Exam 3 - Meds

Ferrous Sulfate Therapeutic Class

Drug for anemia

Ferrous Sulfate Pharm Class

Iron supplement

Ferrous Sulfate MOA

Treats iron deficiency anemia by stimulating RBC production

Ferrous Sulfate ADRs

Anaphylaxis and constipation

Ferrous Sulfate NCs

Give vitamin C to increase absorption, avoid milk or antacids, and use stool softeners PRN

Cyanocobalamin (Vitamin B12) Therapeutic Class

Agent for anemia

Cyanocobalamin Pharm Class

Vitamin Supplement

Cyanocobalamin MOA

Stimulates RBC production and reverses B12 deficiency

Folic Acid Therapeutic Class

Agent for anemia

Folic Acid MOA

Stimulates DNA synthesis to increase RBC, WBC, and platelets

Folic Acid Daily Requirements

Adults: 400 mcg/day

Pregnancy: 600 mcg/day

Lactation: 500 mcg/day

Epoetin Alfa Therapeutic Class

Hematopoietic Growth Factor

Epoetin Alfa Pharm Class

Erythropoietin

Epoetin Alfa MOA

Stimulates RBC production (needs kidney functioning)

Epoetin Alfa Indications

Anemia d/t CKD, chemo, or HIV

Hydroxyurea Therapeutic Class

Antineoplastic Agent

Hydroxyurea Pharm Class

Antimetabolite

Hydroxyurea Indications

Sickle cell anemia and certain cancers

Filgrastim Theraapeutic Class

Neutrophil Production

Filgrastim Pharm Class

Colony-Stimulating Factor (CSF)

Filgrastim MOA

Stimualtes bone marrow to increase neutrophil production

Filgrastim ADR

Stop if ANC >10,000 (1,500-8,000)

Filgrastim NCs

Assess for bone pain and treat with acetaminophen

Thrombopoietic Colony Stimulating Factor-Oprelvekin (Neumega) Therapeutic Class

Platelet enhancer

Thrombopoietic Colony Stimulating Factor-Oprelvekin (Neumega) Pharm Class

Thrombopoietic Colony-Stimulating Factor (IL-11 analog)

Thrombopoietic Colony Stimulating Factor-Oprelvekin (Neumega) MOA

Stimulate megakaryocyte production to increase platelets

Thrombopoietic Colony Stimulating Factor-Oprelvekin (Neumega) Indications

Prevent thrombocytopenia post-chemotherapy

Heparin Therapeutic Class

Anticoagulant

Heparin Pharm Class

Indirect thrombin inhibitor

Heparin Indications

Firs-line drug for acute thrombolytic disorders

Heparin MOA

Prevents clots, inactivates factor X, prevents conversion of prothrombin to thrombin

Heparin NCs

Monitor aPTT or Anti-Xa (0.3-0.7 IU.mL), check platelets for risk of HIT. Antidote is protamine sulfate

Enxoaparin Therapeutic Class

Anticoagulant

Enxoaparin Pharm Class

Low-Molecular-Weight Heparin (LMWH)

Enoxaparin Indications

DVT prevention, PE, MI, or post-op prophylaxis

Enoxparin MOA

Inhibits factor Xa to prevent clot formation

Enoxparin Black Box Warning

Epidural/spinal hematomas

Enoxaparin NCs

Give deep SC, monitor for bleeding or bruising, and monitor neuro

Warfarin Therapeutic Class

Anticoagulant

Warfarin Pharm Class

Vitamin K Anatagonist

Warfarin Indications

Prevent thrombus formation

Warfarin MOA

Block vitamin K and inhibits synthesis of new clotting factors

Warfarin Black Box Warning

Monitor INR

Warfarin NCs

Monitor INR (2-3), check baseline PT/INR, antidote is vitamin K (phytonadione)

Dabigatran Therapeutic Class

Anticoagulant

Dabigatran Pharm Class

Direct thrombin inhibitor

Dabigatran Indication

Stroke prophylaxis

Dabigatran MOA

Inhibits thrombin

Dabigatran NCs

No routine lab monitoring required

Aspirin Therapeutic Class

Salicylate, NSAID, or antiplatelet

Aspirin MOA

Irreversibly inhibits COX-1 in platelets to decrease clot formation

Aspirin Effects

Antipyretic, analgesic, inhibits platelet aggregation

Aspirin Interactions

Gingko, green tea, and ginseng increase bleeding

Clopidogrel Therapeutic Class

ADP (P2Y12) receptor blocker

Clopidogrel MOA

Inhibits platelet activation and decreases aggregation

Abciximab Therapeutic Class

GPIIb/IIIA inhibitor

Abciximab MOA

Lowers fibrinogen binding and inhibits platelet aggregation

Abciximab Indications

Refractory angina, MI, or ACS, or pre-PCI

Alteplase Therapeutic Class

Thrombolytic (fibrinolytic)

Alteplase MOA

Converts plasminogen to plasmin

Desmopressin Therapeutic Class

Synthetic ADH analog, antidiuretic and hemostatic agent

Desmopressin MOA

Stimulates endothelial release of vWF and Factor VIII to promote clotting

Desmopressin NCs

Can be given IV, SC or intranasal

Aminocaproic Acid Therapeutic Class

Hemostatic/Antifibrinolytic

Aminocaproic Acid Pharm Class

Plasminogen Inhibitor

Aminocaproic Acid MOA

Inhibits conversion of plasminogen to plasmin and decreases fibrin breakdown

Aminocaproic Acid Indications

Excessive bleeding

Aminocaproic Acid NCs

Monitor for thrombosis or bleeding control

Tranexamic Acid Therapeutic Class

Hemostatic/Antifibrinolytic

Tranexamic Acid MOAPharm Class

Lysine analog/plasmin inhibitor

Tranexamic Acid MOA

Inhibits fibrinolysis (prevents clot breakdown)

Tranexamic Acid Indications

Trauma, surgery, heavy menses, or postpartum hemorrhage

Tranexamic Acid NCs

Monitor for thromboembolic events and give slowly over IV (10 mins)

Nimodipine Therapeutic Class

Anti-hypertensive, neuroprotective agent

Nimodipine Pharm Class

Calcium Channel Blocker (Dihydropyridine)

Nimodipine Therapeutic Effect

Prevents delayed cerebral ischemia after subarachnoid hemorrhage

Nimodipine MOA

Blocks calcium influx in vascular smooth muscle, especially in cerebral arteries

Dexmedtomidine Therapeutic Class

Sedative, analgesic

Dexmedetomidine Pharm Class

Selective alpha-2 adrenergic agonist

Dexmedetomidine Therapeutic Effects

Sedation

Dexmedetomidine MOA

Activates alpha-2 receptors in the CNS to cause sedation and analgesia without respiratory depression

Propofol Therapeutic Class

General anesthetic

Propofol Pharm Class

Sedative-hypnotic

Propofol Therapeutic Effects

Induces and maintains anesthesia or sedation in ventilated patients

Propofol MOA

Potentiates GABA receptor causing CNS depression and sedation 

Propofol Contraindications

Soy-egg allergy

Propofol NCs

Ensure secure airway

Phenytoin Therapeutic Class

Anticonvulsant

Phenytoin Pharm Class

Hydantoin

Phenytoin MOA

Inhibits sodium channels in neurons to stabilize neuronal membranes

Phenytoin ADRs

Gingival hyperplasia

Phenytoin Black Box Warning

Cardiovascular risk with rapid IV infusion

Phenytoin NCs

Monitor therapeutic drug levels (10-20 mcg/mL)

Carbamazepine Therapeutic Class

Antiepileptic

Carbamazepine Indications

First-line for tonic-clonic and partial seizures

Carbamazepine MOA

Inhibits sodium channels to block neuronal firing

Carbamazepine NCs

Has many herbal interactions

Diazepam Therapeutic Class

Antiepileptic, antianxiety, muscle relaxant

Diazepam Pharm Class

Benzodiazepine

Diazepam Indications

Status epilepticus, relaxation, or muscle relaxation