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Pharm II Final
| Term | Definition |
|---|---|
| cimitidine (Tagamet) | Histamine H2 Antagonist Action: blocks histamine receptors in stomach to decrease acid ADR: reduced libido, confusion, aplastic anemia, agranulocytosis, arrythmias, pneumonia susceptibility Interactions: antacids, warfarin, phenytoin, no smoking |
| omeprazole (Prilosec) | PPIs Action: inhibit ATPase in parietal cells to lower acid ADR: bone loss long term, headaches, GI upset, hypoMg, hypoCa Caution: shouldn't take more than 8 weeks Inter: Ca/ VitD supp, weight bearing Interact: warfarin, phenytoin, St. Johns wort |
| sucralfate (Carafate) | Mucosal Protectant- PUD Action: gel that coats ulcers ADR: constipation Interact: decrease absorp of warfarin, phenytoin, digoxin (take 2hr apart) Intervent: increase fluid/fiber/activity, GI bleed monitor |
| aluminum hydroxide (Amphojel) | Antacid Action: alkaline agent neutralizes acid ADR: constipation, hypoPO4 Intervent: stool softener, increase fluid/fiber, Monitor: GI bleed, PO4 and Na Admin: full glass of water Interact: 1-2hr apart other meds Contra: abd pain w/ unkown cause |
| clarithromycin (Biaxin), tetracycline (Achromycin V) | Antibiotic treatment for Helibactor Pylori (gram negative bacillus). Uses at least 2 antibiotics to treat. |
| ondansetron (Zofran) | Serotonin 5-HT3 Antagonist - Nausea Action: blocks serotonin receptors in CTZ of brain ADR: SEROTONIN SYNDROME, TORSADES DE POINTE, SJS, headache/dizzy, GI Instruct: report headache Intervent: fall risk Interact: MAOI, SSRI, SNRI, lithium, tramadol |
| dimenhydrinate (Dramamine) | Antihistamines/Anticholinergics - Nausea/Vertigo Action: blocks histamine receptors in inner ear ADR: sedation, anticholinergic effects Caution: prostate enlargement and UR Intervent: hard candies, fall risk, no driving |
| metoclopromide (Reglan) | Dopamine Antagonist- Nausea Action: blocks dopamine receptors to increase tone of lower esophageal sphincter, increases peristalsis ADR: sedation, extrapyramidal, NEUROLEPTIC MALIGNANT, diarrhea Intervent: no driving Contra: no mechanical GI obstruct |
| polyethylene glycol (Miralax) | Osmotic Laxative Action: draw water into intestines to increase fecal mass and stim peristalsis ADR: Diarrhea, electrolyte imbalance, nausea, cramps, flatulence Intervent: mon. GI bleed Caution: not for pts with dysphagia, can't be thickened |
| docusate sodium (Colace) | Surfactant Laxative/Stool softener Action: change surface tension of stool and increasing water absorption ADR: Uncommon, but diarrhea, mild cramps, throat irritation, rash Admin: full glass of water Contra: no GI obstruct/perf Interact: mineral oil |
| bisacodyl (Duclolax) | Stimulant Laxative Action: stimulates intestinal motility ADR: diarrhea, cramps. burning (suppository), proctitis (long term suppository use), dehydration, Electrolyte imbalance Caution: can become reliant to defecate Contra: GI obstruct/perf, fissure |
| diphenoxylate with atropine (Lomotil), loperamide (Imodium) | opioids - diarrhea Action: opioids decrease peristalsis ADR: cardiac arrest, arrythmias, anticholinergic effects Intervent: fall risk, no driving Caution: no improvement see healthcare Contra: <2yr Interact: MAOI (HTN crisis), cimetidine (arrythmia) |
| sulfasalazine (Azulfidine) | 5-aminosalicylates - IBD Action: decreases inflammation in the intestines ADR: agranulocytosis, megaloblastic/hemolytic anemia, nausea, headache, fever, rash Intervent: monitor CBC, w/ food Caution: sulfa allergy Interact: iron, antibiotics, digoxin |
| glipizide | Sulfonylureas - DM2 Action: stimulate insulin release ADR: hypoglycemia, N/D Admin: give 30 min before meal Instruct: medical bracelet, carry snack Contra: pregnancy, diabetic ketoacidosis Interact: alcohol (disulfiram-like) |
| metformin | Biguanides - DM2 Action: lower glucose absorption, less synthesis in liver, and increases insulin receptor sensitivity ADR: N/V/D, metallic taste, B12/folic acid deficiency, lactic acidosis Interact: alcohol (lac ac), cimetidine (lac ac), IV contrast |
| acarbose | Alpha-Glucosidase Inhibitors - DM2 Action: block enzyme that break down carbs ADR: GI, bacteria in gut, liver dysfunc. iron deficient anemia, hypoglycemia (w sulfonylurea or insulin) Intervent: iron rich foods Instruct: med bracelet, with first bite |
| empagliflozin (Canagliflozin/Invokana) | SGLT2i -DM2 Action: block transporter in kidney that reabsorbs glucose ADR: diabetic ketoacidosis, hypoglycemia, dehydration, HOTN, bone fractures, kidney injury, genital infections, increased urination, URI, high cholesterol, high PO4, N/C, joint pain |
| glargine | Insulin - DM1/2 Action: identical to insulin produced by beta cells in pancreas ADR: hypoglycemia, hypokalemia, lipodystrophy, lipohypertrophy Interactions: sulfonylureas, Beta blockers, calicylates, alcohol increase hypoglycemia. |
| exenatide (Semaglutide/Ozempic) - Action/ADR | Incretin Mimetics (GLP-1) - DM2 Action: activates GLP-1 receptors and reduce postprandial blood glucose, slow gastric emptying, release insulin, lower glucagon secretion, and more feelings of satiety ADR: Hypoglycemia, N/V/D, renal failure, pancreatitis |
| glucagon | Hyperglycemics - hypoglycemia (insulin overdose) Action: raises blood sugar with breakdown of glycogen in liver ADR: N/V(bad), anaphylaxis Intervent: monitor neuro, turn on side if LOC Contra: hypoglycemia (starvation) Interact: warfarin, phenytoin |
| levothyroxine | Thyroid Replacements - hypothyroidism Action: synthetic thyroxine (T4) is converted to T3 ADR: hyperthyroidism, thyrotoxicosis (angina, tachy, tremor, sweat, insomnia, hyperthermia) Caution: myxedema coma due to sudden withdrawal, take for life |
| somatropin | Growth Hormone - GH defiency (like Turners) Action: insulin growth factor-1 increase growth ADR: hyperglycemia, antibodies that counteract GH, death (PWS, obesity, airway obstruct) Admin: rotate sites (atrophy) Contra: severe obese, resp issue |
| desmopressin | ADH - Diabetes insipidus Action: produces ADH, reabsorp of water ADR: fluid retent/water intox, hypoNa, seizure Contra: CAD, poor circulation, nephritis, electrolyte issues, renal fail Vasopressin: strong vasocontrictor - damage if extravasation |
| hydrocortisone/prednisone | Glucocorticoids - Adrenocortical Insufficiency (Addison's) Action: increases cortisol, promote breakdown of glucose ADR: uncommon at low dose, adrenal suppression, cushing's Admin: with meals Caution: pts w stress higher risk of adrenal insufficiency |
| Signs of Hypoglycemia | tremors, sedation, tachycardia, confusion, irritability, slurred speech, seizures, loss of consciousness, hunger, headache |
| Signs of Hyperglycemia | polyuria, thirst, hunger, dehydration, blurred vision, fatigue, slow healing |
| Signs of Serotonin Syndrome | confusion, hyperreflexia, tremors, muscle rigidity, heavy sweating, fever, tachycardia, HTN |
| Signs of Neuroleptic Malignant Syndrome | severe muscle rigidity, feve4r, altered mental status, tachycardia, heavy sweating, high creatine kinase, dysphagia, drooling |
| Signs of Tardive Dyskinesia | lip smacking/puckering, tongue protrusion, chewing motions, facial grimacing, blinking/eye movements, jerking movement of limbs, pelvic rocking |
| Signs of Lactic Acidosis | Kussmaul's breathing, fatigue, HOTN, N/V, tachycardia, altered mental status, cool clammy skin |
| Insulin lispro class, onset, peak, duration | Class: rapid acting onset: 15-30min peak: 30min-3hr duration: 3-5hr |
| regular insulin class, onset, peak, duration | Class: short acting onset: 30min-1hr peak: 2-4hr Duration: 4-12 hr |
| NPH insulin class, onset, peak, duration | Class: intermediate acting Onset:1-2hr Peak: 4-12hr Duration 14-24hr |
| Insulin glargine class, onset, peak, duration | Class: long acting Onset: 2-4 hr peak: minimal duration: up to 24 hours |
| exenatide (Semaglutide/Ozempic) - Admin, Contraindications, Interactions | Incretin Mimetics (GLP-1) - DM2 Admin: 1hr before meals Contra: renal impairment< t1DM, diabetic ketoacidosis, severe GI disorders, pregnancy Interact: Sulfonylurea (SEVERE hypoglycemia) |
| Signs of Water Intoxication | N/V, hedache, confusion, altered mental status, seizures, decreased LOC, weight gain without edema |
| Signs of Adrenal Insufficiency | hypotension, fatigue, extreme weakness, hyponatremia, hyperkalemia, hypoglycemia, weight loss, poor appetite, hyperpigmentation (bronze skin) |
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