Ncm 61 Pharmacology

-Digital Scrapbook-
By: Hannah Angelu S. Cabading
BSN2D
CONTENTS
 DRUGS ACTING ON THE IMMUNE SYSTEM

 DRUGS ACTING ON THE CENTRAL AND PERIPHERAL NERVOUS SYSTEM

 DRUGS ACTING ON THE AUTONOMIC NERVOUS SYSTEM

 DRUGS ACTING ON THE ENDOCRINE SYSTEM

 DRUGS ACTING ON THE REPRODUCTIVE SYSTEM

 DRUGS ACTING ON THE CARDIOVASCULAR SYSTEM

 DRUGS ACTING ON THE RENAL SYSTEM

 DRUGS ACTING ON RESPIRATORY SYSTEM

 DRUGS ACTING ON THE GASTROINTESTINAL SYSTEM

DRUGS ACTING ON IMMUNE SYSTEM
The immune system discriminates self from non-self allowing it to destroy infectious
invaders or tumors while leaving normal cells intact. Two components, innate and
adaptive provide an early active response and an antigen-specific response,
respectively. Innate immunity is comprised of complement, granulocytes,
monocytes/macrophages, natural killer cells, mast cells, and basophils, whereas B and
T lymphocytes are the main cell types of adaptive immunity.
The immune system is of tremendous importance in human disease. Examples of
immunological diseases include autoimmune diseases such as type 1 diabetes mellitus
and rheumatoid arthritis, malignancies, and asthma and other allergic conditions.
Therapies exist and more are being developed to treat these immunological
diseases.
Drug classes which modulate the immune response act as immunosuppressants or
immunostimulants by interacting with specific receptors and cellular components of
the innate and adaptive response.
 DRUG CLASSIFICATIONS
Immunosuppressants  Drug:  cyclosporine (Sandimmune) 

Tumor Necrosis Factor - α Blocking Agent  Drug:  infliximab (Remicade) 

Antimetabolites Drug:  methotrexate (Rheumatrex) fluorouracil (5-FU)

Plant Alkaloids Drug:  vincristine (Oncovin)

Alkylating Agents Drug:  cyclophoshamide (Cytoxan) cisplatin (Platinol) 

Anti –Tumor Antibiotics Drug:  doxorubicin (Adriamycin

Interferons Drug:  interferon alfa 2a (Roferon-A), interferon alfa 2b

(Intron-A)

Hematopoietic Drugs Drug: epoetin alfa (Epogen), subcut, IV

Colony Stimulating Agents Drug: filgrastim (G-CSF) (Neupogen) 

Interleukins Drug: aldesleukin (Proleukin) 

Drug study
 Drug Study:
Acetaminophen
Mechanism of Action
Acetaminophen belongs to a class of drugs called
analgesics (pain relievers) and antipyretics Indications or Purpose Contraindications
(fever reducers). The exact mechanism of action of Acetaminophen is used to treat mild to Contraindicated with allergy to acetaminophen.
acetaminophen is not known. It may reduce the moderate and pain, to treat moderate to Use cautiously with impaired hepatic function, chronic
production of prostaglandins in the brain. Prostaglandins severe pain in conjunction with opiates, or to alcoholism, pregnancy, lactation.
are chemicals that cause inflammation and swelling. reduce fever. Common conditions
that acetaminophen treats include headache,
muscle aches, arthritis, backache, toothaches,
sore throat, colds, flu, and fevers.

Side Effects 
Adverse Reactions Nursing Responsibilities 
Skin swelling (angioedema) CNS: Headache Do not exceed the recommended dosage.
Disorientation CV: Chest pain, dyspnea, myocardial damage when doses of 5–8 Consult physician if needed for children < 3 yr; if needed for
Dizziness g/day are ingested daily for several weeks or when doses longer than 10 days; if continued fever, severe or
Rash (may itch) of 4 g/day are ingested for 1 yr recurrent pain occurs (possible serious illness).
Hives
GI: Hepatic toxicity and failure, jaundice Avoid using multiple preparations containing acetaminophen.
Low levels of red blood cells,
GU: Acute kidney failure, renal tubular necrosis Carefully check all OTC products.
white blood cells, and/or platelets Hematologic: Methemoglobinemia—cyanosis; hemolytic anemia— Give drug with food if GI upset occurs.
Shortness of breath/cough hematuria, anuria; neutropenia, leukopenia, pancytopenia, Discontinue drug if hypersensitivity reactions occur.
thrombocytopenia, hypoglycemia Treatment of overdose: Monitor serum levels regularly, N-
Hypersensitivity: Rash, fever. acetylcysteine should be available as a specific
antidote; basic life support measures may be
necessary.
 
Drugs acting on central and peripheral
nervous system

The central nervous system directs the functions of all tissues of the
body. The peripheral nervous system receives thousands of
sensory inputs and transmits them to the brain via the spinal
cord. The brain processes this incoming information and
discards 99% as unimportant. After sensory information has
been evaluated, selected areas of the central nervous system
initiate nerve impulses to organs or tissue to make an
appropriate response.
Chemical influences are capable of producing a myriad of effects on
the activity and function of the central nervous system. Since
our knowledge of different regions of brain function and the
neurotransmitters in the brain is limited, the explanations for the
mechanisms of drug action may be vague. The known
neurotransmitters are: acetylcholine which is involved with
memory and learning; norepinephrine which is involved with
mania-depression and emotions; and serotonin which is involved
with biological rhythms, sleep, emotion, and pain.

- Anxiolytic and Hypnotic Agents
Are used to alter an individual’s
responses to environmental
stimuli. These agents are
referred to as anxiolytics or to
prevent feelings of tension and
fear.
Drugs:
• Benzodiazepines –Diazepam
and Iorazepam
• Barbiturates- Phenobartibal
and mephobaartibal
Drug Classifications
Antidepressant Agents
- Are a class of drugs that
reduce symptoms of depressive
disorders by correcting
chemical imbalances of
neurotransmitters in the brain.
Drugs:
• Tricyclic Antidepressants-
Desipramine and trimiparamine
• Monoamine Xidase inhibitors-
Isocarboxaxid, phenelzine and
tranylcypromine.
• Selective Serotonin Reuptake
Inhibitors- Fluvoxamine and
Vilazodone.
Psychotherapeutic Agents
- Are used to treat psychosis
which refers to a group of
mental disorders for example
depression, schizophrenia, manic
depressive disorders and so on.
Drugs:
• Antipsychotic/Neuropletic Drugs-
Typical Antipsychotics-
Chlorpromazine
Atypical Antipsychotics-
Clozapine
• Antimanic Drugs- Aripiprazole,
lamotrigine
• Central Nervous System
Stimulants
Dextroamphetamine
Lisdexamfetamine
Drug study

Mechanism of Action
Diazepam is a benzodiazepine tranquilliser with
anticonvulsant, sedative, muscle relaxant and
amnesic properties.
Benzodiazepines, such as diazepam, bind to receptors
in various regions of the brain and spinal cord.
This binding increases the inhibitory effects of
gamma-aminobutyric acid (GABA). GABAs
functions include CNS involvement in sleep
induction. Also involved in the control of
hypnosis, memory, anxiety, epilepsy and
neuronal excitability   delirium tremens and hallucinosis.
Drug Study:
diazepam
Indications or Purpose
Valium is indicated for the management of
anxiety disorders or for the shortterm relief
of the symptoms of anxiety. Anxiety or tension
associated with the stress of everyday life
usually does not require treatment with an
anxiolytic. In acute alcohol withdrawal, Valium
may be useful in the symptomatic relief of
acute agitation, tremor, impending or acute  is contraindicated
Contraindications
Valium is contraindicated in patients with a known hypersensitivity
to diazepam and, because of lack of sufficient clinical experience,
in pediatric patients under 6 months of age. Valium is also
contraindicated in patients with myasthenia gravis, severe
respiratory insufficiency, severe hepatic insufficiency, and 
sleep apnea syndrome. It may be used in patients with 
open-angle glaucoma who are receiving appropriate therapy, but

Nursing Responsibilities 
It is crucial to monitor respiratory and cardiovascular status,
Adverse Reactions blood pressure, heart rate, and symptoms of anxiety in
Side Effects 
Like most benzodiazepines, the adverse patients taking diazepam.  With long-term use, monitor
Side effects most commonly reported were
reactions of diazepam include CNS and liver enzymes, CBC, and for signs of propylene glycol
drowsiness, fatigue, muscle weakness, and ataxia.
respiratory depression, toxicity, including serum creatinine, BUN, serum lactate,
The following have also been reported:Central
dependence, and benzodiazepine and osmolality gap. With critically ill patients, monitor
Nervous System: confusion, depression, 
withdrawal syndrome. the depth of sedation
dysarthria, headache, slurred speech, tremor, 
Serious adverse effects of diazepam include: Assess blood pressure, pulse and respiration if IV
vertigo Gastrointestinal
Respiratory depression administration.
System: constipation,nausea, gastrointestinal
Seizures - Provide frequent sips of water for dry mouth.
 disturbances Special Senses: blurred vision, 
Suicidality - Provide fluids and fibre for constipation.
diplopia, dizziness Cardiovascular System: 
Dependency and abuse - Evaluate therapeutic response, mental state and physical
hypotensionPsychiatric and Paradoxical
Withdrawal symptoms dependency after long-term use.
Cardiovascular collapse
DRUG ACTING ON AUTONOMIC NERVOUS SYTEM

The autonomic nervous system is a coordinated motor system that consists of

innervated cardiac muscle, smooth muscle, and glands. The ANS maintains

homeostasis and provides a coordinated response to external

stimulation. Much of homeostasis occurs involuntarily, but some

autonomic processes have a degree of voluntary control (urination,

sexual activity). The major components are the sympathetic and

parasympathetic nervous systems.

 Drug Classification

The ANS are divided into two groups according to the type of neuron involved in their mechanism of
action:

The
Adrenergic
The cholinergic Drug Drug
-act on receptors that
are activated by -act on receptors that
acetylcholine. are stimulated by
norepinephrine or
epinephrine.
CREDITS: This presentation template was created by Slidesgo,
DRUG STUDY
including icons by Flaticon, infographics & images by Freepik
 Drug Study:
Metropolol
Mechanism of Action
any of various drugs that inhibit, enhance, or mimic the
action of the neurotransmitter acetylcholine, the primary Indications or Purpose Contraindications
transmitter of nerve impulses within the Treatment of myasthenia gravis, • Pulmonary disease (COPD/bronchial asthma)
parasympathetic nervous system—i.e., that part of antidote for nondepolarizing • Peptic ulcer disease (may use with caution)
the autonomic nervous system that contracts neuromuscular junction blockers, • Arrhythmias (atrial fibrillation)
smooth muscles, dilates blood vessels, increases bodily • Coronary vascular disease 
secretions, and slows the heart rate.
increased survival after • Angle-closure glaucoma
exposure to nerve gas. • Hyperthyroidism 
Treatment of mild to moderate • Intestinal resection or anastomosis
Alzheimer's disease. • Urinary obstruction
• Orthostatic hypotension
• Severe miosis

Adverse Reactions
Side Effects  The effect of the drug may be therapeutic, but becomes
Increased sweating.
an adverse reaction if severe or if the drug is given
loss of bladder control. for another purpose or if there is an overdose.
muscle weakness. – CNS – excessive stimulation (tremor, restlessness,
nausea, vomiting, diarrhea, or stomach confusion), followed by excessive CNS depression
cramps or pain. (respiratory depression, coma)
shortness of breath, tightness in chest, – Tachycardia
or wheezing. – Constipation (result of decreased GI motility &
slow or irregular heartbeat. muscle tone)
watering of mouth. – Dry mouth (result of decreased salivation)
– Urinary retention
– Hot, dry skin (due to decreased sweating)
– Blurred vision, dilation of the pupil
Nursing Responsibilities Administer oral drug on empty stomach to decrease
nausea and vomiting.
If drug is given intravenously, administer slowly to avoid severe cholinergic
effects.
Monitor patient response closely (e.g., blood pressure, ECG, urine output) to
arrange to adjust dose accordingly to ensure the most benefit.
Maintain a cholinergic-blocking drug on standby such as atropine to use as an
antidote for excessive doses of cholinergic drugs.
Discontinue drug if excessive salivation, diarrhea, emesis, or frequent urination
becomes a problem to decrease the risk of severe adverse reactions.
Provide safety precautions if the patient reports poor visual acuity in dim light
to prevent injury.
Provide comfort measures (e.g., quiet room, support and relaxation measures)
to help patient cope with drug effects.
Provide patient education about drug effects and warning signs to report to
enhance knowledge about drug therapy and promote compliance.
 DRUGS ACTING ON THE ENDOCRINE
SYSTEM
Endocrine drugs are agents directed to a malfunctioning endocrine path. Several agents are
secreted in or target the nervous system, and are thus more prone to cause neurologic adverse
events (AEs). This chapter focuses on commonly used endocrine agents directed to the
hypothalamus-pituitary axis, thyroid, and antidiabetic agents. The therapeutic agents are discussed in
terms of indication, mechanism of action, description, and frequency of AEs, and risk factors for
occurrence where available.
 Drug Classification

Agents for
Hypothyroidism

- levothyroxine, T4 (Levothroid, Levoxyl, Synthroid) • liothyronine, T3 (Cytomel) • liotrix

(Thyrolar) • thyroid (Armour Thyroid)
Drug study
 Drug Study:
COTRIMOXAZOLE

Mechanism of Action:
Sulfamethoxazole component inhibits
formation of dihydrofolic acid from Indications or Purpose Contraindications
PABA; trimethoprim component Treatment of infection due to susceptible Hematologic toxicity: neutropenia,
inhibits dihydrofolate reductase. Both organism thromboctopenia,agranulocysis, aplasticanemi
Decrease Bacterial Folicacid Contradiction in patients with known hypersensitivity to
synthesis trimethoprim or sulfonamides, or with documented
megalobastic anemia seconday tofolatedecficiency

Side Effects  Adverse Reactions Nursing Responsibilities 

Hypersensitivity reactions- pain,
localirritation, inflammation and
rarelythrombophlebitis
Co-trimoxazole relatively frequently causes
reversible exanthemas. Loss of appetite,
nausea, vomiting, and diarrhea.
 
Severe allergic skin reaction
Maintain adequate fluid intake to prevent crystalluria; infuse
I.V. co-trimoxazole over 60-90 minutes; must be further
diluted 1:25 (5 mL drug to 125 mL diluent, ie, D 5W); in
patients who require fluid restriction, a 1:15 dilution (5 mL
drug to 75 mL diluent, ie, D5W) or a 1:10 dilution (5 mL
drug to 50 mL diluent, ie, D5W) can be administered
Monitor CBC, renal function test, liver function test, urinalysis
 DRUGS ACTING ON THE
REPRODUCTIVE SYSTEM
Several sites in the reproductive system
either are vulnerable to chemicals or can be
manipulated by drugs. Within the central nervous
system, sensitive sites include
the hypothalamus (and adjacent areas of the brain)
and the anterior lobe of the pituitary gland.
Regions outside the brain that are vulnerable
include the gonads (i.e., the ovaries in the female
and the testes in the male), the uterus in the
female, and the prostate gland in the male.
CREDITS: This presentation template was created by
Slidesgo, including icons by Flaticon, and infographics &
images by Freepik.
 Drug classification
?
Bravelle (follicle stimulating hormone)

Cetrotide (gonadotropin-releasing hormone antagonist)

Clomid (clomiphene citrate) ?

Crinone (progesterone)

Dostinex (prolactin reducing)

Factrel (gonadotropin-releasing hormone)

Femara (Letrozole)

Follistim (follicle stimulating hormone)

Gonal-F (follicle stimulating hormone) Pregnyl (human chorionic gonadotropin)

Menopur (human menopausal gonadotropin) Prometrium (progesterone)
Novarel (human chorionic gonadotropin) Serophene (clomiphene citrate)
Ovidrel (human chorionic gonadotropin) Urofollitropin (follicle stimulating hormone
Parlodel (prolactin reducing)

Pergonal (human menopausal gonadotropin)

Zoladex ( gonadotropin-releasing hormone analog)

Drug study
 Drug Study:
Urofollitropin
Mechanism of Action
Urofollitropin contains primarily follicle-stimulating
hormone (FSH). Urofollitropin mimics the actions of Indications or Purpose Contraindications
endogenous FSH, which is required for normal follicular Induction of ovulation in patients with Uncontrolled non-gonadal endocrinopathies (eg, thyroid,
growth, maturation, and gonadal steroid production functional anovulatory infertility that is not adrenal, pituitary). Undiagnosed abnormal uterine bleeding.
due to ovarian failure, or stimulation of Ovarian cysts or enlargement. Tumor of pituitary,
multiple follicles in ovulatory patients hypothalamus, breast, ovary, or uterus.
undergoing Assisted Reproductive
Technologies (ART) who have previously
received pituitary suppression.

Side Effects  thromboembolism, etc.) to prevent any untoward complications.
stomach cramps or bloating;
headache, general pain;
nausea;
trouble breathing;
hot flashes; or
mild pelvic pain, pain after an egg is
removed for in-vitro fertilization
Nursing Responsibilities 
Assess for the mentioned cautions and contraindications (e.g. drug allergies,
cardiovascular diseases, metabolic bone disease, history of
Adverse Reactions Perform a thorough physical assessment (e.g. bowel sounds, skin assessment, vital
Headache, nausea, vomiting, mild signs, mental status, etc.) to establish baseline data before drug therapy
stomach/abdominal pain, bloating, begins, to determine effectiveness of therapy, and to evaluate for
occurrence of any adverse effects associated with drug therapy.
redness/pain at the injection site, or
Assist with pelvic and breast examinations. Ensure specimen collection for Pap
breast tenderness/pain may occur. If smear and obtain a history of patient’s menstrual cycle to provide baseline
any of these effects persist or worsen, data and to monitor for any adverse effects that could occur.
Arrange for ophthalmic examination especially for patients who are wearing
tell your doctor or pharmacist promptly.
contact lenses because hormonal changes can alter the fluid in the eye and
curvature of the cornea, which can change the fit of contact lenses and
alter visual acuity.
Monitor laboratory test results (e.g. urinalysis, renal and hepatic function tests, etc.)
to determine possible need for a reduction in dose and evaluate for toxicity.
 DRUGS ACTING ON THE CARDIOVASCULAR SYSTEM

Drugs affect the function of the heart in three main ways. They can affect the force of contraction of the
heart muscle (inotropic effects); they can affect the frequency of the heartbeat, or heart rate (chronotropic effects);
or they can affect the regularity of the heartbeat (rhythmic effects).
 ●Anticoagulants ●Angiotensin II Receptor Blockers (or Inhibitors)
●(Also known as Blood Thinners.) ●(Also known as ARBs):



Apixaban (Eliquis) 

Dabigatran (Pradaxa)
Drug classification  Azilsartan (Edarbi)

 Candesartan (Atacand)
 Edoxaban (Savaysa)
 Eprosartan (Teveten)
 Heparin (various)
 Irbesartan (Avapro)
 Rivaroxaban (Xarelto)  Losartan (Cozaar)
 Warfarin (Coumadin)  Olmesartan (Benicar) 

 Telmisartan (Micardis) 
●Angiotensin-Converting Enzyme (ACE) Inhibitors
 Valsartan (Diovan)
 Benazepril (Lotensin) ●Beta Blockers
 Captopril (Capoten) ●(Also known as Beta-Adrenergic Blocking Agents)

 Enalapril (Vasotec)  Acebutolol (Sectral)

 Fosinopril (Monopril)  Atenolol (Tenormin)

 Lisinopril (Prinivil, Zestril)  Betaxolol (Kerlone)

 Moexipril (Univasc)  Bisoprolol/hydrochlorothiazide (Ziac)

 Perindopril (Aceon)  Bisoprolol (Zebeta)

 Metoprolol (Lopressor, Toprol XL)

 Quinapril (Accupril)
 Nadolol (Corgard)
Drug study
 Drug Study:
Heparin
Indications or Purpose
Mechanism of Action
HEPARIN SODIUM INJECTION is indicated for:
Heparin catalyzes the inactivation of
Prophylaxis and treatment of venous thrombosis
thrombin by ATIII by acting as a template
and pulmonary embolism; Contraindications
to which both the enzyme and inhibitor Prophylaxis and treatment of thromboembolic Absolute contraindications to heparin include
bind to form a ternary complex. known hypersensitivity, past or present heparin-induced
complications associated with atrial fibrillation;
The heparin-antithrombin system: a
natural anticoagulant mechanism.
Treatment of acute and chronic consumption thrombocytopenia and active bleeding. Caution is required
coagulopathies (disseminated intravascular when prescribing heparin to patients with conditions that
coagulation); may increase the risk of bleeding
Prevention of clotting in arterial and cardiac surgery;
Prophylaxis and treatment of peripheral arterial
embolism;
Anticoagulant use in blood transfusions, extracorporeal
circulation, and dialysis procedures.

Nursing Responsibilities 
Lab tests: Baseline blood coagulation tests, Hct, Hgb, RBC, and platelet
counts prior to initiation of therapy and at regular intervals
Side Effects  throughout therapy.
easy bleeding and bruising; Adverse Reactions Monitor APTT levels closely.
pain, redness, warmth, irritation, or • bruising more easily. Note: In general, dosage is adjusted to keep APTT between 1.5–2.5 times

skin changes where the
medicine was injected;
itching of your feet; or.
bluish-colored skin.
• bleeding that takes longer to stop.
• irritation, pain, redness, or sores at the
injection site.
• allergic reactions, such as hives, chills,
and fever.
• increased liver enzymes on liver function
test results.
normal control level.
Draw blood for coagulation test 30 min before each scheduled SC or
intermittent IV dose and approximately q4h for patients
receiving continuous IV heparin during dosage adjustment
period. After dosage is established, tests may be done once
daily.
Patients vary widely in their reaction to heparin; risk of hemorrhage
appears greatest in women, all patients >60 y, and patients with
liver disease or renal insufficiency.
Monitor vital signs. Report fever, drop in BP, rapid pulse, and other S&S
of hemorrhage.
Observe all needle sites daily for hematoma and signs of inflammation
(swelling, heat, redness, pain).
Antidote: Have on hand protamine sulfate (1% solution), specific heparin
antagonist.
 Drugs Acting on Renal System
Kidney is mainly a regulatory organ, it also has excretory function. The functional unit of kidney is nephron, each

kidney contains about 1 million nephron, the functions of kidney are:

Regulatory. Acid base, Extretory. Excretion of Hormonal, Activation of

fluid and electrolyte nitrogeneous aste vit. D, production of renin
balance products and erythopoeitin.
 Drug classification
1. Drugs Acting at proximal
convoluted tubule
•Carbonic Anhydrase inhibitor:
Acetazolomide 4. Drug acting at late distal
2. Drugs Acting at thick ascem- tubule and
bling limbs of loop of henle site
collecting duct site-4
2
•Adosterone Antagonist:
•Loop diuretics: furosemide,
spironolactone, and
bumetadine, torsemide,
ethacrynic acid epleronine
3. Drugs acting at early distal • Direct inhibor of Na+ channels:
tubule Amiloride and triamterene
site- 5. Drug acting on entire nephron
•Thiazides: chlorothiazides, (main site of action of loop
hydrochlorothiazide, henle)
polytheazide, benzthiazide •Osmotic Diuretics: Manito,
•Thiazide related diuretics: glycerol, i
chlorthalidone,
indapamide, metolazone
 Drug Study:
Thiazide diuretics
Mechanism of Action
Thiazide diuretics control Indications or Purpose
hypertension in part by inhibiting Thiazide diuretics are used to treat high Contraindications
reabsorption of sodium (Na+) and blood pressure and congestive heart • Hypotension.
chloride (Cl−) ions from the distal failure as well as the accumulation of • Allergy to sulfa drugs.
convoluted tubules in the kidneys fluid and swelling (edema) of the body • Gout.
by blocking the thiazide-sensitive caused by conditions such as heart • Hypokalemia.
Na+-Cl− symporter. failure, cirrhosis, chronic kidney failure, • Renal failure.
corticosteroid medications, and • Lithium treatment.
nephrotic syndrome

Side Effects  Nursing Responsibilities 

dizziness and lightheadedness, Give thiazides in the morning to prevent nocturia, and keep a
blurred vision, Adverse Reactions urinal or commode at the bedside. Provide potassium-
loss of appetite, • Hypokalemia rich foods and potassium supplements as ordered to
itching, • Hyponatremia maintain an acceptable serum potassium level. Teach
• Metabolic alkalosis your patient the reason for diuretic therapy and the
stomach upset, importance of adherence.
headache, and. • Hypercalcemia
weakness. • Hyperglycemia
 Drugs acting on Respiratory System
Barbiturates, benzodiazepines, and opioids are all known to cause respiratory depression.
Barbiturates and benzodiazepines act by facilitating the effects of GABA (the main inhibitory
neurotransmitter in the CNS) at the α-subunit of the GABAA receptor. Opioids act at μ receptors throughout
the body, the effects of which can be both excitatory and inhibitory. These drugs depress the response of
the respiratory center in the medulla to hypercapnia (↑ CO2) leading to respiratory depression.
 Drug Classification

Respiratory Diseases: Drug Classifications for Respiratory

1. Asthma Disease:
2. Allergic Reactions •Symphathomimetics (adrenergic)
3. Chronic Obstructive Pulmonary Disease •Paramsympatholytics (anticholinergic)
(COPD) •Mucoactives (Mucolytic)
4. Cough •Corticosteroids
•Anti-asthmatics (prophylactic)
•Anti-infectives (antibiotic)
 Drug Study:
Symphathomimetics
Mechanism of Action
\ Sympathomimetic drugs are
agents which in general mimic Indications or Purpose Contraindications
Sympathomimetic agents are used to augment the No universal set of contraindications exists for all
responses due to stimulation of
endogenous catecholamines of the sympathetic nervous sympathomimetics, but a patient’s current condition may
sympathetic nerves. These agents system for therapeutic benefit. The body has a wide
are able to directly activate offer relative contraindications and the need for careful
distribution of different adrenergic receptors across many
adrenergic receptors or to organ systems. Without a thorough understanding of the titration or selection of a more appropriate
indirectly activate them by adrenoreceptor subtypes involved in various tissues, the sympathomimetic. Although extremely rare, true
increasing norepinephrine and clinical effects observed can seem confusing due to hypersensitivity reactions would be considered a
epinephrine (mediators of the overlapping receptor activities and different effects seen contraindication to specific agents.
sympathoadrenal system) levels. at different doses.

Nursing Responsibilities 
• Assess for contraindications or cautions (e.g. history of
Adverse Reactions allergy, pheochromocytoma, fatal arrhythmias, etc.) to
Side Effects  • fine tremor, usually in the hands avoid adverse effects.
Hypertension. • nervous tension • Establish baseline physical assessment to monitor for
Reflex. bradycardia. (due • headache any potential adverse effects.
to. hypertension. ) or. • peripheral vasodilation • Assess vital signs, especially pulse and blood pressure
tachycardia. • sinus tachycardia to monitor for possible excess stimulation of the
Dizziness. • hypokalaemia after high doses - salbutamol cardiac system.
Nausea, vomiting • Note respiratory rate and auscultate lungs for
• hypersensitivity, including paradoxical
adventitious sounds to evaluate effects on bronchi and
bronchospasm respirations.
• impaired glucose tolerance in diabetics • Monitor urine output to evaluate perfusion of the
kidneys and therapeutic effects.
• Monitor laboratory test results (e.g. liver and renal
function tests) to determine need for possible dose
adjustment, and serum electrolyte levels to evaluate
fluid loss and appropriateness of therapy.
 Drugs Acting on Gastrointestinal System
The gastrointestinal (GI) tract includes the mouth, stomach, small intestine (duodenum, jejunum, and ileum), large
intestine (cecum and colon), rectum, anus, and its accompanying exocrine glands (the salivary glands, the pancreas, and the
gallbladder). Drugs affecting the GI system are used in the treatment of gastric acidity, peptic ulcers, and gastroesophageal
reflux disease (GERD), bowel motility disorders (gastroparesis [delayed gastric emptying due to partial paralysis of the
stomach muscles], constipation, and diarrhea), and for the treatment of nausea and vomiting.
 Drug Classification
• Omeprazole
• Esomeprazole
• Lansoprazole
• Pantoprazole,
• Rabeprazole

Mechanism of Action
Omeprazole is a proton pump
inhibitor. It inhibits the parietal cell H+ /
K+ ATP pump, the final step of acid
production. In
turn, omeprazole suppresses gastric
basal and stimulated acid secretion.
Adverse Reactions
Side Effects  The
Back, leg, or stomach pain
bleeding or crusting sores on the lips
blisters
bloody or cloudy urine
chills
continuing ulcers or sores in the mouth
difficult, burning, or painful urination
fever
frequent urge to urinate
Drug Study:
Omeprazole
Indications or Purpose
Omeprazole indications also include gastric
ulcers in adults, and gastroesophageal reflux
disease in adults and pediatric populations.
Studies have shown the efficacy of omeprazole
for short term treatment in erosive esophagitis.
most common adverse reactions reported (i.e., with
an incidence rate ≥ 2%) from PRILOSEC-treated
patients enrolled in these studies included
headache (6.9%), abdominal pain (5.2%), nausea
(4.0%), diarrhea (3.7%), vomiting (3.2%), and flatulence
(2.7%).
Contraindications
Contraindicated in patients with known hypersensitivity to
any component of the formulation. Treatment with
omeprazole may mask the symptoms of other gastric
disease. Caution should be exercised in patients with
hepatic impairment.
Nursing Responsibilities 
Advise patient to avoid alcohol and foods that may cause an
increase in GI irritation. Instruct patient to report
bothersome or prolonged side effects, including skin
problems (itching, rash) or GI effects (nausea, diarrhea,
vomiting, constipation, heartburn, flatulence, abdominal
pain).