pharm part PART 3 Loop diuretics

Loop Diuretics (e.g., Lasix)
  - Key Points to Monitor:
    - Blood pressure
    - Potassium levels
    - Heart rate (not critical)
    - BUN and creatinine levels
    - I&Os (Input and Output)
  - Possible Side Effects:
    - Hypokalemia (low potassium)
    - Dehydration
  - Administering Lasix:
    - Administer slowly, typically at a rate of $10 ext{mg/min}$ .
Thiazide Diuretics (e.g., Hydrochlorothiazide)
  - Electrolyte Considerations:
    - Can lead to dehydration
    - Excretes potassium, which may lead to hypokalemia
    - Lowers blood pressure
Potassium-Sparing Diuretics (e.g., Spironolactone)
- Monitoring:
- Can lead to hyperkalemia (high potassium levels)
Osmotic Diuretics
  - Used in emergencies to treat:
    - Increased intracranial pressure (ICP)
    - Increased intraocular pressure

Schedule I: Highly addictive with no medical use
Schedule II: Has medical uses, potential for abuse
Examples of Antihypertensives:
  - Beta Blockers (e.g., Propranolol)
    - Mechanism of Action:
      - Blocks sympathetic nervous system effects, which can increase heart rate
      - Slows heart rate and dilates blood vessels
      - Lowers blood pressure and heart rate
    - Uses:
      - Anxiety management; antiarrhythmias (e.g., A fib)
  - Common Side Effects:
    - Drowsiness, fatigue, cold extremities

ACE Inhibitors (e.g., Lisinopril)
  - Adverse Effects:
    - Dry cough
    - Angioedema
Calcium Channel Blockers
  - Engages with myocardial contractility, leading to decreased blood pressure
  - Common Medications:
    - Amlodipine, Verapamil
Alpha/Beta Blockers (e.g., Carvedilol, Labetalol)
- Promote vasodilation

Statins
  - Common Side Effects: Rhabdomyolysis (muscle breakdown)
  - Signs to Monitor:
    - Muscle aches or pains

Nitroglycerin (Nitro)
  - Used for treating chest pain due to decreased oxygen to the heart
  - Administration:
    - Can be administered sublingually, one every five minutes, up to three times
    - Replace every six months if stored properly
    - Do not use with erectile dysfunction medications due to severe hypotensive effects
    - Common side effect: headache

Warfarin (Coumadin)
- Monitored by INR (normal range: 0.8 - 1.1, therapeutic range: $2$ )
- Antidote: Vitamin K
Heparin
- Monitored by PT (11-13.5 seconds) and PTT (25-30 seconds)
- Antidote: Protamine sulfate

Function: Mimic hormones produced by adrenal glands; possess anti-inflammatory properties
Administration Forms: Oral, IV, topical, inhaled
Adverse Effects: Immunosuppression, hyperglycemia (increased blood glucose)
Common Medications: Cortisone, Hydrocortisone, Prednisone, Prednisolone
Patient Education: Monitor signs of hyperglycemia, adjust insulin as necessary

Monitor effectiveness via A1C (average glucose over three months)
Key Medications:
  - An insulin: subcutaneous administration; regular insulin can be given IV
  - Metformin: commonly causes diarrhea, typically stabilizes over time
  - Januvia: enhances insulin response and reduces glucose release from liver
Insulin Types and Administration Timing:
  - Short-acting (e.g., Humalog): administer within five to fifteen minutes of a meal
  - Regular insulin: administer within thirty minutes of a meal
  - Long-acting (e.g., Lantus): administer at scheduled time regardless of current blood sugar

Vasopressin: Antidiuretic hormone; holds water to raise blood pressure in dehydration situations
Synthroid (Levothyroxine): Synthetic thyroid hormone for hypothyroidism; administer on an empty stomach first thing in the morning to maximize absorption