PHARM Exam 3 PDF

Drug Class Therapeutic Uses Mode of Action Side Effects Adverse Reactions Contraindications Drug-Drug Interactions Insulin Control diabetes by Promotes the use of Confusion, agitation, Tachycardia, palpitations,...

Drug Class Therapeutic Uses Mode of Action Side Effects Adverse Reactions Contraindications Drug-Drug Interactions Insulin Control diabetes by Promotes the use of Confusion, agitation, Tachycardia, palpitations, Hypersensitivity, Inc. hypoglycemic effect with oral anticoagulants, lowering blood glucose by body cells flushing, hunger, hypoglycemic reaction, hypoglycemia alcohol, and oral hypoglycemics glucose fatigue, flu-like rebound hyperglycemia Dec. hypoglycemic effect with thiazides, thyroid symptoms drugs Sulfonylureas Control Directly stimulates beta drowsiness, headache, hypoglycemia Hypersensitivity, Type 1 Alcohol may produce a disulfiram-like reaction hyperglycemia in cells in the pancreas to confusion, tremors, diabetes (flushing, headache, sweating, N/V) type 2 diabetes secrete insulin; indirectly weight gain Inc. hypoglycemia with beta blockers and antacids alters sensitivity of Inc. hyperglycemia with thiazides and peripheral glucocorticoids insulin receptors, allowing inc. insulin binding Biguanides Control Inc. binding of insulin to Metallic taste, Hypoglycemia, lactic Hypersensitivity, Inc. Hypoglycemia with beta blockers and alcohol hyperglycemia in receptors weakness, flushing acidosis diabetic ketoacidosis Inc. Hyperglycemia with Thiazides type 2 diabetes Improve tissue sensitivity to insulin Inc. glucose transport to skeletal muscles and fatty tissues Dec. glucose production in the liver Thyroid Treat hypothyroidism, Inc. levels of T3 and T4 Tremors, nervousness, Tachycardia, hypertension, Cardiovascular disease, Inc. effects of anticoagulants and decongestants Replacement myxedema (severe irritability, insomnia, palpitations hypertension, diabetes Dec. effects of antidiabetics hypothyroidism), and weight loss Dec. absorption with antacids and estrogens cretinism (juvenile hypothyroidism) Antithyroid control overactive Reduces excessive Lethargic, drowsiness, Hypotension, bradycardia None None thyroid due to secretion of thyroid weight gain Graves disease and hormones by inhibiting toxic nodular goiter thyroid secretion (T3 and T4). Vitamin D Treat parathyroid Reabsorbs calcium by the Hypercalcemia Hypercalciuria, Hypersensitivity Dec. effects with barbiturates Analogue disorders and to kidneys, effects-fatigue, hypercalcemia, and Hypercalcemia Enhanced effects with thiazide diuretics manage Enhances intestinal weakness, drowsiness, hyperphosphatemia Hypervitaminosis D hypocalcemia in absorption of dietary metallic taste chronic renal failure calcium, Dec. serum phosphate, bone resorption and parathyroid hormone levels Glucocorticoid Treat adrenocortical Suppress inflammation, Fluid and sodium Cardiac arrest, GI Untreated serious Additive effects occur with corticosteroid sufficiency and immune responses, and retention, inc. ulceration, GI bleeding, infections, Inc. GI toxicity with NSAIDS Addison’s disease adrenal function appetite, mood pulmonary edema hypersensitivity, Inc. Potassium loss with Diuretics changes, and diabetes, hypertension immunosuppression Salicylates Reduce pain and Inhibits cyclooxygenase 1 Dizziness, hearing loss Tinnitus, ulceration, GI Hypersensitivity, under Inc. risk of bleeding with anticoagulants inflammatory (COX-1) and 2 (COX-2). bleeding, heartburn, 18, anticoagulant Inc. ulcerogenic effect with glucocorticoids symptoms **COX-1->protects Reye’s syndrome (swelling therapy Decrease body stomach lining, reduces of liver & brain), in teens temperature fever, under 18 Inhibit platelet promotes platelet aggregation aggregation. COX-2->triggers pain and inflammation Propionic Acid Reduce inflammatory Inhibits cyclooxygenase Dizziness, fluid GI bleeding, Severe renal or hepatic Inc. bleeding with oral anticoagulants Derivatives process, relieve pain, 1(COX-1) & 2 (COX-2) retention with edema, nephrotoxicity disease, peptic ulcer, and reduce fever **aspirin like drugs but tinnitus anticoagulant therapy, have stronger effects and bleeding disorders less GI irritation COX-2 Inhibitor Treat osteoarthritis Inhibits COX-2, but not Dizziness Peripheral edema Hypersensitivity, severe Dec. effect of ACE inhibitors and rheumatoid COX-1 renal and hepatic Inc. toxicity with lithium arthritis disease Immunosuppressive treat refractory Suppresses the None None None None s rheumatoid arthritis inflammatory process of (arthritis that does not rheumatoid respond to anti- arthritis inflammatory drugs) Immunodulators- Treat moderate to Binds to TNF and blocks it Coughing, chills, hot Severe infections, Hypersensitivity, heart Concurrent immunosuppressives may increase risk TNF Blockers severe rheumatoid from attaching to TNF flashes hypotension, bradycardia failure for INFE arthritis receptors on synovial cell surfaces. Reduces infiltration of inflammatory cells, and delays inflammatory process Anti-inflammatory Treat gout Inhibits the migration of Gastric irritation None Severe renal disease, None Gout leukocytes to the cardiac or GI problems inflamed site Uric Acid Inhibitor Treat gout and Reduction of uric acid Metallic taste, edema Bradycardia Hypersensitivity Inc. effect of anticoagulants hyperuricemia synthesis Dec. uric acid effect with antacids Uricosurics Treat chronic gout Increase rate of uric acid Flushed skin, sore Kidney stones History of blood Inc. uric acid retention with aspirin *Can be taken with excretion by inhibiting its gums dyscrasias (leukemia, colchine reabsorption hemophilia) *Should not be used during acute attacks TCAs Treat major Block the uptake of Orthostatic Cardiotoxicity, seizures MAOIs, seizures, acute Inc. side effects/adverse reactions with other depression norepinephrine and hypotension, sedation, myocardial infarction antidepressants serotonin in the brain anticholinergic effects Inc. sedation with alcohol and other CNS depressants SSRIs Treat depression, Block the reuptake of Nervousness, dry Increase suicidal risk hypersensitivity, MAOIs, Inc. effects of CNS and respiratory depression OCD, bulimia, serotonin in the brain mouth, restlessness, suicidal tendencies, Hypotensive effect with alcohol and CNS bipolar, and panic insomnia severe liver depressants disorder or kidney disease SNRIs Treat depression, Block the uptake of Drowsiness, dizziness, Hangover, dependence, Hypersensitivity, MAOIs, Inc. effects of CNS, respiratory depression, generalized anxiety norepinephrine and insomnia, dry mouth excessive depression, suicidal tendencies hypotensive effect with alcohol and CNS disorder, social serotonin in the brain respiratory depression, depressants anxiety disorder, and seizures, tachycardia panic disorder MAOIs Treat depression Increase the levels of Dizziness, insomnia, Lightheadedness, Severe kidney and liver Potential fatal hypertensive crisis with CNS norepinephrine, dry mouth orthostatic hypotension disease stimulants dopamine, Potential fatal hypertensive crisis with foods that epinephrine, and contain serotonin by inhibiting the tyramine (cheese, cream, yogurt, coffee, chocolate, Monoamine bananas, raisins, beer, and red wines) Oxidase enzyme** **Monoamine Oxidase enzyme inactivates all the neurotransmitters Mood Stabilizers Treat bipolar manic Alteration of ion transport Memory impairment, Hyponatremia Severe dehydration, Inc. lithium levels with NSAIDS and antidepressants episodes in muscles and. Nerve metallic taste, hyponatremia Inc. mania with amphetamines cells; increased receptor dizziness sensitivity to serotonin Phenothiazine Manage symptoms of Blocks the D2 Dry mouth, blurred Extrapyramidal Syndrome narrow angle glaucoma, Increase toxicity with anticholinergics psychosis, ADHD, and (dopaminergic) receptor vision, photosensitivity (Pseudoparkisonism), Parkinson’s disease Increase sedation with alcohol Tourette syndrome hypotension Atypical Manage symptoms of Blocks the D2 drowsiness, dizziness, EPS (less), hypotension hypersensitivity, severe Inc. sedation and orthostatic hypotension with Antipsychotics psychosis (dopernergic) receptor dry mouth CNS depression alcohol and/or CNS depressants *reverse of phenothiazine* and serotonin Other Antipsychotics may enhance the risk of 5-hydroxytryptamine (5- Neuroleptic Malignant Syndrome (NMS)* HT2) receptor Benzodiazepines Treat anxiety, panic increase the action of the lethargy, drowsiness, hangover, dependence, respiratory depression, increase CNS depressive effects with alcohol and disorders, insomnia inhibitory memory impairment excessive depression, acute alcohol other CNS depressants neurotransmitter respiratory depression intoxication, gamma-aminobutyric hypersensitivity acid (GABA) to the GABA receptors --> Neuron excitability is reduced (CNS depression) Dopaminergic Treat Parkinson’s Transmission of levodopa Anorexia, fatigue, Involuntary movements, narrow angle glaucoma Increased hypertensive crisis with MAOIs disease and to brain cells for dry mouth, bitter orthostatic hypotension, severe cardiac, renal, Decreased levodopa effect with anticholinergics parkinsonism and to conversion to dopamine; taste, twitching, urinary retention, hepatic disease May cause hypertension with methyldopa relieve tremors and carbidopa blocks the blurred vision, excess psychosis, depression with psychosis rigidity conversion of levodopa to dark sweating, urine suicidal tendencies suicidal tendencies dopamine in the intestine discoloration and (red, brown, or black) peripheral tissues Dopamine Agonist Alleviate the Stimulates the dopamine Dizziness, drowsiness, Hallucinations, nightmares None *Most patients develop a tolerance symptoms of receptors orthostatic *Not as effective as dopaminergic Parkinson’s disease hypotension *Can be taken alone or w/ dopaminergic or an anticholinergic Monoamine Treat the symptoms of Inhibits MAO-B and thus None None None None Oxidase B Parkinson’s disease or prolongs the action of Inhibitors Parkinsonism levodopa *The enzyme MAO-B causes breakdown of dopamine Catechol-O- Treat the symptoms of Increase the amount of None None None None Methyltransferase Parkinson’s disease or levodopa concentration in INH Parkinsonism the brain *The enzyme COMT inactivates dopamine *Used in combination with carbidopa and levodopa in order to reduce the  “wearing off” effects of levodopa. Acetylcholinesteras Improves memory loss elevates acetylcholine weight loss, Seizures, bradycardia, liver and renal disease Inc. the effect of theophylline e in Alzheimer disease, concentration *AChE depression, confusion, orthostatic hypotension, urinary tract obstruction Inc. GI effects with NSAIDS decreased effects control and treat inhibitors prevent the dry mouth, myocardial infarction orthostatic hypotension with TRICYLCLIC ANTIDEPESSANTS (TCA) myasthenia gravis enzyme AChE from dehydration COPD breaking down Acetylcholine Immunomodulators To decrease both the Antiviral and immune- depression, suicidal Hepatotoxicity Albumin hypersensitivity, None number and severity regulatory properties are tendencies, vision hamster protein of Multiple Sclerosis produced by interacting problems, hypersensitivity (MS) relapses with specific receptor myalgia, muscle sites on spasm, flulike cell surfaces symptoms Centrally Acting Short-term treatment Relieves muscle spasms anticholinergic effects angioedema, seizures acute Myocardial Increased CNS depression with alcohol and/or Muscle Relaxants of muscle spasms through a central action (blurred vision, Infarction (MI), seizure other CNS constipation, dry disorder, depressants mouth, tachycardia, alcohol, CNS urinary retention) depressants, glaucoma, urinary retention, diabetes, hypertension Alpha-Glucosidase Inhibitors MOA - Acts by inhibiting the digestive enzyme in the small intestine that is responsible for the release of glucose from complex carbohydrates in the diet Thiazolidinediones MOA - Stimulate the beta cells in the pancreas to release Insulin Incretin Modifier MOA - Increase the level of incretin hormones, increase insulin secretion, and decrease glucagon secretion to reduce glucose production Glucagon MOA - Increases blood glucose by stimulating glycogenolysis (glycogen breakdown) in the liver Disease-Modifying Antirheumatic Drugs: When NSAIDs do not control immune-mediated arthritic disease, the following DMARDS agents are used:  - IMMUNOSUPPRESSIVES - IMMUNOMODULATORS - ANTIMALARIALS type 1 - born with type 2 - developed later in life