Pharmacology Lecture Flashcards

Vocabulary practice flashcards covering drug classifications, mechanisms of action, adverse reactions, and essential nursing implications across neurological, anti-infective, glycemic, endocrine, immunological, and antineoplastic medication topics.

Sumatriptan classification

Serotonin receptor agonist (5-HT1); abortive migraine drug

Sumatriptan MOA

Stimulates 5-HT1 receptors, causing vasoconstriction, which affects vasoactive peptides and blocks pain pathways

Sumatriptan side effects

Serotonin syndrome (especially with MAOIs); vasoconstriction, so monitor blood pressure

Sumatriptan nursing implications

Treat EARLY; NO MAOIs; keep a headache diary; regular BP checks; routes PO, SubQ, IM, IV; goal is fewer and milder migraines, not necessarily migraine-free

Cyclobenzaprine (Flexeril) classification

Centrally acting muscle relaxant

Cyclobenzaprine (Flexeril) MOA

Enhances the inhibitory effect of GABA in the spinal column; relieves short-term, acute muscle spasms from musculoskeletal injury

Cyclobenzaprine (Flexeril) side effects

Drowsiness, dizziness, decreased BP, nausea, constipation

Cyclobenzaprine (Flexeril) nursing implications

NO MAOIs within 2 weeks; not for cerebral palsy; caution in renal and cardiac disease; start low, increase gradually; give with food or milk; check BUN, creatinine, AST, ALT; no alcohol or CNS depressants; assess for serotonin syndrome; no driving if drowsy, change positions slowly; increase fluids and fiber

Baclofen (Lioresal) classification

Centrally acting muscle relaxant

Baclofen (Lioresal) MOA

Enhances the inhibitory effect of GABA in the spinal column; used for long-term spasticity (cerebral palsy, spinal cord injury, MS)

Baclofen (Lioresal) side effects

Drowsiness, dizziness, decreased BP, nausea, constipation; seizures; withdrawal if stopped abruptly; may raise blood glucose

Baclofen (Lioresal) nursing implications

NEVER stop abruptly (taper); oral or intrathecal pump; start low, increase gradually; give oral with food or milk; check renal function; no alcohol or CNS depressants; diabetics may need med adjustments; fluids and fiber; educate caregivers

Phenytoin (Dilantin) classification

Anticonvulsant (antiepileptic); hydantoin

Phenytoin (Dilantin) MOA

Inhibits sodium influx through sodium channels, decreasing activity of seizure-generating neurons; treats tonic-clonic and partial seizures

Phenytoin (Dilantin) side effects

Drowsiness, gingival hyperplasia, GI upset, skin rash (Stevens-Johnson syndrome); teratogenic (Category X)

Phenytoin (Dilantin) nursing implications

Narrow therapeutic index, level 10-20 mcg/mL; monitor levels and liver labs; give with food; IV slowly and check compatibility; do not stop abruptly; no alcohol or CNS depressants; lowers oral contraceptive effectiveness; soft toothbrush and oral care; report rash; know driving laws

Carbamazepine (Tegretol) classification

Anticonvulsant (antiepileptic); iminostilbene derivative

Carbamazepine (Tegretol) MOA

Acts in the motor cortex; reversibly binds sodium channels in their inactive state; treats partial, generalized tonic-clonic and mixed seizures

Carbamazepine (Tegretol) side effects

Drowsiness, ataxia, dizziness, nausea and vomiting, photosensitivity; BLACK BOX: blood dyscrasias (aplastic anemia, thrombocytopenia, agranulocytosis); teratogenic (Category D)

Carbamazepine (Tegretol) nursing implications

Narrow therapeutic index: monitor drug levels, AST/ALT, bone marrow suppression (bruising); take with meals; NO MAOIs, alcohol or grapefruit juice; titrate up gradually; do not stop abruptly; sunscreen; higher skin reaction risk in people of Asian descent; seizure journal; know driving laws

Diazepam (Valium) classification

Benzodiazepine

Diazepam (Valium) MOA

Potentiates (enhances) GABA; first-line rescue drug for status epilepticus

Diazepam (Valium) side effects

Respiratory depression (most serious), apnea, hypotension, somnolence, EKG changes

Diazepam (Valium) nursing implications

IV: large vein, 5 mg/min or less, inject close to IV site, do NOT dilute or mix, no continuous infusion; monitor seizure activity, respiratory status, vital signs, EKG; also PO, IM, intranasal (teach caregivers); no alcohol or CNS depressants

Penicillin classification

Beta-lactam antibiotic; bactericidal

Penicillin MOA

Blocks transpeptidase (needed for cell wall formation) and activates autolysin, weakening the cell wall and destroying the bacteria; no effect on human cells

Penicillin side effects

GI upset (nausea, vomiting, diarrhea); pseudomembranous colitis; Candida superinfection (thrush, vaginal yeast); rash; anaphylaxis

Penicillin nursing implications

Penicillin allergy = cross-allergy to other penicillins and cephalosporin risk; monitor for reaction 30 min after IV, 1-2 hours after oral; do not crush or chew; give with water or at start of meals; extra contraceptive method; finish all doses; report watery or bloody diarrhea, mouth pain, vaginal itching; stop drug for allergic reaction; 911 for trouble breathing

Azithromycin (Zithromax) classification

Macrolide antibiotic; bacteriostatic

Azithromycin (Zithromax) MOA

Inhibits protein synthesis: blocks transfer RNA from binding messenger RNA at the ribosomal acceptor site; gram-positive and some gram-negative

Azithromycin (Zithromax) side effects

Nausea, vomiting, diarrhea, flatulence, anorexia, hepatotoxicity, jaundice; QT prolongation (torsades de pointes); ototoxicity (reversible); superinfections (C. diff, candidiasis)

Azithromycin (Zithromax) nursing implications

With or without food, 8 oz water; check allergies, liver and cardiac function; PT/INR with warfarin; LFTs if therapy over 2 weeks; backup birth control; complete the course; highly protein-bound

Ciprofloxacin classification

Fluoroquinolone antibiotic; bactericidal

Ciprofloxacin MOA

Inhibits DNA replication and cell division; many gram-negative (Klebsiella, E. coli), some gram-positive; prevents anthrax after inhalation

Ciprofloxacin side effects

Dizziness, headache, confusion (caution in older adults); nausea, vomiting, diarrhea; Achilles tendon tear; photosensitivity

Ciprofloxacin nursing implications

Check kidneys in older adults; IV diluted and infused over 60 min in a large vein; take with food; antacids 2 hours after or 6 hours before; avoid sun; athletes avoid exercise

Vancomycin classification

Cell wall synthesis inhibitor (glycopeptide antibiotic); bactericidal; gram-positive

Vancomycin MOA

Weakens and destroys the bacterial cell wall; treatment of choice for MRSA; oral form treats C. diff colitis

Vancomycin side effects

Ototoxicity; nephrotoxicity; thrombophlebitis and tissue damage if IV infiltrates; red person syndrome (flushing, itching, hypotension, shortness of breath)

Vancomycin nursing implications

Infuse over at least 1 hour (90+ min for larger doses) to prevent red person syndrome; antihistamines if it occurs (can pretreat with Benadryl and Tylenol); monitor trough levels at steady state; adjust dose for renal insufficiency

Isoniazid (INH) classification

Antimycobacterial (anti-TB)

Isoniazid (INH) MOA

Blocks mycolic acid synthesis in the mycobacterial cell wall; for active and latent TB

Isoniazid (INH) side effects

Peripheral neuropathy (B6 deficiency); hepatotoxicity; hyperglycemia

Isoniazid (INH) nursing implications

Give vitamin B6 25-50 mg/day; monitor LFTs and stop if elevated; avoid alcohol; contraindicated in liver disease; monitor blood glucose; take 1 hour before or 2 hours after meals with a full glass of water; direct observation if TB is active; second form of birth control

Rifampin classification

Broad-spectrum antimycobacterial; bactericidal

Rifampin MOA

Inhibits protein synthesis; always given with at least one other anti-TB drug to prevent resistance

Rifampin side effects

Orange urine, saliva, sweat and tears; pseudomembranous colitis; DRESS syndrome; mild GI upset; hepatotoxicity

Rifampin nursing implications

Non-hormonal contraception; speeds metabolism of warfarin, oral contraceptives, protease inhibitors, NNRTIs (monitor PT/INR); monitor LFTs, avoid alcohol; report fever, diarrhea, abdominal pain, bloody stool; give 1 hour before or 2 hours after meals; working when breath sounds clear, no night sweats, 3 negative sputum cultures

Glucagon classification

Hyperglycemic hormone (glucose-elevating drug)

Glucagon MOA

Stimulates the liver to convert glycogen to glucose; treats severe hypoglycemia when the patient cannot swallow

Glucagon side effects

Nausea and VOMITING (turn patient on side), itchy or watery eyes, nose and throat, sneezing, headache, cough

Glucagon nursing implications

Use only with decreased level of consciousness and inability to swallow; SQ, IM, IV or intranasal; monitor blood glucose during and 3-4 hours after; monitor potassium; give carbs once awake; caution in starvation, pregnancy, lactation, children under 4; increases warfarin effect, bigger HR and BP rise with beta blockers, phenytoin lowers its effect

D50W classification

Glucose-elevating drug (IV dextrose)

D50W MOA

Gives sugar directly into the vein for an immediate rise in blood glucose

D50W side effects

Not covered on the slides

D50W nursing implications

Used for hypoglycemia when the patient is unconscious; feed the patient once awake so glucose does not crash again

Metformin classification

Biguanide (oral antihyperglycemic); first-line for type 2 diabetes

Metformin MOA

Decreases liver glucose production, decreases intestinal glucose absorption, increases tissue glucose uptake; does not cause hypoglycemia on its own

Metformin side effects

Lactic acidosis, nausea, vomiting, diarrhea, metallic taste, vitamin (B12) deficiency

Metformin nursing implications

Hold before iodine contrast dye (ask provider when to stop and restart); take with food; avoid alcohol; report weakness, fatigue, lethargy, hyperventilation; avoid in cardiac, hepatic, renal insufficiency; monitor blood glucose

Glipizide classification

Sulfonylurea (oral antihyperglycemic)

Glipizide MOA

Stimulates pancreatic beta cells to release more insulin; type 2 only (needs a working pancreas)

Glipizide side effects

Hypoglycemia, nausea, diarrhea

Glipizide nursing implications

Take 30 minutes before a meal; do not skip meals; monitor for hypoglycemia and blood glucose; avoid alcohol; ask about beta blockers (mask lows) and thiazides (reduce effect); avoid in pregnancy, lactation, DKA, renal or hepatic dysfunction

Insulin classification

Hormone; antidiabetic

Insulin MOA

Stimulates glucose uptake into cells and inhibits liver glucose production; does not fix receptor sensitivity

Insulin side effects

Hypoglycemia (most important); hypokalemia with large doses (muscle cramps, heart rhythm changes)

Insulin nursing implications

High-alert drug: verify type, route, timing, dose in units, second nurse check; check blood glucose first; insulin syringes only; roll vials, do not shake; NPH cloudy, others clear; rotate sites; never share pens; clarify orders if NPO; carry sugar and ID bracelet; avoid alcohol; draw up clear (regular or rapid) before cloudy (NPH)

Levothyroxine (Synthroid) classification

Thyroid hormone replacement (synthetic T4)

Levothyroxine (Synthroid) MOA

Replaces missing thyroid hormone; synthetic T4 that the body converts to T3

Levothyroxine (Synthroid) side effects

Too much: fast heart rate, anxiety, tremors, heat intolerance, weight loss, insomnia. Too little: fatigue, weight gain, cold intolerance, slow heart rate, constipation

Levothyroxine (Synthroid) nursing implications

Daily on an empty stomach, 30-60 min before breakfast; not within 4 hours of calcium, iron, antacids, soy; monitor TSH; lifelong, never stop suddenly; IV for myxedema coma

Propylthiouracil (PTU) classification

Antithyroid drug

Propylthiouracil (PTU) MOA

Blocks iodine from being built into tyrosine (stops T3 and T4 synthesis) and blocks conversion of T4 to T3

Propylthiouracil (PTU) side effects

Hypothyroidism (dose too strong), agranulocytosis, aplastic anemia, hepatotoxicity

Propylthiouracil (PTU) nursing implications

Give every 8 hours; do not stop abruptly; takes 1-2 weeks to start, 3-12 weeks for full effect; report fever, sore throat, jaundice, dark urine, RUQ pain; monitor LFTs, blood counts, PT/INR and aPTT with anticoagulants; safer than methimazole in first trimester and lactation

Epinephrine classification

Nonselective adrenergic agonist (mimics the sympathetic nervous system)

Epinephrine MOA

Stimulates all adrenergic receptors: raises heart rate and contractility, vasoconstriction (raises BP), bronchodilation; used for anaphylaxis, asthma, shock, CPR

Epinephrine side effects

Hypertensive crisis, angina, arrhythmias, tremors, weakness, dizziness, anxiety, palpitations, sweating, nausea and vomiting, increased blood sugar

Epinephrine nursing implications

Monitor vital signs and heart rhythm; check blood sugars in diabetics; caution in diabetes, heart disease, hypertension; interacts with tricyclic antidepressants and beta blockers; asthmatic children may get hypotension and syncope; Pregnancy Category C; brief, simple teaching during the crisis

Oseltamivir (Tamiflu) classification

Antiviral; active against influenza A and B

Oseltamivir (Tamiflu) MOA

Blocks neuraminidase so new virions cannot bud from infected cells and spread; shortens uncomplicated influenza

Oseltamivir (Tamiflu) side effects

Nausea and vomiting, bronchitis, insomnia, nightmares, vertigo

Oseltamivir (Tamiflu) nursing implications

Start within 48 hours; full 5 days; take with food and a full glass of water; shake liquid; no alcohol; fluids; behavior changes in children; insomnia: take in the morning; vertigo: change positions slowly; cough and deep breathe to prevent pneumonia

Acyclovir classification

Antiviral agent (HSV-1, HSV-2, VZV)

Acyclovir MOA

Works against active viral replication and decreases viral shedding; does NOT prevent infection

Acyclovir side effects

Nausea, diarrhea, headache, skin irritation, Stevens-Johnson syndrome, mild CNS effects, jaundice, peripheral edema, anemia

Acyclovir nursing implications

Plenty of fluids during and 2 hours after IV; monitor BUN and creatinine; avoid with zidovudine; start at first sign for 7 days (14 if immunocompromised); even intervals; do not crush or chew; no OTC creams; yearly Pap if genital HSV; working when lesions crust and heal

Interferon alfa-2a classification

Cytokine (immune modulator)

Interferon alfa-2a MOA

Boosts natural killer cells, macrophages and neutrophils; triggers enzymes that stop viral replication; inhibits tumor growth; used for chronic hepatitis C

Interferon alfa-2a side effects

Headache and fatigue (bed-bound fatigue is dose-limiting); flu-like symptoms at the start

Interferon alfa-2a nursing implications

Monitor vital signs, jaundice (sclera), liver labs, CBC; rotate injection sites; avoid alcohol, aspirin, antiemetics, sun, crowds, sick people; inject at bedtime; 3 L fluids a day; refrigerate; B-complex; handwashing; rest

HAART classification

Combination antiretroviral therapy (multiple HIV drugs together)

HAART MOA

Stops HIV replication to raise CD4 count and lower viral load; does NOT cure HIV; goal is undetectable viral load

HAART side effects

GI upset, nausea, vomiting, fever, chills, fatigue, myalgia, rash, headache, elevated liver enzymes; BLACK BOX: bone marrow suppression, anemia, neutropenia

HAART nursing implications

Monitor LFTs, CBC, viral load, CD4; adherence even when feeling better or worse; no alcohol or recreational drugs; safe sex and notify partners; report trouble breathing, BP changes, bleeding, infection signs; handwashing

Doxorubicin ("the red devil") classification

Antineoplastic

Doxorubicin ("the red devil") MOA

Inhibits DNA and RNA synthesis by forming a complex with DNA, killing rapidly replicating cells

Doxorubicin ("the red devil") side effects

Red urine and tears

Doxorubicin ("the red devil") nursing implications

EKG and ECHO before starting the drug