Phenobarbaratol's Lovely list of Exam 2 drugs

We don't 'need' to know this set of drugs anymore, but we do 'need to know them forever.' So here's another tidy list o' exam 2 drugs compliments of Barbara. Thanks Barb[ituate]!


ANTIEMETICS

Benadryl Antihistamine
Use: allergy, insomnia, motion sickness
Adverse: cardiovascular collapse, anaphylactic shock.

Phenergan Dopamine antagonist, anticholinergic, phenothiazine
Use: suppresses CTZ , CNS depressant
Adverse: resp. depression, agranulocytosis, apnea

Haldol Dopamine antagonist
Use: chemo pts, post-op, Tourettes
Adverse: laryngospasm, resp. depression

Reglan Dopamine antagonist
Use: enhance GI motility, nausea
Adverse: sedation, HTN crisis

Ativan GABA mediated, benzodiazepine
Use: anxiety, suppress REM sleep
Adverse: hyper/hypotension

Zofran Selective serotonin antagonist in CTZ and vagus nerve
Use: nausea
Adverse: diarrhea

Decadron Hormone, glucocorticoid
Use: anti-inflammatory, immunosuppressant, reduces capillary dilation
Adverse: edema, hyperglycemia, bowel perforation, impaired wound healing

Cannabinoids


ANTIDIARRHEAL

Lomotil Synthetic opiate agonist
Use: reduces GI motility
Adverse: constipation, paralytic ileus

Sandostatin Hormone, somatostatin analog
Use: stimulates fluid & electrolyte absorption from GI tract, prolongs intestinal
transit time
Adverse: hyper/hypoglycemia, constipation

Kaopectate OTC antidiarrheal
Use: coats muscosa, binds bacteria and toxins that cause diarrhea
Adverse: CNS depression, constipation









LAXATIVES

Lactulose Osmotic
Use: moves water from plasma to intestines, stimulates peristalsis
Adverse: diarrhea, hypernatremia

Dulcalax Contact irritant
Use: irritates nerve endings and induces peristalsis
Adverse: electrolyte disturbance, esp. Ca and K

Metamucil Bulk laxative (mucilloid)
Use: bulk producing, promotes natural elimination
Adverse: if not taken with enough water, have hard BMs and possible blockage

Colace Emollient
Use: prevention of constipation


ANTIULCER

Amphojel Antacid
Use: neutralizes stomach acid and reduces gastric activity
Adverse: constipation

Zantac Histamin 2 blocker
Use: GERD, block parietal cells from producing acid
Adverse: hepatotoxicity, toxicity w/Metroprolol, cardiac dysrythmias

Prevacid PPI
Use: suppress gastric acid production
Adverse: diarrhea, elevated liver enzymes

Carafate Mucosal protectant
Use: absorbs bile, inhibits pepsin, blocks diffusion of H+, protects mucosa

NEURO: SYMPATHOMIMETIC

Epinephrin Adrenergic agonist
Use: anaphylaxis, cardiac arrest, asthma, glaucoma
Adverse: acute MI, V fib, pulmonary edema

Albuterol Beta 2 agonist
Use: bronchospasm
Adverse: bradycardia, tachycardia, hyper/hypotension

Atenolol cardio-selective beta blocker
Use: Acute MI, hypertension, angina. Decreases symp. flow to periphery, decreases rennin activity
Adverse: hypotension, bradycardia, CHF







NEURO: PARASYMPATHOMIMETIC

Urecholine Cholinergic agonist
Use: increases parasympathetic response (rest and digest). Relaxes GI tract and bladder. Used for post-op and postpartum urinary retention, BPH
Adverse: transient complete heart block, asthma

Atropine Anticholoinergic
Use: increase heart rate and cardiac output, bronchodilator, decrease GI spasm
Adverse: V fib, paralytic ileus

CNS STIMULANTS

Ritalin Cerebral cortex stimulant
Use: ADHD, narcolepsy
Adverse: hepatotoxicity, exfoliative dermatitis

Imitrex Serotonin agonist
Use: migraine, vasoconstricts cranial vessels
Adverse: angina, HTN, MI, cardiac arrest, coronary artery vasospasm

CNS DEPRESSANTS

Seconal Barbituate
Use: insomnia, pre-op for general, spinal or local anesthesia
Adverse: dependency, decreased LOC, resp. depression

Xanax Benzodiazepine
Use: anxiety, panic, increases GABA
Adverse: resp. depression, REM rebound

NEURO: PAIN MANAGEMENT

Tylenol NSAID, nonnarcotic analgesic
Use: mild to moderate pain, lowers body temp with fever
Adverse: hepatotoxicity, acute renal failure, coma

Morphine Narcotic opiate agonist
Use: severe acute and chronic pain; relief of dyspnea of acute L ventricular failure and pulmonary edema and pain of MI.
Adverse: cardiac arrest, resp. depression

Demerol Synthetic Morphine, narcotic opiate agonist
Use: moderate to severe pain, pre-op med, support anesthesia
Adverse: resp. depression, cardiac arrest, bronchoconstriction, CNS toxicity and seizure

Dilaudid Synthetic narcotic opiate agonist
Use: 8-10 times more potent than morphine, moderate to severe pain, cough suppressant
Adverse: resp. depression

Narcan Narcotic antagonist
Use: overdose of opiates, resp. sedation and hypotension
Adverse: HTN, tachycardia, elevated PT

ANTICONVULSANTS

Dilantin Reduces voltage, frequency and spread of electrical charges in motor cortex.
Use: controls grand mal seizures, psychomotor and nonepileptic seizures
Adverse: cardiovascular collapse, aplastic anemia, agranulocytosis, exfoliative dermatitis, toxic epidermal necrosis

Valproate Increases bioavailability of GABA to brain, decreases neuronal discharge in CNS Use: management of absence (petit mal) and mixed seizures, mania, migraine
Adverse: liver failure, coma, bone marrow depression

Neurontin GABA analog, mechanism of action unknown
Use: promotes GABA release for treatment of partial seizures and neuropathic pain
Adverse: increased frequency of partial seizures

NEUROLOGICAL DISORDERS

Sinemet Anticholinergic
Use: makes more levodopa available to brain for management of Parkinson’s Disease symptoms.
Adverse: neuroleptic malignant syndrome, depression/suicidal ideation

Cognex Cholinergic / cholinesterase inhibitor
Use: elevates Ach levels in cerebral cortex, improves memory in early stage Alzheimer’s and dementia
Adverse: hepatotoxicity, diarrhea

PSYCHIATRIC AGENTS *anticholinergics inc. HR, dec GI, dilate pupils, inhibit sweating

Prolixin Dopamine antagonist, phenothiazine, anticholinergic
Use: antipsychotic, schizophrenia. Combined anticholinergic, thermoregulatory effects. Depresses PNS
Adverse: agranulocytosis, grand mal seizures, impaired thermoregulation

Haldol Dopamine antagonist, nonphenothiazine
Use: agitation of psychosis, Tourette’s, short term treatment for hyperactive children, severe behavior problems in children
Adverse: laryngospasm, agranulocytosis, tardive dyskinesia, neuroleptic malignant syndrome, resp. depression

Ativan GABA inhibitor, benzodiazepine
Use: anxiety, insomnia
Adverse: hyper/hypotension

Elavil Serotonin and norepinephrine blocker, tricyclic antidepressant (TCA)
Use: major depression, anxiety, bipolar disorder
Adverse: agranulocytosis, thrombocytopenia, seizures

Prozac Selective Serotonin Reuptake Inhibitor
Use: depression, OCD, bulimia, premenstrual dysphoric disorder
Adverse: sexual dysfunction, anxiety, insomnia, diarrhea




Buspar Dopamine agonist in brain, serotonin reuptake inhibitor
Use: anxiety
Adverse: interacts with grapefruit, causes toxicity

Lithium Competes with cations and affects body water, neurotransmitters. Inhibits neurotransmitters and decreases receptor activity to control manic phase of bipolar disorder
Adverse: peripheral circulatory collapse


ENDOCRINE AGENTS

THYROID DRUGS

Synthroid Thyroid replacement, increases metabolism, oxygen consumption, body growth
Use: treat myxedema, hypothyroidism
Adverse: tachycardia, HTN, thyroid crisis, angina, CV collapse

ADRENAL DRUGS

Prednisone Glucocorticoid, synthetic analog of cortisone, anti-inflammatory
Use: cancer therapy, dermatologic disorders, immunosuppressant, decrease inflammation
Adverse: delayed wound healing, infection, muscle wasting, hypokalemia, asceptic necrosis of bone

Vanceril Glucocorticoid, inhaled
Use: treat steroid dependent asthma, rhinitis
Adverse: immunosuppression

Solu-Medrol Corticosteroid
Use: intermediate acting anti-inflammatory for allergic rxn, short-term asthma therapy, cerebral edema
Adverse: immunosuppression

ANTIDIABETIC DRUGS

INSULIN (subcut) Use: Type 1 DM

Lispro Rapid acting, shorter duration than regular insulin
Onset: 5 min. (< 15 min)
Peak: 0.5 – 1h
Duration: 3-4h

Regular Humulin R
Short acting – only insulin given IV Clear, colorless
Onset: 0.5 – 1h
Peak: 2 – 4h
Duration: 5 – 7h

Humulin NPH Intermediate acting, cloudy suspension (zinc insulin crystals)
Onset: 1 -2h
Peak: 4 – 12h
Duration 18 – 24h


Lantus Long duration, usually given at bedtime
Onset: 3 -4h
Peak:
Duration: 10.4 – 24h

Adverse side effects of subcut insulin: hyperinsulinemia, coma, psychic disturbances with overdose, hypoglycemia.

INSULIN (oral) Use: Type 2 DM, adjunct to diet control of hyperglycemia

Glucotrol Sulfonylurea: stimulates beta cells to make insulin. Increases insulin binding at receptors. Inhibits hepatic glucose production.
Adverse: hypoglycemia, coma

Prandin Meglitinide: stimulates release of insulin by pancreatic islets
Adverse: hypoglycemia

Actos Glitizone: stimulates insulin secretion, increases insulin receptor sensitivity, decreases hepatic glucose output,
Adverse: hypoglycemia

Glucophage Fixed combination: glyburide-metformin, Stimulates release of insulin from pancreas. Metformin decreases cell resistance, decreases hepatic glucose production, increases glucose uptake.
Adverse: upper resp. infection, diarrhea, lactic acidosis

Glucovance Biguanide: (Metformin) decreases cell resistance, prevents liver breakdown of glycogen, stimulates release of insulin.
Adverse: upper resp. infection, diarrhea, lactic acidosis

Precose Alpha-glucosidase inhibitor: delays absorption of glucose in GI tract.
Adverse: hypoglycemia, anemia