NCLEX * Pharmacology

63 terms by Atrinak

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Rx for Acitinic Keratoses

1. Flouracil( Carac,Efudex,Fluoroplex)2-6wk
2. Diclofenac sodium( Solaraze)3 mo
3. Imiquimod 5% cream( Aldara)4 mo
4. Aminovulinic acid (Levulan Kerastick) 14-18 hours + blue light exposure

Rx for Herpes Zoster

1. Acyclovir( Zovirax)
2. Valacyclovir (Valtrex)
3. Famciclovir( Famvir)

Rx for Atopic Dermatitis

Immunosuppressants
1. Methotrexate
2. Cyclosporine(Sandimmune)
3. Azathioprine(Imuran)

Topical Immuno
1. Tacrolimus(Protopic)
2. 1% pimecrolimus cream (Elidel)

Rx for Poison Ivy

1. Bentoquatam-prevention only
2. Calamine lotion
3. Hydrocortisone
4. Isopropanol
5.Zinc acetate

Rx for Psoriasis(Topical)

1. Anthralin(Dritho-Scalp,Psoriatec) ovrnight
2. Calcipotriene(Dovonex) vit D
3. Coal tar
4. Glucocorticoids
5. Keratolytics( salicylic,sulfur)
6. Tazarotene(Tazorac) vit A

Rx for Psoriasis(Systemic)

1. Acitretin( Soriatane)
2. Cyclosporine ( Neoral)
3. Methotrxate
Systemic Biological
1. Alefacept( Amevive)
2. Ustekinumab( Stelara)

Rx for Psoriasis( Phototherapy)

1. Coal tar + UVB
2. Psoralen + UVA

Busulfan(Myleran,Busulfex)

Alkylating antineoplastic; may cause Hyperuricemia

Chlorambucil (Leukoran)

Alkylating antineoplastic; May cause gondal suppression and Hyperuricemia

Mechlorethamine( Mustargen)

Alkylating antineoplastic; May cause gondal suppression and Hyperuricemia

Cisplatin(Platinol-AQ)

Alkylating antineoplastic; A platinum compound, may cause ototoxicity, tinnitus, hypokalemia, hypocalcemia,hypo magnesia,and nephrotoxicity.

Cyclophosphamide( Cytoxan,Neosar)

Alkylating antineoplastic; May cause alopecia,gonadal suppression,hemorrhagic cystitis,and hematuria.
2. Administered without food

Ifosfamide(Ifex)

Alkylating antineoplastic; given with Mesna(Mesnex) to reduce the potential of idlers IDE induced cystitis.

Daunorubicin(daunoXome)

Antibiotic antineoplastic; may cause congestive heart failure and dysrhythmia

Doxorubicin(Adriamycin,Doxil)

Antibiotic antineoplastic; may cause cardiotoxicity,cardiomyopathy,and ECG changes.
2. Dexrazoxane is administered with Doxorubicin to reduce cardiomyopathy

Idarubicin(Indamycin)

Antibiotic antineoplastic;may cause cardiotoxicity,cardiomyopathy,and ECG changes.

Bleomycin(Blenoxane)

Antibiotic antineoplastic; pulmonary toxicity can occur with this medication ; pulmonary status is monitored.

Cytarabine(Cytosar-U,DepoCyt, Tarabine PFS)

Antimetabolite antineoplastic; may cause alopecia,stomatitis,Hyperuricemia, and hepatotoxicity

Floururacil(Adrucil)

Antimetabolite antineoplastic; may cause alopecia,stomatitis, diarrhea, photo toxicity reactions,and cerebella dysfunction
2. Assess for cerebella dysfx(dizziness,weakness,ataxia)
3. Assess for diarrhea and stomatitis; may warrant DC
4. Use sunscreen and wear protective clothing

Mercaptopurine(Purinethol)

Antimetabolite antineoplastic; may cause Hyperuricemia and hepatotoxicity

Methotrexate(Rheumatrx,Trexall)

Antimetabolite antineoplastic; may cause alopecia,stomatitis,Hyperuricemia,photosensitivity,hepatoxicity,and hematological,gastrointestinal and skin toxicity.
2. Use sunscreen and wear protective clothing
3. Administer leukovorin(folinic acid or citrovorum factor) to prevent toxicity

Vincristine( Oncovin,Vincasar)

Mitotic inhibitor antineoplastic; neurotoxicity presents as nibness,tingling in fingers and toes,constipation and paralytic ileum.

Mitotane(Lysodren)

Hormonal antineoplastic; may cause hemorrhagic cystitis, hypouricemia,and hyperchloesterolemia

Monoclonoal antibody antineoplastics

Work at gene level
1. Rituximad( Rituxan)
2. Tositumomab( Bexxar)
3. Trastuzumab(Herceptin)
4. Aletuzmab( Campath)
5.Cetuximab(Erbitux)

Rx for Diabetes Insipidus

1. Vasopressin tannate ( Pitressin)
2. Desmopressin acetate(DDAVP, Stimate)

Rx for SIADH

1. Normal or Hypertonic saline

Rx for Addisonian Crisis

1. Hydrocortisone sodium succinate(Solu-Cortef)

Rx for Hyperaldosteronism(Conn's)

1. Spirolactone(Aldactone)

Rx for Pheochromocytoma

1. B blockers

Rx for Hypothyroidism

1. Levothyroxine sodium(Synthroid); take on empty stomach

Rx for Giardiasis

1. Metronidazole( Flagyl)
2. Nitazoxandine( Alinia)
3. Albendazole (Albenza)

Rx for Pinworms

1. Mebendazole( Vermox)
2. Pyrantel pamoate (Pin-Rid, Antiminth)
3. Albendazole (Albenza)

Rx for Hyperthyroidism

1. PTU

Rx for Hyperparathyroidism

1. Furosemide( Lasix)
2. Calcitonin (Calcimar)
3. Phosphates

Rx for Severe Hypoglycemia

1. IM or SQ injection of glucagon
Or
2. Injection of 25-50 ml of 50% dextrose in water

Antacids

Indicated for GERD and PUD.
React with gastric acid to produce neutral salts or salts of low acidity; taken 1-3 hours after each meal and at bedtime followed with a glass of water or milk; allow 1 hr between antacid administration and other meds

Misoprostol(Cytotec)

Gastric protectant; antisecretory med that enhances mucosal defenses; administered with meals; causes abdominal pain and diarrhea.

Sulcralfate(Carafate)

Gastric protectant; creates a protective barrier against acid and pepsin; taken orally on an empty stomach; may cause constipation; can impede the absorption of warfarin sodium( Coumadin), phenytoin( Dilantin), theophylline, digoxin(Lanoxin) and some abx; should be administered at least 2 hours apart from these meds.

Pirenzepine(Gastrozepine)

Muscarinic antagonist; suppresses acid secretion by blocking muscarinic cholinergic receptors.

H2 Receptor Antagonist

Indicated for GERD, heartburn, and PUD.

Suppress secretion of gastric acid and prevent stress ulcers; does not need to be taken with food as it decreases the rate of absorption.

Cimetidine( Tagamet)

H2 Receptor Antagonist; can be administer orally,IV or IM; IV can cause hypotension and dysrhythmias;does not need to be taken with food; antacids can decrease the absorption of cimetidine so they need to be administered 1 hour apart from each other; dosage reduction in people with renal impairment; can cross blood-brain barrier to cause confusion,agitation,psychosis,depression,anxiety or disorientation.

Caution: if administer with warfarin sodium( Coumadin),phenytoin(Dilantin),theophylline, or lidocaine the dosages of these medications should be reduced.

Ranitidine(Zantac)

H2 Receptor Antagonist; can be administered orally,IM or IV; side effects are uncommon and does not penetrate blood brain barrier; not affected by food

Fmotidine(Pepcid) and Nizatidine(Axid)

H2Receptor Antagonists; similar to famotidine and cimetidine; do not need to be administered with food.

Proton Pump Inhibitor

Proton Pump Inhibitor;Indicated for active ulcer disease,erosive esophagitis, and pathological hypersecretory conditions.

Supress gastric acid secretion; common side effects headache,diarrhea,abdominal pain, and nausea; contraindicated in hypersensitivity

Esomeprazole( Nexium)

Proton Pump Inhibitor;Indicated for active ulcer disease,erosive esophagitis, and pathological hypersecretory conditions.

Supress gastric acid secretion; common side effects headache,diarrhea,abdominal pain, and nausea; contraindicated in hypersensitivity

Lansoprazole( Prevacid)

Proton Pump Inhibitor;Indicated for active ulcer disease,erosive esophagitis, and pathological hypersecretory conditions.

Supress gastric acid secretion; common side effects headache,diarrhea,abdominal pain, and nausea; contraindicated in hypersensitivity

Omeprazole(Prilosec)

Proton Pump Inhibitor;Indicated for active ulcer disease,erosive esophagitis, and pathological hypersecretory conditions.

Supress gastric acid secretion; common side effects headache,diarrhea,abdominal pain, and nausea; contraindicated in hypersensitivity

Pantoprazole(Protonix)

Proton Pump Inhibitor;Indicated for active ulcer disease,erosive esophagitis, and pathological hypersecretory conditions.

Supress gastric acid secretion; common side effects headache,diarrhea,abdominal pain, and nausea; contraindicated in hypersensitivity

Rabeprazole( Aciphex)

Proton Pump Inhibitor;Indicated for active ulcer disease,erosive esophagitis, and pathological hypersecretory conditions.

Supress gastric acid secretion; common side effects headache,diarrhea,abdominal pain, and nausea; contraindicated in hypersensitivity

Rx for H. Pylori

1. Triple therapy: Esomeprazole( Nexium),Amoxicillin( Amoxil), Clarithromycin( Biaxin)
2. Quadruple therapy:
A. Esomeprazole(Nexium), metronidazole( Flagyl), tetracycline, bismuth e
B. Ritidine(Zantac), metronidazole( Flagyl), tetracycline, bismuth subsalicylate

Metoclopramide( Reglan)

Prokinetic agent; Indicated for GERD and paralytic ileus

Stimulates gastric motility of the upper GI tract and increases the rate of gastric emptying; may cause restlessness, drowsiness, insomnia,headache, hypertensive crisis in pt c pheochromocytoma,parkinsonian rx(discontinue)or extrapyramidal reactions; administered 30 minutes before meals and at bedtime; contraindicated in clients with mechanical obstruction,perforation,or GI hemorrhage

Alcohol,sedatives,cyclosporine,tranquilizers can cause additive effect

Anticholinergics and opiod analgesic can antagonize

Colesevelam( Welchol)

Bile acid Sequestrants; indicated for hyperchloesterolemia, biliary obstruction, and primeur associated with biliary disease

Absorb and combine with intestinal bile salts which are then secreted in the feces prevent intestinal reabsorption; side effects include nausea,bloating and constipation; stool softeners and other sources of fiber can be used to abate GI side effects; use caution with pts suspected to have bowel obstruction or severe constipation

Cholestyramine(Questran, Prevalite)

Bile acid Sequestrants; indicated for hyperchloesterolemia, biliary obstruction, and primeur associated with biliary disease

Absorb and combine with intestinal bile salts which are then secreted in the feces prevent intestinal reabsorption; side effects include nausea,bloating and constipation; stool softeners and other sources of fiber can be used to abate GI side effects; use caution with pts suspected to have bowel obstruction or severe constipation

Colestipol(Colestid)

Bile acid Sequestrants; indicated for hyperchloesterolemia, biliary obstruction, and primeur associated with biliary disease

Absorb and combine with intestinal bile salts which are then secreted in the feces prevent intestinal reabsorption; side effects include nausea,bloating and constipation; stool softeners and other sources of fiber can be used to abate GI side effects; use caution with pts suspected to have bowel obstruction or severe constipation

Rx for Hepatic Encephalopathy

Lactulose(Constulose, Enulose)

Promotes increased perstalsis and bowel evacuation,expelling ammonia from the colon and lowering ammonia level; improves protein tolerance in clients with advanced hepatic cirrhosis; administered as oral syrup or rectally

Rx for Chronic Constipation

Lactulose(Constulose, Enulose)

Promotes increased perstalsis and bowel evacuation,expelling ammonia from the colon and lowering ammonia level; improves protein tolerance in clients with advanced hepatic cirrhosis; administered as oral syrup or rectally

Pancreatin

Indicated to supplement or replace pancreatic enzymes and improve nutritional status and reduce the amount of fatty stools

Should be taken with all meals and snacks; side effects include nausea,abdominal cramps or pain,and diarrhea; products that contain calcium carbonate or magnesium hydroxide interfere with med action

Pancrealipase( pancreas MT,Viokase, Lipram, Pancrecarb MS)

Indicated to supplement or replace pancreatic enzymes and improve nutritional status and reduce the amount of fatty stools

Should be taken with all meals and snacks; side effects include nausea,abdominal cramps or pain,and diarrhea; products that contain calcium carbonate or magnesium hydroxide interfere with med action

Rx for IBS(Antimicrobials)

1. Ciproflaxin(Cipro)
2.Metronidazole(Flagyl)

Prescribed to prevent or treat secondary infection

Rx for IBS( 5- Aminosalicylates)

1. Balsalazide( Colazal)
2. Mesalamine( Rowasa, Asacol, Pentasa, Canasa)
3. Olsalazine ( Dipentum)
4. Sulfalazine( Azulfidine)

Decrease GI inflammation; adverse effects include nausea,rash,arthralgia, and hematological disorders

Rx for IBS( Corticosteroids)

1. Budesonide( Entocort-EC)
2. Prednisone

Act as an anti- inflammatory to decrease GI inflammation

Rx for IBS ( Immunosuppressants)

1. Azathioprine( Imuran)
2. Cyclosporine (Sandimmune, Neoral, Gengraf)
3. Mercaptopurine( Purinethol)

Suppress the immune system; can cause PA creators and neutropenia secondary to bone marrow depression; used for those who have not responded to conventional therapy.

Rx for IBS( Immunomodulators)

1. Adalimumab( Humira)
2. Certolizumab( Cimzia)
3. Infliximab( Remicade)
4. Natalizumab( Tysabri)

Monoclonal antibodies that modulate the immune response to induce and maintain remission

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