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Summary

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Description

Drug name

MOA/class

Indications

C/I Contraindicatio ns

A/E Adverse effects

Bethanechol

Cholinergic

Urinary retention

Mech. obstruction of urinary tract

SLUDGE

Donepezil

Cholinesterase inhibitor (cholinergic)

Anti-alzheimers! Slows progression of AD.

pyridostigmine

Cholinesterase inhibitor (cholinergic action)

MG, helps ease sx of MG and build muscle strength due to ACh incr. Effects @ NMJ

Atropine

Anticholinergic, anti-arrythmic

Perioperative use to reduce GI secr. And salivation, inc HR and aide in asystole treatment

Glycopyrrolate

anticholinergic

Perioperative salivatory and respiratory sec reductions Antidote is neostigmine

Scopolamine

anticholinergic

‘Cruise ship drug’ used to ease N/V w traveling, motions sickness, also eases sx of N/V r/t opioid analgesia and general anesthesia

Carbidopa/levodop a

Antiparkinson (levodopa dopamine agonist, carbidopa decarboxylase

PD,

SLUDGE

Muscle relaxer use

SLUDGE

Hyperthermia BUDCAT

MG, GI, GU obstructions

Hyperthermia BUDCAT

BUDCAT

Glaucoma, Melanoma, cholinergic or MAOI use

Darkens sweat/urine, dyskinesia, “wearing off” phenomenon

inh.) entacapone

COMT inh. (prev. Breakdown of levodopa)

PD, for when ‘wearing off’ effects occurs, used in adjunct tx w/ carbidopa/levodo pa

NMS, dark sweat and urine, high protein diet reduces effectiveness

benztropine

Anticholinergic

PD, blocks ACh, reduces tremors, rigidity,

BUDCAT

memantine

NMDA antag. (blocks glutamate)

AD, dementia or neurocognitive s/sx (doesnt slow progression or cure dx)

Dizziness, HA, confusion, constipation

Methylphenidate

CNS stim

ADHD, narcolepsy, obesity, migraine, respiratory stimulation.

Don’t take w/ alcohol, coffee, MAOIs, take drug holidays!

Mirabegron

B3 agonist (first of its kind) b3 receptors bladder specific, cause detrusor relaxation

OAB

Angioedema, bladder outlet obstruction

Monitor for Angioedema,

Oxybutynin

Anticholinergic

OAB, neurogenic bladder,

BPH, obstruction, urinary retention

BUDCAT

Zolpidem

sedative/hypnoti c, binds to GABA receptor

Insomnia

Sleep apnea, suicidality, drug abuse

Somnambulatio n, schedule 4

Ramelteon

Sedative hypnotic. Melatonin receptor agonist

Earlier onset of sleep, circadian rhythm maintenance, Insom

Baclofen

Muscle relaxant, centrally acting

MS, SCI, cerebral palsy, decreased muscle spasticity,

Hallucinations, fatigue, dizziness

CNS depressants,

CNS depression, GI upset, urinary

increases bowel and bladder function

retention, d/c drug slowly, rhabdo can occur w/ abrupt d/c

Dantrolene

Muscle relaxant, direct acting

MS, cerebral palsy, SCI, stroke, malignant hyperthermia

CNS effects

cyclobenzaprine

Muscle relaxant, centrally acting

Acute pain w muscle spasms, fibromyalgia,

Beers list! CNS depression, can cause dependence, taper is necessary

Carbamazepin e

Antiepileptic

Anticonvusion tx, mood stabilizer and pain reduction of trigeminal neuralgia,

Oral contraceptives may lose effectiveness. Nystagmus, hematological issues, rash, autoinduction leads to lower than expected drug levels, Black box for suicidal thoughts

diazepam

Benzodiazepine, hypnotic (GABA potentiation) long acting

Anx, seizure mgmt for status epilepticus, alcohol withdrawal,

CNS depressant use (additive depression)

Decreased HR, never d/c suddenly, taper is necessary

Valproic acid

Antiepileptic

Seizure disorders, bipolar disorders, migraine

CNS depressant use (additive depression)

Monitor serum levels, also black box for suicidal thoughts GI effects, hepatotoxicity, pancreatitis, teratogenic effects.

phenobarbital

barbiturate

Tonic-clonic

Narrow

seizures, fever induced convulsions (low doses sedative, higher doses hypnotic)

therapeutic index, can cause skin, CNS reactions, black box

Monitor serum drug levels. Admin precautions w/ IV phenytoin (dilute in only NS, irritating to veins) give w/ food, gingival hyperplasia, acne, hirsutism

Phenytoin

antiepileptic/anticonvulsa nt, 1st line

Epilepsy, convulsions, seizures

Alprazolam

Benzodiazepine, sedative/hypnotic Intermediate acting

Anxiety and anx related issues, panic disorder

CNS depressant s (additive depression)

diazepam

Benzodiazepine, sedative/hypnotic, Long acting

Seizure mgmt for status epilepticus, alcohol withdrawal

CNS depressant s, (additive depression)

buspirone

Atypical anxiolytic, no abuse potential

General anxiety dx

Morphine sulfate

Opioid analgesic

Pain, postoperative analgesia

CNS depressant s (additive depression)

High abuse potential, respiratory depression, miosis, diaphoresis, constipation, falls, orthostatic hypotension

Fentanyl

Opioid analgesic

Pain, postoperative analgesia, pain tx in terminally ill pt’s

CNS depressant s (additive depression)

High abuse potential, respiratory depression, miosis, diaphoresis,

Serotonin syndrome, EPS, TD

constipation, falls, orthostatic hypotension naloxone

Opioid antagonist

Opioid overdose

Pain recurrence (if opioid OD r/t analgesic tx and not illicit drug use)

acetaminophe n

Non-opioid Analgesic and antipyretic

Mild to moderate pain and fever, alternative to aspirin for aspirin C/I

Hepatotoxicity, renal failure, N/V, 3g/daliy for healthy adults, 2g for older and those w/ liver dyfunct.

acetylcysteine

mucolytic

Breakdown of mucous, antidote for acetaminophen toxicity

Sumatriptan

Antimigraine, serotonin receptor agonist,

Abortive migraine tx, not a prophylactic drug

Hx of MI, CAD, HTN

Angina (vasoconstrictive effects),

Aspirin

Coagulation modifier, antiplatelet, NSAID

Antiinflammato ry effects, reduce cardiac death after MI (325/81 dosing), RA

Gout (inc uremic acidemia), pregnancy 3rd trim

NSAIDS may counteract cardio effects

clopidogrel

Anti-platelet (inh platelet adhesion)

Reduction of atherosclerotic events post MI, acute coronary syndrome, CVA, PVD,

prev prim and sec CVA dabigitran

NOAC, direct thrombin inhibitor

Reduces stroke risk w/ a-fib

pregnancy

Lower dose for renal dysfunc, bleeding

LMWH heparin

anticoagulant

Prev of DVT or PE, prev of ischemic complications from nonstable angina or non STEMI

Indwelling epidural

Epidural hematoma, bleeding, heparin-induced thrombocytopeni a, antidote is protamine sulfate

UNFX heparin

anticoagulant

DVT, PE, MI, CVA, prev complications of evolving angina, aPTT needed!

warfarin

Anticoagulant (most common oral anticoagulant)

Stroke, a-fib, DVT, PE, postMI, INR monitoring is essential, INR 2-3.5 is therapeutic (high INR, more impaired clotting)

Rotate injection sites around umbilicus (2in radius) hematuria, melena, petechiae, antidote is protamine sulfate preg

Livedo reticularis, purple toes. Antidote is vitamin K. bleeding may occur.

Alteplase

thrombolytic

Acute MI, arterial thrombolysis, DVT, shunt or cath occlusion, PE, acute ischemic stroke

Hemorrhagic stroke, known bleeding, brain tumor, AVM, recent head trauma, spinal trauma, recent surgery.

Bleeding, GI bleeding, intracranial hemorrhage, cardiac dysrhythmias

Erythropoeitin

RBC erythropoeisis

Tx of anemia rt ESRD, chemo

Uncontrolled HTN,

Ineffective w/o adequate iron body

stimulant

ind. Anemia, anemia assoc. w/ HIV tx (oft given w/ iron supplement)

Ferrous sulfate

Iron supp

Iron deficiency, anemia r/t iron defeciency,

Folic acid

Water soluble b12

Pernicious anemia and megaloblastic anemia

filgrastim

Granulocyte colony stimulating factor

Neutropenia, inf. control

oprelvekin

Platelet promoter

Low platelets, enhance chemo thromocytopenia

celecoxib

NSAID, COX-2 inhib

Ank. spon, RA, dysmenorrhea, OA, gout,

NSAID allergy, Aspirin allergy, upcoming surgery, pts w/ sulfa allergy, ACEi int

NSAID, antipyretic, antirheumatic

RA, OA, dysmenorrhea, gout, dental pain, musculoskel dx, fever

NSAID allergy, upcoming surgery, ACEi int

ibuprofen

stores. HTN fever, headache, pruritis, rash, NV, arthralgia

GI disorders

Tarry black stools, take w/ OJ, keep in fowlers for 30m Deep IM injection, pain

Flu like s/sx

will interact with anti-coagulants (warfarin), aspirin, corticosteroids and other ulcerogenic drugs; this drug may mask signs of an infection; d/c all NSAIDS 1 week prior to surgery or invasive testing,

acute renal failure, noncardiogenic pulmonary edema, increased risk of MI and stroke, altered hemostasis, hepatoxicity, skin eruption, GI: ulcers and bleeding; NSAIDS

precaution vitamin K deficiency, peptic ulcer disease, thrombocytopenia, will int w anticoag (warfarin), ACEi int indomethacin

NSAID, anti inflam, analgesic, antirheumatic, antipyretic

RA, OA, tendonitis, bursitis, Ank Spon, gouty arthritis, preterm labor,

naproxen

NSAID, second most commonly used

Mild to moderate ACEi int pain, dymenorrhea, fever, RA, OA

adalimumab

Biologic DMARD, antirheumatic, monoclonal antibody

Mod to severe RA, psoriatic arth, ank spon, chrohns, UC, decreased swelling and joint destruction of RA and ank spon

Active infections, immunizations up to date, dont give concurrent W live vaccine

Inf, recurrent Hep, TB, opportunistic inf,

prednisone

Glucocorticoid, anti inf.

Chronic resp inf. (w/ steroid),

Addisons disease,

CV effects, (hypokalemia, hypernatremia) , CNS, endocrine (Cushings) no taper, suddenly stops can cause Addisons, too much can cause Cushings, make sure you draw baseline BGs

ACEi int, Warfarin int, Beta blockers int.

gastritis, reflux disease, ulcer disease, DM, cardiac, renal or liver dysfunction allopurinol

Antigout, antihyperuricemic

prevention of attack of gouty arthritis and nephropathy; lowers the serum uric acid levels; inhibits

Gout attacks, renal insuff, dehydration, elderly pt use caution

Skin related dx

production of uric acid by inhibiting the action of xanthine oxidase (less selective than febuxistat); febuxistat

Nonpurine selective inh. Of xanthine oxidase

Chronic mgmt of hyperuricemia w/gout pts

Risk for adverse CV events

colchicine

antigout

Short term mgmt or prev of gout, reduces inf. Response to deposits of urate crystals in joint tissue

May cause short term leukopenia/anemia or urinary/GI bleeding

Methotrexate

Trad. nobiologic DMARD; antineoplastic, antirheumatic,

Adults w active RA, children w juvenile idiopathic arthritis, cancer and severe psoriasis

cyclosporine

Immunosupressant and antirheumatic, nonbiologic DMARD

Organ transplant prophylaxis, lupus E in nonresponsive pt’s, RA, psoriasis

Opp inf.

Epinephrine

Adrenergic; stimulates both alpha and beta adrenergic receptors

Anaphylaxis, asthma attacks, heart blocks, cardiac arrest, hemostasis (alpha and beta adrenergic agonism causes vasoconstriction as well as bronchial dilation; these are only few of the MANY

BEESTING; –

Active infections

opportunistic infections, pancytopenia risk increases, hepatotoxicity;

blood glucose elevation, eye pain (increased pressure), elevated BP, stroke/heart attack, tachycardia and tremors, irritability and anxiety, nervousness, gangrene

effects)

(peripheral vasoconstriction, blood shunted central

phenylephrine Alpha adrenergic agonist; postsynaptic; causes a raise in BP r/t vasoconstriction

Indicated for therapeutic raise in BP, ie vascular failure in shock, paroxysysmal supra. Vtach, anesthesia, nasal decongestion

fear, anxiety, restlessness, HA, nausea, decreased urine formation, pallor

dopamine

Adrenergic agonist (alpha and beta)

improves BP, CO (peripheral circulation), urine output in treatment of shock unresponsive to fluid replacement

Adrenergic antagonist; produces alpha 1 blockade

Therapeutic drop in BP, HTN and BPH, antidote for OD of alpha 1 agonism, reynaud’s disease.

Beta 1 and beta 2 receptor antagonist, added a1 antagonist properties

HTN, pheochromocytoma , clonidine withdrawal HTN,

Doxazosin

labetalol

high alert med; extravasation may occur

orthostatic hypotension, reflex tachycardia, nasal congestion, inhibition of ejaculation, sodium retention dizziness, vertigo, fatigue, gastric pain, flatulence, impotence, bronchospas m, dyspnea,

cough (WIFSOB) propranolol

Nonselective Neg inotrope, beta antagonist chronotrope, (b1, b2) dromotrope, ind, for mgmt of HTN, arrhythmias, angina, migraines,

Lisinopril

ACEi, inhibits angiotensin 1 from being converted to angiotensin 2 in the lungs, resulting in less bradykinin breakdown, decreased BP and retention of potassium

#1 choice for pt w HTN in HF, HTN, HF, decreases preload, prevention of LV hypertrophy post-MI, compelling ind in DM for renal protective effects!,

Category X! Reduced effectiveness w. Concurrent NSAID use

hyperkalemia and dry unproductive cough, angioedema (very rare but fatal)

Losartan

ARB (angiotensin 2 receptor blocker) blocks ang2 binding and thus aldosterone secretion. This leads to

HTN, HF tx adjunct,

renal or hepatic dysfunction and pts with renal artery stenosis,

chest pain, fatigue, hypoglycemia, diarrhea, UTI, anemia, weakness, hyperkalemia and cough

arrhythmia, bradycardia, HF, pulmonary edema, StevensJohnson syndrome, anaphylaxis; avoid abrupt withdrawal of med, take apical pulse prior to administering PO (WIFSOB) Weakness impotence, fatigue, shortness of breath

reduced BP, and higher serum potassium levels Atenolol

Beta1 receptor antagonist (cardioselectiv e) decreases excitability of the heart, competes w NE and Epi for adrenergic receptors

Verapemil

Non DHP CCB, HTN, Angina, slows conduction (neg dromotrope), causes SM relaxation by blocking calcium from binding to its receptors

LV dysfunction, 2nd + 3rd degree heart block, severe HF and severe HTN

Non-DHP CCB, slows conduction (neg

LV dysfunction, 2nd + 3rd degree heart block, severe

Diltiazem

Angina pectoris, HTN, MI, migraine prophylaxis, alc withdrawal, SVT

HTN, Angina, HF

weakness, impotence, fatigue, SOB, bradycardia, glycemic unawareness; contraindicate d in shock, and uncompensat ed HF; long term use causes reduced peripheral vascular resistance orthostatic hypotension, constipation, peripheral edema, exacerbation of angina, flushing, dizziness, HA, reflex tachycardia (can give beta blockers with this to make this go away)

orthostatic hypotension, constipation,

dromotrope), causes SM relaxation by blocking calcium from binding to its receptors

HF and severe HTN

peripheral edema, exacerbation of angina, flushing, dizziness, HA, reflex tachycardia (can give beta blockers with this to make this go away)

Amlodipine

Dihydropyridin e CCB, (neg dromotrope) antihypertensiv e, antianginal

HTN, angina, lower BP,

peripheral edema, bradycardia, hypotension, palpitations, gingival hyperplasia

Furosemide

Loop diuretic, antihypertensiv e,

HTN, edema, pulm, htn or renal dx, nephrotic system and ascites, increase renal excretion of calcium.

hypokalemia, hyperglycemia , hyperuricemia

Hydrochlorothiazid e,

thiazide diuretic, distal convoluted tubule,

HTN, excretion of potassium, sodium, chloride. Edematous states, diastolic HF, cirrhosis, corticosteroid/estro gen tx

hypokalemia, hyperglycemia , hyperuricemia , hypochloremic alkalosis; don’t use if creatinine ↓clearance is...