Pharmacology

Glucocorticoids

Therapeutic effect: reduces inflammation

Salicylate Toxicity

Tinnitus

Maximum recommended dose of Acetaminophen

4,000 mg per day

Nurse caring for a client who is receiving liothyronine (Cytomel) for treatment of hypothyroidism. Which of the following should the nurse recognize as therapeutic response?

A. Loss of appetite B. Increase in daily weight C. Improvement of overall mood D. Decrease in body temperature C. improvement of overall mood

Nurse has just administered dose of Diazepam (Valium) to a client. Which of the following actions should the nurse take before she leaves the room?

A. Turn off the overhead lights B. Reduce the ringer volume on the client's telephone C. Put up the side rails on the client's bed D. Turn off the client's television C. Put up the side rails on the clients bed

Client has developed agranulocytosis as result of taking propylthiouracil (PTU) to treat hyperthyroidism. When preparing to reinforce teaching with the client, the nurse should base her instructions on the fact that the client is at serious risk for which of the following?

A. excessive bleeding B. Ecchymosis C. Infection D. Hyperglycemia C. infection Agranulocytosis is failure of bone marrow to make enough WBC causing neutropenia and lowering the body defenses against infection

Nurse is talking with a client about taking an expectorant to treat a cough. The nurse should explain that this type of medication treats coughs because of which of the following actions?

A. reduces inflammation B. Suppresses the urge to cough C. Dries mucous membranes D. Stimulates secretions D. Stimulates secretions * Expectorants act by increasing secretions to improve a cough's productivity

-Sartan

ARB - Angiotensin II Receptor Blockers

Lantus (long acting insulin)

Administered at night Not used on sliding scale

ARB - Angiotensin II receptor Blocker

Adverse effects: Angioedema Edema of tongue, glottis, pharnyx Resulting in limitation or blockage of airway = Respirations are unlabored = therapeutic response to medication

Bronchodilator

Albuterol * Used to treat bronchospasm associated with asthma, bronchitis, or other reversible obstructive airway diseases * Administered to promote respiratory function and prevent respiratory distress * Monitor HR & BP (can increase or decrease)

-Statin

Anti-Lipidemic Lipid Lowering agents (cholesterol) Ex: atorvastatin (Lipitor) Simvastatin (Zocor) * Do not take with grapefruit juice * Usually taken 1x per day in evening with meal or at bedtime * Can be taken with or without food * Monitor liver enzymes Cholesterol is produced in the liver

Prednisone (Deltasone)

Anti-inflammatory, immunosuppressant Treatment: Rheumatoid arthritis, exacerbations of multiple sclerosis Adverse effects of Prednisone: Headache Insomnia HF HTN Hyperglycemia Increased appetite Hypernatremia Hypokalemia Alteration in memory

Atropine

Anticholinergic Causes HR to increase, dilation of pupils Do not give to pts with glaucoma

Warfarin (Coumadin)

Anticoagulant Used for prophylaxis (preventive) and tx for: * DVT * PE * A fib

Diphenhydramine (Benadryl)

Antihistamine Given during allergic reactions

Sucralfate (Carafate)

Antiulcer * Given to someone with Peptic ulcer disease * Take on an empty stomach, 1 hr. before meals * Do not take within 30 min. of taking anti-acids * Do not take with food or milk (reduces effectiveness)

Diazepam (Valium)

Benzodiazepine Causes sedation & has anti-anxiety & muscle relaxation properties Nursing care: * Raise side rails * Place bed in low position * Call light within reach

-olol

Beta Blocker Ex: propranolol (Inderal) Adverse effects of beta blockers: * Bronchospasms * Difficulty breathing * Wheezing * Bradycardia * Orthostatic hypotension Monitor HR (hold if less than 60)

Insulin Pump

Designed to administer rapid acting or short acting insulin 24 hr. a day * Change needle every 2-3 days * Refrigerate insulin that is not in use to maintain potency * Prevent exposure to sunlight * Insulin in use should be kept at room temp. for up to 28 days to reduce irritation at injection site

Cyclobenzaprine

Flexeril Reduce muscle spasms Avoid activities that require complete alertness Drowsiness

Ferrous Iron

Given for iron deficiency anemia *Best absorbed in acidic environment: orange juice, fruit juices Vitamin C enhances iron absorption * liquid iron given with straw or med dosage syringe * Monitor for constipation and GI upset * No antacids, coffee, tea, dairy products, or whole grain breads 1 hr. after administration * Z track method (IM - ventrogluteal) * Do not massage injection site

Valproic acid (Depakene)

Given for seizures Side effects: Liver toxicity Mucosal yellowing Abdominal pain Increase appetite

Disulfiram (Antabuse)

Given to treat chronic alcoholism Do not give if pt. has is intoxicated If pt. drinks alcohol while taking this med may cause: Respiratory depression Arrhythmias Cardiac arrest

What reverses the effects of insulin over dose (severe hypoglycemia)

Glucagon

Ginkgo Biloba

Herb Can interact with other meds & cause adverse effects

Furosemide (Lasix)

High ceiling Loop Diuretic Treatment of HF, hepatic impairment, renal disease, HTN Adverse effect: Hyponatremia Hypokalemia

Nurse is reviewing following VS: HR 86/min, BP 80/40, RR 28/min with stridor, & temperature 101.5F. Which of the following actions should the nurse take next?

Hold Captopril (Capoten) * Why? This is an ACE inhibitor used to treat HTN Adverse effect of captopril = hypotension, cough

TB client taking pyrazinamide - side effects

Hypersensitivity Arthralgia Myalgia Hepatotoxicity Photosensitivity Thrombocytopenia

Digoxin toxicity symptoms

Hypokalemia Loss of appetite N/V Visual disturbances

For administration of IM injection, the needle should be inserted at what angle?

IM injection, needle should be inserted at 90degree angle

Preparing to administer glycerin suppository to client. What is the best position for suppository?

Left lateral (left side lying)

Vastus lateralis muscle injection location

Locate this muscle by placing one hand below the greater trochanter of the femur and one hand's width above the knee Inject lateral to midline of upper portion of quadriceps muscle

Enoxaparin (Lovenox)

Low molecular weight heparin * Inhibits thrombus and clot formation * Preventive doses are low & client does not require monitoring of PT or aPTT

Ibuprofen

NSAID - Nonsteroidal anti-inflammatory Used for: * RA & Osteoarthritis * Mild to moderate pain * Reduction of fever To minimize GI upset, take with a meal or immediately after

Aspirin

Nonnarcotic analgesic Can cause bleeding (inhibits platelet aggregation) Would not be prescribed for client undergoing surgery

Spironolactone (Aldactone)

Potassium sparing diuretic Causes loss of sodium & water, & retention of potassium Client at risk for: Hyperkalemia and hyponatremia

Morphine sulfate

Opiate narcotic Used for: * Systemic relief of pain

When clients receiving heparin, what med should the nurse have on hand in event of heparin overdose?

Protamine (reverses effects of heparin)

Calcium supplements can cause

Renal stones = Increase water intake while taking calcium supplements = Report any blood in urine or flank pain

Nurse preparing a med & observes the date of expiration on vial occurred 2 months ago. Which action should the nurse perform?

Return the medication to the pharmacy

What is the antidote of warfarin (Coumadin)

Vitamin K

Rectal Suppository which position should client lie in?

Sim's position * Exposes the anus and helps client relax the external sphincter while lying in bed * allows for easier insertion of suppository

Antitussives:

Suppresses the urge to cough

what reverses the effects of warfarin (Coumadin)

Vitamin K

Montelukast (Singulair)

To treat asthma Prevents asthma exacerbations Take on daily basis Once a day, in evening Take even if client does not have symptoms Can take with or without meals

Methotrexate (Rheumatrex)

Treats RA May take 4-6 weeks to reach therapeutic effects Do not drink alcoholic beverages Report unexplained bruising to provider Avoid people who have infections Can cause bone marrow suppression

Allopurinol (Zyloprim)

Treats gout Need to drink 3 quarts of water each day Report rash immediately Take after meals Report fever

Alendronate Sodium (Fosamax)

Treats: osteoporosis, Paget's disease Adverse effects: Jaw pain Blurred vision Ocular inflammation Headache Dysphagia Esophagitis Pt Teaching: * Take in morning with full glass of water * Do not chew or suck on tablet * Wait 30 min. after taking before eating, drinking, or taking other drugs * Remain upright 30 min. after taking and until you have eaten first food of the day

What increases iron absorption

Vitamin C

Minor over dose/ aspirin toxicity can cause

tinnitus (ringing of ear)