Barbara's Exam 3 drugs

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NUTRITION & ELECTROLYTES

Micro K Use: correct potassium deficit, strengthen cardiac muscle contraction
Action: transmits and conducts nerve impulses, contracts muscle
Adverse: dysrhythmia, respiratory distress, cardiac arrest

Calcium Use: treat tetany, spasms, convulsions
Carbonate Action: calcium supplement for hypo/hypercalcemia
Adverse: hypercalcemia


CANCER AGENTS

Cytoxan Use: breast, lung, ovarian cancers; Hodgkins disease; leukemias; lympohomas
Action: alkylating agent: inhibits protein synthesis through interference with DNA replication
Adverse: bone marrow depression, leucopenia, thrombocytopenia, cardiotoxicity, hepatotoxicity

Neupogen Use: decrease length of post-cancer neutropenia; permit delivery of higher doses of chemotherapy; prevent severe thrombocytopenia with chemotherapy
Action: stimulates growth and differentiation of bone marrow stem cells
Adverse: tachycardia, pallor, confusion, thrombocytopenia

Procrit Erythropoietin
Use: anemia
Action: stimulates RBC production in bone marrow
Adverse: HTN, chest pain, injection site reaction, CVA, MI


RESPIRATORY AGENTS

Benadryl Antihistamine (1st generation)
Use: allergic rhinitis, itching, sleep aid, antitussive
Action: prevents allergic response
Adverse: agranulocytosis, hemolytic anemia, thrombocytopenia


Robitussin Antitussive and expectorant
DM Use: temporary relief of non productive coughs
Action: suppresses cough reflex by inhibiting cough control center in medulla, reduces viscosity of tenacious/stringy secretions
Adverse: hallucinations, CNS depression with very large doses

Alupent Sympathomimetic - tablet or inhaler
Use: asthma, bronchitis, emphysema (COPD)
Action: beta 2 agonist, bronchodilator
Adverse: dysrhythmias, HTN, cardiac arrest, paradoxical bronchoconstriction

Singulaire Leukotriene receptor antagonist:
Use: prophylaxis and maintenance of asthma. Not for acute attacks.
Action: interrupts bronchoconstriction
Adverse: none



Vanceril Glucocorticoid, long acting steroid
Use: inhaler for acute asthma attack COPD, allergies.
Action: suppresses inflammation and
Adverse: symptoms of hypercortism with large doses, HTN, hyperglycemia

Nedrocromil Mast cell stabilizer, inhaler
Use: prophylaxis and maintenance of bronchial asthma
Action: inhibits inflammation (histamine release)
Adverse: none


ANTIINFLAMMATORY AGENTS (NSAIDS)

Aspirin Use: dull pain in headache, cramps; acts on PNS pain receptor sites
Action: analgesic, antipyretic, antiplatelet, anti-inflammatory. Inhibits prostaglandin synthesis, inhibits heat-regulating center es
Adverse: tinnitus, ulceration, agranulocytosis, bronchospasm, thrombocytopenia, GI upset and bleeding

Toradol Use: analgesic, anti-inflammatory, antipyretic. Controls acute post-op pain. 5x as strong as morphine, should only be used short term.
Action: peripherally acting analgesic, inhibits prostaglandin synthesis by acting on Cox-1 and Cox-2 enzymes
Adverse: hemorrhage

Celebrex: Use: analgesic, Cox-2 inhibitor, doesn’t act on Cox-1; anti-inflammatory
Action: inhibits prostaglandin synthesis by inhibiting Cox-2
Adverse: Increased risk of cardiovascular events

Motrin: Use: reduce inflammation and fever
Action: inhibits prostaglandin synthesis, inhibits both Cox-1 and Cox-2
Adverse: GI bleeding, blood dyscrasias, cardiac dysrhythmias, nephrotoxicity


ANTIGOUT AGENTS

Zyloprim Use: antigout
Action: reduces uric acid synthesis
Adverse: retinopathy, cataracts, bone marrow disorders


ANTIBACTERIALS

Amoxil Peniclillin
Use: gram- and gram+ infections; ear infections, UTIs, etc.
Action: inhibits cell wall synthesis, bacterialcidal
Adverse: superinfections, blood dyscrasias, respiratory distress

Ancef Cephalosporin
Use: preop prophylaxis, UTI, bone, joint, soft tissue infections, bacteremia
Action: inhibits cell wall synthesis, destroys cell
Adverse: superinfections, seizures, anaphylaxis



Zithromax Macrolide
Use: gram+ and some gram- ; patients allergic to PCN; respiratory infections, gonorrhea
Action: inhibits protein synthesis; bacteriostatic/cidal
Adverse: superinfections, hepatotoxicity

Vibramycin Tetracycline
Use: treat uncommon bacterial infections
Action: inhibits protein synthesis; bacteriostatic/cidal
Adverse: blood dyscrasias, hepatotoxicity, CNS toxicity

Garamycin Aminoglycoside
Use: serious infections from gram- bacteria, PID, MRSA
Action: inhibits bacterial synthesis; bacteriocidal
Adverse: oliguria, superinfection, ototoxicity, nephrotoxicity, liver damage

Levoquin Fluoroquinolone
Use: lower respiratory tract, renal, bone, joint infections
Action: interferes with DNA enzyme, bacteriocidal
Adverse: encephalopathy, seizures, dysrhythmias

Bactrim Sulfonamide
Use: complex UTI, bronchitis, PCP (pneumonitis, most common cause of death in AIDS patients), burns
Action: inhibits protein synthesis, bacteriocidal
Adverse: bone marrow disorders, renal failure


ANTITUBURCULAR AGENTS

INH Use: TB treatment and prophylaxis
Action: Inhibits cell wall synthesis
Adverse: blood dyscrasias, hepatotoxicity



ANTIFUNGAL AGENTS

Diflucan Use: treat candida infections and meningitis
Action: Increases permeability of cell membrane
Adverse: none





ANTIVIRAL NON-HIV DRUGS

Zovirax Acyclovir
Use: treat HSV-2 (herpes simplex virus)
Action: Interferes with viral DNA synthesis
Adverse: nephrotoxicity, bone marrow depression, renal failure




HIV DRUGS

AZT Use: HIV infected clients and prevention of maternal-fetal HIV
Action: inhibits viral enzyme transcription
Adverse: anemia, seizures and convulsions


Sustiva Use: non nucleoside to use w/other antiretroviral agents
Action: binds to reverse transcriptase, blocks enzyme activity
Adverse: allergic rxn, convulsions, liver failure


Kalestra Use: treatment with other agent
Action: protease inhibitor
Adverse: hyperglycemia

VACCINE

Varivax Use: prevention of chicken pox
Action: stimulates active immunity against natural disease
Adverse: anaphylaxis, thrombocytopenia


MEDICAL ERROR DRUGS

INSULIN Humalog (Lispro): Rapid acting
Onset: <15 min
Peak: 0.5-1hr
Duration: 3-4hr

Regular: Short acting, only insulin given IV
Onset: 0.5-1hr
Peak: 2-4hr
Duration: 5-7hr

NPH: Intermediate acting
Onset: 1-2hr
Peak: 4-12hr
Duration: 18-24hr

Lantus: long duration
Onset: 3-4hr
Duration: 10-24hr


MORPHINE SULFATE
Use: severe acute and chronic pain, pre-op med, support anesthesia, relief of dyspnea of acute L ventricular failure and pulmonary edema and pain of MI
Action: narcotic opiate agonist
Adverse: cardiac arrest, resp. depression

HEPARIN Use: venous thrombosis, pulmonary embolism, thrombolitic complications
Action: inhibits fibrin formation, inactivates clotting factors
Adverse: bleeding, hemorrhage, hypotension


COUMADIN Use: DVT, pulmonary embolism, TIA, prophylactic for cardiac valves
Action: inhibits hepatic synthesis of vitamin K, decreases clotting factors in veins
Adverse: bleeding

KCL Use: potassium replacement
Action: intracellular cation, important for cardiac rhythm regulation
Adverse: very narrow therapeutic range, easy to become hyperkalemic and have dysrhythmias or hypokalemic and have cardiac arrest