Pharmacology Exam 1- Galen

Benzodiazepine- Midazolam - Uses: Conscious sedation S/E: Dizzy Adverse reactions/ Toxicity: Respiratory depression PT teaching: Safety Contraindications: Cardiopulmonary disease Non- Benzodiazepine- zolpidem tartrate - Uses: Insomnia S/E: Dizziness, Drowsiness, Behavioral changes Adverse reactions/ Toxicity: Complex sleep behavior Local Anesthetic- Lidocaine - Uses: Minor procedure S/E: Confusion, drowsiness, stinging, bradycardia Nursing considerations: Rapid onset Spinal Anesthesia- Spinal, Epidural - Uses: Pain, Pregnancy S/E: Back pain, Shivering Adverse reactions/ Toxicity: Respiratory depression, Hypotension, Headache, Nerve damage Pt teaching: Lay flat, Monitor for headache NSAID (non-selective)- Ibuprofen - Uses: Moderate to high pain, fever, inflammation S/E: GI distress, Blurred vision, Fluid retention, headache, peripheral edema Adverse Reactions/ Toxicity: Seizure, Ulcer, Hearing loss, Tinnitus, Kidney damage, kidney damage, nephrotoxicity Pt teaching: take with full glass of water, take as directed, don't take more than 10 days/pain and 3 days/fever Nursing considerations: Pts with asthma, allergy, nasal polyps have high risk for reactions, assess GI bleed, look 4 renal impairment Lab values: BUN, CBC, serum creatine, liver function test will be increased, alcohol increases bleeding Contraindications: CABG, pregnancy, asthma, contraindicated in bleeding disorders. NSAID(COX 2 inhibitor)- Celecoxib - Uses: Inflammation, Severe S/E: Dizziness, GI distress, Peripheral edema, Herbal remedies Adverse reactions/ Toxicity: Thromboembolism Contraindications: CABG, Angina, Renal/ Hepatic disfunction NSAID(Salicylate)- Aspirin - Uses: Inflammation, anti-platelet S/E: GI distress, Nosebleed Adverse reactions/ Toxicity: Hearing, Tinnitus, Reye syndrome, Hyperuricemia Contraindications: GI bleeding, Gout, Pregnancy Anti-gout- Allopurinol - Uses: Lowers uric acid levels S/E: GI upset, dizziness Adverse reactions/ Toxicity: Hepatotoxicity, hepatotoxicity Pt teaching: No alcohol, increase water intake, alkaline diet Nursing considerations: I &O, monitor kidney function Lab values: I&O, BUN, Creatinine Contraindications: Severe kidney disease Non- Opioid Analgesic- Acetaminophen - Uses: Pain, fever, NOT NSAID S/E: GI upset Adverse reactions/ Toxicity: Hepatotoxicity (Liver), steven Johnson syndrome, epidermal necrolysis Pt teaching: Take exactly as directed, chronic used can lead to hepatotoxicity, avoid alcohol, consult PCP if fever not relieved in 3 days. Nursing considerations: Asses for overall alcohol use and health status. Lab values: Evaluate hepatic hematologic & renal function. (About 4g/per day) Opioid Analgesic- Morphine sulfate - Uses: MI, Cancer pain, SOB for dyspnea S/E: urinary retention, dizziness, pinpoint pupils Adverse reactions/ Toxicity: Respiratory depression, severe hypotension Pt teaching: teach of abuse potential, avoid use of alcohol, change positions Nursing Considerations: Use extreme caution with MAO inhibitors, assess conscience level, BP, pulse, and respirations Lab values: Liver enzymes Contraindications: hepatic/ renal dysfunction Opioid Antagonist (NARCAN)- Naloxone - Uses: Opioid overdose, Reserves respiratory depression S/E: N/V, hypertension, hypotension Adverse reactions/ Toxicity: Ventricular arrhythmias Nursing Considerations: monitor respiratory rate, BP, and pulse, given in slow increments. Anti- (Migraine)- Sumatriptan - Uses: Migraines, Cluster headache S/E: Drowsy, Flushing, warm sensation Adverse reactions/ Toxicity: Bradycardia Pt teaching: Only use during a migraine attack, avoid alcohol, overuse can cause headache Contraindications: History of hypertension, liver failure, pregnancy CNS Stimulant- (Amphetamine Like drug)- Methylphenidate - Uses: ADHD, Narcolepsy S/E: Insomnia, Irritability, weight loss, decreased appetite Adverse reactions/ Toxicity: Growth suppression, Hypertension, Tachycardia, sudden death, anaphylaxis, PT teaching: Take early in day, Eat more calories Nursing considerations: Monitor height/weight Contraindications: Anxiety, hypertension, history of seizures, coronary artery disease Antiseizure- (Valproate)- Valproate acid - Uses: Seizures S/E: Drowsy, Dizzy Adverse reactions/ Toxicity: hepatotoxicity, suicidal thoughts Pt teaching: monitor CBC, platelets, bleeding time Nursing considerations: Institute seizure, precautions, assess suicidal tendencies Contraindications: Pregnancy, PT's with liver disease ( Take 2-3 hours before or after antacids)( Take @ same time every day) Antiseizure- Barbiturate- Phenobarbital - Uses: Anti-convulsant S/E: Drowsy, Dizzy Adverse reactions/ Toxicity: Respiratory depression if you take too much Pt teaching: Notify PCP of S/S of angioedema, fever, sore throat, swelling, nose bleeds, No alcohol Nursing considerations: Monitor BP, Pulse, Resp, S/S of angioedema Lab values: Hepatic function, renal function, CBC Contraindications: Pregnancy ( Take 2-3 hours before or after antiacids)( Take @ same time every day) Antiseizure- Hydantoin- Phenytoin - Uses: prevention of grand mal Seizures S/E: Red/pink urine, N/V, thick gums, drowsy, hypotension, ataxia Adverse reactions/ Toxicity: Steven Johnson syndrome, blood dysrasia, aplastic anemia, suicidal thoughts, cardiac arrest Pt teaching: monitor behavior changes Nursing considerations: Do not take with anticoagulants or warfarin, no herbal remedies, eat more calcium, avoid alcohol Lab values: Monitor drug levels Contraindications: Pregnancy, drugs that mess with blood ( Take 2-3 hours before or after antacids)( Take @ same time every day) Benzodiazepine- Lorazepam - Uses: Acute alcohol withdrawal S/E: Drowsy, Dizziness Adverse reactions/ Toxicity: Respiratory depression, Bradycardia Pt teaching: Used short term, known for abusive potential Nursing considerations: keep supine for 8 hours after giving, regular assessment Benzodiazepine- Diazepam(Benzodiazepine- Alprazolam) - Uses: Uses for seizures (status epilepticus) S/E: Drowsy, Dizziness Adverse reactions/ Toxicity: Respiratory depression, hypotension Pt teaching: advice of abuse potential, avoid alcohol & opioids. Nursing considerations: Monitor BP, pulse, resp, assess risk for abuse, addiction misuse. Lab values: Hepatic & renal function, CBS Contradictions: Do not take with other CNS Antipsychotic- Haloperidol - Uses: Schizophrenia, Acute sycosis S/E: Dry mouth, Sedation Adverse reactions/ Toxicity: EPS(Tremors) NMS(fever, rigidity) Contradictions: Mood stabilizers & antipsychotics Atypical Antipsychotic- Aripiprazole - Uses: Schizophrenia S/E: Dryness, Weight gain, Drowsy, Sedation anticholinergic effects Adverse reactions/ Toxicity: Suicidal ideation, EPS, NMS Pt teaching: Nursing considerations: Wont work overnight about 3 weeks Lab values: Monitor CBC, blood glucose, cholesterol levels SNRI- Venlafaxine - Uses: anti- depression S/E: Dryness, urinary retention Adverse reactions/ Toxicity: Renal failure, Steven Johnson Syndrome Lab values: BUN, Creatine