medication
Pharmacologic intervention across the lifespan (essential 1, program outcome 1).
Apply principles of quality, patient safety, and health education to the provision of pharmacologic interventions
for patients and families across the lifespan
Apply knowledge of healthcare technology to aid in obtaining and utilizing current information on medication
and safe medication administration
iscuss the nurse’s role in legal, ethical, and economic issues related to the development, preparation,
prescription, and administration of medications in the United States
Utilize principles of effective professional communication with all members of the health care team regarding
pharmacologic interventions
Discuss the impact of lifespan, cultural, and genetic variations on drug therapy as well as possible interactions
of drugs with other drugs, nutrients, and/or environmental factors
evidence-based practice to the provision of pharmacologic interventions
ondansetron - zofran
used to prevent nausea and vomiting
stops serotonin from triggering vomiting center in brain
prevents nausea and vomiting caused by cancer chemotherapy, radiation therapy, and surgery
ceftriaxone
antibiotic given by injection to treat serious bacterial infections
Bacterial infections: Treats infections in the lungs, ears, skin, urinary tract, blood, bones, joints, and abdomen
Cures gonorrhea, pelvic inflammatory disease, and meningitis
Helps stop infections before or after medical operations
Antibiotics and antivirals
Antihyperlipidemics
Antihypertensives
Antiglycemics
Antiarthritics
Antiparkinson agents
Analgesics
Antidepressants
Anxiolytics
Antipsychotics
Diuretics
Diclofenac
Fluconazole
Acyclovir
Amoxicillin
bulk forming agents
Polycarbophil - bulk forming agent
methylcellulose - bulk forming laxative
not recommended in patients whose large fluid intake is contraindicative
bulk forming agents in powder form could cause constipation if in less than 240mL, needs to be swallowed quickly
X
casanthronol - stimulant cathartic
bisacodyl - stimulant cathartic
docusate potassium - emollient
doxuste sodium - stool softener
sodium phosphate - laxative
magnesium hydroxide - osmotic agent
emollient laxatives
lowering the surface tension of the feces
stool softeners that are detergents
allowing water and fat to penetrate
saline based laxatives
have an osmotic effect
increase pressure in the bowel
acts as a stimulant for peristalsis
stimulant cathartics
cause local irritation to the intestinal mucosa
increase intestinal motility
inhibits reabsorption of water into large intestine
increase diarrhea
may cause fluid and electrolyte imbalances
opioid analgesics
cause constipation
slow peristalsis
slow contractions
antibiotics
decrease intestinal bacterial microflora
cause diarrhea
enema
tap water enema
caution if they need to be repeated because wter toxicity or circulatory overload develops if the body absorbs large amounts of water
hypertonic solution enema
contracindication for patients with dehydration
normal saline enema
associated with a decrease risk of excess fluid absorption
medications that should never be crushed
only split meds with a manufacturer split line
know the right route
syringes
if the specified route is not the recommended one
if you can get the same med switched from oral to suppository
administer a drug accordingly to the instructions around meal time
if drugs can be given together
Q8H - around the clock
TID - given during waking hours
can be given around activities
timely
thorough
accurate
medication error
administering an antidote
withholding the next dose
insulin
times of onset
peak effects
duration of action
rapid acting
onset 15-30 minutes
peak 1-3 hr
duration 3-6.5 hr
lispro
aspart
glulisine
short acting
regular
onset 30min-1hr
peak 1-5 hr
duration 6-10 hr
intermediate acting
onset 1-2hr
peak 6-14hr
duration 16-24hr
isophane insulin suspension
long lasting
onset 0.8-2 hr
peakless - nonpeaking
duration 24hr
detemir
levemir
different types of insulin are not interchangeable
know how much to draw up based on blood glucose
injection site
subcutaneous
upper arm
anterior or lateral aspect of thigh
buttocks
belly, but avoid 2 inch radius around umbilicus
expected absorption rate
belly,> arms,> thigh,>buttocks
draw up insulin from vial
place a label around syringe
dial up the number of units
look for date
not expired
refridgerated
let it come to room temperature
Terazosin
Verapamil
Finasteride
Dutasteride
Furosemide
modafinil
armodafinil
methylphenidate
sodium oxybate
L-tryptophan
Hypnotics
• Interfere with reaching deeper sleep stages
• Provide only temporary (1-week) increase in quantity of sleep
• Eventually cause “hangover” during day; excess drowsiness, confusion, decreased energy
• Sometimes worsen sleep apnea in older adults
Antidepressants and stimulants
• Suppress REM sleep
• Decrease total sleep time
Alcohol
• Speeds onset of sleep
• Reduces REM sleep
• Awakens person during night and causes difficulty returning to sleep
Caffeine
• Prevents person from falling asleep
• Causes person to awaken during night
• Interferes with REM sleep
Diuretics
• Nighttime awakenings caused by nocturia
Beta-adrenergic blockers
• Cause nightmares
• Cause insomnia
• Cause awakening from sleep
Benzodiazepines
• Alter REM sleep
• Increase sleep time
• Increase daytime sleepiness
Nicotine
• Decreases total sleep time
• Decreases REM sleep time
• Causes awakening from sleep
• Causes difficulty staying asleep
Opiates
• Suppress REM sleep
• Cause increased daytime drowsiness
Anticonvulsants
• Decrease REM sleep time
• Cause daytime drowsiness
Benzodiazepines
benzodiazepine-like drugs
zolpidem
oxazepam,
lorazepam
temazepam
concepts | Exemplars | ||||
sexuality | ED Meds HRT BPH meds | ||||
Immunity | HIV Meds Antihistamines | ||||
Health/ Illness/ Wellness | Adherence Medication Management | ||||
Safety | Safe Drug Administration | ||||
Cellular Regulation | Chemo Blood Cell Builders | ||||
Communication | Drug Teaching | ||||
Advocacy | patient Advocacy | ||||
Elimination | Drugs for GI/GU problems | ||||
Gas Exchange | Bronchodilators Inhaled Drugs | ||||
Perfusion | Cardaic Meds HTN Meds Anticoagulants Nitrates Antilipemics | ||||
Infection | Antimicrobials | ||||
metabolism | Insulin Oral hypoglycemic Thyroid Replacement | ||||
Fluid and Electrolytes | Diuretics Electrolyte Replacement | ||||
Comfort | Analgesics Sleep Aids | ||||
Intracranial regulation | Drugs fro seizure | ||||
Inflammation | NSAIDS Steroids | ||||
Cognition | Alzheimer's Meds Parkinson's Meds Antipsychotics/depression | Antipsychotics and antidepressants are similar because they both treat mood and psychiatric disorders, overlap in treating conditions like major depressive disorder and anxiety, and share certain side effects like drowsiness, weight gain, and sexual dysfunction | Combination Therapy: Doctors frequently use atypical antipsychotics as an add-on or "augmentation" treatment alongside antidepressants for treatment-resistant depression or depression with psychotic features. The FDA has even approved specific combination pills containing both types of medication. [1, 2, 3] | Sleep and Mood Support: Both classes alter sleep-wake functions by interacting with neurotransmitter receptors in the brain to help manage agitation, mood shifts, or insomnia. |
Reducing preload
Diuretics
Vasodilators
Reducing afterload
Ace inhibitors
ARBs
Reducing rate and force of contraction
Beta blockers
Cardia Glycoside- Digoxin
(Lanoxin)
– Positive Inotropic effect
– IV/IM, PO
– MOA:
– Slows rate of ventricular contraction
– Increased force of contraction
– Use
– Heart failure
– Chronic a. fib
– Adverse effects:
– Bradycardia, N/V, anorexia, Bl vision
– Toxicity > narrow therapeutic index
– Dysrhythmias (atrial and ventricular)
– N/V, loss of appetite
– Visual changes (yellow-green halos, color perception)
– High Risk situations:
– Hypokalemia, hypomagnesemia, hypocalcemia
– Renal impairment
– Narrow therapeutic range
– 0.8-2 ng/mL – ideal 0.5-0.8 ng/mL
– What increases risk?
– Hypokalemia
– Rapid loading doses
– Advanced age
– Hypoxia
– Hypothyroidism
– How is it treated?
– Hold the med
– Potassium if potassium low
– Antidysrhythmics if needed
– Atropine for bradycardia
– Digoxin immune fab (digibind)
– Interactions:
– Furosemide and other things that decrease potassium
– Adrenergic agonists
– Nursing care:
– What do we need to monitor before and after administration? (Box 30.5)
– Drawing Levels
– IVP slow over 5 minutes
– Monitor for symptoms of toxicity
– CI: 2/3 heart block, Vent. Dysrhythmias; caution acute MI, 1HB, electrolyte imbalances
– Patient teaching:
– Same time every day
– How to take a pulse
– Take with food
– Maintain adequate potassium intake
– Signs of toxicity
what types of warning signs is a nurse supposed to notice associated with beta signals and ace signals among all these other things associated with the heart, and what has to occur for the doctor to recommend one of these medications that affects the heart
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