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Pharmacology Exam 3

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Created by: serenity5234

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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