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My Pharm > Herbals > Flashcards

Herbals Flashcards

learn to recognize drugs and their details by their class suffix.

1
Q

-nacin

A

antimuscarinic (anticholinergic)

  • darifenacin, solifenacin
  • EXCEPTIONS: ATROPINE, BENZTROPINE, OXYBUTYNINE (muscarinic antagonist)
  • MOA: Slows GI motility, Mydriasis, Increase HR, Bronchodilation, Urinary Rtn,
  • CI: Narrow angle glaucoma,
  • T. Use:
  • SE/AR: N, Atropine-effects [Dry mouth, blurred vision, mydriasis (IOP), constipation], Antihistamine effects (sedation, drowsiness)
  • Intervention: Take w/ food,
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2
Q

-zosin

A

alpha blocker

  • terazosin, prazosin, doxazosin
  • MOA:
  • T. Use:
  • SE/AR:
  • CI:
  • Assess:
  • Intervention
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3
Q

-terol

A

beta agonist; bronchodilator

  • albuterol, formoterol, salmeterol
  • MOA:
  • T. Use:
  • SE/AR:
  • CI:
  • Assess:
  • Intervention
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4
Q

-olol

A

beta blocker (Beta-adrenergic blocker)

  • propranolol, metoprolol, atenolol, carvediolol
  • MOA:
  • T. Use:
  • SE/AR:
  • CI:
  • Assess: Blood sugar
  • Intervention:
    • Monitor blood sugars (masks hypoglycemia)
    • Do not stop abruptly
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5
Q

-caine

A

local anesthetic

  • bupivacaine, lidocaine, prilocaine, proparacaine
  • MOA: lidocaine used for ventricular (VT and V-fib)
  • T. Use:
  • SE/AR: Confusion, drowsiness, muscle twitching, seizures, parasthesias (see slide 33 for SAMS toxicity)
  • CI:
  • Assess: Cardiac monitoring, lidocaine toxicity
  • Intervention:
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6
Q

-dipine

A

calcium channel blocker (CCBs)

  • amlodipine, nimodipine, nisoldipine (work only on vessels)
    • EXCEPTIONS: diltiazem HCL, Verapamil (work on heart and vessels)
  • Calcium channels found in SA node, AV node, cardiac cells, and vascular smooth muscles – causes contraction/constriction & produces cardiac impulse
  • MOA: dec. Ca IN heart
    • prevents muscle contraction → causes vasodilation → dec. BP → dec. afterload, peripheral resistance, and workload
  • T. use: HTN, angina, Cardiac arrhythmias
  • Interventions:
  • SE/AR: Hypotension, Bradycardia, HA/flushing, dizziness, Reflex tachycardia
  • CI: Digoxin, ß-blockers, Antihypertensives (ACEs, ARBs, a-blockers, diuretics), IV calcium, grapfruit juice
  • Nimodipine - crosses BBB, can be used to dec. vasospasm in brain
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7
Q

-fenac

A

NSAID

  • bromfenac, diclofenac, nepafenac
  • MOA:
  • T. Use:
  • SE/AR:
  • CI:
  • Assess:
  • Intervention
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8
Q

-lamide

A

carbonic anhydrase inhibitor

  • acetazolamide, brinzolamide, dorzolamide, methazolamide
  • MOA:
  • T. Use:
  • SE/AR:
  • CI:
  • Assess:
  • Intervention
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9
Q

parin; -parin

A

antithrombotic; anticoagulant (blood thinner)

  • warfarin, heparin, tinzaparin,
  • EXCEPTION: fondaparinux
  • MOA:
  • T. Use:
  • SE/AR:
  • CI:
  • Assess:
  • Intervention:
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10
Q

-phylline

A

xanthine derivative (bronchodilator)

  • aminophylline, dyphylline, theophylline
  • MOA:
  • T. Use:
  • SE/AR:
  • CI:
  • Assess:
  • Intervention:
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11
Q

-pril

A

ACE inhibitor

  • lisinopril, benazepril, captopril, enalapril, moexipril, ramipril
  • MOA: dilates venuoles/arterioles → improves renal blood flow and dec. fluid vol.
  • T. Use:
  • SE/AR:
  • CI:
  • Assess:
  • Intervention:
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12
Q

-profen

A

NSAID

  • fenoprofen, flurbiprofen, ibuprofen, ketoprofen
  • MOA:
  • T. Use:
  • SE/AR:
  • CI:
  • Assess:
  • Intervention:
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13
Q

-sartan

A

angiotensin II receptor antagonist; ARB

  • candesartan, irbesartan, losartan, olmesartan, valsartan
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14
Q

-semide

A

loop diuretic (water pill)

  • furosemide, torsemide
  • MOA:
  • T. Use:
  • SE/AR:
  • CI:
  • Assess:
  • Intervention:
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15
Q

-statin

A

HMB-CoA reductase inhibitor; statins

  • atorvastatin, lovastatin, pravastatin, rosuvastatin, simvastatin
  • MOA:
  • T. Use:
  • SE/AR:
  • CI:
  • Assess:
  • Intervention:
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16
Q

-thiazide

A

thiazide diuretic (water pill)

  • chlorothiazide, hydrochlorothiazide, methyclothiazide
  • MOA:
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17
Q

No suffix

Cardiac Glycosides

A
  • Digoxin, Digitoxin, Oubain
  • MOA:
    • Inc. [Na and Ca] in cardiac cells – inc. force of contraction
    • Negative chronotropic fx – dec. HR
  • T. use
    • HF, afib & aflutter
  • SE/AE: Digitalis toxicity! → N.V.D, loss of appetite (anorexia), HA, anxiety, blurred vision/ yellow vision, confusion, halluciations
    • Cardiotoxicity → bradycardia
  • CI:
    • hypokalemia (inc. dig toxicity), hyperkalemia (dec. efficacy), Impaired renal, AV block, Wolff-Parkinson-White syndrome
    • Drug I -
      • Diuretics (K loss can inc. fx),
      • Glucocorticoids (Inc. fx),
      • Antacids (dec. absorp),
      • St. John’s Wart (dec. fx),
      • Sympathomimetics (dopamine inc. HR),
      • ACE Inhibitors and ARB (inc. risk of hyperkalemia)
      • Quinidine (inc. digtox)
      • Verapamil (inc. levels of digoxin)
  • Antidote: digoxin immune Fab (Digiband)
  • Assessment:
    • Toxicity; AHR (full60) hold if
  • Monitor serum K and digoxin levels, report abnormals
  • Teaching:
    • Take pulse before med, Take at same time daily, Report SE of hypokalemia and digtox, Consult HCP before OTC (inlcuding antacids), Eat foods high in K, Admin IV over >5min.
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18
Q

General considerations for herbal use

A
  • Do not take if pregnant or nursing
  • Do not give to infants and young children
  • Use safest for middle-aged, healthy adults
  • Do not take in large quantities
  • Buy only products w/plant and quantity labled
  • Contact HCP before stopping Rx
  • Store in a cool dry place
  • Use only current products
  • Don’t delay seeking care
  • Advise against “miracle cures”
  • Herbs are NOT placebos
  • Risk for interactions are greater
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19
Q

Aloe vera

A
  • External
    • pain relief
    • healing burns
  • Internal
    • constipation, arrhythmias, neuropathies, edema
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20
Q

Chamomile

A
  • Relief of digestive complaints
  • May have sedative effects
  • Rare allergic rxn of urticaria and bronchoconstriction if allergic to daisy or ragweed.
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21
Q

Dong quai

A
  • All-purpose woman’s tonic
  • Frequently mixed with fillers
  • Contains B12
  • SE:
    • fever
    • excessive menstrual bleeding
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22
Q

Echinacea

A
  • Stimulates immune system; however, immunosuppression may occur with extended use
  • For colds, flu, recurrent respiratory and UT infections, limit to 2 weeks
  • People w/ autoimmune diseases should not use.
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23
Q

Evening primrose

A
  • Natural estrogen promoter; aids in lowering cholesterol and relieving pain and inflammation
  • may lower seizure threshold if taken with an anticonvulsant
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24
Q

Feverfew

A
  • Interferes with platelet aggregation; acts as a serotonin antagonist for migraine headaches, RA, PMS
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25
Q

Garlic

A
  • Detoxifies and increases immune function; decreases platelet aggregation; for hypercholesterolemia, mild HTN
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26
Q

Ginger

A
  • Stimulates digestion; antispasmodic; decreases platelet aggregation
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27
Q

Ginkgo biloba

A
  • Antioxidant; peripheral vasodilator and increased blood flow to CNS; decreased platelet aggregation
  • Used for dementia, early stroke, and Raynaud’s phenomenon
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28
Q

Kava Kava

A
  • CNS sedation without loss of mental acuity or memory; may be hepatotoxic
29
Q

Licorice

A
  • Antiinflammatory; antibacterial; antiviral; topical: psoriasis and eczema
30
Q

Milk Thistle

A
  • Increases liver cell regeneration; liver tonic; cirrhotic disease slows and increased quality of life
31
Q

Ginseng

A
  • Used for stress relief
  • Boosts energy, helps digestion
  • Supports immune system, preventing infections
32
Q

Peppermint

A
  • Internal: stimulates appetite and aids in digestion
  • External: relief of tension headaches when rubbed on forehead (according to research in Germany, comparable to acetaminophen)
33
Q

Sage

A
  • Herb of longevity
  • Used for sore throat and cough
  • Limit use to 2 weeks
34
Q

Saw palmetto

A
  • Decreases size of prostate; discontinue herb 1 to 2 weeks before PSA test because can cause false-negative test results
  • “Plant catheter”
35
Q

Velerian

A
  • Mild sedative
    • Sleep-inducing agent
    • “Herbal valium”
    • “Dirty socks” odor
36
Q

St. John’s Wort

A
  • Antidepressant and antiviral; for depression, anxiety, sleep disorders;
    • effects in 4 to 8 weeks;
    • drug interactions: transplant medications and antidepressants;
    • not of benefit to HIV clients
    • Can cause serotonin syndrome when taken with prescription anti-depressants
  • NOTE: the table on p. 172 states SJW decreases level/effects of all the meds listed—this is WRONG!!
    • It will increase effects of SSRIs, MAOIs, & benzodiazapines
    • It will decrease effectiveness of Coumadin, Oral Contraceptives, Theophylline, and Digoxin
37
Q

Potential Hazards of Herbs

A
  • No preparations are safe in all situations
  • Contamination
  • Interaction with Rx and OTC drugs
38
Q

Assessment for Herbs

A
  • Baseline of client’s use of herbs
  • Identify complete product information
  • Identify all prescription and OTC drugs
39
Q

Interventions for Herbs

A
  • Monitor client’s response to Rx, OTC, and herbal products
  • Consult w/ dietitian and others as appropriate
  • Continue w/ same brand; discuss w/ HCP before changing or starting product
40
Q

Pt teaching for Herbs

A
  • General – look these up in the book!
  • Diet
  • SE
  • Self-admin
  • cultural considerations
  • Evaluation
41
Q
A
42
Q

ANTIDOTE FOR DIGOXIN

A

DIGIBIND

43
Q

S/S DIGITALIS TOXICITY

A

N, V, VISUAL DISTURBANCES, BRADYCARDIA

0.5-2.0 ng/mL

ANTIDOTE: DIGOXIN IMMUNE FAB

44
Q

WHEN DO YOU HOLD BETA BLOCKERS

A

HR LESS THAN 50

45
Q

S/S NITROGLYCERIN OVERLOAD

A

LIGHTHEADEDNESS, DIZZYNESS, HYPOTENTION, REFLEX TACHYCARDIA

46
Q

ADENOSIN

A

FOR DYSRRHTHMIAS

FOR SUPERVENTRICULAR TACHYCARDIA

GIVE VERY QUICKLY

CAUSES THE PT TO FLATLINE BRIEFLY

USED TO DETERMINE WHAT RYTHM THEY ARE IN

47
Q

KNOW WHICH BP MEDS WHICH CAN CAUSE EDEMA

WHAT CAN YOU DO FOR THIS?

A

ALPHA-ADRENERGIC BLOCKERS

ALPHA2 AGONISTS

Ca CHANNEL BLOCKERS

Tx with DIURETIC (HTCZ)

48
Q

ANTIDOTE FOR HEPARIN

A

PROTAMINE SULFATE

49
Q

WHEN DO YOU GIVE DIURETICS?

HOW OFTEN

A

GIVE ONCE OR TWICE

IN THE MORNING AND EARLY AFTERNOON

50
Q

ASSESSMENTS FOR DIURETICS

A

DAILY WEIGHT

I AND O

ELECTROLYTES

RESPIRATORY (CRACKLES)

51
Q

ACE INHIBITORS

KNOW THE CLASSIFICATIONS OF THE MEDS – WHAT ARE DIFFERENT

WHAT IS THE DIFFERENT SYMPTOM FOR ACE

A

ALWAYS COUGHING EXCESSIVELY

52
Q

KNOW MEDS USED TO TREAT CHEST PAIN

A

MORPHINE SULFATE

NITROGLYCERIN

OXYGEN

53
Q

ROUTE OF ADMIN FOR HEPARIN, TESTS TO LOOK AT, WHERE TO ADMINISTER

FOR HEPARIN, LOVANOX, ETC.

K, NA, PT/INR, APTT, PTT

A

IV, SQ

aPTT, PTT

54
Q

KNOW HOW ST. JOHN’S WART AFFECTS DIGOXIN LEVELS

KNOW WHAT DIAMOX WORKS AS A DIURETIC

A
55
Q

ANTIDOTE FOR ENOXAPARIN SODIUM (LOVENOX)

A

PROTAMINE SULFATE

56
Q

ANTIDOTE FOR WARFARIN

A

VITAMIN K

57
Q

ANTIDOTE FOR MYASTHENIA GRAVIS

A

ATROPINE

58
Q

ANTIDOTE FOR MORPHINE SULFATE

A

NARCAN

59
Q

ANTIDOTE FOR BETA AND CALCIUM CHANNEL BLOCKER OVERDOSE

A

GLUCAGON

60
Q

Anticoagulants include

A

heparins and oral anticoagulants (Warfarin)

  • Anticoagulants - Prevent clot formation, they do NOT dissolve the clot
61
Q

Heparin

A
  • Anticoagulant - inhibits clot formation (they do not dissolve clots!)
  • T. Use: prevention and/or management of pulmonary embolism, DVT
  • Admin: IV or SQ
  • Labs: PTT (=>90), aPTT(35-40)
  • Antidote: protamine sulfate
  • SE: bleeding, thromboctopenia
  • Teaching: soft toothbrush, no straight edge razors, etc.
62
Q

Low-Molecular-Weight Heparin (LMWH)

A
  • Enoxaparin sodium (Lovenox) and dalteparin sodium (Fragmin)
    • Don’t require freq. aPTT monitoring
    • SE: similar to Heparin - bleeding, thrombocytopenia
    • Admin: ONLY SQ in anterolateral area (Love Handles)
    • H1/2: 2-4x longer than heparin
    • Antidote: protamine sulfate
    • Always keep the air bubble in for enoxaparin sodium (Lovenox)
    • OK for pregnant women
63
Q

Oral Anticoagulants

warfarin (Coumadin)

A
  • Use: prevention of clots
  • SE: Bleeding (check stools, monitor PT/INR, electric shaver, soft toothbrush)
  • Monitor:
    • PT (13.75 - 37.5)
    • INR (2.6 - 6)
  • Interactions
    • garlic, ginger, gingko all inc. bleeding itme
    • Avoid Vitamin K rich foods: green leafy veggies, potatoes, prunes
  • Antidote: Vitamin K
64
Q

Antiplatelets work by

A
  • Prophylactic use to prevent thrombis by decreasing the stickiness of platelets (aggregation)
  • Antiplatelet drugs
    • ASA (aspirin)
    • Clopidogrel (Plavix)
    • Ticlopidine (Ticlid)
    • Dipyridamole (Persantine)
  • Taken with ASA, garlic, gingko, and feverfew can increase bleeding
65
Q

How do Thrombolytics work?

A
  • They dissolve clots (should be given within 3 hrs of thrombolyti stroke
  • Fx: Promotes converstion of plasminogen to plasmin
  • CI: Stroke (hemorrhagic), contusion
  • Drugs: Alteplase (t-PA), streptokinase, reteplase
  • SE: Hemorrhage, vascular collapse
  • A CT Scan MUST be done to determine what type of stroke it is.
66
Q

Good cholesterol is

A

HDL

  • removes cholesteral from blood and transports to liver for elimination
67
Q

Bad Cholesterol is

A

LDL

  • Containes higher percent of cholesterol
68
Q

Very low-

A

My Pharm (15 decks)

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