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Pharm Test 3 > Meds to Know > Flashcards

Meds to Know Flashcards

1
Q

COPD: Pathophysiologic Changes

A

Airway obstruction with increased airway resistance to airflow

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2
Q

Major disorders which fall under COPD

A

Chronic bronchitis, Bronchiectasis, Emphysema , and Asthma

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3
Q

Ventolin (Albuterol)

A 
Bronchodilation
Rapid onset of action
Longer duration of action
Fewer side effects 
ISSA BETA2 RECEPTOR AGONIST
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4
Q

What happens when you overdose on beta2 adrenergic agonists?

A

May cause some degree of Beta1 nervousness

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5
Q

For diabetics, what effect does Albuterol have on their glucose levels?

A

May increase it, monitor!

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6
Q

Fluticasone propionate and salmeterol (Advair)

A

Inhaler
For asthma, not to treat acute asthmatic symptoms
ISSA COMBO DRUG: Glucocorticoid and Beta2 Agonist

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7
Q

Fluticasone proprionate and vilanterol (Breo Ellipta)

A

Inhaler

For long-term maintenance of COPD, including bronchitis or emphysema

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8
Q

Theophylline

A

Action: relaxes smooth muscle of bronchi, bronchioles, increasing cAMP, promoting bronchodilation

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9
Q

Why is theophylline not a preferred drug to treat asthma?

A

Because it can get higher in toxicity (has a low therapeutic index and narrow therapeutic range)

Only for chronic stable asthma and emphysema

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10
Q

What kinds of patients do we not prescribe theophylline to?

A

Seizure patients, cardiac, renal, or liver patients.

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11
Q

What happens if theophylline and a beta-adrenergic agonist are given together?

A

A synergistic effect can occur and result in cardiac dysrhythmias

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12
Q

Side effects/Adverse reactions of theophylline?

A

N/v, anorexia, gastric pain caused by gastric acid secretion, intestinal bldg, nervousness, dizziness, headache, irritability, cardiac dysrhythmias, tachycardia, marked hypotension, hyperreflexia, seizures

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13
Q

T or F: You would take xanthines with theophylline

A

False

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14
Q

T or F: Theophylline can cause hyperglycemia, decreased clotting time, and rarely leukocytes

A

True

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15
Q

T or F: Caffeine is preferred to take with theophylline

A

False

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16
Q

Should you give theophylline IV push?

A

No because it can cause dizziness, flushing, hypotension, severe bradycardia, and palpitation

GIVE SLOWLY THROUGH INFUSION PUMP

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17
Q

Which drugs decrease liver metabolism and increase half-life of theophylline?

A

Beta blockers
Cimetidine (Tagamet)
Propanolol (Inderal)
Erythromycin (E-Mycin)

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18
Q

Which drugs decrease theophylline effects?

A

Barbiturates

Carbamazepine (Tegretol)

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19
Q

T or F: Theophylline decreases rick of digitalis toxicity and increases the effect of lithium

A

False

Theophylline actually poses a higher risk of digitalis toxicity due to its risky effects on the heart. Lithium would have a decreased effects, which them could pose the patient to have lithium toxicity and be on dialysis.

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20
Q

What are the four classes of antidysrhythmic drugs?

A

A. Sodium-channel blockers
B. Beta-adrenergic blockers
C. Drugs that prolong repolarization
D. Calcium (slow) channel blockers

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21
Q

Sodium-channel blockers

A

Decrease sodium influx into cardiac cells

Response include decreased conduction velocity in cardiac tissues; suppression of automaticity, and increased recovery time (depolarization or refractory period)

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22
Q

Class 1A: Sodium-channel blockers

A

They slow conduction and prolong depolarization

-Control dysthrhythmias

Examples include quinidine, procainamide HCl (deals with ventricular tachycardia), and disopyramide phosphate (Norpace) (help with decrease PVCs)

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23
Q

Of the drugs under class 1A sodium channel blockers, which one can increase digoxin concentration?

A

Quinidine

Side effects: n/v, diarrhea, abdominal pain, confusion, hypotension and cramps which are COMMON SIDE EFFECTS

can cause heart block and neurologic and psychiatric symptoms

Procainamide causes LESS cardiac depression than quinidine

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24
Q

Diopyramide phosphate and its relation to ACh

A

rise in anticholingeric symptoms

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25
Q

Class 1B: Sodium-channel blockers

A

Slows conduction and shortens depolarization

Examples include: lidocaine and mexiletine HCl

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26
Q

Lidocaine is great for what kind of patients

A

those who are from cardiac and MI surgery

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27
Q

Mexiletine HCl can cause GI distress if you do not take it with?

A

FOOD!

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28
Q

What are side effects of Mexiletine?

A

N/v, heartburn, tremor, dizziness, nervousness, lightheadedness

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29
Q

Class 1C: Sodium-channel blockers

A

Prolongs conductions with little to no effect on repolarization

Both drugs are used for life-threatening ventricular dysrhythmias

Examples include: flecainide (Tambocor) and Propafenone HCl (Rhythmol)

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30
Q

Contraindications of Flecainide

A

Cardiogenic shock and brach blocks

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31
Q

Contraindications of Propafenone HCl

A

Cardiogenic shock , branch blocks, uncontrolled HF, severe hypotension, bronchospasm, bradycardia

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32
Q

Class II: Beta Blockers

A

Decrease conduction velocity, reduce calcium entry, automaticity, and recovery time

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33
Q

What are some examples of beta blockers?

A

Propranolol (Inderal)
Acebutolol (Sectral)
Esmolol (Brevibloc)
Sotalol (Betapace)

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34
Q

Is Acebutolol a Beta 1 or Beta 2?

A

Beta 1

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35
Q

is Esmolol a Beta 1 or Beta 2?

A

Beta 1

  • for short term use only
  • for patients who are having dysrhythmias during surgery
    contraindications: cariogenic shock and heart failure, and heart blocks
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36
Q

Propanolol (Inderal) a Beta 1 or Beta 2

A

Actually… IT’S BOTH

Used for ventricular dysrhythmias, PAT, and atrial and ventricular ectopic beats

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37
Q

What types of patients would you not want to prescribe Propanolol to?

A

Asthma patients

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38
Q

Sotalol: contraindications

A

Bronchial asthma and heart blocks

Correct hypokalemia and hypomagnesemia before prescribing this medication

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39
Q

What is the main purpose of acebutolol (Sectral)?

A

To block beta1-adrenergic receptors in cardiac tissues

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40
Q

Class III: Prolong repolarization

A

These drugs are used in emergency treatment of ventricular dysrhythmias when other antidysrhythmics are ineffective.

Example: Amiodarone (Cordarone)
-this drugs has an increased risk for photosensitivity

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41
Q

Class IV: Calcium-Channel blockers

A

Block calcium influx, thereby decreasing calcium excitability and myocardium contractility

Increases the refractory period of the AV node, which decreases ventricular response

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42
Q

Examples of calcium-channel blockers

A

Verapamil (Calan, Isoptin)

Diltiazem (Cardiazem)

43
Q

Verapamil is contraindicated in patients with?

A

AV block or Heart failure

44
Q

The health care provider is planning to discontinue a patient’s beta blocker. Which instruction will the nurse give the patient regarding the beta blocker?

A

The beta blocker should not be abruptly stopped; the dose should be tapered down.

45
Q

What are less serious side effects of lidocaine?

A

Dizziness, lightheadedness, and confusion

46
Q

Adverse effects of lidocaine?

A

Cardiovascular depression, bradycardia, hypotension, seizures, blurred vision, and double vision.

Caution of use in patient with liver problems and heart failure

47
Q

What are side effects of beta blockers?

A

Bradycardia and hypotension

48
Q

What are side effects of calcium blockers?

A

N/v, hypotension, and bradycardia

49
Q

What is the job of anti-platelets?

A

To prevent thrombosis in the arteries by suppressing platelet aggregation

50
Q

What two drugs prevent thrombosis in the veins?

A

Heparin and warfarin

51
Q

What kind of patients would take anti-platelet drugs?

A

Those who want to prevent MIs or have had an MI; stroke patients

52
Q

What inexpensive treatment is effective in suppressing platelet aggregation?

A

Aspirin

53
Q

How long should you discontinue taking Aspirin before surgery?

A

At least 7 days

54
Q

What are examples of anti-platelet drugs?

A 
Dipyridamole (Persantine)
Ticlopidine (Ticlid)
Clopidogrel (Plavix) - can be prescribed with aspirin, better together than not 
Anagrelide HCl (Agrylin)
Abciximab (ReoPro)
Eptifibatide (Integrilin)
Tirofiban (Aggrastat) - taken with aspirin
Ticagrelor (Brilinta)
55
Q

Which herbs are cautioned to interfere with platelet aggregation?

A

Dong quai, feverfew, garlic, and ginkgo biloba

56
Q

What are peripheral vasodilator used for?

A

To improve blood flow

Peripheral arterial (vascular) disease

  • arteriosclerosis
  • hyperlipidemia
57
Q

What are the four classifications of peripheral vasodilators?

A
  • Alpha-drenergic antagonists
  • Direct-acting peripheral vasodilators
  • Hemorrheologic
  • Others
    • antiplatelets (Plavix, Pletal)
    • selected antihypertensives
58
Q

What are some drugs that promote vasodilation?

A

Papaverine (Para-time)
Prazosin (Minipress) - Alpha blocker
Nifedipine (Procardia) - calcium blocker

59
Q

What are side effects of peripheral vasodilators?

A

Lightheadness, dizziness, orthostatic hypotension, tachycardia, palpitation, flush, and GI distress

60
Q

Cilostazol (Pletal)

A
  • vasodilator and anti platelet drug
  • treats intermittent claudication
  • side effects: n/v, dizziness, syncope, blood in eye, headache, abdominal pain, abnormal stools, peripheral edema
61
Q

Pentoxigylline (Trental)

A
  • improves microcirculation and tissue perfusion
  • decrease blood viscosity
  • improves flexibility of erythrocytes
  • inhibits aggregation of platelets and red blood cells
  • decreases blood viscocity
62
Q

Adrenergic agonists

A

Drugs that stimulate the sympathetic nervous system

They do this because they mimic the sympathetic neurotransmitters norepinephrine and epinephrine.

Act on one of more sites located in the effector cells of the muscles, such as the heart, bronchiole walls, GI tract, urinary bladder, and ciliary muscle of the eye.

Four main receptors: alpha1, alpha2, beta1, and beta2

63
Q

Alpha1 - blood vessel, eye, bladder, prostate

A

Increases cardiac contractility, vasoconstriction

Dilates pupils, decreases salivary gland secretion

Increases bladder and prostate contraction

64
Q

Alpha2 - postganglionic sympathetic nerve endings

A

Inhibits norepinephrine release
-promotes vasodilation and decreased BP

Decreased GI motility and tone

65
Q

Beta1 - located in the kidney but primarily in the heart

A

increases myocardial contractility and heart rate

66
Q

Beta2 - mostly in the lung and gastrointestinal tract, the liver, and the uterine muscle

A
  • decrease GI tone and motility
  • bronchodilation
  • increases blood flow in skeletal muscles
  • relaxes smooth muscle of uterus
  • Activates liver glycogenolysis
    • increases blood pressure
67
Q

Adrenergic blockers

A

Block effects of adrenergic neurotransmitter

  • block alpha and beta receptor sites
  • indirectly by inhibiting release of neurotransmitter epinephrine and norepinephrine
68
Q

Alpha1 Blockers

A
  • Vasodilation, decreased BP, reflex tachycardia
  • Pupil constriction
  • Suppresses ejaculation
  • Reduces contraction of smooth muscles in neck and prostate

ex. Prazonsin HCL (Minipress)
ex. Phentolamine mesylate (Regitine)

69
Q

Nonselective alpha blockers

A

Block alpha1 and 2

70
Q

Why do we not prescribed alpha adrenergic blockers as much?

A

It can cause orthostatic hypotension and reflex tachycardia

71
Q

Beta1 Blockers

A

Reduces cardiac contractility
Decreases pulse

ex. Metropolol (Lopressor), Acebutalol (Sectral)

72
Q

What is the caution for using nonselective beta blockers?

A

Patients with COPD and asthma should not take these medications

73
Q

Beta2 Blockers

A

Bronchoconstriction
Contracts uterus
Inhibits glycogenolysis

74
Q

What are side effects of Nonselective Propranolol?

A

Impotence, decreased libido, reversible alopecia

75
Q

Propranolol: Decreased drug effects with?

A

Phenytoin, isoproterenol, NSAIDS, barbiturates, theophylline

76
Q

Propranolol: Heart block may occur with

A

Digoxin, calcium channel blockers

77
Q

Cholingeric agents

A

Drugs that stimulate the parasympathetic nervous system because they mimic acetylcholine

Study the effects of cholinergic agents

78
Q

Anticholinergic

A

Inhibit action of ACh by occupying ACh receptors

79
Q

COX-1

A

protects the stomach lining and regulates blood platelets

80
Q

COX-2

A

triggers inflammation and pain

Second-generation NSAIDS

81
Q

Patient-controlled analgesia (PCA)

A

an alternative route for opioid administration for self-administered pain relief as needed

Usually a loading dose

Look on pg. 362 of the text

82
Q

What is the name of the drug that is frequently prescribed to someone if they have a hypersensitivity to penicillin?

A

Erythromycin

83
Q

What are some examples of macrolides?

A

Azithromycin (Zithromax)
Clarithromycin (Biaxin)
Erthromycin (E-Mycin)

84
Q

Action of macrolides?

A
  • Bind to 50S ribosomal subunits and inhibits protein synthesis
  • Broad spectrum
  • Most gram-positive, some gram-negative bacteria
  • Bacteriostatic: low to moderate doses
  • Bactericidal: high doses
85
Q

What are some of the uses of macrolides?

A
  • Moderate-to-severe infections
  • Respiratory, GI tract
  • Skin, soft tissue
  • STIs
  • Treat mycoplasmal pneumonia
  • Treat Legionnaire’s disease
86
Q

What is Azithromycin?

A

Frequently prescribed to treat upper and lower respiratory infections, STIs, and uncomplicated skin infections.

87
Q

Route of macrolides

A

Oral and IV

88
Q

What are the side effects/adverse reactions of macrolides?

A
  • Tinnitus, ototoxicity
  • GI distress
  • Superinfection
  • Hepatotoxicity
89
Q

Drug Interactions - Macrolides

A
  • Levels of warfarin, theophylline, and carbamazepine increase
  • Erythromycin levels increase with fluconazole (Diflucan), ketoconazole (nizoral)
    • Risk of sudden cardiac death
  • Azithromycin levels may be reduced by antacids
90
Q

Action of Fluroquinolones

A
  • Interfere with enzyme DNA gyrase
  • bactericidal action on both gram-positive and gram-negative bacteria
  • Effective in the treatment of urinary tract, bone, and joint infections, bronchitis, gastroenteritis, and gonorrhea
91
Q

Ciprofloxacin (Cipro)

A

-Urinary tract infections; lower respiratory tract infections; and skin, soft-tissue, bone, and joint infections

92
Q

Norfloxacin (Noroxin)

A

-Urinary tract infections

93
Q

Levofloxacin (Levaquin)

A

-Community-acquired pneumonia, chronic bronchitis, acute sinusitis, UTIs, and uncomplicated skin infections

94
Q

Moxifloxacin (Avelox)

A

Once-a-day and parenteral dosing

Used to treat the same infections other fluroquinolones are effective against

95
Q

Antitubercular drugs: Isoniazid (INH)

A

A bacterial drug that inhibits tubercle cell wall synthesis and blocks pyridoxine (vitamin B6), which is used for intracellular production

96
Q

What drug should be prescribed with INH to avoid peripheral neuropathy?

A

Vitamin B6

97
Q

Is isoniazid a first or second line anti-tubercular drug?

A

First-line

98
Q

What is the difference between first line and second line anti-tubercular drugs?

A

First line drugs are more effective and less toxic (ex. INH, streptomycin, rifampin)

Second line drugs are less effective and more toxic (Ex. capreomycin, cyclosterine)

99
Q

Isoniazid is used in prophylactic therapy for Tb patients. What kind of patients is this therapy contraindicated in?

A

-Persons with liver disease. May cause isoniazid-induced liver damage

100
Q

T or F: Isoniazid cannot be taken with other anti tubercular drugs

A

False

Multidrug therapy is proven more effective

101
Q

Drug-Food Interactions: Isoniazid

A

Increase effect with alcohol, rifampin, cycloserine, and phenytoin; decrease GI absorption while taking aluminum antacids

102
Q

Drug-Lab: isoniazid

A

increase AST, ALT, bilirubin

May also get diabetic retinopathy, alcoholism, severe renal or hepatic disease, low platelet and WBC count, psychotic problems

103
Q

Side effects: INH

A

Drowsiness, tremors, rash, blurred vision, photosensitivity, tinnitus, dizziness, n/v, dry mouth, constipation

Pharm Test 3 (1 decks)

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