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