Pharm Exam 3 Flashcards
Somatotropin (Genotropin)
Used for growth.
Assess baseline ht & wt
cons: hyperglycemia
neutralizing antibodies
carpal tunnel syndrome
fatality in PWS (obesity, respiratory impairment)
glucocorticoids oppose growth
Octreotide (Sandostatin)
octreotide [Sandostatin]
anti-growth
GH receptor antagonist
IM, SQ – diarrhea, N/V
desmopressin (DDAVP)
Increases the reabsorption of water, and produces vasoconstriction of blood vessels at high doses
Water intoxication
Drowsiness, listlessness, HA then convulsions & terminal coma
Insulins
Short: lispro/aspart
Intermediate: NPH (cloudy/can be mixed with short)
Long: glargine
Short: give right before or after meal/ lispro 5-10 min before
Intermed: BID-TID
Long: daily
Reg: 30-60 min before meal
metformin
Does NOT stimulate insulin release – really no hypoglycemia risk
GI UPSET
Lactic acidosis
Sulfonylureas
GLIPPIES
Oral antidiabetic drug
TAKE WITH MEAL
HYPOGLYCEMIA, weight gain
Thiazolidinediones/Pioglitazone
Must have insulin for drug to work
Treat type 2 DM
cons: URI, HA, sinusitis, myalgia
Jardiance, Farxiga
increase glucose excretion in urine → decreasing glucose levels
Jardiance (probably the most commonly prescribed)
Farxiga: vulvovaginitis, genital infections, back pain, polyuria, inc Hct
Ozempic, Victoza
Non-insulin injectable drugs
[Victoza] medullary thyroid carcinoma
hypoglycemia, GI effects
renal impairment
weight loss
Levothyroxine (Synthroid)
Drug of choice for all forms of hypothyroidism
TAKE ON EMPTY STOMACH
Methimazole (Tapazole)
1st line for hyperthyroid
dangerous in pregnancy/lactation
Propylthiouracil (PTU)
2nd line for hyperthyroid
Preferred for:
pregnant women (1st trimester), Thyrotoxic crisis, methimazole intolerance
Radioactive idone
Used for grave’s disease
Sometimes only need one treatment
Cons: delayed effect (2-3mo), significant delayed hypothyroid (~90% of pts)
Propranolol (Inderal)
suppress tachycardia & other symptoms of Grave’s disease
beneficial in Thyrotoxic crisis
Hydrocortisone/Prednisone/
Dexamethasone
“in the sone”
treats adrenal insufficiency
ACTH – Cosynotropin (Cortosyn)
Give…wait 30 -60 minutes…measure cortisol levels
If cortisol levels rise after dose of ACTH, then the adrenals are good
morphine
Opioid: used to treat severe pain Requires patient to be conscious
fentanyl
100 x more potent than morphine
Via 3 routes
Methadone
Used for pain and opioid addicts
Hydromorphone (Dilaudid)
Less nausea but more orthostatic hypotension than morphine
More rapid onset, but shorter duration of activity than morphine
Hydrocodone/Oxycodone
Oral opiates with moderate effectiveness
Hydrocodone most widely prescribed drug in U.S.
Buprenorphine (Suboxone)
IM/IV/SL: moderate – severe pain
transdermal / SL: opioid withdrawal/dependence
Naloxone (Narcan)
Respiratory depression= Treat with naloxone (Narcan)
Opioid Agonists Moderate to Strong: reverse is naloxone
Dexmedetomidine (Precedex)
Nonopiod
Used for icu or sedation
Causes hypotension, bradycardia
Sumatriptan/triptains
Migraine treatment
vasoconstriction of intravascular vessels & vascular inflammation
abort ongoing migraine, relieve HA & symptoms
Cons: Chest – “heavy arms” or “chest pressure”
vasospasm – angina
Propofol
induction & maintenance of anesthesia, no analgesia
also for sedation
Unconsciousness in 60 sec, lasts 3-5 min
Can cause: profound respiratory depression, hypotension, BACTERIAL INFECTION
Risk for abuse
Ketamine
dissociative anesthesia, sedation, immobility, analgesia, amnesia
Adverse psychologic reactions
Drug of abuse: “special K”
Lidocaine (xylocaine)
Local anesthetic
allergic rxn rare
CNC and CV toxicity
hepatic metabolism
Chlordiazepoxide (Librium)
use in alcohol withdraw
Decrease symptoms, stabilize VS, prevent seizures & delirium tremens (DTs)
“Banana bag”
IV bag that looks yellow like bananas
Used to support ETOH withdraws
nicotine replacement
Patch: Nicoderm
Gum: Nicorette
Lozenge: Nicorette Lozenge
Nasal Spray: Nicotrol NS
Inhaler: Nicotrol Inhaler
Bupropion (Wellbutrin)
atypical antidepressant
Reduces the urge to smoke and reduces some symptoms of nicotine withdrawal, such as irritability and anxiety
Adverse effects: Dry mouth and insomnia
Midazolam (versed)
CONSCIOUS SEDATION
Cardio-resp side effects
Acetaminophen (Ofirmev)
Acetaminophen IV
Nonopiod pain management
Ketorolac (Toradol)
IM/IV pain management option for clients in the hospital/clinic setting
Succinylcholine
Patient will cease breathing thus you must be breathing for them.
Short acting Avoid use in clients with hyperkalemia
Management of malignant hyperthermia
methimazole, beta blocker (Propranolol)
migraine management
Class: Triptains (easy name)
Med: Sumatriptan
