Pharmacology and the Nursing Process, 8th Ed., Lilley, Rainforth Collins & Snyder | Practical Nurse (LPN) School Study Aid
Routes of Administration Part One
- Oral
- Sublingual
- Buccal
- Rectal
- Tubes
- Transdermal
- Drops/Spray
- Vaginal
- Inhalation
Alendronate (Fosamax)
- Inhibits Osteoclasts
- Osteoporosis
- Paget's Disease
- Esophageal Ulcers
- Musculoskeletal Pain
- Vision Changes
- Atrial Fibrillation
- Osteonecrosis of the Jaw
- Take on Empty Stomach
- Remain Upright
Carbamazepine (Tegretol)
- Inactivates Na+ Channels
- Seizures
- Bipolar Disorder
- Trigeminal Neuralgia
- Nystagmus
- Ataxia
- Hepatotoxicity
- Blood Dyscrasias
- Water Retention
- Stevens-Johnson Syndrome
- Avoid Grapefruit Juice
Iron (Ferrous Sulfate)
- Ferrous Salts
- Anemia
- GI Distress
- Nausea and Vomiting
- Dark Stools
- Take Between Meals
- Liquid can Stain Teeth
- Keep out of Reach from Children
- Caution with GI Disorders
- Avoid Antacids
Hydralazine (Apresoline)
- Severe Hypertension
- CHF
- Reduced Afterload
- Pregnancy
- Vasodilates Arterioles
- Drug-induced Lupus
- Reflex Tachycardia
- Hypotension
- Combined with Diuretic and Beta Blocker
Spironolactone (Aldactone)
- Inhibition of Aldosterone
- Potassium Retention
- Hypertension
- Edema
- Heart Failure
- Hyperkalemia
- Endocrine Effects
- Avoid Potassium Supplements
Lithium
- Mood Stabilizer
- Unknown Mechanism
- Bipolar Disorder
- Nephrogenic Diabetes Insipidus
- Hypothyroidism
- Tremor
- Heart Block
- Pregnancy
- Monitor Plasma Levels
NSAIDs
- Anti-inflammatory
- Analgesic
- Fever
- Closure of Patent Ductus Arteriosus
- Reversible Inhibition of COX-1 and COX-2
- Block Prostaglandin Synthesis
- Interstitial Nephritis
- Gastric Ulcer
- Renal Ischemia
Theophylline (Theo-24)
- Bronchial Smooth Muscle Relaxation
- Asthma
- Insomnia
- Restlessness
- Arrhythmias
- Seizures
- Narrow Therapeutic Range
- Monitor Plasma Levels
Macrolides
- End in "-thromycin"
- Bacteriostatic
- Alternative for Penicillin Allergy
- Respiratory Infections
- Pneumonia
- QT Prolongation and Sudden Death
- C.Diff Overgrowth
- GI Distress
- Slow IV Infusion
Routes of Administration Part Two (Parenteral)
- Intradermal
- Subcutaneous
- Intramuscular (IM)
- Intravenous
- Epidural
- Intrathecal
- Intraosseous
- Intraperitoneal
Transdermal Medication Administration
- Patch or Disc
- Directly on Skin of Arms, Chest, Upper Back
- Avoids First Pass Metabolism
- Sustained Administration of Medication
- Clean Skin After Removal
- Rotate Sites of Patches
- Apply to Dry Skin
- Avoid Shaved Skin
- Avoid Heat
- Nitro Effects Lost After 24 Hours
Needle Sizes and Uses
- Adjust Size Based on Height/Weight
- Subcutaneous Injections
- 3/8 or 5/8 inch
- Intramuscular (IM)
- 1-1.5 inches
Intramuscular Medication (IM) Administration
- Injury to Nerves, Bone, and Blood Vessels
- Deltoid
- Vastus Lateralis
- Ventrogluteal
- Selection of Needle Length
- Aseptic Technique for Drawing Up
- Z-Track
- 90 Degree Angle
- Max Amount (2-5 mL Adult, 1 mL Child)
- Techniques to Reduce Pain
Acetaminophen
- Fever
- Pain
- Reversibly Inhibits COX
- Acts Primarily in CNS
- Hepatic Necrosis
- N-acetylcysteine Antidote
Warfarin (Coumadin)
- Inhibits Clotting Factors
- Atrial Fibrillation
- Venous Thrombosis
- Pulmonary Embolism
- PT/INR Levels
- Observe for Bleeding
- Pregnancy
- Vitamin K and Fresh Frozen Plasma
- Prolonged Therapeutic Onset
- Maintain Same Diet
Ibuprofen (Advil, Motrin)
- NSAID
- COX Inhibitor
- General Pain
- Fever
- Inflammatory Conditions
- GI Ulcers
- Nephrotoxicity
- Rash
- Avoid with Alcohol
- Risk of Thrombotic Event
Phenytoin (Dilantin)
- Blocks Na+ Channels
- Tonic-clonic Seizures
- Ataxia
- Nystagmus
- Sedation
- Gingival Hyperplasia
- Purple Glove Syndrome
- Hirsutism
- Rash
- Anemia
- Individualized Dosing
Diazepam (Valium)
- Anxiety
- Seizures and Status Epilepticus
- Muscle Spasms
- Alcohol Withdrawal
- Dizziness/Vision Changes
- Confusion/Amnesia
- Urinary Incontinence
- Behavioral Changes
- Respiratory Depression
- Flumazenil (Romazicon)
- Fall Precaution
- Do Not Stop Abruptly
Omeprazole (Prilosec)
- "-prazole" Suffix
- Zollinger-Ellison Syndrome
- Gastritis
- Peptic Ulcer
- Gastroesophageal Reflux Disease (GERD)
- Proton Pump Inhibitor (PPI)
- Inhibit H+/K+/ATPase
- Hip Fracture
- Pneumonia
Codeine
- Opioid Receptor Agonist
- Mild to Moderate Pain
- Cough Suppressant
- Sedation
- Constipation
- Miosis
- Close Monitoring When Breast Feeding
- Often Combined with Non-Opioids
Fluoxetine (Prozac)
- Inhibits Reuptake of Serotonin
- Depression
- Sexual Dysfunction
- CNS Stimulation
- Weight Changes
- Serotonin Syndrome
- No MAO-Is
- No Anticoagulants / Antiplatelets
- Suicide Risk
- Delayed Onset of Action
Calcium Channel Blockers (Verapamil and Diltiazem)
- Slows AV Conduction
- Angina Pectoris
- Arrhythmias
- Essential Hypertension
- Bradycardia
- Hypotension
- Constipation
- Peripheral Edema
- Gingival Hyperplasia
- Medication Education
Cyclosporine (Sandimmune) Overview
- Immunosuppressant
- Inhibits Calcineurin, Decreasing IL-2
- Prevent Transplant Rejection
- Psoriasis
- Rheumatoid Arthritis
- Monitor Plasma Levels
- Avoid Grapefruit Juice
- Increased Risk of Lymphoma
Lidocaine
- Blocks Na+ Channels
- Ventricular Arrhythmia
- Anesthetic
- Paresthesias
- Seizures
- Respiratory Depression
- Drowsiness
- Anesthetic Effects Extended with Epinephrine
Phenobarbital (Barbiturates)
- Barbiturate
- Seizures
- Ataxia
- Paradoxical Excitement
- Fatigue/Drowsiness
- Monitor Plasma Levels
- High Potential for Abuse
Azoles (Ketoconazole)
- "-azole" suffix
- Local and Less Serious Systemic Mycosis
- Inhibits Ergosterol Synthesis
- Inhibits P450
- Liver Dysfunction
- Inhibition of Testosterone Synthesis
Renal Corpuscle
- Arterioles
- Glomerulus
- Capillaries
- Fenestrations
- Plasma Solutes and Other Small Molecules Become Ultrafiltrate
- Bowman's Capsule Encapsulates Glomerulus
Proximal Tubule
- Na+ Reabsorbed Via Active Transport
- Water Follows Na+
- Most Of Glucose Reabsorbed
- Most Of Amino Acids Reabsorbed
- Bicarbonate Exchanged For H+
- Drugs and Toxins Excreted
- Filtrate Osmolarity Same As Plasma
- Leads To Loop Of Henle
Loop of Henle
- Descending Limb
- Water Follows Na+
- Medullary Hypertonicity
- Increased Water Reabsorption
- Vasa Recta
- Na+ Reabsorbed Via Active Transport
- Ascending Limb
- Reabsorbs Na+, K+, Cl-
- Decreased Concentration of Filtrate
- Impermeable to Water
- Distal Tubule
Distal Tubule
- Hormonally Regulated
- Aldosterone Causes Na+ Reabsorption
- Na+ Reabsorbed Via Active Transport
- Water follows Na+
- Parathyroid Hormone Causes Ca2+ Reabsorption
- Leads to Collecting Duct
Collecting Duct
- Na+ Reabsorption
- Vasopressin Causes Water reabsorption
- Concentrates Filtrate
Peak and Trough
- Peak
- Highest Concentration
- Trough
- Lowest Level of Therapeutic Range
- Obtain Before Next Dose
- Half-Life
Benzodiazepine Intoxication Assessment
- Drowsiness
- Confusion
- Respiratory Depression
- Hypotension
- Coma
- Flumazenil (Romazicon)
Fluoroquinolones
- End in "-floxacin"
- Bactericidal
- Variety of Infections
- GI Distress
- Photosensitivity
- Achilles Tendon Rupture
- Pregnancy
- Children
- Myasthenia Gravis
- Avoid Milk Products or Antacids
- Slow IV Infusion
Tetracyclines Overview
- End in "-cycline"
- Bacteriostatic
- Infectious Diseases
- Acne
- Periodontal Disease
- Avoid Milk, Antacids, Iron
- Sunlight Protection
Buspirone (Buspar)
- Increases Serotonin
- Anxiety
- Dizziness
- Insomnia
- Delayed Effect
- Safer with Alcohol than Other Anxiolytics
- Low Side Effect Profile
- Low Abuse Potential
Tacrolimus (Prograf) Overview
- Immunosuppressant
- Inhibits Calcineurin, Decreasing IL-2
- Transplant Rejection
- Atopic Dermatitis
- Increased Lymphoma Risk
- Avoid Grapefruit Juice
Statins
- Rhabdomyolysis
- Hepatotoxicity
- HMG-CoA reductase inhibitors
- Decrease LDL
- Decrease Triglycerides
- Increase HDL
Atorvastatin (Lipitor)
- -statin Suffix
- HMG-CoA Reductase Inhibitors
- High Cholesterol
- Hepatotoxicity
- Rash
- Rhabdomyolysis
- Myopathy
- Monitor Liver Enzymes
- Administer at Bedtime
- Avoid Grapefruit
Hypersensitivity Type I
- Previous Antigen Exposure
- Immediate Reaction
- IgE Cross-linking
- Presensitized Mast Cells
- Histamine Release
- Vasodilation
- Anaphylaxis
- Allergies
- Epinephrine
Humoral Adaptive Immunity
- B Cell Binds Free Floating Antigen
- B Cell Presents Antigen to Helper T Cell
- Helper T Cells Help B Cells Develop Antigen Specificity
- Plasma B Cells Secrete Antibodies
- Memory B Cells Cause Faster Secondary Response
Atropine
- Muscarinic Antagonist
- Bradycardia
- Increased Exocrine Secretions
- Smooth Muscle Spasms
- Tachycardia
- Dry Mouth
- Urinary Retention
Tricyclic Antidepressant (TCA) Antidote
- Sodium Bicarbonate (NaHCO3)
Acute Digoxin Toxicity
- Hyperkalemia
- Cholinergic (Nausea, Vomiting, Diarrhea)
- Blurry Yellow Green Vision with Halo of Light
- Arrhythmia
- Bradycardia
- Prolonged PR interval
- Decreased QT
- Scooping on EKG
- T Wave Inversion
Digoxin Toxicity Treatment
- Activated Charcoal
- Slowly Normalize K+
- Digibind (Anti-Digoxin Fab)
- Magnesium Sulfate
- Lidocaine
- Cardiac Pacing
Beta Blockers
- "-olol" suffix
- Decreases Heart Rate and Contractility
- Decreases Peripheral Vascular Resistance
- Decreases Renin Release
- Hypertension
- Heart Failure
- Angina Pectoris
- Asthma and Heart Block Patients
- Assess Blood Pressure and Heart Rate
- Masking Signs of Hypoglycemia
- Do Not Stop Abruptly
Naloxone (Narcan)
- Competitive Opioid Receptor Antagonist
- Opioid Induced CNS Depression
- Severe Nausea and Vomiting
- Excitable State
- Opioid Withdrawal Symptoms
- Repeated Dosing Often Required
Monoamine Oxidase Inhibitors (MAO-Is)
- Atypical Depression
- Increase Levels of Amine Neurotransmitters
- "Takes Pride In Shanghai"
- Tranylcypromine
- Phenelzine
- Isocarboxazid
- Selegiline