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Pharmacology > Exam 2.0 > Flashcards

Exam 2.0 Flashcards

1
Q

Used to Treat Respiratory Conditions such as Pneumonia, COPD, Bronchitis and Asthma

A

Sympathomimetic - Beta Adrenergic Agonists, Anticholinergics and Bronchodilators.

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2
Q

Used to treat Upper Respiratory Conditions such as the Common Cold, Seasonal Rhinitis, Sinusitis, Pharyngitis and Laryngitis.

A

Antitussives, Expectorants, Decongestants, and Intranasal Glucocorticoids.

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3
Q

Sympathomimetic - Beta Adrenergic Agonists

A

Albuterol and Salmeterol

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4
Q

Albuterol

A

a. CNS stimulation, GI upset, arrhythmias, hypertension, bronchospasm, sweating, etc
b. Give every 2-4 hours PRN
c. Check pre/post lung sounds, O2 Stats and pulse

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5
Q

Salmeterol (Servent)

A

a. To prevent bronchospasm in patients who are not controlled on long term asthma medication
b. Prevention of exercise induced bronchospasm
c. Twice daily only!
d. Shallow breathers may inhale 2-3 times if chamber isn’t advanced

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6
Q

Anticholinergic Agents

A

Ipratropium Bromide (Atrovent), Tiotropiom (Spiriva) - Duonebs, Leukotriene Blockers

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7
Q

Ipratropium Bromide (Atrovent), Tiotropiom (Spiriva)

A

a. Maintenance treatment of bronchospasm associated with COPD
b. Contraindicated in glaucoma
c. Void before and rinse mouth after administering
d. Once a day only, capsule goes in chamber

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8
Q

Duonebs

A

Inhaler version of Ipratropium Bromide (Atrovent)

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9
Q

Anticholinergic Effects

A

Tachycardia, urinary retention, constipation, dry mouth and blurred vision. Tricyclic Antidepressants

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10
Q

Leukotriene Blockers

Montelukast (Singulair), Zafirlukast (Accolate)

A

a. Decrease inflammation component of asthma and allergies
b. Decreases exercise induced asthma
c. Preventative or maintenance, not for rescue
d. Administer in evening and at least two hours before exercise regardless of presence of symptoms.

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11
Q

Bronchodilators - Theophylline (Aminophylline)

A

Narrow Therapeutic window, monitor levels frequently. Rarely used do to AE of dysrhythmias, convulsions and cardiorespiratory collapse.

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12
Q

Inhaled Steriods

A

a. Decrease the inflammatory response in the airway
b. Given IV or IM for crisis situations. Oral dosing once crisis is controlled
c. Prevention and treatment of asthma
d. Increased risk of thrush – rinse mouth after.

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13
Q

Dexomethorphan (Robitussin) Codeine (Opioid)

A

Antitussives

Block the cough reflex

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14
Q

Guaifenesin (Mucinex)

A

Expectorant

Loosen secretions to increase productive cough to clear airways

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15
Q

Pseudophedrine (Sudafed)

A

a. Decongestants
b. Decrease blood flow to the upper resp tract and decrease the overproduction secretions
c. FDA removed OTC products
d. Diphenhydramine (Benadryl), Certrizine (Zyrtec), Loratidine (Claratin)
e. Antihistamine
f. Block the release or action of histamine that increases secretions and narrows airways.

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16
Q

Fluticasone (Flonase, Flovent)

A

Seasonal Allergies and Intranasal Glucocorticoids

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17
Q

Digoxin

A

i. Used to correct A fib and A flutter. Inhibits the sodium-potassium pump, resulting in an increase in intracellular sodium
ii. Slows and strengthens the heart – A-fib and CHF
iii. IV – giver over 5 minutes
iv. Therapeutic window – 0.5 – 2.0
v. Antidote – Digoxin immune fab (Digibind)
vi. Hold if HR <60 – Educate Patients
vii. Visual Disturbances, Visual halos (white, green, or yellow halos), anorexia, nausea, confusion, dysrhythmias, hypokalemia.

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18
Q

ACE Inhibitors - Angiotension

A

Captopril (Capoten), Enalapril (Vasotec), Lisinopril (Prinivil)

i. End in ‘pril’ and drug of choice for heart failure
ii. Act as a diuretic and decrease the workload of the heart and support circulation through vasodilation
iii. Enhance effects of Thiazide diuretics
iv. Angioedema, facial swelling, dry cough, hyperkalemia, hypotension, sore throat
v. No NSAIDS or alcohol, hold if SBP <90

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19
Q

Nitroglycerin - Nitrates - Vasodilator

A

i. Don’t give with hypotension or meds for erectile dysfunction
ii. Acts directly on smooth muscle of blood vessels
iii. 1 ever 5 min, up to 3. Chest pain that doesn’t respond in 10-15 min or after 2-3 doses = call paramedics
iv. Remove transdermal patches at night. No alcohol, aspirin or antihistamines
v. Causes bad headaches.

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20
Q

Sodium Channel Blockers

Lidocaine, Procainamide

A

i. Anesthetic-like action slows excitability of the heart to treat different dysrhythmias and life threatening ventricular dysrhythmias
ii. Anticholinergic effects, hypotension, dizziness and syncope
iii. Too much causes CNS depression

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21
Q

Potassium Supplements

A

i. Taken to avoid hypokalemia and digitalis toxicity
ii. Frequently needed with Thiazide diuretics
iii. Not used with Potassium-Sparing Diuretics!

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22
Q

Beta Blockers

Atenolol (Ternormin), Metoprolol (Lopressor), Propranolol (Inderall)

A

i. End in ‘lol’
ii. Slows HR and decreases BP, used with caution in client with heart failure
iii. Hold if HR <60 or SBP <90
iv. Can cause hyperglycemia or mask the symptoms of hypoglycemia
v. Don’t give if client has asthma

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23
Q

Calcium Channel Blockers

Amlodipine, Nifedipine, Diltiazem, Veramapil

A

i. Block calcium from entering the cell which prevents muscular contraction. Dilate coronary artery
ii. Used for HTN, angina, A-fib
iii. Hold if HR <60 or SBP <90
iv. No Grapefruit juice, limit antacids, caffeine St.John’s Wort, laxatives.

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24
Q 
ARBs - Angiotension 2 Receptor Blockers 
Lorsartan potassium (cozaar), Valsartan (Diovan)
A

i. Cause vasodilation and decrease peripheral resistance – afterload
ii. End in ‘Starten’
iii. Client on ACE inhibitor with cough will often be switched to ARB

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25
Q

Alpha-Adrenergic Blockers

Prasozin (Minipress)

A

i. Vasodilation, decreased BP and lipid control

ii. Watch for Orthostatic Hypotension

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26
Q

Heparin

A

i. Subcutaneous. Unable to dissolve clots
ii. PTT & aPTT: NOT on heparin = 25-35 sec
iii. ON heparin = 70-120 sec
iv. Antidote = Protamine Sulfate

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27
Q

Enoxaparin Sodium (Lovenox)

A

i. Low-molecular weight heparin
ii. Produces more stable response; lower risk of bleeding; duration 2-4 times that of heparin
iii. Pre-filled syringe with air bubble. Don’t expel air bubble and administer in the abdomen.

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28
Q

Warfarin (Coumadin)

A

i. Oral anticoagulant. Takes 2-5 days to reach therapeutic effect
ii. INR therapeutic level = 2-3
iii. Antidote is Vitamin K
iv. Treats A fib and has lots of med interactions.

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29
Q 
Aspirin 
Clopidogrel (Plavix)
A

i. Antiplatelet therapy – prevent clot formation
ii. Do not take with other anticoagulants such as heparin or warfarin
iii. Less risk of bleeding than with anticoagulants

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30
Q

Protamine Sulfate

A

i. Anticoagulant Antagonist
ii. Given if hemorrhage occurs with heparin therapy
iii. Given IV
iv. Can also act as a anticoagulant unless heparin is present – then it is antidote

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31
Q

Vitamin K

A

Antidote for Warfarin OD, Takes 24-48 hours to be effective

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32
Q

Potassium Sparing Diuretics

Spironolactone (Aldactone)

A

i. Weakest of all diuretics with decreased risk of hypokalemia and increased risk of hyperkalemia
ii. Patients should avoid foods high in K+ including salt subsitutes
iii. Concurrent use with ACE inhibitors increase risk of hyperkalemia

33
Q

Loop Diuretics

Furosemide (Lasix), Bumetadine (Bumex)

A

i. Most potent – high risk for dehydration and hypokalemia
ii. Reserved for serious HTN or Heart Failure
iii. Can be used with renal impairment

34
Q

Thiazide Diuretics

A

i. Increases secretion of sodium and water
ii. Hypokalemia main concern, eat foods high in K+
iii. Most common maintenance diuretic. Inexpensive with lots of generics
iv. Can be combined with loop diuretics

35
Q

Statins -

Atorvastatins (Lipitor), Simvastatin (Zocor), Lovastatin (Mevacor)

A
  1. Can reduce LDL 20-40%; slightly increase HDL; and reduce CV events by 25-30%
  2. Contraindicated with liver damage
  3. Rhabdomyolosis – breakdown of muscle leading to renal failure – muscle pain and fever
  4. Administer with food in the evening and avoid grapefruit juice
36
Q

Statins -

Cholystyramin (Questran), Colestipol (Colestid)

A
  1. Cholesterol – lowers LDL
  2. Bile Acid Resins
  3. Reduce LDL by binding bile acid
  4. Contraindicated with Digoxin or Warfarin
37
Q 
Statins -
Nitcotinic Acid (Niacin)
A
  1. Cholesterol – lowers LDL, raises triglycerides and HDL
  2. Vitamin B3
  3. Hot Flashes extremely common, may give aspirin to prevent
38
Q

Fibric Acid Agents

Fenofibrate (TriCor), Gemfibozil (Lopid)

A
  1. Found to increase overall mortality so rarely used
  2. Sometimes used in conjuction with a statin to lower excessive triglyceride and VLDL levels
  3. Avoid with anticoagulants
39
Q

Metoclopramide (Reglan)

A

i. Antiemetic – Dopamine Agonist
ii. Short term treatment for heartburn caused by GERD and slow gastric emptying in people with diabetes
iii. Prevention of chemotherapy induced emesis
iv. Monitor for sedation, extrapyramidal symptoms, and involuntary movements.

40
Q

Promethazine (Phenergan)

A

i. Antiemetic – Phenothiazines
ii. Treats motion sickness, allergy symptoms ‘thiazines’
iii. Monitor for sedation, extrapyramidal symptoms and involuntary movements
iv. Use caution in patients with Parkinson’s

41
Q

Milk of Magnesia

A

Stimulant Laxative

42
Q

Pantoprazole

A

Treat erosive esophagitis and other conditions involving excess stomach acid

43
Q

Eye Drops

A

a. the installation of liquid topical medication or lubricating agent directly into the eye.
i. Do not apply a second drop within a 1min, and do not apply a second eye drop medication within 5 minutes of each other.

44
Q

Transdermal Agents

A

Anticholinergic Side Effects - Dizziness, drowsiness, dry mouth, constipation

45
Q

Placement and rotation

A

1.5 mg (1mg dose over 3 days) apply patch behind ear at least 4 hours before antiemetic effects are required

46
Q

Scopolamine Patch

A

i. Antihistamine for motion sickness. Placed behind the ear, for 3 days. Is frequently prescribed for activities such as flying, cruising on the water and bus or automobile trips.
ii. This drug can have anticholinergic properties. Which can cause mydriasis, which can exacerbate narrow-angle glaucoma.
iii. Patch effective for 3 days, alternate ears is using for longer than 3 days. Wash hands after applying disc/patch. Wear no more than one disc/patch at a time.

47
Q

Pregnancy Category A

A

No risk to fetus. Studies have not shown evidence of fetal harm

48
Q

Pregnancy Category B

A

No risk in animal studies, and well-controlled studies in pregnant women are not available. It is assumed there is little to no risk in pregnant women

49
Q

Pregnancy Category C

A

Animal studies indicate a risk to fetus. Controlled studies on pregnant women are not available. Risk vs. Benefit of the drug must be determined.

50
Q

Pregnancy Category D

A

A risk to the human fetus has been proved. Risk vs. Benefit of the drug must be determined. It could be used in life-threatening conditions.

51
Q

Pregnancy Category X

A

A risk to the human fetus has been proved. Risk outweighs the benefit, and drug should be avoided during pregnancy.

52
Q

Aspirin during Pregnancy

A

Iron supplements are best absorbed on an empty stomach and when administered with water or juice. Vitamin C helps with absorbing Iron
Concurrent administration of 200mg ascorbic acid/vitamin C per 30mg of elemental iron increases the absorption of iron

53
Q

Premarin

A
  • Treat symptoms of Menopause such as hot flashes and vaginal dryness - Do Not take with Grapefruit and Cardiac Meds
  • Jaundice, Thromboembolic disorders, Depression, hypercalcemia, gallbladder disease.
    • Life-Threatening: thromboembolism, cerebrovascular accident, pulmonary embolism, myocardial infarction, endometrial cancer.
  • a. Tablet 0.3mg, 0.45mg, 0.625mg, 0.9mg, 1.25mg, 2.5mg, daily PO. Vaginal cream – 0.625mg/d intravaginal daily.
54
Q

Tadalafil (Cialis) - similar to Viagra

A
  • Facilitates erections by enhancing blood flow to the penis.
  • Should not be used with Nitrates such as Nitroglycerin.
  • Do not take with Alpha-blockers for treatment of HBP, Increased risk of hypotension
55
Q

Oral Birth Control

A

High dose increase risk of VTE (Venous ThromboEmbolism), MI (Myocardial Infarction) and stroke
- Clots, heart attacks, stroke women 35+, miss a day need another form

56
Q

Plan B

A

Progestin-only Emergency Contraception. Most effective taken within 24 hours after unprotected intercourse.

57
Q

Antineoplastic Agents - Chemotherapy

A

When the chemo drug takes full effect, and the immunosuppression is depressed within the body.
- N/V/D, bleeding from the IV site

58
Q

Cuclophosphamide (cytoxan)

A

an analogue of nitrogen mustard, may be prescribed orally, intrapleurally, or IV.

  • Take early in the day, report signs of infection, don’t visit those with respiratory infections, don’t use if breast feeding
  • N/V/D, dizziness, sterility, hemorrhagic cystitis, infection
    • Hemorrhagic cystitis, Cardiomyopathy and inappropriate antidiuretic hormone secretion (SIADH) - darkening of skin or fingernails.
  • Breast Cancer, Prostate Cancer, Non-Hodgkin’s Lymphoma, Lung Cancer, Ovarian Cancer
59
Q

Serotonin Syndrome

A

High fever, seizures, irregular heartbeat, confusion, high BP and HR, loss of muscle control, restlessness

60
Q

What medications cause Serotonin Syndrome?

A
  • SSRI - Citalopram (Celexa), Fluoxetine (Prozac, Sarafem), Fluvoxamine, Paroxetine (Paxil), Sertranline (Zoloft)
  • MAOI - Isocarboxazid (Marplan), Phenelzine (Nardil)
  • SNRI - Trazadone, Duloxetine (Cymbalta), Venlafaxine (Effexor)
61
Q

Psychotropic Washout Period

A

Period allowed for all of the administered drug to be eliminated from the body
- Psychotropic drugs require this

62
Q

Atypical Psych Meds

A

Clozapine - schizophrenia and psychotic disorders
Serotonin/Dopamine Antagonists
Quetiapine (Seroquel), Olanzapine (Zyprexa)

63
Q

Extrapyramidal Effects

A

Physical symptoms - tremor, slurred speech, akathisia, dystonia, anxiety, distress, paranoia, and bradyphrenia
- Primarily associated with improper dosing of or unusual reactions to neuroleptic (antipsychotic) medications

64
Q

What meds can cause Extrapyramidal effects?

A

Dopamine receptor blocking agents (DRBA) - Tetrabenazine (Xenozine), Clozapine (Clozaril), Trihexyphenidyl (Artane).

65
Q

What does tolerance mean when taking psych medications?

A

It takes a higher dose of the drug to achieve the same level of response achieved initially

66
Q

Tricyclic Antidepressants

A

i. Block the reuptake of norephinephrine into presynaptic neuron
ii. Treats depressive disorders
iii. Amitriptyline (Elavil)
iv. Low doses are effective for peripheral neuropathy

67
Q

Lithium (Lithobid)

A

i. Mood stabilizer agents – Bipolar disorder
ii. Antimania drug – calming effect
iii. Memory loss and confusion, Teratogenic effects, metallic taste
iv. Therapeutic serum range 0.5-1.5 mEq/L

68
Q

MAOIs - Monoamine Oxidase Inhibitors

A

Geriatrics due to less adverse reactions with drug-food interactions.
Treatment of depression - 2nd choice

69
Q

Benzodiazepines

A

i. Anticonvulsants, Sedative-hypnotics, preoperative drugs, substance abuse withdrawal agents, Anxiolytics
ii. Chlordiazepoxide (Librium), Diazepam (Valium), Clorazepat Dipotassium (Tranxene), Lorazepam (Ativan), Alprazolam (Xanax).
iii. Sedation, dizziness, headaches, dry mouth, blurred vision, rare urinary incontinence

70
Q

SSRIs/SNRIs -

Selective Serotonin Reuptake Inhibitors / Serotonin Norepinephrine Reuptake Inhibitors

A

i. Serotonergic synapse
ii. Major Depressive Disorders, Anxiety – OCD, Panic, Phobias, PTSD, etc.
iii. Fluoxetine (Prozac), Fluvoxamine (Luvox), Sertraline (Zoloft), Paroxetine (Paxil), Citalopram (Celexa), Escitalopram (Lexapro) Duloxetine (Cymbalta) and Desvenlafaxine (Pristiq).
iv. Sexual Dysfunction – ejaculation dysfunction. Stevens-Johnson syndrome

71
Q

Depakote, Valproate - Valproic Acid

A

i.Manic episodes, Bipolar disorder, major depression, tonic-clonic seizures, and migraine prophylaxis.

72
Q

Narcotic / Opiates Antidote

A

Naloxone (Narcan)

73
Q

Naloxone (Narcan)

A

Side effects headache

  • no adverse effects although watch for recurrent opiate effects
  • Respiratory depression and hypotension
74
Q

Benzodiazepine Antidote

A

Flumazenil (Romazicon)

75
Q

Flumazenil (Romazicon)

A

Competes with Benzod

- side effects - seizures from withdrawal.

76
Q

Heparin Antidote

A

Protamine Sulfate

77
Q

Warfarin (Coumadin) Antidote

A

Antidote for Warfarin

78
Q

Digoxin Antidote

A

Digoxin immune Fab (Digibind)

Pharmacology (6 decks)

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