Pharmacology Midterms PDF

- - - - CARDIOVASCULAR SYSTEM ===================== OVERVIEW -------- - ### Drug Classes to Improve Cardiovascular Function 1. 2. 3. 4. 5. 6. INOTROPIC DRUGS --------------- ### Cardiac Glycosides - - - ### Phosphodiesterase Inhibitors (PDEI): - - - - AN...

- - - - CARDIOVASCULAR SYSTEM ===================== OVERVIEW -------- - ### Drug Classes to Improve Cardiovascular Function 1. 2. 3. 4. 5. 6. INOTROPIC DRUGS --------------- ### Cardiac Glycosides - - - ### Phosphodiesterase Inhibitors (PDEI): - - - - ANTIARRHYTHMIC DRUGS -------------------- - ### Classes of Antiarrhythmic Drugs: - - - - - - - - - - - - - - - - - - - - - - - - - - - - - ANTIANGINAL DRUGS ----------------- - ### Classes of Antianginal Drugs 1. - - - - - 2. - - - 3. - - - - ARRHYTHMIAS ----------- - **Atrial Fibrillation (AFib)** - Atrial fibrillation is an irregular heart rhythm that can lead to blood clots, stroke, heart failure, and other heart-related complications. It occurs when the atria, the heart\'s upper chambers, beat irregularly, disrupting blood flow. - - - - - - - **ASYSTOLE -** Asystole, also known as \"**flatline**,\" is the absence of electrical activity in the heart, often resulting in cardiac arrest with no detectable heartbeat. - - - - - - - **Ventricular Fibrillation (VFib)** - Ventricular fibrillation is a life-threatening heart rhythm that results in the heart\'s ventricles quivering instead of effectively pumping blood. - - - - - - - - ARTERIAL OCCLUSIVE DISEASE -------------------------- - This condition is characterized by reduced blood flow due to blocked or narrowed arteries, often in the legs, leading to pain, numbness, and increased risk of tissue ischemia. - - - - - - - - - - - ANTIHYPERTENSIVE DRUGS ---------------------- - **Hypertension**, characterized by an elevated systolic and/or diastolic blood pressure, increases the risk of cardiovascular complications. - - - - **1. Sympatholytic Drugs** - - - - - - - - - - - **2. Vasodilating Drugs** - - - - **3. ACE Inhibitors (ACEIs)** - - - - - - - - - - - - - - - - - - - - - - - - - - - - - **4. Angiotensin II Receptor Blockers (ARBs)** - - - - - - - - - - - - - - - - - - - - - DIURETIC DRUGS -------------- - - - - - - ### 1. Thiazide and Thiazide-like Diuretics -- Sulfonamide derivatives - - - - - - - - - - - - ### 2. Loop Diuretics - - - - - - - - - - - - - ### 3. Potassium-Sparing Diuretics - - - - - - - - - - ANTILIPEMIC DRUGS ----------------- - Antilipemic drugs are primarily used to lower abnormally high levels of lipids in the blood, including cholesterol, triglycerides, and phospholipids. These medications are crucial for individuals at risk of coronary artery disease (CAD). - **Classes of Antilipemic Drugs** 1. ### Bile-Sequestering Agents - - - - - - - ### 2. Fibric Acid Derivatives: - - - - - - - - - - - - - - - ### 3. HMG-CoA Reductase Inhibitors (Statins) - - - - - - - - - - - - ### 4. **Nicotinic Acid (Niacin)** - - - - - - - - 4. ### Cholesterol Absorption Inhibitors - - - - - - - - - - - - HEMATOLOGIC DRUGS ----------------- - Hematologic drugs are essential in treating various blood disorders, targeting components of blood such as **plasma** (liquid component of blood) and **blood cells** (RBC, WBC, and platelets). These drugs are broadly classified into **hematinic drugs**, **anticoagulant drugs**, and **thrombolytic drugs**. ### HEMATINIC DRUGS - - - **Iron** - **Vitamin B12** - **Folic Acid** - **Erythropoietin agents** (specifically for treating **normocytic anemia**) - - **Iron, Vitamin B12, and Folic Acid** are used to treat various forms of anemia: - **Microcytic Anemia**: Typically treated with iron supplementation. - **Macrocytic Anemia**: Often treated with Vitamin B12 and folic acid. - **Erythropoietin Agents**: Used specifically for **normocytic anemia**, often due to chronic illness or renal disease. #### IRON THERAPY - Iron therapy is crucial in managing **iron-deficiency anemia (IDA)**, the most common anemia worldwide. - - - - - - - - - - - - - - - - **Target Populations for IDA (Iron Deficiency Anemia) Prevention:** - - - **Parenteral Iron Therapy** - Parenteral iron is administered when oral iron is ineffective or inappropriate, such as in cases of: - - - - - - **Drug Interactions with Iron** - Certain substances and medications can reduce iron absorption: - - - **Side Effects and Adverse Reactions of Iron Therapy** - - - #### VITAMIN B12 THERAPY - **Primary Use:** Vitamin B12 is primarily used to treat **pernicious anemia**, a form of **megaloblastic anemia**. - **Common Forms of Vitamin B12 Supplements:** - - - - **Mechanism and Function of Vitamin B12** - - - - - - **Pernicious Anemia** - - - **Drug Interactions (DDIs) with Vitamin B12** - #### FOLIC ACID THERAPY - **Primary Use:** Essential component for normal RBC production and growth. Folic acid is given to treat **megaloblastic anemia** due to insufficient dietary intake, particularly in: - - - **Function of Folic Acid:** - - **Deficiency Indicators:** - - #### ERYTHROPOIETIN AGENTS - Erythropoietin agents are synthetic forms of a glycoprotein hormone that stimulate **RBC production** (erythropoiesis) in the bone marrow. - **Types of Erythropoietin Agents** - - - **Mechanism of Action** - - - - **Clinical Applications** - ANTICOAGULANT DRUGS ------------------- - Anticoagulant drugs are crucial in reducing blood clot formation, effectively managing conditions associated with high risk of thrombosis. They are categorized into several types: - - - - - ### 1. Heparin and Its Derivatives **Overview:** Heparin is an anticoagulant derived from animal tissues, functioning as an **antithrombotic agent**. It prevents blood clots but cannot dissolve existing ones or affect clotting factor synthesis. #### Types of Heparin: - - - - #### Administration and Monitoring - - - - #### Mechanism of Action - - #### Clinical Uses: - - - #### **Pharmacotherapeutics**: - - - - #### Drug Interactions (DDIs): - - #### Adverse Reactions (ADRs): - - ### 2. Oral Anticoagulants **Primary Agent:** **warfarin sodium** (a coumarin derivative) #### Mechanism of Action: - #### Absorption and Metabolism: - - #### Therapeutic Uses: - - **Drug Interactions (DDIs):** - - **Adverse Reactions (ADRs):** - - ### 3. Antiplatelet Drugs Antiplatelet drugs are designed to prevent **arterial thromboembolism** and reduce risk in patients with conditions like **myocardial infarction (MI)**, **stroke**, and **arteriosclerosis**. **Common Drugs:** - - **Pharmacokinetics and Pharmacodynamics** - - - - - **Clinical Uses** - - - - **Drug Interactions (DDIs):** - - **Adverse Reactions (ADRs):** - - ### 4. Direct Thrombin Inhibitors (DTIs) Direct thrombin inhibitors block **all thrombin activity**, preventing clot formation. **Examples:** - - - **Administration**: DTIs are generally administered via **continuous IV infusion** or **intra-coronary bolus** during cardiac catheterization. **Pharmacokinetics**: - - - **Clinical Uses**: - - **Special Considerations**: - - **Drug Interactions (DDIs)**: - - ### 5. Factor Xa Inhibitor Drugs **Primary Agent:** **fondaparinux** (approved in the USA) **Mechanism of Action**: Factor Xa inhibitors prevent **DVT** by binding to **antithrombin III** and neutralizing **factor Xa**, thus inhibiting the coagulation cascade and reducing clot formation. **Administration**: Given subcutaneously. **Clinical Use**: Primarily used to prevent blood clot formation, especially in patients undergoing **total hip or knee replacement surgery**. THROMBOLYTIC DRUGS ------------------ - - - - - - - **Mechanism of Action** - - - - **Clinical Uses** - - - - - - - - **Reversal and Inhibition** - **Adverse Drug Reactions (ADR)** - - CARDIOVASCULAR DRUGS AND DISEASES ================================= OVERVIEW -------- - Cardiovascular diseases (CVDs) affect the heart and blood vessels, causing high rates of morbidity and mortality. This category includes conditions like arrhythmias, congestive heart failure, myocardial infarction, angina, hypertension, and hyperlipidemia, which often stem from modifiable factors such as lifestyle habits. Pharmacologic treatments play a crucial role in managing these conditions, including antiarrhythmics, antianginals, antihypertensives, and antihyperlipidemic drugs. - Cardiovascular disease refers to various disorders involving the heart, arteries, and veins, often leading to serious outcomes like myocardial infarction (MI), stroke, or heart failure. Risk factors include both lifestyle and genetic components such as family history, obesity, and sedentary habits. - CAD (Coronary Artery Disease), which refers to the narrowing or obstruction of heart arteries. - atherosclerosis (fatty deposits in arteries) - hyperlipidemia (high cholesterol and triglycerides) ### I. Antihyperlipidemic Drugs Used to reduce elevated blood cholesterol and triglyceride levels, these drugs play a key role in preventing atherosclerosis, heart attacks, and strokes. 1. #### Drug Class: Bile Acid Binding Resins - - - - - 2. #### Drug Class: Niacin (Nicotinic Acid, Vitamin B3) - - - - - 3. #### Drug Class: HMG-CoA Reductase Inhibitors (Statins) - - - - - 4. #### Drug Class: Fibric Acid Derivatives - - - - - 5. #### Drug Class: Miscellaneous Antilipemic Agents - - - - - ### II. Antihypertensive Drugs Medications that lower high blood pressure, reducing the risk of stroke, myocardial infarction, and other complications. 1. #### Diuretics - - - - - - - - - - - - - 2. #### Beta-Blockers - - - - 3. #### ACE Inhibitors - - - - 4. #### Angiotensin II Receptor Blockers (ARBs) - - - - 5. #### Calcium Channel Blockers - - - - ### III. Antiarrhythmic Drugs Used to treat abnormal heart rhythms by stabilizing the heart\'s electrical conduction pathways. 1. #### Class I - Sodium Channel Blockers - - - 2. #### Class II - Beta-Blockers - - - 3. #### Class III - Potassium Channel Blockers - - - 4. #### Class IV - Calcium Channel Blockers - - - ### IV. Antianginal Drugs Used to relieve chest pain due to decreased blood flow to the heart muscle. 1. #### Nitrates - - - 2. #### Beta-Blockers and Calcium Channel Blockers - - ANTIHYPERTENSIVE DRUGS AND HYPERTENSION MANAGEMENT ================================================== - - - - ### I. Diuretics Diuretics are often the first line of defense in managing hypertension as they decrease blood volume by promoting sodium and water excretion, leading to reduced blood pressure and peripheral vasodilation. 1. #### Carbonic Anhydrase Inhibitors - - - - 2. #### Thiazide and Thiazide-like Diuretics - - - - 3. #### Loop Diuretics - - - - 4. #### Potassium-Sparing Diuretics - - - - 5. #### Osmotic Diuretics - - - - ### II. Beta-Adrenergic Blocking Agents (Beta-Blockers) Beta-blockers decrease heart rate, myocardial contractility, and oxygen demand by blocking beta-1 receptors, lowering BP. - - - - ### III. Angiotensin-Converting Enzyme (ACE) Inhibitors ACE inhibitors reduce blood pressure by inhibiting the enzyme that converts angiotensin I to angiotensin II, a potent vasoconstrictor. - - - - ### IV. Angiotensin II Receptor Blockers (ARBs) ARBs block angiotensin II receptors, preventing vasoconstriction without causing a cough. - - - - ### V. Direct Renin Inhibitors Direct renin inhibitors **block the first step in the renin-angiotensin-aldosterone system (RAAS)**, preventing hypertension. - - - - ### VI. Aldosterone Receptor Antagonists Aldosterone antagonists block aldosterone receptors, reducing sodium reabsorption and blood pressure. - - - - ### VII. Calcium Channel Blockers (CCBs) Calcium channel blockers inhibit calcium influx in vascular smooth muscle and cardiac cells, which leads to vasodilation, reduced peripheral resistance, and lower blood pressure. They are divided into two main classes based on their primary effects and selectivity: 1. #### dihydropyridines (DHPs) - - - - 2. #### non-dihydropyridines (Non-DHPs) - - - - ### VIII. Alpha-1 Adrenergic Blocking Agents Alpha blockers reduce peripheral resistance by blocking alpha-1 receptors in vascular smooth muscle. - - - - ### IX. Central Acting Alpha Agonists These agents reduce blood pressure by acting on the central nervous system to decrease sympathetic outflow. - - - - ### X. Direct Vasodilators Direct vasodilators act by relaxing vascular smooth muscle, particularly in arterioles, reducing blood pressure. 1. #### hydralazine - - - 2. #### minoxidil - - - 3. #### sodium nitroprusside - - - DYSRHYTHMIAS AND ANTIDYSRHYTHMIC DRUG CLASSES --------------------------------------------- - - ### I. Sodium Channel Blockers (Class I) Class I anti-dysrhythmic drugs are subdivided based on their effect on the cardiac action potential into three categories: IA, IB, and IC. 1. #### Class IA: Intermediate-acting Sodium Channel Blockers - - - 2. #### Class IB: Rapid-acting Sodium Channel Blockers - 3. #### Class IC: Slow-acting Sodium Channel Blockers - - ### II. Beta-Adrenergic Blocking Agents (Class II) Class II agents act by blocking beta-adrenergic receptors, which decreases heart rate, myocardial contractility, and overall myocardial oxygen demand. - - - - ### III. Potassium Channel Blockers (Class III) Class III agents work by blocking potassium channels, which prolongs the cardiac action potential and refractory period. - - ### IV. Calcium Channel Blockers (Class IV) Calcium channel blockers inhibit calcium influx in the heart, particularly affecting the SA and AV nodes, thus reducing automaticity and heart rate. 1. - - 2. - - ### V. Miscellaneous Antidysrhythmic Agents These agents possess unique mechanisms that don\'t fall under the Vaughan Williams classification. 1. #### Adenosine (Adenocard) - - 2. #### Digoxin (Lanoxin) - - 3. #### Dronedarone (Multaq) - - ANGINA PECTORIS --------------- - **Angina pectoris** is characterized by chest pain resulting from an imbalance between oxygen supply and demand in the myocardium. Factors affecting oxygen demand include heart rate, strength of contraction, and resistance to blood flow. ### Types of Angina 1. #### Stable Angina - - - - - 2. #### Unstable Angina - - - - 3. #### Variant Angina (Prinzmetal's Angina) - - - - - ### Symptoms Patients may experience: - - - - - ### Diagnosis Diagnosis of angina includes: - - - - - - ### Risk Factors Common risk factors include: - - - - - - - - ### **Initiating Factors for Angina Attacks**: - - - - - - ### Pharmacological Management of Angina 1. #### Drug Class: Nitrates - - - - - - - - - - 1. Assess the level, location, duration, intensity, and pattern of the patient\'s pain. 2. Inquire about the last dose of nitrates taken and the degree of relief obtained. 2. #### Drug Class: Beta-Adrenergic Blockers - - - - - 3. #### Drug Class: Calcium Channel Blockers - - - - - - - - - 4. #### Drug Class: Angiotensin-Converting Enzyme (ACE) Inhibitors - - 1. 2. 3. 4. 5. 5. #### Drug Class: Fatty Oxidase Enzyme Inhibitors - - - - - HEART FAILURE (HF) ------------------ - **Also Known As**: Congestive Heart Failure (CHF) - Heart failure is a clinical syndrome characterized by the heart\'s inability to pump sufficient blood to meet the body's oxygenation needs, leading to decreased cardiac output and insufficient tissue perfusion. ### Types of Heart Failure 1. #### Systolic Heart Failure (Contractile Dysfunction) - - - - - 2. #### Diastolic Heart Failure (Filling Dysfunction) - - - - ### Symptoms of Heart Failure - - - - ### Treatment Goals for Heart Failure - - - ### Pharmacological Management of Heart Failure 1. #### Drug Class: ACE Inhibitors - - - - - - - 2. #### Drug Class: Natriuretic Peptides - - - - - - - - 3. #### Drug Class: Beta-Adrenergic Blocking Agents - - - - - 4. #### Drug Class: Digitalis Glycosides - - - - - 1. 2. 3. 4. 5. #### Drug Class: Phosphodiesterase Inhibitors - - - - - - - - - - - - - - - - ### Patient Monitoring and Education - - - DRUGS FOR SHOCK AND RENAL FAILURE ================================= ### Categories of Drugs and Agents: 1. - - - 2. 3. 4. SHOCK ----- - **Shock** is a critical medical condition where vital organs and tissues receive insufficient blood supply, leading to inadequate oxygen delivery. This results in impaired cellular metabolic processes, and without prompt intervention, irreversible organ damage or death may occur. - - - - - - - - - ### Treatment Goals and Approach Shock requires immediate intervention. Treatment focuses on maintaining basic life support (BLS), restoring fluid volume and composition, maintaining adequate blood pressure, and identifying the underlying cause as quickly as possible. - - - - - - ### Fluid Replacement Agents - Fluid replacement is essential in cases of hypovolemic shock, where significant blood or fluid loss has occurred and might be caused by Hemorrhage, burns, severe DHN, persistent vomiting or diarrhea - #### **Types of Fluid Replacement Agents**: - - - - #### Complications and Monitoring: - - - #### Patient Education: - TREATING SHOCK WITH VASOCONSTRICTORS/VASOPRESSORS ------------------------------------------------- - Vasopressors are vital in shock management to raise BP and stabilize the cardiovascular system by inducing vasoconstriction and enhancing heart contractions. Sympathomimetic vasoconstrictors, stabilize BP in shock clients - - - - - - INOTROPIC AGENTS ---------------- - Inotropic agents, also known as **cardiotonic** drugs, increase cardiac output by enhancing the force of heart contractions, which is particularly useful in treating shock. - - - ### Contraindications and Special Considerations: - - - - - - - - ANAPHYLAXIS ----------- - **Anaphylaxis** is a potentially fatal allergic response where the body responds quickly minutes after exposure to an allergen, leading to a sudden release of histamines and other inflammatory agents. - - ### Treatment Approach: - - - - - - - ### Nursing Consideration and Patient Education: - - ### Miscellaneous Diuretics Diuretics play a significant role in managing fluid balance and reducing pressure in conditions like renal failure and heart failure. - - - - - - - - - #### Patient Education: - - - - - - ### Natural Therapy - ENDOCRINE DRUGS =============== - - 1. 2. 3. ANTIDIABETIC DRUGS AND GLUCAGON ------------------------------- ### Diabetes Mellitus (DM) - - - - - ### Hypoglycemic Drugs - 1. 2. ### Hyperglycemic drug - Insulin Therapy =============== #### Role of Insulin - - - - - #### Types of Insulin 1. 2. 3. 4. #### How Insulin Works - 1. 2. 3. - - - - - - #### Indications for Insulin Therapy 1. - 2. - - - - - 3. - - 4. - - - #### Drug Interactions with Insulin - - - #### Adverse Effects of Insulin - - - - - ### Oral Antidiabetic Drugs (OADs) #### Classes of Oral Antidiabetic Drugs 1. - - 2. 3. 4. 5. #### Mechanism of Action of OADs 1. - 2. - 3. - - - - - 4. - - - 5. - 6. - - 7. - 8. - - - - - - - - - - #### Indications for OADs - - #### Drug Interactions and Cautions - - GLUCAGON -------- ### Characteristics of Glucagon - - - - - - ### Uses of Glucagon - - - ### How Glucagon Increases Blood Glucose 1. - 2. - 3. - 4. - 5. - - 6. - - ### Type 1 Diabetes Mellitus #### Characteristics of Type 1 DM - - - - #### Somogyi Phenomenon - ##### Mechanism 1. - 2. - - - - 3. - ##### Clinical Implications 1. - - 2. - ##### Management 1. - 2. - - 3. - 4. - #### Types of Insulin Preparations - - - - - ### Type 2 Diabetes Mellitus #### Characteristics of Type 2 DM - - - - ### Regulation of Blood Glucose Levels - - - - - - - - ### Hyperglycemic Hormones These hormones can raise blood glucose levels, especially during stress or illness: - - - - ### Drugs Affecting Blood Glucose Levels - - - - - - - - - DIABETES MELLITUS (DM) ---------------------- ### Etiology of Diabetes Mellitus - - - - ### Overview of Diabetes Mellitus - - - - - ### Pathophysiology and Complications of Untreated DM - - - - - - ### Energy Imbalance and Ketoacidosis - - - - - ### Insulin Therapy for Diabetes Mellitus #### Historical Development and Goals of Insulin Therapy - - - - #### Importance of Timing and Risks of Insulin Therapy - - - - #### Insulin Dosage and Availability - - - #### Types of Insulin and Analog Modifications - - - - - #### Common Adverse Effects and Management of Hypoglycemia - - - - ### Insulin Administration Guidelines #### Timing, Dosage, and Safety Considerations - - - - - #### Client Teaching on Hypoglycemia and Monitoring - - - #### Injection Site Management - - #### Storage of Insulin - - #### Client Safety and Compliance - - - ### Type 2 Diabetes Mellitus (DM) and Oral Hypoglycemics #### Oral Hypoglycemic Medications - - - - - - - - - - - - - - - #### Recognition of Hyperosmolar Nonketotic Coma (HNKC) in Type 2 DM - - ### Nursing Considerations for Diabetes Management #### Comprehensive Client Education - - - - ### Natural Supplements and Alternative Therapies - DRUGS THAT AFFECT THE AUTONOMIC AND CENTRAL NERVOUS SYSTEM ========================================================== DRUGS USED FOR ANXIETY DISORDERS -------------------------------- ### Overview of Anxiety - - #### **Types of Anxiety**: - - - - - ### Common Anxiety Disorders #### 1. Generalized Anxiety Disorder (GAD) - - - - - - - - - #### 2. Panic Disorder - - - - #### 3. Phobias - - - - - - - - - - - - - #### 4. Obsessive-Compulsive Disorder (OCD) - - - - - - - - - - - - - - - - - ### Drug Therapy for Anxiety Disorders **Considerations** - - - - - ### Classes of Anxiolytic Medications **1. Pure Sedative Effects** - **2. Antianxiety with Less Sedative Activity** - **3. Other Medications** - - - - ### Treatment Modalities by Disorder - ##### Generalized Anxiety Disorder (GAD) - 1. 2. 3. 4. - - ##### Panic Disorder - - - - - ##### Phobias - - - - ##### Obsessive-Compulsive Disorder (OCD) - - ### Nursing Process for Anxiety Disorders #### Assessment 1. - - - 2. - 3. - - 4. - 5. - #### Implementation 1. - - - 2. - - 3. - - - 4. - ### I. ANXIOLYTICS (ANTI-ANXIETY DRUGS) #### Overview - - #### Nursing Considerations for Anxiolytics 1. - - - 2. 3. 4. 5. - - - - - - - #### 1. BENZODIAZEPINES ##### Common Drugs - - - - - - ##### Mechanism of Action - - - - - ##### Therapeutic Indications - - - - - ##### Special Notes - - - ##### Therapeutic Outcome - ##### Monitoring and Nursing Considerations 1. - - 2. - - - - - - - 3. 4. #### 2. AZAPIRONES ##### Common Drug - ##### Mechanism of Action - - ##### Therapeutic Indications - ##### Therapeutic Outcome - ##### Administration - - #### 3. SELECTIVE SEROTONIN REUPTAKE INHIBITORS (SSRIs) ##### Common Drug - ##### Mechanism of Action - ##### Therapeutic Indications - ##### Therapeutic Outcome - #### 4. MISCELLANEOUS ANTI-ANXIETY AGENTS ##### A. hydroxyzine (Vistaril, Atarax) - - - - - - - - - ##### B. meprobamate - - - ### Common Groups of Drugs for Lowering Anxiety 1. - 2. - 3. - - #### Tyramine - - - - - - - - - ### II. CENTRAL NERVOUS SYSTEM (CNS) STIMULANTS #### Overview A. B. i. it restores mental alertness or consciousness ii. Stimulating the respiratory center, overcoming depression iii. Treating hyperkinetic children by acting as a depressant in a child C. iv. Amphetamines v. Anorexiant vi. analeptics #### 1. AMPHETAMINES ##### Mechanism of Action - ##### Therapeutic Indications 1. 2. 3. 4. ##### Therapeutic Outcomes - - - ##### Drug interactions: 1. 2. **Withdrawal syndromes**: physical reaction after cessation or severe reduction in substance intake to induce euphoria, intoxication, or pain/distress relief. ##### Common Drugs - - - - ##### Nursing Considerations 1. 2. 3. 4. #### 2. ANOREXIANTS - - ##### **Mechanism of Action**: - - ##### Therapeutic Indications - ##### Common Drugs 1. 2. 3. 4. ##### Adverse Effects 1. 2. 3. ##### Nursing Considerations 1. 2. 3. - - #### 3. ANALEPTICS AND METHYLXANTHINES - - ##### **Mechanism of Action**: - - ##### Therapeutic Indications 1. - - - 2. - ##### Common Drugs 1. - - - 2. - ##### Adverse Effects 1. 2. 3. 4. ##### Nursing Considerations 1. 2. 3. 4. ### III. PSYCHOTROPICS #### Overview - #### 1. ANTIPSYCHOTIC AGENTS (NEUROLEPTICS) ##### Mechanism of Action - - - ##### Therapeutic Indications 1. - - - - 2. ##### Common Drugs 1. - - - 2. 3. - 4. 5. - ##### Adverse Effects 1. - - - 2. - 3. - ##### Nursing Considerations 1. - - 2. - 3. 4. 5. 6. 7. 8. 9. #### 2. ANTIDEPRESSANTS AND MOOD STABILIZERS ##### Classifications 1. - 2. - 3. - 4. - ##### Key Points - - DRUGS USED FOR MOOD DISORDERS ----------------------------- ### Understanding Mood Disorders - - - - - - - - - - ### Symptoms of Mood Disorders - - - - - - ### Types of Mood Disorders 1. #### **Major Depressive Disorder (MDD)**: - 2. #### **Dysthymia**: - 3. #### **Bipolar Disorder**: - 4. #### **Cyclothymia**: - ##### Key Complications - - ### TREATMENT OPTIONS #### 1. Non-Pharmacologic Therapy - #### 2. Pharmacologic Therapy ##### A. Mood Stabilizers - - - - - - 1. **Minor Toxicity**: - - - 2. **Major Toxicity**: - - - - - - - 1. Monitor **serum lithium levels**: - - - 2. **Administration**: - - 3. **Renal Function**: - 4. **Hydration**: Prevent dehydration to avoid toxicity. 5. **Contraindications**: Avoid during pregnancy and lactation. ##### B. Tricyclic Antidepressants (TCAs) - - - - - - - **Therapeutic Uses**: - - - - - - - - 1. 2. 3. - 4. - ##### C. Monoamine Oxidase Inhibitors (MAOIs) - - - - - - - - 1. 2. 3. - 1. 2. 3. ##### D. Selective Serotonin Reuptake Inhibitors (SSRIs) - - - - - - - - - - - - 1. - - 2. 3. ##### E. Skeletal Muscle Relaxants - - - - - - - - - - - - 1. 2. 3. DRUGS ACTING ON THE NEUROMUSCULAR SYSTEM ---------------------------------------- ### 1. Peripherally or Direct-Acting Agents - #### **Action**: - - - #### **Uses**: - 1. 2. 3. 4. - - #### **Major Side Effects**: - - - - - #### **Drug-Drug Interactions (DDI)**: - - #### **Nursing Implications (NI)**: - - - - #### **Common Drug**: - ### 2. Antimyasthenic Agents #### Overview of Myasthenia Gravis (MG): - - - - - #### Pharmacologic Details: - ##### **Action**: - - - ##### **Uses**: 1. Manage **myasthenia gravis (MG)** symptoms, such as muscle weakness and fatigue. 2. Reverse the effects of **neuromuscular blocking agents** postoperatively or during anesthesia recovery. - ##### **Major Side Effects**: - - - ##### Drug-Drug Interactions (DDI): - - ##### Nursing Implications (NI): - - - - - - - - - - - - - ##### Common Drugs: - - - ### 3. Neuromuscular Blocking Agents #### General Overview: - ##### **Action**: - - - ##### **Indications**: 1. Relaxation of skeletal muscles during surgery. 2. Control/Decrease muscle spasms during **drug-induced** or **electrically induced convulsions**. 3. Facilitate **mechanical ventilation** by suppressing spontaneous respiration. #### A. Non-Depolarizing Agents - ##### **Action**: - - ##### **Uses**: 1. Facilitate **endotracheal intubation**. 2. Reduce anesthetic requirements during surgery. 3. Provide skeletal muscle relaxation for clients on mechanical ventilation. - ##### **Major Side Effects**: - - - ##### **Drug-Drug Interactions (DDI)**: - - ##### Nursing Implications (NI): - - - - - - - ##### **Common Drugs**: - - - - #### B. Depolarizing Agents - ##### **Action**: - - - ##### **Uses**: - 1. 2. 3. - ##### **Major Side Effects**: - - - - ##### **Drug-Drug Interactions and Nursing Implications**: - - ##### **Common Drug**: - DRUGS USED FOR PAIN MANAGEMENT ------------------------------ ### I. ANALGESICS #### 1. Narcotics (Opioid Analgesics) - ##### **Action**: - - - ##### **Uses**: 1. 2. 3. 4. 5. - ##### Nursing Implications (NI): 1. 2. 3. 4. 5. 6. 7. - - 8. 9. - ##### **Common Drugs**: 1. 2. 3. 4. 5. 6. #### 2. Mixed Narcotic Agonist-Antagonist Agents - ##### **Action**: - - - ##### **Uses**: 1. 2. 3. - ##### **Nursing Implications (NI)**: - - ##### **Common Drugs**: 1. 2. 3. #### 3. Narcotic Antagonists - ##### **Action**: - - ##### **Uses**: 1. 2. 3. - ##### **Side Effects (SE)**: - - - ##### **Nursing Implications (NI)**: 1. Monitor for **respiratory depression relapse** and be prepared for repeated antagonist doses. 2. Regularly assess **vital signs (VS)**: Focus on RR and BP every 5 minutes during administration. 3. Administer antidotes **intravenously (IV)** during emergencies for rapid action. 4. Provide alternative pain management once opioids are reversed. - ##### **Common Drugs**: 1. 2. ### Key Considerations for Pain Management #### 1. Ethical Responsibility - #### 2. Pain as the Fifth Vital Sign (VS) - - - - - - - - - #### 3. Administration Guidelines - - - - #### 4. Special Populations - - #### 5. NSAID Allergy Consideration - #### 6. Effectiveness Evaluation - Central and Peripheral Nervous System (CNS & PNS) ================================================= The Nervous System ------------------ - - 1. 2. Classification and Naming of Autonomic Drugs -------------------------------------------- 1. ### Stimulation of the Sympathetic Nervous System (SNS) - - - 2. ### Inhibition of the Sympathetic Nervous System (SNS) - - 3. ### Stimulation of the Parasympathetic Nervous System (PNS) - - 4. ### Inhibition of the Parasympathetic Nervous System (PNS) - - - - - Drug Classifications and Uses ----------------------------- ### Adrenergic Agents (Sympathomimetics) - - - - - #### **Receptor-specific actions**: - - - - ### Adrenergic-Blocking Agents (Antagonists) - - - ### Cholinergic Agents (Parasympathomimetics) 1. #### **Direct-acting agents**: - - - 2. #### **Indirect-acting agents**: - - - ### Cholinergic Blocking Agents (Anticholinergics) - - - Key Points for ANS Drugs ------------------------ - - - - - - Natural Therapies ----------------- - - - Seizure Disorders ----------------- ### Classification of Seizure Drugs 1. #### **Hydantoin and Phenytoin-like Drugs**: - 2. #### **Phenytoin-like Agents**: - 3. #### **Succinimides**: - 4. #### **Barbiturates**: - 5. #### **Benzodiazepines**: - Emotional and Mood Disorders ---------------------------- ### Antidepressants 1. #### **Tricyclic Antidepressants (TCA)**: - 2. #### **Selective Serotonin Reuptake Inhibitors (SSRIs)**: - 3. #### **Monoamine Oxidase Inhibitors (MAOIs)**: - - - ### Bipolar Disorder - #### **Drug**: l**ithium (Eskalith)** - - ### Attention Deficit Hyperactivity Disorder (ADHD) - #### **CNS Stimulants**: - - ### Psychoses #### Drug Classes 1. ##### **Phenothiazines**: - 2. ##### **Nonphenothiazines**: - 3. ##### **Atypical Antipsychotics**: - Pain Management --------------- ### Drug Types 1. #### **Opioid Analgesics**: - 2. #### **Opioid Antagonists**: - 3. #### **Nonopioid Analgesics**: - 4. #### **NSAIDs**: - 5. #### **Antimigraine Agents (Triptans)**: - ### Effects of Catecholamines and Non-Catecholamines 1. #### Catecholamines - - - 2. #### Non-Catecholamines - - 3. #### Beta Blockers - - Anticonvulsants --------------- Anticonvulsants are drugs used to manage seizure disorders by stabilizing neural activity. 1. ### phenytoin - - - - - - 2. ### valproate (Valproic Acid) - - - - - 3. ### carbamazepine - - - 4. ### Phenytoin-Like Drugs - - - 5. ### Seizure Causes: - Drugs for Parkinson's Disease ----------------------------- Parkinson's disease medications aim to restore the balance of dopamine and acetylcholine. 1. ### levodopa - - - - 2. ### trihexyphenidyl - - 3. ### Combination Therapy: - Anxiolytics and Sedatives ------------------------- These drugs manage anxiety, insomnia, and related disorders by depressing CNS activity. 1. ### benzodiazepines - - - - 2. ### lithium - - Anesthetics ----------- Anesthetics are used for pain management and to induce unconsciousness during procedures. 1. ### Local Anesthetics - #### lidocaine: - - - #### Benzocaine - 2. ### Topical Anesthetics - 3. ### General Anesthetics - - - 4. ### succinylcholine (Anectine) - 5. ### Gastroscopy Anesthesia: - Antidepressants and Psychotropic Drugs -------------------------------------- These drugs manage mood disorders, psychosis, and related conditions. 1. ### Monoamine Oxidase Inhibitors (MAOIs) - - 2. ### Haloperidol (Haldol) - - 3. ### fluphenazine (Prolixin) - 4. ### ritalin (Methylphenidate): - 5. ### Extrapyramidal Symptoms (EPS): - - Miscellaneous Drugs and Therapies --------------------------------- 1. ### cyclobenzaprine - - 2. ### cayenne (Capsicum annum): - 3. ### Botulinum Toxin (Botox): - - Adverse Drug Reactions ---------------------- 1. ### Stevens-Johnson Syndrome (SJS): - - 2. ### Drug Toxicity and Overdose: - General Considerations ---------------------- 1. ### Pharmacotherapy Goals: - 2. ### Safety Precautions: - - ### Verapamil - - - - - CNS Stimulants -------------- 1. ### Amphetamines - - - - - - - - - 2. ### Anorexiants - - - - 3. ### Analeptics - - - - - - - - - CNS Depressants --------------- 1. ### Sleep Stages - - 2. ### Barbiturates - - - - - - - - 3. ### Benzodiazepines - - - - - - - 4. ### Benzodiazepine Antagonists - - 5. ### Non-Benzodiazepine Sleep Agents - - - 6. ### Melatonin Agonists - - 7. ### Opioid Agonists - - - 8. ### Natural CNS Depressants: - - Anesthetics ----------- 1. ### Classification of Anesthetics: - - 2. ### Nitrous Oxide - - 3. ### Stages of Anesthesia: - #### **Analgesia:** - - #### **Excitement/Delirium:** - - #### **Surgical Anesthesia:** - - #### **Medullary Paralysis:** - 4. ### Local Anesthetics: - - - - 5. ### **Spinal Anesthesia**: - Antiseizure Drugs ----------------- 1. ### Mechanisms of Action: - - - 2. ### Common Antiseizure Drugs: - - - - - 3. ### Natural Therapies and Drug Interactions: - - 4. ### Status Epilepticus: - - Parkinson\'s and Alzheimer\'s Disease ------------------------------------- 1. ### Parkinson's Disease - - - ##### Symptoms: - - - - #### Treatment: - - - - 2. ### Alzheimer\'s Disease - - #### Treatment: - - Neuromuscular Disorders ----------------------- 1. ### Myasthenia Gravis - - #### Treatment: - 2. ### Multiple Sclerosis - - #### Treatment: - - Parkinson\'s Disease -------------------- - - ##### **Symptoms**: - - - - ##### **Drugs**: - - - - **References** - -