_pharm class:_ Anti-Parkinson Agent, Decarboxylase Inhibitor _moa_ :circulates in the plasma to the blood-brain-barrier (BBB), where it crosses, to be converted by striatal enzymes to dopamine _use_ :Parkinson disease, [OFFLABEL] rls, parkinsonism _admin_ :Remove one cassette from refrigerator 20 minutes prior to use. Gel is administered directly to the jejunum via a portable infusion pump. Extended-release capsule: Administer with or without food; a high-fat, high-calorie meal may delay the absorption of levodopa by ~2 hours. Swallow capsules whole; do not chew, divide, or crush capsules. _Adverse Effects_ :Dyskinesia, n/v, constipation, orthostatic hypotension, Peripheral neuropathy, depression, dizziness, h/a, increased creatine phosphokinase in blood specimen, Increased blood urea nitrogen _Monitoring Parameters_ :Signs and symptoms of Parkinson disease; periodic hepatic function tests, BUN, creatinine, and CBC; periodic skin examinations; signs and symptoms of postural hypotension.

_pharm class_ :anti platelet, ADP receptor blocker _moa_ :The active metabolite irreversibly blocks the P2Y12component of ADP receptors on the platelet surface, which prevents activation of the GPIIb/IIIa receptor complex, thereby reducing platelet aggregation _use_ :Myocardial infarction, ischemic stroke, or peripheral atherosclerotic disease [OFFLABEL] Carotid artery atherosclerosis _admin_ :Administer without regard to meals _Adverse Effects_ :Bleeding, Thrombotic thrombocytopenic purpura, allergies, _Monitoring Parameters_ :Signs of bleeding; hemoglobin and hematocrit periodically

_pharm class_ :Calcium channel blocker _moa_ :Inhibits calcium ion from entering the “slow channels” or select voltage-sensitive areas of vascular smooth muscle and myocardium during depolarization; produces relaxation of coronary vascular smooth muscle and coronary vasodilation _use_ :Hypertension, chronic stable angina, vasospastic angina [OFFLABEL] a fib, tachy _admin_ : before meals and at bedtime. Tablets may be swallowed whole, crushed, or chewed; do not split nonscored tablets. _Adverse Effects_ :Conduction abnormalities, allergies, Peripheral edema _Monitoring Parameters_ :LFTs, kidney function, BP, ECG, heart rate

_pharm class_ :Anticoagulant, Low Molecular Weight Heparin, antithrombotic _moa_ :enhancing the inhibition rate of clotting proteases by antithrombin III impairing normal hemostasis and inhibition of factor Xa _use_ :Acute coronary syndromes, Deep vein thrombosis treatment, Venous thromboembolism prophylaxis [OFFLABEL] frostbite, pulmonary embolism _admin_ :Enoxaparin is available in 100 mg/mL and 150 mg/mL concentrations SUBQ or IV _Adverse Effects_ :anemia, hemorrhage, _Monitoring Parameters_ :Platelet count, hemoglobin, hematocrit, fecal occult blood, signs and symptoms of bleeding

_pharm class_ :5 Alpha-Reductase Inhibitor _moa_ :competitively inhibits type II 5-alpha reductase, resulting in inhibition of the conversion of testosterone to dihydrotestosterone and markedly suppresses serum dihydrotestosterone levels _use_ :Androgenetic alopecia (male pattern hair loss), Benign prostatic hyperplasia [OFFLABEL] Hirsutism _admin_ :Oral: May be administered with or without meals _Adverse Effects_ :Genitourinary: Impotence _Monitoring Parameters_ :establish a new PSA baseline ≥6 months after treatment initiation and monitor PSA periodically thereafter

_pharm class_ :Antiseizure Agent, GABA Analog _moa_ :Gabapentin is structurally related to GABA, High affinity gabapentin binding sites have been located throughout the brain _use_ :Postherpetic neuralgia, Seizures [OFFLABEL] alcohol withdrawal, Neuropathic pain, rls _admin_ :immediate release: May administer without regards to meals. Administer first dose on first day at bedtime to avoid somnolence and dizziness. Dosage must be adjusted for renal function; when given 3 times daily _Adverse Effects_ :Viral infection, Ataxia, dizziness, fatigue _Monitoring Parameters_ :Periodic renal function, suicidality, resp depression

_pharm class_ :Beta2 Agonist _moa_ :Relaxes bronchial smooth muscle by action on beta2-receptors with little effect on heart rate _use_ :Bronchospasm _admin_ :Metered-dose inhaler: Shake well before use, avoid spraying in the eyes. Prime with 4 test sprays prior to first use or if inhaler has not been used for more than 3 days. Clean actuator (mouthpiece) weekly with warm water and air dry thoroughly. A spacer device or valved holding chamber is recommended _Adverse Effects_ :h/a, nausea, vomting, viral infection, rhinitis _Monitoring Parameters_ :Asthma symptoms; FEV1, peak flow, and/or other pulmonary function tests; heart rate, blood pressure, CNS stimulation; arterial blood gases. serum potassium, serum glucose

321 Flashcards by Timothy Sapienza

Allopurinol

*pharm class**:Antigout Agent; Xanthine Oxidase Inhibitor
*moa**:Allopurinol inhibits xanthine oxidase, the enzyme responsible for the conversion of hypoxanthine to xanthine to uric acid.
*use**: Gout,

[OFFLABEL] Nephrolithiasis, prevention of recurrent uric acid stones
admin:
Oral: Administer after meals.
IV: The rate of infusion depends on the volume of the infusion. IV daily dose can be administered as a single infusion or in equally divided doses at 6-, 8-, or 12-hour intervals (manufacturer’s labeling).
Adverse Effects:Acute gout attacks, Hepatotoxicity
Monitoring Parameters: CBC; serum uric acid levels, LFTs, renal function (BUN, serum creatinine, or creatinine clearance), Monitor hydration status, signs/symptoms of hepatotoxicity

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Budesonide/Formoterol

pharm class:Beta2 Agonist;Beta2-Adrenergic Agonist, Long-Acting;Corticosteroid, Inhalant (Oral)

*moa**:Formoterol: Relaxes bronchial smooth muscle by selective action on beta2 receptors with little effect on heart rate;Budesonide: A corticosteroid which controls the rate of protein synthesis, depresses the migration of polymorphonuclear leukocytes/fibroblasts, and reverses capillary permeability and lysosomal stabilization at the cellular level to prevent or control inflammation.
*use**:Asthma, Chronic obstructive pulmonary disease, maintenance

[OFFLABEL] asthma

*admin**:For oral inhalation only administered every morning and evening, approximately 12 hours apart. Prior to first use, inhaler must be primed by releasing 2 test sprays into the air; shake well for 5 seconds before each spray.Rinse mouth with water (spit out without swallowing) after each use. Do not wash inhaler with water; clean mouthpiece using a dry wipe every 7 days
*Adverse Effects**:Nasopharyngitis, Headache, upper Respiratory tract infection
*Monitoring Parameters**: FEV1, peak flow meter and/or other pulmonary function tests; monitor growth in pediatric patients, symptom relief, monitor for increased use if short-acting beta2-adrenergic agonists (may be a sign of asthma or COPD deterioration); HPA axis suppression; bone mineral density; blood pressure, heart rate; CNS stimulation; serum glucose, serum potassium

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Carbidopa/Levodopa

*pharm class:** Anti-Parkinson Agent, Decarboxylase Inhibitor
*moa**:circulates in the plasma to the blood-brain-barrier (BBB), where it crosses, to be converted by striatal enzymes to dopamine
*use**:Parkinson disease,

[OFFLABEL] rls, parkinsonism

*admin**:Remove one cassette from refrigerator 20 minutes prior to use. Gel is administered directly to the jejunum via a portable infusion pump. Extended-release capsule: Administer with or without food; a high-fat, high-calorie meal may delay the absorption of levodopa by ~2 hours. Swallow capsules whole; do not chew, divide, or crush capsules.
*Adverse Effects**:Dyskinesia, n/v, constipation, orthostatic hypotension, Peripheral neuropathy, depression, dizziness, h/a, increased creatine phosphokinase in blood specimen, Increased blood urea nitrogen
*Monitoring Parameters**:Signs and symptoms of Parkinson disease; periodic hepatic function tests, BUN, creatinine, and CBC; periodic skin examinations; signs and symptoms of postural hypotension.

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Celecoxib

pharm class: Analgesic, Nonopioid; Nonsteroidal Anti-inflammatory Drug (NSAID), COX-2 Selective

*moa**: Inhibits prostaglandin synthesis by decreasing the activity of the enzyme, cyclooxygenase-2
*use**:Anti-inflammatory, Dysmenorrhea, Juvenile idiopathic arthritis, Migraine, Osteoarthritis, Pain

[OFFLABEL] gout
admin:Capsules: May be swallowed whole or the entire contents emptied onto a teaspoon of cool or room temperature applesauce and administered immediately with water. The contents of the capsules sprinkled onto applesauce may be stored under refrigeration for up to 6 hours.

Oral solution: Administer full dose directly from bottle. Administer partial dose with a calibrated measuring device (not a household teaspoon or tablespoon).

*Adverse Effects**:MI, cerebrovascular accident, heart failure, Gastrointestinal events, anemia, Hepatic effects, Hypersensitivity reactions, Kidney effects,
*Monitoring Parameters**:CBC, hemoglobin/hematocrit, basic metabolic panel, liver function tests; renal function, weight gain, edema; bleeding, bruising; GI effects

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Clopidogrel

*pharm class**:anti platelet, ADP receptor blocker
*moa**:The active metabolite irreversibly blocks the P2Y12component of ADP receptors on the platelet surface, which prevents activation of the GPIIb/IIIa receptor complex, thereby reducing platelet aggregation
*use**:Myocardial infarction, ischemic stroke, or peripheral atherosclerotic disease

[OFFLABEL] Carotid artery atherosclerosis

*admin**:Administer without regard to meals
*Adverse Effects**:Bleeding, Thrombotic thrombocytopenic purpura, allergies,
*Monitoring Parameters**:Signs of bleeding; hemoglobin and hematocrit periodically

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Diltiazem

*pharm class**:Calcium channel blocker
*moa**:Inhibits calcium ion from entering the “slow channels” or select voltage-sensitive areas of vascular smooth muscle and myocardium during depolarization; produces relaxation of coronary vascular smooth muscle and coronary vasodilation
*use**:Hypertension, chronic stable angina, vasospastic angina

[OFFLABEL] a fib, tachy

*admin**: before meals and at bedtime. Tablets may be swallowed whole, crushed, or chewed; do not split nonscored tablets.
*Adverse Effects**:Conduction abnormalities, allergies, Peripheral edema
*Monitoring Parameters**:LFTs, kidney function, BP, ECG, heart rate

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Enoxaparin

*pharm class**:Anticoagulant, Low Molecular Weight Heparin, antithrombotic
*moa**:enhancing the inhibition rate of clotting proteases by antithrombin III impairing normal hemostasis and inhibition of factor Xa
*use**:Acute coronary syndromes, Deep vein thrombosis treatment, Venous thromboembolism prophylaxis

[OFFLABEL] frostbite, pulmonary embolism

*admin**:Enoxaparin is available in 100 mg/mL and 150 mg/mL concentrations SUBQ or IV
*Adverse Effects**:anemia, hemorrhage,
*Monitoring Parameters**:Platelet count, hemoglobin, hematocrit, fecal occult blood, signs and symptoms of bleeding

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Escitalopram

*pharm class**:Antidepressant, Selective Serotonin Reuptake Inhibitor
*moa**:selectively inhibits the reuptake of serotonin with little to no effect on norepinephrine or dopamine reuptake
*use**:Major depressive disorder, Generalized anxiety disorder,

[OFFLABEL] Binge eating disorder; Body dysmorphic disorder; Bulimia nervosa; Obsessive-compulsive disorder; Panic disorder; Posttraumatic stress disorder; Premature ejaculation; Premenstrual dysphoric disorder; Vasomotor symptoms associated with menopause

*admin**:Oral: Administer once daily (morning or evening), with or without food.
*Adverse Effects**: diarrhea, nausea, ejaculatory disorder, drowsiness, h/a, insomnia,
*Monitoring Parameters**: ECG, electrolytes, liver and renal, hx of mental disorder

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Finasteride

*pharm class**:5 Alpha-Reductase Inhibitor
*moa**:competitively inhibits type II 5-alpha reductase, resulting in inhibition of the conversion of testosterone to dihydrotestosterone and markedly suppresses serum dihydrotestosterone levels
*use**:Androgenetic alopecia (male pattern hair loss), Benign prostatic hyperplasia

[OFFLABEL] Hirsutism

*admin**:Oral: May be administered with or without meals
*Adverse Effects**:Genitourinary: Impotence
*Monitoring Parameters**:establish a new PSA baseline ≥6 months after treatment initiation and monitor PSA periodically thereafter

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Gabapentin

*pharm class**:Antiseizure Agent, GABA Analog
*moa**:Gabapentin is structurally related to GABA, High affinity gabapentin binding sites have been located throughout the brain
*use**:Postherpetic neuralgia, Seizures

[OFFLABEL] alcohol withdrawal, Neuropathic pain, rls

*admin**:immediate release: May administer without regards to meals. Administer first dose on first day at bedtime to avoid somnolence and dizziness. Dosage must be adjusted for renal function; when given 3 times daily
*Adverse Effects**:Viral infection, Ataxia, dizziness, fatigue
*Monitoring Parameters**:Periodic renal function, suicidality, resp depression

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Insulin Lispro Recombinant

*pharm class**:Insulin, Rapid-Acting
*moa**:Insulin acts via specific membrane-bound receptors on target tissues to regulate metabolism of carbohydrate, protein, and fats
*use**: diabetes mellitus

[OFFLABEL] Diabetic ketoacidosis

*admin**:subq
*Adverse Effects**:Antibody development, hypoglycemia, Infusion site reaction, Headache, pain, Cough, flu-like symptoms, nasopharyngitis
*Monitoring Parameters**: blood glucose, electrolytes; renal function; hepatic function; weight

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Insulin Aspart Recombinant

*pharm class**:Insulin, Rapid-Acting
*moa**:Insulin acts via specific membrane-bound receptors on target tissues to regulate metabolism of carbohydrate, protein, and fats
*use**:Diabetes mellitus

[OFFLABEL] Diabetic ketoacidosis

*admin**: subq
*Adverse Effects**: hypoglycemia, Antibody development, h/a, hyporeflexia, Nasopharyngitis, viral respiratory tract infection
*Monitoring Parameters**: blood glucose, electrolytes; renal function; hepatic function; weight

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Insulin Glargine, Human

*pharm class**:Insulin, Long-Acting
*moa**:Insulin acts via specific membrane-bound receptors on target tissues to regulate metabolism of carbohydrate, protein, and fats.
*use**:Diabetes mellitus

[OFFLABEL] Hyperglycemia in hospitalized patients

*admin**:subq
*Adverse Effects**:Hypertension, peripheral edema, hypoglycemia, Diarrhea, Urinary tract infection, influenza, infection, Depression, Arthralgia, back/limb pain, Bronchitis, cough, nasopharyngitis, sinusitis, upper resp tract infection,
*Monitoring Parameters**: blood glucose, electrolytes; renal function; hepatic function; weight

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Lanoxin (digoxin)

*pharm class**:Antiarrhythmic Agent, Cardiac Glycoside
*moa**:Inhibition of the sodium/potassium ATPase pump in myocardial cells results in a transient increase of intracellular sodium. Direct suppression of the AV node conduction to increase effective refractory period and decrease conduction velocity - positive inotropic effect.
*use**:Atrial fibrillation or atrial flutter, rate control, Heart failure with reduced ejection fraction

[OFFLABEL] Fetal supraventricular tachyarrhythmia
admin:IM: IV route preferred. If IM injection necessary, administer by deep injection followed by massage at the injection site. Inject no more than 2 mL per injection site. May cause intense pain.

IV: May be administered undiluted or diluted. Inject slowly over ≥5 minutes.

*Adverse Effects**:nausea, vomiting, visual disturbances (“halos,” yellow or blurred vision), lethargy,
*Monitoring Parameters**:Heart rate and rhythm, monitor serum potassium, magnesium, and calcium. digoxin levels

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Levalbuterol

*pharm class**:Beta2 Agonist
*moa**:Relaxes bronchial smooth muscle by action on beta2-receptors with little effect on heart rate
*use**:Bronchospasm
*admin**:Metered-dose inhaler: Shake well before use, avoid spraying in the eyes. Prime with 4 test sprays prior to first use or if inhaler has not been used for more than 3 days. Clean actuator (mouthpiece) weekly with warm water and air dry thoroughly. A spacer device or valved holding chamber is recommended
*Adverse Effects**:h/a, nausea, vomting, viral infection, rhinitis
*Monitoring Parameters**:Asthma symptoms; FEV1, peak flow, and/or other pulmonary function tests; heart rate, blood pressure, CNS stimulation; arterial blood gases. serum potassium, serum glucose

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Levothyroxine

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*pharm class**: thyroid product
*moa**:Levothyroxine (T4) is a synthetic form of thyroxine, an endogenous hormone secreted by the thyroid gland.
*use**:Hypothyroidism, Pituitary thyrotropin-stimulating hormone suppression

[OFFLABEL] Deceased organ donor management

*admin**:Administer consistently in the morning on an empty stomach, at least 30 to 60 minutes before food
*Adverse Effects**:palpitations, tachycardia, exercise intolerance, dyspnea on exertion, widened pulse pressure, and atrial fibrillation
*Monitoring Parameters**:Heart rate, BP, new/worsened cardiac symptoms (eg, chest pain, palpitations, edema), clinical signs of hypo- and hyperthyroidism; bone mineral density

Losartan

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pharm class:Angiotensin II Receptor Blocker;Antihypertensive

*moa**:blocks the vasoconstrictor and aldosterone-secreting effects of angiotensin II
*use**:Hypertension, chronic, Proteinuric chronic kidney disease, diabetic

[OFFLABEL] Heart failure with reduced ejection fraction

*admin**:Administer without regard to meals; however, administer consistently with respect to food intake at about the same time every day.
*Adverse Effects**: aki, hyperkalemia
*Monitoring Parameters**:Baseline and periodic BP, electrolytes, renal function

Memantine

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*pharm class**:N-Methyl-D-Aspartate (NMDA) Receptor Antagonist
*moa**:functions as an effective receptor blocker only under conditions of excessive stimulation; memantine does not affect normal neurotransmission.
*use**:Alzheimer disease

[OFFLABEL] Dementia (ie, Parkinson disease dementia, dementia with Lewy bodies, comorbid vascular dementia); Neurocognitive toxicity of whole brain irradiation, prevention

*admin**:without regard to meals. Extended release capsules may be swallowed whole or entire contents of capsule may be sprinkled on applesauce and swallowed immediately; do not chew, crush, or divide
*Adverse Effects**:confusion, dizziness, and headache,
*Monitoring Parameters**:Cognitive function; functional outcomes

Metoprolol

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*pharm class**:Beta-Blocker, Beta-1 Selective
*moa**:competitively blocks beta1-receptors, with little or no effect on beta2-receptors
*use**:Angina, Heart failure with reduced ejection fraction, Hypertension, MI

[OFFLABEL] a fib, migraine prevention, arrhythmias

*admin**:Administer with or immediately following meals
*Adverse Effects**:Bradycardia, fatigue, sleep disturbance, insomnia
*Monitoring Parameters**:Acute cardiac treatment: Monitor ECG, heart rate, and blood pressure with IV administration; heart rate, rhythm, and blood pressure with oral administration.Mental alertness, signs and symptoms of bronchospasm.

Polyethylene Glycol

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*pharm class**:Laxative, Osmotic
*moa**:causes water retention in the stool; increases stool frequency
*use**:Constipation, occasional

[OFFLABEL] Bowel preparation before colonoscopy
admin:Stir powder in 120 to 240 mL (4 to 8 ounces) of water, juice, soda, coffee, or tea until dissolved and administer immediately
Adverse Effects:Gastrointestinal signs and symptoms, diarrhea
Monitoring Parameters:

Rivaroxaban

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pharm class:Anticoagulant, Factor Xa Inhibitor;Direct Oral Anticoagulant (DOAC)

*moa**:Inhibits platelet activation and fibrin clot formation via direct, selective and reversible inhibition of factor Xa
*use**: afib, Coronary artery disease, Peripheral artery disease, Venous thromboembolism

[OFFLABEL] Acute coronary syndrome, Heparin-induced thrombocytopenia

*admin**:Administer doses ≥15 mg with food; doses of 2.5 mg and 10 mg may be administered without regard to meals
*Adverse Effects**:Heavy menstrual bleeding, Gastroenteritis, vomiting, cough, bleeding
*Monitoring Parameters**:Renal function and CBC prior to initiation, hepatic function; signs and symptoms of bleeding

Rosuvastatin

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*pharm class**:Antilipemic Agent, HMG-CoA Reductase Inhibitor
*moa**:Inhibitor of 3-hydroxy-3-methylglutaryl coenzyme A (HMG-CoA) reductase, the rate-limiting enzyme in cholesterol synthesis
*use**:Familial hypercholesterolemia, Prevention of cardiovascular disease

[OFFLABEL] Transplantation, post heart; Transplantation, post kidney

*admin**:Oral: Administer with or without food. May be taken at any time of the day. Swallow capsule whole
*Adverse Effects**:Myalgia, rhabdomyolysis
*Monitoring Parameters**:Lipid panel (total cholesterol, HDL, LDL, triglycerides)

Sitagliptin

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*pharm class**:Antidiabetic Agent, Dipeptidyl Peptidase 4 (DPP-4) Inhibitor
*moa**:inhibits dipeptidyl peptidase-4 (DPP-4) enzyme resulting in prolonged active incretin levels. Incretin hormones (eg, glucagon-like peptide-1 [GLP-1] and glucose-dependent insulinotropic polypeptide [GIP]) regulate glucose homeostasis
*use**:Diabetes mellitus, type 2, treatment
*admin**:Oral: Administer without regard to meals.
*Adverse Effects**:Dermatologic reactions, Heart failure, Anaphylaxis and angioedema, Pancreatic events
*Monitoring Parameters**:Serum glucose; renal function prior to initiation and periodically during treatment; signs/symptoms of heart failure, hypersensitivity, and/or pancreatitis; development of blisters or erosions.

Spironolactone

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pharm class:Antihypertensive;Diuretic, Potassium Sparing

*moa**:Competes with aldosterone for receptor sites in the distal renal tubules, increasing sodium chloride and water excretion while conserving potassium and hydrogen ions
*use**:Ascites due to cirrhosis, Heart failure with reduced ejection fraction, Hypertension, chronic, Primary hyperaldosteronism

[OFFLABEL] Acne vulgaris, females, moderate to severe; Heart failure with preserved ejection fraction; Heart failure with reduced ejection fraction (New York Heart Association class II); Hirsutism, females; Hormone therapy for transgender females, male-to-female; Post myocardial infarction, complicated by reduced ejection fraction

*admin**:Tablet: Administer with or without food. Suspension: Shake well before administering dose
*Adverse Effects**:Gynecomastia, Hyperkalemia
*Monitoring Parameters**:Blood pressure, serum electrolytes (potassium [within 1 week of initiation or dose titration and regularly thereafter], sodium), uric acid, glucose, renal function, volume status

Theophylline

* *_pharm class_**:Phosphodiesterase Enzyme Inhibitor, Nonselective * *_moa_**:smooth muscle relaxation (ie, bronchodilation) and suppression of the response of the airways to stimuli * *_use_**:reversible airflow obstruction associated with chronic asthma, or other chronic lung diseases (eg, emphysema, chronic bronchitis). copd [OFFLABEL] Bradycardia, heart transplantation; Reversal of dipyridamole-, **_admin_**:IV: Administer loading dose over 30 minutes; follow with a continuous infusion as appropriate.Oral: Extended release: Administer consistently with or without food (to maintain a consistent drug level); do not chew or crush tablets; may split tablet if scored. Adverse Effects: Headache, hyperactivity (children), insomnia, restlessness, seizure, status epilepticus, tachy, **_Monitoring Parameters_**:Heart rate, CNS effects (insomnia, irritability); respiratory rate (COPD patients often have resting controlled respiratory rates in low 20s); arterial or capillary blood gases (if applicable); fluid balance, electrolyte concentrations, and acid-base balance during prolonged IV therapy.

321 Flashcards

(25 cards)