PHARM FINAL please god Flashcards

1
Q

Antitussives (respiratory drug)

A

Medications:
o Benzonatate
o Codeine (generic)
o Hydrocodone (generic)
o Dextromethorphan (prototype)

Actions:
o Act directly on the medullary cough center of the
brain to depress the cough reflex

Indications:
o Control nonproductive cough

Adverse Effects:
o Drying effect on the mucous membranes
o CNS adverse effects and GI upset

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2
Q

Topical Nasal Decongestants (respiratory drug)

A

Medications:
o “Zoline” (prototype)
o Phenylephrine

Actions:
o Affects the sympathetic nervous system.
o Decrease the overproduction of secretions by causing local vasoconstriction & decrease the blood flow to the upper respiratory tract.

Indications:
o Relieve the discomfort of nasal congestion that
accompanies the common cold, sinusitis, and allergic rhinitis.

Adverse Effects:
o Local stinging and burning
o Rebound congestion
o Sympathomimetic effects

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3
Q

Oral decongestants (respiratory medication)

A

Medication:
o Pseudoephedrine (prototype)

Actions:
o Decrease nasal congestion by vasoconstriction related to the common cold, sinusitis, and allergic rhinitis by shrinking the mucous membrane

indications:
o Promotion of drainage in the sinuses and improving air flow

Adverse Effects:
o Rebound congestion
o Sympathetic effects

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4
Q

Topical Nasal Steroid Decongestants (Respiratory Medication)

A

Medications:
o Beclomethasone
o Budesonide
o Flunisolide (prototype)
o Fluticasone (generic)
o Triamcinolone (generic)

actions:
o Relieves inflammation]

indications:
o Seasonal allergic rhinitis
o Inflammation after the removal of nasal polyps

Adverse effects:
o Local burning, irritation, stinging, dryness of the
mucosa, and headache
o Suppression of healing can occur in a patient who
has had nasal surgery or trauma

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5
Q

Antihistamines (respiratory medication)

A

Medications:
“amines” (prototype)

Actions:
o Block the release or action of histamine that increases secretions and narrows airways
o decreases allergic responses

Indications:
o Seasonal and perennial allergic rhinitis, allergic conjunctivitis, uncomplicated urticaria, and angioedema

adverse effects:
o Drowsiness and sedation
o Anticholinergic effects

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6
Q

Expectorants (respiratory medication)

A

Medication:
o Guaifenesin

Actions:
o increase productive cough to clear the airways. They liquefy lower respiratory tract secretions, reducing the viscosity of these secretions and making it easier for the patient to cough them up.

Indications:
o Symptomatic relief of respiratory conditions characterized by a dry, non-productive cough

Adverse effects:
o GI symptoms
o Headache
o Dizziness
o Mild rash
o Prolonged use may result in masking a serious
underlying disorder

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7
Q

Mucolytics (respiratory medication)

A

Medications:
o Acetylcysteine (prototype)
o Dornase alfa

Actions:
o Work to break down mucous in order to aid the high-risk respiratory patient in coughing up thick, tenacious secretions.

Indications:
o Patients who have difficulty coughing up secretions
o Patients who develop atelectasis
o Patients undergoing diagnostic bronchoscopy
o Postoperative patients
o Patients with tracheostomies

Adverse effects:
o GI upset
o Stomatitis and/or rhinorrhea
o Bronchospasm
o Rash

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8
Q

Xanthines (respiratory medication)

A

Medications:
o Caffeine
o Theophylline (prototype)

Actions:
o Direct effect on the smooth muscles of the respiratory tract, both in the bronchi and in the blood vessels

Indications:
o Symptomatic relief or prevention of bronchial asthma and for reversal of bronchospasm associated with COPD

Adverse Effects:
o Related to theophylline levels in the blood
o GI upset, nausea, irritability, and tachycardia to seizure, brain damage, and even death

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9
Q

Sympathomimetics (respiratory medication)

A

medication:
o Albuterol
o Arformoterol
o Ephedrine (generic)
o Epinephrine (prototype)
o Formoterol
o Indacaterol
o Isoproterenol
o Levalbuterol
o Metaproterenol (generic)
o Olodaterol
o Salmeterol
o Terbutaline (generic)

actions:
o Mimic effects of the sympathetic nervous system: dilation of bronchi with increased rate and depth of respiration

indications:
o Acute asthma attack
o Bronchospasm in acute or chronic asthma
o Prevention of exercise-induced asthma

Adverse effects:
o Sympathomimetic stimulation
o CNS stimulation
o GI upset, cardiac arrhythmias, hypertension,
bronchospasm, sweating, pallor, and flushing

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10
Q

Anticholinergics (respiratory medication)

A

Medication:
“ium” (prototype)

Actions:
o blocks ach
o Patients who cannot tolerate the sympathetic effects of the sympathomimetic might respond to the anticholinergic drugs

Indications:
o Maintenance treatment of bronchospasm associated with COPD

Adverse effects:
o Dizziness, headache, fatigue, nervousness, dry
mouth, sore throat, palpitations, and urinary
retention

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11
Q

Inhaled steroids (respiratory medication)

A

medication:
o Beclomethasone
o Budesonide (prototype)
o Ciclesonide
o Fluticasone
o Triamcinolone (generic)

actions:
o Decrease the inflammatory response in the airway

indications:
o Prevention and treatment of asthma
o Treat chronic steroid-dependent bronchial asthma

Adverse effects:
o Sore throat
o Hoarseness
o Coughing
o Dry mouth
o Pharyngeal and laryngeal fungal infections

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12
Q

Leukotriene Receptor Antagonists (respiratory medication)

A

Medication:
“Kast” (prototype) and Zileuton

Action:
o act more specifically at the site of the problem
associated with asthma
o Selectively and competitively block or antagonize receptors for the production of leukotrienes

indication:
o Prophylaxis and chronic treatment of bronchial asthma in adults and in patients younger than 12 years of age

Adverse effects:
o Headache, dizziness, myalgia, nausea, diarrhea and abdominal pain, elevated liver enzyme
concentrations, vomiting, and generalized pain

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13
Q

Lung surfactants (respiratory medication)

A

Medications:
“tant” (prototype)

actions:
o Naturally occurring compounds or lipoproteins containing lipids and apoproteins that reduce the surface tension within the alveoli, allowing expansion of the alveoli for gas exchange

indications:
o Rescue treatment of infants who have developed
RDS

adverse effects:
o Patent ductus arteriosus
o Hypotension
o Intraventricular hemorrhage
o Pneumothorax
o Pulmonary air leak
o Hyperbilrubinemia
o Sepsis

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14
Q

Mast cell stabilizers (respiratory medication)

A

Medication:
Cromolyn

actions:
o Works at the cellular level to inhibit the release of
histamine and inhibits the release of SRSA

indications: Treatment of chronic bronchial asthma

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15
Q

Histamine-2 (H 2 ) Antagonists (GI medication)

A

Medication:
“Tidine” (prototype)

Actions:
o Selectively block histamine-2 receptor sites
o This blocking leads to a reduction in gastric acid secretion and a reduction in overall pepsin production

indication:
o Short-term treatment of active duodenal ulcer or benign gastric ulcer
o Treatment of pathological hypersecretory conditions such as Zollinger–Ellison syndrome
o Prophylaxis of stress-induced ulcers and acute upper GI bleeding in critical patients

adverse effects:
o GI effects
o CNS effects
o Cardiac arrhythmias and hypotension

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16
Q

Antacids (Gi medications)

A

Medications:
o Sodium bicarbonate (prototype)
o Calcium carbonate
o Magnesium salts
o Aluminum salts

actions:
o Neutralize stomach acid by direct chemical reaction

indications:
o Symptomatic relief of upset stomach associated with
hyperacidity, as well as hyperactivity

adverse effects:
o Rebound acidity
o Alkalosis
o Hypercalcemia
o Constipation or diarrhea
o Hypophosphatemia

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17
Q

Proton Pump Inhibitors (GI medication)

A

Medication:
“prazole” (prototype)

Actions:
o Act at specific secretory surface receptors to prevent the final step of acid production and thereby decrease the level of acid in the stomach

Indications:
o Short-term treatment of active duodenal ulcers, GERD, erosive esophagitis, and benign active gastric disease
o Long-term treatment of pathological hypersecretory conditions

adverse effects:
o CNS effects: Dizziness, headache, asthenia, vertigo, insomnia, apathy
o GI Effects: Diarrhea, abdominal pain, and tongue atrophy
o Upper respiratory tract symptoms: Cough, stuff nose, hoarseness, and epistaxis
o Other: Rash, alopecia, pruritis, dry skin, back pain, and fever

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18
Q

GI protectant (GI medication)

A

Medication:
o Sucralfate

Action:
o Forms an ulcer-adherent complex at duodenal ulcer sites, protecting the sites against acid, pepsin, and bile salts

indication:
o Promote ulcer healing

adverse effects:
o GI effects – Constipation, diarrhea, nausea,
indigestion, gastric discomfort, dry mouth
o Dizziness
o Sleepiness
o Vertigo
o Skin rash
o Back pain

19
Q

Prostaglandin (GI medication)

A

medication:
o misoprostol

Action: Inhibits gastric acid secretion and increases bicarbonate and mucous production in the stomach

indication:
o Prevention of NSAID-induced gastric ulcers
o Treatment of duodenal ulcers

adverse effects:
o GI effects – Nausea, diarrhea, abdominal pain,
flatulence, vomiting, dyspepsia, and constipation
o GU effects – Miscarriages, excessive bleeding,
spotting, cramping, hypermenorrhea, dysmenorrhea, and other menstrual disorders

20
Q

Digestive Enzymes (Gi medication)

A

Medication:
o Saliva substitute
o Pancrelipase (prototype)

action:
o Saliva substitute – Contains electrolytes and carboxymethylcellulose to act as a thickening agent in dry mouth conditions
o Pancreatic enzymes are replacement enzymes that help the digestion and absorption of fats, proteins, and carbohydrates

Indication:
o Replacement therapy

Adverse effects:
o Saliva – Complications from abnormal electrolytes – increased levels of magnesium, sodium, or potassium
o Pancreatic enzyme – GI irritation, nausea, abdominal cramps, and diarrhea

21
Q

Chemical stimulants (GI medication)

A

Medication:
o Bisacodyl: Very popular OTC laxative
o Cascara (Generic): Reliable agent that leads to intestinal evacuation
o Castor Oil (Prototype): Old standby for thorough
evacuation of the intestine
o Senna: Reliable drug, similar to cascara (OTC)

actions:
o Begin working at the beginning of the small intestine and increase motility throughout the rest of the GI tract by irritating the nerve plexus

indications: treatment of slowed GI tract

Adverse effects:
o GI: diarrhea, abdominal cramping, nausea
o CNS: dizziness, headache, weakness
o Sweating, palpitations, flushing, fainting
o Cathartic dependence
o Castor oil: blocks absorption of fats and fat-soluble vitamins

22
Q

Bulk Stimulants (Gi medication)

A

Medication:
o Methylcellulose
o Polycarbophil
o Psyllium (prototype)

action/indications:
o Increase motility by increasing size of fecal material, which will increase fluid in the GI tract, cause more stretch on GI tract, stimulate local stretch receptors, and activate local GI activity

adverse effects:
o GI: diarrhea, abdominal cramping, nausea
o CNS: dizziness, headache, weakness
o Sweating, palpitations, flushing, fainting

23
Q

Osmotic laxatives (GI medications)

A

Medications:
o Magnesium sulfate
o Magnesium citrate (prototype)
o Magnesium hydroxide
o Lactulose
o Polyethylene glycol
o Polyethylene glycol electrolyte solution
o Sodium picosulfate with magnesium oxide

Actions:
o Draw more water into GI tract and stimulate
increased GI motility

Indications: Treatment of decreased GI motility

Adverse effects:
o GI: diarrhea, abdominal cramping, abdominal
bloating, nausea; dehydration: dry mouth, dizziness, light-headedness
o CNS: dizziness, headache, weakness
o Sweating, palpitations, flushing, fainting
o Rectal irritation

24
Q

Lubricants (GI medications)

A

Medications:
 Docusate
o Has a detergent action on the surface of the
intestinal bolus, making a softer stool
 Glycerin
o Hyperosmolar laxative used to gently evacuate the rectum without systemic effects higher in the GI tract
 Mineral Oil (prototype)
o Forms a slippery coat on the contents of the
intestinal tract

Indications: Relief of constipation

adverse effects:
o GI: diarrhea, abdominal cramping, nausea; leakage and staining with mineral oil
o CNS: dizziness, headache, weakness
o Sweating, palpitations, flushing, fainting

25
Q

Gastrointestinal stimulants (GI medication)

A

Medications:
 Dexpanthenol
o Increases acetylcholine levels and stimulates the
parasympathetic system
 Metoclopramide (prototype)
o Blocks dopamine receptors and makes the GI cells more sensitive to acetylcholine
o Leads to increased GI activity and rapid movement of food through the upper GI tract

actions:
o Stimulate parasympathetic activity within the GI
tract
o Increase GI secretions and motility

indications:
o Rapid movement of GI contents is desirable

adverse effects:
o Nausea, vomiting, diarrhea, intestinal spasms,
cramping, decreased blood pressure and heart rate, weakness, and fatigue

26
Q

Antidiarrheal drugs (GI medications)

A

medications:
o Bismuth Subsalicylate
o Crofelemer
o Loperamide (prototype): Slows peristalsis, increased time for absorption
o Opium Derivatives

actions:
o Slow the motility of the GI tract through direct action on the lining of the GI tract

indications:
o Relief of symptoms of acute or chronic diarrhea
o Reduction of volume of discharge from ileostomies
o Prevention and treatment of traveler’s diarrhea

adverse effects:
o Constipation
o Abdominal distension
o Abdominal discomfort
o Nausea
o Dry mouth
o Toxic megacolon
o Fatigue
o Weakness
o Dizziness

27
Q

Phenothiazines (GI medications)

A

Medications: “Azines” (prototype)

actions:
o Antianxiety drug that blocks the responsiveness of the CTZ to stimuli, leading to a decrease in nausea and vomiting

indications:
o Treatment of nausea and vomiting

adverse effects:
o Drowsiness, dizziness, weakness, tremor, headache
o Hypotension, hypertension, cardiac arrhythmias
o Dry mouth, nasal congestion, anorexia, pallor,
sweating, urinary retention
o Menstrual disorders, galactorrhea, and gynecomastia
o Photosensitivity

28
Q

Phenothiazines (GI medications)

A

Medications: “Azines” (prototype)

actions:
o Antianxiety drug that blocks the responsiveness of the CTZ to stimuli, leading to a decrease in nausea and vomiting

indications:
o Treatment of nausea and vomiting

adverse effects:
o Drowsiness, dizziness, weakness, tremor, headache
o Hypotension, hypertension, cardiac arrhythmias
o Dry mouth, nasal congestion, anorexia, pallor,
sweating, urinary retention
o Menstrual disorders, galactorrhea, and gynecomastia
o Photosensitivity

29
Q

Nonphenothiazines (GI medications)

A

Medications:
o Metoclopramide
o Ondansetron (prototype)

actions:
o Prevention of nausea and vomiting associated with emetogenic cancer chemotherapy, prevention of postoperative nausea and vomiting

indications:
o Prevention of nausea and vomiting

Adverse effects:
o Drowsiness
o Fatigue
o Restlessness
o Extrapyramidal symptoms

30
Q

Substance P/Neurokinin 1 Receptor
Antagonists (GI medications)

A

Medications: “pitant” (prototype)

Actions:
o Act directly in the CNS to block receptors associated with nausea and vomiting

indications:
o In combination with other agents to prevent nausea and vomiting

adverse effects:
o Anorexia, fatigue, constipation, diarrhea, liver
enzyme elevation, dehydration

31
Q

Drugs Affecting Hypothalamic Hormones (endocrine)

A

Medications:
 Goserelin: synthetic GnRH
 Histrelin: GnRH is used as antineoplastic
 Leuprolide (prototype): GnRH agonist
 Nafarelin: GnRH agonist
 Tesamorelin: GRH analogue used to simulate
GH release from the pituitary

Indications: treatment of advanced prostatic cancer

32
Q

Growth hormone agonists (Endocrine)

A

Medications:
o Somatropin (prototype)

actions:
o Somatropin is a hormone of recombinant DNA origin that is equivalent to human growth hormone

Indications:
o Used in patients experiencing growth failure

Adverse effects:
o Inflammation
o Swelling and joint pain
o Hypothyroidism and insulin resistance

33
Q

Growth Hormone Antagonists (endocrine)

A

Medications:
o Bromocriptine mesylate (prototype)
o Lanreotide
o Octreotide
o Pegvisomant

Actions:
o Is an inhibitory factor released from the
hypothalamus
o Not used to decrease GH
o Has multiple effects on many of the secretory
systems

Indications:
o Treatment of acromegaly

Adverse effects:
Varies…

34
Q

Drugs Affecting Posterior Pituitary
Hormones (endocrine)

A

Medications:
o Desmopressin (prototype)
o Conivaptan
o Tolvaptan

actions:
Has pressor and diuretic effects; increases levels of clotting factor VIII

Indications:
o Treatment of neurogenic diabetes insipidus
o Desmopressin is also indicated for the treatment of hemophilia A and von Willebrand’s disease
o Nocturnal enuresis

adverse effects:
o Water intoxication, related to the shift in water retention
o Stimulation of GI tract
o Local nasal irritation
o Hypersensitivity

35
Q

Glucocorticoids (endocrine)

A

Medications:
 Beclomethasone
 Betamethasone
 Budesonide
 Cortisone (generic)
 Dexamethasone (generic)
 Flunisolide (generic)
 Hydrocortisone
 Methylprednisolone
 Prednisolone
 Prednisone (prototype)
 Triamcinolone

actions:
o Enter target cells and bind to cytoplasmic receptors
o Initiate many complex reactions responsible for anti-inflammatory and immunosuppressive effects
o Hydrocortisone, cortisone, and prednisone have some mineralocorticoid activity

Indications:
o Short-term treatment of many inflammatory disorders
o To relieve discomfort
o To give the body a chance to heal from the effects of inflammation

adverse effects:
o Related to route of administration
o Systemic use is associated with endocrine disorders

36
Q

Mineralocorticoids

A

Medications:
o Cortisone
o Fludrocortisone (prototype)
o Hydrocortisone

actions:
o Holds sodium, and with it, water in the body
o Causes the excretion of potassium by acting on the renal tubule

Indications:
o Replacement therapy in primary and secondary adrenal insufficiency

Adverse effects:
o Increase fluid volumes
o Allergic reactions

37
Q

Replacement Hormone Products for
Treating Hypothyroidism (endocrine)

A

Medications:
o Levothyroxine (prototype): Synthetic salt of T 4
o Thyroid Desiccated: Prepared from dried animal thyroid glands and contains both T 3 and T 4
o Liothyronine: Synthetic salt of T 3
o Liotrix: Synthetic preparation of T4 and T3 in a
standard 4:1 ratio

actions:
o increases the metabolic rate of body tissues, increasing oxygen consumption, respiration, and heart rate; the rate of fat, protein, and carbohydrate metabolism; and growth and maturation

indications:
o Replacement therapy in hypothyroidism; pituitary TSH suppression in the treatment of euthyroid goiters, management of thyroid cancer; thyrotoxicosis in conjunction with other
therapy; myxedema coma

adverse effects:
o Skin reactions
o Symptoms of hyperthyroidism
o Cardiac stimulation
o CNS effects

38
Q

antithyroid agents (endocrine)

A

Medications/actions:
o Methimazole(Thioamides): prevent the formation of thyroid hormone within the thyroid cells, lowering the serum level, partially inhibit conversion of T4 to T3
o Iodine Solutions: high doses block thyroid function

Indications:
o Hyperthyroidism

Adverse effects:
o Thioamides: Thyroid suppression
o Iodine Solutions: Hypothyroidism

39
Q

Antihypocalcemic Agents (endocrine)

A

Medications:
o Calcitriol (Teriparatide) (prototype)
o Parathyroid hormone

actions:
o Stimulation of osteoclasts or bone cells to release calcium from the bone
o Increased intestinal absorption of calcium
o Increased calcium resorption from the kidneys
o Stimulation of cells in the kidney to produce calcitriol

Indications
o Management of hypocalcemia in patients undergoing chronic renal dialysis
o Treatment of hypoparathyroidism

Adverse effects:
o GI effects
o CNS effects

40
Q

Antihypercalcemic Agents (endocrine)

A

Medication names: “Dronate”(prototype) and calcitonin salmon (prototype) (helps with paget’s disease)

Actions:
o Bisphosphonates- Slow or block bone resorption; by doing this, they help to lower serum calcium levels, but they do not inhibit normal bone formation and mineralization
o Calcitonin’s- Inhibits bone resorption, lowers serum calcium levels in children and in patients with Paget’s disease, and increases the excretion of phosphate, calcium, and sodium from the kidney

Indications:
o Hypercalcemia
o Slow or block bone resorption

Adverse effects:
o Bisphosphates- Most common, headache, nausea, and diarrhea, bone pain with Paget’s disease
o Calcitonins- Flushing of the face and hands, skin
rash, nausea and vomiting, urinary frequency, and
local inflammation at the site of injection.

41
Q

Insulin (endocrine)

A

Medication:
Insulin

Actions:
o Hormone that promotes the storage of the body’s
fuels
o Facilitates the transport of various metabolites and ions across cell membranes
o Simulates the synthesis of glycogen from glucose
o Reacts with specific receptor sites on the cells

Indications:
o Treatment of type 1 diabetes mellitus
o Treatment of type 2 diabetes mellitus in patients
whose diabetes cannot be controlled by diet or other agents

Adverse effects:
o Hyperglycemia and ketoacidosis

42
Q

Sulfonylureas (endocrine)

A

Medications:
o 1st generation: “amide”
o 2nd generation: “Gl” and “ide”

Actions:
o Stimulate insulin release from the beta cells in the pancreas
o They improve binding to insulin receptors

Indications:
o Adjunct to diet and exercise to lower blood glucose levels in type 2 diabetes

adverse effects:
o Hypoglycemia
o GI distress
o Allergic skin reactions

43
Q

Antidiabetic agent (endocrine)

A

Medication:
o Metformin

Action: increase production of insulin, decrease hepatic glucose production

Indications: treatment of type 2 diabetes

adverse effects: Hypoglycemia, lactic acidosis

44
Q

Glucose Elevating Agents

A

Medication:
o Diazoxide
o Glucagon
actions:
o Increase the blood glucose levels by decreasing
insulin release and accelerating the breakdown of
glycogen in the liver to release glucose

indication:
o Treatment of hypoglycemia

adverse effects:
o GI upset
o Vascular effects