Meds Flashcards
0.45% sodium chloride (1/2 NS)
hypotonic solution
fluid shifts from plasma into cells
154 mOsm/L
0.9% sodium chloride (NS)
isotonic solution
expands extracellular fluid volume without causing fluid shift
308 mOsm/L
10% dextrose in water (D10W)
hypertonic solution
fluid shifts from intracellular and interstitial space into plasma
505 mOsm/L
1st generation non-steroidal anti-inflammatories (NSAIDs)
Class: anti-platelet, anti-inflammatory, non-opioid analgesic, anti-pyretic
Indication: ischemic stroke, prevention and treatment of MI, angina, PAD, Inflammatory disorders, pain
Contraindications: hypersensitivity to aspirin
SE/ADRs: bleeding, gastric ulceration, renal impairment
Notes: inhibits platelet aggregation; irreversibly changes platelets
20% dextrose in water (D20W)
hypertonic solution
fluid shifts from intracellular and interstitial space into plasma
660 mOsm/L
3% sodium chloride
hypertonic solution
fluid shifts from intracellular and interstitial space into plasma
1030 mOsm/L
5% dextrose in water (D5W)
hypotonic solution
fluid shifts from plasma into cells
252 mOsm/L
abciximab
ReoPro
glycoprotein (GP) IIb/IIIa inhibitor (antiplatelet)
inhibits fibrin attachment to platelets
used to keep arteries patent during cardiac catheterization
acarbose
Precose
alpha-glucosidase inhibitor, antidiabetic
acetaminophen
Brands: Tylenol, Infant’s Feverall, Acephen; Ofirmev (IV)
Class: non-opioid analgesic, antipyretic
Action: inhibits synthesis of prostaglandins, primarily in CNS; no anti-inflammatory properties
Contraindications: severe hepatic impairment or acute liver disease
SE/ADRs: hepatotoxicity, jaundice, elevated LFTs
Notes: do not exceed 4g/day; antidote is acetylcysteine (Acetadote)
alprazolam
Xanax
benzodiazepine
altepase
tPA
tissue plasminogen activator
thrombolytic
amlodipine
Norvasc
calcium channel blocker (acting on smooth muscle only)
apixaban
Brand: Eliquis
Class: anticoagulant, Factor Xa inhibitor
Indication: treat and prevent DVT,PE, and A-fib
Notes: standard dose with less frequent lab draws, less RF bleeding, quick onset; no safe reversal agent
non-steroidal anti-inflammatories (NSAIDs)
Types: aspirin, ibuprofen
Class: antiplatelet
Indications: ischemic stroke, stable/unstable angina, Tx and prevention of myocardial infarction, peripheral artery disease
SE/ADRs: bleeding, gastric ulceration, renal impairment, ototoxicity
aspirin
AKA: acetylsalicylic acid (ASA)
Class: anti-platelet, anti-pyretic, non-opioid analgesic, 1st generation NSAID, salicylate
Indications: inflammation, mild to moderate pain, prophylaxis of TIAs and MI, suspected acute MI
Contraindications: bleeding disorders, children under 19 years (Reye’s syndrome)
Notes: prolongs bleeding time 4-7 days; large doses may prolong PT time; avoid
SE/ADRs: bleeding, gastric ulcer, ototoxicity, GI bleeding, hepatotoxicity
aspirin
acetylsalicylic acid (ASA)
Class: anti-platelet, antipyretic, non-opioid analgesic; salicylate
Indication: ischemic stroke, MI treatment and prevention, angina, PAD, inflammatory disorders (RA, OA), fever, mild to moderate pain
SE/ADRs: bleeding, gastric ulceration, renal impairment, ototoxicity, salicylism (N/V, tinnitus)
Notes: inhibits platelet aggregation; irreversibly changes platelets
atenolol
Tenormin
cardio-selective beta blocker
atorvastatin
Lipitor
HMG-CoA reductase inhibitor
betamethasone
Class: corticosteroid, anti-inflammatory
Indication: many; short-term administration to high risk mothers to prevent RDS in newborn
bumetanide
Bumex
Loop diruetic
buspirone
BuSpar
atypical anxiolytic/non-barbiturate anxiolytic
Action: initial response takes 1 week, 2-4 weeks for full effects (not PRN med); no sedation, does not potentiate other CNS depressants, very small risk of dependency
SE/ADRs: dizziness, nausea, headache, lightheadedness, agitation, constipation, suicidal ideation
Contraindications: pregnancy, breastfeeding, MAOIs
Interactions: erythromycin, ketoconazole, St. John’s wort, grapefruit juice
butorphanol
Brand: Stadol
Class: opioid analgesic
Indication: analgesia during labor
candesartan
Atacand
angiotensin receptor blocker (ARB), RAAS inhibitor
captopril
Capoten
ACE inhibitor, RAAS inhibitor
carvedilol
Coreg
cardio nonselective beta and alpha recptor blocker
cefazolin
Ancef
1st generation cephalosporin
ceftriaxone
Rocephin
3rd generation cephalosporin
cephalexin
Keflex
1st generation cephalosporin
chlordiazepoxide
Librium
benzodiazepine
ciprofloxacin
Brand: Cipro
Class: broad-spectrum anti-infective, fluorquinolone
Route: PO, IV
Indication: respiratory, GI, and GU tract infections; infections of bones, joints, skin, and soft tissues
Contraindications: myasthenia gravis, lactation, pediatrics, tizanidine
SE/ADRs: C. diff infection, tendon rupture, photosensitivity, diarrhea, nausea, hepatotoxicity, aortic aneurysm/dissection, increased ICP, seizures, suicidal thoughts, hypersensitivity reactions
clonazepam
Klonopin
benzodiazepine
clonidine
Brands: Catapres, Kapvay, Duraclon
Class: alpha II adrenergic agonist, centrally acting adrenergic
Indications: hypertension, ADHD, management of cancer pain, neuropathic pain, opioid withdrawal
clopidogrel
Brand: Plavix
Class: antiplatelet, platelet aggregation inhibitor
Route: PO
Indication: ischemic stroke, MI, PAD
clorazepate
Tranxene
benzodiazepine
dabigatran
Brand: Pradaxa
Class: anticoagulant; direct thrombin inhibitor
SE/ADRs: bleeding, increased RF GI bleeding, GI disturbances
Notes: antidote is dialysis; no reversal agent; med stays in system about 12 hours
dantrolene
Brand: Dantrium, Revonto, Ryanodex
Class: skeletal muscle relaxant (direct acting)
Route: PO, IV
Indication: prophylaxis and treatment of malignant hyperthermia; treatment of spasticity associated with SCI, STK, MS, CP (PO); management of neuroleptic malignant syndrome (unlabeled)
Contraindications: lactation
SE/ADRs: flushing, diarrhea, muscle weakness, drowsiness, hepatotoxicity, anaphylaxis
diazepam
Diastat
benzodiazepine
IV use
digoxin
Brand: Lanoxin
Class: inotrpoic med
Route: PO, IV
Indications: chronic HF in sinus rythm, a-fib, symptomatic HF
Action: increases heart contractility thereby increasing CO; reduces HR; inhibits sympathetic activity
Notes: narrow tx window; digoxin and K+ have inverse relationship and bind to same cell receptors; hypokalemia increases RF digoxin toxicity (sx: abd pain, anorexia, n + v, visual disturbances, bradycardia); frequent monitoring of digoxin and potassium levels; use cautiously in pts on diuretic tx
diltiazem
Cardizem
calcium channel blocker (acting on smooth muscle (arterioles) and cadiac conduction)
antiangianl, anti-arrhythmic, anti-hypertensive
dinoprostone
Brand: Cervidil, Prepidil
Class: cervical ripening agent, prostaglandin, oxytocic
Indication: induction of labor
Notes: available as endocervical gel or vaginal insert
enalapril
Vasotec
ACE inhibitor, RAAS inhibitor
enoxaparin
Brand: Lovenox
Class: anticoagulant; low-molecular weight heparin
Route: subcut
Indication: Tx and prevent DVT/PE
SEs/ADRs: hemorrhage, heparin-induced thrombocytopenia (HIT; Sx of thrombosis with 50% or more decrease in platelets or thrombocytopenia)
Notes: antidote is protamine sulfate (1 mg inactivates 100 units lmwh)
eptifibatide
Integrelin
glycoprotein (GP) IIb/IIIa inhibitor (antiplatelet)
inhibits fibrin attachment to platelets
used to keep arteries patent during cardiac catheterization
exenatide
Byetta
incretin mimetic, antidiabetic
flumazenil
Romazicon
GABA receptor antagonist
Antidote for benzodiazepine toxicity
fondaparinux
Brand: Arixtra
Class: anticoagulant, Factor Xa inhibitor
Route: subcut
Indication: PE/DVT treatment and prevention
Notes: usually used when pt allergic to heparin; fixed dose, therefore less lab testing
furosemide
Lasix
loop diurectic
glimepiride
Amaryl
Sulfonylurea
glipizide
Glucotrol
sulfonylurea
glyburide
DiaBeta
sulfonylurea
heparin
Anticoagulant
- monitor aPTT (IV), platelets and H&H (subcut)
- starts and stops working quickly
- Indications: Tx and prevent DVT/PE
- Contraindications: surgeries/invasive procedures, brain/eye/spinal cord injuries
- ADRs: hemorrhage, heparin-induced thrombocytopenia (HIT)
- HIT: Sx of thrombosis and 50% or more platelet reduction from baseline
- antidote is protamine sulfate (1 mg inactivates 100 units heparin)
hydralazine
Apresoline
vasodilator
acts on arterioles
hydrochlorothiazide (HCTZ)
Hydrodiuril, Microzide, Oretic
thiazide diuretic
1st line for HTN
hydrocodone
Brand: Hysingla
Class: opioid analgesic, antitussive; schedule II
Route: PO, PO-ER
hydrocodone-acetaminophen
Lortab, Lorcet, Vicodin, Norco
hydromorphone
Brand: Dilaudid
Class: opioid agonist, antitussive
Routes: PO (IR and ER), IV, IM, PR, subcut
Notes: controlled substance schedule II
ibuprofen
Brands: Motrin, Advil
Class: NSAID, antipyretic, non-opioid analgesic, anti-rheumatic
Route: PO, IV
Indication: for mild pain
SE/ADRs: gastric upset, GI bleeding, gastric ulcer, HF, MI, STK, hepatits,
indomethacin
Brand: Indocin
Class: NSAID, antirheumatic, nonopioid analgesic, ductus arteriosus patency adjunct
Indication: tocolytic to delay pre-term delivery, PDA management
Contraindication: after 30 weeks gestation (premature closure of DA)
intermediate acting insulin
Neutral Protamine Hagedorn (NPH) insulin, isophane insulin
(Humulin N, Novolin N)
onset: 1-3 hours
peak: 8 hours
duration: 12-16 hours
*cloudy*
isosorbide dinitrate
Isordil
vasodilator
isosorbide mononitrate
Imdur
vasodilator
ketorolac
Brand: Toradol, Sprix
Class: NSAID, non-opioid analgesic
Route: IV, IM, PO, IN
Indication: short-term management for moderate to severe pain, not to exceed 5 days total for all routes combined
Notes: analgesic effect as strong as morphine w/o respiratory depression
labetolol
Trandate
non-cardio-selective beta blocker
lactated ringers/ringers lactate (LR/RL)
isotonic solution
expands extracellular fluid volume without causing fluid shift
254 mOsm/L
aka Hartmann’s solution
contains sodium chloride, sodium lactate, potassium chloride, and calcium chloride in water
liraglutide
Victoza
incretin mimetic, antidiabetic
lisinopril
Prinivil, Zestril
ACE inhibitor, RAAS inhibitor
long acting insulin
insulin glargine (Lantus), insulin detemir (Levemir)
onset: 1 hour
peak: none
duration: 20-26 hours
DO NOT MIX C/ OTHER INSULINS
lorazepam
Ativan
benzodiazepine
IV use
losartan
Cozaar
angiotensin receptor blocker (ARB), RAAS inhibitor
lovastatin
Mevacor
HMG-CoA reductase inhibitor
magnesium sulfate
indication: treat or prevent hypomagnesemia; tocolytic; prevention and treatment of seizures r/t pre-eclampsia or eclampsia
SE/ADRs: hypermagnesemia, cardiac dysrythmias, respiratory depression
MUST be given via infusion pump
metformin
Brand: Glucophage
Class: antidiabetic, biguanide
Route: PO
Indications: Tx and prevent type 2 diabetes (first-lineTx), gestational diabetes
Contraindications: renal failure, alcohol, cimetidine, iodinated radiocontrast media
SEs/ADRs: lactic acidosis (extreme fatigue, hyperventilation), GI issues (diarrhea, anorexia)
Notes: not metabolized, excreted unchanged by kidneys; hold 48 hours a/ procedure c/ contrast dye, resume 48 hours p/ procedure; usually d/c for inpatient; monitor BUN and Cr (renal failure can lead to toxic levels)
Mechanism of Action: inhibits glucose production by liver, synthesizes insulin receptors in fat and skeletal muscle; slighlty decreases glucose absorption in gut
metformin with glyburide
Glucovance
methyldopa
Aldomet
alpha II adrenergic agonist
methylergonovine
Brand: Methergine
Class: oxytocic, ergot alkaloid
Indication: prevention and treatment of postpartum/postabortion hemorrhage caused by uterine atony or subinvolution
Contraindication: should not be used to induce labor; do not breastfeed until 12 hours after last dose
metoclopramide
Brand: Reglan, Gemoti
Class: anti-emetic
Action: blocks dopamine receptors in CNS, stimulates motility in upper GI tract, accelerates gastric emptying
Indications: N/V, GERD, diabetic gastroparesis, facilitation of small bowel intubation during radiographic procedures, hiccups
SE/ADRs: drowsiness, dysguesia, extrapyramidal reactions, neuroleptic malignant syndrome, restlessness
metoprolol
Lopressor, Toprol
cardio-selective beta blocker
metronidazole
Brand: Flagyl
Class: anti-infective, antiprotozoal, anti-nuclear agent
Indication: anaerobic infections, amoebic dysentery, bacterial vaginosis, trichomonaisis, CDAD, peptic ulcers r/t H. pylori
Contraindications: first trimester pregnancy
SE/ADRs: abd pain, nausea, vomiting, seizures, headache, dizziness, aseptic meningitis, encephalopathy
miglitol
Glyset
alpha-glucosidase inhibitor, antidiabetic
misoprostol
Brand: Cytotec
Class: prostaglandin, antiulcer agent, cytoprotective agent
Indication: cervical ripening and labor induction (unlabeled)
morphine
Class: opioid agonist
Indications: analgesia for severe pain
Routes: IV, IM, PO, PO-ER, subcut, PR, IT, epidural
Notes: controlled substance schedule II
naloxone
Brand: Narcan, Kloxxado
Class: opioid antagonist, antidote
Action: competitively blocks the effects of opioids, including CNS and respiratory depression, without producing any agonist/opioid-like effects
Routes: IV, IM, subcut, intranasal
SE/ADRs: withdrawal symptoms in dependent pt, loss of analgesic effect, ventricular arrhythmias
Notes: effects seen almost immediately, potency lasts 30-90 minutes; short half-life necessitates multiple doses
nateglinide
Starlix
meglitinide, antidiabetic
nicardipine
Cardene
calcium channel blocker (acting on smooth muscle only)
nifedipine
Procardia
calcium channel blocker (acting on smooth muscle only)
nitroglycerin
Nitro
vasodilator
acts on veins
clopidogrel
Brands: Plavix
Class: antiplatelet
Indications: ischemic stroke, MI, PAD
Notes: can be cost-prohibitive
ofirmev
IV acetaminophen
ondansetron
Brand: Zofran
Class: anti-emetic, 5-HT3 antagonist
Action: blocks effects of serotonin in vagal nerve terminals and CTZ in CNS
SE/ADRs: torsades de pointes, constipation, diarrhea, serotonin syndrome, headache, stevens-johnson syndrome, toxic epidermal necrolysis
Notes: most frequently prescribed antiemetic
oxazepam
Serax
benzodiazepine
oxycodone
Brand: Oxycontin, Oxaydo, Roxicodone, Xtampza ER
Class: opioid agonist; schedule II
Routes: PO, PO-ER
oxycodone-acetaminophen
Percocet, Oxycet
oxytocin
Brand: Pitocin
Class: hormone
Indication: induction of labor at term, control of bleeding after expulsion of placenta
patiromer
Veltassa
cationic exchange resin
electrolyte modifier, hypokalemic
PO
Indication: hyperkalemic
pioglitazone
Actos
thiazolidinedione, antidiabetic
potassium chloride
brand: K-dur (PO)
given IV or PO, NEVER subcut or IM
indications: hypokalemia
SE/ADRs: cardiac dysrythmias, hyperkalemia
NEVER given IV push
MUST be given via infusion pump
ALWAYS diluted (10 mEq/ 100 mL)
NEVER given faster than 10 mEq/hr
MAX dose is 40 mEq in 4 hours
pramlintide
Symlin
amylin mimetic, antidiabetic
prochlorperazine
Brand: Compazine, Compro
Class: anti-emetic, antipsychotic, phenothiazines
Action: alters effect of dopamine in CNS; anticholinergic and alpha-adrenergic blocking activity; depresses chemoreceptor trigger zone in CNS
SE/ADRs: blurred vision, constipation, dry eyes, dry mouth, agranulocytosis, neuroleptic malignant syndrome
promethazine
Brand: Phenergan
Class: antiemetic, antihistamine, sedative/hypnotic
Indications: treatment and prevention of nausea/vomiting, preop sedation, adjunct to anasthesia/analagesia, tx of allergic conditions, tx of motion sickness
Contraindications: comatose pt, prostatic hypertrophy, bladder neck obstruction, angle-closure glaucoma
SE/ADRs: neuroleptic malignant syndrome, confusion, disorientation, sedation
propranolol
Inderal
non-cardio-selective beta blocker
protamine sulfate
antidote to heparin and enoxaparin
1 mg inactivates 100 units
rapid acting insulin
insulin aspart (Novolog), insulin lispro (Humalog)
onset: 15 min
peak: 30-90 min
duration: 3-5 hours
prefered insulin for sliding scale coverage
repaglinide
Prandin
meglitinide, antidiabetic
reteplase
Retavase
tissue plasminogen activator
thrombolytic
rivaroxaban
Brand: Xarelto
Class: anticoagulant, Factor Xa inhibitor
Route: PO
Indication: treat and prevent DVT, PE, and A-fib
Notes: quick onset, fixed dose, less RF bleeding, and fewer labs; med stays in system about 12 hours; no reversal agent
rosiglitazone
Avandia
thiazolidinedione, antidiabetic
rosuvastatin
Crestor
HMG-CoA reductase inhibitor
saxagliptin
Onglyza
dipeptidyl peptidase-4 inhibitor, antidiabetic
short acting insulin
regular insulin (Humulin R, Novolin R)
onset: 30-60 min
peak: 2-4 hours
duration: 5-8 hours
can use sliding scale
the ONLY insulin given IV
simvastatin
Zocor
HMG-CoA reductase inhibitor
sitagliptin
Januvia
dipeptidyl peptidase-4 inhibitor, antidiabetic
sodium polystyrene sulfonate
brand name: Kayexalate
indications: hyperkalemia
SE/ADRs: new cardiac dysrythmia, hypokalemia, intestinal necrosis
should cause at least two loose bowel movements per day
spironolactone
Aldactone
aldosterone receptor antagonist (potassium-sparing diuretic); antimineralocorticoid
tenectaplase
TNK, TNKase
tissue plasminogen activator
thrombolytic
terbutaline
Brand: Bricanyl
Class: bronchodilator, adrenergic
Indication: management of preterm labor (tocolytic),
ticagrelor
Brilinta
antiplatelet
SE/ADRs: dyspnea, bleeding, increased uric acid levels
tirofiban
Aggrastat
glycoprotein (GP) IIb/IIIa inhibitor (antiplatelet)
inhibits fibrin attachment to platelets
used to keep arteries patent during cardiac catheterization
torsemide
Demadex
loop diuretic
valsartan
Diovan
angiotensin receptor blocker (ARB), RAAS inhibitor
vancomycin
Brand: Vancoin, Firvanq
Class: anti-infective; effective against Gram positive organisms
Route: IV, PO (C. diff only)
Indication: treatment of life-threatening infections when less-toxic ABX (penicillins) contraindicated; endocarditis, meningitis, osteomyelitis, pneumonia, septicemia, MRSA, enterocolitis/C. diff
SE/ADRs: renal failure, ototoxicity, red man syndrome (vancomycin flushing syndrome)
Notes: rapid infusion releases histamine causing red man syndrome (facial flushing, rash, pruritus, hypotension, tachycardia); infuse over at least one hour, on pump; irritating to tissues and can cause necrosis with extravasation
verapamil
Calan
calcium channel blocker (acting on smooth muscle (arterioles) and cadiac conduction)
anti-anginal, anti-arrhythmic, antihypertensive, vascular headache suppressant
warfarin
Brand: Coumadin
Class: Anticoagulant
Route: PO
Indication: Tx and prevent DVT/PE and A-fib
SE/ADRs: bleeding, hemorrhage
Notes: reversal agent is vitamin K (diet needs consistent amounts); requires frequent blood draws (monitor PT-INR), takes 2-4 days to start working and at least 1 week to stop working (hold 1-2 weeks before surgeries/procedures)
albuterol
Brand: Proventil, ProAir, Ventolin
Class: short acting beta agonist, bronchodilator, adrenergic
levalbuterol
Brand: Xopenex
Class: short acting beta agonist, bronchodilator, adrenergic
formoterol
Brand: Perforomist, Foradil
Class: long acting beta agonist, bronchodilator, adrenergic
salmeterol
Brand: Severent
Class: long acting beta agonist, bronchodilator, adrenergic
ipratropium
Brand: Atrovent
Class: anticholinergic, bronchodilator
Route: inhalan, intranasal
Indications: maintenance Tx for COPD (inhaln); rhinorrhea associated with allergies or cold (intranasal)
SE/ADRs: dry mouth, tremors, constipation, urinary retention, increase intraoccular pressure
Notes: short-acting, can be used as rescue inhaler
tiotropium
Brand: Spiriva
Class: anticholinergic, bronchodilator
Indication: long-term maintenance of COPD or asthma
Contraindication: concurrent ipratropium use
SE/ADRs: dry mouth, hypersensitivity reactions, tremors, constipation, glaucoma, urinary retention, glaucoma
Notes: comes in capsule form, do not swallow; long-acting; cannot be used as rescue med
fluticasone (inhalation)
Brand: Flovent, Armonair, Arnuity
Class: inhaled glucocorticoid, corticosteroid, anti-inflammatory
Indication: maintenance Tx of asthma as prophylactic therapy
SE/ADRs: hyperglycemia, thrush, osteoporosis, headache, hypersensitivity reactions
Notes: use spacer; take 5 minutes after bronchodilator; do not stop taking abruptly, rinse mouth after use
budesonide
Brand: Pulmicort
Class: inhaled glucocorticoids, steroidal anti-inflammatory
Indication: maintenance/prophylactic Tx of asthma
SE/ADRs: headache, hyperglycemia, thrush, osteoporosis, otitis media, anaphylaxis
Notes: use spacer; take 5 minutes after bronchodilator; do not stop taking abruptly; rinse mouth after use
guaifenesin
Brand: Mucinex, Robitussin
Class: expectorant, mucolytic