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sav NUR 326 > exam 4 meds > Flashcards

exam 4 meds Flashcards

1
Q

Aldendronate

Raloxifene

Calcitonin-salmon

pharm for?

A

osteoporosis

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2
Q

osteoporosis
class
1. Bisphosphonates
2. Selective estrogen receptor modulators (SERMs)
3. Hormone therapy

Raloxifene
Aldendronate
Calcitonin-salmon

A
  1. Aldendronate
  2. Raloxifene
  3. Calcitonin-salmon
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3
Q

osteoporosis pharm
MOA
1. MOA – binds permanently to surfaces of bones to inhibit osteoclast activity (reduce bone breakdown)
2. MOA – mimics estrogen by increasing bone density, inhibits bone resorption
3. MOA – inhibits bone removal by osteoclasts

Raloxifene
Aldendronate
Calcitonin-salmon

A
  1. Aldendronate
  2. Raloxifene
  3. Calcitonin-salmon
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4
Q

osteoporosis pharm

  1. Used as prevention and treatment
  2. must take at least 5 years to see long term benefits
  3. Treatment ONLY (not prevention)

Raloxifene
Calcitonin-salmon

A
  1. Raloxifene
  2. Calcitonin-salmon
  3. Calcitonin-salmon
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5
Q
  1. GI issues – n/v/d and Esophageal ulcerations
    • Hot flash and Leg cramping
      BLACK BOX WARNING - Stroke risk
  3. nasal irritation

Raloxifene
Aldendronate
Calcitonin-salmon

A
  1. Aldendronate
  2. Raloxifene
  3. Calcitonin-salmon
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6
Q

osteoporosis pharm

    • Take with water
      • Don’t take with food, drinks (other than water), calcium or vitamins for 2 hours – very low bioavailability
      • Don’t lie down for 30 mins after taking – esophageal ulcers
    • Must take adequate calcium and vitamin D replacement for it to work
      • d/c at least 72 hours before planned procedures, any prolonged immobilization periods, high risk of blood clotting
      • don’t smoke or drink alcohol
      • don’t use if pregnant

Raloxifene
Aldendronate
Calcitonin-salmon

A
  1. Aldendronate
  2. Raloxifene
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7
Q
  • NSAIDS
  • Glucocorticoids (Prednisone – most common) – short term, Use only when symptoms not controlled with NSAIDS, Not best choice for long term therapy – usually small doses
  • DMARDS disease modifying anti-rheumatic drugs (metho and hydroxy)– slow/stop progression

treatment for?

A

RA

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8
Q

Methotrexate

Hydroxychloroquine

Biologic agents

treatment for?

A

RA (and lupus)

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9
Q

RA and lupus pharm

  1. DMARDS disease modifying anti-rheumatic drugs

Antineoplastic

Anti-rhematic

  1. DMARDS disease modifying anti-rheumatic drugs

antimalarial

Anti-rhematic

  1. Newer generation of DMARDS disease modifying anti-rheumatic drugs

Hydroxychloroquine
Biologic agents
Methotrexate

A
  1. Methotrexate
  2. Hydroxychloroquine
  3. Biologic agents
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10
Q

RA and lupus pharm
MOA
1. MOA – immunosuppressive

  1. Anti-inflammatory processes
  2. Biologic response modifiers

Target parts of the immune system that trigger inflammation that cause joint and tissue damage

Hydroxychloroquine
Biologic agents
Methotrexate

A
  1. Methotrexate
  2. Hydroxychloroquine
  3. Biologic agents
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11
Q

RA and lupus pharm
indications
1. slow/stop progression of RA
(ALSO FOR LUPUS)
Slows progression of RA when used with other DMARDs
2. slow/stop progression
used with methotrexate for early/mid RA
(ALSO FOR LUPUS)

Hydroxychloroquine
Biologic agents
Methotrexate

A
  1. Methotrexate
  2. Hydroxychloroquine
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12
Q

s/e
RA and lupus pharm
DMARDS

  1. GI , Bone marrow suppression , Shortened life expectancy
    11 BLACK BOX WARNINGS
  2. Retinopathy
  3. Can increase risk of severe skin or lung infections, skin cancer, serious allergic reactions

Hydroxychloroquine
Biologic agents
Methotrexate

A
  1. Methotrexate
  2. Hydroxychloroquine
  3. Biologic agents
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13
Q

RA and lupus pharm

  1. Route - PO, SQ, IV
    - Patient needs folic acid supplementation
    - NO alcohol
    - Teratogenic – NEVER ok for pregnant
    - High risk of infection – contact HCP if s/s of infection
    - Caution with liver and kidney disease
    - Aplastic anemia risk when using with NSAIDS
    - Given weekly – death can occur if given daily
  2. Used with methotrexate
  3. Usually given with methotrexate
    Very expensive

Hydroxychloroquine
Biologic agents
Methotrexate

A
  1. Methotrexate
  2. Hydroxychloroquine
  3. Biologic agents
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14
Q

_______ pharm

NSAID
Allupurinol
Colchicine
Probenecid

which is 1st line?
which is 2nd line?

A

gout pharm

NSAIDS - 1st line
Allupurinol
Colchicine - 2nd line
Probenecid

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15
Q

gout pharm
class
1. XOE inhibitor
2. Uricosuric agent

Probenecid
Allupurinol
Colchicine

A
  1. Allupurinol
  2. Probenecid
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16
Q

gout pharm
MOA
1. MOA – inhibits the xanthine oxidase enzyme which prevents uric acid production

  1. Reduces inflammatory response to the deposits or urate crystals in joint tissues
  2. Inhibits reabsorption of uric acid in kidneys
    Promote excretion

Probenecid
Allupurinol
Colchicine

A
  1. Allupurinol
  2. Colchicine
  3. Probenecid
17
Q

gout pharm
indications
1. Gout is r/t excess uric acid production (hyperuricemia)
Prevention only !!

  1. Gout flares short term
    - Prophylaxis
  2. Treats hyperuricemia with gout
    Used alone or with allopurinol when not effective alone

Probenecid
Allupurinol
Colchicine

A
  1. Allupurinol
  2. Colchicine
  3. Probenecid
18
Q

gout pharm
s/e

    • Agranulocytosis
      • Aplastic anemia
      • Fatal skin reactions – SJS/TENS
        Monitor:
      • WBC
      • CBC
  2. GI bleed, GU bleed
    Powerful inhibitor of cell mitosis and can cause
    - short term leukopenia
    - bone marrow suppression
  3. GI upset – take with food
    - Dizzy
    - h/a
    - kidney/liver impairment – watch for signs of kidney issues
    - lots of drug interactions

Probenecid
Allupurinol
Colchicine

A
  1. Allupurinol
  2. Colchicine
  3. Probenecid
19
Q

gout pharm

  1. Drug interactions:
    Increases effect of antidiabetic meds and warfarin when taken with _______
    Monitor:
    Sugar and INR levels
  2. Contraindications
    - Sever renal disorder
    - GI disorder
    - Hepatic disorder
    - Cardiac disorder
    - Bleeding disorder
    Route – PO only
    vomiting = toxicity, stop med

Probenecid
Allupurinol
Colchicine

A
  1. Allupurinol
  2. Colchicine
20
Q

_________ pharm
Abx
1. Obtain culture
2. Empiric abx therapy - administration of antibiotics based on the most likely diagnosis, b/c we don’t want to delay treatment
- Nafcillin
- Cefazolin
- Vancomycin – sometimes continuous infusions, other times direct therapy such as infusing abx though a wound vac
3. Switch to bacteria-specific therapy

A

Osteomyelitis

21
Q

__________ pharm
Mild to moderate
- acetaminophen
- topical capsaicin - heat sensation
- NSAIDS - OTC
Moderate to severe
- NSAIDS – Rx strength
- NSAIDS + colchicine
- Acetaminophen + tramadol
- Opioids
- Steroid injections into joint

A

Osteoarthritis

22
Q

_______ pharm
agents used depend on system involved
- NSAIDS = h/s, musculoskeletal, pleuritis, pericarditis
- High dose corticosteroids = severe kidney disease, CNS
- Low dose corticosteroids = arthritis
- Antimalarials/DMARD (hydroxychloroquine) = skin, musculoskeletal, prevention of kidney and CNS organ damage
- Immunosuppressives/DMARD (methotrexate) = severe organ involvement

A

Lupus

sav NUR 326 (19 decks)

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