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Pharmacology 283 > Exam 4 drugs > Flashcards

Exam 4 drugs Flashcards

1
Q

Turmeric

A

Category Class:
antiinflammatory

Indication:
Arthritis, chronic pain (due to inflammation), joint health

CI:
w/ anticoagulants

NI:
Concern abt antiplatelet activity

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2
Q

St Johns Wort

A

Category Class:
Improve mood

Indication:
Depression, anxiety, insomnia

CI:
Most meds

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3
Q

Gingko

A

Category Class:
Inc cog fxn, vasodilator

MOA:

Indication:
Inc memory, inc circulation of brain

CI:
Antiplatelets, anticoags

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4
Q

Garlic

A

Category Class:
Diuretic, anthelmintic, inc circulation

Indication:
Colds, dec BP, diabetes

Caution: potentiates w/ anticoag/antiplatelet, dec BP, diuresis
CI any w/ same effect

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5
Q

Black Cohosh

A

Category Class:
Stim estrogen receptors

Indication:
Menopause (hot flashes), hormone inbalances

CI:
PG

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6
Q

Valerian Root

A

Category Class:
Sedative effect. Inc GABA (natures benzo)

Indication:
Insomnia/Anxiety

NI:
Taper (withdrawal)

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7
Q

Kava

A

Indication:
Anxiety/depression, seizure/insomnia

CI:
Caut: hepatotoxicity

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8
Q

NSAIDS (ASA, ibu, ketorolac, naproxen)

A

Category Class:
antiinflammatory

MOA:
Stop prostaglandin prod by inhibiting COX

Indication:

  • *Antiinflammatory** (OA, RA, Lupus, gout, dysmenorreah)
  • *Analgesic** (bone/joint/tooth/HA)
  • *antipyretic**

CI:
High risk thrombotic events (black box)
PG, PUD, RF, bleeding disorder, w/ ETOH, viiral inf

Caut:
AC, glucocort, ACE/ARBs, hx ischemic CVA/MI

SE:
Usually few
Inc circ to renal/neuro/heart -> RF, CVA, MI
Inc gastric bicarb layer -> GIB, PUD
Inc platelet agg-> bleeding (ASA)

Route:

NI:
Parenteral nsaids= high risk RF
NSAIDS+ opiods= synergystic
Dec GIB/PUD w/ food, avoid gastric irritants, high risk geri
RF: monitor HF/I/Os

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9
Q

ASA

A

NSAIDS
I: MI/CVA prophlactic, emergency MI (chew)
NI: sometimes w/ clopidogrel (inc antiplatelet effect)
Must give 7 days to clear
Avoid GIB: used EC/buffered ASA
CI: <19 (reyes)

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10
Q

DMARDS

A

Methotrexate, hydroxychloriquine, azathioprine, cyclor sporinem, tacrolimus
Category Class:
Disease mod antirheumatic drugs

Indication:

  • *Autoimmune** (peak 3-6 wks)
  • *antiinflammation**

CI:
Never during acute inf

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11
Q

Methotrexate

A

DMARD
MOA:
Immunomodulator (cytotoxic)

Indication:
Severe AI disorders (SLE)

CI:
PG, lact, Peds

SE:
Hepatotoxic
Cytotoxic: ulcerative stomatitis, bone marrow suppression

NI:
Liver fxn test, inspect mouth/gums/throat, monitor CBC

PE:
Empty stomach, no sunlight

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12
Q

hydroxychloroquine

A

DMARD
Category Class:
antimalarials

MOA:
Antimalarial/antihelmintic

SE:
Retina damage, STOP w. BV

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13
Q

Azathioprine, Cyclosporine, Tacrolimu

A

DMARD
Category Class:
immunosuppressants

Indication:
Organ transplants

SE:
RF, hepatotox, blood dyscrasia/bleeding, hirsutism (reversible), gingival hyperplasia

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14
Q

Colchichine

A

antigout
MOA:
Antiinflammation (ONLY GOUT)

SE:
GI distress
Dec bone marrow, rhabdo,

NI:
Monitor NEW muscle pain, CBC
Eat w/ food, no grapefruit
Give daily (doesn’t FIX)

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15
Q

Allopurinol

A

Antigout
MOA:
Dec serum uric acid (biosynth)

CI:
PG

SE:
Hepatotox (inc risk nephrolith)

Route:

NI:
Inc fluids (2-3 L/day)
**Avoid food high in purine**s (red meat, organ meat, scallops, cheese, alc, caff)
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16
Q

ACET/APAP

A

Non opioid
MOA:
Analgesics/pyretic

Indication:
Inflammation (dec SE than NSAIDS)

NI:
MAX: 4000 mg/24 hrs
Malnourished: 3000
ETOH dam: 2000

Acet+opioids=synergistic
OD: acetylcystiene

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17
Q

opioid analgesics

A

MOA:
Block CNS recep. Prev pain sensation

CI:
COPD/Pneu (resp dep)
Trauma/inj/hem CVA (inc ICP)

SE:
M iosis (fall risk)
O rtho hypo
R esp dep (check HR/BP before)
P ulse/brady
H appy/euphoria
I inc ICP
N ausea (inc CTZ, give antiemitic)
E mesis
U rine ret/constipation (always use prophylactic lax)
S ed/hypnotic
D ependence/tolerance
A spiration (dec cough/gag-> SILENT)

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18
Q

Naloxone

A

Naloxone
I: tx opioid OD, reverse resp/CNS dep
NI: acute w/drawal symptoms
Abrupt pain/anxiety, sweating, HA
Depression/SI/anorexia/ab cramps
Dysrhyth
Nalox 1/2 life< opioids -monitor!!

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19
Q

Codeine sulfate

A

I: PRN cough/diarrhea/mild pain
NI: prodrug (acet+codeine)

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20
Q

hydrocodone

A

I: PRN moderate pain
NI: acet+hydro

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21
Q

oxycodone

A

I: mod pain
Oxy+acet

22
Q

tramodol

A

NI: sched IV

  • *prodrug**
  • *max 300 mg/24 hrs**
23
Q

morphine

A

PO, oral drops, PR, IV, IM, spinal (not SQ)
I: severe pain
NI: 10x stronger t tramadol, controlled release

24
Q

hydropmorphone

A

PO/IV/IM/SQ/PR
I: PRN severe
NI: 6x stronger morphine

25
Meperidine
Opioid like MOA: **Anticholinergic, 2\* analgesic** Indication: **Analgesic, allergy to opioids** CI: RF SE: **Neurotox (delirium/seizures)** dysrhythmia Route: PO, Im, IV, SQ NI: **Short duration (Only in OR)**
26
Fentanyl
Opioid like Indication: **Short acting severe pain (30-60 mins, imm onset)** CI: SE: Route: IV/IM?transdermal (mcg/h)/lozenge NI: 50x morphine **Don't let chew, doc where put it!**
27
Methdone
Category Class: opioid MOA: **Long acting** (red cravings) Indication: **Heroin detox/maintenance prog**
28
Ketolorac tromethamine
I: dec post op inflammation after **cataract** surg, Seasonal allergic conjunct (pain/burn/itch/photopjob) SE: delay hearing (post op), corneal damage (erosion/ulcer)
29
Brimonidine
**Antiglaucoma** Category Class: A 2 agonist MOA: **Dec production aqueous humor**, inc outflow SE: Burning, stinging, BV, HA, reddened sclera, systemic effects (vasodil)
30
Latanoprost
Category Class: **Prostaglandin analogs** MOA: Vasodilator, inc outflow SE: Inc pigmentation iris/eyelids/lases
31
carbamide peroxide
**cerumenolytic** NI: Directions: tilt head, 5-10 drops, keep in for several minutes Flush ear gently, NO suction Tid \<4 days
32
Somatropin
MOA: Inc GH Indication: Dwarfism (before epiphyseal closure) CI: Other dwarfism (not growth hormone) Obesity, resp dx (sleep apnea) SE: DM (dec insulin), hypothyroidism Route: IM/SQ
33
ocreotide
Indication: Gigantism/acromegaly Severe diarrhea, esoph varices/bleed SE: Pancreatitis, hypothyroidism Route: IV/PO/SQ NI: Kidney/liver fxn tests
34
Levothyroxine sodium (T4)
MOA: Synthetic thyroid hormone Indication: PO: hypothyroidism IV: myxedema CI: MI SE: s/s hyper/hypothy Hyperglycemia, tachypnea Protein bound (toxic w/ low protein, dec w/ oral AC) AE: Tachydysrhythmia CP/HTN/Seizure Route: NI: ONLY empty stom (1 hr AC) Check levels freq PE: -lifelong -don't stop w/o endocrinologist Slow absorp/onset, long half life Ther effect: 6-8 wks
35
Methimazole/PTU
MOA: Inh TH synth NOT DESTROY existing TH Indication: Hyperthyroidism (graves) Thyrotoxicosis (thyroid storm) Adjunct to radiation CI: PG/lact SE: S/S hyper/hypothy GI distress Route: NI: Don’t discont abruptly (thyrotoxicosis) Don’t eat foods w/ iodine (seafood) Take w/ food PE: Interactions Oral AC, insulin, dig, lith, pheny
36
cortiocotropin
Indication: 1) 2\* adrenal insufficifency 2) Diagnosing 1/2\* (check q 30) 3) Acute exacerbation inflamm dx a. SLE/MS/sarcoidosis/psoriatic/RA CI: 1\* adrenal insuff (addisons) SE: Fluid/Na ret RF Inc BG BP/HTN (monitor trend) ``` Route: Parenteral only (IV/IM/SQ) ``` NI: Monitor cortisol level Taper dose Monitor for edema
37
glucocort
glucocorticoids Indication: 1) 1\* adrenal insuff (addisons) Inflammatory/AI/allergy
38
desmopressin
MOA: Dec urine, inc osmolality urine, slight vasocon Indication: DI SE: FVE-\> worsening HF (monitor I/Os, wgt, CMP, AMS) Vaso constriction (anglina, MI, dysrhyth, HTN) Route: PO/IV/SQ NI: Looong (20 hrs)
39
vasopressin
MOA: Severe periph vasoconstriction ``` Indication: Severe HypoT (not DI) ``` CI: SE: FVE-\> worsening HF (monitor I/Os, wgt, CMP, AMS) Vaso constriction (anglina, MI, dysrhyth, HTN) Route: IV (vesicant) NI: Short (30-60 mins)
40
tolvaptan
MOA: Aquaresis (exc H2O, no electrolyte loss) Indication: SIADH SE: Hypovolemia, inc K, inc BG
41
Calcitriol
MOA: Inc Ca absorption in GI Inc osteoclast/release from bone Indication: Dec serum Ca/dec PTH 1. Hypoparathyroidism (PO) 2. Dec Vit D (PO) 3. Renal hormone replacement (ESRD) PO/IV CI: SE: Dizzy, fall, vertigo, metallic
42
Calcitonin-Salmon
MOA: Calcitonin rec agonist (mimics calcitonin) Deposit Ca to bones Indication: Osteoporosis Other (hyperparathy, thiazides, vit A/D, milk alkali synd, prolonged immobility) CI: SE: Hypocalcemia Numb/tingling around mouth Tachy/spasms/inc DTR, seizure Nasal spray-\> nasal dryness Route: IM/SQ/Nasal
43
Insulin
MOA: Inc BG, glycogen-\> glucose, inc potassium (in cells) Indication: 1. Type 1 2. Type 2 (when oral agents fail, or acute stress, gestational) 3. Hyperkalemia Route: SQ/IV (only regular, and avoid if BG \<70) -syrunge, multidose vial, insulin pen, insulin pump NI: SQ always in same area (lipodystrophy) Sliding scale insulin (SSI) Standing order Manage BG: AC if willing and able to eat PE: Storage: not effective after expiration Room: 29 days, 3 mos Fridge after opening Never in freezer No heat/sunlight Premixed=always fridge Wear med bracelet Meal planning: Dec BG at onset/peak Inc BG at duration Labs: serum glucose Point of care (not w/ edema) Serum BG
44
Lispro/aspart
rapid acting Onset: \<30 Peak: 30-90 Duration: 3-5 hrs NI: SSI/AC
45
regular insulin
Short Acting: regular (IV) Onset: 30 Peak: 2-5 hrs Duration: 4-12 hrs NI: SSI/AC
46
Isophane NPH
Intermediate: isophane NPH (cloudy) Onset: 1-2 hrs Peak: 4-12 hrs Duration: \<24 hrs NI: BID
47
Glargine/detemir
Long Acting: glargine/detemir Onset: 1 hr Peak: glar: none, det: 6-8 Duration: 24 hrs NI: glar: qid/HS, det: qid HS/BID
48
Oral antidiabetic agents
MOA: Inc cell sensitivty to endogenous insulin Inc insulin prod Inc incretin (SI) to inc insulin Dec breakdown glycogen Dec starch breakdown in GI Indication: Type 2 CI: Type 1 DM, PG © Caut: req 24 hr meal planning Hepatic/renal impairment (use insulin) SE: Inc heart fxn/myocardial O2 demand Monitor angina/dysryth Route: NI: No ETOH, liver fail-\> dec BG, dec PO -\> dec BG, disulfiram like rxn Goal: fasting BG \<150 (normal \<100) Prevent dec BG (Med emer) PE: Log BG w/ related factors
49
Glimepiride/glipizide/glyburide
SE: hypoglycemia, aplastic anemia, wgt gain, disulfiram like CI: liver fail, PG, lact, surg/sev inf
50
Metformin
NI: not w/in 48 hrs IV contrast-\> RF SE: GI upset, diarrhea, N, anorex, weight loss (contact PCP) Take BID w/ meals to prev diarrhea Vit B12/folic acid (B9) dec: poor absorp Give supplements PRN CI: inc infection, acute disorders (shock, hypoxia), chronic ETOH
51
Acarbose
MOA: blocks panc amylase (no sucrose breakdown) NI: SAFETY: manage dec BG w/ dextrose paste Take w/ meal TID SE: dec iron absorption-\> anemia (H&H) CI: IBS/UC, bowel obstruction

Pharmacology 283 (6 decks)

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