Rasmussen
University
Pharmacology for
professional Nursing
Exam 2 Midterm
Review
Exam 2 Pharmacology Review:
, Review asthma and meter dose inhalers
- MDI are used with a spacer usually albuterol – RESCUE.
- 1-2 puffs q 4 hours prn
- Wait 1 full minute in between puffs. Must inhale prior to activating device.
Why we use glucocorticoids in asthma
- The most effective drugs available for long term control of airway inflammation
- Decreased inflammation
- Reduces bronchial hyperreactivity.
- Decrease mucous in airway
How we manage asthma in an emergency situation
- DuoNeb – Albuterol and ipratropium bromide
o Inhaled SABA= albuterol
o Inhaled anticholinergic (bronchodilator)= ipratropium bromide
- IM or IV glucocorticoids= methylprednisolone (Solu-Medrol)
- Oxygen
How we treat and manage COPD
- MDI inhaler with spacer and dry powder inhaler (Advair-prophylaxis)
o Advair – must rinse mouth out after use to prevent oral thrush
- Rinse mouth after steroid inhaler use
- Rinse any equipment such as inhalers, after each use.
How we treat cough and cold in children
- Administer one medication at a time incase there is a reaction and give with fluids.
How we treat pts with ulcers
- H2 receptor antagonist
o Cimetidine- best if taken on an empty stomach.
o Antacids can decrease absorption of this med and should be administered at least 1 hour apart.
- PPI
o Omeprazole- usually taken short term 4-8 weeks and taken first thing in the AM
- Antiulcer Drugs
o Sucralfate – has no acid-neutralizing capacity and does not decrease acid secretions
Lasts 6 hours and usually taken 4x a day
Must take on an empty stomach at least 30 minutes to 2 hours from food or drugs
Can impede absorption of phenytoin, theophylline, digoxin, warfarin, cipro so must be taken at least 2 hours
apart.
- Antacids- calcium carbonate (TUMS) is the safest choice of antacid in pts with renal failure as it is not systemically absorbed.
Review cimetidine:
- (OTC solution or tablet)
- Best if taken on an empty stomach.
- Antacids can decrease absorption of cimetidine and should be administered at least 1 hour apart.
Review furosemide and digoxin and what we need to monitor
Loop Diuretics- in pts with CHF, gets rid of excess fluid which decrease pulmonary edema. Adverse effects are dehydration
and electrolytes depletion hyponatremia and hypokalemia.
Furosemide (Lasix)
These block reabsorption of sodium and chloride.
Act on the thick ascending loop of Henle to block reabsorption of sodium and chloride.
Most effective diuretics available and are very potent; can cause marked depletion of water and electrolytes.
Useful in pts with severe renal impairment (can promote diuresis even when GFR and renal blood flow are
low)
These should be taken in the AM
Report weight gain >2lbs in 24 hours
Caution pt about possible orthostatic hypotension- advise pts to get up slowly
When you push Lasix IV you have to push over 1-2 minutes as it can cause ototoxicity. NOT to exceed
20mg/min
Too rapid of a push can cause tinnitus and ototoxicity especially when combined with other
ototoxic drugs like gentamicin or vancomycin
Digoxin (Lanoxin)
Three effects on the heart muscle
Positive inotropic action (increase myocardial contraction, increase cardiac output)
Negat ive chronotropic action (decrease HR) to allow time for filling
University
Pharmacology for
professional Nursing
Exam 2 Midterm
Review
Exam 2 Pharmacology Review:
, Review asthma and meter dose inhalers
- MDI are used with a spacer usually albuterol – RESCUE.
- 1-2 puffs q 4 hours prn
- Wait 1 full minute in between puffs. Must inhale prior to activating device.
Why we use glucocorticoids in asthma
- The most effective drugs available for long term control of airway inflammation
- Decreased inflammation
- Reduces bronchial hyperreactivity.
- Decrease mucous in airway
How we manage asthma in an emergency situation
- DuoNeb – Albuterol and ipratropium bromide
o Inhaled SABA= albuterol
o Inhaled anticholinergic (bronchodilator)= ipratropium bromide
- IM or IV glucocorticoids= methylprednisolone (Solu-Medrol)
- Oxygen
How we treat and manage COPD
- MDI inhaler with spacer and dry powder inhaler (Advair-prophylaxis)
o Advair – must rinse mouth out after use to prevent oral thrush
- Rinse mouth after steroid inhaler use
- Rinse any equipment such as inhalers, after each use.
How we treat cough and cold in children
- Administer one medication at a time incase there is a reaction and give with fluids.
How we treat pts with ulcers
- H2 receptor antagonist
o Cimetidine- best if taken on an empty stomach.
o Antacids can decrease absorption of this med and should be administered at least 1 hour apart.
- PPI
o Omeprazole- usually taken short term 4-8 weeks and taken first thing in the AM
- Antiulcer Drugs
o Sucralfate – has no acid-neutralizing capacity and does not decrease acid secretions
Lasts 6 hours and usually taken 4x a day
Must take on an empty stomach at least 30 minutes to 2 hours from food or drugs
Can impede absorption of phenytoin, theophylline, digoxin, warfarin, cipro so must be taken at least 2 hours
apart.
- Antacids- calcium carbonate (TUMS) is the safest choice of antacid in pts with renal failure as it is not systemically absorbed.
Review cimetidine:
- (OTC solution or tablet)
- Best if taken on an empty stomach.
- Antacids can decrease absorption of cimetidine and should be administered at least 1 hour apart.
Review furosemide and digoxin and what we need to monitor
Loop Diuretics- in pts with CHF, gets rid of excess fluid which decrease pulmonary edema. Adverse effects are dehydration
and electrolytes depletion hyponatremia and hypokalemia.
Furosemide (Lasix)
These block reabsorption of sodium and chloride.
Act on the thick ascending loop of Henle to block reabsorption of sodium and chloride.
Most effective diuretics available and are very potent; can cause marked depletion of water and electrolytes.
Useful in pts with severe renal impairment (can promote diuresis even when GFR and renal blood flow are
low)
These should be taken in the AM
Report weight gain >2lbs in 24 hours
Caution pt about possible orthostatic hypotension- advise pts to get up slowly
When you push Lasix IV you have to push over 1-2 minutes as it can cause ototoxicity. NOT to exceed
20mg/min
Too rapid of a push can cause tinnitus and ototoxicity especially when combined with other
ototoxic drugs like gentamicin or vancomycin
Digoxin (Lanoxin)
Three effects on the heart muscle
Positive inotropic action (increase myocardial contraction, increase cardiac output)
Negat ive chronotropic action (decrease HR) to allow time for filling
