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Flashcards in Capstone Pharmacology Deck (51):
1

-caine

Classification

Local Anesthetic

lidocaine (Xylocaine)

tetracaine (Pontocaine)

procaine (Novocain)

2

-cillin

Classification

Antibiotic

penicillin

amoxicillin

ampicillin

piperacillin tazobactam (Zosyn)

3

-dine

Classification

H2 Blockers (Anti-Ulcer)

ranitidine hydrochloride (Zantac)

cimetidine (Tagamet)

famotidine (Pepcid)

nizatidine (Axid) 

4

-done

Classification

Opioid Analgesic

5

-ide

Classification

Oral Hypoglycemics

chlorpropamide (Diabinese)

glipizide (Glucotrol)

tolzamide

glyburide (DiaBeta)

glimepiride (Amaryl)

repaglinide (Prandin)

nateglinide (Starlix)

** Not to be confused with diuretics **

6

-lam

Classification

Anti-Anxiety Agents

 

alprazolam (Xanax)

Diazepam (Valium)

Lorazepam (Ativan)

Oxazepam (Serax)

Clonazepam (Klonopin)

7

-micin / -mycin

Classification

Antibiotic

8

-mide 

Classification

Diuretic

9

-nium 

Classification

Neuromuscular Blocking Agents

10

-olol 

Classification

Beta Blockers

11

-oxacin 

Classification

Antibiotic

12

-pam 

Classification

Anti-Anxiety Agents

13

-pril 

Classification

ACE inhibitors

14

-sone 

Classification

Steroid

15

Aspirin

Analgesic (Anti-platelet)

Do not give together with other anticoagulants

Stop taking aspirin several (7?) days prior to surgery

Do not give to children with viral infections (possibility of Reye Syndrome)

16

Ibuprofen

NSAID

Take with food

Contraindicated for people with GI ulcers

17

Morphine

Opioid Analgesic

Respiratory depressant -- should be witheld if respirations are <10

Antidote: Narcan

18

Dilatin

Anti-Convulsant

May cause gum hyperplasia - advise clients to visit dentist regularly

19

Prednisone

Anti-Inflammatory

Causes Cushing-like symptoms

Common side effects include immunosuppression (monitor client for infection) and hyperglycemia

20

Heparin

Anti-Coagulant

Monitor labs: PTT

Antidote: Protamine sulfate

  • Heparin helps prevent thrombin from converting fibrinogen to fibrin. Administered IV or SQ.
  • Enoxaparin (Lovenox) is a low-molecular weight heparin - same action but longer half-life and administered SQ
  • Protamine sulfate is the antidote
  • Administer when there is a likelihood of clot formation such as MI or DVT
  • Risk for bleeding is major side effect; monitor for bleeding, bruises, hematuria, petechiae
  • Instruct clients to avoid corticosteroid use, oral hypoglycemic agents, salicylates, NSAIDs, excessive green leafy veggies and other foods high in vit K
  • Normal aPTT is 20-36seconds but to maintain a therapeutic level, aPTT should be 1.5-2x normal (60-80sec)

21

Coumadin / Warfarin

Anti-Coagulant

Monitor labs: PT & INR

Antidote: Vitamin K

  • Coumadin (Warfarin) interferes with coagulation factors by antagonising vitamin K
  • Oral admin (IV heparin may be used until therapeutic level of coumadin achieved)
  • Use is contraindicated in clients with low platelet counts or uncontrolled bleeding
  • Mephyton (vitamin K) is the antidote
  • Advise clients to avoid food high in vit K as well as acetaminophen, glucocorticoids, aspirin; wear a medicalert bracelet
  • Dose is usually once daily
  • INR and PT are monitored (PT should be 1.5-2x control; INR should be 2-3x control)
  • No coumadin for pregnant women! Oral anticoagulants are pregnancy category X.

22

Cogentin

Anti-Parkinson

Used to treat EPS (extrapyramidal symptoms)

23

Sinemet

Anti-Parkinson

Drug is effective when tremors are not oberved

24

Theophylline / Aminophylline

Respiratory

Side effects: tachycardia

25

Digoxin 

 (Lanoxin) 

Cardiovascular

Signs of toxicity: pt may complain of visual changes in colors; loss of appetite

Therapeutic Serum Blood Level: 0.5 - 2.0 ng/mL

26

Magnesium Sulfate

Anti-Hypertensive (Pre-Eclampsia)

Monitor for deep tendon reflexes and respiratory depression

27

Hydrochlorothiazide

Diuretic

Monitor potassium levels

28

Furosemide (Lasix)

Diuretic

Monitor potassium levels

29

Aldactone (Spironolactone)

Diuretic

Potassium-sparing; still need to monitor potassium levels to watch for hyperkalemia

30

Lithium

Psychotropic

Therapeutic range: 0.8 - 1.2 mEq

Know symptoms of toxicity -  can cause severe CNS, renal, and pulmonary problems that may lead to death.

Serum levels of 1.5-2.0 mEq/L: CNS problems, including lethargy, slurred speech, muscle weakness, and fine tremor; polyuria, which relates to renal toxicity; and beginning of gastric toxicity, with nausea, vomiting, and diarrhea; ECG irregularites may be present

Adequate fluid and salt intake is important

Encourage routine serum levels measured

31

MAOI Inhibitors

Psychotropic

Have dangerous food-drug interactions -- foods with tyramine (such as aged cheeses, aged meats, and wine) should be avoided

Also has many drug-drug interactions

32

Disulfiram (Antabuse)

Psychotropic

Used for alcohol aversion therapy

Clients must avoid any form of alcohol (including cough medicines and mouthwash) or they will develop a severe reaction

33

Oxytocin

Maternity (?)

Assess uterus frequently for tetanic contraction

34

Tegretol

35

Atropine

36

Epogen

37

Acyclovir

Anti-Viral

Used for various viral infections including shingles

38

Antiemetics

Medications used for the tx and prevention of N/V.

5-HT3 Receptor Antagonists (serotonin antagonists)
Dolasetron 
Granisetron
Ondansetron (Zofran)
Tropisetron 

Dopamine Antagonists
Promethazine (Phenergan)
Prochlorperazine (Compazine)
Metoclopramide (Reglan) -- monitor for EPS!

Antihistamines (H1 histamine receptor antagonists)
Diphenhydramine (Benadryl)
Dimenhydrinate (Dramamine)

Cannabinoids
Cannabis (Medical Marijuana)

*Most antiemetics cause some form of sedation so watch for additive effect with other meds

39

Proton Pump Inhibitors (PPIs)

Decrease stomach acid by inhibiting gastric proton pumps (which make the acid) -- stop the flow of acid at the pump!!

Omeprazole (Prilosec, Omepral)

Lansoprazole (Prevacid)

Esomeprazole (Nexium)

Pantoprazole (Protonix)

"Zole" is the friendly guy who turns of the pump but, if he stays around too long, he can cause b-12 deficiency.

40

Statins

HMG CoA Reductase Inhibitors - used to treat primary hypercholesterolemia, prevention of coronary events, protection against MI and stroke in pts with diabetes, help increase HDL

HDL should be HIGH and LDL should be LOW

Atorvastatin (Lipitor)
Simvastatin (Zocor)
Lovastatin

Risk of hepatoxicity - monitor liver function; instruct pts to avoid alcohol

Risk of myopathy and peripheral neuropathy - monitor CK levels and instruct pts to report muscle pain, weakness, tingling, etc.

41

Antiplatelets

Prevent platelet aggregation by inhibiting enzymes and factors that normally allow for arterial clotthing - used to prevent MI and stroke

Aspirin (Ecotrin)
Clopidogrel (Plavix)
Pentoxifyline (Trental)

Low dose therapy often used (81mg aspirin)

Monitor for bleeding - educate pts about "coffee ground" emesis and bloody or tarry stools; watch for bleeding, bruising, and petechiae

Observe for signs of weakness, dizziness, and headache -- could indicate hemorrhagic stroke

Avoid concurrent use with NSAIDs, heparin, warfarin, corticosteroids

42

Thrombolytic Agents

Clot busters - dissolve clots that have already been formed by converting plasminogen to plasmin, which destroys fibrigoen and other clotting factors

Streptokinase (Streptase)

Must be administered within 4 to 6 hours of onset of symptoms

Goal is the restoration of circulation

Risk is of increased bleeding -- baseline blood counts should be monitored; venipuncture, SQ, IM should be avoided

43

Erectile Dysfunction Agents

Act by increasing nitric oxide which opens and relaxes the blood vessels of the penis causing increased blood flow

Sildenafil (Viagra)
Vardenafil (Levitra)
Tadalafil (Cialis)

"Fil" is well tolerated by most clients but adverse effects include headache, flushing, back pain and muscle aches (Levitra), temporary vision changes.

Men who have heart problems, uncontrolled blood pressure, hx of stroke, or another health problem that my exacerbate the likelihood of priapism, should not hang out with "Fil."

44

Hypoglycemia

When using insulin, hypoglycemia is most likely to occur at the peak of the insulin's action -- important to know onset, peak, and duration of all insulin formulations

S/S of abrupt-onset hypoglycemia: tachycardia, palpations, diaphoresis, shakiness

S/S of gradual-onset hypoglycemia: headache, tremors, weakness

45

Lispro (Humalog)

Fastest: rapid-acting insulin

Onset: <15min

Peak: 30min - 1hr

Duration: 3 - 4hrs

46

Regular (Humulin R)

Fast: short acting insulin

Onset: 30min - 1hr

Peak: 2 - 3hrs

Duration: 5- 7hrs

47

NPH Insulin (Humulin N)

Slow: intermediate-acting insulin

Onset: 1 - 2hrs

Peak: 4 - 12hrs

Duration: 18 -24hrs

48

Insulin glargine (Lantus)

Slowest: long-acting insulin

Onset: 1hr

Peak: none

Duration: 10 - 24hrs

49

Epinephrine 

(Adrenaline)

  • Alpha1 Receptors

    • Vasoconstriction

      •  Slows absorption of local anesthetics

      • Manages superficial bleeding

      • Reduces congestion of nasal mucosa

      • Increases blood pressure

  • Beta1 Receptors
    • Increases heart rate
    • Strengthens myocardial contractility
    • Increases rate of conduction through the AV node
      • Treatment of AV block and cardiac arrest
  • Beta2 Receptors
    • Bronchodilation
      • Tx of Asthma

50

Dopamine 

(Intropin)

  • Tx of shock and heart failure

  • Beta1 Receptors

    • Low dose (2 to 5 mcg/kg/min)
    • Renal blood vessel dilation
    • Increases:

      • Heart rate

      • Myocardial contractility

      • Rate of conduction through the AV node

      • Blood pressure

  • Beta1 & Alpha1 Receptors
    • High dose (>10 mcg/kg/min)
      • Renal blood vessel vasoconstriction
    • Increases:
      • Heart rate
      • Myocardial contractility
      • Rate of conduction through the AV node
      • Blood pressure
      • Vasoconstriction

51

Dobutamine 

(Dobutrex)

  • Treatment of heart failure
  • Beta1 Receptors
    •  Increases:
      • Heart rate
      • Myocardial contractility
      • Rate of conduction through the AV node
  •