Pharmaceuticals (161-180) Flashcards
Naltrexone
C: Opioid antagonist
A: opioid receptor antagonist
I: opioid addiction and OD and alcoholism
SE: N/V, headache, hepatitis
CI: patient who requires opiates for pain control
Intx: reversal of opioid analgesic effects
Acetaminophen/Paracetamol (Tylenol)
C: Analgesic and antipyretic
A: inhibits CNS PG synthesis - DOES NOT affect platelet aggregation or inflam
I: mild pain, MSK pain, RA, OA
SE: nephro/hepatotoxicity, antidote: charcoal, NAC
CI: liver dz/failure, alcoholism
Aspirin (acetylsalicyclic acid)
C: NSAID
A: inhibits COX1 and COX2 = decreases PG synthesis + analgesia + AI + antipyretic + IRREVERSIBLE platelet aggregation
I: minor pain, fever, OA, RA, thromboembolism (prevent and tx MI and ischemic strokes)
SE: nephrotoxic, salicylism - tinnitus, OD may be lethal
CI: children with viral infx, PUD, bleeding disorders, HF, allergy
Intx: alcohol, SSRI, anticoagulants, hypoglycemics, insulin
Ibuprofen and Naproxen
C: NSAIDs
A: inhibits COX1 and COX2 = decreases PG synthesis + analgesia + AI + antipyretic + IRREVERSIBLE platelet aggregation
I: minor pain, fever, OA, RA
SE: nephrotoxic, allergy is common, OD may be lethal
CI: PUD, bleeding disorders, HF
Intx: cyclosporine, alcohol, SSRI, anticoagulants
Celecoxib (Celebrex)
C: NSAIDs
A: selective COX2 inhibitor - less GI irritation so safer choice in patients with pain and PUD because not working on both COX enzymes
I: minor pain, fever, OA, RA, MSK pains
SE: SERIOUS CVD events, nephrotoxic, allergic rxn is common
CI: CVD, bleeding disorders, HF
Intx: alcohol, SSRI, anticoagulants, other NSAIDs, salicylates, anti-HTN drugs
Cannabis
C and A: anti-emetic, anticonvulsive, psychoactive effects
I: glaucoma, appetite loss, chemo induced nausea and vomiting, tremors and spasticity with MS
SE: Many
CI: CV or respiratory dz, immunocompromised, epilepsy
Intx: theophylline, barbiturates, warfarin, CNS depressants
Prednisone
C: Glucocorticoid
A: AI, immunosuppressive, catabolic effect on skin, bone, and muscle. Alters fat deposition
I: inflam and allergic conditions, IBD, AI dz
SE: adrenal suppression, cushings, HTN, avascular necrosis of femur, changes in behavior
CI: systemic fungal or other severe infx, live vaccine, abrupt wthdrawal
Intx: estrogens and many more
Fluticasone and Mometasone
C: Inhaled corticosteroids
A: AI, immunosupressive, vasoconstrictive (IN)
I: prevent asthma
SE: oral thrush is big one, adrenal suppression and cushings
CI: systemic fungal or other severe infx, live vaccine, abrupt wthdrawal
Intx: estrogens and many more
Dexamethasone
C: Corticosteroids
A: AI, immunosupressive
I: inflam and allergic conditions, AI dz
SE: acne, weight gain, high glucose, low potassium, OP, avascular necrosis of femur
CI: systemic fungal or other severe infx, with a vaccine, abrupt wthdrawal
Intx: estrogens and many more
Methylprednisolone
C: Corticosteroid
A: synthetic glucorticoid = decreases inflam and immune response = SM relaxation
I: acute or severe persistent asthma, arthritis
SE: weight gain, high glucose, low potassium, OP, etc.
CI: system fungal or other severe infx, abrupt withdrawal, premature infants
Intx: live vrus vaccines, desmopressin
Hydrocortisone (cortisol)
C: Corticosteroid
A: AI, immunosuppressant
I: acute or severe persistent asthma, arthritis
SE: weight gain, high glucose, low potassium, Cushings, adrenal suppression, OP, etc.
CI: system fungal or other severe infx, abrupt withdrawal, premature infants
Intx: live vrus vaccines, desmopressin
Adalimumab
C: TNF alpha inhibitor
A: AI and immunosuppressive effects
I: RA, PA, AS
SE: infection site reaction and infx, cancers, lymphomas
CI: SLE, HF, MS, active infx
Intx: increased risk of infx with live vaccinations
Hydroxychloroquine
C: Anti-malarials
A: inhibits movement of neutrophils and eosinophils = impairs complement dependent antigen-antibody reactons
I: RA, SLE, malaria prevention
SE: ocular toxicity, visual changes, skin pigmentations
CI: G6PD deficiency, eye dz
Intx: digoxin
Methotrexate
C: Folic acid analog
A: inhibits dihydrofolate reductaste = DNA synthesis cant happen = cytotoxic and immunosuppresant
I: RA, psoriasis, cancer
SE: asx elevation of liver enzymes, hepatotoxicity, diarrhea, ulcerative tomatitis, BM suppression, nephrotoxicity
CI: BM suppression, blood dyscrasia, anemia, alcoholism
Intx: cyclosporin, NSAIDS, Sulf-Tri and penicillin
Tofacitinib
C: JAK inhibitor
A: decreases hematopoiesis and immune system function
I: PA, RA, UC
SE: infx, viral reactivation, cytopenias
CI: active infx, cytopenia
Intx: live vaccines, other immunosuppressive agents
