relieve or suppress coughing by blocking the cough reflex in the medulla of the brain; alleviate nonproductive dry coughs and should not be used with productive coughs (ex: hydodan, vicks formula 44)
MECH: stool softener, laxative, surface-active agent, facilitates hydration of fecal material and softens feces
USE: prevent constipation, fecal impaction (rectal enema)
TOX/Other: do not use within 2 hour of other laxatives
Best for PREVENTION, not very effective treatment
Softens stool in 1-3 days
Diarrhea, ab cramps
No significant drug interxns
Safe in pregnancy but bulk agents are first line
Enoxaparin is a
Lovenox; Low molecular weight heparin; acute coronary syndromes, DVT prophylaxis and treatment
Enoxaparin side effects
Atrial fibrillation, heart failure; eczematous drug eruption, skin necrosis; hemorrhage; intracranial hemorhage, paraplegia; pneumonia
Some Xanthine Derivatives
theophylline , aminophylline, used to relax muscles
Xanthine Derivatives the main
action of xanthine-derivative bronchodilators is to relax the smooth muscle cells in the bronchi and blood vessels in the lungs. used as adjunctive therapy to treat the symptoms of bronchospasm in acute and chronic bronchial asthma, bronchitis, and emphysema and in treating neonatal apnea. They may also be used to treat acute pulmonary edema by promoting bronchodilation and diuresis.
Xanthine Derivatives Side effects are
Nausea, Vomiting, Anorexia, Gastro Reflux, Sinus Tachycardia, Extra Systole, Palpitations, V Disrhythmia, Increased Urniation, Hyperglycemia. AVOID CAFFEINE
Xanthine Derivatives will
Dilate the bronchi by relaxing the smooth muscles, Require blood level monitoring, Normal level: 10-20, >20 toxic range, N/V, >35 cardiac impairment, brain damage
Xanthine Derivatives CAUSES
MOA: Cause of bronchodilation by increasing levels of energy producing substance cAMP; Increases blood flow to heart. INDICATIONS:used to dilate airways in pt w/ asthma, chronic bronchitis or emphysema. *BREAKS DOWN INTO CAFFEINE! EXAMPLE: theophylline (Theo-Dur) CONTRAINDICATIONS:Allergy, cardiac problems, seizures, peptic ulcers, cautious use in pt w/ liver disease. ADVERSE EFFECT: Nausea, vomiting, anorexia, seizures, termor, anxiety, tachycardia *INTERACTIONS: Many food / drug
These inhalers should be used first, 60 second wait between puffs, and waiting 5 minutes before prescribed bronchodilators should be used.
Some steroid inhalers are
budesonide, fluticasone, becomethason, triamcinolone, flunisolide
steroid inhaler can be
topical to the lungs and do not cause the same problems as systemic corticosteroids, but can cause problems with candida infections in mouth.
Leukotriene receptor agonists wiil
Modify or inhibit the activity of leukotrienes with immune cells; prevent bronchial airway smooth muscle contraction, decrease mucus secretion, and reduce vascular permeability.
Leukotriene side effects
dyspepsia, liver toxicity. contraindicated in pts with abnormal liver function.
Leukotriene common side effects
- Montelukast: HA, Flu-like sx, Abdominal pain
- Zafirlukast: HA, Infection, Nausea, Diarrhea
- Zileuton: HA, Nausea, Sinusitis, Other upper respiratory sx
- Montelukast: Angioedema, Anaphylaxis, Churg-Strauss syndrome.
- Zafirlukast: Angioedema, Hepatitis, Churg-Strauss syndrome, Vasculitis.
- Zileuton: Hepatotoxicity, Interactions with warfarin and theophylline.
Some Antituberculars are
Isoniazid-neuropathy, give with B6
Rifampin- causes red bodily secretions
Ethambutol-causes visual problems, also w/ color perception
Second line drugs
rifampin, isoniazid(INH), pyrazinamide, ethambutol
Antituberculars more side effects
Peripheral Neuropathy (hands and feet), heptotoxicity, jaundice, depletes vitamin B6, GI distress
on EMPTY stomach1 Hour Before or 2 Hours After meals!!!!
Levadopa is a
Parkinson's drug; used with carbidopa in form of Sinemet; prevents peripheral decarboxylation of L-DOPA to form DA; converted once inside BBB; alleviates all clinical symptoms of Parkinson's, esp bradykinesia; may cause nausea and vomiting, cardiac stimulation, tachycardia, and postrual hypotension. Depression, delusions, anxiety and agitation
Levadopa on Empty stomach because
Food delays its absorption and High-protein foods will reduce therapeutic effects. Vitamin B 6 interfers with, so avoid increase Vitamin B 6 foods. Also, neutral amino acids compete with it for both absorption and for transport across the BBB.
NPH insulin is a
Intermediate acting insulin. Cloudy white appearance. Usually taken AFTER food
• Onset - 1.5 hrs
• Peak - 4-12 hours
• Duration - 16-24 hours
*If mixed with Novolog or Humalog, it must be injected within 3-5 mins*
The NPH insulins are
Humulin N, Novolin N
Insulin/Type I Diabetes
Onset: 15-30 min
Peak: 30-2.5 hours
Novolin N - Humulin N
Onset 1-3 hours
Peak 8 hours
Duration 20 hours
onset:1-2hr., clear, no peak, duration:24 hrs., cannot be combined
Enhances gastric emptying, tranquilizer. USED FOR NAUSEA EX: Reglan, Inapsine...phenergan, zofran
Ondansetron Reglan, Inapsine...phenergan, zofran
Control nausea and vomiting by blocking nerve impulses to the vomiting center of the brain
Antimetic side effects
used to induce vomiting (Apomorphine HCl, Ipecac syrup) must have Gag reflex
Opioid antidiarrheal. No more than 8 per day, take after loose BM
Lomotil is a
Diphenoxylate and Atropine
Reducing spasams in bladder, stomach, and intestines.