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Mem Pharm 2 Test1

anitulcer emetic laxative diarrheal coagulant thrombolytic glucocorticoid

QuestionAnswer
histamine H2 receptor antagonist -tidine; decrease acid production; raise gastric and duodenal pH
proton pump inhibitor (PPI) - prazole; decrease acid production
antimicrobial treat H. pylori
antacid neutralize acid
cytoprotectant increase barrier to acids
cimetidine histamine H2 receptor antagonist; decrease acid production; antiulcer agent
famotidine histamine H2 receptor antagonist; decrease acid production; antiulcer agent
ranitidine histamine H2 receptor antagonist; decrease acid production; antiulcer agent
omeprazole proton pump inhibitor (PPI); decrease acid production; antiulcer agent
esomeprazole proton pump inhibitor (PPI); decrease acid production; antiulcer agent
lansoprazole proton pump inhibitor (PPI); decrease acid production; antiulcer agent
amoxicillin antimicrobial; treat H. pylori; antiulcer agent
clarithromycin antimicrobial; treat H. pylori; antiulcer agent
tetracycline antimicrobial; treat H. pylori; antiulcer agent
metronidazole antimicrobial; treat H. pylori; antiulcer agent
aluminum hydroxide antacid; neutralize acid; antiulcer agent
magnesium hydroxide/aluminum hydroxide antacid; neutralize acid; antiulcer agent
calcium carbonate antacid; neutralize acid; antiulcer agent
sodium bicarbonate antacid; neutralize acid; antiulcer agent
bismuth subsalicylate viscous coating cytoprotectant; increase barrier to acids; antiulcer agent
sucralfate viscous paste-forming cytoprotectant; increase barrier to acids; antiulcer agent
misoprostol prostaglandin E-like mucus producing cytoprotectant; increase barrier to acids; antiulcer agent
cimetidine important drug interaction effect Inhibits CYP450 enzymes
chronic aluminum hydroxide use causes: decrease in plasma phosphate, and constipation
what is a common effect of calcium antacid use? acid rebound, especially with large dose
which antiulcer types can cause abdominal pain? Is it serious? proton pump inhibitors: contct hcp. Misoprostol: just bothersome
Why should you increase intake of calcium and vit D with PPI? can decrease bone mineral density, increasing risk of fracture
Why should you protect yourself from exposure to microorganisms while taking H2 rec antagonists or PPI? increased risk of pneumonia
What very important teaching should accompany use of bismuth subsalicylate? do not use if allergic to aspirin, or child/adolescent with chickenpox or viral illness.
what GI effects can occur with misoprostol cramping (no biggie), diarrhea
H2 receptor antagonist and confusion in older adult dangerous side effect; discontinue and contact hcp
H2 receptor antagonist and cardiac dysrhythmias dangerous side effect; discontinue and contact hcp
H2 receptor antagonist and symptoms: fatigue, weakness, pale, increased infection, bleeding agranulocytosis or aplastic anemia; dangerous side effect; discontinue and contact hcp
What antiulcer agents bind other drugs? Why is this a problem? antacids (incl with H2 receptor anatagonists) and sucralfate; prevents the drugs from absorbing
what is the likely effect when taking both sodium bicarbonate and glucocorticoid? edema
ondansetron 5-HT3 (serotonin) receptor antagonist; antiemetics
aprepitant neurokinin (NK1) receptor antagonist; blockade receptors for substance P in CTZ; antiemetic
prochlorperazine dopamine receptor antagonist; dopamine 2 receptors in CTZ; antiemetic
metoclopramide dopamine receptor antagonist; dopamine 2 receptors in CTZ; antiemetic
dronabinol cannabinoid; antiemetic
scopolamine anticholinergic; blocks H1 or Ach receptors, stopping neural transmission betw inner ear to vomiting center; antiemetic
dimenhydrinate anticholinergic effect (antihistamine); antiemetic
marijuana natural product as antiemetic
ginger natural product as antiemetic
5-HT3 receptor antagonist -setron blocks serotonin receptors on vagal afferents and in CTZ; chemo INV, radiation, postop
neurokinin receptor antagonist -prepitant, blocks substance P/neurokinin receptors in brain; chemo INV
dopamine receptor antagonist -azine and others, blocks dopamine receptors in CTZ; chemo INV, postop, other
cannabinoid chemo INV;m activate receptors in vomiting center
anticholinergic affects neural transmission between the inner ear and vomiting center in the brain; motion
antihistamine anticholinergic effect; motion sickness
psyllium bulk-forming laxative
methylcellulose bulk-forming laxative
docusate sodium surfactant laxative (stool softener)
bisacodyl stimulant laxative (irritant laxative, cathartic)
senna stimulant laxative (irritant laxative, cathartic)
cascara sagrada (no FDA) natural product stimulant laxative (irritant laxative, cathartic)
aloe vera (no FDA) natural product stimulant laxative (irritant laxative, cathartic)
magnesium salts saline laxative
polyethylene glycol saline laxative
mineral oil lubricant laxative
lubiprostone chloride channel activator
methylnaltrexone peripheral opioid receptor antagonist
diphenoxylate with atropine opioid antimotility agents; antidiarrheal
loperamide opioid antimotility agents; antidiarrheal
bismuth subsalicylate intraluminal antidiarrheal
psyllium intraluminal antidiarrheal
various antibiotics and antiprotozoals miscellaneous antidiarrheal
What effects should be monitored if taking opioid antidiarrheal? urinary retention, dry mouth, impaired heat regulation, drowsiness, dizziness
heparin unfractionated heparin; anticoagulant
dalteparin low molecular weight heparin; anticoagulant
enoxaparin low molecular weight heparin; anticoagulant
warfarin anticoagulant
dabigatran direct thrombin inhibitor; anticoagulant
rivaroxaban factor Xa inhibitor; anticoagulant
protamine sulfate antidote for heparin overdose
phytonadione antidote for warfarin overdose
aspirin cyclooxygenase inhibitor; antiplatelet agent
clopidogrel ADP Receptor antagonist; antiplatelet agent
eptifibatide glycoprotein IIb/IIIa inhibitor; antiplatelet agent
alteplase tissue plasminogen activator (tPA); thrombolytic
What do anticoagulants do? reduce ability of blood to clot: inhibit formation of fibrin
Where do anticoagulants prevent thrombi? veins and cardiac atria
What do antiplatelet agents do? interfere with platelet activation and aggregation
Where do antiplatelet agents prevent thrombi? arteries
which antiplatelet agent is for short-term Iv use? glycoprotein IIb/IIIa inhibitor
Which antiplatelet agent is for chronic use, prevention of CV events for those at high risk? ADP receptor antagonist
What do thrombolytics do? dissolve clots that already are formed
What is the benefit of thrombolytic effects? restore blood flow
What is unfractionated heparin? "Normal" heparin; molecules vary in weight, requires lab measure aPTT
Why is aPTT measured when taking unfractionated heparin? activated partial thromboplastin time measures coagulation, to make sure unfr. Heparin is working at appropriate level
Why is aPTT not required when taking LMW heparin? low molecular weight heparin is at predictable levels in blood; do require CBC and fecal occult blood tests
How is heparin use different in those with severe liver disease? They synthesize less antithrombin so response to heparin is altered
What are parameters for heparin administration? Parenteral, polarized molecule doesn't cross membranes; protein bound; does not cross placenta; renal impairment delays heparin elimination (inc levels); rapid onset/offset of action
what dietary teaching is important when taking warfarin? don't change intake of vit K foods: leafy greens, cauliflower, milk, mayonnaise, yogurt
How does warfarin acheive anticoagulation? inhibit synthesis of vit K related clotting factors; may be several days to effect while existing factors are used up
Warfarin is pregnancy category... X -- enters placenta/ breastmilk; causes birth defects
What is the genetic issue with warfarin metabolism? Some people have genetic variations of the CP450 enzyme that metabolizes warfarin; they may have inc levels and bleed
Why is warfarin therapy monitored with PT or INR? Prothrombin time, or adjusted International Normalized Ratio, measures coagulation effect, dose can be adjusted
What needs to be considered when remembering time factor for heparin/warfarin antidotes? time factor of the drug itself
Who should not use dabigatran? those with decreased kidney function -- can lead to toxicity
Important teaching about dabigatran keep in original packaging -- can't be exposed to moisture
What is the use of oral rivaroxaban? prevent VT after hip/orthopedic surgery
Parameters of rivaroxaban? highly protein bound; metabolized by CYP450; some excreted renally as active drug
how is clopidogrel metabolized? prodrug: requires CYP450 enzyme metabolism to take active form
Is a thrombolytic a good idea after surgery? no -- need to form clots to stop bleeding and allow tissue healing
When is use of thrombolytics ideal? within a few hours of clot formation; life threatening: pulmonary embolism, ischemic stroke
-sone; -olone glucocorticoids
budesonide glucocorticoids -- asthma
dexamethasone glucocorticoids
fluticasone glucocorticoids -- asthma
hydrocortisone glucocorticoids
methylprednisolone glucocorticoids
prednisolone glucocorticoids
prednisone glucocorticoids
triamcinolone glucocorticoids -- topical
types of bronchodilators adrenergic agonists, xanthines, anticholinergics
epinephrine nonselective alpha and beta adrenergic agonist; adrenergic bronchodilator; antiasthmatic
albuterol -terol; selective beta2-adrenergic agonist; adrenergic bronchodilator; antiasthmatic; rapid onset, short duration by inhalation; slow onset, long duration orally
salmeterol slow onset, long duration by inhalation; selective beta2-adrenergic agonist; adrenergic bronchodilator; antiasthmatic
theophylline -ophylline; xanthine bronchodilator (methylxanthine); adrenergic bronchodilators; antiasthmatics
ipratropium by inhalation; anticholinergic bronchodilator; adrenergic bronchodilator; antiasthmatic
glucocortisoids fluticasone by inhalation; prednisone
montelukast -lukast; oral; leukotriene modifier; antiinflammatory; antiasthmatic
zafirlukast -lukast; oral; leukotriene modifier; antiinflammatory; antiasthmatic
cromolyn sodium inhalation; mast cell stabilizer; antiinflammatory; antiasthmatic
omalizumab subq; anti-IgE monoclonal antibody; antiinflammatory; antiasthmatic
how do glucocorticoids reduce inflammation? stop action of prostaglandins, leukotrienes; stop WBC and antibody production; stop pro-inflammatory cytokines; stop histamine release
What is a major drawback to use of glucocorticoids? impairs wound healing
glucocorticoid metabolism specific CYP450 enzymes
glucocorticoid absorption well absorbed through multiple routes
why is cortisol secretion inhibited by exogenous glucocorticoids? amounts much larger than normal cortisol, triggers negative feedback
what effects will glucocorticoids have in the body (general)? the same as cortisol: homeostasis in fight or flight (sympathetic) response
S/s of adrenal insufficiency Weakness, weight loss, anorexia, nausea, vomiting, hypotension, hypoglycemia, hyponatremia, and hyperkalemia
what are the four classess of antidiarrheals? 1. absorbents; 2. anticholinergics; 3. intestinal flora modifiers; 4. Opiates;
MOA for absorbents? coat the wall of the intestines; bind with the causative bacteria or toxin and eliminate it in the stools;
MOA for Anticholinergics? decrease peristalsis
MOA for intestinal flora modifiers? obtained from bacteria; restore the body's normal flora;
MOA for Opiates? decrease bowel motility;
Classification of Kaopectate (PeptoBismol)? absorbant antidiarrheal agents
Adverse rxn of Kaopectate (PeptoBismol)? increased bleeding time, constipation, dark stools, confusion, tinnitus, hearing loss, twitching, metalic taste in mouth
Classification fo Belladonna Alkaloid (Donnatal)? anticholinergic; antidiarrheal
Adverse rxn of Belladonna Alkaloid (Donnatal)? urinary retention/hesitancy, impotence, drowsiness, headache, hypotension, tachycardia, blurred vision, photophobia;
Classification of Lactobaccilus Acidophillus? intestinal flora modifier given as a food additive;
Adverse rxn of Lactobaccilus Acidophillus? drowsiness, sedation, respiratory depression, bradycardia, hypotension, urinary retention;
Classification and therapeutic use of Diphenoxylate (Lomotil) & Loperamide (Immodium)? opiate used as anti-diarrheal.
Adverse rxn of Diphenoxylate (Lomotil) & Loperamide (Immodium)? drowsiness, sedation;
Created by: hezasan