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Pharm Final Flashcards

1
Q

Penicillin G

A

-Gram-positive bacterial infections, anaerobes, spirochetes
- Highly Protein Bound
- NO Penicillin/Cephalosporin allergies
-May not see the allergic reaction with first-time dose (usually with 2nd or 3rd dose) Bc B-cell antibodies take a minute to recognize and attack

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2
Q

Cefazolin

A

-Similar to penicillin: structure & activity (Considered beta-lactam ABX)
-PCN allergy = high risk of cephalosporin allergy

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3
Q

Tetracycline

A
  • inhibit the growth of gram-positive and gram-negative bacteria, but do not kill
    -Rickettsia species, Mycoplasma pneumoniae, and Chlamydia trachomatis, acne
    -SE:Affects tooth development of kids from the fourth month of fetal development to 8 years old, Temporary and permanent discoloration of developing teeth, and Photosensitivity
    -NC:Take on empty stomach either 1 hour before or 2 hours after any meal or other drugs to maximize absorption.
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4
Q

Ciprofloxacin

A

-Uncomplicated urinary tract infections(UTI), Anthrax, VAP, Typhoid, Plague
-Inhibits the relaxation of DNA and promotes the breakage of bacterial DNA
-SE: Athropathy(joint disease) which is Often irreversible, and Ppl under 18 years old(Achilles tendon rupture)

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5
Q

Sulfamethoxazole

A

-Uncomplicated UTIs, systemic infection
-Bactericidal-Folate antagonist, competes with para aminobenzoic acid (PABA);Med takes place of PABA, which starves the bacteria
-NC:Wear sunscreen bc more likely to get sunburns, Take 1-2 hours before/after meal with full glass of water to enhance med absorption

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6
Q

Vancomycin

A

-Eradicates most gram-positive pathogens
-Bacterial septicemia, endocarditis, bone and joint infections, MRSA
-Oral admin = C-Diff tx
-Bacteriocidal & Bacteriostatic(prevents growth)
-SE:Ototoxic, Nephrotoxic, “Red Man” syndrome, Flushing system = profound release of histamine = face beet red color
-Use is limited by ability to produce toxic effects in kidneys & 8th cranial nerve (inner ear)
-Used only when other ABX fail to resolve infection

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7
Q

Amphotericin B

A

-Progressive and potentially fatal systemic fungal or protozoal infections
-Binds to sterols in fungal cell membranes and ruptures the fungus
-SE: Amphoterrible(Nephrotoxicity(40% receiving IV drugs), Anemia, Electrolyte imbalances= Hypokalemia, Hypomagnesemia, Hypocalcemia)

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8
Q

Fluconazole

A

-Oral Candidiasis (thrush) & Candida vaginits
-Inhibit synthesis of ergosterol
-Better tolerated with less side effects
-Primarily given topically

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9
Q

Metronidazole

A

-Inhibits DNA synthesis agts anaerobic bacteria
-Truchomoniasis, Toxoplasmosis, Pneumocystisi Pneumonia, Amebiasis, Giardiasis
-C.Diff, antiparasitic, H.Pylori, antibacterial
-Caution with alchy and other sexual partners have to be treated at the same time

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10
Q

Acyclovir

A

-Decrease in flu-like symptoms
-Frequency of herpes-like flare-ups decrease
-SE: nephrotoxicity
- NC: Admin tablets/capsules with a full glass of water with/without food, Drink at least eight 8oz glasses of water/day, Emphasize that med does not cure disease; not effective against HIV, and Need an alarm to wake pts up to take doses

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11
Q

Omeprazole (Prilosec)

A

-Inhibits gastric acid production in proton pump of gastric parietal cells in last phase of production and antimicrobial for H.Pylori
-Heartburn, GERD, Peptic Ulcers, H.Pylori
-SE: Long-term use has led to cancer of the stomach(don’t have a higher level of acid anymore), osteoporosis, and malabsorption of Mg and Vit. D, and Increase C.Diff development
-NC:Given automatically in hospital to prevent stress ulcers, Cant just quit-> can lead to overproduction of stomach acid, Causes Warafin action to be increased(bleeding) and Clopidogrel to be decreased(clotting), Take 1 hr before meals and on empty stomach(They have to eat 1 hr after taking med and the med doesnt work well if taken after meal);If malnoourished-> pt. Will need more med bc it is highly protein bound

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12
Q

Famotidine (Pepcid)

A

-GERD, Duodenal & Gastric Ulcers
-Decrease acid secretion in stomach by blocking the effect of histamine at H2 receptors-> allowing GI ulcers to heal
-NC:Not as potent as PPI, Works best after meals, Smoking reverses effect, and If famotidine and antiacids are prescribe-> give them at least 2 hrs apart to prevent decrease absorption of Pepcid

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13
Q

Psyllium mucilloid (Metamucil)

A

-Bulk-forming fiber laxative
-Safest type of laxative
-Can be used to treat diarrhea
-Absorbs water to increase bulk & Pass through body undigested (no systemic effects)
-Distended bowel to initiate to initiate reflex bowel activity by Stimulates peristalsis
-Slow-acting (12-72 hours)
-NC: Can take every single day but Must be followed with a large amount of fluid; Chewed/dry powder form may cause esophageal obstruction and/or fecal impaction (bezoar) bc Insoluble lump in GI tract of anything that causes an obstruction

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14
Q

Diphenoxylate HCL

A

-Antidiarrheal
-Acts on intestinal smooth muscle by Slowing intestinal motility, allowing time for fluid reabsorption and better stool formation
-Synthetic narcotic with an anticholinergic(Dosage not high enough for pain relief and Take too much = anticholinergic effects)
-Alcohol, barbituates, tranquilizers (CNS Depressants)
-Rarely used in hospital;Antidote = Narcan

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15
Q

Prochlorperzaine (Compazine)

A

-N/V, hiccups
-Blocks the dopamine in chemoreceptor trigger zone in brain stem
-SE: Extrapyramidal symptoms and CNS Depression
(Restlessness, drowsiness, insomnia, headache, anxiety, and confusion) and Anticholinergic effects(dry mouth, urinary retention)

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16
Q

Ondansetron (Zofran)

A

-N/V associated with cancer or chemo
-Prevents the stimulation of type 3 serotonin receptors in Chemo Receptor Trigger Zone(brain stem and vagal nerves).
-SE: Serotonin syndrome, Prolong QT interval(telementary)
-Much safer than compazine/promazine and doesn’t cause much symptoms

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17
Q

Simethicone

A

-Decrease gas production
-Defoaming action that alters the surface tension of gas bubbles, makes one bigger gas bubble
-Should be given after meals and at bedtime to increase its effectiveness

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18
Q

Magnesium hydroxide

A

-Saline Laxative and Attract or retain water in the intestinal ume, resulting in an increased intraluminal pressure that stimulates peristalsis
-SE: Overactive bowel and fluid/electrolyte imbalances
- NO pts with ABD pain (will worsen), bowel obstruction
-NC:Drink glass of water after admin to prevent dehydration and to promote a more rapid effect, May cause dehydration and electrolyte imbalances, and Not used regularly

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19
Q

Docusate sodium- (Colace)

A

-Stool softener that should be used for prevention not treatment
-Permits mixing of fats and fluids with fecal mass -> making it easier to pass stool
-Does not stimulate peristalsis
-Takes a couple of days to work

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20
Q

Albuterol

A

-Bronchodilator; Beta agonist (sympathomimetic)
-Beta stimulation (SNS) = bronchial dilation + RR rate & depth
-SE: tachy, tremors, Tachycardia, Tremors, palpitations, anxiety, headache, insomnia, GI symptoms

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21
Q

What are the contraindications with albuterol?

A

-Beta blockers = Propranolol (Inderal)
-Limit caffeine intake

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22
Q

Amiodarone

A

-atrial fib/flutter and life-threatening ventricular arrhythmias
-Therapeutic level 0.8 - 2.8 mcg/ml
-Close ICU/CVP, telemetry(QT intervals) monitoring

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23
Q

What are side effects on amiodarone?

A

-Pulmonary Toxicity, arrhythmia exacerbation, liver disease, (skin turns gray/blue in sun),

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24
Q

What are the contraindications with amiodarone?

A

NO: Digoxin/Warfarin

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25
Aspirin
-NSAID -Inflammation, fever, pain, anti-platelet -Pts have to be off aspirin for 5-7 days so their platelets can clot properly -Don't use aspirin unless its a super high fever -GI issues = enteric coated ASA & will digest in small intestine instead -Give with milk or food to decrease GI upset and taking it on an empty stomach does not cause ulcers
26
What are the side effects of Aspirin?
S/S: Reye’s syndrome in children ( no baby aspirin to kids)
27
What are the contraindications to Aspirin?
-Peptic Ulcer Disease, Bleeding DIsorders, Children with Viral illness
28
Atorvastatin
-Inhibits HMG0-COA reductase - High 1st past effect + protein bound -S/S: rhabdomyolysis, myopathies -NO liver disease, pregnancy, grapefruit juice - Monitor Liver enzymes + CPK(3 weeks, 1 month, then 6 months) - Take in evening bc cholesterol is dumped in blood stream by midnight
29
Atropine
a. Anticholinergic effects (“Can’t see, pee, spit, shit” & mydriasis, peripheral vasodilation (red face) b. Max dose= 3 mg IV total (leads to bowel ischemia) c. NO Myasthenia Gravis d. Antidote: Neostigmine -0.5 mg Q5 min until HR increases
30
Beclomethasone
-Inhaled glucocorticoid steroid -NO: immunosuppression; systemic fungal infection a. Dilates bronchial tree bc it reaches the lower lung b. Toxicity (HTN) d. Longer-term use= child stunt growth
31
Benztropine
-Anticholinergic used in Parkinsons -Drives heart rate up - Can’t see, pee, shit, spit -blocks (acetylcholine)
32
Bethanechol
-GI Hypoactivity, GERD, Dry mouth, urinary retention,(non-obstructive) -Parasympathomimetic= Activates rest & digest a. NO BPH or obstructions, pulmonary issues bc it stiffens the lungs, Parkinson’s, bradycardia, anticholinergic, atropine, epi b. Monitor for Cholinergic Crisis  D- diaphoresis and diarrhea  U-urinary frequency  M-miosis  B-bronchospasms  E-emesis  L-lacrimation i. S- salivation
33
Catopril
ACE inhibitor= blocks angiotensin 2 in the lungs and causes build-up bradykinin= cough b. S/S:1st dose syncope, non-productive cough, neutropenia, angioedema c. NO Pregnancy d. Cough = switch to Angiotensin receptor blockers (works directly on blood vessels, no bradykinin build-up
34
What should you monitor for with Catopril?
-Hypotension - Cr+ BUN -K+(drug tolerance)
35
Cholestyramine
a. Used when other hyperlipidemia drugs don’t work b. Does not absorb within the body by attaching to bile salts preventing reabsorption. c. Don’t take other meds two hours before or after
36
11. Cyanocobalamin
a. Pernicious & Megoblastic anemia b. Can take PO if have intrinsic factor; Take Nasal or SC if pt has dumping syndrome. c. Can turn urine bright yellow
37
12. Cyclobenzaprine
a. Centrally acting muscle relaxant b. NO MAOI use with 14 days of beginning & Hyperthyroidism(arrhythmias risk for both) c. Caution with driving due to CNS depression
38
13. Cyclosporine
a. Immunosuppressant b. Stops the immune system from rejecting new organs by binding to calcineurin cells and disrupting T cells c. S/S: Decrease renal function
39
14. Dantrolene
a. Peripheral-Acting Antispasmodic b. Ca+ blocker in skeletal muscle c. Treats Spinal cord injuries, CVA, MS d. NO severe CP, liver disease, pulmonary/cardiac issues e. Abrupt cessation after long term use-> seizures
40
15. Desmopressin
a. Synthetic Vasopressin; increases clotting factoring. b. Tx: DI and Nocturnal enuresis c. May cause severe hyponatremia. d. S/S resembles a cold
41
16. Dextromethorphan
a. Chronic nonproductive cough b. Cough reflex suppressants c. Directly affects cough center in the medulla d. NO pts with Chronic coughs from emphysema and asthma bc we want them to cough secretions up.
42
17. Digoxin
a. Increase heart force contraction= CO b. Slows in calcium exchange= increase calcium across the muscle c. S/S of toxicity: Yellow/green halo around lights, visual changes, bradycardia, psychosis, weakness & fatigue, Anorexia/Nausea. d. Narrow Therapeutic Level: 0.8- 2.0
43
19. Diphenhydramine
b. S/S: Thickens respiratory secretions c. NO pts with BPH, GI obstruction, hyperthyroidism d. Caution with asthma(traps secretions in leading to pneumonia) e. NO Fruit juice decrease absorption
44
20. Dopamine
a. Tx: 2nd degree MI Renal failure b. Nonselective beta-adrenergic agonist(mimics SNS) c. IV does not work with Parkinson's bc it doesn’t cross BBB d. High dose above 5 mcg/kg/min and low does is above e. phentolamine for extravastion treatment
45
21. Epinephrine
a. Nonselective adrenergic agonist b. NO pts in labor, Glaucoma, sulfite allergies
46
22. Ferrous Sulfate
a. Provides iron molecule essential to RBC + Hemoglobin formation b. Don’t give with antiacids or antibiotics(causes iron to get absorbed) c. Z-track method IM d. Don’t give PO within 1 hr of bedtime (GI upset) e. Don’t shake the vial f. S/S: darken stool. g. Will stain teeth if given as a liquid h. Antidote: Deferoxamine-> turns urine a reddish-brown color
47
24. Fluticasone
a. Intranasal Corticosteroid b. Must take every day to work c. No pts with infection (mask s/s) d. Large amounts cause palpitations and
48
27. Haloperidol
a. Typical antipsychotic b. NO pts with Parkinson’s bc it blocks dopamine and dementia c. S/S: EPD(involuntary facial, neck, and mouth movements, lip smacking/chewing, grimacing, shuffling gait)
49
28. Heparin
a. Blocks Factor 3(Prevents prothrombin -> thrombin + fibrinogen -> Fibrin b. Half-life 90 mins(short-acting) c. Monitor aPTT d. Heparin-Induced Thrombocytopenia (HIT) e. Protamine- Sulfate is the antidote and no spinal procedures
50
29. Hep B Vaccine
a. 3 IM injections i. 2nd dose given 1 month after 1st ii. 3rd dose: 6 months after first b. Given to children at birth, 1-4 months, and 6-18 months later c. NO pts with Immunosuppression therapy d. Antidote is epi
51
30. Hydrochlorothiazide
a. Acts in distal tubule by excreting NA and Cl b. Weaker diuretic c. NO pts with anuria (UO less than 100 ml/24 hrs) d. Can cause all electrolytes to be low
52
31. Ibuprofen
a. Ibuprofen plus aspirin= decreases platelet activity…. Bleed out b. Monitor platelets & renal function-> inhibits blood flow to kidneys by COX-1 and COX-2 c. Off 1 week before surgical procedure
53
32. Insulin
a. All DM b. Only Insulin that can be given IV c. NO Beta- blockers bc blocks the symps of hypoglycemia or hypokalemia
54
33. Ipratropium
a. Anticholinergic agent b. No peanut or soybean allergic c. S/S: paradoxical acute bronchospasm, dysgeusia(bad taste)
55
34. Isoflurane
a. Inhaled anesthic agent b. Remains in lung dead spaces must deep breathe post-op c. S/S: hypotension, fam or personal hx of NM, cardiac dysrhythmias
56
Diltiazem
-Ca+ blocker -Relax coronary & peripheral blood vessels -Brings more oxygen to myocardium and reduces workload -NO: MI, AV heart block, Sick sinus syndrome, severe Hypotension, aneurysm, carnail surgery pt, beta blockers, Dantrolene -ADX: Atropine or isoproteneraol -Works better for A-fib than Dig does!
57
Flumazenil
ADX for benzoodiazepines
58
Glucagon
-Pancreatic hormone -Stimulates hepatic production of glucose from glycogen stores (glycogenolysis) -Relaxes musculature of GI tract, temporarily stopping movement -Emergency treatment of severe hypoglycemia in pt. Who is unable to take IV glucose; facilitation of radiographic exam of GI tract
59
Glyburide
-Sulfonylureas -Increases sensitivity to insulin at receptor sites after stimulating pancreatic insulin release -T2 diabetes when diet therapy fails -NO: alcohol = disulfuram-like reaction, T1 diabetes, DKA, sulfonamides
60
Levodopa/Carbidopa
a.Parkinson's b. Levodopa-> dopamine-> carbidopa stops levodopa breakdown in peripheral circulation-> can cross BBB and be utilized c. Combining these agents reduces the required Levodopa dose by 25% d. Don’t eat high protein (mess with absorption) and must eat carbs b4 meds e. Monitor for skin cancers(photosensitivity)
61
Levothyroxine
-Replaces natural T4 thyroid hormone; lifelong tehrapy -s/s: HTN, tachycardia, GI irritation, heat intolerance -NOL Thyrotoxicosis -Musk take on empty stomach -UP to 3 weeks to get effects
62
Lidocaine
-Local anesthetic; Na blocker -Reversible nerve conduction blockade, lowers nerve membrane permeability to sodium -IV = control V-tach by numbing excessive electrical heart activity -CAUTION: fetal bradycardia by blocking Na channel in baby heart -NO: anti-HTN meds; MAOI -s/s: severe allergic reactions; eythema dyesthesia (unpleasant sensation)
63
Lorazepam
-TX: anticonvulsant, muscle relaxation, acute alcohol withdrawal, general anesthesia induction, -NO: psychoses, child under 6mo -s/s: ataxia (cannot walk), paradoxical reaction (excitement, acute rage, worsening psychoses) -ADX = FLumanezil
64
Metformin
-Non-sulfonylurea; T2 diabetes -Decrease: hepatic glucose production, intestinal absorption of glucose from food, and carb absorption from intestines Increase: insulin sensitivity by increasing peripheral glucose uptake -NO: hepatic disease (risk of lactic/metabolic acidosis) -s/s: Anorexia, N/V, Weight loss, ABD pain (delays boewl emptying), Dyspepsia, diarrhea, metallic taste, -Contrast dye can lead to lactic acidosis (kidneys fried)
65
Metoprolol
-Beta-adrenergic blocker (beta 1& 2) “Allows sick heart to rest between beats” -TX: HTN, Angina, HF, arrhythmia, migraine -s/s: bronchospasm, cognitive dysfunction, asymptomatic hypoglycemia, diarrhea, headache (NOT MIGRAINE), weight loss, -NO: Airway issues, severe bradycardia, cardiogenic shock, Raynauds,
66
Milrinone
-Phosphodiesterase 3 inhibitor; short term therapy only -Increase Calcium for heart contraction in muscle + inotropic response -TX: HF -s/s: PVC, hypotension, significant BP drop in 15 min -NO: MI, past arrhythmia
67
Morphine
-Blocks P substance and MU/Kappa receptors in brain -CNS depressant on respiration & cough reflex center -s/s: causes vasodilation & increase in cardiac stipulation, such as MI -Drops BP and decreases workload of the heart by decreasing catecholamines
68
Naloxone
-Works in 2 minutes; will have return of pain/withdrawal symptoms -NO: liver disease
69
Nifedipine
-Selective Ca+ blocker in myocardium, vascular smooth muscle, coronary arteris -TX: HTN, Raynaud’s ANgina -s/s: Reflexive tachycardia, flushing, peripheral edema -NO: Heart block, uncompenstaed HF
70
Nitroglycerin
-Dilates vascular smooth muscle & dilates arterial (after load) and venous Preload vessels -NO: anti-htn, head trauma/ICP issue, severe anemia, dehydration, glaucoma, systolic <90 -Glass bottle = titrate 5mcg/min to pain and BP
71
Phenelzine (Nardil)
-MAOI -NO: bad liver, CHF, anti HTN meds, Tyramine = HTN crisis (rotten, cured, wine, chocolate, fava beans) -s/s: liver issues, anticholilnergic effects -Rare: blood issues
72
Phentolamine
-Short-acting alpha-Adrenergic blcoker -TX: pheochromocytoma, Administer for dopamine tissue infiltration/extravasation ASAP -s/s: (hypotension, angina, tachycardia) all 3 are COMMON
73
Phenylephrine
-Adrenergic Alpha-1 agonist -Parenteral: vascular failure in shock (ICU ONLY DRUG) -Topically: Nasal decongestant Rebound congestion if used more than 3 days -NO: HTN, diabetes, -Neurovascular check; Powerful vasoconstrictor may turn extremities black -S/S: reflex bradycardia
74
Phenytoin (Dilantin)
-Na+ blocker; antiarrhythmic; Highly protein bound -S/S: gingival hyperplasia (common), stroke-like symptoms -Dose range: (10-20 mcg/mL) IV in dedicated line -Slow (50mcg/min) and even slower in edlerly
75
Prazosin (opposite of phenylephrine)
-Alpha-1 antagonist -TX: causes lower BP in: CHF, Raynaud vasospasm, Prostatic outflow obstruction -Oral admin only -s/s: 1st dose syncope, reflex tachycardia
76
Prednisone
-Glucocorticoid steroid -Increase water retention, decrease new bone, lower excitation threshold in brain, lowers immunity -Decreases Ca absorption & bone growth Increases: WBC, BG -s/s: hyperglycemia, delayed wound healing, mask infections, -Long term = cushingoid syndrome, peptic ulcer disease -Sudden stopping = sudden adrenal insufficiency
77
Propofol (new addition)
-Parenteral induction gets body ready for deep anesthesia in 40 seconds -Though to stimulate GABA to shut down nerve endings -White color due to lipid crossing BBB (cloudy = fat soluble) -Pt malpositioned in OR = nerve damafe
78
Propranolol (new addition)
-Class II Antiarrythmic & Beta-blocker -Blocks adrenergic receptors -Most effective drug for controlling ventricular rate in A-fib
79
Risperidone
-Atypical antipsychotic; Selective Dopamine (D2); Highly protein bound -TX: short term acute bipolar, schizophrenia -NO: CNS depressants -s/s: Hostility, Tardive dyskinesias, insomnia, agitation, nervousness -Rare: Blood dyscrasia, orthostatic hypotension
80
spironolactone
-Androgen blocker; Weakest diuretic -Blocks K in distal tubule -NO: renal/liver disease -DO NOT ADMIN IF K is above 6 -s/s: photosensitivity, nephrotoxicity
81
Succinylcholine (new addition)
-Functional Depolarizing Neuromuscular Junction Blocker; Cholinergic nicotinic agonist (receptors at end of motor plate = repeated contraction) -Muscle cell membrane depolarizes + excites = Muscle contraction & leads to muscle paralysis after repeated excitation -TX: rapid endotracheal intubation; endoscopies -NO: Hx of Malignant hyperthermia (admin dantrolene) -MONITOR: Damaged muscles release K+... would cause hyperkalemia
82
Sumatriptan
-Serotonin-selective agonist drug “triptans” -Effects trigeminal nerve (blocks inflammatory peptides) -Acts on receptors of dilated cranial blod vessels -TX: 1st line for migraine headache caused by vasodilation (great vasoconstrictor), nausea -s/s: Chest pain, Dysrythmia, MI, Hypertension, Coronary artery vasospasm -NO: CAD; previous MI
83
Warfarin
-Oral anticoag from dicamoural in rotting clover -INR (2-3) -Heparin to warfarin transition = both dugs admin for 2-3 days -TX: long-term risk for thrombus formation -HL = 0.5 - 3 days (long-acting) -NO: vit K rich foods, -ADX = Vit K
84
Zolpidem
-Short-term insomnia (7-10days) -Why is it bad to take long-term? -Make old fucks go cray -ADX = FLumanezil

Pharmacology Test 1 (4 decks)

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