medications Flashcards
warfarin (coumadin)// blood thinner
prevent blood clot
G biloba (herb)
help improve memory
-cant mix with blood thinners & blood clot med ex: warfarin & aspirin(salicylates)
Skin inflammation
-enhance the laxative effects (drug interactions)
Aloe
Elevated cholesterol levels
Garlic
Mild anxiety
-Central nervous system depression
Valerian
Nausea and vomiting
Ginger
Benign prostatic hyperplasia
Saw palmetto
Unsafe and should not be used
Chaparral
anti-inflammatory
- calming agent
- herbal tea, has a mild sedative effect that may be beneficial in promoting sleep
chamomile (can’t mix with antidepressant)
stimulant of immune sys
Echinacea (used for upper Resp infection)
Wound healing (anti-inflammatory) arthiritis(Inhibition of serotonin and prostaglandins)
Feverfew
Increased physical endurance, improved immune function
-aging related disease
Ginseng
use: GI disorders, including gastric ulcers and hepatitis C
Licorice
Memory improvement
-Alzheimer’s disease and dementia
ginkgo biloba
don’t use if: Warfarin and anticoagulants
Aspirin and NSAIDs
Ginger, Ginkgo biloba, ginseng
potential drug interactions: Furosemide (Lasix) and loop diuretics
Aloe
potential drug interactions:Barbiturates and other sleep medications, Alcohol, Antihistamines
Valerian
potential drug interaction: Warfarin and blood thinners
-Saquinavir and other anti-HIV drugs
Garlic
decreases the number of lesions, shortens duration of fever, and decreases itching, lethargy, and
anorexia (does NOT permit scarring)
-When the lesions are crusted, the chickenpox is no longer contagious
Acyclovir (Zovirax) (chickenpox)
is given to high risk children to help prevent the development of chickenpox
-used for high risk children after exposure to chickenpox to prevent varicella
Varicella zoster immune globulin(VZIG)
decreases morbidity and mortality associated with measless (rubeola)
Vitamin A supplementation
treat infection (anti-biotic) -side effect ototoxic (hearing)
vancomycin
reduce HTN (systolic& diastolic)
Tai Chi (herb)
prophylaxis of deep vein thrombosis
-side effect- internal bleeding
Heparin and low-molecular-weight heparin
dose is 0.3 to 3 mg taken 2 hours before bedtime
-side effects of nausea, headache, and dizziness being infrequent.
receptor agonist: ramelteon or tasimelteon
melatonin supplement (help sleep)
side effect : diarrhea, drowsiness, tiredness and dizziness.
receptor agonist: ramelteon or tasimelteon (melatonin)
effective in mild insomnia and RLS (restless leg syndrome) ch 6 potter
Valerian
essential oil may improve sleep quality
Lavender (oil help w/sleep)
has mild sedative effects and is used as a natural sleep aid
Passionflower (maypop) //herb
because of their long duration of action, which can cause confusion, constipation, urinary retention, and an increased risk of falls
Caution older adults about using over-the-counter antihistamines
amphetamines, caffeine, nicotine, terbutaline, theophylline, and modafinil
CNS stimulants
alcohol, barbiturates, tricyclic antidepressants (amitriptyline, imipramine, and doxepin), and triazolam causes insomnia.
CNS depressants
are commonly used to treat sleep problems and are intended for short-term use
- treat insomnia
- relaxation, antianxiety, and hypnotic effects by facilitating the action of neurons in the CNS =decrease level of arousal
Benzodiazepines and benzodiazepine-like drugs
for short-term use (no longer than 2 to 3 weeks)
- treat insomnia (sedative)
- less dependence n side effects than benzodiazepines
zolpidem (Ambien)
at the lowest possible dose for short-term treatment of insomnia are recommended.
- cause also cause respiratory depression; next-day sedation; amnesia; rebound insomnia; and impaired motor functioning and coordination, which leads to an increased risk of falls
- severe if confusion, incontinent, impaired mobility
- contraindicated in infants less than 6 months old.
Short-acting benzodiazepines (e.g., oxazepam, lorazepam, or temazepam)
is a serotonin antagonist and reuptake inhibitor (SARI) antidepressant often used in patients with depression or anxiety and insomnia.
- most common side effects are daytime grogginess (weak & unsteady on feet) and orthostatic hypotension.
- alternative for benzodiazepine (older adults)
Trazodone
is a problem after stopping a medication, particularly the benzodiazepines
Rebound insomnia
urine turn orange
phenazopyridine-
–intense yellow color of urine
riboflavin
may increase the risk for urinary retention by inhibiting bladder contractility
Anticholinergics (e.g., atropine, overactive agents)
may reduce the ability to recognize and act on the urge to void.
Hypnotics and sedatives (e.g., analgesics, antianxiety agents)
are used to treat urinary urgency.
- most common adverse effects of antimuscarinics are dry mouth, constipation, and blurred vision
- change in mental status in older adults
antimuscarinics (e.g., oxybutynin and trospium)// medication
class of medications called beta-3 adrenergic agonists.
- relaxes the bladder muscles to prevent urgent, or uncontrolled, urination
- monitor BP- can increase
mirabegron//medication
via the renin-angiotensin system (i.e., release of aldosterone and prostacyclin)
kidneys play a major role in blood pressure control
are used to treat urinary urgency.
antimuscarinics (e.g., oxybutynin and trospium)// medication
class of medications called beta-3 adrenergic agonists.
mirabegron//medication
Urinary retention is sometimes treated with
bethanechol
men with outlet obstruction caused by an enlarged prostate are treated with agents that relax the smooth muscle of the prostatic urethra, such as
tamsulosin and silodosin
agents that shrink the prostate, such as
finasteride and dutasteride
Patients with painful urination are sometimes prescribed urinary analgesics that act on the urethral and bladder mucosa
(e.g., phenazopyridine).
laxative (suppository)
- promotes defecation
- act within 30 minutes.
- Give the suppository shortly before a patient’s usual time to defecate or immediately after a meal.
bisacodyl
- Passage of stool will occur in 12 to 24 hours.
- agents must be taken with water and should be used with patients who have an adequate food and fluid intake.
- choice for chronic constipation (e.g., pregnancy, low-residue diet).
- They also relieve mild diarrhea. If treating diarrhea, administer less water.
- RISK: IF powder form cause constipation if not mixed with at least 240 mL of water or juice and swallowed quickly.
- RISK:are not for patients for whom large fluid intake is contraindicated.
Methylcellulose (Citrucel) //BULK FORMING LAXATIVE MED.
Psyllium (Metamucil, Naturacil)
Polycarbophil (Fibercon)
- little value for treatment of chronic constipation
- short-term therapy to relieve straining on defecation (e.g., hemorrhoids, perianal surgery, pregnancy, recovery from myocardial infarction).
Docusate sodium (Colace)//Emollient or Wetting LAXATIVE MED. Docusate calcium (Surfak) Docusate potassium (Dialose)
-pull fluid into the bowel to soften the stool and distend the bowel to stimulate peristalsis.
-only for acute emptying of bowel (e.g., endoscopic examination, suspected poisoning, acute constipation).
-Agents may be used to treat chronic constipation.
-RISK :not for long-term management of constipation or for patients with kidney dysfunction. They may cause toxic buildup of magnesium.
Phosphate salts are not recommended for patients on fluid restriction.
Saline-based//OSMOTIC LAXATIVE MED. Magnesium citrate or citrate of magnesia Magnesium hydroxide (Milk of Magnesia) Sodium phosphate (Fleet Phospho-Soda) Polyethylene glycol, lactulose, sorbitol based, Lactulose, Miralax
-drugs cause formation of a soft-to-liquid stool in 6 to 8 hours and usually contain bisacodyl or Senna.
-only used used occasionally
-prepare bowel for diagnostic procedures or may be needed for those with constipation from frequent opioid use
-RISKS: severe cramping.
Agents are not for long-term use.
Chronic use could cause fluid and electrolyte imbalances
Bisacodyl (Dulcolax)//Stimulant Cathartics (similar to laxative med) Castor oil Casanthranol (Peri-Colace) Correctol Senna (Ex-Lax, Senokot)
decrease intestinal muscle tone to slow the passage of feces.= body absorbs more water thru intestinal walls
Antidiarrheal agents
may be used for management of chronic severe diarrhea in patients with diseases such as Crohn’s disease, ulcerative colitis, and acquired immunodeficiency syndrome (AIDS).
Codeine or tincture of opium (diarrhea medication)
most common antidiarrhea agent used
loperamide or diphenoxylate with atropine
promotes sleep in patients with anxiety;
- it should be used cautiously because of its potential toxic effects on the liver
Kava
for depression
sertraline (Zoloft)
dont mixed dark green vegetables with blood thinner because its high in Vitamin (counteract effects of blood thinner)
warfarin (coumadin)// blood thinner
metabolism.
medications such as insulin, glucocorticoids, and thyroid hormones affect
taste.
antifungal agents frequently affect
medications stimulate appetite
cyproheptadine, megestrol, or dronabinol
gastric emptying and decrease the risk of aspiration
Prokinetic medications such as metoclopramide, erythromycin, or cisapride promote
(e.g., ranitidine, famotidine, nizatidine),
gastric acid inhibitor
(e.g., omeprazole).
proton pump inhibitor
Prevent thromboembolism
• Recommended for patients with an ejection fraction <20% and/or atrial fibrillation
Anticoagulants
Prevent or treat dysrhythmias
Antidysrhythmic Drugs
- Promote reverse remodeling
- Decrease afterload
- Inhibit SNS
- Reverse cardiac remodeling
- Reduce mortality and morbidity in patients with chronic HF
β-Adrenergic Blockers
bisoprolol (Zebeta)
carvedilol (Coreg)
metoprolol succinate (Toprol XL)
- Block absorption of sodium and chloride in the kidneys at the loop of Henle
- Increase urine output
- Decrease fluid volume
- Decrease preload
- Decrease pulmonary venous pressure
- Relieve symptoms of fluid congestion
Loop Diuretics
bumetanide (Bumex)
furosemide (Lasix)
- Affect electrolyte reabsorption at the distal renal tubule resulting in sodium and chloride excretion
- Increased urine output (milder diuretic effect than loop diuretics)
- Decrease blood pressure
Thiazide Diuretics
hydrochlorothiazide
metolazone (Zaroxolyn)
- Inhibit aldosterone that causes sodium and water retention and antiinflammatory responses in HF
- Prevent potassium loss by inhibiting sodium and potassium exchange in the distal tubule
- Mild diuretic effect
- Reduce mortality and HF hospitalizations in patients with chronic HF
Aldosterone Antagonists (Potassium-Sparing Diuretics)
eplerenone (Inspra)
spironolactone (Aldactone)
- Binds to opioid receptors
- May decrease the chemoreceptor response to hypoxia, and/or cause vasodilation reducing pulmonary congestion
- Reduces anxiety
Morphine
MS Contin, Duramorph, Embeda, Kadian
- Sacubitril inhibits neprilysin, decreasing natriuretic degradation which promotes diuresis, natriuresis
- Valsartan selectively blocks angiotensin II receptors
- Lower blood pressure
- Dilate venules and arterioles
- Improve renal blood flow
- May decrease mortality and hospitalizations in patients with chronic HF
Neprilysin-Angiotensin Receptor Inhibitors
sacubitril/valsartan (Entresto)
- Increase contractility (positive inotropic effect)
- Increase CO
- May reduce PAWP
- May cause dysrhythmias
- Increase myocardial O2 demand
Positive Inotropes
β-Adrenergic Agonists∗
dobutamine
dopamine
- Weak positive inotrope mostly at higher doses
- Reduce effects of RAAS and SNS
- May reduce HF symptoms and hospitalization if added to standard therapy for chronic HF
Positive Inotropes
Digitalis Glycoside
digoxin
(toxicity= nausea, diplopia, hypokalemia)
- Produce mild vasodilation
- Increase SV and CO
- Promote vasodilation
Positive Inotropes
Phosphodiesterase Inhibitor∗
milrinone
- Dilate venules and arterioles
- Reduce afterload and SVR
- Improve renal blood flow
- May relieve HF symptoms
- Promote reverse remodeling
- May reduce morbidity, mortality, and HF hospitalizations in patients with chronic HF
Renin-Angiotensin-Aldosterone System Inhibitors (#1 for HF)
ACE Inhibitors
benazepril (Lotensin)
captopril (Capoten)
enalapril (Vasotec)
Angiotensin II Receptor Blockerslosartan (Cozaar)
valsartan (Diovan)
- Selectively inhibits the I f-current in the SA node
- Decreases heart rate
- May reduce CVD death and HF hospitalizations in patients with HFrEF in sinus rhythm with a HR ≥70 bpm
- Used only for patients with chronic HF
Selective SA Node Inhibitor
ivabradine (Corlanor)
- Reduce afterload
- Dilate the arterioles of the kidneys, leading to increased renal perfusion and fluid loss
- Decrease BP
- Decrease preload
- Neseritide may reduce PAWP
- May relieve HF symptoms (e.g., dyspnea)
- Isosorbide dinitrate/hydralazine, fixed dose, may reduce morbidity and mortality in blacks with HFrEF and NYHA Class III–IV symptoms
Vasodilators
isosorbide dinitrate/hydralazine (BiDil)
neseritide (Natrecor)∗
nitrates (e.g., nitroglycerin [Nitro-Bid], isosorbide dinitrate [Isordil])
nitroprusside (Nitropress)∗
