Pharm Flashcards - flash cards/ drug classes PDF

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Pharm Flashcards NERVOUS SYSTEM Benzodiazepines  Alprazolam  Diazepam  Lorazepam  Chlordiazepoxide  Sedation  Dependency/Withdrawal - Short term  Antidote is Flumazenil Atypical Anxiolytics  Buspirone  No Sedation - No Dependency - Long term  Full effects take weeks  Take with meals SSRIs  Paroxetine  Sertraline  Fluoxetine  Insomnia  Watch for Serotonin Syndrome (Agitation, Hallucinations, Fever, Diaphoresis, Tremors)  Do Not Take With St. John’s Wort  Full Effects take months Atypical Antidepressants  Bupropion  Trazodone (Major Side Effect - Sedation)  Depression & Smoke Cessation  Insomnia, headache, GI Distress, Weight Loss, Agitation, Seizures TCAs  Amitriptyline  Imipramine  Sedation, orthostatic hypotension Anticholinergic Effects (Urinary Retention, Constipation, Dry Mouth, Blurry Vision, Photophobia) MAOIs  Phenelzine  Tranylcypromine  HTN Crisis  Do not eat foods with tyramine

Mood Stabilizers  Lithium  Side Effects: GI Upset, Fine Hand Tremors (Coarse in Tox), Polyuria, Weight gain, Kidney Tox, Electrolyte imbalances  Monitor Plasma Levels: Tox over 1.5 mEq/L  Toxicity (Coarse hand tremors, confusion, hypotension, seizures, tinnitus  No diuretics, Anticholinergics or NSAIDs  Contraindicated in Renal Disease  Closely monitor NA, Drink 2-3 L of water Antiepileptics (Bipolar Disorder)  Carbamazepine (Blood Issues (Anemia, Thrombocytopenia & Leukopenia), Vision Issues & Rash)  Valproic Acid (GI Upset, Hepatotoxicity, Pancreatitis, Thrombocytopenia) Antipsychotics  Chlorpromazine  Haloperidol  EPS, NMS, Agranulocytosis, Anticholinergic Effects, Sedation  Monitor Vitals 1-2 hours  Benztropine can control EPS  Dantrolene can control NMS Atypical Antipsychotics  Risperidone (IM q 2 weeks for non-compliance)  Clozapine (Agranulocytosis)  Olanzapine  Diabetes, Weight Gain, Increased Cholesterol, Sedation, Anticholinergic Effects  Avoid Alcohol

ADHD Meds  Methylphenidate  Amphetamine  Insomnia, Dysrhythmias, Decreased Appetite, Weight Loss  Do not give at night  Give Immediately Before/After Meals  Monitor Child’s Weight Alcohol Abuse (Withdrawal) *Withdrawal Starts Within 4-12 Hours of Last Drink *Peaks at 24-48 Hours  Benzodiazepines - Stabilizes vitals, Decrease Seizures  Carbamazepine - Decreases Seizures  Clonidine - Decreases BP & HR

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Beta Blockers - Decreases BP, HR, & Cravings

Alcohol Abuse (Abstinence)  Disulfiram - Vomit  Naltrexone - Decreases Cravings  Acamprosate - Decreases Abstinence Symptoms Opioid & Nicotine Withdrawal Opioid  Methadone - Used for Withdrawal & Long-Term Nicotine  Bupropion  Nicotine Replacements - Gum, Patch, Nasal Spray  Varenicline - Reduces Cravings/Withdrawal; monitor for depression Cholinergics  Neostigmine  Pyridostigmine  Edrophonium (Used to Diagnose MG vs. Cholinergic Crisis)  Myasthenia Gravis, Reverses Nerve Blocks  Increased Salivation, Diarrhea, Nausea/Vomiting, Sweating, Bradycardia  Antidote is Atropine

Anti Parkinson’s (Dopamine Agonist)  Levodopa/Carbidopa  N/V, Drowsiness, Tics, Orthostatic Hypotension, Darkening of urine/sweat  Do not take with High Protein Meals, can take with other meals Anti Parkinson’s (Anticholinergic)  Benztropine  Anticholinergic Effects (Dry mouth, Dry Eyes, Blurry Vision, Urinary Retention) Antiepileptics  Phenytoin  Lamotrigine  Carbamazepine  Valproic Acid  Gingival Hyperplasia, double vision, rash, ataxia  Narrow Therapeutic Range - Monitor Levels  Decreases Oral Contraceptives Anti Glaucoma (Beta Blockers)  Timolol  Glaucoma  Hold Gentle Pressure on Nasolacrimal Duct for 30-60 Seconds

Anti Glaucoma (Carbonic Anhydrase Inhibitor)  Acetazolamide  Causes Diuresis  Flu Like Symptoms, GI Upset, Electrolyte Imbalance  Give with Food Ear Drops to Treat Otitis Externa (Swimmer’s Ear)  Cipro W/ Hydrocortisone  Roll Container, Don’t Shake  Position on Unaffected Side  Keep pt on Side for 5 mins  Lightly Pack w/ cotton  Dry Ear Canal after Swimming/Bathing

Neuromuscular Blocking Agent  Succinylcholine  Pancuronium  Respiratory Arrest, Apnea, Malignant Hyperthermia, Muscle Pain  Treatment of Malignant Hyperthermia (100% O2, Cooling, Dantrolene (Muscle Relaxant)) Muscle Relaxant (Direct on Skeletal Muscle)  Dantrolene  Used for MS, Muscle Spasm, Cerebral Palsy, Malignant Hyperthermia  Drowsiness, Muscle Weakness, GI Upset, Hepatotoxicity  Monitor for Liver Damage Muscle Relaxant (Centrally Acting)  Baclofen  Muscle Spasm, Cerebral Palsy, MS, can also treat Malignant Hyperthermia  Drowsiness, GI Upset, Constipation (Increase Fiber) Urinary Tract Stimulant  Bethanechol  Treats Non-Obstructive Urinary Retention  Cholinergic Symptoms (Flushing, Sweating, Urinary Urgency, Bradycardia, Hypotension)  Administer 1 Hour Before or 2 Hours After Meals Urinary Tract Antispasmodic  Oxybutynin  Treats Overactive Bladder  Anticholinergic Symptoms (Dry Mouth, Urinary Retention, Constipation, Blurred Vision)

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Increase Fiber & Fluid

Insomnia Medication  Zolpidem  Causes Daytime Drowsiness, Dizziness  Allow for 8 hours of Sleep

Sedative/Hypnotic  Phenobarbital  Propofol (High Risk for Bacterial Contamination - Monitor for signs of infection)  Midazolam  Induces Anesthesia  Respiratory/CV Depression  Have Resuscitation Equipment Available, Monitor EKG/Vitals RESPIRATORY Beta 2 Adrenergic Agonist  Albuterol  Salmeterol  Treats Asthma/COPD  Tachycardia, angina, tremors  Take 5 Mins Before glucocorticoid Xanthines  Theophylline  Long term control of Asthma/COPD  GI Upset, Dysrhythmias, Seizures  Serious side effects, not used much, periodic serum levels Inhaled Anticholinergic  Ipratropium  Asthma/COPD  Dry Mouth, Hoarseness  Increase Fluids, suck on sugar free candies Inhaled Glucocorticoids  Beclomethasone  Asthma  Hoarseness, candidiasis (Rinse Mouth)  Maintenance Use

Glucocorticoids  Prednisone  Side Effects: Bone loss, Weight Gain/Fluid Retention, Hyperglycemia, Hypokalemia, Infection, Muscle Weakness, PUD, Adrenal Gland Suppression  Stress may need increased doses  Do not stop suddenly, taper off  Monitor for s/s of infection  Avoid NSAIDs Leukotriene Modifier  Montelukast (Take in evening or 2 hours before exercise)  Zafirlukast (Increased liver enzymes, take with food)  Asthma/Exercise induced Bronchoconstriction Antitussives  Codeine  Nonproductive cough  Change positions slowly, avoid, ETOH, increase fluid/fiber Expectorants  Guaifenesin  Nonproductive cough  Thins mucus (Increase Fluids)  GI Upset, Drowsiness, Rash Mucolytics  Acetylcysteine  Pulmonary Disorders W/ Thick Mucus, CF  Antidote for Acetaminophen Poisoning  Bronchospasm, N/V, Rash  Smells like rotten eggs, No Asthma Decongestants  Phenylephrine  Pseudoephedrine  Runny nose  Vasoconstricts Respiratory Tract Mucosa  Agitation, Nervousness, Palpitations, Rebound Congestion Antihistamines 1st & 2nd Gen  Diphenhydramine (1st)  Loratadine (2nd)  Nasal Congestion, Mild Allergic Reactions, Motion Sickness  Sedation, Anticholinergic Effects (Dry Mouth, Constipation, Urinary Retention) Nasal Glucocorticoids

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Mometasone Fluticasone Budesonide Rhinitis, Decreases inflammation in nasal passages Headache, Sore Throat

CARDIOVASCULAR Loop Diuretics  Furosemide  Pulmonary Edema, HTN  Blocks reabsorption of Water, Na, Cl in the Loop of Henle  Rapid Diuresis  Dehydration, Electrolyte Imbalances, Hypotension, Ototoxicity, Hyperglycemia  Administer during the day  Infuse at 20mg/min  Weigh Daily  Monitor I & Os/Electrolytes  Encourage Foods High in Potassium Thiazide Diuretics  Hydrochlorothiazide  HTN, Edema  Blocks Water, Na, & Cl Reabsorption at the distal tubule  Dehydration, Hypokalemia, Hyperglycemia, No Ototoxicity  Administer during the Day  Weigh Daily, Monitor I&Os, Electrolytes  Encourage Foods High in Potassium

Potassium Sparing Diuretics  Spironolactone  HF, HTN  No Kidney Failure  Blocks Aldosterone, Excretes Na & Water, but Keeps K  Hyperkalemia, Amenorrhea, Gynecomastia, Impotence  Monitor K Levels, Avoid Salt Substitutes Osmotic Diuretics  Mannitol  Edema, Increased ICP, Increased IOP  Draws fluid back into Interstitial Fluid & Plasma  HF, Pulmonary Edema, Renal Failure, Dehydration, Electrolyte Imbalances

ACE Inhibitors  Captopril  Lisinopril  HTN, HF, MI, Diabetic Neuropathy  Blocks Angiotensin I to Angiotensin II, causing vasodilation  Hypotension, Angioedema, Cough, Elevated K, Rash Angiotensin II Receptor Blockers  Losartan  Valsartan  HTN, HF, MI, Diabetic Neuropathy  Blocks action of Angiotensin II, causing Vasodilation  Angioedema, GI Upset, Hypotension CCBs  Diltiazem  Verapamil  Nifedipine  HTN, Angina  Blocks Ca channels in blood vessels & Heart, causing Vasodilation & Decreased HR  Bradycardia, Hypotension, Dysrhythmias, Constipation, Peripheral Edema  No Grapefruit Juice Centrally Acting Alpha II Agonists  Clonidine  Decreases Sympathetic to Heart & Blood Vessels, Causes Decreased HR, CO & BP  Drowsiness, Dry Mouth  Suck on Hard Candy, Increase Fluid Intake Beta I Blocker  Metoprolol  Atenolol  HTN, HF, MI, Angina  Blocks Beta I Receptors (Heart), Decreases BP, HR  Bradycardia, Decreased CO, Hypotension, Fatigue, Erectile Dysfunction  Take BP Daily Nonselective Beta Blockers (1 & 2)  Propranolol  Labetalol  Carvedilol  HTN, Angina, Arrhythmias, MI  Blocks Beta I & 2 Receptors

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Bronchoconstriction, Fatigue, Hypotension, Bradycardia, Decreased CO Do NOT use in patients with Asthma

Vasodilator (For HTN Crisis)  Nitroprusside  Direct vasodilation of arteries & veins, rapidly decreases BP  Hypotension, Cyanide Poisoning, Thiocyanate Toxicity Adrenergic Agonists  Epinephrine  (Cardiac Arrest, Asthma, Anaphylaxis)  Causes Bronchodilation, Vasoconstriction, Increases BP, HR, CO  Dopamine  (Shock, HF, Improves renal Blood Flow)  Increased HR/CO  Dobutamine  (HF)  Increases CO Cardiac Glycosides  Digoxin  HF, AFib  Positive Inotropic & Negative Chronotropic Effects  Dysrhythmias, Bradycardia, Toxicity (GI Upset, Fatigue/Weakness, Vision Changes)  Check Apical Pulse Rate Before (Do Not give below 60 bpm)  Monitor Levels (Should be 0.5-2.0 ng/mL)  Hypokalemia increases risks for toxicity  Increase High K Foods  Treat Bradycardia with Atropine  Treat Overdose with Digibind Antianginal  Nitroglycerine  Angina  Vasodilation, Decreases Preload & Myocardial O2 Demand  Headache, Orthostatic Hypotension, Reflex Tachycardia  Store in cool/dark place  Take up to 3 Tabs (5 Mins apart) Antidysrhythmic Class I  Procainamide  Lidocaine  SVT, V Tach, A Flutter, A Fib  Na Channel Blocker  Hypotension, Lupus, Leukopenia, Thrombocytopenia, Arrhythmias

Antidysrhythmic Class II  Propranolol  A Fib, A Flutter, SVT, HTN, Angina  Non-selective Beta Blocker  Hypotension, Bradycardia, Fatigue, Weakness, Bronchospasm  Do not use in Pts W/ Asthma

Antidysrhythmic Class III  Amiodarone  A Fib, V Fib, V Tach  K Channel Blocker  Hypotension, Bradycardia, Pulmonary Toxicity, Visual Disturbances, GI Upset, Liver Toxicity, Thyroid Dysfunction Antidysrhythmic Class IV  Verapamil  Diltiazem  A Fib, A Flutter, SVT, HTN, Angina  CCB  Hypotension, Bradycardia, GI Upset Antilipemic Agents (Statins)  Atorvastatin  Simvastatin  Hypercholesterolemia, Prevents MIs  Decreases LDL, Increases HDL  Hepatotoxicity, GI Upset, Muscle Pain, Rhabdomyolysis  Administer W/ Evening Meal  Monitor Liver & CK Levels  Avoid Alcohol Antilipemic Agents (Cholesterol Absorption Inhibitor)  Ezetimibe  Hypercholesterolemia  Inhibits absorption of Cholesterol in Small Intestine  Hepatotoxicity & Muscle Pain  Monitor Liver & CK Levels Antilipemic Agents (Bile Acid Sequestrant)  Colesevelam  Hypercholesterolemia  Binds bile acids in the intestines, causing increased excretion of LDLs  Constipation (Increase Fiber/Fluid)

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Take with food & full glass of water Interferes with absorption of fat soluble vitamins & Oral contraceptives

Antilipemic Agents (Niacin)  Niacin  Nicotinic Acid  Hypercholesterolemia  Decreases Lipoprotein (Lowers LDL) & Triglyceride Synthesis  Flushing of Face, GI Distress, Hepatotoxicity, Hyperglycemia  Monitor Liver Function & Blood Glucose Levels Antilipemic Agents (Fibrates)  Gemfibrozil  Hypercholesterolemia  Decreases Triglyceride Production & Increases HDL  GI Upset, Gallstones, Hepatotoxicity, Muscle Pain  Give 30 mins before breakfast & dinner  Monitor Liver & CK Levels HEMATOLOGIC Anticoagulants IV  Heparin  Enoxaparin  Stroke, DVT  Activates Antithrombin, Inhibits Thrombus Formation  Bleeding, Heparin Induced Thrombocytopenia (HIT)  Monitor aPTT (1.5-2.0 times baseline)  Antidote is Protamine Anticoagulants Oral  Warfarin  DVT, A Fib W/ Thrombus, Prevents MI, TIA, PE, DVT  Antagonizes Vitamin K  Bleeding, GI Upset, Hepatitis  Monitor PT/INR (2-3) (Usually takes 3-5 Days)  Antidote is Vitamin K  Maintain Consistent Intake of Vitamin K

Anticoagulant Xa Inhibitor  Rivaroxaban  Prevents DVT, PE, Stroke in pts with A Fib  Inhibits Factor Xa

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Monitor Liver Function, Hgb, & Hematocrit

Antiplatelets  Aspirin  Abciximab  Clopidogrel  Prevents MI, Stroke  Inhibits Platelet Aggregation  GI Upset, Bleeding, Tinnitus  Do not give ASA to children (Reye’s) Thrombolytics  Alteplase  Reteplase  MIs, Strokes, PEs, Occluded Central Lines  Breaks up Fibrinogen  Bleeding, Contraindicated in pts who have hemorrhagic stroke, internal bleeding, recent trauma/surgery, severe HTN  Should be taken within 3 hours of symptoms, closely monitor labs, VS  Limit venipunctures & IM injections Erythropoiesis Growth Factors  Epoetin Alfa  Anemia, Increases Production of RBCs in pts with anemia r/t chronic kidney disease, HIV, Chemotherapy  Stimulates Bone Marrow to produce more RBCs  HTN, Increased Risk of DVT/Stroke  Do not agitate vial  Monitor BP, Hgb & HCT twice a week, check Fe Levels

Leukopoietic Growth Factors  Filgrastim  Neutropenia, Decrease Infection in pts with Neutropenia (R/T Chemo)  Causes Bone Marrow to Produce more Neutrophils  Bone Pain, Leukocytosis (High WBC), Splenomegaly  Do Not agitate Vial, Monitor CBC twice a week GASTROINTESTINAL Histamine 2 Receptor Agonists  Ranitidine  Famotidine  Duodenal & Gastric Ulcers, GERD, Zollinger-Ellison Syndrome

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Blocks H2 Receptors, Reducing Gastric Acid Secretion Increased Bacteria in Stomach & Respiratory Tract

Proton Pump Inhibitor  Omeprazole  Pantoprazole  Duodenal & Gastric Ulcers, GERD, Zollinger-Ellison Syndrome  Inhibits enzyme needed for gastric acid secretion  GI Upset, Increased risk of osteoporosis Mucosal Protectant  Sucralfate  Duodenal Ulcers  Reacts W/ Stomach Acid to form thick paste which covers ulcers  Constipation (Increase Fluid/Fiber)  Take 1 Hour Before Meals & At Bedtime (4 times a day) Antacids  Aluminum Hydroxide  Sodium Bicarbonate  Calcium Carbonate  PUD, GERD  Neutralizes Stomach Acid  Constipation (Aluminum & Calcium) & Diarrhea (Magnesium)  Take 1 Hour & 3 Hours After Meals & at Bedtime  Take at least 1 Hour Before or After Other Meds Prostaglandins  Misoprostol  Prevents gastric ulcers in pts taking NSAIDs  Also induce labor by ripening the cervix  Decreases Stomach Acid Secretion, Increases production of protective mucus  Dysmenorrhea, Miscarriage, GI Upset  Do not Administer to a Pregnant Woman (Pregnancy Test) Antiemetics  Ondansetron  N/V due to chemo, Radiation, or Post Op  Blocks Serotonin Receptors  Headache, Dizziness, GI Upset  Administer Prior to Chemotherapy Laxatives  Psyllium - Softens Stool & Increases Bulk  Docusate Sodium - Increases Surface area of stool allowing water in (Softens)  Bisacodyl - Stimulates Peristalsis

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Magnesium Hydroxide - Draws water into the intestine, promotes peristalsis (Monitor for Mg Tox & Dehydration) Contraindicated for Bowel Obstructions (Increase Fluid/Fiber/Exercise)

Laxative Used For Hepatic Encephalopathy  Lactulose  Constipation, Hepatic Encephalopathy, Decrease Ammonia Levels, Improves mental status of patients  Lowers pH in the colon, which promotes ammonia excretion  GI Upset, Electrolyte Imbalances, Hyperglycemia Antidiarrheal  Loperamide  Diphenoxylate + Atropine (Can cause Anticholinergic Effects @ High Doses)  Stimulates Opioid Receptors in intestines, causing decreased motility & Increased absorption of Na & Water  Constipation, Drowsiness

Prokinetic Agents  Metoclopramide  N/V, Gastroparesis, GERD  Accelerates Gastric Emptying, Blocks Dopamine & Serotonin Receptors  Drowsiness, GI Upset, EPS Irritable Bowel Syndrome Meds  Alosetron  IBS W/ Diarrhea  Increases firmness of stool & Decreases urgency  Constipation    

Lubiprostone IBS W/Constipation Increases fluid secretion in intestine & Intestinal Motility Diarrhea, Nausea

5 Aminosalicylates  Sulfasalazine  IBS, Crohn’s, Ulcerative Colitis  Inhibits Prostaglandin Synthesis, Decreasing Colon Inflammation  Blood Issues (Anemia, Agranulocytosis), GI Upset, Rash, Headache Iron Supplements  Ferrous Sulfate (PO)  Iron Dextran (IV/IM) (Use Z-Track)  Iron Deficiency Anemia

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Can Cause GI Upset/Constipation, Teething Straining (Drink W/ Straw), Dark Green/Black Stools Vitamin C Increases Absorption Take on Empty Stomach, Before meals Increase Fluid/Fiber Encourage Intake of High Iron Foods

REPRODUCTIVE Estrogens  Premarin  Estradiol  Contraception, PMS Symptoms, Post menopausal osteoporosis, Dysmenorrhea, Prostate Cx  Can Cause Embolic Events, HTN, Weight Gain, Edema, Increased risk of some Cx  Contraindicated in pts who smoke, have HTN, or are at high risk for embolic events, or have estrogen dependent Cx Progesterones  Medroxyprogesterone  Contraception, Counters Estrogen  Can Cause Embolic Events, Menstrual Changes, Edema, Increased Risk For Breast Cx  Delay conception for 3 months after stopping Contraindicated for someone at risk for embolic events Androgens  Testosterone  Treats Delayed puberty in boys, Hypogonadism, Postmenopausal Breast Cx  Can Cause Acne, Hypercholesterolemia, Edema, Liver Dysfunction, Polycythemia (Increased Hgb & HCT), Premature epiphyseal Closure Can cause deepening of voice, baldness & Hirsutism in women  Contraindicated in pts with prostate Cx, High abuse potential BPH Medication (Androgen Inhibitor)  Finasteride  Treats BPH & Baldness  Prevents conversion of testosterone, reducing prostate size & increased hair growth  Can Cause ED & Gynecomastia  Pregnant Women Should Not Handle This Med

BPH Medication (Peripherally Acting Antiandrenergic)  Tamsulosin  Treats BPH  Relaxes Smooth Muscle of the Prostate, Improving Urine Flow  Can Cause Hypotension, Dizziness, Headache & Issues with Ejaculation  Take at the same time Every Day (30 Mins After Meal) Monitor BP Erectile Dysfunction Medication  Sildenafil  Treats ED  Increases Flow to the Penis  Can Cause Priapism (Prolonged Erection), MI  Do Not Take With Other Nitrates, Use Cautiously W/ CV Disease Uterine Stimulant  Oxytocin  Induction of Labor, Placenta Delivery, Postpartum Hemorrhage  Stimulates the Uterus  Can Cause Uterine Rupture, Painful Contractions  Closely Monitor Contractions (Should be less than 60 Secs)  Monitor Maternal/Fetal BP & Pulse  Magnesium can be used to relax the uterus Medications to Treat Preterm Labor  Terbutaline Sulfate  Treats Preterm Labor, Delays, but does not prevent labor, Also used for Asthma/COPD  Causes Relaxation of the Uterus & Bronchodilation  Can Cause Tachycardia, Angina, Restlessness, Tremors  Contraindicated for Gestation of 34 Weeks or for Dilation Greater Than 6cm

Opioid Analgesic During Labor  Meperidine Hydrochloride  Treats Severe Pain During Labor

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Binds to Opioid Receptors in the CNS, Decreases Pain W/O significant Respiratory Depres...