pharm-d-ngn-sd.pdf

lOMoARcPSD|44784722 Pharm D NGN - SD Pharmacology (California State University Los Angeles) Scan to open on Studocu Studocu is not sponsored or endorsed by any college or university Downloaded b...

lOMoARcPSD|44784722 Pharm D NGN - SD Pharmacology (California State University Los Angeles) Scan to open on Studocu Studocu is not sponsored or endorsed by any college or university Downloaded by Kyle Yuan ([email protected])  lOMoARcPSD|44784722 Pharm D NGN 1. IV: Flow Rate When the dose per hour when kilograms are given multiply in kg by dose/kg/min to get dose per min. and multiply that result 60 minutes. When initiating an IV infusion, you must encourage the client to cooperate and tell them to not raise the arm over the head to avoid sleeping on side. Consider that the automatic regulation of flow rate is not necessary to calculate the drop/min. 2. Medications: Antidepressant: Reuptake Inhibitors The medication bupropion is a drug that decreases the reuptake of dopamine in the CNS and it is used for smoking cessation. Some adverse effects are tremors, dry mouth, and motor seizures. Nurses may see frequent mood changes and have to care for patients by doing frequent oral care. 3. Medications: Cyclooxygenase Inhibitors Cyclooxygenase inhibitors inhibit cyclooxygenase and prostaglandin synthesis. An example is NSAIDs that are analgesics used for pain, inflammation and fever. Some adverse effects to be concerned with are bleeding (especially in the GI), so this is one of the things nurses should be monitoring. 4. Medications: Cystic Fibrosis Medications for CF include Dornase Alfa which is inhaled recombinant DNA and it decreases the viscosity of pulmonary secretions improving the lungs function. This drug should not be used with antacids and patients must understand that it must be taken with meals and snacks. Some adverse effects include skin rashes, vomiting, anorexia → things the client should know. 7. Medications: Schedule Drugs Schedule V drugs are much more minimal potential for abuse compared to schedule I which are a much more high level of abuse that is not acceptable. These high level medications are used for research. The Schedule II has more potential for abuse and requires non renewable prediction. 9. Medications: Antihistamine Antihistamines compete for binding at H1 receptor sites and antagonize effects of histamines. Adverse effects include systemic effects including drowsiness for 1st gen and little drowsiness for 2nd gen drugs. Nurses need to be cautious with administering to geriatric clients or clients with glaucoma. 15. Inhalers: Metered Dose (MDI) And Dry Powder (DPI) MDI is a pressurized inhaler that is applied directly to the site of action through the mouth. It is a bronchodilator and corticosteroid. It can be used in rescue inhalers of short acting medications used for immediate relief of acute respiratory distress. 18. Medications: Angiotensin Converting Enzyme (ACE) Inhibitors ACE inhibitors have an adverse effect of orthostatic hypotension so the patients need to be careful when standing up too quickly as they are at risk for fall. Nurses must monitor the pulse and BP for several hours after the first dose is given especially if the client takes diuretics. Must hold med is the systolic BP is below 90 mm 19. Medications: Angiotensin Converting Enzyme (ACE) Inhibitors Repeat 20. Medications: Angiotensin Converting Enzyme (ACE) Inhibitors Repeat 23. Medications: Mineral Deficiencies Downloaded by Kyle Yuan ([email protected])  lOMoARcPSD|44784722 Iron supplements, specifically carbonyl iron, is a pure elemental iron that is absorbed slowly in the body. It required high doses to be toxic to patients. It is used specifically for patients with iron deficiency anemia and it increases the availability of iron in Hg. 27. Blood Administration When administering blood to a client, a nurse must check for allergies and previous blood reactions. Checking for reactions is vital and it must be started slowly during the first 15 minutes. Nurses must stay with clients and take vital signs before and after 15 minutes + every hour per agency protocol. 28. IV: Flow Rate Repeat 30. IV: Flow Rate Repeat 34. Medications: Anti-Infectives: Sulfonamides & Fluoroquinolones Anti-Infective medication kills bactericidal and inhibits the growth of bacteria. Suflonadmises specifically inhibit folic acid synthesis and one must obtain culture & sensitivity before treatment. This medication can be taken with food and with 2-3 liters of fluid daily. 35. Medications: Anti-Infectives: Aminoglycosides Aminoglycosides bind to the 30S subunit of bacterial ribosomes proteins and they are used for bacterial infections. Adverse effects include GI distress, superinfection and ototoxicity. Nurse must obtain a specimen for culture & sensitivity before the first dose and must monitor before and during treatment for functions of kidney, heapitc, and 8th cranial nerve. 38. Fluid And Electrolytes When a patient is on fluid restrictions, this is due to retaining fluid and there is a fluid volume excess. Must communicate with the dietary department on not too many fluids on the meal tray. The fluids must also be calculated in the total amount and there must be oral and parenteral fluids. 39. Fluid And Electrolytes Repeat 40. IV: Complications An IV complication could be infiltration which is when the needle moves out of the vein and fluid leaks into the adjoining tissue. A phlebitis is due to the presence of the IV in susceptible clients and should be reported to HCP immediately. An allergic reaction can also occur based on the medication or substance in the IV fluid. 42. IV: Initiating Initiating when doing an IV determines the insertion site you will use and factors that come into play include knowing the condition of the vein. The type of fluid and medication infused and duration of therapy are also important. For the infusion set and type, a micro and macro drip can be used. 43. Fluid And Electrolytes Repeat 44. Medications: Epilepsy Medications for epilepsy prevent motor and no motor seizures that occur. Some older medications used are carbamazepine and phenytoin. Phenytoin is never to be mixed with IV medications or dextrose. Clients must be educated that their sweat urine may be a red-brown or pink color. 46. Medications: Antivirals Downloaded by Kyle Yuan ([email protected])  lOMoARcPSD|44784722 Acyclovir is a medication that suppresses the biochemical process required for viral replication and used for recurrent genital herpes. It is important to consider that it is administered orally, IV and topically to slow progression symptoms specific to patients. Atovaquone is used to treat and prevent pneumonia and adverse effects include fever, rash, and headache. 47. Medications: Tuberculosis Ethambutol is to be used cautiously as it is used for kidney and liver impairment. Its adverse effects include blurred vision, change in color perception and dizziness. Clients should be educated on getting regular visual exams and liver function tests. 48. Medications: Anticoagulant Heparin is used for short-term therapy and can be given IV or SubQ. It activates thrombin and prevents conversion of fibrinogen to fibrin. Adverse effects include hemorrhage and thrombocytopenia. It is important to leave the needle in place for 10 seconds after injecting and not to massage the site. 49. Medication Administration: Eye When administering medication in the eye, it is important to use clean gloves and sterile cotton balls to clean from the inner canthus to the outer. For eye drops, the lower conjunctival sac should be exposed and the eye should be approached from the side. The dropper should not touch the cornea and after administering, the client needs to close eye. 52. Medications Administration: Eye Repeat 53. Medications: Tuberculosis Repeat 56. Medications: Adrenocortical Hormones: Glucocorticoids Corticosteroids are produced by the adrenal cortex and it suppresses severe inflammation or immune response. Adverse effects include hyperglycemia, muscle wasting moon face and osteoporosis. Nurses must monitor for BP, daily weights, LOC, and I&Os. Do not drink medication with grapefruit juice and it should not be taken abruptly. 57. Chemotherapy Some adverse effects of chemo are bone marrow suppression, fatigue, stomatitis, and impaired oral mucous membrane. Things nurses should monitor are for bleeding, nutrition and I&Os. Clients should understand the S&S of infection and methods to prevent any infection from occurring. 59. Respiratory: Respirations Diaphragmatic breathing is respirations using the diaphragm and normal rhythmic breathing. The chest muscles should be resting or not used. This can occur with fractured ribs and pleurisy. 61. Medications: Anticoagulant Repeat 62. Medications: Anticancer: Antimetabolites And Platinum Compounds The Cell-cycle phase is specific to killing cells only during specific types of cell replications. The cell cycle phase (non-specific) acts during any phase of replication. The cytotoxic agents are classified as platinum compounds, mitotic inhibitors, antimetabolite agents, etc. 65. Medications: Cardiac Glycoside Downloaded by Kyle Yuan ([email protected])  lOMoARcPSD|44784722 Digoxin administration needs to follow and gather the baseline of vital signs. Checking for signs of toxicity, especially for furosemide, is important like symptoms of vomiting, anorexia and confusion. For infants and children the margin of safety for digoxin blood levels is narrow. 66. Medications: Asthma Cromolyn is a mast cell stabilizer that suppresses allergic response use for asthma. Its adverse reaction is irritation and patients must understand that contacts should be worn during treatment. They also need to be taken as directed and taken daily for preventative control. 67. Medications: Anti-Anxiety Antianxiety agents are used for anxiety symptoms, convulsive disorders and preoperative sedation. It depresses the subcortical levels in the CNS and the limbic system. It causes a calming effect and all levels of CNS depression are affected. 69. Medications: Peptic Ulcer Disease For peptic ulcers, Histamine 2 Receptor antagonists are used to inhibit gastric acid secretion and decrease total pepsin output. Its adverse effects include confusion, headache, and dizziness. Nurses must monitor for confusion and teach patients to avoid antacids within 1 hour of med administration. 70. Medications: Antihypertensives Antihypertensives are used to prevent and control BP, but generally for chronically high BP. It is important for clients to rise from sitting or lying in a position slowly to avoid dizziness. If they feel dizzy they must sit down and the med should continue to be taken even if they feel better as there is a possibility of thrombotic activity. Downloaded by Kyle Yuan ([email protected])