Last 2 Units Flashcards
Acetominophen
Tylenol
Non-opioid
No additional relief past upper limit
No tolerance/dependence
Analgesic
Antipyretic
Contraindications: liver disease, allergy, alcohol
MOA: blocks prostaglandins, synthesis in CNS, does not affect platelets
Antidote: Acetyl cysteine
Adjuvant of opioid therapy
Ibuprofen
Advil
NSAIDs
MOA: Inhibits COX 1 & 2 pathway to prevent prostaglandin production
Contra: bleeding, peptic ulcer, vitamin K deficiency
Adverse: hypovolemia from acute renal failure, heartburn
Antidote: Charcoal, lavage
Codeine
Codeine
Mild opioid analgesic (with hydrocodone)
Works on CNS, full agonist
Only opioid with ceiling effect
Antitussive
Not with peds
GI tract upset but is not allergic rx
Can give with Tylenol and cough suppressant
Decrease gradually
Fentanyl
Moderate to severe pain
Full agonist
Post-op pain
Cough suppression
Expected effects: nausea, itching, flushing
Contra: Asthma
Adverse: Nausea/vomit, cardiac suppression, urinary/poopoo retention. Constipation will remain after the rest clear.
100X more potent than morphine
Naloxone
Opioid antagonist
Occupies all opioid sites
Reverses opioid induced respiratory depression
Prednisone
Inhibits macrophages and leukocytes, inflammatory cytokines, inhibits chemical mediators to suppress immune system
Uses: autoimmune disease, COPD, inflammation, organ transplant
Leads to hyperglycemia by turning on GNG in the liver
Susceptible to infections
Fluid/Electrolyte imbalances
Neomycin
Aminoglycoside
Neomycin+Polymyxin B= Neosporin cream for skin wounds
Neomycin B given orally for decontamination before surgery
Narrow spectrum
Prevent protein synthesis
Gram-negative bacteria
Renal and ototoxic
Amoxicillan
Beta-Lactam Antibiotic
(w/ penicillins suffix -illin and cyclosporine)
Destroy peptidoglycan cell wall and bind to penicillin-binding protein in call. Result: Cell lysis
Broad spectrum
Gram + and - bacteria
Beta lactamase is bacterial enzyme that makes it resistant by destroying penicillin (4 years).
Amoxicillian + Clavulanate = Augmentin (against beta lactamase)
Common: GI upset
Adverse: Angioedema
If allergic to penicillin might have allergies to other beta-lactam antibiotics
Take with water
Cefazolin
First generation cephalosporins
Related to penicillin
Generations: Each gets better at fighting gram - bacteria and resisting beta-lactamase
1st: Good gram +, poo gram-, prophalactically for abd surgery
2nd: Good gram +, better gram -, surgical prophylaxis
3rd: Most potent aga gram -, poor gram +, rocefin
4th: Excellent gram -, excellent spectrum coverage, UTIs
5th: Broader spectrum, MRSA
Erthromycin
Macrolides
Azithromycin
Prevent protein synthesis
Bacteriostatic but -cidal in high concentrations
GI upset is main reason for noncompliance
Enteric coated helps to get drug into small intestine
Strep, URI, LRI, spirochetal infections, gonorrhea
Azithromycin and clarithromycin have fewer GI effects, longer duration, better efficacy
Doxycycline
Tetracyclines
Teratogenic
Inhibit protein synthesis
Bacteriostatic
Dairy, antacids, iron salts decrease absorption
Broad spectrum
Spirochetal infections
Lidocaine
Class: Amides
MOA: Blocks transduction locally or regionally, epidural affects dermatome
Local injections: Can be paired with epinephrine to keep lidocaine local
Epidural may cause headaches if puncture. Use blood patch
Antidote: Epinephrine
Lidocaine patch
Up to 3 at a time
Works for 3 hrs
Leave on for 12
Adverse: Localized redness or edema
Alone or adjuvant
Fentanyl patch
Mostly for chronic pain (cancer) hard to titrate
Interactions: Alcohol, antihistamines, barbiturates, benzodiazepines, CNS depressants
Will increase liver enzymes, CK, lipase, lactate
Aminoglycosides
Narrow spectrum
Prevent protein synthesis
Gram-negative bacteria
Renal and ototoxic
