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Final Flashcards

1
Q

Zileuton (Zyflo) is used for?

A

Used to control chronic asthma & reduce # of asthma attacks by blocking leukotrienes
does not treat acute asthma attack

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2
Q

Zileuton (Zyflo) adverse effects

A 
N/V
Drowsiness
Constipation
gas 
dizziness
insomnia
joint pain
red eye
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3
Q

Topotecan (hycamptin)

is for ?

A

metastatic ovarian cancer after failure of other chemotherapy-relapsed small cell lung cancer-cervical cancer

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4
Q

Topotecan (hycamptin) MOA

A

topoisomerase inhibitor-causes DNA strand breakage and damage

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5
Q

Topotecan (hycamptin adverse effects

A

Neutropenia
Myelosuppression
Alopecia
Interstitial Lung Disease

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6
Q

Topotecan (hycamptin) nursing concerns

A

CBC
avoid vaccines
avoid OTC products

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7
Q

Pyridostigmine (Mistinon)

is used for?

A

used as a muscle relaxant or for myasthenia gravis

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8
Q

Pyridostigmine (Mistinon) MOA

A

inhibits destruction of acetylcholine increasing concentration of acetylcholine released

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9
Q

Vasopressin (Pitressin)
Desmopression (DDAVP)
-Pituitary Hormone

is used for?

A

Diabetes insipidus
Gastrointestinal hemorrhage
Nocturnal enuresis

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10
Q

Vasopressin (Pitressin)
Desmopression (DDAVP)
-Pituitary Hormone

nursing concerns

A

Always assess vital signs and serum sodium levels
Contraindications/cautions
Angina
Decreased cardiac output
Increased peripheral resistance (hypertension)
Arrhythmia

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11
Q

Vasopressin (Pitressin)
Desmopression (DDAVP)
-Pituitary Hormone

adverse effects

A 
Bradycardia 
Premature atrial contraction 
Heart block 
Fluid overhydration 
Always assess vital signs and serum sodium levels
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12
Q 
Levothyroxine (Synthroid, T4)
Thyroid Hormones (supplement)

MOA

A

supply thyroid hormones to correct hypothyroidism

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13
Q 
Levothyroxine (Synthroid, T4)
Thyroid Hormones (supplement)

adverse effects

A 
1. Overdose:
hyperthyroidism – thyroid crisis
2. Thyroid crisis:
angina
tachycardia
palpitations
hypertension
cardiac dysrhythmia
N/V/D
Cramping
Insomnia
Tremors
Headache
Nervousness
Irritability
weight loss
 fever
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14
Q

Rapid acting insulin

A

(Novolog)

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15
Q

intermediate acting insulin

A

(NPH, Humulin H, Novolin H)

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16
Q

long acting insulin

A

(Lantus and Levemir)

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17
Q

What drug is

  • Biguanides
  • Oral Diabetic Drug
A

Glucophage (metformin)

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18
Q

MOA for Glucophage (metformin)

A
  • Reduce blood glucose by reducing gluconeogenesis, thereby suppressing hepatic production of glucose
  • Decrease intestinal reabsorption of glucose and increase cellular uptake of glucose
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19
Q

Glucophage (metformin)

adverse effects

A

Hypoglycemia

GI: n/v, heartburn, diarrhea

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20
Q

Glucophage (metformin) nursing concerns

A
  • Take medications preferable 30min prior to breakfast and take same time each day
  • If a dose missed, take it as soon as remembered but not double up if close to next dose
  • Teach signs and symptoms of hypoglycemia and instruct patient to consume juice or candy once hypoglycemia and notify health providers
  • Avoid other medications like aspirin and EtOH
  • Encourage routine follow ups, proper diet, and exercise.
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21
Q

anti-hyperthyroidism

drug

A

Propylthiouracil (Propacil, Propyl-Thyracil, PTU)

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22
Q

Propylthiouracil (Propacil, Propyl-Thyracil, PTU)

MOA

A

Inhibit thyroid hormone synthesis

Suppress peripheral conversion of T4 to T3

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23
Q

Propylthiouracil (Propacil, Propyl-Thyracil, PTU) adverse effects

A

CNS: dizziness, neuritis, weakness, paresthesias, fatigue, headache
CV: bradycardia
Others: leukopenia, myelosuppression, hypersensitivity reactions, rash

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24
Q

Propylthiouracil (Propacil, Propyl-Thyracil, PTU) nursing concerns

A

baseline VSs, ECG and lab studies including T3, T4, TSH and CBC, S/S of thyroid crisis (tachycardia, dysrhythmia, fever, heart failure, flushed skin, apathy, confusion, behavioral changes)
Teaching for S/S of hypothyroidism
Take medications at the same time every day around the clock
Instruct to monitor pulse rate and to report significant increase or decrease in pulse rate
The most serious adverse effects of antithyroid agents is agranulocytosis. Regularly check CBC for leukopenia

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25
Rosiglitazone (Avandia)
Oral diabetic drugs (Thiazolidinedione)
26
Rosiglitazone (Avandia) MOA
Lower blood glucose by increasing cellular sensitivity to insulin, thereby reducing insulin resistance
27
Rosiglitazone (Avandia) is used for
Diabetes Mellitus
28
Rosiglitazone (Avandia) adverse effects
hypoglycemia and hyperglycemia
29
Filgrastim (Neupogen) | -Colony Stimulating is used for
chemotherapy induced neutropenia
30
Filgrastim (Neupogen) | -Colony Stimulating MOA
stimulate neutrophils (WBC) production and decrease duration of chemotherapy induced neutropenia
31
Methotrexate (Folex) -Antimetabolites is used for
Osteosarcoma Lymphomas Leukemias Breast and lung cancers.
32
Methotrexate (Folex) | -Antimetabolites MOA
Disrupt metabolic pathways of cancer cells and inhibit critical enzymes Folic acid analog Cell cycle specific to S phase
33
Methotrexate (Folex) | -Antimetabolites adverse effects
bone marrow suppression (myelosuppression), | dermatological side effects and photosensitivity, Stevens-Johnson syndrome
34
Epoetin alpha (Epogen) Colony Stimulating Factors is used for
chemotherapy induced anemia
35
``` Epoetin alpha (Epogen) Colony Stimulating Factors MOA ```
stimulate RBC production and decrease duration of chemotherapy induced anemia
36
Vincristine (Oncovin) - Natural products - Three categories:
- Vinca alkaloids - Taxanes (Taxol) - Topoisomerase inhibitors (Etoposide)
37
Vincristine (Oncovin) is used for
Treated for Acute lymphocytic leukemia (ALL), Lymphomas etc.
38
Vincristine (Oncovin) MOA
Bind to tubulin which makes up the microtubules of the cells necessary for cell division and disrupt mitosis resulting in cell death Cell cycle specific to phase M
39
Vincristine (Oncovin) adverse effects
neurotoxicity, which may take several months to resolve Myelosuppression GI Epithelial Cell Changes Alopecia
40
Valproic acid (Depakene, Depacon) Antiseizure agent Is used for
- Absence seizures | - Complex partial seizures
41
``` Valproic acid (Depakene, Depacon) -Antiseizure agent MOA ```
Increase concentration of GABA in brain and suppress abnormal neuronal discharges by blocking the influx of sodium into neurons
42
``` Valproic acid (Depakene, Depacon) -Antiseizure agent Nursing concerns ```
- Complete neurologic assessment including pupil response, LOC, orientation, motor response, verbal response, and cognition - Obtain baseline data – history, previous drug reactions, vital signs, electrolytes, CBC - Monitor seizure activity - Assess serum levels of drugs - Watch for blood dyscrasia - Ensure environmental safety issues
43
MAO inhibitors | Monoamine oxidase inhibitors (MAOIs)
Phenelzine (Nardil) | -Effective but seldom used due to serious adverse effects
44
Phenelzine (Nardil) is used for
For depression.
45
Phenelzine (Nardil) MOA
Bind irreversibly to MAO; Intensify actions of endogenous epinephrine, norepinephrine, serotonin, dopamine
46
Phenelzine (Nardil) adverse effects
Orthostatic hypotension (most common side effect)
47
Phenelzine (Nardil) nursing concerns
Common drug and food interactions | Avoid food containing tyramine
48
Selective Serotonin Reuptake Inhibitors Second generation antidepressant Effective and low incidence of serious side effects
Fluoxetine (Prozac)
49
Fluoxetine (Prozac) MOA
Block uptake of serotonin at neuronal presynaptic membrane; Enhance action of serotonin
50
Fluoxetine (Prozac) adverse effects
GI upset, Anorexia, Sexual dysfunction
51
Fluoxetine (Prozac) nursing concerns
Full therapeutic effects appear in 2-6 weeks
52
Antipsychotics Dopamine antagonist 2nd generation/Atypical – fewer adverse effects, better patient adherence and more effective
Risperidone (Risperdal) Clozapine (Clozaril) (dopamine antagonist) Aripirazole (Abilify) (dopamine system stabilizer)
53
Risperidone (Risperdal) Clozapine (Clozaril) (dopamine antagonist) Aripirazole (Abilify) (dopamine system stabilizer) adverse effects
Extrapyramidal Symptoms (EPS) Serious adverse effects from antipsychotics Extrapyramidal system associated with postural and automatic movements EPS including Acute dystonia – severe muscle spasm on neck, back and face Akathisia – uncontrollable need to be moving Antipyschotic induced Parkinsonism – not distinguished Tardive dyskinesia – involuntary movement of tongue and face
54
Risperidone (Risperdal) Clozapine (Clozaril) (dopamine antagonist) Aripirazole (Abilify) (dopamine system stabilizer) nursing concerns
Baseline history, physical and vital signs Assess suicide risk, mental status and behavior Instruct for drug actions and adverse effects Increase fluid intake and dietary sources of fiber Monitor EPS and anticholinergic adverse effects Assess skin conditions and lab results Patient support system
55
Tricyclic Antidepressants | Mainstay for treatment of depression
Amitriptylline (Elavil) | Nortriptyline (Pamelor)
56
Amitriptylline (Elavil) | Nortriptyline (Pamelor) is used for
Commonly used for depression
57
Amitriptylline (Elavil) | Nortriptyline (Pamelor) MOA
Block reuptake of norepinephrine and serotonin into presynaptic nerve terminate; increase actions of both neurotransmitters; block Ach receptors
58
Amitriptylline (Elavil) | Nortriptyline (Pamelor) adverse effects
Many adverse effects | No known antidote for overdose and estimated 70% TCA overdoses died before reach to hospital
59
a drug of choice for many tonic-clonic and partial seizures | antiseizure agent
Carbamazepine (Tegretol)
60
Carbamazepine (Tegretol) | MOA
Inhibit sodium channels and block repetitive, sustained firing of neurons; Other mechanisms likely but incompletely understood
61
Carbamazepine (Tegretol) is used for
Used with phenytonin for patients requiring polytherapy | Siezure
62
Carbamazepine (Tegretol) nursing concerns
Complete neurologic assessment including pupil response, LOC, orientation, motor response, verbal response, and cognition Obtain baseline data – history, previous drug reactions, vital signs, electrolytes, CBC Monitor seizure activity Assess serum levels of drugs Watch for blood dyscrasia Ensure environmental safety issues
63
Antipsychotic agents/ | antidopaminergics/phenothiazine
Promethazine (Phenergan)
64
Promethazine (Phenergan) | MOA
antiemetic, antihistamine, H1 receptor antagonist acts on blood vessels, GI, and respiratory system by competing with histamine for H1 receptor sites decreasing allergic response
65
Promethazine (Phenergan) is used for
vertigo (N/V) motion sickness nausea rhinitis
66
Promethazine (Phenergan) adverse effects
constipation dry mouth urinary retention vesicant causing extravasation
67
Promethazine (Phenergan) nursing concerns
Assess nutritional, fluid and electrolyte status Place on side lying position with altered LOC to prevent aspiration Withhold foods and fluid until nausea subsides Monitor for Extrapyramidal symptoms (EPS) in elderly, emaciated patients (extreme weight loss) and children Instruct not to drive or other hazardous activities Avoid alcohol

Pharmocology (28 decks)

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