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243 Cards in this Set

  • Front
  • Back
What is the pharm class of Albuterol (Proventil)?
Adrenergic: Selective short-acting beta 2 agonist
What is the therapeutic class of Albuterol (Proventil)?
bronchodilator
What is the pharm class of Salmeterol (Serevent)?
Adrenergic: Selective long-acting beta 2 agonist
What is the therapeutic class of Salmeterol (Serevent)?
bronchodilator
What is the pharm class of Short-acting theophylline (Aminophylline)?
xanthine
What is the therapeutic class of short-acting theophylline (Aminophylline)?
bronchodilator
What is the pharm class of Fluticasone (Flonase)?
corticosteroid
What is the pharm class of Montelukast (Singulair)?
leukotriene antagonist
What is the therapeutic class of Montelukast (Singulair)?
bronchodilator
What is the therapeutic class of Diphenhydramine (Benadryl)?
antihistamine
antitussive
What is the pharm class of Promethazine (Phenergan)?
phenothaizine
What is the therapeutic class of Promethazine (Phenergan)?
antihistamine
antiemetic
sedative/hypnotic
What is the pharm class of Cetrizine (Zyrtec)?
piperazine: peripherally selective
What is the therapeutic class of Cetrizine (Zyrtec)?
antihistamine
What is the pharm class of Phenylephrine (Neo-Synephrine)?
adrenergic vasopressor
What is the therapeutic class of Phenylephrine (Neo-Syneprine)?
vasopressor
What is the therapeutic class of Guaifenesin (Robitussin)?
expectorant
What is the therapeutic class of Acetylcysteine (Mucomyst)?
mucolytic
antidote for acetaminophen toxicity
What is the pharm class of Aluminum hydroxide/magnesium hydroxide (Maalox)?
antacid
What is the therapeutic class of alum hydroxide/magnesium hydroxide (Maalox)?
anti-ulcer agent
What is the pharm class of Famotidine (Pepcid)?
histamine H2 antagonist
What is the therapeutic class of Famotidine (Pepcid)?
anti-ulcer agent
What is the pharm class of Omeprazole (Prilosec)?
proton pump inhibitor
What is the therapeutic class of Omeprazole (Prilosec)?
anti-ulcer agent
What is the pharm class of Misoprostol (Cytotec)?
prostaglandin
What is the therapeutic class of Misoprostol (Cytotec)?
anti-ulcer agent
abortifacient
What is the pharm class of sucralfate (Carafate)?
GI protectant
What is the therapeutic class of Sucralfate (Carafate)?
GERD medication
anti-ulcer agent
What is the pharm class of Bismuth subsalicylate (Pepto-Bismol)?
adsorbent
What is the therapeutic class of bismuth subsalicylate (Pepto-Bismol)?
antidiarrheal
anti-ulcer
What is the pharm class of Psyilium (Metamucil)?
bulk forming agent
What is the therapeutic class of Psyilium (Metamucil)?
laxative
What is the pharm class of Docusate sodium (Colace)?
stool softener
What is the therapeutic class of docusat sodium (Colace)?
laxative
What is the pharm class of magnesium citrate?
saline
What is the therapeutic class of magnesium citrate?
laxative
What is the pharm class of Bisacodyl (Dulcolax)?
stimulant laxative
What is the pharm class of Lactulose (Cephulac)?
osmotic
What is the therapeutic class of Lactulose (Cephulac)?
laxative
What is the pharm class of Diphenoxylate/atropine (Lomotil)?
anticholinergic
What is the therapeutic class of Diphenoxylate/atropine (Lomotil)?
antidiarrheal
What is the pharm class of Cholestryramine (Questran)?
bile acid sequestrate
What is the therapeutic class of Cholestryramine (Questran)?
lipid-lowering agent
Wat is the therapeutic class of Metronidazole (Flagyl)?
anti-infective
anti-protozoal
anti-ulcer
What is the pharm class of Ondansetron (Zofran)?
5 HT3 antagonist
What is the therapeutic class of Ondasetron (Zofran)?
antiemetic
What is the pharm class of Scopolamine?
anticholinergic
What is the therapeutic class of Scopolamine?
antiemetic
chronic reactive airway disease characterized by bronchoconstriction, inflammation, and hyperactivity of the airways

reversible in early stages of disease
asthma
What are the 2 major types of drugs that treat asthma and COPD?
bronchodilators
anti-inflammatory drugs
What are the goals of asthma therapy, according to the NAEPP?
1. Minimal or no chronic symptoms day or night
2. Minimal or no exacerbations
3. No limitations on activities; for children, no school/parent's work missed
4. Minimal use of short-acting inhaled beta 2 agonists (<1 time per day, <1 canister per month)
5. Minimal or no adverse effects from medication
How do bronchodilating drugs work?
they stimulate beta 2 adrenergic receptors in the smooth muscle of the bronchi, producing bronchodilation
What type of beta agonist is epineprhine?
non-selective (this means it hits beta 1 and 2...causing increased cardiac rate and force of contraction)
What is the toxic blood level of theophylline (aminophylline)?
20 mcg/mL
What are the first signs of theophylline (aminophylline) toxicity?
ventricular dysrhythmias
seizure
coma
What are the drug interactions with theophylline?
Nicotine and Phenytoin may decrease effectiveness.

Fluoroquinolones (anti-biotics) may lead to toxicity.
type of anti-inflammatory drug used to treat asthma that stablizies the mast cells and prevents the release of inflammatory substances
mast cell stablizer (inhaled drug)
once a day pill given in the evening for asthma

really helps other bronchodilators work
Montelukast (Singulair)
How should patients taking a nasal decongestant and Flonase take their meds?
They should take decongestant 5-15 min before Flonase spray.
What is the green zone of peak flow monitoring?
80-100% of personal best
What is the yellow zone of peak flow monitoring?
50-80% of personal best

(check triggers and start monitoring more often to see where you'll go from there)
What is the red zone of peak flow monitoring?
50% or less of personal best

(neede to be seen by a practitioner)
Are antiasthmatic drugs usually given alone or in combination?
in combination - know the type and purpose of each drug!
Every type of anti-asthmatic drug except _____________ should be taken on a regular schedule and continued even when symptom free.
short-acting, inhaled bronchodilators (ex. albuterol)
When an asthma attack occurs, the only fast-acting commonly used medication is:
an inhaled, short-acting bronchodilator (ex. albuterol)
A common cause of acute asthma attacks is:
not taking medications correctly (b/c of long-term use, expense, and adverse effects)
What can asthmatics do to help thin secretions in the throat and lungs, making them easier to remove?
drink 2-3 quarts of fluid a day
Asthmatics should avoid excessive intake of ____________ because they may increase HR and cause palpitations, nervousness, and insomnia.
caffeine-containing fluids such as coffee, tea, and cola
Do not use __________ more often than every 12 hours.
Salmeterol (Serevent)
a chemical mediator released in immune/inflammatory responses

located in mast cells and basophils

discharged in allergic reactions, cellular injury, and extreme cold
histamine
Which histamine receptor is involved in the contraction of smooth muscle in the bronchi and bronchioles (bronchoconstriction and respiratory distress)
H1
Which histamine receptor stimulates the vagus nerve endings to produce reflex bronchoconstriction and cough?
H1
Which histamine receptor causes increased permeability of veins and capillaries, which allows fluid to flow into sub-cutaneous tissues and form edema?
H1
Which histamine receptor causes increased secretion of mucous glands?
H1
Which histamine receptor stimulates the sensory peripheral nerve endings to cause pain and pruritus?
H1
Which histamine receptor causes dilation of capillaries in the skin, to cause flushing?
H1
Which histamine receptor causes increased secretion of gastric acid and pepsin?
H2
Which histamine receptor causes increased rate and force of myocardial contraction?
H2
Which histamine receptor causes decreased immunologic and proinflammatory reactions?
H2
immediate type of allergic reaction

occurs within minutes

occurs with a second or later exposure to an antigen

ex. anaphylaxis
Type I
cell membrane dependent type of allergic reaction

includes drug and blood reactions

ex. blood transfusion reaction
Type II
allergic reaction characterized by the formation of antigen-antibody complexes

ex. serum sickness
Type III
type of allergic reaction that occurs several hours or days after exposure to an antigen

ex. contact dermatitis, also happens with some antibiotics
Type IV
immediate life-threatening allergic reaction that occurs on FIRST exposure to agent

is not an antigen-antibody reaction
pseudoallergic drug reaction
What is the most common cause of pseudoallergic drug reactions?
radioopaque dyes (ex. cardiac cath or IVP)
How does an antihistamine work?
it occupies the same receptor sites as histamine

does NOT prevent or reduce the amount of histamine being released
Are first generation H1 receptor antagonists:

selective or nonselective?
sedating or nonsedating?
nonselective
sedating
Who is Benadryl contraindicated in?
older adults (Beer's list)
people already taking anticholingergic drugs
What are the indications for Benadryl?
anaphylaxis
allergic rhinitis
allergic dermatoses
dystonic reactions
nighttime sedation
prevention of motion sickness
a list of drugs in which the risks outweigh the benefits for use in older adults
Beer's list
Is Promethazine (Phenergan) on the Beer's list?
yes (it is first generation H1 receptor antagonist)
Are second generation H1 receptor antagonists:

selective or nonselective?
sedating or nonsedating?
selective (for H1)
nonsedating
Why are second generation H1 receptor antagonists nonsedating?
they do NOT cross the blood brain barrier
Is Cetrizine (Zyrtec) on the Beer's list?
NO!

(2nd generation H1 receptor antagonist)
What are some potential adverse effects of 1st generation H1 receptor antagonists IN CHILDREN?
drowsiness
paradoxical excitement

OD may cause hallucinations, convulsions, death!
What are some potential adverse effects of 1st generation H1 receptor antagonists in OLDER ADULTS?
confusion
dizziness
hypotension
sedation
syncope
unsteady gait
paradoxical CNS stimulation
anticholinergic effects
Do NOT take Benadryl if you have:
active asthma, bronchitis, or pneumonia (b/c Benadry thickens respiratory tract secretions and makes them more difficult to remove)
With what group of drugs should you avoid prolonged exposure to the sunlight?
antihistamines (they may increase risk of sunburn)
drugs used to relieve nasal obstruction and discharge

most often adrenergic
nasal decongestants
What are the contraindications to taking nasal decongestants?
CVD
HTN
DM
glaucoma
MAOIs
Nasal decongestant sprays should not be used for longer than:
3 days
drugs that supress a cough by depressing the cough center in the brain or the cough recpetors in the throat, trachea, and lungs
antitussive
What are the 3 types of antitussive drugs?
narcotic (act on the central cough center)
non-narcotic (act on peripheral cough receptors)
locally acting (throat lozenges and cough drops)
What kind of cough should antitussives be used for?
dry, hacking, nonproductive cough that interferes with rest and sleep
drugs that liquefy respiratory secretions while being formed for easier removal
expectorants
drugs that liquefy mucous after formation

given by inhalation
mucolytics
With antitussive sprays, throat lozenges, and cough drops, what should you tell your patient?
Drink a glass of water after taking medicine to move it out of the throat and into the body.
Who is Guaifenesin (Robitussin) contraindicated in?
alcoholics (it contains alcohol)
diabetics (it contains sugar)
What is the inhaled form of Acetylcysteine (Mucomyst) used for?

What is the oral form of Acetylcysteine (Mucomyst) used for?
inhaled - mucolytic

oral - given for an acetaminophen (Tylenol) overdose
Do not give products containing ______ or _______ to children under 18.
ASA
salicylates
Digestive system drugs primarily alter what 3 things?
secretion
absorption
motility
alkaline drugs that neutralize gastric acids

change pH, but don't block secretion
antacids
Magnesium-based antacids are contraindicated in:
renal failure
Aluminum-based antacids cause what adverse effect:
constipation
Magnesium-based antacids cause what adverse effects:
diarrhea
hypermagnesemia
drugs that inhibit basal and stimulated secretion of gastric acid
histamine 2 receptor antagonists
What is another indication for Famotidine (Pepcid) besides peptic ulcer disease, GERD, and GI bleeding?
urticaria (hives) b/c Pepcid also has some effect on H1 receptor sitess
drug of choice for treatment of GERD/ulcers/GI bleed

binds to the gastric proton pump and inhibits response to stimulation of histamine, gastrin, and acetylcholine
proton pump inhibitors
Omeprazole (Prilosec) should be used with caution in people with:
liver disease
drug that inhibits gastric acid secretion and increases mucus and bicarbonate secretion

is a synethetic prostaglandin E
prostaglandin

ex. Misoprostol (Cytotec)
Who should take Misoprostol (Cytotec)?

Who should NOT take Misoprostol (Cytotec)?
Indicated for: client at high risk for GI ulceration/bleeding and clients taking high doses of NSAIDs

NOT indicated for: women who are pregnant (will induce abortion)
type of drug that protects the lining of the stomach

doesn't change pH or amount of secretions

used to prevent and treat ulcer disease
GI protectant

ex. Sucralfate (Carafate)
What drug should you give 2 hours before or after other drugs?
Sucralfate (Carafate)
intoxication with aspirin or one of its derivatives (treated with activated charcoal)
salicylate poisoning
What are the signs and symptoms of salicylate poisoning?
lethargy
dehydration
tinnitus
skin rash
bleeding
Who should NOT take bimuth subsalicylate (Pepto-Bismol)?
people allergic to aspirin
people taking alot of aspirin
What are some indications for laxative use?
relieve constipation
prevent straining at stool after MI
empty the bowel before surgery
accelerate elimination of toxic substances
acceleration excretion of parasites
prevent intestinal absorption of ammonia
What are some CONTRAindications for laxative use?
intestinal obstruction
fecal impaction
undiagnosed abdominal pain
Why is mineral oil not an oral laxative of choice in any condition?
because there is a risk of lipid pneumonia if it is aspirated into the lungs
What group of people are usually on laxatives?
clients with cancer (b/c of the constipation associated with morphine)
What groups of people should use laxatives cautiously?
renal failure
congestive heart failure
antidiarrheal drug that is also used for the management of hypercholestermia
Cholestryramine (Questran)
strong antibiotic drug that is used as an anti-diarrheal agent
Metronidazole (Flagyl)
With what drug should you not drink alcohol during and for 3 days after?
Metronidazole (Flagyl)
What antidiarrheal drug blocks the absorption of other drugs in the intestine?
Cholestryramine (Questran)
What are contraindications to the use of antidiarrheal drugs?
diarrhea caused by:
toxic materials
microorganisms
campylobacter
antibiotic-associated colitis
Opiates are contraindicated in what type of diarrhea?
chronic
Lomotil is contraindicated in who?
children <2

b/c it has atropine in it
type of drug that is effective in preventing/treating N/V induced by drugs, radiation, surgery, and most other stimuli
phenothiazines (Phenergan)
type of drug given to treat/prevent moderate to severe nausea and vomiting postoperatively and associated with chemo/radiation
5-HT3 receptor antagonist
What groups of people is Ondansetron good for?
cancer patients b/c it doesn't cause much sedation
pregnant women in 1st trimester with hyperemesis
anticholinergic antiemetic drug used to treat motion sicknes and mild nausea from chemo
Scopolamine
What is the main thing to remember with Scopolamine?
wash your hands after putting patch on!!!
What is the pharm class of Dopamine (Intopin)?
adrenergic
What is the pharm class of Norepinephrine (Levophed)?
adrenergic
What is the pharm class of Dobutamine (Dobutrex)?
adrenergic
What is the therapeutic class of Dopamine (Intropin)?
positive inotropic vasopressor
What is the therapeutic class of Norepinephrine (Levophed)?
positive inotropic vasopressor
What is the therapeutic class of Dobutamine (Dobutrex)?
positive inotropic vasopressor
What is the pharm class of Captopril (Capoten)?
ACE inhibitor
What is the therapeutic class of Captopril (Capoten)?
antihypertensive
What is the pharm class of Losartan (Cozaar)?
Angiotensin II Receptor Antagonist (ARB)
What is the therapeutic class of Losartan (Cozaar)?
antihypertensive
What is the pharm class of Valsartan (Diovan)?
angiotensin receptor antagonist (ARB)
What is the therapeutic class of Valsartan (Diovan)?
angiotensin receptor antagonist (ARB)
What is the pharm class of Prazosin (Minipress)?
alpha1 agonist (peripherally acting)
What is the therapeutic class of Prazosin (Minipress)?
antihypertensive
What is the pharm class of Clonidine (Catapres)?
alpha2 agonist (centrally acting)
What is the therapeutic class of Clonidine (Catapres)?
antihypertensive
What is the pharm class of Metoprolol (Lopressor)?
beta blocker (cardioselective)
What is the therapeutic class of Metoprolol (Lopressor)?
antihypertensive
antianginal
What is the pharm class of Amlodipine (Norvasc)?
calcium channel blocker
What is the therapeutic class of Amlodpidine (Norvasc)?
antihypertensive
antianginal
What is the pharm class of Nicardipine (Cardene)?
calcium channel blocker
What is the therapeutic class of Nicardipine (Cardene)?
antihypertensive
antianginal
What is the pharm class of Heparin?
antithrombotic
What is therapeutic class of Heparin?
anticoagulant
What is the pharm class of Enoxaparin (Lovenox)?
antithrombotic
low molecular weight heparin
What is the therapeutic class of Enoxaparin (Lovenox)?
anticoagulant
What is the pharm class of Bivalirudin (Angiomax)?
thrombin inhibitor
What is the therapeutic class of Bivalirudin (Angiomax)?
thrombolytic
What is the pharm class of Warfarin (Coumadin)?
coumarin
What is the therapeutic class of Warfarin (Coumadin)?
anticoagulant
What is the pharm class of Aspirin (ASA, Bufferin)?
salicylate
What is the therapeutic class of aspirin (ASA, Bufferin)?
antiplatelet
What is the pharm class of Clopidogrel (Plavix)?
platelet aggregation inhibitor
What is the therapeutic class of Clopidogrel (Plavix)?
antiplatelet
What is the pharm class of Alteplase (Activase)?
plasminogen activator
What is the therapeutic class of Alteplase (Activase)?
thrombolytic
What is the pharm class of Drotecogin alfa (Xigris)?
activated protein C
What is the therapeutic class of Drotecogin alfa (Xigris)?
anti-infective
thrombolytic
What is the pharm class of Atorvastatin (Lipitor)?
Hmg-CoA reducase inhibitor
What is the therapeutic class of Atorvstatin (Lipitor)?
lipid lowering agent
What is the pharm class of Fenofibrate (Tricor)?
fibric acid derivative
What is the therapeutic class of Fenofibrate (Tricor)?
lipid lowering agent
What is the pharm class of Niacin (Nia-bid)?
water soluble vitamin
What is the therapeutic class of Niacin (Nia-bid)?
lipid lowering agent
What is the pharm class of Ezetimibe (Zetia)?
cholesterol absorption inhibitor
What is the therapeutic class of Ezetiibe (Zetia)?
lipid-lowering agent
What are some general s/s of shock?
hypotension
tachycardia
cool, clammy skin
diaphoresis
pallor
oliguria
What are the CI for giving hypotension and shock related drugs?
unstable dysrhythmias
cardiogenic shock after MI
What are some adverse effects of drugs that treat hypotension and shock?
arrhythmias
hypertension
tissue necrosis with extravasation
palpitations
chest pain
What is the only drug indicated for cardiogenic shock?
Dobutamine (Dobutrex)
The more the fibers in the heart are stretched, the greater their force of contraction...but only to a point.
Starling's Law
What are the only drugs proven to improve post-MI survival?
ACE inhibitors

ex. Captopril (Capoten)
What drugs should diabetics take to protect their kidneys from damage?
ACE inhibitors

ex. Captopril (Capoten)
What are the main adverse effects of ACE inhibitors?
hyperkalemia
dry, nonproductive cough
angioedema
What is the advantage of taking ARBs instead of ACE inhibitors to control HTN?
ARBs are less likely to cause hyperkalemia or persistent cough.
When activated, alpha 1 & 2 receptors produce:

This means that alpha 1 & 2 blockers produce:
vasoconstriction

vasodilation
When activated, alpha 1 receptors produce:

This means that alpha 1 blockers produce:
increased contractility of the heart

decreased contractility of the heart
When activated, beta 1 receptors produce:

This means that beta 1 blockers produce:
increased contractility, heart rate, and conduction

decreased contractility, heart rate, and conduction
When activated, beta 2 receptors produce:

This means that beta 2 blockers produce:
vasodilation and bronchodilation

vasoconstriction and bronchoconstriction
When activated, alpha 1 & 2 receptors produce:

This means that alpha 1 & 2 blockers produce:
vasoconstriction

vasodilation
When activated, alpha 1 receptors produce:

This means that alpha 1 blockers produce:
increased contractility of the heart

decreased contractility of the heart
When activated, beta 1 receptors produce:

This means that beta 1 blockers produce:
increased contractility, heart rate, and conduction

decreased contractility, heart rate, and conduction
When activated, beta 2 receptors produce:

This means that beta 2 blockers produce:
vasodilation and bronchodilation

vasoconstriction and bronchoconstriction
What is the important AE to remember about Prazosin (Minipress)?
first dose phenomenon - should give first time at night
What is the most important AE to remember about Clonidine (Catapres)?
orthostatic hypotension

*also causes withdrawal phenomenon (rebound hypertension)
Is Clonidine (Catapres) on the Beer's list?
yes - because of the risk of orthostatic hypotension
What are the CI of taking Metoprolol (Lopressor)?
bradycardia
heart block
asthma
What are the other indications for taking calcium channel blockers besides hypertension?
angina
dysrhythmias
What are some causes of venous thrombosis?
impaired outflow of venous blood
decreased activity
thrombophlebitis
venous stasis
What is the main AE of anticoagulant drugs?
bleeding
What are the important lab tests that go along with anticoagulant drugs?
PT/INR
aPTT
LFT - liver function test
Platelets
What are the CI of taking anticoagulants?
active bleeding, except for DIC
bleeding disorders
blood dyscrasias
ulcers
liver and kidney disease
spinal cord/brain injuries
What is important to remember about IV Heparin?
it acts immediately and must be given on IV infusion pump
What aPTT is expected when taking heparin?
1.5 to 2.5 what is normal
What is the antidote for Heparin?
Protamine sulfate
What is the anticoagulant drug of choice for pregnancy and breast feeding?
Heparin
What route is Enoxaparin (Lovenox) given?
sub-Q
What is the most commonly used oral anticoagulant?
Warfarin (Coumadin)
How long does it take for Warfarin (Coumadin) to start working?
3-5 days
What is the important lab value that you must monitor with Warfarin (Coumadin)?
PT/INR - should be between 2 and 3
What is the antidote for Warfarin (Coumadin)?
Vitamin K
Which drug has a high potential for food and drug interactions?
Warfarin (Coumadin)
What is the reversal agent for Alteplase (Activase)?
Aminocaproic acid (Amicar)
What is the indicataion for Drotecogin alfa (Xigris)?
reduce mortality in adult patients with sepsis
Which thrombolytic drug has a short half-life (25 min)?
Bivalirudin (Angiomax)
What are some medications that raise LDL and lower HDL?
beta blockers
oral estrogens
glucocorticoids
thiazide diuretics
drugs for HIV
Which lipid-lowering drug should be given at night?
Atrovastatin (Lipitor)

...because cholesterol is made at night by the body
Which lipid-lowering drug is proven to reduce the risk of CAD and death from CVD?
Atrovastatin (Lipitor)
What are the adverse effects of Atrovastatin (Lipitor)?
rhabdomyolysis
myopathy
hepatotoxicity
What is the most widely used and most effective lipid lowering drug?
Atrovastatin (Lipitor)
What is the most effective drug for reducing triglycerides and increasing HDL?
Fenofibrate (Tricor)
Don't mix ___________ with Atrovastatin (Lipitor) because it will cause severe myopathy.
Fenofibrate (Tricor)
With what lipid lowering drugs should you give other drugs at least 1 hour before or 4 hours after?
Cholestryramine (Questran)
What lipid lowering drug may be combined with statin to further reduce LDL?
Cholestryramine (Questran)
What are the main adverse effects of Cholestryramine (Questran)?
GI discomfort
constipation
gallstones
What is the most effective drug for increasing HDL?
Niacin (Nicotinic Acid)
What lipid lowering drug requires high doses to be given?
Niacin (Nicotinic acid)
What are the AE of Niacin (Nicotinic acid)?
skin flushing
pruritus
gastric irritation
____________ can be given 1/2 hour before giving Niacin (Nicotinic acid) to decrease ____________.
ASA (aspirin)
flushing
What lipid lowering drug blocks absorption of cholesterol from the gut?
Ezetimibe (Zetia)