pathopharm 1 drugs mod 7 Flashcards
class: adsorbents
bismuth subsalicylate
bismuth subsalicylate MOA
-coats the walls of the GI tract
-bind the causative agent for elimination
(activated charcoal)
bismuth subsalicylate SE
(in large amounts)
-increased bleeding time
-constipation
-dark stools and darkening of tongue
class: anti motility
loperamide & diphenoxylate
loperamide & diphenoxylate MOA
slows peristalsis by reducing rhythmic contractions & smooth muscle tone of the GI and also has a drying effect
loperamide & diphenoxylate SE
-urinary retention
-headache, dizziness, anxiety, drowsiness
-bradycardia, hypotension
-dry skin
-flushing
what if added to diphenoxylate makes it no longer be able to be sold over the counter
atropine (causes all the SE)
class: probiotics
-lactobacillius organism (bacid, culturelle)
-saccharomyces boulardii (florastor)
probiotic MOA
replenish bacteria and restore normal flora
lactobacillius organism
bacteria that make up the majority of normal flora of the gut
saccharomyces boulardii
C.Diff for treatment by replenishing bacteria & restoring normal flora (need supplement)
class: bulk forming laxatives
psyllium
psyllium MOA
-act similar to dietary fiber
-absorb water into the intestine, increasing bulk
-distends bowel to initiate reflex bowel activity and bowel movement
psyllium SE
-impaction above strictures
-fluid/lyte imbalance (less likely than others)
-gas formation
-esophageal blockage
class: emollient
docusate sodium & mineral oil
for impaction, both prevent water from moving out of intestines
docusate sodium MOA
lubricates fecal material and walls, promotes fat absorption into fecal mass
docusate sodium uses
prevent opioid induced constipation
docusate sodium route
PO
mineral oil MOA
lubricate intestines
mineral oil uses
fecal impactions
mineral oil route
PO or PR
docusate sodium & mineral oil SE
-skin rashes
-decreased absorption of vitamins
class: hyperosmotic
-glycerin
-lactulose
-polyethylene glycol
glycerin use
mild & seen in children
lactulose use
liver disease & hepatic encephalopathy
digested in large intestine creating a hyper-osmotic environment which draws water into the colon + reduces blood ammonia levels
polyethylene glycol use
giver before diagnostic surgical bowel procedures bowel prep for col
glycerin, lactulose
& polyethylene glycol MOA
-increasing water content in feces
-promotes distention, peristalsis & evacuation
glycerin, lactulose
& polyethylene glycol SE
-abdominal bloating
-rectal irritation
-electrolyte imbalance
class: saline
-magnesium salts
-sodium salts
saline MOA
increase osmotic pressure and draw water into colon
saline SE
-mag toxicity
-lyte imbalance
-cramping, diarrhea
class: stimulants
-bisacodyl
-senna
most likely to cause dependence
stimulants use
constipation or whole bowel evacuation
stimulants SE
-nutrition malabsorption
-gastric irritation
-lyte imbalance
antihistamines
suppress histamine mediator activity
immunosuppressants (including corticosteroids)
-suppress cell mediated immunity
-anti inflammatory
epinephrine
halts mediator activity (turns off mast cells)
-mimics SNS
-works on alpha (arteries) & betas (<3, lungs, arteries & skeletal muscles)
class: vasopressors, bronchodilator, anti asthmatic, vasoconstrictor
epinephrine
epinephrine indication
severe allergic reactions, cardiac arrest, severe asthmatic attack
epinephrine SE
CV: angina, arrhythmias, HTN, tachycardia
CNS: nervousness, restlessness, tremor
what is epinephrine dosage based on
wt based
epinephrine nursing considerations
-monitor vitals
-overdose is fatal, have co worker check
-teach to use exactly as directed
trimethoprim
-1st line for lower UTIs
-do not give w/ sulfa allergies
ciprofloxacin
given for lower UTIs if sulfa allergies are present
nitrofurantoin
for recurring lower UTIs
phenazopyridine MOA
local analgesic action (used for pain relief r/t UTI)
phenazopyridine SE
reddish/orange urine (dye used in paint)
class: antispasmotic
mirabengron
mirabengron MOA
selectively stimulates beta-3 adrenergic receptors, relaxing bladder smooth muscle
mirabengron SE
-HTN
-Urinary retention
-UTI
-Headache
class: anti cholinergic
oxybutynin
oxybutynin MOA
block the action of acetylcholine (acetylcholine activates smooth muscle contractions) can be extended release
oxybutynin indications
overactive bladder, incontinence
oxybutynin SE
-dry mouth
-constipation
class: serotonin re uptake inhibitor (SSRI)
fluoxetine
fluoxetine MOA
-inhibitors of serotonin at nerve endings
-more serotonin is available at the nerve endings
fluoxetine SE
-wt gain
-GI & dry mouth
-CNS: headache, nervousness, insomnia
-sexual dysfunction
-serotonin syndrome (serotonin overall)
-withdraw if not weaned
-suicide risk
-neonatal effect (small risk of pulmo HTN)
fluoxetine advantages
-less severe & fewer side effects
-few drug-drug/drug-food
fluoxetine nursing consideration
avoid use w/ MAO inhibitors
class: serotonin & norepinephrine reuptake inhibitors
venlafazine
venlafazine MOA
blocks neuronal activity of serotonin and norepinephrine (more serotonin in synaps)
venlafazine SE
nausea, headache, anorexia, insomnia, somnolence, sexual dysfunction, withdrawal syndrome, sweating, blurred vision, increased LFTs
venlafazine nursing considerations
do not use with MAO inhibitors
class: tricyclic antidepressants
amitryptaline
amitryptaline MOA
blocks reuptake of 2 momoamine transmitters, norepinephrine & serotonin, making more available in the synapse
anticholinergic effects
“hot as a hare”
“dry as a bone”
“blind as a bat”
“red as a beet”
“mad as a hatter”
amitryptaline SE
-sedation
-orthhostatic hypotension
-sexual dysfunction
-cardiac toxicity
-anticholinergic effects
amitryptaline nursing consideration
interaction with MAO
HTN crisis
class: monoamine oxidase inhibitors
phenelzine
phenelzine MOA
inhibits MAO enzyme found in the liver, intestinal wall and terminals of neurons (MAO convertd norepi, 5-HT, and dopamine to inactive product soooo decreased MAO increases availability of neurotransmitters at the nerve ending)
phenelzine SE
-food/drug interactions (charcuterie board + red wine)
-CNS stimulation
-ortho hypo
-can lead to rapid increases in BP, stroke, coma, sweating, tremors
-drug/drug interaction
class: atypical antidepressants
ketamine & trazadone
ketamine
-low dose nasal
-pain mgt
-rapidly help w/ suicidality & other serious symptoms
ketamine SE
-perceptual disturbances
-dissociation
trazadone
-2nd line agent
-blockage of 5-HT reuptake
-minimal effectiveness in depression
-often used to help w/ anxiety or insomnia
class: benzodiazepines
lams & pams
-alprazolam
-diazepam
-lorazepam
lam & pam MOA
enhance inhibitory effects of GABA in CNS (**increasing GABAs relaxing effect, we inhibit anxiety w/ gaba)
lam & pam indications
generalized anxiety disorder & panic disorders
lam & pam SE
-CNS depresssion, LOC decreased
-w/drawal
-memory loss
-respiratory depression
lam & pam nursing considerations
-teratogneic, do not take pregnant
-avoid grapefruit
-schedule 4, mod risk for abuse
-do not mix w/ other meds that decrease LOC (alc, benny, opioids)
benzo antidote
flumazenil
class: medication assisted treatment opioids
methadone
methadone SE
-lightheaded
-hives
-chest pain
-tachycardia
-hallucinations
-confusion
methadone nursing considerations
it to help people who are addicted to opioids but people can become addicted but at a lesser level (get at a clinic)
buprenorphine
partial opioid agonist
naloxone
opioid antagonist, blocks opioid receptor
buprenorphine & naloxone SE
-headache
-opioid w/drawal symptoms
-anxiety
-insomnia
-sweating
-depression
-constipation
-nausea
