Final Exam Flashcards

Question

✮ **ATROPINE** ✮ class indications actions side effects caution

Answer 1

* ANTICHOLINERGIC/PARASYMPATHOLYTIC * for bradycardia; reducing salivation preop; overactive bladder; IBS; peptic ulcers; parasympathomimetic toxicity * blocks vagus stimulation; ↑ HR; dilates pupils * causes **Neuro—**blurred vision; _pupil dilation_; tremors; **CV—**_tachycardia_; **GI/endo—**_paralytic ileus_; dry mouth; constipation; **F & E—**_urinary retention_; **Integ—**↓ sweating * avoid heat & activity * do not drive (vision changes)

Answer 2

* MACROLIDE ANTIBIOTIC * for respiratory infections; skin infections; UTI; GI infections * bacteriostatic & bacteriocidal; inhibits protein synthesis * very broad spectrum * causes **Neuro—**_confusion_; CNS changes; **GI/endo—**_pseudomembranous colitis;_ n/v/d; anorexia; **Integ—**rash; **Imm—**_superinfection_

Answer 3

* CENTRALLY ACTING MUSCLE RELAXANT * for muscle spasm * interferes with reflexes causing spasms * causes **Neuro—**dizziness; drowsiness; weakness; h/a; insomnia; **CV**—hypotension; **GI/endo—**dry mouth; constipation; nausea; **F & E—**urinary frequency * NO CNS depressants * NO alcohol

Answer 4

* ANTICHOLINERGIC * for Parkinson’s; adjunct medication * suppresses ACh dominance * causes **Neuro—**_depression_; disorientation; _confusion_; memory loss; dizziness; blurred vision; **GI/endo—**dry mouth; constipation; **F & E—**_urinary retention, hesitancy_; **Integ—**flushing; ↓ sweating * caution in pts taking other anticholinergics * not as effective as dopaminergics

Answer 5

* CORTICOSTEROID * hormone replacement for Addison’s; suppression of inflammation; other uses * causes **Neuro**—_mood changes_/irritability; euphoria; nervousness; insomnia; _personality change_; cataracts; **GI/endo**—_hyperglycemia_; _peptic ulcers_; ↑ appetite; **F & E**—electrolyte imbalance; **MS**—osteoporosis/bone changes; **Integ**—_delayed wound healing_; acne; facial hair; **Rep—**menstrual changes; **Other**—_Cushing's syndrome_ * monitor for sx of infection; glucose * contraindicated during active infection * caution with DM & peptic ulcer disease * pregnancy category C * start with a large dose, then decrease

Answer 6

* DIRECT ACTING CHOLINERGIC; PARASYMPATHOMIMETIC * for atonic bladder pre/post partum * activates tissue response at receptors * causes **GI/endo**—salivation; abd discomfort; n/v/d; **Integ—**sweating; flushing * antidote—atropine

Answer 7

* VASODILATOR * combination of hydralazine & isosorbine dinitrate * for HF in African Americans * ↓ cardiac workload; vasodilation; ↓ preload; ↓ BP; Na+ & water retained * causes **CV—**_reflex tachycardia_; **F & E**—peripheral edema * tx for reflex tachycardia—beta blockers

Answer 8

* STIMULANT LAXATIVE * for constipation * irritate nerve endings in intestinal mucosa; stimulate peristalsis * causes **GI/endo—**n/v/d; cramps; _laxative dependence;_ **F & E—**_imbalance_ * monitor F & E * contraindicated with appendicitis; bowel obstruction

Answer 9

* ANTIDIARRHEAL * for diarrhea * OTC

Answer 10

* DOPAMINERGIC * for Parkinson’s * restores dopamine * causes **Neuro—**_NMS_ with quick withdrawal; _psychosis_; drowsiness; _dyskinesias_ (ticks; grimacing; tremors); **CV**—cardiovascular effects; ortho hypotension; **GI/endo**—n/v; **Other**—_sweat & urine turn red/brown_ * contraindicated with melanoma; psychosis; glaucoma * avoid vitamin B6—interferes with drug

Answer 11

* INTRANASAL CORTICOSTEROID * prophylaxis for asthma * anti-inflammatory * causes **Neuro—**h/a; **Resp—**drying of nasal mucosae; **Imm—**_infection risk;_ **Local—**burning; stinging; _irritation_

Answer 12

* LOOP DIURETIC * for HF; pulmonary edema; kidney disease; liver disease; HTN * acts on loop of Henle; inhibit Na+ and Cl- reabsorption * causes **Neuro—**dizziness; vertigo; _paresthesia_; _ototoxicity;_ **CV—**_dysrhythmias_ (hypokalemia); hypotension; **GI/endo—**_hyperglycemia_; n/v; **F & E—**_severe F & E losses; dehydration_; hyponatremia; hypokalemia; hypochloremia; _metabolic alkalosis_; **MS**—_↑ uric acid (gout)_ * monitor K+; glucose; sx dehydration; uric acid

Answer 13

* OPIOID PARTIAL AGONIST * for pain * acts on Mu receptor * causes **Neuro—**dependence; dizziness; sedation; euphoria; **CV—**palpitations; **GI/endo—**n/v; constipation; **F & E—**ureteral spasm; **Integ**—sweating * may be combined with naloxone * decreased risk of abuse than opioids; fewer side effects

Answer 14

* OPIOID PARTIAL AGONIST * for pain; labor pain * acts on Kappa receptor * causes **Neuro—**_dependence_; dizziness; sedation; euphoria; **CV—**palpitations; **GI/endo—**n/v; constipation; **F & E—**_ureteral spasm_; **Integ**—sweating * may be combined with naloxone * decreased risk of abuse than opioids; fewer side effects

Answer 15

* ANTACID * symptomatic relief of hyperacidity; promotes ulcer healing * neutralizes HCl * causes **GI/endo—**_constipation_; _gastric; acid rebound_ when d/c; **Other—**_systemic alkalosis_ * monitor pH * admin 2 hours before/after other meds * simethicone may be added to reduce flatus

Answer 16

* ACE INHIBITOR * for HTN * inhibits angiotensin II formation; blocks vasoconstriction & aldosterone; Na+ and water excreted; K+ retained * causes **CV—**tachycardia; _arrhythmias_; hypotension; _severe ortho hypotension (first dose);_ **Resp—**_persistent dry cough (ACE cough_, ↑ bradykinin); **GI/endo**—n/d; irritation; _peptic ulcers;_ **F & E—**_hyperkalemia_; _angioedema;_ **MS—**bone marrow suppression; **Integ**—rash * monitor for first dose reaction; hyperkalemia * caution with K-sparing diuretics * start with low dose

Answer 17

* ANTICONVULSANT * for partial/focal seizures; migraines * blocks Na+ channels * causes **Neuro—**drowsiness; ataxia; **CV—**_heme disorders;_ **GI/endo—**_hepatitis_; n/v; **MS—**bone marrow suppression; **Integ—**Stevens Johnson; **Rep**—_teratogenic_ (cleft palate; spina bifida) * pregnancy category D

Answer 18

* CENTRALLY ACTING MUSCLE RELAXANT * for muscle spasm * interferes with reflexes causing spasms * causes **Neuro—**dizziness; drowsiness; weakness; h/a; insomnia; **CV**—hypotension; **GI/endo—**dry mouth; constipation; nausea; **F & E—**urinary frequency * NO CNS depressants * NO alcohol

Answer 19

* BETA BLOCKER * for HTN; angina; MI prevention; dysrhythmias * block beta receptors in kidney to inhibit renin; ↓ HR, myocardial contraction, CO; ↑ renal perfusion * cause **Neuro—**_depression_; **CV—**_bradycardia_; ↓ CO; AV block; ortho hypotension; rebound myocardium; HF; arrhythmia; **Resp**—_bronchospasm_; **GI/endo—**n/v/d; _hypoglycemia masking_; **Rep—**_↓ libido_ * assess BP & HR before admin; do not give if HR \<60 * d/c gradually * caution for DM pts * contraindicated for asthma pts; pts on Ca+ channel blockers

Answer 20

* CEPHALOSPORIN ANTIBIOTIC * inhibits cell wall * causes **GI/endo**—anorexia; n/v/d; **Imm**—_cross-sensitivity c penicillin_; superinfection * monitor for hypersensitivity & c-diff * refrigerate oral solutions * 4th and 5th generations effective against resistant bacteria

Answer 21

* COX-2 INHIBITOR; NSAID * for arthritic pain

Answer 22

* ALKYLATING AGENT * for many types of cancer * interferes with DNA * causes **GI/endo—**_hepatotoxicity_; n/v/d; anorexia; **F & E—**renal toxicity; _hemorrhagic cystitis;_ **MS—**bone marrow suppression; **Integ—**alopecia; **Local—**_tissue necrosis if IV infiltrates_ * pt should drink lots of fluid * cytoprotectant—mesna (prevents hemorrhagic cystitis)

Answer 23

* ANTIPROTOZOAL * for malaria * blocks parasitic DNA * causes **Neuro—**h/a; dizziness; _retinal changes;_ **CV—**_hypotension;_ **GI/endo—**_hepatic dysfunction_; n/v/d; anorexia; **Integ—**rash; pruritus; **Imm—**fever; chills; malaise

Answer 24

* PHENOTHIAZINE; TYPICAL ANTIPSYCHOTIC * for schizophrenia & psychosis * blocks dopamine receptors; limits brain stimuli; anticholinergic; antihistamine; alpha-adrenergic blocking * causes **Neuro—**_EPS; NMS; photophobia_; sedation; drowsiness; vertigo; dizziness; h/a; **CV—**ortho hypotension * therapeutic effects seen in 3-6 weeks

Answer 25

* BILE ACID SEQUESTRANT * for HLD * binds with bile acids in intestines; ↓ LDL * causes **CV—**_↑ bleeding time;_ **F & E—**_hypokalemia;_ **GI/endo—**bloating; constipation; flatulence; _hemorrhoids_; _interference c vitamin & mineral absorption_ * combined with statins * excreted in the feces

Answer 26

* HISTAMINE BLOCKER * for duodenal & benign gastric ulcers; stress ulcers; acute upper GI bleed prophylaxis; GERD; gastric distress * block histamine receptors in parietal cells * causes **Neuro—**h/a; dizziness; _confusion_; _somnolence;_ **CV—**_dysrhythmias;_ **GI/endo—**n/v/d; _gynecomastia_ * do not give w/i an hour of antacid admin

Answer 27

* FLUOROQUINALONE ANTIBIOTIC * for UTI; skin infections; resp infections; anthrax * inhibits DNA synthesis * broad spectrum * causes **Neuro—**_photosensitivity_; dizziness; h/a; restlessness; **CV—**_dysrhythmias;_ **GI/endo**—_hepatotoxicity_; n/v/d; **MS**—_tendon rupture_ * monitor for long QT interval * admin IV over 60 mins * contraindicated in children \<18yo * avoid antacids; iron; dairy (6 hrs after taking) * ↑ serum caffeine

Answer 28

* MACROLIDE ANTIBIOTIC * for respiratory infections; skin infections; UTI; GI infections * bacteriostatic & bacteriocidal; inhibits protein synthesis * very broad spectrum * causes **Neuro—**_confusion_; CNS changes; **GI/endo—**_pseudomembranous colitis;_ n/v/d; anorexia; **Integ—**rash; **Imm—**_superinfection_

Answer 29

* LINCOSAMIDE ANTIBIOTIC * for serious infections; septicemia; bone/joint infections * inhibits protein synthesis; bactericidal * causes **GI/endo—**_fatal PMC; severe effects;_ **MS—**bone marrow suppression * caution with liver or kidney transplant

Answer 30

* BENZODIAZEPINE * schedule IV * for anxiety * intensifies GABA * causes **Neuro—**_depression_; drowsiness; weakness; amnesia; _CNS depression_; disorientation; _ataxia_; blurred vision; **CV—**abnormal heart rhythm; _BP change_; **Resp—**_resp depression_; **GI/endo—**constipation; n/v; **F & E**—urinary retention * contraindicated with glaucoma; drug abuse; liver disease; suicidality * monitor respirations * antidote—flumazenil

Answer 31

* ANTIPLATELET * for prevention of CVA, MI, DVT, etc * causes **Neuro—**h/a; dizziness; **CV**—_bleeding_, bruising; _thrombocytopenia;_ **GI/endo—**n/d; abd pain; **Integ—**rash * monitor for signs of bleeding

Answer 32

* ANTIFUNGAL * for tinea infections; thrush; vaginal candidiasis * causes **Topical—**stinging, rash, redness, swelling; **Vaginal—**irritation; urinary frequency; abd pain; **PO—**n/v; _abnormal LFTs_

Answer 33

* ATYPICAL ANTIPSYCHOTIC * for schizophrenia, positive and negative sx; psychosis * causes **Neuro—**seizures; _photosensitivity_; _NMS_; drowsiness; sedation; h/a; **CV—**ortho hypotension; **GI/endo—**wt gain; dry mouth; _hyperglycemia_; **Other**—fever * less likely to cause EPS

Answer 34

* OPIOID * for severe pain; cough * binds to opioid receptors in CNS * causes **Neuro—**_tolerance_; _dependence_; withdrawal; sedation; confusion; blurred vision; _euphoria_; lightheadedness; dizziness; **CV—**_hypotension_; ortho hypotension; **Resp—**_depression_; _apnea;_ **GI/endo—**n/v; constipation; **F & E—**urinary retention; **Integ—**itching; **Imm—**_anaphylaxis_ * contraindicated with head injury; respiratory disorders; shock; hypotension * hold if respirations \<12

Answer 35

* CORTICOSTEROID * hormone replacement for Addison’s; suppression of inflammation; other uses * causes **Neuro**—_mood changes_/irritability; euphoria; nervousness; insomnia; _personality change_; cataracts; **GI/endo**—_hyperglycemia_; _peptic ulcers_; ↑ appetite; **F & E**—electrolyte imbalance; **MS**—osteoporosis/bone changes; **Integ**—_delayed wound healing_; acne; facial hair; **Rep—**menstrual changes; **Other**—_Cushing's syndrome_ * monitor for sx of infection; glucose * contraindicated during active infection * caution with DM & peptic ulcer disease * pregnancy category C * start with a large dose, then decrease

Answer 36

* ALKYLATING AGENT * for many types of cancer * interferes with DNA * causes **GI/endo—**_hepatotoxicity_; n/v/d; anorexia; **F & E—**renal toxicity; _hemorrhagic cystitis;_ **MS—**bone marrow suppression; **Integ—**alopecia; **Local—**_tissue necrosis if IV infiltrates_ * pt should drink lots of fluid * cytoprotectant—mesna (prevents hemorrhagic cystitis)

Answer 37

* T & B CELL SUPPRESSOR * for transplant rejection prophylaxis * causes **Neuro—**_tremor;_ **CV—**_HTN;_ **GI/endo—**hepatotoxicity; _gum hyperplasia_; diarrhea; **F & E—**nephrotoxicity; **MS—**bone marrow suppression; **Integ—**_hirsutism_; acne; **Imm—**_predisposition to infection_; increased risk for _neoplasms_

Answer 38

* DIRECT ACTING MUSCLE RELAXANT * for muscle spasm * interferes with Ca+ * causes **Neuro—**drowsiness; dizziness; **CV—**BP change; tachycardia; **GI/endo—**_hepatitis_; _hepatotoxicity c contraceptives_; diarrhea; **F & E—**urinary frequency; _crystalline urine_ **MS—**_myalgia_; weakness; **Integ—**rash * increase intake of fluids to prevent crystalline urine

Answer 39

* ANTIDIURETIC * for diabetes insipidus (ADH deficiency) * ↑ water reabsorption; hemostatic—shortens clotting time; ↑ CO; peripheral vasoconstriction * causes **Neuro—**h/a; **CV—**_↑ BP;_ **GI/endo—**nausea; **F & E—**_fluid retention_; electrolyte imbalance; _hyponatremia_; _water intoxication;_ **Other**—facial flushing; reaction at injection site * monitor BP; I & O; electrolytes; thirst * caution with HTN

Answer 40

* CORTICOSTEROID * hormone replacement for Addison’s; suppression of inflammation; other uses * causes **Neuro**—_mood changes_/irritability; euphoria; nervousness; insomnia; _personality change_; cataracts; **GI/endo**—_hyperglycemia_; _peptic ulcers_; ↑ appetite; **F & E**—electrolyte imbalance; **MS**—osteoporosis/bone changes; **Integ**—_delayed wound healing_; acne; facial hair; **Rep—**menstrual changes; **Other**—_Cushing's syndrome_ * monitor for sx of infection; glucose * contraindicated during active infection * caution with DM & peptic ulcer disease * pregnancy category C * start with a large dose, then decrease

Answer 41

* CYTOPROTECTANT * cellular protectant for doxorubicin/antineoplastics

Answer 42

* ANTITUSSIVE * for nonproductive cough * depresses cough reflex in medulla's cough center * causes **Neuro—**dizziness; drowsiness; **Resp—**_depression;_ **GI—**nausea * may contain codeine

Answer 43

* antidote to insulin

Answer 44

* BENZODIAZEPINE * schedule IV * for anxiety * intensifies GABA * causes **Neuro—**_depression_; drowsiness; weakness; amnesia; _CNS depression_; disorientation; _ataxia_; blurred vision; **CV—**abnormal heart rhythm; _BP change_; **Resp—**_resp depression_; **GI/endo—**constipation; n/v; **F & E**—urinary retention * contraindicated with glaucoma; drug abuse; liver disease; suicidality * monitor respirations * antidote—flumazenil

Answer 45

* CARBONIC ANHYDRASE INHIBITOR * for glaucoma & adjunct to other diuretics * formation of sodium bicarb & excretion of hydrogen * causes **Neuro—**weakness; fatigue; _paresthesia_; confusion; **Resp**—_rapid shallow breathing_ (acidemia); **GI/endo—**anorexia; **F & E**—_acidic urine; metabolic acidosis_ (loss of bicarb); hypokalemia; **MS—**bone marrow suppression * monitor pH & K+ * contraindicated in pts with sulfonamide or thiazide allergy

Answer 46

* NONSELECTIVE COX INHIBITOR; NSAID * for pain & inflammation * inhibits COX-1 * causes **Neuro—**dizziness; **CV**—_risk for thrombotic event;_ **GI/endo—**n/v; heartburn; _epigastric pain_; ulcers; bleeding; **F & E—**_renal impairment;_ **Integ—**rash; **Imm—**allergic reaction * pregnancy category C; category D after 30 weeks

Answer 47

* CARDIAC GLYCOSIDE * for HF * inhibits Na+/K+ pump; influx of Ca+ into cardiac cells; ↑ efficiency of muscle fiber contraction; improves pumping ability; slows HR & rate of conduction; ↑ CO, force of contraction; ↑ renal perfusion * _sx of toxicity_—**Neuro**—_vision changes_ (green/yellow halos, blur, double); **CV**—_bradycardia_; **GI/endo**—n/v; _abd pain_; anorexia * monitor drug levels; HR; K+ levels * hold if HR \<60 bpm * _caution with hypokalemia_—increases risk of toxicity * therapeutic range—_0.5-1.8 ng/mL_ * antidote—digoxin immune fab * antacids & antidiarrheals slow absorption

Answer 48

* CALCIUM CHANNEL BLOCKER * for chronic HTN; angina; dysrhythmias; premature labor * blocks Ca+ in vascular smooth muscle; vasodilation; relaxes uterus * causes **Neuro**—dizzyness; h/a; **CV**—_bradycardia_; flushing; **F & E**—peripheral edema * no grapefruit * no beta blockers

Answer 49

* ANTICHOLINERGIC; ANTIHISTAMINE * for Parkinson’s (adjunct medication); allergic & seasonal rhinitis; cold sx; n/v * suppresses ACh dominance; sedative * causes **Neuro—**_depression_; disorientation; _confusion_; memory loss; dizziness; blurred vision; drowsiness; sedation; _paradoxical excitation_ (children) **CV**—_bradycardia_; **Resp**—_thickening of secretions_; **GI/endo—**dry mouth; constipation; epigastric pain; **F & E—**_urinary retention, hesitancy_; **Integ—**flushing; ↓ sweating; rash * caution in pts taking other anticholinergics; caution with driving * avoid alcohol, other CNS depressants * not as effective as dopaminergics for Parkinson’s

Answer 50

* ANTIDIARRHEAL * for diarrhea * slows GI motility * schedule V * Rx

Answer 51

* STOOL SOFTENER * for prevention of constipation * causes **GI/endo—**n/d; cramps; bloating * monitor last BM * contraindicated with appendicitis; bowel obstruction

Answer 52

* INDIRECT CHOLINERGIC; PARASYMPATHOMIMETIC * for Alzheimer’s * inhibits cholinesterase; permits ACh to accumulate * causes **Neuro—**insomnia; **GI/endo—**n/v/d; dyspepsia; abd pain; **MS—**muscle cramps * antidote—atropine

Answer 53

* CARBAPENEM ANTIBIOTIC * for abdominal infections; UTI; skin infections; bone/joint infections; gynecological infections * inhibits cell wall synthesis * broad spectrum * causes **Neuro—**h/a; dizziness; **CV**—_thrombophlebitis;_ **GI/endo**—_pseudomembranous colitis_; n/v/d; **Integ—**rash; **Imm—**superinfection

Answer 54

* ALPHA 1 BLOCKER * for HTN * causes vasodilation * causes **Neuro**—dizzyness; h/a; **CV—**_hypotension_; _tachycardia_; flushing; **Resp—**_nasal congestion;_ **GI/endo—**n/d; dyspepsia; **F & E**—edema; **Rep—**_priapism_ (prolonged erection)

Answer 55

* ANTINEOPLASTIC * for several kinds of cancer * interferes with DNA * causes **CV—**_cardiac toxcity;_ **GI/endo—**n/v/d; **F & E**—_red urine;_ **MS—**bone marrow suppression; **Integ—**alopecia; rash; **Local—**_vesication of tissue_ * cytoprotectant—dexrazoxane

Answer 56

* TETRACYCLINE ANTIBIOTIC * for typhus; cholera; Rocky Mtn spotted fever; Lyme; H. pylori; chlamydia; acne * inhibits protein synthesis * causes **GI/endo—**_permanent discoloration of teeth_ (children); n/v/d; **MS—**bone marrow suppression; **Integ—**rash; **Imm—**superinfection; **Rep**—_affects fetal bone/teeth dev_ * take iron & dairy 2 hours after taking * contraindicated for \<8yo

Answer 57

* SNRI * for depression * causes serotonin, norepinephrine, and epinephrine reuptake * causes **Neuro—**_suicidal ideation_ (younger pop); _serotonin syndrome;_ **CV—**_tachycardia_; _HTN;_ **GI/endo—**n/v; constipation; **F & E—**urinary retention; **Integ—**sweating; **Rep—**_ED_

Answer 58

* ACE INHIBITOR * for HTN * inhibits angiotensin II formation; blocks vasoconstriction & aldosterone; Na+ and water excreted; K+ retained * causes **CV—**tachycardia; _arrhythmias_; hypotension; _severe ortho hypotension (first dose);_ **Resp—**_persistent dry cough (ACE cough_, ↑ bradykinin); **GI/endo**—n/d; irritation; _peptic ulcers;_ **F & E—**_hyperkalemia_; _angioedema;_ **MS—**bone marrow suppression; **Integ**—rash * monitor for first dose reaction; hyperkalemia * caution with K-sparing diuretics * start with low dose

Answer 59

* ANTICOAGULANT; LOW MOLECULAR WEIGHT HEPARIN * for prevention of thromboembolism * prevents clotting * causes **CV**—_hemorrhage_; thrombocytopenia * monitor for signs of bleeding * adminstered SQ into the “love handles”; do not rub; hold firm pressure * caution with spinal anesthesia * contraindicated with CVA; peptic ulcers; blood dyscrasias; eye, brain and spinal surgery * advantages over heparin—↓ bleeding risk, side effects; less effects on thrombin, clotting, PT; better stability in pt response; aPTT monitoring unnecessary; home admin allowed * antidote—protamine sulfate

Answer 60

* ANTIVIRAL * for hepatitis B * blocks DNA replication * causes **Neuro—**h/a; asthenia; **GI/endo—**_fatal hepatomegaly_; nausea; **F & E—**_nephrotoxicity_; **Other—**_lactic acidosis_

Answer 61

* ERYTHROPOIETIC GROWTH FACTORS * for anemia r/t renal failure or chemotherapy * acts on bone marrow to ↑ RBC production * causes **Neuro—**h/a; body ache; seizures; dizziness; **CV—**HTN; _thrombolytic event;_ **GI/endo—**n/v/d; **F & E—**edema * tx goal—Hgb to 10-11 g/dL; Hct to 33%

Answer 62

* CARBAPENEM ANTIBIOTIC * for abdominal infections; UTI; skin infections; bone/joint infections; gynecological infections * inhibits cell wall synthesis * broad spectrum * causes **Neuro—**h/a; dizziness; **CV**—_thrombophlebitis;_ **GI/endo**—_pseudomembranous colitis_; n/v/d; **Integ—**rash; **Imm—**superinfection

Answer 63

* MACROLIDE ANTIBIOTIC * for respiratory infections; skin infections; UTI; GI infections * bacteriostatic & bacteriocidal; inhibits protein synthesis * very broad spectrum * causes **Neuro—**_confusion_; CNS changes; **GI/endo—**_pseudomembranous colitis;_ n/v/d; anorexia; **Integ—**rash; **Imm—**_superinfection_

Answer 64

* ANTIRHEUMATIC * for rheumatoid arthritis; psoriatic arthritis; inflammatory diseases * disrupts inflammatory process * causes **CV—**blood dyscrasias; **Integ—**Stevens-Johnson syndrome; **Imm—**_predisposition to infection_; **Other—**_lymphoma & other cancers_; flulike sx * monitor for TB; for hepatitis; liver enzymes * do NOT give during infection

Answer 65

* ANTITUBERCULIN ANTIBIOTIC (*STRIPE*) * for tuberculosis * causes **Neuro—**peripheral _neuropathy_; clumsiness; **GI/endo**—_drug-induced hepatitis_; jaundice; distress; **F & E**—_vit B6 depletion_; **MS—**bone marrow suppression; muscle ache; **Rep—**_interference c oral contraception_ * caution with liver disease & alcoholism

Answer 66

* GLP-1 INCRETIN ENHANCER * for T2DM * ↑ incretin hormone causes ↑ insulin release; ↓ glucagon production; ↑ fullness; ↓ food intake; slows gastric emptying

Answer 67

* CHOLESTEROL ABSORPTION INHIBITOR * for HLD * inhibits cholesterol absorption in SI; ↓ LDL & triglycerides * causes **Resp**—_URIs;_ **GI/endo**—abd pain; _hepatitis_; diarrhea; **MS**—_muscle pain_; arthralgia * often combined with statins

Answer 68

* ANTIVIRAL * for herpes infection * lowers frequency of episodes; diminishes intensity * causes **Neuro—**h/a; vertigo; tremors; **GI/endo—**n/v; **Integ—**rash * caution with renal & hepatic disease

Answer 69

* HISTAMINE BLOCKER * for duodenal & benign gastric ulcers; stress ulcers; acute upper GI bleed prophylaxis; GERD; gastric distress * block histamine receptors in parietal cells * causes **Neuro—**h/a; dizziness; _confusion_; _somnolence;_ **CV—**_dysrhythmias;_ **GI/endo—**n/v/d * do not give w/i an hour of antacid admin

Answer 70

* OPIOID * for severe pain * binds to opioid receptors in CNS * causes **Neuro—**_tolerance_; _dependence_; withdrawal; sedation; confusion; blurred vision; _euphoria_; lightheadedness; dizziness; **CV—**_hypotension_; ortho hypotension; **Resp—**_depression_; _apnea;_ **GI/endo—**n/v; constipation; **F & E—**urinary retention; **Integ—**itching; **Imm—**_anaphylaxis_ * contraindicated with head injury; respiratory disorders; shock; hypotension * hold if respirations \<12

Answer 71

* IRON SUPPLEMENT * for anemia * ↑ hemoglobin & RBC production * causes **GI/endo—**n/v; constipation; _dark, tarry stools_; _teeth staining_ (liquid) * give with vitamin C * contraindicated with tetracyclines & antacids * OD may be fatal in children

Answer 72

* MACROLIDE ANTIBIOTIC * for respiratory infections; skin infections; UTI; GI infections * bacteriostatic & bacteriocidal; inhibits protein synthesis * very broad spectrum * causes **Neuro—**_confusion_; CNS changes; **GI/endo—**_pseudomembranous colitis;_ n/v/d; anorexia; **Integ—**rash; **Imm—**_superinfection_

Answer 73

* COLONY STIMULATING FACTOR * for suppressed bone marrow * increases neutrophil production * causes **Neuro—**h/a; pain; fatigue; **GI/endo—**n/v/d; anorexia; **MS—**_bone pain_; weakness; **Integ—**alopecia

Answer 74

* FLUOROQUINALONE ANTIBIOTIC * for UTI; skin infections; resp infections; anthrax * inhibits DNA synthesis * broad spectrum * causes **Neuro—**_photosensitivity_; dizziness; h/a; restlessness; **CV—**_dysrhythmias;_ **GI/endo**—_hepatotoxicity_; n/v/d; **MS**—_tendon rupture_ * monitor for long QT interval * admin IV over 60 mins * contraindicated in children \<18yo * avoid antacids; iron; dairy (6 hrs after taking)

Answer 75

* ANTIFUNGAL * for oropharyngeal, esophageal & vaginal fungal infections * binds to sterols in cell membranes * causes **Neuro—**h/a; **GI/endo—**n/v/d; abd pain; **Integ—**rash * caution with liver/renal impairment

Answer 76

* ANTIDOTE * for benzodiazepine toxicity

Answer 77

* SSRI * for major depression & anxiety disorders * blocks reuptake of serotonin; enhances serotonin transmission * causes **Neuro—**_suicidal ideation_; seizures; _serotonin syndrome_; insomnia; h/a; dizziness; nervousness; tremors; **GI/endo—**_wt changes_; anorexia; n/d; **Rep—**_sexual dysfunction_

Answer 78

* INTRANASAL CORTICOSTEROID * prophylaxis for asthma * anti-inflammatory * causes **Neuro—**h/a; **Resp—**drying of nasal mucosae; **Imm—**_infection risk;_ **Local—**burning; stinging; _irritation_

Answer 79

* HYDANTOIN * for seizures * inhibits Na+ influx; prevent disruptive neuron firing; stabilizes cell membranes * causes **Neuro—**_slurred speech_; ataxia; tremor; confusion; _nystagmus;_ **CV—**_dysrhythmias_; _thrombocytopenia_; hypotension; **GI/endo—**_inhibition of insulin; hyperglycemia; interference c folate absorption; gingival hyperplasia;_ **Integ—**Stevens Johnson syndrome; **Imm—**_leukopenia_; agranulocytosis; **Rep—**_teratogenic (_cleft palate; heart defects); **Local—**site irritation * never give with dextrose; always give with saline * flush line before & after use * therapeutic range—10-20 mcg/ml * pregnancy category D

Answer 80

* LOOP DIURETIC * for HF; pulmonary edema; kidney disease; liver disease; HTN * acts on loop of Henle; inhibit Na+ and Cl- reabsorption * causes **Neuro—**dizziness; vertigo; _paresthesia_; _ototoxicity;_ **CV—**_dysrhythmias_ (hypokalemia); hypotension; **GI/endo—**_hyperglycemia_; n/v; **F & E—**_severe F & E losses; dehydration_; hyponatremia; hypokalemia; hypochloremia; _metabolic alkalosis_; **MS**—_↑ uric acid (gout)_ * monitor K+; glucose; sx dehydration; uric acid

Answer 81

* FIBRIC ACID AGENT * for HLD; high triglycerides * ↓ triglycerides; ↓ VLDL * causes **GI/endo**—dyspepsia; n/v/d; abd pain; **MS**—muscle pain * take with meals * do NOT use with statins * contraindicated with gallbladder & liver disease

Answer 82

* AMINOGLYCOSIDE ANTIBIOTIC * for serious, systemic G- infections * bactericidal; inhibits protein synthesis * causes **Neuro—**_ototoxicity_; _neuromuscular blockade;_ **F & E**—nephrotoxicity * therapeutic range—5-10 mcg/mL * monitor renal function; s/s of ototoxicity * NMS tx—calcium gluconate

Answer 83

* LONG-ACTING INSULIN * for DM; gestational DM; steroid use * ↓ blood glucose * causes **GI/endo**—_hypoglycemia_ * monitor glucose * o. 1-2 hr; d. 24 hr * antidote—dextrose

Answer 84

* SULFONYLUREA * for T2DM * stimulates insulin release * causes **GI/endo**—_hypoglycemia_; wt gain; nvd; heartburn; _hepatotoxicity;_ **Imm—**hypersensitivity reactions * monitor glucose * alcohol causes disulfiram-like reactions

Answer 85

* SULFONYLUREA * for T2DM * stimulates insulin release * causes **GI/endo**—_hypoglycemia_; wt gain; nvd; heartburn; _hepatotoxicity;_ **Imm—**hypersensitivity reactions * monitor glucose * alcohol causes disulfiram-like reactions

Answer 86

* EXPECTORANT * for productive cough * causes **Neuro**—dizziness; h/a; **GI—**n/v * encourage fluids

Answer 87

* NONPHENOTHIAZINE TYPICAL ANTIPSYCHOTIC * for schizophrenia & psychosis * decrease dose for older adults; increase dose with seizure meds; use injectable slow release for patients who regularly refuse

Answer 88

* ANTICOAGULANT * for DVT; PE; coronary thrombosis; artificial heart valves; non-hemorrhagic CVA * prolongs bleeding time & prevents clots * causes **CV**—_hemorrhage_; thrombocytopenia * monitor for signs of bleeding; PTT/aPPT * hold firm pressure over SQ injection; do not rub * caution with spinal anesthesia * does not cross placenta; does cross breastmilk * antidote—protamine sulfate

Answer 89

* VASODILATOR * for HF, especially in African Americans * ↓ cardiac workload; vasodilation; ↓ preload; ↓ BP; Na+ & water retained * causes **CV—**_reflex tachycardia_; **F & E**—peripheral edema * tx for reflex tachycardia—beta blockers

Answer 90

* THIAZIDE DIURETIC * for HTN (first line); mild/moderate HF * acts on distal convoluted tubule; inhibits Na+ and Cl- reabsorption; increases water & K+ excretion * causes **Neuro—**dizziness; vertigo; **CV**—ortho hypotension; **GI/endo—**n/v/d; _hyperglycemia;_ **F & E**—_hypercalcemia_; _hypokalemia;_ **MS**—_↑ uric acid (gout)_; muscle cramps & spasms * monitor for dehydration; Ca+; K+; glucose; uric acid * give KCl for hypokalemia * not effective immediately

Answer 91

* CORTICOSTEROID * hormone replacement for Addison’s; suppression of inflammation; other uses * causes **Neuro**—_mood changes_/irritability; euphoria; nervousness; insomnia; _personality change_; cataracts; **GI/endo**—_hyperglycemia_; _peptic ulcers_; ↑ appetite; **F & E**—electrolyte imbalance; **MS**—osteoporosis/bone changes; **Integ**—_delayed wound healing_; acne; facial hair; **Rep—**menstrual changes; **Other**—_Cushing's syndrome_ * monitor for sx of infection; glucose * contraindicated during active infection * caution with DM & peptic ulcer disease * pregnancy category C * start with a large dose, then decrease

Answer 92

* OPIOID * for severe pain * binds to opioid receptors in CNS * causes **Neuro—**_tolerance_; _dependence_; withdrawal; sedation; confusion; blurred vision; _euphoria_; lightheadedness; dizziness; **CV—**_hypotension_; ortho hypotension; **Resp—**_depression_; _apnea;_ **GI/endo—**n/v; constipation; **F & E—**urinary retention; **Integ—**itching; **Imm—**_anaphylaxis_ * contraindicated with head injury; respiratory disorders; shock; hypotension * hold if respirations \<12

Answer 93

* ANTIPROTOZOAL * for malaria * blocks parasitic DNA * causes **Neuro—**h/a; dizziness; _retinal changes;_ **CV—**_hypotension;_ **GI/endo—**_hepatic dysfunction_; n/v/d; anorexia; **Integ—**rash; pruritus; **Imm—**fever; chills; malaise

Answer 94

* ANTINEOPLASTIC * for sickle cell anemia * ↑ amt of hemoglobin produced in bone marrow; dilutes formation of abnormal hemoglobin; less clogging of small vessels * causes **Neuro—**dizziness; h/a; **GI/endo—**_stomatitis_; anorexia; n/v; **MS—**bone marrow depression; **Integ—**rash; _erythema_

Answer 95

* NONSELECTIVE COX INHIBITOR; NSAID * for pain & inflammation * inhibits COX-1 * causes **Neuro—**dizziness; **CV**—_risk for thrombotic event;_ **GI/endo—**n/v; heartburn; _epigastric pain_; ulcers; bleeding; **F & E—**_renal impairment;_ **Integ—**rash; **Imm—**allergic reaction * pregnancy category C; category D after 30 weeks

Answer 96

* CARBAPENEM ANTIBIOTIC * for abdominal infections; UTI; skin infections; bone/joint infections; gynecological infections * inhibits cell wall synthesis * broad spectrum * causes **Neuro—**h/a; dizziness; **CV**—_thrombophlebitis;_ **GI/endo**—_pseudomembranous colitis_; n/v/d; **Integ—**rash; **Imm—**superinfection

Answer 97

* TCA * for depression * blocks reuptake of norepinephrine & serotonin * causes **Neuro—**_seizures_; sedation; **CV—**_cardiac toxicity_; ortho hypotension; **MS—**bone marrow suppression; **Rep—**_sexual dysfunction_ * clinical response in 2-4 weeks * discontinue slowly

Answer 98

* THIAZIDE DIURETIC * for HTN (first line); mild/moderate HF * acts on distal convoluted tubule; inhibits Na+ and Cl- reabsorption; increases water & K+ excretion * causes **Neuro—**dizziness; vertigo; **CV**—ortho hypotension; **GI/endo—**n/v/d; _hyperglycemia;_ **F & E**—_hypercalcemia_; _hypokalemia;_ **MS**—_↑ uric acid (gout)_; muscle cramps & spasms * monitor for dehydration; Ca+; K+; glucose; uric acid * give KCl for hypokalemia * not effective immediately

Answer 99

* NONSELECTIVE COX INHIBITOR; NSAID * for pain & inflammation * inhibits COX-1 * causes **Neuro—**dizziness; **CV**—_risk for thrombotic event;_ **GI/endo—**n/v; heartburn; _epigastric pain_; ulcers; bleeding; **F & E—**_renal impairment;_ **Integ—**rash; **Imm—**allergic reaction * pregnancy category C; category D after 30 weeks

Answer 100

* ANTIRHEUMATIC * for rheumatoid arthritis; psoriatic arthritis; inflammatory diseases * disrupts inflammatory process * causes **CV—**blood dyscrasias; **Integ—**Stevens-Johnson syndrome; **Imm—**_predisposition to infection_; **Other—**_lymphoma & other cancers_; flulike sx * monitor for TB; for hepatitis; liver enzymes * do NOT give during infection

Answer 101

* IMMUNE STIMULATOR * for cancer * inhibits tumor growth * causes **Neuro—**dizziness; confusion; **MS—**bone marrow suppression; **Imm**—flulike sx; **Rep—**_teratogenic_

Answer 102

* ANTICHOLINERGIC * for daily COPD sx; COPD maintenance * dilates bronchioles * causes **Neuro—**nervousness; dizziness; h/a; **CV—**_palpitations;_ **GI/endo—**distress; nausea * use 3-4x/day * fewer side effects than PO anticholinergics

Answer 103

* ANTICHOLINERGIC * for daily COPD sx; COPD maintenance * dilates bronchioles * causes **Neuro—**nervousness; dizziness; h/a; **CV—**_palpitations;_ **GI/endo—**distress; nausea * use 3-4x/day * fewer side effects than PO anticholinergics

Answer 104

* MAOI * for depression * inhibits monoamine oxidase; serotonin, dopamine, norepinerphrine, epinephrine rise * causes **Neuro—**_delirium_; CNS stim; _mania_; dizziness; vertigo; **CV—**_HTN crisis_; ortho hypotension; **GI/endo—**constipation; dry mouth; **MS—**_hyperreflexia_ * no foods containing tyramine * no vasoconstrictors; no cold medications

Answer 105

* ANTITUBERCULIN ANTIBIOTIC (*STRIPE*) * for tuberculosis * causes **Neuro—**peripheral _neuropathy_; clumsiness; **GI/endo**—_drug-induced hepatitis_; jaundice; distress; **F & E**—_vit B6 depletion_; **MS—**bone marrow suppression; muscle ache; **Rep—**_interference c oral contraception_ * caution with liver disease & alcoholism

Answer 106

* VASODILATOR * for HF, especially in African Americans * ↓ cardiac workload; vasodilation; ↓ preload; ↓ BP; Na+ & water retained * causes **CV—**_reflex tachycardia_; **F & E**—peripheral edema * tx for reflex tachycardia—beta blockers

Answer 107

* ANTIFUNGAL * for oropharyngeal, esophageal & vaginal fungal infections * binds to sterols in cell membranes * causes **Neuro—**h/a; **GI/endo—**n/v/d; abd pain; **Integ—**rash * caution with liver/renal impairment

Answer 108

* ANTIHELMINTHIC * for nematode infections * interferes with metabolic processes * causes **GI/endo—**_transient abd pain_; diarrhea; **Imm—**fever

Answer 109

* ELECTROLYTE MODIFIER * for hyperkalemia * given with K+ sparing diuretics

Answer 110

* ANTIFUNGAL * for oropharyngeal, esophageal & vaginal fungal infections * binds to sterols in cell membranes * causes **Neuro—**h/a; **GI/endo—**n/v/d; abd pain; **Integ—**rash * caution with liver/renal impairment

Answer 111

* NONSELECTIVE COX INHIBITOR; NSAID * for pain & inflammation * inhibits COX-1 * causes **Neuro—**dizziness; **CV**—_risk for thrombotic event;_ **GI/endo—**n/v; heartburn; _epigastric pain_; ulcers; bleeding; **F & E—**_renal impairment;_ **Integ—**rash; **Imm—**allergic reaction * pregnancy category C; category D after 30 weeks

Answer 112

* ANTIDIARRHEAL * for diarrhea * OTC

Answer 113

* OSMOTIC LAXATIVE * for constipation * hyperosmolar salts pull water into colon; ↑ bulk, stimulates peristalsis * causes **GI/endo—**diarrhea; cramps; bloating; **F & E—**_dehydration_ * monitor F & E * contraindicated with appendicitis; bowel obstruction * caution with DM

Answer 114

* PROTON PUMP INHIBITOR * for gastric & duodenal ulcers; erosive esophagitis; GERD * inhibits H+/K+ ATPase system in parietal cells * causes **Neuro—**h/a; vertigo; insomnia; **GI/endo—**n/v/d; _pain;_ **MS—**_fracture risk_ * take 1x/day, prior to breakfast * do not chew, crush, break * takes a few weeks to work

Answer 115

* ANTIDOTE * for methotrexate toxicity

Answer 116

* DOPAMINERGIC * for Parkinson’s * restores dopamine * causes **Neuro—**_NMS_ with quick withdrawal; _psychosis_; drowsiness; _dyskinesias_ (ticks; grimacing; tremors); **CV**—cardiovascular effects; ortho hypotension; **GI/endo**—n/v; **Other**—_sweat & urine turn red/brown_ * contraindicated with melanoma; psychosis; glaucoma * avoid vitamin B6—interferes with drug

Answer 117

* FLUOROQUINALONE ANTIBIOTIC * for UTI; skin infections; resp infections; anthrax * inhibits DNA synthesis * broad spectrum * causes **Neuro—**_photosensitivity_; dizziness; h/a; restlessness; **CV—**_dysrhythmias;_ **GI/endo**—_hepatotoxicity_; n/v/d; **MS**—_tendon rupture_ * monitor for long QT interval * admin IV over 60 mins * contraindicated in children \<18yo * avoid antacids; iron; dairy (6 hrs after taking)

Answer 118

* HORMONE REPLACEMENT * for hypothyroidism; myxedema; cretinism * T4 replacement * causes **Neuro—**tremors; h/a; _nervousness_; insomnia; **CV—**palpitations; _angina_; _tachycardia;_ **GI/endo—**n/v/d; wt loss; **Integ**—_hair loss_ * monitor VS; EKG; weight; glucose; TH levels * take in the morning on an empty stomach * d/c slowly & do not switch brands

Answer 119

* LOCAL ANESTHETIC * for surgery * blocks pain in specific area * causes **Neuro—**_convulsions_; h/a; _excitement (early toxicity sign)_ **CV—**_cardiac arrest_; hypotension; _bradycardia;_ **Resp—**_depression;_ **F & E**—urinary retention * sometimes epinephrine added to decrease bleeding—do not give in terminal areas (fingers, nose, penis, etc)

Answer 120

* LINCOSAMIDE ANTIBIOTIC * for serious infections; septicemia; bone/joint infections * inhibits protein synthesis; bactericidal * causes **GI/endo—**_fatal PMC; severe effects;_ **MS—**bone marrow suppression * caution with liver or kidney transplant

Answer 121

* OXAZOLIDINONE ANTIBIOTIC * for resistant infections * inhibits protein synthesis * causes **Neuro—**h/a; dizziness; **CV—**_thrombocytopenia;_ **GI/endo—**_PMC_; n/v/d * no tyramine containing foods * no MAOIs (HTN crisis)

Answer 122

* GLP-1 INCRETIN ENHANCER * for T2DM * ↑ incretin hormone causes ↑ insulin release; ↓ glucagon production; ↑ fullness; ↓ food intake; slows gastric emptying

Answer 123

* ACE INHIBITOR * for HTN * inhibits angiotensin II formation; blocks vasoconstriction & aldosterone; Na+ and water excreted; K+ retained * causes **CV—**tachycardia; _arrhythmias_; hypotension; _severe ortho hypotension (first dose);_ **Resp—**_persistent dry cough (ACE cough_, ↑ bradykinin); **GI/endo**—n/d; irritation; _peptic ulcers;_ **F & E—**_hyperkalemia_; _angioedema;_ **MS—**bone marrow suppression; **Integ**—rash * monitor for first dose reaction; hyperkalemia * caution with K-sparing diuretics * start with low dose

Answer 124

* RAPID-ACTING INSULIN * for DM; gestational DM; steroid use * ↓ blood glucose * causes **GI/endo**—_hypoglycemia_ * monitor glucose * o. \<15 min; p. 30-90 min; d. 3-5hr * antidote—dextrose

Answer 125

* MANIC MOOD STABILIZER * for manic sx of bipolar * increases receptor sensitivity to serotonin * causes **Neuro—**h/a; lethargy; amnesia; _tremors_; _tinnitus_; _blurred vison; coma;_ **CV—**_cardiovascular collapse;_ **GI/endo—**n/v/d; **F & E—**risk for _dehydration;_ **MS—**weakness * monitor Na+; labs every 2 weeks; maintenance every month * caution with dehydration & diuretics * therapeutic range—0.6-1.5 mEq/L

Answer 126

* ANTIDIARRHEAL * for diarrhea * OTC

Answer 127

* BENZODIAZEPINE * schedule IV * for anxiety * intensifies GABA * causes **Neuro—**_depression_; drowsiness; weakness; amnesia; _CNS depression_; disorientation; _ataxia_; blurred vision; **CV—**abnormal heart rhythm; _BP change_; **Resp—**_resp depression_; **GI/endo—**constipation; n/v; **F & E**—urinary retention * contraindicated with glaucoma; drug abuse; liver disease; suicidality * monitor respirations * antidote—flumazenil

Answer 128

* ANGIOTENSIN RECEPTOR BLOCKER * for HTN * prevents angiotensin II from reaching receptors; causes vasodilation * causes **Neuro—**dizzyness; h/a; **CV**—_hypotension;_ **GI/endo—**diarrhea; abd pain

Answer 129

* HERBAL LAXATIVE * for IBS * monitor F & E

Answer 130

* OSMOTIC DIURETIC * for acute renal failure 2nd to OD, shock, trauma; high ICP; high intraocular pressure 2nd to glaucoma * acts on prox tubules, loop of Henle, collecting duct; inhibits water & Na+ reabsorption; promotes mvmt of toxins through kidneys * causes **Neuro**—h/a; dizziness; **CV—**hypotension; _cardiac decompensation in HF;_ **GI/endo—**dry mouth; thirst; n/v; **F & E**—_dehydration_; sudden drop in fluids; _hypokalemia_ * monitor K+; Na+; uric acid; glucose; kidney function * crystallizes when exposed to cold; use a filtered needle and keep out of cold * contraindicated in HF

Answer 131

* ANTIHELMINTHIC * for nematode infections * interferes with metabolic processes * causes **GI/endo—**_transient abd pain_; diarrhea; **Imm—**fever

Answer 132

* NONSELECTIVE COX INHIBITOR; NSAID * for pain & inflammation * inhibits COX-1 * causes **Neuro—**dizziness; **CV**—_risk for thrombotic event;_ **GI/endo—**n/v; heartburn; _epigastric pain_; ulcers; bleeding; **F & E—**_renal impairment;_ **Integ—**rash; **Imm—**allergic reaction * pregnancy category C; category D after 30 weeks

Answer 133

* OPIOID * for severe pain * binds to opioid receptors in CNS * causes **Neuro—**_tolerance_; _dependence_; withdrawal; sedation; confusion; blurred vision; _euphoria_; lightheadedness; dizziness; **CV—**_hypotension_; ortho hypotension; **Resp—**_depression_; _apnea;_ **GI/endo—**n/v; constipation; **F & E—**urinary retention; **Integ—**itching; **Imm—**_anaphylaxis_ * contraindicated with head injury; respiratory disorders; shock; hypotension * hold if respirations \<12

Answer 134

* CYTOPROTECTANT * for alkylating agents * reduces risk of hemorrhagic cystitis

Answer 135

* BIGUANIDE * for T2DM * ↓ hepatic glucose production; ↓ insulin resistance; alters glucose absorption; ↓ triglycerides & LDL; promotes wt loss * causes **GI/endo**—_severe nvd;_ **Other—**lactic acidosis (rare) * monitor LFTs

Answer 136

* ANTITHYROID * for hyperthyroidism; Graves’ * inhibits synthesis of thyroid hormones * causes **Neuro**—_bradykinesia_; _emotional dullness;_ **CV**—_bradycardia_; anemia; **GI/endo**—wt gain; constipation * monitor VS; EKG; weight; glucose; TH levels * take in the morning on an empty stomach * d/c slowly & do not switch brands

Answer 137

* ANTIMETABOLITE * for inflammatory disorders; breast cancer; ovarian cancer * disrupt nutrient/nucleic acid metabolism * causes **GI/endo—**_mucositis_; n/v/d; anorexia; **F & E—**_renal toxicity;_ **MS—**bone marrow suppression; **Integ—**alopecia; **Imm—**malaise * antidote—leucovorin calcium

Answer 138

* THIAZIDE DIURETIC * for HTN (first line); mild/moderate HF * acts on distal convoluted tubule; inhibits Na+ and Cl- reabsorption; increases water & K+ excretion * causes **Neuro—**dizziness; vertigo; **CV**—ortho hypotension; **GI/endo—**n/v/d; _hyperglycemia;_ **F & E**—_hypercalcemia_; _hypokalemia;_ **MS**—_↑ uric acid (gout)_; muscle cramps & spasms * monitor for dehydration; Ca+; K+; glucose; uric acid * give KCl for hypokalemia * not effective immediately

Answer 139

* HERBAL LAXATIVE * for opioid-induced constipation * monitor F & E

Answer 140

* CNS STIMULANT * for ADHD & narcolepsy * causes **Neuro—**_paradoxical hyperactivity_; insomnia; nervousness; **CV—**_tachycardia_; **GI/endo—**anorexia; _wt loss_; nausea; abd pain * used with atomoxetine

Answer 141

* CORTICOSTEROID * hormone replacement for Addison’s; suppression of inflammation; other uses * causes **Neuro**—_mood changes_/irritability; euphoria; nervousness; insomnia; _personality change_; cataracts; **GI/endo**—_hyperglycemia_; _peptic ulcers_; ↑ appetite; **F & E**—electrolyte imbalance; **MS**—osteoporosis/bone changes; **Integ**—_delayed wound healing_; acne; facial hair; **Rep—**menstrual changes; **Other**—_Cushing's syndrome_ * monitor for sx of infection; glucose * contraindicated during active infection * caution with DM & peptic ulcer disease * pregnancy category C * start with a large dose, then decrease

Answer 142

* GI STIMULANT * for postop, chemo-related n/v * stimulates parasympathetic activity; ↑ ACh sensitivity; stimulates gastric emptying * causes **Neuro—**_restlessness_; _extrapyramidals_; drowsiness; fatigue; _Parkinson-like reactions;_ **GI—**n/d

Answer 143

* BETA BLOCKER * for HTN; angina; MI prevention; dysrhythmias * block beta receptors in kidney to inhibit renin; ↓ HR, myocardial contraction, CO; ↑ renal perfusion * cause **Neuro—**_depression_; **CV—**_bradycardia_; ↓ CO; AV block; ortho hypotension; rebound myocardium; HF; arrhythmia; **Resp**—_bronchospasm_; **GI/endo—**n/v/d; _hypoglycemia masking_; **Rep—**_↓ libido_ * assess BP & HR before admin; do not give if HR \<60 * d/c gradually * caution for DM pts * contraindicated for asthma pts; pts on Ca+ channel blockers

Answer 144

* ANTIPROTOZOAL * for multiple protozoal infections * causes cell death & prevents reproduction * causes **Neuro—**h/a; dizziness; ataxia; **GI/endo—**_metallic taste_; n/v/d; **F & E—**_darkened urine_ * no alcohol

Answer 145

* BENZODIAZEPINE PREOP SEDATIVE * preoperative; eases anesthesia induction; conscious sedation * causes unconsciousness; amnesia * causes **Neuro—**amnesia; **CV—**_potential cardiac arrest; hypotension;_ **Resp—**_depression_ * monitor respiratory & cardio

Answer 146

* OSMOTIC LAXATIVE * for constipation * hyperosmolar salts pull water into colon; ↑ bulk, stimulates peristalsis * causes **GI/endo—**diarrhea; cramps; bloating; **F & E—**_dehydration_ * monitor F & E * contraindicated with appendicitis; bowel obstruction

Answer 147

* TETRACYCLINE ANTIBIOTIC * for typhus; cholera; Rocky Mtn spotted fever; Lyme; H. pylori; chlamydia; acne * inhibits protein synthesis * causes **GI/endo—**_permanent discoloration of teeth_ (children); n/v/d; **MS—**bone marrow suppression; **Integ—**rash; **Imm—**superinfection; **Rep**—_affects fetal bone/teeth dev_ * take iron & dairy 2 hours after taking * contraindicated for \<8yo

Answer 148

* PROSTAGLANDIN ANALOGUE * for gastric distress with NSAIDs * suppresses acid secretion; ↑ cytoprotective mucus * causes **GI/endo—**n/v/d; flatulence; **Rep—**_miscarriage_; _hypermenorrhea_ * pregnancy category X

Answer 149

* INTRANASAL CORTICOSTEROID * prophylaxis for asthma * anti-inflammatory * causes **Neuro—**h/a; **Resp—**drying of nasal mucosae; **Imm—**_infection risk;_ **Local—**burning; stinging; _irritation_

Answer 150

* LEUKOTRIENE MODIFIER * for prophylaxis of chronic bronchial asthma; allergic reactions * inhibits bronchoconstriction; reduces inflammation * causes **Neuro—**h/a; dizziness; **Resp—**_infection_; _cough_; _pharyngitis;_ **GI/endo—**n/v

Answer 151

* OPIOID * for severe pain * binds to opioid receptors in CNS * causes **Neuro—**_tolerance_; _dependence_; withdrawal; sedation; confusion; blurred vision; _euphoria_; lightheadedness; dizziness; **CV—**_hypotension_; ortho hypotension; **Resp—**_depression_; _apnea;_ **GI/endo—**n/v; constipation; **F & E—**urinary retention; **Integ—**itching; **Imm—**_anaphylaxis_ * contraindicated with head injury; respiratory disorders; shock; hypotension; biliary tract spasm * hold if respirations \<12

Answer 152

* OPIOID PARTIAL AGONIST * for pain * causes **Neuro—**_dependence_; dizziness; sedation; euphoria; **CV—**palpitations; **GI/endo—**n/v; constipation; **F & E—**_ureteral spasm_; **Integ**—sweating * may be combined with naloxone * decreased risk of abuse than opioids; fewer side effects

Answer 153

* OPIOID ANTAGONIST * for opioid OD; RR \<10 * reverses effects of opioids: resp depression, sedation, hypotension, analgesia * causes **Neuro—**tremors; _reversal of analgesia;_ **CV—**_erratic BP_; tachycardia; **Resp—**_hyperventilation;_ **GI/endo—**n/v; **Integ—**sweating * may require several doses; keep resuscitation equipment nearby

Answer 154

* NONSELECTIVE COX INHIBITOR; NSAID * for pain & inflammation * inhibits COX-1 * causes **Neuro—**dizziness; **CV**—_risk for thrombotic event;_ **GI/endo—**n/v; heartburn; _epigastric pain_; ulcers; bleeding; **F & E—**_renal impairment;_ **Integ—**rash; **Imm—**allergic reaction * pregnancy category C; category D after 30 weeks

Answer 155

* BETA BLOCKER * for HTN; angina; MI prevention; dysrhythmias * block beta receptors in kidney to inhibit renin; ↓ HR, myocardial contraction, CO; ↑ renal perfusion * cause **Neuro—**_depression_; **CV—**_bradycardia_; ↓ CO; AV block; ortho hypotension; rebound myocardium; HF; arrhythmia; **Resp**—_bronchospasm_; **GI/endo—**n/v/d; _hypoglycemia masking_; **Rep—**_↓ libido_ * assess BP & HR before admin; do not give if HR \<60 * d/c gradually * caution for DM pts * contraindicated for asthma pts; pts on Ca+ channel blockers

Answer 156

* AMINOGLYCOSIDE ANTIBIOTIC * for serious, systemic G- infections * bactericidal; inhibits protein synthesis * causes **Neuro—**_ototoxicity_; _neuromuscular blockade;_ **F & E**—nephrotoxicity * therapeutic range—5-10 mcg/mL * monitor renal function; s/s of ototoxicity * NMS tx—calcium gluconate

Answer 157

* ANTIVIRAL * for HIV/AIDS * prevents viral replication * causes **Neuro—**h/a; **GI/endo—**_liver dysfunction_; n/v/d; **Imm—**_fever_; chills * take around the clock; do not miss a dose

Answer 158

* NICOTINIC ACID (VIT B2) * for HLD * ↓ VLDL & LDL; inhibits release of fatty acids * causes **CV**—_severe flushing_; palpitations; **GI/endo**—_hyperglycemia_; n/d; bloating; **Integ**—_pruritus_ * contraindicated with DM * maximum dose—6 g/day * give aspirin 30 mins prior for flushing

Answer 159

* CALCIUM CHANNEL BLOCKER * for chronic HTN; angina; dysrhythmias; premature labor * blocks Ca+ in vascular smooth muscle; vasodilation; relaxes uterus * causes **Neuro**—dizzyness; h/a; **CV**—_bradycardia_; flushing; **F & E**—peripheral edema * no grapefruit * no beta blockers

Answer 160

* NITRATE * for acute angina * vasodilator; dilates veins & capillaries; ↓ vascular resistance; dilate coronary arteries; ↓ cardiac workload * causes **Neuro—**_severe_ _h/a_; dizzyness; **CV—**_hypotension_; _reflex tachycardia_; flushing; **GI/endo—**n/v * monitor BP * keep out of sunlight * take 1 tablet 5 mins apart for a maximum of 3 before calling 911

Answer 161

* VASODILATOR * for severe HTN; HTN emergency * relaxes smooth muscle of arteries * causes **CV—**_reflex tachycardia;_ **F & E**—_Na+ & water retention_; peripheral edema * give beta blocker for reflex tachycardia

Answer 162

* HISTAMINE BLOCKER * for duodenal & benign gastric ulcers; stress ulcers; acute upper GI bleed prophylaxis; GERD; gastric distress * block histamine receptors in parietal cells * causes **Neuro—**h/a; dizziness; _confusion_; _somnolence;_ **CV—**_dysrhythmias;_ **GI/endo—**n/v/d; _gynecomastia_ * do not give w/i an hour of antacid admin

Answer 163

* HERBAL LAXATIVE * for opioid-induced constipation * monitor F & E

Answer 164

* OPIOID * for severe pain * binds to opioid receptors in CNS * causes **Neuro—**_tolerance_; _dependence_; withdrawal; sedation; confusion; blurred vision; _euphoria_; lightheadedness; dizziness; **CV—**_hypotension_; ortho hypotension; **Resp—**_depression_; _apnea;_ **GI/endo—**n/v; constipation; **F & E—**urinary retention; **Integ—**itching; **Imm—**_anaphylaxis_ * contraindicated with head injury; respiratory disorders; shock; hypotension * hold if respirations \<12

Answer 165

* INTERMEDIATE-ACTING INSULIN * for DM; gestational DM; steroid use * ↓ blood glucose * causes **GI/endo**—_hypoglycemia_ * monitor glucose * o. 1-1.5 hr; p. 4-12 hr; d. 18-24 hr * antidote—dextrose

Answer 166

* GH ANTAGONIST * for GH excess; acromegaly; gigantism * causes **Neuro—**h/a; fatigue; **GI/endo—**_gallbladder disease; hyperglycemia_; abd pain; _cholelithiasis_; nvd; **MS**—back pain * monitor glucose * contraindicated in DM & gallbladder disease

Answer 167

* PROTON PUMP INHIBITOR * for gastric & duodenal ulcers; erosive esophagitis; GERD * inhibits H+/K+ ATPase system in parietal cells * causes **Neuro—**h/a; vertigo; insomnia; **GI/endo—**n/v/d; _pain;_ **MS—**_fracture risk_ * take 1x/day, prior to breakfast * do not chew, crush, break * takes a few weeks to work

Answer 168

* SEROTONIN RECEPTOR ANTAGONIST * for chemo-related n/v * causes **Neuro—**h/a; dizziness; drowsiness; **GI/endo—**constipation; **F & E—**retention; **MS—**_myalgia_ * no extrapydramidals

Answer 169

* LIPOGLYCOPEPTIDE ANTIBIOTIC * for severe G+ infections; MRSA * inhibits cell membranes * causes **Neuro—**ototoxicity; **F & E—**nephrotoxicity; **Integ—**_red man syndrome_ (fast infusion) * monitor peak & trough (narrow TR)

Answer 170

* ANTIVIRAL * for influenza * prevents viral replication * causes **Neuro—**lightheadedness; dizziness; insomnia; _depression_; **CV—**_ortho hypotension_; **GI/endo—**nausea; **Integ—**Stevens-Johnson; **Rep—**_teratogenic_ * caution with renal impairment

Answer 171

* PENICILLIN ANTIBIOTIC * for Strep and Staph * inhibits cell wall synthesis * broad & extened spectrum * causes **Imm—**allergy; superinfection * monitor 30 mins after first few doses; bleeding; renal function; superinfections * take on an empty stomach

Answer 172

* URINARY TRACT ANTISPASMODIC * for UT spasms (cystitis, prostatitis, urethritis); dysuria; _incontinence;_ urgency; nocturia * blocks parasympathetic activity; suppresses overactivity * causes **Neuro**—drowsiness; dizziness; _blurred vision;_ **CV—**_tachycardia;_ **GI/endo—**dry mouth; nausea; **F & E**—_urinary hesitancy;_ **Integ**—↓ sweating * give water & hard candy for dry mouth * monitor intraocular pressure; I & O

Answer 173

* ANTICONVULSANT * for partial/focal seizures; migraines * blocks Na+ channels * causes **Neuro—**drowsiness; ataxia; **CV—**_heme disorders;_ **GI/endo—**_hepatitis_; n/v; **MS—**bone marrow suppression; **Integ—**Stevens Johnson; **Rep**—_teratogenic_ (cleft palate; spina bifida) * pregnancy category D

Answer 174

* ALPHA ADRENERGIC AGONIST; SYMPATHOMIMETIC * for PO—cold/allergy; IV—shock; topical/eye drop—pupil dilation for exam; topial/intranasal—congestion * causes vasoconstriction * causes **Neuro—**_nervousness_; restlessness; tremors; dizziness; anxiety; h/a; **CV—**_palpitations_; dysrhythmias; _HTN_; _tachycardia;_ **Resp—**_dyspnea_; _pulmonary edema; rebound congestion_ **GI/endo—**dry mouth; n/v; _hyperglycemia;_ **F & E**—urninary retention * contraindicated with HTN * monitor VS; urine output; glucose * rebound effect—use no more than 3-5 days

Answer 175

* PROTON PUMP INHIBITOR * for gastric & duodenal ulcers; erosive esophagitis; GERD * inhibits H+/K+ ATPase system in parietal cells * causes **Neuro—**h/a; vertigo; insomnia; **GI/endo—**n/v/d; _pain;_ **MS—**_fracture risk_ * take 1x/day, prior to breakfast * do not chew, crush, break * takes a few weeks to work

Answer 176

* SSRI * for major depression & anxiety disorders * blocks reuptake of serotonin; enhances serotonin transmission * causes **Neuro—**_suicidal ideation_; seizures; _serotonin syndrome_; insomnia; h/a; dizziness; nervousness; tremors; **GI/endo—**_wt changes_; anorexia; n/d; **Rep—**_sexual dysfunction_

Answer 177

* COLONY STIMULATING FACTOR * for suppressed bone marrow * increases neutrophil production * causes **Neuro—**h/a; pain; fatigue; **GI/endo—**n/v/d; anorexia; **MS—**_bone pain_; weakness; **Integ—**alopecia

Answer 178

* PENICILLIN ANTIBIOTIC * for Strep and Staph * inhibits cell wall synthesis * broad & extened spectrum * causes **Imm—**allergy; superinfection * monitor 30 mins after first few doses; bleeding; renal function; superinfections * take on an empty stomach

Answer 179

* OPIOID PARTIAL AGONIST * for pain * causes **Neuro—**_dependence_; dizziness; sedation; euphoria; **CV—**palpitations; **GI/endo—**n/v; constipation; **F & E—**_ureteral spasm_; **Integ**—sweating * may be combined with naloxone * decreased risk of abuse than opioids; fewer side effects

Answer 180

* SHORT ACTING BARBITUATE * for inducing sedation; anesthesia adjunct * CNS depressant; intensifies GABA * causes **Neuro—**_addiction_; dependence; _hallucinations; nightmares_; CNS depression; hypnosis; _somnolence_; agitation; confusion; ataxia; syncope; coma; _death;_ **CV—**_hypotension_; _bradycardia;_ **Resp—**_depression_; _laryngospasm;_ **GI/endo—**hepatotoxicity; constipation; n/v/d; **F & E—**_vit D & B deficiency;_ **Local—**_tissue necrosis c IV;_ inflammation c IM * no alcohol * no other CNS depressants * d/c slowly

Answer 181

* ANTICOAGULANT * for intermittent claudication * ↓ viscosity of RBCs; ↑ flexibility of RBCs * causes **GI/endo—**upset

Answer 182

* OPIOID * for severe pain * binds to opioid receptors in CNS * causes **Neuro—**_tolerance_; _dependence_; withdrawal; sedation; confusion; blurred vision; _euphoria_; lightheadedness; dizziness; **CV—**_hypotension_; ortho hypotension; **Resp—**_depression_; _apnea;_ **GI/endo—**n/v; constipation; **F & E—**urinary retention; **Integ—**itching; **Imm—**_anaphylaxis_ * contraindicated with head injury; respiratory disorders; shock; hypotension * hold if respirations \<12

Answer 183

* OPIOID * for severe pain * binds to opioid receptors in CNS * causes **Neuro—**_tolerance_; _dependence_; withdrawal; sedation; confusion; blurred vision; _euphoria_; lightheadedness; dizziness; **CV—**_hypotension_; ortho hypotension; **Resp—**_depression_; _apnea;_ **GI/endo—**n/v; constipation; **F & E—**urinary retention; **Integ—**itching; **Imm—**_anaphylaxis_ * contraindicated with head injury; respiratory disorders; shock; hypotension * hold if respirations \<12

Answer 184

* SCABICIDE; PEDICULOCIDE * for lice; crab lice; scabies; other mites * lice—apply shampoo 10 mins before you rinse * scabies—apply 8-14 hours before bathing; repeat in 7-10 days if tx fails

Answer 185

* MAOI * for depression * inhibits monoamine oxidase; serotonin, dopamine, norepinerphrine, epinephrine rise * causes **Neuro—**_delirium_; CNS stim; _mania_; dizziness; vertigo; **CV—**_HTN crisis_; ortho hypotension; **GI/endo—**constipation; dry mouth; **MS—**_hyperreflexia_ * no foods containing tyramine * no vasoconstrictors; no cold medications

Answer 186

* LONG ACTING BARBITUATE * for sedation; seizures * CNS depressant; intensifies GABA * causes **Neuro—**_addiction_; dependence; _hallucinations; nightmares_; CNS depression; hypnosis; _somnolence_; agitation; confusion; ataxia; syncope; coma; _death;_ **CV—**_hypotension_; _bradycardia;_ **Resp—**_depression_; _laryngospasm;_ **GI/endo—**hepatotoxicity; constipation; n/v/d; **F & E—**_vit D & B deficiency;_ **Local—**_tissue necrosis c IV;_ inflammation c IM * no alcohol * no other CNS depressants * d/c slowly

Answer 187

* URINARY TRACT ANALGESIC * for UT irritation * causes **Neuro**—h/a; **GI/endo**—upset; _liver toxicity_ (jaundice); **F & E**—renal toxicity; **Integ**—rash; **Other**—_red/orange discoloration of skin, sclera, urine_ * monitor for jaundice & d/c if jaundice occurs

Answer 188

* ALPHA ADRENERGIC AGONIST; SYMPATHOMIMETIC * for PO—cold/allergy; IV—shock; topical/eye drop—pupil dilation for exam; topial/intranasal—congestion * causes vasoconstriction * causes **Neuro—**_nervousness_; restlessness; tremors; dizziness; **CV—**_palpitations_; dysrhythmias; _HTN_; _tachycardia;_ **Resp—**_dyspnea_; _pulmonary edema;_ **GI/endo—**dry mouth; n/v; _hyperglycemia;_ **F & E**—urninary retention * contraindicated with HTN * caution with CV disease; hyperthyroidism; DM * monitor VS; urine output; glucose

Answer 189

* HYDANTOIN * for seizures * inhibits Na+ influx; prevent disruptive neuron firing; stabilizes cell membranes * causes **Neuro—**_slurred speech_; ataxia; tremor; confusion; _nystagmus;_ **CV—**_dysrhythmias_; _thrombocytopenia_; hypotension; **GI/endo—**_inhibition of insulin; hyperglycemia; interference c folate absorption; gingival hyperplasia;_ **Integ—**Stevens Johnson syndrome; **Imm—**_leukopenia_; agranulocytosis; **Rep—**_teratogenic (_cleft palate; heart defects); **Local—**site irritation * never give with dextrose; always give with saline * flush line before & after use * therapeutic range—10-20 mcg/ml * pregnancy category D

Answer 190

* DIRECT ACTING CHOLINERGIC; PARASYMPATHOMIMETIC * for dry mouth; glaucoma * activates tissue response at receptors * causes **Local—**stinging; burning; tearing; red eyes; h/a * antidote—atropine

Answer 191

* OSMOTIC LAXATIVE * for constipation * hyperosmolar salts pull water into colon; ↑ bulk, stimulates peristalsis * causes **GI/endo—**diarrhea; cramps; bloating; **F & E—**_dehydration_ * monitor F & E * contraindicated with appendicitis; bowel obstruction

Answer 192

* SUPPLEMENT * for hypokalemia * never give IV push (will cause death)

Answer 193

* STATIN * for HLD * inhibits HMG CoA reductase; ↓ LDL; ↑ HDL * causes **Neuro**—h/a; **GI/endo—**_↑ liver enzymes_; abd pain; flatulence; cramps; constipation; **F & E**—_acute renal failure_; **MS—**_rhabdomylysis_; **Integ—**rash * NO grapefruit juice or alcohol * do NOT take with fibric acid agents * contraindicated during pregnancy * may require CoQ10 supplements * therapeutic effects appear in 2-4 weeks

Answer 194

* ALPHA 1 BLOCKER * for HTN * causes vasodilation * causes **Neuro**—dizzyness; h/a; **CV—**_hypotension_; _tachycardia_; flushing; **Resp—**_nasal congestion;_ **GI/endo—**n/d; dyspepsia; **F & E**—edema; **Rep—**_priapism_ (prolonged erection)

Answer 195

* CORTICOSTEROID * hormone replacement for Addison’s; suppression of inflammation; other uses * causes **Neuro**—_mood changes_/irritability; euphoria; nervousness; insomnia; _personality change_; cataracts; **GI/endo**—_hyperglycemia_; _peptic ulcers_; ↑ appetite; **F & E**—electrolyte imbalance; **MS**—osteoporosis/bone changes; **Integ**—_delayed wound healing_; acne; facial hair; **Rep—**menstrual changes; **Other**—_Cushing's syndrome_ * monitor for sx of infection; glucose * contraindicated during active infection * caution with DM & peptic ulcer disease * pregnancy category C * start with a large dose, then decrease

Answer 196

* SODIUM CHANNEL BLOCKER * for a-fib; PACs; PVCs; V-tach

Answer 197

* PHENOTHIAZINE * for vomiting * causes **Neuro—**_extrapyramidals_; drowsiness; _dystonia_; _photophobia_; blurred vision; **Resp—**_congestion;_ **F & E—**retention; **Local—**_thrombophlebitis_

Answer 198

* PHENOTHIAZINE * for vomiting * causes **Neuro—**_extrapyramidals_; drowsiness; _dystonia_; _photophobia_; blurred vision; **Resp—**_congestion;_ **F & E—**retention; **Local—**_thrombophlebitis_ * mix with 10mL & infuse slowly

Answer 199

* BETA BLOCKER * for HTN; angina; MI prevention; dysrhythmias * block beta receptors in kidney to inhibit renin; ↓ HR, myocardial contraction, CO; ↑ renal perfusion * cause **Neuro—**_depression_; **CV—**_bradycardia_; ↓ CO; AV block; ortho hypotension; rebound myocardium; HF; arrhythmia; **Resp**—_bronchospasm_; **GI/endo—**n/v/d; _hypoglycemia masking_; **Rep—**_↓ libido_ * assess BP & HR before admin; do not give if HR \<60 * d/c gradually * caution for DM pts * contraindicated for asthma pts; pts on Ca+ channel blockers

Answer 200

* GENERAL ANESTHETIC * for surgery; sedation on ventilation * causes **CV—**hypotension; **Resp—**_depression; arrest; apnea_ * o. 40-60 sec; d. 10-15 min

Answer 201

* ANTITHYROID * for hyperthyroidism; Graves’ * inhibits synthesis of thyroid hormones * causes **Neuro**—_bradykinesia_; _emotional dullness;_ **CV**—_bradycardia_; anemia; **GI/endo**—wt gain; constipation * monitor VS; EKG; weight; glucose; TH levels * take in the morning on an empty stomach * d/c slowly & do not switch brands

Answer 202

* ANTIDOTE * for heparin & enoxaparin toxicity

Answer 203

* DECONGESTANT * for congestion * causes vasoconstriction * causes **Neuro—**_nervousness_; restlessness; anxiety; h/a; dizziness; **Resp—**_rebound congestion_ (\>3-5 days); **CV—**_HTN_ * caution with HTN; CV disease; hyperthyroidism; DM * used to cook meth

Answer 204

* BULK FORMING LAXATIVE * for chronic constipation * absorb water into intestine; promote large soft stools * causes **GI/endo—**cramps; bloating; diarrhea * mix in water/juice; follow with another cup of fluid; give as soon as it's mixed * monitor F & E * contraindicated with appendicitis; bowel obstruction; abd surgery

Answer 205

* ANTITUBERCULIN ANTIBIOTIC (*STRIPE*) * for tuberculosis * causes **Neuro—**peripheral _neuropathy_; clumsiness; **GI/endo**—_drug-induced hepatitis_; jaundice; distress; **F & E**—_vit B6 depletion_; **MS—**bone marrow suppression; muscle ache; **Rep—**_interference c oral contraception_ * caution with liver disease & alcoholism

Answer 206

* INDIRECT CHOLINERGIC; PARASYMPATHOMIMETIC * for myasthenia gravis * inhibits cholinesterase; permits ACh to accumulate * causes **CV—**_bradycardia_; **GI/endo**—salivation; n/v; _incontinence;_ **F & E—**urinary frequency; **Other—**tearing * antidote—atropine

Answer 207

* ANTIPROTOZOAL * for malaria * blocks parasitic DNA * causes **Neuro—**h/a; dizziness; _retinal changes;_ **CV—**_hypotension;_ **GI/endo—**_hepatic dysfunction_; n/v/d; anorexia; **Integ—**rash; pruritus; **Imm—**fever; chills; malaise

Answer 208

* HISTAMINE BLOCKER * for duodenal & benign gastric ulcers; stress ulcers; acute upper GI bleed prophylaxis; GERD; gastric distress * block histamine receptors in parietal cells * causes **Neuro—**h/a; dizziness; _confusion_; _somnolence;_ **CV—**_dysrhythmias;_ **GI/endo—**n/v/d; _gynecomastia_ * do not give w/i an hour of antacid admin

Answer 209

* SHORT-ACTING INSULIN * for DM; gestational DM; steroid use * ↓ blood glucose * causes **GI/endo**—_hypoglycemia_ * monitor glucose * o. 30-60 min; p. 2-4 hr; d. 6-12 hr * antidote—dextrose

Answer 210

* MEGLITINIDE * for T2DM * stimulates insulin release * causes **GI/endo**—_hypoglycemia_ * monitor LFTs; glucose

Answer 211

* THROMBOLYTIC/FIBRINOLYTIC * for thrombotic CVA; early onset MI; restoring patency of central lines * converts plasminogen to plasmin; destroys fibrin of clots * causes **Neuro—**h/a; pain; **CV**—_bleeding_; hypotension; _reperfusion dysrhythmias;_ **Imm—**allergic reaction; fever * best used w/i 4-6 hours of CVA * monitor PTT/PT/INR; sx of allergic reaction; bleeding * contraindicated in recent major surgery or trauma; intracranial hemorrhage; history of GI bleed * antidote—aminocaproic acid

Answer 212

* ANTITUBERCULIN ANTIBIOTIC (*STRIPE*) * for tuberculosis * causes **Neuro—**peripheral _neuropathy_; clumsiness; **GI/endo**—_drug-induced hepatitis_; jaundice; distress; **F & E**—_vit B6 depletion_; **MS—**bone marrow suppression; muscle ache; **Rep—**_interference c oral contraception;_ **Other—**_discoloration of sweat, tears_ * caution with liver disease & alcoholism

Answer 213

* ANTIVIRAL * for influenza * prevents viral replication * causes **Neuro—**lightheadedness; dizziness; insomnia; _depression_; **CV—**_ortho hypotension_; **GI/endo—**nausea; **Integ—**Stevens-Johnson; **Rep—**_teratogenic_ * caution with renal impairment

Answer 214

* ATYPICAL ANTIPSYCHOTIC * for schizophrenia, positive and negative sx; psychosis * causes **Neuro—**seizures; _photosensitivity_; _NMS_; drowsiness; sedation; h/a; **CV—**ortho hypotension; **GI/endo—**wt gain; dry mouth; _hyperglycemia_; **Other**—fever * less likely to cause EPS

Answer 215

* ANTICOAGULANT * for DVT; a-fib * inhibits factor X * causes **CV—**_bleeding;_ **GI/endo—**upset * no antidote

Answer 216

* THIAZOLIDINEDIONE * for T2DM * ↓ insulin resistance * causes **CV—**_↑ risk for adverse events;_ **F & E—**fluid retention * contraindicated with symptomatic heart disease; CHF

Answer 217

* ANTICHOLINERGIC * for vomiting * causes **Neuro—**drowsiness; dizziness; dry mouth * also called “devil’s breath”

Answer 218

* HERBAL LAXATIVE * for constipation * irritates bowel * monitor F & E

Answer 219

* SSRI * for major depression & anxiety disorders * blocks reuptake of serotonin; enhances serotonin transmission * causes **Neuro—**_suicidal ideation_; seizures; _serotonin syndrome_; insomnia; h/a; dizziness; nervousness; tremors; **GI/endo—**_wt changes_; anorexia; n/d; **Rep—**_sexual dysfunction_

Answer 220

* for flatulence with antacids

Answer 221

* STATIN * for HLD * inhibits HMG CoA reductase; ↓ LDL; ↑ HDL * causes **Neuro**—h/a; **GI/endo—**_↑ liver enzymes_; abd pain; flatulence; cramps; constipation; **F & E**—_acute renal failure_; **MS—**_rhabdomylysis_; **Integ—**rash * NO grapefruit juice or alcohol * do NOT take with fibric acid agents * contraindicated during pregnancy * may require CoQ10 supplements * therapeutic effects appear in 2-4 weeks

Answer 222

* DPP-4 INHIBITOR INCRETIN ENHANCER * for T2DM * ↑ incretin hormone causes ↑ insulin release; ↓ glucagon production; ↑ fullness; ↓ food intake; slows gastric emptying

Answer 223

* ANTACID * symptomatic relief of hyperacidity; promotes ulcer healing * neutralizes HCl * causes **GI/endo—**_constipation_; _gastric; acid rebound_ when d/c; **Other—**_systemic alkalosis_ * monitor pH * admin 2 hours before/after other meds * simethicone may be added to reduce flatus

Answer 224

* OSMOTIC LAXATIVE * for constipation * hyperosmolar salts pull water into colon; ↑ bulk, stimulates peristalsis * causes **GI/endo—**diarrhea; cramps; bloating; **F & E—**_dehydration_ * monitor F & E * contraindicated with appendicitis; bowel obstruction

Answer 225

* HORMONE * for GH deficit; dwarfism * stimulates skeletal & organ growth * causes **Neuro—**h/a; **GI/endo—**_insulin resistance; hyperglycemia;_ **F & E—**edema; **MS—**arthralgia; **Imm—**_antibodies to GH;_ **Other—**injection site pain * monitor glucose; thyroid function; nutritional needs * caution with DM * give early in life before epiphyses close

Answer 226

* POTASSIUM-SPARING DIURETIC * for edema r/t HF, cirrhosis, renal disease; hyperaldosteronism; HTN * acts on collecting duct & late distal tubules; Na+ excretion and K+ retention * causes **Neuro—**dizziness; vertigo; **GI/endo—**diarrhea; **F & E**—_hyperkalemia;_ **_Androgen effects_—**hirsutism; gynecomastia; irregular menses; deepening voice * monitor K+ & sx of hyperkalemia * caution with ACE inhibitors (hyperkalemia) * hyperkalemia—kayexalate

Answer 227

* THROMBOLYTIC/FIBRINOLYTIC * for thrombotic CVA; early onset MI; restoring patency of central lines * converts plasminogen to plasmin; destroys fibrin of clots * causes **Neuro—**h/a; pain; **CV**—_bleeding_; hypotension; _reperfusion dysrhythmias;_ **Imm—**allergic reaction; fever * best used w/i 4-6 hours of CVA * monitor PTT/PT/INR; sx of allergic reaction; bleeding * contraindicated in recent major surgery or trauma; intracranial hemorrhage; history of GI bleed * antidote—aminocaproic acid

Answer 228

* AMINOGLYCOSIDE ANTIBIOTIC * for serious, systemic G- infections * bactericidal; inhibits protein synthesis * causes **Neuro—**_ototoxicity_; _neuromuscular blockade;_ **F & E**—nephrotoxicity * therapeutic range—5-10 mcg/mL * monitor renal function; s/s of ototoxicity * NMS tx—calcium gluconate

Answer 229

* NEUROMUSCULAR JUNCTION BLOCKER * for surgery; intubation; ventilation * causes temporary flaccid paralysis * causes **CV—**dysrhythmias; **Resp—**_depression; arrest; apnea; bronchospasm_ * monitor cardio; resp * only give with ventilation & ACLS available

Answer 230

* PEPSIN INHIBITOR * for ulcers; oral & esophageal ulcers due to cancer tx * covers ulcer; protects from acid, pepsin, bile salts * causes **Neuro—**_sleepiness_; dizziness; vertigo; insomnia; **GI/endo—**dry mouth; n/v/d; _indigestion;_ **Integ—**rash * dissolve tablet in water

Answer 231

* SULFONAMIDE ANTIBIOTIC * for otitis media; UTI; STDs * inhibits folic acid synthesis * broad spectrum * causes **Neuro—**_photophobia;_ **GI/endo—**hepatotoxicity; n/v/d; **F & E—**_toxic nephrosis;_ **MS—**bone marrow suppression; **Integ—**_Stevens-Johnson;_ **Imm—**hypersensitivity; **Rep—**_teratogenic_ * avoid sun exposure

Answer 232

* SULFONAMIDE ANTIBIOTIC * for otitis media; UTI; STDs * inhibits folic acid synthesis * broad spectrum * causes **Neuro—**_photophobia;_ **GI/endo—**hepatotoxicity; n/v/d; **F & E—**_toxic nephrosis;_ **MS—**bone marrow suppression; **Integ—**_Stevens-Johnson;_ **Imm—**hypersensitivity; **Rep—**_teratogenic_ * avoid sun exposure

Answer 233

* ANTIMIGRAINE AGENT * for migraine * constricts cranial vessels * causes **Neuro—**dizziness; vertigo; **CV—**_hypertension; coronary artery vasospasm; angina_ * caution with liver & heart disease * works w/i 10-20 mins

Answer 234

* ANTIESTROGEN ANTINEOPLASTIC * for hormone sensitive tumors; breast cancer; prostate cancer * blocks substances essential for tumor growth * causes **Neuro—**_pain;_ **CV—**_stroke_; _PE_; vaginal bleeding; **GI/endo—**n/v/d; **F & E**—edema; **Integ—**rash * used with corticosteroids

Answer 235

* OXAZOLIDINONE ANTIBIOTIC * for resistant infections * inhibits protein synthesis * causes **Neuro—**h/a; dizziness; **CV—**_thrombocytopenia;_ **GI/endo—**_PMC_; n/v/d * no tyramine containing foods * no MAOIs (HTN crisis)

Answer 236

* LIPOGLYCOPEPTIDE ANTIBIOTIC * for severe G+ infections; MRSA * inhibits cell membranes * causes **Neuro—**ototoxicity; **F & E—**nephrotoxicity; **Integ—**_red man syndrome_ (fast infusion) * monitor peak & trough (narrow TR)

Answer 237

* ANTIVIRAL * for hepatitis B * blocks DNA replication * causes **Neuro—**h/a; asthenia; **GI/endo—**_fatal hepatomegaly_; nausea; **F & E—**_nephrotoxicity_; **Other—**_lactic acidosis_

Answer 238

* TETRACYCLINE ANTIBIOTIC * for typhus; cholera; Rocky Mtn spotted fever; Lyme; H. pylori; chlamydia; acne * inhibits protein synthesis * causes **GI/endo—**_permanent discoloration of teeth_ (children); n/v/d; **MS—**bone marrow suppression; **Integ—**rash; **Imm—**superinfection; **Rep**—_affects fetal bone/teeth dev_ * take iron & dairy 2 hours after taking * contraindicated for \<8yo

Answer 239

* ANTIPLATELET * for prevention of CVA, MI, DVT, etc * causes **Neuro—**h/a; dizziness; **CV**—_bleeding_, bruising; _thrombocytopenia;_ **GI/endo—**n/d; abd pain; **Integ—**rash * monitor for signs of bleeding

Answer 240

* ANTIPLATELET * for prevention of CVA, MI, DVT, etc * causes **Neuro—**h/a; dizziness; **CV**—_bleeding_, bruising; _thrombocytopenia;_ **GI/endo—**n/d; abd pain; **Integ—**rash * monitor for signs of bleeding

Answer 241

* ANTICHOLINERGIC * for daily COPD sx; COPD maintenance * dilates bronchioles * causes **Neuro—**nervousness; dizziness; h/a; **CV—**_palpitations;_ **GI/endo—**distress; nausea * use 3-4x/day * fewer side effects than PO anticholinergics

Answer 242

* URINARY TRACT ANTISPASMODIC * for UT spasms (cystitis, prostatitis, urethritis); dysuria; _incontinence;_ urgency; nocturia * blocks parasympathetic activity; suppresses overactivity * causes **Neuro**—drowsiness; dizziness; _blurred vision;_ **CV—**_tachycardia;_ **GI/endo—**dry mouth; nausea; **F & E**—_urinary hesitancy;_ **Integ**—↓ sweating * give water & hard candy for dry mouth * monitor intraocular pressure; I & O

Answer 243

* ANTICONVULSANT * for partial/focal seizures; migraines * blocks Na+ channels * causes **Neuro—**drowsiness; ataxia; **CV—**_heme disorders;_ **GI/endo—**_hepatitis_; n/v; **MS—**bone marrow suppression; **Integ—**Stevens Johnson; **Rep**—_teratogenic_ (cleft palate; spina bifida) * pregnancy category D

Answer 244

* LOOP DIURETIC * for HF; pulmonary edema; kidney disease; liver disease; HTN * acts on loop of Henle; inhibit Na+ and Cl- reabsorption * causes **Neuro—**dizziness; vertigo; _paresthesia_; _ototoxicity;_ **CV—**_dysrhythmias_ (hypokalemia); hypotension; **GI/endo—**_hyperglycemia_; n/v; **F & E—**_severe F & E losses; dehydration_; hyponatremia; hypokalemia; hypochloremia; _metabolic alkalosis_; **MS**—_↑ uric acid (gout)_ * monitor K+; glucose; sx dehydration; uric acid

Answer 245

* MAOI * for depression * inhibits monoamine oxidase; serotonin, dopamine, norepinerphrine, epinephrine rise * causes **Neuro—**_delirium_; CNS stim; _mania_; dizziness; vertigo; **CV—**_HTN crisis_; ortho hypotension; **GI/endo—**constipation; dry mouth; **MS—**_hyperreflexia_ * no foods containing tyramine * no vasoconstrictors; no cold medications

Answer 246

* POTASSIUM-SPARING DIURETIC * for edema r/t HF, cirrhosis, renal disease; hyperaldosteronism; HTN * acts on collecting duct & late distal tubules; Na+ excretion and K+ retention * causes **Neuro—**dizziness; vertigo; **GI/endo—**diarrhea; **F & E**—_hyperkalemia;_ **_Androgen effects_—**hirsutism; gynecomastia; irregular menses; deepening voice * monitor K+ & sx of hyperkalemia * caution with ACE inhibitors (hyperkalemia) * hyperkalemia—kayexalate

Answer 247

* SULFONAMIDE ANTIBIOTIC * for otitis media; UTI; STDs * inhibits folic acid synthesis * broad spectrum * causes **Neuro—**_photophobia;_ **GI/endo—**hepatotoxicity; n/v/d; **F & E—**_toxic nephrosis;_ **MS—**bone marrow suppression; **Integ—**_Stevens-Johnson;_ **Imm—**hypersensitivity; **Rep—**_teratogenic_ * avoid sun exposure

Answer 248

* URINARY TRACT ANTISPASMODIC * for UT spasms (cystitis, prostatitis, urethritis); dysuria; _incontinence;_ urgency; nocturia * blocks parasympathetic activity; suppresses overactivity * causes **Neuro**—drowsiness; dizziness; _blurred vision;_ **CV—**_tachycardia;_ **GI/endo—**dry mouth; nausea; **F & E**—_urinary hesitancy;_ **Integ**—↓ sweating * give water & hard candy for dry mouth * monitor intraocular pressure; I & O

Answer 249

* ANTIVIRAL * for herpes infection * lowers frequency of episodes; diminishes intensity * causes **Neuro—**h/a; vertigo; tremors; **GI/endo—**n/v; **Integ—**rash * caution with renal & hepatic disease

Answer 250

* VALPROATE * for seizures; migraines * ↑ GABA * causes **Neuro—**sedation; drowsiness; h/a; _tinnitus;_ **CV—**_prolonged bleeding time_; **GI/endo—**_pancreatitis_; hepatotoxicity; n/v/d; dyspepsia; **Rep—**_teratogenic_ * pregnancy category D & X

Answer 251

* ANGIOTENSIN RECEPTOR BLOCKER * for HTN * prevents angiotensin II from reaching receptors; causes vasodilation * causes **Neuro—**dizzyness; h/a; **CV**—_hypotension;_ **GI/endo—**diarrhea; abd pain

Answer 252

* LIPOGLYCOPEPTIDE ANTIBIOTIC * for severe G+ infections; MRSA * inhibits cell membranes * causes **Neuro—**ototoxicity; **F & E—**nephrotoxicity; **Integ—**_red man syndrome_ (fast infusion) * monitor peak & trough (narrow TR)

Answer 253

* ANTIDIURETIC * for diabetes insipidus (ADH deficiency) * ↑ water reabsorption; hemostatic—shortens clotting time; ↑ CO; peripheral vasoconstriction * causes **Neuro—**h/a; **CV—**_↑ BP;_ **GI/endo—**nausea; **F & E—**_fluid retention_; electrolyte imbalance; _hyponatremia_; _water intoxication;_ **Other**—facial flushing; reaction at injection site * monitor BP; I & O; electrolytes; thirst * caution with HTN

Answer 254

* SNRI * for depression * causes serotonin, norepinephrine, and epinephrine reuptake * causes **Neuro—**_suicidal ideation_ (younger pop); _serotonin syndrome;_ **CV—**_tachycardia_; _HTN;_ **GI/endo—**n/v; constipation; **F & E—**urinary retention; **Integ—**sweating; **Rep—**_ED_

Answer 255

* CALCIUM CHANNEL BLOCKER * for paroxysmal SVT; supreventricular tachycardia

Answer 256

* MITOTIC INHIBITOR/PLANT ALKALOID * for leukemia; Hodgkin lymphoma * blocks cell division * causes **Neuro—**_neurotoxicity_; peripheral _nerve damage_; ataxia; **MS—**muscle wasting; **Integ—**alopecia; **Imm—**_leukopenia_

Answer 257

* ANTICOAGULANT * for prevention of thromboembolism * prolongs bleeding time; prevents clots; inhibits hepatic synthesis of vit K & clotting factors * causes **CV**—_hemorrhage_; thrombocytopenia * monitor for signs of bleeding; PT/PTT/aPPT/INR * admin FFP for bleeding * eat vitamin K rich foods consistently * contraindicated in pregnancy * antidote—injectable vitamin K

Answer 258

* ANTIVIRAL * for HIV/AIDS * prevents viral replication * causes **Neuro—**h/a; **GI/endo—**_liver dysfunction_; n/v/d; **Imm—**_fever_; chills * take around the clock; do not miss a dose

Answer 259

* ANTIMIGRAINE AGENT * for migraine * constricts cranial vessels * causes **Neuro—**dizziness; vertigo; **CV—**_hypertension; coronary artery vasospasm; angina_ * caution with liver & heart disease * works w/i 10-20 mins

Answer 260

* SEDATIVE/HYPNOTIC * for insomnia * CNS depressant * causes **Neuro—**_depression_; _suicidal_ thoughts; severe _neuropsychiatric reaction_; hallucinations; _sensory distortion_; _sleepwalking;_ daytime sedation; confusion; amnesia; dizziness; **GI/endo—**_nocturnal eating_ * take before sleeping * fall risk * works in 7-27 mins

Answer 261

* ANTIHISTAMINE 2ND GEN * for allergy sx; hay fever; hives; itching; watery eyes; sneezing * causes **Neuro—**drowsiness; tiredness; _paradoxical excitation (children);_ **GI/endo—**dry mouth; stomach pain * fewer sx than diphenhydramine

Answer 262

* ANTIHISTAMINE 2ND GEN * for allergy sx; hay fever; hives; itching; watery eyes; sneezing * causes **Neuro—**drowsiness; tiredness; _paradoxical excitation (children);_ **GI/endo—**dry mouth; stomach pain * fewer sx than diphenhydramine

Answer 263

* ANTIHISTAMINE 2ND GEN * for allergy sx; hay fever; hives; itching; watery eyes; sneezing * causes **Neuro—**drowsiness; tiredness; _paradoxical excitation (children);_ **GI/endo—**dry mouth; stomach pain * fewer sx than diphenhydramine

Answer 264

* ANTIHISTAMINE 2ND GEN * for allergy sx; hay fever; hives; itching; watery eyes; sneezing * causes **Neuro—**drowsiness; tiredness; _paradoxical excitation (children);_ **GI/endo—**dry mouth; stomach pain * fewer sx than diphenhydramine