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ATI Final Classification NSAIDS Prototype NSAIDS: Asprin2nd Gen: Celecoxib (celebrex) Action decrease inflammation, pain, and

fever decrease inflammation prevent inflammation and dilation to intracranial blood vessels interfere with the action of opioids Block ACh at neuromuscular junction Uses Inflammation, Analgesia, fever reduction, dysmenorrhea Side effects GI discomfort, gastric ulcers, bleeding, renal dysfunction, Salicylism, Reye Syndrome GI toxicity Ergot: GI discomfort; Ergotism, physical dependence, abortionTriptans: Chest symptoms, angina, teratogenic tachycardia, tachypnea, abstinence syndrome Respiratory arrest, hypotentionSuccinylcholine: apnea, malignant hypertension, hyperkalemia Levodopa: N/V, Dyskinesias, ortho hypo, cardio effects, psychosis, discoloration of sweat and urine, activation of malignant melanoma Mirapex: sleep attacks, daytime sleepiness, ortho hypo, psychosis, dyskinesias, NauseaCogentin: N/V, Atropine effects. CNS effects, skin rash, toxicity, Cardio effects, teratogenisis, GI effects, respiratory depression Interactions Warfarin, Glucocorticoids, Alcohol, Ibuprofen Warfarin Triptains with MAOI's Avoid trigger factors. NI Take with food, milk, or fully glass of water Affecting Pain and inflammation

Antigout Migraine Medications

Colchicine Ergot alkaloids: Ergotamine (ergostat) Serotonin receptor agonists (Triptains): Sumatripitan (Imitrex)

Gout abort acute migraine attack, prevent migraines

Pain and inflammation Pain and inflammation

Opioid Antagonist

Naloxone (Narcan)

Neuromuscular Blocking Agents

Nondepolarizing: Tubocurarine (Tubarine) Depolarizing: succinylcholine (Anecitine)

opioid overdose, reverse effects of opioids, reversal of resp. depression in infants adjuncts to general anesthesia, diagnosis myasthenia gravis, seizure control, endotracheal intubation, endoscopy Parkinsons

Pain and inflammation General anesthetics, Aminoglycosides, tetracyclines, Cholinesterase inhibitors Levodopa: Protients, conventional antipsychotic agents, pyridoxine, MAOIs. Mirapex: Levodopa continuous cardiac monitoring

Nervous system

Anti Parkinsons

Dopaminergic: Levodopa (Dopar, Larodopa) Dopamine agonists: pramipexole (Mirapex) Centrally acting anticholengerics: Benztropine (congentin) Dopamine releaser (Antiviral): Amantadine (symmetrel)

block receptors

effects may not be noticeable for several weeks to months

Nervous system


Barbiturates: phenobarbital (Luminal) Hydantoins: phenytoin (Dilantin) Benzodiazepines: diazepam (valium), lorazepam (Ativan) Carbamazepine (Tegretol), ethosuximide (zaronin), valproic acid (Depakote), gabapentin (Neurontin)

slow entrance of Na and Ca, suppress neuronal firing, inhibit GABA

generalized seizures, partial seizures

Muscle relaxants and Antispasmodics dantrolene (Dantrium)

acts directly on spastic muscles decrease conduction of pain impulses

relief of spasticity

Local Anesthetics

Amide: lidocaine (xylocaine)"cain"

minor procedures...

General Inhalation Anesthetics

Halothane (fluothane)"ane"

loss of sensation, consciousness, memory loss inhibit psychotic symptoms

Surgery, diagnostic procedures, analgesia, muscle relaxation schizo, bipolar, tourettes, delusions, dementia, Huntingtons chorea


Low: Chlorpromazine (thorazine) High: Haloperidol (haldol)

CNS depression, hepatic toxicity, physical dependence CNS excitation, Hypotension, Allergic reactions, Spinal headache, urinary retention hypotension, resp and cardio depression, malignant hyperthermia, hepatotoxicity EPS, TD, Neuroleptic malignant syndrome, Anticholinergic effects, ortho hypo, sedation,

Dilantin: OC, warfarin, glucocorticoids, alcohol, valium. Tegretol: OC, warfarin, grapefruit juice, phenytoin, phenobarbital. CNS depressants

use for control not cure, seizure frequency chart

Nervous system

dont stop taking medication

Nervous system

CNS depressants, CNS stimulants, morphine sulfate, succinylcholine Anticholinergic agents, CNS depressants, Levodopa

NPO 6-8 hrs. before

Nervous system

Nervous system


clozapine (clozaril)

blocks serotonin and dopamine block reuptake of norepi and serotonin--intensify effects

severe schizo, psychosis


amitriptyline (Elavil)

Depression, bipolar

seizures, sexual dysfunction, skin effects Agranulocytosis, seizures, weight gain, inflammation of heart muscle ortho hypo, anticholinergic effects, sedation, cardiac toxicity,

Immunosuppressive meds MAOIs, Antihistamines, Epinephrine, NE, Ephedrine, amphetamine, CNS depressants MAOIs, warfarin, Tricyclic antidepressants, NSAIDS anticoagulants, antidepressants, SSRIs, Antihypertensives, Mepridine(Demerol), Tyramine rich foods, Vasopressors MAOIs effects not experienced until 1-3 weeks

Nervous system

Nervous system


Fluoxetine (prozac)

block reuptake of serotonin

Depression, OCD, bulimia, panic disorders, PTSD


Phenelzine (Lardil)

increase amount of NE and serotonin avaliable

atypical depression, bulimia, OCD

Sexual dysfunction, wt. gain, mental confusion, agitation, anxiety, withdrawal syndrome, hyonatremia, rash, sleepiness CNS stimulation, ortho hypo, hypertensive crisistrycyclic

take with food

Nervous system

Nervous system

Atypical Antidepressants

bupropion HCL (Wellbutrin)

Inhibit dopamine uptake serotonin blockade

depression, aid to quit smoking

Mood stabilizers

Litium: Valproic acid(depakote), carbamazepine (tegretol) diazepam (Valium)

bipolar, alcoholism, bulimia, schizo Anxiety, seizure, insomnia, muscle sapsm, alcohol withdrawal, panic disorder insomnia GAD


enhance GABA in CNS

Non Benzo Anxiolytic-Non-Barbiturate

zolpidem (Ambien) buspirone(BuSpar)

CNS Stimulant

Methylphenidate (ritalin,Concerta)

do ot function as muscle relaxant binds to serotoinin and dopamine receptors Release NE and dopamine increase HR, Contractility, rate of conduction

H/A, dry mouth, contipation, tachycardia, nausea, wt.loss, seizures GI effects, tremors, polyuria, renal toxicity, goiter, teratogenesis, CNS depressions, paradoxical response, respiratory depression, teratogenesis, acute toxicity daytime sleepiness and lightheadedness CNS effects

take daily

nervous system

Diuretics, NSAIDS, Anticholinergics CNS depressants

monitor litium levels taper dose when D/C

Nervous system

Nervous system

CNS depressants, food Erythromycin, ketoconazole, grapefruit juice MAOIs, Caffeine, Phenytoin, warfarin, OTC cold meds MAOIs, Tricyclic antidepresants, general anthetics, alpha-adrenergic blocking agents, beta adrenergic blocking agents, diuretics Antihypertensive meds anti HTN meds, praxosin, MAOIs, tricyclic antidepressants, CNS depressants CCB,

take before bedtime take with meals dont chew or crush IV continuous infusion

Nervous system

Nervous system

ADHD, Narcolepsy, Obesity

CNS stimulation, wt.loss, Cardioeffects, Hypertensive crisis, dysrhythmias, necrosis, increase HR

Nervous system

Adrenergic Agonists

epinephirne (Adrenaline)Dopamine (Intropin)Dobutamine(Dobutrex)

Tx of AV block and cardiac arrest, HF, shock, hypertenstion

Cardiovascular system

Alpha Adrenergic blockers (sympatholytic) Centrally Acting Alpha2 agonists



venous and arterial dilation, smooth muscle relaxation decrease sympathetic outflow

hypertension, BPH

First dose hypertension

BP,HR, take w/food, inital dose at bedtime


HTN,sever CA pain

Drowsiness, sedation, dry mouth rebound hypertension


Beta Adrenergic Blockers

Cardio selective: metoprolol (lopressor) nonselective:

block beta1

angina, HTN, dysrhythmias,

Bradycardia, decrease CO,

dont d/c med



Propranolol (Inderal)"lol"

adrenergic receptors


ACE inhibitors



lorsartan (Cozaar)"artan" nifedipine (Adalat,Procradia)"ipine"verapamil (calan), diltiazem (cardizem)

block the production of Ang II (vasodilation, excretion of Na and H2o and retention of K) blocks action of ang II vasodilation

HF, HTN,MI, nephropathy

AV block, ortho hypo, rebound myocardium excitation, bronchoconstriction, glycogenolysis inhibited first dose ortho hypo, cough, hyperkalemia, rash, angioedema, neutropenia

Antihypertensive meds, insulin

with out dr. orders, dont crush or chew

Diuretics, antiHTN meds, K supplements, lithium, NSAIDS

1hr before meals


HTN, HF, MI, Stroke,nephropathy Angina, HTN,Verapamil:dysrhythmias

angioedema, fetal injury reflex tachy, peripheral edema, acute toxicityverapamil: ortho hypo, constipation, suppression of cardiac function, dysrhythmias excessive hypotention, cyanie poisoning, thiocyanate poisoning, H/A, ortho hypo, reflex tachycardia, tolerance Dysrhythmias, bradycardia, GI effects(anorexia, N/V, abd pain) CNS effects(fatigue, weakness, vision changes) hepatotoxicity, myopathy, peripheral neuropathy Gall stones, myopathy,hepatotoxicity

anti HTN meds beta blockers, grapefruit juiceverapamil: plus digoxin

taken with or with out food IV 2-3 min

cardio cardio

Hypertensive crisis

Sodium nitroprusside

direct vasodilation

hypertensive emergencies, decrease bleeding angina

dont mix with other medications Alcohol, antihypertensive meds, viagra Thiazide, ACE, ARBs, sympathomimetic meds, quinidine, verapamil fibrates, erythromycin, grapefruit juice Warfarin, statins, cholestyramine


Organic Nitrates

nitroglycerine (Nitrol, Nitrostat)



Cardiac Glycosides

digoxin (Lanoxin, lanoxicaps, digitek)

increase force of contraction, decrease HR

HF, dysrhythmias(A fib)

check apical pulse, same time daily,



atorvastatin (Lipitor)


Antilipemics: fibrates

gemfibrozil (Lopid)

increase VLDL excretion, increase HDL levels

hyperohlesterolemia, prevent coronary events, protect MI, raise HDL levels Reduction of VLDLs, increase HDL

take with evening meal obtain baseline cholesterol levels, take 30 min prior to meals baseline cholesterol levels, no reguard to food disolve in 4oz of H2O baseline vitals, monitor CBC,monitor aPPT (60-80sec) IV administered slowly vitals, monitor PT, CBC, platelet count, Hct levels small doses orally



Antilipemics-Cholesterol Absorption ezetimibe (zetia) Inhibitor

absorb cholesterol

lower LDL


Cholestyramine, statins, fibrates, cyclosporine, digoxin, warfarin, thiazides, tetracyclines anti-platelet agents


Antilipemicsbile-acid-sequestrants Anticoagulants/parenteral

cholestyramine (Questran)

lower LDL

Lower LDL




prevents bleeding


Hemmorrhage, hypersensitivity reactions


Tx of Heparin overdose Anticoag/Oral

Protamine Sulfate Warfarin (coumadin)

antidote prevent synthesis of coagulation factors

reversal of heparin administration thrombosis

Blood Blood


heparin, aspirin, glucocorticoids, acetaminophen, foods high in vit K

Warfarin overdose

Vit K(phytonadione, Aquamephyton)

promotes synthesis of coag factors

reversal of bleeding, Vit k deficiency

anaphylactoid-type reaction (flushing, hypotension,



Asprin (ecotrin)

Thrombolytic medications Iron Preparations

Streptokinase (streptase) "ase" Ferrous sulfate (feosol)Iron dextran (INFeD)

prevent platelets from clumping together by inhibiting enzymes dissolves clots that have already formed provide iron

MI, stroke, coronary syndromes

urticaria, cardio collapse) GI effects (bleeding), Hemorrhagic stroke

NSAIDs, Heparin, warfarin


MI, DVT, PE, ischemic stroke iron deficiency

bleeding, hypotension, allergic reaction GI distress, Teeth staining, Anaphylaxis HTN, increased risk for cardiovascular event Tachycardia, angina, tremors

NSAIDs, Heparin, Warfarin antacids, vit c

Blood take on empty stomach, green blackish stool monitor iron levels, BP, Hgb and Hct blood

Hematopoietic growth factors

epoetin alfa (Epogen, Procrit)

increase production of RBC activate the beta receptorsin the bronchial smooth muscle bronchodilation brochodilation prevent inflammation, suppression of airway mucus, Anti-inflammation

anemia, HIV


Beta2-Adrenergic agonists

Albuterol (proventil, Ventolin)


beta blockers, MAOIs, tricyclic antidepressants caffeine


Methylxanthines Inhaled Anticholinergic Glucocorticoids

theophylline (Theolair) ipratropium (Atrovent) belcomethasone dipropionate (QVAR)

asthma brochospasm, asthma prophylaxis of asthma, oral therapy, replacement therapy

GI distress, restlessness, seizures local anticholingergic effects difficulty speaking, hoarsness, candidiasis, bone loss, hyperglycemia, myopathy, peptic ulcer disease, infection,

Respiratory Respiratory Respiratory

k-depleting diuretics, NSAID

fixed schedule

Mast Cell Stabilizers

cromolyn sodium (Intal)

chronic asthma, exercised and allergen induced asthma

take 15 min before exercise or exposure to allergen liver injury warfarin,Theophylline


Leukotriene Modifiers

montelukast (singulair)

Antitussive-Opioids Mucolytics

Codiene acetylcysteine (Mucomyst)

suppresses inflammation, bronchoconstriction, edema, mucous production Cough suppression enhance the flow of secretions in respiratory passaes

Long term asthma


for non-productive cough pulmonary disorders, cystic fibrosis

CNS effects, GI distress, potiential for abuse Aspiration, bronchospasm

Respiratory odor that smells like rotten eggs, dilute medication in fruit juice lateral head low position when taking daily wts Respiratory



cause reduction in inflammation prevent reaborption of H2O block reabsorbtion of Na and Cl block action of aldosterone increases blood osmolality supplys K

rhinitis, sinusitis

Rebound congestion, CNS stimulation, Vasoconstricion Dehydration, hypotension, ototoxicity, hypokalemia dehydration, hypokalemia, hyperglycemia hyperkalemia, endocrine effects HF, pulmonary edema, Renal failure, fluid and electrolyte imblalances GI distress, local GI ulceration, hyperkalemia Digoxin, Antihypertensives, litium, NSAIDS Digoxin, Antihypertensives, litium, ACE, K supplements


High Ceiling Loop Diuretics

furosemide (Lasix)

Pulmonary edema, renal impairment essential HTN, mild-mod HF, liver and kidney disease k sparing effects, HF Renal failure, decrease ICP, IOP hypokalemia


Thiazide Diuretic


k levels, daily wts k levels, daily wts


K sparing diuretics osmotic diuretics

spironolactone (Aldactone) mannitol (Osmitrol)

fluids Fluids

K supplements

potassium chloride (K-Dur)

ACE, spironolactone



Histamine Receptors Antagonists Proton Pump Inhibitor

ranitidine hydrochloride (Zantac) omeprazole (Prilosec)


aluminum hydroxide gel (Amphojel)

Prostaglandin E Analog laxatives Prokinetic agents

misoprostol (cytotec) psyllium(Metamucil)docusate sodium (Colace)bisacodyl (Dulcolax)magnesium hydroxide metoclopramide (Reglan)

suppress secretion of gastric acid reduce gastric acid seretion by irreversibly inhibiting enzyme neutralize gastric acid and inactivate pepsin decreases acid production softens fecal mass suppress emeisis promote insulin release reduce production of glucose within liver increases breakdown of glycogen into glucose synthetic form of T4

GERD, H.pylori, Heart burn, sour stomach peptic ulcers, GERD, hypersecretory contitions

decrease libido, CNS effects

warfarin, antacids Ampicillin, digoxin, iron

eat 6 small meals dont crush or chew



constipation, hypophosphatemia, diarrhea, abd pain, dysmenorrhea GI irritation, Rectal burning sensation EPS, sedation, Diarrhea hypoglycemia GI effects, Vit B12 deficiency, lactic acidosis GI distress

warfarin, tetracycline

chew tablets then drink 8 oz of H2O or milk


long term NSAID use prevent ulcers, pregnant constipation GERD, chemo enduced Nasuea, type 2 diabetes type 2 diabetes PCOS hypoglycemia

GI milk, antacids opioids alcohol, NSAIDs, beta blockers Alcohol monitor for CNS depressant exercise with breakfast and dinner GI GI Endocrine Endocrine Endocrine

Oral hypoglycemics-sulfonylureas tolbutamide (orinase) glipizide (Glucotrol, Glucotrol XL) Oral hypoglycemicsmetformin HCl (Glucophage) Biguanides Insulin Overdose Glucagon

Thyroid hormones


hypothyroidism, emergency tx of myxedema coma grave's disease diabetes insipidus, used during cardiac arrest induction of labor, fetal stress test


Antithyroid Medications posterior pituitary hormone

propylthiouracil (PTU) vasopressin (pitressin synthetic)

Uterine stimulants

oxytocin(pitocin, syntocinon)

block synthesis of thyroid hormoones promotes reabsorption of H20 within kidneys stimulates uterus

overmedication, agranulocytosis reabsorption of too much water uterine rupture, HTN crisis

binding agents, antiseizure and anti depressant, warfarin increase anticoag effects

vitals, TSH levels


Endocrine Endocrine


Tocolytic medications

terbutaline sulfate (brethine)

uterine smooth muscle relaxation

delay preterm labor

tachycardia, tremors

adrenergic agonists, MAOIs, betablockers


Testosterone enanthate (Delatestryl)

promotes skeletal muscle growth estrogen hormones

hypogonadism, delayed puberty Contraception, postmenopausal symptoms, treatment of prostate cancer dysfunctional uterine bleeding, anmenorrhea, endometriosis erectile dysfunction

hepatotoxicity, cardio risk, Virilism effects Endometrail and ovearin CA, embolic events, feminization Breast CA, thromboembolic events, breakthrough bleeding, edema MI, sudden death, Priapism


conjugated equine estrogens(Premarin)

warfarin, glucocorticoids, hepatotoxic drugs warfarin, phenytoin

use infusion pump, monitor for hyperstimulaion monitor BP, frequency and duration of contractions, fetal distress report wt. gain of >2lbs. rotate injection sites withdrawal bleeding 1 hr before sexual activity






medroxyprogesterone acetate (Provera)

Erectile dysfunction


Immune Globulin Immunostimulants

Gamma globulin, immunoglobulin G (IgG) Interferon Alfa,Aldesleukin (interleukin-2)

induce favorable conditions for fetal growth augments effects of nitric oxide relase during sexual stimulation provide passive immunity enhance host immune responses

tegretol, dilantin, rifampin organin nitrates, grapefruit juice, erthromycin live viruses Theophylline, Zidovudine, antihypertensives



immunodeficiency syndrome, hep a, hep b hairy cell leukemia, maligannt melanoma, AIDS-related kaposi's sarcoma

local reaction, systemic allergic reaction Flu like symptoms, bone marrow suppression, hypotension

Immune store in fridge Immune


Chemotherapy agents

diphenhydramine (Benadryl),promethazine (phenegran), dimenhydrinate (Dramamine)2nd Gen: Loratadine (claritin), cetirizine (Zyrtec), fexofenadine (Allegra), desloratadine(Clarinex) cyclophosphamide(Cytoxan,Neosar)cisplatin(Planinol AQ)metotrexate(Rheumatrex, trexall)cytara bine(Cytosar-U) penicillin G (Bicillin LA)

block of histamine release

mild allergic reactions, anaphylaxis, motion sickness, insomnia CA

sedation, anticholingergic effects, GI discomfort, acute toxicity Bone marrow suppression, N&V, alopecia, mucosistis, reproductive toxicity, hyperuricemia Allergies, renal impairment,hyperkalemia

CNS depressants


destroy CA cells



weakening the bacterial cell wall

meningitis, syphilis, prophylaxis bacterial endocarditis UTI, postoperative infection, pelvic infection, meningitis pneumonia, peritonitis, UTI serious infections rickettsia, acne vulgaris

Aminoglycosides, OC


cephalexin (Keflex)cefaclor (Ceclor)ceftriaxone(Rocephin)cefepime(maxipime imipenem (Primaxin) Vancomycin (Vancocin) tetracycline hydrochloride (sumycin)

destroy bacterial cell wall destroy cell wall destroy cell wall inhibit growth

Carbapenems Monobactams Tetracyclines

Bacteriostatic inhibitors Aminoglycosides Sulfonamides and trimethoprim

erthyromycin (E-mycin) gentamicin (Garamycin) trimthoprim-sulfamethoxazole(TMP-SMZ, Bactrim)

slows growth disrupt protein syntesis inhibit bacterial growth

treat clients with penicillin allergy, whooping cough tapeworm UTI

Urinary Tract Antispeptics

nitrofurantoin (macrodantin)

damages DNA


Antimycobacterial( Antituberculosis)


Anti-hansens Disease Antiviral


ihibits growth of mycobacteria, prevents synthesis ofmycolic acid prevents synthesis of folic acid prevents reproduction of viral DNA


Allergice, bleeding, thrombophlebitis, cross allergy allergy, GI symptoms, Suprainfection ototoxicity, infusion reaction, thrombophlebitis GI discomfort, yellow/brown tooth discoloration, hepatotoxicity, photosensitivity, suprainfecrtion GI discomfort, thrombophlebitis Ototoxicity, nephrotoxicity, neuromuscular blockade hypersensitivity,blood dyscrasias, kernicterus(jaundice, increase bili), photosensitivity GI discomfort, Hypersensitivity reactions, blood dyscrasias, peripheral neruopathy peripheral neuropathy, hepatotoxicity

disulfiram reaction, probenecid

full glass of water 1 hr before meals or 2 hr after take with food



Infection Infection Milk products, iron, magnesium,antacids, OC dont give with food Infection

Antihistamines, theophylline, warfarin penicillin warfarin, phenytoin, slufonylurea

empty stomach peak and trough empty stomach, full glass of water

infection infection Infection

urine will have brownish discoloration phenytoin, Alcohol empty stomach



treatment of hansens disease


herpes simplex virus, HIV





inhibition of enzyme necessary for DNA replication slows growth

severe infections, resp, urinary, and GI infections peptic ulcer disease, protozoal infections

discoloration of body fluids, hepatoxicity, mild GI discomfort phlebitis and inflammation at site, nephrotoxicity, mild GI discomfort, Granulocytopenia and thrombocytopenia, reproductive toxicity GI discomfort, Achilles tendon rupture, suprainfection, GI discomfort, metallic taste, darkening of urine, CNS symptoms

warfarin, OC,protease inhibitors

complete course


never administer bolus, IV over 1 hour


Cationic compounds, theophylline, warfarin alcohol, metronidazole complete course




amphotericin B deoxycholate(fungizone)

acts on fungal cell membranes to increase cell permeability slows production of prostaglandins act of mu receptors

fungal infections, dermatophytic infections

Acetaminophen Opioid Agonists

acetaminophen (Tylenol) Morphine sulfate

Analgesic, antipyretic moderate to severe pain, sedation, reduction of bowel motility, Codiene: cough suppression

Infusion reaction, thrombophlebitis, nephrotoxicity, hypokalemia, bone marrow suppression Acute toxicity Respiratory depression, constipation, orthostatic hypotention, urinary retention, sedation, biliary colic, emesis, opioid overdose triad Abstinence syndrome

Aminoglycosides, flucytosine


Alcohol, Warfarin CNS depressants, Anticholinergic agents, MAOI's, Antihypertensives withhold if R<12, IV slowly (4-5 min)

Pain and inflammation Pain and inflammation

AgonistsAntagonist Opioids

Pentazocine (Talwin)

Cholinesterase inhibitors

neostigmine (Prostigmin) "mine"

low potential for abuse, less respiratory depression. Antagonist to mu receptors, agonist to kappa receptors increase amount of ACh available at receptor sites

mild to moderate pain


withhold if R<12

Pain and inflammation

Myasthenia gravis, reversal of neuromuscular blocking agents

increase GI motility and secretions; Cholinergic crisis, bradycardia, urinary urgency

Atropine, tubocuraine, Succinylcholine

medical alert bracelet

Nervous system