Term
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Definition
(Ch.63: Drugs that affect the uterine function)
- stimulates uterine contractions
- induction or augmentation of labor
-Control of postpartum bleeding (contracts the uterus by providing direct pressure)
- induction of abortion (not a common use) |
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Term
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Definition
(Ch. 63: Drugs that affect the uterine function)
- suppression of preterm labor |
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Term
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Definition
(Ch. 63: Drugs that affect uterine function)
- Uterine relaxant
- the most commonly used in the hospital setting
- Once mg gets high enough level, provides smooth muscle relaxation, thus stops contraction
- may also stop breathing b/c smooth muscles of diaphragm slow/stop
- Be sure to check on pt b/c they may stop breathing |
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Term
| Beta2-selective adrenergic agonist |
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Definition
(Ch. 63: Drugs that affect uterine function)
– Smooth muscle relaxation of the lungs
– Ritodrine
– Terbutaline [Brethine]
• Relax lungs, uterus, any smooth muscles
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Term
Nifedipine [Procardia, Adalat, Nifedical] |
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Definition
(ch. 63: Drugs that affect uterine function)
- Calcium channel blocker
- relax smooth muscle |
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Term
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Definition
(Ch. 63: Drugs that affect uterine function)
- uterine stimulant (oxytocics)
- peptide hormone produced by the posterior pituitary
- milk ejection
- water retention
- Precaution: uterine rupture may occur
- Do NOT give to women w/ active genital herpes (these women will give birth by c-section)
- A.E.: water intoxication, uterine bleeding, uterine tearing |
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Term
| Carboprost tromethamine (Hemabate) |
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Definition
(Ch. 63: Drugs that affect uterine function)
- "stops-blood"
- uterine stimulant (oxytocics)
- Drug of choice for controlling postpartum hemorrhage
- causes intense uterine contractions
- AE: GI, vomit, diarrhea, fever, vasoconstriction, bronchi constriciton
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Term
Dinoprostone (Prepidil, Cervidil)
Dinoprostone gel
Dionoprostone vaginal inserts (Cervidil)
Misoprostol (Cytotec) |
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Definition
Drugs used to promote cervical ripening
- these agenst used in conjunciton w/ oxytocin |
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Term
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Definition
(Ch.64: Androgens)
- major endogenous androgen is testosterone
- Therapeutic uses: male hypogonadism, delayed puberty, breast cancer, replacement therapy in menopausal women, wasting in pts w/ AIDS, anemias
- AE: virilization, premature epiphyseal closure, hepatotoxicity, edema, gynecomastia, abuse potential |
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Term
Phosphodieterase type 5 (PDE5) inhibitors I
sildenafil (Viagra) |
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Definition
(Ch. 65: Drugs for erectile disfunction and benign prostatic hyperplasia)
- used for erectile dysfunction
- high fat meal slows absorption
- little or no effect on men who do not have ED
- AE: hypotenstion, priapism (prolonged painful erection)
- Drug interactions: Nitrates, Alpha blockers, Inibitors of cytochrome P450 (CYP3A4) |
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Term
PDE5 inhibitors II:
vardenfil (Levitra) |
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Definition
(Ch. 65: Drugs for Erectile Dysfunction and Benign Prostatic Hyperplasia)
- Used for Erectile Dysfunciton (pretty much the same as Viagra)
- AE: headache, flushing
- Drug interactions: Alpha-adrenergic blockers, Nitroglycerin and other nitrates
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Term
PDE5 inhibitors II:
tadalafil (Cialis) |
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Definition
(Ch. 65: Drugs for erectile dysfunciton and benign prostatic hyperplasia)
- used for erectile dysfunciton
- effect of 72 hrs (so if pt comes in that has taken Cialis, canNOT give nitro for heart attack
- AE: headache, dyspepsia, back pain
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Term
| papaverine plus phentolamine |
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Definition
(Ch.65: Drugs for erectile dysfunction and benign hyperplasia
- used to conteract impotence
- AE: priapism, painles fibrotic nodules in the corpus cavernosum, orthostatic hypotension w dizziness
- Injected directly ino the copus cavernosum & immediately before sexual activity |
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Term
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Definition
(Ch. 65: Drugs for Erectile Dysfunction and Benign Prostatic Hyperplasia)
- treatment of BPH
- MOA: finasteride is a competitive inhibitor of both tussue and hepatic 5-alpha reductase. This results in inhibition of the conversion of testosterone to dihydrotestosterone and markedly suppresses serum dihydrotestosterone levels. May take up to 6 months to achieve full efficacy
- AE: impotence, libido decreased |
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Term
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Definition
(Ch. 65: Drugs used for Erectile Dysfunction & Benign Prostatic Hyperplasia)
- treats BPH
- MOA: competitively inhibits postsynaptic alpha1-adrenergic receptors in prostatic stromal and bladder neck tissues. This reduces the sympathetic tone-induced urethral stricture causing BPH symptoms. May take up to 6 months to achieve full efficacy
- AE: dizziness, orthostatic hypotension, fatigue |
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Term
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Definition
(Ch. 65: Drugs for Erectile Dysfunction & Benign Prostatic Hyperplasia)
- Used to treat BHP
- MOA:tamsulosin is an antagonist of Alpha1A-andrenoreceptors in teh prostate. Smooth muscle tone in the prostate is mediated by alpha1A-adrenoreceptors;blocking them leads to relaxation of smooth muscle in the bladder neck and prostate causing an improvement of urine flow and decreased symtoms of BPH. May take up to 6 months to achieve full efficacy
- AE: Orthostatic hypotension, headache, dizziness, abnormal ejaculation |
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Term
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Definition
(Ch. 68: Immunosuppressants)
- inhibit immune response
- Uses: prevention of organ rejection, treatment of autoimmune diseases
- Toxicity: increased risk of infection, increased risk of neoplasms |
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Term
| Cyclosporine (Sandimmune) |
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Definition
(Ch. 68: Immunosuppressants)
- MOA: to suppress the production of interleukin-2, interferon gamma, and other cytokines
- Uses: prevent rejection of transplants (used alot in bone marrow transplants), autoimmune diseases
- AE: nephrotoxicity, infection, hepatotoxicity, lymphoma, hypertension, anaphylactic reactions
- Drug & food interactions: drugs that can decrease/increase cyclosporine levels (there are more than 20), nephrotoxic drugs, grapefruit juice
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Term
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Definition
(Ch. 68: Immunosuppressants)
- An alternative to cyclosporine (not used as much as it, but used in more difficult transplants such as heart, kidney)
- Use: prophylaxis of organ rejection
- AE: nephrotoxicity, neurotoxicity (PRESS), GI effects, hypertension, hyperkalemia
- Drug & food interactions: Agents that inhibit CYP3A4, grapefruit juice, NSAIDs
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Term
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Definition
(Ch. 68: Immunosuppressants)
- Use: only for prevention of renal transplant rejection, use in conjunction w/ cyclosporine & glucocorticoids
- AE: increased risk of infection, raises levels of cholesterol & triglycerides, risk of renal injury, sever complications in liver & lung
- Drug & food interactions: drugs that inhibit or induce CYP3A4, high fat foods, grapefruit juice
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Term
| Cyclophosphamide (Cytoxan, Neosar) |
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Definition
(Ch. 68: Immunosuppressants)
- other cytotoxic drug
- anticancer drug
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Term
| Methotrexate (Rheumatrex, Trexall) |
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Definition
(Ch. 68: Immunosuppressants)
- other cytotoxic drug
- anticancer agent
- utilized in the treatment of RA
-Suppression of B & T lymphocytes
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Term
| Mycophenolate mofetil (CellCept, Myfortic) |
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Definition
(Ch. 68: Immunosuppressants)
- other cytotoxic drug
- approved for prophylaxis of organ rejection
- acts on B & T lymphocytes to inhibit inosine monophosphate dehydrogenase
- selective inhibition of B & T lymphocyte proliferation
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Term
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Definition
(Ch. 69: Antihistamines)
- Uses: relief of allergic symptoms caused by histamine release, including nasal allergies & allergic dermatosis, adjunct to epinephrine in the treatment of anaphylaxis, nighttime sleep aid (not a good one), prevention or treatment of motion sickness, antitussive (anti-cough), management of parkinsonian syndrome including drug-induced extrapyramidal symptoms, topically for relief of pain & itching associated w/ insect bites, minor cuts and burns, rashes due to poison ivy, poison oak, and poison sumac or other irritants |
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Term
H1 Antagonists - First Generation
(First Generation is usually not that good) |
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Definition
(Ch. 69: Antihistamines)
- MOA: competes w/ histamine for H1-receptor sites in the GI tract, blood vessels, and respiratory tract
- Uses: mild allergy, severe allergy, motion sickness, insomnia, common cold
- AE: sedation, difficulty thinking, lower acidity levels, anitcholinergic effects (cant see, cant spit, cant pee, cant shit), cardiac dysrhythmias
- Drug interactions: CNS depressants
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Term
| H1 Antagonists - First Generation Drugs |
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Definition
(Ch. 69: Antihistamines)
Azatadine, Brompheniramine, Chlorpheniramine, Clemastine, Cyproheptadine, Dexchlorpheniramine, Diphenhydramine, hydroxyzine, phenindamine, promethazine
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Term
H1 Antagonists - Second Generation
(Self-proclaimed Non-sedating) |
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Definition
(Ch. 69: Antihistamines)
- MOA: competes w/ histamine for H1-receptor sites in the GI tract, blood vessels and respiratory tract (basically same as 1st gen)
- DOES NOT cross BBB resulting in a reduced potential for sedation
- AE: drowsiness, fatigue, headache, nausea, dry mouth, (same general as 1st gen, but less severe)
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Term
| H1 Antagonists - Second Generation Drugs |
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Definition
(Ch. 69: Antihistamines)
- Fexofenadine (Allegra), Cetirizine (Zyrtec), Loratadine (Claritin, Tavist ND, Alavert), Desloratadine (Clarinex), Azelastine (Astelin)
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Term
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Definition
(Ch. 69: Antihistamines)
- $47 million in sales
- Only active ingredient for sleep is diphenhydramine
- Acetaminophen is included for pain relief (acetaminophen is weak pain reliever)
- contains generic form of Benadryl
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Term
| Cyclooxygenase Inhibitors |
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Definition
(Ch. 70: Cyclooxygenase Inhibitors: Nonsteroidal Anti-Inflammatory Drugs and Acetaminophen)
- Analgesic, anit-inflammatory and antipyretic
- widely used for treatment of arthritis and pain
- 14 million regular users
- not as efficacious as analgesics as opiods
- MOA: inhibition of cyclooxygenase (COX), of which there are 2 isoforms: COX1 & COX2 |
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Term
| Action of Prostaglandin Inhibition |
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Definition
(Ch. 70: Cyclooxygenase Inhibitors: Nonsteroidal Anti-Inflammatory Drugs and Acetaminophen)
- NSAIDS block the action of COX thus inhibiting prostaglandins, prostacyclin & thromboxane
- renal blood flow(PGI)->renal ischemia
- gastric mucous(PGE)->irritaiton, ulcers
- platelet aggregation(TXA)->bleeding
- uterine contractoins (PGE)->delays labor
- inflammation(PGE)->anti-inflammatory
- nociceptor sensitization(PGE)->analgesia
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Term
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Definition
(Ch. 70: Cyclooxygenase Inhibitors: Nonsteroidal Anti-Inflammatory Drugs and Acetaminophen)
- MOA: Irreversibly inhibits COX1&COX2 enzymes
- analgesic, antipyretic, anti-inflammatory
- suppression of platelet aggregation by inhibiting thrybroxine
- dysmenorrhea, cancer prevention, prevention of Alzheimer
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Term
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Definition
(Ch. 70: Cyclooxygenase Inhibitors: Nonsteroidal Anti-Inflammatory Drugs and Acetaminophen)
- AE: GI bleeding, renal impairment, salicylism, reye's syndrom, hypersensitivity reaction
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Term
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Definition
(Ch. 70: Cyclooxygenase Inhibitors: Nonsteroidal Anti-Inflammatory Drugs and Acetaminophen)
- 2nd generation COX2 inhibitor-fewer AE's than 1st generation
- Uses: Osteoarthritis, RA, acute pain, dysmenorrhea, familial adenomatous polyposis (FAP)
- AE: dyspepsia, GI ulceration, abdominal pain, renal toxicity sulfonamide allergy,
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Term
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Definition
(Ch. 70: Cyclooxygenase Inhibitors: Nonsteroidal Anti-Inflammatory Drugs and Acetaminophen)
- IS NOT AN NSAID!
- Analgesic, antipyretic, does NOT possess anti-inflammatory activity
- MOA: inhibits prostaglandin synthesis in CNS
- AE: hepatotoxicity, over dose-hepatic necrosis
- does NOT cuase ulcers, does NOT cause bleeding
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Term
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Definition
(Ch. 71: Glucocorticoids in Nonendocrine Diseases)
- Uses: RA, SLE, inflammatory bowel disease, misc. inflammatory disorders, allergic conditions, asthma, dermatologic disorders, neoplasms, suppression of allograft rejection, prevention of respiratory distress syndrome
- AE: adrenal insufficiency, osteoporosis, infection, glucose intolerance, myopathy, fluid & electrolyte disturbance, growth retardation, psychologic disturbances, cateracts & glaucoma, peptic ulcer disease, Iatrogenic cushing's sundrome
- Drug interactions: interactions r/t K+ loss, NSAIDS, insulin & oral hypoglycemic, vaccines |
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Term
| Methotrexate (Rheumatrex) |
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Definition
(Ch. 72: Drug Therapy of Rheumatoid Arthritis)
- Most rapid-acting DMARD
- Therapeutic effect - 3-6 weeks
- AE: hepatic fibrosis, bone marrow supression, GI ulceration |
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Term
| Etanercept (Enbrel), Humira, Remicade |
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Definition
(Ch. 72: Drug Therapy of Rheumatoid Arthritis)
- New DMARDS
- Inactivates tumor necrosis factor (TNF), slows progression of disease, $$$, very specific=very expensive
- AE: infeciton, lymphoma, injection site reactions
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Term
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Definition
(Ch. 73: Gout)
- Decreases pain
- MOA: blocks migration of neutrophils to affected area, not an anti-inflammatory, indirect anti-inflammatory drug
- Uses: treat acute gout attack, reduce incidences of attack, abort an impending attack
- AE: gastrointestinal, diarrhea is dose limiting
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Term
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Definition
(Ch. 72: Drug Therapy of RA and Gout)
- MOA: blocks conversion of hypoxanthine to uric acid, reduce blood levels of uric acid
Uses: prophylaxis, hyeruricemia due to chemotherapy (Tumor Lysis Syndrome)
AE: well tolerated, hypersensitivity syndrome can occur years after initiation of therapy, gastrointestinal
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