Medications for Final Exam: Patho/Pharm II

Vocabulary practice cards covering various medications including Antineoplastics, Antiretrovirals, Perfusion, Oxygenation, and Intracranial Regulation agents.

Bone marrow suppression labs

Complete blood cell count (CBC) is used to monitor for leukopenia, anemia, neutropenia, and thrombocytopenia.

Hepatotoxicity lab parameters

Liver function tests including total bilirubin ($0.3-1.0\,mg/dl$), ALP ($30-120\,mg/dl$), AST ($5-40\,IU/L$), and ALT ($5\times 35\,IU/L$).

Chlorambucil

An alkylating agent (non cell cycle specific) that interferes with DNA replication; adverse effects include tremors, muscle twitching, confusion, and sterility.

Methotrexate

An S phase specific antimetabolite that inhibits DNA production; adverse effects include ulcerative stomatitis, interstitial pneumonitis, and alopecia.

Leucovorin rescue

The administration of Leucovorin within $24\,hrs$ of Methotrexate infusion to lower drug levels and reduce hematologic effects.

Doxorubicin

A non cell cycle specific antineoplastic antibiotic that interferes with DNA synthesis; can cause cardiac toxicity and cause urine to turn red.

Vincristine

A mitotic inhibitor (M phase specific) that arrests cell division at metaphase; can cause ataxia, neuritic pain, and tissue damage via extravasation.

Tamoxifen

A hormone modulator that competes with estrogen; adverse effects include hypercalcemia, pulmonary emboli, and menopause-associated symptoms like hot flashes.

Nevirapine

A nonnucleoside reverse transcriptase inhibitor that blocks HIV-1 replication; patients should contact the HCP for fever over $101.5^{\circ}F$ or yellowing of the skin.

Zidovudine

A nucleoside reverse transcriptase inhibitor (NRTI) used for HIV-1; unique for being the only NRTI that may be used in pregnancy/lactation, though it causes bone marrow suppression.

Fosamprenavir

A protease inhibitor that produces noninfectious viral particles; can cause redistribution of body fat (buffalo hump) and Stevens-Johnson syndrome.

Enfuvirtide

A fusion inhibitor that prevents HIV entry into cells; administered SQ; nursing considerations include assessing respiratory status for pneumonia.

Maraviroc

A CCR5 co-receptor antagonist that prevents HIV entry; side effects include hepatotoxicity and musculoskeletal symptoms.

Nitroglycerin

A nitrate that relaxes vascular smooth muscle; administered SL every $5\,minutes$ for a maximum of $3\,doses$ for chest pain.

Metoprolol

A Beta Blocker that decreases cardiac output and workload; nursing considerations include holding the dose if the HR is $<60\,bpm$.

Diltiazem

A calcium channel blocker used for Prinzmetal angina and hypertension; hold if HR is $<60\,bpm$ or SBP is $<100\,mmHg$.

Digoxin

A cardiac glycoside that increases intracellular calcium; toxicity is indicated by yellow halos around objects and is more likely with hypokalemia.

Digoxin immune fab

The official antidote used for Digoxin toxicity.

Milrinone

A phosphodiesterase inhibitor for short-term HF treatment; monitor for arrhythmias, thrombocytopenia, and burning at the IV injection site.

Isoniazid

An antimycobacterial for TB; side effects include peripheral neuropathies, hepatitis, gynecomastia, and lupus syndrome.

Albuterol

A Beta2 selective adrenergic agonist used for acute bronchodilation; can cause tachycardia, palpitations, and paradoxical bronchospasm.

Budesonide

An inhaled steroid used for asthma prevention; requires mouth rinsing after use to prevent laryngeal or tracheal fungal infections.

Beractant

A lung surfactant for infants with RDS; administered intratracheal and the infant should not be suctioned immediately following administration.

Ferrous Sulfate

An iron preparation used for iron deficiency anemia; should be taken on an empty stomach with a full glass of water.

Mannitol

An osmotic diuretic used to treat cerebral edema and increased ICP by pulling water into the renal tubule.

Donepezil

An indirect-acting cholinergic agonist for Alzheimer's; inhibits cholinesterase to increase acetylcholine; take in the morning to decrease insomnia.

Phenytoin

A hydantoin anticonvulsant targeting sodium channels; can cause gingival hyperplasia and nystagmus at higher doses.

Ethosuximide

A suximide drug that suppresses abnormal wave and spike activity associated with absence seizures.

Diazepam

A benzodiazepine used for status epilepticus; potentiates the effects of GABA but carries the risk of respiratory depression and drug dependence.

Valproic Acid

A GABA modulator used for seizures; requires monitoring of LFTs, amylase, lipase, and ammonia levels for hepatotoxicity and pancreatitis.

Levodopa

An antiparkinsonian dopamine precursor; adverse effects include adventitious movements, ataxia, and psychosis/hallucinations.

Benztropine

An anticholinergic agent that normalizes the acetylcholine-dopamine imbalance to reduce tremors, rigidity, and drooling.

Pyridostigmine

An indirect acting cholinergic agonist used for MG; inhibits break down of Ach; administered $30\,min$ before meals if dysphagia is present.

Cholinergic crisis

A condition caused by overdose of cholinergic meds featuring abdominal cramps, excessive salivation, and muscular paralysis; treated with Atropine.

Levothyroxine

A thyroid preparation for hypothyroid states; increases metabolic rate; should be administered before breakfast.

Methimazole

An antithyroid agent that inhibits thyroid hormone synthesis; must be taken at $8\,hour$ intervals to maintain therapeutic levels.

Lactulose

An osmotic laxative that reduces serum ammonia levels by converting ammonia into ammonium ions excreted via stool.

Adefovir

An antiviral for chronic Hepatitis B; nursing considerations include monitoring for lactic acidosis (weakness, dyspnea) and nephrotoxicity.

Glecaprevir/Pibrentasvir

A combination protease/NS5A inhibitor for Hepatitis C; carries a risk of HBV reactivation (monitor for jaundice and dark urine).

Fentanyl

An opioid agonist; monitor for respiratory depression and biliary spasm; toxicity is treated with naloxone.

Epoetin Alpha

A glycoprotein that stimulates RBC production in the bone marrow; contraindicated in patients with uncontrolled hypertension.

Hydrochlorothiazide

A thiazide diuretic that blocks sodium and chloride transport; may cause hypokalemia and orthostatic hypotension.

Furosemide

A loop diuretic that blocks the chloride pump in the loop of Henle; can cause ototoxicity, hyperuricemia, and hyperglycemia.