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