pharm exam 4 medication Flashcards
Glucagon injectable (90º) (thigh or butt or stomach) (SQ, IM, IV)
MOA: raises blood sugar through activation of hepatic glucagon receptors, stimulating glycogenolysis and the release of glucose
indication: treat severe hypoglycemia, usually to people who are passed out, EMERGENT
SE: nausea, vomit, hyperglycemia, toxic effect can be hypokalemia
NI/CE:
CI:
aspart (novolog) (insulin meds)
rapid-acting, onset:15-30 mins, peak: 1-3 hours, duration: 3-5 hours, administer within 15 minutes before meal, side effects hypoglycemia, hypokalemia
humulin R and regular insulin (insulin meds)
short acting, onset: 30 minutes, peak: 3 hours, duration: 8 hours, administer 30 minutes before meal, side effects: hypoglycemia and hypokalemia
humulin NPH (insulin meds)
intermediate acting, onset: 1-2 hours, peak: 6 hours, duration: up to 24 hours, administer once or twice daily, side effects: hypoglycemia, hypokalemia
glargine (lantus) (insulin meds)
long-acting, onset:3-4 hours, peak: none, duration: >24 hours, administer once daily, side effects: hypoglycemia and hypokalemia
Glipizide oral (Class: Sulfonylurea)
MOA: The beta cell of the pancreas secretes insulin has a sulfonylurea receptor. When stimulated the receptor causes the beta cell to release insulin
indication: lower sugar come down
SE: hypoglycemia
NI/CE:
CI:
Metformin oral (Class: Biguanide)
MOA:
indication:type 2 diabetes
SE: nausea, diarrhea, bloating
NI/CE:
CI:
Sitagliptin (Januvia) oral (Class: DPP4 inhibitor)
MOA:
indication: incretin modulator, help lower blood sugar, type 2
SE:weight, hypoglycemia, acute pancreatitis, upper respiratory infections, serious skin reactions
NI/CE: medications should be used with caution in
clients with renal disease
CI:
Empagliflozin (Jardiance) oral (Class: SGLT2 inhibitor)
MOA: inhibits SGLT2, which transports sodium-
glucose, so it reducing glucose and sodium
reabsorption, incr. urinary glucose excretion and
sodium delivery to distal tubule
indication: help lower blood sugar type 2
SE: Glucosuria, increased urination.
May cause serious urinary tract infections
NI/CE:
CI: Patients with decreased renal
function
advantages: weight loss and decrease CV risks
Semaglutide (Wygovy) injectable (Class: GLP-1 agonists)
MOA: GLP-1 receptor in the brain makes patient feel more full after a meal
indication: weekly injectable, incretin analogs, with a reduced calorie diet and increased physical activity
SE: diarrhea, nausea, vomit, headaches, dizziness, increased sweating, indigestion, constipation, loss of appetite, BLACK BOX WARNING: thyroid cancer
NI/CE:
CI:
Prednisone (PO) glucocorticoids
MOA:
indication: Short-term to reduce inflammation. Long- term for immunosuppression
SE: imbalances, increase blood glucose, muscle weakness, peptic ulcers, thin fragile skin, cushings syndrome, mask signs, poor healing
NI/CE:
CI: never stop abruptly, lowest dose possible, treatment for osteoporosis and blood glucose levels, adrenal suppression, untreated systemic infections
Methylprednisolone (IV) glucocorticoids
MOA:
indication: Short-term to reduce inflammation. Long-term for immunosuppression
SE: imbalances, increase blood glucose, muscle weakness, peptic ulcers, thin fragile skin, cushings syndrome, mask signs, poor healing
NI/CE:
CI: never stop abruptly, lowest dose possible, treatment for osteoporosis and blood glucose levels, adrenal suppression, untreated systemic infections
Fludrocortisone (mineralocorticoid)
MOA:
indication: Aldosterone replacement in
Addison’s disease
SE: retention of sodium and water, hypertension, edema, cardiac enlargement, CHF, potassium loss, hypokalemic alkalosis
NI/CE: monitor disease or stress, surgery, infection, trauma
CI:
Levothyroxine
MOA:
indication: hypothyroidism
SE: (we are replacing thyroid hormone, so SE might show signs of hyperthyroidism), nervousness, tremors, insomnia, tachycardia, palpitations, dysrhythmias, angina, shortness of breath
NI/CE:
CI:
Propylthiouracil (PTU)
MOA: Block synthesis of thyroid hormones
indication: hyperthyroidism
SE:
NI/CE: monitor cardiac, hypothyroidism, rash, N/V agranulocytosis and lupus
CI:
Calcitonin
MOA:
indication: osteoporosis
SE:
NI/CE:
CI:
Trimethoprim-sulfamethoxazole
MOA: Inhibit bacterial synthesis
indication: Uncomplicated UTI, Standard therapy in women
SE:
NI/CE:
CI:
Alendronate (biphosphonate)
MOA: Inhibits osteoclast-mediated bone
resorption. Reverses bone loss and decreases risk
of fracture
indication: Enhances bone mineral density in
osteoporosis
SE:
NI/CE:
CI:
Antacids - calcium carbonate (Tums)
MOA: Neutralize stomach acid and elevate pH
indication: Symptomatic relief of heartburn, acid indigestion and upset stomach
SE: Constipation, Hypercalcemia, Rebound acidity when stopped
NI/CE: come in tables, chewable, capsules and liquid, It can be taken three to four times a day, Do not administer within 1-2 hours or other medications, Drink a full glass of water after administration
CI: Kidney disease, GI obstruction
Histamine-2 (H2) receptor antagonist - Famotidine
MOA: Block histamine-2 receptor sites of parietal cell which reduces hydrochloric acid
indication: Heartburn, GERD, Peptic ulcer disease, erosive esophagitis, Adjunct treatment for upper GI bleeding
SE: Constipation or diarrhea, CNS effects (headaches or dizziness)
NI/CE: Available over the counter, but given IV in the hospital setting, Take 15-60 minutes before eating or
drinking
CI:
PPI – pantoprazole
MOA: Blocks the secretion of hydrochloric
acid at the proton pump
indication: GERD, erosive esophagitis, Prophylactic with surgery, In combination with antibiotics for H.Pylori infection, Short-term treatment of active
duodenal ulcers
SE: Headache, Abdominal pain, diarrhea or constipation, Acute renal dysfunction, Long-term: Osteoporosis & bone fracture, Potential zinc, magnesium, or B12 deficiency, Immediately report signs of bleeding ulcers such as coughing/vomiting of blood
NI/CE: Available orally, with an NG tube, or as IV injection in the hospital setting, Can be taken with or without food
CI:
Mucosal protectants - Sucralfate
MOA: Locally covers the ulcer site and protects the sites against acid, pepsin, and bile salts
indication: Promote ulcer healing
SE: constipation
NI/CE: Administer on an empty stomach, 2 hours after or 1 hour before meal
CI: Renal failure or dialysis
Bismuth subsalicylate (Pepto-Bismol)
MOA: Coats the lining of the GI tract and decreases the flow of fluids and electrolytes into the bowel, reducing
inflammation
indication: diarrhea and heartburn
SE: Black or darkened tongue, Black stool
NI/CE: Avoid taking other salicylates (aspirin), Avoid taking simultaneously with antibiotics (they will not work)
CI:
Loperamide (Imodium) Opioid agonist
MOA: inhibits intestinal perstailis through direct effects on the longitudinal and circular muscles of the intestinal wall, slowing motility and movement of water and electroltyes
indication: acute diarhea, and chronic dairhea, most effective
SE: abdominal pain, distention, discomfort, dry mouth, nausea, constipation, dizziness, drowsiness, tired
NI/CE:
CI:
Fiber supplements- psyllium (Metamucil)
MOA: absorbs water
indication: constipation, chronic, safest laxative
SE:
NI/CE:
CI: may decreased effect of other medications
Stool softener- Docusate (Colace)
MOA: Absorb water and fats into stool
to make it soft
indication: constipation
SE: Abdominal cramping
NI/CE:
CI:
Osmotic laxative- Milk of Magnesia
MOA: thought to work by drawing water into the intestines, an effect that helps to cause movement of the intestines
indication: heartburn, upset stomach, or indigestion, constipation
SE: diarrhea, and dehydration
NI/CE:
CI:
polyethylene glycol (MiraLAX) osmotic laxative
MOA: Increases bowel movement by causing water to be retained with stool, purging of toxins, for fecal impaction
indication: constipation
NI/CE:
CI:
Stimulant laxative- Bisacodyl (Dulcolax)
MOA:
indication: Often used as bowel prep, BM within 1 hour, constipation, orally or suppository
SE:
NI/CE:
CI: Do not take bisacodyl with milk
or antacids
safest and strongest
Anticholinergic - Scopolamine
MOA: patch
indication: Used in combination to treat
emesis induced by chemotherapy
SE:
NI/CE:
CI:
Dopamine antagonist – Metoclopramide (Reglan)
MOA: Blocks dopamine receptor
to improve nausea, PO, IM or IV
indication: nausea and vomiting
SE: CNS depression (drowsiness,
fatigue), Tardive dyskinesia or
neuro-malignant syndrome
NI/CE:
CI: Interacts: Alcohol, narcotics,
tranquilizers
Serotonin antagonist- Ondansetron (Zofran)
MOA: blocks specific receptor sites associated with nausea and vomiting, peripherally and in the CTZ, oral disintegrating, PO or IV
indication: nausea and vomiting, prevention of surgery and chemo
hyperemesis
SE: headache, dizziness, drowsy, myalgia, urinary retention, constipation, pain in injection site
NI/CE:
CI:
Anticholinergic – dicyclomine (bentyl)
end of GI
MOA: oral
indication: Irritable bowel syndrome
SE: Drowsiness, constipation, dry month
NI/CE:
CI:
Trimethoprim-sulfamethoxazole
MOA: inhibit bacterial synthesis
indication: uncomplicated uti
SE: allergy, skin reactions, abnormal CBC
NI/CE:
CI:
Nitrofurantoin
MOA: disrupt cell metabolism
indication: uncomplicated UTI caused by E. Coli
SE: gi upset, peri, neuropathy, penumonitits
NI/CE:
CI:
Ciprofloxacin (second line agents)
MOA:
indication: uncomplicated UTI
SE: nausea, vomit, diarrhea, gi pain, headache, rash, tendon rupture, arrythmias, angina, convulsions, gi bleeding, nephritis
NI/CE:
CI:
Levofloxacin (second line agents)
MOA:
indication: uncomplicated UTI
SE: nausea, vomit, diarrhea, gi pain, headache, rash, tendonitis, tendon rupture, arrthymias, nephrotoxicity, hepatoxicity
NI/CE:
CI:
Vaginal yeast – Fluconazole (diflucan)
MOA:
indication: Candida albicans vaginitis (Vaginal Yeast Infection)
SE:
NI/CE:
CI:
not sexually transited, abnormal discharge caused by yeast
Bacterial vaginosis - Metronidazole
MOA:
indication: bacterial vaginosis
SE:
NI/CE:
CI:
not sexually transmitted
Chlamydia - Doxycycline
MOA:
indication: chlamydia
SE:
NI/CE:
CI:
Gonorrhea - Ceftriaxone
MOA:
indication: gonorrhea
SE:
NI/CE:
CI:
Trichomonas - Metronidazole
MOA:
indication: trichomonas vaginalis
SE:
NI/CE:
CI:
Estradiol
MOA: most potent endogenous female sex hormone, responsible for estrogen effects on body
indication: treat vasomotor symptoms of vulvar and vaginal atrophy in menopause
SE: eye changes, photosensitivity, bloating, premenstrual syndorme, abdomen cramps
NI/CE:
CI: metabolized in liver and excreted in urine
Magnesium sulfate (tocolytsis) (IV)
MOA: smooth muscle relaxant to decrease uterine contractions
indication: preterm labor
SE: low BP, resipiratory depression
NI/CE:
CI:
Indomethacin (NSAID)
MOA:
indication: delay preterm labor in 3rd trimester
SE:
NI/CE:
CI: risk to fetus, premature ductus artiosus closure in heart and brain bleed
Misoprostol (vaginally) If cervix is not “favorable”
MOA:
indication: Cervical ripening and to stop
postpartum hemorrhage
SE:
NI/CE: only used in hospital, wait > 4 hours before oxytocin
CI: Uterine rupture or uterine
hyperstimulation, Needs to be on fetal monitor to assess contractions and fetal heart rate
Oxytocin (pitocin) if cervix is “favorable” IV
MOA: synthetic form stimulates the uterus
indication: initiate or improve uterine contractions for early vaginal delivery
SE: cardiac arrhythmias, hypertension, fetal bradycardia, nausea, vomiting, uterine rupture
NI/CE:
CI:
Butorphanol tartrate (stadol)
MOA:
indication: drug used to induce labor, anesthesia, analgesia
SE:
NI/CE:
CI:
Nalbuphine-hydrochloride (nubain)
MOA:
indication: drugs used to induce labor, anesthesia, analgesia
SE:
NI/CE:
CI:
Epidural anesthesia (fentanyl)
MOA:
indication: drug used to induce labor, anesthesia, analgesia
SE:
NI/CE:
CI:
acyclovir
MOA:
indication: genital herpes
SE:
NI/CE:
CI:
estrogen/progestin combinations, oral contraceptive pills
MOA: suppresses LH and FSH, inhibiting ovulation; alters cervical mucus and endometrium, ovaries get smaller
indication: oral contraceptives, endometriosis, acne, PCOS, abnormal uterine bleeding
SE: breakthrough bleed, nausea, breast tenderness, hypertension
NI/CE:
CI: smoking, high BP, heart disease, breast and cervical cancer, migraine
ANTIBIOTICS ALTER BC PILLS, plus 7 days after ending antibiotics
ranitidine
used for when pregnant women get heartburn
