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Pathophysiology/Pharmacology > Exam 2 > Flashcards

Exam 2 Flashcards

1
Q

Bronchodilators

A

SABA, LABA, Short acting anticholinergic, Methylxanthines

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2
Q

Albuterol

A

SABA - Rescue therapy
PK: inhaled formulations generally exert their effect locally
MOA: beta-adrenergic agonist - stimulation of beta 2 receptors in the smooth muscle leading to bronchodilation; also improves mucociliary transport
AE: paradoxical bronchospasm, tachycardia, palpitations, tremors, dry mouth

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3
Q

Salmeterol

A

LABA - used in treatment of asthma and COPD

  • Use on a regular basis
  • Best when used with anti-inflammatory agents
  • NOT used to treat acute symptoms
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4
Q

Ipratropium (Atrovent)

A

Short Acting Inhaled Anticholinergic
PK: inhaled, local effects
MOA: blocks parasympathetic NS - blocks muscarinic receptors resulting in bronchodilation and decreased mucus secretion
AE: tachycardia, constipation, blurred vision, dizziness, headache, dry mouth, metallic taste, urinary retention
DO NOT USE TO TREAT ACUTE SX
***Always give bronchodilator first

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5
Q

Theophylline (Theolair)

A

Methylxanthines
PK: oral solution or tablet, absorbed rapidly and converted to active form
MOA: Smooth muscle relaxation, decreased inflammatory mediators — monitor blood serum levels to prevent toxicity
AE: severe – not used commonly AVOID caffeine cardiac: tachy, palpitations, dysrhythmias, neuro: HA, dizziness, irritability, insomnia, GI: abdominal discomfort, N/V

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6
Q

Glucocorticoids (ICS)

A

Prototypes: beclomethasone (QVar), budesonide (pulmocort), ruticsone (Rovent Diskus)

Decreases exaverbations in COPD stages C & D
Not used alone - in combo with bronchodilators
***Helps reduce inflammation in airways
AE: oral thrush (rinse mouth), dysphonia, reflex cough/bronchospasm
There are many combination preparations with SABAs and LABAs

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7
Q

budesonide

A

Glucocorticoid - inhaled

Anti-inflammatory for respiratory disorders

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8
Q

budesonide

A

Glucocorticoid - inhaled

Anti-inflammatory for respiratory disorders

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9
Q

montelukast (Singular)

A

Leukotriene inhibitor
Anti-inflammatory for respiratory disorders
Not for acute attacks

Monitor patient’s mood/behavior changes (suicide precautions)

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10
Q

cromolyn

A

Mast cell stabilizer
Anti-inflammatory for respiratory disorders
Not for acute attacks
Prophylactic therapy - occasional pulmonary function tests

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11
Q

dextromethorphan

A

Suppressant /anti-tussive

AE: Central nervous system: Confusion, excitement, irritability, nervousness, serotonin syndrome

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12
Q

guaifenesin

A

Expectorant
used for cough
AE: dizziness, headache, decreased uric acid, kidney stone formation (high doses)

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13
Q

phenylephrine

A

Decongestant
Alpha1 receptor agonist
AE: CNS - Anxiety, dizziness, excitability, headache, insomnia, nervousness, restlessness

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14
Q

diphenhydramine (1st gen)

loratadine (2nd gen)

A

Histamine1 receptor antagonist

Anti-histamine

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15
Q

ondansetron (Zofran)

A

Anti-emetic Drug
5-HT3 (serotonin) receptor antagonist
AE: headache, malaise, fatigue

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16
Q

promethazine (Phenergan)

A

Anti-emetic Drug
Dopamine2 receptor antagonist
AE: tinnitus, decreased HR

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17
Q

aprepitant

A

Anti-emetic Drug
Neurokinin antagonist
AE: fatigue, hiccups, weakness, dizziness
**Use with caution for pts. with renal impairment
Monitor for fatigue, weakness, constipation, low blood pressure, and dizziness

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18
Q

aluminum hydroxide, magnesium hydroxide, calcium

carbonate, etc.

A

Drugs for gastric ulcer / GERD
Antacid
Take after meals and at bedtime for the temporary relief of heartburn, acid indigestion, and sour stomach
AE: Constipation, discoloration of feces (white speckles), fecal impaction, nausea, stomach cramps, vomiting

Monitor calcium and phosphorus levels

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19
Q

ranitidine

A 
Drugs for gastric ulcer / GERD 
Histamine2 receptor antagonist 
Uses: ulcers, heartburn, GERD
AE: a little bit of everything
Monitor AST, ALT, creatinine, s/s of gastric ulcer, signs of confusion

Use in caution with pt. who has renal impairment

20
Q

omeprazole

A

Drugs for gastric ulcer / GERD
Proton pump inhibitor
AE: headache, dizziness

21
Q

misoprostol (Cytotec)

A

Drugs for gastric ulcer / GERD
Prostaglandin
Preg. test for women prior to use

22
Q

sucralfate

A 
Drugs for gastric ulcer / GERD 
Mucosal barrier 
Prevention of mucositis 
AE: constipation
Use caution in presence of renal failure. Teach patient proper timing of other medications. May cause constipation.
23
Q

psyllium (Metamucil)

A

Laxative
Bulk forming
Dietary fiber laxative

24
Q

docusate (colace)

A

Laxative
Surfactant-stool softener
AE: throat irritation

25
Q

bisacodyl

A

Laxative
stimulant
Tx of constipation
AE: abdominal cramps, nausea, vertigo, electrolyte imbalance

26
Q

polyethylene glycol

A

Laxative - osmotic

AE: Abdominal bloating, cramping, diarrhea, flatulence, nausea

27
Q

loperamide (Imodium)

A

Anti-diarrheal
Opioid-type
May cause drowsiness or dizziness, which may impair physical or mental abilities; patients must be cautioned about performing tasks which require mental alertness
AE: dizziness, constipation

28
Q

mesalamine

A 
Inflammatory bowel disease drugs - UC
5-Aminosalicylates 
AE: headache, abdominal pain
Monitor: renal function, CBC, hepatic function
Adequate hydration important
29
Q

azathioprine

A

Inflammatory bowel disease drugs - Crohns disease (off label)
immunosuppressant
AE: N/V, diarrhea, hepatotoxicity
Monitor for opportunistic infection, and signs/symptoms of malignancy

30
Q

infliximab

A

Inflammatory bowel disease drugs
Immunomodulator (TNF inhibitor)
Premedication with antihistamines, acetaminophen, and/or corticosteroids may be considered to prevent and/or manage infusion-related reactions.
AE: headache, N/V, diarrhea, abdominal pain
Do not use with live vaccines

31
Q

alendronate (Fosamax)

A

Osteoporosis
Bisphosphonate
**Patients should receive supplemental calcium and vitamin D if dietary intake is inadequate
Monitor serum calcium and vitamin D 25 levels.

32
Q

raloxifene

A

Osteoporosis
SERM
May increase risk for DVT or PE
Contraindicated for those with hx of DVT, pregnant/bfeeding women
AE: peripheral edema, hot flashes, leg cramps, flu syndrome
**Evaluate lipid profile and BMD. Monitor for DVT, PE, chest pain, migraine, and rash on a regular basis during therapy.

33
Q

denosumab

A

Osteoporosis
RANKL antagonist
***Administer calcium and vitamin D as necessary to prevent or treat hypocalcemia
AE: htn, CV issues, preg. class X

34
Q

teriparatide

A

Osteoporosis
PTH analog
AE: orthostatic hypotension, dizziness, headache, N/V
Monitor for chest pain, hypotension, nausea, vomiting, arthralgia, leg cramps, and dyspnea at beginning of and regular intervals during therapy.

35
Q

Ibuprofen, naproxen

A

NSAID
Uses: Arthritis, acute gout attack
AE: ulcers

36
Q

methotrexate

A

Arthritis
Disease Modifying Antirheumatic Drugs (DMARD), Nonbiologic
AE: neurotoxicity - seizures, headache
Close monitoring of CBC with differential, liver function tests, and renal function is important. Monitor for acute neurotoxicity. Signs include drowsiness, blurred vision, headaches, or stroke-like symptoms. Restrict alcohol intake to decrease hepatic toxicity

37
Q

etanercept (enbrel)

A

Rheumatoid Arthritis - SubQ injection
anti-TNF alpha
DMARD, biological
Monitor for signs of respiratory infections, liver function test

38
Q

colchicine

A

Acute gout attack
AE: diarrhea, N/V, fatigue, headache, abdominal pain
Monitor LFT, BUN/creatinine

39
Q

allopurinol

A

Prevention - Xanthine oxidase inhibitor
Obtain renal function; dosage adjustments may be needed. Monitor uric acid levels, CBC, liver function tests, and renal function tests. Monitor for therapeutic response; frequency and severity of gouty attacks. Observe for signs of hypersensitivity

40
Q

heparin

A

DVT - anticoagulants

Hemoglobin, hematocrit, signs of bleeding; fecal occult blood test; aPTT (or antifactor Xa activity levels) or ACT depending upon indication

41
Q

enoxaparin (Lovenox)

A

DVT - anticoagulants

LMW heparin

42
Q

dabigatran

A

DVT - anticoagulants
Direct thrombin inhibitor
Take with full glass of water

43
Q

rivaroxaban (Xarelto)

A

DVT - anticoagulants
Direct Xa inhibitor
Avoid abrupt discontinuation in patients with atrial fibrillation; increased risk of stroke
Monitor aPTT, PT

44
Q

warfarin (Coumadin)

A

DVT - anticoagulants
Vit K antagonist
Monitor INR

45
Q

morphine

A

Pain (mod-severe)
Opioid
AE: respiratory depression

46
Q

dantrolene

A

Malignant Hyperthermia
Skeletal muscle relaxant
AE: flushing, tachycardia
Monitor vital signs, IV site, cardiac function

47
Q

dantrolene

A

Malignant Hyperthermia

Skeletal muscle relaxant

Pathophysiology/Pharmacology (3 decks)

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