PHARMACOLOGY Flashcards by Shiella Mae Abangan-Medallo

Azithromycin, Erthyromycin, Clarithromycin
Hepatotoxic (Acetaminophen, Sulfa Drugs and Phenothiazine)
Watch out for PROLONGED QT Interval

MACROLIDES (thromycin)

How well did you know this?

Not at all

Perfectly

Tobramycin, Gentamycin, Vancomycin
Nephrotoxic
Ototoxic (REPORT: Tinnitus, Vertigo)

AMINOGLYCOSIDES (mycin)

How well did you know this?

Not at all

Perfectly

For Severe Acne
Contraindicated: PREGNANT WOMEN
USE 2 contraceptives to ensure not to get pregnant
TOXICITY: Liver, Increased ICP, GI upset
S/E: Dry mouth/ skin, photosensitivity
AVOID: Excessive sun exposure, blood transfusion, tetracycline

ISOTRETINOIN

How well did you know this?

Not at all

Perfectly

Doxy, Mino, Tetra
Taken on an empty stomach with full glass of water
Photosensitivity
NO Antacids/ Dairy
Decrease effectiveness of oral contraceptive pills
Drug of choice: LYME’S DISEASE

TETRACYCLINE (cyclines)

How well did you know this?

Not at all

Perfectly

Amox, Ampi
Cross sensitivity to Cephalosporin
(if allergic to Penicillin most likely allergic also to Cephalosporin and vice versa)

PENICILLIN

How well did you know this?

Not at all

Perfectly

Better absorbed thru IV
ORAL: For GI Infections
Therapeutic Level: 10-20mg/dl
REDMAN SYNDROME (flushing, pruritus) - NORMAL: decrease IV rate
STOP in case of anaphylaxis

VANCOMYCIN

How well did you know this?

Not at all

Perfectly

Remove excess Potassium and Retains Sodium
Monitor for fluid overload

SODIUM POLYSTERENE SULFONATE

How well did you know this?

Not at all

Perfectly

HOLD 24-48hrs before and after undergoing IODINE CONTRAST procedure

METFORMIN HCL

How well did you know this?

Not at all

Perfectly

Urinary analgesic (UTI)
S/E: Bright red orange secretion (wear napkin and eyeglasses )

PHENAZOPYRIDINE HCL

How well did you know this?

Not at all

Perfectly

Severe pain
Morphine, Hydromorphone, Codeine etc.
ANTIDOTE: NALOXONE (effective for 90mins) could be given again after 90mins. if first dose is not effective
S/E: pupil constriction, respiratory depression (report if less than 10), pilo rection (goosebumps), euphoria, constipation
WITHDRAWAL S/SX: sweating, yawning (first sign) diarrhea, coryza (flu like s/sx), irritable, tremors

NARCOTICS / OPIODS

How well did you know this?

Not at all

Perfectly

Most common S/E: GINGIVAL HYPERPLASIA (no need to report)
Mouth care: soft bristle toothbrush, gargle with NSS / warm water
Decreases WBC and PLATELET COUNT - prone to infection; avoid crowds, use of electric razor, avoid fresh / raw foods
Administration: Sandwich technique (5cc NSS + phenytoin +5cc NSS)
NORMAL Level: 10-20 mcg/mL
TOXICITY: Extreme 6

PHENYTOIN

How well did you know this?

Not at all

Perfectly

Thrombolytic (dissolves clot)
Given within 4-5 hrs (DO NOT exceed) after stroke
FOR ISCHEMIC STROKE
Given if with normal labs and patient did not take any recent anticoagulant
Contraindications: HEMORRHAGIC STROKE, SBP greater than 180mmHg

TpA (Alteplase, Urokinase, etc. )

How well did you know this?

Not at all

Perfectly

S/E: Dark brown urine and saliva
AVOID: MAOIs, PROTEIN, Vitamin B6
Effectivity: More than 3weeks

CARBIDOPA + LEVIDOPA

How well did you know this?

Not at all

Perfectly

Pyridostigmine, Neostigmine
Increases ACTH
Drug of choice: MYASTHENIA GRAVIS
If late given: MYASTHENIC CRISIS
If early given: CHOLINERGIC CRISIS
TENSILON TEST: (Inject Edrophonium) - to determine if Myasthenic/Cholinergic crisis
If INCREASES strength: MYASTHENIC CRISIS
If DECREASES strength: CHOLINERGIC CRISIS (give ATROPINE SULFATE)

ANTICHOLINESTERASE

How well did you know this?

Not at all

Perfectly

For Motion Sickness
Apply >4hrs before travel
Apply at the back of the ear (no hair)
Remove old patch before applying new patch
DON’T TOUCH with bare hands
Effective for 72hrs (replace after 72hrs)

TRANSDERMAL SCOPOLAMINE

How well did you know this?

Not at all

Perfectly

IF AWAKE: Ask to eat (increase glucose 15g CHO, 6oz low fat milk/ juice, 1tb honey, 6 candies, 4oz soda)
IF UNCONCIOUS: D5050 IV

HYPOGLYCEMIA

How well did you know this?

Not at all

Perfectly

PTU (Propylthiouracil)
Lugol’s Solution (iodine-based preparation) - taken with water / orange juice to alter bitter taste
RAI 101 (Radioactive Iodine) - CI: Pregnancy

HYPERTHYROIDISM

How well did you know this?

Not at all

Perfectly

Levothyroxine, Synthroid , Liothyronine
GIVEN: Morning to prevent insomnia, before meals to increase absorption
GIVEN AT LEAST 2hrs apart: Antacid, Multivitamins, Iron (Decreases absorption)

HYPOTHYROIDISM

How well did you know this?

Not at all

Perfectly

Decreases SODIUM (Monitor for Headache - seizure)
Increases BP

DESMOPRRESSIN / VASOPRESSIN

How well did you know this?

Not at all

Perfectly

Anaphylactic Management
NO skin prep
Increases HR, palpitations , dizziness (expected)

EPI -AUTO INJECTOR

How well did you know this?

Not at all

Perfectly

ADALIMUMAB, INFLIXIMAB, ETARNECEPT
for RA, PSORIASIS, CROHN’S
IMMUNOSUPPRESANT - risk for infection (tuberculin skin test yearly, annual Influenza / flu vaccine)
AVOID LIVE VACCINES (BCG, MMR, Herpes Zoster, ROTA Virus, Yellow Fever )

TNF (TUMOR NECROSIS FACTOR INHIBITOR)

How well did you know this?

Not at all

Perfectly

Anti-Malaria
Drug of choice: SLE (Systemic Lupus Erythematosus) Decreases skin and arthritic symptoms; Decreases exacerbations
EFFECTIVITY: Several months
TAKEN with MEALS
Watch out for: RETINAL toxicity, visual problems

HYDROXYCHLOROQUINE

How well did you know this?

Not at all

Perfectly

ABCIXIMAB, EPTIFIBATIDE, TIROFIBAN
Prevent occlusion
CAUSES BLEEDING
Check CBC and bleeding

GLYCOPROTEIN PLATELET INHIBITORS

How well did you know this?

Not at all

Perfectly

Anti-inflammatory / Immunosuppressant - Risk for INFECTION
Prevents organ REJECTION

AZATHIOPRINE

How well did you know this?

Not at all

Perfectly

ANTI-METABOLITE/ Anti -Neoplastic (IMMUNOSUPPRESSANT) RISK for INFECTION AVOID LIVE VACCINES Hepatotoxic

METHOTREXATE

INCREASES NEUTROPHILS

FILGRASTIM

Anti inflammatory , Antibiotic, DMARD S/E: Crystalluria (Increase oral intake) , Photosensitivity (sunscreen), Agranulocytosis Steven Johnson Syndrome - Rashes on the skin (STOP and REPORT) Orange - Yellow urine/ skin : Expected

SULFA DRUGS

METOCLOPROMIDE/ PROMETHAZINE - long use; causes TARDIVE DYSKINESIA (report)

ANTI-EMETICS

ESOMEPRAZOLE, PANTOPRAZOLE, OMEPRAZOLE Long Term : Osteoporosis - check bone density Test Calcium and Vit. D supp GI Infection - C. Difficile Pneumonia Taken 1hr before or 2hrs after meals

PPI (PROTON PUMP INHIBITOR)

CIMETIDINE , RANITIDINE , FAMOTIDINE SHORT TERM : effective overnight/ overnight relief

H2 BLOCKERS

Prevent ulcers Does not decrease stomach ulcers can cause constipation (Increase oral fluid intake) Taken 1hr before meals NOT taken with other meds (take other meds 2hrs before sucralfate)

SUCRALFATE

Anticholinergic S/E: Dry mouth (expected DO NOT REPORT)

OXYBUTININ

ALENDRONATE , RISIDRONATE, IBANDRONATE Taken in the morning with empty stomach then upright for 30mins

BIPHOSPHONATES

Risk for clotting d/o (DVT, STORKE, MI)

HORMONE REPLACEMENT THERAPY

28 active pills If taken 3hrs or more late (use backup contraceptive) Vomiting within 3hs (take additional pill) NO PERIODS/ IRREGULAR S/E: Breakthrough bleeding

POP (PROGESTIN ONLY PILLS)

Enhances FERTILITY

CLOMIPHENE

RIVAROXABAN , EDOXABAN, APIXABAN Anti coagulants LESS RISK for bleeding NOT affected by Vitamin K AVOID: NSAIDs , GARLIC , GINGER

FACTOR Xa INHIBITORS

Drug of choice: BREAST CA A/E: UTERINE BLEEDING (heavy bleeding during periods - REPORT) S/E: Menopausal Symptoms ( Vaginal dryness , decrease libido, hot flushes, cold symptoms )

TAMOXIFEN

All CARDIAC DRUGS can cause ORTHOSTATIC HYPOTENSION except Advise to move slowly

DIGOXIN

"PRILS" if with SENSITIVITY to ACE shift to ARBS ("SARTANS") Decrease BP ; Does NOT affect HR CI: Pregnancy Can cause cough ELEVATES POTASSIUM - avoid Potassium sparing diuretics NOT given with kidney problem or with increase creatinine

ACE INHIBITORS

BISOPROLOL, ATENOLOL, BETAXOLOL, ACETABULOL, ESMOLOL, METROPOLOL (BABAEM) Can cause DECREASE LIBIDO Decreases HR

CARDIO SELECTIVE BB / SELECTIVE BETA BLOCKERS

PROPANOLOL, PINDOLOL, PENBUTOLOL, NADULOL, TIMOLOL, SOTALOL Causes Bronchoconstriction

NON SELECTIVE BETA BLOCKERS

Asthma Blocks (AV, Heart) CHF (Chronic Heart Failure) Diabetes (hides signs and symptoms of hypoglycemia)

BETA BLOCKERS CONTRAINDICATIONS

VERAPAMIL , NIFEDIPINE , DILTIAZEM Decrease HR and BP "calms the heart" Check HR prior to giving Change position slowly Causes BAD headache

CALCIUM CHANNEL BLOCKER

Decreases HR only, does NOT affect BP Check APICAL Pulse before giving Watch out for Toxicity: (>2) BANDAV (Bradycardia, Anorexia, Nausea (1st sign) Abdominal cramping, Visual disturbances (halo sign - green/yellow vision) Decreases Potassium If with KIDNEY Problem could lead to TOXICITY

DIGOXIN

NITROGLYCERIN , NITROPRUSSIDE, HYDRALAZINE, ISOSORBIDE, MINOXIDIL (for severe heart failure) Decreases preload and afterload Decreases BP

DILATORS (VASODILATOR)

S/E: (Expected) Headache, Hypotension, Hot flushes CI: VIAGRA (SILDENAFIL) STOP if with SEVERE HYPOTENSION : irritability, sweating, pallor. lack of coordination

NITROGLYCERINE

For STABLE Angina Goal: NO chest pain while performing ADL Max of 3 doses (5mins interval) CALL 911: 5mins after the 1st dose if still with chest pain then take 2nd dose STORAGE: Dark container, DO NOT put in pocket Replace every 6mos

NITROGLYCERIN PILL/ SPRAY

For UNSTABLE Angina NOT PRN, place once a day OK to shower with patch Rotate daily site (use gloves)

NITROGLYCERIN PATCH

Loop, Potassium wasting diuretic Can cause OTOTOXICITY if given fast Increase dosage can cause HEPATOTOXICITY

FUROSEMIDE

Drug of choice: SVT Given 1-2 secs bolus then flush S/E: (Expected) Flushing, Chest pain, Palpitations

ADENOSINE

POTASSIUM wasting diuretic CI: LICORICE ROOT

THIAZIDES

Seizure prophylaxis Check BP before giving Normal: 4-7meqs/L Toxic: >7 Magnesium Sulfate Toxicity: Decrease BP, Decrease UO, Decrease RR, Absence patellar/ DTR (1st sign)

MAGNESIUM SULFATE

Safe ANTI HYPERTENSIVE drugs for PREGNANT

HYDRALAZINE , LABETOLOL , METHYLDOPA

promotes uterine contractions

UTEROTONICS

Given after delivery of baby Side drip Monitor FHR / Maternal

OXYTOCIN

CI: Hypertension

METHYLERGONOVINE (METHERGINE)

Given RECTALLY Safe with Hypertension

MISOPROSTOL

"ZINE" HALOPERIDOL For POSITIVE symptoms High EPS (Extrapyramidal Symptoms) Toxic A/E: NMS (Neuroleptic Malignant Syndrome) High fever (1st sign) Diaphoresis, ALOC, Muscle problems NMS Management: Meds for Parkinson's Disease

TYPICAL ANTIPSYCHOTICS

"PINE" "DONE" ZIPRASIDONE - Low BP, wide QT intervals For NEGATIVE and POSITIVE symptoms Toxic A/E: AGRANULOCYTOSIS - Sore throat (1st sign) , Leukopenia (Check CBC) NOT given to patient with DEMENTIA

ATYPICAL ANTIPSYCHOTICS

BENZTROPIN , DIPHENHYDRAMINE, BIPERIDINE, TRIHEXYPHENEDRYL Muscle relaxant Given when patient manifest EPS

ANTICHOLINERGICS

High suicide risk if taken less than 2weeks Slow onset and slow taper off (2-4 weeks effectivity) NEVER mix MAOIs with other antidepressants: SSRI with SJW (St. John's Wort) ALL PSYCH DRUGS decreases BP, increases WT, HEPATOTOXIC

ANTIDEPRESSANTS

"INE" " PRAM" Sexual Dysfunction, low libido, pilo erection DO NOT Mix with MAOIs, St. John's Wort, Tramadol Can be mixed with Benzodiazepines Serotonin Syndrome - if taken with MAOIs , SJW, Tramadol (Sweaty hot fever, Rigidity, Restlessness, Tremors, Agitation, Increased HR)

SSRI

"PRAMINE" "TRIPTYLINE" Anticholinergic side effects Blurred Vision Photophobia Urinary Retention Dry mouth , constipation , sedation AVOID taking if with GLAUCOMA

TCA

TRANYLCYPROMINE, PHENELZINE, ISOCARBOXACID, SELEGILINE Given in the morning (causes insomnia) Cause Massive Hypertension AVOID Tyramine rich foods (could lead to Hypertensive Crisis - wine, cheese (swiss, cheddar, aged, mozzarella) beer, sausage, salami, soya, yoghurt, dry and fermented fruits ) AVOID OTC MEDS: Calcium Antacids, Acetaminophen, NSAIDs (CAAN) Increase Suicide Risk

MAOIs

Chronic pain; improves sleep

DULOXETINE

priapism ; DO NOT TAKE alcohol and sedatives

TRAZODONE

DO NOT crush / chew DO NOT smoke

BUPOPRION XL, SR

Anti manic Check renal function prior to giving (creatinine and urinary output) NORMAL Level: 0.5-1.5 Toxicity signs: Diarrhea, Thrist, Polyurea, Vomiting Increase fluids, regular sodium HOLD NSAIDs : Decreases renal blood flow INCREASED SODIUM: Toxic DECREASED SODIUM: Less effective Substitutes: Valproic Acid (Hepatotoxic, check AST/ALT, DO NOT ABRUPTLY stop) Carbamazepine (Drug of Choice: TRIGEMINAL NEURALGIA, not effective if taken with oral contraceptives, check for presence of fever and sore throat) Anti Psychotic

LITHIUM

ADHD Taken in the morning after breakfast DO NOT give at nighttime (causes insomnia) S/E: Growth retardation/ Suppression

METHYLPHENIDATE

"ZEPAM" "ZOLAM" LOW and SLOW Dizziness (most common s/e - Hang-over effect) ANTIDOTE: FLUMAZENIL DIAZEPAM CI: Valerian root, okay with Gingko, Ginseng

BENZODIAZEPINES

NO sedative effect Can drive bus Long Term NOT addictive SAFEST anxiolytic NO withdrawal 2-4weeks

BUSPIRONE

ADDICTIVE LOW AND SLOW

BARBITURATE and BENZODIAZEPINES

Long acting prevention DON'T SMOKE Rinse mouth with water PNEUMOCOCCAL Vaccine + Influenza Vaccine (if infection risk)

FLUTICASONE / SALMETEROL

SABA (short acting beta 2 agonist) Symphatomimetic (Tachycardia, Tremors, Insomnia, Low Potassium)

ALBUTEROL

Narcotic Cough Suppressant

CODEINE

Bronchodilator Normal: <20mcg/mL Toxic: Seizure, Arrhythmia, Anorexia, Insomnia , Restlessness AVOID: Cimetidine, Ciprofloxacin, Caffeine

THEOPHYLLINE