Medication Class Flashcards

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1
Q

3-hydroxy-3-methylglutaryl coenzyme A (HMG-CoA) reductase inhibitors

A
  • lipid-lowering agents
  • indications: dyslipidemia (high LDL, low HDL), hypertriglyceridemia, prevention of coronary heart disease
  • contraindicated in active liver disease, persistent elevated AST/ALT, pregnancy, lactation
  • inhibits enzyme responsible for catalyzing early step of cholesterol synthesis
  • LFTs, cholesterol and TGAs q. 3-6 months
  • administer in evening (more cholesterol synthesized at night)
  • avoid grapefruit juice
  • SE/ADRs: myopathy, hepatotoxicity
  • atorvastatin (Lipitor), rosuvastatin (Crestor), lovastatin (Mevacor), simvastatin (Zocor)
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2
Q

aldosterone receptor blocker

A
  • potassium-sparing diuretic
  • indications: hypertension, edema associated with cirrhosis or nephrotic syndrome, primary aldosteronism, acne, transgender hormone therapy (male to female)
  • contraindications: anuria, hyperkalemia, acute renal insufficiency, renal impairment, Addison’s disease, eplerenone
  • causes loss of sodium bicarbonate and calcium while saving potassium and hydrogen ions; inhibits testosterone secretion and androgen binding on androgen receptor
  • weak diuresis; used to counteract potassium wasting effect of other diuretics
  • SE/ADRs: hyperkalemia
  • spironolactone (Aldactone, Carospir)
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3
Q

angiotensin converting enzyme (ACE) inhibitors

A
  • RAAS inhibitor, antihypertensive
  • blocks conversion of angiotensin I to angiotensin II; prevents degradation of bradykinin and other vasodilatory prostaglandins; increase plasma renin; decrease plasma aldosterone; causes diuresis and natriuresis → vasodilation, decreased blood volume/CO, decreased arterial pressure
  • indications: hypertension, heart failure, myocardial infarction, diabetic nephropathy (unlabeled)
  • contraindications: pregnancy, lactation
  • SE/ADRs: first dose effect, hypotension, angioedema, hypokalemia, hyperkalemia, cough
  • captopril (Capoten), enalapril (Vasotec), lisinopril (Prinivil)
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4
Q

angiotensin II receptor antagonist (ARBs)

A
  • RAAS inhibitor, antihypertensive
  • blocks vasoconstriction and aldosterone-secreting effects of angiotensin II at various receptor sites (vascular smooth muscle and adrenal glands) → vasodilation, diuresis, decreased blood volume/CO, decreased arterial pressure
  • indications: hypertension, heart failure, MI, diabetic nephropathy, stroke prevention in pts c/ HTN and left ventricular hypertrophy
  • contraindications: bilateral renal artery stenosis, pregnancy, lactation
  • SE/ADRs: first dose effect, hypotension, angioedema, hypokalemia, hyperkalemia
  • losartan (Cozaar), candesartan (Atacand), valsartan (Diovan)
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5
Q

anti-emetics

A
  • indication: nausea and vomiting
  • SE/ADRs: excessive sedation, respiratory depression
  • promethazine (Phenergan), metoclopramide (Reglan), prochlorperazine (Compazine), ondansetron (Zofran)
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6
Q

anti-platelets

A
  • treats and prevents thromboembolic events (MI, stroke, PAD)
  • inhibits platelet aggregation; irreversibly changes platelets
  • ADRs: bleeding, gastric ulceration, renal impairment, ototoxicity, salicylism (N/V, tinnitius)
  • aspirin, clopidogrel (Plavix), ticagrelor (Brintilla), 1st generation NSAIDs
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7
Q

Anticoagulants

A
  • Interrupt coagulation cascade and thereby reduce fibrin formation
  • Indications: venous disease processes; treatment and prevention of VTEs; atrial fibrillation
  • prevent clot formation and extension; do not dissolve clots
  • contraindicated in coagulation disorders, malignancies, ulcers, recent surgery, active bleeds
  • heparin, enoxaparin, warfarin, fondaparinux, rivaroxaban, apixaban, dabigatran
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8
Q

beta-1 adrenergic receptor antagonists

A
  • antihypertensive; cardioselective beta blocker
  • compete with norepinephrine and epinephrine at beta-1 adrenergic receptor sites in heart resulting in decreased sympathetic activity → decreased heart rate, decreased cardiac contractility
  • indications: angina, hypertension, MI/CAD (core measure), heart failure
  • contraindications: pulmonary edema, uncompensated HF, cardiogenic shock, bradycardia, heart block
  • SE/ADRs: bradycardia, hypotension, fatigue, erectile dysfunction, hypoglycemic unawareness
  • do not abruptly discontinue
  • metoprolol (Lopressor), atenolol (Tenormin)
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9
Q

beta-1 and beta-2 adrenergic receptor antagonists

A
  • antihypertensive; non-cardioselective beta blocker
  • compete with epinephrine and norepinephrine at receptor sites in heart, bronchioles, and vascular smooth muscle resulting in decreased sympathetic activity → decreased HR, decreased contractility, some vasoconstriction, and bronchoconstriction
  • indications: angina, hypertension, MI/CAD (core measure), heart failure
  • contraindications: asthma, acute bronchospasm, lung issues, uncompensated HF, pulmonary edema, cardiogenic shock, bradycardia, bradyarrhythmias, heart block
  • SE/ADRs: bradycardia, hypotension, bronchospasm, fatigue, erectile dysfunction, hypoglycemic unawareness
  • carvedilol (Coreg), labetolol (Trandate), propranolol (Inderal)
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10
Q

calcium channel blockers

A
  • antihypertensive
  • blocks entry of calcium into cells of vascular smooth muscle and myocardium → dilation of coronary arteries and inhibition of vasospasm; diltiazem and verapamil also slow conduction through AV node → slowed HR
  • indications: angina, hypertension, coronary artery vasospasm, dysrhythmias (verapamil and diltiazem), cerebral vasospasm (nimodipine; has relatively selective effect on cerebral blood vessels)
  • contraindications: bradycardia, heart block (2nd or 3rd degree), decompensated HF
  • SE/ADRs: bradycardia, heart block, hypotension, constipation
  • verapamil (Calan), diltiazem (Cardizem), amlodipine (Norvasc), nifedipine (Procardia), nicardipine (Cardene)
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11
Q

cephalosporins

A
  • broad-spectrum antibiotics
  • action: binds to bacterial cell wall membrane, causing cell death
  • cross-sensitivity to penicillins
  • SE/ADRs: anaphylaxis, rash, diarrhea, CDAD
  • cefazolin (Ancef, Kefzol), cephalexin (Keflex), cephtriaxone (Rocephin), cefepime (Maxipime)
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12
Q

centrally-acting anti-adrenergics

(alpha II adrenergic agonists)

A
  • antihypertensive
  • stimulates alpha receptors in CNS producing decreased sympathetic outflow to heart, blood vessels, and kidneys → inhibits cardioacceleration and vasoconstriction causing decreased blood pressure, peripheral resistance, and heart rate; stimulates alpha receptors in spinal cord to prevent pain transmission to CNS
  • indications: hypertension, adjunctive treatment of neuropathic pain, management of opioid withdrawal
  • SE/ADRs: rebound hypertension, hypotension, sedation, dry mouth
  • methyldopa (Aldomet), clonidine (Catapres)
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13
Q

Direct thrombin inhibitor

A
  • anticoagulant
  • Treatment and prevention of DVT,PE, and A-fib
  • increased RF for GI upset or bleeding
  • Antidote is dialysis
  • ADR: bleeding, GI disturbanct
  • dabigatran (Pradaxa)
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14
Q

factor Xa inhibitors

A
  • anticoagulant to treat and prevent PE/DVT and atrial fibrullation
  • fondaparinux (Arixtra)
  • rivaroxaban (Xarelto)
  • apixaban (Eliquis)
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15
Q

glucocorticoids

A
  • steroidal anti-inflammatory, immune modulator (immunosuppressant)
  • SE/ADRs: osteoporosis, hyperglycemia, fluid retention, impaired wound healing, increased risk for infection
  • DO NOT abruptly d/c med; must be tapered off to prevent adrenal insufficiency
  • prednisone (Rayos, Sterapred), methylprednisolone (Solu-Medrol, Depo-Medrol), betamethasone, budesonide (Pulmicort), cortisone, dexamethasone, hydrocortisone (Cortef, Solu-cortef), prednisolone (Orapred)
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16
Q

loop diuretics

A
  • indications: hypertension, edema due to HF, hepatic impairment, or renal disease
  • contraindications: cross-sensitivities with thiazides and sulfonamides possible, hepatic coma, anuria
  • inhibits reabsorption of sodium and chloride from loop of Henle and distal renal tubule; increases renal excretion of water, sodium, chloride, magnesium, potassium, and calcium
  • effective with impaired renal function/decreased GFR
  • produces large amounts of diuresis
  • monitor I&O, daily weight
  • SE/ADRs: dehydration, hypokalemia, electrolyte imbalances
  • furosemide (Lasix), bumetanide (Bumex)
17
Q

moderate to strong opioid agonists with acetaminophen

A
  • indication: moderate pain (4-6)
  • max 4g/day for acetaminophen
  • SE/ADRs: respiratory depression, constipation, urinary retention, cough suppression, change in LOC, sedation
  • PO meds
  • oxycodone/acetaminophen (Percocet), hydrocodone/acetaminophen (Lortab, Norco, Vicodin)
18
Q

non-steroidal anti-inflammatory drugs (NSAIDs)

A
  • indications: mild to moderate pain, fever, inflammatory conditions
  • contraindications: hypersensitivity to aspirin
  • action: analgesic and anti-inflammatory effects due to inhibition of prostaglandin synthesis; antipyretic effects due to vasodilation and inhibition of prostaglandin synthesis in CNS
  • SE/ADRs: gastric ulcers, bleeding/increased clotting time, renal impairment
  • give with food and full glass of water to decrease gastric upset
19
Q

penicillins

A
  • anti-infective/anti-antibiotic
  • action: binds to bacterial cell wall resulting in cell death
  • narrow-spectrum; active against most Gm+, some Gm-, some anaerobic, some spirochetes
  • only treatment for enterococcal endocarditis
  • SE/ADRs: anaphylaxis/hypersensitivity reactions, rash, diarrhea, seizures
  • most common cause of drug allergy
  • PenicillinV (PO), PenicillinG (IM, IV), benzathine (IM), procaine (IM)
20
Q

Sedative hypnotic anxiolytics

A
  • Benzodiazepines
  • enhance GABA effects in CNS
  • rapid-acting
  • short-term use r/t RF dependence and withdrawal Sx
  • SE/ADRs: CNS depression (dizziness, ataxia, sedation, lightheadedness, decreased cognitive function), anterograde amnesia, oral toxicity (lethargy, confusion), IV toxicity (respiratory depression, sever HoTN, cardiac/respiratory arrest), paradoxical effects
  • diazepam and lorazepam for IV use
  • flumazenil is antidote; oral gastric lavage, activated charcoal, saline cathartics for PO toxicity
  • Contraindications: pregnancy, breastfeeding, sleep apnea, respiratory depression, glaucoma
  • Interactions: CNS depressants (alcohol, barbiturates, opioids), grapefruit juice, high fat foods
  • alprazolam (Xanax), diazepam (Diastat), lorazepam (Ativan), chlordiazepoxide (Librium), oxazepam (Serax), clorazepate (Tranxene), clonazepam (Klonopin)
21
Q

strong opioid agonists

A
  • indication: severe (7-10) pain
  • SE/ADRs: respiratory depression, respiratory arrest, change in LOC, sedation, cough suppression, constipation, urinary retention, hypotension, euphoria/addiction potential
  • do not crush/chew pills
  • morphine, hydromorphone (Dilaudid)
22
Q

thiazide diuretics

A
  • indications: hypertension (1st line Tx), edema associated with HF, renal dysfunction, cirrhosis, glucocorticoid therapy, estrogen therapy
  • contraindications: cross-sensitivities with sulfonamides, lactation, anuria
  • inhibits sodium reabsorption in distal convoluted tubule; promotes excretion of water, sodium, chloride, potassium, hydrogen, magnesium, phosphate, and bicarbonate
  • takes time to work; not effective with reduced GFR; mild diuresis
  • SE/ADRs: electrolyte imbalance, hypokalemia, dehydration
  • hydrochlorothiazide/HCTZ (Hydrodiuril, Microzide)
23
Q

vasodilators

A
  • antianginal, nitrates
  • indications: hypertension, angina, heart failure
  • contraindications: ED meds
  • SE/ADRs: hypotension, reflex tachycardia, headache
  • isosorbide (Isordil), hydralazine (Apresoline), nitroglycerine (Nitro)
24
Q

tetracyclines

A

*broad-spectrum antibiotic
*tetracycline, doxycycline, minocycline, tigecycline
*indications: treats unusual organisms (Mycoplasma, Chlamydia, Rickettsia, Borellia burgdorferi); periodontal disease, chlamydia, gonorrhea and syphilis in PCN-allergic pt, H. pylori, acne
*contraindications: children < 8 years (tooth staining), lactation, pregnancy
*SE/ADRs: tooth discoloration, hepatotoxicity, renal toxicity, photosensitivity, GI upset
*notes: binds with calcium; take 2 hours before or 6 hours after antacids, calcium supplements, zinc products, laxatives containing magnesium, iron; do not take with Ca/Fe/milk

25
Q

aminoglycosides

A

*Treats serious Gram negative organisms when less-toxic ABX contraindicated; only used when causative organism is known
*gentamicin (Garamycin), amikacin (Amikin), streptomycin, tobramycin (Nebcin)
*contraindication: pregnancy
*SE/ADRs: ototoxicity, nephrotoxicity
*usually only given parenterally

26
Q

Short-Acting Beta Agonist

A

*Bronchodilator; relieves bronchospasm associated with asthma or COPD
*Emergency inhaler
*affects mostly beta-2 receptors, also beta-1
* SE/ADRs: tachycardia, palpitations, tremors, headache, nausea, BP changes, restlessness, nervousness, dizziness, dry/irritated throat, unusual taste, paradoxical bronchospasm
*albuterol (Proventil, Ventolin, ProAir); levalbuterol (Xopenex)

27
Q

Long-Acting Beta Agonist

A

– Bronchodilator; relieves bronchospasm associated with asthma or COPD
– affects beta-2 receptors
– not for emergency use; maintenance therapy
– taken before steroid inhaler; wait 5 minutes between meds
– SE/ADRs: palpations, tachycardia, tremors, nervousness, headache, nausea, bad taste, dry mouth, BP changes
– formoterol (Foradil, Perforomist), salmeterol (Severent)

28
Q

Tuberculosis meds

A

– isoniazid (INH), rifampin (Rifadin), pyrazinamide (PZA), ethambutol (Myambutol)
– pt on 2-4 meds for 6-12 months; compliance is crucial