Pharmacology Made Easy
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Transcript of Pharmacology Made Easy
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PHARMACOLOGY
Children- safety
Observe, report, teach about undesirable
effects
Medsno OTC w/o consultation
Pregnancy/lactating are out w/ meds
Liver must be intact Interactionspharmacological, assess &
teach
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PHARMACOKINETICS
PO, IM, IV
GI mobility
AbsorptionDrug-drug interaction
Metabolism
Protein/Tissue bindingElimination
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DRUG-DRUG INTERACTIONS
(THE MAD WAR)Tricyclic antidepressants
Histamine antagonist (Tagamet)
Ethanol; Erythromycin
MAO inhibitors
Aminophylline; Aspirin Digoxin; Dilantin; Diuretics
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Warfarin
Azole (antifungal); Antacids
Rifampin
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FOOD-DRUG INTERACTIONS
DRUG
Antacids (Calcium
carbonate)
Antibiotics(erythromycin,
penicillin)
TetracyclineAnticoagulants
(warfarin)
FOODS TO AVOID
Bran & whole grain
breads
Citrus fruit, colas
Calcium
Vitamin K
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FOOD-DRUG INTERACTIONS
DRUG
MAO inhibitors
FOODS TO AVOID
Tyramine
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DRUGS THAT CAN CAUSE
NEPHROTOXICITYAcetaminophen (high doses, acute)
Acyclovir, parenteral (zovirax)
AminoglycosidesAmphotericin B, parenteral (Fungizone)
Analgesic combinations cont.
acetaminophen, aspirin, or other salicylatesin high doses, chronically
Ciprofloxacin
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DRUGS THAT CAN CAUSE
NEPHROTOXICITY Cisplatin (platinol)
Methotrexate (high doses)
NSAIDs
Rifampin
Sulfonamides
Tetracyclines(except doxycycline &minocycline)
Vancomycin, parenteral (Vancocin)
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DRUGS THAT CAN CAUSE
NEPHROTOXICITY
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DRUGS THAT CAN CAUSE
HEPATOTOXICITYACE inhibitor
Acetaminophen
Alcohol
Iron overdose
Erythromycins
Estrogens
Fluconazole (Diflucan)
Isoniazid (INH)
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DRUGS THAT CAN CAUSE
HEPATOTOXICITYItraconazole (Sporanox)
Ketonazole (nizoral)
NSAIDs
Phenothiazines
Phenytoin (Dilantin)
Rifampin (Rifadin)
Sulfamethooxazole&trimethoprin (bactrim,septra
Sulfonamides
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DRUGS THAT CAN CAUSE
OTOTOXICITY Aminoglycosides
Bumetanide, parenteral (Bumex)
Cisplatin Erythromycin (renal impairment&hi doses)
Ethacrynic acid (Edecrin)
Furosemide (Lasix) Hydrochloroquine (Plaquenil)
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DRUGS THAT CAN CAUSE
OTOTOXICITY NSAIDs
Salicylates (chronic high doses, overuse)
Vancomycin, parenteral (high doses & renalimpairment)
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POLYPHARMACY
The presentation of
numerous
medications.
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CARDIOVASCULAR AGENTS
Cardiac GlycosidesLIZZY DIGGY
D- dig level 2ng/ml
I- increases myocardial contractility
G- GI or CNS signs indicate adverse effects
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CARDIOVASCULAR AGENTS
NitroglycerinANDY ANGINA
ACTION
Relaxes vascular smooth muscleDecreases venous return
Decrease arterial BP
Decreases L ventricular workloadDecreases myocardial O2 consumption
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CARDIOVASCULAR AGENTS
NitroglycerinANDY ANGINA
ACTION
Relaxes vascular smooth muscleDecreases venous return
Decrease arterial BP
Decreases L ventricular workloadDecreases myocardial O2 consumption
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CVS AGENTS
ANTIARRYTHMIC: LIDOCAINELIDDY LIDOCAINE
Liddy Lidocaine is the strongman that puts thelid on the trash can of PVCs. This drug
reduces sodium permeability, resulting in a
decrease in ventriculararrythmias & caediac
irritability. Observe for S/E like dizziness,
drowsiness & confusion.
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CONCEPT:
ANTIHYPERTENSIVE MEDSPRESSURE
Pressure (blood) monitor
Rise slowly to reduce orthostatic hypotension
Eating must be considered
Stay on medications
Skipping or stopping is a no-no
Undesirable responsesRemind to exercise, decrease alc
Eliminate smoking; educate
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ACE INHIBITORS
PRIL SISTERS
Cough;C/I in renal artery stenosis
Hypotension;Hyperkalemia (S/E)
First dose-watch for hypotensionSVR; PVR decrease
Tx of MI
Release of aldosterone decrease
Occult diabetic nepropathy decrease
LVD after MI
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ANGIOTENSIN II RECEPTOR
BLOCKERS (ARBS)SARTAN SISTERS
Administer without regard to meals
Renal function test- review
Blocks vasoconstriction effect of renin-
angiotensin system
Salt substitution or K+ supplements- do notuse
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ALPHA ADRENERGIC
BLOCKERSMINIS SINS
Syncope; Sexual dysfunction
Increased drowsiness, orthostatic
hypotension, HR
Need to be recumbent for 3-4 hours after
initial dose
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BETAADRENERGIC
BLOCKERSTHE LOL TEAM
The LOL team blocks hypertension by
blocking (decreasing) the contractility in
the heart, the renintern release from the
kidneys, & the sympathetic output from the
vasomotor center of the brain.
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BETA BLOCKER ACTIONS
B1 BLOCKERS AFFECT- affect the Beta1receptors in the heart. They decrease theexcitability, cardiac workload, O2
consumption, renin release & lower BP
B2 BLOCKERS AFFECT
Stimulate the beta receptors in the lung, relaxbronchial smooth mm, increase vitalcapacity, & decrease airway resistance
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BETA BLOCKER ACTIONS
B1 BLOCKERS AFFECT- affect the Beta1receptors in the heart. They decrease theexcitability, cardiac workload, O2
consumption, renin release & lower BP
B2 BLOCKERS AFFECT
Stimulate the beta receptors in the lung, relaxbrochial smooth mm, increase vitalcapacity, & decrease airway resistance
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BLOCKER
Bradycardia
Lipidemia (inc); Libido (decrease)
brOnchospasmCHF; Conduction abnormalities
Konstriction peripheral vascular
Exhaustion; Emotional depressionReduces recognition of hypoglycemia
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CALCIUM CHANNEL
BLOCKERSmy rate is slower & my pressure is down!
Major undesirable effects of Ca2+ channelblock include: headache(most common),
hypotension, syncope, peripheral edema&
bradycardia.
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CENTRAL ALPHA2
AGONISTSCATAPRES
C is at her eyes because the adrenergic hormone is
released from the brain
A is at her nose because the risk factors ofhypotension, hepatotoxicity & hemolytic anemia
are as clear as the nose on her face
T is at her chin as it drops w/ transient drowsinessA is body wide because arterial P all over the body is
lowered
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CENTRAL ALPHA2
AGONISTSCATAPRES
P indicates paradoxical HPN w/ propanolol
R is at her baseline feet to remind you to
record V/S
E on her belt may expand because she mayhave a wt.gain; evaluate her liver
S is tapered down her dress because the drugsshould be slowly tapered down & notstopped suddenly
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VASODILATORS
DILLY DILATOR
Directly acts on vascular smooth mm, causingvasodilation
Increases renal & cerebral blood flowLupus-like rxn (fever, facial rash, mm & joint ache,
splenomegaly)
Assess for peripheral edema of hands & feet
Take with food
Other- headache, dizziness, anorexia, tachycardia,hypotension)
Review BP
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DIURETICS
DIURETIC
Diet- inc K+ for all except aldactone
Intake & output daily wt.
Undesirable effects: F&E imbalanceReview HR, BP, & electrolytes
Elderly- careful
Take w/ or after meals & in am
Increase risk of orthostatic hypotension; moveslowly
Cancel alcohol
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LOOP DIURETICS
LOU LA BELLLou La Bell goes spinning over the falls
because she has lost so much fluid from
diuresing. Her ears are ringing & she is
dizzy from a decrease in her BP. She haslost K+ in the falls. Loop diuretics act in the
ascending loop of henle & 1 common drug
is LASIX.
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LOOP DIURETICS
LOU LA BELLRemember, THIAZIDES at the distal tubule
(major differences bet. Undesirable effects
of THIAZIDES & LOOPS is that LOOPS
may cause ototoxicity & hypocalcemia).
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K+ SPARING DIURETICS
ALAN- ALDACTONELow Na+
Elevated T waves from hyperkalemia
Agranulocytosis w/triamterene
K+ level must be monitored
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OSMOTIC DIURETICS
(BUSTER BRAIN MAN)Oliguria, edema, inc. ICP- indications
Stops reabsorption of water
MannitolOutput of urine, electrolytes- monitor
Tissue DHN- UE
Increased frequency/volume of urinationCirculatory overload- UE
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ANTICOAGULANT:
WARFARIN(CORA COUMADIN)
Check VS. platelet ct., PT
Observe for bleedingReview bleeding protocol (i.e. electric razors,
soft toothbrushes)
Avoid ASA, may use acetaminophen
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ANTICOAGULANT: HEPARIN
SODIUM(HARRY HEPARIN)
Harry Heparin is getting his anticoagulant IVor SQ in the abdomen. His soft toothbrush
will help keep gums from bleeding & hiselectric razor will keep him from bleedingwhen he shaves. Even the band-aid whenpulled off his arm may cause a big bruise.
If Harrys PTT is >1.5-2.5 x control, he maybleed too freely.
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ANTIPLATELET: ASPIRIN
(ANNIE ASPIRIN)
Fever
Inflammation
Reduces TIAs due to fibrin platelet embolus
Eliminates (reduces) death with hx of MI
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ANTIPLATELET: ASPIRIN
(ANNIE ASPIRIN)
Annie is busy firing at platelets to reduce
the blood coagulation in her body especially
with MI or TIA. She is holding her stomach
as this med can cause stomach irritation.
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THROMBOLYTIC AGENTS
(ADAM ASE)CBC, hgb, hct- monitor
Look for dysrythmias
O
bserve for bleedingThe V/S must be monitored
Adam ASE will dissolve the clog in this
sink just as he dissolves the CLOT in ablood vessel. He will use t-PA or another
thrombolytic agent that ends in ASE
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BILE- ACID SEQUESTRANT
LDL is low 15-30%
Increase fluids & fiber
PT monitoring
Increase in GI distress- constipation
Decreases absorption of many meds
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FIBRIC ACID
Liver or renal dse- WARNING
Increases effect of warfarin or sulfonylureas
VLDL, LDL, triacylglycerols & cholesterol-monitor
Encourage diet low in fat, cholesterol &
sugars
R avoid alcohol
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HMG CoA INHIBITORS
(L.L. STATIN)Officer LL (lipid lowering) Statin has
stopped the liver mobile & its driver.
Cholesterol. These drugs lower cholesterol
and can be highly toxic to the liver. Drugsthat are in this group end in statin.
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NIACIN
Note liver fxn tests- regular intervals
Itching & flushingUE
Aspirin before Niacin may decrease UE of
vasodilation
Contraindications: hepatic dse, Px
Instruct to take w/ food & at bedtimeNo high cholesterol foods
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Do not think that the knowledge you presentlypossess is changeless, absolute truth. Avoidbeing narrow-minded & bound to present
views. Learn & practice non-attachmentfrom view in order to be open to receiveothers viewpoints. Truth is found in life ¬ merely in conceptual knowledge. Be
ready to learn throughout your entire life &to observe reality reality in yourself & thein the world at all times. Thich Nhat Hanh
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BRONCHODILATORS
Breathing & coughing techniques
Relaxation techniques
Evaluate HR & BP
Arm identification
Tremors
Have 8 or more glasses of fluidsEmphasize no smoking
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ANTIHISTAMINES
CLARITIN + ALCOHOL + CNS depressant=SLEEP
CLARITIN + MAOIs = DRYNESS
Antihistamines (Claritin) combined w/ alc &
CNS depressant may result to sleep.Antihistamines & MAOIs may result indryness.
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BETA2 ADRENERGIC
AGONISTS(MAX AIR)
Max air is smiling because he has been able to
relieve bronchospasms from asthma & other
respiratory diseases. He has plenty of air to
breathe & air blow up the balloons in the R
hand. His L hand is shaky & weak. His
heart is beating fast & his BP is up fromundesirable effects of his medication.
A S
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XANTHINES
(AMILY TOXICITY)Amily represents some of the most commonly
occurring undesirable effects nausea (1st
sign of toxicity), arrythmias, tachycardia,
nervousness and tremors (later sign oftoxicity)
CORTICOSTEROID
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CORTICOSTEROID
INHALERS (AZMA)ACTION= decreased respiratory tract edema
Zero improvement- contact provider
Must taper off gradually
Asthma control
LEUKOTRIENE RECEPTOR
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LEUKOTRIENE RECEPTOR
ANTAGONIST(LOOK ! A TRAIN!)
It is OK to board the train in the town of
Chronic, but it is too late by the time the
train goes to the town of Acute (asthma).
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ANTI- INFECTIVE AGENTS
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ANTIBIOTICS
Monitor superinfections.
Evaluate renal/liver functions.
Diarrhea- take yogurt.
Inform provider prior to taking other meds.
Cultures prior to initial dose.
Alcohol is out, ask about allergy.
Take full course (of pills).
Evaluate cultures, WBC, T, blood.
AMINOGLYCOSIDES
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AMINOGLYCOSIDES
(AMINO MICE)Gentamycin Amikacin Kanamycin
Neomycin Strepnomycin Tobramycin
3 Amino Mice
One cant feel. Vestibular fxn&audiograms.
One cant hear. Should be studied in Pt. careOne cant pee. Plans.
AMINOGLYCOSIDES
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AMINOGLYCOSIDES
(AMINO MICE)Grab BUNs & creatinine quick as you can.
Our 3 Amino Mice will assist in
remembering 3 major UE of this category
of drugs: ototoxicity, nephrotoxicity, &
neurotoxicity).
CEPHALOSPORINS
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CEPHALOSPORINS
(CEF THE GIANT)Get nausea, vomiting, diarrhea
Increase in glucose values
Anaphylaxis may occur; alcohol may cause
vomiting
Nephrotoxicity
ThrombocytopeniaGiant a powerful antibiotic that can destroy
several types of bacteria. 1stgeneration.
FLUOROQUINOLONES
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FLUOROQUINOLONES
(T.T. FLOXACIN)Theophylline
Anticoagulant
Digoxin
TAD may result in drug toxicity when takenw/ the fluoroquinolones. This group of
drugs ends in floxacin & used to treat UTIsas well as a wide range of Gm- & Gm+infections.
MACROLIDE
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MACROLIDE
ANTIBIOTIC:ERYTHROMYCIN(MACROLIDE GIRL)
GI disturbancesUE
IV site-check for irritation
Reduces activity of med if given with acids
(fruit juices) or food
Liver function tests
PENICILLINS
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PENICILLINS
(PENICILLIN)PEN the antibiotic has his destroyer laser
aimed at several types of bacteria. He is a
broad spectrum antibiotic.
SULFONAMIDES
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SULFONAMIDES
(SULFA)Sunlight sensitivityUE
Undesirable effectsrash, renal toxicity
Look for UO, fever, sore throat & bleeding
Fluids galore!
Anorexia, anemia - UE
TETRACYCLINES
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TETRACYCLINES
(TETRA CYCLINES)S unlight sensitivity
T ake with full glass of H2O
antacid, iron, milk
P ut drug into empty stomach
VANCOMYCIN
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VANCOMYCIN
HYDROCHLORIDE(RUDOLPH THE RED - NECK REINDEER)
Rudolph the red-neck reindeer
Had an adverse side effect
From the drug Vancomycin,Must keep all labs in check.
Caution with renal failure
Hearing loss and allergies,
Take a temp. & blood cultures,
Specially a CBC!!!
ANTITUBERCULAR:
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ANTITUBERCULAR:
ISONIAZID(INA TUBERCULOSIS)
L iver enzymes-monitored
U se cautiously w/ renal dysfunction
No alcohol
G ive pyridoxine-prevent peripheralneuropathy
S hould take on empty stomachscreen vision
ANTITUBERCULAR:
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ANTITUBERCULAR:
ISONIAZID(INA TUBERCULOSIS)
Tuberculosis has undesirable effects from
INH. She is nauseated, has an enlarged
liver, tingling in her feet (peripheral
neuropathy), & her secretion have turned
orange. LUNGS will help you recall some
in preventions.
ANTITUBERCULAR:
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ANTITUBERCULAR:
RIFAMPIN(REDMAN RIFAMPIN)
many Drug - drug interactions.
Do not take alcohol.
Dont stop taking .
Dizzydont drive.
Does havoc the liver.
Dyscrasias
He is taking some rest & relaxation.
ANTIFUNGAL:
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ANTIFUNGAL:
AMPHOTERICIN B(AMPHOTERRIBLE)
Amphoterrible is a monster. He treats monster
infections such as histoplasmosis & other
life threatening fungal infections. He has aterrible habit of creating irregularities in the
heart (arrythmias). The X marks the spot of
the kidney since 80% of clients receivingthis drug may develop some nephrotoxicity.
ANTIFUNGALS
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ANTIFUNGALS
(ZOLE)Z OLEmany drug interactions can occur
O bserve hygiene measures to control
infection
L iver Function Testsmonitor
E ducate to take with food.
ANTIPROTOZOAL
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ANTIPROTOZOAL,
AMEBICIDE: FLAGYLFLAGYL
F lushing
A LCOHOL will cause these effects
I ncreased vomitingN ausea
T achycardia
If Flagyl is mixed w/ alcohol, there will be adisulfiram-like rxn, & that is why this lady feelsFAINT.
ANTIVIRALS
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ANTIVIRALS
(THE VIR HOUSE OF SHINGLES)The haunted house of shingles (herpes zoster),
chicken pox (varicella), herpes simplex & the
cytomegaly virus is most often repaired w/ drugs
that include VIR in them. Acyclovir (Zovirax),
Famciclovir (Famvir), & Valacyclovir (Valtrex)
are a few of these drugs.
The house is shaky&haunted because the recipient of
these drugs may experience a headache&shakesfrom chills. Its enough to make you throw up.
PYRIDIUM
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PYRIDIUM
(MR. P.O.)G I disturbance
U rine turns yellow orange
S lera & skin
H emolytic anemia
Mr. P.O. was not happy w/ his pain but after taking
Pyridium the pain from his UTI must be gone.Remember Pyridium turns urine ORANGE.
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ANTINEOPLASTIC AGENTS
A life is not measured by the games that are
won, but that you in the moment and
learned to have FUN.
Michael Dooley
UNDESIRABLE EFFECTS
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UNDESIRABLE EFFECTS
FROM ANTICANCER DRUGSB one marrow depression
A lopecia
R etching- nausea/vomiting
F ear and anxiety
S tomatitis
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ALKYLATING AGENTS
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ALKYLATING AGENTS
(NITROGEN MUSTARD)B one marrow depression
(leukopenia,thrombocytopenia)
A norexia/alopecia
D istressful nausea & vomiting
@ destroying malignant neoplasm
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ANTIMETABOLITES
M onitor CBC & platelets weekly
E valuate renal fxn tests
T emp assessment q 4-6 hrs
A sepsis- strict
B leeding, anemia, & nausea- report
O ral hygiene- brush w/ soft toothbrushL ots of fluids (2-3L/day)
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ANTIMETABOLITES
I ntake & output, nutritional intake- monitor
T he Protocols for handling & administering-
follow
E mphasize protective Isolation
ANTI-INFLAMMATORY
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ANTI-INFLAMMATORY
AGENTSWe are all on the way up the mountain & we
need each others help.
Jon Kabat-Zinn
NONSTEROIDAL ANTI-
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NONSTEROIDAL ANTI-
INFLAMMATORY DRUGS(NSAIDs)
N o alcohol
S E: BIRTH (bone marrow dep,inc GI
distress,renal toxicity, tinnitus&hepatotoxicity)A spirin sensitivity- do not give
I nhibits prostaglandins
D o take w/ foodS top 5-7 days before surgery
ANTIGOUT: ALLOPURINOL
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ANTIGOUT: ALLOPURINOL
(ZYLOPRIM)GOUT
G ulp 10-12 glasses (8oz) of fluid daily
I distress- UE
O utput & input- monitor closely
U ric acid production decreased
se no alcoholT ake after meals
GASTROINTESTINAL
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GASTROINTESTINAL
AGENTSEvery dream you dream
Will one day come true,
So dream your dreams
All they need is you!
Michael Dooley
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ANTACIDS
AUNT ACIDS FAMILY
ALUMINUM MAGNESIUM
Mag & Al have a Hx of an ulcer. While the
ant-acids, may help in coating their
stomachs, they may also experience UE.
Als problem is constipation. Mag has a
problem w/ diarrhea.
ANTI-ULCER MEDICATIONS:H2
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ANTI ULCER MEDICATIONS:H2
HISTAMINE ANTAGONISTS(NO WINE JUST DINE)
CIMETIDINE FAMOTIDINE
NIZATIDINE RANITIDINE
D ont take w/ antacids
I nform provider of bleeding
N o smoking, alc or NSAIDsE levate head of bed
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CHOLNERGIC BLOCKERS
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CHOLNERGIC BLOCKERS
(ANTICHOLINERGICS)ANTICHOLINERGICS
Cant pee
Cant see
Cant spit
Cant shit
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PROTON PUMP INHIBITOR
P risolec
U E: headache, GI disturbances
M aximum of 16 weeks for Protonix
P rotonix
PEPSIN INHIBITOR:
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PEPSIN INHIBITOR:
CARAFATE (CARA)C onstipation- UE
A dminister on an empty stomach
R isk of Aluminum toxicity w/ Al antacids
A dminister antacids 30 min. before or after med
Carafate will form a protective coating on the ulcer
surface. It protects against pepsin&acid
A A A O O
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ANTIDIARRHEAL: LOMOTIL
D rowsiness, dizziness, dry mouth, DHNI nhibits gastric mobility
A lcohol is out
R eport if there is a narcotic drug HxR esponse of a drug determined prior to driving
H abit forming- only take prescribed dose
E lectrolytes- monitor w/ severe diarrhea; encourage
clear liquidsA ssess frequently of BM; bowel sounds
BULK FORMING:
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BULK FORMING:
METAMUCIL(SILLY PSYLLIUM)
Silly got his name by taking Psyllium
(Metamucil) w/ a jigger of H2O instead of a
BIG glass of H2O. Now hes sweatingbecause this bulk-forming laxative that
expands has bulked his bow tie instead of
his stool.
ENDOCRINE AGENTS
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ENDOCRINE AGENTS
Learning is finding what you already know.Doing it is demonstrating that you know it.
Richard Bach
CORTICOSTEROIDS
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CORTICOSTEROIDS
(CUSHY CARL)C ushing-like Sx
bU ffalo hump
S odium; SweatingH eadache; Hyperglycemia
I ncrease in BP, HR appetite
N ot healing quickly
G I upset
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THYROID PREPARATIONS
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THYROID PREPARATIONS
(MORBID MATILDA)T SH, T3, T4- monitor
H ypo/Hyperthyroidism- monitor
R eview how to take a pulseO bserve clinical improvement in 3-4 days
I ncrease metabolic rate- action
D o not change brands of drug
Synthroid gives Matilda a boost so she will be lesstired.
ANTITHYROID
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ANTITHYROID
(GO GETTER GERTRUDE)
Everything is running EXCEPT my periods!
I need PTUT for my BIG thyroid!
B leeding
I nfectionG ive w/ food
HYPOGLYCEMIA
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HYPOGLYCEMIA
T remors; Tachycardia
I rritability
R estless
E xcessive hunger
D iaphoresis; Depression
HYPOGLYCEMIA
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HYPOGLYCEMIA
Hot & dry
Your sugars high
Your insulin is what you need.
Cold & clammy
You need some candy,And milk will help indeed.
DIABETES
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DIABETES
D iet, wt.loss, exercise
I dentification- medical alert bracelet
A void alcohol & other meds
B lood sugar & urine sugarE d.about antidiabetic agents
T herapy decreases signs, not a cure
E d. foot care, no smoking, stressorsS igns & Sx of Hyper/Hypoglycemia; skin care
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AVANDIA
S igns of anemia, inc liver enzymes: UEU se barrier contraceptives
G lucose urine & serum- monitor
A dminister w/ mealsR osiglitazone (Avandia)
This VAN is improving the action of insulin,w/c helps in the mgt. of diabetes.
INSULIN
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INSULIN
RAPID ACTING: CLEARRegular Humulin R Semilente
Actrapid Crystalline Zinc
Peak: 2-4 H
INTERMEDIATE ACTING: CLOUDY
NPH Humulin N
Lente Monotard
Peak: 6-8 H
INSULIN
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INSULIN
LONG ACTING: CLOUDY
Ultralente
Peak: 16-20 H
SC; DO NOT shake; massage
CENTRAL NERVOUS
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SYSTEM AGENTS
The greatest danger confronting us is not anyparticular kind of thought, but absence of
thought.
Henry Commager
NARCOTIC ANALGESICS
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NARCOTIC ANALGESICS
(DROOPY DEUTERONOMY)
D epressed respirations
D izzy
D rowsy
D rug dependence
D ecreased BPD ecreased GI peristalsis & UO
NARCOTIC ANTAGONISTS
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NARCOTIC ANTAGONISTS
(PERKY PERKOLATOR)
P erspiration increase
P ulse increase
P ain increase
P ressure increase
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ANTICONVULSANT AGENTS
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ANTICONVULSANT AGENTS
Dont go outside you house to see theflowers, my friend, dont bother withexcursion. Inside your body there areflowers. One flower has a thousand petals.That will do for a place to sit. Sitting thereyou will have a glimpse of beauty inside thebody & out of it, before the gardens & after
the gardens.kabir
ANTICONVULSANT:
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DILANTIN
DILANTIN (DIAL AT TEN)
G ingival hyperplasia
U se alternate birth control
M outh care-preventive dental check-up
S oft toothbrush, dont stop abruptly
ANTIEPILEPTIC AGENT:
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NEURONTIN
(CAESAR)
C NS: dizziness, insomnia-UE
Antacids decrease
Eat food with drug
Support group for epileptics
Alert tag indicating specific drugReport U E
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BENZODIAZEPINES
(ANTIANXIETY)
T each to rise slowly from supine
Y es,alcohol should be avoided
MISCELLANEOUS ANTIANXIETY
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AGENTS:NONBENZODIAZEPINES
(BUSPAR BUS)
NO sudden STOPS
Get on the Buspar bus to decrease anxiety.
The seats recline for the UE of dizziness &
drowsiness. Smiles can be seen after taking
the drug for a week.
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CONCEPT: DEPRESSION
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CONCEPT: DEPRESSION
(ANTIDEPRESSANT)
S afety measures (i.e., change position slowly)
I nstruct client to report UE
O bserve for suicidal tendencies
N o alcohol or CNS depressants
SELECTIVE SEROTONIN REUPTAKE
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INHIBITORS (SSRIs)
(PAXIL)CNS
C NS system stimulation; nervousness,
headacheN ausea, anorexia, vomiting
S kin rash; Sexual dysfunction
Paxil packs extra baggage when taking SSRIs.
TRICYCLIC
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ANTIDEPRESSANTS
(TINA TRICYCLE)
T rimipramine H ypotension
I mipramine A nticholinergic
N ortriptyline T achycardia
A mitriptyline Sedation
TRICYCLIC
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ANTIDEPRESSANTS
(TINA TRICYCLE)
Tina tricycle is sitting on the curb as she is
sleepy & cant pee, cant see, cant see.
Obviously she should not be driving heavymachinery while taking TCAs. The 3
wheels represent that the therapeutic effects
may have a 3 wk delay of onset.
MONOAMINE OXIDASE
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INHIBITOR (MAOI)
(THE TYRANT KING)
The tyrant king loves good food, but can
develop a life threatening hypertensive
crisis if he eats or drinks productscontaining TYRAMINE while taking MAO
inhibitors. The TYRANT is No Popular
Man (Nardil, Parnate, Marplan).
ANTIMANIC MEDICATION
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ANTIMANIC MEDICATION
(BIPOLAR CLOWN)L eveltherapeutic (0.5-1.0 mEq/L)
I ncreased urination
T hirst increasedH eadache; Hand tremors
I ncrease fluids
U nsteadyM ortons Salt-adequate intake
ANTIPSYCHOTICS
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ANTIPSYCHOTICS
(STANCE)S edation; Sunlight sensitivity
T ardive dyskinesia; Tachycardia; Tremors
A nticholinergic; AgranulocytosisN euroleptic malignant syndrome
C ardiac arrhythmias (orthostatic hypotension)
E xtrapyramidal (akathesia); Endocrine(change in libido)
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OXYTOCINS
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OXYTOCINS
(PITOCIN)P ressure is elevated
I ntoxication w/ H2O
T itanic contractionsO xygen decrease in fetus
C ardiac arrhythmia
I rrenegularity in fetal heart rateN ausea and vomiting
MAGNESIUM SULFATE
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MAGNESIUM SULFATE
(A ROAD BLOCK TO PIH & SEIZURES)Magnesium SO4, a CNS depressant reduces or
stops convulsions in the OB client.
MAG SULFATE
Decreased BP
Decreased Pee Pee
Drop in RR
Patellar reflex there aintGive antidote calcium gluconate
FOSAMAX
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FOSAMAX
(JOSEPHINE BONE-A-PART)Bone mass rebuilds
Only take w/ full glass of H2O, no food
Nausea- never lie down after taking
Esophageal irritation
SELECTIVE ESTROGEN RECEPTOR
MODULATOR (SERM)
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MODULATOR (SERM)
SERM
SERM is a gift to Josephine whose bones
are coming apart. Selective Estrogen
Receptor Modulator are used to preventosteoporosis in postmenopausal women.
These drugs do not turn on breast or uterine
receptors. The benefit is there is noincreased risk of breast or endometrial CA.
ESTROGEN
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ESTROGEN
(ESTROGEN)
Estrogen builds strength in bones (reducing
bone loss) & protects the heart from cardiac
disease. Estrogen also has been linked to theprevention of Alzheimers. Estrogen helps
maintain the functioning of the female
reproductive system.
VITAMINS, MINERALS,
ELECTROLYTES
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ELECTROLYTES
Dont be afraid to take a big step if one isindicated. You cant cross a chasm in two
small jumps.
David Lloyd George
VITAMIN: PYRIDOXINE (B6)
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VITAMIN: PYRIDOXINE (B6)
I N H (Isoniazid)N
C
RE
A
SE ANTI-TUBERCULIN
VITAMIN: PYRIDOXINE (B6)
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VITAMIN: PYRIDOXINE (B6)
L evodopa ANTI-PARKINSONISMO
W
ER
Our B6 is telling you that B6 should be increased
when taking INH.
B6 should be lowered to prevent toxicity when
taking Levodopa
MINERAL: IRON
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MINERAL: IRON
(IDA USES)
Iron improves IDA, anemia in Px,
malnutrition & blood loss.
Take iron with vit. C, swallow whole tablet orcapsule (do not crush), do not take with
milk or antacid, take liquid iron w/ a straw,
& increase fluid, fiber & exercise.
ELECTROLYTE: POTASSIUM
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C O O SS U
(K+)
Potassium sparing diuretics- monitor K+
Outputmonitor closely
Take with food
Ace inhibitors- monitor K+
Signs of digitalis toxicity if K+ is low
Serum K+ level3.5-5.0 mEq/L
ELECTROLYTE: POTASSIUM
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(K+)
IV site monitored for infiltration
Undesirable effects: N/V, cardiac arrythmias
Medical follow-up
SUPPLEMENT: CALCIUM
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(Ca2+)
Better teeth
Osteoporosis
Normal Ca2+ (8.5-10.5 mg/dl)
EKG changes- UE
Sunshine
COMPLEMENTARY AGENTS
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Health is the state which medicine hasnothing to say.
W.H. Auden
COENZYME Q10
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Q
Evitamin helps preserve Co-Q10
N ausea, vomiting, anorexia-U E
alZheimers, schizophrenia, CHF-indications
Y es, it has ANTI-AGING effects
Mackeral, Salmon, Sardines-inc.in vit.E
Effectiveness of Co-Q10 is decreased w/
oral antidiabetics
ECHINACEA
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Echinacea is giving a powerful boost to theimmune system so colds, flu, sore throats
will heal quickly and smiles will return
EVENING PRIMROSE
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R heumatoid arthritis, PMS, menopause: indO il of Evening Primrose-best source of GLA
S eizures high risk if herb is taken w/
phenothiazines
E ducation-dont use if client has a Hx of
breast CA or seizures.
FEVERFEW
(MYRA MIGRAINE)
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(MYRA MIGRAINE)
M ay cause mouth ulcersY ou cant use during Px
R educes pain
A nticoagulants may cause bleeding
Feverfew reduces the pain headache & photophobia.
It has also stimulated Myras appetite & her dress
size is about to outgrow her big hair.
GARLIC
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O bserve for bleeding if taking anticoagulantsD oes also have antitumor & antimicrobial
effects
O dorless garlic supplements are available
R evaluate BP & lab reports
Garlic also helps her yeast infection. Decrease
cholesterol, triglycerides, BP.
GINGKO BILOBA
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A few weeks on Gingko Biloba & he receivesthe benefits of increased memory &
decreased depression. He can just feel the
better blood flow through his brain & cannow think like Einstein!
GINSENG
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GINSENG BEAR GETS TO THE FINISHLINE FIRST! He has taken his tonic that
improves stamina & fights fatigue. Needless
to say, the 2nd
bear in the race did not takehis ginseng.
KAVA-KAVA
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K a w/ interacts w/ CNS depressantsA dvise to w/ food
V isual & mild GI disturbances: UE
A lprazolam given w/ Kava may cause a comaKava-Kava has been restless, nervous,
anxious,& unable to sleep, but she is nowfloating on her cloud of calm. She will notbe able to stay on her cloud for too long,because this herb also acts as a diuretic.
SAW PALMETTO BERRY:
SERENOA REPENS
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SERENOA REPENS
S tomach problems & headaches may occurA lters PSA (prostate-specific antigen) test.
May cause false.
W atch for bloody urine
ST. JOHNS WORT
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W atch the sunO K for stings & bites
R educes viral infections
T aking MAOIs & SSRIs may cause serious
UE.
St. johns Wort calms the emotions & is used
for depression.
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1 kg = 2.2 lbs= 1000 gm
1 gm = 1000 mg
= 1 cc/ml
= 15 grains
60 mg = 1 grain
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1L = 1000 ml = 1 quart1 pint = 500 ml
1 gal = 4L = 4 quarts
1 oz = 30 ml
1 glass = 240 cc
1 dram = 15 ml = 1 tbsp
1tsp = 5 ml
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1 tbsp = 3 tsp = 15 ml1 ml = 15 minims/gtts = 60 mgtts
1 gtt = 4 mgtts
C = F32 X 5/9
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ODOnce a day
Bidtwice a day
Tidthree times a day
Qidfour times a day
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Q4hevery four hours
Q8hevery eight hours
HSat bed time
Q6Hevery six hours
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QOD- very other dAy
ACbefore meals
PCafter meals
Q 3H every three hours