pharmacology reviewer for nle.doc

8/13/2019 Pharmacology Reviewer for NLE.doc

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Decrease cardiac

conduction

Consti#ationDi..inessHeart failure

%! Increase dietary fier, fluidintake and e"reat with "ylenol*! Increase dietary fier, fluidintake and exercise

Angiotension-convertingen.yme inhiitors

Ca#oto#ril,enala#ril, ena.e#ril

0revents #roduction of

angiotension II, causingsystem vasodilation

Dry coughDro# in B0 duringfirst -* hoursfollowing first doseDi..iness,orthostatic

hy#otension

Hy#ertension&anagement ofCHF

! treat with "ylenol%! increase dietary fier, fluidintake and exercise*! advise clients to change#osition slowly+! monitor B0, weight, signs to

CHF resolutionAntihy#ertensives Hydrala.ine

hydrochloride,#ra.osinhydrochloride

$elaxes smooth muscle "achycardia,#al#itation/rthostatichy#otensionHeadache, di..inessausea, vomiting,diarrhea, anorexia6eight gain

Hy#ertension7congestive heartfailure

! monitor heart rate andrhythm%! teach client to stand u#, takestairs and move around slowly*! treat with "ylenol! "eachclient to lie down if di..y+! give with meals1! give diuretic if needed

Coigearedis2idmiadchCoincdruse

Antihy#ertensive &ethyldo#a 2ym#atholytic Drowsiness,

sedation/rthostatichy#otensionausea, vomitingDry mouth'dema, weight gain

Hy#ertension ! teach client that drug may

cause drowsiness and to standu#, take stairs and movearound slowly%! give with meals*! #rovide fluids, hard candy+! weigh daily1! give diuretic if needed

Agents for Fluid and'lectrolyte Balance

"hia.ides andthia.ide-likediuretics

Chlorothia.ide,hydrochlorothia.ide,chlorthalidone,9uinetha.one

Inhiit sodium

asor#tion In the kidney

Increase excretion of

sodium and water

Hy#okalemiaAltered glucosemetaolism

Hy#ertension'dema

! monitor intake and out#ut,weight and #otassium level%! teach client to increasedietary #otassium intake*! oserve for signs ofhy#okalemia+! monitor lood sugar1! oserve for signs ofhy#erglycemia

)ito Hitox#o

3oo# d iuretics Furosemide,ethacrynate

Inhiit sodium and

chloride rearsor#tion in

Fluid and electrolyteimalance

'dema0ulmonary edema

! monitor intake and out#ut,weight and serum electrolytes

)ito


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sodium, ethacrynicacid

the kidney

Increase excretion of

sodium and water

Hy#okalemiaHy#onatremiaHy#ochloremiaHy#ocalcemiaDehydration/rthostatichy#otension

%! teach clients to increasedietary #otassium intake*! oserve for signs ofHy#okalemia+! teach clients to stand u#,take the stairs and move slowly

Hitox#o3aa#dig

Caronicanhydraseinhiitor diuretics

Aceta.olamide 0romote urinary

excretion of sodium,#otassium, icaronate,

and water

AcidosisHy#okalemia

'dema)laucoma

! use for short-term treatmentor use intermittentadministration schedule

%! monitor intake and out#ut,weight and serum electrolytes*! teach client to increasedietary #otassium intake+! oserve for signs ofhy#okalemia

&iscellaneousdiuretics

2#inorolactone,triamterene

Increased excretion of

water and sodium

$educes #otassium

excretion

Hy#erkalemia 'demaHy#ertension

! monitor intake and out#ut,weight and serum electrolytes%! teach client to avoidexcessive dietary #otassium

&aco#odiu

&iscellaneousdiuretics

&annitol Increased osmotic

#ressure of glomerularfiltrate

Increased excretion of

water and electrolytes

Fluid and electrolyteimalances"ransient #lasmavolume increase0ulmonary edema

Cellular dehydration

/liguria'demaIncreasedintraocular#ressure

Increasedintracranial#ressure

! monitor vital sign includingcentral venous #ressure hourly%! insert Foley, record urineout#ut hourly*! monitor weight, intake and

out#ut and serum sodium and#otassium

I5 cry$einfo

'lectrolytere#lacement drugs

0otassium chloride ecessary for cardiac

contration, renal functionand transmission of nerveim#ulses

Cardiac arrhythmias,heart lock, cardiacarrest

Hy#okalemia ! give I5 infusions as dilutesolution infused slowly%! monitor '() and serum#otassium levels*! give oral dose with mealsand #lenty of fluids

Antimicroial Agents0enicillin Amoxicillin,

Am#icillin,Cloxacillin

Bactericidal

Inhiits cell wall

synthesis

Hy#ersensitivity:rash, urticaria,ana#hylaxis

)ram ;some )ram ;-=cocci

1! /tain client history?! /serve for hy#ersensitivity@! "ake meds as ordered! )ive -% hours efore meals

or %-* hours after meals forest asor#tion

$ede

Ce#halos#horins Cefa.olin,Ce#halexin,Ce#halotin sodium

Both actericidal andacteriostatic Hy#ersensitivity3ocal irritation atin8ection site

)ram ; some )ram ;-=cocci

! /tain client history%! Change I5 sites after * days*! Caution in #atients w renal

oglu


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Inhiits cell wall

synthesis

0ro#hylaxis

efore o#eration

#rolem '

un

Aminoglycosides )entamicin,eomycin,"oramycin,2tre#tomycin

Both actericidal and

acteriostaticInhiits cell wall synthesis

$enal toxicity/totoxicity

serious acterial

infections

Bowel sterility

eforegastrointestinalsurgery

! 6eigh client to otainaseline renal functionstudies

%! &onitor out#ut, urinalysis,B and creatinine levels

*! Increase fluid intake+! 'valuate clients hearing

efore and during

medication2ulfonamides 2ulfisoxa.ole

Central nervous2ystem Drugs

on-arcoticAnalgesics

A#irin Analgesic

Anti#yretic

Anti-inflammatory

0rolonged leedingtimeausea, vomiting, )Idistress

Arthritis&ild #ainfever

! "each client who takeslarge doses for a longtime to watch for signsof leeding

%! )ive with meals, milkor antacids

Cochyeuschlinsy

arcoticAnalgesics

Codeine sulfate&e#eridininehydrochloride&or#hine sulfate

Alter #erce#tion of #ain $es#iratoryde#ressionHy#otension!Bradycardia

2edation, cloudedsensorium, eu#horiaausea, vomiting,consti#ation

&oderate to severe#ain

! &onitor res#irationsefore and duringtreatment

%! &onitor B0 and #ulse

*! "each client to avoidactivities that re9uirealertness

arevindde

Anticonvulsants 0henytoin sodium Inhiits s#read of

sei.ure activity

Ataxia)ingival hy#er#lasia

)rand mal sei.ure ! Determine if ataxia is asym#tom of thedisease or a toxiceffect of the drug

%! "each client to avoidactivities that re9uirealertness

*! se only clearsolutions for infusion

+! )ood oral hygine andregular dental care

Dode#reoc

Autonomic ervous2ystem Drugs

CholinergicBlockers

Ben.tro#inemesylate, i#eridenhydrochloride,

0arasym#atholyticAnticholinergicBlurred visionDry mouth

0arkinsonsdisease'xtra #yramidal

! 0rovide fluids, hardcandy! Ice chi#s

%! Increase dietary fier,

'ld#ato


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#rocyclidinehydrochloride,trihex#henidylhydrochloride

Consti#ationrinary retention/rthostatichy#otensiondrowsiness

sym#tomsassociated withanti#sychotics

fluid intake andexercise

*! &onitor intake andout#ut

+! &onitor B01! "each client to avoid

activity that re9uiresalertness

Caeua

)astrointestinalDrugs

Antacids Aluminumhydroxide

Calcium caronateAluminummagnesiumcom#lex

$educe acid in )I tract

Decrease #e#sin

activity

Consti#ationHy#ernatremia

Hy#ermagnesemiahy#o#hos#hatemia

0e#tic ulcers ! $ecord amount andconsisting of stools

%! increase

Antiemetics 0rochlor#era.inemaleate"rimethoen.amidehydrochloride

Acts centrally y

lockingchermorece#tor trigger.one, which acts onvomiting center

Drowsiness,di..iness

ausea andvomitting

! "each client to avoidactivities that re9uirealertness

lcer &edications #ro#antheline Anticholinergic Drowsiness,di..iness, lurredvision

0e#tic ulcer ! "each client to avoidactivities that re9uirealertness

Hormonal Agents 2teroids Cortisone acetateDexamethasone#rednisone

Anti-inflammatory Adrenalinsufficiency

Allergic

inflammation,edema,immunosu#ression

Insulins 2emilente regularinsulin3ente 0Hltralente0rotamine

Facilitates trans#ort of

glucose into cells

3owers serum glucose

level

Hy#oglycemiahy#erglycemia

Diaetes me llitus ! )ive orange 8uice orcandy 0/

%! )ive ra#id actinginsulin

$erecno

2ulfonylureas "olutamideChlor#ro#amidetola.amide

Increase insulin release

from the #ancreas

hy#oglycemiahe#atotoxicity

Adult onset, non-insulin de#endentDiaetes mellitus

! "each client to take inmorning to avoidhy#oglycemic reactionat night

%! %! Avoid /"2medications andalcohol

Hematologic Agents Hematinics Ferrous sulfate 2ource of iron

re#lacement

ausea,consti#ation,lackstool

Iron deficiencyanemia

! Asor#tion est if givenetween meals

%! %! For )I u#set, give

5itinc


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with meals or orange8uice

*! *! "each client toincrease dietary fier,fluid intake andexercise

Anticoagulants He#arin sodium 0revents conversion of

firinogen to firin, and#rothromin

hemorrhage Hromosis0ulmonaryemolism&yocardial

infarction

! &onitor #latelet count%! &onitor #artial

thromo#lastintime;0""=

*! Avoid salicylates+! /serve for leddinggums, ruises, noseleeds, and #etechiae

I5 regsuin8

0"% tAn#ro

Antineo#lastics Act y many different

mechanisms, mostaffected DA synthesisor function

&any caused onemarrow de#ression,nausea, vomitingand mouth ulcers

CancerChemothera#hy

! Assess for signs ofinfection

%! &onitor #latelet count*! &onitor I5 site

carefully, ensure#atency, follow#rotocols for infiltrationto #revent tissue,ulceration and necrosis

+! 6ear gloves, masks,gowns while handlingor #re#aringmedication7 discarde9ui#ment indesignated containers

/stetrics /xytocics oxytocin 2timulates contractions

of the uterus

Hy#otension"achycardia fetalradycardia ortachycardiaDecreased urineout#ut

Induction of laor ! &onitor uterine contractions,lood #ressure, heart rateand fetal heart rate

%! &onitor intake and out#ut

sis defetfetfav

terine $elaxants $itrodinehydrochloride

Inhiits contraction of

uterine smooth muscle

Hy#otensionhy#ertension

0remature laor ! &onitor lood #ressure and#ulse

%! Heart rate and fetal heartrate

terine $elaxants "erutaline sulfate $elaxes uterine smooth

muscle

ervousness"remors

Headache

0remature laor ! &onitor lood #ressure and#ulse

%! Heart rate and fetal heartrate

scli

hehy


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Anticonvulsants &agnesium sulfate Anticonvulsant $es#iratorydde#ressionHeart lockCirculatory colla#seIncreasedmagnesium

0rimaryintracereralhemorrhage

! Hold drug if res#irations lessthan ?%

%! &onitor for arrhythmias*! &onitor intake and out#ut+! /serve for neuromuscular

or res#iratory de#resiion

Anglu

Antidotes Calcium gluconate eeded for

nervousmusculoskeletalen.yme reactions,

cardiaccontraction, loodcoagulation! Andendocrine andexocrinesecretions

BradycardiaArrhythmias5enous irritation

Hy#ermagnesemia ! &onitor #ulse%! &onitor for arrhythmias*! Assess I5 site

Codig

'strogens 'stradiol Hormone needed

for ade9uatefunctioning offemalere#roductivesystem7 inhiitsovulation

0romotes calcium

use in one

structure

Hy#oglycemiaDi..iness,hy#otensionausea, vomiting

A##etite increase,weight gainemolism

0revent#ost#artum reastsengorgement

!/serve glucose in diaetics%!&onitor weight*!$e#ort headache, chest #ain

arcoticAntagonists

aloxone Interferes with

narcoticasor#tion atnarcotic rece#torsites

$a#id #ulseDrowsiness,nervousnessausea, vomitting

"reatment ofnarcotic inducedde#ression ofneonate

!&onitor res#iratory rate andde#th of neonate

Anti-InflammatoryDrugs

Betamethasone Corticosteroid )Idistress,hemorrhage,#ancreatitis0oor wound healingC2 de#ression,flushing, sweating"hromocyto#enisHy#ertension, circ!Colla#se, emolism

2timulate lungdevelo#ment ininfant

!&onitor tem#erature%!&onitor lood #ressure,

re#ort chest #ain

Dodiscri

'ye &edications &iotics

0u#illlaryconstriction

&yo#iaBlurred vision )laucoma2urgical !sually disa##ears after -+ days of treatment 0rca


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#rocedures on theeye

or sy

&ydriatics 0u#illary dilatation,cyclo#legia

Blurred vision0hot#hoia

Acute inflammationof the eyeDiagnostic#rocedure

!6arn client aout tem#orarylurring of vision

%!Dark glasses*!"each client not to drive until

vision clearAnti-anxiety agents Ben.odia.e#ine

Com#oundsC2 de#ression&uscle relaxantanticonvulsant

2edatingAntihistamines

C2 de#resant 0reo#retivemedication

Anxiolytics us#irone nknown $elief of short tremanxiety

!"each %-* week lag timeefore thera#eutic effectachieved

%!&onitor B0, #ilseBeta-Blockers 0ro#ranolol

Clonidineon-selective B-locker Di..iness, confusion

Hy#otension,radycardiaDry mouthDrowsiness,sedation

Anxiety disoredersarcoticwithdrawalconvulsions

!/serve carefully%!&onitor when out of ed*!&onitor B0, #ulse+!Increase fluids

2edative-Hy#notics

Flura.e#am"erma.e#am"ria.olam

0roduces C2 de#ressionand sedation

Drowsiness,di.innes,lighthedeadness

2lee# disturanceof anxiatey2hort term useonly

!/serve carefully%!Advice caution when out of

ed*!2uicide assessment+!/tain emergency medical

tretament

Anti-de#ressantagents

"etracyclicAntide#ressants

Amoxa#ine&a#rotiline

Blocks re-u#take ofnore#ine#hrine andserotonin into nerveendings

AgranulocytosisHy#otension0aralytic ileus

de#ression !&onitor CBC%!Caution to stand u# slowly*!/serve for nausea and

vomitting"ricyclic

Antide#ressantsImi#ramineDesi#ramine

Amitri#tylinenortri#tyline

Blocks re-u#take ofnore#ine#hrine andserotonin into nerveendings

AgranulocytosisHy#otension0aralytic ileus

&a8or de#ressivedisorders

Agora#hoia0anic disorders/sessivecom#ulsivedisorder0sychogenic #aindisoreder

!&onitor CBC%!Caution to stand u# slowly*!/serve for nausea and

vomitting

&A/ Inhiitors Beacuase ofdietary restrictions,


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use as second lineantide#ressant ifotherantide#ressantsnot effective

&ood stail i.ers &ood 2tai li.ers 3ith ium caronate Alters a, (, and iontrans#ort in nerve7interferes with alance ofe#ine#hrine and serotoninin C2, therey affecting

emotional res#onses

Bi#olar disorder,manic #hase&a8or de#ression

Aggressiveconduct disorder

pharmacology reviewer for nle.doc

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