Medications & Mechanism of Action Flashcards
Acetaminophen
May work peripherally to block pain impulse generation and inhibit prostaglandin synthesis in the CNS
AcetaZOLAMIDE (Diamox, Diamox Sequels)
Inhibits hydrogen ion excretion in the renal tubules, increasing sodium, potassium, bicarbonate, and water excertion and producing alkaline diuresis
Acetic Acid (Vinegar)
Provides an acidic medium during irrigation of the ear that minimizes bacterial and fungal promulgation | Stabilizes nematocyst discharge in jellyfish found outside the United States, which would decrease the pain
Acetylcysteine (Mucomyst, Acetadote)
Restores glutathione concentrations within the liver; Glutathione, an antioxidant, has many actions in the body, including detoxifying substances
Activated charcoal
Adsorbs ingested toxic substances from the GI tract
Adenosine (Adenocard)
Short-acting drug that slows conduction through the AV node; Restore sinus rhythm in patients with SVT and Terminates regular tachycardias caused by reentrant AV nodal pathways
Albumin (Albumarc, Albutein, Flexbumin)
Oncotically similar to human plasma; Causes the body to shift approximately 3.5 times the amount administered into the intravascular space
Albuterol
Selective beta-2 adrenergic agonist that causes bronchia smooth muscle relaxation and inhibits mediator release from mast cells
Amiodarone (Cordarone, Pacerone)
Blocks sodium, potassium, and calcium channels; Prolongs the action potential’s duration and Delays repolarization; Decreases AV conduction and sinoatrial (SA) node function
Aspirin (Acetylsalicylic Acid)
Prevents thromboxane A2 formation to prevent platelet aggregation and plug formations | Has antipyretic and analgesic properties
Atropine sulfate
Inhibits acetylcholine at postganglionic parasympathetic neuroeffector sites | Increases heart rate in symptomatic bradydysrhythmias | Reverses muscarinic effects of cholinergic poisoning
Benzocaine Spray (Hurricane)
Prevents impulse transmission along sensory nerve fibers and at nerve endings
Bumetanide (Bumex)
A potent loop diuretic with a rapid onset and short duration of action | Inhibits the reabsorption of sodium and chloride in the ascending limb of the loop of Henle
Calcium chloride
Mineral component of bones and teeth; Cofactor in enzymatic reactions and affects the secretory activity of endocrine and exocrine glands; Essential for neurotransmission, blood clotting, and contraction of cardiac, smooth, and skeletal muscles
Calcium gluconate
Mineral component of bones and teeth; Cofactor in enzymatic reactions and affects the secretory activity of endocrine and exocrine glands; Essential for neurotransmission, blood clotting, and contraction of cardiac, smooth, and skeletal muscles
Cimetidine (Tagamet)
Blocks the effects of histamine at H2 receptors of gastric parietal cells, leading to a reduction of gastric acid volumn and gastric aciditiy
Hetastarch (Hespan)
A starch-containing colloid used as an intravascular volume expander | Following administration, the plasma volume is expanded slightly more than the volume of Hetastarch; this effect has been overved for up to 24 to 36 hours | Hetastarch increases intravascular volume by virtue of its colloid osmotic pressure
Plasma Protein Fraction (Plasmanate)
Protein-containing colloid that remains in the intravascular compartment | Increases intravascular volume by attracting water from other fluid compartments by virtue of its colloid osmotic pressure
0.9% Sodium Chloride (Normal Saline)
Replaces water and electrolytes
0.45% Sodium Chloride
Replaces water and electrolytes
Lactated Ringer Solution (Hartmann Solution)
Replaces water and electrolytes
3% Sodium Chloride (Hypertonic Saline)
Osmotic effect allows fluid to cross the blood-brain barrier, reducing the amount of fluid in the cranial cavity and decreasing the ICP
5% Dextrose in 0.45% Sodium Chloride
Replaces free water and electrolytes and provides nutrients in the form of dextrose
5% Dextrose in 0.9% Sodium Chloride
Replaces free water and electrolytes and provides nutrients in the form of dextrose
5% Dextrose in Lactated Ringer Solution
Replaces free water and electrolytes and provides nutrients in the form of dextrose
Total Parenteral Nutrition
Replenishes electrolyte and nutrients
Dexamethasone sodium phosphate (Decadron)
Suppresses acute and chronic inflammation; Immunosuppressive effects
Dextran
A sugar-containing colloid used as an intravascular volume expander | Remains in the intravascular compartment for approximately 12 hours | Increases intravascular volume by attracting water from other fluid compartments by virtue of its colloid osmotic pressure
Bacteriostatic Water
Works as a solvent or dilutional agent
5% Dextrose in Water
Provides nutrients in the form of dextrose as well as free water
10% Dextrose in Water
Provides nutrients in the form of dextrose as well as free water
Dextrose
Rapidly increases serum glucose levels | Short-term osmotic diuresis
Diazepam (Valium, Diastate, AcuDial)
Appears to act on part of the limbic system, as well as on the thalamus and hypothalamus, to induce a calming effect; Inhibits GABA receptors in the CNS, reducing neuron excitability; Raises the seizure threshold; and Induces amnesia and sedation
Digoxin (Lanoxin)
(not listed per textbook)
Diltiazem (Cardizem, Dilacor, Diltiaz)
Inhibits extracellular calcium ion influx across membranes of myocardial cells and vascular smooth muscle cells, resulting in inhibition of cardiac and vascular smooth muscle coontraction and therby dilating the main coronary and sestemic arteries | No effect on serum calcium concentrations | Substantial inhibitory effects on the cardiac conduction system, acting principally at the AV node, w/ some effects at the SA node | Less-negative inotropic effects than verapamil
DiphenhydrAMINE HCl (Benadryl)
Blocks H1 receptors in the respiratory tract, blood vessels, and GI smooth muscle | Reverses extrapyramidal reactions
DOBUTamine Hydrochloride (Dobutrex)
Synthetic catecholamine that primarily simulates beta-1 receptors with minor stimulation of beta-2 and alpha-1 receptors | Increases myocardial contractility and stroke volume, resulting in increased cardiac output w/ modest chronotropic effects | Increases renal blood flow secondary to increased cardiac output
DOPamine Hydrochloride (Intropin)
Immediate metabolic precursor to norepinephrine (and dose-depandent effects w/ alpha adrenergic, beta adrenergic, and dompaminergic)| Doses of 1 to 2 mcg/kg/min simulate dopamine receptors; causes vasodilation in the renal, mesenteric, coronary, and intracerebral vascular beds | Doses of 2 to 10 mcg/kg/min simulate beta-1 receptors; increases myocardial contractility and enhancing cardiac impulse conduction | Doses of 10 to 20 mcg/kg/min simulate alpha receptors; resulting in vasoconstriction, increased systemic vascular resistence, and increase in BP | Doses greater than 20 mcg/kg/min, alpha stimulations predominate; resultant vasoconstriction can compromise circulation in the limbs
Droperidol (Inaspine)
Produces marked tranquilization and sedation | Reduces motor activity and anxiety | Possesses adrenergic-blocking, antifibrillatory, antihistaminic, and anticonvulsive properties
EPINEPHrine
Catecholamine with strong alpha adrenergic, strong beta-1, and moderate beta-2 effects | Effects of alpha stimulation result in systemic vasoconstriction, increasing perpheral vascular resistance | Effects of the beta-1 stimulation result in increases in heart rate, myocardial ocntractility, cardiac output, and myocardial oxygen demand | Effects of beta-2 stimulation result in bronchial smooth muscle relaxation | Secondary relaxation effect on the smooth muscle of the stomach, intestine, uterus, and urinary bladder
Etomidate (Amidate)
Ultra-short-acting hypnotic that produces rapid sedation with minimal cardiovascular or respiratory depression
Famotidine (Pepcid)
Inhibits the volume and concentration of gastric secretions
FentanNYL Citrate (Sublimaze)
Binds to opioid receptors, producing analgesia, euphoria, respiratory depression, and sedation
Furosemide (Lasix)
(not listed per textbook)
Glucagon (GlucaGen)
Increases blood glucose level by stimulating the breakdown of stored glycogen to glucose (glycogenolysis) and inhibiting thesynthesis of glycogen from glucose (glycogenesis) | Unknown mechanism of stabilizing cardiac rhythm in beta blocker overdose | Minimal positive inotropic and chronotropic responses | Decreases GI motility and secretions
Glucose, oral
Increases circulating blood glucose level post GI tissue
Haloperidol (Haldol)
Antagonizes dopamine-1 and dopamine-2 receptors in the brain; Depresses the reticular activating system and inhibits release of hypothalamic and hypophyseal hormones
Helium Gas Mixture (Heliox)
Reduces airflow resistance within the bronchial tree in patients with obstructive lung disease; May reduce the work of breathing and improve pulmonary gas exchange efficiency
HydrALAZINE (Apresoline)
Relaxes arteriolar, but not venous, smooth muscle | Thought to interefere w/ calcium movement in vascular smooth muscle, which is responsible for vasoconstriction, resulting in lower BP
Hydrocortisone sodium succinate (Colu-Cortef)
Anti-inflammatory | Immunosuppressive with salt-retaining actions
HYRDROmorphone (Dilaudid)
Opioid agonist-analgesic of opioid receptors; Inhibits ascending pain pathways; Increases the pain threshold; Produces analgesia, respiratory depression, and sedation
Hydroxocobalamin (Cyanokit)
A synthetic, injectable form of vitamin B12 (cobalamin) that binds with cyanide to form nontoxic cyanocobalamin; Excreted renally
Ibuprofen (Advil, Motrin)
Inhibits prostaglandin synthesis, thereby reducing swelling, pain, and fever
Insulin
(not listed per textbook)
Ipratropium Bromide (Atrovent)
Antagonizes the action of acetylcholine on bronchial smooth muscle
Isopropyl Alcohol
Antiseptic | Antiemetic - mechanism here is unkown, but antiemetic effect bay be from possible influenced neurotransmission at several sites that activate the chemoreceptor trigger zones
Ketamine (Ketalar)
Blocks pain receptors and minimizes spinal cord activity, affecting the brain’s association pathways between the thalamus and the limbic system
Ketorolac Tromethamine (Toradol)
Potent analgesic that inhabits prostaglandin synthesis; Does not have any sedative or anxiolytic properties
Levalbuterol (Xopenex)
Stimulates beta-2 receptors resulting in smooth muscle relaxation of the bronchial tree and peripheral vasculature
Lidocaine HCl (Xylocaine)
Cardiac: Inhibits recovery after repolarization, thereby inhibiting recovery after repolarization, and decreasing myocardial excitability and conduction velocity | Local anesthetic: Inhibits ion transport across the neuronal membrane, blocking conduciton of normal nerve impulses | RSI: May decreases ICP response during laryngoscopy
LORazepam (Ativan)
Anxiolytic, anticonvulsant, and sedative effect; Suppresses propagation of seizure activity produced by foci in the cortex, thalamus, and limbic areas; Inhibits GABA receptors in the CNS, reducing neuron excitability
Magnesium sulfate
Depresses the CNS, blocks peripheral neuromuscular transmission, and produces anticonvulsant effects | Decreases the amount of acetylcholine released at the endplate by motor nerve impulses, slows the rate of SA node impulse formation in the myocardium, and prolongs conduction time | Promotes calcium, potassium, and sodium movement in and out of cells and stabilizes excitable membranes | Induces uterine relaxation | Can cause bronchodilation after beta agonists and anticholinergics have been administered
Mannitol (Osmitrol)
Promotes the movement of fluid from the intracellular space to the extracellular space | Decreases cerebral edema and ICP | Promotes urinary excretion of toxins
Meperidine Hydrochloride (Demerol)
Synthetic opioid analgesic whose effects on the CNS and smooth muscle organs are similar to those of morphine; Primarily acts as an analgesic and a sedative
MethylPREDNISolone Sodium Succinate (Solu-Medrol)
Highly potent synthetic glucocorticoid that suppresses acute and chronic inflammation; Potentiates vascular smooth muscle relaxation by beta adrenergic agonists; Has few to no mineralocorticoid properties
Metoclopramide (Reglan)
Blocks dopamine (at high doses) and serotonin receptors in the chemoreceptor trigger zones of the CNS; Sensitizes tissues to acetylcholine; Increases upper GO motility but not secretions; Increases lower esophageal sphincter tone
Midazolam Hydrochloride (Versed)
Inhibits GABA receptors in the CNS, thereby reducing neuron excitability and causing sedative, anxiolytic, amnesic, and hypnotic effects
Milrinone (Primacor)
Increases myocardial contractility; Has a direct dilating effect on vascular smooth muscle; Does not possess beta adrenergic properties
Morphine sulfate (Roxanol, MS Contin)
Alleviates pain through CNS action | Suppresses the fear and anxiety centers in the brain | Depresses brainstorm respiratory centers | Increases peripheral venous capacitance and decreases venous return | Decreases preload and afterload, which decreases myocardial oxygen demand
Naloxone Hydrochloride (Narcan, EVZIO)
Competitive inhibition at opioid receptor sites; reverses respiratory depression and sedation secondary to opioids
NIFEdipine (Procardia, Adalat, Nifedical)
Inhibits movement of calcium ions across cell membranes; Inhibits cardiac and vascular smooth muscle contraction, thereby dilating the main coronary and systemic arteries, reducing preload and afterload, and reducing myocardial oxygen demand; Does NOT prolong AV nodal conduction
Nitroglycerin (NGT)
Smooth muscle relaxant, which acts on the vasculature, bronchial, uterine, and intestinal smooth muscle | Dilated peripheral arterioles and veins | Reduces peripheral vascular resistance, preload, and afterload, decreasing the heart’s workload and myocardial oxygen demand
Nitroprusside (Nitropress)
Arterial and venous vasodilator that reduces afterload, resulting in decreases BP and increases cardiac output
Nitrous oxide 50:50 (Nitronox)
Exact mechanism is unknown; the analgesic action is thought to occur by potentiating the release of endogenous endorphins that react w/ opioid receptors in the CNS and alter the pain threshold
Norepinephrine Bitartrate (Levophed, Levarterenol)
Produces constriction of resistance and capacitance vessels, thereby increasing systemic BP and coronary artery blood flow; also acts on beta-1 receptors | In lower doses, the cardiac-stimulant effect predominates | In larger doses, the vasoconstrictor effect predominates
Ondansetron (Sandostatin)
Mimics the actions of the naturally occuring hormone, somatostatin, decreasing viceral blood flow and inhibiting the release of serotonin, gastrin, vasoactive intestinal peptide, secretin, motilin, and pancreatic polypeptide
Olanzapine (Zyprexa)
Exact mechanism has not been determined; May act through a combination of dopamine and serotonin type 2 receptor site antagonism
Onansetron Hydrochloride (Zofran, Zuplenz)
Blocks the action of serotonin, a natural substance that causes N/V | Does not affect dopamine receptors, so it does NOT cause extrapyramidal sxs
Oxygen
Reverses hypoxemia
Oxymetazoline (Afrin, Dristan 12-hours, Vicks Sinus-12hours)
Stimulates alpha adrenergic receptors in the arterioles of the nasal mucosa to produce vasoconstriction
Oxytocin (Pitocin)
Binds to oxytocin receptor sites on the surface of uterine smooth muscle, Increases the force and frequency of uterine contractions | Causes dilation of vascular smooth muscle, thereby increasing renal, coronary, and cerebral blood flow
Pancuronium Bromide (Pavulon)
Binds to the receptor for acetylcholine at the neuromuscular junction | Skeletal muscle relaxation proceeds in a predictable order, starting w/ muscle associated w/ fine movements (ex: eyes, face, neck), followed by muscles of the limbs, chest, and abdomen, and then the diaphragm; muscle tone returns in the reverse order
Phenylephrine (Neo-Synephrine)
Stimulates alpha adrenergic receptors in the arterioles of the nasal mucosa to produce vasoconstriction
Potassium Iodide (Pima Syrup, SSKI, ThyroSafe, ThyroShield)
Potassium iodide (KI) can help block radioactive iodine from being absorbed by the thyroid gland, thereby protecting this gland from radiation injury and reducing the risk of thyroid cancer | Does not keep radioactive iodine from entering the body and cannot reverse health effects caused by radioactive iodine once the thyroid is damaged | the protection against radoiactive iodine provided by KI depends on the time after contamination, the rate of KI absorption, and the dose of radioactive iodine
Pralidoxime (2-PAM, Protopam)
Binds to organophosphates and breaks their alkyl phosphate-cholinesterase bonds to restores the activity of acetylcholinesterase
Procainamide Hydrochloride (Pronestyl)
Inhibits recovery after repolarization, resulting in decreased myocardial excitability and conduction velocity | Direct membrane depressant that decreases conduction velocity, prolongs the refractory period, decreases automaticity, and reduces repolarization abnormalities
Prochlorperazine (Compazine)
Exerts its antiemetic effect by depressing the brain’s chemoreceptor trigger zone; also has moderate anticholinergic and alpha adrenergic receptor blocking effects | Alpha-1 adrenergic receptor blockade produces sedation, muscle relaxation, and cardiovascular effects (ex: hypotension, reflex tachycardia, minor EKG pattern changes)
Promethazine Hydrochloride (Phenergan)
H1 receptor antagonist; Blocks the action (but not the release) of histamine; Possesses sedative, antimotion, antiemetic, and anticholinergic activity; Potentiates the effects of opioids to induce analgesia
Proparacaine Opthalmic (Alcaine, Ophthaine)
Produces local anesthesia by blocking sodium ion channels, thereby stopping cellular depolarization and preventing the action potential development of nerve impulses at the ophthalmic pain nerve cell membrane
Propofol (Diprivan)
Produces a rapid and brief state of general anesthesia
Rocuronium Bromide (Zemuron)
Antagonizes acetylcholine at the motor endplate, producing skeletal muscle paralysis
Sildenafil (Revatio, Viagra)
Inhibits phosphodiesterase enzyme 5 in lung tissue, which results in relaxation of pulmonary vascular muscle cells and subsequent vasodilation of the pulmonary vasculature
Sodium bicarbonate
Reacts with hydrogen ions to form water and carbon dioxide, correcting metabolic acidosis | Increases blood and urinary pH by releasing a bicarbonate ion, which in turn neutralizes hydrogen ion concentrations
Sodium thiosulfate (Nithiodote)
Converts cyanide to the less toxic thiocyanate, which is then excreted in the urine
Succinylcholine Chloride (Anectine)
Ultra-short-acting depolarizing skeletal muscle relaxant that mimics acetylcholine | It binds w/ the cholinergic receptors on the motor endplate, producing a phase 1 block manifested by muscle fasciculations
Tadalfil (Cialis, Adcirca)
Inhibits phosphodiesterase enzyme 5 in lung tissue, which results in relaxation of pulmonary vascular smooth muscle cells and subsequently vasodialation of the pulmonary vasculature
Tetracaine Opthalmic Solution (Pontocaine)
Produces local anesthesia by blocking sodium ion channels, thereby stopping cellular depolarization and preventing the action potential development of nerve impulses at the ophthalmic pain nerve cell membrane
Thaimine Hydrochloride (Vitamin B1)
Combines with adenosine triphosphate to form thiamine pyrophosphate, a coenzyme essential for carboydrate metabolism
Tranexamic Acid (Cyklokapron, Lysteda)
Inhibits the activation of plasminogen, thereby reducing the conversion of plasminogen to plasmin (which breaks down fibrin clots, fibrinogen, and other plasma protiens) | Now, Clotting factors and circulating platelet plugs can form a seal (fibrin clot) and reduce bleeding
Vecuronium Bromide (Norcuron)
Neuromuscular agent with an intermediate duration of action that competes with acetylcholine for receptors at the motor endplate, resulting in neuromuscular blockade
Verapamil Hydrochloride (Isoptin, Calan)
Slows AV node conduction, Shortens the refractory period of accessory pathways, and Acts as a negative inotrope and vasodilator
Ziprasidone (Geodon)
Blocks synaptic reabsorption of serotonin and norepinephrine | Binds to alpha adrenergic receptors, dopamine receptors, and serotonin receptors
