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PHARMACOLOGY DRUGS for ATI test graded A+ 100% VERIFIED
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PHARMACOLOGY DRUGS for ATI test graded A+ 100% VERIFIED
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PHARMACOLOGYDRUGS
for
ATI
test
Receptors
-
ANSNorepinephrine-Adrenergic
(adrenergic
comes
from
the
word
adrenalin)
Alpha
1-all
sympathetic
target
organs
except
the
heart-constrict
the
blood
vessels
and
dilation
of
pupils
Alpha
2-Presynaptic
adrenergic
nerve
terminal-inhibits
the
release
of
norepinephrine
Beta
1-Heart
and
Kidneys
(BETA
1-ONE
HEART)-increased
heart
rate
and
force
of
contraction,
release
of
renin
Beta
2-All
sympathetic
target
organs-inhibits
smooth
muscle
(BETA
2-TWO
LUNGS)
EXAM
1
DRUGS!!!!
-
ANS...........
Beta
blockers/olol's
-
ANSBeta-Adrenergic
Blockers
Metoprolol/Lopressor
ENDING
OLOL
Beta
Blockers
are
use
with
heart
failure,
hypertension,
angina
and
with
myocardial
infarctions.
Action
=
Blocks
Beta-Receptors
in
the
heart
causing...
Decreases
=
HR,
force
of
contraction,
Rate
of
atrioventricular
(AV)
conduction
SE
=
Bradycardia,
lethargy,
GI
disturbance,
congestive
heart
failure,
decrease
BP,
depression
The
beta
blockers
stop
sympathetic
nervous
system
stimulation
of
the
heart.
Does
not
allow
the
heart
rate
and
blood
pressure
to
rise
with
stress
thus
lowering
the
oxygen
demand
of
the
heart.
It
is
very
heart
protective!
Will
slow
the
heart
rate
and
lower
the
blood
pressure
Can
have
beta
2
blockage
with
larger
doses-will
constrict
the
bronchioles-watch
for
clients
with
known
COPD,
Asthma
Nursing
Interventions
Check
pulse-needs
to
be
60
or
above
Check
blood
pressure-if
hypotensive
do
not
give
(Systolic
below
100
is
a
good
rule
of
thumb
I
go
by)
Monitor
for
sexual
dysfunction-impotence
for
men-a
good
reason
for
CCB,/calcium
channel
blockers
-
ANSNifedipine/Adalat/Procardia/Norvasc-controls
blood
vessels
Diltiazem/Cardizem
Verapamil/Calan/Isoptin/Verelan-controls
heart
rate
and
blood
vessels
Angina/Raynaud's/Vasospastic
Angina/Atrial
Arrhythmia's
Blocks
calcium
channels
in
the
myocardial
and
vascular
smooth
muscles,
decreases
the
contraction
of
smooth
muscle-relaxes
the
arteries-vasodilation.
Blocking
of
calcium
channels in
the
SA
and
AV
node-Slows
conduction
through
the
SA
and
AV
node.
Decreases
the
force
of
contraction
slows
heart
rate
Grapefruit
juice
may
increase
absorption
of
nifedipine
Side
Effects:
Relaxes
smooth
muscle
and
cardiac
muscle-
Headache
Dizziness-Take
lying,
sitting
and
standing
B/P,
educate
client
to
sit
and
stand
slowly
Peripheral
edema-assess
for
edema,
monitor
for
worsening
(diuretic)
Flushing
Reflex
tachycardia-monitor
for
elevated
heart
rate
(may
need
a
BB)
Constipation-increase
fibers
and
fluids
(if
not
restricted)
stool
softener
Fatigue-Due
to
low
heart
rate-monitor
EKG,
pulse
rate
and
rhythm
Wea
Pril/ace
inhibitors
-
ANSEnalapril/Vasotec
PRIL-is
the
ending
for
ace's
Reduces
Angiotensin
2
and
aldosterone
levels
Prevents
Angiotensin
1
from
converting
to
Angiotensin
2
in
the
lungs-leaves
the
Angiotensin
1
hanging
in
the
lungs-creates
irritation-cough
Vasodilation-mostly
arteriole
(decreases
afterload)
Excretion
of
sodium
and
water-retention
of
K
(decreases
preload)
Treats
hypertension
and
heart
failure
Do
not
take
2nd
and
3rd
Trimester
of
pregnancy
SE
=
Angioedema-allergic
reaction-swelling
of
tongue,
throat-stop
taking
and
notify
md
Hyperkalemia-monitor
for
widening
and
slowing
of
pulse/qrs,
weakness,
fatigue,
avoid
high
K
foods,
AVOID
SALT
SUBSTITUTES-usually
very
high
in
K,
avoid
potassium
sparing
diuretics,
sport
drinks
are
high
in
K
also
Orthostatic
Hypotension-teach
client
to
sit
and
stand
slowly,
enact
fall
precautions
Neutropenia/Agranulocytosis-monitor
CBC-WBC
count,
reoccurring
infections
Renal
Insufficiency-Monitor
weight,
edema,
I/O,
BUN,
Cr,
and
GFR
Hepatic
Insufficiency-Monitor
AST,
ALT,
Sartan's/angiotension
blockers/arb's
-
ANS...
Arb's-Angiotensin
receptor
blockers,
sartan's
No
Cough,
same
effects
and
side
effects
as
Ace's-just
not
as
potent
Nitrates
-
ANSNitroglycerin/Nitrostat,
Nitro-Bid,
Nitro-Dur
Nitrates
form
nitric
acid
which
is
a
relaxes
smooth
muscle
and
dilates
venous
and
arterial
blood
vessels
Open
veins-blood
pools
in
the
legs-not
as
much
blood
returning
to
the
heart-reduces
preload
Open
arteries-heart
does
not
have
to
work
as
hard
to
pump
blood
out
of
the
heart-reduces
afterload
Opens
the
coronary
arteries
and
helps
supply
blood
to
the
heart
tissue
Can
be
given
sublingually,
orally,
topically,
IV,
buccal
Can
be
for
acute
or
long
term
use Nitroglycerin
dilates
any
artery
and
vein-including
yours
if
you
touch
it
while
administering
it-WEAR
GLOVES
Nitroglycerin
IV
needs
a
glass
bottle
and
covered
from
light-some
hospitals
still
use
special
tubing
(nitro
is
absorbed
in
the
tubing)
Short
term-nitrostat-sublingually-1
tablet
every
5
minutes
x
3
for
relief
of
chest
pain-still
having
chest
pain
call
911/physician
Long-term
nitro-dur
will
last
for
up
to
14
hours
in
the
body
Side
Effects:
Headache-dilates
the
cerebral
arteries-do
no
Digoxin
-
ANSCardiac
Glycoside
Digoxin/Digitek,
Lanoxin,
Lanoxicaps
(Dig)
Increases
the
contractility
of
the
heart
muscle
-
Inotropic
effect-
Increases
cardiac
output
Also
Suppresses
the
SA
node
and
slows
conduction
through
the
AV
node
Half-life
is
3-4
days
Great
Drug-real
side
effects
Digoxin
SE
=
Dysrhythmias
Toxicity
0.5-1.8
normal
level
Signs
of
toxicity-halos
around
objects,
Nausea/Vomiting/Anorexia,
blurred
vision,
fatigue
Bradycardia-must
take
an
apical
pulse
for
one
full
minute,
must
be
60
or
above
to
give
digoxin
Give
with
caution
with
pediatric
and
geriatric
patients
due
to
inadequate
renal
or
hepatic
metabolic
enzymes
Hyperkalemia
can
reduce
effects
of
digoxin
Digoxin
and
Beta
Blockers
can
really
lower
the
pulse
Give
with
caution
with
renal
failure-digoxin
excreted
via
the
kidneys
DIGIBIND
IS
THE
ANTIDOTE
FOR
DIGOXIN
TOXICITY
Digoxin
Decreases
automaticity
of
the
SA
nose
and
slows
conduction
through
the
AV
node
Atrial
dysrhythmias
All
the
side
effects
and
warnings
are
still
important
Heparin
-
ANSNaturally
found
in
the
liver
and
lining
of
blood
vessels
Prolong
coagulation
time
IV
immediate
onset,
Sub
Q
1
hour
Destroyed
by
gastric
enzymes
Weight
based
aPTT
(PTT
also,
but
in
the
hospital
we
use
the
aPTT)
Sub
Q
Thrombocytopenia
occurs
in
30%
of
client
Protamine
Sulfate
is
the
antidote,
1
mg
for
every100
units
of
heparin,
works
for
Lovenox
also
Coumadin
-
ANSWarfarin/Coumadin
Warfarin
inhibits
the
action
of
Vitamin
K,
and
without
adequate
Vitamin
K
the
synthesis
of
clotting
factors
2,
7,
9,
and
10
is
diminished INR/PT
Warfarin
takes
2-3
days
to
achieve
therapeutic
effect-99%
of
warfarin
is
bound
to
plasma
proteins
and
unavailable
to
produce
effects
Vitamin
K
is
the
antidote-green
leafy
veggies
Aquamephyton-works
within
6
hours
Normal
INR
therapeutic
range
is
2-3
Normal
INR
for
everyone
who
is
not
taking
an
anticoagulant
is
around
1
Category
X
for
pregnancy
Avoid
alcohol,
diuretics,
SSRI's,
Antidepressants,
Steroids,
Antibiotics,
Vaccines,
Some
Vitamins,
Amiodarone-all
can
potentiate
warfarin
Bleeding-
Amiodarone
-
ANSAmiodarone
(Cordarone/Pacerone)
Class
III
antidysrhythmic
Potassium
channel
blocker
Ventricular
and
Atrial
Arrhythmias-especially
with
heart
failure
IV
onset
or
PO
onset
looks
to
be
2-3
days
to
1-3
weeks
Half
life
can
be
greater
than
100
days
Check
K
and
MG
levels
prior
to
starting
therapy
Side
Effects:
Fibrosis
of
lungs,
destruction
of
thyroid,
Photosensitivity-Smurfs,
Liver
destruction,
N/V,
Hypotension,
Blindness,
very
hard
on
the
stomach-GI
Distress
Can
increase
serum
digoxin
levels
by
70%,
Increase
warfarin
levels,
Increase
phenytoion
(Dilantin),
Stop
BB
and
CCB?
Statins
(Lipitor)
-
ANSHMG-CoA
reductace
inhibitor-(liver
is
where
the
cholesterol
is
made,
it
is
where
the
HMG-CoA
work)
LDL/Cholesterol
is
reduced
Give
with
food
to
reduce
GI
symptoms
Lipitor
can
be
taken
at
anytime,
most
of
the
class
of
this
medication
needs
to
be
taken
at
bedtime-cholesterol
is
made
by
the
liver
at
night
Up
to
30
days
to
achieve
full
affect
Side
Effects:
GI-constipation,
bloating,
gas,
nausea
Liver-monitor
enzymes-alt,
ast,
alk
phas,
bilirubin,
jaundice,
enlarged
liver-ascites
Rhabdomyolysis-muscle
destruction-CK
elevation-muscle
pain-MD
has
to
be
notified.
Renal
failure
is
very
common
with
Rhabdomyolysis-need
to
make
sure
urine
output
is
30
ml
or
greater
an
hour
No
grapefruit
juice
The
statins
are
hard
on
the
liver-you
need
to
make
sure
other
drugs
the
client
is
on
is
not
hard
on
the
liver-Amiodarone
and
Nizoral
are
two
drugs
that
come
immediately
to
my
mind
furosemide/lasix
(-ide)
-
ANS...Loop
Diuretics-prevents
Na/Cl
reabsorption,
thus
Na
leaves
the
body,
water
follows
Na
and
K
follows
the
water
Furosemide/Lasix,
Bumex/Bumetanide,
Torsemide/Demadex
Work
on
the
entire
Loop
of
Henle-large
volumes
of
water,
Na,
and
K
are
removed
Works
in
renal
failure
Hypovolemic
and
hypokalemia
very
common
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