Maam Amboy Pointers PDF

Antiarrhythmics: Classes & Mechanism of Action (MOA) Antiarrhythmics are divided into four main classes based on their mechanism of action:  Class I: Sodium channel blockers (e.g., Lidocaine) - affect the depolarization phase.  Class II: Beta-blockers - reduce sympathetic nervous sy...

Antiarrhythmics: Classes & Mechanism of Action (MOA) Antiarrhythmics are divided into four main classes based on their mechanism of action:  Class I: Sodium channel blockers (e.g., Lidocaine) - affect the depolarization phase.  Class II: Beta-blockers - reduce sympathetic nervous system effects.  Class III: Potassium channel blockers (e.g., Amiodarone) - prolong repolarization.  Class IV: Calcium channel blockers - affect the plateau phase of the action potential. ACE Inhibitors: Common Side Effects & Next Line of Drugs for Hypertension if Not Tolerated Common side effects of ACE inhibitors include cough, hyperkalemia, and angioedema. If not tolerated, ARBs (Angiotensin II Receptor Blockers) like Losartan are often used as an alternative Antiemetics: For Motion Sickness Antiemetics for motion sickness include anticholinergic drugs and H1 antihistamines Sucralfate: MOA Sucralfate forms a protective barrier over ulcers, preventing gastric acid damage and stimulating mucosal protective mechanisms Nursing Interventions: Priorities Post-Administration of Oral Hypoglycemic Agents or Insulin Therapy Monitor blood glucose levels closely, educate patients on signs of hypoglycemia, and ensure they understand the importance of timing and dosage Types of Insulin: Onset of Action  Rapid-Acting: Lispro (Humalog) - onset in 5-15 minutes.  Short-Acting: Regular insulin - onset in 30-60 minutes.  Intermediate-Acting: NPH - onset in 1-2 hours.  Long-Acting: Glargine - onset in 1-2 hours Amiodarone: Adverse Effects (Toxicity) Adverse effects include pulmonary toxicity, thyroid dysfunction, and liver toxicity. Continuous monitoring is essential Antihypertensives: Medications of Choice for Pregnancy Methyldopa and Labetalol are commonly used antihypertensives during pregnancy due to their safety profile Beta-blockers: Assessments Before Administration Assess heart rate, blood pressure, and respiratory status, especially in patients with asthma or COPD Nitrates: Common Side Effects & Priority Actions Common side effects include headache, dizziness, and hypotension. Priority actions include monitoring blood pressure and educating patients on proper administration Beta-blockers: Contraindications/Precautions Contraindicated in patients with bradycardia, heart block, and caution in asthma or COPD due to bronchoconstriction Amlodipine: Side Effects & Health Teaching Side effects include peripheral edema, dizziness, and fatigue. Educate patients on monitoring blood pressure and avoiding sudden position changes Antacids: MOA Antacids neutralize gastric acid, increasing gastric pH and providing symptomatic relief from conditions like GERD Oxytocin: Contraindications & Priority Actions Contraindicated in cases of fetal distress, unfavorable fetal positions, and previous uterine surgery. Priority actions include continuous fetal monitoring and assessing uterine contractions Cervical Ripening Agents: Nursing Interventions/Considerations Monitor fetal heart rate, uterine contractions, and assess for signs of labor progression. Educate patients on the procedure and potential side effects ACE Inhibitors: Adverse Effects/Reactions Adverse effects include cough, hyperkalemia, and angioedema. Monitor renal function and electrolytes Heart Failure: Drugs of Choice for Worsening Conditions ACE inhibitors, ARBs, beta-blockers, and diuretics are commonly used. Monitor for signs of fluid overload and adjust therapy as needed Oral Hypoglycemic Agents: Health Teaching to Prevent Hypoglycemia Educate patients on recognizing hypoglycemia symptoms, the importance of regular meals, and monitoring blood glucose levels Safe Drug Administration: (e.g., Enoxaparin, Captopril, Aspirin, Metoprolol, Omeprazole, Ranitidine) Ensure correct dosage, monitor for side effects, and educate patients on administration timing and potential interactions Side Effects: (e.g., Atorvastatin, Labetalol, Metformin) Common side effects include muscle pain (Atorvastatin), dizziness (Labetalol), and GI upset (Metformin). Monitor for adverse reactions and educate patients on lifestyle modifications Teaching Plans: (e.g., Lisinopril, Hydrochlorothiazide, Nitrostat patch, Simvastatin, Nitroglycerin tablets, Atorvastatin, Amlodipine, Glimepiride) Develop individualized plans focusing on medication adherence, lifestyle changes, and monitoring for side effects Pantoprazole: MOA Pantoprazole is a proton pump inhibitor that reduces gastric acid secretion by inhibiting the H+/K+ ATPase enzyme in the stomach lining Basic Pharmacology Calculations Ensure accurate dosage calculations based on patient weight, age, and renal function. Double-check calculations to prevent medication errors. Levothyroxine: Health Teaching Educate patients on taking levothyroxine on an empty stomach, monitoring thyroid function tests, and recognizing signs of over- or under-treatment Contraindicated Drugs: For Worsening Heart Failure Avoid NSAIDs, certain calcium channel blockers, and thiazolidinediones as they can exacerbate heart failure symptoms Lipitor (Atorvastatin): Adverse Effects & Management Monitor for muscle pain, liver function abnormalities, and educate patients on reporting unexplained muscle pain or weakness [NUR 213] UNIT 15_ Endocrine System Drugs.pdf Page 3. Digoxin: Toxicity (S/Sx, Lab Values) & Side Effects Signs of toxicity include nausea, vomiting, visual disturbances, and arrhythmias. Monitor digoxin levels and electrolytes Biguanides (Metformin): Clinical Use & Risk of Lactic Acidosis Used for type 2 diabetes management. Monitor for signs of lactic acidosis, especially in patients with renal impairment Acarbose: MOA Acarbose is an alpha-glucosidase inhibitor that delays carbohydrate digestion and absorption, reducing postprandial blood glucose levels ARBs: Client Education (Nutrition) & Priority Interventions Educate on low-sodium diet, monitor blood pressure, and assess for signs of hyperkalemia Timing Considerations: PPIs & Antacids: Interval Timing PPIs should be taken before meals, while antacids should be spaced 1-2 hours apart from other medications to avoid interactions Insulin: Repercussions of Faulty Timing Incorrect timing can lead to hypoglycemia or hyperglycemia. Educate patients on the importance of timing insulin with meals Non-pharmacologic Plans: For PPIs and Laxative Use Encourage lifestyle modifications such as dietary changes, increased fluid intake, and regular exercise to complement medication therapy PPI Risks: Bacterial Infections & Nursing Management Long-term PPI use can increase the risk of bacterial infections. Monitor for signs of infection and educate patients on potential risks Antacids: Types, Formulations & Indications Antacids are available in various formulations (e.g., aluminum hydroxide, magnesium hydroxide) and are used for rapid relief of heartburn and indigestion Laxatives: Side Effects & Complementary Health Teaching Common side effects include abdominal cramping and diarrhea. Educate patients on dietary fiber intake and adequate hydration Special Mentions:  Dronabinol: Used for nausea and appetite stimulation. Dronabinol: MOA Dronabinol is used for nausea and appetite stimulation. It acts on the central nervous system to produce its effects Ondansetron: Nursing Management & Indications Ondansetron is used to control nausea and vomiting after surgical anesthesia, chemotherapy, and radiotherapy. It can be administered orally, intravenously, or intramuscularly. Nursing management includes monitoring for side effects such as headaches, gastrointestinal disturbances, and arrhythmias. Life-threatening side effects include serotonin syndrome, which can occur when combined with certain antidepressants Bismuth Subsalicylate: Side Effects Bismuth subsalicylate forms a protective coating over the gastric lining and has anti-inflammatory and antimicrobial properties. Common side effects include temporary blackening of the tongue and stool. It can also cause ototoxicity, leading to hearing loss and tinnitus Mucosal Protective Agents: Common/Representative Drugs Mucosal protective agents include sucralfate and bismuth compounds. These agents shield the stomach lining from gastric acid by creating a barrier or increasing mucus production, and are used to treat peptic ulcers and Misoprostol: Contraindications Misoprostol is contraindicated in pregnancy due to its abortifacient potential and can induce abortion. It should be used with caution in clients with cardiovascular disease, respiratory diseases like asthma, and hepatic or renal disease Ranitidine: Indications Ranitidine is used for reducing gastric acid production and is indicated for the treatment of peptic ulcers and gastroesophageal reflux disease (GERD) Histamine H2 Blockers: Representative Drugs Histamine H2 blockers include ranitidine and famotidine. They work by blocking histamine type 2 receptors in the stomach, decreasing gastric acid production Insulin Sliding Scale: Administration The insulin sliding scale is used for adjusting insulin doses based on blood glucose levels. It is important to monitor blood glucose closely and educate patients on the importance of timing insulin with meals to prevent hypoglycemia or hyperglycemia