Mini Pharm Review PDF

**BLOCK 2 PHARM REVIEW:** **ANALGESICS** ASA (Aspirin) - Antipyretic, analgesic, antiplatelet, enteric coated to prevent GI irritation(bleed). 81mg daily treatment for cardiac (not pain or fever)/ 325mg for acute MI. **TOXICITY:** Tinnitus, sweating/fever, headache, dizziness, Resp....

**BLOCK 2 PHARM REVIEW:** **ANALGESICS** ASA (Aspirin) - Antipyretic, analgesic, antiplatelet, enteric coated to prevent GI irritation(bleed). 81mg daily treatment for cardiac (not pain or fever)/ 325mg for acute MI. **TOXICITY:** Tinnitus, sweating/fever, headache, dizziness, Resp. distress. **ANTIDOTE:** Sodium bicarbonate, activated charcoal. APAP (Acetaminophen) - Antipyretic, analgesic blocks pain receptor, lacks anti-inflammatory process, no effect on bleeding, harsh side effects on the liver with LONG-TERM use (Alcohol ↑ risk for liver damage). \< 3000 mg/24hr **ANTIDOTE:** N-acetylcysteine (NAC/Mucomyst) Administer PO/IV NSAIDs (Ibuprofen, Naprosyn, Diclofenac, Indomethacin, Celecoxib, Mobic) - Antipyretic/Anti-inflammatory affecting steroidal function, monitor kidney function with LONG-TERM use. Can increase bleed time, high risk anaphylaxis. Indomethacin(Indocin)- treatment for arthritis/gout, risk GI-BLEED. Ibuprofen \< 3600 mg/24hr (take with food/milk) IM/IV NSAID (Ketorolac) - IV dosage 15 or 30mg Q6h (30mg dose does not exceed 120mg/day) (15mg dose does not exceed 60mg/day) RISK FOR GI BLEED S/E: Headache, dizziness, nervousness, constipation, diarrhea, flatulence, GI disturbance (NOTE: Inhibits COXI reducing the protective prostaglandins of the GI tract, don't administer to patients with GI problems and/or PPI). Report unusual bleeding, tinnitus, blurred vision, swollen hands/feet OPIOIDS (-CODONE) (Oxycodone(ASA,APAP), Hydrocodone, Codeine) - PO: affects the opioid receptors of the brain to block CNS receptors (↓HR, ↓BP, ↓RR, ↓GI/constipation), altered mental response. Don't give to hypovolemic patient or patient with unstable/low vitals. Check allergies to ASA, APAP. Monitor RR (\3 before admin) PO dose, Treatment dose varies Heparin: APTT normal value= 30-40sec, expected value 1.5-2.5x norm. Enoxaparin: used to treat blood clots or decrease MI in patients with unstable angina or mild MIs. Low Molecular Weight Heparin (LMWH)- If administered SQ in the abdomen (Don't aspirate/massage), rotate sites, keep air bubble seal after injection. **B:** Bleeding (monitor for decreased platelets(thrombocytopenia), and/or thrombosis **B:** Brusing **B:** Balance (Admin bedtime related risk of falls) Increase risk of bleed with ETOH abuse and liver failure Educate: (↓Vit. K+ diet (Avoid green leafy veg. (↓ effect of warfarin) **ANTIDOTE:** Heparin- Protamine Sulfate, Warfarin-Vit. K Target Specific Oral Anticoagulants( Dabigatran, Rivaroxaban, Apixaban) **CARDIAC** ACE INHIBITOR (-A'PRIL) (Quinapril, Captopril, Lisinopril, Enalapril) - Inhibits angiotensin, ↓ aldosterone to excrete Na/H2O ↓ BP, ↓JVD, ↓bounding pulse, ↓ volume. Peak effect 3-6hrs (Na/H~2~0 excretion exchanged for K^+^ retention ↑K^+^), taken with NSAIDS ↓ effectiveness Monitor BP, HR (watch trends for *lowering* BP), Electrolytes -- ↑ K^+^, ↓WBC (neutropenia) CHF -- monitor weights, S/S of fluid overload S/E - non-productive/persistent dry cough, metallic/loss taste (think ACE TASTE), dizziness, fatigue, Headache CAUTION used with K^+^ sparring diuretics (hyperkalemia, retention of K^+^) Give in the MORNING due to safety reasons BETA BLOCKER (-LOL) (Metoprolol (may be used to prevent MI, angina)) - Block ß adrenergic receptors of heart to Prevent SA node from contracting too much. (ß~1~= heart. ß~2~ + lungs) Agonists stimulate heart to contract / lungs (bronchioles) to dilate. *Blocker* (antagonist) works against the ß~1~ & ß~2~ receptors to block stimulation of heart, slow down the pump (HR), ↓CO & O~2~ consumption CALCIUM CHANNEL BLOCKERS (-PINE) (Diltiazem) - Work by blocking Ca^+^ into the cell to make vessels less hard (since Ca^+^ calcifies/hardens the vessels, blocking Ca^+^ dilates the arteries more elastic). Blocking Ca^+^ cells into heart ↓ conduction of the heart, ↓ BP and ↓ effort the heart must exert to pump blood (arterial vasodilation to ↑ coronary perfusion). Also, slow electrical conduction thru heart to correct abnormal heart rhythms & ↑ CO Assess BP \