Pharmacology Competencies Medical Surgical Nursing

8/13/2019 Pharmacology Competencies Medical Surgical Nursing

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Classification Drug/Trade Drug/Generic Basic action Pre-administration Assessments

Related Decision

Making (notify or hold) Patient Teaching Common Adverse Effects Antidote

Angiotensin II receptor

blockers (ARB's)

Cozaar Losartan Dilation of arterioles

and veins.

Baseline BP. High risk patients: renal artery stenosis,

history of hypersensitivity to ARB's.

if SBp


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Related Decision


Antidote for Opioids Naloxone Narcan Blocks the effects of

opioids (CNS and

respiratory depression)

Monitor respiratory rate, rhythm, depth, pulse, ECG,

Bp, LOC

Only give for suspected

opioid overdose/toxicity

n/a n/a

Antiemetics Phenergan Promethazine Blocks the effect of the

chemoreceptor trigger

zone in the medulla,

resulting in antiemetic

properties.

Monitor Bp, P, R. Access for level of nausea/vomiting. Tachycardia, delirium,

dizziness, blurred vision,

dysphagia, no

nausea/vomiting, HOLD

and call

Change positions

slowly, rinse mouth

frequently, keep good

oral hygiene.

Confusion, disorientation, sedation.

Antiemetics Zofran Ondansetron Reduces the activity of

the vagus nerve, which

deactivates the

vomiting

HR, rhythm If you have PKU, history

of long QT syndrome,

liver disease, electrolyte

imbalance, irregular

heart beat HOLD and

call

Take with a full glass of

water. Do not miss

follow up appointments

with doctor. Take

exactly as prescribed.

Regular checkup should

include ECG. Do not

double up on a

missed/skipped dose.

Diarrhea, headache, constipation,

weakness, tiredness, dizziness.

Antihypertensive ACE

inhibitors

Zestril Lisinopril Hypertension - blocks

the conversion of

angiotensin 1 to the

vasoconstrictor

angiotensin II, increases

the plasma renin levels

and reduces

aldosterone levels,

resulting in systemic

vasodilation, lowers the

blood pressure.

Bp, P, weight, lungs for rales/crackles, dyspnea (SOB),

peripheral edema, jugular venous distention.

SBp


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Related Decision


Antiulcer, proton pump

inhibitors

Protonix Pantoprazole Binds to an enzyme in

the presence of acidic

gastric pH, preventing

final transport of H+

ions into the gastric

lumen.

Assess patient routinely for epigastric or abdominal

pain, occult blood in stool, emesis, or gastric aspirate

Take as directed, even if

feeling better. Avoid

alcohol, aspirin or

NSAID's, foods that

cause GI irritation.

Report onset of black,

tarry stools; diarrhea;

or abdominal pain to

physician promptly. Do

not break, chew or

crush tablets.

Headache, insomnia, diarrhea,

abdominal pain, flatulence,

pancreatitits, rash, hyperglycemia,

weight loss/gain, hyponatremia,

hypomagnesemia, myalgia,

pneumonia, Stevens-Johnson

syndrome, toxic epidermal

necrolysis, anaphylaxis, angioedema,

Rhabdomyolysis (is the breakdown

of muscle fibers that leads to the

release of muscle fiber contents

(myoglobin) into the bloodstream.

Myoglobin is harmful to the kidney

and often causes kidney damage).

Beta Blocker, Anti-

anginal, anti-

hypertensive

Lopressor Metoprolol Blocks beta receptors in

heart, reducing h/r

Baseline ECG, Bp, HR, anginal attacks, I & O HR


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Related Decision


Calcium Channel

Blocker

Cardizem Diltiazem Blocking of calcium

channels, Systemic

vasodilation, decreasing

blood pressure

Check Bp and p before administering. Assess for signs

of CHF, peripheral edema, rales/crackles, dyspnea,

weight gain, jugular vein distention.

If SBp


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Related Decision


Laxative MOM Magnesium Hydroxide Stool softener by

facilitating water

penetration

Assess patient for abdominal distention, presence of

bowel sounds, usual pattern of bowel function.

Assess color, consistency, and amount of stool

produced.

Do not administer at

bedtime or late in the

day, electrolyte

imbalance, or no longer

constipated.

Do not take within 2 hr

of taking other

medications. Increase

bulk in the diet, fluid

intake, mobility. Drink a

full glass of water and

take on an empty

stomach.

Diarrhea

Laxative Senokot Senna Stool softener by

facilitating water

penetration

Assess patient for abdominal distention, presence of

bowel sounds, usual pattern of bowel function.

Assess color, consistency, and amount of stool

produced.

Do not administer at

bedtime or late in the

day, electrolyte

imbalance, or no longer

constipated.

Do not take within 2 hr

of taking other

medications. Increase

bulk in the diet, fluid

intake, mobility. Drink a

full glass of water and

take on an empty

stomach.

Diarrhea

Multivitamin Theragran-

M/minerals/iron

Multivitamin w/min/Fe Dietary supplement for

vitamin deficiencies

Check levels in CBC Signs of nutritional

deficiency, alcohol

intolerance.

Chewable tablets

should be chewed

completely before

swallowing. Follow a

well balanced diet.

Stool may be black from

iron.

Hypersensitivity to preservatants,

colorants, allergies.

Non Opioid Analgesic,

Antipyretic

Tylenol Acetaminophen Inhibits the synthesis of

prostaglandins that may

serve as mediators of

pain, primarily in the

CNS.

Assess for location and severity of pain, increased

temperature, alcohol usage, OTC drugs. Evaluate

hepatic, hematologic, and renal function prior and

periodically during prolonged, high dose therapy.

Renal disease, allergies,

glucose deficiency,

overdose or toxicity

HOLD and call

Notify physician if rash

develops, avoid alcohol

consumption.

Upset stomach, heartburn, nausea. acetylcysteine

Opioid Analgesics -

Moderate to Strong

OxyContin Oxycondone Binds to opiate

receptors in the CNS,

alters perception of and

response to painful

stimuli while production

generalized CNS

depression.

Assess level of consciousness, Bp, P, R prior to

administration and 20 minutes after.

R


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Related Decision


Potassium Imbalance K-Dur/Potassium Potassium Chloride conduction of nerve

impulses in heart, brain,

and skeletal muscle

Lab Values Monitor Lab values Take with a full glass of

water. Do not stop

taking without talking to

DR first. Keep

appointments for blood

work and ECG.

Mild nausea, upset stomach,

diarrhea.

Kayexelate

Thyroid Hormones Synthroid Levothyroxine Replacement therapy

for natural thyroxine

TFT (Thyroid functioning test) Cardiovascular

anomalies HOLD and

call

Take on an empty

stomach 30 to 60

minutes before

breakfast. Can be a life

long therapy. Avoid

overheating, follow

regular blood testing.

Insomnia, irritability, changes in

menstrual periods, appetite changes,

weight changes.

Advair Diskus (Salmeterol & Fluticasone)

Albuterol (Proventil inhalant)

Altace (Ramipril)

Aspirin

Cardizem (Diltiazem)

Cozaar (Losartan)

Diovan (Valsartan)

Epogen (Epoetin Alfa)

Glucophage (Metformin)

Lanoxin (Digoxin)

Lasix (Furosemide)

Levaquin (Levofloxacin)

Lopressor (Metoprolol)

Lovenox (Enoxaparin)

Morphine Sulfate

Nitro-Dur (Nitroglycerin Patch)

Nitroglycerin SL

Norvasc (Amlodopine)

Percocet (Oxycodone/Acetaminophen)

Plavix (Clopidogrel)

Protonix (Pantoprazole)

Retrovir (Zidovudine)

Synthroid (Levothyroxin)

Tenormin (Atenolol)

Vasotec (Enalapril)

Zestril (Lisinopril)

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Pharmacology Competencies Medical Surgical Nursing