Pharmacology Exam 1

Ciprofloxacin (Cipro) Action

interfere with DNA replication in susceptible gram negative bacteria

Amoxicillin (Amoxil) Indication

susceptible bacteria (skin, respiratory, GI/GU, ear infections & peptic ulcer w/ H. pylori)

What drug is a lipoglycocpeptide?

Vancomycin (Vancocin)

What drug is an antitubercular?

Isoniazid (INH)

Fluconazole (Diflucan) Adverse Effects

headache

nausea/vomiting

abdominal cramps/diarrhea

skin irritation

Fluconazole (Diflucan) Interventions/education

administer entire course of drug (can take up to 6 months)

Metronidazole (Flagyl) Indication

C. diff

H. pylori

trichomonad (STD)

Anti-inflammatory/ Antiarthritis Agents classes

NSAIDs

Acetaminophen

Glucocorticoids

Tumor Necrosis Factor-Blockers

What drug is a NSAID?

Ibuprofen (Advil)

Etanercept (Enbrel) & Infliximab (Remicade) Indication

rheumatoid arthritis

juvenile idiopathic arthritis

Etanercept (Enbrel) & Infliximab (Remicade) Adverse Effects

fatal infections

Interferon Alfa-2b (Intron A) Interventions/education

no alcohol

assess mental status

educate on flu/cold symptoms importance

Mycophenolate mofetil (CellCept) Adverse Effects

infection risk

nausea/vomit/diarrhea

What drug is an antimetabolite?

Methotrexate (Rheumatrex, Trexall)

chemo & RA med

Methotrexate (Rheumatrex, Trexall) Indication

cancer

autoimmune disorder

Doxorubicin (Doxil, Adriamycin) Intervention/education

monitor WBC, platelets, Hgb, Hct levels

sever tissue damage

Tamoxifen (Soltamox) Indication

breast cancer

Drugs acting on the hematology

lipid-lowering agents, blood coagulation agents, anemia drugs

Clopidogrel (Plavix) Indication/education

CONTRANDICATED:

-pregnancy, PUD, intracranial hemorrhage

monitor for brusing

diet may inc. effectiveness (ginger, St. John's wort, garlic)

monitor platelet counts

Antihemophilic Factor Intervention/education

avoid meds that inc. bleeding risk (NSAIDS)

use IV route only

monitor signs of thrombosis

Types of Anemia drug classes

Erythropoiesis-stimulating agents, mineral, megaloblastic agents

What drug is a erythropoiesis-stimulating agent?

Epoetin alfa (Epogen, Procrit)

Ferrous sulfate (Foesol) Intervention/education

vitamin C increases effectiveness

interferes with other med absorptions

caffeine decreases absorption

expect Hgb level to increase by 2g/dL after a month of use

measure effectiveness by Ferritin levels

Sodium bicarbonate & Aluminum hydroxide (Amphojel, Alugel) Indication

upset stomach from hyperactivity

GI bleed

stress ulcers

renal issues

Sodium bicarbonate & Aluminum hydroxide (Amphojel, Alugel) Intervention/education

can be administered 7x day

low phosphate diet

take 2 hours after other meds to decrease chance of drug interaction

Sucralfate (Carafate) Intervention/education

interferes w/ absorption of other meds

antacids interfere w/ effects of sucralfate

Metoclopramide (Reglan) Indication

stimulate gastric emptying

treatment of nausea/vomiting

gastroparesis relief

GERD

Metoclopramide (Reglan) Adverse Effects

restlessness

lethargy

drowsiness

fatigue

Loperamide (Imodium) Indication

diarrhea

Partial Thromboplstin Time (PTT) test

used to monitor heparin; higher the number the slower the clot

Ranges:

60-70 secs

critical value= >100 secs

HDL Cholesterol levels

greater than 40 mg/dL

Drugs Acting on Infections types

Antibiotics, Antiviral, Antifungal, & Antiprotozoal

Antibiotic Drug classes

aminoglycosides

fluoroquinolones

penicillin

lipglycocpeptides

antitubercular

Antibiotic drugs

Gentamicin (Garamycin)

Ciprofloxacin (Cipro)

Amoxicillin (Amoxil)

Vancomycin (Vancocin)

Isoniazid (INH)

What drug is an aminoglycosides?

Gentamicin (Garamycin)

(Gentamicin looks "gentle" but it is the opposite of gentle)

Gentamicin (Garamycin) Action

inhibits protein synthesis in gram negative bacteria

FOR RESISTANT BUGS

Gentamicin (Garamycin) Indication

serious infections caused by susceptible bacteria

Gentamicin (Garamycin) Adverse Effects

ototoxicity

sinusitis

nephrotoxicity

hives

Gentamicin (Garamycin) Interventions/Education

Monitor Hearing Loss

Blood Levels (peak, trough)

Monitor renal function

Peak & Trough for Gentamicin (Garamycin)

Peak: 30 minutes after infusion (5-8mcg/mL)

Trough: 30 minutes before next dose (no less than 2 mcg/mL)

Withhold dose if too high!

What drug is a fluoroquinolone?

Ciprofloxacin (Cipro)

(Cipro= might slip due to Achilles tendon rupturing)

Ciprofloxacin (Cipro) Indication

gram negative UTI

dermatological infection

anthrax exposure

URIs

bone joint infections

Ciprofloxacin (Cipro) Adverse Effects

photosensivity

phlebitis at IV site

rash

diarrhea

Ciprofloxacin (Cipro) Interventions/education

-linked to tendonitis (Achilles tendon)

-avoid- children under 18

-no milk products (and minerals)

-monitor for anaphylaxis

-monitor for c.diff

Amoxicillin (Amoxil) Action

inhibits synthesis of cell wall leading to cell death

bactericidal action

Amoxicillin (Amoxil) Adverse Effects

rash

allergic reaction (nausea, vomiting, diarrhea)

Vancomycin (Vancocin) Action

binds to bacterial cell wall leading to cell death

Vancomycin (Vancocin) Indication

C. diff

susceptible bacteria

Vancomycin (Vancocin) Adverse Effects

red man syndrome (caused by rapid med infusion)

ototoxicity

nephrotoxicity

Vancomycin (Vancocin) Intervention/education

monitor renal function

monitor for rash (RMS)

monitor IV site for necrosis

assess peak/trough levels (moderate=

Isoniazid (INH) Action

interferes with lipid & nucleic acid synthesis in actively growing tubercle bacilli

Isoniazid (INH) Indication

tuberculosis (TB)

Isoniazid (INH) Adverse Effects

jaundice

peripheral neuritis (hand/feet numbness)

epigastric distress

hepatotoxicity

neurotoxicity

nephrotoxicity

Isoniazid (INH) Intervention/education

no alcohol

no aged cheese/smoked meats (has tyramine)

vitamin b6 deficiency

What drug is an antiviral agent?

Acyclovir (Zorivirax)

Acyclovir (Zorivirax) Action

inhibits viral DNA replication

Acyclovir (Zorivirax) Indication

herpes simplex virus (HSV)

Acyclovir (Zorivirax) Adverse Effects

vertigo

tremors

headache

rash

nausea

Acyclovir (Zorivirax) Intervention/education

assess pain (MAIN GOAL)

monitor reoccurences

assess lesions

What drug is an azole anti fungal?

Fluconazole (Diflucan)

Fluconazole (Diflucan) Action

binds to sterols in fungal cell membrane & change permeability

Fluconazole (Diflucan) Indication

oral, esophageal, & vaginal candidiasis

What drug is an azole anti-protozoal?

Metronidazole (Flagyl)

Metronidazole (Flagyl) Action

inhibits DNA synthesis of specific anaerobes leading to cell death

Metronidazole (Flagyl) Interventions/education

educate on metallic taste

educate on darkening of urine

no alcohol (includes some mouthwashes, deodorants, aftershaves, & bath splashes)

Drugs acting on the immune system/inflammation

anti-inflammatory, antiarthritis, immune modulators, vaccines, & sera.

Immune Modulator classes

Interferons

Immunosuppressive agents

Vaccines/Sera

Vaccine

Immune sera

Ibuprofen (Advil) Action

inhibits prostaglandin synthesis & inhibits inflammatory cells

NOT IMMEDIATE RESPONSE

Ibuprofen (Advil) Indication

pain relief

arthritis symptoms

fever reduction

Ibuprofen (Advil) Interventions/education

nephrotoxicity

hepatotoxicity

take w/ food

monitor Hgb, Hct, & platelet count

Acetaminophen (Tylenol) Action

acts on hypothalamus to causes sweating for fever reduction

Acetaminophen (Tylenol) Indication

fever reduction

cold/flu symptoms

musculoskeletal pain

pretreatment for anemia transfusions

Acetaminophen (Tylenol) Adverse Effects

hepatotoxicity

fever

rash

Acetaminophen (Tylenol) Intervention/education

don't exceed dosage recommendations

no alcohol

Prednisone Action

initiates complex reaction (anti-inflammatory & immunosuppressive effects)

Prednisone Indication

pallative (comfort) care

allergic reactions

inflammatory disorders

Prednisone Adverse Effects

immunosuppressed

cushingoid effects (moon face, buffalo hump, red skin)

What drug is a Tumor Necrosis Factor Blocker?

Etanercept (Enbrel) & Infliximab (Remicade)

Etanercept (Enbrel) & Infliximab (Remicade) Actions

slows inflammatory response & suppresses immune system

Etanercept (Enbrel) & Infliximab (Remicade) Interventions/education

NONE LISTED

What drug is an Interferon?

Interferon Alfa-2b (Intron A)

Interferon Alfa-2b (Intron A) Action

inhibits tumor growth

Interferon Alfa-2b (Intron A) Indication

leukemia

melanoma

AIDS related Karposi Sarcoma

Hep B & C

Interferon Alfa-2b (Intron A) Adverse Effects

encephalopathy

chest pain

bone marrow suppression

alopecia

flu/cold symptoms

What drug is an immunosuppressive agent?

Mycophenolate mofetil (CellCept)

Mycophenolate mofetil (CellCept) Action

interferes w/ DNA/RNA production, growth, & development

Mycophenolate mofetil (CellCept) Indication

organ transplant patients

Mycophenolate mofetil (CellCept) Interventions/education

avoid pregnancy (take birth control)

avoid large crowds

Types of Neoplastic Drugs classes

antimetabolites, antineoplastic agents, hormone modulators, interferons (Interferon Alfa-2b; Intron A)

Types of Palliative Drug classes

Glucocorticoid Agents (Prednisone)

Methotrexate (Rheumatrex, Trexall) Action

inhibits folic acid reductase leading to DNA

Methotrexate (Rheumatrex, Trexall) Adverse Effects

folic acid deficiency

ulcerative stomatitis

hepatotoxicity

bone marrow suppression (SEVERE)

Methotrexate (Rheumatrex, Trexall) Intervention/education

no alcohol

avoid NSAIDS

report bruising

monitor bone marrow suppression

What drug is an antineoplastic agent?

Doxorubicin (Doxil, Adriamycin)

can treat AIDS-related Karposi Sarcoma

Doxorubicin (Doxil, Adriamycin) Actions

binds to DNA and causes cell death

Doxorubicin (Doxil, Adriamycin) Adverse Effects

cardiac toxicity

red urine

mucositis

What drug is a hormone modulator?

Tamoxifen (Soltamox)

Tamoxifen (Soltamox) Action

prevents feeding o tumor by binding to estrogen receptors

Tamoxifen (Soltamox) Adverse Effects

menopausal symptoms

edema/pain