Download Drug list #9 - aj pharmacy

Drug list #9
Pharmacology mod 100
MY PYRAMID
• www.fnic.nal.usda,gov contains several
resources including link to ‘my pyramid’
and current dietary guidelines
VITAMIN A
RETINOL BETA-CAROTENE
• Indication:
– dietary supplement
– antioxidant
• Action:
–
–
–
–
–
–
affects vision,
dental development,
Growth
hydrocortisone synthesis
immune function
mucous membranes
• Sources:
– liver, butter, cheese, whole milk, egg yolk,
meat and fish. Dark green leafy vegetables,
carrots, sweet potato, squash, cantaloupe
• Warnings:
– do not exceed RDA. Watch use in pregnancy,
lactation, kidney or liver disease. May cause
skin discoloration
Thiamine
(b1)
• Indication:
– vitamin deficiency, beriberi
• Action:
– carbohydrate metabolism, normal growth, transmission
of nerve impulses and acetylcholine synthesis
• Sources:
– brewers yeast, legumes, beef, pork, milk, liver, nuts,
whole grains
• Warnings:
– hypersensitivity may cause death
Riboflavin
(b2)
• Indication:
– vitamin deficiency. Off label: lactic acidosis in AIDS
patients on NRTIs, in infants with hyperbilrubinemia
• Action:
– glucose oxidation, amino acid deamination and fatty
acid breakdown
• Sources:
– meats, poultry, fish, dairy products, broccoli, turnips
asparagus, spinach.
• Warnings:
– yellow discoloration of urine
Niacin
(b3)
• Indication:
– vitamin deficiency, pellagra, hypercholesterolemia
• Action:
– participates in oxidation-reduction reactions
• Sources:
– liver, meat, fish, poultry, whole-grain, nuts,
legumes, green vegetables, yeast and potatoes.
• Warnings:
– flushing, take with food. Avoid alcohol
Pantothenic acid
(b5)
• Indication:
– vitamin deficiency
• Action:
– precursor of coenzyme A
• Sources:
– meat, poultry, fish, cereals, fruits, vegetables,
milk, egg yolks
Pyridoxine
(b6)
• Indication:
– vitamin deficiency, drug induced deficiency ( INH,
hydralazine, oral contraceptives)
• Action:
– necessary for normal breakdown of proteins,
carbohydrates and fats. Essential in hemoglobin
production and immune system maintenance
• Warnings:
– avoid over dosing
• Drug interactions:
– levodopa, phenytoin
Folic acid
(b9)
• Indication:
– megaloblastic anemia, deficiency during
pregnancy
• Action:
– essential in normal erythropoesis, nucleoprotein
synthesis. Especially important during rapid cell
division and growth
• Sources:
– leafy vegetables, beans, peas, liver, bakers yeast
• Warnings:
– may mask pernicious anemia
• Drug interactions:
– oral contraceptives
– Sulfasalazine
– phenytoin
Cyanocobalamin
(b12)
• Indication:
– vitamin deficiency
• Action:
– essential in growth, cell reproduction, hematopoiesis and
nucleoprotein and myelin synthesis
• Sources:
– foods of animal origins. It is recommended that persons that
do not ingest animal products to use a supplement.
• Warnings:
– absorbtion of B12 is dependent on the presence of intrinsic
factor and calcium. Deficiencies longer than 3 months may
produce permanent degenerative lesions of the spinal cord
Ascorbic acid
(C)
• Indication:
– vitamin deficiency, scurvy, antioxidant, urine
acidification
• Action:
– necessary for collagen formation and tissue repair,
many metabolic reactions
• Sources:
– citrus fruits, strawberries, tomatoes, cabbage greens,
leafy vegetables and melons
• Warnings:
– n/v, increased iron absorption, diarrhea
Vitamin D (D2, D3)
ergocalciferol, cholecalciferol
• Indication:
– vitamin deficiency, rickets, hyperparathyroidism
• Action:
– essential in calcium absorption, stimulates skeletal
growth, magnesium metabolism
• Sources:
– D2-fungal and plant sources.
– D3-animal sources and made in the skin when
exposed to UVB light (Wikipedia has an
interesting article detailing this)
Alpha tocopherol
(E)
• Indication:
– vitamin deficiency, antioxidant and many off label
uses
• Action:
– prevents oxidation of vitamins A & C, protects cell
membranes and red blood cells, suppresses platelet
aggregation
• Sources:
– vegetables, oils, seeds, corn, soy, whole wheat
flour, margarine, nuts, milk, eggs, meat
Phytonadione
(K)
• Indication:
– coagulation disorders due to faulty formation of factors
II, VII, IX and X when caused by K deficiency or
interference with activity
• Action:
– promotes hepatic biosynthesis of vitamin K dependant
clotting factors. Oral form can only be absorbed in the
presence of bile salts. Injection is indicated in
medication caused prothrombin deficiency ( see
rxlist.com, wikipedia or other source for full list). Note:
phytonadione does not counteract the anticoagulation
action of heparin.
• Sources:
– green leafy vegetables, avocado, kiwi
• Warnings:
– severe reactions possible with IV or IM use
(black box warning)
Niaspan
• Indication:
– hypercholesterolemia
• Action:
– same as above
• Warnings:
– increase dose slowly to minimize side effects
Paricalcitol (vitamin D)
• Indication:
– hyperparathyroidism associated with chronic
kidney disease
• Dosing:
– 3 times weekly, not more than every other day
while on dialysis
Calcium
• ( Wikipedia article covers chemical properties as well as
nutritional)
• Indications:
– calcium deficiency
• Action:
– calcium is the 5th most abundant element in the
body with most of it residing in the bone. Essential
in nervous, muscular systems, cardiac function, cell
permeability and blood coagulation. Special
attention to childhood bone growth, pregnancy and
lactation and osteoporosis prevention.
• Sources:
– dairy, seaweed, nuts, broccoli, eggshells
• Warnings:
– recommended patients take vitamin D with
calcium to promote absorption. Take with food
and a large glass of water. May cause
constipation
Ferrous gluconate
• Indication:
– iron deficiency, supplement during epoetin therapy
• Action:
– key component in hemoglobin. Deficiency has
been associated with behavioral or learning
problems in children.
• Sources:
– red meat, fish, poultry, lentils, beans, leafy
vegetables, tofu, black eyed peas, chickpeas
• Warnings:
– black box warning concerning accidental
overdose in children. This is a leading cause of
fatal poisoning in children under 6yo. Refer to
F&C for the 4 stages of overdosing. There may
be permanent damage to GI tract, hepatic
cirrhosis and CNS.
– Take with food, avoid antacids, tcns and
fluoroquinolones with in 2 hours of dosing
Sodium fluoride
• Indication:
– prevention of dental caries when water supply is
inadequate, off label use of treating osteoporosis
• Action:
– works systemically before tooth eruption, topically
post eruption. Increases tooth resistance to acid,
promote remineralization and inhibits microbial
damage
• Warnings:
– avoid taking with milk, expectorate excess.
Prenatal, prenatal/zinc
• Indication:
– pregnancy supplement
• Action:
– assures nutrient intake during pregnancy of key
elements
• Warnings:
– take with food, may cause constipation