Pharmacology All Semester Review

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Glipizide SE

Hypoglycemia

Metronidazole Interaction

Disulfiram reaction with alcohol

Levofloxacin SE

Tendon rupture (disrupts extracellular matrix of cartilage)

QT prolongations

Photosensitivity

Glipizide Interaction

Beta Blockers (masks signs of hypoglycemia)

Glipizide Nursing Considerations

Check blood glucose prior to administration

Repaglinide MOA

stimulate release of insulin

Repaglinide Interaction

Beta Blockers

Pioglitazone SE

Weight Gain

Worsening HF

both caused by fluid retention

Exenatide MOA

Slows gastric emptying

Stimulates the release of insulin

Cholestyramine MOA

Reduces LDLs by eliminating bile acids and cholesterol in the feces

Cholestyramine SE

Constipation

Esophageal Obstruction

Gemfibrozil SE and interactions

Elevated INR with warfarin

Nicotinic Acid SE

skin flushing and itching

Rosuvastatin SE

Rhabdomyolysis (check for unexplained muscle weakness or pain)

Rosuvastatin Nursing Considerations

Nocturnal dosing preferred

Monitor creatinine (you are monitoring for Rhabdo)

Dysrhythmia vs Arrhythmia

Dysrhythmia = disturbance in heart rhythm

Arrhythmia = absence of heart rhythm

Lidocaine Indication

PVCs

VT

VF

Lidocaine MOA

Decreased automaticity

Lidocaine SE

hypotension

HB

Lidocaine Interaction

Beta Blockers

Propranolol Indication

atrial and ventricular tachydysrhythmias

HTN

fine hand tremors

Propranolol SE

Hypotension

Bradycardia

Propranolol Contraindications/Precautions

DM

HB

Sinus bradycardia

Chronic lung diseases (asthma and COPD)

Propranolol Interactions

Other antihypertensives

Digoxin

Amiodarone Indication

Atrial and ventricular dysrhythmias

Amiodarone SE

Gray discoloration of skin

Vision Loss

Extended ½ life, which causes pulmonary toxicity (fibrosis)

Photosensitivity

Amiodarone Contraindication

Chronic Lung Disease

Diltiazem Indication

Atrial Dysrhythmias

A fib

A flutter

SVT

Diltiazem SE

Hypotension

Bradycardia

Diltiazem Interactions

Digoxin

Other antihypertensives

Metoprolol MOA

Selectively block beta 1 receptor sites

Metoprolol SE

Hypotension (orthostatic and baseline)

Bradycardia

Bronchospasms

Metoprolol Precaution/Contraindications

DM

Bradycardic rhythms

HB

Younger than 6

Metoprolol Interactions

Other antihypertensives

Digoxin

Doxazosin SE

Orthostatic Hypotension (give first dose at night)

Doxazosin Contraindication

Hypotension

Doxazosin Interactions

Sildenafil

ACEs ending

-pril

ARBs ending

-artan

ACE/ARB SE

Hypotension

Hyperkalemia

Fetal Harm (oligohydramnios)

Angioedema (dry hacking cough in ACE and swollen oral cavity in ARB)

ACE/ARB Precaution/Contraindication

Renal impairment

HF

Hyperkalemia

Pregnancy

Nifedipine Indications

HTN

Vasomotor stablization

Nifedipine SE

Bradycardia

Peripheral Edema

Dizziness/HA

Digoxin MOA

Positive inotrope

Negative chronotrope

Digoxin SE

Bradycardia

Digoxin Interactions

Everything

Digoxin Nursing Interventions

Take a apical pulse (60 seconds)

Digoxin Antidote

Digibind

Nitroglycerine MOA

Atrial dilation at high doses

Nitroglycerine SE

HA

Orthostatic Hypotension

Reflex tachycardia

Tachyphylaxis (tolerance to med that requires you to take a drug holiday)

Nitroglycerine Contraindication

R MI

Nitroglycerine Interaction

Phosphodiesterase inhibitors

Ex. sildenafil (Viagra)

Furosemide Class

Loop diuretics

Furosemide MOA

Extensive diuresis

Furosemide SE

Electrolyte disturbances

Renal Failure

Ototoxicity

Hypotension

Furosemide Interactions

Digoxin

Hydrochlorothiazide Class

Thiazide Diuretic

Hydrochlorothiazide Use

HTN

Not diuresis

Hydrochlorothiazide MOA

Promote sodium, chloride, and water excretion

Hydrochlorothiazide SE

Electrolyte Disturbances

Orthostatic Hypotension

Hydrochlorothiazide Contraindications

Renal impairment/failure

Spironolactone MOA

Weakest diuretic

inhibits aldosterone in DCT and collecting ducts

Spironolactone Class

Potassium Sparing Diuretic

Spironolactone SE

Hyperkalemia

Spironolactone interactions

ACEs/ARBs

K increasing medication

Spironolactone Client Education

Avoid salt substitutes (NuSalt)

Mannitol Class

Osmotic Diuretic

Mannitol Precautions/Contraindications

Electrolyte Imbalances

HF

Renal Failure

Mannitol Indication

Increased ICP (used in ICU)

Formoterol Indication

long term control of asthma

Formoterol SE

Black box for paradoxical bronchospasm

Cromolyn Indication

Asthma (long term control)

Cromolyn SE

bronchospasm

Montelukast Administration

PO

Inhaled Fluticasone Indication

Maintenance therapy for COPD

Inhaled Fluticasone SE

thrush

Pharmacokinetics

how the body moves the drug

Pharmacodynamics

what the drug does to the body

Hypersensitivity Type I reaction

mast cell activation = histamine release

Trimethoprim/Sulfamethoxazole Contractindiation

Infants/pregnant/lactating

babes get kernicterus (bilirubin in brain)

indication for sub Q heparin

prevention of VTE

enoxaparin indication

tx and prevention of VTE

warfarin indication

DVT tx

warfarin monitoring lab

PT/INR

how to mix insulin

“Clear to cloudy”

R-N(ph)

insulin interactions

beta blockers

metformin MOA

increases sensitivity of receptor tissues

metformin SE

diarrhea

lactic acidosis

metformin interactions

iv contract medium

metformin contracindications

acutely ill

DKA

Liver/kidney insufficiency

lactic acidosis

glipizide moa

stimulate the release of insulin

ipratropium indictation

copd - decrease bronchoconstriction

diphenhydramine SE

anticholinergic

intranasal fluticasone indication

nasal congestion

more effective than other oral antihistamines with fewer side effects

intranasal fluticasone SE

nose bleeds

oral decongestant SE

stimulation

HTN

dextromethorphan contraindication

asthma (never use with asthma)

Guaifenesin nursing consideration

always give to patients with COPD

phenytoin indication

seizure maintenance therapy

Phenytoin therapeutic range

10-20 mcg/ml