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92 Cards in this Set
- Front
- Back
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What is used to treat myasthenia gravis (muscular disease) by reversing neuromuscular blockers by stimulating nicotinic receptors?
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Neostigmine
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Neostigmine is a
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muscarinic agonist
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About Muscarinic Agonists
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(SLUD the pig)- bradycardia, tearing/sweating, relaxation of smooth muscles, miosis, increased urination
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Which drugs are a Muscarinic Agonist used to treat Alzheimer's Dementia
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Donepezil and Rivastigmine
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About Muscarinic Antagonists
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Boy + Bear: dry mouth, blurred vision, constipation, tachycardia, CNS: confusion, agitation, delirium, hallucination, and memory loss
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Atropine, Scopolamine, Solifenacin, Tolterodine, Oxybutin, propantheline, the bromides, trihexylphenidyl, benzotropine are all
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Muscarinic Antagonist
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What is the antidote for SLUD overdose?
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Atropine
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This drug is used for cardiac arest in code blue situations, an antispasmodic/antidiarrheal. Good in eye surgeries to widen the pupils
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Atropine
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This drug helps lessen motion sickness and is similar to atropine
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Scopolamine
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These drugs are for urinary incontinence and overactive bladder
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Solifenacin, Tolterodine, oxybutin, and propantheline
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These drugs are bronchodilators
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Iprantropium bromide and tioptropium bromide
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These drugs are for parkinson's symptoms
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Trihyexylphenidyl and Benztropine
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List the Adrenergic Agonists
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Epinephrine, Norepinephrine, Isoproternol, Dobutamine, dopamine, Phenylphrine, and Albuterol
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Epinephrine is used for
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treating asthma, anaphlyactic shock, stops small bleeding, and cardiac arrest/code blue. Good for increasing bp and tachycardia
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Epinephrine how it works:
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vasoconstricts skin/mucous membrane, vasodilation of liver, heart, and skeletal muscles.
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Norepinephrine treats
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dramatic increased bp, severe septic shock
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Norepinephrine is different because
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it can only be a short term med since it will eventually cause a loss of blood flow to kidneys and extremities and can also cause reflex bradycardia
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About Isoproternol
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Decreases Bp, bronchodilator, and hyperglycemia and in diabetics, increases contraction. Treats: bradycardia and asthma
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Dobutamine
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increases contraction and cardiac output, treats acute heart failure
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Dopamine
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Will increase bp without hurting kidneys and increases kidney function. Drug of choice for: cardiovascular shock while also treating acute heart failure
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Phenylephrine
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reflex bradycardia, decongestant, and treats tachycardia
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Albuterol
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Asthma!
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This drug decreases bp, treats chronic hypertension, treats withdrawal symptoms of nicotine, opiates, benzo, and alcohol, avoid abrupt withdrawal, SE's: drowsiness, dry mouth, constipation, headache, impaired ejaculation
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Clonidine
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word ending for a-1 blockers
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azosin
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a-1 blocker MOA
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blocks a1 receptors
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a-1 blockers treat
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HTN, urinary retention, and Raynaud's disease
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a-1 blockers side effects
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orthostatic hypotension, first dose effect: fainting when rising, reflex tachycardia, dizziness, drowsiness, nasal congestion, headache, decreased libido. Rise slowly and take at bedtime
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Selective and Nonselective b-blockers ending
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olol
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b-blockers MOA
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blocks beta-1 and beta-2 receptors
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B-blockers treat
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Hypertention, angina, post MI, heart failure, atrial fib., and tachycardia
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B-blocker's Side Effects
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sexual impairment, heart failure, bradycardia, peripheral vasoconstriction, bronchoconstriction, hypoglycemia in diabetics. Do not stop immediately! Use caution in people with: asthma, copd, prd, and diabetics
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Ace-Inhibitors word ending
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pril
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ACE-I's treat
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chronic hypertension, slows progression of CHF, and slows renal failure in diabetics
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How ACE-I's work
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Na+ leaves so K+ stays causing decreased hr and bp
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ACE-I's Side Effects
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Hacky cough, hyperkalemia, non-allergic rash, hypotension, rarely angioedema (swelling of lips and face)
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Angiotension II Receptor Blockers (ARBs) word ending
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tan
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ARBs MOA
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blocks angiotension II receptors
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About ARBs
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Same treatments as ACE-Is and synergy with ACE-Is, also much safer than ACE-I because it is less likely to cause cough, rash, and angioedema
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Calcium Channel Blockers word ending
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*mostly pine* except verapamil and dilitiazem
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CCBs MOA
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inhibit the entrance of Ca2+ into smooth muscle cells
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CCBs are similar to
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B-blockers
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CCBs Side Effects
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vasodilation, edema, headache, reflex tachycardia, flushing, and constipation
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What does verapamil and diltiazem do?
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decreases force of contraction and treats chronic hypertension, angina, atrial fib, and tachycardia
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What's Diuretics do?
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Blocks reabsorption of Na+, when Na+ is increased, water will follow.
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List the Thiazide Diuretics
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HCTZ and metolazone
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Thiazide Diuretics are best at
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hypertention, while treating mild to moderate edema
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Thiazide Diuretic Side Effects
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dehydration, electrolyte imbalance, and hypokalemia
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List the Loop Diuretic
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furosemide
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Furosemide is best at
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edema
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Loop diuretic MOA
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blocks na+ reabsorption in the loop of henle
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Major Side Effect for Loop Diuretics
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Ototoxicity
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People taking loop diuretics will also need
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K+ supplements and avoid taking before bedtime
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List the potassium sparing diuretics
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Spironolactone
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Spironolactone MOA
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blocks aldosterone production, Na+ wasting and K+ retention
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About Spironolactone
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Never powerful enough to use alone and helps prevent hypokalemia
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Side Effects of Spironolactone
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Hyperkalemia and gynecomastia
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What is Aspirin's MOA?
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Irreversibly cox-I and cox-II
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About Apirin
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Effects last 7-10 days, daily dose: 81 mg or 325 mg
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Aspirin Side Effects
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GI Ulcers and Reye's Syndrome
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What is the market ploy that is like Aspirin?
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Aggrenox, which is not any better than Aspirin
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Anti-platelets are used in secondary prevention by treating
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previous MI, previous CVA, TIA, or ischemic stroke, and angina
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Antiplatelet Primary prevention treats
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50 yrs old +, hypertension, diabetes, high cholesterol, and currently smokes *these people need to take a daily aspirin*
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Other uses of antiplatelets
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acute coronary syndrome and after stent placements
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What is the antiplatelet that is only used in emergency situations?
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Glycoprotein IIb-IIIa Inhibitors
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What are the anticoagulants
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Heparin, LMWH, and Warfarin
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What is Heparin's MOA
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bind to antithrombin III to inhibit fibrin formation
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Heparin is drug of choice for
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rapid onset treating acute stroke, MI, DVT, and PE
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Heparin Side Effects
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Minor/major bleeding, avoid use after surgeries with high risk of bleeding
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Heparin is prescribed in
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Units, not mg!
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Heparin monitoring
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APTT-length of time it takes for clot to form (average: 30-40 seconds)
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What is the heparin antidote
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Protamine sulfate
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Low Molecular Weight Heparins (LMWH)
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longer half-life and more selective same effects as heparin and costs 4 times more more without APTT monitoring
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Warfarin MOA
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blocks synthesis of Vit K dependent clotting factors
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Warfarin onset
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3-5 days and very narrow therapeutic window
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Why is Warfarin useful?
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Only oral anticoagulant
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Warfarin Side Effects
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minor/major bleeding, N/V, loss of appetite, diarrhea, and hair loss
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Warfarin is not for
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pregnant women, alcoholics, recent surgeries with high risk of bleeding, peptic ulcer disease
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What is the warfarin antidote
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Vit K
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Monitoring Warfarin
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typical INR is 1.0 therapeutic INR is 2.0-3.0
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About Angina
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Chest pain from blood flow that is insufficient to meet the demands of Oxygen in the heart
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What are the drug options to treat Angina?
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B-Blockers, CCBs, and Nitrates
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Nitrate Side Effects
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Vasodilatory SE's, headache, orthostatic hypotenstion, flushing
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Nitrate tolerance
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will occur and allow drug free intervals of 8-12 hours per day
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Compliance information for Nitroglycerin Sublingual Tablets
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rapid onset of 1-3 minutes, dissolve under tongue, may repeat every 3-5 minutes, more than 3 tablets go to the ER, you know it's working when: there's tingling under the tongue and a headache
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These are other nitrate options that can be taken daily to prevent attacks
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Nitroglycerin ointment, transdermal patch, sustained release capsules, Isosorbide dinitrate, and isosorbide mononitrate
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Treatment of Angina in a hospital setting
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IV nitrates, B-blockers, CCBs, Heparin or aspirin, IV Morphine
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Treatment for Chronic stable angina
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nitrates, CCBs, or B-blockers, and acute SL nitro
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Treatment for variant angina
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nitrates or CCBs and SL nitro
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Warfarin Patient Education
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avoid vit K binging, keep intake of vit K steady, same time each day, don't skip doses, don't use aspirin or other NSAIDs, not for pregnancy, alochol consumption in moderate amounts no more than once or twice per week, watch for bleeding in stools and urine, nose bleeds, gums, or cuts, and clot signs include SOB, chest pain, and swelling in legs
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What do thrombolytics do?
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Clot busters treating acute DVT massive PE, MI, clotted catheters, and stroke
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Contradictions of Thrombolytics
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active bleeding, aortic dissection, cerebral neoplasm (cancer) or aneurysm, surgery, or trauma
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What is important about thrombolytics?
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Used with heparin, they work together because thrombolytics will break the clot while heparin keeps it from forming.
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