Pharmacology Exam 1 Study Guide PDF

**PHARMACOLOGY EXAM 1 STUDY GUIDE (Ch. 4, 52, 18, 19, 20, 21)** **Ch 52 Antiemetic and Antinausea Drugs** Antiemetics are drugs given to relieve nausea and vomiting. "emesis" = vomiting 7 categories of antiemetic drugs, all have different mechanisms of action but mostly work the same by blocking...

**PHARMACOLOGY EXAM 1 STUDY GUIDE (Ch. 4, 52, 18, 19, 20, 21)** **Ch 52 Antiemetic and Antinausea Drugs** Antiemetics are drugs given to relieve nausea and vomiting. "emesis" = vomiting 7 categories of antiemetic drugs, all have different mechanisms of action but mostly work the same by blocking pathways that induce vomiting. Chemoreceptors Trigger Zone (CTZ): area of the brain that is involved in the sensation of nausea and the action of vomiting. **Metoclopramide (Reglan)** Class: Prokinetic Drug Route: PO , Parenteral, prescription only\ Indications: GERD, delayed gastric emptying, N/V Mechanism of Action: Blocks dopamine receptors in the CTZ, causes CTZ to be desensitized to impulses it receives from GI tract, stimulates peristalsis in GI tract, enhancing emptying of the stomach contents Contraindications: patients with - - - - - Adverse Effects: - - Nursing Implications: - - - Patient Education: - - Extra Notes: - **Ondansetron (Zofran)** Classification: Serotonin Blocker Route: PO , injectable form 8mg IV push over 2min Indications: - - - Mechanism of Action: block serotonin receptors in the GI tract, CTZ, and VC Contraindications: - Adverse Effects: known drug allergy Nursing Implications: - - - Patient Education: - - - **Meclizine (Antivert)** Classification: Antihistamine (H1 receptor blockers) Route: PO Indications: - - - - - Mechanism of Action: inhibit ACH by binding to H1 receptors, prevent cholinergic stimulation in vestibular and reticular area, thus preventing nausea and vomiting Contraindication: - - Adverse Effects: - - - - Nursing Implications: assess drug allergy, drug interactions Patient Education: cause drowsiness caution doing things need to be awake **💢HIGH ALERT Promethazine (Phenergan, Phenadoz, Promethegan)** Classification: Antidopaminergic Route: PO, IM 'preferred', IV 'common but not preferred' Indications: - - - - Mechanism of Action: block dopamine receptors in the CTV Contraindications: children less than 2 years bc risk of fatal respiratory depression Adverse Effects: - - - - Nursing Implications: - - - Patient Education: - - - 💢Notes: - **Scopolamine (Transderm-Scop, Scopace)** Classification: Anticholinergic \[ACh\] blocker Route:72-hr transdermal patch releases 1mg Indications: - - - Mechanism of Action: - - Contraindications: patients with - - - Adverse Effects: - - - - - Nursing implications: - - Patient Education: - **Ch. Adrenergic Agonists (Sympathomimetics)** ANS and SNS play a big role in adrenergics. Catecholamines: Endogenous 'have receptors' Alpha 1 and 2 Receptors - - - Alpha 1: located on post synaptic cell "effector cell" Alpha 2: located on pre synaptic ↑Vasoconstriction= agonist action , Vasodilation = antagonist action Beta 1 receptors: located on arterials causing vasoconstriction, primary located in heart "cardioselective drugs" Beta 2 receptors: located in lungs and arterials Dopaminergic: dilates blood vessels causing increased blood flow - **Adrenergic Meds**: Stimulate SNS mimicking the response of a neurotransmitters. Indications: - - - - Contraindications: Hypertension Interactions: - - - - Adverse Effects: - Toxicity: - Treatments: - - **💢HIGH ALERT Epinephrine (Epi-Pen) 1-10mg/ml** NASCAR: nervousness, angina, sugar increase(glycogenolysis),cardiac arrest, allergy, respiratory distress Classification: Alpha and Beta adrenergic agonist Indications: - - - - Mechanism of Action: - Contraindications: - - - - Adverse Effects: - - - - - - Nursing Implications: - - **💢HIGH ALERT Dopamine (Inotropen)** DRAG: dilation pupil, rate heart \^, arterioles BP\^, gi drag motility Classification: Beta 1 Adrenergic Agonist Route: IV 1-50 mcg/kg/min Indications: diff doses = diff things - - - Mechanism of Action: - - Contraindications: - Adverse Effects: - - - - - Nursing Implications: monitor - **Mirabegron (Myrbetriq)** Classification: GU Adrenergic Agonist (Beta 3 adrenergic) Route: PO 20-50mg/day Indications: treatment if overactive bladder Mechanism of Action: - - Contraindications: None reported Adverse Effects: HTN, UTI, HA, nausea, nasopharyngitis, dizziness Nursing Implications: assess - Patient Education: take as prescribed, do not stop abruptly **Ch. 19 Adrenergic Blocking Drugs** **Tamsulosin (Flomax)** Classification: Alpha Adrenergic Blocker Route: PO 0.4-0.8mg/day for BPH Indications: - - Mechanism of Action: - - Contraindications: - Adverse Effects: HA, abnormal ejaculation, rhinitis, abdominal pain Nursing Implications: monitor - - Patient Education: - - **Sotalol (Betapace)** Classification: Nonselective Beta Blocker Route: PO 80mg Indications: used for management of difficult to treat dysrhythmias Mechanism of Action: Class III antiarrhythmic properties - - Contraindications: - - - Adverse Effects: - - - - Nursing Implications: - - Patient Education: - - **Metoprolol (Lopressor)** Classification: Beta 1 Blocker Route: IV💢, PO, succinate 50mg form Indications: - Mechanism of Action: acts on beta 1 receptors in the heart and reduces the effects of catecholamines on cardiac function Contraindications: pt w/ - - - - Adverse Effects: skin rash, diarrhea, dyspnea Nursing Implications: - - **Ch. 20 Cholinergic Drugs** **Memantine (Namenda)** Classification: N-methyl-D-aspartate (NMDA) receptor antagonist Route: PO 5mg/day Indications: NOT a cholinergic drug but is included because used in treatment of Alzheimer\'s dementia. Mechanism of Action: - - Contraindications: known drug allergy Adverse Effects: uncommon but my include - - - - - - - - Nursing Implications: - Patient Education: - **Pyridostigmine (Mestinon)** Classification: Indirect-Acting Cholinergic Drugs Route: PO 600 mg/day in 2 dose, IV 0.1-0.25mg/kg/dose Indications: - - - Mechanism of Action: - Contraindications: - - - - - Adverse Effects: - Nursing Implications: - **Ch. 21 Anticholinergic Drugs AKA Cholinergic-Blocking Drugs** **Oxybutynin (Ditropan)** Classification: Synthetic Antimuscarinic Drug Route: PO 5-30 mg/day , Transdermal Patch avail. OTC Indications: - - Mechanism of Action: anticholinergic medication that blocks the muscarinic action of acetylcholine on smooth muscle cells in the bladder. This inhibits involuntary bladder contractions and increases bladder capacity. Contraindications: - - - Adverse Effects: - - - - - - - Nursing Implications: Monitor for anticholinergic side effects, especially in elderly patients. Ensure adequate fluid intake. Assess for urinary retention. Provide reassurance that dry mouth is an expected side effect Patient Education: Take with food or milk to minimize dry mouth. Stay well-hydrated. Report difficulty urinating, severe constipation or vision changes. Avoid tasks requiring mental alertness until medication\'s effects are known. Discuss alternatives if side effects are intolerable. **Dicyclomine (Bentyl)** Classification: Synthetic Antispasmodic Cholinergic Blocker Route: PO 80-160 mg/day Indications: - - Mechanism of Action: Dicyclomine is an anticholinergic agent that blocks the muscarinic action of acetylcholine on smooth muscle cells in the gastrointestinal tract. This inhibits smooth muscle contractions and intestinal spasms. Contraindications: - - - - - - Adverse Effects: Dry mouth, blurred vision, constipation, urinary retention, drowsiness, dizziness, tachycardia. Nursing Implications: Monitor for anticholinergic side effects, especially in elderly patients. Ensure adequate fluid intake and use stool softeners to prevent constipation. Assess for urinary retention. Provide reassurance that dry mouth is an expected effect. Patient Education: Take with food or milk to minimize dry mouth. Stay well-hydrated. Report difficulty urinating, severe constipation or vision changes. Avoid driving or operating machinery until medication effects are known. Discuss alternatives if side effects persist. **Ch. 4 Cultural and Ethical Considerations** Veracity - The principle of truthfulness and honesty in communication and actions. Nonmaleficence - The principle of avoiding harm or injury to others. Nurses have an obligation to protect patients from harm. Autonomy -The right of patients to make decisions about their medical care without coercion. Nurses respect patient autonomy. Beneficence - The principle of doing good and promoting wellbeing for the patient. Nurses act in the best interest of patients. Confidentiality - Protecting patient information and privacy. Nurses maintain confidentiality of patient records and health details. Justice - Fairness and equal treatment. Nurses provide care without discrimination based on personal attributes or circumstances. These principles are essential in determining nursing negligence and liability in legal cases involving patient harm. ↓ Duty: Nurses have a legal and ethical duty to provide competent care that meets the standard of care. Breach of Duty: Occurs when a nurse fails to uphold their duty, deviating from the standard of care expected. Causation: Establishes a direct link between the nurse\'s breach of duty and the harm caused to the patient. Damage: Refers to the actual injury or harm suffered by the patient as a result of the nurse\'s breach of duty. A cultural assessment is a systematic process of gathering data about a patient\'s cultural background, beliefs, values, and practices that may influence their health behaviors and care preferences. It involves asking open-ended questions to explore areas such as: \- Cultural identity and heritage \- Language and communication patterns \- Family roles and organization \- Dietary practices and food preferences \- Use of traditional remedies or healers herbs \- Beliefs about health, illness, and the body \- Attitudes towards pain and suffering \- Spiritual and religious practices \- Views on death and dying