Final Flashcards
Serotonin Antagonist
Anti emetic
Ondasetron
AE: QT prolongation , GI: diarrhea, Brain: headache, dizziness
Dopamine Antagonist
Antiemetic
Phenothiazine, Promethazine, Prochlorperazine
AE: EPS, anticholinergic, sedation.
Promethazine boxed: extravasation (dilute, IVPB), respiratory depression in peds
Dopamine Antagonist- prokinetic
Antiemetic [gastroporesis, NV, GERD]
Metoclopramide
AE: EPS (Tardive dyskinesia), diarrhea, cramping
CI: bowel obstruction , GI perforation and hemorrhage
Cannabinoids
Anti emetic [CINV, appetite stimulant]
Dronabinol
AE: sedation, euphoria, dysphoria, hallucination, anxiety, tachycardia, palpitation
Anticholinergics
Anti emetic [motion sickness, post op NV, pre op increase saliva]
Scopolamine Patch
AE: Anticholinergic toxidrome, metal in patch, sedation
CI: BPH, glaucoma
Admin: 4 hrs prior , change every 3 days
1st gen antihistamine
Anti emetic [ motion sickness, vertigo , NV]
meclizine, hydroxyzine, dimenhydrinate, doxylamine
AE: sedation , anticholinergic
Antihistamine + Water Soluble Vitamin
Anti emetic [morning sickness]
Doxylamine + Vitamin B6 (pyridoxine)
Diclegis
AE: antihistamine effects
Herbal
Anti emetic
Ginger
Anthracycline
Doxorubicin
- cardiotoxic
- ruby red bodily fluids
Vinca alkaloids
Vincristine
-Peripheral neuropathy: decreased reflexes, weakness, sensory loss, paresthesia, autonomic nerve damage: constipation, urinary retention
Nitrogen Mustard
Cyclophosphamide
- acute hemorrhagic cystitis: increase fluid to 3L, watch out for electrolyte imbalance (hyperkalemia)
- Mesna: given in combination to protect bladder
Platinum compound
Cisplatin
-highly emetogenic, paresthesias, ototoxic, nephrotoxic
Antimetabolites/ DMARD
Methotrexate
Used to treat: solid tumors, lymphomas, leukemia, RA, ectopic pregnancy
-tumor lysis: nephrotoxic - BUN, SCr, Uric acid- allopurinol, stay hydrated
Hepatotoxic
SCAR (SJS/ TEN)
Photosensitivity + Protect from sunlight
Pregnancy category X
Drug Drug: increased effects- NSAIDS, ABx
Antidote: Leucovorin (folic acid analog) - save good cells
DMARD Biologic
Adalimumab (Humira), Infliximab (remicade)
Used to treat: RA, IBD: crohn’s, ulcerative colitis
AE: injection/ infusion reactions, infections: fungal, atypical bacteria (TB), malignancy (s/s: splenomegaly, hepatomegaly, weight loss, fever), blood dyscrasia (aplastic anemia, pancytopenia), liver injury, **heart failure((, hypersensitivity
Nursing: check for TB/ HBV
Traditional DMARD/ immunosuppressant
Cyclosporine, Mycophenolate, Tacrolimus
Used to treat: RA, transplants, ulcerative colitis
AE: LIFE
L-lifelong therapy
I- immunosuppressed (infection, malignancy)
F- frequent monitoring of liver, kidneys, BP, drug levels
E- electrolyte abnormalities (hyperkalemia)
**immunosuppression/ malignancy, HTN, Nephrotoxic, hepatotoxic, electrolyte abnormalities, narrow therapeutic. Cyclosporine= hirsutism, gingival hyperplasia)
Hypothyroidism drugs
Levothyroxine (T4)
used to treat: hypo, myxedema coma
AE: over dose –> hyperthyroidism –> HEART
Drug interactions: antacids, cations, bile acid sequestrant, sympathomimetic drugs, increases effects of warfarin
other hypothyroidism: Liothyronine (T3), Desiccated animal thyroid
Hyperthyroidism Drugs
Methimazole + Propylthiouracil (PTU)
used to treat: hyperthyroidism, graves, thyroid storm
AE: liver and bone marrow suppression, agranulocytosis
PTU boxed warning: hepatotoxicity
Nursing: avoid iodine foods, monitor bone marrow suppression fever, sore throat, lesions, monitor liver
Glucocorticoid
Adrenal drugs
Prednisone, methylprednisolone, hydrocortisone
AE: CUSHINGOID, STEROID
elctrolytes: decreased potassium, increased sodium + water, hyperglycemia, increased cholesterol, increased WBC
Rapid Acting Insulin
insulin lispro (humalog) insulin aspart (novolog) glulisine (apidra) Onset: 15-30 min Peak: 0.5-2.5 hrs Duration: 3-6 hrs
Regular acting insulin
Regular insulin: Humulin R, Novolin R
Onset: 0.5-1 hr
Peak: 1-5 hrs
DurationL 6-10 hrs
Intermediate Acting Insulin
NPH Insulin: Humulin N, Novolin N
Onset: 1-2 hr
Peak: 6-14 hr
DurationL 16-24 hr
Long acting insulin
Insulin glargine ( Lantus) Insuline Detemir (Levemir) Onset: 70 min Peak: none durationL 24 hr
Biguanides
Metformin
AE: NV –> decreased B12 and folic acid absorption, lactic acidosis
Drug drug: contrast dye (hold metformin for 48 hrs after), alcohol (prevents break down of lactic acid)
Sulfonylureas (2nd gen)
glipizide, glyburide, glimepiride
AE: hypoglycemia, weight gain, sulfa allergy + photosensitivity, disulfiram like rx with alcohol (and alcohol increases hypoglycemic risk)