pharm

Classification and Uses:
  - Antipyretic
  - Analgesic
  - Antiplatelet
Pharmacological Formulation:
- Enteric-coated formulations are utilized to decrease the risk of gastrointestinal bleeding.
Dosage and Administration:
- Available dosage: 325 mg/ml.
- Administer anti-protamine and check platelet levels.
Toxicity and Side Effects:
  - Symptoms of toxicity include:
    - Tinnitus
    - Sweating
    - Fever
    - Headache
    - Dizziness
    - Respiratory distress
  - Antidotes for toxicity:
    - Protamine sulfate
    - Sodium bicarbonate

Classification and Uses:
- Antipyretic
- Analgesic
Mechanism of Action:
- Blocks pain receptors in the central nervous system.
- It lacks anti-inflammatory properties.
Pharmacological Concerns:
- Has no effect on bleeding or anticoagulation.
- Toxic to the liver at doses higher than 4 mg/day (or 3 mg/day in cases of liver dysfunction).
Antidote for Toxicity:
- Acetylcysteine.

Classification and Uses:
- Antipyretic
- Anti-inflammatory
Monitoring:
  - Monitor kidney function with prolonged use.
  - Can increase bleeding time.
  - Administration Guidance:
  - Recommended to take with food or milk to minimize gastrointestinal irritation.
Specific Drugs:
- Indomethacin (Indocin): Used for arthritis and gout; carries a risk of gastrointestinal bleed.

Administration:
  - Usually administered intravenously.
  - Suitable for patients with low blood pressure who cannot take oral medications.
  - Short-term use is recommended (less than 1 day).
Side Effects:
- Nephrotoxic effects may occur.

Common side effects include:
  - Headache
  - Nervousness
  - Gastrointestinal disturbances
Patients should be educated to report unusual signs such as:
  - Unusual bleeding
  - Tinnitus
  - Blurred vision
  - Swelling in extremities.

Classification:
- Includes various medications ending in -codone.
Mechanism of Action:
- Affects opioid receptors in the brain to block central nervous system responses.
Side Effects:
  - Hypotensive responses (bradycardia, hypertension)
  - Gastrointestinal issues (constipation)
  - Altered level of consciousness (ALOC).
Precautions:
  - Prior to administration, assess for allergies to aspirin and acetaminophen.
  - Do not administer if respiratory rate (RR) is less than 12.
  - Avoid in hypovolemic patients.
Antidote:
- Naloxone.
Management of Combination Medications:
- Watch for daily dosages of NSAIDs. E.g., Hydromorphone, Dilaudid, Morphine, Meperidine (Demerol), Nalbuphine; caution against exceeding 300 mg/day due to toxicity symptoms (e.g., agitation).

Purpose:
- Prevent and treat thrombosis and pulmonary embolism (PE).
- Useful in atrial fibrillation (A-Fib) to prevent clotting.
Clinical Guidelines:
- If an active bleed is present, hold anticoagulant medications.
- Mechanism: Inhibits the conversion of prothrombin into thrombin and fibrinogen into fibrin while also inhibiting platelet function.

Monitoring and Administration:
  - Therapeutic INR (International Normalized Ratio):
    - Target range: 2-3; call if INR is above 3.
  - Vitamin K antagonist; maintain a consistent intake of green leafy vegetables.

Monitoring and Administration:
- Monitor APTT (Activated Partial Thromboplastin Time):
- Normal range 30-40 sec; therapeutic level is 1.5x normal.
Antidote:
- Protamine sulfate.

Clinical Use:
- Treats blood clots or lower myocardial infarction.
Monitoring:
- Check platelet levels only.
- Do not co-administer with antiplatelet agents (e.g., NSAIDs).

Purpose and Use Cases:
- Prevention of cerebrovascular accidents (CVA) and myocardial infarctions (MI).
- Used in the prevention of DVT (deep vein thrombosis).
Common Agents:
- Clopidogrel (often with aspirin).
Considerations:
- Do not administer if the patient has had a hemorrhagic stroke (confirm with CT).

Classification and Use:
- Treatment of myocardial infarction and other clot-related conditions.
- Commonly known as clot busters.
Risks:
- Extreme risk of bleeding; administration time is critical (CVA within 3-4 hrs, DVT within 3-5 days).

Classification:
- Antihypertensive agents, such as -pril medications.
Mechanism of Action:
- Inhibits angiotensin and aldosterone to promote sodium and water excretion, thereby lowering blood pressure.
Common Side Effects:
  - Metallic taste
  - Persistent cough
  - Angioedema.
Patient Education:
  - Advise on hypotension risk, weight loss, low sodium diet, smoking cessation, and moderate alcohol.
  - Instruct to check blood pressure weekly.
  - If the dry cough is bothersome, consider switching to ARB.

Classification:
- Medications ending in -olol used for hypertension, congestive heart failure (CHF), glaucoma, dysrhythmias, and migraines.
Mechanism of Action:
- Blocks beta-adrenergic receptors of the heart.
Side Effects:
  - Bradycardia
  - Hypotension
  - Hyperglycemia masking
  - May cause bronchospasm.
General Precautions:
- Do not discontinue abruptly.
- Use cautiously with asthma or COPD patients.

Agents of Interest:
- Dihydropyridines (e.g., -pine) and non-dihydropyridines (e.g., diltiazem).
Mechanism of Action:
- Blocks calcium entry into cells, promotes vasodilation and lowers heart workload.
Administration Considerations:
  - Assess blood pressure 30 minutes after administration (5-10 minutes is best practice).
  - Avoid administration if systolic blood pressure is under 100 or heart rate is below 60.
  - Citrus products may interact and increase drug levels.

Digoxin:
  - Cardiac glycoside used primarily for atrial fibrillation and heart failure.
  - Monitoring:
    - Check apical pulse for one full minute; watch for toxicity signs (e.g., yellow/green halos).
  - Antidote:
    - Digibind.
Nitrates:
- Includes Nitroglycerin, known for vasodilation properties used in angina management.
- Monitor vital signs closely during administration.

Classification:
- Anti-cholesterol medications ending in -statin.
Mechanism of Action:
- Blocks cholesterol production in the liver.
Monitoring and Side Effects:
- Monitor liver enzymes and lipid panel.
- Risks: Muscle tenderness and rhabdomyolysis; check creatine kinase (CK) levels.

General Considerations:
- Don't forget to check allergies prior to administration.
- Monitor for signs of superinfection (e.g., diarrhea).
Classifications Include: