Pharm final

• DEA schedules drugs according to their potential for abuse.
• Schedule 1 is highest abuse potential, schedule 5 is lowest.

• illegal
• Heroin, LSD, Meth

• Must have prescription, handwritten in ink by physician, no refills - only 30 day supply:
• Morphine
• PCP
• Cocaine
• Methadone,
• Oxy

assess ability to swallow prior to administering enteral drug

• Refers to what the BODY does with a drug
• Absorption, distribution, metabolism, excretion
• *absorption can be impaired with food or iron

The relationship or point btwn right amount of drug to get therapeutic effect vs where side effects happen

• Assessment
• Dx
• Planning
• Implement
• Evaluation ~ for pharm, this is where drug effectiveness is evaluated. duh

• assess client
• tell physician
• fill out incident report

• A- all right, studies show no increased risk
• B- Ok. animal studies show no risk but no adequate studies in humans done OR animals show AE but studies in humans failed to show risk 
• C- Use caution. Animals show AE, no adequate studies in human OR No studies done
• D- Adequate studies demonstrate risk to fetus, but benefits may outweigh risks
• X- Contraindicated in preg woman. Ex: accutane

• Women seek med care more than man; however, women take longer to get help with heart probs
• Side effects of drugs can be gender specific

• Green tea
• Garlic
• Ginseng
• Ginger
• Ginkgo
• *Not Golden Seal! doesn't interfere with warfarin

• Can be fatal
• S/S of withdrawal: tremors (delerium tremors), seizures, hallucinations, confusion, fatigue, anxiety

• heparin/lovenox: protamin
• Benzos: flumazenil (reverses CNS effects of benzos)
• Opiods: Narcan (Nolaxon)
• Warfarin: Vit K.

• Surface decontamination ~ remove clothes, wash with soap and water
• charcoal, single dose w/in 60 mins of consumption

anticholinergics are used for bradycardia, IBS, PUD, parkinson's (because it lowers acetylcholine).

• 1- Interrupt parasympathetic nerve impulses
• 2. prevent acetylcholine from stimulating cholinergic receptors
• 3- Dont block all cholinergic receptors, just Muscarinic

• drug class that inhibits/disrupts SNS (sympathetic nervous system): adrenergic antagonists.
• Classified according to their site of action: Alpha-adrenergic blockers
• Beta-adrenergic blockers

give flumazenil to reverse the CNS effects of Benzos.

• risk for falls.
• Gabapentin (Neurontin) is an antiseizure and neurpathy drug.
• Causes dizziness, drowsiness, ataxia (uncoordinated movement, like a drunk), vertigo.

• Risperidone is an atypical antipsychotic/schizophrenia drug. Antipsychotics treat the positive and negative effects of mental disorder
• SE include:
• NME (Neuroleptic malignant syndrome)
• Agranulocytosis (low WBC count) 
• hyperactivity, fatigue
• Nausea, wt gain

• Neuroleptic Malignant Syndrome
• life threatening neuro disorder caused by AE of antipsychotic meds
• S/S include:
• high fever
• sweating
• unstable blood pressure
• stupor
• muscular rigidity
• autonomic dysfunction.

• respiratory depression
• sedation
• N/V
• urine retention/constipation
• pruritus
• delirium

the epinephrine prolongs the anesthetic effect at the site (b/c it vasoconstricts, keeping the med in the area longer)

• AKA sinemet.
• Used in parkinsons to help pt perform ADLs, leads to dopamine synthesis (which lack of dopamine is cause of park)
• Toxicity of Sinemet is muscle twitching and spasmodic winking. 
• must continue gradually
• Take on empty stomach for better absorption

• cyclobenzaprine is for muscle spasm.
• SE:other than
• sedation
• dizziness
• dry mouth
• blurred vision
• Ataxia (loss of full control of body movements)
• Tongue swelling
• tachycardia.

• GI distress
• H/A
• fatigue
• heartburn
• *Rhabdomyolysis ~ a breakdown of muscle fibers

• diuretics cause dehydration, orthostatic hypotension, hypokalemia 
• teach pt to rise slowly.
• First line of treatment for stage 2 HTN: thiazide diuretic.
• Loop diuretic can cause electrolyte imbalance of potassium hypokalemia

• Taken for hypertension and heart failure. 
• Duh

• "Can't run, can't have sex. LOL"
• Will cause depression
• bronchoconstriction (don't use w asthma pt)

With metoprolol, monitor for hypotension and bradycardia.

If on long term, teach to take patch off at night to help avoid tolerance

• *Used for Heart failure and shock, it affects strength of myocardial contraction
• Increases BP and force of myocardial contraction 
• Increases urine output
• SE: can cause dysrhythmias and tachycardia
• Extravasation (med goes into extracellular space instead of vein) in peripheral IV's, causing BAD tissue damage

*Low dopamine causes parkinson's

• *remember dysrhythmia has nothing to do with contraction, but conduction
• Important to monitor HR: pulse, rate, rhythm, quality

• bleeding. duh.
• blood tests used to monitor warfarin: PT/INR is lab test
• 1 is the norm, 2-3 is therapeutic

• PR = prothrombin time (time to coagulate)
• INT = internationalize normalized ratio, recall this makes it possible for people to travel out of the country & still be able to have blood levels checked

take through straw cause it's nasty and can stain teeth

• Active immunity - body produces own antibodies in response to exposure. Happens when given vaccines
• Passive immunity - antibodies are donated or transferred from one person to another. Happens w mother/baby

*type of immunity that immunoglobulin gives: artificial passive immunity.

• can cause damage to stomach lining due to lower mucus production.
• can cause GI upset and bleeding, reduce kidney function
• Cox 1: aspirin, IBprof (3200 mx/day), Naproxen
• Cox 2: Celebrex
• *NSAID's block inflammation by inhibiting COX, the key enzyme in making prostaglandins (which are able to promote inflammation)

• penicillin lowers effectiveness of contraceptives (so double up).
• General category of infection caused by antibiotics: superinfection.

AKA Flagyl (used with giardia and Cdiff.) Eliminate alcohol from diet.

• (Retrovir)
• Used for HIV pts.
• Fever, chills,
• muscle weakness,
• headache,
• constipation, n/v, weight loss,
• severe bone marrow problems,
• lactic acidosis

• instruct family members to not get live vaccines.
• 2 indications of bone marrow problems with chemotherapy: leukocytopenia, agranulocytopenia, thrombopenia

• Use soft toothbrush, use electric razor, avoid commercial mouthwash
• VS every 4hr, even slight fever needs to be reported

• AKA fluticasone
• Drug for allergic rhinitis.
• An intranasal corticosteroid.
• B/c of the systemic effects, with intranasal steroids: teach pt Don't Swallow!

• side effects include headache, nervousness, tachycardia.
• Rinse mouth after

• the proton pump is activated by food to produce acid....
• take omeprazole (Prilosec) before breakfast on an empty stomach

• AKA metamucil.
• Take 1 glass (12 oz.) with drug and 1 glass after.

• folic acid prevents spinabifida.
• Vit B12 prevents pernicous anemia.

if pt is on levothyroxin and heart rate starts to go up..... suspect hyperthyroidism.

• don't mix lantus with anything else.
• When giving lantus and lispro, give them seperately.

Potassium

A1c

diabetes

• Metformin (Glucophage)
• only drug in class
• Is an oral hyperglycemic drug, often used because it is safe and doesn't cause hypoglycemia. decreases glucose production by liver
• doesn't do anything to pancreas

•  
• teach to monitor BS, s/s of infection

• don't give contraceptive to women who smoke or have blood clots or history of blood clots.
• Penicillin lowers the effectiveness of contraceptives, so double up.

• AKA Viagra.
• Don't take with nitrates.

• AKA alendronate.
• Osteoporosis drug- A bisphosphonate.
• Give with a full glass of water and stay upright for 30 mins after
• call doc if you have heartburn.

Can cause hypocalcemia, cause it takes calcium out of blood and puts in bone

• AKA isotretinoin
• PREGO CAT X!
• used for severe acne w cysts

• contacts should be kept out for 15 minutes after putting in eye drops.
• Don't mix drugs
• Wait 5 mins btwn drugs
• Place in conjunctiva

• Strongest anti-inflammatory used for asthma.
• Dexamethazone is a steroid.
• Side effect of glucocorticoids which could lead to GI bleed: peptic ulcer.
• osteoporosis, 
• Fat, bitchy and pimply

Vit K is the antidote for warfarin.

check BP, assess lungs, check edema

Assess BP and listen to lungs for crackles. Also monitor normal blood levels of electrolytes.