-
lowers IOP by facilitating aqueous humor flow
side effects: heightened brown pigmentation of iris, eyelid and eyelashes
Latanoprost
-
lowers IOP indirectly by contraction of ciliary muscle and production of miosis
side effects: local irritation, eye pain, brow ache, renal detachment and decrease in visual acuity
Pilocarpine
-
Side effects of optic administration of beta blockers
Hint: local & systemic
- Local: conjuctivitis, blurred vision, photophobia and dry eyes
- Systemic: lungs and heart of great concern
-
a water-soluble dye that detects lesions of the corneal epithelium. abrasions and other defects turn bright green
Used topically or IV to assess aqueous humor flow -- IV used to facilitate retinal blood vessels, evaluate diabetic retinopathy and other abnormalities of the retinal vasculature
Flurorescein
-
a prokinetic drug that increases GI tone and motility
used to suppress postoperative N&V, emesis associated w/ cancer chemotherapy, radiation therapy, toxins and opioids
indications: GERD, CINV and diabetic paraesis
Reglan
-
motility antispasmodics
dicyclomine and hyoscyamine
-
antibiotic cocktail to treat ulcers
Nexium (esomeprazole), Amoxicillin, and Clarithromycin
-
acts topically to disrupt cell wall ofH. pylori, thereby causing lysis and death
antibiotic
#1 side effect is black hairy tongue and black stool
Bismuth (pepto-bismol)
-
effective antiulcer medication that promotes ulcer healing by creating a protectibe barrier against acid and pepsin
antiulcer drug/ a mucosal protectan
dosage 1gm 4x/day, taken 1 hour before meals and at bedtime
Carafate
-
this type of treatment are antisecretory agents that suppress acid secretion by blocking (a certain type of) receptors on parietal cells
H2 receptor antagonists
-
Examples of (antisecretory agents) H2 receptor antagonists
Pepcid, Zantac, Axid, Tagamet
-
an antisecretory agent that enhances mucosal defenses
an antiulcer drug that prevents gastric ulcers caused by long-term therapy of NSAIDs, helps protect stomach by suppressing secretion of gastric acid, serves as a replacement for endogenous prostaglandins
side effects: diarrhea, abdominal pain
Cytotec
-
prevention and treatment of duodenal ulcers; prevpack pack contains lansoprazole, amoxicillin and clarithromycin
taken immediately before meals; 15 or 30 mg 1x/day
side effects: diarrhea, abdominal pain, nausea
Prevacid
-
an antibiotic for ulcer therapy
disrupts cell wall and is good when given with Omeprazole (prilosec, a PPI)
Amoxicillin
-
examples of proton pump inhibitors
Nexium, Prevacid, Omeprazole (prilosec), protonix, aciphex
-
suppresses acid secretion by inhibiting H+, K+ - ATPase, the enzyme that makes gastric acid
Proton Pump Inhibitors (ends in "-azole")
-
an H2 receptor antagonist
promotes secretion of gastric acid, reduces both volume of gastric juice and its hydrogen ion concentration, suppresses basal acid secretion and secretion stimulated by gastrin and acetylcholine
since this drug produces selective blockade for H2 receptors, the drug cannot reduce symptoms of allergy
promotes healing of gastric and duodenal ulcers, drug of choice to relieve s/s of GERD, promote healing of ulcers in pt's w/ Zollinger-Ellsion syndrome, prevents aspiration pneumonitis
side effects: confusion, hallucinations CNS depression or excitation, etc in elderly pt's w/ hepatic or renal impairment
Tagamet (cimetidine)
-
releases carbon dioxide in stomach to cause belching and flatulence
side effects: constipation, hypercalcemia, metabolic alkalosis, soft tissue calcification and impaired renal function
Antacids -- Calcium carbonate
-
Drugs to control and induce vomiting a diarrhea; examples of antiemetics
Phenegran, Zofrn, Lomotil and Immodium
-
an opioid, nonspecific antidiarrheal agent, ANTIEMETIC
used only for diarrhea, taken orally, no significatn side effect on CNS
Lomotil
-
antiemetic
used to prevent N&V associated w/ radiotherapy and anesthesia by blocking serotonin (5-HT) peripherally, centrally, and in small intestines; very effective by itself but even more effective when combined w/ dexamethasone (glucocorticoid used for nausea associated w/ chemotherapy)
side effects: N/A
Zofran (ondansetron)
-
used to treat diarrhea and reduce the volume of discharge from ileostomies by suppressing bowel motility and from suppressing fluid secretion into the intestinal lumen
Immodium
-
antihistamine, H1 receptor antagosits (sedative), and antiemetic
acts on CTZ (chromoreceptor trigger zone) to decrease vomiting, increases CNS stimulation; acts on blood vessels, GI and respiratory ssytem; decreases allergic response
side effects: dizziness, drowsiness, poor coordination, fatigue, euphoria, confusion, parasthesia, neuritis, EPS, and neuroleptic malignant syndrome
Phenergan
-
drugs to relieve constipation
laxatives, catharsis, Purgative (go lytely)
-
soften stool and reduce painful elimination
leisure, relatively mild effect
laxative
-
prompt fuid eevacuation out of bowel
effect: relatively fast and intense
Cathertics
-
4 types of laxatives
bulk-forming, stimulant, surfactant, and osmotic laxatives
-
a laxative safe for people w/ cardiovascular or renal problems and if they are dehydrated
osmotic + bulk-forming laxative
Purgative (go lytely)
-
produces soft, formed stool 1-3 days after onset of treatment
bulk-forming laxative
-
produces a soft stool several days after onset of treatment
surfactant laxative
-
produces a semi-fluid stool w/in 6-12 hours
stimulant laxative
-
produces a soft or semi-fluid stool in 6-12 hours
osmotic laxative
-
a stimulant laxative
site of action in colon; stimualtes peristalsis and softens feces by increaing secretion of water and electrolytes into intestine and decreasing water and electrolyte absorption
unique among stimulant laxatives b/c it can be administered recal suppository and orally
Bisacodyl
-
examples of 5-HT3 receptor antagonists
- Zofran (ondansteron), granosetron, dolasetron, palonosetron
- ends in "-tron"
-
receptors located in the CTZ and on afferent vagal neurons in upper GI tract; relieves CINV
what additional drug would you expect to administer concurrently w/ these type of drugs
- 5-HT3 receptor antagonists
- dexamethasone
-
common, chronic inflammatory disorder of the airways (airway inflammation results from immune respnse to known allergens)
asthma
-
identify 2 current treatments options for asthma
anti-inflammatory drugs and bronchodilators
-
small, hand-held, pressurized device that delivers a measured dose of drug w/ each actuation
must begin to inhale prior to activating device, wait 1 minuted between puffs if 2 puffs are need, typically 1-2 puffs, hand-lung coordination required
1 expansion
metered-dose inhalers
-
these devices are available to be used w/ MDI devices and attach directly to the MDL. they increase delivery of the drug to the lungs and decrease deposition of the drug on oropharyngeal mucosa. some of these devices contain one-way valves that activate upon inhalation, so a person needs good hand-lung coordination. some of the devices have alarms that'll sound when inhalation is too rapid
spacers
-
small machines used to convert a drug solution into a mist for inhalation. droplets in mist are much finer than those in inhalers. inhalation done w/ facemask or mouthpiece. takes several minutes to deliver the same amount of the drug contained in 1 puff from an inhaler.
USED WHEN PT'S ARE RESISTANT TO BRONCHODILATERS. BRONCHODILATION - LUNGS KEEP EXPANDNG AND EXPANDING compared to an inhaler where you only get 1 expansion
nebulizers
-
drugs most commonly used in inhalers
ALBUTEROL (beta drug), cromolyn, zieluton, singulair, theophylline, ipitoprium
-
this drug is used for prophylaxis of asthma; suppresses bronchial inflammation
what would you expect patient outcome to be?
- Cromolyn
- pt will have suppressed/decreased inflammation
-
relaxes smooth muscles of bronchi, bronchioles, and pulmonary blood vessels; inhibits the enzyme phophodiesterase, thus increasing cyclic AMP, which promotes bronchodilation
this drug is a methylxanthine employed in asthma, has a narrow therapeutic index therefore dosage must be controled
side effects: GI disturbances, nervousness, irritability, cardiac dysrythmias, tachycardia, palpitations and hyperglycemia
theophylline
-
appropriate plasma levels for theophylline
considered toxic at what level?
- (5-15 in peyton's notes) 10-20 from book
- levels above 20 are considered toxic
-
makes cough more productive by stimulating the flow of respiratory tract secretions (guiafesin)
(stimulates flow of respiratory tract secretions to make cough more productive)
expectorant
-
suppresses cough, some act w/ CNS and some act peripherally (dextromethorphan)
antitussives
-
reacts directly w/ mucous to make it more watery (mucomyst) to help make cough more productive
(makes mucous more watery to make cough more productive)
Mucolytics
-
effects of antihistamines in mild allergic reactions
- in mild allergies are caused largely by histamine, so they are generally responsive to antihistamines
- suppose to decrease nasopharyngeal secreations, itching and tickling that causes sneezing
-
effects of antihistamines in severe allergic reactions
histamines play a much smaller role in anaphylaxis therefore antihistamines are of little help for treatment
-
side effects of antihistamines on allergic reactions
- sedation (most common) dizziness, confusion, nausea, vomiting, diarrhea
- ANTICHOLINERGIC EFFECTS: DRYING OF MUCOSA MEMBRANES IN MOUTH, NOSE AND THROATE, urinary hesitancy, constipation
-
these 2 things differ in antihistaminic efficacy and the ability to cause sedation and muscarinic blockade
1st generation vs 2nd generation antihistamines
-
CNS depression (SEDATION)
side effects: dry mouth, urinary hesitancy, drowsiness
1st genertion antihistamine
-
nonsedating antihistamines, poor cross of BBB, largely devoid anticholinergic effects, now available OTC
2nd generation antihistamines
-
inhibits leukotriene formation; bronchodilator; pt's will be able to breathe easier
Singulair (montelukast)
-
glucocorticoids, msot effective in antiansthma drug available
teaching?
side effects?
- inhaled steroids
- teaching: take on fixed schedule, used spacer if using MDI w/ CFCs but no spacer if using MDI w/ HFA
- side effects: oropharyngeal candidasis (hoarsness) and dysphonia (difficulty speaking), adrenal suppression, osteoporosis, decreased growth in kids, hyperglycemia, and PUD
-
reduced outflow of aqueous humor through chamber angle, causing IOP to gradually increase since fuid cannot leave the eye at the rate it is produced OR narrowed angle and forward displacement of iris
glaucoma
-
fuid pressure w/in the eye
intraocular pressure
-
powerful suppressant of acid secretion; approved for short-term therapy of duodenal ulcers, gastric ulcers, erosive esophagitis, and GERD. long-term therapy for Zollinger-Ellison synfrome
dosing: take before meal
Prilosec (PPI, omeprazole)
-
-
approved for treatment and prevention of duodenal ulcers and treatmet of gastric ulcers, GERD, and hypersecretory states (Zollinger-Ellison syndrome)
Pepcid (H2 receptor antagonsit, Famotidine)
-
this drug is similar to Prilosec - a powerful suppressant of acid secretion; approved for short-term therapy of duodenal and gastric ulcers, erosive esophagitis, and GERD. long-term therapy fr hypersecretory states (Zollinger-Ellison syndrome)
this drug achieves higher BP, lasts longer
side effects: headache, diarrhea
Nexium (esoemeprazole, PPI)
-
-
antibiotic
very effective against sensitive strains of H. pylori/ resistance
do not take if pregnant and don't consume alcohol
Flagyl (Metronidazole)
-
surfactant laxative, type 3
alter stool consistency by lowering surface tension, which facilitates penetration of water into feces
produces a soft stool after several days of onset treatment
Docusate
-
prototype surfactant
docusate sodium
Colace
-
dopamine antagonists
suppresses emesis by blocking dopamine receptors in CTZ. reduces emesis associated w/ surgery, cancer chemotherapy and toxins
what are the extrapyrimidal symptoms?
Phenothiazines and EPS
-
helps colon absorb water to soften feces and increase thier mass; effect is leisurely and relatively mild
fiber laxative
-
a PPI
for duodenal and gastric ulcers, GERD and hypersecretory states (Zollinger-Ellison syndrome)
Protonix (Pantoprazole, PPL)
-
2nd generation (nonsedating) H1 antagonist antihistamine, poorly cross BBB, administered orally and through nasal spray
a metered spray used for allergic fhinits
Azelastine
-
for allergic rhinitis and chronic idiopathic urticaria, causes more sedation than other 2nd generation antihistamines, but less sedation that 1st generation antihistamines
side effects: drowsiness, fatigue, dry mouth/nose/throat
Zyrtec
-
a sympathomimetics that is used for nasal decongestion; causes vasoconstriction (shrinks swollen membranes), only relieves stuffiness
what do you combine sympathomimetics with?
- Afrin
- combine sympathomimetics + antihistamines
-
for allergic rhinites, asthma and common cold; blockade of cholinergic receptors inhibits glandular secretions, thereby decreasing rhinorrhea; does not readily cross membranes
side effects: nasal drying and irritation
Ipratropium bromide
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