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MC Pharm Exam 4

MC Fabick Fall 2012

DrugClass
epoetin alfa recombinant (Epgoen, Procrit) hematopoietic growth factor
EPO hematopoietic growth factor
darbepoetin alfa (Aranesp) hematopoietic growth factor
filgrastim (Neupogen) Colony-stimulating factors prototype, S/E same as hematopoeitic growth factors
pegfilgrastim (Neulasta) Colony-stimulating factors long duration
sargramostim (Leukine) Colony-stimulating factors tx of non hodgkins lymphoma and autologous bone marrow transplantation...teach to avoid infection!
oprelvekin (Neumega) platelet enhancer platelets, s/e- edema, weight gain, given SQ only
romiplostim (NPlate) platelet enhancer given for PO ITTP
eltrombopag (Promacta) platelet enhancer
cyannocobalamin (Crystamine) antianemic agents, most common, purified form of vitamin B12, tx percutaneous anemias, weekly to monthly tx for life, mental and behavioral changes noted
folic acid (Folvite) antianemic agents
ferrous sulfate (Feosol) antianemic agents constipation, dark green or black stools, stained teeth, iritating to tissues, anaphylaxes if given IV
Humalog insulin
regular (Humulin R) insulin, more effective, less allergenic and less resistance. comes from e. coli, effects cell transport, tx IDDM and some NIDDM, controls storage/use of carbs, S/E dka,
NPH insulin
glargine (Lantus) insulin
sulfonylureas oral hypoglycemic class
biguanides oral hypoglycemic class
alpha glucosidase inhibitors oral hypoglycemic class
thiazolidineadione oral hypoglycemic class
meglitinides oral hypoglycemic class
glipizide (Glucotrol & Glucotrol XL) sulfonylureas
metformin (Glucophage) biguanide antihyperglycemis, prototype,
metformin (Glumetza) biguanide antihyperglycemis, long acting, once daily dosing, give after eating, use alongside with sulfonylureas, a/e- lactic acidosis
acarbose (Prescose) Alpha-glucosidase inhibitors, block enzyme in small bowel that breaks down complex carb that prevents absorption in small intestine, give with first bite of food, causes hypoglycemia, careful of garlic and ginseng, check ALT and AST's!
rosiglitazone (Avandia) thiazolidineadione antihyperglycemics, a/e- edema, effects lipid levels, hepatotoxic, chf, does not cause hypoglycemia
pioglitazone (Actos) thiazolidineadione antihyperglycemics
nateglinide (Starlix) meglitinides antihyperglycemics, stimulate insulin production from pancreatic cells, 2-4 hr action, well tolerated, hypoglycemia = main s/e
repaglinide (Prandin) meglitinides antihyperglycemics
exenatide (Byatta) Combo antihyperglycemics,incretin mimetics, a/e- N/V/D, take SQ, BID
pramlintide (Symlin) Combo antihyperglycemics,injectable, type 1 and 2, mimics amylin
Jenuvia (Sitajilpin) Combo antihyperglycemics, PO it stops breakdown of incretin, decrease in blood sugar levels
Glucagon hyperglycemic agents
D50W hyperglycemic agents
calcium carbonate (Bio Cal, Calcite-500) Calcium Supplements & Vitamin D
calcium citrate (Citracal) Calcium Supplements & Vitamin D
Calcium salts Calcium Supplements & Vitamin D, use slow IV*, avoid zinc foods (nuts,legumes, seeds, sprouts and tofu), chvostek and trossue tests
calcitriol (Calcijex, Rocaltrol) osteomalacia drugs, prototype, tx rickets also, promotes intestinal absorption and improves calcium levels, administer with calcium supplements
alendronate (Fosamax) bisphosphonates, prototype, take daily, metallic and altered taste, given iv cause nephrotoxicity, take on empty stomach w/ glass of water, stay upright 30-60 min, NPO 2hrs,esophageal erosion, causes ulcers
bisphosphonates osteoporosis drugs
SERM osteoprosis drugs
ibandronate (Boniva) bisphosphonates
risedronate (Actonel) bisphosphonates
etidronate disodium (Didronel) bisphosphonates
raloxifene (Evista) SERM, prevention of osteoporosis in postmenopausal women, CI preg/lactating
DMARDs RA drugs
TNF Inhibitors or MABs also DMARDs RA drugs
hydroxychloroquinine sulfate (plaquenil) DMARDs
methotrexate (Rheumatrex, Folex, Mexate) DMARDs
infliximab (Remicade) TNF Inhibitors, decreases inflammation, binds to TNF's
adalimumab (humira) TNF Inhibitors, prevents joint damage
auranofin (Ridaura) TNF Inhibitors
gold sodium tiomalate (Myochrysine) TNF Inhibitors
colchicine (Colchicine & Colgout) antigout, used in acute attacks, get from autumn crocus (flower), does not clear or get rid of uric acid, but gets rid of inflammation and pain, take qhr until pain relieved or have diarrhea
probenecid (Benemid) uricosuric, prototype for chronic gout, discontinued at onset if acute attack, a/e- wheezing, or other allergic reaction sx
sulfinpyrazone (Anturane) uricosuric, leads to nephrolithiasis made up of uric acid stones, watch for kidney stones, increase fluids b/c gout
allopurinol (zyloprim & lopurin) uricosuric, renal failure, BUN and Creatinine, and liver toxicity, liver alt and ast
acetylsalicylic acid (aspirin) salycylates
ibuprofen (motrin, advil) prostaglandin synthtase inhibitors (PSI)
ketoprofen (orudis) prostaglandin synthtase inhibitors (PSI)
meloxicam (mobic) prostaglandin synthtase inhibitors (PSI), arthtitis pts
naproxen (Naprosyn) prostaglandin synthtase inhibitors (PSI), 12 hr dosing
naproxen sodium (Aleve & Anaprox) prostaglandin synthtase inhibitors (PSI)
indomethacin (Indocin) acetic acids
diclofenac sodium (Voltaren) acetic acids
ketorolac(Toradol) acetic acids
phenylbutazone (Butazolidin) pyraxolone derivative
nabumetone (Relafen) alkanones, newer, used for osteo and rheumatoid arthritis, daily dosing
celecoxib (Celebrex) COX2 Inhibitor,for inflammation, does not cause stomach probs, do not take if allergic to aspirin or sulfonimides
prednisone (Deltasone) glucocorticoids-corticoids, replacement therapy with Addison's disease (adrenal glands not functioning), prevents asthma, delayed wound healing, hyperglycemia, heirchtism, cushings, skinny arms and legs, increase the med with stress
beclomethasone dipropionate (Beclovent & Veanceril) glucocorticoids-corticoids inhaled
triamcinolone acetonide (Aristocort, Kenocort, Aristospan, Kenalog) glucocorticoids-corticoids inhaled
hydrocortisone glucocorticoids-corticoids topical
methlprednisolon glucocorticoids-corticoids topical
betamdethasone glucocorticoids-corticoids topical
dexamethasone glucocorticoids-corticoids topical
triamcinolone glucocorticoids-corticoids topical
fludrocortisone (Florinef acetate) mineralcorticoids, replacement for adison's disease
acetaminophen (Tylenol) para-aminophenol , prototype, widely used OTC analgesic and antipyretic, no anti-inflammatory or antiplatelet, not an NSAID!, overdose= hepatotoxicity
decoction boiled 30-60 min very concentrated
extract solvents form highly concentracted
infusion soaked 15 min stronger tea
tea soaked 5-10 min & convenient
tincture extracted with alcohol by soaking
hematopoeitic growth factors S/E- asthenia (muscle weakness)...flulike symptoms (M/C)..clotting (shut off dialysis shunt)...polycythemia (increase in blood cells)...risk for thromboembolic disease
hct and hbg levels hct: 38-47 women, 46-54 males, hgb: 11.5-16 women and 13.2-17.5 males
iron soures liver, eggs, legumes (peanuts and beans), whole enriched grains, dark green veggies, iron cookware, organ meats
folic acid sources dark green veggies, legumes, liver, OJ
B12 sources animal products only...meat, fish, eggs, liver, poultry, milk, cheese
colony stimulating factors "stim"
anemias blood has reduced ability to carry oxygen...anemia is a sign NOT a symptom
important about insulin 100 ml syringe (rarely 500)...know how to calculate, can not be given PO, don't give cold but give at room temp
exubra inhaled regular insulin approved in 2006
hypoglycemia s/x ittitability, LOC (coma), convulsions, lipodistrophy
hyperglycemia 3 p's
levemir peakless
glipizide (Glucotrol) 2 generation sulfonylureas, prototype, assess for sulfa allergies, tx NIDDM if not controlled by diet and exercise, s/e-photosensitivity, rash, hypoglycemia (mc), weight gain, hepatotoxicity, antibuse reaction (can't drink alcohol- can kill them)
glipizide (Glucotrol) levels onset 15-30 minutes, peak 1-2 hrs, duration 24 hrs basal control
hyperglycemia does not happen with this class thiazolidinedione antihyperglycemics
bromocreptine mesylate (perlodel or cycloset) combination drug, used with Parkinson's, perlodel tx type 2 DM
stevia 300 times sweeter than sugar, not approved sweetener bc it mutates cells
glucagon hyperglycemic agent- duration 1.5 hrs repeat in 20 min, s/e- rash, dizziness, resp distress, n/v, Hyperglycemia, dosage 0.5-1 mg
bisphosphonates cause TMJ
zolendronate (reclas, zomata) given IV 5 min, repeat in 7 days
HRT controversial, correlated with Bcancer, thromboembolic disease, and uterine cancer
calcitonin lowers serum calcium levels
paget's disase bisphosphonates- DOC, calcitonin second
DMARDs taken for RA if NSAIDS are not working, slows disease progression, may induce remission, a/e- irreversible retinal damage (vision checks q 6 months), low bc (agranulocytosis),
glucosamine and chondroitin taken for several months to improve catilage
gout high levels of uric acid leads to inflammation, pain , and joint deformity
salicylates CI- preggers (in third trimester) and pts with peptic ulcer disease or increased risk of bleeding, get hyperthermia and tinnitus
NSAIDS education take with water, meals, antiacid, or milk, causes bleeding, bruising, and tinnitus, take around the clock for inflammation
glucocorticoids watch for oral or vaginal canditiasis, avoid OTC drugs and aspirin), never stop quick,using it inhaled rinse mouth piece and mouth after each use, causes dysphonia (change in voice), avoid exposure to contagious agents and avoid cowds, Never stop absuptly
Created by: midnight1854