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Melissa's Pharm 2 > Final Part 1 > Flashcards

Final Part 1 Flashcards

1
Q

Nitroglycerin

A

Nitrate (anti-angina)

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2
Q

Isosorbide mononitrate

A

Nitrate (anti-angina)

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3
Q

Ranolazine

A

Anti-angina

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4
Q

PDE-5 Inhibitors

A

ED

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5
Q

What anti-angina decreases preload? What anti-angina decreases O2 demand?

A

Decreases preload- nitrates

Decreases O2 demand- Ranolazine

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6
Q

What anti-angina causes prolonged QT interval?

A

Ranolazine

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7
Q

What anti-angina has interactions with PDE-5 inhibitors?

A

Nitrates (nitroglycerin and isosorbide monoitrate)

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8
Q

Amidarone is primarily a ___ blocker. What class?

A

K+; 3

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9
Q

What heart drug has an EXTREMELY long 1/2 life?

A

Amidarone (25-120 days)

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10
Q

Amidarone can make your skin turn _____ due to photosensitivity

A

Blueish-grey

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11
Q

Amidarone is ___ iodine. Increased risk for what?

A

40%; hypo/hyperthyroidism

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12
Q

DIGOXIN IS VERY IMPORTANT TO KNOW ABOUT!!!!

Digoxin stimulates the ____ which releases ____, so it slows down the ____.

A

Vagus nerver; ACh; HR

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13
Q

Digoxin is also good because it blocks the NaKATPase pump, so it causes ______

A

Increased contractility

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14
Q

What is the therapeutic range for digoxin?

A

0.5-0.8

VERY NARROW

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15
Q

Where is digoxin excreted?

A

Kidneys

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16
Q

Digoxin adverse effects?

A

Seeing yellow; halos

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17
Q

What is early digoxin toxicity signs?

A

Anorexia
N
V

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18
Q

What is late digoxin toxicity signs?

A 
Dysrhythmias
MS changes (can progress to coma)
Visual changes (seeing yellow and halos)
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19
Q

Digoxin competes with ____ for the same sites. Why is this important?

A

Potassium!
If K+ levels are high, digoxin isn’t working well (little or no therapeutic effects)
If K+ levels are low, digoxin may be working too well (become toxic)

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20
Q

HDL or LDL is good?

A

HDL

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21
Q

Pravastatin

A

Dyslipidemia med (statin)

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22
Q

Simvastatin

A

Dyslipidemia med (statin)

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23
Q

Atorvastatin

A

Dyslipidemia med (statin)

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24
Q

Rosuvastatin

A

Dyslipidemia med (statin)

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25
Q

Statins are dyslipidemia meds. They are the DOC for _____ LDL.

A

decreasing!!

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26
Q

Which statin has NO CYP interactions?

A

Pravastatin

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27
Q

Which statin is most commonly associated with rnhabdomyloysis?

A

Rosuvastatin

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28
Q

What are the pleiotropic effects of the statins?

A
  1. Stabilizes arterial plaque
  2. Anti-inflammatory properties
  3. Anti-oxidant properties
  4. Anti-platelet/thrombotic properties
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29
Q

A patient has nonalcoholic fatty liver disease and wants to know if they can take a statin. We know that statins have adverse effects of muscle pain (myopathy), hepatoxicity, and CYP interactions. Is it okay to still administer a stain?

A

Yes. With nonalcoholic fatty liver disease, there is no problems for hepatotoxicity.

*every other liver disease (hep, alcoholic), a statin would be contraindicated!

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30
Q

What preg category are statins?

A

X!!!!

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31
Q

How long does it take a statin to work? When should they be taken and why?

A

2 weeks; in the evening–that is when your body is making cholesterol and it works the best when it can block the production of cholesterol..if cholesterol is made at night, thats when it needs to be taken

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32
Q

Niacin (Vit. B3)

A

Dyslipidemia Med

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33
Q

1 adverse effect of the dyslipidemia med Niacin?

A

Intense flushing (take aspirin 30 min prior to help) & itching

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34
Q

Bile acid sequestrants

A

Dyslipidemia

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35
Q

Cholesevelam

A

Bile acid sequestrates (dyslipidemia)

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36
Q

Ezetimibe

A

Dyslipidemia

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37
Q

Fibrates

A

Dyslipidemia

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38
Q

Fenofibrate

A

Fibrate-dyslipidemia

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39
Q

Gemfibrozil

A

Fibrate-dyslipidemia

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40
Q

The dyslipidemia meds that are fribrates (fenofibrate and gemifibrozil) are _____ and cannot be combined with ____. What is the most common adverse effects of these drugs?

A

Protein bound; can’t be combined with WARFARIN

RASH and GI disturbances

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41
Q

Fish oil

A

Dyslipidemia

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42
Q

Non-statins do more of the _____ (effects on LDL, HDL, and TG). Statins do more of the _______ (decrease number of MI, stroke)

A

Non-statin: Surrogate endpoint

Statin: Clinical endpoint

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43
Q

What level tell a doctor the patient has a hear problem. Elevated BNP or ANP?

A

BNP

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44
Q

Angiotensinogen is made by the ____

A

Liver

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45
Q

Renin is secreted by ____

A

Kidney

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46
Q

ACE is an enzyme found in the ____

A

Lungs

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47
Q

Angiotensin II causes _____

A

Vasoconstriction

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48
Q

ACE inhibitors

A

RAAS drugs

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49
Q

-Prils

A

ACE inhibitor (RAAS)

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50
Q

ARBs

A

RAAS drugs

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51
Q

-Sartans

A

ARBs (RAAS)

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52
Q

Adverse effects of ACE and ARBs (RAAS)?

A 
HAHA
first-dose HYPOTENSION (fall risk!!!)
ACUTE kidney injury
HYPERKALEMIA
ANGIOEDEMA
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53
Q

What RAAS is cardioprotective?

A

ACE (-prils)

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54
Q

What RAAS causes dry cough?

A

ACE (-prils)

*because ACE normally breaks down bradykinin, when we block ACE with RAAS drugs, bradykinin doesn’t get broken down so a cough happens

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55
Q

BB: Normal effects of A1, B1, B2?

A

A1- constrict
B1- Heart beats faster and with more force
B2- Dilation

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56
Q

BB: What happens when we block A1, B1, B2?

A

A1 block-dilation
B1- slow HR
B2- Constriction (BAD FOR ASTHMA PTS)

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57
Q

Cardioselective BB?

A 
Atenolol
Metoprolol tartrate (2x/d)
Metoprolol succinate (long lasting)
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58
Q

What BB blocks B1 and B2?

A

Propranolol

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59
Q

What BB blocks A1, B1, and B2?

A

Carvedilol

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60
Q

Who takes BB?

A

HAHAP

  • HTN
  • Angina
  • HF
  • A-fib
  • Post-MI
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61
Q

What else is Propranolol indicated for?

A

Crosses BBB so for MIGRAINE prophylaxis
Hemangioma
Stage fright

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62
Q

Big adverse effect of BB?

A

MASKING HYPOGLYCEMIA (signs to look for would be hungry, dizzy, forgetful NOT the usual shaking)

other adverse effects= symptoms of decreased BP or HR, fatigue/depression, bronchospasm [nonselective ones]

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63
Q

BBW for BB?

A

Do not abruptly stop a BB unless absolutely necessary!!!

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64
Q

Can we give a BB to someone with severe peanut allergy?

A

No; if they eat a peanut, we would need to give EPI…but if they are taking the BB, the BB blocked the EPI receptors, so the EPI WILL NOT HELP THE ALLERGIC REACTION!!

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65
Q

Dihydropyrindes and non-dihydropyridines

A

CCB

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66
Q

Nifedipine XL

A

D (CCB)

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67
Q

Amlodipine

A

D (CCB)

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68
Q

Amlodipine/benazepril

A

D (CCB) [combined with -pril {ACE inhibitor}]

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69
Q

CCB: D are arteries, heart, or both?

A

Effect the arteries only

HTN and Angina

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70
Q

CCB: Non-d are arteries, heart, or both?

A

Both;
HTN
Angina
A-fib

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71
Q

Verapamil

A

Non-d (CCB)

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72
Q

Diltiazem

A

Non-d (CCB)

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73
Q

What if a client who is taking CCB says “my shoes don’t fit”

A

They are experiencing DOSE-DEPENDENT PERIPHERAL EDEMA [most common complaint!!!]

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74
Q

4 adverse effects of CCB?

A

dose-dependent peripheral edema
headache
flushing
dizziness

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75
Q

What CCB class causes reflex tachycardia?

A

The D

Primarily nifedipine IR–potentially dangerous!! Combine with BB to help reduce the risk of it!!

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76
Q

Since non-d blocks receptors in both arteries and heart, what are some side effects associated?

A

Bradycardia
CYP interactions
Constipation (VERAPAMIL)
Avoid with HF and blocks!

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77
Q

Furosemide

A

Loop diuretic

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78
Q

HCTZ

A

Thiazide diuretic

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79
Q

Spironolactone

A

Potassium sparing diuretic

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80
Q

Mannitol

A

Osmotic diuretic

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81
Q

___ & ___ diuretic cause HYPOkalemia

What foods to give?

A

Furosomide and HCTZ

Dried fruit, nuts, spinach, potatoes, bananas, avacado

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82
Q

____ diuretic causes HYPERKALEMIA

A

Spironolactone

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83
Q

BIG adverse effect of furosemide?

A

Ototoxicity (transient)

Do NOT combine with amino glycoside (gentemycine)

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84
Q

What 3 things does HCTZ increase?

A

Calcium, uric acid, and glucose!

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85
Q

Adverse effects of spironolactone?

A

HYPERkalemia
Gynecomastia
Menstrual irregularities
Impotence

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86
Q

Mannitol is given ___ and must be kept [warm or cold] so it won’t crystalize. Indication?

A

IV; warm; cerebral edema [ICP]

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87
Q

Statins are pregnancy risk category ___

A

X

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88
Q

Talk about nitroglycerin (anti-angina)

A

Sit or lie down bc drops BP quick
DISSOLVE TAB UNDER TONGUE -do not swallow!
Wait 5 min
If angina is still there, take another tab and call 911
*can take up to 3 tabs q5 min

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89
Q

Talk about isorobide mononitrate teaching (anti-angina)

A

DO NOT CRUSH
Only lasts 12 hours
Must have “nitrate free interval”
Improves exercise tolerance

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90
Q

Nitrates cause VASODILATION. Expected SE?

A

Headache
Orthostatis (decreased BP)
FLushing
Dizziness

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91
Q

ST elevation with ___ angina

A

Prinzmetal

92
Q

ST depression with ____ and ___

A

stable and unstable angina

93
Q

Nitrates and _____ DO NOT COMBINE

A

PDE-5 Inhibitors (ED drugs)

94
Q

Ranolazine (anti-angina) is long acting and it can cause _______

A

Torsades de pointes –which can lead to V-fib..which is FATAL

95
Q

What drug has a REALLY LONG HALF life?

A

Amiodarone

96
Q

What drug has a very narrow therapeutic range and is indicated for A-fib (stimulating vagus nerve) and HF (blocking NaKATPase pump)?

A

Digoxin

therapeutic range= 0.5-0.8

97
Q

What drug may you see yellow or halos?

98
Q

Early toxicity of digoxin? late?

A

Early: anorexia, N/V
Late: dysrhythmias, MS changes, Visual changes

99
Q

Digoxin competes with _____!!! MUST MONITOR BOTH THESE LEVELS

A

POTASSIUM!!!!!!!

100
Q

Is digoxin cardioprotective?

A

NO; take an ACE to get cardioprotective benefits

*ACE are -prils

101
Q

Aspirin

A

Blood thinner

102
Q

Clopidogrel

A

Blood thinner

103
Q

Big effects of aspirin?

A

GI problems

Tinnitus (ringing of the ears)–dose dependent

104
Q

Clopidogrel doesn’t work for a lot of people due to genetic variance and it causes multiple interactions. Lots of people quit taking it. Is it okay to stop it abruptly??

A

NO; can cause thrombotic clot!

105
Q

Warfarin

A

Blood thinner

106
Q

Heparin

A

Blood thinner

107
Q

Enoxaparin

A

Blood thinner

108
Q

Warfarin is very unpredictable, meaning it has a high variable response..mainly due to diet and genetics. Warfarin blocks the reactivation of _____.

109
Q

Digoxin competes with ____.

Eating lots of ____ can effect Warfarin.

A

Digoxin competes with K+ (potassium)

Eating lots of Vit. K can effect warfarin (more vit. k, the higher the dose of warfarin!!)

110
Q

What test do you monitor when taking Warfarin?

A

Prothrombin time (PT)
International normalized ratio (INR)
*INR corrects PT

111
Q

It takes warfarin ~__days to reach the goal of thinning blood

112
Q

S/S of bleeding when taking warfarin?

A

Melena
Blooding looking urine
Coffee ground vomit

113
Q

What are novel oral anticoagulants?? (POSSIBLE ATI QUESTION)

A

Dabigatran
RivaroXAban
ApiXAban

highly predictable, no routine blood work, works immediately, safer-more effective

114
Q

Is heparin rapid acting or slow acting?

115
Q

Can heparin cross BBB?

116
Q

Heparin look at ___ levels

117
Q

Heparin inhibits both ____ so it works immediately.

Warfarin blocks the reactivation of ____ so the liver stops making clotting factors. but the clotting factors that were already in the blood are still there up to ~___, which makes warfin a slower acting blood thinner.

Enoxaparin inhibits ____

A

Factor X and II

Vit. K; ~5 days

Factor X

118
Q

Protamine sulfate

A

Antidote for heparin overdose!

119
Q

Lots of monitoring with enoxaparin?

120
Q

Special administration with enoxaparin?

A
  • SQ ONLY
  • Love handles preferred
  • Predosed syringe
  • LEAVE THE AIR BUBBLE IN
121
Q

Normal Hgb range for women? men?

A

Women: 12-15
Men: 14-17

122
Q

4 ingredients to RBC?

Basically you could have anemia if one (or more) of these “ingredients” are deficient

A

Iron
Vit B12
Folic Acid
Erythropoietin (EPO)

123
Q

How can iron be administered?

A

PO, IV, IM

124
Q

What are some weird things about iron?

A

Can cause dark green or black stools and this is NORMAL

Stains the teeth (liquid version)

125
Q

Iron taken with food or on empty stomach?

A

Empty stomach

*body can’t absorb more than 200 mg/d

126
Q

Ferrous sulfate

A

Iron (anemia med)

127
Q

Vit B12 deficiency due to not getting enough in their diet or problems with absorption?

A

Problems with absorption

128
Q

Can cause pernicious anemia

A

Vit. B12 deficiency

129
Q

Cyanocobalamin

A

Vit. B12 drug (anemia med)

130
Q

Clopidegril

A

Blood thinner (works poorly)

131
Q

Vit. B12 can cause HYPO or HYPERkalemia?

A

HYPOkalemia

132
Q

What GI disorder decreases the absorption of folic acid?

133
Q

If a mother doesn’t have sufficient stores of folic acid very early in pregnancy, there is a significant risk of _____

A

Neural tube defects–spina bifida

take an additional 400-800 mcg/d if pregnant!!

134
Q

Short term adverse effects of folic acid? long term?

A

Short term: none

Long term: cancer

135
Q

Epoetin alfa

A

EPO drug (anemia)

136
Q

Darbepoetin alfa

A

EPO drug (anemia)

137
Q

Who gets EPO drugs?

A
  • anemia due to CHRONIC LIVER FAILURE
  • Chemotherapy induced anemia
  • HIV clients taking AZT
138
Q

Most common issue for EPO drugs?

A

HTN–cant take EPO if you have uncontrolled BP

Others are cardiovascular effects and tumor progression (in the cancer patients)

139
Q

We want to take EPO drugs only if they are REALLY NEEDED. Remember Hgb in males in 14-17 and in females 12-15. We want to stop taking the EPO when Hgb levels reach ____.

A

If Hgb gets above 11 because we don’t want the Hgb to rise too quickly.

140
Q

In a 2 week period, EPO drugs should NOT rise by more than ____.

A

1 gm/dL

7.1 initially…EPO and two weeks later the Hgb is 8.4. DOSE NEEDS LOWERED. It rose more than 1 gm/dL

141
Q

How should EPO be stored?

A

Fridge
Don’t freeze
Dont shake (its a protein and will break)

142
Q

Short term complications of diabetes?

A

Hyperglycemia–Ketoacidosis and HHNS

Hypoglycemia

143
Q

Long term complications of diabetes?

A

Macrovascular damage (Heart disease, HTN, stroke)

Microvascular damage (Retinopathy, neuropathy, sensory and motor neuropathy, autonomic neuropathy [gastroparesis], infection & amputation, ED)

144
Q

Know the difference between type 1 and type 2 diabetes.

A

Type 1: Beta cell destruction; can lead to DKA

Type 2: Insulin resistance; HHNS

145
Q

Hypoglycemia SNS [fight or flight responses] activation?

A

Tachycardia
Palpitations
Sweating
Nervousness

146
Q

Hypoglycemia decreased glucose in CNS responses?

A

Headache
Confusion
Drowsiness
Fatigue

147
Q

What drug blocks the SNS activation? What does this mean?

A

BETA BLOCKERS

Teach patints that low blood glucose is going to be shown as headache, confusion, drowsiness, and fatigue if they are also on a BB

148
Q

Fasting plasma glucose indicating diabetes?

A

Greater than or equal to 126

149
Q

Causal plasma gluocse indicating diabetes?

A

greater than 200 mg/dL PLUS symptoms

150
Q

Hgb A1C indicating glucose?

A

greater than/equal to 6.5%

151
Q

Symptoms of diabetes?

A

Polyuria
Polydipsia
Polyphagia

152
Q

How many times do you check levels if you are preg. and diabetic ?

153
Q

Oral agents are approved only for type __ diabetes

154
Q

Metformin

A

Oral agent diabetes

155
Q

Sulfonylureas

A

Oral agent diabetes

156
Q

TZDs

A

Oral agent diabetes

157
Q

DPP-4 inhibitors

A

Oral agent diabetes

158
Q

SGLT-2 inhibitors

A

Oral agent diabetes

159
Q

Glipizide

A

Sulfonylureas (oral agent diabetes)

160
Q

Rosiglitazone

A

TZD (oral agent diabetes)

161
Q

TZD suffix?

A

-Glitazone

162
Q

Sitagliptan

A

DPP-4 inhibitors (oral agent diabetes)

163
Q

Canagliflozin

A

SGLT-2 inhibitors (oral agent diabetes)

164
Q

Metformin

A

Oral agent diabetes

165
Q

Glyburide

A

Sulfonylureas (oral agent diabetes)

166
Q

Glimepridide

A

SUlfonylureas (oral agent diabetes)

167
Q

Pioglitazone

A

TZD (oral agent diabetes)

168
Q

DPP-4 Inhibtors (diabetes)?

A

Sitagliptan

169
Q

SGLT-2 inhibitors (diabetes)?

A

Canagliflozin

170
Q

TZDs (diabetes) ?

A

Rosilitazone

Pioglitazone

171
Q

Sulfonylureas (diabetes)?

A

Glipizide
Gluburide
Glimepiride

172
Q

Most common adverse effect of metformin (oral diabetes), aka the DOC? Does metformin cause you to gain weight?

A

Diarrhea and flatulence

No, weight NEUTRAL

173
Q

Glipizide, glyburide, glimepiride are all sulfonylureas (oral agent diabetes). What are their 3 adverse effects?! They have a _____ reaction & ____ HYPOglycemic effects.

A 
HYPOgltcemia
Weight gain (5-10 lbs)
Burn out (5-10 years)

Disulfiram like reaction; potentiate

174
Q

Which glitazone (TZD-oral diabetic) causes mixed effects on the lipids?

*these take 3-4 months to start working

A

Pioglitazone

175
Q

Sitagliptan (DPP4 inhibitor-oral diabetic) may cause ____ issues and pancreatitis [rare]

A

Upper respiratory issues (runny nose)

176
Q

What oral diabetic med is taken BEFORE breakafst?

A

SGLT-2 inhibiors (canagliflozin)

177
Q

What are the adverse effects of SGLT-2 inhibitors?

A

Weight loss (5-7 lbs)
Dehydration
HYPERkalemia
GENITAL INFECTIONS (fungal)

178
Q

What oral diabetic has a rare adverse effect of lactic acidosis?

179
Q

What oral diabetic has weight gain of 5-10 lb?

A

Sulfonylureas (glipizide, glyburide, glimepiride)

180
Q

What oral diabetic has weight loss of 5-7 lbs?

A

SGLT-2 inhibitors (canagliflozin)

181
Q

What oral diabetic is weight neutral?

182
Q

Is TZD causing weight loss or weight gain? Why?

A

Gain–because it has Na+ retention and that causes edema which causes weight gain!!!

183
Q

What oral agent diabetic do you take before breakfast?

A

SGLT-2 inhibitors (canagliflozin)

184
Q

Major DPP-4 inhibitor (oral diabetic)?

A

Sitagliptan

185
Q

Proton pump inhibitors & H2 blockers are what kind of meds?

A

Anti-ulcer

186
Q

Proton pump inhibitors suffix?

187
Q

Most prazoles (proton pump inhibitor-antiulcer) are DR forms, meaning ____.

A

Don’t crush the tab!!

188
Q

Big adverse effect of parazole (proton pump inhibitor-antiulcer)?

A

Acid rebound (taper dose when discontinuing)

189
Q

Controversial adverse effects of parazoles (proton pump inhibitors)?

A

Pneumonia
C.diff
Decreased levels in Vit.B12, iron, magnesium, calcium
Osteoporosis

190
Q

When do you take a prozole?

A

AM before breakfast!!

191
Q

H2 blocker suffix?

192
Q

Do H2 blockers have a rebound effect?

A

Yes! (taper dose when discontinuing)

193
Q

Antacids

194
Q

Sucralfate

195
Q

What does sucralfate do? How long does it last?

pH requirement?

A

Creates a cover/protective barrier around the ulcer; ~6hr

A little acidic for it to work–pH less than 4

196
Q

Antacids raise pH. They can work systemically. What happens if your pH is 7.5?

A

You have metabolic alkalosis

197
Q

Docusate sodium

A

Stool softener laxative

198
Q

Important thing to do if taking docusate sodium? How long till BM?

A

Take with full glass of water; several days

199
Q

PEG 3350

A

Osmotic laxative

200
Q

When is BM with PEG 3350? What is PEG 3350 good for? Teaching?

A

BM 2-4 days
Chronic constipation
Teaching: dissolve in 4-8 oz and takes 5-10 min to completely dissolve

201
Q

Senna

A

Stimulant laxative

202
Q

Bisacodyl

A

Stimulant laxative

203
Q

Senna/docusate

A

Stimulate laxative + stool softener

204
Q

When do you have BM with stimulate lax?

A

12 hour if taken PO, 1 hr if taken PR

205
Q

What is the weird effect with senna?

A

Yellowish-brown or pink urine

206
Q

PEG 3350 w/ electrolyes?

A

Bowel prep lax

207
Q

Talk about PEG 3350 with electrolytes.

A

Must drink 4 L and it has high Na concentration so it tastes like salt

Teaching: Chill beforehand, add crystal light, chug-dont sip it, and have easy access to a toilet

208
Q

Dicyclomine
What receptor?
What side effects?

A 
Diarrhea med (anticholinergic-slows down bowel motility)
Typical anti-cholinergic effects
209
Q

Loperamide
What receptor?
What side effects?

A 
Diarrhea med (works on mu receptor-slows down bowel motility)
Well tolerated
210
Q

Diphenoxylate/atropine

What side effects?

A 
Diarrhea med (opioid that slow down bowel motility and atropine is added for anticholinergic to help with the opiod effects f diphenoxylate)
If they took too high a dose, then anti-cholinergic effects and a buzz..if a normal dose, drug is well tolerated
211
Q

Dicyclomine (diarrhea med) is given for a disorder that can cause diarrhea. Example?

212
Q

Does loperamide (diarrhea med) cross BBB, since it’s an opioid?

A

No…so no pain relief, euphoria, or addiction with it!

213
Q

Diphenoxylate is an ____.
Atropine is an _____.
Why do we give atropine?

A

Diphenoxylate is an opioid and it can cause a buzz if you take too high of a dose of it. That’s why atropine is added, because it atropine is an anticholinergic, because if this drug is taken in high doses, the pt. will experience anti-cholinergic effects. AKA ones no one wants. So the buzz happens if you take too high a dose, but all these other effects happen too, and people don’t want those effects along with their “buzz”

Schedule 5

214
Q

Atropine

A

Part of the diphenoxylate drug for diarrhea but ALSO USED IN CODE SITUATIONS

215
Q

If someone has an acute infection of diarrhea, do we give anti-diarrhea drugs?

A

NO; we want to see what the underlying cause of the diarrhea is!!!! The drug only works on the receptors in the gut and don’t necessarily treat the cause!

216
Q

3 diarrhea drugs?

A

Dicyclomine
Loperamide
Diphenoxylate/atropine

217
Q

4 antiemetics (anti-vomiting) drugs?

A

Ondansetron
Promethazine
Prochloperazine
Metoclopramide

218
Q

What antiemetic is a “clean drug”? Why?

A

Ondansetron; it only blocks one receptor [5-HT3]

219
Q

Big issue with Ondansetron (anti-vomiting)? But is this issue common or rare?

A

Can prolong QT interval
Rare–this only happens if you are taking a REALLY high dose of the drug..normal dose would be about 8mg, but if you took 30mg, you may be at risk for prolonged QT–who takes that high of a dose? CHEMO PATIENTS!!

220
Q

Why is it good that Ondansetron (anti-vomiting) comes in all sorts of forms?

A

Bc sometimes you can’t keep down anything and the PO route wouldn’t work

221
Q

What is the major receptor Phenothiazine blocks?

222
Q

Side effects of Phenothiazine?

A

EPS (bc blocks dopamine), orthostatic hypotension (bc blocks alpha1)

223
Q

Who CANNOT take Phenothiazine (anti-vomiting)?

A

Children under age 2 because it can cause severe respiratory depression–deaths have occurred

224
Q

If Phenothiazine (anti-vomiting) drug infiltrates, then what happens?

A

Can lead to gangrene and amputation

225
Q

What receptor does Prochlorperazines (anti-vomiting) block? What does this mean?

A

Blocks DOPAMINE!

EPS effects!!!

226
Q
  • What receptor does Metoclopramide block?’
  • What does this mean?
  • What does it increase (good thing), so who would that be good for??
  • What’s the big problem with it and the BBW?
A
  • DOPAMINE
  • EPS side effects!
  • Increases gastric motility…a lot of long term diabetics experience this microvascular effect, and giving Metoclopramide is good for them to increase the gastric motility!
  • EPS!!!! DO NOT TAKE METOCLOPRAMIDE MORE THAN 12 WEEKS!!! (the risk of tardive dyskinesia increases)

Melissa's Pharm 2 (32 decks)

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