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78 Cards in this Set
- Front
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drugs that weaken the bacterial cell wall |
penicillins, cephalosporins, carbapenems, monobactams, vancomycin, fosfomycin |
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beta lactams |
penicillins, cephalosporins, carbapenems, monobactams |
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cephalosporins |
cefazolin, cefotetan, ceftriaxone, cefepime (1st-4th gen) as generations progress, more effective against GN bacteria, more resistance to beta-lactamase, increased ability to reach CSF |
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monobactams |
aztreonam (Azactam) narrow range, used against GN bacteria--E. coli, P. aeruginosa, salmonella |
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main tx for MRSA |
Bactrim if uncomplicated, vancomycin if complicated |
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bacteriostatic inhibitors of protein synthesis |
tetracyclines, macrolides, clindamycin, linezolid (Zyvox), telethromycin (Ketek), chloramphenicol (Chloromycetin), tigecycline (Tygacil), retapamulin (Altabax), mupirocin (Bactroban) |
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drugs that cause C diff |
tetracyclines, clindamycin |
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drugs that treat C diff |
vancomycin, metronidazole |
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other drugs that treat MRSA |
linezolid (Zyvox), tigecycline (Tygacil), daptomycin (Cubicin) |
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tetracyclines |
doxycycline (Vibramycin) broad spectrum, do not give to pregnant women or children under 8 (permanent staining of teeth), do not give with calcium or aluminum |
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macrolides |
erythromycin, azithromycin (Zithromax), clarithromycin (Biaxin) broad spectrum, safe alternative for PCN allergy, erythromycin causes GI issues, azithromycin does not QT prolongation, elevated levels with theophylline, carbamazepine, warfarin |
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drug of choice for typhoid fever |
chloramphenicol (Chloromycetin) may cause fatal aplastic anemia (1 in 35,000), reserved for severe infections where other anti-infectives do not work |
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drugs used topically for impetigo |
retapamulin (Altabax), mupirocin (Bactroban) |
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bactericidal inhibitors of protein synthesis |
aminoglycosides (gentamycin, amikacin, tobramycin) |
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aminoglycosides |
gentamycin, amikacin, tobramycin ototoxic (likely irreversible), nephrotoxic, rarely neuromuscular blockade (flaccid paralysis, resp. depression) do not mix with PCN or other ototoxic drugs |
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drugs that disrupt the synthesis of folic acid |
sulfonamides (sulfamethoxazole, sulfamethoxazole/trimethoprim [Bactrim]) can cause crystalluria--PUSH FLUIDS hypersensitivity, blood dyscrasias, kernicterus, stevens-johnson MRSA and UTI |
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fluoroquinolones |
ciprofloxacin (Cipro), levofloxacin (Levaquin) cipro often used for UTI, can rarely cause tendon rupture |
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TCAs |
amitriptyline used for depression, bipolar disorder block neuronal reuptake of norepinephrine and serotonin can cause severe dysrhythmias, avoid in suicidal patients |
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SSRI's |
Prozac, Zoloft, Lexapro, Celexa selectively inhibits serotonin reuptake used for depression, bipolar disorder, panic, OCD, PMDD, bulimia SE's: sexual dysfunction, nausea, HA, weight gain, suicide risk |
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serotonin/norepinephrine reuptake inhibitors |
Pristiq, Effexor, Cymbalta used for major depression SE's: nausea, HA, dry mouth, sweating, constipation, ED, decreased libido |
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MAOI's |
selegiline (Eldapryl) and emsam (TD) used for atypical depression, OCD and bulimia not first choice--many side effects, drug interactions, and eating foods with tyramine causes hypertensive crisis |
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monoamine oxidase |
converts norepinephrine, serotonin, and dopamine into inactive products inactivates tryamine in foods MAOI's block this enzyme |
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atypical antidepressants |
bupropion (Welbutrin) similar structure to amphetamine used for depression, prevention of SAD, counteracts sexual dysfunction in pts taking SSRI'S, hypoactive sexual desire disorder SE's: seizures, agitation, HA, dry mouth, insomnia, weight loss, GI upset, dizziness, tremor, tachycardia |
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foods containing tyramine |
chianti, cheese, overripe bananas, avocados, aged meat, dried fish, imported beers |
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first generation antipsychotics |
Thorazine and Haldol major SE's are extrapyramidal symptoms, acute dystonia, parkinsonism, tardive dyskinesia, akathisia; also anticholinergic effects, sexual dysfunction, photosensitivity, agranulocytosis, severe dysrhythmias may also cause neuroleptic malignant syndrome (rare but potentially fatal) |
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acute dystonia |
muscle spasms in face, neck, and back can be treated with benadryl |
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parkinsonism |
bradykinesia (slow movements), mask-like face, drooling, tremor, rigidity, shuffling gait can be treated with anticholinergics |
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akathisia |
pacing, squirming, need to be in continuous motion treat with anticholinergics, beta blockers, and benzodiazepines |
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tardive dyskinesia |
twisting, writhing, worm-like movements of the tongue, lip smacking no good treatment and may be irreversible caused by 1st gen antipsychotics as well as Phenergan and Reglan |
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neuroleptic malignant syndrome |
lead pipe rigidity caused by excessive muscle contraction, leading to elevated temp and BP; rare but associated with 1st gen antipsychotics treated with muscle relaxers such as dantralene |
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second generation antipsychotics |
Zyprexa and Geodon less likely to cause extrapyramidal symptoms and tardive dyskinesia Zyprexa causes weight gain though, which can lead to hyperlipidemia, diabetes, etc. Geodon has low risk of EPS and prolongs QT interval but also low risk of weight gain, dyslipidemia, diabetes |
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therapeutic plasma level of lithium |
0.4-1.0 is ideal must keep less than 1.5s |
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signs of lithium toxicity |
GI upset, thirst, muscle weakness, hand tremors |
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non-stimulant ADHD medications |
atomoxetine (Strattera) selective inhibitor of NE reuptake (others stimulate release of NE) may cause suicidal thinking in children |
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target blood sugar for diabetics |
70-130 before meals 100-140 at bedtime |
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target A1C for diabetics |
less than 7% average blood glucose level over last 2-3 months |
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short duration: rapid acting insulins |
lispro, aspart, glulisine onset: 10-30 minutes peak: 1-2/3 hours duration: 3-5/6 hours |
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short duration: slower acting insulin |
regular insulin onset: 30-60 minutes peak: 1-5 hours duration: 6-10 hours |
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intermediate duration insulins |
NPH (neutral protamine hagedorn) and insulin detemir onset: 60-120 minutes peak: 6-14 hours duration: 16-24 hours |
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long duration insulin |
insulin glargine onset: 70 minutes peak: none duration: 24 hours |
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metformin |
inhibits glucose production and absorption, sensitizes insulin receptors on fat and skeletal muscle, enhances glucose metabolism and uptake by skeletal muscle pts need to avoid alcohol (increases risk of lactic acidosis) |
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sulfonylureas |
glipizide (Glucatrol) stimulates insulin secretion by the pancreas causes fetal harm, disulfiram-like reaction with alcohol, also interacts with NSAID's and sulfonamide antibiotics |
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Thiazolidinediones (Glitazones) |
Avandia (discontinued) and pioglitazone (Actos) reduce glucose levels by decreasing insulin resistance can cause fluid retention, hepatotoxicity, and cardiovascular events (CHF) |
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Meglitinides |
Repaglinide (Prandin) stimulates pancreatic insulin release administer 30 min before each meal Lopid inhibits Prandin |
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alpha-glucosidase inhibitors |
acarbose (Precose) delays absorption of carbs, lowers post-prandial blood glucose levels can cause GI symptoms, hypoglycemia, liver dysfunction |
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Gliptins |
sitagliptin (Januvia) stimulates glucose-dependent release of insulin from pancreas suppresses post-prandial release of glucagon from liver can cause upper resp infections, HA, rarely pancreatitis |
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normal BUN range |
10-20 mg/dL |
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normal creatinine range |
females: 0.5-1.0 males: 0.6-1.2 lower in children, slightly higher in elderly |
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normal AST range |
0-35 units/L higher in children and elderly |
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normal ALT range |
4-36 units/L higher in infants, elderly, men, and African Americans |
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therapeutic digoxin level |
0.5-2.0 ng/mL |
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adjuvant analgesics |
NSAIDs, antihistamines (vistaril), TCA's, antiseizure drugs, local anesthetics, muscle relaxants, corticosteroids mainly NSAIDs and Tylenol |
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local anesthetics |
lidocaine, novocaine, cocaine suppress pain by blocking sodium channels, which blocks impulse conduction along axons (only in neurons close to admin site) use w/ vasoconstrictors (epi) to prolong effect |
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cholinergic receptors |
mediate responses to acetylcholine nicotinic m, nicotinic n, and muscarinic |
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nicotinic m receptors |
cholinergic affect skeletal muscle--involved at NMJ of skeletal muscle most drugs that affect these receptors will block skeletal muscle contraction (succinylcholine) |
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nicotinic n receptors |
cholinergic few drugs affect these receptors in PNS |
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muscarinic receptors |
cholinergic when stimulated, mimic parasympathetic response increased secretions, contraction of smooth muscle in bronchi and GI tract, slowing of HR, miosis, contraction of ciliary muscle in eye, dilation of blood vessels, voiding of urinary bladder |
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adrenergic receptors |
mediate responses to epinephrine and norepinephrine mimic sympathetic response alpha 1, alpha 2, beta 1, beta 2 |
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alpha 1 receptors |
adrenergic midriasis, vasoconstriction, ejaculation, contraction of bladder and prostatic capsule |
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alpha 2 receptors |
adrenergic few drugs affect alpha 2 receptors in PNS |
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beta 1 receptors |
adrenergic located in heart and kidney increase HR, force of contraction, and velocity of conduction through AV node in kidney, promotes release of renin (increase BP) |
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beta 2 receptors |
adrenergic bronchial dilation; vasodilation in heart, lung, and skeletal muscle; relaxation of uterine smooth muscle; promotes glycogenolysis in liver and skeletal muscle |
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dopamine in PNS |
causes dilation of kidney vasculature administer if patient is in shock to increase perfusion to kidneys and prevent renal failure |
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neuromuscular blocking agents |
block nicotinic m receptors Pavulon and Norcuron are non-depolarizing succinylcholine is depolarizing, constant depol = no repol; can cause malignant hyperthermia |
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epinephrine |
adrenergic agonist, all 4 receptors |
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norepinephrine |
adrenergic agonist, alpha 1, alpha 2, beta 1 treats hypotensive states and cardiac arrest; does not promote hyperglycemia (no beta 2) |
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isoproterenol (Isuprel) |
adrenergic agonist; beta 1 and beta 2; overcomes AV heart block, cardiac arrest, increases CO during shock, treats bronchospasm during anesthesia (NOT asthma) |
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catecholamines |
epi, NE, isoproterenol, dopamine, dobutamine (all adrenergic agonists except terbutaline) cannot be used orally or cross BBB, brief duration of action, require continuous IV infusion |
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dopamine (IV) |
adrenergic agonist, beta 1 (alpha 1 at high doses); treats shock, heart failure, acute renal failure |
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dobutamine (Dobutrex) |
adrenergic agonist, beta 1; treats heart failure |
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terbutaline |
adrenergic agonist, beta 2; treats asthma and preterm labor; non-catecholamine |
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prazosin (Minipress) |
adrenergic antagonist; blocks alpha 1 treats HTN and BPH (blocks contraction of bladder muscles and prostatic capsule) |
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propranolol (Inderal) |
adrenergic antagonist; blocks beta 1 and beta 2; reduces HR, decreases force of ventricular contraction, suppresses impulse conduction through AV node = lower CO; treats HTN, angina, dysrhythmias, and MI |
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metoprolol (Lopressor) |
adrenergic antagonist; blocks beta 1 preferred beta blocker for pts with asthma or diabetes (does not affect beta 2 receptors); treats HTN, heart failure, angina, MI; do not abruptly D/C |
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atropine |
muscarinic antagonist; increases HR |
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oxybutynin (Ditropan) |
anticholinergic, muscarinic antagonist; treats overactive bladder |
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clonidine (Catapress) |
adrenergic agonist, alpha 2 decreases BP and pain |
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bethanecol (Urecholine) |
prototype muscarinic agonist treats urinary retention |
