Exam 2 Drugs Flashcards
(139 cards)
1
Q
atorvastatin (Lipitor) category
A
Statins
reduce cholesterol
2
Q
atorvastatin (Lipitor) minor adverse effects
A
headache, fatigue, muscle or joint pain, and heartburn, neuropathy
3
Q
atorvastatin (Lipitor) severe adverse effects
A
severe myopathy & rhabdomyolysis,
4
Q
atorvastatin (Lipitor) nursing considerations
A
liver function tests
no alcohol
monitor for muscle pain or weakness
5
Q
weaker statin sisters
A
lovastatin (Mevacor)
fluvastatin (Lescol)
pravastatin (Pravachol)
6
Q
Stronger statin sisters
A
simvastatin (Zocor)
atorvastatin (Lipitor)
rosuvastatin (Crestor)
7
Q
cholestyramine (Questran) category
A
Bile-Acid Resins
lower cholesterol
8
Q
cholestyramine (Questran) adverse effects
A
GI: bloating and constipation, abdominal pain
9
Q
cholestyramine (Questran) nursing considerations
A
Do not take with other drugs! Take w/food, Mix w/H20
10
Q
niacin (active form vitamin B3) category
A
Nicotinic Acid-Niacin
11
Q
niacin (active form vitamin B3) levels
A
As vitamin-25mg/d
As lipid lowering-2-3g/d
12
Q
niacin (active form vitamin B3) primary use
A
lower VLDL
raise HDL
13
Q
niacin (active form vitamin B3) adverse effects
A
flushing, (take ASA 30 min before dose) hot flashes, nausea, excess gas, diarrhea
serious: hepatotoxicity, gout, increased blood sugar
14
Q
niacin (active form vitamin B3) teaching
A
3X/day, w/or wo meals
15
Q
gemfibrozil (Lopid) category
A
Fibric-Acid Agent
16
Q
gemfibrozil (Lopid) use
A
treat severe hypertriglyceridemia
combine w/statin for more better result
17
Q
gemfibrozil (Lopid) adverse effects
A
GI distress, watch for bleeding with clients on anticoagulants, myalgia (check CK), rash, fatigue, cholelithiasis, pancreatitis, liver toxicity
18
Q
gemfibrozil (Lopid) considerations
A
give 30 minutes prior to morning & evening meals, Ø ETOH
19
Q
ezetimibe (Ezetrol, Zetia), ezetimibe + simvastatin (Vytorin) use
A
inhibits absorption of cholesterol
20
Q
ezetimibe (Ezetrol, Zetia), ezetimibe + simvastatin (Vytorin) considerations
A
Administer with statin to avoid body making more cholesterol
21
Q
ezetimibe (Ezetrol, Zetia), ezetimibe + simvastatin (Vytorin) adverse effects
A
hepatitis, myopathy
22
Q
hydrochlorothiazide (HydroDiuril) mechanism of action
A
to increase amount of urine produced and excreted
Thiazide diuretic
23
Q
hydrochlorothiazide (HydroDiuril) adverse effects
A
electrolyte imbalances, especially loss of potassium
erectile dysfunction
24
Q
hydrochlorothiazide (HydroDiuril) use
A
for mild to moderate hypertension
25
furosemide (Lasix) mechanism of action
Loop diuretic
| increase urine flow, reducing blood volume and cardiac workload
26
furosemide (Lasix) use
reduce edema and pulmonary congestion
27
furosemide (Lasix) adverse effects
dehydration, electrolyte imbalance, hypotension, ototoxicity
28
spironolactone (Aldactone) catagory
Potassium-Sparing Diuretic
| Mild diuresis
29
spironolactone (Aldactone) adverse effects
hyperkalemia, dysrhythmias, HA, fatigue, dizziness, blood dyscrasias
30
spironolactone (Aldactone) adverse effects in men
gynecomastia, impotence, ↓libido
31
spironolactone (Aldactone) adverse effects in women
hirsutism, breast tenderness, menstrual irregularities, voice deepening
32
nifedipine (Procardia) category
Calcium Channel Blocker
33
nifedipine (Procardia) mechanism of action
to cause vasodilation, decreasing B/P
34
nifedipine (Procardia) use
for hypertension and angina
| possible use w/ small kidney stones to dilate urethra
35
nifedipine (Procardia) adverse effects
possible male infertility, sexual difficulties, “male contraceptive”
36
nifedipine (Procardia) considerations
check kidney, liver labs
37
Enalapril (Vasotec) category
ACE inhibitor
38
Enalapril (Vasotec) use
lower blood pressure & peripheral resistance
| Helps renal failure, diabetic neuropathy
39
Enalapril (Vasotec) adverse effects
first-dose hypotension, orthostatic hypotension, cough, HA, dizziness, angioedema, neutropenia, agranulocytosis, ↑ K+
40
carvedilol (Coreg) category
Beta & Alpha-Adrenergic Blocker
41
carvedilol (Coreg) mechanism of action
slow heart rate and B/P, reducing workload of heart
42
carvedilol (Coreg) use
reduce symptoms of heart failure and slow progression of disease
43
carvedilol (Coreg) adverse effects
fluid retention, fatigue, heart block,
| ↓ libido, impotence, depression, lethargy
44
lisinopril (Prinivil, Zestril)
| category
ACE inhibitor
45
lisinopril (Prinivil, Zestril) mechanism of action
vasodilation & enhance excretion of sodium and water
46
lisinopril (Prinivil, Zestril) primary use
HF, HTN
47
lisinopril (Prinivil, Zestril) adverse effects
first-dose hypotension, cough, hyperkalemia, renal failure, neutropenia
Takes 2-3 weeks for effects
48
metoprolol extended release (Toprol-XL), (Lopressor)
| category
Beta-Adrenergic Blocker
49
metoprolol extended release (Toprol-XL), (Lopressor)
| mechanism of action
slow heart rate and B/P, reducing workload of heart
50
metoprolol extended release (Toprol-XL), (Lopressor)
| use
slow progression of HF and reduce long-term consequences of HF
51
metoprolol extended release (Toprol-XL), (Lopressor) adverse effects
hypotension, bradycardia
*Start with 1/10 of target does
to avoid worsening HF
52
```
isosorbide dinitrate (Isordil)
category
```
Vasodilator
53
```
isosorbide dinitrate (Isordil)
mechanism of action
```
relax blood vessels
54
```
isosorbide dinitrate (Isordil)
use
```
lower blood pressure
| Used for PT's who cannot take ACE inhibitors
55
```
isosorbide dinitrate (Isordil)
adverse reactions
```
reflex tachycardia, orthostatic hypotension
56
digoxin (Lanoxin) category
Cardiac Glycoside
57
digoxin (Lanoxin) dose
0.125-0.25 mg/day
| max dose: 1mg/day
58
digoxin (Lanoxin) adverse effects
neutropenia, dysrhythmias, digitalis toxicity, hold for pulse <60
59
milrinone (Primacor) category
Phosphodiesterase Inhibitors
60
milrinone (Primacor) use
as short-term therapy for heart failure, given IV
| decrease afterload
61
milrinone (Primacor) adverse effects
hypokalemia, hypotension, ventricular dysrhythmias
| *check K+ levels
62
Nesiritide (Natrecor)
Structurally related to endogenous human beta-type natriuretic peptide (hBNP)
63
Nesiritide (Natrecor) adverse effects
severe hypotension (requires continuous cardiac monitoring)
64
nitroglycerin (Nitrostat) mechanism of action
to be potent vasodilator
65
nitroglycerin (Nitrostat)
| use
for lowering myocardial oxygen demand
66
nitroglycerin (Nitrostat)
| administration time
Change nitro patch every 24 hours
| Sublingual tabs every 5 min x 3
67
nitroglycerin (Nitrostat)
| adverse effects
hypotension, dizziness, blurred vision, dry mouth, headache
68
clopidogrel (Plavix) category
ADP receptor blocker
| Antiplatelet Drug
69
Plavix mechanism of action
to alter the plasma membrane of platelets so they cannot aggregate
70
Plavix use
to prevent thrombi formation after a stroke or myocardial infarction (MI)
71
Plavix adverse effects
abnormal bleeding
| No serious other side effects
72
alteplase (Activase) category
Thrombolytics “ase”
73
alteplase (Activase) mechanism of action
converts plasminogen to plasmin, which digests fibrin and dissolves clot
74
alteplase (Activase) use
```
dissolve existing clots
treat acute MI (w/in 12 hrs)
DVT
CVA (w/in 4.5 hrs)
pulmonary embolism
arterial thrombosis
To clear IV catheters (2mg)
```
75
alteplase (Activase) adverse effects
***bleeding***
76
Filgrastrim (Neupogen) category
Granulocyte colony-stimulating factor
77
Filgrastrim (Neupogen) action
Increase production of neutrophils in bone marrow
78
Filgrastrim (Neupogen) uses
Chronic neutropenia or neutropenia secondary to chemotherapy
79
Filgrastrim (Neupogen) adverse effects
**BONE PAIN**
80
Pegfilgrastim (Neulasta) category
Granulocyte colony-stimulating factor
81
Pegfilgrastim (Neulasta) action
Form of filgrastim but with molecule of polyethylene glycol (PEG), PEG decreases renal excretion allowing for longer duration of action
82
Pegfilgrastim (Neulasta) adverse effects
**BONE PAIN**
83
Granulocyte macrophage colony-stimulating factor (GM-CSF) (Leukine) action
Causes progenitor (parent) cells to divide into granulocyte macrophage (WBC that destroys bacteria through phagocytosis)
84
Granulocyte macrophage colony-stimulating factor (GM-CSF) (Leukine) uses
Induce and support myeloid reconstitution after bone marrow transplant, acute myelogenous leukemia
85
Granulocyte macrophage colony-stimulating factor (GM-CSF) (Leukine) adverse effects
leukocytosis, peripheral edema, capillary leak syndrome, weight gain, pericardial/pleural effusion
86
Recombinant human interleukin 11 (Neumega) category
platelet enhancer
87
Recombinant human interleukin 11 (Neumega) action
Platelet growth factor
88
Recombinant human interleukin 11 (Neumega) uses
Prevent recurrent chemotherapy-induced thrombocytopenia and reduce need for platelet transfusions
89
Recombinant human interleukin 11 (Neumega) adverse effects
edema
90
cyanocobalamin (Crystamine, vitamin B12, others) mechanism of action
replace vitamin B12
91
cyanocobalamin (Crystamine, vitamin B12, others) use
treatment of vitamin B12 deficiency
92
cyanocobalamin (Crystamine, vitamin B12, others) adverse effects
diarrhea, hypokalemia, rash, anaphylaxis
93
```
ferrous sulfate (Feosol, others)
mechanism of action
```
supplement iron needed by body
94
ferrous sulfate (Feosol, others) adverse effects
Nausea, heartburn, constipation, dark stools
Cardiovascular collapse, aggravation of peptic ulcers or ulcerative colitis
Hepatic necrosis, anaphylaxis (iron dextran)
95
ferrous sulfate (Feosol, others) nursing considerations
monitor CBC and stool
rest
administer on empty stomach if possible
do not allow child access to medication
96
Palifermin (Kepivance) use
prevent & treat oral mucositis
97
Palifermin (Kepivance)
growth factor that stimulates cell production growth and development
Decreases time to replace the cells of the oral mucosa
Give IV 3 days before and 3 days after chemo
98
Tyrosine Kinase Inhibitor action
Inhibition of EGFR-TK leads to inhibition of tumor growth and progression and promotion of cancer cell death.
99
Tyrosine Kinase Inhibitor side effects
GI: diarrhea, nausea and vomiting
Cutaneous: rash, dry skin, pruritis, photosensitivity, inflammation
Pulmonary disease is rare
100
Tyrosine Kinase Inhibitor example
erlotinib (TarcevaTM)
101
penicillin G (Pentids)
Ampicillin, Amoxicillin, Ticarcillin
| "cillin"
102
penicillin G (Pentids) mechanism of action
to kill bacteria by disrupting cell walls with penicillin’s beta-lactam ring
103
penicillin G (Pentids) use
tx of streptococci, pneumococci, & staphylococci organisms that do not produce penicillinase
Also gonorrhea and syphilis
104
penicillin G (Pentids) adverse effects
diarrhea, nausea, vomiting, superinfections, anaphylaxis, nullify birth control pills
*allergy is most common*
105
penicillin G allergy
most common reaction
| avoid cephalosporins
106
cefotaxime (Claforan) mechanism of action
to act with broad-spectrum activity against gram-negative organisms
107
cefotaxime (Claforan) use
serious infections of lower respiratory tract, central nervous system, genitourinary system, bones, blood, and joints
108
cefotaxime (Claforan) adverse effects
hypersensitivity, anaphylaxis, diarrhea, vomiting, nausea, pain at injection site, ↓ prothrombin levels, renal and hepatic function
avoid alcohol
109
tetracycline HCL (Sumycin) mechanism of action
effective against broad range of gram + and - organisms
110
tetracycline HCL (Sumycin) use
chlamydia, typhus, cholera, rickettsiae, Lyme, & mycoplasma
111
tetracycline HCL (Sumycin) adverse effects
superinfections, GI: nausea, vomiting, epigastric burning, diarrhea, discoloration of teeth, photosensitivity
112
tetracycline HCL (Sumycin) examples
Tetracycline, Doxycyline (Vibramycin), Minocycline (Minocin)
113
Aminoglycosides
Narrow-spectrum drugs, bactericidal
| for G- bacteria
114
Aminoglycosides use
serious urinary, respiratory, nervous, or GI infections
115
Aminoglycosides adverse effects
ototoxicity & nephrotoxicity
116
Fluoroquinolones examples
Ciprofloxacin (Cipro), levofloxacin (Levaquin)
117
Sulfamethoxazole, (Bactrim, Septra) use
UTIs, Pneumocystis carinii pneumonia, shigella infections of small bowel, and acute episodes of chronic bronchitis
118
Sulfamethoxazole, (Bactrim, Septra) adverse effects
skin rashes, nausea, vomiting, agranulocytosis or thrombocytopenia, photosensitivity, anemia or other hematological disorders
stevens johnson syndrome
119
Sulfamethoxazole, (Bactrim, Septra) considerations
Assess renal function; increases risk for crystalluria
120
Metronidazole (Flagyl) use
treat H. pylori infections of stomach & parasites
121
Clindamycin (Cleocin) use
for oral infections caused by bacteroides
| Associated with pseudomembranous colitis
122
Vancomycin (Vancocin) use
MRSA infections
123
Vancomycin (Vancocin) adverse effects
ototoxicity, nephrotoxicity, red man syndrome
**give over at least 1 hour**
124
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amphotericin B (Fungizone)
mechanism of action
```
binds to ergosterol in fungal-cell membranes
| Mainly IV, little resistance
125
amphotericin B (Fungizone) use
has wide spectrum of activity
| Includes most fungi pathogenic to humans
126
amphotericin B (Fungizone) adverse effects
fever,
**chills, rigor**
vomiting, headache at beginning of therapy
Phlebitis common during IV therapy
Nephrotoxicity, electrolyte imbalances common
Cardiac arrest, hypotension, dysrhythmias possible
127
fluconazole (Diflucan) mechanism of action
to act by interfering with synthesis of ergosterol
128
fluconazole (Diflucan) use
treat fungal infections in CNS, bone, eyes, urinary tract, respiratory tract
Not effective against nonalbicans Candida species
129
fluconazole (Diflucan) adverse effects
Few-nausea, vomiting, diarrhea reported at high doses, hepatotoxicity rare unlike ketoconazole
130
fluconazole (Diflucan) advantages
Rapid absorption- 1 tablet!
| Few serious side effects
131
fluconazole (Diflucan) disadvantages
narrow spectrum-candida albicans only
132
nystatin (Mycostatin) mechanism of action
binds to sterols in the fungal-cell membrane, allowing leakage of intracellular contents
133
nystatin (Mycostatin) use
Candida infections of intestines, vagina, skin, mouth
134
nystatin (Mycostatin) adverse effects
minor skin irritation, nausea, vomiting, diarrhea
135
nystatin (Mycostatin) dose
Adults: 400,000-600,000 units 4 X daily
Peds: 200,000 units 4X daily
136
Choroquine (Aralen) mechanism of action
prevents metabolism of heme and builds toxic levels in the parasite
137
Choroquine (Aralen) use
tx of malaria
138
Choroquine (Aralen) adverse effects
nausea and diarrhea
| CNS and cardiovascular toxicity at high doses
139
metronidazole (flagyl) adverse effects
Anorexia, N/V, diarrhea, metallic taste, HA
| no alcohol!
