Medications Flashcards
OXYGEN (02): Indications for use
Treatment of hypoxaemia by increasing alveolar oxygen tension. The aim is to achieve a normal or near-normal oxygen saturation for an individual patient
OXYGEN (02): Monitoring Requirements
SpO2, RR, PaO2, Arterial Blood Gas, colour of patient
OXYGEN (02): Patient Education
Include correct administration and use of oxygen delivery devices
OXYGEN (02): Adverse Effects
Toxicity with prolonged exposure to high O2 concentrations; decreased affinity of Haemoglobin for CO2 in CO2 retainers (Haldane effect)
OXYGEN (02): Precautions
Oxygen therapy devices should not be used near an open flame due to its’ high combustibility
OXYGEN (02): Pharmacodynamics
Oxygen therapy improves effective cellular oxygenation. It acts to restore normal cellular activity at the mitochondrial level and reduce metabolic acidosis
OXYGEN (02): Pharmacokinetics
Oxygen is largely inhaled into the alveoli and diffuses into the capillary bed. Oxygen combines with haemoglobin, with a small amount being dissolved in the plasma. Oxygen is metabolised in the tissues almost entirely in the mitochondria, where oxidative enzymes reduce the oxygen in the formation of adenosine triphosphate (ATP). Excretion of oxygen metabolites (CO2 and H2) is via the lung and renal system
SALBUTAMOL Short-acting adrenergic agonist (SABA): Indications for use
Bronchodilator - relief of symptoms during maintenance treatment of asthma and COPD; prevention or treatment of exercise/allergen induced bronchospasm
SALBUTAMOL Short-acting adrenergic agonist (SABA): Monitoring requirements:
Peak flow measurements before and after administration can help determine effectiveness
SALBUTAMOL Short-acting adrenergic agonist (SABA): Patient Education
Common side effects to expect, appropriate delivery of inhaler (including spacer, mouth care), Asthma and COPD action plans
SALBUTAMOL Short-acting adrenergic agonist (SABA): Adverse Effects
Tachycardia, headache, nervous tension, fine hand tremor, hypotension, hyper/hypokalaemia (which may cause weakness, fatigue, tremors, muscle spasm)
SALBUTAMOL Short-acting adrenergic agonist (SABA): Contra-indications
Caution with cardiovascular disease, diabetes and hypertension. The inhaler may contain lactose
SALBUTAMOL Short-acting adrenergic agonist (SABA): Pharmacodynamics
Salbutamol is a B2-adrenergic agonist and stimulates B2-adrenergic receptors. Binding to these receptors in the lungs results in relaxation of bronchial smooth muscles
SALBUTAMOL Short-acting adrenergic agonist (SABA): Pharmacokinetics
Onset by inhalation is rapid (5-15 mins). Peak effect reached in 1-2 hours. Metabolised in the liver and excreted in kidneys
GTN (Glyceryl Trinitrate Antianginal): Indications for use
Chest Pain/Angina
GTN (Glyceryl Trinitrate Antianginal): Monitoring Requirements
BP and HR
GTN (Glyceryl Trinitrate Antianginal): Patient Education
Sit down, Stand up slowly
GTN (Glyceryl Trinitrate Antianginal): Side Effects
Flushing, Headache, Dizziness, Dry mouth (rare)
GTN (Glyceryl Trinitrate Antianginal): Contra-indications
VIAGRA, ETOH (ethanol), HR <50
GTN (Glyceryl Trinitrate Antianginal): Pharmacodynamics
Antagonises NO receptors = relaxes smooth muscle. Dilates veins and arteries. Reduces BP
GTN (Glyceryl Trinitrate Antianginal): Pharmacokinetics
Sublingual, dermal, rapidly metabolised short duration
Morphine Sulfate: ADDITIONAL NAMES INCLUDE:
Morphine Sulfate (IV), Oxynorm, Sevredol, MS Contin
MORPHINE SULFATE: Indications for use
Analgesia/sedation
MORPHINE SULFATE: Monitoring Requirements
RR, BP, HR
MORPHINE SULFATE: Patient education
Careful mobilising. Avoid ethanol and other opiates
MORPHINE SULFATE: Side Effects
Sedation, Dizziness, Nausea, constipation, hallucinations
MORPHINE SULFATE: Contra-Indications
Respiration rate, depression, severe asthma, acute abdomen pain, traumatic brain injury (TBI)
MORPHINE SULFATE: Pharmacodynamics
Opioid mu-receptor antagonist. Targets CNS opiate receptors. Depresses CNS, RR, GI. Vasodilation
MORPHINE SULFATE: Pharmacokinetics
Oral, IM, IV, Per rectum. Short half life
Low Dose Aspirin (Acetylsalicylic Acid) NSAID: Indications for use
Anti-Platelet
Low Dose Aspirin (Acetylsalicylic Acid) NSAID: Monitoring Requirements
Monitor for signs of increased bleeding, peptic ulcer disease
Low Dose Aspirin (Acetylsalicylic Acid) NSAID: Patient Education
Do not take if you have a history of peptic ulcer disease, Asthma or uncontrolled high blood pressure, take with food
Low Dose Aspirin (Acetylsalicylic Acid) NSAID: Common Adverse Effects
GI bleeding, Acute renal insufficiency
Low Dose Aspirin (Acetylsalicylic Acid) NSAID: Contra-indications
Asthma, GI bleeding, peptic ulcer
Low Dose Aspirin (Acetylsalicylic Acid) NSAID: Pharmacodynamics
Impedes clotting by blocking prostaglandin synthesis preventing formation of platelet-aggregating substance thromboxane A2 - works for lifespan of platelet
Low Dose Aspirin (Acetylsalicylic Acid) NSAID: Pharmacokinetics
Oral, IV, per rectum. Rapidly absorbed, peak serum levels 60 minutes
Atorvastatin / Lipitor HMG CoA Reductase Inhibitors: Indications for use
Reduce the risk of heart attack and stroke by lowering total cholesterol and low-density lipoprotein cholesterol
Atorvastatin / Lipitor HMG CoA Reductase Inhibitors: Monitoring Requirements
Liver Function
Atorvastatin / Lipitor HMG CoA Reductase Inhibitors: Patient Education
Avoid grapefruit juice, Minimal alcohol, Can be taken at any time of the day - with or without food
Atorvastatin / Lipitor HMG CoA Reductase Inhibitors: Common Side Effects
Dyspepsia, nausea, flatulence, diarrhoea, muscle pain, tenderness or weakness
Atorvastatin / Lipitor HMG CoA Reductase Inhibitors: Contra-Indications
Avoid in pregnancy, care in liver disease
Atorvastatin / Lipitor HMG CoA Reductase Inhibitors: Pharmacodynamics
Lowers plasma cholesterol and lipoprotein levels, the liver is the primary site of action
Atorvastatin / Lipitor HMG CoA Reductase Inhibitors: Pharmacokinetics
Oral, Mean elimination half-life values range from 11 to 24 hours
METOPROLOL (beta blocker): Indications for Use
Hypertension, angina, heart failure, arrhythmias, post-myocardial infarction, migraine prophylaxis
METOPROLOL (beta blocker): Monitoring Requirements
BP and HR
METOPROLOL (beta blocker): Patient Education
Do not stop abruptly, modified release tablets can be halved or swallowed whole with a glass of water. Do not crush or chew
METOPROLOL (beta blocker): Side Effects
Dizziness, nausea, fatigue, bradycardia
METOPROLOL (beta blocker): Contra-indications
Avoid in patients with a history of asthma - can precipitate bronchospasm. Do not confuse immediate release and modified release
METOPROLOL (beta blocker): Pharmacodynamics
B1-selective B-blocker; reduces or inhibits the agonistic effect of catecholamines on the heart
METOPROLOL (beta blocker): Pharmacokinetics
Oral, IV. The mean elimination half-life of metoprolol in plasma is 3.5 hours
Cilazapril, Enalapril / ACE Inhibitors: Indications for use
For treatment of fluid volume excess in heart failure and hypertension
Cilazapril, Enalapril / ACE Inhibitors: Monitoring Requirements
Maintain BP and HR, fluid balance and weight documentation and watch urine output
Cilazapril, Enalapril / ACE Inhibitors: Patient Education
May take some time to work. Have regular BP checks. Avoid alcohol. Will need blood checks
Cilazapril, Enalapril / ACE Inhibitors: Common side effects
Dehydration, hyperkalaemia, dry cough
Cilazapril, Enalapril / ACE Inhibitors: Contra-indications
Significant drug interactions, precautions kidney function, rash, liver impairment
Cilazapril, Enalapril / ACE Inhibitors: Pharmacodynamics
Prevents angiotensin I from converting to angiotensin II. Prevents constriction of blood vessels and prevents angiotensin I from secreting aldosterone. Promotes diuresis
Cilazapril, Enalapril / ACE Inhibitors: Pharmacokinetics
Oral, IV. Binds to tissue and plasma protein. Often by glomerular filtration, absorbed and eliminated rapidly. BP decreases, heart rate decreases and urine output increases
FRUSEMIDE (Frusid, Lasix) Loop Diuretic: Indications for use
Treatment of oedema associated with heart failure, cirrhosis, renal impairment and nephrotic syndrome
FRUSEMIDE (Frusid, Lasix) Loop Diuretic: Monitoring Requirements
Weight, blood pressure, pulse, electrolytes, fluid balance
FRUSEMIDE (Frusid, Lasix) Loop Diuretic: Patient Education
Take with food. Possible potassium supplements, report ringing in ears, abdomen pain, muscle weakness and cramps
FRUSEMIDE (Frusid, Lasix) Loop Diuretic: Side Effects
Electrolyte disturbance, dizziness, postural hypotension, ototoxicity
FRUSEMIDE (Frusid, Lasix) Loop Diuretic: Contra-indications
Interacts with several drugs including Aminoglycoside antibiotics, anticonvulsants, anti diabetics (etc)
FRUSEMIDE (Frusid, Lasix) Loop Diuretic: Pharmacodynamics
Inhibits reabsorption of sodium and chloride in the loop of Henle
FRUSEMIDE (Frusid, Lasix) Loop Diuretic: Pharmacokinetics
Oral, IV. Highly protein bound, oral half life 1-2hrs, peak effect 1 hr, IV peak effect 30 mins
Low Dose Asprin (acetylsalicylic acid) ANTI-PLATELET: Monitoring Requirements
Monitor for signs of increased bleeding (coffee ground vomit/dark stool), peptic ulcer disease
Low Dose Asprin (acetylsalicylic acid) ANTI-PLATELET: patient education
do not take if you have a history of peptic ulcer disease, asthma or uncontrolled high blood pressure without consultation with a MO. Take with food.
Low Dose Asprin (acetylsalicylic acid) ANTI-PLATELET: Common adverse effects
GI Bleeding, Acute renal insufficiency
Low Dose Asprin (acetylsalicylic acid) ANTI-PLATELET: Significant drug interactions
some vaccines, ginkgo biloba, SSRIs
Low Dose Asprin (acetylsalicylic acid) ANTI-PLATELET: Pharmacodynamics
Impedes clotting by blocking prostaglandin synthesis preventing formation of platelet-aggregating substance thromboxane A2- works for lifespan of platelet
Low Dose Asprin (acetylsalicylic acid) ANTI-PLATELET: Pharmacokinetics
Rapidly absorbed from stomach (and more slowly small intestine), peak serum levels 20-40 minutes. Rapidly metabolised by tissue and converted to acetic acid and salicylate. Salicylate binds to plasma protein for distribution. Excreted via kidneys.
