-
cholinergics:
Bethanecol (urecholine) >>banner drug for this class altho not used as frequently now
- Uses:
- slowing of the heart rate, increased sweating, salivation, bronchial secretions, and gastric acid secretions.
- Bethanecol is used to treat unobstructed urinary retention
- adverse reations:
- hyptotension, bradycardia, excessive salivation, increased secretion of gastric acid, abdominal cramps, diarrhea
-
anti-cholinergics:
atrophine
ipatropium
Trick to remember:
cant see
cant pee
cant spit
cant poop
- uses:
- Dries respiratory & GI secretions; increases heart rate in cardiac emergencies. When these drugs are used in inhaler form it can help people breathe easier.
- atrophine is used to dry up respiratory and GI secretions before going to surgery so excess secretions wont aspirate them
Ipatropium is used to relieve bronchospasms in COPD
- adverse reactions:
- Dry mouth, blurred vision, urinary retention, constipation,absence of sweating, trachycardia
-
Catecholamines: cannot be taken by mouth, very short half life, and typically used in emergency situations
epinephrine
norepinephrine
dopamine increases heart rate and esp blood pressure. given to patients in small doses to help in renal failure. but large doses will be toxic to kidneys
dobutamine (dobutrex) one actual effect: helps patients during heart failure
isoproterenol (isuprel)
- uses:
- increases heart rate, blood pressure, and blood glucose levels, stimulates renal function, promotes bronchodilation, treats hypotension.
- epinephrine is the drug of choice to treat anaphylactic shock
- adverse reactions:
- tachycardia, anginal pain
-
Non-catecholamines
ephedrine
phenylephrine
terbutaline (brethine)
- uses:
- used as a stimulant, nasal decongestant, appetite suppressant, treats hypotension.
- terbutaline is a bronchodilator (beta-2 agonist) and delays pre-term labor
- adverse reactions:
- tachycardia, arrhythmia, tremors, hypertension
-
Alpha agonists:
clonidine (catapres)
methyldopa (aldomet)
- uses:
- to treat hypertension (clonidine may also be used in an epidural infusion to relieve pain)
- adverse reactions:
- sedation, dry mouth and nose, bradycardia, orthostatic hypotension, impotence
-
Alpha antagonists (blockers)
doxasosin (cardura)
prazosin (minipress)
terazosin (hytrin)
tamsulosin (flomax)
tricks:
generic names end in "-osin"
remember- alpha-osin
- uses:
- the first three are used to treat hypertension, and Tamsulosin is used to treat the symptoms of benign prostatic hyperplasia (BPH) common in men-they cant properly empty bladder
- adverse reactions:
- hypotension, reflex tachycardia, nasal congestion, inhibition of ejaculation
-
Bronchodilators: opens up airways
Beta-2 Agonists:
salmeterol
pirbuterol
Methylxanthines:
aminophylline
tricks:
generic names end in "-ol"
1/2 of beta blockers "-olol"
uses: brochodilators to treat asthma, COPD, etc
- adverse reactions:
- cardiac arrhythmias, angina, headache, tremors
-
Beta blockers:
metoprolol (toprol)
atenolol (tenormin)
tricks:
Lots of little betas laughing out loud
Generic names end in "-olol"
- uses:
- useful in the treatment of hypertension, angina, heart failure.will slow heart rate and lower blood pressure which dumps the hearts workload
- adverse reactions:
- must be careful before giving to patients because their blood pressure must be high enough to support taking this medication. also must be sure patient isnt bradycardic (heart rate under 60bpm in adult).
- bradycardia, reduced cardiac output
-
Levodopa/carbidopa (sinemet)
tricks:
-dopa
- uses:
- to treat Parkinson's disease
- adverse reactions:
- nausea, vomiting, dyskinesias, postural hypotension, dysrhythmias, psychosis, dark urination and sweat
-
Anti-Epileptics:
phenytoin (dilantin)
phenobarbital
carbamazepine (tegretol) may be used to treat migrain headaches
valproic acid (depakote) may be used to treat migrain headaches
gabapentin (neurontin)
- uses:
- used to treat and/or prevent seizures associated with epilepsy.
- gabapentin may also be used as adjuvant therapy in the treatment of peripheral neuropathy
- adverse reactions:
- vary from drug to drug
-
muscle relaxants:
baclofen (lioresal)
carisoprodol (soma)
cyclobenzaprine (flexeril)
diazepam (valium) also in the benzodiazepines class
- uses:
- used to relieve muscle spasms and depression
- adverse reactions:
- CNS depression, liver damage
-
Spasticity: severe muscle spasms
dantrolene (dantrium)
- uses:
- to treat spasticity from other conditions
- adverse reactions:
- CNS depression, liver damage, muscle weakness
-
opiods:
morphine banner drug
hydromorphone (dilaudid) more potent then morphine
meperidine (demerol)
codeine
hydrocodone (lortab)
oxycodone (percocet; oxy contin) sustained release
fentanyl (sublimaze; duragesic patch) best kinds of treatment for chronic pain bc its better to treat slowly then immediately
methadone utilized for chronic pain and coming down from opiod addiction. but must be cautious when mixing with antidepressant drugs
trick:
many of the generic names end in "-one"
- uses:
- relief of moderate to severe pain.
- codeine and hydrocodone also have anti-tussive effects coughing
- adverse reactions:
- respiratory depression, constipation, othostatic hypotension, urinary retention, and the potential for tolerance and/or dependence
-
opioid antagonists:
naloxone (narcan)
naltrexone (ReVia)
nalmefene (revex)
tricks:
the generic names for most of these begin with "nal-"
- uses:
- reversal of sedation/oversedation from opiods (narcan has a 2hr half-life and may require re-dosing. they wake up and a few hours later knock back out)
adverse reactions: can cause agitation and vomiting if given too fast and induce withdrawal in opioid addicts
-
opioid agonists/antagonists: for patients that were addicted to opioids or other kinds of pain meds but we must treat it. so this group combines opioids and opioid antagonists for this purpose. also safer for pregnant women
pentazocine (talwin)
nalbuphine (nubaine)
butorphanol (stadol)
buprenorphine (buprenex)
- uses:
- relief of mild to moderate pain with very little potential for abuse and little respiratory depression
- adverse reactions:
- may be less potent in relieving pain; may stimulate withdrawal in opioids addicts
-
tramadol (ultram)
non-opioid centrally acting analgesic
- uses:
- essentially as effective in the treatment of pain as Codeine combined with ASA or Tylenold. Minimal potential for tolerance, dependence or respiratory depression
- adverse reactions:
- sedation, dizziness, headache, dry mouth, constipation, seizures
-
migraine headache drugs: pain on one side of the head, nausea, vomiting, light sensitivity, sound sensitivity, very painful. will happen more then once
ergot alkaloids:
ergotamine drug of choice
"triptans":
sumatriptan (imitrex)
Preventive therapy:
beta blockers:
propranolol (inderal)
tricyclic antidepressants:
amitriptyline (elavil)
anti-epileptic drugs:
depakote
topamax
gabapentin
gabitril
estrogens
calcium channel blockers:
verapamil
tricks:
"ergot"
generic names will end in "-triptan"
- uses:
- ergotamine is the drug of choice for stopping an ongoing migraine
imitrex is taken to stop an ongoing mirgraine
- adverse reactions:
- usually well tolerated-can cause nausea and vomiting in some (hard to tell if its the drug or the headache causing this)
triptans are usually well tolerated-may cause coronary vasospasm
-
Nsaid (1st generation):
acetyl salicyclic acid (ASA) aspirin
- uses:
- treatment of mild to moderate pain, reduce inflammation, reduce fever, and prevent platelet aggregation and reduce heart attacks and strokes
- adverse reactions:
- GI upset and/or bleeding.
- cannot give to children under 16, esp with a viral illness due to potiental for Reye's syndrome.
- overdosage results in salicylism (tinnitus, nausea, vomiting, etc)
-
Nsaid (1st generation):
ibuprofen (motrin)
naproxen (aleve)
ketoprofen
Trick:
many of the generic names end in "-profen"
- uses:
- analgesic, anti-pyretic, anti inflammatory
- adverse reactions:
- generally well tolerated.
- much less stomach upset then ASA
- may pose a risk to patients with hypertension or heart disease and rarely causes Stevens-Johnson syndrome
-
2nd generation NSAIDS:
celecoxib (celebrex)
trick:
only one drug now on the market, ends in "-coxib"
- uses:
- osteoarthritis, rheumatoid arthritis, acute pain with inflammation
- adverse reactions:
- dyspepsia, GI ulcers, potential CV risk, renal toxicity.
- contraindicated in those with sulfonamide allergy this gets missed a lot by doctors so you may need to watch this as a nurse
-
acetaminophen (tylenol)
trick:
anytime you see "-apap" or a pain med ending in "-cet" tylenol is there
drugs like lortab or oxycodone, tylenol is added to increase pain control. no more than 4g of tylenold per day. so must watch for other drugs that have tylenol added
- uses:
- analgesic, anti-pyretic
- has essentially no anti-inflammatory effects
- adverse reactions:
- hepatotoxicity (toxicity to the liver)
acetylcysteine (mucomyst, acetadote) is the antidote for tylenol overdose
-
Antihistamines;
(1st generation):
diphenhydramine (benadryl)
chlorpheniramine (chlortrimeton)
(2nd generation):
loratadine (claritin)
fexofenadine (allegra)
ceftirizine (zyrtec)
trick:
usually the generic names will end in "-amine"
- uses:
- used to treat mild to severe allergies, colds, motion sickness, and insomnia
second generation antihistamines are used to treat mild to severe allergies
- adverse reactions:
- first gen: sedation (altho children and some adults may have the opposite reaction), CNS effects, anti-cholinergic effects
second gen: essentially no sedation with these
-
glucocorticoids (corticosteroids are exact same thing)
hydrocortisone
dexamethasone (decadron)
prednisone
methylprednisolone (solumedrol)
trick:
most of the generic names end in "-sone" sometimes "-lone"
- uses:
- used to reduce inflammation in rheumatoid arthritis, asthma, lupus, and other inflammatory conditions
- adverse reactions:
- adrenal insufficiency adrenal gland gets lazy, osteoporosis softening of bone, glucose intolerance
-
Leukotriene (substances that have to do with allergic reations)modifiers:
montelukast (singular) usually patients are instructed to take these at night between 5-7 once a day by mouth
zafirlukast (accolate)
Trick:
most generic name will end in "-kast"
- uses:
- decrease inflammation, bronchoconstriction, and mucus production in asthma, COPD
- adverse reactions:
- liver injury, headache, GI disturbances
-
tricyclic antidepressants oldest antidepressants; three rings to these drugs:
amitriptyline (elavil)
nortriptyline (pamelor)
Trick:
some will end in "-triptyline"
- uses:
- primarily to treatment of mild to moderate depression; bipolar disorder not appropriate to just give an antidepressant to bipolar; must treat other symptoms, neuropathy pain, or prevention of migraine headaches
- adverse reactions:
- orthostatic hypotension; anticholinergic effects, sedation, cardiac toxcity, seizures, suicide attempts (most likely successful)
- these effects are why SSRI's are more commonly used
-
Seletive serotonin reuptake inhibitors (SSRIs):
fluoxetine (prozac)
escitalopram (lexapro)
citalopram (celexa)
paroxetine (paxil)
sertraline (zoloft)
trick:
generic names may end in "-oxetine" or "-pram"
- uses:
- treatment of mild to moderate depression with fewer side effects then TCAs
- adverse reactions:
- CNS stimulation, sexual side effects, weight gain, dizziness, fatigue, potential for serotonin syndrome
-
Monoamine oxidase inhibitors (MAOIs)
Nardil
Marplan
Parnate
trick:
conehead names
- uses:
- treatment of profound depression that has not responded to other more first line therapies
- adverse reactions:
- hypertensive crisis, orthostatic hypertension, MANY drug and food interactions
-
benzodiazepines
alprazolam (xanax)
diazepam (valium)
lorazepam (ativan)
midazolam (versed)
trick:
generic names will generally end in "-pam" or "-lam"
- uses:
- used as a sedative to aid in the relief of anxiety or to promote sleep.
- drugs of choice for treatment of insomnia.
- valium is also used as a muscle relaxant and to treat status epilepticus.
- Lorazepam may also be used to treat status epilepticus, and
- versed is used for conscious sedation
- adverse reactions:
- CNS depression, paradoxical effects, physical dependence, abuse
antidote for overdose is Flumazenil (Romaxicon)
-
Benzodiazepine-like drugs:
ambien
sonata
lunesta
- adverse effects:
- drowsiness, dizziness, headache, sleep-eating, sleep-driving
-
barbiturates (are older then benzodiazepines but worse side effects):
phenobarbital
secobarbital (seconal)
tricks:
end in "-barbital"
- uses:
- daytime sedation, induction of sleep, suppression of seizures, general anesthesia
- adverse reactions:
- respiratory depression, suicide, CNS depression, tolerance, abuse, hangover
-
diuretics:
thiazide diuretics:
hydrochlorothiazide (HCTZ)
chlorothiazide (diuril)
loop diuretics: more commonly used; patients on these will be on potassium supplements
furosemide (lasix)
bumetanide (bumex)
potassium-sparing diuretic:
spironolactone (aldactone)
tricks:
generics will end in "-zide" or "-iazide"
"-ide"
- uses:
- mobilization of edematous fluid in hypertension, heart failure, hepatic or renal failure
- adverse reactions:
- hypotension, hypokalemia, hypocloremia, hyponatremia, dehydration (watch for drops in potassium and other nutrients)
spironolactone (aldactone) does not deplete potassium and pulls off less fluid than thiazides and loops
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