Exam 4 Drugs Flashcards
What drug class is alendronate?
Bisphosphonate
What is the MOA of alendronate?
Binds permanently to surfaces of bones to inhibit osteoclast activity
What are the common side effects of alendronate?
N/V/D, esophageal ulcerations
What education should be given to a patient prescribed alendronate?
Take with small sip of water, do not lie down for 30 minutes after taking, do not take with other foods/drinks/calcium/vitamins
What medication class is raloxifene?
Selective estrogen receptor modulator
What is the MOA of raloxifene?
Mimics estrogen by increasing bone density and inhibits bone resorption
What is the indication for raloxifene?
Prevention and treatment of postmenopausal osteoporosis
What are the side effects of raloxifene?
Hot flashes, leg cramping
What type of fractures does raloxifene reduce the risk for and by how much?
Spinal fractures only - 50 %
What does a patient need to have enough of to have raloxifene work?
Calcium and vitamin D
How long before a procedure should raloxifene be discontinued?
At least 72 hours
Does raloxifene increase or decrease clotting risk?
Increase
What is the MOA of calcitonin-salmon?
Inhibits bone removal by osteoclasts
What is the indication of calcitonin-salmon?
Treatment of osteoporosis
What is the side effect of calcitonin-salmon if given intranasally?
Nasal irritation
What type of fracture does calcitonin-salmon reduce the risk for, by how much, and how long does it take to see this?
Spinal fractures, by 50%, have to take for at least 5 years to see
What class is methotrexate?
DMARD
What is the MOA of methotrexate?
Acts as an immunosppressive
What are the side effects of methotrexate?
N/V, bone marrow suppression
Methotrexate is a first line therapy - true or false?
True
What supplement can you anticipate taking while on methotrexate?
Folate
What labs should the nurse monitor for a patient on methtrexate?
Liver enzymes, WBC, RBC
What are the major contraindications of methotrexate?
Kidney and liver disease
Pregnancy - this is extremely teratogenic
What is the concern of taking NSAIDS with methotrexate?
Aplastic anemia
What class is hydroxychloroquine?
Anti-rheumatic, antimalarial
What is the MOA of hydroxychloroquine?
Unknown but does have anti-inflammatory processes like decreased macrophage, T-helped cells, and inflammatory cytokine activity
What are the side effects of hydroxychloroquine?
Rare - retinopathy (encourage reporting vision changes)
What medication is commonly used with hydroxychloroquine?
Methotrexate for early or mid level RA
What class is allopurinol?
Xanthine oxidase inhibitor
What is the MOA of allopurinol?
Inhibits the xanthine enzyme which prevents uric acid production
What are the indications of allopurinol?
Prophylactic for patients whose gout is related to hyperuricemia
What are the side effects of allopurinol?
Agranulocytosis = worried about infection
aplastic anemia
can cause steven johnson syndrome
How can allopurinol affect glucose?
Can make the patient hypoglycemia
How does allopurinol affect INR?
Can increase INR with warfarin
What labs are important to monitor while taking allopurinol?
WBC, CBC
What is the MOA of colchicine?
Reduces inflammatory response to the deposits of urate crystals in the joints
What are the indications for colchicine?
Gout flares and prophylaxis
What are the side effects of colchicine?
GI bleeding and urinary bleeding
Colchicine is a first line therapy - true or false?
False, it is a second line therapy
How can colchicine affect the bone marrow?
Can suppress it and cause short term leukopenia
What are the contraindications for colchicine?
Anybody with severe renal, GI, hepatic, or cardiac / bleeding disorders
What class is probenecid?
Uricosuric agent
What is the MOA of probenecid?
Inhibits resorption of uric acid in the kidney and promotes the excretion of it
What is the indication of probenecid?
Treats hyperuricemia with gout
What are the side effects of probenecid?
GI upset, dizziness, headache, liver impairment, many drug drug interations
What is probenecid usually used in combination with?
Allopurinol
What is the MOA of cytotoxic agents?
Disrupts DNA synthesis and mitosis
What type of growth fraction does cytotoxic agents work the best against?
High cell growth fraction
How are cytotoxic agents usually given?
Through a CVC
What class is cylcophosphamide?
Alkylating agent
What is the MOA of cyclophosphamide?
Disrupts DNA synthesis and mitosis
What are the side effects of cyclophosphamide?
Normal chemo SE + vesicant, hemorrhagic cystitis, sterility, discoloration of skin and nails
Is cyclophosphamide cell cycle specific or non-specific?
Non specific
When methotrexate is used against leukemia and some lymphomas is it cell cycle specific or non-specific?
Specific, usually S phase
What class is methotrexate when being used for leukemia and some lymphomas?
Antimetabolite
What class is doxorubicin?
Anti tumor antibiotic
What is the MOA of doxorubicin?
Disrupts DNA synthesis and mitosis
What are the side effects of doxorubicin?
Normal chemo SE + cardiotoxic
Can have acute or delayed reactions
Harmless red color to urine and sweat
What are the side effects of vincristine?
No bone marrow suppression, peripheral neuropathy, vesicant
What is the MOA of vincristine?
Disrupts cell DNA and mitosis
Is doxorubicin cell cycle specific or non-specific?
Non specific
What is the class of vincristine?
Mitotic inhibitors - vinca alkaloids
Is viscristine cell cycle specific or non-specific?
Specific - usually M
Which route is preferred with promethazine?
IVPB
What is the MOA of biologics as chemo?
Uses the body’s immune system to kill cancer cells
What are the side effects of biologics?
Pain, swelling, soreness, flu-like symptoms, weight gain, diarrhea, increased risk for infection
