Deck 1 Flashcards
1
Q
- calci
A
Calcium and Vitamin D supplements
- Calcifero
- Calcitrol
- ergocalciferol
2
Q
- ase, plase
A
Thrombolytics
- alteplace ( Activase)
- streptokinase (streptase)
- reteplase (Retavase)
3
Q
Antidote for thrombolytics such as alteplase ( activase)
A
Amicar ( Aminocaproic acid)
4
Q
What should you watch for when giving Thrombolytics
A
preventing bleeding & watch for reperfusion arrhythmias if administered for myocardial infarction
5
Q
When is streptokinase contraindicated?
A
if strep infections or previous streptoknnase in the last 6 months
6
Q
What is Alteplase (Activase) used for?
what is an important thing to remember when giving this drug?
A
used in treatment of acute ischemic stroke in adults
needs to be started within 3 hours of on set
7
Q
-fenac, -lac
A
Non-steroidal anti-inflammatory drug
- diclofenac ( Cataflam, Voltaren)
- etodolac ( Lodine)
- nepafenac
- Ketrolac ( Toradol)
8
Q
Side effects of NSAIDS
A
GI irritation/ulcers/bleeding, nephrotoxicity.
9
Q
- profen
A
Non-steroidal anti-inflammatory drugs
- Fenoprofen (Naprofen)
- Ibuprofen ( Motrin, Advil)
- Ketoprofen ( Actron, Orudis)
10
Q
What is the difference between -fenac and - lac NSAIDS and -profen NSAIDS
A
-profen NSAIDS have low to intermediate analgesic potency and fenacs have the most potent analgesic effect, comparable with opioids
11
Q
-afil
A
Phosphodiesterase inhibitors- PDE-5 inhibitors
- sildenafil
- tadalafil
- vardenafil
12
Q
What is the action and results of Phosphodiesterase inhibitors?
A
block 1 or more of the 5 PD enzyme ( PDE) subtypes, resulting in increased intracellular cAMP
Overall causing increased cardiac contactility, vasodilation and bronchodilation
13
Q
-afil PDIs that selectively block PDE- 5 found where? What are they used for?
A
found in the corpus cavernosum in the penis. Can treat erectile dysfunction
14
Q
-rinone
A
Phosphodiesterase inhibitors-PDE-3 inhibitors
- amrinone
- milrinone
15
Q
what is the overall effect of phosphodiesterase inhibitors-PDE 3?
A
increased cardiac contractility and vasodilation
16
Q
What are phosphodiesterase inhibitors-PDE 3 useful for?
A
the treatment of acute congestive heart failure and cardiogenic shock because of the ability to increase contractility and vasodilation
17
Q
-zepam
A
sedative/anxiolytics-Benzodiazepine
- clonazepam
- diazepam (Valium)
- lorazepam ( Ativan)
- temazepam
18
Q
What is the mode of action of sedative/anxiolytics- Benzodiazepine?
A
Act on BZD receptors on chloride channel- increase chloride influx into neuronal cells to decrease excitability
19
Q
What are Benzodiazepines used for?
A
anxiety agent, sedative and anti-convulsant
20
Q
What drug is the first line for stopping seizure in progress in status epilepticus?
A
Benzodiazepine
21
Q
-zolam
A
Sedatives/Anxiolytics- Benzodiazepine
- alprazolam ( Xanax)
- estazolam
- midazolam ( Versed)
- Oxazepam ( Serax
22
Q
What is a precaution when giving Midazolam ( Versed)
A
It can cause Amnesia
23
Q
-glinide, ide
A
hypoglycemic agents- secretogues
- glipizide ( glucotrol)
- glyburide ( Micronase, DiaBeta)
- Nateglinide ( Starlix)
- Repaglinide ( Prandin)
24
Q
What are the therapeutic effects of hypoglycemia agents -glinide, ide
A
increase insulin secretion by pancreatic beta cells
25
What re side effects/ adverse effect of sulfonylureas( glyburide, glipizide)
weight gain
| glyburide increases sensitivity to sun
26
-glitazone
Hypoglycemic Agent- Thiazolidinediones
- Pioglitazone* (Actos)
- Rosiglitazone (Avandia)
27
What is the mode of action for Thiazolidinedione hypoglycemic Agents?
insulin sensitizers- increase insulin uptake and effectiveness by skeletal muscle cells and adipose tissue
28
- limus
Immunosuppressant
-Pimecrolimus (Elidel)
-Sirolimus ( Rapamune)
Tacrolimus ( Prograf)
29
-mab, -monab
immuntherapy-Monoclonal Antibody ( MAB)
- adalimumab (Humira)
- alemtuzumab(campath)
- daclizumab (zenapax)
- infliximab (remicade)
30
What are Immunotherapy- Monoclonial Antibody (-mab, -monab) used for?
treatment or prevention of organ rejection or graft vs host disease: also for management of autoimmune disorders
31
Which MAB is used to inhibit cell proliferation in some type of cancers?
Alemtuzumab and transtuzumab
32
Which MAB are anti-necrosis factor? What are they used for?
adalimumab, Etanercept, golimumab. Used for rheumatoid arthritis
33
What are the possible side effects of MABs
Flu-like symptoms, aches, pain, fever and nausea
34
- zoline
Nasal Decongestants
- oxymetozoline
- zylometazoline
35
What type of drugs are Nasal Decongestatns ( -zoline)? How do they work?
Alpha Adrenergic Agonists. Exert their effect by causing vasoconstriction of nasal blood vessels.
36
What are the possible side effects of Nasal Decongestants?
They can enter systemic circulation and produce CNS effects- tachycardia and hypertension
37
-nium
Neuromuscular blocking agents
| -pancuroium
38
What are Neuromuscular Blocking agents ( -nium) used for?
skeletal muscle relaxation during surgery or other procedures. Also used for mechanically ventilated patients to avoid " bucking" or resisting the vent.
39
-curium
Neuromuscular blocking agents-Muscle-relaxant
- atracurium
- mivacurium
40
-coxib
Non-Steroidal Anti-inflammatory drug ( NSAID) Cyclooxygenase -2 ( COX-2) selective inhibitor
- valdecoxib ( bextra)
- celecoxib ( celebrex)
- rofecoxib ( Vioxx)
41
What is unique to the Cylooxygenase-2 ( COX-2) selective NSAIDS (-coxib)? Compared to other NSAIDS
Because this class of NSAIDS does not block the COX-1 pathway, it exerts an anti-inflammatory effect without the common side effects of GI irritation ulcers, bleeding and Nephrotoxicity.
42
What is a disadvantage of the Cyclooxygenase-2 NSAID group?
They do not have anti-platelet effect so there is an increased risk of thrombi and emboli formation- leading to higher risk of stroke, myocardial infarction, pulmonary embolus and deep vein thrombosis. Contraindicated in pts at high risk for this
43
pred-
Corticosteroid
- loteprednol
- methylprednisolone* (Medrol, Depo-Medrol)
- Prednicarbate
- Prednisolone ( Orapred, Prelone)
- Prednisone* ( Sterapred)
44
-sone
Corticosteroid
- betamethasone ( Celestone)
- cortisone ( Cortone Acetate)
- dexamethasone ( Decardron)
- prednisone
45
-tretin
Dermatogic Agent-Retinoid/Vitamin A
- acitretin
- alitretinoin
- isotretinoin
- tretinoin
46
What are Dermatogic Agents Retinoid/ Vitamin A (-tretin) used for?
Topically for skin lesions such as acne, psoriasis, kaposi's sarcome lesions
47
What is a major contraindiction associated with Acitretin?
Contradicted in pregnancy due to tetratogenic effects. Should also not use if planning pregnancy within the next 3 years
48
-lamide
Diuretics - Carbonic Anhydrase Inhibitors
- acetazolamide
- brinzolamide
- dorzolamide
- methazolamide
49
What are Carbonic Anhydrase Inhibitors (-lamide) used for?
glaucoma ( decreases edema in eye) and metabolic alkalosis
50
-semide
Diuretics-loop diuretic
- furosemide
- torsemide
51
What is the mode of action in Loop diuretic (-semide)?
They block sodium, potassium, chloride and water reabsorption in ascending Loop of Henle
52
What are the possible adverse effects of giving Loop Diuretics too quickly?
Ototoxicity and syncope
53
-thiazide
Diuretics-Potassium losing
- chlorthiazide ( Hygroton, Diuril)
- hydrochlorothiazide(hydodiuril)
54
-actone
Diuretics-Potassium sparing
- aldactone
- spironolactone
55
What is the mode of action for potassium losing diuretics (-thiazide) ?
inhibits sodium, chloride, and water re-absorption to end portion of ascending LOH and distal tubule
56
In addition to diuretics what else can Diuretic -Potassium losing (-thiazide) do?
Vasodilation- #1 drug for hypertension
57
When should -thiazides not be given?
When a pt has sulfa allergy
58
What are side effects of thiazides?
hypo- kalemia, magnesemia, natremia, tension, chloremia, academia
hyper- glycemia, uricemia
59
What is the mode of action for -actone potassium sparing diuretics?
blocks the effects of aldoesterone- decreases sodium/chloride/water reabsorption and increases excretion. Increases potassium reabsorption
60
What must be watched when taking potassium sparing diuretics
hyperkalemia
61
-trel
female hormone-progestrin
- desogestrel
- etonogestrel
- levonorgestrel
- norgestrel
62
What are female hormone progestrin ( -trel ) used for?
hormonal contraception
63
-stim
Hematopoietic agent-colony stimulating factor
- filgrastim
- pegfilgrastim
- sargramostim
64
What are hematopoietic agents-colony stimulating facor ( -stim) used for?
used to off-set bone marrow suppressive effects of cancer chemotherapy, radiation and other treatments
65
What are side effects of hematopoietic agents?
flu-like symptoms, fever, chills, aches, pains, malasie, fatigue, Nausea, Anorexia
66
-phylline
Bronchodilators- xanthine derivative
- Aminophylline (Phyllocontin)
- dyphylline
- oxytryphylline
- theophylinne ( Theo-Dur, Slo-bid)
67
What is the mode of action of bronchodilators-xanthine derivative ( -phylline )
Relaxes smooth muscle of bronchi and bronchioles by increasing intracellular cAMP --> increase bronchodilation
68
What are possible side effects of Bronchodilators-xanthine derivative?
CNS stimulant effect- tachycardia, nervousness, tremors, visual hallucinations and seizures
69
What is an important nursing consideration when giving Bronchodilators-xanthine derivative ( -phylline )
monitoring blood levels because of the narrow therapeutic window
10-20mcg/blood > 20=toxicity
70
-tropium
Bronchodilators-anticholinergic
- ipratropium (atrovent)
- tiotropium* (spiriva)
71
What is the mode of action for Anticholinergc- Bronchodilators ( -tropium )
block the bronchoconstrictive effect of acetylcholine from parasympathetic system, promotes SNS causing bronchodiation
72
What are Anticholinergic-bronchodilators usuaully used for?
treatment of COPD
73
-stigmine
cholinergic agonists
- neostigmine
- physostigmine
- pyridostigmine
74
What are cholinergic used for?
treats myasthenia gravis and overdoes of neuromuscular blocking agents like curare
75
-ine
CNS stimulants
- amphetamine
- dextroamphetamine (Adderall)
- caffeine (NoDox, Vivarin)
- terbutaline
- theophylline
- epinephrine
- lisdexamfetamine (Vyvanse)
- norepinephrine
- dopamine
76
What are catecholamines such as epinephrine, norepinephrine and dopamine used for?
to prolong the compensatory phase of shock
77
-cort
corticosteroid
- clocortolone
- fludrocortisones
- hydrocortisone
78
What are the general uses for corticosteroids?
treatment of chronic inflammatory disorders ( arthritis, asthma, chronic pain disorders, autoimmune disorders) and prevention or treatment of acute or chronic organ rejection in transplantation
79
What are the adverse effects of corticosteroids
cushings syndrome-hyperglycemia, hyperlipidemia, sodium and water rentention, hypertension, labile mood, stretch marks, muscle atrophy, increased suseptibility to infections, moon face, buffalp ump, masked signs of infection
80
What should be avoided when on corticosteroids
avoid grapefruit and juice
81
When should corticosteroids be taken?
in morning
82
-onide, -sonide
corticosteroid
83
-idone
Antipsychotic-atypical
- paliperidone ( Invega)
- resperidone ( Risperdal)
- ziprasidone (geodon)
- lloperidone (fanapt)
84
What is the mode of action for antipsychotic-atypical drugs ( -idone )
blocks dopamine receptors and serotonin receptor 5HR2A
85
What are the possible side effects
weight gain and changes in metabolism - risk of diabetes and hyperlipidemia
86
-pine
antipsychotics-atypical
- clozapine (clozaril)
- olonazapine*
- quetiapine* ( Seroquel)
87
-prazole
Anti-ulcer- Gastric proton pump inhibitors
- esomeprazole* (Nexium)
- lansoprazole (Prevacid)
- omeprazole* (Prilosec)
- pantoprazole ( Prontonix)
88
What is the mode of action for Anti-ulcer Gastric Proton Pump Inhibitors ( -prazole ) ?
inhibit gastric acid production by the parietal cells on the surface of the stomach
89
What drugs could proton pump inhibitors effect and how?
they can increase bioavailability and risk of toxicity of anticoagulants, diazepam and dilantin
90
-tidine
Anti-Ulcer--H2 receptor antagonists
- Cimetidine ( Tagament)
- Famotidine* (Pepcid)
- Niazatidine ( Axid )
- Ranitidine ( Zantac)
91
What is the mode of action for Anti-Ulcer- H2 receptor antagonists (-tidine)
prevent histamine-induced gastric acid production
92
What are possible side effects of H2- receptor antagonist (-tidine)
headache
| may causes confusion in severly ill patients > 50 yrs old.
93
Which H2- receptor antagonist may have more adverse effects? What effects are these?
Cimetidine is more prone to have hepatic/renal toxicity and bone marrow suppression
94
When should H2 receptor antagonists be taken?
orally and at least 1-2 hours apart from antacids
95
-dronate
Biphosphonates- Bone resorption inhibitor
96
What is the mode of action for Biphosphoinates-bone resorption inhibitor? ( -dronate )
inhibits resorption of calcium from bone to blood.
97
What are possible side effects of biphosphonates
irritating to esophagus and GI tract- if taken orally.
98
How should Biphosphonates be taken?
should be taken 6-8 ounces of water on empty stomach. it upright or stand for at least 30 minutes after taking
99
-terol
Bronchodilators- Beta-2 agonist
- short acting: albuerol, levalbuterol, metaproteronolo, pirbuterol
- long acting: Arformoterol, formoterol, salmeterol ( Serevent )
100
What are the side effects of Bronchodilators-beta- 2 agonists
increase HR, increase SNS stimulation
101
-adol
Analgesics – Opioid
| Tapnetadol (Nucynta), tramadol*(Rybix, Ryzolt, Ultram)
102
-one ,-done
Analgesics -- Opioid
| hydrocodone* (Norco,Vicodin), hydromorphone (Dilaudid, Exalgo), oxycodone* (OxyContin, Percocet), methadone
103
hydrocodone* (Norco,Vicodin), hydromorphone (Dilaudid, Exalgo), oxycodone* (OxyContin, Percocet), methadone
```
o Depressed respirations
o Dizziness
o Drowsiness
o Decreased peristalsis
o Decreased BP
o Dependency
CNS depressant, everything SLOWS DOWN with opioids
```
104
-ane
Anesthetics -- General
| cyclohexane, ethane, fluorane
105
-caine
Anesthetics – Local/ Antiarrhythmics -- Class I
bupivacaine, cocaine, lidocaine (local anesthetic plus Class I Antiarrhythmic), xylocaine (local anesthetic plus Class I Antiarrhythmic), procainamide (Pronestyl – Class I antiarrhythmic)
106
All “caine” drugs work by
inhibiting or blocking the sodium channels. Sodium does not rush in as fast during an action potential, decreasing heart rate in the heart; decreased rate of pain transmission from the pain receptors
- CNS depressant effect
107
-nitrate, nitro-
```
Antianginals – Nitrates
Isorbid dinitrate (Isordil, Sorbitrate); isorbide mononitrate* (Monoket, Imdur); nitroglycerin (Nitro-Dur, Nitro-Bid, Nitrostate)
```
108
Antianginals – Nitrates (-nitrate, nitro) work by
prevention or treatment of angina in patients with atherosclerosis
- Vasodilation (arteries) and -Venodilation (veins) effect
109
Antianginals-Nitrates need replaced ..
Potency of NTG SL lost within 3 mos of opening bottle – needs replaced
110
Side effects of Antianginals-Nitrates?
Headache, dizziness, hypotension
111
Pts taken Viagra and Nitrates are at a high risk for what?
dangerous hypotension
