Pharmacology Flashcards
Antilipid/Anti-Cholesterol
Statins
-Simvastatin, Pravastatin, Atrovastain
-anticholesterol HMG-CoA inhibitors
-works in liver to prevent formation of cholesterol
-Lowers LDL, triglycerides, CAD, risk of MI
-Increases HDL (happys), warfarin levels, bleeding
-Give with food..NO grapefruit
-monitor muscle tenderness (rhabdomylosis) monitor CK levels.
-check liver enzymes q6mo
Give PM
Antiplatelets
- “grel” clopidogrel, pasugrel, ASA,
- “grel” = gel…..makes platelets slippery…prevents clots
- ASA for quick action (MI stat)
- Increase risk for bleeds, monitor WBW
- Take with food
- if in pain take Tylenol
- ASA toxicity–(early sign) is increased RR, hyperventilating.
Thrombolitics
“-ase” Alteplase, urikinase
- Clot Buster!
- use for CVA (stoke) if within 3 hrs.
- Extreme risks for bleeds
- use for DVT, PE, MI (in first 12 hrs of MI)
- contraindicated for active bleeds, spinal/cranial surgeries, uncontrolled hypertension
- know when to question physicians.
Calcium Channel Blockes
Antihypertensive.
“-pines” …..like the tree Amlodipine, Nidedipine, Dialtizam (hold if HR below 50)
-Blocks Ca entry into muscle cells.
-decreases electrical conduction, force of contractility, work load, BP (vasodialation)
-prevents chest pain, angina, corrects abnormal rapid disrhythmias
-NO grapefruit
-SE: hypotension, liver dysfunction, dysrhythmias.
M-meals U-under sys of 100 C-citrus H-hypertensive
Nitrates
- nitro nitroglycerin, isosorbide
- treats angina. vasodialation relieves chest pain,decreases BP
- isosorbide does NOT relieve pain- its is preventative
- Admin sublingual/buccel. Max of 3 tabs, 5 mins apart. Call EMS at 2 tabs. Can give transdermal (apply in AM. remove Q PM) or IV
- store in dark bottle, NO sunlight
- SE: severe HA, hypotension (give sitting/lie down) , palpitations
- Ca channel blockers are compatible with Nitro
Antihystamine
- “mines” promethazine, diphenhydramin, cetirizine
- treats seasonal allergies, anaphylaxsis.
- Blocks action of histamines (H1 receptor site)
- SE: drowsiness, dry mouth, constipation, confusion
- for best results take before onset of symptoms.
- Benadryl given with blood transfusion IV 10-50 mg
- Vistaril- given pre op or for itching
antitussive
suppresses the cough reflex
administered as a gel is a local analgesic
Codeine/hydrocodone -acts on CNS helps sleep
not given in nervous system impairments, pt who need to cough (risk of lung infections, aspiration and analectasis)
caution with emphysema, asthma- lose reparatory reserve
S/E sedation, dizziness, monitor for respiratory depression
Bronchodialators
Beta 2 Agonists
Beta 2 Agonists-dilates- end in “-terol”
Albuterol, Levalbuterol, Epinephrine,
-BAAM- Beta 2 Agonist Anithistamines Methylzanthines
-Albuterol- SABA-short acting “resucue med”- causes palpitations-shaking
-Salmeterol-LABA- long acting- taking long term
-Sympatico memetics- mimic SNS
-Contraindicated in heart pts
-Admin before exercise or in an emergency
-exhale, compress and inhale, hold, exhale
*BAAM (bronchodialate) before you SLM (steroids)
‘normal’ platelet count
150,000-400,000
Central Acting Agents
Antihypertensives
-clonidine, methyldopa
-stimulates alpha receptors in the brain to open arteries to increase blood flow and lower BP, lower HR
-treats high BP, menopause hotflashes, drug overdose
-do NOT abruptly stop -will cause high BP
SE: fatigue, drowsy, dizzy, hypotension,bradycardia
antitussive
suppresses the cough reflex
administered as a gel is a local analgesic
Codeine/hydrocodone -acts on CNS helps sleep
not given in nervous system impairments, pt who need to cough (risk of lung infections and analectasis)
caution with emphysema, asthma- lose reparatory reserve
S/E sedation, dizziness
Nitrates
- nitro nitroglycerin, isosorbide
- treats angina. vasodialation relieves chest pain,decreases BP
- isosorbide does NOT relieve pain- its is preventative
- Admin sublingual/buccel. Max of 3 tabs, 5 mins apart. Call EMS at 2 tabs. Can give transdermal (apply in AM. remove Q PM) or IV
- store in dark bottle, NO sunlight
- SE: severe HA, hypotension (give sitting/lie down) , palpitations
nasal decongestant
constricts blood vessels in the nose, decreasing congestion, increase breathing ease
oral decongestant cautions and S/E
exacerbate glaucoma, increase blood pressure, DM, prostate obstructions, urinary retention
S/E rebound congestion (teach not to use greater than 7days) anxiety, sweating, pallor
Expectorants
guaifenesin
Reduces the thickness or viscosity of bronchial secretions, increase water secretion to the respiratory tract
Makes it easier to cough up phlegm
Teach pt to increase fluid intake 1500-2000/day to decrease mucous viscosity
Mucolytic
n-acetylcysteine
Directly loosens thick, viscous bronchial secretions breaks down the chemical structure of mucus molecules
do NOT use in chronic bronchitis
Corticosteriods
(-sone) or (-one) methylprednisolone(IV), prednisolone(3-10days)
decreases severity inflammation/mucus, increases beta-2 sensitivity,
NOT a rescue med (BAM then SLM)
Inhaled-preferred therapy for preventing asthma attack, not effective at terminating acute episodes
Local S/E hoarseness, and oropharyngeal candidiasis/thrush
Systemic S/E bone loss/oseopororosis (teach diet and exercise) hyperglycemia (may need to increase insulin in diabetics) muscle weakness, peptic ulcers, increase risk of infection weight gain, hypo adrenal function
Do not stop taking immediately, tamper off
Start with high dose taper down, admin on alternate days
Leukotriene
(-kast) montelukast
2nd drug of choice to reduce inflammation and ease bronchoconstriction. Long term treatment of allergy asthma. NOT a rescue med
Work by blocking leukotriene receptors
Take for 1-2 weeks before effects seen
Take at night b/c cause sedation
Take on empty stomach
S/E liver dysfunction, N, anorexia, abdominal pain
decreases coumadin levels check labs and may need to change dose
Leukotriene
-kast
2nd drug of choice to reduce inflammation and ease bronchoconstriction. Used when asthma not controlled on other drugs. Used for prophylaxis of chronic asthma
But how!!! Work by blocking leukotriene receptors
Take for 1-2 weeks before effects seen
Take on empty stomach
Example= montelukast
Mast cell stabilizers
-crom Prevents the release of histamine from mast cells. Inhibits inflammatory response Used for the prophylaxis of asthma Note - NOT an antihistamine Must take 2-6 weeks before effects seen Example = cromolyn SE: drowsy, dry mouth, swollen tongue, throat irritant Blow nose before use!
Bronchodialators
. Beta 2 Agonists-dilates- end in “-terol”
ii. BAAM- (Beta 2 Agonist Anithistamines Methylzanthines)
iii. Albuterol- SABA-short acting “resucue med”- causes palpaitations-shaking
iv. Salmeterol-LABA- long acting- taking long term
v. Sympatico memetics- mimic SNS
vi. Contraindicated in heart pts
BAAM before you SLM
Methylxanthines
Antihistamine
- phylline Theophylline, aminophylline
- Prevents or Reverse bronchospasm
- ” Theo fill you with Meth” S/E increased HR, dialates lungs, increase 02 to brain, palpitation, insomnia, irritability, HA, GI upset, report NV, diarrhea
- Normal 5-15 . Toxicity over 30
- Give theraputically for COPD, Chronic Bronchitis (older chronic pts)
- avoid caffine.
Cardiac Glycosides
digoxin (Lanoxin)
increases myocardium contractility (positive inotrope)
slows HR, hold if less than 60bpm
Digoxin tosicity greater than 2(therapeutic is 0.5 to 2.0)
S&S of toxicity; N/V, changes in vision- yellow/green halo while looking at lights
if pt has low potassium levels-increased risk for toxicity
antidote -digabind but atrope is often given instead
