Pharmacology Final

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Pharmacology Final
2012-11-25 16:45:53
Pharmacology Final

Source: Davis's Drug Guide for Nurses 11th edition
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  1. aspirin
    • a. salicylates
    • b. antipyretics, nonopioid analgesics
    • c. inflamm. disorders including: ra, osteoarthritis. mild to moderate pain, fever. prophylaxis of transient ischemic attachs and mi
    • d. gi bleeding, dyspepsia, epigastric distress, nausea, exfoliative dermatitis, steven-johnson syndrome, ,toxic epidermal necrolysis, anaphylaxis, laryngeal edema
    • e. monitor pt for onset of tinnitus, headache, hyperventilation, agitation, mental confusion, lethargy, diarrhea, and sweating
    • f. full glass, upright 15-30min
    • g. rport tinnitus; unusual bleeding of gums; bruising; black, tarryy stools; or fever lasting longer than 3days
    • h. pedi: reyes syndrome (chickenpox)
    • i. relief to mild-mod discomfort; increased ease of joint movement. may take 2-3wk for maximum effectiveness; reduction of fever; prevention of transient ischemic attacks/mi
  2. Ticlid
    • a. antiplatelet agents
    • b. platelet aggregation inhibitors
    • c. prevention of stroke in pt who have had a completed thrombotic stroke or precursors to stroke and are unable to tolerate aspirin
    • d. inhibits platelet aggregation by altering the function of platelet membranes. prolongs bleeding time; decreases incidence of stroke in high-risk pts
    • e. diarrhea, rashes, agranulocytosis, aplastic anemia, intracerebral bleeding, neutropenia
    • f. monitor bleeding time throughout therapy & cbc
    • g. may cause thrombocytopenia
    • h. may increased serum total cholesterol and triglyceride lvls
    • i. admin with food or immed. after eating to min. gi discomfort and increase absorption
    • j. 10-14 days before surgery d/c
    • k. prevention of stroke
  3. verapamil - Calan
    • a. antianginals, antiarrhythmics, antihypertensives, vascular headache supressants
    • b. CCB
    • c. management of htn, angina pectoris, and/or vasospastic angina. management of supraventricular arrhythmias and rapid ventricular rates in atrial flutter or firillation; prevention of migraine headache. management of cardiomyopathy
    • d. inhibits the transport of calcium into myocardial and vascular smooth msucle cells, resulting in inhibition of excitation-contraction coupling and subsequent contraction. decreases sa and av conduction and prolongs av node refractory period in condution tissue
    • e. decreased blood pressure; decreased freq. and severity of attacks of angina; supression of ventricular tachyarrhytmias
    • f. orthostatic hotn, constipation, supression of cardiac function (bradycardia, HF), dysrhytmias, acute toxicity resulting in hotn, bradycardia, av block and ventricular tachydsyrythmias
    • g. grapefruit juice: toxicity
    • h. decrease in bp, freq and sevverity of anginal attacks, ^ activity tolerance and sense of well being, supression and prevention of atrial tachyarrhythmias
  4. Fosamax
    • a. bone resorption inhibitors
    • b. biphosphonates
    • c. tx and prevention of postmenopausal osteoporosis. tx of osteoporiss in men. tx of pagets disease of the bone
    • d. inhibits resorption of bone by inhibiting osteoclast activity
    • e. reversal of the progression of osteoporisis with decreased fx. decreased progression of pagets disease
    • f. headache, blurred, abd distention, abd pain, diarrhea, dyspepsia, dysphagia, esophageal ulcer, flatulence, gastritis, n/v, rash, musculoskeletal pain
    • g. admin. first thing in the morning 6-8oz plain water 30min before other medications/bev/food
    • h. waiting longer than 30min will improve absorption
  5. allopurinol - Zyloprim
    • a. antigout agents, antihyperuriemics
    • b. prevention of attack of gouty arthritis an dnephropath
    • c. tx of secondary hyperuricemia, which may occur during tx of tumors or leukemias
    • d. rash, bone marrow depression
    • e. monitor i&o
    • f. min. 2500-3000/day fluid intake to min. risk of kindey stone formation
    • g. asses pt for rash or more severe hypersensitivity reactions
    • h. monitor for joint pain and swelling
    • i. may be admin afte rmilk or meals to min gi irritationl give with plenty of fluid. maybe crushed and given with fluid. may be crushed and given with fluid or mixed with food for pt who have difficulty swallowing
    • j. helps prevent, bt does not relive acute gout attacks
  6. aluminum hydroxide - amphojel
    • a. antiulcer agents, hypophosphatemics
    • b. antacids, phosphate binders
    • c. lowering of phosphate lvls in pt with chronic renal failure. adjunctive therapy in the tx of peptic, duodenal, and gastric ulcers. hyperacidity, inidigestion, reflux of esophagitis
    • d. binds phosphate in the gi tract. neutralizes gastric acid and inactivates pepsin
    • e. lowering of serum phosphate lvls. healing of ulcers and decreased pain associtated with ulcers or gastric hyperacidity. constipation limits use alone in the tx of ulcer disease. frequently found in combination with magnesium-containing compounds
    • f. constipation, hypophosphatemia
    • g. in tx of severe ulcer disease, guaiac stools, and emesis, monitor ph of gastric secretions
    • h. hypophosphatemic: for phosphate lowering follow dose with full glass of water or fruit juice
    • i. antacid: may be given in conjunction with magnesium containing antacids to min. constipation except in pt with renl failure. admin 1 and 3hr after meals and at bedtime for max antacid effect
    • j. tx of peptic ulcer, aluminum hydroxie may be admin every 1-2 hr wile the pt is awake or diluted with 2-3 parts water and admin intragastrically every 30min for 12 or more hr per day. physician may order ng tube clamped after admin.
    • k. for reflux esophagitis, admin 15ml 20-40min after meals and at bedtime
    • l. not to take aluminum hydroxide within 1-2 hr of other meds
    • m. pt with chg or htn or those on sodium restriction should use low sodium preparations
    • n. potential for constipation
    • m. low phosphate diet
    • o. decrease in serum phosphate levels; decrease in gi pain and irr.; increase in the ph of gastric secretions. in tx of peptic ulcer, antacid theraphy should be contin. for at lease 4-6wk after symptoms have disappeared because there is no correlation btween disappearance of symptoms and healing of ulcers
  7. Garamycin; steptomycin (aminoglycosides)
    • a. anti-infectives
    • b. tx of serous gram-neg bacillary infections and infections caused by staphylococci when penicillins or other less toxic drugs are contraindicated; strep: in combination with other agents in the management of active tb; genta&strep: enterococal infections
    • c. inhibits protein synthesis in bacteria at lvl of 30S ribosome; bactericidal action
    • d. ototoxicity, ataxia, nephrotoxicity, d/n/v, muscle paraplysis, apnea
    • e. asses pt for infection; c&s; evaluate 8th cranial nerve function by audiometry before and throughout therapy. hearing loss is usually in the high-freq range; vestibular dysfunction (vertigo, ataxia, n/v)
    • f. monitor i&o
    • g. hepatic encephalopathy: monitor neuro status before admin.
    • h. lab tests: renal function (urinalysis), specific gravity, BUN, creatinine, and CCr before and during therapy
    • i. monitor blood lvls
    • j. 1500-2000mlday hydrate
    • signs of hypersensitivity: tinnitus, vertigo, hearing loss, rash, dizziness, diff. urinating
    • l. if no response is seen within 3-5days, new cultures should be taken; prevention of infection in intestinal surgery; improved neurologic status in hepatic encephalopathy; endocarditis prophylaxis
  8. losartan - Cozaar
    • a. angiotensisn II receptor antagonists
    • b. antihypertensives
    • c. management of htn. tx of diabetic nephropathy in pt with type2 and htn; management of chf who cannot tolerate ace inhibitors; prevention of stroke in pt with htn and left ventricular hypertrophy; reduction in risk of death
    • d. blocks vasoconstrictor and aldosterone producing effects of angiotensin II at receptor sites including vascular smooth muscle and the adrenal glandsl lowering of bp. slowed progression of diabetic nephropathy. reduced cardiovascular death and hospitalization due to chf in pt with chf. decreased risk of cardiovascular death in pt with left ventricular systolic dysfunction who are post mi. decreased risk of stroke in pt with htn and left ventricular hypertrophy
    • e. dizziness, hotn, angiedema
    • f. assess bp; angioedema; chf- daily wt, resolution of fluid overload
    • g. avoid salt substitutes containing potassium or food containing high lvls of potassium or sodium unless directed by hcp
    • h. orthostatic hotn
    • i. may cause dizziness
    • j. notify: swelling of face, eyes, lips, tongue, diff swallowing or breathing
    • k. htn: wt reduction, low sodium diet, dc smoking, mod alcohol, reg. exercise, stress management
  9. theophylline
    • a. bronchodilators
    • b. xanthines
    • c. long-term control of reversible airyway obstruction caused by ashtma or COPD. increases diaphramatic contracility
    • d. bronchodilation, cns stimulation, positive inotropic and chronotropic effects, diuresis, gastric acid secretion
    • e. seizures, anxiety, arrhythmias, tachycardia, n/v
    • f. assess bp, pulse resp. i&o, pulmonary function tests
    • g. lab: abgs, acid base, fluid and electrolyte balance
    • h. therapeutic plasma lvls range from 10-15 for asthma and 6-14 for apnea or prematurity; excess 20 - toxicity; caffeine - falsely elevate; geri: 60yrs old ^ risk of toxicity
    • i. oce a day doses should be admin in the morning
    • j. with food or full glass of water to min gi irr.; 1hr before or 2hr after meals for more rapid absorption
    • k.2000mlday liquids
    • l. avoid otc may ^ s/e and cause arrhythmias
    • m. min intake of xanthine containing foods/bev (colas, coffee, chocolate) char-broiled
    • n. increased ease in breathing; clearing of lung fields on auscultationl resp. and myocardial stim. in apnea of infancy