NCLEX - Pharmacology

Adrenergic

Communication between the nerves and muscles that uses epinephrine as the 'messenger.' Adrenergic stimulation is what is involved in the 'flight or fight' response, which means the body is alerted to a danger of some sort and prepares to basically run or

Adrenergic Response

Increased HR, sweating, and increased Blood Pressure.

Norepinephrine (Levophed)

Vasoconstrictor to increase blood pressure and cardiac output.
*Reflex bradycardia may occur with rise in BP.
Infuse with Dextrose solution, not saline.

Dopamine (Intropin) [low dose vs high dose)

Low Dose: Dilates renal and coronary arteries
High Dose: Vasoconstrictor, increases myocardial oxygen consumption
*Headache is early symptom of drug excess.

Epinephrine (Adrenalin)

Stimulates alpha and beta adrenergic recptors
Always check strength: Inhalation - 1:100; SC/IM 1:1,000

Dobutamine Hydrocholoridie (Dobutrex)

Stimulates beta 1 receptors. Incompatible with alkaline solutions (sodium bicarb). Administer through CVC or Large PIV. Do not infuse line with other meds.
*Monitor EKG, BP, I/O, K+

Shock, Cardiac Arrest and Anaphylaxis Meds

Norepinephrine (Levophed)
Dopamine (Intropin)
Epinephrine (Adrenalin)
Isoproterenol (Isuprel)
Phenylephrine (Neo-Synephrine)
Dobutamine Hydrocholoride (Dobutrex)
Milrinone (Primacor)
Sodium Nitroprusside (Nitropress)
Diphenhydramine HCl (Benadryl)

Antianxiety Agents - Benzodiazepine Derivatives Meds

Chlordiazepoxide (Librium)
Diazepam (Valum)
Alprazolam (Xanax)
Clonazepam (Klonopin)
Lorazepam (Ativan)
Oxazepam (Serax)
Midazalam (Versed)

Antianxiety Agents - Benzodiazepine Derivatives Info

Affects neurotransmitters, CNS Depressant.
Used for anxiety disorders, manic episodes, panic attacks.
SE: Sedation, confusion, Hepatic Dysfunction
NSG: Potential for addiction/overdose.
Avoid ETOH will cause Respiratory Depression!!
Monitor Liver Function

Chlordiazepoxide (Librium) and Diazepam (Valum)

CNS Depressant. Used for anxiety, sedation, Alcohol withdrawal, seizures.
*Alcohol increases CNS depression.

Antianxiety Agents - Nonbenzodiazepine Antianxiety Meds

Buspirone (Buspar)
Hydroxyzine (Vistaril, Atarax)

Herbals - Kava and Melatonin

Kava: Similar to benzodiazepines, suppresses emotional excitability and produces mild euphoria.
*Do not take with CNS Depressant. Pregnant or lactating women should not take
Melatonin: Used for Jet lag, insomnia, influences sleep-wake cycles (levels are h

Antacid Meds

Aluminum hydroxide gel (Amphojel)
Calcium Carbonate (Titralac)
Aluminum Hydroxide (Milk of Mg)
Aluminum hydroxide and magnesium hydroxide (Maalox).

Antacid

Neutralizes gastric acids (does not coat ulcer). Raises gastric pH
Inactivates pepsin.
Use: Peptic ulcers, prevent/tx indigestion reflex esophagitis
SE: Constipation, diarrhea, acid rebound after taking.
NSG: Interferex with absorption of Antibx, Iron Pre

Antidysrhytmics Info

Decreases myocardial irritability, interferes with electrical excitability of heart.
Uses: Afib, flutter, tachycardia, PVC
SE:
Light-headed, hypotension, urinary retention
NSG:
Monitor VS very frequently.
Monitor cardiac rhythm

Antidysrhytmics - Class IA

Procainamide (Pronestyl)
Disopyramine (Norpace)
SE: Hypotension, heart failure
NSG: Monitor BP. Monitor for widening of PR, QRS, QT intervals.

Antidysrhytmics - Class IB

Lidocaine (xylocaine)
Mexiletine hydrocholirde (Mexitile)
Tocainide hydrochloride (Tonocard)
SE: Slurred speech, confusion, drowsiness, confusion, seizures, Hypotension and bradycardia.
NSG: Monitor CNS side effects. Monitor BP and HR and cardiac rhythm

Antidysrhytmics - Class IC

Flecainide (Tambocor)
Propafenone hydrochloride (Rythmol)
SE: Bradycardia, hypotension, dysrhythmia. CNS - anxiety, insomnia, confusion, seizures
NSG. Monitor for increasing dysrhythmias. Monitor HR and BP and CNS effects

Antidysrhytmics - Class II

Propanolol (Inderal)
Acebutolol (Sectral)
Esmolol hydrochloride (Brevibloc)
Sotalol hydrochloride (Betapace)
SE: Bradycarida and Hypotension. Bronchospasm. Increase in Heart Failure. Fatigue and sleep disturbances.
NSG:
**Monitor Apical HR for 1 min befor

Antidysrhytmics - Class III

Amiodarone hydrochloride (Cordarone)
Ibutailide fumarate (Corvert)
Dofetilide (Tikosyn)
SE: Hypotension, bradycardia. AV block. Muscle weakness, tremors, photosensitiviey and photophobia, liver toxicity.
NSG:
Continuous monitoring of cardiac rhythm during

Antidysrhytmics - Class IV

Verapamil (Calan)
Diltiazem hydrochloride (Cardizem)
SE: Bradycaria, hypotension, Dizziness and orthostatic hypotension, heart failure.
NSG:
Monitor apical HR and BP. INstruct clients about orthostatic precautions.

Alpha Adrenergic Receptor

Vasoconstriction of Coronary Arteries
Vasoconstriction of Veins
Decrease motility of smooth muscle in GI tract

Beta Adrenergic response

Increases in HR --> Increase in Cardiac Output (positive chronotropic effect)
Increases impulse conduction

Antibiotic - Aminoglycoside (Drug Names)

Gentamycin (Garamycin)
Neomycin
Streptomycin (Tobrax)
Amikacin (Amikin)

Antibiotic - Aminoglycoside

Inhibits protein syntheis in Gram- neg bacteria
Use:
Psuodmonas, E. Coli, Severy systemic infection of CNS.
SE:
Ototoxicity (ears), Nephrotoxicity, Anorexia, N/V, Diarrhea ( Kills normal flora in GI)
NSG:
Check 8th cranial nerve fxn (hearing)
Check renal

Antibiotic - Cephalosporin (Drug Names)

Cephalexin (Keflex)
Cefaclor (Ceclor)
Ceftriaxone (Rocephin)
Cefepime (Maxipine)

Antibiotic - Cephalosporin

Inhibits synthesis of bacterial cell wall
Uses -
Tonsilitis, otitis media, Meningitis, Perioperative prophylaxis
SE:
Rash, Superinfection
Bone marrow depression --> Monitor Lab values
NSG:
Take with food.
**
Cross allergy with penicillins
**
False positiv

Antibiotic Info

1. First sign of SE is allergy/hypersensitivity
Range: Mild rash/hives - Severe Sensitivity (anaphylactic shock)
SOB (usually first symptom within 20 min.
2. Superinfection - May destroy normal flora
3. Organ Toxicity (liver, kidney)

Antibiotic - Fluoroquinolones

Interferes with DNA repliction
Uses:
Ecoli, Pseudomonas, S. Aureus.
SE:
Diarrhea
Elevated BUN, AST (SGOT), ALT (SGPT), serum creatinine, alkaline phosphatase --> dt decrease in normal flora
Decreased WBC and Hct (interferes with blood formation
NSG:
Food

Antibiotics - Glycopeptides

Vancomycin (Vancocin