Medications Flashcards
Aspirin
Acetylsalicyclic acid
Class: NSAID, analgesic, antipyretic
Action: Exhibits antipyretic, anti-inflammatory, and analgesic effects.
Use: Analgesic, antipyretic, anti-inflammatory, and cardiovascular uses
Common SE: Dyspepsia, nausea, epigastric discomfort
Serious SE: Massive GI bleeding, potentiation of peptic ulcer, bronchospasm, asthma-like symptoms, anaphylaxis
Blackbox Warning: Do not use in children or teenagers due to the possibility of Reye’s syndrome, a rare but serious illness. Increased potential for stomach bleeding
Fosamax
(Alendronate)
51
Class:Bone growth regulator, bisphosphonate
Action: Binds to bone hydroxyapatite and inhibits osteoclast activity, thereby preventing bone resorption.
Use: Prevent osteoporosis in women who are at risk of developing osteoporosis and to maintain bone mass and reduce the risk of future fracture.
Common SE: Abdominal pain, dyspepsia, nausea, constipation, diarrhea.w
Etidronate disodium
(Didronel)
649
Class: Bone growth regulator, bisphosphonate
Action: Slows bone metabolism, thereby decreasing bone resorption, bone turnover, and new bone formation; it also reduces bone vascularization. Renal tubular reabsorption of calcium is not affected.
Use: Paget’s disease, prevention and treatment of heterotopic ossification due to spinal cord injury or total hip replacement.
Common SE: Diarrhea, nausea, increased or recurrent bone pain at paretic sites, onset of pain at previously asymptomatic sites.
Methocarbamol
1092
Class: Skeletal muscle relaxant, centrally-acting.
Action: Beneficial effect may be related to the sedative properties of the drug. Has no direct effect on the contractile mechanism of striated muscle, the motor endplate, or the nerve fiber, and it does not directly relax tense skeletal muscles.
Use: Adjunct to rest, physical therapy, and other measures for the relief of acute, painful musculoskeletal conditions
Common SE: Drowsiness, dizziness, GI upset/nausea, blurred vision, fever
Serious SE: Anaphylactic reaction
Boniva
(Ibandronate Sodium)
850
Class: Bone growth regulator, bisphosphonate
Action: A bisphosphonate that inhibits osteoclast activity and reduces bone resorption and turnover. In postmenopausal women, the drug reduces the elevated rate of bone turnover, leading to a net gain in bone mass.
Use: Prophylaxis of postmenopausal osteoporosis in women who are at risk of developing osteoporosis. Increases bone mineral density and reduce the incidence of vertebral fractures.
Common SE: Back/arm/leg pain, diarrhea, dyspepsia, abdominal pain, constipation, pain/difficulty swallowing, headache, nausea, rash.
Serious SE: Angioedema, anaphylaxis
Cortisone Acetate
Class: Glucocorticoid
Action: Possesses both glucocorticoid and mineralocorticoid activity
Use: Replacement therapy in chronic cortical insufficiency. Short-term for inflammatory or allergic disorders.
Common SE: Insomnia, N&V, GI upset, fatigue, dizziness, muscle weakness, joint pain, increased hunger/thirst, problems with diabetes control.
Carisoprodol
274
Class: Skeletal muscle relaxant, centrally-acting
Action: Does not directly relax skeletal muscles. Sedative effects may be responsible for muscle relaxation.
Use: As an adjunct to rest, PT, and over measures to treat skeletal muscle disorders including bursitis, low back disorders, contusions, fibrositis, spondylitis, sprains, and muscle strains.
Common SE: Dizziness, drowsiness, N&V, headache, tachcardia
Serious SE: Allergic or idiosyncratic reactions, angioneurotic edema, anaphylaxis.
Cyclobenzaprine hydrochloride
413
Class: Skeletal muscle relaxant, centrally-acting
Action: Thought to inhibit reflexes by reducing tonic somatic motor activity. Does not interfere with muscle function.
Use: Adjunct to rest and physical therapy for relief of muscle spasms associated with acute and/or painful musculoskeletal conditions. Management of fibromyalgia.
Common SE: Drowsiness, dizziness, dry mouth, confusion, nausea, constipation, dyspepsia, unpleasant taste, headache, fatigue.
Serious SE: Convulsions, arrhythmias, anaphylaxis
NSAIDS
(Nonsteroidal Anti-inflammatory drugs)
2045
Class:NSAID
Action: The anti-inflammatory effect is likely due to inhibition of the enzyme cyclooxygenase. The analgesic activity is due, in part, to relief of inflammation. The antipyretic action occurs by decreasing prostaglandin synthesis in the hypothalamus, resulting in an increase in peripheral blood flow and heat loss as well as promoting sweating.
Use: Inflammatory disease, non rheumatic inflammatory conditions, mild to moderate pain, primary dysmenorrhea, etc.
Common SE: Peptic or duodenal ulceration and GI bleeding, intestinal ulceration with obstruction and stenosis, reactivation of preexisting ulcers.
Serious SE: Perforation and hemorrhage of esophagus, stomach, duodenum, small or large intestine, seizures, coma, bronchospasm, laryngeal edema, agranulocytosis, aplastic anemia, hemolytic anemia, toxic epidermal necrolysis, angioneurotic edema, Stevens-Johnson syndrome, shock-like syndrome, angioedema, anaphylaxis.
Vitamin D
Calcitriol, cholecalciferon, dihydrotachysterol, ergocalciferol, viosterol)
2098
Class: Vitamin
Action: Intestinal absorption and metabolism of calcium and phosphorus as well as renal reabsorption; release of calcium from bone and resorption.
Use: Essential for promoting growth, health, vitality, life, general well-being, and for the prevention and cure of many health problems and diseases.
Food Sources: Cheese, eggs, fortified milk, butter, fish liver oils, fortified foods.
Deficiency: Osteomalacia (adult) Rickets (child)
Signs & Symptoms: Demineralization of bones and teeth with bone pain and skeletal muscle deformities.
Calcium Citrate
Class: Calcium Supplement
Action: Unknown
Use: Fracture of bone, fluorosis, hyperparathyroidism due to renal insufficiency, hypocalcemia, increased bone formation, osteoporosis, premenstrual syndrome, rickets.
Common SE: Constipation, flatulence, swollen abdomen
Serious SE: Myocardial infarction, hypercalcemia, urolithiasis, prostate cancer, milk alkali syndrome, prostate cancer.
Blackbox Warning:
Calcitonin
Salmon
Class: Calcitonin, Calcium regulator
Action: Reduces the number of osteoclast and prevents resorptive activity of the bone resulting in a reduced bone turnover rate. It also temporarily improves bone formation by increasing osteoblastic activity.
Use: Hypercalcemia, Paget’s disease, postmenopausal osteoporosis, cancer pain, fracture of bone, osteoporosis.
Common SE: Flushing (face or hands), injection site reaction, nausea, rhinitis, sinusitis
Serious SE: allergic reaction, acute, anaphylaxis,cancer
Hydroxychloroquine
Plaquenil
Class: Aminoquinoline, Antimalarial
Action: Beneficial effect in lupus erythematosus and acute or chronic rheumatoid arthritis.
Use: Lupus erythematosus, malaria, rheumatoid arthritis
Common SE: Disorder of cornea
Serious SE: Torsades de pointes, agranulocytosis, aplastic anemia, leukopenia, thrombocytopenia, fulminanta hepatic failure, drug-induced myopathy, seizure, retinopathy, hearing loss, angioedema.
Azathioprine
(Imuran)
155
Class: Immunosuppressant
Action: Antimetabolite that is quickly split to form mercaptopurine. The precise mechanism in depressing the immune response is unknown, but it suppresses cell-mediated hypersensitivities and alters antibody production.
Use: As an adjunct to prevent rejection in renal homotransplantation, rheumatoid arthritis
Common SE: GI toxicity (severe N&V, diarrhea), fever, rash, malaise, myalgias, leukopenia
Serious SE: Severe bone marrow depression, increased risk of carcinoma, hepatotoxicity.
Blackbox Warning: Chronic immunosuppression with azathiprine increases the risk of neoplasia.
Leflunomide
(Arava)
989
Class: Antiarthritic drug
Action: Inhibits dihydroorotatede hydrogenase, an enzyme involved in de novo pyrimidine synthesis;
has anti proliferative activity and anti-inflammatory and uricosuric effects.
Use: Treatment of active rheumatoid arthritis in adults to reduce signs and symptoms, to inhibit structural damage as evidenced by x-ray erosions and join-space narrowing, and to improve physical function.
Common SE: Diarrhea, respiratory infection, hypertension, alopecia, rash, headache, nausea, bronchitis, dyspepsia, GI/abdominal pain, back pain, UTI.
Serious SE: Pancreatitis, hepatic necrosis, hepatic failure, serious hepatic injury, Stevens-Johnson syndrome, toxic epidermal necrolysis, interstitial lung disease, sepsis
Blackbox Warning: Contraindicated in pregnant women, hepatotoxicity
Infliximab
(Remicade)
892
Class: Treatment of Crohn’s disease, antiarthritic
Action: In rheumatoid arthritis, infliximab reduces infiltration of inflammatory cells in inflamed areas of the joint, as well as expression of molecules mediating cellular adhesion. In Crohn’s disease, it reduces infiltration of inflammatory cells and production in inflamed areas of the intestine.
Use: Reduces signs and symptoms and inducing and maintaining clinical remission of moderate to severe Crohn’s disease, used to reduce the number of draining fistulas, rheumatoid arthritis, plaque psoriasis, etc.
Common SE: URTI, nausea, headache, diarrhea, abdominal pain, pharyngitis, sinusitis, coughing, bronchitis, pain, fatigue, rash, dyspepsia, UTI, arthralgia, anemia, blood in stool, flushing, leukopenia, bone fracture, infections, etc.
Serious SE: Layrngeal/pharyngeal edema, severe bronchospasms, anaphylaxis, sepsis, GI hemorrhage, intestinal perforation, acute liver failure, seizures, suicide attempt, worsening heart failure, MI, pulmonary embolism, sepsis, etc.
Blackbox Warning: Risk of infections and malignancy
Etanercept
(Enbrel)
641
Class: Immunomodulator
Action: Binds specifically to tumor necrosis factor, involved in normal inflammatory and immune responses.
Use: Reduce S&S, delays structural damage, and improves physical function in moderate to severe active rheumatoid arthritis in adults.
Common SE: URTI, non-URTI, injection site reaction, infections, headache, nausea, dizziness, rash, abdominal pain, cough, pharyngitis, asthenia, peripheral edema, headache, N&V, abdominal pain.
Serious SE: GI hemorrhage, intestinal perforation, stroke, seizures, heart failure, MI, pancytopenia, Stevens-Johnson syndrome, epidermal necrolysis, sepsis, serious infections
Blackbox Warning: Risk of serious infections
Adalimumab
Humira
Class: Immunomodulator
Action: TNF plays an important role in the pathologic inflammation and joint destruction in rheumatoid arthritis.
Use: Reduces S&S of rheumatoid arthritis, including major clinical response, inhibiting the progression of structural damage, and improving physical function in adults with moderate to severe rheumatoid arthritis.
Common SE: Injection site reactions, hemorrhage, pain, swelling, headache, sinusitis, URTI, rash, nausea, UTI, accidental injury
Serious SE: Sepsis, anaphylaxis, pancreatitis, GI hemorrhage, hepatic necrosis, large bowel perforations, bronchospasm subdural hematoma, MI, cardiac arrest, etc.
Blackbox Warning: Serious infections, malignancy
Ibuprofen
Class: Analgesic, NSAID, Propionic Acid
Action: exhibits analgesic and antipyretic activities by inhibiting prostaglandin synthesis
Use: RA, OA, primary dysmenorrhea, gout, mild to moderate pain, musculoskeletal disorders, antipyretic
Blackbox: Increased risk of serious cardiovascular thrombotic events, MI, stroke. NSAIDs also increase risk of serious GI adverse events such as bleeding, ulceration, and perforation.
Contra: hypersensitivity, other NSAIDs, coronary artery bypass graft (CABG) surgery, treatment of perioperative pain
Common SE: GI stuff (like N/V, bleeding, constipation, diarrhea,) rash, heartburn, N/V, dizziness, headache
Serious SE: HTN
M/T:
- monitor liver and renal function, cardiovascular events, GI adverse events like prolonged bleeding or ulcers
- Teach pt to avoid additional NSAIDs, avoid use in late pregnancy, report symptoms MI/stroke, GI events, hepatotoxicity
- take with food/milk to minimize GI irritation
- pt should not drink alcohol or smoke to reduce the risk of GI bleeds
Indomethacin
(Indocin)
888
Class: NSAID
Action: Anti-inflammatory effect is likely due to inhibition of cycle-oxygenase. Effective in reducing join swelling, pain, and morning stiffness, as well as to increase mobility in those with inflammatory disease.
Use: Not a simple analgesic. Moderate to severe rheumatoid arthritis, ankylosing spondylitis, gouty arthritis, moderate to severe osteoarthritis.
Common SE: Headache, dizziness, N&V, diarrhea, constipation, dyspepsia/indigestion, GI distress, tinnitus, GI bleeding, elevated serum potassium, fluid retention, hyponatremia, intracranial bleeding, retrolental fibroplasia.
Blackbox Warning: Increased risk of serious CV thrombotic events, MI, and stroke, which can be fatal. Contraindicated for treatment of preoperative pain, GI risks.
Naproxen
Class: Analgesic, NSAID, Propionic Acid
Action: Inhibits prostaglandin synthesis, (unknown)
Use: Ankylosing spondylitis, bursitis, gout (acute), OA, RA, pain, primary dysmenorrhea, tendinitis (acute)
Blackbox: Increased risk of serious cardiovascular thrombotic events, MI, stroke. NSAIDs can also increase risk of serious GI adverse events especially in the elderly, including bleeding, ulceration, and perforation of the stomach or intestines.
Contra: Asthma, urticaria, or allergic-type reaction following aspirin or other NSAID administration; severe, even fatal anaphylactic-like reactions have been reported. CABG surgery, treatment of preoperative pain, hypersensitivity to naproxen.
SE: edema, ecchymosis, pruritus, rash, abdominal pain, constipation, heartburn, nausea, dizziness, headache, somnolence, ototoxicity, tinnitus, dyspnea, blood dyscrasias, vision changes, angioedema, jaundice, tachycardia, back pain, nausea.
Celecoxib
309
Class: NSAID, COX-2 inhibitor
Action: Inhibits prostaglandin synthesis, which decreases inflammation. Causes fewer GI complications, such as bleeding and perforation, compared with other NSAIDs.
Use: Relief of S&S of osteoarthritis and rheumatoid arthritis in adults, ankylosing spondylitis, acute pain in adults, primary dysmenorrhea, reduce the number of colorectal polyps.
Common SE: Abdominal pain/cramps, diarrhea, nausea, dyspepsia/indigestion, URTI
Serious SE: GI hemorrhage, MI
Blackbox Warning: Cardiovascular risk. May cause an increased risk of serious CV thrombotic events, MI, and stroke, which can be fatal. GI risk.
Allopurinol
58
Class: Antigout drug
Action: Decreases uric acid production by inhibiting the biochemical reactions immediately preceding uric acid formation.
Use: IV management of clients with leukemia, lymphoma, and solid tumor malignancies in whom cancer chemotherapy causes elevations of serum and urinary uric acid levels and who cannot tolerate PO therapy. Used for primary or secondary gout, joint destruction, nephropathy, uric acid lithiasis.
Common SE: Skin rash, maculopapular rash, nausea, diarrhea, increased attacks of acute gout.
Serious SE: Toxic epidermal necrolysis, Stevens-Johnson syndrome, irreversible hepatotoxicity, death, hemorrhagic pancreatitis, hepatic necrosis, liver failure, aplastic anemia, pancytopenia.
Colchicine
395
Class: Antigout drug
Action: May reduce the crystal-induced inflammation by reducing lactic acid production by leukocytes by inhibiting leukocyte migration, and by reducing phagocytosis.
Use: Prophylaxis and treatment of acute attacks of gout. Treatment of Mediterranean fever in adults
Common SE: N&V, diarrhea, pharyngolaryngeal pain, abdominal pain/cramps, dermatoses.
Serious SE: Aplastic anemia, agranulocytosis
