SLCC Pharmacology Drugs
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| Use: Isoflurane (Forane) | Inhalation anesthetic
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| Use: Lidocane (Xylocaine) | 1) Infiltration, ophthalmic, dental, obstetric anesthesia.
2) Regional blocks
3) Nerve blocks
NOTE: Local
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| Contraindication: Isoflurane (Forane) | 1) Hypersensitivity
2) Predisposition to malignat hyperthermia
NOTE: (can cause malignat hyperthermia)
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| Contraindication: Lidocane (Xylocaine) | 1) Hypersensitivity ( Amide anesthetics, Sulfites, Methyl paraben)
2) Infection or inflamation at site of administration)
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| Adverse Effects: Isoflurane (Forane) | Serious: Respiratory depression
Common: Hypotension, Hypothermia, N/V
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| Adverse Effects: Lidocane (Xylocaine) | Serious: Allergic reactions
Common: Minimal unless accidental IV or intrathecal
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| Nursing Interventions: Isoflurane (Forane) | • Low stimulus environment
• Preoperative teaching
Anesthesia
Surgical procedure
• Monitor respiratory status
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| Nursing Interventions: Lidocane (Xylocaine) | • Calm reassurance
• Read labels carefully
• Right preparation for right procedure
• Safety due to lack of sensation
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| Pharmacokinetics: lorazepam (Ativan) | Highly lipid soluble and protein bound
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| Use: lorazepam (Ativan) | • Management of anxiety
• Short-term relief of anxiety symptoms
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| Contraindications: lorazepam (Ativan) | • Hypersensitivity
• Psychosis, hepatic disease
• Acute narrow-angle glaucoma
• <6 months of age
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| Adverse Effects: lorazepam (Ativan) | Common: (Sedation and ataxia, Hangover effect)
Serious (Anterograde amnesia, Psychosis & Suicidal tendencies)
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| Lifespan Alert: lorazepam (Ativan) | • Elderly: reduce dose, start with smallest dose
• Children: start with smallest dose
• Cultural: Asians more sensitive
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| Nursing Interventions: lorazepam (Ativan) | • Admin with food or water
• Protect IM/IV from light
• Divide oral doses (largest at bedtime)
• Safety measures (effective contraceptive methods, limit use to 2 weeks, identification, impaired mental or physical ability)
• Avoid other CNS depressants
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| CENTRALLY ACTING MUSCLE RELAXANTS | cyclobenzaprine (Flexeril)
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| SPASMOLYTICS: CENTRALLY and PERIPHERALLY acting | Central: Baclofen (Liorsal)
Peripheral: Dantrolene (Dantrium)
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| Pharmacodynamics: cyclobenzaprine (Flexeril) | • Reduces pain and tenderness
• Improves mobility
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| Use: cyclobenzaprine (Flexeril) | Muscle spasms
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| Adverse Side Effects: cyclobenzaprine (Flexeril) | Common: Sedation
Serious: Agitation, auditory or visual hallucinations, seizures, psychotic symptoms
NOTE: Effects with abrupt withdrawal
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| Lifespan Alert: cyclobenzaprine (Flexeril) | • Elderly: more prone to sedation & anticholinergic effects
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| Nursing Interventions: cyclobenzaprine (Flexeril) | • May take 1-2 days for optimal effects
• Take exactly as prescribed
• Avoid other CNS depressants
• Never abruptly withdraw (with long term and high dose therapy)
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| Pharmacodynamics: baclofen (Lioresal) | Reduces excessive reflex activity
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| Pharmacokinetics: baclofen (Lioresal) | Crosses BBB
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| Use: baclofen (Lioresal) | Muscle spasms or spasticity
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| Contraindications: baclofen (Lioresal) | Patients that use spasticity to maintain posture or balance
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| Adverse Effects: baclofen (Lioresal) | Common: Seditaion
Serious: Agitation, auditory or visual hallucinations, seizures, psychotic symptoms
NOTE: Effects with abrupt withdrawal
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| Lifespan Alert: baclofen (Lioresal) | Elderly: more prone to sedation and other CNS effects
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| Nursing Interventions: baclofen (Lioresal) | • Evenly space
• Change positions slowly
• Never abruptly stop
• Avoid other CNS depressants
• Diabetes: increases blood and urine glucose levels (use capillary blood for monitoring)
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| Pharmacodynamics: dantrolene (Dantrium) | Direct effect on muscle cells (no CNS effects)
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| Pharmacokinetics: dantrolene (Dantrium) | Metabolized to active metabolites
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| Use: dantrolene (Dantrium) | • Muscle spasms or spasticity
• Drug of choice for malignant hyperthermia
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| Contraindications: dantrolene (Dantrium) | • Patients that use spasticity to maintain posture or balance
• Active liver disorders
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| Adverse Effects: dantrolene (Dantrium) | Common: Muscle weakness
Serious: Fatal hepatitis (especially women >35 and taking estrogens)
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| Nursing Interventions: dantrolene (Dantrium) | • Upper motor neuron disorders: may take 1 week or longer for therapeutic effects
• Give with food or milk
• Assist with ambulation
• Teach symptoms of hepatitis
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| Drugs that Decrease Sodium Influx | phenytoin (Dilantin)
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| Drugs that Decrease Calcium Influx | ethosuximide (Zarontin)
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| Pharmacokinetics: phenytoin (Dilantin) | • Absorption: rate & extent vary; IM-slow & unpredictable
• 87-93% protein bound
• CYP inducer
Half-life increases with dosages
Note: 10-20 Mcg/ml
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| Pharmacokinetics: ethosuximide (Zarontin) | • Half-life
o Children: 30 hours
Adults: 60 hours
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| Use: phenytoin (Dilantin) | Drug of choice for most seizure types (not absence)
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| Use: ethosuximide (Zarontin) | Drug of choice for absence seizures
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| Contraindications: phenytoin (Dilantin) | AV heart block Sinus bradycardia
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| Contraindications: ethosuximide (Zarontin) | Hypersensitivity
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| Adverse Effects: phenytoin (Dilantin) | Common: Sedation, nystagmus, ataxia, HA, nausea, gingival hyperplasia
Serious: Blood dyscrasias, Lupus erythematosus Stevens-Johnson syndrome
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| Adverse Effects: ethosuximide (Zarontin) | Common: Sedation, nausea, ataxia, HA, blurred vision, pruritis
Serious: Pancytopenia
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| Nursing Interventions: phenytoin (Dilantin) | • Maintain therapeutic concentration (10-20 mcg/mL)
• Good oral hygiene
• Frequent dental follow-up
• Take with food (except milk & antacids)
Abrupt withdrawal may cause status epilepticus
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| Nursing Interventions: ethosuximide (Zarontin) | •Maint therapeutic concentration (40-100 mcg/mL)
•Store drug in tight, lightresistant container, room temp
•Mont CBC
•Report S/S blood dyscrasias
•May color urine pink, brown, or reddish-brown
Abrupt withdrawal may cause status epilepticus
(Rotten p
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| NARCOTIC ANALGESICS (Strong, Mild, Agonist\Antagonist) | Strong: Morphine (Roxanol)
Mild: Codeine
Agonist\Antagonist: Pentazocine (Talwin)
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| Use: Morphine | Moderate to severe pain
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| Contraindications: Morphine | • Significant respiratory depression
• Increased ICP
• CNS depression
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| Adverse Effects: Morphine | Common: Light-headedness, Dizziness, N/V
Serious: Respiratory depression
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| Lifespan Alert: Morphine | Avoid in premature infants or during labor of premature infants
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| Nursing Interventions: Morphine | • Asses pain before & during therapy
• Individualize dose
• Monitor VS
• Have naloxone readily available
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| Use: codeine | • Mild to moderate pain
• Cough suppressant
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| Contraindication: codeine | • Respiratory depression
• Other CNS depressant use
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| Adverse Effects: codeine | common:
Cough suppressant
•Drowsiness, sedation, dry mouth, N/V, constipation
•Analgesic
Similar to morphine (milder)
•N/V
•Dizziness
•Light-headedness
•Euphoria
serious: Respiratory depression
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| Lifespan Alert: Codeine | Avoid in premature infants or during labor of premature infants
Note: Same as morphone
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| Nursing Interventions: Codeine | Same as morphine and avoid if patient’s health status requires a strong cough
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| Pharmcokinetics: pentazocine (Talwin) | • Significant first-pass phenomenon
• Bioavailability 20%
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| Use: pentazocine (Talwin) | • Moderate to severe pain
• Abused on the street
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| Adverse Effects: pentazocine (Talwin) | Common: N/V, Dizziness, Light-headedness, Euphoria
Serious: Respiratory & circulatory depression
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| Nursing Interventions: pentazocine (Talwin) | Same as other narcotics and avoid alcohol and other CNS depressants
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| CENTRALLY ACTING STIMULANTS | dextroamphetamine
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| RESPIRATORY STIMULANTS | caffeine
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| Use: dextroamphetamine | • Narcolepsy
• ADHD
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| Adverse Effects: dextroamphetamine | Restlessness, insomnia, dizziness, overstimulation, palpitations, tachycardia, hypertension, dry mouth, unpleasant taste, diarrhea
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| Nursing Interventions: dextroamphetamine | • Take with food in morning
• Take at least 6 hours before bedtime
• Baseline assessment to compare treatment outcomes
• Avoid other stimulants
• Abuse potential
• Adhere to dosing scheduling
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| Pharmacokinetics: caffeine | • Crosses BBB and placenta
• Limited metabolism in neonates
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| Use: caffeine | • Post-surgical respiratory depression
• Neonatal apnea
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| Adverse Effects: caffeine | • Caffeine withdrawal syndrome with abrupt cessation
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| DRUGS AFFECTING ADRENERGIC FUNCTION | • ADRENERGIC AGONISTS NONSELECTIVE: epinephrine
• ADRENERGIC ANTAGONISTS ALPHA: prazosin (Minipress)
• ADRENERGIC ANTAGONISTS BETA: propranolol (Inderal)
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| Phamacodynamics: epinephrine | Stimulates CV, skin & viscera, respiratory receptors
NOTE: Open Glaucoma
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| Use: epinephrine | • Anaphylactic shock
• Cardiac emergencies
• Asthma
• Glaucoma
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| Contraindications: epinephrine | • Hypersensitivity
• Active labor
• Closed angle glaucoma
• General anesthesia
• Severe organic cardiac disease
• Shock other than anaphylaxis
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| Phamacodynamics: prazosin (Minipress) | • Decreases sympathetic tone of vasculature
• Dilate arterioles and veins
• Lowers supine and standing BP
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| Use: prazosin (Minipress) | • Refractory CHF
• HTN
• Raynaud vasospasm
• Prostatic obstruction
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| Contraindications: prazosin (Minipress) | Hypersensitivity
Note: Orthostatic Hypotension
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| Pharmacodynamics: propranolol (Inderal) | • Beta-1 blockade Heart & Kidneys (decrease BP)
• Beta-2 blockade Many adverse effects (bronchospasm, hypoglycemia, peripheral vasoconstriction)
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| Phamacokinetics: propranolol (Inderal) | First-pass phenomenon
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| Use: propranolol (Inderal) | • Hypertension
• Angina
• Cardiac arrhythmias
• Migraines
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| Contraindications: propranolol (Inderal) | • Bradycardia
• Complete heart block
• Cardiogenic shock, uncompensated cardiac failure
• Reactive airway diseases
• Raynaud disease
Note: Take pulse, don't stop abruptly, Rebound Tachycardia
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| Adverse Effects: epinephrine | Common:
• Fatigue
• Sleep disturbances
• Tremor
• Weakness
• Dizziness
• Hyperglycemia
• Tachycardia
Serious:
• Cardiovascular stimulation
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| Adverse Effects: prazosin (Minipress) | Common:
• Light-headedness
• Dizziness
• HA
• Drowsiness
• Weakness
• Lethargy
• Nausea
• Palpitations
Serious:
• First dose syncope
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| Adverse Effects: propranolol (Inderal) | Common:
• Postural hypotension
• Bronchospasm
Serious:
• MI
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| Nursing Interventions: epinephrine | • Monitor CV status closely
• Schedule doses to minimize sleep disruption
• Allow appetite and meal times to coincide
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| Nursing Interventions: prazosin (Minipress) | • No OTC drugs
• Safety with CNS effects
• Safe ways to deal with postural hypotension
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| Nursing Interventions: propranolol (Inderal) | • Hypotensive stability may not occur for 2-3 weeks
• Take exactly as prescribed
• Never double the dose
• Minimize stressors
• Teach taking pulse
• Safe mobility
• Never abruptly stop taking
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| DRUGS AFFECTING CHOLINERGIC FUNCTION | • AGONISTS DIRECT-ACTING MUSCARINIC: pilocarpine (Akarpine)
• AGONISTS DIRECT-ACTING NICOTINIC: nicotine
• ANTAGONISTS ANTIMUSCARINIC: atropine
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| Pharmacodynamics: pilocarpine (Akarpine) | • Topical: Miosis, decrease IOP
• Oral: stimulates secretions of exocrine glands
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| Use: pilocarpine (Akarpine) | • Simple and acute glaucoma
• Pre & post-operative intraocular tension
• Mydriasis
• Xerostomia
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| Contraindications: pilocarpine (Akarpine) | • Hypersensitivity
• Oral: severe respiratory disease
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| Adverse Effects: pilocarpine (Akarpine) | Common:
• Blurred vision
• Myopia
Serious:
• Cholinergic crisis
• Bronchospasm
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| Nursing Interventions: pilocarpine (Akarpine) | • Topical: administer into conjunctival cul-de-sac & use aseptic technique
• Have antidote available
• S/S of cholinergic crisis
Note: More Secretions
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| Pharmacodynamics & Pharmacokinetics: nicotine | • Pharmacodynamics: Potent ganglionic and CNS stimulant
• Pharmacokinetics: Extensive first-pass phenomenon
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| Use: nicotine | Adjunct to smoking cessation programs
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| Contraindications: nicotine | • Immediately post MI
• Life threatening dysrhythmias
• Severe angina
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| Adverse Effects: nicotine | Common:
• Erythema
• Pruritis & burning
• HA
• Insomnia
Serious:
• Vasculitis
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| Nursing Interventions: nicotine | • Adhere to recommended dosing
• Promote rest and sleep by adjusting timing of last dose
• Avoid other CNS stimulants
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| Pharmacodynamics: atropine | • Blocks GI & smooth muscle, exocrine glands, heart, eye
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| Use and Contraindications: atropine | Use:
• Prevent postoperative secretions
• Drug of choice in cholinergic crisis
Contraindications:
• Hypersensitivity to sulfites
• Myasthenia gravis
• Acute MI
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| Adverse Effects: atropine | Common:
• Blurred vision
• Constipation
• Dry mouth
• Urinary retention
Serious:
• Severe bradycardia
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| Nursing Interventions: atropine | • Take exactly as prescribed
• Good oral hygiene
• Fluid replacement
• Safety issues for blurred vision
• Avoid OTC and herbal meds
Note: Less Secretions
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| DRUGS FOR UPPER RESPIRATORY SYSTEM | ANTITUSSIVE: dextromethorphan (Benylin)
DECONGESTANT: psuedoephedrine
ANTIHISTAMINE: fexofenadine (Allegra)
EXPECTORANT: guaifenesin
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| Pharmacodynamics: dextromethorphan (Benylin) | Suppresses cough reflex
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| Use & Contraindications: dextromethorphan (Benylin) | Use:
• Nonproductive cough
Contraindications:
• cough resulting from emphysema or asthma
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| Adverse Effects: dextromethorphan (Benylin) | Common:
• N/V and irritability
Serious:
• Drowsiness
• Dizziness
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| Lifespan alert: dextromethorphan (Benylin) | Not for children <6
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| Nursing Interventions: dextromethorphan (Benylin) | • Administer at evenly spaced intervals
• Safety precautions
• Seek medical attention if cough not relieved
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| Pharmacodynamics: psuedoephedrine | • Nasal vasoconstriction
• Promotes sinus drainage
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| Use & Contraindications: psuedoephedrine | Use:
• Nasal congestion
Contraindications:
• Severe hypertension
• Severe cardiac disorders
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| Adverse Effects: psuedoephedrine | Common:
• Tachycardia
• Palpitations
• Nervousness
Serious:
• Dysrhythmias
• Hypertension
• Coronary vasospasm
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| Nursing Interventions: psuedoephedrine | • Increase fluid intake
• Use humidifier
• Safety precautions
• Take as prescribed (not longer than 4 days)
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| Pharmacodynamics: fexofenadine (Allegra) | • Blocks histamine
• Anticholinergic effects
• Antipruritic effects
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| Use & Contraindications: fexofenadine (Allegra) | Use:
• Allergic disorders
Contraindications:
• Children <12
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| Adverse Effects: fexofenadine (Allegra) | Common:
• Flu-like symptoms
• N/V
• Dysmenorrhea
• Drowsiness
Serious:
• QT prolongation
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| Nursing Interventions: fexofenadine (Allegra) | • Increase fluid intake
• Use humidifier
• Safety precutions
• Use with allergic symptoms
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| Pharmacodynamics: guaifenesin | • Increases output of respiratory fluids
• Increases productive cough
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| Use & Contraindications: guaifenesin | Use:
• Dry, nonproductive cough
Contraindications:
• Hypersensitivity
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| Adverse Effects: guaifenesin | • N/V
• Anorexia
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| Nursing Interventions: guaifenesin | • Good pulmonary toilet
• Eat small frequent meals
• Medical attention if cough not resolved
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| Pharmacodynamics: albuterol (Proventil) | • Relaxes bronchial smooth muscle
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| Use and Contraindications: albuterol (Proventil) | Use:
• COPD
• Asthma
Contraindication:
• Hypersensitivity
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| Adverse Effects: albuterol (Proventil) | Common:
• Throat irritation,
• palpitations
• tachycardia
• anxiety
• tremors
• increase BP
Serious:
• Bronchospasm
• urticaria
• angioedema
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| Nursing Interventions: albuterol (Proventil) | • Correct use of inhalation device
• Do not overdose
• Used first for all acute symptoms
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| Pharmacodynamics & Pharmacokinetics: flunisolide (AeroBid) | Pharmacodynamics
• decrease leukotrienes
• decrease inflammatory cells
• decrease mucus
Pharmacokinetics:
• Most effective Anti-inflam
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| Use and Contraindications: flunisolide (AeroBid) | Use:
• CAL & asthma
Contraindication:
• Caution: active infection of respiratory system
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| Adverse Effects: flunisolide (AeroBid) | Common:
• Dry mouth, dysphonia
Serious:
• Oral candidiasis, systemic absorption
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| Nursing Interventions: flunisolide (AeroBid) | • Peak effect in 1-2 week
• Take daily
• Rinse mouth after each administration
• Use spacer
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| Pharmacodynamics: cromolyn sodium (Intal) | • Exact mechanism unclear
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| Use and Contraindications: cromolyn sodium (Intal) | Use:
• Prophylaxis of allergic symptoms
Contraindications:
• Hypersensitivity
• Acute symptoms
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| Adverse Effects: cromolyn sodium (Intal) | Common:
• Dry throat, cough, wheezing
Serious:
• Bronchospasm, anaphylaxis
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| Nursing Interventions: cromolyn sodium (Intal) | • Correct use of inhalation device
• Take daily
• May take weeks for improvement
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| Pharmacodynamics: zafirlukast (Accolate) | • decrease bronchoconstriction
• decrease mucous secretion
• decrease vascular permeability
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| Use and Contraindications: zafirlukast (Accolate) | Use:
• Management of COPD and Asthma
Contraindications:
• Hypersensitivity to povidone, lactose, titanium dioxide, cellulose
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| Adverse Effects: zafirlukast (Accolate) | Common:
• HA, gastritis, pharyngitis, rhinitis
Serious:
• Hepatic failure, Churg-Strauss syndrome
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| Nursing Interventions: zafirlukast (Accolate) | • Administer daily
• Take as prescribed
• Will not abort acute attack
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| Class & Drug: penicillin G | Class: PENICILLINS
Drug: penicillin G
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| Pharmacodynamics & Pharmacokinetics: penicillin G | Pharmacodynamics:
• Bacteriocidal
Pharmacokinetic:
• Unstable in gastric acid
• Protein binding
• Does not cross BBB
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| Use and Contraindications: penicillin G | Use:
• Gram-positive
• Anaerobes
• Spirochetes
• Prophylactic bacterial endocarditis
Contraindications:
• Hyper-sensitivity
o Penicillins
o Cephalosporins
o Imipenem
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| Adverse Effects: penicillin G | Common:
• N/V
• Diarrhea
Serious:
• Hyper-sensitivity
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| Nursing Interventions: penicillin G | • Give on empty stomach
• C&S for gram-negative
• Monitor I&O
• Take as prescribed
• Take entire prescription
• S/S allergic reaction
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| Class & Drug: cefazolin (Ancef, Kefzol) | Class: CEPHALO-SPORINS
Drug: cefazolin(Ancef, Kefzol)
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| Pharmacodynamics & Pharmacokinetics: cefazolin (Ancef, Kefzol) | Pharmacodynamics:
• Bacteriocidal
Pharmacokinetics:
• Does not cross BBB
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| Use and Contraindications: cefazolin (Ancef, Kefzol) | Use:
• Gram-positive
• Anaerobes
• Spirochetes
• GI/GU surgery
Contraindications:
• Hyper-sensitivity
o Cephalo-sporins
o Penicillins
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| Adverse Effects: cefazolin (Ancef, Kefzol) | Common:
• N/V
• Diarrhea
Serious:
• Hyper-sensitivity
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| Nursing Interventions: cefazolin (Ancef, Kefzol) | • C&S for gram-negative
• IM: large muscle
• Take as prescribed
• S/S allergic reaction
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| Class & Drug: Ciprofloxacin (Cipro) | Class: FLUORO-QUINOLONES
Drug: Ciprofloxacin(Cipro)
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| Pharmacodynamics & Pharmacokinetics: Ciprofloxacin (Cipro) | Pharmacodynamics:
• Bacteriocidal
Pharmacokinetic:
• Minimal penetration to CSF
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| Use and Contraindications: Ciprofloxacin (Cipro) | Use:
• Aerobic gram-negative
Contraindications:
• Hyper-sensitivity
• Children
• Pregnancy
• Breast-feeding
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| Adverse Effects: Ciprofloxacin (Cipro) | Common:
• GI
Serious:
• Arthropathy
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| Nursing Interventions: Ciprofloxacin (Cipro) | • Complete full course
• Small frequent meals
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| Class & Drug: Sulfamethoxazole-trimethoprim (SMZ-TMP, Bactrim) | Class: SULFONAMIDES
Drug: Sulfamethoxazole-trimethoprim (SMZ-TMP, Bactrim)
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| Pharmacodynamics & Pharmacokinetics: Sulfamethoxazole-trimethoprim (SMZ-TMP, Bactrim) | Pharmacodynamics:
• Bacteriostatic
Pharmacokinetic:
• Crosses BBB
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| Use and Contraindications: Sulfamethoxazole-trimethoprim (SMZ-TMP, Bactrim) | Use:
• UTI
• Pneumocystitis carinii pneumonia
• Legionella, shigella, salmonella
• Haemophilus influenzae
• Strep
Contraindications:
• Hypersensitivity
• G6PD or other folate deficiency
• Urinary obstruction
• Term pregnancy
• no <2 months
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| Adverse Effects: Sulfamethoxazole-trimethoprim (SMZ-TMP, Bactrim) | Common:
• N/V
• Diarrhea
Serious:
• Hematopoietic effect
• Crystalluria
• Stevens-Johnson syndrome
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|
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| Nursing Interventions: Sulfamethoxazole-trimethoprim (SMZ-TMP, Bactrim) | • Give on empty stomach
• Increase fluids
• Strategies to avoid photosensitivity & crystalluria
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|
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| ANALGESICS Common Adverse Effect | Discolor urine
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| Class & Drug: acetylsalicylic acid (Aspirin, Bayer Aspirin) | Class: NSAIDS Salicylates
Drug: acetylsalicylic acid (Aspirin, Bayer Aspirin)
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|
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| Pharmacodynamics & Pharmacokinetics: acetylsalicylic acid (Aspirin, Bayer Aspirin) | Pharmacodynamics:
• Antipyretic
• Anti-inflammatory
• Antithrombotic
Pharmacokinetic:
• Protein bound
• Crosses placenta
• Enters breast-milk
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| Use and Contraindications: acetylsalicylic acid (Aspirin, Bayer Aspirin) | Use:
• Analgesic
• Antipyretic
• Anti-inflammatory
• Antiplatelet
Contraindications:
• Peptic ulcer disease
• Gout
• Renal or hepatic impairment
• Bleeding disorders
• Anticoagulation therapy
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|
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| Adverse Effects: acetylsalicylic acid (Aspirin, Bayer Aspirin) | Common:
• GI
Serious:
• Hepatic & renal toxicity
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|
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| Lifespan Alert: acetylsalicylic acid (Aspirin, Bayer Aspirin) | • children: do not give with varicella or flu-like symptoms
• do not give in pregnancy
• monitor patients >60
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|
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| Nursing Interventions: acetylsalicylic acid (Aspirin, Bayer Aspirin) | • give with food or milk
• inquire about OTC drugs
• monitor S/S for GI distress or bleeding, anemia, hepatotoxicity, renal failure
• keep in safe place
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|
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| Class & Drug: ibuprofen | Class: Prostaglandin synthetase inhibitors
Drug: ibuprofen (Motrin, Advil)
🗑
|
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| Pharmacodynamics & Pharmacokinetics: ibuprofen | Pharmacodynamics:
• Inhibits prostaglandins
Pharmacokinetic:
• Highly protein bound
• Slowed absorption with food
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|
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| Use and Contraindications: ibuprofen | Use:
• Anti-inflammatory
• Analgesic
• Antipyretic
Contraindications:
• Active GI diseases
🗑
|
||||
| Adverse Effects: ibuprofen | Common:
• GI
Serious:
• Hepatic and renal toxicity
🗑
|
||||
| Lifespan Alert: ibuprofen | • pregnancy: category D in 3rd trimester
• monitor carefully patients >60
🗑
|
||||
| Nursing Interventions: ibuprofen | • give with food or milk
• inquire about OTC drugs
• alcohol and cigarette smoking
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|
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| Class & Drug: acetaminophen | Class: Para-aminophenol derivatives
Drug: acetaminophen
🗑
|
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| Pharmacodynamics & Pharmacokinetics: acetaminophen | Pharmacodynamics:
• Exact mechanism unknown
• Weak inhibitor or COX
🗑
|
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| Use and Contraindications: acetaminophen | Use:
• Mild to moderate pain
• Antipyretic (fever)
Contraindications:
• Hepatic disease
• Viral hepatitis
• Alcoholism
(no with liver problems)
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|
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| Adverse Effects: acetaminophen | Common:
• Rash
• Urticaria
• Nausea
Serious:
• Hepatic or renal toxicity
🗑
|
||||
| Lifespan Alert: acetaminophen | • children: drug of choice for flu or flu-like symptoms
• pregnancy & lactation: drug of choice
🗑
|
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| Class & Drug: | Class: Disease-Modifying Antirhuematic Drugs
Drug: Methotrexate (Rheumatrex)
🗑
|
||||
| Pharmacodynamics & Pharmacokinetics: | Pharmacodynamics:
• Immunosuppressive effects
Pharmacokinetic:
• Absorption decreased with food
🗑
|
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| Use and Contraindications: | Use:
• Rheumatoid arthritis
Contraindications:
• Immunosuppression
• Blood dyscrasias
• Pregnancy
🗑
|
||||
| Adverse Effects: | Common:
• Nausea
• HA
• Stomatitis, gingivitis
• Alopecia
Serious:
• Bone marrow depression
🗑
|
||||
| Nursing Interventions: | • Remain hydrated
• Take vitamin B
• Educate adverse effects and to report to provider
• Monitor CBC, liver and renal function tests
🗑
|
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| Pharmacodynamics & Pharmacokinetics: hydrochlorothiazide (Hydrodiuril) | Pharmacodynamics:
• Weak diuretic effect
• increase excretion of Na+, Cl-, K+, Mg, bicarbonate
• decrease excretion of Ca+
• May decrease GFR & increase BUN
Pharmacokinetics:
• 50% bound to protein
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|
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| Use and Contraindications: hydrochlorothiazide (Hydrodiuril) | Use:
• HTN
• Edema with CHF, hepatic or renal disease, secondary drug use
Contraindications:
• Severe renal disease
🗑
|
||||
| Adverse Effects: hydrochlorothiazide (Hydrodiuril) | Common:
• Dizziness, light-headedness, vertigo, N/V
Serious:
• Aplastic anemia
• Thrombocytopenia
🗑
|
||||
| Nursing Interventions: hydrochlorothiazide (Hydrodiuril) | • Give in AM
• Monitor BP, weight, I/O, serum electrolyte levels
• Importance of blood work (electrolytes, CBC)
🗑
|
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