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NURS 133 Exam 1 and 2 Medication Review

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jasmine's version from 2016-06-13 23:53

Section 1

Question Answer
Estrogen Oral contraceptives or to treat menopausal and menstrual disorder
Estradiol Metabolic effects include reduced blood cholesterol, protein synthesis, and sodium and water retention; Treatment and prevention of post-menopausal osteoporosis
Progestin Relaxation of uterine smooth muscle; pituitary inhibition; withdrawal bleeding in the presence of estrogen; Restoration of hormonal balance with control of uterine bleeding, and successful outcome in assisted reproduction
Plan B Emergency contraceptive; Prevents pregnancy after unprotected sex, and must be taken within 72 hours
Mifepristone (RU-486) Abortion
MethotrexateCancer of breast, skin, head and neck, or lung; Joint pain and swelling; Abortion; Sickle Cell disease; Rheumatoid arthritis; Severe psoriasis
Misoprostol Often used in combination with mifepristone or methotrexate to end pregnancy; Induction of labor; prevention or treatment of serious post-partum hemorrhage
Pitocin Induction of labor; Control of bleeding after birth
Clomiphene Fertility; Follicular maturation and ovulation
Sildenafil (Viagra) Increase of blood flow to corpus cavernosum; Enhances effects of nitric oxide released during sexual stimulation
Finasteride Reduce prostate size with associated decrease in urinary symptoms
Terazosin Hypertension; Lowers BP; Decreased symptoms of prostatic hyperplasia (urinary urgency, hesitancy, nocturia); Alpha 1 blocker; Antagonist
Penicillin Strept, staph, gonorrhea
CephalosporinUTI, skin, respiratory, bone; Cross-sensitivity to penicillins
Vancomycin C. diff, MRSA
Tetracycline Chlamydia, syphilis, gonorrhea
Macrolides STIs, skin, respiratory, soft tissue
Aminoglycosides E. Coli, serious infections
Sulfonamides UTIs
TrimethoprimUTIs; Ear infections; In combination with other drugs, certain types of pneumonia
Metronidazole Vagina, stomach, skin, joints, respiratory
Rifaximin Travelers diarrhea
Bacitracin (ointment) Small cuts, wounds, burns
Sulfonylureas Type 2 diabetes; Stimulates release of insulin and may decrease hepatic glucose production
Metformin Type 2 diabetes: Decreases hepatic glucose production and intestinal glucose absorption; Increases sensitivity to insulin
Long Acting Insulin Type 1 and 2 diabetes; Control of hyperglycemia; Lower blood glucose by stimulating glucose uptake in skeletal muscle and fat, inhibiting hepatic glucose production; Inhibition of lipolysis (breakdown of fats and other lipids by hydrolysis to release fatty acids) and proteolysis (breakdown of proteins or peptides into amino acids by action of enzymes), enhanced protein synthesis
Short Acting InsulinType 1 and 2 diabetes; Rapid acting: Control of hyperglycemia by stimulating glucose uptake in skeletal muscle and fat, inhibiting hepatic glucose production; Inhibition of lipolysis (breakdown of fats and other lipids by hydrolysis to release fatty acids) and proteolysis (breakdown of proteins or peptides into amino acids by action of enzymes), enhanced protein synthesis
Slow acting: Adjunct to diet and exercise to improve glycemic control by regulation of glucose metabolism-Bind to insulin receptors on muscle and adipocytes and lower blood glucose by facilitating cellular uptake of glucose and simultaneously blocking the output of glucose from the liver
Levothyroxine Hypothyroidism; Thyroid supplementation; Treatment or suppression of euthyroid goiters; Adjunctive treatment for thyrotropin-dependent thyroid cancer; Aid in the development of the brain and CNS
Phenytoin (Dilantin) Tonic-clonic (grand mal) seizures and complex partial seizures; Anti-epileptic/Anti-convulsant; Does NOT treat all seizures; Diminished seizure activity; Termination of ventricular arrhythmias
Valporic acid (Depakene) Monotherapy and adjunctive therapy for simple and complex absence seizures; Also used to treat manic episodes related to bipolar disorder, and to prevent migraine headaches; Increases levels of GABA
Lorazepam (Ativan) Anxiety disorder; Pre-operative sedation; Depresses CNS by possibly potentiating GABA, an inhibitory neurotransmitter
Paroxetine (Paxil) Major depressive disorder; Panic disorder; Obsessive compulsive disorder (OCD); Generalized anxiety disorder (GAD); Social anxiety disorder; Post-traumatic disorder (PTSD); Pre-menstrual dysphoric disorder (PMDD); Brisdelle: Moderate to severe vasomotor symptoms associated with menopause; Selective Serotonin Reuptake Inhibitor (SSRIs); Blocks neuronal reuptake of serotonin in the CNS, thus potentiating the activity of serotonin; Has little effect on norepinephrine or dopamine; Mechanism for benefit in treating vasomotor symptoms unknown
Phenelzine (Nardil) (MAOI; anti-depressant) Depressive disorder; Depression in patients who have failed other modes of therapy (TCAs, SSRIs, SSNRIs or electroconvulsive therapies) NOT major nor bipolar disorder; Blocks the enzyme monoamine oxidase, resulting in an accumulation of various neurotransmitters (dopamine, epinephrine, norepinephrine, and serotonin) in the body
Doxepin (TCA; Tricyclic anti-depressant) Relief of depression; Decreased anxiety; Sedation and improved sleep maintenance; Topical: Decreased pruritus (severe itching of skin) due to anti-histamine properties; Alpha 1 blocker; Antagonist; Anti-cholinergic properties; Prevents reuptake of norepinephrine and serotonin by pre-synaptic neurons
Sertraline (Zoloft) (SSRI) Major depressive disorder; Panic disorder; Obsessive compulsive disorder (OCD); Generalized anxiety disorder (GAD); Social anxiety disorder; Post-traumatic disorder (PTSD); Pre-menstrual dysphoric disorder (PMDD); Selective Serotonin Reuptake Inhibitor (SSRIs); Blocks neuronal reuptake of serotonin in the CNS, thus potentiating the activity of serotonin; Has little effect on norepinephrine or dopamine
Difference between Paroxetine (Paxil) and Sertraline (Zoloft)Paxil went out in the early 90s, while Zoloft was approved by the FDS in 1997
Sertraline (Zoloft) should not be taken with electroconvulsive therapy
Sertraline (Zoloft) is associated with significantly less clinical worsening during taper period than Paroxetin (Paxil)
Sertraline (Zoloft) is significantly better tolerated, while Paroxetin (Paxil) has a higher rate of treatment discontinuation due to adverse effects
Paroxetine (Paxil) has a significantly higher rate of weight gain, and is associated with higher incidence of sexual side effects like delay of orgasm or ejaculation and impotence
Paroxetine (Paxil) discontinuation is associated with the higher degree of emergence of new somatic and psychological symptoms in patients than Sertraline (Zoloft)
Sertraline (Zoloft) may have advantages in comparison to Paroxetin (Paxil), in elderly patients, due to the comparatively low potential for drug interactions
Travoprost (Travatan) Intraocular pressure in patients with open-angle glaucoma or ocular hypertension who are intolerant of other intraocular pressure lowering medication or insufficiently responsive to another intraocular pressure lowering medication; Reduces intraocular pressure by increasing the drainage of aqueous humor
Timolol (Betimol) Open-angle glaucoma and ocular hypertension; Reduces elevated, as well as normal, intraocular pressure, whether or not accompanied by glaucoma; Decreases amount of fluid within the eye; Non-selective Beta 1 and 2 blocker; Antagonist
Difference between Travoprost (Travatan) and Timolol (Betimol)Timolol (Betimol) is in the drug class of non-cardio-selective beta blockers, and Travoprost (Travatan) is in the drug class of ophthalmic glaucoma agents
Timolol (Betimol) should not be used in patients with asthma or severe chronic obstructive pulmonary disease (COPD), certain serious heart conditions, especially AV block, or sever or uncontrolled congestive heart failure, and Travoprost (Travatan) has category C (pregnancy) and breast feeding warnings
Gabapentin (peripheral neuropathy) Partial seizures (adjunct treatment) (immediate release only); Post-herpetic neuralgia (Nerve pain due to damage caused by the varicella zoster virus. Typically is confined to an area, and follows an outbreak of herpes zoster (commonly known as shingles); Restless leg syndrome; May affect transport of amino acids across and stabilize neuronal membranes
Atropine (vision)Eye drops used to treat uveitis (inflammation of the uvea) and early amblyopia (Lazy eye: impaired or dim vision without obvious defect or change in the eye); Dilates the pupils before surgery; Involuntary Nervous System Blocker; Also increases heart rate; Decreases GI and respiratory secretions (given before anaesthesia); Reversal of muscarinic effects (parasympathetic effects); Also used to treat used to treat certain types of nerve agent and pesticide poisonings, some types of slow heart rate, and to decrease saliva production during surgery. May have a spasmolytic action (relieves spasm of smooth muscle) on the biliary and genitourinary tracts; Blocks the action of acetylcholine at post-ganglionic sites located in smooth muscle, secretory glands, and CNS (anti-muscarinic activity); It is typically given intravenously or by injection into a muscle; Anti-arrhythmic-Anti-cholinergic-Anti-muscarinic
Pseudoephedrine (hearing)Used to open obstructed eustachian tubes in chronic otic inflammation or infection-Congestion of the tubes that drain fluid from your inner ears, called the eustachian (yoo-STAY-shun) tubes
Also used for allergy, cold, and cough remedies, nasal drying agents/decongestants; Symptomatic management of nasal congestion associated with acute viral upper respiratory tract infections; Used in combination with anti-histamines in the management of allergic conditions; Alpha agonist (Alpha 2); Stimulates alpha and beta receptors; Produces vasoconstriction in the respiratory tract mucosa (alpha-adrenergic stimulation) and possibly bronchodilation (beta 2 stimulation), resulting in reduction of nasal congestion, hyperemia, and swelling in nasal passages; Sympathomimetics: Often used in nasal decongestants
Captorpril Management of hypertension, HF, and decrease progression of diabetic nephropathy
Enalapril (Vasotec) Management of hypertension, HF, and slowed progression of left ventricular dysfunction into overt HF
Lisinopril (Prinivil) Management of hypertension and HF; ACE inhibitors also increase plasma renin levels and decrease aldosterone levels; Net result is systemic vasodilation
Diltiazem Coronary vasodilation resulting in decreased frequency and severity of attacks of angina; Systemic vasodilation resulting in decrease BP; Reduction of ventricular rate in atrial fibrillation or flutter
Amlodipine (Norvasc) Systemic vasodilation resulting in decreased BP; Coronary vasodilation resulting in decreased frequency and severity of attacks of angina; Inhibits the transport of calcium into myocardial and vascular smooth muscle cells, resulting in inhibition of excitation-contraction coupling and subsequent contraction
Atenolol (Norvasc) Decrease BP and heart rate; Decreased frequency of attacks of angina pectoris; Prevention of MI; Blocks stimulation of beta1 (myocardial)-adrenergic receptors; DOES NOT usually affect beta2 (pulmonary, vascular, uterine)-receptor sites
Propranolol (Inderal) Decreased heart rate and BP; Suppression of arrhythmias; Prevention of MI; Blocks stimulation of Beta 1 (myocardial) and Beta 2 (pulmonary, vascular, and uterine) adrenergic receptor sites
Etanercept Rheumatoid arthritis, juvenile arthritis, ankylosing spondylitis, psoriatic arthritis or plaque psoriasis; Decreased inflammation and slowed progression
Belimumab (Benlysta) Systemic Lupus Erythematosus (SLE) (autoimmune disease in which the body’s immune system mistakenly attacks health tissue-it can affect the skin, joints, kidneys, brain, and other organs; Symptoms vary from person to person, and may come and go; Almost everyone with SLE has joint pain and swelling. Some develop arthritis. The joints of the fingers, hands, wrists, and knees are often affected. Other common symptoms include chest pain when taking a deep breath, fatigue, fever with no other cause, general discomfort, uneasiness, or ill feeling (malaise), hair loss, mouth sores, sensitivity to sunlight, skin rash (butterfly rash in about half people with SLE, often seen over the cheeks and bridge of the nose, yet can be widespread and gets worse in sunlight), swollen lymph nodes, and other symptoms depend on which part of the body affected)
Rh immune globulin Rh negative pregnant women; Prevent production of anti Rh antibodies in Rh negative patients who were exposed to Rh positive blood; Increase platelet counts in patients with ITP
Tenofovir HIV; Disruption of DNA synthesis; Pregnancy category B
Avonex MS; Interferon Beta 1A; Reduce incidence of relapse (neurologic dysfunction) and slow physical disability
Glatiramer acetate (Copaxone) MS; Used to reduce episodes of symptoms in patients with relapsing-remitting forms; Stops body from damaging its own nerve cells (myelin)
memorize

Section 2

Question Answer
Beta 1 receptorsResponsible for heart contraction and kidney; Stimulate heart to beat faster and kidney-renin release from cells; Increases calcium release
Beta 2 receptors Responsible for muscle relaxation by vasodilation; Located in lung bronchioles and skeletal muscle arteries; Vascular and airway smooth muscle
Beta 3 receptors Responsible for muscle relation by vasodilation. Located in adipose tissue, smooth muscle tissue, particulary in the GI tract and urinary bladder smooth muscle; Also found in gallbladder and urinary bladder
Beta agonist example Used to treat asthma by relaxing airway smooth muscle and premature labor by relaxing uterine smooth muscle
Alpha 1 receptors Responsible for stimulation by vasoconstriction; Located in skin, sphincters of GI system, kidney (renal artery) and contraction of urinary bladder, and brain
Alpha 2 receptors Responsible for smooth muscle contraction (vasoconstriction) and neurotransmitter inhibition/blocker; Located in liver cells, on pancreatic beta cells, platelets, and smooth muscle of blood vessels; Found on both pre-synaptic neurons and post-synaptic cells, they work mainly as auto-receptors to mediate feedback blockage of sympathetic (block norepinephrine release from adrenergic neurons) transmission; Blocks insulin release from pancreatic beta cell membranes and block acetylcholine release from cholinergic neurons
What activates both alpha 1 and 2 receptors Epinephrine and norepinephrine
Presynaptic alpha 2 receptors Activation blocks the release of norepinephrine, hence norepinephrine acts at presynaptic alpha 2 receptors to block its own release
Alpha blocker medication Causes vasodilation and can be used to treat such as hypertension
memorize