Medications Flashcards
Ibuprofen
Advil
MOA: Inhibits COX-1 and COX-2, reduces pain, inflammation, fever.
SE: Gastrointestinal affects, bleeding, renal impairment
NC: Avoid alcohol, anticoagulants, glucocorticoids
Monitor: pain, BUN, liver function, fever
Aspirin
Aspirin
MOA: Inhibits COX-1 and COX-2, reducing pain, inflammation, fever, platelet aggregation; excreted through kidney.
SE: GI bleeding, bleeding, renal impairment
NC: avoid alcohol, anticoagulants, glucocorticoids
Monitor: hepatic function, s/s TIA, MI, fever
Glucocorticoids
Prednisone
MOA: Inhibit synthesis of chemical mediators (prostaglandins, leukotrienes, histamine), reducing swelling, warmth, redness, pain. Suppress infiltration of phagocytes, proliferation of lymphocytes.
AE: osteoporosis, infection, glucose intolerance, F&E disturbance, growth delay, cataracts & glaucoma, peptic ulcer disease, mental status disturbances, adrenal insufficiency.
Nursing Considerations: Lowest possible dose, shortest duration possible, alternating and tapering, topical/intranasal preferred to systemic.
Diphenhydramine
Benadryl
MOA: bind selectively to H1-histaminic receptors, inhibits dilation, flushing, prevents permeability/edema, reduces itching, pain, mucous
SE: sedation, dizziness, confusion, anti-cholinergic effects
Penicillin
Penicillin G (Crystapen)
MOA: weaken cell wall, increase uptake of water into cell, cell rupture. BACTERICIDAL.
AE: most common abx allergy, GI upset (NVD), hives/itching, black “hairy” tongue, hemolytic anemia, MRSA
Interactions: aminoglycosides-inactivated by Penicillin G, give separately; drugs that cause hemolytic anemia (cephalosporins, bactrim, levodopa, NSAIDS)
Monitor: s/s anaphylaxis, infection, C. diff. Advise pt to finish course.
Cephalosporins
Keflex
MOA: weaken cell wall, bring water into cell, cell rupture. BACTERICIDAL.
AE: hypersensitivity rxns, thrombophlebitis, hemolytic anemia, nephrotoxicity, pseudomembranous colitis, drug resistance
Interactions: drugs that cause hemolytic anemia: penicillins, bactrim, levodopa, NSAIDS
Monitor: kidney function-BUN, creatinine, stool
NI: Do not give w/penicillin allergy, give IM/IV (poorly absorbed in GI tract)
Vancomycin
Vancomycin
MOA: weaken cell wall, brings water into cell, cell rupture. BACTERICIDAL.
AE: renal failure (#1 toxicity), ototoxocity, “Red Man syndrome”, thrombophlebitis, C. diff, VRE
DI: ototoxic drugs
Monitor: peak & trough, kidney function
NI: report tinnitus, hearing loss
Macrolides
Erythromycin
MOA: inhibit bacterial protein synthesis by blocking addition of new AA’s to peptide chain; BACTERIOSTATIC
AE: GI disturbances-pain, NVD; prolonged QT interval, hepatotoxicity, C. diff
DI: any med that increases QT interval, p450 inhibitors (bc metabolized by p450 system), alcohol
Monitor: liver function, stools, EKG
Aminoglycosides
Gentamycin MOA: disrupt protein synthesis; inhibition, premature termination &/or production of abnormal proteins; BACTERICIDAL AE: ototoxicity, nephrotoxicity DI: ototoxic, nephrotoxic meds Monitor: kidney fxn, peak and trough NI: keep pt well hydrated
Sulfonamides
Bactrim (sulfamethazole)
MOA: suppress bacterial growth by inhibiting molecule needed for DNA, RNA, protein synthesis; BACTERIOSTATIC
AE: hypersensitivity rxns (i.e. hives), increased photosensitivity, microbial resistance, hepatitis, C. diff, hemolytic anemia
DI: meds that cause hemolytic anemia
Monitor: allergic/skin reactions, electrolytes
NI: AIDS pts more succeptible to allergic rxns
Fluoroquinolones
Cipro (ciprofloxacin)
MOA: inhibits enzymes needed for cell division & DNA replication; BACTERIOSTATIC
AE: NVD, pancreatitis, increased QT interval, CNS effects-dizziness, hemolytic anemia, restlessness, confusion, tendon rupture (risk in pts over 60, organ transplant pts, those taking glucocorticoids)
DI: glucocorticoids-tendon rupture, increases levels of coumadin
Monitoring: pancreatic enzymes (amylase, lipase), consider EKG
NI: avoid calcium, zinc, magnesium, aluminum
Nucleoside/Nucleotide Reverse Transcriptase Inhibitors
NRTIs
MOA: prevents reverse transcriptase from adding bases, inhibits HIV replication
AE: lactic acidosis, fatty liver, enlarged liver
Monitor: blood lactate level, blood HIV level, liver labs, kidney labs
Non-Nucleoside Reverse Transcriptase Inhibitors
NNRTIs
MOA: Bind to the active center of reverse transcriptase, changes configuration. Impairs binding of nucleosides leading to decreased replication and increased termination.
AE: No AEs shared by all NNRTIs. Abacavir = hypersensitivity, lab test available
Monitoring: hypersensitivity rxns, lactic acidosis, viral load count, CD4 cell count regularly
Protease Inhibitors
PIs
MOA: blocks protease, preventing maturation of HIV enzyme; immature HIV virus can’t infect CD4 cells.
AE: hyperglycemia, development of diabetes, decreased cardiac conduction, drug interaction-p450 inhibitors
Monitor: viral load, CD4 counts, sulfa allergy, blood glucose
Integrase Strand Inhibitors
ISI
MOA: inhibits integrase, preventing integration of HIV into cell DNA
AE: none specific to all
Monitor: changes in mood/behavior, viral load and CD4 count
HIV Fusion Inhibitors
HIV-FI
MOA: Prevents fusion of HIV with cell membrane, HIV is unable to enter CD4 cell
RESERVED FOR DRUG RESISTANT STRAINS OF HIV
AE: injection site reactions, increased risk of pneumonia, hypersensitivity reactions
Monitor: viral load, CD4 count, skin rxns, breathing
CCR5 Antagonists
CCR5 Antagonists
MOA: binds to CCR5 co-receptor, preventing HIV from entering cell. Only certain strains of HIV bind w/CCR5.
AE: injection site reactions, increased risk of pneumonia, hypersensitivity reactions
Monitor: viral load, CD4 count, skin, breathing
Biguanides
Metformin (oral diabetic med)
MOA: inhibits glucose production in the liver, sensitizes insulin receptors in fat and skeletal muscles, slightly reduces gut absorption
AE: decreased appetite, nausea, diarrhea, lactic acidsis
Monitoring: lab abnormalities, blood glucose, BP, renal function, serum folic acid, B12
Rapid Acting Insulin
Onset 10-30 minutes
Lispro (Humalog)
MOA: lowers blood glucose by stimulating uptake in skeletal muscle and fat, inhibiting hepatic glucose production, inhibiting lipolysis and proteolysis, enhaces protein synthesis.
AE: Hypoglycemia, hypokalemia
Monitor: s/s hypoglycemia, s/s hyperglycemia, weight, BG
Short Acting Insulin
Onset 30-60 minutes
Humulin R (regular insulin)
MOA: lowers blood glucose by stimulating uptake in skeletal muscle and fat, inhibiting hepatic glucose production, inhibiting lipolysis and proteolysis, enhaces protein synthesis.
AE: hypoglycemia, hyperglycemia, weight, BG
Intermediate Acting Insulin
Onset 90 min-4 hours
Humulin N (NPH)
MOA: lowers blood glucose by stimulating uptake in skeletal muscle and fat, inhibiting hepatic glucose production, inhibiting lipolysis and proteolysis, enhaces protein synthesis.
AE: Hypoglycemia, hypokalemia
Monitor: s/s hypoglycemia, s/s hyperglycemia, weight, BG
Long Acting Insulin
Onset: 45 min-4 hours
Lantus (Glargine)
MOA: lowers blood glucose by stimulating uptake in skeletal muscle and fat, inhibiting hepatic glucose production, inhibiting lipolysis and proteolysis, enhances protein synthesis.
AE: Hypoglycemia, hypokalemia
Monitor: s/s hypoglycemia, s/s hyperglycemia, weight, BG, hemoglobin A1C
