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Pharmacology Exam 3
| Term | Definition |
|---|---|
| Lorazapam | Treat anxiety and insomnia (short term), sedation, procedural amnesia |
| Lorazepam Contraindicated | Psychoses, acute narrow glaucoma, children under 6m Pregnancy D Low dose for older ptns |
| Lorazepam Adverse Effects | (CNS) confusion, ataxia, drowsy, GI SERIOUS: paradoxical reaction |
| Lorazepam Patient Ed | Avoid alcohol & CNS depressants CNS side effects 2-3 doses/day |
| Lorazepam Nursing Needs | Monitor P,RR,BP, consciousness Safety: low bed, side rails up, call button |
| Zolpidem | Treat short and long term insomnia DFA, EMA |
| Zolpidem Contraindicated | ½ dose for elderly |
| Zolpidem Adverse Effects | (CNS) Headache, drowsy, dizzy Sleep walking and eating Weird dreams |
| Zolpidem Patient Ed | 7hrs of sleep Take on empty stomach (avoid high fat foods) Avoid CNS depressants |
| Nortriptyline | Treat symptoms of depression, chronic pain (neuropathy) |
| Nortriptyline Contraindicated | Preexisting cardiovascular Elderly: ½ dose BLACK BOX: Children-risk for suicidal thoughts/ behaviors |
| Nortriptyline Adverse Effects | Anticholinergic Constipation, dry eye/mouth Hypotension, drowsy SERIOUS: Arrhythmias |
| Nortriptyline Patient Ed | Give at bed time Lag: 3 months Storage Sexual dysfunction |
| Nortriptyline Nursing Needs | Monitor serum levels (toxicity) Check therapeutic levels |
| Lithium Carbonate (LiCO3) | Prevent severe mood swings, mania and depression |
| Lithium Carbonate (LiCO3)Contraindicated | Severe Cardiovascular and kidney disease, pregnant, lactating, Na+ imbalance Elderly: risk of hypothyroidism Nephrogenic diabetes insipidus Drug Induced Goiter |
| Lithium Carbonate (LiCO3)Adverse Effects | Increase thirst, frequent urination, nausea, coarse hand tremors SEVERE: Lithium toxicity Seizure, Coma, neuro arrhythmias |
| Lithium Carbonate (LiCO3)Patient Ed | Avoid alcohol and too much salt Fluids, weather, activity Regular AE and toxicity |
| Lithium Carbonate (LiCO3)Nursing Needs | Monitor kidneys and thyroid |
| Sertralin | Treat long-term anxiety, depression PTSD, OCD premenstrual dysphonic (mood swings) |
| Sertralin Contraindicated | Patients with decreased liver function SERIOUS/ BLACK BOX Increased risk of suicide for children, adolescents and young adults |
| Sertralin Adverse Effects | GI DISTRESS Sleep disturbance, abnormal ejaculation |
| Sertralin Patient Ed | Avoid UV light lag time take w/ food Avoid alcohol/drugs Serotonin Discontinuation Syndrome: Flu-like Light-headed Uneasy Sleep Headache |
| Sertralin Nursing Needs | Create therapeutic relationship |
| Haloperidal | High-potency Typical Anti-psychotics Treat psychotic disorder and schizophrenia |
| Haloperidal Contraindicated | Parkinson Disease Young males: r/o dystonias Older women: r/o tardive dyskinesia BLACK BOX: Increased risk of mortality in elderly dementia patients |
| Haloperidal Adverse Effects | acute dystonias, akathesias, tardive dyskinesia , EPS CNS SERIOUS: NMS (medical emergency) |
| Haloperidal Patient Ed | Avoid starting and stopping Take with anticholinergic drugs Continue therapy/ coping |
| Haloperidal Nursing Needs | Direct Observation Therapy (DOT) Keep does low Monitor serum Ask about thought process (TP) Thought Content (TC) |
| Olanzapine | Atypical Anti-psychotic Psychotic symptom Short term bipolar/ mania and schizophrenia |
| Olanzapine Contraindicated | Elderly increased r/o adverse effects BLACK BOX: Increased risk of mortality in elderly dementia patients |
| Olanzapine Adverse Effects | (CNS) Drowsy, hyperglycemia, sedation, appetite and weight SERIOUS: Tardive dyskinesia (TD) Neuroleptic Malignant Syndrome (NMS) |
| Olanzapine Patient Ed | Avoid alcohol Diet/exercise Take doses regularly and at bedtime Lag time |
| Olanzapine Nursing Needs | Monitor glucose levels |
| Rivastigmine | Ace Inhibitors Mild to moderate Alzheimer-type dementia |
| Rivastigmine Adverse Effects | (GI) CNS: peripheral edema, urinary retention, joint pain, agitation SERIOUS: Bradycardia |
| Rivastigmine Patient Ed | Small frequent meals Not a cure burnout Preserve memory/slow progression |
| Rivastigmine Nursing Needs | Monitor heart, weight Assess and correct any treatable factors that may impair cognition |
| Phenytoin | Antiepileptic drugs that decrease sodium influx Used to control partial and (tonic-clonic grand mal) seizures |
| Phenytoin Contraindicated | Bradycardia Heart block |
| Phenytoin Adverse Effects | Ataxia, dizzy, nausea, gingival hyperplasia, blurred vision SERIOUS: Liver damage blood dyscrasia Lifethreatening Dermatalogic reaction |
| Phenytoin Patient ED | Pregnancy D take with food, caution with diving |
| Phenytoin Nursing Needs | Monitor blood levels of drug (narrow therapeutic range) Administer slow Monitor mood |
| Ehosuximide | Antiepileptic that decreases Ca+ influx Used to treat absent (petit mal) seizures |
| Ehosuximide Contraindicated | Hyper-sensitivity |
| Ehosuximide Adverse Effects | Drowsy, dizzy, lethargy, n/v SERIOUS: Blood dyscrasia |
| Ehosuximide Patient Ed | Take w/ milk/ food Notify provider about adverse effects (rash, joint pain, infection unusual bleeding) |
| Ehosuximide Nursing Needs | Assess allergies, history of renal or hepatic dysfunction Assess CBC, UA, LFT Taper dose slowly Monitor drug levels |
| Cyclobenzaprine | Centrally acting muscle relaxants Manage muscle spasms associated with acute Musculoskeletal disorders |
| Cyclobenzaprine Contraindication | Hyperthyroidism 14 days w/in use of MAOI’s |
| Cyclobenzaprine Adverse Effects | CNS depression Anticholinergic activity, MI’s, sedation (ptn safety) seizure, arrhythmias SERIOUS: Auditory/visual hallucinations, psychotic Sx, agitation seizure |
| Cyclobenzaprine Patient Ed | Do not take with OTC drugs Avoid alcohol and other CNS depressants Take with H2O and at even intervals Coordinate physical therapy administration Do not stop abruptly |
| Cyclobenzaprine Nursing Needs | Evaluate patient safety Monitor levels of sedation |
| Baclofen | Centrally Acting Spasmolytics Relieves some components of spinal spasticity and MS, CP trauma to spinal cord |
| Baclofen Contraindicated | Hypersensitivity Spasticity of cerebral origin (balance/ posture) |
| Baclofen Adverse Effects | (CNS) Sedation, h/n/v Hypotension SERIOUS: Agitation, auditory/ visual hallucination, seizures or psychotic Sx upon abrupt with drawl |
| Baclofen Patient Ed | Take with full glass of H2O Take with meals Do not take with Alcohol Do not stop abruptly |
| Baclofen Nursing Needs | Ensure Patient safety Monitor for hallucinations or psychotic episodes |
| Dantrolene | Peripherally acting Spasmolytic Used to treat malignant hyperthermia, skeletal muscle relaxant for spasticity |
| Dantrolene Contraindicated | Liver disease Patients who use spasticity to maintain posture/ balance (CP) |
| Dantrolene Adverse Effects | GI, Muscle weakness, CNS sedation, acne, photosensitive SERIOUS: Fetal Hepatitis, seizures,pleural Effusion w/ pericarditis |
| Dantrolene Patient Ed | Take with food or milk Do not crush XR capsules Use sunscreen, know symptoms of hepatitis |
| Dantrolene Nursing Needs | Patient safety, assist with ambulation Titrate dose slowly Monitor adverse effects |
| Carbidopa- Levodopa | Antiparkinson Drug Dopaminergics Used to treat Parkinson disease |
| Carbidopa- Levodopa Contraindicated | Closed angle glaucoma Hypersensitivity Melanoma Undiagnosed pigment lesions Breastfeeding Allergy to tartrazine |
| Carbidopa- Levodopa Adverse Effects | Orthostatic hypotension Abnormal movements GI effects SERIOUS: Neuroleptic Malignant Syndrome |
| Carbidopa- Levodopa Patient Ed | Take on empty stomach at even intervals Low protein and pyridoxine diet Not a cure Avoid Vitamin B6 On – Off syndrome and hypotension |
| Carbidopa- Levodopa Nuring Needs | Titrate dose |
| Riluzole | Anti-ALS Drugs Centrally Acting Anticholinergic Indicated to treating ALS because it slows down the disease progression (not a cure) |
| Riluzole Contraindicated | Hypersensitivity Liver Disease |
| Riluzole Adverse Effects | Muscle fatigue, nausea, dizzy, diarrhea, anorexia, vertigo, somnolence SERIOUS: Neutropenia, hepatic injury |
| Riluzole Patient Ed | Take with H20 on empty stomach Caution with driving Expensive Decrease protein intake, avoid caffeine, charcoal-broiled food, tobacco and alcohol |
| Riluzole Nursing Needs | Follow up care |
| Glatiraramer | Anti-MS drugs Used to delay progression of MS, used to reduce frequently on MS attacks slows development of new lesions on myelin sheath |
| Glatiraramer Contraindicated | IV administration Hypersensitivity to mannitol |
| Glatiraramer Adverse Effects | Chest pain or tightness, breathing difficulties, hives or severe rash, injection site, GI, weakness |
| Glatiraramer Patient Ed | Store in Refrigerator, administer at room temp Avoid accidental IVadministration |
| Glatiraramer Nursing Needs | Rotate injection site Evaluate progression of disease |
| Captopril | Antihypertensive ACE inhibitor Used for HTN, HF, Left ventricular dysfunction (LVD), prevents diabetic neuropathy and retinopathy |
| Captopril Contraindicated | none |
| Captopril Adverse Effects | Angioedema, rash, decreased BP, K+ sparring, neutropenia, dyspnea, annoying cough (symptomatic) |
| Captopril Patient Ed | Take at night (1st dose syncope) Talk about K+ Warn about cough Mention angioedema (swelling in face throat) |
| Captopril Nursing Ed | Monitor electrolytes (K+) (Na+) |
| Losartan | Antihypertensive Angiotensin II receptor blockers ARBS Used for HTN, HF, LVD, prevent diabetic neuropathy |
| Losartan Contraindicated | Pregnancy |
| Losartan Adverse Effects | Decrease BP, diarrhea, asthenia, dizzy, fatigue, K+ sparring |
| Losartan Patient Ed | Avoid grapefruit juice (speeds up metabolism) |
| Eplerenone | Antihypertensive Selective Aldosterone Receptor Blocker Used for HTN, decrease death from CV in patients with HF and previous MI |
| Eplerenone Contraindicated | Abnormal K+ level and creatinine clearance (kidney function) |
| Eplerenone Adverse Effects | Increase K+, diarrhea, albuminuria, gynecomastia, increase cholesterol, abnormal vaginal bleeding |
| Eplerenone Patient Ed | safety |
| Nitroprusside | Antihypertensive ER Drug (IV) Used for hypertensive crisis Systolic >or= 210 Diastolic >or=120 |
| Nitroprusside Contraindicated | Women of childbearing years Elderly (orthostatic hypertension) |
| Nitroprusside Adverse Effects | Dizzy, HA (drop in BP), nausea, decrease CO and BP |
| Nitroprusside Patient Ed | Safety Adverse Effects |
| Nitroprusside Nursing Needs | Cyanide toxicity Decrease CO, BP Rate of infusion (stay w/ patient) NURSING CARE |
| Eplerenone Nursing Needs | Check for normal K+ level and creatinine clearance (Kidney function) |
| Hydrochlorothiazide (HCTZ) | Antihypertensive(Diuretics)MAMA 1st Line Drug for HTN Used for HTN, HF, DI (diabetes insipidus) |
| Hydrochlorothiazide (HCTZ)Contraindicated | Caution: hypersensitivity to sulfonamides. |
| Hydrochlorothiazide (HCTZ)Adverse Effects | Change in electrolytes, decrease BP, dizzy, hyperglycemia, fluid shedding 1st 2 weeks |
| Hydrochlorothiazide (HCTZ)Patient Ed | Signs and Symptoms to report TLC |
| Hydrochlorothiazide (HCTZ)Nursing Need | Monitor electrolytes (K+ sparring) decrease BP |
| Furosemide | Potent loop diuretic Hospital Drug PAPA Used for HTN, HF, edema Used when HTN goes with HF |
| Furosemide Contraindicated | none |
| Furosemide Adverse Effects | Electrolytes, ototoxic (fluid loss in ears), hyperglycemia, dizzy, vertigo, hypokalemia |
| Furosemide Patient Ed | TLC (fruits and veggies) |
| Furosemide Nursing Needs | Monitor blood glucose, serum level, IV rate (I’s and O’s) foley catheter |
| Triamterene | Weak Potassium sparring diuretics BABY Used for Edema, adjunt HTN (used to boost drugs for HTN or HF) |
| Triamterene Contraindicated | none |
| Triamterene Averse Effects | Weak potassium sparring, nephrotoxic, thrombocytopenia, HA, photosensitive, LFT (CBC) |
| Triamterene Nursing Needs | Monitor BP, edema, K+ supplement |
| Mannitol | Osmotic Diuretics ER/ICU drug Acute renal failure, increased intracranial pressure (ICP) secondary to cerebral edema, decreased intraocular edema |
| Mannitol Contraindicated | none |
| Mannitol Adverse Effects | Electrolyte loss, tachycardia r/t decrease BP, dehydration > dizzy, dry mouth, thirst, n/v |
| Mannitol Nursing Needs | Monitor I&Os renal function, vitals, electrolytes |
| Acetazolamide | Carbonic anhydrase inhibitor(Hospital drug) Used for heart failure related to edema, open angle glaucoma |
| Acetazolamide Contraindicated | none |
| Acetazolamide Adverse Effects | (CNS,GI) a/n/c, dizzy, drowsy, tinnitus, ataxia |
| Acetazolamide Nursing Needs | Monitor kidneys, I&O’s, CBC(rare bone marrow), RENAL, electrolytes |
| Lovastatin | Antihyperlipidemics (statins) #1 drug for high cholesterol and hyperlipidemia Used for hyperlipidemia Lowers LDLs raises HDL |
| Lovastatin Contraindicated | Pregnancy X |
| Lovastatin Adverse Effects | GI, muscle aches, cramps (coenzyme Q10) Weakness, liver damage (treat every 12 months) RARE: rhabdomylosis (muscle tissue breakdown) |
| Lovastatin Patient Ed | Decrease fats, increase fiber Take coenzyme Q10, take at night, TLC, exercise Avoid grapefruit juice |
| Lovastatin Nursing Needs | Monitor liver and muscles Check lipids |
| Digoxin | Cardiac Glycosides (Maintenance drug) Used for CHF, afib |
| Digoxin Antidote | Digibind |
| Digoxin Adverse Effects | (GI, CNS) a/n/v/d/ha TOXICITY: dysrhythmias, confusion, seizures, delirium |
| Digoxin Patient Ed | Hold and call for pulse <60 (check everyday before meals) S&S of toxicity Take everyday Daily weighs, edema Come back |
| Digoxin Nursing Needs | Monitor serum levels, EKG |
| Nesiritide | Natriuretic peptides (Hospital drug) Used for acute HF |
| Nesiritide Adverse Effects | Hypotension, injection site reaction, sweating, itchy, leg cramps, confusion, renal, cough, apnea, repiratory |
| Nesiritide Nursing Needs | Continuous cardiac monitoring, CO, BP, P |
| Nitroglycerine | Used for angina (heart pain from lack of O2) |
| Nitroglycerine | Directions: Open door, have phone, sit down. Take dose wait 5 mins if doesn’t work take another (do twice) if unresolved after 3 call 911 |
| Nitroglycerine | HEADACHE, postural hypotension, tachycardia, syncope, vertigo, CNS |
| Nitroglycerine | Patch: ½ on, ½ off Cream: postop at risk of Heart disease Take before activities Should sting Can Overdose |
| Nitroglycerine | Wear gloves |
| Lidocain | ICU/ER drug Used for acute ventricular arrhythmias |
| Lidocain Adverse Effects | Arrhythmias, decreased BP, dizzy, CNS |
| Lidocain Nursing Needs | Continuous cardiac monitoring Monitor CNS side effects Check liver and kidney function |
| Lidocain Contraindicated | none |
| Procainamide | Used for ventricular arrhythmias, ACLS, ECC, systemic lupus |
| Procainamide Contraindicated | none |
| Procainamide Patient Ed | Avoid alcohol |
| Disopyramide Contraindicated | Patients having MI or non-emergency adverse effects |
| Verapamil | Calcium Channel Blocker Used for HN, afib flutter |
| Verapamil Contraindicated | Heart failure patients |
| Verapamil Adverse Effects | *constipation* Gingival hyperplasia, headache, nausea, CNS (dizzy), decreased BP, peripheral edema |
| Verapamil Patient Ed | Oral hygiene, flossing, dentist X’s 4/year No grapefruit juice, fluids and fiber |
| Verapamil Nursing Needs | Follow-up EKG, electrolytes Monitor BP, P Check for peripheral edema |
| Sodium Polystyrene Sulfate (resin) | Hospital drug Used for hyperkalemia |
| Sodium Polystyrene Sulfate (resin)Contraindicated | none |
| Sodium Polystyrene Sulfate (resin) Adverse Effects | Hypokalemia, electrolyte imbalance, GI (n/v/c) |
| Sodium Polystyrene Sulfate (resin)Patient Ed | GI side effects |
| Sodium Polystyrene Sulfate (resin)Nursing Needs | Assess diet and drugs high in K+ Treat constipation Monitor K+ |
| Clopidogrel | Antiplatelet (ASA) Used decrease atherosclerosis, patients at risk for MI, cardiovascular disease with ischemic stroke |
| Clopidogrel Contraindicated | Bleeding disorders |
| Clopidogrel Adverse Effects | Bleeding GI upset Neutropenia |
| Clopidogrel Patient Ed | Safety (medical alert) GI side effects Come back for CBC Routine labs for bleeding time and platelets |
| Clopidogrel Nursing Need | Monitor CBC Labs bleeding time and platelets |
| Heparin | Anticoagulant Stops clotting Only anticoagulant for pregnant women |
| Heparin Antidote | Protamine Sulfate |
| Heparin Contraindicated | Bleeding disorders |
| Heparin Adverse Effects | Bleeding Thrombocytopenia (HIT) |
| Heparin Patient Ed | Safety Frequent labs |
| Heparin Nursing Needs | Adjust according to protocol |
| Warfarin | Anticoagulant Prototype |
| Warfarin Antidote | Vitamin K |
| Warfarin Contraindicated | bleeding disorders |
| Warfarin Adverse Effects | BLEEDING GI |
| Warfarin Patient Ed | Frequent lab Drug-drug, food, herb Avoid vt.K leafy greens, citrus, organ meat, green tea |
| Warfarin Nursing Needs | Lab PT with INR (2.5 – 3.5) >or= 5 danger |
| Alteplase recombinant | CLOT-BUSTING ER Thromboembolic events Thrombus- brain, pulmonary embolism, MI |
| Alteplase recombinant Contraindicated | None |
| Alteplase recombinant Adverse Effects | Bleeding (internal bleeding, chest/ joint pain, diff. bleeding) |
| Alteplase recombinant Nursing Needs | Stay with patient Check labs Continuous monitoring Give within 3hrs of stroke symptoms |
| Epoetin Alfa | Used to treat anemia, chronic kidney disease (CKD), HIV, cancer Protocol for patients who reject blood infusion Immune compromised ptns, ptns on dialysis Needs normal BP |
| Epoetin Alfa Contraindicated | Chronic hypertension, hypersensitivity |
| Epoetin Alfa Adverse Effects | Hypertension, fever, headache, n/v/d, edema |
| Epoetin Alfa Patient Ed | Injectable drug Eat iron rich foods |
| Epoetin Alfa Nursing Needs | Monitor CBC, increase in Hgb, BP Slow to see rise |
| Filgrastin | Expensive Used to increase neutrophils (WBCs) Patients with cancer |
| Filgrastin Contraindicated | none |
| Filgrastin Adverse Effects | #1 long bone pain Fever, rash, epitaxis (nose bleeds) |
| Filgrastin Patient Ed | Avoid crowds, sick people Hand washing Immunization update |
| Filgrastin Nursing Needs | Monitor LFT CBC with diff Monitor for signs and symptoms of infection |
| Oprelvekin | Used to prevent severe thrombocytopenia |
| Oprelvekin Contraindicated | Caution with heart failure patients |
| Oprelvekin Adverse Effects | Fluid retention > weight gain Tachycardia (84% of peds) Arrhythmias, palpatations, vasodilation, syncope, rash |
| Oprelvekin Patient Ed | Infection Adverse effects of vasodilation $$ |
| Oprelvekin Nursing Needs | Labs CBC w/ diff., weighs Deal with n/v Monitor for infection |
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