NSG124 Pharmacology Drug Card Template., Exams of Nursing

Download NSG124 Pharmacology Drug Card Template. and more Exams Nursing in PDF only on Docsity! NSG124 Pharmacology Drug Card Template. Who takes this? How does it work? Pharmacokinetics/How is it given? Contraindications Drug & Class How does the nurse know it is working? Nursing Considerations: What is the nurse going to do/teach/assess? Adverse Effects NSG124 Pharmacology Drug Card Template Who takes this? How does it work? Pharmacokinetics/How is it given? Hypertension, diabetic nephropathy, heart failure, MI Blocks production of angiotensin II PO Excreted in the urine Peak 1 hr; duration 2-6 hr; half-life <2 hr, increased in renal disease Pregnancy and Breastfeeding, children, potassium-sparing diuretics 1. Captopril [Capten] 9.1 + 9.4 + 9.5 Angiotensin-Converting Enzyme (ACE) Inhibitor Decrease in B/P, decreased diabetic nephropathy symptoms, Improve hemodynamics in patients with heart failure Should be administered 1 hour before meals or 2 hr after meals Do not discontinue product abruptly – adhere to dosage schedule, even if feeling better. Warn patients about the possibility of persistent cough - avoid OTC Hyperkalemia may occur – avoid potassium supplement and potassium- containing salt substitutes Signs and symptoms of angioedema Signs and symptoms of neutropenia Cough – persistent dry, irritating, nonproductive, Neutropenia, Angioedema Patients with hypertension, diabetic nephropathy, stroke Blocks the actions of angiotensin II Oral – may be taken with or without food Peak 1 hr; half-life 2 hr; Contraindications Drug & Class How does the nurse know it is working? Nursing Considerations: What is the nurse going to do/teach/assess? Adverse Effects NSG124 Pharmacology Drug Card Template Who takes this? How does it work? Pharmacokinetics/How is it given? prevention, diabetic retinopathy Excreted in urine/feces Pregnancy-during the 2nd and 3rd trimesters, Bilateral renal artery stenosis, a history of hypersensitivity reactions 1. Losartan [Cozaar]9.1 + 9.4 + 9.5 Antihypertensive Angiotensin II receptor antagonist Decreased B/P Decrease diabetic nephropathy Photosensitivity may occur- avoid sunlight, wear sunscreen if in sunlight Do not discontinue abruptly- comply with dosage schedule Dizziness, fainting, light-headedness may occur-avoid hazardous activities until reaction is known To rise slowing to sitting or standing position to minimize orthostatic hypotension Fetal Injury, Angioedema, renal failure, Hypertension, alone or in combination with thiazide diuretics, HF, post-MI Binds to mineralocorticoid receptor and blocks the binding of aldosterone, a component of the rennin-angiotensin- aldosterone system (RAAS) Peak 1½ hr; serum protein binding 50%; half-life 4-6 hr; metabolized in liver by CYP3A4; excreted in urine <5%, feces NSG124 Pharmacology Drug Card Template Who takes this? How does it work? Pharmacokinetics/How is it given? Contraindications Drug & Class How does the nurse know it is working? Evaluate: • Therapeutic response: decrease in B/P Teach patient/family: • About the importance of complying with dosage schedule even if feeling better; that if dose is missed, take as soon as possible; that if it is almost time for the next dose, take only that dose; do not double dose; do not take with high-fat meal or grapefruit • How to take B/P and normal reading for age group • Not to use OTC products including herbs, supplements unless approved by prescriber •To report to prescriber immediately: dizziness, faintness, chest pain, palpitations, uneven or rapid heartbeat, headache, severe diarrhea, swelling of tongue or lips, trouble breathing, difficulty swallowing, tightening of the throat • Not to operate machinery or perform hazardous tasks if dizziness occurs • To rise slowly to avoid faintness Black Box Warning: Pregnancy: To notify if pregnancy is planned or suspected; if pregnant, product will need to be discontinued Courtney 1. Verapamil [Calan] 9.2 + 9.4 + 10.1 + Nursing Considerations: What is the nurse going to do/teach/assess? Adverse Effects NSG124 Pharmacology Drug Card Template Who takes this? How does it work? Pharmacokinetics/How is it given? Contraindications Drug & Class How does the nurse know it is working? 10.3 Chronic stable angina pectoris, variant angina, hypertension. Inhibits calcium ion influx across cell membrane during cardiac depolarization; relaxes coronary vascular smooth muscle; dilates coronary arteries; increases myocardial oxygen delivery in patients with vasospastic angina; dilates peripheral arteries. 1. Nifedipine [Adalat] 9.2 + 9.4 Nursing Considerations: What is the nurse going to do/teach/assess? Adverse Effects NSG124 Pharmacology Drug Card Template Who takes this? How does it work? Pharmacokinetics/How is it given? Essential hypertensions, Dilates the arteriolar smooth muscle by PO: Onset 20-30 min, peak 1-2hr, Courtney HF: Peripheral edema, dyspnea, weight gain >5 lb, jugular venous Distention, rales; monitor I&O ratios, daily weights GI obstruction: ext. rel products have been associated with rare reports of obstruction in those with strictures and no known GI issues Serious skin disorders: rash that starts suddenly, fever, cutaneous lesions that may have been pustules present; discontinue product if fever present or if rash is severe. Pregnancy/breastfeeding: use only if benefits outweigh fetal risk; do not breastfeed. To notify prescriber of dyspnea, edema of extremities, nausea, vomiting, severe ataxia, severe rash; changes in pattern, frequency, severity of angina. Not to discontinue abruptly; to gradually taper CNS: Headache, fatigue, drowsiness, dizziness, anxiety, depression, weakness, insomnia, light-headedness, paresthesia, tinnitus, blurred vision, nervousness, tremor flushing. CV: Dysrhythmias, edema, hypotension, palpitation, tachycardia. GI: Nausea, vomiting, diarrhea, gastric upset, constipation, increased LFT’s, dry mouth, flatulence, gingival hypertension. GU: Nocturia, polyuria HEMO: Brusing, bleeding, petechiae. INTEG: Rash, pruritus, flushing, hair loss, Stevens-Johnsons syndrome, toxic epidermal necrolysis, exfoliative dermatitis MISC: Sexual difficulties, cough, fever, chills. NSG124 Pharmacology Drug Card Template Who takes this? How does it work? Pharmacokinetics/How is it given? Contraindications Drug & Class How does the nurse know it is working? Nursing Considerations: What is the nurse going to do/teach/assess? Adverse Effects NSG124 Pharmacology Drug Card Template Who takes this? How does it work? Pharmacokinetics/How is it given? People with edema of HF, hypertension, diuretic-induced hypokalemia, primary hyperaldosteronism, edema of nephrotic syndrome, cirrhosis of liver with ascites Competes with aldosterone at receptor sites in distal tubule, thereby resulting in the excretion of sodium chloride and water and the retention of potassium and phosphate Onset 24-48 hours, peak 48-72 hours, metabolized in the liver, excreted in urine, crosses placenta, protein binding >90%, terminal half-life 10-35 hours Hypersensitivity, anuria, severe renal disease, hyperkalemia 1. Spironolactone [Aldactone] 9.4 Potassium-sparing diuretic Improvement in edema of feet, legs, sacral area daily if medication is being used in HF Normal BP if being used for HTN Teach: avoid foods with high potassium content, drowsiness, ataxia, mental confusion may occur, notify prescriber of cramps, diarrhea, lethargy, thirst, headache, skin rash, menstrual abnormalities, deepening voice, or breast enlargement, take in AM to prevent sleeplessness, avoid hazardous activities until reaction is known, notify prescriber if pregnancy is planned or suspected, not to breastfeed Assess: hypokalemia, hyperkalemia, HF assessment daily, hydration Hyperkalemia: don’t use with other potassium-sparing diuretics, potassium supplements, and they should not be used routinely with ACE inhibitors, angiotensin II receptor blockers, or aldosterone antagonists, all of which promote significant hyperkalemia Chronic stable angina pectoris, hypertension, supraventricular dysrhythmias, migraine Nonselective beta-blocker with negative ionotropic, chronotropic, dromotropic properties Metabolized by liver; crosses placenta, blood-brain barrier; Excreted in breast milk; Protein binding 90% CYP2D6 Contraindications Drug & Class How does the nurse know it is working? Nursing Considerations: What is the nurse going to do/teach/assess? Adverse Effects NSG124 Pharmacology Drug Card Template Who takes this? How does it work? Pharmacokinetics/How is it given? prophylaxis, pheochromocytoma, cyanotic spells related to hypertrophic subaortic stenosis, essential tremor, acute MI, vascular headache prophylaxis enzyme system causes 7% of population to be poor metabolizers Hypersensitivity to this product; Cardiogenic shock, AV heart block; bronchospastic disease; Sinus Brady cardia; Bronchospasm; Asthma 1. Propranolol [Inderal/Inderal LA] 9.4 + 10.1 + 10.3 Antihypertensive, antianginal, antidysrhythmic (class II) Decreased blood pressure, dysrhythmias Teach: not to discontinue abruptly, to avoid OTC products unless approved by prescriber, avoid alcohol, avoid hazardous activities if dizzy, about importance of compliance with medical regimen, monitor blood glucose (may mask symptoms of hypoglycemia), make position changes slowly to prevent fainting, sensitivity to cold may occur, how to take pulse blood pressure Assess: blood pressure, pulse, respirations during beginning therapy, ECG continuously if using as dysrhythmic IV, hepatic enzymes, angina pain, tolerance with long term use, headache, lightheadedness, decreased blood pressure, fluid overload, I&O ratio, pregnancy/breastfeeding (only use if benefits outweigh fetal risk), cautious use in breastfeeding Heart failure, AV block, and sinus arrest. Hypotension can occur secondary to reduced cardiac output. In patients with asthma, blocking beta2 receptors in the lung can cause bronchospasm. Contraindications Drug & Class How does the nurse know it is working? Nursing Considerations: What is the nurse going to do/teach/assess? Adverse Effects NSG124 Pharmacology Drug Card Template Who takes this? How does it work? It is inhibiting reabsorption of sodium and Pharmacokinetics/How is it given? PO: Onset 1 hour, peak 1–2-hour, Fardowsa 1. Metoprolol [Toprol XL, Lopre NSG124 Pharmacology Drug Card Template Who takes this? How does it work? Pharmacokinetics/How is it given? Assess: Electrolytes Monitor product levels Apical pulse for 1 min before giving product; if pulse <60 in adult or <90 in infant, take again in one hour, call prescriber, note rate, rhythm, character, and monitor ECG. Monitor I&O, daily weight, and check for edema. Beers: avoid dosage >0.125mg/dL in atrial fibrillation, heart failure in older adults Pregnancy/breastfeeding: used if clearly needed; excrete small amount in breast milk, may breastfeed. Teach patient/family: Not to stop abruptly and to take exactly as prescribed, and how to monitor heart rate. Avoid OTC medication, herbal remedies because they can reverse the medication. Notify prescriber if loss of appetite, lower stomach pain, diarrhea, weakness, drowsiness, headaches, blurred or yellow vision, rash, depression toxicity. Maintain sodium restricted diet. Carry id stating condition treating. Cardiac dysrhythmias: most serious adverse effects of digoxin. They result from altering the electrical properties of the heart. Noncardiac adverse effects: Anorexia, nausea, and vomiting are the most common GI side effects. Digoxin rarely causes diarrhea. Fatigue is the most frequent CNS effect. Visual disturbances (e.g., blurred vision, yellow tinge to vision, appearance of halos around dark objects) are also relatively common. Shock, increased perfusion, hypotension, cardiogenic septic shock. Unlabeled uses: Bradycardia, cardiac arrest, CPR, acute renal failure, cirrhosis, barbiturate intoxication. Causes increased cardiac outputs. Causing vasoconstriction in blood vessels; low dose causes renal and, mesenteric vasodilation. IV: Onset 5 min; duration <10 min; metabolized in live, kidney, plasma; excreted in urine; half-life 2 min Contraindications Drug & Class How does the nurse know it is working? Nursing Considerations: What is the nurse going to do/teach/assess? Adverse Effects NSG124 Pharmacology Drug Card Template Who takes this? How does it work? Pharmacokinetics/How is it given? Contraindications Drug & Class How does the nurse know it is working? Hypersensitivity, ventricular fibrillation, tachydysrhythmias, pheochromocytoma, hypovolemia. 1. Dopamine (a sympathomimetic) 9.5 Function class: Androgenic Chem class: Catecholamine Therapeutic response: Increased B/P with stabilization; increased urine output. Assess: Hypovolemia, oxygenation/perfusion, heart failure, I&O ratio, ECG, B/P, pulse q5min, paresthesia and coldness of the extremities, pregnancy/breastfeeding. Teach patient/family: The reason for product administration, to report immediately when shortness of breath, numbness/tinging of extremities. To report immediately of pain, burning, and redness at IV site. CNS: Headache, anxiety CV: Palpitation, angina, wide QRS complex, peripheral vasoconstriction, hypotension. GI: Nausea, vomiting, diarrhea INTEG: Necrosis, tissue sloughing with extravasation RESP: Dyspnea Atrial fibrillation, PAT, ventricular tachycardia, atrial flutter, Wolff- Parkinson-White syndrome; PVST, malaria/IV quiNIDine gluconate Prolongs duration of action potential and effective refractory period, thus decreasing myocardial excitability; anticholinergic properties PO: (sulfate) peak 1-6 hr, duration 6-8 hr, (sulfate ER) peak 4 hr, duration 8-12 hr; (gluconate PO) peak 3-4 hr, duration 6-8 hr, half-life 6-7 hr (prolonged in geriatric patients, cirrhosis, HF), metabolized in liver, excreted unchanged (10%-50%) by kidneys, protein bound (80%-90%) Hypersensitivity, idiosyncratic response, digoxin toxicity, blood 1. Quinidine (Class IA) 10.1 • Therapeutic response: decreased dysrhythmias Nursing Considerations: What is the nurse going to do/teach/assess? Adverse Effects NSG124 Pharmacology Drug Card Template Who takes this? How does it work? Pharmacokinetics/How is it given? dyscrasias, myasthenia gravis, AV block quiNIDine gluconate (Rx) (kwin′i-deen) quiNIDine sulfate (Rx) Func. class.: Antidysrhythmic (Class IA) Chem. class.: QuiNINE dextroisomer • Monitor ECG, B/P, pulse continuously during IV, baseline, and periodically (PO) to determine increased PR or QRS segments, QT interval; discontinue product or reduce dose • Blood levels (therapeutic level 2-5 mcg/mL), CBC, LFTs • For cinchonism: tinnitus, headache, nausea, dizziness, fever, vertigo, tremors; may lead to hearing loss Black Box Warning: Cardiac toxicity: asystole, ventricular dysrhythmias, widening QRS, torsades de pointes • CNS effects: dizziness, confusion, psychosis, paresthesias, seizures; product should be discontinued • Hepatotoxicity: monitor LFTs for first 1-2 mo of treatment • Pregnancy/breastfeeding: use only if clearly needed; avoid use in breastfeeding, excreted in breast milk Teach patient/family: • That if dizziness, drowsiness occurs, to avoid driving or hazardous activities • To use sunglasses; product may cause sensitivity to light • To carry emergency ID stating disease, medication use • How to take pulse; when to notify prescriber • To avoid all products unless approved by prescriber • Not to crush, chew ext rel product • Not to use grapefruit juice with this product • QuiNIDine toxicity (cinchonism): to report immediately visual changes, nausea, headache, ringing in the ears • To report diarrhea, anorexia, decreased B/P CNS: Headache, dizziness, involuntary movement, confusion, psychosis, restlessness, irritability, syncope, excitement, depression, ataxia CV: Hypotension, bradycardia, PVCs, heart block, CV collapse, arrest, torsades de pointes, widening QRS complex, ventricular tachycardia EENT: Cinchonism: tinnitus, blurred vision, hearing loss, mydriasis, disturbed color vision GI: Nausea, vomiting, anorexia, abdominal pain, diarrhea, hepatotoxicity HEMA: Thrombocytopenia, hemolytic anemia, agranulocytosis, hypoprothrombinemia INTEG: Rash, urticaria, angioedema, swelling, photosensitivity, flushing with severe pruritus RESP: Dyspnea, respiratory depression Ventricular tachycardia, ventricular dysrhythmias during cardiac surgery, digoxin toxicity, cardiac catheterization Increases electrical stimulation threshold of ventricle, His-Purkinje system, which stabilizes cardiac membrane, decreases automaticity Half-life 8 min, 1-2 hr (terminal); metabolized in liver; excreted in urine; crosses placenta IM: Onset 5-15 min, duration 1½ hr IV: Onset 2 min, duration 20 min • NSG124 Pharmacology Drug Card Template Who takes this? How does it work? Pharmacokinetics/How is it given? Contraindications Drug & Class How does the nurse know it is working? RESP: Pulmonary fibrosis/toxicity, ARDS • Beers: Avoid as first-line therapy for atrial fibrillation in older adults unless heart fibrillation in older adults unless heart failure or substantial left ventricular hypertrophy is present Teach patients/family: • To take this product as directed; to avoid missed doses; not to use with grapefruit juice; not to discontinue abrubtly, not to use other drugs, herbs without prescriber approval, many interactions To use sunscreen or stay out of sun to prevent burns; that dark glasses may be needed for photophobia To report side effects immediately; more common at high dose and longer duration • That skin discoloration is usually reversible • To report vision changes, weight change, rash, blistering, numbness, temperature intolerance Pregnancy/breastfeeding: identify if pregnancy is planned or suspected or if breastfeeding; not to be used in pregnancy and breastfeeding PSVT, as a diagnostic aid to access myocardial perfusion defects in CAD, Wolff- Parkinson-White syndrome Slows conduction through AV node, can interrupt reentry pathways through AV nodes, and can restore normal sinus rhythm in patients with paroxysmal supraventricular tachycardia; decreases cardiac oxygen demand, decreasing hypoxia. Cleared from plasma in <30 sec, half-life 10 sec, converted to inosine/adenosine monophosphate. Given: IV Bolus Hypersensitivity, 2nd- or 3rd degree AV block, sick sinus syndrome, bradycardia 1. Adenosine [Adenocard] 10.1 Adenocard, Adenoscan Therapeutic response: normal sinus rhythm or diagnosis of perfusion defect Nursing Considerations: What is the nurse going to do/teach/assess? Adverse Effects NSG124 Pharmacology Drug Card Template Who takes this? How does it work? Pharmacokinetics/How is it given? Func. Class: Antidysrhythmic Chem. Class: Endogenous nucleoside Assess: • Cardiopulmonary status: B/P, pulse, respiration, rhythm, ECG intervals (PR, QRS, QT); check for transient dysrhythmias (PVCs, PACs sinus tachycardia, AV block) • Respiratory status: rate, rhythm, lung fields for crackles, watch for respiratory depression; bilateral crackles may occur in HF patients; increased respiration, increased pulse, product should be discontinued • Pregnancy/breastfeeding: identify if pregnancy is planned or suspected, or if breastfeeding; use only if benefits outweigh fetal risk; do not breastfeed • CNS effect: dizziness, confusion, psychosis, paresthesia, seizures; product should be discontinued Teach patient/family: • To report facial flushing, dizziness, sweating, palpitations, chest pain; usually transient; chest pressure may occur immediately after administration • To report IV discomfort • Pregnancy/breastfeeding: to advise prescriber if pregnancy is planned or suspected or if breastfeeding; do not breastfeed CNS: light-headedness, dizziness, arm tingling, numbness, headache; seizures, stroke (Adenoscan) CV: chest pain, pressure, atrial tachydysrhythmias, sweating, palpitations, hypotension, facial flushing, AV block, cardiac arrest, ventricular dysrhythmias, atrial fibrillation GI: nausea, metallic taste RESP: dyspnea, chest pressure, hyperventilation, bronchospasm (asthmatics) EENT: blurred vision MS: back pain Contraindications Drug & Class How does the nurse know it is working? Nursing Considerations: What is the nurse going to do/teach/assess? Adverse Effects NSG124 Pharmacology Drug Card Template Who takes this? How does it work? Pharmacokinetics/How is it given? Raul 1. Lovastatin [Mevacor]10.2 Bile-Acid Sequestrants Contraindications Drug & Class How does the nurse know it is working? Nursing Considerations: What is the nurse going to do/teach/assess? Adverse Effects NSG124 Pharmacology Drug Card Template Who takes this? How does it work? Pharmacokinetics/How is it given? are responsible for decreasing left ventricular end diastolic pressure, systemic vascular resistance. Hypersensitive Severe anemia Intracranial pressure 1. Nitroglycerin 10.3 Decreased prevention of anginal pain Assess: chest pain, BP Avoid alcohol. If headaches occur use non opioid analgesics take before stressful activity. Collapse Tachycardia Vomiting People who need rapid onset of anticoagulant effects Heparin suppresses coagulation by helping antithrombin inactivate clotting factors, IV only Not able to cross membrane, so will not Contraindications Drug & Class How does the nurse know it is working? Nursing Considerations: What is the nurse going to do/teach/assess? Adverse Effects NSG124 Pharmacology Drug Card Template Pulmonary Embolism, Deep Vein Thrombosis, open heart surgery. Preferred in pregnancy primarily thrombin and factor Xa. be able to be taken orally. Contraindicated for patients with thrombocytopenia and uncontrollable bleeding. In addition, heparin should be avoided both during and immediately after surgery of the eye, brain, or spinal cord. Lumbar puncture and regional anesthesia are additional contraindications. Heparin (unfractionated) 10.4 Hemorrhage, Heparin-induced thrombocytopenia (HIT), hypersensitivity, local injection irritation Who takes this? How does it work? Pharmacokinetics/How is it given? Contraindications Drug & Class How does the nurse know it is working? Nursing Considerations: What is the nurse going to do/teach/assess? Adverse Effects prevention of DVT following abdominal surgery, hip replacement surgery, or knee replacement surgery Treatment of established DVT, with or without PE Prevention of ischemic complications in patients with unstable angina, non–Q-wave MI, and ST-elevation MI (STEMI). LMW heparins preferentially inactivate factor Xa, being much less able to inactivate thrombin. SubQ Hypersensitivity to product, active major bleeding, thrombocytopenic purpura, heparin induced thrombocytopenia Enoxaparin (low-molecular-weight heparin) [Lovenox] Functional Class: Anticoagulant, antithrombotic Prevention of CVT/PE Antidote: Protamine Sulphate Monitor bleeding time, any abdominal pain, avoid other injections Bleeding, severe neurological injury, hemorrhage, Contraindications Drug & Class How does the nurse know it is working? Pt at risk for the following: • Ischemic stroke (to reduce the risk of death and nonfatal stroke) • TIAs (to reduce the risk of death and nonfatal stroke) • Chronic stable angina (to reduce the risk of MI and sudden death) • Unstable angina (to reduce the combined risk of death and nonfatal MI) • Coronary stenting (to prevent reocclusion) • Acute MI (to reduce the risk of vascular mortality) • Previous MI (to reduce the combined risk of death and nonfatal MI) • Primary prevention of MI (to prevent a first MI in men and in women age 65 and older) Irreversibly inhibits cyclooxygenase, and thereby blocks synthesis of TXA2. TXA2 is one of the factors that can promote platelet activation. In addition to activating platelets, TXA2 acts on vascular smooth muscle to promote vasoconstriction. Aspirin suppresses both TXA2-mediated vasoconstriction and platelet aggregation, thereby reducing the risk of arterial thrombosis. PO Effects persist 7–10 days after the last dose Metabolized by the liver; excreted by the kidneys; crosses placental barrier; excreted in breast milk Do not take in 1st trimester 1. Aspirin (cyclooxygenase [COX] Check clotting factors in blood test. Nursing Considerations: What is the nurse going to do/teach/assess? Adverse Effects NSG124 Pharmacology Drug Card Template Who takes this? How does it work? Pharmacokinetics/How is it given? Contraindications Drug & Class How does the nurse know it is working? Avoid alcohol Do not stop suddenly taking inhibitor) – 10.4 Assess pain, fever, check liver labs ( AST, ALT ), check renal labs (BUN, creatinine), check blood studies, can be liver toxic, ototoxicity, and possible allergic reactions. aspirin increases the risk of GI bleeding and hemorrhagic stroke The drug is taken to prevent stenosis of coronary stents and for secondary prevention of MI, ischemic stroke, and other vascular events. Clopidogrel [Plavix] is an oral antiplatelet drug with effects much like those of aspirin. Clopidogrel blocks P2Y12 ADP receptors on platelets and thereby prevents ADP- stimulated platelet aggregation. Clopidogrel is rapidly absorbed from the GI tract, both in the presence and absence of food. Metabolized by the liver; excreted by the kidneys; crosses placental barrier; excreted in breast milk Hypersensitivity and bleeding, pregnancy Do not suddenly stop taking 1. Clopidogrel (P2Y12 ADP receptor antagonist) [Plavix] 10.4 Check clotting factors in blood test. Nursing Considerations: What is the nurse going to do/teach/assess? Adverse Effects NSG124 Pharmacology Drug Card Template Who takes this? How does it work? Pharmacokinetics/How is it given? Contraindications Drug & Class How does the nurse know it is working? Blood work is necessary during treatment. Report any unusual bleeding. Take without regard to food. Report rashes, pruritus, hypersensitivity. Notify if you become pregnant. The most common complaints are abdominal pain, dyspepsia, diarrhea, and rash. Like all other antiplatelet drugs, clopidogrel poses a risk of serious bleeding Therapeutic Uses: Alteplase has three major indications: (1) acute MI, (2) acute ischemic stroke, and (3) acute massive PE. In all three settings, timely intervention is essential: The sooner alteplase is administered, the better the outcome. Works by: The drug first binds with plasminogen to form an active complex. The alteplase- plasminogen complex then catalyzes the conversion of other plasminogen molecules into plasmin, an enzyme that digests the fibrin meshwork of clots. In addition to digesting fibrin, plasmin degrades fibrinogen and other clotting factors. These actions don't contribute to lysis of thrombi, but they do increase the risk IM standard infusion adult > than 65, 100 milligrams total given over 3 hours as follows 60 milligram given over first hour adult < 65 1.25 milligrams per kilogram over a 3 hour Cleared by the liver, 80% cleared within 10 minutes of product termination, on set immediate, half-life 35 minute, peak one hour Nursing Considerations: What is the nurse going to do/teach/assess? Adverse Effects NSG124 Pharmacology Drug Card Template Who takes this? How does it work? Pharmacokinetics/How is it given? Contraindications Drug & Class How does the nurse know it is working? Ferrous sulfate: GI Disturbances such as : Nausea, constipation, epigastric pain, black and red tarry stools, vomiting, diarrhea People who have pernicious anemia deficiancy, vit B12 malabsorption syndrome, Schilling test, increased requirements with pregnancy, thyrotoxicosis, hemolytic anemia, hemorrhage, renal/hepatic disease, nutritional supplementation Following ingestion, vitamin B12 forms a complex with intrinsic factor. Upon reaching the ileum, the B12–intrinsic factor complex interacts with specific receptors on the intestinal wall, causing the complex to be absorbed. In the absence of intrinsic factor, absorption of vitamin B12 is greatly reduced. However, about 1% of the amount present can still be absorbed by passive diffusion; no intrinsic factor is needed. PO route With fruit juice to disguise taste; immediately after mixing With meals if possible for better absorption; large doses should not be used because most is excreted • Protect from light, heat IM route • By IM inj for pernicious anemia for life unless contraindicated Intranasal route • Avoid use within 1 hr of hot fluids, food, no priming needed IV route • IV route not recommended but may be admixed in TPN solution Hypersensitivity to this product, cobalt, benzyl alcohol, optic nerve atrophy Precautions: Pregnancy, breastfeeding, children, 1. Vitamin B12 – Cyanocobalamin 10.6 Needed for adequate nerve functioning, protein and carbohydrate metabolism, normal growth, RBC development, cell reproduction Nursing Considerations: What is the nurse going to do/teach/assess? Adverse Effects NSG124 Pharmacology Drug Card Template Who takes this? How does it work? Pharmacokinetics/How is it given? Contraindications Drug & Class How does the nurse know it is working? renal/hepatic disease, folic acid/iron deficiency anemia, infection Check for demyelination of neurons, primarily in the spinal cord and brain. Assess for disrupting the production of erythrocytes, lack of B12 also prevents the bone marrow from making leukocytes (white blood cells) and thrombocytes (platelets). Many of the consequences of B12 deficiency result from disruption of DNA synthesis so the nurse will check DNA synthesis Cyanocobalamin is generally devoid of serious adverse effects. One potential response, hypokalemia, may occur as a natural consequence of increased erythrocyte production. Erythrocytes incorporate significant amounts of potassium. Therefore, as large numbers of new erythrocytes are produced, levels of free potassium may fall Megaloblastic or macrocytic anemia caused by folic acid deficiency; hepatic disease, alcoholism, hemolysis, intestinal obstruction, pregnancy to reduce risk for neural tube defects Unlabeled uses: Methotrexate toxicity prophylaxis, in those receiving methotrexate for RA treat folic acid deficiency and certain types of anemia (lack of red blood cells) caused by folic acid deficiency. It help the body to produce and maintain new cells and also prevent changing to DNS that may leads to cancer RDA • Adult and child ≥14 yr: PO 400 mcg • Adult (pregnant/lactating): PO 600 mcg/da Child 9-13 yr: PO 300 mcg • Child 4-8 yr: PO 200 mcg • Child 1-3 yr: PO 150 mcg • Infant 6 mo-1 yr: PO 80 mcg • Neonate/infant <6 mo: PO 65 mcg Megaloblastic/macrocytic anemia due to folic acid or nutritional deficiency • Pregnant/lactating: PO 800-1000 mcg Therapeutic dose • Adult and child: PO/IM/SUBCUT/IV up to 1 mg/day Nursing Considerations: What is the nurse going to do/teach/assess? Adverse Effects NSG124 Pharmacology Drug Card Template Who takes this? How does it work? Pharmacokinetics/How is it given? Hypersensitivity Precautions: Pregnancy, anemias other than megaloblastic/macrocytic anemia, vit B12 deficiency anemia, uncorrected 1. Folic acid 10.6 Needed for erythropoiesis; increases RBC, WBC, platelet formation with megaloblastic anemias Check patients' diet :-(1) poor diet (especially in patients with alcohol use disorder), and (2) malabsorption secondary to intestinal disease. Rarely, certain drugs may cause folate deficiency. Asse intestinal absorption if it is block by sprue. Sprue is an intestinal malabsorption syndrome that decreases folic acid uptake Alcohol use disorder, either acute or chronic, may be the most common cause of folate deficiency. Deficiency results for two reasons: (1) insufficient folic acid in the diet and (2) derangement of enterohepatic recirculation secondary to alcohol-induced injury to the liver. Fortunately, with improved diet and reduced alcohol consumption, alcohol- related folate deficiency will often reverse. -check for megaloblastic anemia Oral folic acid is nontoxic when used short term. Massive dosages (e.g., as much as 15 mg) have been taken with no ill effects.