Pharmacology Notes

1. Digoxin (Lanoxin)

D- dig level 2ng/ml or greater is toxic

I- inhibits sodium potassium ATPase
G-GI or CNS signs indicate adverse effects (N/A for adult toxicity, stomach upset in older
child
O-output, intake, and weight should be monitored
X- dont give if pulse is less than 60 bpm
I- indicated for CHF- a-fib
N- note K+, ECG, and renal function tests

2. Epinephrine

N- nervousness (undesirable effect)

A- angina, arrhythmia (undesirable)
S- sugar is increased
C- cardiac arrest
A- allergic reaction
R-respiratory bronchodilator

3. norepinephrine (levophed)

S- stim alpha and beta adrenergic receptors

H- hypovolemia- should be corrected before using drug
O- output of urine should increase
C- constriction of blood vessels
K- keep monitoring vital signs every 5-15 min

4. nitroglycerin

A- avoid alcohol
N- note BP and apical pulse before admin
G- given to relax the vascular smooth system
I- indicated for angina pectoris
N-note for postural hypotension; rise slowly
A- advice client to see medical assistance if pain is unrelieved after 3 doses with 5 min
interval

5. ACE INHIBITORS

S- suppresses renin angiotensin aldosterone system

W- warn clinet with renal or thyroid diseases
E- ends with pril- captopril (capoten) enalapril (vasotec)
R- rise slowly to reduce orthostatic hypotension
T- treatment of htn
E- evaluate BP
 6. Beta- adrenergic blockers

end in lol- atenolol (Tenormin)

B- bradycardia
B- blood pressure too low
B- bronchial constriction
B- blood sugar is masked when low

7. Calcium channel blocker

amlodipine (norvasc), diltiazem (cardizem), nifedipine (procardia)

B- blocks calcium access to cells
I- indicated for htn
L- let client take drug with milk or meal
L- light and moisture- protect

8. Diuretics

D- diet; increase K+ for all except aldactone

I- intake, output, daily weight monitoring
U- undesirable effects- F&E imbalance
R- review HR, BP, and electrolytes
E- elderly careful, evening dose not recommended
T- take with or after meals and in AM
I- incrase risk of orthostatic hypotension, move slowly
C- cancel alcohol and cigs

9. warfarin (coumadin)
monitor?
antidote?
what food should be avoided?

prothrombin time is monitored 1.5-2.5 X control is the therapeutic range

Vit K is the antidote
Green leafy veg should be avoided

10. warfarin

C- check vital signs, platelte count, and PT

O- observe bleeding
R- review bleeding protocol
A- avoid ASA, may use acetaminophen

11. heparin sodium

PTT must be monitored 1.5-2.5 X control

Antidote is protamine sulfate
hospitalization is required for IV heparin

12. Clopidogrel (PLAVIX)

B- bleeding, brochospasms- undesired effects
L- lowers risk of atherosclerotic events
E- evaluate bruising
E- evaluate liver function
D- do take with food or after meals

13. HMG CoA inhibitors

competitive inhibitors of HMG-COA reductase, an enzyme necessary for cholesterol

biosynthesis
indicated for hypercholesterolemia
atorvastatin (lipitor), simvastatin (zocor)

14. HMG COA inhib pneumonic

S- statin is the ending

T- take with food and at bedtime
A- always consume 2-3 L of fluid daily
T- teach client to do exercise and weight reduction as well
T- treat hypercholesterolemia
I- increase fiber in diet
N- never give if with liver disease

15. Antibiotics pneumonic

M- monitor superinfections
E- evaluate renal/liver function
D- diarrhea- take yogurt
I- inform provider prior to taking other meds
C- cultures prior to initial dose
A- alcohol is out, ask about allergy
T- take full course
E- evaluate cultures, WBC, temp, blood

16. Aminoglycosides

end in mycin
*serious infections caused by gram- negative infections

17. Allopurinol

G- gulp 10-12 glasses of fluid daily, GI distress (undesirable effect)

O- output and input monitor closely
U- uric acid production decreased, use no alcohol
T- take after meals

18. Phenytoin (dilantin)

G- gingival hyperplasia
U- use alternate birth control
M- mouth care; preventative dental check up
S- soft toothbrush don't stop abruptly

19. Lithium pnuemonic

L- level therapeutic 0.6-1.2 meq/l

I-increased urination
T- thirst increased
H- headache and tremor
I- increase fluids

20. LIDOCAINE pneumonic

(antiarrhythmic drug- subclass 1B)

L- local anasthetic
I- ICU popular antiarrythmic
D- digitalis toxicity used
O- orally inactive
C- cinetidine+ propanolol
A- decrease Automacity
I- inactivated Na Channel blocker
N- nystagmus
E- eye blurred vision, ECG change

21. You have 1 heart and 2 lungs":

Beta-1 are therefore primarily in the heart.

Beta-2 primarily in the lungs.

22. Anti-Epileptic Side Effect

ABCDEFGH

A taxia
B lood dyscrasia
C left lip
D upuytrens / Vit D deficiency
E xfoliation of skin & Stevens Johnson's
F its
G I upset/gum hypertrophy
H epatitis/hairy

23. Barbiturate Side Effects

ABCD

A taxia
B ehavioral disturbance
C oncentration decreased/coma
D epression/drowsy/diplopia

24. ACE Inhibitor Side Effects

CAPTOPRIL

C ough
A naphylaxis
P alpitations
T aste
O rthostatic hypotension
P otassium elevated
R enal impairment
I mpotence
L eukocytosis

25. SIDE EFFECTS OF CORTICOSTERIODS;

(CORTICOSTEROIDS)

C-cushings syndrome
O-osteoporosis
R-retardation of growth
T-thin skin n easy brusibility
I-infections n immunosupression
C-cataract n glaucoma
O-odema
S-supression of HPA axis
T-thining n ulceration of gastric mucosa
E-Emotional disturbance
R-rise in BP
I-Increase in hair growth(hirsuitism)
O-otherz like fetal abnormalties n hypokalemia
D-diabetes mellitus precipitation
S-stria

26. Drugs for heart failure-

< 3 D's for heart
failure >

Digoxin,
Diuretics,
Dilators

27. Respiratory Depression Inducing drugs

STOP breathing":
Sedatives and hypnotics
Trimethoprim
Opiates
Polymyxins

28. TB treatment

If you forget your TB drugs, you'll die and might need a PRIEST":
Pyrazinamide
Rifampin
Isoniazid (INH)
Ethambutol
STreptomycin

29. Drugs to treat viral respiratory infections

"You'd get a respiratory infection if you shoot an ARO (arrow) laced with viruses into the
lungs":
ARO:
Amantadine
Rimantadine
Oseltamivir

30. Atropine
31. emergency drugs to LEAN on

32. Drugs for Bradycardia and decreased BP

(IDEA)
33. Cholinergic crisis- SLUD
34. Beta Blocker Actions
35. Anticancer drugs
36. These drugs can interact (TDCI)
37. aminoglycoside toxicity
38. Quinalones and Tetracyclines ok in pregnancy???
39. SE of adrenergic antagonists
40. Lidocaine Toxicity
SAMS
41. B6 relationship to INH and levadopa?
42. Mixing insulin
43. antiinflammatory
44. salicylate poisoning
45. SASH technique
46. serious complications of oral birth control pills
(ACHES)
47. saw palmetto
stomach problems
alters PSA
watch for bloody urine

48. ginko
before couldn't think well.. now can think better!

49. Potassium
50. estrogen
51. Bipolar clown image
52. Buspar
53. Dueteronomy
54. miotics
55. insulins and onset
56. metformin
a major complication with this medicine is lactic acidosis

57. cushing
58. synthroid
59. PTU
60. tuberculin syringe has the capacity of?

0.5 ml

61. Drug label should be read?

3 times

62. patch testing

identify sensitivity to contact materials such as soap, pollen, and dyes.. allergen on patch is
placed in contact with back, arms, or thighs. Patch is left in place for 48 hours. Site is aired for
15 min, then read. Wheal is the definitive reaction measured from 1+ to 4+. Emergency
equipment must be available in case of anaphylaxis.

63. after applying eye drops how long do you hold pressure to the inner corner of eyelid?

1-2 min
64.

how to put in ear drops for child younger than 3

down and back

*older than 3 up and back
They should remain in position for a few min after application

65. MDI meds should be shaken?

vigorously 5-6 times prior to use. The client may position her mouth around the device or 2-4
cm in front of mouth

66. DPI (dry powder inhalers)

not to be shaken, and the client should place the mouthpiece between lips.

*For DPI and MDI client should exhale and then inhale the med deeply through the mouth for
3-5 sec and then hold breath for 5-10 sec.

67.why might a spacer be attached to an MDI

the spacer keeps the med in the device longer and thereby facilitates delivery of the med to the
lungs and decreases the amount of med deposited in the oropharynx. This is beneficial for the
delivery of glucocorticoids

68.after applying ear drops apply pressure to the?

tragus of the ear with finger

69.how are suppositories stored?

refrigerated! Remove foil wrapper and lubricate supposiory if needed. Instruct client to retain
med and not expel it. Rectal suppositories are insterted beyond the internal sphincter and
vaginal suppositories are inserted with an applicator.

70.Intramuscular route

used for irritating meds, solutions in oils, and aqueous suspensions.

common sites are the ventrogluteal, dorsogluteal, deltoid, and vastus lateralis (peds).
needle gauge 22-25, 18-27 needle size
1 1/2 inch long and inject 90 degree angle.

71.volume injected IM route

1-3 ml. If a greater amount is required it should be divided into 2 syringes and two different
sites should be used.

72.z-track
prevents medication from leaking back into subcutaneous tissue
used for meds that cause visible or permanent skin stains such as certain iron preps

73.

Intradermal

tuberculin testing or checking med/allergy sensitivities

may be used for cancer immunotherapy
small amount of solution 0.01-0.1 ml in a tuberculin syringe with a fine gauge needle 26-27 in
lightly pigmented, think skin, hairless site. 10-15 degree angle

74.Time release capsules crushed?

They should not be crushed or diluted as med will be absorbed at a faster rate than
recommended.

75.When should a breastfeeding mother take medication to ensure the least amount is
recieved by the infant?

immediately after breastfeeding so this will minimize med concentration in the next feeding

76.Instilling vag meds

pt in lithotomy position, elevate hips with pillow

remain in position for 5-10 min after application
wash applicator with warm soapy water after each use.

77.antimicrobials

treat bacterial, viral, and fungal infections

78.narrow spectrum antibiotics

are effective against a few species of microorganisms such as gram positive cocci, gram
positive bacilli, and gram neg aerobes

79.broad spectrum antibiotics

effective against a wide variety of microorganisms

80.what should be collected prior to antimicrobial therapy

specimens for a culture and sensitivity test

81.prescribed antimicrobial meds should be taken with what freq?

around the clock to maintain therapeutic blood levels

82.adverse reactions to antimicrobials

rash
anaphylaxis
suprainfection
organ toxicity (nephrotoxicity and ototoxicity)
decrease oral contraceptives effectiveness

83. how do penicillins destroy bacteria

weaken the bacterial cell wall

84.penicillins are the choice for?

gram + cocci such as streptococcus pneumonia (pnuemonia and meningitis)infectious

endocarditis, streptococcus pyogenes (pharyngitis)

85. penicillins are also med of 1st choice for

meningitis - gram neg cocci and for treatment of syphillus

86.should penicillin and aminoglycosides be mixed in same intravenous solution

no, b/c penicillin inactivates aminoglycosides when mixed in same IV solution

87.nurse gives penicillin, what should nurse watch for?

observe client 30 min following admin of parenteral penicillin

monitor clients kidney function and cardiac and electrolyte status

88.________ are beta lactam antibiotics sim to penicillins that destroy bacterial cell walls
causing destruction of the micro-organism

cephalosporins, grouped into 4 generations. they are broad spectrum with a high therapeutic
index that treat UTI, post op infections, pelvic infections, and meningitis

89.clients should take oral cephalosporins with?

food, oral cephalosporin suspensions should be stored in the refrigerator.

90.bacteriostatic

prevent bacteria from reproduction

91.carbapenems

meropenem, beta lactam antibiotics that destroy bacterial cell wall

effective for serious infections like pneumonia, peritonitis, and uti cause by gram positive
cocci, gram neg cocci and bacilli, and mixed aerobic and anaerobic bacteria.

92.monobactams- vancomycin
beta lactam antibiotics destroy bacterial cell wall
*drug of choice for serious infections caused by methicillin resistant staph and c-diff

93.vancomycin peak blood levels should be collected?

1-2 hrs after completion of IV infusion. Appropriate peak levels are between 30-40 mg/ml

94.how do we evaluate vancomycins effectiveness?

clear breath sounds, wound healing, improvement of sx of antibiotic associated pseudo colitis
symptoms such as resolution of diarrhea and negative stool cultures for c-diff.

95.

Tetracyclines (sumycin)

other meds- doxycycline. Broad spectrum antibiotics that inhibit microorganism growth by
preventing protein synthesis (bacteriostatic). Tx acne. 1st line med for rickettsia (rocky
mountain spotted fever, typhus fever, infections of urethra or cervix caused by chlamydia,
lyme disease, anthrax, GI infections caused by h.pylori and periodontal disease.

96.avoid giving tetracycline to?

children under 8, yellow/brown tooth discoloration

avoid taking it at bedtime to reduce the risk of esophageal ulceration

97.taking tetracycline with milk/calcium/mag/antacids

should take tetracyclines at least 1 hr before and 2 hr after taking food and supplements
containing calcium and mag

98.Tetracyclines should not be given with food except for?

doxycycline and minocycline

99.Bacteriostatic inhibitors

erythromycin, clindamycin, axithromycin, etc

slows the growth of microorganisms by inhibiting protein synthesis. At high doses it can be
bactericidal.

100.bacteriostatic inhibitors are used to?

treat infection in clients with a penicillin allergy. ex) diptheria, whoop cough, chlamydia.

101.medication interactions with erythromycin?

antihistamines, theophyline (asthma med), carbamazepine (anticonvulsant), and warfarin

(anticoagulant). result in toxicity
102.aminoglycosides- gentamicin

bactericidal antibiotics disrupt protein synthesis. med of choice against aerobic gram neg
bacilli

103.aminoglycosides adverse effects

ototoxicity and nephrotoxicity

104.peak levels of aminoglycosides should be obtained?

30 min after admin IM or IV.

105.sulfa

TMP- bactrim. inhibit bacterial growth by inhibiting synthesis of folic acid. folic acid is
essential for production of DNA, RNA, and proteins.

106.

Bactrim drug of choice

for uti caused by e.coli and other infections (otitis media, bronchitis, shigellosis, pneumonia)

107.Bactrim is contraindicated in?

clients with a folate deficiency, b/c it increases the risk of megaloblastic anemia. Avoid use in
pregnancy and lactation risk of kernicterus increases. Do not use if creatinine clearance is less
than 15 ml/min

108.how should bactrim be taken?

on an empty stomach with a full glass of water

109.antimycobaterial (antituberculosis)

isoniazid INH, streptomycin, ethambutol, pyranzinamide

110.INH

highly specific for mycobacteria. Inhibits growth of mycobacteria by preventing sysnthesis of

mycolic acid in cell wall. Indicated for active and latent use.
latent- INH only daily for 6 months
active- multiple med therapy including INH, rifampin, pyrazinamide, and/or pyridoxine daily
for 6 months.

111.Stop INH if?

Liver function tests are elevated

112.pt on INH develops peripheral neuropathy

admin 50-20 mg of vit b6 daily

113.How should patient take INH?

on an empty stomach 1 hr before meals or 2 hrs after. Can taken INH with meals if GI upset
occurs.

114.Antiviral (acyclovir)

prevents reproduction of viral DNA

med of choice for HSV, chicken pox, and cytomegalovirus.

115.ganciclovir

tx of choice for CMV retinitis in immunocompromised clients with HIV, transplant clients at
risk for CMV infection. Med of choice for CMV (cytomegalovirus).

116.pt on ganciclovir, if neutrophil count is below 500?

stop treatment. Cell counts improve within 3-5 days.

117.gancyclovir and pregnancy?

it is tetratogenic, women should avoid pregnancy during course of therapy and for 90 days
after the end of therapy. males should be informed about sterility.

118.never admin acyclovir by?

IV bolus, it should be administered by IV infusion slowly over 1 hr or longer. Clients should

understand than acyclovir diminishes symptoms but does not cure the virus. For topical admin
advise client to put on rubber gloves to avoid transfer of virus to other areas of body.

119.Fluoroquinolones

ciproflaxacin (cipro), levaquin, floxin

inhibits the activity of DNA gyrase, an enzyme needed for the replication of bacteria
broad spectrum antimicrobials used for gram - and gram +, klebsiella, ecoli

120.ciproflaxacin should not be administered to children less than 18 years of age due
to?

risk of achilles tendon rupture

121.common s/e of quinolones

N, V, diarrhea, discomfort, dizzy, light headed

122.used to treat soft tissue infections

quinolones.. contraindicated in children, pregnancy
potential for permanent cartiladge dammage

123.for inhalation anthrax infection ciproflaxacin is administered every?

12 hours for 60 days

124.treat UTI and otitis media, used prophylactically in pts susceptible to streptococcal
infection or rheumatic fever when penicillin is contraindicated

sulfanomides

125.antiprotozoals

metronidazole (flagyl)
only effective against anaerobic bacteria

126.s/e of flagyl

GI discomfort, dry mouth, metallic taste, dark urine (harmless effect of med), CNS symptoms
(stop med)

127.flagyl is effective when

no more bloody muscoid diarrhea,

has formed stool, neg stool for ameba and giardia. Negative blood cultures for anaerobic
organisms in the CNS

128.Streptogramins

synercid
inhibit protein synthesis or bacterial cells
Treat VRE and MRSA

129.Antitubercular agent
Ethambutol (Myambutol)

Alter cellular RNA synthesis and phosphate metabolism

tx- tb
S/E- N, V, A, abdominal cramps
serious- red greeen vision change, confusion, hallucination, blurred vision

130.why is vit B6 admin with INH?

decrease neurologic side effects

131.Antitubercular Agent
Rifampin
prevent RNA synthesis by inhibiting DNA dependent RNA polymerase
use- eliminate meningococci and H. influenza type b, hib from asymptomatic carriers
s/e- reddish orange discoloration of secretions

132.antifungals
amphotericin B deoxycholate

acts on fungal cell membranes to increase cell permeability which results in leakage of
intracellular cations leading to cell death. These agents can be fungistatic (slow growth) or
fungicidal (destroys fungus).

133.topical antifungal agents

clotrimazole, miconazole, ketoconazole, nystatin,

134.amphotericin B

tx systemic life threatening fungal infections. Administration of amphotericin B should be

infused slowly over 2-4 hr by IV route. Renal dammage can be lessened with administration
of 1L saline solution on the day of amphotericin B infusion.

135.Ketoconazole

antifungal used to tx superficial fungal infections; dermatophytic infections, tinea pedis, tinea
cruiris.

136.amphotericin B- infusion reactions

fever, chills, rigors, h/a 1-3 hr after innitiation. Pretreat with diphenhydramine (Benadryl) and
aspirin. Meperidine or dantrolene may be given for rigors
use lipid based prep of amphotericin B to minimize reactions

137.Griseofulvin

stop cell division and new growth

tx ringworm
s/e N,V, abdominal cramps

138.B lymphocytes or B cells

produce antibodies IgA, IgD, IgG, IgE, or IgM

139.Helper T lymphocytes or CD 4 cells

activate B cells and are responsible for teh delayed hypersensitivity reaction

140.CD 8 cells

destroy target cells directly causing death of the microorganism

141.hep B immunization

dosese at birth, 1-2 months and 6-18 months

142.Diptheria and tetanus toxoids and pertussis vaccine DTAP

doses at 2, 4, 6, 15 to 18 months, and at 4-6 yrs

143.TDAP

11-12 years

144.TD booster

every 10 years following DTAP

145.HIB

dose at 2, 4, 6, and at 12-15 months

146.innactivated polio virus vaccine

dose at 2, 4, 6 to 18 months, and at 4-6 yrs

147.MMR measles, mumps, and rubella

12- 15 months and at 4-6 years

148.caricella vaccine

single dose at 12-18 months or 2 doses administered 4 weeks apart if administered after age
13

149.Pneumococcal conjugate vaccine (PCV)

dose at 2,4,6, and 12-15 months

150.hep A

2 doses 6 months apart after age 12

151.influenza vacinne

begin at age 6 months (october through november)

152.meningococcal vaccine MCV4

a dose at age 11-12 years

153.MMR is contraindicated in?

pregnant women and children who are allergic to eggs, gelatin, and neomycin
client with hx of thrombocytopenia, or thrombocytopenic purpura
immunocompromised children
clients with advanced HIV
for clients who recently recieved blood products or immunoglobulins

154.DTAP is contraindicated in?

severe febrile illness

occurence of encephalopathy 7 days after administering DTAP immunization
an occurence of seizure within 3 days of vaccination

155.Hep B is contraindicated in?

prior hx of anaphylactic reaction

an allergy to bakers yeast

156.if you have a hypersensitivity to eggs can you get the influenza vaccine?

no, vaccine is grown in eggs and may contain small amount of egg proteins. conduct a skin
test prior to administration

157.adult influenza vaccine

annually after age 50, earlier if specific risk factors

158.PPV adult

one dose at age 65 and revaccinate every 6-8 years after initial vaccination

159.Immune globulins provide what immunity

passive immunity and provide gamma globulin antibodies

effective when- prevention of infection and increase platelets

160.Immune globulins given-

within 6 days of measles exposure, 7 days of hep B exposure, and within 14 days of hep A
exposure

161.Interferon Alfa- Interleukin 2

immunostimulant enhance host immune response and reduce proliferation of cancer cells

162.Interleuken-2 is used to tx

hairy cell leukemia, chronic myelogenous leukemia, malignant melanoma, AIDS

163.S/E interleuken 2
flu like sx, bone marrow suppression, alopecia, cardiotoxicty, neurotoxicity, hypotension

164.meds to avoid while on interleuken 2

antihypertensives, retrovir ( increase risk of neutropenia), theophylline

165.storage and admin of interleuken 2

store med in refrigerator and do not freeze. Administer at room temp. Do not shake vial.
Admin subcutaneously or IM as prescribed.

166.Immunosuppressants

cyclosporine, glucocorticoid, prednisone, cytotoxics, imuran, prograf, rehumatrex

167.immunosupressants act-

suppression of the proliferation of b cells and t cells.

immunosuppressants are used for the tx of autoimmune disorders, RA, SLE, myasthenia
gravis, early type 1 diabetes.

168.antiviral

famvir, inhibit viral replication, tx recurrent infections of genital herpes and acute herpes
zoster

169.zidovudine (AZT) retrovir

hiv inhib viral replication. Used in combin with other antiviral agents to HIV-1.

170.antihistamine actions is on-

H1 receptors which results in blocking histamine release in the small blood vessels, capilaries,
and nerves during an allergic reaction.

171.antihistamines/pregnancy

contraindicated during the third trimester of pregnancy for mothers who are breastfeeding and
for newborns. Newborns are sensitive to the sedation effects of this med

172.Chemotherapy agents

cytoxan, methotrexate, rheumatrex,

destroy cancer cells as well as healthy cells by preventing the replication of DNA.

173.s/e of chemo agents

bone marrow suppression

GI discomfort,
alopecia
mucositis
reproductive toxicity- males sperm bank before tx
hyperuricemia- elevated levels of uric acid may cause renal dammage
* administer allopurinol is uric acid level is elevated.

174.dosage for chemo agents should be

individualized

175.when should a pt preparing for chemo select a hairpiece?

before the occurence of hair loss

176.patient who has recieved immune globulins, whole blood, serum, and specific
immune globulins, when should MMR vaccine be scheduled?

postponed 3-6 months.

177.does tylenol have an antiinflammatory effect?

no, but it has analgesic and antipyretic effects

178.salicylism

tinnitus, sweating, headache and dizziness, respiratory alkalosis

179.when should aspirin be stopped before a scheduled surgery

1 week

180.take aspirin with?

food, milk, water to reduce gastric discomfort

181.Ketorolac

provides analgesia w/o anti-inflammatory. Ketorolac should ne used no more than 5 days.
Usually started as a parenteral administration and then progresses to oral doses.

182.not to exceed ___ g tylenol a day

4g

183.antidote of tylenol-

mucomyst

184.pt on tylenol and coumadin-

places client at risk for bleeding, watch for bruising, petechia, hematuria,
185.opiod agonist- morphine sulfate
fentanyl, demerol, oxycontin

act on the mu receptors, produces analgesia, respiratory depression, euphoria, and sedation,
relieve of moderate to severe pain

186.stop opiods if the clients RR is less than

12 bpm

187.avoid use of opiods with?

CNS depressants (barbituates, benzo's, and consumption of alcohol)

188.pt on morphine assess the clients bladder?

for distention by palpating the lower abdomen area every 4-6 hr

189.morphine is contraindicated in

premature infants and after biliary tract surgery

190.meperidine dosing

do not administer more than 600 mg/24 hr and limit its use to less than 48 hrs

191.opiods/antihypertensives

don't, it can further lower BP...

192.administer opiods

intravenously slowly over a period of 4-5 min, have narcan and resuscitation equipment
available.

193.administer opiods to client with cancer

on a fixed schedule around the clock, not when necessary

194.fentanyl is 100 times more potent than

Morphine

195.agonist-antagonist

stadol and talwin

low potential for abuse
less respiratory depression
cause analgesia, sedation, and decrease GI motility
tx- of mild to moderate pain
196.abstinenece syndrome-

cramping, htn, vomitting, may be precipitated when given to clients who are physically
dependent on opiod agonsits.

197.opiod antagonist- narcan

tx of opiod overdose
reversal of respiratory depression
S/E- tachypnea and tachycardia
abstinence syndrome may also occur

198.route to admin nalaxone

IV,IM, or SC. Do not administer orally.

199.Adjuvant meds for pain

tricyclic antidepressants- elavil

anticonvulsants- tegretol, neurontin, dilantin
CNS stimulant- ritalin, dexedrine
antihistamine- vistaril
glucocorticoids- decadron, deltasone
biphosphonates- didronel and aredia

*used in combin with opiods, cannot be used as a substitute