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Textbook: Pharmacology and the Nursing Process
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Contradictions: ulcerative colititis/enteritis. severe uncontrolled HTN, renal/hepatic disease, COPD, hypersensitivity to this product or other thrombolytic enzymes.
Signs of Toxicity: NA
Administration Guidelines: IV use
Precautions: pregnancy(b), aterial emboli, hepatic dise
Side Effects/Interactions: headache, nausea, vomiting, decreased hematocrit, bleeding, rash, urticaria, SOB, bronchospasm, retroperitoneal bleeding.
Contradictions: hypersensitivity, optic nerve atrophy.
Precautions: pregnancy(A), breastfeeding, children.
Interactions: increased absorption when taken with prednisone;
Side Effects: CHF, pulmonary edema, diarrhea, anaphlactic shock
Administration: keep away from light and heat. PO, IM, and IV
Contradictions: hypersensitivity, any anemia other than megaloblastic, vitamin b12 deficency.
Precautions: pregnancy A
Side Effects: bronchospasm, flushing.
Administration: PO, Im, Subcut, IV
* Store in a light resistant container.
Contradictions: hypersensitivity, ulcerative colitis/ enteritis, hemosiderosis, hemochromatosis, pepric ulcer disease, hemloytic anemia, cirrhosis.
Precautions: prenancy B
Side Effects: nausea, constipation, epigastric pain, black and tarry stools
Toxicity: nausea, vomitting, diarrhea, green then tarry stools, hematemsis, pallor, cyanosis, shock, and coma.
** Avoid reclining 30 minutes after taking iron(could cause esophagel erosion).
Precautions: Pregnancy C, acute renal disease, asthma, lupus, hypotension,
Side Effects: seizure, shock, nausea, leukocytosis,
Toxicity: nausea, vomiting, diarrhea, fever, abdominal pain, cyanosis, CV collapse
Black Box: hypersensitivity, allergy, anaphylaxis, rash, purititis, fever, chills, wheezing
Overdose: Give Benadrayl or Epinephrine
Contradictions: hypersensitivity to H-1 receptors. acute asthma attack, lower respiratory disease, neonates.
Precautions: IOP, cardiac/renal disorders, HTN, bronchial asthma, seizure disorder, peptic ulcers, hyperthyroidism
Side Effects: dizziness, drowisness, retention of urine. Avoid us in children.
Treatment of OD: Diazepam, vasopressor, phenytoin IV.
Contradictions: hypersensitivity, breastfeeding, agranulocytosis, bone marrow suppression, coma, jaundice, Reye's syndrome
Precautions: pregnancy C, cardiac/hepatic/renal, seizure disorder, glaucoma, COPD
Side Effects: dizziness, drowsiness, constipation, urinary retention
Black Box warning: infants, neonates, children, intraareterial/SUBcut administration, extravasatition.
Contradictions: breastfeeding, hypersensitivity to opiates, respiratory depression, increased ICP, severe respiratory disorders.
Precautions: pregnancy C, geriatric patients, cardiac dysrhythmias, prostatic hypertrophy, bowel impaction.
Side Effects: drowisness, sedation, nausea, vomiting, anorexia, constipation,
Treatment of OD: naloxone diuted with NaCl and given IV push
** can cause respiratory depression and dysfunction
Precautions: pregnancy C, fever, hepatic disease, asthma, chronic cough
Side Effects: dizziness, nausea,
*Avoid smoking, alcohol, dust
Administration: PO, SUS
Contradictions: Pregnancy D, breastfeeding, children with flu-like symptoms, hypersensitivity to salicylates.
Precautions: abrupt discontinuation, acetaminophen/NSAIDs hypersensitivity,
Side Effects: nausea, vomiting, rash. Toxicity: hepatotoxicity dark urine, clay colored stools, yellowing of the skin, sclera, itching, abdominal pain, fever diarrhea.-- Ototoxicity- may occur after long term therapy.
Contradictions: pregnancy D, hypersensitivity to NSAIDs, asthma, severe renal/hepatic disease, ulcer disease
Precautions: pregnancy, geriatrics, children, other anti-inflammatory agents.
Side Effects: Mi, stroke, hepatitis, Gi ulceration, bleeding, perforation, blood dyscrasias,
Black Box Warning: cardiac status, thrombotic events, GI status, ulceration,
Contradictions: pregnancy D, hypersensitivity to product.
Precautions: Pregnancy, breastfeeding, and children.
Side Effects: headache, anorexia
Black Box warning: GI bleeding, MI, stroke
Toxicity: blurred vision, ringing in ears.
Tx of OD: lavage,
Contradictions: hypersensitivity to yellow dye number 5, alcohol,
Precautions: pregnancy B, breastfeeding, geriatrics, and anemia.
** Very liver toxic. Tx: gastric lavage.
Administration: PO and rectal
Contradictions: sepsis, active infections
Precautions: pregnancy B, breastfeeding, children
Side Effects: headache, injection site reactions, pharyngitis, cough, rhinitis
** Do not give concurrently with immunizations.
Contradictions: hypersensitivity, moderate to severe CHF
Black Box: infection, neoplastic disease, TB
Side Effects: headache, dizziness, depression, vertigo, anxiety, fever, chills, flu-like symptoms, nausea, vomiting, abdominal pain, constipation, dyspepsia, flatulence. rash.
** DO not administer to patients with infections.
Black Box Warning: perioperative pain in CABG, stroke, GI bleeding, and MI
Side Effects: headache, nausea, vomiting, constipation,
Toxicity: sx include blurred vision and tinitis,
Side Effects: headache, nausea, vomiting, anorexia, malaise,
Uric Acid levels should be less than 6mg/dl- levels will need to be monitored q 2/weeks
Administer: PO and IV.
Side Effects: A-fib, esophagel perforation, angioedema.
Contradictions: hypersensitivity, esophageal delayed emptying,
Serious Reactions: angioedema, Stevens-Johnsons Syndrome, A-Fib.
* take with an 8oz glass of water and remain upright/no eating for 30 minutes.
Side Effects: pharyngitis, oral candidasis, upper respiratory infeciton.
Contradiction: hypersensitivity to this product or milk protein.
Not for use in acute asthma attacks.
Side Effects: dizziness, fatigue, headache, abdominal pain, influenza cough, LFT increase
Assess to Chrug- Strauss Syndrome.
DOSE AT NIGHT TIME
Side Effects: minimal systemic effects, dry mouth and throat irritation, peanut allergy
Administration: MDI or nebulizers four times a day.
Side Effects: systemic effects like constipation, and urinary retention. cough, sinusitis
Administration: DPI once daily
Administer: take 15 minutes before activity.
Side Effect: headache, dizziness,
Short Acting Beta 2 agonist
Side Effects: tachycardia, angina, jitterness, and tremor
Administration: MDIs, DPIs, Nebulizers--1-2 puffs or treatments ~ 3-4 times a day
Most patients with persistent asthma should be on long-acting drugs. Preventative therapy.
Administration: Used for patients with frequent attacks. Fixed schedule dosing- not prn use. Not first choice agents for long-term control. Should not be used alone
Side Effects: May increase the risk of severe asthma and asthma-related death(they only tx the symptoms(bronchoconstriction) and not the cause(inflammation)
Side Effects: anxiety, restless, insomnia, dizziness, palpatstations, sinus tachycardia, nausea, vomiting.
Administraiton: monitor levels, 10-20mg/dl.
administered PO and very rarely used.
Side Effects: tremor, anxiety, anorexia, vomiting,
WARNING: MAOIs or Tricyclic antidepressants can cause HTN crisis when used with this
Administer: take at bed time,
Side Effects: dry mouth, constipation
Administer: do not take 30 mins before or after taking an antacid. Take on an empty stomach.
Side Effects: Antiandrogenic effects- risk of low libido, ED, and gyneomastia(breast tissue development). CNS effects. Pneumonia. IV bolus – can experience hypotension and dysrhythmias
** Gynomastia and Impotence may occur. Monitor for bleeding. Smoking decreases the effects.
Side Effects: Significant ones uncommon. Does not bind to androgen receptors
Administer antacids one hour before and after. Do not take maxim OTC for more than two weeks.
Aluminum Hydroxide (Maalox)
Side Effects: constipation, hypophostamia, Stools may appear white or speckled.
Side Effects: Does not bind to androgen receptors. Possible increased risk for pneumonia due to elevation of pH
Administer: 1 before or 2 hours after meals.
Side Effect: headache, dizziness, diarrhea, flatulence, rash, cough,
Administer: same time daily, one hour before the meal.
Report: diarrhea, abdominal pain, tarry stools.
Side Effects: headache, abdominal pain, diarrhea, rash. Hyperglycemia can occur.
Report Severe Diarrhea, or Tarry Stools.
Side Effects: headache, dizziness, asthenia, diarrhea, abdominal pain, vomiting, constipation, flatulence. Stevens-Johnsons syndrome can occur.
Contradicted: in Asain population.
Hypoglycemia can occur. Report black, tarry stools.
Side Effects: nausea, abdominal pain, erucationg
Administer: with food BID.
Notify prescriber of GI symptoms, diarrhea, hypersensitivity reactions.
Docusate sodium (Colace)
Side Effects: cramps, nausea,--no regular occurying side effects.
Administer: with milk or juice to decrease bitter taste. Take morning or night.
Side Effects: nausea, vomiting, anorexia, cramps.
Not to be used long term, can cause loss of bowel tone.
Warning: Eclampsia, seizure precautions.
Side Effects: nausea, vomiting, abdominal pain,
store in light resistance containers.
warning; blood dyscrasias and allergic reactions.
Side Effects: headache, dizziness, depresison, vertigo, fatigue, anxiety, chills, flu-like symptoms. N/V, constipation, dyspepsia, rash, dermatitis.
Black Box Warnign: TB, Infection, neoplastic disease.
Side Effects: Most common – dose-related diarrhea (13%-40%) and abdominal pain (7%-20%)
Contraindicated during pregnancy – category X**(can be used on the cervix when a woman is in labor. Causes effacement and dilation of the cervix)
Significant actions need to be taken to ensure that pregnancy does not occur after therapy starts and that patient is not pregnant at therapy initiation.
Administeration: oral therapy is generally preferred. Initial dosage is 1-1.5 mg
Toxicity: hyper salivation, nausea or vomiting, loss of appetite or anorexia, changes in the rate and rhythm of the heart, visual disturbances just like yellowish tints, diarrhea, dizziness,
Normal Levels: should remain at 0.6-1.2.
monitor k+ levels.
Slow impulse conduction in the atria/ventricles, and HIS-Purkinje system.
Largest group of anti-dysrhythmic drugs
Effects in the heart
SA node: they reduce automaticility
AV node: they slow conduction velocity
In the atria and ventricles: they reduce contractility
Delay repolarization of fast action potentials
Prolong action potential duration and refractory period
Both drugs suppress dysrhythmias by decreasing conduction through the AV node and refractory automaticity in the SA node
Long-term beta or calcium channel blocker therapy to slow ventricular rate
PRN flecainide or propafenone (class Ic dysthrythmics)
Warfarin for clot prevention
Non-Pharmacologic Treatment, DC cardioversion, Short treatment drugs (amiodarone), Radiofrequency ablation of of the dysrhythmia source
HR is 150-250 beats/minute
Carotid sinus massage
IV beta blockers or calcium channel blockers emergently, then orally when stable
Arises from a single, rapidly firing ventricular ectopic foci
Rate in the 150-250 beats/minute
Cardioversion is treatment of choice
IV meds: amioadorone, lidocaine, procainamide
Oral sotalol for long-term control if needed
Implantable cardiac defibrillator (ICD)
Caused by 1 or more ectopic foci
Don’t treat unless additional signs of heart disease
Treat in acute MI because they may be precursor to VT or VF
Beta blockers are the drugs of choice
Short half-life (1.5-10 seonds)
Not effective for atrial dysrhythmias
Moderate disease = angina pain
Severe disease = acute myocardial infarction (MI/heart attack)
Pathology of athersclerosis
Fatty streak in the arterial wall
Deposition of fibrous plaque
Atherosclerotic plaque grows and impedes blood flow
Plaque cap encourages the formation of thrombi (clots)
Deliver triglycerides to nonhepatic tissues
Influence on athersclerosis
Probably contribute to athersclerosis
Account for the majority (60-70%) of all cholesterol in the blood
Delivery of cholesterol to non-hepatic tissues
Influence on atherosclerosis
Definitely contributes to athersclerosis
Direct relationship between higher LDL levels and CHD
Account for 20-30% of all cholesterol in the blood
Carries cholesterol from peripheral tissue back to the liver
They promote cholesterol removal
Protect against athersclerosis
LDL < 100 mg/dL
HDL > 40 mg/dL (men) >45 mg/dL (women)
Triglycerides < 150 mg/dL
Men >45 years
Women >55 years
Family history of CHD in 1st degree relative
Males <55 years
Females A<65 years
Current cigarette smoking
Low HDL cholesterol <40 mg/dL
HMG-CoA reductase inhibitors (statins)
Atorvastatin, simvistatin, resuvastatin, others…
Bile acid sequestrants
About this deck
Textbook: Pharmacology and the Nursing Process
Size: 65 flashcards