NCTI- Pharmacology- Drug List A

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18397
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NCTI- Pharmacology- Drug List A
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2010-05-08 22:52:50
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NCTI Pharmacology Drug List
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NCTI- Pharmacology- Drug List A
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  1. Acetylsalicylic Acid
    trade name
    • ASA
    • Aspirin
  2. Acetylsalicylic Acid
    class
    • Analgesic
    • Antipyretic
    • Platelet Aggregate Inhibitor
    • NSAID
  3. Acetylsalicylic Acid
    mechanism of action
    • 1. Inhibits aggregation (clumping) of platelets by blocking the formation of the substance thromboxane (A2) ; prolonging bleeding time
    • 2. Provides analgesia by inhibiting prostaglandins and other substances that sensitize pain receptors (blocking of prostaglandins also accounts for the drug’s anti-inflammatory effects).
    • 3. Relieves fever by acting upon the hypothalamic heat regulating center
  4. Acetylsalicylic Acid
    indications
    • 1. Acute myocardial infarction
    • 2. Thrombotic stroke
  5. Acetylsalicylic Acid
    contraindications
    • 1. Active gastrointestinal bleeding
    • 2. Asthma patients with nasal polyps (anaphylaxis is common)
  6. Acetylsalicylic Acid
    side effects
    • Gastrointestinal: bleeding, heartburn, epigastric pain
    • CNS: dizziness, confusion, drowsiness
    • ENT: tinnitus, hearing loss
    • Other: may impair renal function, may prolong labor in pregnancy with increased bleeding
  7. Acetylsalicylic Acid
    precautions
    • 1. Medical history of pre-existing ulcers, liver disease or bleeding disorders
    • 2. Due to the possible association of aspirin with Reye’s syndrome, do not give drug to children or teenagers with signs and symptoms of chickenpox (varicella) without physician consultation
  8. Acetylsalicylic Acid
    interactions
    • 1. inhibits anti-hypertensive effects of ACE inhibitors
    • 2. Ammonium chloride and other urine acidifying drugs will increase effects of aspirin – watch for toxicity
  9. Acetylsalicylic Acid
    routes
    PO
  10. Acetylsalicylic Acid
    onset and duration
    Onset is 5-30 minutes and may last 1-4 hours, peak in 15 min.
  11. Acetylsalicylic Acid
    dosages
    • Adult: 162-325 mg PO
    • Pediatric: not recommended
  12. Acetylsalicylic Acid
    notes
    none
  13. Morphine Sulfate
    trade name
    none
  14. Morphine Sulfate
    class
    • opioid narcotic
    • CNS depressant
  15. Morphine Sulfate
    mechanism of action
    • 1. Alters pain perception and produces euphoria
    • 2. Decreases myocardial oxygen demand by decreasing preload (venous pooling due to peripheral vasodilation) and decreasing afterload (decreased systemic vascular resistance due to peripheral vasodilation)
    • 3. Depresses the CNS by interacting with opiate receptors in the brain
  16. Morphine Sulfate
    indications
    • Moderate to severe pain
    • Chest pain of suspected myocardial origin
    • Pulmonary Edema from Congestive Heart Failure with or without chest pain
    • Burns
  17. Morphine Sulfate
    contraindications
    • Altered level of consciousness
    • Abdominal pain of unknown etiology
    • Respiratory depression
    • Head injury
    • Hypovolemia
  18. Morphine Sulfate
    side effects
    • Cardiovascular: bradycardia, hypotension, (rebound tachycardia/hypertension)
    • Neurological: sedation, agitation, tremors/seizures, hallucinations
    • Respiratory: depression, arrest
    • Gastrointestinal: nausea/vomiting
  19. Morphine Sulfate
    precautions
    Morphine Sulfate is an opiate derivative – Naloxone should be available to reverse any severe respiratory side effects
  20. Morphine Sulfate
    interactions
    Use with caution with patients taking other analgesics, depressants or narcotics
  21. Morphine Sulfate
    routes
    IV, IO, IM
  22. Morphine Sulfate
    onset
    IV/IO will have an onset of 2-5 minutes and IM will have an onset of 5-10 minutes. Each will last approximately 3-5 hours
  23. Morphine Sulfate
    dosages
    • Adult:
    • Pain Relief: 1.0 – 10.0 mg IV titrated to pain relief or 5.0 – 10.0 mg IM as a single dose only
    • Pulmonary Edema: 5.0 – 10.0 mg slow IV push (2.0 mg/minute)

    Pediatric: 0.1 – 0.2 mg/kg slow IV push (1.0 mg/minute) titrated to pain relief or 0.1 mg/kg IM
  24. Morphine Sulfate
    notes
    May draw 10 mg (1 ml) into a 10 ml syringe and mix with 9 ml of Normal Saline. This creates a 1 mg/1 ml concentration for better control when administering the medication.
  25. Activated Charcoal
    trade name
    • Acta-Char
    • Actidose-Aqua
    • Insta-Char
    • Liqui-Char
    • CharcoAid
  26. Activated Charcoal
    class
    adsorbent
  27. Activated Charcoal
    mechanism of action
    Binds (adsorbs) toxic substances inhibiting gastrointestinal absorption, leaving less toxic substance in body circulation; increasing fecal elimination of drug/charcoal complex
  28. Activated Charcoal
    indications
    Suspected ingestion of drugs or chemicals
  29. Activated Charcoal
    contraindications
    • Patients with a compromised airway – need to minimize chance for aspiration or obstructionIngestion of Iron or multi-vitamins
    • Caustic acids/alkalis
    • Cyanide Poisoning
  30. Activated Charcoal
    side effects
    • Respiratory: choking
    • Gastrointestinal: vomiting, black stools, abdominal cramping/bloating
  31. Activated Charcoal
    precautions
    • Should not be administered immediately after Syrup of Ipecac
    • Must shake vigorously prior to administration
    • Do not use charcoal with sorbitol (an added sweetener) in children < 1 yr
  32. Activated Charcoal
    interactions
    Does not adsorb cyanide, ethanol, methanol, ferrous sulfate, caustic alkali or mineral acids, or lithium
  33. Activated Charcoal
    routes
    PO voluntarily by patient or PO via nasogastric/orogastric tube
  34. Activated Charcoal
    onset and duration
    Onset is immediate, peak effect and duration are unknown
  35. Activated Charcoal
    dosages
    • Adult: Initially 1g/kg PO
    • Pediatric: Initially 1g/kg PO
  36. Activated Charcoal
    notes
    • Most effective if administered within 30 minutes of ingestion
    • Use very cautiously in patients who cannot protect their own airway
  37. Nitroglycerin
    trade name
    • Nitrolingual
    • Nitrostat
    • Nitrobid
    • Tridil
  38. Nitroglycerin
    class
    • Vasodilator
    • Nitrate
    • Antianginal
  39. Nitroglycerin
    mechanism of action
    • Relaxes smooth muscles causing venous dilation
    • Reduces preload and afterload to the heart
    • Dilates the coronary arteries resulting in increased perfusion of the myocardium
  40. Nitroglycerin
    indications
    • Chest pain of cardiac origin
    • Acute pulmonary edema
  41. Nitroglycerin
    contraindications
    • Blood pressure less than 100 mmHg systolic
    • Patients who have taken Erectile Dysfunction medications in the last 24-48 hours
    • Signs and symptoms of head trauma (increased intracranial pressure) or cerebral hemorrhage
    • Poor systemic perfusion
  42. Nitroglycerin
    side effects
    • Cardiovascular: hypotension, bradycardia, rebound hypertension/tachycardia, palpitations
    • Neurological: headache
    • Other: flushed skin, sublingual burning
  43. Nitroglycerin
    precautions
    Monitor blood pressure closely for signs of hypotension (before and after administration)
  44. Nitroglycerin
    interactions
    Use with caution with patients who already use vasodilators, alcohol, calcium channel blockers, beta blockers and phenothiazides
  45. Nitroglycerin
    routes
    SL, TM (transmucosal), transdermal (nitropaste)
  46. Nitroglycerin
    onset and duration
    Onset in 1-3 minutes and may last 30-60 minutes
  47. Nitroglycerin
    dosages
    • Adult: 0.4 mg as a single spray or single tablet. May repeat every 3-5 minutes
    • Pediatric: not recommended
  48. Nitroglycerin
    notes
    • Do not shake canister if administered as a spray as it will altered the metered dose in a single spray
    • Do not have patient inhale drug on administration as it will alter absorption rate
    • Establish IV prior to or immediately following administration to combat hypotension if necessary
  49. Oxygen
    trade name
    02
  50. Oxygen
    class
    gas
  51. Oxygen
    mechanism of action
    Increases percentage of oxygen in inspired air (FiO2)
  52. Oxygen
    indications
    • Increase oxygen demand
    • Hypoxemia or hypoxia
    • Chest pain of myocardial origin, cardiovascular compromise or emergencies
    • Respiratory insufficiency
    • Neurological diseases or disorders
    • Hypoperfusion state or trauma
  53. Oxygen
    contraindications
    none
  54. Oxygen
    side effects
    Respiratory: dry mucous membranes, upper respiratory irritation, pulmonary edema
  55. Oxygen
    precautions
    • Closely monitor patients with COPD
    • Patients with respiratory insufficiency should be monitored closely to ensure adequate ventilation
    • Non-humidified oxygen may cause drying of the mucous membranes
    • Neonates should not receive high concentrations for long periods of time
  56. Oxygen
    interactions
    none
  57. Oxygen
    routes
    inhaled
  58. Oxygen
    onset and durations
    Onset in 1-2 minutes and may last 30 minutes
  59. Oxygen
    dosages
    • Nasal Cannula 2-6 LPM
    • Simple Face Mask 6-10
    • LPMNonrebreather Mask 10-15 LPM
    • HHN/Neb Mask 6-8 LPM
    • BVM 15 LPM
  60. Oxygen
    notes
    none

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