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PHARMACOLOGY II, BY ANGIE LAWSON RN, BSN, SULFONAMIDES, Bacteriostatic - antagonism to PABA

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2021-10-12 published at Spiritual/ Inspirational category

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1.PHARMACOLOGY II BY ANGIE LAWSON RN, BSN
2.SULFONAMIDES Bacteriostatic - antagonism to PABA, which some bacteria need to multiply Uses: UTI and 2nd and 3rd degree burns Adverse Reactions Agranulocytosis Thrombocytopenia Aplastic anemia Leukopenia Take with a full glass of water & not with meals
3.PENICILLINS Bactericidal or bacteriostatic – prevents bacteria from using a substance necessary for maintaining their cell wall Uses: UTI’s, septicemia, meningitis, gonorrhea, syphilis, pneumonia and respiratory infections Adverse reactions (increase risk if allergic to other substances): Anaphylactic shock - severe hypotension, respiratory distress Superinfection – diarrhea Take with a full glass of water & not with meals
4.CEPHALOSPORINS Affect the bacterial cell wall, bactericidal Uses: pharyngitis, tonsillitis, otitis media, lower resperatory infections, UTI’s septicemia and gonorrhea Adverse reactions Nausea, vomiting & diarrhea Superinfection: sore mouth and throat urticaria Take with food or milk
5.TETRACYCLINE Bacteriostatic – inhibits bacteria protein synthesis Uses: Rocky mountain spotted fever, intestinal amebiasis, chlamydia & severe acne Adverse reactions Photosensitivity (exaggerated sunburn – avoid exposure to sunlight or sun lamps Do not take with milk or milk products
6.MACROLIDES Bacteriostatic or bactericidal – binds to the cell membrane and causes changes in protein function Uses: acne, skin infections & upper respiratory infections Adverse reactions Nausea, vomiting, diarrhea Hypersensitivity reactions (itching, wheezing, rashes) Take with full glass of water & avoid alcohol
7.LINCOSAMIDES Bactericidal – inhibit protein synthesis Uses: more serious infections Adverse reactions Abdominal pain, nausea, vomiting, diarrhea Take with full glass of water & avoid alcohol
8.FLUOROQUINOLONES Bactericidal – interferes with DNA gyrase needed by the bacteria to synthesis DNA Uses: lower respiratory infections, UTI’s, STD’s & skin infections Adverse reactions Ototoxicity, nephrotoxicity, neurotoxicity Take with full glass of water, drink 6-8 glasses of fluids daily, avoid sunlight, and NO alcohol
9.AMINOGLYCOSIDES Bactericidal – blocks a step in protein synthesis preventing multiplication Uses: preoperatively, hepatic coma Adverse reactions Nephrotoxicity, ototoxicity, neurotoxicity Nausea, vomiting, anorexia, rash, urticaria Take with full glass of water, drink 6-8 glasses of fluids daily, avoid sunlight, and NO alcohol
10.OTHER ANTI-INFECTIVES CHOLORAMPHENICOL LINEZOLID MEROPENEM METRONIDAZOLE PENTAMIDINE ISETHIONATE SPECTINOMYCIN VANCOMYCIN
11.ANTITUBERCULAR DRUGS Used to treat NOT cure Bacteriostatic – inhibits bacterial cell wall synthesis Giving three drugs for the treatment of TB helps slow the development of bacterial resistance Must be given for 6-9 months continuously
12.LEPROSTATIC DRUGS Bactericidal – exact action unknown Uses: treatment of leprosy Given orally, maybe for years Prior to initializing treatment assess affected areas on the body.
13.ANTIVIRAL DRUGS Inhibit viral DNA or RNA replication Uses: herpes simplex 1 & 2, HIV, chytomegalovirus, infuenza A, RSV Adverse Reactions GI upset Antibiotic can be given at the same time to prevent or treat secondary bacterial infections, but not to cure a virus. The drugs will not prevent the spread of the infection to others.
14.ANTIFUNGAL Thought to have an effect on the cell membrane Uses: superficial or deep fungal infections Adverse Reactions Local reactions (irritation, burning, redness or stinging) Be sure to clean area prior to applying topical tx. Vaginal Suppositories should be given, high in the vagina and at bedtime.
15.ANTIHELMINTIC Kills the parasite Uses: roundworms, pinworms, whipworms, hookworms, and tapeworms Adverse Reactions Mild if they even occur Educate patients to wash hands thoroughly after urinating or defecating
16.ANTIMALARIAL Interfere with the life cycle of the plasmodium Uses: prevention and management of malaria Adverse Reactions Hypotension, visual disturbances, headache, nausea Photosensitivity, anorexia, nausea Tinnitus, dizziness, headache, GI disturbances When used for prevention take once weekly, on the same day each week.
17.SALICYLATES All Salicylates are similar in actions, Aspirin has a greater anti-inflammatory effect Uses: pain relief, fever, inflammation, reduce the risk of MI and stroke. Adverse Reactions Gastric upset, heartburn, nausea, vomiting, anorexia, GI bleeding. Aspirin inhibits the aggregation of platelets. S&S of mild salicylism – dizziness, tinnitus, difficulty hearing
18.NON SALICYLATES Mechanism of action is unknown Uses: pain relief, fever (doesn’t have an anti-inflammatory action.) Adverse Reactions Very few and usually occur with chronic use or overdose Take with food or full glass of water
19.NSAIDS Nonsteroidal anti-inflammatory drug’s Thought to act by inhibiting prostaglandin synthesis Uses: pain relief, primary dysmenorrhea, fever reduction Adverse Reactions GI reactions, can be severe or even fatal Age increases the risk of adverse reactions Take with food or a full glass of water
20.NARCOTIC ANALGESICS Agonist – Partial Agonist – Mixed Agonist-Antagonists (see definitions for actions) Uses: relieve or manage severe acute or chronic pain. Adverse Reactions Light-headedness, dizziness, sedation, constipation, anorexia, nausea, vomiting and sweating. Miosis may occur after giving some narcotic analgesics, this puts them at risk for injury
21.NARCOTIC ANTAGONISTS Counteracts the actions of something else. Uses: complete or partial reversal of narcotic depression Adverse Reactions Nausea, vomiting, sweating tachycardia & anxiety Monitor V/S every 5 minutes initially after giving an narcotic antagonist
22.ADRENERGIC DRUGS Mimic the activity of the sympathetic nervous system Uses: hypovolemic shock, episodes of hypotension bronchial asthma, superficial asthma, allergic reactions Adverse Reactions Cardiac arrhythmias, headache insomnia, nervousness, anorexia Relaxes the smooth muscles of the bronchi Overuse of nasal decongestants, can cause rebound congestions
23.ADRENERGIC BLOCKING DRUGS Alpha, Beta, Anti- & Alpha/Beta Adrenergic Drugs (see definitions) Alpha adrenergic drugs produce their greatest effects on the adrenergic nerves that control the vascular system Beta adrenergic blocking drugs produce the greatest effect on the heart Some beta adrenergic blocking drugs can be used to treat patients who have glaucoma
24.CHOLINERGIC DRUGS May act like the neurohormone Ach or inhibit the release of the neurohormone AChE Uses: glaucoma, myasthenia gravis, urinary retention Adverse Reactions: Excess salivation, nausea, vomiting, & diarrhea Contraindicated with peptic ulcer disease Ongoing treatment should include checking the eye and around the eye for redness, inflammation and secretions
25.Inhibits the activity of acetylocholine in parasympathetic nerve fibers Uses: pylorospasm, peptic ulcer, ureteral colic, reduce secretions of upper respiratory tract (preoperatively) Adverse Reactions Dry mouth, blurred vision, and photophobia Contraindicated with glaucoma ANTI-CHOLINERGIC DRUGS
26.SEDATIVES & HYPNOTICS Produces CNS depression and mood alteration Uses: insomnia or as a preoperative regimen Adverse Reactions Somnolence, agitation, confusion, lethargy, respiratory distress, bradycardia, hypotension It is only acceptable to give a hypnotic with a narcotic analgesic when it is being given preoperatively When giving to the elderly monitor for marked excitement and confusion Hold a hypnotic if vital signs vary from the patients baseline.
27.CNS STIMULANTS Analeptics, Amphetamines & Anorexiants (see definitions) Uses: limited in medicine, analeptics – temp. tx of respiratory depression; amphetamines – temp. tx of exogenous obesity, narcolepsy; ADHD; anorexiants – tx of exogenous obesity Adverse reactions Dizziness, headache, apprehension, disorientation, insomnia Anorexiants and amphetamines are highly addictive and have a abuse potential
28.ANTICONVULSANTS Reduce the excitability of the neurons in the brain Uses: the more common types of seizures Adverse Reactions Sedation, nausea, vomiting, constipation, nystagmus Take with food to decrease nausea Do not abruptly discontinue taking med because it can cause seizures
29.ANTIPARKINSONISM DRUGS Mechanism of action is not completely understood Uses: Parkinson's disease Adverse Reactions Dystonic movements (facial grimacing, protruding tongue, jerking of extremities), dry mouth, blurred vision & dizziness Avoid alcohol, do not increase, decrease or omit dose without consulting physician
30.PSYCHOTHERAPEUTIC DRUGS ANTIANXIETY DRUGS ANTIDEPRESSANT DRUGS ANTIPSYCHOTIC DRUGS
31.ANTIANXIETY DRUGS Exact mechanism of action unknown. Acts on the limbic system and reticular formation in the brain Uses: anxiety disorders, long and short term Adverse Reactions mild drowsiness(1st few days), lethargy, fatigue, sedation Do not discontinue abruptly
32.ANTIDEPRESSANTS Exact mechanism of action is unknown, thought to slow the adaptive changes in noreepinephrine and serotonin receptor systems. Uses: depression, major and minor Adverse Reactions Sedation, dry mouth, dry eyes, urinary retention, nausea A serious adverse reaction of a MAOI is hypertensive crisis The nurse must check for cheeking
33.ANTIPHSYCHOTIC DRUGS Thought to inhibit or block the release of the neurohormone dopamine in the brain Uses: manage acute and chronic psychoses Adverse Reactions Dry mouth, sedation, hypotension, nasal congestion, headache Do not take OTC drugs; Take exactly as directed; Do not drink alcohol
34.CHOLINESTERASE INHIBITORS Increase the level of actylcholine in the CNS by inhibiting its breakdown and slowing neuronal destruction Uses: dementia associated with Alzheimer’s disease Adverse Reactions Limited – anorexia, nausea, vomiting, weight loss It is not a cure, but just a delay in progression
35.ANTIEMETIC DRUGS Inhibits the CTZ or depresses the sensitivity of the vestibular apparatus of the inner ear Uses: prophylactic or tx of nausea and vomiting Adverse Reactions Varying degrees of drowsiness Avoid driving, take as directed, avoid alcohol and other sedatives
36.ANTIVERTIGO DRUGS Inhibits the CTZ or depresses the sensitivity of the vestibular apparatus of the inner ear Uses: vertigo (see definitions) Adverse reactions Varying degrees of drowsiness Avoid driving, take as directed, avoid alcohol and other sedatives
37.ANESTHETIC DRUGS LOCAL ANESTHESIA – topical, local infiltration, regional (spinal & conduction blocks) PREANESTHETIC – to prepare for anesthesia, the antianxiety drug will aid in reducing the dose of the anesthetic induction agent needed. GENERAL ANETHESIA – several drugs used POST ANESTHESIA - check airway, respiratory status and give O2 as needed, position to prevent aspiration, and monitor VS q 5-10mins
38.ANTIHISTAMINES Prevent histamine from entering the histamine receptor site Uses: relief of S&S of allergies, motion sickness, nausea & vomiting & sedation Adverse Reactions Drowsiness, sedation, dry mucus membranes Most are given with food to prevent gastric upset.
39.DECONGESTANTS Produce localized vasoconstriction of the small blood vessels of the nasal membranes Uses: congestion assoc. with colds, allergies and middle ear infections Adverse Reactions: Nasal burning, stinging & dryness Contraindicated with hypertension Overuse can make symptoms worse
40.BRONCHODILATORS Opens the bronchi and allow more air to enter the lungs Uses: reversible airway obstruction, (asthma, bronchitis, emphysema) Adverse Reactions Elevated B/P, anxiety, cardiac arrythmias Avoid smoking (makes it hard to adjust dose)
41.ANTIASTHMA DRUGS CORTICOSTEROIDS LEUKOTRIENES MAST CELL STABILIZERS
42.ANTITUSSIVES Depresses the cough center located in the medulla, centrally acting drugs Uses: to relieve non productive coughs Adverse Reactions Respiratory depression, euphoria, light-headedness, sedation, nausea, vomiting Do not exceed recommended dose Push fluids If cough is productive call Dr STAT
43.MUCOLYTICS & EXPECTORANTS Increases mucus production by decreasing the viscosity of the mucus Uses: emphysema, bronchitis, asthma, TB Adverse Reactions Sedation, nausea, drowsiness If equipment is being utilized teach patient how to use it properly
44.CARDIOTONICS Increases cardiac output through positive inotropic activity Uses: heart failure, atrial fibrillation Adverse reactions Headache, weakness, drowsiness If taking Digoxin and c/o nausea and blurred vision (call dr. STAT)
45.ANTIARRHYTHMIC DRUGS The drug works differently depending on what class it falls in Uses: prevent and treat cardiac arrhythmias Adverse Reactions Light-headedness, weakness, hypotension, bradycardia & drowsiness If taking parenterally, measure and record I&O Check B/P, apical & radial pulse and respirations q 1-4 hours
46.ANTIANGINALS (Nitrates) Relaxes the smooth muscles of the blood vessels Uses: angina pectoris Adverse Reactions Headache, hypotension, dizziness, vertigo, weakness, flushing Do not use alcohol, Keep an adequate supply of meds on hand, Do not change name brands.
47.ANTIANGINALS (Calcium channel blockers) Dilate coronary arteries and arterioles, Dilate peripheral arteries and reduces the workload of the heart Uses: vasospastic angina and chronic stable angina Adverse Reactions Dizziness, light-headedness, nausea, diarrhea, flushing Make position changes slowly, Do not use alcohol, Keep an adequate supply of meds on hand
48.PERIPHERAL VASODILATING DRUGS Acts on the smooth muscle layers of peripheral blood vessels Uses: peripheral vascular disease Adverse Reactions Hypotension, headache, dizziness, palpitations Avoid driving and sudden changes in position Stop smoking
49.ANTIHYPERTENSIVES Dilate or increase the size of the arterial blood vessels Uses: high blood pressure Adverse Reactions Postural hypotension, dizziness, light-headedness, orthostatic hypotension Must assess B/P immediately prior to giving med Prior to giving the a B/P med for the initial time take B/P in both arms
50.ANTIHYPERLIPIDEMICS Bile acid sequestrants HMG-CoA Reductase Inhibitors Fibric Acid Derivatives Uses: lower serum lipid levels Adverse Reactions Nausea, vomiting, headache, abdominal pain A paradoxical elevation of the lipid levels may occur Usually drugs will be discontinued if no improvement in 3 months.
51.ANTICOAGULANTS Interfere with the clotting mechanism of the blood Uses: DVT, MI, embolizms Adverse Reactions Mild to severe bleeding, nausea, vomiting, alopecia INR must be reported if the level is above 2 Give Vit K to reverse the action of an oral anticoagulant
52.THROMBOLYTIC DRUGS Break down fibrin clots by converting plasminogen to plasmin Uses: treat acute MI, PE, DVT Adverse Reactions external or internal bleeding Need continuous monitoring, bed rest during therapy
53.ANEMIA DRUGS (Iron) Elevate the serum iron concentration Uses: iron deficiency anemia Adverse Reactions GI irritation, nausea, black stools, constipation If giving iron IM, give in the buttock using the Z-track method If giving oral, do not give with tetracylines
54.ANEMIA DRUGS (CONT.) Anemia assoc. with chronic renal failure Epoetin Alfa – hypertension, headache tachycardia Folic acid deficiency anemia Leucovorin – few adverse reactions, Pernicious anemia Vitamin B12 – mild diarrhea and itching
55.DIURETICS Carbonic Anhydrase Inhibiotors Loop Diuretics Osmotic Diuretics Potassium Sparing Diuretics Thiazides If take drug once daily, take in the early morning ALERT- poor skin turgor & dry mucous membranes are signs of excess diuresis
56.URINARY ANTIINFECTIVES Uses: UTI’s Adverse Reactions Nausea, vomiting, anorexia, abdominal pain Stress the importance of completing a full course of therapy Avoid the use of nonprescription drugs
57.GI SYSTEM DRUGS Antacids Reduce the acidity of stomach and duodenal contents Uses – heartburn, GERD, sour stomach Adverse reactions – constipation Anticholinergics Reduces gastric motility Uses – peptic ulcers Adverse reactions – dry mouth, blurred vision, urinary retention
58.GI SYSTEM DRUGS (cont.) GI stimulants Mode of action unclear Uses – GERD, gastric stasis Adverse reactions – mild, drowsiness or dizziness Histamine H2 antagonists Inhibit the action of histamine at the receptor cells of the stomach Uses – gastric or duodenal ulcers Adverse reactions -
59.GI SYSTEM DRUGS (cont.) Antidiarrheals Decreases intestinal peristalsis Uses – diarrhea Adverse reactions –anorexia, nausea, constipation, vomiting Antiflatulents Has a defoaming action the disperses and prevents the formation of mucus-surrounded gas pockets in the intestines Uses – painful symptoms of excess gas Adverse reactions – none
60.GI SYSTEM DRUGS (cont.) Digestive enzymes Breakdown and digest fats Uses – pancreatic enzyme insufficiency Adverse reactions – none reported Emetics Causes local irritation of the stomach and induces vomiting Uses – ingested poison or drug overdose Adverse reactions – none reported
61.GI SYSTEM DRUGS (cont.) Gallstone – Solubilizing drugs Suppress the manufacture of cholesterol Uses – nonsurgical tx of radiolucent gallstones Adverse reactions – diarrhea, cramps, nausea, vomiting, (prolonged use – toxic to the liver) Laxatives Each works differently but they produce a relief in constipation Uses: constipation Adverse reactions – diarrhea, abdominal pain, flatulence
62.GI SYSTEM DRUGS (cont.) Proton pump inhibitors Suppress gastric acid secretions by blocking the production of gastric acid Uses – ulcers, GERD, Adverse reactions – headache, diarrhea, abdominal pain Take stool softeners and laxatives with a full glass of water Do Not give ipecac syrup if the patient has ingested gasoline
63.ANTIDIABETIC DRUGS (Insulin) Insulin helps glucose enter the cells of striated muscle and adipose tissue Uses: diabetes mellitus type 1 & 2 Adverse Reactions Hypoglycemia, hyperglycemia Rotate injections sites, follow the prescribed diet, wear an medical ID bracelet
64.PITUITARY & ADRENOCORTICAL HORMONES Hormone supplement or replacement Measure I&O daily Avoid alcohol Wear a medical alert tag Drink one or two glasses of water prior to taking med Long-term glucocorticoid therapy adverse reactions are decreased resistance to infection
65.THYROID & ANTITHYROID DRUGS Uses: hyper or hypothyroidism Adverse reactions Signs of hyper or hypothyroidism Administer med early in the morning preferably before breakfast
66.MALE & FEMALE HORMONES Male hormones Androgens, anabolic steroids, androgen hormone inhibitors Female hormones Estrogens, progestins, contraceptive hormones Taking anabolic steroids can cause severe mental and personality changes Oral contraceptives are best taken with evening meal or at bedtime
67.DRUGS ACTING ON THE UTERUS Oxytocic drugs – used before birth to induce contractions (stimulates the uterus) Uterine relaxants – decrease uterine activity and prolongs pregnancy Keep the patient under constant observation if receiving IV oxytocin
68.IMMUNOLOGIC AGENTS Vaccines & toxoids – stimulate the immune response within the body to specific antigens or toxins. Immune Globulins and Antivenins – contain ready made antibodies & are given for passive immunity against disease Fatalities and serious viral infections have been associated with the administration of vaccines
69.ANTINEOPLASTIC DRUGS Generally affect cells that rapidly proliferate Uses: they interfere in some way with cell division Adverse Reactions Bone marrow suppression, nausea, vomiting, stomatitis diarrhea and hair loss Take drug on an empty stomach, keep all appointments, Do not take OTC meds, Avoid Alcohol
70.TOPICAL DRUGS FOR THE SKIN Anti-infectives – direct local affect on bacteria, fungi and viruses Antiseptics & Germicides – reduce the number of bacteria on the skin surface Corticosteroids – localized anti-inflammatory activity Antipsoriatics – tx of psoriasis
71.TOPICAL DRUGS FOR THE SKIN (cont) Enzymes – removal of dead soft tissues Keratolytics – removes excess growth of the epidermis Local anesthetics – temp. inhibit the conduction of impulses from sensory nerve fibers Remove a drug with soap and warm water prior to apply more
72.OTIC & OPTIC DRUGS Otic Uses: to relieve pain, treat infection and inflammation, aid in the removal of ear wax Adverse reactions – prolonged use (superinfection) Ophthalmic – Uses: glaucoma, infections, inflammation and allergies Adverse Reactions – varies depending on type Warm otic solutions prior to instillation to prevent dizziness
73.FLUIDS & ELECTROLYTES Uses to correct nutritional of fluid deficiencies or treat certain diseases and conditions Fluids Blood plasma, plasma proteins fractions, protein substrates, energy substrates, plasma expanders, & intravenous replacement solutions Electroytes Bicarbonate, calcium, magnesium, potassium, sodium, Adverse reactions Hypokalemia
74.DEFINITIONS: BACTERICIDAL – destruction of bacteria by an antibiotic BACTERIOSTATIC- slows the multiplication of bacteria ANAEROBIC- able to live without oxygen AGONIST – binds to a receptor and causes a response PARTIAL AGONIST – binds to a receptor, but the response is limited MIXED AGONISTS – ANTAGONISTS – properties of both the agonist and antagonist
75.DEFINITIONS cont: Alpha adrenergic blocking drugs – block alpha adrenergic receptors Beta adrenergic blocking drugs – block beta adrenergic receptors Anti-adrenergic drugs- block adrenergic nerve fibers Alpha/beta adrenergic blocking drugs – block both alpha and beta adrenergic receptors
76.DEFINITIONS cont: ANALEPTICS – drugs that stimulate the respiratory center AMPHETAMINES – produce euphoria and wakefulness ANOREXIANTS - suppress the appetite TARDIVE DYSKINESIA – rhythmic voluntary movements of the tongue or face
77.DEFINITIONS cont: ACETYLCHOLINE – chemical in the brain required for memory and thinking VERTIGO – a feeling of spinning or a rotation-type motion LOADING DOSE – series of doses of the drug until it starts to exert full therapeutic effect

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