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Pharm Module 7/8

NUR 334 Pharmacology Module 7 and 8 Review

QuestionAnswer
What are some drugs for peptic ulcer disease (PUD) Proton pump inhibitors H2-rececptor antagonists Antacids Antibiotics Miscellaneous drugs
What are some risk factors for PUD Close family history of PUD Blood group O Smoking tobacco (Increases gastric acid secretion) Caffeine Drugs (corticosteroids, NSAIDS, platelet inhibitors) Excessive psychological stress Infection w/ Helicobacter pylori
PUD Medication Contradictions -N/A
What is the most common ulcer? Duodenal Ulcer
What are some symptoms for Duodenal Ulcer? Gnawing or burning upper-abdominal pain Occur 1-3 hours after a meal (maybe) Pain worse when stomach is empty Pain relieved by eating Nocturnal pain, nausea, vomiting Bleeding may occur Bright red blood in vomit Black, tarry stools
Describe Gastric Ulcer Not relieved by food Anorexia, weight loss, vomiting
What is drug is Proton Pump Inhibitor? (PPI) Omeprazole (Prilosec)
What is the administration for (PPI) Omeprazole (Prilosec) Administer before breakfast on an empty stomach It may be administered with antacids Capsules and tablets should not be chewed, divided, or crushed Pregnancy category C Should be used short-term according to book
What is the MOA for (PPI) Omeprazole (Prilosec) Reduces acid secretion in stomach by binding irreversibly to enzyme H, K-ATPase
Which drug is classified as an H2-Receptor Antagonists? Ranitidine (Zantac)
what are some adverse effects of H2-Receptor Antagonists-Ranitidine (Zantac)? Uncommon and mild, with headache being the most common. High doses may result in impotence or loss of libido in men.
what is the MOA of H2-Receptor Antagonists-Ranitidine (Zantac)? it blocks H2 receptors in the stomach, reducing acids
If someone did have gerd what is a non-pharm method to not have gerd anymore? Make sure to sit up after eating. Avoid fatty & acid foods. Eliminate tobacco and alcohol. Lose weight to eliminate the symptoms.
what drug is an antacids Aluminum Hydroxide pg 685 (AlternaGEL, others)
What is the pharm class for Aluminum Hydroxide Antacid or anti heartburn agent
What is the Administrations Alerts Aluminum Hydroxide Administer aluminum antacids at least 2 hours before or after other drugs because absorption could be affected. Pregnancy category Chew tabs do not swallow Take with water and increase fiber and fluids
What are some actions and uses Aluminum Hydroxide Primary action neutralize stomach acid, raising pH of stomach contents.H2-receptor antagonists & PPIs, aluminum antacids dont reduce volume of acid secretion effectively used in combination w/ antiulcer drugs symptomatic relief /heartburn due to PUD/ GERD
What can Aluminum Hydroxide be mixed with Mixed with magnesium to reduce to potential for constipation Should not be taken at the same time as other medications because they may interfere with absorption. Sodium polystyrene sulfonate may cause systemic alkalosis.
H. Pylori Infection, How do we take these? Try to keep a schedule or write something down that will help with Combination Antibiotics -PPIs, antibiotics, bismuth compound
Drugs for H. Pylori Infection: Bismuth MOA inhibits bacterial growth and prevents h pylori from adhering to gastric mucosa, it is like a coating
Drugs for H. Pylori Infection: Bismuth Education keep a schedule if taking more than one
Drugs for H. Pylori Infection: Misoprostol (Cytotec) MOA is? Inhibits acid & stimulates mucus
H. Pylori Infection: Misoprostol (Cytotec) is for people who take what? nsaids or steroids
Adverse Effects for Misoprostol (Cytotec) includes? diarrhea, abdominal cramping Do not give to pregnant women because it can terminate the pregnancy Pregnancy risk X, terminates pregnancy or induces abortion
Drugs for H. Pylori Infection: Metoclopramide (Reglan) Administered how? for? Given iv but can be given po and im prescribed for nausea committing after surgery or chemotherapy
Drugs for H. Pylori Infection: Metoclopramide (Reglan) MOA causes muscles in upper intestine to contract Helps with increased motility Faster emptying of the stomach
What is the black box warning for H. Pylori Infection: Metoclopramide (Reglan) tardive dyskinesia
Laxatives :Psyllium (Metamucil) Administration mix with 8 oz of water, juice, or milk, takes 1-3 days to have a therapeutic effect may reduce serum glucose for patients with diabetes pregnancy category C
Psyllium (Metamucil) Mechanism of action wells and increases size of fecal mass which promotes passage of food helps with constipation
Antidiarrheals Probiotics Lactobacillus help with? Restores the normal flora in the stomach They are live microorganisms
Antidiarrheals Diphenoxylate with Atropine (Lomotil) pharm class is? Opioid 
Antidiarrheals Diphenoxylate with Atropine (Lomotil) adverse include what? dizziness & drowsiness,
How do you give Diphenoxylate with Atropine (Lomotil)? Slowly
What is the MOA of Diphenoxylate with Atropine (Lomotil)? slow peristalsis, allows time for absorption from the stomach
What is the chance for dependency on Lomotil Low potential for abuse, no pain-relieving properties
Can you drive on Lomotil No
What is an OTC antidiarrheal Loperamide (Imodium)
Drugs for IBS Definition? ulcerative colitis: erosions in large intestine and inflammatory disease, Crohn’s disease: ulcers in small intestine
What are some symptoms for IBS? abdominal cramping and diarrhea
What drug helps ibs but also tx constipation? Anticholinergics
Definition of IBD is? ulcerative colitis: erosions in large intestine and inflammatory disease, Crohn’s disease: ulcers in small intestine
name some symptoms for IBD abdominal cramping and diarrhea
Prototype for IBD is Sulfasalazine (Azulfidine)
What is the MAO for Sulfasalazine (Azulfidine) ? inhibits inflammatory mediators such as prostaglandins and leukotrienes
What is the Pharm class for Sulfasalazine (Azulfidine)? 5-aminosalicylate, sulfonamide
What is Sulfasalazine (Azulfidine)? considered? DMARD
What is the administer alert for Sulfasalazine (Azulfidine)? Do not crush, monitor hepatic function, do not take if you have allergies to aspirin or sulfa 
What are some contraindications Sulfasalazine (Azulfidine)? patients hypersensitive to sulfa or aspirin, anemia, hepatic impairment, urinary obstruction, dehydration, diabetes, hypoglycemia, do not give to people with HIV or children under age 2
What is the zone that helps with vomiting? Medulla of the brain, the inner ear, chemoreceptor trigger zone, cerebral cortex
What can you give to someone that is not meds? Mint or ginger
Antiemetics prototype is? Prochlorperazine (Compazine) - antipsychotic
Prochlorperazine (Compazine) - antipsychotic MOA is? blocks dopamine receptors in the brain
What are some adverse effects for Prochlorperazine (Compazine) ? dry mouth & mucous membranes, constipation, sedation, orthostatic hypotension, tachycardia, EPS 
what are some herbal options for Antiemetics Mint or Ginger
Med: ondansetron (Zofran) admin alert includes? administer according to schedule not prn. Q4-8hrs
Pancrelipase is.... a Pancreatic Enzyme Replacement
Pancreatic Enzyme Replacement actions include? converts lipase into glycerol and fatty acids, converts starches into dextran and starches, converts protein into peptides
Pancreatic Enzyme Replacement adverse effects nausea, vomiting, diarrhea, Steatorrhea (fatty stools), Hyperuricosuria
What people do you give Pancreatic Enzyme Replacement to? cystic fibrosis 
Why do we check if the eat pork with pancreatic enzyme replacements? Make sure they can eat pork because it is made from it
When do you give Pancreatic Enzyme Replacement 1-2 hours before or with meals, also given as a powder on food
Drugs for Nutritional Disorders - Vitamins What is the role for vitamins? Vitamins are organic compounds required by the body in small amounts for growth and for the maintenance of normal metabolic processes. Cannot make ourselves except for vit D Essential substances needed to maintain optimal wellness.
Nutritional disorders - Liable soluble include which vitamins? A, D, E, K
What is the vitam A pharm class? and adverse effects? CNS toxicity, Headache, irritability, possible coma
which vitamin helps with clotting? K
for the table for lipid soluble check table 43.2 N/A
What are the water soluble vitamins? Vitamin C, B complex 6 b vitamins Folic acid (B 9)
What does Folic acid promote? Promotes normal fetal growth, neural tube defects during pregnancy Helping with chronic alcohol abuse
What is an adversed effect for folic acid flushed after iv
What if we do not have enough vitamin C? Scurvy
What are some minerals nutritional disorders? Calcium, sulfate
what can happen when you take enough Calcium? it can cause muscle twitching, cardiac abnormalities
Admin alerts/ labs checked when?avoid which type of foods for Calcium IF given iv look for pushing, pain at injection, check for infiltration and redness Recheck labs 4-6 hours after infusion Avoid zinc-rich foods
How can you admin calcium? Can give by mouth, but also IV By mouth is given twice daily
…sulfate helps with what and how is admin? Helps with restless leg syndrome, muscles, heart Can give IV, slow infusion, give over 4 hours
Nutritional Supplement included? TPN (hyperalimentation)
TPN (hyperalimentation) Administration and Monitor for… let it set at least 30 min before giving it
TPN (hyperalimentation)Nursing interventions include... monitor CMP, AST/ALT, monitor for fluid overload (crackles, JVD, tachycardia, high bp), weigh daily
TPN (hyperalimentation) Parenteral is through... IV
For the peripheral vein and the central vein is long term and which is short term? Peripheral vein: (short term), Central: long term
What is a Drug for obesity? Orlistat (Alli)
Orlistat (Alli) pharm class is? a lipase inhibitor
what is the MOA for Orlistat (Alli) inhibits absorption of lipids
What is the primary use for Orlistat (Alli) ? administer if higher than 30 (obesity) or 27 if no other morbidity
What is the administration for Orlistat (Alli) take 1 hr before meals containing fat, skip dose if it does not contain fat
Orlistat (Alli) adverse effects are? oily stool, fecal urgency, abdominal pain, flatus with discharge
What is the an Anorexiant: appetite suppressors
Anorexiant example is? Phentermine
What is the Intrinsic Factor? Helps intestines absorb B12
Drugs for disorders and conditions of the Male Reproductive Pharmacotherapy with androgens : Definition male sex hormone
Testosterone pg. 809 Black Box Warning virilization in women and children may occur if exposed
Testosterones is drug for male infertility's Pharm class? androgen; anabolic steroid; antineoplastic
What does testosterone promote? virilization and treats hypogonadism
Which gland secretes testosterone? The testes
Contraindications with disorders and foods for testosterone includes.. Breast cancer or prostate cancer, liver disease, kidney disease, BPH, women becoming pregnant
what are some actions and uses for testosterone? promotes virilization (secondary sex characteristics, enlargement of sex organs) and treats hypogonadism, increases libido, extra hair, corrects erectile dysfunction
testosterone Administration: wash hands and use gloves if women are administering it, especially pregnant women because it can also harm baby, apply on hairless area on back, abdomen, back of arm, rotate sites every 7 days, if given IM give it in the gluteal muscle
What pregnancy category is testosterone? X
what are some adverse effects with medication with testosterone? virilization, edema, if taken too much it can retain salt, damage to liver, acne, skin irritation, increased or decreased libido
what are some Drug to Drug interactions with testosterone? anticoagulants because it increases bleeding, corticosteroids can cause edema, hepatotoxic drugs
what is Hypogonadism? low testosterone
what can low testosterone lead to? Can lead to erectile dysfunction
what is the prototype for drugs for erectile dysfunction? Sildenafil (Viagra)
what are some contraindications with Sildenafil (Viagra) cardiac problems, nitrates (nitroglycerin), MI, stroke, HF, arrythmias, deformities of the penis
for Sildenafil (Viagra) what are some herbal/food interactions? avoid grapefruit juice bc it increases plasma concentrations, avoid high-fat meals bc it decreases absorption
what is the MOA for Sildenafil (Viagra) relaxes smooth muscle in cavernosa allowing increased blood flow to penis
what is the Administration for Sildenafil (Viagra)? avoid taking with high fat meals, avoid grapefruit juice, take it after dinner, or in the mood
Sildenafil (Viagra) pharm class is... phosphodiesterase (PDE)-5 inhibitor
what is an Adverse effect for Sildenafil (Viagra) hypotension, because it dilates vessels, flushing, HA, dizziness, rash, nasal congestion, diarrhea, UTI, chest pain, indigestion, blurred vision, priapism
what are the drugs for benign prostatic hyperplasia for? Blocks urethra
what are some common symptoms for drugs for benign prostatic hyperplasia? dribbling, nocturia, increased frequency, urgency, incomplete emptying of bladder, decreased forced
Alpha-adrenergic blockers --Tamsulosin (Flomax) is for? Relaxes smooth muscles cells in prostate, urethra, bladder neck
5 Alpha reductase for benign prostatic hyperplasia prototype is.. Finasteride (Proscar)
The Assesment for Finasteride (Proscar) includes...
what is the MAO for Finasteride (Proscar) inhibits 5 alpha reductase, shrinks the enlarged prostate
what is the admin for Finasteride (Proscar) pregnant nurses & pharmacists should avoid handling crushed tablets bc it can harm fetus, patients taking it cannot donate blood
what is the contraindication for Finasteride (Proscar) pregnancy/lactation, children
what is an adverse effect of Finasteride (Proscar)? sexual dysfunction
Drugs for disorders and conditions of the Female Reproductive inlcude... Estrogen and progesterone
What do you assess first?  female reproductive if they’re pregnant, if they have a hx of clots, stroke, CAD
Hormonal contraceptives contain... contain estrogen and progesterone
Combination contraceptives is... ethinyl estradiol and norethindrone (Ortho-Novum)
Pt education for Hormonal contraceptives? record duration and frequency of breakthrough bleeding, evaluate for possible pregnancy if 2 or more periods are missed, if taking orally, take it daily at same time, if missed, f/u with provider and use back up contraceptive method
what happens if you miss a day of hormonal contraceptives? if you don’t take them then, take as soon as remembered or 2 the next day, if you miss 3 days then ASSESS first if they had sex (might need plan b) then restart a new pack
Why 28 days? So you don’t miss one
Inert pills tx is? acne, endometriosis
what are some adverse effects of hormonal contraceptives? Nausea, pain, breast tenderness, weight gain, breakthrough bleeding, edema, changes in vision, HA, HTN
Plan B One-Step is... (levonorgestrel): (1 dose), take within 120 hours after unprotected sex
Plan B is.. (levonorgestrel) take within 72 hrs, 12 hours apart (2 doses)
what is the Mechanism of action for plan B prevents ovulation or implantation of fertilized egg; does not induce abortion
Estradiol and Norethindrone Black Box Warning is.. don’t take if smoking, it can increase risk for cardiovascular effects
Estradiol and Norethindrone Contraindications include.. smoking, breast cancer, thromboembolic events (stroke, MI, blood clots, CAD), pregnancy risk X, abnormal vaginal bleeding, jaundice
a drug to drug interaction with Estradiol and Norethindrone include.. carbamazepine, phenobarbital, warfarin, heparin, oral hypoglycemics, theophylline, imipramine
what is the brand name for Medroxyprogesterone Depo Provera
What is the MOA for depo provera? inhibits effect of estrogen on uterus and restores hormonal balance Used for Endometriosis, uterine bleeding, amenorrhea, and contraceptive
what is the pharm class for depo provera Progestin
what are some Adverse effects for depo provera weight gain, depression, nausea, vomiting, breakthrough bleeding, breast tenderness, amenorrhea, dysmenorrhea, thromboembolic events are contraindicated
what is the Administration for depo provera? Given IM q3mo, watch for site redness or swelling, pain at injection site.
what is the prototype for hormonal replacement Conjugated estrogen (Cenestin, Enjuvia)
Who can get Conjugated estrogen (Cenestin, Enjuvia) For women that had hysterectomy (removal of ovaries) and for postmenopausal
How can it be Administered? IV, pill
what are some Contraindications for Conjugated estrogen (Cenestin, Enjuvia) pregnant women, thromboembolic events, liver disease, breast cancer, abnormal uterine bleeding
Drugs for dysfunctional uterine bleeding.. Uterine stimulants and relaxants
Prototype for dysfunctional uterine bleeding.. Oxytocin
What is the pharm class for Oxytocin oxytocic hormone
what are some actions and uses for Oxytocin? induces labor, reduces hemorrhage after baby is delivered so it brings uterus back to normal
what is the MOA for Oxytocin... increases contractions
Which gland does it come from? Posterior pituitary gland
What are some drugs for emergency contraception and pharmacologic abortion Levonorgestrel
Alternative birth control: length of use Depot injections provides 3 months of protection
Alternative birth control: length of use Subdermal implants Provides contraception protection up to 3 years, goes into fatty tissue
Alternative birth control: length of use Transdermal implants 7 days then reapply patch for the first 3 weeks followed by patch-free week 4
Alternative birth control: length of use Vaginal route NuvaRing- Covered for 3 weeks
Alternative birth control: length of use Intrauterine Route (IUD) Marena- 5 years 3-6 yrs depending on brand
Drugs for bone and joint disorders -Calcitriol (Calcijex, Rocaltrol) - Administration? give with meals (2x a day)
Pharm class for -Calcitriol (Calcijex, Rocaltrol) bone resorption inhibitor
MOA for bone resorption inhibitor Calcitriol (Calcijex, Rocaltrol) elevates serum levels of calcium, reduces bone resorption, promotes intestinal absorption of calcium
What would you monitor for Calcitriol (Calcijex, Rocaltrol) electrolyte levels
Drugs for bone and joint disorders Raloxifene (Evista) MOA... decreases bone reabsorption and increases bone mass and density
Pharm class for -Raloxifene (Evista) selective estrogen receptor modulator
Primary use for-Raloxifene (Evista) is ... prevents osteoporosis in postmenopausal women, also reduces risk of breast cancer in women
Administration for -Raloxifene (Evista) is.. with or without food, pregnant category X, increase intake of calcium & vit D
What are some common effects with -Raloxifene (Evista) hot flashes, weight gain, leg cramps, migraine HA,
What is the Black Box Warning for Raloxifene (Evista) increases risk of venous thromboembolism and death from strokes in women with CAD or hx of thromboembolism
Pharmacotherapy for Joint Disorders Therapy of RA… First give NSAIDs, then steroids, then DMARD therapy.
Pharmacotherapy for Joint Disorders Methotrexate (Otrexup) :adverse effects? HA, sore throat, black tarry stools, bone marrow depression, gingivitis, mild leukopenia, nausea, ulcerative stomatitis, aplastic anemia, liver cirrhosis, nephrotoxicity, sudden death, pulmonary fibrosis, teratogenicity Folic acid reduces toxic effects
Pharmacotherapy for Joint Disorders Hydroxychloroquine (Plaquenil) adverse effects? s: anorexia, GI disturbances, loss of hair, HA, mood and mental changes, affects vision, photophobia, blacked out areas in visual fields.
Pharmacotherapy for Joint Disorders Hydroxychloroquine (Plaquenil) Mechanism of action: ? relieves inflammation of lupus, RA, and malaria
Pharmacotherapy for Joint Disorders Hydroxychloroquine (Plaquenil) check pts ..... Check pts eyes during treatment
Gout is... buildup of uric acid in the big toe
Gout is triggered by Triggered by alcohol, red meat
What do you give for GOUT Give endomethacin, naproxen, steroids
Prototype for Gout Allopurinol (Lopurin)
When do you take Allopurinol (Lopurin) Daily
Allopurinol (Lopurin) MOA is... inhibits synthesis of uric acid and decreases chances of acute gout attacks
Allopurinol (Lopurin) pharm class... Xanthine oxidase inhibitor
Allopurinol (Lopurin) primary use includes? decreases inflammation of gout
Cannot take if alcoholism, renal disease/impaired liver function, hx of peptic ulcers, lower GI disease, pregnancy, bone marrow depression
IMPORTANT Make sure to know what bph meds do
IMPORTANT Tamsulosin vs finasteride and the type of drugs
If someone comes in with gu, peptic ulcer disease. What meds do you question? NSAIDS on a daily basis.
Created by: samanthaweber01
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