Pharm Test 2

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melissafaye2006
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236809
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Pharm Test 2
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2013-09-30 17:50:19
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Pharm Test 2 Drugs
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  1. ethinyl estradiol with norethindrone
    (Ortho-Novum 1/35)
    Mechanism of action: to inhibit release of FSH and LH, thus preventing ovulation

    Primary use: as contraceptive, for improvement in menstrual cycle regularity, to decrease incidence of dysmenorrhea

    • Adverse effects: edema, nausea, abdominal cramps, dysmenorrhea,breast tenderness, fatigue, Skin rash, acne, headache, weight gain, midcycle breakthrough bleeding, vaginal candidiasis, photosensitivity,
    • changes in urinary patterns

    Serious cardiovascular side effects more common in smokers
  2. conjugated
    estrogens (Premarin) and conjugated estrogens with medroxyprogesterone
    (Prempro)
    Mechanism of action: replacement for female sex hormones, to exert positive metabolic effects

    Primary use: for postmenopausal replacement therapy

    Also to treat abnormal uterine bleeding due to hormonal imbalance

    Adverse effects: nausea, fluid retention, edema, breast tenderness, abdominal cramps and bloating, acute pancreatitis, appetite changes, acne, mental depression, decreased libido, headache, fatigue, nervousness, weight gain
  3. medroxyprogesterone
    (Provera)
    Mechanism of action: Inhibits effect of estrogen on uterus, restores normal hormonal balance

    Primary use: to treat dysfunctional uterine bleeding, secondary amenorrhea, contraception

    May also be given IM for palliation of metastatic uterine or renal carcinoma

    Adverse effects: breakthrough bleeding, breast tenderness, weight gain, depression, hypertension, nausea, vomiting, dysmenorrhea, and vaginal candidiasis

    Most serious side effect: increased risk for thromboembolic disease
  4. oxytocin (Pitocin, Syntocinon)
    • Mechanism of action: to induce labor by increasing frequency and force of uterine
    • contractions

    Primary use: as drug of choice for inducing labor

    • Adverse effects: Complications in fetus include dysrhythmias or intracranial
    • hemorrhage

    Serious complications in mother may include uterine rupture, seizures, coma
  5. testosterone base (Andro)
    Mechanism of action: Stimulates RNA synthesis and protein metabolism

    Primary use: for treatment of hypogonadism in males

    Adverse effects: virilization, salt and water often retained, causes edema, liver damage, acne and skin irritation
  6. sildenafil (Viagra)
    • Mechanism of action: Relaxes smooth muscle in corpus cavernosum, blocks
    • enzyme phosphodiesterase-5, allows increased blood flow into penis

    Primary use: to treat erectile dysfunction

    Adverse effects: Most serious is hypotension, headache, dizziness, flushing, rash, nasal congestion, diarrhea, dyspepsia, UTI, chest pain, indigestion, blurred vision, changes in color perception, priapism
  7. finasteride
    (Proscar)
    Mechanism of action: Inhibits 5-alpha-reductase

    Primary use: Promotes shrinkage of enlarged prostates, also prescribed to promote hair regrowth

    Adverse effects: sexual dysfunction, impotence, diminished libido, ejaculatory dysfunction
  8. Plan B – levonorgestrel
    May be administered within 72 hours after unprotected sex

    Prevents implantation of fertilized egg

    Two doses, 12 hours apart; most effective when taken within 120 hours (5 days) of unprotected sex
  9. misoprostol (Cytotec)
    Pharmacological abortion
  10. oxytocin (Pitocin, Syntocinon)
    Mechanism of action: to induce labor by increasing frequency and force of uterine contractions

    Primary use: as drug of choice for inducing labor

    Adverse effects: Complications in fetus include dysrhythmias or intracranial hemorrhage. Serious complications in mother may include uterine rupture, seizures, coma
  11. magnesium slufate (tocolytic)
    Use: Prolong pregnancy

    Adverse effects:
     complete heart block, circulatory collapse, respiratory paralysis
  12. bromocriptine (parlodel)
    reduction of high prolactin levels
  13. clomiphene (clomid, milophene, serophene)
    Drug of choice for female infertility due to lack of ovulation

    • Stimulates release of LH
    • Results in maturation of increased number of ovarian follicles
    • Promotion of follicle maturation and ovulation
  14. GnRH Antagonists
    Prevention of premature ovulation or control of endometriosis
  15. GnRH Analogs/Agonists
    Suppression of FSH and control of endometriosis
  16. Androgens vs. Anabolic Steriods
    Used to treat hypogonadism; increase libido and correct erectile dysfunction

    VS.

    • Testosterone-like compounds
    • Frequently abused by athletes, even though illegal
  17. epinephrine (Adrenaline, Epinephrine)
    Action – alpha1, alpha2, beta1, and beta2 agonist

    Potent Inotropic – force of contractioins

    Use – in emergencies anaphylaxis, bronchospasm, cardiac arrest, potent vasoconstrictor

    Route – inhaled, SQ, IV, topically (lidocaine)

    Side Effects – A/N/V, tremors, tachycardia, pulmonary edema, HTN

    Precautions – (b/c it increases all of these) use cautiously with HTN, BPH, DM, Hyperglycemia, Hyperthyroidism
  18. Norephinephrine (Levophed)
    Similar to epi

    Does NOT stimulate beta2

    Does not cause hypoglycemia

    Cardiac and critical care

    Hypotension, shocky states – cardiac arrest, potent vasoconstrictor
  19. pseudoephedrine (Sudafed and others)
    Stimulate alpha1 and beta2 – “spills over to others”

    Used topically to tx rhinitis and sinus congestion
  20. phenylephrine (Neo-Synephrine, Allerest, Dristan, Dimetapp)
    Mechanism of action: potent vasoconstrictor - decongestant

    To stimulate the sympathetic nervous system directly/indirectly

    Produce many of the same responses as the anticholinergics
  21. clonidine (Catapress)
    Used primarily as antihypertensive agents.
  22. isoproterenol (Isoprel)
    Action – stimulates beta1&2 receptors

    Use – bronchospasm, asthma, bronchitis, emphysema, CHF, heart block, shock and cardiac arrest

    Contraindicated – CAD, DM, tachycardia, tachydysrhythmias, sensitivity to SNS stimulation

    Adverse effects – N/V, tachycardia, dysrhythmias, hypertension, hypotension

    Nsg Resp – start with small doses and increase slowly as tolerated, monitor pt
  23. dopamine (Intropin)
    Mimics endogenous dopamine – stimulates Beta1 receptors, some Alpha1 too

    Action – dose related

    Low doses – increased renal perfusion Moderate doses – increase force of heart High doses – vasoconstriction, increased BP, decreased renal perfusion
  24. dobutamine (Dobutrex)
    Similar to dopamine in action, increased contractility, increased SV

    Used to increase cardiac output, and tx CHF and cardiogenic shock
  25. albuterol sulfate (Proventil, Ventolin)
    Selective for beta 2 receptors

    Use – tx bronchospasm, asthma, rapid short acting – rescue inhaler

    Route – inhaled, PO

    Side effects – tremor, tachycardia, dysrhythmia, dizziness

    Nsg Resp – avoid use with HTN, severe cardiac disease, avoid taking with MAOIs – psych/antidepressant, do not use w/increase BP
  26. metaproterenol sulfate (Alupent, Metaprel)
    Similar to albuterol
  27. prazosin (Minipress)
    Mechanism of action: to inhibit the sympathetic nervous system

    Primary use: hypertension, dysrhythmias, angina, heart failure, benign prostatic hypertrophy, narrow-angle glaucoma

    Adverse effects: dizziness, drowsiness, headache, loss of energy and strength, palpitations, dry mouth, 1st dose syncope
  28. doxazosin mesylate (Cardura)
    Similar to prazosin

    Used for HTN and BPH, longer acting
  29. phentolamine mesylate (Regitine)
    Use – PVD, and tx tissue necrosis from extravasation of certain meds
  30. propranolol HCL (Inderol)
    Use – tx dysrhythmias, HTN, angina, MI, migraine prophylaxis

    Action – blocks beta1 and beta2 adrenergic receptor sites

    Side effects – bradycardia, H/A, fatigue, hyper/hypoglycemia, blood dyscrasias, laryngospasm, sexual disfunction
  31. Pilocarpine HCL (Pilocar)
    Has limited usage. Constricts the pupils

    Use – tx Glaucoma

    Side effects – stinging/burning topically

    Also causes systemic side effects 

    Antidote – atropine sulfate
  32. bethanechol (Urecholine)
    Mechanism of action: to the cholinergic (muscarinic) receptor

    Uses: urinary retention, abdominal distention

    Adverse effects: N/V/D, flushing, salivation, sweating, increased muscle tone, urinary frequency, bradycardia, orthostatic hypotension miosis, abd discomfort, muscle weakness, acute asthmatic attach, heart block, cardiac arrest
  33. Nicotine (Habitrol, Nicoderm, Nicotrol)
    Use – smoking cessation, nicotine replacement.

    Route – gum, patch, nasal spray

    Nsg Resp – avoid tobacco products

    varenicline (Chantix) – similar
  34. Neostigmine (Prostigmin)
    Use – tx myasthenia gravis, postop urinary retention, paralytic ileus

    Action – blocks enzyme to increase acetylcholine at receptor sites
  35. Atropine Sulfate
    Action – blocks acetylcholine, increases heart rate, paralyzing the iris sphincter

    Use – as preoperative medication, antispasmodic drug for tx peptic ulcers, to increase heart rate, to dilate pupils for eye exams

    Side effects – dry mouth, blurred vision, constipation, urinary retention, H/A, N, decreased perspiration, dry skin, abd distension, tachycardia, photophobia, hypo/hypertension, impotence, coma
  36. benztropine (Cogentin)
    Used to tx parkinson’s disease and EPS
  37. ipratropium bromide (Atrovent)
    Used with asthma, and rhinorrhea
  38. scopalamine hydrobromide
    (Scopalamine, Hycoscine, Transderm Scop)
    Used for motion sickness, preanesthetic
  39. trihexyphenidyl (Artane)
    Dicyclomine HCL (Bentyl)
    tiotripoum (Spiriva)
    tolterodine (Detrol)
    Anticholinergics
  40. propantheline bromide (Pro-Banthine)
    Synthetic anticholinergic
  41. cyclophosphamide (Cytoxan)
    Alkylating Agents
    Mechanism of action: Attaches to DNA and disrupts replication

    Primary use: to treat wide variety of cancers, including Hodgkin's disease, lymphoma, multiple myeloma, breast cancer, ovarian cancer

    Adverse effects: immunosuppressant effects, thrombocytopenia, nausea, vomiting, anorexia, diarrhea, alopecia, hemorrhagic cystitis
  42. mechlorethamine (Mustargen)

    cisplatin (Platinol, Cisplatinum, CDDP)

    Nitrosureas (alkylating agents)
    carmustine (BCNU)
    streptozocin (Zanosar)
    lomustine (CeeNU)
    Alkylating Agents
  43. methotrexate (Rheumatrex, Trexall)
    Antimetabolites
    • Mechanism of action: Blocks synthesis of folic acid
    • (vitamin B9) to inhibit replication

    • Primary use: to treat choriocarcinoma,
    • osteogenic sarcoma, leukemias, head and neck cancers, breast carcinoma, lung
    • carcinoma

    • Adverse effects: fatal bone marrow toxicity at high doses, hemorrhage and bruising, low
    • platelet counts, nausea, vomiting, anorexia, gastrointestinal ulceration, intestinal bleeding
  44. doxorubicin (Adriamycin)
    Antitumor Antibiotics
    Mechanism of action: Attaches to DNA, distorts double helical structure and prevents normal DNA and RNA synthesis

    Primary use: solid tumors of the lung, breast, ovary, and bladder, and for various leukemias and lymphomas

    Adverse effects: cardiotoxicity, dysrhythmias, irreversible heart failure, lower blood cell counts, nausea, vomiting
  45. daunorubicin (DNR, Cerubidine)

    bleomycin (Blenoxane)
    Antitumor Antibiotics
  46. vincristine sulfate (Oncovorin, Oncovin)

    vinblastine (Velban)
    • Mitotic Inhibitors/Natural Products
    • Vinca alkaloids
  47. paclitaxel (Taxol)

    docetaxel (Taxotere)
    • Taxanes
    • Mitotic Inhibitors/Natural Products
  48. vincristine (Oncovin)
    Mitotic Inhibitors/Natural Products
    Mechanism of action: cell cycle–specific (M-phase) agent that kills cancer cells by preventing their ability to complete mitosis

    Primary use: treatment of Hodgkin's and non-Hodgkin's lymphomas, leukemias, Kaposi's sarcoma, Wilms' tumor, bladder carcinoma, breast carcinoma

    Adverse effects: nervous system toxicity, numbness and tingling in limbs, muscular weakness, loss of neural reflexes, pain, paralytic ileus, constipation, alopecia
  49. Adrenocorticosteroids
    (prednisone,    dexamethasone, others)

    Androgens (testosterone, FSH, LH)

    Estrogens (diethylstilbestrol [DES],     estradiol

    Progestins megestrol acetate (Megace)

    Antiestrogens

    Tamoxifen (Nolvadex)

    Raloxifen (Evista)

    Aromatase inhibitors

    letrozole (Femara)

    anastroxol (Aramidex)
    Hormone/Hormone Antagonists
  50. tamoxifen
    Hormone/Hormone Antagonists
    Mechanism of action: Blocks estrogen receptors on breast cancer cells

    Primary use: patients with breast cancer. Also given to high-risk patients to prevent disease

    Adverse effects: nausea and vomiting, association with increased risk of endometrial cancer and thromboembolic disease, hot flashes, fluid retention, vaginal discharges common
  51. bevacizumab (Avastatin)

    rituximab (Rituxan)

    trastuzumab (Herceptin)
    Monoclonal antibodies (MABs) – targets and binds to a specific CA cell
  52. aldesleukin (Proleukin)
    Interleukins
  53. Monoclonal antibodies
    (MABs) 

    Interleukins
    Biologic Response Modifiers, Immune Therapies
  54. interferon alfa-2a (Roferon-A)

    interferon alfa-2b (Intron-A)
    Interferons

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