Exam 2 drugs

Question 1

BCG vax MOA

Answer 1

Stim inflam response in bladder so own immune sys recognized cancerous cells and attacks

Question 2

BCG vax indications

Answer 2

Bladder cancer

Question 3

BCG vax SE

Answer 3

Bladder irritation (UTI sx last even after tx), systemic infection

Question 4

BCG vax NC

Answer 4

• give weekly for 6-12W
• live vax–not for immunocomp
• Instructions–empty bladder, instill vax in with I&O cath, keep in 2h and change position q15 minutes
• disinfect urine for 6h post-tx bleach urine to kill bac)

Question 5

Sodium bicarb MOA

Answer 5

Dec pH of pt and raise bicarb level

Question 6

Sodium bicarb indications

Answer 6

Tx metabolic acidoses to slow KCD, prevent bone loss, and improve nutritional status

Question 7

Sodium bicarb SE

Answer 7

Bloating

Question 8

Sodium bicarb NC

Answer 8

• taken orally
• measure efficiency with bicarb level
• start when HCO3 less than 15 (goal is 18-20)

Question 9

Finasteride (Proscar) and Dutasteride (Advodart) class

Answer 9

5-α-reductase inhibitors

Question 10

Finasteride (Proscar) and Dutasteride (Advodart) MOA

Answer 10

Blocks conversion of T to DHT (alpha 1 receptors); dec epithelial tissue in prostate and mech obstruction of urethra but does NOT dec overall circulating T levels;
Dutasteride works on alpha 1 and 2 receptors

Question 11

Finasteride (Proscar) and Dutasteride (Advodart) indications

Answer 11

Mechanical obstruction or urethra, pattern baldness in men and women

Question 12

Finasteride (Proscar) and Dutasteride (Advodart) SE

Answer 12

Inc hair growth, impotence, dec libido, gynecomastia, birth defects

Question 13

Finasteride (Proscar) and Dutasteride (Advodart) NC

Answer 13

• Works best in larger prostates but won’t affect smaller prostates much
• takes 6-12M to work
• need to take for rest of life
• dec prostate specific antigen (PSA) levels (check before start and 6M later)
• caution in handling for pregnant women–teratogenic (nurses don’t open or give)
• can’t donate blood
• Dutasteride works similarly

Question 14

Tamsulosin (Flomax) class

Answer 14

Alpha 1 adrenergic antagonist

Question 15

Tamsulosin (Flomax) MOA

Answer 15

Blocks alpha receptors and relax smooth muscles, selective for alpha receptors in prostate

Question 16

Tamsulosin (Flomax) indications

Answer 16

dyanmic obs of urethra

Question 17

Tamsulosin (Flomax) SE

Answer 17

Well tolerated, abnormal ejaculation

Question 18

Tamulosin (Flomax) NC

Answer 18

• commonly used
• no systemic effect
• happens quickly
• taken for life
• can be used in combination therapy with a 5-α-reducatase inhibitor and will work better but $$$

Question 19

Sildenafil (Viagra) class

Answer 19

PDE-5 inhibitors

Question 20

Sildenafil (Viagra) MOA

Answer 20

Inhibits PDE5, inc and preserve cGMP levels, only enhances the normal response to sexual stimuli so will not work if that is not there

Question 21

Sildenafil (Viagra) indications

Answer 21

Relief of ED, BPH, pulmonary arterial HTN

Question 22

Sildenafil (Viagra) SE

Answer 22

HA, flushing, dyspepsia, CV issues

Question 23

Sildenafil (Viagra) NC

Answer 23

• reliable
• does not affect men w/o ED
• up to 4h before sex and onset 30-60 min
• CI preexisting CV disease, hypotension
• CI nitrate RX, causes signif dec in BP and pass out
• call 911 if chest pain or s/s heart attach during sex, loss of vision in one or both eyes, loss of hearing
• not more than once per day
• priapism–painful erection that lasts over 4h–medical emergency

Question 24

Timolol–nonselective
Betaxolol–B1 receptor blocker class

Answer 24

Optic-topical beta blockers

Question 25

Timolol–nonselective Betaxolol–B1 receptor blocker MOA

Answer 25

Block SNS stim of beta receptors

Question 26

Timolol–nonselective Betaxolol–B1 receptor blocker indications

Answer 26

Open-angle glaucoma maintenance tx, if acute-angle–need drops asap and other

Question 27

Timolol–nonselective Betaxolol–B1 receptor blocker SE

Answer 27

Transient burning and discomfort; if go systemic–systemic fx

Question 28

Timolol–nonselective Betaxolol–B1 receptor blocker NC

Answer 28

- CI–same as oral beta blockers (asthma, severe COPD, sinus brady or heart failure)--Betaxolol can be given to these pt - must take or go blind - apply nasolacrimol pressure

Question 29

Lantanoprost (Xalatan) class

Answer 29

Prostaglandin analogs

Question 30

Lantanoprost (Xalatan) MOA

Answer 30

Inc outflow drainage of aqueous humor

Question 31

Lantanoprost (Xalatan) indications

Answer 31

Open-angle glaucoma, ocular HTN

Question 32

Lantanoprost (Xalatan) SE

Answer 32

well-tolerated

Question 33

Brimonidine (Alphagan) class and MOA

Answer 33

Alpha adrenergic agonist - Dec AH production, may inc drainage/outflow

Question 34

Brimonidine (Alphagan) SE

Answer 34

Burning/stinging, dry mouth, fatigue, HA, blurred vision, hypotension

Question 35

Dorzalamide (Trusopt) class and MOA

Answer 35

Carbonic anyhydrase inhibitor - dec production of aqueous humor

Question 36

Dozalamide (Trusopt) indications

Answer 36

open angle inc IOP

Question 37

Dozalamide (Trusopt) SE and NC

Answer 37

- Stinging, bitter taste, allergic rxns (conjunctiva or lid rxn) - can be combined with timolol (Cosopt)

Question 38

Calcium carbonate (tums) MOA

Answer 38

Binds to phosphate (phos binder essentially)

Question 39

Calcium carbonate indications

Answer 39

Treat hyperphosphatemia

Question 40

Calcium carbonate SE

Answer 40

hypercalcemia

Question 41

Calcium carbonate NC

Answer 41

- take with meals - monitor Ca levels

Question 42

Calcitriol MOA

Answer 42

(1, 25- dihydroxyvitamin D); activated form of vit D, stim intestinal abs of calcium/phosphate, and bone mineralization

Question 43

Calcitriol indications

Answer 43

Tx renal osteodystrophy

Question 44

Calcitriol SE

Answer 44

Hypercal, hyperphos

Question 45

Calcitriol NC

Answer 45

Monitor labs

Question 46

Ciprofloxacin class and indications

Answer 46

- Fluroquinolones - Treat UTIs, STIs, lower and upper resp infx, gonorrhea, other infx, anthrax

Question 47

Ciprofloxacin SE and NC

Answer 47

- Arthropathy (joint disease), often irreversible; prolonged post-abx effect–concentrated in neutrophils - PO, IV, topical - minimal usage on BBB/CSF - good for rapid and slow orgs - avoid pt under 18 and over 60 (bc joints)

Question 48

What does it mean if PSA does not decrease with finasteride?

Answer 48

Pt may have prostate cancer