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212 > Exam 3 Drugs > Flashcards

Exam 3 Drugs Flashcards

1
Q

Carvedilol (Coreg)

AE= 1

A
  • Class: beta blocker
  • MOA: decrease the heart rate and myocardial contractility reducing cardiac output
  • AE: orthostatic hypotension
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2
Q

Prazosin (Minipress)

AE= 1

A
  • Class: Selective Alpha 1 Adrenergic antagonist
  • MOA: inhibit sympathetic activation causing vasodilation
  • AE: orthostatic hypotension
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3
Q

Hydralazine (Apresoline)

A
  • Class: Direct arterial vasodilator
  • MOA: Directly relax vascular smooth muscle causing vasodilation and decreasing BP
  • AE: MI, severe hypotension, blood dyscrasias, lupus erythematosus (SLE)
  • Teach: Take the initial dose at bedtime to minimize the increased 1st dose ADE response, Consult with physician before taking OTC meds
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4
Q

Nifedipine (Adalat CC, Procardia XL)

A

Class: dihydropyridine CCB
MOA: Inhibits calcium ion influx into vascular smooth muscle and myocardium
AE: CHF, severe hypotension, arrhythmia

no grapefruit juice

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5
Q

Furosemide (Lasix)

and Monitoring

AE=2

A
  • Class: loop diuretic
  • MOA: inhibits loop of Henle and proximal and distal convoluted tubule sodium and chloride resorption
  • AE: Severe hypokalemia/electrolyte imbalance
  • Monitor: BUN/Cr/GFR, serum CO2, electrolytes frequently early in tx, CBC, weight, ototoxicity
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6
Q

Diltiazem (Cardizem)

A
  • Class: nondihydropyridine CCB
  • MOA: Decreased preload, afterload, workload with decreased vasospasm and increased O2 supply.
  • AE: severe bradycardia, heart failure and hypotension

no grapefruit juice

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7
Q

Lisinopril (Zestril)

and monitoring

A
  • Class: Angiotension-Concerting enzymeinhibitor (ACEi)
  • MOA: act in the lungs to prevent ACE conversion from angiotensin I to angiotensin II.
  • AE: Angioedema, hyperkalemia, renal impairment
  • Monitor: kidney function, potassium
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8
Q

Losartan (Cozaar)

and monitoring

A
  • Class: Angiotension 2 receptor blocker (ARB)
  • MOA: selectively antagonizes angiotensin II angiotensin 1 (AT1) receptors thereby preventing the effect of angiotensin II
  • AE: hypotension, hyperkalemia, renal failure
  • Monitor: potassium, kidney function
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9
Q

Atorvastatin (lipitor)

3 teach

A
  • Class: Statin- HMG-CoA reductase inhibitor
  • MOA: Inhibits HMG-CoA reductase (a key enzyme for cholesterol synthesis); thus, inhibiting the liver’s cholesterol synthesis.
  • AE: Rhabdomyolysis, acute renal failure, hepatotoxicity
  • Teach: take in the evening, may cause constipation and bloating, never give during pregnancy
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10
Q

Colesevelam (Welchol)

and teaching

A
  • Class: bile acid sequestrants
  • MOA: Increase cholesterol excretion in the stool by binding cholesterol containing bile acids; DM MOA unknown
  • AE: esophageal/intestinal obstruction, dysphagia, pancreatitis
  • Teach: Administer just before a meal. Give oral drugs at least 4 h before colesevelam
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11
Q

Gemfibrozil (Lopid)

Teach instead of AE

A
  • Class: fibric acid drug
  • MOA: inhibits triglyceride synthesis and stimulates catabolism of triglyceride-rich lipoproteins (fibric acid derivative).
  • Teaching: taken bid before breakfast and dinner
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12
Q

Ezetimibe (Zetia)

A
  • Class: cholesterol absorbing inhibitors
  • MOA: blocks small intestine cholesterol absorption
  • AE: rhabdomyolysis, hepatitis, pancreatitis
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13
Q

Nitroglycerin (Nitrostat)

A
  • Class: Organic Nitrates
  • MOA: The body converts nitroglycerin (NTG) to the vasodilator nitric oxide (NO), which ultimately stimulating smooth muscle relaxation
  • AE: Severe hypotension, syncope,
  • headache
  • Teach: call 911 after 3 tabs each 5 min apart with no chest pain relief
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14
Q

metoprolol (Lopressor, Toprol)

1 AE

A
  • Class: beta adrenergic antagonist
  • MOA: decrease the heart rate and myocardial contractility reducing cardiac output
  • AE: orthostatic hypotension
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15
Q

hydrochlorothiazide (Microzide)

A
  • Class: thiazide and thiazide like diuretic
  • MOA: inhibits distal convoluted tubule sodium and chloride resorption. Because most Na+ was reabsorbed before reaching the distal tubule, thiazides diuresis less than loop diuretics.
  • AE: Electrolyte imbalances: hypokalemia, hyponatremia, impaired renal function
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16
Q

spironolactone (Aldactone)

1 DDI

A
  • Class: potassium sparing diuretic, aldosterone receptor antagonist
  • MOA: antagonizes aldosterone-specific mineralocorticoid receptors primarily in the distal convoluted tubule, decreasing Na and water reabsorption and increasing K retention
  • AE: renal failure, severe hyperkalemia, arrhythmia
  • DDI: potassium rich foods
17
Q

digoxin (Lanoxin)

A
  • Class: cardiac glycoside
  • MOA: Inhibits sodium-potassium ATPase resulting in calcium ion release which causes a positive inotropic effect. Suppresses SA node and slows AV node conduction to lower ventricular rate.
18
Q

digoxin antidote called?

A

Digibind

19
Q

fluconazole (diflucan)

2 DDI,

A
  • Class: azoles
  • MOA: Azoles interfere with the biosynthesis of ergosterol, which is essential for the construction of fungal cell membranes
  • AE: Hepatotoxicity, anaphylaxis, blood dyscrasias.
  • Nursing Implications:
    DDI-antidiabetic drugs, inhibitor of CYP
    Monitor AST/ALT
    teratogenic
20
Q

nystatin (Nystop)

1 key point

A
  • Class: polyene
  • MOA: Binds to cell membrane sterols, increasing permeability
  • AE: hypersensitivity
  • Key point: not absorbed well orally
21
Q

metronidazole (Flagyl

2 DDIs

A
  • Class: nitromidazole
  • MOA: Binds to DNA, RNA, and intracellular proteins within the cell causing cell death
  • AE: Seizures, peripheral neuropathy, bone marrow suppression
  • DDI: warfarin, ETOH
22
Q

acyclovir (Zovirax)

2 AE

A
  • Class: synthetic nucleoside analogues
  • MOA: Inhibits DNA polymerase; incorporates into viral DNA
  • AE: nephro and neuro toxicity
23
Q

oseltamivir (Tamiflu)

2 teach points

A
  • Class: neuraminidase inhibitors
  • MOA: inhibits influenza neuraminidase enzyme
  • AE: Bronchitis, bronchospasm, serious skin hypersensitivity reactions
  • Teach: give within 48 hours of onset of sx’s. Shortens sx’s from 7 to 5 days.
24
Q

Penicillin G

no class

A
  • MOA: binds to bacterial cell wall, inhibiting bacterial cell wall
    synthesis
  • allergy/anaphylaxis; dermatologic reactions (SJS/TENs/DRESS, etc.); clostridium difficile
25
Q

Cefazolin (Ancef)

1 contraindication

A
  • Class: 1st gen cephalosporins
  • MOA: bind to the penicillin-binding proteins (PBPs) on bacterial cell wall & inhibit synthesis of the bacterial cell wall, causing cell lysis
  • AE: allergy/anaphylaxis; dermatologic reactions; seizure
  • Contra: PCN allergy (due to cross sensitivity)
26
Q

vancomycin (Vancocin)

1 nursing implication

A
  • Class: misc cell wall inhibitor-glycopeptide
  • MOA: bactericidal; inhibits cell wall synthesis and RNA synthesis
  • AE: nephrotoxicity, ototoxicity, red man syndrome
  • Nursing Implications: GIVE SLOW IV to prevent red man syndrome

red man: flushing, hypotension, tachycardia, & rash on the upper body

27
Q

tetracycline (Achromycin)

2 teach

A
  • Class: tetracycline
  • MOA: broad spectrum bacteriostatic inhibitors of protein synthesis
  • AE: superinfections, hepatotoxicity, lupus
  • Teach: take on empty stomach, use sunscreen and protective clothing
28
Q

erythromycin, azithromycin

A
  • Class: macrolides
  • MOA: Macrolides are bacteriostatic inhibitors of protein synthesis.
  • AE: hepatotoxicity/cholestatic hepatitis, dysrhythmias(QT), pseudomembranous colitis (PMC)
29
Q

gentamicin (Pred-G)

1 AE, 3 implications

A
  • Class: aminoglycosides
  • MOA: bactericidal inhibitors of protein synthesis
  • AE: ototoxicity
  • Nurse Implications: tinnitus and headache= 1st sign of ototoxicity, not metabolized, narrow therapeutic range
30
Q

linezolid (Zyvox)

No AE, 1 Important fact

A
  • Class: oxazolidinones
  • MOA: Inhibits the 1st step in protein synthesis
  • Important: it is effective against
    infections that are resistant to most other antibiotics, including MRSA and VRE
31
Q

ciproflaxacin (Cipro)

1 teach

A
  • Class: fluoroquinolones
  • MOA: inhibits bacterial DNA replication
  • AE: Hepatotoxicity, CNS toxicity, Tendon rupture
  • Teach: stop after first signs of joint pain or swelling
32
Q

trimethoprim-
sulfamethoxazole (Bactrim)

2 contras

A
  • Class: sulfonamides
  • MOA: Both SMZ and TMP are inhibitors of the bacterial metabolism of folic acid
  • AE: SJS/TEN; myelosuppression (aplastic anemia, acute hemolytic
    anemia, and agranulocytosis), fulminant hepatic necrosis
    Contra: pregnancy, infants

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