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Exam 1 Drugs 9/17/25
| Drug | MOA | Indications | Adverse Effects | Contraindications | Nursing Implications | Other | Word Part |
|---|---|---|---|---|---|---|---|
| Penicillins (PCN) | Bactericidal: binds to cell wall and causes cell to rupture | Bacterial Infections | -Hypersensitivity -GI -Superinfection -Neuropathy -CNS -BBW: IV PCN G | Hypersensitivity/allergy to ANY PCN w/a 5-10% cross-sensitivty with cephalosporins | -Generally safe for children and older adults -Take on any empty stomach with a glass of water -Can take with food resulting in GI upset -Renal Excretion -Hepatic impairment: Augmentin -Monitor 1st dose for atleast 30 minutes -IM=Large muscle | -Systematic, exreted through kidneys -Citric juice reduces effectiveness of oral | -Cillin |
| Cephalosporins | Bactericidal: most effective against cells undergoing division | Surgical prophylaxis and infections | -Hypersensitivty -GI -Superinfection | Hypersensitivty or previous anaphylaxis to PCN | -Generally safe for children -Decrease dose for older adults -May impair vitamin K synthesis -Take with food/milk | 1st and 2nd: Surgical Prophylaxis (1 hr. prior) 3rd: CSF and Combination Therapy 4th: Broad spectrum 5th: Gram -, anaerobic, and resistance to beta-lactam enzymes | Sef-, Ceph- |
| Carbapenems | Bactericidal | Broad-Spectrum | |||||
| Monobactam | Bactericidal | ||||||
| Aminoglycosides | Bactericidal: impairs protein synthesis | -Serious systemic infections - gram - aerobic, Synergistic Effect | -BBW: Ototoxicity and nephrotoxicity -Peripheral Neuropathy -Cautiouse use for those with Myasthenia Gravis | Hypersensitivty | -Cautious use with neonates, children, and older adults -Dosing -ID pts with renal impairment -Hydration -Monitor CrCL and peak and trough serum levels | Mycin-, Micin- | |
| Fluroquinolones | Bactericidal: impairs DNA replication | -Gram - aerobic -ANTHRAX (Cipro) | -GI -Photosensitivity -BBW: tendinitis and tendon rupture, peripheral neuropathy, CNS/CV effects, Myasthenia Gravis -HA | -Not routinely used in children -ODA dosing -No dairy -2 to 3 L of fluids -Cautious use w/liver disease -Prolong QT interval | -Floxacin | ||
| Tetracyclines | Bacteriostatic: Inhbits protein synthesis suppressing growth | -Anthrax treatment -Prophylaxis for Malaria | -NV -Photosensitivty -GI symptoms -CNS -Hepatotoxicity -Renal toxicity -Superinfections | -Hypersensitivity -Renal Failure -Pregnancy -<8 yrs old | -Take on empty stomach with glass of water -Avoid milk, Fe, and iron within 2 hours -Photosensitivity -Oral contraceptives ineffective | Severe reactions taking expired tetracycline | -Cycline |
| Sulfonamides | Bacteriostatic: inhibits folic acid synthesis of proliferating cells | -UTIs -Burns -Chronic Bronchitis | -N/V/D -Photosensitivity -Kernicterus -Renal damage -Blood Dyscrasias -Steven-Johnson Syndrome | -Renal failure -Hypersensitivty -Late pregnancy | -2 L fluid to prevent crystallization (monitor pH) -Take with glass of water -Reduces oral contraceptive effectiveness -Photosensitivity | Highly resistant | Sulfa- |
| Nitrofurantoin | UTIs | ||||||
| Macrolides | Bacteriostatic or Bactericidal depending on dosing: protein synthesis | -Strep/Staph infections -URI -Some STIs -Newborn opthalmic prophylactic | -GI -Cautious w/liver disease -CNS -Emotional Lability | Hypersensitivty | -Take on empty stomach w/glass of water -Avoid citrus -Reduces effectivness of oral contraceptives | -Thromycin | |
| Vancomycin (Glycopeptide) | Bactericidal: inhibits cell wall synthesis in gram+ ONLY | -IV for serious systemic infection -Oral for pseudomembranous colitis | -Reversible nephrotoxicity -Redman syndrome | Hypersensitivty | -Slow IV infusion rate (1-2 hrs) -Monitor renal function -Prophylaxis: Bactroban nasal administration for staph sternal incision | ||
| Isoiazid (INH) | Bactericidal: inhibits cell wall synthsis | -Latent TB -Active TB | -BBW: Hepatotoxic -Peripheral neuropathy (B6) | -Monitor LFT -Avoid ETOH -Teaching -DOT -Latent TB treatment can be delayed until delivery -Take on empty stomach with glass of water -Several drug-drug interactions | |||
| Rifamycins | Bactericidal: inhibits synthesis of RNA | -Latent TB -Active TB | -GI -Rash -Hepatotoxicity -AKI -Reddish-orang discoloration to clear bodily fluids | -Monitor LFT -Avoid ETOH -Take on empty stomach -Reduces effectiveness of oral contraceptives | -Synergistic with INH -Enzyme inducer -Ethambutol: optic neuritis | ||
| Anti-Viral Medications | Inhibit viral DNA replication | Viral infections: Covid, Herpes, CMV, RSV, Flu | -Ganciclovir: monitor for bone marrow suppression -Ribavirin: Teratogenic (BBW) | -May cause some harm to host | -Vir | ||
| Anti-Retriviral Medications | Prevents or inhibits viral reverse trancriptase and protease enzyme | -Anorexia -N/V/D -Fever -HA -Bone marrow depression -Renal impairment | -Prevention -Compliance -Stress reduction -Monitor CD4, viral load, CBC -PREP and PEP | -Zidovudine (AZT)-:NRTI used Prophylaxis to prevent HIV transmission between mother and baby during labor -Dovato: Preferred for pregnant women -Truvada | |||
| Amphotericin B | Serious systemic fungal infections | -BBW: Nephrotoxicity -Chills -Hypotension -Tachycardia -Malaise -Muscle Pain -Joint Pain | -Monitor LFT -Premedicate with anti-pyretic, emetic, and histamine | May seriously harm host cells | |||
| Azoles | Local and systemic funcal infections | -Avoid exposure w/impaired immune system -Monitor LFT and Renal Function | May seriously harm host cells | -Azole | |||
| Iron | Iron is stored in small intestine and excess exreted in stool | During times of increased need and anemia | -GI -Black-Green stool -Oral liquid may stain teeth | -Anemias not iron associated -GI disorders -Disorders where Fe accumulates in the body | -Take on ampty stomach with glass of water -Vitamin C -Oral liquid through straw then rinse -2 to 4 hours before or after other meds/meals | -IV>IM -BBW: Anaphylaxis -IM: Z-Track Method -IV Dextran: Emergency Equipment | Fe- |
| Calcium Gluconate | Hyperkalemia and Magnesium Toxicity | Hypercalcemic | Protects heart from cardiac dysrrythmias | ||||
| Insulin + Glucose | Causes K+ to move into cells and Glucose prevents hypoglycemia | ||||||
| Sodium Polystyrene Sulfonate (Kayexalate) | Combines with K+ in colon and eliminated via stool | With sorbitol: increased risk of intestinal necrosis | -Must enter GI tract -Takes several hours to work | ||||
| Potassium Chloride (KCL) | -Prevent or treat hypokalemia -Prevention with diuretics | -Potassium sparing diurectics -Untreated Addison's disease -Severe renal impairment -Hyperkalemia | -PO>IV -Before giving IV check K+ levels AND urine output >30mL/hr. -Must be diluted and giving no faster than 10 mEq/hr | ||||
| Penicillamine | Excess Copper | ||||||
| Succimer | Lead Poisoning | ||||||
| Deferoxamine | Iron Toxicity | ||||||
| Deferaxirox | Iron Overload | ||||||
| Magnesium | -Hypomagnesemia -Preganancy associated convulsions -Depressant on CNS and mucle | Diarrhea :) | -Impaired renal function -Comatose | ||||
| Zinc | Promotes wound healing | Intranasal zinc is not recommended | |||||
| Multiple Mineral-Electrolyte Preparations | -Fluid and Electrolyte replacement and Dehydration -Children with Diarrhea | ||||||
| Phentermine Hydrochloride | Appetite supression by inhbiting serotonin and norepinephrine | Obesity (short-term) | Increased SNS | -HTN -CV Disease -Hyperthyroidism -Pregnancy -Hx of Drug Abuse -Anxiety/Agitation | -Tolerance within 4-6 weeks -Take on empty stomach -AM OAD -Do not operate heavy machinery | -Noradrenergic Sympathomimetic Anorexiants -Schedule IV | |
| Phentermine and Topiramate | -Tachycardia -Suicidal Thoughts -Vision Changes | -Noradrenergic-Sympathomimetic Anorexiants -Pregnancy Catergory X | |||||
| Lipase Inhibitors | Blocks 30% of fats from being absorbed | Obesity | GI Fatty Stuff | -Malabsorption -Cholestasis | -Frequent Dosing -Multivitamin Supplementation (2 hrs. before) | -Anticoagulant interference | |
| GLP-1 Receptor Agonist | Slows gastric emptying | Long-Term weight management | -GI -BBW: Medullary thyroid cancer and pancreatitis | ||||
| Antacids | Neutralizes HCL in the stomach -pH 3.5 | -PUD -GERD -esophagitis -"Heartburn" -Gastritis -Gi bleed and stress ulcers | Undiagnosed GI problems and s/s of appendicitis | Must be taken 1 hour before or after other medications | |||
| Aluminum Hydroxide | CKD and hyperphosphatemia | Constipation and increased aluminum levels | |||||
| Magnesium Hydroxide | CKA and all meganesium products | Diarrhea and hypermagnesemia | |||||
| Calcium Carbonate | CKD and hyperphosphatemia | Hypercalcemia | |||||
| Simethicone | Antiflatulence | ||||||
| H2 Receptor Agonist | Blocks action of H2 receptors decreasing gastric acid | -PUD -GERD -Esophagitis -GI Bleeding -Zollinger-Ellison Syndrome -"Heartburn" -Prophylactic for Stress Ulcers | Rare | Use cautiously w/children, pregnancy, older adult, renal/hepatic impairment | -Available OTC at lower doses | -Tidine | |
| Cimetidine | Inhibits hepatic metabolism increasing serum blood levels | May cause diarrhea, dizziness, drowsiness, HA, confusion, gynecomastia, and confusion in older adults | |||||
| Proton Pump Inhibitor | Irreversibly binds to the enzyme that generates gastric acid preventing "pumping" | -PUD -GERD w/erosive gastritis -Zollinger-Ellison Syndrome -GI Bleeding -Prophylactic for Stress Ulcers | -Minimal: may cause N/D, HA -Long-term use impacts GI absorption of Mg and B12 | -Hypersensitivity -Pregnancy | Pharmogenomic effects | -Prazole | |
| Prostaglandin E (synthetic) | Inhibits gastric acid secretion, increases mucus and bicarb production, and increases mucosal blood flow | -Used w/NSAIDS to protect gastric mucosa -High risk for GI ulceration | -N/V/D -Vaginal Bleeding -BBW: birth defects | Pregnancy: cramps and miscarriage | |||
| Sulcrafate | Unclear: thought to bind to ulcer and form a protective barrier (3-5% systemic absorption) | Treat or prevent GI ulcers | Rare: constipation, dry mouth (d/t not absorbed systematically) | Do not administer at the same time as H2RA, PPI, or antacid d/t blocking absorption | |||
| Bismuth Subsalicylate | -Salicylate may cause bleeding | -DO NOT give to children = Reye's Syndrome -Allergy to aspirin | |||||
| Antiemetic | Prevent and treat N/V | Prevent or delay diagnosis | -PRN -Avoid ETOH and operating heavy machinery -Assessment for Causative Factor -Cautiously w/older adults -Reduce dose with hepatic impairment -Prophylaxis: 30 min to 1 hr prior | -Oral forms preferred for prophylaxis(most effective) -Rectal/parenteral forms for therapeutic | |||
| Phenothiazine | CNS depressant: blocks dopamine receptors in CTZ | Prevent and treat N/V | -Extrapyramidal Effects -Anticholinergic Effects -Sedation -BBW: Increased risk of death in older adults with dementia-related psychosis | -Always dilute IV administration -PRN -Avoid ETOH and operating heavy machinery -Assessment for Causative Factor -Cautiously w/older adults -Reduce dose with hepatic impairment -Prophylaxis: 30 min to 1 hr prior | Levine vs Wyeth | ||
| Antihistamine | Block H1 receptor sites and acetylcholine receptors in brain | N/V and motion sickness | -Sedation -Anticholinergic effects | Beers Criteria | -DO NOT give hydroxizine IV only deep IM -Take dose 1 hr prior to travel -PRN -Avoid ETOH and operating heavy machinery -Assessment for Causative Factor -Cautiously w/older adults -Reduce dose with hepatic impairment | -Meclizine for vertigo -Avoid operating heavy machinery | |
| Serotonin Receptor Antagonist 5HT3 | Antagonize serotonin receptors | Prevent/treat moderate to severe N/V | -Diarrhea -HA -Dizziness -Constipation -Transient elevated LFT | Cautious with hepatic impairment | -PRN -Avoid ETOH and operating heavy machinery -Assessment for Causative Factor -Cautiously w/older adults -Reduce dose with hepatic impairment -Prophylaxis: 30 min to 1 hr prior -Max dose for Zofran <16 mg , risk of QT prolongation | -Setron | |
| Substance P/Neurokinin 1 Receptor Antagonist | Blocks activation of Substance P inhibiting perception of nausea | -Chemotherapy N/V -Prevention of postop nausea | Typically well tolerated: fatigue, weakness, dizziness, abnormal HR, HA, hiccups | -Oral dose 1 hr prior to chemo then as prescribed -Oral contraceptives are ineffective for ~28 days -PRN -Avoid ETOH and operating heavy machinery -Assessment for Causative Factor -Cautiously w/older adults -Reduce dose with hepatic impairment | -Usually given as combination therapy w/5HT3 and corticosteroids | ||
| Corticosteroids | -Chemotherapy induced emesis -Postop nausea | Mild adverse effects with short-term use | -PRN -Avoid ETOH and operating heavy machinery -Assessment for Causative Factor -Cautiously w/older adults -Reduce dose with hepatic impairment -Prophylaxis: 30 min to 1 hr prior | ||||
| Prokinetic Agents | Increases GI motility by releasing aCH and antagonizing dopamine | -Sedation -Restlessness -Extrapyramidal Effects (children) | Parkinson's disease | -PRN -Avoid ETOH and operating heavy machinery -Assessment for Causative Factor -Cautiously w/older adults -Reduce dose with hepatic impairment -Prophylaxis: 30 min to 1 hr prior | |||
| Scopolamine (patch) | Anticholinergic | Motion Sickness | -PRN -Avoid ETOH and operating heavy machinery -Assessment for Causative Factor -Cautiously w/older adults -Reduce dose with hepatic impairment -Prophylaxis: 30 min to 1 hr prior | ||||
| Bulk Forming Laxative | Non-digestable agents swell H2O to soften and increase bulk of stool stimulating peristalsis | Flatulence and bloating | Psyllium: dysphagia, esophageal stricture, or other narrowing of GI lumen | -Must be taken with a glass of water -Fluids, high-fiber food, and exercise -Best option for long term use -NEVER for those with acute abdominal pain, n/v -Not for weight control -Glycerin supp is best for children | |||
| Lubricant Laxative | Lubricates feces slowing colonic absorption of water | ORAL Route | -Retention enema -Fluids, high-fiber food, and exercise -Temporary -NEVER for those with acute abdominal pain, n/v -Not for weight control -Glycerin supp is best for children | ||||
| Surfactant Laxative | Decreases surface tention allowing water to penetrate | Prevent straining | -Fluids, high-fiber food, and exercise -Temporary -NEVER for those with acute abdominal pain, n/v -Not for weight control -Glycerin supp is best for children | ||||
| Stimulant Cathartics | Irritates mucosa and pulls H2O resulting in watery stool | -Constipation (opioid use) -Bowel prep | -Abd pain -GI Cramping -N/d -Weakness | -Swallow tablet whole at night -Fluids, high-fiber food, and exercise -Bisacodyl < 1 week -NEVER for those with acute abdominal pain, n/v -Not for weight control -Glycerin supp is best for children | |||
| Saline Laxatives | Increases osmotic pressure causing retention of water and bowels to distend and stimulate peristalsis | Short-term treatment of constipation, rapid evacuation of bowels, prep | -Dehydration -Electrolyte Loss | Renal impairment (Mg Products) | -Fluids, high-fiber food, and exercise -Temporary -NEVER for those with acute abdominal pain, n/v -Not for weight control -Glycerin supp is best for children | ||
| Chronulac | Hypertonic solution that pulls H2O into intestinal lumen producing semi-formed stool | -Constipation -Hepatic encephalopathy | -Can be mixed with fruit juice, water, or milk -Fluids, high-fiber food, and exercise -Temporary -NEVER for those with acute abdominal pain, n/v -Not for weight control -Glycerin supp is best for children | ||||
| Lubiprostone | Chronic constipation of unknown origin | -Fluids, high-fiber food, and exercise -Temporary -NEVER for those with acute abdominal pain, n/v -Not for weight control -Glycerin supp is best for children | |||||
| Diphenoxylate | Slows peristalsis by acting on muscles of small and large intestines | Moderate to severe diarrhea | -Tachycardia -Dizziness -HA -Flushing -N/V -Dry Skin -Dry mucous membranes -Urinary retention | -Children under 2 -Diarrhea caused by toxic materials/microorganisms | -Schedule V -Monitor closely to prevent electrolyte imbalances/dehydration -2 to 3L -Maintain bland diet -Seek healthcare for abnormal stool -Antidiarrheal Therapy -Stop when diarrhea subsides | ||
| Loperamide | Decreases GI motility | Diarrhea | Generally mild: abd pain, constipation, drowsiness, fatigue, n/v -BBW: higher dose can cause life threatening CV effects | -OTC -Monitor closely to prevent electrolyte imbalances/dehydration -2 to 3L -Maintain bland diet -Seek healthcare for abnormal stool -Antidiarrheal Therapy -Stop when diarrhea subsides | |||
| Paregoric | Increases muscle tone of intestinal tract inhibiting peristalsis (also a antitussive fun fact!) | -Schedule III or V -Monitor closely to prevent electrolyte imbalances/dehydration -2 to 3L -Maintain bland diet -Seek healthcare for abnormal stool -Antidiarrheal Therapy -Stop when diarrhea subsides | |||||
| Bismuth subsalicylate | Antibacterial and Antiviral Qualities | -Salicylate may cause bleeding | -DO NOT give to children = Reye's Syndrome -Allergy to aspirin | -OTC -Monitor closely to prevent electrolyte imbalances/dehydration -2 to 3L -Maintain bland diet -Seek healthcare for abnormal stool -Antidiarrheal Therapy -Stop when diarrhea subsides | |||
| Ocreatide | Decrease GI secretion and motility | -Diarrhea unresponsive to other therapies -HIV/AIDS -Carcinoid Syndrome -Intestinal Tumors | -Diarrhea -HA -Cardiac Dysrhythmias -Injection-Site pain | -Monitor closely to prevent electrolyte imbalances/dehydration -2 to 3L -Maintain bland diet -Seek healthcare for abnormal stool -Antidiarrheal Therapy -Stop when diarrhea subsides | |||
| Polycarbophil | Pysllium used to absorb water and decrease fluidity of stool | -Monitor closely to prevent electrolyte imbalances/dehydration -2 to 3L -Maintain bland diet -Seek healthcare for abnormal stool -Antidiarrheal Therapy -Stop when diarrhea subsides | |||||
| Pancreatic Enzymes | Replace loss enzymes | Steatorrhea | -Monitor closely to prevent electrolyte imbalances/dehydration -2 to 3L -Maintain bland diet -Seek healthcare for abnormal stool -Antidiarrheal Therapy -Stop when diarrhea subsides | ||||
| Cholestryramine | Inactivates bile salts and LDL | Diarrhea associated with IBD | -Monitor closely to prevent electrolyte imbalances/dehydration -2 to 3L -Maintain bland diet -Seek healthcare for abnormal stool -Antidiarrheal Therapy -Stop when diarrhea subsides | ||||
| Rifaximin | Antibacterial: GI effects not systematic | "Traveler's Diarrhea" | -Monitor closely to prevent electrolyte imbalances/dehydration -2 to 3L -Maintain bland diet -Seek healthcare for abnormal stool -Antidiarrheal Therapy -Stop when diarrhea subsides | ||||
| Nitazoxanide | Antiprotozoal | Diarrhea associated w/Giardia or Cryptosporidium | -Monitor closely to prevent electrolyte imbalances/dehydration -2 to 3L -Maintain bland diet -Seek healthcare for abnormal stool -Antidiarrheal Therapy -Stop when diarrhea subsides | ||||
| 5HT3 Receptor Antagonist | Women with non-responsive chronic IBS associated diarrhea |
Created by:
Kelly So
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