pharmacology made easy

5/24/2018 Pharmacology Made Easy

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PHARMACOLOGY

Children- safety

Observe, report, teach about undesirable

effects

Medsno OTC w/o consultation

Pregnancy/lactating are out w/ meds

Liver must be intact Interactionspharmacological, assess &

teach


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PHARMACOKINETICS

PO, IM, IV

GI mobility

AbsorptionDrug-drug interaction

Metabolism

Protein/Tissue bindingElimination


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DRUG-DRUG INTERACTIONS

(THE MAD WAR)Tricyclic antidepressants

Histamine antagonist (Tagamet)

Ethanol; Erythromycin

MAO inhibitors

Aminophylline; Aspirin Digoxin; Dilantin; Diuretics


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Warfarin

Azole (antifungal); Antacids

Rifampin


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FOOD-DRUG INTERACTIONS

DRUG

Antacids (Calcium

carbonate)

Antibiotics(erythromycin,

penicillin)

TetracyclineAnticoagulants

(warfarin)

FOODS TO AVOID

Bran & whole grain

breads

Citrus fruit, colas

Calcium

Vitamin K


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FOOD-DRUG INTERACTIONS

DRUG

MAO inhibitors

FOODS TO AVOID

Tyramine


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DRUGS THAT CAN CAUSE

NEPHROTOXICITYAcetaminophen (high doses, acute)

Acyclovir, parenteral (zovirax)

AminoglycosidesAmphotericin B, parenteral (Fungizone)

Analgesic combinations cont.

acetaminophen, aspirin, or other salicylatesin high doses, chronically

Ciprofloxacin


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NEPHROTOXICITY Cisplatin (platinol)

Methotrexate (high doses)

NSAIDs

Rifampin

Sulfonamides

Tetracyclines(except doxycycline &minocycline)

Vancomycin, parenteral (Vancocin)


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NEPHROTOXICITY


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HEPATOTOXICITYACE inhibitor

Acetaminophen

Alcohol

Iron overdose

Erythromycins

Estrogens

Fluconazole (Diflucan)

Isoniazid (INH)


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HEPATOTOXICITYItraconazole (Sporanox)

Ketonazole (nizoral)

NSAIDs

Phenothiazines

Phenytoin (Dilantin)

Rifampin (Rifadin)

Sulfamethooxazole&trimethoprin (bactrim,septra

Sulfonamides


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OTOTOXICITY Aminoglycosides

Bumetanide, parenteral (Bumex)

Cisplatin Erythromycin (renal impairment&hi doses)

Ethacrynic acid (Edecrin)

Furosemide (Lasix) Hydrochloroquine (Plaquenil)


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OTOTOXICITY NSAIDs

Salicylates (chronic high doses, overuse)

Vancomycin, parenteral (high doses & renalimpairment)


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POLYPHARMACY

The presentation of

numerous

medications.


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CARDIOVASCULAR AGENTS

Cardiac GlycosidesLIZZY DIGGY

D- dig level 2ng/ml

I- increases myocardial contractility

G- GI or CNS signs indicate adverse effects


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NitroglycerinANDY ANGINA

ACTION

Relaxes vascular smooth muscleDecreases venous return

Decrease arterial BP

Decreases L ventricular workloadDecreases myocardial O2 consumption


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NitroglycerinANDY ANGINA

ACTION

Relaxes vascular smooth muscleDecreases venous return

Decrease arterial BP

Decreases L ventricular workloadDecreases myocardial O2 consumption


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CVS AGENTS

ANTIARRYTHMIC: LIDOCAINELIDDY LIDOCAINE

Liddy Lidocaine is the strongman that puts thelid on the trash can of PVCs. This drug

reduces sodium permeability, resulting in a

decrease in ventriculararrythmias & caediac

irritability. Observe for S/E like dizziness,

drowsiness & confusion.


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CONCEPT:

ANTIHYPERTENSIVE MEDSPRESSURE

Pressure (blood) monitor

Rise slowly to reduce orthostatic hypotension

Eating must be considered

Stay on medications

Skipping or stopping is a no-no

Undesirable responsesRemind to exercise, decrease alc

Eliminate smoking; educate


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ACE INHIBITORS

PRIL SISTERS

Cough;C/I in renal artery stenosis

Hypotension;Hyperkalemia (S/E)

First dose-watch for hypotensionSVR; PVR decrease

Tx of MI

Release of aldosterone decrease

Occult diabetic nepropathy decrease

LVD after MI


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ANGIOTENSIN II RECEPTOR

BLOCKERS (ARBS)SARTAN SISTERS

Administer without regard to meals

Renal function test- review

Blocks vasoconstriction effect of renin-

angiotensin system

Salt substitution or K+ supplements- do notuse


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ALPHA ADRENERGIC

BLOCKERSMINIS SINS

Syncope; Sexual dysfunction

Increased drowsiness, orthostatic

hypotension, HR

Need to be recumbent for 3-4 hours after

initial dose


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BETAADRENERGIC

BLOCKERSTHE LOL TEAM

The LOL team blocks hypertension by

blocking (decreasing) the contractility in

the heart, the renintern release from the

kidneys, & the sympathetic output from the

vasomotor center of the brain.


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BETA BLOCKER ACTIONS

B1 BLOCKERS AFFECT- affect the Beta1receptors in the heart. They decrease theexcitability, cardiac workload, O2

consumption, renin release & lower BP

B2 BLOCKERS AFFECT

Stimulate the beta receptors in the lung, relaxbronchial smooth mm, increase vitalcapacity, & decrease airway resistance


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BETA BLOCKER ACTIONS

B1 BLOCKERS AFFECT- affect the Beta1receptors in the heart. They decrease theexcitability, cardiac workload, O2

consumption, renin release & lower BP

B2 BLOCKERS AFFECT

Stimulate the beta receptors in the lung, relaxbrochial smooth mm, increase vitalcapacity, & decrease airway resistance


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BLOCKER

Bradycardia

Lipidemia (inc); Libido (decrease)

brOnchospasmCHF; Conduction abnormalities

Konstriction peripheral vascular

Exhaustion; Emotional depressionReduces recognition of hypoglycemia


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CALCIUM CHANNEL

BLOCKERSmy rate is slower & my pressure is down!

Major undesirable effects of Ca2+ channelblock include: headache(most common),

hypotension, syncope, peripheral edema&

bradycardia.


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CENTRAL ALPHA2

AGONISTSCATAPRES

C is at her eyes because the adrenergic hormone is

released from the brain

A is at her nose because the risk factors ofhypotension, hepatotoxicity & hemolytic anemia

are as clear as the nose on her face

T is at her chin as it drops w/ transient drowsinessA is body wide because arterial P all over the body is

lowered


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CENTRAL ALPHA2

AGONISTSCATAPRES

P indicates paradoxical HPN w/ propanolol

R is at her baseline feet to remind you to

record V/S

E on her belt may expand because she mayhave a wt.gain; evaluate her liver

S is tapered down her dress because the drugsshould be slowly tapered down & notstopped suddenly


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VASODILATORS

DILLY DILATOR

Directly acts on vascular smooth mm, causingvasodilation

Increases renal & cerebral blood flowLupus-like rxn (fever, facial rash, mm & joint ache,

splenomegaly)

Assess for peripheral edema of hands & feet

Take with food

Other- headache, dizziness, anorexia, tachycardia,hypotension)

Review BP


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DIURETICS

DIURETIC

Diet- inc K+ for all except aldactone

Intake & output daily wt.

Undesirable effects: F&E imbalanceReview HR, BP, & electrolytes

Elderly- careful

Take w/ or after meals & in am

Increase risk of orthostatic hypotension; moveslowly

Cancel alcohol


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LOOP DIURETICS

LOU LA BELLLou La Bell goes spinning over the falls

because she has lost so much fluid from

diuresing. Her ears are ringing & she is

dizzy from a decrease in her BP. She haslost K+ in the falls. Loop diuretics act in the

ascending loop of henle & 1 common drug

is LASIX.


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LOOP DIURETICS

LOU LA BELLRemember, THIAZIDES at the distal tubule

(major differences bet. Undesirable effects

of THIAZIDES & LOOPS is that LOOPS

may cause ototoxicity & hypocalcemia).


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K+ SPARING DIURETICS

ALAN- ALDACTONELow Na+

Elevated T waves from hyperkalemia

Agranulocytosis w/triamterene

K+ level must be monitored


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OSMOTIC DIURETICS

(BUSTER BRAIN MAN)Oliguria, edema, inc. ICP- indications

Stops reabsorption of water

MannitolOutput of urine, electrolytes- monitor

Tissue DHN- UE

Increased frequency/volume of urinationCirculatory overload- UE


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ANTICOAGULANT:

WARFARIN(CORA COUMADIN)

Check VS. platelet ct., PT

Observe for bleedingReview bleeding protocol (i.e. electric razors,

soft toothbrushes)

Avoid ASA, may use acetaminophen


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ANTICOAGULANT: HEPARIN

SODIUM(HARRY HEPARIN)

Harry Heparin is getting his anticoagulant IVor SQ in the abdomen. His soft toothbrush

will help keep gums from bleeding & hiselectric razor will keep him from bleedingwhen he shaves. Even the band-aid whenpulled off his arm may cause a big bruise.

If Harrys PTT is >1.5-2.5 x control, he maybleed too freely.


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ANTIPLATELET: ASPIRIN

(ANNIE ASPIRIN)

Fever

Inflammation

Reduces TIAs due to fibrin platelet embolus

Eliminates (reduces) death with hx of MI


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ANTIPLATELET: ASPIRIN

(ANNIE ASPIRIN)

Annie is busy firing at platelets to reduce

the blood coagulation in her body especially

with MI or TIA. She is holding her stomach

as this med can cause stomach irritation.


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THROMBOLYTIC AGENTS

(ADAM ASE)CBC, hgb, hct- monitor

Look for dysrythmias

O

bserve for bleedingThe V/S must be monitored

Adam ASE will dissolve the clog in this

sink just as he dissolves the CLOT in ablood vessel. He will use t-PA or another

thrombolytic agent that ends in ASE


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BILE- ACID SEQUESTRANT

LDL is low 15-30%

Increase fluids & fiber

PT monitoring

Increase in GI distress- constipation

Decreases absorption of many meds


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FIBRIC ACID

Liver or renal dse- WARNING

Increases effect of warfarin or sulfonylureas

VLDL, LDL, triacylglycerols & cholesterol-monitor

Encourage diet low in fat, cholesterol &

sugars

R avoid alcohol


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HMG CoA INHIBITORS

(L.L. STATIN)Officer LL (lipid lowering) Statin has

stopped the liver mobile & its driver.

Cholesterol. These drugs lower cholesterol

and can be highly toxic to the liver. Drugsthat are in this group end in statin.


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NIACIN

Note liver fxn tests- regular intervals

Itching & flushingUE

Aspirin before Niacin may decrease UE of

vasodilation

Contraindications: hepatic dse, Px

Instruct to take w/ food & at bedtimeNo high cholesterol foods


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Do not think that the knowledge you presentlypossess is changeless, absolute truth. Avoidbeing narrow-minded & bound to present

views. Learn & practice non-attachmentfrom view in order to be open to receiveothers viewpoints. Truth is found in life &not merely in conceptual knowledge. Be

ready to learn throughout your entire life &to observe reality reality in yourself & thein the world at all times. Thich Nhat Hanh


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BRONCHODILATORS

Breathing & coughing techniques

Relaxation techniques

Evaluate HR & BP

Arm identification

Tremors

Have 8 or more glasses of fluidsEmphasize no smoking


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ANTIHISTAMINES

CLARITIN + ALCOHOL + CNS depressant=SLEEP

CLARITIN + MAOIs = DRYNESS

Antihistamines (Claritin) combined w/ alc &

CNS depressant may result to sleep.Antihistamines & MAOIs may result indryness.


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BETA2 ADRENERGIC

AGONISTS(MAX AIR)

Max air is smiling because he has been able to

relieve bronchospasms from asthma & other

respiratory diseases. He has plenty of air to

breathe & air blow up the balloons in the R

hand. His L hand is shaky & weak. His

heart is beating fast & his BP is up fromundesirable effects of his medication.

A S


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XANTHINES

(AMILY TOXICITY)Amily represents some of the most commonly

occurring undesirable effects nausea (1st

sign of toxicity), arrythmias, tachycardia,

nervousness and tremors (later sign oftoxicity)

CORTICOSTEROID


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CORTICOSTEROID

INHALERS (AZMA)ACTION= decreased respiratory tract edema

Zero improvement- contact provider

Must taper off gradually

Asthma control

LEUKOTRIENE RECEPTOR


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LEUKOTRIENE RECEPTOR

ANTAGONIST(LOOK ! A TRAIN!)

It is OK to board the train in the town of

Chronic, but it is too late by the time the

train goes to the town of Acute (asthma).


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ANTI- INFECTIVE AGENTS


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ANTIBIOTICS

Monitor superinfections.

Evaluate renal/liver functions.

Diarrhea- take yogurt.

Inform provider prior to taking other meds.

Cultures prior to initial dose.

Alcohol is out, ask about allergy.

Take full course (of pills).

Evaluate cultures, WBC, T, blood.

AMINOGLYCOSIDES


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AMINOGLYCOSIDES

(AMINO MICE)Gentamycin Amikacin Kanamycin

Neomycin Strepnomycin Tobramycin

3 Amino Mice

One cant feel. Vestibular fxn&audiograms.

One cant hear. Should be studied in Pt. careOne cant pee. Plans.

AMINOGLYCOSIDES


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AMINOGLYCOSIDES

(AMINO MICE)Grab BUNs & creatinine quick as you can.

Our 3 Amino Mice will assist in

remembering 3 major UE of this category

of drugs: ototoxicity, nephrotoxicity, &

neurotoxicity).

CEPHALOSPORINS


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CEPHALOSPORINS

(CEF THE GIANT)Get nausea, vomiting, diarrhea

Increase in glucose values

Anaphylaxis may occur; alcohol may cause

vomiting

Nephrotoxicity

ThrombocytopeniaGiant a powerful antibiotic that can destroy

several types of bacteria. 1stgeneration.

FLUOROQUINOLONES


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FLUOROQUINOLONES

(T.T. FLOXACIN)Theophylline

Anticoagulant

Digoxin

TAD may result in drug toxicity when takenw/ the fluoroquinolones. This group of

drugs ends in floxacin & used to treat UTIsas well as a wide range of Gm- & Gm+infections.

MACROLIDE


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MACROLIDE

ANTIBIOTIC:ERYTHROMYCIN(MACROLIDE GIRL)

GI disturbancesUE

IV site-check for irritation

Reduces activity of med if given with acids

(fruit juices) or food

Liver function tests

PENICILLINS


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PENICILLINS

(PENICILLIN)PEN the antibiotic has his destroyer laser

aimed at several types of bacteria. He is a

broad spectrum antibiotic.

SULFONAMIDES


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SULFONAMIDES

(SULFA)Sunlight sensitivityUE

Undesirable effectsrash, renal toxicity

Look for UO, fever, sore throat & bleeding

Fluids galore!

Anorexia, anemia - UE

TETRACYCLINES


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TETRACYCLINES

(TETRA CYCLINES)S unlight sensitivity

T ake with full glass of H2O

antacid, iron, milk

P ut drug into empty stomach

VANCOMYCIN


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VANCOMYCIN

HYDROCHLORIDE(RUDOLPH THE RED - NECK REINDEER)

Rudolph the red-neck reindeer

Had an adverse side effect

From the drug Vancomycin,Must keep all labs in check.

Caution with renal failure

Hearing loss and allergies,

Take a temp. & blood cultures,

Specially a CBC!!!

ANTITUBERCULAR:


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ANTITUBERCULAR:

ISONIAZID(INA TUBERCULOSIS)

L iver enzymes-monitored

U se cautiously w/ renal dysfunction

No alcohol

G ive pyridoxine-prevent peripheralneuropathy

S hould take on empty stomachscreen vision

ANTITUBERCULAR:


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ANTITUBERCULAR:

ISONIAZID(INA TUBERCULOSIS)

Tuberculosis has undesirable effects from

INH. She is nauseated, has an enlarged

liver, tingling in her feet (peripheral

neuropathy), & her secretion have turned

orange. LUNGS will help you recall some

in preventions.

ANTITUBERCULAR:


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ANTITUBERCULAR:

RIFAMPIN(REDMAN RIFAMPIN)

many Drug - drug interactions.

Do not take alcohol.

Dont stop taking .

Dizzydont drive.

Does havoc the liver.

Dyscrasias

He is taking some rest & relaxation.

ANTIFUNGAL:


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ANTIFUNGAL:

AMPHOTERICIN B(AMPHOTERRIBLE)

Amphoterrible is a monster. He treats monster

infections such as histoplasmosis & other

life threatening fungal infections. He has aterrible habit of creating irregularities in the

heart (arrythmias). The X marks the spot of

the kidney since 80% of clients receivingthis drug may develop some nephrotoxicity.

ANTIFUNGALS


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ANTIFUNGALS

(ZOLE)Z OLEmany drug interactions can occur

O bserve hygiene measures to control

infection

L iver Function Testsmonitor

E ducate to take with food.

ANTIPROTOZOAL


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ANTIPROTOZOAL,

AMEBICIDE: FLAGYLFLAGYL

F lushing

A LCOHOL will cause these effects

I ncreased vomitingN ausea

T achycardia

If Flagyl is mixed w/ alcohol, there will be adisulfiram-like rxn, & that is why this lady feelsFAINT.

ANTIVIRALS


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ANTIVIRALS

(THE VIR HOUSE OF SHINGLES)The haunted house of shingles (herpes zoster),

chicken pox (varicella), herpes simplex & the

cytomegaly virus is most often repaired w/ drugs

that include VIR in them. Acyclovir (Zovirax),

Famciclovir (Famvir), & Valacyclovir (Valtrex)

are a few of these drugs.

The house is shaky&haunted because the recipient of

these drugs may experience a headache&shakesfrom chills. Its enough to make you throw up.

PYRIDIUM


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PYRIDIUM

(MR. P.O.)G I disturbance

U rine turns yellow orange

S lera & skin

H emolytic anemia

Mr. P.O. was not happy w/ his pain but after taking

Pyridium the pain from his UTI must be gone.Remember Pyridium turns urine ORANGE.


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ANTINEOPLASTIC AGENTS

A life is not measured by the games that are

won, but that you in the moment and

learned to have FUN.

Michael Dooley

UNDESIRABLE EFFECTS


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UNDESIRABLE EFFECTS

FROM ANTICANCER DRUGSB one marrow depression

A lopecia

R etching- nausea/vomiting

F ear and anxiety

S tomatitis


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ALKYLATING AGENTS


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ALKYLATING AGENTS

(NITROGEN MUSTARD)B one marrow depression

(leukopenia,thrombocytopenia)

A norexia/alopecia

D istressful nausea & vomiting

@ destroying malignant neoplasm


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ANTIMETABOLITES

M onitor CBC & platelets weekly

E valuate renal fxn tests

T emp assessment q 4-6 hrs

A sepsis- strict

B leeding, anemia, & nausea- report

O ral hygiene- brush w/ soft toothbrushL ots of fluids (2-3L/day)


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ANTIMETABOLITES

I ntake & output, nutritional intake- monitor

T he Protocols for handling & administering-

follow

E mphasize protective Isolation

ANTI-INFLAMMATORY


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ANTI-INFLAMMATORY

AGENTSWe are all on the way up the mountain & we

need each others help.

Jon Kabat-Zinn

NONSTEROIDAL ANTI-


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NONSTEROIDAL ANTI-

INFLAMMATORY DRUGS(NSAIDs)

N o alcohol

S E: BIRTH (bone marrow dep,inc GI

distress,renal toxicity, tinnitus&hepatotoxicity)A spirin sensitivity- do not give

I nhibits prostaglandins

D o take w/ foodS top 5-7 days before surgery

ANTIGOUT: ALLOPURINOL


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ANTIGOUT: ALLOPURINOL

(ZYLOPRIM)GOUT

G ulp 10-12 glasses (8oz) of fluid daily

I distress- UE

O utput & input- monitor closely

U ric acid production decreased

se no alcoholT ake after meals

GASTROINTESTINAL


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GASTROINTESTINAL

AGENTSEvery dream you dream

Will one day come true,

So dream your dreams

All they need is you!

Michael Dooley


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ANTACIDS

AUNT ACIDS FAMILY

ALUMINUM MAGNESIUM

Mag & Al have a Hx of an ulcer. While the

ant-acids, may help in coating their

stomachs, they may also experience UE.

Als problem is constipation. Mag has a

problem w/ diarrhea.

ANTI-ULCER MEDICATIONS:H2


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ANTI ULCER MEDICATIONS:H2

HISTAMINE ANTAGONISTS(NO WINE JUST DINE)

CIMETIDINE FAMOTIDINE

NIZATIDINE RANITIDINE

D ont take w/ antacids

I nform provider of bleeding

N o smoking, alc or NSAIDsE levate head of bed


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CHOLNERGIC BLOCKERS


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CHOLNERGIC BLOCKERS

(ANTICHOLINERGICS)ANTICHOLINERGICS

Cant pee

Cant see

Cant spit

Cant shit


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PROTON PUMP INHIBITOR

P risolec

U E: headache, GI disturbances

M aximum of 16 weeks for Protonix

P rotonix

PEPSIN INHIBITOR:


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PEPSIN INHIBITOR:

CARAFATE (CARA)C onstipation- UE

A dminister on an empty stomach

R isk of Aluminum toxicity w/ Al antacids

A dminister antacids 30 min. before or after med

Carafate will form a protective coating on the ulcer

surface. It protects against pepsin&acid

A A A O O


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ANTIDIARRHEAL: LOMOTIL

D rowsiness, dizziness, dry mouth, DHNI nhibits gastric mobility

A lcohol is out

R eport if there is a narcotic drug HxR esponse of a drug determined prior to driving

H abit forming- only take prescribed dose

E lectrolytes- monitor w/ severe diarrhea; encourage

clear liquidsA ssess frequently of BM; bowel sounds

BULK FORMING:


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BULK FORMING:

METAMUCIL(SILLY PSYLLIUM)

Silly got his name by taking Psyllium

(Metamucil) w/ a jigger of H2O instead of a

BIG glass of H2O. Now hes sweatingbecause this bulk-forming laxative that

expands has bulked his bow tie instead of

his stool.

ENDOCRINE AGENTS


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ENDOCRINE AGENTS

Learning is finding what you already know.Doing it is demonstrating that you know it.

Richard Bach

CORTICOSTEROIDS


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CORTICOSTEROIDS

(CUSHY CARL)C ushing-like Sx

bU ffalo hump

S odium; SweatingH eadache; Hyperglycemia

I ncrease in BP, HR appetite

N ot healing quickly

G I upset


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THYROID PREPARATIONS


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THYROID PREPARATIONS

(MORBID MATILDA)T SH, T3, T4- monitor

H ypo/Hyperthyroidism- monitor

R eview how to take a pulseO bserve clinical improvement in 3-4 days

I ncrease metabolic rate- action

D o not change brands of drug

Synthroid gives Matilda a boost so she will be lesstired.

ANTITHYROID


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ANTITHYROID

(GO GETTER GERTRUDE)

Everything is running EXCEPT my periods!

I need PTUT for my BIG thyroid!

B leeding

I nfectionG ive w/ food

HYPOGLYCEMIA


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HYPOGLYCEMIA

T remors; Tachycardia

I rritability

R estless

E xcessive hunger

D iaphoresis; Depression

HYPOGLYCEMIA


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HYPOGLYCEMIA

Hot & dry

Your sugars high

Your insulin is what you need.

Cold & clammy

You need some candy,And milk will help indeed.

DIABETES


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DIABETES

D iet, wt.loss, exercise

I dentification- medical alert bracelet

A void alcohol & other meds

B lood sugar & urine sugarE d.about antidiabetic agents

T herapy decreases signs, not a cure

E d. foot care, no smoking, stressorsS igns & Sx of Hyper/Hypoglycemia; skin care


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99/151INSULIN SENSITIZER:


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AVANDIA

S igns of anemia, inc liver enzymes: UEU se barrier contraceptives

G lucose urine & serum- monitor

A dminister w/ mealsR osiglitazone (Avandia)

This VAN is improving the action of insulin,w/c helps in the mgt. of diabetes.

INSULIN


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INSULIN

RAPID ACTING: CLEARRegular Humulin R Semilente

Actrapid Crystalline Zinc

Peak: 2-4 H

INTERMEDIATE ACTING: CLOUDY

NPH Humulin N

Lente Monotard

Peak: 6-8 H

INSULIN


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INSULIN

LONG ACTING: CLOUDY

Ultralente

Peak: 16-20 H

SC; DO NOT shake; massage

CENTRAL NERVOUS


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SYSTEM AGENTS

The greatest danger confronting us is not anyparticular kind of thought, but absence of

thought.

Henry Commager

NARCOTIC ANALGESICS


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NARCOTIC ANALGESICS

(DROOPY DEUTERONOMY)

D epressed respirations

D izzy

D rowsy

D rug dependence

D ecreased BPD ecreased GI peristalsis & UO

NARCOTIC ANTAGONISTS


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NARCOTIC ANTAGONISTS

(PERKY PERKOLATOR)

P erspiration increase

P ulse increase

P ain increase

P ressure increase


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ANTICONVULSANT AGENTS


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ANTICONVULSANT AGENTS

Dont go outside you house to see theflowers, my friend, dont bother withexcursion. Inside your body there areflowers. One flower has a thousand petals.That will do for a place to sit. Sitting thereyou will have a glimpse of beauty inside thebody & out of it, before the gardens & after

the gardens.kabir

ANTICONVULSANT:


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DILANTIN

DILANTIN (DIAL AT TEN)

G ingival hyperplasia

U se alternate birth control

M outh care-preventive dental check-up

S oft toothbrush, dont stop abruptly

ANTIEPILEPTIC AGENT:


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NEURONTIN

(CAESAR)

C NS: dizziness, insomnia-UE

Antacids decrease

Eat food with drug

Support group for epileptics

Alert tag indicating specific drugReport U E


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111/151ANTIANXIETY:


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BENZODIAZEPINES

(ANTIANXIETY)

T each to rise slowly from supine

Y es,alcohol should be avoided

MISCELLANEOUS ANTIANXIETY


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AGENTS:NONBENZODIAZEPINES

(BUSPAR BUS)

NO sudden STOPS

Get on the Buspar bus to decrease anxiety.

The seats recline for the UE of dizziness &

drowsiness. Smiles can be seen after taking

the drug for a week.


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CONCEPT: DEPRESSION


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CONCEPT: DEPRESSION

(ANTIDEPRESSANT)

S afety measures (i.e., change position slowly)

I nstruct client to report UE

O bserve for suicidal tendencies

N o alcohol or CNS depressants

SELECTIVE SEROTONIN REUPTAKE


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INHIBITORS (SSRIs)

(PAXIL)CNS

C NS system stimulation; nervousness,

headacheN ausea, anorexia, vomiting

S kin rash; Sexual dysfunction

Paxil packs extra baggage when taking SSRIs.

TRICYCLIC


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ANTIDEPRESSANTS

(TINA TRICYCLE)

T rimipramine H ypotension

I mipramine A nticholinergic

N ortriptyline T achycardia

A mitriptyline Sedation

TRICYCLIC


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ANTIDEPRESSANTS

(TINA TRICYCLE)

Tina tricycle is sitting on the curb as she is

sleepy & cant pee, cant see, cant see.

Obviously she should not be driving heavymachinery while taking TCAs. The 3

wheels represent that the therapeutic effects

may have a 3 wk delay of onset.

MONOAMINE OXIDASE


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INHIBITOR (MAOI)

(THE TYRANT KING)

The tyrant king loves good food, but can

develop a life threatening hypertensive

crisis if he eats or drinks productscontaining TYRAMINE while taking MAO

inhibitors. The TYRANT is No Popular

Man (Nardil, Parnate, Marplan).

ANTIMANIC MEDICATION


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ANTIMANIC MEDICATION

(BIPOLAR CLOWN)L eveltherapeutic (0.5-1.0 mEq/L)

I ncreased urination

T hirst increasedH eadache; Hand tremors

I ncrease fluids

U nsteadyM ortons Salt-adequate intake

ANTIPSYCHOTICS


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ANTIPSYCHOTICS

(STANCE)S edation; Sunlight sensitivity

T ardive dyskinesia; Tachycardia; Tremors

A nticholinergic; AgranulocytosisN euroleptic malignant syndrome

C ardiac arrhythmias (orthostatic hypotension)

E xtrapyramidal (akathesia); Endocrine(change in libido)


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OXYTOCINS


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OXYTOCINS

(PITOCIN)P ressure is elevated

I ntoxication w/ H2O

T itanic contractionsO xygen decrease in fetus

C ardiac arrhythmia

I rrenegularity in fetal heart rateN ausea and vomiting

MAGNESIUM SULFATE


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MAGNESIUM SULFATE

(A ROAD BLOCK TO PIH & SEIZURES)Magnesium SO4, a CNS depressant reduces or

stops convulsions in the OB client.

MAG SULFATE

Decreased BP

Decreased Pee Pee

Drop in RR

Patellar reflex there aintGive antidote calcium gluconate

FOSAMAX


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FOSAMAX

(JOSEPHINE BONE-A-PART)Bone mass rebuilds

Only take w/ full glass of H2O, no food

Nausea- never lie down after taking

Esophageal irritation

SELECTIVE ESTROGEN RECEPTOR

MODULATOR (SERM)


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MODULATOR (SERM)

SERM

SERM is a gift to Josephine whose bones

are coming apart. Selective Estrogen

Receptor Modulator are used to preventosteoporosis in postmenopausal women.

These drugs do not turn on breast or uterine

receptors. The benefit is there is noincreased risk of breast or endometrial CA.

ESTROGEN


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ESTROGEN

(ESTROGEN)

Estrogen builds strength in bones (reducing

bone loss) & protects the heart from cardiac

disease. Estrogen also has been linked to theprevention of Alzheimers. Estrogen helps

maintain the functioning of the female

reproductive system.

VITAMINS, MINERALS,

ELECTROLYTES


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ELECTROLYTES

Dont be afraid to take a big step if one isindicated. You cant cross a chasm in two

small jumps.

David Lloyd George

VITAMIN: PYRIDOXINE (B6)


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I N H (Isoniazid)N

C

RE

A

SE ANTI-TUBERCULIN



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L evodopa ANTI-PARKINSONISMO

W

ER

Our B6 is telling you that B6 should be increased

when taking INH.

B6 should be lowered to prevent toxicity when

taking Levodopa

MINERAL: IRON


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MINERAL: IRON

(IDA USES)

Iron improves IDA, anemia in Px,

malnutrition & blood loss.

Take iron with vit. C, swallow whole tablet orcapsule (do not crush), do not take with

milk or antacid, take liquid iron w/ a straw,

& increase fluid, fiber & exercise.

ELECTROLYTE: POTASSIUM


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C O O SS U

(K+)

Potassium sparing diuretics- monitor K+

Outputmonitor closely

Take with food

Ace inhibitors- monitor K+

Signs of digitalis toxicity if K+ is low

Serum K+ level3.5-5.0 mEq/L

ELECTROLYTE: POTASSIUM


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(K+)

IV site monitored for infiltration

Undesirable effects: N/V, cardiac arrythmias

Medical follow-up

SUPPLEMENT: CALCIUM


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(Ca2+)

Better teeth

Osteoporosis

Normal Ca2+ (8.5-10.5 mg/dl)

EKG changes- UE

Sunshine

COMPLEMENTARY AGENTS


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Health is the state which medicine hasnothing to say.

W.H. Auden

COENZYME Q10


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Q

Evitamin helps preserve Co-Q10

N ausea, vomiting, anorexia-U E

alZheimers, schizophrenia, CHF-indications

Y es, it has ANTI-AGING effects

Mackeral, Salmon, Sardines-inc.in vit.E

Effectiveness of Co-Q10 is decreased w/

oral antidiabetics

ECHINACEA


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Echinacea is giving a powerful boost to theimmune system so colds, flu, sore throats

will heal quickly and smiles will return

EVENING PRIMROSE


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R heumatoid arthritis, PMS, menopause: indO il of Evening Primrose-best source of GLA

S eizures high risk if herb is taken w/

phenothiazines

E ducation-dont use if client has a Hx of

breast CA or seizures.

FEVERFEW

(MYRA MIGRAINE)


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(MYRA MIGRAINE)

M ay cause mouth ulcersY ou cant use during Px

R educes pain

A nticoagulants may cause bleeding

Feverfew reduces the pain headache & photophobia.

It has also stimulated Myras appetite & her dress

size is about to outgrow her big hair.

GARLIC


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O bserve for bleeding if taking anticoagulantsD oes also have antitumor & antimicrobial

effects

O dorless garlic supplements are available

R evaluate BP & lab reports

Garlic also helps her yeast infection. Decrease

cholesterol, triglycerides, BP.

GINGKO BILOBA


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A few weeks on Gingko Biloba & he receivesthe benefits of increased memory &

decreased depression. He can just feel the

better blood flow through his brain & cannow think like Einstein!

GINSENG


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GINSENG BEAR GETS TO THE FINISHLINE FIRST! He has taken his tonic that

improves stamina & fights fatigue. Needless

to say, the 2nd

bear in the race did not takehis ginseng.

KAVA-KAVA


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K a w/ interacts w/ CNS depressantsA dvise to w/ food

V isual & mild GI disturbances: UE

A lprazolam given w/ Kava may cause a comaKava-Kava has been restless, nervous,

anxious,& unable to sleep, but she is nowfloating on her cloud of calm. She will notbe able to stay on her cloud for too long,because this herb also acts as a diuretic.

SAW PALMETTO BERRY:

SERENOA REPENS


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SERENOA REPENS

S tomach problems & headaches may occurA lters PSA (prostate-specific antigen) test.

May cause false.

W atch for bloody urine

ST. JOHNS WORT


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W atch the sunO K for stings & bites

R educes viral infections

T aking MAOIs & SSRIs may cause serious

UE.

St. johns Wort calms the emotions & is used

for depression.


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1 kg = 2.2 lbs= 1000 gm

1 gm = 1000 mg

= 1 cc/ml

= 15 grains

60 mg = 1 grain


147/151

1L = 1000 ml = 1 quart1 pint = 500 ml

1 gal = 4L = 4 quarts

1 oz = 30 ml

1 glass = 240 cc

1 dram = 15 ml = 1 tbsp

1tsp = 5 ml


148/151

1 tbsp = 3 tsp = 15 ml1 ml = 15 minims/gtts = 60 mgtts

1 gtt = 4 mgtts

C = F32 X 5/9


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ODOnce a day

Bidtwice a day

Tidthree times a day

Qidfour times a day


150/151

Q4hevery four hours

Q8hevery eight hours

HSat bed time

Q6Hevery six hours


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QOD- very other dAy

ACbefore meals

PCafter meals

Q 3H every three hours

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