New User Special Price Expires in

Let's log you in.

Sign in with Facebook


Don't have a StudySoup account? Create one here!


Create a StudySoup account

Be part of our community, it's free to join!

Sign up with Facebook


Create your account
By creating an account you agree to StudySoup's terms and conditions and privacy policy

Already have a StudySoup account? Login here

Pharm Exam 4 Notes

by: Brittany Bedard

Pharm Exam 4 Notes NURS 200

Brittany Bedard
Lansing Community College

Preview These Notes for FREE

Get a free preview of these Notes, just enter your email below.

Unlock Preview
Unlock Preview

Preview these materials now for free

Why put in your email? Get access to more of this material and other relevant free materials for your school

View Preview

About this Document

All notes for exam 4!
Irie lott
Study Guide
pharmacology, Nursing
50 ?




Popular in Pharmacology

Popular in Nursing and Health Sciences

This 9 page Study Guide was uploaded by Brittany Bedard on Thursday March 31, 2016. The Study Guide belongs to NURS 200 at Lansing Community College taught by Irie lott in Winter 2016. Since its upload, it has received 131 views. For similar materials see Pharmacology in Nursing and Health Sciences at Lansing Community College.


Reviews for Pharm Exam 4 Notes


Report this Material


What is Karma?


Karma is the currency of StudySoup.

You can buy or earn more Karma at anytime and redeem it for class notes, study guides, flashcards, and more!

Date Created: 03/31/16
Thursday, March 31, y Pharm Exam 4 Notes Glucocorticoids ­ Increase blood glucose (Diabetics taking these drugs need to monitor blood sugar  more) ­ Decrease protein synthesis ­ Promote fat breakdown (fat redistribution­ moon face, buffalo hump) ­ Review info on the effects. ­ Physiologic effects: Used for endocrine disorders, low dose therapy, mimics  endogenous effects, no toxicity. ­ Pharmacologic effects: use to suppress inflammation/immunity, high dose therapy,  risk for toxicity. ­ Prototype: prednisone (Deltasone) Prototype: hydrocortisone (Cortef) Uses: Used to treat inflammatory disorders. Will help symptoms but they cannot cure  inflammatory disorders!!! Longer on these the riskier the treatment is. Pharmacokinetics: predonisone: PO hydrocortisone: PO, IV, IM, topical rectal. Dosage tapering: Need to be done if taken longer than 2 weeks, the adrenal glands  will be suppressed so the body needs time to adjust and start creating the hormones  on its own again. Adverse Effects: Mostly with long term treatment. Adrenal suppression, GI  irritation, hyperglycemia, fluid retention, infection, potassium loss, growth suppression in children, hair growth. Precautions/contraindications: Pregnant, CV disorders, Diabetes, Peptic ulcer, known allergy or acute infection. Drug2Drug: NSAIDS­ risk for ulcer, Digoxin (diuretics)­ loss of potassium, diabetic  medications, live virus vaccines. Implementation: educate (avoid crows and sick people), check for fever (indicates  infection) 1 Thursday, March 31, y ­ Respiratory Drugs Asthma and COPD are similar and many drugs are utilized in both but most drugs are COPD drugs. ­ Asthma disease process: bronchoconstriction, Airway inflammation, Mucous  production. ­ Asthma Drugs: Bronchodilatiors: opens airways Anti­inflammatory drugs: reduce inflammation Combination drugs: containt two or more asthma meds in one device. Rescue medication: Sympathomimetics­ Beta 2 Adrenergic Agonists Matinence medications: inhaled glucocorticoids, leukotriene antagonists, mast cell  stabilizers, xanthines, anticholinergics ­ Know types of inhalers: MDI­ hand held (typical device) wait one minute between puffs if need to do another  puff. Spacer utilization will improve depositing into the lungs. DPI­ dry powder inhaler, hand­held; breath activated. Nebulizers­ machine converts drug into mist, delivered by face mask or mouthpiece. ­ Anti inflammatory inhaled glucocorticoid: Budesonide Action: decreases inflammatroy response in airways, limits irritation and swelling Indications: preventativee asthma treatment WONT STOP AN ASTHMA ATTACK Adverse effects: sore throat mouth infections RINSE MOUTH AFTER USE! ­ Anti inflammatory leukotriene antagonists: Montelukast (Singular) Actions: block receptors for the production of leukotrienes= decreases inflammation  and bronchoconstirction medicated by leukotrienes.  Indication: PREVENTS asthma but will not stop attacks, Adverse effects: not many, may see behavioral changes ­ Antiinflammtory mast cell stabilizers: Cromolyn (Intal) Action: stabilize membrane of mast cells to prevent histamine release Indications: preventative treatment, exercise­induced asthma. Rare to have adverse effects. 2 Thursday, March 31, y ­ Bronchodilators Beta 2 Adrenergic agonist: Albuterol Action: Beta 2 agonist Indications: albuterol­ acute asthma attack, bronchospasm, prevention of sports  induced asthma, Epinephrine­ activates alpha and beta receptors Adverse: sympathetic effects: tachycardia, arrhythmias, hypertension, sweating,  flushing, jitters CNS stimulation, GI upset. ­ Bronchodilators Xanhines: Theophylline Action: dilate bronchi Indication: maintenance therapy for chronic, stable asthma, reversal of  bronchospasm associated with COPD Pharmacokinetics: oral administration, IV route for emergencies, Narrow  therapeutic range so risk for toxicity. Plasma monitoring necessary. Adverse Effects: related to blood levels >20mcg: NVD, restlessness, >30mcg:  tachycardia, seizure, brain damage, death. Contraindications: coronary disease, hypothyroidism Drug/food interactions: some drugs increase theophylline metabolism (ciprofloxac ­ Bronchodilators Anticholinergics: Ipratropium (atrovent) Atrovent is an  anticholinergic look for allergies (THREE A’s to remember this) Action: atropine derivative that bllocks muscarinic receptors causing bronchodilation Indication: maintenance treatment of bronchospasm  Peanut allergy is a caution due to containing soya lectin ­ Nursing considerations of all of these: allergies, age, condition, teach about  rescue meds versus macitence, MDI use shake before use one minute wait  between puffs, rinse mouth after using. Administer bronchodilators first before  anything else ­ Histamine Actions: Peripherally­ dilates small vessels, increase capillary permeability. Lungs­ bronchoconstriction, mucous secretion Gi­ promotes acid secretion CNS­ seizure suppression, sleep/wake cycle 3 Thursday, March 31, y ­ Antihistamines Prototype 1st generation: Diphenhydramine (Benadryl) Protoype 2nd Generation: Cetirizine (Zyrtec) ­ First generation, can cross the BBB causing sedation (drowsiness), shorter half lives, block muscarinic receptors (anticholinergic effects ie: constipation, dry  mouth, palpations racing heart) ­ Second generation: no sedation, no anticholinergic effects  ­ Antihistamines Benadryl, Zyrtec Actions: block the effects of histamine at histamine 1 receptor sites. Benadryl: has anticholinergic and antipruritic effect  Zyrtec: has anti pruritic effects (Anti itching) ­ Indications: pretty much same for both. ­ Benadryl is taken orally, Zyrtec oral administration but food delays the  absorption ­ Major adverse effects: found in benadryl (DROWSINESS, sedation, dry mouth  constipation etc) ­ Both category B for pregnancy but typically people can take them ­ Cautions: Asthmatics because the mucus is stuck in the lungs because its dry and  hard to expel with the combo of antihistamines and asthmatic drugs. Any drugs that  cause drowsiness, other anticholinergic drugs ­ Intranasal glucocorticoids: Flunisolide (Nasarel) Action: reduce congestion, runny nose, sneezing, itchiness, redness. Used on longer term basis than sympathomeimetic decongestants.  Pharmacokinetics: nasal spray inhalation so blow nose before hand Adverse: nasal irritation, nose bleeds Contraindications: acute infection, report signs of infection immediately ­ Decongestants: Phenylephrine and Pseudoephendrine  Action: sympathomimmetic (activates alpha and beta receptors) 4 Thursday, March 31, y Indication: decrease nasal congestion THATS IT Pharmacokinetics: Pseudophedrine (Sudafed­ has been abused so products  are regulated and show ID to buy them) Phenylephrine (Topical drops or spray) Adverse Effects: local stinging and burnging, rebound congestion,  sympathomimetic effects with oral meds Contraindications/Cautions: lesion in mucous membranes, any condition that may  be exacerbated by sympathetic activity, not for children under 4 ­ Combination drugs that contain Antihistamines and decongestants  Claritin D: loratadine and pseudo ephedrine Allegra D: Fexofenadine and pseudo ephedrine Actifed cold and allergy: tripolidine and pseudopehedrine  Pharm Exam 4 GI Drugs ­ Anti­Secretory Agents (Histamine­2 Blockers) Prototype: Cimetidine (Tagemet) Action: selectively blocks H2 receptors, which decreases acid secretion. Indications: Short term ulcer treatment, GERD, stress ulcer prophylaxis, aspiration  pneumonitis, OTC products for heartburn management Pharmacokinetics: Oral, IM, Iv admin Adverse: Pneumonia. Androgen blocking effects (gynecomastia, reduced libido) CNS  effects (dizziness, headache, confusion, hallucinations) Drug2Drug: Decreased metabolism of several drugs including Warfarin, phenytoin,  theophylline. Antacids can reduce absorption don't take together! ­ Proton Pump Inhibitor (PPI) Anti­secretory Agent Prototype: Omeprazole (Prilosec) Action: acts within cells of the stomach to prevent the final step of acid production  (overall decrease in acid secretion) **MOST EFFECTIVE ACID REDUCER** Indications: Short term ulcer treatment, with treatment for h. pylori. GERD  management, stress ulcer etc. Pharmacokinetics: oral admin­ delayed release capsule or powder. 5 Thursday, March 31, y Adverse effects: RARE but headache, NVD, pneumonia, increased rates of c.diff  infection. ­ Nursing considerations for both drugs above Education: diet­ types of foods to avoid (greasy spicy etc) meal frequency­ 5 or 6 small meals Stop smoking Avoid NSAID use. OTC products taken 30 min before meal to relieve anticipated heart burn Do not take OTC products longer than 2 weeks­ consult doctor if symptoms continue. ­ Antacids Action: Alkaline compounds that neutralize stomach acid ­ aluminum, magnesium,  calcium and sodium Indications: peptic ulcer disease, preoperative pneumonitis etc (same as others) Pharmacokinetics: Oral administration (liquid or tablet) Adverse effects: Constipation (aluminum and calcium compounds) Diarrhea  (magnesium compounds) Hyernatremia (some sodium compounds) rebound acidity. Contraindications: heart patients, renal failure Drug2Drug: Decreased absorption of many drugs­ take two hours before or after  other medications Know slide with all the different types of antacids. ­ Mucosal Protectant  Prototype: Sucralfate (carafate) Action: forms an ulcer­adherent complex protecting the ulcer against acid, pepsine  and bile salts to promote healing. Indication: promotes ulcer healing Pharmacokinetics: oral­administration empty stomach. THIS IS CRUCIAL!!!! Prototype: Misoprostol (Cytotec) Action: Analog of prostaglandin­E= Inhibits gastric acid secretion and increases  bicarbonate and mucus production in the stomach  Indications: Prevention of NSAID­induced gastric ulcer, treatment of duodenal ulcer Pharmacokinetics: Oral Administration with meals and at bedtime Contraindication: Pregnancy Category X 6 Thursday, March 31, y ­ Motility Agent (Gastro­stimulant) Prototype: Metoclopramide (Reglan) Action: Blocks dopamine receptors (prevents NV) sensitizes GI cells to acetylcholine  (increase GI motility which limits reflex) Indications: NV, GERD Pharmacokinetics: Oral, IV, IM administration Adverse effects: sedation, diarrhea and cramping, decreased BP and HR,  extrapyramidal effects or parkinson type symptoms­ comes from blocking  dopamine Contraindications: GI obstruction, Parkinson's disease, antipsychotic patients Drug interactions: Digoxin and alcohol  ­ Constipation and How to limit it Assess use of drugs that decrease GI motility (opioid, anticholinergics) Dietary changes: fiber and probiotics Increase fluids orally or IV Increase mobility Increases toiling options (bedpan, commode, ambulate to bathroom) ­ Laxative effect vs catharsis Laxative: production of soft, formed stool over a period of 1 or more days, relatively  mild. Catharsis: prompt, fluid evacuation of bowl, fast and intense. ­ Laxatives Action: direct stimulation of GI, production of bulk or increased fluid in the lumen,  lubrication or softening to promote passage Indications: short­term relief of constipation, prevent straining, evacuate bowel for  diagnostic procedures, removal of ingested poisons Pharmacokinetics: Oral, rectal administration.  Minimally absorbed laxatives exert their therapeutic effect directly in the GI tract Contraindications: acute abdominal disorders, impaction or obstruction. Not ok for  pregnancy, but the bulk laxatives are fine. Drug2Drug: Do not take with other meds can effect absorption. ­ Bulk Laxatives­ short term constipation relief Prototype: Psyllium (Metamucil) 7 Thursday, March 31, y Nondigestable­ absorbs water, bulk stimulates peristalsis, esophageal obstruction is  possible so take with full glass of water or juice. Osmotic Laxative­ large fluid evacuation Prototype: Magnesium Citrate Pulls water into the intestine and stimulates peristalsis  Adverse effects: water loss! GI Diarrhea cramping Nauseua, CNS and CV effects  related to water loss. Stimulant Laxative­ produce semi­liquid stool in 6­12 hours Prototype: Bisacodyl (Dulcolax); Senna (Senekot) Abuse and cathartic dependence  DO NOT CRUSH OR CHEW (enteric coated to pass thru acidic stomach) Cathartic dependency  Surfactant­ produce softer stool Prototype: Ducosate (Colace) (stool softener) Take with full glass of water ­ Antidiarrheal drugs Prototype: Loperamide (Immodium) Action: opioid derivative­ stimulates opioid receptors in GI tract to slow peristalsis,  allowing increased time for absorption of fluid and electrolytes  Indications: relief of symptoms of acute or chronic diarrhea, treatment of mild  travelers diarrhea  Pharmacokinetics: Oral administration  Cautions: History of GI obstruction, history of abdominal conditions, diarrhea due to  poisonings (let it run its course to get the poison out) ­ Nausea and Vomiting Assessment  Frequency, duration aand triggers (medications, causes, interactions) accompanying  signs and symptoms (any signs of acute abdomen such as pain etc do NOT give  medication), fluid and electrolyte status, level of consciousness, many agents depress LOC ­ Antiemetics: Serotonin Receptor Blockers Prototype: Ondansetron (Zofran) Action: Block serotonin receptors in CTZ Indications: most effective drugs for suppressing chemotherapy NV, preventing acute  8 Thursday, March 31, y emesis, pregnancy, stomach viruses, opioids, head injury Admin: Oral/IV Adverse effects: drowsiness, headache, dizziness, constipation and diarrhea  ­ Antiemetics: Dopamine Antagonists Prototype: Prochlorperazine (Compazine) Action: block dopamine receptors in CTZ Indications: reduce emesis r/t chemotherapy, surgery and toxins Admin: Oral, rectal, IM IV Adverse: sedation, hypotension and extrapyramidal effects Prototype: Metoclopramide (Reglan) Indications: suppress post op etc see further up in notes 9


Buy Material

Are you sure you want to buy this material for

50 Karma

Buy Material

BOOM! Enjoy Your Free Notes!

We've added these Notes to your profile, click here to view them now.


You're already Subscribed!

Looks like you've already subscribed to StudySoup, you won't need to purchase another subscription to get this material. To access this material simply click 'View Full Document'

Why people love StudySoup

Steve Martinelli UC Los Angeles

"There's no way I would have passed my Organic Chemistry class this semester without the notes and study guides I got from StudySoup."

Janice Dongeun University of Washington

"I used the money I made selling my notes & study guides to pay for spring break in Olympia, Washington...which was Sweet!"

Steve Martinelli UC Los Angeles

"There's no way I would have passed my Organic Chemistry class this semester without the notes and study guides I got from StudySoup."


"Their 'Elite Notetakers' are making over $1,200/month in sales by creating high quality content that helps their classmates in a time of need."

Become an Elite Notetaker and start selling your notes online!

Refund Policy


All subscriptions to StudySoup are paid in full at the time of subscribing. To change your credit card information or to cancel your subscription, go to "Edit Settings". All credit card information will be available there. If you should decide to cancel your subscription, it will continue to be valid until the next payment period, as all payments for the current period were made in advance. For special circumstances, please email


StudySoup has more than 1 million course-specific study resources to help students study smarter. If you’re having trouble finding what you’re looking for, our customer support team can help you find what you need! Feel free to contact them here:

Recurring Subscriptions: If you have canceled your recurring subscription on the day of renewal and have not downloaded any documents, you may request a refund by submitting an email to

Satisfaction Guarantee: If you’re not satisfied with your subscription, you can contact us for further help. Contact must be made within 3 business days of your subscription purchase and your refund request will be subject for review.

Please Note: Refunds can never be provided more than 30 days after the initial purchase date regardless of your activity on the site.