pharm phinal

• Levodopaclass/moa


  Dopaminergic agent, increase dopamine synthesis
• Levodopa use/prior info


  used for parkinson's, Must be combined w/ dopamine agonist (carbidopa/entacapone), Food delays absorption, effects reduced w/ high protein food, loss of effect after 5 years
• levodopa adverse effects


  psychosis, disabling dyskinesia, hallucinations, N/V, paranoia/anxiety, insomnia
• Entacapone class/MOA


  inhibit COMT to prolong effectiveness of Levodopa (increase availability)
• entacapone adverse effects


  N/V/D/C, orange urine, dyskinesia, hallucinate, sleep disturbance, Orthostatic hypotension
• Donepezil class/MOA


  Cholinesterase inhibitor, block enzyme that breaks down AcH
• donepezil use


  alzheimer’s dementia, slow progression but cannot stop it
• donepezil adverse effects (cholinergic effects)


  N/D, dizzy, headache, bronchoconstriction, bradycardia, fainting, fall
• donepezil interactions


  drugs that block cholinergic (antihistamines, conventional antipsychotic, amitriptyline)
• memantine class/MOA


  Neuronal (NMDA) receptor blocker, prevent entrance of Ca
• Memantine use/adverse effects


  Use: alzheimer’s dementia Adverse effects: dizzy, headache, confusion, constipation
• interferon-beta class/use


  Immunomodulator Use: secondary progressive MS, reduce attacks + lesions, delay progression
• interferon-beta adverse effects


  myelosuppression, hepatotoxicity, flu-like reaction, injection site reaction
• mitoxantrone class/use


  Immunosuppressant USE: secondary progressive MS, decrease neurologic disability + relapses
• mitoxantrone prior info


  CBC, liver function tests, pregnancy test, left ventricular ejection fraction
• mitoxantrone adverse effects


  cardiotoxicity, myelosuppress, teratogenic, hair loss, N/V, amenorrhea, blue tint of urine
• pantoprazole class/MOA


  Proton pump inhibitior,Irreversible block of ATPase (enzyme that makes acid)
• pantoprazole use


  heartburn, Only use 4-8 weeks, inhibit gastric acid release
• pantoprazole adverse effects


  Short term SE: N/V/D Long term: hip fracture, risk for gastric carcinoma
• misoprostol use


  gastric ulcers from NSAIDS, hold if pregnant
• misoprostol side effects


  diarrhea, abdominal pain, dysmenorrhea
• misoprostol MOA


  prevent secretion of gastric acid, promote mucus + bicarb secretion + submucosal bloodflow
• misoprostol class


  prostaglandin E1 analog, antisecretory
• sucralfate use


  ulcers
• Sucralfate prior info

  • Give 1 hr before meals, w/ water on empty stomach,
  • Don’t give with antacids or H2 antagonists, give 2 hrs apart with other meds
• sucralfate class/MOA

  • Mucosal protective agent, no ANC, Create barrier against acid, pepsin thickens + sticks to ulcer
• sucralfate SE


  constipation (drug mostly eliminated thru feces so very few SE)
• Magnesium hydroxide/MOM use


  antacid, peptic ulcer disease, osmotic saline laxative
• magnesium hydroxide/MOM contraindication


  undiagnosed abdominal pain, renal impairment
• magnesium hydroxide/MOM adverse effects

  diarrhea, CNS depression
• magnesium hydroxide/MOM MOA


  pull water into intestines to increase bulk of feces, neutralizes/inhibits pepsin (high ANC + rapid acting)
• calcium carbonate (tums)


  antacid, rapid acting, high ANC
• calcium carbonate/tums SE

  constipation, eructation (gassy, burping), acid rebound
• calcium carbonate use


  peptic ulcer disease, heartburn, indigestion
• Maalox

  magnesium + aluminum hydroxide

  • Low ANC, slow acting
• Maalox use


  antacid, peptic ulcer disease, ulcer healing
• maalox MOA

  • Bind to/inactivate pepsin
• Maalox SE


  hypophosphatemia, diarrhea
• amitriptyline use


  bipolar disorder, ADHD, OCD, neuropathic pain, depression, chronic insomnia, panic disorder
• amitriptyline side effects


  cardiac toxicity, diaphoresis, sedation, seizures, orthostatic hypotension, hypomania