Adverse Effects/Contraindications/Side Effects/Interactions in NCLEX® for Nursing RN

Benzodiazepine Antidote

Flumazenil

40 secs

Warfarin Antidotes

Vitamin K

Fresh Frozen Plasma

59 secs

Acetylcholinesterase Inhibitor Antidote

Atropine

Pralidoxime

1 min

Acetaminophen Antidote

N-Acetylcysteine

33 secs

Antimuscarinic Antidote

Physostigmine Salicylate

44 secs

Amphetamine Antidote

Ammonium Chloride (NH4Cl)

Acidify Urine

34 secs

Beta Blocker Antidote

Glucagon

29 secs

Arsenic, Gold and Copper Antidotes

Arsenic

Gold

Copper

Penicillamine

Dimercaprol (BAL)

Succimer

2 mins

Iron Antidote

DeFEroxamine

23 secs

Opioid Antidote

Naloxone

29 secs

Tricyclic Antidepressant (TCA) Antidote

Sodium Bicarbonate (NaHCO3)

27 secs

Aspirin Poisoning (Salicylism) Assessment

Nausea and Vomiting

Tinnitus

Confusion

Hyperventilation

Respiratory Alkalosis

Metabolic Acidosis

Coma

Hyperthermia

1 min

Lead Antidotes

Dimercaprol

CaEDTA

Succimer

39 secs

Anticholinergics

B.O.AT.S Acronym

Benztropine

Parkinson's Disease

Oxybutynin

Decrease bladder spasms

Atropine

Mydriasis and Cycloplegia

Scopolamine

Motion Sickness

1 min

Anticholinergics Continued

Glycopyrrolate

Reduces Airway Secretions

Ulcer Treatment

Ipratropium

Asthma and C.O.P.D

Dicyclomine

Hyoscyamine

Irritable Bowel Syndrome

1 min

Atropine

Muscarinic Antagonist

Bradycardia

Increased Exocrine Secretions

Smooth Muscle Spasms

Tachycardia

Dry Mouth

Urinary Retention

2 mins

Benztropine (Cogentin)

Anticholinergic

Parkinson's Disease

Acute Dystonia

Blurred Vision

Dry Mouth

Urinary Retention

Tachycardia

Constipation

Psychosis

2 mins

Direct Cholinomimetics

Muscarinic Agonists

Bethanechol

Bladder and Bowels

Methacholine

Bronchoconstriction

Pilocarpine

Contracts Ciliary Muscle and Pupillary Sphincter

Carbachol

Releases Intraocular Pressure

1 min

Indirect Cholinomimetics

Acetylcholinesterase Inhibitors

Edrophonium

Myasthenia Gravis (Diagnosis)

Pyridostigmine and Neostigmine

Myasthenia Gravis (Tx)

Ileus

Physostigmine

Atropine Overdose

Glaucoma

Donepezil

Alzheimer's

2 mins

Pilocarpine (Pilocar)

Direct Cholinergic Agonist

Contracts Iris Sphincter

Contracts Ciliary Muscle

Xerostomia

Glaucoma

Detached Retina

Decreased Visual Acuity

Eye Irritation

Cholinergic Effects

Avoid with Asthma or Bradycardia

2 mins

Acetylcholinesterase Inhibitor Poisoning

DUMBBELSS

Diarrhea

Urination

Miosis

Bronchospasm

Bradycardia

Emesis

Lacrimation

Salivation

Sweating

2 mins

Alpha Agonists

-RINE suffix

Norepinephrine

Hypotension

Phenylephrine

Hypotension

Congestion

Ephedrine

Congestion

Urinary Incontinence

Hypotension

Epinephrine

Anaphylaxis and Asthma

Hypotension

1 min

Prazosin (Minipress)

-osin suffix

Selective Alpha-1 Receptor Blocker

Hypertension

Benign Prostatic Hyperplasia (BPH)

Nightmares

Orthostatic Hypotension

Tachycardia

Priapism / Inhibition of Ejaculation

Nasal Congestion

First Dose Effect

Administer at Bedtime

2 mins

Beta Blockers

"-olol" suffix

Decreases Heart Rate and Contractility

Decreases Peripheral Vascular Resistance

Decreases Renin Release

Hypertension

Heart Failure

Angina Pectoris

Asthma and Heart Block Patients

Assess Blood Pressure and Heart Rate

Masking Signs of Hypoglycemia

Do Not Stop Abruptly

2 mins

Cardiovascular Effects of Beta-Blockers

Cardiac Myocytes and Vasculature

Decrease cAMP

Decreases SA and AV Node Conduction Velocity

Lower Blood Pressure

Decrease O2 Consumption

Decreases Mortality Post-MI

2 mins

Systemic Effects of Beta-Blockers

Respiratory

Bronchoconstriction

Metabolic

Decreased Insulin

Decreased Glycolysis and Lipolysis

Eye

Reduces Intraocular Pressure

1 min

Epinephrine (Adrenaline)

Alpha and Beta Agonist

Anaphylaxis

Primary Open Angle Glaucoma (POAG)

Bleeding

Cardiac Arrest

Tachycardia

Hypertension

Tremors

Insomnia

Multiple Strengths

2 mins

Ephedrine

Alpha Agonist

Beta Agonist

Rhinitis

Hypotension

Urinary Incontinence

35 secs

Norepinephrine (Levophed)

Alpha Agonist

Beta-1 Agonist

Severe Hypotension

Decreases Renal Blood Flow

Arrhythmias

Hypertension

Tissue Necrosis

Last Resort Medication

2 mins

Dobutamine

Beta-1 Agonist

Inotropic

Heart Failure

Tachycardia

Arrhythmias

Closely Monitor Patients

Other Meds May Increase Potency

1 min

Selective Serotonin Reuptake Inhibitor (SSRI) Overview

Depression

Anxiety

Selective Serotonin Reuptake Inhibitors

Paroxetine

Sertraline

Escitalopram

Fluoxetine

Sexual Dysfunction

Serotonin Syndrome

Treat with Cyproheptadine

2 mins

Fluoxetine (Prozac)

Inhibits Reuptake of Serotonin

Depression

Sexual Dysfunction

CNS Stimulation

Weight Changes

Serotonin Syndrome

No MAO-Is

No Anticoagulants / Antiplatelets

Suicide Risk

Delayed Onset of Action

2 mins

Serotonin Norepinephrine Reuptake Inhibitors (SNRIs)

Depression

Diabetic Peripheral Neuropathy

Duloxetine

Panic and Anxiety

Venlafaxine

Inhibits Reuptake of Serotonin and NE

Hypertension

Insomnia

Nausea and Vomiting

Decreased Libido

1 min

Bupropion

Depression

Smoking Cessation

Increase Dopamine and NE

Stimulant Side Effects

Seizure

1 min

Tricyclic Antidepressants (TCAs)

Inhibits Reuptake of Norepinephrine and Serotonin

Depression

Bipolar Disorder

Fibromyalgia

Sedation

Orthostatic Hypotension

Anticholinergic Effects

Cardiac Toxicity

Delayed Effect

Do Not Stop Abruptly

2 mins

Tricyclic Antidepressants (TCAs) Indications

Major Depression

Bedwetting

Fibromyalgia

OCD

-Iptyline or -Ipramine Suffix

Amitriptyline

Desipramine

Clomipramine

Imipramine

Nortriptyline

2 mins

Monoamine Oxidase Inhibitor (MAOI) Contraindications

Wine and Cheese

Hypertensive Crisis

Serotonin Drugs

Serotonin Syndrome

1 min

Monoamine Oxidase Inhibitors (MAO-Is)

Atypical Depression

Increase Levels of Amine Neurotransmitters

"Takes Pride In Shanghai"

Tranylcypromine

Phenelzine

Isocarboxazid

Selegiline

1 min

Aripiprazole (Abilify)

2nd Generation Atypical Antipsychotic

Schizophrenia

Bipolar Disorder

Depression

Headache

Dizziness

Nausea and Vomiting

Insomnia

Anxiety

Low Risk of Extrapyramidal Symptoms

Lowest Risk of Weight Gain

2 mins

Serotonin Syndrome Assessment

Restlessness

Diaphoresis

Tachycardia

Hypertension

Diarrhea

Hyperthermia

Decreased Level of Consciousness

Muscle Rigidity

Seizure and Coma

Cyproheptadine

2 mins

Vortioxetine

Inhibits Reuptake of Serotonin

Major Depressive Disorder

Nausea

Sexual Dysfunction

Anticholinergic Effects

Sleep Disturbances

Serotonin Syndrome

2 mins

Antipsychotics Overview

Typical

Atypical

Blocks D2 Receptor

2nd Generation Blocks the 5-HT 2 Receptor

Psychosis

Delirium

Bipolar Disorder

Tourette’s Syndrome

Hyperprolactinemia

Extrapyramidal Symptoms

Tardive Dyskinesia

Neuroleptic Malignant Syndrome

4 mins

Low Potency Antipsychotic Drugs

Chlorpromazine

Corneal Deposits

Thioridazine

Retinal Deposits

Alpha1 Antagonist Effects

Anticholinergic Effects

51 secs

High Potency Antipsychotic Drugs

Fluphenazine

Trifluoperazine

Haloperidol

Extrapyramidal Symptoms

Short Term

Dystonia

Torticollis

Long Term

Tardive Dyskinesia

Parkinson's-like Symptoms

2 mins

Atypical Antipsychotics

Schizophrenia

Unknown Mechanism

Seizures

Prolonged QT Interval

Agranulocytosis

Weight Gain

Fewer Extrapyramidal Side Effects

Fewer Anticholinergic Side Effects

2 mins

Neuroleptic Malignant Syndrome

FEVER Acronym

Fever

Encephalopathy

Vital Signs Unstable

Elevated Enzymes

Rigidity of muscles

D2 Agonists

Bromocriptine

Dantrolene

2 mins

Malignant Hyperthermia vs. Neuroleptic Malignant Syndrome vs. Serotonin Syndrome

Autonomic Instability

Muscle Rigidity

Ryanodine Receptor 1 Mutation

Inhaled Anesthetics

Succinylcholine

Dantrolene

Antidopaminergic Medications

Hyporeflexia

Myoglobinuria

Dantrolene

Serotonergic Medications

Hyperreflexia

Clonus

Cyproheptadine

3 mins

Haloperidol (Haldol)

High Potency Antipsychotic

Migraine

Schizophrenia

Extrapyramidal Symptoms

Weight Gain

QT Prolongation

Restlessness

Caution in Seizure Patients

Neuroleptic Malignant Syndrome

2 mins

Chlorpromazine (Thorazine)

Low Potency Antipsychotic

Schizophrenia

Hiccups

Sedation

Weight Gain

Orthostatic Hypotension

Anticholinergic Effects

QT Prolongation

Neuroendocrine Effects

Caution in Seizure Patients

Corneal Deposits

2 mins

Clozapine (Clozaril)

Atypical Antipsychotic

Schizophrenia

Levodopa-Induced Psychosis

Weight Gain

Hypersalivation (Sialorrhea)

Myocarditis

Agranulocytosis

Sedation

Orthostatic Hypotension

Constipation (Risk of Bowel Ileus)

Weekly Lab Tests

2 mins

Risperidone (Risperdal)

Atypical Antipsychotic

Schizophrenia

Bipolar Mania

Autism-Associated Irritability

Extrapyramidal Symptoms

Hyperprolactinemia

Gynecomastia

Galactorrhea

Amenorrhea

Prolonged QT

Intramuscular Long Acting (Depot) Form

2 mins

Lithium

Mood Stabilizer

Unknown Mechanism

Bipolar Disorder

Nephrogenic Diabetes Insipidus

Hypothyroidism

Tremor

Heart Block

Pregnancy

Monitor Plasma Levels

2 mins

Triazolam (Halcion)

Rapid-Onset Benzodiazepine

Insomnia

Rebound Insomnia

Respiratory Depression

Hypotension

Paradoxical Excitement

Amnesia

Confusion

Pregnancy

Short-Term Administration

2 mins

Zolpidem (Ambien)

Hypnotic

Insomnia

Daytime Drowsiness

Bizarre Sleep Behaviors

Sleep Driving

Angioedema

Short Term Administration

Take Immediately Before Bedtime

1 min

Diazepam (Valium)

Anxiety

Seizures and Status Epilepticus

Muscle Spasms

Alcohol Withdrawal

Dizziness/Vision Changes

Confusion/Amnesia

Urinary Incontinence

Behavioral Changes

Respiratory Depression

Flumazenil (Romazicon)

Fall Precaution

Do Not Stop Abruptly

2 mins

Phenobarbital (Barbiturates)

Barbiturate

Seizures

Ataxia

Paradoxical Excitement

Fatigue/Drowsiness

Monitor Plasma Levels

High Potential for Abuse

1 min

Buspirone (Buspar)

Increases Serotonin

Anxiety

Dizziness

Insomnia

Delayed Effect

Safer with Alcohol than Other Anxiolytics

Low Side Effect Profile

Low Abuse Potential

1 min

Trazodone

Insomnia

Depression

Inhibit Serotonin Reuptake

Alpha-1 Blocker

Histamine (H1) Blocker

Sedation

Orthostatic Hypotension

Dry Mouth

Priapism

Arrhythmias

2 mins

Short-acting Benzodiazepines

ATOM

Alprazolam

Triazolam

Oxazepam

Midazolam

Anesthesia Induction

Insomnia

Anxiety

Half-life < 12 Hours

Dependence

2 mins

Benzodiazepines Overview

First Line for Status Epilepticus

Anesthesia Induction

Anxiety

Eclampsia

Detoxification

'-zepam' and '-zolam" Suffix

Increase Frequency of Cl- Channel Opening

Decrease REM Sleep

CNS Depression

Dependence

Flumazenil for Overdose

2 mins

Long-acting Benzodiazepines

Lorazepam

Diazepam

Clonazepam

Chlordiazepoxide

Insomnia

Anxiety

Seizures

Eclampsia

Alcohol Withdrawal

Half-life > 24 Hours

Dependence

3 mins

CNS Stimulants

Attention Deficit Hyperactivity Disorder (ADHD)

Obesity

Increase Catecholamines at Synaptic Cleft

Increase Norepinephrine

Increase Dopamine

Methylphenidate (Ritalin)

Methamphetamine

Potential for Abuse

57 secs

CNS Stimulant Indications

Amphetamine

Methylphenidate (Ritalin)

Increased Norepinephrine

Increased Dopamine

Attention Deficit Hyperactivity Disorder (ADHD)

Obesity

Narcolepsy

1 min

CNS Stimulant Side Effects

Agitation

Insomnia

Hypertension

Tachycardia

Tics

Anorexia

Tolerance Develops

High Risk of Abuse and Dependence

2 mins

Amphetamines Intoxication Assessment

Euphoria

Insomnia

Mydriasis

Diaphoresis

Hypertension

Tachycardia

Paranoia

Anxiety

Anorexia

Seizures

2 mins

Cocaine Intoxication Assessment

Euphoria

Delusions

Mydriasis

Hallucinations

Agitation

Hypertension

Arrhythmias

Hyperthermia

Seizures

Nasal Septum Perforation

2 mins

Local Anesthetic Overview

Minor Procedures

Epidurals

Blocks Na+ Channels

State Dependent

Combined with Vasoconstrictors

Infected Tissue Requires Higher Dose

Esters

Amides

Arrhythmias

Cardiotoxicity

1 min

Inhaled Anesthetics

Unknown Mechanism

HEISMN Drug Name Acronym

Respiratory Depression

Myocardial Depression

Lower Metabolic Demand, Increased Cerebral Blood Flow

Hepatotoxicity (Halothane)

Nephrotoxicity (Methoxyflurane)

Seizure (Enflurane)

Malignant Hyperthermia

Expansion of Trapped Gas

2 mins

IV Anesthetics

Barbiturates

Benzodiazepines

Respiratory Depression

Hypotension

Ketamine

NMDA Receptor Antagonist

Hallucinations

Opioids

Propofol

Potentiates GABA-A

2 mins

Lidocaine

Blocks Na+ Channels

Ventricular Arrhythmia

Anesthetic

Paresthesias

Seizures

Respiratory Depression

Drowsiness

Anesthetic Effects Extended with Epinephrine

1 min

Malignant Hyperthermia

Autosomal-Dominant

Ryanodine Receptor 1 Mutation

Inhaled Anesthetics

Succinylcholine

Autonomic Instability

Muscle Rigidity

Dantrolene

2 mins

Lamotrigine (Lamictal)

Blocks Na+ Channels

Seizures

Bipolar Disorder

Diplopia

Stevens-Johnson Syndrome

Headache

Aseptic Meningitis

Nausea and Vomiting

Screen for Suicide Risk

2 mins

Phenytoin (Dilantin)

Blocks Na+ Channels

Tonic-clonic Seizures

Ataxia

Nystagmus

Sedation

Gingival Hyperplasia

Purple Glove Syndrome

Hirsutism

Rash

Anemia

Individualized Dosing

2 mins

Valproic Acid (Depakote)

Blocks Na+ Channels

Increases GABA Concentration

Tonic-clonic Seizures

Bipolar Disorder

Migraine Prophylaxis

Hepatotoxicity

Blood Dyscrasias

GI Distress

Tremor

Pancreatitis

1 min

Carbamazepine (Tegretol)

Inactivates Na+ Channels

Seizures

Bipolar Disorder

Trigeminal Neuralgia

Nystagmus

Ataxia

Hepatotoxicity

Blood Dyscrasias

Water Retention

Stevens-Johnson Syndrome

Avoid Grapefruit Juice

2 mins

Ethosuximide (Zarontin)

First Line Absence Seizure

Blocks Thalamic T-Type Ca2+ Channels

Stevens-Johnson Syndrome

Fatigue

Diarrhea

Blood Dyscrasias

Do Not Stop Abruptly

2 mins

Topiramate

Seizure Treatment

Migraine Prophylaxis

Increase GABA Action

Blocks Voltage-Gated Na+ Channels

Kidney Stones

Weight Loss

Sedation

1 min

Valproic Acid (Valproate) Side Effects

Vomiting

Alopecia

Liver Toxicity

Pancreatitis/Pancytopenia

Retain Fat (Weight Gain)

Oedema (Edema)

Appetite Increase

Tremor

Enzyme Inhibitor (P450)

2 mins

Pregabalin (Lyrica)

GABA Analog

Seizures

Neuropathic Pain

Fibromyalgia

Headache

Dizziness

Somnolence (Fatigue)

Weight Gain

Angioedema

Rhabdomyolysis

Dependence

1 min

Nondepolarizing Neuromuscular Blocking Drugs

Names Include "Cur"

Competitive Antagonists

Acetylcholine Competition

Reversal of Blockade

Neostigmine, Edrophonium

1 min

Succinylcholine

Inducing Paralysis

Neuromuscular Blocking Drugs

Motor Nicotinic Receptor

ACh Receptor Agonist

Depolarization

Phase I (Paralysis Non-reversible)

Phase II (Paralysis Reversible)

Neostigmine (Reversal Agent)

2 mins

Parkinson's Drugs

Decreased Dopamine

Increased Acetylcholine

BALSA Acronym

Bromocriptine

Amantadine

Levodopa

Selegiline

Antimuscarinics

2 mins

Levodopa/Carbidopa (Sinemet)

Increases Dopamine in Brain

Parkinson's Disease

Nausea and Vomiting

Arrhythmias

Dyskinesia

Psychosis

Orthostatic Hypotension

Report Uncontrolled Movements

Darkened Sweat or Urine

Off and On Phenomenon

2 mins

Memantine

Alzheimer's Disease

NMDA Receptor Antagonist

Prevents Excitotoxicity

Confusion

Hallucinations

1 min

Donepezil

Alzheimer's Disease

Acetylcholinesterase Inhibitor

Increased Acetylcholine

Nausea and Vomiting

Dizziness

52 secs

Sumatriptan

Short Half-Life

5-HT Agonist

Inhibits Trigeminal Nerve Activation

Induces Vasoconstriction

Migraine

Cluster Headache

Increased Risk of Serotonin Syndrome

Paresthesias

Coronary Vasospasm

Prinzmetal's Angina

Coronary Artery Disease (CAD)

3 mins

Gabapentin

Seizure Treatment

Peripheral Neuropathy

Postherpetic Neuralgia

Bipolar Disorder

Migraine Prophylaxis

Inhibits Voltage-Gated Ca2+ channels

Designed as a GABA Analog

Ataxia

Sedation

2 mins

Codeine

Opioid Receptor Agonist

Mild to Moderate Pain

Cough Suppressant

Sedation

Constipation

Miosis

Close Monitoring When Breast Feeding

Often Combined with Non-Opioids

2 mins

Morphine

Opioid Receptor Agonist

Pain

Myocardial Infarction

Nausea and Vomiting

CNS Depression

Biliary Colic

Constipation

Increased Intracranial Pressure (ICP)

Pupillary Constriction

Hypotension

2 mins

Meperidine (Demerol)

Opioid Receptor Agonist

Moderate to Severe Pain

Post Anesthesia Shivering

Tremors

Constipation

CNS Depression

Sedation

Short Term Administration

Increased Risk Serotonin Syndrome

Does NOT cause Miosis

Renal Failure Increases Toxicity Risk

2 mins

Naloxone (Narcan)

Competitive Opioid Receptor Antagonist

Opioid Induced CNS Depression

Severe Nausea and Vomiting

Excitable State

Opioid Withdrawal Symptoms

Repeated Dosing Often Required

1 min

Tramadol

Chronic Pain

Weak Opioid

Inhibit Serotonin and NE reuptake

Increased Risk of Seizure

48 secs

Butorphanol

Migraine

Severe Pain

Labor

Partial Agonist at Mu and Full Agonist at Kappa Receptors

Less Respiratory Depression

Withdrawal Symptoms

1 min

Acetaminophen-Hydrocodone (Vicodin)

Combination Analgesic

Opioid Receptor Agonist

Hydrocodone

Reversible Inhibition of COX

Acetaminophen

Moderate to Severe Pain

CNS Depression

Respiratory Depression

Hepatotoxicity

Addiction

2 mins

Oxycodone

Opioid Receptor Agonist

Refractory Pain

Respiratory Depression

Constipation

CNS Depression

Addiction

Naloxone

2 mins

Suvorexant

Orexin Receptor Antagonist

Insomnia

CNS Depression

Headache

Abnormal Dreams

Contraindicated in Narcolepsy

Avoid in Liver Disease

1 min

Fentanyl

Opioid Receptor Agonist

High Potency

Anesthesia Induction

Chronic Pain

Breakthrough Pain

CNS Depression

Respiratory Depression

Constipation

Miosis

Addiction

3 mins

Buprenorphine-Naloxone (Suboxone)

Combination Drug

Partial Opioid Receptor Agonist (Buprenorphine)

Opioid Receptor Antagonist (Naloxone)

Opioid Use Disorder

CNS Depression

Diaphoresis

Hypotension

Low Abuse Potential

2 mins

Acetazolamide

Glaucoma

Altitude Sickness

Pseudotumor Cerebri

CHF

Metabolic Alkalosis

Carbonic Anhydrase Inhibitor

Sodium Bicarbonate (NaHCO3) Diuresis

Metabolic Acidosis

Paresthesias

1 min

Hypertension Medications

Diuretics

ACE Inhibitors

Angiotensin Receptor Blockers (ARBs)

Beta Blockers

Dihydropyridine Calcium Channel Blockers

2 mins

Angiotensin-Converting Enzyme (ACE) Inhibitors

"-pril" Suffix

Block Renin Angiotensin-Aldosterone System (RAAS)

Hypertension

Heart Failure

Dry Non-productive Cough

Hypotension

Dizziness

Possible Hyperkalemia

Angioedema

Slowly Change Position

Do Not Stop Abruptly

2 mins

Angiotensin II Receptor Blockers (ARBs)

Ends in "-sartan"

Blocks Angiotensin II Receptor

Hypertension

Angioedema

Renal Artery Stenosis

Pregnancy

1 min

Hydralazine (Apresoline)

Severe Hypertension

CHF

Reduced Afterload

Pregnancy

Vasodilates Arterioles

Drug-induced Lupus

Reflex Tachycardia

Hypotension

Combined with Diuretic and Beta Blocker

1 min

Minoxidil (Loniten, Rogaine)

Vasodilates Arterioles

Severe Hypertension

Baldness

Reflex Tachycardia

Blood Volume Expansion

Hypertrichosis

Pericardial Effusion

Rash

Give with Beta Blocker and Diuretic

2 mins

Nitroglycerin

Decreases Preload

Angina

Up to 3 doses q 5 mins

Headache

Hypotension

Viagra (Sildenafil)

Assess Blood Pressure

Protect From Light

Use Glass Bottle and Special Tubing

Gloves for Applying Topically

2 mins

Sodium Nitroprusside (Nitropress)

Venous and Arterial Dilation

Hypertensive Crisis

Cyanide Toxicity

Thiocyanate Toxicity

Hypotension

Short Term Administration

Light Sensitive, Use Container

Continuous BP Monitoring

2 mins

K+ Sparing Diuretics

CHF and Hypertension

Hypokalemia

Hyperaldosteronism

Collecting Tubule

Spironolactone

Competitive Aldosterone Receptor Antagonist

Amiloride and Triamterene

Block Na+ Channels

Hyperkalemia

Gynecomastia

2 mins

Clonidine

Alpha-2 Agonist

Hypertensive Urgency

Attention Deficit Hyperactivity Disorder (ADHD)

Tourette Syndrome

Opioid Withdrawal

CNS Depression

Respiratory Depression

Hypotension

Rebound Hypertension if Abrupt Cessation

2 mins

Adenosine (Adenocard)

Slows AV Conduction

Supraventricular Tachycardia (Paroxysmal)

Bradycardia

Flushing

Dyspnea

Rapid IV Push

Caffeine and Theophylline Decrease Effectiveness

Dipyridamole May Intensify Effects

2 mins

Magnesium Sulfate

Muscle Relaxant

Preterm Labor Contractions

Preeclampsia

Warm Feeling

Hypotension

Decreased Deep Tendon Reflexes (DTRS)

Decreased Respiratory Rate

Decreased Urine Output

Paralytic Ileus

Calcium Gluconate

2 mins

Calcium Channel Blockers (Verapamil and Diltiazem)

Slows AV Conduction

Angina Pectoris

Arrhythmias

Essential Hypertension

Bradycardia

Hypotension

Constipation

Peripheral Edema

Gingival Hyperplasia

Medication Education

2 mins

Amiodarone

Class III Antiarrhythmic (K+ Channel Blocker)

Decreases SA and AV Node Conduction

Inhibits Cytochrome P450

Supraventricular Tachycardia with Heart Failure

Ventricular Tachycardia

Hepatotoxicity

Pulmonary Fibrosis

Bradycardia

Heart Block

Thyroid Disorders

Blue/Gray Skin Deposits

Corneal Deposits

3 mins

Digoxin (Lanoxin)

Increases Inotropy

Heart Failure

Atrial Fibrillation

Bradycardia

Fatigue

Heart Block

Heart Rate Below 60

Hypokalemia

Monitor for Toxicity and Visual Changes

Digibind

2 mins

Acute Digoxin Toxicity

Hyperkalemia

Cholinergic (Nausea, Vomiting, Diarrhea)

Blurry Yellow Green Vision with Halo of Light

Arrhythmia

Bradycardia

Prolonged PR interval

Decreased QT

Scooping on EKG

T Wave Inversion

2 mins

Digoxin Toxicity Treatment

Activated Charcoal

Slowly Normalize K+

Digibind (Anti-Digoxin Fab)

Magnesium Sulfate

Lidocaine

Cardiac Pacing

2 mins

Beta-1 Agonists

Dobutamine

Heart Failure

Cardiac Stress Test

Isoproterenol

Bradyarrhythmias

Torsades de Pointes

1 min

Milrinone and Amrinone

Phosphodiesterase 3 Inhibitor

Potentiates Beta Receptor Effects

Inotrope

Vasodilator

Acute Decompensated Heart Failure

Ventricular Arrhythmias

Hypotension

2 mins

Atorvastatin (Lipitor)

-statin Suffix

HMG-CoA Reductase Inhibitors

High Cholesterol

Hepatotoxicity

Rash

Rhabdomyolysis

Myopathy

Monitor Liver Enzymes

Administer at Bedtime

Avoid Grapefruit

2 mins

Bile Acid Resins

Hyperlipidemia

Bile Acid Reabsorption Prevented

Slight Increase HDL/Triglycerides

Decrease LDL

Colestipol (Colestid)

Cholestyramine

Colesevelam

Cholesterol Gallstones

Decreased Absorption of Fat-soluble Vitamins

Patients Hate It

2 mins

Bile Acid Resins

Hyperlipidemia

Bile Acid Reabsorption Prevented

Decrease LDL

Colestipol (Colestid)

Cholestyramine (Questran)

Colesevelam (Welchol)

GI Distress

Cholesterol Gallstones

Decreased Absorption of Fat-soluble Vitamins

2 mins

Gemfibrozil (Fibrates)

Decreases Triglycerides

Increase in HDL

Slight Decrease in LDL

Hypertriglyceridemia

Hepatotoxicity

Cholesterol Gallstones

Myopathy

Do Not Combine with Statins

Warfarin Toxicity

2 mins

Ezetimibe

Hyperlipidemia

Cholesterol Absorption Blocker

Decreases LDL

Diarrhea

Increased LFT Values

1 min

Fibrates

Hyperlipidemia

Upregulate LPL

Decreases Triglycerides

Slight Increase in HDL

Slight Decrease in LDL

Hepatotoxicity

Cholesterol Gallstones

1 min

Vitamin B3 - Niacin (Nicotinic Acid)

Decreases Triglycerides

Decreases LDL

Increases HDL

Dyslipidemia

Pellagra

Diarrhea

Dermatitis

Dementia

Flushing

GI Distress

Hepatotoxicity

2 mins

Statins

Rhabdomyolysis

Hepatotoxicity

HMG-CoA reductase inhibitors

Decrease LDL

Decrease Triglycerides

Increase HDL

2 mins

Aspirin (Acetylsalicylic Acid)

Inhibits Platelet Aggregation

NSAID

Thrombotic Event Prevention

General Pain

Inflammatory Conditions

Fever

Pancytopenia

GI Ulcers

Bleeding

Withhold Before Surgery 7-10 Days

Reye's Syndrome

2 mins

Warfarin (Coumadin)

Inhibits Clotting Factors

Atrial Fibrillation

Venous Thrombosis

Pulmonary Embolism

PT/INR Levels

Observe for Bleeding

Pregnancy

Vitamin K and Fresh Frozen Plasma

Prolonged Therapeutic Onset

Maintain Same Diet

2 mins

Heparin (Unfractionated)

Suppresses Coagulation

Deep Vein Thrombosis (DVT)

Pulmonary Embolism

Hemorrhage

Heparin-Induced Thrombocytopenia (HIT)

Monitor aPTT

Preferred (Safe) During Pregnancy

Protamine Sulfate

2 mins

Enoxaparin (Lovenox)

Inhibits Clotting Factors

Factor Xa

Clot Formation Prevention

Heparin Induced Thrombocytopenia (HIT)

Bleeding

Medication Education

Subcutaneous Injection

2 Inches from Umbilicus or Incisions

Protamine Sulfate

2 mins

Clopidogrel (Plavix)

ADP Receptor Antagonist

Prevent Platelet Aggregation

Acute Coronary Syndrome (ACS)

Prevention of Thrombotic Events

Bleeding

Thrombotic Thrombocytopenic Purpura (TTP)

Pancytopenia

Abdominal Pain

Withhold Before Surgery

2 mins

Ticlopidine (Ticlid)

ADP Receptor Antagonist

Irreversibly Inhibits Platelet Aggregation

Thrombotic Event Prevention

Neutropenia

Thrombotic Thrombocytopenic Purpura (TTP)

GI Distress

Rash

Withhold Before Surgery

Monitor Blood Count

2 mins

Alteplase

Tissue Plasminogen Activator

Thrombosis

Bleeding

Intracranial Hemorrhage

Internal Hemorrhaging

Minimize Bleeding

Monitor for Shock

Aminocaproic Acid

2 mins

Abciximab and Tirofiban (GP IIb/IIIa Inhibitors)

IIb/IIIa Receptor Inhibitors

Inhibits Platelet Aggregation

Thrombotic Event Prevention

Acute Coronary Syndrome (ACS)

Percutaneous Coronary Intervention (PCI)

Bleeding

Expensive

Combination Drug Therapy

2 mins

Tamoxifen

Selective Estrogen Receptor Modulator (SERM)

Antagonist on Breast Tissue

ER-positive Breast Cancer

Decreased Risk of Osteoporosis

Increased Risk of Endometrial Cancer

Increased Risk of Venous Thromboembolism (VTE)

1 min

Busulfan

CML

Bone Marrow Ablation

Cross-Links DNA

Myelosuppression

Pulmonary Fibrosis

Hyperpigmentation

55 secs

Cisplatin (Platinol)

Alkylating Agent

Cross-Links DNA

Testicular Cancer

Ovarian Cancer

Nausea and Vomiting

Myelosuppression

Nephrotoxicity

Ototoxicity

Peripheral Neuropathy

Antiemetics Before Administration

Aggressive Hydration

3 mins

Vincristine (Oncovin)

Vinca Alkaloid

Inhibits Microtubules

Leukemias

Lymphomas

Peripheral Neuropathy

Paralytic Ileus

Vesicant

2 mins

Bleomycin

Testicular Cancer

Hodgkin's Lymphoma

Induces Free Radical Formation

Breaks in DNA Strands

Pulmonary Fibrosis

Skin Changes

Mucositis

1 min

Hydroxyurea

Inhibits Ribonucleotide Reductase

Decreased DNA Synthesis

S-phase Specific

Melanoma

Chronic Myelogenous Leukemia (CML)

Sickle Cell Disease

Through Increased HbF (Fetal Hemoglobin)

Myelosuppression

GI Distress

2 mins

Cyclophosphamide

Requires Bioactivation by Liver

Cross-links DNA

Guanine N7 Position

Autoimmune Disorders

Leukemia

Lymphoma

Solid Tumors

Myelosuppression

Hemorrhagic Cystitis

Prevent with Mesna

3 mins

Rituximab

Chronic Lymphocytic Leukemia (CLL)

Non-Hodgkin Lymphoma

Rheumatoid Arthritis

Microscopic Polyangiitis (MPA)

Granulomatosis with Polyangiitis (Formerly Wegener's)

Monoclonal Antibody Against CD20

Found on B Cell Neoplasms

Infusion Reactions

Skin and Mouth Reactions

Reactivation of Hepatitis B Virus (HBV)

Progressive Multifocal Leukoencephalopathy (PML)

3 mins

Silver Sulfadiazine (Silvadene) and Mafenide Acetate (Sulfamylon)

Topical Antimicrobial

Burns

Open Wound Care

Mafenide

Pain

Acidosis

Administer Analgesic Prior to Wound Care

1 min

Azoles (Ketoconazole)

"-azole" suffix

Local and Less Serious Systemic Mycosis

Inhibits Ergosterol Synthesis

Inhibits P450

Liver Dysfunction

Inhibition of Testosterone Synthesis

1 min

Amphotericin B

Systemic Mycosis

Fungal Meningitis

Last Resort for Protozoan infections

Polyene

Binds Ergosterol

Forms Membrane Pores

1 min

Amphotericin B Side Effects & Toxicity

Fever/Chills "Shake and Bake"

Nephrotoxicity

Milder with Liposomes

Hypotension

Anemia

IV Phlebitis

Arrhythmias

1 min

Flucytosine

Cryptococcus

Candida

Used in Combination with Amphotericin B or Azoles

Inhibits DNA and RNA Synthesis

Converted to 5-FU by Cytosine Deaminase

Bone Marrow Suppression

1 min

Griseofulvin

Disrupts Microtubules in Mitosis

Antifungal for Superficial Infections

Tinea and Ringworm

Teratogen

P450 Inducer

Confusion

Headache

2 mins

Terbinafine

Dermatophytosis

Onychomycosis

Inhibits Squalene Epoxidase

Hepatotoxicity

GI Distress

Taste Disturbances

Headache

2 mins

Echinocandins

"-Fungin" Suffix

Invasive Aspergillosis

Candida

Inhibits Cell Wall Synthesis

Inhibits Synthesis of Beta-glucan

GI Distress

Flushing

1 min

Nystatin

Candidiasis

Vaginal

Oral

Cutaneous

Polyene

Binds Ergosterol

Forms Membrane Pores

Topical form of Amphotericin B

Rash

1 min

NSAIDs

Anti-inflammatory

Analgesic

Fever

Closure of Patent Ductus Arteriosus

Reversible Inhibition of COX-1 and COX-2

Block Prostaglandin Synthesis

Interstitial Nephritis

Gastric Ulcer

Renal Ischemia

1 min

Reye's Syndrome

Aspirin (Salicylates) to Treat Viral Illness (In Children)

Cerebral Edema

Lethargy (Decreased LOC)

Vomiting

Liver Failure

Monitor for Increased ICP

Mannitol (Osmitrol)

No Aspirin for Children

2 mins

Ibuprofen (Advil, Motrin)

NSAID

COX Inhibitor

General Pain

Fever

Inflammatory Conditions

GI Ulcers

Nephrotoxicity

Rash

Avoid with Alcohol

Risk of Thrombotic Event

2 mins

Prednisone (Glucocorticoids)

Glucocorticoid

Inflammatory Conditions

Organ Transplant Rejection

Cataracts and Glaucoma

Cushing's Syndrome

Osteoporosis

Immunosuppression

Hyperglycemia

Ulcers

Adrenal Insufficiency

Taper Gradually

2 mins

Acetaminophen

Fever

Pain

Reversibly Inhibits COX

Acts Primarily in CNS

Hepatic Necrosis

N-acetylcysteine Antidote

51 secs

Celecoxib

Rheumatoid Arthritis

Osteoarthritis

Pain

NSAID

Selectively Inhibits COX-2

Sulfa Allergy

Increased Risk of Thrombosis

GI Bleed

Pregnancy > 30 Weeks

1 min

Opioids Overview

Pain

Weaning

Cough

Diarrhea

Agonists at Mu (μ), Kappa (Κ), and Delta (δ) Receptors

Decrease Synaptic Transmission

Respiratory Depression

Addiction

Miosis

Constipation

2 mins

Opioid Use Disorder and Withdrawal Assessment (Formerly Opioid Abuse and Withdrawal Assessment)

Euphoria

Miosis

CNS Depression

Yawning

Gooseflesh

Sweating

Rhinorrhea

Kicking Movements

Naloxone

1 min

Alendronate (Fosamax)

Inhibits Osteoclasts

Osteoporosis

Paget's Disease

Esophageal Ulcers

Musculoskeletal Pain

Vision Changes

Atrial Fibrillation

Osteonecrosis of the Jaw

Take on Empty Stomach

Remain Upright

2 mins

Hydroxychloroquine

Immunosuppressant

Malaria

Rheumatoid Arthritis

Systemic Lupus Erythematosus (SLE)

Porphyria Cutanea Tarda

Cardiotoxicity

Retinopathy

Ophthalmological Exams

3 mins

Raloxifene

Selective Estrogen Receptor Modulator (SERM)

Agonist in Bone

Antagonist in Breast and Uterus

Osteoporosis

Breast Cancer Prophylaxis

Uterine Fibroids

Hot Flashes

Thromboembolism

2 mins

Mannitol (Osmitrol)

Osmotic Diuresis

Reducing Intracranial Pressure

Reducing Intraocular Pressure

Renal Failure Prophylaxis

Edema

Fluid and Electrolyte Imbalance

Avoid Use in Cardiac Patients

IV Administration

2 mins

Loop Diuretics

Thick Ascending Limb of Loop of Henle

Inhibits Na+-K+-2Cl-

Sulfa Drug

Furosemide

Lasix

Ototoxicity from Rapid Injection

Gout

Dehydration

Hypocalcemia

Hypokalemia

Orthostatic Hypotension

2 mins

Loop Diuretic Education

Furosemide (Lasix)

Heart Failure

Pulmonary Edema

Acute Renal Failure (ARF)

Edema

Notify the provider of weakness, dizziness, or muscle cramping

Increase Potassium Intake

Check BP Daily

Daily Weights and Monitor IandOs

1 min

Ethacrynic Acid

Non-sulfa Drug

Phenoxyacetic Acid Derivative

Loop Diuretic

Inhibits Na+-K+-2Cl- Cotransporter

Thick Ascending Loop of Henle

Diuresis

Hypokalemia

Ototoxicity

Gout

2 mins

Hydrochlorothiazide HCTZ

Inhibits Reabsorption NaCl and H₂O

Edema

Mild to Moderate Hypertension

Hypokalemia

Hyponatremia

Dehydration

Hyperglycemia

Gout

Sulfa Allergy

Pregnancy and Breastfeeding

1 min

Spironolactone (Aldactone)

Inhibition of Aldosterone

Potassium Retention

Hypertension

Edema

Heart Failure

Hyperkalemia

Endocrine Effects

Avoid Potassium Supplements

2 mins

Erythropoietin

Stimulates RBC Production

Chronic Renal Failure

Anemia

Increased Risk of Thrombosis

Pelvic and Limb Pain

Hypertension

Do Not Shake

Monitor Hemoglobin (Hgb) Weekly

May Accelerate Tumor Progression

2 mins

Insulin

Rapid Acting

Insulin Lispro (Humalog)

Insulin Aspart (Novolog)

Insulin Glulisine (Apidra)

Short Acting

Regular Insulin (Humulin R)

Intermediate Acting

Isophane NPH (Humulin N)

Long Acting

Detemir (Levemir)

Glargine (Lantus)

2 mins

Metformin (Glucophage)

Decrease Glucose Production

Increase Insulin Sensitivity

Type 2 Diabetes

Polycystic Ovary Syndrome (PCOS)

GI Distress

Decreased Appetite

Lactic Acidosis

IV Contrast

Limit Alcohol Consumption

2 mins

Mixing NPH and Regular Insulin for Injection

Verify Order

Roll NPH Insulin

Alcohol to Multiuse Vials

Inject Air into NPH Insulin (Cloudy)

Inject Air into Regular Insulin (Clear)

Withdraw Regular Insulin Units

Withdraw NPH Units

Verify with 2nd Nurse

Discard if Error

3 mins

Chlorpropamide and Tolbutamide (Orinase) (1st Generation Sulfonylureas)

1st Generation Sulfonylureas

Stimulate Release of Insulin

Type 2 Diabetes

Hypoglycemia

Possible Cardiovascular Toxicity

Weight Gain

Exacerbated Hypoglycemia with Beta-blockers

Avoid During Pregnancy and Breast Feeding

Avoid Alcohol

2 mins

Glyburide and Glipizide (2nd Generation Sulfonylureas)

2nd Generation Sulfonylureas

Blocks Potassium Channels in Beta Cells

Stimulate Release of Insulin

Type 2 Diabetes

Hypoglycemia

More Potent

Beta Blockers Reduce Effects

Avoid Alcohol

Avoid Breastfeeding

2 mins

Pioglitazone (Thiazolidinediones)

-glitazones Suffix

Binds PPAR-Gamma

Decreases Insulin Resistance

Type 2 Diabetes

Weight Gain

Heart Failure

Myalgia

Hypoglycemia

Upper Respiratory Infection

Increased Risk of Bladder Cancer

Increased Fracture Risk in Women

Monitor Liver Enzymes

2 mins

Acarbose (Precose) and Miglitol (Glyset) (Alpha Glucosidase Inhibitors)

Alpha Glucosidase Inhibitors

Delays Absorption of Carbohydrates

Type 2 Diabetes

Flatulence

Diarrhea

Anemia

Cramps

Monitor LFTs

Oral Glucose for Hypoglycemia

2 mins

Repaglinide and Nateglinide (Meglitinides)

Meglitinides

Increased Insulin Release

Type 2 Diabetes

Hypoglycemia

Eat Within 30 Minutes

Gemfibrozil Increases Risk of Hypoglycemia

Short Half-Life

2 mins

Sitagliptin (Januvia) and Saxagliptin (Onglyza) (DPP-4 Inhibitors)

-gliptin Suffix

DPP-4 Inhibitor

Increases Insulin Release

Type 2 Diabetes

Pancreatitis

Upper Respiratory Infection and Inflammation

Stevens-Johnson Syndrome

Used as Add-on Agents

2 mins

Pramlintide (Symlin)

Synthetic Amylin Analog

Diabetes Type 1 and 2

Supplement Mealtime Insulin

Nausea

Skin Reactions at Injection Site

Hypoglycemia When Combined with Insulin

Delayed Absorption of Oral Drugs

2 mins

Exenatide (Byetta)

Incretin Mimetic

GLP-1 Synthetic Analog

Type 2 Diabetes

Hypoglycemia

Nausea and Vomiting

Diarrhea

Thyroid Cancer

Pancreatitis

Renal Failure

(Give Exenatide) One Hour After Other Medications

Adjunct Therapy

3 mins

Glucagon (GlucaGen)

Increases Glucose

Hypoglycemic Emergency

Nausea and Vomiting

Reconstitute Powder

Consume Oral Carbohydrates

50% Dextrose IV (If No Effect)

2 mins

Levothyroxine (Synthroid)

Synthetic T4

Hypothyroidism

Thyrotoxicosis

Tremors

Heat Intolerance

Insomnia

Tachycardia

Do Not Use for Obesity

TSH Monitoring

2 mins

Propylthiouracil (PTU) and Methimazole (MMI)

Hyperthyroidism

Inhibits Thyroid Peroxidase

PTU Blocks Peripheral Conversion of T4 to T3

Agranulocytosis

Skin Rash

Hepatotoxicity (PTU)

Teratogen (MMI)

1 min

Tacrolimus (Prograf) Overview

Immunosuppressant

Inhibits Calcineurin, Decreasing IL-2

Transplant Rejection

Atopic Dermatitis

Increased Lymphoma Risk

Avoid Grapefruit Juice

1 min

Tacrolimus (Prograf) Side Effects

Nephrotoxicity

Neurotoxicity

GI Distress

Infection

Hypertension

Hyperkalemia

Hyperglycemia

1 min

Cyclosporine (Sandimmune) Overview

Immunosuppressant

Inhibits Calcineurin, Decreasing IL-2

Prevent Transplant Rejection

Psoriasis

Rheumatoid Arthritis

Monitor Plasma Levels

Avoid Grapefruit Juice

Increased Risk of Lymphoma

2 mins

Cyclosporine (Sandimmune) Side Effects

Nephrotoxicity

Hepatotoxicity

Infection

Hypertension

Hirsutism

Tremor

Hyperkalemia

Hypomagnesemia

Gingival Hyperplasia

1 min

Methotrexate

Rheumatoid Arthritis

Cancer

Medical Abortion

Folic Acid Analog

Inhibits Dihydrofolate Reductase

Pulmonary Fibrosis

Myelosuppression is Treated with Leucovorin Rescue (Folinic Acid)

Macrocytic Anemia

Hepatitis

Teratogenic

Mucositis

2 mins

Omeprazole (Prilosec)

"-prazole" Suffix

Zollinger-Ellison Syndrome

Gastritis

Peptic Ulcer

Gastroesophageal Reflux Disease (GERD)

Proton Pump Inhibitor (PPI)

Inhibit H+/K+/ATPase

Hip Fracture

Pneumonia

2 mins

Cimetidine and Famotidine (H2 Receptor Blockers)

-tidine Suffix

H2 Receptor Blocker

Suppress Gastric Acid Secretion

Pneumonia

Anti-androgen Effects

CNS Changes

2 mins

Pancreatin, Pancrelipase (Pancreatic Enzymes)

Pancreatic Enzymes

Cystic Fibrosis

Pancreatic Insufficiency

GI Distress

Inactivated by Gastric Acid

24 Hour Fat Excretion

Take with Every Meal and Snack

2 mins

Sucralfate (Carafate)

Creates Protective Barrier

GI Ulcers

Constipation

Require Acidic Environment

Give on Empty Stomach

Oral Suspension Available

May Decrease Absorption of Other Meds

2 mins

Activated Charcoal (Actidose)

Binds to Toxins

Ingested Poison

Black Stool

GI Distress

Give As Soon As Possible

Via Mouth or NG Tube

Gastric Lavage

Do Not Administer with Antidotes

2 mins

Promethazine (Phenergan)

Histamine H1 Receptor Antagonist

Weak Dopamine Antagonist

Nausea and Vomiting

Motion Sickness

Respiratory Depression

Sedation

Anticholinergic Effects

Extrapyramidal Symptoms

Use Large Bore IV

Monitor for Tissue Necrosis

2 mins

Ondansetron

Postoperative Vomiting

Chemotherapy-induced Nausea and Vomiting

5-HT3 Serotonergic Antagonist

Centrally-acting Antiemetic

Headache

Constipation

QT Prolongation

1 min

Osmotic Laxatives

Increases Osmotic Load

Hepatic Encephalopathy

Constipation

Magnesium Hydroxide

Magnesium Citrate

Polyethylene Glycol

Sorbitol

Lactulose

Diarrhea

Dehydration

Misused in Bulimia Nervosa

2 mins

Metoclopramide

Antiemetic

Promotility Agent

Increased Resting Tone

Antagonist at D₂Receptor

Parkinsonian Symptoms

Galactorrhea

Small Bowel Obstruction

Parkinson's Disease

2 mins

Proton Pump Inhibitors (PPIs)

"-prazole" Suffix

Zollinger-Ellison Syndrome

Gastritis

Peptic Ulcer

Gastroesophageal Reflux Disease (GERD)

Inhibit H+/K+/ATPase

Hip fracture

Pneumonia

2 mins

Orlistat

Inhibits Gastric and Pancreatic Lipase

Decrease Absorption of Fat

Weight Loss

Increased Bowel Movements

Steatorrhea

Abdominal Pain

Flatulence

Calcium Oxalate Kidney Stones

Decreased Absorption of Fat-Soluble Vitamins

2 mins

Hepatitis C Pharmacotherapy

Glecaprevir

Grazoprevir

Simeprevir

Ledipasvir

Elbasvir

Velpatasvir

Sofosbuvir

Ribavirin

2 mins

Vitamin A (Retinol)

Maintains Mucous Membranes

Eyes and Skin

Dietary Deficiency

Skin Disorders

Hepatosplenomegaly

Jaundice

Increased ICP

Vomiting

Teratogen

Animal Food Products

Dark Green and Orange Fruits/Vegetables

2 mins

Vitamin B1 (Thiamine)

Carbohydrate Metabolism

Dietary Deficiency

Beriberi

Wernicke-Korsakoff

Alcoholics Highest Risk

Give Before Glucose

Give IM or IV

Enriched Whole Grains

Pork

2 mins

Beriberi (Thiamine Deficiency)

Thiamine Deficiency

Dry Beriberi

Polyneuritis

Muscle Wasting

Wet Beriberi

Dilated Cardiomyopathy

Edema

2 mins

Vitamin B6 (Pyridoxine)

Amino Acid and Protein Metabolism

Heme Synthesis

Neurotransmitters

Adjunct to Isoniazid

Dietary Deficiency

Premenstrual Syndrome (PMS)

Ataxia

Peripheral Neuropathy

Levodopa

Cereals and Meats

3 mins

Cobalamin (Vitamin B12)

Vitamin B12

Vitamin Deficiency

Pernicious Anemia

Hypokalemia

Arthralgia

Dizziness

IM Injection for Pernicious Anemia

Never Give IV

2 mins

Vitamin C (Ascorbic Acid)

Antioxidant

Collagen Formation

Steroid Synthesis

Dietary Deficiency

Scurvy

GI Distress

Citrus Fruits

May Improve Healing

2 mins

Ergocalciferol (Vitamin D2)

Vitamin D2

Hypoparathyroidism

Rickets

Hypophosphatemia

Fatigue

Constipation

Hypercalcemia

Kidney Stones

2 mins

Vitamin E (Alpha-tocopherol)

Antioxidant

Fat Malabsorption Syndrome

Alpha-TTP Deficiency

Bleeding

Increased Risk Hemorrhagic Stroke

Limit Doses < 200 IU per Day

Nuts and Whole Grains

Vegetable Oils

2 mins

Vitamin K1 (Phytonadione)

Synthesizes Clotting Factors II, VII, IX, X

Hypoprothrombinemia

Newborn Prophylaxis

Bleeding from Warfarin Overdose

Shock

Kernicterus

Cardiac Arrest

Bile Salts required for Intestinal Absorption

Increased Risks with IV Administration

2 mins

Iron (Ferrous Sulfate)

Ferrous Salts

Anemia

GI Distress

Nausea and Vomiting

Dark Stools

Take Between Meals

Liquid can Stain Teeth

Keep out of Reach from Children

Caution with GI Disorders

Avoid Antacids

3 mins

Total Parenteral Nutrition (TPN)

Nutrition Given Outside GI

Hyperglycemia

Hyperlipidemia

Refeeding Syndrome

Nausea and Vomiting

Slow IV Infusion

Use Large Central Vein

No Added Meds to TPN Line

2 mins

Cholecalciferol (Vitamin D3)

Vitamin D3

Dietary Supplement

Vitamin D Deficiency

Fatigue

Constipation

Hypercalcemia

Kidney Stones

More Effective Than Ergocalciferol

Hypervitaminosis D

2 mins

Vitamin D Deficiency

Rickets in children

Bending bones

Rachitic rosary

Breast milk has decreased vitamin D

Osteomalacia in adults

Tetany from Hypocalcemia

2 mins

RhoGam [Rho(D) Immune Globulin]

Antepartum Prevention at 28 weeks

Suppress Antibody Production

Lysis of Fetal RBC in Maternal Bloodstream

Myalgia and Lethargy

Negative Coombs Test

Standard Dose 300 mcg

Microdose 50 mcg

Blood Product

2 mins

Isoniazid

Tuberculosis (TB)

Requires Catalase Peroxidase

Decreases Mycolic Acid Synthesis

Fast vs Slow Acetylators

B6 Deficiency

Neurotoxicity

Hepatotoxicity

Drug-induced Lupus

1 min

Leuprolide

GnRH Agonist (Pulsatile Use)

GnRH Antagonist (Continuous Use)

Upregulates FSH And LH

Downregulates FSH And LH

Infertility

Prostate Cancer

Precocious Puberty

Uterine Fibroids

Endometriosis

Anti-androgenic Effects

2 mins

Macrolides

Bacteriostatic

Bind to 23S rRNA of 50S Subunit

Inhibit Protein Synthesis by Blocking Translocation

Erythromycin

Azithromycin

Clarithromycin

Gram-Positive Cocci

Atypical Pneumonia

Chlamydia

Resistance by Methylation of 23S rRNA Binding

2 mins

Methylergonovine (Methergine) and Ergotamine (Ergot Alkaloids)

Smooth Muscle Contraction

Vasoconstriction

Migraine

Postpartum Hemorrhage

Nausea and Vomiting

Severe Hypertension

Tachycardia

2nd Line Agent

2 mins

Ethambutol

Bacteriostatic

Blocks Arabinosyltransferase

Arabinosyltransferase Polymerizes Carbohydrates

Carbohydrate Polymers Make Mycobacterium TB Cell Wall

Red/Green Color Blindness

Reversible with Drug Discontinuation

40 secs

Oxytocin (Pitocin)

Increase Uterine Contractions

Labor Induction

Control Postpartum Hemorrhage

Uterine Rupture

Water Intoxication

Fetal Lung Immaturity

Cervix Not Ripened

Active Genital Herpes Infection

Use Lowest Dose

IV Pump

3 mins

Rifampin

Tuberculosis (TB)

Blocks RNA Polymerization

Haemophilus influenzae Type B

Leprosy

Meningitis

P450 inducer

Red-orange urine

55 secs

Carboprost (Hemabate)

Prostaglandin F2-alpha Analog

Smooth Muscle Contraction

Postpartum Hemorrhage

Abortion

GI Distress

Hypertension

Fever

Bronchoconstriction

Identify Cause of Fever

2 mins

Foscarnet

CMV Retinitis

Acyclovir-resistant HSV

Does Not Require Activation (by Viral Kinase)

Inhibits Viral DNA Polymerase

Pyrophosphate Analog

Resistance through Mutated DNA Polymerase

Nephrotoxicity

Electrolyte Abnormalities

Hypokalemia

Hypocalcemia

Hypomagnesemia

2 mins

Dinoprostone and Misoprostol

Prostaglandins

Promote Cervical Ripening

Prevent GI Ulcers

Medical Abortion

Fetal Distress

Hyperstimulation of Uterus

Vaginal Insertion

Give Before Induction of Labor

2 mins

Ganciclovir

Cytomegalovirus (CMV)

Immunocompromised

Guanosine Analog

Disrupts DNA Synthesis

Inhibits Viral DNA Polymerase

Hematologic Effects

Nephrotoxicity

1 min

Terbutaline (Brethine)

Beta-2 Agonists

Asthma

Tocolytic

Hypotension

Tremor

Tachycardia

Pulmonary Edema

Hyperglycemia

2 mins

Mifepristone, Ulipristal (Antiprogestins)

Progesterone Receptor Antagonist

Mifepristone

Pregnancy Termination With Misoprostol

Ulipristal

Emergency Contraception

Abdominal Pain

Vomiting

Diarrhea

At High Doses: Cortisol Antagonist

2 mins

Clomiphene

Infertility

Polycystic Ovarian Syndrome (PCOS)

Selective Estrogen Receptor Modulator (SERM)

Hypothalamus

Estrogen Antagonist

Increased GnRH, LH and FSH Secretion

Induction of Ovulation

Multiple Gestations

Visual Disturbances

Hot Flashes

2 mins

Posterior Column (Dorsal Column)

Ascending Pathway (Sensory)

Proprioception

Fine Touch

Pressure

Vibration Sensation

Dorsal Root

Fasciculus Cuneatus

Arms

Fasciculus Gracilis

Lower Limbs

Vitamin B12 Deficiency

Tabes Dorsalis

2 mins

Beta-2 Agonists

Short-term Treatment

Terbutaline

Asthma

Tocolysis

Albuterol

Asthma

Long-term Treatment

Salmeterol

Asthma

Chronic Obstructive Pulmonary Disease (COPD)

3 mins

NRTIs (Nucleoside Reverse Transcriptase Inhibitors)

HIV

Pregnancy and Prophylaxis given ZDV

Inhibit Nucleotide Binding to Reverse Transcriptase

Chain Termination

Require Phosphorylation

1 min

Albuterol (Proventil)

Short-Acting Beta-2 Agonist

Bronchospasm

Asthma

Angina

Tachycardia

Tremor

1 min

Cromolyn (Mast Cell Stabilizers)

Mast Cell Stabilizer

Asthma Prophylaxis

Bronchial Inflammation

Allergic Rhinitis

Cough

Bronchospasm

Fixed Schedule Administration

2 mins

Theophylline (Theo-24)

Bronchial Smooth Muscle Relaxation

Asthma

Insomnia

Restlessness

Arrhythmias

Seizures

Narrow Therapeutic Range

Monitor Plasma Levels

1 min

Cidofovir

CMV Retinitis

Acyclovir-Resistant HSV

Inhibits Viral DNA Polymerase

Nephrotoxicity

Administer with Probenecid and IV Saline

1 min

Montelukast (Singulair)

Leukotriene Receptor Blocker

Allergic Rhinitis

Asthma Prophylaxis

Exercise Induced Bronchospasm

Fatigue

Headache

Mood Changes

Suicidal Thoughts

Increased Risk of Churg Strauss

2 mins

Zanamivir (Relenza) and Oseltamivir (Tamiflu)

Influenza A and B

Treatment and Prophylaxis

Inhibits Release of New Virus

Inhibits Influenza Neuraminidase

1 min

NRTI Toxicity

Bone Marrow Suppression

Reverse with G-CSF and Erythropoietin

Rash

Neuropathy

Anemia

Pancreatitis

Lactic Acidosis

1 min

Second Generation Antihistamines

Allergies

Lipophobic

Histamine H1 Receptor Antagonist

Azelastine + Fluticasone (Dymista)

Intranasal Spray

Cetirizine (Zyrtec)

Loratadine (Claritin)

Fexofenadine (Allegra)

Fewer Anticholinergic Effects

Fewer CNS Effects

2 mins

NNRTIs (Non-nucleoside Reverse Transcriptase Inhibitors)

HIV

Do Not Require Intracellular Metabolism

Inhibits Reverse Transcriptase

Rash

Hepatotoxicity

Vivid Dreams and CNS Symptoms

Pregnancy

2 mins

First Generation Antihistamines

Histamine H1 Receptor Antagonist

Allergies

Nausea and Vomiting

Motion Sickness

Anaphylaxis

Diphenhydramine (Benadryl)

Promethazine (Phenergan)

Chlorpheniramine

Sedation

Anticholinergic Effects

2 mins

Stages of Asthma Treatments

Short-acting Inhaled Beta-Agonist

Low-Dose Inhaled Corticosteroid

Montelukast (Leukotriene Receptor Antagonist)

Low to Medium-dose Inhaled Corticosteroid

Zileuton

High-Dose Inhaled Corticosteroid

Systemic Corticosteroids

Omalizumab (Allergies)

2 mins

Isoniazid (INH)

Interferes with DNA Metabolism

Tuberculosis (TB)

Optic Neuritis

Nausea and Vomiting

Hepatotoxicity

Peripheral Neuropathy

Vitamin B6 Prophylaxis

Monitor AST/ALT

2 mins

Ethambutol (Myambutol)

Inhibits RNA Synthesis

Bacteriostatic

Tuberculosis (TB)

Optic Neuritis

Red/Green Color Blindness

Gouty Arthritis

Monitor Vision Acuity

2 mins

Antibiotics Overview

Cell Wall Inhibitors

Penicillins

Cephalosporins

Monobactams

Carbapenems (Imipenem & Meropenem)

Beta-Lactamase Inhibitors

Protein Synthesis Inhibitors

Aminoglycosides

Macrolides

Clindamycin

Tetracyclines

Linezolid

Chloramphenicol

Fluoroquinolones

Sulfonamides

4 mins

Penicillin

Weakens Cell Wall

Gram-Positive Infections

Prophylaxis

Pain at IM Injection Site

Allergic Reaction

Skin Tests

Allergy ID

Medication Education

2 mins

Alpha 1 Receptor

Gq Subunit

Increase Vascular Smooth Muscle Contraction

Increase Pupillary Dilator Muscle Contraction

Increase Intestinal and Bladder Sphincter Muscle Contraction

1 min

Alpha 2 Receptor

Gi Subunit

Decrease Sympathetic Outflow

Decrease Insulin Release

Decrease Lipolysis

Increase Platelet Aggregation

Decrease Aqueous Humor Production

2 mins

Beta-1 Receptor

Gs Protein Class

Increased Heart Rate

Increased Contractility

Increase Renin Release

Increased Lipolysis

44 secs

Beta-2 Receptor

Gs protein class

Increased Heart Rate

Increased Contractility

Increased Lipolysis

Increased Insulin

Increased Aqueous Humor Production

Ciliary Muscle Relaxation

Vasodilation

Bronchodilation

Decrease Uterine Tone

2 mins

P450 Inhibitors

Quinidine

Ciprofloxacin

Isoniazid

Grapefruit Juice

Acute Alcohol Use

Erythromycin (Macrolide)

Indinavir

Cimetidine

Sulfonamides

Ketoconazole

Amiodarone

2 mins

P450 Inducer

Griseofulvin

Phenytoin

Carbamazepine

Rifampin

Barbiturates

Chronic Alcohol Use

St. John's Wort

51 secs

Ampicillin and Amoxicillin

Aminopenicillin

Broad Spectrum Penicillin

Gram-Positive and Some Gram-Negative Infections

Rash

Diarrhea

No Effect Against Staph Aureus

Often combined with Beta Lactamase Inhibitor

Allergic Reaction

2 mins

Pediatric Vaccinations - Age 2 Months

Hepatitis B

DTaP - Diphtheria Tetanus acellular Pertussis

RV - Rotavirus

HiB - Haemophilus Influenzae Type B

IPV - Inactivated Polio Vaccine

PCV - Pneumococcal

1 min

Aztreonam (Azactam)

Monobactam Antibiotic

Bactericidal

Gram-Negative Infections

No Activity on Gram-Positives or Anaerobes

Blood Dyscrasias

Pain at Injection Site

Safe for Penicillin Allergy

Synergistic with Aminoglycosides

Nebulizer Form Available

2 mins

Pediatric Vaccinations - Age 4 Months

DTaP - Diphtheria Tetanus acellular pertussis

RV - Rotavirus

HiB - Haemophilus Influenzae Type B

IPV - Inactivated Polio Vaccine

PCV - Pneumococcal

1 min

Cephalosporins

Starts with "Cef-"

Bactericidal

Gram-Positive and Gram-Negative Infections

Allergic Reactions

Thrombophlebitis

Bleeding

Renal Impairment

Avoid IV Calcium with Ceftriaxone

No Alcohol

2 mins

Pediatric Vaccinations - Age 6 Months

Hepatitis B

DTaP - Diphtheria Tetanus acellular pertussis

RV - Rotavirus

HiB - Haemophilus Influenzae Type B

IPV - Inactivated Polio Vaccine

PCV - Pneumococcal

Influenza

2 mins

Imipenem and Meropenem (Carbapenems)

Carbapenems

Broad-spectrum Antibiotic

Bactericidal

Gram Positive and Gram Negative Infections

GI Distress

Suprainfections

Seizures

Penicillin Allergy

IV or IM Route

Imipenem Combined with Cilastatin

3 mins

Pediatric Vaccinations - Age 12 to 15 Months

Varicella Zoster

MMR

Hepatitis A

DTaP - Diphtheria Tetanus acellular pertussis

HiB - Haemophilus Influenzae Type B

IPV - Inactivated Polio Vaccine

PCV - Pneumococcal

2 mins

Macrolides

End in "-thromycin"

Bacteriostatic

Alternative for Penicillin Allergy

Respiratory Infections

Pneumonia

QT Prolongation and Sudden Death

C.Diff Overgrowth

GI Distress

Slow IV Infusion

2 mins

Pediatric Vaccinations Age 4-6 Years

Varicella Zoster

DTaP - Diphtheria Tetanus acellular pertussis

IPV - Inactivated Polio Vaccine

MMR

1 min

Macrolides Side Effects

Diarrhea

Prolonged QT Interval

P450 Inhibitor

Cholestatic Hepatitis

Skin Rash

Eosinophilia

3 mins

Nocardia

Aerobic

Gram-Positive

Catalase-Positive

Urease-Positive

Acid Fast

Branching

Beaded Filament

AIDS/Immunocompromised

Soil

Lung Cavitation

Brain Abscess

Kidney Abscess

TMP-SMX

2 mins

Aminoglycoside Overview

End in "-mycin"

Gentamicin

Neomycin

Amikacin

Tobramycin

Streptomycin

Bactericidal

Severe Gram Negative Infections

Bowel Surgery Prep

1 min

Aminoglycoside Side Effects

Ototoxicity

Nephrotoxicity

Respiratory Paralysis

Pregnancy

Peak and Trough

Never Mix with Penicillin in Same IV

2 mins

Neomycin Sulfate

Aminoglycoside Antibiotic

Topical Infection

Intestinal Surgery Prophylaxis

Ototoxicity

Nephrotoxicity

Rash

Blood Dyscrasias

GI Superinfection

2 mins

Killed (Inactivated) Whole Vaccines

Require Booster Shots

Mostly Humoral Immune Response

Polio (Salk)

Rabies

Cholera

Hepatitis A

54 secs

Chloramphenicol (Chloromycetin)

Bacteriostatic

Gram Positive or Gram Negative Infections

Bone Marrow Suppression

Aplastic Crisis

Gray Syndrome

Toxicity Limits Use

Monitor Blood Counts

2 mins

Live Attenuated Vaccines

Humoral and Cellular Immune Response

May Revert to Virulent Form

Do Not Require Boosters

Varicella (Chickenpox)

Zoster (Shingles)

Polio (Sabin)

Smallpox

Yellow Fever

Influenza (Intranasal)

MMR

Rotavirus

Typhoid Fever (Oral)

BCG (Bacillus Calmette-Guérin)

4 mins

Tetracyclines Overview

End in "-cycline"

Bacteriostatic

Infectious Diseases

Acne

Periodontal Disease

Avoid Milk, Antacids, Iron

Sunlight Protection

1 min

Killed (Inactivated) Fractional Protein Vaccines

Subunit

Influenza (Intramuscular)

Bordetella Pertussis

Hepatitis B

Human Papillomavirus (HPV)

Bacillus anthracis (Anthrax)

Toxoid

Corynebacterium diphtheriae (Diphtheria)

Clostridium tetani (Tetanus)

DTaP and Tdap

3 mins

Tetracyclines Side Effects

Superinfection

Clostridioides difficile

Discoloration of Teeth

Bone Deformities

Photosensitivity

Children Under 8

Pregnancy

1 min

Toxoid Vaccines

Consist of Toxins Released From a Pathogen

May Require Boosters

Safe In Immunocompromised Patients

Corynebacterium Diphtheriae Vaccine

Tetanus Vaccine

Bordetella Pertussis Vaccine

2 mins

Tetracycline Toxicities

Inhibition of Bone Growth in Children

Teratogen

Discoloration of Teeth

Photosensitivity

GI Distress

2 mins

Somatostatin

Secreted by D Cells

Pancreas

GI Tract

Decrease Secretion of Gastric Acid and Pepsinogen

Decrease Pancreatic and Small Intestine Fluid Secretion

Decrease Gallbladder Contraction

Decrease Glucagon and Insulin Secretion

Secretion is Increased by Acid

Secretion is Decreased by Vagal Stimulation

Octreotide

Carcinoid Syndrome

Variceal Bleeds

2 mins

Tigecycline (Tygacil)

Glycylcycline Antibiotic

Binds 30S Subunit

Inhibits Protein Synthesis

Severe Infections

Broad Spectrum Coverage

Anaerobic & Multidrug-Resistant Organisms

Deep Tissue Penetration

GI Distress

Severe Nausea and Vomiting

2nd Line Agent

3 mins

Fluoroquinolones

End in "-floxacin"

Bactericidal

Variety of Infections

GI Distress

Photosensitivity

Achilles Tendon Rupture

Pregnancy

Children

Myasthenia Gravis

Avoid Milk Products or Antacids

Slow IV Infusion

2 mins

Fluoroquinolones Toxicities

Diarrhea

Skin Rash

Headache

Tendon Rupture in Adults

Myalgias in Kids

Damage to Cartilage

Teratogen

QT Prolongation

1 min

Vancomycin Side Effects & Toxicity

Thrombophlebitis

Nephrotoxicity

Ototoxicity

Diffuse Flushing Called Red Man Syndrome

Prevent with Antihistamine

Prevent with Slow Infusion

2 mins

Vancomycin

Inhibits Bacterial Cell Wall Synthesis

Serious Gram-Positive Infections

Nephrotoxicity

Ototoxicity

Red Man Syndrome

Thrombophlebitis

Culture Samples First

Infuse IV Over 60 Minutes

Take Around the Clock

2 mins

Linezolid (Zyvox)

Oxazolidinone Antibiotic

Binds 23S rRNA of 50S Subunit

Inhibits Protein Synthesis

Gram-Positive Organisms

MRSA

VRE (Vancomycin Resistant Enterococci)

Bone Marrow Suppression

Decreased Platelet Count

Peripheral Neuropathy

Lactic Acidosis

Serotonin Syndrome

Avoid Tyramine Containing Foods

4 mins

Clindamycin

Bacteriostatic

Binds 50S Ribosomal Subunit

Gram-Positive Infections

Anaerobic Infections

Rash

Pseudomembranous Colitis

C. Difficile (Associated Diarrhea)

Arrhythmias

Blood Dyscrasias

Monitor for Diarrhea

3 mins

Sulfonamides

Bacteriostatic

Urinary Tract Infection

Crystalluria

Photosensitivity

Hemolytic Anemia

Kernicterus

Rash

Sulfa Allergy

Encourage Fluids

2 mins

Sulfonamides Side Effects

Hypersensitivity

Nephrotoxicity

Photosensitivity

Kernicterus in Infants

Displaces Warfarin from Albumin

Hemolysis with G6PD Deficiency

3 mins

Sulfa Drug Allergies

Sulfasalazine

Sulfonylureas

Thiazide Diuretics

Acetazolamide

Furosemide Diuretic

Celecoxib

Probenecid

49 secs

Daptomycin (Cubicin)

Lipopeptide Antibiotic

Disrupts Cell Membrane

Causes Rapid Depolarization

Gram-Positive Cocci

MRSA

Myopathy

Rhabdomyolysis

Peripheral Neuropathy

Inactivated by Surfactant

Not Used (Avoid) for Pneumonia

3 mins

Trimethoprim

Bacteriostatic

Inhibits Bacterial Dihydrofolate Reductase

Causes Sequential Block of Folate Synthesis

Used in Combination with Sulfamethoxazole

Combination Used For Recurrent Urinary Tract Infections

Shigella

Salmonella

Pneumocystis Jiroveci Pneumonia

Decrease in Red and White Blood Cells

Alleviated with Leucovorin Rescue

2 mins

Acyclovir (Zovirax)

Guanosine Analog

Inhibits Viral Replication

Thymidine Kinase Activation

Herpes Simplex Virus (HSV)

Varicella Zoster Virus (VZV)

Headache

GI Distress

CNS Toxicity

Nephrotoxicity (Crystalline Nephropathy)

Prevents Recurrent Episodes

Slow IV Infusion

2 mins

HAART

HIV

Begin at Diagnosis

3 Drugs

2 NRTIs (Nucleoside Reverse Transcriptase Inhibitors)

NNRTI (Non-Nucleoside Reverse Transcriptase Inhibitor)

or Protease Inhibitor

or Integrase Inhibitor

1 min

NNRTI Drug Names

Nevirapine (Viramune)

Rilpivirine (Edurant)

Delavirdine (DLV, Rescriptor)

Efavirenz (EFV, Sustiva)

Etravirine (ETR, Intelence)

54 secs

NRTIs for HIV (Drug Names)

DEALSZ

Didanosine (DDI)

Emtricitabine (FTC)

Abacavir (ABC)

Lamivudine (3TC)

Stavudine (d4T)

Zidovudine (ZDV)

Tenofovir (TDF)

2 mins

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