Exam 4 (Drugs 151 - 200) Flashcards
Ramipril
Altace
MOA thought to be due to its suppression of the renin-angiotensin-aldosterone system by competitively inhibiting the angiotensin-converting enzyme (ACEI)
Ramipril, Benazepril
Capsaicin may increase the incidence of coughing
Ramipril, Benazepril
Use with caution in pregnant and nursing women, in patients with impaired renal function, collagen vascular disease (may cause agranulocytosis), or aortic stenosis, and in patients undergoing surgery or anesthesia
Ramipril, Benazepril
AE’s include cough, ANGIOEDEMA, hypotension, fatigue, headache, and nausea
Ramipril, Benazepril
Capsules can be swallowed whole or sprinkled over food; may also be mixed into water or apple juice and consumed. Pre-mixed solutions are stable for 24 hrs at room temp and 48 hrs under refrigeration
Ramipril
Avoid nonprescription cough, cold, and allergy medications unless otherwise directed
Ramipril, Benazepril
Report any sign of facial swelling, difficulty in breathing, or infection (unexplained fever or for throat)
Ramipril, Benazepril
Darifenacin Hydrobromide
Enablex
A competitive muscarinic receptor antagonist with a high affinity for the M3 receptor. Blockage of this receptor results in an increase in bladder capacity by decreasing the frequency of unstable detrusor contractions and increasing the volume threshold for unstable contractions
Darifenacin
May inhibit the metabolism of CYP2D6 substrates such as flecainide, thioridazine, and TCA’s.
Darifenacin
Potent CYP3A4 inhibitors such as ketoconazole, itraconazole, ritonavir, nelfinavir, clarithromycin, and nefazadone may decrease hepatic metabolism of this drug
Darifenacin
CI in patients with urinary retention, gastric retention, or uncontrolled narrow-angle glaucoma and in patients who are at risk for these conditions
Darifenacin
Use with caution in patients with bladder outflow obstruction, severe constipation, ulcerative colitis, myasthenia gravis, controlled narrow-angle glaucoma, or any level of hepatic impairment
Darifenacin
AE’s are usually mild and transient and include: dry mouth, constipation, UTI, blurred vision, dyspepsia, abdominal pain, nausea, diarrhea, dizziness, asthenia, and dry eyes
Darifenacin
Avoid prolonged exposure to hot weather. May cause dizziness. May cause dry mouth or blurred vision
Darifenacin
Benazepril HCl
Lotensin
Sumatriptan Succinate
Imitrex
A selective agonist for a vascular 5-HT1 receptor subtype with no significant affinity or pharmacological activity at other receptors. 5-HT1 receptors are present in cranial arteries and in the vasculature of the dura mater. This drug activates this receptor to cause vasoconstriction, which relieves migraines
Sumatriptan
Separate use with ergot-containing drugs by 24 hours due to the theoretical basis of this drug having an additive effect on the prolonged vasospasm reactions that ergot-containing drugs cause
Sumatriptan
Injection should not be given intravenously due to its potential to cause coronary vasospasm
Sumatriptan
CI in ischemic heart disease (angina pectoris, history of MI, or documented silent ischemia), in patients with Prinzmetal’s angina, and in uncontrolled HTN
Sumatriptan
Do not administer to patients with basilar or hemiplegic migraine
Sumatriptan
Serious coronary events following administration can occur, therefore consideration should be given to administering the first dose in the physician’s office to patients in whom unrecognized coronary disease is comparatively likely
Sumatriptan
Chest, jaw, or neck tightness is relatively common after injection, but has only rarely been associated with ischemic ECG changes
Sumatriptan
AE’s include tingling, warmth, burning, feeling of heaviness, pressure, tightness, numbness, tight feeling in head, flushing, tightness in chest, bad taste, discomfort of the throat, nose, tongue, or mouth, muscle weakness, neck pain/stiffness, dizziness/vertigo, diarrhea, and drowsiness
Sumatriptan
CI in patients with a known tendency to drug induced, hemolytic, or other anemias and in patients with significant renal or hepatic impairment
Metaxalone
Use with caution in patients allergic to anesthetic agents of the para-aminobenzoic acid class (procaine, tetracaine)
Benzonatate
Severe life-threatening reactions, including CV collapse and bronchospasm, have occurred from chewing or sucking this drug
Benzonatate
Acts peripherally by anesthetizing the stretch receptors located in the respiratory passages, lungs, and pleura by dampening their activity and thereby reducing the cough reflex at its source
Benzonatate
Inhibits reabsorption of sodium and chloride in the ascending limb of the loop of Henle
Bumetanide
CI in patients with anuria and in patients with uncorrected hepatic coma or severe electrolyte depletion
Bumetanide
AE’s include: DIZZINESS, hypotension, MUSCLE CRAMPS, WEAKNESS, IMPAIRED HEARING, hyperuricemia, hypochloremia, hyponatremia, HYPOKALEMIA, azotemia, and hyperglycemia
Bumetanide
Serious GI toxicity (including bleeding, ulceration, and perforation) may occur at any time during chronic therapy
Diclofenac
Inhibits dihydrofolic acid reductase, an enzyme which reduces dihydrofolates to tetrahydrofolates.
Methotrexate
BECAUSE OF THE POSSIBILITY OF SERIOUS TOXICITY RXNS (WHICH CAN BE FATAL), THIS DRUG SHOULD ONLY BE USED IN LIFE-THREATENING NEOPLASTIC DISEASES, OR IN PATIENTS WITH PSORIASIS OR RHEUMATOID ARTHRITIS WITH SEVERE, RECALCITRANT, DISABLING DISEASE WHICH IS NOT ADEQUATELY RESPONSIVE TO OTHER FORMS OF THERAPY
Methotrexate
AE’s may include: ulcerative stomatitis, leukopenia, abdominal distress, RASH, NEPHROTOXICITY, HEPATOTOXICITY, COUGH, & ANEMIA
Methotrexate
Thought to work via selective antagonism of dopamine and serotonin 5-HT2 receptors in the CNS
Olanzapine
CI IN PATIENTS WITH DEMENTIA-RELATED PSYCHOSIS
Olanzapine
Causes inhibition of acetyl-coenzyme A, interfering with the metabolism of carbohydrates in susceptible bacteria
Nitrofurantoin
Magnesium salts may decrease effectiveness
Nitrofurantoin
CI in patients with anuria, oliguria, significantly impaired renal function, in pregnant patients at term, and in infants under one month of age
Nitrofurantoin
Benztropine
Cogentin
Selectively blocks cholinergic histaminic receptors in the parasympathetic nervous system
Benztropine
CI in children < 3 years of age
Benztropine
Inhibits platelet aggregation in response to platelet activation factor (PAF), collagen, and adenosine diphosphate (ADP). Also inhibits prostaglandin and thromboxane A2 synthesis by acetylating the enzyme cyclooxygenase
Dipyridamole and Aspirin
Use with caution in patients undergoing surgery where fentanyl is used, in patients recently discontinuing b-adrenergic blocker therapy, and in patients with tight aortic stenosis, hepatic impairment, or CHF. May cause rare increase in angina or MI on starting therapy or increasing dose
Nifedipine
AE’s include: peripheral edema, palpitations, hypotension, dizziness, giddiness, HA, weakness, rash, N/V, flushing, nasal congestion, dyspnea, muscle cramps, and cough
Nifedipine
Caution: may cause fainting with sudden changes in posture
Nifedipine
Thought to work at the level of the spinal cord by inhibiting the flexor and crossed extensor reflexes. Also causes sedation which may add to its therapeutic effect
Methocarbamol
AE’s include: dizziness, drowsiness, nausea, PRURITIS, RASH, blurred vision, HA, fever
Methocarbamol
Synthetic acyclic purine nucleotide which in vitro inhibits Herpes simplex types 1 & 2, varicella zoster, Epstein-Barr, and cytomegalovirus
Acyclovir
Precipitation of this drug in renal tubules may occur in patients who are dehydrated
Acyclovir
Apply one-half inch ribbon of ointment per four square inches of surface area (using a rubber glove) every 3 hours (6 times per day) for 7 days
Acyclovir
Competitively inhibits the enzyme 5-alpha-reductase which is responsible for metabolizing testosterone to 5-alpha-dihydrotestosterone (DHT) in the prostate gland, liver, and skin
Finasteride
CI in women and children
Finasteride
AE’s include impotence & decreased libido
Finasteride
Thought to form an ulcer-adherent complex that covers the ulcer site and protects it against further attack by acid, pepsin, and bile attributed to the neutralization of gastric acid.
Sucralfate
Constipation occurs in approximately 2% of patients on this drug
Sucralfate
Take on an empty stomach one hour before or two hours after a meal. Antacids should not be taken within one-half hour.
Sucralfate
A naturally-occurring antibiotic produced by fermentation of the organism Pseudomonas fluorescens. MOA is derived from an inhibition of bacterial protein synthesis by reversibly and specifically binding to bacterial isoleucyl transfer-RNA synthetase
Mupirocin
An inhibitor of the release of histamine from the mast cell and a relatively selective histamine H-1 antagonist that inhibits the type 1 immediate hypersensitivity reaction including inhibition of histamine induced effects on human conjunctival epithelial cells
Olopatadine
At least 10 minutes should lapse after using and before inserting contact lenses
Olopatadine
AE’s: HA (7%), asthenia, blurred vision, burning or stinging, cold symptoms, dry eye, foreign body sensation, hyperemia, hypersensitivity, keratitis, lid edema, nausea, pharyngitis, pruritis, rhinitis, sinusitis, and taste perversion (all
Olopatadine
AE’s: HA, dizziness, nausea, VISUAL DISTURBANCES, edema, weight loss, BLOOD DYSCRASIAS, nervousness, anorexia, and abnormal skin pigmentation
Hydroxychloroquine
Competitively blocks the post-synaptic dopamine receptors in the cerebral cortex, basal ganglia, hypothalamus, limbic system, medulla, and the brain stem
Prochlorperazine
CI in patients hypersensitive to phenothiazines, in patients in comatose or greatly depressed CNS states, in patients with bone marrow depression, in children
Prochlorperazine
AE’s: drowsiness, dizziness, amenorrhea, blurred vision, itching, photosensitivity, urticaria, hypotension, EXTRAPYRAMIDAL reactions, and TARDIVE DYSKINESIA
Prochlorperazine
CI in women who are or may become pregnant and in women with active or past history of venous thromboembolic events, including deep vein thrombosis, pulmonary embolism, and retinal vein thrombosis
Raloxifene
AE’s: hot flashes, leg cramps, weight gain, peripheral edema, sinusitis, rash, and sweating
Raloxifene
This drug is rapidly converted into acyclovir
Valacyclovir
Amiodarone
Cordarone, Pacerone
A class III anti arrhythmic with its primary MOA a lengthening of the cardiac action potential
Amiodarone
CI in patients with cardiogenic shock, marked sinus bradycardia, and 2nd or 3rd degree AV block unless a functioning pacemaker is available. SHOULD ONLY BE PRESCRIBED AND ADMINISTERED BY PHYSICIANS WHO ARE FAMILIAR WITH ITS DOSING, ITS RISKS AND BENEFITS, AND WHO HAVE ADEQUATE MONITORING EQUIPMENT AVAILABLE.
Amiodarone
Binds to intestinal opiate receptors decreasing peristalsis and affecting water and electrolyte movement through the lower intestine. These actions are due to effects on the circular and longitudinal muscles of the intestine. The second drug component is included to discourage deliberate abuse and overdosage
Diphenoxylate with Atropine
CI in patients with obstructive jaundice or diarrhea associated with pseudomembranous enterocolitis
Diphenoxylate with Atropine
AE’s: constipation, drowsiness, anorexia, N/V, dry mouth, and stomach pain
Diphenoxylate with Atropine
D/C use if clinical response is not seen within 48 hours
Diphenoxylate with Atropine
Inhibits the membrane pump mechanism responsible for the reuptake of NE and 5-HT at the presynaptic nerve terminals, potentiating activity at the postsynaptic terminals
Nortriptyline, Doxepin
CI in patients on MAOI’s. Wait two weeks after D/C MAOI before initiating therapy. Also CI during the recovery phase of an MI.
Nortriptyline
Decreases total peripheral resistance by competitively blocking alpha-1 adrenoreceptors, resulting in vasodilation of arterioles and veins which leads to decreased peripheral resistance and decreased BP.
Terazosin
Caution should be used when given with other antihypertensive agents to avoid the possibility of significant hypotension. When adding another antihypertensive or diuretic, dosage reduction and reiteration may be necessary
Terazosin
Episodes of syncope have occurred during therapy, especially during the first few doses of therapy or after missing a few doses of maintenance therapy. To decrease the chance of syncope, all patients should be started with 1 mg tablets given at bedtime
Terazosin
AE’s: asthenia (11%), palpitations (4%), nausea (4%), HA (16%), nasal congestion (6%), peripheral edema (5%), and dizziness (19%)
Terazosin
Metabolized in the liver to quinaprilat. MOA is due to its suppression of the renin-angiotensin-aldosterone system by competitively inhibiting the angiotensin-converting enzyme (ACE)
Quinapril
Binds to the 50S subunit of susceptible bacterial ribosomes and suppresses protein synthesis
Clindamycin
Pseudomembranous colitis has been reported and should be considered in patients with severe or persistent diarrhea
Clindamycin
Drink a full glass of water (240 mL) after each dose
Clindamycin
CI in patients with systemic fungal infections
Methylprednisolone
AE’s: blurred vision, upset stomach, N/V, fluid and electrolyte disturbances, Cushing’s syndrome, increased susceptibility to infections, osteoporosis, vertebral compression, various behavioral disturbances, peptic ulceration, myopathy, suppression of growth in children, and signs of adrenal suppression
Methylprednisolone
Exerts its antibacterial actions by preventing the synthesis of bacterial DNA through inhibition of the enzyme DNA gyrase
Levofloxacin
AE’s: nausea (7%), diarrhea (5%), HA (5%), constipation (3%), taste perversion (1%), TENDINITIS & TENDON RUPTURE
Levofloxacin
Competitively inhibits phosphodiesterase causing an increase in cyclic adenosine monophosphate (cAMP). This action releases endogenous epinephrine and may inhibit the release of histamine and/or slow reacting substance of anaphylaxis (SRS-A).
Theophylline
CI in patients with active peptic ulcer disease and in individuals with an underlying seizure disorder
Theophylline
AE’s: HA, N/V, nervousness, epigastric pain, irritability, tachycardia, palpitations, and insomnia
Theophylline
Doxepin
Sinequan
Oral concentrate should be diluted with approximately 120 mL of water, milk, or juice just prior to administration
Doxepin
A sympathomimetic amine with pharmacologic activity similar to the prototype drugs of this class used in obesity, the amphetamines
Phentermine
Use with an MAOI may precipitate a hypertensive crisis
Phentermine
CI in patients with advanced arteriosclerosis, CV disease, moderate to severe HTN, hyperthyroidism, glaucoma, agitated states, a history of drug abuse, or in patients hypersensitive to sympathomimetic amines
Phentermine
Rare cases of primary pulmonary hypertension (dyspnea, angina pectoris, syncope, lower extremity edema) have been reported
Phentermine
Partial agonist at nicotinic receptors in the brain. MOA appears to be due to selective binding to the alpha-4-beta-2 neuronal nicotinic acetylcholine receptors
Varenicline
Serious neuropsychiatric symptoms (changes in behavior, agitation, depressed mood, suicidal ideation, and suicidal behavior) have occurred
Varenicline
Register with the GETQUIT support program
Varenicline
A histamine H1 receptor antagonist that blocks histamine release in peripheral tissues
Azelastine
AE’s: bitter taste in mouth (20%), HA (14%), drowsiness (12%), nasal burning (4%), pharyngitis (4%), dry mouth, sneezing, nausea (3%), rhinitis, fatigue, dizziness, nosebleed, and weight increase (2%)
Azelastine
Units need to be primed with 4 sprays upon assembly and with 2 sprays if not used for 3 days
Azelastine
Metolazone
Zaroxolyn
Inhibits the reabsorption of sodium and chloride at the cortical diluting site and in the proximal convoluted tubule
Metolazone
A synthetic prostaglandin F analogue which selectively stimulates FP prostanoid receptors. The primary MOA to reduce intraocular pressure is thought to be through increased uveoscleral outflow
Travoprost
May permanently change the pigmentation and growth of the eyelashes and increase the pigmentation of the iris and periorbital tissue (eyelid)
Travoprost
Most common AE: ocular hyperemia (50%)
Travoprost
Wait at least 5 minutes before instilling other ophthalmic preparations. Avoid squinting or closing of eyes tightly after instilling drops.
Travoprost
Centrally acting synthetic opioid analgesic compound
Tramadol with APAP
AE’s are dose-related: constipation (6%), somnolence (6%), increased sweating (4%), diarrhea (3%), nausea (3%), anorexia (3%), dizziness (3%), dry mouth (2%), pruritis (2%), insomnia (2%), and prostatic disorder in men (2%)
Tramadol with APAP
Clotrimazole with Betamethasone
Lotrisone
Increases membrane permeability of various intracellular substances by permeating the chitin of the fungal cell wall
Clotrimazole with Betamethasone
AE’s: paresthesia, erythema, stinging, blistering, peeling, pruritis, urticaria, burning, and general irritation of the skin
Clotrimazole with Betamethasone
Should not be used with occlusive dressings; may stain clothing. When applied to the groin area, should apply sparingly and for no longer than 2 weeks
Clotrimazole with Betamethasone
