Pathopharm Drug Tables Nclex Review
Pathopharm Drug Tables Nclex Review
Pathopharm Drug Tables Nclex Review
“-tidine” H2 Receptor H2RAs decrease gastric acid Malabsorption of iron, -Duodenal and
Antagonist secretion by reversibly binding to calcium, magnesium Gastric Ulcers
histamine H2 receptors located on -GERD
gastric parietal cells, thereby -Heartburn
inhibiting the binding and action of
the endogenous ligand histamine.
H2 blockers thus function as
competitive antagonists.
Bradycardia, decreased
respirations
“-prazole” Proton Pump Proton pump inhibitors (PPIs) Malabsorption of: GERD,
Inhibitor block the gastric H,K-ATPase, iron, calcium, Duodenal/Gastric
-Taken 30 inhibiting gastric acid secretion. magnesium ulcers
mins. before malabsorption PUD
meals They are the most potent
inhibitors of acid secretion
available today.
Omeprazole PPI Back, leg, or stomach Oral Iron, Part of the treatment
pain. iazepam, for PUD
carbamazepine,
clozapine, indinavir,
nelfinavir,
Antacids alkaline agents, not recommended Increases stomach OTC acid reflux
as only treatment, symptom releif PH, so affects how relief.
only! OTC Iron, Calcium and
Magnesium
absorption
Calcium Antacid
Carbonate
All a bit Antidiarrheal Agonists, Targets MU2 receptors Low doses otc, high prevents or relieves
different s (opioids in GI, causes decreased doses prescription diarrhea; inhibits
+atropine) peristalsis. The Atropine blocks peristalsis and
parasympathetic system and reduces fecal volume
stimulates the sympathetic
drive/stimulation- in the gi tract,
this decreases motility, which we
are working for.
Combats CNS depression and
decreased heartrate/ventrility
drive
Atropine is a stimulant, which
countereffects the opioid!
Lomotil Antidiarrheal
(dypenoxylat
e opioid +
atropine)
Imodium Antidiarrheal
(loperamide
HCL
meperidine +
atropine)
Metamucil, Bulk Forming Pull water into stool and add size Dehydration
PO, Laxative to it, water intake a must, used in
Suppository long term care homes
Colace Softener Pull water and Fat into Stool, Systemic effect, patients Post myocardial
(Docusate decrease surface tension and need to have good renal infarction (less strain)
Sodium) emulsify stool function for excretion Post surgery
Milk of Saline/ Pull water into stool Lactulose not absorbed in Pre-procedural
Magnesia, Osmotic lactose intolerance, milk
Lactulose of magnesia is renally Potent
excreted, so good function
needed.
Dulcolax, Stimulants Irritants, increase peristalsis, not N&V, cramping DO NOT USE IF
Senna, first choice for constipation or pre OBSTRUCTION OF
Castor OIl surgery PERFORATION
Dimenhydrin H1
ate Antagonist
Meclizine H1
(dramamine) antagonist
Doxylamine+ H1
pyridozine antagonist
hydrochloride
(diclectin)
Ondasetron 5HT3 Serotonin receptor Antagonist -Known to prolong the QT Drug induced,
(Zofran) Serotonin interval. Chemotherapy,
-Po, IV Antagonist -May cause cardiac Visceral pain
dysrhythmias. Nausea, chronic pain
Metocloprami D2 Receptor
de (maxeran, Antagonist
Reglan)
Dronabinol, Cb1/2 Receptor binding stimulated Patients may feel a little Chemotherapy,
Cesamet Agonism GABA, inhibitory effects, inhibition more sedated Chronic Disease,
of sympathetic activity (therefore Challening cases
no nausea) (Nausea)
PERFUSION DRUGS
Name Class MOA Side Effects Drug Interactions What it helps
Nipride Direct Acting Stimulates endothelial cell- Reflex tachycardia, Hypertensive Crisis
(Nitroprusside) - Vasodilator produced endogenous hypotension, syncope,
IV t1/2= 2 substance NITRIC OXIDE headache.
minutes (IV (L-arginine activates nitric
infusion) OR ET oxide)
for pulmonary
vasodilation.
Hydralazine- Direct Acting Stimulates endothelial cell- Reflex tachycardia, Hypertensive Crisis
PO/IV Vasodilator produced endogenous hypotension, syncope,
substance NITRIC OXIDE headache
(L-arginine activates nitric
oxide)
Furosemide Diuretics Blocks Na+, K+, Cl- (NKCC2) Hypokalemia, ototoxicity Highly PPB *1st line therapy for
(Lasix)- Potent, (Loop) reabsorption in Loop of Henle - hypertension
PO/IV increased Na, K, Cl out
Hydrochlorothia Diuretics -Renal distal convoluted tubule hypokalemia, *1st line therapy for
Thiazides increase
zide (HZTZ)- (Thiazides) -Decreases reabsorption of Na hyponatremia, hypertension
digitalis levels
PO from distal tubule hyperglycemia promoting visual
-alcohol and caffeine can
-increased Na & K out (allows disturbances.
enhance the hypotensive
K out) effect of Thiazides.
-ADME travel unchanged
Chlorothiazide Diuretics -Renal distal convoluted tubule hypokalemia, *1st line therapy for
Thiazides increase
(Diuril)- PO (Thiazides) -Decreases reabsorption of Na hyponatremia, hypertension
digitalis levels
from distal tubule hyperglycemia promoting visual
-alcohol and caffeine can
-increased Na & K out (allows disturbances
enhance the hypotensive
K out) effect of thiazides.
-ADME travel unchanged
Metolazone Diuretics -Renal distal convoluted tubule hypokalemia, *1st line therapy for
Thiazides increase
(Zaroxolyn)- PO (Thiazides) -Decreases reabsorption of Na hyponatremia, hypertension
digitalis levels
from distal tubule hyperglycemia promoting visual
-alcohol and caffeine can
-increased Na & K out (allows disturbances
enhance the hypotensive
K out) effect of thiazides.
-ADME travel unchanged
Spironolactone Diuretics -In Distal tubule. Hyperkalemia- can cause DON’T give with *1st line therapy for
(Aldactone)- (Potassium a Myocardial Infarction ACE inhibitors or hypertension
long t1/2= 1-2 Sparing) -Blocks renal aldosterone ARBs because of
days (Aldosterone = causes Na hyperkalemia.
retention) -Receptors = DON’T give with
increases Na out & keeps K+ in Digoxin.
-increases Na out
-ADME:
Therapeutically active
metabolites
-Temporary measure
for treatment of
intraocular pressure
-low use for
cardiovascular
-Temporary measure
for treatment of
intraocular pressure
-low use for
cardiovascular
“-pril” ACE Inhibitors Reduce vasoconstriction Severe hypotension *1st line therapy for
(vasodilate) via Angiotensin- Heart Failure
converting enzyme HIGH EFFICACY
Hypertension
Enalapril
(Vasotec)
Captopril-
frequently used!
Monopril
Ramipril
(Altace)
Cosart-H Thiazide
Diuretic and
ARB combo
Lovastatin Statins Lowers LDL myopathy- weakening of CYP3A4, CYP2C9 *1st line for post
(Mevacor)- PO -Decreased synthesis (via muscles interactions Myocardial Infarction
qd HMG reductase inhibition) & Pregnancy category X- Highly PPB
-liver function increased hepatic metabolism interferes with fetal CNS
dependant myelination
Rhabdomyolysis
Atorvastatin Statins Lowers LDL myopathy- weakening of CYP3A4, CYP2C9 *1st line for post
(Lipitor)- PO qd -Decreased synthesis (via muscles interactions Myocardial Infarction
-liver function HMG reductase inhibition) & Pregnancy category X- Highly PPB
dependant increased hepatic metabolism interferes with fetal CNS
myelination
Rhabdomyolysis
Simvastatin Statins Lowers LDL myopathy- weakening of CYP3A4, CYP2C9 *1st line for post
(Zocor)- PO qd -Decreased synthesis (via muscles interactions Myocardial Infarction
-liver function HMG reductase inhibition) & Pregnancy category X- Highly PPB
dependant increased hepatic metabolism interferes with fetal CNS
myelination
Rhabdomyolysis
Niacin- a form of Herbal Increases HDL -Intense flushing and hot Ideal for patients with
Vitamin B3 flashes low HDL
-decreases liver cholesterol
- 3 g/day synthesis and increases -Tingling of the fingers -Used for synergy
clearance and toes with Statins mainly
-life-threatening= up to 3%
of patients
-life-threatening= up to 3%
of patients
Nitroglycerine Organic
(Nitro)- SL Nitrates Exogenous ‘Nitric Oxide’ - Can cause fainting, *1st line Acute
tablet/spray/ IV Causes vasodilation dizziness- especially in Intervention
-1 SL tablet older adults
q5min x 3 doses
=> call EMS -Should be sitting down
while taking nitroglycerine
-High coronary
circulation
efficacy
Topical
ointment= can
be applied to
ANY skin
surface
Patch=
repeated use of
the SAME
application site
will decrease
absorption and
cause skin
irritation.
Isosorbide
P Inhibitors
Milrinone-
>minutes
•IV only
Amrinone-
>minutes
•IV only
ANTIINFECTIVE DRUGS
Cell Wall Inhibitors
Name Class MOA Side Effects Drug What it helps
interactions
Clavulanic
Ticarcillin (co- Acid &
ticarclav tazobactam
(Timentin)) (combinatio
n
Pip-Taz Clavulanic
(Pipercillin/Tazo Acid &
bactam, tazobactam
(Tazosin, (combinatio
Zosyn)) n
Broad spectrum
penicillin
Ampicillin/ Prophylaxis
subactam
Piperacillin/ Prophylaxis
tazobactam
“cef” Cephalospo Largest antibiotic class, Chemical structure: 1st choice now for Skin
rins beta-lactam ring Bactericidal infections
gram + and gram -, higher generations cross
BBB (3-5th)
Cefazolin Cephalospo
(Ancef), IV rins
Cephalexin Cephalospo
(Keflex) PO rins
Cefuroxime Cephalospo
rins
“-penem” Carbapene Chemical Structure: Beta lactam ring, Very broad spectrum, serious
Imipenum, ms Bactericidal and mixed infections,
Meropenem meningitis, aspiration
Potent, not 1st pneumonia
line therapy; IV
only Resistance
growing
Vancomycin Glycopeptid
e 1st choice now for: MRSA
(Staph. Aureus)
“-ycline” Tetracycline Broad spectrum Gram Bone deformations i.e. Lyme disease, Cholera, H-pylori,
+, -, bacteriostatic Chlamydia, Acne (Accutane preferred:
Vitamin A); Malaria prophylaxis
Doxycycline Tetracycline
Demeclocyclin Tetracycline
e
“-mycin” Macrolides PO, very effective, 1st choice now ‘community acquired’
bacteriocidial, adult pneumonia
bacteristatic, gram + • Last tx option for Gonorrhea
mostly, some - (combined w a Cephalosporin)
Erythromycin, Macrolide
Azithromycin Macrolide
(Zithromax)
Clarithromycin Macrolide
(Biaxin)
Gentamicin -IV Aminoglycosi Gram - POTENT Narrow TI-Serum Gram -, high risk infections
des levels completed!
Tobramycin - Nephrotoxicity, Eye drops for conjunctivitis
ophthalmic Neurotoxicity,
drops Hepatotoxicity
Streptomycin- Aminoglycosi
IV des
Neomycin-IV Aminoglycosi
de
Cefazolin IV + Combination
Gentamicin IV therapy:
• E.g. utilizing
penicillins or properties of
cephalosporins individual
+ drugs to
aminoglycosid improve
es efficacy
Bacterial wall
inhibition +
bacteriostatic
within cell
Levofloxacin Fluroquinolones
Norfloxacin Fluroquinoles
ANTIMETABOLITE
Name Class MOa Side effects Drug How it helps
intera
ction
s
-Sulfa prefix Sulfonamides Inhibit folic acid synthesis ,inhibits ALLERGY Gram + & - bacteria
sulfamethoxazole; cellular function UTI (now preferred)
t-
sulfamethoxazole
(TMP/SMX,
Bactrim, Septra)
Rifampin TB
+ 4 more anti-TB Treatment 6-12
meds months Resistant
strains present!
•Ganciclovir Herpesvirus-5
(CMV)
Tamiflu Influenza
Amantadine Influenza
•Check for
ALLERGY (Opioid
allergies are not
uncommon)
•Caution: in severe
asthma patients (d/t
opioid stimulated
histamine release)
Pregnancy
Category D
hydrocodone, Opioids
oxycodone MODERATE EFFICACY
(OxyNeo) + Heroin, Opium= Opioids
oxycontin;
Percocet
(oxycodone +
acetaminophen),
Percodan
(oxycodone +
ASA), Vicodin
(hydrocodone +
acetaminophen),
Tramacet
(Tramadol +
acetaminophen),
buprenorphine
Budesonide Glucocorticoids •Lipophilic = hydrophilic via metabolism •Few side-effects •For Allergic Rhinitis
(Rhinocort) High Efficacy (low systemically) (nasal symptoms)
-easily excreted
Fluticasone •Overall highly PPB
(Flonase)
•Histamine release suppression
Mometasone
(Nasonex) •Prostaglandin synthesis inhibition
(COX-2)
•Intranasal
administration •Suppression of
Phagocytes/lymphocytes
Diabetes Drugs
Name Class MOA Side effects Drug What it helps
Interactions
•Peak: 1-2 hr
Entuzity (KwikPen)
•5x more concentrated; for
high daily insulin
requirements;duration= 15 min
– 20 hrs!!!
Glyburide (DiaBeta) SULFONYLU Increase Insulin release & Safe for most DM 2
REAS receptor sensitivity diabetic patients; s/e:
•Action: onset 1 hr, peak 2-3
weight gain!;
hrs, duration 10-24 hrs
abdominal pain; no
•Administer: PO, daily ETOH intake
DM 2
Rosiglitazone (Avandia) -increases glucose uptake into weight gain
cells from plasma
Hypothyroidism
Levothyroxine (Synthroid) Therapeutic action = Identical to
endogenous thyroid hormones.
-Synthetic form of T4
-PO (IV if necessary); 40-80%
Onset of action 3-5 days bioavailability
Neurology
All CNS Drugs:
•Norepinephrine Catecholam
ines •Stimulate sympathetic nervous
(alpha- more alpha system
specific+beta)
•Receptor specificity or not!
•Epinephrine
(alpha+beta)
•Dobutamine (beta1)
•Dopamine (beta1)
Isoproterenol (Isuprel)
(alpha1, beta1, beta2)
•Phenylephrine (alpha)
•Ventolin (beta2)- used
in asthma
•Serevent (beta 2)-
used in COPD
•Pilocarpine (Decrease Cholinomim Stimulate parasympathetic nervous •topical formulation= tearing, Glaucoma tx
intraocular pressure) etics system blurry vision, headache
•eye drops (topical •Stimulate Acetylcholine •vs systemic cholinergic effects
formulation) (e.g IV)
•Effects: dilation of trabecular
•Combination meshwork = increased aqueous ‘cholinergic’ effects
treatment with humour outflow = decreased ocular •Hypotension, Bradycardia
NSAIDs- decreases pressure
inflammation in the •Increased secretions
tissue! •Bladder spasms
Bupropion (Zyban, Dopamine •Nicotine via other delivery routes seizures, insomnia, headache, Nicotine
Wellbutrin) & VS changes Replacement
•Decreased bioavailability Therapy
Norepineph
rine •Decreased toxic substances other
reuptake than nicotine
inhibitor •E.g. Patch
increased dopamine &
norepinephrine
Neostigmine Acetylcholin
esterase •inhibition of Cholinesterase •For low muscle
-no BBB cross inhibitors enzyme = decreased tone!
neurotransmitter re-uptake
AKA
within the synapse
cholinester
ase =Increased Ach presence in
blockers CNS synapse
•Vecuronium Nicotinic
Antagonists •Block Acetylcholine binding at •Constant monitoring •Patient who
•Rocuronium nicotinic receptors of vital signs- will need needs to be
•Pancuronium to receive analgesia! paralyzed-
(SNS, PNS, and skeletal
muscle junctions) complex surgery,
Neuromuscular severe trauma
blockade -no BBB penetration accident-
•Succinylcholine (short diaphragm and
t1/2)-For patients who intercostals will
need to be intubated!
not move- anyone
•Botox (Intradermal receiving these
injection; superficial needs a ventilator!
paralysis)
Benzodiazepines work by
binding to the GABAa
neurotransmitter- opening the
chloride channel- causing a
calming effect
Benzodiaze Benzodiazepine
Flunitrazepam pines Abuse
(Rohypnol)= roofy
•10x potency of Valium
•Intermediate acting
benzo
•Onset 15 min
•Peak 2 hrs
•Duration 4-6 hrs
Alprazolam (Xanax)
Benzodiaze Euthanasia
Benzodiazepine IV + pine and
Propofol- anesthesia Anesthesia
medication + and
Rocuronium-
neuromuscular blockade Nicotinic
Antagonist
(Neuromus
cular
Blockade)
Antipsychot Psychosis
ics AKA Block Limbic system D2 •D2 antagonism in
neuroleptic dopamine receptors basal ganglia =>
s Extrapyramidal side
•Limbic system- main control of
effects:
mood, behavior, emotion
•Tardive dyskinesia
•degree of antagonism =
(strange tongue
success with therapy
movement),
•degree of specificity = fewer Parkinsonism (rigidity),
other effects tremors, restlessness,
•NOT addictive dystonias (muscle
spasm)
•Wide TI
•Stop/reassess tx
•High PPB
Antipsychot Psychosis
‘Typical’/Original drugs: ics AKA •associated
neuroleptic 5HT/serotonin
Chlorpromazine
s blockade;
Haloperidol (Haldol) anticholinergic;
sedation!
Onset of action:
•Anticholinergic side
•days to improvement of effects: urinary
hallucinations/delusions retention, dry mouth,
•6-8 weeks to overall sexual dysfunction
improvement •ALERT: Neuroleptic
•If change of therapy, Malignant Syndrome
slow toxic reaction:
withdrawal/‘weaning’ hyperthermia, unstable
protocols: risk of BP, diaphoresis,
Delirium tremens- rapid incontinence
onset of confusion: Physical Dependance
symptoms= irritability,
insomnia, anxiety, •The body adapts to
tremors, N&V, seizures, the presence of
hallucinations exogenous substance
•Creates tolerance
(defined as requiring
higher doses to yield
the same effect, not
always seen for all
effects)
•Agitation,
hallucinations
•Tachycardia, BP
changes
•N&V, diarrhea
•Tachycardia, BP
changes
•N&V, diarrhea
Potency of alcohol
and cocaine
becomes about
3.5x higher when
both are taken
together
•Active metabolite =
extra long duration of
action (12-20 hrs)
-PO route most common
-Also comes as a
sublingual tablet in
blotting papers
ETOH overdose:
Symptomatic support,
benzodiazepines, high
dose IV vitamins
Quaaludes Sedative
hypnotics/h •Increased: serotonin &
(Methaqualone)
allucinogen dopamine
s
•NMDA (Glutamate) receptor
antagonist =>
•hallucinations, altered
perceptions/thoughts
•sedation & amnesia with
some drugs
Dimethyltryptamine Sedative
hypnotics/h •Increased: serotonin &
(DMT) AKA Aya
allucinogen dopamine
(Ayahuasca), dimitri,
business trip, fantasia s •NMDA (Glutamate) receptor
antagonist =>
•Route: tea; PO,
smoked, snorted, IV •hallucinations, altered
perceptions/thoughts
•sedation & amnesia with
some drugs
NUTRITION DRUGS
Name Class MOA Side effects Drug What it helps
Interac
tions
IV or IM
administration-
avoids GI upsets!
Iron Poisoning
Deferoxamine ‘chelator’; ‘chelation therapy’
(Desferal)
•chelates (binds) iron to form non-
T ½ = 6 hrs reactive complexes
•Highest affinity for ferritin &
IV administration
hemosiderin-bound iron
highest efficacy
•Low affinity for transferrin-bound iron
INFECTION DRUGS
Name Class MOA Side effects Drug What it helps
Interactions
Human Blood To create an osmotic Allergic reactions possible though Low plasma volume
Serum product gradient that draws fluid uncommon
Albumin Collioid from the interstitial space Peripheral edema Hypovolemic shock
(Albuminar, into the vasculature; Pulmonary congestion Hypoproteinemia
Alburex, increased intravascular Clotting difficulties as dilution of
Plasbumin) volume, increases blood blood increases
IV pressure Circulatory overload if too much
fluid drawn into vasculature
Can exacerbate heart failure Renal
failure can promote fluid overload
ONCOLOGY DRUGS
Name Class MOA Side effects Drug Interactions What it helps
Tamoxifen (Nolvaldex) SERMs Hormones and Hormone Bind to receptor sites that
(selective estrogen receptor Antagonists promote growth (cell cycle Non-cytotoxic,
modifiers) (cell cycle non-specific) non-specific) typically palliative,
therapy limited to
•Antagonizes estrogen receptor in SERMs (selective estrogen
breast or prostate
breast, agonist in other tissues (ie receptor modifiers) cancers
bone) •Tissue specific agonists /
•Blocking estrogen receptor in breast antagonists of estrogen
reduces tumour growth receptors
•Blocking estrogen receptor
•Prophylaxis of breast cancer for at breast can limit tumour
high-risk patients growth
•Adjunctive therapy following a Aromatase inhibitors
mastectomy to decrease potential for •Prevent formation of
cancer in the contralateral breast estradiol (another form of
estrogen) from androgens,
only effective post-
menopause
GnRH (gonadotropin
releasing
hormone)analogues
•Used for prostate cancer
•Initially increases
production of endogenous
testosterone, but negative
feedback mechanism stops
endogenous production
Corticosteroids
•Used for lymphomas and
leukemias
Tamoxifen, Toemifene and SERMs (selective estrogen Hot flashes, fluid •Gold standard for
Fulvestrant receptor modifiers) •Block estrogen receptors retention, NV, endocrine treatment
•A prodrug that is converted to active and only work against menstrual of breast cancer
metabolites cells that are estrogen irregularities, •Used to treat
receptor positive established disease
hypercalcemia, and for primary
•Benefits derive from endometrial cancer prevention of
depriving tumor cells of and blood clots women at high risk
the growth promoting •Continuing
influence of estrogen Tamoxifen for 10
•Blocks estrogen years can almost
receptors in some tissues halve breast cancer
(breast cancer benefit to mortality in the
prevent growth and second decade
proliferation) and activates after diagnosis.
them in others (increased •Reduces the
bone mineral density, incidence of breast
reduction of LDL, cancer in high risk
elevation of HDL) women by 44%
taking the drug for 4
years
Aromatase
Anastrozole Trastuzumab Inhibitors •Block estrogen from •Increase the risk of •Treat estrogen
•monoclonal antibody approved for androgenic precursors but fractures and receptor positive
HER-2 metastatic cancer and not from ovaries associated with breast cancer in
adjuvant therapy of HER-2 positive moderate to severe post-menopausal
breast cancer and HER-2 metastatic •May cause a myalgias women
gastric cancer. Adverse effects: compensatory rise in •Anastrozole is well
cardiotoxicity, manifesting often as estradiol in tolerated but most
congestive heart failure; combining premenopausal women common adverse
with paclitaxel can result in cardiac •Drugs work by depriving effects are
damage. Concurrent use with breast cancer cells of musculoskeletal
doxorubicin and other anthracyclines estrogen. pain (over 50%),
should be avoided. headache, and
menopausal
Does not cause bone marrow symptoms. N&V
suppression or alopecia, Diarrhea, dyspnea,
peripheral edema
Ado-Trastuzumab Emtansine and hypertension
•High dose Vitamin
Pertuzumab C and D may help
with myalgia and
Denosumab and Bisphosphonates bone density;
used to preserve bone integrity, increases the risk of
decrease hypercalcemia and osteoporosis and
fractures; decrease osteoclast related fracture.
activity, block tumor adhesion to
bone
Hematopoietic growth
factors
•Promote formation of
blood cells to reduce
complications from
myelosuppression