NURSING PHARMACOLOGY
 PharmacoDynamics – what the Drug
does to the body
o Receptor interaction
o Dose response phenomenon
o Mechanisms of therapeutic and
toxic action
 PharmacoKinetics – what the Katawan
does to the drug (ADME)
o Absorption – first pass effect on
the liver
o Distribution
o Metabolism – drug is transformed
into less toxic form
o Elimination
Side Notes: BQ.
Oral drugs undergo first pass effect
Rectal drug (e.g. suppository) – also
undergo first pass effect (partial first pass
effect); thru superior rectal vein to the liver
ALL that goes thru the GIT undergo 1st
pass metabolism (rectum is part of GIT)
CYTOCHROME P450 (BQ, no specific
question given, just understand the MOA)
 Enzyme inhibitor
 Enzyme inducer
Enzyme Inhibitor Enzyme Inducer
D2 E (x) D2 E Inhibitor
D1 D1
CYP450 Inducers (Isa lang tandaan mo, pag
wala dito edi nasa kabilang classification)
Ethel Booba Phen-phen and Refuses Greasy Carb Shakes
Ethanol (chronic)
Barbiturates (antiseizure)
Phenytoin (antiseizure)
Rifampicin (alam mo na ‘to)
Griseofulvin (antifungal)
Carbamazepine (trigeminal neuralgia, bipolar)
St. John’s Wort (herbal drug for depression)
CYP450 Inhibitors
Inhibitors Stop Cyber Kids from Eating GRApefruit QV
Isoniazid
Sulfonamides
Cimetidine – H2 inhibitor
Ketoconazole – antifungal
Erythromycin – macrolides
Grapefruit juice or “suha” (BQ)
Ritonavir (acute ingestion)
Amiodarone – antiarrhythmic
Quinidine – antimalarial; antiarrhythmic
Valproic acid – DOC for bipolar
Side Notes for Grapefruit Juice (BQ daw e)
Dagdag lang ni Bea
DO NOT consume grapefruit with:
Felodipine (Plendil)
Nifedipine (Procardia)
Amlodipine (Norvasc)
Verapamil (Calan)
Carbamazepine (Tegetrol)
Buspirone (Buspar)
Lovastatin (Mevacor)
Illustration below:
CYP3A4, isozyme of CYP450
Grapefruit juice (also metabolized in the liver)
absorption of drugs mentioned above
Drugs build up to a dangerous level
(increased drug potency)
R
Guidelines for
Medication
Administration
SAFETY ISSUES
FROM THE LECTURES OF DR. BAYLON 12.15.2018
BQ Side notes:
gtts/min. computation SMX + TMP = Cotrimoxazole (a bactericidal)

Amount of infusion x gtt factor Drug Interactions

60 60 Additive 1+1 = 2 (Metro + Amox)
Synergism 1+1 = 3 (Ampi + Genta)
15 = macroset Potentiation 1+0 = 2 (Amox + Cluvanic Acid =
60 = microset Co-amoxiclab)
Antagonism 1+1 = 0 (Cipro & Doxy)
dosage computation Antibiotic Resistance (lam na dis; complete dosage
as px by MD)
Apply cross multiplication:
Cell Wall Synthesis Inhibitors
Dose on hand x Desired dose  Natural Penicillin - Pen V, Pen G
Quantity on hand Desired quantity (x) V – oral, “sa ViVig”, primary prophy.
G – parenteral, secondary prophy
Dose on hand (x) = Desired dose (Quantity on hand)
Dose on hand Dose on hand Side notes:
RHD
Desired quantity = D x Q Benzathine & Penicillin are Pen G, IM, buttocks
S (gluteus minimus), q 21 days

 Antistaphylococcal Penicillin (Isoxazolyl

Child’s Dosage = Penicillin)
Surface area of child (m2) = N adult dose  Methicillin, Nafcillin, Oxacillin,
1.7 m2 Cloxacillin, Dicloxacillin
Side notes:
 1 cc = 15 gtts/min MRSA  give Vancomycin
 4-5 cc = 1 tsp If not relieved, VRSA  give Linezolid
 15 cc = 1 tbsp
 30 cc = 1 fl. oz.  Extended Spectrum Penicillin
 500 cc = 1pint (Aminopenicillin)
 1000 cc = 1 quart  Ampicillin, Amoxicillin
 4000 cc = 1 gallon  Antipseudomonal Penicillin
 Carboxypenicillin – Carbenicillin,
ANTI-INFECTIVES/ANTIBIOTICS Ticarcillin
Confer selective toxicity (only target  Ureidopenicillin, Mezlocillin,
pathogenic organisms) Azlocillin
Side notes:
 Bactericidal – Kills Penicillin A/E: Steven Johnsons Syndrome
Vancomycin
Fluroquinolones (…xacin)
Penicillins
Aminoglycosides
Metronizadole
 Bacteriostatic – Inhibits growth; needs host
defense mechanism to eradicate infxn Penicillin S/E: Redness
(ECSTaTiC)
Erythromycin  Cephalosporins
Clindamycin  1st Gen. Cefazolin (Commonly used
SMX antibiotics post-op), Cephalexin,
TMP Cefadroxil
Tetracycline  2nd Gen. Cefuroxime, Cefoxitin,
Chloramphenicol Cefotetan
FROM THE LECTURES OF DR. BAYLON 12.15.2018
  3rd Gen. Ceftriaxone, Cefotaxime, ANTI-TB MEDS (BQ is MOA)
Ceftazidime H – Isoniazid
 4th Gen. Cefipime, Ceftaroline, MOA: Inhibits mycolic acid synthesis
Cefpirome S/E: Peripheral neuritis – numbness/tingling of
fingers and toes
Gram +
Mgt: Vit. B6
Cephalospirins (purple) Gram –
Generation Most common: (pink)
Staph R – Rifampicin
st
1 Gen ++++ + MOA: Inhibits DNA-RNA synthesis
2nd Gen +++ ++ S/E: Red-orange urine
3rd Gen ++ +++ Mgt: Re-assure client it’s N
4th Gen + ++++ S/E: Flu-like signs and symptoms

 Antipseudomonal Cephalosporins (used Z – Pyrazinamide

for Hospital-acquired UTI/Infection) MOA: Unkown
 Ceftazidime (3rd Gen), Cefipime BQ: MOST HEPATOTOOOOXXXXIC
(4th Gen), Cefoperazone (2nd S/E: Uric acid; gouty arthritis
Gen)
E – Ethambutol
Side notes BQ MOA: Inhibits arabinosyl transferase
Epinephrine – IM for Anaphylaxis BQ: NOT HEPATOTOXIC 
IV for Code S/E: Optic neuritis, Red-green color blindness
(perform Ishihara Test)

Imipinem – cilastin

Vancomycin – Grame (+) S – Streptomycin
S/E: Red man syndrome 2° to release of MOA: Protein synthesis inhibitor
antihistamine S/E: Ototoxic, Nephrotoxic, Teratogenic (DO
NOT give if pregnant)
Act on 30s ribosome

TB Categories
Category Intensive Maintenance
Nsg Mgt: STOP INFUSION. It is caused by fast Phase Phase
IV drip of Vancomycin I HRZE HR
Newly 2 mo. 4 mo
Protein Synthesis Inhibitors diagnosed
 Aminoglycosides Act on 30s Ia HRZE HR
eg is Streptomycin ribosome of EPTB new 2 mo. 10 mo.
 Tetracycline bacteria
II HRZES HR
Relapse 2 mo. 5 mo.
 Chloramphenicol (1) Treatment HRZE
 Erythromycin – macrolide After Failure 1 mo.
 Lincosamides Act on 50s Treatment
eg is Clindamycin ribosome of After Lost to
bacteria
 Linezolid (1) Follow-up
 Streptogramins (TALF)
IIa HRZES HR
EPTB 2 mo. 9 mo.
previously HRZE
treated 1 mo.
FROM THE LECTURES OF DR. BAYLON 12.15.2018
 NNRTI (Nonnucleoside reverse
transcriptase inhibitors) – Efavirenz, Nevirapine

Protease inhibitor – eg Ritonavir

Side notes:
Side notes:
HIV ARV combination drugs
FLUROQUINOLONES (ciprofloxacin (Cipro),
1 NRTI + 2 NNRTI or
gemifloxacin (Factive), levofloxacin (Levaquin),
moxifloxacin (Avelox), norfloxacin (Noroxin), and 1 NRTI + 2 NNRTI +1 Pro
ofloxacin (Floxin)) cause TENDON RUPTURE
and JOINT DEFORMITY to clients before 18 y; AH1N1
not given to pedia. Antiviral – Oseltamivir (Tamiflu)

(BQ)Tetracycline causes Tooth enamel Antifungals (Nephrotoxic, so mostly are topical)

discoloration e.g. Terbinafir, Miconazole, Nystatin (DOC for
Candidiasis), Fluconazole
(BQ)Streptomycin, if pregnant, causes
sensorineural deafness Antihelminthic
e.g. Mebendazole (roundworms)

8
OTHER ANTI-INFECTIVES
CN VIII
Albendazole (Hookworms – these
causes anemia to children 2° to blood loss)
Praziquantel (flatworms or tapeworms)
Pyrantel pamoate (pinworms)

Side notes:
Antivirals DEC/Diethylcarbamazine citrate (Hetrazan)
 Lamivudine – used to both HIV and DOC for Filariasis
HepaB
 HIV antiretrovirals Alternative: Ivermectin
NRTI (Nucleoside reverse transcriptase
inhibitors) AZT (Zidovudine)
Antiprotozoa
 Quinine – antimalarial
S/E: Cinchonism

Headache

Tinnitus Vertigo

Decreases possible transmission to baby  Artemether Lumefantrine

Not for Pregnant, Not for BF momma
Administer with fatty meal

FROM THE LECTURES OF DR. BAYLON 12.15.2018

  Chloroquine – prophylaxis for malaria  Edrophonium
For MG
If resistant, DOXYCYCLINE For differentiation of crisis
MG DOC: Pyridostigmine
S/E: Itchiness Neostigmine
Physostigmine
1 wk b4 to 4 wks
after travel

Passes thru BBB;

AUTONOMIC DRUGS more effective
Adrenergic receptors Cholinomimetric
 Organophosphates
α1 – vasoconstriction M1 – face
Insecticides and nerve gases
α2 – vasodilation M2 – pupil
constriction Side notes:
ß1 – cardiac M3 - GIT Alzheimer’s disease Drugs
inc. HR, inc. inotropy
ß2 – lungs DONEPEZIL ORAL
bronchodilation TACRINE

Side notes: RIVASTIGMINE – By Patch/Topical

BQ Inotropy – inc. strength of contraction of
Muscarinic Antagonists (Anticholinergics)
cardiac muscles A/E: Dryness, Flushing, Hyperthermia, Visual
BQ Chonotropy – inc. HR disturbances, Hallucinations
Antidote: Physostigmine 2° reversal
CHOLINOMIMETRIC of hallucinations
 Acetylcholine mimickers
Metacholine  Atropine SO4
Bethanecol – relieves post-op ileus Mydriasis with cyclopegia
(BQ) Pilocarpine – glaucoma, xerostomia Antidote to cholinesterase inhibitors
 Scopolamine
Glaucoma  Ipratropium
 Glycopyrrolate – retinal exam.
Increased IOP
 Benztropin
N IOP – 10-21mmHg
Side notes:
Patho may be an
increased in Aqueous Salbutamol + Ipratropium
Humor or blocked
passageway of A. H.
Short-acting Short-acting
beta agonist muscarinic antagonist
A/E of Cholinomimetrics (SABA) (SAMA)
Diarrhea
Urination
Miosis (Combivent)
Bronchospasm
Excitation
Lacrimation
Salivation
Sweating
FROM THE LECTURES OF DR. BAYLON 12.15.2018
Adrenergic Agonists 2. Hydrochlorthiazide (Thiazide)
α1 – Phenylephrine At the distal convoluted tubule
A/E: stroke S/E: Hypercalcemia
α2 – Clonidine, Methyldopa (used in pre-ec) HYPER G-glycemia
L-lipidemia
ß agonist – Isoproterenol
U-uricemia
Dobutamine
C-calcemia
Selective ß2 agonists – Albuterol, Terbutaline, 3. Aldosterone antagonist (K sparing)
Metaproterenol, Isoxsuprine, Ritodrine e.g. Spironolactone
A/E: Hyperkalemia, metabolic
Side notes: acidosis

Differentiation of Norepi to Epi Acetalozamide

α1 At the proximal convoluted tubule
NE
α2

ß1 E 65% Na absorption

ß2 Side notes:
Hydralazine – given q 5 min. IV
Indirect Acting Adrenergic Agonists Drug-Induced Lupus
1. Amphetamine Hydralazine
2. Ephedrine Isoniazid
3. Dopamine (BQ) Procainamide
Increased GFR = low dose Nitroprusside
IV
Increased CO = medium cyanide accumulation
dose cover the IV bottle with carbon paper
Increased BP 2° vasoconstriction = high dose
good for 24h only; if more than 24h it
may cause cyanide toxicity (BQ)
Adrenergic Blockers
1. Nonselective α antagonists
Phentolamine
Phenoxybenzamine (DOC for Pheochromo) ANTIDOTE: AmylNitrate
2. Selective α1 antagonists
Prazosin, Terazosin, Doxazosin (for BPH) Lead toxicity: antidote is EDTA/BAL
3. ß Blocker Beta blocker toxicity: antidote is GLUCAGON
ß selective – Acetabulol to Metoprolol
(WITH asthma) 3. Calcium Channel Blockers (…dipine)
ß nonselective – N to Z Amlodipine, Nifidipine (causes bipedal
(BQ C/I to clients with asthma) edema)
Drugs for Glaucoma Side notes:
Acetalozamide – mountain sickness RAAS – Renin inhibitor (eg Aliskiren – causes
Latanoprost – a prostaglandin
hyperkalemia)
S/E: Lengthening of eyelashes

CARDIOVASCULAR AND RENAL DRUGS ACE inhibitors (…pril)

BQ. 1. FUROSEMIDE – most potent diuretic
works at the thick ascending loop of henle
potassium-wasting
ototoxic
may cause toxicity with Digoxin due to hypokalemia (BQ)
 increases bradykinin in the lungs that
causes BQ dry cough (give ARBs (e.g.
…sartan))

FROM THE LECTURES OF DR. BAYLON 12.15.2018

ANGINA PECTORIS Onset Rapid Slow
Nitrates: unstable angina (S/E: reflex Monitoring PTT PT/INR
tachycardia, orthostatic hypotension) Use Acute use Chronic use
B blockers: stable angina Pregnancy OK NOT okay
Ca channel blocker: prinzmetal angina Antidote Protamine Vitamin K,
Sulfate FFP
Digoxin
 (+) inotrope Antihistamine
 (-) chonotrope 1st Gen: Nakaka-antok
 increases contraction 2nd Gen: Loratadine (ALLERTa)
 BQ. Inhibits Na K ATPase
MOA
Increases intracellular Ca Ergot Alkaloids
 Nsg consideration: Check HR prior to admin. - Derived from Claviceps purpurea
 Electrolyte imbalance: Hypokalemia (fungus)
 A/E: - Toxicity: Vasospasm
Blurring of vision - Eg. Bromocriptine, Carbergolide,
Anorexia Pergolide
Nausea - Ergonovine (Methergine)
Diarrhea/Disorientation
a Side notes:
Vomiting Carboprost (3rd line during PP bleeding)
 Antidote: Digibind/Digifab
ANTI-ASTHMA
Side notes:
BQ: Mode of action of nitroglycerine
Acute attacks Controllers
DILATES THE VEIN Oral ICS (Inhaled
salbutamol corticosteroids)
Antiplatelets – work on the platelet
Antitrombolytic – pampatunaw Nursing Management for Inhaled Steroids
Anticoagulants – works on the clotting factor After puff, GURGLE -> oral thrush

Aspirin – when to administer? P.C. Mast Cell Stabilizers

Alternative: Clopidogrel  Disodium cromogylate, Nedocromyl

Oxytocin: A/E is water toxicity Montelukast – anti-inflammatory drug

Furo – check BP (not lower than 90/60) Omalizumab – binds to IgE on synthesized
mast cells
Sumatriptan – antimigraine
Side notes:
HEPARIN WARFARIN Oral salbutamol – a short acting beta
MOA Activates Impairs post- antagonist
anti-thrombin translational Given with 15-20 minutes interval
III modification 3 doses only
of factors II,
VII, IX, X Mainstay drug for asthma: ICS
(Vitamin K
dependent) Caffeine smoke: Alternative if in a distant
Route Parenteral Oral place; walang-wala ng synthetic drug
Site of action Blood Liver
FROM THE LECTURES OF DR. BAYLON 12.15.2018
COUGH MEDICATIONS GIT DRUGS FOR CONSTIPATION:
Mucolytic – N-Acetylcysteine 1. Bulk-forming laxatives (eg Psyllium,
S/E: Nakakaputi Methylcellulose)
Antidote for Acetaminophen 2. Stool surfactants (eg Docusate, mineral oil)
Expectorant – Ambroxol 3. Osmotic laxatives (eg Lactulose – DOC for
Antitussives – if coughing is disturbing (eg hepatic encephalopathy)
Rubitusin) 4. Stimulant laxatives
Eg Senna (SE: melanosis coli – black
discoloration of the intestine)
GIT DRUGS Eg Aloe
1. Antacids – given 1 h after meals; short-
acting (1-2h) GIT DRUGS FOR DIARRHEA:
Opioid agonists – Loperamide
2. H2 Receptor Antagonists
Cimetidine NAUSEA AND VOMITING
Ranitidine Palonosetron
Dolasetron
3. Proton Pump Inhbitor Odansetron – post-op N&V
 Inhibits H+/K-ATPase
DOC for GERD and Peptic Ulcer Side notes:
 Given 30 minutes b4 meals Diazepam – for seizures attack
Given IV
Peptic Ulcer – causative organism H. pylori Given transrectal (for kids)
Triple therapy
1 PPI 1 PPI
1 Amox 1 Amox ANTI-SEIZURES
1 Metronidazole 1 Clarithromycin Benzodiazepines (Acts on GABA)
Quadruple therapy MOA: Increases frequency of chloride channel
Triple therapy + Bismuth subsalicylate opening

Barbiturates
MOA: Increases duration of chloride channel
Mucosal protectant opening
(eg Sucralfate (oral))
Nsg Mgt for Bismuth: Phenytoin
Reassure that black stool is N  Used for maintenance of seizures
 Action: Na channels
Side notes:  Watch out for blood therapeutic levels:
If mefenamic acid is taken b4 meals, it causes 10-20 mg/dL
NSAIDS-INDUCED ULCER  S/E: Gingival hyperplasia (same with
Verapamil)
Mg Hydroxide Al Hydroxide  Teratogetic – fetal hydantoin syndrome
S/E: Diarrhea S/E: Constipation
Valproic Acid (BQ)
Combined to counteract side effects
 For absence seizure
 DOC for bipolar dso
 Teratogenic – bb is depleted of folic
Metoclopramide (Anti-emetic)
acid; may lead to NTD (BQ)
MOA: Increases the transit of food downward

FROM THE LECTURES OF DR. BAYLON 12.15.2018

Ethosuximide IV Anesthetics
 DOC for absence seizure Depolarizing agents: Succinylcholine
Non-depo: Atracurium
Carbamazepine
 DOC for partial seizure
Inc. histamine release
Oxcarbazepine Antidote: Neostigmine
 ONLY drug with effect on K channel
Side note:
Novel anti-seizures Rococurium – antidote: Sugammadex
 Leviteracetam – can trigger psychosis
 Lamotrigine Spinal Anes./Epidural
Bupivacaine – cardio-toxic
GABAergics
 Pregabalin – inhibits seizure signals in Amides Esters
the brain Bupivacaine Procaine
 Gabapentin Lidocaine

ANTI-PARKINSONS Local
L-dopa with carbidopa Lidocaine – also an anti-arrhythmic

Side notes:
ANESTHETICS BQ. What pain med. undergo skin testing?
General anes. (Balanced anes.)
BA. KETOROLAC
o Volatile gases
o Non-depolarizing agents
Ketamine – SE: Dissociative amnesia
o Depolarizing agents
Opioids
Local anes.
AE: Respiratory depression
SE: Constipation
Pain meds.
Antidote: Narcan (Naloxone)
o Ketamine
o Opioid
COX2 Inhibitor
o NSAIDs
Celecoxib
o COX2 inhibitors
BQ. Colchicine MOA – Dec. inflammation in
VOLATIVE GASES (succinylcholine,
the joints; SE – Diarrhea (Mgt: DO NOT TAKE
halothane)
anymore; NSAIDs)
A/E: Malignant hyperthermia
Spasm
Uricosurics (Probenecid)
Inc. PR
Mgt: Inc. fluid intake
Inc. BP
Inc. CO2
Allopurinol (Xanthine Oxidase Inhibitor)
Male, young, muscular
AE: Steven Johnson’s Syndrome
(BQ) Antidote: Dantrolene (Dantrium)
 Can be Febuxostat

If refractory gout, use PEGLOTICASE

FROM THE LECTURES OF DR. BAYLON 12.15.2018

ENDOCRINE DRUGS Side notes:
Insulin (memorize OPD) METFORMIN – does not cause hypoglycemia;
it prevents gluconeogenesis; AE: LACTIC
ACIDOSIS (BQ)

THYROID MEDS (eg. Levothyroxine)

Hyperthyroidism Hypothyroidism
Methimazole Levothyroxine
Tapazole 1st dose
REDUCED to
**inhibits TPO (thyroid cardiac and
peroxidase) elderly patients

SE: Agranulocytosis, esp.

neutrophils; 1st sign:
SORE THROAT (BQ)

Methimazole – given for

2nd and 3rd trimesters
PTU

BQ: Regular (thru IV) *inhibits TPO + inhibits

BQ: Long-acting (NO peak) peripheral conversion of
BQ: Cloudy is NPH; CleaR is Regular T3 and T4 (an active
BQ: Aspirate: Clear b4 Cloudy form)

Sites: SE: Hepatotoxic

Abdomen DOC for thyroid storm
Triceps area
Thigh Given for 1st trimester
B blocker such as
Insulin secretagogues propranolol
-Sulfonylureas SSKI/KISS/Lugol’s
-Meglitinide (Repaglinide) MOA: (BQ) DEC.
> Biguanides vascularity of thyroid b4
> Thiazolidinediones – SE is edema surgery
> Alpha glucosidase inhibitors – SE is diarrhea
> GLP 1 receptor agonists – eg Exenatide (SQ) *used in thyroid storm
> Amylin Agonists (SQ)
> DPP4 inhibitors (Sitagliptin) – used in DM
with renal failure DRUGS FOR OSTEOPOROSIS
> SGLT1 inhibitor (Empaflozin) 1 Calcium
acts on nephron 2 Vitamin D
nagtatapon ng sugar sa urine 3 SERM (Raloxifene)
SE: UTI, candidiasis -enhances estrogen receptor
Mgt: INC. fluid intake; indicate in the -post-menopausal women (if given as
laboratory hormonal replacement, client is at risk for
uterine CA)

FROM THE LECTURES OF DR. BAYLON 12.15.2018

4 Biphosphonates (Alendronate) Side notes:
-drink with 1 glass of H20, empty Cyclophosphamide
stomach SE: Hemorrhagic cystitis, Antidote: Mesna
-remain upright for 30 minutes
Actinomycin D
SE: Peripheral neuritis
CUSHING’S MEDS
Aminogluthimide Busulfan
SE: Pulmonary fibrosis
ADDISONS MEDS
Steroids (Fludrocortisone) Atracycline/Doxorudizine
SE: Cardiomyopathy, Antidote: Dexrazoxane

PITUITARY MEDS Cell cycle specific agents (BQ)

GH vs Somatostatin (Octreotide) 1 Antimetabolites – 5-FU, 6-MP, MTX
**SE: Bone marrow depression

For acromegaly 2 Antitumor antibiotics – Bleomycin

For bleeding of esophageal varices **SE: Pulmonary fibrosis

3 Vinca alkaloids – prevents mitosis (cell

SIADH DOC division) causing cell death (Vinblastine,
Demeclocycline Vincristine)

DI DOC 4 Epipodophyllotoxins – Etoposide, Teniposide

Vasopressin (IV/IM)
Desmopressin (BQ. Intranasal) 5 Taxanes – Paclitaxel, Docetaxel

HORMONAL THERAPY
ADH Antagonist 1. Tamoxifen – anti-estrogen;
Tolvaptan – V2 receptor DOC for breast CA
Conivaptan – V1 and V2 receptors 2. Anastazole – DOC for postmenopausal
women with breast CA
CA TX 3. Flutamide, Finasteride (Proscar)
Chemotherapy - anti-androgen
Antineoplastics – kills/inhibits the - DOC for prostate CA and BPH
reproduction of neoplastic cells respectively (BPH, not a precursor for CA)

Cell cycle nonspecific agents (BQs): COMMONLY USED MONOCLONAL

1. Alkylating agents – affects the synthesis of ANTIBODIES
DNA by to inhibit cell reproduction 1. Anti-angiogenesis – Bevacizumab
2. Anthracyclines 2. Trastuzumab (Herceptin) – HER2/neu
3. Antitumor antibiotics – interferes with DNA inhibitor; for breast CA UNRESPONSIVE to
and RNA synthesis Tamoxifen
4. Camptothecins
5. Platinum Analogs

FROM THE LECTURES OF DR. BAYLON 12.15.2018

 CHEMO MAN Thromocytopenia
- Monitor bleeding signs
- AVOID activities that can traumatize
the skin
- Use the SMALLEST GAUGE needle,
apply pressure 10-15 minutes to the
puncture site
- Use soft-bristled toothbrush, electric
BD B razor, laxatives
- NO dental floss
- Oprelvekin (Neumega) – stimulate
C C megakaryocytopoiesis

Y 5. Extravasation – apply ice (except if Vinca-

6MP alkaloids are the cause)
6MP

5FU
5FU WHO ANALGESIC LADDER
BQ: Meds used per ladder
Lowest – Non-opioid (aspirin, paracetamol,
NSAIDs)
Middle – codeine
Top – morphine

SIDE EFFECTS OF CHEMO IMMUNOTHERAPY

1 Alopecia – disturbed body image; may wear BQ. Interleukin 2 – helps 1L1 & 1L6
wigs; reassure pt. that this is temporary; within Interleukin 1 – fever and anorexia; with TNF-a,
6 mos. hair will return but thinner and lighter 1L1
2 N&V – meds trigger CTZ in the medulla; give
anti-emetic 30mins. B4 chemo Side notes:
(odansetron/placil) 1L6 & 1L12 – inflammatory
3 Mucositis/Stomatitis – mouth care (no OH- Interferon – prevent viral replication
based and glycerine-based) BCG – intravesical chemo for bladder CA
4 Myelosuppression – ANEMIA – limit O2
demand; frequent rest in bw activities;
Epoeitin Alfa (Epogen); LEUKOPENIA, BONE MARROW TRANSPLANT
THROMBOCYTOPENIA 1 Allogenic – from a donor other than the pt
2 Autologous – from patient
Leukopenia 3 Syngeneic – from identical twin
- Prone to infection; FEVER- 1st sign
- Monitor temp. q 4h; WBC count with PSYCHE DRUGS
differentials
Anxiolytics (eg Benzodazepines – Alprazolam)
- Adhere to proper HW, wear mask
– for panic dso, anxiety dso.
- No infected visitors nor invasive
procedures
Antipsychotics (Typical vs Atypical)
- No bacterial diet – NO fresh fruits
and veggies
Typical Atypical
- G-CSF/GM-CSF – Filgastrim
(Neupogen)/PEG Filgastrim Eg Clozapine Eg Risperidone
Old New
Dopa > sero Sero > dopa
FROM THE LECTURES OF DR. BAYLON 12.15.2018
 Targets (+) s&sx Targets (+)&(-) s&sx
SE: EPS, Akathisia, Olanzapine –
Wry neck tumataba

Risperidone –
approved for youth
<25 y; SE:
Hyperprolactinemia
(same with parlodel)

Ziprasidone
SE: Arrthythmia

Quetiapine

Antidepressants
- MAOI – NO to thyramine-containing
foods such as cheese, chocolate,
beer (may result to hypertensive
crisis)
- TCA – Toxicity sx are convulsion,
coma
- SNRI (sero-norepi reuptake inhibitor)
eg. Venlafaxine
- SSRI – mainstay for depression; also
used in bulimia; eg. Fluoxetine
(Prozac) – hindi nakakapatulog

Mood stabilizer
- Lithium (SE: Teratogenic – Ebstein’s
anomaly, DI, thyroid enlargement)
- Threshold for toxi: 2 mEq/L, mostly
due to accidental ingestion or
change in hydration status
- WATCH OUT FOR: HYPOnatremia

NOTE TO SELF:
ONCE READ/TAUGHT, I
SHOULD NEVER
GO WRONG!!!

FROM THE LECTURES OF DR. BAYLON 12.15.2018