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Chris Shared "Pharmacology" - 300 Picmonics

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Pharmacology

Warfarin
Mechanism of Action
Interferes with Vitamin K-dependent Clotting Factors
Extrinsic Pathway
Bridge with Heparin
Indications
Chronic Anticoagulation
Side Effects
Bleeding
Necrosis
Cytochrome P450
Contraindications
Pregnancy
Antidote
FFP + Vitamin K
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2 mins
Heparin Mechanisms
Mechanism of Action
Short Half-life
Antithrombin Activation Cofactor
Decrease Thrombin, Factor Xa
Side Effects
Bleeding
Heparin Induced Thrombocytopenia (HIT)
Antidote
Protamine Sulfate
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2 mins
Aminoglycosides
Drug Names
Gentamicin
Neomycin for Bowel Surgery Prep
Amikacin
Tobramycin
Streptomycin
Mechanism of Action
Bactericidal
Inhibit Formation of Initiation Complex
Cause Misreading of mRNA
Require O2 for Uptake
Resistance
Resistance by Transferase Enzymes
Acetylation
Phosphorylation
Adenylation
Indications
Gram-Negative Rod Infections
Synergistic with B-Lactam Antibiotics
Side Effects
Nephrotoxicity Especially When Used with Cephalosporins
Ototoxicity Especially When Used with Loop Diuretics
Teratogen
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5 mins
Vancomycin Mechanism
Bacteriostatic and Bactericidal
Gram-Positive
Inhibits Cell Wall Mucopeptide
Binds to D-ala D-ala
Resistance with Change to D-ala D-lac
Staphylococcus aureus
Orally for Clostridium difficile
Enterococci
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2 mins
Fluoroquinolones Antibiotics
-floxacin
Mechanism of Action
Inhibits Topoisomerase II & IV
Bactericidal
Indications
Gram-negative Rods
Pneumonia
Gastrointestinal Infections
Urinary Tract Infection
Genital Infections
Drugs
Levofloxacin
Ciprofloxacin
Has Pseudomonas Coverage
Considerations
Avoid Polyvalent Cations
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3 mins
Needle Sizes and Uses
Adjust Size Based on Height/Weight
Subcutaneous Injections
3/8 or 5/8 inch
Intramuscular (IM)
1-1.5 inches
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1 min
Peak and Trough
Peak
Highest Concentration
Trough
Lowest Level of Therapeutic Range
Obtain Before Next Dose
Half-Life
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2 mins
Routes of Administration Part One
Enteral Administration
Oral
Sublingual
Buccal
Rectal
Tubes
Topical or Mucous Membrane Administration
Transdermal
Drops/Spray
Vaginal
Inhalation Administration
Inhalation
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2 mins
Routes of Administration Part Two (Parenteral)
Parenteral Administration
Intradermal
Subcutaneous
Intramuscular (IM)
Intravenous
Epidural
Intrathecal
Intraosseous
Intraperitoneal
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2 mins
Intramuscular Medication (IM) Administration
Risks
Injury to Nerves, Bone, and Blood Vessels
Sites
Deltoid
Vastus Lateralis
Ventrogluteal
Nursing Considerations
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
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2 mins
Transdermal Medication Administration
Application
Patch or Disc
Directly on Skin of Arms, Chest, Upper Back
Benefits
Avoids First Pass Metabolism
Sustained Administration of Medication
Nursing Considerations
Clean Skin After Removal
Rotate Sites of Patches
Apply to Dry Skin
Avoid Shaved Skin
Avoid Heat
Nitro Effects Lost After 24 Hours
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2 mins
Ear Drops Medication Administration
Indications
Earwax Buildup
Ear Infections
Pulling The Pinna
Child - Back and Downward
Adult - Back and Upward
Procedure
Side-Lying with Ear Up
Instill Medication
Stay for 2-3 Minutes
Nursing Considerations
Room Temperature
May Massage Tragus
Perforated Eardrum
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2 mins
Eye Medication Administration
Procedure
Supine with Neck Hyperextended
Wash Away Crusts
Cotton Ball on Cheekbone
For Ophthalmic Drops
Instill Drops into Conjunctival Sac
Repeat if Missed or Patient Blinks
5 Minutes Before 2nd Medication
For Ophthalmic Ointment
Thin Stream Along Inner Edge
Inner Canthus to Outer Canthus
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2 mins
Alpha 1 Receptor
Characteristics
Gq Subunit
Increase Vascular Smooth Muscle Contraction
Increase Pupillary Dilator Muscle Contraction
Increase Intestinal and Bladder Sphincter Muscle Contraction
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1 min
Alpha 2 Receptor
Characteristics
Gi Subunit
Decrease Sympathetic Outflow
Decrease Insulin Release
Decrease Lipolysis
Increase Platelet Aggregation
Decrease Aqueous Humor Production
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2 mins
Beta-1 Receptor
Characteristics
Gs Protein Class
Increased Heart Rate
Increased Contractility
Increase Renin Release
Increased Lipolysis
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44 secs
Beta-2 Receptor
Characteristics
Gs protein class
Increased Heart Rate
Increased Contractility
Increased Lipolysis
Increased Insulin
Increased Aqueous Humor Production
Ciliary Muscle Relaxation
Vasodilation
Bronchodilation
Decrease Uterine Tone
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2 mins
P450 Inhibitors
Quinidine
Ciprofloxacin
Isoniazid
Grapefruit Juice
Acute Alcohol Use
Erythromycin (Macrolide)
Indinavir
Cimetidine
Sulfonamides
Ketoconazole
Amiodarone
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2 mins
P450 Inducer
Griseofulvin
Phenytoin
Carbamazepine
Rifampin
Barbiturates
Chronic Alcohol Use
St. John's Wort
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51 secs
Benzodiazepine Antidote
Antidote
Flumazenil
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40 secs

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