Pharm Exam 2 Flashcards
Morphine and Oxycodone
PAIN
CNS Depressant
-sedation
-orthostatic hypotension
-bradycardia
Constipation and urinary retention
NV
Cough suppression
Pupil constriction
Toxicity
CNS depression -> severe respiratory depression (decreased rate of breathing)
CM
-coma
-respiratory depression
-pinpoint pupils
Naloxone
OPIOID OVERDOSE ANTIDOTE
Reversal of analgesia
Increased BP
Tremors
Hyperventilation
Rapid pulse
Aspirin, Ibuprofen, Naproxen
PAIN, FEVER, INFLAMMATION
GI irritation and ulceration/bleeding
-care, take with meals
-CI peptic ulcer, irritates stomach lining
Bleeding
-CI for bleeding disorder, thins blood
-withdraw 1 week before surgery/birth
Renal impairment (from reduced blood flow)
Reye’s Syndrome (brain dysfunction, liver damage)
Allergic reactions
-urticaria
-nasal polyps
-asthma
Pregnancy and lactation, birth defects, drug can leak into break milk
Toxicity (>12g)
“Salicylism”
-tinnitus
-hearing-loss
-hyperventilation
-NV
-acid-base imbalance
-dehydration
Celecoxib
PAIN, FEVER, INFLAMMATION
Adverse CV effects = last choice therapy
Acetaminophen
PAIN, FEVER (not inflammation)
Risk of renal or hepatic (liver) toxicity
Toxicity
-NV
-sweating, pallor
-hepatic damage
Prednisolone
ANTI-INFLAMMATORY GLUCOCORTICORD
Susceptibility to adrenal suppression
Osteoporosis and muscle wasting
GI irritation, take with food
Electrolyte disturbances (hypernatremia, hypokalemia)
Increase in blood glucose
Susceptible to infections
Mood disturbances
Cushing’s Syndrome (too much sugar)
Methotrexate
DMARD FOR RA
Hepatotoxic
NVD
Bone marrow suppression
CI in pregnancy
Etanercept
DMARD FOR RA
Susceptibility to infection
Colchicine
ACUTE GOUT
GI
Sumatriptan
MIGRAINE
Nausea, weakness (from high amt of vasoconstriction)
Vasoconstriction
-numbness
-tingling
-CP, tightness
-heavy arms
-CI for patients with CV problems, such as angina, obesity, HTN, congestive heart failure
No smoking, no cold weather
Ergotamine & Dihydroergotamine
MIGRAINE
Nausea, weakness (from high amt of vasoconstriction)
Vasoconstriction
-numbness
-tingling
-CP, tightness
-heavy arms
-CI for patients with CV problems, such as angina, obesity, HTN, congestive heart failure
No smoking, no cold weather
CNS excitation effects
Uterine cramping (spasms, can be used in post partum hemorrhages to constrict bleeding)
Toxicity: ergotism
-burning pain (vasoconstriction may cause vessels to close -> blood pools -> throbbing)
-hallucinations
Cimetidine & Ranitidine
HYPERACIDITY, GERD, ULCERS
CNS effects (disorientation, confusion, changes in pH with elderly
Pneumonia
*caution if impaired renal or hepatic function
-inhibits liver metabolising enzyme -> care with patients taking phenytoin, warfarin
-less acid -> impairs absorption
Omeprazole
(for hyperacidity, GERD, ulcers)
Side effects
-headache
-dry mouth
-diarrhea
Sucralfate
(for hyperacidity, GERD, ulcers)
very few side effects
Ondansetron
ANTIEMETIC
Side effects
-headache
-constipation
-diarrhea
CI: hx of allergic reactions
Chlorpromazine
ANTIEMETIC
EPSE (movement)
Sedation
CI = Parkinson’s
Nabilone
ANTIEMETIC
Side effects
-mental disturbances
-drowsiness
-abuse/dependence
CI: pt with psychiatric disorders
Scopolamine & Diphenhydramine
ANTIEMETIC
Dry mouth
Polycarbophil & Methylcellulose
SLOW-ACTING LAXATIVE
Side effects
-least harmful
-mix with fluid
Docusate
SLOW-ACTING LAXATIVE
Side effects
-mild abdominal cramping (from all the peristalsis)
Bisacodyl & Senna
INTERMEDIATE-ACTING LAXATIVE
Cramping (from all the movement)
Laxative abuse (bowel becomes dependence and losing own intrinsic factor)
Laxative salts
INTERMEDIATE-ACTING LAXATIVE
Cramping
Penicillin G, Amoxicillin, Oxacillin, Amox + Clavulanate, Ceftriaxone, Ceftaroline
BETA-LACTAM (CELL WALL)
Allergic reactions
-rashes
-urticaria
-anaphylaxis
-guidelines (be careful, skin tests)
GI distress
-take with food
-divide dose
-use probiotics
-water after
Tetracyclines & Minocycline
PREVENT BACTERIAL PROTEIN SYNTHESIS
GI disturbances
Superinfection
*May stain teeth in children under 8, not to be given
Photosensitivity
Hepatotoxicity
Food and drug interactions (avoid antacids, milk/dairy, no mineral supplements)
Chloramphenicol
PREVENT BACTERIAL PROTEIN SYNTHESIS
GI upset
Superinfection
Erythromycin & Clarithromycin
PREVENT BACTERIAL PROTEIN SYNTHESIS
GI disturbances
Superinfections
Ototoxicity: erythromycin
Kidney and liver damage
Clindamycin
PREVENT BACTERIAL PROTEIN SYNTHESIS
GI disturbances
Superinfection
-AAPMC
Rashes
Anaerobic infections
Watery, bloody stools
Gentamicin
PREVENT BACTERIAL PROTEIN SYNTHESIS
Triad:
-Nephrotoxicity (kidney, renal failure; 3L of water a day)
-Ototoxicity (toxic to ear/cranial nerve 8)
-Neuromuscular blockade (problems breathing, muscle impairment, watch for pt with Parkinson’s)
Headache, confusion, tremors
Blood dyscrasias (blood count is off)
Ciprofloxacin
INHIBIT DNA REPLICATION
Triad:
-GI: NVD
-CNS: dizziness, headache, tinnitus, insomnia
-cartilage and tendon damage (do not give to children, interferes with growth cartilage)
Allergies: rash, urticaria, photosensitivity
Superinfections
Metronidazole
ANTIBIOTIC FOR ANAEROBIC INFECTIONS
GI: NVD
Metallic taste in mouth
Abdominal cramps
May discolor urine
CNS: dizziness, headache
Damages DNA in pregnancy
Violent reaction with alcohol (flushing, nausea, headaches, cramps)
Vancomycin
ANTIBODIES FOR NOSOCOMIAL INFECTIONS
Triad:
-IV infusion = nausea, flushing, itching
-histamine release -> “red neck”
-nephrotoxicity (most common, decreased kidney function -> drink more water)
Ototoxicity
Daptomycin
ANTIBODIES FOR NOSOCOMIAL INFECTIONS
GI
CNS
Myopathy (muscle pain)
Linezolid
ANTIBODIES FOR NOSOCOMIAL INFECTIONS
GI