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ATI Pharmacology

Ati Pharma @ Lu
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Side ASide B
migraine medications
ergotamine (ergostat) triptans such as sumatriptan. beta blockers like propranolol. anticonvulsuants such as divalproex (depakote ER)  tricyclic antidepressants (antitriptyline...
when do you want to alert the doctor with migraine medications? 
Ergotamine:Ergotism (muscle pain, parasthesias in fingers and toes, cold pale extremities. physical dependencebeta blockers: extreme tierdness, fatigue, depression, and asthma exacerbation.amitriptyline...
when do you administer bacteriostatic inhibitors?what are examples of these
erythromycin: meal times. alert dr if GI affects. full glass of water. also says later without meals. (1 hr before or 2 hours after). clindamycin. erythromcycin. azithromycin....
when do you give tetracycline
2 hr before 2 hours after a meal. empty stomach. not near antacids. 
side effects of antilepemics. what are the antielipemics which cause these effects?
 hepatotoxicity myopathy and peripheral neuropathymain one: atorvastatin (lipitor). simvastatom/ ;pvastatom/ [ravastatom/ rpsivastatom/ 
gemfibrozil is a ? what are the SE
antilipemic:fibrate. gall stones, myopathy, hepatotoxicity. 
bile sequestrants. example. side effects
cholestyramine (questran). or  colestipol (colestid).   no system ic effects bc the gi tract does not absorb. only causes constipation. 
mood stabalizing drugs
lithium. valproicacid. study these! 215-217 valproic
administering heparin
deep subq injection or iv infusion. dosage: check with another nurse before administering.for continuous IV administration, use infusion pump and monitor q20-60 min. monitor aPPT...
what should the aptt levels be for heparin. 
60-80 seconds
examples of aminoglycosides. 
gentamicin. amikacin. tobramycin sulfate. neomycin. streptomycin. paromomycin.
side effects of gentamicin. amikacin. tobramycin sulfate. neomycin. streptomycin. paromomycin.
ototoxicity. nephrotoxicity. intensified neuromuscular blockade resulting in respiratory depression. hypersensitivity, neurologic disorder (peripheral neuritis, optic nerve dysfunction,...
adverse effects of opioid agonists
respiratory depression, constipation, orthostatic hypotension, urinary retention, cough suppression, sedation, biliary colic, emesis, opioid overdose triad: coma, respiratory depression,...
teaching to prevent hypoglycemia
-monitor client for signs. abrupt onset includes sns symptoms (tachycardia, palpitations, diaphoresis, shakiness.  if gradual. cns symptomos (headaches, tremors, weakness, diaphoresis....
what do you give for anaphylaxis?what route. blood brain barrier? action time?
adrenergic agonist: most often epinephrine. other names are catecholamine, dopamine, dobutamine. all catechomines.  not PO. no bbb, and action is short
epinephrine action on different receptors (alpha 1, b1 and b2)
alpha:vasoconstriction. decrease congestion. increas bpbeta1-increase heart rate, myocardial contractility, and increase reate of conduction through av nodebeta 2-bronchodilation. (asthma...
agonist-antagonist opioid examples:   what kinda pain to they work on?considerations. adverse effects. risk factors when to hold the med. 
stadol  (butorphanol), pentazocine (talwin). mild to moderate pain.  high doses cause adverse affects, not euporia. however, be careful with pt adicted to opioid agonists....
administering morphine: 
withold if RR is less than 12. follow controlled substance procedures. double check opioid dose with another nurse. administer opioid IV slowly over 4-5 minutes. Have nalaxone (narcan)...
hematopoietic growth factors: examplesevaluating clients response
epoetin alfa (epogen, procrit)increases the producton of rbcmonitor pt iron levels. take measures to ensure normal iron. RBC is dependat on adequate quantities of iron, folic acid,...
antipsychotics-atypical. what are examples of these?
clozapine (clozaril). risperidone, olanzpine, quetiapine, aripiprazole (abilify)schizophrenia and psychosis induced by levodopa therapy
neostimine is what?
a cholinesterase inhibitor. used to increase muscle strength with myasthenia gravis.  can also be used to revers Neuromuscular blocking agents following surgery. 
what is a cholinergic crisis?
excessive muscarinic stimulation and respiratory depression from neuromuscular blockage. interventions?: canb e treated withatropine. provide respiratory support through mechanical...
how do you evaluate the effects of clozapine (clozaril). risperidone, olanzpine, quetiapine, aripiprazole (abilify)evaluate effects. 
improved symptoms. absence of hallucinations, delusions, anxiety, hostility. improved adL's. improved socializationa nd improved sleeping and eating. start low then increase dose....
what is the antimycobacterial antituberculosis medication? main one? others?considerations for long term use
isoniazid. streptomycin. ethambutol. pyrazinamide...
considerations for long term use of isoniazid. streptomycin. ethambutol. pyrazinamide...
compliance! used DOT sometimes to ensure compliance. advise the client toa take on an empty stomach. advise to take with meals with gastric discomfort. .  NEEED to complete entir...
what are cardiac glycosides? used for?
digoxin, lanoxin, lanoxicaps, and digitek. They  are a positive inotrope and a negative chronotrope. They treat heart failure and dysrhythmias. 
contraindications for cardiac glycosides?
pregnancy risk catagory C. contraindicated with disturbed ventricular rhythm: ventricular fib, v tach, and second and third degree heart block.  USE CAUTIOUSLY with hypokalemia,...
who should you be cautious about giving an opiod too?
clients with asthma, emphysema, and or head injuries with the risk of resp depression. infants. older adults. laboring pt. obese pt---greater risk for prolonged side effects. slowed...
what can occur with repeated use of meperidine?
accumulation of normeperidine. this can result in seizures or neurotoxicity. do not give more than 600 mg/24 hours. limit it suse to less than 48 hours. DONT USE WITH MAOIS. 
MORPHINE IS CONTRAINDICATED WITH WHAT PT?
BILIARY TRACT SURGERY, OR PREMATURE INFANTS.  (BEFORE OR AFTER DELIVERY) RESP DEPRESSION.  
what are the three things an opioid can dor(positiupve effects)
relief of pain. cough suppression. resolve diarrhea. 
what should those who take nitrates be aware of.?
NO alcohol. hypotensive effects. other antihypertensive meds.  VIAGRA,, heck no. you do not wanna die that way. 
treating an anginal attack with nitrates
stop activity. take does of rapid-acting nitroglycerine immediately. if pain is unrelieved in 5 minutes--call 9-1-1. you can take 2 more at 5 min intervals.don;t stop taking long acting...
 adrenergic  agonists? examples of the drugs?
epinephrine, catecholamines, dopamine. catehcolamine. dobutamine
how do you titrate adrenergic  agonists? how do you control?  what are the signs of effectiveness
based on blood pressure. use iv pump to control.------improved perfusion aeb urine output of over 30 ml per hour. improved mental status. and systolic bp maintained at above 90. 
monitor for what with adrenergic agonists?
chest pain. also for infiltration. extravasation can be treated with a blocking agent, such as phenotolamine. watch ekg for any sings of tachy or dysrhythmias. 
oral hypoglycemics? what are the drugs
1st generation: tobutamide.  chlorpropamide 2nd? glipizide.  and glyburide
1st generation: tobutamide.  chlorpropamide 2nd? glipizide.  and glyburide: medicaltion interactions?
alcohol. can cause disulfiram like reaction. (nausea, vomiting, flushing, palpitations....-----.....also NSAIDS, sulfonamide antibiotics, ranitidine, and cimetidine. ALL OF THESE CAUSE...
what are examples of thrombolytic medications? how do they work?
streptokinase. alteplase, tenecteplase, reteplase. dissove clots that have ALREADY FORMED. 
adverse effects and how to minimize
bleeding: limit punctures. apply pressure. check vs. notify dr with changes. hypotension: monitor. give infusion slowly. allergic reaction: monitor for allergy. be aware and...
Things to note with streptokinase. alteplase, tenecteplase, reteplase. 
-get baseline platelet, hemoglobin, hematocrit, aPTT, PT, INR, fibrinogen, and monitor t.-monitor hemodynamic status. monitor for adverse effects continuously. -make sure there...
biphosphonates: what are they? what are they for?
decrease the number and action of osteoclasts-therefore inhibiting bone reabsorption. alendronate sodium (fosamax) ibandronate sodium (boniva) risedronate (actonel)
alendronate sodium (fosamax) ibandronate sodium (boniva) risedronate (actonel) MEDICATION ADMINISTRATION:
take first thing in the mornign after getting out of bed. take with 8 oz of water. sit or stand after taking medications. do not take any other meds within 30 minutes of taking fosomax. AVOID...
Immunosuppressants: examples:
calcineurin inhibitors (cyclosporine, sandimmune, grengraf, neoral) glucocorticoids such as prednisone. cytotocics: azathioprine (imuran). tacrolimus (prograpfs) methotrexate. (rheurmatrex,...
calcineurin inhibitors (cyclosporine, sandimmune, grengraf, neoral) glucocorticoids such as prednisone. cytotocics: azathioprine (imuran). tacrolimus (prograpfs) methotrexate. (rheurmatrex,...
act on helper T lymphocytes to suppress production of immune response components resulting in the suppression of B cells and cytotoxic T cells. LIFE LONG THEREAPY NEEDED IN TRANSPLANT...
ANTICOAGULANTS-HEPARIN. WHAT LAB VALUES?
MONITOR  aPTT ever 4-6 hours until appropriate dose is determined. then daily. aPTT levels of 60-80 seconds. administer protamine sulfate with overdose of heparin. 
ANTICOAGULANTS-warfarin. WHAT LAB VALUES?
vitamin K is the antagonist. PT levels: 18-24. INR of 2-3.  most accurate.  HOLD DOSE AND NOTIFY DR IF LEVES EXCEED THIS LEVEL.monitor cbc and platelet and hematocrit...
glucocorticoids: client teaching for MDI's
Inhaled agents used for long term prophylaxis of asthma. Use spacer with MDI. advise the client to rinse out mouth and gargle post use. if candidiasis develops treat with mycostatin...
sedative hypnotic medications: non-benzo's examples
zolpidem *ambien.   also zalepion, ezopiclone (lunesta) and trazodone. enhance GABA in CNS. this =prolonged sleep and decreased awakenings. 
sedative hypnotic medications: non-benzo's evaluating. 221
take at bedtime.  not associated with dependance or tolerance. MONITOR PT for imprvement in symptoms and prolonged sleep. watch for pt who have impaired kidney, liver...
glucocorticoid drugs:
beclomethasone dipropionate. budesonide. fluticasone propionate (flovent) triamcinolone acetonide and prednisone (deltasone). 
what to monitor with alpha adrenergic? prazosin. doxazosin. 
 signs of hypotension. lie down if you feel faint. advise to avoid OTC NSAIDS ( nsaids or clonoditne can counteract efffects). OBtain a base hr and bp.  instruct meds...
beta blockers: monitoring the client
monitor pulse. below 60-hold medication. use caution with DM.  use catutiously with HF. start low and titrate.  get a baseline ECG to monitor. DONT ADMINISTER IF CLIENT HAS...
WHEN DO YOU increase and decrease insulin in pt?
increase with caloric intake, infection, stress, growth spurts, and in the second and third trimesters.  DECREASE with exercise and in first trimester. preprandial 90-130....
TIPS WITH iron ferous sulfate or iron dextranto 
used to treate iron deficiency anemia. administer with food only if nausea. may need to dosage with gi disress. monitor bowel pattern with constipation. teach pt to dilute liquid...
**MORE CLIENT TEACHING WITH IRON..
empty stomach. 1 hr before meals to max absorption. dark green/black stool. increase water and fiber. constipation. still take appropriate IRON in food. .  SHOULD SEE RETICULOCYTE...
 Selective serotonin reuptake inhibitors are what meds?
fluoxetine (prozac)  citalopram, (celexa---escitalopram oxalate (lexero, paroxetine, sertraline
fluoxetine (prozac)  citalopram, celexa---escitalopram oxalate (lexero, paroxetine,csertralineera  what interactions-o-s
MAOI'S: SEROTONIN SYNDROMEWarfarin: displaces the warfarin bound protein. increased warfarin levels. monitor PT and INR levels. assess for bleeding. assess dosage.    Tricyclic...
tocalyptic medication: what are they? for? adverse reactions:
terbutaline sulfate, and mag sultachycardia, palpitations, chest pain: monitor. intervene based on tolerance.tremors, adache. nxiety heatcontractions. notify if they increasemonitor...
leukotriene modifiers:
montelukast (singulair)  supresses inflammation, bronchoconstriction, airway edema, and mucs production.  LONG TERM CONTROL OF ASTHMA. 
RISKS FOR OPIOID USE-RESP DEPRESSION
monitor vs. stop use if less than 12 rr. notify dr. avoid use of opioids with cns depressand meds. (barb. benzo, alcohol.)
what are anti parkinson meds? whats the MOA?
levadopa, pramipexole, benztropine, amatadine
cerebral palsy: theuraputic effects of meds. 
meds: diazepam (valium)  dantrolene, baclofen, cylobenzaprine, metaxalone. for cerebral palsy: relief of spasticity and muscle spasms
contraindication of anticoagulants:
low platelet counts, uncontrollable bleeding, surguries on eyes, spinal cord, lumbar puncture, regional anesthesia, hemophilia, increased cap permeability dissected aneurysm. peptic...
antilipemics. drugs?   client teaching.
atorvastatin (lipitor) simvistatin...etc.give after evening meal.  most without food-but lovastatin needs food.   ATORVASTATIN AND FLUVASTATIN FOR RENAL FAILURE. obtain baseline...
tetracycline interacts with what?
milk products, calcium iron magnesium containing laxatives, and most antacids. (therefore give on empty stomach with full glass of water. administer at least 1 hour before and 2 hours...
nitrates interactions
alcohol. antihypertensive meds (use cautiously) and viagrap( life threatening hypotension. )
cardiact glycosidesss
Digoxin! interactions: thiazide diuretics. HCTZ: and loop diuretics increase the risk of digoxin induced dysrhythmias. monitor K+ levels. treat with potassium supplements. (also...
opioid PCA pump?
closely monitor. dose, lockout interval. and 4 hour limit. reasure the client to the safety measures. encourage PCA to be used prohylactically prior to activities that may be painful....MAke...
when does a pt need an opioid?
releif of moderate to severe pain. postoperative. myocardial infarction, cancer pain.  assess pain on  aregular basis-document response.cancer: fixed schedule.  also...
side effects of opioids?
respiratory depression. constipation (increase fluid intake and physical activity. admin laxative). Ortho hypo (sit and lie when symptomatic. help ambulate)  urinary retention...


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