Term
|
Definition
Action: Increase inhibitory action of GABA
Indication: short-term therapy for anxiety and muscle tenseness, alcohol withdrawal, antiepileptic or preoperative surgeries
SE: drowsiness, malaise, loss of dexterity, constipation, dry mouth, HA, blurred vision, dizziness, skin rash
Precautions: smoking decreases effectiveness, additive with CNS depressants, easily addictive, must be tapered off
Toxicity/OD: respiratory depression and cardiac arrest, somnolence, confusion, coma |
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Term
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Definition
Indication: muscle relaxant, anxiety, alcohol withdrawal, antiepileptic, preoperative
Drug of choice for status epilepticus
SE: CNS depression, feeling of "hangover", GI symptoms, epigastric pain, hypotension bradycardia, hypoventilation, apathy, urinary retention
Cautions: more addicting than other anxiolytics, paradoxical effect possible, passes through breast milk |
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Term
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Definition
Indications: anxiety, panic (most common BZ used for anxiety) also can be used for depression
shorter 1/2 life, less SE than Valium |
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Term
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Definition
Indications: anxiety, panic, sedation in pre-op or ICU, antiemetic prior to chemo, management of epilepsy
Caution: rapid infusion greater than 2mg/min can lead to cardiac arrest, bradycardia, apnea |
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Term
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Definition
Indications: insomnia, anxiety, sedation, relief of muscle spasm, management of acute alcohol withdrawal, prep for surgical and/or diagnostic procedures, acute seizures
Action: selectivity for CNS effects, bind to specific benzo receptors and potentiate GABA |
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Term
|
Definition
Antidote for OD on benzos
Given IV 1-2 minute onset
0.2mg initial dose, 0.3mg 30 second after, 0.5mg repeat doses
Tapered on and off |
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Term
|
Definition
Action: binds with GABA receptors, less affect on REM
Rapid onset, Controlled release, less residual hangover compared to benzos |
|
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Term
|
Definition
Classified by length of action:
ultra-short, short used for insomnia, preanesthetics
intermediate used for sedative-hypnotics
long-acting used for epilepsy, neurologic disorders |
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Term
|
Definition
Action: nonselective CNS depression, decreases wakefullness and alertness, not analgesics
Indications: treatment for insomnia is rare, low dose=sleep, higher doses produce sleep, adjuncts to anesthesia, seizure disorders, anxiety, nervousness
ADME: Oral/IV
SE: paradoxical effect: restlessness, anxiety (elderly/pediatric more likely), CNS depression (ataxia, daytime hangover, no HA, loss of REM sleep, irritability), respiratory depression at very high doses, decrease levels of Vit K and D (bleeding, bone health)
Toxicity: confusion, persistent irritability, ataxia, weakness, respiratory depression, bradycardia, CV collapse
Caution: tolerance/dependence and withdrawal can occur at unpredictable rates, abrupt withdrawal may cause seizures in clients with epilepsy
Status Epilepsy- continuous seizure (30 minutes or more) |
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Term
|
Definition
Indications: ADD, hyperactivity disorders, narcolepsy
Action: act as cortical and RAS stimulant by releasing catecholamines, improve concentration and ability to focus on incoming stimuli, CNS stimulants are controlled substances-Schedule II, paradoxically calms hyperactive children
Contraindications: allergy, marked anxiety, agitation, glaucoma, severe fatigue, cardiac disease, pregnancy (Category C)
SE: nervousness, insomnia, dizziness, HA, blurred vision, anorexia, nausea, wt loss, hypertension, angina, dysrhythmias, rash is common
Caution: if seizure disorder or ETOH/drug dependence |
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Term
|
Definition
Indications: moderate to severe ADHD, may increase cognition and motor activity
SE (high incidence): insomnia, suppressed appetite, tremor, restlessness, euphoria, can exacerbate psychotic illnesses, stimulate HR and raise BP, slowing of growth in prepuberty
Caution: be alert that child/arent can divert meds to street, must reduce dose gradually to reduce withdrawal effects, indication that these children likely to abuse other drugs, must monitor CV effects on growth |
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Term
|
Definition
Action: decreases GABA transmission, heightens alertness, increases focus
Indication: narcolepsy
SE: HA, nausea, nervousness, anxiety, insomnia
Pt. Teaching: take drugs early in the day, report tremors or seizures, no refills, needs tapering, need to use nonhormonal birth control |
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Term
| Selective Serotonin Reuptake Inhibitors (SSRIs) |
|
Definition
Action: slow or inhibit the reuptake of serotonin into the presynaptic terminals therefore increasing the amount of serotonin available
SE: sexual functioning, drowsiness/sleepiness, weight gain, dry mouth, insomnia, fatigue, nausea, dizziness, tremors/shaking
AR: Serotonin Syndrome: mental status changes, hypertension, hyperpyrexia, akathesia (motor restlessness), tremor, muscle twitches, ataxia, seizures, coma
Tapered Withdrawal |
|
|
Term
|
Definition
Action: blocks reuptake of serotonin
Indication: depression without anxiety overlay
SE: at onset: queasy, feel "fuzzy", more active dreams, longer term: dry mouth, constipation, anorexia, weight loss, sexual dysfunction, anxiety, HA, insomnia, nervousness, diarrhea, tremor pruritus |
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Term
|
Definition
Action: no appreciable effect on NE or serotonin, does have modest effect on blocking dopamine
Indication: antidepressant, nicotine craving
SE: highest risk of seizures of all SSRIs |
|
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Term
|
Definition
Action: SSRI
Indication: inducing sleep, diabetic neuropathic pain
SE: decrease BP, fetal abnormalities |
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Term
|
Definition
Action: inhibits both serotonin and NE uptake, weaker dopamine effect
Others Indications: HTN, improve hot flashes during menopause |
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Term
|
Definition
Action: (TCAs) block reuptake of released NE and serotonin and allow them to accumulate at the nerve endings
Indications: depression, especially with anxiety component, induce restful sleep for chronic pain patients, phobic attacks
SE: antimuscarinic effects: dry mouth, blurred vision, dry eyes, photophobia, low BP, orthostatic hypotension, tachycardia, arrhythmias, CNS sedation, anxiety, insomnia, nightmares
OD/Toxicity: common (small margin of safety), heart block, dysrhythmias, hypotension, respiratory depression, seizures, coma Treatment: emesis, gastric lavage, cardiac monitoring, physostigmine, diazepam, anticonvulsants, bicarb speeds, elimination by alkalizing urine |
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Term
| Monoamine Oxidase Inhibitors (MAOIs) |
|
Definition
Action: blocks MAO on the surface of the cell, resulting in more NE available for release and in the synapse
Many drug-drug interactions also tyramine-rich foods
Ex: Marplan, Nardil, Parnate |
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Term
|
Definition
Action: not well known, theory it accelerates the destruction of serotonin, dopamine and NE, Na+ in cells of clients increases 200% may stabilize cell membranes
Indication: manic-depressive illness
Effect: decreases number and severity of episodes in 80% of cases
SE: dry mouth, nausea, thirst, drowsiness, weight gain, sleeplessness in early weeks, higher blood levels produce more weight gain, metallic taste, altered taste in food, HA, pruritus, edema of hands and feet
Toxicity: very low margin of safety (0.8-1.2 mEq/L)
Serum Levels Increased by: diarrhea, diuretics, dehydration, low salt diets, high fevers, strenuous exercise
Serum Levels Decreased by: high salt intake, high intake of sodium bicarbonate, pregnancy
Toxicity: gastric lavage, hemodialysis, Antidote: Flumazenil (Romazicon) |
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Term
|
Definition
Typical: block dopamine receptors preventing stimulation
Atypical antipsychotics: block both dopamine and serotonin receptors
Action: block dopamine receptors in limbic system which produces desired tranquilizing effect, newer block D2 receptors and 5-HT2 receptors
SE: CNS sedation, weakness, tremor, extrapyramidal effects, hypotension, dysrhythmias, CHF, pulmonary edema, laryngospasm, dyspnea, alcohol increases risk |
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Term
| Chlorpromazine (Thorazine) |
|
Definition
Action: dopamine blockade in specific CNS areas, inhibit the vagus nerve in the GI tract, antianxiety effect by depressing the reticular activating system
Indications: psychosis, N/V, pain, sedation, intractable hiccups
Effects: low potency in comparison, sedation, affective indifference, emotional quieting, psychomotor slowing
SE: dry mouth, blurred vision, photophobia, hypotension, orthostatic hypotension, Thorazine Shuffle: slow motor movements
Extrapyramidal Effects: akathisia (jitteriness, nervous energy, restlessness, irritability), dystonia (severe muscle rigidity and spasm, protruding tongue, fixed upward gaze, excessive salivation), parkinsonism (shuffling gait, drooling, tremors, bradykinesia, akinesia), Tardive Dyskinesia (involuntary muscle movement)
OD/Toxicity: common but rarely fatal, CNS depression, hypotension, extrapyramidal effects, care is supportive |
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Term
|
Definition
Action: blocks D2 receptors, increased brain dopamine
Indications: psychotic disorders, antiemetic, Tourette's syndrome, severe agitation, combativeness |
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Term
|
Definition
Action: less affinity for D2, therefore less likely to cause extrapyramidal effects
Indications: treatment-resistant schizophrenia
SE: agranulocytosis; significant weight gain |
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Term
|
Definition
Action: blocks both serotonin and dopamine receptors
Indications: psychotic disorders, improve both + and - sx of schizophrenia
SE: dry mouth, cough, dreaming, weight gain, visual changes, sexual dysfunction, extrapyramidal sx |
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Term
| Neuroleptic Malignant Syndrome |
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Definition
Adverse Reaction for all antipsychotic drugs, rare problem but potentially fatal, more likely at the onset
S/S: extrapyramidal: seizures, tachycardia, sweating, skeletal rigidity, dyskinesias, WBC elevations and high fever, frequently starts with facial tic
Tx: is to discontinue drug, supportive care |
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Term
|
Definition
Action: stabilize nerve membranes, less sedating than other anticonvulsants
Indication: more effective for tonic-clonic seizures than other types
SE: CNS depression, sluggishness, ataxia, slurred speech, GI sx, skin rash, hair and gingival overgrowth, deficiencies in folic acid, Vit D & K, decreases cardiac electrical conduction
Narrow range 10-20 ug/mL
Toxicity: serious, CNS depression, cardiac depression, coma, not antidote, only supportive care |
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Term
|
Definition
Action: inhibits postsynaptic responses
Indication: tonic-clonic and partial seizures
SE: CNS depression, GI upset, allergic reaction
Caution: renal or liver impairment, not to be used during pregnancy or lactation |
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Term
|
Definition
used as anti-convulsant in eclampsia patients
Action; role in neurotransmission and muscular hyperexcitability
Goal: inhibit seizures but not induce respiratory depression
Check Deep Tendon Reflexes, if 0-1 must stop! |
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Term
| levodopa-carbidopa (Sinemet and Sinemet CR) |
|
Definition
Action: biological precursor of dopamine which increases dopamine concentration.
Indications: all types of Parkinsonism except drug-induced
SE: involuntary movements, anxiety, nightmares, mood changes, increased aggressiveness, confusion, dysrhthmias, hypotension, palpitations, urinary retention, dark urine, cough, blurred vision, mydriasis, ataxia, increased tremor in hand, numbness
Long-term use: abnormal muscle development, end of dose failure, on-off phenomenom, LFTs required
Not improved: constipation, stooped posture, dementia, visual problems, bladder problems
Toxicity: eye/muscle twitching early signs, hypotension and dysrhythmias
DI: no vitamin B6 or MAOIs |
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Term
|
Definition
Action: releases dopamine from storage sites, blocks uptake of dopamine so there is more accumulation
Effects: sense od well-being, elevated mood
Indications: anti-dyskinetic, antiviral
SE: impaired concentration, dizziness, irritability, anorexia, nausea, nervousness, confusion, ortho hypotension, difficult urination
Toxicity: severe confusion, insomnia, nightmares, seizures |
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Term
| bromocriptine (Parlodel), and pergolide (Permax) |
|
Definition
Action: activates postsynaptic dopamine receptors, stimulated production of dopamine
ADME: only 25% absorbed
Contraindications: breastfeeding, sensitivity to ergots
SE: drowsiness, HA, nausea, hypotension, less common: confusion, hallucinations, uncontrolled body movements |
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Term
|
Definition
| Action: directly binds with postsynaptic dopamine receptors, act as a direct dopamine agonist in the substantia nigra |
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Term
|
Definition
Actions: synthetic atropine like drug, restores imbalance of dopamine and ACh by inhibiting ACh effects on the brain.
Indications: early parkinsons, used to control drug-induced extrapyramidal effects
SE: same as atropine |
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Term
|
Definition
Action: anticholinergic, reduces tremors, and drooling
SE: disorientation, dizziness, other anticholinergic effects |
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Term
|
Definition
Indication: mild to moderate Alzheimers
Action: indirect-acting cholinergic agonist, blocks acetylcholinesterase at the synapse, leads to prolonged stimulation of ACh receptor sites, readily crosses the blood-brain barrier |
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Term
|
Definition
Action: inhibit activity of ACh-esterase enhancing activity at receptor sites
Indication: symptomatic treatment of EARLY Alzheimer symptoms, does not stop or cure disease
SE: increases risk of GI bleed if on NSAID, can exacerbate action of succinylcholine (used for intubation)
Toxicity: abd cramps, salivation, flushing, N/V, dyspnea, ortho hypertension, heart block, cholinergic crisis- circulatory collapse, hypotension, bloody diarrhea, shock, arrest
used earlier is best
after severe dementia sets in, no need to continue meds |
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Term
|
Definition
Action: believed that persistent activation of CNS NMDA receptors contributes to the symptoms of Alzheimers. Blocking these sites can reduce or delay these symptoms
only drug in its class
SE: HA, dizziness, fatigue, confusion, constipation
Caution: dose reduction for people with renal impairment |
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Term
|
Definition
Indication: treatment of muscle spasticity associated with MS, muscle rigidity, spinal cord injury
AR: actio in the CNS, causes drowsiness, weakness, fatigue, depression |
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Term
|
Definition
Direct-Acting Muscle Relaxant
Action: stimulates ACh receptors
ADME: absorption is slow
SE: drowsiness, weakness, confusion, HA, some GI effects, urinary frequency |
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Term
|
Definition
Botulinum toxins A and B
injected locally no systemic absorption
binds directly to receptor sites of motor nerve terminals, used to paralyze specific muscle groups. not for MSK injury, only neurologic
SE: anaphylaxis: local effect at injection site, Type A can cause HA, respiratory infections, droopy eyelids, flu-like syndrome |
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Term
|
Definition
Action: suppress pain impulses in the CNS, also suppresses respiratory and cough centers in the medulla
Indication: moderate to severe pain
SE: respiratory depression in high doses <10 breaths/min, decrease in BP < 90/60mmHg, N/V, constipation, urinary retention
OD: pinpoint pupils, bradypnea or respiratory arrest Antidote: Narcotic Antagonists: Narcan, Revex, ReVia |
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Term
|
Definition
Indication: moderate to severe pain
ADME: passes blood-brain barrier
Effects: drowsiness, lethargy, alters mood, respiratory depression, stimulates vomiting center, decreases peristalsis and increases sphincter tone, diminished sensation to void, miosis, hypotension, flushing of upper body
Can be in PCA, more effective if given before pain level intolerable
SE: light-headedness, sleepiness, N/V, urinary retention, tolerance, dependence, respiratory depression, pruritus with epidural use,
AR: seizure, tinnitus, jaundice, allergic rxn, respiratory depression, tachycardia
Toxicity: usually 40mg dose or more, resp. depression leads to cardiac collapse Treatment: Narcan and Airway support |
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Term
| Other Pure Narcotic Agents |
|
Definition
meperidine (Demerol): same potency, shorter action than MS, no cough suppressant, usually given after surgery
Codeine: mild to moderate pain, common to mix with ASA, or Tylenol
hydromorphone (Dilaudid): potent, common choice for abuse in healthcare professionals
diacetyl morphine (Heroin): enters brain faster, no medicinal use
Methadone: longest duration of any narcotic, used for detox or maintenance of narcotic addiction
Hydrocodone (Vicodin): analgesic and antitussive, commonly for outpatients
Oxycodone (Perdocan, Percocet, Tylox): available in comb. with ASA, Tylenol (Oxycotin), outpatients
Fentanyl (Sublimaze, Innovar, Duragesic): adjunct to anesthesia
Propoxyphene (Darvon) or (Darvocet): similar to codeine, in combo with ASA or Tylenol very effective |
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Term
|
Definition
Mixed Narcotic Agonist-Antagonist
Action: stimulate some of the opiate receptors but they block the ability of pure narcotic agonists to stimulate those same receptors
Indication: mild to moderate pain relief |
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Term
|
Definition
Opiod-Like Analgesic
Action: binds to mu receptors
Indication: moderate to moderately severe pain
do not use in pt with narcotic dependence or are addicted
high street value |
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Term
| acetylsalisylic acid (Asprin or ASA) |
|
Definition
NSAID
Effects: inhibits enzyme cycloxygenase which is needed in synthesis of prostaglandins
Indication: mild to moderate pain, HA, muscle and joint pain with inflammation, fever, arthritis, prophylaxis of recurrent MI or stroke
Anti-Inflammatory, Antipyretic, Antiplatelet, Uricosuric
SE: ulcerogenic, increased bleeding potential, hyperuricemia, hypersensitivity reactions, Reye's syndrome in children used for viral illnesses
Toxicity: mild: tinnitus, HA, dizziness, drowsiness, confusion, paresthesias, ventilatory stimulation, GI distress Salicylate poisoning: increased resp rate, then depression, alkalosis to acidosis, shock, seizures from high fever Treatment: induce emesis, ventilatory support, correct acid-base balance, hasten excretion |
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Term
| rofecoxib (Vioxx), celecoxib (Celebrex) |
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Definition
Indication: pain relief similar to ibuprofen or naproxen- inhibits cycloxygenase (COX)
less SE, less ulcerogenic, more excpensive
used in acute post-op or trauma pain |
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Term
|
Definition
Effects: antiprostaglandin but only reduces pain not inflammation
Indication: relief of mild pain and fever
SE: few with normal dosage, rash, induced fever,
Toxicity: fairly common, fatal liver damage, Treatment: Mucomyst |
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Term
|
Definition
CNS depressants
Types: general and regional
usually in combination with one another
General: inhalation or IV
Stages of General: 1: analgesia (admin to loss of consciousness), 2: excitement (reflexes still present, may be exaggerated), 3:surgical anesthesia (increasing depth of anesthesia, affects resp., loss of reflexes, flaccidity, lower body temp), 4: medullary paralysis (toxic) (resp arrest and vasomotor collapse) |
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Term
| thiopental (Pentothal) and methohexital (Brevital) |
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Definition
Effects: CNS depressants, produce hypnosis and anesthesia without analgesia, amnesia, combined with muscle relaxants
P- truth serum
SE: during recovery phase: shivering, trembling, N/V, severe: delirium, dysrhthmias, allergic rxn
Toxicity: irritating to tissues |
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Term
|
Definition
Effects: blocks transmission of pain perception, increases secretions of salivary and bronchial glands, increased HR,
Indications: short procedures that don't require muscle relaxation
SE: hypertension, increased HR, delirium |
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Term
|
Definition
Action: combines antipsychotic with narcotic to produce analgesia and psychomotor sedation, alters pain perception, pt is neither asleep or awake, can follow commands
SE: hypo or hypertension, anxiety, sweating, hyperexcitability, resp. depression if used with opioid |
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Term
|
Definition
| SE: anxiety, restlessness, dizziness, bradycardia, hypotension, |
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Term
|
Definition
Action: anesthesia of sensory nerve endings
SE: cyanosis caused by methemoglobinemia, weakness, hypotension, breathing difficulties, increased HR, dizziness, collapse
SE: spinal block: numbness, ringling, HA, paralysis of lower legs, breathing difficulties, severe resp difficulty, bradycardia, backache, loss of sexual function, poor bladder/bowel control |
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Term
| Hib (haemophilus influenza-B) |
|
Definition
Route: IM
Given to children under 2 yo in several doses
Don't give to pt with febrile illness or active infection.
Dramatic reduction of ear infections, tonsillitis, epiglottis, and meningitis |
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Term
|
Definition
Route: IM
Three doses
Provides 90% protection, duration unknown
Produce mild SE
Continue schedule even with delay
Most have some immunity even after 2 |
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Term
| Injected polio vaccine (IPV) |
|
Definition
Route: IM
Inactivated whole virus
Schedule: requires several to reach immunity
Protective immune response cannot be assured in immunocompromised
Safer for others around children
Given to adults if outbreak |
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Term
|
Definition
Route: PO, live virus
Schedule: 4 doses, 2 &4 mo, 6-18 mo, and 4-6 years
Don't give if acutely ill
Store in freezer
Admin directly in mouth
Shed fecally for 10 days |
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Term
| Diptheria, pertussis, tetanus (DPT, DTAP) |
|
Definition
Route: IM, (acellular toxoid)
Schedule: 4 doses, first 3 are 2 mo apart, 4th at least 6 mo after 3rd dose
Not recommended after 7 yo
Contraindicated if previous rxn
Report serious rxn: high fever, convulsions, screaming or inconsolable crying, shock |
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Term
| Measles, mumps, rubella (MMR) |
|
Definition
Route: SC, live virus
Schedule: one dose at 12-15 mo, reimmunize age 4-6 or before 6th grade
Contraindicated if allergy to chicken or neomycin, pregnancy
Most common SE is fever, convulsions rare, orchitis, myalgias, HA |
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Term
|
Definition
for Pneumonia
Route: IM (inactivated bacteria)
Schedule: 4 doses for infants @ risk; unknown duration
might be required at soe daycares
risk::preemie, immunocompromised, heart defect, RSV hospitalization |
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Term
|
Definition
Route: IM (live virus)
Schedule: unknown duration, booster probably will be needed; 21 days until immunity
Contraindicated: immunosuppressed, active TB, active febrile illness
Must be kept at different temp than other vaccines, storage issue |
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Term
|
Definition
Route: SubQ
Schedule: 1 dose, given in epidemics and to those at risk: college freshmen, military recruits, jails
Efficacy: response takes 5 days
contraindicated in pregnancy
may have local reaction |
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Term
|
Definition
Route: IM
Schedule: DTP preferred for children, Td preferred for adults, booster q10yr
dont given for treatment of acute tetanus infection
Needs to have had initial series |
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Term
| Tetanus Immune Globulin (Hyper-Test) |
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Definition
Given to those who imunization status incomplete or uncertain if: trauma, deep laceration, primary start of immunizations adult
Is form of gamma globulin
takes 21 days to impact |
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Term
|
Definition
Route: IM,killed virus
Schedule: given annually in late fall: split doses to those under 13
Contraindicated if allergice to eggs, toxic drug rxns with dilantin, theopylline, warfarin
effective against limited strains
serious adverse rxn: Guillain-Barre syndrome
CANNOT GET THE FLU FROM SHOT |
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Term
|
Definition
Route; subq or IM
Schedule: not used in children under 2; given age 65
contraindicated in pregnancy, within 10days of chemotherapy
no revaccination unless immunocompromised, wait 5-10 years
MEDICARE PAYS for it. |
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Term
|
Definition
Prophylaxis for persons at high risk
inactivated virus
duration: 10 years
schedule: first shot, needs booster 6-12 months, plan ahead
contraindicated in patients with bleeding orders or febrile illness |
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Term
|
Definition
Route: skin pricks (inactivated virus)
Schedule: up to 5 days post exposure; recommended for high risk groups (EMS, Police, ER personnel, Community Health responders, military)
Forms lesion that can transfer to others: does not transmit small pox, transfers vaccinia rash |
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Term
| ibuprofen (Motrin, Advil) |
|
Definition
Indications: pain, fever, inflammation
Action: blocks 2 enzymes (COX-1 and COX-2) that contribute to the production of prostaglandins
SE: Dyspepsia, GI pain, diarrhea, potential for GI bleeding, HA, dizziness, fatigue
Interactions: decreased diuretic effect if taken with lop diuretics, decreased effect with beta blockers, lithium toxicity |
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|
Term
| Gold Salt, aurothioglucose (Solganal) |
|
Definition
Indication: rheumatoid arthritis
Action: blocks phagocytosis thus reducing tissue destruction
Excreted in urine and feces
SE: variety of effects r/t deposits in tissues, tomatitis, glossitis, gingivitis, GI inflammation, bone marrow depression, nephrotic syndrome, dermatological effects |
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Term
|
Definition
Indication: renal transplant, start 1-5 days prior to surgery
SE: GI sx, megaloblastic anemia, hepatitis, sores in the mouth, skin rash
Monitor: CBC weekly during 1st month, twice a month for next 2-3 months, then monthly, LFTs: renal function |
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Term
|
Definition
Indication: renal, hepatic or cardiac, usually in conjunction with steroids
SE: leg cramps, N/V, acne or oily skin, tremors, swollen and bleeding gums, severe HTN
Monitor: baseline data q2wk during firs 3 months, then monthly, dental exams q3mo |
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|
Term
| interferon alpha-2b (Intron-A) |
|
Definition
Indication: treatment of leukemia, Kaposi sarcoma, warts, malignant melanoma, chronic Hepatitis B
Action: prevent virus particles from replicating
SE: diziness, GI sx, stomatitis, wt loss, pruritus, rash, anemia, leuko-and thrombocytopenia, flu-like syndrome
Monitor: BP (hypotension), CBC (bone marrow depression), LFTs and renal function |
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|
Term
| aldesleukin (interleukin-2) |
|
Definition
Indication: leukemia, malignant melanoma, AIDS-related Kaposi sarcoma, chronic hepatitis B
Action: activate cellular immunity by increasing the number of lymphocytes, increases natural killer cells, increases number of circulating platelets
Route: IV
SE: dyspnea, arrhythmias, hypotension, GI sx, oliguria or anuria, pruritus, anemia, stomatitis, coagulation disorders, leuko- and thrombocytopenia, acidosis
Monitor: continuous EKG during therapy, resp status, signs of anemia, GI bleeding, signs of infection |
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|
Term
|
Definition
Indication: preent neutropenia and infection in patients who receive cancer drugs
Action: binds to immature neutrophils and causes them to divide and differentiate
Route: IV or SC
SE: excessive leukocytosis, medullary bone pain
Monitor : CBC and platelets 2x/week, pain |
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|
Term
| cyclosporine (Sandimmune) |
|
Definition
Indication: suppress inflammation, prevent transplant rejection
Action: modify the release of interleukins
SE: tremor, HTN, hypeplasia of gums, renal, GI, derm, bone marrow depression, at risk for infection or tumor development |
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|
Term
| muromonab-CD3 (Orthoclone OKT3) |
|
Definition
Indication: allograft rejection in organ transplants
Action: reacts as an antibody to human T-cells disabling them
SE: acute pulmonary edema associated with severe fluid retention, fever, chills, GI sx, myalgia, increased susceptibility to infection
Should not use with other immunosuppressants because of the danger of infection or neoplasm |
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|
Term
|
Definition
Action: reduces viral shedding, time to crusting, severity of sx, and duration of local pain
Indication: herpes simplex, herpes zoster, varicella
Topical, oral, parenteral
Works best if started at first sign of lesions coming.
Still shed virus while on drugs |
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|
Term
|
Definition
Indication: oropharyngeal candidiasis
Action: binds to sterols in the fungal cell membrane, makes cell wall leaky
SE: n/v, stinging, redness, uticaria, abnormal lfts |
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|
Term
|
Definition
action: buffer or neutralize hydrochloric acid and increase gastric pH
Indications: hyperacidity r/t gastritis, peptic ulcer, GERD, hiatal hernia
Goal: neutralize pH to 3.5
SE: aluminum-constipation, bone semineralization, calcium-gastric acid hypersecretion, constipation, kidney failure, increase calcium levels, magnesium-diarrhea, increased potassium and decreased magnesium levels, sodium- sodium overload, gastric acid hypersecretion
Give 1-3 hr after meals and hs
Shake liquid suspensions
Long-term use can cause kidney failure |
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|
Term
|
Definition
action: block receptors in chemoreceptor trigger zone (CTZ) in the emetic center in the medulla that are activated by neurotransmitters
Indication: prevent or relieve nausea and vomiting
SE: drowsiness, tardive dyskinesia
Ex: anticholinergic: transderm-scop, benadryl, pepto-bismol |
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|
Term
|
Definition
Action: stimulates the CTZ and irritates the gastric mucosa
Indication: poisonings, anorexics and bullimics also use to purge
Induces vomiting within 20-30 minutes
Follow with 3-4 full glasses of water |
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Term
| Cimetidine (Tagamet), ranitidine (Zantac), pepcid, axid |
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Definition
Action: prevent histamine fromstimulating H2 receptors on gastric parietal cells, reducing gastric acid secretion, relieves pain from hyperacidity
Indication: treatment and prevention of PUD, reflux diseases, hypersecretion of acid
SE: HA, drowsiness, muscle aches, anorexia, n/v, diarrhea, constipation, sexual dysfunction, confusion, delusions |
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Term
| Sucralfate (Carafate, Sulcrate) |
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Definition
Action: chemically combines with substances from damaged cells in the ulcer crater, forms a protective acid-resistant barrier in the crater and prevents further erosion
Indication: peptic ulcer tx, prevent stress ulcers
SE: most reported is constipation
Caution: if using antacids, separate doses by at least 1/2 hr |
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Term
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Definition
Action: stimulates increased secretion of the protective mucus that lines the GI tract
Don't take if pregnant can cause abortion. |
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Term
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Definition
Action: blocks acid secretion by inhibiting the ATPase enzyme at the gastric parietal cells
Indication: severe erosive esophagitis from GERD, duodenal ulcer, long-term tx of hypersecretion
SE: stomach colic, heartburn, GI sx, HA, weakness, dizziness, chest pain, rash
Education: 4-6 week therapy, best taken in am ok to take with antacid |
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Term
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Definition
Action: absorb water and form a soft bulky mass which stimulates peristalsis
Onset 12 hr but up to 1-3 days
Caution: increase fluids, if not can cause obstruction |
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Term
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Definition
Action: draw water from the capillaries of the gut and stimulate gut motility
Works in 30 minutes to 6 hr
Caution: usually loose or watery stool, used when rapid and complete evacuation of bowel is desired |
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Term
| Bisacodyl (Dulcolax, Feenamint, Correctol) |
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Definition
Action: work on intestinal muscles and secretory cells to stimulate motility and fluid movement
Usually works 6-8 hr
Caution: associated with fluid loss, can lead to dependency |
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Term
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Definition
Action: increases ACh levels and stimulates the PNS
Indications: GERD, postop risk for ileus, to eliminate barium
Caution: don't give if pt has intestinal blockage |
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Term
| Docusate (Colace, Surfak, Doss) |
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Definition
Action: decreases surface tension of stool and forms an emulsionbtwn the fats and water of the stool
Works 12-72 hr
Useful in pt who have trouble with hard stools or to help avoid straining. |
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Term
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Definition
Action: consists of sugars which are metabolized to acids to produce an osmotic effect with increased fluid accumulation, distention, peristalsis also decreases serum ammonia levels for persons with chronic kidney disease
Works 24-72 hr
Indication: chronic constipation that doesn't respond to OTC bulk laxatives
SE: flatulence, intestinal cramps, belching, nausea, diarrhea |
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Term
| Polyethylene glycol (GoLYTELY) |
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Definition
Action: mix of PEG sodium salts, and potassium chloride, is isotonic to body fluids so doesn't absorb or secrete electrolytes but acts as osmotic
Indications: bowel cleansing before colonoscopy or barium enema, is safe for dehydrated, renal or cardiac disease
ADME: fast 3-4 hr prior, drink 4 L at a rate of 240 ml q 10 minutes
SE: low incidence n/v, bloating, cramps |
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Term
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Definition
action: coats wall of GI tract, absorb bacteria or toxins causing diarrhea, decreases fluid content of stool by inhibiting fluid secretion or by increasing fluid absorption
Take after each loose stool |
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Term
| Paregoric (tincture of opium) |
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Definition
Action: decrease GI motility, allows reabsorbing of water and electrolyes, reduces pain and spasms
Indication: persistent diarrhea, don't use if cause of diarrhea is invading organism
SE: CNS effects-depression and sedation
Caution: schedule II |
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Term
| Loperamide (Imodium), diphenoxylate and atropine (Lomotil) |
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Definition
Action and indication: same as opioids
SE: dizziness, rash, dry mouth, drowsiness, tachycardia, rash, agitation |
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