Pharm - Exam 4 Flashcards
Omeprazole
Prilosec / Proton Pump Inhibitor
Reduces acid secretion in the stomach by irreversibly binding H+, K+, ATPase.
Primary use is for short term 4-8wk therapy for peptic ulcers and GERD.
Administer before breakfast on an empty stomach; may be administered with antacids; capsules and tablets should not be chewed/divided/crushed.
Famotidine
Pepsid / Histamine H2 Antagonist
Inhibits the action of histamine at the H2 receptor site, located primarily in the gastric parietal cells, resulting in inhibition of gastric secretion.
ST treatment of active duodenal ulcers and gastric ulcers after healing of active ulcers.
use cautiously if there’s renal impairment, or if the pt is pregnant/lactating
children age 1-16y dosage: 0.5 mg.kg.day as a single bedtime dose or in 2 divided doses (up to 40 mg daily)
Aluminum Hydroxide
AlternaGEL; antiheartburn/Antacid
Administer aluminum hydroxide antacids at least 2 hours before or after other drugs because absorption could be affected.
Drug/drug: use with sodium polysterene sulfonate may cause systemic alkalosis.
Herbal/Food: aluminum antacids may inhibit the absorption of daily iron.
Ginger 1
It has been shown to stimulate appetite, promote gastric secretions, and increase peristalsis. Its effects appear to stem from direct action on the GI tract, rather than on the CNS.
Its widest use is for treating nausea, including that caused by motion sickness, pregnancy morning sickness, and in cancer chemotherapy when used as a supplement to traditional anti-nausea drugs. Ginger may reduce the pain and disability associated with osteoarthritis.
Psyllium
Metamucil; laxative
Mechanism of action: swells and increases size of fecal mass
Mix with at least 8 o z of water, fruit juice, or milk, and administer immediately. Follow each dose with an additional 8 o z of liquid.
Observe older adults closely for possible aspiration.
Psyllium should not be administered to patients with undiagnosed abdominal pain, intestinal obstruction, or fecal impaction.
Psyllium may decrease the absorption and effects of warfarin, digoxin, nitrofurantoin, antibiotics, tricyclic antidepressants, carbamazepine, and salicylates.
Diphenoxylate
Lomotil / Antidiarrheal & Opioid
Slows peristalsis, allowing time for additional H20 reabsorption from the colon and more solid stools. Atropine is added to discourage from taking too much.
No analgesic properties and low potential for abuse.
Adverse effects could be dizziness/drowsiness; should not drive or operate machinery.
Overdose can be serious; use naloxone.
Sulfasalazine
5-aminosalicylate, sulfonamide
approved for mild-mod ulcerative colitis in age2+
Off label used for Crohn’s disease.
Approved also for rheumatoid arthritis and is a DMAR
Sulfasalazine inhibits mediators of inflammation in the colon, such as prostaglandins and leukotrienes.
Contraindicated in patients with sulfonamide or salicylate hypersensitivity, urinary obstruction, and with caution in dehydrated patients. Can increase insulin secretion and worsen hypoglycemia, use with caution in diabetics.
Overdose will cause pain, anuria, drowsiness, gastric distress, nausea, seizures, and vomiting. Treatment is supportive.
Ondansetron
Zofran
Antiemetic
Serotonin (5-HT3) Receptor Antagonist
Ondansetron acts by blocking serotonin receptors in the GI tracts, as well as the chemoreceptor trigger zone in the brain.
Start at least 30 minutes prior to chemo/radiation therapy and continue for several days after.
Most common side effects are headache, dizziness, drowsiness, and constipation or diarrhea.
Pancrelipase
Creon/Pancreaze
Pancreatic Enzymes
Pancrelipase contains lipase, protease, and amylase of pork origin and is used as replacement therapy for patients with insufficient pancreatic exocrine secretions (pancreatitis and CF).
Do not crush or open enteric-coated tablets. Powder formulations may be sprinkled on food.
Give the drug 1-2 hrs before or with meals, or as directed.
Acute Pancreatitis usually gets better on it’s own.
Chronic Pancreatitis is usually associated with alcoholism.
Folic Acid
Nutriceutical
Used for megaloblastic anemia. Also given during pregnancy to help the fetus (particularly in the beginning part of the pregnancy)
This drug may cause loss of appetite, nausea, confusion, irritability, or sleep-pattern disturbance. large doses may cause a bad taste.
Do not drink alcohol.
Folic Acid and Pafolacianin E may result in reduced detection of malignant lesions.
Do not use with TEA, Barbiturates, Primidone, phenytoin.
Magnesium Sulfate
mineral/electrolyte replacement supplement
adjunctive treatment for bronchodilation in moderate to severe acute asthma and off label treatment for torsades de pointes.
Monitor for hypomagnesemia / anticonvulsant –> respirations should be at least 16 before each dose. Institute seizure precautions and test the patellar reflex (knee jerk)
May potentiate Ca2+ channel blockers and neuromuscular blocking agents.
levothyroxine
synthroid
= thyroid hormone
Levothyroxine is a synthetic form of T4 that is a drug of choice for replacement therapy in patients with low thyroid fxn. Actions are those of endogenous thyroid hormone and include loss of weight, improved tolerance to temperature, increased activity, and increased pulse rate.
Administer at the same time every day, preferably in the morning to decrease the potential for insomnia.
Hydrocortisone
Adrenal Hormone / Corticosteroid
Cortef / Hydrocortone/Others
Hydrocortisone is a synthetic corticosteroid and drug of choice for treating adrenocortical insufficiency.
It is also available for the treatment of inflammation, allergic disorders, and can be given as an intra-articular injection to decrease severe inflammation in affected joints.
Administer exactly as prescribed and at the same time every day. Administer oral formulations with food.
Hydrocortisone may increase serum values for glucose, cholesterol, sodium, uric acid, or Ca2+. May decrease serum values of K+ and T3/T4.
Insulin
Parenteral drug for diabetes; pancreatic hormone
Short-acting hypoglycemic drug
Insulin promotes cellular uptake of glucose, amino acids, and potassium.
Ensure that patient has sufficient food and is not hypoglycemic before administration of insulin.
Regular insulin is the only type of insulin that may be used for IV injection.
Rotate injection sites; use sites not used at home when in the hospital.
Administer ~30 minutes before meals so insulin will be absorbed.
Onset = 30-60 min subQ; 15 min IV
Peak = 2-3hr SubQ; 30-60 min IV
Duration = 3-6h subQ; 30-60 min IV
Overdose causes hypoglycemia. Mild cases are treated with oral glucose and severe episodes are treated with parenteral glucagon or IV glucose.
Metformin
Antidiabetic drug; Biguanide
Metformin reduces fasting and postprandial glucose levels by decreasing the hepatic production of glucose (gluconeogenesis) and reducing insulin resistance. It does NOT promote insulin release from the pancreas and actions don’t depend on stimulating insulin release, so it is able to lower glucose levels in patients who no longer secrete insulin.
off label –> polycystic ovary syndrome.
Onset = <1hr
Peak = 1-3hr reg; 4-8 hr ER
Duration = 12 hr reg; 24 h ER
Black Box: lactic acidosis is a rare, potentially fatal side effect. Risk is increased for patients with CKD or any condition that puts them at risk for increased lactic acid production, such as liver disease, severe infection, excessive alcohol intake, shock, or hypoxemia.
