Pharmacology Easy Notes

Digoxin (Lanoxin)

– Antidysrhythmic
– Inotropic (Increases contractility)

D- dig level 2ng/ml or greater is toxic
I- inhibits sodium potassium ATPase
G-GI or CNS signs indicate adverse effects (N/A for adult toxicity, stomach upset in older child
O-output, intake, and weight should be monitored
X- dont give if pulse is less than 60 bpm
I- indicated for CHF- a-fib
N- note K+, ECG, and renal function tests

Epinephrine

– Increased CO and HR
– Decrease renal perfusion and PVR

N- nervousness (undesirable effect)
A- angina, arrhythmia (undesirable)
S- sugar is increased
C- cardiac arrest
A- allergic reaction
R-respiratory bronchodilator

Norepinephrine (Levophed)

– Increase CO and HR
– Decrease renal perfusion and PVR

S- stim alpha and beta adrenergic receptors
H- hypovolemia- should be corrected before using drug
O- output of urine should increase
C- constriction of blood vessels
K- keep monitoring vital signs every 5-15 min

Nitroglycerin

– Lowers BP
– Increase HR

A- avoid alcohol
N- note BP and apical pulse before admin
G- given to relax the vascular smooth system
I- indicated for angina pectoris
N-note for postural hypotension; rise slowly
A- advice client to seek medical assistance if pain is unrelieved after 3 doses with 5 min interval

ACE Inhibitors (pril)
– Benazepril (Lotensin)
– Captopril (Capoten)
– Enalaprilat (Vasotec)
– Lisinopril (Zestril)
S- suppresses renin angiotensin aldosterone system
W- warn client with renal or thyroid diseases
E- ends with pril- captopril (capoten) enalapril (vasotec)
R- rise slowly to reduce orthostatic hypotension
T- treatment of HTN, HF
E- evaluate BP

ACE Inhibitor SE
C ough
A naphylaxis
P alpitations
T aste
O rthostatic hypotension
P otassium elevated
R enal impairment
I mpotence
L eukocytosis

Beta Blockers (lol)

– Atenolol (Tenormin)
– Labetalol (Trandate)
– Carvedilol (Coreg)

B- bradycardia
B- blood pressure too low
B- bronchial constriction
B- blood sugar is masked when low

Calcium Channel Blocker (Increase myocardial o2 delivery for angina pt)
– Amlodipine (norvasc)
– Diltiazem (Cardizem)
– Nifedipine (Procardia)
B- blocks calcium access to cells
I- indicated for HTN
L- let client take drug with milk or meal
L- light and moisture- protect

Diuretics

– Loop (Furosemide/Lasix)
– Osmotic (Mannitol/Osmitrol)
– K+ Sparing (Aldactone/spironolactone)

D- diet; increase K+ for all except aldactone (Spironolactone)
I- intake, output, daily weight monitoring
U- undesirable effects- F&E imbalance
R- review HR, BP, and electrolytes
E- elderly careful, evening dose not recommended
T- take with or after meals and in AM
I- incrase risk of orthostatic hypotension, move slowly
C- cancel alcohol and cigs

warfarin (coumadin)
monitor?
antidote?
what food should be avoided?
– prothrombin time is monitored 1.5-2.5 X control is the therapeutic range
– Vit K is the antidote
– Green leafy veg should be avoided

Warfarin (coumadin)
C- check vital signs, platelte count, and PT
O- observe bleeding
R- review bleeding protocol
A- avoid ASA, may use acetaminophen

Heparin Sodium
– Anticoagulant
– Indicated for DVT/PE`
– PTT must be monitored 1.5-2.5 X control
– Antidote is protamine sulfate
– hospitalization is required for IV heparin

Clopidogrel (Plavix)
– Antiplatelet
– MI, stroke, CAD
B- bleeding, brochospasms- undesired effects
L- lowers risk of atherosclerotic events
E- evaluate bruising
E- evaluate liver function
D- do take with food or after meals

Lipid lowering agents / HMG CoA inhibitors

– Atorvastatin (lipitor)
– Lovastatin (Mevacor)
– Simvastatin (Zocor)

– Competitive inhibitors of HMG-COA reductase, an enzyme necessary for cholesterol biosynthesis
indicated for hypercholesterolemia
atorvastatin (lipitor), simvastatin (zocor)

lipid lowering agents/ HMG CoA inhibitors pneumonic
S- statin is the ending
T- take with food and at bedtime
A- always consume 2-3 L of fluid daily
T- teach client to do exercise and weight reduction as well
T- treat hypercholesterolemia
I- increase fiber in diet
N- never give if with liver disease

Antibiotics Pneumonic

– Metronidazole/Flagyl
– Trimethoprim/Primsol
– Penicillin/Amoxicillin/ Augmentin

M- monitor superinfections
E- evaluate renal/liver function
D- diarrhea- take yogurt
I- inform provider prior to taking other meds
C- cultures prior to initial dose
A- alcohol is out, ask about allergy
T- take full course
E- evaluate cultures, WBC, temp, blood

Aminoglycosides (-mycin)
– Amikacin, Gentamicin
– Serious infections caused by gram- negative infections
– AE: htn,HA, N,V,Tremor, Weakness,
– Ototoxicity, Nephrotoxicity

Allopurinol (Zyloprim)

– Antigout agents

G- gulp 10-12 glasses of fluid daily, GI distress (undesirable effect)
O- output and input monitor closely
U- uric acid production decreased, use no alcohol
T- take after meals

Phenytoin (Dilantin)
– Antidysrhythmic
– Anticonvulsant
– Can cause ataxia (lack of muscle control) and Nystagmus (Involuntary eye movement)
G- gingival hyperplasia
U- use alternate birth control
M- mouth care; preventative dental check up
S- soft toothbrush; don’t stop abruptly

Lithium (eskalith) pneumonic (Lithi)
L- level therapeutic 0.6-1.2 meq/l
I-increased urination
T- thirst increased
H- headache and tremor
I- increase fluids

Lidocaine Pneumonic

– Used for ventricular arrhythmias also

L- local anasthetic
I- ICU popular antiarrythmic
D- digitalis toxicity used
O- orally inactive
C- cinetidine+ propanolol
A- decrease Automacity
I- inactivated Na Channel blocker
N- nystagmus
E- eye blurred vision, ECG change

You have 1 heart and 2 lungs
Beta-1 are therefore primarily in the heart.
Beta-2 primarily in the lungs.

Antiepileptic SE (ABCDEFGH)

– Tx for seizures
– Carbamazepine (Tegretol)
– Phenytoin (Dilantin)
– Clonazepam (Klonipin)
– Phenobarbital

A taxia
B lood dyscrasia
C left lip
D upuytrens / Vit D deficiency
E xfoliation of skin & Stevens Johnson’s
F its
G I upset/gum hypertrophy
H epatitis/hairy

Barbituates (ABCD)

– Produce sedation
– Pentobarbital (nembutal)
– Secobarbital (seconal)

A taxia
B ehavioral disturbance
C oncentration decreased/coma
D epression/drowsy/diplopia

Corticosteroid SE

– Betamethasone (Celestone)
– Hydrocortisone (cortef)
– Dexmethasone (decadron)

C-cushings syndrome
O-osteoporosis
R-retardation of growth
T-thin skin n easy brusibility
I-infections n immunosupression
C-cataract n glaucoma
O-odema
S-supression of HPA axis
T-thining n ulceration of gastric mucosa
E-Emotional disturbance
R-rise in BP
I-Increase in hair growth(hirsuitism)
O-otherz like fetal abnormalties n hypokalemia
D-diabetes mellitus precipitation
S-stria

3 D’s for heart failure
– Digoxin
– Diuretics
– Dilators

Respiratory depression inducing drugs (STOP)
– Sedatives and hypnotics
– Trimethoprim
– Opiates
– Polymyxins

TB Treatment (PRIEST)

– s/s Cough/wt loss, F, Night sweat
– Manage: Isolate and medicate

Pyrazinamide
Rifampin
Isoniazid (INH)
Ethambutol
STreptomycin

ARO drugs to Tx respiratory infection
1. Amantadine- Antiviral, Parkinson Tx, Contraindicated in narrow angle glaucoma/breastfeeding

2. Rimantadine (Flumadine) – Antiviral; D/C if seizures occur

3. Oseltamivir (Tamiflu)- Caution w/ CV/Renal disease

Atropine (Anticholinergic)

– What happens w/ OD
– How do you Tx

1. Increased temp, Confusion/delirium, Flushed, Dry/thirsty
2. Physotigmine

What occurs in a cholinergic crisis (SLUD)
– Salivation
– Lacrimation
– Urination
– Defacation

Anticholinergic effects
– Dry mouth
– Blurry vision
– Constipation
– Orthostatic htn
– Urinary hesitancy/retention

Drugs for bradycardia and decreased BP aka shock (IDEA)
” Shocking idea”
– Isoproternol (isuprel)
– Dopamine (intropin)
– Epinephrine
– Atropine

Potassium
Potassium sparing diuretics- Monitor K+
Output- Monitor closely
Take with food
Ace inhibitors Monitor K+
Signs of digitalis toxicity if K+ low
Serum level 3.5-5.0
IV site monitor for infiltration
Undesireable effects: N/V/CV dysrhythmia
Medical follow up

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