Pharmacology Flashcards
Magnesium Sulfate
- *Indication** HTN, hypomagnesameia, preterm labor, torsade de pointes, asthma, anticonvulant with eclampsia
- *Action** magnesium plays a role in muscle excitability
- *Class** mineral/electrolytes
- *Nursing Considerations** caution with renal insufficiency, decreased respiratory rate, dysrthymias, hypotension, muscle weakness. Monitor EKG and repsiratory status. Monitor Mg levels. 2 practictioner check
Altepase
- Indication MI, Acute ischemis strok, occluded central lines
- Action converts plasminogen to plasmin, degrades fibrin in clots
- Class thrombolytic
- Nursing Considerations Intracranial hemorrhage, bleediing, anaphylaxis, HTN, neuro status
Calcium Acetate
Indication hypocalcemia, menopausal osteoporosis, hypokalemia,
Action maintains cell membranes, muscle contraction, nerve impulses, blood formation and coagulation
Class antacids, minerl/electrolyte replacement
Nursing cardiac arrest and arrhythmias, phlebitis at insertion, hypotension, bradycardia, hypercalcemia, dig toxicity, watch parathyroid hormone
Antidote for Benzodiazepines
Flumazenil
Vasopressin
- *Indication** MGMT of diabetes insipidius, Vt/VF, unresponsibe to initial shock, GI hemorrhage
- *Action** increases water permeability of the kidney collecting duct and distal convoluted tubule elading to water retention, also increases peripheral vascular resistance leading to increased BP
- *Class** antidiuretic hormone
- *Nursing Considerations** caution with HF, and CV disease, contraindicated in renal failure, hypersensitivity to pork. Monitor vitals. Monitor urine specific gravity & osmolality. Weight pt and assess for edema. Monitor electrolyte panel. DO NOT USE alcohol
Propanolol
- *Indication** hypertension, angina, arrthymias, cardiomyopathy, alcohol withdrawal, anziety
- *Action** blocks Beta 1 & 2
- *Class** antianginal, antiarrthymic, antihypertensive, headache suppressant, beta blocker
- *Nursing Considerations** pulmonary edema, contraindicated with CHF, cardiogenic shock, bradycardia, heart block. Masks symptoms associated with diabetes mellitus. Advise physician if difficulty breathing
Atenolol
- *Indication** hypertension, angina, prevention of MI
- *Action** blocks the stimulation of beta 1 receptors in the SNS w/ minimal effect on beta 2
- *Class** antianginal, antihypertensive, beta blocker
- *Nursing Considerations** monitor hemodynamic parameters, bradycardia, CHF, pulmonary edema, Masks symptoms associated with diabete mellitus, advise to change positions slowly to prevent orthostatic hypotension, instruct pt on how to take BP
Diphenoxylate/Atropine
Indication tx of diarrhea
Action inhibits GI motility via anticholinergic effects
Class antidiarrheal, anticholinergic
Nursing contraindicated with angle closure glaucoma, dehydration, r/t opioids watch patients allergic to opioids, SE- constipation, tachycardia, dizziness, ilues, monitor liver, do not double dose
Benzotropine
Indication Parkinson’s Disease
Action anticholinergic to reduce rigidity and tremors
Class antiparkinson, anticholinergic
Nursing arrthymias, hypotension, palpitations, tachycardia, constipation, dry mouth, assess extrapyramidal symptoms, good oral hygiene
Ketorolac (Toradol)
- *Indication** pain
- *Action** pain relif due to prostaglandin inhibition
- *Class** nonsteroidal antiinflammatory agent, non-opioid analgesics, pyrroziline carboxylic acid
- *Nursing Considerations** Steven Johnson Syndrome, anaphylaxis, drosiness, GI bleed, should not exceed 5 days of tx, increased bleeding risk with garlic, ginger and ginkgo, decrease HTN meds and diuretics
Norepinephrine
- *Indication** tx of severe hypotension and shock
- *Action** increase BP and COutput by stimulating alpha-adrenergic receptors in the blood vessels, demonstrates minor beta activity
- *Class** vasopressor
- *Nursing Considerations** monitor bp every couple minutes, can result in rebound hypotension due to tissue ischemia, monitor EKG and CVP if possible. Instruct pt to report headaches, dizziness, and chest pain
Epinephrine
Indication adrenalin, asthma, COPD exacerbations, allergic, cardiac arrest, anesthesia adjunct
Action both beta 1 and beta 2, alpha agonist properties. Bronchodilation, increases HR and BP
Class antiasthmatic, bronchodilator, vasopressor, adrenergic
Nursing angina, tachycardia, hytpertension, restlessness, nervouseness, hyperglycemia, MAOIs can lead to hypertensive crisis, do not use stimulants, hemodynamics, chest pain, adequate fluid intake, rinse after inhalation, beta blockers negate effects, increased blood sugar
Pancrelipase
- *Indication** pancreatic insufficiency, ductal obstruction
- *Action** replacement of pancreatic enzymes: lipase, amylase, protease
- *Class** digestive agent
- *Nursing Considerations** contraindicated in pig products, SOB, rash, assess nutritional status, monitor for steatorrhea, increase uric acid levels, take with meals
semide
diuretic
Hydrochlorothiazide
Indication hypertension, CHF, renal dysfunction, Cirrhosis, glucocorticoid therapy
Action selectively inhibits reuptake serotonin
Class anti hypertensive, diuretics, thiazide diuretic
Nursing dizziness, hypokalemia, hyponatremia, hypophosphatemia, hypomagnesemia, dehydration. hypokalemai can increase risk for dig toxicity. Monitor BP and I/Os. Monitor electrolyte levels. Take same time each day. How to take BP.
-tricin
antibiotics
Altorvastatin
- *Indication** high cholesterol
- *Action** lowers LDL, increase HDL, inhibits HMG-CoA reductase in liver and cholesterol formation
- *Class** lipid lowering agent
- *Nursing Considerations** contraindicated with liver disease,may cayse rhabdomyolysis, renal function, monitor cholesterol, report muscle weakness
Bismuth Subsalicylate
Indication diarrhea, heartburn, indigestion, H.pylori ulcer
Action stimulates absoprtion of f/e’s in intestinal wall, reduction of hypermotility of stomach and binds to toxins
Class antidiarrheal, antiulcer, adsorbant
Nursing contraindicated in aspirin, hypersensitivity, increase risk for impaction with geratric and pediatric patients, monitor liver profile, bismuth may intere fere with radiologic exams
What lab value is an increased risk for dig toxicity
hypokalemia
- Adol -aldol
ex: Tramadol
Analgesic
Indomethacin
Indication inflammaotry disorders when pts do not respond to other meds.
Action decrease pain and inflammation by inhibiting prostaglandin synthesis
Class antirheumatic, ductus arteriosis patency, nonsteroidal antiinflammatory agent
Nursing monitor hepatitis and GI bleed, dizziness, drowsiness and headache. Assess for anaphylactic reaction. Aspirin may decrease effectiveness. Monitor renal labs. Shake supension before administration. Pt should wear sunscreen and protective clothing to protect against photosensitivity.
-azosin
alpha blockers
Examples of selective beta 1s
MEAANe
- Metroprolol
- Exmolol
- Acebutolol
- Atenolol
- Nebivolol
Insulin Mixture
Humulin 70/30
- *Indication** hyperglycemia with diabetes type 1 and type 2, ketoacidosis
- *Action** stimulates uptake of glucose into muscle and fat cells, inhibits production of glucose in the livere, prevents breakdown of fat and protien
- Lispro Mix 15-30 min , pk 2-3 hr*
- Aspart Mix 15 min, 1-4 hr*
- NPH reg 30 min, 4-8 hours*
- *Class** lpancreatics, antidiabetics
- *Nursing Considerations** monitor body weight over time, may cause decreased inorganic phsophates, potassium and mag. Monitor B/S Q6, monitor A1C every 3-6 months
Enalapril
Indication hypertension, MGMT of CHF
Action iblock conversion of angiotensin I to angiotensin II, increases renin levels and decrease aldosterone, vasodilation
Class ACE inhibitor, antihypertensive
Nursing neutropenia, caution with potassium, watch diuretic therapy, admin 1 hour before meals, monitor BP, monitor weight and fluid status, monitor renal profile, monitor CBC
-olone
steroid
Diltiazem
Indication HTN, angina, SVT, Afib, Aflutter
Action inhibits calcium transport resulting in inhibition of excitation and contraction, leads to vasodilation and decreased bp
Class antianginals, antiarrhythmics, antihtn, Calcium Channel Blocker
Nursing contraindicated in 2nd and 3rd av block, dysrythmias, CHF, bradycardia, peripheral edema, ginigval hyperplasia, increases dig levels, no grapefruit juice, monitor EKG, ortho hypotension, monitor potassium, teach how to take BP
Trimethroprim/Sulfamethoxazole
- *Indication** bronchitis, UTI, diarrhea, pneumonia, multiple types of infection
- *Action** bacteriacidal by preventing metabolism of folic acid
- *Class** folat antagonist, antiinfective, antiprotozoal
- *Nursing Considerations** renal damage, steven johnson syndrome, agranulocytosis, aplastic anemia, phlebitis, drink 8-10 glasses of water
Omeprazole
- *Indication** GERD, ulcers, Zollinger syndrome, reduce risk of GI bleed in ill patients, heart burn
- *Action** prevents the transport of H ions into gastric lumen by binding to gastric parietal cells.
- *Class** antiulcer agent, ppi
- *Nursing Considerations** capsules should be swallowed whole, report black tarry stools
Drugs that alter electrolytes
- diuretics
- Thiazides- hold on to Ca & Uric Acid
- ACE- hyperkalemia
- Steroids- hypokalemia
Oxytocin
- *Indication** labor induction, postpartum bleeding
- *Action** stimulates uterine smooth muscle
- *Class** hormone, oxytocics
- *Nursing Considerations** ICH in fetus, asphyxia in fetus, may cause coma and seizures in mother. Monitor blood pressure, assess maternal electrolytes. Uterine Tetany
Cimetidine
Indication duodenal ulcers, CERG, heartburn, Zollinger Ellison syndrome, GI bleeding in crit patients
Action iinhibits action of histamine leading to inhibition of gastric acid secretion
Class H2 antagonist, antiulcer agent
Nursing increases serum levels of warfarin, respiratory infection, watch dysryhthmias, agranulocytosis, aplastic anemia, monitor CBC, increase fluid and fiber intake to decrease constipation
Insulin Rapid Acting
novolog, humalog, apidra,, aspart, lispro, glulisine
- *Indication** hyperglycemia with diabetes type 1 and type 2, ketoacidosis
- *Action** stimulates uptake of glucose into muscle and fat cells, inhibits production of glucose in the livere, prevents breakdown of fat and protien
IAspart 1-20 min , 1-3 hr
glulisine 15 min 1 hr
lispro 15 min 1-1.5 hr
- *Class** lpancreatics, antidiabetics
- *Nursing Considerations** monitor body weight over time, may cause decreased inorganic phsophates, potassium and mag. Monitor B/S Q6, monitor A1C every 3-6 months
Morphine
- *Indication** pain, pulmonary edemia, MI
- *Action** binds to opiate receptors in the CNS and alters perception of pain. Decreases cough reflex and GI motility
- *Class** opioid analgesic,
- *Nursing Considerations** hypotension, constipation, N/V, BP, pulse, RR. Caution with pt receiving MAOIs
Gabapentine
Indication seizures, peripheral neuropathy, neuropathic pain, prevention of migraines
Action exact method of action is unknown
Class anticonvulsant, mood stabilizer
Nursing suicidal thoughts, confusion, depression, drowsiness, ataxia, facial edema, HTN. Monitor pt closely for changes in behavior and dpression. Asses seizure activity, pain. Take as prescribed
-dil-
Vasodilator
Glucagon
Indication severe hypoglycemia, antidote for beta blockers and calcium channel blockers
Action stimulates production of glucose, relaxes GI tract
Class pancreatic, hormone
Nursing anaphylaxis, hypotensionn. Assess for hypoglycemia, neuro status. Monitor serum glucose. Teach pt signs of hypoglycemia
Lamotrigine
- *Indication** Seizures r/t epilepsy, bipolar
- *Action** inibits sodium transport in neurons
- *Class** anticonvulsant
- *Nursing Considerations** suicidal thoughts, dizziness, behavior changes, N/V, photosensitivity, rahs, Steven Johnsons, caution with oral contraceptiv, assess mental status,
Hydralazine
Indication Hypertension
Action arterial vasodilator
Class anti hypertensive, vasodilator
Nursing tachycardia, sodium retention, dysrthymias, angina. Use caution with MAOIs. Monitor BP. Instruct pt on how to take BP
Clindamycin
Indication skin infections, respiratory tract infections, septicemia, intraabdominal infections, osteomyelitis
Action inhibits protein synthesis
Class antiinfective
Nursing arrhthmias, pseudomemrbanous colitis, diarrhea, phlebitis, watch bowel function, cultrues prior to therapy, monitor liver function, monitor cbc
-pidem
hynotic/sedative
Drugs that are ototocxic?
- Loop diuretics
- Aminoglycoside Antibx (Gent)
- Aspirin
-pezil
acetycholinesterase inhibitor
anti-alzheimer agent
Metformin
- *Indication** mgmt of type II DM
- *Action** decreases glucose production inthe liver, decrease absorption, increases ellular insulin sensitivity
- *Class** antidiabetic, Biguanide
- *Nursing Considerations** do not use with renal dysfunction, metabolic acidosis. May cause diarrhea, N/V, lactic acidosis. D/C if acidotic.
Paroxetine
- *Indication** major depressive disorder, OCD, anxiety, PTSD
- *Action** blocks reuptake of CNS
- *Class** antianxiety agent, antidepressant, SSRI
- *Nursing Considerations** neurleptic malignant syndrome, decrease effectiveness of digozin, increase bleeding with warfarin, suicidal thoughts
-thiazide
diuretics
-pamil
vasodilator
-pril
ACE inhibitor
Iron Antidote
Deferoxamine
Antidote for tylenol
acetycysteine
Buproprion
Indication depression, smoking cessation, ADHD
Class antidepressant, smoking deterrents, aminoketones
Nursing seizures, suicidal thoughts, do not take w/ MAOI, renal/liver impairment, assess mental status, avoid alcohol
Alendronate
- *Indication** osteoporosis
- *Action** linhibits osteoclast activity leading to inhibition of resorption of bone
- *Class** bone resorption inhibitor, biphophnates
- *Nursing Considerations** take first thing in the morning w/ water 30 min prior to eating, assess calcium, may cause muscle pain
-mycin
antibiotic
Nystatin
- *Indication** Candidiasis (thrush)
- *Action** causes leakge of funcal cell contents
- *Class** antifungal
- *Nursing Considerations** diarrhea, N/V, caution with dentures, assess mucus membranes
Ibuprofen
Indication mild to moderate pain, inflammatory states
Action decreases pain and inflammation by inhibiting rostaglandins
Class antypyretic, antirheumatics, nonopioid analgesic
Nursing GI bleeding, hepatitis, Stevens Johnson Syndrome. Monitor for headache N/V, constipation. Therapy should be D/Ced after first sign of rash. Monitor renal and liver labs. Avoid alcohol
Cephalexin (Keflex)
Indication skin infections, pneumonia, UTI, otitis media
Action bactericidal
Class antiinfective, cephalosporin 1st generation
Nursing contraindication with penacillin allergy, seizures, pseudomembranous colitis, diarrhea, phlebitis at iv site, anaphalaxis, obtain cultures prior to therapy, monitor bowel function, may lead to super infection, may cause elevated liver enzymes
Propolol
- *Indication** anaesthia, induction, sedation
- *Action** hypnotic, produces amnesia
- *Class** general anesthetic
- *Nursing Considerations** caution with CVD, lipid disorder, increased ICP, apnea bradycardai, hypotension. Burnign pain at insertion site. Can turn urine green, assess respiraotry status and hemodynamic. Maintain patent airway. Assess level of sedation
What lab value is an increased risk for lithium toxicity
hyponatremia
Metoprolol
- *Indication** HTN, angina, prevention of MI, heart failure management. Migrain prophylaxis
- *Action** blocks the stimulation of beta1, receptors in the SNS does not effect beta 2,
- *Class** antianginal, antihypertensive, beta blocker
- *Nursing Considerations** monitor hemodynamics, may lead to bradycardia, pulmonary edema, assess I&Os and monitor signs of CHF
Haloperidol
Indication schisophrenia, mania, aggressive and agitated
Action alters effect of dopamine
Class antipsychotic, butryrophenones
Nursing EPS, caution in QT prolongation. seizures, constipation, dry mouth, agranulosytosis. Assess for hallucinations, Monitor hemodynamics, monitor neurleptic malignant syndrome. CBC with differential
Amiodipine
Indication HTN, Angina
Action blocks transport of calcium into muscle cells inhibiting excitation and contraction
Class antiHTN, CA channel blocker
Nursing Considerations gingival hyperplasia, grapefruit juice may increase drug level, BP and pulse prior to therapy, monitor I/Os, assess signs of CHF, teach patient how to take BP
Beta 1 affects
heart
Famotidine (Pepcid)
Indication short term active ulcer, GERD, heartburn, indigestion, prevetion of GI bleed, over use of NSAIDS
Action blocks action of histamine located in gastric pareital cells, inhibits gastric acid secretion
Class antiulcer agent, H2 antagonist
Nursing dysrthmias, agranulocytosis, aplastic anemias, asses ab pain and occult blood, monitor CBC, instruct pt to increase fluid and fiber intake to prevent constipation
prazole
antiulcer agent
Captopril
Indication hypertension
Action block angiotensin I to angiotensin II, Increases renin levels and decreases aldosterone. Vasodilation
Class ACE inhibitor, antihtn
Nursing neurtopenia, watch potassium, watch diuretics, 1 hr before meals, watch weight and fluid status, renal profile, monitor CBC
Tetracycline
- *Indication** tx of infection, gonorrhea syphilis with penicillin alercy, chornic bronchitis
- *Action** bacteriostatic by inhibiting protein synthesis
- *Class** antiinfective
- *Nursing Considerations** caution with liver impairment. pseudomembranous colitis, diarrhea, N/V, photsensitivity. Increase effects of warfarin.
Chlorpromazine
Indication second line tx for schizo, N/V, pre-op sedation, acute intermittent prphyria, headache, bipolar
Action anticholinergic activity, alters effects of dopamine in CNS
Class phenothiazine, antisychotic, antiemetic
Nursing neuroliptic malignant syndrome, sedation, tardive dyskinesia, hyoptension, agranulocytosis, asses mental status prior to tx, monitor BP, monitor CBC and liver function, do not skip dose
Divalproex
Indication seizures, manic episodes, prevention of headache
Action increases the level of GABA in CNS
Class anticonvulsant, vascular headache suppressants
Nursing suicidal thoughts, agitation, dizziness, insomnia, hepatotoxicity, pancreatitis, increase risk for bleeding w/ Warfarin, caution with MAOIs, monitor liver function
Sertraline
- *Indication** major depressive disorder, OCD, anxiety
- *Action** inhibits uptake of serotonin,
- *Class** antidepressant, SSRI
- *Nursing Considerations** dont use with MAOIs, neurolyptic malignant syndrome, suicidal thoughts, dry mouth, tremors, takes 1-4 weeks for therapy to be effective
Acetaminophen
- *Indication** pain, fever
- *Action** inhibits synthesis of prostaglandins
- *Class** lipid lowering agent
- *Nursing Considerations** do not exceed 4 g per day to limit risk for liver, renal and cardiac damage, OD can lead to hepatotoxicity, increase risk for bleeding w/ warfarin, alter blood glucose measurements
Glipizide
Indication type 2 diabetes mellitus
Action stimulate release and sensitivity to insulin to lower blood glucose
Class anti-diabetic, sulfonylureas
Nursing aplastic anemias, hypoglycemia, photosensitivity, dizziness, drowiness, headache, diarrhea. Monitor CBC, assess for allergy to sulfonamides. Beta blockers may creat signs of hypoglycemia. Instruct patient on how to check blood sugars. Carry source of sugar in case of hypoglycemia
Dexamethasone
Indication cerebral edema, assess for cushing’s dissease
Action suppress inflammation and normal immune response. Used in inflammatory states
Class antiasthmatics, corticosteroids,
Nursing watch liver, avoid in untreated infections, may cause CNS alteration, peptic ulcers, cushings, weight gin, osteoporosis, decrease wound healing, elevated blood sugars, watch lipid and cholesterol
Spironolactone
- *Indication** potassium loss, hypertension, edema CHF
- *Action** inhibits sodium reabsorption while sparing potassium and hydrogen
- *Class** diuretic
- *Nursing Considerations** contraindicated with hyperkalemia, monitor I/O, BP, potassium and renal panel
Diazepam
Indication anxiety, pre-op sedation, conscious sedation, tx of seixures, insomnia, mgmt of alcohol withdrawal
Action depress the CNS
Class benzodiazepine, antianxiety, anticonvulsant, skeletal muscle relaxant
Nursing ccontraindicated in hepatic dysfunction, wathc renal impairment, dizziness, drowsiness, lethargy, hypotension, physical dependence, tolerance, caution with alcohol use
Cardiopa/Levodopa
Indication parkinson’s disease
Action levodopa converts to dopamine and works as a neurotransmitter and carbidopa prevents destruction of levodopa
Class dopamine agonist, antiparkinson agent
Nursing orthostatic hypotension, dark urine, takes weeks to effect, no MAOIs, no with glaucoma/melanoma