Elsevier Inc. items and derived items © 2010 by Saunders, an imprint of Elsevier Inc. Chapter 106 Miscellaneous Noteworthy Drugs

Elsevier Inc. items and derived items © 2010 by Saunders, an imprint of Elsevier Inc.2 Drugs for Pulmonary Arterial Hypertension  Prostacyclin analogs  Epoprostenol (Flolan)  Treprostinil (Remodulin)  Iloprost (Ventavis)  Endothelin-1 receptor antagonists  Bosentan (Tracleer)  Ambrisentan (Letairis)  Sitaxsentan (Thelin) – available in Canada  Sildenafil (Revatio)

Elsevier Inc. items and derived items © 2010 by Saunders, an imprint of Elsevier Inc.3 Sepsis and Treatment  Sepsis  Life-threatening condition triggered by systemic microbial infection  End result – diffuse endovascular injury, MODS, and often death  Drotrecogin alfa (activated) (Xigris)  Adverse effects  Bleeding  Use with caution for patients at risk for bleeding

Elsevier Inc. items and derived items © 2010 by Saunders, an imprint of Elsevier Inc.4 Drugs for Neonatal Respiratory Distress Syndrome  Prenatal and postnatal glucocorticoids  Accelerate fetal lung maturation  Dexamethasone  Betamethasone  Lung surfactant  Direct intratracheal instillation  Poractant alfa (Curosurf), calfactant (Infasurf), and beractant (Survanta)

Elsevier Inc. items and derived items © 2010 by Saunders, an imprint of Elsevier Inc.5 Drugs for Cystic Fibrosis  Inherited disorder resulting in damage to lungs, pancreas, and other organs  Drugs used to alleviate symptoms  Pancreatic enzymes  Fat-soluble vitamins  Antibiotics  Inhaled dornase alfa (Pulmozyme)  Oral ibuprofen  Inhaled beta 2 -adrenergic agonists Salmeterol (Serevent diskus) Salmeterol (Serevent diskus)

Elsevier Inc. items and derived items © 2010 by Saunders, an imprint of Elsevier Inc.6 Drugs for Sickle Cell Anemia  Inherited blood disorder characterized by abnormal hemoglobin, chronic anemia, painful episodes  Analgesics and glucocorticoids  Hydroxyurea  Adverse effects  Myelosuppression  Monitor hematologic state every 2 weeks

Elsevier Inc. items and derived items © 2010 by Saunders, an imprint of Elsevier Inc.7 Drugs for Hyperuricemia Caused by Cancer Chemotherapy  Rasburicase (Elitek)  Adverse effects  Fever  GI effects

Elsevier Inc. items and derived items © 2010 by Saunders, an imprint of Elsevier Inc.8 Gamma-Hydroxybutyrate (Xyrem)  GHB – used for cataplexy in patients with narcolepsy  Adverse effects  Confusion  Depression  Headache  Dizziness  Sleepwalking

Elsevier Inc. items and derived items © 2010 by Saunders, an imprint of Elsevier Inc.9 Riluzole (Rilutek)  Used to treat amyotrophic lateral sclerosis (ALS), also known as Lou Gehrig’s disease  Adverse effects  Asthenia  GI effects  CNS effects  Decreased lung function

Elsevier Inc. items and derived items © 2010 by Saunders, an imprint of Elsevier Inc.10 Phosphate Binders for Patients on Dialysis  Used to treat hyperphosphatemia  Calcium-based phosphate binders  Calcium carbonate  Increase risk of hypercalcemia  Calcium-free phosphate binders  Sevelamer carbonate  Do not increase risk of hypercalcemia but are more costly

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