Pharm IV Final Grid PDF

**Adrenergic-agonist Drugs** - **Alpha and Beta Adrenergic Agonists:** - **Purpose/Indication:** Increase cardiac output, bronchodilation, treat hypotension, shock, or asthma. - **Signs of Improvement:** Increased blood pressure, improved respiratory rate, stronger c...

**Adrenergic-agonist Drugs** - **Alpha and Beta Adrenergic Agonists:** - **Purpose/Indication:** Increase cardiac output, bronchodilation, treat hypotension, shock, or asthma. - **Signs of Improvement:** Increased blood pressure, improved respiratory rate, stronger cardiac output. - **Possible Side Effects:** Hypertension, tachycardia, nervousness, headache. - **Route:** IV (e.g., epinephrine for anaphylaxis or cardiac arrest). **Epinephrine:** Treats anaphylaxis, cardiac arrest. **Norepinephrine (Levophed):** Used for shock and severe hypotension. - **Beta-specific Adrenergic Agonists:** - **Purpose:** Bronchodilation (e.g., albuterol for asthma or COPD). - **Common Side Effects:** Tremors, tachycardia, nervousness. **Albuterol:** Bronchodilation for asthma/COPD. **Dobutamine:** Increases cardiac output in heart failure **Fluid and Electrolytes** - **IV Therapy:** - **Complications:** Fluid overload, infection, phlebitis, electrolyte imbalances. - **Labs to Monitor:** Electrolytes (e.g., sodium, potassium), renal function (BUN, creatinine). - **Assessment:** Monitor for signs of fluid overload (edema, crackles in lungs), infusion site for infiltration. **Lactated Ringer's (LR):** Fluid resuscitation. **Normal Saline (0.9% NaCl):** Volume replacement. **Dextrose 5% in Water (D5W):** Hypoglycemia. **Women's Health** - **Hormonal Contraceptives:** - **Adverse Effects:** Blood clots, hypertension, weight gain, mood changes. - **Teaching:** Report signs of DVT (calf pain, redness, swelling), consistent daily intake. - **Emergency Contraceptives:** Best within 72 hours of unprotected intercourse; take as soon as possible. **Combination Pills (ethinyl estradiol and norethindrone):** Pregnancy prevention. **Emergency Contraceptive (levonorgestrel):** Prevents ovulation post-intercours**Adrenergic Blockers** - **Alpha-blockers:** - **Purpose:** Treat hypertension, benign prostatic hyperplasia (BPH). - **Side Effects:** Orthostatic hypotension, dizziness. - **Doxazosin:** Treats BPH and hypertension. - **Beta-blockers:** - **Side Effects:** Bradycardia, hypotension, fatigue. - **Teaching:** Avoid abrupt discontinuation; monitor pulse before taking. - **Assessment:** Check apical pulse and BP before administering (e.g., amiodarone). - **Metoprolol:** For hypertension and heart failure. - **Propranolol:** Migraine prevention and hypertension. **Lifespan Considerations** - **Elderly:** Higher risk due to reduced renal/hepatic function, polypharmacy. - **Neonates:** Immature liver enzymes reduce metabolism; careful dosing required. - **Pediatric Communication:** Age-appropriate explanations and engagement (play therapy for younger children). - **Elderly:** Warfarin (bleeding risk), digoxin (toxicity). - **Neonates:** Avoid aspirin due to Reye's syndrome. **Glucose Control** - **Hypoglycemia Symptoms:** Shakiness, diaphoresis, confusion, tachycardia. - **Treatment:** Fast-acting glucose (juice, glucose tabs); glucagon IM for severe cases. - **Teaching:** Rotate injection sites, monitor blood sugar regularly.  **Insulin:** - **Rapid-acting (lispro):** Controls postprandial glucose. - **Long-acting (glargine):** Basal control.  **Oral Antidiabetics:** - **Metformin:** Reduces hepatic glucose production. **Anti-Parkinson's** - **Re-evaluation:** Improved motor symptoms (less rigidity, tremors). - **Side Effects:** - Dopaminergic (e.g., **levodopa**): Dyskinesia, orthostatic hypotension. - Anticholinergic (e.g**. Benztropine)** Dry mouth, blurred vision, constipation. - **COMT Inhibitors (e.g., entacapone):** Prolong action of levodopa; fewer \"off\" periods. **Blood Products** - **Indications:** RBCs for anemia, platelets for thrombocytopenia, plasma for clotting disorders. - **Precautions:** Type and cross-match; monitor for reactions. - **Monitor:** Vitals, signs of transfusion reaction (fever, back pain). **Anemia Medications** - **Iron Supplements:** - **Teaching:** Take with vitamin C; avoid dairy/calcium. - **Evaluation:** Improved energy, pallor reduction, increased Hgb levels. **Iron Supplements:** - **Ferrous sulfate:** Corrects iron deficiency. **Vitamin B12:** - **Cyanocobalamin:** Treats pernicious anemia. **Folic Acid:** Prevents neural tube defects in pregnancy. **Antiepileptics** - **Priority Treatment:** Maintain airway during seizure, administer rescue meds (e.g., lorazepam). - **Common Side Effects:** Drowsiness, ataxia, gingival hyperplasia (phenytoin). - **Warning Signs:** Aura, increased seizure frequency. **Phenytoin (Dilantin):** Tonic-clonic seizures. **Levetiracetam (Keppra):** Partial seizures. **Valproic acid:** Bipolar disorder and epilepsy **Cholinergic Agonists** - **Indications:** Glaucoma, urinary retention, Alzheimer's disease. - **Effectiveness:** Increased salivation, improved memory (Alzheimer's). - **Crisis Treatment:** Atropine. **Bethanechol:** Treats urinary retention. **Donepezil:** Improves symptoms of Alzheimer's disease. **Anticholinergic Drugs** - **Uses:** Motion sickness, bradycardia, asthma. - **Side Effects:** Dry mouth, urinary retention, tachycardia. - **Teaching:** Avoid overheating, stay hydrated. - **Evaluation:** Symptom relief (e.g., reduced nausea, improved HR). **Atropine:** Treats bradycardia. **Scopolamine:** Prevents motion sickness. **Ipratropium:** Bronchodilator for COPD **Immunizing Drugs** - **Vaccines Indications:** 1. Influenza: Annual prevention. 2. HPV: Prevent cervical cancer. 3. Zoster: Shingles prevention. 4. Tdap: Tetanus, diphtheria, pertussis. **[Active vaccines]** **1.Live Vaccines** - Measles, Mumps, Rubella (MMR) - Varicella (Chickenpox) - Zoster (Shingles - live form) - Yellow Fever - Oral Polio (Sabin vaccine) **2.Inactivated (Killed) Vaccines:** - Contain killed pathogens; safer but may require boosters. - **Examples:** - Hepatitis A - Inactivated Polio (Salk vaccine) - Rabies **3.Subunit, Recombinant, Polysaccharide, or Conjugate Vaccines:** - Use specific parts of the pathogen to elicit immunity. - **Examples:** - Human Papillomavirus (HPV - Gardasil) - Pneumococcal (PPSV23, PCV13) - Meningococcal - Hepatitis B **4.Toxoid Vaccines:** - Contain inactivated toxins produced by bacteria. - **Examples:** - Tetanus - Diphtheria 1\. **Natural Passive Immunity:** - **Examples:** - Maternal antibodies passed to a baby via placenta (IgG) or breast milk (IgA). **2.Artificial Passive Immunity:** - Pre-formed antibodies administered via injection. - **Examples:** - **Immune Globulins:** - Hepatitis B immune globulin (HBIG) - Rabies immune globulin (RIG) - Tetanus immune globulin (TIG) - **Antitoxins:** - Botulism antitoxin - Diphtheria antitoxin **Feature** **Active** **Passive** --------------------- ---------------------------------- ------------------------------------ **Immune Response** Body produces its own antibodies Antibodies are provided externally **Onset of Action** Takes time (weeks) Immediate **Duration** Long-term (years) Short-term (weeks to months) **Examples** Vaccines (e.g., MMR, Hep B) Immune globulins, antitoxins **1. Basic Formula:** **Formula:** Dose to give -- (desired D / on hand ) X Quaintly (Q) **Example 1: Liquid Medication** - **Order:** 250 mg of amoxicillin - **Available:** 500 mg/5 mL - **How much will you administer?** **Solution:** 250mg/500mg X 5ml= 2.5 mL **2. IV Flow Rate Calculation:** **Formula for mL/hr:** Flow rate (ml/hr)= Total Volume mL/ Time (hour) **Example 2: IV Infusion** - **Order:** 1,000 mL of normal saline over 8 hours - **What is the flow rate?** **Solution:** 1000mL/8 hrs = 125 mL/hr **3. IV Drip Rate (Drops per Minute):** **Formula:** gtt/min=(Total Volume (mL)×Drop Factor (gtt/mL)/Time (minutes) **Example 3: IV Drip Rate** - **Order:** 1,000 mL to infuse over 5 hours - **Drop Factor:** 20 gtt/mL - **What is the rate in drops per minute?** **Solution:**\ Convert hours to minutes: 5 hours=300 minutes gtt/min=(1,000 mL×20 gtt/mL300 minutes)=66.67 gtt/min≈67 gtt/min **4. Pediatric Dosage Calculation (Weight-Based):** **Formula:** Dose=Weight (kg)×Dosage (mg/kg) **Example 4: Pediatric Dose** - **Order:** Acetaminophen 10 mg/kg every 6 hours - **Child's weight:** 22 kg - **How much will you administer?** **Solution:** Dose=22 kg×10 mg/kg=220 mg **5. Titration Calculation:** **Example 5: Heparin Drip** - **Order:** Start heparin drip at 12 units/kg/hr - **Weight:** 70 kg - **Concentration:** 25,000 units in 500 mL - **What is the flow rate in mL/hr?** **Solution:**\ Calculate total units per hour: 12 units/kg/hr×70 kg=840 units Find mL/hr: 840 units/hr25,000 units×500 mL=16.8 mL/hr