NURSING PHARMACOLOGY Med-surg Nursing

1. Drugs That Affect the Gastrointestinal System

1.1. LAXATIVES

1.1.1. Bulk Forming

1.1.2. Emollient

1.1.3. Stimulant

1.1.4. Hyperosmotic

1.2. ANTIDIARRHEALS

1.2.1. Opioids

1.2.2. Bulk Forming

1.2.3. Absorbents

1.2.4. Anticholinergics

1.3. ANTACIDS

1.3.1. Neutralizing Agents

1.3.2. H2 Receptor Antagonists

1.3.3. Proton Pump Inhibitors

1.3.4. Muscosal Protective Agents

1.4. ANTIEMETICS

1.4.1. Anticholinergics

1.4.2. Antihistamines

1.4.3. Neuroleptics

1.4.4. Prokinetics

1.4.5. Serotonin Blockers

1.4.6. Cannabis

2. Drugs That Affect the Cardiovascular System

2.1. BLOOD/COAGULATION

2.1.1. Anticoagulants

2.1.1.1. Heparin

2.1.1.2. Warfarin

2.1.1.3. Antiplatelet Drugs

2.1.2. Fibrinolytics

2.1.3. Antilipemics

2.1.4. Antianemics

2.2. BLOOD VESSELS

2.2.1. Antihypotensives

2.2.2. Antihypertensives

2.3. HEART

2.3.1. Cardiotonics (Inotropics)

2.3.2. Antidysrhythmics

2.3.3. Anti-Angina Pectoris Drugs

3. Neurological/ Musculoskeletal Diseases

3.1. Multiple Sclerosis (MS)

3.2. Parkinson's Disease

3.3. Spinal Cord Injury

3.4. Osteomyelitis

3.5. Osteoporosis

3.6. Fibromyalgia Syndrome

3.7. Chronic Fatigue Syndrome

3.8. Osteoarthritis

3.9. Rheumatoid Arthritis

3.10. Systemic Lupus Erythematosus

3.11. Trauma, Burns, Fractures

3.12. Head Injury

3.12.1. Subarachnoid Hemorrhage

4. GI System Disorders

4.1. Peptic Ulcer Disease

4.2. Gastroesophageal Reflux (GERD)

4.3. Gastritis

4.4. Appendicitis

4.5. Diverticulitis

4.6. Inflammatory Bowel Disease

4.7. Ulcerative Colitis

4.8. Crohn's Disease

4.9. Colorectal Cancer

4.10. Jaundice

4.11. Cholelithiasis

4.12. Hepatitis

4.13. Cirrhosis

4.14. Pancreatitis

5. Oncological Disorders

5.1. Cancer

5.2. Leukemia

5.3. Hodgkin's Disease

5.4. Breast Cancer

5.5. Ovarian Cancer

5.6. Prostate Cancer

5.7. Testicular Cancer

6. Drugs That Affect the Nervous System

6.1. Central Nervous System

6.1.1. DEPRESSANTS

6.1.1.1. Analgesics - Opioids

6.1.1.1.1. Opioid Antagonists

6.1.1.1.2. Nonopioids

6.1.1.2. Sedatives, Hypnotics, Anxiolytic Agents

6.1.1.2.1. Barbiturates

6.1.1.2.2. Benzodiazepines

6.1.1.2.3. NonBenzodiazepines

6.1.1.3. Antiseizure Agents

6.1.1.3.1. Barbiturates

6.1.1.3.2. Benzodiazepines

6.1.1.3.3. Hydantoins

6.1.1.3.4. Carbamazepines

6.1.1.3.5. Valproic Acid

6.1.1.4. Anti-Parkinson Drugs

6.1.1.4.1. Dopaminergics

6.1.1.4.2. Anticholinergics

6.1.1.5. Skeletal Muscle Relaxants

6.1.2. Psychotropic Drugs

6.1.2.1. Antidepressants

6.1.2.2. Mood Stabilizers

6.1.2.3. Antipsychotics

6.1.3. Anaesthetics

6.1.3.1. Locally Acting

6.1.3.2. General (Systemic)

6.1.3.3. Neuromuscular Blocking Agents

6.1.4. Stimulants

6.1.4.1. Amphetamines

6.2. Autonomic Nervous System

6.2.1. SYMPATHETIC DIVISION

6.2.1.1. Adrenergics

6.2.1.2. Antiadrenergics or Adrenergic Blocking Agents

6.2.2. PARASYMPATHETIC DIVISION

6.2.2.1. Cholinergics

6.2.2.2. Anticholinergics

7. Endocrine Disorders

7.1. Type 1 Diabetes

7.2. Type 2 Diabetes

7.3. Diabetes Isipidus

7.4. Syndrome of Inappropriate Antidiuretic Hormone

7.5. Addison's Disease

7.6. Cushing's Syndrome

8. Surgical Nursing

8.1. Pre-Op work up

8.2. Post-Op Complications/Care

8.3. Bowel Obstructions

9. Lab Values

9.1. Anemia

10. Drugs That Affect the Respiratory System

10.1. ANTITUSSIVES

10.1.1. Opioids

10.1.2. Nonopioids

10.2. EXPECTORANTS

10.3. DECONGESTANTS

10.3.1. Common Sympathomimetics

10.3.2. Corticosteroids

10.4. MUCOLYTICS

10.5. ANTIHISTAMINES

10.6. CORTICOSTEROIDS

10.7. BRONCHODILATORS

10.7.1. Beta Adrenergics

10.7.2. Anticholinergics

10.7.3. Xanthine Derivatives

10.7.4. Leukotriene Modifiers

10.7.5. Mast Cell Stabilizers

11. Antimicrobial Agents

11.1. ANTIBACTERIAL AGENTS

11.1.1. Penicillins

11.1.2. Cephalosporins

11.1.3. Aminogylcosides

11.1.4. Fluoroquinolones

11.1.5. Macrolides

11.1.6. Tetracyclines

11.1.7. Sulphonamides

11.2. ANTIVIRAL AGENTS

11.3. ANTITUBERCULAR AGENTS

11.4. ANTIFUNGAL AGENTS

11.5. ANTIPROTOZOAL AGENTS/ ANTIMALARIALS

11.6. ANTHELMINTIC AGENTS

11.7. ANTISEPTICS AND DISINFECTANTS

12. Drugs That Affect the Urinary System

12.1. DIURETICS

12.1.1. Carbonic Anhydrase Inhibitors

12.1.2. Loop Diuretics

12.1.3. Osmotic Diuretics

12.1.4. Potassium-Sparing Diuretics

12.1.5. Thiazides and Thiazidelike Diuetics

12.2. URINARY ANAESTHETICS

12.3. SMOOTH MUSCULAR STIMULANTS (CHOLINERGICS)

13. Antineoplastic Agents

13.1. Alkylating Agents

13.2. Antimetabolites

13.3. Mitotic Inhibitors

13.4. Antitumor Antibiotics

13.5. Topoisomerase-1 Inhibitors

13.6. Hormonal Antagonists

13.7. Biological Response Modifiers

14. Vitamins and Minerals

14.1. VITAMINS

14.1.1. FAT-SOLUBLE VITAMINS

14.1.1.1. A

14.1.1.2. D

14.1.1.3. E

14.1.1.4. K

14.1.2. WATER-SOLUBLE VITAMINS

14.1.2.1. B Complex

14.1.2.2. C

14.2. COMMON MINERALS

14.2.1. Iron

14.2.2. Calcium

14.2.3. Phosphorus

14.2.4. Magnesium

14.2.5. Sodium

14.2.6. Potassium

14.2.7. Zinc

15. Cardiovascular Disorders

15.1. Brain Attack - TIA

15.2. Hypertension

15.3. Coronary Artery Disease (CAD)

15.3.1. Angina

15.3.2. Myocardial Infarction (MI)

15.3.3. Sudden Cardiac Death

15.4. Valvular Heart Disease

15.5. Dysrhythmias

15.6. Peripheral Vascular Disease

15.7. Abdominal Aortic Aneurysm (AAA)

15.8. Heart Failure

15.9. Shock

15.9.1. Anaphylactic

15.9.2. Cardiogenic

15.9.3. Septic

15.10. Hypovolemia

15.11. Cardiopulmonary Arrest

16. Respiratory Disorders

16.1. Asthma

16.2. Pulmonary Embolus

16.3. Pulmonary Edema

16.4. Chronic Obstructive Pulmonary Disease

16.5. Tuberculosis

16.6. Acute Respiratory Distress Syndrome

16.7. Acute Respiratory Failure

16.8. Atelectasis

16.9. Pneumothorax

16.10. Lung Cancer

17. Renal Disorders

17.1. Urinary Tract Infections

17.2. Pyelonephritis

17.3. Nephrotic Syndrome

17.4. Glomerulonephritis

17.5. Urinary Tract Calculi

17.6. Polycystic Kidney Disease

17.7. Acute Renal Failure

17.8. Chronic Renal Failure

17.9. Dialysis

18. DVT

18.1. Heparin

18.1.1. Decrease clotting cascade; check aPTT

18.1.2. Therapeutic range of aPTT on Heparin: 50-80 sec (Normal aPTT 30-40sec)

18.2. Warfarin (Coumadin)

18.2.1. Antagonizes Vitamin K; check PT & INR

18.2.2. INR Target Range: 2-3 during treatment (get checked once a month)

18.3. Enoxaparin (Lovenox)

18.3.1. Low molecular weight heparin; providing anticoagulation action

18.4. Signs & Symptoms of DVT

18.4.1. Pain, swelling, Positive Homan's sign, red & warm leg, dilated veins, low grade fever I.e. 100.4F, unequal leg measurements

19. Pulmonary Embolism

19.1. Pathophysiology: a thrombus in a lower extremity moves out of its localized position

19.2. Signs & Symptoms: (MOST COMMON) no hx, unexplained Dyspnea, tachycardia, tachypnea, (other s/s): chest pain, cough, crackles, fever, decreased mental status, decreased O2 stats

19.3. Complications: Pulmonary Infarction & Pulmonary HTN

19.4. Nursing Care: Bed rest with HOB Elevated, IV Heparin Drip or Lovenox, Monitor Coagulation Studies q 6 Hours, O2 Therapy- started even before vitals if PE is being assessed, Pulse Oximetry, Pain Medications – Morphine IVP Anti-anxiety Medications, Same Patient Teaching as DVT, Treat Atrial Fibrillation of high rate with Digoxin, Monitor for Bleeding from Body Orifices

20. Sepsis

20.1. Signs & Symptoms: Infection, documented or suspected, and some of the following. General Variables • Fever (temperature >100.9° F [38.3° C]) • Hypothermia (core temperature <97.0° F [36° C]) • Heart rate >90 beats/min • Tachypnea • Altered mental status • Significant edema or positive fluid balance (>20 mL/kg over 24 hr) • Hyperglycemia (blood glucose >140 mg/dL) in the absence of diabetes Inflammatory Variables • Leukocytosis (WBC count >12,000/µL) • Leukopenia (WBC count <4000/µL) • Normal WBC count with >10% immature forms • Elevated C-reactive protein • Elevated procalcitonin Hemodynamic Variables • Arterial hypotension (SBP <90 mm Hg, MAP <70 mm Hg, or a decrease in SBP >40 mm Hg) Organ Dysfunction Variables • Arterial hypoxemia (PaO2/FIO2 <300) • Acute oliguria (urine output <0.5 mL/kg/hr for at least 2 hr despite adequate fluid resuscitation) • Serum creatinine increase >0.5 mg/dL • Coagulation abnormalities (INR >1.5 or PTT >60 sec) • Ileus (absent bowel sounds) • Thrombocytopenia (platelet count <100,000/µL) • Hyperbilirubinemia (total bilirubin >4 mg/dL) Tissue Perfusion Variables • Hyperlactatemia (>1 mmol/L) • Decreased capillary refill or mottling

20.2. Sepsis Shock Def: Septic shock is the presence of sepsis with hypotension despite adequate fluid resuscitation, along with inadequate tissue perfusion resulting in tissue hypoxia. The main organisms that cause sepsis are gram-negative and gram-positive bacteria. Parasites, fungi, and viruses can also cause sepsis and septic shock.