Meds - Prescriptions -Immunizations Flashcards
What are Cyclosporins?
IMMUNOSUPPRESSIVE drug.
It can PREVENT ORGAN REJECTION after transplant in its oral form. It can also treat rheumatoid arthritis and psoriasis.
DENTAL consideration: Unusual GROWTH and SWELLING of the GUMS may occur.
Other Side Effects. Shaking, headache, dizziness, unusual growth of body hair, nausea/vomiting, diarrhea, stomach upset, or flushing.
Brand names: Gengraf, Neoral, Sandimmune.
How do CORTICOSTEROIDS work?
What 2 classes do they come in?
ANTI-INFLAMMATORY medicines reduce the swelling and mucus production inside the airways. When that inflammation is reduced, it is easier to breathe.
- GLUCOCORTICOIDS are a class of corticosteroids, which are a class of steroid hormones.
- They INHIBITS various LEUKOCYTE inflammatory events (epithelial adhesion, emigration, chemotaxis, phagocytosis, respiratory burst) In other words, glucocorticoids not only SUPPRESS IMMUNE RESPONSE , but also inhibit the two main products of inflammation, PROSTAGLANDINS and LEUKOTRIENES.
25% of cases of SEVERE ASTHMA may be unresponsive to steroids. This may be the result of genetic predisposition or ongoing exposure to the cause of the inflammation.
- MINERALOCORTICOIDS are a class of corticosteroids, which in turn are a class of steroid hormones.
- Mineralocorticoids are produced in the adrenal cortex and influence salt and water balances (electrolyte balance and fluid balance). The primary mineralocorticoid is ALDOSTERONE
What are some common Steroid Inhalers for Asthma?
Inhaled steroids need to be TAKEN DAILY for best results. Some improvement in asthma symptoms can be seen in 1 to 3 weeks after starting inhaled steroids, with the best results seen after 3 months of daily use.
- Beclomethasone dipropionate(QVAR)
- Budesonide (PULMICORT)
- Budesonide/Formoterol (SYMBICORT) - a combination drug that includes a steroid and a long-acting bronchodilator drug
- Fluticasone (FLOVENT)
- Fluticasone/Salmeterol (ADVAIR) - a combination drug that includes a steroid and a long-actingbronchodilator drug
- Mometasone/formoterol (DULARA) - a combination drug that also includes a long-acting bronchodilator drug
Why is EPINEPHRINE an excellent drug for Anaphylaxis?
EPINEPHRINE is a nonselective ALPHA AND BETA ADRENERGIC RECEPTOR AGONIST.
-ALPHA adrenergic receptors:
-REDUCES ⬇️ VASODILATION
-INCREASES ⬆️ VASOCONSTRICTION
it causes constriction, or tightening, of the blood vessels, which DECREASES SWELLING and also helps to increase blood pressure. it prevents or DECREASES upper airway mucosal EDEMA (laryngeal edema), hypotension, and shock
increases peripheral vascular resistance thus INCREASING BLOOD PRESSURE and coronary perfusion, reversing peripheral vasodilation, and decreasing angioedema.
-DECREASES ⬇️ VASCULAR PERMEABILITY
-BETA-adrenergic receptors:
- ⬆️ BRONCHIAL SMOOTH MUSCLE
RELAXATION.
helps alleviate bronchospasm, wheezing, and dyspnea that may occur during anaphylaxis.
What class of drugs and common prescriptions are seen with people with BI-POLAR illness?
Several ANTICONVULSANT medications are recognized as MOOD STABILIZERS to treat or prevent mood episodes in BIPOLAR disorders.
They are often prescribed for people who have RAPID CYCLING – FOUR or more episodes of mania and depression in a year.
- DEPAKOTE, Depakene (divalproex sodium, valproic acid, or valproate sodium)
- LAMICTAL (lamotrigine)
- TEGRETOL (carbamazepine)
Describe what happens in an Anaphylaxis reaction
ANAPHYLAXIS:
severe,potentially life-threatening ALLERGIC REACTION.
Anaphylaxis symptoms USUALLY occur within MINUTES of exposure to an allergen. Sometimes, however, it can occur a half-hour or longer after exposure.
Signs and symptoms include:
- SKIN reactions, including hives and itching and flushed or pale skin
- ⬇️ LOW BP, blood pressure (hypotension)
- A weak and RAPID PULSE (tachycardia)
- CONSTRICTION of your AIRWAYS and a SWOLLEN tongue or throat, which can cause wheezing and trouble breathing
- NVD: Nausea, vomiting or diarrhea
- Dizziness or fainting
What classes of drugs cause GINGIVAL OVERGROWTH?
“CCC”
CALCONCYCLO
Gingival enlargement may be associated with the administration of three different classes of drugs, all producing a similar response:
“CCC” - ConCalCyclo
- ANTICONVULSANTS (such as phenytoin, phenobarbital, lamotrigine, vigabatrin, ethosuximide, topiramate and primidone NOT common for valproate)
- CALCIUM CHANNEL BLOCKERS
(antihypertensives such as nifedipine, amlodipine, and verapamil) - CYCLOSPORINE , an immunosuppresant.
How long does it take for drug induced hyperplasia of the gingiva to become evident?
Many cases of drug-induced gingival OVERGROWTH develop within the FIRST 1 TO 3 MONTHS of starting drug treatment.
A second peak has been described after 12 months of treatment.
The gingival enlargement often begins in the INTERDENTAL PAPILLAE, especially in the ANTERIOR and FACIAL segments. With progression, there may be more diffuse gingival overgrowth, with envelopment of part or all of the adjacent tooth crowns.
Epinephrine Dosage for Anaphylaxis?
Where to inject?
When to Re-inject?
SC/IM in anterolateral aspect of the THIGH.
- through clothing if necessary.
- When administering to a child, to minimize the risk of injection related injury, hold the leg firmly in place and limit movement.
0.01 mg/kg (0.01 mL/kg)
——————————————————————
- Children Less Than < 30 kg (66 lbs)
EPIPEN Auto-Injector: 0.3 mg (0.3 mL)
up to a maximum of 0.3 mg (0.3 mL) per injection, REPEATED every 5 to 10 minutes as necessary.
EPIPEN JR auto- injector: 0.15 mg (0.15 mL)
*in children under 33lbs/15kg,
use other forms of injectable epinephrine
- Adults And Children > 30 kg (66 lbs) Or More
- 3 to 0.5 mg (0.3 to 0.5 mL) up to a maximum of 0.5 mg (0.5 mL) per injection, repeated every 5 to 10 minutes as necessary.
What class and common prescriptions are found in people who have EPILEPSY?
ANTICONVULSANTS
- LACTIMAL is the best first-choice drug for partial epilepsy,
- VALPROIC ACID is the best first choice for generalized epilepsy,
What are Calcium Channel Blockers prescribed for?
CALCIUM CHANNEL BLOCKERS
- constitute a large class of drugs that are widely used for treating several cardiovascular problems. They are most commonly used today as a FIRST-LINE treatment for HYPERTENSION , but they are also effective in treating ANGINA supraventricular TACHYCARDIA , and hypertrophic CARDIOMYOPATHY.
- REDUCE ⬇️ CALCIUM that enters the SMOOTH MUSCLE in blood vessel walls and heart muscle.
Tylenol 3
“333”
Liquid Form?
The “Trinity” and “Disciples”
TYLENOL #3 “333”
300 mg Acet
30 mg Codeine
TABLETS: 300 mg Acetaminophen constant
#2 15mg codeine #3 30mg codeine #4 60mg codeine
LIQUID:
120 mg acetaminophen / 12 mg codeine per 5ml
What is the acronym for MORPHINE that defines its effects?
MORPHINE
M. Miosis (pupil constriction)
O. Out of it (sedation)
R. Respiratory Depression
P. Pneumonia
H. Hypotension
I. Infrequency
N. Nausea and Vomiting 🤮
E. Euphoria and Dysphoria
SULFONAMIDES
Sulfa Ab
SULFONAMIDES
“SULFA DRUGS”
- bacterioSTATIC “SS”
- FOLATE synthesis inhibitor (competes with PABA)
- Causes folate DEFICIENCY therefore impacting the DNA of the Bacteria
“SO-FULL OF FOLATE”
SULFAdiazine
SULFAmethoxazole
BACTERIOSTATIC
Inhibits / slows growth of bacteria
T/F
Bacteriostatic and Bacteriocidal antibiotics can be mixed together to fight infection.
FALSE
They will CANCEL each other out and should NEVER be MIXED together
FLUOROQUINALONES
FLUOROQUINALONES
- bacterioCIDAL “FT”
- DNA synthesis inhibitor
“FLUORO-FLOXACIN QUIN”
ciproFLOXACIN
levoFLOXACIN
“FLOXI-TOXIC”
DNA INHIBITING ANITBIOTICS
- SULFONAMIDES
- Static
- indirectly inhibit
- FLUOROQUINOLONES
- Cidal
- directly inhibit
PENECILLINS
PENECILLINS
- bacterioCIDAL
- BROAD spectrum (Gram +,-)
- CELL WALL synthesis inhibitor,
- contain B-LACTAM ring in their structure
-CROSS-ALLERGIC with CEPHALOSPORINS
because they are chemically related
- Pen G: IV, more sensitive to acid
generation (stomach acid) - Pen V: Oral
Amoxicillin
Augmentin
AUGMENTIN
AUGMENTIN
- Amoxicillin + Clavulanic Acid
- B-lactamase resistant
(produced by bacteria to fight against
B-lactam Penicillins /Cephalosporins)
“AC and B RESISTANT”
Side effects of Augmentin that are DIFFERENT from amoxicillin include:
- Bloating
- Gas
- Headache
- Reversible HEPATITIS
What THREE antibiotics are B-Lactamase Resistant
😡😡😡
MAD 😡 😡😡
- Augmentin
- Methicillin
- Dicloxacillin
What Cillin has the best/broadest GRAM-NEGATIVE spectrum?
AMPICILLIN
What Cillin is used specifically for PSUEDOMONAS?
CARBENICILLIN
CEPHALOSPORINS
SJ
CEPHALOSPORINS
- bacterioCIDAL
- CELL WALL synthesis inhibitor
- has B-Lactam ring
CEPHalexin (KEFLEX)
CEFuroxime
CEFtriaxone
CEFepime
*OMNICEF CEFdinir (3rd Generation)
Therapeutic uses of cefdinir include otitis media, soft tissue infections, and respiratory tract infections, including sinusitis, strep throat.
It is also one of the medications that can cause toxic epidermal necrolysis or STEVENS-JOHNSON Syndrome.
MONOBACTAMS
MONOBACTAMS
- bacterioCIDAL
- CELL WALL synthesis inhibitor
- contains B-Lactam ring
AztreonAM
CARBAPENEMS
CARBAPENEMS
- bacterioCIDAL
- CELL WALL synthesis inhibitor
- contains B-Lactam ring
ImiPENUM
What 4 classes of antibiotics are CELL WALL synthesis INHIBITORS and contain a B-Lactam ring?
- Penicillins
- Cephalosporins
- Monobactams
- Carbapenems
“The MC was PC playing Off the WALL”
