Pharm Test 2

Mechanism of action: to inhibit release of FSH and LH, thus preventing ovulation

Primary use: as contraceptive, for improvement in menstrual cycle regularity, to decrease incidence of dysmenorrhea

• Adverse effects: edema, nausea, abdominal cramps, dysmenorrhea,breast tenderness, fatigue, Skin rash, acne, headache, weight gain, midcycle breakthrough bleeding, vaginal candidiasis, photosensitivity,
• changes in urinary patterns

Serious cardiovascular side effects more common in smokers

Mechanism of action: replacement for female sex hormones, to exert positive metabolic effects

Primary use: for postmenopausal replacement therapy

Also to treat abnormal uterine bleeding due to hormonal imbalance

Adverse effects: nausea, fluid retention, edema, breast tenderness, abdominal cramps and bloating, acute pancreatitis, appetite changes, acne, mental depression, decreased libido, headache, fatigue, nervousness, weight gain

Mechanism of action: Inhibits effect of estrogen on uterus, restores normal hormonal balance

Primary use: to treat dysfunctional uterine bleeding, secondary amenorrhea, contraception

May also be given IM for palliation of metastatic uterine or renal carcinoma

Adverse effects: breakthrough bleeding, breast tenderness, weight gain, depression, hypertension, nausea, vomiting, dysmenorrhea, and vaginal candidiasis

Most serious side effect: increased risk for thromboembolic disease

• Mechanism of action: to induce labor by increasing frequency and force of uterine
• contractions

Primary use: as drug of choice for inducing labor

• Adverse effects: Complications in fetus include dysrhythmias or intracranial
• hemorrhage

Serious complications in mother may include uterine rupture, seizures, coma

Mechanism of action: Stimulates RNA synthesis and protein metabolism

Primary use: for treatment of hypogonadism in males

Adverse effects: virilization, salt and water often retained, causes edema, liver damage, acne and skin irritation

• Mechanism of action: Relaxes smooth muscle in corpus cavernosum, blocks
• enzyme phosphodiesterase-5, allows increased blood flow into penis

Primary use: to treat erectile dysfunction

Adverse effects: Most serious is hypotension, headache, dizziness, flushing, rash, nasal congestion, diarrhea, dyspepsia, UTI, chest pain, indigestion, blurred vision, changes in color perception, priapism

Mechanism of action: Inhibits 5-alpha-reductase

Primary use: Promotes shrinkage of enlarged prostates, also prescribed to promote hair regrowth

Adverse effects: sexual dysfunction, impotence, diminished libido, ejaculatory dysfunction

May be administered within 72 hours after unprotected sex

Prevents implantation of fertilized egg

Two doses, 12 hours apart; most effective when taken within 120 hours (5 days) of unprotected sex

Pharmacological abortion

Mechanism of action: to induce labor by increasing frequency and force of uterine contractions

Primary use: as drug of choice for inducing labor

Adverse effects: Complications in fetus include dysrhythmias or intracranial hemorrhage. Serious complications in mother may include uterine rupture, seizures, coma

Use: Prolong pregnancy

Adverse effects: complete heart block, circulatory collapse, respiratory paralysis

reduction of high prolactin levels

Drug of choice for female infertility due to lack of ovulation

• Stimulates release of LH
• Results in maturation of increased number of ovarian follicles
• Promotion of follicle maturation and ovulation

Prevention of premature ovulation or control of endometriosis

Suppression of FSH and control of endometriosis

Used to treat hypogonadism; increase libido and correct erectile dysfunction

VS.

• Testosterone-like compounds
• Frequently abused by athletes, even though illegal

Action – alpha1, alpha2, beta1, and beta2 agonist

Potent Inotropic – force of contractioins

Use – in emergencies anaphylaxis, bronchospasm, cardiac arrest, potent vasoconstrictor

Route – inhaled, SQ, IV, topically (lidocaine)

Side Effects – A/N/V, tremors, tachycardia, pulmonary edema, HTN

Precautions – (b/c it increases all of these) use cautiously with HTN, BPH, DM, Hyperglycemia, Hyperthyroidism

Similar to epi

Does NOT stimulate beta2

Does not cause hypoglycemia

Cardiac and critical care

Hypotension, shocky states – cardiac arrest, potent vasoconstrictor

Stimulate alpha1 and beta2 – “spills over to others”

Used topically to tx rhinitis and sinus congestion

Mechanism of action: potent vasoconstrictor - decongestant

To stimulate the sympathetic nervous system directly/indirectly

Produce many of the same responses as the anticholinergics

Used primarily as antihypertensive agents.

Action – stimulates beta1&2 receptors

Use – bronchospasm, asthma, bronchitis, emphysema, CHF, heart block, shock and cardiac arrest

Contraindicated – CAD, DM, tachycardia, tachydysrhythmias, sensitivity to SNS stimulation

Adverse effects – N/V, tachycardia, dysrhythmias, hypertension, hypotension

Nsg Resp – start with small doses and increase slowly as tolerated, monitor pt

Mimics endogenous dopamine – stimulates Beta1 receptors, some Alpha1 too

Action – dose related

Low doses – increased renal perfusion Moderate doses – increase force of heart High doses – vasoconstriction, increased BP, decreased renal perfusion

Similar to dopamine in action, increased contractility, increased SV

Used to increase cardiac output, and tx CHF and cardiogenic shock

Selective for beta 2 receptors

Use – tx bronchospasm, asthma, rapid short acting – rescue inhaler

Route – inhaled, PO

Side effects – tremor, tachycardia, dysrhythmia, dizziness

Nsg Resp – avoid use with HTN, severe cardiac disease, avoid taking with MAOIs – psych/antidepressant, do not use w/increase BP

Similar to albuterol

Mechanism of action: to inhibit the sympathetic nervous system

Primary use: hypertension, dysrhythmias, angina, heart failure, benign prostatic hypertrophy, narrow-angle glaucoma

Adverse effects: dizziness, drowsiness, headache, loss of energy and strength, palpitations, dry mouth, 1st dose syncope

Similar to prazosin

Used for HTN and BPH, longer acting

Use – PVD, and tx tissue necrosis from extravasation of certain meds

Use – tx dysrhythmias, HTN, angina, MI, migraine prophylaxis

Action – blocks beta1 and beta2 adrenergic receptor sites

Side effects – bradycardia, H/A, fatigue, hyper/hypoglycemia, blood dyscrasias, laryngospasm, sexual disfunction

Has limited usage. Constricts the pupils

Use – tx Glaucoma

Side effects – stinging/burning topically

Also causes systemic side effects 

Antidote – atropine sulfate

Mechanism of action: to the cholinergic (muscarinic) receptor

Uses: urinary retention, abdominal distention

Adverse effects: N/V/D, flushing, salivation, sweating, increased muscle tone, urinary frequency, bradycardia, orthostatic hypotension miosis, abd discomfort, muscle weakness, acute asthmatic attach, heart block, cardiac arrest

Use – smoking cessation, nicotine replacement.

Route – gum, patch, nasal spray

Nsg Resp – avoid tobacco products

varenicline (Chantix) – similar

Use – tx myasthenia gravis, postop urinary retention, paralytic ileus

Action – blocks enzyme to increase acetylcholine at receptor sites

Action – blocks acetylcholine, increases heart rate, paralyzing the iris sphincter

Use – as preoperative medication, antispasmodic drug for tx peptic ulcers, to increase heart rate, to dilate pupils for eye exams

Side effects – dry mouth, blurred vision, constipation, urinary retention, H/A, N, decreased perspiration, dry skin, abd distension, tachycardia, photophobia, hypo/hypertension, impotence, coma

Used to tx parkinson’s disease and EPS

Used with asthma, and rhinorrhea

Used for motion sickness, preanesthetic

Anticholinergics

Synthetic anticholinergic

Mechanism of action: Attaches to DNA and disrupts replication

Primary use: to treat wide variety of cancers, including Hodgkin's disease, lymphoma, multiple myeloma, breast cancer, ovarian cancer

Adverse effects: immunosuppressant effects, thrombocytopenia, nausea, vomiting, anorexia, diarrhea, alopecia, hemorrhagic cystitis

Alkylating Agents

• Mechanism of action: Blocks synthesis of folic acid
• (vitamin B9) to inhibit replication

• Primary use: to treat choriocarcinoma,
• osteogenic sarcoma, leukemias, head and neck cancers, breast carcinoma, lung
• carcinoma

• Adverse effects: fatal bone marrow toxicity at high doses, hemorrhage and bruising, low
• platelet counts, nausea, vomiting, anorexia, gastrointestinal ulceration, intestinal bleeding

Mechanism of action: Attaches to DNA, distorts double helical structure and prevents normal DNA and RNA synthesis

Primary use: solid tumors of the lung, breast, ovary, and bladder, and for various leukemias and lymphomas

Adverse effects: cardiotoxicity, dysrhythmias, irreversible heart failure, lower blood cell counts, nausea, vomiting

Antitumor Antibiotics

• Mitotic Inhibitors/Natural Products
• Vinca alkaloids

• Taxanes
• Mitotic Inhibitors/Natural Products

Mechanism of action: cell cycle–specific (M-phase) agent that kills cancer cells by preventing their ability to complete mitosis

Primary use: treatment of Hodgkin's and non-Hodgkin's lymphomas, leukemias, Kaposi's sarcoma, Wilms' tumor, bladder carcinoma, breast carcinoma

Adverse effects: nervous system toxicity, numbness and tingling in limbs, muscular weakness, loss of neural reflexes, pain, paralytic ileus, constipation, alopecia

Hormone/Hormone Antagonists

Mechanism of action: Blocks estrogen receptors on breast cancer cells

Primary use: patients with breast cancer. Also given to high-risk patients to prevent disease

Adverse effects: nausea and vomiting, association with increased risk of endometrial cancer and thromboembolic disease, hot flashes, fluid retention, vaginal discharges common

Monoclonal antibodies (MABs) – targets and binds to a specific CA cell

Interleukins

Biologic Response Modifiers, Immune Therapies

Interferons