Medications Patho Pharm term 1

Alteplase (tPA) Streptokinase (streptase)

Thrombolytic/Fibrinolytic Drugs. Dissolve formed clots and stops MI, PE, and stroke progression. SE: bleeding

Aliskiren

Direct renin inhibitor, binds with renin to reduce RAAS cascade. For HTN. SE: dizzy, hypotension, peripheral edema, hyperkalemia, hyperuricemia

What class of drug is Adenosine?

Class 5

What is the primary use of Adenosine?

To restart the heart

How does Adenosine affect calcium in the heart?

Stops calcium to the SA and AV nodes

Hydrochlorothiazide (hydroDIURIL)

Weaker diuretic 10% of Na, Cl, and water excreted. Early distal convoluted tubule. HTN

What is the administration method for Adenosine?

IV Push

What condition is Adenosine used to treat?

Paroxysmal SVT

What is the half-life of Adenosine?

1.5-10 seconds

What are some side effects of Adenosine?

Bradycardia, dyspnea, chest pain, flushing

Spironolactone (Aldactone)

Potassium sparing diuretic, used with diuretics. Treats HTN and edema. SE: hyperkalemia, deeper voice

Furosemide (Lasix)

Loop diuretic, pill or IV push. Excretes 20% of Na, Cl, and water in ascending loop of Henle. SE: dizzy, dehydrated, hypotension, hyponatremia, hypokalemia, tinnitus

Mannitol (Osmitrol)

For emergencies, IV push or drip. Excretes 65% in proximal convoluted tubule. For acute kidney failure, cystic fibrosis, sever edema, and brain or eye swelling. SE: hyper or hypo tension and natremia, thirst, dizzy, HA, pulmonary edema.

Verapamil (Calan) Diltiazem (Cardizem)

Class 4 Ca channel blockers, vasodilation, decreased contractility, lengthen depolarization. For A-FIB, A-flutter, SVT, V-TACH. SE: hypotension, bradycardia, AV block, peripheral edema, no QRS

Amiodarone (Cordarone)

Class 3 K channel blockers, lengthen repolarization. For A-FIB, V-TACH, V-FIB. Long half-life and lipophilic (sticky). SE: N/V, HA, dysrhythmias (prolonged QT segment), pulmonary fibrosis, liver toxicity. After try procainamide

Quinidine (Quinidex)

Class 1-A blocks Na and K channels, slows arrythmias and tachycardia. For SVT and V-TAC return. SE: diarrhea, AV block, V-TACH, asystole, potentiates digoxin

Metoprolol Atenolol

Class 2 beta blockers Cardioselective (B1). Decrease HR and contractility. For HTN, MI, tachycardia. SE: bradycardia, hypotension, HF, AV block

Propranolol. Carvedilol

Class 2 beta blockers nonCardioselective (B1 and B2). SE: bradycardia, hypotension, HF, AV block, bronchoconstriction and hypoglycemia (not for COPD or diabetics)

Lidocaine (Xylocaine)

Class 1-B blocks Na and throws K out of cells. Accelerate repolarization, for V-TACH and dysrhythmias. SE: dizzy, seizures, confused, block Na in brain, metabolized by the liver

Sartans

Block angiotension II receptors, preventing ang II effects. For primary HTN, HF, diabetic nephropathy, reacted poorly to ACE 1. SE: dizzy, hypotension, HA, hyperkalemia, hyperglycemia, angioedema

Prils

ACE inhibitors, stops angiotension II formation. For primary HTN, HF, diabetic nephropathy. SE: nonproductive cough, insomnia, HA, dizzy, hyperkalemia, tachycardia, hypotension. Not for renal artery stenosis, pregnancy, K sparing, K salt substitutes, older adults poss, African Americans poss.

Hydralazine. Minoxidil

Direct Acting Arteriolar Vasodilator, relax arterioles to decrease afterload. For HTN emergencies, preeclampsia, HF. SE: hypotension, reflex tachycardia, HA, dizzy, edema, nasal congestion, anorexia, N/V, diarrhea.

Labetalol. Carvedilol

A1 and B1 blockers, vasodilation, decreased HR and contractility. For HTN emergency, preeclampsia, HF. SE: hypotension, bradycardia, paresthesia, depression, nasal congestion, nausea, ED

Abciximab (Reopro)

Glycoprotein II A and B receptor antagonists, high intensity anti-platelet and reversible. For MI, cardiac cath/stent, prevents reocclusion. SE: twice the risk of significant bleeding. Watch back pain, HR, BP and 10 days bedrest.

Sins

Alpha-adrenergic blockers, vasodilation and decreased BP, For HTN, benign prostatic hyperplasia (doxazosin), PTSD nightmares (prazosin). SE: orthostatic HTN, tachycardia, HA, drowsy, dizzy, nausea, nasal congestion, edema, weight gain

Atropine Sulfate

Cholinergic blocker, For symptomatic bradycardia. SE: tachycardia, dry mouth, urinary retention

Epinephrine (adrenalin)

Sympathomimetic/Catecholamine. For A1, B1, B2, V-TACH, V-FIB, cardiac arrest, anaphylaxis. SE: tachycardia, HTN, hyperglycemia

Dobutamine

B1 agonist, for active HF patients, drip. SE: tachycardia, palpitation, N/V, hyper or hypo tension, CP, V-TACH, V-FIB

Dopamine

High: A1, Mod: B1, Low: raised perfusion to kidneys. SE: tachycardia, N/V, dysrhythmias, MI, doesn't cross BBB

Nifedipine. Amlodipine

Ca channel blockers (vasodilation). Doesn't block Ca in the heart. For HTN (esp for preeclampsia and pregnancy). SE: reflex tachycardia, hypotension, dizzy, HA, peripheral edema, ED

Statins

Common anticholesterol med, Lowers LDL and triglycerides, increases HDL. For liver effects at night, reduce heart disease risks. SE: GI issues, prevent fat absorption, smelly stool, muscle injuries. Watch creatine kinase, hyperglycemia, AST and ALT

Nicotinic Acid

B3 agonist, lowers LDL and triglycerides. Can combine with statins. SE: vasodilation, itching, GI upset

Cholestyramine (bile-acid sequestrates)

Lower LDL, sticks to meds so 1 hr after other meds, or 4 hrs prior. SE: constipation, collects sticky cholesterol

Fibrates

Lowers triglycerides. SE: little GI upset, watch bleeding w/ warfarin, liver, gallstones, muscle weakness

Ezetimibe

Decrease cholesterol absorption, needs diet modification. SE: hepatic enzymes, myopathy, cholelithiasis, thrombocytopenia

Heparin

Anticoagulant for venous thromboses, inactivated thrombin and Factor Xa. For PE, evolving stroke, DVT, acute MI, DIC, open heart surgery, renal dialysis. SE: bleeding bruising, thrombocytopenia, want 60-80 second PTT, watch Anti-Xa and route. Stop w/ Protamine Sulfate

Enoxaparin (Lovenox)

Low molecular weight heparin, acts of Factor Xa. For preventing DVT, PE, MI. SE: bleeding, bruising, thrombocytopenia

Warfarin (Coumadin)

Stops Vit. K from clotting. For preventing PE, DVT, artificial valves, reduces stroke risk in A-FIB. SE: bleeding, bruising, rash, skin necrosis. Monitor PT and INR. (GIVE Vit. K reversal) Days for peak therapeutic, avoid antiplatelet and acetaminophen.

Dabigatran Etexilate (Pradaxa) Argatroban (Acova)

Direct thrombin inhibitor. For preventing A-FIB clots, DVT, post surgery prophylaxis. Not for artificial valves. SE: bleeding, allergic reaction

Rivaroxaban (Xarelto) Apixaban (Eliguis)

Factor Xa inhibitor, which inhibits thrombin. For knee and hip replacements, non-valvular A-FIB, kidney impairments. SE: bleeding, spinal hematoma

Aspirin /ASA (Bayer, Excedrin)

Supress platelet aggregation, prevent thrombus in arteries. For stroke or MI prevention. SE: bleeding, stomach ulcer. Report bleeding, black tarry stools

Clopidogrel (Plavix) Ticlopidine (Ticlid)

Adenosine diphosphate receptor antagonist, block clot receptors on platelets. For preventing stroke or MI, post stent. SE: bleeding

Diphenhydramine (Benadryl)

First gen antihistamine, blocks H1 in CNS, blocks acetylcholine for anticholinergic side effects. Not for liver disease, glaucoma, or urinary retention

Loratadine (Claritin)

Second gen antihistamine, less anticholinergic side effects since cant cross BBB. Nondrowsy, dry mouth. Not for liver disease or antibiotics.

Nasal Decongestants

Ing: phenylephrine and pseudoephedrine. A1 agonist. SE: tachycardia, palitations, HTN, restlessness, cant use longer than 3 days. Not for heart conditions, caffeine, beta blockers, MAOIs

Intranasal Glucocorticoids

Ing: fluticasone. Anti-inflammatory for allergic rhinitis. SE: nasal irritations, nosebleed, HA, sore throat, infection risk

Antitussives

Ing: dextromethorphan and codeine. For coughing to depress medulla. SE: dizzy, drowsy, hallucinations and psychosis

Expectorants

Ing: guaifenesin. Loosens secretions and mucus in chest congestions. SE: drowsy, dizzy, HA, N/V

Rescue Inhalers

Abluterol (lasts longer) and Metaproterenol (faster and more reaction). For acute bronchospasms, COPD, asthma. SE: HA, tremor, nervous, palpitations, tachycardia. Albuterol SE: hypokalemia, HTN, bronchospasms

Tiotropium (Spiriva)

maintenance: bronchodilation. For bronchospasms mainly in COPD. Inhaled spray or powder. SE: dry mouth, back pain, urinary retention, constipation, tachycardia, sweating, bronchospasms

Theophylline (Uniphyl)

maintenance methylxanthines. Anti-inflammatory and relax muscles around bronchi and pulmonary BV. Tablet, capsule, IV push. SE: N/V, diarrhea, HA, restlessness, irritability, easy overdose

Montelukast (singulair)

Leukotriene recpetors (anti-inflammatory and decreased mucus). Take 2 hrs before exercise. SE: HA, stomach pain, upper respiratory infection, depression, anxiety, hallucinations

Fluticasone (Flovent) Methylprednisolone (Solu-medrol)

stifle WBC response, inhaler, nasal spray, tablet, IV. SE: dry mouth, cough, oral thrush, hyperglycemia, fluid retention, psychosis, osteoporosis, infections. Avoid aspirin and NSAIDS

Cromolyn

Mast cell stabilizer, decrease asthma inflammation, children, inhaler, eye drop, nasal spray, oral. SE: cough, nasal drip, throat irritation, bronchospasms

Acetylcysteine (Mucomyst)

liquifies and loosens mucus, mucolytic, neb or chronic use. SE: N/V, stomatitis, rhinorrhea

Phenytoin

preventing epilepsy, blocks some Na channels in neurons; SE: drowsy, dizzy, weak, constipations, gingival hyperplasia (treat folic acid), rash. 10-20 mcg/mL

Methylphenidate (Ritalin)

ADHD and narcolepsy, blocks reuptake of dopamine and norepinephrine (fight or flight), SE: tachycardia, palpitations, HTN, dysrhythmias, restless, irritable, anorexia, weight loss (lack appetite). Drug holidays for children. No caffeine.

Sumatriptan (Imitrex)

migraine treatment, serotonin receptor agonist (vasoconstriction in brain). SE: angina, dizzy, drowsy, fatigue, dysrhythmias, MI

Levodopa (Dopar) or combined Levodopa/Carbidopa (Sinemet)

increases dopamine, Parkinson’s. SE: N/V, dyskinesia, dysrhythmias, postural hypotension, psychologic disorders. Wait 2-3 mo and don’t take w/ protein

Amantadine (Symmetrel)

W/ Levodopa, increase dopamine and stimulate receptors, Parkinson’s and antiviral. SE: postural hypotension, peripheral edema

Selegiline (Eldepryl)

W/ Levodopa, inhibits MAO-B from breaking dopamine, Parkinson’s. SE: dyskinesia, orthostatic hypotension, sleep disturbed, hallucinations, Alzheimer’s

Rivastigmine (Exelon)

block cholinesterase inhibitor (prevent acetylcholine break down), slow Alzheimers. SE: dizzy, headache, confusion, depression, weight loss, dry mouth, orthostatic hypotension, peripheral edema

Phenothiazine: Fluphenazine (Prolixin), Chlorpromazine (Thorazine)

blocks dopamine, acetylcholine, histamine, norepinephrine, for schizophrenia, bipolar, tourette’s. SE: extrapyramidal, tardive dyskinesia, anticholinergic effects, sedation, orthostatic hypotension, red/brown urine

Anticholinergic Effects

dry mouth, blurred vision, urinary retention

Extrapyramidal

dropped dopamine, acute dystonia (muscle contractions in neck and back), akathisia (moving), tardive dyskinesia

Haloperidol (Haldol)

high potency (IV), for schizophrenia, acute psychosis, tourette’s. SE: extrapyramidal, tardive dyskinesia, prolonged QT. For harming themselves or others.

Tricyclic Antidepressants: Amitriptyline (Elavil), Imipramine (Tofranil), Nortriptyline (Pamelor)

Bethanechol

muscarinic agonist, helps urinary retention. SE: slow heartbeat, constrict airways, stimulate GI and gallbladder. Reverse w/ atropine

Tolterodine Tartrate (Detrol)

antimuscarinic, for overactive bladder to lower contraction. SE: HTN, blurred vision, urinary retention, constipation, tachycardia

Atropine

anticholinergic drug for symptomatic bradycardia. SE: HTN, tachycardia, dilated pupils, urinary retention, constipations. Not for glaucoma

Pilocarpine (Isopto Carpine)

cholinergic agonist, for dry mouth or glaucoma. SE: slow heartbeat, constrict airway, stimulate GI and gallbladder

Metoclopramide (Reglan)

block dopamine receptors, for N/V or gastroparesis. SE: drowsy, dizzy, anxiety, diarrhea, extrapyramidal symptoms, tardive dyskinesia

Benztropine (Cogentin)

anticholinergic, reduces muscle stiffness in Parkinson’s and treats extrapyramidal side effects from meds. SE: HTN, tachycardia, dilate pupils, urinary and BM retention, and hallucinations

Epinephrine

sympathomimetic, A1,2 and B1,2 agonist for cardiac arrest, bronchospasms, and anaphylaxis. SE: tachycardia, blurred vision, urinary retention, constipation, hyperglycemia, HTN. Reverse Phentolamine

Prazosin

A1 block for HTN, BPH, nightmares or PTSD. SE: orthostatic hypotension, weak, dizzy, nauseous

Atenolol

B1 antagonist for HTN, angina, most-MI. SE: bradycardia, hypotension, dizzy, reduced sex drive, HF, mask hypoglycemia