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313 Cards in this Set

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Class 1 Controlled Substances
High Potential for abuse. No accepted medical use. Heroin, Marijuana
Class 2 Controlled Substances
"High Potential for abuse. Accepted medical use. No refills on prescription and cant be transmitted over phone/fax, Oxycodone, Morphine
None
Class 3 Controlled Substances
"Less Potential for abuse than class 2. Moderate or low potential for dependance. Fiver refull maximum. May not refill after six months from date written.
Acetamenophine/codeine
None
Class 4 Controlled Substances
"Limted potential for dependance. Five refill maximum. May not refill 6 months after written.
Lorazepam, Propoxyphene
None
Class 5 Controlled Substances
"Same as Class 4 but less potential for abuse. Five refill max and no refill 6 months after written.
Diphenoxylate/atropine
None
Chloroptic (Chloramphenicol 1%)
ointment- anti-infective for eyes
bleph-10 (Sodium Sulfacetamide 10% soln)
anti-infective for eyes but not very effective anymore.
"Neosporin opth. soln. or oint.
Polysporin opth. oint.
Trimethoprim, polymixin B sulfate (polytrim)
Tobramycin 0.3% (Tobradex)
Trifluridine 1% soln. (viroptic)
Azythromycin (Azamist)
Eye Anti-infectives
Trimethoprim, polymixin B (Polytrim)
sulfate- eye anti-infective
None
Tobramycin 0.3% (Tobrex)
eye anti-infective
None
Trifluridine 1% soln.(Viroptic)
eye anti-infective
None
Azythromycin (Azamist)
eye anti-infective
None
Pregnancy Category A
Safe to use while pregnant.
Pregnancy Category B
Safe to use while pregnant but there are some studies showing it is not.
Pregnancy Category C
May or may not be safe to use while pregnant.
Pregnancy Category X
Do not use while pregnant.
Quinolones
Eye anti-infectives
Drug names end in floxacin
Pregnancy Category C
None
Ciprofloxacin 0.3% soln. or ointment (Ciloxan)
Quinolone
eye anti-infective
None
Levofloxacin 0.5% soln (Quixin)
Quinolone
eye anti-infective
None
Moxifloxacin 0.5% soln (Vigamox)
Quinolone
eye anti-infective
None
Gatifloxacin 0-3% soln (Zymar)
Quinolone
eye anti-infective
None
Pemirolast Potassium 0.1% soln (Alamast)
eye mast cell stabilizer
None
Nedocromil Sodium 2% (Alocril)
eye mast cell stabilizer
None
Cromolyn Sodium 4% (Crolom)
eye mast cell stabilizer
Most commonly used mast cell stabilizer
None
Contraindication of Steroids
Infection
Loteprednol etabonate 0.2% (Alrex)
Eye Steroid
Loteprdnol etabonate 0.5% (Lotemax)
Eye Steroid
Sulfacetamide Sodium 10% + Prednisone acetate 0.2% (Blephamide)
Eye Antibiotic with Steriod
Cortisporin opth. susp. or oint.
Eye Antibiotic + Steroid
Dexacine
Eye Antibiotic + Steriod
Flourmetholone 0.1% (FML)
Eye Steroid
Flourmetholone + sulfactetamide (FML-S)
Eye Steroid + Antibiotic
Prednisolone Sodium Phosphate
Eye Steroid
Prednisolone acetate 0.12%
(Pred Mild)
Eye Steroid
Prednisolone acetate 1%
(Pred Forte)
Eye Steroid
Prednisolone 0.3% + dexamethasone 0-1%
(Tobradex)
Eye Steroid
Remiexolone 1%
(Vexol)
Eye Steroid
Emaedastine 0.05%
(Emadine)
Eye Antihistamine
Levocabastine HCL 0.05%
(Livostin)
Eye Antihistamine
Naphazoline HCL 0.025% + phreniramine maleate 0.3%
(Naphcon A)
Eye Antihistamine + Vasoconstrictor
Ketotifen 0.025%
(Zaditor)
Eye Antihistamine + Mast Cell Stabilizer
Azelastine HCL 0.05%
(Optivar)
Eye Antihistamine + Mast Cell Stabilizer
Olopatadine HCL 0.1%
(Patanol)
Eye Antihistamine + Mast Cell Stabilizer
Cyclosporine 0.05%
(Restasis)
Increases Tear Production for Dry Eyes
Contraindications for Beta Adrenergic Blocking Agents
First Degree Heart Block, cardiogenic shock, or overt cardiac failure
Betaxolol HCL
(Betoptic)
Eye Anti-glaucoma Med.
Cardio Selective Beta Blocker
Timolol Maleate
(Timoptic)
Eye Anti-glaucoma Med.
Non-selective Beta Blocker
Contraindications of Timolol Maleate (Timoptic)
Asthmatics, COPD, Bradycardia, 2nd or 3rd Degree Heart Block, Cardiac Failure, Shock
Dorzolamide HCL
(Truspot)
Carbonic anydrase inhibitor
Watch Sulfa Allergy
Use of Cholinesterase Inhibitors
Treatment of Open Angle Glaucoma
Floropryl
Cholinesterase Inhibitor
Treatment of Open Angle Glaucoma
Rapid Decrease in IOP
Demecarium Bromide
(Humorsol)
Cholinesterase Inhibitor
Treatment of Open Angle Glaucoma
Rapid Decrease in IOP
Acetazolamide Tablets (125mg, 250mg, 500mg)
(Diamox)
Eye Cholinesterase Inhibitor
Ofloxacin 0.3%
(Floxin Otic)
Ear Antibiotic
Ciprofloxacin + Hydrocortisone
(Cipro HC)
For Otitis Media
Contraindicated in perforated TM
Ciprofloxacin + Dexamethasone
(Ciprodex)
Ear Antibiotic and Steroid
Neomycin + Hydrortisone acetate + Thonzonium bromide
(Cortisporin TC otic)
Indications; Susceptible Infections, Mastoidectomy, Fenestration Cavities
Polymyxin B + Neomycin sulfate + Hydrocortisone
(Pediotic)
Ear Anti-infective
Infections, Mastoidectomy, Fenestration Cavities
Aralgon
Pain Relief in Ear Infections
Cerumen Removal
Hydrogen Peroxide
Cerumenex
Debrox
Azelastine
(Astelin)
Nasal Antihistamine
Beclomethasone Diproprionate
(Deconase AQ)
Nasal Steroid
Triamcinolone Acetonide
(Nasocort AQ)
Nasal Steroid
Fluticasone Proprionate
(Flonase)
Nasal Steroid
Flunisolide
(Nasarel)
Nasal Steroid
Mometasone Furoate
(Nasonex)
Nasal Steroid
Budesonide
(Rhinocort AQ)
Nasal Steroid
Cromolyn Sodium
(Nasalcrom)
Nasal Mast Cell Stabilizer
Clotrimazole 10mg
(Mycelex Troche)
Throat/Mouth Antifungal
Mycostatin (Nystatin) susp., pastilles, tablets
Throat/Mouth Antifungal
Itraxonazole 10mg
(Sporonax oral susp.)
Throat/Mouth Antifungal
Fluconazole 10mg/ml or 40mg/ml
(Diflucan susp.)
Throat/Mouth Antifungal
Abreva
Throat/Mouth Antiviral (Anti-herpetic)
Denavir
Throat/Mouth Antiviral (Anti-herpetic)
Zovirax
Throat/Mouth Antiviral (Anti-herpetic)
Potency of Topical Corticosteroids
Group 1= Very High Potency
Group 2= High Potency
Group 3= Med. Potency
Group 4= Low Potency
Aclometasone 0.05%
(Aclovate)
Low Potency
Topical Corticosteroid
Desonide 0.05%
(Desowen)
Low Potency
Topical Corticosteroid
Hydrocortisone Acetate 0.5%-2.5%
(Hytone, Cortaid, Cortizone)
Topical Low Potency Corticosteriod
Betamethasone Valerate
(Valisone)
Medium Potency
Topical Corticosteroid
Triamcinolone Acetonide 0.025-2.5%
(Kenalog, Aristocort)
Medium Potency
Topical Corticosteroid
Hydrocortisone Valerate 0.2%
(Westcort)
Medium Potency
Topical Corticosteroid
Amcinonide 0.1%
(Cyclocort)
High Potency
Topical Corticosteroid
Betamethasone Diproprinate 0.05%
(Diprosone)
High Potency
Topical Corticosteroid
Fluocinonide 0.05%
(Lidex)
High Potency
Topical Corticosteroid
Fluocinolone 0.2%
(Synatar)
High Potency
Topical Corticosteroid
Clobetasol Propionate 0.05%
(Temovate)
Very High Potency
Topical Corticosteroid
Halbetasol 0.05%
(Ultravate)
Very High Potency
Topical Corticosteroid
Mupriocin 2%
(Bactroban)
Topical Antibiotic
Treats impetigo caused by staph aureus, beta hemolytic strep, strep pyogenes
Preg. Category B
Bacitracin
Topical Antibiotic
Gram +
Erythromycin
Topical Antibiotic
Gram + and acne vulgaris
Neomycin sulfate
Gentomycin
Topical Antibiotic
Gram -
Watch Renal Function
Polymyxin B Sulfate
Topical Antibiotic
Anaerobic Gram -
Gram +
Docosanol
(Abreva)
Topical Antiviral
Peniciclovir
(Denavir)
Topical Antiviral
For Cold Sores
Acyclovir
(Zovirax)
Topical Antiviral
For Genital Herpes
Nystatin
Antifungal
Only one Safe for Infants
Clotrimazole
(Lotrimin, Mycelex)
Topical Imidazole
For Tinea Pedis, Cruris, Corporis, and Versicolor
Preg. Cat. B
Ketoconazole
(Nizoral)
Topical Imidazole
For Tinea Pedis, Cruris, Corporis, and Versicolor
Candida and Sebhorrheic dermatitis
Preg. Cat. C
Miconazole
(Monistat, Lotrimin)
Topical Imidazole
For Tinea Pedis, Corporis, and Versicolor
Naftifine
(Naftin)
Topical Triazole
For Tinea Pedis, Cruris, Corporis
Terbinafine
(Lamisil)
For Tinea Pedis, Cruris, Corporis
Mycostatin
(Nystatin)
For Candidiasis
Crotamiton
(Eurax)
Topical Scabies Treatment
Lindane
(Kwell)
For Scabies, Head and Pubic Lice
Very Toxic
Malathion
(Ovide)
Topical for head, body, and pubic lice
Permethrin
(Nix, Elimite)
Topical Scabies and Pediculosis Treatment
Benzoyl Peroxide
Topical Treament for Mild to Moderate Acne
Pregnancy Category C
Tretinoin
(Retin A cream or gel)
Acne Treatment
Use cream for dry skin and gel for oily skin
Pregnancy Category C
Isotretinoin
(Accutane)
For Severe Cystic Acne
Pregnancy Category X
Calcipotriene
(Dovenox)
For chronic moderately severe psoriasis of scalp
Pregnancy Category C
Tazarotene
(Tazorac)
For Plaque Psoriasis
Pregnancy Category X
Pimecrolimus
(Elidel)
Most common Antipsoriatic
For short or intermittent long term treatment of moderate atopic dermatitis
Not to be used on active viral infections.
aa
Abbreviation
of each
ac
Abbreviation
before meals
ad
Abbreviation
to or up to
ad lib
Abbreviation
as desired
aq
Abbreviation
water
au
ad
al or as
Abbreviation
each ear
right ear
left ear
c
Abbreviation
with
cap
Abbreviation
capsule
collyr
Abbreviation
Eye Wash
dil
Abbreviation
Dissolve, Dilute
elix
Abbreviation
elixer
ext
Abbreviation
Extract
hs
Abbreviation
at bedtime
IA
Abbreviation
Intra-arterial
LR
Abbreviation
Lactated Ringers
mEq
Abbreviation
milliequivalent
no
Abbreviation
Number
non rep
Abbreviation
Do Not Repeat
OD
OL, OS
OU
Abbreviation
Right Eye
Left Eye
Both Eyes
PC
Abbreviation
After Meals
QS
Abbreviation
A sufficient quantity
Rx
Abbreviation
Take
Sig
Abbreviation
Label
ss
Abbreviation
One-half
tiw
Abbreviation
Three times a week
tinc
Abbreviation
Tincture
UNG
Abbreviation
Ointment
ut dict
Abbreviation
As Directed
1 fl oz.=__ml
29.6(30)ml=__fl. oz
1 pint=___ml
473(480)ml=___pint
1kilogram=___lbs.
2.2lbs=___kg
1lb=___g
454g=___lbs.
1 tsp.=___ml
5ml=___tsp.
1tbsp.=___ml
15ml=____tbsp.
1 cup=____ml
240ml(8oz)=___cup
Function of Bile Salt Sequestrants
Decrease Cholestrol Absorption
Cholestyramine (Questran)
Bile Salt Sequestrant
For Hyperlipidemia
Colestipol (Colestid)
Bile Salt Sequestrant
For Hyperlipidemia
Colesevelum (Welchol)
Bile Salt Sequestrant
For Hyperlipidemia
Funtion of HMG-CoA Reductase Inhibitors (Statins)
Inhibit HMG-CoA reductase
Limits Cholestrol Synthesis
Pregnancy Category of Statins
X
Simvastatin (Zocor)
Pravastatin (Pravachol)
Lovastatin (Mevacor)
Atorvastatin (Lipitor)
Fluvastatin (Lescol, Lescol XL)
Rosuvastatin (Crestor)-now considered the best
Statin
For Hyperlipidemia
Function of Fibric Acid Derivatives
Decrease total cholestrol, LDL, and Triglycerides
Increases HDL
Gemfibozil (Lopid)
Fibric Acid Derivative
Preg. Cat. B
Take 30 min before breakfast and dinner
Denofibrate (Tricor)
Fibric Acid Derivative
Preg. Cat. C
Take with food
Function of Nicotinic Acids and MOA
Decreases total cholestrol, LDL, and VLDL.
Increases HDL
MOA: Inhibits VLDL Synthesis
Preg. Cat. A
Niacin
Nicotinic Acid
Ezetimibe (Zetia)
Lower Cholestrol
MOA: Selectively inhibits intestinal absorption of cholestrol.
Vytorin
Combination drug of Zetia (Ezetimibe) and Zocor (Simvastatin).
MOA of ACE Inhibitors
Suppresses RAAS which prevents Angiontensin I from converting to Angiotensin II.
Suffix of ACE Inhibitors
-pril
Captopril(Capoten)
Enalapril(Vasotec)
Benzapril(Lotensin)
Fosinopril(Monopril)
Quinapril(Accupril)
Ramipril(Altace)
Meoxipril(Univasc)
Trandolapril(Mavik)
ACE Inhibitors for
HTN
CHF
Diabetic Nephropathy
MOA of ARBs
Blocks the effects of Angiotensin II by blocking the binding of Angiotensin II to its receptors
Suffix of ARBs
-saratan
Losartan(Cozaar)
Valsartan(Diovan)
Irbesartan(Avapro)
Candesartan(Atacand)
ARBs for HTN
MOA of Calcium Channel Blockers
Inhibits the flow of extracellular Ca ions across cell membrane of cardiac cells and vascular tissue which decreases the heart rate.
Classes of Calcium Channel Blockers
Dihydropyridines
Phenylalkylamines
Benzothiazepine
Diarylaminopropylamine
-pine suffix
Dihydropyridine CCB
Nifedipine (Adalatt, Adalatt CC, Procardia, Procardia XL)
Dihydropyridine CCB
Amiodpine (Norvasc)
Dihydropyridine CCB
Felodipine (Plendil)
Dihydropyridine CCB
Isradipine (Dynacirc)
Dihydropyridine CCB
Nicardipine (Cardene, Cardene SR)
Dihydropyridine CCB
Nisodipine (Sular)
Dihydropyridine CCB
Verapamil (Calan, Calan SR, Covera-HS, Isoptin)
Phenylalkylamine CCB
Diltiazem (Cardizem CD, Cardizem SR, Cardizem, Dilacor XR, Tiazic)
Benzothiazepine CCB
Bepridil (Vascor)
Diarykaminopropylamine CCB
Usual CCB Drug of Choice and Why
Preg. Cat. of CCBs
Dihyrdopyridines are doc because they do not interfere with cardiac function

Preg. Cat. C
Three Classes of Diuretics
Loop
Thiazide
Potassium Sparing
MOA of loop diuretics
Inhibits water resorption in ascending loop of henle
Furosemide (Lasix)
Loop Diuretic
Bumetanide (Bumex)
Loop Diuretic
Preg. Cat. D
MOA of Thiazide Diuretics
Inhibits NA resportion in distal tubule causing secretion of water, Na, Potassium, and Hydrogen
Preg. Cat. B
Hyrdochlorthiazide (Hyrdrodiuril)
Thiazide Diuretic
Chlorthalidone (Hyrgroton)
Thiazide Diuretic
MOA and purpose of Amiloride
Potassium sparing diuretic
Blocks Na channels in the luminal membrane of the distal convoluted tubule

Used in combination with thiazide to counteract hypokalemia and hypomagnesia
Sprionolactone and MOA
Potassium Sparing Diuretic
Competes with aldosterone for receptor sites in the distal renal tubules, increasing NaCl and water excretion while sparing K
Propranolol (Inderal, Ipran)
Non-selective Beta Blocker
Hepatically Cleared
Nadolol (Corgard)
Non-selective Beta Blocker
Renally Cleared
Metoprolol tartate (Lopressor)
Beta 1 Selective Agonist Beta Blocker
Shorter Release
Metoprolol succinate (Toprol XL)
Beta 1 Selective Agonist Beta Blocker
Extended Release
Atenolol (Tenormin)
Beta 1 Selective Agonist Beta Blocker
Labetolol (Normodyne)
Alpha 1 Beta 1 and 2 Selective Antagonist
Carvedilol (Coreg)
Alpha 1 Beta 1 and 2 Selective Antagonist
Antiarrhytmic Drugs
¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯
CLASS I
direct membrane action
(na channel blockade)
Antiarrhytmic Drugs
¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯
CLASS II
Beta Blockers
Antiarrhytmic Drugs
¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯
CLASS III
Potassium Blockers
Antiarrhytmic Drugs
¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯
CLASS IV
Calcium channel blockers
Antiarrhytmic Drugs
¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯
Class la

ANS: (5 items)
- Conduction velocity - decreased
- refractory period - prolonged
- automaticity - decreased
- ion blockade - sodium
- ECG effects - prolong QRS & QT
Antiarrhytmic Drugs
¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯
Class la Drugs

ANS: (3 items)
quinidine, procainamide, disopriamide
Quinidine (Quinaglute, Quinidex, Cardioquin)

Adverse Effects

ANS: (5 items)
Antiarrhytmic Drugs:
¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯
Class la

- GI: N/V/D
- Tinnitis, HA, blurred vision, vertigo, confusion
- Cardiovascular: proarrhythmia
- hypersensitivity:drug fever, rash, hives, dermatitis, anaphylaxis
- Hematological: hemolytic anemia, throbotytopenic purpura
Quinidine (Quinaglute, Quinidex, Cardioquin)

Interactions
Antiarrhytmic Drugs:
¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯

Class la

- increase digoxin levels
- Warfarin: increased PT/INR
- Phenytoin & phenobarbital: decrease level of quinidine
Quinidine (Quinaglute, Quinidex, Cardioquin)

Precautions
Antiarrhytmic Drugs:
¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯
Class la

- reduce dose in liver or renal impairment
Procainamide (Procan, Procan-SR, Procanbid, Pronestyl)

Uses
Antiarrhytmic Drugs:
¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯
Class la

A. flutter, A.fib, VT, VF
Quinidine (Quinaglute, Quinidex, Cardioquin)

USE
Antiarrhytmic Drugs: ¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯
Class la

atrial flutter, atrial fibrillation, SVT, VT, VF
Antiarrhytmic Drugs:
¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯
Procainamide (Procan, Procan-SR, Procanbid, Pronestyl)

Adverse effects
Class la

- GI: N/V/D
- Rash, fever, arthragias, pleuritic pain
- Cardiovascular: decreased cardiac output
- Hemtological: agranulocytosis
Antiarrhytmic Drugs:
¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯
Procainamide (Procan, Procan-SR, Procanbid, Pronestyl)

Precautions
Class la

NAPA renally eliminated
Antiarrhytmic Drugs:
¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯
Disopyramide (Norpace, Norpace-CR)

Use
Class la

ventricular arrhythmias
Antiarrhytmic Drugs:
¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯
Disopyramide (Norpace, Norpace-CR)

Adverse Effects
Class la

- Anticholinergic: dry mouth, constipation, blurred vision, urinary retention
- Cardiovascular depressant
Antiarrhytmic Drugs:
¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯
Disopyramide (Norpace, Norpace-CR)

Precautions: Contraindicated in:
Class la

- Sick sinus syndrome
- Glaucoma
- Hypotension
- Urinary retention
Antiarrhytmic Drugs: ¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯
Class lb

ANS: (5 items)
- Conduction velocity: neutral or decreased
- Refractory period: shortened
- Automaticity: decreased
- Ion Blockade: sodium (fast)
- ECG effect: shorten QT slightly
lidocaine, mexilentine, tocainide
Antiarrhytmic Drugs:
¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯
Class lb drugs
Lidocaine (Xylocaine)

use
Antiarrhytmic Drugs:
¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯
Class lb

ventricular arrhythmia
Antiarrhytmic Drugs:
¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯
Lidocaine (Xylocaine)

Adverse Effects
Class lb

dizziness, drowsiness, parathesias, euphoria, dysphoria, confusion, psychosis, seizures
Antiarrhytmic Drugs:
¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯
Lidocaine (Xylocaine)

Drug interactions
Class lb

- propranolol decreases lidocaine clearence
- cimetidine may decrease clearance thus increase levels of lidocaine
Antiarrhytmic Drugs:
¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯
Lidocaine (Xylocaine)

Precautions
Class lb

- 70% eliminated via hepatic first pass metabolism
- active metabolites: monoethylglycinexylidide (MEGX) and glycinexylidide (GX) can accumulate and may cause CNS toxicity
Mexiletine (Mexitil)

USE
Antiarrhytmic Drugs:
¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯
Class lb

oral analog of lidocaine for ventricular arrhythmia prevention
Antiarrhytmic Drugs:
¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯
Mexiletine (Mexitil)

Adverse Effects
Class lb

-dizziness, drowsiness, parathesias, dysphoria, euphoria, confusion, psycosis, seizures
- GI distress, N/V (take with food)
Antiarrhytmic Drugs:
¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯
Mexiletine (Mexitil)

Drug Interactions
Class lb

- Antacids delay absorption
- Motility agents increase absorption
- Inducers decrease half-life (phenobarbital, phenytoin, rifamipin)
Antiarrhytmic Drugs
¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯
Class lc
- conduction velocity: markedly decreased
- refractory period - no effect
- automaticity - decreased
- ion blockade - sodium (slow)
- ECG effect- prolonged PR & QRS/QT
Antiarrhytmic Drugs: Class lc
¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯
drugs
flecainide, propafenone (also class II effects), moricizine
Antiarrhytmic Drugs:
¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯
Propafenone (Rhythmol)

Use
Class lc

prevention of ventricular arrhythmias
Antiarrhytmic Drugs:
¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯
Propafenone (Rhythmol)

ADVERSE EFFECTS
Class lc

- Proarrhythmia
- dizziness, HA
- N/V/C, abnormal taste
Antiarrhytmic Drugs:
¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯
Propafenone (Rhythmol)

DRUG INTERACTIONS
Class lc

- digoxin levels increased
- Warfarin: PT/INR prolonged
Antiarrhytmic Drugs:
¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯
Propafenone (Rhythmol)

Contraindications
Class lc

CHF
Antiarrhytmic Drugs
¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯
Class II
- Conduction velocity: decreased
- Refractory period: prolonged
- Automaticity: decreased
- Ion blockade: calcium (indirect)
- ECG effect: prolong PR
propranolol, atenolol, metoprolol
Antiarrhytmic Drugs: Class II
¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯

drugs
Antiarrhytmic Drugs
¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯
Class III
Conduction velocity: no effect
Refractory period: markedly prolong
Automaticity: no effect
Ion blockade: potassium
ECG effect: prolong QT
amiodarone (also blocks Ca, Na, and beta receptors), bretylium (also blocks beta receptors), sotalol (also blocks beta receptors)
Antiarrhytmic Drugs: Class III
¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯
drugs
Antiarrhytmic Drugs:
¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯
Amiodarone (Cordarone, Pacerone)

USE
Class III

life-threatening ventricular arrhythmias (prevents and treatment)
Antiarrhytmic Drugs:
¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯
Amiodarone (Cordarone, Pacerone)

Adverse effects
Class III

- amiodarone pneumonitis, hepatic enzume elevations
- pro-arrhythmias
- malaise, fatigue, tremor, ataxia, dizziness, parethesia
- abnormal sense of smell, sleep disorders, HA, decreased libido
- peripheral neutopathy, myopathy(rare), N/V/C, anorexia
- corneal microdepositis (after 6 months of therapy)
* dry eyes, halo visions, blurred vision
- photosensitivity
- blue gray skin
- worsening heart failure, hypotension, Bradycardia
- Coagulation abnormailities, eccymosis, thrombocytopenia
Antiarrhytmic Drugs:
¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯
Amiodarone (Cordarone, Pacerone)

Drug Interactions
Class III

- increase in digoxin levels
- increase in flecainide levels
- increase in procainamide levels
- increase in quinidine levels
- prolonged PT/INR with warfarin
- increase in phenytoin concentrations
- fatal interactions with general anesthetics agents
- addictive bradycardia effects with Beta blockers and Calcium Channel Blockers
Antiarrhytmic Drugs:
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Bretylium (Bretylol)

Use
Class III

acute treatment of life-threatening ventricular arrhythmias
Antiarrhytmic Drugs:
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Bretylium (Bretylol)

Adverse Effects
Class III

- hypotension
- vertigo, light-headedness, synscope
- N/V
Antiarrhytmic Drugs:
¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯
Bretylium (Bretylol)

Drug Interactions
Class III

additive effects with other arrhythmics
Antiarrhytmic Drugs:
¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯
Bretylium (Bretylol)

Precautions
Class III

reduce dose in renal impairment
Antiarrhytmic Drugs:
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Sotalol (Betapace)

Use
Class III

chronic management of life-threatening ventricular arrhythmias
Antiarrhytmic Drugs:
¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯
Sotalol (Betapace)

Contraindications:
Class III

2nd and 3rd degree heart block
Antiarrhytmic Drugs:
¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯
Sotalol (Betapace)

Adverse Effects
Class III

- torsades de pointes, may worsen CHF. N/V
- chest pain/palpitation, sinus brady cardia, fatigue, dizziness
- dyspnea, extremity pain, rash
- bleeding, visual disorders, fever
Antiarrhytmic Drugs:
¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯
Sotalol (Betapace)

Precautions
Class III

- Possess non-selective Beta blockers effects
- reduce dose in renal impairment
Antiarrhytmic Drugs
¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯
Class IV
- Conduction velocity: decreased
- refractory period: prolonged
- Automaticity: decreased
- Ion Blockade: calcium
- ECG effect: prolong PR
Antiarrhytmic Drugs
¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯
Class IV

MOA
inhibits Ca ion form entering "slow channels" or select voltage sensitive areas of vascular smooth muscle and myocardium during depolarization, producing a relaxation of coronary vascular smooth muscle and coronary vasodilation
Antiarrhytmic Drugs
¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯
Class IV

DRUGS
Verapamil, Diltiazem
Antiarrhytmic Drugs:
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Verapamil (Calan, Calan SR, Covera-HS, Isoptim-SR)

Use
Class IV

acture use for supraventricular tachycardias (PSVT), A.fib, A. flutter; also HTN and Angina
Antiarrhytmic Drugs:
¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯
Verapamil (Calan, Calan SR, Covera-HS, Isoptim-SR)

Contraindications
Class IV

- Hypotension
- Bradycardia
- Severe heart failure
Antiarrhytmic Drugs:
¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯
Verapamil (Calan, Calan SR, Covera-HS, Isoptim-SR)

Adverse Effects
Class IV

- bradycardia
- 1st, 2nd, 3rd degree AV block
- CHF, hypotension
- peripheral edema, lightheadedness, dizziness, N/C
Antiarrhytmic Drugs:
¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯
Verapamil (Calan, Calan SR, Covera-HS, Isoptim-SR)

Drug interactions
Class IV

- decreased effects with phenobarbital, phenytoin, rifampin
- increased toxicity with amiodarone (cardiotoxicity), aspirin (bruising)
- increased levels of carbamazepine, cyclosporine, igoxin, theophylline
Antiarrhytmic Drugs:
¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯
Diliazem (Cardizem, Cardizem SR, Cardizem CD, Dilacor XR, Tiazac)

USE
Class IV

IV for A. fib, A. flutter, paroxysmal, ventricular tachucardia
Antiarrhytmic Drugs:
¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯
Diliazem (Cardizem, Cardizem SR, Cardizem CD, Dilacor XR, Tiazac)

Adverse Effects
Class IV

- Bradycardia, A-V block, peripheral edema, hypotension
- HA, dizziness, nausea
Antiarrhytmic Drugs:
¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯
Diliazem (Cardizem, Cardizem SR, Cardizem CD, Dilacor XR, Tiazac)

Drug Interactions
Class IV

- increased toxicity with amiodarone, cyclosporine, Beta blockers, carbamzepine
Antiarrhytmic Drugs:
¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯
Diliazem (Cardizem, Cardizem SR, Cardizem CD, Dilacor XR, Tiazac)

Precautions
Class IV

use caution in pt with decreased renal or hepatic function
Digoxin
Miscellaneous Antiarrhythmic
Inhibits Na-K-ATPase pump and has positive inotropic effect on myocardium
Used in A-fib
Antidote to Digoxin
Digibind
Class 1 Heart Failure
Asymptomatic
No limitation of physical activity
Class 2 Heart Failure
Slight limitation of physical activity occurs with moderate to maximum exertion
Class 3 Heart Failure
Marked Limitation of physical activity
Dyspnea with minimal exertion
Class 4 Heart Failure
Unable to carry on any physical activity without worsening symptoms
Nitroprusside (Nitropress)
Vasodilator for CHF
Reduces Peripheral Resistance by increasing CO by decreasing afterload
Important ADR with Nitropress
May get build up of metabolites(cyanide and thiocyanate)
Nitroglycerin (Nitrostat, Minitran, Nitro-dur)
Vasodilator for CHF
Used in acute left ventricular dysfunction from unstable coronary insufficiency
Minoxidil
Vasodilator for severe HTN
Direct vasodilation of arterioles with decreased vascular resistance
Hydralazine (Apresoline)
Vasodilator for CHF and moderate to severe HTN
Isosorbide Dinitrate (Dilatrate)
Vasodilator for CHF
Major nitrate for CHF and proven effective with hydralazine
Heparin MOA
Inhibits fibrin formation
Requires Anti-thrombin 3
Contraindications of Heparin
Any situation in which a patient is likely to bleed
Enoxaparin (Lovenox)
LMWH for Coagulation Disorders
Prevents DVTs
Treats DVTs with or without PE
Dalteparin (Fragmin)
LMWH
Used in prevention of DVT
Used in prevention of ischemic complications with acute coronary syndromes
Ardeparin (Normiflo)
LMWH
Prevention of DVT following knee replacement surgery
Warfarin (Coumadin)
Oral Anticoagulant
used in treatment of thromboembolic disorders
Prevention of recurrent TIA/Stroke
Aspirin
Antiplatelet drug
Used prophylactically to prevent MI and TIA/Stroke
Inhibits cyclooxygenase
Dose of ASA in pt. with low risk for embolism
160-325mg/day
Dose of ASA in pt. with unstable angina
160-325mgDi/day
Dose of ASA in pt. 50 or older with at least one risk factor for CAD
80-325mg/day
Dipyridamole (Perstantine)
Antiplatlet Drug
Inhibits activity of adenosine deaminase
Cilostazol (Pletal)
Antiplatlet Drug
Inhibits activity of adenosine deaminase
Ticlopidine (Ticlid)
Antiplatlet Drug
Inhibits platlet aggregation by inhibiting the ADP pathway of platlets
Helps to Reduce atherosclerotic events (MI Stroke)
Clopidogrel (Plavix)
Antiplatlet Drug
Inhibits platlet aggregation by inhibiting the ADP pathway of platlets
Helps to Reduce atherosclerotic events (MI Stroke)
Abiciximab
Anitplatlet Drug
Binds to platlet glycoprotein IIb/IIIa receptors to prevention adhesion of platelets to fibrinogen
Eptifibatide
Antiplatlet Drug
Binds to glycoprotein IIb/IIIa and inhibits platlet interraction with von Wildebrands factor
Urokinase (Abbokinase)
Fibrinolytic
Converts Plasminogen to plasmin
Used for catheter clearance and DVT treatment
Sreptokinasae (Kabikanse)
Fibrinolytic
Converts tissue proactivator to activator which converts plasminogen to plasmin
Used to treat DVT, PE, post MI
Penicillins MOA
Interfere with bacterial cell wall synthesis
Pregnancy Cat. B
Natural Penicillins work best against
Greatest Activity against gram pos organisms, gram neg. cocci, and non beta lactamase producing anaerobes
Natural Penicillins are susceptible to..
Hydrolysis by beta lactamase
Penicillin VK (Pen Vee K, V-cillin K, Veetids)
Penicillin G (Bicillin, Permapen, Pfizerpen, Wycillin, Crysticillin
Natural Penicillins
Aminopenicillins work against
Relatively Broad gram + and gram - coverage
What are aminopenicillins combined with to treat beta lactamase
Clavulanic Acid or Sulbactam
Antistaphylococcal (Beta-lactamase resistant)work primarily against
Beta Lactamase producing staph infections
Amoxicillin (Trimox, Amoxil)
Ampicillin (marcillin, Principen)
Aminopenicillin
Nafcillin (Nafcil, Nallpen)
Dicloxacillin (Dycill, Dynapen)
Methicillin (Staphcillin)
Antistaphylococcal Penicillins
Antipseudomonal Penicillins works best against
Psuedomonas Aeruginosa and other gram - bacteria
Piperaillin (Pipracil)
Ticarcillin (Ticar)
Mezocillin (Mezlin)
Carbenicillin (Geocillin)
Bacterial Cell Wall Inhibitor
Antipseudomonal Penicillin
Cephalosporin
Bacterial Cell Wall Inhibitor
Same MOA as PCN
More stable against beta lactamase
Uses of First Generation Cephalosporin
UTI
Minor Staph Lesions
Cellulitis
Soft Tissue Abscess
Cephalexin (Keflex)
Cefadroxil (Duricef)
Bacterial Cell Wall Inhibitor
First Generation Cephalosporin
Uses of Second Generation Cephalosporin
Otitis Media
Acute Bronchitis or Pneumonia in COPD
Pharyngitis
Sinusitis
Lyme
More Gram neg. Coverage than 1st Generation
Cefaclor (Ceclor)
Cefuroxime (Ceftin)
Cefprozil (Cefzil)
Loracarbef (Lorabid)
Bacterial Cell Wall Inhibitor
Second Generation Cephalosporin
Uses of Third Generation Cephalosporin
Otitis Media
Acute Bronchitis or Pneumonia in COPD
Pharyngitis
Sinusitis
Lyme
Increased activity against pseudomonas aeruginosa
Cefdinir (Omnicef)
Cefixime (Suprax)
Cefpodoxime (Vantin)
Ceftriaxone (Rocephen)
Cefditoren (Spectrocef)
Bacterial Cell Wall Inhibitor
Third Generation Cephalosporin
Difference between third and fourth generation cephalosporine
Penetrates Cerebral Spinal Fluid
Cefepime (Maxipime)
Bacterial Cell Wall Inhibitor
Fourth Generation Cephalosporin
Uses of Monobactams
UTI
Lower Respiratory Tract Infections
Aztreonam (Azactam)
Bacterial Cell Wall Inhibitor
Monobactam
Imipenem + Cilastatin (Primaxin)
Bacterial Cell Wall Inhibitor
Carbapenems
Wide spectrum of activity against gram +, gram -, and anaerobes
Can cause seizures
Meropenem (Meronem, Merrem)
Bacterial Cell Wall Inhibitor
Carbapenems
Works better against gram - than Imipenem
Clavulanic Acid
Sulbactam Tazobactum
Bacterial Cell Wall Inhibitor
beta lactamase inhibitor
usually combined with a penicillin
Vancomycin (Vancocin)
Bacterial Cell Wall Inhibitor
Block glycopeptide polymerization
Active vs. gram +
Use of Vancomycin
MRSA
Bacitracin (AK-Tracin)
Blocks dephosphorylation of lipid carrier within the growing cell wall
Highly nephrotoxic when given systemically
Use of Bacitracin
Topcial for bacterial flora on skin surface