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Anxiety Medications : Benzodiazepines
****** all ends w/ -PAM except Chlordiazepoxide Alprazolam, Diazepam , Lorazepam, & Chlordiazepoxide o Used for anxiety, seizures, muscles spasm, alcohol withdrawal & induction maintenance anesthesiao Mode of action: they increased the effect of GABA in the CNSo SE: Sedations, amnesia, ****respiratory depression** , possibility in dependency in withdrawalo Key points: ** Used for short-term use only not intended for long term, do not stop the med abruptly b/c of the risk of withdrawal & dependencyo **ANTIDOTE: Flumazenil NOT Narcan or Naloxone (antidote for opioid) TERM 2
Anxiety Medications : Atypical Anxiolytics
DEFINITION 2 Buspirone (Buspar) o Used for anxiety, panic disorders, OCD, PTSDo Mode of action: alternative anxiety medicationso SE : Minimal & common (dizziness, nausea, headache)o Key points: ** It does not cause sedation & dependency is not likely, can use for longer term; full effect of buspirone is not felt for several weeks ; pt take this w/ meal to decrease GI upseto How to remember: Someone named Pam, who has a lot of anxiety & taking lorazepam for her anxiety for a while, which is contraindicated b/c it is a short-term med. TERM 3
Anxiety Medications : SSRIS
DEFINITION 3 Paroxetine, Sertraline, & Fluoxetine o Used for anxiety & depression; also used for OCD & PTSDo Mode of action: they inhibit serotonin reuptake, which in turn increases the amount of serotonin in the bodyo **SE: sexual dysfunction , wt. gain and insomniao Key points: watch for serotonin syndrome which includes (agitation, hallucinations, fever, diaphoresis & tremor); DO NOT TAKE SSRI w/ St. Johns wort b/c **it can increase the risk for serotonin syndrome; **** usually ends with INE or TINE ; full effects can take about a month or sometimes more TERM 4
Depression Medications: Atypical
Antidepressants
DEFINITION 4
Bupropion (Welbutrin) o Used for both depression & an
aid w/ smoking o SE:** insomnia , headache, GI distress,
wt. loss, agitations & seizureso How to remember : Be
appropriate, dont smoke Trazadone o SE: ** sedation
TERM 5
Depression Medications: Tricyclic
Antidepressants
DEFINITION 5 Amitriptyline & Imipramine o Used for depression & neuropathy, fiber myalgia, anxiety, & insomniao SE : sedation, orthostatic hypotension, anticholinergic SE (urinary retention, constipation, dry mouth, blurry vision, photophobia, & tachycardia, sweating & seizures); sweating & seizureso How to remember: o Think of a girl name Amy walking to the deserts & she trips over tricycle (Triptyline is a tricyclic meds); deserts symbolizes all the drying effects that are anticholinergic effects
Depression Medications: Monoamine Oxidase
inhibitors (MAOIS)
Phenelzine & Tranylcypromine o Used for DEPRESSIONo SE: agitation, anxiety, orthostatic hypotension, **** hypertensive crisis** o Key points: **MAOIS interact w/ many other meds including OTC cold medications can result in severe HTN; advise your pt not to consume food high in tyramine (aged cheese, avocados, banana, red wine, salami, peperoni & chocolate)o How to remember : Tyrion Lannister from game of thrones likes all the fine things in life like age cheeses, wine, chocolate, smoke meats TERM 7
Bipolar Medications: Mood Stabilizer
DEFINITION 7 Lithium o Used for bipolar disorderso SE : GI upset, fine hand tremors, polyuria, wt. gain, kidney toxicity, & electrolyte imbalanceso Key points : monitor the pt serum levels of lithium b/c of high risk of toxicity (over 1.5); pt should not take diuretics, or anticholinergics or NSAIDS (will dry pt); closely monitor Na+ levels, adequate fluid intake for 2 to 3 L/ day & Na+o Contraindicated w/ pt w/ renal disease (think about how one of its SE is kidney toxicity, so if this was given to someone with renal disease then kidney failure is going to get worse); TERM 8
Bipolar Medications: Anti-epileptic Drugs
DEFINITION 8 Carbamazepine & Valproic Acid o Used to treat seizures & bipolar disorderso SE: o C: ** blood dyscrasia (anemia, leukopenia (WBC down), thrombocytopenia (platelet down)); vision issues such nystagmus & double vision; hyposmolarity & rash.o **V: GI upset, hepatotoxicity (LIVER DAMAGE), pancreatitis, & thrombocytopeniao Key points: ** monitor the pt. CBC level b/c of blood dyscrasia side effecto How to remember: Carbs are in our blood b/c we love eating it (blood dyscrasia is a side effect) TERM 9
Antipsychotic medications
DEFINITION 9 Positive vs Negative Symptoms of Schizophrenia Positive symptoms: things that the pt is experiencing that shouldnt be such as DELUSIONS & HALLUCINATIONS Negative symptoms: they lack certain things that should be there such as ANERGIA (lack of energy), Anhedonia (lack of pleasure), Social withdrawal (so these are what the schizophrenic pt have that are present on people who doesnt have schizophrenia) TERM 10
Antipsychotic medications: Conventional
Antipsychotics
DEFINITION 10 Chlorpromazine & Haloperidol (Haldol) o Used to tx schizophrenia or other psychotic d/oo Mode of action: mainly control the (+) symptoms (delusions and hallucinations)o SE: Extrapyramidal (EPS): dystonia, parkinsons like symptom (shuffling gait & rigidity), tardive dyskinesia (lip smacking and tongue rolling) Agranulocytosis: decrease neutrophils in the body (which is the main WBC in the body that fights & prevent infection); pt have a higher risk of infection
Alcohol Abuse: Medications for Opioid &
Nicotine Withdrawal (4)
Methadone o Used for OPIOID withdrawal & LONG TERM use Bupropion o Used for NICOTINE withdrawal Nicotine replacements o Includes gum, patch, nasal spray Varenicline Used to reduce cravings and withdrawal symptoms for nicotine; Monitor pt closely for signs of suicidal ideation and depression TERM 17
Nervous system medications: Cholinergic
medications
DEFINITION 17 Neostigmine, Pyridostigmine, Edrophonium o Used for condition such as MYASTHENIA GRAVIS (MG) Myasthenia Gravis (MG)- does not have enough acetylcholine in the neuromuscular junction which causes muscle weakness; with these medications it helps improve strength and mobility of pt with MG ; can also be used to reverse neuromuscular blocking agents ANTIDOTE:Atropine TERM 18**
Nervous system medications: Cholinergic
medications
DEFINITION 18 o Mode of action: increases the acetylcholine at the receptor sites & it does this by inhibiting cholinesterase (enzyme that breaks down acetylcholine)o SE: too much acetylcholine (can cause inc salivation, diarrhea, N/V, sweating, & bradycardia)o How to remember: there is a top driver name Stig; Stig pulls up and stops the cholinesterase enzyme from working by blocking it therefore increasing acetylcholine **Edrophonium: a key medication that is used to help diagnosed MG TERM 19
Nervous system medications: Cholinergic
medications
DEFINITION 19 Symptoms of MG is muscle weakness which is also the key symptom when someone is having a cholinergic crisis; so these two (MG & these cholinergic meds) both exhibit same type of symptoms so its hard sometimes to differentiate b/w (does the pt have a cholinergic crisis or do they have MG?) so we determine bygiving them the Edrophonium which increases the acetylcholine so if the pt responds well and become better then its MG but if they do worse, then the pt will do worst and if they do get worst will give the antidote TERM 20
Drugs Used for Parkinsons
disease
DEFINITION 20
**there is an imbalance where there is too little dopamine or
too much acetylcholine**
Drugs Used for Parkinsons disease :
Dopamine Agonist
(can bring UP the dopamine levels) Levadopa/Carbidopa (Sinemet) o Used for Parkinsonso Help dec the tremors & muscle rigidityo Mode of action: increases dopamine levels in the CNS; specifically, the levodopa is converted into dopamine in the CNS and Carbidopa prevents the breakdown of the Levedopao SE: N/V, drowsiness, dyskinesias (ticks), ortho hypo, darkening of urine and sweat, possible psychosiso Key points: HIGH PROTEIN MEALS can decrease the effectiveness of this med; so should not consume high protein meals TERM 22
Drugs Used for Parkinsons disease :
Anticholinergic Agent
DEFINITION 22 Agent (can bring DOWN the acetylcholine) Benztropine o Use it for Parkinsons; help dec the tremors & muscle rigidityo Mode of action: decreases acetylcholine in the CNS SE: anticholnergic SE (dry eyes, dry mouth, blurry vision, urinary retention, & constipation); to counteract the SE, we should encourage pt to chew gum, wear sunglasses, inc fiber and fluid intake to help prevent constipation. TERM 23
Anti-epileptic Medications
DEFINITION 23 Phenytoin o Used to prevent seizureso **SE: gingival hyperplasia (gums getting enlarged), diplopia (double vision, nystagmus, rash, ataxia, and hypotensiono Key point: serum phenytoin levels need to be monitored routinely bc it has very narrow therapeutic range (range b/w the therapeutic range and the toxicity range is very narrow, about 10- 20mcg/mL ); the pt may need frequent blood draws to make sure the pt is staying w/in the therapeutic range; Phenytoin can decrease the effects of the contraceptive TERM 24
Other anti-epileptic meds
DEFINITION 24
Lamotrigine, Carbamezepine, Valproic acid
TERM 25
Anti-glaucoma Medications: Anti-glaucoma
Agent (Topical Beta Blocker)
DEFINITION 25 Timolol o Used primarily for open angle glaucoma o Mode of action: NON-SELECTIVE BETA BLOCKER (decreases aqueous humor production which in turn decrease intraocular pressure or IOP)o SE: minimal; temporary stinging of the eyeo Key points: dont touch the applicator to the eye, hold gentle pressure on the nasolacrimal duct for about 30-60 sec or punctao OD (overdose) of Timolol: can have systemic effects of non-selective beta blocker but as long you put the right number of drops then you shouldnt have the systemic SE
Urinary Tract Stimulants
Bethanechol o Used for non-obstructive urinary retention; works by stimulating the cholinergic receptors in the GU tract which allows for bladder emptyingo SE: cholinergic SE (flushing, sweating, urinary urgency, N/V, bradycardia and hypotension)o Key points: give this meds 1 hr before or 2 hrs after meals to help minimize N/V How to remember: Beth has a shy bladder and she takes Bethanechol to help her empty her bladder effectively TERM 32
Urinary Tract
Antispasmodics
DEFINITION 32 Oxybutynin o Used for overactive bladder symptoms(frequency, urgency and nocturia)o Mode of action: inhibits acetylcholine in the bladder therefore reducing urinary urgency and frequencyo SE: anticholinergic effects (dry mouth, urinary retention, constipation, dry eyes, blurred vision) Key points: increase fiber and fluid intake, suck on hard candy etc TERM 33
Insomnia medication
DEFINITION 33
Zolpidem (Ambien) o Used for insomnia; increases effect of
GABA in the CNS that helps promote sedation and sleepo SE:
**day time sleepiness , dizziness Key points: pt should
have a dedicated full 8hrs of sleeping per day
TERM 34
Sedative/Hypnotic Medications
DEFINITION 34 Pentobarbital, Profolol, Midazolam o Used these medications for induction and maintenance of anesthesia and also doing moderate sedation or intubation o Mode of action: CNS depression and loss of consciousness in the pt o SE: resp and cardiovascular depression, pain at IV site & high risk of bacterial contamination (Profolol), TERM 35
Sedative/Hypnotic Medications
DEFINITION 35 Key points: if using Profolol make sure to use those medications within 6 hrs to prevent bacterial contamination and also watch for s/s of infection; in addition, when using sedative/hypnotic agents make sure that a resuscitation equipment is available and control to monitor the pts ecg and VS bc of the risk of resp and cardiovascular depression
Respiratory Medications: Beta 2 Adrenergic
Agonist
Albuterol (short acting and for acute episodes of asthma) & Salmetrol (long acting, not used for acute asthma) o Usedo Mode of action: bind to the beta 2 receptors in the airways smooth muscle and this results in bronchodilation o SE: tachycardia, angina, tremorso Key points: if youre using an albuterol along w/ an inhaled glucocorticoid, you may want to first use the beta 2 adrenergic agonist b/c you may want to first open up the airways and then wait 5 min then give the glucocorticoid TERM 37
Respiratory Medications: Xanthines
DEFINITION 37 Theophylline o Used for long term control of asthma or COPDo Mode of action: increase Camp which results in bronchodilation o SE: GI upset (minor); dysrhythmias & seizures (major, really serious) o Key points: mon serum levels very closely b/c of its very narrow therapeutic range; not used much bc of its very serious side effects How to remember: the word theo means God or God like so when you take this medication you may see God sooner b/c of its very serious side effects TERM 38
Respiratory Medications: Inhaled
Anticholinergic
DEFINITION 38 Ipatropium o Used for asthma or COPDo Mode of action: blocks the acetylcholine receptors in the airways sm. muscle that causes bronchodilationo SE: dry mouth, hoarseness, were not going get all the anticholinergic SE bc were only inhaling ito Key points: increase intake of fluids and suck on sugar free candy to help with the dry mouth TERM 39
Respiratory Medications: Inhaled
Glucocorticoids
DEFINITION 39 Beclomethasone o Used for asthma; can be used alone or in conjunction w/ beta 2 adrenergic agonisto Mode of action: decreases inflammation locallyo SE: hoarseness and candidiasis o Key points: after using this the pt must rinse their mouth to prevent the fungal infection ; if youre using an albuterol along w/ an inhaled glucocorticoid, you may want to first use the beta 2 adrenergic agonist b/c you may want to first open up the airways and then wait 5 min then give the glucocorticoid (beclamethasone) TERM 40
Respiratory Medications: Oral Glucocorticoids
**DEFINITION 40 Prednisone o Used wide variety of illnesses such as asthma, autoimmune disorders and inflammatory d/oo Mode of action: decreases inflammation and suppresses the immune response systemically o **SE: bone loss, wt. gain, fluid retention, hyperglycemia, hypokalemia, inc risk of infection, muscle weakness, peptic ulcer disease and adrenal glands suppression o Key points: NEVER d/c suddenly must be tapered slowly; mon pt closely for signs of infection; AVOID NSAIDS b/c it can cause bleeding
Respiratory Medications: Antihistamines
Diphenhydramine (Benadryl, 1st generation) & Loratadine (2nd generation) o Used for nasal congestion, mild allergic rxns & motion sicknesso Mode of action: block histamine release which reduces secretionso SE: minimal but 1st gen can get sedation & anticholinergic SE (dry mouth, constipation, & urinary retention); 2nd gen have diff side effects TERM 47
Respiratory Medications: Nasal
Glucocorticoids
DEFINITION 47
Mometasone, Fluticasone, & Budesonide o Used for
rhinitis (nasal congestion)o Mode of action: dec congestion
in the nasal passages SE: HA, nasal burning, pharyngitis
(sore throat)
TERM 48
Cardiovascular Medications: Loop Diuretics
DEFINITION 48 Furosemide (Lasix) o Used for pulmonary edema, edema r/t to HF, liver disease, kidney disease and HTNo Mode of action: blocks reabsorption of Na & water at the ascending loop of Henle which causes rapid diuresiso SE: risk for dehydration and hypotension (b/c were losing fluid); electrolyte imbalances (hyponatremia & hypokalemia; ototoxicity; hyperglycemia TERM 49
Cardiovascular Medications: Loop Diuretics
DEFINITION 49 o Key points: if possible admin med during the day than at night to reduce nocturia; infuse it 20mg over a min (give it slowly), if its about 40mg then about 2 min; weigh the pt daily ; mon I/O, electrolytes; encourage to consume food high in potassium (dark leafy greens, etc) How to remember: FUR- furiously get rid of excess Na & water TERM 50
Cardiovascular Medications: Thiazide
Diuretics
DEFINITION 50 Hydrochlorothiazide o Used for HTN; often used in combination w/ other antihypertensive meds; used for edema (HF, kidney d/o, or liver d/o)o Mode of action: blocks reabsorption of Na & water (in the distal convoluted tubuleo SE: dehydration, hypokalemia, hyperglycemia; less risk of ototoxicityo Key points: admin during the day, mon I/O, weigh daily, mon electrolytes, encourage food high in potassium
Cardiovascular Medications: Potassium
Sparing Diuretics
Spironolactone o Used for HTNo Mode of action: blocks
aldosteroneo SE: Vomiting, diarrhea and stomach pain
or cramps.
TERM 52
Cardiovascular Medications: Cardiac
Glycosides
DEFINITION 52
Digoxin o Used to tx HF and Afibo Mode of action: has an
inotropic effect which causes the heart to contract more
forcefully and efficiently; chronotropic effect (dec HR)o SE:
dysrhtymias, bradycardia; carry risk for toxicity ** (GI upset
(n/v), fatigue and weakness and vision changes)
TERM 53
Cardiovascular Medications: Cardiac
Glycosides
DEFINITION 53 o Key points: always check pt pulse before administering digoxin; below 60bpm (hold the digoxin); mon digoxin levels during therapy (0.5-2.0); HYPOKALEMIA CAN INCREASE RISK FOR DIGOXIN TOXICITY; encourage to eat high potassium food; can treat bradycardia w/ atropine o OD antidote: DigibindHow to remember: if mom has HF, you say Mom, didya (Digo) pick up your prescription for digoxin? TERM 54
Cardiovascular Medications: Adrenergic
Agonists
DEFINITION 54 Dopamine o Used for shock or HFo Mode of action: primarily works on Beta-I receptors but in high doses it may also start to impact the Alpha-I receptorso SE: irregular heart beats, headache, and chills o Key points: improves kidney blood flow in moderate dose and help increase HR & CO Dobutamine o Used primarily for HR; mostly affect on Beta-Io SE: inc BP (too much can cause hypertensive crisis); dysrhythmias and angina TERM 55
Cardiovascular Medications: Adrenergic
Agonists
DEFINITION 55
Epinephrine o Used for cardiac arrest, asthma; can cause
bronchodilation, vasoconstriction, increase HR & COo Mode
of action: activates receptors in the alpha-I & Beta I & II
BP Medications: Calcium Channel Blockers
Verapamil, Nifedipine, Diltiazem o Used for HTN & anginao Mode of action: blocks calcium channels in the blood vessels in the heart leading to vasodilation and dec HRo SE: bradycardia, hypotension , dysrhythmias, constipation, and peripheral edemao Key points: NO GRAPEFRUIT JUICE ; mon pts BP & HRo How to remember: very nice drugs TERM 62
BP Medications: Alpha-Beta Receptors Review
DEFINITION 62
Alpha-I receptors o Primarily in the blood vessels. When we
activate this, this causes vasoconstriction which increases BP
but if we block those receptors then opposite will happen
Alpha-II receptors o Decrease sympathetic out flow in the
body which causes vasodilation & dec in HR, CO, & BP
TERM 63
BP Medications: Alpha-Beta Receptors Review
DEFINITION 63
Beta-I receptors (heart) o Primarily in the heart and when
activated it causes increase HR and increase contractility
Beta-II receptors (lungs) o Its in the lungs and when we
activate these receptors we cause bronchodilation
TERM 64
BP Medications: Centrally Acting Alpha II
Agonists
DEFINITION 64
Clonidine o Used for HTNo Mode of action: causes
vasodilation and dec HR, CO, & BPo SE: drowsiness and dry
moutho Key points: suck on hard candy, and inc fluid intake
TERM 65
BP Medications: Beta-I Blokers
DEFINITION 65
Metropolol & Atenolol o Used for HTN, angina, HF, & MIo
Mode of action: blocks beta-I receptors in the heart which
dec BP & HRo SE: bradycardia, dec CO, hypotension, fatigue,
erectile dysfxo Key points: change position slowly, take BP
and pulse at home daily
Nonselective Beta Blockers (will affect beta-I
& beta-II in the lungs)
Propranolol, Carvedilol, & Labetalol o Used for angina, HTN, arrhythmias, and MIo Mode of action: block beta-I & beta-II receptors so they decrease BP & HR but they also cause bronchoconstrictiono SE: fatigue, hypotension, bradycardia, dec COo Key points: never give it to someone who has asthma bc this med can cause bronchoconstriction TERM 67
BP Medications: Vasodilator (For Hypertensive
Crisis)
DEFINITION 67
Nitroprusside o Used for hypertensive crisiso Mode of
action: causing direct vasodilation of arteries and veins;
rapidly dec BP both on preload and afterloado SE: **cyanide
poisoning, thiocyanate toxicity, hypotension
TERM 68
Anti-dysrhythmic medications: Class I
DEFINITION 68 Procainamide & Lidocaine o Used for SVT (supraventricular tachycardia), V-tach, atrial flutter, & A-fibo Mode of action: they serve as sodium channel blockero SE: **lupus, leukopenia, thrombocytopenia & possible arrhythmiaso How to remember: John Mccain ran against Obama, he lost, my dad or relative who is Pro Mccain (Procainamide) & got really upset that he lost so he ended up having SVT, V-tach, atrial flutter, & Afib TERM 69
Anti-dysrhythmic medications: Class
II
DEFINITION 69 Propranolol (nonselective Beta Blocker) o Used for Afib, Atrial flutter, PSVT, HTN, Anginao Mode of action: Nonselective Beta Blocker (impacts 1 beta receptor in the heart and 2 in the lungs)o SE: hypotension, bradycardia, fatigue & bronchospasmso Key points: dont use this meds for pts that have asthma TERM 70
Anti-dysrhythmic medications: Class III
DEFINITION 70
Amiodorone o Used for A-fib, V-fib, V-tach o Mode of
action: acts as a potassium channel blockero SE:
hypotension, bradycardia, pulmonary toxicity, visionary
disturbances, GI upset, liver toxicity, thyroid dysfunction
Antilipemic Medication: Fibrates
Gemfibrozil o Used foro Mode of action: decreasing
triglyceride production and transport; helps increase HDL
levelso SE: GI upset, gallstones, hepatotoxicity, & muscle
painKey points: give it 30 min before breakfast and dinner;
mon liver fx and CK levels
TERM 77
Hematologic Medications: Anticoagulants- IV
DEFINITION 77 Heparin o Used for stroke, pulmonary embolism (PE), DVT, & other conditions that need a fast anticoagulationo Mode of action: it activates antithrombin and this in turn inhibit thrombus formation; so well use this to prevent new clots but it will not break down existing clotso SE:bleeding** , HIT (heparin induced thrombocytopenia), hypersensitivity TERM 78
Hematologic Medications: Anticoagulants- IV
DEFINITION 78 o Key points: can be administered thru SQ or IV; mon the pt for s/s of bleeding (coffee ground emesis, tarry stools); use a soft toothbrush & electric razor closely mon aptt levels Therapeutic levels of aptt: 1.5- 2 x baseline Baseline ptt levels- 30-40 sec Max ptt: ~80 seconds E.g. 100- seconds- out of therapeutic range; this is too long; very high risk for bleeding o How to remember: o **ANTIDOTE: PROTAMINE TERM 79
Hematologic Medications: Anticoagulants- IV
DEFINITION 79 o ****HIT-** is like an immune system type of rxn where your body forms this little micro-clots or thrombi all throughout the body and uses up all platelets and now you are risk for bleeding d/t low platelet count but all these micro clots flow down and cut off circulation thru the extremity; so people with HIT they end up getting their circulation cut off like their fingertips or toes and their fingers turn black or necrotic and start falling off b/c of lack of blood flow TERM 80
Hematologic Medications: Anticoagulants-
Oral
DEFINITION 80
Warfarin o Used for venous thrombosis, A-fib w/ thrombus,
prevention of MI & TIA, pulmonary embolism and DVTo Mode
of action: antagonize Vit K to prevent formation of several
clotting factorso SE: **bleeding, GI upset, possible hepatitis
Hematologic Medications: Anticoagulants-
Oral
o Key points: advise pt to maintain a steady intake of Vit K; mon pt for bleeding; have pt use soft toothbrush and electric razor; **closely mon pt and INR levels (this is the most accurate and common way to monitor the therapeutic level of Warfarin) Therapeutic INR: 2-3; it takes about 3-5 days to go back to this therapeutic levels Normal pt levels: 11-12.5 sec Therapeutic pt levels: 18-24 sec o **ANTIDOTE: Vitamin K o How to remember: Warfarin is going to war with Vit K TERM 82
Hematologic Medications: Factor XA
Inhibitor
DEFINITION 82 Rivaroxaban o Used to help prevent DVT, pulmonary embolism, stroke (w/ a pt with A-fib)o Mode of action: selectively inhibitors factor XA which blocks the coagulation cascadeo SE: bleeding, elevated liver enzymeso Key points: mon liver fx, mon hemoglobin & hct during therapyo How to remember: Rivaroxaban reminds me of a river; so this medication will make your blood flow like a river (itll thin it out and flow like a river) TERM 83
Hematologic Medications: Antiplatelets
DEFINITION 83 Aspirin, Abciximab, Clopidogrel o Used for prevention of MI or strokeo Mode of action: inhibiting platelet aggregationo SE: GI upset, bleeding, tinnitus w/ aspirin (ringing of the ears); should not give aspirin to children w/ fever d/t risk or Reyes syndrome o Key points: antiplatelets are contraindicated in pts with bleeding d/o d/t the key side effect of bleedingo How to remember: the way I remember Clopidogrel is it look like CLOP in the front which reminds me of a horse clopping on platelets and preventing aggregation TERM 84
Hematologic Medications: Thrombolytic
Medications
DEFINITION 84
Alteplase, Reteplase o Used in pts who had an MI, stroke,
pulmonary embolism, occluded central IVo Mode of action:
they convert plasminogen plasminbreaks up fibrinogen o SE:
**bleeding
TERM 85
Hematologic Medications: Thrombolytic
Medications
DEFINITION 85 o Key points: contraindicated in pts who had hemorrhagic stroke or internal bleeding or recent surgery or trauma or sever HTN; admin this medication w/in 3 hrs of onset of symptoms of the clot; closely mon labs and VS; limit venipuntures and IM injections d/t high risk of bleedingo How to remember: if youre trying to break up a clot then youve come to the right plase
Gastrointestinal Medications: Mucosal
Proteactant
Sucralfate (mucosal protectant) o Mainly used for duodenal ulcers and reacts w/ the stomach acid that creates a thick paste that adheres to the ulcerso Mode of action: o **SE: constipation o Key points: give it 1 hr before meals and at bedtime (will give it 4x a day); increase intake of fluid and fiber to help prevent constipationo How to remember: Suc this medication will suck down to the ulcers and protect those ulcers TERM 92
Gastrointestinal Medications: Antacids
DEFINITION 92 Aluminum Hydroxide, Magnesium Hydroxide, Sodium Bicarbonate, Calcium Carbonate o Used for peptic ulcer disease or GERDo Mode of action: neutralize stomach acido SE: aluminum & calcium antacids can result in ****constipation** ; however, antacids made from magnesium can cause ****diarrhea** o Key points: antacids are high maintenance medication b/c it needs to be taken 1 hr then 3 hr after meal and at bedtime; make sure to take it 1 hr before or after other medications; dont take it with meals TERM 93
Gastrointestinal Medications: Prostaglandins
DEFINITION 93
Misoprostol (Cytotec) o Used to prevent of gastric ulcers in
pts taking long-term NSAIDS; also used to ripen the cervix in
pregnant women who is going to be delivering (2 purpose)o
Mode of action: decrease stomach acid secretion and
increases the production of protective mucus and
bicarbonate in the body
TERM 94
Gastrointestinal Medications: Prostaglandins
DEFINITION 94 o **SE: dysmenorrhea, miscarriage (remember not to give this to a pregnant woman who has ulcers d/t risk of ripening of the cervix leading to miscarriage; run a pregnancy test first), and GI upset o Key points: o How to remember: its like miso me so pregnant so dont take misoprostol ; or mis-oprostol causes mis-carriage TERM 95
Gastrointestinal Medications: Antiemetics
DEFINITION 95 Ondansetron o Used to tx nausea and vomiting r/t chemotherapy, radiation, post-op patiento Mode of action: blocks serotonin receptors in the CTZ (chemoreceptors trigger zone)o SE: HA, dizziness, GI upseto Key points: give medication prior to chemotherapy (prophylaxis)o How to remember: I threw up on dan-ondansetron
Gastrointestinal Medications: Laxatives
Psyllium: bulk forming laxative that softens the stool and increases bulk Docusate Sodium: surfactant laxative; soften the stool by increasing water content Bisacodyl: stimulant laxative; stimulates peristalsis Magnesium Hydroxide: osmotic laxative that draws water into the intestine & also promotes peristalsis; mon with Mg toxicityo Key points: laxatives will be used for constipation; will not be used for any bowel obstruction; encourage pt to increase fiber and fluid intake; encourage exercise TERM 97
Gastrointestinal Medications: Laxative Used
for Hapatic Encephalopathy
DEFINITION 97
Lactulose o Used for constipation; also used for hepatic
encephalopathy (used to decrease ammonia levels and
improve the mental status for pts that have this)o Mode of
action: lowers the pH in the colon which in turn promotes
ammonia secretiono SE: GI upset, electrolyte imbalances,
hyperglycemia
TERM 98
Gastrointestinal Medications: Antidiarrheal
DEFINITION 98
Loperamide, Diphenoxylate plus Atropine o Used foro
Mode of action: stimulate opiod receptors in the intestines
which causes decrease in motility and increase absorption of
sodium and watero SE: constipation, drowsiness, opiod and
anticholinergic side effects for high dose
TERM 99
Gastrointestinal Medications: Prokinetic
Agents
DEFINITION 99
Metoclopramide o Used for nausea and vomiting,
gastrophoresis, & GERDo Mode of action: **accelerates
gastric emptying and blocks dopamine and serotonin
in the CTZ o SE: drowsiness, GI upset, extrapyramidal side
effects (muscle rigidity, tremors, twitching, tardive
dyskinesia, & restlessness)
TERM 100
Gastrointestinal Medications: Irritable bowel
syndrome (IBS)
DEFINITION 100 Alosetron- blocking the 5H3T receptors, increase the firmness of the stool and decreases the urgency.o **SE: constipation o How to remember: if you have too much diarrhea you may need an ALO- for your back side Lubiprostone- increases fluid secretion in the intestine & increases intestinal motilityo SE: Diarrhea and nausea How to remember: this meds will help lub that stool when constipated
