Pharmacology Exam 1 PDF

[Pharmacology exam 1 ] [Anemia ] [Iron Preparations - Ferrous sulfate ] - Used for - This is for patients with iron-deficiency anemia (will look pain, shortness of breath, dizzy). This can be from nutritional deficiencies, periods, birth, trauma, bariatric surgery. - D...

[Pharmacology exam 1 ] [Anemia ] [Iron Preparations - Ferrous sulfate ] - Used for - This is for patients with iron-deficiency anemia (will look pain, shortness of breath, dizzy). This can be from nutritional deficiencies, periods, birth, trauma, bariatric surgery. - Drug Reaction - Can stain the teeth (liquid) - Iron dextran -- anaphylactic reaction or seizures - Can be very toxic to small children do not over dose - Nurse does - You'll need to check the patient's CBC, Hgb, HCT, RDW (immature red blood cells common to see with people who are anemic) - This is for total RBC, MCV. If the MCV are small it shows they are iron deficient. - Macrosytic = not absorbing - Bands = immature WBC - Tell the patient - Take vitamin C for better absorption. - Can change your poop black (normal) - Advise patient to eat foods high in iron - Muscle meats, whole grains, liver, eggs, fortified cereal [Folic acid ] - Used for - Megaloblastic (macrocytic) anemia - Folate deficiency (alcohol use disorder) - Drug reactions - Neon yellow urine - Masks B12 deficiency in high doses - Prescreen for B12 first - Tell the patient - Eat foods high in folic acid - Citrus, dark leafy greens, meat Vitamin B12 -- cyanocobalamin - Used for - Entrensic anemia (lack of intrinsic factor) - Protecting the myeline sheath - B12 deficiencies will actually damage myeline sheath. - Drug reactions - Erythema - Hypertension - Hypokalemia (neuromuscular changes) - Nurse does - Check stomach absorption for B12 with Schilling test - Get a baseline for B12, Hgb, RBC and reticulocyte every 3 to 6 months. - Tell patient - Eat foods high in B12 - Dairy, egg yolks, seafood. - Report any muscle weakness, nausea, palpations, paresthesia. [Venous system ] [Heparin (factor Xa/thrombin inhibitor)] - Used for - Strokes, pulmonary embolism, DVT - prolonging clotting time - Drug reactions - Bleeding, hemorrhage - Low platelet counts - Stop med give other non-heparin medication - Nurse does - Monitor aPTT - Monitor bleeding, bruising - Antidotes - Protamine - Tell patient - Report - Bruising, black stools, SOB, calf pain, swelling - Expect longer bleeding times - Switch to electric razor and soft toothbrush - No NSAIDs/aspirin - GI bleeds [Vitamin K Antagonist-- warfarin (kumadin)] - Used for - Preventing venous thrombosis, pulmonary embolism, AFIB - Slowing down clotting time - Nurse does - Watch vitals (BP down, HR up) - Watch labs (INR/PT) - Stool changes, bruising - Kumadin -- keep in good level - Elquist -- no levels needed - Tell patient - Wear a medical bracelet - Medical team can know if pt has possibility to bleed out - Teratogenic - Dont eat dark leafy veggies - Not for pts with ETOH/Liver failure [Non-vitamin K antagonist Oral Anticoagulants -- dabigatran ] - Used for - A FIB, DVT, pulmonary embolism - It is a preventative medication - Drug reaction - Bleeding - Antidote -- Prax bind -- blocks and inhibits thrombin - Other - This is an oral medication - Easy to take at home - No labs needed [Adenosine Diphosphate Receptor Inhibitors -- clopidogrel (plavicks) ] [Arterial system ] - Used for - Heart attacks, ischemic strokes, transient stroke, coronary stents - Drug reactions - GI bleeding (black/dark stool) - Bleeding, bruising - Nurse does - Check platelet counts - Stop medication if patient is getting surgery - Watch patients with peptic ulcers closely - Tell patient - To avoid dark leafy greens [Thrombolytics -- alteplase ] [Clot busters -- ER MEDICATION] - Used for - Acute heart attacks - DVT - Massive pulmonary emboli - Ischemic cerebrovascular accident (stroke) - If brain bleed never EVER GIVE! - Clearing the central IV line - Nurse does - Give thrombolytic agents ASAP - Start 2 IV -- limit punctures -- apply pressure - Less than 2 hours for MI - 3 to 4.5 hours for CVA - Can restore function - After given the medication give aspirin/heparin to reduce the risk of repeat thrombosis - Not for patient if - They have peptic ulcer disease - Bleeding disorder - Thrombocytopenia - Intracranial bleeding [Erythropoietic growth factor -- epoetin alfa ] - Used for - [Making erythrocytes] - RBC - Renal failure - Preoperative anemia - Chemo - HIV therapy - Drug reaction - Hypertension - Makes the blood thick - Seizures - Cardio/cerebral events - Chest pains, weakness report! - Nurse does - Monitor Hgb and blood pressure - Get a baseline for labs, pull again periodically - CBC, Hgb, BUN, uric acid, phosphorus, potassium, creatinine, transferring saturation, and ferritin concentration - Trend CBCs to prevent polycythemia (thick blood) - Report Hgb that goes above 12g or more than 1g every 2 weeks - For cancer patients 10g [Leukopoietic Growth Factors -- filgrastim ] - Used for - WBC maker - Reducing infection risk - Bone marrow transplants - Chronic neutropenia - Myelosuppressive chemo - Drug reactions - Leukocytosis -- VERY HIGH - Nurse does - Get a baseline CBC w/ differential, platelet count - draw every two weeks - Give lower dose or stop if WBC are above 10k - Tell patient - Report bone pain and fever - Report stomach pain or fullness - Can affect the spleen [Thrombopoietic Growth Factor -- oprelvekin ] - Used for - Making platelets for patients with thrombocytopenia from chemo - Drug reactions - AFIB, flutter, tachycardia - Heart failure due to fluid retention - Fluid retention - CHF -- fluid shifts from veins to tissues (edema) - Nurse does - Monitor vitals, HR, and ECG - Monitor I&Os, weight - Watch for edema - Get a baseline CBC with platelet count