Exam 5 Drugs Flashcards
1
Q
ACETAZOLAMIDE
class
indications
actions
side effects
monitor…
contraindications
A
- CARBONIC ANHYDRASE INHIBITOR
- for glaucoma & adjunct to other diuretics
- formation of sodium bicarb & excretion of hydrogen
- causes Neuro—weakness; fatigue; paresthesia; confusion; Resp—rapid shallow breathing (acidemia); GI/endo—anorexia; F & E—acidic urine; metabolic acidosis (loss of bicarb); hypokalemia; MS—bone marrow suppression
- monitor pH & K+
- contraindicated in pts with sulfonamide or thiazide allergy
2
Q
ACETYLCYSTEINE
classes
indications
action
side effects
take with…
A
- ANTIDOTE; MUCOLYTIC
- for acetaminophen toxicity; sputum sample
- ↓ viscosity of mucus
- causes Resp—bronchospasm; rhinorrhea; GI/endo—stomatitis; nausea; Integ—urticaria
- mix with fruit juice
3
Q
ALBUTEROL
class
indication
route
action
side effects
how to admin
onset & duration
may be given with…
A
- BETA 2 ADRENERGIC
- for acute asthma attacks
- route—MDI rescue inhaler
- dilates bronchioles
- causes Neuro—nervousness; tremor; CV—tachycardia; dysrhythmias; palpitations; angina; HTN; GI/endo—hyperglycemia
- use with a spacer; hold breath for 10 seconds after inhaling; 1 min between puffs; give 5 mins before steroid admin; rinse mouth after steroid (thrush)
- o. 30 mins; d. 2-6 hours
- may be given with epinephrine (Adrenalin)
4
Q
ALETPLASE
class
indications
action
side effects
used when?
monitor…
contraindications
antidote
A
- THROMBOLYTIC/FIBRINOLYTIC
- for thrombotic CVA; early onset MI; restoring patency of central lines
- converts plasminogen to plasmin; destroys fibrin of clots
- causes Neuro—h/a; pain; CV—bleeding; hypotension; reperfusion dysrhythmias; Imm—allergic reaction; fever
- best used w/i 4-6 hours of CVA
- monitor PTT/PT/INR; sx of allergic reaction; bleeding
- contraindicated in recent major surgery or trauma; intracranial hemorrhage; history of GI bleed
- antidote—aminocaproic acid
5
Q
ALUMINUM HYDROXIDE
class
indications
action
side effects
monitor…
when to admin
may be given with…
A
- ANTACID
- symptomatic relief of hyperacidity; promotes ulcer healing
- neutralizes HCl
- causes GI/endo—constipation; gastric; acid rebound when d/c; Other—systemic alkalosis
- monitor pH
- admin 2 hours before/after other meds
- simethicone may be added to reduce flatus
6
Q
AMILORIDE
class
indications
actions
side effects
monitor…
drug-drug interaction
tx for side effect
A
- POTASSIUM-SPARING DIURETIC
- for edema r/t HF, cirrhosis, renal disease; hyperaldosteronism; HTN
- acts on collecting duct & late distal tubules; Na+ excretion and K+ retention
- causes Neuro—dizziness; vertigo; GI/endo—diarrhea; F & E—hyperkalemia; Androgen effects—hirsutism; gynecomastia; irregular menses; deepening voice
- monitor K+ & sx of hyperkalemia
- caution with ACE inhibitors (hyperkalemia)
- hyperkalemia—kayexalate
7
Q
AMINOCAPROIC ACID
class
indication
A
- HEMOSTATIC AGENT
- for thrombolytic/fibrinolytic toxicity
8
Q
AMINOPHYLLINE
class
indications
actions
side effects
monitor…
drug-drug/food interaction
therapeutic range
A
- METHYLXANTHINE
- for asthma; other chronic lung conditions
- dilates bronchioles; stimulates CNS; stimulates respiration
- causes Neuro—h/a; nervousness; CV—hypotension; dysrhythmias; GI/endo—n/v; stomach pain; MS—convulsions
- monitor levels (if side effects occur)
- NO stimulants (caffeine; nicotine; chocolate)
- TR—5-15 mcg/mL
9
Q
ASPIRIN
class
indications
actions
side effects
pregnancy category
contraindications
caution
how to take
antidote
A
- SALICYCLATE; ANTIPLATELET; ANTIPYRETIC; NONOPIOID ANALGESIC; NSAID
- for clot prevention; pain; fever; inflammation
- inhibits prostaglandins; inhibits platelet aggregation
- causes Neuro—dizziness; ototoxicity; tinnitus; confusion; CV—↑ bleeding time; blood dyscrasias; thrombocytopenia; Resp—hyperventilation; GI/endo—n/v/d; dyspepsia; epigastric pain; anorexia; ulcers; F & E—dehydration; Integ—urticaria; diaphoresis; Imm—anaphylaxis; Other—Reye’s (childhood toxicity); Salicyclism (adult toxicity)
- pregnancy category D in 3rd trimester
- contraindicated in children, especially with a fever
- avoid activity risking injury/bleeding
- take with food
- antidote—activated charcoal
10
Q
AZELASTINE
class
indications
side effects
advantage
A
- ANTIHISTAMINE 2ND GEN
- for allergy sx; hay fever; hives; itching; watery eyes; sneezing
- causes Neuro—drowsiness; tiredness; paradoxical excitation (children); GI/endo—dry mouth; stomach pain
- fewer sx than diphenhydramine
11
Q
BISACODYL
class
indication
action
side effects
monitor…
contraindication
A
- STIMULANT LAXATIVE
- for constipation
- irritate nerve endings in intestinal mucosa; stimulate peristalsis
- causes GI/endo—n/v/d; cramps; laxative dependence; F & E—imbalance
- monitor F & E
- contraindicated with appendicitis; bowel obstruction
12
Q
BISMUTH SUBSALICYLATE
class
indication
OTC or Rx?
A
- ANTIDIARRHEAL
- for diarrhea
- OTC
13
Q
BUDESONIDE
class
indication
action
side effects
A
- INTRANASAL CORTICOSTEROID
- prophylaxis for asthma
- anti-inflammatory
- causes Neuro—h/a; Resp—drying of nasal mucosae; Imm—infection risk; Local—burning; stinging; irritation
14
Q
BUMETANIDE
class
indications
actions
side effects
monitor…
A
- LOOP DIURETIC
- for HF; pulmonary edema; kidney disease; liver disease; HTN
- acts on loop of Henle; inhibit Na+ and Cl- reabsorption
- causes Neuro—dizziness; vertigo; paresthesia; ototoxicity; CV—dysrhythmias (hypokalemia); hypotension; GI/endo—hyperglycemia; n/v; F & E—severe F & E losses; dehydration; hyponatremia; hypokalemia; hypochloremia; metabolic alkalosis; MS—↑ uric acid (gout)
- monitor K+; glucose; sx dehydration; uric acid
15
Q
CALCIUM SALTS
class
indications
action
side effects
monitor…
when to admin
may be given with…
A
- ANTACID
- symptomatic relief of hyperacidity; promotes ulcer healing
- neutralizes HCl
- causes GI/endo—gastric; acid rebound when d/c; Other—systemic alkalosis
- monitor pH
- admin 2 hours before/after other meds
- simethicone may be added to reduce flatus
16
Q
causes acidosis, rapid shallow breathing, hypokalemia
A
carbonic anhydrase inhibitors
17
Q
causes bradycardia & thickening of bronchial secretions
A
diphenhydramine
18
Q
causes bronchospasm; rhinorrhea; stomatitis
A
acetylcysteine
19
Q
causes cardiac decompensation, dehydration, hypokalemia
A
mannitol
20
Q
causes confusion, somnolence, gynecomastia
A
cimetidine
(other histamine blockers w/o gynecomastia)
21
Q
causes dark tarry stools, teeth staining
A
iron
22
Q
causes extrapyramidals; dystonia; photophobia; thrombophlebitis
A
phenothiazines
23
Q
causes extrapyramidals; parkinsonlike reaction
A
metoclopramide
24
Q
causes fracture risk
A
PPIs
25
causes hemorrhage, thrombocytopenia
anticoags
26
causes HTN, thrombolytic event
erythropoietic growth factors
27
causes HTN; hyperglycemia; nervousness; tachycardia
albuterol
28
causes hyperglycemia, hypercalcemia, hypokalemia, gout
thiazide diuretics
29
causes hyperkalemia, androgen effects
K+ sparing diuretics
30
causes hypotension; convulsions; nervousness
aminophylline
31
causes infection; cough; pharyngitis
montelukast
32
causes liver toxicity, jaundice, red/orange discoloration of skin, sclera, urine
phenozopyridine
33
causes miscarriage; hypermenorrhea
misoprostol
34
causes myalgia; urinary retention; constipation
ondansetron
35
causes nervousness & rebound congestion if overused
decongestants
36
causes ototoxicity, blood dyscrasias, hyperventilation, urticaria
aspirin
37
causes ototoxicity, paresthesias, hypokalemia, dysrhythmias, hyperglycemia
loop diuretics
38
causes reperfusion dysrhythmias, bleeding
thrombolytic/fibrinolytics
39
causes reperfusion dysrhythmias, bleeding
thrombolytic/fibrinolytics
40
causes resp depression & drowsiness
dextromethorphan
41
causes stomatitis, erythema
hydroxyurea
42
causes sytemic alkalosis
antacids
43
causes tachycardia, blurred vision, dry mouth, urinary hesitancy
UT antispasmodics
44
**CETIRIZINE**
class
indications
side effects
advantage
* ANTIHISTAMINE 2ND GEN
* for allergy sx; hay fever; hives; itching; watery eyes; sneezing
* causes **Neuro—**drowsiness; tiredness; _paradoxical excitation (children);_ **GI/endo—**dry mouth; stomach pain
* fewer sx than diphenhydramine
45
**CLOPIDOGREL**
class
indications
side effects
monitor…
* ANTIPLATELET
* for prevention of CVA, MI, DVT, etc
* causes **Neuro—**h/a; dizziness; **CV**—_bleeding_, bruising; _thrombocytopenia;_ **GI/endo—**n/d; abd pain; **Integ—**rash
* monitor for signs of bleeding
46
**DEXTROMETHORPHAN**
class
indication
action
side effects
may contain…
* ANTITUSSIVE
* for nonproductive cough
* depresses cough reflex in medulla's cough center
* causes **Neuro—**dizziness; drowsiness; **Resp—**_depression;_ **GI—**nausea
* may contain codeine
47
**DICHLORPHENAMIDE**
class
indications
actions
side effects
monitor…
contraindications
* CARBONIC ANHYDRASE INHIBITOR
* for glaucoma & adjunct to other diuretics
* formation of sodium bicarb & excretion of hydrogen
* causes **Neuro—**weakness; fatigue; _paresthesia_; confusion; **Resp**—_rapid shallow breathing_ (acidemia); **GI/endo—**anorexia; **F & E**—_acidic urine; metabolic acidosis_ (loss of bicarb); _hypokalemia_; **MS—**_bone marrow suppression_
* monitor pH & K+
* contraindicated in pts with sulfonamide or thiazide allergy
48
**DIPHENOXYLATE + ATROPINE**
class
indication
action
schedule
OTC or Rx
* ANTIDIARRHEAL
* for diarrhea
* slows GI motility
* schedule V
* Rx
49
**DOCUSATE SODIUM**
class
indication
side effects
monitor…
contraindications
* STOOL SOFTENER
* for prevention of constipation
* causes **GI/endo—**n/d; cramps; bloating
* monitor last BM
* contraindicated with appendicitis; bowel obstruction
50
**ENOXAPARIN**
class
indication
action
side effects
monitor…
how to admin
caution
contraindications
advantages
antidote
* ANTICOAGULANT; LOW MOLECULAR WEIGHT HEPARIN
* for prevention of thromboembolism
* prevents clotting
* causes **CV**—_hemorrhage_; thrombocytopenia
* monitor for signs of bleeding
* adminstered SQ into the “love handles”; do not rub; hold firm pressure
* caution with spinal anesthesia
* contraindicated with CVA; peptic ulcers; blood dyscrasias; eye, brain and spinal surgery
* advantages over heparin—↓ bleeding risk, side effects; less effects on thrombin, clotting, PT; better stability in pt response; aPTT monitoring unnecessary; home admin allowed
* antidote—protamine sulfate
51
**EPOIETIN ALFA & ERYTHROPOIETIN**
class
indication
action
side effects
tx goal
* ERYTHROPOIETIC GROWTH FACTOR
* for anemia r/t renal failure or chemotherapy
* acts on bone marrow to ↑ RBC production
* causes **Neuro—**h/a; body ache; _seizures_; dizziness; **CV—**_HTN_; _thrombolytic event;_ **GI/endo—**n/v/d; **F & E—**edema
* tx goal—Hgb to 10-11 g/dL; Hct to 33%
52
**FAMOTIDINE**
class
indications
action
side effects
drug-drug interaction
* HISTAMINE-2 BLOCKER
* for duodenal & benign gastric ulcers; stress ulcers; acute upper GI bleed prophylaxis; GERD; gastric distress
* block histamine receptors in parietal cells
* causes **Neuro—**h/a; dizziness; _confusion_; _somnolence;_ **CV—**_dysrhythmias;_ **GI/endo—**n/v/d
* do not give w/i an hour of antacid admin
53
**FERROUS SULFATE**
class
indication
action
side effects
give with…
contraindications
caution
* IRON SUPPLEMENT
* for anemia
* ↑ hemoglobin & RBC production
* causes **GI/endo—**n/v; constipation; _dark, tarry stools_; _teeth staining_ (liquid)
* give with vitamin C
* contraindicated with tetracyclines & antacids
* OD may be fatal in children
54
**FLUTICASONE**
class
indication
action
side effects
* INTRANASAL CORTICOSTEROID
* prophylaxis for asthma
* anti-inflammatory
* causes **Neuro—**h/a; **Resp—**drying of nasal mucosae; **Imm—**_infection risk;_ **Local—**burning; stinging; _irritation_
55
**FUROSEMIDE**
class
indications
actions
side effects
monitor…
* LOOP DIURETIC
* for HF; pulmonary edema; kidney disease; liver disease; HTN
* acts on loop of Henle; inhibit Na+ and Cl- reabsorption
* causes **Neuro—**dizziness; vertigo; _paresthesia_; _ototoxicity;_ **CV—**_dysrhythmias_ (hypokalemia); hypotension; **GI/endo—**_hyperglycemia_; n/v; **F & E—**_severe F & E losses; dehydration_; hyponatremia; hypokalemia; hypochloremia; _metabolic alkalosis_; **MS**—_↑ uric acid (gout)_
* monitor K+; glucose; sx dehydration; uric acid
56
**GUAIFENESIN**
class
indication
side effects
take with…
* EXPECTORANT
* for productive cough
* causes **Neuro**—dizziness; h/a; **GI—**n/v
* encourage fluids
57
**HEPARIN**
class
indications
action
side effects
monitor…
how to admin
caution
pregnancy safety
antidote
* ANTICOAGULANT
* for DVT; PE; coronary thrombosis; artificial heart valves; non-hemorrhagic CVA
* prolongs bleeding time & prevents clots
* causes **CV**—_hemorrhage_; thrombocytopenia
* monitor for signs of bleeding; PTT/aPPT
* hold firm pressure over SQ injection; do not rub
* caution with spinal anesthesia
* does not cross placenta; does cross breastmilk
* antidote—protamine sulfate
58
**HYDROCHLOROTHIAZIDE**
class
indications
actions
side effects
monitor…
tx for side effect
effective when?
* THIAZIDE DIURETIC
* for HTN (first line); mild/moderate HF
* acts on distal convoluted tubule; inhibits Na+ and Cl- reabsorption; increases water & K+ excretion
* causes **Neuro—**dizziness; vertigo; **CV**—ortho hypotension; **GI/endo—**n/v/d; _hyperglycemia;_ **F & E**—_hypercalcemia_; _hypokalemia;_ **MS**—_↑ uric acid (gout)_; muscle cramps & spasms
* monitor for dehydration; Ca+; K+; glucose; uric acid
* give KCl for hypokalemia
* not effective immediately
59
**HYDROXYUREA**
class
indication
actions
side effects
* ANTINEOPLASTIC
* for sickle cell anemia
* ↑ amt of hemoglobin produced in bone marrow; dilutes formation of abnormal hemoglobin; less clogging of small vessels
* causes **Neuro—**dizziness; h/a; **GI/endo—**_stomatitis_; anorexia; n/v; **MS—**bone marrow depression; **Integ—**rash; _erythema_
60
**INDAPAMIDE**
class
indications
actions
side effects
monitor…
tx for side effect
effective when?
* THIAZIDE DIURETIC
* for HTN (first line); mild/moderate HF
* acts on distal convoluted tubule; inhibits Na+ and Cl- reabsorption; increases water & K+ excretion
* causes **Neuro—**dizziness; vertigo; **CV**—ortho hypotension; **GI/endo—**n/v/d; _hyperglycemia;_ **F & E**—_hypercalcemia_; _hypokalemia;_ **MS**—_↑ uric acid (gout)_; muscle cramps & spasms
* monitor for dehydration; Ca+; K+; glucose; uric acid
* give KCl for hypokalemia
* not effective immediately
61
**IPRATROPIUM**
class
indication
action
side effects
how to use
advantage
* ANTICHOLINERGIC
* for daily COPD sx; COPD maintenance
* dilates bronchioles
* causes **Neuro—**nervousness; dizziness; h/a; **CV—**_palpitations;_ **GI/endo—**distress; nausea
* use 3-4x/day
* fewer side effects than PO anticholinergics
62
**KAYEXALATE**
class
indication
given with…
* ELECTROLYTE MODIFIER
* for hyperkalemia
* given with K+ sparing diuretics
63
**LACTOBACILLUS**
class
indication
OTC or Rx?
* ANTIDIARRHEAL
* for diarrhea
* OTC
64
**LACTULOSE**
class
indication
actions
side effects
monitor…
contraindications
caution
* OSMOTIC LAXATIVE
* for constipation
* hyperosmolar salts pull water into colon; ↑ bulk, stimulates peristalsis
* causes **GI/endo—**diarrhea; cramps; bloating; **F & E—**_dehydration_
* monitor F & E
* contraindicated with appendicitis; bowel obstruction
* caution with DM
65
**LANSOPRAZOLE**
class
indications
action
side effects
how to take
caution
how long does it take to work
* PROTON PUMP INHIBITOR
* for gastric & duodenal ulcers; erosive esophagitis; GERD
* inhibits H+/K+ ATPase system in parietal cells
* causes **Neuro—**h/a; vertigo; insomnia; **GI/endo—**n/v/d; _pain;_ **MS—**_fracture risk_
* take 1x/day, prior to breakfast
* do not chew, crush, break
* takes a few weeks to work
66
**LOPERAMIDE**
class
indication
OTC or Rx?
* ANTIDIARRHEAL
* for diarrhea
* OTC
67
**LORATADINE**
class
indications
side effects
advantage
* ANTIHISTAMINE 2ND GEN
* for allergy sx; hay fever; hives; itching; watery eyes; sneezing
* causes **Neuro—**drowsiness; tiredness; _paradoxical excitation (children);_ **GI/endo—**dry mouth; stomach pain
* fewer sx than diphenhydramine
68
**LUBIPROSTONE**
class
indication
monitor…
* HERBAL LAXATIVE
* for IBS
* monitor F & E
69
**MANNITOL**
class
indications
actions
side effects
monitor…
storage & admin intervention
contraindication
* OSMOTIC DIURETIC
* for acute renal failure 2nd to OD, shock, trauma; high ICP; high intraocular pressure 2nd to glaucoma
* acts on prox tubules, loop of Henle, collecting duct; inhibits water & Na+ reabsorption; promotes mvmt of toxins through kidneys
* causes **Neuro**—h/a; dizziness; **CV—**hypotension; _cardiac decompensation in HF;_ **GI/endo—**dry mouth; thirst; n/v; **F & E**—_dehydration_; sudden drop in fluids; _hypokalemia_
* monitor K+; Na+; uric acid; glucose; kidney function
* crystallizes when exposed to cold; use a filtered needle and keep out of cold
* contraindicated in HF
70
**METHYCLOTHIAZIDE**
class
indications
actions
side effects
monitor…
tx for side effect
effective when?
* THIAZIDE DIURETIC
* for HTN (first line); mild/moderate HF
* acts on distal convoluted tubule; inhibits Na+ and Cl- reabsorption; increases water & K+ excretion
* causes **Neuro—**dizziness; vertigo; **CV**—ortho hypotension; **GI/endo—**n/v/d; _hyperglycemia;_ **F & E**—_hypercalcemia_; _hypokalemia;_ **MS**—_↑ uric acid (gout)_; muscle cramps & spasms
* monitor for dehydration; Ca+; K+; glucose; uric acid
* give KCl for hypokalemia
* not effective immediately
71
**METHYLNALTEXONE**
class
indication
monitor…
* HERBAL LAXATIVE
* for opioid-induced constipation
* monitor F & E
72
**METOCLOPRAMIDE**
class
indication
action
side effects
* GI STIMULANT
* for postop, chemo-related n/v
* stimulates parasympathetic activity; ↑ ACh sensitivity; stimulates gastric emptying
* causes **Neuro—**_restlessness_; _extrapyramidals_; drowsiness; fatigue; _Parkinson-like reactions;_ **GI—**n/d
73
**MILK OF MAGNESIA**
class
indication
actions
side effects
monitor…
contraindications
* OSMOTIC LAXATIVE
* for constipation
* hyperosmolar salts pull water into colon; ↑ bulk, stimulates peristalsis
* causes **GI/endo—**diarrhea; cramps; bloating; **F & E—**_dehydration_
* monitor F & E
* contraindicated with appendicitis; bowel obstruction
74
**MISOPROSTOL**
class
indication
action
side effects
pregnancy category
* PROSTAGLANDIN ANALOGUE
* for gastric distress with NSAIDs
* suppresses acid secretion; ↑ cytoprotective mucus
* causes **GI/endo—**n/v/d; flatulence; **Rep—**_miscarriage_; _hypermenorrhea_
* pregnancy category X
75
**MOMETASONE**
class
indication
action
side effects
* INTRANASAL CORTICOSTEROID
* prophylaxis for asthma
* anti-inflammatory
* causes **Neuro—**h/a; **Resp—**_drying of nasal mucosae_; **Imm—**_infection risk;_ **Local—**burning; stinging; irritation
76
**MONTELUKAST**
class
indications
actions
side effects
* LEUKOTRIENE MODIFIER
* for prophylaxis of chronic bronchial asthma; allergic reactions
* inhibits bronchoconstriction; reduces inflammation
* causes **Neuro—**h/a; dizziness; **Resp—**_infection_; _cough_; _pharyngitis;_ **GI/endo—**n/v
77
**NIZATIDINE**
class
indications
action
side effects
drug-drug interaction
* HISTAMINE BLOCKER
* for duodenal & benign gastric ulcers; stress ulcers; acute upper GI bleed prophylaxis; GERD; gastric distress
* block histamine receptors in parietal cells
* causes **Neuro—**h/a; dizziness; _confusion_; _somnolence;_ **CV—**_dysrhythmias;_ **GI/endo—**n/v/d
* do not give w/i an hour of antacid admin
78
**NOLOXEGOL**
class
indication
monitor…
* HERBAL LAXATIVE
* for opioid-induced constipation
* monitor F & E
79
**OLOPATADINE**
class
indications
side effects
advantage
* ANTIHISTAMINE 2ND GEN
* for allergy sx; hay fever; hives; itching; watery eyes; sneezing
* causes **Neuro—**drowsiness; tiredness; _paradoxical excitation (children);_ **GI/endo—**dry mouth; stomach pain
* fewer sx than diphenhydramine
80
**OMEPRAZOLE**
class
indications
action
side effects
how to take
caution
how long does it take to work
* PROTON PUMP INHIBITOR
* for gastric & duodenal ulcers; erosive esophagitis; GERD
* inhibits H+/K+ ATPase system in parietal cells
* causes **Neuro—**h/a; vertigo; insomnia; **GI/endo—**n/v/d; _pain;_ **MS—**_fracture risk_
* take 1x/day, prior to breakfast
* do not chew, crush, break
* takes a few weeks to work
81
**OMETIDINE**
class
indications
action
side effects
drug-drug interaction
* HISTAMINE BLOCKER
* for duodenal & benign gastric ulcers; stress ulcers; acute upper GI bleed prophylaxis; GERD; gastric distress
* block histamine receptors in parietal cells
* causes **Neuro—**h/a; dizziness; _confusion_; _somnolence;_ **CV—**_dysrhythmias;_ **GI/endo—**n/v/d
* do not give w/i an hour of antacid admin
82
**ONDANSETRON**
class
indication
side effects
advantage
* SEROTONIN RECEPTOR ANTAGONIST
* for chemo-related n/v
* causes **Neuro—**h/a; dizziness; drowsiness; **GI/endo—**constipation; **F & E—**retention; **MS—**_myalgia_
* no extrapydramidals
83
**OXYBUTYNIN**
class
indications
actions
side effects
tx for side effect
monitor…
* URINARY TRACT ANTISPASMODIC
* for UT spasms (cystitis, prostatitis, urethritis); dysuria; _incontinence;_ urgency; nocturia
* blocks parasympathetic activity; suppresses overactivity
* causes **Neuro**—drowsiness; dizziness; _blurred vision;_ **CV—**_tachycardia;_ **GI/endo—**dry mouth; nausea; **F & E**—_urinary hesitancy;_ **Integ**—↓ sweating
* give water & hard candy for dry mouth
* monitor intraocular pressure; I & O
84
**OXYMETAZOLINE**
class
indications
action
side effects
contraindication
monitor…
use for how long?
* ALPHA ADRENERGIC AGONIST; SYMPATHOMIMETIC
* for PO—cold/allergy; IV—shock; topical/eye drop—pupil dilation for exam; topial/intranasal—congestion
* causes vasoconstriction
* causes **Neuro—**_nervousness_; restlessness; tremors; dizziness; anxiety; h/a; **CV—**_palpitations_; dysrhythmias; _HTN_; _tachycardia;_ **Resp—**_dyspnea_; _pulmonary edema; rebound congestion_ **GI/endo—**dry mouth; n/v; _hyperglycemia;_ **F & E**—urninary retention
* contraindicated with HTN
* monitor VS; urine output; glucose
* rebound effect—use no more than 3-5 days
85
**PANTOPRAZOLE**
class
indications
action
side effects
how to take
caution
how long does it take to work
* PROTON PUMP INHIBITOR
* for gastric & duodenal ulcers; erosive esophagitis; GERD
* inhibits H+/K+ ATPase system in parietal cells
* causes **Neuro—**h/a; vertigo; insomnia; **GI/endo—**n/v/d; _pain;_ **MS—**_fracture risk_
* take 1x/day, prior to breakfast
* do not chew, crush, break
* takes a few weeks to work
86
**PENTOXIFYLLINE**
class
indication
action
side effects
* ANTICOAGULANT
* for intermittent claudication
* ↓ viscosity of RBCs; ↑ flexibility of RBCs
* causes **GI/endo—**upset
87
**PERMETHRIN**
class
indications
how to admin
* SCABICIDE; PEDICULOCIDE
* for lice; crab lice; scabies; other mites
* lice—apply shampoo 10 mins before you rinse
* scabies—apply 8-14 hours before bathing; repeat in 7-10 days if tx fails
88
**PHENOZOPYRIDINE**
class
indication
side effects
monitor…
* URINARY TRACT ANALGESIC
* for UT irritation
* causes **Neuro**—h/a; **GI/endo**—upset; _liver toxicity_ (jaundice); **F & E**—renal toxicity; **Integ**—rash; **Other**—_red/orange discoloration of skin, sclera, urine_
* monitor for jaundice & d/c if jaundice occurs
89
**PHENYLEPHRINE**
class
indications
action
side effects
contraindication
caution
monitor…
* ALPHA ADRENERGIC AGONIST; SYMPATHOMIMETIC
* for PO—cold/allergy; IV—shock; topical/eye drop—pupil dilation for exam; topial/intranasal—congestion
* causes vasoconstriction
* causes **Neuro—**_nervousness_; restlessness; tremors; dizziness; **CV—**_palpitations_; dysrhythmias; _HTN_; _tachycardia;_ **Resp—**_dyspnea_; _pulmonary edema;_ **GI/endo—**dry mouth; n/v; _hyperglycemia;_ **F & E**—urninary retention
* contraindicated with HTN
* caution with CV disease; hyperthyroidism; DM
* monitor VS; urine output; glucose
90
**POLYTHENE GLYCOL**
class
indication
actions
side effects
monitor…
contraindications
* OSMOTIC LAXATIVE
* for constipation
* hyperosmolar salts pull water into colon; ↑ bulk, stimulates peristalsis
* causes **GI/endo—**diarrhea; cramps; bloating; **F & E—**_dehydration_
* monitor F & E
* contraindicated with appendicitis; bowel obstruction
91
**POTASSIUM CHLORIDE**
class
indication
caution
* SUPPLEMENT
* for hypokalemia
* never give IV push (will cause death)
92
**PROCHLORPERAZINE**
class
indication
side effects
* PHENOTHIAZINE
* for vomiting
* causes **Neuro—**_extrapyramidals_; drowsiness; _dystonia_; _photophobia_; blurred vision; **Resp—**_congestion;_ **F & E—**retention; **Local—**_thrombophlebitis_
93
**PROMETHAZINE**
class
indication
side effects
how to admin
* PHENOTHIAZINE
* for vomiting
* causes **Neuro—**_extrapyramidals_; drowsiness; _dystonia_; _photophobia_; blurred vision; **Resp—**_congestion;_ **F & E—**retention; **Local—**_thrombophlebitis_
* mix with 10mL & infuse slowly
94
**PROTAMINE SULFATE**
class
indication
* ANTIDOTE
* for heparin & enoxaparin toxicity
95
**PSEUDOEPHEDRINE**
class
indication
action
side effects
caution
also used for…
* DECONGESTANT
* for congestion
* causes vasoconstriction
* causes **Neuro—**_nervousness_; restlessness; anxiety; h/a; dizziness; **Resp—**_rebound congestion_ (\>3-5 days); **CV—**_HTN_
* caution with HTN; CV disease; hyperthyroidism; DM
* used to cook meth
96
**PSYLLIUM**
class
indicatoin
action
side effects
how to admin
monitor…
contraindications
* BULK FORMING LAXATIVE
* for chronic constipation
* absorb water into intestine; promote large soft stools
* causes **GI/endo—**cramps; bloating; diarrhea
* mix in water/juice; follow with another cup of fluid; give as soon as it's mixed
* monitor F & E
* contraindicated with appendicitis; bowel obstruction; abd surgery
97
**RANITIDINE**
class
indications
action
side effects
drug-drug interaction
* HISTAMINE BLOCKER
* for duodenal & benign gastric ulcers; stress ulcers; acute upper GI bleed prophylaxis; GERD; gastric distress
* block histamine receptors in parietal cells
* causes **Neuro—**h/a; dizziness; _confusion_; _somnolence;_ **CV—**_dysrhythmias;_ **GI/endo—**n/v/d
* do not give w/i an hour of antacid admin
98
**RETEPLASE**
class
indications
action
side effects
used when?
monitor…
contraindications
antidote
* THROMBOLYTIC/FIBRINOLYTIC
* for thrombotic CVA; early onset MI; restoring patency of central lines
* converts plasminogen to plasmin; destroys fibrin of clots
* causes **Neuro—**h/a; pain; **CV**—_bleeding_; hypotension; _reperfusion dysrhythmias;_ **Imm—**allergic reaction; fever
* best used w/i 4-6 hours of CVA
* monitor PTT/PT/INR; sx of allergic reaction; bleeding
* contraindicated in recent major surgery or trauma; intracranial hemorrhage; history of GI bleed
* antidote—aminocaproic acid
99
**RIVAROXABAN**
class
indications
action
side effects
* ANTICOAGULANT
* for DVT; a-fib
* inhibits factor X
* causes **CV—**_bleeding;_ **GI/endo—**upset
100
**SCOPOLAMIDE**
class
indication
side effects
also called…
* ANTICHOLINERGIC
* for vomiting
* causes **Neuro—**drowsiness; dizziness; dry mouth
* also called “devil’s breath”
101
**SENNA**
class
indication
action
monitor…
* HERBAL LAXATIVE
* for constipation
* irritates bowel
* monitor F & E
102
**SIMETHICONE**
indication
* for flatulence with antacids
103
**SODIUM BICARBONATE**
class
indications
action
side effects
monitor…
when to admin
may be given with…
* ANTACID
* symptomatic relief of hyperacidity; promotes ulcer healing
* neutralizes HCl
* causes **GI/endo—**_gastric acid rebound_ when d/c; **Other—**_systemic alkalosis_
* monitor pH
* admin 2 hours before/after other meds
* simethicone may be added to reduce flatus
104
**SODIUM BIPHOSPHATE**
class
indication
actions
side effects
monitor…
contraindications
* OSMOTIC LAXATIVE
* for constipation
* hyperosmolar salts pull water into colon; ↑ bulk, stimulates peristalsis
* causes **GI/endo—**diarrhea; cramps; bloating; **F & E—**_dehydration_
* monitor F & E
* contraindicated with appendicitis; bowel obstruction
105
**SPIRONOLACTONE**
class
indications
actions
side effects
monitor…
drug-drug interaction
tx for side effect
* POTASSIUM-SPARING DIURETIC
* for edema r/t HF, cirrhosis, renal disease; hyperaldosteronism; HTN
* acts on collecting duct & late distal tubules; Na+ excretion and K+ retention
* causes **Neuro—**dizziness; vertigo; **GI/endo—**diarrhea; **F & E**—_hyperkalemia;_ **_Androgen effects_—**hirsutism; gynecomastia; irregular menses; deepening voice
* monitor K+ & sx of hyperkalemia
* caution with ACE inhibitors (hyperkalemia)
* hyperkalemia—kayexalate
106
**STREPTOKINASE**
class
indications
action
side effects
used when?
monitor…
contraindications
antidote
* THROMBOLYTIC/FIBRINOLYTIC
* for thrombotic CVA; early onset MI; restoring patency of central lines
* converts plasminogen to plasmin; destroys fibrin of clots
* causes **Neuro—**h/a; pain; **CV**—_bleeding_; hypotension; _reperfusion dysrhythmias;_ **Imm—**allergic reaction; fever
* best used w/i 4-6 hours of CVA
* monitor PTT/PT/INR; sx of allergic reaction; bleeding
* contraindicated in recent major surgery or trauma; intracranial hemorrhage; history of GI bleed
* antidote—aminocaproic acid
107
**SUCRALFATE**
class
indications
action
side effects
how to admin
* PEPSIN INHIBITOR
* for ulcers; oral & esophageal ulcers due to cancer tx
* covers ulcer; protects from acid, pepsin, bile salts
* causes **Neuro—**_sleepiness_; dizziness; vertigo; insomnia; **GI/endo—**dry mouth; n/v/d; _indigestion;_ **Integ—**rash
* dissolve tablet in water
108
thrombolytic most likely to cause allergic reaction
streptokinase
109
**TICAGRELOR**
class
indications
side effects
monitor…
* ANTIPLATELET
* for prevention of CVA, MI, DVT, etc
* causes **Neuro—**h/a; dizziness; **CV**—_bleeding_, bruising; _thrombocytopenia;_ **GI/endo—**n/d; abd pain; **Integ—**rash
* monitor for signs of bleeding
110
**TICLOPIDINE**
class
indications
side effects
monitor…
* ANTIPLATELET
* for prevention of CVA, MI, DVT, etc
* causes **Neuro—**h/a; dizziness; **CV**—_bleeding_, bruising; _thrombocytopenia;_ **GI/endo—**n/d; abd pain; **Integ—**rash
* monitor for signs of bleeding
111
**TIOTROPIUM**
class
indication
action
side effects
how to use
advantage
* ANTICHOLINERGIC
* for daily COPD sx; COPD maintenance
* dilates bronchioles
* causes **Neuro—**nervousness; dizziness; h/a; **CV—**_palpitations;_ **GI/endo—**distress; nausea
* use 3-4x/day
* fewer side effects than PO anticholinergics
112
**TOLTERODINE**
class
indications
actions
side effects
tx for side effect
monitor…
* URINARY TRACT ANTISPASMODIC
* for UT spasms (cystitis, prostatitis, urethritis); dysuria; _incontinence;_ urgency; nocturia
* blocks parasympathetic activity; suppresses overactivity
* causes **Neuro**—drowsiness; dizziness; _blurred vision;_ **CV—**_tachycardia;_ **GI/endo—**dry mouth; nausea; **F & E**—_urinary hesitancy;_ **Integ**—↓ sweating
* give water & hard candy for dry mouth
* monitor intraocular pressure; I & O
113
**TORSEMIDE**
class
indications
actions
side effects
monitor…
* LOOP DIURETIC
* for HF; pulmonary edema; kidney disease; liver disease; HTN
* acts on loop of Henle; inhibit Na+ and Cl- reabsorption
* causes **Neuro—**dizziness; vertigo; _paresthesia_; _ototoxicity;_ **CV—**_dysrhythmias_ (hypokalemia); hypotension; **GI/endo—**_hyperglycemia_; n/v; **F & E—**_severe F & E losses; dehydration_; hyponatremia; hypokalemia; hypochloremia; _metabolic alkalosis_; **MS**—_↑ uric acid (gout)_
* monitor K+; glucose; sx dehydration; uric acid
114
**TRIAMTERENE**
class
indications
actions
side effects
monitor…
drug-drug interaction
tx for side effect
* POTASSIUM-SPARING DIURETIC
* for edema r/t HF, cirrhosis, renal disease; hyperaldosteronism; HTN
* acts on collecting duct & late distal tubules; Na+ excretion and K+ retention
* causes **Neuro—**dizziness; vertigo; **GI/endo—**diarrhea; **F & E**—_hyperkalemia;_ **_Androgen effects_—**hirsutism; gynecomastia; irregular menses; deepening voice
* monitor K+ & sx of hyperkalemia
* caution with ACE inhibitors (hyperkalemia)
* hyperkalemia—kayexalate
115
**TROSPIUM**
class
indications
actions
side effects
tx for side effect
monitor…
* URINARY TRACT ANTISPASMODIC
* for UT spasms (cystitis, prostatitis, urethritis); dysuria; _incontinence;_ urgency; nocturia
* blocks parasympathetic activity; suppresses overactivity
* causes **Neuro**—drowsiness; dizziness; _blurred vision;_ **CV—**_tachycardia;_ **GI/endo—**dry mouth; nausea; **F & E**—_urinary hesitancy;_ **Integ**—↓ sweating
* give water & hard candy for dry mouth
* monitor intraocular pressure; I & O
116
**WARFARIN**
class
indication
actions
side effects
monitor…
tx for side effect
food-drug interaction
contraindication
antidote
* ANTICOAGULANT
* for prevention of thromboembolism
* prolongs bleeding time; prevents clots; inhibits hepatic synthesis of vit K & clotting factors
* causes **CV**—_hemorrhage_; thrombocytopenia
* monitor for signs of bleeding; PT/PTT/aPPT/INR
* admin FFP for bleeding
* eat vitamin K rich foods consistently
* contraindicated in pregnancy
* antidote—injectable vitamin K
