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)