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Medications Flashcards

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1
Q

ADRENERGICS (4)

A

NE - vasoconstrictor to ↑ BP
Epi - stim alpha & beta receptors
DA - vasoconstrictor to ↑ BP
Dobutamine - stim beta 1 to ↑ BP

Tx: cardiac arrest, hypovolemic shock, anaphylaxis
SE: tremors, dysrhythmia
NC: ↑BP, pulses, UO

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2
Q

ANTIANXIETY

BZD (4)

NON-BZD (1)

A

BZD: “-zepam, -zolam, -zalam”
Chlordiazepoxide - use alcohol withdrawal, sedation, seizures, anxiety; ∅ elderly
Alprazolam, Clonazepam, Lorazepam - SAFE in elderly

NON-BZD:
Buspirone - NO abuse potential, ∅ grapefruit

MoA: depress CNS
Use: anxiety, manic ep, panic attacks
SE: sedation, confusion, hepatic failure
NC:

  • Taper off, Addiction/ OD, Monitor liver func
  • ∅ alcohol, smoking, caffeine
  • W/ FOOD or MILK
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3
Q

Chlordiazepoxide
(Librium)

A

BZD, CNS Depressant:

USE: alcohol withdrawal, sedation, seizures, anxiety

SE: drowsy, ↓ BP, resp depression, blurred vision, C/A, slurred speech, thrombocytopenia, polyuria (↑ UO),

NC: ∅ elderly (toxic build up)

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4
Q

ANTACIDS (2)

A

Al hydroxide, Mg hydroxide

MoA: neutralize gastric acid, ↑ pH, inactivate pepsin
Use: PUD, indigestion, reflex esophagitis
SE: C/D, acid rebound
NC:

  1. Interferes w/ absorption of Abx, Iron, INH, Oral contraceptives
  2. Bowel Addiction ∴ caution in long term use
  3. admin 1-2 hrs AFTER meals
  4. Metal Tox risk → check DTR
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5
Q

ANTIDYSRHYTHMICS (3)

A

Procainamide HCl, Quinidine, Lidocaine (Vtach)

MoA: ↓ excitability of heart
Use: myocardial irritability, Afib + Flutter, ↑HR, PVCs

SE: lightheaded. ↓BP, ↓HR urinary retention
NC: ambulate slowly

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6
Q

ANTIBIOTICS

General SE, NC

A
  • *Allergic rxn** - common in 2nd exposure, mild-anaphylaxis
  • *Superinfection** - kills abnorm + norm bacteria (sore throat, fever, fatigue)
  • *Organ Tox** - LIVER (metabolize), KIDNEY (excrete)

Teaching:

  • Culture & Sensitivity 1st (ensure kills bacteria)
  • *- ↑ Fluids, Milk + Yogurt** (maintain norm intestinal flora)
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7
Q

AMINOGLYCOSIDES

A

“mycin” - gentamycin, neomycin, streptomycin, tobramycin

MoA: inhibit protein syn in gram-
Use: Pseudomonas, E.coli
SE: ototoxicity, A/N/V/D
NC:

  • √ CN 8 (acoustic), √ Renal func
  • Use 7-10 days
  • ↑ Fluids
  • √ Peak (1 hr post dose) & Trough (before hanging dose)
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8
Q

CEPHALOSPORINS

A

“cef-, ceph-“ - cefaclor, cefazolin, cephalexin

MoA: Inhibits bacterial cell wall syn
Use: Tonsillitis, Otittis media, Meningitis
SE: Bone Marrow Depression (√ labs), Rash
NC:

  • Admin W/ FOOD (d/t GI upset)
  • Cross allergy w/ PENICILLIN
  • ∅ Alcohol - flushing, dizzy, HA
  • Long term use: overgrowth of organisms (√ tongue)
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9
Q

SULFONAMIDES

A

“-azole, -azine” - acetyl sulfisoxazole, co trimoxazole, sulfasalazine

MoA: Antagonize folic acid syn
USE: Ulcerative collitis, Crohn’s, Otitis Media, UTI
SE: Peripheral neuropathy, Crystalluria, Photosensitivity, GI upset, Stomatitis, Allergic rxn (urticaria, rash)

NC:

  • Admin W/ FOOD
  • *- ↑ Fluids** d/t risk of crystals in urine
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10
Q

FLOUROQUINOLONES (1)

A

Ciprofloxin

Use: E.coli, Pseudomonas, Staph. aureus
SE: D (destroys norm flora), ↓ WBC, ↓ Hct, ↑ AST & ALT, Photosensitivity
NC:

  • ↑ Fluids (3,000 mL/day), sunscreen
  • 1 hr ac or 2 hr pc meal ∴ ∅ FOOD (slows absorption)
  • ∅ Antacids, Iron
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11
Q

PENICILLIN

A

“-icillin” - amoxicillin, ampicillin, Augmentin

USE: Mod-severe inf, Syphillis, Lyme disease
SE: Stomatitis (breakdown of mouth & GI tract), D, allergic rxn

NC:

  • 1-2 hrs AC or 2-3 hrs PC ∴ ∅ FOOD
  • Cross allergy w/ Cephalosporins
  • √ Creatinine Clearance - determine dose
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12
Q

GLYCOPEPTIDE (1)

A

Vancomycin

USE: MRSA, C. diff
SE: Thrombophlebitis, Abscess formation, Renal tox, Ototoxicity

NC:

  • √ Renal func + Hearing
  • “Red Man Syn” - ↓ BP, Flushed face + neck → Tx w/ Antihistamine
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13
Q

MACROLIDE (2)

A

“momma Clinda and baby needs Erythro”
Erythromycin, Clindamycin

USE: Acne, Acute inf, URI, allergy to PCN or Cephalosporin
SE: D, Confusion, Liver tox

NC:

  • 1 hr ac or 2 hr pc ∴ ∅ FOOD
  • Admin w/ WATER (∅ juice)
  • *- ↑ Potency of Coumodin (Warfarin)** ∴ bleeding risk
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14
Q

TETRACYCLINE

A

“-cycline” - doxycycline, tetracycline

SE: Phototoxic rxn, glossitis

NC:
1 hr ac or 2 hrs pc ∴ ∅ FOOD
∅ Actacids, Milk, Protein
AVOID SUN!

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15
Q

NITROFURANTOIN

A

TX: UTI (antiinfective)

SE: asthma attacks (ABCs), D

NC:

  • W/ FOOD or MILK, CRANBERRY JUICE (acidify urine)
  • Monitor mulmonary status (SE asthma)
  • ∅ Alkaline foods - almonds, coconut
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16
Q

PHENAZOPYRIDINE

A

TX: UTI Analgesic

SE: HA, vertigo

NE: orange urine

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17
Q

ANTIIMPOTENCE (3)

A

“-afil” - sildenafil (Viagra), vardenafil, tadalafil

MoA: cause erection

SA: HA, ↓ BP, priapism (painful erection)

CONTRA: Nitrates (hypotensive crisis, tx CAD, dilate BVs), Alpha Blockers (severe hypotension)

NC: ∅ Grapefruit, Erection 4+ hrs call HCP

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18
Q

ANTICHOLINERGIC EFFECTS

A

HOT as a hare = ↑ T
DRY as a bone = dry mouth, ↓ sweat
BLIND as a bad = mydriasis (dilated pupils)
RED as a cherry = flushed face
MAD as a hatter = delirium

Urinary retention
↓ BP, ↑ HR

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19
Q

ANTICHOLINERGICS (5)

bipas

A

Benztropine - tx Parkinson’s, taper off
Iproproprium - tx asthma [neb med]
Propanthekine - tx incontinence, PUD
Atropine sulfate - tx badycardia (↑ HR)
Scopolamine - tx motion sickness

MoA: pupil dilation, bronchodilation & ↓ secretions (dry mouth), ↓ GI motility

NC:

  • 30 min ac or 2 hr pc ∴ EMPTY STOMACH
  • ∅ glaucoma - pupil dilation ↓ ophthalamic fluid drainage
  • ∅ paralyzed ileus, BPH
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20
Q

ANTICONVULSANTS (7)

GaP Diva CCaMP

A

Gabapentin
Phenytoin (Dilantin) - ∅ Pregnant pt, NEVER admin w/ another med
Divalproex - ∅ carbonated drinks
Clonazepam (BZD)
Carbamazepine - interferes w/ hormonal birth control
Mg sulfate - √ DTR
Phenobarbitol

MoA: ↓ flow of Ca + Na across neurons (CNS depressant)

USE: seizures

SE: resp depression, aplastic anemia, ataxia, gingival hypertrophy

NC:

  • Taper off, Monitor I&O (urine pink, red), Drowsy
  • ∅ MAOI (lower seizure threshold), Antipsychotics, Grapefruit, alcohol
  • *- W/ FOOD**
  • Cause​ Folate & Vita D deficiency (anemia) ∴ ↑ intake
  • OKAY to continue before surgery (prevent seizures) – NOTIFY ANETHESIOLOGIST
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21
Q

MAO INHIBITORS (3)

TIP

A

Tranylcypromine, Isocarboxazid, Phenelzine sulfate

MoA: ↑ conc of NTs (NE, Epi, Serotonin)

USE: depression, chronic pain

SE: HTN crisis (tyramine foods, HA), Photosensitivity

NC:

  • ∅ TYRAMINE (aged cheese, bologna, pepperoni, salami, banana, raisins, BEER, liver, yogurt)
  • monitor OUTPUT (d/t urinary retention)
  • Effective in 4 wks
  • ∅ Alcohol, Cold meds
  • ∅ SSRI (serotonin syndrome)
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22
Q

SSRI (3)

SParoFlu

A

Setraline HCl, Paroxetine, Fluoxetine

USE: depression, OCD, Bulemia

SE: anxiety, GI upset, Δ appetite & bowel func

NC:

  • SUICIDE @ 2-3 wks
  • Effective in 4 wks
  • Admin in A.M.
  • I&O (Δ appetite), Pink urine
  • ∅ SSRI (serotonin syn), St. John’s Wort
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23
Q

TRICYCLICS (2)

I Am Dox

A

Imipramine, Amitriptyline, Doxepin HCl

MoA: inhibit reuptake of NE & Serotonin

USE: depression, sleep apnea

SE: sedation, anticholinergic effects, confusion, ↓ BP, urinary retention, photosensitivity

OD: excitability, tremors

NC:

  • SUICIDE @ 2-3 wks
  • Effective @ 1-3 wks, Full @ 6-9 wks
  • *- Admin @ P.M.
  • Wean off**slowly
  • ∅ alcohol, sun
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24
Q

HETEROCYCLICS (2)

A

Bupropion, Trazadone

USE: depression, smoking cessation

SE:
Buproprion - agitation, insomnia (HYPER)
Trazadone - sedation, ↓ BP (HYPO)

NC: wean off slowly, ∅ alcohol, depress CNS

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25
Q

ANTIDIARRHEAL (4)

DIBO

A

Diphenoxylate/Atropine, Ioperamide, Bismuth subsalicylate (Pepto), Opium

MoA: ↓ peristalsis (absorbs water, gas, tox, nutrients in bowel), ↑ tone of sphincters

SE: C, fecal impaction, anticholinergic effects

NC:

  • HOLD w/ abd pain [CONTRA]
  • √ urinary retention (output)
  • Admin 2 hr BEFORE or 3 hr AFTER other meds
  • ↑ FLUIDS!
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26
Q

ANTIEMETICS (5)

TriP MOM

A

Trimethobenzamide HCl - inject IM gluts
Prochlorperazine

Metoclopramide - ↓ residual/ aspiration in tube feedings
Ondansetron
Meclizine - ∅ glaucoma

MoA: ↑ GI motility, Block DA, effects in chemoreceptor trigger zone (vomiting zone)

SE: sedation, anticholinergic effects

NC:

  • use BEFORE chemo/ radiation
  • use w/ viral infection - Risk of Reye’s syn (pt <21 yo, toxic encephalopathy)
  • ∅ GI bleeding/ hemorrage
  • ∅ pregnant
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27
Q

ANTIFUNGAL (3)

MAN

A

Metronidazole
Amphotericin B “amphoterrible” - HYPOkalemia (muscle pain), seizures
Nystatin

USE: Candidiasis (oral yeast inf), Oral thrush, histoplasmosis

SE: hepatotox, thrombocytopenia (↑ bleeding, ↓ PLT), leukopenia (↓ WBC, infection risk), pruritis

NC:

  • W/ FOOD (↓ GI upset)
  • Monitor liver func, PLT, WBC
  • Oral hygiene
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28
Q

ANTIGOUT (3)

CAP

A

Colchicine - acute phase of gout tx
Allopurinol
Probenecid - chronic tx of gout, ↑ MoA of ciprofloxin

MoA: ↓ uric acid production & resorption

USE: gout, uric acid stones

SE: aplastic anemia, agranulocytosis (↓ WBC, inf risk), renal calculi, GI upset

NC:

  • Monitor kidney stones (↑ FLUIDS)
  • W/ FOOD, MILK, ANTACIDS
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29
Q

ANTIHISTAMINE (3)

A

Chlorpheniramine maleate, Diphenhydramine (Benadryl), Promethazine (antiemetic)

USE: allergic rhinitis, allergic rxn to blood

SE: drowsy, dry mouth, photosensitivity, bronchospasm, anticholinergic

NC:

  • **W/ FOOD
  • ∅ alcohol**
  • √ RR
  • sunscreen, mouth care
30
Q

ANTILIPEMIC (3 types)

A
  • *Bile Acid Sequestrants** - Cholestyramine, Folic acid
  • *Statins** - Lovostatin, Pravastatin, Atorvastatin
  • *Nicotinic acid** - Niacin

MoA: inhibit cholesterol & tryglyceride syn (↓ cholesterol & LDLs)

SE:

BAS - C, rash, ↓ fat soluble vitas
Statins - myopathy
Nicotinic - flushing, hyperglycemia, gout

NC:

  • Admin @ NIGHT, W/ FOOD (∅ grapefruit)
  • GOOD w/ diet, exercise, ∅ smoking
  • GOOD w/ herbals: flaxseed, garlic, green tea, soy
  • ∅ other meds ∴ Admin 1 hr before or 4 hrs after
31
Q

ACE INHIBITORS

Angiotensin Converting Enzyme Inhibitor

A

“-pril” - Catopril, Enalpril, Lisinopril

** A for Artery ** - SYSTEMIC VASODILATION

MoA: blocks ACE in lungs from converting Angio I → Angio II (vasoconstrictor)

USE: HTN, CHF

SE: ↑ HR, MI, Proteinuria, Cough

NC:

  • ∅ FOOD - 1 hr ac or 2 hr pc
  • small, freq meals
  • Δ positions slowly
  • OK w/ Thiazide DIuretics
  • NO dmg to kidneys
32
Q

β BLOCKERS

A

“-olol” - Atenolol, Propanolol, Metoprolol

** B for Beat ** SLOWS HEART BEAT (↓HR)

MoA: blocks β receptors to ↓ excitability of heart
USE: HTN, Angina, SVT

SE: Bronchospasm (√ airway), ↑ or ↓ HR, gastric pain

NC:

  • MASKS s/sx of Shock & Hypoglycemia (∅ DM)
  • w/ FOOD
  • Taper off slowly
33
Q

Ca CHANNEL BLOCKERS

A

“-dipine” - Nifedipine, Amlodipine, Verapamil

** C for Cardiac **

MoA: slows impulse conduction, ↓ contractility, ↓ HR
USE: HTN, Angina
SE: ↓HR, Dizzy, Angioedema, Renal fail

NC:

  • √ Edema (facial swelling, SOB)
  • SR Tablets ∅ chew or break
34
Q

ANGIOTENSIN II RECEPTOR BLOCKERS (ARBs)

A

“-sartan” - Candesartan, Lorsartan

MoA: blocks vasoconstriction & aldosterone of Angio II
USE: HTN
SE: dizzy, GI upset, angioedema

NC:

  • √ Edema (facial swelling, SOB)
35
Q

α1 BLOCKERS

A

“-zosin” - Doxazosin, Prazosin, Terazosin

MoA: block α1 receptors in BVs ∴ cause vasodilation

USE: HTN, BPH, Raynaud’s disease

SE: reflex tachycardia, nasal congestion

NC:

  • Admin 1st dose @ NIGHT (cause fainting)
  • Δ positions slowly
  • Monitor BUN, WT, edema
36
Q

DIRECT-ACTING VASODILATORS (2)

A

Hydralazine
Minoxidil - ↑ hair growth

MoA: relax smooth muscles to cause vasodilation

SE: ↑HR ∴ use w/ β Blocker

NC: √ HR - HOLD HR< 60

37
Q

CENTRALLY ACTING
α-ADRENDERGIC

A

Clonidine, Methyldopa

MoA: stim α receptors in medulla (CNS) to ↓ SNS action of heart (↓ force, contractility, CO)

USE: HTN

SE: drowsy, sedation

NC: taper off slowly

38
Q 
BIPOLAR AGENTS (3)
LCD
A

Lithium - target blood lvl 1-1.5
Carbamazepine - liver func tests
Divalproex (Depakote) - anticonvulsant, ∅ carbonated drinks

MoA: ↓ catecholamine release & ↑ NE + Sero reuptake

USE: manic ep, MOOD STABILIZERS

SE: GI upset, tremors, polydipsia, polyuria
Lithium Tox
[EARLY] Fine tremors, N/V/D, drowsy, muscle weakness
[LATE] Ataxia, confusion, seizures

NC:

  • Monitor drug lvls (Lithium!!)
  • W/ FOOD + FLUIDS
39
Q

ALKYLATING AGENTS (4)

BCycloChlorCis

A

Busulfan, Chlorambucil, Cisplatin, Cyclophospamide

CHEMO: interfere w/ rapidly reproducing DNA [good + bad] in hair, mucous membrane, blood (WBC, RBC)

USE: leukemia, myeloma

SE: hetapatotox, bone marrow suppression (↓ WBC, PLT, RBC), N/V, Alopecia, Stomatitis, Ototox, confusion, tremors

NC:

  • √ Hematopoietic func
  • ↑ Fluids, Oral hygiene
40
Q

ANTIMETABOLITES (4)

these Metabolite Clones can Fool 5 People

A

Cytarabine, Fluororacil 5, Pemetrexid, Methotrxate

CHEMO: resembles norm metabolites ∴ “fool cells” to stop cell division; inhibit DNA polymerase

USE: ALL, colon, breast, pancreatic cancer

SE: N/V, Bone marrow suppression, Alopecia, oral ulceration

NC: SAME

41
Q

ANTITUMOR ABX

B Do Da

A

Bleomycin, Doxorubicin, Dactinomycin

CHEMO - interferes w/ DNA & RNA syn

SE: bone marrow suppression, alopecia, stomatitis

NC: Admin antiemetic BEFORE

42
Q

HORMONAL (3)

A

Tamoxifen - antiestrogen; bind @ estrogen receptors on malignant cells
Leuprolide - progestin; cause tumor cell regression
Testolactone - androgen; palliative care in advanced breast cancer

USE: breast cancer, testicular cancer

SE: leukopenia (↓ WBC), bone pain (d/t ↓ estrogen), hypercacemia

NC: √ CBC, Ca

43
Q

VINCA ALKALOIDS

A

“Vin-“ - Vinblastine, Vincristine

CHEMO - interferes w/ cell division [good + bad]

USE: cancers

SE: bone marrow suppression, stomatitis, alopecia, ↓ DTR

NC:

  • Antiemetic before chemo
  • √ DTR
  • √ IV for Extravasation @ site (check patency)
44
Q

ANTIPARKINSON

BBAPT LC

A

Bromocriptine mesylate, Benztropine mesylate, Amantadine, Pergolide, Trihexyphenidyl (√ IOP)
Levodopa (precursor to DA)
Carbidopa-Levodopa - ∅ MAO I

MoA: converts into dopamine, stim postsynaptic DA receptors

SE: dizzy, ataxia, confusion, hemolytic anemia

NC:

  • √ urinary retention
  • ANTIDOTE: Vita B6 (large doses reverses effects)
  • ∅ Alcohol
  • w/ FOOD
45
Q

HEPARIN

A

MoA: blocks conversion of PT → Thrombin to stop clotting, ↑ bleeding
USE: Pulmonary embolis, DVT, Acute MI
ROUTE: SubQ, IV

SE: Hematuria, Hemmorrhage, Tissue irritation

NC:

  • ANTIDOTE: PROTAMINE SULFATE (call HCP 1st)
  • ∅ ASA, NSAIDS - ↑ bleeding
  • Monitor PTT (clotting time) → NORM (25-35 sec), THERA (35-85 sec, 1.5-2.5X) - LOW (not bleeding enough), OVER (bleeding too much
46
Q

COUMADIN

(Warfarin)

A

MoA: ↓ syn of vita K clotting factors

USE: Pulmonary embolism, DVT< Acute MI
ROUTE: PO

SE: Hemmorrhage, Alopecia

NC:

  • ANTIDOTE: VITAMIN K (Aquamephyton)
  • START 4-5 days before D/C Heparin
  • PEAK @ 3-5 days
  • ∅ ASA, NSAIDs, Vita K foods, Vita C (↓ E), Vita E (↑ E)
  • Monitor PT: NORM (9-12 sec), THERA (13-18, 1.5X)
  • Monitor bleeding (venapuncture sites, urine
47
Q

AVOID IN ANTICOAG THERAPY (4 Gs)

A

Ginkgo, Ginger, Garlic, Ginsing

↑ BLEEDING RISK

48
Q

ANTIPLATELETS (6)

A

ASA (Salicylates), ADP Antagonists, Clopidogrel, Dipyradamole, Abciximab, Glycoprotein IIb & IIIa Antagonists

MoA: interfere w/ PLT aggregation (↓ clotting)

USE: DVT, pulmonary embolism, CVA prevention

SE: hemorrhage (bleeding!), thrombocytopenia, hematuria, hemoptysis (cough blood)

NC:

  • √ Bleeding (urine, teeth, stool)
  • w/ FOOD or MILK (d/t GI upset)
  • ∅ GGGG
49
Q

ANTIPSYCHOTICS
(3 categories)

A

HIGH POT: Halperidol, Fluphenazine [LOW sedation]
MED POT: Perphenazine
LOW POT: Chlorpromazine [HIGH sedation]

MoA: blocks DA in basal ganglia

USE: acute & chronic psychosis
ROUTE: inject deep IM

SE: ↓ BP, NMS (neuroleptic malignant syn), photosensitivity

  • *akathisia** (motor restlessness)
  • *dyskinesia** (abnorm vol mvmts)
  • *dystonia** (spasms: EARLY (tight jaw, stiff neck, swollen tongue), LATE (swollen airway))
  • *parkinsonism** (shuffled gait, rigid muscles, ↑ salivation, tremors, mask-like expression)
  • *tardive dyskinesia** (invol mvmts: chew, suching, tongue thrusts)

NC:

  • Lowers seizure threshod
  • ∅ Alcohol, Breastfeeding
  • Slows child growth
  • urinary retention
50
Q

ATYPICAL ANTIPSYCH (4)

CRaZy Q

A

Risperidone, Quetiapine, Ziprasidone, Clozapine

MoA: interferes w/ binding of DA in brain

SE: ↓ BP, Bone marrow suppression, Agranulocytosis (LIFE THREATENING)
Extrapyramidal - pseudoparkinsonism, dystonia, akinesia, tardive dyskinesia, swollen airway
Dystonia - EARLY (tight jaw, stiff neck, swollen tongue), LATE (swollen airway)
Anticholinergic - blurry vision, dry mouth, nasal congestion, C, urinary retention

NC:

  • Δ positions slowly; sunscreen
  • ∅ breastfeeding, alcohol, SUN, extremes in heat/cold
  • √ RBC, WBC, PLT
51
Q

ANTIPYRETIC (2)

AA

A

Acetaminophen (Tylenol), ASA (Salicylate)

MoA: antiprostaglandin activity in hypothalamus (control T) to ↓ fever, cause vasodilation, antiinflamm

SE: GI irritation, liver dysfunc

NC:

  • √ Liver Funcs (ACT, AST)
  • ∅ ASA < 21 yo d/t Reye’s Syn
  • ∅ ASA in bleeding disorders
52
Q

ANTITHYROID (3)

MRiKi

A

Methimazole, Potassium Iodine, Radioactive Iodine

** Iodine = Antagonist of Thyroid **

MoA: ↓ vascularity (shrinks) thyroid

USE: Hyperthyroidism

SE: leukopenia (inf.), rash, thrombocytopenia (bleeding)

NC: may cause burning in mouth

53
Q

THYROID REPLACEMENT (2)

LL

A

Levothyroxoid, Liothyronine

MoA: ↑ metabolic rate of body
USE: Hypothyroidism
SE: nervousness, ↑ HR, Wt loss

NC:

  • √ Wt, Pulse, BP
  • Admin in A.M.
  • ↑ action of Warfarin & Antidepressants
  • ↓ action of Insulin (need ↑ dose) & Digoxin
54
Q

DIURETICS

General USE, SE, NC

A

USE: HF, HTN, renal disease, diabetes, ↓ osteoporosis

SE: dizzy, dry mouth, ↓ BP, Leukopenia (↓WBC), polyuria (↑ UO), photosensitivity, ↓ Na

NC:

  • W/ FOOD, MILK in A.M.
  • ↑ K FOODS
  • ∅ Licorice, Aloe (↓ K)
  • Do NOT admin @ Night
55
Q

THIAZIDE DIURETICS

A

“-thiazide” - Hydrochlorothiazide, Chlorothiazide

MoA: inhibit reabsorption of Na + Cl in DRT

SE: ↓ K + Na, ↑ Glucose, blurry vision, ↓ BP

NC:

  • **√ K lvls, I&O, BUN/ Cr
  • W/ FOODS**
  • ↑ K Foods, Fluids
  • ∅ Gingko (↑ BP)
56
Q

Potassium Sparing (1)

A

Spironolactone

MoA: Blocks effect of Aldosterone on renal tubes ∴ cause LOSS of Na + H2O, RETENTION of K

SE: ↑ K, ↓ Na, Hepatic/ Renal dmg, TInnitus

NC: W/ FOOD, ∅ K foods

57
Q

LOOP DIURETICS

F&E

A

Furosemide, Ethacrynic acid

MoA: inhibit reabsorption of Na + Cl

SE: ↓ K + Na, ↓ BP, ↑ Glucose, GI upset

NC:

  • ADMIN IV in Emergency!
  • √ muscle weakness
  • W/ FOOD
58
Q

OSMOTIC DIURETIC (1)

A

Mannitol

MoA: pulls fluids from tissues d/t hypertonic effect

SE: dry mouth, thirst

NC: crystalizes @ room T ∴ ALWAYS use filter needle

59
Q

DIGOXIN

A

MoA: ↑ Force of myocardia contration, ↓ HR

USE: L side HF

SE: ↓ HR, ↑ HR (rebound tachy), A/N/V, Halo vision (halos around dark objects), Dysrhythmias

NC:

  • √ DIGOTIN TOX (risk w/ hypokalemia), K lvl
  • ↑ K Foods!
  • IV Push @ least 5 min - √ extravasation
60
Q

ANTI TB (5)

PERIS

A

Pyrazinamide - ↑ uric acid (gout)
Ethambutol - √ Vision (optic neuritis, ↓ visual acuity)
Rifampin - orange urine/tears/saliva, W/ FOOD
Isoniazid - peripheral neuopathy (tingling), ∅ FOOD
Streptomycin (Aminoglycoside) - ototox (√ hearing)

USE: TB

SE: Hepatitis, Jaundice, Optic neuritis,Seizures, Peripheral neuritis

NC:

  • ACTIVE TB: cover mouth & nose when coughing, wear mask in crowds until 3 negative sputum collections
  • Airborne Precautions: N95 mask
  • Admin Vita B6 (prevent peripheral neuropathy, dizziness, ataxia)
61
Q

SUCRALFATE

A

MoA: Cytoprotective; forms barrier around surface of ulcer

USE: Duodenal ulcer

SE: C, dizzy (vertigo), gas

NC:

  • Admin 1 hr BEFORE meals (∅ FOOD)
  • Admin 2 hrs BEFORE or AFTER meds
  • ∅ Antacids, H2 blockers
62
Q

Bisacodyl

A

Stimulant Laxative: nerve stimulation cause irritation on GI wall ∴ stim peristalsis and evacuation

USE: C, Dependence

NC:

  • ∅ MILK, ANTACIDS
  • CONTRA: abd pain, N/V, fever
  • Chronic use cause HYPOkalemia
63
Q

Docusate

A

STOOL SOFTENER: soften fecal mass

SE: abd cramps, D

NC:

  • CONTRA: abd pain, N/V, fever, Atonic bowel, N/V, GI pain
  • Chronic Use cause HYPOkalemia, Laxative dependency, Bowel dmg, F&E imbalance
64
Q

Milk of Magnesia

A

OSMOTIC/ SALINE AGENT: HYPERtonic ∴ draws water INTO intestines causing soften stool & ↑ peristalsis

SE: ↑ Mg, dehydration, D

NC:

  • CONTRA: abd pain, N/V, fever
  • Chronic use cause HYPOkalemia, dehydration, Laxative dependence
65
Q

Psyllium Hydrophilic Mucilloid

A

BULK FORMING: absorbs water in stool to ↑ bulk, and stim peristalsis

** SAFEST ** (even w/ routine admin)

SE: obstruction of GI tract

NC:

  • Admin w/ FULL GLASS WATER
66
Q

NITOGLYCERIN

A

NITRATE/ ANTIANGINAL: relax smooth muscle, ↓ BP, ↓ myocardia O2 consumption

USE: Angina, HTN, CHF r/t MI

SE: ↓BP, ↑ HR, HA, flushing, dizzy

NC:

  • sublingual dose may repeat Q5min x 3 doses
  • CHECK BP
  • ∅ Alcohol
67
Q

NSAIDs (5)

NIICK

A

Naproxen, Ibuprofen, Indomethacin
Celecoxib - COX2 inhibitor, avoid in sulfonamide allergy
Ketorolac

MoA: inhibit PG (prostaglandins)

USE: Pain, Fever, Arthritis, dysmenorrhea
SE: HA, dizzy, bleeding, GI upset (N/V/D/C), Fluid & Na retention

NC:

  • W/ FOOD
  • CONTRA: ASA, NSAID allergies
  • √ GI bleeding - dark stools
  • monitor liver func
68
Q

H2 ANTAGONISTS

A

“-tidine”- Cimetidine (↑ confusion in elderly), Ranitidine

USE: ULCERS

SE: D, confusion, dizzy, HA

NC:

  • Admin @ Bedtime (suppress nocturnal acid production), W/ MEALS
  • ∅ Antacids within 1 hr of dose
  • ∅ alcohol, smoking, ASA, caffiene (↑ stomach acid)
69
Q

BRONCHODILATORS (9)

I AM A CAT (who) Eats Salmon

A

Aminophylline - ∅ coffee, tea, cola
Terbutaline - short β agonist
Ipratropium bromide [MDI] - anticholinergic
Albuterol - short β agonist
Epinephrine
Salmeterol - long β agonist, dry powder, NOT for acute bronchospasms/ exacerbations
Montelukast - asthma therapy, ∅ Theophylline

Acetylcysteine [NEB] - mucolytic, cough (clear airway) before admin
Cromolyn sodium - mast cell stabilizer, prevent asthma attacks & allergy rxn

USE: asthma, bronchospasm (COPD), bronchitis, emphysema

SE: ↑ HR, seizures, tremors, pulmonary edema, anticholinergic effects (bronchodilation)

NC: aggrevate diabetes (cause HYPERglycemia)

70
Q

ANTISECRETORY AGENTS

A

“-prazole” - Omeprazole, Lansoprazole, Pantoprazole

USE: ULCERS

SE: D, dizzy

NC:

  • Admin @ Bedtime (suppress nocturnal acid production)
  • May sprinkle on food or mix w/ fluid for NG tube
  • ∅ alcohol, smoking, ASA, caffiene (↑ stomach acid)
71
Q

Misoprostol

A

PG ANALOG: prevent ULCERS caused by NSAIDs (which are PG inhibitors)

SE: abd pain, D, miscarriage

NC: ∅ alcohol, smoking, ASA, caffiene (↑ stomach acid)

72
Q

∅ GRAPEFRUIT

A

CCB “-dipine”
Antiimpotence “-afil”
SSRI - Fluoxitine, Sertraline
Caffiene
Carbamazepine (Anticonvulsant)
Buspirone (Antianxiety)
Midazolam (Antianxiety)

NCLEX (4 decks)

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