Pharmacology Final Exam Study Guide PDF

MODULE 1 5 questions Includes: Pharmacodynamics (definitions, how drugs work) Pharmacokinetics (definition, absorption, distribution, metabolism, excretion, first-pass effect) Adverse effects (anaphylaxis, toxicity, neu...

MODULE 1 5 questions Includes: Pharmacodynamics (definitions, how drugs work) Pharmacokinetics (definition, absorption, distribution, metabolism, excretion, first-pass effect) Adverse effects (anaphylaxis, toxicity, neurological) Common Cardiac Drug Suffixes PHARMACODYNAMICS PHARMACOKINETICS Definition: how the drug Definition: how the body acts on the drug affects the body Absorption: what happens to drug How drugs work: from time taken till reaching 1. Replace or act as a circulating fluids and tissues substitute for missing Distribution: movement of drug to body’s tissues chemicals Metabolism (biotransformation): 2. Increase or stimulate changes drugs into new, less certain cellular activities active chemicals that are easily 3. Depress or slow excreted; liver most important Excretion: removal of drugs from activities the body; kidneys most important 4. interfere with the in this functioning of foreign First-pass effect: drug reaches liver and is metabolized before it cells can enter the circulation  Adverse Effects: ANAPHYLAXIS HEPATOTOXICITY NEPHROTOXICITY Anaphylaxis: most rapid *think liver* *think kidney* Assessment: and severe immediate Assessment: Elevated BUN and type 1 hypersensitivity fever, malaise, nausea, creatinine reaction jaundice, change in Decreased urinary output occurs within minutes stool, abdominal pain, Fatigue of re-exposure to elevated liver enzymes, etc antigen etc Interventions: most severe: can lead to Interventions: notify prescriber discontinue medication if shock and death notify prescriber needed Common causes: discontinue medication supportive measures beestings, eating peanuts, if needed REMEMBER: Acute Kidney shellfish, or eggs supportive measures Injury - Intrarenal  GENERAL CNS EFFECTS: EXTRAPYRAMIDAL SYMPTOMS: *think brain and spine* Assessment: *Think Parkinson’s* confusion, delirium, Assessment: insomnia, etc muscle tremors Interventions: changes in gait Safety measures to rigidity prevent injury etc orient patient and Interventions: provide support discontinue Discontinue drug as medication as appropriate appropriate Neurological Effects NEUROLEPTIC MALIGNANT ANTICHOLINERGIC EFFECTS: SYNDROME: *Think dry inside* Assessment: *EMERGENCY* dry mouth, urinary Assessment: retention, blurred vision, neurological symptoms photophobia, headache, etc hyperthermia Interventions: autonomic Sugarless lozenges and disturbances mouth care bowel program as Interventions: appropriate discontinue safety measures if there medication are vision changes reduce patient body have patient void before temperature administration of medication PHARMACOKINETICS THERAPEUTIC ACTIONS CONTRAINDICATIONS/CAUTIONS COMMON ADVERSE EFFECTS INDICATIONS CARDIAC DRUG SUFFIXES PATIENT TEACHING DRUG TO DRUG MONITOR  MODULE 2 8 questions Includes: Hydantoins (phenytoin) Barbiturates (phenobarbital) Valproic Acid Dopaminergic (carbidopa-levodopa) opioid agonist (morphine) opioid antagonist (naloxone)  CONTRAINDICATIONS/CAUTIONS PHARMACOKINETICS THERAPEUTIC ACTIONS hypersensitivity impaired renal/liver function Metabolized: Liver Stabilizes neuronal membranes coma Excreted: Kidneys Prevents hyperexcitability depression Form: Oral (slow) and IV (rapid) Limits spread of seizures psychosis caution in older/debilitated patients ADVERSE EFFECTS ataxia INDICATIONS dysarthria control tonic-clonic slurred speech and psychomotor seizures HYDANTOINS mental confusion dizziness prevents seizures gingival hyperplasia during neurosurgery Phenytoin steven johnson syndrome control status **Do a really good NEURO assessment** liver damage epilepticus nystagmus = toxicity DRUG TO DRUG HALF LIFE THERAPEUTIC LEVELS Alcohol 6-24 hours 10-20 mcg/mL Other CNS Depressants  CONTRAINDICATIONS/CAUTIONS PHARMACOKINETICS THERAPEUTIC ACTIONS hypersensitivity impaired renal/liver function Metabolized: Liver inhibits impulse in RAS coma Excreted: Kidneys depresses cerebral cortex depression Form: Oral, IV, IM, Subcutaneous alters cerebellar function psychosis caution in older/debilitated patients ADVERSE EFFECTS INDICATIONS bradycardia tonic-clonic/focal low BP seizures BARBITURATES Respiratory acute: Status depression epilepticus, Phenobarbital hypoventilation tissue necrosis tetanus, meningitis, eclampsia DRUG TO DRUG THERAPEUTIC LEVELS KNOW Vitamin K Low lipid solubility: slow onset; long 10-40 mcg/mL Vitamin D duration Warfarin  PHARMACOKINETICS THERAPEUTIC ACTIONS CONTRAINDICATIONS/CAUTIONS Metabolized: Liver may increase GABA hepatic or renal impairment Excreted: Kidneys reduces abnormal electrical allergies to sulfonamides and thiazide From: Oral activity in the brain diuretics not used for tonic-clonic hypersensitivity ADVERSE EFFECTS hyperammonemia liver toxicity INDICATIONS DRESS (Drug myoclonic seizures Reaction with absence seizures INHIBITS GABA Eosphinophelia and mania systematic migrane HA Valproic Acid symptoms) complex focal Blurred vision seizures tinnitus blurred vision ataxia THERAPEUTIC LEVEL DRUG TO DRUG KNOW get a good history 50-100 mcg N/A do a good medcon try not to use unless have to  CONTRAINDICATIONS/CAUTIONS PHARMACOKINETICS angle-closure glaucoma THERAPEUTIC ACTIONS Metabolized: Liver lactation Levodopa precursor of dopamine patients taking or recently have taken a Excreted: Kidneys crosses BBB then converted to nonselective MAOI (have to be off for 2 From: Oral dopamine weeks) ADVERSE EFFECTS increased hand tremor numbness INDICATIONS Treatment of DOPAMINERGIC weakness dry mouth (most Parkinsonism and common) Parkinson’s disease Carbidopa-levodopa dysphagia urine retention cardiac irregularities psychosis DRUG TO DRUG PATIENT TEACHING OTC Vitamins MONITOR MAOI Iron Salts PHARMACOKINETICS THERAPEUTIC ACTIONS CONTRAINDICATIONS/CAUTIONS ADVERSE EFFECTS INDICATIONS OPIOID AGONIST Morphine PATIENT TEACHING DRUG TO DRUG MONITOR PHARMACOKINETICS THERAPEUTIC ACTIONS CONTRAINDICATIONS/CAUTIONS OPIOID ADVERSE EFFECTS INDICATIONS ANTAGONIST Naloxone PATIENT TEACHING DRUG TO DRUG MONITOR  MODULE 3 7 questions Includes: Alpha-Beta adrenergic agonist (dopamine) Beta-specific adrenergic agonist (isoproterenol) Non-selective adrenergic blocking agent (labetalol) Non-selective Beta-adrenergic blockers (propranolol) PHARMACOKINETICS THERAPEUTIC ACTIONS CONTRAINDICATIONS/CAUTIONS ALPHA-BETA ADVERSE EFFECTS INDICATIONS ADRENERGIC AGONIST dopamine PATIENT TEACHING DRUG TO DRUG MONITOR  CONTRAINDICATIONS/CAUTIONS THERAPEUTIC ACTIONS Pulmonary hypertension tachyarrythmias PHARMACOKINETICS Works on beta-adrenergic eclampsia receptors to increase heart uterine hemorrhage diabetes rate, positive inotropic effects, thyroid disease bronchodilation and vasodilation heart disease stroke INDICATIONS BETA-SPECFIC ADVERSE EFFECTS Shock with low ADRENERGIC AGONIST cardiac output Cardiac arrest Isoproterenol PATIENT TEACHING DRUG TO DRUG MONITOR  CONTRAINDICATIONS/CAUTIONS THERAPEUTIC ACTIONS GI, CV, and Respiratory effects PHARMACOKINETICS Works on alpha 1 and beta Bronchospasms receptor sites in SNS to lower Asthma BP without reflex tachycardia COPD Decreases renin levels Diabetes ADVERSE EFFECTS INDICATIONS NON-SELECTIVE Hypotension HTN ADRENERGIC BLOCKING Cough Bronchospasm Control BP in pheochromocytoma AGENT Dyspnea Labetalol PATIENT TEACHING DRUG TO DRUG MONITOR  CONTRAINDICATIONS/CAUTIONS THERAPEUTIC ACTIONS bradycardia Blocks beta-adrenergic receptor sites in heart block the heart and juxtaglomerular apparatus shock heart failure increase heart contractility bronchospasm decrease cardiac workload Asthma decrease heart rate COPD INDICATIONS HTN ADVERSE EFFECTS Angina Cardiac Supraventricular tachycardia NON-SELECTIVE BETA- arrhythmias Bradycardia Migraine HA ADRENERGIC BLOCKERS Heart Failure Anxiety Hypotension (Stagefright) Propranolol Pheochromocytoma Prevent reinfarction MI DRUG TO DRUG N/A MODULE 4 3 questions Includes: NSAID (Ibuprofen) Acetaminophen  CONTRAINDICATIONS/CAUTIONS THERAPEUTIC ACTIONS PHARMACOKINETICS Peptic ulcer Inhibits prostaglandin synthesis GI bleed by blocking COX1 and 2 Renal/hepatic dysfunction receptor sites ADVERSE EFFECTS Bleeding HA INDICATIONS Dizziness RA NSAID Somnolence OA Rash Primary Fatigue Ibuprofen Dysmenorrhea Nausea Mild to moderate Dyspepsia pain Constipation **Think Kidneys and GI** Fever bone marrow suppression stroke MI PATIENT TEACHING DRUG TO DRUG MONITOR N/A  CONTRAINDICATIONS/CAUTIONS PHARMACOKINETICS THERAPEUTIC ACTIONS Hepatic dysfunction Metabolized: Liver Acts directly on the Chronic alcoholism Excreted: Kidneys hypothalamus to cause sweating Form: Oral and vasodilation ADVERSE EFFECTS Hepatotoxicity hemolytic anemia INDICATIONS fever Fever OA ACETAMINOPHEN rash renal dysfunction RA Tylenol HA Mild to moderate pain **Think Liver** ANTIDOTE DRUG TO DRUG MONITOR Acetylcysteine N/A  MODULE 5A 8 questions Includes: ACE inhibitors (captopril) ARB’s (losartan) Calcium channel blockers (diltiazem) Vasodilators (nitroprusside) Cardiac glycosides (digoxin)  CONTRAINDICATIONS/CAUTIONS THERAPEUTIC ACTIONS Acute HF exacerbation PHARMACOKINETICS Blocks ACE from converting Salt/volume depletion Angiotensin I to Angiotensin II, Impaired renal function decreasing BP and aldosterone production, and slightly increasing K+ INDICATIONS ADVERSE EFFECTS HTN HF ACE INHIBITOR Dry cough Angioedema Left ventricular Hyperkalemia dysfunction Captopril Diabetic neuropathy DRUG TO DRUG MONITOR PATIENT TEACHING NSAID BP Kidney function K+ sparing diuretics Edema/FLuid shift K+ supplements Potassium Cough PHARMACOKINETICS THERAPEUTIC ACTIONS CONTRAINDICATIONS/CAUTIONS INDICATIONS ARB’S ADVERSE EFFECTS Losartan PATIENT TEACHING DRUG TO DRUG MONITOR PHARMACOKINETICS THERAPEUTIC ACTIONS CONTRAINDICATIONS/CAUTIONS CALCIUM ADVERSE EFFECTS INDICATIONS CHANNEL BLOCKER Diltiazem PATIENT TEACHING DRUG TO DRUG MONITOR  CONTRAINDICATIONS/CAUTIONS THERAPEUTIC ACTIONS PVD PHARMACOKINETICS Acts directly on vascular Conditions worsened by sudden BP drop IV smooth muscle Heart failure Vasodilation Tachycardia Drop BP CAD ADVERSE EFFECTS INDICATIONS Apprehension Severe HTN Acute HF VASODILATOR Diaphoresis Hypotension Maintenance of hypotension during Nitroprusside Cyanide toxicity anesthesia HALF LIFE MONITOR 2 minutes PHARMACOKINETICS THERAPEUTIC ACTIONS CONTRAINDICATIONS/CAUTIONS CARDIAC ADVERSE EFFECTS INDICATIONS GLYCOSIDE Digoxin PATIENT TEACHING DRUG TO DRUG MONITOR  MODULE 5B 8 questions Includes: Nitrates (nitroglycerin) Beta-adrenergic blocker (metoprolol) HMG-CoA reductase inhibitors (atorvastatin) Antiplatelet (ASA) Anticoagulant (Heparin) Thrombolytic agents (alteplase) PHARMACOKINETICS THERAPEUTIC ACTIONS CONTRAINDICATIONS/CAUTIONS ADVERSE EFFECTS INDICATIONS NITRATES Nitroglycerin PATIENT TEACHING DRUG TO DRUG MONITOR PHARMACOKINETICS THERAPEUTIC ACTIONS CONTRAINDICATIONS/CAUTIONS INDICATIONS BETA-ADRENERGIC ADVERSE EFFECTS BLOCKER Metoprolol PATIENT TEACHING DRUG TO DRUG MONITOR PHARMACOKINETICS THERAPEUTIC ACTIONS CONTRAINDICATIONS/CAUTIONS HMG-COA REDUCTASE ADVERSE EFFECTS INDICATIONS INHIBITORS Atorvastatin PATIENT TEACHING DRUG TO DRUG MONITOR PHARMACOKINETICS THERAPEUTIC ACTIONS CONTRAINDICATIONS/CAUTIONS ADVERSE EFFECTS INDICATIONS ANTIPLATELET ASA/Asprin PATIENT TEACHING DRUG TO DRUG MONITOR PHARMACOKINETICS THERAPEUTIC ACTIONS CONTRAINDICATIONS/CAUTIONS ADVERSE EFFECTS INDICATIONS ANTICOAGULANT Heparin PATIENT TEACHING DRUG TO DRUG MONITOR PHARMACOKINETICS THERAPEUTIC ACTIONS CONTRAINDICATIONS/CAUTIONS THROMBOLYTIC ADVERSE EFFECTS INDICATIONS AGENTS Alteplase PATIENT TEACHING DRUG TO DRUG MONITOR  MODULE 6 6 questions Includes: Thiazide/thiazide-like diuretics (hydrochlorothiazide) Loop diuretics (furosemide) Potassium-sparing diuretics (spironolactone) PHARMACOKINETICS THERAPEUTIC ACTIONS CONTRAINDICATIONS/CAUTIONS THIAZIDE-LIKE ADVERSE EFFECTS INDICATIONS DIURETICS Hydrochlorothiazide PATIENT TEACHING DRUG TO DRUG MONITOR PHARMACOKINETICS THERAPEUTIC ACTIONS CONTRAINDICATIONS/CAUTIONS ADVERSE EFFECTS INDICATIONS LOOP DIURETICS Furosemide PATIENT TEACHING DRUG TO DRUG MONITOR PHARMACOKINETICS THERAPEUTIC ACTIONS CONTRAINDICATIONS/CAUTIONS POTASSIUM- ADVERSE EFFECTS INDICATIONS SPARING DIURETICS Spironolactone PATIENT TEACHING DRUG TO DRUG MONITOR  MODULE 7 6 questions Includes: Sympathomimetics (albuterol) Anticholinergics (ipratropium) Inhaled steroid (budesonide) PHARMACOKINETICS THERAPEUTIC ACTIONS CONTRAINDICATIONS/CAUTIONS ADVERSE EFFECTS INDICATIONS SYMPATHOMIMETICS Albuterol PATIENT TEACHING DRUG TO DRUG MONITOR PHARMACOKINETICS THERAPEUTIC ACTIONS CONTRAINDICATIONS/CAUTIONS ADVERSE EFFECTS INDICATIONS ANTICHOLINERGICS Ipratropium PATIENT TEACHING DRUG TO DRUG MONITOR PHARMACOKINETICS THERAPEUTIC ACTIONS CONTRAINDICATIONS/CAUTIONS ADVERSE EFFECTS INDICATIONS INHALED STEROID Budesonide PATIENT TEACHING DRUG TO DRUG MONITOR  MODULE 8 6 questions Includes: Sulfonamides (sulfamethoxazole-trimethoprim) Penicillin (Amoxicillin) Aminoglycosides (gentamycin) Lipoglycopeptides (vancomycin) PHARMACOKINETICS THERAPEUTIC ACTIONS CONTRAINDICATIONS/CAUTIONS SULFONAMIDE ADVERSE EFFECTS INDICATIONS sulfamethoxazole- trimethoprim PATIENT TEACHING DRUG TO DRUG MONITOR PHARMACOKINETICS THERAPEUTIC ACTIONS CONTRAINDICATIONS/CAUTIONS ADVERSE EFFECTS INDICATIONS PENICILLIN LIKE Amoxicillin PATIENT TEACHING DRUG TO DRUG MONITOR PHARMACOKINETICS THERAPEUTIC ACTIONS CONTRAINDICATIONS/CAUTIONS ADVERSE EFFECTS INDICATIONS AMINOGLYCOSIDES Gentamycin PATIENT TEACHING DRUG TO DRUG MONITOR PHARMACOKINETICS THERAPEUTIC ACTIONS CONTRAINDICATIONS/CAUTIONS ADVERSE EFFECTS INDICATIONS LIPOGLYCOPEPTIDES Vancomycin PATIENT TEACHING DRUG TO DRUG MONITOR  MODULE 9 8 questions Includes: Glucocorticoids (prednisone) Thyroid hormone (levothyroxine) Antithyroid (methimazole) All Insulins Sulfonylurea (glyburide) Biguanide (metformin)  CONTRAINDICATIONS/CAUTIONS PHARMACOKINETICS THERAPEUTIC ACTIONS known allergy Metabolized: Liver binds to corticosteroid severe renal dysfunction Excreted: Kidneys and Urine receptors causing anti- acute infection not controlled by antibiotics Form: ORAL inflammatory and diabetes immunosuppressive effects acute peptic ulcers INDICATIONS ADVERSE EFFECTS replacement therapy HYPOtension in adrenal cortical Shock insufficiency GLUCOCORTICOID Sodium and fluid retention inflammation/allergic Prednisone aggravation of disorders infections COPD exacerbations (solumedrol) MONITOR PATIENT TEACHING DRUG TO DRUG Blood sugar closely cannot abruptly stop (puts pt at Potassium levels NSAIDs risk) Heart Alcohol Blood pressure Suppress immune system Potassium depleting agents Electrolytes Increase Blood Sugar Daily Weights Lungs  THERAPEUTIC ACTIONS PHARMACOKINETICS CONTRAINDICATIONS/CAUTIONS Increase metabolic rate of body Acute thyrotoxicosis Metabolized: Liver tissues, increasing oxygen Acute MI Excreted: Bile consumption, respiration, heart rate, HYPOadrenal conditions Form: ORAL and IV growth/maturation, metabolism of (i.e. ADDISONS) Bound to serum proteins fat, carbs, and protein. INDICATIONS ADVERSE EFFECTS treatment of Skin reactions myxedema coma THYROID Headache Nervousness Management of thyroid cancer HORMONE Palpitations Tachycardia HYPOthyroidism Levothyroxine Nausea Vomiting (remember gold Diarrhea standard for hypo) PATIENT TEACHING MONITOR takes about 4 weeks to get into system DRUG TO DRUG take at same time every morning on an Levels Catecholamines empty stomach an 1 before any other VERY CLOSE MONITORING Insulin meds with water Precipitating causes of side do NOT take generic Digoxin effects (stress and infection) Don’t switch brands without approval  PATIENT TEACHING FOR LEVOTHYROXINE MED INSTRUCTIONS Exacerbation of take it at same time hypothyroidism can be life- every morning threatening take on an empty assess for precipitating stomach and one hour causes of side effects (i.e. before any other meds stress and infection) take with water Monitor CLOSELY do NOT take generic Teach pt to report ANY do NOT switch unusual symptoms, chest pain, brands without or heart palpitations approval do NOT take OTC meds without approval If pharmacy switched Therapeutic effects may brands, NOTIFY take several weeks to show provider up (i.e. mental clarity, IMMEDIATELY improved energy levels, and Get levels checked physical stamina) regularly: 4 weeks, 3 months, 6 months  THERAPEUTIC ACTIONS CONTRAINDICATIONS/CAUTIONS PHARMACOKINETICS Thioamides: Prevent formation of known allergy (monitor for this) Metabolized: Liver thyroid hormone within the thyroid cells, Pregnancy and Lactation Excreted: Bile lowering serum level; also partially Caution: Hypertension and Form: Oral inhibit conversion of T3 to T4. Cardiac disease Inhibits synthesis of thyroid hormone. ADVERSE EFFECTS INDICATIONS Paresthesia block production of thyroid ANTITHYROID Nephritis hormone Bone marrow Methimazole suppression treat **REMEMBER: Obtain baseline V/S, Edema HYPERthyroidism Weight, CBC, and Kidney function** MONITOR PATIENT TEACHING Kidney levels do not walk barefoot DRUG TO DRUG CBC may take a couple of weeks to work Skin Catecholamines better tolerated with food Intake and output Insulin Daily weights take at same time each day never stop abruptly Digoxin Lungs avoid foods high in iodine Heart Numbness and Tingling  INTERMEDIATE ACTING SHORT ACTING What is it? NPH (Insulin Isophane Suspension) What is it? Regular Insulin (Humalin R) Onset: 1-2 hours Subcutaneous route: onset in 30-60 Lasts: 10-18 hours minutes; lasts 6-10 hours Peaks: 4-8 hours IV route: Immediate onset; lasts 2-6 hours Situation: Not acute Situation: Acute Appearance: Cloudy Instructions: Roll in hands because of suspension ALL INSULINS Focus on Onsets RAPID ACTING LONG ACTING What is it? Insulin Lispro (Humalog) and Insulin Aspart What is it? Insulin glargine (Lantus) (Novalog) Onset: 1-2 hours Lasts: 24 hours Onset: 5-15 minutes (quickest onset of action) Appearance: Clear, colorless solution Peak: 1-2 hours Lasts: 3-5 hours Situation: Helps maintain consistent level of Situation: Acute insulin in body system; acts like body’s natural Route: SubQ Injection or pump; NEVER IV insulin Instructions: Patient MUST eat RIGHT after injection PHARMACOKINETICS THERAPEUTIC ACTIONS CONTRAINDICATIONS/CAUTIONS Stimulate insulin release from the allergy to sulfas Metabolized: Kidney functioning beta cells in the Diabetic complications (i.e. DKA Excreted: Bile pancreas or HHNKS) Form: Oral Improve binding of insulin to insulin T1DM receptors pregnancy INDICATIONS T2DM ADVERSE EFFECTS HYPOglycemia Adjunct to diet and Heartburn exercise to lower blood glucose levels SULFONYLUREA Nausea in T2DM Glyburide Vomiting Diarrhea Adjunct to metformin and insulin to improve glucose control PATIENT TEACHING DRUG TO DRUG MONITOR Teach that N/V/D will go away after Beta blockers (mask signs of a while Hypoglycemia hypo/hyperglycemia) make sure they eat and keep nutrition Nutrition status Alcohol (mask signs of up Patient is eating hypo/hyperglycemia) take meds, but don’t eat = hypoglycemia  CONTRAINDICATIONS/CAUTIONS THERAPEUTIC ACTIONS PHARMACOKINETICS metabolic acidosis decreased production and increased Metabolized: NOT metabolized uptake of glucose severe renal impairment Excreted: Kidney, primarily urine decreased hepatic glucose production excessive alcohol intake Absorption and elimination times increased peripheral use of glucose pts not eating/drinking due to surgery vary based on type of formulation increased production of insulin pts undergoing studies with contrast Form: Oral Alters intestinal absorption of glucose age 65 years or older INDICATIONS ADVERSE EFFECTS 1st line treatment Nausea BIGUANIDE for Type 2 DM Vomiting Diarrhea PCOS GI discomfort Metformin Heartburn Weight loss HYPOglycemia PATIENT TEACHING MONITOR DRUG TO DRUG advise that it can cause kidney failure drug to drug interactions before alcohol use administration inform alcohol increases risk of lactic acidosis Inform that it is cheap and inexpensive Monitor kidney function Warn about N/V/D Mix contrast dye and metformin = Instruct to eat small meals a few times a renal failure day Have patient take with food  MODULE 10 5 questions Includes: Histamine-2 antagonist (cimetidine) Proton pump inhibitor (omeprazole) Osmotic laxative (magnesium citrate) 5-HT3 receptor blocker (ondansetron) PHARMACOKINETICS THERAPEUTIC ACTIONS CONTRAINDICATIONS/CAUTIONS Metabolized: liver Inhibits actions of histamine at Caution in older adults with Excreted: kidneys H2 receptor sites of the confusion and disorientation Form: Oral stomach, inhibiting gastric acid Hepatic or renal dysfunction secretion Prolonged or continual use INDICATIONS ADVERSE EFFECTS Active duodenal ulcer or benign gastric ulcer (short term) ulcers induced by HISTAMINE-2 stress or NSAID use ANTAGONIST Actue upper GI bleeding Cimetidine GERD H. Pylori Heartburn and indigestion DRUG TO DRUG SUMMARY/MONITOR PATIENT TEACHING Take 1-2 hours before antacids PHARMACOKINETICS THERAPEUTIC ACTIONS CONTRAINDICATIONS/CAUTIONS Metabolized: Excreted: Form: INDICATIONS ADVERSE EFFECTS PROTON PUMP INHIBITOR Omeprazole DRUG TO DRUG SUMMARY/MONITOR PATIENT TEACHING PHARMACOKINETICS THERAPEUTIC ACTIONS CONTRAINDICATIONS/CAUTIONS Metabolized: Excreted: Form: INDICATIONS ADVERSE EFFECTS OSMOTIC LAXATIVE Magnesium citrate DRUG TO DRUG SUMMARY/MONITOR PATIENT TEACHING PHARMACOKINETICS THERAPEUTIC ACTIONS CONTRAINDICATIONS/CAUTIONS Metabolized: Excreted: Form: INDICATIONS ADVERSE EFFECTS 5-HT3 RECEPTOR BLOCKER Ondansetron DRUG TO DRUG SUMMARY/MONITOR PATIENT TEACHING