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Drug Cue Cards (2019) – University of Georgia | Drug Cue Cards (2019)

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Drug Cue Cards (2019) – University of Georgia Morphine sulphate * HIGH ALERT DRUG * (Page 887) Name Fun Class: opiod analgesic Chem Class Alkoloid Controlled Substance Class II Action: dec... reases pain transmission of impulses at the spinal cord level Route Interactions: black tea, green tea, chamomile (cause CNS depression) Lab test: ALT, AST Administration Method: PO with food or milk to minimize GI effects Dosage: Adult 10-30 mg Q3-4hr PO PRN How Drug Works Phamacokinetics - Note that it is rapidly absorbed - Peak: 60 minutes and lasts for 3-4hrs - If you chew it the drugs works within 2 hrs - Affinity: 99% Side effects - Dizziness - Confusion - Headaches - Bradycardia - Shock - Cardiac arrest - Tachycardia - Apnea & respiratory depression - Thrombocytopenia Nursing Considerations - Resp: wheezing, decrease in Asthma exacerbations - Churg-Strauss Syndrome: very rare but observe for rashes, worsening cardiac or pulmonary conditions - DON’T use on pregnant women unless absoulutely necessary - Evaluate respirations carefully - Anaphylaxis (Stevens-Johnson Syndrome): rash, fatigue, muscle aches Black Box warning - Respiratory depression - Patients require constant/close assessments - Do not give to people with addictive personalities - Do no give to pregnant women or geriatric patients unless absoulutely necessary (unknown if it will get into breastmilk; will get into placenta) [RECALL: neonatal opiod withdrawl syndrome] - Take caution with opiod naïve patients Patient Teachings - Avoid alcohol - Drug can cause dizziness - Place close attention to changes in LOC - Granules must be taken PO within 15 mins of drug prep Etiology (reason for drug) Chronic pain can be caused by excessive firing of neurons Pathogenesis - Morphine is used to treat pain 1) Pain receptors and their Delta A and Sensory C fibres (noicocepters) note the pain 2) Neurons generate action potentials and transmit signals across synapse 3) This releases neurotransmitters which triggers reaction from effector neurons 4) Sometimes the noiceceptors keep sending impulses of pain which results in chronic pain 5) Morphine binds to the neurotransmitters which bind to G protein to initiate intracellular communication in order to inhibit their transmission as well as alter the way the brain perceives the pain Clinical manifestations - Slurred speech - Pinpoint pupils - Addiction - Opiod withdrawl Potential complications - Infection: some people become addicted to the opiod and once it is no longer medically necessary the patient will seek other (unsafe) methods of getting the opiod - Bowel syndrome: opiods affect the motility of bowels leading to constipation and abdominal pain - Hyperalgesia: sensitivity to pain; through prolonged use patient’s neurotransmitters begin reversing effects of opiods by building up a tolerance and with the withdrawl the patient may experience more even more pain than before which may be more chronic - Onset of amnesia - Overdoses and/or death Secondary health conditions - Activation of G proteins can lead to effects on messenger generating enzymes - Long term use of drug can alter gene transcription which leads to respiratory depression Absorption - It is absorbed and transported into systemic circulation Distribution - If injected the drug travels through cerbreospinal fluid throughout the body - If taken PO the drug is absorbed and transported by the bloodstream to the liver Metabolism 1) Cytochrome P450 enzyme facilitates reactions; it activates oxidation or hydrolysis of the drug 2) The drug is converted into a hydrophyllic version of itself and is catabolized by uridine diphosphate glucuronosyltransferase (UGT) 3) Now that the drug is hydrophyllic the body is able to excrete it with ease in the kidneys Excretion - Body determines which type of excretion to complete - Hydrophyllic metabolites are diffused out of the glomular membranes - Some of the metabolites are transported by the bloodstream into the kidneys and end up being excreted by the bile Atenolol * High Alert * (page 111) • Cardioselective β-blocker • Commonly used to prevent future heart attacks in patients who have had one attack • Hypertension and angina - - - - - - - - - - Patient Teachings - Monitor blood glucose - NEVER discontinue product abruptly because seizures may occur - Oral hygiene: use soft bristle toothbrush, floss and see dentist frequently - Avoid hazardous activities - Carry emergency ID - Do not change brands or form of drug - Do not use antacids within 2 hours of product - Use nonhormonal contraception - Notify perscriber if: unusual bleeding, bruising, petechiae, clay coloured stool, abdominal pain, dark urine, jaundice of eyes/skin, slurred speech, headache, drowsiness - Report suicidal thoughts/behaviours immediately - Do not have with alcohol Etiology (reason for drug) Treats seizures and prevents vFib Pathogenesis Ventricular fibrillation is a heart rhythm problem that occurs when the heart beats with rapid, erratic electrical impulses. This causes pumping chambers in your heart (the ventricles) to quiver uselessly, instead of pumping blood. Seizures are caused by paroxysmal discharges from groups of neurons, which arise as a result of excessive excitation or loss of inhibition. The key unit of neurotransmission is the synapse, and the fundamental components of synapses are ion channels. Clinical manifestations - Seizures - Rash - Drowsiness - Suicidal thoughts/behaviours - Unusual bleeding/bruising - Abdominal pain - Jaundice - Slurred speech - headache Absorption - Bloodsteam Distribution - Systemic circulation Metabolism - Liver Excretion - Urine Estrogen (Page 520) *HIGH ALERT* Name Trade: Enjuvia or C.E.S Generic Estrogens, conjugated Fun Class: estrogen hormone Chem Class: N/A Action: needed for adequate functioning of female reproductive system; affects release of pituitary gonadotropins Route Interactions: increases toxicity-cycloSPORINE, dantrolene Administration Method: PO or IV/IM Dosage: 0.3-1.25 mg/day 3 wk on, 1 wk off How Drug Works Phamacokinetics - Degraded in liver, excreted in urine, crosses placenta, excreted in breastmilk Side effects Seizures Thromboembolism Stroke Pulmonary embolism MI Nausea Cholestic jaundice Hepatic adenoma Gynecomastia Testicular atrophy Impotence Increased risk of breast cancer Endometrial cancer Nursing Considerations - Assess for breast endometrial cancer: estrogens shouldn’t be used in known, suspected or history of these disorders - Blood glucose should be monitored as hyperglycemia can occur - Weight daily; notify if weight gain of more than 5 lbs - Hypertension may occur - Mental status: affect, mood, behavioural changes, aggression - DON’T USE pregnant Black Box Warnings - Stroke, thromboembolic disease of MI: should not be used in these conditions or known protein C deficiency, protein S deficiency or antithrombin deficency Patient Teachings Avoid breastfeeding Report weight gain over 5 lbs Avoid sunlight Notify perscriber if pregnancy expected Vasomotor symptoms improve within 2 wks or max of 8 wks Etiology (reason for drug) Adequate functioning of female reproductive system Pathogenesis Clinical manifestations - Stroke - MI - Pulmonary Embolus - Mood changes - Weight gain of more than 5 lbs - Breast cancer - Testicular atrophy - impotence Absorption - Bloodsteam Distribution - Systemic circulation Metabolism - Liver Excretion - Urine [Show More]

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