allergy
Topical: bitter after taste, stinging, blurred vision, 15 minute before contact lens
Systemic: Lethargic, drowsiness, headache, seizures, mental status changes, diuretic effect, polyuria, increased thirst, fluid/electrolyte imbalances
As a whole group not as effective and contains many SE

29
Q

Pilocarpine

A

Parasympathomimetic direct acting muscarinic agonist - decreases IOP via miosis and contraction of ciliary muscles (improves outflow of aqueous humor)
SE: vision changes (cannot dilate enough) irritation pain bradycardia, bronchospasm, hypotension

30
Q

Echothiopate (Phospholine Iodide)

A

Cholinesterase Inhibitor - reduces IOP via miosis and constriction of ciliary muscles
SE: blurred vision, bradycardia, urinary urgency, sweating, increased risk of cataracts

31
Q

Netarsudil (Rhopressa)

A

Rho Kinase Inhibitor - decreases IOP, action unclear
Topical drop with minimal SE

32
Q

Topical eye anesthetics

A

Corneal anesthesia achieved in 1 min last 15
SHOULD NOT BE SELF PERFORMED
Ask pt about allergies
Drug Ex: Proparacaine HCL and Tetracaine HCL

33
Q

Cyclosporine ophthalmic emulsion (Restasis)

A

Immunosuppressant
Decreases immune response leading to decreased inflammation, allows tear production to resume
Contraindicated in viral eye infection
Long term risk of cataracts, glaucoma

34
Q

Anticholinergic Mydriatics and Cyclopegics

A

Mydriatics: Dilate pupils
Cycloplegics: paralyze muscles of accommodation
SE: dry eyes (xerophthalmia), blurred vision, increased hr, constipation
Contraindicated in pts with narrow angle glaucoma

35
Q

Acute Otitis Media Antibotics

A

Amoxicillin - first line
Cephalosporins - caution with PCN allergy
Azithromycin + Clarithromycin if severe PCN allergy
Ceftriaxone (Rocephin) IM for resistant and reoccurring infections

36
Q

Ceruminolytics

A

Topical otic agent that can break up cerumen (ear wax) so it can be removed

37
Q

Keratolytics

A

Antiacne drugs: dissolves keratin, mild-moderate acne
SE: erythema, dryness, peeling

38
Q

Benzoyl peroxide

A

First line antiacne often used in combination with antibiotics
CAUTION with asthma patients

39
Q

Salicylic acid

A

Antiacne drugs - reduce frequency if redness or peeling occurs

40
Q

Topical Antibotics

A

Antiacne: Erythromycin, Clindamycin often used with benzoyl peroxide
-Cycline antibotics also used

41
Q

Retinoids - Topical Vitamin A Derivative

A

Antiacne: Alters keratinization process and dcreases inflammation
SE: bursing, peeling, erythema (SE exacerbated with benzoyl peroxide)
Meds: Tretinoin, adapalene, tazarotene

42
Q

Isotretinoin (Amnesteem, Accutane)

A

Systemic antiacne drug, do not use with vitamin A derivatives and tetracycline
SE: skin irritation, thrombocytopenia, elevated triglycerides, teratogenic, suicidal ideation + increased risk for depression
Blood work: two negative pregnancy before, monthly pregnancy, monthly lipid and CBC
Education: two types of birth control

43
Q

Methotrexate

A

Psoriasis treatment - harsh also used for cancer.
Monitor liver, CBC and GI symptoms
Opportunistic infections possible

44
Q

Biologic Psoriasis Agents

A

Act by supressing immune system
SE: infection, TB reactivation, cancer
Monitor for signs of infections
Labs: CBC, TB (required before starting)

45
Q

Podophyllum resin

A

Treatment for gential warts
Not for use in pregnancy
Can irritate healthy tissue, wash off 2-3 times after application

46
Q

Minoxidil (Rogaine)

A

Off label use to treat baldness
Stimulates hair growth - results vary
hair loss resumes when medication is discontinued

47
Q

Mafenide (Sulfamylon Cream)

A

Topical burn treatment
SE: burning, blistering, superinfection, acidosis, bone marrow suppression

Pharm 2 (13 decks)

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