Pharm Drugs Test 1 PDF

PHARM Drugs: Test 1 Study online at https://quizlet.com/_glixwr Agonist Activates receptor, Mimics natural chemicals/hormones Blocks receptor, prevents natural chemical from producing...

PHARM Drugs: Test 1 Study online at https://quizlet.com/_glixwr Agonist Activates receptor, Mimics natural chemicals/hormones Blocks receptor, prevents natural chemical from producing its Antagonist effect Contraindications Drugs should not be used in this case Pantoprazole Omeprazole Proton Pump Inhibitors (PPI's)-Drugs Dexlansoprazole (-Prazole) Suppress gastric acid Drug of choice for GERD Proton Pump Inhibitors (PPI's) Used in combo with antibodies for treatment of H. Pylori Takes once daily, 30 min to an hour before meals Cimetidine (prototype, many drug interactions) Famotidine (Seen more often) Histamine 2 Receptor Antagonists (H2RA's)-Drugs Ramotidine Nizatridine (-"tidine") Causes strong gastric acid secretion Histamine 2 Receptor Antagonists (H2RA's) Does not block histamine on gastric acid producing cells Caution in renal impairment Mylanta (prototype) Magnesium Aluminum Antacids-Drugs Calcium Maalox Mylanta, Rolaids Alkaline compounds; neutralize stomach acid PRN for acute management Antacids (Onset: 1 hr) (1-3 hr after meals + bedtime for acid reduction) Caution in renal failure Aluminum Mylanta (prototype) Magnesium Simethicone Laxative effect Magnesium Avoid in CKD (Kidney disease) Magnesium Hydroxide 1 / 10  PHARM Drugs: Test 1 Study online at https://quizlet.com/_glixwr Milk of magnesia Causes diarrhea Aluminium Constipation Increases sodium, constipation Aluminum hydroxide Hypophosphatemia (low phosphorus in blood) Binds with certain drugs Costipation Calcium Can make constipation worse CO2 in stomach Belching and flatulence (farting) Calcium Carbonate Constipation, acid rebound, milk-alkali syndrome (high-level of calcium in body) Maalox Magnisium + Aluminum Adults: Relives bloating Children: Colic (intense crying) Antiflatulents: Simethicone (Suh-meth-i-cone) Antifoaming agent, lowers gas bubbles. All small gas bubbles form into larger one Does NOT prevent or lower gas, but makes it easier to expel Creates barrier between ulcers and gastric acid (Acid and pepsin) Cytoprotective Agents: Sucralfate No significant adverse effects (AE) Lowers absorption of several drugs, take at least 2 hr apart Prevents ulcers from NSAIDs (specifically Ibuprofen) BBW: Risk for abortion, miscarriage, birth defects, and premature birth Lowers gastric acid secretion, increases bicarbonate & mucus, Cytoprotective Agents: Cytotec and maintains submucosal blood flow AE: Diarrhea, abdominal pain, spotting, and dysmenorrhea (cramping) in some women Pregnancy risk cat X Antibiotics Used in combo with PPI and H2RA for H. pylori CNS depressing properties Antipsychotics Phenothiazines (Fee-no-thy-uh-zeens) Sedating AE: blurred vision, urinary retention, dry mouth photosensitivity, confusion Promethazine (Prow-meth-uh-zeen) Phenothiazines: Drugs Prochlorperazine (Pro-chlor-pear-uh-zeen) BBW: Children under 2, may cause respiratory depression and subcutaneous (tissue) injury 2 / 10  PHARM Drugs: Test 1 Study online at https://quizlet.com/_glixwr Promethazine (Prow-meth-uh-zeen) Route: Deep IM Prevent histamine from exerting widespread effects on body tis- sue More to H1 Antihistamines Block acetylcholine (Uh-set-uh-cole-een) on brain *CNS depression, anticholinergic side effects Hydroxyzine (Hy-drox-suh-zeen) Antihistamines: Drugs Meclizine (Meh-cli-zeen) AKA zofran Serotonin Receptor Antagonists: Ondansetron (on-dan-se-tron) Most commonly used antiemetic agent Pretty safe in all age groups Effective in nausea and vomiting with chemo Substance P/ Neuronkinin I Antagonists: Aprepitant Highly emetic chemo (Uh-prep-ih-tent) More selective receptor Interacts with water to soften stools Take for one day, full effects 2-3 days Genetic Bulk Forming Laxatives OTC AE: Flatulence, bloating, cramping, in rare cases it causes bowel obstruction Psyllium (prototype) Methylcellulose (Meth-thul-cell-u-lose) Bulk Forming Laxatives: Drugs Polycarbophil Soluble fiber Prototype Same impact as fiber Minimal side effects Bulk Forming Laxatives: Psyllium (si-lee-um) Soft, formed stool Have with full glass of water 1 hr before or 2 hr after meals Lowers cholesterol, increases bulk and stretches intestinal wall Lubricates fecal matter Slows absorption of water from fecal matter Lubricant Laxatives Effects in 6-8 hours 3 / 10  PHARM Drugs: Test 1 Study online at https://quizlet.com/_glixwr Best used as an enema PO (by mouth) may cause adverse effects NOT laxative of choice Lubricant Laxatives: Mineral Oil AE: Lowers absorption of fat soluble vitamins with some drugs; may cause pneumonia Lower surface tension of fecal mass, allow water to penetrate stool Does NOT have true laxative effect Surfacant Laxatives 1-3 days to work Take with full glass of water Docusate sodium Surfacant Laxatives: Drugs Docusate calcium Cathartics Rapid/strong bowel evaculation when compared to laxatives Irritates bowels Increases secretion of water into lumen Stimulant Cathartics Semifluid stool within 6-12 hrs Take on empty stomach, do not take within hour of drinking milk Bisacodyl (Bis-a-code-yl) (prototype) Glycerin Stimulant Cathartics: Drugs Senna Castor oil Laxative salts = poorly absorbed, draws water from lumen Rapid effects Saline Cathartics (Osmotic laxatives) AE: Fluid/electrolyte imbalance Contraindicated: Disorders that accumulate magnesium, sodium, phosphate, and potassium Magnesium salts Saline Cathartics: Drugs Sodium salt Polyethylene glycol Cleanses prior to procedure/operation 4 L over 2-3 hours OTC drug Saline Cathartics: Polyethylene glycol (PEG-ES) Do not take longer than 2 weeks AE: Cramping, abdominal bloating, cramping, and flatulence Nonabsorbic compound Lactulose MISC Laxatives Sorbitol w/Sodium polystyrene Sulfonate 4 / 10  PHARM Drugs: Test 1 Study online at https://quizlet.com/_glixwr Diphenoxylate w/Atropine (Dai-phu-nox-uh-late) (Ah-truh-peen) Opioid Antidiarrheal Agents: Drugs Loperamide (Low-per-a-mide) Schedule V (low chance of abuse) Diphenoxylate w/Atropine Reccomended doses: Do not produce Morphine-like side effects (Dai-phu-nox-uh-late) (Ah-truh-peen) Caution with hepatorenal disease (kidney issue) AE: Hypotension, respiratory depression Low potential for abuse Loperamide OTC (Low-per-a-mide) BBW: Torsades de pointes (fast heart), cardiac arrest, death w/high doses Bismuth subsalicylate (sub-sa-li-cil-ate) Octreotide (oc-tree-o-tide) Bulk-forming laxatives Adjuvant Andtidiarrheal Agents Enzymatic replacement (diarrhea caused by lack of digestive en- zymes) Antibiotics for bacterial enteritis (digestive issue) Increased Acetylcholine (uh-cell-ti-chol-ine) Cholinergic drugs (Acetylcholinesterase inhibitors) SLUDGE & DUMBELLS (uh-see-tuh-chole-ine-est-er-ase) Activates parasympathetic nervous system, aka rest and digest Too much cholinergic drug Cholinergic crisis Treatment in early phase: Atrophine (a cholinergic antagonist) Direct: Bind to cholinergic receptors, activates Cholinergic drugs: MOE Indirect: Inhibits cholinosterose Donepezil (prototype) (Doe-neh-puh-zil) indirect anticholinesterase/cholinergic: drugs Memantine (not cholinergic though) (Muh-man-teen) Pyridostigmine (Pee-ruh-doe-stig-meen) Prototype Donepezil Higher acetylcholine (Doe-neh-puh-zil) Treatment of mild-moderate Alzheimer's Treats Alzheimers Memantine (not cholinergic though) Therapeutic effects may not occur until up to 6 weeks (Muh-man-teen) Goal is to increase acetylcholine and to lower cognitive decline (does not reverse memory loss) Pyridostigmine (Pee-ruh-doe-stig-meen) 5 / 10  PHARM Drugs: Test 1 Study online at https://quizlet.com/_glixwr Treats Myasthenia Gravis (Neuromuscular autoimmune disease, drooped eyelids, double vision, impaired speech) Salivation Lacrimation Urination SLUDGE Diarrhea Gastric Distress Emesis Diarrhea Urination Mitosis (pinpoint pupils) Bradycardia DUMBELLS Emesis Lacrimation Lethargy Salivation Anticholinergic Drugs Decreased anetylcholine Can't see Can't pee Can't spit Can't shit Anticholinergic Symptoms Mad as a hatter Blind as a bat Red as a beet Hot as a hare Dry as a bone Inhibits effect of acetylcholine (Anticholinergic) Anticholinergic Drugs: Oxybutynin (ox-ee-bute-uh-nin) Anticholinergic drugs make Myasthenia Gravis, heart problems, and urinary retention worse First gen: Nonselective, block cox 1 & 2 Nonsteroidal Anti-Inflammatory Drugs (NSAID's) Second gen: Selective, block 2 only Nonselective Prototype Mild-moderate pain relief , Lowers fever, treats inflammation for Nonsteroidal Anti-Inflammatory Drugs (NSAID's): Ibuprofen arthritis, initial gout attacks BBW: Increased risk for cardiovascular events GI bleeding (anti-clotting agents & around surgeries) Nonselective Nonsteroidal Anti-Inflammatory Drugs (NSAID's): Indomethacin IV form (in-doe-meh-thu-cin) Used to close patient ductus arteriosus in premature infants (extra blood vessel) Nonselective Nonsteroidal Anti-Inflammatory Drugs (NSAID's): Ketorolac IV form (Ket-or-uh-lak) Pain relief similar to opioids 6 / 10  PHARM Drugs: Test 1 Study online at https://quizlet.com/_glixwr BBW: Limited to no more than 5 days in a row due to high risk of GI problems Selective (prototype) Treats different arthritis Nonsteroidal Anti-Inflammatory Drugs (NSAID's): Celecoxib (Cel-uh-cox-ib) BBW: Incrased risk for cardiovascular events GI Bleeding: Lower risk than nonselective, still a problem Aspirin is prototype Inhibits prostaglandins, lowers platelets Mild-moderate pain relief, lower cardiac risk GI Bleeding Salicylates (Sun-li-suh-lates) Not for children or teens (Reye's syndrome: Swelling of liver and brain) Toxicity: Salicylism 81 mg works the same as 325 mg Prototype is acetaminophen Acts directly on hypothalamus Lowers fever, mild pain relief Acetaminophen (uh-see-tuh-mi-nuh-fin) Toxic for alcohol abusers, easy to confuse dosing bc OFC Antidote: Acetylcysteine (uh-see-til-cist-een) Max 4 g daily Prototype Stops WBC movement Miotic Agent: Colchicine (cole-chuh-seen) Treatment and prevention of gout (acute gout) AE: GI related and hepatoxicity Prototype Lowers uric acid production AE: Kidney stones Uricosuric Medication: Allopurinol (ah-low-per-uh-nol) Contraindications: Family history of hemochromatosis (harmful iron) *Take after meals *Keep hydrated Prototype of agonist Blocks pain transmission Opioid: Morphine sulfate *AE: CNS depression, respiratory depression, constipation 7 / 10  PHARM Drugs: Test 1 Study online at https://quizlet.com/_glixwr BBW: Combined CNS efffects, benzodiazepines (depres- sant;BZD) users Prototype Antagonist Drug of choice to reverse opioid overdose Opioid: Naloxone (Nuh-lock-zone) May precipitate opioid withdrawal IV and nasal spray Prototype Agonist and antagoist Pain relief w/alternate options Opioid: Butorphanol (boo-tore-pha-nol) BBW: Respiratory depression, neonatal withdrawals syndrome Lowers potential for abuse 2nd line option Prototype Local anesthetics: Lidocaine (lie-duh-caine) Blocks nerve conduction LAST (excessive local anesthetics) EMLA cream Topical Anesthetics (used in children) LET solution (Epinephrine prolongs effects of lidocaine) Same class as lidocaine BBW:.75% formulation in pregnant women (Cardiac arrest, diffi- Bupivacaine (byoo-pive-uh-keen) cult resuscitation) Test dose given before full dose Volatile organic liquids Induction and maintenance of general anesthesia AE: Malignant hyperthermia General anesthetics: Isoflurane (I-se-flore-ine) Contraindications: Family history of malignant hyperthermia, his- tory of severe PONV (post operative nausea and vomiting) Subsitute PONV with TIVA (total intravenous anesthesia) Lowers CNS via GABA neurotransmitter (no analgesia - pain reliever) Induction and maintenance of general anesthesia General anesthetics: Propofol (pro-poe-full) Contraindications: -Soy or egg allergies -Lipid metabolism disorders Widely used, risk of mishandling General anesthetics: Ketamine (keh-te-meen) BBW: emergence delirium, hallucinations, and unpleasant dreams Malignant hyperthermia Treat with IV Dantrium NMB Neuromuscular blocker Prototype NMB: Vecuronium (ve-cure-oh-nee-um) Muscle paralysis for operations 8 / 10  PHARM Drugs: Test 1 Study online at https://quizlet.com/_glixwr Recurarization: Return of weakness after assumed recovery (dif- ficulty swallowing, weak cough, trouble talking) Depolarizing NMB: Succinylcholine (sux-suh-nil-cole-ine) Can cause malignant hyperthermia BBW: Sudden cardiac arrest Adjuant Medications Increase potency/efficiancy of certain drugs For general anesthesia Adjuant Medications: Midazolam (muh-daz-o-lam) Short-acting BBW: Profound respiratory depression Midazolam/repiratory depression reversal drug Flumazenil (flu-mah-zun-el) For general anesthesia Supplement sedation Adjuant Medications: Fentanyl (fen-ta-nol) AE: Respiratory depression, Nausea/Vomiting, and urinary reten- tion Fentanyl Reversal Drug Naloxone Migraines/Headaches: NSAID Lowers pain from acute migraines Naproxen (nuh-prox-en) BBW: Higher risk of cardiovascular events and GI bleed Ornaproxin sodium (or-nuh-prox-in) Contraindiated: Pregnancy Migraines/Headaches: Triptan Treats migraine and cluster HA Sumatriptan Serotonin syndrome (CNS toxicity) (Soo-muh-trip-tan) BBW: Migraines/Headaches: NSAID + Triptan Cardiovascular risk (heart attack, stroke) Sumatriptan + Naproxen GI Risk (GI bleed) Pain killer, anti-inflammatory, vacular constriction Pain relief for migraine & tension HA Migraines/Headaches: Acetaminophen-Aspirin-Caffeine AE: Hepatoxicity, hypertension, GI effects, palpitations Contra: Hepatic disease, alcholism, diabetes, pregnancy Constricts brain blood vessels Stops most headaches, not for children Migraines/Headaches: Ergot Alkaloids SE: *Gangrene, fibrosis BBW: For use of CYP inhibitors Prevent decline in estrogen before it happens Migraines/Headaches: Estrogen *Menstrual migraines (ver similar to normal migraines) Estradiol *AE: Thrombocymbolic disorders (blood clots in blood vessels) *Monitor for chest and leg disorders 9 / 10  PHARM Drugs: Test 1 Study online at https://quizlet.com/_glixwr Suppress chemoreceptor zone Migraines/Headaches: Anti-emetic Chlorpromazine HCL *Treats nausea and vomiting associated with headache (Chlor-pru-muh-zeen) AE: CNS depression 10 / 10