D398 Pharmacology Notes

Heart failure

Heart failure

occurs when the heart muscle does not pump blood as well as it should.

Cardiac glycosides

improve cardiac output by increasing the power of ventricular contractions in individuals with heart failure.

Digoxin (Lanoxin – heart failure med) side effects

irritability, tremors, seizures, double vision, visual halos, and inability to sleep.

Digoxin (Lanoxin – heart failure med) cautions

severe kidney or lung damage (doses may need to be adjusted), sudden heart attacks.

Digoxin (Lanoxin – heart failure med) drug interactions

may interact with several drugs, patients should follow up with doctors or pharmacists for any new additions of medications.

Arrhythmia

an irregular heartbeat caused by malfunctioning electrical signals that coordinate heartbeats.

Amiodarone (Cordarone – arrhythmia med)

an oral and injectable antiarrhythmic agent approved for treating arrhythmias.

Amiodarone (Cordarone – arrhythmia med) side effects

tremors, numbness, visual disturbances, lung scarring, or thickness (known as pulmonary fibrosis).

Amiodarone (Cordarone – arrhythmia med) cautions

patients with underlying heart block diseases, thyroid disease, or allergic reactions to iodine.

Hypertension (high blood pressure)

a frequent disorder affecting the body's arteries, requiring the heart to exert more effort to pump blood.

Hypertension meds

Beta Blockers, calcium channel blockers, diuretics, Angiotensin-converting enzyme (ACE) inhibitors, Angiotensin Receptor Blockers (ARBs).

Beta-blockers (Hypertension meds)

lower blood pressure by blocking the beta receptor in the body, reducing the pace and power of cardiac contraction.

Metoprolol (Tropol – Beta Blocker - Hypertension) side effects

dizziness, fatigue, confusion, low blood sugar.

Metoprolol (Tropol – Beta Blocker - Hypertension) cautions

never stop the drug without speaking to a doctor, may interfere with diseases such as asthma or chronic obstructive pulmonary disease.

Calcium channel blockers (Hypertension Meds)

reduce blood pressure by preventing calcium from entering the cells of the heart and arteries, regulating heart rate and blood pressure.

Amlodipine (Norvasc – Calcium Channel Blockers- Hypertension Meds) side effects

edema, abdominal discomfort, and headache.

Diuretics (Hypertension Meds)

decrease blood pressure by increasing urine output, helping rid the body of salt and water.

Hydrochlorothiazide (Microzide - Diuretics - Hypertension Meds) side effects

frequent urination, low potassium, and low magnesium.

ACE inhibitors (Hypertension Meds)

relax veins and arteries to reduce blood pressure by blocking an enzyme called ACE in the body.

Lisinopril (Zestril – ACE Inhibitor – Hypertension Med) side effects

dry cough, rash, and high potassium.

Angiotensin receptor blockers (ARBs – Hypertension Med)

inhibit the angiotensin receptor directly, decreasing blood pressure without a marked change in heart rate.

Losartan (Cozaar - ARBs – Hypertension Med) side effects

dizziness, high potassium levels.

Angina

chest discomfort or pain caused by obstruction of the coronary arteries, resulting in severe chest pains and inability to breathe.

Vasodilators (Angina Med)

widen the blood arteries to improve oxygen flow and minimize the frequency of bouts of chest discomfort.

Nitroglycerin (Nitrostat - Vasodilator – Angina Med) side effects

headaches, flushing, blurred vision, and dry mouth.

Cholesterol

waxy material in the blood that, when excessive, may raise the risk of heart disease by forming fatty deposits in the arteries.

Antilipemic medicines (high cholesterol meds)

used to control high cholesterol and triglyceride levels in the blood.

Statins (Antilipemic meds - High Cholesterol Meds)

suppress the enzyme responsible for cholesterol production.

Atorvastatin (Lipitor – Statins - Antilipemic meds - High Cholesterol Meds) side effects

muscle weakness, rhabdomyolysis, and an increase in liver enzyme markers.

Fibrate (antilipemic med - high cholesterol med)

helpful in individuals with severely excessive triglyceride and cholesterol levels.

Fenofibrate (Tricor – fibrate – antilipemic med – high cholesterol) side effects

GI complaints, gallbladder stones, and muscle pain.

Blood clots (thrombosis)

unstable clots that obstruct blood flow and cause tissue injury.

Anticoagulants

impede the development of blood clots.

Warfarin (Jantoven – oral anticoagulant – Blood Clots meds) side effects

bleeding complications, bloody stool, and red urine.

Bronchoconstriction

occurs in individuals with asthma or chronic obstructive pulmonary disease (COPD).

SABAs (bronchodilator – beta agonist – bronchoconstriction med)

short-acting beta agonists used for acute asthma attacks.

LABAs

Long-acting beta-agonists (LABAs) are bronchodilators used for preventative/maintenance purposes and not for acute bronchoconstriction. An example of a LABA is formoterol (Foradil).

Formoterol

Formoterol is a LABA bronchodilator used to treat bronchoconstriction. It may cause side effects such as throat irritation, hoarseness, sinusitis, nervousness, tremors, dizziness, and headache. Caution should be exercised as it may cause or worsen cardiac irregularities.

Anticholinergics

Anticholinergics are medications that block receptors in the smooth muscle of the airway, inducing bronchodilation and preventing bronchospasms. Ipratropium (Atrovent) is an example of an anticholinergic bronchoconstriction medication.

Ipratropium

Ipratropium (Atrovent) is an anticholinergic bronchoconstriction medication. It may cause side effects such as cardiac effects, CNS stimulation, thickened secretions, dry mouth, metallic taste, constipation, and abdominal pain. Caution should be exercised in patients with unstable cardiac status, history of heart attacks, glaucoma, drug sensitivity, or prostatic hypertrophy.

Xanthine derivatives

Xanthine derivatives, such as theophylline (Theo 24), are bronchoconstriction medications used to prevent and treat wheezing, shortness of breath, and chest tightness in the lungs and respiratory passages. Side effects may include nervousness, insomnia, irritability, headache, tremors, seizures, cardiac effects, and urinary frequency. Caution should be exercised in patients who abruptly cease tobacco smoking.

Corticosteroids

Corticosteroids are respiratory inflammation medications that alleviate inflammation, reduce edema, diminish bronchial hyper-reactivity, and suppress symptoms. Fluticasone (Flovent) is an example of a corticosteroid respiratory medication. Side effects may include throat irritation, dry mouth, oral fungal infections, and increased susceptibility to pneumonia. Caution should be exercised in patients with certain medical conditions.

Expectorants

Expectorants are over-the-counter respiratory medications that decrease the thickness of sputum and aid in its expulsion. Guaifenesin (Mucinex) is an example of an expectorant.

Antitussives

Antitussives are over-the-counter respiratory medications used to stop dry, consistent, and hacking coughs. Dextromethorphan (Delsym) is an example of an antitussive.

Antihistamines

Antihistamines are over-the-counter respiratory medications used to treat allergy symptoms, reduce nasal secretions, post-nasal drip, and dry out the throat. Diphenhydramine (Benadryl) is a first-generation antihistamine, and loratadine (Claritin) is a second-generation antihistamine.

Decongestants

Decongestants are over-the-counter respiratory medications used to alleviate nasal congestion. Pseudoephedrine (Sudafed) and oxymetazoline (Afrin) are examples of decongestants.

Acid reflux

Acid reflux is a condition characterized by heartburn and a sharp feeling in the chest due to irritation of the esophageal lining by stomach acid. Calcium carbonate (Tums/Rolaids) and aluminum hydroxide + magnesium hydroxide (Maalox) are antacids used for acid reflux. Famotidine (Pepcid) and cimetidine (Tagamet) are antihistamines used for acid reflux.

GERD

GERD is a disorder in which acid-containing stomach contents continuously seep back into the esophagus. Proton pump inhibitors (PPIs), such as omeprazole (Prilosec) and esomeprazole (Nexium), are used to reduce stomach acid production in GERD.

Antidiarrheal medicines

Antidiarrheal medicines lower the frequency of loose stools. Bismuth subsalicylate (Pepto-Bismol) is an antidiarrhea medication, and diphenoxylate with atropine (Lomotil) and loperamide (Imodium) are opiate agonists used as antidiarrheals.

Laxatives

Laxatives relieve constipation by facilitating intestinal emptying. Psyllium and polycarbophil are bulk-forming laxatives, and docusate sodium (Colace) is a stool softener.

Antidopaminergics

Antidopaminergics, such as promethazine (Phenergan), are used as nausea medications by stopping the chemoreceptors in the brain from being stimulated.

Adrenal Corticosteroids

Adrenal corticosteroids, such as prednisone (Deltasone) and methylprednisolone (MEDROL dose pack), are synthetic versions of cortisol used to treat inflammatory conditions. They may cause side effects such as mood changes, weight gain, swollen face, acne, or stunted growth in children. Caution should be exercised when stopping these medications abruptly and in patients with certain medical conditions.

Thyroid disorder

Occurs when the thyroid produces too much or too little vital hormone.

Hypothyroidism

Disorder characterized by insufficient production and release of thyroid hormone into circulation. Slows down metabolism.

Levothyroxine (Synthroid - hypothyroidism)

Medication used to treat hypothyroidism. Side effects include muscle weakness, leg cramps, nervousness, and weight loss.

Hyperthyroidism

Condition characterized by an overproduction of the thyroid hormone. Increases metabolic rate.

Methimazole (Tapazole - hyperthyroidism)

Medication used to treat hyperthyroidism. Side effects include rash, itching, and an abnormal taste of blood in the mouth.

Propylthiouracil (PTU – hyperthyroidism)

Medication used to treat hyperthyroidism. Side effects include rash, itching, and an abnormal taste of blood in the mouth.

Diabetes mellitus

Collection of hormonal disorders defined by poor metabolism of carbohydrates, lipids, and proteins, leading to increased blood glucose levels.

Insulin aspart (NovoLog – diabetes med)

Rapid-acting diabetes medication.

Insulin isophane (Humulin N – diabetes med)

Intermediate-acting diabetes medication.

Insulin glargine (Lantus – diabetes med)

Long-acting diabetes medication.

Biguanides

Medications that decrease glucose production in the liver and enhance insulin uptake in muscle tissue. Metformin is a preferred initial first-line monotherapy for type 2 diabetes.

Sulfonylureas

Medications that increase insulin production from the pancreas and improve peripheral insulin activity.

Diuretics

Medications that accelerate urine elimination and lower the amount of fluid in circulation.

Hydrochlorothiazide (Microzide – thiazide diuretic – urinary med)

Medication used as a diuretic. Side effects include electrolyte depletion and caution in severe renal diseases.

Gout

Painful type of arthritis caused by the body producing too much uric acid.

Nonsteroidal anti-inflammatory drugs (NSAIDs)

Medications used to treat gout and reduce inflammation. Examples include ibuprofen and naproxen.

Colchicine (Colcrys - Nonsteroidal anti-inflammatory drugs NSAIDs – anti-gout)

Medication used to treat gout. Side effects include gastrointestinal side effects and bone marrow suppression.

Benign prostatic hyperplasia (BPH)

Condition characterized by an increase in the reproduction of cells that causes prostate enlargement and impedes urine flow.

Antiandrogens

Drugs used to treat the symptoms of benign prostatic hyperplasia (BPH).

Finasteride (Proscar – antiandrogen - BPH - urinary med) and dutasteride (Avodart – antiandrogen - BPH – urinary med)

Medications used to treat BPH. Side effects include decreased sex drive, breast enlargement in males, and inability to maintain an erection.

Alpha-blockers

Medications that relax smooth muscle in the bladder, neck, and prostate, decreasing pressure.

Tamsulosin (Flomax – alpha-blocker - BPH – urinary med) and doxazosin (Cardura – alpha-blocker - BPH – urinary med)

Medications used to treat BPH. Side effects include dizziness, headache, and nasal congestion.

Urinary tract infections (UTIs)

Infections caused by bacteria or fungi entering the urethra and infecting the urinary system.

Phenazopyridine (AZO – over the counter – UTI med – urinary med)

Over-the-counter medication used to relieve UTI symptoms. Side effects include headache and discoloration of body fluid.

Antibiotics

Medications used to treat infections caused by bacteria.

Antivirals

Medications used to treat viral infections.

Antifungal

Medications used to treat fungal infections.

Antineoplastic drugs

Medications used to treat cancer. Also referred to as anticancer, chemotherapy, chemo, cytotoxic, or hazardous drugs.

Antimetabolites (antineoplastic)

Drugs that kill cells. Examples include methotrexate and fluorouracil.

Alkylating agents (neoplastic drugs)

Drugs that prevent cell growth. Examples include cisplatin and cyclophosphamide.

Mitotic inhibitors (neoplastic drugs)

Drugs that inhibit the process of mitosis. Examples include vinblastine and vincristine.

Extravasation

Leaking of drugs intended for intravenous administration, leading to destruction of surrounding skin and tissue.

Antitumor antibiotics (neoplastic drugs)

Drugs that target and kill cancer cells. Example:doxorubicin.

Hormones/Hormone Blockers (neoplastic drugs)

Drugs used to treat hormone-sensitive cancers. Examples include antiestrogens and antiandrogens.

Biologics (neoplastic drugs)

Medications that boost the immune system to fight off cancer cells. Examples include interferons and monoclonal antibodies.

Active/direct biologics (neoplastic drug)

Definition - Interferons, such as interferon alfa, are drugs used to treat a wide variety of cancers and other conditions, such as hepatitis and multiple sclerosis. They have many uncomfortable side effects, including flu-like symptoms, stomach issues, sleep disturbances, and anemia.

Passive/indirect biologics (neoplastic drug)

Definition - Monoclonal antibodies, such as Avastin and Herceptin, are drugs given intravenously to treat specific types of cancer. Avastin treats carcinoma of the colon, kidney, or lungs, while Herceptin is used for breast cancer.

Targeted Cancer Therapy (neoplastic drug)

Definition - Gleevec is a signal transduction inhibitor (STI) used to treat chronic myelogenous leukemia. It blocks signals inside cells that are being passed from one molecule to another and is administered orally.

Vaccines (neoplastic drug)

Definition - Vaccines can be used as preventative measures or treatments for cancer by helping the immune system fight the disease. Examples include FDA-approved vaccines like Gardasil and Cervarix for protection against human papillomavirus (HPV) and Provenge, a personalized vaccine for prostate cancer.

Radioactive isotopes

Definition - Radioactive drugs, such as radioactive sodium iodine, are used in targeted cancer treatments. They interact with cancer cells while minimizing damage to nearby healthy cells. Radioactive sodium iodine is commonly administered orally to treat thyroid cancer.

Medical Abbreviations

Po / Per os = By mouth; Bid/Bis in die = twice daily; C/Cum = with; Rx/Recipere = Take:Definitions - Po/Per os means taking medication by mouth, Bid/Bis in die indicates taking medication twice daily, C/Cum means taking medication with another substance, and Rx/Recipere is an abbreviation for "take" in prescription instructions.

1906 Pure Food and Drug Act

Definition - The 1906 Pure Food and Drug Act established standards for drug strength, purity, and quality. It also required drugs with dangerous ingredients to be labeled as such.

1938 Federal Food, Drug, and Cosmetic Act

Definition - The 1938 Federal Food, Drug, and Cosmetic Act established the Food and Drug Administration (FDA) to enforce regulations regarding drug labeling, approval before release, and warning labels.

1970 Controlled Substances Act

Definition - The 1970 Controlled Substances Act established the Drug Enforcement Agency (DEA) and set strict standards for controlled substances. Prescribers are required to register with the DEA, and the agency enforces the laws outlined in this act.

Fat-soluble vitamins

Definition - Fat-soluble vitamins, including vitamins A, D, E, and K, have a higher risk of overdose. These vitamins play essential roles in the body, such as fighting infections (vitamin A), promoting healthy skin and bones (vitamin D), aiding in food breakdown and organ protection (vitamin E), and blood clotting (vitamin K).

Water-soluble Vitamins

Definition - Water-soluble vitamins, including B complex vitamins and vitamin C, have a lower or no risk of overdose. These vitamins are necessary for various bodily functions, such as brain health (vitamin B1), energy production and red blood cell formation (vitamin B2), red blood cell development and cell growth (vitamin B12 and B9), fat breakdown and iron absorption (vitamin B3), wound healing and teeth/bone health (vitamin C).

Essential Minerals

Definition - Essential minerals, such as sodium, chloride, potassium, calcium, iron, and zinc, play crucial roles in the body. They help maintain body fluid balance, nerve function, bone health, and oxygen transport (iron) among other functions.

Narcolepsy (psychotropic med)

Definition - Narcolepsy is a condition characterized by chronic daytime drowsiness and sudden attacks of sleep. Medications like Modafinil (Provigil) and armodafinil (Nuvigil) are stimulant medications used to treat narcolepsy.