ALL EXEMPLARS FOR FINAL (Exams 1,2 and 3)

mechanisms of action for ibuprofen

inhibits COX1 and COX2 enzymes

ibuprofen is also known as

Advil

adverse reactions of ibuprofen

peptic ulcer, GI bleeding, tinnitus, dizziness, etc.

interactions of ibuprofen

Do not take with aspirin, warfarin, lithium

adverse reactions of aspirin

Gi bleeding, ulcer, tinnitus, and Reyes syndrome in kids

interactions of aspirin

alcohol, NSAIDS, food that have salicylates, blood thinners

nursing implications of aspirin

dont give to asthmatics, dont give to kids, dont give if ulcer or bleeding gums

celecoxib is a

selective COX2 inhibitor, inhibits cox2 but not cox1

indications for celecoxib

arthritis, anti-inflammatory

adverse effects of celecoxib

headache, sinusitis, flatulence, fluid retention

interactions of celecoxib

dont take with lithium or aspirin

prednisone is a

Corticosteroid

mechanism of action for prednisone

suppresses the inflammatory process and inhibits/ decreases WBC

indications of prednisone

allergic reasons, inflammation arthritis, anti-inflammatory

interactions of prednisone

warfarin and other NSAIDS

morphine is an

Opioid

mechanism of action for morphine

CNS depressant that inhibits pain pathways

indications for morphine

acute pain, moderate-severe

adverse effects of morphine

decrease RR (respiratory distress), sedation, decrease BP

interactions of morphine

alcohol and other CNS depressants

what is the antagonist for morphine

Naloxone

acetaminophen is also known as

Tylenol

mechanism of action for acetaminophen

Inhibits prostaglandin synthesis and heat centers in CNS

indications of acetaminophen

reduce pain and fever, for mild to moderator pain

adverse effects of acetaminophen

rash, low GI distress, toxicity

what is the max dose of acetaminophen

4g/day

mechanisms of action for ketorolac

inhibits COX1 and COX2 enzymes, better than opioids

indications of ketorolac

pain, often given after open heart surgery or post op pain

side effects of ketorolac

renal impairment and bleeding

interactions of ketorolac

anticoagulants

gemfibrozil is a

fibrate

niacin is a

niacin

atorvastatin is a

statin

ezetimibe is a

cholesterol absorption inhibitor

cholestyramine is a

bile acid sequestrant

drug action of gemfibrozil

reduce VLDL, LDL, and triglycerides

drug action of niacin

reduce VLDL and LDL

due to the large dose amount and large side effects of niacin

only 20% of patients can tolerate it

drug action of atorvastatin

inhibits HMG-CoA reductase, reduces all lipids expect HDL (slightly increased)

drug action of ezetimibe

inhibits cholesterol absorption in small intestine and reduces serum levels of chol, LDL, triglyc, and apoB levels

drug action of cholestyramine

1st antihyperlipidemic that reduces LDL level

side effects of gemfibrozil

gi upset, dyspepsia, dizziness, blurred vision, and cholelithiasis

side effects of niacin

gi upset, flushing of skin, hypotension, abnormal LFTS

side effects of atorvastatin

gi upset, dizziness, increase LFTs, and rhabdomyolysis

side effects of ezetimibe

diarrhea, infections, cholelithiasis, abdominal and back pain, and arthralgia/myalgia

side effects of cholestyramine

gi upset, constipation, peptic ulcer, GI bleeding

gemfibrozil should not be taken with

anticoagulants

niacin can also cause

hyperglycemia and hyperuricemia

statin overall is well tolerates but you should avoid

grapefruit juice and get annual eye exams

ezetimibe should be given with a

statin

cholestyramine should be given with a

stain

nitroglycerin is a

Nitrate

atenolol is a

beta blocker

diltiazem hyrochloride is a

calcium channel blocker

action of nitroglycerin

vasodilator, decreases preload and afterload

action of atenolol

blocks beta 1 and 2 receptors, blocks actions of catecholamines, and decrease heart workload and oxygen demands

action of diltiazem hyrochloride

relax coronary artery spasm and peripheral arterioles, decrease contractility, afterload, workload, O2 demands, and resistance of heart

side effects of nitroglycerin

headache, hypotension, flushing, weakness, syncope, dizziness

side effects of atenolol

bradycardia, hypotension, erectile dysfunction, peripheral edema, bronchospasms, dizziness, depression, fatigue

side effects of diltiazem hyrochloride

dizziness, flushing, headache, reflex tachycardia, edema, fatigue, hypotension

Routes of Administration for nitroglycerin

Sublingual, translingual, topical, aerosol spray

caution of atenolol

Do not abruptly discontinue... taper dose

Cautions for nitrates

Avoid heat or sunlight, if one dose isn't effective call 911

Gemfibrozil (fibrates) is given

PO, BID, AC (before meals)

Niacin is given

PO, QD PC (after meals)

Atorvastatin (statin) is given

PO, QD

Ezetimibe (cholesterol absorption inhibitor) is given

PO, QD

Cholestyramine (bile acid sequestrant) is given

PO, QD/BID AC (before meals)

the exemplar hydrochlorothiazide is a

thiazide diuretic

the exemplar furosemide is a

loop diuretic

the exemplar mannitol is a

osmotic diuretic

the exemplar acetazolamide is a

carbonic anhydrase diuretic

the exemplar spironolactone is a

potassium sparing diuretic

action of hydrochlorothiazide (thiazide)

acts on the DCT and promotes sodium, chloride and water excretion

use of hydrochlorothiazide (thiazide)

hypertension and peripheral edema

side effects of hydrochlorothiazide (thiazide)

electrolyte imbalances, hyperglycemia and hyperuricemia

contraindications of hydrochlorothiazide (thiazide)

renal failure

drug interactions of hydrochlorothiazide (thiazide)

digoxin and lithium

electrolyte abnormalities with hydrochlorothiazide (thiazide)

HYPO: kalemia and magnesemia

HYPER: calcemia, glycemia, lipidemia, uricemia

action of furosemide (loop diuretic)

inhibits chloride transport of sodium into the circulation, inhibit reabsorption of sodium

side effects of furosemide (loop diuretic)

fluid and electrolyte imbalances, orthostatic hypotension, ototoxicity

electrolyte abnormalities with furosemide (loop diuretics)

HYPO: kalemia, natremia, calcemia, magnesemia

HYPER: glycemia, uricemia

drug interactions of furosemide (loop diuretic)

digoxin and warfarin

action of mannitol (osmotic diuretic)

increase osmolarity and sodium reabsorption in the PCT and loop of Henle

use of mannitol (osmotic diuretic)

potent osmotic K+ wasting diuretic used in emergencies... decrease ICP and IOP

side effects of mannitol (osmotic diuretic)

fluid and electrolyte imbalance, N/V, pulmonary edema, tachycardia

contraindications of mannitol (osmotic diuretic)

heart disease and heart failure

action of acetazolamide (carbonic anhydrase inhibitor)

blocks the action of the enzyme carbonic anhydrase

use of acetazolamide (carbonic anhydrase inhibitor)

decrease IOP in patients with chronic glaucoma

side effects of acetazolamide (carbonic anhydrase inhibitor)

fluid and electrolyte imbalance, N/V, anorexia, confusion, orthostatic hypotension

contraindications of acetazolamide (carbonic anhydrase inhibitor)

contraindicated 1st trimester of pregnancy

action of spironolactone (potassium sparing diuretic)

blocks the aldosterone (Na-K pump, NA retention, K ecretion)

side effects of of spironolactone (potassium sparing diuretic)

hyperkalemia (N/D, cramps, numbness, tachycardia to bradycardia)

drug interactions of spironolactone (potassium sparing diuretic)

life threatening hyperkalemia when given with ACE inhibitors and ARBS

the exemplar metoprolol is a

beta blocker

the exemplar lisinopril is a

ace inhibitor

the exemplar hydralazine is a

direct acting arteriolar vasodilator

the exemplar losartan is a

ARB, angiotensin II receptor blocker

the exemplar diltiazem is a

calcium channel blocker

action of metoprolol (beta blocker)

inhibit beta 1 (heart) and beta 2 (bronchial) receptors.. this drug is selective for beta 1