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PHARM FINAL
Medications
| Drug | Class, Uses, MOA | SE, Labs | Patient Education | Interactions |
|---|---|---|---|---|
| Cimetidine | H2 RA Uses: gastric/peptic ulcers, GERD, Zollinger-Ellison syndrome MOA: inhibits H2 receptors on parietal cells -->acid suppression | SE: GYNECOMASTIA, impotence, low libido, confusion, hallucinations, CNS excitability/depression, PNEUMONIA Labs: renal/hepatic function, occult test (GI, stool). | **If taking antacid, wait 1 hour inbetween. | |
| Calcium carbonate | Antacid Uses: PUD!!! GERD MOA: neutralizes acid at parietal cells | SE: CONSTIPATION, anorexia, hypercalciuria, calculi Labs: urine/serum calcium, CBC, electrolytes (chloride, phosphorus), renal function for calculi. | **Avoid foods high in oxalate. | Oxalate foods: spinach, dairy, cereal |
| Bulk-forming laxatives | Laxative Uses: constipation, diarrhea, IBS, diverticulosis MOA: absorbs water, softening and enlarging stool, stimulating peristalsis | SE: N/V/D, intestinal/esophageal blockage Labs: electrolytes in blood/urine, CBC, FOBT | Take with full glass of water in AM or PM by itself. | Senna, flax increase effect. |
| Lactulose | Osmotic laxative Uses: chronic constipation, portal system encephalopathy (PSE) MOA: absorbs water & softens stool, enhances ammonia excretion | SE: N/V/D, gas, cramping, distention, hypokalemia, hypernatremia, hyperglycemia Labs: blood/urine electrolytes, CBC, FOBT, hepatic function (ammonia, encephalopathy). | Take with full glass of water in AM or PM by itself. | Senna, flax increase effect. |
| Nausea prevention (nonpharmacologic) | -Small frequent meals -Avoiding odors and trigger foods -Acupuncture and ginger | |||
| Doxylamine pyridoxine | Antiemetic (antihistamine + B6) Uses: NVP (morning sickness) MOA: unknown | SE: drowsiness, dizziness, somnolence; URINARY RETENTION Labs: none but renal/hepatic function, electrolytes | Take on an empty stomach with water, do not drive. | |
| Insulins | Antidiabetic Uses: DM 1/2, gestational DM MOA: transports glucose into cells and into glycogen, decreases potassium and phosphate. | SE: HYPOGLYCEMIA, lipodystrophy/hypertrophy, Somogyi effect Labs: FBG, A1C, urine ketones, electrolytes (potassium, calcium) | **Insulin replacement isn't required for DM 2 but may be needed if lifestyle changes aren't enough. | |
| Humalog | Rapid acting Onset: 15-30 mins | Peak: 30-2.5 hrs Duration: 3-6 hrs | Given for a sugar of over 300. | |
| Regular insulin (Humalin R, Novolin R) | Short-acting Onset: 30 min-1 hr | Peak: 1-5 hrs Duration: 6-10 hrs | CAN BE GIVEN IV | |
| Intermediate (Humalin N, Novolin N) | Intermediate Onset: 1-2 hrs | Peak: 6-14 hrs Duration: 16-24 hrs | ||
| Levothyroxine | Thyroid hormone Uses: hypothyroidism, myxedema coma, replacement MOA: increases metabolic rate (increased vitals, growth) | SE: thyrotoxicosis (tachycardia, sweating, heat intolerance, weight loss, dysrhythmias, diarrhea, DECREASED BONE DENSITY) Labs: serum TSH, T4, T3; V/S, weight, bone density, coagulation | Take medication in AM on empty stomach. | Decrease effect: soy, horseradish |
| Propythiouracil (PTU) | Antithyroid Uses: hyperthyroidism, thyroid storm, thyrotoxicosis MOA: blocks t3/t4 production, inhibits iodine organification | SE: lethargy, HEPATITIS, LIVER FAILURE, jaundice, AGRANULOCYTOSIS, leukopenia, thrombocytopenia Labs: CBC, hepatic studies, weight, serum T3/T4 | Take with food at same time each day. | |
| Hydrocortisone | Corticosteroid Uses: adrenal insufficiency, IBS, COPD, asthma, SLE, TB, SJS MOA: decreases inflammation by suppression of leukocyte migration and lymphocyte production | SE: adrenal suppression, Cushing's, osteoporosis, hyperglycemia, infection, mood disorders, delayed growth, PUD, sodium/water retention, potassium loss Labs: glucose, electrolytes (potassium, sodium), WBC count, weight, plasma cortisol, lipid panel, BMD | **Given before 9AM. Taper off slowly . Increase dose in times of stress. Avoid live virus vaccines. CONTRAINDICATED IN PTS WITH GLAUCOMA | Decreases effect: ephedra |
| Somatropin | Growth Hormone Uses: peds & adult GH deficiency, peds short stature, PWS, cachexia, AIDS wasting MOA: stimulates growth | SE: hypercalcuria, PANCREATITIS, hyperglycemia, neutralizing AB, hypertension Labs: glucose, urinalysis, thyroid function, GH AB | **IM/SUBQ : teach how to inject properly. Teach how to monitor BP. | |
| Alendronate | Biphosphonate Uses: osteoporosis in men and PM women, Paget's, GIOP (glucocort-induced) MOA: inhibits osteoclast activity and suppresses resorption of bone. | SE: hypocalcemia, hypophosphatemia, HYPERPARATHYROIDISM, esophageal cancer, A-FIB, fractures Labs: serum calcium and phosphate, BMD, alkaline phosphate | Empty stomach. | |
| Phenylephrine | Adrenergic Agonist Uses: mydriasis MOA: stimulates alpha-1 receptors on iris dilator muscles | SE: angle-closure glaucoma, HYPERTENSION, ARREST, DYSRHYTHMIAS, eye pain, floaters Labs: V/S | ||
| Isotretinoin | Antiacne Uses: severe nodulocystic acne MOA: reduces sebum, sebaceous gland size, inflammation, keratinization | SE: depression, itching/inflammation of lips and skin, muscle/bone/joint pain, UV sensitivity, nosebleeds, increased triglycerides Labs: triglycerides, PREGNANCY TEST!!! | ||
| Oral Corticosteroids | Uses: asthma, IBS, autoimmune diseases, allergies, adrenal insufficiency replacement, immunosuppression in transplant pts MOA: suppresses inflammation and immune responses | SE: hyperglycemia, immunosuppression, fluid retention, hypokalemia, hypertension, glaucoma, OSTEOPOROSIS, INFECTION, DELAYED GROWTH, ADRENAL SUPPRESSION Labs: DEXA BMD, FBG, electrolytes (sodium, potassium, calcium), cortisol levels | **Take before 9AM to mimic natural hormone release. Taper off slowly Increase dose in times of stress (surgery, illness, trauma). AVOID LIVE VIRUS VACCINES IF IMMUNOCOMPROMISED. Contraindicated in patients with glaucoma. | |
| Vitamin D (Calcitriol) | Uses: hypocalcemia, hypoparathyroidism MOA: increases bone resorption of vitamin D, decreasing calcium excretion, increases intestinal absorption of calcium | SE: constipation, dysrhythmias, edema, pancreatitis, myalgia Labs: serum calcium, alkaline phosphate, hepatic/renal studies, electrolytes | Sunlight, not enough in diet. | |
| Modafinil | CNS stimulant Uses: narcolepsy, sleep-wake disorder, sleep apnea MOA: unknown; suspected to be inhibition of reuptake of dopamine and norepinephrine | SE: anxiety, insomnia, diarrhea, SJS, anorexia, increased BP/HR Labs: hepatic/renal studies | Can be taken with/without food. Use contraception! | Increased effects with caffeine |
Created by:
alainamcastillo
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