pharmacology Flashcards
atorvastatin
-Lipid lowering via HMGcoA reductase
-monitor liver: ALT, AST at start and 6wks
-give with CoQ10 atleast 100mg
-discontinue if muscle pain / liver enzymes spike
simvastatin
-lipid lowering agent
-HMGCOA reductase
- give with CoQ10
-monitor liver enzymes at start and 6 wks
- d/c if muscle pain or liver enzymes spike
reasons to discontinue a statin
muscle pain or liver enzyme spike
what should you always give with a statin
coQ10
Niacin
stimulates hepatic lipid breakdown
SE: flushing, rash
CI: liver toxicity - slow release more toxic to liver
1-2 g per day
Hydrochlorothiazide
-HCTZ or diuretic
-For HTN / Edema
-inhibits sodium and chloride reuptake in distal tubule to reduce GFR
-SE: low potassium, high calcium, high glucose, renal failure
NEVER IN SULFONAMIDE OR THIAZIDE INTOLERANCE
Furosemide
Loop diuretic
HTN and Edema
pulls sodium and chloride out of loop of henle
SE: low potassium, high calcium, high glucose, low BP
Triamterene
potassium sparing diuretic
HTN, edema
works in distal tubule
SE: high potassium ( hyperkalemia)
turns urine blue , may combine with HCTZ
Spironolactone
aldosterone antagonist
HTN, Edema, PCOS
SE: high potassium, breast diformity
drug ending in OLOL is what kind
beta blocker
drug ending PRIL
ACE inhibitor
drug ending in SARTAN
ARB
Clonidine
alpha 2 central agonist in brain stem
HTN - used for rapid drop in BP over 4 hrs
relaxes vessels and renal system
TAPER OFF- can cause rebound HTN
Reserpine
Catecholamine depleting agent
HTN
SE: drowsiness, anxiety, depression, bradycardia, congestion, Nausea, diarrhea,
NEVER within 2 weeks of MAOI
ITS VERY LOW DOSE 0.25mg BID max
Atenolol
Beta 1 blocker
HTN, angina
SE: fatigue, vertigo, bradycardia, bronchospasm, CHF
NEVER WITH digitalis
TAPER
metoprolol
Beta 1 blocker
HTN, angina
SE: fatigue, vertigo, bradycardia, bronchospasm, CHF
NEVER with digitalis
TAPER
What two beta blockers are B1 adrenergic receptor blockers
atenolol and metoprolol
Propranolol
Beta 1 and 2 blocker
HTN, angina, arrythmias, migraines essential tremors
SE: fatigue, bradycardia, hypotension, N/V, CHF
ALWAYS TAPER
Carvedilol
beta 1 and 2 blocker
HTN, angina, arrythmias, migraines, essential tremors
SE: fatigue, bradycardia, hypotension, N/V, CHF
TAPER
Timolol
Beta 1 and 2 blocker
HTN, angina, arrythmias, migraines, essential tremor
SE: fatigue, bradycardia, hypotension, N/V, CHF
TAPER
verapamil
Calcium channel blocker
HTN, angina
SE: constipation, dizzy, edema, CHF
NOT WITH CIMETIDINE
diltiazem
calcium channel blocker
Angina, HTN, AFIB
HA, edema, dizzy, arrythmia, CHF, nausea, constipation, rash
NOT WITH CIMETIDINE
amlodipine
calcium channel blocker
HTN, angina
SE: dizziness, CHF, edema, HA, weakness, nausea
capsules are passed in stool
Lisinopril
ACE inhibitor
HTN, heart failure
SE: dry persistent cough , tachycardia, rash, renal dysfunction, HA, high potassium
NEVER IN PREGNANCY
irbesartan
ARB - blocks angiotensin 2 receptor
HTN for those with ACE intolerance
SE: renal dysfunction, high potassium, hypotension
losartan
ARB blocks angiotensin 2 receptor
HTN for those with ACE intolerance
SE: renal dysfunction, high potassium, hypotension
Valsartan
ARB blocks angiotensin 2 receptor
HTN for those with ACE intolerance
SE: renal dysfunction, high potassium, hypotension
warfarin
blocks vitamin K and factors 2,7,9,10
For: thrombosis, rheumatic heart disease, emboli, ischemic heart disease
SE: prolonged bleeding, hemorrhage, rash, fever, diarrhea
Monitor PTT
Heparin
inhibits clotting factors via AT3
prevention of DVT, Emboli, DIC
SE: hemorrhage, cutaneous necrosis, chills, fever, itching
Caution: menstruating female, liver dz, blood dz
clopidogrel
blocks TA2 adn PG2 in clotting cascade
For reducing risk of stroke, MI
SE: salicylism, GI bleed, tinnitus, rash, occult blood, tenderness to palpation
aspirin
blocks TA2, PG2 in clotting cascade
Reduces risk of stroke, MI
SE: GI bleed, tinnitus, rash, occult blood
digoxin
class 1 anti arrhythmic
inhibits sodium potassium pump increasing cardiac action potential threshold with calcium
For: CHF, atrial tachycardia, AFIB, A flutter
SE: fatigue, arrhythmia, weakness, agitation, blurred vision, nausea
Toxicity is high- yellow halo around vision- death
Lidocaine
class 1 anti arrhythmic
AFIB,Aflutter, CHF
SE: fatigue, agitation, blurred vision, nausea
what meds are class 2 anti arrhythmic
beta blockers
amiodarone
class 3 anti arrhythmic
delay repolarization by lengthening AP, and reducing SA node function
MOST PEOPLE CAN’T TOLERATE IT
lung toxicity, liver toxicity
What meds are class 4 anti arrhythmic
calcium channel blockers
nitroglycerin
anti anginal
increases blood flow to heart , decreases preload and afterload
Angina
SE: HA, dizziness, tachycardia, rash, hypotension
sublingual 1 tab every 5 min 3 doses
loratadine
Antihistamine blocks H1 receptor
seasonal allergies
non sedating
NEVER USE WTIH erythromycin, ketoconazole, itraconazole- causes fatal arrythmia
Diphenhydramine
Antihistamine
blocks H 1 receptor
Allergic reactions from Type 1 response or insomnia
SE: DROWSINESS, nausea, seizures, thrombocytopenia, agranulocytosis
NEVER with CNS depressants or MAOI’s
cetirizine
antihistamine
H1 blocker
NON SEDATING
Seasonal allergies
Promethazine
antihistamine
H1 blocker
SEDATING
allergic responses
NEVER with CNS depressants or MAOI’s
epinephrine
Direct sympathomimetic - vasoconstriction of alpha1, vasodilate beta 2
Anaphylaxis,bronchoconstriction and local anesthesia
SE: cerebral hemorrhage, CVA, HTN, Vfib, shock , N/V, drowsiness
IV: 1:10,000 0.1-0.2mg/mL 2 ml every 5 minutes
IM 1:1,000 0.5-1mg/mL 1 ml
NOT IN CLOSED ANGLE GLAUCOMA
oxymetazoline
nasal spray or eye drops for vasoconstriction
Congestion
SE: arrythmia, anaphylaxis, asthmatic episode , HA
DO NOT USE WITH MAOI or sever HTN
Phenylephrine
sympathomimetic- vasoconstricts alpha 1
for Congestion, hypotension
SE: arrythmia, anaphylaxis, asthmatic episode,
NEVER WITH MAOI or severe HTN
pseudoephedrine
sympathomimetic , vasoconstricts alpha 1
decongestant
SE: anxiety, palpitation, HA, insomnia
NEVER with MAOI
albuterol
B2 adrenergic agonist for bronchodilation
Acute asthma , fast acting
SE: anxiety, tachycardia, HA, palpitations, nausea, bronchospasm
NOT with CNS stimulants
Atropine
muscarinic antagonist
emergency bronchodilation
SE: dry mouth tachycardia
acetylcysteine
Mycolytic at high doses
For : pneumonia, bronchitis, TB, CF, emphysema
SE: rhinorrhea, stomatitis, nausea, vomiting, bronchospasm
Not with activated charcoal
guaifenesin
Mucolytic
Pneumonia, TB, emphysema
SE: none
50-400mg every 4 hours depending on age
Glucocorticoids
end in sone, zone or onide
decrease respiratory irritation and inflammation
for use with bronchodilators
SE: water retention, CV problems, osteoporosis, peptic ulcer
ipratropium bromide
anticholinergic bronchodilator
bronchospasm with COPD or asthma
SE: arrhythmias, palpitations, anxiety, nausea
Not for single use
tiotropium
anticholinergic bronchodilator
maintenance of bronchospasm in COPD and asthma
SE: arrhythmias, palpitations, anxiety, nausea
NOT FOR SINGLE USE
what are the rescue acute inhalers
epinephrine, albuterol
what are the maintenance inhalers
steroids, ipratropium, tiotropium,
what are the maintenance inhalers
steroids, ipratropium, tiotropium,
cromolyn sodium
mast cell stabilizer
bronchial asthma in adults and kids
solution 20mg
inhaled 800mcg
budesonide
inhaled steroid
asthma
1-2 per day
fluticasone
steroid
nasal or oral
once daily
salmeterol
LABA
asthma
increased risk of asthma related death
codeine
cough suppressant
hydrocodone
cough suppressant
Nystatin
antifungal - disrupts cell wall
topical kill even in GI tract
for candida anywhere
1million units TID
SE: contact dermatitis
Terbinafine
antifungal
topical and oral
mainly onychomycosis of nails
fluconazole
antifungal
systemic kill
need breaks if using long term
permethrin
antiparasitic
paralysis of parasites
SCABIES, pediculosis
SE: pruritis, edema, rash, burning, stinging
mebendazole
anthelminthic
prevents nutrient uptake by helminths
pinworms, roundworms, hookworms
SE: abdominal pain, fever, diarrhea
repeat after 3 weeks to kill larvae
Metronidazole
antiprotozoal
inhibits DNA synthesis
Amoebas, trich, giardia
SE: GI distress, seizure, ataxia, rash, joint pain
DO NOT DRINK ALCOHOL , Potentiates p450 drugs
hydroxychloroquine
antimalarial
malaria, amebiasis
SE: HA, dizziness, pruritis, seizures, retinal change, ototoxicity
gentamicin
antibiotic - aminoglycosides
stops DNA synthesis
Serious infection with enterobacter, E. Coli, pneumonia, pseudomnoas
SE: ototoxic, nephrotoxic, neurotoxic
okay for breastfeeding
penicillin
antibiotic -targets cell wall
Beta lactams
gram positive bacteria , syphilis
SE: GI dysbiosis, Ki failure especially in IV, liver damage, superinfection , neurotoxic,
not effective against beta lactamase or Gram neg bacteria
ampicillin
antibiotic
inhibits cell wall
gram postivie and negative, prophylaxis for dentist
SE: N/V, rash, urticaria, anaphylaxis
not effective against beta lactam organisms
amoxicillin
antibiotic
inhibits cell wall
some gram positive and negative - dental prophylaxis
not against beta lactimase unless mixed with clavulanate
how long are antibiotics given
10days
cephalexin
cephalosporin - inhibits cell wall 1st gen
For: URI, skin infections, GI
SE: maculopapular rash
CAUTION WITH PENECILLIN ALLERGY
erythromycin
macrolide- stops bacterial DNA synthesis
for M. Pneumonia, pertussis, C. Pneumonia, strep, URI
SE: GI pian, N/V, anaphylaxis
NEVER IN PREGNANCY, caution with kidney problems
clarithromycin
macrolide, stops bacterial DNA formation
Bronchitis, urinary STI that is not gonorrhea
caution in pregnancy
azithromycin
macrolide, interferes with DNA synthesis
bronchitis, non gonococcal uti or STI
fewer GI effects, less medication needed
safer in pregnancy
this is a Zpak
Doxycycline
antibiotic - tetracycline
stops bacterial protein synthesis
Gram positive and negative, chlamydia, lyme
acne- prophylaxis
SE: intracranial HTN, GI upset, rash, increased pigmentation,
NEVER IN PREGNANCY, <9YO, lactation
minocycline
Tetracycline antibiotic
most absorbed in stomach, low GI kill rate
nitrofurantoin
UTI antibiotic
NOT IN SIGNIFICANT RENAL IMPAIRMENT , pregnancy 3rd trimester
take with food
clindamycin
lincosamide antibiotic
gram positive cocci alternative for penacillin
better absorbed more active
ciprofloxacin
fluoroquinolone antibiotic
stops bacterial DNA formation
Wide spectrum: URI, UTI, bone infections, GI
SE: GI, seizures, achilles tendon rupture , stop growth plate development
NEVER IN KIDS UNDER 18
levofloxacin
fluoroquinolone , stops DNA synthesis
Wide spectrum: URI, UTI, GI, bone,
not if <18yo
SE: achilles tendon rupture, stop growth plate closure
isoniazid
Anti TB via inhibits cell wall
TB
SE: neuropathies, hepatotoxic, GI, rash
give with B6
rifampin
anti TB
Tb
GIVE WITH B-6
hepatotoxic
mupirocin
topical antibiotic
stops bacterial RNA
Impetigo, MRS, prophylaxis
Few side effects
expensive
acyclovir
antiviral, stops replication
HSV1 and 2, varicella, herpes, encephalitis, mollerets syndrome may occure
SE: N/V rash
valacyclovir
antiviral, stops replication
HSV1 and 2, varicella, herpes, encephalitis
SE: nausea, rash
