PHARMACOLOGY

📚 NURSING PHARMACOLOGY — COMPLETE DRUG CLASS NOTES (WITH DEFINITIONS)

1. ACE INHIBITORS (“-PRIL”)

Examples: Lisinopril, Enalapril

Purpose: Treat high blood pressure & heart failure

Key Terms

  • Vasoconstriction: Blood vessels tightening → ↑ BP

  • Vasodilation: Blood vessels relaxing → ↓ BP

  • Angioedema: Sudden swelling of lips, face, throat (emergency)

  • Hyperkalemia: High potassium level

How They Work

Block ACE enzyme → prevents vasoconstriction → lowers BP

Side Effects

  • Dry cough

  • Hyperkalemia

  • Angioedema (life-threatening swelling)

Nursing Considerations

  • Check BP & potassium

  • Avoid in pregnancy

  • Tell patient to rise slowly (orthostatic hypotension = BP drops when standing)

2. ARBs (“-SARTAN”)

Examples: Losartan, Valsartan

Purpose: Lowers BP (ACE alternative)

Key Terms

  • Receptor blocker: Prevents a hormone from attaching and causing an effect

  • Hypotension: Low blood pressure

Side Effects

  • Hyperkalemia

  • Hypotension

  • No cough (good for ACE-intolerant pts)

Nursing

  • Check BP & K+

  • Watch kidney labs (creatinine)

3. BETA BLOCKERS (“-OLOL”)

Examples: Metoprolol, Propranolol

Purpose: Slow the heart → lower BP

Key Terms

  • Bradycardia: HR < 60

  • Bronchoconstriction: Tightening of airway (dangerous in asthma)

  • Cardiac workload: How hard the heart has to pump

Side Effects

  • Bradycardia

  • Fatigue

  • Worsens asthma (non-selective BBs)

Nursing

  • Hold if HR < 60

  • Avoid in asthma/COPD

  • Monitor BP & HR

4. CALCIUM CHANNEL BLOCKERS (“-PINE,” Diltiazem, Verapamil)

Examples: Amlodipine, Nifedipine

Purpose: Relax blood vessels and slow the heart

Key Terms

  • Edema: Swelling (usually ankles/feet)

  • Constipation: Hard stools

  • Conduction: How fast the electrical signal moves through the heart

Side Effects

  • Edema

  • Hypotension

  • Constipation (verapamil)

Nursing

  • No grapefruit juice (increases drug level)

  • Monitor BP

  • Watch for swelling

5. DIURETICS (“Water Pills”)

Loop Diuretics (“-IDE”)

Examples: Furosemide, Bumetanide

Purpose: Remove excess fluid → lower BP & reduce swelling

Key Terms

  • Ototoxicity: Damage to the ears/hearing

  • Hypokalemia: Low potassium

Side Effects

  • Hypokalemia

  • Dehydration

  • Hearing issues (high doses)

Nursing

  • Daily weights

  • Monitor electrolytes (K+, Na+)

Thiazide Diuretics

Example: Hydrochlorothiazide

Side Effects:

  • Hypokalemia

  • Hyperglycemia (high sugar)

Potassium-Sparing Diuretics

Example: Spironolactone

Side Effect: Hyperkalemia

Teach: Avoid salt substitutes (they contain potassium)

6. DIGOXIN

Purpose: Strengthens heart contraction & slows HR

Used in heart failure + Afib

Key Terms

  • Contractility: Strength of heart beat

  • Toxicity: When drug level becomes dangerous

  • Apical pulse: Pulse at the heart’s apex (under left breast)

Signs of Toxicity

  • Yellow/green vision (classic sign)

  • Nausea/vomiting

  • Confusion

Nursing

  • Check apical pulse for 1 full minute

  • Hold if HR < 60

  • Low potassium increases toxicity risk

7. BLOOD THINNERS (Anticoagulants & Antiplatelets)

Heparin

Purpose: Prevents clots

Tests: aPTT

Antidote: Protamine sulfate

Terms

  • Anticoagulant: Prevents blood clots

  • Antidote: Drug that reverses another drug

Warfarin

Purpose: Long-term blood thinner

Test: INR (goal 2–3)

Antidote: Vitamin K

Teach

  • Avoid leafy greens OR keep intake consistent

Antiplatelets

Examples: Aspirin, Clopidogrel

Purpose: Prevent platelets from sticking together

Risk: Bleeding

8. INSULIN

Terms

  • Onset: When drug starts working

  • Peak: When it works strongest (BIGGEST hypoglycemia risk)

  • Duration: How long it lasts

Types

  • Rapid: Lispro (onset 15 min)

  • Short: Regular (30–60 min)

  • Intermediate: NPH (cloudy)

  • Long: Glargine (no peak, 24 hr)

Nursing

  • Rotate injection sites

  • Monitor for hypoglycemia (shaky, sweaty, confused)

9. ORAL DIABETES MEDS

Metformin

Purpose: Reduces glucose production

Key Terms

  • Lactic acidosis: Rare but dangerous buildup of acid in the blood

Teach

  • Hold before contrast dye

  • GI upset common

Sulfonylureas (“-IDE”)

Examples: Glyburide, Glipizide

Risk: Hypoglycemia

Teach: Eat with meals

10. OPIOIDS (Pain Meds)

Examples: Morphine, Hydromorphone, Oxycodone

Terms

  • Respiratory depression: Slow breathing (life-threatening)

  • Narcan (Naloxone): Reversal agent

Side Effects

  • Sedation

  • Constipation

  • Respiratory depression

Nursing

  • Monitor RR (hold if < 12)

  • Give stool softeners

  • Keep naloxone nearby

11. ANTIBIOTICS

Penicillins (“-CILLIN”)

Watch for allergies

Cephalosporins (“Cef- / Ceph-”)

Cross-react with penicillin allergies

Macrolides (“-THROMYCIN”)

Side effect: GI upset

Tetracyclines (“-CYCLINE”)

  • Avoid in pregnancy

  • Avoid dairy

  • Causes photosensitivity (sunburn)

Aminoglycosides (“-MYCIN”)

  • Nephrotoxicity (kidneys)

  • Ototoxicity (ears)

12. ANTIDEPRESSANTS

SSRIs (“-INE” / “-PRAM”)

Examples: Sertraline, Fluoxetine

Side effects: Weight gain, sexual dysfunction

Risk: Serotonin syndrome

(Sweaty, hot, rigid, confusion)

TCAs

Examples: Amitriptyline

Side effects: Sedation, orthostatic hypotension

MAOIs

Avoid tyramine foods → hypertensive crisis

(Aged cheese, wine, processed meats)

13. BENZODIAZEPINES (“-PAM / -LAM”)

Examples: Lorazepam, Alprazolam

Purpose: Anxiety, seizures

Risk: Respiratory depression

Antidote: Flumazenil

14. STEROIDS (“-SONE”)

Examples: Prednisone

Side effects:

  • High sugar

  • Weight gain

  • Immune suppression

  • Mood changes

Teach: Do NOT stop abruptly → adrenal crisis

15. THYROID MEDS

Levothyroxine

Purpose: Hypothyroidism

Teach:

  • Take in the morning on empty stomach

  • Takes weeks to work