UNIT 1 PHARMACOLOGY Flashcards
Medications for Chlamydia
Doxycycline and Azithromycin (both inhibit protein synthesis)
Alternate Meds for Chlamydia
Erythromycin, ofloxacin, or levofloxacin
Pt education for Doxycycline
Avoid sun exposure
Do not take with antacids, iron, or dairy
Medication for HPV
No medication cures HPV, only treats symptoms.
Acyclovir, famciclovir, and valacyclovir
Medications for Herpes
Acyclovir, famciclovir, and valacyclovir (Zovirax)
+++ analgesics for pain
Comfort measures for Herpes
warm sitz bath, cotton underwear, and loose-fitting clothes
Meds for Gonorrhea
Ceftriaxone (Rocephin)
Meds for Syphilis
Penicillin G (used for all stages & safe for pregnancy)
Alt meds for syphilis
doxycycline (unsafe in pregnancy), tetracycline (unsafe in pregnancy), erythromycin (unlikely to cure fetal infection)
Meds for PID
Ceftriaxone, Metronidazole (flagyl), ofloxacin, doxyxycline (vibramycin)
Pt education for Metronidazole
avoid alcohol & can cause numbness, pain, hives, weakeness
Meds for Candidiasis
Antifungal: Miconazole (Monistat)
Antibiotic: Ketoconazole (monitor for liver functions)
Pt education for ketoconazole
avoid sun and alcohol
Comfort care for candidiasis
sitz bath w/ oatmeal powder to decrease inflammation
Meds for Trichomoniasis
Metronidazole (Flagyl)
What pharmacologic agent is indicated for pain during pregnancy?
Acetaminophen (analgesics)
What pharmacologic agent is indicated for the prevention of spina bifida during pregnancy?
folic acid
What pharmacologic agent is CONTRAINDICATED for depression during pregnancy?
tricyclic antidepressants
What pharmacologic agent is indicated for the promotion of uterine relaxation during pregnancy? (minimizes risk of preterm labor)
progesterone
What pharmacologic agent is indicated for blood type difference during pregnancy?
Rhogram (RH immune globulin)
What pharmacologic agent is indicated for preterm labor during pregnancy?
Tocolytics (rifedipine)
What pharmacologic agent is indicated for preeclamptic pt’s and preterm labor during pregnancy?
magnesium sulfate
What pharmacologic agent is indicated for vomiting during pregnancy?
Antiemetics (promethazine, ondansetron)
Assessment required prior to antidepressant administration
suicide assessment
SSRI’s
1. Drug type
2. S/E
3. PT Education
4. Assessment
- First choice antidepressant (fluoxetine, paroxetine, sertraline, citalopram, and escitalopram)
- Least # of side effects; S/E are drowsiness, low libido, insomnia, dizziness
- Takes 3-6 weeks to take effect (depression); 8-12 weeks for therapeutic effect (anxiety)
- SUICIDE ASSESSMENT B4 GIVING MED - some young ppl will experience thoughts of suicide when beginning SSRI
SNRI’s
1. Drug type
2. S/E
3. Assessment
- Antidepressant (duloxetine/Cymbalta)
- S/E are HTN, nausea, dizziness, swelling, loss of appetite, abnormal dreams
- SUICIDE ASSESSMENT B4 GIVING MED
TRICYCLICS (3rd or 4th tier choice)
1. Drug type
2. S/E
3. PT considerations
4. Assessment
- LAST CHOICE Antidepressant b/c side effects (amitryptyline, amoxapine, clomipramine (used for OCD), imipramine)
- jitteriness (when first taken), constipation, increased eye pressure, urinary retention, rash, sexual dysfunction, liver failure, abd. cramps, HTN, seizures, AFIB, etc….
- May increase anxiety in older adults, start w/ low dose
- SUICIDE ASSESSMENT B4 GIVING MED
MAOI’s (2nd or 3rd tier choice)
1. Drug type
2. PT Education
3. Assessment
4. PT !!! Consideration
1.LAST CHOICE Antidepressant
2. Foods including tyramine for example, chocolate, red wine, cheese, nuts, tofu, many meats, beans, fruit (raspb., pineal., plums, figs)
3. SUICIDE ASSESSMENT B4 GIVING MED
4. NEVER USED AS FIRST LINE MED, FATAL INTERACTION W/ Phenelzine, Selegiline, and Isocarboxazid
LITHIUM
1. Drug type
2. Dosage considerations
3. PT Education
4. Assessment
- Anti-psychotic; first choice for MANIA in BIPOLAR DISORDER
- Begin w/ lower dose to prevent toxicity, should be taken w/ Birth Control to prevent pregnancy
- Pt needs to know signs of LITHIUM TOXICITY, DO NOT USE DURING BREAST FEEDING
- PREGNANCY TEST BEFORE, Kidney & liver function, blood range (very narrow therapeutic blood range b4 toxicity)
LITHIUM LIVER TOXICITY SIGNS
Diarrhea, vomiting, drowsiness, muscular weakness, lack of coordination
SEVERE: ataxia, giddiness, tinnitus, blurred vision, large output of dilute urine
LITHIUM LONG-TERM S/E
thirst, frequent urination, tremors, diarrhea, weight gain, edema
Anti-epileptic Drugs
1. Drug usage in mood disorders
2. S/E
3. PT Consideration/Assessment
- Mood stabilizer for episodes of bipolar disorder (Carbamazepine, Valpropic acid/valproate, and Lamotrigine)
- In elderly patients, causes POTS, anticholinergic adverse effects, extrapyramidal symptoms
- Carbamazepine can cause toxicity, be mindful of the therapeutic blood range
Consideration for ALL mood spectrum disorder MEDICATIONS
CANNOT BE ABRUPTLY STOPPED
Beta blocker
1. Use
2. MOA
3. S/E
4. Contra-indications
Propranolol, Metoprolol, Clonidide, Atenolol
1. PRN for anxiety (traumatic nightmares, extrapyramidal S/E of antipsychotics, performance anxiety) - decreases tremors and tachycardia
2. blocks effect of norepinephrine & epinephrine
3. postural hypotension, dizziness, brady
4. heart block, glaucoma, diabetes, bradycardia
Benzodiazepines
1. Use
2. MOA
3. RISK
4. S/E
5. Contra-indications
Lorazepam, Alprazolam, Clonazepam, Diazepam
1. Scheduled dose or PRN (as needed) for SHORT-TERM management of anxiety
2. inhibits nerve activity by enhancing effect of neurotransmitter GABA
3. highly addictive & can cause life threatening withdrawal (not for long term use)
4. CNS sedation (dizziness & sedation) & rebound anxiety
5. alcohol use
Non-Benzo Anti-anxiolytic
1. Use
2. Pt consideration
3. S/E
4. MOA
Buspirone & Hydroxyzine
1. Anxiety relief
2. Less effective for pt’s sensitized to benzo’s
3.
4. Buspirone MOA: diminishes serotonin activity (less CNS sedation); Hydroxyzine MOA: blocks histamine 1 receptor to promote sedation
Cholinesterase inhibitors
1. Use
2. MOA
Donepezil, Rivastigmine, Galantamine, Memantine
1. used to maintain memory in those w/ Alzheimer’s (for a few months to 1 year)
2. blocks cholinesterase (breaks down acetylcholine)
Glutamate receptor antagonist
1. Use
delays functional decline in moderate to severe Alzheimer’s
Anti-hypertensives, such as beta-blockers, can cause adverse changes in ___?
A. Cognition
B. Sexuality
C. Reproduction
COGNITION
Cholinesterase inhibitors
1. Use
2. MOA
3. Length of effectiveness
Donepezil, rivastigmine, galantamine
- Used to treat decreased memory and cognition in AD
- blocks cholinesterase to prevent breakdown of acetylcholine ; *Memantine protects nerve cells from excessive glutamate
- Effective for a few months to a year
Glutamate receptor antagonist (NMDA receptor antagonist)
1. Use
2. MOA
Memantine
1. Delays functional decline in moderate to severe AD
2. protects nerve cells from excess amounts of glutamate
Which antipsychotics are used in AD for behavioral problems?
Haloperidol (haldol) and Risperidone (risperdal)
Which benzodiazepine is used for behavioral problems in AD?
Lorazepam (Ativan)
