OCR Pharmacology Modules 4-6 PDF

Module 04 Overview and Activities Objectives By the end of this module you should be able to: Recognize common medications used to treat clients with disorders related to the respiratory and gastrointestinal systems. Contrast the various classes of medications used to treat...

Module 04 Overview and Activities Objectives By the end of this module you should be able to: Recognize common medications used to treat clients with disorders related to the respiratory and gastrointestinal systems. Contrast the various classes of medications used to treat common disorders of the respiratory and gastrointestinal systems. Recognize the indications, pharmacokinetics, laboratory monitoring, and side effects of medications that are commonly used to treat common disorders related to respiratory and gastrointestinal systems. Discuss accepted nursing practice for the care of clients taking medications that affect the respiratory and gastrointestinal systems. Explain the common adverse reactions and client education for frequently prescribed medications that affect the respiratory and gastrointestinal systems. Total Estimated Time 9 hours and 15 minutes Readings Activity Time: 6 hours Lehne's Pharmacology for Nursing Care, Chapters 79, 80, 81, 82, and 83 Lesson Content Module 04 Key Concepts for this Module (Activity Time: Accounted for during campus- based class session) Assignments  Module 04 Exam (Activity Time: Accounted for during campus-based class session, Additional Time for Study, Research, and Reflection: 3 hours, 15 minutes) Module 04 Key Concepts for this Module Module Introduction In this module, you will study drugs that affect both the respiratory system and gastrointestinal system. Respiratory topics covered this week include drugs for asthma, COPD, coughs, and colds. Gastrointestinal topics covered in this module include drugs for peptic ulcer disease, laxatives, and antiemetics. Drug Highlights: Glucocorticoids and Beta2 Agonists Glucocorticoids and beta2 agonists are the hallmark treatments for both asthma and COPD. Most clients with these conditions take both drugs concurrently, and while each drug works differently to reduce symptoms, they also work together to improve quality of life. Glucocorticoids Glucocorticoids are intended for long-term control. Inhalation is the primary route of administration, as it is associated with less adverse reactions than systemic administration via oral or IV routes. Glucocorticoids suppress inflammation by decreasing the synthesis and release of inflammatory mediators, decreasing the activity of the body's immune cells, and decreasing edema within the airway mucosa. Beta2 Agonists Short-acting beta2 agonists are intended for relieving acute symptoms and are most often administered via inhalation. By activating beta2 receptors in the lungs, the bronchi and bronchioles dilate, which relieves bronchospasm and allows more air to enter the lungs. Beta2 Agonists Help Highlight the Importance of Receptor Specificity Beta2 agonists act on the same receptors in the lungs as adrenaline (epinephrine) does when our "fight or flight" response kicks in. When faced with an acute threat, it only makes sense for the body to ensure more air can get to the lungs. In theory, clients experiencing acute symptoms related to asthma or COPD, could receive the same bronchodilating effects from a systemic dose of epinephrine. However, the client would also experience the net effects of activating all of the body's adrenergic receptor subtypes (alpha1, alpha2, beta1, and beta2), which in turn, would produce a host of unnecessary, unwanted, and potentially harmful effects to a person experiencing bronchospasm related to asthma or COPD. This example highlights why selective drugs play such an important role in modern pharmacology. By giving clients who are experiencing bronchospasm a drug that is selective only for beta2 receptors, a much more targeted response from the lungs can be triggered. This targeted response can be made even more specific for the lungs when beta2 agonists are administered by inhalation. Important Prototype Medications for this Module This course focuses on specific prototype medications. As you may recall, a prototype medication is an individual drug that exemplifies the characteristics of all drugs within a group. Focusing on the prototype drug for a group allows you to learn the basic properties, such as side effects and nursing considerations, for all of the drugs within that group. Note: For safety considerations, you should still look up individual medications prior to administering them in a clinical setting, even if you are familiar with the prototype, because there may be specific aspects that are unique to that drug. Important Questions to Consider As you begin to learn about these prototype drugs, always consider the following questions: 1. Why is this drug useful as therapy for a specific condition? 2. How does this drug work to achieve its intended response? 3. What critical actions and assessments should be done before and after administering this drug? 4. Which points must be highlighted when teaching clients about this drug? Prototype Medication Name - Prototype Medication Class Beclomethasone - Glucocorticoids Prednisone - Glucocorticoids  Cromolyn - mast cell stabilizers Zafirlukast - leukotriene modifiers Albuterol - Bronchodilators: Beta2-Adrenergic Agonists Salmeterol - Bronchodilators: Beta2-Adrenergic Agonists Theophylline - Bronchodilators: Methylxanthines Ipratropium - Anticholinergic Drugs Hydrocodone - Opioid Drugs for Cough Dextromethorphan - Nonopioid Drugs for Cough Cimetidine - H2-Receptor Antagonists Omeprazole - Proton Pump Inhibitors Sucralfate - Mucosal Protectants Aluminum hydroxide/magnesium hydroxide - Antacids Methylcellulose - Bulk-Forming Agents Docusate sodium - Surfactants Magnesium hydroxide - Osmotic Laxatives Ondansetron - Serotonin Antagonists Prochlorperazine - Dopamine Antagonists Dronabinol - Cannabinoids References Burchum, J., & Rosenthal, L. (2019). Lehne's pharmacology for nursing care (10th ed.). St. Louis, MO: Elsevier. Module 05 Overview and Activities Objectives By the end of this module you should be able to:  Recognize common medications used to treat clients with disorders related to the cardiovascular and renal systems. Contrast the various classes of medications used to treat common disorders related to the cardiovascular and renal systems. Recognize the indications, pharmacokinetics, laboratory monitoring, and side effects of medications that are commonly used to treat common disorders related to the cardiovascular and renal systems. Discuss accepted nursing practice for the care of clients taking medications that affect the cardiovascular and renal systems. Explain the common adverse reactions and client education for frequently prescribed medications that affect the cardiovascular and renal systems. Total Estimated Time 7 hours and 45 minutes Readings Activity Time: 6 hours and 15 minutes Lehne's Pharmacology for Nursing Care, Chapters 44, 47, 48, 50, 51, and 52 Lesson Content Module 05Key Concepts for this Module (Activity Time: Accounted for during campus-based class session) Assignments Module 05 Quiz (Activity Time: 30 minutes) Module 05 Key Concepts for this Module Module Introduction In this module, you will begin to study cardiovascular medications. Because there are so many drugs that fall into this category, the content has been split over two modules. Topics covered in this module include drugs that affect the renin-angiotensin-aldosterone system, calcium channel blockers, and drugs for hypertension, heart failure, and dysrhythmias. Drug Highlights: Furosemide, Lisinopril, and Metoprolol Furosemide: a loop diuretic Who takes it? Clients with CHF use it to decrease pulmonary edema so they can breathe better. Clients with any type of edema that requires diuresis such as liver failure or kidney failure (unlike most diuretics, furosemide still works with a low GFR). Who is at an increased risk for complications? Clients with cardiovascular disease, renal disease, diabetes, gout, or pregnancy. What are the major adverse effects? Fluid and electrolyte imbalances (hypokalemia, hyponatremia, hypochloremia, dehydration), hypotension, ototoxicity, hyperglycemia, and hyperuricemia. What are the major interactions? Digoxin use increases risk for fatal dysrhythmias. Lithium use may lead to lithium toxicity. Other ototoxic drugs like aminoglycoside antibiotics increase the risk for ototoxicity. Lisinopril: an ACE inhibitor Who takes it? Clients with hypertension use it to reduce blood pressure. Clients with heart failure use it to increase cardiac output. When used after MI, it can reduce mortality. Who cannot take it? Pregnant women in the second and third trimester.  Clients with renal artery stenosis. Anyone with a history of hypersensitivity reactions such as angioedema. Who is at an increased risk for complications? Clients with salt or volume depletion, renal impairment, or collagen vascular disease. What are the major adverse effects? First-Dose Hypotension, cough, hyperkalemia, fetal injury, angioedema, renal failure. What are the major interactions? Diuretics increase the risk for first-dose hypotension. Antihypertensive agents increase the risk for general hypotension. Drugs that elevate potassium levels increase the risk for hyperkalemia. Lithium use can lead to lithium toxicity. NSAIDs can interfere with ACE inhibitor effects. Metoprolol: a beta blocker Who takes it? Clients with hypertension, angina pectoris, heart failure, and cardiac dysrhythmias. Who cannot take it? Clients with sinus bradycardia or AV heart block. Who is at an increased risk for complications? Clients with heart failure, asthma, bronchospasm, diabetes, depression, or clients who also use calcium channel blockers. What are the major adverse effects? Bradycardia, AV heart block, heart failure, rebound cardiac excitation with abrupt withdrawal, postural hypotension, and bronchoconstriction. In diabetics, it can mask signs and symptoms of hypoglycemia and prevent glycogenolysis. CNS effects such as depression, insomnia, and nightmares. What are the major interactions? The calcium channel blockers verapamil and diltiazem can intensify the cardiosuppressant effects of beta blockers.  With insulin therapy, beta blockers can prevent glycogenolysis that normally occurs in response to hypoglycemia. Important Prototype Medications for this Module This course focuses on specific prototype medications. As you may recall, a prototype medication is an individual drug that exemplifies the characteristics of all drugs within a group. Focusing on the prototype drug for a group allows you to learn the basic properties, such as side effects and nursing considerations, for all of the drugs within that group. Note: For safety considerations, you should still look up individual medications prior to administering them in a clinical setting, even if you are familiar with the prototype, because there may be specific aspects that are unique to that drug. Important Questions to Consider As you begin to learn about these prototype drugs, always consider the following questions: 1. Why is this drug useful as therapy for a specific condition? 2. How does this drug work to achieve its intended response? 3. What critical actions and assessments should be done before and after administering this drug? 4. Which points must be highlighted when teaching clients about this drug? Prototype Medication Name - Prototype Medication Class Furosemide - High-Ceiling (Loop) Diuretics Hydrochlorothiazide - Thiazide Diuretics Spironolactone - Potassium-Sparing Diuretics Triamterene - Potassium- Sparing Diuretics Captopril - Angiotensin-Converting Enzyme (ACE) Inhibitors Losartan - Angiotensin II Receptor Blockers Aliskiren - Direct Renin Inhibitors  Eplerenone - Aldosterone Antagonists Verapamil - Calcium Channel Blockers Nifedipine - Calcium Channel Blockers Propranolol - Beta-Adrenergic Blockers Metoprolol - Beta-Adrenergic Blockers Digoxin - Cardiac Glycoside Dopamine - Sympathomimetic Quinidine (Class IA) - Sodium Channel Blockers Lidocaine (Class IB) - Sodium Channel Blockers Amiodarone - Class III Antidysrhythmic Drugs Adenosine - Class V Antidysrhythmic Drugs References Burchum, J., & Rosenthal, L. (2019). Lehne's pharmacology for nursing care (10th ed.). St. Louis, MO: Elsevier. Smith, B. T. (2016). Pharmacology for nurses. Burlington, MA: Jones & Bartlett Learning. Module 06 Overview and Activities Objectives By the end of this module you should be able to: Recognize common medications used to treat clients with disorders related to the cardiovascular and hematologic systems. Contrast the various classes of medications used to treat common disorders related to the cardiovascular and hematologic systems.  Recognize the indications, pharmacokinetics, laboratory monitoring, and side effects of medications that are commonly used to treat common disorders related to the cardiovascular and hematologic systems. Discuss accepted nursing practice for the care of clients taking medications that affect the cardiovascular and hematologic systems. Explain the common adverse reactions and client education for frequently prescribed medications that affect the cardiovascular and hematologic systems. Total Estimated Time 8 hours Readings Activity Time: 7 hours and 30 minutes Lehne's Pharmacology for Nursing Care, Chapters 53, 54, 55, 57, 58, and 59 Lesson Content Module 06 Key Concepts for this Module (Activity Time: Accounted for during campus- based class session) Assignments Module 06 Quiz (Activity Time: 30 minutes) Module 06 Key Concepts for this Module Module Introduction In this module, you will continue studying cardiovascular medications. Topics covered include drugs for cholesterol, angina, and hemophilia as well as drugs that affect clotting and hematopoiesis. Drug Highlights: Atorvastatin, Nitroglycerin, and Warfarin Atorvastatin: an HMG-CoA reductase inhibitor  Who takes it? Clients with elevated LDL cholesterol levels. Who cannot take it? Women who are pregnant or plan to become pregnant. Clients with viral or alcoholic hepatitis. Who is at an increased risk for complications? Clients with nonalcoholic fatty liver disease. Clients who drink excessively. What are the major adverse effects? Hepatotoxicity and myopathy. What are the major interactions? Gemfibrozil, fenofibrate, and ezetimibe increase the risk of myopathy. Drugs that inhibit CYP3A4 such as cyclosporine, macrolide antibiotics, azole antifungal drugs, and HIV protease inhibitors can all increase the risk of myopathy. Nitroglycerin: an organic nitrate Who takes it? Clients with angina pectoris. Who cannot take it? Clients who are hypotensive. Clients who use sildenafil or other PDE5 inhibitors. Note: PDE5 inhibitors are used by men and women for conditions other than erectile dysfunction (e.g., pulmonary hypertension, Raynaud's, vasculitis). Ask all clients about PDE5 use before administering nitroglycerin. Who is at an increased risk for complications? Clients using drugs that reduce blood pressure. How does it work? Nitroglycerin primarily dilates veins which decreases myocardial oxygen demand by decreasing preload. Nitroglycerin does NOT reduce chest pain by dilating coronary arteries.  What are the major adverse effects? Headache, orthostatic hypotension, and reflex tachycardia. What are the major interactions? Alcohol may increase the risk for hypotension. Antihypertensives may increase the risk for hypotension. Warfarin: a vitamin K antagonist Who takes it? Clients at risk for thromboembolism. Clients at risk for embolic stroke from atrial fibrillation. Clients at risk for DVT and associated PE. Clients with prosthetic heart valves. Who cannot take it? Clients with vitamin K deficiency, liver disease, alcoholism, thrombocytopenia, uncontrollable bleeding, pregnancy, and lactation. Who is at an increased risk for complications? Anyone at risk for bleeding. What are the major adverse effects? Hemorrhage, monitor closely for signs of bleeding (reduced blood pressure, increased heart rate, bruises, petechiae, hematomas, red or black stools, cloudy or discolored urine, pelvic pain, headache, and back pain). Fetal hemorrhage and teratogenesis from use during pregnancy. What are the major interactions? Warfarin interacts with a multitude of drugs. Common examples are heparin, aspirin, antiplatelet drugs, acetaminophen, phenobarbital, carbamazepine, and rifampin. There are many other drugs that interact with warfarin. A complete medication history is always warranted and the client should be instructed to avoid all prescription drugs, OTC drugs, vitamins, and dietary supplements unless they have been specifically approved by their warfarin provider. Important Prototype Medications for this Module This course focuses on specific prototype medications. As you may recall, a prototype medication is an individual drug that exemplifies the characteristics of all drugs within a group. Focusing on the prototype drug for a group allows you to learn the basic properties, such as side effects and nursing considerations, for all of the drugs within that group. Note: For safety considerations, you should still look up individual medications prior to administering them in a clinical setting, even if you are familiar with the prototype, because there may be specific aspects that are unique to that drug. Important Questions to Consider As you begin to learn about these prototype drugs, always consider the following questions: 1. Why is this drug useful as therapy for a specific condition? 2. How does this drug work to achieve its intended response? 3. What critical actions and assessments should be done before and after administering this drug? 4. Which points must be highlighted when teaching clients about this drug? Prototype Medication Name - Prototype Medication Class Lovastatin - HMG-CoA Reductase Inhibitors (Statins) Colesevelam - Bile-Acid Sequestrants Ezetimibe - selective cholesterol-absorption inhibitors Nitroglycerin - Organic Nitrates Heparin - Anticoagulants Enoxaparin - Anticoagulants Warfarin - Vitamin K Antagonist Dabigatran - Direct Thrombin Inhibitors Rivaroxaban - Direct Factor Xa Inhibitors Apixaban - Direct Factor Xa Inhibitors Aspirin - Antiplatelet Drugs Clopidogrel - P2Y12 ADP receptor antagonist  Epoetin alfa - Erythropoietic Growth Factors Filgrastim - Leukopoietic Growth Factors Oprelvekin - Thrombopoietic Growth Factors Factor VIII - concentrates Drugs for Hemophilia Factor IX - concentrates Drugs for Hemophilia Desmopressin - Drugs for Hemophilia References Burchum, J., & Rosenthal, L. (2019). Lehne's pharmacology for nursing care (10th ed.). St. Louis, MO: Elsevier.