Pharmacology
Generic name of Drug
Common name, not capitalized
Brand/Trade name of Drug
Name used for marketing and followed by symbol (R). Name is registered and its use is restricted to the owner of the drug.
Chemical Name of Drug
Chemical constitution of the drug
Absorption
drug is transferred from its site of entry into the body to the circulating fluid (blood, lymph)
Distribution
ways in which drugs are transported by the circulating body fluid to the sites of action, metabolism, and excretion
Metabolism
"biotransformation"- process by which body inactivates drugs
Excretion
elimination of metabolites of drugs, and sometimes the active drug, in urine, feces, sweat, tears.
Percutaneous routes of administration
inhalation, sublingual, topical
Drug toxicity
when adverse side effects are severe
Anaphylactic Reaction
a severe, life-threatening reaction that causes respiratory distress and cardiovascular collapse. It is a medical emergency and requires immediate attention.
Drug Incompatibility
When one drug is chemically incompatible with another drug causing deterioration when the two drugs are mixed. Signs: cloudiness, haziness, precipitation, color changes
Ex: ampicillin + gentamicin= ampicillin inactivated gentamicin
Additive Effect
Two drugs with similar actions are taken for a doubled effect
Ex: propoxyphene + aspirin= added analgesic effects
Drug Half-Life
The amount of time required for half of the drug to be eliminated from the body. Drugs with short half lives must be given more frequently than drugs with long half-lives.
Ex: Aspirin half-life: 5 hours-give frequently, Digoxin half-life: 36 hours-give daily
Drug Allergy
Hypersensitivity reaction-occurs in 6-10% of patients taking medications. Occur in patients previously exposed to a drug and have developed antibodies. Most drug allergies are mild. Urticaria is a possible warning to an anaphylactic reaction.
Agonists-Antagonists
Agonists: drugs that interact with a receptor to stimulate a response.
Antagonists: drugs that attach to a receptor, but DO NOT stimulate a response
Nursing Process and Drug
Assessment
Begins with patient admission and ends with discharge. Subjective (what client says) and Objective (what nurse observes)
Nursing Process and Drug
Analyze/Diagnose
Gathering and compiling data obtained from assessment to prioritize patient's needs.
Nursing Process and Drug
Planning
Develop goals (client will), prioritize goals, nursing interventions, and client outcomes
Nursing Process and Drug
Implementation
Process of carrying out established plan of care
Nursing Process and Drug
Evaluation
Determine effectiveness of goals
Six Rights of Drug Administration
Drug, Time, Dose, Patient, Route, Documentation
Actions of analgesic-meperidine (Demerol)
Relieves severe pain without loss of consciousness. Opiate agonists. Acts at the same opiate receptors in CNS as morphine to stimulate analgesic effects.
Opiate Agonists
Routes
PO, SC, IM (Duration 2-4 hours), IV (give very slowly)
Opiate Agonists
What do they do?
Stimulates opiate receptors to block pain without loss of consciousness
Depresses CNS-reflexes, gag, cough, respirations, can cause euphoria and slows GI motility
When can addiction or tolerance occur with opiate agonists?
can occur after 3-6 weeks of continuous use
Side effects to report with opiate agonists
Respiratory Depression, Urinary Retention
What are the sub groups of opiate agonists?
Morphine-like derivatives, meperidine-like derivatives, methadone-like derivatives, and other.
Opiate Antagonist (antidote for morphine)
Naloxene (Narcan)
Competes for and blocks agonists from attaching to the receptor
It is a pure opiate antagonist and its only effect is to reverse the effects of opiate agonists, opiate partial agonists, and propoxyphene.
What is Miosis? What do Mitotic agents do?
a contraction of the iris muscle (pupil narrows)-parasympathetic nerve fibers.
Mitotic agents cause contraction and are used to treat acute angle closure glaucoma.
ex. pilocarpine
What is mydriasis?
dilation of pupil-sympathetic motor nerve fibers. Mydriatic agents cause pupil dilation.
What are the effects of cholinergic agents?
parasympathomimetic
wet and slow
decreased HR, increased GI motility and secretions, increase contractions of bladder, sweating, miosis of eye (decreased IOP), increased force fo contraction of skeletal muscle
What are antiemetics used for?
post-op N/V, motion sickness, pregnancy, psychogenic, chemotherapy-induced N/V, anticipatory (sight/smell causes) delayed emesis, radiation-induced N/V
Treat nausea BEFORE vomiting occurs
Chemotherapy Induced Myelosuppression
Decreased WBC count, Risk for infection, risk for injury (bleeding)
Suppression of bone marrow production of blood cells.
Causes: Leukocytopenia, thrombocytopenia, neutropenia
What is an anticancer drug?
(doxorubicin),Adriamycin
What are the uses of aminoglycosides?
to cure gram negative infections-inhibit protein synthesis-treatment of chronic UTIs and meningitis, life-threatening septicemia. Wound infections
What are the side effects of aminoglycosides?
ototoxicity, nephrotoxicity
What are some examples of aminoglycosides?
end in -mycin, (NOT vancomycin), Tobrmycin and Gentamycin
What are the uses of tetracyclines?
Acne, rickettsial, allergies to penicillins, UTI, Upper respiratory tract infections, pneumonis, meningitis, Rocky Mountain Fever, Lime disease
What are the side effects of tetracyclines?
Nausea, vomiting, anorexia, abdominal cramps, diarrhea, photosensitivity, permanent staining of teeth during last half of pregnancy up to eight years
What is ethambutol (Myambutol)?
Antitubercular drug that is combined with other antitubercular agents to prevent resistance
What are the side effects of ethambutol (Myambutol)?
nausea, vomiting, anorexia, abdominal cramps. REPORT confusion, hallucinations, blurred vision, color blindness (red/green)
What is isoniazide (INH, Nydrazid)?
Antitubercular drug used for prophylaxis and treatment, used in combination with Rifampin. Inhibits metabolism of phenytoin.
What are the side effects of isoniazide (INH, Nydrazid)?
tingling, numbness, nausea, vomiting, dizziness, ataxia, hepatotoxicity
What is rifampin (Rifadin)?
antitubercular drug used for treatment in combination with isoniazide; treats meningitis and tuberculosis
What are the side effects of rifampin (Rifadin)?
reddish-orange secretions interferes with oral contraceptives
Use an alternative form of birth control
What does vancomycin treat? Side effects?
colitis; glycopeptide antibiotic; Red Mans Syndrome
What is Augmentin?
Amoxicillin + Potassium clavulanate; penicillinase (beta-lactamase) destroys beta-lactam ring of penicillin and makes bacteria resistant. Adding another structure to the penicillin that binds the penicillinase allows the penicillin molecule to inhibit cell wall synthesis. Potassium is added to amoxicillin to bind to the penicillinase.
Uses and Side effects of antiviral drugs
Example is acyclovir (Zovirax): Used for herpes genitalis, herpes simplex viral infections; it inhibits viral cell wall replication
the side effects are rash, hives, nephrotoxicity, hypotension, diaphoresis, confusion
What are the uses of cytotoxic drugs?(cell cycle specific)
selectively toxic when cell is in a specific phase of growth-thereofre schedule dependent-best if malignancy that proliferates rapidly
What are the uses of cytotoxic drugs? (cell cycle nonspecific)
active throughout cell cycle-may be more effective against slowly proliferation neoplastic tissue
What is doxorubicin (Adriamycin) used for?
cancers of soft tissue, osteogenic and miscelaneous sarcomas, Hodgkins/NonHodgkins disease, breast carcinoma, leukemias
What are the side effects of doxorubicin (Adriamycin)?
nausea, red urine, bone marrow suppression, cardiotoxicity, alopecia (hair loss), stomatitis
How do you take care of patients with doxorubicin (Adriamycin)?
Monitor vital signs and CBC, red urine is not hematuria, stomatitis (oral hygiene)
What are adrenergics (sympathomimetic or sympathetic)?
Anticholinergic- fast and dry, sympathetic-norephinephrine- "fight or flight"
Alpha: Vasoconstriction "Fight or Flight"
What are the side effects of adrenergics?
increased heart rate and blood pressure, dilated pupils (mydriasis)-screen for open-angle glaucoma due to decrease in IOP, decreased GI motility, decreased secretions, urinary retention, bronchodilation
Cholinergic (parasympathetic)
wet and slow
Cholinergic agent-acetylcholine-"Rest-Replenish-Reproduction"
Side effects: decrease heart rate and BP, pupil constriction (miosis): Increased IOP;screen for closed-angle glaucoma, increased GI motility, bronchoconstriction, increased constriction of urinary bladder, diaphoresis
What are the effects of epinephrine (Adrenaline)?What does it treat?
Increased Heart rate and blood pressure; treats allergic reactions, vasoconstrictor, bronchodilator, cardiac stimulant
Side effects are dysrhythmias, chest pain, hypotension, angina, nausea, vomiting, orthostatic hypotension
What are the effects of Atropine(anticholinergic)?
What does it treat?
reduces saliva and bronchial secretions (pre-op), minimizes bradycardia during intubation (antidote), treats pylorospasm, and spastic conditions of Gi tract, urethral and biliary colic
Antidote to Cholinergics
Side effects: constipation, dryness of mucosa, urinary hesitancy
What is a sedative?
quiets the patient and gives a feeling of rest and relaxation
What is a Hypnotic?
produces sleep
What is the difference between hypnotics and sedatives?
Can be the same drug only in different doses. Primarily used to treat insomnia, decrease anxiety and increase sleep/relaxation prior to procedure
What are barbituates used for?
Used primarily for sedative and hypnotic effects. The long-acting barbituate Phenobarbital is also used as an anticonvulsant. The ultra-short acting agents (methohexital, thiopental) may be administered as a general anesthetic.
How do you take care of patients taking barbituates?
Seek information regarding prior use of sedatives/hypnotic medications
Obtain information related to baseline neurological function
Assess respirations before giving medication (long half-life)
What happens if you discontinue barbitates quickly?
symptoms similar to alcohol withdrawal
What are the side effects of barbituates?
Expect hangover, lethargy, and sedation
REPORT: excessive use/abuse, paradox response, hypersensitivity, blood dyscrasias
What are the drug interactions of Barbituates?
Drugs that increase toxic effects: antihistamines, alcohol, analgesics, anesthetics, tranquilizers, valproic acid, chlormaphenicol, monoamine oxidase inhibitors, and other sedatives
Drugs that decrease toxic effects: Warfarin, digoxin, doxycycline, antidepressants, quinidine, and chlorpromazine
What are the benzodiazepines used for?
most commonly used as sedative-hypnotic
Used as pre-op sedative (IM) and consious sedation (IV) for induction of general anesthesia
What is Valium?
Benzodiazepine used for antianxiety, ethanol withdrawal symptoms, skeletal muscle relaxant, treatment of convulsive disorders
Short or long term use of Benzodiazepine?
When therapy starts, patient feels a sense of deep/refreshing sleep. With chronic use, the amount of REM sleep gradually increases as tolerance develops to the REM suppressant effects. It is important to use for short periods of therapy.
How do you take care of a patient on benzodiazepines?
Take baseline vitals, check history for blood dyscrasias, hepatic disease, or 1st trimester of pregnancy
What are the side effects of benzodiazepines?
drowsiness, hangover, sedation, lethargy
What is the action of antipsychotic agents?
Block the dopamine receptors in the brain. They work at different sites in the brain so the side effects are observed on different systems throughout the body
What are the side effect of antipsychotic agents?
tardive dyskinesia or extrapyramidal effects, blocks cholinergic, antihistamines, and nicotine
What is the drug class for digoxin?
digitalis glycosides
What is digoxin used for?
moderate to severe systolic heart failure not responding to diuretics and ACE inhibitors, atrial fibrillation, atrial flutter, and paroxysmal tachycardia. NOT used to treat diastolic heart failure (may worsen condition).
What is digitalization?
loading doses of digoxin over a period of hours/days to produce desired effect (usually 24-48 hours)
How do you take care of patients on Digoxin?
take apical pulse for 1 full minute, withhold drug if pulse is less than 60 or greater than 100. Witals, weight, labs, monitor for toxicity, hypokalemia, or sudden increase in pulse rate.
What can happen if a patient is on digoxin and diuretics?
hypokalemia
How and when do you give digoxin?
Give over 1 minute (IV) and (orally) after meals to minimize gastric irritation
What are side effects to report of digoxin?
pulse defecit, bradycardia, tachycardia,bigeminy, nausea, vomiting, diarrhea, weakness of arms/legs, extreme fatigue, anorexia, hazy, or blurred vision can signify digitalis toxicity
What is the antidote for digoxin?
Digibind (digoxin immune FAB)
What are diuretics used for?
Treat major diseases affecting the cardiovascular system; heart failure (remove excess sodium and water to relieve symptoms associated with edema and pulmonary congestion) and hypertension
What reduces cerebral edema?
Mannitol
What reduces ascites associated with liver disease and promotes sodium excretion and saves potassium?
spironolactone (Aldactone)
What does Lasix (furosemide) do?
It is a diuretic and can be used to treat hypercalcemia. It should be taken in the morning.
What is a loop diuretic?
It is the most potent type of diuretics. It treats severe fluid volume overload. Watch out for ototoxicity and hypokalemia. Patient should eat potassium rich foods.
What reduces intraocular pressure with glaucoma?
acetazolamide
What is nitroglycerin used for?
angina pectoris
How do you assess a patient before giving nitroglycerin?
Assess pain level, location, duration, intensity. Ask about last dose of nitrates and effectiveness.
What are side effects to report for nitroglycerin?
prolonged headache, hypotension, tolerance
What should patients avoid when on nitroglycerin?
alcohol, smoking (can cause vasoconstriction), calcium ion antagonists, beta adrenergic blockers
What route of nitroglycerin has the longest duration?
patch, place anywhere without hair
What should nurse teach patient about when they are on nitroglycerin?
change position slowly because patient may experience postural hypotension
What is lidocaine (Xylocaine)?
antiarrythmic
What is lidocaine used for?
ventricular arrythmias, convert arrythmia to normal sinus rhythm
What assessments should nurses do before giving the patient lidocaine?
obtain data relating to the 6 cardinal signs of CV disease to be used as a baseline; Assess and record data relating to the patient's basic mental status
What side effects of lidocaine should be reported?
light headedness, muscle twitching, hallucinations, agitation, euphoria, respiratory depression
What are the drug interactions for lidocaine?
phenytoin, cimetidine, procainamide, tocainide, and beta adrenergic blockers (-lol) will enhance the therapeutic and toxic effects
What is succinycholine?
neuromuscular blocking agent
What are vasodilators used for?
relieve angina pectoris (chest pain) by inducing relaxation of peripheral vascular smooth muscles resulting in dilation of arteries and veins. They increase myocardial oxygen supply by dilating large coronary arteries and redistributing blood flow.
How do you administer vasodilators?
sublingual, transmucosal, translingual, topically, sustained release tablets, transdermal disk, and IV
What are the side effects of vasodilators?
hypotension, headache, tolerance
How do you treat hyperlipidemia?
cholestyramine (Questran)
What is cholestyramine (Questran) used for?
used in conjunction with dietary therapy (low fat and cholesterol) and exercise to decrease elevated cholesterol concentration in type 2 hyperlipidemia and to reduce the risk of atherosclerosis leading to CHD (coronary heart disease)
What assessments does the nurse do before giving cholestyramine (Questran)?
Serum triglyceride and cholesterol levels
Obtain any data related to GI alterations
what side effects come with cholestyramine (Questran)?
constipation, bloating, fullness, nausea, flatulence
What drug interactions occur with cholestyramine (Questran)?
reduces the effectiveness of Digitoxin, Warfarin, thyroxine, thiazide diuretics, phenobarbital, NSAIDS, tetracycline, amiodarone, beta blockers, fat soluble vitamins (ADEK), folic acid
What does pentoxifylline (Trental) do?
Decreases blood viscosity and improves blood flow by decreasing concentration of fibrinogen in blood, and preventing aggregation of RBC and platelets.
What is pentoxifylline (Trental) used for?
intermittent claudication
What are expectorants such as guaifenesin (Robitussin) used for?
Dry, nonproductive cough, remove mucus plugs from respiratory tract. Combined with bronchodilators, decongestants, antihistamines, or antitussives to aid in making nonproductive cough more productive. Effective if patient is well hydrated.
How do expectorant such as guaifenesin (Robitussin) work?
thins bronchial secretions to increase flow by decreasing mucus viscosity
How do antitussives such as codeine dextromethophan work?
suppress cough center in brain
What are antitussives such as codeine dextromethorphan used for?
used for dry, hacking nonproductive cough (decreases frequency and nocturnal spams)
How should you educate a patient on Lasix?
Teach them to rise slowly due to orthostatic hypotension. Tell them to administer Lasix with food or milk to decrease GI irritation. If they are allergic to sulfonamides they may also be allergic to Lasix. It should be taken in the morning to prevent nocturia.
What are some side effects of Lasix?
orthostatic hypotension (rise slowly), oral irritation (oral hygiene), dry mouth (ice chips, hard candy)
What should be done daily to a patient on Lasix?
Daily weight; need to watch for fluid and electrolyte imbalance
What should patients on spironolactone (Aldactone) be taught?
Do not take Potassium supplements or use salt substitutes
Should be administered with food
Don't administer at night (nocturia)
When is spironolactone (Aldactone) used?
It is used to treat edema and ascites that doesn't respond to other diuretics. It has been shown to reduce morbidity and mortality for patients with heart failure.
What are side effects of spironolactone (Aldactone)to report?
mental confusion, headache, diarrhea, dehydration, gynecomastia, decreased libido, breast tenderness
What are the most potent diuretics?
Loop diuretics
How do loop diuretics work?
Work on Loop of Henle and sometimes proximal and distal tubules to inhibit sodium chloride reabsorption. Water follows sodium so more water is excreted
What are loop diuretics used for?
severe fluid volume overload (excessive fluid accumulation), hypertension, edema, heart failure
What drugs can cause ototoxicity if combined?
Loop diuretics and aminoglycosides
Loop diuretics and Cisplatin
Note if patient speaks more loudly, asks for statements to be repeated, or plays the TV or radio louder
What are osmotic diuretics used for?
Decrease intraocular pressure (IOP) to treat closed angle glaucoma (decreases amount of intraocular fluid). Elevates osmotic pressure of the plasma, causing fluid from the extravascular spaces ro be drawn into the blood reducing IOP.
Thiazide diuretic-induced hyperuricemia
GOUT
How do Thiazide diuretics work?
acts on distal tubules of kidneys to block reabsorption of sodium and chloride ions from the tubule. The plasma uric acid is frequently elevated by thiazides, which inhibit uric acid excretion
How do you stop patient on thiazide diuretics from developing gout
Add a uricosuric agent or allopurinol to patient's medication regimen.
What should you educate patient who is taking (warfarin)Coumadin about?
They need to comply with the prescribed regimen and the need for lab data to determine the correct maintenance dose. Tell the patient to resume a regular schedule if one dose is missed. If two doses or more are missed, the patient should consult the physician.
Labs for Warfarin
PT/INR
Labs for Heparin
PTT, hemoglobin, platelet count; monitor for bleeding
Antidote for Warfarin
Vitamin K
Antidote for Heparin
protamine sulfate
What does aspirin do?
(anticoagulant)platelet inhibitor that causes the platelet to lose its ability to aggregate and form clots. Used for patients at risk for TIA and stroke.
How does heparin work?
Acts as a catalyst to accelerate the rate of action of naturally occurring inhibitor of thrombin, anti-thrombin 3 (heparin cofactor). In the presence of heparin, antithrombin 3 rapidly neutralizes thrombin, activated factors IXa, Xa, XI, and XII, and plasmin.
How is Novalog and Humalog (lispro) given?
given Subcutaneous
What is the only insulin that can be given IV?
Regular
how is NPH given?
Subcutaneous
How is Lantus given?
Subcutaneous
How is exubera given?
Inhalation powder
What drug class is albuterol in?
Beta-adrenergic bronchodilating agent
How does albuterol work?
relaxes smooth muscles of tracheobronchial tree to open bronchioles and alveolar ducts to greater air volume
What is albuterol used for?
asthma, bronchitis, emphysema, acute bronchospasms-RESCUE INHALER
How should the patient be assessed before being given albuterol?
baseline VS, presence of palpitations/arrhythmias, baseline mental status
What are the side effects to report of albuterol?
tachycardia, palpitations, nervousness, tremors, anxiety, restlessness, headache, nausea, vomiting, dizziness
What are some drug interactions of albuterol?
ticlopidine, tricyclic antidepressants, monoamine oxidase inhibitor, and other sympathetic agents enhance toxic effects
beta-adrenergic blocking agents decrease therapeutic effects
What are iron supplements used for?
treat iron deficiency anemias (patients should also increase iron intake (green leafy veggies, whole grains, meat, eggs, raisins)
how are iron supplements administered?
Use Z-track, so as not to stain the skin
What should patients be taught about iron supplements?
May cause black, tarry stools
What does Potassium Chloride do?
needed for the heart, acid-base balance, nerve conduction, body water balance, muscle contractions, most abundant intracellular mineral
What sources of food have potassium chloride?
citrus fruits, meat, milk, bananas, liver
Vitamins (Vital Amines)
Specific set of chemical molecules that regulate human metabolism and necessary to maintain health
13 Vitamins: 9 water soluble, 4 fat soluble (ADEK)
How do you administer Iron Dextran IM?
Use Z-track Method (Not to stain SC tissue or clothing). Inject deep in dorsal gluteal site 2-3 inches with 19-20 gauge needle. Give small amount and check for allergic reaction before giving complete dose.
What is sodium polystyrene sulfonate (Kayexalate) used for?
Used for hyperkalemia (removes potassium by exchanging sodium ions for potassium ions in the intestines)
What are corticosteroids used for?
immunosuppressive, anti-inflammatory
What are glucocorticosteroids used for?
have anti-inflammatory and antiallergenic effect used to relieve symptoms of Rheumatoid Arthritis (RA), adrenal insufficiency (Addison's), severe psoriasis, urticaria, chronic eczema, multiple myeloma, Hodgkins disease, leukemias, and collagen disease
What is the use of Erythromycin opthalmic ointment in the newborn?
Erythromcin (Ilotycin): antibiotic used prophylactically to prevent opthalmia neonatorum, which is caused by N. gonorrhoeae. Also effective against C. trachomatis.
Prevention of postpartum gonorrhea or chlamydia eye infections
What are the side effects of contraceptive therapy?
nausea, weight gain, spotting, changed menstrual flow, missed periods, depression, mood changes, chloasma, headaches, Consult doctor if symptoms don't resolve in 3 months
What symptoms should patient on contraceptive therapy report?
vaginal Discharge, breakthrough bleeding, yeast infection, blurred vision, severe headaches, dizziness, leg pain (increased risk of DVT), shortness of breath, acute abdominal pain
What is the minipill?
Oral contraceptive, taken daily, that contains ONLY progestin (Nor-QD, Ovrette)
What is Pyridium (phnazopyridine) and how does it work?
Urinary analgesic; Excreted through urinary tract and produces a local anesthetic effect on mucosa of the ureters and bladder. It acts within 30 minutes after oral administration.
What is Pyridium used for?
Relieves burning, pain, urgency, and frequency associated with UTIs. Also relieves bladder spasms which relieves resulting urinary retention
What should patients be taught about Pyridium?
will stain urine orange; stains anything urine touches
How does allopurinol (Zyloprim) work?
Blocks the terminal steps in uric acid formation by inhibiting the enzyme xanthing oxidase
What is allopurinol used for?
treatment of primary gout or gout secondary to antineoplastic (chemo, cell death)therapy. Is NOT effective in the treatment of acute attacks by gouty arthritis.
How does lactulose (Cephulac, Dupphulac) work?
acts as a stool softener by pulling water into the colon. Decreases ammonia levels
What is lactulose used for?
Hepatic encephalopathy (reduces formaton of ammonia in gut), laxative
Use in diabetics with caution (Contains some free lactose, galactose, and other sugars)
Beta-Adrenergic Blocking Agents
Antihypertensives; -lol; side effects: bradycardia, peripheral vasoconstriction, bronchospasms, wheezing, heart failure
ACE inhibitors
Antihypertensives; -pril; side effects: nausea, fatigue, headache, diarrhea, orthostatic hypotension, swelling of face, eyes, lips, tongue, difficulty breathing, dry cough
Prevents angiotensin I from converting to angiotensin II
Calcium Ion Agonists
Antihypertensives; -pine; side effects: hypotension and syncope
Alpha I adrenergic blocking agents
Antihypertensives; -zosin; Side effects: drowsiness, headache, dizziness, weakness, lethargy, tachycardia, fainting
Central Acting Alpha II Agonists
Antihypertensives; Ex: Clonidine;side effects: drowsiness, dry mouth, dizziness, depression
Direct Vasodilators
Antihypertensive;(Menoxadil/Rogain): Side effects:nausea, palpitations, tachycardia, numbness and tingling in the legs, nasal congestion, orthostatic hypotension, fever, chills, joint and muscle pain, skin eruptions
An easy way to remember the side effects of this classification is the slogan "wet and slow"
cholinergic
An easy way to remember the side effects of this classification is the slogan "fast and dry"
anticholinergic
Drug dosage is regulated by the PTT
heparin
This histamine antagonist inhibits the metabolism of certain benzodiazepines, beoculine, and beta blockers. This histamine antagonist can also cause gynecomastia in males.
Tagamet
Symptoms of this disorder are lethargy, constipation, and weight gain
hypothyroidism
Antidote for bradycardia and overdose of cholinergic agents
atropine
Diuretic of choice to treat cerebral edema
mannitol (Osmitrol) (Drug Class: osmotic diuretic)
This drug blocks the synthesis of T3 and T4 in the thyroid gland
(PTU, Propacil) propylthiouracil and (Tapazole) methimazole
Antidote for acetaminaphen or Tylenol poisoning
acetylcysteine (Mucomyst)
Use of this coating agent is like putting a Band-Aid on ulcerated mucosa
sucrafate (Carafate) (Drug Class: coating agent)
Nurses working with this must follow radiation precautions for handling the drug as well as the excretions
Iodine 131
This type of insulin is a clear solution
Regular
This type of insulin is a cloudy solution
NPH
this immune globulin can prevent hemolytic disease of the newborn
Rhogam
A patient who is allergic to sulfa is more likely to be allergic to this class of oral hypoglycemic drugs
sulfonylurea
Administration of this drug turns all body secretions red-orange in color
rifampin (Rifadin)
This type of insulin is the only one that can be administered by IV
Regular
When a diabetic patient refuses to eat it can result in this
Hypoglycemic
Looking for the drug suffix, the suffix of beta adrenergic blockers that decrease heart rate and decrease blood pressure and decrease cardiac ouput
lol
How should the dose of beta adrenergic blockers be stopped?
taper it off
This class of antihypertensives prevents the conversion of angiotensin I to angiotensin II, decreasing pressure and increasing renal blood flow
ACE inhibitors
What is the suffix of ACE inhibitors?
"pril"
This drug provides sodium excretion but saves potassium
spironolactone (Aldactone)
This drug class is specifically used to treat G.I. ulcerations from NSAID and aspirin use
Drug class:gastrointestinal prostaglandin
Drug: misoprostal (Cytotech)
Doses of this drug are based on prothrombin time.
warfarin (Coumadin)
The antidote for opiate agonists overdose
(Narcan) naloxone
This drug may be given PO or IV for tuberculosis as well as meningococcal infection
rifampin (Rifadin)
Name a drug other than aspirin that inhibits platelets.
clopidogrel (Plavix)
These drugs lower the affinity of gastric acid by decreasing the concentration of hydrogen ions.
Antacids
This unusual drug is antibacterial, trichimonacidal, protozoacidal, and amoebacidal
metroonidazole (Flagyl)take when you travel
This class of drugs inhibits movements of calcium ions across cell membranes, decreasing cardiac dysrrhthymias, decreasing heart rate, decreasing blood pressure
Calcium Channel Blockers -pine
This drug is administered to all newborns because the newborn gut is not yet colonized with bacteria to synthesize it
Vitamin K shot
A drug commonly used on babies to prevent a common eye infection in newborns is called opthalmia neonatorum
erythromycin opthalmic ointment (Ilotycin)
First line drug in the treatment of HIV infection
zidovudine (Retrovir)-AZT, ZDV given to pregnant females so that the baby does not get HIV)
this class of diuretics is used to treat severe fluid volume overload
loop diuretics
This class of antibiotics is particularly effective against skin and rickettsial infections (Lyme disease, acne, rocky spotted fever)
Tetracyclines
The drug dosage is regulated by the International Normalized Ratio or INR
warfarin or Coumadin
Other than urine output, a nursing measure to evaluate the degree of patient diuresis
Daily weight
This drug can be given to counteract neurologic side effects of INH and it is also the antidote for INH toxicity
Vitamin B6 (pyridoxine)
When hearing is damaged by aminoglycosides, it is this cranial nerve that is affected
eight (acoustic)
Oral thrush and vaginal yeast infection are examples of this complication of antibiotic therapy
Super infection or secondary infection
this antiviral drug is used specifically for influenza A and commonly used in the treatment of Parkinson's disease.
amantadine (Symmetrel)
this drug suffix is "mycin" so it is a mycin but it is not an aminoglycoside
Drug class: macroclides ex: erythromycin, azithromycin
Pediatric therapy is not recommended with this class of antibiotics due to risk of cartilage damage this class is also teratogenic
Quinolones (ex. Cipro, levaquin)
This antitubercular has a side effect of red-green color change
ethambutol (Myambutol)
A systemic antifungal given PO used to treat ringworm. The only one
griseofulvin microsize (Griseofulvin)
Names of lab test used to determine low and high plasma aminoglycoside levels
peaks and troughs
In order to prevent respiratory depression, check the records of post-op patients to determine if these drugs were given.
neuromuscular blocking agents (succinylcholine, usually paralyzing drugs)
This direct vasodilator is used topically for men with male pattern baldness
Rogaine or minoxidil
Symptoms of this disorder are tremor, weight loss, tachycardia and nervousness
hyperthyroidism
A lab value of 39 mg/dL serum glucose would indicate this
hypoglycemia
This recommendation should be given to a female patient taking an oral contraceptive pill concurrently with an antibiotic
use an alternative form of birth control
Jeff Foxworthy might like this side effect of vancomycin, but a patient would not
redneck "redman redneck syndrome"
This type of oral contraceptive pill contains progestin only
minipill
Alter ego or another name for penicillinase
Beta-lactamase
Medical term for damage to renal function that can result from aminoglycoside use.
nephrotoxicity
This common serious side effect of INH is worse in an alcoholic patient
liver toxicity or hepatotoxicity
This common OTC drug inhibits platelets
Aspirin
Trade or brand name for acyclovir
Zovirax
This antibiotic class in combination with loop diuretics can cause ototoxicity
aminoglycosides
Drug of choice to induce labor at term
oxytocin (Pitocin)
This class of drugs is frequently prescribed in combination with anti-hypertensives to potentiate the hypotensive result
Diuretics
This condition is caused by excessive production of T3 and T4, or TSH
Hyperthyroid
This condition can result from severe and untreated GERD.
Barret's esophagus, esophageal varices
A severe allergic reaction to an antibiotic
anaphylaxis
This systemic antifungal can have side effects of malaise, fever, chills, HA, vomiting: some nurses call it amphoterrible
Amphotericin B
Tooth enamel may be permanently stained yellow, green, or brown if given to a child under 8
tetracycline
Medical term for damage to hearing that can result from aminoglycoside use
ototoxicity