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Pharmacology > Test 3 > Flashcards

Test 3 Flashcards

Starting at class 12

0
Q
  1. Anti-inflammatory Drugs
A
  • Relieve swelling, tenderness, redness, and pain
  • Steroidal anti-inflammatory agents are used in the treatment of local inflammatory disorders; may be applied to the skin for topical treatment of dermatological conditions or injected into a joint, bursa, or skin lesion to reduce inflammation
  • Corticosteroids have potent anti-inflammatory effects; they cause varied metabolic effects, and modify the body’s immune responses to assorted stimuli; used for dermatologic, ophthalmic, respiratory, hematologic, gastrointestinal, and neoplastic diseases, allergic states, edematous states, cerebral edema, adrenocortical insufficiency, hypercalcemia associated with cancer, psoriatic arthritis, rheumatoid arthritis, bursitis, osteoarthritis
  • Nonsteroidal anti-inflammatory drugs (NSAID’s): are synthetic products that are unrelated to substances produced by the body; these are used for inflammation, arthritis, and related disorders
  • Examples: Motrin (Ibuprofen), Decadron (dexamethasone), Allercort (hydrocortisone), Aristocorst (triamcinolone)
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1
Q

Medications used for Musculoskeletal System Disorders:

A
  1. Anti-inflammatory Drugs
  2. Gout
  3. Skeletal Muscle Relaxants
  4. Neuromuscular Blocking Agents
  5. Skeletal Muscle Stimulants
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2
Q
  1. Gout
A
  • It is a hereditary metabolic disease that is a form of acute arthritis
  • Inflammation of the joints; can affect any joint; usually begins in the knee or foot
  • Caused by excessive uric acid in the blood (hyperuricemia) and deposits of urates of sodium in and around joints
  • Treated with Colchicine, Probenecid, Sulfinpyrazone, Allopurinol
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3
Q
  1. Skeletal Muscle Relaxants
A
  • Used to treat painful muscle spasms that may result from musculoskeletal strains, sprains, trauma, or disease
  • Examples: diazepam (Valium), cyclobenzaprine HCl (Flexeril), Robaxin (methocarbamol), carisoprogol , Skelaxin (metaxalone)
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4
Q
  1. Neuromuscular Blocking Agents
A
  • Used to provide muscle relaxation and to reduce the need for deep general anesthesia in patients undergoing surgery
  • Also used to facilitate endotracheal intubation, relieve laryngospasm, provide muscle relaxation in patients undergoing electroconvulsive therapy
  • Example: Tubarine
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5
Q
  1. Skeletal Muscle Stimulants
A
  • Act by inhibiting the action of acetylcholinesterase, the enzyme that halts the action of acetylcholine at the neuromuscular junction
  • Used for myasthenia gravis (autoimmune disorder with impaired neuromuscular transmission)
  • Examples: Tensilon (edrophonium chloride), Mestinon (pyridostigmine bromide)
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6
Q

Medications used for Gastrointestinal System Disorders:

A
  1. Antacids
  2. Histamine H2-Receptor Antagonist
  3. Antispasmodics/Anticholinergics
  4. Laxatives
  5. Antidiarrheal Agents
  6. Antihelmintics
  7. Antiprotozoal Agents
  8. Antiemetics
  9. Emetics
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7
Q
  1. Antacids
A
  • Many GI complaints are simply the result of poor eating habits, stress, over indulgence, alcohol, or smoking
  • Antacids neutralize hydrochloric acid in the stomach; relieve acid indigestion, gas, and heartburn; treatment of peptic ulcers
  • Most are non-systemic because they remain largely in the GI tract
  • Should not be taken within 1-2 hours of any other medication because they can decrease the effectiveness of other medications
  • They are taken for brief periods of time; No more than 2 weeks
  • Some antacids contain aluminum and should not be used by elderly persons with bone problems or with Alzheimer’s disease since aluminum can worsen these conditions; x-ray test results may also be affected
  • Some antacids contain large amounts of sodium; if the patient has high BP or is on a low sodium diet, care must be taken not to give these
  • If the antacid contains calcium or sodium bicarbonate, patient should not drink large amounts of milk or milk products since this will increase the chances of side effects
  • Examples: they come in liquids (these should be shaken before pouring and have patient take a small glass of water after dose to be sure all the medication reaches the stomach), capsules, tablets and powder forms: precipitated chalk (Tums), sodium carbonate (Rolaids), magaldrate (Riopan), magnesium hydroxide (Milk of Magnesia), Zantac, Maalox liquid, Alka Seltzer
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8
Q
  1. Histamine H2-Receptor Antagonist
A
  • Inhibit both daytime and nocturnal basal gastric acid secretion and inhibit gastric acid stimulated by food, histamines, caffeine, insulin, and pentagastrin
  • Used to treat active duodenal ulcer, and pathological hypersecretory conditions, gastric ulcers
  • Examples: cimetidine (Tagamet), ranitidine (Zantac), Nexium
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9
Q
  1. Antispasmodics/Anticholinergics
A
  • Reduce gastric motility by antagonizing the action of acetylcholine at the postganglionic receptors in the parasympathetic nervous system
  • Used as adjunctive therapy in the treatment of peptic ulcer; dyspepsia, irritable colon, mild diarrhea, pylorospasm, biliary colic, hypermotility, and acute pancreatitis
  • Examples: atropine sulfate, dicyclomine HCl (Bentyl)
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10
Q
  1. Laxatives
A
  • Used to relieve constipation and facilitate passage of feces through the lower GI tract
  • Examples: bisacodyl (Dulcolax), phenolphthalein (Ex-Lax), psyllium hydrophilic muciloid (Metamucil)
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11
Q
  1. Antidiarrheal Agents
A
  • Diarrhea may be caused by infection, intoxication, allergy, malabsorption, inflammation, tumors of the GI tract, food poisoning, and certain medications
  • Examples: bismuth subsalicylate (Pepto-Bismol), loperamide HCL (Imodium)
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12
Q
  1. Antihelmintics
A
  • Intestinal infestation by parasitic worms

* Examples: (mebendazole) Vermox, quinacrine HCl (Atabrine), Phenergan, Dramamine

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13
Q
  1. Antiprotozoal Agents
A
  • Malaria, giardiasis, trichomoniasis, and amebiasis

* Examples: metronidazole (Flagyl), chloroquine HCl (Aralen HCl)

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14
Q
  1. Antiemetics
A
  • Prevent or arrest vomiting
  • Used to treat vertigo, motion sickness, nausea associated with radiation
  • Examples: Dramamine, Compazine, Bonine, Voltrol, Marezine, Phenergan, Thorazine
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15
Q
  1. Emetics
A
  • Used to induce vomiting for overdosing or poisoning

* Example: Ipecac syrup

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16
Q

Medications for Circulatory System Disorders

A
  • These medications affect heart action in one or more of the following ways:
  • Inotropic effect: either positive or negative by increasing or decreasing the force of myocardial contraction
  • Chronotropic effect: positive or negative by increasing or decreasing heart rate
  • Dromotropic effect: positive or negative by increasing or decreasing the conduction of electrical impulses through the heart muscle
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17
Q

Types of medications Used for Circulatory System Disorders

A
  1. Digitalis
  2. Antiarrhythmic Agents
  3. Antihypertensive Agents
  4. Anticoagulants
  5. Antiplatelet Drugs
  6. Antianginals
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18
Q
  1. Digitalis
A
  • used for congestive heart failure, atrial fibrillation, atrial flutter, paroxysmal atrial tachycardia
  • Example: digoxin (Lanoxin)
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19
Q
  1. Antiarrhythmic Agents
A
  • Used to control many cardiac arrhythmias
  • Example: propranolol HCl (Inderal), Procan SR, Tambacor (Flecainide), Pronestyl (procainamide), Cardarone (Amiodarone)
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20
Q
  1. Antihypertensive Agents
A
  • Categorized as diuretics, adrenergic blocking agents, or sympatholytics, calcium channel blockers, direct vasodilators, angiotensin antagonists
  • Examples: furosemide (Lasix), methyldopa (Catapres), Diuril, Aldomet, Inderal
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21
Q
  1. Anticoagulants
A
  • Prophylaxis and treatment of venous thrombosis and its extension, prevention of postoperative deep venous thrombosis and pulmonary embolism, prevention of clotting in arterial and heart surgery, atrial fibrillation with embolization
  • Medication should be taken at the same time every day; do not drink alcohol since it may change the prothrombin time) which is used to determine if the medication is being effective
  • Report any excessive bleeding, nosebleeds, brown or brown orange urine (blood), black and tarry stools (blood), unusual bruising
  • Avoid eating large amounts of food high in vitamin K (green leafy vegetables, broccoli, Brussel sprouts, spinach, cauliflower, chickpeas, beef, pork, liver, green tea)
  • Shave with an electric razor
  • Regular lab blood tests are required
  • Many other drugs interfere with the action of anticoagulants; patient must check first even before taking otc meds
  • All providers should know that the patient is on this medication (dentist)
  • Example: heparin sodium, warfarin sodium (Coumadin) (Jantoven)
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22
Q
  1. Antiplatelet Drugs
A
  • Aspirin used to reduce risk of a second heart attack and/or to reduce the risk of having a heart attack and/or a stroke
  • Inhibit essential enzyme that cells use to manufacture prostaglandin (a hormone-like substance that takes an active role in many cellular activities); this inhibits platelet clumping (the first stage of blood clotting process)
  • Examples: Plavix (clopidogrel bisulfate), Novodipiradol (dipyridamole)
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23
Q
  1. Antianginals
A

• Used for chest pain; they widen the blood vessels so the heart can receive more blood and oxygen
• Example: Nitroglycerin
o Should be taken when sitting down
o Do not store in bathroom, near kitchen sink, or in refrigerator; heat and moisture may cause it to lose its effectiveness.
o It lowers the BP; patients taking antihypertensives need to be careful
o Put first tablet under tongue upon signs of angina, wait 5 minutes. If pain is still persistent, put second table and up to a third within another 5 minutes. After 3 tablets, if pain still persists, call 911.
• Same steps are taken if the medication comes in a spray
• For topical and transdermal, use as directed; transdermal patch is usually wore for 24 hours

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24
Q

Medications used for Respiratory System:

A
  1. Antihistamines
  2. Decongestants
  3. Antitussives
  4. Expectorants and Mucolytics
  5. Bronchodilators
  6. Inhalational Corticosteroids
  7. Antituberculosis agents
  8. Influenza A (H1N1) 2009 Monovalent Vaccine
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25
Q
  1. Antihistamines
A
  • Used in the treatment of allergy symptoms that have resulted from the release of histamine; allergic rhinitis, contact dermatitis, urticaria, pruritus, allergic reactions to substances such as blood, plasma, insect stings, plant poisons and as adjunctive therapy during anaphylactic shock.
  • Some are used for the prevention and control of motion sickness and other are used in combination cold remedies to decrease mucus secretion and at bedtime for sedation.
  • Antihistamines are contraindicated in patients who are known to be hypersensitive to any of the ingredients. They should not be used in newborn or premature infants and during breast-feeding.
  • Antihistamines may cause respiratory tract to dry and mucus to thicken; therefore, when taking antihistamines, one should drink plenty of fluids to thin secretions and keep tissue moist.
  • Examples: diphenhydramine HCl (Benadryl), loratadine (Claritin)
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26
Q
  1. Decongestants
A
  • Congestion of the nasal mucosa may occur as a result of infection, inflammation, or emotional upset
  • Decongestants are commonly used for symptomatic relief of nasal congestion; temporary relief of nasal congestion associated the common cold, hay fever and/or other upper respiratory allergies, and sinusitis
  • Decongestants work by constricting arterioles which were dilated in the nasal mucosa; this reduces the blood flow to the affected area, slows the formation of mucus, improves drainage, and opens obstructed nasal passages
  • Decongestants should not be taken more than 7 days; long-term use increases the risk of sensitization, which often causes a rebound effect or an increase in symptoms
  • Patients with heart disease, hypertension, thyroid disease, glaucoma, diabetes, or prostatic hypertrophy should not take decongestants without the permission of their physician
  • Examples: oxymetazoline HCl (Afrin), pseudoephedrine HCl (Sudafed)
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27
Q
  1. Antitussives
A
  • Cough is a physiologic reflex; it is a protective action that clears the respiratory tract of secretions and foreign substances; it helps maintain an open airway in individuals with asthma, chronic obstructive pulmonary disease, and cystic fibrosis; in other people, coughing may be associated with smoking, viral upper respiratory infections, allergy, and numerous other causes
  • Cough can be alleviated by treating the underlying cause
  • Antitussives have no effect on the underlying condition, they ease respiratory discomfort, facilitate sleep, and reduce irritation
  • Nonnarcotic antitussive agents anesthetize the stretch receptors located in the respiratory passages, lungs, and pleura by dampening their activity and thereby reducing the cough reflex at its source
  • Narcotic antitussive agents depress the cough center that is located in the medulla, thereby raising its threshold for incoming cough impulse
  • Narcotic antitussive agents may be habit forming and may cause drowsiness
  • Medication should not be chewed or allowed to dissolve in the mouth because it could anesthetize the throat and lead to choking
  • Liquid medication should not be taken with or followed by water, as this could diminish its effect
  • Examples: codeine, benzonatate (Tessalon), hydrocodone bitartrate (Codone)
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28
Q
  1. Expectorants and Mucolytics
A

• An expectorant is an agent that stimulates and decreases the thickness of respiratory tract secretions
• Mucolytics are drugs that reduce the viscosity of respiratory tract fluids
• These are used in treating coughs, because such actions should facilitate removal of irritants and phlegm
• Conclusive evidence of the effectiveness of these medications is yet to be reported
• Patients should drink plenty of fluids to help keep mucous membranes moist and loosen secretions
• Mucolytics should not be mixed with antibiotics, iron, copper, or rubber products
• Mucolytics should be given a half to one hour before meals for better absorption and to decrease nausea
• Mucolytics can be used as an antidote for acetaminophen overdose
• Examples: Expectorants: Robitussin, Humibid
Mucolytics: Mucomyst, Mucosil, Parvolex

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29
Q
  1. Bronchodilators
A
  • Are used to improve pulmonary airflow in patients with chronic obstructive pulmonary disease
  • Asthma is an episodic, reversible obstruction of the peripheral airways
  • Bronchodilators relax smooth muscle cells of the bronchi; reduce edema in the bronchial mucosa
  • Bronchodilators are used in the prevention and relief of bronchospasm in patients with asthma, bronchitis, and emphysema
  • Examples: albuterol (Ventolin), epinephrine (Adrenaline)
30
Q
  1. Inhalational Corticosteroids
A
  • Corticosteroids are anti-inflammatory agents that are chemically related to the naturally occurring hormone cortisone
  • Inhalational corticosteroids are used in the treatment of bronchial asthma and allergies when other forms of treatment are not effective
  • Examples: dexamethasone (Decadron)
31
Q
  1. Antituberculosis agents
A
  • TB is spread from person to person by airborne transmission; talking coughing, sneezing, laughing or singing
  • There are today drug-resistant strains of TB that can survive through seven of the antibiotics traditionally used
  • TB today occurs primarily among AIDS patients, the homeless, drug abusers, prison inmates, and immigrants
  • Treatment requires long-term therapy (6-9 months)
  • It takes about two weeks for the drugs to kill enough bacteria so that they cannot infect other people
  • Examples: isoniazid (INH), rifampin (Rifadin)
32
Q
  1. Influenza A (H1N1) 2009 Monovalent Vaccine
A

• Date of Approval: September 15, 2009

Companies: CSL Limited; Novartis Vaccines and Diagnostics Limited; Sanofi Pasteur, Inc.; MedImmune LLC

33
Q

• Treatment for: Prevention of Pandemic (H1N1) 2009 Virus

A
  • People with severe or life-threatening allergies to chicken eggs, or to any other substance in the vaccine, should not be vaccinated.
  • Potential side effects of the H1N1 vaccines are expected to be similar to those of seasonal flu vaccines.
  • Adults 18 years of age and older:
  • A single 0.5 mL intramuscular injection.
  • Influenza A (H1N1) 2009 Monovalent Vaccine is an inactivated vaccine that cannot cause influenza but rather stimulates the immune system to produce antibodies.
  • The most common (= 10%) local (injection-site) adverse reactions were tenderness, pain, redness, and swelling. The most common (= 10%) systemic adverse reactions were headache, malaise, and muscle aches.
34
Q

Treating the Urinary System Disorders

A
  • Nephrons are the functional units of the kidneys; this is where filtration and reabsorption occurs
  • Two vital functions are performed: 1. Urine is produced for excretion and 2. The amount of water, electrolytes, and other substances in the blood is regulated
  • Disorders of the urinary system can be attributed to a variety of causes, including infections, damage or dysfunction of the kidneys, bladder, or other organs in the system
35
Q

Medications used for the Urinary System Disorders

A
  1. Diuretics
  2. Medications for cystitis
  3. Urinary Tract Antibacterials
  4. Urinary Tract Antiseptics
  5. Urologic Disorders
36
Q
  1. Diuretics:
A
  • Diuretics decrease reabsorption of sodium chloride by the kidneys, thereby increasing the amount of salt and water excreted in the urine; this action reduces the amount of fluid retained in the body and prevents edema; diuretics are classified according to site and mechanism of action
  • Thiazide diuretics inhibit the sodium and chloride reabsorption in the early portion of the distal tube; they also block chloride reabsorption in the ascending loop of Henle
  • Loop diuretics inhibit the reabsorption of sodium and chloride in the ascending loop of Henle
  • Potassium-sparing diuretics inhibit the exchange of sodium for potassium in the distal tubule; they inhibit potassium excretion
  • Osmotic diuretics can be filtered by the glomerulus, but have a limited capability of being reabsorbed into the bloodstream
  • Carbonic anhydrase inhibitor diuretics act to increase the excretion of bicarbonate ion, which carries out sodium, water, and potassium
  • Diuretics are used in the treatment of congestive heart failure, hypertension, nephrotic syndrom, chronic renal failure, idiopathic edema, diabetes insipidus, and glaucoma; also used sometimes for premenstrual syndrome
  • With most diuretics, potassium is excreted; therefore, bananas, prunes, raisins, oranges, orange juice, cereals, dried peas, and fresh vegetables should be included in the diet to help replenish potassium
  • Avoid potassium-rich foods in potassium-sparing diuretics and in carbonic anhydrase diurectics
  • Patients should increase fluid intake to 2-3 liters per day
  • Watch for signs of fluid or electrolyte imbalance
  • Medication should be taken in the morning to avoid nocturia
  • Use in pregnancy is not recommended
  • Examples: furosemide (Lasix), spironolactone (Aldactone)
37
Q
  1. Medications for cystitis
A
  • Cystitis is an inflammation of the urinary bladder
  • Most common type of bacteria which causes cystitis is E. coli (the colon bacillus)
  • Sulfonamides and antibiotics such as penicillins, cephalosporins, tetracyclines, and aminoglycosides are drugs of first choice
  • Guidelines to help avoid cystitis in women: drink 8 glasses or more of water a day, wipe from front to back, drink a glass of water before engaging in intercourse and then urinate right after intercourse (this helps flush out any bacteria that may have entered the urethra), have partner wear condom, do not use vaginal deodorants, bubble baths, colored toilet paper, and other substances that could cause irritation to the urinary meatus, wear cotton underclothes and keep genital area dry
  • Examples: Sulfa
38
Q
  1. Urinary Tract Antibacterials
A
  • Sulfonamides are the drugs of choice; they prevent growth of microorganisms
  • They should not be given to infants less than 2 months of age, or during pregnancy and breast-feeding
  • Medication should be taken with 8 ounces of water
  • Sulfonamides may decrease the effectiveness of oral contraceptives
  • May increase anticoagulant effect of warfarin agents
  • Examples: trimethoprim and sulfamethoxazole (Bactrim) (Septra)
39
Q
  1. Urinary Tract Antiseptics
A
  • Used in patients who are either intolerant of or unresponsive to one of the first-choice antibiotics
  • Patient should increase fluid intake 2-3 liters per day
  • Examples: nitrofurantoin (Macrodantin…50-100mg Q6-8H qid)( Macrobid) , ciprofloxacin (Cipro) 500-750mg Q12H
40
Q
  1. Urologic Disorders
A

• Disorders of the lower urinary tract are treated with drugs that either stimulate or inhibit smooth muscle activity, thereby improving the functions of the urinary bladder
• Examples: phenazopyridine HCl (Pyridium) 200mg tid X 2D, flavoxate HCl (Urispas) 100mg tid or qid , imipramine HCl (Tofranil) (also used as an antidepressant) 25-300 qd
Pyridium turns urine BRIGHT orange!!!
Macrobid and Pyridium for UTIs

41
Q

Treatment of Endocrine Disorders

A

• The ductless glands of the endocrine system (pituitary, thyroid, parathyroids, pancreas, adrenals, testes, ovaries) secrete chemical substances, known as hormones, directly into the bloodstream; each of the endocrine glands performs an important part in growth, development, and maintenance of normal body functions; the hormones secreted by these glands act as chemical transmitters that either stimulate or inhibit specific organs of the body; when abnormal production of hormones occurs (too little or too much), the resultant disorders can be life threatening

42
Q

Medications used in Treatment of Endocrine Disorders and organs

A 
Pituitary
Thyroid:
Thyroid hormones:
Antithyroid hormones:
Parathyroids
Adrenals
Pancreas
Hyperglycemia
Hypoglycemia
Insulin
43
Q

Treatment for the pituitary

A
  • Hyperpituitarism: overproduction of hormones, (gigantism); often associated with a tumor; treated with radiation, chemotherapy, or surgery
  • Hypopituitarism: underproduction of hormones, (dwarfism); treated with Somatropin (Asellacrin)
  • Diabetes insipidus: underproduction or absence of hormone vasopressin (antidiuretic hormone); treated with Vasopressin
44
Q

Treatment for Thyroid

A
  • Hyperthyroidism: overproduction of hormone; high basal metabolism rate;
  • Hypothyroidism: underproduction of hormone; low metabolic rate
  • Cretinism: untreated hypothyroidism in children
  • Myxedema: untreated hypothyroidism in adults
45
Q

Thyroid hormones

A
  • Increase metabolic rate, cardiac output, oxygen consumption, body temperature, respiratory rate, blood volume, and carbohydrate, fat, and protein metabolism, and influence growth and development at the cellular level
  • Used as supplements or replacement therapy in hypothyroidism, myxedema, and cretinism
  • Administer medication at the same time each day, preferably before breakfast, to maintain drug level and help reduce the possibility of insomnia; avoid foods and over-the-counter medications that contain iodine; if loss of hair occurs, it is generally temporary
  • Examples: levothyroxine sodium (Synthroid)
46
Q

Antithyroid hormones

A
  • Inhibits synthesis of thyroid hormones by decreasing iodine use in manufacture of thyroglobin and iodothyronine
  • Used to treat hyperthyroidism, preparation for thyroidectomy, in thyrotoxic crisis and thyroid storm
  • Examples: potassium iodide solution, methmazole (Tapazole)
47
Q

Parathyroids

A
  • Secrete parathormone in response to lowered serum calcium levels
  • Example: Parathormone (PTH)
48
Q

Adrenals

A
  • Produce hormones that regulate fat, salt, and water metabolism, are essential to the development of male secondary sex characteristics and assist in the regulation of the sympathetic branch of the autonomic nervous system
  • Addison’s disease is adrenal insufficiency
  • Example: cortisone and cortisol
49
Q

Pancreas

A

• Insulin is essential for the proper metabolism of carbohydrates, fats, and proteins; normally, insulin is released following the rise in blood glucose level that accompanies the ingestion of food; may come from beef, pork or humans

50
Q

Hypoglycemia

A

Too much insulin is present in the blood; an abnormally low level of blood sugar (glucose) is the result
• Symptoms of low blood sugar may include headache, nausea, hunger, confusion, drowsiness, weakness, dizziness, blurred vision, fast heartbeat, sweating, tremor, or trouble concentrating. The patient should carry a piece of non-dietetic hard candy or glucose tablets with them in case they have low blood sugar

51
Q

Hyperglycemia:

A

too little insulin is present in the blood; an abnormally high level of blood sugar is the result
• symptoms include increased thirst, loss of appetite, fruity breath odor, increased urination, nausea, vomiting, drowsiness, dry skin, and dry mouth

52
Q

Insulin:

A

stimulates carbohydrate metabolism by increasing the movement of glucose and other monosaccharides into cells
• Brand names: NovoLog, NovoLog FlexPen, NovoLog PenFill
• Used in Type I IDDM, Type II NIDDM when other treatment regimens are not effective, and to treat ketoacidosis
• Essential for life
• Dosage is individualized for each patient and depends upon the patient’s blood glucose level
• Given subcutaneously, using a site rotation system
• Always check expiration date before use; insulin should be gently rotated in the palms of the hand to mix and it should never be shaken
• Blood glucose levels should be monitored
• Patient should not smoke or drink alcohol
• Examples: 1. Rapid-acting or short acting
2. intermediate-acting
3. long-acting
• After administration of fast-acting insulin, the patient should eat something within 5-10 minutes.

53
Q

Oral Hypoglycemic Agents

A
  • They are agents of the sulfonylurea class of chemical compounds; they are used to stimulate insulin secretion from pancreatic islet cells in non-insulin-dependent diabetics with some pancreatic function (NIDDM) Type II stable adult-onset diabetes mellitus
  • Blood sugar and/or urine glucose levels need to be tested
  • Medication should be taken in the morning to prevent hypoglycemic reactions at night
  • Examples: glyburide (Micronase), glipizide (Glucotrol)
54
Q

Nervous System

A
  • The nervous system is comprised of the brain and spinal cord (the central nervous system or CNS) plus the network of nerves and neural tissues throughout the body (the peripheral nervous system or PNS)
  • The peripheral system connects to the brain and spinal cord by way of 12 pairs of cranial nerves and 31 pairs of spinal nerves.
  • Our senses of hearing, taste, equilibrium, touch, smell, and sight all rely on nerves to function properly
55
Q

Medications that affect the Nervous System

A
  1. Pain medications (Analgesics)
  2. Analgesic-Antipyretics
  3. Sedatives and Hypnotics
  4. Antiparkinsonian Drugs
  5. Anticonvulsants
  6. Anesthetics
  7. Ophthalmic Drugs
  8. Drugs used in Vertigo, Motion Sickness and Vomiting
  9. Antidepressants
56
Q
  1. Pain medications (Analgesics)
A
  • Pain receptors alert us to danger from inflammation or hot surfaces
  • Muscular activity is dependent upon proper stimulation by nerve impulses
  • Our ability to think, reason, feel emotions, and interact with others is directly related to our neurological processes
  • Pain: is a symptom of a physical or emotional condition; it is the sensory and emotional experience associated with actual or potential tissue damage
  • A person’s pain is measured by its threshold and its intensity. Pain threshold is the level of stimulus that results in the perception of pain; how one responds to pain is an individual process; some factors associated with how a person perceives pain are age, gender, and the physical, mental, social, cultural and emotional makeup of the individual; pain tolerance is the amount of pain a person can manage without disrupting normal functioning and without requiring pain medication; intensity is the degree of pain felt by the individual
  • An estimated 700 million workdays are lost because of pain, with a cost of 60 billion dollars
  • Some alternative methods for relief of pain are: behavior modification (relaxation training, biofeedback, and hypnosis), surgery (destroying nerves responsible for pain), acupuncture, exercise, ice, heat
  • Analgesics inhibit ascending pain pathways in the central nervous system; they increase pain threshold and alter pain perception
  • Narcotic analgesics can produce drug dependence and have the potential for being abused
  • Examples (non-narcotics): acetylsalicylic acid, acetaminophen, ibuprofen, naproxen,
  • Examples (narcotics: opiate & opioid analgesics): meperidine HCl (Demerol), pentazocine HCl (Talwin), morphine sulfate, Codeine, Dilaudid, Percodan, Phenaphen, Tylenol w/codeine, codeine, morphine
57
Q
  1. Analgesic-Antipyretics
A
  • Relieve pain and reduce fever
  • Inhibit prostaglandin synthesis at peripheral sites
  • All except acetaminophen produce significant anti-inflammatory action
  • Examples: acetaminophen (Tylenol), aspirin (Bayer), ibuprofen (Advil, Motrin, Nuprin), naproxen (Naprosyn)
58
Q
  1. Sedatives and Hypnotics
A
  • Anxiety and insomnia are conditions that often interfere with job performance and one’s ability to interact with others
  • Sedatives and hypnotics are frequently used in the overall treatment of these disorders
  • These drugs depress the central nervous system by interfering with the transmission of nerve impulses
  • Barbiturates, benzodiazepines, and certain other drugs can produce either a sedative or a hypnotic effect
  • When used as a sedative, the dosage is designed to produce a calming effect without causing sleep
  • Used as a hypnotic, the dosage is sufficient to cause sleep (Lunesta- eszopiclone)
  • Barbiturates: affect entire central nervous system; produce mild sedation to deep sleep and anesthesia; large doses of barbiturates depress the respiratory vasomotor centers in the medulla and can lead to respiratory arrest and death
  • Examples of barbiturates: secobarbital (Seconal), phenobarbital (Luminal), Nembutal, Dalmane, Doriden, Placidyl, Phenaphen
  • Benzodiazepines: used for relief of anxiety; reduce incidents of night and early morning awakening; increase the duration of total sleep time; do not produce rebound sleep disturbances
  • Examples of benzodiazepines: Flurazepam HCl, temazepam and triazolam, Xanax (alprazolam), Niravam (alprazolam), Valium (diazepam)
59
Q
  1. Antiparkinsonian Drugs
A
  • Named for British physician James Parkinson, Parkinson’s disease is a neurologic disorder characterized by the development of a fine, slowly spreading tremor, muscular weakness and rigidity, and the development of disturbances in posture and equilibrium; believed to be associated with an imbalance of the neurotransmitters acetylcholine and dopamine in the brain
  • Antiparkinsonian drugs are used for palliative relief from major symptoms
  • Therapy involves an attempt to replenish dopamine levels and/or inhibit the effects of the neurotransmitter acetylcholine
  • Examples: bromocriptine mesylate (Parlodel), levodopa (Dopar)
60
Q
  1. Anticonvulsants
A
  • Epilepsy is the most common of the seizure disorders and affects approximately 1 percent of the population; it is characterized by recurrent abnormal electrical discharges within the brain
  • Anticonvulsants inhibit spread of seizure activity in the motor cortex
  • Anticonvulsant medication should not be abruptly discontinued because seizures can occur if that is done
  • Examples: carbamazepine (Tegretol), clonazepam (Klonopin), diazepam (Valium), phenytoin (Dilantin), Phenobarbital, Gabitril
61
Q
  1. Anesthetics
A
  • These are drugs that interfere with the conduction of nerve impulses and are used to produce loss of sensation, muscle relaxation, and/or complete loss of consciousness
  • Local anesthetics block nerve transmission in the area to which they are applied; they produce loss of sensation and motor activity, but do not cause loss of consciousness
  • General anesthetics affect the central nervous system and produce either partial or complete loss of consciousness; they also cause varying degrees of analgesia, skeletal muscle relaxation, and reduction of reflex activity
  • Examples of local anesthetic drugs: lidocaine HCl (Xylocaine HCl), procaine HCl (Novocaine and Marcaine),
  • Ehrane, Diprivan, Pentothal= general anesthetics
62
Q
  1. Ophthalmic Drugs
A
  • Used in the eye for the treatment of glaucoma, during diagnostic examination of the eye, and in intraocular surgery
  • Glaucoma is an eye disease characterized by increased intraocular pressure, which, if not treated, causes atrophy of the optic nerve and blindness; the disease occurs when there is a failure to remove aqueous humor at a rate equal to its production; drugs used to treat glaucoma either increase the outflow of aqueous humor, decrease its production, or produce both of these actions
  • Examples of drugs to treat glaucoma: acetazolamide (Diamox), carbachol (Carbacel)
  • Mydriatic drugs are used to dilate the pupil during internal examination of the eye and in intraocular surgery
  • Examples of mydriatic drugs: tetrahydrozoline HCl (Murine, Visine)
63
Q
  1. Drugs used in Vertigo, Motion Sickness and Vomiting
A
  • Vertigo is a term used to describe an illusion of movement; it may be caused by a lesion or other process affecting the brain, the eighth cranial nerve, or the labyrinthine system of the ear
  • Motion sickness is usually associated with travel; about one third of the population is highly susceptible to motion
  • Vomiting is a complex reflex that may result from disease, drugs, radiation, toxins, and many other causes that serve to stimulate the vomiting center in the medulla
  • Certain anticholinergic, antihistaminic, and antidopaminergic drugs have been identified as being effective in the treatment of vertigo, motion sickness, and vomiting
  • Examples: dimenhydrinate (Dramamine), diphenhydramine HCl (Benadryl), meclizine HCl (Antivert), promethazine HCl (Phenergan), trimethobenzamide HCl (Tigan)
64
Q
  1. Antidepressants
A

• Used to elevate mood and treat depression
• Best to take at bedtime (except for bupropion and fluoxetine which are best if taken early in the day)
• Should be taken for 2 weeks before patient begins to feel the effects; patient should not stop taking even if they feel better
• May cause drowsiness or blurred vision for the first few days or weeks
• They may interact with many medications and other substances (alcohol)
MAO: monoamine oxidase

65
Q

If taking MAO inhibitors (monoamine oxidase)

A
  • these are some of the oldest antidepressants
  • they balance certain brain chemicals called neurotransmitters by reducing the amount of monoamine oxidase, the substance that breaks down the neurotransmitters. This helps make the symptoms of depression better
  • Examples: isocarboxazid (Marplan), phenelzine (Nardil), tranylcypromine (Parnate)
  • there are foods that the patient should not eat since it can cause serious reactions, including strokes (Foods to avoid include some cheeses, broad beans like fava beans, pickled foods like sauerkraut, and beer and red wine. These foods and drinks can cause severe high blood pressure or death when combined with MAOIsMay increase the appetite
  • Amitriptyline turns urine blue- green so you must warn patients
  • Some other side effects: glaucoma, dry mouth (which can cause dental cavities, gum disease, fungal infections), hypoglycemia, sensitivity to the sun, constipation
66
Q

Reproductive System

A

• The ovaries in the female and the testes in the male are the primary organs of sexual reproduction

67
Q

Medications that affect the Reproductive System

A 
Female hormones:
•	Estrogen 
•	Progesterone:
•	Oral contraceptives:
Male hormones:
•	Testosterone
68
Q

Estrogen

A
  • Estrogen promotes growth, development, and maintenance of the female reproductive system and secondary sex characteristics
  • Used for a variety of conditions: amenorrhea, dysfunctional bleeding, hirsutism, prostatic cancer in men, uncomfortable symptoms of menopause, prevention of osteoporosis
  • Patients who take higher doses of estrogens for a long period of time (five years or more) may have an increased risk of breast cancer
  • There is a 2.5 fold increase in the risk of developing gallbladder disease in women receiving postmenopausal estrogens
  • If higher doses of estrogen are used, there may be an increase in the risk of developing hypertension
  • Estrogen may decrease the action of anticoagulants and oral hypoglycemics
  • Estrogen replacement therapy is relatively well tolerated by most menopausal women who take the recommended lowest effective dose
  • Examples: conjugated estrogens (Premarin) 0.625 mg QD, estradiol (Estrace), Estraderm-Estradiol Transdermal System
69
Q

• Progesterone:

A
  • Prepares the uterus for the implantation of the fertilized ovum
  • Suppresses ovulation during pregnancy and stimulates the breast to secrete milk following delivery
  • Used to prevent uterine bleeding
  • Combined with estrogen, it is used for the treatment of amenorrhea, infertility and threatened or habitual miscarriage
  • It may cause fluid retention
  • Examples: medroxyprogesterone acetate (Provera) 5-10 mg QD x 5-10 D, progesterone (Gesterol)
70
Q

• Oral contraceptives:

A
  • Nearly 100 percent effective when used as directed
  • Contain mixtures of estrogen and progestin in various levels of strength
  • The estrogen in the pill inhibits ovulation of suppressing the normal secretion of FSH and LH from the anterior pituitary gland
  • The progestin inhibits pituitary secretion of LH, causes changes in the cervical mucus that renders it unfavorable to penetration by sperm, and alters the nature of the endometrium
  • Adverse reactions to oral contraceptives are related to their hormone content; those with high estrogen content tend to cause estrogen-related reactions (nausea, weight gain, edema, swelling of the breasts), and those with high progestin content cause progestin-related effects (headache, acne, fatigue)
  • People with the following conditions should not take oral contraceptives: clots in the legs or lungs, angina pectoris, cancer of the breast or sex organs, undiagnosed vaginal bleeding, heart attack or stroke, pregnancy, cigarette smoking
  • Examples: Lo/Ovral, Nordette, Ortho-Novum, Triphasil, Micronor
71
Q

Male Hormones:

A
  • Adequate secretions of androgenic hormones are necessary to maintain normal male sex characteristics, the male libido, and sexual potency
  • Testosterone, the most important androgen, is secreted primarily by the testes
  • Normal men produce 5-10mg of testosterone per day
  • After the age of 40, there is a gradual decline in the amount of testosterone produced, and by the age 80, output is approximately 20 percent of that produced during peak years
  • Used for replacement therapy in androgen deficiency, hypogonadism, crytorchidism and palliative treatment of certain metastatic breast carcinomas in women
  • Examples: fluoxymesterone (Halotestin), testosterone (Andro 100)
72
Q

Drugs Used During Labor and Delivery:

A
  • Stimulate contraction of the myometrium; known as oxytocic agents
  • Used to induce labor at term, to control postpartum hemorrhage and induce therapeutic abortion
  • Examples: methylergonovine maleat (Methergine) 0.2-0.4mg Q6-12H X 2-7 D controls postpartum hemorrhage
  • Pitocin (induces labor)
  • Cervidil (prostaglandin) to induce labor

Pharmacology (6 decks)

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