Drug Families

Card Set Information

Author:
MarieElise
ID:
291943
Filename:
Drug Families
Updated:
2014-12-30 01:31:53
Tags:
Pharmacology NCLEX
Folders:
NCLEX
Description:
General overview of drug families, MOA's, what they treat, AE's and contraindications
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  1. -olol
    Family
    Main action
    Treats
    Block adrenergic receptors (block sympathetic response)

    • decreased CO r/t decreased rate, strength of contractions
    • vasodilation
    • decreased renin →
    • decreased aldosterone  →
    • decreased sodium/water retention

    Treats: HF, MI, arrythmias, HTN
  2. Beta blockers AE's and contraindications
    bronchoconstriction: contraindicated in asthma, COPD

    use with caution in diabetics, can mask tachycardia that signals hypoglycemia

    depression, nightmares
  3. -arin
    Family
    Main Action
    Treats
    • Anticoagulants
    • inhibit clotting cascade and decreasing coagulability
    • Treats clotting disorders, prophylaxis
  4. Anticoagulant AE's and contraindications
    • hemorrhage
    • thrombocytopenia
    • hypotension

    Contraindications: ulcers, liver and kidney disease
  5. aPTT: measures blood level of which drug?
    normal value
    therapeutic value
    • Heparin
    • normal:  20-40 seconds
    • therapeutic: 1.5-2x normal
  6. at what aPTT value should drug dosage be increased?  Decreased?
    (which drug?)
    • 60 seconds: increase heparin dose
    • 80 seconds: decrease
  7. Antidote to heparin
    protamine sulfate
  8. generic name for low-molecular weight heparin
    Enoxaparin
  9. Clinical difference in heparin v. enoxaparin?
    enoxaparin is low weight, has a longer half-life, administered SQ only (v. IV heparin), used more short term
  10. Warfarin MOA
    Indication
    Antidote
    • antagonist to vitamin K
    • long-term anticoagulation
    • antidote: vitamin K (phytonadione)
  11. Warfarin blood level tests
    Normal and therapeutic values
    • PT (Prothrombin time): 9.6-11.8 seconds
    • therapeutic = 1.5-2x as long

    • INR:  normal = 1.3-2
    • Target usuall 2-3 (sometimes up to 4.5)
  12. -ase
    Family
    Main action
    examples
    • Thrombolytics
    • activate enzyme that breaks down clots

    • alteplase
    • reteplase
    • tenecteplase
  13. AE's and Contraindications of thrombolytics
    dysrhythmias

    recent Hx of surgeries

    Hx liver or kidney disease

    Uncontrolled HTN
  14. clopidogrel, cilostazol, dipyridamole
    antiplatelets
  15. dobutamine, dopamine
    Treats
    significant AE's
    • positive inotropic drugs
    • short term management of heart failure
    • Hepatotoxicity
  16. Digoxin main action
    • slows heart rate, increases force and efficacy of myocardial contractions
    • increases cardiac output
  17. Signs of digoxin toxicity
    • Early: GI-- anorexia, N/V/D
    • Late: bradycardia, heart block, PVC's, tachydysrhythmias, visual disturbances
  18. Digoxin levels above ___ are toxic
    2
  19. what electrolyte imbalances can increase likelihood of digoxin toxicity?
    hypokalemia

    hypomagnesemia

    hypothyroidism

    hypercalcemia
  20. AE's of thiazide diuretics
    hypokalemia, hyponatremia

    hypercalcemia, hyperglycemia

    Photosensitivity
  21. -ide
    loop diuretics

    • furosemide
    • bumetanide
    • torsemide
  22. loop diuretics v. thiazide -- efficacy
    loop diuretics more effective
  23. AE's of loop diuretics
    • hypo all electrolytes
    • thrombocytopenia

    ototoxicity, deafness
  24. -zosin
    Main action
    Treat
    alpha blockers

    decrease sympathetic vasoconstriction -> vasodilation, decreased BP

    Maintain renal blood flow
  25. -pril
    Main action
    Treats
    • ACE inhibitors
    • block conversion of angiotensin I to angiotensin II --> lower BP

    HTN, HF, cardioprotective effect after MI
  26. -sartan
    Main action
    Treats
    Angiotensin II Receptor Blockers (ARB's)

    prevent action of angiotensin II --> reduce BP

    HTN, HF
  27. AE's and contraindications of ACE inhibitors and ARB's
    Persistent dry cough, diminished taste (ACE only)

    hyperkalemia

    hypoglycemic reaction if diabetic
  28. What common side effect occurs with ACE inhibitors and what should the patient do about it?
    Persistent dry cough; call doctor if it persists
  29. -pine
    Main Action
    Treats

    which drug is an exception, does not end in -pine?
    • Calcium channel blockers
    • Nifedipine
    • Diltiazem

    decrease cardiac contractility --> decrease workload on heart and oxygen demand

    Treats angina, dysrhythmias, HTN
  30. what kind of drug would you use to treat Raynaud's disease?  What action do you need?
    Peripheral vasodilation

    alpha adrenergic blockers, calcium channel blockers
  31. 4 classes of antidysrhythmic medications
    • 1. sodium channel blockers
    •    -quinidine sulfate
    •    -phenytoin
    • 2. beta blockers
    • 3. potassium channel blockers (delay repolarization)
    •    -amiodarone
    • 4. Calcium channel blockers
    •    -nifedipine
    •    -diltiazem
  32. General side effects/AE's for antidysrhythmic drugs
    • hypotension (orthostatic)
    • Heart failure
    • GI upset/N/V/D
  33. -ine
    Main action
    treats
    examples
    • Adrenergic agonists
    • Dopamine
    • Dobutamine
    • Epinephrine

    Increases force of contractions -> increased cardiac output

    HF, cardiac arrest, shock
  34. AE's of adrenergic agonists

    Administer it where?
    • dysrhythmias
    • restlessness
    • urgency/urinary incontinence

    Administer through large vein
  35. -statin
    Main action
    treats
    • HMG-CoA Reductase inhibitors
    • Antilipemic
    • reduce cholesterol
  36. AE's of statins
    flatulence

    • Muscle cramps (report muscle pain immediately)
    • cataract formation
  37. lovastatin should not be administered with ______ or ________
    anticoagulants or immunosuppressive drugs
  38. calcium carbonate: family
    Main action
  39. antacids
    • react with acid to lower acidity
    • do not coat ulcer
  40. Misoprostol non-maternity use
    AE
    • suppresses secretion of gastric acid, prevent gastric ulcers
    • diarrhea and abdominal pain
  41. Sucralfate
    • gastric barrier
    • take on empty stomach, 2 hours away from other meds
    • may cause constipation
  42. -ine (GI)
    2 classes
    • 1)  muscarinic antagonists
    • suppress acid secretion
    • Pirenzepine

    • 2)  H2 Receptor Antagonists
    • suppress acid secretion
    • prevent ulcers, alleviate symptoms, promote healing
    • -Cimetidine
    • -Ranitidine
    • -Famotidine (Pepcid)
    • -Nizatidine
  43. Cimetidine
    • H2 Receptor Antagonist
    • take away from food (less effective), antacids (less effective), other meds (makes them more effective)
    • reduce dose in patients with renal impairment
  44. -prazole
    • Proton pump inhibitors
    • Suppress gastric acid secretion
  45. How do you treat H. pylori?
    With triple or quadruple antibiotic therapy and something to stop acid production (proton pump inhibitor) (easily becomes resistant to single antibiotics)
  46. Metoclopramide (Reglan)
    Main action
    when to administer
    contraindication
    stimulates motility of GI tract --> increase rate of gastric emptying without stimulating secretions

    • administer 30 min before meals and at bedtime
    • contraindicated in pts with mechanical obstructions, perforation, or GI hemmorhage
  47. bile acid sequestrants
    Main action
    noncompliance
    use caution in
    combine with bile salts to be excreted

    bad taste: take with juice

    use caution with suspected bowel obstruction or severe constipation: may worsen
  48. Lactulose
    treats hepatic encephalopothy by increasing peristalsis to expel ammonia
  49. key side effect of antiemetics
    priority intervention
    drowsiness

    protect from injury
  50. Bulk forming laxatives (name)
    psyllium
  51. stimulant laxatives (names)
    • bisacodyl
    • senna
  52. osmotic laxatives (names)
    • Magnesium hydroxide
    • magnesium citrate
    • sodium phosphate
    • polyethylene glycol and electrolytes
    • polyethylene glycol 3350
  53. lubricant laxative name
    mineral oil

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