Pharm final

Helpfulness: 0
Set Details Share
created 7 years ago by jenkarmata
205 views
Block II Spring 2014 Central AZ College
updated 7 years ago by jenkarmata
show moreless
Page to share:
Embed this setcancel
COPY
code changes based on your size selection
Size:
X
Show:
1

- Beta adrenergic blocking agent
* Used to reduce IOP as they reduce production of
aqueous humor.
* Used for open angle glaucoma or ocular HTN
S/E= Irritation & lacrimation
Adverse= Systemic bradycardia, dysrhythmias, hypotension, bronchospasms.
~ NO BLURRED OR DIM VISION & NIGHT BLINDNESS AFTER
ADMINISTRATION. ~

Timolol (Timoptic)

2

-Sympathomimetic= pupil dilator, increased outflow of aqueous humor, vasoconstriction, and decrease formation of aqueous humor.
* Used for open angle glaucoma
S/S= light sensitivity, irritation & lacrimation.
Adverse- Systemic effects, tachycardia,
dysrhythmias, HTN, diaphoresis & trembling
* Use with caution in patients w/HTN, DM, hyperthyroidism and heart disease, arteriosclerosis, and asthma.

Alpha Adrenergic Ophthalmic Agents

3

Central acting skeletal muscle relaxant= Works on the spinal cord.
* used for MS, SCI, CP (Intrathecal- in spine) &
other spinal cord diseases
** Do not give for Parkinson, Stroke or Rheumatic
disorders.
S/E= nausea, fatigue, HA, drowsiness, dizziness

Baclofen (Lioresal, Kemstro)

4

* Bone marrow stimulant (Human granulocyte colony-
stimulating factor (G-CSF).
** Stimulates the production of WBC
- used to reduce neutropenia after bone marrow
transplant, pt.'s in chemo & treat leukemia

Filgrastim (Neupogen)

5

Direct acting muscle relaxant. Acts directly on
skeletal muscle (limb muscle for movement).
- Produces gen. weakness, decreases contractions,
reflexes, stiffness & spasticity.
* Used for cerebral palsy, MS, SCI & stroke
syndrome & Neuroleptic malignant syndrome.
Adverse: photosensitivity, hepatotoxicity
*Will not have therapeutic effects after 1 week*
~ Do not take along w/CNS depressants & don't DC
abruptly. ~

Dantrolene (Dantrium)

6

Neuroleptic malignant syndrome

A life-threatening neurological disorder most often caused by an adverse reaction to neuroleptic or antipsychotic drugs.

7

Uterine smooth muscle stimulant
Promotes uterine contractions. Active labor!
* Used to control uterine atony & hemorrhage post-
partum.
Adverse= fetal distress, HTN, hypotension, water intoxication, dehydration, hemorrhage.

Oxytocin (Pitocin)

8

Oxytocin (Pitocin): Nursing considerations

1. Obtain baseline vitals
2. Contractions > 90sec-> reduce rate or DC.

9

Uterine relaxant used to inhibit premature labor. Also used for seizures r/t preeclampsia or eclampsia.
Toxicity= feeling hot, thirsty & diaphoretic
-- Use caution when giving to renal pt.'s.
Adverse= Depressed reflexes, confusion

Magnesium sulfate

10

Magnesium sulfate antidote

Calcium gluconate

11

Oxytocin (Pitocin)

Promotes uterine contractions & labor may be initiated.

12

Magnesium sulfate

Used to inhibit premature labor & also for seizures r/t to preeclampsia.

* Toxicity= hot and thirsty, diaphoretic

13

Macrolide antibiotic, prophylactic for gonorrhea in eyes (newborns), also good for C. trachomatis.
* Given in conjunctiva
PE: Teach pt. redness in eyes is temporary and that conjunctiva inflammation is expected.

Erythromycin ophthalmic ointment (Ilotycin)

14

Centrally acting muscle relaxant recommended only for short-term treatment (2-3wks) of painful musculoskeletal conditions; VERY SEDATING.

cyclobenzaprine (Flexeril)

15

Osmotic agent; used IV when oral is unacceptable.
When used preoperatively, admin. 60-90min. before surgery.

Mannitol (Osmitrol)

16

Mannitol (Osmitrol)

1. Use an in-line filter because it has a tendency to crystallize.
2. If crystallized give a warm bath and let cool before administering.

17

Smooth muscle relaxant & vasodilator that improves blood flow in arteries and capillaries. Can prevent endothelial damage.
* used primarily for increasing cerebral blood flow, particularly geriatric patients.
Conditions tx: short-term memory loss, HA,
dizziness, tinnitus & emotional instability with
anxiety.

Ginkgo biloba (Maidenhair tree)

18

Ginkgo biloba (Maidenhair tree)

Used for short term memory and tinnitus, by increasing cerebral blood flow.

19

AKA- Klamath weed, hard hay & amber
Herbal medicine, only buds & flower used
* Prolongs effect of serotonin, dopamine & norepinephrine.
-Adverse- photosensitivity, sunburn easily, pruritus & edema.
-Serotonin syndrome: confusion, agitation, shivering fever, diaphoresis, nausea, diarrhea, muscle spasms.

St. Johns wart

20

AKA featherfoil, flirtwort, bachelors buttons.
Leaves are used.
It's a smooth muscle relaxant in the vessel in brain- antimigrain.
* Also used for Rheumatoid arthritis.
~ May cause ulcers & allergies. Reduces platelet aggregation.

Feverfew

21

Feverfew

Smooth muscle relaxant and used for RA patients.

22

Echinacea

Stimulates the innate immune system. Stimulates phagocytosis, and tumor necrosis factors= increases body's ability to resist (NOT destroy) bacterial & viral infection.
* USED FOR RESPIRATORY INFECTIONS (COLD/FLU), UTI & SUPERFICIAL WOUNDS.

23

* AKA purple coneflower, black Sampson, coneflower.
Roots, rhizomes, above ground parts are used.
* Allergies may occur, do not take if under immunosuppressant therapy.
* Stimulates the innate immune system, phagocytosis & tumor necrosis factors.

Echinacea

24

AKA squawroot, black snakeroot, bugwort.
Fresh or dried rood used.
* Suppress luteinizing hormone. Used for PMS, dysmenorrheal & menopause.
** Do not use for over 6 months before becoming pregnant and do not use at all if pregnant.
~ May cause upset stomach. Be aware to not get confused with blue cohosh.

Black cohosh

25

Used for gout attacks. Stops crystal deposits.
- Encourage fluids
S/E= Big 3
Adverse: blood dyscrasias

Colchicine

26

NSAID- Used for rheumatoid and osteoarthritis, acute painful shoulder, acute gouty arthritis, and closure of patent ductus arteriosus (given IV in this case).

Indomethacin (Indocin)

27

Indomethacin (Indocin)

An NSAID, used for RA & OA, along with acute painful shoulder pain and gouty arthritis.

28

Stops uric acid formation & is for gout!
S/E: acute gout (until therapeutic level), Big 3, dizziness.
Adverse: hepatotoxic, blood dyscrasias, fever pruritus, rash.

Allopurinol (Zyloprim, Aloprim)

29

Disulfiram (Antabuse)

Used for rehab; it blocks metabolism of booze.
S/E: drowsiness, fatigue, HA, impotence, metallic taste.
Adverse: hepatotoxic, hives, pruritus, rash.

30

Anticholinesterase inhibitor; used for dementia r/t Alzheimer's.

Adverse: Hepatotoxic, rash, fever, bradycardia

Tacrine (Cognex)

31

Ciprofloxacin (Cipro)

S/E: Big 3 and dizziness

Quinolone an antibiotic for nosocomial & community acquired UTI's.
-Cannot work against pseudomonas aeroginosa; and is NOT recommended during pregnancy, unless the benefit outweighs the risk.
* Wait 4hrs, before or after taking iron supplements, dairy and antacids, it reduces the absorption of antibiotic.

32

Local anesthetic, that relieves UTI pain, also helps with discomfort r/t catheter.
* Red/Orange urine is normal
Adverse: yellow sclera or skin.

Phenazopyridine hydrochloride (Pyridium)

33

Antitubecular, eliminates meningococci and H. influenza type b. Also used in combination with other agents to treat tuberculosis (INH, ethambutol).
* Finish treatment even if conditions improve!
Reddish orange secretions

Rifampin (Rifadin)

S/E: Nausea, vomiting, anorexia, abdominal cramps

34

Neuromuscular blocking agents

ENSURE THERE IS AN OPEN AIRWAY!!!!!!

35

Interrupt transmission of impulses in skeletal muscles, and is used along with ANESTHESIA, for intubation and tetanus.
S/E= histamine release, discomfort
Adverse: Respiratory distress, diminished cough
reflex, inability to swallow.

Neuromuscular blocking agents

36

1st gen cephalosporin= effective against S. areus, pneumonaie. It's a cephalosporin, cousin to penicillin and is used for people who are allergic to penicillin's.
* Used for UTI, respiratory and abdominal infections, bacteremia, meningitis and osteomyelitis.
**AVOID ORAL CONTRACEPTIVES**

Cefazolin (Ancef)

37

Streptomycin an aminoglycoside:

Used for gram negative infections, UTI, meningitis, wound infections & septicemia. Nosocomial infections don't stand a chance!
*Always obtain 2 cultures prior to giving antibiotics*

38

H2 antagonist= decreased acid output, and increased pH levels.
* Used for GERD
* Advantage of 1 dose daily and not antiandrogenic effects.
DO NOT USE FOR GI BLEED OR HYPERPARATHYROIDISM!
Adverse: Confusion & man boobs, hepatotoxic.

Famotidine (Pepcid)

39

Antabuse

If taken with alcohol can cause profuse vomiting and sickness! Teach not to take w/alcohol and no OTC medications.

40

Secreted by the adrenal cortex, they may cause peptic ulcers. Two categories:
Mineral & glucocorticoids.
Mineralcorticoids- Maintain fluid and electrolyte balance. Used for hypopituitarism or Addison's disease. Ex. fludrocortisone & aldosterone
glucocorticoids- Antiinflammatory, antiallergenic and immunosuppressant activity. May cause hyperglycemia. Major hormone is CORTISOL, you must taper off they increase the effects of Warfarin. Ex. cortisone, hydrocortisone & prednisone.

Steroids (Corticosteroids)

41

Mineralcorticoids

Maintain fluid and electrolyte balance. Used for hypopituitarism or Addison's disease. Ex. fludrocortisone & aldosterone

42

glucocorticoids

Antiinflammatory, antiallergenic and immunosuppressant activity. May cause hyperglycemia. Major hormone is CORTISOL, you must taper off they increase the effects of Warfarin. Ex. cortisone, hydrocortisone & prednisone.

43

Ace inhibitor- stops angiotensin 1 to convert to angiotensin 2, reducing BP.
Used for improved cardiac output and renal blood flow. Also for HTN & renal HTN.
* Good for cardiac & renal nephropathy.

Lisinopril (Zestril)

S/S: dry cough, ortho HTN, nausea, diarrhea, fatigue, HA. * Symptoms more likely to occur w/1st dose.
Adverse: Swollen face, neutropenia, hyperkalemia, nephrotoxic, teratogen.

44

Benadryl (diphenhydramine)

Antihistamine that treats allergic rhinitis, conjunctivitis.
- Best taken on scheduled basis. They do not stop nasal congestion, they prevent it.
* Maintain proper fluid intake. Use hard candy, gum and frequent oral hygiene for oral dryness.

45

Short duration & Rapid acting
Onset: 15-30mins Peak: 0.5-2.5hrs duration: 3-6.5hrs
* Cloudy, clear then draw clear, cloudy.
**Give within 10-15min of a meal
~ Lispro + protamine = longer duration of action time.

Lispro (Humulog)

46

Short duration= Short acting
Onset: 30-60min Peak: 2-5hr duration: 5-10hr
Clear insulin, draw up before cloudy
**Only one approved to be given IV AND SubQ**
~ Give 30-60min before meals

Regular (Humulin R)

47

Long duration= long acting
Onset: 70min Peak: N/A duration: 24hr
Basal insulin coverage= constant amount of insulin
* commonly injected in the evening*
~CANNOT BE MIXED WITH OTHER INSULINS~

Lantus (Insulin Glargine)

48

Vasodilator & antianginal
* No more than 3 SL tabs over 15mins, check BP BEFORE administering.
Patches are left 12-14hr, followed by 10-12hr patch free interval.
S/E: Orthostatic hypotension, HA, tachycardia, dry mouth, dizziness.

Nitro

49

Cholinergic, antiemetic, that increases peristalsis.
* Used for gastric reflux, esophagitis, diabetic gastroparesis, antiemetic. Prevents nausea and vomiting induced by chemotherapy.
~ AVOID MONAMINE OXIDASE INHIBITORS, ALCOHOL, ANTICHOLINERGICS, OPIATES WHILE TAKING THIS~

Reglan (Metoclopramide)

50

Reglan (Metoclopramide) S/E and extra warnings

S/E: drowsiness, fatigue, Suicidal ideations, seizures, neutropenia, leucopenia, agrunolocytosis.
* EXTRAPYRAMIDAL symptoms: restlessness, involuntary movements, facial grimacing, oculogyric crisis, rhythmic tongue protrusion.

51

Antiplatelet, reduces risk of MI and stroke.
* Teach to avoid Heparin, Coumadin, ASA and NSAID's as it increases the effects.
** report bleeding and diarrhea**

Plavix (Clopidogrel)

52

Anticoagulant, inhibits thrombin. It's given prophylactily for DVT or post-op for PE
- Monitor: PTT Dosage: 5000units q8hr-q12hr
Antidote: protamine sulfate.
~ Use soft bristle toothbrush, Carry ID identifying taking this medication.

Heparin

53

Monoamine oxidase inhibitor. Actions: block metabolic destruction of norepinephrine, dopamine, and serotonin neurotransmitters by the enzyme monoamine oxidase.
* Uses: atypical depression, panic disorder, obsessive-compulsive disorder and some phobias.
* 2-4wks for therapeutic effects to be notice

Selegilin (Emsam)

54

Selegilin (Emsam): patches

6mg patch= no diet restriction
9-12mg patch- avoid foods containing tyramines (aged cheese, smoked fish, cured meats and some beers).

55

Beta agonist bronchodilator, short acting beta
* reverse airway constriction. Mainstay of all asthma therapy.
~ Assess for paradoxical bronchospasms. Wash inhaler w/warm water.

Albuterol (Proventil, Ventoilin, Accuneb)

56

Dopamine agonist= used to replace dopamine deficiency in Parkinson's.
- Stimulates D1, D2 & D3 receptors
- Give w/food or milk
- 6mos to assess therapeutic effects
* Must be combined w/Carbidopa*

Levadopa (Larodopa)

57

Alpha-1 adrenergic blocker= found in the prostate.
* Used for BPH, causes more urine flow
* 1 week for visible results, 2-3 mos. for full effect.
~ 1st dose may cause dizziness, hypotension and fainting. Give w/food, once tolerated given 30 min after food.

Tamsulosin (Flomax)

58

Anticoagulant- prevents clot formation
Watch PT/INR tests.
PE: teach to avoid foods w/vitamin K & leafy green vegetables & inform all doctors of anticoagulant therapy.

Coumadin (Warfarin Sodium)

S/S: spontaneous bleeding, HA, bruising, back pain, increased HR, decreased BP.

59

Inotropic agent= changes force of muscle contractions. Increases CO2, slows conduction through AV node, decreases HR.
* Used for: A-Fib, A-flutter & paroxysmal tachycardia, HF & systolic failure.
* Assess for hypokalemia
~ Antidote: digibind
- Maintain a sodium restricted diet.

Digoxin (Lanoxin)

SE: HA, dysrhythmias, hypotension, bradycardia, AV block.
Adverse: Digitalis toxicity

60

Antifungal agent, especially for candida (oral fungus)
* Contraindicated for pregnant women
~ Swish & Swallow or Swish & spit, obtain a culture
prior to administration, avoid mouth washes for
mouth infections.~

Nystatin(Mycostatin)

S/E: Big 3, cramps & rash

61

K+ wasting diuretic, that acts on the loop of Henle
* Used to treat edema, CHF & HTN
* Give in early a.m. & teach to report signs of hypokalemia.
S/E: hypokalemia, dehydration, weakness & polyuria

Furosemide (Lasix)

62

Anti-infective, miscellaneous antibiotic.
* Used for resistant staph infections & effective against gram+ organisms.
** Assess for secondary infections (C-diff, yeast infections)because it destroys normal flora.
S/E: Red neck syndrome, hypotension, otoxicity, and nephrotoxicity.

Vancomycin (Vancocin)

Side effect alert: red neck syndrome!

63

vancomycin

-For staph resistant infections.
-You must assess for secondary infections.
* SE: red neck syndrome, profound hypotension, ototoxicity, nephrotoxicity, neuromuscular blockade in combination w/skeletal muscle blockers.

64

Osmotic laxative, ammonia detoxicant, relieves acute constipation, by drawing water into intestine from surrounding tissues.
- causes cleanse for: colonoscopy & barium enema x-ray exam.
* Assess liver studies, do not give w/other laxatives. Give w/water or fruit juice. Take on empty stomach.

Lactulose (Cephulac)

S/E: big 3 & hypernatremia

65

Biguanide oral antidiabetic agent.
-Patho: it slows down the glucose production in liver, blocks absorption of glucose in small intestines and helps muscles use glucose more efficiently.
* Not effective w/ type 1 diabetics.
* Does not cause hypoglycemia, weight gain and has favorable effect against triglycerides.

** Incourage intake of vit B12 & folic acid***

Metformin (Glucophage)

* Insulin must be present to activate metformin*

66

Antithyroid medicine, that selectively destroys hyperactive thyroid tissue.
Uses: for pt.'s that are poor surgical candidates, older adults beyond childbearing years & recurrent hyperthyroidism.
* Takes 3-6mos to assess for benefits
* common side effect: tenderness in thyroid gland
* Interacts w/Lithium carbonate ( people w/bipolar disorders)!!

Radioactive Iodine (Iodine-131)

*Extremely dangerous; wear latex gloves, watch for allergies to iodine, follow hosp. policy for urine, vomit or stool spills.*

67

Antilipemic- Statin, reduces cholesterol synthesis.
Inhibits HMG-CoA reductase
SE: myopathy, hepatotoxicity, thrombocytopenia
* Teach to avoid taking if liver dysfunction presents and or pregnant. * should be taken w/food, DO NOT CRUSH!

Lovastatin (Mevacor)

68

Nystatin, Lipitor statin, Mevacor & Zorcor

These are all statins 1. Take at night when cholesterol is at it highest, NO GRAPEFRUIT JUICE. - Monitor liver enzymes, check cholesterol levels to see if working.
- May cause muscle aches & pain

69

Causes myopia and rhabdomylosis

Lipitor statin

70

Antidysrhythmic agent, prolongs atrial & ventricular action potential.
* Known to cause systemic & coronary vasodilation
* Used for brady & tachycardia, a-fib and/or flutter.
* Give w/food*

Amioderone hydrochloride (Cordarone, Pacerone)

71

Amioderone hydrochloride (Cordarone, Pacerone)

IV slam for ventricular tachycardia.
- Have crash cart nearby- it makes heart pause!

72

Beta 1 antagonist, may cause hypoglycemia & bronchoconstriction.
* Lower BP, serious SE is hypotension

Atenolol (Tenormin) & Metoprolol (Lopessor)

73

Glycoprotein llb/llla inhibitor.
* Prevents platelet aggregations & clot formation!
-Used for PCI, reducing MI chances & cath procedures.
* Monitor: bleeding from thrombocytopenia

Etifibatide (Intergrillin)

74

Miscellaneous Antidysrhythmic.
* Used: V-tach as it acts on SA, AV node & atrium
SE: Flushed face, SOB, nausea, chest pressure
* half life less than 10 sec.

Adenosine (Adenocard)

75

Low molecular weight heparin.
Use: for DVT, PE & MI prophylactically.
Monitor: CBC, platelet count & occult blood

Enoxaparin (Lovenox)

76

Statin AKA HMG-CoA reductase inhibitor.
Use: Hyperlipidemia, HTN, atherosclerosis
** TAKE AT NIGHT**
- Monitor liver studies

atorvastatin (Lipitor) & Simvastatin (Zocor)

77

Antiplatelet antipyretic, can cause GI bleeds & ulcers. NSAID family

*** CAN CAUSE TINNITUS****

Aspirin (ASA)

78

CNS depressant, opioid analgesic.
Common SE: constipations, nausea & vomiting
Antidote: Narcan!!!!

Morphine

79

Oral hypoglycemic agent, sulfonylurea that acts on beta cells of pancreas. For DM 2
Take: 15-30min before meals

Glipizide (Glucotrol)

80

Metabolic syndrome:

Increased:
Obesity (around waist)increased BMI
High- BP (systolic), BS & cholesterol
Fatigue

81

prevent RH immunization of RH-, also prevents hemolytic disease of newborns in subsequent pregnancies (1st pregnancy only)

rhogam

82

TPN:

- Insulin can be added, along with electrolytes.
- Assess electrolyte imbalance
- Discard soln q 24hrs
- Monitor blood glucose

83

* Broad spectrum antibiotic
Uses: chlamydia & rocky mountain spotted fever, can be used for acne too!
Watch for: epigastric discomfort, diarrhea, heartburn, photosensitivity & suprainfection.
Take on empty stomach

Tetracycline

84

Tetracyline

-Take on empty stomach
- antacids, milk products & iron supplements should
not be consumed until at least 2hrs after dose.
- do not give to pregnant women & children under
age of 8 to avoid tooth discoloration.
**Monitor carefully for diarrhea, an indication of a suprainfection of the bowel (C.difficle)

85

This classification is used for endogenous depression, reactive depression, and depression related to alcohol & cocaine withdrawal

Amitriptyline (Elavil)

Tricyclic antidepressants

86

Amitriptyline (Elavil)

Antidepressants used for endogenous/reactive depression like w/alcohol & cocaine.
Watch for:
* Sedation
* Orthostatic hypotension
* Lowered sexual ability & desire
* Dry mouth
* URINARY RETENTION
* Tachycardia

87

Antidysrhythmic agents: Na channel blockers (quick acting).
Used: treatment of life-threatening PVCs, ventricular, tachycardia & ventricular fibrillation
Expected outcome: conversion of dysrhythmia to normal sinus rhythm.

Lidocaine

88

_____ ______ is recommended for patient at risk for developing infective endocarditis before dental, gastric & genitourinary surgery & other invasive procedures.
recommended prophylactic antibiotic tx for pt.'s with:
Prosthetic cardiac valve
Previous infective endocarditis
Congenital heart disease (CHD)

Prophylactic antibiotics

89

Prophylactic antibiotics are prescribed prior to dental procedures for patients w/which conditions? (Select all that apply)
1. HTN
2. Heart transplant
3. History of infective endocarditis
4. CHF
5. Prosthetic heart valve
6. Coronary artery bypass

2. Heart transplant
3. History of infective endocarditis
5. Prosthetic heart valve