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NUR 3065 Pharmacology Rationale Study Guide
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NUR 3065 Pharmacology Rationale Study Guide NUR 3065 Pharmacology Rationale Study Guide
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lOMoARcPSD|11763056lOMoARcPSD|11763056
Pharmacology
- Gemfibrozil (Lipid-lowering agent, monitor liver panels! AST and ALT)
- Famotidine is an H2-histamine blocker that is taken BEFORE meals or BEDTIME. Used
to treat gastric ulcers and/or duodenal ulcers. Relieves heartburn, difficulty
swallowing, and GERD.
- Esomeprazole: reduces stomach acid as a PPI (prevent ulcers). Indicated: GERD, PUD.
Do NOT take other foods or medications!!! Hypomagnesemia may occur, so use
supplements. Calcium supplements may be needed r/t osteoporosis risk. NO smoking
or alcohol use. Monitor for s/s of BLEEDING: black tarry stool.
- Glipizide: 2nd generation sulfonylurea. Given to clients who produce minimal
amounts of insulin such as T2DM. Meds that increase effects: aspirin, oral
anticoagulants, MAOIs, sulfonamides, cimetidine, some NSAIDs, ginseng, gemfibrozil
- Procainamide: treats PVC’s or atrial tachycardia SE: hypotension and bradycardia
- Lidocaine: used in frequent PVCs > than 6-10 a minute, pulseless V tach.
- Atropine sulfate: antidysrhythmic used in bradycardia if the patient
is SYMPTOMATIC. It ↑ the HR, and ↑ CO.
- Benztropine: anti-parkinsonian agent. Used with EPS side effects to counteract it.
- Verapamil: CCB. treats SVT, you want to check HR. Poor choice for kidney issues.
- Dexamethasone: corticosteroid, take with breakfast to prevent ulcer formation
- Amikacin: aminoglycoside; RISKS: ototoxicity, nephrotoxicity. SE: Nausea,
diarrhea (signs of superinfection). Can POTENTIATE action of WARFARIN so
caution use.
- Estrogen: initial adverse effect is nausea and common at breakfast time so take
after a meal.
- Alteplase: thrombolytic. Dissolves existing or potential clots. Indication: sluggish
blood return, treatment of acute ischemic stroke (given within 4.5 hr of symptoms).
- Oxytocin/pitocin: Stimulate contractions. discontinue if the contractions are greater
than 2 mins or when 5 or more contractions in 10 mins. ASSESS maternal pulse and
BP q 15 mins, contractions and FHR. Give IVPB, NEVER primary IV.
- Heparin: (fast). Antidote: protamine sulfate. Lab: PTT (1.5-2x normal) with platelets.
Administer SQ or IV only 1-2 mL with Needle size: 25g-27g and ⅜”-⅝”. Monitor risk for
bleeding! Safe for pregnancy.
- Enoxaparin: LMWH. Reduces risk of clot formation in lower extremities
(DVT’s). REPORT signs of BLEEDING. 1 mL dose use 1 mL syringe. 28 g
needle SQ. Risk for HIT and occurs ~5-14 days of use. NO PTT labs, only
PLATELETS. Monitor for thrombocytopenia (↓ platelets).
- Potassium Chloride (KCl): Tx: hypokalemia. NO IV PUSH. can cause
burning/discomfort, so change the IV rate. Infiltration: D/C, elevate extremity,
warm compress. S/S: site is cool/clammy or swollen and some pain.
- Spironolactone: K+-sparing diuretic. Encourage diet LOW in potassium (no
oranges, banana, cantaloupe, apricot, broccoli, potato, leafy greens, salt
substitutes).
pg. 1
, lOMoARcPSD|11763056
- Lasix/furosemide: potassium-wasting diuretic. Diet should have adequate
potassium intake or encourage K+ foods. Can cause wasting of sodium,
potassium, calcium and magnesium. Take in the morning to avoid nocturia.
- Ceftriaxone: cephalosporin antibiotic. Monitor for C. Diff, allergic rxn, SJS.
Adequate fluids.
- D5W: isotonic crystalloid. Tx: hypoglycemia, dehydration, nutrition needs.
- Albumin 25%: used in hypoproteinemia
- Prednisone: Corticosteroid. ↑ aldosterone (regulates K+ excretion and
Na+ retention). Potassium will be ↓. Take in the morning WITH food. Do
not take NSAIDs. May increase the BP. Can cause sodium retention so
caution use in HF patients.
- Hydralazine: vasodilator. Treats hypertension.
- Methotrexate: used in autoimmune disorders such as rheumatoid arthritis
(RA). SERIOUS SE: pancytopenia (↓ RBCs, WBCs, and platelets). NEED to
take folic acid. AVOID large crowds, wash hands.
- Amitriptyline: TCA. (used in panic disorder, depression)
- Diazepam: benzodiazepines (anxiety, insomnia, panic disorder)
- Phenelzine/Nardil: MAOI (social anxiety, depression, panic disorder). NOT safe in
Parkinson’s Disease (risk for HTN Crisis).
- Modafinil: treats narcolepsy also oxybate
- ACE Inhibitors: “ACE-I”: A-angioedema, C-cough, Excess potassium, I-instead use
ARBs.
- Phenytoin: 1-20 mcg/mL. Monitor: gingival hyperplasia *large gums, platelets
and WBCs r/t bone marrow suppression. DO NOT GIVE WITH MILK OR
ANTACIDS.
- Valproic acid: given for ALL types of seizures. Monitor liver panels, WBC’s, platelets, GI
- Phosphorus: has inverse relations with calcium, and given PO in hypercalcemia
to decrease it
- Calcitonin: ↓ serum calcium by inhibiting bone resorption
- IV bisphosphonates: osteoporosis medication that ↓ calcium
- Warfarin/coumadin: (Long-term). Indication: atrial fibrillation, thrombotic
stroke, mitral valve replacement. Action: ↑ clotting time preventing
clot formation. NO in Pregnancy. Labs: PT/INR. Antidote: Vitamin K.
- Permethrin: treats head lice
- Depilatory: removes hair from skin
- Scabicide lotion (permethrin): used for scabies
- Common anti-rejection or immunosuppressants: cyclosporine, prednisone,
azathioprine, tacrolimus, mycophenolate, sirolimus, mofetil
- Acetaminophen/Tylenol: max dose is 3000 mg per day.
- NSAIDs: anti-inflammatory and antipyretic. Use: gout, RA. NOT GOOD for
Entire body: bad for ulcers, asthma, ↑ creatinine/BUN, risk for blood
clots, ↑ bleeding risks so take WITH food. DO NOT TAKE with EGGO
(vitamin E, gingko, garlic, omega-3 oils). Do not use it in patients with hx
of clotting issues/disorders, long term hypertension, CVD, CHF.
- Aspirin: stop taking 5-7 days before surgery.
pg. 2
, lOMoARcPSD|11763056
- Aspirin toxicity: tinnitus (ringing of the ears), hyperventilation, vomiting,
dehydration, fever. CAN LEAD TO metabolic acidosis (r/t pulmonary edema). LATE
SIGNS: drowsy, unsteady gait, bizarre behavior, coma. Antidote: sodium
bicarbonate.
- Doxycycline: a tetracycline antibiotic. Nursing considerations: need for backup
birth control, if glossitis develops (white tongue) DO NOT STOP the medication,
take on an empty stomach, use sunscreen/protection, need for follow up and labs
checked.
- Niacin: SE include: facial flushing (high doses). Monitor liver function tests
and
↑ HDL levels.
- Benzonatate: Antitussive. Produces an anesthetic effect in the lung blocking the
cough message. IF CHEWED, may cause numbness of throat and tongue.
- Buspirone: GAD, with NO SEDATIVE effects. Slow onset.
- Sertraline: SSRI. Used in anxiety, depression, OCD, PTSD.
- Sildenafil: Treatment of ED and pulmonary hypertension. DO NOT TAKE
with NITRATES (isosorbide).
- Antiparkinsonian Drugs for relief of EPS: biperiden, levodopa, amantadine
- Methylphenidate: used in ADHD. Monitor height and within pediatrics. Take in
the MORNING because it is a stimulant.
- 1st generation typical antipsychotics: ex: haloperidol, fluphenazine, chlorpromazine.
CONCERN IS RISK FOR EPS effects (dystonia, akathisia, tardive dyskinesia).
- 2nd generation atypical antipsychotics: ex: olanzapine, clozapine, risperidone.
RISK for METABOLIC SYNDROME (↑ glucose, weight gain, ↑ lipids).
- Clozapine: needs followup labs r/t risk for neutropenia.
- Propranolol and akathisia: can treat akathisia (motor restlessness). Assess BP and
HR first.
- Contraindications for propranolol: bronchospastic lung disorders (COPD, asthma),
cardiogenic shock, sinus bradycardia, and heart blocks > 1st degree.
- Drugs that increase risk of lithium toxicity: dobutamine, diuretics (hypoK),
methyldopa, tetracyclines, NSAIDs.
- Mirtazapine: TCA. Sedative side effect. Use in depression, anxiety, insomnia
r/t depression. SE: ↑ appetite, weight gain, dizziness, confusion. TAKE AT
BEDTIME.
- Levothyroxine: take before breakfast to prevent insomnia. TSH will decrease,
replacing T4 hormone only.
- Captopril: ACE-I. NOT SAFE in PREGNANCY. Risk for HyperKalemia, best to prevent
or reduce kidney damage.Take on EMPTY stomach. Report dry cough. Change
positions slowly (OHTN risk).
- Enalapril: ACE Inhibitor. Treatment of hypertension and CHF. REPORT: s/s of
angioedema (swelling of face, lips, eyes).
- Cimetidine: decreases gastric secretions. TAKE WITH MEALS at bedtime. SE:
constipation so increase fiber intake. CNS adverse effects: memory problems
especially in the older adult so we want to decrease cimetidine dose.
- Dextrose 50 (D50): monitor: hyperglycemia (seen in rapid admin), urine output
(osmotic diuresis may occur with hyperglycemia), hypotension (r/t osmotic diuresis).
HOW TO administer: large-bore needle and want to reduce risk of phlebitis.
pg. 3
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