DRUGS

SUPPLEMENTALS ON
PHARMACOLOGY
 Basic pharmacological
classification
 Action and indication
 Bad effects – adverse reaction /side effect
 Considerations
 Drug examples
 DRUGS AND DRUG
CLASSIFICATIONS COMMONLY
ASKED
 DOPAMINE AND DOBUTAMINE
 ADRENALIN
 LIBRIUM
 VALIUM
 ATARAX
 AMPHOGEL
 MAALOX
 LIDOCAINE
 AMINOGLYCOSIDES
 CEPHALOSPORINS
 ERYTHROMYCIN
 PENICILLINS
 SILVADENE
 NITROFURANTOIN
 PYRIDIUM
 PROBANTHINE
 HEPARIN
 COUMADIN
 DILANTIN
 VALIUM
 PHENOBARBITAL
 MAGNESIUM SULFATE
 TEGRETOL AND CLONAZEPAM
 MAO
 TRICYCLICS-E.G.TOFRANIL/ELAVIL
 SSRI-FLOUXETINE
 INSULIN
 OHA
 GLUCAGON

 LOMOTIL / IMMODIUM
 COMPAZINE / DRAMAMINE
 AMPHOTERICIN
 COLCHICINE
 PROBENECID
 ALLOPURINOL
 BENADRYL
 QUESTRAN

ANTIHYPERTENSIVES
 LITHIUM
 ANTINEOPLASTIC AGENTS
ANTIPARKINSONIAN
AGENTS
 ASA

ANTIPSYCHOTICS
 TYLENOL AND PARACETAMOL
 ANTI-THYROIDS
 THYROID REPLACEMENTS
 ANTI TUBERCULAR
 MUCOLYTIC,EXPECTORANTS
 BRONCHODILATORS
 ANTIVIRAL

RITALIN , CYCLERT
 DIAMOX
 PILOCARPINE
 DIGOXIN
 TENSILON
 MESTINON AND PROSTIGMIN
DIURETICS
 ELECTROLYTE REPLACEMENT
 EYE MEDICATIONS
 STEROIDS
 H2-RECEPTOR BLOCKERS
 IMMUNOSUPRESSANTS
 LAXATIVES AND STOOL SOFTENERS
 MIOTICS AND MYDRIATICS
MORPHINE SULFATE
DEMEROL
NITROGLYCERIN
ISORDIL
NSAIDS
 STREPTOKINASE
ENDURANCE – DEVELOPS
EVERYTIME YOU DEFEAT
THE TEMPTATION TO GIVE
UP……QUITTERS NEVER
LOSE BUT THEY NEVER
WIN. REST IF YOU MUST.
BUT DON’T QUIT
 SELECTED DRUGS
C LASSIFICATION
 HOW TO ASSESS FOR
EFFECTIVENESS
 EXACT TIME
 CLIENT TEACHING TIPS
 KEYS IN SAFETY
AMPHOGEL(Aluminum Hydroxide)
 Antacid
 Decrease in abdominal pain; neutralize gastric
acids
 Best given 2 hours after and 1 hour before
meals
 Increase OFI and bulk in diet, ambulate- causes
constipation, absorption of antibiotics
( tetracycline and phenothiazines and
effectiveness of ASA’S and pills are decreased.
 Use cautiously in patients with cardiac and renal
disease; monitor bowel function; monitor for
signs of phosphate deficiency-malaise,weakness
tremors and bone pain
 ALLUPURINOL(ZYLOPRIM)
 ANTIGOUT AGENT
 REDUCED URIC ACID (BOTH SERUM AND
URINARY)BY INHIBITING XANTHINE
OXIDASE.
 GIVEN AFTER MEALS;MAY BE CRUSHED OR
WITH FLUID OR MIXED WITH FOOD
 CAUSES AGRANULOCYTOSIS,APLASTIC
ANEMIA,URTICARIA AND IS HEPATOXIC AND
RENAL INSUFFICIENCY
 AIM IS TO LOWER SERUM URIC ACID LEVEL
TO 6 MG/DL(MONITOR BY 1-3 WKS;
MONITOR LFT’S AND KIDNEY FUNCTION;
REPORT ONSET OF RASH;
INCREASE OFI; AVOID EXPOSURE TO UV
RAYS - CATARACTS
 ANTABUSE
 CAUSES AN UNPLEASANT REACTION WHEN
COMBINED WITH ALCOHOL
 PATIENT AVOIDS ALCOHOL
 BEST TAKEN AFTER ABSTAINING ALCOHOL
FOR 12 HOURS
 INSTRUCT PATIENT TO AVOID ALCOHOL
BASED SUBSTANCES
 INSPECT PATIENTS BELONGINGS AND
CONFISCATE ALCOHOLIC SUBSTANCES,
MONITOR LFT’S
APRESOLINE -HYDRALAZINE
 ANTI HYPERTENSIVE
 DECREASED BP
 BEST TAKEN WITH FOOD
 RISE SLOWLY
 MONITOR FOR ORTHOSTATIC
HYPOTENSION AND HR FOR
TACHYCARDIA
 ATROPINE SULFATE
 ANTICHOLINERGIC, VAGOLYTIC DRYING
AGENT
 INCREASES HEART RATE IN A CLIENT WITH
HEART BLOCK, USED PRE-OPERATIVELY TO
DECREASE SECRETIONS
 BEST TAKEN 30 MINUTES BEFORE MEAL
 MAY CAUSE FACIAL FLUSHING, AVOID
TASKS THAT REQUIRE ACUTE VISION
AVOID HOT ENVT.
CHECK BP, CAUSES HYPOTENSION,
CONSTIPATION AND DRYMOUTH
 Bromcriptine Mesylate ( Parlodel)
 Ergot Alkaloid, Antiparkinsonian agent, ANS
agent
 Restoring of ovulation thus correction of female
infertility and activated dopaminergic receptors
in the CNS – relief of symptoms of parkinsons –
improvement seen in60-90 min
 Give with meals, milk / food afterV.S. stabilized
 May cause shock MI, Raynaud’s ,orthostatic
hypotension and nausea; supressed lactation
 Have patient lie in supine position –may caues
dizziness and fainting;store intightly closed
containers;
CELESTONE(BETHAMETHASONE)
 STEROID,STIMULATES LUNG
MATURITY IN INFANTS
 - RESP DISTRESS
 GIVEN WITH FOOD
 REPORT SIGNS OF INFECTION
 MONITOR WEIGHT , GIVE ONCE A DAY
DOSE IN THE MORNING TO AVOID
INSOMNIA
GIVEN 48 HOURS BEFORE DELIVERY
 Buspirone Hcl ( Buspar)
 Anxiolytic ( SRI and Dopamine agonist)
 Decreased anxiety
 Give with food or 8h before and after drinking
grapefruit juice
 Causes dizziness, drowsiness and headache,
nausea,palpitations; desired response seen in 7-
10 days(optimal 3-4 wks)
 Monitor cardiovascular parameters if taken with
digoxin;ensure compliance; report ASAP the
following manifestations: nervousness,
nightmares, involuntary movements of the neck
or face, blurred vision and depression; monitor
dystonia , GUT function and LFT’s
 CLOZARIL-CLOZAPINE
 ANTIPSYCHOTIC
 DECREASED DELUSION,HALLUCINATIONS
AND LOOSENESS OF ASSOCIATION
 BEST TAKEN AFTER MEALS
 REPORT SORETHROAT AND AVOID
EXPOSURE TO SUNLIGHT
 CHECK BP – CAUSES HYPOTENSION,
ASSESS FOR AKATHISIA, TARDIVE
DYSKENISIA-TONGUE TWITCHING AND LIP
SMACKING
 LIBRIUM-
CHLORDIAZEPOXIDE
 ANTIANXIETY-BENZODIAZEPINES
 DECREASED ANXIETY AND INC.
RELAXATION
 WITH FOOD OR MILK
 NO ACTIVITY REQUIRING ALERTNESS
, SUGARLESS GUM
 HOLD DRUG IF BP DROPS MORE THAN
20 MMHG , WATCH OUT FOR ECG
CHANGES AND TACHYCARDIA-REFER
 Dilantin ( Phenytoin Na)
 Anti convulsants
 Decrease in seizure activity- by decreasing flow
of calcium and Na across neuronal membranes
 Give with at least ½ glass of water or with meals
to decrease GI irritation
 Red brown or pink discoloration of urine may
occur, never mix with any drug or dextrose IV;
perform oral care – gingival hyperplasia;
causes catdiovascular depression,
agranulocytosis and aplastic anemia
 Avoid alcohol and activities that require
alertness; increase vitamin D and exposure to
sunlight in prolonged use;
 DOPAMINE( Intropin)
 ADRENERGIC AGENT
 BROCHODILATION AND INCREASED bp AND
HEART RATE
 GIVEN FOR CARDIAC ARREST AND COPD –
STAT
 MONITOR BP , CARDIAC MONITORING ,
PERIPERAL PULSES ,OUTPUT AND CBG –
CAN CAUSE HYPERGLYCEMIA
 DON’T MIX WITH OTHER SOLUTIONS, CAN
CAUSE ARRYTHMIAS, ANTICHOLINERGIC
EFFECTS AND TREMORS
 GARAMYCIN(GENTAMYCIN)
 AMINOGLYCOSIDE,BACTERICIDAL
- INFECTION
 NO SPECIFIC TIME
 INCREASE FLUID INTAKE, TINNITUS
INDICATES OTOTOXICITY
 MONITOR FOR SIGNS AND SYMPTOMS
OF OTOTOXICITY, NEPHROTOXICITY
AND NEUROTOXICITY
 INDERAL -PROPANOLOL
 ANTIANGINAL, ANTIARRYTHMIC,
ANTIHYPERTENSIVE,REDUCES PORTAL
PRESSURE AND DECREASES THE RISK OF
BLEEDING FROM ESOPHAGEAL VARICES
 DECREASED BP
 BEST TAKEN WITH MEALS
 AVOID DRIVING , DO NOT DISCONTINUE
ABRUPTLY
 CHECK BP – CAUSES HYPOTENSION
 ISORDIL
 ANTIANGINAL/RELAXES SMOOTH
MUSCLES
 DECREASED BP
 BEST TAKEN ON EMPTY STOMACH
 CHANGE POSITION SLOWLY, CAUSES
FACIAL FLUSHING
 CHECK BP, DO NOT CHEW SUSTAINED
RELEASE FORM
 LEVODOPA
 ANTIPARKINSONISM
 MUSCLES BECOME LESS STIFF
 BEST TAKEN WITH MEALS
 AVOID FOODS CONTAINING B6 OR
CHON RICH FOODS-DECREASES
ABSORPTION
 ENSURE PATIENT VOIDS-MAY CAUSE
URINARY RETENTION
 LITHIUM CARBONATE
 ANTIMANIC
 DECREASED HYPERACTIVITY
 BEST TAKEN AFTER MEALS
 INCREASE OFI’S 3 L/D AND Na 3 GM./DAY
 AVOID ACTIVITIES THAT INCREASE
PERSPIRATION
 TAKES 10-14 DAYS BEFORE THERAPEUTIC
EFFECT BECOMES EVIDENT.ANTIPSYCHOTIC
GIVEN DURING THE FIRST TWO WEEKS TO
MANAGE ACUTE SYMPTOMS
 MONITOR SERUM LEVEL , NAVDA-INDICATES
TOXICITY, MANNITOL - ANTIDOTE
 TOFRANIL( Imipramine)
 TCA ‘s
 Decrease in brain amine levels –
alleviation of depression and relief of
obstructive sleep apnea
 Same time in AM ;give sugarless candy
 Causes sedation urinary retention and
confusion( elderly) and photosensitivity
 Do not stop abruptly(HA , vertigo,
nightmares,malaise and weight change) ;
avoid OTC’s, alcohol and sleep inducers
 TODAY WILL NEVER HAPPEN AGAIN ;
DO NOT START IT WITH A BAD BAD
IMPRESSION THAT THINGS ARE
DIFFICULT …….AND THAT YOU
CANNOT MASTER ANYTHING…….
REMEMBER YOU ARE NOT BORN TO
FAIL AND TAKING A SECOND CHANCE
IS NOT AN OPTION…… YOU ARE
BORN TO MAKE IT GOOD.
IT’S ALL IN THE MIND!!!!
 BULLETS
 SALICYLATE POISONING-
TINNITUS,NAVDA,LETHARGY/EXCITABILITY,
HYPERVENTILATION AND
HYPERTHERMIA,METABOLIC ACIDOSIS
 LIDOCAINE TOXICITY
 SLURRED SPEECH
 ALTERED CNS
 MUSCLE TWITCHING
 SEIZURES
 TOXIC LEVEL
 LITHIUM2.0 MeQ/l
 DIGOXIN 2.0 NG/ML
 THEOPHYLLINE 20 MCG/ML
 THIS DRUGS CAN INTERACT
 THEOPHYLLINE,DILANTIN,COUMADIN,ILO
SONE
 TETRACYCLINE AND QUINOLONES-NO
TO PREGNANCY
 AMINO GLYCOSIDE TOXICITY
 OTOTOXICITY AND NEPHROTOXICITY
 PEAK – 1 ½ HOURS AFTER
ADMINISTRATION
 TROUGH – 30 MINUTES PRIOR TO THE
NEXT DOSE
 ORAL BIRTH CONTROL PILLS-COMP.
 ABDOMINAL PAIN
 CHEST PAIN-SOB
 HEADACHES AND HYPERTENSION
 EYE PROBLEMS
 SEVERE LEG PAIN
 LEADS – EMERGENCY DRUGS
 BETA BLOCKER ACTIONS
 BETA 1 – HEART
 BETA 2 – LUNGS
 SIDE
EFFECTS OF ADRENERGIC
ANTAGONIST BETA BLOCKERS
 HYPOTENSION
 DROWSINESS/DEPRESSION
 SYMPTOMS OF CHF
 BRADYCARDIA
EXAMPLES
PROPANOLOL,TENORMIN,LOPRESSOR
 SIDE
EFFECTS OF ADRENERGIC
ANTAGONIST ALPHA BLOCKERS
 SEXUAL DYSFUNCTION
 TACHYCARDIA
 ORTHOSTATIC HYPOTENSION
 VERTIGO
DOXAZOSIN ( CARDURA)
PRAZOSIN (MINIPRESS)
METHYLDOPA ( ALDOMET)
 CALCIUM ANTAGONISTS – VERY NICE
DRUGS
 BLOCKS CALCIUM ACCESS TO CELLS
CAUSING DECREASED
COTRACTILITY,CONDUCTIVITY OF THE
HEART AND DEC. FOR OXYGEN DEMAND
 SIDE
EFFECTS:HYPOTENSION,BRADYCARDIA(AV
BLOCK-
PRECIPITATES)HA,ABDL.DISC,PERIPHERAL
EDEMA
 EXAMPLES:
 VERAPAMIL NIFEDIPINE DIALTIZEM
 VERY NICE DRUGS
 DRUGS FOR BRADYCARDIA

 ISOPROTERINOL
 DOPAMINE
 EPINEPHRINE
 ATROPHINE
 ANTIHYPERTENSIVE DRUGS
 ACE INHIBITORS-
CAPOTEN/CAPTOPRIL,VASOTEC/ENAL
APRIL,LOTENSIN/BENZAPRIL)
 BETA – BLOCKERS-
INDERAL/PROPANOLOL,
TENORMIN/ATENOLOL
 CALCIUM ANTAGONIST- CALAN
ISOPTIN/VERAPAMIL,
CARDIZEM/DIALTIZEM, PROCARDIA/
NIFEDIPINE
 ACE INHIBITORS-

 SIDE EFFECTS-DIZZINESS
 ORTHOSTATIC HYPOTENSION
 GI DISTRESS
 COUGH
 HEADACHE

 ACTIONS-
DECREASED PERIPHERAL
VASCULARRESISTANCE WITHOUT
INCREASED CARDIAC OUTPUT,CARDIAC
RATE AND CARDIAC CONTRACTILITY
 B-BLOCKERS

 ACTION – BLOCKS BETA RECEPTORS

IN THE HEART CAUSING DECREASED
HEART RATE, FORCE OF
CONDUCTION AND RATE OF AV
CONDUCTION

 SIDEEFFECTS-
BRADYCARDIA,LETHARGY,GI DIST.
CHF ,HYPOTENSION,DEPRESSION
 ANTI-CANCER
DRUGS-ADVERSE
REACTIONS AND PRECAUTIONS

 NAVDA
 BONE MARROW SUPPRESSION
 ALOPECIA
 (AVOID PREGNANCY)
 CHOLINERGIC CRISIS- (WEAKNESS)

 SALIVATION
 LACRIMATION
 URINATION
 DEFECATION

 SYMPATHETIC/ANTI -CHOLINERGIC
/ADRENERGIC- FIGHT/FLIGHT
 PARASYMPATHETIC-REST AND DIGEST
 STEROIDS- (ENDS IN ONE) ANTI-
INFLAMMATORY
 INH –INCREASE B6
 LEVODOPA – DECREASE B6
 MAO-NO
PICKLES,WINE,CHEES,BARBITURATES
,TRICYCLIC
ANTIDEPRESSANTS,ANTIHISTAMINES,
ANTIHYPERTENSIVES,OTC COLD
MEDS
SWEATING,TREMORS,HYPERTHERMIA,HPN,

BOUNDING HEART