pharmacology & parenteral therapies

7/25/2019 Pharmacology & Parenteral Therapies

1/44

PHARMACOLOGICAL AND PARENTHERAL THERAPIES

I. Pharmacology Terms and Respons!l"es

A. Medca"on Nomencla"#re

Example:

chemical name generic name trade name

amnopenclln ampclln $Prncpen or Omnpen%

&. Chemcal name ' descrp"on o( a medca"on)s chemcal elemen"s

*. Generc name ' smpler +erson o( "he chemcal name, ne+erchanged and #sed n medcal "ermnology $al-ays lo-er case%

. Trade name ' man#(ac"#rer)s name (or medca"on/ s cap"al0ed

and sho-n n paren"heses ( " (ollo-s generc name $al-ays

cap"al0ed%

&. Pharmaco1ne"cs

&. A!sorp"on

*. Ds"r!#"on. Me"a!olsm

2. E3cre"on

4. Ser#m hal('l(e*. E((ec"s o( Medca"ons

&. Therape#"c e((ec"5 desred prmary e((ec" (or -hch "he medca"on

-as g+en

*. Ad+erse e((ec"5 #ndesred responses "o dr#g admns"ra"on. Sde e((ec"5 ad+erse e((ec" "ha" occ#rs -"h #s#al "herape#"c dose

o( dr#g

2. To3c e((ec" or "o3c"y5 e3"enson o( prmary ac"on carred "o ae3"reme

4. C#m#la"ng e((ec"5 !ody holds more o( "he medca"on !eca#se "

e3cre"es or me"a!ol0es less o( ".6. Hypersens"+"y7allergy5 anaphyla3s, #r"cara, e"c.

8. Tolerance5 !ody !ecomes acc#s"omed "o dr#g so "ha" larger doses

are needed "o prod#ce same e((ec"s9. Dependence5 medca"on needed long'"erm, poss!ly leadng "o

a!#sea. Psychc dependence

!. Physcal dependence. :ara!les a((ec"ng dr#g ac"on

&. Dr#g'rela"ed

a. Dosage!. Ro#"e

c. Dr#g'de" n"erac"on


2/44

d. Dr#g'dr#g n"erac"on

*. Clen"'Rela"ed

a. Age!. ;egh"

c. Gene"c and e"hnc charac"ers"cs

2. ;hen a n#rse g+es medca"ons, "he n#rse s respons!le "o5&. De"ermne ( "he medca"on order s correc"

*.


3/44

*. N#rsng n"er+en"ons

a. Brs", chec1 "ha" medca"on, dose and ro#"e

are correc"!. Assess pa"ency o( I: lne

c. Mon"or ho- clen" reac"s "o medca"on

!. In(#son con"rol de+ces&. @se "o admns"er a (l#d +ol#me acc#ra"ely


a.


4/44

. E3er" osmo"c press#re smlar "o "ha"

o( plasma

. E3amples5 normal salne ./lac"a"ed Rnger)s sol#"on/ 4

de3"rose n -a"er

!. Hypo"onc. E3er"s less osmo"c press#re "han

plasma

. E3amples5 *.4 de3"rose n -a"er/hal( s"reng"h normal salne .24

c. Hyper"onc

. E3er"s hgher osmo"c press#re "han

plasma $dra-s -a"er o#" o( "he cells%. E3amples5 4 de3"rose n normal

salne ./ 4 de3"rose n lac"a"ed

Rnger)s sol#"on

A. O"her

&. S#!lng#al $SL%

*. In"raoc#lar

I. Class(ca"on O( Medca"ons :a =ody Sys"ems

A. Managng Cardac Dsease

Mn'o+er+e-5

&. Cardac Glycosdes*. An"hyper"ens+es

. Throm!oly"cs2. Lpd'Lo-erng Agen"s

4. An"angnals

6. Hypo"enson and Shoc1

8. An"coag#lan"s9. An"dysrhy"hmcs

&. Cardac glycosdes

a. Ac"on5 ma1es hear" !ea" slo-er !#" s"ronger

&. Impro+es p#mpng a!l"y o( hear"*. Increases (orce o( hear")s con"rac"on

. Decreases ra"e o( con"rac"on

2. Increases cardac o#"p#"!. E3amples

&. Dg"o3n $Crys"odgn%

*. Dgo3n $Lano3n%c. @se


5/44

&. Conges"+e hear" (al#re

*. A"ral (l#""er

. A"ral (!rlla"ond. Con"randca"ons

&. :en"rc#lar "achycarda

*. :en"rc#lar (!rlla"one. Ad+erse sde e((ec"s

&. Gas"ron"es"nal e((ec"s s#ch as na#sea and

+om"ng, darrhea*. =radycarda

. Fan"hopsa

2. M#scle -ea1ness

4. Dysrhy"hma(. N#rsng n"er+en"ons

&. =e(ore g+ng glycosde, chec1 apcal p#lse and

hear" rhy"hm. Repor" ( 6 !pm

*. Es"a!lsh !aselne da"a s#ch as +"al sgns,elec"roly"es, clncal symp"oms, crea"nne clearance

"es". Mon"or (or dr#g "o3c"y, -hose early symp"oms

ncl#de

a. In chldren ' cardac arrhy"hmas!. In ad#l"s ' +s#al ds"#r!ances, na#sea and

+om"ng, anore3a

2. Mon"or dr#g le+els

a. Therape#"c range .9 ' *. ng7ml!. To3c range * ng7ml

c. D#re"cs may ncrease chance o( "o3c"y

4. Mon"or n"a1e and o#"p#"6. Clen" "eachng

a. Ta1e medca"on as prescr!ed

!. Teach clen" ho- "o "a1e and record p#lsedaly

c. Iden"(y and repor" sgns o( "o3c"y

. Bor a"ral (!rlla"on5 "a1e p#lse and

repor" ( !elo- 6 or a!o+e & orchanges n rhy"hm

. Daly -egh"s5 repor" * po#nd

ncrease

&. An"hyper"ens+es

a. Ac"on5 dla"es perpheral !lood +essels

!. E3amples

&. hydrala0ne HCL $Apresolne%*. enalaprl malea"e $:aso"ec%

. reserpne $Serpasl%


6/44

2. pra0osn HCL $Mnpress%

4. me"hyldopa $Aldome"%

6. clondne $Ca"apres%

Get a Clue

Many o( "he an"hyper"ens+es ha+e "rade names"ha" con"an

-vas-

-pres-

-pas-

a. @se5 hyper"enson

!. Con"randca"ons

&. Hear" !loc1*. Chldren

c. Ad+erse sde e((ec"s

&. Or"hos"a"c hypo"enson*. D00ness

. =radycarda

2. Tachycarda4. Se3#al dys(#nc"on

6. De"erora"on n renal (#nc"on

8. Agran#loss

d. N#rsng n"er+en"ons&. Mon"or +"al sgns and !lood press#re, s""ng and

s"andng

*. Mon"or (or hearng changes, renal (#nc"onng. I( hypo"enson, closely mon"or clen"

2. Enco#rage n"a1e o( (oods hgh n +"amn =

4. Teach clen"a. Lo- sod#m de"

!. Change pos"ons slo-ly

c. Ta1e medca"on as ns"r#c"ed

d. A+od ha0ardo#s ac"+"ese. Pro"ec" medca"on (rom hea" and lgh"

&. Throm!oly"cs

a. Ac"on5 !nds -"h plasmnogen "o dssol+e "hrom! $clo"s%n coronary ar"eres -"hn 2 "o 6 ho#rs o( myocardal

n(arc"on. Ac"+a"es con+erson o( plasmnogen "o plasmn.

Plasmn s a!le "o !rea1 do-n clo"s $(!rn%.

!. E3amples&. s"rep"o1nase $S"rep"ase%

*. #ro1nase $A!!o1nase%

c. @ses&. Myocardal n(arc"on


7/44

*. Deep +eno#s "hrom!oss

. P#lmonary em!ol

d. Con"randca"ons&. Ac"+e !leedng

*. Cere!ral em!olsm7"hrom!oss7hemorrhage

. Recen" n"raar"eral dagnos"c proced#re or s#rgery2. Recen" ma?or s#rgery

4. Neoplasms o( "he CNS

6. Se+ere hyper"ensone. Ad+erse sde e((ec"s

&. =leedng

*. Allergc reac"ons5#r"cara, "chng, (l#shng,

headache $illustration%. Ele+a"on o( "empera"#re

(. N#rsng n"er+en"ons

&. Mon"or (or !leedng

*. Mon"or coag#la"on s"#des. Mon"or (or allergc reac"ons

2.


8/44

!. To repor" !l#rred +son, se+ere GI

symp"oms, or headache

c. A!o#" lo-'choles"erol hgh'(!er de"2. ;"h choles"yramne, coles"pol5 G+e o"her

medca"ons $e.g., s#ch as "ha0de d#re"cs,

dgo3n, -ar(arn, and cer"an an"!o"cs%& ho#r!e(ore or 2 ho#rs admns"ra"on o( choles"ryramne

and coles"pol, so "ha" "hey -ll no" reac" -"h !le'

acd'!ndng resns

&. An"angnals

a. N"ra"es

&. E3amples5 N"roglycern, sosor!de dn"ra"e $Isordl%

*. Ac"on5 dla"e ar"eroles -hch lo-ers perpheral +asc#lar

ress"ance $a("erload%

. @ses5 "rea"men" and pre+en"on o( ac#"e ches" pan ca#sed !ymyocardal schema

2. Ad+erse e((ec"s5 pos"#ral hypo"enson, headache, (l#shng,d00ness

4. Con"randca"ons

a. Hypersens"+"y!. Se+ere anema

c. Hypo"enson

d. Hypo+olema

6. N#rsng In"er+en"onsa. Mon"or (or or"hos"a"c hypo"enson

!. Mon"or (or "olerance -"h long "erm #sec. Admns"er e+ery (+e mn#"es !#" no" more "han "a!le"sn &4 mn#"es

d. I( pan no" rele+ed a("er &4 mn#"es and "a!le"s, no"(y

physcan mmeda"elye. Ins"r#c" clen"

&. Ta1e p#lse !e(ore "a1ng medca"on

*. Ta1e oral prepara"ons -"ho#" (ood. ;hen "o see1 medcal a""en"on

2. No" "o che- or s-allo- s#!lng#al "a!s

4. Ma1e pos"on changes slo-ly

6. Carry dr#g so "ha" " s al-ays -"hn reach !#"a+od e3pos#re "o !ody hea" and lgh"

8. Replace dr#g appro3ma"ely e+ery 6 mon"hs

9. No alcohol

a. =e"a'Adrenergc =loc1ng Agen"s

&. E3amples5 propranolol $Inderal%


9/44

*. Ac"on5 Inh!" sympa"he"c s"m#la"on o( !e"a recep"ors n "he hear"

decreases hear" ra"e and (orce o( myocardal con"rac"on "h#s decreasng

myocardal o3ygen cons#mp"on. @ses5 red#ces (re#ency and se+er"y o( ac#"e angnal a""ac1s,

dysrhy"hmas

2. Ad+erse e((ec"s5 !lood dyscrasas, hypo"enson, GI ds"#r!ances4. Con"randca"ons5

a. Hypersens"+"y

!. Cardogenc shoc1c. Cardac (al#re

6. N#rsng n"er+en"ons

a. ;egh daly. Repor" -egh" gan o( 4 l!s.

!. Mon"or ECG ( #sng (or dysrhy"hmac. Admns"er on an emp"y s"omach

d. Pro"ec" n?ec"a!le sol#"on (rom lgh"

e. Ins"r#c" clen"

&. Ta1e p#lse !e(ore "a1ng dr#g*. No" "o dscon"n#e medca"on a!r#p"ly

. A+od ha0ardo#s ac"+"es ( dro-sness occ#rs2. Ma1e pos"on changes slo-ly

4. Ta1e dr#g a" same "me each day

!. Calc#m Channel =loc1ers

8. E3amples5 +erapaml $Isop"n%, n(edpne $Adala"%, dl"a0em $Card0em%

9. Ac"on5 Pre+en" "he mo+emen" o( e3"racell#lar calc#m n"o "he cellres#l"ng n coronary and perpheral ar"ery dla"on

. @ses5 s"a!le angna, dysrhy"hmas, hyper"enson&. Ad+erse e((ec"s5 headache, dro-sness, d00ness, GI ds"#r!ances&&. Con"randca"ons5 hypersens"+"y

&*. N#rsng n"er+en"ons

a. Mon"or ches" pan!. Mon"or ECG ( #sed (or dysrhy"hma

c. Admns"er -"h (ood

d. Ins"r#c" clen"&. Increase (l#ds "o co#n"erac" cons"pa"on

*. Ta1e p#lse !e(ore "a1ng dr#g

. A+od ha0ardo#s ac"+"es #n"l s"a!l0ed on dr#g

2. Lm" ca((ene cons#mp"on4. No alcohol

6. Change pos"on slo-ly

&. Hypo"enson and Shoc1

a. Na"#ral and syn"he"c ca"echolamnes!. E3amples5 epnephrne, dopamne $In"ropn%, do!#"amne $Do!#"re3%


10/44

c. Ac"ons5 ncrease cardac o#"p#"

d. @ses5 dopamne and do!#"amne5 hypo+olemc and cardogenc shoc1,

epnephrne5 anaphylac"c shoc1e. Ad+erse e((ec"s5 dysrhy"hmas, hypo"enson, "ss#e necross (

e3"ra+asa"on occ#rs. Tremors, an3e"y, d00ness -"h epnephrne

(. Con"randca"ons&. Hypersens"+"y

*. :en"rc#lar (!rlla"on

. Tachydysrhy"hmasg. N#rsng n"er+en"ons

&. Correc" hypo1alema !e(ore admns"erng

*. Mon"or +"al sgns (re#en"ly

. Mon"or ECG con"n#o#sly d#rng admns"ra"on2. Admns"er -"h n(#son p#mp

4. S"ar" dr#g slo-ly and ncrease accordng "o MD orders

6. Mon"or n?ec"on s"e (or e3"ra+asa"on

8. Pro"ec" sol#"on (rom lgh"9. Do no" #se dscolored sol#"on

. S"op "he dr#g grad#ally

&. An"coag#lan"sa. Ac"on5 dsr#p" "he !lood coag#la"on process, "here!y

s#ppressng "he prod#c"on o( (!rn

!. E3amples&. heparn5 paren"eral admns"ra"on

*. co#madn $;ar(arn%5 oral admns"ra"on

c. @se

&. P#lmonary em!olsm*. Deep +en "hrom!oss

. Myocardal n(arc"on

2. A"ral (!rlla"on4. Ad+erse sde e((ec"s

6. Allergc responses s#ch as chlls, (e+er and #r"cara

8. @se ca#"o#sly ( clen" "ends "o !leed $hemophla,pep"c #lcer%

d. Con"randca"ons

&. Hemophla*. Le#1ema

. Pep"c #lcer

2. =lood dyscrasase. N#rsng n"er+en"ons

&. heparn5 mon"or APTT $ac"+a"ed par"al

"hrom!oplas"n "me%

a. Normal 2 seconds.!. A" "herape#"c le+els, APTT ncreases !y a

(ac"or o( &.4 "o *


11/44

*. co#madn ' mon"or PT $pro"hrom!n "me%

a. Normal &* seconds

!. INR $In"erna"onal normal0ed ra"o% * "o . Do !aselne !lood s"#des !e(ore "herapy

2. Ha+e an"do"e ready5

a. An"do"e "o heparn5 pro"amne s#l(a"e!. An"do"e "o co#madn5 +"amn


12/44

mem!rane d#rng cardac depolar0a"on, red#ce

a#"oma"c"y n SA node, decrease cond#c"on

"hro#gh A: node, and red#ce myocardalcon"rac"l"y

4. O"hers ' dgo3n $Lano3n%, adenosne $Adenocard%/

decrease cond#c"on "hro#gh A: node and red#cea#"oma"c"y n SA node

c. @se5 "o "rea" a!normal"es n cardac ra"e and rhy"hm

Be Prepared

Try "o pace yo#rsel( -hen ans-erng "he#es"ons. Ta1e "he "me yo# need "o ans-er each

#es"on !#" "ry no" "o spend "oo m#ch "me on any

one #es"on.

a. Ad+erse e((ec"s

&. Hypo"enson*. Na#sea and +om"ng

. =lood dyscrasas

2. To3c"y s#ch as CNS ds"#r!ances d#e "o

ne#ro"o3c"y, and darrhea d#e "o GI rr"a"on!. N#rsng n"er+en"ons

&. Mon"or cardac rhy"hm

*. Mon"or !lood le+els. Mon"or (or !lood dyscrasas

2. Admns"er oral prepara"ons -"h meals

4. Mon"or E


13/44

*. Increase hear" ra"e

. Ac" on "he a#"onomc ner+o#s sys"em

!. E3amples&. Adrenergcs5 ephedrne s#l(a"e $Neorespn%,

sopro"erenol HCL $Is#prel% ac" on !e"a'adrenergc

recep"ors o( sympa"he"c ner+o#s sys"em*. Fan"hnes5 amnophyllne, "heophyllne $Theo'D#r%

ac"s on !ronchal smoo"h m#scle

. epnephrne HCL $Adrenaln% ' ncreases "he ra"eand s"reng"h o( cardac con"rac"on "hro#gh "he

sympa"he"c ner+o#s sys"em

2. sopro"erenol HCL $Is#prel% ' ncreases "he hear"

ra"e !y s"m#la"ng "he !e"a'adrenergc !loc1ngagen" o( "he sympa"he"c ner+o#s sys"em

4. a"ropne s#l(a"e5 ncreases "he hear" ra"e !y

s#ppressng "he parasympa"he"c ner+o#s sys"em a"

"he SA $snoa"ral% and A: $a"ro+en"rc#lar% nodesc. @se

&. =ronchospasms*. As"hma

d. Ad+erse e((ec"s

&. D00ness*. Tremors

. An3e"y

2. Palp"a"ons

4. Gas"rc ds"#r!ances6. A"ropne an"cholnergc e((ec"s5 dry mo#"h, !l#rred

+son, #rnary re"en"on

8. Headache9. Tachycarda

. Dysrhy"hmas

e. Con"randca"ons&. Hypersens"+"y

*. Narro- angle gla#coma

. Tachydysrhy"hmas

2. Se+ere cardac dsease(. N#rsng n"er+en"ons

&. Mon"or "heophyllne le+els $normal &'* mcg7dl%

*. Mon"or n"a1e and o#"p#", and +"al sgns. Mon"or E


14/44

*. M#coly"cs7E3pec"oran"s

a. Ac"on

&. M#coly"cs5 dsr#p" molec#lar !onds and "hnsm#c#s

*. E3pec"oran"s5 s"m#la"e a gas"rc m#cosal re(le3 "o

ncrease prod#c"on o( l#ng m#co#s!. E3amples

&. M#coly"c5 ace"ylcys"ene $M#comys"%

*. E3pec"oran"5 g#a(enesn $Ro!"#ssn%c. @ses

&. As"hma

*. Ac#"e or chronc !ronchop#lmonary dsease

. Cys"c (!ross2. M#comys"5 ace"amnophen "o3c"y

d. Ad+erse sde e((ec"s

&. Oropharyngeal rr"a"on

*. =ronchospasm. Gas"rc e((ec"s

e. Con"randca"ons&. Increased n"racranal press#re

*. S"a"#s as"hma"c#s

(. N#rsng n"er+en"ons&. Mon"or respra"ory s"a"#s

*. Teach clen"

a. Ta1e no (l#ds drec"ly a("er oral

admns"ra"on!. Do "a1e plen"y o( (l#ds

c. Enco#rage co#ghng and deep !rea"hng,

especally !e(ore "rea"men". An""#ss+es

a. Ac"on5 "o s#press co#ghs "hro#gh med#llary co#gh cen"er

or ndrec" ac"on on sensory ner+es!. E3amples

&. Narco"c5 codene, hydrocodone !"ar"ra"e $Hycoda%

*. Nonnarco"c ' dphenhydramne HCL $=enadryl%

c. @se5 colds, respra"ory conges"on, pne#mona, !ronch"s,T=, cys"c (!ross, emphysema

d. Ad+erse e((ec"s

&. Dro-sness*. Na#sea

. Dry mo#"h

2. D00nesse. Con"randca"ons5

&. Hypo"hyrodsm

*. Iodne sens"+"y



15/44

&. Mon"or !lood co#n"s -"h long "erm "herapy

*. Increase (l#d n"a1e

. H#md(y clen")s room2. Teach clen"

a. Increase (l#d n"a1e ( no" con"randca"ed

!. Do no" "o "a1e (l#ds mmeda"ely a("ermedca"on

c. A+od dr+ng and o"her ha0ardo#s ac"+"y

especally ( "a1ng narco"c "yped. An""#ss+es add "o "he e((ec"s o( alcohol

2. An""#!erc#loss agen"s

a. Ac"on5 appears "o nh!" RNA syn"hess, so s"ops "#!ercle

!acll (rom m#l"plyng $(rs" lne% or (#nc"onng $secondlne%

!. E3amples

&. Brs" lne5

a. e"ham!#"ol $Myam!#"ol% decreasesmyco!ac"eral RNA syn"hess

!. sona0d $INH% ' s#ppresses myco!ac"eralcell'-all syn"hess

*. Second lne5 nh!"s myco!ac"eral cell me"a!olsm

a. capreomycn $Capas"a"%!. pyra0namde $PJA%

c. Ad+erse e((ec"s

&. Gas"rc rr"a"on

*. CNS ds"#r!ances. L+er ds"#r!ances

2. =lood dyscrasas

4. S"rep"omycn ' o"o"o3c"y6. e"ham!#"ol ' +s#al ds"#r!ances

8. Isona0d ' s#ppressed a!sorp"on o( (a" and +"amn

= comple3d. Con"randca"ons5

&. Se+ere renal dsease

*. Hypersens"+"y

e. N#rsng n"er+en"ons&. Mon"or clen" response "o "herapy

*. Mon"or !lood -or1 d#rng "herapy

. I( CNS ds"#r!ances are e+den", "a1e sa(e"ypreca#"ons

2. Teach clen"

a. To "a1e medca"on as ordered!. To ea" (oods rch n ='comple3 +"amns

c. A+od #se o( alcohol

d. Repor" ( !ecome pregnan"


16/44

e. E"ham!#"ol5 repor" eye pro!lems, ha+e

reg#lar eye e3ams

4. An"hs"amnesa. Ac"on5 !loc1s hs"amne a" recep"or s"es

!. E3amples

&. prome"ha0ne HCL $Phenergan%*. chlorphenramne malea"e $Chlor'Trme"on%

c. @ses

&. Rele+es symp"oms o( allerges, colds, pr#r"#s*. Pre+en"s pro!lems n !lood "rans(#son and dr#g

reac"ons

d. Ad+erse e((ec"s

&. Dro-sness*. Gas"rc e((ec"s

. Dry mo#"h

2. Headache

4. Thc1enng o( !ronchal secre"onse. Con"randca"ons

&. Ac#"e as"hma*. Lo-er respra"ory hear" dsease

. Narro- angle gla#coma

(. N#rsng n"er+en"ons&. Dscon"n#e 2 days !e(ore s1n "es"ng (or allerges

*. A+od n"erac"on -"h CNS depressan"s

. Teach clen"

a. A+od dr+ng and ha0ardo#s ac"+"es!. Ta1e an"hs"amnes -"h (ood

c. Add"+e e((ec" -"h alcohol, o"her CNS

depressan"sd. ;ear medc aler" ?e-elry

6. An"as"hma"cs

a. Ac"on5 s"a!l0es mas" cells so chemcal meda"ors are no"released as easly/ decreases !ronchal hyperreac"+"y

!. E3ample5 cromolyn sod#m $Dsod#m%

c. @se5 "o pre+en" as"hma a""ac1s, e3ercse'nd#ced

!ronchospasmsd. Ad+erse e((ec"s

&. Co#gh

*. CNS ds"#r!ances. =#rnng, s"ngng eyes

2. Throa" rr"a"on

4. Headachee. Con"randca"ons

&. S"a"#s as"hma"c#s

*. Hypersens"+"y



17/44

&. Mon"or eosnophl co#n"

*. Mon"or respra"ory s"a"#s

. S"ore n "gh"ly closed lgh"'ress"an" con"aner/ 1eepcool

2. Teach clen"

a. Ho- "o #se "he nhaler!. Co#gh and !rea"he deeply !e(ore "a1ng "he

NSAID

c. ;ha" "o do (or ac#"e as"hma a""ac1, (cromolyn s no" e((ec"+e

d. Tha" "herape#"c e((ec" may "a1e #p "o 2

-ee1s

&. Ne#rologcal $ncl#dng anes"he"cs%

Mn O+er+e-5

&. An"con+#lsan"s

*. An"par1nson Agen"s

. Cholnes"erase nh!"ors

2. An"depressan"s4. An"manc Agen"s

6. An"psycho"c

8. Hypno"cs9. An"an3e"y $An3oly"c%

. General Anes"he"cs

&. Local Anes"he"cs

&. An"con+#lsan"sa. Ac"on ' mod(es !oelec"rc ac"+"y a" s#!cor"cal and

cor"cal areas!. E3amples

&. da0epam $:al#m%

*. magnes#m s#l(a"e

. pheny"on $Dlan"n%2. pheno!ar!"al $L#mnal%

c. @se5 pre+en"s se0#res

d. Ad+erse e((ec"s&. =lood dyscrasas

*. Gas"rc e((ec"s ' na#sea, +om"ng

. CNS depresson ' d00ness, dro-sness2. Pheny"on5 a"a3a, hrs#"sm, hypo"enson

e. Con"randca"ons

&. Hypersens"+"y

(. N#rsng n"er+en"ons&. G+e medca"on -"h (ood


18/44

*. ;"h pheny"on5 mon"or cond"on o( oral m#cosa,

don)" m3 -"h o"her I: "herapy, mon"or !lood la!

res#l"s, mon"or #rne. Renal, l+er, and !lood s"#des

2. Teach clen"s5

a. A+od alcohol!. No"(y physcan o( #n#s#al symp"oms

c. Carry medcal aler" n(orma"on

d. Ta1e medca"on on sched#le/ do no"dscon"n#e

e. A+od dr+ng and o"her po"en"ally

ha0ardo#s ac"+"es

(. Pheny"on5 good oral hygene

&. An"par1nson Agen"s

a. Ac"on

&. An"cholnergcs5 !loc1 or compe"e a" cen"ral ace"ylcholne

recep"ors

*. Dopamne agons"s5 ac"+a"on o( dopamne recep"ors

Antiparins!n A"ent Brand

#ame

Adverse E$$e%ts #ursin" Interventi!ns

!en0"ropne mesyla"e Cogen"n Dry mo#"h, dro-sy,

d00y, !l#rred +son,#rne re"en"on, -ea1

m#scles

Mon"or I7O and m#scle

s"reng"h. I( -ea1 m#scles,decrease dosage.

"rhe3yphendyl Hcl Ar"ane CNS ds"#r!ances, drymo#"h

Mon"or IKO/ Mon"or (or!eha+or changes/ Mon"or (or

"olerance o+er long'"erm

"herapy

le+odopa Dopar Or"hos"a"c hypo"enson,a"a3a, CNS

ds"#r!ances, le#1opena

Mon"or (or !eha+or changes/early sgns o( o+er dose are

m#scle spasms and spasmodc

-n1ng

aman"adne Hcl Symme"rel Or"hos"a"c hypo"enson,a"a3a, CNS

ds"#r!ances,

le#1opena, CHB

Mon"or IKO/ admns"er a"leas" 2 ho#rs !e(ore HS

. Teach clen"a. Do no" s"op "a1ng an"par1nsonan meds s#ddenly5 may

precp"a"e par1nsonan crss


19/44

!. Con"n#e medcal s#per+son

c. A+od alcohol -hle on "herapy

d. Ta1e -"h mealse. Ca#"on -"h ha0ardo#s ac"+"es

(. To change pos"on slo-ly "o pre+en" or"hos"a"c

hypo"ensong. Le+odopa

&. Elmna"e :"amn =6 (rom de"

*. Do no" "a1e OTC medca"ons -"ho#" physcan)sappro+al

. S-ea" and #rne may !e dar1 colored

2. Le+odopa "o3c"y5 men"al personal"y changes,

ncreased "-"chng, grmacng, "ong#e pro"r#son

. Cholnes"erase nh!"ors

a. Ac"on

&. Pre+en"s !rea1do-n o( ace"ylcholne a" ner+eendngs

*. Bacl"a"es "ransmsson o( mp#lses across

myone#ral ?#nc"on

. S"reng"hens m#scle con"rac"ons ncl#dngrespra"ory m#scles

!. E3amples

&. edrophon#m chlorde $Tenslon% (or dagnos"cp#rposes

*. neos"gmne !romde $Pros"gmn%

. am!enon#m chlorde $My"elase%

c. @se5 "rea" myas"hena gra+sd. Ad+erse e((ec"s

&. Gas"rc rr"a"on5 na#sea, +om"ng, darrhea

*. Hypersal+a"on. CNS ds"#r!ances

2. Or"hos"a"c hypo"enson

4. To3c"y5 p#lmonary edema, respra"ory (al#re,!ronchospasm

e. Con"randca"ons5

&. In"es"nal o!s"r#c"on*. Renal o!s"r#c"on

. Per"on"s

(. N#rsng n"er+en"ons&. Mon"or clen" response "o medca"on/ may need "o

ad?#s" dosage

*. Mon"or +"al sgns d#rng perod o( dosage

ad?#s"men".


20/44

4. Admns"er medca"on as per sched#le

6. Teach clen"5

a. ;ear medc aler" ?e-elry and ID!. Change pos"on ca#"o#sly/ s" a" (rs"

(eelng o( (an"ness.

4. An"manc agen"s

a. Ac"on5 red#ces adrenergc ne#ro"ransm""er le+els ncere!ral "ss#e

!. E3amples

&. An"manc agen"s5 l"h#m car!ona"e $L"hane%*. Al"erna"+e an"manc agen"s5 car!ama0epne

$Tegre"ol%, clona0epam $


21/44

&. E3cess+e seda"on

*. a#ndce

. Or"hos"a"c hypo"enson2. @rnary re"en"on

4. Anore3a

6. Dry mo#"h8. Hypersens"+"y reac"ons $s#ch as pho"oallergc

reac"on, mpo"ence, cardac "o3c"y%

9. E3"rapyramdal sde e((ec"s5 dys"ona,pse#dopar1nsonsm, a1a"hsa, a1nesa, "ard+e

dys1nesa

. Ne#rolep"c malgnan" syndrome5 (e+er, m#scle

rgd"y, ag"a"on, con(#son, delr#m, respra"ory(al#re

e. N#rsng n"er+en"ons

&. Assess clen")s response "o "herapy

*. Mon"or (or sgns o( n(ec"on, l+er "o3c"y,e3"rapyramdal symp"oms

. Mon"or !lood -or1 ( long'"erm "herapy2. Mon"or +"al sgns

4. G+e medca"on a" !ed"me

6. Teach clen"a. A+od alcohol #se

!. A+od dr+ng or o"her ha0ardo#s ac"+"es

c. A+od e3pos#re "o drec" s#nlgh"

d. Good oral hygenee. Repor" e3"rapyramdal symp"oms or sgns o(

n(ec"on "o physcan

(. Drn1 plen"y o( -a"er

Stud& Smart

;hle s"#dyng, re+e- con"en" !y (orm#la"ng

#es"ons a!o#" "he con"en".

8. Hypno"csa. Ac"on5 depress CNS

!. E3amples

&. =ar!"#ra"es5 pen"o!ar!"al $Nem!#"al%, seco!ar!"al$Seconal%5 physcal dependency may res#l" -"h

long "erm #se

*. Ace"ylnc alcohol5 e"hchlor+ynol $Placdyl%. Chloral der+a"+es5 chloral hydra"e $Noc"ec%

c. @ses5 nsomna, seda"on

d. Ad+erse reac"ons

&. Respra"ory depresson


22/44

*. Hypo"enson

. =ar!"#ra"e "o3c"y5 hypo"enson/ p#lmonary

cons"rc"on/ cold, clammy s1n/ cyanoss o( lps/nsomna/ hall#cna"ons/ delr#m

e. Con"randca"ons

&. Hypersens"+"y*. Pregnancy


&. Mon"or clen" response "o medca"on*. Teach clen"

a. Ta1e medca"on e3ac"ly as prescr!ed

!. A+od alcohol and o"her depressan" #se

c. A+od dr+ng and o"her ha0ardo#s ac"+"es-hle #nder "he n(l#ence

9. An"an3e"y $An3oly"c%

a. Ac"on5 depress CNS

!. E3amples&. =en0oda0epnes5 alpra0olam $Fana3%,

chlorda0epo3de $L!r#m%5 physcal dependencyand -"hdra-al symp"oms a("er long "erm #se

*. Propanedols5 mepro!ama"e $E#anl%

. #na0olnes5 me"ha#alone $#aal#de%c. @ses5 an3e"y, sleep dsorders, alcohol -"hdra-al

d. Ad+erse reac"ons

&. CNS ds"#r!ances5 d00ness, dro-sness, le"hargy,

or"hos"a"c hypo"enson*. S1n rash

. =lood dyscrasas


*. Ac#"e narro- angle gla#coma

. L+er dsease(. N#rsng n"er+en"ons

&. No"(y physcan ( sys"olc =P drops * mm Hg

*. Admns"er -"h (ood or ml1

. Teach clen"a. Ta1e medca"on as prescr!ed

!. Do no" "a1e OTC medca"on -"ho#"

physcan)s appro+alc. @se ca#"on -hen dr+ng or ha0ardo#s

ac"+"es

d. Ac"on po"en"a"ed -"h alcohol or seda"+ese. Ne+er a!r#p"ly s"op "a1ng !en0oda0epne

(. ;"h chlorda0epo3de ' a+od e3cess+e

s#nlgh"

. General Anes"he"cs


23/44

a. Ac"on5 depresses "he CNS "hro#gh a progress+e se#ence

!. E3amples&. Inhala"on anes"he"cs5 cyclopropane, en(l#rane

$E"hrane%, e"her, n"ro#s o3de

*. I: !ar!"#ra"es5 "hopen"al sod#m $Pen"o"hal%,me"hohe3"al sod#m $=re+"al%

. I: and IM non!ar!"#ra"es5 mda0olam HCL

$:ersed%, 1e"amne HCL $


24/44

*. Mon"or +"al sgns d#rng local anes"hesa

. I( spnal anes"hesa, 1eep clen" (la" (or 6'&* ho#rs

"o pre+en" headaches

2. Managng M#sc#los1ele"al Cond"ons

Mn O+er+e-5

&. S1ele"al M#scle Rela3an"s

*. NSAIDs

. An"go#" Agen"s&. S1ele"al m#scle rela3an"s

a. @se5 rela3 m#scles, "rea" spasm dsorders

Central Perip'eral

(se: Rele( o( m#scle spasm andpan

Bacl"a"on o(endo"racheal n"#!a"on,or"hopedc manp#la"on

A%ti!n: Depress CNS, leadng "o

rela3a"on o( +ol#n"arym#scles

=loc1 ner+e mp#lses a"

"he myone#ral ?#nc"on

Examples: cyclo!en0apne $Ble3erl%,

da0epam$:al#m%,

orphenadrne$Nor(le3%

gallemne

"re"hodde$Bla3edl %,

s#ccnylcholne chlorde$Anec"ne%

AdverseE$$e%ts:

Tachycarda, d00ness,dro-sness, dry mo#"h,

edema o( "ong#e, CNSds"#r!ances

Hypo"enson, respra"orydepresson, arrhy"hmas

#ursin"

Interventi!ns:

Mon"or clen" (or sa(e"y

preca#"ons/ "each clen" "o

a+od alcohol and ha0ardo#sac"+"es/ admns"er -"h

meals/ (l#ds (or dry mo#"h/

do no" dscon"n#e medsa!r#p"ly

Ha+e res#sc"a"on

e#pmen" a+ala!le/

mon"or +"al sgns, clen"cond"on, and response "o

medca"on/ ;"hhold

medca"on and callphyscan ( clen" sho-s

sgns o( hypersens"+"y

&. Nons"erodal An"n(lamma"ory Dr#gs $NSAIDS%

a. Ac"on5 n"er(eres -"h pros"aglandn syn"hess!. E3amples5 !#pro(en $Mo"rn%, ndome"hacn $Indocn%

c. @se5 rhe#ma"od ar"hr"s, os"eoar"hr"s, dysmenorrhea

d. Ad+erse e((ec"s

&. Gas"rc ds"#r!ances


25/44

*. S1n rash

. =lood dyscrasas7!leedng

2. CNS ds"#r!ances4. Nephro"o3c"y

e. Con"randca"ons

&. Hypersens"+"y*. As"hma

. Renal Dsease

2. L+er dsease(. N#rsng n"er+en"ons

&. Admns"er & ho#r !e(ore or * ho#rs a("er meals

*. Mon"or !lood -or1, +"al sgns

. Mon"or response "o medca"on*. An"go#" agen"s

a. Ac"on5 Increases e3cre"on o( #rc acd and decreases #rc

acd (orma"on

!. E3amples&. allop#rnol $Jyloprm%

*. colchcne $No+ocolchne%. pro!enecd $=enemd%

c. @se5 pre+en" go#" a""ac1s

d. Ad+erse e((ec"s&. Gas"rc e((ec"s5 na#sea and +om"ng, ndges"on

*. =lood dyscrasas

. L+er damage

2. S1n rash4. GI ds"#r!ances

e. Con"randca"ons5 hypersens"+"y

(. N#rsng n"er+en"ons&. Increase (l#d n"a1e "o pre+en" renal calc#l

*. Mon"or (l#d n"a1e and o#"p#"

. Admns"er -"h meals2. Mon"or !lood -or1, ncl#dng ser#m #rc le+els,

and elec"roly"e le+els

4. Ins"r#c" clen"

a. Lose -egh" ( needed!. A+od hgh p#rne (oods $organ mea"s,

sardnes, shell(sh, e"c.%

c. A+od (ermen"ed !e+erages s#ch as !eer, ale,-ne

&. Managng In"eg#men"ary Cond"ons

Mn'O+er+e-5

&. Sca!cdes7Pedc#lcdes


26/44

*. An"'pr#r"cs

. An"'n(ec"+es

2. An"'n(lamma"ory S"erods

&. Sca!cdes7Pedc#lcdes $illustration 1 illustration 2%

a. Ac"on5 "arge"s "he paras"e)s ner+e'cell mem!rane!. E3amples

&. perme"hrn $N3% $Elm"e%*. lndane $


27/44

*. =ladder and #re"hra rrga"ons

c. Ad+erse e((ec"s

&. sl+er s#l(ada0ne5 s1n rr"a"on*. sl+er n"ra"e

a. Elec"roly"e m!alance!. =ro-nsh !lac1 dscolora"on prod#ced on

con"ac"!. N#rsng n"er+en"ons

&. Mon"or clen")s cond"on d#rng "rea"men"

*. Bor eyes, #se only sl+er n"ra"e n oph"halmcsol#"on

. Handle sl+er n"ra"e -"h care5 sol#"ons s"an s1n

and clo"hng2. sl+er s#l(ada0ne5 #se asep"c "echn#e -hen

applyng

*. An"'n(lamma"ory $S"erods, gl#cocor"cods%a. Ac"on5 s"a!l0e le#1ocy"e lysomal mem!ranes, nh!"

phagocy"oss and release o( allergc s#!s"ances

!. E3amples

&. Hydrocor"sone sod#m s#ccna"e $Sol#'Cor"e(%*. Hydrocor"sone sod#m phospha"e $Hydrocor"one%

c. @se5 "o s#ppress n(lamma"ory or mm#ne responses

d. Ad+erse reac"ons&. Sod#m and (l#d re"en"on

*. Na#sea, acne, mpared -o#nd healng

. Anaphylac"c reac"on

2. Mas1ng o( n(ec"on4. =eha+or changes

e. Con"randca"ons5

&. Hypersens"+"y*. Sys"emc (#ngal n(ec"ons


&. Es"a!lsh !aselne o( +"al sgns, I7O ra"o, -egh"*. Mon"or !lood press#re d#rng s"a!l0a"on perod

. Assess clen")s response "o "rea"men"

2. Teach clen"a. Ta1e oral s"erod -"h (ood

!. Ta1e an"'n(lamma"ores on sched#le and

don)" s"op a!r#p"lyc. E3pec" a slgh" -egh" gan

d. A+od alcohol and ca((ene

e. Don)" #se OTC medca"ons #nless appro+ed

!y physcan(. Repor" slo- healng, +ag#e (eelng o( !eng

sc1, or relapse


28/44

g. @se medc aler" ?e-elry or ID

6. Managng Gas"ron"es"nal Cond"ons

Mn'O+er+e-5

&. An"acds*. La3a"+es

. An"darrheals

2. Pancrea"c En0ymes

&. An"acdsa. Ac"on

&. Ne#"ral0es gas"rc acd

*. Coa"s s"omach lnng!. E3amples

&. al#mn#m hydro3de gel $Ampho?el%

*. al#mn#m and magnes#m hydro3des $Maalo3%. magaldra"e $Ropan%

c. @se5 pep"c #lcers, re(l#3 esophag"s, ha"al herna

d. Ad+erse reac"ons

&. Al#mn#m compo#nds ' cons"pa"on, n"es"nalo!s"r#c"on

*. Magnes#m compo#nds ' darrhea

. Red#ced a!sorp"on o( calc#m and rone. N#rsng n"er+en"ons

&. Sha1e oral s#spenson -ell

*. Mon"or clen")s response "o "rea"men"

. Admns"er -"h 9 o0 glass o( -a"er2. Ins"r#c" clen"

a. A+od o+er#se o( an"acds!. De"ary res"rc"ons (or #lcers

c. Need (or de" hgh n calc#m and ron

d. Bor clen"s on lo- sod#m de"s5 an"acds

con"an sod#me. May color s"ools -h"sh

*. La3a"+es

a. Ac"on5 mo+es s"ool/ mechansm dependen" on "ype o(la3a"+e

!. E3amples

&. L#!rcan"s mos"en s"ool/ mneral ol*. S"ool so("eners allo- -a"er "o pene"ra"e s"ool/

doc"yl sod#m s#l(os#ccna"e $Colace%

. =#l1 (ormng5 ncrease !#l1 n n"es"ne/ psyll#m

hydrophlc m#cllod $Me"am#cl%2. Colon rr"an" s"m#la"es pers"alss/ !sacodyl

$D#lcola3%


29/44

4. Salne ca"har"cs ncrease osmo"c press#re "here!y

a!sor!ng (l#d (rom !o-el -all/ ml1 o( magnesa

c. @se5 "o "rea" cons"pa"ond. Ad+erse reac"ons

&. Gas"rc e((ec"s5 na#sea, crampng, darrhea

*. Dependence -"h long'"erm #se. In"es"nal l#!rcan"s nh!" a!sorp"on o( (a"'sol#!le

+"amns

2. Salne ca"har"cs5 dehydra"on, hyperna"remae. Con"randca"ons5

&. GI o!s"r#c"on

*. S#spec"ed appendc"s

. Megacolon2. A!domnal pan

4. Na#sea


&. Mon"or e((ec"s o( medca"on*. Teach clen"

a. de"ary consdera"ons $ncreased (!er and(l#d n"a1e%

!. man"an7ncrease ac"+"y le+el

c. ca#"on regardng o+er#se o( la3a"+esd. m3 !#l1'(ormng la3a"+es -"h a glass o(

-a"er and (ollo- -"h ano"her glass o( -a"er

Plan "o (nsh s"#dyng (or NCLEF a" leas" se+eral days pror

"o yo#r sched#led "me "o "es". Las" mn#"e crammng -ll

ncrease yo#r an3e"y.&. An"'darrheal

a. Ac"on5 (orms "he s"ool/ mechansm depends on "ype o(

medca"on

!. E3amples&. Bl#d a!sor!en"s ' decrease (l#d con"en"/ 1aoln and

pec"n $


30/44

. Mo"l"y s#ppressan"s5 #rnary re"en"on,

"achycarda, seda"on, paraly"c le#s, respra"ory

depressone. Con"randca"ons5

&. @lcera"+e col"s

(. N#rsng n"er+en"ons&. Mon"or e((ec" o( medca"on

*. Assess (or (l#d and elec"roly"e m!alance

. Assess (or ca#se o( darrhea2. Mo"l"y s#ppressan"s may ca#se physcal

dependence, may mpar a!l"y "o per(orm

ha0ardo#s ac"+"es

*. Pancrea"c En0ymesa. Ac"on5 replacemen" (or na"#ral pancrea"c en0ymes

!. E3amples

&. pancrea"n $D0ymes%

*. pancrelpase $Co"a0ym%c. @se5 ad n dges"on/ cys"c (!ross

d. Ad+erse reac"ons, -"h large doses&. Darrhea

*. Na#sea

. Hypersens"+"y reac"on5 snee0ng, s1n rashese. Con"randca"ons5

&. Hypersens"+"y "o por1

*. Chronc pancrea"c dsease

(. N#rsng n"er+en"ons&. Mon"or (or symp"oms o( da!e"es mell"#s $s#ch as

poly#ra, "hrs", h#nger%

*. Mon"or -egh", n"a1e and o#"p#". Admns"er -"h meals

2. Do no" cr#sh en"erc coa"ed medca"ons

4. De"ermne clen")s response "o "herapy

&. Managng Endocrne Cond"ons

Mn'O+er+e-5

&. An"da!e"c Agen"s

*. Hypo"hyrod Agen"s

. Hyper"hyrod Agen"s2. An"eror P"#"ary Gro-"h Hormone

4. An"d#re"c Hormone

&. An"da!e"c agen"s

a. Ac"on5 pro+des ns#ln "o promo"e "ranspor" o( gl#cose/e3ac" mechansm dependen" on "ype o( an"da!e"c agen"

!. E3amples


31/44

&. Oral hypoglycemcs s"m#la"e pancrea"c !e"a cells

"o prod#ce ns#ln "ola0amde $Tolnase%,

"ol!#"amde $Ornase%*. Paren"eral agen"s pro+de e3ogeno#s ns#ln

c. @se5 "rea" da!e"es mell"#s

d. Ad+erse e((ec"s&. Hypoglycema, rr"a!l"y, con(#son

*. Con+#lsons, "achycarda, "remor

. Mos" s1n, headache, h#ngere. Con"randca"ons5

&. Hypersens"+"y


&. Assess clen" (or e((ec" o( medca"on*. Mon"or !lood7#rne gl#cose le+els

. G#delnes (or admns"ra"on o( ns#ln

a. Ro"a"e s"es

!. Admns"ered s#!c#"aneo#slyc. Only reg#lar ns#ln s admns"ered I:

d. ;hen m3ng ns#ln, reg#lar ns#ln s-"hdra-n n"o "he syrnge (rs"

2. Ins"r#c" clen"

a. Ho- "o admns"er "he medca"on!. Complance -"h de"ary res"rc"ons

c. @rne and !lood "es"ng

d. ;ear medc aler" ?e-elry

e. Ho- "o cope -"h hypoglycemc reac"ons(. Sgns o( 1e"oacdoss

*. Hypo"hyrod agen"s

a. Ac"on5 help reg#la"e "he me"a!olc ra"e o( cells!. E3amples

&. le+o"hyro3ne sod#m $Syn"hrod%

*. "hyroglo!#ln $Prolod%. "hyrod $Thyrar%

c. @se5 replace "hyrod hormones

d. Ad+erse reac"ons

&. Hyperac"+"y*. Cardac s"m#la"on

. Thyrod s"orm

e. Con"randca"ons&. Adrenal ns#((cency

*. Myocardal n(arc"on

. Thyro"o3coss2. Hypersens"+"y "o !ee(


&. Mon"or clen")s response "o medca"on

*. Teach clen"
http://yoda.vcampus.com/0001/0023/000000007244/1_23_7244_11/assets/downloads/insu_act.htmhttp://yoda.vcampus.com/0001/0023/000000007244/1_23_7244_11/assets/downloads/insu_act.htm


32/44

a. @s#ally l(elong "herapy

!. Ta1e medca"on same "me each day

c. Mon"or p#lse ra"e/ repor" p#lse ra"e o+er&

d. Repor" sgns o( "o3c"y $s#ch as ches" pan,

palp"a"ons, ner+o#sness%e. ;ear medc aler" ?e-elry 7 ID

(. A+od OTC medca"ons #nless appro+ed !y

physcang. Con"n#e medcal s#per+son

. Hyper"hyrod agen"s

a. Ac"on5 !loc1s syn"hess o( "hyrod hormone

!. E3amples&. odne $L#gol)s sol#"on%

*. me"hma0ole $Tapa0ole%

. propyl"ho#racl $PTL%

c. @se5 "rea" hyper"hyrodsmd. Ad+erse e((ec"s

&. Agran#locy"oss*. S1n ds"#r!ances

. Decreased me"a!olsm

2. Gas"rc ds"#r!ances4. Iodne5 s"ans "ee"h, !""er "as"e

e. Con"randca"ons5

&. Hypersens"+"y

(. N#rsng n"er+en"ons&. Admns"er odne prepara"ons "hro#gh a s"ra-

*. Mon"or e((ec"s o( medca"on

. Ins"r#c" clen"a. Repor" sde e((ec"s

!. A+od OTC dr#gs con"anng odne

c. Do no" dscon"n#e medca"on a!r#p"lyd. Carry medc aler" ?e-erly

2. An"eror p"#"ary5 gro-"h hormone

a. Ac"on5 s"m#la"es "he gro-"h o( prac"cally all organs and

"ss#es!. E3amples

&. soma"rem $Pro"ropn%

*. soma"ropn $H#ma"rope%c. @se5 "rea" d-ar(sm

d. Ad+erse e((ec"s

&. Hyperglycema*. Hypo"hyrodsm

. An"!odes "o gro-"h hormone

2. In"erac"on -"h gl#cocor"cods

e. Con"randca"ons5


33/44

&. Hypersens"+"y "o !en0yl alcohol

*. Closed epphyses

. In"racranal lesons(. N#rsng n"er+en"ons

&. Mon"or da!e"c clen" closely

*. Ins"r#c" clen"a. Record hegh" meas#remen"s a" reg#lar

n"er+als

!. Repor" "o physcan ( gro-"h s less "hane3pec"ed

4. An"d#re"c Hormone

a. Ac"on5 Helps ds"al renal "#!#les rea!sor! -a"er

!. E3amples&. lypressn $Dapd%

*. +asopressn $P"ressn%

c. @se5 "rea"men" o( da!e"es nspd#s

d. Ad+erse e((ec"s&. Gas"rc ds"#r!ances

*. Hypona"rema. ;a"er n"o3ca"on

2. Cardac ds"#r!ances

e. N#rsng n"er+en"ons&. Mon"or response "o "herapy5 n"a1e and o#"p#",

!lood press#re

*. Assess (or dehydra"on

&. Managng Gen"o#rnary Dseases

Mn'o+er+e-5

&. D#re"cs

*. S#l(onamdes

. Imm#nos#ppressan"s

2. An"'n(ec"+es&. D#re"cs

a. Ac"on5 n"er(eres -"h sod#m rea!sorp"on

!. E3amples&. Loop d#re"cs n"err#p" "he "ranspor" o( sod#m ons

n Loop o( Henle

a. e"hacrync acd $Edecrn%!. (#rosemde$Las3%

*. Po"ass#m sparers ac" on ds"al nephron s"es "o

decrease sod#m rea!sorp"on

a. spronalac"one $Aldac"one%!. "rm"erne $Dyren#m%


34/44

. Tha0des5 nh!" rea!sorp"on o( Naand CL'n

early ds"al "#!#le

a. chloro"ha0de $D#rl%!. hydrochloro"ha0de $Hydrod#rl%

2. Osmo"c5 ncrease osmo"c press#re o( glomer#lar

(l"ra"ea. Mann"ol

!. @rea

c. @se5 Trea" hyper"enson, edemad. Ad+erse sde e((ec"s

&. Gas"ron"es"nal rr"a"on

*. Elec"roly"e m!alance5 hypona"rema, hypo1alema

. Or"hos"a"c hypo"enson2. Dehydra"on

e. Con"randca"ons

&. Elec"roly"e m!alances

*. Dehydra"on. An#ra

(. N#rsng n"er+en"ons&. Mon"or -egh", n"a1e and o#"p#", +"al sgns

*. G+e medca"on n mornng

. Mon"or clen" (or (l#d K elec"roly"e m!alance2. Teach clen"

a. Change pos"ons slo-ly

!. Repor" changes n hearng

c. Da!e"c clen"s5 closely mon"or gl#cosele+els

*. S#l(onamdes

a. Ac"on5 s#!s""#"es a (alse me"a!ol"e (or p'amno!en0ocacd, -hch s essen"al (or "he !ac"eral syn"hess o( (olc

acd

!. E3ample&. s#ccnyls#l(a"ha0ole $S#l(as#3dne%

*. s#l(so3a0ole $Gan"rsn%

. s#l(ame"ho3a0ole and "rme"hoprm $=ac"rm,

Sep"ra%c. @se5 #rnary "rac" n(ec"ons

d. Ad+erse e((ec"s

&. Gas"rc rr"a"on5 na#sea and +om"ng, s"oma""s*. Rash

. Malase

2. =lood dyscrasas4. Crys"all#ra

6. Pho"osens"+"y

8. Allergc response

e. Con"randca"ons5


35/44

&. Hypersens"+"y

*. In(an"s * mo

. Pregnancy a" "erm(. N#rsng n"er+en"ons

&. Chec1 ( clen" has a hs"ory o( allerges

*. Mon"or clen" response "o "rea"men". Mon"or +"al sgns and !lood -or1

2. Teach clen"

a. Drn1 plen"y o( (l#ds!. Ta1e medca"on as prescr!ed

c. A+od OTC medca"ons #nless appro+ed !y

physcan

d. A+od drec" s#nlgh". Imm#nos#ppressan"s

a. Ac"on5 nh!" mm#ne responses

!. E3ample5 cyclosporne $Sandmm#ne%

c. @se&. Pre+en" organ re?ec"on n "ransplan" pa"en"

*. Trea" a#"omm#ne dsorders $s#ch as rhe#ma"odar"hr"s, sys"emc l#p#s ery"hema"os#s%

d. Ad+erse e((ec"s

&. Nephro"o3c"y $posons 1dneys%*. In(ec"on

. Hyper"enson

2. Tremor

4. Hrs#"sme. Con"randca"ons5

&. Hypersens"+"y

*. N#rsng n"er+en"ons. Mon"or =@N and crea"nne/ l+er (#nc"on "es"s

2. Teach clen"

a. Repor" early sgns o( n(ec"on $s#ch as(e+er, sore "hroa"%

!. Medca"on may !e "a1en -"h meals

c. Ta1e medca"on same "me each day

d. Hrs#"sm s re+ers!le -hen "rea"men" s"ops2. An"n(ec"+e

a. Ac"on5 n"er(eres -"h se+eral !ac"eral en0yme sys"ems

!. E3ample&. n"ro(#ran"on $B#radan"n%

*. nald3c acd $NegGram%

c. @se5 "rea" pyelonephr"s, pyel"s, cys""sd. Ad+erse e((ec"s

&. Anore3a

*. Na#sea and +om"ng

. Nald3c acd5 +s#al ds"#r!ances


36/44

2. N"ro(#ran"on5 e3(ola"+e derma""s, n"ers""al

nephr"s, necross


*. An#ra

. Se+ere renal dsease2. In(an"s & mo


&. Mon"or n"a1e and o#"p#"*. Teach clen"

a. Ta1e medca"on as prescr!ed

!. Drn1 plen"y o( (l#ds

c. Ta1e medca"on -"h (ood or ml1d. ;"h n"ro(#ran"on5

. Do no" cr#sh pll !eca#se " s"ans

"ee"h/ dl#"e oral s#spensons and

rnse mo#"h a("er "a1ng. Repor" changes n #rnary pa""ern

. Repor" m#scle -ea1ness, "nglng orn#m!ness

+. @rne may loo1 !ro-n or r#s" yello-

+. A+od alcohole. ;"h nald3c acd5

. A+od drec" e3pos#re "o s#nlgh"

-hle on "herapy

. Repor" +s#al ds"#r!ances. A+od dr+ng or o"her ha0ardo#s

ac"+"es

&. Managng Hema"ologcal Cond"ons

&. Hema"opoe"c gro-"h agen"a. Ac"on5 s"m#la"es prod#c"on o( red !lood cells

!. E3ample

&. (lgras"m $Ne#pogen%*. epoe"n al(a $Epogen%

c. @se5 chronc renal (al#re, HI:'n(ec"ed clen"s,

nonmyelod malgnancesd. Ad+erse e((ec"s

&. (lgras"m5 !one pan, "hrom!ocy"opena

*. epoe"n al(a5 hyper"ensone. Con"randca"ons5

&. Hypersens"+"y "o pro"ens o( E. Col


&. Ta1e !aselne C=C and d(( $comple"e !lood co#n"and d((eren"al co#n"% pror "o "rea"men"

*. Mon"or !lood sgns #n"l "arge" reached


37/44

*. Iron s#pplemen"s

a. Ac"on5 ron "ranspor"ed as "rans(errn "o !one marro- and

ncorpora"ed n"o hemoglo!n!. E3amples

&. (erro#s s#l(a"e $Beosol%

*. (erro#s (#mar"e $Beco'T%. (erro#s gl#cona"e $Bergon%

c. @se5 correc" smple ron de(cency anema

d. Ad+erse e((ec"s&. Gas"rc ds"#r!ances

*. ;"h mass+e o+erdose ' le"hargy, dro-sness,

leadng "o me"a!olc acdoss, shoc1 and

cardo+asc#lar collapsee. Con"randca"ons5

&. Hypersens"+"y

*. @lcera"+e col"s

. Pep"c #lcer dsease2. Hemoly"c anema

4. Crrhoss(. N#rsng n"er+en"ons

&. Mon"or hemoglo!n le+el

*. Teach clen"a. Ta1e on emp"y s"omach

!. L#d prepara"on ' "a1e -"h a s"ra-

c. Pro"ec" (rom mos"#re and hea"

d. May ca#se dar1 or greensh s"ools

I. An"!o"cs, An"+rals, An"(#ngals, An"paras"cs

A. An"!o"cs

&. Ac"on5 des"roys or nh!"s !ac"era

*. E3amplesa. Pencllns, !road spec"r#m

&. ampclln $Omnpen%

*. penclln : $:'clln%!. Cephalosporns, !road spec"r#m

&. ce(a0oln sod#m $Ance(%

*. cephalo"hn sod#m $


38/44

*. s"rep"omycn s#l(a"e $S"rycn%

(. Polymy3n5 polymy3n = s#l(a"e $Aerosporn%

g. chloramphencol $Chloromyce"n%. @se5 "rea" !ac"eral n(ec"on

2. Ad+erse e((ec"s

a. Gas"rc ds"#r!ances5 na#sea 7 +om"ng, poor appe""e,darrhea

!. Allergc reac"ons

c. S#pern(ec"ond. Loss o( -a"er'sol#!le +"amns and mnerals

e. Te"racyclnes5 hepa"o"o3c"y, pho"o"o3c"y, hyper#rcema,

"oo"h enamel hypoplasa, and !one de(ec"s n chldren

#nder 9 years o( age(. Amnoglycosdes5 o"o"o3c"y, le#1opena,

"hrom!ocy"opena, headache, con(#son, perpheral

ne#ropa"hy, op"c ne#r"s

g. chloramphencol5 !lood dyscrasas, (e+er, rash, ?a#ndce4. Con"randca"ons5

&. hypersens"+"y


a. Mon"or clen" (or allerges

!. Mon"or clen")s response "o "rea"men"

c. Teach clen"

&. Ta1e allo( prescr!ed medca"on*. Symp"oms o( allergc response

. I( "a1ng a l#d $s#spenson%, sha1e " (rs"2. Ta1e medca"on !e(ore mealsd. Te"racyclnes

&. No" (or yo#ng chldren or n las" hal( o( pregnancy

*. Poss!le oral an"coag#lan" e((ec"e. Amnoglycosdes and polymy3ns5 May po"en"a"e ne#rom#sc#lar !loc1ng

agen"s, general anes"hesa or magnes#m e((ec"s/ mon"or (or all "hree po"en"a"on e((ec"s

(. chloramphencol&. Assess !lood -or1 d#rng "herapy

*. Assess (or po"en"a"on o( pheny"on, oral

an"da!e"c agen"s or co#madn an"coag#lan"

e((ec"s=. An"+rals

&. Ac"on5 n"er(ere -"h DNA syn"hess needed (or +ral replca"on

*. E3amplesa. acyclo+r sod#m $Jo+ra3%

!. aman"adne HCL $Symme"rel%

c. me"hsa0one $Maroran%. @se5 +ral n(ec"ons s#ch as herpes, +ral encephal"s


39/44

2. Ad+erse e((ec"s

a. Or"hos"a"c hypo"enson

!. D00nessc. GI ds"#r!ances

d. Nephro"o3c"y

e. =lood dyscrasas4. Con"randca"ons5

a. Hypersens"+"y

!. Imm#nos#ppresson6. N#rsng n"er+en"ons

a. Mon"or +"al sgns d#rng an"+ral "herapy

!. Mon"or e((ec" o( "herapy

c. Increased (l#d n"a1ed. Mon"or (or sgns o( s#pern(ec"on5 sore "hroa", (e+er,

(a"g#e

C. An"(#ngals $sys"emc%

&. Ac"on5 des"roys (#ngal cells or nh!"s "her reprod#c"on*. E3amples

a. ampho"ercn = $B#ng0one%!. grseo(#l+n $Grsac"n%

c. nys"a"n $Mycos"a"n%

. @se ' "rea" local and sys"ema"c (#ngal n(ec"ons s#ch ashs"oplasmoss, canddass

2. Ad+erse e((ec"s

a. Gas"rc rr"a!l"y5 na#sea, +om"ng

!. Headachec. Be+er, chlls

d. Pares"hesa

e. Renal mparmen"4. Con"randca"ons5

a. Se+ere !one marro- depresson

!. Hypersens"+"y6. N#rsng n"er+en"ons

a. Mon"or +"al sgns and I and O d#rng "herapy

!. ;"h ampho"ercn =5

&. pro"ec" I: sol#"on (rom lgh"*. mon"or !lood -or1

. #se n(#son de+ce (or I: admns"ra"on

c. ;"h grseo(#l+n5 ns"r#c" clen" "o a+od s#nlgh"D. An"paras"cs

&. Ac"on5 n"er(eres -"h paras"e me"a!olsm and reprod#c"on

*. E3amplesa. An"helmn"cs 5 me!enda0ole $:ermo3%, ppera0ne $:erm0ne% $illustration%

!. Ame!cdes5 chloro#ne HCL $Aralen%, me"ronda0ole

$Blagyl%
http://yoda.vcampus.com/0001/0023/000000007244/1_23_7244_11/assets/downloads/h130p0.htmhttp://yoda.vcampus.com/0001/0023/000000007244/1_23_7244_11/assets/downloads/h130p0.htmhttp://yoda.vcampus.com/0001/0023/000000007244/1_23_7244_11/assets/downloads/h130p0.htm


40/44

c. An"malarals5 chloro#ne HCL $Aralen%, #nne s#l(a"e

$#namm%

. @se5 1lls paras"es, helmn"hs $pn-orm and "ape-orm%, pro"o0oa$ame!ass and malara%

2. Ad+erse e((ec"s

a. An"helmn"cs5 GI #pse", CNS ds"#r!ances, s1n rash, headache!. Ame!cdes5 GI #pse", !lood dyscrasas, s1n rash, CNS

ds"#r!ances

c. An"malarals5 GI #pse", !lood dyscrasa, +s#alds"#r!ances

4. N#rsng n"er+en"ons

a. Admns"er medca"on -"h (ood

!. Mon"or +"al sgns, !lood -or1 d#rng "herapyc. @se sa(e"y preca#"ons ( CNS ds"#r!ances man(es"ed

d. Teach clen" "o pre+en" (#r"her n(ec"on

e. ;"h an"malarals5 (re#en" +s#al e3amna"ons, #rne may

"#rn r#s" colored

:. To"al Paren"eral N#"r"on $TPN%

A. A (orm o( specal0ed n#"r"onal s#ppor" n -hch n#"ren"s are pro+ded

!y "he n"ra+eno#s ro#"e=. P#rpose5 "o s#s"an clen"s n#"r"onally. Sol#"ons conss" o( -a"er, amno

acds, gl#cose, mnerals, +"amns and lpd em#lsons, and "race elemen"s

-hch are calc#la"ed (or each clen" nd+d#ally.

C. @sed (or clen"s -ho are #na!le "o dges" or a!sor! en"eral n#"r"onD. Complca"ons

&. Hypoglycema*. Hyperglycema. Bl#d o+erload

2. Ca"he"er ' rela"ed sepss

4. Ar em!olsm6. Cen"ral +eno#s "hrom!oss

8. Ca"he"er accl#son

E. Admns"ra"on&. :a perpheral admns"ra"on ' #p "o & gl#cose sol#"ons

*. :a cen"ral admns"ra"on ' #p "o 4 gl#cose sol#"ons

B. N#rsng In"er+en"ons

&. =e(ore admns"ra"on o( TPNa. Chec1 la!el o( sol#"on -"h medcal order

!. Chec1 ra"e o( n(#son -"h medcal order

c. Inspec" TPN !o""le (or precp"a"es or "#r!d"yd. Admns"er +a an n(#son p#mp

*. D#rng admns"ra"on

a. Mon"or +"al sgns e+ery (o#r ho#rs


41/44

!. O!ser+e (or sgns o( ar em!olsm, pne#mo"hora3, or

allergc responses $s#ch as chlls, ncreased "empera"#re,

#r"cara e"c.%c. Mon"or clen")s -egh" daly

d. Mon"or la!ora"ory +al#es/ ( !lood gl#cose le+els rse, may

need "o #se sldng'scale ns#ln "herapye. Mon"or clen" (or (l#d o+erload

(. Mon"or respra"ory ra"e5 "achypnea may ndca"e e3cess

car!ohydra"es are ncreasng car!on do3de prod#c"ong. Mon"or nser"on s"e (or n(ec"on

h. Mon"or n(#son ra"e

&. I( ra"e "oo hgh, hyperosmolar d#ress and

dehydra"on*. I( "oo slo-, l""le !ene("

. Do no" o+ercorrec" (lo- ra"e ( "oo slo- or (as"

2. Acc#ra"ely record n"a1e and o#"p#"

4. Change nser"on s"e dressng as per (acl"y)spolcy

6. Enco#rage e3ercse as "olera"ed "o promo"e "hede+elopmen" o( m#scle ns"ead o( (a"

8. ;hle changng "#!e, ns"r#c" clen" "o #se :alsal+a

mane#+er and clamp "#!e "o pre+en" an arem!olsm

I. An"neoplas"cs $cy"o"o3c, an"prol(era"+e agen"s%

A. Ac"on

&. Hghly "o3c agen"s "ha" a""ac1 all rapdly d+dng cells, !o"hnormal and malgnan"*. Represen"s a sys"emc approach "ha" !ases "s ac"on on dsr#p"on

o( "he cell l(e cycle

. Mos" agen"s mod(y or n"er(ere -"h DNA syn"hess=. E3amples

&. Al1aly"ng agen"s5 mechlore"hamne HCl $N"rogen M#s"ard%,

cyclophosphamde $Cy"o3an%5 prod#ce !rea1s n DNA molec#leand cross'ln1ng o( s"rands "h#s n"er(erng -"h DNA replca"on/

mos" e((ec"+e n hema"ologc malgnances

*. An""#mor an"!o"cs5 =omycn/ !nd drec"ly -"h DNA changng

"s con(g#ra"on and nh!"ng replca"on. An"me"a!ol"es5 me"ho"re3a"e, 4'(l#oro#racl, (lo3#rdne, cy"osne

ara!nosde, 6'mercap"op#rne, 6'"hog#anne5 nh!" DNA

syn"hess/ mos" e((ec"+e agans" rapdly gro-ng "#mors en0ymesnecessary (or cell (#nc"on and replca"on

2. Plan" al1alods5 :n!las"ne, :ncrs"ne, E"oposde5 =nd "o

s#!s"ances needed "o (orm m"o"c spndle, "h#s pre+en"ng celld+son


42/44

4. Hormones and hormone nh!"ors5 Tamo3(en al"ers "he endocrne

en+ronmen" "o ma1e " less cond#c+e "o cell gro-"h/ #sed n

cancers o( "he !reas", pros"a"e, and o"her reprod#c"+e organsC. Ro#"es o( admns"ra"on

&. In"ra+eno#s $perpheral or cen"ral +eno#s access%

*. Oral. In"raar"eral

2. In"raper"oneal

4. In"raple#ral6. In"ra"hecal

8. :a +en"rc#lar reser+or

D. @se

&. To c#re, con"rol or palla"e res#l"s o( neoplasm*. May !e #sed as an ad?#nc" "o s#rgery and rada"on

E. Ad+erse e((ec"s5 res#l" (rom "he damage "o normal cells

&. Na#sea7 +om"ng, S"oma""s, Al"era"ons n "as"e, Anore3a

*. Darrhea, Cons"pa"on. Alopeca, Derma""s, Pr#r"#s, Pares"hesa, Rash, =r#sng

2. Hemorrhagc cys""s4. Cardomyopa"hy

6. Ba"g#e, Dyspnea, Be+er, Chlls

8. S"erl"y, Amenorrhea9. Depresson, An3e"y

. Myelos#ppresson

B. N#rsng n"er+en"ons

&. Mon"or la! s"#des as ordered*. Mon"or I: admns"ra"on s"e (or e3"ra+asa"on

. Man"an s"rc" asepss

2. Admns"er an"eme"c agen"s as ordered and prophylac"cally!e(ore chemo"herapy.

4. G+e an"hs"amnes as ordered

6. ;"hhold (ood and (l#ds (or 2'6 ho#rs !e(ore "rea"men"8. =e"-een "rea"men"s, g+e small, (re#en", !land meals

9. G+e an"darrheals as ordered

. Mon"or (or sgns o( dehydra"on and enco#rage (l#ds as "olera"ed

&. Pro+de (re#en" oral hygene, l#!rca"e lps as ndca"ed&&. Bor s"oma""s, #se "opcal anes"he"cs !e(ore ea"ng and as

ndca"ed

&*. Apply lo"on "o s1n as ndca"ed/ a+od harsh, dryng soaps&. Pro+de a res"(#l en+ronmen", emo"onal s#ppor" and an3oly"cs

as ordered

&2. Teach clen"a. Medca"ons and sde e((ec"s

!. Tha" alopeca s "emporary

c. To a+od !r#sng, asprn prod#c"s, and persons -"h

n(ec"ons


43/44

d. To conser+e energy

e. To recogn0e sgns o( !leedng/ anema, n(ec"on

(. To #se a so("'!rs"le "oo"h!r#shg. A+od #se o( ra0ors

G. Specal n#rsng consdera"ons

&. E3pos#re "o chemo"herape#"c agen"s can lead "o ad+erse reac"onsa. Con"ac" derma""s

!. Na#sea and +om"ng

c. Darrhea*. E3pos#re d#rng pregnancy can lead "o

a. Increased rs1 o( (e"al a!normal"es

!. Ec"opc pregnances

c. Spon"aneo#s a!or"ons. G#dlnes (or red#cng rs1s -hen handlng cy"o"o3c

an"neoplas"c dr#gs

a. ;ear a mas1 "o a+od nhalng po-der -hen handlng a

po-der (orm o( a dr#g.!. Do no" prepare dr#gs n ea"ng places ;ear glo+es, eye

pro"ec"ors and pro"ec"+e clo"hng -hen n con"ac" -"hn?ec"a!le sol#"ons.

c. Dspose o( con"amna"ed ma"erals n p#nc"#re'proo(

con"aners la!eled as ha0ardo#s ma"eral.d. ;ear glo+es -hen handlng lnens con"amna"ed -"h dr#gs

(or a" leas" 29 ho#rs a("er con"amna"on.

e. ;ash hands "horo#ghly !e(ore and a("er e3pos#re "o dr#gs.

(. Bollo- organ0a"onal proced#re "o clean'#p a("er chemcalspll

I. =lood Trans(#son

A. @se5 res"ore !lood +ol#me or !lood componen"s

=. N#rsng respons!l"es and n"er+en"ons&. :er(y "ha" !lood had !een "yped and cross ma"ched

*. :er(y (+e (ac"ors5

a. clen" n#m!er!. !lood "ype

c. Rh (ac"or

d. !lood n#m!er

e. e3pra"on da"e. Pre"rans(#son assessmen" ncl#des !aselne +"al sgns

2. :er(y n(ormed consen"

4. S"ar" n(#son -"h !lood admns"ra"on se", (l"er, and normalsalne I:

6. ;a"ch (or sgns o( hemoly"c reac"on/ #s#ally occ#rs -"hn "he

(rs" &4 mn#"es $sh+erng, headache, lo-er !ac1 pan, olg#ra,hypo"enson%


44/44

8. ;a"ch (or sgns o( (e!rle reac"on/ #s#ally occ#rs -"hn (rs"

mn#"es $hema"emess, con(#son, !ac1 pan, ele+a"ed "empera"#re,

headache, sha1ng%9. ;a"ch (or allergc reac"on $h+es, -hee0ng, pr#r"#s, ?on" pan%

. Mon"or +"al sgns

&. I( reac"on occ#rs5a. S"op !lood mmeda"ely

!. Man"an I: -"h salne

c. No"(y physcand. Send !lood and #rne specmen "o la!

e. Mon"or clen" d#rng "rans(#son

(. Mon"or la! res#l"s ' hemoglo!n and hema"ocr"

The dosage o( medca"on needed (or a "herape#"c e((ec" can +ary -"h age,

-egh", gender, heal"h s"a"#s and en+ronmen"al (ac"ors.

Mos" dr#gs prod#ce a m3"#re o( "herape#"c and ad+erse e((ec"s. Medca"ons re#re a -r""en order (rom a physcan or a n#rse prac""oner

legally perm""ed "o prescr!e "hem.

=eca#se mos" dr#gs are me"a!ol0ed n "he l+er, " s especally s#scep"!le "o

dr#g nd#ced n?#ry.

The n#rse s respons!le "o ?#dge ndependen"ly !e(ore g+ng a prescr!ed

medca"on.

The ro#"e o( admns"ra"on -ll !e chosen "o ache+e a cer"an "herape#"c ac"on,

a" a cer"an speed.

Medca"ons n"erac" -"h (oods, and "ha" n"erac"on can !loc1 or slo- "herape#"c

ac"on

People me"a!ol0e medca"ons d((eren"ly, dependng on age, gender, !ody s0e,heal"h s"a"#s, dr#g "olerance, c#m#la"+e e((ec" o( medca"on, and gene"cs.

Inhalers are mos" e((ec"+e -hen "her #sers 1no- "he rgh" "echn#e. Teach "he

"echn#e and "hen "es" ho- -ell "he clen" #ses ".

Medca"ons are especally l1ely "o ca#se hypo"enson n elderly people.

There are "-o "ypes o( dr#g dependence5 psychc and physcal. Psychc

dependence mples a cra+ng "o #se "he dr#g perodcally. Physcal dependence

mples physcal symp"oms -hen "he dr#g s -"hheld.

Hypers#scep"!l"y

IdosyncrasyPharmacodynamcs

Po"en"a"on

Tachyphyla3s

To3cology

pharmacology & parenteral therapies

Documents