PHARM Final Study Guide PDF

PHARM FINAL STUDY GUIDE Antihistamines: Histamine is produced in response to an allergic reaction or tissue injury. The release of histamine produces an inflammatory response. - 1st Gen Antihistamines Adverse reaction= Drowsiness - USES:. Relief if the symptoms of seasonal and perennial a...

PHARM FINAL STUDY GUIDE Antihistamines: Histamine is produced in response to an allergic reaction or tissue injury. The release of histamine produces an inflammatory response. - 1st Gen Antihistamines Adverse reaction= Drowsiness - USES:. Relief if the symptoms of seasonal and perennial allergies. Allergic and vasomotor rhinitis. Allergic conjunctivitis. Mild and uncomplicated angioneurotic edema and urticaria. Relief of allergic reactions to drugs, blood, or plasma. Relief of coughs caused by colds and allergies. Adjunctive therapy in anaphylactic shock. Treatment of Parkinson-like symptoms. Relief of nausea & vomiting. Relief of motion sickness. Sedation. Adjuncts to analgesics - Adverse Reactions: - CENTRAL NERVOUS SYSTEM REACTIONS:. Drowsiness or sedation. Disturbed coordination - RESPIRATORY SYSTEM REACTIONS:. Dryness of the mouth, nose, and throat. Thickening of bronchial secretions 2nd Generation preparations (ex: Loratadine) causes less drowsiness and fewer anticholinergic effects than some of the other antihistamines. (A drug allergy that may occur with these drugs are a skin rash or Urticaria) Antitussives: Most depress the “Cough center” located in the medulla and are called “Centrally acting drugs”. - Fluid is unable to come out, used for a dry cough only, pooling is the biggest adverse reaction. - USES:. Used to relieve a NON-PRODUCTIVE cough. - Adverse Reactions:. Lightheadedness. Dizziness. Drowsiness or sedation. Secretions unable to come up and causes pulling Codeine: is an example of centrally acting antitussives. It is an Opioid antitussive. - USES:. It works peripherally by anesthetizing stretch receptors in the respiratory passages, thereby decreasing cough. - Used for an unproductive cough only - Adverse Reactions:. Sedation. Sweating. Headache. Dizziness. Lethargy. Confusion. Lightheadedness when other CNS depressants & alcohol may cause additive depressant effects when administered with antitussives containing codeine!! Dextromethorphan: also, an example of a centrally acting antitussive. It is a nonopioid antitussive. - USES:. Symptomatic relief of cough. Relieve a NON-PRODUCTIVE cough. Antitussive, it depresses cough center in medulla. Expectorant: A drug that THINS respiratory secretions to remove them more easily from the respiratory system. (Ex: Guaifenesin) - USES:. Used to help bring up respiratory secretions.. Used when the cough is dry and PRODUCTIVE.. Used to relieve cough with respiratory infections such as: - Sinusitis - Asthma - Bronchitis - Pharyngitis Xerostomia (Dry Mouth): - How to treat?. Frequently sipping water or other sugar-free fluids, chewing sugar-free gum, and using over- the-counter artificial saliva products may help keep the mouth moist. A room humidifier may also help. Nasal Decongestants Overuse: Overuse can cause “REBOUND” nasal congestion. This means the congestion becomes WORSE with the use of the drug. Educate patient to take the drug as it’s prescribed. Don’t take more than 2 weeks. Oxymetazoline (Afrin) Uses: Used for Nasal congestion. Nasal spray that reduces swelling and inflammation. - USED TO TREAT:. Common cold. Hay fever. Sinusitis. Allergic rhinitis. Congestion associated with rhinitis Albuterol: Wait 1 min between puffs, and wash mouth out after (or at risk for thrush). This is the drug you give for an emergency asthma attack. Bronchodilator:. You should NOT hear wheezing, or crackles because it opens up all the dilates the bronchioles (lumens). Bronchospasm= Bronchioles are constricted meaning the lumen is decreased in size. Montelukast (Singulair):. This drug is a bronchodilator. Do NOT I repeat do NOT give to a patient with asthma. SABA (shot acting beta 2 agonist):. Activates sympathetic nervous system (fight or flight response).. Adverse reaction: High BP, dilation, cardiac arrhythmias, tachycardia. Antihyperlipidemic Drugs:. This could Increase the cholesterol levels.. Usually does NOT affect the pulse, BP, BUN, creatinine.. Allow 3 months for the medication to work and if it doesn’t contact the doctor and get off the medication and try something different. Cholestyramine:. BIGGEST side effect is CONSTIPATION. Cholesterol Levels:. HDL= is the GOOD healthy lipids. LDL= are BAD we want that level to go down Propranolol:. Take at the same time every day, same arm, same position. Educate the patient how to monitor their own BP. Atenolol:. Do NOT give Atenolol to a patient with Asthma.. ALWAYS take a set of vitals before administering this medication. If patient complains of occasional dizziness still continue to give the medication, but still notify the HCP. (New cardiac meds will cause temporary side effects) Nitroglycerin:. Take 1 dose every 5 minutes. Can have up to 3 doses, 15 min total. Verapamil:. Controls rate. Still give if the rate is normal, because it is MAINTAINING the rate.. Do NOT give if rate is below 60bpm. Nitrate:. Cardiac Med. Relieves chest pain. It dilates everything (opens it all up) Nitro Patch:. Place it on the chest close to the heart.. Place where there is no hair. Do not massage Heparin:. Anticoagulant. Monitor Labs such as aPTT levels. Antidote for a heparin overdose is PROTAMINE SULFATE Coumadin: Monitor labs such as PT/INR (Antidote is Vitamin K) Warfarin: Monitor labs such as PT/INR (Antidote is Vitamin K) Digoxin:. Increases the strength of Myocardial contraction, increases cardiac output and renal perfusion.. The therapeutic dose can cause toxicity (digitalis toxicity). Adverse effects are vision changes, bradycardia, arrhythmias, YELLOW HALOS!!. Monitor your labs.. Do not give to patients with Hypokalemia or it could cause the patient to become susceptible to cardiac arrhythmias.. Signs & Symptoms of Digitalis Toxicity are: - N/V - Anorexia - Headache - Drowsiness (weakness) - Vision changes (A yellow halo around objects) - Bradycardia - Arrhythmias *If patients' pulse is lower than 60bpm hold the med. Check apical pulse after administration for 1 FULL MINUTES. Schedule B controlled substances:. LEAST abuse potential Schedule 1 controlled substances:. HIGHEST abuse potential An agonist taken with an Antagonist will cause them to cancel each other out. Idiosyncrasy: “WEIRD” reaction. Anything abnormal. SJS: skin rashes, mouth sores, skin lesions. Sulfonamides:. Treat UTIs, look for crystal in urine.. Increase fluids to 2000mls a day Anaphylactic Shock reactions: allergic reactions that includes hives, laryngeal edema, tachycardia, Tachypnea, hypotension, bronchospasm. Cefazolin: If patient is itching or has hives give Benadryl. Call the HCP to notify. Ceftriaxone: If you’re allergic to penicillin you’re allergic to this med as well. Aminoglycosides: Biggest side effect is tinnitus Nephrotoxicity:. Monitor I’s & O’s, BUN, creatinine  Ferrous Sulfate: DO NOT give on top of antibiotics. Take the ferrous tablet 2 hrs before antibiotics or 2hrs after. Take with orange juice to help with absorption. Fluoroquinolones:. Biggest side effect is TENDON RUPTURE Super Infection:. C. Diff is the most common super infection (Diarrhea) Oseltamivir: Also known as “Tamiflu”. It is an antiviral used to treat the flu. Metronidazole: also known as “flagyl" for big infections, avoid alcohol Tylenol (Acetaminophen):. Treats fever and pain. First choice for children. Max dose is 3250 a day Aspirin: for anticoagulant, pain, fever, inflammation; salicylates; high doses are to decrease clotting; not for children (risk for reye’s syndrome); biggest AR is stomach issues or GI upset; take with food or milk; max dose is 8000mg; if used for blood thinner then 325mg but for prevention of MI then 81mg; discontinue before any surgical or dental procedures Ibuprofen: “Advil”; pain, fever, inflammation (NSAID); max dose is 3200mg; more kidney problems Celecoxib: “Celebrex”; inhibits COX-2 without inhibiting COX-1; doesn’t cause GI upset; NOT FOR CABGs due to increased risk of CV thrombosis, MI, and stroke Salicylism: aspirin toxicity; s/s include tinnitus, dizziness, imbalance (equilibrium is affected) Morphine: opioid analgesic; monitor vitals; hold is BP is low Naloxone (Narcan): opioid antagonist; anecdote Meperidine: opioid analgesic; also known as “Demerol”; monitor respirations  Fentanyl: respiratory depression is greatest AR; opioid naïve patients are at highest risk and more susceptible to addiction Adrenergic drugs: for bronchial asthma patients; epinephrine Cholinergic drugs: rest and digest Cholinergic blockers: atropine; dryness is biggest AR (oliguria, constipation, dehydration) Alendronate: bisphosphonate used for osteoporosis; take in morning before meals Allopurinol: used for gout; increase fluids to 3,000 ml Cyclobenzaprine: muscle relaxant; also known as “flexaryl” educate about not using heavy machinery because of drowsiness Lansoprazole: for GERD; PPI (proton pump inhibitor) Emetics: induce vomiting; risk for aspiration Bisacodyl: don’t give if patient has unknown GI upset or abdominal pain Loperamide: anti-diarrhea; DON’T use for more than 2 days without approval from HCP because it can mask severe issues Furosemide: diuretic that gets rid of water and electrolytes; monitor intake and output, daily weight, edema; monitor electrolytes; increase leafy greens and bananas Potassium levels: (3.5-5.1) DON’T give spironolactone (potassium sparing diuretic) if level is too high Hydrochlorothiazide: thiazide diuretic that is the first line treatment for hypotension; risk of hypokalemia (NOT potassium sparing); educate about intake of potassium foods Methotrexate: cancer drug; monitor CBC because it affects RBCs and WBCs Nitrofurantoin: pulmonary symptoms is main AR (can occur within hours to 3 weeks of therapy); if occurs, stop and call HCP immediately  Phenazopyridine: for pain during UTIs; will discolor urine and turn it bright orange; 2 days prescription Regular insulin: works 30-60 minutes; feed within 30 minutes after giving Hypoglycemia: less than 60mg/dL; weakness, diaphoretic, numbness, tingling lips; “cold and clammy, give them candy”; give them glucose tabs if they’re taking acarbose; if unarousable then give glucose 10% or 50% IV Hydrocortisone: “cortisol”; glucocorticoid used for posttransplant pts, antiinflammation, endocrine disorders; educate about NO live vaccines, infections may be common, GI upset may occur Prednisone: glucocorticoid that is known to cause fluid overload; monitor intake and output, daily weight; educate about intake a high Na+ and Ca+ diet Glucocorticoids: give before 9am; never omit a dose to prevent adrenal suppression Epoetin alfa: for anemia usually before dialysis; NOT for uncontrolled hypertension; monitor BP (if it rises 20 points in either systolic or diastolic, contact HCP) Magnesium- Containing antacids: risk of diarrhea; used for GERD, indigestion, heartburn, peptic ulcer disease; neutralizes or reduces the acidity by combining HCl and increasing the pH levels; educate to chew tablets thoroughly Aluminum-containing antacids: risk of constipation Adalimumab: used for RA, chrons, fibromyalgia; may cause increased risk for infection because it causes immunosuppression; DO NOT GIVE to patients with heart failure or neurogenic demyelinating disease ADEK: these vitamins have decreased absorption when mineral oil enemas (emollient laxative) are administered; watch for lipid pneumonitis Iron supplements: DO NOT GIVE WITH milk or antacids (they decrease absorption); NO tetracyclines, penicillamine, or fluorquinoles; if it has to be mixed, drink with a straw as it will stain teeth; if given IV, administer a test dose of 0.5mL first before pushing it over 30 seconds Know your immunities!!!