Exam (elaborations)
u-world pharmacology exam
- Course
- Institution
u-world pharmacology u-world pharmacology u-world pharmacology
[Show more]
Content preview
u-world pharmacologyAsthma Asthma is a disorder of the lungs characterized by reversible airway hyper-reactivity and chronic
inflammation of the airways. Albuterol (Proventil) is a short-acting beta agonist (SABA) administered as a
quick-relief, rescue drug to relieve symptoms (eg, wheezing, breathlessness, chest tightness) associated
with intermittent or persistent asthma. Beclomethasone (Beconase) is an inhaled corticosteroid (ICS)
normally used as a long-term, first-line drug to control chronic airway inflammation.
When using an ICS metered-dose inhaler (MDI), small particles of the medication are deposited and can
impact the tongue and mouth. Rinsing the mouth and throat well after using the MDI and not
swallowing the water are recommended to help prevent a Candida infection (thrush) (white spots on
tongue, buccal mucosa, and throat), a common side effect of ICSs. The use of a spacer with the inhaler
can also decrease the risk of developing thrush
Proper use of the short-acting beta agonist (SABA) inhaler includes taking it apart and rinsing the
mouthpiece with warm water 1-2 times a week. Proper use of the inhaled corticosteroid (ICS) inhaler
includes taking it apart and rinsing the mouthpiece with warm water daily and rinsing the mouth and
throat after each use to prevent a Candida infection (thrush). When these medications are administered
together, the sequence is SABA first to open the airways and ICS second.
Methylphenidate Methylphenidate (Ritalin, Concerta) is a central nervous system stimulant used to
treat ADHD and narcolepsy. It affects neurotransmitters (dopamine and norepinephrine) in the brain
that contribute to hyperactivity and lack of impulse control.
A common side effect of methylphenidate is loss of appetite with resulting weight loss. Parents and
caregivers should be instructed to weigh the child with ADHD at least weekly due to the risk of
temporary interruption of growth and development. It is very important to compare weight/height
measures from one well-child checkup to the next. If weight loss becomes a serious problem,
methylphenidate can be given after meals; however, before meals is preferable.
Another side effect of methylphenidate is increased blood pressure and tachycardia. These should be
monitored before and after starting treatment with stimulants.
Therapeutic effects of methylphenidate include increased attention span and improvement in
hyperactivity.
,Side effects of methylphenidate therapy that require on-going monitoring are delayed growth and
development and increased blood pressure. Children with ADHD should be weighed regularly at home
or school; weight loss trends should be reported and discussed with the health care provider. Blood
pressure and cardiac function also should be monitored on an on-going basis.
Stimulant medications (eg, methylphenidate, dextroamphetamine, lisdexamfetamine) Stimulant
medications (eg, methylphenidate, dextroamphetamine, lisdexamfetamine) are first-line agents in the
treatment of attention-deficit hyperactivity disorder (ADHD). Methylphenidate (Ritalin) is administered
in divided doses 2 or 3 times daily, usually 30-45 minutes before meals. As a stimulant, methylphenidate
may interfere with sleep and should be given no later than around 6 PM The sustained-release
preparation should be given in the morning. The dosage in children is usually started low and titrated to
the desired response.
Albuterol Albuterol is a short-term beta-adrenergic agonist used as a rescue inhaler to treat reversible
airway obstruction associated with asthma. Dosing in an acute asthma exacerbation should not exceed
2-4 puffs every 20 minutes x 3. If albuterol is not effective, an inhaled corticosteroid is indicated to treat
the inflammatory component of the disease. Albuterol is a sympathomimetic drug. Expected side effects
mimic manifestations related to stimulation of the sympathetic nervous system, and commonly include
insomnia, nausea and vomiting, palpitations (from tachycardia), and mild tremor.
attention-deficit/hyperactivity disorder (ADHD) Attention-deficit hyperactivity disorder (ADHD) causes
problems with executive function (e.g., using working memory, carrying out tasks), which can affect all
aspects of life, including school performance, social relationships, and career success. Methylphenidate
is a central nervous system (CNS) stimulant used to treat ADHD and narcolepsy. It improves focus and
attention by increasing levels of certain neurotransmitters (eg, dopamine, norepinephrine) in the brain.
Adverse effects include irritability, decreased appetite, hypertension, tachycardia, sleep disturbances,
and jitteriness.
Extended-release methylphenidate should be taken in the morning to minimize the risk of sleep
disturbances. Some dosage forms are taken 30-45 minutes before meals because food can affect
absorption, while others are taken with food. Clients should follow the prescription instructions for their
specific medication and may also consult the pharmacist
Selective serotonin reuptake inhibitors (SSRIs) (eg, fluoxetine, paroxetine, sertraline, citalopram
Selective serotonin reuptake inhibitors (SSRIs) (eg, fluoxetine, paroxetine, sertraline, citalopram) are
used to treat a number of psychiatric conditions (eg, major depressive disorder, generalized anxiety
disorder). Clients usually see therapeutic effects in 1-4 weeks. SSRIs may increase the risk of suicide,
,especially in young adults (age 18-24) during initial therapy or after a dosage increase. A client who
reports increased energy without a change in depressive feelings needs to be assessed and monitored
for suicidal ideation or actions as the client may now have the energy to execute the suicide plan .
Common, expected side effects of SSRIs include:
Loss of appetite; weight loss or weight gain
Gastrointestinal disturbances (nausea, vomiting, diarrhea)
Headaches, dizziness, drowsiness, insomnia
Sexual dysfunction
Side effects should gradually diminish over 3 months, although some may persist. If symptoms are
intolerable or a particular SSRI is ineffective, the client may be switched to a different antidepressant.
Selective serotonin reuptake inhibitors (eg, fluoxetine, paroxetine, sertraline, citalopram Selective
serotonin reuptake inhibitors (eg, fluoxetine, paroxetine, sertraline, citalopram) are used to treat
psychiatric conditions (eg, major depressive disorder, generalized anxiety disorder). A client reporting
increased energy with little or no reduction of depression needs immediate assessment for suicide risk.
Tolterodine Tolterodine (Detrol LA), oxybutynin (Ditropan), and solifenacin (Vesicare) are
antimuscarinic/anticholinergic medications used for overactive bladder and urge urinary incontinence.
They decrease urinary urgency and frequency. The most common side effects are anticholinergic (eg, dry
mouth, constipation, cognitive dysfunction). The client's report of not urinating the entire day while at
work may indicate that the dosage is too high and is causing urinary retention. Urinary retention can
lead to bladder infections and distension. This information should be reported to the health care
provider (HCP)
Artificial saliva products and sugar-free hard candy and gum are acceptable ways to manage dry mouth
caused by anticholinergic medications.
Occasional dizziness is a side effect of tolterodine. The client should rise and change positions slowly.
However, if this client is receiving too high a dose, reduction of the dose may alleviate the dizziness.
Severe dizziness should be reported to the HCP.
Constipation can be managed with increased fiber in the diet, fluids, stool softeners, or laxatives.
Educational objective:Anticholinergic medications (eg, tolterodine, oxybutynin, solifenacin) are
commonly used for overactive bladder. The client should experience a reduction in the number of times
, needed to urinate, but the number should not decrease below typical urination frequency. The nurse
should also teach the client how to manage the common side effects of dry mouth, constipation, and
mild dizziness.
Lithium toxicity symptoms Acute: gastrointestinal findings - nausea, vomiting, diarrhea; neurologic
findings occur later
Chronic: neurologic - ataxia, sluggishness, confusion, agitation, neuromuscular excitability (coarse
tremor)
Prevention of lithium toxicity Avoid sodium depletion; low sodium intake precipitates lithium toxicity
Eat regular diet & drink adequate fluids (2-3 L/day)
Therapeutic level is 0.6-1.2 mEq/L (0.6-1.2 mmol/L)
Level >1.5 mEq/L (1.5 mmol/L) is considered toxic
Lithium Lithium is a mood stabilizer commonly prescribed for mania (eg, bipolar disorder) as long-term
maintenance therapy. Because lithium has a narrow therapeutic range (eg, 0.6-1.2 mEq/L [0.6-1.2
mmol/L]), serum levels should be monitored regularly (eg, following dose changes) to prevent toxicity
(>1.5 mEq/L [1.5 mmol/L]).
Lithium is excreted through the kidneys. To prevent toxicity the nurse should hold doses and clarify
prescriptions for clients who have:
Conditions/illnesses in which the kidneys try to conserve sodium (eg, hyponatremia, dehydration) as
sodium and lithium are absorbed in proximal tubules simultaneously
Decreased glomerular filtration rate (eg, severe renal dysfunction) as less of the drug is filtered into the
urine
Consistent amounts of fluid (2-3 L/day) and sodium prevent fluctuations in serum lithium. Clients should
report signs (eg, weight changes, dizziness) and precipitating factors (eg, vomiting, diarrhea, increased
sweating) of fluid and electrolyte imbalance.
Consistent amounts of fluid (2-3 L/day) and sodium prevent fluctuations in serum lithium. Clients should
report signs (eg, weight changes, dizziness) and precipitating factors (eg, vomiting, diarrhea, increased
sweating) of fluid and electrolyte imbalance.
The benefits of buying summaries with Stuvia:
Guaranteed quality through customer reviews
Stuvia customers have reviewed more than 700,000 summaries. This how you know that you are buying the best documents.
Quick and easy check-out
You can quickly pay through credit card or Stuvia-credit for the summaries. There is no membership needed.
Focus on what matters
Your fellow students write the study notes themselves, which is why the documents are always reliable and up-to-date. This ensures you quickly get to the core!
Frequently asked questions
What do I get when I buy this document?
You get a PDF, available immediately after your purchase. The purchased document is accessible anytime, anywhere and indefinitely through your profile.
Satisfaction guarantee: how does it work?
Our satisfaction guarantee ensures that you always find a study document that suits you well. You fill out a form, and our customer service team takes care of the rest.
Who am I buying these notes from?
Stuvia is a marketplace, so you are not buying this document from us, but from seller lectjoseph. Stuvia facilitates payment to the seller.
Will I be stuck with a subscription?
No, you only buy these notes for $12.99. You're not tied to anything after your purchase.
Can Stuvia be trusted?
4.6 stars on Google & Trustpilot (+1000 reviews)
75057 documents were sold in the last 30 days
Founded in 2010, the go-to place to buy study notes for 14 years now