MI DRUGS

OPIOID AGONIST THROMBOLYTIC

 Morphine  Urokinase
PD: vasodilation > venous pooling  Streptokinase
> BP  Alteplase rtPA
Antidote: NALOXONE PD: activates plasminogen > plasmin >
dissolves fibrin > no clot
Goal: Restore blood flow
Golden Hour: 3 hours
SE: Bleeding
Antidote: ANTIFIBRINOLYTICS
AMINO CAPROIC ACID
TRANEXAMIC ACID

ANTIPLATELET
 Acetyl Salicyclic Acid (Aspirin)
 Ticlopidine
 Clopidogrel
PD: blocks formation of platelet plug

SE: Bleeding

ANTICOAGULANTS
 Warfarin Heparin
PD: blocks Vit. K dependent clotting PD: blocks formation of thrombin
factor
Route: Oral Route: IV / SQ
Therapeutic Test: Prothrombin Time Therapeutic Test: Prothrombin Time
Therapeutic Range: 1.5 – 2 x normal Therapeutic Range: 1.5 – 2.5 x normal
(21-28) (21-35)
SE: Bleeding SE: Bleeding
Antidote: VITAMIN K Antidote: PROTAMINE SULFATE
Nursing Care:
 Monitor signs of bleeding
(ecchymosis, petechial, melena,
gums)
 Use soft-bristled toothbrush
 Use electric shaver
 Avoid green leafy vegetables
 Avoid garlic, ginger, ginseng
 CHF DRUGS

SYMPATHOMIMETIC DIURETICS
(Beta 1 Adrenergic Agonist)
 Furosemide (Hypokalemia)
 Dobutamine  Spirinolactone (Hyperkalemia)
PD: Binds to B1 PD: Urine Output

inotropic effect Blood Volume

(force of contraction)
SE: Bleeding Preload

Workload
CARDIOTONIC DRUG
 Digoxin (lamoxin) (+) inotropic effect

PD: Ca+ influx to myocardium

VASODILATORS
(+) inotropic effect
(-) chronotropic effect  Nitroglycerin
(rate of contraction)  Captopril
SE: Bleeding
TL: 0.5 – 2.0 ng/dl
 Enalapril
Nursing Care: PD: Relax vascular smooth muscle
 Monitor HR, BP, electrolytes
 Monitor signs of toxicity > visual
Vasodilation
disturbance (halo) > hallmark of
digitalis toxicity
 Monitor serum K+ level (3.5 – 5.0) > Venous pooling
Hypokalemia > risk of toxicity
 Monitor serum level > toxicity Preload
 Advise eating K+ rich food
Antidote: Digitalis Immune Fab (Digibind) Workload

PHOSPHODIESTERASE (+) inotropic effect

INHIBITORS
 Inamrinone
 Milrinone
PD: Blocks phosphodiesterase

Ca+ influx to myocardium

(+) inotropic effect

 PEPTIC ULCER DISEASE
 Erosion in the mucosal lining
 Causes: STRESS
INCREASE HCL
H. pylori

ANTACIDS CYTOPROTECTIVE
 Al (OH) constipation  Sucralfate
 Mg (OH) diarrhea Pharmacodynamics:
Pharmacodynamics:  Coats the ulcer
 Neutralize acid
Dose: 6 mos No friction in food
Side Effects: rebound acidity
Heal

HISTAMINE 2 RECEPTOR
PROSTAGLANDIN AGONIST
 Cimetidine
 Misoprostol (cytolect)
 Ranitidine
 Famotidine Pharmacodynamics:
 Mucus, HCl
Pharmacodynamics:
 Blocks H-2 Receptor Side Effects: Anortifacient

HCl acid
Dose: 1 tab x 2 mos

PROTON PUMP INHIBITORS

(most and cost effective)
 Omeprazole
 Pantoprazole
Pharmacodynamics:
 Blocks proton pump

HCl acid
Dose: 1 tab x 2 weeks
 DRUGS FOR COPD
 Emphysema
 Chronic Bronchitis
 Asthma
Goal: BRONCHODILATION

SYMPATHOMIMETIC LEUKOTRIENE INHIBITORS

(Beta 2 Adrenergic Agonist)
 Montelukast
 Albuterol/ Salbutamol  Zafirlukast
(Ventolin)
Pharmacodynamics: Blocks leukotriene >
 Terbutaline (tocolytic) Bronchodilation
Side Effect: palpitations, tremors

PARASYMPATHOLYTIC LIPOXYGENASE INHIBITOR

 Ipatropium  Zileuton
Pharmacodynamics: Blocks cholinesterase Pharmacodynamics:
receptor > Bronchodilation
Side Effect: lesser
 Indicated for patient who can’t
tolerate sympathomimetic.
SURFACTANTS
METHYLXANTHINES  Beractant
 Caffeine Pharmacodynamics: lower the surface
 Aminophylline tension in lung > alveoli remains open

Pharmacodynamics: Directly relax the

bronchial smooth muscle >
Bronchodilation
MAST CELL STABILIZER
 Cromolyn Sodium
CORTICOSTEROIDS “one”
Pharmacodynamics:
 Prednisone  strengthens the wall of the mast cell
 Hydrocortisone
 fluticasone
no degranulation
Pharmacodynamics: Blocks Arachidonic Acid
> no leukotriene > Bronchodilation
histamine remains inside the mast cell
TAKEN P.C
 DRUGS OF RESPIRATORY TRACT

DECONGESTANTS MUCOLYTIC
 Phenylephrine  Ambroxol
 Pseudoephedrine  Acetylcysteine (flumucil)
antidote for paracetamol overdose
Pharmacodynamics:
Max Dose: 9 (20 tabs sabay-sabay
 Vasoconstriction
2x every 4 hrs)
Blood Flow  S-Carboxyl-Methyl
Carbocysteine (SCMC)
Cells shrink
Pharmacodynamics:
 Loosens the mucus
Decongestion
Dose: max 5 days – rebound Easily coughed out
decongestion for rhinitis medicanantosa
SE: hypertension Nursing intervention: oral fluid intake

ANTITUSSIVE ANTIHISTAMINE
 Dextronethorphan 1st Generation: Many SE (drowsiness)
(Robitussin DM)  Diphenhydramine
Pharmacodynamics: (Benadryl)
 Block cough refelex  Chlorpheniramine
Unproductive cough 2nd Generation: Less SE

 Loratidine (allerta)
 Desloratidine
EXPECTORANT
 Cetirizine
 Guiatenesin (Robitussin  Lexocetirizine
Expectorant)
Pharmacodynamics:
 Water content of mucus

Thinner mucus

Easier to cough
 Indicated for productive cough
Nursing intervention: oral fluid intake
 ANTIINFLAMMATORY DRUGS
 a drug that blocks any one or more of the signs of inflammation

CORTICOSTEROIDS “one” NON STEROIDAL ANTI-

INFLAMMATORY DRUG
 Prednisone
(NSAID)
 Hydrocortisone
PROPIONIC ACID
Pharmacodynamics:
 Ibuprofen (Advil)
 Blocks Arachidonic Acid & histamine
 Naproxen
 Anti-inflammatory FENAMATES
 Analgesic (rheumatoid arthritis)
 Mefenamic acid
 Antihistamine (allergy)
 Blocks the immune response  Indomethacin (used in PDA)
(antibody) COX-2 INHIBITORS
Side effect & Nursing Intervention:
 Celecoxib
1. Patient will be immunocompromised
- High risk of disease  Valdecoxib
- Avoid crowded place Pharmacodynamics:
- Wear a mask  Blocks PG
2. Take P.C
3. Do not stop gradually ( addisonian  Anti-inflammatory
crisis)  Analgesic
4. Watch out for signs of cushing  Antipyretic
syndrome - Avoid patient with kidney disease
- Moon face - Take PC
- Truncal obesity
- Buffalo hump

SALICYLATES  Acetaminophen/
 ASA (aspirin) Paracetamol
-weak anti-inflammatory drug
Pharmacodynamics:
 Blocks the PC Pharmacodynamics:
 CNS
 Anti-inflammatory
 Analgesic Hypothalamus
 Antiplatelet
 Antipyretic Thermoregulatory center

X dengue fever  Antipyretic

X varicella (chiken pox) > reye’s syndrome  analgesic
> SE: Salycylism – nausea, vomiting,
tinnitus
ANTIHISTAMINE
 Take PC
 ANALGESIC DRUGS
 drugs that block the pain receptor

OPIOID/ NARCOTICS NON OPIOIDS

OPIOID AGONIST 1. Anti-inflammatory drugs
 Morphine 2. Antimigrain
 Meperidine - Ergots
- Triptans
 Codeine
 Fentanyl
 Hydrocodone
 Tramadol
OPIOID AGONIST/ ANTAGONIST
 Nalbuphine
OPIOID ANTAGONIST
 Naloxone

PAIN SCALE

MODERATE-SEVERE
Opioids +/- Non- Opioids
- Morphine
MILD-MODERATE
- Fentanyl
Opioids +/- Non- Opioids
- Codeine
MILD - Nalbuphine
Non- Opioids
- Paracetamol
- ASA
- NSAIDs
 CAD DRUGS

STABLE/UNSTABLE PRINZMETAL
 Nitroglycerin (vasodilator) (Calcium Channel Blocker)
Pharmacodynamics:  Verapamil
 Relaxes the vascular smooth muscle >  Diltiazem
vasodilation
Pharmacodynamics:
Side effect: headache (give paracetamol)
 Heart rate
Nursing Intervention:
 Used for: hypertension, arrhythmia,
1. Route: sublingual
angina
2. Dose: tab
Frequency: q 5 mins  Nifedipine
T1/2: 3 mins  Nicarpidine (DOC of
Max: 3 tabs hypertensive urgency and emergency)
3. Carry: 3 tabs  Amlodipine
4. Storage: dry-ambered-colored  Felodipine
container (photosensitive)
5. Avoid alcohol (vasodilator- Side effect: peripheral edema
hypotension)  Elevate legs
6. Avoid sildenafil (Viagra-vasodilator)
7. Sips of water before SL (dry mucosa-
(Beta Blockers)
delay absorption)
8. Do not discontinue
9. Patch:
 Apply over non hairy areas
 Trim hairy areas
 rotate sites (irritating)
X 24/7 (tolerance)
Nitrate free hours (8hrs)
 ANTIHYPERTENSIVE DRUGS

ACE INHIBITORS ALPHA 1 ADRENERGIC

ANTAGONIST
 Captopril
 Enalapril  Prazosin
Pharmacodynamics:
 Doxazosin
 Blocks ACE  Terazosin
Pharmacodynamics:
No conversion of A1 to A2  Blocks alpha 1 receptor

No binding to A2 receptor Vasodilation

Vasodilation TPR

TPR BP
Site of Action: BLOOD VESSELS
BP Side Effect: hypotension
Site of Action: LUNGS Nursing Care: split dose initially (AM-PM)
Side Effect: cough ( renal blood flow)
Nursing Care:
1. Avoid in patient with Asthma/ COPD
2. Avoid in patient with renal failure

ANGIOTENSIN 2 RECERPTOR ALPHA 2 ADRENERGIC

BLOCKERS (ARB) AGONIST
 Losartan  Methyldopa
 Valsartan  Clonidine
Pharmacodynamics: Pharmacodynamics:
 Blocks angiotensin 2 receptor  Stimulate alpha 2 receptor

Vasodilation Vasodilation

TPR TPR

BP BP
Site of Action: BLOOD VESSELS Site of Action: CNS
 BETA ADRENERGIC BLOCKER CALCIUM CHANNEL BLOCKER

DIURETICS VASODILATORS
THIAZIDE  Nitroglycerin
 Hydrochlorothiazide (most  Nitroprusside
commonly used in hypertension)
LOOP DIURETIC
 Hydralazine (used in PIH)
 Furosemide (KIDNEY)  Minoxidil (SE: hair growth)
regroe
Side Effect: Hypokalemia, Hyperglycemia,
Hyperuricemia Nursing Care:
K+ SPARING 1. Lifestyle Changes (1-4)
2. ABCD 1 drug only
 Spironolactone (aldosterone
3. 1 + 1 drugs
antagonist)
4. 1 + 1 + 1 drugs
Side Effect: Hyperkalemia  Eat PIG (prutas, isda , gulay)
OSMOTIC DIURETIC  Decrease fats
 Decrease salts
 Mannitol
 Increase fibers
 Triamterene
CARBONIC ANHYDRASE INHIBITORS
 Acetazolamide (Diamox)
Pharmacodynamics:
 Urine output

Water retention

Blood volume

TPR

BP
 DIABETIS MELLITUS DRUGS
 metabolic disease
 Problem: INSULIN (carries glucose blood to cell)

TYPES: Problem Tx
DM TYPE 1 - No insulin - Insulin
DM TYPE 2 - Insufficient insulin - OHA (first choice)
- Insulin receptor - Insulin
resistance (obese)
GESTATIONAL DM - Insulin - Insulin

CLASS DURG ONSET PEAK DURATION

ULTRA-SHORT LISPRO 5-15 mins 1 hour 2 hours
ACTING ASPART
SHORT ACTING REAGULAR 30-60 mins 2 hours 6 hours
(rear)
INTERMEDIATE LENTE 2-4 hrs 4-6 hours 18 hours
ACTING NPH
LONG ACTING GLARGINE 2-4 hrs 1 day
DETEMIR 20 hours

Nursing Care:
1. Route: SQ
IM: no- hypoglycemia
PO: no- destroyed by gastric enzyme
IV: YES- but only regular
2. Mix
- Inject air cloudy remove/ aspirate from clear remove
- Inject air clear/ aspirate from cloudy
3. Rotate sites (prevent LIPODYSTROPHY)
4. The only insulin that can’t be mix (lantus)
ORAL HYPOGLYCEMIC AGENTS (OHA)

SULFONYLUREAS
 Chlorpropamide
 Glibenclamide
 Glyburide
 Glycazide

NON- SULFONYLUREAS
A. MEGLITINIDES
 Naleglinide
 Repaglinide

B. THIOZOLIDINEDIONES
 Naleglinide
 Rosiglitazone

C. BIGUANIDES
 Metroformine
- Used in PCOS
- SE: weight loss

D. ALPHA GUCOSIDASE
INHIBITORS
 Acarbose
 Miglitol
 ANTIARRHYTHMIC DRUGS

CLASS I CLASS II
 Quinidine Ia  Propranolol
 Procainamide Ia  Metoprolol
 Lidocaine Ib Pharmacodynamics:
 Phenytoin Ib  Blocks B- Receptor
 Blocks Phase 4
Pharmacodynamics:
 Blocks Na+ channel
 Blocks phase 0

CLASS III CLASS IV

 Amiodarone  Verapamil
Pharmacodynamics:  Diltiazem
 Blocks K+ channel Pharmacodynamics:
 Blocks Phase 3  Blocks Ca+ channel
 Blocks Phase 2