HESI PHARMACOLOGY STUDY GUIDE
HESI version 1
- Community: PARKINSON medication
• Assess for signs and symptoms of PD
Masklike expression
Speech problems
Dysphagia
Rigidity of arms, legs, and neck
• Main med is Sinemet: Levodopa/Carbidopa
• Levodopa converted t...
hesi pharmacology study guide hesi version 1 community parkinson medication • assess for signs and symptoms of pd masklike expression speech problems dysphagia rigidity of arms
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HESI PHARMACOLOGY STUDY GUIDE
HESI version 1
- Community: PARKINSON medication
Assess for signs and symptoms of PD
Masklike expression
Speech problems
Dysphagia
Rigidity of arms, legs, and neck
Main med is Sinemet: Levodopa/Carbidopa
Levodopa converted to dopamine.
Carbidopa increase its effectiveness and prevents or les sens levodopa
side effects
Levodopa side effects: nausea, vomiting, heart rhythm disturbance
TEACHINGS: Take on empty stomach at least 30 minutes, or one hour
before meals
o There are two forms of Sinemet, controlled-release or immediate-release
Sinemet. Controlled-release (CR) Sinemet and immediate-release Sinemet
are equally effective in treating the symptoms of Parkinson's disease, but
some people prefer the controlled release version.
- Cardio vascular - Nitroglycerin- Decreases BP
Nitroglycerin – Anti ANGINA Meds, chronic heart failure
Prototypical nitrate : POTENT VASODILATOR
Large first-pass effect with oral forms
Used for symptomatic treatment of ischemic heart conditions (angina)
IV form used for BP control in perioperative hypertension, treatment of
HF, ischemic pain, pulmonary edema associated with acute MI, and
hypertensive emergencies
Available form: Sublingual tablets, sprays and patches
Nitroglycerin Teaching
Instruct patients in proper technique and guidelines for taking
sublingual nitroglycerin for anginal pain
Instruct patients never to chew or swallow the sublingual form
Instruct patients that a burning sensation felt with sublingual forms
indicates that the drug is still potent
Instruct patients to keep a fresh supply of sublingual medication on
hand; potency is lost in about 3 months after the bottle has been
opened
To preserve potency, medications should be stored in an airtight, dark
glass bottle with a metal cap and no cotton filler
If anginal pain occurs:
Stop activity and sit or lie down, and take a sublingual tablet
If no relief in 5 minutes, call 911/Emergency Services immediately and
take a second sublingual tablet
If no relief in 5 minutes, take a third sublingual tablet
Do not try to drive to the hospital
,- Med Administration
o Doses
o Secondary infusion (drip rates)
o Peak & Trough schedule
Peak level
˜Highest blood level
Trough level
˜Lowest blood level
o Tetracycline – is a form of ANTIBIOTICS
Bacteriostatic—inhibit bacterial growth
Inhibit protein synthesis
Stop many essential functions of the bacteria
Dairy products, antacids, and iron salts reduce oral absorption of
tetracyclines
Should not be used in children under age 8 or in pregnant/lactating
women because tooth discoloration will occur if the drug binds to the
calcium in the teeth
Instruct patients to take antibiotics exactly as prescribed and for the
length of time prescribed; they should not stop taking the medication
early when they feel better
Assess for signs and symptoms of superinfection: fever, perineal
itching, cough, lethargy, or any unusual discharge
The most common adverse effects of antibiotics are nausea, vomiting,
and diarrhea
All oral antibiotics are absorbed better if taken with at least 6 to 8
ounces of water
Tetracyclines
Avoid milk products, iron preparations, antacids, and other dairy
products because of the chelation and drug-binding that occurs
Take all medications with 6 to 8 ounces of fluid, preferably water
Because of photosensitivity, avoid sunlight and tanning beds
o Transdermal Fentanyl (DURAGESIC) – OPIOID ANALGESIC Chapter 10
Fentanyl Transdermal System is indicated for the management of pain
in opioid-tolerant patients, severe enough to require daily, around-the-
clock, long-term opioid treatment and for which alternative treatment
options are inadequate.
Patients considered opioid-tolerant are those who are taking, for one
week or longer, at least 60 mg of morphine daily, or at least 30 mg of
oral oxycodone daily, or at least 8 mg of oral hydromorphone daily, or
an equianalgesic dose of another opioid.
- Med Administration
o Aldactone – heart failure meds: Aldosterone agonist chp 24.
Potassium-sparing diuretic
Also acts as an aldosterone antagonist, which has been shown to
reduce the symptoms of heart failure
, Treats high blood pressure. Also treats fluid retention and related
conditions such as heart failure. Used to treat high levels of
aldosterone and low potassium levels. This medicine is a potassium-
sparing diuretic.
Diuretic drugs – take in the morning.
Primary hyperaldosteronism
o Long test: ALDACTONE is administered at a daily dosage of 400 mg for three to
four weeks.
o Short test: ALDACTONE is administered at a daily dosage of 400 mg for four days.
o ALDACTONE may be administered in doses of 100 to 400 mg daily in preparation
for surgery.
Edema in adults (congestive heart failure, hepatic cirrhosis, or nephrotic
syndrome)
o An initial daily dosage of 100 mg of ALDACTONE administered in either single or
divided doses is recommended, but may range from 25 to 200 mg daily.
Essential hypertension
o For adults, an initial daily dosage of 50 to 100 mg of ALDACTONE administered in
either single or divided doses is recommended.
Hypokalemia
o ALDACTONE in a dosage ranging from 25 mg to 100 mg daily is useful in treating a
diuretic-induced hypokalemia, when oral potassium supplements or other
potassium-sparing regimens are considered inappropriate.
Severe heart failure (NYHA class III – IV)
- Treatment should be initiated with ALDACTONE 25 mg once daily if the patient's
serum potassium is ≤ 5.0 mEq/L and the patient's serum creatinine is ≤ 2.5 mg/dL.
Patients who tolerate 25 mg once daily may have their dosage increased to 50 mg
once daily as clinically indicated. Patients who do not tolerate 25 mg once daily
may have their dosage reduced to 25 mg every other day.
o Antihistamine: PRECAUTIONS
Interacts with OPIOID ANALGESICS
Interacts with barbiturates
Anticholinergic properties – blocks neurotransmitters
Sedative properties
Dries up most glands
Best tolerated when taken with meals—reduces GI upset
If dry mouth occurs, teach patient to perform frequent mouth care,
chew gum, or suck on hard candy (preferably sugarless) to ease
discomfort
o Boniva (side effects)
Used for osteoperosis
that is, the drug is taken at least 30 minutes before the first morning
beverage, food, or other medication and with at least 6 to 8 oz of
water.
Emphasize the importance of remaining upright for at least 30 minutes
after taking the medication to prevent esophageal and GI adverse
effects.
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