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