Patho Test 2 Drugs

Front 1

Narcotic Analgesics General Info

Back 1

-Morphine=Prototype
-Schedule II
-Opiod Agonists
-Well absorbed, extensive first pass effect orally
-Exert effect through opiod receptors in CNS and by inhibiting substance P
-No ceiling effect

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Narcotic Analgesic AE's

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-Resp. Depression
-CNS Depression (drowsiness, sedation, pupil constriction)
**don't use in clients with head injury
-Constipation, Nausea, Vomiting
-Hypotension

Front 3

What is Narcan (naloxone)?

Back 3

Most common narcotic antagonist. Used to reverse effects of narcotics in case of overdosage, toxicity. (Resp. depression is key indicator)

Front 4

Pain: Narcotic Analgesics
Fentanyl

Back 4

-Uses: Anesthesia, post-op analgesic, chronic pain treatment
-High risk of resp. depression, do not exceed rec. dosage
-available in transdermal patch

Front 5

Pain: Narcotic Analgesics
Codeine

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-Use: analgesia and antitussive
-Schedule II alone (III in combo)
-Milder AEs than morphine (less pupil constriction)
-more effective when given orally than many other narcotics
-Synergistic effect when combined with acetaminophen

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Pain: Narcotic Analgesics
Vicoden

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-Combo Med: Hydrocondone and Acetaminophen
-Similar analgesic effects to Codeine
-Beware of taking other acetaminophine-> toxicity

Front 7

Pain: Narcotic Analgesics
Meperidine (Demerol)

Back 7

-Action and use similar to morphine
-BAD BAD AE's, use rarely recommended

Front 8

Non-Analgesic Pain Medications
Tricyclic Antidepressants (TCAs)

Back 8

work at PAG to increase seratonin in synapse and block pain transmission

Front 9

Non-Analgesic Pain Medications
Clonidine

Back 9

antihypertensive, blocks norepinephrine release at PAG

Front 10

Non-Analgesic Pain Medications
Capsaicin (herbal from chili peppers)

Back 10

depletes substance P from nerve endings and is helpful with neuropathic and chronic pain

Front 11

Non-Analgesic Pain Medications
Anticonvulsants

Back 11

suppress spontaneous neural firing, used to treat neuropathic pain

Front 12

Antibiotics-General Info

Back 12

-Can be broad or narrow spectrum, bacteriostatic or cidal. Used for treatment of or prevention from infectious disease.
-General AEs: SUPERINFECTION, nausea and vomiting, diarrhea, nephrotoxicity, neurotoxicity CNS, serum sickness

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Antibiotics: Penicillins General Info

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-Name clue ___cillin, abrev PCN
-Prototype Penicillin G
-Beta Lactam Ring
-Bacteriocidal, Broad Spectrum (gram + or -, anaerobic)
-Lots of resistant gram +
-Used for rsepiratory, GI, GU, Skin
-Drug Interactions: oral contraceptives, inc. effects with Probenecid
-Fatal Anaphlaxis may occus, observe 30 min, ask about allergy, give 1 hr before or 2 hr after meals

Front 14

Antibiotics:Types of Penicillins

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-G and V- PCN G is IM, V is Oral
-Penicillinase-resistant- methicillin: used mainly for staph except MRSA
-Extended Spectrum- carbenicillin: used for gram -
-Combination: augmentin: beta-lactamase inhibitor and a penicillin

Front 15

Antibiotics: Cephalosporins

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-Name clue Cef___ or Ceph____
-e.g. Cefazolin
-Bacteriocidal, Broad
-Beta Lactam Ring
-Gram + and -
-4 generations: from 1 to 4 become less effective against gram + and more effective against gram -
-used for: surgical prophylaxis, resp, skin, GU, bone and joint, bloodstream
-Nursing Imp: Cross Sensitivity with PCNs
-give PO meds with food or milk
-AEs- hypersensitivity (hives, rash)

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Antibiotics: Aminoglycosides

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-Name clue ___mycin
-Prototype: Gentamycin
-Bact.cidal, Broad
-Used IM or IV for serious systemic gram - infections and MDR infections and po to sterilize the GI tract
-is "big gun"
-Serious AEs: nephtoxicity, ototoxicity, neurotoxicity
-Must dose carefully to avoid toxic, peak and trough, encourage increased fluid intake

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Antibiotics: Fluroquinolones

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-name clue ___floxacin
-Prototype Ciprofloxacin
-Bact.cidal, Broad
-UTI, URI, Gonorrhea
-may be given po or IV
-encourage increased fluid intake, avoid sun exposure, contraindicated in kids
-can alter glucose distribution (careful in diabetic patients)
-1st line for pnemonia

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Antibiotics: Tetracyclines

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-Name clue ___cycline
-Bact. STATIC, broad
-mainly used for unusual diseases: cholera, typhus, stds and PID, acne prevention, anthrax
-can stain children's teeth
-give with food but not dairy, old medication decomposes and is toxic, avoid sun exposure

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Antibiotics: Sulfanomides

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-Name clue sulfa____
-1st synthetic antibiotic
-Bac. STATIC, broad
-Used mainly for UTIs, burns
-ask about sulfa allergy, empty stomach with water, inc. fluids

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Antibiotics: Macrolides

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-Name clue ___thromycin
-Prototype: Erythromycin
-Static/Cidal depending on dose
-broad
-use: resp, skin, legionnaire's, MAC, mycoplasma, staph, group A strep
-also one of the front lines for pnemonia
-may cause hepatotoxicity, give on empty stomach, many drug interactions
-Z PACK

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Antibiotics: Vancomycin

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-misc. antimicrobial agent
-bact. cidal only against gram +
-used only for serious gram + infections
-usually IV, give slowly to avoid "red man"
-nephro and oto toxic

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Antibiotics: Metronidazole (Flagyl)

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-Misc. agent
-use: prevention or treatment of bact. infections of the GI tract
-given with colon surgeries to treat C. Diff

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Hypercholesteremia Pharm: Bile acid-binding resin

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-E.G. Cholestyramine (Questran)
-Action: Lower LDL by combining with bile acids in the GI tract to form a compound excreted by the bowel
-drug of choice to treat familial if unable to lower with lifestyle mod
-mix powder with beverage
-AEs GI effects with prolonged use

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Hypercholesteremia Pharm: Statins

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-e.g. Lovastatin (Mavacor)
-decrease lipid levels by interfering with lipid synthesis in the liver
-used to reduce LDL and total blood cholesterol levels, slight rise in HDL
-AEs, altered liver function, myalgia, arthralgia, photosensitivity, rare but serious:liver toxicity, myopathy