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.