N304 Final

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Author:
cban09
ID:
85803
Filename:
N304 Final
Updated:
2011-05-14 16:24:38
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Pharmacology Pharm Saarmann N304 Nursing
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Description:
All heart/BP drugs, diabetic drugs, CAM drugs
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  1. Lipid Solubles?
    • ETOH
    • Gas Anesthetics
    • Barbiturates
  2. Not lipid soluble: ABX
  3. UEM
    EM
    PM
    • Ultra
    • Extensive Metabolizers
    • Poor
  4. How many half-lives to reach steady-state?
    5
  5. MEC
    MTC
    • Minimum Effective Concentration
    • Minimum Toxic
  6. Tachyphylaxis
    Quick drug tolerance
  7. What Vitamin interferes with Coumadin?
    Vitamin K found in green leafy vegetables
  8. Garlic IXs
    • insulin
    • hypoGs
    • Coumadin
    • antiHTNs
    • phenelzine
  9. Ginseng IXs
    • insulin
    • hypoGs
    • Coumadin
    • antiHTNs
    • phenelzine
    • CNS depressants
  10. IXs with CNS depressants
    • Ginseng
    • Kava
    • St Johns
    • Valerian
  11. St Johns IXs
    SSRIs
  12. IXs with anticoags
    • Garlic
    • Ginseng
    • Gingko
    • Ginger
    • Feverfew
  13. Dangerous CAMs
    • Chaparral: kidney, lymph
    • Comfrey: liver, lung, kidney, GI
    • Ephedra: CV
    • Kava: liver
    • Lobelia: depression, HTN
    • Yohimbe: HTN, tachy, dizzy, HA
  14. CAMs that inhibit clotting
    • chamomile
    • dandelion
    • dong quoi
    • horse chestnut
  15. CAMs that cause CNS depression
    • hope
    • kava
    • passion flower
    • valerian
  16. CAMs that decrease PLT aggregation
    • bilberry
    • don quoi
    • feverfew
    • fish oil
    • grape seed
    • Gs: garlic, ginseng, gingko
  17. Nitrates
    SE
    IX
    • HA, flushing, tachy, tolerance
    • CCB, Betas, ETOH, VIAGRA
  18. Beta Blockers
    FX
    SE
    IX
    • -chronotrope, -inotrope, after MI, no tolerance, taper off
    • bady, HF, hypoTN, metabolism, dizzy, lethargy, depression, dreams, impotence, wheeze
    • diuretics, antiHTNs, phenothiazines, anticholinergics, obscures hypoG sxs
  19. CCBs
    FX
    SE
    IX
    • arterial dilation, some -inotroope, depress nodes
    • flushing, HA, hypoTN, edema, [constipation, confu, drowsy, arrythmias, mood with Dilt and Verapamil]
    • betas, dig, grapefruit, STATINS
  20. Beat Blockers:
    • Atenolol: post MI
    • Metoprolol: LA
    • Propranolol: not selective, Asians may not metabolize
  21. CCBs:
    • -dipines
    • Diltiazem
    • Verapamil
  22. Bile Acid Sequestrants:
    • Questran
    • Colestid
    • Welchol
  23. HMG CoA Inhibitors:
    -statins
  24. Fibric Acid Derivitaves:
    • Gemfibrozil
    • Fenofibrate
  25. Niacin:
    Vitamin B3 in large doses
  26. Bile Acid Sequestrants
    SE
    IX
    • constipation, heartburn, N, gas (SE diminish)
    • lipid solubles (AEDK), dig, coumadin
  27. Bile Acid Sequestrants
    FX
    • increase bile-take cholesterol out of bloodstream
    • only work in gut (not as dangerous)
    • give with apple juice, FF
  28. HMG CoA Inhibitors
    FX
    lower cholesterol production in the liver
  29. Fibric Acid Derivitives
    FX
    decrease triglycerides
  30. Niacin
    FX
    increase lipase, breaks down cholesterol
  31. HMG CoA Inhibitors
    SE
    IX
    • mild GI, rash, HA, Rhabdomyolysis, increased liver panel, teratogenic
    • erythromycin, grapefruit, gemfibrozil, niacin (Rhabdo)
  32. Niacin
    SE
    flushing, pruritus, GI distress, hyperG, hyperuremia
  33. Thrombolytics:
    FX
    • convert plasminogen to plasmin, admin within 4-6hrs, no needles
    • Streptase: for MIs
    • Activase: for strokes
    • Tenecteplase
  34. Thrombolytics
    SE
    • allergy, NV, hypoTN
    • Streptase: itching
  35. Hemostatics:
    FX
    • Amicar
    • Desmopressin
    • Thrombin topical
    • stop bleeding, help with anemia, hemophilia (dental)
  36. Hemostatics
    SE
    nasal stuffiness, N, A
  37. Anti-coags
    SE
    • NV, HIT (5-10 days after, need plasmaphoresis)
    • Heparin: alopecia, osteoporosis (long term)
    • Coumadin: purple toe, necrosis
  38. Anti-coags
    Antidotes:
    • Coumadin: Vitamin K
    • Heparin: Protamine sulfate
  39. Normal PT:
    Desired with Coumadin:
    • 60-70 seconds
    • 90-175
  40. Normal aPTT:
    Desired with Heparin:
    • 30-45 seconds
    • 45-112
  41. Normal INR:
    Desired with Coumadin:
    • 0.5-1.5 seconds
    • 2 - 3.5
  42. Direct Thrombin Inhibitors:
    FX
    • -rudin
    • -roban
    • for HIT, coronary procedures, DVTs
  43. Antiplatelet Agents:
    • ASA
    • ADP Blockers: Plavix, Ticlid, Aggrenox
    • Glycoprotein Receptor Blockers: ReoPro, Integrilin, Aggrastat
  44. Plavix
    SE
    GI bleed, flu, HA, bruising, rash
  45. Ticlid
    SE
    NVD, dyspepsia, marrow toxic
  46. ReoPro
    SE
    bleeding, hypoTN, back/chest pain, thrombocytopenia
  47. Antidysrythmics:
    SE
    • Quinidine: D, cinchonism
    • Procainamide: V. dysrythmias, lupus syndrome
  48. MONA
    • Morphine
    • Oxygen
    • Nitro
    • ASA
  49. Andrenergic Agents:
    • Central: Clonodine, Methyldopa, Guanfacine
    • Peripheral: Serpasil
    • Alpha1 Blocker: Prazosin, Terazosin, Labetolol
    • Ganglionic Blocker: Inversine
  50. Andrenergic Agents
    SE
    drowsy, dry, HA, NC, rash, palps, depression
  51. ARBs:
    SE
    • -sartan
    • HA, dizzy, fatigue
  52. Vasodilators:
    SE
    • HA, NVD, dizzy, tachy, anxiety
    • Diazoxide
    • Hydralazine
    • Minoxidil
    • Nitroprusside
  53. Diazoxide
    SE
    • dysrythmias
    • hyperG
  54. Hydralazine
    SE
    edema, dyspnea, dyscrasias, hepatitis, congestion
  55. Minoxidil
    SE
    pericardial effusion, angina, breast tenderness, thrmobocytopenia
  56. Nitroprusside
    SE
    brady, decreased PLTs, cyanide toxicity
  57. ACE Inhibitors:
    FX
    • -pril
    • Decrease Na, prevent Angio I-Angio II, prevent bradykinin
  58. ACE
    SE
    IX
    • fatigue, HA, taste, cough, dyscrasias, mood, rash, angioedema (blacks)
    • NSAIDs, diuretics, antiHTNs
    • used often with CCBs and diuretics
  59. Cardiac Glycoside:
    SE
    Antidote
    • Digoxin
    • dysrythmias, NVAD, fatigue, confu, conv, depression, vision
    • digibind, K+
  60. + Inotropes
    • Digoxin
    • Primacor
    • Inocor
  61. Loop Diuretics
    FX
    • Lasix, Bumex, Demadex, Edecrin
    • Most potent, reduce Na and Cl, also vasodilate
  62. Loop Diuretics
    SE
    IX
    • orthostatic, lytes, tinnitus, glucose tolerance, dyscrasias, SJS, neuro/nephro toxic,
    • Increase uric acid (gout), liver panel, glucose
    • gentamycin, Dig, NSAIDs
  63. Thiazide Diuretics:
    FX
    • Hydrochlorothiazide, Chlorthalidone, Indapamide (sulfas)
    • Excrete Na, Cl, some K, also dilate arterioles, takes 3-4 weeks
  64. Thiazide diuretics
    SE
    IX
    • orthostatic, lytes, glucose tolerance, HA, rash, GI, libido
    • Dig, oral hypoGs (2 hours)
  65. K Sparing Diuretics:
    FX
    • Aldactone, Eplerenone, Dyrenium, Midamor
    • act in distal tubule
  66. K Sparing Diuretics
    SE
    IX
    • anemia, dizzy, sore, dry, menses, hirsutism, impotence
    • hyperK: N, fatigue, weak, brady, dysrythmias
  67. Osmotic Diuretics:
    FX
    • Mannitol, Colace, Ureaphil
    • in proximal tubule, used often for RF and ICP, lose many solutes
  68. Osmotic Diuretics
    SE
    Conv, thrombophlebitis, pulmonary congestion, HA, CP, tachy, fever, blurry
  69. Carbonic Anhydrates:
    FX
    • -amide
    • short term (3-4 days), for glaucoma, epilepsy, altitude sickness
  70. Carbonic Anhydrates
    SE
    • -amide
    • acidosis, drowsy, A, parasthesias, hematuria, urticaria, photo, melena
  71. Counter Regulatory to insulin:
    • GH
    • Glucagon
  72. Rapid Acting Insulins:
    Onset
    Peak
    Duration
    • Lispro, Humalog, Aspart, Nvolog
    • 5-20 minutes
    • 1-3 hours
    • 3-5 hours
  73. Short Acting Insulin:
    Onset
    Peak
    Duration
    • Regular
    • 30-60 minutes
    • 2-4 hours
    • 6-10 hours
  74. Intermediate Acting Insulins:
    Onset, Peak, Duration
    • NPH, Lente
    • 1-4 hours
    • 6-12 hours
    • 18-28 hours
  75. Long Acting Insulins:
    Onset, Peak, Duration
    • Lantus, Glargine
    • 1 hour
    • None
    • 24 hours
  76. What factors may decrease insulin absorption:
    • Smoking
    • Disease (CKD)
  77. Take more insulin with which drugs:
    • Steroids
    • Thyroids
    • Contraceptives
  78. Take LESS insulin with which drugs:
    • ETOH
    • Anabolics
    • MAOIs
    • Betas
    • Salycilates
    • theophyllines
  79. Sulfonylureas:
    FX
    • Diabenase, Glyburide, Glipizide, Amaryl
    • Stimulate pancreatic insulin production, increase receptors
  80. Sulfonylureas
    SE
    IX
    • hypoG, agranulo, hemolytic, thrombocytopenia, rash, photo, jaundice, NV, fullness
    • Many IX (ETOH and Diabenase)
  81. Biguanides:
    FX
    SE
    • Metformin
    • reduces intestinal absorption and production of glucose
    • NVDA, metallic taste, lactic acidosis! (weak, aches, dizzy, brady)
  82. A-Glucosidase Inhibitors:
    FX
    SE
    • Precose, Glyset
    • delays digestion
    • gas, abd pain, D, increased liver panel
  83. Meglitinides:
    FX
    SE
    • Nateglinide, Repaglinide
    • stimulate insulin secretionhypoG, joint pain, URI
  84. Glitazones:
    FX
    SE
    • -glitazone
    • improve use of insulin
    • infection, myalgias, HA, edema, cholesterol, hepatotoxic
  85. Polypeptide Analogs:
    FX
    SE
    • Symlin
    • increases satiety, slows gastric emptying
    • severe hypoG (3hrs after), NV, HA, joint pain, cough
    • DO not mix with insulin (site)
  86. Incretins:
    IX
    • Byetta
    • Januvia
    • cocoa, rosemary
  87. Byetta
    SE
    • NV, allergy, HA, dyspepsia, GERD, restless, pancreatitis, RF possible
    • From Hela monster
  88. Januvia
    SE
    HA, D, nasopharyngitis
  89. Glucagon
    SE
    IX
    • NV, hyperG, BP changes +/-
    • Increases Coumadin levels
    • Betas decrease Glucagon

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