Nursing 204 Pharmacology Review

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Proventil (albuterol)

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is a bronchodilator used for prevention and long term treatment of asthma attacks. Inhaled agents have minimal side effects. Oral agents can cause tachycardia and angina. Advise clients to observe for signs and symptoms (chest, jaw, or arm pain or palpitations). Instruct clients on how to check pulse and to report an increase greater than 20 to 30 beats/min. Use cautiously in patients with diabetes, hyperthyroidism, heart disease, hypertension, and angina.

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Proventil (albuterol)

Prozac

is an SSRI used for depression, PTSD, OCD, and ADHD. Side effects: suicidal behavior, CNS stimulation (inability to sleep, agitation, anxiety), weight gain. Watch for serotonin syndrome it may begin 2 to 72hrs after starting treatment, and it can be lethal watch for: mental confusion, difficulty concentration, hallucinations, incoordination, tremors, fever, and diaphoresis. Asses for alcohol use, make sure they are not taking MAOIs or TCAs because that increases the risk of serotonin syndrome. It may take 1-3 weeks to take effect.

QVAR

is a glucocorticods that prevents inflammation in patients with chronic asthma. It does not provide immediate effects, but rather promotes decreased frequency and severity of exacerbations and acute attacks. The patient can experience difficulty speaking, and hoarseness. Monitor potassium levels, advise them to avoid NSAIDs, and may affect the use of hypoglycemic agents so make sure they check there BGMs.

Potassium

used to treat hypokalemia;
potassium less than 3.5 mEq/L
For clients receiving diuretics resulting in potassium loss, such as furosemide
For clients with potassium loss due to excessive or prolonged vomiting, diarrhea, abuse of laxatives, intestinal drainage, and GI fistulas
Side effects:GI distress and local GI ulceration, nausea, vomiting, diarrhea, abdominal discomfort, and esophagitis with oral administration
Monitor clients receiving IV potassium for
signs of hyperkalemia, such as bradycardia,
hypotension, ECG changes.
1) Mix powdered formulations in at least 4 oz of liquid.
2) Advise clients to take potassium chloride with a glass of water or with a meal to reduce the risk of adverse GI effects.
3) Instruct clients not to crush extended-release tablets.
4)Instruct clients to notify the provider if they have difficulty swallowing the pills.
IV administration
1)Never administer IV bolus. Rapid IV infusion can result in fatal hyperkalemia.
2)Use an IV infusion pump to control the infusion rate.
3)Dilute potassium and give no more than 40 mEq/L of IV solution to prevent vein irritation.
4)Give no faster than 10 mEq/hr.
5)Cardiac monitoring is indicated for serum potassium levels outside of normal parameters.
6)Assess the IV site for local irritation, phlebitis, and infiltration. Discontinue IV immediately if infiltration occurs.
7)Monitor the client's I&O to ensure an adequate urine output of at least 30 mL/hr.

SSRI

Paroxetine (Paxil )
Sertraline (Zoloft)
Escitalopram (Lexapro)
Fluoxetine (Prozac)
Fluvoxamine (Luvox)
selectively inhibits serotonin reuptake, allowing more serotonin to stay at the junction of the neurons.
Adverse effects: nausea, diaphoresis, tremor, fatigue, drowsiness, sexual dysfunction, weight gain, GI bleeding, serotonin syndrome, bruxism, withdrawal syndrome
Inform the patient that it may take up 1-3 weeks to feel the therapeutic effects of the medication.