Pharmacology

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kdevore45
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214824
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Pharmacology
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2013-04-21 19:35:48
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Pharmacology
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Pharmacology From VNSG 1423
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  1. Lisinopril
    (Zestril, Prinivil)
    • Class: Ace Inhibitor
    • MOA: Blocks the conversion of Angiotensin I to Angiotensin II.  Inactivates bradykinin and other vasodilatory prostaglandins.  Also increased renin plasma levels and reduce Aldosterone levels

    • Nursing Implications
    • 1.) Obtain B/P and Pulse prior to administration
    • 2.) Monitor Weight and output with clients with CHF
    • 3.) Monitor Serum BUN and creatinine levels as they may increase
    • 4.) Serum K may be elevated
    • 5.) Serum Na may be Decreased

    • Side Effects:
    • Dizziness
    • Fatigue
    • Cough
    • Hypotension
    • Taste disturbance
    • Protenuria
  2. Lasix
    (Furosemide)
    Class: Loop Diuretic

    MOA: Inhibits the reabsorption of sodium and chloride from the loop Henle and distal renal tubule.  Increases renal excretion of sodium, chloride, magnesium, hydrogen, and calcium.  May have renal and peripheral vasodilatory effects.

    • Nursing Implications:
    • 1.) Assess fluid status
    •                a.)I/O
    •                b.)Daily weight
    •                c.)Edema
    •                d.)Lung sounds
    •                e.)Skin Turgor
    • 2.) Monitor BP and Pulse
    • 3.) Monitor K+ levels (may decrease levels)
    • 4.) Monitor BUN, creatinine, glucose, and uric acid levels (may increase levels)
  3. Lopressor
    (metoprolol)
    Class: Beta Blocker

    MOA: Blocks the stimulation of beta-1 (myocardial) adrenergic receptors.  Does not affect beta-2 (pulmonary, uterine, vascular) adrenergic receptors

    • Nursing Implications:
    • 1.)Monitor B/P and Pulse prior to administration
    • 2.)Monitor I/O
    • 3.)Daily Weights
    • 4.)May increase BUN levels
    • 5.)Administer with meals or directly after eating
    • 6.)Contraindicated in uncompensated CHF, pulmonary edema, Cardiogenic shock, and bradycardia and heart block

    • Side Effects:
    • Hypotension
    • Bradycardia
    • Fatigue
    • Weakness
    • Anxiety
    • CHF
    • Pulmonary edema
    • Erectile dysfunction
  4. Aldactone
    (spironolactone)
    Class: Potassium-sparing Diuretic

    MOA - Inhibits sodium reabsorption in the kidney while saving potassium and hydrogen ions. (done by antagonizing aldosterone receptors)

    • Nursing Implications:
    • 1.) Monitor BP and Pulse prior to administration
    • 2.) Monitor I/O & daily weights
    • 3.) Monitor K+ levels
    • 4.) Contraindicated in patients with impaired renal function (can further increase the potassium levels.)
    • 5.) Monitor BUN/creatinine levels periodically

    • Side Effects:
    • Hyperkalemia
    • Dizziness
    • Erectile dysfunction
    • Breast tenderness
    • Gynecomastia
    • Agranulocytosis
  5. Digoxin
    (Lanoxin,Digitalis,Digitek)

    Digoxin Level
    0.5-2ng/ml
    Class: Cardiac glycoside

    MOA: Increases the force of myocardial contraction.  Prolongs the refractory period of the AV node.  Decreases conduction through the SA and AV node.

    • Nursing implications:
    • 1.) MUST OBTAIN APICAL HR FOR ONE FULL MINUTE BEFORE ADMINISTRATION.  HOLD FOR HR <60BPM.
    • 2.) Slows HR and increases cardiac output
    • 3.) Monitor electrolytes (K+,Mg, Ca+) as hypo states may increase risk of toxicity.

    • Side Effects:
    • Fatigue
    • Headache
    • Weakness
    • Blurred Vision
    • Yellow or green vision
    • Bradycardia
    • Anorexia
    • Nausea
    • Vomiting
    • hyperkalemia with acute toxicity
  6. Norco
    (hydrocodone/acetaminophen)


    Note: Only allowed 4000mg of acetaminophen in 24 hour!!!!
    Class: Schedule III Narcotic

    MOA: Binds to opiate receptors in the CNS.  Alters the perception of and response to painful stimuli while producing generalized CNS depression.  Suppresses the cough reflex via a direct central action.

    • Nursing Implications:
    • 1.) Assess BP, Pulse, Respirations, Pain scale prior to administrition.
    • 2.) Assess bowel function (slows gastric motility).

    • Side Effects:
    • Headache
    • Abdominal Pain
    • Diarrhea
    • Flatulence
    • Hyperglycemia
  7. MS contin
    (morphine)
    Class: Opiod Analgesic

    MOA: Binds to opiate receptors in the CNS. Alters the perception of and response to painful stimuli while producing generalized CNS depression.

    • Nursing Implications:
    • 1.) Assess for Repiratory, HR, and LOC prior to administration
    • 2.) Use cautiously in clients with ICP (increased intracranial pressure)
    • 3.) Assess bowel function for constipation
    • 4.) Prolonged use may produce physiological and psychological dependence and tolerance.

    • Side Effects:
    • Drowsiness
    • Dizziness
    • Conspitation
    • Confusion
    • Hypotension
    • Euphoria
    • Dysphoria
    • Diplopia
  8. Motrin
    (ibuprofen)

    **Use of ibuprofen with more than 3 glasses of alcohol per day may increase the risk of GI bleeding.
    Class: NSAID

    MOA: Inhibits prostaglandin synthesis to decrease pain and inflammation

    • Nursing Implications:
    • 1.) Assess pain level
    • 2.) Assess GI for bleeding (Black tarry stools.)
    • 3.) Assess for Lightheadedness or hypotension
    • 4.) Assess for skin rash (Stevens-Johnson syndome)
    • 5.) Renal dsyfunction
    • 6.) Monitor labs for elevations in BUN and creatinine


    • Side Effects:
    • Headache
    • Dyspepia
    • Dizziness
    • Constipation
    • Vomiting
    • Nausea
    • Abdominal discomfort
    • Stevens-Johnson syndrome
    • Anaphylaxis

    5.)
  9. Humalog
    Humalog mix
    (insulin lispro)
    Type: Fast-acting analog

    Onset : 15 min

    Peak Effect: 1 hr

    Duration of action: 4 hrs
  10. Novolog
    (insulin asparte)
    Type: Fast-acting analog

    Onset: 15min

    Peak: 1 hr

    Duration of Action: 4 hrs
  11. Regular Insulin

    ***Only insulin that can be given IV compatible with all other insulins***
    Type: Short-acting human

    Onset: 30min - 1hr

    Peak: 2-4hrs

    Duration of Action: 5-7hrs
  12. Aspirda
    (insuline gluisine)

    **Incompatible with other insulin preperations**
    Type: Short-acting analog

    Onset: 30min

    Peak: no peak

    Duration of Action: 1-2.5hrs
  13. NPH - Neutral protamine hagedorn
    Humulin N
    Novolin N
    (isophane insuline suspension)
    Type: Intermediate Human

    Onset: 3-4hrs

    Peak: 6-12hrs

    Duration of action: 18-28hrs
  14. Humulin 70/30
    Novolin 70/30
    (70% NPH, 30% regular insulin)
    Type: Combination mix/Intermediate human

    Onset: 30min

    Peak: 4-8hrs

    Duration of action: 24hrs
  15. Humulin 50/50
    (NPH 50%, Regular 50%)

    **Incompatible with other insulin preparations**
    Type: Combination mix/ Intermediate acting insulins

    Onset: 30min

    Peak: 3hrs

    Duration of Action: 22-24hrs
  16. Humalog Mix 75/25
    (75% lispro protamine suspension, 25% lispro insulin)
    Type: Comination mix / short-acting analog

    Onset: 15 min

    Peak: 30min-1.5hrs or 2-4hrs

    Duration of Action: 6-12
  17. Novolog Mix 70/30
    (70% insulin aspart protamine; 30% insulin aspart)

    **Do not mix with other insulins**
    Type: Combination mix; fast acting

    Onset: 15min

    Peak: 1-4hrs

    Duration of action: 12-24hrs
  18. Lantus
    (insulin gargline)

    **Cannot be administered with any insulin!!**
    Type: Long-acting Basal Analog

    Onset: 2-4 hrs

    Peak: 0hrs

    Duration of action: 24hrs
  19. Levemir
    (insulin detemir)

    **cannot be mixed any other insulin**
    Type: Long-acting basal analog

    Onset: 3-8hrs

    Peak: 0hrs

    Duration of Action: 24hrs
  20. Byetta
    (exenatide)

    **Disposable prefilled Byetta pen; 30-day expiration**
    Type: Short-acting analog

    Onset: 40min

    Peak: 0

    Duration of Action: 4hrs
  21. Victoza
    (liraglutide)


    **Disposable prefilled Victoza pen**
    Type: Long analog

    Onset: 0

    Peak: 0

    Duration of Action: 24 hrs
  22. ASA
    (Aspirin)
    Acetylsalicylic Acid

    **Eat with food!!!**
    Class: Salicylate

    MOA: Produces analgesic effects and reduces inflammation and fever by inhibiting production of prostoglandins.  Aspirin only decreases platelet aggregration.

    • Nursing Interventions:
    • 1.) Assess for allergies to aspirin or those that are allergic to tartrazine
    • 2.) Assess clients who have a history of nasal polyps, Asthma, and allergies
    • 3.) Monitor for bleeding (HH)
    • 4.) Monitor for s/s of toxicity/overdose

    • Side Effects:
    • Tinnitus
    • Dyspepsia
    • Gastric Distress
    • Nausea
    • Anemia
  23. Lovenox
    (enoxaparin

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