-ATI-Final Pharmacology PDF

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ATI Final Classification NSAIDS

Prototype NSAIDS: Asprin2nd Gen: Celecoxib (celebrex)

Action decrease inflammation, pain, and fever

Uses Inflammation, Analgesia, fever reduction, dysmenorrhea

Antigout

Colchicine

decrease inflammation

Gout

Migraine Medications

Ergot alkaloids: Ergotamine (ergostat) Serotonin receptor agonists (Triptains): Sumatripitan (Imitrex)

prevent inflammation and dilation to intracranial blood vessels

abort acute migraine attack, prevent migraines

Opioid Antagonist

Naloxone (Narcan)

interfere with the action of opioids

Neuromuscular Blocking Agents

Nondepolarizing: Tubocurarine (Tubarine) Depolarizing: succinylcholine (Anecitine)

Block ACh at neuromuscular junction

opioid overdose, reverse effects of opioids, reversal of resp. depression in infants adjuncts to general anesthesia, diagnosis myasthenia gravis, seizure control, endotracheal intubation, endoscopy

Anti Parkinsons

Dopaminergic: Levodopa (Dopar, Larodopa) block receptors Dopamine agonists: pramipexole (Mirapex) Centrally acting anticholengerics: Benztropine (congentin) Dopamine releaser (Antiviral): Amantadine (symmetrel)

Parkinsons

AEDs

Barbiturates: phenobarbital (Luminal) Hydantoins: phenytoin (Dilantin) Benzodiazepines: diazepam (valium), lorazepam (Ativan) Carbamazepine (Tegretol), ethosuximide (zaronin), valproic acid (Depakote), gabapentin (Neurontin)

slow entrance of Na and Ca, suppress neuronal firing, inhibit GABA

generalized seizures, partial seizures

Muscle relaxants and Antispasmodics

dantrolene (Dantrium)

acts directly on spastic muscles

relief of spasticity

Local Anesthetics

Amide: lidocaine (xylocaine)"cain"

decrease conduction of pain impulses

minor procedures...

General Inhalation Anesthetics

Halothane (fluothane)"ane"

loss of sensation, consciousness, memory loss

Surgery, diagnostic procedures, analgesia, muscle relaxation

Antipsychotics-ConventionalLow: Chlorpromazine (thorazine) High: Haloperidol (haldol)

inhibit psychotic symptoms

schizo, bipolar, tourettes, delusions, dementia, Huntington’s chorea

Antipsychotics-atypical

clozapine (clozaril)

blocks serotonin and dopamine

severe schizo, psychosis

TCA

amitriptyline (Elavil)

block reuptake of norepi and serotonin-intensify effects

Depression, bipolar

Side effects GI discomfort, gastric ulcers, bleeding, renal dysfunction, Salicylism, Reye Syndrome GI toxicity

Interactions Warfarin, Glucocorticoids, Alcohol, Ibuprofen

Ergot: GI discomfort; Ergotism, physical dependence, abortionTriptans: Chest symptoms, angina, teratogenic tachycardia, tachypnea, abstinence syndrome

Triptains with MAOI's

Respiratory arrest, hypotentionSuccinylcholine: apnea, malignant hypertension, hyperkalemia

General anesthetics, Aminoglycosides, tetracyclines, Cholinesterase inhibitors Levodopa: Protients, conventional antipsychotic agents, pyridoxine, MAOIs. Mirapex: Levodopa

continuous cardiac monitoring

Nervous system

effects may not be noticeable for several weeks to months

Nervous system

Dilantin: OC, warfarin, glucocorticoids, alcohol, valium. Tegretol: OC, warfarin, grapefruit juice, phenytoin, phenobarbital. CNS depressants

use for control not cure, seizure frequency chart

Nervous system

Levodopa: N/V, Dyskinesias, ortho hypo, cardio effects, psychosis, discoloration of sweat and urine, activation of malignant melanoma Mirapex: sleep attacks, daytime sleepiness, ortho hypo, psychosis, dyskinesias, NauseaCogentin: N/V, Atropine effects. CNS effects, skin rash, toxicity, Cardio effects, teratogenisis, GI effects, respiratory depression

CNS depression, hepatic toxicity, physical dependence CNS excitation, Hypotension, Allergic reactions, Spinal headache, urinary retention hypotension, resp and cardio depression, malignant hyperthermia, hepatotoxicity EPS, TD, Neuroleptic malignant syndrome, Anticholinergic effects, ortho hypo, sedation, seizures, sexual dysfunction, skin effects Agranulocytosis, seizures, weight gain, inflammation of heart muscle ortho hypo, anticholinergic effects, sedation, cardiac toxicity,

NI Take with food, milk, or fully glass of water

Warfarin Avoid trigger factors.

Affecting Pain and inflammation

Pain and inflammation Pain and inflammation

Pain and inflammation

don’t stop taking medication Nervous system

CNS depressants, CNS stimulants, morphine sulfate, succinylcholine Anticholinergic agents, CNS depressants, Levodopa

NPO 6-8 hrs. before

Nervous system

Immunosuppressive meds MAOIs, Antihistamines, Epinephrine, NE,

Nervous system

Nervous system

effects not experienced until 1-3 weeks

Nervous system

SSRIs

Fluoxetine (prozac)

block reuptake of serotonin

Depression, OCD, bulimia, panic disorders, PTSD

MAOIs

Phenelzine (Lardil)

increase amount of NE and serotonin avaliable

atypical depression, bulimia, OCD

Atypical Antidepressants

bupropion HCL (Wellbutrin)

Inhibit dopamine uptake

depression, aid to quit smoking

Mood stabilizers

Litium: Valproic acid(depakote), carbamazepine (tegretol)

serotonin blockade

bipolar, alcoholism, bulimia, schizo

Benzodiazepines

diazepam (Valium)

enhance GABA in CNS

Anxiety, seizure, insomnia, muscle sapsm, alcohol withdrawal, panic disorder

Non Benzo

zolpidem (Ambien)

do ot function as muscle relaxant binds to serotoinin and dopamine receptors

Anxiolytic-Non-Barbiturate buspirone(BuSpar)

insomnia GAD

Sexual dysfunction, wt. gain, mental confusion, agitation, anxiety, withdrawal syndrome, hyonatremia, rash, sleepiness CNS stimulation, ortho hypo, hypertensive crisistrycyclic

H/A, dry mouth, contipation, tachycardia, nausea, wt.loss, seizures GI effects, tremors, polyuria, renal toxicity, goiter, teratogenesis, CNS depressions, paradoxical response, respiratory depression, teratogenesis, acute toxicity daytime sleepiness and lightheadedness CNS effects

CNS Stimulant

Methylphenidate (ritalin,Concerta)

Release NE and dopamine

ADHD, Narcolepsy, Obesity

CNS stimulation, wt.loss, Cardioeffects,

Adrenergic Agonists

epinephirne (Adrenaline)Dopamine (Intropin)Dobutamine(Dobutrex)

increase HR, Contractility, rate of conduction

Tx of AV block and cardiac arrest, HF, shock, hypertenstion

Hypertensive crisis, dysrhythmias, necrosis, increase HR

venous and arterial dilation, smooth muscle relaxation decrease sympathetic outflow

hypertension, BPH

First dose hypertension

HTN,sever CA pain

Drowsiness, sedation, dry mouth rebound hypertension

Bradycardia, decrease CO, AV block, ortho hypo, rebound myocardium excitation, bronchoconstriction, glycogenolysis inhibited first dose ortho hypo, cough, hyperkalemia, rash, angioedema, neutropenia

Alpha Adrenergic blockers Prazosin(minipress) (sympatholytic) Centrally Acting Alpha2 agonists

Clonidine(Catapress)

Beta Adrenergic Blockers (sympatholytic)

Cardio selective: metoprolol (lopressor) nonselective: Propranolol (Inderal)"lol"

block beta1 adrenergic receptors

angina, HTN, dysrhythmias, MI, HF

ACE inhibitors

Captopril(capoten)"pril"

block the production of Ang II (vasodilation, excretion of Na and H2o and retention of K) blocks action of ang II

HF, HTN,MI, nephropathy

ARBs

lorsartan (Cozaar)"artan"

CCB

nifedipine (Adalat,Procradia)"ipine"verapamil (calan), diltiazem (cardizem)

vasodilation

Hypertensive crisis

Sodium nitroprusside

direct vasodilation

HTN, HF, MI, Stroke,nephropathy Angina, HTN,Verapamil:dysrhythmias

hypertensive emergencies,

Ephedrine, amphetamine, CNS depressants MAOIs, warfarin, Tricyclic antidepressants, NSAIDS anticoagulants,

take with food

Nervous system

antidepressants, SSRIs, Antihypertensives, Mepridine(Demerol), Tyramine rich foods, Vasopressors MAOIs

take daily

nervous system

Diuretics, NSAIDS, Anticholinergics

monitor litium levels

Nervous system

CNS depressants

taper dose when D/C

Nervous system

CNS depressants, food

take before bedtime take with meals

Erythromycin, ketoconazole, grapefruit juice MAOIs, Caffeine, Phenytoin, warfarin, OTC cold meds MAOIs, Tricyclic antidepresants, general anthetics, alpha-adrenergic blocking agents, beta adrenergic blocking agents, diuretics Antihypertensive meds anti HTN meds, praxosin, MAOIs, tricyclic antidepressants, CNS depressants CCB, Antihypertensive meds, insulin

Nervous system

Nervous system Nervous system

don’t chew or crush

Nervous system

IV continuous infusion

Cardiovascular system

BP,HR, take w/food, inital dose at bedtime

Cardio

Cardio

don’t d/c med with out dr. orders, don’t crush or chew

cardio

Diuretics, antiHTN meds, K supplements, lithium, NSAIDS

1hr before meals

cardio

angioedema, fetal injury

anti HTN meds

reflex tachy, peripheral edema, acute toxicityverapamil: ortho hypo, constipation, suppression of cardiac function, dysrhythmias excessive hypotention,

beta blockers, grapefruit juiceverapamil: plus digoxin

taken with or with out food IV 2-3 min

cardio

don’t mix with

cardio

cardio

decrease bleeding

cyanie poisoning, thiocyanate poisoning, H/A, ortho hypo, reflex tachycardia, tolerance

other medications

Organic Nitrates

nitroglycerine (Nitrol, Nitrostat)

angina

angina

Cardiac Glycosides

digoxin (Lanoxin, lanoxicaps, digitek)

increase force of contraction, decrease HR

HF, dysrhythmias(A fib)

Statins

atorvastatin (Lipitor)

Cholesterol

Antilipemics: fibrates

gemfibrozil (Lopid)

increase VLDL excretion, increase HDL levels

hyperohlesterolemia, prevent coronary events, protect MI, raise HDL levels Reduction of VLDLs, increase HDL

Antilipemics-Cholesterol Absorption Inhibitor

ezetimibe (zetia)

absorb cholesterol

lower LDL

NONE

Cholestyramine, statins, fibrates, cyclosporine,

Antilipemicsbile-acid-sequestrants

cholestyramine (Questran)

lower LDL

Lower LDL

Constipation

Anticoagulants/parenteral

Heparin

prevents bleeding

DVT, DIC

Hemmorrhage, hypersensitivity reactions

digoxin, warfarin, thiazides, tetracyclines anti-platelet agents

Tx of Heparin overdose

Protamine Sulfate

antidote

Anticoag/Oral

Warfarin (coumadin)

prevent synthesis of coagulation factors

reversal of heparin administration thrombosis

Warfarin overdose

Vit K(phytonadione, Aquamephyton)

promotes synthesis of coag factors

reversal of bleeding, Vit k deficiency

Antiplatelets

Asprin (ecotrin)

prevent platelets from clumping together by inhibiting enzymes dissolves clots that have already formed provide iron

MI, stroke, coronary syndromes

Thrombolytic medications

Streptokinase (streptase) "ase"

Iron Preparations

Ferrous sulfate (feosol)Iron dextran (INFeD)

MI, DVT, PE, ischemic stroke iron deficiency

Dysrhythmias, bradycardia, GI effects(anorexia, N/V, abd pain) CNS effects(fatigue, weakness, vision changes) hepatotoxicity, myopathy, peripheral neuropathy Gall stones, myopathy,hepatotoxicity

hemorrhage

anaphylactoid-type reaction (flushing, hypotension, urticaria, cardio collapse) GI effects (bleeding), Hemorrhagic stroke bleeding, hypotension, allergic reaction GI distress, Teeth staining, Anaphylaxis

Alcohol, antihypertensive meds, viagra Thiazide, ACE, ARBs, sympathomimetic meds, quinidine, verapamil fibrates, erythromycin, grapefruit juice Warfarin, statins, cholestyramine

heparin, aspirin, glucocorticoids, acetaminophen, foods high in vit K

NSAIDs, Heparin, Warfarin antacids, vit c

increase production of RBC

anemia, HIV

HTN, increased risk for cardiovascular event

Beta2-Adrenergic agonists

activate the beta receptorsin the bronchial smooth muscle bronchodilation

asthma

Tachycardia, angina, tremors

beta blockers, MAOIs, tricyclic antidepressants

asthma

GI distress, restlessness, seizures local anticholingergic effects difficulty speaking, hoarsness, candidiasis, bone loss, hyperglycemia, myopathy, peptic ulcer disease, infection,

caffeine

Methylxanthines

theophylline (Theolair)

Inhaled Anticholinergic Glucocorticoids

ipratropium (Atrovent) belcomethasone dipropionate (QVAR)

brochodilation prevent inflammation, suppression of airway mucus,

brochospasm, asthma prophylaxis of asthma, oral therapy, replacement therapy

Mast Cell Stabilizers

cromolyn sodium (Intal)

Anti-inflammation

chronic asthma, exercised and allergen induced asthma

Leukotriene Modifiers

montelukast (singulair)

suppresses inflammation,

Long term asthma

check apical pulse, same time daily,

cardio

take with evening meal

Cardio

obtain baseline cholesterol levels, take 30 min prior to meals baseline cholesterol levels, no reguard to food disolve in 4oz of H2O

Cardio

baseline vitals, monitor CBC,monitor aPPT (60-80sec) IV administered slowly vitals, monitor PT, CBC, platelet count, Hct levels small doses orally

k-depleting diuretics, NSAID

warfarin,Theophylline

Cardio

Blood

Blood Blood

Blood

Blood take on empty stomach, green blackish stool monitor iron levels, BP, Hgb and Hct

blood

blood

Respiratory

Respiratory

fixed schedule

take 15 min before exercise or exposure to allergen liver injury

cardio

Blood

NSAIDs, Heparin, warfarin

Hematopoietic growth factorsepoetin alfa (Epogen, Procrit)

Albuterol (proventil, Ventolin)

Cardio

Respiratory Respiratory

Respiratory

Respiratory

bronchoconstriction, edema, mucous production Cough suppression

Antitussive-Opioids

Codiene

Mucolytics

acetylcysteine (Mucomyst)

enhance the flow of secretions in respiratory passaes

pulmonary disorders, cystic fibrosis

Decongestants

phenylephrine

cause reduction in inflammation

rhinitis, sinusitis

Rebound congestion, CNS stimulation, Vasoconstricion

High Ceiling Loop Diuretics furosemide (Lasix)

prevent reaborption of H2O

Pulmonary edema, renal impairment

Dehydration, hypotension, ototoxicity, hypokalemia

Thiazide Diuretic

hydrochlorothiazide(HydroDIURIL)

block reabsorbtion of Na and Cl

essential HTN, mild-mod HF, liver and kidney disease

dehydration, hypokalemia, hyperglycemia

K sparing diuretics

spironolactone (Aldactone) mannitol (Osmitrol)

block action of aldosterone increases blood osmolality

k sparing effects, HF

osmotic diuretics

K supplements

potassium chloride (K-Dur)

supplys K

hypokalemia

Histamine Receptors Antagonists Proton Pump Inhibitor

ranitidine hydrochloride (Zantac) omeprazole (Prilosec)

GERD, H.pylori, Heart burn, sour stomach peptic ulcers, GERD, hypersecretory contitions

Antacids

aluminum hydroxide gel (Amphojel)

suppress secretion of gastric acid reduce gastric acid seretion by irreversibly inhibiting enzyme neutralize gastric acid and inactivate pepsin

hyperkalemia, endocrine effects HF, pulmonary edema, Renal failure, fluid and electrolyte imblalances GI distress, local GI ulceration, hyperkalemia decrease libido, CNS effects

Prostaglandin E Analog

misoprostol (cytotec)

laxatives

psyllium(Metamucil)docusate sodium (Colace)bisacodyl (Dulcolax)magnesium hydroxide metoclopramide (Reglan)

Prokinetic agents Oral hypoglycemicssulfonylureas Oral hypoglycemicsBiguanides Insulin Overdose

tolbutamide (orinase) glipizide (Glucotrol, Glucotrol XL) metformin HCl (Glucophage) Glucagon

Thyroid hormones

levothyroxine(Synthroid,levothriod)

Antithyroid Medications

propylthiouracil (PTU)

posterior pituitary hormone vasopressin (pitressin synthetic)

for non-productive cough

Renal failure, decrease ICP, IOP

CNS effects, GI distress, potiential for abuse Aspiration, bronchospasm

constipation, hypophosphatemia,

decreases acid production softens fecal mass

long term NSAID use prevent ulcers, pregnant constipation

suppress emeisis

GERD, chemo enduced Nasuea, type 2 diabetes

diarrhea, abd pain, dysmenorrhea GI irritation, Rectal burning sensation EPS, sedation, Diarrhea

reduce production of glucose within liver increases breakdown of glycogen into glucose synthetic form of T4

block synthesis of thyroid hormoones promotes reabsorption of H20 within kidneys stimulates uterus

type 2 diabetes PCOS hypoglycemia

hypoglycemia GI effects, Vit B12 deficiency, lactic acidosis GI distress

hypothyroidism, emergency tx of myxedema coma

overmedication

grave's disease

overmedication, agranulocytosis reabsorption of too much water uterine rupture, HTN crisis

diabetes insipidus, used during cardiac arrest induction of labor, fetal stress test

Di...