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2010 Pharm Drugs
SLCC Pharmacology Drugs
| Question | Answer |
|---|---|
| Use: Isoflurane (Forane) | Inhalation anesthetic |
| Use: Lidocane (Xylocaine) | 1) Infiltration, ophthalmic, dental, obstetric anesthesia. 2) Regional blocks 3) Nerve blocks NOTE: Local |
| Contraindication: Isoflurane (Forane) | 1) Hypersensitivity 2) Predisposition to malignat hyperthermia NOTE: (can cause malignat hyperthermia) |
| Contraindication: Lidocane (Xylocaine) | 1) Hypersensitivity ( Amide anesthetics, Sulfites, Methyl paraben) 2) Infection or inflamation at site of administration) |
| Adverse Effects: Isoflurane (Forane) | Serious: Respiratory depression Common: Hypotension, Hypothermia, N/V |
| Adverse Effects: Lidocane (Xylocaine) | Serious: Allergic reactions Common: Minimal unless accidental IV or intrathecal |
| Nursing Interventions: Isoflurane (Forane) | • Low stimulus environment • Preoperative teaching Anesthesia Surgical procedure • Monitor respiratory status |
| Nursing Interventions: Lidocane (Xylocaine) | • Calm reassurance • Read labels carefully • Right preparation for right procedure • Safety due to lack of sensation |
| Pharmacokinetics: lorazepam (Ativan) | Highly lipid soluble and protein bound |
| Use: lorazepam (Ativan) | • Management of anxiety • Short-term relief of anxiety symptoms |
| Contraindications: lorazepam (Ativan) | • Hypersensitivity • Psychosis, hepatic disease • Acute narrow-angle glaucoma • <6 months of age |
| Adverse Effects: lorazepam (Ativan) | Common: (Sedation and ataxia, Hangover effect) Serious (Anterograde amnesia, Psychosis & Suicidal tendencies) |
| Lifespan Alert: lorazepam (Ativan) | • Elderly: reduce dose, start with smallest dose • Children: start with smallest dose • Cultural: Asians more sensitive |
| 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 |
| CENTRALLY ACTING MUSCLE RELAXANTS | cyclobenzaprine (Flexeril) |
| SPASMOLYTICS: CENTRALLY and PERIPHERALLY acting | Central: Baclofen (Liorsal) Peripheral: Dantrolene (Dantrium) |
| Pharmacodynamics: cyclobenzaprine (Flexeril) | • Reduces pain and tenderness • Improves mobility |
| Use: cyclobenzaprine (Flexeril) | Muscle spasms |
| Adverse Side Effects: cyclobenzaprine (Flexeril) | Common: Sedation Serious: Agitation, auditory or visual hallucinations, seizures, psychotic symptoms NOTE: Effects with abrupt withdrawal |
| Lifespan Alert: cyclobenzaprine (Flexeril) | • Elderly: more prone to sedation & anticholinergic effects |
| 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) |
| Pharmacodynamics: baclofen (Lioresal) | Reduces excessive reflex activity |
| Pharmacokinetics: baclofen (Lioresal) | Crosses BBB |
| Use: baclofen (Lioresal) | Muscle spasms or spasticity |
| Contraindications: baclofen (Lioresal) | Patients that use spasticity to maintain posture or balance |
| Adverse Effects: baclofen (Lioresal) | Common: Seditaion Serious: Agitation, auditory or visual hallucinations, seizures, psychotic symptoms NOTE: Effects with abrupt withdrawal |
| Lifespan Alert: baclofen (Lioresal) | Elderly: more prone to sedation and other CNS effects |
| 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) |
| Pharmacodynamics: dantrolene (Dantrium) | Direct effect on muscle cells (no CNS effects) |
| Pharmacokinetics: dantrolene (Dantrium) | Metabolized to active metabolites |
| Use: dantrolene (Dantrium) | • Muscle spasms or spasticity • Drug of choice for malignant hyperthermia |
| Contraindications: dantrolene (Dantrium) | • Patients that use spasticity to maintain posture or balance • Active liver disorders |
| Adverse Effects: dantrolene (Dantrium) | Common: Muscle weakness Serious: Fatal hepatitis (especially women >35 and taking estrogens) |
| 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 |
| Drugs that Decrease Sodium Influx | phenytoin (Dilantin) |
| Drugs that Decrease Calcium Influx | ethosuximide (Zarontin) |
| 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 |
| Pharmacokinetics: ethosuximide (Zarontin) | • Half-life o Children: 30 hours Adults: 60 hours |
| Use: phenytoin (Dilantin) | Drug of choice for most seizure types (not absence) |
| Use: ethosuximide (Zarontin) | Drug of choice for absence seizures |
| Contraindications: phenytoin (Dilantin) | AV heart block Sinus bradycardia |
| Contraindications: ethosuximide (Zarontin) | Hypersensitivity |
| Adverse Effects: phenytoin (Dilantin) | Common: Sedation, nystagmus, ataxia, HA, nausea, gingival hyperplasia Serious: Blood dyscrasias, Lupus erythematosus Stevens-Johnson syndrome |
| Adverse Effects: ethosuximide (Zarontin) | Common: Sedation, nausea, ataxia, HA, blurred vision, pruritis Serious: Pancytopenia |
| 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 |
| 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 |
| NARCOTIC ANALGESICS (Strong, Mild, Agonist\Antagonist) | Strong: Morphine (Roxanol) Mild: Codeine Agonist\Antagonist: Pentazocine (Talwin) |
| Use: Morphine | Moderate to severe pain |
| Contraindications: Morphine | • Significant respiratory depression • Increased ICP • CNS depression |
| Adverse Effects: Morphine | Common: Light-headedness, Dizziness, N/V Serious: Respiratory depression |
| Lifespan Alert: Morphine | Avoid in premature infants or during labor of premature infants |
| Nursing Interventions: Morphine | • Asses pain before & during therapy • Individualize dose • Monitor VS • Have naloxone readily available |
| Use: codeine | • Mild to moderate pain • Cough suppressant |
| Contraindication: codeine | • Respiratory depression • Other CNS depressant use |
| 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 |
| Lifespan Alert: Codeine | Avoid in premature infants or during labor of premature infants Note: Same as morphone |
| Nursing Interventions: Codeine | Same as morphine and avoid if patient’s health status requires a strong cough |
| Pharmcokinetics: pentazocine (Talwin) | • Significant first-pass phenomenon • Bioavailability 20% |
| Use: pentazocine (Talwin) | • Moderate to severe pain • Abused on the street |
| Adverse Effects: pentazocine (Talwin) | Common: N/V, Dizziness, Light-headedness, Euphoria Serious: Respiratory & circulatory depression |
| Nursing Interventions: pentazocine (Talwin) | Same as other narcotics and avoid alcohol and other CNS depressants |
| CENTRALLY ACTING STIMULANTS | dextroamphetamine |
| RESPIRATORY STIMULANTS | caffeine |
| Use: dextroamphetamine | • Narcolepsy • ADHD |
| Adverse Effects: dextroamphetamine | Restlessness, insomnia, dizziness, overstimulation, palpitations, tachycardia, hypertension, dry mouth, unpleasant taste, diarrhea |
| 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 |
| Pharmacokinetics: caffeine | • Crosses BBB and placenta • Limited metabolism in neonates |
| Use: caffeine | • Post-surgical respiratory depression • Neonatal apnea |
| Adverse Effects: caffeine | • Caffeine withdrawal syndrome with abrupt cessation |
| DRUGS AFFECTING ADRENERGIC FUNCTION | • ADRENERGIC AGONISTS NONSELECTIVE: epinephrine • ADRENERGIC ANTAGONISTS ALPHA: prazosin (Minipress) • ADRENERGIC ANTAGONISTS BETA: propranolol (Inderal) |
| Phamacodynamics: epinephrine | Stimulates CV, skin & viscera, respiratory receptors NOTE: Open Glaucoma |
| Use: epinephrine | • Anaphylactic shock • Cardiac emergencies • Asthma • Glaucoma |
| Contraindications: epinephrine | • Hypersensitivity • Active labor • Closed angle glaucoma • General anesthesia • Severe organic cardiac disease • Shock other than anaphylaxis |
| Phamacodynamics: prazosin (Minipress) | • Decreases sympathetic tone of vasculature • Dilate arterioles and veins • Lowers supine and standing BP |
| Use: prazosin (Minipress) | • Refractory CHF • HTN • Raynaud vasospasm • Prostatic obstruction |
| Contraindications: prazosin (Minipress) | Hypersensitivity Note: Orthostatic Hypotension |
| Pharmacodynamics: propranolol (Inderal) | • Beta-1 blockade Heart & Kidneys (decrease BP) • Beta-2 blockade Many adverse effects (bronchospasm, hypoglycemia, peripheral vasoconstriction) |
| Phamacokinetics: propranolol (Inderal) | First-pass phenomenon |
| Use: propranolol (Inderal) | • Hypertension • Angina • Cardiac arrhythmias • Migraines |
| 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 |
| Adverse Effects: epinephrine | Common: • Fatigue • Sleep disturbances • Tremor • Weakness • Dizziness • Hyperglycemia • Tachycardia Serious: • Cardiovascular stimulation |
| Adverse Effects: prazosin (Minipress) | Common: • Light-headedness • Dizziness • HA • Drowsiness • Weakness • Lethargy • Nausea • Palpitations Serious: • First dose syncope |
| Adverse Effects: propranolol (Inderal) | Common: • Postural hypotension • Bronchospasm Serious: • MI |
| Nursing Interventions: epinephrine | • Monitor CV status closely • Schedule doses to minimize sleep disruption • Allow appetite and meal times to coincide |
| Nursing Interventions: prazosin (Minipress) | • No OTC drugs • Safety with CNS effects • Safe ways to deal with postural hypotension |
| 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 |
| DRUGS AFFECTING CHOLINERGIC FUNCTION | • AGONISTS DIRECT-ACTING MUSCARINIC: pilocarpine (Akarpine) • AGONISTS DIRECT-ACTING NICOTINIC: nicotine • ANTAGONISTS ANTIMUSCARINIC: atropine |
| Pharmacodynamics: pilocarpine (Akarpine) | • Topical: Miosis, decrease IOP • Oral: stimulates secretions of exocrine glands |
| Use: pilocarpine (Akarpine) | • Simple and acute glaucoma • Pre & post-operative intraocular tension • Mydriasis • Xerostomia |
| Contraindications: pilocarpine (Akarpine) | • Hypersensitivity • Oral: severe respiratory disease |
| Adverse Effects: pilocarpine (Akarpine) | Common: • Blurred vision • Myopia Serious: • Cholinergic crisis • Bronchospasm |
| 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 |
| Pharmacodynamics & Pharmacokinetics: nicotine | • Pharmacodynamics: Potent ganglionic and CNS stimulant • Pharmacokinetics: Extensive first-pass phenomenon |
| Use: nicotine | Adjunct to smoking cessation programs |
| Contraindications: nicotine | • Immediately post MI • Life threatening dysrhythmias • Severe angina |
| Adverse Effects: nicotine | Common: • Erythema • Pruritis & burning • HA • Insomnia Serious: • Vasculitis |
| Nursing Interventions: nicotine | • Adhere to recommended dosing • Promote rest and sleep by adjusting timing of last dose • Avoid other CNS stimulants |
| Pharmacodynamics: atropine | • Blocks GI & smooth muscle, exocrine glands, heart, eye |
| Use and Contraindications: atropine | Use: • Prevent postoperative secretions • Drug of choice in cholinergic crisis Contraindications: • Hypersensitivity to sulfites • Myasthenia gravis • Acute MI |
| Adverse Effects: atropine | Common: • Blurred vision • Constipation • Dry mouth • Urinary retention Serious: • Severe bradycardia |
| 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 |
| DRUGS FOR UPPER RESPIRATORY SYSTEM | ANTITUSSIVE: dextromethorphan (Benylin) DECONGESTANT: psuedoephedrine ANTIHISTAMINE: fexofenadine (Allegra) EXPECTORANT: guaifenesin |
| Pharmacodynamics: dextromethorphan (Benylin) | Suppresses cough reflex |
| Use & Contraindications: dextromethorphan (Benylin) | Use: • Nonproductive cough Contraindications: • cough resulting from emphysema or asthma |
| Adverse Effects: dextromethorphan (Benylin) | Common: • N/V and irritability Serious: • Drowsiness • Dizziness |
| Lifespan alert: dextromethorphan (Benylin) | Not for children <6 |
| Nursing Interventions: dextromethorphan (Benylin) | • Administer at evenly spaced intervals • Safety precautions • Seek medical attention if cough not relieved |
| Pharmacodynamics: psuedoephedrine | • Nasal vasoconstriction • Promotes sinus drainage |
| Use & Contraindications: psuedoephedrine | Use: • Nasal congestion Contraindications: • Severe hypertension • Severe cardiac disorders |
| Adverse Effects: psuedoephedrine | Common: • Tachycardia • Palpitations • Nervousness Serious: • Dysrhythmias • Hypertension • Coronary vasospasm |
| Nursing Interventions: psuedoephedrine | • Increase fluid intake • Use humidifier • Safety precautions • Take as prescribed (not longer than 4 days) |
| Pharmacodynamics: fexofenadine (Allegra) | • Blocks histamine • Anticholinergic effects • Antipruritic effects |
| Use & Contraindications: fexofenadine (Allegra) | Use: • Allergic disorders Contraindications: • Children <12 |
| Adverse Effects: fexofenadine (Allegra) | Common: • Flu-like symptoms • N/V • Dysmenorrhea • Drowsiness Serious: • QT prolongation |
| Nursing Interventions: fexofenadine (Allegra) | • Increase fluid intake • Use humidifier • Safety precutions • Use with allergic symptoms |
| Pharmacodynamics: guaifenesin | • Increases output of respiratory fluids • Increases productive cough |
| Use & Contraindications: guaifenesin | Use: • Dry, nonproductive cough Contraindications: • Hypersensitivity |
| Adverse Effects: guaifenesin | • N/V • Anorexia |
| Nursing Interventions: guaifenesin | • Good pulmonary toilet • Eat small frequent meals • Medical attention if cough not resolved |
| Pharmacodynamics: albuterol (Proventil) | • Relaxes bronchial smooth muscle |
| Use and Contraindications: albuterol (Proventil) | Use: • COPD • Asthma Contraindication: • Hypersensitivity |
| Adverse Effects: albuterol (Proventil) | Common: • Throat irritation, • palpitations • tachycardia • anxiety • tremors • increase BP Serious: • Bronchospasm • urticaria • angioedema |
| Nursing Interventions: albuterol (Proventil) | • Correct use of inhalation device • Do not overdose • Used first for all acute symptoms |
| Pharmacodynamics & Pharmacokinetics: flunisolide (AeroBid) | Pharmacodynamics • decrease leukotrienes • decrease inflammatory cells • decrease mucus Pharmacokinetics: • Most effective Anti-inflam |
| Use and Contraindications: flunisolide (AeroBid) | Use: • CAL & asthma Contraindication: • Caution: active infection of respiratory system |
| Adverse Effects: flunisolide (AeroBid) | Common: • Dry mouth, dysphonia Serious: • Oral candidiasis, systemic absorption |
| Nursing Interventions: flunisolide (AeroBid) | • Peak effect in 1-2 week • Take daily • Rinse mouth after each administration • Use spacer |
| Pharmacodynamics: cromolyn sodium (Intal) | • Exact mechanism unclear |
| Use and Contraindications: cromolyn sodium (Intal) | Use: • Prophylaxis of allergic symptoms Contraindications: • Hypersensitivity • Acute symptoms |
| Adverse Effects: cromolyn sodium (Intal) | Common: • Dry throat, cough, wheezing Serious: • Bronchospasm, anaphylaxis |
| Nursing Interventions: cromolyn sodium (Intal) | • Correct use of inhalation device • Take daily • May take weeks for improvement |
| Pharmacodynamics: zafirlukast (Accolate) | • decrease bronchoconstriction • decrease mucous secretion • decrease vascular permeability |
| Use and Contraindications: zafirlukast (Accolate) | Use: • Management of COPD and Asthma Contraindications: • Hypersensitivity to povidone, lactose, titanium dioxide, cellulose |
| Adverse Effects: zafirlukast (Accolate) | Common: • HA, gastritis, pharyngitis, rhinitis Serious: • Hepatic failure, Churg-Strauss syndrome |
| Nursing Interventions: zafirlukast (Accolate) | • Administer daily • Take as prescribed • Will not abort acute attack |
| Class & Drug: penicillin G | Class: PENICILLINS Drug: penicillin G |
| Pharmacodynamics & Pharmacokinetics: penicillin G | Pharmacodynamics: • Bacteriocidal Pharmacokinetic: • Unstable in gastric acid • Protein binding • Does not cross BBB |
| Use and Contraindications: penicillin G | Use: • Gram-positive • Anaerobes • Spirochetes • Prophylactic bacterial endocarditis Contraindications: • Hyper-sensitivity o Penicillins o Cephalosporins o Imipenem |
| Adverse Effects: penicillin G | Common: • N/V • Diarrhea Serious: • Hyper-sensitivity |
| 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 |
| Class & Drug: cefazolin (Ancef, Kefzol) | Class: CEPHALO-SPORINS Drug: cefazolin(Ancef, Kefzol) |
| Pharmacodynamics & Pharmacokinetics: cefazolin (Ancef, Kefzol) | Pharmacodynamics: • Bacteriocidal Pharmacokinetics: • Does not cross BBB |
| Use and Contraindications: cefazolin (Ancef, Kefzol) | Use: • Gram-positive • Anaerobes • Spirochetes • GI/GU surgery Contraindications: • Hyper-sensitivity o Cephalo-sporins o Penicillins |
| Adverse Effects: cefazolin (Ancef, Kefzol) | Common: • N/V • Diarrhea Serious: • Hyper-sensitivity |
| Nursing Interventions: cefazolin (Ancef, Kefzol) | • C&S for gram-negative • IM: large muscle • Take as prescribed • S/S allergic reaction |
| Class & Drug: Ciprofloxacin (Cipro) | Class: FLUORO-QUINOLONES Drug: Ciprofloxacin(Cipro) |
| Pharmacodynamics & Pharmacokinetics: Ciprofloxacin (Cipro) | Pharmacodynamics: • Bacteriocidal Pharmacokinetic: • Minimal penetration to CSF |
| Use and Contraindications: Ciprofloxacin (Cipro) | Use: • Aerobic gram-negative Contraindications: • Hyper-sensitivity • Children • Pregnancy • Breast-feeding |
| Adverse Effects: Ciprofloxacin (Cipro) | Common: • GI Serious: • Arthropathy |
| Nursing Interventions: Ciprofloxacin (Cipro) | • Complete full course • Small frequent meals |
| Class & Drug: Sulfamethoxazole-trimethoprim (SMZ-TMP, Bactrim) | Class: SULFONAMIDES Drug: Sulfamethoxazole-trimethoprim (SMZ-TMP, Bactrim) |
| Pharmacodynamics & Pharmacokinetics: Sulfamethoxazole-trimethoprim (SMZ-TMP, Bactrim) | Pharmacodynamics: • Bacteriostatic Pharmacokinetic: • Crosses BBB |
| 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 |
| Adverse Effects: Sulfamethoxazole-trimethoprim (SMZ-TMP, Bactrim) | Common: • N/V • Diarrhea Serious: • Hematopoietic effect • Crystalluria • Stevens-Johnson syndrome |
| Nursing Interventions: Sulfamethoxazole-trimethoprim (SMZ-TMP, Bactrim) | • Give on empty stomach • Increase fluids • Strategies to avoid photosensitivity & crystalluria |
| ANALGESICS Common Adverse Effect | Discolor urine |
| Class & Drug: acetylsalicylic acid (Aspirin, Bayer Aspirin) | Class: NSAIDS Salicylates Drug: acetylsalicylic acid (Aspirin, Bayer Aspirin) |
| Pharmacodynamics & Pharmacokinetics: acetylsalicylic acid (Aspirin, Bayer Aspirin) | Pharmacodynamics: • Antipyretic • Anti-inflammatory • Antithrombotic Pharmacokinetic: • Protein bound • Crosses placenta • Enters breast-milk |
| 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 |
| Adverse Effects: acetylsalicylic acid (Aspirin, Bayer Aspirin) | Common: • GI Serious: • Hepatic & renal toxicity |
| 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 |
| 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 |
| Class & Drug: ibuprofen | Class: Prostaglandin synthetase inhibitors Drug: ibuprofen (Motrin, Advil) |
| Pharmacodynamics & Pharmacokinetics: ibuprofen | Pharmacodynamics: • Inhibits prostaglandins Pharmacokinetic: • Highly protein bound • Slowed absorption with food |
| 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 |
| Class & Drug: acetaminophen | Class: Para-aminophenol derivatives Drug: acetaminophen |
| Pharmacodynamics & Pharmacokinetics: acetaminophen | Pharmacodynamics: • Exact mechanism unknown • Weak inhibitor or COX |
| Use and Contraindications: acetaminophen | Use: • Mild to moderate pain • Antipyretic (fever) Contraindications: • Hepatic disease • Viral hepatitis • Alcoholism (no with liver problems) |
| 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 |
| Class & Drug: | Class: Disease-Modifying Antirhuematic Drugs Drug: Methotrexate (Rheumatrex) |
| Pharmacodynamics & Pharmacokinetics: | Pharmacodynamics: • Immunosuppressive effects Pharmacokinetic: • Absorption decreased with food |
| 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 |
| 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 |
| 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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