Meds Flashcards Preview

Pharmacology > Meds > Flashcards

Flashcards in Meds Deck (41)
Loading flashcards...
1

Mefanamic acid (Ponstel)

Category

MOA

SE

Category: NSAID Class: Fenamic acid

MOA: primary anti-inflammatory with some analgesics, antipyretic NON-cox selective

SE: nvd, ulcers, headaches, drowsiness, hematopoietic toxicity

2

Ibuprofen (Motrin, Advil) Category Max dose MOA Metabolism Excretion SE Other drug interactions? Why?

Category: NSAID class: profens Max dose = 3200mg MOA (generally considered to be cox1 selective except for naproxen) Metabolism: liver Excretion: kidneys (as inactive metabolites) SE: less GI than ASA, headache, dizziness, fluid retention edema Other drug interactions: highly bound to plasma proteins

3

COX-1 inhibition side affects are?

COX-1 inhibiton decreases protective cardiovascular effects, GI bleeding

4

Perixicam (Feldine) Meloxicam (Mobic) Cagtegory MOA Metabolized Excreted

Category: NSAID Class: Enolic acid (oxicam) derivatives MOA: higher cox2 selective Metabolized: liver Excreted: kidneys

5

Naproxen (aleve) Ketoprofin (Orudis) Category MOA Metabolism Excretion SE Other drug interactions? Why?

Category: NSAID Class: propionic acid/profens Max dose: 1000mg MOA: analgesic, antipyretic (naproxen more selective to cox2) Metabolism: liver Excretion: kidneys (as inactive metabolites) SE: less GI than ASA, headache, dizziness, fluid retention edema Other drug interactions: highly bound to plasma proteins

6

What are the considerations for NSAID use?

--age > 65 --use of anticoagulant therapy --hx GI bleed --Acute PUD --Concomitant use of glucocorticoids --renal failure --liver cirrhosis ---CHF, nephrotic syndrome ----HTN patients (NSAIDs block prostagandin synthesis at kidneys, decrease GFR which then increases blood volume and pressure)

7

Indomethacin Ketorolac (Toradol) Limits? Category MOA Metabolism Excretion SE

Category: NSAID Class: acetic acid ** only use toradol for 5 days MOA: indomethacin= cox1 selective, primarily anti-inflammatory Ketorolac= primary analgesic, but has anti-inflammaotry, antipyretic Metabolism:Toradol = liver Indomethacin Excretion:Torado = liver SE: Indomethacin = cns toxicity--> headaches to delusions to psychosis, thrombocytopenia) Toradol: inhibits platelet function

8

Phenytoin (Dilantin) Category MOA Metabolism SE CI

Category: anti-epileptic/anticonvulsant MOA: Na+ channel antagonist, slows seizure activity Characteristics: lipid soluble, highly protein bound, CYP inducer Metabolism: Liver SE: nystagmus, ataxia, cognitive impairment CI: hepatic disease, heart block, bradycardia

9

Vancomycin Category MOA Metabolism Excreted SE CI

Category: glycopeptide MOA: bacterial cell lysis Metabolism: NONE Excreted: kidneys, fecal if orally administered SE: redmans syndrom, ototoxicity, nephrotoxicity CI: renal disease

10

What are the side affects of NSAIDS?

--GI: n/v/d, heartburn, ulcers/bleeding --Photosensitivity --Renal: NA+/H2O retention, HTN, damaging with other nephrotoxic drugs --Platelet aggregation (interferes for 2-4 days) -- can cause acute kidney injury in : chronic kidney disease patients( decrease GFR), volumed depleted patients, CHF, nephrotic syndrome, cirrhosis, old age

11

Acetaminophen (Tylenol) Category MOA DOSE Absorbed Metabolized SE CI

Type: analgesic MOA: weak cox1/2 inhibitor (decreases pain) anti-pyretic, NO inflammatory effect Dose: max 4gm Absorbed: GI Metabolized: liver (relatively non-toxic) SE: liver toxicity, dizziness, disorientation, renal damage CI: ETOH abuse or with more than 2 drinks, liver disease, can decrease INR **drug of choice in treating minor, noninflammatory pain especially in pts at risk for GI bleeding

12

ASA (salicylic acid) Bayer, excedrin Category MOA Absorbed Metabolized Eliminated SE CI/toxic levels

Category: NSAID, analgesic Class: salicylates MOA: potent anti-inflammatory, antipyretic, analgesic, irreversibly inhibits cox1/2 and platelet aggregation, decreases risk of heart attack and stroke (cox1 selective) Absorption: sm. intestine, stomach Metabolized: liver to salicylic acid Eliminated: kidneys SE: gastric upset/ulcers, heartburn, asthma, rashes, renal toxicity, hepatotoxicity CI: hx of bleeding disorders, asthma, hypersensitivity to NSAIDS Toxic levels: metabolic acidosis, respiratory depression, cardiotoxicity, ototoxicity Reyes disease in children,

13

Celecoxib (Celebrex) Category MOA Metabolism Excretion

Category: NSAID MOA:COX-2 inhibitor, analgesic, antipyretic, anti-inflammatory, DO NOT inhibit platelet aggregation, minimal renal and CV side effects Less GI toxicity GOOD for treating arthritis short term Metabolized: liver Excreted: urine

14

What do prostaglandins do?

1. Activate inflammatory response

2. Elicitation of pain and fever

3. Contraction and relaxation of smooth muslce

4 .Inhibition of acid synthesis and increased secretion of protective mucus in the stomach

5. increased blood flow to the kidneys

15

Lorcarserin (Belvaq)

MOA ( dont worry about)

SE

CI

How long can pt use for? 

MOA: selective agonist of serotonin C2 receptors which decrease appetite

SE: HA, nausea, dizziness, nasopharyngitis, back pain

CI: pregnancy and other use of serotonin meds

can be habit forming

Can only be used for 3-4-6 months and usually weight comes back on 

16

Orlistate (Xenical, Alli)

MOA

SE

CI

How long can pt use?

MOA: lipase inhibitor, ihibits the aboroption of dietary fats

SE: oily spotting, flatus w/ discharge, fecal urgency, oily stools, increased defecation, fecal incontinence

Forces pts to eat low fat diet or get side effects

Can use long term

17

Phentermine (Adipex-P)

MOA

SE

CI

How long can pts use?

MOA: anorectic agent

amphetamine-like

SE: palpitation, tachycardia, increased BP, restlessness, euphoria, insomina, HA, diarrhea, impotence

18

What is Qsymia? When is it used and for how long?

Qsymia = phentermine (adipex-p) plus topiramate (non-convulsant)

used for weight loss and usually used alone and short term= generally 3 months

no addiction issues, no heart problems but NOT a first line med for weight loss

19

What are the indications for opiod use?

--acute post-op pain

--sever pain for limited duration

--chronic pain 

20

What are the MOA for opiods?

exert their effects through : mu1, mu2, delta and kappa receptors

inhibit excitatory ntm both pre and post synaptically

widely distributed

most profound analgesic effects mediated through mu receptoer in CNS (large # found in peria aquaductal grey matter and dorsal horn of spinal cord)

21

What are the endougenous opioids?

Beta-endorphins = mu

enkephalins = delta

dynorphins = kappa

 

22

What are the side effects of opiods?

N/V

delayed gastric emtying (constipation)

hypotension

brady

sedation

euphoria

resp depression

physical dependance

23

Morphine

Reasons used

SE

used for: severe pain, long acting forms for chronic pain

SE: hypotension if pushed too fast

24

Demerol (meperidine)

Used for

SE

Used for: severe pain

SE: same as morphine with hypotension

25

Methadone

used for

SE

Used for: treating opiod dependence and heroin withdrawal

more affinity for delta, less for mu = less SE

SE = hypo: glycemia, natremia, death

26

Oxycodone

Used for

Combinations?

Used for: moderate to severe pain

Combinations =

acetominaphen : percocet

aspirin : percodan

27

Besides oxycodone, what are other combination opiod meds and what are they called?

Hydrocodone/acetaminophen = vicoden

hydrocodone/ASA = lortab

codeine/acetaminophen = tylenol #3

28

Fentanyl

How potent is it? 

What are its uses?

100x more potent than morphine

used for: surgery, anesthesia, post-op pain

patches for chronic pain

29

Tramadol

(remember it isnt an anti-inflammatory)

what is it used for?

SE?

used for: mild to moderate pain and neuropathic pain = NOT good for chronic pain

SE: HA, dizziness, nausea, constipation

30

TCAs

Side effects:

CI

Avoid in patients with? 

Side effects: no shit, spit, see, pee

Anticholinergic, neurologic, cardiovascular, gastrointestinal

CI: pts with severe cardiac disease, pts with conduction disturbances

Avoid patients with sever GI dysfunction

 

31

What is Amitriptyline (Elavil)?

TCA -- most widley used 

used a lot for: prevention of migranes, shingles,

32

What is Doxepin (Sinequan)?

TCA

CI in acute angle glaucoma

SE: increased appetite, weight gain and impotence in men

33

What is Imipramine (Tofranil)?

TCA

34

What is Nortriptyline (Pamelor)?

TCA

35

What is Desipramine (Norpramin)?

TCA

HIGH risk of cardiac dysrhythmias

36

What is Gabapentin (Neurotonin)?

Used as first, second or third line?

SE? 

Remember not good at treating trigeminal neuralgia

Anticonvulsant

Calcium channel blocker

FIRST LINE 

SE: solmnolence, ataxia, N/D, dizziness, fatigue, mood swings

37

What is Pregabalin (Lyrica)?

MOA

Uses

SE

Anticonvulsant

MOA: same as gabapentin

Uses: peripheral neuropathy and fibromyalgia

SE: dizziness, blurred vision, weight gain, dry mouth, peripheral edema

38

What is Lamotrigine (Lamictal?)

SE

 

Anticonvulsant

SE: rash, dizziness, ataxia, N/V

39

What is Topiramate(Topamax)?

MOA

SE

 

Anticonvulsant

MOA: blocks voltage dependent sodium channels

SE: loss of apetite, weight loss, diarrhea, somnolence

40

What is carbamazepine (Tegretol)?

It is the drug of choice for trigeminal neuralgia

Drug interactions? Why?

Do you need to monitor? Why?

SE?

Anticonvulsant

Interacts with CP450, so will interact with drugs that are metabolized by the liver

Monitor because CAN affect liver and bone marrow so need CBS and LFTs if on long term

SE: dizziness, ataxia, liver toxicity, N/V, stevens johnson syndrome, rash

41

What is duloxatine (cybalta)? 

Used for?

SE?

Antidepressant--SNRI

Used: treating diabetic peripheral neuropathy, foun to work in chronic pain conditions such as fibromyalgia and chronic LBP

SE: dry mouth, fatigue, nausea, constipation, insomina

AVOID in pts with hepatic or severe renal disease