PHARM FINAL please god Flashcards
Antitussives (respiratory drug)
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
Topical Nasal Decongestants (respiratory drug)
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
Oral decongestants (respiratory medication)
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
Topical Nasal Steroid Decongestants (Respiratory Medication)
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
Antihistamines (respiratory medication)
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
Expectorants (respiratory medication)
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
Mucolytics (respiratory medication)
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
Xanthines (respiratory medication)
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
Sympathomimetics (respiratory medication)
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
Anticholinergics (respiratory medication)
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
Inhaled steroids (respiratory medication)
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
Leukotriene Receptor Antagonists (respiratory medication)
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
Lung surfactants (respiratory medication)
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
Mast cell stabilizers (respiratory medication)
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
Histamine-2 (H 2 ) Antagonists (GI medication)
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
Antacids (Gi medications)
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
Proton Pump Inhibitors (GI medication)
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
GI protectant (GI medication)
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
Prostaglandin (GI medication)
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
Digestive Enzymes (Gi medication)
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
Chemical stimulants (GI medication)
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
Bulk Stimulants (Gi medication)
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
Osmotic laxatives (GI medications)
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
Lubricants (GI medications)
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
Gastrointestinal stimulants (GI medication)
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
Antidiarrheal drugs (GI medications)
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
Phenothiazines (GI medications)
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
Phenothiazines (GI medications)
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
Nonphenothiazines (GI medications)
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
Substance P/Neurokinin 1 Receptor
Antagonists (GI medications)
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
Drugs Affecting Hypothalamic Hormones (endocrine)
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
Growth hormone agonists (Endocrine)
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
Growth Hormone Antagonists (endocrine)
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…
Drugs Affecting Posterior Pituitary
Hormones (endocrine)
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
Glucocorticoids (endocrine)
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
Mineralocorticoids
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
Replacement Hormone Products for
Treating Hypothyroidism (endocrine)
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
antithyroid agents (endocrine)
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
Antihypocalcemic Agents (endocrine)
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
Antihypercalcemic Agents (endocrine)
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.
Insulin (endocrine)
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
Sulfonylureas (endocrine)
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
Antidiabetic agent (endocrine)
Medication:
o Metformin
Action: increase production of insulin, decrease hepatic glucose production
Indications: treatment of type 2 diabetes
adverse effects: Hypoglycemia, lactic acidosis
Glucose Elevating Agents
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
