NR 293 Exam 2

NR 293 Exam 2

Name

Chamberlain University

NR-293: Pharmacology for Nursing Practice

Prof. Name

Date

NR 293 Exam 2 Study Guide

This guide provides an overview of key pharmacological aspects, including indications, contraindications, adverse effects, drug interactions, and essential safety/patient education for each class of drugs covered in the course. The guide includes specific exemplars for each drug class to aid in understanding their clinical applications.

Morphine

Indications:
Moderate to severe pain management.

Contraindications:
Patients with epilepsy, heart disease, liver or kidney dysfunction, and those with allergies should not use morphine.

Adverse Effects:
Common side effects include signs of an allergic reaction (rash, swelling), shortness of breath, lower extremity edema, and constipation.

Interactions:
Avoid use with Monoamine Oxidase Inhibitors (MAOIs) within 14 days of taking morphine. Monitor interactions with vitamins, herbal supplements, and alcohol.

Safety/Patient Teaching:
Morphine is habit-forming and carries a high risk for dependence. Pregnant or breastfeeding patients should consult their healthcare provider before use.

Acetaminophen

Indications:
Used for fever reduction and relief of mild to moderate pain.

Contraindications:
Do not use acetaminophen in patients with liver disease.

Adverse Effects:
Adverse reactions include allergy symptoms, black or bloody stools, excessive sweating, and fatigue.

Interactions:
Monitor Prothrombin Time (PT)/International Normalized Ratio (INR) in patients taking anticoagulants.

Safety/Patient Teaching:
Do not exceed 3000 mg in adults and 2000 mg in elderly patients and children. Acetaminophen does not treat inflammation.

Diazepam

Indications:
Used for anxiety, muscle spasms, and seizure management.

Contraindications:
Patients with narrow-angle glaucoma, myasthenia gravis, sleep apnea, or severe liver disease should avoid diazepam.

Adverse Effects:
Common effects include allergic reactions, seizures, confusion, lethargy, nausea, and dizziness.

Interactions:
Avoid combining with MAOIs, theophylline, or medications used to treat depression or seizures.

Safety/Patient Teaching:
Diazepam is habit-forming and can be fatal in high doses. Use caution in patients with liver or kidney disease, and avoid during pregnancy or breastfeeding.

Phenobarbital

Indications:
Controls seizures and prevents withdrawal symptoms in patients dependent on barbiturate medications.

Contraindications:
Contraindicated in patients with acute intermittent porphyria, impaired liver function, or respiratory disease.

Adverse Effects:
Dizziness, drowsiness, headache, nausea, and vomiting are common.

Interactions:
Interactions may occur with drugs used for anxiety, depression, and seizures, as well as sodium oxybate (GHB).

Safety/Patient Teaching:
Avoid use during pregnancy or breastfeeding. Patients with a history of depression or suicidal thoughts should exercise caution.

Drug Class Information

NR 293 Exam 2

Anticoagulants and Related Medications

Therapeutic Monitoring and Drug Interactions

Regular lab monitoring is essential for patients on anticoagulants, particularly for prothrombin time (PT) and international normalized ratio (INR), where a therapeutic range of 2-3 is typically recommended. Thrombolytic drugs play a critical role in breaking down existing clots by activating the conversion of plasminogen to plasmin. These medications are utilized in various acute conditions, including myocardial infarction (MI), arterial thrombosis, deep vein thrombosis (DVT), occlusion of shunts or catheters, pulmonary embolism, and acute ischemic stroke.

Contraindications and Adverse Effects

The use of thrombolytic drugs comes with significant risks, including internal, intracranial, and superficial bleeding. Other potential adverse effects include hypersensitivity reactions, nausea, vomiting, hypotension, and cardiac dysrhythmias. Concurrent use with other anticoagulants or antiplatelet agents can increase the risk of bleeding. Patients should be advised against alcohol consumption while taking medications like disulfiram, as this can lead to unpleasant reactions such as flushing, rapid heartbeats, and low blood pressure.

Medication-Specific Considerations

Bronchodilators

Bronchodilators like albuterol and salmeterol are indicated for the management of asthma and chronic obstructive pulmonary disease (COPD). They are effective in preventing bronchospasm and alleviating symptoms associated with respiratory conditions. However, patients should be cautioned about the potential for paradoxical bronchospasm and the importance of not relying solely on these medications for immediate relief of acute symptoms.

Uric Acid Reducers

Allopurinol is primarily used for managing gout and preventing kidney stones. It is contraindicated in patients with severe kidney impairment and may cause side effects such as gastrointestinal disturbances and drowsiness. Patients should be informed about possible interactions with other medications, particularly those that affect uric acid levels.

Patient Education and Monitoring

Patient education is critical in ensuring the safe use of these medications. It includes monitoring for therapeutic and adverse effects, understanding drug interactions, and adhering to prescribed regimens. For instance, patients on anticoagulants should be educated about the significance of INR monitoring and the signs of bleeding. Additionally, patients taking disulfiram should be thoroughly informed about the dangers of alcohol consumption.

Conclusion

Overall, the management of conditions requiring anticoagulants, bronchodilators, and other related medications involves careful monitoring and patient education to optimize therapeutic outcomes while minimizing risks.

References

• American Heart Association. (n.d.). Anticoagulants: Facts about blood thinners. Retrieved from https://www.heart.org
• National Heart, Lung, and Blood Institute. (n.d.). Thrombolytics: Use and risks. Retrieved from https://www.nhlbi.nih.gov

NR 293 Exam 2

• U.S. National Library of Medicine. (n.d.). Disulfiram. Retrieved from https://medlineplus.gov