Pharmacology Practice Bootcamp

Purpose of heparin

prevent venous thromboembolism (VTE), low molecular Factor Xa and thrombin inhibitor.

What is heparin induced thrombocytopenia 9HIT)

Heparin toxicity which causes sever thrombocytopenia, hold if patients platelet levels fall < 150,000 × 10³ or reducation of platelet levels > than or equal to 50%.

What is prednisone used for?

It is a steroid given to decrease inflammation (ex: asthma). May increases WBCs as a side effect.

What is albuterol?

A bronchodilator used as a rescue med for clients with asthma. Tachycardia is a side effect.

Transdermal Contraception

Patch that releases hormones to prevent pregnancy by preventing ovulation and decreasing chances of implantation or sperm from entering uterus.

What teaching should be included for transdermal contraception applicatoin?

New patch should be applied each week for 3 consecutive weeks. A patch will be removed and no worn on the 4th week to allow for menstruation.

What transdermal contraceptive patch teaching should be included?

apply to clean dry intact skin; avoid breast

use backup contraception if off for > than 24 hours

Use of patch increases risk of blood clots (d/t increased estrogen lvls)

Ompeprazole

PPI (ex: pantoprazole), inhibit hydrochloric acid pumps on parietal cells in stomach decreasing acidity in the stomach to protect from ulcers.

Side effects to look out for with PPI

Decreased acidity may impair absorption of magnesium and calcium. Muscle spasms may indicate possible hypomagnesemia.

When administering vaginal suppositories, what should you do?

Have client void before insertion

position the client supine with legs rotated outward

Use water based lubricant before inserting the suppository as far as possible into the vagina (do not use oil based lubricant as it can clog vaginal glands and increase infection risk)

Insert suppository 3-4 inches or as far as possible into vagina

What is Gout?

connective tissues caused by inability to catabolize purine, resulting in uric acid deposits in joints, particularly hands and feet.

Can you use colchicine with statins?

No, Colchicine (antigout med that inhibits movement of WBCs to the joints and controls inflammatory response to urate crystals. Interacts with HMG-CoA reductase inhibitors like atorvastatin and simvastatin. Statins and colchicine increase risk of myopathy leading to rhabdomyolysis.

What is nitrofuratoin?

Antibiotic used to treat UTI. Complete full course of ABx regardless of symptom improvement. Can cause irreversible nerve degeneration (s/s include tingling, muscle weakness, or numbness) → report IMMEDIATELY, take with food to minimize GI side effects (ex: N/V/D)

What side effects does nitrofurantoin cause?

Can cause serious pulmonary reactions resulting in permanent lung damage. Symptoms of cough, fever, or chest pain should be reported IMMEDIATELY.

What is desmopressin?

AKA vaospressin, synthetic from of ADH to treat DI.

What is diabetes insipidus?

occurs when kidneys cannot conerve water due to lack of ADH causing polyruia and dehydration.

Side effects of desmporession?

water intoxication

hyponatremia → lead to headache, N/V, and muscle cramps; severe cases result in altered mental status, seizures, or coma

Nasal congestion may occur but this is a benign side effect

What are appropriate teachings for topical hydrocortisone application?

Apply in thin layer and rub in completely.

Remain uncovered to decreased localized and systemic side effects

Should be use short term once or twice daily

Do not apply to skin on face, acillae, or perineum because it can increase skin changes and inadvertent contact with mucous membranes which can cause systemic absorption

What type of med is benzoyl peroxide and tretinoin?

Topical acne meds.

What teaching should be included for topical acne medications?

Sunscreen is essential for skin protection d/t increased risk for sunburn

peeling and dryness are expected, but burning and redness can indicate oversure (you can apply moisturizers to help dryness and peeling)

tretinoin is inactivated by light so it should be applied at night

What are some s/s of hypokalemia? (side effect from thiazide and loop diuretics)

Musculoskeletal weakness

muscle contractions

weak and thready pulse

shallow breathing

When administering eye meds for conjunctivitis, the nurse should?

Apply ointment from inner to outer canthus

rest hand holding eye dropper against clients head

occlude the lacrimal duct for one minute after drop administration

What is lamotrigine?

Anticonvulsant medication, manages seizures and bipolar disorder; watch for steven johnson syndrome → widespread rash blisters, and peeling of the skin resulting in detachment of top later of skin from the layers below.

Common SE: N/V, double vision, headaches

Filgrastim

stimulates WBC production for clients receiving chemo

Leucovorin

Administered to protect healthy cells from effects of high dose methotrexate chemo (methotrexate act against rapidly dividing cells)

Trazadone

SARI developed for antidepressant, may be used for managing insomnia

SE of trazodone

Priapism (painful and prolonged erection) → last >4 HRS requires immediate intervention to prevent long term damage

What teaching should be included for taking allopurinol:

Take med with meals (minimize N/V/D)

drink 3 liters of fluid daily (decreases uric acid kidney stone formation)

avoid alcohol (contained purines and triggers gout attack)

May be combined with ibuprofen

Diarrhea is a common AE

If rash develop, discontinue IMMEDIATELY