NCTI- Pharmacology- Drug List A

• ASA
• Aspirin

• Analgesic
• Antipyretic
• Platelet Aggregate Inhibitor
• NSAID

• 1. Inhibits aggregation (clumping) of platelets by blocking the formation of the substance thromboxane (A2) ; prolonging bleeding time
• 2. Provides analgesia by inhibiting prostaglandins and other substances that sensitize pain receptors (blocking of prostaglandins also accounts for the drug’s anti-inflammatory effects).
• 3. Relieves fever by acting upon the hypothalamic heat regulating center

• 1. Acute myocardial infarction
• 2. Thrombotic stroke

• 1. Active gastrointestinal bleeding
• 2. Asthma patients with nasal polyps (anaphylaxis is common)

• Gastrointestinal: bleeding, heartburn, epigastric pain
• CNS: dizziness, confusion, drowsiness
• ENT: tinnitus, hearing loss
• Other: may impair renal function, may prolong labor in pregnancy with increased bleeding

• 1. Medical history of pre-existing ulcers, liver disease or bleeding disorders
• 2. Due to the possible association of aspirin with Reye’s syndrome, do not give drug to children or teenagers with signs and symptoms of chickenpox (varicella) without physician consultation

• 1. inhibits anti-hypertensive effects of ACE inhibitors
• 2. Ammonium chloride and other urine acidifying drugs will increase effects of aspirin – watch for toxicity

PO

Onset is 5-30 minutes and may last 1-4 hours, peak in 15 min.

• Adult: 162-325 mg PO
• Pediatric: not recommended

none

none

• opioid narcotic
• CNS depressant

• 1. Alters pain perception and produces euphoria
• 2. Decreases myocardial oxygen demand by decreasing preload (venous pooling due to peripheral vasodilation) and decreasing afterload (decreased systemic vascular resistance due to peripheral vasodilation)
• 3. Depresses the CNS by interacting with opiate receptors in the brain

• Moderate to severe pain
• Chest pain of suspected myocardial origin
• Pulmonary Edema from Congestive Heart Failure with or without chest pain
• Burns

• Altered level of consciousness
• Abdominal pain of unknown etiology
• Respiratory depression
• Head injury
• Hypovolemia

• Cardiovascular: bradycardia, hypotension, (rebound tachycardia/hypertension)
• Neurological: sedation, agitation, tremors/seizures, hallucinations
• Respiratory: depression, arrest
• Gastrointestinal: nausea/vomiting

Morphine Sulfate is an opiate derivative – Naloxone should be available to reverse any severe respiratory side effects

Use with caution with patients taking other analgesics, depressants or narcotics

IV, IO, IM

IV/IO will have an onset of 2-5 minutes and IM will have an onset of 5-10 minutes. Each will last approximately 3-5 hours

• Adult:
• Pain Relief: 1.0 – 10.0 mg IV titrated to pain relief or 5.0 – 10.0 mg IM as a single dose only
• Pulmonary Edema: 5.0 – 10.0 mg slow IV push (2.0 mg/minute)

Pediatric: 0.1 – 0.2 mg/kg slow IV push (1.0 mg/minute) titrated to pain relief or 0.1 mg/kg IM

May draw 10 mg (1 ml) into a 10 ml syringe and mix with 9 ml of Normal Saline. This creates a 1 mg/1 ml concentration for better control when administering the medication.

• Acta-Char
• Actidose-Aqua
• Insta-Char
• Liqui-Char
• CharcoAid

adsorbent

Binds (adsorbs) toxic substances inhibiting gastrointestinal absorption, leaving less toxic substance in body circulation; increasing fecal elimination of drug/charcoal complex

Suspected ingestion of drugs or chemicals

• Patients with a compromised airway – need to minimize chance for aspiration or obstructionIngestion of Iron or multi-vitamins
• Caustic acids/alkalis
• Cyanide Poisoning

• Respiratory: choking
• Gastrointestinal: vomiting, black stools, abdominal cramping/bloating

• Should not be administered immediately after Syrup of Ipecac
• Must shake vigorously prior to administration
• Do not use charcoal with sorbitol (an added sweetener) in children < 1 yr

Does not adsorb cyanide, ethanol, methanol, ferrous sulfate, caustic alkali or mineral acids, or lithium

PO voluntarily by patient or PO via nasogastric/orogastric tube

Onset is immediate, peak effect and duration are unknown

• Adult: Initially 1g/kg PO
• Pediatric: Initially 1g/kg PO

• Most effective if administered within 30 minutes of ingestion
• Use very cautiously in patients who cannot protect their own airway

• Nitrolingual
• Nitrostat
• Nitrobid
• Tridil

• Vasodilator
• Nitrate
• Antianginal

• Relaxes smooth muscles causing venous dilation
• Reduces preload and afterload to the heart
• Dilates the coronary arteries resulting in increased perfusion of the myocardium

• Chest pain of cardiac origin
• Acute pulmonary edema

• Blood pressure less than 100 mmHg systolic
• Patients who have taken Erectile Dysfunction medications in the last 24-48 hours
• Signs and symptoms of head trauma (increased intracranial pressure) or cerebral hemorrhage
• Poor systemic perfusion

• Cardiovascular: hypotension, bradycardia, rebound hypertension/tachycardia, palpitations
• Neurological: headache
• Other: flushed skin, sublingual burning

Monitor blood pressure closely for signs of hypotension (before and after administration)

Use with caution with patients who already use vasodilators, alcohol, calcium channel blockers, beta blockers and phenothiazides

SL, TM (transmucosal), transdermal (nitropaste)

Onset in 1-3 minutes and may last 30-60 minutes

• Adult: 0.4 mg as a single spray or single tablet. May repeat every 3-5 minutes
• Pediatric: not recommended

• Do not shake canister if administered as a spray as it will altered the metered dose in a single spray
• Do not have patient inhale drug on administration as it will alter absorption rate
• Establish IV prior to or immediately following administration to combat hypotension if necessary

0₂

gas

Increases percentage of oxygen in inspired air (FiO2)

• Increase oxygen demand
• Hypoxemia or hypoxia
• Chest pain of myocardial origin, cardiovascular compromise or emergencies
• Respiratory insufficiency
• Neurological diseases or disorders
• Hypoperfusion state or trauma

none

Respiratory: dry mucous membranes, upper respiratory irritation, pulmonary edema

• Closely monitor patients with COPD
• Patients with respiratory insufficiency should be monitored closely to ensure adequate ventilation
• Non-humidified oxygen may cause drying of the mucous membranes
• Neonates should not receive high concentrations for long periods of time

none

inhaled

Onset in 1-2 minutes and may last 30 minutes

• Nasal Cannula 2-6 LPM
• Simple Face Mask 6-10
• LPMNonrebreather Mask 10-15 LPM
• HHN/Neb Mask 6-8 LPM
• BVM 15 LPM

none