Exam 3 (Drugs 101 - 150) Flashcards
Insulin Aspart
Novolog
Insulin is the primary hormone responsible for carrying out proper glucose utilization in metabolic processes
Insulin Aspart, Insulin Lispro, Insulin Detemir
Hypoglycemic reactions are not uncommon in diabetics and may be caused by excessive insulin dose or when glucose absorption is decreased due to fasting, diarrhea, or vomiting
Insulin Aspart, Insulin Lispro, Insulin Detemir
May cause lipodystrophy at the injection site
Insulin Aspart, Insulin Lispro, Insulin Detemir
Administer 5 - 10 minutes before eating
Insulin Aspart
Estrogens (conjugated)
Premarin
A mixture of naturally occurring estrogens derived from pregnant mares’ urine
Premarin
CI in patients with known or suspected cancer of the breast except in selected patients being treated for metastatic disease. Do not use in patients with known or suspected estrogen-dependent neoplasia, known or suspected pregnancy, undiagnosed genital bleeding, or in pts with thrombophlebitis, thrombosis, or thromboembolic disorders
Premarin, Estradiol (topical)
Estrogens have been reported to increase the risk of endometrial carcinoma and to increase the risk of cardiovascular events including MI, stroke, pulmonary emboli, and DVT in postmenopausal women. Because of these risks, estrogens should be prescribed at the lowest effective dose and for the shortest duration consistent with treatment goals
Premarin
AE’s include rash, acne, alopecia, hirsutism, abnormal menstrual BLEEDING, edema, changes in weight, cholestatic JAUNDICE, changes in cervical erosion and cervical secretions, mental depression, pyrexia, insomnia, nausea, and somnolence
Premarin
Report any severe side effects to your physician including pains in the legs, coughing blood, abnormal vaginal bleeding, skin yellowing, and abdominal pain
Premarin
Read patient information sheet carefully
Premarin
Hydroxyzine Pamoate (antianxiety)
Vistaril
Antagonizes the H1 receptors in the subcortical region of the CNS. Primary skeletal muscle relaxation, bronchodilator activity, and antihistaminic and analgesic activity have been demonstrated
Hydroxyzine Pamoate
May potentiate the effects of opioids and barbiturates, dosage requirements may be necessary
Hydroxyzine Pamoate
Sedating drugs may cause confusion and over sedation in the elderly; elderly patients should be started on a lower dose
Hydroxyzine Pamoate
The most common AE’s are dry mouth and drowsiness. Drowsiness is usually transitory in nature and may disappear after a few days of treatment
Hydroxyzine Pamoate
Tizanidine HCl
Zanaflex
Agonist at alpha-2 adrenergic receptor sites and presumably reduces spasticity by increasing presynaptic inhibition of motor neurons. Does not affect skeletal muscle fibers or the neuromuscular junction with minimal effects on monosynaptic spinal reflexes
Tizanidine
Structurally similar to clonidine but with much lower effects on blood pressure
Tizanidine
Tablet and capsule formulations are bioequivalent when given in the fasted state, but not when given with food. When given with food, the plasma concentrations of the tablet form are increased and the plasma concentration of the capsule form are decreased
Tizanidine
Oral contraceptives decrease this drug’s clearance
Tizanidine
Occasional cases of liver injury have been reported during therapy. Monitor liver enzymes before and during treatment (baseline, 1, 3, 6 months) and stop therapy if liver function tests > 3x ULN. Animal studies have shown dose-related retinal degeneration & corneal opacities
Tizanidine
More frequent AE’s include dry mouth, drowsiness, asthenia, bradycardia, hypotension, and dizziness. Less frequent include constipation, ABNORMAL LIVER FUNCTION TESTS, BLURRED VISION, rhinitis, nervousness, vomiting, speech disorder, and pharyngitis
Tizanidine
Methylphenidate HCl
Ritalin (SR, LA), Methylin, Metadate
Presumably activates the brain stem arousal system and cortex to produce its stimulant effect
Methylphenidate
May produce hypertensive crisis when used with MAOI’s
Methylphenidate
CI in patients with anxiety, tension, or agitation, in patients with glaucoma or motor tics, and in patients with a family history or diagnosis of Tourette’s syndrome
Methylphenidate
Should not be used in children < 6 yo
Methylphenidate
Take last dose early in the evening to avoid insomnia. LA capsules may be swallowed whole or the contents sprinkled over soft food and ingested without chewing
Methylphenidate
Ciprofloxacin HCl
Cipro (XR)
A fluoroquinolone antibiotic which prevents the synthesis of bacterial DNA by interfering with the enzyme DNA gyrase. Has a wide range of activity against gram-negative and gram-positive bacteria.
Ciprofloxacin
Antacids and iron salts decrease bioavailability. Probenecid increases serum levels by decreasing exertion. NSAID’s may lower seizure thresholds and predispose patients to convulsive seizures when taking this drug.
Ciprofloxacin
Do not use in children, adolescents, or pregnant women due to permanent lesions in weight-bearing joints. Do not use in patients receiving theophylline. Patients should be well hydrated to avoid crystalluria.
Ciprofloxacin
Quinolones have been shown to cause ruptures of the shoulder, hand, and Achilles tendons.
Ciprofloxacin
Most common AE’s are nausea, RASH, diarrhea, sun sensitivity, and dizziness
Ciprofloxacin
Drink a full glass of water after each dose. May be taken without regards to meals, although it is preferable to take dose two hours following a meal. Do not take antacids during therapy.
Ciprofloxacin
Suspension may be stored at room temperature or in the refrigerator and is stable for 14 days after reconstitution. Shake vigorously for 15 seconds before each dose
Ciprofloxacin
Do not take antacids or products containing calcium, zinc, or iron at the same time as this drug. This drug can be taken 2 hours before or 6 hours after these products
Ciprofloxacin
Lansoprazole
Prevacid
Inhibits the H+/K+ ATPase enzyme system at the secretory surface of the gastric parietal cell. This enzyme system is involved in the movement and production of gastric acid.
Lansoprazole
Ezetimibe
Zetia
Lipid-lowering compound that selectively inhibits the intestinal absorption of cholesterol and is related to phytosterols. Appears to act at the brush border of the small intestine to inhibit cholesterol absorption thereby decreasing the delivery of cholesterol to the liver
Ezetimibe
AE’s include myalgia, increased CPK, elevations in liver transaminases, hepatitis, thrombocytopenia, urticaria, arthralgia, and myopathy/rhabdo
Ezetimibe
Do not take within 2 hours before or 4 hours after the administration of a bile acid sequestrant (cholestyramine)
Ezetimibe
Propranolol HCl
Inderal (LA), Innopran XL
Causes non-selective blockage of beta-adrenergic receptors resulting in 1) a decreased HR, 2) a decrease in systolic and diastolic BP, 3) an inhibition of isoproterenol tachycardia, and 4) a decrease of reflex tachycardia
Propranolol
Toxic effects may be increased with concurrent use of VERAPAMIL
Propranolol
CI in patients with cardiogenic shock, bronchial asthma, sinus bradycardia, greater than 1st degree heart block, and CHF, unless secondary to tachyarrhythmia treatable with propranolol
Propranolol
Patients with diabetes need to be aware that this agent can cause masking of hypoglycemic symptoms
Propranolol
Fentanyl (transdermal)
Duragesic
An opioid analgesic, therefore analgesia is produced centrally via action on the central opiate receptors. Interacts predominantly with the mu-opioid receptor.
Fentanyl
Patches should be applied to non-irritated and non-irradiated skin on a flat surface of the upper torso. Do not apply to extremities below the knee or elbow. Hair at the application site should be clipped (not shaved) prior to system application.
Fentanyl
Patches should be applied immediately upon removal from the sealed package. The transdermal system should be pressed firmly in place with the palm of the hand for 10 - 20 seconds. Each patch may be worn continuously for 72 hours.
Fentanyl
Used systems should be folded so that the adhesive side of the system adheres to itself and then flushed down the toilet immediately upon removal. Do not cut or puncture systems
Fentanyl
Nystatin (topical)
Nystop
An antimycotic polyene antibiotic obtained from Streptomyces noursei. MOA is that it binds to sterols in the cell membrane of susceptible Candida species, changing the permeability of the cell membrane. Fungicidal and fungistatic against many fungi. It is not absorbed from intact skin or mucous membranes
Nystatin
Cream, ointment, and powder preparations are not to be used in ophthalmic, intravaginal, oral or systemic infections
Nystatin
Do not use in or around the eyes - not for opthalmic use
Nystatin
Doxycycline Hyclate
Vibramycin & Vibra-Tabs
Tetracycline antibiotic which prevents bacterial protein synthesis by competitively binding to the 30S ribosomal subunit. Bacteriostatic at normal dosage ranges.
Doxycycline
May impair the action of bactericidal antibiotics. May impair the systemic absorption of oral contraceptives. Absorption may be impaired by aluminum, bismuth, calcium, magnesium, zinc, iron salts, and urinary alkalinizers
Doxycycline
Use with precaution in children < 8 yo (during tooth development). Cases of C. diff associated diarrhea have occurred during treatment
Doxycycline
Preferably taken on an empty stomach - one hour before or two hours after meals - with a full glass of water. Taken at intervals, preferably around the clock. Avoid prolonged exposure to the sunlight.
Doxycycline
Insulin Lispro
Humalog
Administer 15 minutes before eating
Insulin Lispro
Carbidopa with Levodopa
Sinemet (CR)
Levodopa crosses the BBB and is converted into dopamine in the basal ganglia. A large portion of levodopa is converted to dopamine in extracerebral tissue. Dopamine does not cross the BBB. Carbidopa inhibits the dopa-decarboxylase in extracerebral tissue, thereby increasing the levels of levodopa available to the CNS and decreases the side effects (nausea) seen from high levels of peripheral dopamine.
Carbidopa with levodopa
Hydantoins and pyridoxine (vitamin B6) may decrease effectiveness. Hypertensive crisis may occur if given with MAOI’s.
Carbidopa with levodopa
CI in patients with narrow-angle glaucoma, in patients with a suspicious, undiagnosed skin lesion or a history of melanomas, and in patients currently taking MAOI’s
Carbidopa with levodopa
D/C levodopa therapy at least 8 hours before initiation of Sinemet therapy
Carbidopa with levodopa
AE’s include DYSTONIC or involuntary movements, depression, dementia, and nausea
Carbidopa with levodopa
_____ CR may be given whole or in half tablets but should not be crushed or chewed
Carbidopa with levodopa
Avoid vitamin B6 (pyridoxine) products
Carbidopa with levodopa
Valsartan
Diovan
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)
Valsartan
NSAID’s, including COX-2 inhibitors, may decrease effects and increase risk of renal function deterioration
Valsartan
Use with caution in volume or salt-depleted patients due to excessive hypotension
Valsartan
Famotidine
Pepcid
Competitively inhibits histamine at the H2 receptors, including receptors on gastric cells. Inhibits basal, nocturnal, and food stimulated gastric secretion.
Famotidine
Shake suspension well and discard unused portion after 30 days
Famotidine
Antacids may be given concomitantly to relieve acute pain
Famotidine
Sitagliptin Phosphate
Januvia
Inhibits the dipeptidyl-peptidase-4 (DPP-4) enzyme - this enzyme is responsible for deactivating the incretin hormones glucagon-like peptide-1 (GLP-1) and glucose-dependent insulinotropic polypeptide (GIP)
Sitagliptin
The use of this drug with drugs that may cause hypoglycemic reactions (including sulfonylureas & insulin) has not been adequately studied and these combinations should be avoided.
Sitagliptin
Most common AE is nasopharyngitis (5%)
Sitagliptin
May be taken without regard to meals. Quarterly HbA1c testing should be performed
Sitagliptin
Eszopiclone
Lunesta
A pyrrolopyrazine of the cyclopyrrolone class (structurally unrelated to benzodiazepines). Thought to act at GABA-receptor complexes at binding sites located near or coupled to BZD receptors
Eszopiclone
Additive CNS depressant effect is seen when this drug is given with CNS depressants, including alcohol.
Eszopiclone
Sleep disturbances may be a sign of a physical and/or psychiatric disorder. The failure of insomnia to remit after 10 days of treatment may indicate the presence of a primary physical and/or psychiatric illness.
Eszopiclone
Most common AE’s (>10%) are drowsiness, HA, and an unpleasant taste sensation. Less common AE’s (< 5%) include dry mouth, anxiety, depression, dysmenorrhea, gynecomastia, and infection
Eszopiclone
Preferably taken on an empty stomach. High fat meals delay onset of action. Take immediately before bedtime. A rapid decrease or abrupt D/C of therapy may precipitate withdrawal symptoms
Eszopiclone
Temazepam
Restoril
Facilitates the inhibitory neurotransmitter action of GABA, which mediates both pre- and post-synaptic inhibition in all regions of the CNS
Temazepam
Insomnia may be a sign of an underlying psychiatric disorder. Reevaluate therapy if insomnia fails to remit after 10 days of treatment
Temazepam
This medication is not intended to be used for longer than 10 consecutive days
Temazepam
