Pharmacology

• ^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

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)

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

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

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

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

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

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.)

Type: Fast-acting analog

Onset : 15 min

Peak Effect: 1 hr

Duration of action: 4 hrs

Type: Fast-acting analog

Onset: 15min

Peak: 1 hr

Duration of Action: 4 hrs

Type: Short-acting human

Onset: 30min - 1hr

Peak: 2-4hrs

Duration of Action: 5-7hrs

Type: Short-acting analog

Onset: 30min

Peak: no peak

Duration of Action: 1-2.5hrs

Type: Intermediate Human

Onset: 3-4hrs

Peak: 6-12hrs

Duration of action: 18-28hrs

Type: Combination mix/Intermediate human

Onset: 30min

Peak: 4-8hrs

Duration of action: 24hrs

Type: Combination mix/ Intermediate acting insulins

Onset: 30min

Peak: 3hrs

Duration of Action: 22-24hrs

Type: Comination mix / short-acting analog

Onset: 15 min

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

Duration of Action: 6-12

Type: Combination mix; fast acting

Onset: 15min

Peak: 1-4hrs

Duration of action: 12-24hrs

Type: Long-acting Basal Analog

Onset: 2-4 hrs

Peak: 0hrs

Duration of action: 24hrs

Type: Long-acting basal analog

Onset: 3-8hrs

Peak: 0hrs

Duration of Action: 24hrs

Type: Short-acting analog

Onset: 40min

Peak: 0

Duration of Action: 4hrs

Type: Long analog

Onset: 0

Peak: 0

Duration of Action: 24 hrs

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