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