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Final Exam-Extra Material > Drugs for Final > Flashcards

Drugs for Final Flashcards

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1
Q

What class does Alendronate belong to?

A

Biphosphate

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2
Q

What does Alendronate do?

A

Blocks bone breakdown and increased BMD.

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3
Q

What are the adverse effects of Alendronate?

A 
Heart attack
Nausea, vomiting, diarrhea
Metallic taste
Esophageal erosion
Dental issues
Femoral fracture
Myalgia
Hypocalcemia
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4
Q

What drugs interact with Alendronate?

A

MVI, iron, antacids, calcium all need to be given separately.
Avoid Aspirin

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5
Q

What do you need to educate you patient on if they are given Alendronate?

A

Take with a full glass of water on empty stomach in the morning and stay sitting for 30 minutes.

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6
Q

What class does Atorvastatin belong to?

A

Statin

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7
Q

What is the action of Atorvastatin?

A

HMG CoA reductase inhibitor

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8
Q

What is Atorvastatin the drug of choice for and why?

A

Reducing LDL levels

They interfere with the synthesis of cholesterol working at the cellular level

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9
Q

What is the contraindication for Atorvastatin?

A

Active liver disease or history of alcoholic liver disease

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10
Q

What should you monitor in a patient who is on Atorvastatin?

A

Liver function tests

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11
Q

What are the adverse effects of Atorvastatin?

A 
Heart attack
Dizziness 
Blurred vision
Insomnia
 Fatigue
Cataracts
Flatulence
Abdominal pain
Cramps
Nausea
Vomiting
Constipation
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12
Q

What is the main adverse effect you need to watch for in a patient on Atorvastatin?

A

Rabdomylosis- muscle pain

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13
Q

What should you educate your patient on if they are taking Atorvastatin?

A

NO grapefruit juice

Take in the morning

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14
Q

What class does Cholestyramine belong to?

A

Bile acid sequestrant

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15
Q

What is the method of action for Cholestyramine?

A

Binds to bile acids in intestine allows excretion in feces instead of reabsorption- causes cholesterol to be iodized in liver and levels to fall

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16
Q

True or false:

Cholestyramine is absorbed systemically.

A

False:

It is not and is excreted in feces.

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17
Q

What is contraindicated for Cholestyramine?

A

Complete biliary abstraction, abnormal intestinal function.

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18
Q

What are the adverse effects of Cholestyramine?

A 
Heart attack
Fatigue
Drowsiness
Nausea
Constipation
INCREASED BLEEDING TIMES
Vitamin A and E deficiencies.
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19
Q

What drugs should you not give if the patient is on Chloestyramine?

A 
Thiazide diuretic
Digoxin
Warfarin
thyroid hormones
Corticosteroids
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20
Q

What should you educate your patient on if they are on Chloestyramine?

A

Don’t take with meals.
2 hours before or after meals of other meds.
Do not mix with carbonated beverages.

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21
Q

What class does Hydrochlorothiazide belong to?

A

Thiazide diuretic

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22
Q

What is the action for Hydrochlorothiazide?

A

Block the chloride pump. Keeps chloride and sodium in the tubule to be excreted in urine and prevents reabsorption of both into the vascular system.

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23
Q

What is the contraindication for hydrochlorothiazide?

A

Allergy to sulfonamides and bipolar disorder.

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24
Q

What are the adverse effects for Hydrochlorothiazide?

A 
Decreased calcium excretion
Dizzy
Vertigo
Orthostatic Hypotension
Vomiting
Anorexia
Dry mouth
Diarrhea
Polyuria
Nocturia
Muscle cramps or spasms
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25
What can Hydrochlorothiazide cause?
Hyperglycemia
26
What class does Metoprolol belong to?
Beta blocker
27
What does Metoprolol do?
Blocks the stimulator effects of the SNS decreasing cardiac output and renin release
28
What is the use for Metoprolol?
Treatment of stable angina and hypertension, prevents reinfarction in MI patients and treats stable CHF.
29
What are the contraindications for Metoprolol?
Bradycardia, heart block, cardiogenic shock, asthma, COPD.
30
What diagnoses should make you use caution when giving Metoprolol?
Diabetes and PVD.
31
What are the adverse effects of Metoprolol?
Related to the blockage of SNS (CHF, decreased CO, Arrhythmias, dizziness, fatigue, emotional depression, bonchospasm).
32
What should you not give with Metoprolol?
Clonidine
33
What may intensify the effect of beta blockers?
Calcium channel blockers like Diltiazem.
34
What class does Diltiazem belong to?
Calcium channel blocker
35
What is Diltiazem used for?
Prinzmentals angina
36
What is the action of Diltiazem?
Inhibits the movement of calcium ions across the membranes of myocardial and arterial muscle cells altering the action potential and blocks contractions.
37
What diagnoses are contraindicated for use of Diltiazem?
heart block Sick sinus syndrome renal or hepatic dysfunction
38
What are the adverse effects of Diltiazem?
Cardiac arrhthmia GI upset Skin reaction
39
What should you NOT use with Diltiazem?
Grapefruit juice
40
What class does Exenatide belong to?
Incretin-enhancer GLP-1 Agonist.
41
What does Exenatide do?
Increases insulin release and decreases glucagon release. Slows gastric emptying and increases satiety.
42
When should you NOT give Exenatide?
``` NPO patient Gastroparesis Pregnant or child Renal impairment After a meal ```
43
When should you give Exenatide and how?
60minutes of morning and evening meals- SQ
44
What class does Fluoxetine belong to?
SSRI
45
What does Fluoxetine do?
Inhibits CNS reuptake of serotonin. Little effect on norepinephrine.
46
What is Fluoxetine used for?
``` Depression OCD Panic attacks Bulemia PTSD MCDD Social phobia Anxiety ```
47
When is Fluoxetine contraindicated for use?
``` Impaired renal/hepatic function Cardiac disease Diabetes Severe depression Suicidal patient ```
48
What are the adverse effects of Fluoxetine?
``` Heart attack Drowsiness Insomnia Anxiety Tremor Chest Pain Agitation Sexual Dysfunction Palpitation Increased appetite Hyponatremia ```
49
What are the special considerations for Fluoxetine?
Serotonin syndrome and do not stop abruptly
50
What is serotonin syndrome?
When given with other drugs that increase serotonin. Increased HR and BP, agitation, sweating, hyperthermia, CV collapse, coma, seizures.
51
What class does Glyburide belong to?
Sulfonylurea
52
What does Glyburide do?
Stimulates insulin release and improves insulin binding to receptors.
53
What is contraindicated for Glyburide?
Trauma Surgery CV disease Diabetes type 1
54
What are the adverse effects of Glyburide?
Hypoglycemia GI upset Cardiovascular upset
55
What interacts with Glyburide?
``` Beta blockers Garlic Alcohol Anticoagulants Ginseng ```
56
What class does Digoxin belong to?
Cardiac glycoside
57
What does Digoxin do?
Produces an inotropic effect- increasing strength of contraction with increased cardiac output. Negative chronotropic effect- slowing the heart by decreasing conduction velocity.
58
What should you check before administering Digoxin?
Apical pulse for 1 full minute
59
What is Digoxin used for?
CHF, Afib, Atrial flutter, other SVT.
60
When is Digoxin indicated for use?
Heart block Renal insufficiency Hypocalcemia
61
If you are giving Digoxin via IVP how long should you push it for?
Slowly over 5 minutes
62
What should you check every 6 months if you are on Digoxin?
Serum levels
63
What is the reversal drug for Digoxin?
Digoxin immune fab
64
When should you notify your doctor that something isn't right when taking Digoxin?
A weight gain of over 2 pounds a day
65
What class does Escitalopram belong to?
SSRI
66
What does Escitalopram do?
Increases availability of serotonin at specific postsynaptic receptor sites within the CNS.
67
What is Escitalopram used for"?
Generalized anxiety and depression
68
What are the adverse effects for Escitalopram?
``` Dizziness Nausea Insomnia Somnolence Confusion Seizures ```
69
What class does Sertraline belong to?
SSRI
70
What does Sertraline do?
Inhibits serotonin reuptake
71
What does Sertraline treat?
``` Depression OCD Anxiety Panic Social anxiety PMDD PTSD ```
72
Do not take Sertraline when?
Taking MAOIs or within 14 days of taking an MAOI
73
When is the use of Sertraline contraindicated?
Hyponatremia
74
What are the adverse effects of Sertraline?
``` Suicidal ideation Seizure Agitation Insomnia Heart attack Dizziness Somnolence Fatigue ```
75
What should you monitor when a patient is on Sertraline?
Suicidal ideation and worsening depression
76
What is Protamine sulfate used for?
antidote for heparin
77
What class does Furosemide long to?
Loop diuretic
78
What does Furosemide do?
Blocks the chloride pump in the ascending loop of Henley. Causing reabsorption of sodium and chloride.
79
What are the adverse effects of Furosemide?
``` Dizziness Vertigo Paresthesias Orthostatic hypotension Rash Uricaria Nausea Anorexia Vomiting Glycosuria Urinary bladder spasm ```
80
What should you report when giving Furosemide?
Tinnitus | Decreased urine output
81
When can you not take Furosemide?
IF they are allergic to sulfonamide
82
What does Furosemide mask?
S&S of hypoglycemia
83
When pushing Furosemide what should you make sure you should do?
PUSH SLOW
84
What class does Prednisone belong to?
Systemic Corticosteroid
85
What does Prednisone do?
Suppresses histamine and prostaglandins. Immunosuppressant and anti-inflammatory.
86
What should you teach your patient when they are prescribed Prednisone?
Take with food Do NOT stop abruptly Causes hyperglycemia Can mask infections
87
What are the contraindications for use of Prednisone?
``` Systemic infection Cataracts Peptic ulcer Osteoporosis HTN Renal disease ```
88
What are the adverse effects of Prednisone?
``` Suppresses adrenal gland function Hyperglycemia Cushing syndrome in long term use Mood changes Cataracts Peptic ulcers Hypokalemia Osteoporosis ```
89
What class does Nitroglycerin belong to?
Nitrate
90
What does Nitroglycerin do?
Acts directly on smooth muscle to cause relaxation and depress muscle tone.
91
What is Nitroglycerin used for?
Prevention and treatment of angina pectoris atacks
92
When should you NOT give Nitroglycerin?
Cases of severe anemia Head trauma Cerebral Hemorrhage If patient is anemic
93
When should caution be used after administering Nitroglycerin?
In hypotension, hypovolemia, and any condition limiting CO.
94
What should you check when administering Nitroglycerin?
BP- if too low do not give
95
What are the Adverse effects of Nitroglycerin?
``` Heart attack Dizziness Nausea Vomiting Hypotension Flushing Increased perspiration ```
96
What are the drugs that interact with Nitroglycerin?
Ergot derivatives and heparin
97
What class does Imipramine belong to?
TCA
98
What is Imipramine used for?
Treatment of depression, enuresis and neuropathic pain
99
When is Imipramine contraindicated for use?
``` Cardiovascular disease Recent MI Liver dysfunction Angle closure glaucoma Urinary retention History of seizures Manic depression Pregnancy ```
100
What are the adverse effects of Imipramine?
Orthostatic hypotension Arrythmias Sedation Bone marrow suppression
101
What drugs interact with Imipramine?
``` St John's Worst CNS depressants Antihypertensives Oral anticoagulants Sympathomimetics SSRIs ```
102
What should you educate your patient about with Imipramine?
``` Slowly change position No alcohol use Do not drive until effect is known. Take at bedtime if sedation occurs Avoid strong sunlight ```
103
When does a therapeutic effect occur in Imipramine?
2-6 weeks of use.
104
What class does Raloxifene belong to?
Selective Estrogen Receptor Modulator
105
What does Raloxifene do?
- Decrease bone reabsorption. - Increase bone mass and density in postmenopausal women. - Reduce vertebral fracture - Decrease cholesterol and LDL.
106
What are the adverse effects of Raloxifene?
``` Hot flashes Migraines Flu like symtoms Endometrial disorder Breast pain Vaginal bleeding ```
107
When is Raloxifene contraindicated for use?
Pregnancy | History of DVT
108
What class does Guaifenesin belong to?
Expectorant
109
What is Guaifenesin used for?
Relief of dry nonproductive cough and mucous in the respiratory tract.
110
What does Guaifenesin cause?
Output of respiratory tract fluid.
111
What are the adverse effects of Guaifenesin?
``` Nausea Vomiting Heart Attack Dizziness Rash ```
112
Prolonged use of Guaifenesin causes what?
Masking of an underlying disorder
113
What class does Metformin belong to?
Biguanides
114
What does Metformin do?
Decreased hepatic production of glucose.
115
When is Metformin used?
For reduced insulin resistance
116
What does Metformin NOT do?
Promote insulin release and does not often cause hypoglycemia
117
What are the adverse effects of Metformin?
``` Nausea and vomiting Metallic taste Anorexia Flatulence Heart Attack Fatigue ```
118
What can Metformin cause that is rare but fatal?
Lactic acidosis.
119
What are the contraindications for use of Metformin?
Alcoholism Cardiopulmonary insufficiency Serious infection Being under 10 years old.
120
When should you withhold Metformin and how long should you hold it for?
40 hours before and after contrast dye.
121
What three drugs increase the risk of hypoglycemia when using Metformin?
Catopril Furosemide Nifedipine
122
What three drugs decrease elimination of Metformin?
Digoxin Morphine Vancomycin
123
What class does Warfarin belong to?
Anticoagulant
124
What is the antidote for Warfarin?
FFP and Vitamin K
125
What labs need to be tested for Warfarin?
PT/ INR
126
What is the pregnancy category for warfarin?
X
127
What is the onset for warfarin?
2-7 days
128
What is crucial patient education for warfarin?
Consistent diet to maintain therapeutic INR | Be careful with food and drug interactions.
129
What class does Sitagliptin belong to?
Incretin Enhancer DPP-4 Inhibitor
130
What does Sitagliptin do?
Slows breakdown of GLP-1 which increases insulin secretion and decreases glucagon secretion and slows GI emptying
131
When taking Sitagliptin how do meals play in administration?
They do not. If taken orally you can take regardless of meal times.
132
What are the adverse effects of Sitagliptin?
``` Pancreatitis Heart Attack Nausea Vomiting Diarrhea URI ```
133
What may Sitagliptin increase?
Digoxin levels
134
What class does Captopril belong to?
ACE inhibitor
135
When is Captopril contraindicated for use?
With impaired renal function
136
What are the adverse effects of Captopril?
``` Related to vasodilation- Heart Attack, MI GI irritation (ulcers) Renal insufficiency Non-productive cough Increase in Potassium levels Fluid loss ```
137
What drug does Captopril interact with?
Allopurinol
138
What class does Heparin belong to?
Anticoagulant
139
What is the antidote for Heparin?
Protamine Sulfate
140
What labs are associated with Heparin?
PTT and aPTT
141
What does Heparin do?
Disrupts the conversion of prothrombin to thrombin
142
What is Heparin used for?
The prophylaxis and treatment of DVT and PE
143
What class does Enoxaparin belong to?
Anticoagulant
144
What is Enoxaparin also known as?
Low Molecular Weight Heparin
145
What does Enoxaparin do?
Inhibits thrombus and clot formation by blocking factors Xa and Iia.
146
What is Enoxaparin often used?
It has fewer systematic adverse reactions
147
Why is Enoxaparin used in conjunction with chemo?
It blocks the process that allows cancer cells to develop new vessels.
148
What is the antidote for Enoxaparin?
Protamine Sulfate
149
What class does Omeprazole belong to?
Proton Pump Inhibitor
150
Omeprazole is the drug of choice for what?
Severe GERD
151
What does Omeprazole do?
Reduces acid secretion by binding irreversibly to an enzyme H1, K1- ATPase.
152
What is Omeprazole used for?
Treatment of peptic ulcers and GERD.
153
How long is Omeprazole used for?
2-6 months
154
What are the adverse effects of Omeprazole?
``` Heart attack Nausea Diarrhea Rash Abdominal pain ```
155
Long term use of Omeprazole increases what?
Risk of gastric cancer and hip fracture
156
What class does Aspirin belong to?
Antiplatelet
157
What does Aspirin do?
Alters formation of platelet plug and reduces inflammation
158
What are the adverse effects of Aspirin?
Heart burn Abdominal pain Ulceration Tinnitus
159
What is the contraindication for Aspirin?
Increased intracranial pressure or intracranial bleeding. Bleeding disorders Alcoholism
160
What class does Losartan belong to?
Angiotensin II receptor blocker
161
What does Losartan do?
Selectively blocks binding of angiotensin II to specific tissue receptors on vascular smooth muscle
162
What drug does Losartan interact with?
Phenobarbital
163
What class does Clarithromycin belong to?
Macrolide
164
Why is Clarithromycin used to treat peptic ulcers?
It is acid resistant and does not dissolve in the stomach so it can treat H. Pylori
165
For treating a peptic ulcer- When should the patient take Clarithromycin?
BID (twice a day)
166
For a peptic ulcer- is Clarithromycin the only drug used?
No- it is used in a combination with other drugs
167
What does Clarithromycin do?
Inhibits protein synthesis by binding bacterial ribosome.
168
What is Clarithromycin effective at treating?
Gram positive bacteria
169
What are adverse effects of Clarithromycin?
``` Nausea Abdominal cramping Vomiting Diarrhea Superinfection Resistance ```
170
What class does Amoxicillin belong to?
Penicillin
171
Amoxicillin is used with what to treat peptic ulcers?
In conjunction with Clarithromycin and tetracycline for H. Pylori
172
How does Amoxicillin work?
By disrupting bacteria cell walls allowing water to enter.
173
What type of bacteria is Amoxicillin most effective on?
Gram positive bacteria
174
What are the adverse effects of Amoxicillin?
Resistance | low RBC, WBC, platelet counts
175
What class does Tetracycline belong to?
Tetracycline
176
What is Tetracycline effective against?
Broad range of gram positive and gram negative organisms
177
How does Tetracycline work?
It inhibits protein synthesis
178
Why is Tetracycline only a drug of choice for a few bacterium?
Due to increased resistant strains
179
What are the adverse effects of Tetracycline?
``` Superinfections Nausea Vomiting Diarrhea Discoloration of teeth Photosensitivty ```
180
What class does Metronidazole belong to?
Antiprotozoal drugs
181
How does Metronidazole work?
With antiprotozoal and antibiotic activity against anaerobic bacteria- specifically amoebas
182
What are the adverse effects of Metronidazole?
``` Anorexia Nausea Diarrhea Dizziness Heart attack Dry mouth Metallic taste ```
183
What type of reaction may occur due to Metronidazole?
Disulfum reaction
184
What should you NOT use when taking Metronidazole?
Alcohol
185
Vitamin K is that antidote for what?
Warfarin
186
What class does Timolol belong to?
Beta-Adrenergic Antagonist
187
When using Timolol orally h0w is it prescribed?
As a mono therapy or in combination with thiazide diuretic
188
What is Timolol used for?
Treatment of GLAUCOMA To prevent reinfarction after MI and to treat mild hypertension
189
What are the adverse effects of Timolol?
``` Fatigue Headache Bradycardia Depression Hypotension Dyspepsia Nausea ```
190
What is Timolol associated with?
Exacerbation of angina and MI when abruptly discontinued.
191
What should you assess if a patient is on Timolol?
Heart rate and Blood pressure before administration and at regular intervals after administration.
192
What class does Methadone belong to?
Narcotic analgesic
193
What schedule does Methadone belong to?
Schedule II
194
What is Methadone used for?
Treatment of severe pain
195
What are the adverse effects of Methadone?
Constipation and respiratory depression
196
What can Grapefruit cause in a patient who takes Methadone?
Increased serum levels and adverse effects.
197
What should you not take while on Methadone?
Other CNS depressants
198
What should you monitor on a patient who has taken Methadone?
Respiratory function
199
What is Methadone associated with?
Abuse Respiratory depression QT prolongation
200
What class does Thiamine belong to?
Vitamin B1
201
What is Thiamine used for?
Treatment and prophylaxis of thiamine deficiency
202
What are the adverse effects of Thiamine?
Anaphylaxis and cardiovascular collapse
203
What education is important to teach when giving a patient Thiamine?
The pill must be swallowed WHOLE. NEVER crushed.
204
what class does Disulfiram belong to?
Anti-alcohol agent
205
What is Disulfiram used in adjunction with?
Treatment of the patient with chronic alcoholism who seriously wants to maintain sobriety.
206
What are the adverse effects of disulfiram?
``` Hypotension to shock level arrhythmias Acute congestion failure Respiratory depression Unconsciousness Convulsions Sudden death ```
207
Who should Disulfiram not be given to?
Anyone in a state of alcohol intoxication or without a patients full knowledge.
208
What is Dantrolene used for?
Antidote for malignant hyperthermia
209
What class does Memantine belong to?
Receptor Antagonist/ Antidementia
210
What is Memantine used for?
Moderate to severe Alzheimer's disease
211
What are the adverse effects of Memantine?
``` Dizziness Headache Confusion Pain Flu-like symptoms ```
212
What class does Donepezil belong to?
Central acting cholinergic- therapeutic antidementia
213
What is Donepezil used to treat?
Mild, moderate, or severe dementia/Alzheimers.
214
What are the adverse effects of Donepezil?
``` Headache Insomnia Nausea Diarrhea Vomiting Muscle cramps Anorexia ```
215
What should you monitor for with a patient on Donepezil?
S&S of GI ulceration and bleeding
216
In patients taking Donepezil what should you monitor for?
Patients with asthma or obstructive pulmonary disease. And monitor cardiovascular status
217
What class does Lisinopril belong to?
Antihypertensive
218
What should you monitor for when a patient is taking Lisinopril?
Monitor drug effect for several hours or until BP is stabilized for at least an additional hour after.
219
What are the adverse effects of Lisinopril?
Dizziness Hypotension Chest pain Nausea
220
What may Lisinopril increase?
Lithium levels and toxicity
221
What has Lisinopril been associated with?
Fetal injury and death
222
If hypotension occurs within the first 1-5 hours after the first administration of Lisinopril what should you do?
Place the patient in a supine position and notify prescriber
223
What class does Gemfibrozil belong to?
Quinolone antibiotic
224
What is Gemfibrozil a treatment for?
Acute exacerbations of chronic bronchitis and mild to moderate community acquired pneumonia.
225
What should you monitor in patients who are talking Gemfibrozil?
Cardiac Status
226
Gemfibrozil increases the risk of what?
Tendinitis, tendon rupture, and exacerbation of muscle weakness in those with MG
227
Where is Calcitonin found in?
Salmon
228
What does Calcitonin from salmon do?
Increases bone density by inhibiting bone resorption and opposing effects of PTH lowering serum calcium.
229
How is Calcitonin administered?
Nasal Spray or SQ
230
What is Calcitonin from salmon used for?
Osteoporosis, Paget's, emergency treatment of hypercalcemia.
231
What are the adverse effects of Calcitonin?
Nausea Vomiting Flushing Hypocalcemia
232
Where is Calcitonin secreted from?
Thyroid gland
233
What does Calcitonin do?
Stimulates bone deposition, removes calcium from blood, and helps control homeostasis.
234
Where does Calcitonin target?
Bones Kidneys GI tract
235
What two hormones control Calcium homeostasis?
Calcitonin and Parathyroid Hormone
236
Where is PTH stimulated from?
Parathyroid
237
What does PTH do?
Stimulates osteoclasts and accelerates bone resorption, increases GI absorption of calcium. Increases calcium in blood
238
Calcitriol is the active form of what?
Vitamin D
239
What is Calcitriol used for?
Management of hypocalcemia
240
What are the adverse effects of Calcitriol?
``` Heart attack Weakness Nausea Vomiting Constipation ```
241
What interacts with Calcitriol?
Cholestyramine
242
What should you monitor for when a patient is taking Calcitriol?
Liver and renal function Magnesium levels Calcium and phosphate levels.
243
Thiamine is used to treat this disease that causes a deficiency in thiamine.
Alcoholism

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