Drug Facts to Remember

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Drug Facts to Remember
2011-06-30 09:37:18
Drug Facts Remember

Drug Facts to Remember
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  1. Atropine Overdose
    • Temperature rises (Hot as a hare)
    • Confusion, delitium (Mad as a hatter)
    • Flusher face (Red as a beet)
    • decreased secretions, thirsty (Dry as a bone)
  2. Trihexyphenidyl (Atropine)
    • Classification:
    • anticholinergic
    • antispasmodic
    • antidysrhythmic
    • Action: inhibits action of acetylcholine. Primary effects are on the heart, exocrine glands, smooth muscles, and eye
    • Uses:
    • antidysrhythmic-increases the heart rate
    • preoperative-decreases secretions, prevents bradycardia
    • relaxes smooth muscle-bronchi, bladder, gastrointestinal tract
    • Contraindications:
    • glaucoma
    • tachycardia
    • Precautions:
    • hyperthyroid
    • liver or renal disease
    • congestive heart failure
    • gastric ulcer
    • asthma
    • Side effects:
    • decreased sweating, which can lead to hyperthermia and flushing
    • central nervous system-toxic doses may cause delirium and hallucinations
    • dry mouth, tachycardia
    • blurred vision, urinary retention, urinary hesitancy, constipation
    • Nursing indications:
    • Evaluate hydration status
    • evaluate frequently for urinary retention, especially in elderly men with prostate problems
    • do not administer if client has tachycardia
  3. Phenazopyridine (Pyridium)
    • Classification: urinary tract analgesic
    • Action: exerts topical analesic effect on urinary tract mucosa (coats the walls with an orange to red medication, the flakes will stop the burning)
    • Uses:
    • relief of pain, burning, utgency, frequency resulting from lower urinary tract mucosa irritation
    • Contraindications:
    • renal and liver insufficiency
    • Side effects:
    • headache, bright orange-colored urine
    • gastrointestional disturbance
    • rash and pruritus
    • Nursing implications:
    • teach client how to avoid upper urinary tract infections
    • take with meals
    • explain discoloration of urine (reddish orange)
    • the drug may discolor contace lenses and stain underwear
    • do not crush, break or chew tablet
    • medication is available over the counter (OTC)
  4. Potassium Chloride (IV, PO)
    • Classification: Electrolyte replacement
    • Action: necessary for nerve impulse conduction; maintians electrical excitability of the heart and assists to regulate acid base balance
    • Uses: potassium deficiency
    • Contraindications:
    • Hyperkalemia
    • renal impairment
    • untreated addison's disease
    • Percautions:
    • acute acidosis resulting in potassium shifts
    • Side effects:
    • gastrointestinal discomfort-nausea and vomiting
    • diarrhea and abdominal discomfort
    • hyperkalemia-ventricular tachycardia, confusion, anxiety, dyspnia, weakness and tingling
    • dysrhythmias, fatigue, muscle weakness, cramps, and decreased reflexes
    • Nursing implications:
    • Give with a full glass of water with or after meals
    • monitor serum potassium (3.5 to 5.5 normal)
    • watch for signs of renal insufficiency (increased creatinine, increased blood urea nitrogen (BUN)
    • intravenous (IV) potassium must always be diluted before administering
    • Never administer potassium via IV push
  5. Salicylate Poisoning
    • initally respiratory excitation occurs (hyperventilation) resulting in respiratory alkalosis
    • As toxicity occurs, a decrease in ventilation develops (hypoxemia) resulting in an increase in carbon dioxide levels, resulting in respiratory acidosis
    • the respiratory acidosis is umcompensated because the bicarbonate stores are depleted during the early stages of poisoning
    • metabolic acidosis results from the acidity of aspirin, along with an increased production of lactic and pyruvic acids
    • Signs and Symptoms
    • initial symptoms: tinnitus, sweating, headache, and dizziness, hyperventilation
    • toxicity: hyperthermia, sweating, and dehydration; respiratory depression, resulting in respiratory acidosis, stupor and coma
    • Treatment:
    • gastric lavage with activated charcoal
    • oxygen or ventilation assistance as necessary
    • treat for hyperthermia (external cool down, tepid water sponge bath), dehydration (intravenous, balance pH and electrolytes), and reverse acidosis (slow infusion of bicarbonate)
    • dialysis if necessary
    • Nursing implications:
    • teach parents safe medication storage
    • teach parents not to administer aspirin to children who are suspected of having a viral infection, especially chicken pox or influenza
    • monitor respiratory status, blood gasses, and for progression of symptoms
    • if child complains of any tinnitus, aspirin should be discontinued; parents should have child evaluated
  6. Lithium Toxicity
    • therapeutic levels:
    • 0.8 to 1.4 mEqL
    • toxic level: <2.0 mEq/L (levels should be kept below 1.5 mEq/L)
    • levels should be drawn in the morning, 12 hours after the evening dose
    • most common cause of lithium accumulation is sodium depletion
    • Signs and symptoms:
    • side effects (with therapeutic levels):
    • fine hand tremors
    • gastrointestinal (GI) effects: nausea, diarrhea, anorexia; fatigue, weakness, headache, polyuria, thirst
    • Toxic effects (1.5 to 2.0 mEq/L):
    • persistent GI problems (vomiting, diarrhea)
    • course hand tremors
    • hyperirritability
    • poor coordination
    • Acute (above 2 mEq/L) Toxicity:
    • ataxia
    • high output of diluted urine
    • electrocardiographic (ECG) changes
    • tinnitus
    • blurred vision
    • severe hypotension
    • symptoms may progress to coma and death
  7. Digoxin Toxicity
    • Optimal level: 0.5 to 0.8 ng/ml
    • Toxic level: >2.0 ng/ml
    • Hypokalemia is the most common predisposing factor to toxicity
    • Signs and Symptoms:
    • GI signs: anorexia and nausea and vomiting
    • CNS signs: fatigue and visual disturbances
    • dysrhythmias-atrioventricular (AV) block resulting in bradycardia, ventricular ectopic beats, which may lead to ventricular fibrillation
  8. Theophylline Toxicity
    • Optimal level: 5 to 15 mcg/ml
    • Toxic level: >20 mcg/ml
    • Signs and Symptoms:
    • too rapid intravenous (IV) infusion may cause hypotension, tachycardia, hyperventilation
    • GI symptoms initially include severe dysrhythmias and seizures
  9. Effects of Grapefruit Juice on metabolism