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Pharmacology
Unit 10
Question | Answer |
---|---|
Aspirin | Salicylates |
Salicylates: Actions | -Inhibits the synthesis of prostaglandins -Blocks effects of pyrogens at the hypothalamus -Inhibits platelet aggregation by blocking thromboxane A2 |
Salicylates: Indications | -Treat inflammatory conditions -Reduce fever and relieve pain |
Salicylates: Contraindications & Cautions | -Allergy -Bleeding abnormalities -Impaired renal function -Caution: Don't use it if you don't need it |
Salicylates:Adverse Effects | -N,V -Heartburn -Epigastric discomfort -Occult blood loss -Dizziness -Tinnitus -Acidosis |
Salicylates:Nursing Considerations | -Monitor:petechiae,bleeding gums,GI bleeding;CBC,platelets, PTT;Auditory function;If aspirin sensitive,bronchospasm; Therapeutic range=10-30mg/dl -Teaching:Other OTC contain aspirin, avoid alcohol,take w/food,milk,water to D GI upset,Stop 5-7d b/f surger |
Ibuprofen | NSAIDs |
Naproxen | NSAIDs |
NSAIDs: Actions, Non-Selective | -Inhibit prostaglandin synthesis by blocking COX-1 and COX-2 and cyclooxygenase activity -COX-1 (maintain stomach lining) -COX-2 (mediate inflammatory response) |
NSAIDs: Actions, Selective | -Block COX-2 enzymes so inhibit prostaglandin synthesis -Fewer GI side effects |
NSAIDs: Indications | -Used to decrease inflammation (not fever) -Rheumatoid arthritis, osteoarthritis -Dysmenorrhea, migraines -Bursitis, tendonitis ] -Mild to moderate pain |
NSAIDs: Contraindications | -Allergy to sulfonamides -CV dysfunction, hypertension -Peptic ulcer, GI bleeding -Renal,hepatic dysfunction |
NSAIDs: Adverse Effects | -HA,N,C -Dizziness -Somnolence -Fatigue -Rash -Dyspepsia -Bleeding |
NSAIDs: Drug-Drug | -Affect NSAID: fluconzole, phenobarbital,rifampin, ritonavir -NSAID affect: anticoagulants, aminoglycosides,ACE inhibitors, beta blockers, digoxin, dilantin |
NSAIDs: Nursing Considerations | -May take 1-4wks to achieve full effect -May mask signs of infection -Take w/full glass water so reaches stomach -Take w/meals or milk if GI response -Use protection when exposed to sun -Dosing:6-12-6-12 (around the clock) |
Celecoxib | -Cyclooxygenase-2 Inhibitor -Treatment of arthritis in adults -Involved in a study concerning CV dysfunction correlating to dosage |
Acetaminophen | -Tylenol -Related Agent |
Acetaminophen:Actions | -Action on hypothalamus to cause vasodilation and sweating -Reduce fever -Mechanism of analgesic isn't fully understood |
Acetaminophen: Indications | -Pain,fever,influenza,HA -Prophylaxis for children receiving TDaP -Musculoskeletal pain associated w/arthritis -Not affect platelet function or inflammation -Absorbed well rectally |
Acetaminophen:Contraindication | -Allergy -Pregnancy,Lactation -Hepatic dysfunction -Chronic alcoholism |
Acetaminophen: Adverse Effects | -Rash -Fever -Chest pain -Liver toxicity and failure -Bone marrow suppression |
Acetaminophen: Drug-Drug | -Anticoagulants (increase bleeding) -Liver toxicity (barbiturates, carbamazepine, isoniazid, phenytoin, alcohol) -Decrease effects of lamotrigine, loop diuretics, zidovudine |
Acetaminophen: Nursing Considerations | -Check label and dosage carefully (Drops 80 mg/ml; Elixir 120mg/ml) -Consult HCP if child <2 -Don't use if temp >103 or >3 days -Watch intake: hepatoxic |
Autothioglucose | -Gold compounds |
Gold compounds: Actions | -Taken up by macrophages, inhibits phagocytosis and release of lysosomal enzymes that cause damage associated w/inflammation |
Gold compounds:Indications | -Treatment of selected cases of adult and juvenile rheumatoid arthritis -Most effective in early stage of disease |
Gold compounds: Contraindications | -Diabetes -CHF -Renal or hepatic impairment -Allergy to gold; exposure to heavy metals -Pregnancy (prevent w/barrier contraceptive) |
Gold compounds: Adverse Effects | -N,V -Dermatitis (bad rashes) -Stomatitis -Anemia -Interstitial pneumonitis -Acute tubular necrosis |
Gold compounds: Drug-Drug | -Penicillamine -Antimalarials -Cytotoxic drugs -Immunosuppressive agents |
Interferon Alfa-2b | -Interferon (Immune stimulant) |
Interferon: Actions | -Naturally released in response to viral invasion -Prevent virus particles from replicating inside other cells -Stimulate interferon receptor sites on non invaded cells to produce antiviral proteins -Inhibit tumor growth and replication |
Interferon: Indications | -Leukemia -Malignant melanoma -AIDS related kaposi sarcoma -Chronic Hepatitis B and C |
Interferon: Contraindications and Cautions | -Cardiac disease -Bone marrow suppression -CNS dysfunction -Concurrent use of live viral vaccines -CNS depressants |
Interferon: Adverse effects | -N -Dizziness -Confusion -Rash, Dry skin -Anorexia -Bone marrow suppression -Difficulty breathing -Edema -Leukopenia -Neutropenia -Thrombocytopenia -Anemia |
Interferon:Nursing Considerations | -Check for allergy to phenol -Teaching:Monitor temp,Premedicate w/acetaminophen,Give @ bedtime,Give SQ instead of IM if low platelets, dispose of syringes safely, keep hydrated, good oral hygiene, frequent blood tests,causes hair loss |
Aldesleukin | Interleukin |
Interleukin: Actions | -Activates human cellular immunity and inhibits tumor growth through increases in lymphocytes,platelets,and cytokiens |
Interleukin: Indications | -Renal carcinomas -Possible treatment AIDS -AIDS related disorders |
Interleukin:Adverse Effects | -Mental status changes -Dizziness -Hypotension -Arrhythmias -Pruitus -N,V,D -Anorexia -GI bleeding -Bone marrow suppression -Resp Difficulties -Fever,chills,pain |
Interleukin: Nursing Considerations | -Start on an inpatient setting, they can become very sick |
Cyclosporine | -T and B cell Suppressors |
T and B cell Suppressors: Actions | -Reversibly inhibits immunocompetent lymphocytes -Inhibits T helper cells and T suppressor cells -Lymphokine production -Release of interleukin-2 and T-cell growth factor |
T and B cell Suppressors: Indications | -Suppression of rejection in transplants -Rheumatoid arthritis -Psoriasis |
T and B cell Suppressors: Contraindications and Cautions | -CNS disease -Hepatic disease -Pregnancy -Increased risk for infection and neoplasms -Hepatic and renal toxicity -Pulmonary edema |
T and B cell Suppressors: Adverse Effects | -Tremor -Hypertension -Gum hyperplasia -Renal dysfunction -D,N,V -Hirsutism -Acne -Bone marrow suppression -Infection -Kidney and Liver toxicity -Hyperkalemia |
Muromonab-CD3 | -Monoclonal Antibodies |
Monoclonal Antibodies: Actions | -Monoclonal antibody to the antigen of human T cells -Functions as an immunosuppressant by enabling T cells |
Monoclonal Antibodies: Indications | -Treatment of acute allograft rejection in renal transplant patients -Treatment of steroid-resistant acute allograph rejection in cardiac and hepatic transplant patients |
Monoclonal Antibodies: Adverse Effects | -Malaise -Tremors -V,N,D -Acute pulmonary edema -Dyspnea -Fever,chills -Increase susceptibility to infection |
Monoclonal Antibodies: Nursing Considerations | -Multimode monitoring: Organ rejection -Injections:Fever, sore throat, malaise; WBC <3000mm -Blood dyscrasia (side effect) hemoglobin and hematocrit, platelets <100,000mm |
Vaccinations: Indications | -Stimulate active immunity in people at risk of getting disease -Depends on exposure to pathogen -Provide life-long immunity |
Vaccinations: Contraindications | -Immune deficiency -Immune suppression -Acute infection -Pregnancy -Allergic to components of vaccine -Taking immune globulin -Blood or blood products within last 3 months |
Vaccinations: Cautions | -Hx of febrile convulsions or cerebral injury -Conditions for which high fever is dangerous |
Vaccinations: Side effects | -Malaise -Fretfulness -Irritability -Drowsiness -Fever -Rash -Chills -Anorexia -Vomiting Site: pain,redness,swelling,nodule |
Vaccinations: Nursing Considerations | -Have emergency supplies available (epinephrine) -For discomfort (aspirin for adults,acetaminophen for children, warm for moist heat to injection sites) -Promote completion of series (explain rationale,invite ?s, discuss sched,provide documentation) |
Diptheria and tetanus toxoids and acellular pertussis vaccine,absorbed | -Immunization of children against diptheria,tetanus,and pertussis as the fourth and fifth doses of the immunization series -Booster for adolescents and adults |
Hepatitis B vaccine | Immunization against hepatitis B infections in susceptible people and in infants born w/ mothers with hepatitis B |
Measles,Mumps,Rubella Vaccine | Immunization against measles,mumps,and rubella in adults and children > 15 mo of age |
Poliovirus Vaccine, Inactivated | -Immunization against polio infections in adults and children |
Varicella Virus vaccine | Immunization against chickenpox infections in adults and children > or = mo of age |
Immune Globulin, Intramuscular | -Immune Sera |
Immune Sera: Actions | -Provides preformed antibodies to hepatitis A, measles, varicella,rubella,and perhaps other antigens providing a passive short-term immunity |
Immune Sera: Indications | -Prophylaxis against hepatitis A, measles,varicella,rubella -Prophylaxis for patients with immunoglobulin deficiency |
Immune Sera:Contraindications and Cautions | -Hx or reaction to immune sera (may have produced antibodies and may trigger an anaphylactic reaction) -Coagulation defects -Previous exposure to the immune sera |
Immune Sera: Adverse Reaction | Allergic Reaction -Chest tightness -Decreased BP -Difficult breathing Local reaction:swelling,tenderness,pain @ injection, muscle stiffness |
Immune Sera: Nursing Considerations | -Check for allergies -Comfort measures: acetaminophen,rest,heat to injection site |
Antiglobulin D (RhoGam) | -For Rh- mother who isn't sensitized -Prophylaxis at 24-28 wks -If baby Rh+ give within 72h of birth -If baby Rh- no action needed |