Medications Flashcards
OXYBUTYNIN
Class, mechanism of action, indication, side effects + contraindications, interactions
Class: Anti-muscarinic
Mechanism of action: Competitive agonist of muscarinic Ach, spasmolytic affects on smooth muscle of bladder
Indication: Urgency UI
Side effects + contraindications: Dry mouth, skin and eyes, constipation, POSTURAL HYPOTENSION, cognitive decline, memory problems, worsening of dementia, urinary retention
Contraindicated in urinary retention, MG, intestinal obstruction, uncontrolled acute angle closure glaucoma
Interactions: Other drugs causing antimuscarinic affects
TROSPIUM
Class, mechanism of action, indication, side effects + contraindications, interactions
Class: Anti-muscarinic
Mechanism of action: Competitive agonist of muscarinic Ach, spasmolytic affects on smooth muscle of bladder
Indication: Urgency UI
Side effects + contraindications: Dry mouth, skin and eyes, constipation, POSTURAL HYPOTENSION, cognitive decline, memory problems, worsening of dementia, urinary retention
Contraindicated in urinary retention, MG, intestinal obstruction, uncontrolled acute angle closure glaucoma
Interactions: Other drugs causing antimuscarinic affects
SOLIFENACIN
Class, mechanism of action, indication, side effects + contraindications, interactions
Class: Anti-muscarinic
Mechanism of action: Competitive agonist of muscarinic Ach, spasmolytic affects on smooth muscle of bladder
Indication: Urgency UI
Side effects + contraindications: Dry mouth, skin and eyes, constipation, POSTURAL HYPOTENSION, cognitive decline, memory problems, worsening of dementia, urinary retention
Contraindicated in urinary retention, MG, intestinal obstruction, uncontrolled acute angle closure glaucoma
Interactions: Other drugs causing antimuscarinic affects
TOLTERADINE
Class, mechanism of action, indication, side effects + contraindications, interactions
Class: Anti-muscarinic
Mechanism of action: Competitive agonist of muscarinic Ach, spasmolytic affects on smooth muscle of bladder
Indication: Urgency UI
Side effects + contraindications: Dry mouth, skin and eyes, constipation, POSTURAL HYPOTENSION, cognitive decline, memory problems, worsening of dementia, urinary retention
Contraindicated in urinary retention, MG, intestinal obstruction, uncontrolled acute angle closure glaucoma
Interactions: Other drugs causing antimuscarinic affects
MIRABEGON
Class, mechanism of action, indication, side effects + contraindications, interactions
Class: Beta 3 agonist
Mechanism of action: Mirabegron is a potent and selective agonist of beta-3 adrenergic receptors. The activation of beta-3 receptors relaxes detrusor smooth muscle during the storage phase of the urinary bladder fill-void cycle, which increases the bladder’s storage capacity thereby alleviating feelings of urgency and frequency
Indication: Urge incontinence when anti-muscarinic not suitable
Side effects + contraindications: Increased blood pressure, UTI, dizziness, constipation,diarrhoea, tachycardia, nausea
Contraindicated in uncontrolled HTN, QT prolongation, kidney or liver problems
Interactions: Mirabegron may increase the levels of some drugs if taken concurrently, including:
Beta blockers (metoprolol).
Colchicine.
Dabigatran.
Digoxin.
Everolimus, sirolimus.
Fexofenadine.
Loperamide.
Tricyclic antidepressants (for example imipramine).
TAMSULOSIN
Class, mechanism of action, indication, side effects + contraindications, interactions
Class: Alpha-adrenergic blocker
Mechanism of action: Tamsulosin blocks alpha1 receptors located in and around the prostate, the top of the urethra, and the neck of the bladder, which reduces muscle tone. As a result urine flow rates are improved and there is a reduction in the symptoms of BPH.
Indication: BPH
Side effects + contraindications: POSTURAL HYPOTENSION. Dizziness, headache, a runny nose, drowsiness, and sexual dysfunction (abnormal ejaculation).
SHOULD NO BE PRESCRIBED TO WOMEN OR CHILDREN
Interactions: May interact with several drugs including strong inhibitors of CYP3A4 hepatic enzymes (such as ketoconazole), inhibitors of CYP2D6 (such as paroxetine), PDE5 inhibitors (such as sildenafil [Viagra]), or warfarin.
DOXAZOSIN
Class, mechanism of action, indication, side effects + contraindications, interactions
Class: Alpha-adrenergic blocker
Mechanism of action: Tamsulosin blocks alpha1 receptors located in and around the prostate, the top of the urethra, and the neck of the bladder, which reduces muscle tone. As a result urine flow rates are improved and there is a reduction in the symptoms of BPH.
Indication: BPH
Side effects + contraindications: POSTURAL HYPOTENSION. Dizziness, headache, a runny nose, drowsiness, and sexual dysfunction (abnormal ejaculation).
SHOULD NO BE PRESCRIBED TO WOMEN OR CHILDREN
Caution in hypotension, neutropenia, hepatic impairment
Interactions: May interact with several drugs including strong inhibitors of CYP3A4 hepatic enzymes (such as ketoconazole), inhibitors of CYP2D6 (such as paroxetine), PDE5 inhibitors (such as sildenafil [Viagra]), or warfarin.
FINASTERIDE
Class, mechanism of action, indication, side effects + contraindications, interactions
Class: 5 alpha reductase inhibitor
Mechanism of action: blocks the conversion of testosterone to dihydrotestosterone, reduces prostate size
Indication: BPH
Side effects + contraindications:
decreased interest in sex;
trouble getting or keeping an erection;
trouble having an orgasm;
abnormal ejaculation; or
breast swelling or tenderness.
Interactions: Some known drug interactions of Propecia include St. John’s Wort, carbamazepine, and rifampin. These substances increase the breakdown of Propecia in the liver, leading to reduced levels of the substance in the blood and reduced effectiveness.
On the other hand, erythromycin and Itraconazole have the opposite effect. When you mix Finasteride with these drugs, you can end up increasing the total amount of the drug in your system.
DONEPEZIL
Class, mechanism of action, indication, side effects + contraindications
Class: acetylcholinesterase inhibitor
Mechanism of action: Donepezil binds and reversibly inactivates the cholinesterases, thus inhibiting hydrolysis of acetylcholine. This increases acetylcholine concentrations at cholinergic synapses.
Indication: Alzheimer’s, Lewy Body Dementia, mixed dementias
Side effects + contraindications:
n&v, diarrhea, sleepiness, dizziness, hepatic impairment, renal impairment, neuroleptic malignant syndrome, peptic ulcers, bradycardia, heart block
Caution in: Asthma; chronic obstructive pulmonary disease; sick sinus syndrome; supraventricular conduction abnormalities; susceptibility to peptic ulcers
MEMANTINE
Class, mechanism of action, indication, side effects + contraindications, interactions
Class: glutamate receptor antagonist
Mechanism of action: NMDA receptor antagonist that improves memory by restoration of homeostasis in the glutamatergic system
Indication: Alzheimer’s, Lewy body and mixed dementias
Side effects + contraindications: psychosis, HF, pancreatitis, liver failure, DVT, headaches, constipation
Interactions: Antimuscarinics — memantine possibly enhances effects of antimuscarinics.
HALOPERIDOL
Class, mechanism of action, indication, side effects + contraindications, interactions
Class: First generation antipsychotic
Mechanism of action: Blocks D1 and D2 receptors in the brain
Indication: Acute delirium, psychotic symptoms, aggression
Side effects + contraindications: extra-pyramidal side effects, blurred vision, constipation, weight gain, and xerostomia, QTc prolongation
Contraindicated in patients with Parkinson’s, breast cancer
Interactions: CNS depressants, drugs prolonging QT interval
MACROGOL
Class, mechanism of action, indication, side effects + contraindications, interactions
Class: Osmotic laxative
Mechanism of action: Causes water to be retained in the bowel instead of being absorbed into the body.
Indication: Constipation, bowel prep
Side effects + contraindications: Rectum irritation, excessive thirst, sleep disorder, nausea and vomiting, bloating, malise
Interactions: Low interaction potential, may decrease drug resorption
ALENDRONATE
Class, mechanism of action, indication, side effects + contraindications, interactions
Class: Bisphosphonate
Mechanism of action: Interferes with osteoclasts therefore reducing their ability, preventing bone reabsorption
Indication: Osteoperosis, Pagets Disease of the Bone
Side effects + contraindications: Refluz, oesophogeal erosions, osteonecrosis (jaw, external auditatory canal, atypical fractures)
Interactions: No known serious drug interactions
70mg PO take 30 mins before food sat upright once a week
Class, mechanism of action, indication, side effects + contraindications, interactions
Class:
Mechanism of action:
Indication:
Side effects + contraindications:
Interactions:
Increasing morphine dosage in palliative care?
In palliative care, you would increase the dose of morphine by 30-50% each time until pain is controlled.
