Patho 1 & 2 Overall Review Flashcards
thiazide diuretics use, MOA, and nursing considerations
use - HTN, FVE
MOA - inhibits the reabsorption of Na, K, and Cl which decreases CO in distal convoluted tubule
NC - monitor K levels, may encourage foods high in K
loop diuretics use, MOA, major SE, and NC
HTN, FVE
MOA - encourages kidneys to reabsorb sodium within the loop of henley
SE - ototoxicity
NC - monitor K, may receive KCl
potassium sparing diuretics use, MOA, SE
use - HTN, FVE
MOA - blocks aldosterone, retains K, excretes Na and water
SE - endocrine effects
beta blockers use, MOA, SE, NC
use - HTN, cardiovascular disease
MOA - selectively blocks B1 which decreases HR and contractility
SE - bradycardia, hypotension, masks hypoglycemia
NC - taper, hold if HR <60 or systolic BP <100
alpha 2 adrenergic antagonist prototype, use, MOA, SE, NC
prototype - clonidine
use - HTN
MOA - decreases outflow of the SNS, decreases stimulation of the adrenergic receptors
SE - rebound HTN, may worsen pre-existing liver disease
NC - give at night to avoid drowsiness
ACE Inhibitors use, MOA, SE, NC
use - HTN
MOA - block angiotensin converting enzyme which inhibits the production of angiotensin II
SE - first dose hypotension, cough*, angioedema
NC - use cautiously in those with renal disease, monitor WBC and K
angiotensin receptor blockers use, MOA, SE, and NC
use - HTN, HF, CVA
MOA - blocks angiotensin II
SE - angioedema
NC - teratogenic
renin inhibitors MOA and NC
MOA - inhibits renin
NC - teratogenic
calcium channel blockers MOA and SE
MOA - blocks cell’s access to calcium which decreases contractility and conductivity
SE - orthostatic hypotension, edema
vasodilators MOA
causes relaxation to arterial smooth muscles in the veins, decreases vascular resistance
HMG-CoA Reductase Inhibitors MOA, SE, NC
“statins”
MOA - inhibit HMG-CoA which reduces production of cholesterol in the liver
SE - myopathy, rhabdomylosis, AKI, and hepatotoxicity
NC - take with food, avoid drugs that increase the risk of myopathy, avoid alcohol
rapid acting insulin name, timings, and NC
lispro
starts working in 15 minutes, peaks in 30, and lasts for 2-4 hours
administered with meals
short acting insulin name, timings
regular
starts working in 30 minutes, peaks in 2 hours, and works for up to 8 hours
intermediate acting insulin name, timings
NPH
starts working in 2 hours, peaks in 8 hours, and works for 16 hours
long acting insulin name, timings
glargine
once a day dosing at night
starts working in 70 minutes, does not peak, and works for up to 24 hours
sulfonylureas
glipizide and glyburide
treats hyperglycemia
stimulates the secretion of insulin
teratogenic
metformin
treats DM II
decreases glucose production
do not use with elevated ALT, 48 hours after contrast, or with HF, KF, LF, of alcoholics
DPP4 Inhibitors
“gliptins”
increases insulin release and reduces glucagon release
GLP-1 receptor agonists
-tide
stimulates glucose dependent release of insulin
do not use in those with pancreatitis, medullary thyroid carcinoma, or renal disease
BBW - thyroid c-cell tumors
SLG2 Inhibitors
-flozin
prevents kidneys from reabsorbing glucose
contraindicated with RF
glucagon
hypoglycemia antidote
half life is only 25-35 mins
orlistat
reduces fat absorption by 30%
BBW - liver injury
SE - flatulance
rebound effect*
cholinesterase inhibitors
donepezil
used for alzheimers
blocks acetylcholinesterase
given PO at bedtime
NMDA receptor agonist
memantine
blocks NMDA receptors
used for alzheimers
SSRI
fluoxitine
blocks seretonin
SE - seretonin syndrome
avoid use with MAOI
SNRI
venlafaxine
blocks seretonin and norepi
void use with MAOI
tricyclic antidepressant
amitriptyline
blocks reuptake of seretonin and norepi
SE - anticholinergic effects
avoid with MAOI
MAOI
phenelzine
blocks MAO enzyme in liver walls
SE - HTN crisis if taken with tyramine
many drug-drug interactions
used when nothing else works
ketamine as an antidepressant
NMDA receptor agonist
rapid help with suicidality
SE - disassociation
benzos
-lam -pam
increases GABA
SE - CNS depression, withdrawal
teratogenic
do not mix with other LOC meds or fatty foods
antidote for benzos
flumazenil
methadone
mu-agonist
helps those with addiction stay clean
may receive daily from a clinic
buprenorphine and naloxone
helps those who suffer with addiction recover quickly
SE - withdrawal
works quickly
gabapentin
lessens neuronic firing
can be partially revered with naloxone
treats neuropathic pain
NSAIDS
blocks prostaglandin and COX enzyme
nonselective - GI risks
selective - CV risks
no aspirin for kids
antidote for acetaminophen
acetylcysteine
opioids
binds to mu receptors
do not give with any other CNS depressants
antidote for opioids
naloxone
phenytoin
anti seizure
increases the threshold of the motor cortex
BBW - risk of suicidal ideation, depression
teratogenic
opioid withdrawal timeline
starts
peaks 72 hours later
lasts for 1 month
benzos withdrawal timeline
starts in 6-12 hours
peaks in 2 weeks
lasts for months-years
alcohol withdrawal timeline
starts in 8 hours
peaks in 1-3 days
lasts for weeks
sodium bicarb
treats low sodium
raises blood and urine pH
monitor for cardiac symptoms
KCl
treats low K
NEVER PUSH
contraindicated in renal failure
must be on tele
sodium polystyrene
Kayexalate
treats high K
could cause intestinal obstruction
only use for those with normal bowel function
D50/Insulin
treats high K in blood
check BS before and after
mag sulfate
treats low mag
could cause confusion
mag oxide
treats long term low mag
could cause confusion, SOA, and abnormal EKG
calcium chloride
tums
treats low calcium
take with vitamin D
pegfilgrastim
treats low WBC
increases neutrophils
nystatin
binds to sterols in cell membrane
no oral admin
amphotericin B
binds to egosterol, causes cells to leak
synergistic effect if given with flucytosine
IVF must be diluted
monitor BUN and creatinine
pretreat with diphenhydramine, tylenol, or aspirin
azoles
treat superficial and systemic infections
interrupts the integrity of the cell wall
take with food, separate from antacids
fluconazole special considerations
monitor coags if on warfarin
monitor for hypoglycemia if on a sulfa drug
heparin
activates antithrombin
AE - bleeding
antidote for heparin
protamine sulfate
enoxaparin
low molecular weight heparin
activates antithrombin
inactivates Xa
antidote for enoxaparin
protamine
warfarin
blocks vitamin K
monitor PT/INR
many drug interactions
apixaban and ruvaroxiban
blocks Xa
BBW - spinal hematomas
drug interactions
monitor LFTs
aspirin as an anticoag
blocks platelet aggregation
no aspirin for kids
antidote for apixiban and ruvaroxaban
andexxa
antidote for aspirin
DDAVP
clopidogrel and ticafrelor
anti-platelet ADP blocker
contraindicated with bleeding
BBW - risk of CV events
ex of glucocorticoids and mineralcorticoids
glucocorticoids - hydrocortisone, prednisone, dexamethasone
mineral - fludrocortisone
treatments for open angle glaucoma
timolol
betaxolol
lantoprost
brimodine
dozolamide
finasteride and dutasteride
blocks the conversion of testosterone to DHT
works best when the prostate is large
tamsulosin
relaxes smooth muscle cells
sildenafil
viagra
blocks PDE-5
caution with CV disease or taking nitrates
bismuth suvsalicylate
pepto
lines the walls of the GI tract
treats diarrhea
loperamide
slows peristalsis
treats diarrhea
psyllium
absorbs water in the intestine
long term constipation use
only one okay for long term use*
docusate sodium
lubricates fecal matter
prevents constipation due to opioids
senna
bowel evacuation
most likely to cause dependence
phenazopyridine
treats pain due to a UTI
turns body fluids red or orange
epinephrine
blocks release of mediators from mast cells
for severe allergic reactions
diphenhydramine
blocks histamine release from receptors
helps get symptoms under control
avoid alcohol
SE - anticholinergic
cintirizine
loratidine
fexofenadine
blocks histamine release from receptors
keeps symptoms at bay
albuterol
mimics SNS and stimulates beta 1
relieves bronchospasm
contraindicated with uncontrolled HTN, MAOI
albuterol antidote
beta blocker
salmeterol
prevents bronchospasms
mimics SNS to relax and dilate airways
always given with an inhaled corticosteroid
has been linked to asthma related deaths
xanthine derivatives
-phylline
preventative treatment for asthma
increases levels of cAMP
many contraindications and drug interactions
no caffeine or smoking
montelukast
prevents leukotrienes from attaching to receptors on immune cells
not for acute asthma attacks, prophylaxis only
beclomethasone
inhaled corticosteroid
prevents asthma attacks
rinse mouth after
take on a regular schedule
cromolyn
stabilizes mast cells
prevents asthma attacks
isoniazid
treats TB
disrupts cell wall synthesis
could cause hepatotoxicity*
avoid antacids, rifampin, and phenytoin
BBW - increased risk of hepatitis
rifampin
treats TB
blocks protein synthesis by attacking the hydrocarbon ring
decreases effects of may drugs
ethambutol
supress RNA synthesis
could cause disease of optic nerve
not for children under 13
treats TB
streptomycin
interferes with normal protein synthesis
may cause ototoxicity and nephrotoxicity
erythropoietin alpha
mimics human erythropoietin
can increase mortality in surgery/kidney/cancer patients
stop if Hgb is >10
use lowest dose possible
ferrous sulfate
helps bone marrow cells make RBC
could cause teeth staining
take on an empty stomach
iron dextran
BBW - potential for fatal anaphylaxis
epi and CPR equipment ready
small test dose before
persistent pain, discoloration of the skin with IM
cyancobalamin
for B12 deficit
caution with folic acid due to masking B12 defecit
folic acid
concerts to an active form of folic acid after admin
can mask B12 deficiency
penecillins
disrupt cell wall synthesis, activates autolysis
penecillin SE
angioedema
interact with oral contraceptives, NSAIDs and warfarin
ampicillin SE
diarrhea, rash
renal sensitive
piperacillin and ticarcillin SE
ticarcillin - Na overload, interferes with platelet function
piperacillin - monitor for platelet function, monitor for those with renal dysfunction
cephalosporins
block cell wall synthesis
could cause rash
cefazolin - surgical prophylaxis
ceftiraxone - able to cross the BBB
carbepenems
bacterial and cell wall inhibitor
could cause seizure
vancomycin
immediately halts cell wall synthesis and causes death
ototoxicity, nephrotoxicity, and red man syndrome
gentamycin
blocks bacterial ribosomes
CNA side effects
don’t give with a neuromuscular blockade
clinidamycin
binds to ribosomes
could cause pseudomembranous colitis
very toxic
tetracyclines
inhibits protein synthesis by attaching to ribosomes
permanent discoloration of permanent teeth and enamel
contraindicated for pregnant and nursing women
ciprofloxacin
alters bacteria DNA
arthropathy
avoid in patients <16 and >60
metronidazole
blocks DNA synthesis
treats CDiff
do not take with alcohol
SE - xerostema, vaginal candidiasis
acyclovir
vaccine for herpes
interferes with viral nucleic acid synthesis
oseltamivir
vaccine for the flu
blocks neuraminidase
could cause renal impairment
gancyclovir
vaccine for CMV
blocks viral DNA polymerases
4 BBW
monitor with kidneys
zidovudine
HIV treatment
inhibits reversal of transcriptase
toxicities - severe anemia and neutropenia
efavirenz
HIV treatment
blocks reverse transcriptase
CYP450
raltegravere
HIV treatment
inhibits integrase
metabolized by UGT enzyme
lopenivir
HIV treatment
inhibits protease
could cause hyperglycemia and lipodystrophy
enfurvirtide
blocks entry of HIV into CD4
could cause pneumonia or hypersensitivity
maraviroc
blocks entry of CCR5 into CD4
BBW - liver injury
substrate of CYP3A4
