Pharmacology Final Exam and NCLEX Suggestions, Study Guides, Projects, Research of Pharmacology

Download Pharmacology Final Exam and NCLEX Suggestions and more Study Guides, Projects, Research Pharmacology in PDF only on Docsity! Pharmacology Final Exam and NCLEX Suggestions 1. Cardiac Glycosides a. Digoxin (Lanoxin)- Used for HF. .125 dose i. Monitor pulse- Have patient demonstrate correct way to read pulse, verbally repeat what we taught, answer questions correctly about process. ii. Levels: 0.8 – 2.0 ng/ mL b. Coumadin (Warfarin) (Blood thinner) – Cardiac Glycoside i. INR 1. 2-3 if on warfarin 2. 0.8-1.2 normal person not on warfarin. 3. Would be very high if bleeding internally. ii. Antibiotics iii. Consistent amount of Vitamin K 2. ACE Inhibitors (Lisinopril) (Benazepril) a. Dilate venules and arterioles, improving renal blood flow and decreasing blood fluid volume. b. Blood pressure meds (anti-hypertensive). c. Monitor for dry cough d. Given for HTN e. Monitor BP. 3. BiDil a. FDA approval for treating HF, especially in African Americans. 4. AntiHypertensives / Diuretics a. Hydrochlorathiazide (HCTZ)- BP medicine. Potassium wasting drug not potassium sparing. i. Monitor BP. ii. Peripheral edema. iii. Orthostatic Hypotension. iv. Dizziness, confusion. v. Monitor potassium labs. 1. 3.5-5 ** Patient will also be on potassium. Monitor hypokalemia. If low, give hold med, OJ and call the doctor. vi. Hypokalemia 1. Weakness, fatigue, arrhythmias, polyuria, polydipsia. b. Diuretics (Lasix or Furosemide) – Diuretics produce increased urine output by inhibiting sodium and water reabsorption from the kidney tubules. i. Give AM, daily weight. (report weight changes above 2 pounds) ii. Loop diuretic iii. Potassium wasting drug (3.5-5) c. Aldactone (Spironolactone) (Potassium Sparing Diuretic) i. Also used to treat HF. ii. No salt substitutes. 1. Hyponatremia iii. Hyperkalemia 1. Fatigue, muscle weakness, paresthesia, confusion, dyspnea, cardiac arrhythmias. 2. Hold Potassium supplements if potassium is above 5. 5. Calcium Channel Blockers (Amlodipine) (Nifedipine) a. Don’t take with grapefruit. b. Don’t take with antacids. c. Monitor BP, monitor for edema, jugular vein distention. d. Dilators. 6. Beta Blockers (Atenolol, Propanolol) a. Masks hypoglycemia. b. Can make wheezing worse. c. Monitor vitals (pulse and blood pressure). Hold if pulse under 60. d. First choice of drug category in anti-hypertensives. 7. Nitroglycerin spray and tablets a. What would you educate the client on? i. Change positions slowly. 1. First dose should be taken while in a sitting or reclining position, especially in geriatric patients. 2. Expect a headache ii. Notify HCP if dry mouth or blurred vision occurs. iii. Tablets 1. Keep tablets in original container. Exposure to air, heat, and moisture can cause loss of potency. iv. Lingual Spray 1. Instruct patient to lift tongue and spray dose under tongue (Nitrolingual, NitroMist) or on tongue (NitroMist). 2. 8. Cholesterol Drugs (Lipitor) a. Side Effects i. Rhabdomyolysis- a breakdown of muscle tissue that releases a damaging protein into the blood. ii. Rashes iii. Abdominal cramps, constipation, heartburn. iv. Contact doctor if muscle weakness and have liver enzymes checked. b. Liver enzymes c. Monitor CK (Creatine Kinase) levels if patient develops muscle tenderness during therapy. d. Notify HCP if unexplained muscle pain, tenderness, or weakness occurs, especially if accompanied by fever or malaise. 9. Viagra a. Contraindications i. Nitrates b. Education i. Only take once per day. 10. Cardiac Dysrhythmias a. Lidocaine—ventricular ectopy i. Know how to use. iii. Albuterol iv. Bronchodilator then mucolytics so can be coughed out. v. Sympathomimetics 1. Epinephrine (Adrenalin) a. Side Effects- Palpitations, dizziness, nervousness, tremors, tachycardia, dysrhythmias, hypertension. vi. Anticholinergics 1. Ipratropium (Atrovent)- used to treat asthma. a. *Urinary retention. b. Bitter aftertaste (Can use mints/gum after). c. Caution- Narrow-angle glaucoma. 2. When using the anticholinergic agent in conjunction with an inhaled glucocorticoid (steroid) or cromolyn, the ipratropium bromide should be used five minutes before the steroid or cromolyn. vii. Methylzanthine (xanthine) derivatives 1. *Theo 24 (Theophylline) –Stimulant. Bronchodilator. a. Long-term control of reversible airway obstruction caused by asthma or COPD. b. Side Effects i. Seizures ii. Anxiety iii. Arrhythmias iv. *Tachycardia v. Nausea vi. Vomiting c. Leukotrine Modifier Blockers i. Long term acting drugs for asthma. ii. Give short term first (albuterol), then long acting (Leukotrine), then the steroid (Advair). iii. Montelukast (Singulair) 1. Use: Prophylactic and maintenance for chronic asthma (prevent asthma attacks). (can take at bedtime) d. Glucocorticoids (Steroids) i. Can contribute to heart failure because of the side effect of fluid retention. ii. Rinse mouth and inhaler pieces after administration (THRUSH) and rinse the mouth! iii. Can stunt growth in children and suppress the immune system. iv. Steroids (suppresses immune system—thrush) Effects on lungs and heart. 1. Lungs a. Crackling b. Edema in lungs. 2. Heart a. Tachycardia b. Blood clot ulcerations. c. Edema (peripheral) v. Advair for respiratory- asthma. 1. Thrush 2. Short acting. 3. Wash neb pieces. 20. Non-steroid Neb treatments (Albuterol, Levalbuterol)---bronchodilators. a. Short term. b. Increased energy (jittery) c. Albuterol-Rescue inhaler. d. Increased vitals. e. Tremors f. Constipation g. Urinary Retention. 21. Antiulcer Drugs a. Avoid carbonated beverages b. Antacids i. Take before meals. ii. Calcium Carbonate (Tums) 1. Safest for renal patients. 2. If used in combination with other calcium supplements, can cause kidney stones. c. Histamine 2 Blockers (Pepcid) (Zantac) i. Tagamet and Zantac---Don’t take with antacids. ii. Reduce gastric acid by blocking H2 receptors of parietal cells in stomach. iii. Take care, can accentuate or inactivate the effects of other meds d. Proton pump inhibitors i. Omeprazole (Prilosec). e. Pepsin Inhibitors (mucosal protective drugs). i. Forms thick paste covering ulcer and protects from acid and pepsin. ii. Give 20 minutes before meals and bedtime. f. Pantoprozole, a proton pump inhibitor, taken on an empty stomach before eating. g. Carafate, take before meals. Coats the stomach Digoxin: client education HCTZ: low potassium recommendations. ACE inhibitor Zestril (how does it work?), cough Calcium Channel Blockers (contraindications in food/beverages), what is it for? And how does it work? Nitrolgycerin Self Care practices: medication administration Metoprolol when do you hold the medication? Minipress teaching What is the antidote to Heparin overdose? Protamine sulfate Coumadin—what might need to be done if the client is on antibiotics? if INR is high and black tarry stool Hold the med and call the doctor Salt substitute and Aldactone Atropine what do you watch for? After administering it. Watch monitor, NPO until passes gas, obtain order for PRN catheterization. Calcium channel blockers prevent chest pain by dilating coronary arteries. Lipitor—causes weakness, muscle pain and tenderness Milk of magnesia- No for people with dementia and renal failure. Magnesium toxic in renal failure.