Exam 2 (Drugs 51 - 100) Flashcards
Venlafaxine HCl
Effexor (XR)
Potent inhibitor of neuronal 5-HT & NE reuptake
Venlafaxine
Do not begin within 14 days of D/C MAOI. Also, wait to start an MAOI until at least 7 days after D/C this drug.
Venlafaxine
ANTIDEPRESSANTS INCREASE SUICIDAL THOUGHTS AND ACTIONS IN SOME CHILDREN AND TEENAGERS
Venlafaxine, Mirtazapine, Paroxetine
Continued therapy of up to 2 weeks may be needed to show noticeable improvement
Venlafaxine
Clonidine HCl
Catapres (TTS)
Stimulates central alpha-adrenergic receptors resulting in inhibition of bulbar sympathetic cardioaccelerator and sympathetic vasoconstrictor centers
Clonidine
Dangerous increases in BP when used with beta-blockers and when either drug is D/C
Clonidine
Sudden cessation of therapy may produce severe HTN
Clonidine
Change transdermal skin sites with each application
Clonidine-TTS
Aripiprazole
Abilify
MOA is a combination of partial agonist activity at dopamine D2 and 5-HT1A receptors & antagonist activity at 5-HT2A receptors
Aripiprazole
CI IN PATIENTS WITH DEMENTIA-RELATED PSYCHOSIS
Aripiprazole
Rare cases of Neuroleptic Malignant Syndrome (NMS) have occurred in patients taking this med
Aripiprazole
TARDIVE DYSKINESIA is a rare possibility in patients taking this drug
Aripiprazole
Use appropriate precautions against heat exposure and dehydration
Aripiprazole
Store oral solution in the refrigerator and use within 6 months of opening the bottle
Aripiprazole
Lisinopril with HCTZ
Zestoretic, Prinzide
Electrolyte disturbances may cause DIGITALIS-induced arrhythmias
Lisinopril w/HCTZ
CI in patients with a history of angioedema related to a previous treatment with an ACEI
Lisinopril w/HCTZ
Timing of dose is important bc of increased diuresis. Usually given in the early AM.
Lisinopril w/HCTZ, Spironolactone, Triamterene with HCTZ
Morphine Sulfate (extended release)
MS Contin
Produces analgesia by a central action on the central opiate receptors
Morphine sulfate
CI in patients with respiratory depression in the absence of resuscitative equipment, and in patients with acute or severe bronchial asthma. Also CI in any patient with a paralytic ileus.
Morphine sulfate
Fenofibrate
Tricor
Lowers total cholesterol, LDL, and triglycerides by activation of peroxisome proliferator activated receptor-a (PPARa).
Fenofibrate
Avoid use in conjunction with HMG-CoA reductase inhibitors as this can lead to serious AE’s (rhabdomyolysis)
Fenofibrate
CI in patients with hepatic or severe renal dysfunction, including primary biliary cirrhosis, in patients with unexplained persistent liver function abnormality, and in patients with preexisting gallbladder disease
Fenofibrate
Serious liver toxicity is a potential AE of this drug therapy
Fenofibrate
Promptly report RASH, MUSCLE PAIN, TENDERNESS, or WEAKNESS (signs of myositis)
Fenofibrate
Important to closely follow prescribed diet with this medication
Fenofibrate
Rosuvastatin Calcium
Crestor
Selective, competitive inhibitor of HMG-CoA reductase
Rosuvastatin, Pravastatin
CI in patients with active liver disease or with unexplained persistent elevations of serum transaminases and during pregnancy and lactation
Rosuvastatin, Pravastatin
Azithromycin Dihydrate
Zithromax & Zmax
A macrolide antibiotic that binds to the 50S ribosomal subunit of susceptible bacteria thereby suppressing protein synthesis
Azithromycin
Pseudomembranous colitis and secondary bacterial infections may occur with broad spectrum abx
Azithromycin
Do not use for complicated pneumonia, gonorrhea, or syphilis
Azithromycin
Do not take antacids within 1 hour of administration (slow drug absorption)
Azithromycin
Pravastatin Sodium
Pravachol
Grapefruit juice has little to no effect on plasma levels
Pravastatin
May cause optic nerve degeneration
Pravastatin
Avoid overexposure to sunlight due to possibility of photosensitivity. Use a sunscreen and wear appropriate clothing until the level of sensitivity is determined.
Pravastatin
Naproxen
Naprosyn
MOA probably due to inhibition of cyclooxygenase resulting in decreased biosynthesis of prostaglandins
Naproxen
NSAID’s may produce serious GI toxicity with or without warnings
Naproxen
May require up to 2 weeks to see noticeable improvement in arthritic conditions
Naproxen
Concurrent ingestion of alcohol may increase ulcerogenic effect
Naproxen
Tamsulosin HCl
Flomax
Selective alpha-adrenergic blocking agent for receptors found in the prostate (used in BPH). Blocking these receptors relaxes the prostate gland and bladder neck to result in increased urinary flow and a reduction in BPH symptoms.
Tamsulosin
Orthostatic hypotension may occur during therapy, therefore patients should be warned about possible syncope and dizziness
Tamsulosin
Take dose 1/2 hour following the same meal every day
Tamsulosin
Divalproex Sodium
Depakote (ER)
MOA thought to be related to increased brain levels of GABA
Divalproex
CI in patients with hepatic disease (hepatic failure resulting in fatalities has occurred in patients receiving this drug)
Divalproex
Capsules may be swallowed whole or the contents sprinkled over soft food and ingested without chewing
Divalproex
Donepezil HCl
Aricept
A reversible acetylcholinesterase inhibitor that works centrally to increase the amount of acetylcholine available at cholinergic synapses
Donepezil
CI in patients with known hypersensitivity to the drug or piperidine derivatives
Donepezil
May be beneficial to D/C use prior to known anesthesia. May cause vagotonic effects on the heart therefore use caution in patients with sick sinus syndrome. May increase gastric acid secretion therefore use caution in patients prone to ulcers or GI bleeding
Donepezil
Take in the evening, just prior to retiring. May be taken with or without food
Donepezil
Ibuprofen
Motrin
Produces a reversible inhibition of cyclooxygenase which results in a decreased synthesis of prostaglandins
Ibuprofen
Not recommended in pregnancy due to the known effects of this class of drugs on the human fetal cardiovascular system (closure of the ductus arterioles)
Ibuprofen
Pregabalin
Lyrica
High binding affinity to the alpha(2)-delta site in CNS tissues
Pregabalin
When discontinuing therapy, taper gradually over a minimum of 1 week
Pregabalin
Peripheral edema has been reported, especially in patients also taking thiazolidinedione antidiabetic agents
Pregabalin
Oral solution must be used within 45 days of opening the stock container
Pregabalin
Lamotrigine
Lamictal (XR)
MOA unknown - may be due to inhibition of voltage-sensitive sodium channels, resulting in a stabilization of neuronal membranes and modulation of presynaptic transmitter release of excitatory amino acids (glutamate & aspartate)
Lamotrigine
Use with ORAL CONTRACEPTIVES may decrease the serum concentrations of the progestin component while significantly decreasing the serum concentration of this drug
Lamotrigine
Serious life-threatening rashes have been reported in association with the use of this drug. Rashes usually occur within the first two weeks of therapy and are more common in pediatric patients.
Lamotrigine
Chewable tablets may be chewed or dispersed in a teaspoonful of water or diluted fruit juice
Lamotrigine
Alendronate Sodium
Fosamax
Adheres to sites of bone resorption inhibiting osteoclast activity
Alendronate
As a general rule, do not administer any oral medication within 30 minutes of this drug
Alendronate
CI in patients with abnormalities of the esophagus which delay esophageal emptying such as stricture or achalasia, in patients who cannot sit upright or stand for at least 30 minutes, and in patients with hypocalcemia. Can cause severe local irritation of the upper GI mucosa
Alendronate
Must be swallowed with 6 - 8 ounces of plain water immediately upon arising for the day (at least 30 minutes before the first food, beverage, or medication for the day). Do not lie down for 30 minutes after swallowing the tablet and not until the first food of the day has been consumed.
Alendronate
Isosorbide mononitrate (antianginal)
Imdur
Acts by reduction of myocardial oxygen demand through the relaxation of vascular smooth muscle
Isosorbide
CI in patients who are hypersensitive to nitrates
Isosorbide
Use is not recommended in acute phase of MI or in those with congestive HF. Use with caution in patients with hypotension or volume depletion.
Isosorbide
Tolerance and physical dependence may occur after prolonged use
Isosorbide
Most common AE’s include headache (50%) and dizziness (10%)
Isosorbide
May cause dizziness, headache, or flushing. Headaches are a sign of drug effectiveness. Do not adjust dosage to treat headaches - use aspirin or APAP as needed.
Isosorbide
Spironolactone
Aldactone
Works by competitive antagonism of aldosterone, primarily at the aldosterone-dependent Na+/K+ exchange sites in the distal convoluted renal tubule
Spironolactone
CI in patients with anuria, acute renal insufficiency, significant impairment of renal function, hyperkalemia, and in patients hypersensitive to sulfonamides
Spironolactone
Common AE’s include WEAKNESS, PARESTHESIA, MENTAL CONFUSION, DRY MOUTH, & MUSCLE CRAMPS
Spironolactone
Losartan Potassium
Cozaar
Blocks the vasoconstrictor and aldosterone-secreting effects of angiotensin II by selectively blocking the binding of angiotensin II to the AT1 receptor found in many tissues (ARB)
Losartan
Glipizide
Glucotrol (XL)
A sulfonylurea antidiabetic medication that stimulates insulin synthesis and release from beta cells in the pancreatic islets
Glipizide
CI in juvenile, unstable (labile), or complicated DM as the sole therapy, in patients allergic to sulfa drugs, and in diabetic ketoacidosis with or without coma
Glipizide, Glyburide
In patients with severe burns, infections, or trauma, this drug may need to be D/C and insulin given
Glipizide, Glyburide
Mild hypoglycemic reactions (sweating, tremor, blurred vision, weakness, hunger, and confusion) may occur rarely and should be treated with oral glucose
Glipizide, Glyburide, Glimepiride
Take 30 minutes prior to meals. Compliance with therapy is essential for optimum effect. Follow prescribed diet closely. Avoid excessive use of alcohol.
Glipizide
Risperidone
Risperdal
Thought to act by direct antagonism of dopamine (D2) and serotonin (5-HT2) receptors in the CNS
Risperidone
CI IN PATIENTS WITH DEMENTIA-RELATED PSYCHOSIS. Antipsychotic drugs have produced a potentially fatal symptom complex called neuroleptic malignant syndrome (NMS). Do not dispense large quantities of this drug to suicidal patients.
Risperidone
EXTRAPYRAMIDAL SYMPTOMS & TACHYCARDIA are two big AE’s of this drug
Risperidone
May cause fainting with initial doses - use caution when getting up from a sitting or lying position. Solution is compatible with orange juice, coffee, and low-fat milk.
Risperidone
M-Tab tablets must be used immediately after opening their blister. Do not try to push the tablet through the blister. Open with dry hands and do not try to split or store tablets after the blister is opened.
Risperidone
Carisoprodol
Soma
May work centrally in the spinal cord or the descending reticular formation to produce muscle relaxation. The metabolite is meprobamate.
Carisoprodol
CI in acute intermittent porphyria (rare disease in which hemoglobin is abnormally metabolized)
Carisoprodol
Ropinirole HCl (antiparkinson)
Requip (XL)
A non-ergoline dopamine agonist with full intrinsic activity at the D2 & D3 dopamine receptor subtypes
Ropinirole
Patients have reported sudden initiation of sleep without warning. This has occurred during normal activities of daily living, including the operation of vehicles.
Ropinirole
Cigarette smoking decreases AUC by 38%. Inform the physician if planning to start or stop smoking
Ropinirole
If being taken for Parkinson’s disease, do not stop therapy abruptly; treatment should be tapered over time
Ropinirole
Diazepam
Valium
Facilitates the inhibitory neurotransmitter action of GABA, which mediates both pre- and post-synaptic inhibition in all regions of the CNS
Diazepam
CI in patients with myasthenia gravis, severe respiratory insufficiency, severe hepatic insufficiency, in sleep apnea, in children under the age of 6 months, in narrow-angle glaucoma, and in untreated open-angle glaucoma
Diazepam
Oral concentrate must be diluted prior to use
Diazepam
Allopurinol
Zyloprim
Competitively inhibits xanthine oxidase which is the enzyme responsible for the conversion of hypoxanthine to xanthine to uric acid
Allopurinol
Gout attacks may increase during initiation of therapy. Use colchicine or NSAIDs prophylactically
Allopurinol
A sufficient fluid intake (to yield urine output of 2 liters per day) and the maintenance of a neutral to slightly alkaline urine are recommended to avoid the formation of xanthine calculi and to help prevent renal precipitation of urates in patients receiving concomitant uricosuric agents.
Allopurinol
Compliance with therapy is essential. May take one or more weeks to reach maximum effectiveness. High fluid intake during therapy is beneficial to help prevent kidney stone formation.
Allopurinol
Mirtazapine
Remeron
Antagonist of central presynaptic alpha-2 adrenergic inhibitory auto receptors and heteroreceptors, an action that is postulated to result in an increase in central noradrenergic and serotonergic activity
Mirtazapine
SolTabs must be used immediately upon opening individual tablet blisters
Mirtazapine
Oxybutynin Chloride (oral) (urinary bladder modifier)
Ditropan (XL)
Inhibits the muscarinic action of acetylcholine on smooth muscle. Blockage does not occur at skeletal neuromuscular junctions or autonomic ganglia. Relaxes bladder smooth muscle which decreases urgency, frequency, urinary leakage, and dysuria.
Oxybutynin
CI in uncontrolled narrow-angle glaucoma, urinary retention, and gastric retention
Oxybutynin
Heat prostration can occur in the presence of high environmental temperature. Avoid prolonged exposure to hot weather.
Oxybutynin
The semipermeable membrane tablet shell of the extended-release tablets passes through the GI tract intact and may be found in the stool
Oxybutynin
Pioglitazone HCl
Actos
A thiazolidinedione antidiabetic agent that decreases insulin resistance by improving target cell response to insulin (requires presence of insulin)
Pioglitazone
CI in patients with NYHA Class III or IV HF. Can exacerbate congestive HF. Because it requires insulin, do not use in T1DM
Pioglitazone
Quarterly HbA1c testing should be performed
Pioglitazone
Memantine HCl
Namenda (XR)
Works as a low to moderate affinity uncompetitive (open-channel) NMDA receptor antagonist
Memantine
Daily doses above 5 mg should be given BID and dose increases should not be made sooner than once a week
Memantine
Metoclopramide HCl
Reglan
MOA as an antiemetic is due to an inhibition of dopamine receptors which results in decreased nerve transmission from afferent nerves to the vomiting center and an increase in the vomiting center threshold
Metoclopramide
MOA as a GI motility stimulant is thought to be caused by an imbalance between dopaminergic and cholinergic actions in the GI tract through inhibition of dopamine induced gastric smooth muscle relaxation
Metoclopramide
CI in patients with pheochromocytoma, GI hemorrhage, mechanical obstruction or perforation, and in epilepsy. Do not use in patients receiving drugs that may cause EPS.
Metoclopramide
AE’s include restlessness, drowsiness, tardive dyskinesia, and fatigue
Metoclopramide
Take 30 minutes before meals (in order to achieve effects as a GI motility stimulant)
Metoclopramide
Baclofen
Lioresal
An analog of GABA, most likely works at the spinal cord level, reducing both the flexor and extensor spasms
Baclofen
Do not D/C abruptly due to risk of hallucinations and seizures
Baclofen
Phenylketonurics should be warned that orally-disintegrating tablets contain phenylalanine
Baclofen
Folic Acid (Folacin, Pteroylglutamine Acid; Folate)
No brand name
An important vitamin required for the synthesis of thymidylate, synthesis of purine nucleotides, and for maintenance of normal erythropoiesis. Deficiency can lead to megaloblastic anemias in adults and children & neural tube defects in unborn infants
Folic Acid
CI in the treatment of pernicious anemia and other megaloblastic anemias where vitamin B12 is deficient
Folic Acid
The US Public Health Services recommends the use of 0.4 mg of folic acid in women of childbearing age to reduce the incidence of neural tube defects.
Folic Acid
Amoxicillin Trihydrate
Amoxil, Moxatag, Trimox
Inhibits bacterial cell wall synthesis via acylation of the transpeptidase enzyme
Amoxicillin
Changes in GI flora may disrupt the absorption of oral contraceptives
Amoxicillin
CI in patients hypersensitive to PCNs and/or cephalosporins. Incidence of cross-sensitivity is 5 - 16%
Amoxicillin
AE’s are DIARRHEA, RASH, N/V, hives, itching
Amoxicillin
Preferably taken on an empty stomach 1 hour before or 2 hours after meals with a full glass (240 mL) of water. Take at even intervals, preferably around the clock
Amoxicillin
Keep suspension refrigerated. Discard after 14 days
Amoxicillin
Amphetamine with Dextroamphetamine Salts
Adderall (XR)
MOA in ADD is unknown. Causes CNS stimulation by a direct action on adrenergic receptors, releasing norepinephrine from storage sites
Adderall
CI in advanced arteriosclerosis, CV disease, moderate HTN, hyperthyroidism, agitated states, glaucoma, and within 14 days of therapy with MAOI’s. Do not use in patients with known history of drug abuse.
Adderall
Buspirone HCl
BuSpar
Exact MOA is unknown - may be due to a number of changes in brain chemistry including 1) increasing the metabolism of NE in the locus ceruleus, 2) acting as a moderate presynaptic dopamine agonist, 3) acting as a serotonin agonist
Buspirone
Because of this drug’s ability to bind to dopamine receptors, there is a possibility of dystonia, parkinsonism, and tardive dyskinesia occurring during therapy
Buspirone
Glyburide
Micronase, Diabeta
Stimulates insulin synthesis and release from beta cells in the pancreatic islets
Glyburide, Glimepiride
Take with breakfast or the first main meal. Compliance with therapy is essential for optimum effect
Glyburide, Glimepiride
Promethazine HCl
Phenergan
Competitively inhibits histamine at the H1 receptor site causing a spasmolytic and decongestant effect
Promethazine
CI in patients with hypersensitivity to other phenothiazines and in patients with lower respiratory tract symptoms (including asthma). CI in pediatric patients
Promethazine
Levetiracetam
Keppra
A pyrolidine derivative that is chemically unrelated to existing anti epileptic drugs. Inhibits burst firing in the hippocampus without affecting normal neuronal excitability
Levetiracetam
No known clinically significant drug interactions exist
Levetiracetam
Therapy should be withdrawn slowly to minimize the potential of triggering a seizure
Levetiracetam
Could cause hostility and nervousness, in addition to somnolence, asthenia, infection, and dizziness
Levetiracetam
Sulfamethoxazole with Trimethoprim
Bactrim, Septra
________ blocks the production of tetrahydrofolic acid by inhibiting the enzyme dihydrofolate reductase. ________ inhibits bacterial synthesis of dihydrofolic acid by competitive antagonism of PABA
Bactrim
CI in infants < 2 months of age, during pregnancy, in nursing mothers, in patients allergic to sulfa drugs, and in patients with megaloblastic anemia due to folate deficiency
Bactrim
Increased sensitivity to sunlight, Stevens-Johnson Syndrome, N/V, DIARRHEA, dizziness, anorexia, and RASH
Bactrim
Preferably taken on an empty stomach one hour before or two hours after meals with a full glass (240 mL) of water. Avoid prolonged exposure to sunlight.
Bactrim
Pantoprazole Sodium
Protonix
A PPI that suppresses the final step in gastric acid production by forming a covalent bond to two sites of the (H+, K+)-ATPase enzyme system at the secretory surface of the gastric parietal cell
Pantoprazole
Antacids may be taken at the same time as this drug.
Pantoprazole
Digoxin (inotropic agent)
Lanoxin, Lanoxicaps, Digitek
Digitalis glycosides inhibit membrane bound Na+/K+ ATPase resulting in an increased intracellular Na+ concentration and a slightly decreased intracellular K+ concentration
Digoxin
CI in patients with ventricular fibrillation
Digoxin
AE’s include anorexia, N/V, gynecomastia, blurred vision, HA, and bradycardia
Digoxin
Do not take any nonprescription cough or cold medicines, antacids, laxatives, or antidiarrheals without first consulting your pharmacist or physician
Digoxin
Lidocaine (transdermal)
Lidoderm
Exhibits neuronal membrane-stabilizing properties by combining with fast sodium channels during their inactive state to inhibit repolarization
Lidocaine
CI in patients with a known hypersensitivity to local anesthetics of the amide type
Lidocaine
Excessive dosing by using more than 3 patches per day or by using for longer than the recommended 12 hours may lead to increased absorption and high blood concentrations. Do not apply to broken or inflamed skin
Lidocaine
The most common AE’s of this medication are topical in nature (erythema, bruising, edema, papules, vesicles, discoloration, burning, pruritis, dermatitis, petechia, blisters, and exfoliation)
Lidocaine
Wash hands after the handling of this medication. If irritation or a burning sensation occurs during application, remove the patch and do not reapply until the irritation subsides. Do not use external heat sources such as electric blankets or heating pads. Do not leave patches on for more than 12 hours within a 24 hour period.
Lidocaine
Tolterodine Tartrate
Detrol (LA)
Competitive muscarinic receptor antagonist. Effects on the bladder include an increase in residual urine, reflecting an incomplete emptying of the bladder, and a decrease in detrusor pressure
Tolterodine
CI in patients with urinary retention, gastric retention, uncontrolled narrow-angle glaucoma, or hypersensitivity to any ingredient
Tolterodine
Most common AE’s include dry mouth, HA, dizziness, constipation, dyspepsia, and somnolence
Tolterodine
Triamterene with HCTZ
Dyazide, Maxzide
Inhibits the reabsorption of sodium in exchange for potassium at the distal renal tubule
Triamterene with HCTZ
CI in patients with anuria, hyperkalemia, hypersensitivity to sulfonamide-derived drugs, or patients currently taking other potassium-sparing diuretics
Triamterene with HCTZ
AE’s include dry mouth, MUSCLE CRAMPS, N/V, WEAKNESS, dizziness, orthostatic hypotension, GI distress including diarrhea and constipation, hyperglycemia, photosensitivity, impotence, RASH, and transient blurred vision
Triamterene with HCTZ
Paroxetine HCl
Paxil (XR), Pexeva
Highly selective inhibitor of neuronal serotonin uptake (SSRI)
Paroxetine
Contact a physician if patient develops leg, foot, or hand swelling or has excessive thirst (drug may cause hyponatremia)
Paroxetine
Do not take sooner than every 24 hours
Paroxetine
Hydroxyzine HCl
Atarax
Antagonizes the H1 (histamine) receptors in peripheral tissues. May also suppress histamine activity in the subcortical region of the CNS.
Hydroxyzine
CI in early pregnancy. Use caution in nursing mothers and in patients taking CNS depressants
Hydroxyzine
Dicyclomine HCl
Bentyl
Causes inhibition of acetylcholine at postganglionic parasympathetic receptor sites in smooth muscle, secretory gland tissue, and to a lesser degree in the CNS.
Dicyclomine
CI in patients with urinary tract or intestinal obstruction, intestinal atony, unstable CV status in acute hemorrhage, myasthenia gravis, severe ulcerative colitis, paralytic ileus, or glaucoma, and in infants
Dicyclomine
Glimepiride
Amaryl
Celecoxib
Celebrex
Produces its anti-inflammatory, analgesic, and antipyretic effects by inhibiting prostaglandin synthesis through inhibition of cyclooxygenase-2 (COX-2)
Celecoxib
CI in patients who have experienced asthma, urticaria, or allergic-type reactions after taking sulfonamides, aspirin, or NSAIDs. CI in treatment of preoperative pain in the setting of coronary artery bypass graft surgery. May cause an increased risk of serious CV thrombotic events, MI, and stroke
Celecoxib
Promptly report any signs of ulcerations and bleeding (intense GI pain, dark stools) to a physician
Celecoxib
