PHARMACOLOGY EXAM 2 NOTES

rescue inhaler medication for asthma patient

albuterol

low dose inhaled corticosteroid as a controller medication for asthma patient

fluticasone

moderate asthma medication treatment plan

combining the inhaled steroid with a longer acting bronchodilator or increasing the steroid doseto achieve better control of symptoms and reduce exacerbations.

ex medication NAME for moderate asthma patient

salmeterol

what is ICS and what is an example med

inhaled corticosteroid: it reduces inflammation and is a maintenance medication. it is a low dose and used for starting/ mild asthma

EX MED: flutiasone

what is LABA and what is an example med

long acting beta-2 agonist: it is a bronchodilator that lasts 12+ hours, it is a maintenance medication

EX MED: salmeterol

TRUE OR FALSE: LABA medications can be used on their own

FALSE: never use LABA alone in asthma, ALWAYS COMBINE with ICS

what is SABA and what is an example med

short acting beta-2 agonist: fast acting and is used during attacks

EX MED: albuterol

when treating a patient with cystic fibrosis, what are the three challenges you have to note of to treat

the mucus, the digestion, and the genetic defect itself

what are the medicines that thin the mucus out making it easier for CF patients to cough up

mucolytics

example mucolytics

dornase alfa, and acetylcysteine

explain the digestion issue when it comes to cystic fibrosis patients

the pancreas is not making enzymes it should so the patient takes capsules with meals that contain those enzymes

what are the medications that help CF patients digestion called and what is an example

pancreatic enzyme replacements

EX: pancrelipase

what are the medicines that help fix the faulty chloride channels in certain types of cystic fibrosis and what are some examples

CFTR modulators

EX MEDS: ivacaftor and trikafta

patient education for a patient using a steroid inhaler

to rinse their mouth because it can cause oral thrush

when should mucolytics be administered

before chest physiotherapy so the loosened mucus can be cleared

when should enzymes be taken

with meals or snacks

what should CFTR modulators be taken with

fatty foods

what should be monitored while a patient is on CFTR modulators

liver function

top 3 medications for asthma, COPD, and cystic fibrosis

• corticosteroids'

• mucolytics

• bronchodilators

these medications help open up the airways by relaxing the muscles around them

bronchodilators

these are all about calming inflammation —> think anti inflammatory cream for your airways

corticosteroids

these medications break up mucus so it’s easier to cough up

mucolytics

what is the function of the stomach

produces acid and enzymes to break down food

what is the function of intestines

to absorb the nutrients and push everything along using muscle contractions called peristalsis

what medication is the strongest tool to turn off stomach acid

PPI’s

what is a PPI and how does it work

a proton pump inhibitor works by shutting off the final step in acid production in the stomach

when are PPI’s used

• patients with frequent heartburn

• stomach ulcers

• patient that needs protection from medication that irritate stomach lining

when should PPI’s be taken

before meals (ideally in the morning, 30 min before breakfast)

what are the nursing consideration for long term PPI use

monitor patient because without re- evaluation, it can lead to:

• B12 deficiency

• higher risk of bone fractures

• low magnesium

what is the common suffix for PPI

-prazole

these medications block histamine receptors in the stomach that trigger acid release

H2 blockers

what are H2 blockers used for

for milder symptoms or as a supplement to PPI’s

what are the nursing considerations for H2 blockers

• take with meals or before bed

• be mindful of kidney function in older adults

these medications are a quick- fix option for stomach acid

antacids

how do antacids work

they do not stop acid production, instead they neutralize the acid that is already there

what are antacids used for

occasional heartburn (especially after meals)

what are the nursing considerations for antacids

• they do not last long

• they can interfere with other medications, so space them out from other drugs

• they need to be taken after meals

what medication do we use when we want to protect the stomach directly

sucralfate and misoprostol

how do sucralfate work

acts like a protective bandage that covers ulvers and keeps acid from making them worse

what are the nursing considerations for sucralfate

• it needs to be taken on an empty stomach (1 hour before a meal or 2 hours after a meal)

• it needs to be kept away from other medications because it can block their absorption

how does misoprostol work

it helps boost the stomach’s mucus defenses and lowers acid output

what is the nursing consideration for misoprostol

NEVER GIVE DURING PREGNANCY, it can lead to a miscarriage or early labor

antiemetics are used when

someone feels nauseated or is vomiting (can be used for nausea related to surgery, chemotherapy, or motion sickness)

what does ondansetron block and what type of medication class is it

serotonin ; antiemetics

what does promethazine block and what type of medication class is it

dopamine ; antiemetics

what are the nursing considerations for antiemetics

• monitor for drowsiness or dizziness

• monitor for extrapyramidal symptoms (like muscle rigidity, tremors, or restlessness)

what can promethazine do in children under two

suppress breathing

how does blocking serotonin help nausea

when the gut is irritated, serotonin is activated and sends a message to the brain telling it to throw up but when serotonin is blocked (5-HT3 receptors), then that message never gets sent

how does blocking dopamine help with nausea

dopamine triggers the brains chemoreceptor trigger zone (CTZ) and so when dopamine is blocked, CTZ does not get activated and so nausea stops

how does osmotic laxative work and whats an example

it pulls water into the stool, making it softer. an example is miralax

how does a stimulant laxative work and whats an example

it nudges the intestinal mucus to contract. an example is bisacodyl

how does bulk- forming laxatives work and whats an example

it gives the stool more structure to move naturally through the bowel. an example is added fiber

what can laxatives cause

• cramping

• diarrhea

• dehydration

• make the bowel lazy

whats the risk with peripheral opioid antagonist laxative and how does it work

there is a chance of triggering withdrawal symptoms like chills or anxiety. it works by helping constipation caused by opioids

what does sulfonulureas do and what type of medication is it

it pushes the pancreas to make more insulin and it is an endocrine medication

what does metformin do and what type of medication is it

it helps the body use insulin better and stop the liver from releasing so much sugar, and it is an endocrine medication

what is raloxlfene called and what does it do

they are called estrogen receptor modulators. in some parts of the body, they act like estrogen and in others, they block it

what does clomiphene help with

they can help when someone is trying to become pregnant but is not ovulating, this can gently nudge the ovaries into action

what does oxytocin help with

trigger contractions

what does mifepristone help with

when pregnancy needs to be ended for medical or personal reasons, this medication helps to do safely

what does anabolic steroids help with

can help people with low testosterone or muscle loss

what does sildenafil help with

can help with erectile dysfunction by increasing blood flow where it is needed the most

what can happen if you give too much levothyroxine

it can cause a fast heart rate and anxiety

what can happen if you give too little levothyroxine

it can lead to fatigue and weight gain

steroids can increase the risk of what

infection

what is the nursing consideration when it comes to steroid medications

it must not be stopped immediately to avoid adrenal emergencies

what is a normal glucose level

70-99 mg/dL

what glucose level is considered critical

500+

what three hormone meds come with higher risk

1. insulin

2. corticosteroids (prednisone, hydrocortisone)

3. thyroid hormones (levothyroxine)

how does metoclopramide work

by facilitating gastric emptying

what can metoclopramide cause

tardive dyskinesia

what is atherosclerosis (the pipe analogy)

think of it like rust and buildup clogging a pipe over years until water can barely get through

what is the best medication to help reduce the risk of heart attacks and strokes by blocking cholesterol production in the liver

statins

what is the bad cholesterol

LDL

what is the good cholesterol

HDL

this cholesterol is sticky and clings to artery walls, building plaques

LDL

this cholesterol is like the clean- up crew sweeping LDL out of circulation

HDL

this is another form of fat in the blood and is often linked to diabetes and obesity

triglycerides

how do statins work

1. it blocks HMG-CoA reductase —> liver slows down cholesterol production

2. LDL drops —> less material available to build new plaque

3. the existing plaque becomes more stable —> less likely to rupture and cause a clot/ heart attack

the goal of high intensity statins

cut LDL by at least 50%

the goal of moderate intensity statins

cut LDL by about a third (30-50%)

what are the nursing considerations for statins

• check liver enzymes before and during treatment

• monitor for muscle pain and dark urine

• educate patients on lifestyle changes like diet and exercise

• no grapefruit juice with statins

what do creatine kinase levels help detect while a patient is taking a statin medication

muscle damage

if a patient has high CK levels and the patient has muscle pain or weakness, what complication are we looking at

rhabdomyolsis

what time of day should a patient take their statin

nighttime

ASCVD risk calculator helps estimate the risk of

a patient having a stroke or heart attack in the future

(6) interventions for chest pain with suspection of heart attack

1. give aspirin to stop platelets from clumping

2. check oxygen levels

3. only give oxygen if theyre under 90%

4. place patient on monitor

5. prepare to give nitroglycerin (if the blood pressure is safe)

6. ensure a statin is ordered within the first 24 hours

(4) interventions for heart failure

1. FIRST MOVE: sit the patient upright

2. give oxygen if needed

3. administer diuretics to remove the extra fluid

4. track daily weights

what is happening with heart failure

the heart is weak, fluid builds back up and the patient struggles to breathe

why do you track daily weight in a heart failure patient

because a sudden jump can signal fluid overload

what is going on in atrial fibrillation

the heart beats chaotically fast

what medications help with atrial fibrillation

beta blocks and calcium channel blockers

how can peripheral arterial disease improve

smoking cessation, regular walking, foot care, statin therapy

what does venous thromboembolism prevention rely on

anticoagulants, leg elevation, and keeping the patients moving

if your patient on atorvastatin reports leg cramps and tea- colored urine, what would you do

STOP the drug and notify the provider

(sign of muscle breakdown)

other name for water pills

diuretics

what do diuretics do

helps the body get rid of extra salt and water by increasing how much you pee

what are the two nursing considerations for a patient on diuretics and why are they important

1. keep an eye on hydration levels because since the patient has increased urine output it can lead to dehydration

2. keep an eye on electrolyte levels because some diuretics lower potassium too much causing muscle cramps and dangerous heart rhythms ; other diuretics (called potassium- sparing diuretics) can cause potassium build up

common side effect of antihypertensives

orthostatic hypotension