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fever decrease inflammation prevent inflammation and dilation to intracranial blood vessels interfere with the action of opioids Block ACh at neuromuscular junction Uses Inflammation, Analgesia, fever reduction, dysmenorrhea Side effects GI discomfort, gastric ulcers, bleeding, renal dysfunction, Salicylism, Reye Syndrome GI toxicity Ergot: GI discomfort; Ergotism, physical dependence, abortionTriptans: Chest symptoms, angina, teratogenic tachycardia, tachypnea, abstinence syndrome Respiratory arrest, hypotentionSuccinylcholine: apnea, malignant hypertension, hyperkalemia Levodopa: N/V, Dyskinesias, ortho hypo, cardio effects, psychosis, discoloration of sweat and urine, activation of malignant melanoma Mirapex: sleep attacks, daytime sleepiness, ortho hypo, psychosis, dyskinesias, NauseaCogentin: N/V, Atropine effects. CNS effects, skin rash, toxicity, Cardio effects, teratogenisis, GI effects, respiratory depression Interactions Warfarin, Glucocorticoids, Alcohol, Ibuprofen Warfarin Triptains with MAOI's Avoid trigger factors. NI Take with food, milk, or fully glass of water Affecting Pain and inflammation
Colchicine Ergot alkaloids: Ergotamine (ergostat) Serotonin receptor agonists (Triptains): Sumatripitan (Imitrex)
Opioid Antagonist
Naloxone (Narcan)
opioid overdose, reverse effects of opioids, reversal of resp. depression in infants adjuncts to general anesthesia, diagnosis myasthenia gravis, seizure control, endotracheal intubation, endoscopy Parkinsons
Pain and inflammation General anesthetics, Aminoglycosides, tetracyclines, Cholinesterase inhibitors Levodopa: Protients, conventional antipsychotic agents, pyridoxine, MAOIs. Mirapex: Levodopa continuous cardiac monitoring
Nervous system
Anti Parkinsons
Dopaminergic: Levodopa (Dopar, Larodopa) Dopamine agonists: pramipexole (Mirapex) Centrally acting anticholengerics: Benztropine (congentin) Dopamine releaser (Antiviral): Amantadine (symmetrel)
block receptors
Nervous system
AEDs
Barbiturates: phenobarbital (Luminal) Hydantoins: phenytoin (Dilantin) Benzodiazepines: diazepam (valium), lorazepam (Ativan) Carbamazepine (Tegretol), ethosuximide (zaronin), valproic acid (Depakote), gabapentin (Neurontin)
relief of spasticity
Local Anesthetics
minor procedures...
Halothane (fluothane)"ane"
Surgery, diagnostic procedures, analgesia, muscle relaxation schizo, bipolar, tourettes, delusions, dementia, Huntingtons chorea
Antipsychotics-Conventional
CNS depression, hepatic toxicity, physical dependence CNS excitation, Hypotension, Allergic reactions, Spinal headache, urinary retention hypotension, resp and cardio depression, malignant hyperthermia, hepatotoxicity EPS, TD, Neuroleptic malignant syndrome, Anticholinergic effects, ortho hypo, sedation,
Dilantin: OC, warfarin, glucocorticoids, alcohol, valium. Tegretol: OC, warfarin, grapefruit juice, phenytoin, phenobarbital. CNS depressants
Nervous system
Nervous system
CNS depressants, CNS stimulants, morphine sulfate, succinylcholine Anticholinergic agents, CNS depressants, Levodopa
Nervous system
Nervous system
Antipsychotics-atypical
clozapine (clozaril)
blocks serotonin and dopamine block reuptake of norepi and serotonin--intensify effects
TCA
amitriptyline (Elavil)
Depression, bipolar
seizures, sexual dysfunction, skin effects Agranulocytosis, seizures, weight gain, inflammation of heart muscle ortho hypo, anticholinergic effects, sedation, cardiac toxicity,
Immunosuppressive meds MAOIs, Antihistamines, Epinephrine, NE, Ephedrine, amphetamine, CNS depressants MAOIs, warfarin, Tricyclic antidepressants, NSAIDS anticoagulants, antidepressants, SSRIs, Antihypertensives, Mepridine(Demerol), Tyramine rich foods, Vasopressors MAOIs effects not experienced until 1-3 weeks
Nervous system
Nervous system
SSRIs
Fluoxetine (prozac)
MAOIs
Phenelzine (Lardil)
Sexual dysfunction, wt. gain, mental confusion, agitation, anxiety, withdrawal syndrome, hyonatremia, rash, sleepiness CNS stimulation, ortho hypo, hypertensive crisistrycyclic
Nervous system
Nervous system
Atypical Antidepressants
Mood stabilizers
bipolar, alcoholism, bulimia, schizo Anxiety, seizure, insomnia, muscle sapsm, alcohol withdrawal, panic disorder insomnia GAD
Benzodiazepines
CNS Stimulant
Methylphenidate (ritalin,Concerta)
do ot function as muscle relaxant binds to serotoinin and dopamine receptors Release NE and dopamine increase HR, Contractility, rate of conduction
H/A, dry mouth, contipation, tachycardia, nausea, wt.loss, seizures GI effects, tremors, polyuria, renal toxicity, goiter, teratogenesis, CNS depressions, paradoxical response, respiratory depression, teratogenesis, acute toxicity daytime sleepiness and lightheadedness CNS effects
take daily
nervous system
Nervous system
Nervous system
CNS depressants, food Erythromycin, ketoconazole, grapefruit juice MAOIs, Caffeine, Phenytoin, warfarin, OTC cold meds MAOIs, Tricyclic antidepresants, general anthetics, alpha-adrenergic blocking agents, beta adrenergic blocking agents, diuretics Antihypertensive meds anti HTN meds, praxosin, MAOIs, tricyclic antidepressants, CNS depressants CCB,
take before bedtime take with meals dont chew or crush IV continuous infusion
Nervous system
Nervous system
Nervous system
Adrenergic Agonists
Cardiovascular system
Prazosin(minipress)
Clonidine(Catapress)
venous and arterial dilation, smooth muscle relaxation decrease sympathetic outflow
hypertension, BPH
Cardio
HTN,sever CA pain
Cardio
block beta1
cardio
(sympatholytic)
Propranolol (Inderal)"lol"
adrenergic receptors
MI, HF
ACE inhibitors
Captopril(capoten)"pril"
ARBs CCB
block the production of Ang II (vasodilation, excretion of Na and H2o and retention of K) blocks action of ang II vasodilation
AV block, ortho hypo, rebound myocardium excitation, bronchoconstriction, glycogenolysis inhibited first dose ortho hypo, cough, hyperkalemia, rash, angioedema, neutropenia
cardio
angioedema, fetal injury reflex tachy, peripheral edema, acute toxicityverapamil: ortho hypo, constipation, suppression of cardiac function, dysrhythmias excessive hypotention, cyanie poisoning, thiocyanate poisoning, H/A, ortho hypo, reflex tachycardia, tolerance Dysrhythmias, bradycardia, GI effects(anorexia, N/V, abd pain) CNS effects(fatigue, weakness, vision changes) hepatotoxicity, myopathy, peripheral neuropathy Gall stones, myopathy,hepatotoxicity
cardio cardio
Hypertensive crisis
Sodium nitroprusside
direct vasodilation
dont mix with other medications Alcohol, antihypertensive meds, viagra Thiazide, ACE, ARBs, sympathomimetic meds, quinidine, verapamil fibrates, erythromycin, grapefruit juice Warfarin, statins, cholestyramine
cardio
Organic Nitrates
angina
Cardio
Cardiac Glycosides
cardio
Statins
atorvastatin (Lipitor)
Cholesterol
Antilipemics: fibrates
gemfibrozil (Lopid)
hyperohlesterolemia, prevent coronary events, protect MI, raise HDL levels Reduction of VLDLs, increase HDL
take with evening meal obtain baseline cholesterol levels, take 30 min prior to meals baseline cholesterol levels, no reguard to food disolve in 4oz of H2O baseline vitals, monitor CBC,monitor aPPT (60-80sec) IV administered slowly vitals, monitor PT, CBC, platelet count, Hct levels small doses orally
Cardio
Cardio
absorb cholesterol
lower LDL
NONE
Cholestyramine, statins, fibrates, cyclosporine, digoxin, warfarin, thiazides, tetracyclines anti-platelet agents
cardio
Antilipemicsbile-acid-sequestrants Anticoagulants/parenteral
cholestyramine (Questran)
lower LDL
Lower LDL
Constipation
Cardio
Heparin
prevents bleeding
DVT, DIC
Blood
Blood Blood
hemorrhage
Warfarin overdose
Blood
Antiplatelets
Asprin (ecotrin)
prevent platelets from clumping together by inhibiting enzymes dissolves clots that have already formed provide iron
Blood
bleeding, hypotension, allergic reaction GI distress, Teeth staining, Anaphylaxis HTN, increased risk for cardiovascular event Tachycardia, angina, tremors
Blood take on empty stomach, green blackish stool monitor iron levels, BP, Hgb and Hct blood
increase production of RBC activate the beta receptorsin the bronchial smooth muscle bronchodilation brochodilation prevent inflammation, suppression of airway mucus, Anti-inflammation
anemia, HIV
blood
Beta2-Adrenergic agonists
asthma
Respiratory
GI distress, restlessness, seizures local anticholingergic effects difficulty speaking, hoarsness, candidiasis, bone loss, hyperglycemia, myopathy, peptic ulcer disease, infection,
fixed schedule
Respiratory
Leukotriene Modifiers
montelukast (singulair)
Antitussive-Opioids Mucolytics
suppresses inflammation, bronchoconstriction, edema, mucous production Cough suppression enhance the flow of secretions in respiratory passaes
Respiratory
Respiratory odor that smells like rotten eggs, dilute medication in fruit juice lateral head low position when taking daily wts Respiratory
Decongestants
phenylephrine
cause reduction in inflammation prevent reaborption of H2O block reabsorbtion of Na and Cl block action of aldosterone increases blood osmolality supplys K
rhinitis, sinusitis
Rebound congestion, CNS stimulation, Vasoconstricion Dehydration, hypotension, ototoxicity, hypokalemia dehydration, hypokalemia, hyperglycemia hyperkalemia, endocrine effects HF, pulmonary edema, Renal failure, fluid and electrolyte imblalances GI distress, local GI ulceration, hyperkalemia Digoxin, Antihypertensives, litium, NSAIDS Digoxin, Antihypertensives, litium, ACE, K supplements
Respiratory
furosemide (Lasix)
Pulmonary edema, renal impairment essential HTN, mild-mod HF, liver and kidney disease k sparing effects, HF Renal failure, decrease ICP, IOP hypokalemia
Fluids
Thiazide Diuretic
hydrochlorothiazide(HydroDIURIL)
fluids
fluids Fluids
K supplements
ACE, spironolactone
Fluids
Antacids
suppress secretion of gastric acid reduce gastric acid seretion by irreversibly inhibiting enzyme neutralize gastric acid and inactivate pepsin decreases acid production softens fecal mass suppress emeisis promote insulin release reduce production of glucose within liver increases breakdown of glycogen into glucose synthetic form of T4
GERD, H.pylori, Heart burn, sour stomach peptic ulcers, GERD, hypersecretory contitions
GI GI
PUD, GERD
constipation, hypophosphatemia, diarrhea, abd pain, dysmenorrhea GI irritation, Rectal burning sensation EPS, sedation, Diarrhea hypoglycemia GI effects, Vit B12 deficiency, lactic acidosis GI distress
warfarin, tetracycline
GI
long term NSAID use prevent ulcers, pregnant constipation GERD, chemo enduced Nasuea, type 2 diabetes type 2 diabetes PCOS hypoglycemia
GI milk, antacids opioids alcohol, NSAIDs, beta blockers Alcohol monitor for CNS depressant exercise with breakfast and dinner GI GI Endocrine Endocrine Endocrine
Oral hypoglycemics-sulfonylureas tolbutamide (orinase) glipizide (Glucotrol, Glucotrol XL) Oral hypoglycemicsmetformin HCl (Glucophage) Biguanides Insulin Overdose Glucagon
Thyroid hormones
levothyroxine(Synthroid,levothriod)
hypothyroidism, emergency tx of myxedema coma grave's disease diabetes insipidus, used during cardiac arrest induction of labor, fetal stress test
overmedication
Uterine stimulants
oxytocin(pitocin, syntocinon)
block synthesis of thyroid hormoones promotes reabsorption of H20 within kidneys stimulates uterus
overmedication, agranulocytosis reabsorption of too much water uterine rupture, HTN crisis
binding agents, antiseizure and anti depressant, warfarin increase anticoag effects
Endocrine
Endocrine Endocrine
Vasopresssors
Tocolytic medications
tachycardia, tremors
Androgens
hypogonadism, delayed puberty Contraception, postmenopausal symptoms, treatment of prostate cancer dysfunctional uterine bleeding, anmenorrhea, endometriosis erectile dysfunction
hepatotoxicity, cardio risk, Virilism effects Endometrail and ovearin CA, embolic events, feminization Breast CA, thromboembolic events, breakthrough bleeding, edema MI, sudden death, Priapism
Estrogens
use infusion pump, monitor for hyperstimulaion monitor BP, frequency and duration of contractions, fetal distress report wt. gain of >2lbs. rotate injection sites withdrawal bleeding 1 hr before sexual activity
Reproductive
Reproductive
Reproductive
reproductive
Progesterones
Erectile dysfunction
sildenafil(Viagra)
induce favorable conditions for fetal growth augments effects of nitric oxide relase during sexual stimulation provide passive immunity enhance host immune responses
tegretol, dilantin, rifampin organin nitrates, grapefruit juice, erthromycin live viruses Theophylline, Zidovudine, antihypertensives
reproductive
Reproductive
immunodeficiency syndrome, hep a, hep b hairy cell leukemia, maligannt melanoma, AIDS-related kaposi's sarcoma
local reaction, systemic allergic reaction Flu like symptoms, bone marrow suppression, hypotension
Antihistamines
Chemotherapy agents
diphenhydramine (Benadryl),promethazine (phenegran), dimenhydrinate (Dramamine)2nd Gen: Loratadine (claritin), cetirizine (Zyrtec), fexofenadine (Allegra), desloratadine(Clarinex) cyclophosphamide(Cytoxan,Neosar)cisplatin(Planinol AQ)metotrexate(Rheumatrex, trexall)cytara bine(Cytosar-U) penicillin G (Bicillin LA)
sedation, anticholingergic effects, GI discomfort, acute toxicity Bone marrow suppression, N&V, alopecia, mucosistis, reproductive toxicity, hyperuricemia Allergies, renal impairment,hyperkalemia
CNS depressants
Immune
destroy CA cells
Immune
Penicillins
meningitis, syphilis, prophylaxis bacterial endocarditis UTI, postoperative infection, pelvic infection, meningitis pneumonia, peritonitis, UTI serious infections rickettsia, acne vulgaris
Aminoglycosides, OC
Cephalosporins
cephalexin (Keflex)cefaclor (Ceclor)ceftriaxone(Rocephin)cefepime(maxipime imipenem (Primaxin) Vancomycin (Vancocin) tetracycline hydrochloride (sumycin)
destroy bacterial cell wall destroy cell wall destroy cell wall inhibit growth
nitrofurantoin (macrodantin)
damages DNA
UTI
Antimycobacterial( Antituberculosis)
isoniazid(INH)
dapsone
ihibits growth of mycobacteria, prevents synthesis ofmycolic acid prevents synthesis of folic acid prevents reproduction of viral DNA
TB
Allergice, bleeding, thrombophlebitis, cross allergy allergy, GI symptoms, Suprainfection ototoxicity, infusion reaction, thrombophlebitis GI discomfort, yellow/brown tooth discoloration, hepatotoxicity, photosensitivity, suprainfecrtion GI discomfort, thrombophlebitis Ototoxicity, nephrotoxicity, neuromuscular blockade hypersensitivity,blood dyscrasias, kernicterus(jaundice, increase bili), photosensitivity GI discomfort, Hypersensitivity reactions, blood dyscrasias, peripheral neruopathy peripheral neuropathy, hepatotoxicity
Infection
Infection
Infection Infection Milk products, iron, magnesium,antacids, OC dont give with food Infection
empty stomach peak and trough empty stomach, full glass of water
Infection
Infection
acyclovir(Zovirax)
Fluoroquinolones
ciprofloxacin(Cipro)
Antiprotozoals
metronidazole(flagyl)
severe infections, resp, urinary, and GI infections peptic ulcer disease, protozoal infections
discoloration of body fluids, hepatoxicity, mild GI discomfort phlebitis and inflammation at site, nephrotoxicity, mild GI discomfort, Granulocytopenia and thrombocytopenia, reproductive toxicity GI discomfort, Achilles tendon rupture, suprainfection, GI discomfort, metallic taste, darkening of urine, CNS symptoms
complete course
infection
Infection
Infection
infection
Antifungal
amphotericin B deoxycholate(fungizone)
acts on fungal cell membranes to increase cell permeability slows production of prostaglandins act of mu receptors
Analgesic, antipyretic moderate to severe pain, sedation, reduction of bowel motility, Codiene: cough suppression
Infusion reaction, thrombophlebitis, nephrotoxicity, hypokalemia, bone marrow suppression Acute toxicity Respiratory depression, constipation, orthostatic hypotention, urinary retention, sedation, biliary colic, emesis, opioid overdose triad Abstinence syndrome
Aminoglycosides, flucytosine
Infection
Alcohol, Warfarin CNS depressants, Anticholinergic agents, MAOI's, Antihypertensives withhold if R<12, IV slowly (4-5 min)
AgonistsAntagonist Opioids
Pentazocine (Talwin)
Cholinesterase inhibitors
low potential for abuse, less respiratory depression. Antagonist to mu receptors, agonist to kappa receptors increase amount of ACh available at receptor sites
NONE
withhold if R<12
Nervous system