Pharm Test 3 Study Guide PDF

cyclophosphamide​ drug class: alkylating agents (antineoplastic) action: attaches to DNA and disrupts replication actions/uses: treat wide variety of cancers, like Hodgkin disease administration: chemotherapy adverse effects: alopecia, mucositis (painful ulcerations, GI bleeding, diarrhea), N/V, bon...

cyclophosphamide​ drug class: alkylating agents (antineoplastic) action: attaches to DNA and disrupts replication actions/uses: treat wide variety of cancers, like Hodgkin disease administration: chemotherapy adverse effects: alopecia, mucositis (painful ulcerations, GI bleeding, diarrhea), N/V, bone marrow depression (anemia, leukopenia, thrombocytopenia), fear/anxiety, hemorrhagic cystitis methotrexate​ drug class: antimetabolites (antineoplastic) action: blocks synthesis of folic acid to inhibit replication actions/uses: choriocarcinoma, osteogenic sarcoma, leukemias, head/neck cancers, breast carcinoma, lung carcinoma, rheumatoid arthritis, ulcerative colitis, psoriasis administration: chemotherapy adverse effects: fatal bone marrow toxicity at high doses, hemorrhage/bruising, thrombocytopenia, N/V, anorexia, GI ulcers, GI bleeding doxorubicin​ drug class: antitumor antibiotics (antineoplastic) action: inhibits cell growth through cytotoxicity actions/uses: narrow spectrum administration: chemotherapy adverse effects: cardiotoxicity (within minutes or years) leading to cardiomyopathy, dysrhythmias, heart failure, low blood cell counts, N/V vincristine​ drug class: natural products (antineoplastic) action: kills cancer cells by preventing their ability to complete mitosis actions/uses: Hodgkin and non-Hodgkin lymphomas administration: adverse effects: nervous system toxicity, numbness/tingling in limbs, muscular weakness, loss of neural reflexes, pain, paralytic ileus, constipation, alopecia tamoxifen​ drug class: hormone (antineoplastic) action: blocks estrogen receptors on breast cancer cells actions/uses: breast cancer only and prevention administration: chemotherapy adverse effects: N/V, increased risk of endometrial cancer and thromboembolic disease, hot flashes, fluid retention, vaginal discharge biological response modifiers (BRMs)​ stimulate or assist patient’s immune system to rid itself of cancer cells less toxic, includes interferons, interleukins, monoclonal antibodies inhibit enzyme tyrosine kinase in tumor cells imatinib and sorafenib targeted therapies​ drugs that block specific gene products with a goal of attacking cancer cells with greater precision monoclonal antibodies (MABs)​ binds to cancer cell either killing it or marking it for destruction by other cells small molecule therapies​ low-molecular-weight antineoplastic that can readily enter cells to modulate key metabolic pathways herbal therapies for anxiety​ kava: high doses associated with liver damage valarian: take at night, effective at producing drowsiness and promoting sleep lorazepam​ drug class: benzodiazepine, GABAA-receptor agonist actions and uses: decreases GABA neurotransmitter, status epilepticus, withdrawals, anxiety administration: IV/PO adverse effects: drowsiness, sedation, amnesia, weakness, disorientation contraindications: acute narrow-angle glaucoma, closed-angle glaucoma, misuse/excessive use of drugs, liver disease, impaired brain function, suicidal ideation interactions: other CNS depressants, alcohol, levodopa, kava, valerian, chamomile overdose treatment: flumazenil escutalopram​ drug class: SSRI black-box: potential for suicidal behavior zolpidem​ drug class: non-benzo actions and uses: social anxiety and short term insomnia adverse effects: next-day drowsiness, abnormal thinking, sleep walking, nocturnal eating black-box warning: schedule IV controlled substance that can lead to dependency barbiturates (phenobital)​ CNS depressant prescribed for status epilepticus high risk for dependence low doses to reduce anxiety and moderate doses promote sleep MOA: bind with GABA receptor-chloride channel molecules inhibiting brain impulses END IN -bital antidepressants​ MOA: used to enhance, elevate, or stabilize mood by either blocking the enzymatic breakdown of norepi or slowing the reuptake of serotonin and norepi uses: major depressive disorder, depressive phases of bipolar, general anxiety (phobias, OCD, panic attacks) selective serotonin reuptake inhibitors (SSRIs)​ first line treatment for depression examples of drug type: sertraline MOA: slow the reuptake of serotonin into presynaptic nerve terminals uses: depression, social anxiety, OCD, PTSD serotonin syndrome: MEDICAL EMERGENCY, may occur when taking multiple serotonin drugs. symptoms: mental status change, HTN, tremors, sweating, hyperpyrexia or ataxia treatment: discontinuation of med, supportive black-box: may increase suicidal ideation effects: agitation, insomnia, headache, dizziness, fatigue contraindications: use with MAOIs or pimozide as it can increase serotonin interactions: digoxin and warfarin, MAOIs can cause neuroleptic malignant syndrome, HTN, SES serotonin and norepinephrine reuptake inhibitors (SNRIs)​ examples of drug type: duloxetine, venlafaxine, bupropion (smoking cessation and ADHD) action: inhibit reuptake of serotonin and norepi and elevate mood: may affect dopamine as well tricyclic antidepressants​ examples of drug type: imipramine (end in -mine) uses: major depression, withdrawal symptoms, can take 2 weeks to see therapeutic results effects: sedation, anticholinergic effects, dysrhythmias, heart block, HTN herbal/food: primrose oil and ginkgo may lower seizure threshold, St. Johns wort can cause SES black-box: may increase suicidal ideation MAO inhibitors (MAOIs)​ examples of drug type: phenelzine action: inhibits MAO, the enzyme that terminates the actions of neurotransmitters such as dopamine, NE, epi, and serotonin side effects: orthostatic hypertension, headache, insomnia, diarrhea interactions: insulin and oral antibiotics increase hypoglycemic effect mood stabilizer - lithium​ used to treat bipolar disorder lithium toxicity: levels above 1.5 symptoms include GI discomfort, tremors, confusion, somnolence, and seizures phenothiazines (typical first gen antipsychotics)​ examples of drug type: chlorpromazine, thioridazine, fluphenazine, perphenazine action: D2 dopamine receptor antagonist effects: acute dystonia, akathisia, secondary parkinsonism, tardive dyskinesia, dizziness, drowsiness, orthostatic hypotension, neuroleptic malignant syndrome (fever, stiff/rigid muscles, altered LOC, ANS dysfunction) interactions: sedatives, tricyclic antidepressants, anti seizure meds, kava/st johns wort increase risk of dystonia non phenothiazines​ examples of drug type: pimosize, loxapine, thiothixene, haloperidol action: same as phenothiazines uses: acute and chronic psychotic disorders, 50x more potent than chlorpromazine effects: acute dystonia, akathisia, secondary parkinsonism, tardive dyskinesia, NMS black-box: dementia increased risk for death contraindications: Parkinsons, seizures, alcoholism, severe mental depression second gen atypical antipsychotics​ examples of drug: quetiapine, risperidone, olanzapine uses: schizophrenia and acute mania with bipolar, irritability in children with autism, reduction of excitement, paranoia, or negative behaviors associated with psychosis effects: acute dystonia, akathisia, secondary parkinsonism, tardive dyskinesia, weight gain, hyperglycemia, increase prolactin levels black-box: dementia increased risk of death dopamine stabilizers​ examples of drug: aripiprazole, brexpiprazole, cariprazine, lumateperone effects: headache, N/V, fever, constipation, anxiety benzodiazepines​ examples of drug: clonazepam, lorazepam, diazepam uses: absence seizures, myoclonic seizures, anxiety, skeletal muscle spasms, alcohol withdrawal syndrome hydantoin​ examples of drug: phenytoin action: sodium channels are not blocked but desensitized uses: seizures effects: gingival hyperplasia, acne, hirsutism, Dilantin facies (swollen lips/butterfly rash), drowsiness, and osteoporosis low albumin levels increase chances of toxicity due to binding to protein antiepileptic drugs​ levetiracetam valproic acid gabapentin or pregabalin topiramate levetiracetam​ uses: focal seizures with and without secondary generalization effects: generally well tolerated opioids​example of drug: morphine, fentanyl, meperidine, methadone, codeine, oxycodone, hydrocodone, hydromorphone uses: serious acute and chronic pain after nonnarcotic analgesics have failed, SOB in heart failure, pulmonary edema, end of life effects: respiratory depression, constipation, orthostatic hypotension, N/V, urinary retention, dysphoria (restlessness), hallucinations, itching interactions: CNS depressants, alcohol, sedatives overdose: naloxone opioid receptor antagonist - naloxone​ uses: complete or partial reversal of opioid effects when overdose is suspected (will immediately cause opioid withdrawal symptoms) effects: rapid loss of analgesia, increased blood pressure, tremors, hyperventilation, N/V, drowsiness NSAIDs​ examples of drug: aspirin, ketorolac (IV ibuprofen), ibuprofen, COX-2 inhibitors uses: reduced fever, inflammation, and mild-moderate pain acetaminophen​ relief of pain and fever do not exceed 4g a day overdose: acetylcysteine - symptoms include abd. discomfort, vomiting, sweating, diarrhea contraindications: liver disease - 2000 mg day max aspirin​type: nonopioid analgesic - NSAID - antipyretic uses: inhibits prostaglandin synthesis involved in process of pain, antipyretic, antiplatelet effects: GI upset and bleeding, tinnitus for aspirin toxicity contraindications: warfarin, heparin overdose: activated charcoal, gastric lavage, laxative, or drug therapy for overdose symptoms such as dizziness, drowsiness, abd. pain, or seizures dopamine precursor​ examples of drug: levodopa, carbidopa, entacapone uses: restores dopamine relieving Parkinson’s symptoms effects: uncontrolled/purposeless movements, loss of appetite, N/V, muscle twitching/spasms, orthostatic hypotension, psychosis interactions: haloperidol may antagonize, antihypertensives may increase hypotensive effect, anticonvulsants may decrease effect, antacids with Mg, Ca, or NaHCO3 may lead to toxicity anticholinergics for Parkinsons​ examples of drug: benztropine, biperiden, trihexyphenidyl uses: block acetylcholine in Parkinsons cholinesterase inhibitors for alzheimers​ examples of drug: donepezil, galantamine, rivastigmine, memantine MOA: prevent breakdown of acetylcholine and slow progression of AD uses: 6 months for max effect, once daily effects: MANY! vomiting, diarrhea, CNS symptoms (insomnia, syncope), muscle cramps, bone fractures, contact dermatitis contraindications: GI bleeding and jaundice interferons for MS​ examples of drug: avonex, betaseron uses: multiple sclerosis effects: flu-like, anxiety, discomfort at injection site, hepatotoxic glatiramer for MS​ MOA: synthetic protein that stimulates myelin basic protein thought to curb the body’s attack of the myelin reducing lesions effects: redness, pain, swelling, itching, lump at injection site, flushing, chest pain, anxiety, muscle stiffness riluzole​uses: ALS MOA: extend survival by reducing levels of glutamate within the CNS types: tiglutik (thickened liquid form) and exservan (dissolving tablet) edaravone​ slows the decline in daily functioning in ALS centrally acting muscle relaxants​ examples of drug: cyclobenzaprine, baclofen MOA: inhibits upper-motor-neuron activity causing CNS depression use: localized spasms (cyclo - short term back pain or muscle aches, baclofen - long term for CP or spinal injury) effects: CNS depression, hepatic toxicity, physical dependence, anticholinergic effects direct acting antispasmodics​ example of drug: dantrolene sodium MOA: interferes with release of calcium ions in skeletal muscles uses: to relieve dystonias and leg cramps, CP or MS effects: hepatic toxicity, muscle weakness, drowsiness, diarrhea proton pump inhibitors​ examples of drug: omeprazole, pantoprazole MOA: reduce acid secretion in stomach use: for short-term therapy for PUD and GERD admin: before meals effects: headache, nausea, diarrhea, rash, abd. pain, longterm use linked to gastric cancer H2 receptor blockers​ examples of drug: famotidine, ranitidine MOA: blocking H2 receptors in stomach to decrease acid production uses: to treat PUD and GERD admin: PO/IV effects: reduced RBC, WBC, platelets, impotence, loss of libido in men antacids​ examples of drug: aluminum hydroxide, calcium carbonate, milk of magnesia MOA: neutralize stomach acid by raising pH of stomach contents uses: in combo with other antiulcer agents for relief of heartburn due to PUD and GERD effects: constipation, hypercalcemia simethicone​ antiflatulent uses: reduce the discomforts of gastric or intenstinal gas MOA: alters elasticity of mucus-coated gas bubbles, breaking them into smaller ones decreasing gas pain and increasing expulsion via rectum or mouth laxatives​ soften fecal mass and increase bulk psyllium (may cause impaction) docusate sodium (promotes water and fat in stools to lubricate stool) biscodyl (stimulates intestinal peristalsis - given as suppository) magnesium hydroxide (draws water into intestine to increase mass of stool, stretching masculature, resulting in peristalsis) senna (stimulates peristalsis, used with docuate often) lactulose (used for constipation but mostly for hepatic encephalopathy as it draws amnio from the blood) magnesium citrate (saline causes more water to enter intestines - used prior to colonoscopies) antidiarrheal medications opioid agonists​ diphenoxylate/atropine - dry mouth, urinary retention, constipation loperamide probiotics​ antidiarrheal MOA: intenstinal flora modifiers and bacterial replacement supplying missing bacteria to the GI tract and suppressing the growth of diarrhea-causing bacteria example: lactobacillus acidophilus anticholinergics for IBS​ reduce bowel spasms dicyclomine alosetron for severe diarrhea in women over 18 eluxadoline and rifaximin IBS​ constipation: lubiprostone, linaclotide diarrheal: loperamide, eluxadoline misc: dicyclomine, ondansetronm,, amitriptyline and doxepin 5-aminosalicylate sulfonamide​ example of drug: sulfonamide sulfasalazine, olsalazine, mesalamine MOA: inhibits the inflammation in the colon such as prostaglandins and leukotrienes uses: mild to moderate symptoms of ulcerative colitis effects: N/V, diarrhea, dyspepsia, abd. pain, headache, skin rashes (SJS) contraindications: hypersensitivity, anemia, folate disorders, hepatic impairment antiemetics - serotonin antagonist​ example of drug: ondansetron MOA: blocks serotonin receptors on vagal nerve that travels from the upper GI tract to the chemoreceptor trigger zone uses: chemotherapy, radiation, post op nausea, nausea admin: PO/IM/IV effects: prolonged QTc interval or constipation antiemetics - dopamine antagonists​ MOA: block dopamine receptors in the CTZ promethazine - PO/IV/suppository, for chemo, post op nausea given PRN prochlorperazine metoclopramide - AC and HS, helps with gastroparesis with diabetes, prevents nausea, short term for GERD antiemetics​ dronabinol cannabinoid cancer patients who are not eating well or suffering from failure to thrive scopolamine anticholinergic used for pre op or motion sickness dimenhydrinate motion sickness 5-alpha reductase inhibitors​ examples of drug: finasteride, dutaseride MOA: decreases usable testosterone causing a reduced prostate size uses: BPH, male pattern baldness effects: decreased libido, gynecomastia alpha1 adrenergic antagonists​ examples of drug: tamsulosin, alfuzosin, doxazosin MOA: decreases mechanical obstruction of the urethra by relaxing smooth muscles of the bladder neck and prostate uses: BPH, HTN effects: hypotension, problems with ejaculation PDE-5 inhibitors​ examples of drug: sildenafil, tadalafil MOA: enhanced blood flow to the penis uses: erectile dysfunction contraindications: cardiac patients who are taking nitrates such as isosorbide or nitroglycerin