Basic Pharmacology Review with Antidotes Flashcards
Antidote for OD on APAP/Tylenol
Acetylcysteine (Mucomyst)
Hepatotoxicity with acute OD
APAP, Tylenol
Non-narcotic analgesic
Acetaminophen
Has no anti-inflammatory properties
APAP/Tylenol
name 3 generic drugs that are NSAIDS
Aspiring (ASA), Motrin, Advil
Dose for antiplatelet properties with daily dosing
typically 81-325mg
NSAIDS therapeutic properties
inhibit prostaglandin synthesis and thromboxane (stops platelet aggregation)
SE for NSAIDS
Dizziness, confusion, tinnitus, epistaxis, N/V, GI bleed, bruising, gastritis, edema
Drug profiles for Narcotic analgesics
Morphine Sulfate, Meperidine, Methadone
MOA-Narcotics
Binds to opioid receptors to decrease pain perception
SE-Narcotics
Confusion, euphoria, sedation, pupil constriction, RESPIRATORY DEPRESSION, impaired coordination, N/V, urinary retention, constipation, physical and psychological dependence
Effect that narcotics produce to the eyes
constriction-miosis
2 things that are vital to assess before giving narcotics
respiratory rate and patient’s pain perception
What should you evaluate during the administration of narcotics
the effectiveness of medication given
Antidote for narcotic OD (give generic and trade)
naloxone hydrochloride (Narcan)
CNS agents (5 total)
Barbiturates, benzodiazepines, antiepileptics, antiepileptics/ Mood stabilizers, antipsychotics
MOA-barbiturates and their ending
potentiates GABA (-barbital)
CNS agent that promotes sleep/calm anxiety and their ending
benzodiazepines (-lams and -pams)
classification of Phenytoin (Dilantin) and dose range
benzodiazepine, 10-20
used as mood stabilizer
Clonazepam (Klonopin)
prototype-anti-epileptics
phenytoin (Dilantin)
given for gingival hyperplasia
carbamazepine (Tegretol)
antiepileptic- phenytoin may only be given how?
IV- only in NS and administered slowly
3 drugs-anti-epileptics/mood stabilizers
carbamazepine (Tegretol), valproic acid (Depakote), gabapentine (Neurotin)
ending for antipsychotics
-azine
MOA-anti-diabetic (insulin)
insulin binds to receptor sites on cells and allows glucose to enter the cell for energy
SE-anti-diabetics
hypoglycemia, ketoacidosis
Drug profiles for anti-diabetic agents (6)
Insulin, sulfonylureas, biguanides, thiazolidinediones, alpha-glucosidase inhibitors, meglitinides
essential to know before administering anti-diabetics
onset, peak, and duration (also patients last glucose level)
nursing considerations with anti-diabetics
roll gently, rapid first only IV, monitor blood sugar
classification of Digoxin (Lanoxin)
cardiac glycoside
prototype used for Congestive Heart Failure and/ A-Fib
Digoxin (Lanoxin)
MOA-digoxin (2 effects on the heart)
positive inotrope, negative chronotrope
SE-digoxin
bradycardia, arrhythmias, visual disturbances, HA, malaise, fatigue, anorexia, GI upset, N/D
Hypokalemia can increase toxicity with which drug
digoxin (Lanoxin)
Dose range for dig
0.5-2.0 mg/mL
What must you check before administering digoxin
heart rate (60-100)
Antidote for digoxin
Digoxin Immune Fab (Digibind)
MOA-beta blockers
blocks effects of SNS at beta receptor sites
SE-beta blockers
dizziness, drowsiness, insomnia, heart block, bradycardia, hypotension, and rash
Antidote for Beta-blocker overdose
glucagon
must obtain before administration of beta blockers
heart rate and B/P
monitor with beta-blockers
HR&B/P, I&O, wt
classification of lidocaine (Xylocaine)
sodium channel blocker
SE-sodium channel blocker
drowsiness, v-tach, heart block, HTN, bradycardia
monitor with administration of lidocaine (Xylocaine)
ECG
2 calcium channel blockers that do not have the ending -dipine
diltiazem (Cardizem), verapamil (Calan)
SE- calcium channel blockers
hypotension, bradycardia, peripheral edema
Nursing considerations-calcium channel blockers
monitor pulse and blood pressure
antidote for calcium channel blocker OD
Glucagon
nitrates SE
postural hypotension, HA, tachycardia
nursing consideration for why nitroglycerin isn’t taken PO but SL
large first pass effect
centrally acting agents MOA
binds to alpha 2 receptor sites and decreases outflow of the SNS from the brain
drug-centrally acting agents
clonidine (Catapres)
Alpha 1 Blockers ending
-zosin
classification (s) for alpha 1 blockers
anti-hypertensive and BPH
ACE inhibitors ending
-prils
ACE inhibitors MOA
inhibits the ACE in the lungs and prevents the formation of angiotensin II, this stops vasoconstriction and aldosterone
SE-ACE inhibitors
CAPTOPRIL-cough, angioedema, proteinuria, taste change, orthostatic hypotension, pruritus, renal failure/rash, increased potassium, liver toxicity/leukopenia
angiotensin II blockers ending
-sartans
Angiotensin II blockers MOA
binds to angiotensin II receptor sites
Diuretics MOA
inhibit the reabsorption of Na and H2O
what lab level must be checked before administering a diuretic?
potassium
name a loop diuretic
furosemide (Lasix)
loop diuretics ending
-amide
name a potassium-sparing diuretic
spirolactone (Aldactone)
name a thiazide diuretic
HCTZ
heparin is a drug affecting what
coagulation (its an anticoagulant)
what must you monitor in a patient while he is on heparin?
monitor PTT
what is the antidote for heparin?
protamine sulfate
enoxaparin is the generic name for what drug
Lovenox
the anti-coagulant warfarin-sodium (Coumadin) must be given with monitoring what 2 things?
monitor PT/INR
What is the antidote for warfarin sodium (Coumadin)?
vitamin K
side effect that’s associated with anticoagulants?
hemorrhage
name 3 antiplatelets
ASA, dipyridamole (Persantine), ticlopidine (Ticlid)
name an anti-fibrinolytic
aminocaproic acid (Amicar)
name two thrombolytics generic and trade name
streptokinase (Streptase) and alteplase (Activase)
what is identifying organisms and the drugs that kill the bugs?
culture and sensitivity
where is normal flora located?
oropharynx (bacteria, fungi, protozoa), upper and lower intestine, lower GU tract, conjunctive and skin.
what are microbial agents that prevent pathogens from causing infection when normal flora are killed during broad spectrum antibiotic therapy.
normal flora
name two drug resistant organisms
MRSA, VRE
antibiotics (8)
penicillin cephalosporin vancomycin tetracyclines aminoglycosides macrolides quinolones sulfonamides
anti-tubercular that prevent peripheral neuritis
isoniazid (INH) and pyridoxine (Vit B6)
side effects for aminoglycosides (antibiotic)
nephrotoxicity and ototoxicity
name 4 anti-tuberculars
ethambutol (Myambutol), pyrazinamide, rifampin, streptomycin
anti-viral agents for influenza A
amantadine and rimantadine
anti-viral agent for HSV
acyclovir (Zovirax)
anti-viral agents for CMV
cidofovir, ganciclovir, foscarnet
bone marrow suppressor that was the first anti-HIV medication inhibiting WBC, limiting HIV presence in the body (nucleotide reverse transcriptase inhibitor)
zidovudine (AZT)
two drugs that are classified as non-nucleoside reverse transcriptase inhibitors (NNRTIs)
delavirdine (rescriptor) and nevirapine (viramune)
antivirals that are classified as protease inhibitors
saquinavir (Invirase), ritonavir (Norvir), indinavir (Crixivan)
ending-anti-fungal agents
-azole
name 4 anti-fungal agents
griseofulvin, amphotericin B, diflucan (Fluconazole), Nystatin
GI drug that neutralizes gastric acid
antacids
magnesium is well known to cause
diarrhea
Calcium and aluminum causes
constipation
antacids should be avoided in what patient population?
renal patients
drug antagonist that binds to H2 receptor sites to decrease HCL acid production and its ending
H2 antagonist(-tidine)
drug classification that blocks all HCL acid production and its ending
proton pump inhibitors (-prazole)
this drug classification is contraindicated in AAC
anti-diarrheals
this drug class form a bulk stool and are safest and most natural
laxatives
what is an agent given to counteract the effects of poison?
antidote
name the medication (inhaled form) that is mainly used as a mucolytic agent to help liquefy respiratory mucous secretions.
acetylcysteine (Mucomyst)
unlabeled use of this drug can be given before potentially nephrotoxic exposure occurs to prevent kidney damage
acetylcysteine
MOA-acetylcysteine (Mucomyst)
protects the liver by maintaining cell function and preventing acetaminophen metabolites
List the standard maximum daily dose of APAP
3,000 mg/daily
treatment must be given for OD on APAP within ___hours of ingestion
24
whats the initial loading dose of acetylcysteine (Mucomyst)
140 mg/kg
after the initial dose of acetylcysteine (Mucomyst) (140 mg/kg), how many doses after are given and of how many mg/kg every how many hours?
17 doses
70 mg/kg/every 4 hours
IV form for the antidote: acetylcysteine (Mucomyst)
Acetado
Acetado is most effective if given within __hours of OD with acetaminophen
10
Acetado (IV form antidote for APAP OD) can be given up to __ hours after OD
24
Adverse reactions with activated charcoal (Actidose)
black stools, nausea, constipation, intestinal obstruction
follow charcoal (Actidose) administration with what treatment that does not contain what ingredient?
stool softener or laxative without the ingredient: sorbitol
MOA: anti-fibrinolytic
treats excessive bleeding from surgery or overactivation of fibrinolytic system
AR: anti-fibrinolytic
dizziness, seizures, thrombosis, renal failure
nursing considerations with aminocaproic acid
monitor coagulation studies
the patient must have the ability to do what when given an anti-fibrinolytic?
ability to clot
a chelating agent binds to what?
iron
deferoxamine mesylate (Desferal) is the antidote for what acute intoxication?
acute iron intoxication
MOA: deferoxamine mesylate (Desferal)
combines with iron in bowel lumen and prevents absorption
adjunctive tx of acute iron intoxication
chelating agent
what are the leading cause of poison death in children less than 6 years?
Iron pills
what antidote is a benzodiazepine antagonist?
flumazenil (Romazicon)
two specific antidotes mentioned that need to be monitored for resedation
narcan and rimantidin
AR: deferoxamine mesylate (Desferal)
blurred vision, diarrhea, hypersensitivity reactions/ anaphylaxis
you must monitor this type of patient with impaired renal function during the administration of which drug?
deferoxamine mesylate (Desferal)
digoxin immune FAB (Digibind) is used for what
OD of dig. severe bradycardia, advanced heart block, ventricular tachycardia or v-fib, and severe hyperkalemia
AR:digibind
heart failure, rapid ventricular rate, hypersensitivity reaction, anaphylaxis
what must you monitor with digibind?
potassium level
what is the parenteral form fo digibind?
40 mg/vial
disulfiram (Antabuse) inhibits the enzyme that converts _____________to ________ ________
acetaldehyde to acetic acid
AR: disulfiram (Antabuse)
drowsiness, impotence, disulfiram reaction with ethanol use, flushing, HA, dyspnea, nausea, copious vomiting, diaphoresis, thirst, confusion, anxiety, hypotension, severe respiratory/cardiovascular collapse, fatal MI
nursing consideration with disulfiram (Antabuse)
avoid sources of alcohol for 14 days after the last dose. never give without a pt’s knowledge.