Nursing Pharmacology (Drugs)
nevirapine
"A Non-Nucleoside Reverse Transcriptase Inhibitor (NNRTI) that binds to HIV reverse transcriptase. Adverse effects include rash, erythema multiforme, Stevens-Johnson syndrome, hepatotoxicity, and multiple drug interactions.
spironolactone
"Aldosterone receptor blocker - shown to have efficacious effects in treating a patient with heart failure.
regular insulin
"Short-duration/slower acting insulin. It is the only form of insulin given IV.
pseudoephedrine
Alpha1 Adrenergic Receptor Agonists (Sympathomimetics)
Bismuth
Antibiotics for H.pylori ulcers
clarithromycin
Antibiotics for H.pylori ulcers
succinylcholine
Depolarizing Neuromuscular Blocker (i.e. Noncompetitive NicotinicM Receptor Antagonist)
nifedipine
calcium channel blocker
clopidogrel
decreases platelet aggregation and is used to prevent arterial thrombosis or stroke. Major SEs include risk of major GI bleeding. This drug is not an NSAID and does not inhibit COX
dabigatrine
direct thrombin inhibitor, (PO)
NPH insulin
intermediate duration insulin.
metformin
"Biguanide that acts by decreasing glucose production. Major SEs include hypoglycemia and lactic acidosis. It is a preferred treatment for obese pts with insulin resistant diabetes, and possibly for NIDDM prevention.
metoprolol
"Cardiac-specific beta blocker - shown to have efficacious effects in treating a patient with heart failure.
lidocaine
"Class IB Antidysrhythmic Drug that accelerates repolarization with little or no effect on ECG. Is also used as a local anesthetic. Adverse effects include mental confusion and paresthesias.
levothyroxine
"Common treatment for all forms of hypothyroidism. It is highly protein bound with a half-life of 7 days. SEs include tachycardia, angina, and tremors.
carbenicillin
"Extended spectrum (antipseudomonal penicillins), which has the same spectrum of activity as broad-spectrum penicillins, plus treatment of Pseudomonas aeruginosa
sodium nitroprusside
"Fastest acting vasodilatr/antihypertensive agent. It is the drug of choice for HTN emergencies. It is a potent venous and arterial vasodilator with minimal reflex tachycardia. It may produce thiocyanate toxicity after prolonged administration, or cyanide poisoning or excessive hypotension if too rapidly administered
cephalexin
"First generation cephalosporin poor activity against Gram negative bacteria, sensitive to to most beta-lactamases, unable to reach CSF. Used for Staphylococcus if mild penicillin allergy.
lovastatin
"Inhibitor of HMG-CoA reductase leading to increases in the number of LDL receptors. Beneficial actions include lowering LDL levels, raising HDL levels and increasing plaque stability. SEs include headache, myalgia, and rash. Category X drug.
dopamine
"Inotropic agent that requires constant BP/EKG monitoring. Activates beta1 AR in heart and increases contractility and HR (risk of tachycardia). Dilates renal blood vessels and increases urine output via receptor activation in the kidney
insulin glargine
"Long duration insulin that includes less risk of hypoglycemia than shorter acting insulins. It is produced by making an amino acid switch from natural insulin. NOT mixed with other insulins.
digoxin
"Medication prescribed for treating heart failure and some dysrhythmias. It is an ionotropic agent with narrow therapeutic index. Increases myocardial contractility and cardiac output. Improves symptoms but not shown to increase life expectancy. Significant cardiotoxicity requires monitoring of drug levels and K+ levels
nafcillin
"Narrow-spectrum penicillinase resistant (antistaphylococcal) penicillin. Active against methicillin-sensitive Staphylococcus aureus.
zidovudine (AZT)
"Nucleoside Reverse Transcriptase Inhibitor (NRTIs) that inhibits HIV replication. Adverse effects include Anemia, Neutropenia, Lactic acidosis, Gastrointestinal effects, and CNS effects.
indinavir
"Protease inhibitor. Side effects include hyperglycemia/diabetes, fat redistribution, hyperlipidemia, reduced bone density, hepatotoxicity, and increased bleeding in hemophiliacs.
heparin
"Rapid-acting anticoagulant that enhances activity of antithrombin and inactivates clotting factors. It is used in treating pulmonary embolism, evolving stroke, and prevention of vein thrombosis. Its adverse effects include hemorrhage, drug-induced thrombocytopenia, and hypersensitivity reactions.
tetracycline
"Static, BROAD. inhibits protein synthesis. SEs: hepatotoxic, renal toxic, bone and teeth (yellowing), suprainfections, GI (take with food), photosensitivity. DDIs: antacids--DO NOT GIVE WITH ANTACIDS; decreases contraceptive activity Pregnancy D"
cefotaxime
"Third generation cephalosporin with activity against meningitis and nosocomial infections resistant to others (restricted use). It has greater activity against Gram negative bacteria, increased resistance to beta-lactamases, and better ability to reach CSF.
minoxidil
"Vasodilator with the unusal SE of hypertrichosis; used for treating HTN unresponsive to other drugs.
buproprion
(DA and NE). Weight loss, seizure, insomnia, headache, serotonin syndrome (see laundry list above), withdrawal, Neonatal Abstinence Syndrome
venlaflaxine
(Effexor, SNRI). Depression or anxiety. Anticholinergic effects, weight loss, seizure, insomnia, headache, GI upset.
warfarin
(PO) vitamin K antagonist; indirect inhibitor of coagulation, effects monitored by PT/INR (prothrombin time/international normalized ratio). INR of 2 - 3 appropriate for most patients. Preg Cat X. overdose tx: vit. K
albuterol
(SABA) short acting beta 2 receptor agonist, used for bronchospasm, acute symptoms of asthma
imipramine
(prototype) tricyclic antidepressant and anxiolytic; block reuptake of norepinephrine (NE) and 5-hydroxytryptamine (5-HT)
diphenhydramine
1st Generation H1 Competitive Antagonist; antihistamine (benadryl), sedation effects
celecoxib
2nd Generation Nonsteroidal Antiinflammatory Drug (COX-2 Selective NSAID); AE: risk of CV events, warfarin may be more effective with celecoxib
fexofenadine
2nd gen antihistamine, H1 competitive antagonist (allegra), lesser sedative effects
glyburide
2nd generation sulfonylurea; stimulates insulin release in pancreas; Same as Tolbutamide, but more potent. [-ide];
aspirin
A drug that decrease platelet aggregation and is used to prevent arterial thrombosis, stroke, or MI. Major SEs include risk of major GI bleeding. This drug is an NSAID that works by inhibiting platelet COX, COX-1, and COX-2.
clavulanic acid
A penicillinase inhibitor that is combined with a broad spectrum penicillin to increase is bactericidal activity.
captopril
ACE inhibitor - shown to have efficacious effects in treating a patient with heart failure. Blocks production of angiotensin II, dilates arterioles and veins, and decreases release of aldosterone. It may show the adverse effects of hypotension, hyperkalemia, or persistant cough, CARDIAC REMODELING
interactions between HTN, CHF drugs and digoxen
ACEI: increase K+, decrease digoxen levels Loop D: decrease K+, increase dig levels CCB: no K+ dependent DDI, increase Dig levels
phenylephrine
Alpha1 Adrenergic Receptor Agonists (Sympathomimetics); antirhinnorhea
ketoconazole
Alternative antifungal drug for systemic mycoses and is also suitable for superficial mycoses. Fewer SEs and only slightly less effective fungistatic activity. AE: hepatotoxicity, effects on sex hormones, nausea & vomiting, headache, and abdominal pain.
acyclovir
Antimetabolite for Treating Herpes Simplex Virus & Varicella-Zoster Virus Infections; MOAs: Purine necleoside analog: DNA polymerase inhibitor, suppresses synthesis of viral DNA, resistance.
lithium
BPD; drug of choice for euphoric mania.Na+ depletion can lead to Lithium toxicity (diuretics, dehydration) When the body is low on sodium, it holds onto lithium, voiding increased
losartin
Blocks the effects of Angiotensin II on receptor organs: counters RAAS & blocks release of aldosterone. Tx: HTN. SE: Angioedema.
amoxicillin
Broad-spectrum penicillin active against H. influenzae, E. coli, and N. Gonorrhoeae. It is inactivated by beta-lactamases, so not helpful for Staphylococcus.
verapamil
CCB, class IV antidysrhythmic that reduces myocardial contractility. Adverse effects include hypotension and edema; and, constipation. DDIs include elevated digoxin levels and increased risks for effects if combined with beta blockers.
neostigmine
Cholinesterase Inhibitors [AChE-I]
vancomycin
Cidal, narrow (G+, MRSA and C. diff. Binds to cell wall. SES--KNOW THESE!--Ototoxicity (ear poisoning), red man's syndrome (allergy marked by flushing, pruritus/skin itch, tachycardia, hypotension; can be avoided by infusing the med slowly); thrombophlebitis.
gentamicin
Cidal, narrow (G-)--> ONLY ONE. Lethal inhibition of protien synthesis (ONLY ONE THAT DOES THIS). SE: Ototoxic (High pitch tinnitus and headache), Kidney problems (nephrotoxicity). Hypersensitivity, Neuro-mm'r blockade=resp. depression. KNOW THESE GENTAMICIN SEs."
amiodarone
Class 3 Potassium channel blocker Only approved for life-threatening dysrhythmias. Delays repolarization and extends action potential of heart muscle cells. SE: Profound hypotension."
sitagliptin
DDP-4 inhibitor, incretin hormone. Stimulates release of insuline; suppresses release of glucagon (decreasing levels of glucose). Basically, metformin + tolbutamide = sitagliptin
haloperidol
FGA, high potency; treats positive symptoms. SE: EPS (Acute-dystonia, parkinsons-like, akathesia and Late- Tardive Dyskinesia) and NMS. Immediate effects. Only used in emergent situation, b/c of SE
chlorpromazine
FGA, low potency, treats positive symptoms. SE: Sedation, orthostatic hypotension, anticholinergic effects. NOTE: it may take up to 6 weeks to see effects
sulfasalazine
IBS D
alosetron
IBS-D, women only
cholestyramine
Inhibits bile reabsorption in intenstine, increases LDL receptors in liver, accelerates bile excretion. Many of the adverse effects result from the drug not being absorbed from GI, including constipation and a decreased absorption of fat-soluble vitamins (A, D, E, & K).
salmeterol
Long-Acting Beta2 Adrenergic Receptor Agonist; bronchodilator
furosemide
Loop diuretic. Site of action in the nephron is the Loop of Henley. Can cause hypokalemia. Diuretics increase the risk of dysrhythmias in a patient taking digoxin by promoting potassium loss. Used for HTN and HF. Works with low GFR.
phenelzine
MAOIs: sexual dysfunction, orthostatic hypotention, weight gain, insomnia, HTN crisis (chest pain, headache, confusion, blurred vision, nausea and vomitting, anxiety, SOB, seizure, unresponsive)--due to tyramine foods. So, no cheese, aged meats, yeast, figs, naners, or wine.
erythromycin
Macrolid; Static, narrow (G+), inhibits protein synthesis SEs: GI; DDIs with 3A4 inhibitors (cardiotoxic) and antidysrythmics"
theophylline
Methylxanthine bronchodilator; narrow therapeutic range, not used anymore mostly
norepinephrine
Mixed Alpha 1,2 /Beta 1 Adrenergic Receptor Agonists (Nonselective)
epinephrine
Mixed Alpha/Beta Adrenergic Receptor Agonists (Nonselective)
benzodiazapine
Potentiate GABA (inhibitory enzyme) activity. Pros: faster onset, target CNS and Physical Symptoms. Cons: higher abuse potential.
paroxetine
Pros: Tx both anxiety and depression, lower abuse potential. Cons: 4-6 week onset, SE felt before therapeutic effects, less effective at motor physical symptoms of anxiety
iodine (131I)
Radioactive isotope that produces clinical remission of hyperthyroidism by destruction of thyroid gland.
ipratropium
Respiratory Muscarinic Acetylcholine Receptor Antagonist (bronchodilator)
xetine (ending)
SSRI
lispro insulin
Short-duration/rapid acting insulin often taken with longer acting insulin. It is produced by making an amino acid switch from natural insulin.
hydrochlorothiazide
Thiazide diuretic. Site of action in the nephron is the Distal Convoluted Tubule. First line of treatment for patients without compelling indications. Can cause hypokalemia. Does not work with low GFR. Also used for HF.
niacin
Vitamin B3; lowers LDL by raising HDL
aPTT; INR
__ is for monitoring heparin and __ is for monitoring warfarin
tolbutamide
a sulfonylurea oral hypoglycemic that stimulates release of insulin. Used for insulin deficient patients.
hydralazine
a vasodilator that directly dilates arterioles. It may produce SEs including systemic lupus erythematosus-like syndrome, reflex tachycardia, and increased blood volume; BB can prevent tachycardia
bisacodyl
abx for PUD, cell wall disruptor
prazosin
alpha 1 antagonist, anti- HTN
clonidine
alpha 2 agonist, HTN drug -> vasodilation
morphine sulfate
analgesic; Strong Mu Opioid Agonist
magnesium hydroxide
antacid
Aluminum hydroxide
antacid; constipation
Calcium carbonate
antacid; constipation
loperamide
antidiarrheal
protamine sulfate
antidote to too much heparin
prochlorperazine
antiemetic dopamine antagonist
aprepitant
antiemetic, Substance P/neurokinin antagonists
ondansetron
antiemetic; seratonin antagonist
Benztropine
antiparkinson's anticholinergic
Amantadine
antiparkinson's drug; dopamine agonist
Carbidopa
antiparkinson's drug; dopamine agonist
Pramipexole
antiparkinson's drug; dopamine agonist
codeine
antitussive, AE: respiratory depression also weak mu opioid agonist
aspirin; warfarin
arterial thrombi best prevented with ___. venous thrombi prevented with ___.
TXA2
aspirin blocks platelet aggregation by blocking synthesis of
clozapine
atypical antipsychotic; 2nd Gen. Treats negative symptoms. Greater efficacy than 1st gen. Fewer EPS/tardive dyskinesia side effects. SE: Agranulocytosis and Metabolic effects (Weight gain, diabetes, hyperlipidemia)
trimethoprim/sulfamethoxazole
bactrim
amphotericin B
broad spectrum antifungal, which is the agent of choice for systemic mycoses, despite being highly toxic. Its uses are limited to treating progressive and potentially fatal infections. Adverse effects include infusion reactions, nephrotoxicity, and hypokalemia.
psyllium
bulk forming laxative
dronabinol
canabinoid agonist, anti emetic
acetaminophen
centrally acting cox inhibitor; analgesic and antipyretic properties; no antiinflammatory,antirheumatic properties
non potassium-sparing diuretics
check potassium levels with these HTN drugs
quinidine
class IA Antidysrhythmic Drug that delays repolarization. Adverse effects include diarrhea, cardiotoxicity, and potential for developing an arterial embolism or hypersensitivity reactions. Many DDIs, including digoxin and warfarin
propranolol
class II Antidysrhythmic Drug that may cause heart failure, AV block, sinus arrest, or hypotension. Beta blocker but also blocks calcium channels.
t-PA tissue plasminogen activator
clot buster used in acute settings for stroke, PE and MI. Dissolves the clot to return blood flow to heart, brain, or other affected area.
Levodopa
dopamine receptor agonist; counteracts FGA; antiparkinson's drug
valproate
drug of choice for rapid cycling bipolar; increases GABA neurotransmission (inhibitory); targets depressive phase better than manic
beta blocker or CCB and warfarin
drugs for initial management of atrial fibrillation
verapamil (cardio active CCB), digoxin, propranol (BB)
drugs that suppress AV nodal conductance
gemfibrozil
fibroacid derivative, lowers triglycerides
ciprofloxacin
fluoroquinolone broad -cidal. PO tetracycline and cipro should NOT BE GIVEN WITH ANTACIDS. ALSO KNOW IT CAN RUPTURE TENDONS AND CAUSE CANDIDA. "
trimethoprim
folic acid inhibitor antimicrobial (static), given with sulfonamide as Bactrim.
dexamethasone
glucocorticoid IBS drug
parenteral anticoagulants
heparin (sub q, IV, hospital only, must be titrated); enoxaparin (may be used at home)
cimetidine
histamine 2 receptor antagonist; peptic ulcer disease
Infliximab
immunomodulator for IBS
Cyclosporin
immunosuppressent for IBS
exenatide
incretin mimetic; Activates receptors for GLP-1. Increases insulin secretion; slows GI absorption of glucose and gastric emptying. [-ide, acts similar to tolbutamide]
beclomethasone
inhaled corticosteroid used to treat airway inflammation in asthma
enoxaparin
low molecular weight heparin; indirect inhibitor, a shorter form of heparin, can be given using a fixed dose with no aPTT monitoring. Inactivates ONLY Xa. subQ only. Can be used at home.
digoxen toxicity
manifest with... dysrhythmias, bradycardia, muscles weakness, anorexia, nausea, vomiting, fatigue, and visual disturbances.
cromolyn
mast cell stabilizer, inhaled, for asthma or allergies
sucralfate
mucosal protectant for PUD
bethanechol
muscarinic agnonist, used primarily for urinary retention
atropine
muscinarinic receptor antagonist/anticholinergic drug; used for mydriases (eye exams), to raise HR, lower GI motility, and as antidote to muscarinic poisoning (rx, shrooms)
penicillin G
narrow-spectrum penicillinase sensitive penicillin. It is active against most Gram positive bacteria lacking penicillinases, including Streptococcus sp.
dextromethorphan
non opioid antitussive
quinidine
only targets the myocardium and His Purkinje system and not the SA or AV nodes
diphenoxylate+atropine
opioid agonist antidiarrheal, plus atropine to prevent abuse
hydrocodone/acetaminophen
opioid and non opioid combined for analgesia
prednisone
oral corticosteroid, used for long term control of asthma
rosiglitazone
oral hypoglycemic. Increases insulin sensitivity but has been used less commonly due to known risk of cardiotoxicity.
Mannitol
osmotic diuretic; promotes diuresis by creating an osmotic force within the lumen of the nephron; preserves urine flow; reduces ICP; lowers intraocular pressure; may cause edema
magnesium hydroxide
osmotic laxative drug
heparin
preferred anticoagulant during pregnancy (doesn't cross placenta)
metoclopramide
prokinetic antiemetic
misoprostol
prostaglandin analog for PUD; mucosal protectant
omeprazole
proton pump inhibitor
montelukast
respiratory anti inflammatory; Leukotriene Modifier (PO)
naloxone (Narcan)
reverses opioid OD (receptor antagonist)
pancuronium
short acting nicotinic M blocker, used for surgeries, does not depolarize muscles, causes paralysis with consciousness
nitroglycerin
stable angina = reduces oxygen demand; variant angina = increases supply by stopping spasms in coronary vessels; 8 hour break/ day to prevent tolerance; use w/ BB or CCB to prevent reflex tachycardia
linezolid
static, inhibits protein synthesis ;cross-resistance unlikely. Activity against multidrug-resistant gram-positive pathogens, including vancomycin-resistant enterococci (VRE) and methicillin-resistant Staphylococcus aureus (MRSA). It is NOT active against Gram negative bacteria. Its use is highly reserved in order to limit development of resistance.
sulfamethoxazole
sulfonamide: MOA: anti-metabolite, often given with trimethoprim; SE: hypersensitivity rxns
docusate sodium
surfactant laxative
ciprofloxacin; tetracycline
these antibiotics should not be taken with dairy, antacids, or minerals
glucagon
treats hypoglycemia; carbohydrate; opposite effects of insulin
vitamin k
treats warfarin overdose
oral anticoagulants
warfarin (indirect), dabigatran (direct thrombin inhibitor)
