Pharm ALTs exam 2

Tiotropium category class...

anticholinergic

Tiotropium therapeutic use...

For maintenance treatment of asthma and COPD, long term, including chronic bronchitis and emphysema

tiopropium pharmacological action...

competitively antagonistic at muscarinic receptor sites, causes smooth muscle relaxation, leading to bronchodilation

complications with tiotropium

increased hr

dilated pupils

decreased salivation

urinary retention

decreased sweat

decreased bronchial secretions

restlessness

irritability

disorientation

hallucinations

delirium

Tiotropium interactions

risk of increased adverse effects if combined with other anticholinergics

tiotropium contraindications

known drug allergy

angle-closure glaucoma

acute asthma or other respiratory disease

myasthenia gravis

acute cardiovascular instability

gi or gu tract obstruction

Tiotropium: Nursing Interventions

instruct pt of proper use of inhaler device

tiotropium med administration

powder inhalation (inhaler)

tiotropium client education

avoid getting powder in eyes

empty bladder before use if pt has a urinary retention problem

tiotropium evaluation of medication effectiveness

relief of long term, once daily maintenance treatment of bronchospasm associated with COPD

Clonidine category class...

central acting adrenergic alpha agonist

clonidine therapeutic use

hypertension, severe pain in cancer patients, ADHD in 6-17 yr

expected pharmacological action of clonidine

stimulates CNS alpha-adrenergic receptors, inhibits sympathetic cardioaccelerator and vasoconstrictor centers and decreases sympathetic outflow from CNS

clonidine medication administration

oral

extended release tablets

transdermal

epidural

Clonidine contraindications

hypersensitivity to clonidine, use cautiously with severe coronary insufficiency, revent MI, cerebrovascular disease, chronic renal failure, pregnancy, lactation

Complications of Clonidine

drownsiness, dizziness, headache, weakness, dry mouth, GI upset, dreams, nightmares

nursing interventions of clonidine

record VS

monitor IV site for infiltration

avoid cold medicines and diet pills

avoid continuous use of adrenergic nasal sprays

interactions with clonidine

anesthetic drugs

tricyclic antidepressants

MAOIs

antihistamines

thyroid preparation's

other adrenergic agonists

Client Education for clonidine

take drug exactly as prescribed

attempt to lower BP with lifestyle changes

evaluation of medication effectiveness for clonidine

relief of hypertension

pain relief in cancer patients

relief of adhd

clonazepam category class

anticonvulsant/benzodiazipines

clonazepam therapeutic use

prevents seizures and helps treat panic disorders

expected pharmacological action of clonazepam

presynaptic inhibition and sedative effects in CNS

clonazepam contraindications

pregnant women should not take this

complications of clonazepam

drownsiness

nausea

fatigue

rash

weight gain

behavior changes

suicidal thoughts

Interactions of Clonazepam

drug to drug: opioids, CNS depressants

medication administration of clonazepam

PO

tablets

capsules

Nursing Interventions for Clonazepam

observe seizure activity and ECG

monitor behavior changes

Evaluation of Medication Effectiveness for Clonazepam

decreases the amount of seizure activity and panic attacks

Client Education for Clonazepam

take as prescribed

notify primary health provider if complications interfere with daily life

cyclobenzaprine category class

skeletal muscle relaxant

Therapeutic use for Cyclobenzaprine

less muscle spasms and hyperactivity

expected pharmacological action of cyclobenzaprine

used to reduce the somatic muscle activity of brainstem

complications of cyclobenzaprine

nausea

dry mouth

fatigue

dizziness

blurred vision

stomach pain

loss of appetite

Medication Administration (Cyclobenzaprine)

PO

tablets and extended release tablets

Interactions of Cyclobenzaprine

drug to drug: CNS depressants, alcohol, antihistamines

Contraindications/Precautions of Cyclobenzaprine

SCD

conduction disturbances of the heart

hyperthyroidism

Nursing Interventions for Cyclobenzaprine

monitor ECG

monitor thyroid

assess range of motion

Client Education for Cyclobenzaprine

take as instructed and prescribed

avoid excessive alcohol intake

must wear this med off over one week

evaluation of medication effectiveness of cyclobenzaprine

reduction of muscular spasms

gabapentin category class

anticonvulsant (treat seizures)

therapeutic use of gabapentin

treatment of partial seizures

expected pharmacological action of gabapentin

enhances the activity of gaba

Gabapentin interactions

drug to drug: antacids, alcohol, losartan, phenytoin, morphine

Complications of Gabapentin

dizziness

drowsiness

weakness

confusion

hallucinations

mental depression

abnormal vision

tinnitus

dyspnea

chest pain

abdominal pain

gingivitis

alopecia

ataxia

allergic reactions

Contraindications for Gabapentin

avoid antacids

avoid alcohol and caffeine

Medication Administration of Gabapentin

po

capsule

tablet

extended release

liquid

intranasal

IV

Nursing Interventions for Gabapentin

assess and monitor location and duration of seizure activity

when discontinuing, do it gradually

Client Education for Gabapentin

take medication as directed

do not discontinue abruptly

do not drive until cleared by primary care

Evaluation of Medication Effectiveness for Gabapentin

decreased amount of seizures and intensity of seizures

Phenytoin category class

anticonvulsant/hydantoin

therapeutic use of phenytoin

prevention of tonic-clonic seizures and complex partial seizures

limits seizures

Nursing Interventions for Gabapentin

monitor ecg

CBC with differential

serum drug level

assess skin for rash and hypersensitivity syndrome

expected pharmacological action of phenytoin

alerts ion transport, and decreases synaptic transmission

Administration of Phenytoin

capsules

extended release

IV

Contraindications for phenytoin

avoid alcohol and other CNS depressants

Complications of Phenytoin

urine discoloration***(red)

ataxia

agitation

cerebral edema

dizziness

hypotension

constipation

diplopia tachycardia

interactions of phenytoin

drug to drug: alcohol, CNS depressants

Client Education for Phenytoin

take as directed

do not drive until physician has given clearance

floor and brush teeth carefully

maintain well-balanced diet

evaluation of medication effectiveness on phenytoin

if there is a decrease in amount of seizures and prevention of seizures

dextroamphetamine category class...

stimulant

therapeutic use of dextroamphetamine

treats attention deficit hyperactivity disorder(ADHD) and narcolepsy

expected pharmacological action of dextroamphetamine

prevents reuptake, stimulates reverse-transport of dopamine in synaptic cleft, causes release of norepinephrine from nerve endings

complications of dextroamphetamine

itching

rash

difficulty breathing

trouble swallowing

swelling of extremities

blurred vision

hallucinations

difficulty sleeping

HR abnormal

Contraindications of Dextroamphetamine

medication has high dependence and abuse potential, use with MAOI, avoid acidic juices

medication administration for dextroamphetamine

tablet PO (2-3 times a day, daily)

extended release tablet (once a day)

Nursing Interventions for Dextroamphetamine

assess dizziness

report balance problems

monitor HR

monitor weight

monitor BP

monitor respirations

interactions of dextroamphetamine

drug to drug: furazolidone, iproniazid, methylene blue, alcohol, tobacco

drug to medical problems: severe anxiety, glaucoma, CAD, drug abuse, HF, stroke

client education of dextroamphetamine

store at room temp

do not use if it is outdated

take the right route

report insomnia or palpitations

Evaluation of Dextroamphetamine Effectiveness

assess effectiveness of treatment of ADHD or narcolepsy with decreased symptoms.

Diazepam category class

antianxiety/sedative-hypnotic/bendodiazpine

Diazepam therapeutic use

treats anxiety, treats status epilepticus

expected pharmacological action of diazepam

produce anxiolytic effect, effects mediated by GABA

Diazepam Contraindications

avoid drinking grapefruit juice

avoid kava, valerian, and chamomile, can increase CNS depression

avoid use of alcohol

avoid other CNS depressants

Complications of Diazepam

dizziness

drowsiness

lethargy

confusion

headache

blurred vision

constipation

diarrhea

nausea

rashes

physical dependence

hangover effect

Medication Administration (Diazepam)

PO- tablets or liquid

IV

IM

Diazepam interactions

drug to drug- cimetidine, darunvair, idelalisib, many other CNS depressants, and alcohol

Grapefruit juice

Client Education for Diazepam

take med as directed

older adults may have higher hangover effect

Nursing interventions diazepam

assess degree of anxiety

monitor CBC with differential

monitor renal and liver failure

do not judge patient

Evaluation of Medication Effectiveness

Diazepam

if anxiety symptoms have decreased since the administration of this drug on a consistent timeline

alprazolam category class

seditive-hypnotic

therapeutic use of alprazolam

relief of anxiety

expected pharmacological action of alprazolam

acts at many levels in the cns to produce anxiolytic effect. may produce CNS depression

alprazolam interactions

drug to drug: opioids, cns depressants

anxiolytics, general anesthetics

drug to natural: kava-kava, valerian, chamomilecan

drug- food: grapefruit juice

Contraindications/Precautions

Alprazolam

cross sensitivity with other benzos

severe uncontrolled pain

angle-closure glaucoma

sleep apnea

lactation/pregnancy

Complications of Alprazolam

dizziness

drowsiness

lethargy

confusion

depression

blurred vision

constipation

nausea

weight gain

tolerance

Medication Administration of Alprazolam

only administered orally

Client Education on Alprazolam

take medication as directed

do not take more than prescribed

avoid grapefruit juice

avoid alcohol or cns depressants

Nursing Interventions for Alprazolam

assess degree of anxiety and mental status

watch for toxicity

assess for drowsiness

monitor CBC and liver/renal failure

assess cns effects

Evaluation of Medication Effectiveness for Alprazolam

decreased sense of anxiety without cns effects

decreased frequency and severity of panic attacks

decreased symptoms of premenstrual syndrome

Bupropion category class

norepinephrine dopamine reuptake inhibitor

expected pharmacological action for bupropion

decreases neuronal reuptake of dopamine in the cns

therapeutic use of bupropion

diminished depression

decreased craving for cigarettes

Complications of Bupropion

suicidal/homicidal thoughts/behaviors

agitation

headache

seizures

anxiety

paranoia

hyper/hypoglycemia

dry mouth

tremor

contraindications of bupropion

MAO drugs

concurrent use of ritonavir

seizure disorders

severe head injury

barbiturate

pregnancy/lactation

Medication Administration of Bupropion

this medication to be given orally

Interactions of Bupropion

drug to drug: mao inhibitors

linezolid

antidepressants

nicotine

beta blocker

Nursing Interventions for Bupropion

assess mental status and mood changes

monitor hepatic and renal function

false positive urine test for amphetamines

administer doses in equally spaced time

Client Education for Bupropion

take med at same time each day

suicidality

herbals

use sunscreen to prevent photosensitivity reaction

Evaluation of Medication Effectiveness for Bupropion

increased sense of well being

cessation of smoking