Pharmacology PDF

Respiratory agents 3.) expectorant - reducing the viscosity of pulmonary secretion Respiratory tract - increase fl...

Respiratory agents 3.) expectorant - reducing the viscosity of pulmonary secretion Respiratory tract - increase fluid intake while taking this medications Upper respiratory tract. 4) antitussive - nasal cavity - large group of narcotic or non -Pharynx narcotic drug - Larynx - suppress the cough reflex Lower respiratory tract * Nonnarcotic - suppress the cough reflex by -Trachea numbing the stretch receptors - primary bronchi - lungs * Narcotic - suppress the cough reflex by direct action in the medulla Upper respiratory tract infection (URTI) - common cold - acute rhinitis Lower respiratory tract infection -Sinusitis - acute pharyngitis *Common disorder: Bronchial asthma Drugs for upper respiratory disorder Asthma - heightened airway reactivity -Results to harrowing and swelling of 1) antihistamines (H1 blockers) the airway Histamine - allergic reaction Status asthmaticus - acute, severe - results of dilatation of capillaries asthma attack - Decreased BP - unresponsive to usual treatment -Increased gastric secretion - Constriction of the bronchi and uterus Drugs for lower respiratory disorder H1 receptors - Found in lungs Bronchodilators - dilate the bronchioles - results in bronchoconstriction 1) sympathomimetic 2) methylxanthines H2 receptors - found in stomach 3.) Anticholinergic'S - Results in increase gastric acid secretion Sympathomimetics Anticholinergic properties results in decreased - Beta, 2-adrenergic agonists secretions blocks H2 receptor Beta 2 agonists Salmeterol Metaproterenol Action of antihistamines - blocks HI receptors to Albuterol decrease allergic response Ritodrine Terbutaline 2) decongestants (sympathomimetic amines) - eliminates or reduces congestion or swelling  B2 agonists Nursing interventions: - assess respiratory status -Assess liver function tests Short acting Long acting - Does not treat acute asthma attacks Terbutaline Salmeterol Preventers - reduce swelling & Salbutamol Formoterol inflammation in the airways SABA- asthma attack, emergency or rescue meds LABA- maintenance, prevention Controllers - are long-acting beta- adrena receptor (LABA) 2) xanthine derivatives (methylxanthines) Common drugs: aminophylline - oral or IV -Theophylline Relievers - are short-acting beta 2 adrena receptor (SABA) Side effects: - used as "needed" to relieve asthma attacks Cardiac stimulation gastro intestinal distress Tremors Nursing implications: Avoid food and beverage Monitor blood levels for toxicity Therapeutic blood level is 10 to 20 ug/ml Greater than 20 ug/ml = nausea - 1st sign Greater than 35 ug/ml= tremors- late sign 3.) Anticholinergic'S - blocks ach-muscarinic receptors - bronchodilation - often in inhalation forms Anti-inflammatory 1.)Glucocorticoids - corticosteroids 2.) Leukatriene receptor antagonist Glucocorticoids Action: anti-inflammatory effect - decrease inflammatory substances - reduce mucus plugs and edema Nursing interventions: - use bronchodilator before corticosteroid Leukatriene Receptor antagonist - new class of drugs for asthma - most beneficial in treating asthma - combination of both bronchodilators and anti-inflammatory effects  Nervous system agents 2) anorexiants Composed of : Action: suppress the appetite by acting on A) Central nervous system hypothalamus 1) Brain USE: Weight reduction when 2) spinal cord accompanied medical complications B) peripheral nervous system 3) analeptics 1) somatic nervous system Action: stimulates the CNS by acting on - voluntary the cerebral cortex &medulla - skeletal muscles and sensory information Use: respiratory stimulation to primary use 2) autonomic nervous system - involuntary Major side effects: - cardiac and smooth muscles -Dysrhythmias -abnormality activity of the heart or brain - glandular secretions - heart attacks * Sympathetic -fight fight system - tachycardia * Parasympathetic - Energy conservation -Tachypnea - Seizures and tolerance/abuse Central nervous systems medication Nursing implication: A) CNS stimulants - monitor the dietary intake of caffeine *Stimulants- substance that quickens the CNS by - watch the withdrawal symptoms increasing the rate of neuronal discharge - avoid other foods & drinks that contain stimulants Classification: CNS stimulants Amphetamines CNS depressants Anorexiants Sedative-hypnotics Analeptics Anesthetics Analgesics 1) amphetamines & Amphetamine Anticonvulsants Anxiolytics Action: stimulate the release of norepinephrine Antidepressants - Cause increased alertness 1) sedative-hypnotics Narcolepsy - characterized by sudden sleep attack Sedative - agent that produces a state Endogenous obesity- dysfunction of the endocrine of calmness - amphetamines suppress the appetite Hypnotic - agent given at bedtime to Attention deficit hyperactivity disorder (ADHD) - induce sleep amphetamine increases attention span while decreasing the hyperactivity Categories of sedative- hypnotics Mental depression - elevate the mood A) barbiturates Action: produce levels of CNS Nursing applications: depression by decreasing synaptic -Diet & exercise program membranes - Check with pharmacist about all OTC medications Use: sedative and hypnotic - Do not stop the drug if not necessary Preoperatively & as anesthetic -Do not make up missed dose - Anticonvulsant - avoid other stimulants while on these drugs - avoid taking the last dose after 4 to 6PM to prevent insomnia  B) benzodiazepines Action: increase in GABA inhibitor - Calming effect 2) Anesthetics Anesthesia - loss of sensation Classification of anesthetics A) General - agents cause reversible loss of consciousness B.) regional Nursing considerations: -loss of pain sensation Avoid discontinuation after C) local prolonged use - blocks pain where the drug is administered not given if BP is decreased Xanax Barbiturates - commonly used in iv anesthetic Increase in 3D'S ( drowsiness, dizziness Benzodiazepine - cause antegorade amnesia and decrease in bp) Ketamine hydrochloride - Used for short Enhance action of GABA surgical procedures teach to rise slowly from supine Propofol- can cause respiratory depression yes, alcohol I caffeine should be avoided 3) anticonvulsants Antidepressants and mood stabilizers -Substance that prevents or stop the severity of epileptic disorder A) tricyclic antidepressants (TCAs) Action': increases neurotransmitter GABA( gamma - Aminobutyric acid ) concentration - is the main inhibitory neurotransmitter Nursing implication: Glutamate - major excitatory neurotransmitter - 1 to 3 weeks before drug will take effect Nursing considerations: B) monoamine oxidase inhibitors (MAOIs) Action: inhibit Mao enzymes CNS: dizziness - 2nd line antidepressants eat food with drug Antacids decrease C) selective serotonin reuptake inhibitors Support group for epileptics (SSRIs) Alert tag indicating drug Action: antidepressant response the is from Report adverse effect serotonin uptake Anxiolytics / antianxiety drugs Action: enhance the effect of GABA Gastrointestinal agents 4) osmotic laxatives Action: water retention or osmotic effect Vomiting (emesis) where soft bulky stool - the forceful expulsion of gastric contents via mouth Drugs used to treat peptic ulcer - activated by dopamine Ulcer - disruption of mucosal integrity - stimulated by odor, smell, taste, gastric of the stomach mucosal irritation - leads to excavation due to active inflammation 1) antihistamines Action: act primarily on vomiting center Pharmacologic treatment; Acid-suppressing dugs 2.) Anticholinergic'S mucosal protective agents Action: act primarily on vomiting center 3) dopamine-antagonists Action: block dopamine 2 receptors in 1) antacids the CTZ vomiting center Action: neutralization of secreted acid Side effects: 4) serotonin (5-HT3) Receptor antagonists - rebound acidity Action: black serotonin receptors in the CTZ - Constipation if aluminum products -Effective in suppressing nausea caused by are used cancer chemotherapy - diarrhea if magnesium products are used Drugs used to treat diarrhea - Fluid retention if sodium bicarbonate are used Diarrhea -Milk-alkali syndrome if calcium - passage of abnormally liquid or unformed stools salts are used - fecal output is greater than 200grams per day on low-fiber diet Nursing interventions: - administer the drug from other oral Laxatives medications, hour before or 2hours after Constipation 2)H2 receptor antagonists - persistent, difficult defecation Action: selectively black histamine H2 receptor Types of laxatives Cimetidine-anti androgenic effects 1) bulk forming - natural, fibrous substances 3) proton-pump inhibitors(PPIs) Action: fluid in the intestinal contents Action: inhibits the hydrogen 2) surfactant laxatives- also known as” Nursing implications: emollients” or "lubricant laxatives" - should be taken before meals Action: lowers surface tension & promote - monitor patient response to drug water accumulation Mucosal protective agents 3.) stimulant/ contact laxatives Sucralfate Action: stimulates the nerve plexus in the - absorbs pepsin and decreases its intestinal wall concentration