final exam meds Flashcards
Erythropoiesis Stimulating Agent
Prototype: epoetin alfa
MOA: mimics human erythropoietin
FDA approved to maintain RBC count in patients with:
CKD
HIV infection on drug therapy
Anemia 2 chemotherapy in certain cancers
Pre-operative in patients with anemia
ROUTE: SUBQ
Iron therapy
Prototype: Ferrous Sulfate
Indication: iron deficiency and prevention
MOA: taken up by bone marrow cells to make hemoglobin
AE: GI disturbances and teeth staining
ANTACIDS REDUCE ABSORPTION
Parenteral Iron (IM or IV)
Prototype: Iron Dextran
Indication: Clear diagnosis of iron deficiency, oral iron is intolerable/ineffective
AE: Black box warning: potentially fatal anaphylaxis
**Small test dose before each dose
Vitamin B12
Prototype: Cyancobalmin
Indication: B12 deficiency
AE: Hypokalemia
USE CAUTION WITH FOLIC ACID
Folic Acid
MOA: converts to the active form of folic acid after administration
Indication: treatment of folic acid deficiency, prophylaxis of folate deficiency, initial treatment of severe anemia from vitamin B12 deficiency
IT CAN MASK B12 DEFICIENCY
Aluminum
BASAJEL
Class: antacid
MOA: neutralize acid in the stomach
Indication: heal PUD, treat GERD symptoms, stress ulcers
SE: CONSTIPATION
Calcium
TUMS
Class: antacid
MOA: neutralize stomach acid
Indication: PUD, GERD treatment, stress ulcer
SE: CONSTIPATION
Magnesium
Milk of magnesia
Class: antacid
MOA: neutralize the acid in the stomach
Indication: heal PUD, treat GERD symptoms, stress ulcers
SE: DIARRHEA
Aluminum + Magnesium
MAALOX + MYLANTA
Class: antacid
MOA: neutralize stomach acid
Indication: PUD, GERD symptoms, stress ulcers
Cimetidine
Class: Histamine type II receptor antagonist
MOA: blocks H2 receptors and reduces gastric secretion
Indication: GERD symptoms, PUD healing
SE: CNS in elders
** INHIBITS CYP450 ENZYMES
Famotidine
Class: Histamine type II receptor Antagonist
MOA: blocks H2 receptors and reduces gastric secretion
Indication: GERD symptoms, healing PUD
SE: CNS in elderly
Omeprazole
Class: Proton Pump Inhibitor
MOA: binds to protein pump and irreversibly inhibits secretion of HCl
Indication: SHORT TERM treatment of GERD and PUD
SE: Pneumonia and Hip Fracture and Anemia
Pantoprazole
Class: Protein Pump Inhibitor
MOA: binds to protein pump and irreversibly inhibits secretion of Hal
Indication: SHORT TERM treatment of GERD and PUD
SE: Pneumonia and hip fracture and anemia
Sucralfate
Class: protectant
MOA: alters when exposed to gastric acid
Indication: gastric and duodenal ulcer
** Decreased Drug Absorption
PO- tablet/suspension
Metoclopramide
Class: Pro kinetic Antiemetic
MOA: Increase upper GI motility and decrease emesis
Indication: GERD, N/V, Post-op
SE: sedation, restlessness, extra pyramidal reaction
SHORT TERM
Insulin Lispro
Class: Rapid- Acting Insulin
MOA: helps facilitate the uptake of glucose
Indication: Type 1 diabetes
Start: 15 min
Peak: 1 hours
Duration: 2-4 hours
SE: hypoglycemia, allergic reaction
NC: GIVE WITH MEALS
**Give in conjunction with intermediate or long lasting insulin
Insulin Regular
Class: Short-Acting Insulin
MOA: helps facilitate the uptake of glucose
Indication: Type 1 diabetes
Onset: 30-60
Peak: 2-6 hrs
Duration: 3-8 hrs
NC: GIVE BEFORE MEALS
NPH
Class: Intermediate Acting Insulin
MOA: binds to cells on surface of cells and promotes uptake of glucose
Indication: Type 1 diabetes
Onset: 2-4 hours
Peak: 4-10 hrs
Duration: 10-20 hrs
NC: Inject 2 daily with meals
**Clear before cloudy
**Roll cloudy insulin
Insulin Aspart
Class: Rapid Acting Insulin
MOA: Allows insulin to be absorbed into the bloodstream quicker than regular human insulin
Indication: Type 1 diabetes
Onset: 15 mins
Peak: 60 mins
Duration: 2-4 hours
NC: Give before meals cover glucose rise that occurs after eating
Insulin Glargine
Class: Long acting insulin
MOA: binds to insulin receptors on cells and stimulates glucose uptake
Indication: Type 1 diabetes
Onset: 70 mins
Duration: All day
NC: GIVE AT NIGHT! check sugars during meals and correct with rapid acting PRN
** NEVER MIX WITH OTHER INSULIN
Glipizide
Class: sulfonyureas
MOA: binding and closing K-ATP channels in the pancreatic beta cells thereby STIMULATING the secretion of insulin
Indication: Type 2 diabetes
SE: hypoglycemia
NC: DO NOT TAKE WHILE PREGNANT
caution with taking with alcohol, NSAIDS, cimetidine
Glyburide
Class: sulfonureas
MOA: binding and closing the K-ATP channels in the pancreatic beta cells thereby STIMULATING the secretion of insulin
Indication: Type 2 diabetes
SE: hypoglycemia
NC: DO NOT TAKE WHILE PREGNANT
caution while taking with alcohol, NSAIDS, cimetidine can lead to worsening SE
Metformin
Class: biguanides
MOA: decrease blood glucose by decreasing the production of glucose in the liver
Indication: Type 2 diabetes
ONSET: several days
PEAK: 2-4 weeks
SE: abdominal bloating, N/V/D, LACTIC ACID, GI Problems
NC: monitor serum blood glucose, give 30 minutes before meals
**DO NOT USE in pt with increased ALT levels
** DO NOT USE in pt. with kidney disease, liver disease, alcoholism
**MUST BE HELD 48 hrs post IV contrast
Dulaglutide
Class: GLP-1 Receptor Agonist
MOA: enhances glucose dependent insulin secretion
Indication: Type 2 diabetes
Peak: 2 hours
Half life: 2 1/2 hours
SE: N/V/D, headache, URIs
NC: DO NOT USE with those who have pancreatitis, ESRD, or renal disease
**GILA monster
BOX WARNING THYROID C-CELLS
Semaglutide
Class: GLP-1 Agonist
MOA: enhances glucose dependent insulin secretion
Indication: Type 2 diabetes
Peak: 2 hrs
Half-life: 2 1/2 hours
SE: N/V/D, headache, URI, decreased GI
NC: DO NOT use with those who have pancreatitis, ESRD, or severe renal disease
**GILA monster
BOX WARNING THYROID C-CELLS
Linagliptin
Class: DPP4 inhibitors
MOA: inhibits DPP4 an enzyme that inactivates the incretin hormone (increases insulin, decreases glucagon)
Indication: hyperglycemia
SE: GI issues, skin, flu symptoms
Sazagliptin
Class: DPP4 inhibitors
MOA: inhibits DPP4 enzyme that inactivates the incretin hormone (increase insulin, decrease glucagon)
Indication: hyperglycemia
SE: GI problems, flu, skin, pancreatitis
Empagliflozin
Class: SLGT-2 inhibitors
MOA: prevents kidneys from reabsorbing glucose
Indication: type 2 diabetes
SE: increase risk of UTIs
NC: Don’t give with ESRD, kidney disease
Dapagliflozin
Class: SLGT-2 inhibitors
MOA: prevents kidneys from reabsorbing glucose
Indication: type 2 diabetes
SE: increase risk of UTIs
NC: Do not give with those who have ESRD and kidney disease
Glucagon
Class: anti-hypoglycemic agent
MOA: activates hepatic glucagon receptors, gluconeogenesis and glucose
Indication: hypoglycemia
SHORT DURATION
*check finger stick 15 minutes
Finasteride
Class: 5 alpha reductant inhibitor
MOA: blocks conversion of testosterone to DHT (ALPHA 1 RECEPTORS)
decrease epithelial tissue in prostate
Indication: mechanical obstruction of urethra
SE: impotence, decreased libido, gynecomastia
NC: DECREASED PSA levels
used for male pattern baldness
Dutasteride
Class: 5 alpha reductase inhibitor
MOA: blocks the conversion of testosterone to DHT(alpha 1 and 2 receptors)
decrease the epithelial tissue in the prostate
Indication: mechanical obstruction of urethra
Tamulosin
Class: Alpha 1 Adrenergic Antagonist
MOA: relaxes smooth muscle cells selective for alpha receptors in prostate
Indication: dynamic obstruction of urethra
SE: well tolerated, abnormal ejaculation
Dutasteride and tamsulosin
superior to either agent alone
FDA approved
Sildenafil
Class: PDE 5 inhibitor
MOA: inhibits PDE 5, increases and preserves cGMP levels, only enhances the normal response to sexual stimuli
Indication: relief of ED, pulmonary arterial hypertension, BPH
SE: Hypothalyamic annorea, flushing, and dyspepsia
NC: caution with preexisting CV disease and if on nitrate and hypotension
ONSET: 30-60 minutes
PRIAPISM: medical emergency
Levodopa
Class:
Levodopa MOA:converts to dopamine in the brain and activates dopamine receptors
Carbidopa MOA: blocks the destruction of levodopa
Indication: Parkinson’s disease
SE: N/V, dyskinesia, postural hypotension, dysrhythmias, psychosis, hallucinations, nightmares, paranoia
**Most effective drug for Parkinson’s
** Does not work long term
Riuzole
Class: Glutamate inhibitor
MOA: glutamate antagonist, reduces damage to motor neurons
Indication: ALS
SE: dizziness, GI, hepatotoxicity
** delays need for trach, vent, and increases life expectancy by 2-3 months
Neostigmine
Class: cholinesterase inhibitor
MOA: prevent inactivation of acetylcholine by cholinesterase
Indication: Myasthenia gravis
SE: increase secretions, increased GI motility, urinary urgency, bradycardia, bronchial constriction, miosis,
NC:
