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Pharm 2 > Neurotransmitter drugs > Flashcards

Neurotransmitter drugs Flashcards

1
Q

Antidepressant discontinuation syndrome

A
  • Stopping antidepressant suddenly
  • Important to taper off AD gradually over 6-8 weeks
  • If not will experience:
    Flu-like symptoms
    insomnia
    nausea
    dizziness
    Hyperactivity
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2
Q

Imipramine (Tofranil) CLASS

A

Tricyclic antidepressant (TCA)

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3
Q

Imipramine (Tofranil) MOA

A

Strong NON-selective reuptake inhibitor

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4
Q

Imipramine (Tofranil) INDICATIONS

A

Depression

Prevention of Bedwetting (because of anticholinergic effects)

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5
Q

Imipramine (Tofranil) SIDE EFFECTS (4)

A
  • Most common adverse effects: Sedation, orthostatic hypotension, and anticholinergic effects (which is what decreases bed wetting)
  • Most dangerous adverse effect: Cardiac toxicity
  • Danger of overdose, therefore limited use and never in suicidal patients.
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6
Q

Imipramine (Tofranil) NI

A

baseline EKG, assess for suicidal thoughts prior to starting

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7
Q

Phenelzine (Nardil) CLASS

A

Monoamine Oxidase Inhibitor

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8
Q

Phenelzine (Nardil) MOA

A

Block MAO (enzyme) in brain making norepinephrine and serotonin available

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9
Q

Phenelzine (Nardil) INDICATIONS

A

Depression (usually treatment resistant), OCD

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10
Q

Phenelzine (Nardil) SIDE EFFECTS (3)

A
  • Orthostatic hypotension
  • CNS stimulation
  • Hypertensive crisis from dietary tyramine
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11
Q

Phenelzine (Nardil) CI/CAUTIONS

A
  • Tyramine rich food (Aged cheese, cured meats, red wine, bananas etc. )
  • Many drug interactions
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12
Q

Phenelzine (Nardil) MAJOR POINT

A

High incidence of drug-drug and drug-food interactions so rarely given unless treatment resistant depression

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13
Q

Fluoxetine (Prozac) CLASS

A

Selective Serotonin Reuptake Inhibitor (SSRI)

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14
Q

Fluoxetine (Prozac) MOA

A

Blocks serotonin reuptake which increases serotonin availability for the body

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15
Q

Fluoxetine (Prozac) INDICATIONS (3)

A

Depression, Anxiety, OCD

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16
Q

Fluoxetine (Prozac) SIDE EFFECTS (4)

A

N/V, anxiety, insomnia, diarrhea

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17
Q

Fluoxetine (Prozac) CI/CAUTIONS

A

Life threatening interaction with MAO-I, must wait 2 weeks between use; Other Serotonin drugs including St. John’s Wort (risk for serotonin syndrome)

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18
Q

Fluoxetine (Prozac) BLACK BOX

A

suicidal ideation

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19
Q

Venlafaxine (Effexor) CLASS

A

Serotonin and Norepinephrine Reuptake Inhibitor (SNRI)

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20
Q

Venlafaxine (Effexor) MOA

A

Inhibits serotonin and NE reuptake, making more available for use

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21
Q

Venlafaxine (Effexor) INDICATIONS

A

Depression, Anxiety, Pain

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22
Q

Venlafaxine (Effexor) SIDE EFFECTS (7)

A

More than SSRI but much less than TCA and MAO-I
Same as SSRI (n/v, anxiety, insomnia, diarrhia) + Hypertension +Adrenergic effects (more nervousness, insomnia, etc) +Tachycardia = SHAT

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23
Q

Venlafaxine (Effexor) CI/CAUTIONS

A

Cardiac, hepatic, or renal disease

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24
Q

Goal of antipsychotic therapy

A

relieve symptoms with minimal or tolerable adverse effects

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25
Q

Positive (activating) symptoms of psychotic disorders

A

hallucinations, delusions, racing thoughts

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26
Q

Negative symptoms of psychotic disorders

A

apathy, lack of emotion, poor or nonexistent social functioning

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27
Q

Psychotic medications: promoting adherence

A

Ensure that the medication is taken

Encourage family members to oversee medication for outpatients

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28
Q

MOA of antipsychotics

A
  • Block dopamine receptors in the brain (limbic system, basal ganglia)—areas associated with emotion, cognitive function, motor function
  • tranquilizing effect in psychotic patients
  • Dopamine levels in CNS are decreased
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29
Q

Haloperidol (Haldol) INDICATIONS

A

Schizophrenia, acute psychosis, Tourette’s syndrome

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30
Q

Haloperidol (Haldol) SIDE EFFECTS (4)

A
  • Cause serious movement disorders known as extrapyramidal symptoms (EPS)
  • Can prolong the QT interval and cause dysrhythmias
    Respiratory depression, sleepiness
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31
Q

Haloperidol (Haldol) CI/CAUTIONS (3)

A

Parkinson’s, seizure disorders, severe depression (all because of issues with blocking dopamine)

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32
Q

Haloperidol (Haldol) BLACK BOX

A

Greater risk of death in older adult population, EPS and Withdrawal in infants exposed

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33
Q

Risperidone (Risperdal) INDICATIONS

A

Schizophrenia, Mania, drug of choice although at times expensive
Treat positive and negative symptoms

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34
Q

Risperidone (Risperdal) SIDE EFFECTS (3)

A

Fewer EPS than first generation AP
Weight gain is very common
GI problems

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35
Q

Risperidone (Risperdal) BLACK BOX

A

Fatal Agranulocytosis, Risk of Hyperglycemia, Drug increases seizure activity as dose increases

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36
Q

Risperidone (Risperdal) CI/CAUTIONS

A

seizure disorder, agranulocytosis or low WBC, caution in CV

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37
Q

Risperidone (Risperdal) MOA (why more effective?)

A

Produce moderate blockade of dopamine receptor, other receptors as well which may make it more effective

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38
Q

Lithium (Lithobid) MOA

A

Unclear, increases synthesis of serotonin

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39
Q

Lithium (Lithobid) INDICATIONS

A

Manic episodes in Bipolar disorder, can be used in Schizophrenia

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40
Q

Lithium (Lithobid) THERAPEUTIC LEVELS

A
  • 1-3 weeks to reach therapeutic effects (cover with antipsych or benzo until then)
  • Narrow Therapeutic Index- (> 1.5 mEq/L is toxic)
  • Monitor levels every 2 to 3 days at initiation of therapy, and then every 3 to 6 months
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41
Q

Lithium (Lithobid) SIDE EFFECTS

A

KIDNEY impairment, circulatory collapse, leukocytosis, goiter/ hypothyrodism

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42
Q

Lithium (Lithobid) CI/CAUTIONS

A
  • Do not take Diuretics. Diuretics cause loss of sodium and water, which increases lithium toxicity.
  • Patients with renal impairment must have dose reduced and serum blood levels carefully monitored
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43
Q

Lorazepam (Ativan) CLASS

A

Benzodiazepine

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44
Q

Lorazepam (Ativan) MOA

A

Enhance inhibitory effects of GABA

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45
Q

Lorazepam (Ativan) INDICATIONS

A
  • Relieves anxiety, tension, nervousness and produces sleep
  • Pre-op sedation
  • Prevent agitation with withdrawal
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46
Q

Lorazepam (Ativan) SIDE EFFECTS

A 
CNS depression (check respirations, emergency resuscitation equip) 
Serious adverse effect = cardiovascular collapse, bradycardia and hypotension
(2-3 days after beginning)
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47
Q

Lorazepam (Ativan) CI/CAUTIONS

A

Elderly (falls), children, resp disorders, severe kidney or liver disease

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48
Q

Lorazepam (Ativan) INTERACTIONS

A

CNS depressants, alcohol

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49
Q

Lorazepam (Ativan) ANTIDOTE

A

Flumazenil

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50
Q

Zolpidem (Ambien) CLASS

A

Sedative hypnotic

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51
Q

Zolpidem (Ambien) MOA

A

Enhances inhibitory effects of GABA, inducing sleep

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52
Q

Zolpidem (Ambien) SIDE EFFECTS

A
  • Daytime drowsiness and dizziness,
  • parasomnias (unusual behaviors that occur during sleep)
  • Amnesia (Ambulating, Eating, Driving)
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53
Q

Zolpidem (Ambien) TEACHINGS

A
  • Administer before bed with 8 hours of possible sleep

- Do not take with alcohol and other CNS depressants

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54
Q

Amphetamine and Dextroamphetamine (Adderall) CLASS

A

CNS Stimulant

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55
Q

Amphetamine and Dextroamphetamine (Adderall) MOA

A

Stimulates brain to increase amounts of Dopamine, Norepinephrine, and possibly serotonin in brain

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56
Q

Amphetamine and Dextroamphetamine (Adderall) INDICATIONS

A

ADD, ADHD and Narcolepsy

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57
Q

Amphetamine and Dextroamphetamine (Adderall) SIDE EFFECTS

A

Psychosis, Cardiovascular (HTN, Tachy), Weight loss (major issue for growing kids), Anxiety symptoms, GI distress

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58
Q

Amphetamine and Dextroamphetamine (Adderall) BLACK BOX

A

Misuse can lead to sudden cardiac death

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59
Q

Amphetamine and Dextroamphetamine (Adderall) CI/CAUTIONS

A

Hx of drug abuse, hyperthyroid,

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60
Q

Amphetamine and Dextroamphetamine (Adderall) NI

A
  • Watch blood pressure, baseline EKG, CBC and Platelet,
  • Children should time to take in morning allowing absorption and breakfast,
  • last dose at least 6 hours before bed,
  • “drug holiday” when off school
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61
Q

Atomoxetine (Strattera) CLASS

A

Selective norepinephrine reuptake inhibitor

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62
Q

Atomoxetine (Strattera) MOA

A

Selective inhibitor of norepinephrine reuptake

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63
Q

Atomoxetine (Strattera) INDICATIONS

A

ADD, ADHD (including in children), Alternative to Stimulant meds

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64
Q

Atomoxetine (Strattera) SIDE EFFECTS

A
  • Gastrointestinal reactions
  • Reduced appetite
  • Dizziness
  • Somnolence
  • Mood swings
  • Trouble sleeping
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65
Q

Parkinson’s

A

an excess of Acetylcholine and a depletion of dopamine

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66
Q

To treat parkinson’s

A

Increase dopamine, decrease acetylchonine

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67
Q

Levodopa/Carbidopa (Sinemet) MOA

A

LevoDOPA becomes dopamine in the brain. Levodopa crosses BBB

Carbidopa is the CAR that gets the dopamine there. It does NOT cross the BBB,

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68
Q

Levodopa/Carbidopa (Sinemet) SIDE EFFECTS

A 
Nausea/Vomiting
Cardiovascular
Hallucinations, CNS effects
Activates melanoma
Dyskinesias
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69
Q

Levodopa/Carbidopa (Sinemet) DRUG INTERACTIONS

A

MAO-I (risk of hypertensive crisis)

Antipsychotics block dopamine making this med ineffective

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70
Q

Levodopa/Carbidopa (Sinemet) TEACHINGS

A

High-protein foods reduce therapeutic effects- instruct patient to spread protein throughout day

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71
Q

Benztropine (Cogentin) CLASS

A

Cholinergic antagonist (anticholinergic)

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72
Q

Benztropine (Cogentin) MOA

A

Block muscarinic receptors in the striatum, inhibiting the effects of acetylcholine, and resulting in more available dopamine

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73
Q

Benztropine (Cogentin)SIDE EFFECTS

A

Anticholinergic and CNS depressing effects, risk of paralytic ileus (Nursing intervention: check bowel status)

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74
Q

Benztropine (Cogentin) INDICATIONS

A 
Parkinson disease (Reduce tremor and possibly rigidity)
Drug-induced EPS
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75
Q

Benztropine (Cogentin) CI/CAUTIONS

A

Avoided in the elderly, who are intolerant of CNS side effects

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76
Q

Benztropine (Cogentin) DRUG INTERACTIONS

A
  • Additive toxicity: Antihistamines, tricyclic antidepressants, MAOIs,
  • Additive sedative effect: Alcohol, CNS depressants
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77
Q

Alzheimer’s Disease

A

depletion of acetylcholine

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78
Q

Acetylcholinesterase

A

inhibition stops breakdown of acetylcholine

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79
Q

Donepezil (Aricept) CLASS

A

Acetylcholinesterase inhibitor

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80
Q

Donepezil (Aricept) MOA

A

Inhibits metabolism of acetylcholine in brain, making it more available.

81
Q

Donepezil (Aricept) SIDE EFFECTS

A

Nausea and diarrhea • Bradycardia • Fainting • Falls • Fall-related fractures

82
Q

Donepezil (Aricept) CI/CAUTIONS

A

Do not combine with anticholinergic drugs including First generation antihistamines (Benadryl)

83
Q

Donepezil (Aricept) OVERDOSE TREATMENT

A

Anticholinergic drugs to reverse symptoms of cholinergic crisis

84
Q

Seizures

A

neurological electrical storm

85
Q

Phenytoin (Dilantin) CLASS

A

Hydantoins

86
Q

Phenytoin (Dilantin) MOA

A

Selective inhibition of sodium channels

87
Q

Phenytoin (Dilantin) SIDE EFFECTS

A

Vision issues
Gingival hyperplasia (swollen gums)- Good oral hygiene critical
Drowsiness and CNS depression

88
Q

Phenytoin (Dilantin) DRUG INTERACTIONS

A

Oral contraceptives
Warfarin (Coumadin)
Glucocorticoids
Do not take with CNS depressants (i.e. alcohol)

89
Q

Phenytoin (Dilantin) NI

A

Monitor and maintain therapeutic levels: 10 to 20 mcg/mL

90
Q

Carbamazepine (Tegretol) CLASS

A

Dibenzepines

91
Q

Carbamazepine (Tegretol) MOA

A

Inhibit the influx of sodium through sodium channels in cortical neurons

92
Q

Carbamazepine (Tegretol) SIDE EFFECTS

A

Visual disturbances
Decreased excretion of water (fluid retention)
Bone marrow suppression (fatigue, bleeding, fever, chills, etc.)

93
Q

Carbamazepine (Tegretol) BLACK BOX

A
  • RASH (Epidermal necrolysis
    Stevens-Johnson syndrome)
  • Agranulocytosis and Aplastic Anemia
94
Q

Carbamazepine (Tegretol) CI/CAUTIONS

A

Cardiac, Myelosupression, Pregnancy, Drinking grapefruit juice can increase plasma levels.

95
Q

Carbamazepine (Tegretol) DRUG INTERACTIONS

A

Phenytoin, Phenobarbital, OC, Warfarin

96
Q

Valproic Acid (Depakote) CLASS

A

GABA Agonist

97
Q

Valproic Acid (Depakote) MOA

A

Suppress neuronal Na+ & Ca+ channels, increase GABA effects

98
Q

Valproic Acid (Depakote) INDICATIONS

A

Seizure

Bipolar disorder

99
Q

Valproic Acid (Depakote) SIDE EFFECTS

A
  • Life threatening AE: Hepatic failure and Pancreatitis (Black Box)
  • Myelosupression and Prolonged Clotting time
  • GI disturbances
100
Q

Valproic Acid (Depakote) BLACK BOX

A

Pregnancy (neural tube defect)- this med is the most dangerous for pregnant women with seizure disorder.

101
Q

Valproic Acid (Depakote) NI

A

Monitor platelets, bleeding times, liver function, serum levels

102
Q

Gabapentin (Neurontin) CLASS

A

GABA Analog (similar structure to GABA)

103
Q

Gabapentin (Neurontin) EXTRA INFO (3)

A
  • Single agent used for partial seizures
  • You will often see it clinically prescribed for : Neuropathic pain
  • Not a Scheduled Drug, but becoming more widely abused- “Johnny’s”
104
Q

Gabapentin (Neurontin) SIDE EFFECTS

A

Well tolerated

CNS: Somnolence, dizziness, ataxia, fatigue, nystagmus, peripheral edema

105
Q

Gabapentin (Neurontin) DRUG INTERACTIONS

A

Opioids may cause additive CNS depression

106
Q

Gabapentin (Neurontin) CI/CAUTIONS

A

Pregnancy, Status Epilepticus Renal impairment

107
Q

Gabapentin (Neurontin) NI

A

Assess renal function, Addiction/drug seeking potential, CNS depression

108
Q

Phenobarbital (Luminal) CLASS

A

Anticonvulsant Barbiturate

109
Q

Phenobarbital (Luminal) MOA

A

Enhances Effects of GABA

110
Q

Phenobarbital (Luminal) INDICATIONS

A

Seizures, Can also be used to induce sleep (heavy CNS depressant)

111
Q

Phenobarbital (Luminal) SIDE EFFECTS

A

Mainly related to CNS depression (Respiratory depression, sedation); Psych change, Causes dependency, Bone problems (Ricketts)

112
Q

Phenobarbital (Luminal) CI/CAUTIONS

A

Pregnancy, Respiratory issues (due to risk of resp depression), Suicide thoughts or history, Heavily metabolized in liver so no liver impairment, renal impairment.

113
Q

Phenobarbital (Luminal) DRUG INTERACTIONS

A

Oral contraceptives, Valproic Acid, Warfarin, CNS depressants

114
Q

Status Epilepticus

A

Continuous series of tonic-clonic seizures

115
Q

Management of Status Epilepticus: Goals (4)

A
  • Maintain ventilation
  • Terminate seizures: Diazepam (Valium)
  • Correct hypoglycemia
  • Initiate or continue long-term suppression drugs such as phenytoin (Dilantin)
116
Q

Management of Status Epilepticus (drug)

A

Administration of “rescue” Diazepam

- Usually non-oral route since person is seizing: IV, Intranasal, Rectal, IM

117
Q

Diazepam (Valium) CLASS

A

Benzodiazepine (same family as Ativan)

118
Q

Diazepam (Valium) MOA

A

Enhance inhibitory effects of GABA

119
Q

Diazepam (Valium) INDICATIONS

A
  • Status Epilepticus
  • Muscle relaxant
  • Anxiety
120
Q

Diazepam (Valium) SIDE EFFECTS

A 
CNS depression (check respirations, emergency resuscitation equip) 
Serious adverse effect = cardiovascular collapse, bradycardia and hypotension
121
Q

Diazepam (Valium) ANTIDOTE

A

Flumazenil

122
Q

Levothyroxine (Synthroid) FOR?

A

long-term treatment of hypothyroidism (medical supervision needed)

123
Q

Levothyroxine (Synthroid) SIDE EFFECTS

A

signs and symptoms of hyperthyroidism, tachycardia, cardiac dysrhythmias, fractures from bone loss

124
Q

Levothyroxine (Synthroid) NI

A
  • Take on empty stomach in AM
  • Take pulse before administering (100 or greater hold and contact provider)
  • Dosage individualized
  • Watch for thyroidtoxicosis
125
Q

Propylthiouracil (PTU) CLASS

A

Anti-thyroid, thionamide

126
Q

Propylthiouracil (PTU) MOA

A

Suppress synthesis of thyroid hormone in hyperthyroidism

127
Q

Propylthiouracil (PTU) DOSE DEPENDENT ON?

A

dependent on metabolism. As thyroid gets under control, less drug needed (metabolism fast at beginning, slows with med)

128
Q

Propylthiouracil (PTU) BLACK BOX

A

severe liver injury resulting in death or acute liver failure

129
Q

Propylthiouracil (PTU) SIDE EFFECTS

A

hypothyroidism, agranulocytosis, dermatologic effects, CNS effects, GI effects

130
Q

Propylthiouracil (PTU) children? older adults?

A

Good for children who have greater risks with radioactive iodine. Not preferred in older adults.

131
Q

Somatropin (Genotropin) CLASS

A

Synthetic Human Growth Hormone

132
Q

Somatropin (Genotropin) MOA

A

Stimulates skeletal, linear, muscle, and organ growth – given SQ or IM

133
Q

Somatropin (Genotropin) children? adults?

A

Used in children whose growth is impaired by deficiency of endogenous GH
May be used in adults with GH deficiency

134
Q

Somatropin (Genotropin) SIDE EFFECTS

A

not common; fewer in children

135
Q

Somatropin (Genotropin) NI/INTERACTIONS

A

Drug decreases insulin sensitivity, resulting in hyperglycemia
Interacts with glucocorticoids- do not take at same time

136
Q

Desmopressin (DDAVP) CLASS

A

Posterior pituitary hormone: Antidiuretic Hormone Replacement

137
Q

Desmopressin (DDAVP) INDICATIONS

A

Main use is diabetes insipidus- disorder of insufficient Antidiuretic Hormone, which causes excessive dumping of urine and dehydration

138
Q

Desmopressin (DDAVP) CI/CAUTIONS

A

Creatinine clearance of less than 50 = contraindication

139
Q

Desmopressin (DDAVP) ROUTE

A

Given oral, intranasal, and IV

140
Q

Desmopressin (DDAVP) BLACK BOX

A
  • hyponatremia may develop and lead to seizures

- changes in fluid volume status may result in cardiac arrest in clients with known cardiovascular disease

141
Q

Hydrocortisone (Solu Cortef) MOA

A

Glucocorticoid or Corticosteroid

142
Q

Hydrocortisone (Solu Cortef) INDICATIONS

A

Useful in acute and chronic adrenal insufficiency
(Addison’s disease)
Lifelong therapy in these situations

143
Q

Hydrocortisone (Solu Cortef) older adults?

A

need lower doses

144
Q

Hydrocortisone (Solu Cortef) BLACK BOX

A

clients should not receive live virus vaccines when taking hydrocortisone

145
Q

Hydrocortisone (Solu Cortef) when to increase dosage?

A

times of stress

146
Q

Hydrocortisone (Solu Cortef) time?

A

Need to take majority by 0900 each day to prevent HPA suppression

147
Q

Conjugated Estrogen (Premarin) CLASS/MOA

A

Synthetic estrogen- Mimics hormone estrogen

148
Q

Conjugated Estrogen (Premarin) INDICATIONS

A

Relieve vasomotor symptoms of menopause

149
Q

Conjugated Estrogen (Premarin) SIDE EFFECTS (MINOR)

A

GI/ Fluid retention/Weight gain/ depression

150
Q

Conjugated Estrogen (Premarin) SIDE EFFECTS (MAJOR)

A
  • Thromboembolic events
  • Risk of breast cancer when given with progestin
  • Dementia in postmenopausal women
151
Q

Conjugated Estrogen (Premarin) BLACK BOX

A

Stroke

152
Q

Conjugated Estrogen (Premarin) CI/CAUTIONS

A

Liver disease, those at risk for any of above disorders, those with family Hx of repro cancer, Smoking, Fibroids, UNDIAGNOSED vaginal bleeding

153
Q

Conjugated Estrogen (Premarin) DRUG INTERACTIONS

A

Anticonvulsants, barbiturates, Rifampin

154
Q

Conjugated Estrogen (Premarin) NI/TEACHINGS

A

Use for the shortest period of time possible. If you still have a uterus you must also take a progestin while taking this to prevent endometrial buildup that leads to endometrial cancer.

155
Q

Medroxyprogesterone acetate (Provera, Depo-Provera) CLASS/MOA

A

Synthetic Progestin that mimics naturally occurring hormone Progesterone

156
Q

Medroxyprogesterone acetate (Provera, Depo-Provera) INDICATIONS

A
  • Decrease hyperplasia of uterine lining
  • Changes proliferative endometrium into secretory
  • Suppress pituitary hormones to inhibit ovulation (Depo Provera)
157
Q

Medroxyprogesterone acetate (Provera, Depo-Provera) SIDE EFFECTS

A

Headache/ Migraines/ Depression/Vision changes/loss/Weight gain
Irregular vaginal bleeding
GI Upset with nausea and vomiting

158
Q

Medroxyprogesterone acetate (Provera, Depo-Provera) BLACK BOX (3)

A
  • Bone loss with Depo Provera

- Increased risk of cardiac complications, thromboembolic events

159
Q

Medroxyprogesterone acetate (Provera, Depo-Provera) CI

A
  • CV disease
  • Hx of thromboembolic event or cerebral hemorrhage
  • renal disease (progestin metabolites excreted in urine)
  • hepatic disease (metabolism of progestin occurs in liver)
160
Q

Conjugated estrogen-medroxyprogesterone (Prempro)

A

Conjugated Estrogen (Premarin) and Medroxyprogesterone acetate (Provera) combined in one pill

161
Q

Conjugated estrogen-medroxyprogesterone (Prempro) FOR?

A

Created for women with an intact uterus who need to take Progestin with Estrogen HRT to reduce endometrial hyperplasia and subsequent risks

162
Q

Estradiol & Norethindrone (Ortho-Novum) CLASS/MOA

A

Synthetic Estrogen and Progestin used to suppress menstrual cycle

163
Q

Estradiol & Norethindrone (Ortho-Novum) INDICATIONS

A

Contraception, Acne, PMDD, Menstrual disorders

164
Q

Estradiol & Norethindrone (Ortho-Novum) SIDE EFFECTS (9)

A
  • Nausea/ Vomiting (take with food or at bedtime to reduce)
  • Thromboembolism/MI/stroke/ - Cardiovascular (Smoking significantly increases risks)
  • Gallbladder disease
  • Edema/weight gain/headache
165
Q

Estradiol & Norethindrone (Ortho-Novum) CI/CAUTIONS

A
  • 35+ smoking
  • Liver issues
  • Reproductive cancers in your family- esp Breast
  • Clot/ stroke Hx
  • Migraine with Aura
166
Q

Estradiol & Norethindrone (Ortho-Novum) DRUG INTERACTIONS

A

Antibiotics, Anticonvulsants, Barbiturates, Griseofulvin- (Increase chance of pregnancy when combined)

167
Q

ACHES

A

Abdominal pain
Chest pain
Headaches
Eye problems
Swelling and/or severe leg aching or pain
- Warning sign for blood clot, impending thromboembolic event in women taking Estrogen contraceptives or Hormone replacement therapy

168
Q

Oxytocin (Pitocin) MOA

A

Mimics oxytocin that naturally occurs in body

169
Q

Oxytocin (Pitocin) INDICATIONS

A
  • Induces or augments labor by increasing strength , frequency and length of uterine contractions
  • Control of postpartum bleeding
170
Q

Oxytocin (Pitocin) SIDE EFFECTS

A
  • Hyperstimulation (bad for baby)
  • Uterine rupture
  • Post delivery atony when used intrapartum (risk for bleeding)
171
Q

Oxytocin (Pitocin) CAUTIONS

A

Potentiates Hypertensive effects of other drugs

172
Q

Magnesium sulfate MOA

A

Decreases uterine contraction
Decreases neuromuscular conduction
Decreases acetylcholine release
Causes vasodilation

173
Q

Magnesium sulfate INDICATIONS

A

Premature onset of labor

Pre-eclampsia and eclampsia

174
Q

Magnesium sulfate SIDE EFFECTS

A
  • CNS depression, Heart and Reflexes depression
  • Flushing, sweating, hypotension
  • Flaccid Paralysis
175
Q

Magnesium sulfate CI/CAUTIONS

A

Additive effect with CNS depressants

176
Q

Alendronate (Fosamax) CLASS

A

Bisphosphonate

177
Q

Alendronate (Fosamax) INDICATIONS

A

Osteoporosis

178
Q

Alendronate (Fosamax) MOA

A

Suppresses Osteoclasts

179
Q

Alendronate (Fosamax) SIDE EFFECTS

A
  • Esophagitis, dysphagia, esophageal ulcers
  • Headache, Muscle Pain, Decrease in serum calcium
  • Atypical femur fracture/Osteonecrosis of the jaw (unusual AE)
180
Q

Alendronate (Fosamax) NI

A

Full glass of WATER, not juice or coffee, 30 minutes before breakfast and other drugs, Upright 30 minutes after to promote absorption and decrease gastric irritation

181
Q

Alendronate (Fosamax) CI/CAUTIONS

A

Must be able to sit up for 30 min, No renal impairment

182
Q

Alendronate (Fosamax) DRUG INTERACTIONS

A

ASA, NSAIDS, Antacids & Ca+ 2 hours apart from admin

183
Q

Testosterone

A

Man made version of naturally occurring testosterone in the body

184
Q

Testosterone INDICATIONS

A

Androgen deficiency, impotence, growing boys with sex hormone deficiency, some female libido issues

185
Q

Testosterone SIDE EFFECTS

A

masculine characteristics, Acne, Hair loss,
Hypercalcemia, bitter taste, mouth irritation, gum tenderness
Jaundice, Edema

186
Q

Testosterone CI/CAUTIONS

A

Liver disease

Prostate issues

187
Q

Finasteride (Proscar) CLASS

A

5 Alpha Reductase Inhibitor

188
Q

Finasteride (Proscar) MOA

A

Shrinks prostate so urine can pass

189
Q

Finasteride (Proscar) INDICATION

A

Benign Prostatic Hyperplasia (BPH)

190
Q

Finasteride (Proscar) SIDE EFFECTS

A

Sexual dysfunction, feminine characteristics enhanced in men (i.e. breast growth)

191
Q

Finasteride (Proscar) CI/CAUTIONS

A

Pregnant women should not handle this med
Children should not take
Can not give blood while taking

192
Q

Finasteride (Proscar) DRUG INTERACTIONS

A

Testosterone, Anticholinergics, Saw Palmetto (herbal)

193
Q

Sildenafil (Viagra) CLASS

A

Phosphodiesterase type 5 (PDE5 Inhibitor)

194
Q

Sildenafil (Viagra) MOA

A

Smooth muscle relaxation and vasodilation

Enhances erection by increasing blood flow to penis, vasodilating effects

195
Q

Sildenafil (Viagra) INDICATIONS

A

Erectile dysfunction: does not cause an erection in someone unable to get an erection (impotence), enhances

196
Q

Sildenafil (Viagra) SIDE EFFECTS

A

Increased risk of hypotension
Headache, Facial flushing, nasal congestion, Dizziness (vasodilation symptoms)
Permanent loss of vision (rare), loss of hearing (rare)
Priapism (Persistent and painful erection)

197
Q

Sildenafil (Viagra) DRUG INTERACTIONS/CI/CAUTIONS

A

Nitrates, Alpha blockers, Antifungals, Erythromycin, antiviral, antiretrovirals, Fatty foods decrease absorption, alcohol

198
Q

Sildenafil (Viagra) TEACHINGS

A

Onset 20-60 minutes, lasts up to 4 hours

Only take once in a 24 hour period

Pharm 2 (5 decks)

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