Exam 2 Drugs Flashcards by Isaiah Smith

BCG Vaccine Intravesical Therapy: Class

Intravesical Therapy

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BCG Vaccine: MOA

-Stimulates inflammatory response in the bladder —> goal is for the immune system to recognize cancerous cells and attack

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BCG Vaccine: Indication

Bladder Cancer

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BCG Vaccine: Major Adverse Reactions

-Bladder irritation

-Systemic infection (live bacteria)

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BCG: NSG considerations

Given weekly for 6-12 weeks

Disinfect urine for 6 hours post treatment; watch for infection

Live vaccine: Do not give to immunocompromised

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BCG Vaccine Patient Instructions

Patient Instructions

Empty bladder
Instill Vaccine into bladder (dwell 2 hours)
Change positions q 15

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Sodium Bicarbonate: MOA

Alkaline agent and decrease pH

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Sodium Bicarbonate: Indications

-Metabolic acidosis causing CKD

-Slow CKD
Prevent bone loss
Improve nutritional status

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Sodium Bicarbonate: Adverse Effects

Bloating

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Sodium Bicarbonate: NSG considerations

-Initiate when HCO3 is less than 15 mEq/mL: Goal is 18-20

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Calcium Carbonate: MOA

Binds to phosphate

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Calcium Carbonate: Indications

-Hyperphosphatemia

-Keep normal phosphate levels

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Calcium Carbonate: Adverse Reactions and NSG consideration

Hypercalcemia

take with meals

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Calcitriol: MOA

-Activated from vitamin D; stimulate intestinal absorption of calcium/phosphate and bone mineralization

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Calcitriol: Indications

Used to treat renal osteodystrophy

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Calcitriol: Adverse Reactions

Hypercalcemia

Hypophosphatemia

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Calcitriol: Nsg Consideration

-25 dihydroxy vitamin D (active forum)

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5 alpha reductase inhibitor drugs

finasteride

dutasteride

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finasteride and dutasteride: MOA

-Blocks conversion of testosterone to DHT (alpha 1 receptors)

-Decrease epithelial tissue in prostate

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finasteride and dutasteride: Indications

Mechanical obstruction of urethra

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finasteride and dutasteride: Adverse Reactions

-Impotence

-Decreased libido (5-10%)

-Gynecomastia

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finasteride and dutasteride: NSG considerations

-Works best in men’s prostates who are very enlarge

-6-12 months for the med to work and take for the rest of your life

-Increase hair growth and used to treat baldness

-Decrease PSA levels and if the PSA doesn’t fall evaluate for prostate cancers

-Women should not handle this drug because it can cause birth defects in men

-Cannot donate blood

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tamsulosin: Class

Alpha 1 Adrenergic Antagonist

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tamsulosin: MOA

-Relaxes smooth muscle cells

-Selective for alpha receptors in the prostate

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tamsulosin: Indications

Dynamic obstruction of urethra

tamsulosin: Adverse Reactions

Abnormal ejaculation Well tolerated

tamsulosin: Nsg consideration

-Works quickly but has to be taken for life to maintain benefits

sildenafil: class

PDE-5 inhibitors

sildenafil: MOA

-Inhibits PDE5 -Increases and preserves cGMP levels -Only enhance the normal response to sexual stimulation

sildenafil: Indication

-Relief of ED

sildenafil: Adverse Reactions

-HA 16% -Flushing 10% -Dyspepsia 7% -Priapism: Erection that is painful or last more than 4 hours medical emergency -No more than once per day

sildenafil: Nsg Consideration

-Take up to 4 hours before sexual activity (onset 30-60 minutes) -Contraindicated: Preexisting CV disease or if on nitrate and hypotension -Do not take with nitrates -If you have chest pain or signs of heart attack call 911 -Sudden loss of vision or sudden loss of hearing

timolol: class

Nonselective Optic-topical beta blocker

timolol: MOA

-Block sympathetic nervous system stimulation beta receptors

timolol: Indication

OA glaucoma

timolol: Adverse Reaction

-Transient burning and discomfort -If allowed to go systemic can have systemic effects

timolol: Nsg Consideration

-Contraindications: Same as oral BETA blockers -Must take- otherwise will progress to blindness

betaxolol

Optic-topical beta blockers Selective

latanoprost: class

Prostaglandin analogs

latanoprost: MOA

Increase outflow drainage of AH

latanoprost: Indication

OA glaucoma Ocular HTN

latanoprost: Adverse reaction and Nsg consideration

none

brimonidine: Class

Alpha-adrenergic agonist

brimonidine: MOA

Decrease AH productions, may increase drainage/outflow

brimonidine: Indications

OA glaucoma Increase IOP

brimonidine: Adverse Reactions

-Burning/stinging -Dry mouth -Fatigue - HA - BV - Hypotension

dorzolamide: class

Carbonic Anhydrase Inhibitor

dorzolamide: MOA

Decrease AH productions

dorzolamide: Indications

Second line OA glaucoma and increase IOP

dorzolamide: Adverse Reactions

-Stinging -Bitter taste -Allergic reactions (conjunctiva or lid reactions)

pancrelipase: Class

Pancreatic enzyme replacment

pancrelipase: MOA

Replace pancreatic enzymes

pancrelipase: Indications

Chronic pancreatitis

pancrelipase: Adverse reaction and NSG

Rare take with every meal or snack

lactulose: Class

Hyperosmotic laxative

lactulose: MOA and Indication (same)

-Reduces blood ammonia absorption in hepatic encephalopathy

lactulose: Adverse Reaction + Nsg consideration

None -PO or Enema -Can be given to titrate by number of stools or by ammonia levels -Not just given for high ammonia levels --- must have S/S of encephalopathy -Make sure patient is NOT hypokalemic

rifaximin: MOA

-Inhibits bacterial RNA synthesis by binding to bacterial DNA (initially used as an antibiotic for GI infections)

rifaximin: Indication

Hepatic encephalopathy

rifaximin: Adverse Reactions

-Peripheral edema -Nausea -Ascites -Dizziness -Fatigue -Pruritis -Skin rash -Abdominal pain -Anemia

rifaximin: Nsg Consideration

-Second line if -lactulose isn’t working -Sometimes given as preventive -Associated with increased risk of C diff