PHARM Final Exam (untested content)

histamine-2 receptor antagonists

cimetidine (Tagamet), famotidine (Pepcid)

cimetidine (Tagamet)

med that decreases amount, acidity, and pepsin content of gastric juices by blocking histamine 2 receptors; increases pH of stomach acid 

• treats PUD, GERD, GI bleeding, Zollinger-Ellison Syndrome 

GI irritation

avoid NSAIDs, aspirin, and alcohol with cimetidine because of possible _______________.

antacids

avoid _______ within 1hr of administration of cimetidine.

proton pump inhibitors (PPIs)

omeprazole (Prilosec), pantoprazole (Protonix)

omeprazole (Prilosec)

med that inhibits hydrogen potassium ATPase in the stomach thereby inhibiting gastric acid production

• treats PUD, GERD w/ esophageal erosion, Zollinger-Ellison Syndrome; GERD prophylaxis in hospital setting secondary to intubation or decreased mobility 

bone density loss

long-term use of PPIs increases risk for ____________.

8

PPIs should only be taken for ____ weeks at a time.

sucralfate (Carafate)

mucosal protectant

sucralfate (Carafate)

med that causes chemical reaction in the stomach thereby creating a gel that coats ulcers and creates barrier between stomach and gastric secretions 

• treats peptic ulcers (4-8 week treatment), may bind to ulcer and form a protective barrier from gastric acid

4;1; bedtime

sucralfate is taken PO on an empty stomach, ____ times a day, ___ hr before meals and at ___________.

30

do not give sucralfate ____ mins before/after antacids

antacids

aluminum hydroxide (Amphojel), magnesium hydroxide (MIlk of Magnesia), calcium-carbonate (Tums)

antacids

class of meds that are alkaline compounds that neutralize gastric acid

• treats PUD & GERD

4; full glass of water

antacids can be taken up to ___ times a day w/ a _________.

constipation

ADR of calcium based antacids is _______.

diarrhea

ADR of magnesium based antacids is _________.

hypophosphatremia

ADR of aluminum-based antacids is __________.

misoprostol

postaglandin E analog

misoprostol

med that decreases gastric acid secretion; increases bicarbonate & protective mucus 

• prevents gastric ulcers resulting from long-term use of NSAIDs

pregnancy; spontaneous abortion

misoprostol is contraindicated in _________ because it can cause _________________.

ondansetron (Zofran)

5-hydroxytryptamine/serotonin receptor antagonists

ondansetron (Zofran)

med that blocks 5-HT3 serotonin receptors in chemoreceptor trigger zone (CTZ) of brain; minimizes N/V 

• N/V secondary to chemo-radiation therapy and in post-op recovery

antihistamine/anticholinergic

dimenhydrinate, diphenhydramine (Benadryl)

dimenhydrinate

med that prevents vertigo, N/V by blocking release of histamines (H1) receptors in inner ear and those connected to CTZ 

• treats N/V secondary to chemo/radiation therapy and in post-op recovery

metoclopramide (Reglan)

dopamine antagonist/prokinetic

metoclopramide (Reglan)

med that is a dopamine receptor blocker; increases threshold of CTZ in brain 

• treats N/V secondary to chemo/radiation therapy and in post-op recovery

polyethylene glycol (MiraLAX)

osmotic laxatives

polyethylene glycol (MiraLAX)

med that draws H2O into intestines resulting in enlargement/softening of fecal mass --> increased peristalsis

• treats constipation —> BM within 2-12hrs

stool softeners

docusate sodium (Colace)

docusate sodium (Colace)

med that changes surface tension of stool; increased water absorption into stool 

• treats constipation

cathartics

bisacodyl (Dulcolax)

bisacodyl (Dulcolax)

med that treats constipation, neurogenic bowel or for bowel prep

• BM in 6-12hrs (PO)

• BM in 15mins-1hr (rectal)

beta-lactams

penicillins, caphalosporins, monobactams

superinfection

development of a “new” infection while being treated for original infection  

• Ex. Yeast infections, clostridium difficile, VRE, MRSA 

• Common w/ treatment of broad antibiotics 

  • Suppression of normal flora 

  • Opportunistic bacteria/fungi grow rapidly 

  • Very common in hospitals (nosocomial) 

penicillins

amoxicillin (Amoxil), penicillin G, piperacillin

penicillins

class of meds that weakens & destroys bacterial cell wall --> interruption in normal cell wall synthesis --> bacteria death

• G+ broad spectrum (ENT) and narrow spectrum (UTIs); several treat G-; respiratory & skin infections also

penicillins; cephalosporins

_________ and __________ are generally safe antibiotics in pregnancy/lactation.

cephalosporins

cefazolin (Ancef) and cephalexin (Keflex), cefoxitin (2^nd), ceftazidime (3^rd), ceftriaxone (3^rd), cefepime (4^th) 

cephalosporins

class of meds that inhibits enzyme necessary for cell-wall formation --> destroys bacteria & weakens cell wall; bactericidal against G+ & G- (later gens) 

• surgical prophylaxis; skin, soft tissue, respiratory, bones/joints, GU, brain, blood

monobactams

aztreonam (Azactam)

aztreonam (Azactam)

med that inhibits bacterial wall synthesis

• urinary & lower respiratory tract infections; some abdominal & gynecologic infections; G- ONLY

monobactams

safety of _________ in pregnancy/lactation is not established.

tetracyclines

tetracycline, doxycycline

tetracycline

med that inhibits protein synthesis in G- and G+ only when resistance does not develop (common)

• chlamydia, chronic bronchitis, gonorrhea, syphilis (w/ PCN allergy), helicobacter pylori, small animal bites, Lyme disease, acne bulgaris, malaria prophylaxis 

1hr; 2hrs

tetracycline must be taken ____ before meals or _____ after meals because it is best absorbed on an empty stomach.

pregnancy; kids <8

avoid tetracycline during __________ and for ___________.

2hrs

avoid dairy products with tetraccyline within ______.

macrolides

erythromycin, azithromycin (Zithromax) Z-pack

erthromycin

med that inhibits microbial protein synthesis --> cell death

• PCN substitute; Legionnaires disease, upper respiratory infections, 2/2 group B strep, dental procedures (those w/ mechanical heart valves & allergy to PCN); G+ or G-

aminoglycosides

gentamicin

gentamicin

med that disrupts protein synthesis, thereby altering function/replication 

• narrow spectrum antibiotic; treats G- infections (E. Coli, K. pneumoniae, P. aeruginosa); can treat G+ in combo therapy

teratogenic

gentamicin is __________ because it may cause congenital deafness.

fluoroquinolones

ciprofloxacin (Cipro), levofloxacin

med that inhibits DNA synthesis, cell growth, replication

• treats wide range of infections (G- & G+); respiratory, GU/GI tracts, bone/joints, skin, soft tissue; treats anthrax exposure

sulfonamides

trimethoprim-sulfamethoxazole (TMP-SMZ) (Bactrim)

trimethoprim-sulfamethoxazole (TMP-SMZ)

med that halts multiplication of new bacteria/inhibits folic acid

• UTIs, 2/2 Enterobacteriaceae, pneumocystis, ulcerative colitis, burns/wounds (topical)

teratogenic

TMP-SMZ is __________.

TMP-SMZ

avoid concurrent use of NSAIDs/salicylates with ___________.

vancomycin

med that treats pseudomembranous colitis caused by cdiff as well as other infections

first gen NSAIDs (COX-1 & COX-2 inhibitors)

aspirin (ASA) & ibuprofen (Advil, Motrin), naproxen (Aleve), ketorolac (Toradol)

aspirin (ASA)

med that inhibits actions of COX-1 & COX-2; has analgesic, antipyretic, and antiplatelet actions

• relieves mild-moderate pain/fever/inflammation/dysmenorrhea; reduces risk of TIAs/CVAs/MIs

81

low dose of aspirin = ___mg

325

high dose of aspirin = _____ mg

aspirin (ASA)

BW of ______ is Reye’s Syndrome if used in anyone 18 years old or less.

teratogenic

aspirin is ___________.

1 week

aspirin should be stopped approximately _________ before or after major surgeries and dental procedures.

ibuprofen (Advil or Motrin)

med that inhibits actions of COX-1 & COX-2, but slightly more selective with COX-2 

• relieves mild-moderate fever, inflammation, dysmenorrhea

teratogenic

ibuprofen is __________.

ibuprofen (Motrin or Advil)

BW for ________ is: should not be given to pts after coronary artery bypass surgery to treat pain 

alcohol

avoid ________ with ibuprofen.

celecoxib (Celebrex)

second gen NSAIDs (COX-2 inhibitors)

celecoxib (Celebrex)

med that inhibits COX-2 enzyme to decrease inflammation; does not affect COX-1 enzyme --> protecting the lining of GI tract & not inhibiting clotting factors

• given to treat swelling in joints caused by (RA and OA) by suppressing inflammation

MI; CVA

BW for celecoxib (Celebrex) is increased risk for _______ or _______.

sulfa/sulfonamides

celecoxib (Celebrex) is contraindicated in pts with an allergy to ______________.

2hrs

give celecoxib (Celebrex) ______ before or after magnesium or aluminum-based antacids.

acetaminophen (Tylenol)

nonopioid analgesic

acetaminophen (Tylenol)

med that acts directly on hypothalamus to increase vasodilation & sweating to reduce fever; inhibits COX to decrease pain but has no anti-inflammatory or anticoagulant effects 

• reduces fever & decrease minor pain

4000mg; 24hrs

do not exceed more than ________ of acetaminophen (Tyelonol) in ______.

325-650mg

adult dose of acetaminophen (Tylenol) is _____________.

tramadol (Ultram)

centrally acting nonopioid

tramadol (Ultram)

med that binds to select opioid receptors and blocks reuptake of norepinephrine & serotonin in the CNS

• treats moderate to moderately severe pain

Mu (receptor)

opioid receptor in the body responsible for feelings of euphoria, respiratory depression, dependence, sedation 

Kappa (receptor)

opioid receptor in the body responsible for pupil constriction, total sedation, dysphoria 

Delta (receptor)

opioid receptor in the body responsible for enabling body to feel pain relief

opioid agonists

morphine, fentanyl, codeine, oxycodone, methadone

methadone

opioid agonist that is chemically like morphine but blocks the euphoric effects of opioids and educes cravings; used to treat opioid use disorder (OUD)

morphine

med that mimics actions of naturally occurring opioids, endorphins, and enkephalins; binds with Mu receptors at opioid receptor sites; causes analgesia, sedation, euphoria, respiratory depression

• treats moderate to severe pain

teratogenic

morphine is ___________.

II

morphine is a schedule _____ controlled substance.

naloxone (Narcan)

the antidote for morphine is ____________.

buprenorphine (Buprenex)

opioid agonist-antagonist

buprenorphine (Buprenex)

med that is a Mu receptor antagonist and Kappa receptor agonist; fewer Mu-related ADRs (ex. Resp. Depression, euphoria, dependence); produces milder analgesic effects 

• analgesia for moderate to severe pain; anesthesia adjunct; treat opioid use disorder (OUD)

naloxone (Narcan)

the antidote for buprenorphine (Buprenex) is ______________.

IV

buprenorphine is a schedule ____ controlled substance.

naloxone (Narcan)

opioid antagonist

naloxone (Narcan)

med that blocks opioid receptors, effectively reversing/antagonizing effects of opioids 

• reversal of opioid effects; overdose

gout

Overproduction of uric acid or an ability to excrete uric acid results in uric acid crystals to deposit in the synovial joint lining 

• Results in pain and inflammation of the joints 

• Most common joint --> great toe 

• Treatment --> antigout/antihyperuricemic agents, NSAIDs, corticosteroids 

allopurinol (Zyloprim)

antigout/antihyperuricemic agents

allopurinol (Zyloprim)

med that nhibits the enzyme that is responsible for the conversion of purines to uric acid, therefore reducing uric acid production

• management of signs/symptoms of gout to reduce uric acid concentration