Pharmacology for NPTE

Suffix for Beta Blockers

-OLOL

What are examples of common beta blockers

Metoprolol, Atenolol, Propranolol, Carvedilol, and Labetalol

What are the common effects of Atenolol

Decreases HR, BP and bronchoconstriction

Beta Blockers are indicated for?

CAD, HTN, and arrhythmias (NOT ok for COPD or ASTHMA)

What are some possible adverse effects of beta blockers

orthostatic hypotension, dizziness, venous pooling, no reflex tachycardia

What are some PT considerations for patients who take Metoprolol

blunted HR so utilize RPE. They may also demonstrate an increased PR interval on an EKG

suffix for calcium channel blockers (3)

-PINES, -ZEMS, Verapamil

commonly prescribed calcium channel blockers

dihydropyridines (e.g., Amlodipine, Nifedipine) and non-dihydropyridines (Diltiazem, Verapamil)

common effects of calcium channel blockers

decrease HR, BP, Reduce contractility and vasoconstriction

Calcium channel blockers are indicated for

CAD, HTN, arrhythmias, and are ok for COPD and/or asthma

What are possible adverse effects of calcium channel blockers

orthostatic hypotension, dizziness, venous pooling and bradycardia

what are possible PT considerations of patients who take Amlodipine

Utilize an RPE and may demonstrate a prolonged QT interval on an EKG

What is an example of a loop diuretic

Lasix

Lasix causes what intended effects

inhibits water/electrolyte reabsorption, occuring at the loop of henle

Lasix is indicated for what conditions

HTN, CHF, Edema, and Pulmonary Edema

common adverse effects of Furosemide (Lasix)

HYPOkalemia, HYPOcalcemia, HYPOnatremia, dehydration, Orthostatic hypotension, reflex tachycardia, dizziness, lethargy

What is an example of potassium sparing diuretics

Spironolactone

what are the intended effects of Aldactazide (spironolactone/hydrochlorothiazide)

Binds to receptors at the Na/K exchange site in the distal convoluted renal tubule. Is Potassium sparing

What conditions is Aldactazide (spironolactone/hydrochlorothiazide) indicated for

CHF, HTN, Combined with other drugs causing hypokalemia

Possible adverse effects of spironolactone

Hyperkalemia, hypocalcemia, hyponatremia, dehydration, orthostatic hypotension, reflex tachycardia, gynecomastia, dizziness, lethargy

What is a consideration for a patient who is taking a potassium sparing diuretic

avoid bananas (or other foods high in potassium)

What are some common Thiazide Diuretics

Hydrochlorothiazide (HCTZ) and Chlorthalidone

What is the intended effect of Hydrochlorothiazide (HCTZ)

Block sodium and calcium channels in the distal convoluted tubule of the nephron. Inhibit the reabsorption of sodium and water

What are conditions commonly treated with Hydrochlorothiazide (HCTZ)

HTN, CHF and Edema

Thiazide diuretics can potentially cause these adverse effects

Hypercalcemia, Hyperuricemia, Hyperlipidemia, Hyponatremia, dehydration, Orthostatic hypotension, reflex tachycardia, and dizziness

Who/what conditions are thiazide diuretics not appropriate for

those with DM, renal dysfunction and the elderly

What is the suffix for ACE inhibitors

-PRIL

What are common examples of ACE Inhibitors

Capoten (captopril), Vasotec (enalapril), Prinivil (lisinopril), Altace (ramipril)

What is the intended effect of Capoten (Captopril)

Suppressing ACE (an Enzyme) that decreases BP and afterload

What conditions are commonly treated with Vasotec (Enalapril)

CHF and HTN

What are some adverse effects of Prinivil (lisinopril)

Hyponatremia, Hyperkalemia, orthostatic hypotension, dry hacking cough, angioedema

What is a possible consideration for a patient taking an ACE inhibitor

Can react with diuretics and cause hypotension

Suffix associated with ARB blockers

-SARTANS

Common ARB Blockers

Cozaar (losartan), Atacand (Candesartan), Diovan (valsartan)

What is the intended effect of Diovan (valsartan)

Block Angiotensin II receptors and decreased the effects of Angiotensin II. Hence decrease BP

Common conditions treated with Cozaar (losartan)

HTN and CHF, intolerant to ACE

Common adverse effects of Atacand (Candesartan)

Hyponatremia, Hyperkalemia, hypotension, dizziness, lightheadedness, fatigue

What is the action/intended effect of digitalis

Acts on the myocardium ATPace pump to slow the HR and increase CO

Digitalis commonly treats

CHF (systolic dysfunction) and Atrial fibrillation

what are some adverse effects associated with digitalis toxicity

arrhythmias/palpitations, GI disturbances, visual disturbances, hyperkalemia, confusion/delirium

Nitrates are intended to treat what and how

Treat angina by causing relaxation of smooth muscles and dilation of peripheral arteries

What are some adverse effects of Nitrates

dizziness, lightheadedness, orthostatic hypotension, headaches, flushing and reflex tachycardia

describe proper administration of nitrates

Give sublingually (under tongue), 3 doses every 5 min, while sitting or laying. If there is no relief after three tablets potential MI call EMS

Examples of anticoagulants

Warfarin/Heparin

What is the intended effect of Warfarin

Inhibit vitamin K formation and prevent synthesis of clotting factors

What conditions are Heparin commonly used for

DVT, MI, and Stroke

What are possible adverse events associated with warfarin

Bleeding, easy bruising, hemorrhage, hemarthrosis, lightheadedness

What are some considerations for anticoagulants

INR: between 2-3

Examples of antiplatelet drugs

Aspirin and clopidogrel

What is the purpose of antiplatelets

prevent aggregation of platelets

Conditions commonly treated with antiplatelets

prevention of stroke and MI

What are adverse side effects associated with apiring/clopidogrel

Peptic Ulcers, Gastritis, risk of internal bleeding

Examples of NSAIDS

Celecoxib/celebrex, aspirin, ibuprofen, motrin

What is the difference between selective and non selective NSAIDS

Selective only blocks COX2 while Nonselective blocks COX1 and COX2

example of nonselective NSAIDS

Aspirin and Ibprofen

Example of selective NSAIDs

Celecoxib and Meloxicam

What conditions or symptoms are NSAIDS treating

Anti Inflammatory, antipyretic, analgesic

What are adverse effects of NSAIDS

Adverse cardiovascular effects such as increased risk of MI, stroke. Also known to cause gastric ulcers, bleeding, n/v

What is the intended effect of acetaminophen

blocks pain sensation (analgesic), antipyretic, and decrease HA

Is acetaminophen an anti-inflammatory

NO!!!!

Adverse effects of acetaminophen

liver damage, jaundice, clay colored stools

Common suffix associated with opioids

-DONE

What are commonly prescribed Opioids

hydrocodone, Oxycodone, Morphine

What are common adverse events associated with oxycodone use

Respiratory and CNS depression, Bradycardia, constipation, slowed breathing, dizziness, drowsiness/slowness, addiction, tolerance

what are some PT considerations for patients taking prescription opioids such as Hydrocodone

Take 30 min prior to therapy

What are some examples of Benzodiazepine’s

Diazepam, valium, clozepam, alpraxolam, xanax

What are Benzodiazepines such as Xanax commonly used to treat

muscle spasms, anxiety, insomina and alcohol withdrawl

What are some adverse effects of Valium

Tolerance, dizziness, hallucination, drowsiness, sedation, fatigue, hypotoniaW

What are some PT considerations for a patient taking Diazepam

increased fall risk

What is Baclofen used to treat

Muscle spasticity, MS, SCI, CP

What are adverse effects associated with baclofen use

hypotonia, confusion, dizziness, increased risk of falls, drowsiness, shallow breathing

Common examples of short acting Beta 2 agonists

Albuterol and levalbuterol

Common examples of long acting beta 2 agonists

Formoterol, salmeterol, indacaterol

what suffix is commonly associated with beta 2 agonists

-OL

What suffix is commonly associated with cholinergic drugs

-PIUM

commonly prescribed cholinergic bronchodilators

short-acting ipratropium bromide (Atrovent) and long-acting agents like tiotropium (Spiriva)

What conditions would be treated with bronchodilators

COPD, BA

Common adverse effects from bronchodilators

tremors, palpitations, GI disturbances, Dry mouth

Examples of glucocorticoid agents (corticosteroids)

Dermacort (hydrocortisone or cortisol), Cordrol (prednisone), Pediapred (prednisolone), Medrol (methylprednisolone)

What is the action of medrol (methylprednisolone)

provide hormonal antiinflammatory, and metabolic effects including suppression of articular and systemic diseases.W

What are indications of hydrocortisone or cortisol

replacement therapy for endocrine dysfunction, anti inflammatory and immunosuppressive effects, treatment of rheumatic, respiratory and various other disorders

What are possible adverse effects associated with corticosteroids

muscle atrophy, GI distress, glaucoma, adrenocortical suppression, drug induced ceshing’s syndrome, weakening with breakdown of supporting tissues, mood changes, HTN

Patients who take glucocorticoid agents (corticosteroids) are associated with increased risk for….

osteoporosis and muscle wasting