Pharmacology-Drugs By Catagories For Olol -Endocrine & Cardiac

Front 1

Insulins

Back 1

R - Humulin and Novolin O-30m-1h, peak- 2-4h, d-5-7h
NPH - Humulin and NovolinO-1-2 h, P- 8-12h, D-18-24h
Lispro- Humalog- O-15m, P-30-90 m, D - 5 h - less hypogl
Lantus - insulin glargine- sustained release - SQ at bed-never mix!
inhaled - O-15m, P-30-90m, D-4-6h
-----------------------------
increase: Ace inhibitors,alcohol,anaboli steroids,antidiabetic drugs,oral, beta blockers
decrease: adrenergics, corticosteroids, estrogens, glucagon, propranolol/Inderal thiazide diuretcs

Front 2

Oral Hypoglycemics Agents

use with pts with Type 2 with some insulin - never on type 1

Back 2

Biguanides-metformin/Glucophage works at cell level- Mala
Glitazones- rosiglitazone/Avandia - cell level - may cause CHF - liver dysfunctions -
Meglitinides- repaglinide/Prandin - excreted by kidney not liver
drug intera & not elderly pt
neuroendocrine Hormone- symlin/amylin - CNS requlates bld. glucose levels-do not mix in same syr
P1-2h, D3-5h

Front 3

Thyroid Hormones

+O2, +heat prod, +CO, -Chol.,lose wgt

Back 3

Thyroid & Parathyroid
Anterior & Posterior Pituitary
Gonadal
-----------------------------drugs that decrease the effect: antihypertensives, estrogens, propranolo (inderal) phenytoin, rifampin

Front 4

Hypothyroidism

Hyperthyroidism

Back 4

levothyroxine sodium/Synthroid-T4, life long, requlated based on TSH levels cause +BP, +Diarrhea, Tachycardia/palpitations, Exopthalmus
increase-capillary fragility
decrease CO, BP & HR
cardiac enlargement
CHF
anemia
-----------------------------
tachycardia, Increases CO,BV,systolic BP dysrythmias, CHF
antithyroid drugs- PTUs Iodine, propranolol/Inderal

Front 5

anti-thyroid drugs

Back 5

propylthiouracil (PTU) -inhibits thyroid hormones- takes 1 yr to decrease- assess for agranulocytosis (sore throat & fever)-can't fight infection
Iodine- inhibits release-accumulate in thyroid gland -
radioactive Iodine- destroys thyroid tissue-warn family members
propranolol/Inderol

Front 6

Calcium Regulators

Back 6

Hypocalcemia- treat with Vitamin D analogues
1.alters absorption of Ca from GI tract
2.alters renal excretion of Ca
3. reabsorbs bone
Chvosteks sign or Trousseaus sign- can cause osteoporosis, kidney stones
-----------------------------
increase effects: Vit.D, Thiazide diuretics
decrease eff: corticosterooids,

Front 7

Acute Hypocalcemia

Back 7

IV Calcium Gluconate - ER drug - when parathyroid glands removed

Front 8

Hypercalcemia

Back 8

calcitonin/Miacalcin- promotes buildup of calcium in bone- monitor serum ca levels-drink lots of fluids

Front 9

Growth Hormone

Back 9

anterior pituitary hormone
given IM -may cause allergic reaction-skin sensitivity test b4 admin
watch for severe hip or knee pain or for limp

Front 10

Posterior Pituitary Hormone

Back 10

ADH- Anti-Diuretic hormone'used in treatment of Diabetes Insipidus- watch for, hypertension/angina, pulmonary crackles, peripheral edema, increased specific gravity
drugs: Oxytocin/Pitocin - induces labor, stimulates uterine cont.
Vasopressin/Pitressin-& Desmopressin -diabetes insipidus

Front 11

Androgenic & Anabolic Steriods

Back 11

Sch. III
anab. used for muscle wasting
cause-liver-tumor & hepititus
Cns-aggression
acne, Na & fluid retention, cardiac disease, wgt gain
-----------------------------
do not use with calcitonin & barbiturates

Front 12

Estrogens

Back 12

Estrogen/Estace- produced by ovaries, long bone growth, treats prostate cancer, menopause
+ breast cancer, +bl.clotting
+hypertension, edema

Front 13

Progestins

Back 13

medroxyprogesterone/Provera
prod. by ovaries, bl.clot risk, -do not smoke, migraines, thrombosis-contraindicators
drug interaction do not use with Rifampin (TB), anticonvulsants, antibiotics

Front 14

Caton-Exchange Resins

Back 14

Sodium polystyrene/Kayexalate
decreases K+ levels in pts with hyperkalemia, Monitor K+ levels and Na levels

Front 15

Ammonia Detoxicating Agents

Back 15

lactulose (laxative)/Cephulac
caused by liver disease
lowers serum ammonia levels with pts with hepatic encephalopathy & to treat constipation

Front 16

Cardio Drugs

Back 16

Inotropic-Contraclitity
Chronotropic-Automaticity
Dromotropic-Conductivity
Exitability-Readiness to respond

Front 17

Low CO

Back 17

releases renin from Kidneys, which release angiotension 1 & 2 which cause vasodilation and aldosterone secretion which increase P. resistence and water retention which cause high BP & angina

Front 18

Glycosides

Back 18

Lanoxin/digoxin - increase contractions (inotropic), decrease HR (chronotropic), decrease conductivity (dromotropic)so +CO, -renin release, +NA excretion, + urine - BV, -Preload,-workload,-angina,-arrythmia
toxcity- anorexia, NVD, Visual distur, bradycardia (low HR

Front 19

anti-dig med

Back 19

Digibind- reverses the affects of Dig, but levels remain high,
------------------------------increase eff. Adrenergic drugs, antidysrhythmics, calcium preparations, ca channel blockers
decrease: antacids, cholestyramine, laxatives, oral aminoglycosides

Front 20

Antiarrythmics

Back 20

Sodium channel blockers - 1A Quinidine Sulfate - decrease all 4 ...tropics -does not sustain survival - given sustained release-
work by decreasing the O2 need of the heart which decreases the workload and/or increasing the O2 supply to the heart which stops angina and arrythmia

Front 21

Antiarrythmic con't

Back 21

Lidocaine 1B- ER med, IV push, decreases automaticity in the ventricles, stops arrythimia - S&S - paresthesias, light head., visual and hearing distur. confusion,
do not give if: allergy to local anesthestics, or heartblock

Front 22

Antiarrythimic con't 2

Back 22

class II- Beta Adrenergic Blockers (or BB or beta adrenergic antagonists or beta antagonists) stop arrythimia - gives negative: chronotro.,inotro., dromot., decreases renin response (beta 1) decreases glucose release (beta 2)

Front 23

Antiarrythimic con't 3

Back 23

Cardioselective Beta Blockers - only work on beta 1 receptors (cardiac cells) it does not cause bronchoconstriction (no wheezing)
non-selective BB- cause, bradycardia, hypoten. bronchconstriction (will have wheezing) hypoglycemia, impotence- do not stop abruptly causes rebound.
hold if BO <90, or HR <60,do not give to asthmatics

Front 24

Antiarrythimics con't 4

Back 24

class IV calcium channel blockers - verapamil/Isoptin
dilates perip.& coronary art. -decrease workload and increase O2 to heart to stop arrythimias, assess for hypotension, bradycardia (low HR) pedal edema and flushing
-----------------------------
for all antiarrythemia
drugs that increase: other antiarrythemic/antidysrhythimic drugs, antihypertensives, diurecitcs,

Front 25

Antianginals

Back 25

not enough oxygen to heart
Nitrates
Beta Blockers
Calcium Channel Blockers- work by decreasing workload and increase O2 or both
-----------------------------
drug that increase: antiarrythmics, antihypertensive, diuretics, digoxin
decrease: adrenergic drugs(epinephrine), calcium salts, rifampin

Front 26

Antianginal- Nitrate

Back 26

Nitroglycerin - dilates periph.vessels, causes decreaded preload and afterload-dilates healthy cardiac arteries, can give many ways- most sublingual- replace tabs ev.3mths, keep cool and dark, expect stinging under tongue, max-3 tabs ev 5 min,
side eff. hypotension, headache, flushing
cause vasodilation

Front 27

Antianginal - Beta Blockers and Ca channel blockers

Back 27

lower HR, workload, contractivity, oxygen demand, stops angina-
Ca channel bl. work same way but also cause coronary vasodilation

Front 28

Antihypertensives, blood pressure regulation

Back 28

A ce Inhibitors
B eta Blockers
C a channel blockers
D iuretics
-----------------------------increase eff: other antihypertensives, alcohol, digoxin
decrease: adrenergics, antacids, oral contraceptives

Front 29

BP reg.

Back 29

Ace -Angiotensin Converting Enzyme Inhibitors - use for hypertension, heart failure, decreae renal impairment in diabetic pts
side eff: persistent cough, hyperkalemia in pts with renal dysfunction- do not use with lithium,
ARBs Angiotension II receptor antagonist, block angiotenstion II at receptor sites, does not cause cough and rarely causes hyperkalemia

Front 30

Antihypertensives, BP regs con't

Back 30

Beta Blokers - propranolol/Inderal- decreases BP by decreasing HR and contractility(volume)

Front 31

Antihypertensives/BP regs con't 2

Back 31

Ca channel blockers - Procardia/nifedipine -decreases BP by dilating peripheral vessels
1. Alpha 1 blocker- prazosin/Minipress- cause dilation of bl. vessels, decrease perph.resistance, 1st dose often causes orthostatic hypotension
2. Alpha 2 blockers- clonidine/Catapres- stilmulates alpha 2 receptors in brain, peripheral bl.vess.dilation, decreases HR and BP

Front 32

Antihypertensives/BP regs
con't 3

Back 32

Diurectics: decrease BP by decreasing blood volume

Front 33

Antihyp/BP regs/Diurectics

Back 33

Thiazides- Diuril/chlorothiazide
Loop Diurectics-Lasix/furosemide
Aldosterone Antagonist
Osmotic Diuretics-Mannitol
-----------------------------
drugs not to be used with:
increase: antihypertensive agents
decrease: oral contraceptives, vasopressors (epinephrine,norep.)

Front 34

Antihyp/BP regs/Diurectics
con't

Back 34

Thiazides- Diuril/chlorothiazide- & Loop- Lasix/furosemide (more powerful of the two) inhibits Na reab. increases K+ excretion
side effect- hypokalcemia, hyponatremia, intravascular volume depletion resulting in hypotension
contraindicators: oliguria (no urine), hypokalemia, hyponatremia

Front 35

Antihyp/BP regs/Diurectics
con't 2

Back 35

Aldosterone Antagonist- K+ sparing - increases excretion of Na without excreting K+, blocks hypokalemia when used with other diuretics-its major use

Front 36

Antihyp/BP regs/Diurectics
con't3

Back 36

Osmotic diuretic- Mannitol
increases osmolatily of plasma and renal tubular fluids, use in ICP, & oliguria, IV only,

Front 37

Antihyp/BP regs/Diurectics
con't 4

Back 37

nursing intervention:
I&O
monitor labs-K+ & Na
assess for S&S of Hypo/hyperkalemia and hyponatremia
assess BP

Front 38

Antilipemics- statins

Back 38

used to treat elevated serum lipid levels

Front 39

Antilipemics- statins

Back 39

HMG-COA Reductase Inhibitors
Cholesterol Synthesis Inhibitors- Mevacor/lovastatin
block enxyme required for hepatic synthesis of cholesterol - reduces LDL chol, after 4-6 wks therapy
side eff: NCD (cramp), hepatotoxicity and muscle destruction, monitor liver function studies

Front 40

Antilipemics - not statin

Back 40

Bile Sequestering agents- cholestyramine/Questran- -binds with bile acids in the intestines and exc. in feces - reduces LDL, often used with statins
side eff- bloating, flatulence, constipation, drug interactions

Front 41

Antilipemics - not statin

Back 41

Fibrates- gemfibrozil/Lopid- decreases triglycerides,
side eff: GI discomfort, diarrhea, gallstones

Front 42

Antilipemics - not statin

Back 42

Niacin- B vitamin- decrease chol. and trigly. only high doses so causes flushing, pruritus and gastric irritation, most eff. when used with another antilipemic

Front 43

Hematology agents

Back 43

Iron preps. used to treat iron deficiency anemia, oral admin except with pts with ulcers or intestinal problems, give by straw, causes dark stools and consti. IM inject admin via Z-tract to stop discoloration of skin, if given by Z-tract can give to pts with stomach problems

Front 44

Hematology agents- con't

Back 44

Vitamin B12- IM injection- treats pernicious anemia, monthly for life of pts who had gastrectomy b/c they no longer have the intrinsic factor to absorb B12-

Front 45

Hematology agents con't 2

Back 45

Anticoagulants - Heparin- parenteral- prevents thrombosis form or enlargement and embolization
for ER- IV or SQ, use pump for IV, Abdomen site for SQ
contraindication: PUD, bowel dis. server hypertension, and bleeding
side eff: bleeding, thromobocytopenia (hits)
Antidote: Protamine Sulfate
short half-life
monitor Ptt

Front 46

Hematology agents - con't 3

Back 46

Lovenox/enoxaparin- cousin to heparin- prevent thrombosis in knee and hip surgery- and other conditions that make pt at risk for thrombosis
labs not requ. does not bleed
given SQ
onset longer than heparin
do not use with parenteral anticoagulants

Front 47

Hematology agents - con't 4

Back 47

Coumadin/warfarin- by PO - used long-term to prevent thrombosis formation- atrial fib, thromboembolic disorders, prosthetic heart valves-
onset 2-7 days so can give with heparin
acts as K+ antagonist, stops clotting factors
major side eff: bleeding
proteinbound- drug reactions
monitor PT and/or INR data
PT 1.5x control, INR 2-3 x control
antidote: vit K or fresh frozen plasma
nursing imp: any thing that is traumatic and will cause bleeding-also green leafy vegs

Front 48

Hematology agents- antiplatelite agents

Back 48

aspirin- prevents thrombosis formation, blocks enzyme in platelets which causes platelet aggregation,
side eff: bleeding PUD
dosage 81 mg

Front 49

Hematology agents- Thrombolytic agents

Back 49

streptokinases/Streptase- IV med, used to dissolve or breakdown thrombi in an active situation- used to dissolve clots in IV catherers
side eff: bleeding-may be severe because fibrinolysis is non-selective
contraindicaitons-severe HTN- recent trauma or CVA, PUD

Front 50

Drugs not to use with Anticoagulants, antiplatelet and thrombolylic agents

Back 50

any other drug that affects homestatis,
increase the eff. of heparin:
antiplatlet drugs, warfarin, parenteral penicillins
decrease eff. of heparin:
antihistamines, digoxin, tetracyclines
increase eff. of warfarin:
analgesics, androgens and ana. steriods, cardiovascular drugs of all kinds
thyroid preparations
gastrointestinal drugs

Front 51

Drugs that affect Statins,

Back 51

niacin, , bile acid drugs, rifampin, antacids, isradipine