Term
|
Definition
(Duvoid, Urecholine)
T: Drug to treat urinary retention
P: Muscarinic agonist (direct acting)
MOA: binds to muscarinic receptors to cause parasympathetic stimulation
Route: PO
SE: Increase salivation, abdominal cramping, sweating, miosis, blurred vision, N/V. Serious effects: orthostatic hypotension, bradycardia, reflex tachycardia, complete heart block, acute bronchospasm
Overdose treatment: atropine |
|
|
Term
|
Definition
(Mestinon, Regonol)
T: Drug for Myasthenia Gravis
P: Indirect cholinergic agonist, AchE inhibitor
I: MG, prophylaxis for nerve gas
MOA: inhibits action of AchE at cholinergic synapses, allowing Ach to accumulate
Route: PO, IV
SE: Increased peristalsis, bronchoconstriction, bradycardia, hypotension. Involuntary contraction or twitching of muscles, N/V, miosis, increased salivation. Severe: cholinergic crisis
Overdose treatment: atropine
NC: dosing regimen needs to be individualized for each pt |
|
|
Term
|
Definition
T: agent for bradycardia, antidote for cholinergic agonist overdose
P: muscarinic antagonist
I: Drug of choice for few conditions bc of adverse effects.
- Bradycardia
- Hypermotility or spasmic disorders of GI tract (dysentery, IBS)
- Anesthesia adjunct: suppress secretions of salivary glands and respiratory tract
- Dilation of pupil for opthalmic examinations
- Antidote to reverse toxicity from cholinergic agonist overdose
MOA: Blocks muscarinic receptors and TF parasympathetic stimulation
Route: SubQ, IM, PO
SE: Drying of oral and nasal mucosa, constipation, urinary retention, increased HR, blurred vision, photophobia. Serious effects: ventricular fibrillation, delirium, coma
Contraindications: Glaucoma, COPD, cardiovascular pathology, hyperthyroidism, GI conditions, GERD |
|
|
Term
|
Definition
(Anectine)
T: skeletal muscle relaxant
P: Neuromuscular blocker (depolarizing type)- nicotinic antagonist
I: neuromuscular blocker during short surgical procedures
MOA: same mechanisms as Ach, but not destroyed by AchE so stays in cholinergic receptor sites at the neurmuscular junction (nicotinic)
Route: IV, IM
SE: paralysis of diaphragm and intercostal muscles, tachycardia, hypotension, urinary retention. Malignant hyperthermia. BB: children with certain congenital musculoskeletal diseases at greater risk for cardiac arrest, should be monitored very closely
NC: Monitor vitals (transient apnea), keep airway free of secretions. Prepare for emergency endotrach intubation. Extra caution: elderly with falls. Educate that muscle stiffness and pain last for 24-30 hrs post procedure. Report persistent muscle weakness |
|
|
Term
|
Definition
T: skeletal muscle relaxant
P: neuromuscular blocker (nondepolarizing type)- nicotinic antagonist
I: neuromuscular blocker during longer surgical procedures
MOA: Competes for Ach at motor end plates blocking nerve transmission to skeletal muscle and preventing contraction. Blocks Ach synapses ganglia at higher doses
Route: IV (bc doesn't cross membranes)
SE: Death due to paralysis of respiratory muscles. Malignant hyperthermia. Can cause release of histamine causing bronchospasm and hypotension. Common adverse effects: muscle weakness, hypotension, increased salivation
NC: Monitor vitals (temp, airway), Pts with renal impairment may have prolonged drug action. Assess bowel sounds for impaired peristalsis. Report continued muscle weakness. Caution with activities using muscle strength |
|
|
Term
|
Definition
(Adrenalin)
T: Antishock and antianaphylaxis agent, bronchodilator
P: Nonselective adrenergic agonist, catecholamine
I: Cardiopulmonary resuscitation, anaphylaxis (BP increase, relieve shortness of breath). Given w/ local anesthetic to cause vasoconstriction of vessels, opthalmically: glaucoma, intranasally: congestion
MOA: Nonselective adrenergic agonist, stimulates alpha and beta receptors throughout body to produce fight or flight response.
SE: Common: nervousness, tremors, palpitations, tachycardia, dizziness, headache Serious: HTN, dysrhythmias, PE, cardiac arrest.
Route: SubQ, inhalation, IV, IM |
|
|
Term
|
Definition
(Neo-Synephrine)
T: Antihypotensive, nasal decongestant, vasoconstrictor
P: Alpha1-adrenergic agonist
I: increase BP, reduce congestion, dilate eye during exams
MOA: Directly activates alpha1-adrenergic receptors in PNS producing vasoconstriction
SE:
- Intranasal: stinging, sneezing, rebound congestion.
- Ophthalmic: glaucoma or photophobia. - Parental: CNS stimulation: anxiety, restlessness, tremor.
- Serious: reflex bradycardia, reduced bloodflow to peripheral tissues
Route: PO, subQ, IV
NC: No nasal or eye use in kids. Don't use decongestant for more than 3 days or you get rebound congestion. Limit caffeine. Use sunglasses after eye dilation. |
|
|
Term
|
Definition
(Isuprel)
T: Bronchodilator
P: Nonselective beta-adrenergic agonist
I: Increase CO in cardiac arrest, once used for asthma, now more effective drugs
MOA: activates beta1 and beta2
SE: Headache, N/V, symptoms of CNS stimulation (tremors, anxiety, insomnia). Serious: dysrhythmias
Route: IV |
|
|
Term
|
Definition
(Minipress)
T: anti-HTN
P: selective alpha1-adrenergic antagonist
I: Reduce BP Little effect on CO or HR. Off label: symptomatic BPH, Raynoud's disease
MOA: Competes with NE at alpha1 adrenergic receptors on vascular smooth muscle in arterioles and veins
SE: Dizziness, drowsiness, fatigue, weakness, palpitations, orthostatic hypotension, headache. Erectile dysfunction. First dose phenomenon: syncope.
Route: PO
NC: Fall risk, ethnically diverse populations respond differently to anti HTN. Take drug at same time each day, record daily BP. Report difficulty urinating to provider. Consult provider before taking OTCs. |
|
|
Term
|
Definition
(Inderal, InnoPran XL)
T: Antihypertensive, antidysrhythmic
P: Nonselective beta-adrenergic blocker
I: Hypertension, angina pectoris, dysrhythmias, migraine prophylaxis, prophylaxis of MI
MOA: blocks beta1 and beta2 receptors
SE: Common: N/V, diarrhea, diminish as therapy progresses. Fatigue, insomnia, drowsiness, bradycardia, confusion, sometimes impotence. Severe: Stevens-Johnson syndrome, anaphylaxis.
Route: PO, IV
NC: Take radial pulse before each dose. Suppresses signs of hypoglycemia so be careful in diabetics, make position changes slowly, don't stop taking abruptly |
|
|
Term
|
Definition
(Lopressor, Toprol)
T: anti HTN
P: Selective beta1-adrenergic antagonist
I: HTN, reduce risk for MI death. Off label: stable, symptomatic HF, essential tremor, migraine prophylaxis, control HR in atrial dysrhythmia
MOA: blocks beta1 receptors
SE: Common: N/V, dizziness, fatigue, insomnia, bradycardia, heartburn, dysnpea. Serious: agranulocytosis, laryngospasm, complete heart block, thyroid storm
Route: PO, IV
NC: orthostatic hypotension = fall risk. Take radial pulse before each dose. Suppresses signs of hypoglycemia in diabetics, report symptoms of Raynaud's disease. Don't stop taking abruptly. Erectile dysfunction can result in nonadherence |
|
|
Term
|
Definition
(Lipitor)
T: Antihyperlipidemic
P: HMG-CoA reductase inhibitor, statin
MOA: Inhibits HMG-CoA reductase (primary enzyme regulating cholesterol biosynthesis) As liver makes more LDL receptors, removing more LDL from blood
SE: rhabdomylosis (breakdown of muscle fibers, spill contents into systemic circulation and causing potentially fatal acute renal failure)
NC: Monitor hepatic function. Take medication with food in evening. Immediately report symptoms of unexplained muscle pain or weakness (rhabdomyolysis). Preg cat. X |
|
|
Term
|
Definition
(Questran)
T: Antihyperlipidemic
P: Bile acid sequestrant
MOA: Binds to bile acids to form an insoluble complex containing cholesterol that is excreted in the feces
SE: GI bc isn't absorbed into gen circulation
NC: Monitor bowel sounds in older adults. Take other meds 1 hr before or 4 hr after administration. Deficiency in fat soluble vitamins? |
|
|
Term
|
Definition
reduce triglycerides and LDL cholesterol levels but adverse effects limit its usefulness (hot flashes)
Need 2-3g/day |
|
|
Term
|
Definition
(Lopid)
T: Antihyperlipidemic
P: fibric acid agent
I: lower triglycerides, not prescribed bc little effect on mortality from CV
MOA: unknown
SE:
- GI: abdominal cramping, diarrhea, nausea, dyspepsia.
- NS: headache, dizziness, peripheral neuropathy, dminished libido.
- Serious: cholelithiasis, anemia, eosinophilia
Route: PO
NC: Monitor for fall risk. Monitor for gallbladder disease. No breast feeding. |
|
|
Term
|
Definition
(Adalat CC, Procardia XL)
T: Antihypertensive
P: Calcium channel blocker, dihydropyridine type
MOA: blocks CC in peripheral and coronary arteries leading to fall in BP, more O2 for heart
I: HTN, prevent premature labor
SE: all relate to vasodilation
DI: Nifedipine is a substrate for hepatic CYP3A4 and may interact with drugs that induce or inhibit this enzyme. May increases levels of digoxin.
D/F: Grapefruit juice. Melatonin. St. John's wort. Alcohol. |
|
|
Term
|
Definition
(Calan, Isoptin, Verelan)
T: Antihypertensive, antianginal, antidysrhythmic
P: Calcium channel blocker, phenylalkylamine type
MOA: Inhibits the flow of Ca into cardiac and vascular smooth muscle cells causing vasodilation of peripheral arterioles and reduced contractility of the myocardium
SE: Peripheral vasodilation: flushed skin, headache, dizziness, lightheadedness, and peripheral edema.
cardiac- worsening of HF, bradycardia, reflex tachycardia, and AV block.
- CNS: confusion, drowsiness, and mood changes.
- Elevated hepatic enzymes and rare cases of liver damage.
DI: Metabolized by hepatic P450 enzymes. Elevates blood levels of digoxin, cause bradycardia. Other antihypertensive drugs, (ACE inhibitors, beta-adrenergic blockers) cause additive hypotension or bradycardia
FI: Grapejuice. Herbal supplements (hawthorn), high doses of calcium. Alcohol. |
|
|
Term
|
Definition
(Prinivil, Zestril)
T: Anti HTN
P: ACE inhibitor
I: HTN, HF, acute MI prophylaxis
MOA: block ACE, decrease angiotensin II = decrease SNS, decrease aldosterone (decrease H2O retention)
SE: hyperkalemia, angioedema, death to fetus
NC: Monitor for angioedema in older adults, African Americans. Monitor potassium levels for those at greater risk for hyperkalemia (diabetics). Monitor BP. Immediately report any swelling of the face, mouth, lips or tongue, hoarseness or sudden trouble with breathing. Report pregnancy. |
|
|
Term
|
Definition
(Cozaar)
T: Anti HTN
P: angiotensin II receptor blocker
I: Treatment of HTN, stroke prophylaxis in patients with Left ventricular hypertrophy, and prevention of diabetic nephropathy
MOA: Blocks angiotensin AT1 receptors = BP decline. Blockage of angiotensin II receptors prevent cardiac remodeling and deterioration of renal function in patients with diabetes
SE: low incidene. angioedema, hyperkalemia, fetal death
NC: Monitor for angioedema in older adults, African Americans. Monitor potassium levels for those at greater risk for hyperkalemia (diabetics). Monitor BP. Immediately report any swelling of the face, mouth, lips or tongue, hoarseness or sudden trouble with breathing. Report pregnancy. Fall risk. |
|
|
Term
|
Definition
(Lasix)
T: anti HTN
P: loop or high-ceiling diuretic
I: acute edema associated with HF, renal impairment, liver cirrhosis
MOA: Prevents reabsorption of Na and Cl by blocking the Na+ K+ CL- symporter in the loop of Henle (normally filers bulk of Na so profound diuresis). Can result in the increased urinary excretion of Na, Cl, K, and H+.
SE: hypovolemia, electrolyte imbalance, ototoxicity, hypokalemia w/ associated dysrhythmias, hypocholemia, metabolic alkalosis
NC: monitor K, glucose (in diabetics), fall risk, avoid direct contact with sunlight |
|
|
Term
|
Definition
(Microzide)
T: anti HTN
P: thiazide-type diuretic
I: Most widely prescribed diuretic for HTN. Ascites, edema, HF, HTN, and nephrotic syndome.
MOA: Decrease reabsorption of Na at distal tubule causing moderate diuresis
SE: electrolyte imbalances, hypokalemia w/ dysrhythmias, hypotension, dizziness
NC: monitor K, fall risk, avoid sunlight |
|
|
Term
|
Definition
(Aldactone)
T: anti HTN
P: K sparing diuretic/aldosterone antagonist
I: HTN, edema and Na retention
MOA: Inhibits aldosterone in the distal tubule and collecting ducts of the nephron causing increase in secretion of Na, Cl, H2O and retention of K+.
SE: Hyperkalmia associated w/ cardiac dysrhthmias. Muscle weakness, paresthesia, fatigue, bradycardia, flaccid paralysis of the extremities, and shock. Can cause gynecomastia, impotence, and diminished libido. Menstrual irregularities, hirsutism, and breast tenderness. BB- produces tumors in lab animals
NC: fall risk, monitor K, BP, avoid food w/ excessive K |
|
|
Term
|
Definition
(Osmitrol)
T: drug for renal failure
P: osmotic diuretic
I: increase fluid in acute renal failure, can pull fluid out of extravascular spaces to reduce intracranial pressure and lower intraocular pressure
MOA: Filtered by the glomerulus of the kidney but is incapable of being reabsorbed from the renal tubule. Creates an absorption gradient, resulting in decreased water and Na+ reabsorption and increased diuresis
SE: electrolyte imbalances, fatigue, N/V, dizziness, convulsions, tachycardia
NC: fall risk, monitor electrolyes, report confusion, don't breastfeed |
|
|
Term
|
Definition
(Sublimaze)
T: analgesic, anesthetic
P: opioid agonist
I: short duration anesthesia as part of anesthesia premedication
MOA: opioid agonist at mu and kappa receptors
SE: respiratory repression, N/V, constipation, bradycardia
NC: narcan to reverse, monitor resps, monitor ethnically diverse pts |
|
|
Term
|
Definition
(Versed)
T: antianxiety agent, anesthetic
P: benzodiazepine, GABA agonist
I: reduce stress and anxiety of surgery
MOA: Acts at limbic, thalamic, and hypothalamic regions to produce CNS depression and skeletal muscle relaxation.
SE: respiratory depression, drowsiness, fatigue, ataxia, tachycardia, laryngospasm
NC: benzo antagonist: flumazenil (reversal agent). Fall risk, amnesia in post op period. |
|
|
Term
|
Definition
(Diprivan)
T: general anesthetic
P: NMDA agonist
I: induce and maintain anesthesia
MOA: unclear, GABA activation?
SE: resp depression, Propofol infusion syndrome (organ failure, metabolic acidosis, hyperkalemia, rhabdomylosis, cardiac/renal failure)
NC: assess kids and elderly for drug induced excitement |
|
|
Term
|
Definition
T: gaseous general anesthetic
P: GABA receptor agonist, opioid agonist
I: when administered alone cannot produce deep anesthesia, used in combination
MOA: Unknown. Analgesic effect from activation of opiod receptors in the midbrain? Relaxation due to activation of GABA receptors inhibiting neuronal firing?
SE: anxiety, excitement, combativeness, N/V
NC: older pt more sensitive. deep breathing to remove from lungs. next day monitor safety bc dizziness, drowsiness, lethary maybe still present |
|
|
Term
|
Definition
(Apresoline)
T: AntiHTN
P:Direct Vasodilator
I: Treatment of moderate to severe HTN
MOA: Causes peripheral vasodilation, acts directly to relax arterial smooth muscle. Because drug is selective for arterioles and does not cause dilation of veins, orthostatic hypotension is not a major adverse effect.
SE: Headache, tachycardia, N/V, peripheral edema SERIOUS: Aganuloxytosis and leukopenia
NC: Do not abruptly stop taking |
|
|
Term
|
Definition
(Nipride, Nitropress)
T: Drug for HTN emergency
P: Direct vasodilator
I: Hypertensive emergencies
MOA: Dilation of both veins and arteries
SE: related to vasodilation; BB: requires dilution prior to infusion and is not suitable for direct injection |
|
|
Term
|
Definition
(Glucophage)
T: Antidiabetic agent
P: Biguanide
I: Lowers blood glucose in patients with Diabetes T2
MOA: Reduces gluconeogenesis, thereby suppressing hepatic production of glucose. In addition drug decreases intestinal reabsorption of glucose and increases cellular uptake of glucose.
SE: GI problems, rarely causes hypoglycemia or weight gain. BB: lactic acidosis is rare, though potentially fatal adverse effect. |
|
|
Term
|
Definition
(Humulin R, Novolin R)
T: Antidiabetic agent, pancreatic hormone
P: Short-acting hypoglycemic agent
I: used to maintain blood glucose levels within normal limits
MOA: identical to endogenous insulin, decreases blood glucose by increasing cellular uptake of glucose
ROUTE: Subcu; IV (only regular insulin can be given IV); inhalation
SE: Hypoglycemia; patients with hypokalemia should be monitored carefully because insulin may worsen condition |
|
|
