Pharmacologic classes Flashcards
What are aminoglycosides therapeutic actions
they are antibiotics that are bactericidal. They inhibit protein synthesis in susceptible strains of gram-negative bacteria and appear to disrupt the functional integrity of bacterial cell membrane, causing cell death. Oral aminoglycosides are very poorly absorbed and are used for the suppression of Bacterial flora.
Aminoglycosides drugs
Amikacin, gentamicin, kanamycin, neomycin, streptomycin, and tobramycin.
What are Angiotensin-converting enzyme(ACE) inhibitors therapeutic actions
They block ACE in the lungs from converting angiotensin I, activated when renin is released from the kidneys , to angiotensin II, a powerful vasoconstrictor. Blocking this conversion leads to decreased BP, decreased aldosterone secretion, a small increase in serum potassium levels, and sodium and fluid loss; increased prostaglandin synthesis also may be involved in the antihypertensive action.
What are the indications of using ACE inhibitors
Treatment of hypertension (alone or with thiazide type diuretics),
treatment of heart failure (used with diuretics and digitalis),
treatment of stable patients within 24 hr of acute MI to improve survival (lisinopril),
Reduction in risk of MI, stroke, and death from CV causes (Ramipril),
Treatment of left ventricular dysfunction post-MI (captopril, trandolopril),
Treatment of asymptomatic left ventricular dysfunction (enalapril),
Treatment of diabetic neuropathy (captopril).
ACE inhibitors drugs
Benazepril, captopril, enalapril, enalaprilat, fosinopril, lisinopril, moexipril, perindopril, quinapril, ramipril, trandolapril.
Antiarrhythmics therapeutic actions
They act at specific sites to alter the action potential of carica cells and interfere with the electrical excitability of the heart. Most of these drugs may cause new or worsened arrhythmias (proarrhythmic effect) and must be used with caution and with continuous cardiac monitoring and patient evaluation.
Antiarrhythmic indications
Treatment of tachycardia when rapid but short-term control of ventricular rate is desirable (patients with atrial fibrillation, atrial flutter, in both perioperative and postoperative situations).
Treatment of noncompensatory tachycardia when heart rate requires specific intervention.
Treatment of atrial arrhythmias.
Antiarrhythmic drugs
Type IA: disopyramide, procainamide, quinidine,
Type IB: lidocaine, mexiletine, phenytoin,
Type IC: flecainide, moricizine, propafenone,
Type 2: acebutolol, esmolol, propranolol,
Type 3: amiodarone, dofetilide, ibutilide, sotalol,
Type 4: Diltiazem, verapamil,
Type 5: adenosine, digoxin, dronedarone
Anticoagulant therapeutic action
oral anticoagulants interfere with the hepatic synthesis of vitamin K- dependent clotting factors (factors 2, prothrombin, 6, 9, 10) resulting in their eventual depletion and prolongation of clotting times: parenteral anticoagulants interfere with the conversion of prothrombin to thrombin, blocking the final step in clot formation but leaving the circulating levels of clotting factors unaffected.
Anticoagulant indications
Treatment and prevention of pulmonary embolism and venous thrombosis and its extension.
Treatment of atrial fib with embolization
Prevention of DVT
Prophylaxis of systemic embolization after acute MI
Prevention of thrombi following specific surgical procedures and prolonged bedrest (low molecular weight heparins)
Anticoagulant interventions
monitor INR (warfarin) or aPTT(heparin) to adjust dosage. Evaluate patient for signs of blood loss (petechiae, bleeding gums, bruises, dark stools, dark urine)
Anticoagulant drugs
Oral drugs: dabigatran, rivaroxaban, warfarin sodium
Parenteral Drugs: argatroban, bivalirudin, desirudin, fondaparinux, heparin, lepirudin
Low-molecular weight heparins: dalteparin, enoxaparin, tinzaparin
Antidiabetics therapeutic actions
oral antidiabetics include several drug types. One type, called the sulfonylureas, stimulates insulin release form function beta cells in the pancreas and may either improve binding between insulin and insulin receptors or increase the number of insulin receptors.
Second-generation sulfonylureas (glipizide and glyburide) are thought to be more potent than first generation sulfonylureas. Other types include drugs that increase insulin receptor sensitivity (thiazolidinediones); drugs that delay or alter glucose absorption (acarbose, miglitol); drugs that increase the stimulus for insulin release (DPP-4 inhibitors , incretin mimetics); and insulin, which is used for replacement therapy.
Antidiabetic indications
Adjuncts to diet and exercise to lower blood glucose in patients with type 2 (non-insulin dependent) diabetes mellitus
Adjuncts to insulin therapy in the stabilization of certain cases of insulin dependent maturity-onset diabetes, reducing the insulin requirement and decreasing the chance of hypoglycemic reactions.
Replacement therapy in type 1 (insulin dependent) diabetes mellitus and when oral drugs cannot control glucose levels in type 2 diabetes.
