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PHARM 327 > Final Exam > Flashcards

Final Exam Flashcards

1
Q

Drug for Motion Sickness

A

Scopolamine: Prevents nausea stimuli at CTZ, decreases GI secretions, slows smooth muscle contraction

Adverse Effects: Anticholinergic, Impaired cognition

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2
Q

Dopamine Antagonists

A

promethazine (Phenergan): Blocks dopamine2 receptors

Adverse Effects: Anticholinergic effects, extrapyramidal reactions, drowsiness, photosensitivity

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3
Q

Serotonin Receptor Antagonists

A

Ondansetron (Zofran): Blocks serotonin receptors in the GI tract, CTZ, and the vomiting center

Adverse Effects: Headache, Diarrhea, Dizziness, Constipation, Fever,
Serotonin syndrome

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4
Q

Opioids Used for Diarrhea

A

loperamide (Imodium): Decreases intestinal motility; Decreases fluid secretion into the intestine.

Adverse Effects: Dizziness

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5
Q

Osmotic Laxatives

A

Sodium salts, Magnesium salts, Polyethylene glycol: Draws water into the intestinal lumen. Fecal mass softens and swells.

Adverse Effects: Dehydration, sodium retention.

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6
Q

Stimulant Laxatives

A

Bisacodyl (Dulcolax), Senna (Senokot): Stimulate intestinal motility and increase water in the intestine.

Adverse Effects: Cramping/nausea, Red/brown urine (Senna), Fluid/electrolyte imbalances.

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7
Q

Bulk-forming Laxatives

A

Psyllium (Metamucil):Similar to dietary fiber

Adverse Effects: Esophageal obstruction, Intestinal obstruction.

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8
Q

Surfactant Laxatives

A

Docusate (Colace): Alter surface tension of stool. Allows increased water to enter feces.

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9
Q

Histamine2-Receptor Antagonists

A

famotidine (Pepcid): Block H2 receptors. It decreases the volume of gastric juices and decreases ion concentration.

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10
Q

Proton Pump Inhibitors

A

Omeprazole (Prilosec), Pantoprazole (Protonix): Bind to the hydrogen-potassium ATPase enzyme system of the parietal cell. Inhibit the secretion of hydrochloric acid.

Adverse Effects: Interfere with the liver metabolism of other meds. Can potentially exacerbate zinc deficiency. Hypomagnesemia.

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11
Q

Other Antiulcer Drugs

A

Sucralfate (Carafate): Promotes ulcer healing.

Adverse Effects: Almost none; constipation.

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12
Q

Narrow-Spectrum Penicillins

A

Penicillin G: Effective against gram-positive and a few gram-negative bacteria.

Least toxic of all antibiotics; Few side effects, Allergic reactions.

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13
Q

Penicillinase-Resistant Penicillins

A

Methicillin: Effective against gram-positive bacteria

Treats: Endocarditis, Meningitis, Bacteremia, Skin, and respiratory infections.

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14
Q

Broad-Spectrum Penicillins

A

Amoxicillin: Same antimicrobial spectrum as Penicillin G + increased activity against certain gram-negative bacilli

Treats: Haemophilus influenzae, Escherichia coli, Salmonella

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15
Q

Penicillins (Combined with Beta-Lactamase Inhibitors)

A

Amoxicillin/clavulanic acid (Augmentin), Piperacillin/tazobactam (Zosyn): Beta-lactamases are enzymes produced by bacteria that break open the beta-lactam ring, inactivating the beta-lactam antibiotic.

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16
Q

Therapeutic Uses of Cephalosporins

A

First Generation: Cephalexin (Keflex), Cefazolin (Ancef).

Second Generation: Cefoxitin (Mefoxin)

Third Generation: Ceftriaxone (Rocephin)

Fourth Generation: Cefepime (Maxipime)

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17
Q

Glycopeptide

A

Vancomycin: Inhibits cell wall synthesis, Effective against gram-positive MRSA.

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18
Q

Tetracyclines

A

Bacteriostatic Inhibitor of Protein Synthesis. Inhibit protein synthesis. Prevents bacterial growth & replication. Does not cause outright death. Broad-spectrum antibiotics

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19
Q

Aminoglycosides

A

Gentamicin: Bactericidal Inhibitors of Protein Synthesis. Effects limited to gram-negative bacilli. Parenteral Therapy.

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20
Q

Fluoroquinolones

A

ciprofloxacin (Cipro), levofloxacin (Levaquin): Broad-spectrum agent, Inhibit bacterial DNA gyrase (the enzyme needed for DNA supercoiling)

Adverse Effects:
MILD; GI problems, Nausea, Vomiting, Diarrhea

CNS effects; Dizziness, Headache, Confusion

Tendon rupture; May cause Candida infections as a result of treatment

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21
Q

Sulfonamides

A

sulfamethoxazole with trimethoprim (Bactrim or Septra): First drugs available for systemic treatment of bacterial infections. Inhibit the bacterial synthesis of folic acid. Used for UTIs

Adverse Effects: Hypersensitivity Reactions, Hematologic Effects, Kernicterus, Renal Damage

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22
Q

Nitroimidazoles

A

Metronidazole (Flagyl): Disrupts DNA and protein syntheses in bacteria and protozoa, Bacteriocidal

Adverse Effects: Anaphylaxis, GI distress, Disulfiram-like reaction.

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23
Q

Drugs for Hypothyroidism

A

Levothyroxine (Synthroid): Synthetic preparation of thyroxine (T4). Conversion to T3.

Adverse Effects: Rare! Acute overdose = thyrotoxicosis may develop. Educate patient about s/sx of overtreatment. Symptom diary.

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24
Q

Drugs for Hyperthyroidism

A

Propylthiouracil (PTU); Methimazole (Tapazole): Inhibits production of new thyroid hormone. Inhibits the conversion of T4 to T3.

Adverse Effects: Agranulocytosis, Hypothyroidism, Acute Liver Injury

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25
Q

Types of Insulin

A

Rapid Acting: Insulin Lispro
Short Duration: Regular Insulin
Intermediate Duration: NPH Insulin
Long-acting: Insulin Glargine
Combination Insulin: Humulin 70/30

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26
Q

Inhalation of Insulin

A

Afreeza: Technosphere insulin-inhalation system. Fine powder of regular insulin inhaled by lungs. Replaces mealtime insulin.

Adverse Effects: Hypoglycemia, Decreased lung function, Increased risk of lung cancer, Cough/Sore Throat.

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27
Q

Oral Hypoglycemics

A

Sulfonylureas
Glinides
Biguanides- Metformin
SGLT2 Inhibitors-Gliflozins

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28
Q

Sulfonylureas

A

Glipizide (Glucotrol), Glyburide (DiaBeta): These medications are sencond generation. They work by promoting insulin release by the pancreas.

Adverse Effects: Hypoglycemia, Cardiovascular Toxicity.

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29
Q

Glinides

A

Repaglinide (Prandin): Stimulate pancreatic insulin release. They bind to the Glucagon Like Peptide-1 receptor and stimulate glucose-dependent insulin release from the pancreatic islets, as described above. They do not usually cause hypoglycemia

Adverse Effects: Hypoglycemia
Especially with liver dysfunction patients. Headache, Dizziness, Jitteriness, GI distress

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30
Q

Biguanides

A

Metformin (Glucophage): ○ Decrease hepatic production of glucose from stored glycogen. Use for type 2 diabetes.

Adverse Effects: Decreases appetite, Nausea/Diarrhea, Vitamin Deficiencies, and Lactic Acidosis.

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31
Q

SGLT2 Inhibitors (Gliflozins)

A

Empagliflozin (Jardiance): Decreases blood glucose by causing the kidneys to remove sugar from the body through urine.

Adverse Effects: Urinary tract infections, Increased urination, Elevated LDL, Increased risk of bone fractures, Should be held before surgery to decrease the risk of DKA.

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32
Q

GLP-1 Agonists

A

Exenatide (Byetta): Slows gastric emptying, and stimulates the glucose-dependent release of insulin. Inhibits postprandial release of glucagon, and suppresses appetite

Adverse Effects: Hypoglycemia, Pancreatitis, Rick of Thyroid C cell tumors

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33
Q

Hyperglycemics

A

Glucagon: Increase blood glucose by stimulating glycogenolysis

***IV/PO glucose is preferred for the treatment of hypoglycemia if available and able to deliver

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34
Q

Medications that Stimulate Alpha1 Receptors

A

Epinephrine
Norepinephrine
Dopamine

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35
Q

Medications that Stimulate Beta1 Receptors

A

Epinephrine
Norepinephrine
Dopamine
Dobutamine

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36
Q

Medications that stimulate Beta2

A

Albuterol

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37
Q

Adrenergic Agonists #1

A

Epinephrine: Stimulates Alpha1+2, Beta1+2. Restore cardiac function following cardiac arrest, and bronchodilation for asthmatics. Elevate blood pressure, and overcome AV block
Treatment of choice for anaphylactic shock (IM)

Adverse Effects: Hypertensive Crisis, Dysrhythmias, Angina Pectoris, Tissue necrosis with extravasation, Hyperglycemia

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38
Q

Adrenergic Agonists #2

A

Dopamine: Beta1; Alpha1. Receptor specificity. Used for shock, heart failure, and acute renal failure.

Adverse Effects: Tachycardia, Dysrhythmias, Anginal pain

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39
Q

Adrenergic Agonists #3

A

Dobutamine: Selective activation of beta1 receptors. Used for heart failure.

Adverse Effects: Tachycardia, Dysrhythmia, Angina

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40
Q

Anticholinergic Side Effects

A

Hot as a Hare
Dry as a bone
Blind as a bat
Red as a beet
Mad as a hatter

“Can’t see can’t pee, Can’t spit can’t shit”

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41
Q

The Five Rights to Medication Administration

A

Right patient
Right medications
Right dose
Right route
Right time

42
Q

Medication Interaction

A

Medication can interact with other medications, drugs, alcohol, food, and other drinks.

43
Q

Medication-induced Photosensitivity

A

Skin reaction by taking a medication that increases sensitivity to the sun while taking those particular medications.

44
Q

Idiosyncratic effect

A

Uncommon drug response resulting from a genetic predisposition

45
Q

Teratogenic

A

Drug-induced birth defects

46
Q

Carcinogenic

A

The ability of medication to cause cancer

47
Q

Complementary and Alternative Therapies

A

Herbal supplements. Supplements cannot be claimed to prevent, treat, or cure disease. Standardization remains a concern without full FDA regulation

48
Q

Commonly Used Herbal Supplements

A

Saw palmetto: Prostate disease, testosterone enhancement
Garlic: hypercholesterolemia, hypertension
Gingko biloba: Memory, cognition
Echinacea: immunostimulant
Ginseng: boosts energy, enhances physical and mental performance, treats erectile dysfunction, strengthens the immune response
Hawthorn: supportive treatment for angina, atherosclerosis, heart failure, angina, atherosclerosis, high blood pressure
Goldenseal: antiseptic qualities

49
Q

Adolescent Consideration for Medication Administration

A

Physical changes
Cognitive level and abilities
Social, reasoning, and decision-making skill development
Emotional development
Independence from parents
Self-care behaviors
Impact of chronic illness

50
Q

Pediatric Consideration for Medication Administration

A

Consider developmental and cognitive differences
Maintain safety while ensuring comfort
Family-centered, atraumatic care
Utilize, honesty, respect, explanations, least amount of restraint

51
Q

Older Adult Consideration for Medication Administration

A

Polypharmacy
Changes in metabolism
Adverse drug events
Adherence

52
Q

Anti-Inflammatory Medication Groups

A

Nonsteroidal anti-inflammatory drugs (NSAIDs)
Corticosteroids
Disease-modifying antirheumatic drugs (DMARDs)
Antigout drugs

53
Q

Acetylsalicylic Acid

A

Aspirin Non-selective anti-inflammatory. COX-1: Protects vs. stroke and heart attack.
COX-2: Decreases pain, inflammation & fever.

Adverse Effects: GI upset, increased bleeding, salicylism, Reye’s syndrome.

54
Q

Cyclooxygenase Inhibitors

A

Inhibition of COX-1:Protection against MI, stroke, Gastric erosion, Bleeding, and Renal impairment

Inhibition of COX-2: Suppression of inflammation, Alleviation of pain, Fever reduction, Renal impairment, and Promotion of MI and stroke

55
Q

Ibuprofen

A

Non-selective cox inhibitor, used to treat mild to moderate pain.

Adverse Effects: Headaches, GI bleeding, GI upset, Steven-Johnson Syndrome

56
Q

Ketorolac

A

Toradol: non-selective cox inhibitor, used to treat short-term moderate to severe breakthrough pain.

Adverse Effects: Drowsiness, headaches, GI bleeding, SJS, and Renal failure

57
Q

Naproxen

A

Naprosyn: non-selective cox inhibitor, used to treat mild to moderate pain. It has a longer half-life and is a OTC medication

58
Q

NSAIDs

A

Non
Steroidal
Anti
Inflammatory
Drugs

59
Q

Celecoxib

A

Celebrex: Slective Cox-2 inhibitor, used for pain from arthritis and suppresses inflammation.

Adverse Effects: Hypertension, Peripheral edema, Increased liver enzymes, GI distress

60
Q

Corticosteroids

A

Prednisone: Controla inflammation by suppressing or preventing many of the components of the inflammatory process at the injured site

Adverse Effects: Hyperglycemia, Abnormal fat deposits, Adrenal insufficiency, Osteoporosis, Infection, Glucose Intolerance, Cataracts/Glaucoma

61
Q

DMARDs

A

Disease
Modifying
Antirheumatic
Drugs

62
Q

Acetaminophen

A

Tylenol: Inhibits prostaglandin synthesis, used to treat muscular aches, pain, and fever

Toxic Effect (overdose): Hepatotoxicity, renal failure, Blood dyscrasias, hearing loss, acetylcysteine (antidote)

63
Q

Opioid Agonists

A

Morphine

Fentanyl citrate (Duragesic)

Hydromorphone (Dilaudid): Less specific pharmacokinetics but similar to morphine.

Hydrocodone: mixed with acetaminophen or ibuprofen.

Oxycodone: combined or alone for
faster release. Similar pharmacodynamics to hydrocodone.

64
Q

Adverse Effects of Opioids

A

Respiratory Depression
Constipation
Orthostatic Hypotension
Urinary Retention
Nausea
Elevation of Intracranial Pressure
Sedation
Impairment of mental or physical abilities needed to perform potentially hazardous activities

65
Q

Opioid Antagonists

A

Naloxone: Blocks receptors and displaces any present opioid.

Adverse Effects: Sweating, tachycardia, Hypo/hypertension, Nausea, vomiting, Reversal of analgesia

66
Q

Nitroglycerin #1

A

Nitrates: Improves the balance of myocardial oxygen supply and demand. Leads to: Venous vasodilation, Coronary vasodilation, Arterial vasodilation.

Adverse Effects: Headache, Orthostatic Hypotension

67
Q

Nitroglycerin #2

A

Nitrostate: Same as Nitrates but is given sublingual and has an extensive first-pass effect

68
Q

Nitroglycerin #3

A

Ntg (Nitro-dur) Transdmeral: Same as Nitrates but it is a patch you can place on the skin

69
Q

HMG CoA Reductase Inhibitors

A

Statins: Inhibit the enzyme HMG CoA reductase in cholesterol biosynthesis. Decreases LDL, VLDL, & triglycerides. Promote plaque stability and reduce the risk of thrombosis

Adverse Effects: Headache, fatigue, GI distress, abdominal pain, Hepatotoxicity, Cataracts, hyperglycemia, Rhabdomyolysis, muscle cramps.

70
Q

Bile-Acid Sequestrants

A

Cholestyramine (Questran); Colesevelam (Welchol): Reduce LDL cholesterol levels by binding with bile acids in the intestine. Often used as an adjunct to statin.

Side Effects: Anorexia, nausea, vomiting, Cramping, steatorrhea - fatty stool, GI bleeding/obstruction
Folate deficiency.

71
Q

Fibric Acid

A

Gemfibrozil (Lopid): Most effective for lowering VLDL and triglycerides.

Adverse Effects: GI upset, rashes, gallstones, dizziness, blurred vision.

72
Q

Niacin

A

Nicotinic Acid: Reduces VLDL, LDL. Most effective at increasing HDL.

Side Effects: Dizziness, headache, Hypotension, weakness, GI distress, liver damage, Hyperglycemia, hyperuricemia, FLUSHING

73
Q

Cholesterol Absorption Inhibitor

A

Ezetimibe (Zetia): Acts on the cells in the small intestine to inhibit cholesterol absorption.

Side Effects: Fatigue, myalgia, arthralgia, Diarrhea, cholelithiasis.

74
Q

Heparin

A

Prevents thrombosis associated with PE, MI, unstable angina, prosthetic heart valves, and DVT. Inhibits thrombin, preventing fibrinogen to fibrin. Given SubQ or IV.

75
Q

Low-Molecular-Weight Heparin

A

Enoxaparin (Lovenox): Inactivates Factor Xa. Prevent venous thromboembolism – used prophylactically for DVT and acute PE. Lower risk of bleeding

76
Q

Warfarin

A

Coumadin: Prevents thromboembolic conditions – thrombophlebitis, PE, embolism formation from Atrial Fibrillation. Inhibits hepatic synthesis of vitamin K, affecting clotting factors II, VII, IX & X

Adverse Effects: Hemorrhage, Headache, GI distress, Alopecia, Weakness, Priapism.

77
Q

Direct Thrombin Inhibitors

A

dabigatran (Pradaxa): Prevention of blood clots and strokes. Decrease risk of DVT/PE. Higher rates of GI bleeding (compared with Coumadin). More effective for stroke prevention

Antidote: idarucizumab (Praxbind)

78
Q

Selective Factor Xa Inhibitors

A

Apixaban (Eliquis), Rivaroxaban (Xarelto): Non-valvular atrial fibrillation. Treatment of DVT and PE. Reduce the risk of recurrent DVT and PE.

Adverse Reactions: Blood thinning effects are quickly gained and lost (within 24 hours). The risk for GI bleed is HIGHER than Coumadin.

79
Q

Aspirin

A

Can also be used for suppressing platelet aggregation. Inhibits cyclooxygenase (COX enzyme)

80
Q

Clopidogrel

A

Plavix: Similar to aspirin, generally well tolerated

81
Q

Thrombolytic Drugs

A

Alteplase or Tissue plasminogen activator (tPA) & Tenecteplase (TNK tPA): Converts plasminogen to plasmin, which destroys the fibrin in the blood clot – Clot Buster! Used for PE, DVT, Thrombotic Strokes, Arterial Occlusion

Adverse Effects: Intracranial bleeding, Hemorrhage, Anaphylaxis, Bleeding, Hematoma

82
Q

Antihistamines

A

First Generation:Diphenhydramine (Benadryl)

Second Generation: Loratadine (Claritin)

83
Q

Decongestants

A

Oxymetazoline (Afrin), Pseudoephedrine (Sudafed): Treat nasal congestion caused by allergic rhinitis, and nasal mucosa inflammation.

Side Effects: CNS excitation: Restlessness, irritability, anxiety, insomnia, Cardiovascular effects: Widespread vasoconstriction, Drowsiness, Dizziness, Rebound congestion, Abuse; Effects similar to amphetamine.

84
Q

Combination

A

Montelukast (Singulair): Antihistamine/Sympathomimetics

85
Q

Intranasal Glucocosrticoids

A

Fluticasone (Flonase): Decrease rhinorrhea (runny nose), sneezing, and congestion through anti-inflammatory action

Side effects: Headache, nasal irritation, pharyngitis, fatigue, insomnia, candidiasis.

86
Q

Antitussives

A

Opioid: codeine
Non-opioid: dextromethorphan
Acts on the cough-control center of the medulla

Side Effects: Dizziness, drowsiness, confusion, fatigue, ataxia, nausea, vomiting, restlessness

87
Q

Expectorants

A

Guaifenesin (Mucinex): Loosens bronchial secretions by reducing the surface tension of secretions, and allows elimination by coughing.

Side Effects: Drowsiness, dizziness, headache, nausea.

88
Q

Bronchodilators: Sympathomimetics

A

Epinephrine: Causes bronchodilation, restores circulation, and increases airway patency.

Side Effects: Dizziness, nervousness, tremors, hypertension, angina, palpitations, tachycardia, dysrhythmias, restlessness.

89
Q

Selective Beta-Agonists

A

Albuterol: Causes bronchodilation and has a rapid onset of action. Longer duration of action.

Side Effects: Headache, rhinitis, excitability, tremors, bronchospasm, palpitations, tachycardia, hyperglycemia.

90
Q

Anticholinergics

A

Tiotropium (Spiriva): Maintenance treatment of bronchospasms associated with COPD

Ipratropium (Atrovent): Asthma

DuoNeb: Albuterol and anticholinergics

91
Q

Methylxanthines

A

Methylxanthine derivatives (Theophylline): Relaxes smooth muscle of bronchi and bronchioles increasing cAMP and promoting bronchodilator. Used for Asthma

92
Q

Leukotriene Receptor Antagonists

A

montelukast (Singulair): Reduce inflammatory process and decrease bronchoconstriction. Used for Asthma, prophylaxis of exercise-induced bronchospasm

Side Effects: distress, depression, weakness, infection

93
Q

Glucocorticoids (Steroids)

A

Prednisone, Solumedrol: Anti-inflammatory effect.

Side Effects: Dry mouth, throat irritation, hoarseness, thrush (MDI), Immune suppression, Headache, euphoria, confusion, depression, Hyperglycemia, GI distress, hypertension, insomnia, Electrolyte imbalance, fluid retention, diaphoresis, Osteoporosis, psychosis, superinfections , Menstrual irregularities

94
Q

Cromolyn

A

Action: Inhibit the release of histamine and leukotrienes from the mast cell.

Use: Bronchial asthma prophylaxis

Common side effects: Cough, postnasal drip

Adverse effect: Rebound bronchospasm

95
Q

Mild Intermittent Asthma

A

Treated on PRN basis. Long-term control meds not needed. Beta2 agonist manages occasional attacks. If Beta2 more than twice/week, move up.

96
Q

Mild Persistent Asthma

A

Combination of long-term control meds plus quick relief. Daily inhalation of anti-inflammatory. If using Beta2 every day, move up

97
Q

Moderate Persistent Asthma

A

Inhaled glucocorticoid - low dose. Add long-acting beta2 agonist (Serevent). Better control & less systemic effects. If still using beta2 agonist every day, move up.

98
Q

Severe Persistent Asthma

A

Daily inhalation of high-dose glucocorticoid, plus long-acting beta2 agonist.

99
Q

Severe Asthma Exacerbations

A

Relieve obstruction and hypoxemia. Normalize lung function. Repetitive inhalation of beta2 agonist. Give oxygen to keep oxygen saturation up. Oral glucocorticoids x 1 week after discharge.

100
Q

Am I going to pass this Final

A

YES!!!

PHARM 327 (2 decks)

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