Class notes
NURB 3150 Key Concepts by chapter Notes
- Course
- Nurb 3150
- Institution
- Northwestern State University Of Louisiana
Key Concepts by chapter.
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Pharm Key ConceptsCh. 6 Care of Pregnant or Lactating Women
Ch. 7 Women’s Health
Ch. 9 Coagulation Disorders
Ch. 10 Dyslipidemia
Ch. 16 Decrease Pain, Fever, and Inflammation
Aspirin, other NSAIDs, and acetaminophen inhibit COX enzymes, which are
required for prostaglandin formation.
Aspirin and other nonselective NSAIDs inhibit both COX-1 and COX-2. The COX-2
inhibitor, celecoxib, is more selective for the COX-2 enzyme. The exact mechanism of
action of acetaminophen is unclear.
The FDA has issued a BLACK BOX WARNING ♦ for aspirin stating that children or
teenagers should not take aspirin to treat chickenpox or flu-like symptoms because of the
risk of Reye’s syndrome.
Prostaglandins produced by COX-1 are important in regulating homeostasis and
are associated with platelet aggregation and protective effects on the stomach and
kidneys. Drug-induced inhibition results in gastric ulceration, renal dysfunction, and
diminished blood clotting.
Prostaglandins produced by COX-2 are associated with pain and inflammation.
Drug-induced inhibition results in therapeutic effects of analgesia and anti-inflammatory
activity.
People with hypersensitivity to aspirin should not take NSAIDs due to the risk of
cross-sensitivity to other antiprostaglandin drugs.
The use of gastroprotective drugs such as antacids, H2 blockers, and proton pump
inhibitors may be indicated to prevent upper GI bleeding with chronic use of aspirin and
other nonselective NSAIDs.
Acetaminophen is the drug of choice for fever in children. Acetaminophen and
ibuprofen may be alternated in the treatment of children with fever.
The major drawback of acetaminophen use is the potentially fatal liver damage
with overdose. Acetylcysteine is the specific antidote to acetaminophen overdose.
The FDA has issued a BLACK BOX WARNING ♦ stating that ibuprofen is
contraindicated for the treatment of perioperative pain after coronary artery bypass graft.
A BLACK BOX WARNING ♦ states that patients who take meloxicam are at risk for
cardiovascular events and GI bleeding.
Another BLACK BOX WARNING ♦ reports that an increased risk for adverse
cardiovascular thrombotic effects, including myocardial infarction and cerebrovascular
accident, may occur with indomethacin.
The FDA has issued a BLACK BOX WARNING ♦ stating that patients who take
meloxicam are at risk for cardiovascular events and GI bleeding.
Drugs related to indomethacin are etodolac, ketorolac (Toradol), and
nabumetone. Etodolac reportedly causes less gastric irritation, especially in older adults at
high risk for GI bleeding.
The FDA has issued a BLACK BOX WARNING ♦ for ketorolac; this drug places the
patient at risk for GI irritation, inflammation, ulceration, bleeding, and perforation.
, The FDA has issued a BLACK BOX WARNING ♦ for celecoxib concerning its
cardiac and vascular risks.
Allopurinol, which inhibits the synthesis of uric acid, is the drug of choice for
people with gout due to “overproduction” of uric acid.
Colchicine is the only antigout drug with anti-inflammatory effects; it is useful for
treating acute attacks.
Febuxostat, probenecid, and sulfinpyrazone are uricosuric drugs effective in
treating people with gout who “underexcrete” uric acid.
During treatment for gout, the nurse encourages patients to increase fluid intake
to 2000 mL/d to prevent renal calculi.
Ch. 22 Tuberculosis and Mycobacterium avium Complex Disorders
Ch. 23 Viral Infection
Ch. 24 Fungal Infections
Ch. 26 Hypertension
Ch. 27 Dysrhythmias
Ch. 28 Coronary Heart Disease
Ch. 31 Nasal Congestion
Ch. 32 Decrease Histamine Effects and Allergic Response
Ch. 33 Asthma and Bronchoconstriction
Ch. 34 Fluid Volume Excess
Diuretic drugs act on the kidneys to decrease reabsorption of sodium, chloride,
water, and other substances.
A body weight change of 2.2 pounds (1 kg) may indicate a gain or loss of 1000
mL of fluid.
Excessive table salt and salty foods (e.g., ham, packaged sandwich meats, potato
chips, dill pickles, most canned soups) may aggravate edema or hypertension.
Thiazide diuretics are the drugs of choice for most patients who require diuretic
therapy, especially for long-term management of heart failure and hypertension.
High-dose furosemide continuous IV infusions should be given at a rate of 4
mg/min or less to decrease or avoid risks of adverse effects, including ototoxicity.
There is a known cross-sensitivity of some sulfonamide-allergic patients to a
sulfonamide nonantibiotic, such as the thiazides.
Loop diuretics have a sodium-losing effect up to 10 times greater than that of
thiazide diuretics.
Patients with renal impairment should not take potassium-sparing diuretics
because of the high risk of hyperkalemia.
The U.S. FDA has issued a BLACK BOX WARNING for spironolactone, which has
been shown to be tumorigenic with chronic toxicity in rats; unnecessary use should be
avoided.
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