Reading...
Play button
Play button
Use LEFT and RIGHT arrow keys to navigate between flashcards;
Use UP and DOWN arrow keys to flip the card;
H to show hint;
A reads text to speech;
135 Cards in this Set
- Front
- Back
|
Cox inhibitors work to
|
decrease pain, suppress inflammation, decrease fever, protect against mi and stroke
|
|
|
Which COX inhibitors work to protect against mi and stroke? arthritis?
|
ASA only one that woks to protect. Arthritis only non asa nsaids
|
|
|
Adv effect of cox inhibitors
|
renal problems gastric ulcers
|
|
|
COX 1 work in which tissues? Cox2?
|
all tissues- housekeeper
cox2 at injury site |
|
|
which drugs have anti-inflammatory properties? without antiimflammatory properties
|
with-nsaids, asa, motrin, naproxin, celebrex
without- tylenol |
|
|
1st generation nsaids inhibit___________ second generation inhibit _______
|
cox1 and 2
Cox 2 (less adv more risk mi/stroke) |
|
|
1st generation nsaids are used to tx ____________ they can cause ______________
|
inflammatory do (alleviate mild-mod pain, antipyretic, relieve dysmennorhea)
cause ulcers (cox1 is protective for stomach) |
|
|
Aspirin is the drug of choice for ______________
|
RA
|
|
|
Adverse effect of aspirin
|
GI/renal problems (to reverse renal stop drug) Reye syndrom in children, hypersensitivity (swelling tongue and throat)
|
|
|
Celebrex is a __________ NSAID it is used to ___________
|
2nd generation NSAID, tx osteoarthritis, RA, ankylosing spondylitis, acute pain and dysmennorrhea it decreases inflammation and pain
|
|
|
Aspirin suppresses ____________-
|
platelet aggregation so prevent mi and stroke
|
|
|
Celebrex does not suppress plt aggregation so increased risk of
|
mi stroke
|
|
|
adv effects of celebrex
|
dyspepsia, abd pain, heartburn, belching, renal toxicity
|
|
|
Celebrex should not be given to
|
renal or heart pts or if sulfa allergy
|
|
|
Aspirin should not be taken with ____________
|
anticoagulants
|
|
|
Acetaminophen has no __________ and ___________ actions
|
antiinflammatory and antirheumatic
|
|
|
OD of acetaminophen causes
|
liver damage- increased risk in etoh
|
|
|
early s/s acetaminophen toxicity
|
n/v/d/sweating abd discomfort
|
|
|
Late s/s acetaminophen toxicity
|
hepatic necrosis
|
|
|
When giving acetylcysteine for best results it should be given within ___________hours, you should dilute it with __________-
|
8-10 hours, dilute with 50mg/ml h20,juice, soda
IT tastes and smells horrible |
|
|
Using COx for chronic pain you should first try _____ then _______ then ___________ then last resort is
|
non drug, tylenol or asa, non selective nsaid (motrin, naproxen), cox2
|
|
|
S/s of renal impairment with aspirin and tx
|
decreased UO, conc urine, increased bun creat, wt gain.
STOP DRUG can be reversed |
|
|
RA is an __________ ________ response with s/s
|
autoimmune, inflammatory response that causes joint pain, fever, wt loss, thinning of skin
|
|
|
There are 3 classes of antiarthritic drugs
|
NSAIDS(start with) DMARDS (can give with NSAIDS) GLUCOCORTICOIDS(while waiting for dmard to take effect)
|
|
|
DMARDS take ____ to work
|
weeks to months
|
|
|
This class is the 1st choice for RA
|
NSAID- start w/ 1st generation, one nsaid may work different for each person
|
|
|
Oral Glucocorticoids are used for ______________ symptoms in RA if 1-2 joints are affected _____ may be given
|
generalized symptoms,
intraarticular injection |
|
|
Long term tx with glucocorticoids are limited to pts that
|
don't respond to all other options
|
|
|
Name a glucocorticoid
|
prednisone or prednisolone
|
|
|
DMARDS can be __________ or _____________
|
non biologic (sm molecule, synthetic) biologic
|
|
|
Methotrexate is a ____________
|
non biologic dmard
|
|
|
Methotrexate works in ____ you must watch for these adverse effects
|
3-6 weeks,
Liver, bone marrow suppression, pneuminitis, gi ulcers |
|
|
The Biologic DMARDS are _______________ antagonists
|
tumor necrosis factor
|
|
|
Etanercept is the 1st TNF antagonist used it is used for _________RA, it workers ______________that methotrexate
|
mod-severe RA,
better than methotrexate and faster |
|
|
Big SE's of etanercept is
|
injection site reaction (itching, red, swollen) and Serious Infection
|
|
|
Etanercept should not be used in
|
liver or heart pts
|
|
|
Remicade is a _________ that is given widely to ________
|
biologic DMARD,
decrease symptoms and delay progression of RA (often given with methotrexate) |
|
|
Adv effect of Remicade include, it shouldnt be given to
|
HA, infection, infusion reaction,
LIVER/HEART pTS |
|
|
B-lymphocyte depleting drug that is used for RA ________-
|
Rituximab
|
|
|
Rituximab is used with ___________ in pts that havent responded to
|
methotrexate, 1 or more TNF antagonists
|
|
|
Serious ADV effect of rituximab include
|
INFUSION REACTION- happens withi 30-120 min dec bp, broncospasm, angioedema, hypoxia, pulm infiltrates, mi, cardiogenic shock. TO PREVENT PREMEDICATE WITH ANTIHYSTAMINE AND TYLENOL also causes hep b reactivation, flu like symptoms
|
|
|
Minocycline is a ____________ used for watch for this adv reaction _____
|
tetracycline antibiotic, used to improve morning stiffness, pain, tenderness in RA, takes 12weeks to 12 mos to see effect watch for RASH
|
|
|
Hydroychloroquine is a ___________ drug given with methotrexate that can _____________ takes ____________ for result and can cause this toxicity _____
|
antimalarial, can improve long term outcome, 3-6mos for result, toxicic retinal damage *get eye exam b4 starting
|
|
|
What is the 1st choice tx for gout? second?
|
NSAID, GLUCOCORTECOIDS (not in hyperglycemia)
|
|
|
Colchicine is an _________ with what adv effect, use caution in which pts
|
antiinflamatory, GI symptoms, if given IV very dangerous, caution in elderly, heart, renal, gi pts
|
|
|
Allopurinal decreases ______________ and is used for
|
production of uric acid, chronic tophaceous gout and gout 2nd to chemo
|
|
|
adv effect of allopurinal is
|
hypersensitivity (rash, temp, eosinophilia, rf, lf) D/c immediatly mild se gi/neuro metallic taste
|
|
|
Probenecid ____________of uric acid adv effects include _______
|
increases excretion, adv gi/hypersensitivity/kidney
|
|
|
Sulfinpyrazone ______________ of uric acid and is contraindicated in
|
inhibits reabsorption of uric acid, SULFA ALLERGY
|
|
|
Defensive factors of PUD
|
mucous, bicarb, blood flow and prostaglandins
|
|
|
Aggressive factors of PUD
|
h. pylori (most common) NSAIDS, gastric acid, pepsin, smoking
|
|
|
Antibiotics are used as an antiulcer drug for this cause of PUD
|
h pylori
|
|
|
amoxicillian major se
|
diarrhea
|
|
|
clarythromycin major s/e's
|
distortion of taste, n/d
|
|
|
bismuth is a _____ drug used to ___________ h pylori its se include
|
topical - lyse h pylori, harmless black tongue and stool, with long term neurologic injury
|
|
|
Tetracycline s/e
|
staining of teeth, not for pregnant or kids
|
|
|
Flagyl s/e and teaching
|
HA, avoid alcohol and pregnancy
|
|
|
Tindamax teaching should include avoiding
|
alcohol
|
|
|
h2 receptor antagonists are the 1st choice for _________
|
gastric duodenal ulcer
|
|
|
An h2 receptor antagonist that decreases volume of gastric juices and hydrogen ion concentration is
|
Cimetidine (tagament)
|
|
|
Tagament can cross ____ drug of choice for ___ and preventative for ______ it should be taken
|
BBB, Gerd, prevent aspiration pneumitis (60-90 min b4 anesthesia) take with meals
|
|
|
s/e tagament include
|
gynecomastia, decreased libido, impotence, hallucinations, confusion
|
|
|
For a duodenal ulcer tagament takes ______ wks for a gastric ulcer ______wks
|
4-6, 8-12
|
|
|
With tagament the dose should be decreased in ______ patients
|
renal
|
|
|
Ranitidine (zantac_ is __________ than cimetidine with less
|
more potent less se
|
|
|
Pepcid should be taken
|
1hr b4 meals with h20
|
|
|
Nizatidine (Axid) should be taken ____ its risk for
|
bedtime or 30min b4 meals if heartburn, risk for pneumonia and increased platelet
|
|
|
Zollinger ellison syndrome is a
|
hypersecretion of gastric acid and development of peptic ulcer
|
|
|
This drugs suppress secretion of gastric acid
|
Proton Pump inhibitors
|
|
|
Proton Pump Inhibitors are preferred for pud r/t ____
|
nsaid use
|
|
|
PPI include
|
Omeprazole (prilosec) all other ZOLE
|
|
|
Prilosec is used for
|
short term therapy of duodenal, gastric ulcers, erosive esophagitis and GERD and for long term therapy of hypersecretory conditions liek zollinger ellison syndrome
|
|
|
Adverse effects of prilosec include
|
ha/d/n/v long term therapy gastric cancer or hip fracture
|
|
|
Antacids are used for
|
PUD and GERD
|
|
|
adv effects of antacids include
|
constipation, diarrhea, sodium loading,
|
|
|
Pepcid should be taken
|
1hr b4 meals with h20
|
|
|
Pepcid should be taken
|
1hr b4 meals with h20
|
|
|
Nizatidine (Axid) should be taken ____ its risk for
|
bedtime or 30min b4 meals if heartburn, risk for pneumonia and increased platelet
|
|
|
Zollinger ellison syndrome is a
|
hypersecretion of gastric acid and development of peptic ulcer
|
|
|
Nizatidine (Axid) should be taken ____ its risk for
|
bedtime or 30min b4 meals if heartburn, risk for pneumonia and increased platelet
|
|
|
This drugs suppress secretion of gastric acid
|
Proton Pump inhibitors
|
|
|
Zollinger ellison syndrome is a
|
hypersecretion of gastric acid and development of peptic ulcer
|
|
|
Proton Pump Inhibitors are preferred for pud r/t ____
|
nsaid use
|
|
|
This drugs suppress secretion of gastric acid
|
Proton Pump inhibitors
|
|
|
Proton Pump Inhibitors are preferred for pud r/t ____
|
nsaid use
|
|
|
PPI include
|
Omeprazole (prilosec) all other ZOLE
|
|
|
PPI include
|
Omeprazole (prilosec) all other ZOLE
|
|
|
Prilosec is used for
|
short term therapy of duodenal, gastric ulcers, erosive esophagitis and GERD and for long term therapy of hypersecretory conditions liek zollinger ellison syndrome
|
|
|
Prilosec is used for
|
short term therapy of duodenal, gastric ulcers, erosive esophagitis and GERD and for long term therapy of hypersecretory conditions liek zollinger ellison syndrome
|
|
|
Adverse effects of prilosec include
|
ha/d/n/v long term therapy gastric cancer or hip fracture
|
|
|
Adverse effects of prilosec include
|
ha/d/n/v long term therapy gastric cancer or hip fracture
|
|
|
Antacids are used for
|
PUD and GERD
|
|
|
Antacids are used for
|
PUD and GERD
|
|
|
adv effects of antacids include
|
constipation, diarrhea, sodium loading,
|
|
|
adv effects of antacids include
|
constipation, diarrhea, sodium loading,
|
|
|
Sucralfate promotes ulcer healing by
|
creating a protective barrier against acid and pepsin
|
|
|
Sucralfate adverse
|
constipation
|
|
|
Serotonin antagonists are a subclass of ________ drugs they are most effective to stop
|
antiemetic- stop n/c from anticancer drugs, radiations and anesthesia
|
|
|
Common ending of serotonin antagonists are
|
TRON
|
|
|
To suppress CINV(chemo induced n/v) a ________ of drugs is most effective
|
combination
|
|
|
___________ are the most effective antidiarrheal agens
|
opiods
|
|
|
travelers diarrhea can be treated with
|
loperaminde, a fluroquinolone abx like cipro or azithromycin (for pregnant women and kids)
|
|
|
________ IS the most common disorder of gi tract
|
IBS
|
|
|
Alosetron can cause
|
ischemic colitis and constipation it is used for IBS-D in women
|
|
|
Ulcerative colitis and Crohns disease are treated with
|
5aminosalicylates (sulfasalazine), glucocorticoids (dexamethasone) immunosuppressants and abx
|
|
|
Palifermin is the first drug approved to decrease
|
oral mucositis
|
|
|
Adv effect of palifermin are
|
rash, erythema, edema, pruritis, distortion of taste
|
|
|
Metoclopramide(reglan) is a ________ agent used to
|
prokinetic agent, used to suppress post op n/v and emesis with chemo, radiation, and opiods
|
|
|
Reglan adv effects include
|
with long ter/high dose- tarditve dyskinesia - do not use in obstruction , hemorrhage or perf of gi tract
|
|
|
Scopalamine is used for_______ it is a _________
|
motion sickness, muscarinic antagonist
|
|
|
Name 2 glucocorticoids used to suppress CINV
|
decadron, solumedrol
|
|
|
2 drug classes for asthma
|
anti inflammatory or bronchodilator
|
|
|
what is the anti inflammatory drug class used for asthma and how often is it given
|
glucocorticoids- fixed schedual
|
|
|
what is the bronchodilator given for asthma and how is it given
|
beta 2 agonist, fixed or prn
|
|
|
Cromolyn (Intal) is a _____ tx for asthma it has very few adv effects includeing
|
prophylactic drug that suppresses inflammation- cough and broncospasm
|
|
|
b2 agonists are the most effective for ______________
|
acute broncospasm and prevention of EIB
|
|
|
SE of albuterol
|
tachy, angina, tremor
|
|
|
oral b2 agonists are only for ______________ and should not be used alone
|
long term control-not 1st line
|
|
|
Leukotriene modifiers suppress effects of leukotrienes resulting in
|
decreased inflammation, dec bronchoconstriction, dec edema, dec mucous
|
|
|
Montelukast(singulair) is the ___________- you get a max effect within ____ hrs and it is taken every night
|
most common leukotriene modifier, 24 hrs, NOT PRN`
|
|
|
Singulair is used to
|
dec nocturnal awakening, increase morning lung fx, decrease need for b2 agonist
|
|
|
Formoterol is a _________ it should be added 2 regimen that inadequate conrrol with __________ it takes ________ for bronchodilation
|
long acting b2, glucocorticoid, 1-3 min
|
|
|
Glucocoricoids can be inhaled, iv or oral they will _______________ used for ________ they are given on a __________
|
suppress inflammation, prophylaxis of chronic asthma, fixed schedual
|
|
|
adv effect of inhaled glucocorticoids
|
adrenal suppression/boneloss/candidias/dysphoria
|
|
|
after using inhaled glucocorticoids pt should
|
gargle
|
|
|
to prevent bone loss with glucocorticoids pt should
|
use lowest dose possible, adequate calcium/vit d, weight bearing exercise
|
|
|
Do you need a spacer with flovent
|
no
|
|
|
inhaled glucocorticoids should not be used in children because they
|
suppress growth
|
|
|
resp distress assessment look at
|
rr, assesory muscle use, color, sat, lung sounds, loc
|
|
|
Theophilline has a narrow therapeutic index of
|
10-20mcg/ml
|
|
|
You see mild signs at 20-25mcg/ml theophylline including
|
n/v/d/restless/insomnia
|
|
|
If emergency theophylline is given
|
IV
|
|
|
At theophylline level greater than 30 you will see
|
v fib, convultions GIVE CHARCOAL
|
|
|
__________ causes metabolism of theophilline to increase
|
nicotine
|
|
|
Zyrtec side effects
|
phargitis, dry mouth, nose, throat drowsiness
|
