Pharmacology for Nurses
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| Emergency drugs to lean on | Lidocaine, Epinephrine, Amiodarone/ Atropine, Narcan
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| Why are vasoconstrictors and local anesthetics combined? | Termination of local anesthesia is determined in large part by regional blood flow. Hence, the combination of epinephrine , a vasoconstrictor, prolong anesthesia.
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| What nerves do they (local anesthetics) affect? | Suppresses pain by blocking impulse conduction along axons
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| Mom had an epidural. You are the nursery nurse. What do you monitor for? | Respiratory distress, bradycardia
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| Combined anesthesia and analgesia | Balance anesthesia refers to the uses of several drugs to ensure that inductions of anesthesia is smooth and rapid and that analgesia and muscle relaxation are adequate.
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| What does atropine prevent? | May be given to prevent bradycardia
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| Neuromuscular blocking agents, what do they do? | paralyze, relax muscles, good for surgery
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| If med (pain) is not working, what to do? | Contact provider
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| Labor mom received Demoral, what to watch in baby? | Bradychardia, respiration
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| What to avoid with Butrans? | Watch for exposure to sun
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| Side of effects of morphine | urinary retention(Relaxes the bladder muscles), lowers blood pressure,
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| Narcotic antagonist | Increases blood pressure, tremors, hyperventilation
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| Respiratory Depression | Ask provider for Narcan
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| What are the different ways Fentanyl can be used? | Commonly used for analgesia as IV drip in ICU patients and is used to induce and maintain anesthesia, Also used transdermally (patch) as a patch for postoperative pain and chronic pain relief
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| Epidural | use lidocaine or bupivacaine; injected into the epidural space and diffusion of anesthetic across dura
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| Fentanyl: the risk | Respiratory depression, sedation, constipation, urinary retention, nausea; schedule II drurg
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| Imitrex: drug interaction | avoid use with ergotamine and MAOIs in the last 24 hours (oxygen therapy)
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| Prader-Willi Syndrome | Fatalities have occurred in PWS patients treated with GH. Growth hormones is contraindicated in PWS patients who are severely obese or have severe respiratory impairment.
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| Growth hormones | If it is cloudy with particles DO NOT USE IT
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| Effects of prolactin in males | In men, libido and potency are reduced; galactorrhea occurs on occasion
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| Cushing's syndrome | One cause in excess glucocorticoid
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| Glucocorticoids therapy- know when and how to take | when there is an adrenal insufficiency; Giving the entire daily does in the morning, or by splitting the daily does, giving, two-thirds in the morning and one-third in the afternoon. Increase doses at times of stress (surgery, infection, trauma)
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| Estrogen Therapy | Adverse Effects: can cause endometrial and ovarian cancers when on prolonged therapy, increased risk of breast cancer, can cause embolic events (MI, pulmonary embolism, DVT, stroke)
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| IUD | IUDs are among the most reliable forms of reversible birth control, neither device prevents ovulation, can cause cramping and alteration of menses
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| Oral contraceptives, breast tenderness, nausea | lower patients's dosage
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| Tocolytics, what do they do? | Used to delay delivery by 24-28 hours; suppress preterm labor and delay delivery
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| Magnesium sulfates | suppress preterm labor; administered IV; also used to manages pregnancy-induced hypertension or eclampsia
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| Thinks to Know about insulin | Cannot be given PO, only give Regular IV, know onset, peak, and duration of actions, double check dose, store in the refrigerator, when to give and not to give (related to procedures),
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| Rapid-Acting Insulin | Onset 5-15 minutes-just before meals, Can be given SQ or as a SQ infusion, Cannot be give IV, clear solution,
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| Short Acting insulin | Injected or inhaled 30-60 minutes before meals, SQ, IM, IV, inhaled, control postprandial hyperglycemia, SQ to provide basal control, IV to treat DKA, if client doesn't eat, do no give
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| Intermediate Acting Insulin | Peak 6-14 hours, duration 12-14 hours. NPH in the only insulin that is still cloudy, gently roll between the palms to make the suspension uniform
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| Long Acting Insulin | Onset 1 hour, no peak= basal (less risk of hypoglycemia), maintains a steady state for 24 hours, given once a day usually at bedtime, NEVER GIVE IV
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| Mixture Insulin | The mixture relates to the amount of rapid/short acting insulin and the amount of intermediate acting insulin; Humulin 70/30 = 70% NPH and 30% Regular
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| What are three things to look for with diabetes? | Hyperglycemia, hypoglycemia, and DKA
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| A1 C and what is shows? Duration time? | Hgb A1c measures glycemic control for the previous 60-90 days – (it is basically a “tattle tale” for how the client has managed their blood sugar, what they have eaten). In the diabetic client, we would like to see the Hgb A1c less than 7%.
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| Thyroid replacement | thyroid replacement is LIFELONG!
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| Levothyroxine can increase free warfarin | increased risk for bleeding
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| IUD | Someone who is sexually active with many partners is not the best person to get an IUD because of STDs
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| osteopenia | helps prevent the onset of osteoporosis
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| PWS- who should not take treatment? | those with liver issues
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| Ketoconazole, what does it do? | Can be used to suppress synthesis of adrenal steroids in patients with Cushing's syndrome.
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| Spinal anesthetic | use bupivacaine, lidocaine, and/or tetracaine; local anesthetic injected into subarachnoid space; watch for hypotension
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| Imitrex | Considered the BEST drug for migraine attacks
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| Hypothyroidism | Cold, dry skin, fatigue, intolerance to cold, heart rate and temperature is lowered;
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| Hyperthyroidism | Grave's Disease or toxic nodular goiter; more common in women, CNS stimulated, intolerance to heat, skin is moist and warm, appetite increased
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| Anterior Pituitary Hormones | GH, ACTH, TSH, FSH, LH
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| Posterior Pituitary Hormones | ADH, Oxytocin
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| levothyroxine, when is it taken? | On an empty stomach in the morning, at least 30 to 60 minutes before breakfast
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| levothyroxine, patient has taken and deemed ineffective. What do you, the nurse, do first? | Asses- When was it lasted filled?
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| Does beta-blocker and insulin mix well? | NO! Don't prescribe Beta blockers with insulin. It will cause hypoglycemia.
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| Who can use oral hypoglycemic agents? | Can only be used by Type II diabetics
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| Name the oral hypoglycemic agents | sulfonylureas, biguanides, alpha glucosidase inhibitors, meglinitides, thiazolidnediones
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| Thyroid with pregnancy do we treat with this? | Yes
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