Pharmacology3

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Galen College of Nursing *

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210

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Medicine

Date

Apr 3, 2024

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08886481088 Nonsteroidal Anti inflammatory giggration Celecoxib Medications Ibuprofen Celeb rex NSAIDs are not recommended Motrin Advil during pregnancy lactation Indomethacin Indocin Naproxen Naprosyn Risk of bleeding hot Ketorolac Toradol Action NSAIDs inhibit COX 1 and Cox 2 enzymes and the cox it ptEÉts stomatchining blood clotting maintains renal sodium and water balance COX 2 is active at sites of injury responds to injury triggers pain Indications NSAIDs are used in the treatment of Rheumatoid arthritis Fever pain relieve Osteoarthritis Acute gout and body Adeggery Nausea vomiting dizziness Bleeding Broncho spasm GIentraritaettiention can cause peptic ulcers and t risk of GI bleeding Nephrotoxic s t renal blood flow Pruvitis Interaction NSAIDs decreases the effectiveness of antihypertensive Drug drug medications such as loop diuretics and beta blockers Hypoglycemia can occur if Ibuprofen is taken with Insulin contraindications NSAIDs are contraindicated in patients with renal hepatic or cardiac dysfunction heart failure Use with caution in patients with history of GI bleeding peptic ulcer asthma diabetes alcohol use Assess patients for Hx of hepatic or renal disease chunssiderations GI bleeding peptic ulcer Educate patient to avoid NSAIDs for 1 2 weeks prior to surgery NSAIDs can be taken with food or milk to prevent GI upset Monitor patient closely and instruct patient to report for signs of bleeding such as tarry black stools petechia bleeding gums ecchymosis

GABS 8800 Acetyl salicylic acid Nonsteroidal Anti inflammatory Drugs Action Aspirin inhibits prostaglandins and the synthesis of vasoconstrictor thromboxane Az Prostaglandin can cause an increase in body temperature Thromboxane Az can t blood clot formation platelet aggregation Indications Fever Mild to moderate pain Rheumatoid arthritis Osteoarthritis Reduce risk of myocardial infarction MI ischemic stroke transient ischemic attacks Allergy to salicylates NSAIDs Bleeding disorders contraindications Impaired renal function DÉEDE O Surgery dental work Pregnancy lactation Children especially those with chickenpox or influenza Risk for Reye's syndrome swelling in the brain liver Bleeding abnormalities hemolysis T bleeding time Adeffergs Blood loss Tinnitus Ringing in the ears Heartburn Dizziness Nausea Vomiting Headaches Dyspepsia Flushing 88 Salicylism can occur when patient has high levels of aspirin in their body aspirin poisoning Sls Tinnitus ringing in the ears Metabolic acidosis Dizziness Tachypnea hyperventilation Nausea vomiting Pulmonary edema Contusion Organ failure cardiovascular respiratory Tetany muscle cramps spasms renal Avoid Aspirin in children due to the risk of Reye's syndrome down'ssiderations Avoid Aspirin during pregnancy lactation to prevent harm to the fetus I neonate Instruct patient to stop taking Aspirin 1 2 weeks before surgery to reduce the risk for bleeding Monitor patient for signs of bleeding such as dark tarry stools coffee ground emesis

Woof on a Anticoagulant The Antidote for Action Warfarin inhibits the liver from warfarin is making vitamin K dependent clotting factors Phytonadione I VII IX X and prothrombin vitamin K Warfarin is used for longterm anticoagulation Indications Prevent pulmonary embolism embolism formation due to Afib MI thrombosis heart valve damage Prevent deep vein thrombosis DVT due to bed rest or post surgical Contraindicated for pregnancy pregnancy category X contraindications Contraindicated in patients with active bleeding bleeding disorders hemorrhagic brain injuries Bleeding bleeding gums GI tract Liver damage jaundice Dermatitis Purple toe syndrome Adefteds Bone marrow deppression discolored painful toes Bruising dermal necrosis Alopecia Osteoporosis fracture can occur with long term use Interactions Medications to avoid while taking warfarin Drug drug salicylates Sulfonamides Corticosteroids Cimetidine Anti infecties's Allopurinol Oral contraceptives increase the effect of warfarin can decrease the effect of warfarin dungsignegragons Monitor INR international normalized ratio level daily to determine a safe dose for patient INR is the standarized measure of prothrombin levels Warfarin helps raise INR to an appropriate level Monitor PT Therapeutic INR level 2 3 INR Only administer warfarin when INR is below or within the PTnormal range therapeutic abragegethe therapeutic range 11 12.5 When INR is seconds G Hold the medication report to the provider Onset takes 3 5 days to reach therapeutic level not for acute situation G Bridgetherapy subcu heparin is used to bridge patient to warfarin until INR reaches the therapeutic range

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2 GOOOOOD PatientEducation take'gafetythmeasurest bleeding the nurse must educate satient to Use electric razor soft toothbrush Wear sleeves to protect the skin Avoid alcohol and medications that can increase the risk of bleeding such as NSAIDs aspirin acetaminophen Avoid limit activities that can increase the risk of injury Monitor patient for signs of bleeding such as bleeding gums epistaxis hematuria blood in stool bright red dark tarry stool coffee ground emesis petechia e abdominal pain Educate patient to maintain a consistent intake of Vitamin K to prevent bleeding Educate patient to notify the health care provider about the use of Warfarin Warfarin must be stopped prior to surgery dental procedures colonoscopy INR level must be checked prior to procedure i iItI Nursing illustration

8788000893 Anticoagulant É Action Heparin binds with antithrombin to inactivate factor Xa thrombin and the conversion of fibrinogen to fibrin Indications Heparin is used to treat thrombotic conditions such as Pulmonary embolism stroke ptgart attack Disseminated intravascular coagulation DIC the antidote Immediate onset via IV for Onset 30 60 minutes via subcu heparin is Hemorrhage easy bruising hematoma Blood in stool or emesis protamine EETs Heparin Induced Thrombocytopenia At sulfate Elevated liver enzymes Low hemoglobin hematocrit or thrombocyte count Ecchymosis petechia e purpura Normal activated partial thromboplastin time a PTT Labs 30 40 Seconds a PTT therapeutic range should be 1.5 2 times the baseline a PTT must be checked every 4 6 hours until stable response then check daily per facility policy a PTT too high decrease dose or stop infusion a PTT too low increase dose or administer bolus dose Heparin prevents existing clots from getting larger and cMngderations the formation of new clots Heparin does not break up existing clots Heparin is a high alert medication that requires a verification of a second nurse for administration Monitor patient for ecchymosis petechia abdominal pain jaundice GI bleeding dark tarry stool coffee ground emesis bleeding gum epistaxis Monitor a PTT and platelet count Inject Heparin subcutaneously into the abdomen at a 90 degree angle do not rub the injection site Nursing illustration

8008080 Damp IcoloD8008 Omeprazole Pvilosed Medications Esomeprazole Nexium Lansoprazole Prevacid Pantoprazole Protonix PPIs suppress the production of gastric acid by binding Action an enzyme on gastric parietal cells Gastric ulcers Duodenal ulcers Indications Gastroesophageal reflux disease Erosive gastritis Zollinger Ellison syndrome hyper secretory condition onset Oral PPIs have an onset of 2 4 hours with a duration of 24 hours or longer Headache abdominal pain Adeggery Diarrhea nausea vomiting Vitamin B12 deficiency hypomagnesemia Fractures Pneumonia cyngsiderations Use with caution in elderly patients patients with hepatic diseases Educate patient to take medication before meals Instruct patient to report diarrhea or respiratory symptoms long term use of PPI can predispose patient to the risk of having pneumonia C difficile and GI infections Long term use of PPIs could lead to osteoporosis fractures due to decreased calcium absorption Educate patient to maintain adequate intake of calcium and vitamin D Not for children under Zyrs Avoid taking antacids and PPI together because antacids can affect the absorption of PPIs Prolonged therapy of PPIs can increase the effect of warfarin PPIs can decrease the effectiveness of clopidogrel an antiplatelet medication s which can increase the risk of stroke or myocardial infarction Nursing illustration

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Pharmacology3

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