PHARMACOLOGY

ANTIBIOTIC
 they inhibit bacterial DNA
 they inhibit protein synthesis
 they interfere with formation of the bacterial cell wall.
*culture blood test
*high WBC n: 5000-10000
*numerous count urinalysis
*increase size of lymph nodes
*redness
*pus
*inflammatory “itis principles “
*tenderness
*pain
 Indication
 skin/structure infection
 respiratory tract infection
 Gonococcal
 community or hospital acquired infection *geria
 given in cases of meningitis
 surgical prophylaxis
KIDNEY. *common side effect “diarrhea”
*crea 0.6-1.2
*BUN 10-20
NURSING CONSIDERATION
 take blood culture before starting the antibiotic
 Assess for ototoxicity (change in hearing, ringing in the ears dizziness or unsteady
gait)
 Assess nephrotoxicity (monitor BUN and creatinine)
 LABORATORY ALERT
Oliguria urine output less than 400ml per day
 Drink 2 to 3liters of fluid daily
 Absorption is reduce by milk product and antacids
 Minimize using higher generation in less severe infection and in those in which
risk factors for multi drug resistant are not present
 Dilute solution and administer slowly to decrease phlebitis on IV site
NSAID or Non Steroidal Anti inflammatory Drugs
-use as;
 analgesic
 antipyretic
 anti inflammatory
Drug examples:
  Acetylsalicylic acid (aspirin, ASA) uses; anti inflammatory, anti platelet.
Contraindications; leukemia, ITP (bleeding),cancer (chemotherapy) LONG TERM
EFFECT; ringing sensation ‘tinnitus’
 Ibuprofen (advil, motrin)
 Fenoprofen (Naprosyn)
 Acetaminophen( tylenol, tempra)
 Diclofenac (voltaren)
 NARCOTIC ANALGESIC morphine *severe pain monitor: RR narcotics
analgesic lead for respiratory depression ready antidote Naloxone(narcan)
CONTRAINDICATIONS
 do not give pt with liver or renal diseases
 do not give pt if he is on anti coagulant
 do not give children with the flu symptoms of the risk of R eye syndrome
 do not crush or cut enteric coated form
ADVERSE EFFECTS
 salicylism
 tinnitus
 gastric irritation
 dizziness
 rash, dermatitis
 erosive gastric with bleeding
 hypotension
 blood dycrasias
low RBC, WBC, Platelets
 sodium and water retention

ACE INHIBITORS
Angiotensin Converting Enzymes
These are disease that Ace inhibitors
 hypertension
 Congestive heart failure
earliest manifestations of shock * decrease LOC
earliest manifestation of ICP *decrease LOC
earliest manifestation of cerebral hypoxia * decrease LOC
-TAKE ACTION OF WHAT ORGAN: LUNGS
‘and they lower the risk of stroke and heart attack’
-If client is on ACE inhibitors you should see the desirable outcomes.
-Blood pressure controlled within normal limits
-Improve survival rates for client suffering from acute MI
-decrease workload on cardiovascular system
safest range of potassium 3.5 to 4.5
normal sodium 135 to 145
SIDE EFFECT
  Postural hypotension (commonly as head rush or dizzy spell
 Fatigue
 Loss of appetite
 Nausea, vomiting, diarrhea
 hyperkalemia
 insomnia
 Could exacerbate non productive COUGH
 Angioedema
NURSING CONSIDERATION
 It cause retention of potassium. Hence, monitor electrolytes
 elderly client are at highest risk for postural hypotension
 Do not abruptly discontinue medication because rebound hypertension can occur
 Monitor the blood pressure frequently
 If your client has impaired renal function, you have to be cautions if they will be
using these drug
 Notify the clients physician if dizziness still persists
To decrease the potassium level is to give insulin

ELECTROLYTES
Na 135 to 145
potassium 3.5 to 4.5
phosphorus 2.5 to 4.5
magnesium 1.5 to 2.5
pH 7.35 to 7.45
RBC in million 4.5 to 5.5
Chloride 98 to 106
Bicarbonate 22 to 106
Calcium 9 to 11
0 to 10 upper limit ICP

ANTI- ANGINALS
- Stable (chest pain, reliefs in rest and nitrates) normal tropi
- Unstable (chest pain, reliefs in full rest and nitrates) ST segment
- Variant (coronary vasopasm, pre infarction)
- (Gitna chest heart, elevated bp)
- Nitroglycerin
- peripheral vasodilator
- Decreases the cardiac workload
- 3-5 mins assess the efficiency of nitrate up to 3x can take of patient
- Assess bp
- Stemi ST segment elevated tropi
- Morphine - Assess the RR, BP, Pupillary
- Antidote for morphine- Naloxone
- Beta-blocker - ends in olol
Tropolitics sample
- Uricainaise
- Streptocainaise
- Tissue Activator
- Antidote: amicate (generic)
- enstemi (non- ST Segment elevation Myocardial Infaction) aspirin 325mg , clopidrogel
300mg can chew
- assess for GI disoder and allegies
-give anti-coagulant enoxafarin
SIDE EFFECTS:
- headache, blurred vision and dry mouth
- Postural hypotension
- Syncope
- Reflex tachycardia
Nursing Consideration
1. Let them know purpose of transdermal patch (12 hrs tolerance in chest pain)
2. Advise your client that alcohol will potentiate postural hypotension
3. Report to physician continues-headaches, blurred vision or dry mouth
4. Topical application is used for sustained protection against angina attacks
5. Avoid skin contact with topical form

Anticoagulants
Maintain to blood cloth
- blood thinners
- I.V (Heparin)
- Antidote: (protamine sulfate)
- SubQ (Enoxaparin): less mobility
- Oral (Warfarin)
- Antidote: vitamin K
Indication
- Treat or prevent thromboembolic disorders( DVT, Pulmonary embolism, atrial fib w/
emboli)
- PT (Prothrombin Time): 10 to 14 sec (warfarin)
- aPTT (Activated partial Thromboplastin time): 20 to 36 sec (heparin)
- INR: 2.0 to 3.0
Contraindication
- underlying coagulation disorder
- Recent surgery
- Cancer
- Thrombocytopenia (mababa platelets)
- Normal platelet count: 150,000 to 450,000
- Thrombocytosis ( mataas platelet
- High WBC : leukocytosis
- Low WBC : leukopenia
- High RBC : polycytemia
- Low RBC: anemia
Nursing responsibilities
- Don't give heparin by I.M ROUTE
- Don't aspirate or rub injection
- Rotate injection sites
- Minimize venipuncture and injections apply pressure to all puncture
- Heparin is given initially then warfarin as maintenance
- Caution the patient not to increase dietary Vit.K (can alter warfarin effect)
-Inform practitioner or dentist before undergoing any medical treatment
-assess for bleeding
-Monitor for hemoglobin, clotting time and platelet
-Female 12 to 14g/dl
-male 14 to 16gg/dl
-multiply to 3
-Normal Clotting Time 8-15mins

ANTI PLATELET DRUG

theses drug inhibit the aggregation of platelets in the clotting process and prevent
thrombus formation
Uses treatment:
Cerebrovascular accident
myocardial infarction
Rheumatic heart disease
pericarditis
Pulmonary Embolism
deep vein thrombosis
ANTI PLATELETS DRUGS
 Aspirin
 Clopidogrel (plavix)
 Pentoxifylline (trental)
 Cilostazol (pletal)
 Ticlopidine (ticlid)
SIDE EFFECT
bruising
hematuria
Gl bleeding
Melena
CONTRAINDICATIONS
peptic ulcer
Bleeding problems
DIURETIC
1. Loop diuretic- ends in suffix “semide”
ex. Furosemide, torsemide
-potassium wasting diuretic
1. Thiazide Diuretic- ends in suffix “thiazide”
ex. Hydrochlorothiazide
-Used only for normal renal functions
1. Osmotic diuretic- e.g Mannitol (osmitrol)
ex. Prolonged used - metabolic acidosis
1. Carbonic Anhydrase Inhibitors- e.g acetazolamide
2. Potassium sparing diuretic- e.g Spironolactone