DRUGS UNIT 2

raloxifene (Evista) - class

class - selective estrogen reuptake modulators (SERMs)

raloxifene (Evista) - IND

IND - postmenopausal osteperosis

raloxifene (Evista) - MOA

MOA - stimulates estrogen receptors in bone, dec. RANKL effect and inc. bone density

raloxifene (Evista) - AE

Hot flashes, DVT, PE, leukopenia, peripheral edema, infxn, cramping, arthralgia, muscle spasms, flu like symptoms

raloxifene (Evista) - NC

monitor for sigsn of venous thromboembolism, encourage mobility

raloxifene (Evista) - BBW

BBW - inc. risk of venous thromboembolism, and inc. risk of stroke in postmenopausal women w/ cardiovasccular dz

raloxifene (Evista)

Class - selective estrogen reuptake modualtor (SERM)

IND - postmenopausal oseteoperosis

MOA - stimulates estrogen receptors on bone, dec. RANKL effect, inc. boine density

AE - hot flashes, DVT, PE, leukopenia, peripheral edema, infxn, arthralgia, muscle spasms, cramping, flu like symtpoms,

NC - encourage mobility, monitor for venous thromboembolism

BBW - can worsen risk of VTE, inc. risk of stroke in postmenopausal women w/ cardiac dz

alendronate (Fosamax) - class

class - biphosphonate

alendronate (Fosamax) - IND

IND - osteoperosis

alendronate (Fosamax) - MOA

MOA - inhibits osteoclastic bone resporption

alendronate (Fosamax) - AE

AE - hyopcalcemia, hypophosphatemia, osteonecrosis of the jaw, esophageal erosion, atypical fermur fractures, bone pain

alendronate (Fosamax) - NC

NC - must sit up for 30 mins after takine, must take w/ full glass of water, good oral hygene, >10yr HL

alendronate (Fosamax)

Class - biphosphate

IND - osteoperosis

MOA - inhibits osteoclastic bone resporption

AE - hypocalcemia, hypophosphatemia, osteonecrosis of the jaw, esophageal erosion, atypical femur fractures, bone pain

NC - must sit up for 30 min after takin, must take w/ full glass of water, good oral hygiene

entanercept (Enbrel) - Class

Class - disease modifying antirheumatic arthritis drugs

entanercept (Enebrel) - IND

IND - rheumatoid arthritis, psoriatic arthritis, ankylosing spondylitis

entanercept (Enebrel) - MOA

MOA - biological TNF blocker, binds to TNF to inhibit movement of macrophages and neutrophils into joint, knocking them out of the immune sys.

entanercept (Enebrel) - AE

AE - rash, diarrhea, infxn

entanercept (Enebrel) - NC

NC - weekly SC injection that can take weeks to work, often taken w/ NSAIDs or corticosteroids, monitor fro infxn symptoms

entanercept (Enebrel) - BBW

BBW - inc. infxns, very small risk of cancer

entanercept (Enebrel) -

Class - disease modifying antirheumatic arthritis drugs

IND - rehumatoid arthritis, psoriatic arthritis, ankylosing spondylitis

MOA - biological TNF blocker, binds to TNF preventing movement of macrophages/neutrophils into the joints

AE - infxn, rash, diarrhea

NC - weekly SQ injections that take few weeks to work, usually taken w/ cotricosteroids or NSAIDs, monitor for infxn signs

BBW - serious infxns and small risk of cancer

allopurinol (Zyloprim) - IND

IND - gout nephrolithiasis

allopurinol (Zyloprim) - MOA

MOA -inhibits xanthine oxidase, prevent uric acid formation

allopurinol (Zyloprim) - AE

AE - leukopenia, agranulocytosis, aplastic anemia, potentially fatal skin injury

allopurinol (Zyloprim) - NC

NC - monitor for rash, fever, blistering on skin or mucosal involvement, stop immediately if feel allergic rxn

allopurinol (Zyloprim) - BBW

BBW - can cause steven johnson syndrome

allopurinol (Zyloprim)

IND - gout, nephrolithiasis

MOA - inhibits xanthine oxidase, preventing uric acid formation

AE - leukopenia, agranuocytosis, aplastic anemia, potenitally fatal skin rxn

NC - monitor for rash, fever, blistering, or moucosal movement, monitor for sx of hypersensitivty

BBW - can cause steven johnson syndrome

ketorolac (Toradal) - ind

IND - MSK moderate to severe pain, used to treat some types of arthritis and severe pain

allopurinol (Zyloprim) - MOA -

MOA - inhibits enxyme cyclooxygenase, reducing pstroglandynin synthesis

allopurinol (Zyloprim) - AE

AE - abd pain, dyspepsia, nausea, headaches and GI bleed,

allopurinol (Zyloprim) - NC

NC - use small doses, avoid using fro more than 5 days

allopurinol (Zyloprim) - BBW

BBW - GI bleeding, ulceration

allopurinol (Zyloprim)

IND - MSK moderate to severe pain,treats some arthritis

MOA -inhibts enyme cyclooxygenase reducing prostoglandanin synthesis

AE - abd pain, dyspepsia, nausea, headacehs, GI bleed

NC - use lowest possible does, avoid use for longer than 5days, take w/ food

BBW - ulceration gastric bleeding

celecoxib celebrex - IND

IND - acute and long term management of RA, OA, acute pain

celecoxib celebrex - MOA

MOA - inhibit cox 2 to dec. inflammation

celecoxib celebrex - AE

AE - CNS: headache, dizzy, somnolence, insomnia,inc. risk of MI and CVA,

derm: rash pururitis, stomatitis

celecoxib celebrex - NC

NC - watch for anticoag, aspirin, use 1-2 hrs before antacid, assess fro GI issues

celecoxib celebrex - BBW

BBW - cariac and vascular risk