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1
Q

Drugs used for HF

A

ACE inhibitors, angiotensin receptor blockers
Adrenergic agents, cardiac glycosides
Vasodilators, diuretics,

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2
Q

1st line of defence tx of post op NV

A

Haldol

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3
Q

Main 3 Pharmacological Management of Angina Pectoris (2 of 3)

A

Nitrates:
Dialation of coronary arteries to reduce O2 needs
- Relaxes venous muscle reducing preload
- Relaxes coronary arteriole muscle, reducing pain and increasing o2

Beta-adrenergic blockers

Prevent anginal episodes by reducing CO and O2 demand

Ca Channel Blockers

Prevent angina episodes by either reducing CO (decrease O2 demand) dilating coronary arteries (increase O2 demand) or both

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4
Q

Atorvastatin

A

Used in response to hypercholesterolemia or Family hx of it

Inhibits enzyme in liver producing LDL cholesterol

Liver removes LDL cholesterol from blood

Adverse effects:
Headache
Abdom discomfort Diarrhea/Const
Muscle pain
Elevated liver enzymes
Rhabdomyolosis

Can cause fetal abnormalities

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5
Q

Digoxin

A

Cardiac Glycoside

Tx of HF and Afib

Blocks Na+ / K+ ATPase the critical enzyme responsible for pumping sodium out of the myocardial cell in exchange for potassium. As Na+ accumulates in myocytes calcium ions are released from their storage areas in the cell which produces a more forceful contraction.
Suppresses the SA node and slows electrical conduction through the AV node.

+ Inotrope, - Chronotrope

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6
Q

Lorazapam

A

Ativan is a benzodiazepine

Tx: General Anxiety Disorder (GAD)
Anxiolytic, sedative-hypnotic
Anti-seizure
Pre-anaesthetic

MoA: Binds to GABA receptors in nerve cells enhancing GABA release

AE: Dizziness, ataxia, fatigue, Hepatotoxicity, alopecia, anaphylaxis

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7
Q

Barbituates

A

Used as antiseizure med

Mechanism of Action – same as for benzo-diazepines; bind GABAA receptors causing opening of its Cl- channels

AE: Res depression, Paradoxical excitement

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8
Q

tolerance to barbiturates can promote tolerance to__________

A

opioids

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9
Q

Nalaxone

A

an antidote to opioid overdose. Over using opioid drugs – such as morphine, oxycodone, methadone, heroin, or fentanyl – can slow or completely stop breathing.

temporarily reverse the effects of an opioid overdose for 30-90 minutes.

naloxone restores normal breathing and consciousness within 1 to 5 minutes of injection, preventing death or brain damage caused by lack of oxygen. It is most commonly administered as an intramuscular injection.

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10
Q

Methadone

A

a long-acting opioid drug used to replace the shorter-acting opioids that someone may be addicted to, such as heroin, oxycodone, fentanyl or hydromorphone

drug acts more slowly in the body, for a longer period of time. The effects of methadone last for 24 to 36 hours\

methadone prevents withdrawal symptoms and reduces drug cravings without causing the person to feel high

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11
Q

Pantoprazole (Class, route, tx, AE)

A

a proton-pump inhibitor

PO or IV

Tx condiitons involving TOO much stomach acid
- short term tx of GERD or peptic ulcers

AE: Usually mild, can increase risk of stomach cancer

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12
Q

Metamucil

A

Bulk forming lax
AKA Psyllium

tx: FOR Occasional constipation
Reduction of blood cholesterol with longer use

Mechanism of action
Absorbs water in bowel forming a bulky stool
Bulky stool stimulates defecation reflex

AE
- safest laxitive if taken as directed with water – can cause mild Diarrhea or cramping

If NOT taken with water, can cause GI obstruction

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13
Q

prednisone

A

Corticosteriods

For tx of IBD

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14
Q

Hydrocortisone

A

Glucocorticoid

Secreted in response to ACTH (ACTH secreted by anterior pituitary in response to corticotropin releasing factor (CRF), released by hypothalamus

Replacement therapy for adrenocortical insufficiency
As an antiinflamm agent
To prevent and reduce allergic responses

replacement for endogenous corticosteroids
Anti-inflammatory agent
Blocks actions of chemical mediators associated with inflammatory response

AE: HTN
Tcardia
Cushing synd
Osteperosis
Hyperglycemia
Peptic ulcers

Know more

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15
Q

Levothyroxine (Synthroid Uses

A

T4 replacement

Increases metabolic rate
thereby increasing oxygen
consumption, respiration, and heart rate

Increases rate of fat protein and carb metabolism

Promotes growth and maturation

AE: Overexpression of T3/4

CNS excitiablitliuy
Tremors
Insomnia
D/V
TCardia - Cardiac arrest

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16
Q

Phenobarbital

A

Tx of all seizures EXCEPT absence, Anxiolytic, sedative hypnotic

MoA Increases activity of GABAA receptor, reducing excitability of post-synaptic neurons and increasing seizure threshold

AE: Drowsiness, sedation, excitation (children), difficulty focusing, confusion, depression, headache
Nausea, vomiting, loss of appetite
Vit defs
CNS depression (OD) - death

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17
Q

Diazepam

A

AKA Valium

Tx:
Status epilepticus, Prevention of seizures
Anti-anxiety, sedative, hypnotic; often used prior to procedure
General anaesthetic

MoA: Stimulates GABA receptors in brain, reducing neuronal discharges

AE: Drowsiness, fatigue, dizziness
Vertigo
Ataxia
Laryngeal spasms
Urinary retention
Menstrual irregulariti
CNS depress w/ IV

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18
Q

Phenytoin

A

AKA Dilantin

Most common seizure med. Useful in treating AND PREVENTING ALL seizures except abscence

It is able to provide effective seizure suppression without CNS depression or the abuse potential.

MoA: Delays influx of sodium ions in neurons
Slows propagation and spread of abnormal discharges

Narrow therapeutic range

AE: Bradycardia, hypotension
Agranulocytosis, leukopenia, thrombocytopenia
Gingival hyperplasia
rashes
Weight loss
Hepatotoxicty

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19
Q

Morphine

A

Mechanism of action: binds to both Mu and Kappa receptors to produce profound analgesia

Used for relief of moderate and severe pain

Decreases the sensation AND emotional reaction to pain

Resp depression
Constipation
Urinary retention
Cough suppression
Nausea/vomiting
Dependence

20
Q

Opioid agonist - Codeine

A

Codeine, is an opioid that naturally occurs in the opium poppy.

Found in cough syrups, tyloneol T1, T2, T3, T4

Once codeine enters your system, the body breaks it down and converts it into morphine. Codeine is classified as a depressant, which means it slows down your nervous system, including your breathing rate.

Normally taken PO, but can be injected or snorted

21
Q

Oxycodone

A

Oxycodone

a semi-syntheticopioidused medically for treatment of moderate to severepain
.highly addictive and a commonlyabused drug.

Oxycodone/paracetamol (Percocet),
acombination of the opioid oxycodone with paracetamol (acetaminophen),used to treat moderate to severepain.

22
Q

Hydromorphone

A

Indications
Moderate-to-severe pain (alone and in combination with nonopioid analgesics); extended-release product for opioid-tolerant patients requiring around-the-clock management of persistent pain. Antitussive (lower doses).

Action
Binds to opiate receptors in the CNS. Alters the perception of and response to painful stimuli while producing generalized CNS depression. Suppresses the cough reflex via a direct central action.

23
Q

Tramadol

A

An opioid effective for both general and nerve related pain

It can cause dependence and use may be limited by side effects such as nausea and sedation.
Prescribed for Back Pain, Chronic Pain, Anxiety, Depression, Pain, Fibromyalgia, Obsessive Compulsive Disorder, Restless Legs Syndrome.

24
Q

Toradol

A

NSAID (Cox1 and 2 inhibitors)

(kertolac) is a very strong NSAID that should only be considered for the short-term relief of acute, moderately severe pain that occurs following surgery.
It carries a high risk of severe gastrointestinal side effects and can increase bleeding.
Treatment with Toradol should not exceed five days.

25
Gabapentin (Tx, AE, and caution for who)
a medicine used to treat neuropathic pain (nerve pain). It works in different ways to stop seizures (epilepsy) and to block pain messages reaching the brain. may make cause feel dizziness, sleepiness, or decreased alertness. CAUTION - Gabapentin should be used with caution in patients with kidney disease
26
Atropine
Used for: Mod-severe diarrhe MoA: Binds to mu opioid receptors in GI tract reducing peristalsis - Atropine blocks ACh receptors to reduce peristalsis Combined, this combo provides time for water to be abosrombed from LI
27
Scopolamine (Class, route, tx, AE)
Anticholinergics Often given as a patch or SQ Tx: Nausea due to Motion sickness or Post OP AE-Dry mouth, Sleepines, Urinary retention, Agitation, Dilated pupils
28
Antihistimanines example
Gravol
29
Gravol (Class, tx, AE)
Antihistamine Nausea due to motion sickness Cause significant drowsiness AE- Drowsiness. Dizziness, Blurred vision,Dry mouth, nose, and throat, Constipation
30
Serotonin Receptor antiagonists
Ondansetron - zofran Chemotherapy-induced nausea and vomiting AE- Blurred vision, bradycardia, anxiety, agitation, shivering
31
Cannabinoids (Marinol-dronabinol)
Used to treat NV caused by Antineoplastic (Chemo) therapy Stimulate appetite (CAN be a benefit) AE- seizures, tachycardia, mood changes
32
What types of vomiting are Corticosteroids used to tx
Tx of NV in Antineoplastic therapy (Cancer tx) Post-surgical nausea and vomiting
33
H2 receptor antagonists
ie prochlorperazine Antineoplastic therapy - NV
34
Metoclopramide
(Maxeran) Phenothiazine (D2 Receptor Antagonist) Tx of severe NV Blocks D2 receptors in brain, preventing signaling to the vomiting centre AE: Drowsiness, Extrapyramidal effects (Smack lips, lick lips, twisting neck etc/)
35
Atropine
(lomitil): Mod-severe diarrhe MoA: Binds to mu opioid receptors in GI tract reducing peristalsis - Atropine blocks ACh receptors to reduce peristalsis Combined, this combo provides time for water to be abosrombed from LI
36
Atrovent
Tx: Relieving and preventing bronchospasm of asthma and chronic bronchitis Can relieve acute bronchospasm in minutes, peaks in 1-2 hours and continues for up to 6 hours MoA: Blocks muscarinic Ach receptors in bronchial smooth muscle AE: headache * dizziness * dry mouth * throat irritation * cough * nausea * vomiting * a change in bowel movements (e.g. constipation, diarrhoea
37
Beclomethasone (Class, tx, AE)
Tx: Asthma, allergic rhinits Glucocorticoid that reduces frequency and intensity of response, thus decreasing frequency of asthma episodes AE Dry mouth, hoarseness, change to sense of taste, masks infection Can cause fungal infections
38
Solu-Medrol
Methylprednisolone injection It is used to treat a number of different conditions, such as inflammation (swelling), severe allergies, adrenal problems, arthritis, asthma, blood or bone marrow problems, eye or vision problems, lupus, skin conditions, kidney problems, ulcerative colitis, and flare-ups of multiple sclerosis
39
Nystatin
Candida infections of the vagina, skin, mouth, throat Candidiasis of the intestine- can be absorbed in the GI Binds to cell membrane lysing cell AE: Topical Minor skin irritation and burning Contact dermatitis (related to preservatives in topical formulations) PO Nausea, vomiting, diarrhea
40
Metronidazole
AKA Flagyl Tx: Also has antibiotic activity Amebiasis, Giardiasis , Trichomoniasis Crohn’s disease, colitis Used to treat several serious respiratory, bone, skin, and CNS infections Inhib DNA synth - Bacteriocidal AEAnorexia, nausea, vomiting, diarrhea, abdominal pain Dizziness, headache Dry mouth, metallic taste Vaginal candidiasis if using vaginal gel
41
Ca Channel Blockers
i.e. Nifedepine Tx of Vasospastic angina, stable angina Hypertension Atrial dysrhythmias MoA: Relax arterial muscle (nifedipine, diltiazem) Increases O2 supply Decreases afterload, decreasing O2 demand Some reduce heart rate and contractility (verapamil, diltiazem) Decreases O2 demand
42
Nitro
NO relaxes vascular smooth muscle of arteries (increases O2 supply, decreases afterload and O2 demand) and veins (decreasing preload and O2 demand) AE: Anaphylaxis, methemogloineamia
43
Metropolol
Beta1 receptor blocker (selecticve) Does NOT cause bronchconstriction decreased HR and contractility which decreases myocardial O2 demand Treats Angina, MI Hypertension Some dysrhythmias Some cases of congestive heart failure Migraines HOTN Masks symptoms of hypoglycemia Cause fatigue Dizziness Blurred vision GI effects
44
Reteplase (Retavase)
Used for MI Mech of action: Functions as a tissue plasminogen activator (tPA) converting plasminogen to plasmin, dissolves clots Adverse effects: Bleeding N/V, Fever
45
Antiplatlet meds examples
ASA chewable, then either ticagrelor or clopidogrel.
46
Ace inhibitors examples
ramipril (all the prils)
47

NURS200 (30 decks)

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