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Nursing Lecture Pharmacology

Nursing Lecture Pharmacology

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Published by: Aedge010 on Sep 01, 2010
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11/20/2013

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1.Cardiac glycosidesa.action: makes heart beat slower but strongei.improves pumping ability of heartii.increases force of heart's contractioniii.decreases rate of contractioniv.increases cardiac output b.examplesi.digitoxin (Crystodigin)ii.digoxin (Lanoxin)c.use
i.
ii.
iii.
atrial fibrillationd.contraindicationsi.ventricular tachycardiaii.ventricular fibrillationiii.second and third degree heart block e.adverse side effectsi.gastrointestinal effects such as nausea and vomiting, diarrhea, andanorexia
ii.
iii.
xanthopsiaiv.muscle weaknessv.dysrhythmiaf.nursing interventions
i.
 before giving glycoside, check apical pulseand heart rhythm. Reportif < 60 bpm
ii.
establish baseline data such as vital signs, electrolytes, clinicalsymptoms,creatinine clearance test iii.monitor for drug toxicity
in children - cardiac arrhythmias
in adults - visual disturbances, nausea and vomiting,anorexia
older clients more prone to toxicityiv.monitor drug levels
therapeutic range 0.8 to 2.0 ng/ml
toxic range > two ng/ml
diuretics may increase chance of toxicityg.monitor intake and outputh.client teachingi.take medication as prescribedii.teach client how to take and record pulse dailyiii.identify and report signs of toxicity
for atrial fibrillation: take pulse and report if below 60 or above 100 or changes in rhythm
daily weights: report two pound increase2.Antihypertensivesa.action: dilates peripheral blood vessels b.examplesi.hydralazine HCL (Apresoline)ii.enalapril maleate (Vasotec)iii.reserpine (Serpasil)iv.prazosin HCL (Minipress)v.methyldopa (Aldomet)vi.clonidine (Catapres)
 
c.use: hypertensiond.contraindicationsi.heart blocii.childrene.adverse side effects
i.
orthostatic hypotensionii.dizzinessiii.bradycardiaiv.tachycardiav.sexual dysfunctionvi.deterioration in renal function
vii.
agranulosisf.nursing interventionsi.monitor vital signs and blood pressure, sitting and standingii.monitor for hearing changes, renal functioningiii.if hypotension, closely monitor clientiv.encourage intake of foods high in vitamin Bv.teach client
low sodium diet
change positions slowly
take medication as instructed
avoid hazardous activities
 protect medication from heat and light3.Thrombolytics
a.
action: binds with plasminogento dissolve thrombi (clots) in coronary arterieswithin four to six hours of myocardial infarction.Activates conversion of  plasminogen to plasmin. Plasmin is able to break down clots (fibrin). b.examplesi.streptokinase (Streptase)ii.urokinase (Abbokinase)c.usesi.myocardial infarction
ii.
iii.
 pulmonary embolid.contraindicationsi.active bleedingii.cerebral embolism/thrombosis/hemorrhageiii.recent intraarterial diagnostic procedure or surgeryiv.recent major surgeryv.neoplasms of the CNSvi.severe hypertensione.adverse side effectsi.bleeding
ii.
allergic reactions:urticaria,itching, flushing, headache (
 
)a.nursing interventionsiii.monitor for bleedingiv.monitor coagulation studiesv.monitor for allergic reactions
vi.
keep available: aminocaproic acid (fibrinolysisinhibitor)4.Lipid-lowering agents (antilipemic)a.action and use: lower LDL levels by reducing the synthesis of cholesteroland/or triglycerides. Use: primary hypercholesterolemia b.examplesiii.cholestyramine (Questran)
 
iv.atorvastatin (Lipitor)v.colestipol (Colestid)vi.nicotinic acid (Niacin)c.contraindications:iii.hypersensitivityiv.pregnancy/lactationv.active liver diseased.adverse side effectsiii.skin flushingiv.gastric upsetv.niacin: temporary, intense flushing of face, neck and earsvi.reduced absorption of fat-soluble vitaminsvii.disruption of liver functionviii.muscle tenderness or weakness (rhabdomyolysis)e.nursing interventionsiii.monitor cholesterol levelsiv.monitor liver function testsv.teach clientI.blood work and eye exams will be necessary duringtreatmentII.to report blurred vision, severe GI symptoms, or headacheIII.about low-cholesterol high-fiber dietIV.to report muscle weakness or tendernessvi.with cholestyramine, colestipol: Give other medications (e.g., such asthiazide diuretics, digoxin, warfarin, and certain antibiotics) one hour  before or four hours after administration of cholestryramine andcolestipol, so that they will not react with bile-acid-binding resins5.Antianginalsa.nitratesiii.examples: nitroglycerin, isosorbide dinitrate (Isordil)iv.action: dilate arterioles which lowers peripheral vascular resistance(afterload)v.uses: treatment and prevention of acute chest pain caused bymyocardial ischemiavi.adverse effects: postural hypotension, headache, flushing, dizzinessvii.contraindicationsI.hypersensitivityII.severe anemiaIII.hypotensionIV.hypovolemiaviii.nursing InterventionsI.monitor for orthostatic hypotensionII.monitor for tolerance with long term useIII.administer every five minutes but not more than threetablets in 15 minutesIV.if pain not relieved after 15 minutes and three tablets,notify physician immediatelyV.instruct clientI.take pulse before taking medicationII.take oral preparations without foodIII.when to seek medical attentionIV.not to chew or swallow sublingual tabsV.make position changes slowlyVI.carry drug so that it is always within reach butavoid exposure to body heat and lightVII.replace drug approximately every six monthsVIII.avoid alcohol ingestion b.beta-adrenergic blocking agentsiii.examples: propranolol (Inderal), metoprolol (Lopressor)iv.action: inhibit sympathetic stimulation of beta receptors in the heartdecreases heart rate and force of myocardial contraction thusdecreasing myocardial oxygen consumption

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