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Pharm 3 Final

Statin Contraindications Pregnacy Category X.
Nicotinic Acid SE Facial and neck Flushing which can be reduced by giving ASA prior to dose. Hyperglycemia, Gouty arthritis, and Hepatotoxic.
Bile Acid-Binding Resins Interactions Decreased absorption of warfarin, dig, thiazides, propanolol, PCN G, tetracyclines, thyroid meds.
VLDLs Large amount of Triglycerides 56-65% and 20-30% cholesterol. Contains 15-20% of the total blood cholesterol and most of the triglycerides in the body. Particle are large so it is thought NOT to be assocciated with Atherosclerosis.
LDLs Major Portion of cholesterol (60-7%). Most Harmful. If elevated = increased risk for atherosclerosis.
HDLs Function is to transport cholesterol from peripheral cells to liver, where it is metaboliozed and excreted. The transport prevents accumulation of the lipids in the arterial walls. Protects against CHD. Higher level = low risk of CVD.
Fish Oil Decreased risk of CHD and thrombotic stroke. Eat at least 2 servings a wk. ( maskerel, halibut,herring, salmon, tuna, trout)
Plant Stanol and Sterol Esters Can reduce intestinal absorption of cholesterol= decrease in LDL. Benecol and Take Control are common margarines
Estrogen therapy In postmenopausal women it reduces LDLs and increased HDLs. Does NOT reduce CV morbidity or mortaility
Cholestin dietary supp. that can lower cholesterol levels. Contains lovastatin.
Quinidine SE GI symptoms, cinchonism (tinnitus, HA, N, vertigo, and disturbed vision), cardiotoxicity ( at high doses Sinus arrest, AV block, V-tach, Asystole), arterial embolism.
Quinidine- Drugs to prevent SEs The main effect of the Body is a high heart rate. To prevent this pretreat with dig, verapamil, or a BB.
Lidocaine SE CNS effects (drowsiness, confusion, paresthesias) toxic doses mnay cause convulsions and resp. arrest.
Flecainide (Tambocor) Uses Ventricular and supraventricular dysrhythmias
Verapamil SE (CCB) Bradycardia, AV block, Heart Failure, hypotension, constipation, and peripheral edema
Adenosine Stops the Heart. Used to terminate SVT. Extremly shor half life (1.5-10 sec) IV as close to heart as possible. Only lasts 1 min.
NTG SE HA (use ASA or Tylenol), orthostatic hypotension, reflex tachycardia. Pretreatment with CCB or BB can prevent sympathetic stimulation of the heart
NTG Administration/ Sublingual Absorbed through oral mucosa to blood stream=bypass liver. Taked effect in 1-3min and lasts 1hr. Used for terminating ongoing and short-term prophykaxis when exertion is anticipated. Once opened can store for up to 24 months.
NTG sublingual If pain not better in 5min call 911; can take 2nd and 3rd q5min up to 3.
Procardia SE Bradycardia, chest pain, hypotension, palpitations, syncope, tachycardia, steven-johnsons syndrome, gingival hyperplasia. Avoid grapefruit juice.
Heparin Administration IV, SQ. Low dose for pre and post surgical prophylaxis of thrombosis. For continuous use a PUMP. SQ injection: abdomen, sites rotated, not within 2in of umbilicus
Thrombolytics Use Tx of choice for MI. Acute PE, peripheral artial occlusion, DVT. Also, to clear AV shunts, arterial or venous catheters.
Aspirin Use Inhibits PLT aggregation. Works on Arteries. Effective prophylatic tx in TIA (CVA), MI or stable angina (recurrent MI). Primary prevention of MI.Low does work better to prevent thrombosis. High dose is for Acute MIa and you want pt to chew it.
Antidote: 1. Heparin/lovenox 2. coumadin 3. 1. protamine sulface (Heprin 1mg per 100 units) (Lovenox 1mg per 1 mg) 2.Vit K
Lovenox and Heparin PTT
Coumadin PT/INR
Decreased GFR Loop diuretics (Lasix) promotes fluid loss when GFR is low. Thiazides do NOT work with a low GFR.
Digoxin Instructions Do NOT take every time you have chest pain. therapeutic index 1-2. ck HR before each dose.
Digoxin SE Cardian dusrhythmias are most common, V-Flutter and V-Fib are ther most dengerous, AV block with escaped beats is most common. Other: anorexia, N/V, blurred vision, yellow tinge vision, halos around dark objects
Digoxin Antidote Digibind
RA drugs to Treat NSAIDs, Glucocorticoids, DMARDS, and TNF inhibitors, T-Cell costimulary blockade, B-cell Depletion, Interleikin-1, IM gold, other: imuran, cyclosporine (sandimmune), Cyclophosphamide (cytoxan), and D-penicillamine (Cuprimine)
DMARDS Methotrexate, Plaquenil, azulfidine, arava
Plaquenil SE Most important toxicities are on the eyes: corneal deposits, extraocular muscular weakness, loss of accomodation (and sensitivity to light),& retinopathy that may progress to irreversible visual loss. Pt should get baseline eye exams and follow ups q12mon
Triple Therapy Methotrexate, Azulfidine (sulfasalazine), and plaquenil (hydroxyxhloroquine)
Leflunomide (Arava) action Has the ability to inhibit De Novo pyrimidine buosynthesis through the inhibition of the enzyme dihydroorotate dehydrogenase.
TNFs SE Increased risk of infection, URI, Positive ANA, Disseminated TB, lymphomas, lupus. Dont give to pts with CHF or demyelinating disease.
Abatacept (orencia) Use Interfere with the interactions between antigen-presenting cells and T lymphocytes and affect early stages in the pathogenic cascade of events in RA. Will become active, pro;eferative, traffic to inflammed areas, and secrete proinflammatory cytokines (TNF
Cyclosporine (sandimmune) Use RA and is also approved for preventing renal and liver transplant rejection. Helps with psoriasis and other autoimmune disease too.
D-Penicillamine (Cuprimine) SE Severe rash and effects on renal function. Must carefully monitor kidney function. Pt may also develop lupus like illness or other autoimmune diseases while taking this.
Ketamine SE Emergence CNS reactions including vivid dreams, hallucinations, and delirium; HTN, tachycardia, increased ICP, tonic clonic movements, resp depression. when pt back in room dim lights and reduce stimuli. Acid Trip
Sedative SE Much like a hangover- HA, unpleasant memory of the procedure, N/V. Brief period of amnesia after procedure many follow the administration of concious sedation.
Antidotes for Conscious Sedation- 1. Benzos (Versed, Ativan, Valium) 2. Opiods (Fentanyl, Demerol, Morphine) 1. Flumazenil (Ramazacon) 2. Narcan (Naloxone)
Nitrous Oxide General CNS Depressant. For sedation and analgesia. Avoid in pregnant women due to a increased risk of spontaneous abortion and teratogenicity. SE- Bone Marrow Supression and neurogenic dysfunction. Should NOT be given without O2 or after eating a meal.
Created by: bspaur



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