Final Exam Flashcards
Antiseizure Therapy: Barbiturates
Phenobarbital
-Schedule IV drug that may cause dependence
-enhancing the action of
the GABA neurotransmitter,
Antiseizure Therapy: Benzodiazepines
lorazepam (GABA receptor antagonist)
- should not be taken with alcohol or other CNS depressants
- contraindicated in narrow angle glaucoma
- overdose tx- flumazenil
Antiseizure Therapy: Hydantoins
Phenytoin
Antiseizure Therapy: Phenytoin-like Drug (Valproate)
Valproic Acid
Antiseizure Therapy: Succinimides
Ethosuximide
Pain Control: Opioids
Morphine, Hydromorphone, & Fentany
Pain Control: Nonsteroidal anti-inflammatory Drug
aspirin
Pain Control: Opioid Receptor Antagonist
naloxone
Pain Control: Triptans, antimigraine drug
Sumatriptan; 5-HT (serotonin) receptor drug
-contraindicated in AKI and hepatic impairment
Parasympathetic Nervous System Agents: Nonobstructive urinary retention drug, Muscarinic Cholinergic Agonist
Bethanechol
- Side effects include increased salivation, sweating, abdominal cramping, and hypotension that could lead to fainting
- Contraindications: Patients with asthma, epilepsy, parkin-sonism, hyperthyroidism, peptic ulcer disease, or bradycardia should not use this drug
Parasympathetic Nervous System Agents: Antidote for anticholinesterase poisoning; Muscarinic Cholinergic Blocker (Anticholinergic)
Atropine
- contraindicated in patients with glaucoma
- side effects include dry mouth, constipation, urinary retention, and an increased heart rate.
Parasympathetic Nervous System Agents: Acetylcholinesterase Inhibitor
Physostigmine
Sympathetic Nervous System Agents: Nonselective Adrenergic Agonist
Epinephrine
Sympathetic Nervous System Agents: Adrenergic Drug; Nasal decongestant; mydriatic drug; antihypotensive
Phenylephrine
- intranasal, topic, parenteral
- rebound congestion (prolonged intranasal use)
- Contraindications:acute pancreatitis, heart disease, hepatitis, or narrow-angle glaucoma.
Sympathetic Nervous System Agents: antihypertensive; Adrenergic-Blocking Drug
Prazosin
- rapid decrease in peripheral resistance that reduces blood pressure.
Sympathetic Nervous System Agents: Catecholamine Reuptake Inhibitor
Cyclobenzaprine
Sympathetic Nervous System Agents: Direct-Acting Antispasmodic/Calcium Release Blocker
Dantrolene Sodium
Respiratory: Antihistamines/h1 receptor antagonist
diphenhydramine
Respiratory: Drug for allergic rhinitis, asthma, and skin inflammation; Corticosteroid
fluticasone
- Therapy usually begins with two sprays in each nostril, twice daily, and decreases to one dose per day.
- can mask signs of infection
Respiratory: Sympathomimetic
oxymetazoline
Respiratory: Centrally acting antitussive
dextromethorphan hydrobromide
Respiratory: Expectorant
guaifenesin
Respiratory: Mucolytic
acetylcysteine
Respiratory: Beta-adrenergic agonist
albuterol
Respiratory: Anticholinergic, bronchodilator
ipratropium; contraindicated in soybean/peanut allergy
Respiratory: Anticholinergic
tiotropium
Respiratory: Methylxanthine derivative
theophylline
Respiratory: anti-inflammatory, inhaled corticosteroid
beclomethasone (asthma & allergies)
- prolonged use can lead to oral fungal infection
- can mask signs of infection
Respiratory: Leukotriene receptor antagonist
montelukast (asthma prophylaxis)
-possible neuropsychiatric events (suicidal ideation)
Renal/Diuretic: Loop diuretics
furosemide (heart failure & HTN)
-rapid; possible hypokalemia
Renal/Diuretic: Thiazide diuretics
hydrochlorothiazide (HTN & edema)
-may reduce the effectiveness of anticoagulants, sulfonylureas, and antidiabetic drugs, including insulin
Renal/Diuretic: Potassium-sparing diuretics
spironolactone (antihypertensive & edema)
- may decrease the effects of digoxin.
- contraindicated during pregnancy
- gynecomastia in men, diminished libido
- possible hyperkalemia (fatigue, muscle weakness, bradycardia)
Renal/Diuretic: Osmotic diuretics
mannitol
Renal/Diuretic: Carbonic anhydrase inhibitors
acetazolamide
Cardiac: Drug for heart failure and HTN; Angiotensin converting enzyme (ace) inhibitors
lisinopril (heart failure & HTN)
-2 to 3 weeks of therapy may be required to reach maximum effectiveness
Cardiac: Angiotensin ii blockers (arbs)
losartan (HTN)
- Grapefruit juice may increase
- NSAIDs may reduce the antihypertensive activity of losartan and increase the risk for CKD.
Cardiac: Calcium channel blockers
nifedipine (HTN & angina)
- Alcohol potentiates the vasodilating action of nifedipine and could lead to syncope caused by a severe drop in blood pressure.
- Grapefruit juice may enhance the absorption of nifedipine
Cardiac: Beta-adrenergic blockers
metoprolol (heart failure & HTN)
-may enhance the hypoglycemic effects of insulin and oral antidiabetic drugs.
Cardiac: Alpha1 adrenergic blockers
doxazosin (HTN & benign prostatic hyperplasia)
-dilates arteries and veins and is capable of causing a rapid fall in blood pressure
Cardiac: Alpha2 adrenergic agonists
clonidine
Cardiac: Drug for hypertension and heart failure; Direct acting vasodilators
hydralazine
-due to safety concerns, other drugs have replaced
Heart Failure: Cardiac glycosides
digoxin
Heart Failure: Drug for heart failure; Phosphodiesterase inhibitors
milrinone
- only IV
- few s/e
Angina: Nitrates
nitroglycerin
Antiarrhythmics: Class i: sodium channel blockers
procainamide
Antiarrhythmics: Class ii: beta-adrenergic blockers
propranolol
Antiarrhythmics: Class iii: potassium channel blockers
amiodarone
Antiarrhythmics: Class iv: calcium channel blockers
verapamil
Coagulation: anticoagulant; Indirect thrombin inhibitor
heparin
-overdose tx: protamine sulfate
Coagulation: anticoagulants; Direct thrombin inhibitors
argatroban
Coagulation: Low-MOLECULAR weight heparin
enoxaparin
Coagulation: anticoagulant; Vitamin k antagonist
warfarin
- Unlike with heparin, the anticoagulant activity of warfarin can take several days to reach its maximum effect.
- overdose tx: vitamin k
Coagulation: anti platelet; Adp receptor blocker
clopidogrel
-Tablets should not be crushed or split.
Coagulation: Drug for dissolving clots; Thrombolytic
alteplase
Coagulation: Clot stabilizer; Hemostatic
aminocaproic acid
Lipid Lowering: Antihyperlipidemic; HMG-CoA reductase inhibitor, Statins
atorvastatin
-intestinal cramping, diarrhea,
and constipation
Lipid Lowering: antihyperlipidemic, Bile-acid sequestrants
cholestyramine (powder taken with fluid)
- constipation, bloating, gas, and nausea
Lipid Lowering: antihyperlipidemic, Fibric-acid agents
gemfibrozil
- contraindicated in renal impairment
- may increase effect of anti diabetic drugs
Lipid Lowering: Cholesterol absorption inhibitors
ezetimibe
Hematopoiesis: Erythropoietin
epoetin alfa
Hematopoiesis: Drug for increasing neutrophil production
; Colony stimulating factors
filgrastim
- Common adverse effects include fatigue, rash, epistaxis, decreased platelet counts, neutropenic fever, nausea, and vom-iting.
- Bone pain
Hematopoiesis: Platelet enhancer
Oprelvekin
-prescribed for patients at risk for or with thrombocytopenia.
Hematopoiesis: Vitamin supplement
cyanocobalamin
Hematopoiesis: Iron supplement
ferrous sulfate
Cholinergic drugs do this
stimulate parasympathetic nervous system (feed and breed)
- constricts eyes
- produce saliva
- lowers heart rate
- tightens airway muscles
adrenergic drugs do this
stimulate sympathetic nervous system
- dilate pupils
- increase heart rate
- relax airways
- slows digestion
antibacterial agents: penicillins prototype drug
penicillin G (narrow spectrum)
- has beta-lactam that interferes with cell wall synthesis
- static or cidal depending on dose
- DOC for strep & pneumonia
- no PO, poor oral absorption
antibacterial agents: Cephalosporins P.D.
cefazolin
penicillin allergies can cross react not effective against MRSA IV given over 30-35 mins increase glucose values watch for anaphylaxis nephrotoxic
antibacterial agents: tetracyclines p.d
tetracycline (broad spectrum)
protein synthesis inhibitor, short half life impacts adherence, take w/ full glass of water
- DOC lymes disease, rocky mountain spotted fever
- cause photosensitivity
- toxic to fetus, never in pregnancy
- outdated cause toxicity
- causes discoloration in child teeth
- dairy interferes with absorption
antibacterial agents: aminoglycosides (used in e. coli)
gentamycin (inhibit protein synthesis)
ototoxic, nephotoxic, neuro-muscular blockade
doesn’t cross BBB in adults but does in children
antibacterial agents: glycopeptides p.d.
vancomycin
- oto and nephro toxic
- Red mans syndrome- when IV is pushed too rapidly
- Steven Johnsons syndrome- flu like symptoms, painful rashes and blisters
- avoid diphenhydramine
antibacterial agents: fluoroquinolones p.d.
lower respiratory infections
ciprofloxacin (bacterial DNA synthesis inhibitor)
- new BB warning- spontaneous tendon rupture
- report calf pain
- monitor BUN, creat, GFR
- photosensitivity,
- avoid NSAIDS
- can increase oral antidiabetics
- can cause crystalluria (crystals cause cloudy urine)
antibacterial agents: sulfonamides p.d.
alternative to PCN
mostly PO
trimethoprim-sulfamethoxazole
- cause photosensitivity
- crystalluria
- not used in pregnancy (folic acid)
- monitor BUN and liver functions
tuberculosis: mycolic acid inhibitor p.d.
isoniazid
first line agent for TB
administered on empty stomach
neuro toxicity effects
avoid antacids and alcohol
antifungal therapy: polyene p.d.
amphotericin B & nystatin
antifungal therapy: azole p.d
fluconazole (narrow spectrum)
inhibitor of fungal cell membrane synthesis (ergosterol)
- report GI effects
- avoid alcohol
- monitor blood glucose
- ineffective against non-albicans candida species
- n/v
antiprotozoal therapy: heme complexing agent p.d.
chloroquine
antiprotozoal therapy: drug that disrupts nucleic acid synthesis
metronidazole
antiretroviral/HIV therapy: NRTI p.d.
zidovudine
antiretroviral/HIV therapy: NNRTI p.d.
efavirenz
antiretroviral/HIV therapy: protease inhibitor p.d.
lopinavir w/ritonavir
antiretroviral/HIV therapy: fusion entry inhibitors p.d.
fuzeon
antiretroviral/HIV therapy: CCR5 antagonist entry inhibitor p.d.
maraviroc
antiretroviral/HIV therapy: integrase strand transfer inhibitor p.d.
dolutegravir
antiviral therapy: nucleoside analog p.d.
acyclovir
antiviral therapy: neuraminidase inhibitors p.d.
zanamivir & oseltamivir
antineoplastic agents: alkylating agents p.d.
cyclophosphamide
antineoplastic agents: antimetabolite, folic acid analog p.d.
methotrexate
antineoplastic agents: antitumor antibiotic p.d.
doxorubicin
antineoplastic agents: vinca alkaloid, mitotic inhibitor, natural product
vincristine
antineoplastic agents: estrogen receptor antagonist
tamoxifen
common side effects of antibiotics
allergies
super infections (loss of normal flora)
thrush, c.dif, UTI, candidiasis
organ toxicity
beta-lactam nursing considerations
take care with geriatrics and renal impairment (renally excreted)
decreases oral contraceptives
do not take with IV aminoglycosides
antibacterial: macrolides
erythromycin (broad spectrum)
protein synthesis inhibitor
increased risk of super infections
watch antacids
rifampin side effects
body fluids can turn orange
antifungal therapy: polyene p.d. (deep & dangerous)
amphotericin b
antifungal therapy: polyene p.d. (superficial)
nystatin