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NR pharm hesi

pharm hesi

Narrow Therapeutic Index: monitor drug levels
Half Life: dose a drug before half life is over; amount of time it take for half of the medication to be excreted from medication system; after 5 half life’s have passed the medication is eliminated
Indications: what medication used for
Contraindications: something that means the medication shouldn’t be used in that specific patient (i.e. Tylenol use and liver failure patients)
Adverse effects:
Patient variables: Pediatric, Gerontology, Pregnancy/Breast-feeding, Gender, and Cultural/Ethnic variations
Assessments to include: vital signs, physical assessment, labs, & diagnostics
Drug administration: safety, route considerations, med orders
Drug toxicity (signs/symptoms) and antidote if applicable
Patient teaching
Oral, suspension, injectable, IV (ml/hr and gtt/min)
Metric and household conversions
Synergestic effects
Antagonistic effects
Tolerance: need more medication to get therapeutic effect
Addiction: cannot function without drug; psychical: (i.e. alcohol) need to physically function; psychological: think they need the drug to function
Anaphylaxis: it is an adverse effect where pt goes into state of shock from overexposure to medication
Adverse effects vs. Side effects: used interchangeably; an unintended effect of medication
Opioids/Pain Management: Schedule II narcotics (have high rate of addition and potential for abuse; side effect of euphoric/high feeling)
Risk for constipation/antidote Oxycodone (Percocet)—Narcan/Nalozone is antidote
Acetaminophen (Tylenol)/antidote: found in many OTC meds; hepatotoxic; many accidental ODs; antidote is Mucomyst—N-Acetylcistine
Fentanyl (Duragesic)
Aspirin and NSAIDs: Ketorelac (Toradol)
Romazicon and Flumazenil are antidotes for Benzodiazepines
Narcan and Romazicon= drug it is used as an antidote to may have longer half life so may need to give alternate doses of antidote
Muscle Relaxants: Baclofen (administered through implantable pump or IV); Dantrolene
Baclofen Cause muscles to relax; usually because of spasms or muscle injury
Dantrolene used as treatment for malignant hyperthermia to relax muscle rigidity
Neuromuscular blockers/Anesthetics: Nalbuphine (Nubain)
Paralytic medications- do not give to awake patient (sedate first) o Used most commonly in conjunction with anesthesia and critical care units o Will need mechanical support (cannot breathe on their own)
Local Anesthesia- used for small area; patient not asleep; lidocaine and epinephrine—keeps localized; i.e. stitches
General anesthesia- inhaled and IV meds to do surgery; artificially ventilated
Cholinergics: Tensilon
Conscious (moderate) sedation- pt able to follow commands and breathe on own but unaware of procedure being done (systemic effect); i.e. colonoscopy, EGD
Antiepileptics: Depakote
Stimulants: Amphetamine (Adderall)
Antidepressants: SSRIs: Fluoxetine (Prozac)
Antipsychotics: Clozapine (Clozaril), Haloperidol (Haldol)
Osteoporosis tx: Miacalcin
Leukotrienes allergic reaction mediators; designed to prevent allergic reaction from happening
Anticongestants/Antitussives/Expectorants: used to relieve cold symptoms; cannot treat cold but can treat symptoms
Bronchodilators/Inhaled corticosteroids: given in conjunction—give bronchodilators first because it will open airway allowing corticosteroid to relieve inflammation
Antianginals: Nitrates/Nitroglycerin
Digoxin- slows heart electrical conduction and rate, increases contractility (+inotrope, -chromotrope/dromotrope); check apical pulse 60sec (60+bmp)
Cordarone (Amiodorone)- decreases ventricular dysrhythmias but can slow conduction of atrial excitability; half life 90 days
Lidocaine- ventricular dysrhythmias only
Antihypertensives: Calcium Channel Blockers
Antiplatelets- prevent platelet aggregation
Anticoagulants- stop clot from getting bigger, do not break clots
**Warafarin/Coumadin—Vitamin K; check PT/INR
**Heparin—Protamine Sulfate; check PTT/aPTT
Thrombolytics- break clots apart
Antilipemics: Statins- monitor liver; affect how liver deals with cholesterol
Diuretics: Loop: Furosemide (Lasix); watch K+; potassium wasting
Osmotics: Mannitol; primarily used for glaucoma (decrease intraocular pressure) and decrease ICP; pull fluid into vasculature and then excreted by kidneys
Anti-infectives **may need to do a C&S to find out which one to use (may take up to 72 hours so treat with broad spectrum antibiotic in mean time) **complications: superinfections, yeast infections (vaginal or thrush), etc.
Antibiotics: Tetracycline Cephalosporins Metronidazole (Flagyl) Piperacillin + tazobactam (Zosyn
Piperacillin + tazobactam (Zosyn) Beta lactamase antibiotics; given to inhibit the breakdown of the beta lactam ring to protect atntibiotic from breaking down before getting to site of infection (given in conjunction)
Sulfa drugs: Bactrim (SMZ-TMP)
Drugs for treating UTI: -Nitrofurantoin (Macrodantin) -Pyridium
Antivirals: HSV and hepatitis tx
HIV Drugs: Protease inhibitors
Antitufungals: Terbinafine (Lamisil)
Antituberculars: Rifampin
Antihelminthics: Vermox
GI drugs **Pts may take antacids to treat symptoms which may be a symptom for a bigger underlying cause
**laxatives may cause decreased absorption because flushed out quickly; analgesics and antidiarrheals may increase absorption because in GI tract longer
**Too much Sodium Bicarb can cause metabolic alkalosis
**medications taken with antacids may decrease breakdown of medication
**H2 Blockers: decrease hydrochloric acid secretions; smoking decreases effectiveness
**PPI: completely stop secretion of hydrochloric acid (pantproazole, omeprazole, etc); recommended for short term use only (*long
**antacids: neutralize stomach acid
GERD/PUD Tx: -Sucralfate (Carafate) -Aluminum hydroxide (Amphojel)
Laxatives: -Bulk-forming- only one for long term use; drink water!! -Enulose (Lactulose)- excrete Ammonia (hepatic encephalopathy)
Vitamins & Mineral Supplements: Iron Vitamin C Vitamin D
Antidiabetics: Insulin-Only insulin that can be given IV is Regular
Antidiabetics Glimepiride (Amaryl)
Adrenal drugs: ACTH
Thyroid drugs: -PTU -Radioactive Iodine
Immunologic Drugs **HIV treat with a retroviral not antiviral
Immunologic Drugs • Immunosuppressants: Cyclosporine • Biologic Response Modifiers (BRMS): Filgrastim (Neupogen)
Reproductive Drugs Steroids (anabolic)
Ophthalmic Drugs Beta-blockers Miotics
Dermatologic Drugs Anti-Acne: Isotretinoin (Accutane)
Created by: lalad13