Final
Salicylates action
Blocks the inflammatory response by inhibiting Cox 1 prostaglandin Commonly prescribed in MI, stroke, and mild pain
Antiviral for Herpes, Varicella & CMV (-clovir) Education
Cause GI upset and nausea, confusion, insomnia, and dizziness Careful in patients with renal dysfunction and renal failure ' Ganciclovir and valganciclovir associated with bone marrow suppression
NSAIDs uses
Therapeutic actions and indications - Block two enzymes, COX-1 and COX-2 to limit their activation of prostaglandins Sold over the counter, which may lead to abuse Anti-inflammatory, analgesic, and antipyretic effects
Categories of Anti-Infective Agents
Antibiotics Antifungal Antiviral Antiprotozoal
Anabolic steroids education
Can cause priapism, electrolyte changes, and liver dysfunction, impotence
Salicylates Education
Bleeding risks can occur with those taking daily due to inhibited platelet aggregation due to cox 1 inhibition Do not give to peds under 16 y.o. due to risk of Reyes Can lead to GI upset symptoms due to Cox 1 inhibition Salicylism: toxicity can lead to tinnitus, acid-base imbalance,& poss death
What is the difference between cox 1 and cox 2 prostaglandins?
Both help w/ inflammation pain & fever Cox1 prostaglandins increase mucus prod in the gut for gut lining protection&increase platelet aggregation Cox2 prostaglandins increase synovial fluid in joints&decrease platelet aggregation meds that block either/both of these prostaglandins will do the opposite
Macrolides (-romycin) common meds
Erythromycin, azithromycin (Zithromax), clarithromycin These are your suffix -romycin agents
Estrogens meds
Estradiol (Estrace), conjugated estrogens (Premarin)
Other Antifungal Agents Action
Flucytosine is a less toxic drug that alters the cell membrane of susceptible fungi, causing cell death Griseofulvin is an older antifungal that chanes cell membrane permeability and causing cell death. Nystatin binds to sterols in the cell wall, changing membrane permeability and allowing leaking of the cellular components, resulting in cell death drugs bind to sterols and can cause cell death (a fungicidal effect) or interfere with cell replication (a fungistatic effect) Terbinafine is a nonazole antifungal that blocks the formation of ergosterol.
Carbapenems (-penem) education
GI upset Risk for superinfections
Cephalosporins (Cef- or ceph) education
GI upset symptoms Call provider if blood diarrhea present could mean Pseudomembranous colitis
Glycopeptides education
Peak and trough needs to be monitored for renal dysfunction Can cause both ototoxicity and nephrotoxicity Can cause red man syndrome (anaphylactic reaction with rash)
Drugs for Erectile Dysfunction action
Relax the vascular smooth muscle to aid in blood flow through the corpus cavernosum to create an erection
Estrogen receptor Modulators education
Risk for thromboembolism- smoking cessation When taken with warfarin (anticoagulant), decreases warfarin effectiveness
Macrolides (-romycin) Action
bactericidal or bacteriostatic by interfering with protein synthesis Often used when patients are allergic to penicillin.
Antifungal Agents common meds
fluconazole (Diflucan), itraconazole (Sporanox), ketoconazole (Nizoral), posaconazole (Noxafil), voriconazole (Vfend), and isavuconazonium (Cresemba) These are you -nazole agents
Growth hormone-releasing hormone (GHRH) Agonists common meds
goserelin (Zoladex; synthetic GnRH), histrelin (Supprelin LA, Vantas), leuprolide (Eligard Kit, Fensolvi Kit, Lupron Depot) and nafarelin (Synarel), tesamorelin (Egrifta)
Growth Hormone Agonists MOA
stimulate overall growth and production of protein. They bind to GH receptors on target tissues
What is the term Bactericidal?
substance that causes the death of bacteria, usually by interfering with cell membrane stability or with proteins or enzymes necessary to maintain the cellular integrity of the bacteria
Sulfonamides (sulfa-) common meds
sulfadiazine, sulfasalazine, and cotrimoxazole (Septra, Bactrim) These are prefix sulfa- agents
Estrogen receptor Modulators meds
raloxifene (Evista), toremifene (Fareston)
Estrogen receptor Modulators use
Not hormone replacement, but acts to stimulate specific estrogen sites, to aid in positive effects of estrogen replacement and reduce negative effects Commonly given to treat/prevent osteoporosis in post menopause
Anabolic steroids meds
Oxandrolone (Oxandrin), oxymetholone (Anadrol-50)
Uterine Motility Drugs meds
Oxytocic- oxytoncin (Pitocin) & methyergonovine (Methergine) Abortifacients- dinoprostone (Cervidil), carbonprost (Hemabate)
Antiviral for Herpes, Varicella & CMV (-clovir) Action
Drugs that combat herpes and CMV inhibit viral DNA replication for the virus
Growth Hormone Antagonists common meds
dopamine agonist (bromocriptine [Parlodel]) somatostatin analogues (octreotide acetate [Sandostatin and others], lanreotide [Somatuline Depot]) GH analogue (pegvisomant [Somavert]).
Carbapenems (-penem) common meds
doripenem, ertapenem, imipenem-cilastatin, and meropenem These are your -penem suffix agents
Antifungal Agents Action
drugs bind to sterols and can cause cell death (a fungicidal effect) or interfere with cell replication (a fungistatic effect) Ketoconazole, fluconazole, and itraconazole work by blocking the activity of a sterol in the fungal wall.
Metronidazole Action
Bactericidal effects against anaerobic bacterial pathogens as well as several protozoa agents, by interfering with DNA replication
Tetracyclines (-cycline) Action
Bacteriostatic by Inhibit protein synthesis preventing replication of bacteria Broad spectrum for gram (+) Positive and gram (-) negative agents
Sulfonamides (sulfa-) Action
Bacteriostatic by preventing folic acid use for bacteria in cells. Broad spectrum Not commonly used because of resistance
What are the 4 cardinal symptoms of inflammation?
Swelling, redness, heat, and pain
anterior pituitary hormones
ACTH (Adrenocorticotrophic hormone) TSH (Thyroid-stimulating hormone) LH (Luteinising hormone) FSH (Follicle-stimulating hormone) PRL (Prolactin) GH (Growth hormone) MSH( Melanocyte-stimulating hormone)
posterior pituitary hormones
ADH, or vasopressin Oxytocin
Fluoroquinolones (-floxacin) Education
A black box warning all drugs increase risk of tendinitis and tendon rupture when using these antibiotics Photosensitive, wear sunscreen
Acetaminophen uses
Acts directly on the thermoregulatory cells of the hypothalamus to cause sweating and vasodilation Mechanism of action unknown but related to analgesic effects, though to work on cox prostaglandins???? Used to treat pain and fever only, NO INFLAMMATION ACTION
Anabolic steroids uses
Aid in tissue building effects, increasing hemoglobin and RBC mass Can be used in cases of anemia Commonly seen as illegal enhancement drug in competitive sports
What is an anti-infective agent?
An agent that interfere with biosynthesis of the bacterial cell wall or prevents replication of cell (RNA or DNA effects)
Growth Hormone Antagonists MOA
Analogues of somatostatin, octreotide acetate, and lanreotide inhibits GH release Bromocriptine is a postsynaptic dopamine receptor agonist that modulates secretion of prolactin LH management and advanced prostate cancer
Tetracyclines (-cycline) education
Are teratogenic, and can make oral contraceptive less effective Educate women to us at least 2 forms of birth control Don't give to children <8yrs - monitor teeth Photosensitivity- wear sunscreen
Salicylates meds
Aspirin (Bayer), Choline salicylate, mesalamine
NSAIDs education
Avoid in GI bleeding, ulcerations Avoid in liver dysfunction Assess for allergies to NSAID or salicylate, and sulfonamides Avoid ETOH Stop a week prior to surgery
Estrogens - Education
Avoid in estrogen dependent cancers Causation for DVT formation/ incidence avoid in pregnancy it can lead to fetal defects avoid smoking to reduce risk for DVT formation
Progestins education
Avoid smoking, and risks for increased thromboembolism Avoid use in issues such as PID, STI, endometriosis Drospirenone has a risk for hyperkalemia development because of suppression of aldosterone - monitor
Aminoglycosides (-mycin , cin) Actions:
Bactericidal & some Bacteriostatic by Inhibits protein synthesis Broad spectrum primarily gram-negative bacteria
Fluoroquinolones (-floxacin) Action
Bactericidal by interfering with DNA replication causing cell death Broad spectrum, but mostly against gram negative agents but not anaerobic agents
Glycopeptides Action
Bactericidal by preventing cell wall synthesis Works on gram (+) Positive bacteria
Penicillin and Penicillinase-resistant antibiotics (-cillin) Action
Bactericidal by preventing cell wall synthesis beta-lactam antibiotic, Broad spectrum The OG of antibiotics, now has lots of resistance
Carbapenems (-penem) Actions:
Bactericidal by preventing cell wall synthesis beta-lactam antibiotic, Broad spectrum against many gram (+) Positive and gram (-) negative agents
Cephalosporins (Cef- or ceph) Action
Bactericidal by preventing cell wall synthesis beta-lactam antibiotic, Broad-spectrum Useful against gram (+) Positive and gram (-) negative strains Four generations
Growth Hormone Antagonists education
Caution during pregnancy due to increased risk of inducing hypertension. It should not be used during lactation because it blocks lactation Monitor blood sugar levels Monitor injection site inflammation
Other Antifungal Agents Education
Caution in the presence of liver or renal impairment Benefits vs. risk in lactation and pregnancy Bone marrow suppression
Penicillin and Penicillinase-resistant antibiotics (-cillin) education
Check for allergies to penicillin's or cephalosporin's GI upset N/V/D
Progestins meds
Drospirenone (Yasmin, Yaz), levonorgestrel (Mirena), progesterone (Prometrium)
Progestins (mechanism, use)
Contraceptive use primarily (combined with estrogens) Amenorrhea or uterine bleeding Aid in fertility treatments
Growth hormone-releasing hormone (GHRH) Agonists education
Crosses placenta and breast milk Increase blood glucose - monitor
Growth hormone-releasing hormone (GHRH) Antagonists education
Crosses placenta and breast milk hot flashes, decreased libido, erectile dysfunction, changes in menstrual flow, fluid and electrolyte changes, irritability, decreased muscle/bone mass, and gynecomastia
NSAIDs meds
Cyclooxygenase-2 Inhibitors Celecoxib (Celebrex) Fenamates Mefenamic acid (Ponstel) Propionic Acids Fenoprofen Ibuprofen (Motrin, Advil) Naproxen (Naprosyn) •Oxicam Derivative •Meloxicam (Mobic) •Piroxicam •Acetic Acids •Indomethacin (Indocin) •Ketorolac (Toradol) •Diclofenac (Voltaren)
Aminoglycosides (-mycin , cin) education
Depend on the kidney for excretion and are toxic to the kidney Can cause ototoxicity Monitor peak and trough levels (gentamycin)
Drugs for Erectile Dysfunction education
Do not give with nitrates of alpha-adrenergic blockers to a client with PDE5 inhibitor, will cause extreme hypotension and possible death Do not use with penile implants See a provider if erection lasts longer than 4 hours
Metronidazole education
Do not take with alcohol/alcohol products can cause disulfiram effect Avoid in first trimester and in breastfeeding mothers
acetaminophen education
Dose for children based upon age Avoid in liver dysfunction, in large doses can cause hepatotoxicity Adults: no more than 4gm/day Antidote is acetylcysteine
Androgens - Education
Inform of Androgenic effects (masculine changes), Potential cardiovascular effect Caution in liver dysfunction Impotence
Growth hormone-releasing hormone (GHRH) Antagonists Use
LH management and advanced prostate cancer
Metronidazole common meds
Metronidazole (flagyl) Other -azole agents can be antibacterial, antifungal, antiprotozoal, or anthelmintic
Macrolides (-romycin) education
Monitor the patient for nausea, vomiting, diarrhea, dizziness, and other CNS effects Commonly called z-pack
Fertility Drugs (female) education
Potential for multiple births and or defects can occur with this therapy Therapy may not have desired effects (may require multiple attempts with each cycle
Drugs for Erectile Dysfunction meds
Prostaglandin -alprostadil (Caverject) Phosphodieasterase type 5 inhibitors (PD5)- sildenafil (Viagra), tadalafil (Cialsis), vardenafil (Levitra) Suffix -afil drugs
Growth hormone-releasing hormone (GHRH) Agonists use
Prostate Cancer, endometriosis, fertility
Categories of Anti-inflammatory Agents
Salicylates NSAIDs Tylenol Corticosteroids Anti-arthritic agents
Estrogens uses
Small doses for hormonal replacement therapy Aid in early menopause discomforts Combination for contraceptives Palliation in certain cancers (i.e. breast cancer)
Fertility Drugs (female) Action
Stimulate female reproductive system by directly stimulating follicles and ovulation or increase FSH and LH levels to aid in maturation of ova
Uterine Motility Drugs action
Stimulate uterine contraction to assist labor (oxytocis) or induce abortion (abortifacients)
What is Bacteriostatic?
Substance that prevents the replication of bacteria, usually by interfering with proteins or enzyme systems necessary for the reproduction of the bacteria
Anti-Infective Agents education
Take antibiotics as prescribed Resistance increases w/ improper use, super bugs Educate to take probiotics in diet like yogurts to decrease risk for infections from normal flora elimination Photosensitivity is common w/ Fluoroquinolones, Tetracycline's, & Sulfonamides Be aware of teratogenic effects in Tetracycline's & sulfonamides Some antibiotics reduce contraceptive effectiveness Avoid alcohol especially w/ Metronidazole, but many antibiotic are harsh on liver & can increase onset of liver dysfunction Take on an empty stomach w/ Macrolides, Fluoroquinolones & Tetracycline's; rest w/ food
Sulfonamides (sulfa-) Education
Teratogenic and need to be avoided in pregnancy Monitor the patient for CNS toxicity, nausea, vomiting, diarrhea, liver injury, renal toxicity, and bone marrow depression
Androgens meds
Testosterone (multiple), danazol, methyltestosterone
Tetracyclines (-cycline) common meds
Tetracycline, demeclocycline, doxycycline, minocycline These are your suffix -cycline agents
Uterine Motility Drugs education
Use cautiously with Coronary disease or HTN clients b/c of increased vasoconstriction Avoid in those who have had a previous cesarean birth
Why is the presence of the inflammatory response important?
The response to the inflammatory stimuli involves local vasodilation, increased capillary permeability, and the stimulation of pain fibers. These reactions alert the person to the injury and bring an increased blood flow to the area. Without the response, mediators to aid in healing would not be activated.
Androgens uses
To replace the hormone testosterone is cases where testes haven't fully developed and certain cancers
Glycopeptides common meds
Vancomycin
What is Priapism?
a painful and continual erection of the penis
Antiviral for Herpes, Varicella & CMV (-clovir) common meds
acyclovir (Sitavig, Zovirax), cidofovir (generic), famciclovir (generic), foscarnet (Foscavir), ganciclovir (Cytovene), letermovir (Prevymis), valacyclovir (Valtrex), and valganciclovir (Valcyte) These are you -clovir agents
Aminoglycosides (-mycin , cin) common meds
amikacin (Amikin), gentamicin, neomycin (Mycifradin), streptomycin, and tobramycin (TOBI) These are you -mycin , cin suffix agents
Other Antifungal Agents common meds
amphotericin B (Abelcet, AmBisome), flucytosine (Ancobon), griseofulvin (Gris-Peg), nystatin, and terbinafine (Lamisil)
Antifungal Agents Education
avoided in patients with hepatic dysfunction to prevent serious hepatic toxicity male patients may have gynecomastia, decreased libido, and/or erectile dysfunction caution in the presence of liver or renal impairment
Vasopressin Blockers MOA
cause a loss of water through the urine increase in serum sodium levels as the water level decreases and a return to fluid balance.
Cephalosporins (Cef- or ceph) common meds
cephalexin (Keflex), ceftazidime, ceftriaxone (Rocephin), cefepime These are the Cef- or ceph prefix agents
Growth hormone-releasing hormone (GHRH) Antagonists common meds
cetrorelix (Cetrotide), ganirelix acetate (generic; GnRH antagonists and fertility drugs), and degarelix (Firmagon)
Fluoroquinolones (-floxacin) common meds
ciprofloxacin (Cipro), Gemifloxacin, levofloxacin (Levaquin), ofloxacin These are your suffix -floxacin agents
Vasopressin Blockers uses
clinically significant hypervolemic or euvolemic hyponatremia, SIADH
Fertility Drugs (female) meds
clomiphene (Clomid), cetrorelix (Cetrotide)
Antiviral for Herpes, Varicella & CMV (-clovir) uses
cold sores, encephalitis, varicella-zoster, and genital infections
Vasopressin Blockers common meds
conivaptan (Vaprisol) and tolvaptan (Jynarque, Samsca) desmopressin (DDAVP, Nocdurna) and Vasopressin (Vasostrict) - synthetic ADH
Growth Hormone Agonists education
injection site reactions, edema, myalgia, and arthralgia Insulin resistance and hyperglycemia should be monitored, and antihyperglycemic agent doses may need to be increased
Penicillin and Penicillinase-resistant antibiotics (-cillin) common meds
penicillin G, benzathine penicillin G, potassium penicillin V, amoxicillin, and ampicillin Penicillinase - resistant antibiotics: nafcillin and oxacillin These agents end in the suffix -cillin
Vasopressin Blockers education
water intoxication (drowsiness, light-headedness, headache, coma, convulsions) related to the shift to water retention and resulting electrolyte imbalance tremor, sweating, vertigo, and headache related to water retention (a "hangover" effect) Constipation, dry mouth, and thirst monitored for liver injury when administered tolvaptan
Growth Hormone Agonists common
widely distributed in the body and localize in highly perfused tissues, particularly the liver and kidney. excretion through the urine and feces.