Exam 2 Drugs Flashcards

1
Q

atorvastatin (Lipitor) category

A

Statins

reduce cholesterol

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2
Q

atorvastatin (Lipitor) minor adverse effects

A

headache, fatigue, muscle or joint pain, and heartburn, neuropathy

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3
Q

atorvastatin (Lipitor) severe adverse effects

A

severe myopathy & rhabdomyolysis,

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4
Q

atorvastatin (Lipitor) nursing considerations

A

liver function tests
no alcohol
monitor for muscle pain or weakness

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5
Q

weaker statin sisters

A

lovastatin (Mevacor)
fluvastatin (Lescol)
pravastatin (Pravachol)

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6
Q

Stronger statin sisters

A

simvastatin (Zocor)
atorvastatin (Lipitor)
rosuvastatin (Crestor)

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7
Q

cholestyramine (Questran) category

A

Bile-Acid Resins

lower cholesterol

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8
Q

cholestyramine (Questran) adverse effects

A

GI: bloating and constipation, abdominal pain

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9
Q

cholestyramine (Questran) nursing considerations

A

Do not take with other drugs! Take w/food, Mix w/H20

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10
Q

niacin (active form vitamin B3) category

A

Nicotinic Acid-Niacin

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11
Q

niacin (active form vitamin B3) levels

A

As vitamin-25mg/d

As lipid lowering-2-3g/d

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12
Q

niacin (active form vitamin B3) primary use

A

lower VLDL

raise HDL

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13
Q

niacin (active form vitamin B3) adverse effects

A

flushing, (take ASA 30 min before dose) hot flashes, nausea, excess gas, diarrhea

serious: hepatotoxicity, gout, increased blood sugar

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14
Q

niacin (active form vitamin B3) teaching

A

3X/day, w/or wo meals

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15
Q

gemfibrozil (Lopid) category

A

Fibric-Acid Agent

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16
Q

gemfibrozil (Lopid) use

A

treat severe hypertriglyceridemia

combine w/statin for more better result

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17
Q

gemfibrozil (Lopid) adverse effects

A

GI distress, watch for bleeding with clients on anticoagulants, myalgia (check CK), rash, fatigue, cholelithiasis, pancreatitis, liver toxicity

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18
Q

gemfibrozil (Lopid) considerations

A

give 30 minutes prior to morning & evening meals, Ø ETOH

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19
Q

ezetimibe (Ezetrol, Zetia), ezetimibe + simvastatin (Vytorin) use

A

inhibits absorption of cholesterol

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20
Q

ezetimibe (Ezetrol, Zetia), ezetimibe + simvastatin (Vytorin) considerations

A

Administer with statin to avoid body making more cholesterol

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21
Q

ezetimibe (Ezetrol, Zetia), ezetimibe + simvastatin (Vytorin) adverse effects

A

hepatitis, myopathy

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22
Q

hydrochlorothiazide (HydroDiuril) mechanism of action

A

to increase amount of urine produced and excreted

Thiazide diuretic

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23
Q

hydrochlorothiazide (HydroDiuril) adverse effects

A

electrolyte imbalances, especially loss of potassium

erectile dysfunction

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24
Q

hydrochlorothiazide (HydroDiuril) use

A

for mild to moderate hypertension

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25
Q

furosemide (Lasix) mechanism of action

A

Loop diuretic

increase urine flow, reducing blood volume and cardiac workload

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26
Q

furosemide (Lasix) use

A

reduce edema and pulmonary congestion

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27
Q

furosemide (Lasix) adverse effects

A

dehydration, electrolyte imbalance, hypotension, ototoxicity

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28
Q

spironolactone (Aldactone) catagory

A

Potassium-Sparing Diuretic

Mild diuresis

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29
Q

spironolactone (Aldactone) adverse effects

A

hyperkalemia, dysrhythmias, HA, fatigue, dizziness, blood dyscrasias

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30
Q

spironolactone (Aldactone) adverse effects in men

A

gynecomastia, impotence, ↓libido

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31
Q

spironolactone (Aldactone) adverse effects in women

A

hirsutism, breast tenderness, menstrual irregularities, voice deepening

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32
Q

nifedipine (Procardia) category

A

Calcium Channel Blocker

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33
Q

nifedipine (Procardia) mechanism of action

A

to cause vasodilation, decreasing B/P

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34
Q

nifedipine (Procardia) use

A

for hypertension and angina

possible use w/ small kidney stones to dilate urethra

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35
Q

nifedipine (Procardia) adverse effects

A

possible male infertility, sexual difficulties, “male contraceptive”

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36
Q

nifedipine (Procardia) considerations

A

check kidney, liver labs

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37
Q

Enalapril (Vasotec) category

A

ACE inhibitor

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38
Q

Enalapril (Vasotec) use

A

lower blood pressure & peripheral resistance

Helps renal failure, diabetic neuropathy

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39
Q

Enalapril (Vasotec) adverse effects

A

first-dose hypotension, orthostatic hypotension, cough, HA, dizziness, angioedema, neutropenia, agranulocytosis, ↑ K+

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40
Q

carvedilol (Coreg) category

A

Beta & Alpha-Adrenergic Blocker

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41
Q

carvedilol (Coreg) mechanism of action

A

slow heart rate and B/P, reducing workload of heart

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42
Q

carvedilol (Coreg) use

A

reduce symptoms of heart failure and slow progression of disease

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43
Q

carvedilol (Coreg) adverse effects

A

fluid retention, fatigue, heart block,

↓ libido, impotence, depression, lethargy

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44
Q

lisinopril (Prinivil, Zestril)

category

A

ACE inhibitor

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45
Q

lisinopril (Prinivil, Zestril) mechanism of action

A

vasodilation & enhance excretion of sodium and water

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46
Q

lisinopril (Prinivil, Zestril) primary use

A

HF, HTN

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47
Q

lisinopril (Prinivil, Zestril) adverse effects

A

first-dose hypotension, cough, hyperkalemia, renal failure, neutropenia
Takes 2-3 weeks for effects

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48
Q

metoprolol extended release (Toprol-XL), (Lopressor)

category

A

Beta-Adrenergic Blocker

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49
Q

metoprolol extended release (Toprol-XL), (Lopressor)

mechanism of action

A

slow heart rate and B/P, reducing workload of heart

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50
Q

metoprolol extended release (Toprol-XL), (Lopressor)

use

A

slow progression of HF and reduce long-term consequences of HF

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51
Q

metoprolol extended release (Toprol-XL), (Lopressor) adverse effects

A

hypotension, bradycardia

*Start with 1/10 of target does
to avoid worsening HF

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52
Q
isosorbide dinitrate (Isordil)
category
A

Vasodilator

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53
Q
isosorbide dinitrate (Isordil)
mechanism of action
A

relax blood vessels

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54
Q
isosorbide dinitrate (Isordil)
use
A

lower blood pressure

Used for PT’s who cannot take ACE inhibitors

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55
Q
isosorbide dinitrate (Isordil)
adverse reactions
A

reflex tachycardia, orthostatic hypotension

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56
Q

digoxin (Lanoxin) category

A

Cardiac Glycoside

57
Q

digoxin (Lanoxin) dose

A

0.125-0.25 mg/day

max dose: 1mg/day

58
Q

digoxin (Lanoxin) adverse effects

A

neutropenia, dysrhythmias, digitalis toxicity, hold for pulse <60

59
Q

milrinone (Primacor) category

A

Phosphodiesterase Inhibitors

60
Q

milrinone (Primacor) use

A

as short-term therapy for heart failure, given IV

decrease afterload

61
Q

milrinone (Primacor) adverse effects

A

hypokalemia, hypotension, ventricular dysrhythmias

*check K+ levels

62
Q

Nesiritide (Natrecor)

A

Structurally related to endogenous human beta-type natriuretic peptide (hBNP)

63
Q

Nesiritide (Natrecor) adverse effects

A

severe hypotension (requires continuous cardiac monitoring)

64
Q

nitroglycerin (Nitrostat) mechanism of action

A

to be potent vasodilator

65
Q

nitroglycerin (Nitrostat)

use

A

for lowering myocardial oxygen demand

66
Q

nitroglycerin (Nitrostat)

administration time

A

Change nitro patch every 24 hours

Sublingual tabs every 5 min x 3

67
Q

nitroglycerin (Nitrostat)

adverse effects

A

hypotension, dizziness, blurred vision, dry mouth, headache

68
Q

clopidogrel (Plavix) category

A

ADP receptor blocker

Antiplatelet Drug

69
Q

Plavix mechanism of action

A

to alter the plasma membrane of platelets so they cannot aggregate

70
Q

Plavix use

A

to prevent thrombi formation after a stroke or myocardial infarction (MI)

71
Q

Plavix adverse effects

A

abnormal bleeding

No serious other side effects

72
Q

alteplase (Activase) category

A

Thrombolytics “ase”

73
Q

alteplase (Activase) mechanism of action

A

converts plasminogen to plasmin, which digests fibrin and dissolves clot

74
Q

alteplase (Activase) use

A
dissolve existing clots
treat acute MI (w/in 12 hrs)
DVT
CVA (w/in 4.5 hrs)
pulmonary embolism
arterial thrombosis
To clear IV catheters (2mg)
75
Q

alteplase (Activase) adverse effects

A

bleeding

76
Q

Filgrastrim (Neupogen) category

A

Granulocyte colony-stimulating factor

77
Q

Filgrastrim (Neupogen) action

A

Increase production of neutrophils in bone marrow

78
Q

Filgrastrim (Neupogen) uses

A

Chronic neutropenia or neutropenia secondary to chemotherapy

79
Q

Filgrastrim (Neupogen) adverse effects

A

BONE PAIN

80
Q

Pegfilgrastim (Neulasta) category

A

Granulocyte colony-stimulating factor

81
Q

Pegfilgrastim (Neulasta) action

A

Form of filgrastim but with molecule of polyethylene glycol (PEG), PEG decreases renal excretion allowing for longer duration of action

82
Q

Pegfilgrastim (Neulasta) adverse effects

A

BONE PAIN

83
Q

Granulocyte macrophage colony-stimulating factor (GM-CSF) (Leukine) action

A

Causes progenitor (parent) cells to divide into granulocyte macrophage (WBC that destroys bacteria through phagocytosis)

84
Q

Granulocyte macrophage colony-stimulating factor (GM-CSF) (Leukine) uses

A

Induce and support myeloid reconstitution after bone marrow transplant, acute myelogenous leukemia

85
Q

Granulocyte macrophage colony-stimulating factor (GM-CSF) (Leukine) adverse effects

A

leukocytosis, peripheral edema, capillary leak syndrome, weight gain, pericardial/pleural effusion

86
Q

Recombinant human interleukin 11 (Neumega) category

A

platelet enhancer

87
Q

Recombinant human interleukin 11 (Neumega) action

A

Platelet growth factor

88
Q

Recombinant human interleukin 11 (Neumega) uses

A

Prevent recurrent chemotherapy-induced thrombocytopenia and reduce need for platelet transfusions

89
Q

Recombinant human interleukin 11 (Neumega) adverse effects

A

edema

90
Q

cyanocobalamin (Crystamine, vitamin B12, others) mechanism of action

A

replace vitamin B12

91
Q

cyanocobalamin (Crystamine, vitamin B12, others) use

A

treatment of vitamin B12 deficiency

92
Q

cyanocobalamin (Crystamine, vitamin B12, others) adverse effects

A

diarrhea, hypokalemia, rash, anaphylaxis

93
Q
ferrous sulfate (Feosol, others)
mechanism of action
A

supplement iron needed by body

94
Q

ferrous sulfate (Feosol, others) adverse effects

A

Nausea, heartburn, constipation, dark stools
Cardiovascular collapse, aggravation of peptic ulcers or ulcerative colitis
Hepatic necrosis, anaphylaxis (iron dextran)

95
Q

ferrous sulfate (Feosol, others) nursing considerations

A

monitor CBC and stool
rest
administer on empty stomach if possible
do not allow child access to medication

96
Q

Palifermin (Kepivance) use

A

prevent & treat oral mucositis

97
Q

Palifermin (Kepivance)

A

growth factor that stimulates cell production growth and development
Decreases time to replace the cells of the oral mucosa
Give IV 3 days before and 3 days after chemo

98
Q

Tyrosine Kinase Inhibitor action

A

Inhibition of EGFR-TK leads to inhibition of tumor growth and progression and promotion of cancer cell death.

99
Q

Tyrosine Kinase Inhibitor side effects

A

GI: diarrhea, nausea and vomiting
Cutaneous: rash, dry skin, pruritis, photosensitivity, inflammation
Pulmonary disease is rare

100
Q

Tyrosine Kinase Inhibitor example

A

erlotinib (TarcevaTM)

101
Q

penicillin G (Pentids)

A

Ampicillin, Amoxicillin, Ticarcillin

“cillin”

102
Q

penicillin G (Pentids) mechanism of action

A

to kill bacteria by disrupting cell walls with penicillin’s beta-lactam ring

103
Q

penicillin G (Pentids) use

A

tx of streptococci, pneumococci, & staphylococci organisms that do not produce penicillinase
Also gonorrhea and syphilis

104
Q

penicillin G (Pentids) adverse effects

A

diarrhea, nausea, vomiting, superinfections, anaphylaxis, nullify birth control pills
allergy is most common

105
Q

penicillin G allergy

A

most common reaction

avoid cephalosporins

106
Q

cefotaxime (Claforan) mechanism of action

A

to act with broad-spectrum activity against gram-negative organisms

107
Q

cefotaxime (Claforan) use

A

serious infections of lower respiratory tract, central nervous system, genitourinary system, bones, blood, and joints

108
Q

cefotaxime (Claforan) adverse effects

A

hypersensitivity, anaphylaxis, diarrhea, vomiting, nausea, pain at injection site, ↓ prothrombin levels, renal and hepatic function
avoid alcohol

109
Q

tetracycline HCL (Sumycin) mechanism of action

A

effective against broad range of gram + and - organisms

110
Q

tetracycline HCL (Sumycin) use

A

chlamydia, typhus, cholera, rickettsiae, Lyme, & mycoplasma

111
Q

tetracycline HCL (Sumycin) adverse effects

A

superinfections, GI: nausea, vomiting, epigastric burning, diarrhea, discoloration of teeth, photosensitivity

112
Q

tetracycline HCL (Sumycin) examples

A

Tetracycline, Doxycyline (Vibramycin), Minocycline (Minocin)

113
Q

Aminoglycosides

A

Narrow-spectrum drugs, bactericidal

for G- bacteria

114
Q

Aminoglycosides use

A

serious urinary, respiratory, nervous, or GI infections

115
Q

Aminoglycosides adverse effects

A

ototoxicity & nephrotoxicity

116
Q

Fluoroquinolones examples

A

Ciprofloxacin (Cipro), levofloxacin (Levaquin)

117
Q

Sulfamethoxazole, (Bactrim, Septra) use

A

UTIs, Pneumocystis carinii pneumonia, shigella infections of small bowel, and acute episodes of chronic bronchitis

118
Q

Sulfamethoxazole, (Bactrim, Septra) adverse effects

A

skin rashes, nausea, vomiting, agranulocytosis or thrombocytopenia, photosensitivity, anemia or other hematological disorders
stevens johnson syndrome

119
Q

Sulfamethoxazole, (Bactrim, Septra) considerations

A

Assess renal function; increases risk for crystalluria

120
Q

Metronidazole (Flagyl) use

A

treat H. pylori infections of stomach & parasites

121
Q

Clindamycin (Cleocin) use

A

for oral infections caused by bacteroides

Associated with pseudomembranous colitis

122
Q

Vancomycin (Vancocin) use

A

MRSA infections

123
Q

Vancomycin (Vancocin) adverse effects

A

ototoxicity, nephrotoxicity, red man syndrome

give over at least 1 hour

124
Q
amphotericin B (Fungizone)
mechanism of action
A

binds to ergosterol in fungal-cell membranes

Mainly IV, little resistance

125
Q

amphotericin B (Fungizone) use

A

has wide spectrum of activity

Includes most fungi pathogenic to humans

126
Q

amphotericin B (Fungizone) adverse effects

A

fever,
chills, rigor
vomiting, headache at beginning of therapy
Phlebitis common during IV therapy
Nephrotoxicity, electrolyte imbalances common
Cardiac arrest, hypotension, dysrhythmias possible

127
Q

fluconazole (Diflucan) mechanism of action

A

to act by interfering with synthesis of ergosterol

128
Q

fluconazole (Diflucan) use

A

treat fungal infections in CNS, bone, eyes, urinary tract, respiratory tract
Not effective against nonalbicans Candida species

129
Q

fluconazole (Diflucan) adverse effects

A

Few-nausea, vomiting, diarrhea reported at high doses, hepatotoxicity rare unlike ketoconazole

130
Q

fluconazole (Diflucan) advantages

A

Rapid absorption- 1 tablet!

Few serious side effects

131
Q

fluconazole (Diflucan) disadvantages

A

narrow spectrum-candida albicans only

132
Q

nystatin (Mycostatin) mechanism of action

A

binds to sterols in the fungal-cell membrane, allowing leakage of intracellular contents

133
Q

nystatin (Mycostatin) use

A

Candida infections of intestines, vagina, skin, mouth

134
Q

nystatin (Mycostatin) adverse effects

A

minor skin irritation, nausea, vomiting, diarrhea

135
Q

nystatin (Mycostatin) dose

A

Adults: 400,000-600,000 units 4 X daily
Peds: 200,000 units 4X daily

136
Q

Choroquine (Aralen) mechanism of action

A

prevents metabolism of heme and builds toxic levels in the parasite

137
Q

Choroquine (Aralen) use

A

tx of malaria

138
Q

Choroquine (Aralen) adverse effects

A

nausea and diarrhea

CNS and cardiovascular toxicity at high doses

139
Q

metronidazole (flagyl) adverse effects

A

Anorexia, N/V, diarrhea, metallic taste, HA

no alcohol!