Exam 2 drugs Flashcards
BCG vax MOA
Stim inflam response in bladder so own immune sys recognized cancerous cells and attacks
BCG vax indications
Bladder cancer
BCG vax SE
Bladder irritation (UTI sx last even after tx), systemic infection
BCG vax NC
- give weekly for 6-12W
- live vax–not for immunocomp
- Instructions–empty bladder, instill vax in with I&O cath, keep in 2h and change position q15 minutes
- disinfect urine for 6h post-tx bleach urine to kill bac)
Sodium bicarb MOA
Dec pH of pt and raise bicarb level
Sodium bicarb indications
Tx metabolic acidoses to slow KCD, prevent bone loss, and improve nutritional status
Sodium bicarb SE
Bloating
Sodium bicarb NC
- taken orally
- measure efficiency with bicarb level
- start when HCO3 less than 15 (goal is 18-20)
Finasteride (Proscar) and Dutasteride (Advodart) class
5-α-reductase inhibitors
Finasteride (Proscar) and Dutasteride (Advodart) MOA
Blocks conversion of T to DHT (alpha 1 receptors); dec epithelial tissue in prostate and mech obstruction of urethra but does NOT dec overall circulating T levels;
Dutasteride works on alpha 1 and 2 receptors
Finasteride (Proscar) and Dutasteride (Advodart) indications
Mechanical obstruction or urethra, pattern baldness in men and women
Finasteride (Proscar) and Dutasteride (Advodart) SE
Inc hair growth, impotence, dec libido, gynecomastia, birth defects
Finasteride (Proscar) and Dutasteride (Advodart) NC
- Works best in larger prostates but won’t affect smaller prostates much
- takes 6-12M to work
- need to take for rest of life
- dec prostate specific antigen (PSA) levels (check before start and 6M later)
- caution in handling for pregnant women–teratogenic (nurses don’t open or give)
- can’t donate blood
- Dutasteride works similarly
Tamsulosin (Flomax) class
Alpha 1 adrenergic antagonist
Tamsulosin (Flomax) MOA
Blocks alpha receptors and relax smooth muscles, selective for alpha receptors in prostate
Tamsulosin (Flomax) indications
dyanmic obs of urethra
Tamsulosin (Flomax) SE
Well tolerated, abnormal ejaculation
Tamulosin (Flomax) NC
- commonly used
- no systemic effect
- happens quickly
- taken for life
- can be used in combination therapy with a 5-α-reducatase inhibitor and will work better but $$$
Sildenafil (Viagra) class
PDE-5 inhibitors
Sildenafil (Viagra) MOA
Inhibits PDE5, inc and preserve cGMP levels, only enhances the normal response to sexual stimuli so will not work if that is not there
Sildenafil (Viagra) indications
Relief of ED, BPH, pulmonary arterial HTN
Sildenafil (Viagra) SE
HA, flushing, dyspepsia, CV issues
Sildenafil (Viagra) NC
- reliable
- does not affect men w/o ED
- up to 4h before sex and onset 30-60 min
- CI preexisting CV disease, hypotension
- CI nitrate RX, causes signif dec in BP and pass out
- call 911 if chest pain or s/s heart attach during sex, loss of vision in one or both eyes, loss of hearing
- not more than once per day
- priapism–painful erection that lasts over 4h–medical emergency
Timolol–nonselective
Betaxolol–B1 receptor blocker class
Optic-topical beta blockers
Timolol–nonselective
Betaxolol–B1 receptor blocker MOA
Block SNS stim of beta receptors
Timolol–nonselective
Betaxolol–B1 receptor blocker indications
Open-angle glaucoma maintenance tx, if acute-angle–need drops asap and other
Timolol–nonselective
Betaxolol–B1 receptor blocker SE
Transient burning and discomfort; if go systemic–systemic fx
Timolol–nonselective
Betaxolol–B1 receptor blocker NC
- CI–same as oral beta blockers (asthma, severe COPD, sinus brady or heart failure)–Betaxolol can be given to these pt
- must take or go blind
- apply nasolacrimol pressure
Lantanoprost (Xalatan) class
Prostaglandin analogs
Lantanoprost (Xalatan) MOA
Inc outflow drainage of aqueous humor
Lantanoprost (Xalatan) indications
Open-angle glaucoma, ocular HTN
Lantanoprost (Xalatan) SE
well-tolerated
Brimonidine (Alphagan) class and MOA
Alpha adrenergic agonist
- Dec AH production, may inc drainage/outflow
Brimonidine (Alphagan) SE
Burning/stinging, dry mouth, fatigue, HA, blurred vision, hypotension
Dorzalamide (Trusopt) class and MOA
Carbonic anyhydrase inhibitor
- dec production of aqueous humor
Dozalamide (Trusopt) indications
open angle inc IOP
Dozalamide (Trusopt) SE and NC
- Stinging, bitter taste, allergic rxns (conjunctiva or lid rxn)
- can be combined with timolol (Cosopt)
Calcium carbonate (tums) MOA
Binds to phosphate (phos binder essentially)
Calcium carbonate indications
Treat hyperphosphatemia
Calcium carbonate SE
hypercalcemia
Calcium carbonate NC
- take with meals
- monitor Ca levels
Calcitriol MOA
(1, 25- dihydroxyvitamin D); activated form of vit D, stim intestinal abs of calcium/phosphate, and bone mineralization
Calcitriol indications
Tx renal osteodystrophy
Calcitriol SE
Hypercal, hyperphos
Calcitriol NC
Monitor labs
Ciprofloxacin class and indications
- Fluroquinolones
- Treat UTIs, STIs, lower and upper resp infx, gonorrhea, other infx, anthrax
Ciprofloxacin SE and NC
- Arthropathy (joint disease), often irreversible; prolonged post-abx effect–concentrated in neutrophils
- PO, IV, topical
- minimal usage on BBB/CSF
- good for rapid and slow orgs
- avoid pt under 18 and over 60 (bc joints)
What does it mean if PSA does not decrease with finasteride?
Pt may have prostate cancer
