Exam I Pharm

lidocaine

anesthisic

topical for local anethesia

local anesthetic

dantrolene

skeletal muscle relaxer

prevents/treats malignment hyperthermia

reduce muscle spasisity

side effects: HF (can hear this and have swelling in extremities), muscle weakness, diarrhea, anaphylaxis, hepatotoxicity

assess: vitals, muscle weakness before walking, cardiac monitor

patient teaching: explain purpose, report muscle weakness, lightheadedness, grip strength

midazolam

benzodiazepines/ antianxiety

produce generalized cns depression.

used for short term sedation/anxiety pre or during operation

side effects: arrythmias, cardiac arrest, phlebitis(infiltrates) at iv site, suicidal thoughts, apnea, laryngospasm, respiratory depression, amnesia

assess level of sedation and consciousness for 2-6 hours after administration, monitor iv site, telemetry or ecg, rr, bp

education: might be forgetful of procedure/decreased mental recall, drowsiness, avoid driving

can be reversed with flumazenil

morphine

opioid analgesics

for severe pain

binds to opiate receptors in the cns and alters the perception of painful stimuli while producing generalized cns depression

side effects: hypotension, confusion, respiratory depression, sedation, constipation

assess: pain location and level, bp, hr, rr, bowel function

naloxone is the antidote to reverse respiratory depression or coma

should be discontinued gradually after long term use to prevent withdrawal symptoms

can be administered with food or milk to minimize GI upset

naloxone

opioid antagonists

block the effects of opioids including cns and respiratory depression, without producing any agonist effects

side effects: hypertension, hypotension, ventricular arrythmia, nausea, vomiting

intranasal side effect: musculoskeletal pain, headache, abdominal pain, edema, inflammation

monitor: rr, rhythm, and depth, hr, ecg(due to arrythmias), bp, level on consciousness, pain

additional doses cna be given every 2-3 min in alternating nostrils

ondansetron (zofran)

antiemetic

prevents nausea and vomiting

can be given postop

blocks serotonin H3 receptor sites

side effects: serotonin syndrome (shaking, tremors, flushing, hot, irritability, tachycardia), cardiac arrythmias, QT interval prolongation, constipation,

nursing considerations: promote fluids and stool softeners

patient teaching: report involuntary movements, irregular heart beat, constipation/abdominal cramping

tramadol

transition

side effects: sedation

ketorolac

transition

side effects: bleeding

diphenhydramine

famotidine

Histamine 2 agaonist

can give for ulcers and reflux

high risk for GI bleeds

pantoprazole

antiulcer/ protone pump inhibitor

reduces acid secretion

side effect: C diff/foul smelling stools, more at risk for bleeding

manages GERD in young children

take before breakfast

for ulcers and reflux

DONT CRUSH

sucralfate

take before each meal

peptic ulcer disease ONLY

fluoxetine

SSRI(selective serotonin reuptake inhibitor)- boosts mood

depression, anxiety, helps with eating disorders

side effects- suicidal ideation, worsen depression, diaphoresis, serotonin syndrome(tachycardia, hyperreflexia, seizures, coma, agitation)—> NMS- comes after serotonin syndrome(no diaphoresis, rigid, no murmurs, clear lungs)

take in the morning since it may cause insomnia

takes 2-3 weeks after taking consistently to start to take effect

cant take when pregenant

celecoxib

NSAID that is better for stomach with peptic ulcer disease