Exam 1 Medications


1 Pathophysiology/Pharmacology II Flashcards on Exam 1 Medications, created by tera_alise on 29/01/2016.
Flashcards by tera_alise, updated more than 1 year ago
Created by tera_alise almost 8 years ago

Resource summary

Question Answer
When do you take acarbose (precose)? With the first bites of each meal
What does acarbose (precose) do? Interferes with carbohydrate absorption
Side effects of acarbose (precose) Flatulence, abdominal distention, diarrhea
Who can't take acarbose (precose) IBS
What is dextrose 50% given for? Acute and severe hypoglycemia in patients who can't swallow
Route for dextrose 50% IV push
Example of incretin mimetic Exendatide (Byetta injection)
What does exendatide (byetta inj) do? Stimulates release of insulin but IS NOT INSULIN ITSELF
What do you not take with exendatide (byetta inj)? Insulin
SIde effects of exendatide (byetta inj) Decreased food intake, decreased gastric emptying
Onset of glargine (lantus) 1-2 hours
Peak of glargine (lantus) No peak (long acting)
Duration of glargine (lantus) 24+ hours
What should you not do with glargine (lantus)? Mix it with any other solution
How often do you give glargine (lantus)? Once a day
What do glipizide (glucotrol) and glimepiride (amaryl) do? Stimulate insulin production in the pancreas
What are some side effects of glipizide and glimiperide? Altered taste, dizziness, drowsiness, weight gain, constipation
What does glucagon do? Increases blood glucose
What is a side effect of glucagon? Rebound hypoglycemia
Onset of humulin N 2-4 hours
Peak of Humulin N 4-10 hours
Duration of Humulin N 10-16 hours
When do you take humulin N? Before a meal
Onset of Humulin R (regular insulin) 0.5-1 hour
Peak of humulin R (reg insulin) 2-3 hours
Duration of humulin R (regular insulin) 3-6 hours
Which type of insulin can be given via IV? Humulin R (regular insulin)
Onset of lispro (humalog) 15 minutes
Peak of lispro (humalog) 1-1.5 hours
Duration of lispro (humalog) 3-4 hours
What does metformin (glucophage) do? Reduces glucose production in liver (DOES NOT STIMULATE INSULIN) Enhances glucose sensitivity and transport to tissues and cells
When should you not take metformin (glucophage)? In any procedure requiring contrast, you have to cancel the med 24 hours before and 48 hours after Could cause lactic acidosis, kidney failure
Examples of meglitinides Nateglinide (Starlix) Repaglinide (Prandin)
What do nateglinide (Starlix) and repaglinide (Prandin) do? Increases insulin production from pancreas
When do you take nateglinide (starlix) and repaglinide (Prandin)? 30 minutes before a meal
When should you not take nateglinide (starlix) and repaglinide (Prandin)? If the pt skipped the meal
Which oral agent is most effective in insulin resistant diabetic patients? Pioglitazone (Actos)
What does pioglitazone (actos) do? Increases insulin sensitivity, transport and utilization at target tissues
What route of administration is used for pramlintide (symlin)? SubQ injection
What is amylin? A hormone secreted from beta cells along with insulin in the pancreas
What is pramlintide (symlin) used for? Type I and type II DM
What does amylin/pramlintide (symlin) do? Slows gastric empyting, reduces postprandial glucagon secretion and increases satiety
What do sitagliptin (Januvia) and saxagliptin (Onglyza) do? Slows inactivation of incretin hormone, potential for hypoglycemia
What is aqeuous vasopressin (Pitressin) used for? Chronic ADH replacement therapy in diabetes insipidus patients
What symptoms does aqueous vasopressin (Pitressin) address? It decreases urine output and thirst
What is desmopressin (DDAVP)? ADH
How can desmopressin (DDAVP) be given? Oral, IV, SubQ, nasal
What does desmopressin (DDAVP) do? Decreases urine output, thirst Given to diabetes insipidus patients
What does octreotide (Sandostatin) do? Stops growth hormone
Who takes octreotide (Sandostatin)? Patients with hyperactive pituitary gland
How is Octreotide (Sandostatin) given? SubQ 3x/week
What is Somatropin (Omnitrope, Genotropin, Humatrope)? Growth hormone
How is somatropin (omnitrope,etc.) administered? SubQ injection every day in the evening
Who takes somatropin (omnitrope, etc.)? Patients with hypoactive pituitary gland
When should calcium gluconate be made readily available? After a thyroidectomy
How is calcium gluconate administered? Slow IV push - can cause hypotension and cardiac arrest
What is calcium gluconate used to treat? Tetany, pts with hypoparathyroid and hypocalcemia
What does iodine do? Inhibits synthesis of T3 and T4
When and why is iodine administered? Used pre-surgery to reduce vacularity (and therefore bleeding) of thyroid gland
When is the maximal effect of iodine seen? 1-2 weeks
When do you use ipratropium (Atrovent)? Quick relief when pt has symptoms of acute exacerbation
Indication for tiotropium (Spiriva) COPD pts along with other drugs
When do you use Albuterol (ProAir, Proventil, Ventolin) and Pirbuterol (Maxair)? Quick relief for COPD and asthma
What should you monitor when giving Albuterol (ProAir, Proventil, Ventolin) and Pirbuterol (Maxair)? BP and HR
What do Albuterol (ProAir, Proventil, Ventolin) and Pirbuterol (Maxair) do? Bronchodilators
How long does Albuterol (ProAir, Proventil, Ventolin) and Pirbuterol (Maxair) last? 4-8 hours
When do you use salmeterol (serevent) and albuterol (VoSpire ER)? NOT FIRST MED USED Use in conjunction with other meds if others are ineffective
Side effects of salmeterol (serevent) and albuterol (VoSpire ER) Headache, dry throat, tremors, dizziness, pharyngitis
What is the difference between salmeterol (serevent) and albuterol VoSpire ER? Salmeterol is inhaled, albuterol VoSpire ER is oral
How long do salmeterol (serevent) and albuterol VoSpire ER last? 12 hours
How do fluticasone (Flovent), budesonide (Pulmicort), and triamcinolone acetonide (Azmacort) work? Suppress inflammatory response (anti-inflammatory corticosteroids) Reduces bronchial hyperresponsiveness, decreases mucus production
Side effects of fluticasone (Flovent), budesonide (Pulmicort), and triamcinolone acetonide (Azmacort) Oropharyngeal candidiasis, hoarseness, dry cough
Why would you use inhaled corticosteroids? Long term control of bronchial constriction, taken on a fixed schedule
How do you reduce side effects of inhaled corticosteroids? Using a spacer Gargling mouth after use
When should you be cautious about using inhaled corticosteroids? Adrenal and liver problems Hypersensitivity to corticosteroids
What do leukotrienes do? Bronchoconstriction
Which meds block the action of leukotrienes? Leukotriene modifiers - zafirlukast (accolate), montelukast (singulair) Leukotriene synthesis inhibitors - sileuton (Zyflo CR)
When should you NOT use zafirlukast (accolate), montelukast (singulair) and sileuton (Zyflo CR)? In the event of an acute attack
What are zafirlukast (accolate), montelukast (singulair) and sileuton (Zyflo CR) used for? Prophylactic and maintenance therapy
When do you take zafirlukast (accolate), montelukast (singulair) and sileuton (Zyflo CR)? 1-2 hours before meals
Side effects of zafirlukast (accolate), montelukast (singulair) and sileuton (Zyflo CR) Headache, abdominal pain and diarrhea
Examples of methylxanthines Oral - theophylline (Theo-Dur) IV - aminophylline (Truphylline)
Margin of safety for oral theophylline (Theo-Dur) and aminophylline (truphylline) 10-20 is therapeutic
What can happen in the event that pt has >20 after the use of oral theophylline or aminophylline? Seizures Signs of toxicity = N/V, seizures, insomnia
What do oral theophylline (Theo-Dur) and aminophylline (truphylline) do? Less effective bronchodilator, little effect on bronchial hyperresponsiveness
When could you need to use calcium gluconate emergently? Post-thyroidectomy
What type of patient receives calcium gluconate? Hypoparathyroid and hypocalcemic patients
What symptom would prompt the use of calcium gluconate? Tetany
How should calcium gluconate be administered? IV push SLOWLY May cause hypotension and cardiac arrest
What is the mechanism of action of iodine? Rapidly inhibits synthesis of T3 and T4
When do you give iodine? Pre-thyroidectomy to reduce vascularity and minimize bleeding
When will you see the maximum effect of iodine? 1-2 weeks
In relation to meals, when do you give iodine? After meals through a straw with juice or water
What is the drug of choice for hypothyroidism? Levothyroxine (Synthroid)
What VS should you check prior to giving levothyroxine (synthroid)? Apical HR If >100, HOLD and provide intervention for tachycardia
When do you take levothyroxine (synthroid)? In the morning to mimic circadian rhythm
When do you start to see the effects of levothyroxine (synthroid)? 2 weeks If they stop taking it---HYPOTHYROID SX If they take too much ---HYPERTHYROID SX
What does Lugol's solution do? Rapidly inhibits synthesis of T3 and T4
When do you use Lugol's solution? Pre-thyoidectomy to reduce vascularity of tissue and reduce bleeding
How do you take Lugol's solution? With juice or water through a straw after meals
When do you see the effect of Lugol's solutions? 1-2 weeks
How often do you taken methimazole (tapazole)? Once a day
Who takes methimazole (tapazole)? Hyperthyroid patients
What is the MOA of methimazole (tapazole)? Blocks iodine reuptake
When do you take methimazole (tapazole)? In the event of a thyroid storm
Side effects of methimazole (tapazole) Fever, dizziness, loss of taste
What should you monitor if your patient is taking methimazole (tapazole)? WBC - agranulocytosis could increase chance of infection
What does propylthiouracil (PTU) do? Blocks peripheral conversion of T4-T3
How often do you take propylthiouracil (PTU) and how? 3X a day orally
What is propylthiouracil (PTU) used for? Tx of hyperthyroidism
Which type of patients usually receive propylthiouracil (PTU) as opposed to tapazole? Pregnant women
What does dexamethasone (Decadron), methylprednisolone (Solu-Medrol) and Prednisone (Deltasone) do? Stops, controls, and reduces anti-inflammatory response
What are potential complications due to long term use of dexamethasone (Decadron), methylprednisolone (Solu-Medrol) and prednisone (Deltasone)? Cushing's syndrome
When do you take dexamethasone (Decadron), methylprednisolone (Solu-Medrol), and prednisone (Deltasone)? In the morning DO NOT abruptly stop taking it
What is the most common indication for dexamethasone (Decadron), methylprednisolone (Solu-Medrol) and prednisone (Deltasone)? Addison's disease
Side effects of dexamethasone (Decadron), methylprednisone (Solu-Medrol) and prednisone (Deltasone) Edema, peptic ulcers, delayed wound healing, osteoporosis, infections
What type of diet is needed for a patient taking dexamethasone (Decadron), methylprednisonolone (Solu-Medrol) and prednisone (Deltasone)? High in protein, calcium, and potassium
Which antihistamines are 2nd generation? Cetirizine (Zyrtec) Fexofenadine (Allegra) Hydroxyzine (Vistaril) Loratidine (Claritin)
Which antihistamines are 1st generation? Diphenhydramine (Benadryl) Promethazine (Phenergan)
Which 2nd gen. antihistamine is used for motion sickness and vertigo along with sneezing, rhinorrhea, PND? Cetirizine (Zyrtec)
Side effects of cetirizine (Zyrtec) Pharyngitis, dry mouth, dry nose/throat, drowsiness
Which antihistamine can be given via IM injection? Hydroxyzine (Vistaril)
Which 1st gen. antihistamine is used for motion sickness/sedation? Promethazine (Phenergan)
What does acetylcysteine (Mucomyst) do? Liquifies mucus by breaking links that bind mucus together; makes it easier to cough up
When should you use acetylcysteine (Mucomyst)? OD on acetaminophen
Side effects of acetylcysteine (Mucomyst)? Nausea, rhinorrhea, bronchospasms, dizziness
What is the indication for Benzonatate (Tessalon)? Reduction of a non-productive cough
Side effects of benzonatate (tessalon)? Drowsiness, GI upset, constipation
What does guaifenesin (Robitussin) do? Expectorant: irritates mucus membranes to release mucus Creates a productive cough
Side effects of guaifenesin (Robitussin) GI upset, nausea, drowsiness
How does oseltamivir (Tamiflu) work? Prevents from viruses budding and spreading to other cells (esp. respiratory)
Which types of influenza are indications for oseltamivir (Tamiflu)? Influenza A and B
When should you take oseltamivir (Tamiflu)? Within first 2 days of symptoms
What do decongestants do? Stimulate adrenergenic in blood vessels which promotes vasoconstriction Reduces edema rhinorrhea
Side effects of decongestants Insomnia, headache, increased BP and ocular pressures, palpitations, tachycardia
Which decongestants are offered as nasal sprays? Phenylephrine hydrochloride (Neosynephrine) Oxymetazoline (Afrin) Pseudoephedrine (Sudafed)
Which decongestants are offered PO? Pseudoephedrine (Sudafed)
Indications for inactivated flu vaccines 6mo and older Safe for anyone except Guillain-Barre, hypersensitivity to eggs GIVEN VIA INJECTION
Indications for live attenuated flu vaccines (LAIV) 2-49 yrs Non-pregnant, healthy people INTRANASAL
When should you start taking intranasal corticosteroids (i.e. fluticasone [Flonase, Flovent] and triamcinolone [Nasacort])? 2 weeks before seasonal allergies begin
How often should you take intranasal corticosteroids (i.e. fluticasone [Flonase, Flovent] and triamcinolone [Nasacort])? Daily - DO NOT USE PRN
Side effects of intranasal corticosteroids (i.e. fluticasone [Flonase, Flovent] and triamcinolone [Nasacort]) Mild nasal burning stinging Watch for infection
What is an example of a mast cell stabilizer? Cromolyn spray (NasalCrom)
What does Cromolyn spray (NasalCrom) do? Inhibits degranulation of sensitized mast cells Prevents allergy symptoms
Side effects of Cromolyn spray (NasalCrom) Nasal burning, irritation
When should you start Cromolyn nasal spray (NasalCrom)? 2 weeks before pollen season OR 10-15 minutes before exposure to allergen (used prophylactically)
What is amoxicillin used for? Skin infection, respiratory infections, GU/GI infections, otitis media, peptic ulcer, H. Pylori
What is amoxicillin's mode of action? Bactericidal
Side effects of amoxicillin N/V/D
How can azithromycin (Zithromax) be given? IV, PO
What does azithromycin (Zithromax) do? Binds to receptor sites in susceptible organisms to prevent protein synthesis
What is azithromycin (Zithromax) used for? Pneumonia, mucobacterium avius complex, COPD, chlamydia, pharyngitis, tonsilitis, skin infections, STDs
Indications for penicillin Gonorrhea, UTI, peronitis, pneumonia and other respiratory infections, septicemia, meningitis
Mode of action of penicillin Bacteriostatic or bactericidal
Side effects of penicillin GI distress, oral/vaginal candidiasis, generalized rash, anaphylaxis
Indications for pneumococcal vaccine Pt with chronic illness (COPD, DM) >65yo Pt recovering from illness
What does STRIPE stand for? Streptomycin Rifampin (Rifadin) Isoniazid (NIH) Pyrazinamide (PZA) Ethambutol (Myambutol)
Side effects of streptomycin Ototoxicity, nephrotoxicity, neurotoxicity
Side effects of Rifampin Hepatitis, thrombocytopenia, orange discoloration of bodily fluids (urine, sputum, sweat, tears)
What test should be done before giving isoniazid (INH)? Liver function test
Instructions for patients receiving isoniazid DO NOT drink alcohol - causes B6 deficiency Take all pills, do not discontinue
Route of isoniazid (INH) IM, PO
Side effects of isoniazid Hepatitis, clumsiness, jaundice, epigastric distress muscle ache, peripheral neuritis
Side effects of pyrazinamide (PZA) Hepatitis, arthralgia, hyperuricemia
Side effects of ethambutol (Myambutol) Ocular toxicity (decreased red and green discrimination)
What should you monitor in patients taking pyrazinamide (Myambutol)? Visual acuity and color discrimination
What does omalizumab (Xolair) do? Monoclonal antibody to IgE Decreases circulating and free IgE levels Prevents IgE from attaching to mast cells - prevents release of chemical mediators
How often do you give omalizumab (Xolair)? SQ q2-4 weeks
What is the black box warning for omalizuman (Xolair)? Increases ischemic heart disease, arryhthmias, cardiomyopathy and cardiac failure
When should you NOT use omalizumab (Xolair)? Case of acute bronchospasms
When should you use omalizumab (Xolair)? Moderate to severe persistent allergic asthma
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