PHARMACOLOGY: 4.

Smooth muscle contraction

Adrenergic / Sympathomimetic Examples:

olols
ALPHA 1
1. Vasoconstriction 2 TYPES of BETA ADRENERGIC
2. Midriasis
3. Closure of bladder and sphincter 1. Non-selective
a. Affect the other system of the
**Decongestant body
- Phenylepinephrine i. Propanolol not for COPD
and Asthma
ALPHA 2 2. Selective
1. Inhibits norephineprine acetylcholine a. Less affect the body
i. Metoprolol
**Clonodine (Catapress)
**Phentolamine CHOLINERGICAGENTS (PARA)
**Yohimbine
1. Bethanecol (Duvoid Urecholine)
BETA 1 2. Pyridostigmine
1. Increase chronotropy and inotropy 3. Edrophonium
2. Increase AV node conduction velocity 4. Neostigmine
3. Velocity
H.U.B.A.D.S
**Dopamine
**Epinephrine 1. Hypotension
2. Urinary Urgency
BETA 2 3. Bradycardia
- Relaxes the following; 4. Abdominal Cramps
1. Bronchus 5. Salivation
2. Uterine
3. Bladder ANTI CHOLINERGIC (SNS)
4. Ciliary - Contraindicated to patients with glaucoma
5. GIT Motility 1. Atropine (Isopto Atropine)
6. Smooth muscle 2. Benzotropinee Mesylate (Cogentine)

**Albuterol or Terbutaline Adverse S/E:

- Cannot see (blurred vision)
- Cannot pee (urinary retention)
ADRENERGIC BLOCKING AGENTS - Cannot spit (dry mouth)
1. Vasodilation - Cannot shit (constipation)
2. Miosis
3. Opening of the bladder sphincter

Ex:
Prazosin for HTN ANTIHYPERTENSIVE DRUGS
Tamsulosin BPH
1. ACE INHIBITORS (Angiotensin Converting
Enzyme)
a. Benazepril
BETA ADRENERGIC BLOCKERS b. Captopril (Capoten)
1. Decrease chronotropy and inotropy c. Enalapril (Vasotec)
(heart rate)
2. Decrease AV node conduction velocity CAUTION: Do not stop ABRUPTLY as this may
(electrical impulse) cause rebound hypertension
3. Decrease renin
COMMON S/E - Should have drug free period to avoid drug
- Dry persistent cough tolerance
o Report to MD
- Angio Edema CARDIAC GLYCOSIDE
o Facial
- Hyperkalemia 1. Digoxin (Lanoxin)
- Teratogenic
Nursing Consideration:
TIPS: Avoid food high in potassium - Apical pulse
- Take it on an empty stomach
2. ARB (Angiotensin II Receptor Blocker) - Diet high in potassium and avoid calcium
a. Losartan supplement
b. Valsartran - Take cautiously with DIURETICS
- WOF S/Sx of Toxicity
NOTE: This is the replacement drug for ACE
ANTIDOTE: Digibind
3. CALCIUM CHANNEL BLOCKER
a. Amlodipine (Norvasc) DIGOXIN TOXICITY (VANDAb)
b. Diltiazem (Cardizem) - Visual disuturbances
c. Felodipine (Plendil) - Abdominal pain
d. Nifedipine - Nausea and vomiting
- Diarrhea
TIPS: Avoid grape fruit (high in potassium) - Anorexia
- Bradycardia
S/E:
- Dizinnes ANTICOAGULANTS
- Orthostatic hypotension 1. IV HEPARIN (APTT)
- Take medications on time a. ANTIDOTE: Protamine Sulfate
2. PO WARFARIN
ANTI ANGINAL MEDICATONS a. ANTIDOTE: Vitamin K
(Phytonadione)
1. Nitroglycerin IV (Nitro BID)
2. Sublingual (Nitrostat)
3. Topical (Nitro BID, Nitrong, Nitrostat)
Nursing Consideration:
The following medication below are both given in - Check VS, platelet count
NTG: - APTT (NV 20-36 seconds)
1. Isosorbide Dinitrate - Observe for bleeding
2. Isosorbide Mononitrate - Review bleeding protocol
- Avoid ASA

Nursing Consideration: BRONCHODILATOR

- Position: Sitting /lying down
- Gradual change of position BETA 2 AGONIST (affect the bronchus)
- Burning sensation - Short acting (< = 20 mins, last 4-8 hours
- Onset: 1-2 minutes, duration 30 minutes - Long acting - Terbutaline
- MAX: 3 dose every 5 minutes - Leukotrene - vasoconstriction
- STORAGE: cool and dry place, use dark
amber colored air tight container ANTICHOLINERGIC
- Change medication every 6 months to ensure - Ipatromium Bromide
the potency of the drug when given
XANTHINES
Transdermal Patch - Amynophilline
- Maintenance - NV = 10-20 mcg/ml
- Worn 8-12 hours per day and rotate is side
Toxicity
 20 mcg/ml = nausea (1st sign) 3. Weight gain
35 mcg/ml = tremor (late sign) 4. GI Bleeding
5. Cataract
Avoid: Caffeine, Tea and Chocolates 6. Hirsuitism (Female)

Nursing Consideration: NOTE: Stopping this abruptly may cause

- Breathing and coughing ADDISONIAN CRISIS
- Relaxation techniques
- Evaluate HR and BP MINERALOCORTICOID
- Arm indetification 1. Fludrocortisone (Florinef)
- Tremors
- Have more glass of water Nursing Consideration:
- Emphasis to stop smoking - Monitor hypokalemia
- Limit intake of sodium
- Increase dosage in times of stress to prevent
THYROID AGENTS adrenal sufficiency
1. Levothyroxine (Synthroid)
a. Increases the TSH but the T3 and T4
will be decreased ORAL HYPOGLYCEMICS
i. Hypothyroidism increase 1. Oral Sulfonylureas Meglintinides
in T3 and T4 but decrease a. SOA: Pancreas
in TSH b. MOA: Increase insulin secretions
Examples:
Nursing Consideration - Repaglinide
- Given before meals - Nateglinide
- Check PR
- Observe 3-4 days clinical improvement NOTE: Avoid alcohol
- Do not change brand of drugs
Examples: 2. Thiazolidinedione
a. SOA: Liver
1. Methimazole b. MOA: decrease basal hepatic
2. Prophythiourazil PTU glucose production
3. Lugols Solution S/E: URTI, Liver damage and fluid retention
a. Given pre-op to decrease the
vascularity 3. Biguanides
b. Mixed with juice or water a. SOA: Muscle
c. Take it with straw as this may b. MOA: increase insulin glucose
stain the teeth intake

NOTE: When giving make sure to check the
laboratory WBC as this may cause
AGRANULOCYTOCIS increase in infection
AVOID: Salt, Shellfish and OTC Meds
ADRENOCORTICAL AGENTS
S/E: Lactic acidosis, decrease pH blood
(Kaussmal Respiration) rapid shallow breathing
4. Alpha glucosidase inhibit
a. SOA: intestine
b. MOA: decrease GI absorption of
glucose

GLUCCOCORTICOID S/E: Bloating, Flatulence, Diarrhea, Abdominal

1. Steroids Pain
2. Cortisone (Cortisone Acetate)
3. Prednisone (Deltasone)
4. Dexamethasone INSULIN

S/E: - Decreases the blood sugar

1. Osteoporosis - Increases transport of glucose to the
2. Infection (immunosuppression) membrane
 o Ranitidine (Zantac)
CLEAR
1. Short acting Nursing Consideration
a. Insulin aspart 1. Take is at bedtime
b. Lispro 2. Not mixed with ANTACIDS
SHORT ACTING 3. Inform provider with bleeding
1. Buffered insulin
2. Insulin human (Humulin R) NCLEX Proton Pump Inhibitor
3. Regular insulin, pork - Given before meals
- Medications that ends with prazole
CLOUDY
1. Intermediate 1. Esomeprazole
Adverse S/E: 2. Omeprazole
- Local allergic reaction 3. Pantoprazole
- Insulin lipodystrophy
- Dawn phenomenon
- Somogyi phenomenon Sucralfate Carafate
- Coats the HCL
Nursing Consideration: - Given for ulcers
- 45 90 degrees SQ o CYTOTEC WOF pregnancy
- steady absorption
- less pain CATHARTICS / LAXATIVES
- ER Cases (DKA) TYPE I
o IV Insulin - Osmotic laxatives and stool softeners

Hyperosmolar Non-ketotic Diabetic Syndrom 1. Lactulose

- Occurs in Type II 2. Ducosate Sodium
3. Bisacodyl - contact laxative
4. Metamucil /Psyllium - Bulk Forming
MIXING INSULIN a. 8 oz of liquid to prevent fecal
- 1st: Aspirate clear impaction
- 2nd cloudy 5. Mineral Oil emollients / lubricants

INTERMEDIATE ACTING (NCLEX) Nursing Consideration

- NPH 1. Increase fiber roughage and water intake
- Humulin N 2. Remind client to use only when necessary

ANTACIDS DIURETICS
- Given after meals
1. Loop Diuretics
1. Amphogel (Al based) constipation a. Furosemide (Lasix)
2. Milk of Magnesia (Mg based) diarrhea i. Ototoxic when given rapid
3. Maalox (Al & Mg base) normal administration
4. Tums (Ca based) constipation ii. DO NOT INCORPORATE
5. Sodium Citrate (Na based) with ANTIBIOTICS
b. Bumetanide (Bumex)
Nursing Consideration: 2. Thiazides
1. 1-3 hours after meals a. Chlorothiazide (Diuril)
2. DO NOT COMBINE IT TO OTHER b. Hydrochlorothiazide (Esidrix HTCZ)
MEDICATIONS i. NOTE: Causes
HYPERGLYCEMIA
H2 BLOCKERS 3. Osmotic Diuretic
- Anti ulcer medications a. Mannitol (Osmitrol)
- Given with meals i. Given with patients
- Drugs that ends in dine increase ICP
o Cimetidine (Tagamet) 4. Carbonic Anhydrase Inhibitor
 a. Acetazolamide (Diamox) a. The most hepatotoxic
i. Potassium sparing b. Give Vitamin B6 Pyridoxine
3. PYRAZINAMIDE (Z)
Nursing Consideration a. Hyperuricemia
1. Diet b. Hepatotoxic
2. I and O 4. ETHAMBUTOL
3. Undesirable effect: F and E imbalances a. Optic Neuritis
4. Elderly careful b. Advise frequent eye exam every 6
5. Take with meal or after months
6. Increase risk for orthostatic hypotension 5. STREPTOMYCIN
7. Cancel alcohol
Nursing Consideration:
ANTIBIOTICS 1. Monitor superinfection
2. Evaluate renal/liver function
1. Aminoglycoside 3. Diarrhea
a. Ototoxic 4. Inform provider taking other medications
b. Nephrotoxic 5. Culture prior to initial dose
c. Medications that ends with 6. Alcohol is out, ask about allergy
mycin 7. Take full course of drugs
i. Neomycin 8. E
ii. Amikacin
iii. Streptomycin NARCOTICS
iv. Gentamycin
2. Cephalosporins 1. Narcotic Agonist
a. Cefa drugs a. Morphine Sulfate
3. Flouroquinoiones (xacin) b. Meperidine (Demerol)
4. Macrolides 2. Narcotic
a. Erethromycin a. Naloxone (Narcan)
b. Azithromycin
5. Penicillin Pain Scale
a. DO NOT GIVE CEPHA IF ALLERGIC 1-3: oral medications (NSAID)
TO PENICILLIN 4-6: combination of oral and IV analgesic
i. Macrolides substitute 7-10: administration of
6. Sulfonamides narcotics/IV/Morphines
7. Tetracycline
a. Doxycycline ASPIRIN TOXICITY remarkable signs TINNITUS
b. Minocycline
i. Limes Disease Morphine Sulfate
ii. Rocky Spotted Mountain 1. Do not give with dx of pancreatitis
Fever causes sphincter of odi

REMEMBER:
- Do not take it with milk
- Use sun protective items d/t photosensitivity
- Do not give <8 y/o because of the decrease S/E:
absorption of calcium that would result to 1. Monitor RR respiratory depression
bone and teeth malformation 2. BP orthostatic hypotension
8. Vancomycin 3. Constipation
a. Given when there is drug 4. N/V
resistance disease
Nursing Consideration:
ANTIMYCOBACTERIAL ANTIBIOTICS 1. Narcotic antagonist
2. Administer with food
1. RIFAMPIN (R ) a. MOS04 increase physical
a. Orange d/c of the secretions dependency
2. ISONIAZIDE (H) 3. Avoid alcohol

Abciximab
- Anticoagulant
- Normally it will take effect 3-4 days or more
Calcium is inversely proportional to phosphorus
S/E: Sexual dysfunction, weight gain
Cystic Fibrosis
- Unable to absorb fats, starches
- Thick secretions that blocks the enzymes
- Given immediately before meals

Lithium
- Should increase sodium intake Enteracept (DMARD)
o As this may lead to lithium toxicity - Tumor necrosis factor inhibitor
- Increase fluid intake - Immunosuppressant use d for autoimmune
- NSAID have drug interaction disorders;
o Rheumatoid Arthritis
o Psoriasis
Vitamin E o Chrons Disease
- Prevent leg cramp - Patients are required to under go Tuberculin
skin test where they should be NEGATIVE,
Sildenafil otherwise TB reactivation
- Vasodilator - Examples:
- NTG avoid as this may have synergistic effect 1. Endaril
2. Infliximab
Tumor Lysis Syndrome 3. Adalimumab
- Patient taking chemo drugs
Azathioprine
Metoclopromide - Given after kidney transplant to prevent
- Antiemetic rejection
- Immunosuppressant
S/E
- Tardive Dyskenesia Allopurinol
o Extrapyramidal Symptoms - Decrease the uric acid level
Excessive blinking of the eye
Lip smacking Colchicine
Puffing of cheeks - Alleviate gout pain
Chewing movement
Twisting fingers

Black Cohosh
- For dysmenorrhea

Cisplatin
- Chemo drugs
- Nephrotoxic drug

ANTIPLATELET
1. Diclopidine
2. Aspirin
3. Clopidogrel
4. Dypirimadole
Saw Palmetto
- Herbal supplement drug for BPH, which may
cause false low PSA in blood test and should
be dcd 1-2 weeks prior to test PSA

Sertaline
- SSRI (Antidepressant)