Untitled Flashcard Set

Aspirin Pharmacology Mastery Chart

Category	Fillable Section
Therapeutic Classification	Non-narcotic analgesic, Antipyretic, Antiplatelet
Pharmacologic Classification	NSAID
Therapeutic Effects and Uses	Mild to moderate intensity pain, inflammation, and fever
Mechanism of Action	Reduces prostaglandin synthesis
Route of Administration	oral, rectal
Absorption	80 - 100% absorbed (Not susceptible to first pass metabolism)
Distribution	crosses the placenta; 80-90% bound to plasma protein
Primary Metabolism	hepatic
Primary Excretion	renal
Onset of Action	within the hour; 5-30 minutes PO; 1-2 hours rectal
Duration of Action	PO = 1-4 hours; rectal 7 hours
Common Adverse Effects	Stomach irritation, , heartburn, n/v/d, and stomach pain
Serious Adverse Effects	Bronchospasm, laryngeal edema, and anaphylaxis hypersensitivity reaction
Hematologic Effects	thrombocytopenia, hemolytic anemia, occult bleeding
Rare Toxicities	Nephrotoxic effects and hepatotoxicity
Unique Effects	Tinnitus and hearing loss with/ high doses
Contraindications	Aspirin triad Chronic rhinitis, acute bronchospasm History of GI bleeding
Pregnancy Category	Pregnancy categories C - first and 2nd trimester; D 3rd trimester
Pediatric Risk	Children and teens with fever or flu-like illnesses Reyes syndrome
Age Consideration	Patients over 60 do not give
Drug Interactions	Other salicylates increase toxicity Acetaminophen causes kidney toxicity Three or more alcoholic beverages a day causes GI Ulcers Corticosteroids cause gastric irritation, GI ulcers
Herbal Interactions	Caffeine increases absorption St. John's Wort increases sedation
Overdose Management	emesis, gastric lavage, hemodialysis

Ibuprofen Pharmacology Mastery Chart

Category	Fillable Section
Therapeutic Classification	Analgesic, Anti-inflammatory Drug, Antipyretic
Pharmacologic Classification	NSAID
Therapeutic Effects and Uses	Relief of fever and mild to moderate pain a/w RA and OA Myalgia, headache, dental pain, and dysmenorrhea
Mechanism of Action	Reduces prostaglandin synthesis
Route of Administration	PO
Absorption	80% Absorbed
Distribution	Crosses placenta: Highly protein-bound
Primary Metabolism	hepatic
Primary Excretion	Renal: small amount Billiary
Onset of Action	1 hour
Duration of Action	6-8hours
Common Adverse Effects	GI-related bleeding, anorexia, heartburn, N/V/D, or constipation Anybody is at risk CNS-related dizziness, headache, drowsiness,
Serious Adverse Effects	Peripheral Edema
Black Box	fatal CV, thrombotic events, GI adverse effects
Contraindications	Allergy Pts with/ PUD, bleeding abnormalities, perioperative pain r/t to CABG
Pregnancy Category	Pregnancy category D (3rd trimester)
Precautions	Pts w/ HTN, HF Pts w/ hx of GI bleeding, stroke, MI, DM Pts w/ impaired renal or hepatic function Pediatric pts w/asthma
Drug Interactions	Increased drug toxicity of digoxin, lithium, and methotrexate
Herbal Interactions	Increased bleeding w/ feverfew, garlic, ginger, and ginkgo
Overdose Management	Administration of activated charcoal and nasogastric suction

Celebrex Pharmacology Mastery Chart

Category	Fillable Section
Therapeutic Classification	Anti-Inflammatory
Pharmacologic Classification	COX-2 Inhibitor, NSAID
Therapeutic Effects and Uses	Mild to moderate pain and inflammation
Mechanism of Action	Selectively inhibits the enzyme COX-2 Inhibits prostaglandin synthesis
Route of Administration	PO
Absorption	Well absorbed
Distribution	97% protein Bound
Primary Metabolism	hepatic ; CYP2C9
Primary Excretion	Feces, urine
Onset of Action	Peak 3 hours
Duration of Action	Half-life - 11.2 hours
Common Adverse Effects	GI related V/D, Dyspepsia Respiratory-related URI, cough Severe skin adverse effects CKD and Hepatic Impairment
Black Box	fatal CV, thrombotic events, GI adverse effects
Contraindications	Pts w/ hepatic impairment and CKD Pts w/ anemia, CABG postoperative phase Pts w/ hx of GI bleeding or PUD
Pregnancy Category	C and D (third trimester)
Precautions	Pts receiving anticoagulants Pts w/ hx of asthma, Pts w/ bone marrow suppression Pts w/ stroke, PVD, HF, fluid retention
Drug Interactions	Increased lithium toxicity Decreased antihypertensive effects
Herbal Interactions	Increased bleeding
Overdose Management	Administer activated charcoal and nasogastric suction

Acetamenophin Pharmacology Mastery Chart

Category	Fillable Section
Therapeutic Classification	Non - Opioid Analgesic, antipyretic
Pharmacologic Classification	Para-aminophenol derivative
Therapeutic Effects and Uses	Mild to moderate pain
Mechanism of Action	May inhibit chemical mediators of pain Direct action on heat-regulating center of hypothalamus
Route of Administration	PO, Rectal, IV
Absorption	Rapid and complete absorption
Distribution	Crosses placenta: 25% bound to Plasma Protien
Primary Metabolism	hepatic
Primary Excretion	renal
Onset of Action	PO - 30 to 60 min: IV 15 minutes
Duration of Action	3-8hours
Common Adverse Effects	Hepatoxicity: Increased liver enzymes- ALT, AST, Bilirubin
Serious Adverse Effects	neutropenia, pancytopenia, leukopenia, thrombocytopenic purpura hepatotoxicity in ETOH-dependent pts & CKD
Black Box	Severe liver injury, anaphylaxis
Contraindications	Pts w/ severe hepatic impairment and CKD
Precautions	Pts w/ anemia, bone marrow depression, immunosuppression
Drug Interactions	Increased HApatoxicity Increased bone marrow toxicity with antiretrovirals
Herbal Interactions	Increased analgesic effects with caffeine
Overdose Management	3-bag method of acetylsteine (Acetadote

DMARD Prototype: Methotrexate Pharmacology Mastery Chart

Category	Fillable Section
Therapeutic Classification	Antirheumatic; Imumunospressant
Pharmacologic Classification	Antimetabolite (folate antagonist)
Therapeutic Effects and Uses	1st Line for RA
Mechanism of Action	Blocks folate metabolism Decreases DNA synthesis Decreased immune activity
Route of Administration	PO
Common Adverse Effects	Bone marrow suppression Hepatoxicity
Serious Adverse Effects	Pulmonary Fibrosis
Contraindications	Liver disease
Pregnancy Category	TERTATOGEN - lethal to fetus
Drug Interactions	NSAIDS increase drug toxicity risk Alcohol increases hepatoxicity risk
Herbal Interactions	Avoid echinacea; it decreases the effect
Nursing Considerations	Avoid Alcohol Use contraception during and after therapy

Biologic Prototype: Adalimumab Pharmacology Mastery Chart

Category	Fillable Section
Therapeutic Classification	Antirheumatic, anti-inflammatory
Pharmacologic Classification	Monoclonal Antibody
Indications	Moderate to severe RA - with or without methotrexate
Mechanism of Action	Neutralizes TNF-a
Route of Administration	Injection
Common Adverse Effects	Increased Infection Risk
Serious Adverse Effects	Malignancies, demyelinating disorders
Contraindications	Active infection Demyelinating disease Heart failure
Black Box	Serious infections and malignancies are possible
Drug Interactions	Other immunosuppressants and infection risk AVOID LIVE VACINES
Herbal Interactions	Avoid echinacea - immune stimulation
Nursing Considerations	TB screening before therapy Monitor for fever, cough, night sweats Educate on self-injection techniques Store refrigerated

Coricosteroid Prototype: Prednisone Pharmacology Mastery Chart

Category	Fillable Section
Therapeutic Classification	Antirheumatic, anti-inflammatory
Indications	RA flares/bridge
Mechanism of Action	Decreased pro-inflammatory cytokines
Route of Administration	PO, IV, Injection
Common Adverse Effects	Hyperglycemia HTN/Fluid retention Mood changes Infection risk GI ulcer bleed Osteoporosis Adrenal suppression
Contraindications	Systemic fungal infection Caution diabetes Osteoporosis PUD Live Vaccines
Black Box	none
Drug Interactions	NSAIDs increase GI bleed Risk Warfarin = viable INR (blood thinner)
Other Interactions	CYP3A4 inhibitors increase gc levels; inducers decrease levels Hypoglycemics may need higher doses
Monitoring	Baseline assessments Ongoing assessments Bone protection: Ca/Vit d, biophosphate in less than or equal to 3 months PPI if also NSAID and GI risk PJP prophylaxis is less than or equal to 20 mg prednisone daily less than 4 wks + other is agents
Tapering and Adrenal Suppression	Suppression risk - less then 3 weeejs Tapper gradually after 2-3 weeks Stress-dose steroids if suppressed + illness/surgery
Patient Education	AM dosing Never stop abruptly Report fever, sore throat, black stools, mood/vision changes No live vaccines Bone health - CA/ vit D, weight-bearing exercise Steroid ID if chronic Use

Antimalarial Prototype: hydroxychloroquine Pharmacology Mastery Chart

Category	Fillable Section
Therapeutic Classification	Anti-Rheumatic
Pharmacologic Classification	Antimalarial
Indications	SLE (Reduces flares)
Mechanism of Action	Inhibit antigen processing and immune cell activation
Route of Administration	PO
Common Adverse Effects	Gi Upset Skin rash
Serious Adverse Effects	Retinal Damage - Irreversible
Contraindications	Pregnancy (Relative-risk/benefit)
Black Box	none
Drug Interactions	Antacids may decrease absorption
Herbal Interactions	none
Nursing Considerations	Take with food or milk Annual eye exams Report blurred vision immediatly

Antigout Prototype: Colchicine Pharmacology Mastery Chart

Category	Fillable Section
Therapeutic Classification	Anti Gout
Pharmacologic Classification	Microtubule assembly inhibitor
Indications	Acute gout Flares
Mechanism of Action	Disrupts microtubule formation Inhibits leukocyte migration
Route of Administration	PO
Common Adverse Effects	Gi Upset Severe malnutrition and electrolyte abnormalities
Serious Adverse Effects	Myelosuppression Cytopenias myopathy
Contraindications	Severe renal/hepatic disease Caution in pregnancy
Black Box	none
Drug Interactions	CYP3A4 Inhibitors increase toxicity Statins increase myopathy risk
Herbal Interactions	none
Nursing Considerations	Start within 24-36 hours of flare Encourage hydration

Xanthine Oxidase Inhibitor Prototype: Allopurinol Pharmacology Mastery Chart

Category	Fillable Section
Therapeutic Classification	Antihyperuricemic
Pharmacologic Classification	Xanthine oxidase inhibitor
Indications	Chronic gout prophylaxis Prevention of tumor lysis syndrome
Mechanism of Action	Inhibits xanthine oxidase Blocks uric acid fromation
Route of Administration	PO
Common Adverse Effects	Hepatoxicity Bone marrow supression
Serious Adverse Effects	Rash - SJS/TEN risk
Contraindications	Hypersensitivity Caution in pregnancy
Black Box	none
Drug Interactions	Warfarin increases bleeding risk Azathioprine increases toxicity
Herbal Interactions	none
Nursing Considerations	Stop immediately if rash appears Monitor LTFs Take after meals or during a meal (Never on an empty stomach)

Uricosuric Prototype: Probenecid Pharmacology Mastery Chart

Category	Fillable Section
Therapeutic Classification	Uricosuric
Pharmacologic Classification	Uric Acid reabsorption inhibitor
Indications	Chronic gout
Mechanism of Action	Blocks the reabsorption of uric acid in renal tubules
Route of Administration	PO
Common Adverse Effects	Gi Upset Kidney Stones
Serious Adverse Effects	none
Contraindications	Severe renal impairment
Black Box	none
Drug Interactions	Decrease renal excretion of penicillin Aspirin antagonizes the uricosuric effect, holding onto too much uric acid
Herbal Interactions	none
Nursing Considerations	Encourage more than 2L/day fluid intake Monitor uric acid levels Avoid aspirin

Bisphosphate Prototype: Alendronate Pharmacology Mastery Chart

Category	Fillable Section
Therapeutic Classification	Osteoporosis agent
Pharmacologic Classification	Bisphophonate
Indications	Osteoporosis Pagets disease
Mechanism of Action	Inhibits osteoclasts Decreases reabsorption
Route of Administration	PO
Common Adverse Effects	MSK pai ONJ Atypical femur fracture
Serious Adverse Effects	Esophagitis hypocalcemia
Contraindications	Can't sit upright for 30 minutes
Black Box	none
Drug Interactions	Ca/antacids decrease absorption
Herbal Interactions	Coffee and juice decrease absorption
Nursing Considerations	Empty stomach Water only Stay upright for 30 minutes or longer