Meds
Meds | Class | MOA | Uses | AE | N.C. |
Anti-Infectives | Anti-Infectives | Anti-Infectives | Anti-Infectives | Anti-Infectives | Anti-Infectives |
Antibiotics | |||||
Amoxicillin | Penicillin | Inhibits cell wall synthesis → weak cell wall → bacterial lysis (death) | Upper Respiratory Infections otitis media, UTIs | Allergic reaction (rash → anaphylaxis), diarrhea | ALWAYS check penicillin allergy; cross-sensitivity with cephalosporins; take full course |
Tetracycline | Broad-spectrum | Binds 30S ribosome → blocks protein synthesis → bacteria can’t grow | Acne, STIs, Lyme | Photosensitivity, tooth discoloration | No dairy/antacids; avoid in pregnancy & kids |
Gentamicin | Aminoglycoside | Binds 30S → misreads mRNA → defective proteins → bacterial death | Severe infections | Nephrotoxicity, ototoxicity | Monitor BUN/Cr + hearing; check drug levels |
Vancomycin | Glycopeptide | Inhibits cell wall synthesis → prevents bacterial growth → death | MRSA, C. diff | Red man syndrome, nephrotoxicity | Infuse slowly; monitor trough levels |
Metronidazole | Antiprotozoal/ antibiotic | Disrupts DNA → inhibits nucleic acid synthesis → bacterial death | C. diff, STIs | Metallic taste, disulfiram reaction (flushing) | NO alcohol |
TB Drugs | |||||
Isoniazid | Antitubercular | Inhibits mycolic acid synthesis → disrupts bacterial cell wall → death | TB | Hepatotoxicity, neuropathy | Give vitamin B6; monitor liver; avoid alcohol |
Rifampin | Antitubercular | Inhibits RNA synthesis → blocks protein production → bacterial death | TB | Hepatotoxicity, orange fluids | Warn about discoloration; ↓ birth control effectiveness |
Antifungal | |||||
Nystatin | Antifungal | Binds cell membrane → creates pores → leakage → fungal death | Thrush | Minimal | Swish & swallow; continue after symptoms improve |
Fluconazole | Antifungal | Inhibits ergosterol synthesis → weak membrane → fungal death | Candida | Hepatotoxicity | Monitor liver enzymes |
Antiviral | |||||
Acyclovir | Antiviral | Inhibits viral DNA polymerase → prevents viral replication → stops spread | Herpes, Shingles | Nephrotoxicity | Hydrate well; monitor kidneys |
Cardio/ Hematology | Cardio/ Hematology | Cardio/ Hematology | Cardio/ Hematology | Cardio/ Hematology | Cardio/ Hematology |
Anticoagulants | |||||
Heparin | Anticoagulant | Activates antithrombin III → inhibits thrombin & factor Xa → prevents clot formation | DVT, PE, acute anticoagulation | Bleeding, HIT (low platelets) | Monitor aPTT (2–2.5x normal); antidote = protamine sulfate |
Warfarin | Anticoagulant | Inhibits vitamin K → ↓ clotting factors II, VII, IX, X → prevents clot formation | Long-term anticoagulation | Bleeding, teratogenic | Monitor INR (2–3); antidote = vitamin K; consistent vitamin K diet |
Dabigatran | Direct thrombin inhibitor | Directly inhibits thrombin → prevents fibrin clot formation | Stroke prevention (A-fib), DVT/PE | Bleeding, GI upset | No routine labs; antidote = idarucizumab |
Thrombolytics | |||||
Thrombolytics | Fibrinolytics | Convert plasminogen → plasmin → break down existing clots | Stroke, MI, PE (emergencies) | SEVERE bleeding (hemorrhage) | Check for bleeding risk; avoid after surgery/trauma; monitor closely |
GI | GI | GI | GI | GI | GI |
Acid Control | |||||
Omprazole | Proton Pump Inhibitor | Inhibits H⁺/K⁺ ATPase (proton pump) → ↓ gastric acid secretion | GERD, ulcers | Long-term: ↓ Ca²⁺ → fracture risk, C. diff | Take before meals; don’t crush; monitor long-term use |
PPI | PPI (ex. Omeprazole) | Block final step of acid production → strongest acid suppression | GERD, ulcers | Infection risk, bone loss | Use shortest duration possible |
Histamine 2 Blockers | H2 blockers (ex: cimetidine) | Block H2 receptors → ↓ acid secretion | GERD, ulcers | Confusion (elderly), gynecomastia (cimetidine) | Less potent than PPIs; monitor elderly |
Antidiarrheal | |||||
Diphenoxylate x/atropine | Antidiarrheal (opioid) | Slows intestinal motility → ↑ absorption → ↓ diarrhea | Diarrhea | Constipation, drowsiness | Monitor hydration; do not use in infectious diarrhea |
Laxatives | |||||
Bisacodyl | Stimulant laxative | Stimulates bowel nerves → ↑ peristalsis → bowel movement | Constipation | Cramping, diarrhea | Short-term use only (can cause dependence) |
Psyllium | Bulk-forming laxative | Absorbs water → forms bulk stool → promotes movement | Constipation | Bloating | Take with lots of water |
Docuusate sodium | Stool softener | ↓ surface tension → allows water into stool → softens | Constipation prevention | Minimal | Good for post-op/straining pts |
Lactulose | Osmotic laxative | Pulls water into colon → ↑ stool → also ↓ ammonia | Constipation, hepatic encephalopathy | Diarrhea, electrolyte imbalance | Monitor ammonia levels |
Magnesium Hydroxide | Osmotic laxative | Draws water into intestines → rapid bowel movement | Constipation | Diarrhea, ↑ Mg²⁺ | Avoid in renal failure |
Laxatives | Class | Increase stool movement (varies by type) | Constipation | Diarrhea, imbalance | Avoid long-term use |
Other GI | |||||
Ondansetron | Antiemetic (5-HT3 antagonist) | Blocks serotonin receptors → ↓ nausea/vomiting reflex | Nausea, chemo | QT prolongation, headache | Monitor ECG in high-risk pts |
Pancreatic Enzymes | Enzyme replacement
| Replaces digestive enzymes → improves fat/protein breakdown | Pancreatic insufficiency | GI Upset | Take with meals |
Neuro/CNS | Neuro/CNS | Neuro/CNS | Neuro/CNS | Neuro/CNS | Neuro/CNS |
Seizure | |||||
Phenytoin | Anticonvulsant | Blocks sodium channels → stabilizes neurons → prevents seizure spread | Seizures | Gingival hyperplasia, rash (SJS), nystagmus | Monitor drug levels (10–20); oral care; IV give slow |
Benzos | |||||
Diazepam | Benzodiazepine | ↑ GABA → CNS depression → calming effect | Seizures, anxiety, muscle spasms | Respiratory depression, sedation | Monitor RR; fall risk |
Lorazepam | Benzodiazepine | ↑ GABA → CNS depression → stops seizure activity | Status epilepticus, anxiety | Respiratory depression, sedation | First-line for seizures; monitor airway |
Benzodiazepines | CNS depressants | Enhance GABA → slow brain activity | Anxiety, seizures | Sedation, dependence | Avoid alcohol; taper off |
Sleep | |||||
Eszopiclone | Sedative- hypnotic | Enhances GABA → promotes sleep | Insomnia | Drowsiness, dizziness | Take right before bed; ensure full night sleep |
Muscle Relaxers | |||||
Baclofen | Muscle relaxer | Acts on GABA receptors → ↓ muscle spasticity | Spasticity (MS, spinal cord injury) | Weakness, sedation | Do not stop abruptly (withdrawal) |
Cyclobenzaprine | Muscle relaxer | Acts on CNS → ↓ muscle spasms | Acute muscle spasms | Drowsiness, dry mouth | Short-term use only |
Dantrolene | Muscle relaxer | Blocks Ca²⁺ release in muscle → ↓ contraction | Malignant hyperthermia (MH), severe spasticity | Hepatotoxicity, weakness | Monitor liver; emergency drug for MH |
Local Anesthetic | |||||
Lidocaine | Local anesthetic | Blocks sodium channels → prevents nerve signal transmission → numbness | Local anesthesia, arrhythmias | CNS toxicity, cardiac effects | Monitor for toxicity (confusion, seizures) |
Psych | Psych | Psych | Psych | Psych | Psych |
Antidepressants | |||||
Fluoxetine | SSRI | Blocks serotonin reuptake → ↑ serotonin → improved mood | Depression, anxiety | Serotonin syndrome, insomnia, sexual dysfunction | Do not stop abruptly; takes weeks to work |
SNRI/SSRI | Antidepressants | SSRI: ↑ serotonin; SNRI: ↑ serotonin + norepinephrine | Depression, anxiety | Serotonin syndrome, GI upset | Avoid with MAOIs; monitor mood changes |
MAOIs | Antidepressants | Inhibits MAO enzyme → ↑ serotonin, NE, dopamine | Depression (last-line) | Hypertensive crisis, serotonin syndrome | Avoid tyramine foods; no SSRIs with this |
Antidepressants | Class | ↑ neurotransmitters (serotonin ± norepinephrine ± dopamine) → improved mood | Depression, anxiety | Serotonin syndrome, suicidal thoughts (early), sexual dysfunction | Takes 2–4 weeks; monitor for suicide risk initially |
Stimulants | |||||
Methylphenidate | CNS stimulant | ↑ dopamine & norepinephrine → ↑ focus | ADHD | ↓ appetite, insomnia, ↑ HR/BP | Give in morning; monitor weight |
Dextroamphetamine | CNS stimulant | ↑ dopamine & norepinephrine → ↑ alertness | ADHD | Dependence, insomnia, ↑ BP | High abuse risk; monitor vitals |
Endo/Misc | Endo/Misc | Endo/Misc | Endo/Misc | Endo/Misc | Endo/Misc |
Corticosteroids | |||||
Cordicosteroids | Anti-inflammatory / immunosuppressant | Mimics cortisol → ↓ inflammatory response → suppresses immune system | Asthma, autoimmune diseases, inflammation | Hyperglycemia, infection risk, weight gain, osteoporosis | Do NOT stop abruptly (taper); monitor blood sugar; watch for infection; monitor bones |
Rerspiratory/ Allergy | Rerspiratory/ Allergy | Rerspiratory/ Allergy | Rerspiratory/ Allergy | Rerspiratory/ Allergy | Rerspiratory/ Allergy |
Antihistamines | |||||
Diphenhydramine | Antihistamine (1st gen) | Blocks H1 receptors → ↓ histamine effects (swelling, itching) | Allergies, sleep aid | Sedation, dry mouth, urinary retention | Causes drowsiness; avoid driving; caution in elderly |
Antihistamines | H1 blockers | Block histamine → ↓ allergic response | Allergies | Sedation (1st gen), dry mouth | Avoid alcohol; can increase fall risk |
Emergency | |||||
Epinephrine | Adrenergic agonist | Stimulates α & β receptors → bronchodilation + vasoconstriction → opens airway | Anaphylaxis (FIRST LINE) | ↑ HR, ↑ BP, anxiety | Give IM immediately; monitor airway, HR, BP |
Renal/Diuretics | Renal/Diuretics | Renal/Diuretics | Renal/Diuretics | Renal/Diuretics | Renal/Diuretics |
Furosemide | Loop diuretic | Blocks Na⁺/K⁺/Cl⁻ reabsorption in loop of Henle → ↑ water + electrolyte excretion → ↓ fluid volume | Edema, heart failure, HTN | Hypokalemia, dehydration, hypotension, ototoxicity | Monitor K⁺, BP, I&O; give in morning; watch for dizziness |
Spironolactone | Potassium-sparing diuretic | Aldosterone antagonist → ↓ Na⁺ reabsorption, ↓ K⁺ excretion → retains potassium | Heart failure, HTN | Hyperkalemia, gynecomastia | Monitor K⁺; avoid potassium supplements |
Other Important | Other Important | Other Important | Other Important | Other Important | Other Important |
Atropine | Anticholinergic | Blocks acetylcholine → ↑ heart rate + ↓ secretions | Bradycardia, pre-op | Tachycardia, dry mouth, urinary retention | Monitor HR; watch for anticholinergic effects |
Donepezil (alzheimers) | Cholinesterase inhibitor | Inhibits acetylcholinesterase → ↑ acetylcholine in brain → improves cognition | Alzheimer’s disease | Bradycardia, GI upset | Monitor HR; give at bedtime |
Filgrastim | Colony-stimulating factor | Stimulates bone marrow → ↑ neutrophil (WBC) production | Neutropenia (chemo pts) | Bone pain, leukocytosis | Monitor WBC count |
Antineoplastics | Chemotherapy agents | Inhibit cell division → target rapidly dividing cancer cells | Cancer | Bone marrow suppression, hair loss, N/V | Monitor WBC, platelets; infection risk |
Calcium + Vitamin D | Supplement | ↑ calcium absorption in gut → strengthens bone | Osteoporosis, deficiency | Hypercalcemia, constipation | Take with food; monitor calcium levels |