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48 Cards in this Set

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Sulfonylureas
MOA: Causes pancreas to release insulin

SE: Sulfa allergy, hypoglycemia, hepatotoxicity
Biguanides
MOA: Decrease hepatic glucose production, decrease glucose absorption, increase glucose uptake in the skeletal muscles

SE: GI disturbances, metallic taste in mouth, anorexia
Meglitinides
MOA: Increase insulin release from pancreas (related to sulfonylureas, shorter duration)

***If you skip a meal, skip a dose

SE: Hypoglycemia, hepatotoxicity, GI disturbances
Alpha-Glucosidase Inhibitors
MOA: Block action of alpha-glucasidase, delays ingestion of carbohydrates

***Take w/ first bite, skip a meal, skip a dose

***Can't step out of a low with normal table sugar

SE: Hypoglycemia, flatulence, hepatotoxicity
Thiazolidineodiones (TZD's)
MOA: Increase sensitivity in muscle and fat tissue to insulin, allow more glucose to enter the cells in the presence of insulin

***Do not use in patients with CHF

SE: N/V, weight gain, edema, decrease in HgB, Hct, and WBC and increase in lipids, hepatotoxicity
Exubera
First inhaled insulin
Drugs to treat Gonorrhea
ceftriaxone, ciprofloxacin, azithromycin
Drugs used to treat Chlamydia
azithromycin, doxycycline, erythromycin
Candida Albicans
Diflucan (flucoanzole)
Trichomoniasis
Flagyl (metronidazole)
Gardnerella
Metrogel
Estrogen
MOA: Inhibits ovulation by blocking release of FSH

SE: Nausea, HA, breast tenderness, weight gain, mood changes
Progestin
MOA: Inhibits ovulation by decreasing the relase of LH

SE: Irritability, depression, HA, acne, changes in weight and menstrual cycle
Combination pill
Monophasic (fixed ratio estrogen:progestin for 21 d), Biphasic (fixed ratio of estrogen:progestin days 1-10 then lower progestin 11-21), Triphasic (three separate raios of estrogen:progestin for each of the three weeks)
Minipill
Progestin only
Transdermal Contraceptives
Ortho-Evra
Benign Prostatic Hypertrophy
~ Check PSA levels
Symptoms ~ Problems with urination, retention, dysuria, nocturia
Treatment ~ Alpha-blockers, Antiandrogen drugs (inhibits 5-alpha reductase which blocks conversion of testosterone to DHT)
Erectile Dysfunction
Treatment ~ sildenafil (viagra), tadalafil (Cialis), vardenafil (Levitra)

***DO NOT USE WITH NITROGLYCERIN
Function of adrenal gland
Medulla produces adrenalin
Cortex produces other hormones
Hypothalamus-pituitary axis
Stress causes hypothalamus to release CRH. Pituitary releases ACTH. Adrenal gland releases cortisol, a stress hormone. Negative feedback loop stops hypothalamus from releasing CRH.
Mineralocorticoids
Impact sodium and potassium homeostasis, helps with fluid balance
Addison's disease
Aldosterone
Controls BP, restore electrolyte balance
Glucocorticoids
Metabolized to ACTIVE metabolites
Cortisol
Affects metabolism of CHO, fat, and PROT.
Increases gluconeogenesis
Mostly dosed as creams
Treats inflammatory states, leudemia, and shock
Long term use can cause osteoperosis
Adverse effects of glucocorticoids
Electrolyte imbalance (increase sodium, decrease potassium)
Fluid retention (increase BP)
Weight gain (moon face)
Infection
Behavior changes
Hyperglycemia (increase gluconeogenesis)
Peptic ulcer formation
Musculoskeletal (osteoporosis)
Visual disturbances
Dermatologic
Withdrawal symptoms
Suppression of normal adrenal function
Patient teaching for corticosteriods
Apply topicals systemically
Long-term use in kids could stunt growth
Take with food
Rinse mouth w/ inhaled steroids
Taper dose appropriately
Diagnosing an infection
Get a specimen
Culture and Sensitivity
MIC - Minimum Inhibitory Concentration
Gram Negative and Positive
Antibiotic Therapy
Only for bacterial infections
Keep levels of drugs above MIC

SE: N/V, diarrhea

Toxicity - Nephrotoxicity, Hepatotoxicity, Ototoxicity, Blood dyscrasias
Secondary infections - Thrush, Vaginitis, C. Diff, Pseudomembranous colitis (PMC)

Decrease effectiveness of oral contrapceptives
Aminoglycosides
MOA: Inhibit protein synthesis (treat Gram neg.)

Administered primarily IV, IM

SE: Ototoxicity, Nephrotoxicity, Neuromuscular blockade
Carbapenems
MOA: Inhibit bacterial cell wall synthesis (used for Gram pos. and neg.)

Administered IV or IM

SE: Severe diarrhea, seizures, confusion
Cephalosporins
MOA: Inhibit cell wall synthesis

1st gen - Gram pos > gram neg
2nd gen - Increased effectiveness against gram neg
3rd gen - gram neg > gram pos
4th gen - Equal effectiveness

SE: Diarrhea, thrush, thrombophlebitis, cross sensitivity to penicillins
Macrolides
MOA: Inhibit protein synthesis

Used for respiratory, GI, and STDs

SE: N/V, diarrhea, thrombophlebitis
Penicillins
MOA: Interferes with the synthesis of bacterial cell walls

Has a beta-lactam ring, some bacteria have an enzyme that can break this ring down and render penicillin ineffective

Used against mostly gram pos.

SE: Allergic reaction, diarrhea
Quinolones
MOA: Inhibit the action of DNA gyrase which blocks the replication of bacterial DNA

SE: N/V, diarrhea, phototoxicity
Streptogramins
MOA: Inhibit protein synthesis

Used for life-threatening Vancomycin-Resistant Entrococcus Faecium (VRE)

Administered IV

SE: Thrombophlebitis, Arthralgia, myalgia, hepatoxicity
Hypothyroidism
Bradycardia, increased weight, sluggishness, decreased appetite, cold intolerance, susceptible to infections

Mysedema (hypothryoidism that occurs during adult life)
Cretinism (Child born with hypothryoidism)
Hyperthyroidism
Tachycardia, decreased weight, increased appetite, insomnia, moist/warm/flushed skin, amenorrhea

Grave's disease, goiter, thyrotoxicosis
Thyroid replacements
MOA: Replace deficient T3 and T4

Levothyroxine, Liothyronine, Liotrix, Thyroid USP
Antithyroid medicines
MOA: Radioactive medicines destroy hormone-making abillities, some medicines block synthesis of T3 and T4

Iodine-131, propylthiouracil, methimazole
Tetracyclines
MOA: Inhibit protein synthesis of bacteria

SE: Allergies to "cycline", excreted in breast milk, stains teeth yellow, PHOTOSENSITIVITY
Antituburcular agents
MOA: Inhibits tuberculosis bacterial growth by altering RNA synthesis and phosphate metabolism

SE: N/V, anorexia, abdominal cramps, red-green color blindness,
Antifungals
MOA: Alters cell membranes of fungi

SE: Nephrotoxicity, eletrolyte imbalance, fever, chills, HA, N/V, thrombophlebitis
Antivirals
MOA: Inhibit viral cell replication

Used in HIV/AIDS treatments
Urine characteristics
Smokey/reddish/brown - blood
White/cloudy - infection
Dark yellow/amber - jaundice
Green, deep yellow/brown - biliary disease

Foul smell - infection
Sweet/fruity - starvation/diabetes

Foamy/frothy - protein

Glucose - major infection/diabetes

pH - <4.5 - metabolic acidosis
>8.0 - Bacteriuria

RBC > 3 - occult bleeding
WBC > 5 - infection

Specific grav - high=dehydration
low=fluid accumulation
Fosfomycin antibiotics
MOA: Inhibiting cell wall synthesis and reducing adherence of bacteria to urinary walls

SE: Perineal burning, dysuria
Quinolone antibiotics
MOA: Inhibit DNA gyrase enzymes needed for DNA replication

SE: N/V, visual disturbances, flatulence, photosensitivity
Bladder-active drugs
MOA: Causes contraction of the detrusor muscles, stimulate gastric motility, increase gastric tone, and restore impaired rhythmic peristalsis

SE: N/V, sweating, colicky pain, abdominal cramps, diarrhea, belching, involuntary defecation
Osmotic agents
MOA: Reduce intraocular pressure by elevating osmostic pressure of the plasma, causing fluid from the extravascular spaces to be drawn into the blood

SE: thirst, nausea, dehydration, electrolyte imbalance, HA, circulatory overload
Carbonic Anhydrase Inhibitors
MOA: Inhibits carbonic anhydrase which decreases the production of aqeous humor, thus lowering IOP

SE: Electrolyte imbalance, dehydration, dermatologic, hematologic, and neurologica reactions
Cholinergic agents
MOA: Contracts iris and ciliary body musculature to increase outflow of aqueous humor

SE: Conjunnctival irritation, systemic side effects, erythema, HA