Pharmacology Bundle Notes

Pharmacology Bundle Notes

Table of Contents

• Antibiotics
• Cardiac Medications
• Endocrine Medications
• Medications For Infection
• Drug Card
• Therapeutic drug levels
• Respiratory Medications
• Nursing Process Related to Respiratory Medications
• Psychiatric Medication A to Z
• Musculoskeletal Meds
• Vitamins
• Drug Suffix, Prefix and Root
• Pain Medications
• Mood Stabilizing Medications
• Medication Administration
• Drug Delivery to the Cardiovascular System
• Antidepressants
• Principles of Ethics for Nurses
• Drug Dosage Calculations
• Cancer Medications
• Immunosuppressant Medications
• Alcohol Withdrawal Medications
• Antivirals
• Chemotherapy Medication
• Antianxiety Medications
• Tuberculosis Medication
• Pregnancy Of Medications
• ADHD Medications
• Renal & Urinary Medications
• AIDS Medication
• Antifungals Medications
• Bronchodilators Medication
• Oncology Medications
• Trauma Medications
• Neuro Medications
• Insulin
• Diuretics
• Spasmolytics

Drug Suffixes Cheat Sheet

• Suffixes are placed at the end of a word after the stem.
• Commonly used to group drugs based on action.

Prefix, Root, and Suffix

• Generic names often follow patterns with prefixes, roots, and suffixes indicating the medication class.

Antibiotics

• Treat bacterial infections; do not work on viruses.
• Alexander Fleming discovered penicillin in 1928.
• Overuse leads to antibiotic resistance.

Types of Antibiotics

• Penicillins: amoxicillin (Amoxil)
• Macrolides: azithromycin (Zithromax)
• Cephalosporins: cephalexin (Keflex)
• Fluoroquinolones: ciprofloxacin (Cipro)
• Lincosamides: clindamycin (Cleocin)

Side Effects

• Diarrhea
• Nausea
• Vomiting
• Rash
• Upset stomach
• Sensitivity to sunlight (tetracyclines)
• Allergy (rash, hives, swelling, coughing, wheezing, difficulty breathing)

Antibiotic Prophylaxis

• Preventive use:
  • Operations
  • Bites or wounds
  • High-risk health problems (spleen removal, chemotherapy)

When Antibiotics Are Needed

• Infections unlikely to clear without antibiotics.
• Infections that could infect others.
• Infections with risk of serious complications.

Missing a Dose

• Take the missed dose as soon as you remember, unless it's almost time for the next dose.

Pain Medications

• Manage chronic and other types of pain.
• Use the safest drugs at the lowest effective dose for the shortest time.

Over-the-Counter (OTC) Pain Relievers

• Acetaminophen (Tylenol)
• Nonsteroidal anti-inflammatory drugs (NSAIDs): ibuprofen, naproxen, diclofenac gel

Common OTC Pain Meds:

• Acetaminophen: Dulls pain receptors in the brain.
• NSAIDs: Lower prostaglandin production to reduce inflammation and pain; aspirin compounds (Excedrin), ibuprofen (Advil, Motrin), naproxen sodium (Aleve).
• Combination: Acetaminophen and aspirin.
• Topical: Creams, gels, sprays, or patches block pain receptors; may contain aspirin, lidocaine, capsaicin.

What OTC Pain Relievers Treat

• Lower fevers and ease pain:
  • Arthritis, bursitis, tendonitis
  • Back strains and sprains
  • Broken bones
  • Burns, sunburns
  • Colds, flu, ear infections
  • Headaches, migraines
  • Menstrual cramps (dysmenorrhea)
  • Muscle pain, neck pain
  • Surgeries and minor procedures
  • Toothaches

Prescription Pain Relievers

• Corticosteroids
• Opioids
• Antidepressants
• Anticonvulsants
• NSAIDs

What Prescription Pain Relievers Treat

• Alleviate pain:
  • Cancer
  • Fibromyalgia
  • Migraines
  • Nerve (neuropathic) pain (diabetes-related neuropathy)
  • Postoperative pain
  • Severe arthritis pain
  • Severe muscle pain, back pain
  • Traumatic injuries (broken bones, burns)

Types of Prescription Pain Relievers

• Antidepressants: Affect neurotransmitters in the brain for chronic pain and migraines; tricyclics (Elavil) and SNRIs (Effexor, Cymbalta) are used. SSRIs like Prozac may not relieve pain as well and may reduce the effectiveness of other pain meds.
• Anti-seizure medications: Interrupt pain messages to the brain for nerve pain and fibromyalgia; gabapentin (Gabarone), pregabalin (Lyrica).
• Muscle relaxers: Reduce pain by relaxing tight muscles and relieving spasms.
• Opioids: Change how the brain perceives pain. Rarely prescribed for chronic pain due to the addiction risk. Codeine, fentanyl, hydrocodone, morphine are examples.
• Steroids: Strong anti-inflammatory drugs (Prednisone) stop the body from making irritation and inflammation chemicals to treat migraines, severe arthritis, and back pain.
• Topical: Prescription-strength creams, gels, sprays, patches for muscle pain, arthritis, and fibromyalgia.

Psychiatric Medication A to Z

• List of psychiatric medications from A to Z.

Cardiac Medications

Sacubitril/valsartan

• First angiotensin receptor neprilysin inhibitor.
• Combines ARB (valsartan) and neprilysin inhibitor (sacubitril).
• Neprilysin: Breaks down sodium and water loss natriuretic peptides.
• Effects: Decreased intravascular volume and blood pressure, decreased preload and afterload.
• Indications: Reduce the risk of hospitalization and death in patients with chronic heart failure and reduced ejection fraction.
• Adverse effects: Dizziness, fatigue, cough, hypotension, and hyperkalemia.
• Nursing points: Sacubitril/valsartan should not be given with an ACE inhibitor.

ARBs

• Block the action of angiotensin II more directly than ACE inhibitors.
• Block angiotensin II receptors in blood vessels and adrenal glands; cause vasodilation to reduce preload and afterload and decrease aldosterone release.
• Nursing points: ARBs and ACE inhibitors shouldn't be used interchangeably. ACE inhibitors are preferred because they’re associated with a decrease in morbidity and mortality.
• Adverse effects: Well-tolerated, minimal side effects.

Beta-blockers

• Block adrenaline effects during stress.
• Prescribed for: Angina, Heart attack, Congestive heart failure, and Abnormal heart rhythms.
• Adjust dosage for desired response.
• Adverse effects: Fluid retention, fatigue, bradycardia, and hypotension.
• Examples: Bisoprolol, carvedilol, sustained-release metoprolol.
• Nursing points:
  • Fluid retention may worsen heart failure but can usually be managed with diuretics.
  • If bradycardia or hypotension are problematic, the provider may reduce the beta blocker dose.
  • Shouldn’t be administered at the same time as ACE inhibitors

ACE Inhibitors

• Cause vasodilation, decreasing preload and afterload, increasing blood flow and ejection fraction.
• Block the enzyme needed to convert angiotensin I to angiotensin II, which is a vasoconstrictor.
• Adverse effects: Hyperkalemia, renal failure, dry cough associated with increased bradykinin.
• If the cough is intolerable, switch to ARB.
• Nursing points: Although the cough can be annoying, explain to the patient that it’s a side effect of the medication and encourage him or her to continue its use.

Ivabradine

• SA-node modulator, decreases normal SA node activity and lowers heart rate; doesn't affect myocardial contractility.
• Adverse effects: Bradycardia and hypotension.
• Nursing points: Administer ivabradine as ordered if a patient’s heart rate is ≥ 70 bpm.

Diuretics

• Help the body get rid of excess fluid and sodium; reduces the workload of the heart, decreases fluid buildup in the lungs and elsewhere in the body.
• Prescribed to lower blood pressure and reduce swelling.
• Examples: amiloride, chlorothiazide, Lasix, Lozol, and Aldactone.
• Adverse effects: Electrolyte loss.
• Nursing points:
  • Instruct patients to decrease their dietary intake of sodium.
  • Weigh themselves daily.
  • Take the diuretic early in the day to prevent nocturia.
  • Hypokalemia is a side effect of loop diuretics; monitor patients’ serum potassium levels.
• Examples: Furosemide, bumetanide, and torsemide.

Hydralazine/isosorbide dinitrate

• Combined pill to reduce cardiac preload and afterload through vasodilation.
• Adverse effects: Headache, dizziness, and orthostatic hypotension.
• Nursing points: Advise patients to change position slowly to prevent falls due to postural changes in blood pressure.
• Indications: decreases deaths and hospitalization in African Americans because of endothelium differences.

Endocrine Medications

Diabetic Agents

Hormone Agonists

Hormone Antagonists

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Medications For Infection

• Penicillin: treats a wide range of infections.
• Cephalosporin: Treats a bacterial infections from gram-positive and gram-negative bacteria.
• Tetracycline: Treats bacterial infections.
• Carbapenems: Treats complicated bacterial infections.
• Macrolides: Treats pneumonias.
• Lincosamides: Treats infections caused by Gram-positive bacteria.
• Antivirals: Medication that fights of certain viruses.
• Antiprotozoal: Treat infections caused by protozoa, single-cell organisms that are parasites.
• Antifungal: Treats Fungal infections for skin, hair, and nails.
• Topical Antibacterials: Treats superficial pyodermas, or treatment or prevention of infections following minor cuts.
• Antitubercular: Treats tuberculosis.
• Aminoglycoside: Antibiotic used in treatment in severe infection abdominal/urinary tract.
• Sulfonamide: Broad-spectrum treatment for human and animal bacterial infections.

Drug Card

Drug Class

• Generic Name
• Brand Name
• Dosage
• Indications
• Mechanisms of Action
• Adverse Effects
• Contraindications
• Interactions
• Nursing Considerations
• Patient Education

Therapeutic Drug Levels

• Lab tests to look for the amount of a drug in the blood.

How the Test is Performed

• A blood sample is needed.
• Blood is drawn from a vein.

How to Prepare for the Test

• Change the times you're taking any of your medicine.
• Do NOT stop or change your medicines unless directed by your provider.

Why the Test is Performed

• Some medicines are harmful if the level rises too high or do not work if the levels are too low.
• Monitoring makes sure the drug levels are in the proper range.

Drug level testing is done for people

• Flecainide, procainamide or digoxin, which are used to treat abnormal beating of the heart
• Lithium, used to treat bipolar disorder
• Phenytoin or valproic acid, which are used to treat seizures or other conditions
• Gentamicin or amikacin, which are antibiotics used to treat infections
• Tacrolimus, sirolimus or cyclosporine, which are used to suppress immune system activity against transplanted organs