Class of Medications Anticholinergic/ Cholinergic/ Sympatho mimetic, Sympatholytic Approximate Breakdown of Questions 4 Adrenergic agonists (Sympathomimetics): Epinephrine: “Think Epi Pen” Code or anaphylaxis. Isoproterenol and Albuterol: “opens everything up” increase HR, bronchodilation, relax uterus. Can be used in ER situations. Dopamine: Used in shock situations to help with Low BP. Watching CAREFULLY during IV treatment. **What do you use to treat extravasation? Tx: Phentolamine!** Adrenergic Antagonist (sympatholytics): Doxazosin: Vasodilator- used for HTN and BPH. “Doc Zosin said use this for HTN and BPH” Propranolol: “Two Ps for 2 blockers” Not very picky… Tx HTN. Careful for asthma patients bc of effects on Lungs. Atenolol and metoprolol: “only treats 1 heart”: HTN and arrhythmias Cholinergic: Bethanechol: “Aunt Bethany needs to unclench and pee” Treats urinary retention Pyridostigmine: “Py for My” Used to tx Myasthenia gravis. *Tensilon test is the diagnostic. Donepezil: “Uncle Don has Alzheimer’s and takes his pill”. Blocks the break down of ACH Musculoskeletal/ Neuro Junction Blockers Anticholinergic: Atropine: “Climb the Pine tree to increase the HR. Pine is also dry” Use in codes and for OD of organophosphates (insecticides) 1-2 Succinylcholine: “It SUCKS to be intubated”. Used to paralyze before intubation. Careful for cirrhosis, cancer and burns. **How to treat is malignant hyperthermia occurs??? Tx with Dantolene** Antidepressants 4-6 TCAs: Imipramine and amitriptyline (Im a pear and trip the line)Serotonin and NE. Drying effects with this med. Contraindicated in MI, glaucoma, sz pts MAOIs: Nar-Mar-Par- Phenelzine- (No Phene “fennel” on the charchuterie board”. Does not play nice with others, especially other Antidepressants. Wean off slowly, be off for a few weeks and then start new medication. SSRIs: Fluoxetine & Sertraline: (Flus and SERS make me need serotonin). Natural supplements like St. John’s wort, ginko, ginseng and valerian are no nos. Matching Antipsychotic Bupropion: (the boo be happy drug. Your boo will be happy with your weight loss and sexual function) Do not give to sz pts. Wellbutrinsmoking cessation. 2-3 3-4 Chlorpromazine- block dopamine. (Chlorine and prom dates, block dope times) Do not give to dementia pts. Cause EPS symptoms (Tardive dyskinesia, puesdoparkinsons, Akathsia, dystonia). **How do you treat??= Benadryl and benztropine** Clozapine: (Clause is a schizo). Causes neuroleptic malignant syndrome. Watch WBCs! Regular lab draws to monitor for agranulocytosis. Lithium: watch fluid balance. Monitoring is important because there are toxic levels which can cause ECG changes, CV changes Methylphenidate: (meth for your ADD). Weigh first! Cause loss of appetite. Benzos Parkinson’s Haloperidol: (Halo for your doll of a pt). Watch for dystonia. **How do you treat? Your best friends Ben! Benztropine and Benadryl** 2-4 Diazepam and Lorazepam: Increase your GABA. “show GABA GABA makes you calm down”. **How do you treat**? Flumazenil? “treat the benzo flu!” Why can’t you take when pregnant? Cleft palate and lip, cardiac defects, microcephaly, pyloric stenosis. Which med do you give for active seizure? Lorazepam. 1-3 Barbiturates Thyroid Diabetes Levodopa- (Lift up your dopamine! & with carbs you need less lifting). What is on-off syndrome? The short half-life requires redosing or the symptoms turn on suddenly. More Carbs, less protein and vitamin B6 (only with Levadopa). 1-3 Must watch for respiratory depression, must have good liver function, can be used to prevent seizures but NOT active seizures. 3-4 Hyperthyroid: High T3/T4. (Toooo much hype, yo!). Tx. “Put Thyroid Under”= PTU Hypothyroid: Low T3/T4. (Hypo Hippo. Loww and slowww). Tx: Levothyroxine. “Lift up the thyroid”. Take with full glass, in am, before anything else. 3-4 Rapid: Humalog. “Logs roll rapidly down hills”. Genetic: Lispro. Lisps go rapidly off the lips. 5-30 min Regular. “Regular people are short people”. 30-60 min NPH: “Neil Patrick Harris is an intermediate actor.” 1-2 hours to watch his movies. Long: Glargine and Detemir are LONGGG words. S/s of Hyper: PPP, fruity breath, rapid breathing, vision changes Antiemetic s/s of hypo: “Think HANGRY!!” grumpy, sweating, palpitations, weakness, headache, shakes. What is the rule of 15s? 15 g of sugar, check 15 min, 15 g of sugar. 3-4 Scopolamine: Patch for seasickness and dry secretions. “use the scope on the deck while on sea” Ondansetron: tx N&V by blocking the receptors Dronabinol: THC nausea tx during chemo. GI motility Prochlorperazine: decreases stimulation in the medulla. Used for hiccups. Watch for photosensitivity, dark urine and EPS. 2-3 Bisacodyl: stimulate to empty bowels. “Too many biscuits make you go poop” Magnesium citrate: Think about those stories of drinking the whole bottle. Watch of mag toxicity Docusate: lubricates stool. Metoclopramide: Treats GERD. GI secretions Loperamide: “Loops of the bowel” tx diarrhea. Don’t take too much to prevent rebound constipation 2-3 Sucralfate: film over the ulcer. May cause dizziness, nausea or dry mouth. Can block other drug absorption. Cimetidine: H-2 blocker. “Dine- to eat” Tx of duodenal ulcer, gastric ulcer, hypersecretions and GERD. Antacids (calcium carbonates): excessive use can lead to alkalosis. Watch electrolyte imbalance. Male/Fe Reproductive Meds Omeprazole: Proton Pump Inhibitor: Heartburn and GERD. Helps with abx for H. Pylori. May cause headache, dizziness, or vertigo. Do NOT crush. May cause brittle bones with long term use. 2-3 Female: Estradiol: Treats menopause and hormone replacement. Can treat prostate cancer and inoperable breast cancer. Increased risk of breast and cervical cancer. No grapefruit, no St. Johns Wort. Raloxifene: ERM: Increase bone density. Clomiphene: “Clome the mom”. Infertility drug. Could cause multiple births, defects or over stimulation of the ovaries Oxytocin: Uterine contraction. Male: Testosterone: Male sex hormone. Can increase RBC or treat breast cancer. Can cause DVT, PE, weight gain or sexual dysfunction. Oxandrolone: “Strong as an Ox”: body building steroid. Increase hemoglobin and RBCs. Can cause sexual dysfunction, weight gain, cardio issues. Immune Sildenafil: “Get a fill”. Tx for erectile dysfunction. Do NOT give with Nitroglycerin. Pulmonary hypertension. 2-4 Interleukin: Suppress the leukocytes Interferons- “Interferers”- Cause flu like symptoms. Chemo (includes antihelmith and antiprotozoal) Filgrastim (Neupogen): “Neutrophils= Neutro- Fil”- Cause bone pian alopecia and rash 4-5 Antiprotozoals: Chloroquines: “Chlorine Queen fights malaria”. Can effect the CNS, visual and ototoxicity Antihelminth: Mebendazole: “Bend over from the worms”. Stool samples for O&P testing. Clean clothing and sheets daily and good handwashing! Antineoplastics: Methotrexate: Multiple uses. Cancer and RA. Get a full drug history. Doxorubicin: “ruby urine”- Watch for red urine Vincristine: “Vinny has bloody urine and its giving him chills and a heart attack” Tamoxifen: “Tampax like symptoms”. Approximate Breakdown of Questions on Final 4/26/22 50 Questions each worth 2 points 33% of Questions on Exam 1 Content 33% Question on Exam 2 Content 34% of Questions on Last Section after Exam 2