NURSING ASSESSMENT PROGRAM

PHARMACOLOGY

COLLEGE OF NURSING AND ALLIED MEDICAL SCIENCES

1st SEMESTER A.Y. 2023 – 2024

ANTIBIOTICS • Analgesic
• They inhibit bacterial DNA • Antipyretic
• They inhibit protein synthesis • Anti-inflammatory
• They interfere with the formation of the
bacterial cell wall EXAMPLES
• Acetylsalicylic Acid (Aspirin, ASA)
EXAMPLES • Ibuprofen (Advil, Motrin)
• Ceftriaxone – renal problems, pneumonia, • Fenoprofen
gonorrhea • Naproxen (for pain and inflammation)
• Ciprofloxacin – urinary tract infection • Acetaminophen (Tylenol, Tempra)
• Clindamycin- for skin infection • Diclofenac (long term – edema)
• “Ceph/Cef” – cephalosphorins (drug class) • Narcotic Analgesic (always check RR
because it is prone to respiratory depression)
o Naloxone – antidote
INDICATIONS
• Skin/skin structure infection CONTRAINDICATIONS
• Respiratory tract infection • Avoid if there is presence of liver/renal
• Gonococcal disease
• Community or Hospital Acquired Pneumonia • Avoid if the patient is on anti-coagulant
• Cases of meningitis • Avoid if there is presence of flu symptoms
• Surgical prophylaxis because of risk for Reye’s Syndrome
• Do not crush/cut enteric coated
Normal WBC Count (5,000 – 10,000)
Normal BUN (10-20 mg/dl) ADVERSE EFFECTS
Normal Creatinine (0.6-1.2 mg/dl) • Salicylism
• Tinnitus
NURSING CONSIDERATIONS • GI Irritation
• Take blood culture and sensitivity • Dizziness
• Assess for ototoxicity (change in hearing, • Rash, dermatitis
ringing in the ears, dizziness, or unsteady • Erosive gastritis
gait) TINNITUS • Hypotension
• assess for nephrotoxicity (monitor BUN and • Blood dyscrasias (low RBC, WBC, Platelet)
Creatinine) • Sodium and water retention
• Laboratory value alert
o BUN (10-20 mg/dl) EARLIEST MANIFESTATION OF SHOCK
o Creatinine (0.6-1.2 mg/dl) • Altered LOC
o Oliguria (<400 ml/day)
• Decreased sensorium
o Anuria (<100 ml/day)
• Restlessness
• Drink 2-3 liters/day
• Confusion
• Absorption is reduced by milk products and
• Irritability
antacids
• Cerebral hypoxia
• Minimize using higher generation in less
severe infections and in those in which risk • Increased ICP
factors for multidrug resistance are not
present
• Dilate solution and administer slowly to
decrease phlebitis on IV site
o Phlebitis – warm to touch
o Infiltration – cold to touch

ACE INHIBITOS (ANTI-HYPERTENSIVES)

NSAIDs • Angiotensin Converting Enzyme
Used as • Suffix: “-pril”

Hanna Jeuline DR. Palapal, RN 2024 1

 NURSING ASSESSMENT PROGRAM
PHARMACOLOGY

COLLEGE OF NURSING AND ALLIED MEDICAL SCIENCES

1st SEMESTER A.Y. 2023 – 2024

INDICATIONS • Notify the patient’s physician if dizziness still

• Hypertension persist
• Congestive Heart Failure
o Pumping failure PISO – Potassium inside, Sodium outside
o Cardiomegaly Tall T-wave (Hyperkalemia)
o Ventricular hypertrophy Hypokalemia – administer insulin
• RAAS – compensatory mechanism for Insulin – puts Potassium inside the cell
hypotension Normal Glucose (70-110 mg/dl)

ELECTROLYTE LEVELS
Na: 135-145 Ph: 7.35-7.45

K: 3.5-4.5. PaCo2: 35-45

P: 2.5-4.5 RBC in million: 4.5-5.5

Mg: 1.5-2.5

Cl: 98-106
HCO3: 22-26
Ca: 9-11
Intraocular Pressure: 10-20

ANTI-ANGINALS
• Peripheral Vasodilator
Normal Potassium (3.5-4.5) • Decrease cardiac workload
Normal Sodium (135-145) • Generic name usually ends in “nitrate”

DESIRED OUTCOME • Stable Angina – relieved by rest or nitrates

• Blood pressure controlled with normal limits • Unstable Angina – poorly relieved
• Improved survival rates for patients suffering • Variant Angina – coronary vasospasm
from acute MI
• Decreased workload on cardiovascular MYOCARDIAL ISCHEMIA
system • ST Segment Depression
• Decreased or absence of chest pain • T-wave Inversion
• Normal Trop I
SIDE-EFFECTS
• Postural hypotension (head rush, dizzy spell) DRUG USES
• Fatigue • Angina
• Loss of appetite • Controls perioperative blood pressure
• Nausea, vomiting, and diarrhea • STEMI
• Hyperkalemia o Increased Trop I
• Insomnia o Nitroglycerin
o Morphine Thrombolytics
• Could exacerbate non-productive cough
o Beta-blockers “olol”
• Angioedema
o ACE inhibitor
o Antidote: Aminocaproic Acid
NURSING CONSIDERATIONS
• Monitor electrolytes
• Elderly are at highest risk for postural
• NSTEMI
hypotension
o Aspirin 325mg
• Do not discontinue medication because o Clopidogrel 300mg
rebound hypotension can occur o Anticoagulant (Enoxaparin SQ)
• Monitor blood pressure frequently
• If patient has renal dysfunction, you have to SIDE-EFFECTS
be cautious if they will be using these drugs • Headache. Blurred vision, dry mouth
• Postural hypotension

Hanna Jeuline DR. Palapal, RN 2024 2

 NURSING ASSESSMENT PROGRAM
PHARMACOLOGY

COLLEGE OF NURSING AND ALLIED MEDICAL SCIENCES

1st SEMESTER A.Y. 2023 – 2024

• Syncope • Rotate injection site

• Reflex tachycardia • Minimize venipuncture and injections, apply
pressure
NURSING CONSIDERATIONS • Heparin is given initially then warfarin as
• Let them know the purpose maintenance
• Limit alcohol intake • Caution the patient not to increase dietary
• Report if side effects are present Vitamin K intake
• Topical application is used for sustained
protection against angina attacks SIGNS OF BLEEDING
o Avoid skin contact with topical • Bruises, ecchymosis
• Hypo-Tachy-Tachy
Dark amber container • Low RBC and hemoglobin
Change every 6 months
Moist = Discard • Inform dentist or practitioner before
undergoing treatment
Transdermal: 12 hours interval to prevent • Assess for bleeding
tolerance • Monitor for hemoglobin, clotting time, and
platelet
ANTICOAGULANTS o Normal clotting time (8-15 mins)
Blood thinners • Use soft bristle toothbrush and electric razor
EXAMPLES ANTIPLATELET DRUGS
• IV Forms – Heparin (Check PTT) • Inhibits the aggregation(formation) of platelet
• SQ – Enoxaparin (Check for signs of in the clotting process and prevent thrombus
bleeding) formation
• Oral – Warfarin (Check PT) • Given with food
• Phytonadione – for blood clotting caused by • Used to treat:
Vitamin K o Cerebrovascular accident
o Vitamin K Health Ed: Avoid green o MI
leafy vegetables o Rheumatic heart disease
o Pericarditis
INDICATIONS o Pulmonary embolism
• Treat or prevent thrombolytic disorders o DVT
o DVT
o Pulmonary embolism EXAMPLES
o Atrial fibrillation with emboli • Aspirin
• Clopidogrel
Normal PT (10-14 seconds) • Pentoxifylline
Normal aPTT (20-36 seconds) • Cilostazol
Normal INR (2.0-3.0 seconds)
• Ticlopidine
CONTRAINDICATIONS
• Underlying coagulation disorders
• Recent surgery SIDE-EFFECTS
• Cancer • Bruising
• Thrombocytopenia (low platelet count) • Hematuria
Normal Platelet (150,000-450,000) • GI bleeding
Thrombocytosis (>450,000)
• Melena
ADVERSE EFFECTS
CONTRAINDICATIONS
• Pain at injection site
• Peptic ulcer
• Thrombocytopenia
• Bleeding
• Hemorrhage
DIURETICS
NURSING RESPONSIBILITES 1. Loop Diuretics
• Do not give heparin via IM • Ends in suffix “-semide”
• Do not aspirate or rub injection site

Hanna Jeuline DR. Palapal, RN 2024 3

 NURSING ASSESSMENT PROGRAM
PHARMACOLOGY

COLLEGE OF NURSING AND ALLIED MEDICAL SCIENCES

1st SEMESTER A.Y. 2023 – 2024

• Potassium wasting diuretics

2. Thiazide diuretics
• “-thiazide”
• Used for normal renal function

3. Osmotic Diuretics
• Mannitol
• Prolonged use: metabolic acidosis

4. Carbonic Anhydrase Inhibitor

• Acetazolamide

5. Potassium Sparing Diuretics

• Spironolactone

Hypokalemia – Presence of U-wave

Increase potassium chloride

Hanna Jeuline DR. Palapal, RN 2024 4