Pharmacology B

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kylemac
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Pharmacology B
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2012-05-19 14:32:57
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  1. penicillin V
    penicillin G
    • chemotherapeutics: beta-lactam antibiotics: penicillins
    • cell wall synthesis inhibitors

    Narrow-spectrum type: for sensitive strains of streptococci, meningiococci and spirochetes
  2. Dicloxacillin
    Nafcillin
    • chemotherapeutics: beta-lactam antibiotics: penicillins
    • cell wall synthesis inhibitors

    • penicillinase-resistant type: for staphylococcal infections (i.e. acute endocarditits and osteomyelitis), skin and soft tissue infections
    • bacteria resistant to these are termed MRSA
  3. Amoxicillin
    Ampicillin
    Piperacillin
    ticarcillin
    • chemotherapeutics: beta-lactam antibiotics: penicillins
    • cell wall synthesis inhibitors

    • Extended-spectrum type:
    • Aminopenicillins are used on streptococci and some enterococci; Amoxicillin largely used for RTI's (OM, sinusitis, bronchitis, community pneumonia).
    • Antipseudomonal types (piperacillin...) are for a range of gram + and -
    • All are becoming increasing combined with beta-lactase inhibitors (clavulanate, sulbactam).
  4. cephalexin
    cefazolin
    • chemotherapeutics: beta-lactam antibiotics: cephalosporins
    • cell wall synthesis inhibitors

    • 1st Generation:
    • cephalexin: skin/soft-tissue infections from gram + cocci
    • cefazolin: for more serious infections, used as a surgical prophylactic for staph and gram - bacilli
  5. cefotetan
    cefoxitin
    cefprozil
    cefuroxime
    • chemotherapeutics: beta-lactam antibiotics: cephalosporins
    • cell wall synthesis inhibitors

    • 2nd Generation:
    • has the same action against gram + but increased activity against gram -
  6. cefdinir
    cefotaxime
    ceftazidime
    ceftriaxone
    cefepime
    • chemotherapeutics: beta-lactam antibiotics: cephalosporins
    • cell wall synthesis inhibitors

    • 3rd generation:
    • effective against a wider range of gram - bacilli
    • Cefepime is aka a 4th generation as it is used against those that are resistant to other cephalosporins
  7. Aztreonam
    • chemotherapeutics: beta-lactam antibiotics: Monobactam
    • cell wall synthesis inhibitors

    useful for infections caused by multi drug resistant strains
  8. Imipenem
    Meropenem
    Ertapenem
    Doripenem
    • chemotherapeutics: beta-lactam antibiotics: Carbapenems
    • cell wall synthesis inhibitors

    • penicillin-like, broad spectrum
    • also good for multi drug resistant bacteria
  9. Vancomycin
    chemotherapeutics: cell wall synthesis inhibitor

    used to treat MRSA infections. Also good for C.diff,
  10. streptomycin
    gentamicin
    tobramycin
    Neomycin
    spectinomycin (Trobicin)
    • chemotherapeutics: inhibit protein synthesis
    • Aminoglycosides

    used with gram - or mycobacterial infections
  11. Doxycycline
    Minocycline
    Tetracycline
    Tigecycline (Tyacil)
    • chemotherapeutics: inhibit protein synthesis
    • Tetracyclines

    • used on mycoplasma pneumonia
    • can act bacteriocidal or bacteriostatic
  12. Clindamycin
    chemotherapeutics: inhibit protein synthesis

    used on MRSA and penicillin-resistant streptococci
  13. Azithromycin
    Erythromycin
    Clarithromycin
    • chemotherapeutics: inhibit protein synthesis
    • Macrolide and Ketolide antibiotics

    used on URTI's and pneumonia (community)
  14. Cipro (Ciprofloxacin)
    Rexar (Grepafloxacin)
    Levaquin (Levofloxacin)
    Trovan (Trovofloxacin)
    • chemotherapeutics: inhibit nucleic acid formation
    • Fluoroquinolones

    • respiratory infections (bronchitis, pneumonia, sinusitis, etc)
    • urinary and gastro infections (cipro and levo)
  15. Sulfisoxazole
    sulfamethoxazole
    sulfadiazine
    • chemotherapeutics: inhibit nucleic acid formation
    • Sulfonamides: antifolates (inhibit folic acid formation)

    used on UTI's, burn/skin infections (silver sulfadiazine)
  16. Bactrim
    Septra
    • chemotherapeutics: inhibit nucleic acid formation
    • combined trimethoprim-sulfamethoxazole (TMP-SMX)

    • trimethoprim can be used alone on prostatitis and vaginitis but is mainly combined with a sulfa drug to make it bacteriocidal and more potent
    • used on UTI's and protatic infections, some resp infections (pneumocystitis carinii in AIDS)
  17. Isotamine (isoniazid)
    Rifadin (Rifampin)
    Myambutal (Ethambutol)
    Tebrazid (Pyrazinamide)
    Streptomycin
    • Anti-TB agents: 1st line drugs
    • use in combinations: orders depend on degree on infection and +/- resistance to rifampin/isoniazid
  18. Rifamate
    Rifater
    • Anti-TB agents: 1st line drugs
    • manufactured combinations

    • Rifamate (Isoniazid + Rifampin)
    • Rifater (Isoniazid + Rifampin + Pyrizinamide)
  19. Rifabutin
    Rifapentine
    Fluoroquinolones
    cycloserine
    ethambutol
    amikacin
    azithromycin
    Anti-TB agents: 2nd line drugs

    used in combinations in cases of resistant strains (or on pt's who are immunocompromized, i.e. Rifabutin)
  20. Coumadin (warfarin)
    • Anticoagulant (antithrombotic)
    • Prevents venous thrombi formation; acts like Vit.K
    • effects take days to develope
  21. Heparin
    • Anticoagulant (antithrombotic)
    • prevents venous thrombi formation; potentiates endogenous anticoagulant activity
    • fast-acting
  22. Innohep (tinzaparin)
    Lovenox (Enoxaprin)
    • Low molecular weight heparins
    • anticoagulant (antithrombotic)
    • prevent venous thrombi formation

    longer duration of action than heparin
  23. Asprin (acetylsalicyclic acid; ASA)
    • Antiplatlet (antithrombotic), Non-Opiod Analgesic, anti-pyretic and anti-inflammatory
    • A nonselective Cyclooxygenase inhibitor

    use: pain, fever, inflammation, prophylaxis of MI, stroke and other thromboemolotic disorders.
  24. Persatin (Dipyridamole)
    • Antiplatlet (antithrombotic)
    • used in conguntion with other anticoagulants
    • keeps cAMP elevated, blocking platelet function
  25. Streptase (streptokinase)
    Activase rt-PA (alteplase)
    • Thrombolytic (antithrombotic)
    • convert plasminogen to plasmin which digests fibrin and other coagulation factors

    • use: acute MI
    • streptokinase: emboli and DVT's
  26. Protamine
    • anti-heparin agent
    • binds with heparin so it can't bind the AT-III protein anymore.
    • on its own, it can have anti-coagulant effects due to it's anti-platlet activity.
  27. Flolan (Epoprostenol)
    • Pulmonary vasodilator
    • mimics prostaglandin, PGI2 or prostacyclin
    • Autocoid

    • selective dilation of pulmonary vessels used for PPHN or pulmonary HTN from high PVR
    • also reduces platlet aggregation
    • continuous infusion- life long therapy
  28. Revatio (Sildenafil)
    • pulmonary vasodilator
    • Type 5 PDI

    • selective dilation of pulmonary vessels used for PPHN or pulmonary HTN from high PVR
    • oral, IV or inhalational
  29. Nitric oxide (iNO)
    pulmonary vasodilator

    • selective dilation of pulmonary vessels used for PPHN or pulmonary HTN from high PVR
    • *used for acute pulmonary HTN, refractory hypoxemia or post cardiac transplant
  30. normal saline (N/S)
    Ringer's lactate (R/L)
    Normosol
    Crystalloid volume expanders

    • use: hypotension due to plasma or blood loss
    • preferred for fluid replacement
  31. Albumin
    Pentaspan (pentastarch)
    Colloid volume expanders

    • use: hypotension due to plasma or blood loss
    • preferred if there is extensive 3rd spacing fluid loss; have high oncotic pressures
  32. RBC's
    platlets
    plasma...
    blood products used as volume expanders

    use: hypotension due to plasma or blood loss
  33. Valium (Diazepam)
    Ativan (Lorazepam)
    Versed (Midazolam)
    Sedatives/Anxiolytics: Benzodiazepines (BZ)

    • increase GABA at BZ receptora
    • use: anxiety, EtOH withdrawal, muscle relaxant, anti-convulsive, amnesia and sleep

    *Midazolam is used for conscious sedation (anethesia) and insomnia- preferred over barbiturates
  34. Precedex (dexameditomadine HCl)
    • sedative/anxiolytic
    • short-acting alpha-2 agonist

    use: sedation of intubated patients. Provides "co-operative" sedation= no delirium and doesn't affect respiratory centers.
  35. Anexate (Flumazenil)
    a benzodiazepine (BZ) antagonist

    competetive antagonist, reverses BZ effects or OD
  36. Luminal (phenobarbital)
    Pentothal (Thiopental)
    Hypnotics: Barbiturates

    • Powerful (rarley used still)
    • use: IV anesthesia, anti-convulsive, insomnia. Have anti-analgesic/hyperanalgesic effects and cause Resp depression
  37. Noctec (chloral hydrate)
    hypnotic

    used for pediatric patients as it doesn't cause hyperanalgesia or paradoxical excitement
  38. Imovane (zopiclone)
    Ambien (zolipedem)
    Sonata (zaleplon)
    Lunesta (exzopiclone)
    sedative-hypnotics

    use: insomnia
  39. Propofol (Diprivan)
    IV anesthetic-hypnotic

    • used in the OR and ICU for hypnotic properties. IV induction or pre-anesthetic sedation
    • rapid emergence, less hangover effects
  40. Etomidate (amidate)
    IV anesthetic-hypnotic

    use: IV anesthetic for conscious sedation or RSI. for sedation/hypnotic effects without analgesia
  41. Ketamar (ketamine)
    IV anesthetic-hypnotic

    • use: IV anesthetic, produces "dissociative anesthesia." Analgesia, reduced sensory perception, immobility and amnesia
    • useful in children
  42. Nozinan (methotrimeprazine)
    hypnotic: phenothiazine

    use: insomnia (esp in ICU with psychosis), anxiolytic, anagesic, neuralgia
  43. morphine
    Opioid anagesic

    use: moderate to severe acute or chronic pain. nebulized morphine used to treat dyspnea in end-stage diseases.

    opiods cause respiratory depression
  44. Dilaudid (hydromorphone)
    opioid anagesic

    • use: pain relief and cough supression.
    • 10x stronger than morphine; rapid onset and faster duration of action with less hypnotic effects
  45. Codeine
    opioid analgesic

    use: cough supressant, mild-moderate pain (combined with other anagesics)
  46. Demerol (Meperidine)
    opioid anagesic

    • use: second line agent for moderate to severe pain relief
    • 1/10 the potency of morphine
  47. Dolophine (methadone)
    opioid analgesic

    use: maintenance of narcotic addicts during heroine or morphine withdrawal
  48. Sublimaze (fentanyl)
    opioid analgesic

    • use: induction and maintenance of general anesthesia
    • same effects as morphine but shorter duration and more potent. No adverse CNS effects
  49. Sulfenta (sulfentanil)
    opioid analgesic

    • use: adjuct to anesthsia or as an anesthetic. Useful in cardiac surgery due to its lack of cardiac effects
    • 10x more potent than fentanyl
  50. Ultiva (remifentanyl)
    opioid analgesic

    • use: anagesia and anethesia
    • 3-5 min duration, decreases ICP, CMRO2 without touching CPP
  51. Narcan (Naloxone)
    Opioid antagonist (competetive)

    causes immediate reversal of OD symptoms
  52. Asprin (ASA)
    Motrin/Advil (Ibuprofen)
    Indocid (Indomethacin)
    Non-opioid analgesics: NSAIDS

    • inhibit cyclooxygenase pathway (non-selective COX inhibitors)
    • Asprin also has anti-inflammatory, anti-pyretic and anti-platelet properties
    • Indocid is used to help close a PDA in neonates
  53. Tylenol (acetaminophen)
    Non-opioid analgesic: Para-aminophenol derrivatve

    use: mild-moderate pain, anti-pyretic, works better on the CNS than the PNS
  54. Xylocaine (lidocaine)
    Novocaine (Procaine)
    Marcaine (Bupivacaine)
    cocaine
    local anesthetics

    • cocaine has good topical effects and its own vasoconstrictor
    • lidocaine is a prototype: can be admin parenterally, orally and topically

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