Meds Post Exam III Flashcards Preview

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Flashcards in Meds Post Exam III Deck (23):
1

Morphine

Class: Pure Opiod Agonists

Action: Acts on the mu receptors and to a lesser degree the kappa receptors to produce analgesia, respiratory depression, euphoria, sedation

AE: respiratory depression, constipation, orthostatic hypotension, urinary retention

2

Naloxone

Class:

Action:

AE:

3


Alendronate

AKA Fosamax
Class: Bisphosphonates

Action: *decreases bone loss!
Decrease osteoclast activity, causes osteoclast apoptosis, inhibits bone resorption

AE: esophagitis, musculoskeletal pain, ocular inflammation, osteonecrosis of the jaw, hyperparathyroidism in Paget’s disease
*-admin in morning with lots of water, empty stomach before breakfast; do not eat anything 30-60 minutes after and stay upright

4


Methotrexate

Class: Non-biologic Disease Modifying Antirheumatic Drugs (DMARDs)

Action: Treatment for rheumatoid arthritis- decrease B and T lymphocytes

AE: hepatic fibrosis, bone marrow supresion, GI ulceration

5


Levadopa+Carbidopa

Class: Dopamine precursor

Action: -Increases synthesis of DA in striatum; enters brain through active transport, once in brain update into few dopaminergic nerve terminals that remain, only small amount reaches brain

AE: N/V, dyskinesias (about 80% of pts develop involuntary movements within the first year), cardiovascular effects (postural hypotension, increase salt and water intake), psychosis, darken sweat and urine

respond quickly but decrease over time, drug interactions!

6

Ropinirole

Class: Dopamine agonist; highly selective for dopamine (D2 and D3) receptors

Action: -can be used early on in PD diagnosis as monotherapy or adjunct to levodopacarbidopa


AE: nausea, dizziness, somnolence, hallucinations

7

Seligiline

Class: MAOB-inhibitor

Action: *modest benefits, can reduce “wearing off” effect of levodopa+c
-selective and irreversible inhibition of MAO-B

AE: hypertensive crisis *drug interactions!

8

Donepezil

Class: Acteylcholinersterase Inhibitors

Action: Provide modest improvements in cognition, behavior, and function by preventing breakdown of ACh by AChE for those with mild, mod, and severe AD

AE: N/V/D, dyspepsia *if bad, stop therapy and reassess, dizziness, headache, bronchoconstriction, symptomatic bradycardia
*anticholinergic!

9

Memantine

Class: NMDA antagonist

Action: Modulates effect of glutamate (major excitatory CNS transmitter)

AE: dizziness, headache, confusion, constipation
*drug interactions, really excreted

10

Ranitidine

Zantac
Class: H2 receptor antagonist

Action: Supresses
the secretion of gastric acid by selective blocking H2 receptors in parietal cells lining stomach

AE: caution in preg
-multiple drug interactions (CYP450)
-doses need to be adjusted in renal insufficiency

11

Omeprozole

Prilosec
Class: Proton pump inhibitor

Action: Irreversible inhibits H+, K+, ATPase (proton pump), blocks gastrin production

AE: Drug interaction w CYP2C19- Clopidogrel/Plavix
Long term use increases risk of osteoporosis (decreased Ca absorption)

12

Ondansetron

Zoran! v effective for chemo induced vomiting
Class: serotonin antagonist

Action: Blocks 5HT3 receptors in CTZ & afferent vagal neurons in the upper GI tract

AE: QTC prolongation, HA, dizziness, lightheadedness

13

Promethazine

Phenergan
Class: phenothiazin

Action: Blocks dopamine receptors in CTZ

AE: respiratory depression, sedation, local tissue injury w extravasation, EPS

14

Metoclopramide

Reglan

Class: Prokinetic/Dopamine Antagonists

Action: Controls N/V by blocking dopamine and serotonin receptors
-augments action of acetylcholine, which increases GI motility
-good for gastroparesis

AE: contraindicated in clinical w GI perforation, bleeding or obstruction, can cause diarrhea and tardive dyskinesia (EPS)

15

Psyllium

Class: Bulk forming laxatives

Action: Function similar to dietary fiber: swell w water to form a gel to soften fecal mass and increase mass
-48-72 hours for effect


Minimal AE (maybe esophageal obstruction)

preferred treatment for temporary treatment of constipation (diverticulitis and IBS)

16

Docusate

Colace
Class: Surfactatnt laxatives

Action: Alter stool consistency by lowering surface tension- facilitates penetration of water into feces
-stimulate intestinal motility, increase quantity of water and elec in intestinal lumen

*widely used and abused

17

Bisacodyl

Dulcolax
Class: Stimulant laxatives

Action: Selective action on the nerve plexus of intestinal smooth muscle leading to enhanced motility


AE: harsh cramping, castor oil (pregnancy category X)

*enteric coated; ingestion of oral meds should be avoided within 1-2 hours

18

Lactulose

Class: Osmotic laxative; -semisynthetic disaccharide
(galactose and fructose)

Action: Metabolized by colonic bacteria to lactic, formic, and acetic acids
-also used for hepatic encephalopathy
-acids exert mild osmotic action
-effect in 1-3 days

AE: sig flatulence and cramping

19

Diphenhydramine

Class: First Generation Antihistamine
use for allergic runs, sleep, motion sickness, common cold

Action: antihistamine; H1 blocker

AE: sedation, more readily crosses BBB, dry mouth, constipation, CNS, dizziness, incoordination, confusion, fatigue, CNS stimulation, resp depression, severe local tissue injury

*injectable, oral, topical
Adult dose= 6.25-50 mg IV/PO Q4/6 hrs PRN

20

Cetirizine

Class: Second Generation Antihistamine
*non-sedating

Action: AntiHistamine H1 blocker

AE:

21

Prednisone

Class: Glucocorticoid

Action: Interrupt inflammatory process via: -inhibit synthesis of mediators (i.e. prostaglandins, leuks, histamines)
-suppress infiltration of phagocytes
-suppress proliferation of lymphocytes

AE: adrenal insufficiency (you will be overly stressed, so you will lack the stress response once you actually get stressed), osteoporosis, infection, glucose intolerance, myopathy, fluid and electrolyte abnormalities, growth retardation, psychological disturbances, cataracts and glaucoma, peptic ulcer disease

*do not take NSAIDs with this or anticoagulants
*do not stop abruptly, watch for thrush

22

Methylprednisone

Class: Glucocorticoid

Action: Interrupt inflammatory process via: -inhibit synthesis of mediators (i.e. prostaglandins, leuks, histamines)
-suppress infiltration of phagocytes
-suppress proliferation of lymphocytes

AE: adrenal insufficiency (you will be overly stressed, so you will lack the stress response once you actually get stressed), osteoporosis, infection, glucose intolerance, myopathy, fluid and electrolyte abnormalities, growth retardation, psychological disturbances, cataracts and glaucoma, peptic ulcer disease
*same precautions as prednisone

23

Epinephrine IM

Class: Sympathomimetic (Adrenergic agent)

Action: increases BP, HR, air movement via stimulating B1, B2, alpha receptors (alpha stimulates periphery, B1 heart, B2 lungs)

AE: HTN, dysrhythmias, angina, necrosis, hyperglycemia (activates beta receptors), 1:1000, 1:10,000, wheezing, SOB

SYRINGE OF EPI ONLY GOES INTO A PATIENTS IV IF THEY ARE DEAD. IM or SQ if they are alive (1:1000)