Final Exam Drugs PT. 2 Flashcards
Bismuth subsalicylate: Class
Absorbent (form of aspirin)
Bismuth subsalicylate: MOA
-Coats the walls of the GI tract
-Binds to causative agent
Bismuth Subsalicylate: Indications
Diarrhea
Bismuth subsalicylate: Adverse Reactions
-Increase bleeding
-Dark stools and tongue (bismuth)
Loperamide: Class
Antimotility
Loperamide: MOA
Slows peristalsis
anti diarrhea
Diphenoxylate: Class
-Antimotility
Diphenoxylate: MOA
Drying effect due to it being anticholinergics
anti diarrhea
Diphenoxylate: Adverse Reactions
Urinary retention
Headache and Dizziness
Bradycardia / Hypotension
Dry skin - Flushing
Diphenoxylate: Nursing consideration
-Prescription only because of anticholinergics effects
Lactobacillus and Sccharomyces
Probiotics
Help replenish and restore normal flora
What probiotic is used for treatment of C-Diff
Saccharomyces Bouldardii
psyllium: class
Bulk forming laxative
psyllium: MOA
-Similar to fiber
-Absorb water into intestine to increase bulk
psyllium: Indications
-Constipation
psyllium: Adverse Reaction
-Impaction
-Fluid and Electrolyte imbalance
-Gas formation
Psyllium: Nursing consideration
-Okay for long term use
-Take with liberal amounts of water to avoid impaction
-Contraindicated in intestinal obstruction or fecal impaction
Docusate Sodium: Class
Emollient
Docusate Sodium: MOA
Lubricates fecal material and walls
Docusate sodium: Indications
Opioid-induced constipation
Docusate Sodium: Adverse reactions
-Skin rash and decrease absorption of vitamins
Mineral Oil: Class
Emollient
Mineral Oil: MOA
Lubricates the intestines
Mineral Oil: Indications
Fecal impaction
Glycerin: Class
Hyperosmotic
Glycerin: MOA
-Increase water content into the feces
Glycerin: Indicaitons
-For children
-Evacuate bowels before diagnostics and surgical procedures
Glycerin: Adverse Effects
-Bloating
-Rectal Irritation
-Electrolyte imbalance
Magnesiums Salts
+
Sodium Salts
Saline laxatives
increase osmotic pressure and draw water into colon
Magnesium toxicity and electrolyte imbalance
Use in cautions with renal or kidney problems
Bisacodyl
+
Senna: Class
-Stimulant Laxative
Bisacodyl
+
Senna: MOA
-Work on entire GI tract. More you take more action you will see.
Bisacodyl
+
Senna: Indicaitons
-Constipations or whole bowel evacuation
Bisacodyl
+
Senna: Adverse Effects
-Nutrient malabsorption
-Gastric Irritation
-Electrolyte imbalance
-Dependence
Bisacodyl
+
Senna: Nursing Considerations
Most likely to cause dependence and be abused
Epinephrine: Class
-Vasopressor
-Bronchodilator
-Anti-athmatic - vasoconstrictor
Epinephrine: MOA
Inhibits release of mediators from mast cells
Epinephrine: Indications
-Severe allergic reactions
-Cardiac arrest
-Severe asthma attacks
Epinephrine: Adverse Reactions
-CV: Angina - Arrhythmias _ HTN - Tachy
-CNS: Nervousness - Restlessness
Epinephrine: Nursing considerations
Only used in emergency situations
All routes expect PO
Monitor Vital Signs closely
Correct dose is crucial. Overdose can be FATAL. Have coworkers recheck dose.
SSRI’s
-Selective serotonin reuptake inhibitors
SSRI: Adverse Effects
-Weight gain
-Sexual dysfunction
-RISK OF SUICIDE
Serotonin syndrome
2-72 hours after treatment, altered mental status, increased occurrence with MAOIs and other serotonergic drugs
SSRI: Withdrawal Syndrome
-Dizziness, H/A, sensory disturbances, tremor, anxiety, and dysphoria
fluexetine: Class
SSRI
Fluoxetine: Nursing considerations
-Several advantages over older drugs. Less food drug and drug drug interactions
-Therapeutic benefit reached in 3-4 weeks
-Avoid use with MAOI
venlafazine: Class
SRNI’s
venlafazine: MOA
-Blocks neuronal activity of serotonin and norepinephrine
Venlafazine: Adverse effects
-Nausea, headache, anorexia, insomnia, somnolence, sexual dysfunction, withdrawal syndrome, sweating, blurred vision, increased LFTs
Venlafazine: Nursing considerations
Contraindicated with MAOI’s
amitriptyline: Class
TCA
tricyclic antidepressants
Amitriptyline: MOA
-Block reuptake of 2 monoamine transmitter, norepinephrine and serotonin (intensify the effects), making more available in the synapse
amitriptyline: Adverse reactions
-Sedations
-Orthostatic hypotension
-Anticholinergic effects (Hot as a hare, Dry as a bone, Blind as a bate, Mad as a hatter)
Amitriptyline: Nursing considerations
FATAL OVERDOSE
-Used to treat neuropathic pain
-Drug-drug interactions with MAOI –> HTN crisis
phenelzine: Class
MAOI’s
phenelzine: MOA
Inhibits MAO - enzyme found in the liver, intestinal wall, and terminals of neurons
MAO converts norepi, 5-HT, and dopamine to inactive product.
Decrease MAO increases availability of neurotransmitters at the nerve endings
phenelzine: Indications
-Refractory depression
-Atypical depression
phenelzine: adverse effects
-LOTS food drug: Tyramine rich foods = HTN issues
-CNS: always on edge
-Orthostatic hypertension
-Can lead to rapid increases in BP - Stroke - Coma
MAOI most serious problem
Hypertensive crisis when taken with tyramine
burprorion: Class
Atypical Antidrpessants
burprorion: What to know
-Unkown MOA
-Depression and Anxiety
-Smoking cessation
-Shorter to reach effects vs other antidepressants
Ketamine
-Atypical antidepressants
-Rapidly help with suicide and depression and in low doses
-Perceptual disturbances -Dissociation - Halluncinate
K-HOLE
Trazadone
Atypical antidepressants
Block reuptake of 5-HT
Insomnia (sleep aid)
Alprazolam
Diazepam
Lorazepam
Class
Benzodiazepines
Alprazolam
Diazepam
Lorazepam
MOA
Enhance the inhibitory effects of GABA in the CNS
Turns up GABA which is responsible for relaxation
Alprazolam
Diazepam
Lorazepam
What to know
Short term use only
Break through meds
CNS depression
CYP450
Do not mix with other meds
Alprazolam
Diazepam
Lorazepam
Antidote
Flumazenil
Buprenorphine and naloxone: Class
Opioid agonist and Opioid antagonist
Buprenorphine and naloxone: MOA
-Partial opioid agonist (helps receptor to prevent craving)
-Partial opioid antagonist (blocks opioid receptor)
Buprenorphine and naloxone: Nursing considerations
-Still has potential for abuse, but less than methadone and buprenorphine alone
-Sublingual and buccal
