Showing posts with label Pharmacology. Show all posts
Showing posts with label Pharmacology. Show all posts
ASTHMA
| Major Side Effects | Nursing Intervention | |
| albuterol, terbutaline (theophyline | tremor dizziness palpitation | -do not exceed prescribed dose -notify physician if client becomes non-responsive to usual dose |
| theophyline | arrhythmias, seizures | - monitor vital signs -maintenance: teach client to take at regular intervals during day |
| corticosteroids | cushing's syndrome | - do not discontinue abruptly (may trigger adrenal insufficiency crisis) |
Saturday, May 17, 2008 | Labels: Pharmacology | 0 Comments
ANTIARRHTHMIC DRUGS
- all antiarrhythmics have the potential to worsen arrhythmia ->bradycardias, tachycardias, hypotension - instruct client to take exactly as prescribed
| Major Side Effects | Nursing Intervention | |
| procainamide | reversible lupus erythematosus | -discontinue, under medical supervision if lupus occurs |
| phenytoin | gingival hyperplasia | -teach client proper mouth and dental care |
| quinidine | potentiates digitoxin toxicity | -monitor apical heart rate and blood pressure -monitor ECG |
Saturday, May 17, 2008 | Labels: Pharmacology | 0 Comments
ANTICOAGULANTS
| Antagonist (in case of Overdose) | Nursing Interventions | |
| heparin (immediate effect) | protamine sulfate | -do not give IM(hematoma and pain) -watch for bleeding, bruises -teach client to avoid aspirin -monitor partial thromboplastin time (PTT) |
| warfarin (takes 4-5 days for full effect) oral | vitamin k | -watch for bleeding, bruises -teach client to avoid aspirin -if ongoing therapy: client should carry medical alert card -monitor prothrombin time (PT) |
| streptokinase, urokinase (to dissolve thrombi) | aminocaproic acid | -risk of severe bleeding have blood available for transfusion |
Saturday, May 17, 2008 | Labels: Pharmacology | 0 Comments
INOTROPIC DRUGS
- increased strength of cardiac contraction -> increased stroke volume -> increased cardiac output
| Major Side Effects | Nursing Intervention | |
| digoxin, digitoxin | low therapeutic index!!! (= high risk of toxicity | -take apical pulse for full minute, monitor ECG -don't give if hearth rate is low (<60bpm) -monitor potassium levels (risk of enhanced toxicity) |
| dobutamine, dopamine | hypertension, headache, angina | -alert physician if arrhythmia, chest pain or dyspnea occur |
Saturday, May 17, 2008 | Labels: Pharmacology | 0 Comments
DIURETICS
| Major Side Effects | Nursing Intervention | |
| furosemide (loop diuretics) | hypokalemia | -recommend foods rich in potassium: bananas, prunes... -watch for signs of hypokalemia: muscle weakness, cramps |
| thiazides | hypokalemia hyperglycemia | -recommend foods rich in potassium: bananas, prunes... -watch for signs of hypokalemia: muscle weakness, cramps -monitor blood glucose |
| spirinolactone (potassium sparing) | gynecomastia menstrual irregularity | -clients need to be advised of possible endocrine effects -teach client to avoid excessive dietary potassium |
| mannitol (osmotic diuretic) | transient plasma volume increase | -monitor vital signs and central venous pressure |
Saturday, May 17, 2008 | Labels: Pharmacology | 0 Comments
NITRITES
| Major Side Effects | Nursing Intervention | |
| nitroglycerin. ISDN | headache, dizziness orthostatic hypotension | -occasional headache: aspirin or acetaminophen -frequent headache: may have to adjust dosage -instruct client to rise slowly from sitting position -instruct client to protect drug from light, heat and moisture |
Saturday, May 17, 2008 | Labels: Pharmacology | 0 Comments
ANTIHYPERTENSIVE DRUGS
| Contraindications | Nursing Interventions | |
| propranolol (beta-blockers) | diabetes asthma peripheral vascular disease | -watch client: dizziness and fatigue increase risk of injury -advice client not to discontinue abruptly -risk of rebound hypertension, angina or MI |
| nifedipine (Ca2+ antagonists) | congestive heart failure | -advice clients not to discontinue abruptly |
| captopril (ACE inhibitor) | pregnancy | -advice client to stand up slowly (orthostatic hypotension is a common problem) |
Compliance is a big problem since side effects are often worse than disease.
(hypertension is often asymptomatic)
Thursday, May 15, 2008 | Labels: Pharmacology | 0 Comments
CORTICOSTEROIDS
| Major Side Effects | Nursing Interventions | |
| cortizone, dexamethazone | cushing's syndrome, adrenal depression, skin atrophy | CREAMS: -do not apply to broken skin -don't apply near eyes SYSTEMIC: -monitor for edema, signs of infection -avoid immobility (increased risk of osteoporosis) -never discontinue abruptly (taper the dose) |
Thursday, May 15, 2008 | Labels: Pharmacology | 0 Comments
NONSTEROIDAL ANTI-INFLAMMATORY DRUGS
> NSAIDs inhibit prostaglandin synthesis and may cause erosive gastritis and bleeding. Discourage "routine" use.
| Major side effects | Nursing Interventions | |
| aspirin | GI distress, occult bleeding suppresses platelet function may cause Raye's syndrome | -give with meals or milk -dont give within 1 week of surgery (risk of bleeding) -dont give with children with viral infection |
| acetaminophen | liver toxicity with overdose | -monitor liver enzymes for 1 week in case of overdose |
| ibuprofen | GI distress | -give with meals or milk |
| phenylbytazone | bone marrow depression, anemia | -monitor CBC -should not be used for more than 1 week |
| indomethacin | CNS: dizziness, lightheadedness, blurred vision | -regular eye exam if used for long term therapy |
signs of salicylate intoxications:
mild- tinnitus, central hyperventilation
severe- respiratory plus metabolic acidosis
Reye's syndrome:
avoid aspirin in children with viral infection
rish for fulminant hepatitis, cerebral edema
-Haunurses 5/14/08 3:42 PM
Wednesday, May 14, 2008 | Labels: Pharmacology | 0 Comments
ANTIBIOTICS
>antibiotics may cause diarrhea due to disruption of normal flora.
| Major side effects | Nursing Interventions | |
| penicillins | allergic reactions: -maculopapular rash -anaphylactic shock | -watch for rash, fever and chills -be prepared to treat anaphylaxis. |
| cephalosporins | allergic reactions | -check patient history: avoid in patients with known penicillin allergy |
| sulfonamides | renal toxicity | -best absorbed on empty stomach -increase fluid intake |
| aminoglycosides | renal toxicity ototoxicity | -increase fluid intake -watch for tinnitus, vertigo or hearing loss |
| tetracyclines | bind with calcium | -give at least 2 hours before or after ingesting milk. -dont give in 2nd half of pregnancy or to children <8years (->tooth discoloration) |
| isoniazid (antitubercular) | hepatotoxicity peripheral neuropathy | -watch for loss of appetite, jaundice, dark urine -monitor liver function test -avoid alcohol |
| rifampicin (antitubercular) | hepatotoxicity orange color urine | -teach client that orange urine coloration is normal effect |
| ethambutol (antitubercular) | impaired vision | -evaluate clients vision and color discrimination |
Wednesday, May 14, 2008 | Labels: Pharmacology | 0 Comments
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