Medications- Exam 2 Flashcards Preview

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Flashcards in Medications- Exam 2 Deck (33):
1

Nitroglycerin

*Eventually converted to nitric oxide, leads to vasodilation

Class: Antianginal agent


Action: Dilates veins and decrease venous return (preload) which decreases oxygen demand


AE: Phosphodiesterase Type 5 inhibitor; tolerance (tachyphylaxis)- depletion of sulfhydryl groups
-can’t convert nitroglycerin to nitric oxide

2

Aspirin

Class: Antiplatelet agent

Action: Targets TXA2; which is produced by activated platelets and stimulates activation of new platelets and platelet aggregation

AE: GI bleeding, bleeding, renal impairment, tinnitus, salicylate toxicity (renal failure, AMS, resp alkalosis)

*active metabolite and irreversible inhibition

3


Clopidogrel

Class: Antiplatelet agent

Action: PG2 Y12 receptor antagonist (antiplatelet agent); prevents ADP stimulated platelet aggregation

AE: -irreversible antiplatelet effect
-bleeding, TTP, drug interactions with proton pump inhibitors

*pro-drug

4

Atorvastatin

Class: Hyperlipidemia treatment

Action: -CoA reductase inhibitor (rate limiting step enzyme in cholesterol biosynthesis)
Reduces LDL/TG, increases HDL

AE: hepatotoxicity, pregnancy category X, myopathy/rhabdo

5


NIacin

Class: Hyperlipidemia treatment

Action: Reduces LDL and TG and raises HDL

AE: skin lfushing and itching, hepatotoxicity, increased uric acid, hyperglycemia
*titrate slowly

6

******Alteplase

Class: Fibrinolytic agent

Action: Tissue plasminogen activator (used for STEMI, stroke, PE, restore patency to catheters)



7


Atropine

Class: Muscarinic antagonist

Action: Blocks Ach binding to muscarinic receptor
-used to treat symptomatic bradycardia, decrease secretions, use to dilate pupils

AE: tachycardia, drying, constipation

8


Procainamide

Class IA; Na channel blocker anti arrhythmic

Action: slows cardiac conduction velocity via blockade; delays repolarization (used for SVT, VT, A flutter, Afib)

AE: systemic lupus, fever, painful and swollen joints, butterfly rash on face, neutropenia and thrombocytopenia, cardiotoxicity (widening of QRS and prolonged QT and PR intervals), hypotension

9

Lidocaine

Class IB sodium channel blocker

Action: Slows cardiac conduction velocity via blockade; decrease electrical conduction, increase rate of repol, decrease automaticity

AE: short term use for ventricular dysthythmias
-AE: CNS- drowsines, AMS, paresthesias, seizures, hypotension, CV collapse

*first pass effect when given orally

10

Propafenone

Class 1C sodium channel blocker

Action: Slows cardiac conduction velocity via blockade; used for SVT
-decrease conduction velocity in atria, ventricles, Hi-Purkinje system


-AE: bradycardia, heart failure, dizziness, weakness, hypotension, bronchospasm

11


Propranolol

Class II agents- beta blockers

Action: Beta blocker- prevents SNS stimulation of heart (decreased HR, decreased auto through SA node)
-used for Afib, A flutter, paroxysmal SVT, HTN, angina, PVCs

AE: bronchoconstriction, decrease in blood pressure due to smooth muscle relaxation, bizzare dreams
-decreases formation of T3/T4

12

Amiodarone

Class III; prolong action potential and prolong refractory period

Action: prolongs the action potential and refractory period due to K channel blockade
-used for atrial and ventricular dysrhythmias

AE: pulmonary fibrosis, cardiac sinus bradycardia, decreased contractility, hepatotoxicity, ophthalmic, dermatologic
oral and IV; CP450 DRUG INTERACTIONS!

13


Adenosine

Class: Antiarrhythmic; naturally occurring nucleotide

Action: inhibits cAMP induced calcium influx; suppresses calcium dependent action potentials in the SA and AV nodes
-used to treat supra ventricular tachycardia

AE: AE: sinus bradycardia, dyspnea, hypotension, facial flushing, chest discomfort
*IV only, pt might flatline!

14


Verapamil

Class IV; blocks Ca channels

Action: prolongs cardiac conduction, depresses depolarization and decreases O2 demand of heart by blocking Ca channels
-decrease force, rate, slows conduction

AE- bradycardia, hypotension, heart failure, constipation, peripheral edema
CYP450 interactions

15

Furosemide

Class: Loop diuretic; significant diuresis

*works even with low GFR
AE: hypokalemia, hypotension

16


Spironolactone

Class: Potassium sparing diuretic; minimal diuresis

AE: hyperkalemia,gynocamastia in men
*can be used to prevent hypokalemia w loop diuretics

17


lisinopril

Class: ACE inhibitor

Action: Arteriolar dilation (afterload reduction), venous dilation (reduces preload)
-suppresses aldosterone release

AE: angioedema, hyperkalemia, cough
*cornerstone of therapy, decreased mortality, improved function

18


losartan

Class: Angiotensin II Receptor Blocker

Action: improves LV EF, increases exercise tolerance, enhances QOL

AE: hyperkalemia, less angioedema *less cardiac remodeling effect vs. ACE I

19

metoprolol

Class: Beta Blocker

Action for heart failure: Protecting heart from excessive sympathetic stimulation and protect against dysrythmia
-improve LVEF, increase exercise tolerance, slows progression of HF


AE: bradycardia, orthostatic hypotension, fluid retention, fatigue

20

digoxin

Class: Cardiac glycoside

Action: Positive ionotrope (inhibits Na-K-ATPase pump), increases cardiac output, alters electrical activity of the heart, favorable effect on neurohormonal systems, reduces HF systems)

AE: AE: cardiac dysrhythmias (complicated but can be exacerbated by hypokalemia and elevated digoxin levels)
-anorexia, nausea, vomiting, visual disturbances

21

Fluconazole

Class: Antifungal

Action: Inhibits fungal C P450, enzyme responsible for sterol synthesis (cell wall weakness)
*used for systemic mycoses

22

Nystatin

Class: Antifungal


-admin orally or topically
(no sig absorption from oral route)

23

Isoniazid

Class: Anti TB medication

Action: Exact MOA is unknown but thought to inhibit DNA synthesis for proteins neeed for cell wall; treat active and latent TB

AE: Peripheral neuropathy, hepatitis, hyperglycemia
*signs and symptoms of liver impairment

24

Rifampin

Class: Anti TB medication

Action: Inhibits DNA-dependent RNA polymerase activity in susceptible bacterial cells


AE: flu-like sx, N/V/D, anorexia, hepatitis, thrombocytopenia, orange urine!
*increases elimination of other drugs

25


Pyrazinamide

Class: Anti TB medication

Action: Unknown MOA

AE: hepatotoxicity, hyperuricemia (increase in uric acid so gout), GI distress, rash, arthralgias

26


Ethambutol

Class: Anti TB medication

Action: unknown

AE: GI distress and possible optic neuritis

27


Acyclovir

Class: Antiviral Agents

Action: suppresses synthesis of viral DNA


AE: IV phlebitis, reversible nephrotoxicity (deposits in renal tubules), infuse slowly and hydrate during infusion and for 2 hours post
*give fluid load when IV admin

28


Oseltamivir

Class: Antiviral agent
*tamiflu!

Action: -Neuramidase inhibitor; prevents viral particles from budding off from the cytoplasmic membrane of infected host cells= stops viral spread

AE: nausea, vom, rare neuropsychiatric effects (delirium in younger pts)

29


Efavirenz

Class: Non-Nucleotide Reverse Transcriptase Inhibitors (NNRTIs)

Action: nactivates reverse transcriptates
-often used to prevent med resistance


AE: rash, HA, flu-like sx, fatigue, hepatotoxicity, CNS sx

30


Zidovudine

Class: Nucleoside Analouge Reverse Transcriptase Inhibitors (NRTIs)

Action: Prevents replication by providing faulty proteins for replication, inhibiting DNA synthesis and viral replication


AE: active metabolite is just as toxic to human DNA polymerase as it is for viral reverse transcriptase (bone marrow suppression)
-N/V/D

31


Ritonavir

Class: Protease inhibitor

Action: Alter and inactivates the virus inhibiting enzyme needed for HIV replication

AE: bone loss/osteoporosis, hyperglycemia/diabetes, hypersensitivity (rash), N/V, elevated serum lipids, thrombocytopenia, leukopenia

32

Raltegravir

Class: Integrase Inhibitor (INSTI)

Action: Inhibits integrase enzymes (catalyzes the process of putting HIV DNA into human DNA)

AE: HA, insomnia, skin rash, hepatotoxicity

33


Maraviroc

Class: CCR5 antagonist

Action: Prevets HIV from entering lymphocytes by binding to CCR5 on cell membrane

AE: skin rash, cough, upper resp tract infections, dizziness, orthostatic hypotension, hepatotoxicity, pseudomembranous colitis