drugs nursing medsurg

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drugs nursing medsurg
2011-03-16 11:38:54
drugs pharmacology med surg nursing nurse

drugs common to medsurg
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  1. Beta-blockers
    Medication ending with ALOL or LOL

    "Beta laughs alot"

    Mechanism of action: Selective beta 1-adrenergic blockers but occasional blocks beta 2.

    • Block sympathetic nervous systems to heart and lungs
    • *You got one heart (beta 1) and two lungs (beta 2)
    • **B1 hr^, Bp^
    • **B2 bronchodialate

    • Commonside effects: bradycardia, hypotension, and congestive heart
    • failure(if HR too low), and brochospasm.

    • Assessment prior to giving medication
    • *BP must be >100 or per MD
    • *HR must be >60 or per MD

    Assess breath sound for wheezing
  2. ACE inhibitors
    ending with pril

    "Ace tennis is played in April"

    • Mechanism of action: angiotension
    • converting enzyme inhibitors.
    • *Normal: liver produces angiotensin I (mild vasoconstrictor) with the present of renin angiotensin it converts to angiotensin II (potent vasoconstrictor) to
    • increase blood pressure. This medication blocks the above effects.
    • **=vasodilate + lowers water
    • **=Drop in BP

    S/E: chronic cough, angioedema,(do not know why) and hypotension.

    • Not drug of choice for black patient (not
    • effective)

    • Assessment: monitor BP and assess for s/s of chronic cough or angioedema (can
    • happen at any time), hypotension

    • A=angioedema (swelling throat/tongue)
    • C=cough
    • E=edema
  3. Angiotensin II blockers (ARB's)
    ending with “SARTAN”

    MOA: blocks angiotensin II, which is a vaso-constrictor.

    • Side effects: hypotension, dizziness, and
    • syncope.

    very effective for black people.

    "black angio is blocked from a spartan lifestyle"

    <side effecst than ACE inhibitors, no cough
  4. Calcium channel blockers
    Calcium channel blockers are very nice grapfruit drugs

    • Medications ending in pine and the following:
    • *Verapamil
    • *Nifedipine
    • *Diltiazem/cardizem

    MOA: blocks calcium from going into cardiac smooth muscle causing slowed hr and vaso-dilation.

    • Calcium aide with muscle contraction.
    • *Less calcium =less contraction
    • *For every contraction = heart beat

    Side Effects: Bradycardia, hypotension, and heart failure

    • avoid when taking
    • *Grapefruit (enhanced drug absorption)

    • reverse the affects of Calcium channel blockers OD?
    • *Calcium Chloride/Calcium gluconate
  5. Cholesterol lowering drugs
    ending with statin except nystatin.

    MOA: inhibiting fat absorption and inhibit cholesterol production in the liver.

    avoid grapefruit

    if not enough, Break down muscle which causes rhabomylosis.

    • If your body does not absorbed
    • fat from food consumed, would see fatty stool or floaters.

    • Side effects: Flatulence, abdominal
    • discomfort, stetorrhea, muscle weakness (rhabdomyolosis).
    • **complications from Rhabdomyolosis?
    • ***ARF due to excess waste and caused nephrons irritation and nephrons death.
    • ****cell break down debris clog nephrons = renal failure w. muscle weakness & aching
    • ****treatments =Fluid and lasix

    Cholesterol converted at night. Best time to give.

    No grapefruit w. drug.
  6. Aminoglycoside
    • Antibiotics ending in myocin
    • *Gentamyocin, vacomyocin, or amikacin

    aminos are the fungus amongst us nephrotoxic myocins

    MOA: inhibit aminoglycoside (cell membrane) and inhibit DNA of the organism.

    Side effect: secondary infections, nephrotoxic, and ototoxic

    Dose is weight based to avoid side affects.

    Prior: assess BUN/CR

    Give over 90m

    • "fungus amongst us"
    • *yeast infection/diarria/oral candidias/clustridrium difficule.
  7. Anti-viral (Vir)
    • Any medication ending in Vir is
    • an anti-viral.

    MOA- inhibit cell wall synthesis and caused cell death.

    Side effects: secondary infection, nausea, vomiting, and diarrhea.

    • Why these type of side effects and what can
    • you do to prevent the severity.
  8. Treatment for angina

    Treatments in order:

    O-oxygen...do not need order

    • A-Asprin-anticoagulant.
    • *It works by preventing platelet aggregation.
    • *Common S/E: bleeding (GI etc),
    • bruising, and tinnitus

    • N-nitroglycerin- nitrate
    • *Acts by systemic vasodilatation
    • and improve coronary perfusion
    • *Use to decrease workload
    • (decrease preload and after load)
    • *SE: hypotension, headache (why?),
    • and dizziness.
    • *NG if BP<100

    • Morphine: opiate agonist
    • *Acts by blocking opiate receptors
    • in the brain to alter pain perception and it also has vasodilatation property.
    • *S/E- hypotension, (CNS depressant) lethargy, respiratory depression, and constipation

    • Beta-blocker-beta adrenergic
    • block.
    • *Use to decrease workload by
    • decreasing the BP and heart rate.
    • *This medication also improve
    • survival of patient with angina

    • ACE-inhibitors will be added
    • later to prevent cardiac tissue re-engineering (scar formation and prevent CHF)
  9. nitrate
    • Medication ending in nitrate
    • Example:isosorbide dinitrate

    Classification: systemic vasodilator

    • MOA- dilate coronary artery and blood
    • vessels.

    Decreases preload and afterload

    Side effects: headache (why), hypotension, dizziness, syncope, reflex tachicardia

    Application: Sublingal/paste (nitro paper, date/time/need gloves)
  10. anticoagulant
    • Lovenox: low molecular heparin.
    • *MOA: inhibits the conversion of prothrombin to thrombin and fibrinogen to fibrin.
    • *S/E: bleeding & bruising
    • *monitor ptt (10-13s) or aptt (25-39s)
    • *2 to 3x/day
    • *more stable.

    • Heparin
    • *MOA: inhibits the conversion of prothrombin to thrombin and fibrinogen to fibrin
    • *Diagnostic test: PTT (partial prothrombin time)
    • *Antidote: protamine sulfate (hi allergy potential) or hold heparin for 6 hours (half life of heparin)
    • S/E: HIT (heprin induced throbocytopenia)
    • if subQ: no blood monitoring due to 1/2 lift, stomach 2" away from bb.

    • Coumadin/warfarin :
    • *MOA: inhibit vitamin K in the
    • clotting cascade.
    • *S/E: bleeding. brain bleed common
    • *Diagnostic test: Protime (PT) and INR
    • *Antidote: Vitamin K (24 hr to work) and/or FFP
  11. Cortico-steroid
    • Any medication ending with (ONE)
    • *Example predisone or methylpredisolone

    Cortico is the one sex sugar salt steroid

    • MOA-cortico-steroid. It acts by inhibiting immune response and
    • also anti-inflammatory. Inhibits neutrophil prduction.

    S/E- cushing’s syndrome (fluid retention, wt. gain, moon face, and striae). . Facial hair

    • sex: androgen testostorone (aggresiveness, facial hair)
    • sugar: cortisol (diabetes, fat deposit/buffulo hump)
    • salt:Aldosterone (edema,hypertension, HF)
  12. insulin
    Insulin-aide in the transport of glucose into the cell.

    • Why are there so many types of insulin?
    • *Peak and half life is different

    • Goals: maintain stable blood
    • glucose and avoid peaks and valleys.

    MOA: insulin binds to glucose and potassium (K) to form a perfect key in order to transport glucose into the cell.

    • What type of side of effect would you most likely observe?
    • *Hypoglycemic (stimulate
    • SNS-tachycardia, irritability, confusion, agitation, and diaphoresis)
    • *Hypokalemia (arrhythmias)

    • What would you assess prior to giving insulin?
    • *Blood glucose and mental status
    • *If on large amount of insulin-
    • potassium level.