DRUGSDRUGS

SUPPLEMENTALS ON SUPPLEMENTALS ON PHARMACOLOGYPHARMACOLOGY

Basic pharmacological Basic pharmacological classificationclassification

Action and indicationAction and indicationBad effects – adverse reaction /side effectBad effects – adverse reaction /side effectConsiderations Considerations Drug examplesDrug examples

DRUGS AND DRUG DRUGS AND DRUG CLASSIFICATIONS COMMONLY CLASSIFICATIONS COMMONLY

ASKEDASKED

DOPAMINE AND DOBUTAMINEDOPAMINE AND DOBUTAMINE ADRENALINADRENALIN

LIBRIUMLIBRIUM VALIUMVALIUM ATARAXATARAX

AMPHOGELAMPHOGEL MAALOXMAALOX

LIDOCAINELIDOCAINE AMINOGLYCOSIDESAMINOGLYCOSIDES CEPHALOSPORINSCEPHALOSPORINS

ERYTHROMYCINERYTHROMYCIN PENICILLINSPENICILLINS SILVADENESILVADENE

NITROFURANTOINNITROFURANTOIN PYRIDIUMPYRIDIUM

PROBANTHINEPROBANTHINE HEPARINHEPARIN COUMADINCOUMADIN

DILANTINDILANTIN VALIUMVALIUM PHENOBARBITALPHENOBARBITAL MAGNESIUM SULFATEMAGNESIUM SULFATE TEGRETOL AND CLONAZEPAMTEGRETOL AND CLONAZEPAM

MAOMAO TRICYCLICS-E.G.TOFRANIL/ELAVILTRICYCLICS-E.G.TOFRANIL/ELAVIL SSRI-FLOUXETINESSRI-FLOUXETINE

INSULININSULIN OHAOHA GLUCAGONGLUCAGON

LOMOTIL / IMMODIUMLOMOTIL / IMMODIUM COMPAZINE / DRAMAMINECOMPAZINE / DRAMAMINE

AMPHOTERICINAMPHOTERICIN COLCHICINECOLCHICINE PROBENECIDPROBENECID ALLOPURINOLALLOPURINOL

BENADRYLBENADRYLQUESTRANQUESTRAN

ANTIHYPERTENSIVESANTIHYPERTENSIVESLITHIUMLITHIUMANTINEOPLASTIC AGENTSANTINEOPLASTIC AGENTS

ANTIPARKINSONIAN ANTIPARKINSONIAN AGENTSAGENTS

ASAASA

ANTIPSYCHOTICSANTIPSYCHOTICS

TYLENOL AND PARACETAMOLTYLENOL AND PARACETAMOL ANTI-THYROIDSANTI-THYROIDS THYROID REPLACEMENTSTHYROID REPLACEMENTS ANTI TUBERCULARANTI TUBERCULAR MUCOLYTIC,EXPECTORANTSMUCOLYTIC,EXPECTORANTS BRONCHODILATORSBRONCHODILATORS ANTIVIRALANTIVIRAL

RITALIN , CYCLERTRITALIN , CYCLERT DIAMOXDIAMOX PILOCARPINEPILOCARPINE DIGOXINDIGOXIN

TENSILON TENSILON MESTINON AND PROSTIGMINMESTINON AND PROSTIGMINDIURETICSDIURETICSELECTROLYTE REPLACEMENTELECTROLYTE REPLACEMENTEYE MEDICATIONSEYE MEDICATIONSSTEROIDSSTEROIDSH2-RECEPTOR BLOCKERSH2-RECEPTOR BLOCKERS IMMUNOSUPRESSANTSIMMUNOSUPRESSANTSLAXATIVES AND STOOL SOFTENERSLAXATIVES AND STOOL SOFTENERSMIOTICS AND MYDRIATICSMIOTICS AND MYDRIATICS

MORPHINE SULFATEMORPHINE SULFATEDEMEROLDEMEROLNITROGLYCERINNITROGLYCERINISORDILISORDILNSAIDSNSAIDSSTREPTOKINASESTREPTOKINASE

ENDURANCE – DEVELOPS ENDURANCE – DEVELOPS EVERYTIME YOU DEFEAT EVERYTIME YOU DEFEAT THE TEMPTATION TO GIVE THE TEMPTATION TO GIVE UP……QUITTERS NEVER UP……QUITTERS NEVER LOSE BUT THEY NEVER LOSE BUT THEY NEVER WIN. REST IF YOU MUST. WIN. REST IF YOU MUST. BUT DON’T QUITBUT DON’T QUIT

SELECTED DRUGSSELECTED DRUGS

C LASSIFICATIONC LASSIFICATIONHOW TO ASSESS FOR HOW TO ASSESS FOR

EFFECTIVENESSEFFECTIVENESSEXACT TIMEEXACT TIMECLIENT TEACHING TIPSCLIENT TEACHING TIPSKEYS IN SAFETYKEYS IN SAFETY

AMPHOGEL(Aluminum Hydroxide)AMPHOGEL(Aluminum Hydroxide) AntacidAntacid Decrease in abdominal pain; neutralize gastric Decrease in abdominal pain; neutralize gastric

acidsacids Best given 2 hours after and 1 hour before Best given 2 hours after and 1 hour before

mealsmeals Increase OFI and bulk in diet, ambulate- causes Increase OFI and bulk in diet, ambulate- causes

constipation, absorption of antibiotics constipation, absorption of antibiotics ( tetracycline and phenothiazines and ( tetracycline and phenothiazines and effectiveness of ASA’S and pills are decreased.effectiveness of ASA’S and pills are decreased.

Use cautiously in patients with cardiac and renal Use cautiously in patients with cardiac and renal disease; monitor bowel function; monitor for disease; monitor bowel function; monitor for signs of phosphate deficiency-malaise,weakness signs of phosphate deficiency-malaise,weakness tremors and bone paintremors and bone pain

ALLUPURINOL(ZYLOPRIM)ALLUPURINOL(ZYLOPRIM) ANTIGOUT AGENTANTIGOUT AGENT REDUCED URIC ACID (BOTH SERUM AND REDUCED URIC ACID (BOTH SERUM AND

URINARY)BY INHIBITING XANTHINE URINARY)BY INHIBITING XANTHINE OXIDASE.OXIDASE.

GIVEN AFTER MEALS;MAY BE CRUSHED OR GIVEN AFTER MEALS;MAY BE CRUSHED OR WITH FLUID OR MIXED WITH FOODWITH FLUID OR MIXED WITH FOOD

CAUSES AGRANULOCYTOSIS,APLASTIC CAUSES AGRANULOCYTOSIS,APLASTIC ANEMIA,URTICARIA AND IS HEPATOXIC AND ANEMIA,URTICARIA AND IS HEPATOXIC AND RENAL INSUFFICIENCYRENAL INSUFFICIENCY

AIM IS TO LOWER SERUM URIC ACID LEVEL AIM IS TO LOWER SERUM URIC ACID LEVEL TO 6 MG/DL(MONITOR BY 1-3 WKS; TO 6 MG/DL(MONITOR BY 1-3 WKS; MONITOR LFT’S AND KIDNEY FUNCTION; MONITOR LFT’S AND KIDNEY FUNCTION; REPORT ONSET OF RASH;REPORT ONSET OF RASH;INCREASE OFI; AVOID EXPOSURE TO UV INCREASE OFI; AVOID EXPOSURE TO UV RAYS - CATARACTSRAYS - CATARACTS

ANTABUSEANTABUSE

CAUSES AN UNPLEASANT REACTION WHEN CAUSES AN UNPLEASANT REACTION WHEN COMBINED WITH ALCOHOLCOMBINED WITH ALCOHOL

PATIENT AVOIDS ALCOHOLPATIENT AVOIDS ALCOHOL BEST TAKEN AFTER ABSTAINING ALCOHOL BEST TAKEN AFTER ABSTAINING ALCOHOL

FOR 12 HOURSFOR 12 HOURS INSTRUCT PATIENT TO AVOID ALCOHOL INSTRUCT PATIENT TO AVOID ALCOHOL

BASED SUBSTANCESBASED SUBSTANCES INSPECT PATIENTS BELONGINGS AND INSPECT PATIENTS BELONGINGS AND

CONFISCATE ALCOHOLIC SUBSTANCES, CONFISCATE ALCOHOLIC SUBSTANCES, MONITOR LFT’SMONITOR LFT’S

APRESOLINE -HYDRALAZINEAPRESOLINE -HYDRALAZINE

ANTI HYPERTENSIVEANTI HYPERTENSIVEDECREASED BPDECREASED BPBEST TAKEN WITH FOODBEST TAKEN WITH FOODRISE SLOWLYRISE SLOWLYMONITOR FOR ORTHOSTATIC MONITOR FOR ORTHOSTATIC

HYPOTENSION AND HR FOR HYPOTENSION AND HR FOR TACHYCARDIATACHYCARDIA

ATROPINE SULFATEATROPINE SULFATE

ANTICHOLINERGIC, VAGOLYTIC DRYING ANTICHOLINERGIC, VAGOLYTIC DRYING AGENTAGENT

INCREASES HEART RATE IN A CLIENT WITH INCREASES HEART RATE IN A CLIENT WITH HEART BLOCK, USED PRE-OPERATIVELY TO HEART BLOCK, USED PRE-OPERATIVELY TO DECREASE SECRETIONSDECREASE SECRETIONS

BEST TAKEN 30 MINUTES BEFORE MEALBEST TAKEN 30 MINUTES BEFORE MEAL MAY CAUSE FACIAL FLUSHING, AVOID TASKS MAY CAUSE FACIAL FLUSHING, AVOID TASKS

THAT REQUIRE ACUTE VISIONTHAT REQUIRE ACUTE VISIONAVOID HOT ENVT.AVOID HOT ENVT.

CHECK BP, CAUSES HYPOTENSION, CHECK BP, CAUSES HYPOTENSION, CONSTIPATION AND DRYMOUTHCONSTIPATION AND DRYMOUTH

Bromcriptine Mesylate ( Parlodel)Bromcriptine Mesylate ( Parlodel)

Ergot Alkaloid, Antiparkinsonian agent, ANS Ergot Alkaloid, Antiparkinsonian agent, ANS agentagent

Restoring of ovulation thus correction of female Restoring of ovulation thus correction of female infertility and activated dopaminergic receptors infertility and activated dopaminergic receptors in the CNS – relief of symptoms of parkinsons – in the CNS – relief of symptoms of parkinsons – improvement seen in60-90 minimprovement seen in60-90 min

Give with meals, milk / food afterV.S. stabilizedGive with meals, milk / food afterV.S. stabilized May cause shock MI, Raynaud’s ,orthostatic May cause shock MI, Raynaud’s ,orthostatic

hypotension and nausea; supressed lactationhypotension and nausea; supressed lactation Have patient lie in supine position –may caues Have patient lie in supine position –may caues

dizziness and fainting;store intightly closed dizziness and fainting;store intightly closed containers;containers;

CELESTONECELESTONE((BETHAMETHASONEBETHAMETHASONE))

STEROID,STIMULATES LUNG STEROID,STIMULATES LUNG MATURITY IN INFANTSMATURITY IN INFANTS

- RESP DISTRESS- RESP DISTRESSGIVEN WITH FOODGIVEN WITH FOODREPORT SIGNS OF INFECTIONREPORT SIGNS OF INFECTIONMONITOR WEIGHT , GIVE ONCE A DAY MONITOR WEIGHT , GIVE ONCE A DAY

DOSE IN THE MORNING TO AVOID DOSE IN THE MORNING TO AVOID INSOMNIAINSOMNIAGIVEN 48 HOURS BEFORE DELIVERYGIVEN 48 HOURS BEFORE DELIVERY

Buspirone Hcl ( Buspar)Buspirone Hcl ( Buspar) Anxiolytic ( SRI and Dopamine agonist)Anxiolytic ( SRI and Dopamine agonist) Decreased anxietyDecreased anxiety Give with food or 8h before and after drinking Give with food or 8h before and after drinking

grapefruit juicegrapefruit juice Causes dizziness, drowsiness and headache, Causes dizziness, drowsiness and headache,

nausea,palpitations; desired response seen in 7-nausea,palpitations; desired response seen in 7-10 days(optimal 3-4 wks)10 days(optimal 3-4 wks)

Monitor cardiovascular parameters if taken with Monitor cardiovascular parameters if taken with digoxin;ensure compliance; report ASAP the digoxin;ensure compliance; report ASAP the following manifestations: nervousness, following manifestations: nervousness, nightmares, involuntary movements of the neck nightmares, involuntary movements of the neck or face, blurred vision and depression; monitor or face, blurred vision and depression; monitor dystonia , GUT function and LFT’sdystonia , GUT function and LFT’s

CLOZARIL-CLOZAPINECLOZARIL-CLOZAPINE

ANTIPSYCHOTICANTIPSYCHOTIC DECREASED DELUSION,HALLUCINATIONS DECREASED DELUSION,HALLUCINATIONS

AND LOOSENESS OF ASSOCIATIONAND LOOSENESS OF ASSOCIATION BEST TAKEN AFTER MEALSBEST TAKEN AFTER MEALS REPORT SORETHROAT AND AVOID REPORT SORETHROAT AND AVOID

EXPOSURE TO SUNLIGHTEXPOSURE TO SUNLIGHT CHECK BP – CAUSES HYPOTENSION, CHECK BP – CAUSES HYPOTENSION,

ASSESS FOR AKATHISIA, TARDIVE ASSESS FOR AKATHISIA, TARDIVE DYSKENISIA-TONGUE TWITCHING AND LIP DYSKENISIA-TONGUE TWITCHING AND LIP SMACKINGSMACKING

LIBRIUM-LIBRIUM-CHLORDIAZEPOXIDECHLORDIAZEPOXIDE

ANTIANXIETY-BENZODIAZEPINESANTIANXIETY-BENZODIAZEPINESDECREASED ANXIETY AND INC. DECREASED ANXIETY AND INC.

RELAXATIONRELAXATIONWITH FOOD OR MILKWITH FOOD OR MILKNO ACTIVITY REQUIRING NO ACTIVITY REQUIRING

ALERTNESS , SUGARLESS GUMALERTNESS , SUGARLESS GUMHOLD DRUG IF BP DROPS MORE THAN HOLD DRUG IF BP DROPS MORE THAN

20 MMHG , WATCH OUT FOR ECG 20 MMHG , WATCH OUT FOR ECG CHANGES AND TACHYCARDIA-REFERCHANGES AND TACHYCARDIA-REFER

Dilantin ( Phenytoin Na)Dilantin ( Phenytoin Na) Anti convulsantsAnti convulsants Decrease in seizure activity- by decreasing flow Decrease in seizure activity- by decreasing flow

of calcium and Na across neuronal membranesof calcium and Na across neuronal membranes Give with at least ½ glass of water or with meals Give with at least ½ glass of water or with meals

to decrease GI irritationto decrease GI irritation Red brown or pink discoloration of urine may Red brown or pink discoloration of urine may

occur, never mix with any drug or dextrose IV; occur, never mix with any drug or dextrose IV; perform oral care – gingival hyperplasia;perform oral care – gingival hyperplasia;causes catdiovascular depression, causes catdiovascular depression, agranulocytosis and aplastic anemiaagranulocytosis and aplastic anemia

Avoid alcohol and activities that require Avoid alcohol and activities that require alertness; increase vitamin D and exposure to alertness; increase vitamin D and exposure to sunlight in prolonged use; sunlight in prolonged use;

DOPAMINE( Intropin)DOPAMINE( Intropin) ADRENERGIC AGENTADRENERGIC AGENT BROCHODILATION AND INCREASED bp AND BROCHODILATION AND INCREASED bp AND

HEART RATEHEART RATE GIVEN FOR CARDIAC ARREST AND COPD – GIVEN FOR CARDIAC ARREST AND COPD –

STATSTAT MONITOR BP , CARDIAC MONITORING , MONITOR BP , CARDIAC MONITORING ,

PERIPERAL PULSES ,OUTPUT AND CBG – PERIPERAL PULSES ,OUTPUT AND CBG – CAN CAUSE HYPERGLYCEMIACAN CAUSE HYPERGLYCEMIA

DON’T MIX WITH OTHER SOLUTIONS, CAN DON’T MIX WITH OTHER SOLUTIONS, CAN CAUSE ARRYTHMIAS, ANTICHOLINERGIC CAUSE ARRYTHMIAS, ANTICHOLINERGIC EFFECTS AND TREMORSEFFECTS AND TREMORS

GARAMYCIN(GENTAMYCIN)GARAMYCIN(GENTAMYCIN)

AMINOGLYCOSIDE,BACTERICIDALAMINOGLYCOSIDE,BACTERICIDAL - INFECTION- INFECTIONNO SPECIFIC TIMENO SPECIFIC TIME INCREASE FLUID INTAKE, TINNITUS INCREASE FLUID INTAKE, TINNITUS

INDICATES OTOTOXICITYINDICATES OTOTOXICITYMONITOR FOR SIGNS AND SYMPTOMS MONITOR FOR SIGNS AND SYMPTOMS

OF OTOTOXICITY, NEPHROTOXICITY OF OTOTOXICITY, NEPHROTOXICITY AND NEUROTOXICITYAND NEUROTOXICITY

INDERAL -PROPANOLOLINDERAL -PROPANOLOL

ANTI ANGINAL, ANTIARRYTHMIC, ANTI ANGINAL, ANTIARRYTHMIC, ANTIHYPERTENSIVE,REDUCES PORTAL ANTIHYPERTENSIVE,REDUCES PORTAL PRESSURE AND DECREASES THE RISK OF PRESSURE AND DECREASES THE RISK OF BLEEDING FROM ESOPHAGEAL VARICESBLEEDING FROM ESOPHAGEAL VARICES

DECREASED BPDECREASED BP BEST TAKEN WITH MEALSBEST TAKEN WITH MEALS AVOID DRIVING , DO NOT DISCONTINUE AVOID DRIVING , DO NOT DISCONTINUE

ABRUPTLYABRUPTLY CHECK BP – CAUSES HYPOTENSIONCHECK BP – CAUSES HYPOTENSION

ISORDILISORDIL

ANTIANGINAL/RELAXES SMOOTH ANTIANGINAL/RELAXES SMOOTH MUSCLESMUSCLES

DECREASED BPDECREASED BPBEST TAKEN ON EMPTY STOMACHBEST TAKEN ON EMPTY STOMACHCHANGE POSITION SLOWLY, CAUSES CHANGE POSITION SLOWLY, CAUSES

FACIAL FLUSHINGFACIAL FLUSHINGCHECK BP, DO NOT CHEW SUSTAINED CHECK BP, DO NOT CHEW SUSTAINED

RELEASE FORMRELEASE FORM

LEVODOPALEVODOPA

ANTIPARKINSONISMANTIPARKINSONISMMUSCLES BECOME LESS STIFFMUSCLES BECOME LESS STIFFBEST TAKEN WITH MEALSBEST TAKEN WITH MEALSAVOID FOODS CONTAINING B6 OR AVOID FOODS CONTAINING B6 OR

CHON RICH FOODS-DECREASES CHON RICH FOODS-DECREASES ABSORPTIONABSORPTION

ENSURE PATIENT VOIDS-MAY CAUSE ENSURE PATIENT VOIDS-MAY CAUSE URINARY RETENTIONURINARY RETENTION

LITHIUM CARBONATELITHIUM CARBONATE ANTIMANICANTIMANIC DECREASED HYPERACTIVITYDECREASED HYPERACTIVITY BEST TAKEN AFTER MEALSBEST TAKEN AFTER MEALS INCREASE OFI’S 3 L/D AND Na 3 GM./DAYINCREASE OFI’S 3 L/D AND Na 3 GM./DAY AVOID ACTIVITIES THAT INCREASE AVOID ACTIVITIES THAT INCREASE

PERSPIRATIONPERSPIRATION TAKES 10-14 DAYS BEFORE THERAPEUTIC TAKES 10-14 DAYS BEFORE THERAPEUTIC

EFFECT BECOMES EVIDENT.ANTIPSYCHOTIC EFFECT BECOMES EVIDENT.ANTIPSYCHOTIC GIVEN DURING THE FIRST TWO WEEKS TO GIVEN DURING THE FIRST TWO WEEKS TO MANAGE ACUTE SYMPTOMSMANAGE ACUTE SYMPTOMS

MONITOR SERUM LEVEL , NAVDA-INDICATES MONITOR SERUM LEVEL , NAVDA-INDICATES TOXICITY, MANNITOL - ANTIDOTETOXICITY, MANNITOL - ANTIDOTE

TOFRANIL( Imipramine)TOFRANIL( Imipramine)

TCA ‘sTCA ‘sDecrease in brain amine levels – Decrease in brain amine levels –

alleviation of depression and relief of alleviation of depression and relief of obstructive sleep apneaobstructive sleep apnea

Same time in AM ;give sugarless candySame time in AM ;give sugarless candyCauses sedation urinary retention and Causes sedation urinary retention and

confusion( elderly) and photosensitivityconfusion( elderly) and photosensitivityDo not stop abruptly(HA , vertigo, Do not stop abruptly(HA , vertigo,

nightmares,malaise and weight change) ; nightmares,malaise and weight change) ; avoid OTC’s, alcohol and sleep inducersavoid OTC’s, alcohol and sleep inducers

TODAY WILL NEVER HAPPEN AGAIN ; TODAY WILL NEVER HAPPEN AGAIN ; DO NOT START IT WITH A BAD BAD DO NOT START IT WITH A BAD BAD IMPRESSION THAT THINGS ARE IMPRESSION THAT THINGS ARE DIFFICULT …….AND THAT YOU DIFFICULT …….AND THAT YOU CANNOT MASTER CANNOT MASTER ANYTHING…….REMEMBER YOU ARE ANYTHING…….REMEMBER YOU ARE NOT BORN TO FAIL AND TAKING A NOT BORN TO FAIL AND TAKING A SECOND CHANCE IS NOT AN SECOND CHANCE IS NOT AN OPTION…… YOU ARE BORN TO MAKE OPTION…… YOU ARE BORN TO MAKE IT GOOD.IT GOOD.

IT’S ALL IN THE MIND!!!!IT’S ALL IN THE MIND!!!!

BULLETSBULLETS

SALICYLATE POISONING-SALICYLATE POISONING-TINNITUS,NAVDA,LETHARGY/EXCITABILITY, TINNITUS,NAVDA,LETHARGY/EXCITABILITY, HYPERVENTILATION AND HYPERVENTILATION AND HYPERTHERMIA,METABOLIC ACIDOSISHYPERTHERMIA,METABOLIC ACIDOSIS

LIDOCAINE TOXICITYLIDOCAINE TOXICITY SLURRED SPEECHSLURRED SPEECH ALTERED CNSALTERED CNS MUSCLE TWITCHINGMUSCLE TWITCHING SEIZURESSEIZURES

TOXIC LEVELTOXIC LEVELLITHIUM 2.0 MeQ/lLITHIUM 2.0 MeQ/lDIGOXIN 2.0 NG/MLDIGOXIN 2.0 NG/MLTHEOPHYLLINE 20 MCG/MLTHEOPHYLLINE 20 MCG/ML

THIS DRUGS CAN INTERACTTHIS DRUGS CAN INTERACTTHEOPHYLLINE,DILANTIN,COUMADIN,ILOTHEOPHYLLINE,DILANTIN,COUMADIN,ILO

SONESONETETRACYCLINE AND QUINOLONES-NO TETRACYCLINE AND QUINOLONES-NO

TO PREGNANCYTO PREGNANCYAMINO GLYCOSIDE TOXICITYAMINO GLYCOSIDE TOXICITY

OTOTOXICITY AND NEPHROTOXICITYOTOTOXICITY AND NEPHROTOXICITY

PEAK – 1 ½ HOURS AFTER PEAK – 1 ½ HOURS AFTER ADMINISTRATIONADMINISTRATION

TROUGH – 30 MINUTES PRIOR TO THE TROUGH – 30 MINUTES PRIOR TO THE NEXT DOSENEXT DOSE

ORAL BIRTH CONTROL PILLS-COMP.ORAL BIRTH CONTROL PILLS-COMP.ABDOMINAL PAINABDOMINAL PAINCHEST PAIN-SOBCHEST PAIN-SOBHEADACHES AND HYPERTENSIONHEADACHES AND HYPERTENSIONEYE PROBLEMSEYE PROBLEMSSEVERE LEG PAINSEVERE LEG PAIN

LEADS – EMERGENCY DRUGSLEADS – EMERGENCY DRUGSBETA BLOCKER ACTIONSBETA BLOCKER ACTIONS

BETA 1 – HEARTBETA 1 – HEARTBETA 2 – LUNGSBETA 2 – LUNGS

SIDE EFFECTS OF ADRENERGIC SIDE EFFECTS OF ADRENERGIC ANTAGONIST BETA BLOCKERSANTAGONIST BETA BLOCKERSHYPOTENSIONHYPOTENSIONDROWSINESS/DEPRESSIONDROWSINESS/DEPRESSIONSYMPTOMS OF CHFSYMPTOMS OF CHFBRADYCARDIABRADYCARDIA

EXAMPLES EXAMPLES PROPANPROPANOLOLOLOL,TENORMIN,LOPRESSOR,TENORMIN,LOPRESSOR

SIDE EFFECTS OF ADRENERGIC SIDE EFFECTS OF ADRENERGIC ANTAGONIST ALPHA BLOCKERSANTAGONIST ALPHA BLOCKERSSEXUAL DYSFUNCTIONSEXUAL DYSFUNCTIONTACHYCARDIATACHYCARDIAORTHOSTATIC HYPOTENSIONORTHOSTATIC HYPOTENSIONVERTIGOVERTIGO

DOXAZOSIN ( CARDURA)DOXAZOSIN ( CARDURA)PRAZOSIN (MINIPRESS)PRAZOSIN (MINIPRESS)METHYLDOPA ( ALDOMET)METHYLDOPA ( ALDOMET)

CALCIUM ANTAGONISTS – VERY NICE CALCIUM ANTAGONISTS – VERY NICE DRUGSDRUGS

BLOCKS CALCIUM ACCESS TO CELLS BLOCKS CALCIUM ACCESS TO CELLS CAUSING DECREASED CAUSING DECREASED COTRACTILITY,CONDUCTIVITY OF THE COTRACTILITY,CONDUCTIVITY OF THE HEART AND DEC. FOR OXYGEN DEMANDHEART AND DEC. FOR OXYGEN DEMAND

SIDE SIDE EFFECTS:HYPOTENSION,BRADYCARDIA(AV EFFECTS:HYPOTENSION,BRADYCARDIA(AV BLOCK-BLOCK-PRECIPITATES)HA,ABDL.DISC,PERIPHERAL PRECIPITATES)HA,ABDL.DISC,PERIPHERAL EDEMAEDEMA

EXAMPLES:EXAMPLES: VERAPAMIL NIFEDIPINE DIALTIZEMVERAPAMIL NIFEDIPINE DIALTIZEM VERY NICE DRUGSVERY NICE DRUGS

DRUGS FOR BRADYCARDIADRUGS FOR BRADYCARDIA

ISOPROTERINOLISOPROTERINOLDOPAMINEDOPAMINEEPINEPHRINEEPINEPHRINEATROPHINEATROPHINE

ANTIHYPERTENSIVE DRUGSANTIHYPERTENSIVE DRUGS ACE ACE

INHIBITORS-CAPOTEN/CAPTOPRIL,VASINHIBITORS-CAPOTEN/CAPTOPRIL,VASOTEC/ENALAPRIL,LOTENSIN/BENZAPRILOTEC/ENALAPRIL,LOTENSIN/BENZAPRIL))

BETA – BLOCKERS- BETA – BLOCKERS- INDERAL/PROPANOLOL, INDERAL/PROPANOLOL, TENORMIN/ATENOLOLTENORMIN/ATENOLOL

CALCIUM ANTAGONIST- CALAN CALCIUM ANTAGONIST- CALAN ISOPTIN/VERAPAMIL, ISOPTIN/VERAPAMIL, CARDIZEM/DIALTIZEM, PROCARDIA/ CARDIZEM/DIALTIZEM, PROCARDIA/ NIFEDIPINENIFEDIPINE

ACE INHIBITORS-ACE INHIBITORS-

SIDE EFFECTS-DIZZINESSSIDE EFFECTS-DIZZINESS ORTHOSTATIC HYPOTENSIONORTHOSTATIC HYPOTENSION GI DISTRESSGI DISTRESS COUGH COUGH HEADACHEHEADACHE

ACTIONS- DECREASED PERIPHERAL ACTIONS- DECREASED PERIPHERAL VASCULARRESISTANCE WITHOUT VASCULARRESISTANCE WITHOUT INCREASED CARDIAC OUTPUT,CARDIAC INCREASED CARDIAC OUTPUT,CARDIAC RATE AND CARDIAC CONTRACTILITYRATE AND CARDIAC CONTRACTILITY

B-BLOCKERSB-BLOCKERS

ACTION – BLOCKS BETA RECEPTORS ACTION – BLOCKS BETA RECEPTORS IN THE HEART CAUSING DECREASED IN THE HEART CAUSING DECREASED HEART RATE, FORCE OF HEART RATE, FORCE OF CONDUCTION AND RATE OF AV CONDUCTION AND RATE OF AV CONDUCTIONCONDUCTION

SIDE EFFECTS- SIDE EFFECTS- BRADYCARDIA,LETHARGY,GI DIST. BRADYCARDIA,LETHARGY,GI DIST. CHF ,HYPOTENSION,DEPRESSIONCHF ,HYPOTENSION,DEPRESSION

ANTI-CANCER DRUGS-ADVERSE ANTI-CANCER DRUGS-ADVERSE REACTIONS AND PRECAUTIONSREACTIONS AND PRECAUTIONS

NAVDANAVDABONE MARROW SUPPRESSIONBONE MARROW SUPPRESSIONALOPECIAALOPECIA (AVOID PREGNANCY)(AVOID PREGNANCY)

CHOLINERGIC CRISIS- (WEAKNESS)CHOLINERGIC CRISIS- (WEAKNESS)

SALIVATIONSALIVATIONLACRIMATIONLACRIMATIONURINATION URINATION DEFECATIONDEFECATION

SYMPATHETIC/ANTI SYMPATHETIC/ANTI -CHOLINERGIC/ADRENERGIC- -CHOLINERGIC/ADRENERGIC- FIGHT/FLIGHTFIGHT/FLIGHT

PARASYMPATHETIC-REST AND DIGESTPARASYMPATHETIC-REST AND DIGEST

STEROIDS- (ENDS IN ONE) ANTI-STEROIDS- (ENDS IN ONE) ANTI-INFLAMMATORYINFLAMMATORY

INH –INCREASE B6INH –INCREASE B6LEVODOPA – DECREASE B6LEVODOPA – DECREASE B6MAO-NO MAO-NO

PICKLES,WINE,CHEES,BARBITURATESPICKLES,WINE,CHEES,BARBITURATES,TRICYCLIC ,TRICYCLIC ANTIDEPRESSANTS,ANTIHISTAMINES,ANTIDEPRESSANTS,ANTIHISTAMINES,ANTIHYPERTENSIVES,OTC COLD ANTIHYPERTENSIVES,OTC COLD MEDSMEDS

SWEATING,TREMORS,HYPERTHERMIA,HPN,SWEATING,TREMORS,HYPERTHERMIA,HPN,BOUNDING HEARTBOUNDING HEART