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12 terms

KAPLAN Pharm Nursing Implications

Remediation
STUDY
PLAY
Synthroid (Levothyroxine)
monitor pulse before each dose during dosage adjustment

notify MD > 100

monitor weight

teach / report signs of toxicity
Ampicillin (Omnipen)
Antibiotic
Anti-infective of the penicillin type

SE
- gastritis
- diarrhea, n/v
- rash
- anaphylaxis
- hematological abnorms
- glossitis
- stomatitis
- black hairy tongue
Ampicillin (Omnipen)

Nursing Implications
- obtain C&S before first dose
- take careful Hx of penicillin reaction
- check for HTN to other drugs, esp. cephalosporins

- give 1-2 hours BEFORE meals
- or give 2-3 hours AFTER meals
- to reduce gastric acid destruction of the drug

- observe for 30 min. post-iM injection
- monitor for loose, foul smelling stool and chance in tongue
- teach to continue medication for entire time prescribed, even if Sx
resolve and take it act
Atorvastatin calcium (Lipitor)
Anti-hyperlipidemic
HMG-CoA inhibitor

used o lower serum cholesterol LDLs
and to increase serum HDLs
and to lower triglyceride levels

SE
- HA
- abdominal pain
- rash
- myalgia
- rhabdomyolysis
Atorvastatin calcium (Lipitor)
Nursing Considerations
- monitor for muscle pain, tenderness or weakness
- advice patient to take medication at the same time each day
- monitor LFT
Salicylate Poisoning

- any of several widely prescribe drugs derived from salicylic acid, having analgesic, anti-pyretic and anti-inflamm actions
ASA is most important

Indications of poisoning of salicylate into may be acute or chronic and include
- tinnitus
- sense of fullness in ears
- decreased or muffled hearing
- hyperventilation
- hypoglycemia
- respiratory failure

In children
- hyperventilation
- confusion
- agitation
- behavioral changes
- lethargy
- drowsiness
- sweating
- constipation
Salicylate Poisoning Interventions
- remove salicylate from GI tract and prevent further absorption
- correct acid/base and fluid + electrolyte imbalances
- induce vomiting, gastric lavage, activated charcoal, IV sodium bicarbonate
Nifepipine (Procardia)

CCB
Anti-HTN
Anti-anginal
SE
- dizziness
- HA
- hypotension
- nervousness
- couhg
- arrhythmias

Nursing Considerations
- monitor BP during dosage adjustments
- advice the change positions slowly
Haloperiodel (Haldol)
Anti-pyschotic

SE
- extrapyamidial reactions (muscle rigidity, tremors, tongue protrusion, slowing of voluntary movement, abnormal posture)

- tardice dyskinesia
- blurred vision
- dry mouth
Heparin
- Anti-coag used for short term therapy

- give iV or SQ

- inactivated thrombin and prevents conversion of fibrinogen to fibrin
- leave needle in place for 10 seconds
- don't massage after SQ
- dosage adjusted according to aPTT
- therapeutic range is 1.5 - 2 times normal value

SE
- hemorrhage with excessive dose
- thrombocytopenia
- hypersensitivity reactions

- antagonist = PROTAMINE SULFATE
Naproxen (Naprosyn)
NSAID

inhibits prostaglandins

SE
- HA
- dizziness
- epigastric distress

Nursing Considerations
- administer with food
- cautious use in pts with hx of aspirin allergy
- optimal there. response seen after 2 week of Tx
Spironolactone (Aldactone)
Diuretic
K+ sparring
- often used with other diuretics and Anti-HTN agents

SE
- hyperkalemia
- hyponatremia
- rash, dizziness, HA
- deepening of voice
- hirsutiusm

Nurse Considerations
- monitor elec. imbal
- give with meals at bedtime
- avoid salt substitutes containing K+
- limit intake of high K+ foods
- monitor I&O
- weigh patient daily