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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
St. Johns wort
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
Lantanoprost (Xalantan)
Antiglaucoma agent - prostaglandin analogue Lowers IOP and improves outflow of aqueous humor
27
Brimonidine (Alphagan P)
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
Carbonic Anhydrase Inhibitors
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
Pilocarpine
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
Echothiopate (Phospholine Iodide)
Cholinesterase Inhibitor - reduces IOP via miosis and constriction of ciliary muscles SE: blurred vision, bradycardia, urinary urgency, sweating, increased risk of cataracts
31
Netarsudil (Rhopressa)
Rho Kinase Inhibitor - decreases IOP, action unclear Topical drop with minimal SE
32
Topical eye anesthetics
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
Cyclosporine ophthalmic emulsion (Restasis)
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
Anticholinergic Mydriatics and Cyclopegics
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
Acute Otitis Media Antibotics
Amoxicillin - first line Cephalosporins - caution with PCN allergy Azithromycin + Clarithromycin if severe PCN allergy Ceftriaxone (Rocephin) IM for resistant and reoccurring infections
36
Ceruminolytics
Topical otic agent that can break up cerumen (ear wax) so it can be removed
37
Keratolytics
Antiacne drugs: dissolves keratin, mild-moderate acne SE: erythema, dryness, peeling
38
Benzoyl peroxide
First line antiacne often used in combination with antibiotics CAUTION with asthma patients
39
Salicylic acid
Antiacne drugs - reduce frequency if redness or peeling occurs
40
Topical Antibotics
Antiacne: Erythromycin, Clindamycin often used with benzoyl peroxide -Cycline antibotics also used
41
Retinoids - Topical Vitamin A Derivative
Antiacne: Alters keratinization process and dcreases inflammation SE: bursing, peeling, erythema (SE exacerbated with benzoyl peroxide) Meds: Tretinoin, adapalene, tazarotene
42
Isotretinoin (Amnesteem, Accutane)
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
Methotrexate
Psoriasis treatment - harsh also used for cancer. Monitor liver, CBC and GI symptoms Opportunistic infections possible
44
Biologic Psoriasis Agents
Act by supressing immune system SE: infection, TB reactivation, cancer Monitor for signs of infections Labs: CBC, TB (required before starting)
45
Podophyllum resin
Treatment for gential warts Not for use in pregnancy Can irritate healthy tissue, wash off 2-3 times after application
46
Minoxidil (Rogaine)
Off label use to treat baldness Stimulates hair growth - results vary hair loss resumes when medication is discontinued
47
Mafenide (Sulfamylon Cream)
Topical burn treatment SE: burning, blistering, superinfection, acidosis, bone marrow suppression

Pharm 2 (13 decks)

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