Miscelaneous agents Flashcards
adalimumab
Brand - Humira, Amjevita
Class - Antibody, antirheumatic, TNF blocking agent
Indication - Crohns, Hidradenitis suppurativa, juvenile idiopathic arthritis, plaque psoriasis, rheumatoid arthritis
Pregnancy - Weigh risks/benefits
Black Box - Antibody formation, Hematologic disorders, active infection, HIV, live vaccines
Counseling - Closely monitor CBC, autoiimune disorder, malignancy, hepatomegaly, abdominal pain, fever, night sweats, weight loss; SQ admini tech, rotate injection site, leave at room temp up to 30 min before use.
MoA - Antibioty binds to human tumor necrosis factor alpha, interfering w/ cytokine-driven inflammatory processes - decreases symptoms of arthritis and progression of structural damage, reduces epidermal thickeness in osiruasus and maintains remission in Chron disease and ulcerative colitis.
adapalene
Brand - Differin, Plixda
Class - Retinoid (antiacne)
Indication - Acne vulgaris
Counseling - Avoid eyes, lips, nose folds, mucous membranes, cuts/scapes/burns. Avoid UV*. May take up to 12 weeks. Wash and dry area prior to application, follow up with moisturizer.
MoA - Second generation of retinoic acid that is more selective (less irritating) > normalizing the differentiation of skin cells to prevent microcomedone formation and thus acne lesions
alendronate
Brand - Fosamax, Binosto
Class - Bisphosphonate
Indication - Osteoporosis (including postmenopausal, glucocorticod-induced, and prophylaxis), Paget disease
Contraindications - Esophageal abnormalities or risk, hypocalcemia, inability to sit/stand upright for 30 min
Pregnancy - Risk
Counseling - Swallow (or dissolve for 5 min if effervescent) w/ a large glass of plain water and remain upright for 30 min and don’t eat/drink anything, and then do not lie down until after you have eaten food.
MoA - Binds to hydroxyapatite and inhibits osteoclast activity to inhibit bone resorption
allopurinol
Brand - Zyloprim
Class - Xanthine oxidase inhibitor, Antigout
Indication - Gout, hyperuricemia, nephrolithiasis prophylaxis
Contraindications - Concurrent use of diadanosine
Pregnancy - No data
Counseling - Tk after meals for GI upset, maintain hydration, avoid alcohol/caffeine. Seek medical attention if signs of myelosuppression, agranulocytosis (neutropenia), or Stevens-Johnson syndrome (flu-like, red rash, mucousal blistering)
MoA - Decreases production of uric acid by inhibiting xanthine oxidase (hypoxanthine > xanthine > uric acid)
benzonatate
Brand - Tessalon Perles
Class - Antitussive
Indication - Cough
Pregnancy - Weigh risks/benefits
Counseling - Tk w/ food if GI upset. Accidental ingestion by kids <2 can kill. Do not chew capsules.
MoA - Anesthetizing the stretch receptors in the resp passages by dampening activity (reduces cough reflex)
brimonidine [tartrate]
Brand - Lumify, Alphagan P
Class - Adrenergic agonist, antiglaucoma agent
Indication - Ocular hypertension, open-angle glaucoma, ocular redness
Contraindications - Concurrent MAOIS, children <2y
Counseling - Drop into the pocket between lower lid and eyeball, close eye and hold for 1 min. Put cap on bottle asap, reinsert contacts after 15 min or wait 5 min for other drops.
MoA - Selective alpha agonist, reduces aqueous humor production and increases uveoscleral outflow (used to lower IOP)
calcium / cholecalciferol
Class - Supplement, Ca2+ containing Antacid
Indication - Vitamin deficiency
Contraindications - Hypercalcemia, Hypervitaminosis D
Counseling - Overdose symptoms (nausea, loss of appetite, thirst, urinating more or less than usual, body aches, stiffness, confusion, or irregular heartbeats).
MoA - Vitamin D3 regulates Ca2+, phosphate, and citric acid metabolism, promotes the intestinal absorption of calcium and controls the incorporation of calcium into the organic bone matrix.
cholecalciferol
Brand - Adrovance
Class - Vitamin D3 analog
Indication - Vitamin D deficiency, Refractory rickets, hypoparathyroidism, familial hypophosphatemia
Contraindications - Hypercalcemia, Hypervitaminosis D, Hyperlipidemia, Hyperphosphatemia, Liver disease, renal impairment/osteodystrophy, sarcoidosis, arteriosclerosis, cardiac conditions, thiazide diuretics
Pregnancy - Fetal risk cannot be ruled out
Counseling - Warn patient to report symptoms of hypercalcemia. Side effects with excessive use may include nausea, anorexia, weight loss, constipation, polyuria, polydispsia, hypertension, weakness, and muscle aches or stiffness. Instruct patient to maintain adequate intake of calcium with drug. Avoid additional vitamin D supplements.
MoA - Vitamin D3 regulates both the calcium and phosphate as well as citric acid metabolism, promotes the intestinal absorption of calcium and controls the incorporation of calcium into the organic bone matrix
clobetasol (topical)
Brand - Impoyz, Temovate
Class - (Topical) Corticosteroid
Indication - Skin disorders, Plaque psoriasis
Pregnancy - Risk
Counseling - Apply thin layer to clean, intact, affect skin, avoiding eyes, mouth, and occlusive clothing; wash hands after admin.
MoA - Anti-inflammatory, antipruritc, vasoconstrictive. Induce lipocortins that control inflammatory mediators by inhibiting release of arachidonic acid by phospholipase A2.
colchicine
Brand - Colcrys, Gloperba
Class - Antigout
Indication - Gout (acute/prophylaxis), Familial Mediterranean fever
Contraindications - Concurrent use of CYP3A4/5 inhibitors in renal/hepatic failure
Counseling - Instruct on dosing strategy for flares
MoA - May interrupt the cycle of Na+ urate crystal deposition in joint tissues and inflamm response that initiates/sustains an attack (probably by inhibiting oxidation of glucose and lactic acid production in leukocytes)
cyanocobalmin
Brand - Cobolin-M
Class - Essential B Vitamin, B-12
Indication - Cobalamin deficiency (malabsorption or normal)
Contraindications - Hypersensitivity to cobalt
Counseling - Avoid alcohol (inhibits absorption), tk ER w/ food, may require several weeks for max effect
MoA - B12 is required for the synthesis of methionine from homocysteine, which is needed for DNA synthesis so deficiency presents as macrocytic anemia when RBC can’t extrude their nucleus.
epinephrine [autoinjector]
Brand - EpiPen, Adrenaclick
Class - Anaphylaxis agent, alpha/beta agonist
Indication - Emergency treatment of acute anaphylaxis due to allergic reaction
Pregnancy - Risk, but i mean life or death yo
Counseling - Instruct admin technq, seek medical assist, inject into anterolateral aspect of thigh (IM or SQ, not IV)
MoA - Stimulates alpha/beta receptors. Alpha > Vascular constriction +BP, Beta1 > +HR & contractility, Beta2> bronchial relaxation (thus alleviating dyspnea). Also alleviates pruitus, urticaria, and angioedema.
ergocalciferol
Brand - Drisdol
Class - Vitamin D analog
Indication - hypoparathyroidism, Refractory rickets, familial hypophosphatemia
Contraindications - Hypercalcemia, malabsorption syndrome, abnormal sensitivity to the toxic effects of vitamin D, and hypervitaminosis D
Counseling - Best absorbed when taken after a meal, but may be taken with or without food. Bile acid sequestrants can decrease the absorption of Vitamin D - separate at least 2 hours if possible.
MoA - After the activation of the vitamin D receptor, mobilize and accretion of calcium and phosphorus in the bone, absorption of calcium and phosphorus in the intestine, and reabsorption of calcium and phosphorus in the kidney
ferrous sulfate
Class - Iron mineral supplement
Indication - Iron deficiency
Contraindications - Anemia other than iron-deficiency anemia, hemochromatosis, hemosiderosis
Black Box - Accidental overdose of iron-containing products is a leading cause of fatal poisoning in children under 6.
Counseling - Works best when taken on an empty stomach, but tk w/ food if GI upset. May tk up to 4 w to feel full effect (feel better after 1 w). side effect constipation/diarrhea
MoA - Ferrous sulphate contains iron, hope that helps
finasteride
Brand - Proscar, Propecia
Class - 5alpha-reductase inhibitor
Indication - Benign prostatic hyperplasia, male pattern alopecia
Contraindications - Pregnancy or use in children
Pregnancy - Contraindicated
Counseling - Takes 3mo for hair loss, 6mo for prostate. Can get into body through the skin and spread through semen, pregnant people must avoid it (prevent fetal genitalia development). Report any shortness of breath, breast swelling, or breast mass.
MoA - Inhibits conversion of testosterone into DHT
