Pharmacology-Bundle.pdf

DRUG SUFFIXES CHEAT SHEET –SORTED ALPHABETICALLY– A suffix is the ending of a word, placed after the word’s stem, which often communicates meaning. Drug suffixes are commonly used to group drugs based on the drug’s action. Name Drug Classification Exam...

DRUG SUFFIXES CHEAT SHEET –SORTED ALPHABETICALLY– A suffix is the ending of a word, placed after the word’s stem, which often communicates meaning. Drug suffixes are commonly used to group drugs based on the drug’s action. Name Drug Classification Examples Action Increase the fluid excreted by the kidneys, while retaining potassium in the body. Potassium-Sparing spironolactone reduces cardiovascular -actone Diuretics aldactone congestion and edema that results from CHF. They also lower blood pressure. “Clot busters” that break down clots that streptokinase lead to heart attacks or -ase Thrombolytics alteplase (tPA) strokes, to restore blood flow to the obstructed area. Treat and prevent azine Antiemetics promethazine nausea and vomiting. Prevent the transmission of nerve lidocaine -caine Local Anesthetics impulses or pain xylocaine without causing unconsciousness. Broad spectrum antibiotics tetracycline -cycline Tetracyclines that treat bacterial doxycycline infections. Relax blood vessels, therefore increasing blood -dipine Calcium Channel amlodipine nifedipine supply and oxygen to the Blockers heart and reducing the heart’s workload while lowering blood pressure.  Name Drug Classification Examples Action ciprofloxacin Broad spectrum -floxacin Fluoroquinolones levofloxacin antibiotics that treat bacterial infections. repaglinide Lower blood glucose Meglitinides levels by triggering the -ide nateglinide production of insulin; glyburide used to treat type 2 glipizide diabetes. Sulfonylureas diphenhydramine Treat allergy symptoms, loratadine such as sneezing, runny Antihistamines nose, itching, and hives, brompheniramine caused by histamine activation. -ine Block or delay the fluoxetine reabsorption of Selective Serotonin sertraline serotonin; used to Reuptake Inhibitors treat major depressive (SSRIs) disorders and anxiety disorders Treat anxiety; prolonged use may -lam Benzodiazepines alprazolam lead to physical dependence. Increase the fluid excreted by the kidneys, while atenolol retaining potassium in the metoprolol body. reduces -lol Beta Blockers propranolol cardiovascular congestion and edema that results from CHF. They also lower blood pressure. Anti-inflammatory drugs used to control Corticosteroids methylprednisolone -lone many different inflammation-related symptoms.  Name Drug Classification Examples Action Broad spectrum -micin - gentamicin Aminoglycosides antibiotics that treat mycin tobramycin bacterial infections. Treat anxiety; alprazolam prolonged use may -pam Benzodiazepines diazepam lead to physical lorazepam dependence. Dilate the bronchi and bronchioles, theophylline decreasing resistance -phylline Bronchodilators in the airway and increasing airflow to the lungs. Often used for asthma and COPD. Block or delay the reabsorption of Selective Serotonin citalopram serotonin; used to -pram Reuptake Inhibitors treat major depressive (SSRIs) disorders and anxiety disorders Anti-ulcer drugs that Proton Pump lansoprazole -prazole reduce gastric acid Inhibitors omeprazole production. Reduce blood pressure captopril by dilating blood -pril ACE Inhibitors lisinopril vessels, thus reducing the heart’s workload. Inhibit blood vessel Angiotensin-II losartan constriction, helping -sartan Receptor valsartan blood vessels relax, Blockers which lowers blood pressure. Anti-inflammatory drugs used to control -sone Corticosteroids dexamethasone many different prednisone inflammation-related symptoms.  Name Drug Classification Examples Action Reduce LDL atorvastatin cholesterol and lower -statin Antilipidemics simvastatin risks from cardiovascular disease. Dilate the bronchi and bronchioles, decreasing resistance albuterol levabutero -terol Bronchodilators in the airway and increasing airflow to the lungs. Often used for asthma and COPD. Increase fluid and potassium excreted by the kidneys. Reduces Thiazide Diuretics hydrochlorothiazide cardiovascular -thiazide congestion and edema that results from CHF. They also lower blood pressure. Block the action of H2-receptor histamine in the cimetidine -tidine Antagonists (H2 stomach, decreasing famotidine Blockers) the production of stomach acid. Treat depression, Tricyclic amitriptyline bipolar disorder, -triptyline Antidepressants anxiety, OCD, and nortriptyline other mood disorders.  Antibiotics Antibiotics are powerful medications that treat certain infections and can save lives when used properly. They either stop bacteria from reproducing or destroy them. They include a range of powerful drugs used to treat diseases caused by bacteria. Antibiotics cannot treat viral infections, such as cold, flu, and most coughs. The main types of antibiotics include: Penicillins - for example, phenoxymethylpenicillin, flucloxacillin and amoxicillin. Cephalosporins - for example, cefaclor, cefadroxil and cefalexin. Tetracyclines - for example, tetracycline, doxycycline and lymecycline Fast facts on antibiotics Side effects of Antibiotics Alexander Fleming Diarrhea discovered penicillin, the Nausea first natural antibiotic, in Vomiting 1928. Rash Antibiotics cannot fight viral Upset stomach infections. Sensitivity to sunlight, when Fleming predicted the rise of taking tetracyclines antibiotic resistance. Types of antibiotics Class Examples Pencillins Amoxicillin (Amoxil) Macrolides Azithromycin (Zithromax) Cephalosporins Cephalexin (Keflex) Fluoroquinolones Ciprofloxacin (Cipro) Lincosamides Clindamycin (Cleocin)  Allergy A raised rash, or hives Swelling of the tongue and face Coughing Wheezing Difficulty breathing Antibiotics to prevent infection Antibiotics are sometimes given as a precaution to prevent, rather than treat, an infection. This is called antibiotic prophylaxis. Situations where antibiotics are given as a preventive treatment include: if you're having an operation after a bite or wound that could get infected if you have a health problem that means you're at higher risk of infection such as if you've had your spleen removed or you're having chemotherapy treatment When antibiotics are needed? Antibiotics may be used to treat bacterial infections that: are unlikely to clear up without antibiotics could infect others could take too long to clear without treatment carry a risk of more serious complications People at a high risk of infection may also be given antibiotics as a precaution, known as antibiotic prophylaxis. Missing a dose of antibiotics If you forget to take a dose of your antibiotics, take that dose as soon as you remember and then continue to take your course of antibiotics as normal.But if it's almost time for the next dose, skip the missed dose and continue your regular dosing schedule.  Pain Medications Pain medicines, whether they’re over-the-counter or prescription strength, can help you manage chronic pain and other kinds of pain. They’re powerful drugs, so it's important to use them with care. It’s best to start with the safest drugs at the lowest effective dose for the shortest amount of time and work up from there as needed. Over-the-Counter Pain Relievers Over-the-counter (OTC) pain relievers include: Acetaminophen (Tylenol) Nonsteroidal anti-inflammatory drugs (NSAIDs), including ibuprofen, naproxen, and diclofenac gel Types of over-the-counter pain relievers Common OTC pain medications include: Acetaminophen: This drug (Tylenol®) dulls pain receptors in the brain. As a result, you feel less pain. Nonsteroidal anti-inflammatory drugs (NSAIDs): NSAIDs lower the production of prostaglandins. These hormone-like chemicals irritate nerve endings, causing inflammation and pain. NSAIDs include aspirin compounds (Excedrin®), ibuprofen (Advil® and Motrin®) and naproxen sodium (Aleve®). Combination: Some pain relievers contain both acetaminophen and aspirin (an NSAID). Certain OTC headache medicines also have caffeine. Topical: You apply this pain medication directly to your skin. It comes as a cream, gel, spray or patch. Topical medicines block pain receptors in the brain. They may contain aspirin, lidocaine, capsaicin pepper or other medication. Some topical treatments make the skin feel warmer or cooler. What do over-the-counter pain relievers treat? OTC pain medications lower fevers and ease pain from a variety of problems, including: Arthritis, bursitis and tendonitis. Back strains and sprains. Broken bones. Burns, including sunburns. Colds, flu and ear infections. Headaches and migraines. Menstrual cramps (dysmenorrhea). Muscle pain, including neck pain. Surgeries and minor procedures. Toothaches. Prescription Pain Relievers Prescription medicines to treat pain include: Corticosteroids Opioids Antidepressants Anticonvulsants (anti-seizure medications) NSAIDs What do prescription pain relievers treat? Prescription pain relievers can alleviate pain brought on by: Cancer. Fibromyalgia. Migraines. Nerve (neuropathic) pain, including diabetes-related neuropathy. Postoperative pain. Severe arthritis pain. Severe muscle pain, including back pain. Traumatic injuries, including broken bones and burns.  Types of prescription pain relievers Prescription pain medications provide stronger pain relief than OTC drugs. Types of prescription pain relievers include: Antidepressants: Antidepressants work on chemicals called neurotransmitters in the brain. These drugs work best for chronic pain, including migraines. The largest pain relief comes from tricyclics (Elavil®) and serotonin-norepinephrine reuptake inhibitors (SNRIs), such as Effexor® and Cymbalta®. Studies show that selective serotonin reuptake inhibitors (SSRIs) like Prozac® don’t work as well for pain. SSRIs may make other pain medicines less effective. Anti-seizure medications: Medications for epilepsy interrupt pain messages to the brain. Types include gabapentin (Gabarone®) and pregabalin (Lyrica®). These medicines can ease nerve pain and fibromyalgia. Muscle relaxers: These medications reduce pain by relaxing tight muscles. They also relieve muscle spasms. Opioids: Opioids are lab-made narcotic pain medicines. They change how your brain perceives pain messages. Because they can be addictive, healthcare providers rarely prescribe opioids for chronic pain. You may take opioids for a short time after a surgery or traumatic injury. Codeine, fentanyl, hydrocodone and morphine are all opioids. Steroids: Corticosteroids are strong anti-inflammatory drugs. Like NSAIDs, they stop your body from making chemicals that cause irritation and inflammation. Steroids such as Prednisone® treat migraines and severe arthritis and back pain. Topical: Your provider can choose among prescription-strength skin creams, gels, sprays and patches. They can ease muscle pain, arthritis and fibromyalgia.  Psychiatric Medication A to Z A B C D E F Abilify Benperidol Clozaril Denzapine Ebesque Faverin Alaquet Biquelle Cipramil Depakote Edronax Fluanxol Alzain Brancico Clopizol Depefex Efexor Fluoxetine Anquil Brintellix Clopixol Depixol Epilim Flupentixol Axalid Buspirone Cipralex Dolmatil Escitalopram Foraven Alventa H Chloractil I L M Amphero Haldol Circadin Imipramine Lamictal Majoven Arpoya Halkid Cariprazine Invega Largactil Manerix Ativan Haloperidol N Isocarboxazid Latuda Mintreleg Allegron Heminevrin Nardil O Lecaent Modecate P Q Nozinan Olena Li-liquid Mogadon Psytoxil Quetiapine Nortriptyline Orap Librium Molipaxin Prozep R Nitrazepam Oxactin Lomont S Prozac Reaglia T Oxazepam V Seroquel Prothiaden Risperdal Tegretol Olanzapine Valdoxan Seroxat Priadel Reboxetine Tenprolide W Venaxx Sinepin Politid Risperidone Tensium Welldorm Venlablue Slenyto Phenergan X Trevicta Z Venlalic Solian Parnate Xanax Tropium Zalasta Venlasoz Sominex Pimozide Xeplion Temazepam Zaluron Vensir Stelazine Paroxetine -- Trazodone Zaponex Venzip Stemetil Phenelzine -- Trimipramine Zimovane ViePax Stesolid -- -- -- Zispin Venlafaxine Stilnoct -- -- -- Zolpidem Vortioxetine Sulpor -- -- -- Zopiclone Valproate Sunveniz -- -- -- ZypAdhera -- Surmontil -- -- -- Zyprexa -- Sycrest  Cardiac Medications Sacubitril/valsartan This is the first in a class of heart Nursing points: failure medication called angiotensin Sacubitril/valsartan should not be receptor neprilysin inhibitors. It given with an ACE inhibitor. combines an angiotensin receptor blocker (valsartan) with a neprilysin Adverse effects: enzyme inhibitor (sacubitril). Adverse effects include dizziness, Neprilysin breaks down natriuretic fatigue, cough, hypotension, and peptides, which are responsible for hyperkalemia. sodium and water loss when Indications: ventricles are overloaded. Delaying Sacubitril/valsartan is indicated their breakdown lengthens their to reduce the risk of effects and removes more sodium hospitalization and death in and water from the body, decreasing patients with chronic heart intravascular volume and blood failure and reduced ejection pressure, resulting in decreased fraction. preload and afterload. Angiotensin receptor blockers Similar to ACE inhibitors, ARBs block the Nursing points: action of angiotensin II. However, they work ARBs and ACE inhibitors at a different level of interaction with angio shouldn’t be used ten – sin II, reducing the risk of hyperkalemia interchangeably. ACE or cough that’s seen with ACE inhibitors. inhibitors are preferred ARBs block angiotensin II receptors in the over ARBs because they’re blood vessels and the adrenal glands. In the associated with a decrease blood vessels, ARBs cause venous and arterial in morbidity and mortality. dilation to reduce both preload and afterload. Blocking angiotensin II receptors in the Adverse effects: ARBs are well tolerated adrenal glands decreases the release of and have minimal side aldosterone, which in turn increases the effects. excretion of sodium and water.  Beta-blockers Beta-blockers block the effects of Nursing points: adrenaline, which comes on in Fluid retention may worsen heart response to stressful situations. failure but can usually be managed Beta-blockers are prescribed in the with diuretics. If bradycardia or treatment of these four conditions: hypotension are problematic, the Angina. provider may reduce the beta Heart attack. blocker dose. Because of decreased Congestive heart failure. heart rate and blood pressure Abnormal heart rhythms. associated with beta blockers, they Dosage of these medications must shouldn’t be administered at the be adjusted for the desired response. same time as ACE inhibitors. Your doctor will monitor you for Adverse effects: dizziness (due to low heart rate) Adverse effects of beta blockers kidney and liver problems. include fluid retention, fatigue, bradycardia, and hypotension. Examples: Bisoprolol, carvedilol, sustained-release metoprolol. ACE inhibitors Angiotensin-converting enzyme (ACE) inhibitors cause vasodilation in both the venous and arterial systems, so they decrease both preload and afterload, increasing blood flow to vital organ systems and improving ejection fraction. These medications also block the enzyme needed to convert angiotensin I to angiotensin II. Angiotensin II is a strong vasoconstrictor that raises blood pressure, releases aldosterone, and leads to sodium and water retention. ACE inhibitors prevent this cascade of effects. Adverse effects: Nursing points: Include hyperkalemia, renal failure, Although the cough can be and a dry, persistent cough associated annoying, explain to the with increased bradykinin. If the cough patient that it’s a side effect is intolerable, the provider may of the medication and discontinue the ACE inhibitors in favor encourage him or her to of an angiotensin receptor blocker continue its use. (ARB).  Ivabradine Ivabradine, the first sinoatrial (SA)- Adverse effects: node modulator approved to treat include bradycardia and hypotension. heart failure, decreases normal SA node activity and lowers heart rate. It Nursing points: Administer ivabradine as ordered if a does not affect myocardial contractility. ≥ patient’s heart rate is 70 bpm. Diuretics Diuretics help the body get rid of Adverse effects: Electrolyte loss. excess fluid and sodium. This helps reduce the work the heart Nursing points: must do. It also decreases fluid Instruct patients to decrease their dietary buildup in the lungs and intake of sodium, weigh themselves daily, elsewhere in the body. It is and take the diuretic early in the day to prescribed to lower blood prevent nocturia. Hypokalemia is a side pressure and to reduce swelling. effect of loop diuretics, so monitor patients’ Some of the common drug names serum potassium levels are amiloride, chlorothiazide, Examples: Lasix, Lozol and Aldactone. Furosemide, bumetanide, and torsemide. Hydralazine/isosorbide dinitrate The drugs Adverse effects: isosorbide include headache, dizziness, and orthostatic hypotension. dinitrate and hydralazine have Nursing points: Advise patients to change position slowly to been combined prevent falls due to postural changes in blood into a single pill to pressure. reduce both cardiac preload Indications: and afterload This medication decreases deaths and hospitalization through venous in African Americans, who are less responsive to and arterial angiotensin-converting enzyme inhibitors because of vasodilation. suspected differences in endothelial function.  Endocrine Medications Endocrine medications can be broken down into the following categories: Diabetic agents Hormone agonists Hormone antagonists Diabetic Agents Sulfonylureas (1st Generation) Name Mechanism of Action Key Indication(s) Key Toxicity Chlorpropamide Inhibits ATP-sensitive K+ Second-line Hypoglycemia Tolazamide channels resulting in β- treatment for type II Renal failure Tolbutamide cell depolarization and diabetes Disulfiram effects insulin release Sulfonylureas (2nd Generation) Name Mechanism of Action Key Indication(s) Key Toxicity Glipizide Inhibits ATP-sensitive K+ Second-line Hypoglycemia (long- channels resulting in β- treatment for type II lasting) Glyburide cell depolarization and diabetes Renal failure insulin release Disulfiram effects Biguinides Name Mechanism of Action Key Indication(s) Key Toxicity Exact mechanism First-line Lactic acidosis in Metformin treatment for patients with poor unknown renal function ↓ gluconeogenesis type II diabetes ↑ insulin sensitivity and metabolic ↑ glycolysis syndrome ↓ serum glucose levels ↓ postprandial glucose levels  Alpha-Glucosidase Inhibitor Name Mechanism of Action Key Indication(s) Key Toxicity Acarbose Prevents breakdown of Refractory type II Osmotic diarrhea Miglitol carbohydrates into single diabetes mellitus Flatulence glucose molecules decreasing rate of absorption Thioglitazones Name Mechanism of Action Key Indication(s) Key Toxicity Pioglitazone Stimulates PPAR-γ which Type II diabetes Heart failure controls insulin-sensitive combination Hepatotoxicity Troglitazone genes resulting in increased therapy Weight gain insulin sensitivity in Rosiglitazone peripheral tissues Hormone Agonists Progestins Name Mechanism of Action Key Indication(s) Key Toxicity Synthetic progestin Appetite stimulant Weight gain Megestrol suppresses leuteinizing Anti-neoplastic Nausea acetate hormone by inhibition of agent Vomiting pituitary function Anorexic mechanism Estrogen Name Mechanism of Action Key Indication(s) Key Toxicity Polyestradiol Inhibits actions of Palliative prostate Feminization dihydrotestosterone cancer therapy Nausea Blocks LH secretion by Headache pituitary Water retention Decreases testosterone synthesis Blocks testosterone uptake into prostate cells Diethylstilbestrol Inhibits HPG axis Believed to decrease Clear cell carcinoma Blocks testosterone synthesis incidence of stillbirth Vaginal adenosis Induces chemical castration T-shaped uterus  Gonadotropin Releasing Hormones Name Mechanism of Action Key Indication(s) Key Toxicity Leuprorelin Acts as a gonadotropin Hormone Flushing releasing hormone responsive cancer Sweating agonist which inhibits (non-pulsatile) Fatigue gonadotropin secretion Fertility (pulsatile) Edema Hormone Antagonists Anti-Estrogens Name Mechanism of Action Key Indication(s) Key Toxicity Tamoxifen Competitively binds to ER/PR positive Endometrial cancer estrogen receptors breast cancer Growth plate fusion inhibiting effects of Increased bone estrogen density Anti-Androgens Name Mechanism of Action Key Indication(s) Key Toxicity Flutamide Blocks action of Prostate cancer Gynecomastia testosterone by binding (used prior to GnRH GI disturbance to adrogen receptors analogues) Enzyme Inhibitors Name Mechanism of Action Key Indication(s) Key Toxicity Anastrozole Inhibits aromatase ER/PR positive Osteoporosis breast cancer Bone fracture Fertility  Medications For Infection Penicillin Cephalosporin Penicillin is a medication used to Cephalosporins are beta-lactam manage and treat a wide range of antimicrobials used to manage a infections. It is in the beta-lactam wide range of infections from antibiotic class of drugs. This gram-positive and gram-negative activity describes penicillin's bacteria. The five generations of indications, action, and cephalosporins are useful against contraindications as a valuable skin infection, resistant bacteria, agent in treating infection. meningitis, and other infections Carbapenems Tetracycline Carbapenems exhibit unique Tetracyclines (tetracycline, pharmacological properties and doxycycline, minocycline, are typically used to treat tigecycline) are a class of complicated bacterial infections. A medication used to manage and carbapenem is often combined treat various bacterial infections. with an antibiotic that targets Tetracyclines classify as protein Gram-positive bacteria when used synthesis inhibitor antibiotics and for the empirical treatment of are considered to be broad- patients with serious nosocomial spectrum. infections of unidentified origin. Macrolides Lincosamides Macrolides are a class of drugs used to manage and treat Lincomycin is the prototype of this various bacterial infections. class and clindamycin the only Azithromycin, clarithromycin, member of this group in clinical and erythromycin are use. Clindamycin is a bacteriostatic commonly used to treat antibiotic. It is mainly used in the infections like pneumonia, treatment of infections caused by sinusitis, pharyngitis, and Gram-positive bacteria. tonsillitis.  Aminoglycoside Sulfonamide Aminoglycosides are used in the Sulfonamides (SN) or sulfanilamides treatment of severe infections of belong to an important class of the abdomen and urinary tract, as synthetic antimicrobial drugs that well as bacteremia and are pharmacologically used as broad endocarditis. They are also used for spectrum for the treatment of prophylaxis, especially against human and animal bacterial endocarditis. Resistance is rare but infections increasing in frequency Antiprotozoal Antifungal Antiprotozoal agents are a class of drugs used to treat infections Antifungal medicines are used to caused by protozoa, which are treat fungal infections, which most single-cell organisms, belonging to commonly affect your skin, hair and a group of parasites. Protozoans nails. typically are microscopic and Topical Antibacterials similar to plants and animals as they are eukaryotes, thus having a Topical antibacterials are clearly defined cell nucleus commonly used for superficial pyodermas such as impetigo and Antivirals treatment or prevention of Antivirals are medications that help infections following minor cuts, your body fight off certain viruses abrasions, burns, and surgical that can cause disease. Antiviral wounds. Several antibiotics and drugs are also preventive. They can antiseptics are available for use in protect you from getting viral different indications. One of the infections or spreading a virus to major uses of topical antibacterials others. is acne in which benzoyl peroxide is the drug of the first choice either Antitubercular singly or in combination with A broad-spectrum antibiotic used in antibiotics or retinoids. the treatment of tuberculosis and certain urinary tract infections (UTI). An aminoglycoside antibiotic used as an adjunct drug in tuberculosis.  Drug Drug Class Generic Name Brand Name Dosage Indications Mechanisms of Action Adverse Effects Contraindications Interactions Nursing Considerations Patient Education  Therapeutic drug levels Therapeutic drug levels are lab tests to look for the amount of a drug in the blood. Needle is introduced into Tourniquet is applied vein, blood is drawn into and area is disinfected vial and analyzed How the Test is Performed? A blood sample is needed. Most of the time, blood is drawn from a vein located on the inside of the elbow or the back of the hand. How to Prepare for the Test? You will need to prepare for some drug level tests. Your health care provider will tell you if you need to change the times you take any of your medicines. DO NOT stop or change your medicines without talking to your provider first. Why the Test is Performed? With most medicines, you need a certain level of the drug in your blood to get the proper effect. Some medicines are harmful if the level rises too high and do not work if the levels are too low. Monitoring the amount of the drug found in your blood allows your provider to make sure the drug levels are in the proper range. Drug level testing is important in people taking drugs such as: Flecainide, procainamide or digoxin, which are used to treat abnormal beating of the heart Lithium, used to treat bipolar disorder Phenytoin or valproic acid, which are used to treat seizures or other conditions Gentamicin or amikacin, which are antibiotics used to treat infections Tacrolimus, sirolimus or cyclosporine, which are used to suppress immune system activity against transplanted organs Normal Test Results Acetaminophen: varies with use Amikacin: 15 to 25 mcg/mL (25.62 to 42.70 micromol/L) Carbamazepine: 5 to 12 mcg/mL (21.16 to 50.80 micromol/L) Cyclosporine: 100 to 400 ng/mL (83.20 to 332.80 nmol/L) (12 hours after dose) Desipramine: 150 to 300 ng/mL (563.10 to 1126.20 nmol/L) Digoxin: 0.8 to 2.0 ng/mL (1.02 to 2.56 nanomol/L) Ethosuximide: 40 to 100 mcg/mL (283.36 to 708.40 micromol/L) Flecainide: 0.2 to 1.0 mcg/mL (0.5 to 2.4 micromol/L) Gentamicin: 5 to 10 mcg/mL (10.45 to 20.90 micromol/L) Imipramine: 150 to 300 ng/mL (534.90 to 1069.80 nmol/L) Kanamycin: 20 to 25 mcg/mL (41.60 to 52.00 micromol/L) Lidocaine: 1.5 to 5.0 mcg/mL (6.40 to 21.34 micromol/L) Lithium: 0.8 to 1.2 mEq/L (0.8 to 1.2 mmol/L) Methotrexate: varies with use Nortriptyline: 50 to 150 ng/mL (189.85 to 569.55 nmol/L) Phenobarbital: 10 to 30 mcg/mL (43.10 to 129.30 micromol/L) Phenytoin: 10 to 20 mcg/mL (39.68 to 79.36 micromol/L) Quinidine: 2 to 5 mcg/mL (6.16 to 15.41 micromol/L) Salicylate: varies with use Sirolimus: 4 to 20 ng/mL (4 to 22 nmol/L) Tacrolimus: 5 to 15 ng/mL (4 to 25 nmol/L) (12 hours after dose) Theophylline: 10 to 20 mcg/mL (55.50 to 111.00 micromol/L) Valproic acid: 50 to 100 mcg/mL (346.70 to 693.40 micromol/L)  AbNormal Test Results Acetaminophen: greater than 250 mcg/mL (1653.50 micromol/L) Amikacin: greater than 25 mcg/mL (42.70 micromol/L) Carbamazepine: greater than 12 mcg/mL (50.80 micromol/L) Cyclosporine: greater than 400 ng/mL (332.80 micromol/L) Desipramine: greater than 500 ng/mL (1877.00 nmol/L) Digoxin: greater than 2.4 ng/mL (3.07 nmol/L) Ethosuximide: greater than 100 mcg/mL (708.40 micromol/L) Flecainide: greater than 1.0 mcg/mL (2.4 micromol/L) Gentamicin: greater than 12 mcg/mL (25.08 micromol/L) Imipramine: greater than 500 ng/mL (1783.00 nmol/L) Kanamycin: greater than 35 mcg/mL (72.80 micromol/L) Lidocaine: greater than 5 mcg/mL (21.34 micromol/L) Lithium: greater than 2.0 mEq/L (2.00 millimol/L) Methotrexate: greater than 10 mcmol/L (10,000 nmol/L) Nortriptyline: greater than 500 ng/mL (1898.50 nmol/L) Phenobarbital: greater than 40 mcg/mL (172.40 micromol/L) Phenytoin: greater than 30 mcg/mL (119.04 micromol/L) Quinidine: greater than 10 mcg/mL (30.82 micromol/L) Salicylate: greater than 300 mcg/mL (2172.00 micromol/L) Theophylline: greater than 20 mcg/mL (111.00 micromol/L) Tobramycin: greater than 12 mcg/mL (25.67 micromol/L) Valproic acid: greater than 100 mcg/mL (693.40 micromol/L)  Respiratory Medications Beta2-agonists Methylxanthines Beta2-agonists (bronchodilators) Methylxanthines are relatively are a group of drugs prescribed to weak bronchodilators that are treat asthma. Short-acting beta- administered systemically. They agonists (SABAs) provide quick have been used for treatment of relief of asthma symptoms. They acute exacerbations as well as for can also be prescribed to be taken long-term control of asthma before exercising in order to symptoms. The most common prevent exercise-induced methylxanthine used for asthma bronchoconstriction. treatment is theophylline. Decongestants Antihistamines Decongestants are a type of An antihistamine is a prescription medicine that can provide short- or over-the-counter medication term relief for a blocked or stuffy that blocks some of what histamine nose (nasal congestion). does. “Anti” means against, so They can help ease the symptoms antihistamines are medicines that of conditions such as colds and flu, work against or block histamine. hay fever and other allergic reactions, catarrh and sinusitis. Glucocorticoids They work by reducing the swelling Inhaled and intranasal of the blood vessels in your nose, glucocorticoids (GCs) are the most which helps to open the airways. common and effective drugs for Examples include pseudoephedrine controlling symptoms and airway Types of decongestants inflammation in respiratory nasal sprays diseases such as allergic rhinitis, Drops chronic rhinosinusitis Tablets or capsules with/without nasal polyps, and Liquids or syrups asthma, and the respiratory Flavoured powders to dissolve epithelium is a primary target of in hot water GC anti-inflammatory actions.  Nursing Process Related to Respiratory Medications Implementation of Interventions Respiratory medications are available in many different formulations, such as nasal spray, inhalations, oral tablets or liquids, injections, or intravenous route, so it is always important to verify the correct route and anticipate the associated side effects. For example, inhalations deliver the required medicine or medicines directly to the lungs, which means the medicine(s) can act directly on the lung tissues, minimizing systemic side effects. On the other hand, intravenous medications are administered to act quickly, but can cause systemic side effects. Additionally, some products contain more than one medicine with different dosages (for example, inhalers that combine a long-acting bronchodilator with a glucocorticoid). Respiratory medications are available in many different formulations, such as nasal spray, inhalations, oral tablets or liquids, injections, or intravenous route, so it is always important to verify the correct route and anticipate the associated side effects. For example, inhalations deliver the required medicine or medicines directly to the lungs, which means the medicine(s) can act directly on the lung tissues, minimizing systemic side effects. On the other hand, intravenous medications are administered to act quickly, but can cause systemic side effects. Additionally, some products contain more than one medicine with different dosages (for example, inhalers that combine a long-acting bronchodilator with a glucocorticoid). Additionally, the nurse should also ensure the proper use of the inhalers by the patient. Observe the patient self-administering the medication, and further instruct the patient in proper use  Nursing Process Related to Respiratory Medications Nursing Process: Evaluation Finally, it is important to always evaluate the patient’s response to a medication. With respiratory medications, the nurse should assess decrease in allergy symptoms (cough, runny nose, tearing eyes) and any decrease in shortness of breath. The nurse should complete a respiratory assessment (respirations, pulse oximetry, and lung auscultation) before and after the medications have been administered and compare the results. If the symptoms are not improving or the clinical assessment is worsening, prompt intervention is required (such as notification of the health care provider for further orders) to prevent further clinical deterioration.  Musculoskeletal Meds Musculoskeletal Pain Musculoskeletal pain is pain that affects: Bones. Joints. Ligaments. Muscles. Tendons. Musculoskeletal pain can be acute, meaning it is sudden and severe. Or the pain can be chronic (long-lasting). You may have localized pain (in one area of your body), or it may affect your entire body. Types of musculoskeletal pain The most common types of musculoskeletal pain include: Bone pain: Injuries such as bone fractures or other musculoskeletal injuries cause bone pain. Less commonly, a tumor may cause bone pain. Joint pain: Stiffness and inflammation often accompany joint pain. For many people, joint pain gets better with rest and worsens with activity. Muscle pain: Muscle spasms, cramps and injuries can all cause muscle pain. Some infections or tumors may also lead to muscle pain. Tendon and ligament pain: Ligaments and tendons are strong bands of tissue that connect your joints and bones. Sprains, strains and overuse injuries can lead to tendon or ligament pain. Types of musculoskeletal pain Common causes of musculoskeletal pain include: Bone fractures. Joint dislocation Direct blows to muscles, bones or joints. Overuse injuries. Poor posture. Symptoms of musculoskeletal pain Symptoms may vary depending on the cause of your musculoskeletal pain. Common symptoms include: Aching and stiffness. Burning sensations in the muscles. Fatigue. Muscle twitches. Pain that worsens with movement. Sleep disturbances. How is musculoskeletal pain diagnosed? Your healthcare provider starts a diagnosis by taking a thorough medical history. Your healthcare provider may ask you questions to determine: If you have other symptoms, such as a rash or fever. Whether your pain is acute or chronic. Which factors make pain worse or relieve it. Then, your healthcare provider does a hands-on exam to look for the pain’s source. Your provider may touch or move the affected area. How is musculoskeletal pain treated? Your treatment plan will depend on the underlying cause of your musculoskeletal pain. Common treatments include: Acupuncture. Chiropractic adjustment. Occupational therapy. Pain relievers. Physical therapy. Splints. Steroid injections. Therapeutic massage. Can musculoskeletal pain treated at home? Your healthcare provider may guide you to manage musculoskeletal pain at home. Recommendations may include: Hot and cold therapy. Over-the-counter pain relievers. Strengthening and conditioning exercises. Stretching exercises. Stress reduction techniques. Medications used for musculoskeletal pain Acetaminophen (Tylenol®). Nonsteroidal anti-inflammatory drugs (NSAIDs). Prescription medications, such as opioids. How to prevent musculoskeletal pain? Maintaining strong bones and joints is crucial for preventing musculoskeletal pain. You can work to avoid musculoskeletal pain if you: Limit repetitive movements. Use good posture. Practice correct lifting techniques. Stretch regularly. How to cope with musculoskeletal pain? To cope with musculoskeletal pain: Avoid smoking, which increases inflammation. Eat a healthy, non-inflammatory diet. Rest the injured muscle, joint or bone. Stretch daily or as often as your healthcare provider advises. Take pain medications as prescribed. Use ice and heat to decrease swelling and inflammation.  Vitamins Vitamins are organic substances present in minute amounts in natural foodstuffs. Having too little of any particular vitamin may increase the risk of developing certain health issues. A vitamin is an organic compound, which means that it contains carbon. It is also an essential nutrient that the body may need to get from food. Fat-soluble vitamins Vitamins A, D, E, and K are fat-soluble. The body storesTrusted Source fat-soluble vitamins in fatty tissue and the liver, and reserves of these vitamins can stay in the body for days and sometimes months. Dietary fats help the body absorb fat-soluble vitamins through the intestinal tract. Water-soluble vitamins Water-soluble vitamins do not stay Trusted Source in the body for long and cannot be stored. They leave the body via the urine. Because of this, people need a more regular supply of water-soluble vitamins than fat- soluble ones. Vitamin C and all the B vitamins are water-soluble. Vitamin A It is fat-soluble. Function: It is essential for eye health. Deficiency: This may cause night blindness and keratomalacia, which causes the clear front layer of the eye to grow dry and cloudy. Good sources: These include liver, cod liver oil, carrots, broccoli, sweet potatoes, butter, kale, , some cheeses, eggs, apricots, cantaloupe and milk. Vitamin B1 Vitamin B2 It is water-soluble. It is water-soluble. Function: It is essential for Function: It is essential for the producing various enzymes that growth and development of help break down blood sugar. body cells and helps metabolize Deficiency: This may cause food. beriberi and Wernicke-Korsakoff Deficiency: Symptoms include syndrome. inflammation of the lips and Good sources: These include fissures in the mouth. yeast, pork, cereal grains, Good sources: These include sunflower seeds, brown rice, asparagus, bananas, whole grain rye, asparagus, kale, persimmons, okra, chard, cauliflower, potatoes, oranges, cottage cheese, milk, yogurt, liver, and eggs. meat, eggs, fish, and green beans. Vitamin B3 Vitamin B6 It is water-soluble. It is water-soluble. Function: The body needs niacin for the Function: It is vital for cells to grow and work correctly. the formation of red Deficiency: Low levels result in a health blood cells. issue called pellagra, which causes Deficiency: Low levels diarrhea, skin changes, and intestinal may lead to anemia upset. and peripheral Good sources: Examples include chicken, neuropathy. beef, tuna, salmon, milk, eggs, tomatoes, Good sources: These leafy vegetables, broccoli, carrots, nuts include chickpeas, and seeds, tofu, and lentils. beef liver, bananas, squash, and nuts. Vitamin B5 It is water-soluble. Function: It is necessary for producing energy and hormones. Deficiency: Symptoms include paresthesia, or “pins and needles.” Vitamin C Vitamin D It is water-soluble. It is fat-soluble. Function: It contributes to Function: It is necessary for the collagen production, wound healthy mineralization of bone. healing, and bone formation. It Deficiency: This may cause also strengthens blood vessels, rickets and osteomalacia, or supports the immune system, softening of the bones. helps the body absorb iron, and Good sources: Exposure to UVB acts as an antioxidant. rays from the sun or other Deficiency: This may result in sources causes the body to scurvy, which causes bleeding produce vitamin D. Fatty fish, gums, a loss of teeth, and poor eggs, beef liver, and mushrooms tissue growth and wound also contain the vitamin. healing. Vitamin E Vitamin K It is fat-soluble. It is fat-soluble. Function: Its antioxidant activity Function: It is necessary for helps prevent oxidative stress, an blood clotting. issue that increases the risk of Deficiency: Low levels may widespread inflammation and cause an unusual various diseases. susceptibility to bleeding, or Deficiency: This is rare, but it may bleeding diathesis. cause hemolytic anemia in Good sources: These include newborns. This condition destroys natto, leafy greens, blood cells. pumpkins, figs, and parsley. Good sources: These include wheat germ, kiwis, almonds, eggs, nuts, leafy greens, and vegetable oils.  Principles of Ethics for Nurses Autonomy Justice Autonomy is recognizing each Justice is that there should be an individual patient’s right to self- element of fairness in all medical determination and decision-making. and nursing decisions and care. As patient advocates, it is imperative Nurses must care for all patients that nurses ensure that patients with the same level of fairness receive all medical information, despite the individual's financial education, and options in order to abilities, race, religion, gender, choose the option that is best for and/or sexual orientation. them. This includes all potential An example of this is when working risks, benefits, and complications to at a free flu clinic or diabetes make well-informed decisions. screening clinic. These are open to Once the patient has all relevant all individuals in the community information, the medical and regardless of the previously nursing team can make a plan of care mentioned factors. in compliance with the medical wishes of the patient. It is important that nurses support Nonmaleficence the patient in their medical wishes and ensure that the medical team is Nonmaleficence is to do no harm. This remembering those wishes. is the most well known of the main Sometimes, nurses will need to principles of nursing ethics. More continue to advocate for a patient specifically, it is selecting despite the wishes being verbalized. interventions and care that will cause the least amount of harm to achieve a beneficial outcome Beneficence The principle of nonmaleficence ensures the safety of the patient and Beneficence is acting for the good community in all care delivery. Nurses and welfare of others and including are also responsible to report such attributes as kindness and treatment options that are causing charity. The American Nurses significant harm to a patient which Association defines this as “actions may include suicidal or homicidal guided by compassion.” ideations.