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Pharm 2 > E3 Medications > Flashcards

E3 Medications Flashcards

(62 cards)

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1
Q

Fluphenazine (Prolixin)

A

Blocks dopamine receptors in brain; typical antipsychotic (FGA)
Interactions: Alcohol (increased depression) Kava Kava (EPS)
Available in long acting IM for use when patient is stabilized on oral dose

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2
Q

Haloperidol (Haldol)

A

Blocks dopamine receptors in treatment of acute/chronic psychoses also used in dementia, schizophrenia, Tourette’s
SE: Similar to al FGA’s + EPS although less likely to cause sedation, hypotension, anticholinergics

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3
Q

Chlorpromazine (Thorazine)

A

Typical FGA used for schizophrenia, bipolar and other psychotic disorders
SE: orthostatic hypotension, anticholinergic effects, tardive dyskinesia, EKG changes (prolonged QT)

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4
Q

Thioridazine (Melleril)

A

High likelihood of EKG changes (prolong QT) so other FGAS should be tired first
SE: EPS, sedation, orthostatic hypotension, anticholinergic effects

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5
Q

Clozapine (Clozaril)

A

SGA used for severe schizophrenia that does not respond to other medications
Adverse: Agranulocytosis (fever, sore throat and mouth ulcers signs - reported immediately) + seizures
Interventions: Monitor WBC and neutrophil if ANC is below 1000 drug must be permanently discontinued

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6
Q

Olanzapine (Zyprexa)

A

SGA - Does not cause EPS
SE: weight gain, DM, duslipidemia, leukopenia/neutropenia
Nursing: WBC before starting and for multiple months after if ANC is less than 1000 stop medication and monitor for infection

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7
Q

Risperidone (Risperdal)

A

SGA - does not cause agranulocytosis
SE: low risk of EPS, weight gain, DM, dyslipidemia, agitation, fatigue, dizziness, orthostatic hypotension
Long acting IM available

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8
Q

Benzodiazepines

A

Immediate onset of action, can be used to treat anxiety - used on a schedule or PRN potential for dependence or abuse
SE: sedation, pt should avoid alcohol or other depressants
Ex: Chlordiazepoxide (Librium) Diazepam (Valium) Lorazepam (Ativan) Alprazolam (Xanax)

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9
Q

Buspirone (BuSpar)

A

Treats anxiety + depression
Effects in 2-4 weeks
SE: dizziness, headache, nausea, nervousness
Interacts with grapefruit juice (toxicity)

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10
Q

Phase 1 TB treatment

A

2 months, in regions without drug resistance
Isoniazid, rifampin, pyrazinamide, ethambutol

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11
Q

Phase 2 TB treatment

A

Minimum of 18 weeks
Isoniazid and rifampin are preferred
Generally 6-9 months of total treatment

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12
Q

Treatment for mutlidrug-resistant TB

A

Extended treatment time - 24 months, 2nd + 3rd line used. May need 5+ medications, extremely expensive 40-60% die

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13
Q

First line TB drugs

A

Isoniazid, rifampin, pyrazinamide, ethambutol, rifabutin, rifapentine
More effective than second line and less toxic

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14
Q

Second line drugs

A

cycloserione, ethionamide, caprdomycin, para-amino salicyclic acid, anminoglycosides (streptomycin, amikacin, kanamycin), quinolones (levofloxacin, moxifloxacin)
Less effective and more toxic

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15
Q

Bedaquiline

A

New treatment option for TB, does not interfere with metabolism of other medication, high mortality rate in trials
SE: prolonged QT + hepatotoxic

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16
Q

Isoniazid (INH)

A

Inhibits bacterial cell wall synthesis (prophylaxis and treatment of TB)
SE: gi distress, hepatotoxicity, blurred vision (photosensitivity) tinnitus, dizziness, peripheral neuropathy, psychotic behavior, seizures, blood dyscrasias, risk of hyperglycemia
Interaction: Increased risk of liver damage (alcohol, rifampin, rifabutin, rifapentine) increased phenytoin levels
Decreased absorption with antiacids
Teaching: complete regimen, sputum specimens early morning, pyridoxine (B6) to prevent neuropathy, frequent eye examinations, report (numbness, tingling, burning) teach about sun precautions and avoid antacids

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17
Q

Rifampin

A

Used with isoniazid to treat TB
Suppresses RNA synthesis
Tkae 1 hour before or 2 hours after meals
Red-orange discoloration of urine sweat and tears
Pt cannot wear soft contact lenses
Interactions: reduced effect of hormonal birth control

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18
Q

Rifapentine

A

May be taken with food
SE: Red orange discoloration of urine, sweat and tears (no soft contact lenses)
Interactions: reduced effect of hormonal BC

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19
Q

Rifabutin

A

Tb treatment - take with food to reduce GI upset, red/orange color body fluids
Uveitis - DC if eye pain
Interactions: reduced effect of BC

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20
Q

Pyrazinamide

A

Hepatotoxicity - monitor liver enzymes
Nongouty polyarthralgias (joint pain, NSAID treatment, hyperuricemia)

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21
Q

Ethambutol

A

Visual disturbances (visual acuity, color discrimination) Assess before and monthly, encourage pts to report symptoms and stop medication
SE: dizziness, confusion, hallucinations, joint pain

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22
Q

Valacyclovir HCL (Valtrex)

A

HSV-1, HSV-2 – acute outbreaks and/or chronic treatment
Herpes zoster (shingles)
Vericella (chicken pox)

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23
Q

Famciclovir (Famvir)

A

HSV, herpes zoster
Can decrease duration of shingles
HSV used for onset, recurrence, and prophylactically

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24
Q

Ganciclovir (Cytovene)

A

Systemic CMV treatment
Side effect: thrombocytopenia, nephrotoxicity, increased bilirubin
Hazardous – requires special training for handling
Serious side effects! Only used with immunocompromised!

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25
Cidofovir (Vistide)
CMV retinitis, esp in AIDs patients May cause severe kidney damage – given with probenecid which delays elimination, reduces the required frequency of dosing
26
Foscarnet (Foscavir)
CMV retinitis, HSV-1 & 2, varicella Monitor kidney function, electrolytes
27
Topical Herpes Treatment
Penciclovir (Denavir) – HSV-1 &2 Trifluridine (Viroptic) – herpes eye infections
28
Acyclovir
Primary drug used to treat HSV 1+2 and Herpes zoster (CMV mostly resistant) Drug Interactions: risk of nephrotoxicity Interventions: Monitor renal function, safe in pregnancy, IV admin (maintain adequate fluid intake, infuse slowly to reduce risk of kidney damage)
29
Interferon Alfa
Treatment of HCV (+ HBV) - protects cells from virus, SQ administration Combined treatment with ribavirin SE: flu-like symptoms, depression and suicidal ideation
30
Ribavirin
Combined treatment with interferon alfa for HCV, available in a aerosol for children SE: anemia, flu-like symptoms, teratogenic
31
Simeprevir
Protease inhibitor - treatment of HCV Hepatotoxic, photosensitivity, used in combo of other medications Interactions: Amiodarone - increases levels causing severe bradycardia -Statins - increases levels, in turn lower the statin dose
32
NS5A Inhibitors + NS5B Inhibitors
Treatment of HCV Many drug interactions (amiodarone - severe bradycardia) + should not use alone bc of resistance Daclatasvir (NS5A) + Sofosbuvir (NS5B)
33
Lamivudine
Nucleoside Analog - treatment of HBV Also used in treatment of HIV and must be tested before administering bc of difference in dose
34
Amantadine (Symmetrel)
Prophylaxis against influenza A, must be started 48 within symptom onset Never used for B
35
Rimantadine HCL (Flumadine)
Prophylaxis and treatment of influenza A, not often used d/t resistance Never used for B
36
Oseltamivir phosphate (Tamiflu)
Treatment of influenza A & B Must be given within 48 hours of symptom onset Shorten length of illness and decrease symptoms, reduce incidence of complications (sinusitis, bronchitis) Nursing Considerations: GI upset, take with food
37
Zanamivir (Relenza)
Treatment of influenza A & B Must be given within 48 hours of symptom onset Shorten length of illness and decrease symptoms, reduce incidence of complications (sinusitis, bronchitis) Nursing considerations: Inhaled powder, cough and throat irritation may occur
38
Baloxavir Marboxil
For treatment of both influenza A & B Use within 2 days of symptom onset Not to be administered with salts Calcium salts, iron salts, magnesium salts
39
Remdesivir
Nucleotide analog, FDA approved to treat corona, IV medication, lots of SE
40
Paxlovid (combination of nirmatrelvir and ritonavir)
Inhibits the SARS-CoV-2 protein from replicating oral antiviral pill started within 5 days of sx can be taken at home helps keep high-risk patients from needing to be hospitalized - Must be 12+ years old AND at high risk of complications from COVID 19 illness, MUST be positive SE: altered or impaired sense of taste, diarrhea, increased BP, muscle aches
41
Amphotericin B
Polyene for treatment of severe fungal infections - DRUG OF CHOICE - for systemic Monitor for toxicity (nephrotoxicity - kidney function + hydration, hypokalemia, bone marrow suppression, hypotension/hypertension, seizures Interventions: Give IV slowly, monitor vitals, increase fluids, monitor UO and weight, monitor electrolytes, renal and liver function
42
Nystatin (mycostatin)
Oral or topical administration Teaching: needs to make contact with infected area, oral (swish siwsh swallow, gargle if throat involved)
43
Ketaconazole (Nizoral)
Azole class antifungal Topical scalp infection (seborrheic dermatitis) or PO for systemic infections Teaching: ETOH increases risk of hepatotoxicity
44
Fluconazole (Diflucan)
Azole - IV or PO used for systemic + topical infections Vaginal yeast infections (one time PO dose)
45
Itraconazole (Sporanox)
Taken PO for fungal nail infections - requires consistent treatment Monitor for hepatotoxicity
46
Caspofungin (Cancidas)
Echinocandins class - treatment of antifungals, only available for IV administration High risk of phlebitis, treats systemic infections
47
Flucytosine (Ancobon)
Pyrimidine Analog - used to treat serious systemic fungal infections SE: hepatotoxicity + bone marrow suppression
48
Chloroquine
Treatment of malaria mild/moderate attack or for prophylaxis SE: visual changes, GI effects, H/A, pruitis Assessment/Intervention: Monitor kidney + liver function, take drug with meals, report vision (CNII) and hearing (CN VIII) changes, avoid large quanities of alcohol, lemon juice decreases effect
49
Primaquine
Drug of choice for prevention of relapse of P. vivax, SHOULD NOT be administered until further infection risk has ceased (not returning to endemic areas Not effective for treatment during erythocytic phase Monitor urine for hemoglobin - discontinue if hemolysis develops
50
Quinine
Antimalarial - Lots of side effects (potential cardiovascular effects) only treatment for the last 100 years
51
Polymyxin B
Peptide Antibiotic - Treats gram negative bacteria, slow IV infusion (not well absorbed in GI tract) Adverse: nephrotoxicity + neurotoxicity
52
Bacitacin
Peptide Antibiotics - Meningitis, skin and ocular infections Route: topical opthalmic oitments or IM (not well absorbed in GI) Adverse: GI distress/renal damage
53
Anthelminitics (3)
1. Ivermectin (Stromectol) Works on multiple parasites Also works for lice Single dose 2. Praziquantel (Biltricide) Tapeworms, flukes Safe to use during pregnancy 3. Pyrantel pamoate (Pin-X, Reese’s Pinworm Medicine) Hookworms, pinworms Single dose Given for 1-3 days SE: Gi upset, dizziness/drowsiness (warn against driving) HA, weakness Interventions: Give after meals to prevent Gi upset, encourage good hygiene (showers over baths) wash bedding, towels and undergarments daily, proper food preparation, wash hands well, at risk for re-infections
54
Nitrofurantoin (Macrodantin)
Antibotic treatment for UTI, effective against many gram-positive + gram-negative organisms (especially E. Coli)
55
Phenazopyridine (Pyridium)
Urinary analgesic - relieves pain/bladder spasms, burning sensation, frequency + urgency SE: GI upset, red-orange urine, blood dyscrasia, nephrotoxicity/hepatotoxicity
56
Methenamine Hippurate (Hiprex)
Treatment of chronic UTI strains of E.coli + P. aeruginosa: Bactericidal when urine is acidic (pH <5.5) Caution: should not be given to pts with renal impairment (check BUN/creatine) do not use with sulfa drugs - increased risk of crystalluria Pt teaching - consume acidic foods/fluids (cranberry juice, vitamin C)
57
Trimethoprim and sulfamethoxazole (Bactrim, Septra)
Used in treatment/prevention of acute/chronic UTIS - both lower and upper SE: Gi upset, rash + prutitus (not associated with allergic reaction, worse with sun exposure)
58
Fluoroquinolones -floxacin
Treats lower and upper UTIS SE: dizziness (elderly) photo sensitivity (sun protection and sun glasses)
59
Fosfomycin tromethamine (Monurol)
Treatment of lower UTI Single dose (improves compliance)
60
Bethanechol (Urecholine)
Treatment of hypotonic bladder (neurogenic, spinal cord injury or severe head injury) Action: increases bladder tone of detrusor muscle SE: GI distress (cholinergic effect) dizziness, fainting, may exacerbate asthma Contraindicated with PUD, gastric ulcers, IBS, or urinary blockage
61
Oxybutynin (Ditropan)
Relieves spasms + prevents urinary urgency SE: drowsiness, tachycardia, dizziness, fainting, blurred vision, dry mouth, constipation, urinary retention (anticholinergic effects) Assessment: avoid in glaucoma, GI or urinary obstruction, use cautiously with cardiac, renal, hepatic or prostate problems
62
Tolterodine Tartrate (Detrol)
Used to control and overactive bladder (which causes frequency) Decrease in urge and incontinence SE: anticholinergic effects, dizziness, fainting, blurred vision

Pharm 2 (13 decks)

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