ati finalpharmacology

11
ATI Final Classification Prototype Action Uses Side effects Interactions NI Affecting NSAIDS NSAIDS: Asprin2nd Gen: Celecoxib (celebrex) decrease inflammation, pain, and fever Inflammation, Analgesia, fever reduction, dysmenorrhea GI discomfort, gastric ulcers, bleeding, renal dysfunction, Salicylism, Reye Syndrome Warfarin, Glucocorticoids, Alcohol, Ibuprofen Take with food, milk, or fully glass of water Pain and inflammati Antigout Colchicine decrease inflammation Gout GI toxicity Warfarin Pain and inflammati Migraine Medications Ergot alkaloids: Ergotamine (ergostat) Serotonin receptor agonists (Triptains): Sumatripitan (Imitrex) prevent inflammation and dilation to intracranial blood vessels abort acute migraine attack, prevent migraines Ergot: GI discomfort; Ergotism, physical dependence, abortionTriptans: Chest symptoms, angina, teratogenic Triptains with MAOI's Avoid trigger factors. Pain and inflammati Opioid Antagonist Naloxone (Narcan) interfere with the action of opioids opioid overdose, reverse effects of opioids, reversal of resp. depression in infants tachycardia, tachypnea, abstinence syndrome Pain and inflammatio Neuromuscular Blocking Agents Nondepolarizing: Tubocurarine (Tubarine) Depolarizing: succinylcholine (Anecitine) Block ACh at neuromuscular junction adjuncts to general anesthesia, diagnosis myasthenia gravis, seizure control, endotracheal intubation, endoscopy Respiratory arrest, hypotentionSuccinylc holine: apnea, malignant hypertension, hyperkalemia General anesthetics, Aminoglycosides, tetracyclines, Cholinesterase inhibitors continuous cardiac monitoring Nervous sys Anti Parkinsons Dopaminergic: Levodopa (Dopar, Larodopa) Dopamine agonists: pramipexole (Mirapex) Centrally acting anticholengerics: Benztropine (congentin) Dopamine releaser (Antiviral): Amantadine (symmetrel) block receptors Parkinsons Levodopa: N/V, Dyskinesias, ortho hypo, cardio effects, psychosis, discoloration of sweat and urine, activation of malignant melanoma Mirapex: sleep attacks, daytime sleepiness, ortho hypo, psychosis, dyskinesias, NauseaCogentin: N/V, Atropine effects. Levodopa: Protients, conventional antipsychotic agents, pyridoxine, MAOIs. Mirapex: Levodopa effects may not be noticeable for several weeks to months Nervous sys AEDs Barbiturates: phenobarbital (Luminal) Hydantoins: phenytoin (Dilantin) Benzodiazepines: diazepam (valium), lorazepam (Ativan) Carbamazepine (Tegretol), ethosuximide (zaronin), slow entrance of Na and Ca, suppress neuronal firing, inhibit generalized seizures, partial seizures CNS effects, skin rash, toxicity, Cardio effects, teratogenisis, GI effects, respiratory Dilantin: OC, warfarin, glucocorticoids, alcohol, valium. Tegretol: OC, use for control not cure, seizure frequency Nervous sys

Upload: claudia-manning

Post on 17-Oct-2014

749 views

Category:

Documents


2 download

TRANSCRIPT

Page 1: ATI FinalPharmacology

ATI Final

Classification Prototype Action Uses Side effects Interactions NI AffectingNSAIDS NSAIDS: Asprin2nd Gen: Celecoxib (celebrex) decrease

inflammation, pain, and fever

Inflammation, Analgesia, fever reduction, dysmenorrhea

GI discomfort, gastric ulcers, bleeding, renal dysfunction, Salicylism, Reye Syndrome

Warfarin, Glucocorticoids, Alcohol, Ibuprofen

Take with food, milk, or fully glass of water

Pain and inflammation

Antigout Colchicine decrease inflammation

Gout GI toxicity Warfarin Pain and inflammation

Migraine Medications Ergot alkaloids: Ergotamine (ergostat) Serotonin receptor agonists (Triptains): Sumatripitan (Imitrex)

prevent inflammation and dilation to intracranial blood vessels

abort acute migraine attack, prevent migraines

Ergot: GI discomfort; Ergotism, physical dependence, abortionTriptans: Chest symptoms, angina, teratogenic

Triptains with MAOI's

Avoid trigger factors.

Pain and inflammation

Opioid Antagonist Naloxone (Narcan) interfere with the action of opioids

opioid overdose, reverse effects of opioids, reversal of resp. depression in infants

tachycardia, tachypnea, abstinence syndrome

Pain andinflammation

Neuromuscular BlockingAgents

Nondepolarizing: Tubocurarine (Tubarine) Depolarizing: succinylcholine (Anecitine)

Block ACh at neuromuscular junction

adjuncts to general anesthesia, diagnosis myasthenia gravis, seizure control, endotracheal intubation, endoscopy

Respiratory arrest, hypotentionSuccinylcholine: apnea, malignant hypertension, hyperkalemia

General anesthetics, Aminoglycosides, tetracyclines, Cholinesterase inhibitors

continuous cardiac monitoring

Nervous system

Anti Parkinsons Dopaminergic: Levodopa (Dopar, Larodopa) Dopamine agonists: pramipexole (Mirapex) Centrally acting anticholengerics: Benztropine (congentin) Dopamine releaser (Antiviral): Amantadine (symmetrel)

block receptors Parkinsons Levodopa: N/V, Dyskinesias, ortho hypo, cardio effects, psychosis, discoloration of sweat and urine, activation of malignant melanoma Mirapex: sleep attacks, daytime sleepiness, ortho hypo, psychosis, dyskinesias, NauseaCogentin: N/V, Atropine effects.

Levodopa: Protients, conventional antipsychotic agents, pyridoxine, MAOIs. Mirapex: Levodopa

effects may not be noticeable for several weeks to months

Nervous system

AEDs Barbiturates: phenobarbital (Luminal) Hydantoins: phenytoin (Dilantin) Benzodiazepines: diazepam (valium), lorazepam (Ativan) Carbamazepine (Tegretol), ethosuximide (zaronin), valproic acid (Depakote), gabapentin (Neurontin)

slow entrance of Na and Ca, suppress neuronal firing, inhibit GABA

generalized seizures, partial seizures

CNS effects, skin rash, toxicity, Cardio effects, teratogenisis, GI effects, respiratory depression

Dilantin: OC, warfarin, glucocorticoids, alcohol, valium. Tegretol: OC, warfarin, grapefruit juice, phenytoin, phenobarbital.

use for control not cure, seizure frequency chart

Nervous system

Muscle relaxants and Antispasmodics

dantrolene (Dantrium) acts directly on spastic muscles

relief of spasticity CNS depression, hepatic toxicity, physical dependence

CNS depressants don’t stop taking medication

Local Anesthetics Amide: lidocaine (xylocaine)"cain" decrease conduction of pain impulses

minor procedures... CNS excitation, Hypotension, Allergic reactions, Spinal headache, urinary retention

Nervous system

General InhalationAnesthetics

Halothane (fluothane)"ane" loss of sensation, consciousness, memory loss

Surgery, diagnostic procedures, analgesia, muscle relaxation

hypotension, resp and cardio depression, malignant hyperthermia, hepatotoxicity

CNS depressants, CNS stimulants, morphine sulfate, succinylcholine

NPO 6-8 hrs. before

Nervous system

Antipsychotics-Conventional Low: Chlorpromazine (thorazine) High: Haloperidol (haldol)

inhibit psychotic symptoms

schizo, bipolar, tourettes, delusions, dementia, Huntington’s chorea

EPS, TD, Neuroleptic malignant syndrome, Anticholinergic effects, ortho hypo, sedation, seizures, sexual dysfunction, skin effects

Anticholinergic agents, CNS depressants, Levodopa

Nervous system

Page 2: ATI FinalPharmacology

Antipsychotics-atypical clozapine (clozaril) blocks serotonin and dopamine

severe schizo, psychosis Agranulocytosis, seizures, weight gain, inflammation of heart muscle

Immunosuppressive meds

Nervous system

TCA amitriptyline (Elavil) block reuptake of norepi and serotonin--intensify effects

Depression, bipolar ortho hypo, anticholinergic effects, sedation, cardiac toxicity,

MAOIs, Antihistamines, Epinephrine, NE, Ephedrine, amphetamine, CNS depressants

effects not experienced until 1-3 weeks

Nervous system

SSRIs Fluoxetine (prozac) block reuptake of serotonin

Depression, OCD, bulimia, panic disorders, PTSD

Sexual dysfunction, wt. gain, mental confusion, agitation, anxiety, withdrawal syndrome, hyonatremia, rash, sleepiness

MAOIs, warfarin, Tricyclic antidepressants, NSAIDS anticoagulants,

take with food Nervous system

MAOIs Phenelzine (Lardil) increase amount of NE and serotonin avaliable

atypical depression, bulimia, OCD

CNS stimulation, ortho hypo, hypertensive crisistrycyclic

antidepressants, SSRIs, Antihypertensives, Mepridine(Demerol), Tyramine rich foods, Vasopressors

Nervous system

Atypical Antidepressants bupropion HCL (Wellbutrin) Inhibit dopamine uptake

depression, aid to quit smoking H/A, dry mouth, contipation, tachycardia, nausea, wt.loss, seizures

MAOIs take daily nervous system

Mood stabilizers Litium: Valproic acid(depakote), carbamazepine (tegretol)

serotonin blockade bipolar, alcoholism, bulimia, schizo

GI effects, tremors, polyuria, renal toxicity, goiter, teratogenesis,

Diuretics, NSAIDS, Anticholinergics

monitor litium levels

Nervous system

Benzodiazepines diazepam (Valium) enhance GABA in CNS

Anxiety, seizure, insomnia, muscle sapsm, alcohol withdrawal, panic disorder

CNS depressions, paradoxical response, respiratory depression, teratogenesis, acute toxicity

CNS depressants taper dose when D/C

Nervous system

Non Benzo zolpidem (Ambien) do ot function as muscle relaxant

insomnia daytime sleepiness and lightheadedness

CNS depressants, food take before bedtime

Nervous system

Anxiolytic-Non-Barbiturate buspirone(BuSpar) binds to serotoinin and dopamine receptors

GAD CNS effects Erythromycin, ketoconazole, grapefruit juice

take with meals Nervous system

CNS Stimulant Methylphenidate (ritalin,Concerta) Release NE and dopamine

ADHD, Narcolepsy, Obesity CNS stimulation, wt.loss, Cardioeffects,

MAOIs, Caffeine, Phenytoin, warfarin, OTC cold meds

don’t chew or crush

Nervous system

Adrenergic Agonists epinephirne (Adrenaline)Dopamine (Intropin)Dobutamine(Dobutrex)

increase HR, Contractility, rate of conduction

Tx of AV block and cardiac arrest, HF, shock, hypertenstion

Hypertensive crisis, dysrhythmias, necrosis, increase HR

MAOIs, Tricyclic antidepresants, general anthetics, alpha-adrenergic blocking agents, beta adrenergic blocking agents, diuretics

IV continuous infusion

Cardiovascular system

Alpha Adrenergic blockers (sympatholytic)

Prazosin(minipress) venous and arterial dilation, smooth muscle relaxation

hypertension, BPH First dose hypertension Antihypertensive meds

BP,HR, take w/food, inital dose at bedtime

Cardio

Centrally Acting Alpha2 agonists

Clonidine(Catapress) decrease sympathetic outflow

HTN,sever CA pain Drowsiness, sedation, dry mouth rebound hypertension

anti HTN meds, praxosin, MAOIs, tricyclic antidepressants, CNS depressants

Cardio

Beta Adrenergic Blockers (sympatholytic)

Cardio selective: metoprolol (lopressor) nonselective: Propranolol (Inderal)"lol"

block beta1 adrenergic receptors

angina, HTN, dysrhythmias, MI, HF

Bradycardia, decrease CO, AV block, ortho hypo, rebound myocardium excitation,

CCB, Antihypertensive meds, insulin

don’t d/c med with out dr. orders, don’t crush or chew

cardio

Page 3: ATI FinalPharmacology

bronchoconstriction, glycogenolysis inhibited

ACE inhibitors Captopril(capoten)"pril" block the production of Ang II (vasodilation, excretion of Na and H2o and retention of K)

HF, HTN,MI, nephropathy first dose ortho hypo, cough, hyperkalemia, rash, angioedema, neutropenia

Diuretics, antiHTN meds, K supplements, lithium, NSAIDS

1hr before meals cardio

ARBs lorsartan (Cozaar)"artan" blocks action of ang II

HTN, HF, MI, Stroke,nephropathy

angioedema, fetal injury anti HTN meds taken with or with out food

cardio

CCB nifedipine (Adalat,Procradia)"ipine"verapamil (calan), diltiazem (cardizem)

vasodilation Angina, HTN,Verapamil:dysrhythmias

reflex tachy, peripheral edema, acute toxicityverapamil: ortho hypo, constipation, suppression of cardiac function, dysrhythmias

beta blockers, grapefruit juiceverapamil: plus digoxin

IV 2-3 min cardio

Hypertensive crisis Sodium nitroprusside direct vasodilation hypertensive emergencies, decrease bleeding

excessive hypotention, cyanie poisoning, thiocyanate poisoning,

don’t mix with other medications

cardio

Organic Nitrates nitroglycerine (Nitrol, Nitrostat) angina angina H/A, ortho hypo, reflex tachycardia, tolerance

Alcohol, antihypertensive meds, viagra

Cardio

Cardiac Glycosides digoxin (Lanoxin, lanoxicaps, digitek) increase force of contraction, decrease HR

HF, dysrhythmias(A fib) Dysrhythmias, bradycardia, GI effects(anorexia, N/V, abd pain) CNS effects(fatigue, weakness, vision changes)

Thiazide, ACE, ARBs, sympathomimetic meds, quinidine, verapamil

check apical pulse, same time daily,

cardio

Statins atorvastatin (Lipitor) Cholesterol hyperohlesterolemia, prevent coronary events, protect MI, raise HDL levels

hepatotoxicity, myopathy, peripheral neuropathy

fibrates, erythromycin, grapefruit juice

take with evening meal

Cardio

Antilipemics: fibrates gemfibrozil (Lopid) increase VLDL excretion, increase HDL levels

Reduction of VLDLs, increase HDL

Gall stones, myopathy,hepatotoxicity

Warfarin, statins, cholestyramine

obtain baseline cholesterol levels, take 30 min prior to meals

Cardio

Antilipemics-Cholesterol Absorption Inhibitor

ezetimibe (zetia) absorb cholesterol lower LDL NONE Cholestyramine, statins, fibrates, cyclosporine,

baseline cholesterol levels, no reguard to food

cardio

Antilipemics-bile-acid-sequestrants

cholestyramine (Questran) lower LDL Lower LDL Constipation digoxin, warfarin, thiazides, tetracyclines

disolve in 4oz of H2O

Cardio

Anticoagulants/parenteral Heparin prevents bleeding DVT, DIC Hemmorrhage, hypersensitivity reactions

anti-platelet agents baseline vitals, monitor CBC,monitor aPPT (60-80sec)

Blood

Tx of Heparin overdose Protamine Sulfate antidote reversal of heparin administration

IV administered slowly

Blood

Anticoag/Oral Warfarin (coumadin) prevent synthesis of coagulation factors

thrombosis hemorrhage heparin, aspirin, glucocorticoids, acetaminophen, foods high in vit K

vitals, monitor PT, CBC, platelet count, Hct levels

Blood

Warfarin overdose Vit K(phytonadione, Aquamephyton) promotes synthesis of coag factors

reversal of bleeding, Vit k deficiency

anaphylactoid-type reaction (flushing, hypotension, urticaria, cardio collapse)

small doses orally

Blood

Antiplatelets Asprin (ecotrin) prevent platelets from clumping together by

MI, stroke, coronary syndromes

GI effects (bleeding), Hemorrhagic stroke

NSAIDs, Heparin, warfarin

Blood

Page 4: ATI FinalPharmacology

inhibiting enzymesThrombolytic medications Streptokinase (streptase) "ase" dissolves clots that

have already formedMI, DVT, PE, ischemic stroke bleeding, hypotension,

allergic reactionNSAIDs, Heparin, Warfarin

Blood

Iron Preparations Ferrous sulfate (feosol)Iron dextran (INFeD) provide iron iron deficiency GI distress, Teeth staining, Anaphylaxis

antacids, vit c take on empty stomach, green blackish stool

blood

Hematopoietic growth factors epoetin alfa (Epogen, Procrit) increase production of RBC

anemia, HIV HTN, increased risk for cardiovascular event

monitor iron levels, BP, Hgb and Hct

blood

Beta2-Adrenergic agonists Albuterol (proventil, Ventolin) activate the beta receptorsin the bronchial smooth muscle

asthma Tachycardia, angina, tremors

beta blockers, MAOIs, tricyclic antidepressants

Respiratory

Methylxanthines theophylline (Theolair) bronchodilation asthma GI distress, restlessness, seizures

caffeine Respiratory

Inhaled Anticholinergic ipratropium (Atrovent) brochodilation brochospasm, asthma local anticholingergic effects RespiratoryGlucocorticoids belcomethasone dipropionate (QVAR) prevent

inflammation, suppression of airway mucus,

prophylaxis of asthma, oral therapy, replacement therapy

difficulty speaking, hoarsness, candidiasis, bone loss, hyperglycemia, myopathy, peptic ulcer disease, infection,

k-depleting diuretics, NSAID

fixed schedule Respiratory

Mast Cell Stabilizers cromolyn sodium (Intal) Anti-inflammation chronic asthma, exercised and allergen induced asthma

take 15 min before exercise or exposure to allergen

Respiratory

Leukotriene Modifiers montelukast (singulair) suppresses inflammation, bronchoconstriction, edema, mucous production

Long term asthma liver injury warfarin,Theophylline

Respiratory

Antitussive-Opioids Codiene Cough suppression for non-productive cough CNS effects, GI distress, potiential for abuse

Respiratory

Mucolytics acetylcysteine (Mucomyst) enhance the flow of secretions in respiratory passaes

pulmonary disorders, cystic fibrosis

Aspiration, bronchospasm odor that smells like rotten eggs, dilute medication in fruit juice

Respiratory

Decongestants phenylephrine cause reduction in inflammation

rhinitis, sinusitis Rebound congestion, CNS stimulation, Vasoconstricion

lateral head low position when taking

Respiratory

High Ceiling Loop Diuretics furosemide (Lasix) prevent reaborption of H2O

Pulmonary edema, renal impairment

Dehydration, hypotension, ototoxicity, hypokalemia

Digoxin, Antihypertensives, litium, NSAIDS

daily wts Fluids

Thiazide Diuretic hydrochlorothiazide(HydroDIURIL) block reabsorbtion of Na and Cl

essential HTN, mild-mod HF, liver and kidney disease

dehydration, hypokalemia, hyperglycemia

Digoxin, Antihypertensives, litium,

k levels, daily wts

fluids

K sparing diuretics spironolactone (Aldactone) block action of aldosterone

k sparing effects, HF hyperkalemia, endocrine effects

ACE, K supplements k levels, daily wts

fluids

osmotic diuretics mannitol (Osmitrol) increases blood osmolality

Renal failure, decrease ICP, IOP

HF, pulmonary edema, Renal failure, fluid and electrolyte imblalances

Fluids

K supplements potassium chloride (K-Dur) supplys K hypokalemia GI distress, local GI ulceration, hyperkalemia

ACE, spironolactone NEVER GIVE IV PUSH

Fluids

Histamine ReceptorsAntagonists

ranitidine hydrochloride (Zantac) suppress secretion of gastric acid

GERD, H.pylori, Heart burn, sour stomach

decrease libido, CNS effects warfarin, antacids eat 6 small meals

GI

Proton Pump Inhibitor omeprazole (Prilosec) reduce gastric acid seretion by irreversibly

peptic ulcers, GERD, hypersecretory contitions

Ampicillin, digoxin, iron

don’t crush or chew

GI

Page 5: ATI FinalPharmacology

inhibiting enzymeAntacids aluminum hydroxide gel (Amphojel) neutralize gastric

acid and inactivate pepsin

PUD, GERD constipation, hypophosphatemia,

warfarin, tetracycline chew tablets then drink 8 oz of H2O or milk

GI

Prostaglandin E Analog misoprostol (cytotec) decreases acid production

long term NSAID use prevent ulcers, pregnant

diarrhea, abd pain, dysmenorrhea

GI

laxatives psyllium(Metamucil)docusate sodium (Colace)bisacodyl (Dulcolax)magnesium hydroxide

softens fecal mass constipation GI irritation, Rectal burning sensation

milk, antacids GI

Prokinetic agents metoclopramide (Reglan) suppress emeisis GERD, chemo enduced Nasuea,

EPS, sedation, Diarrhea opioids monitor for CNS depressant

GI

Oral hypoglycemics-sulfonylureastolbutamide (orinase) glipizide (Glucotrol, Glucotrol XL)

promote insulin release

type 2 diabetes hypoglycemia alcohol, NSAIDs, beta blockers

exercise Endocrine

Oral hypoglycemics-Biguanides

metformin HCl (Glucophage) reduce production of glucose within liver

type 2 diabetes PCOS GI effects, Vit B12 deficiency, lactic acidosis

Alcohol with breakfast and dinner

Endocrine

Insulin Overdose Glucagon increases breakdown of glycogen into glucose

hypoglycemia GI distress Endocrine

Thyroid hormones levothyroxine(Synthroid,levothriod) synthetic form of T4 hypothyroidism, emergency tx of myxedema coma

overmedication binding agents, antiseizure and anti depressant, warfarin

vitals, TSH levels

Endocrine

Antithyroid Medications propylthiouracil (PTU) block synthesis of thyroid hormoones

grave's disease overmedication, agranulocytosis

increase anticoag effects

Endocrine

posterior pituitary hormone vasopressin (pitressin synthetic) promotes reabsorption of H20 within kidneys

diabetes insipidus, used during cardiac arrest

reabsorption of too much water

Endocrine

Uterine stimulants oxytocin(pitocin, syntocinon) stimulates uterus induction of labor, fetal stress test

uterine rupture, HTN crisis Vasopresssors use infusion pump, monitor for hyperstimulaion

Reproductive

Tocolytic medications terbutaline sulfate (brethine) uterine smooth muscle relaxation

delay preterm labor tachycardia, tremors adrenergic agonists, MAOIs, betablockers

monitor BP, frequency and duration of contractions, fetal distress

Reproductive

Androgens Testosterone enanthate (Delatestryl) promotes skeletal muscle growth

hypogonadism, delayed puberty

hepatotoxicity, cardio risk, Virilism effects

warfarin, glucocorticoids, hepatotoxic drugs

report wt. gain of >2lbs.

Reproductive

Estrogens conjugated equine estrogens(Premarin) estrogen hormones Contraception, postmenopausal symptoms, treatment of prostate cancer

Endometrail and ovearin CA, embolic events, feminization

warfarin, phenytoin rotate injection sites

reproductive

Progesterones medroxyprogesterone acetate (Provera) induce favorable conditions for fetal growth

dysfunctional uterine bleeding, anmenorrhea, endometriosis

Breast CA, thromboembolic events, breakthrough bleeding, edema

tegretol, dilantin, rifampin

withdrawal bleeding

reproductive

Erectile dysfunction sildenafil(Viagra) augments effects of nitric oxide relase during sexual stimulation

erectile dysfunction MI, sudden death, Priapism organin nitrates, grapefruit juice, erthromycin

1 hr before sexual activity

Reproductive

Immune Globulin Gamma globulin, immunoglobulin G (IgG) provide passive immunity

immunodeficiency syndrome, hep a, hep b

local reaction, systemic allergic reaction

live viruses Immune

Immunostimulants Interferon Alfa,Aldesleukin (interleukin-2) enhance host immune responses

hairy cell leukemia, maligannt melanoma, AIDS-related kaposi's sarcoma

Flu like symptoms, bone marrow suppression, hypotension

Theophylline, Zidovudine, antihypertensives

store in fridge Immune

Antihistamines diphenhydramine (Benadryl),promethazine (phenegran), dimenhydrinate (Dramamine)2nd Gen: Loratadine (claritin), cetirizine (Zyrtec), fexofenadine (Allegra), desloratadine(Clarinex)

block of histamine release

mild allergic reactions, anaphylaxis, motion sickness, insomnia

sedation, anticholingergic effects, GI discomfort, acute toxicity

CNS depressants Immune

Chemotherapy agents cyclophosphamide(Cytoxan,Neosar)cisplatin(Planinol AQ)metotrexate(Rheumatrex, trexall)cytara

destroy CA cells CA Bone marrow suppression, N&V, alopecia, mucosistis,

Immune

Page 6: ATI FinalPharmacology

bine(Cytosar-U) reproductive toxicity, hyperuricemia

Penicillins penicillin G (Bicillin LA) weakening the bacterial cell wall

meningitis, syphilis, prophylaxis bacterial endocarditis

Allergies, renal impairment,hyperkalemia

Aminoglycosides, OC full glass of water 1 hr before meals or 2 hr after

Infection

Cephalosporins cephalexin (Keflex)cefaclor (Ceclor)ceftriaxone(Rocephin)cefepime(maxipime

destroy bacterial cell wall

UTI, postoperative infection, pelvic infection, meningitis

Allergice, bleeding, thrombophlebitis, cross allergy

disulfiram reaction, probenecid

take with food Infection

Carbapenems imipenem (Primaxin) destroy cell wall pneumonia, peritonitis, UTI allergy, GI symptoms, Suprainfection

Infection

Monobactams Vancomycin (Vancocin) destroy cell wall serious infections ototoxicity, infusion reaction, thrombophlebitis

Infection

Tetracyclines tetracycline hydrochloride (sumycin) inhibit growth rickettsia, acne vulgaris GI discomfort, yellow/brown tooth discoloration, hepatotoxicity, photosensitivity, suprainfecrtion

Milk products, iron, magnesium,antacids, OC

don’t give with food

Infection

Bacteriostatic inhibitors erthyromycin (E-mycin) slows growth treat clients with penicillin allergy, whooping cough

GI discomfort, thrombophlebitis

Antihistamines, theophylline, warfarin

empty stomach infection

Aminoglycosides gentamicin (Garamycin) disrupt protein syntesis

tapeworm Ototoxicity, nephrotoxicity, neuromuscular blockade

penicillin peak and trough infection

Sulfonamides and trimethoprim

trimthoprim-sulfamethoxazole(TMP-SMZ, Bactrim) inhibit bacterial growth

UTI hypersensitivity,blood dyscrasias, kernicterus(jaundice, increase bili), photosensitivity

warfarin, phenytoin, slufonylurea

empty stomach, full glass of water

Infection

Urinary Tract Antispeptics nitrofurantoin (macrodantin) damages DNA UTI GI discomfort, Hypersensitivity reactions, blood dyscrasias, peripheral neruopathy

urine will have brownish discoloration

Infection

Antimycobacterial(Antituberculosis)

isoniazid(INH) ihibits growth of mycobacteria, prevents synthesis ofmycolic acid

TB peripheral neuropathy, hepatotoxicity

phenytoin, Alcohol empty stomach Infection

Anti-hansensDisease

dapsone prevents synthesis of folic acid

treatment of hansens disease discoloration of body fluids, hepatoxicity, mild GI discomfort

warfarin, OC,protease inhibitors

complete course infection

Antiviral acyclovir(Zovirax) prevents reproduction of viral DNA

herpes simplex virus, HIV phlebitis and inflammation at site, nephrotoxicity, mild GI discomfort, Granulocytopenia and thrombocytopenia, reproductive toxicity

never administer bolus, IV over 1 hour

Infection

Fluoroquinolones ciprofloxacin(Cipro) inhibition of enzyme necessary for DNA replication

severe infections, resp, urinary, and GI infections

GI discomfort, Achilles tendon rupture, suprainfection,

Cationic compounds, theophylline, warfarin

Infection

Antiprotozoals metronidazole(flagyl) slows growth peptic ulcer disease, protozoal infections

GI discomfort, metallic taste, darkening of urine, CNS symptoms

alcohol, metronidazole

complete course infection

Antifungal amphotericin B deoxycholate(fungizone) acts on fungal cell membranes to increase cell permeability

fungal infections, dermatophytic infections

Infusion reaction, thrombophlebitis, nephrotoxicity, hypokalemia, bone marrow suppression

Aminoglycosides, flucytosine

Infection

Acetaminophen acetaminophen (Tylenol) slows production of prostaglandins

Analgesic, antipyretic Acute toxicity Alcohol, Warfarin Pain and inflammation

Page 7: ATI FinalPharmacology

Opioid Agonists Morphine sulfate act of mu receptors moderate to severe pain, sedation, reduction of bowel motility, Codiene: cough suppression

Respiratory depression, constipation, orthostatic hypotention, urinary retention, sedation, biliary colic, emesis, opioid overdose triad

CNS depressants, Anticholinergic agents, MAOI's, Antihypertensives

withhold if R<12, IV slowly (4-5 min)

Pain and inflammation

Agonists-Antagonist Opioids

Pentazocine (Talwin) low potential for abuse, less respiratory depression. Antagonist to mu receptors, agonist to kappa receptors

mild to moderate pain Abstinence syndrome NONE withhold if R<12 Pain and inflammation

Cholinesterase inhibitors neostigmine (Prostigmin) "mine" increase amount of ACh available at receptor sites

Myasthenia gravis, reversal of neuromuscular blocking agents

increase GI motility and secretions; Cholinergic crisis, bradycardia, urinary urgency

Atropine, tubocuraine, Succinylcholine

medical alert bracelet

Nervous system