MOA: inhibit the synthesis of prostaglandins in the central nervous system and work peripherally to block pain impulse generation; produces antipyresis from inhibition of hypothalamic heat-regulating center. COX2 inhibitor

SE: nausea, rash, H/A

Use: treatment of mild to moderate pain and fever

MOA: COX1 and COX2 inhibitors; inhibits prostaglandin synthesis.

SE: Gastric issues: decreased acid secretion, decreased HCO3 production and decreased mucus production.

Prolonged bleeding d/t anti-platelet aggregation

Use: mild to moderate pain, fever, anti-inflammatory

MORPHINE

MOA: Binds to opioid receptors in the CNS, causing inhibition of ascending pain pathways, altering the perception of and response to pain; produces generalized CNS depression

SE: Constipation, itching, sedation, N/V, Respiratory depression, Myoclonic jerking, delerium.

Use: moderate to severe pain

CODEINE

MOA: Binds to opioid receptors in the CNS, causing inhibition of ascending pain pathways, altering the perception of and response to pain; causes cough suppression by direct central action in the medulla; produces generalized CNS depression

SE: dizziness, sedation, N/V, sweating, constipation

Use: mild to moderately severe pain

MEPERIDINE

MOA: Binds to opioid receptors in the CNS, causing inhibition of ascending pain pathways, altering the perception of and response to pain; produces generalized CNS depression

SE: dizziness, sedation, light head, N/V, constipation, bradycardia, diaphoresis, resp depression

Use: Management of moderate to severe pain; preoperative sedation

MOA:Binds to opiate receptors in the CNS, causing inhibition of ascending pain pathways, altering the perception of and response to pain; produces generalized CNS depression. 

SE: light head, dizzy, sedation, N/V, Abdominal pain, constipation, decreased appetite, sweating

Use: Management of moderate to severe pain unresponsive to nonopioids; opiod dependence. 

MOA:antineoplastic drug that forms reactive intermediates on DNA bases that leads to cross linking of bases, abnormal base pairing, and DNA strand breakage. 

SE: Alopecia, Myelosuppression, Mucocitis, N/V, Male sterility, Nephrotoxicity (pretreatment hydration recommended), ototoxicity

Use: osteosarcoma, breast, ovary, lung, testis.

MOA: Methotrexate is a folate antimetabolite that inhibits DNA synthesis, repair, and cellular replication.

SE: myelosuppression, mucositis, alopecia, rash, N/V, diarrhea, hepatotoxicity.

Use: Osteosarcoma, ALL, Burkitts lymphoma, carcinoma of the breast, head, neck, ovary and bladder

MOA:Binds to tubulin and prevents polymerization of microtubules; arrests cell at metaphase blocking mitosis. Chromosomes either disperse or clump, leads to cell death. 

SE: constipation, peripheral neuropathy, alopecia, phlebitis, N/V, diarrhea.

Use: ALL, Wilm's tumor, Ewings sarcoma, Hodgkin's Lymphoma, non-Hodgkins, Neuroblastoma, Rhabdomyosarcoma

MOA: Hydolyzes blood asparagine and depriving tumor cells of the nutrient needed for protein synthesis.

SE: Hypersensitivity, Pancreatitis, decreased clotting, liver abnormalities, seizures.

Use: ALL/AML

CYCLOPHOSPHAMIDE

(CYTOXAN)

MOA: Alkylating agent prevents cell division by cross-linking DNA strands, decreasing DNA synthesis. Liver must activate metabolites.

SE: Alopecia, hemorrhagic cystitis, N/V, amenorrhea, male sterility.

Use: ALL, breast, ovary, lung, testis, CLL, CML, Hodgkins lymphoma, myeloma, nom-Hodgkins, burkitts, retinoblastoma

ANTHRACYCLINES

(DOXORUBICIN)

MOA: Interferes with DNA replication and transcription. Inhibits DNA/RNA synthesis. Iron chelator. Uncoils double helix; triggers DNA cleavage.

SE: Cardiomyopathy, myelosuppression, mucositis, Alopecia, N/V.

Use: solid tumors, leukemias, lymphomas, ALL, AML

MOA: Purine antagonist that inhibits DNA & RNA synthesis. Acts as a false metabolite.

SE: malaise, rash, anorexia, diarrhea, N/V, infertility, myelosuppression. pancytopenia, jaundice.

Use: ALL

MOA: microtubule inhibitor that arrests mitosis in metaphase.

SE:HTN, malaise, alopecia, pain, constipation, myelosuppression.

Use: Hodgkin's lymphoma, testicular cancer.

MOA: decreases inflammation by reversing capillary permeability. immunosupresses by decreasing lymphatic activity & volume. 

SE: adrenal suppression, growth inhibition, F/E imbalances, hyperglycemia.

Use: ALL, Hodgkins, ITP, hemangiomas

DIGOXIN

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