Title: Microsoft Word - Unit 2 Table Winter 2025 - completed
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# Unit 2
Pharmacologic Drug Class Action Drug Examples Indication
(Areas of Use)
Adverse
Reactions Side Effects Nursing Implications &
Patient Education
# Benzodiazepine
## Review Nursing
## Process on
## pg. 210-211 &
## Prototype on pg. 210
Increase the action of the
inhibitory neurotransmitter
gamma-aminobutyric acid
(GABA) to the GABA
receptors.
Neuron excitability is
reduced.
CNS Depression
Lorazepam
Diazepam
Alprazolam
Midazolam
Anxiety/Seizures/Substance
abuse withdrawal (ETOH)
PO/IV/IM
Acute seizures (status
epilepticus) PO/PR
Anxiety - PO
Conscious Sedation for
minor procedures - IV
Hypotension
Respiratory depression
Dependency
Seizures
Depression
Drowsiness
Decreased VS
Dizziness
Memory
Impairment
Blurred Vision
Headache
Close monitoring of V/S, Resp. Status, and LOC
Complete drug history both prescribed and
OTC/herbal (page 211); Safety Precautions
Cautions/Contraindications :
Older adults; Patients with renal impairment;
Patients on other CNS depressants; Pregnant women
Patients with sleep apnea; respiratory depression,
hypotension, alcohol intoxication, or sedation;
Depression.
Patient Teaching (Pages 210-211) :
Change positions slowly. Safety precautions. No
driving. Avoid ETOH or other CNS depressants
(OTC herbs or medications). Report a decrease in
blood pressure, or excessive dizziness and
drowsiness. Report any plans for pregnancy or if
you become pregnant. Do not discontinue
abruptly/taper if coming off. Not indicated for long-
term use.
## Non-Benzodiazepine
## Review Prototype on
## pg. 212 & Nursing
## Process on
## pg. 212-213
CNS depression,
neurotransmitter inhibition
CNS Depression
Zolpidem
Tartrate Insomnia
Physiological
dependency
Vivid
Dreams/Nightmares
Respiratory Depression
Drowsiness/
Hangover
Dizziness
Memory
impairment
Complex Sleep
Behaviors/Amnesia
Cautions/Contraindications:
Renal impairment; Liver impairment;
Benzodiazepine allergy; Pregnant women women
in general; Safety precautions.
Older adults; Children; Patients with depression
Patient Teaching (Page 213):
Avoid ETOH or other CNS depressants. Educated
RE complex sleep behavior instruct family to
monitor. Administer at bedtime ensure you allow
6-8 hrs. for sleep. If taking for a long period of time
do not discontinue abruptly. Encourage sleep
hygiene no caffeine, limiting screentime, avoiding
stimulating activities, develop a sleep routine. Do
not take more than more than prescribed. Indicated
for short-term use only (<10 days).
Safety precautions.
# Local Anesthetics
## Review Nursing
## Process on pg. 217
Local anesthetics block pain
at the site where the drug is
administered by preventing
conduction of nerve impulses.
Blocks Pain Sensations
Lidocaine
Hydrochloride
Topical Anesthesia,
infiltrate or nerve block Local skin reactions Prolonged loss of
sensation
Monitor for loss of sensation.
Assess for tissue damage if immobile.
Patient Teaching : May feel numb.
Remove patch after 12 hours.
# Spinal Anesthesia
## Review Nursing
## Process on pg. 217
Local anesthetics block pain
at the site where the drug is
administered by preventing
conduction of nerve impulses.
CNS Depression
Lidocaine
Hydrochloride
Epidural, and spinal
anesthesia
Hypotension
Respiratory
Depression
(Spinal & Epidural)
Headache
(Spinal & Epidural)
Anticipate loss of sensation.
Monitor vital signs , urine output and LOC
Caution : Narcotic Administration or other
CNS Depressants Pharmacologic Drug Class Action Drug Examples Indication
(Areas of Use)
Adverse
Reactions Side Effects Nursing Implications &
Patient Education
# NSAID
## Review Prototype on
## pg. 286 & Nursing
## Process on pg. 287
COX-1:
Stops bleeding
Protects Stomach
COX-2:
Causes pain and inflammation
(vasodilation )
Inhibit or block both
COX-1 and COX-2.
Ibuprofen
(non-selective)
Anti-inflammatory
Fever Reduction
Pain Control
Tinnitus
Bleeding GI/Ulcers
Anemia
Anaphylaxis
Renal Failure
GI Upset
Dizziness
Bruising
Peripheral Edema
> Monitor vital signs and for signs of bleeding.
> Monitor H/H.
> Complete drug history both prescribed and OTC/herbal.
> Pain assessment.
> Cautions/Contraindications:
> Bleeding disorders, peptic ulcer disease;
> Hepatic or Renal Impairment; Pregnancy
> Asthma; Patients on anticoagulant therapy; 5Gs
> Patient Teaching (Page 287):
> Take w/food to decrease GI upset. Avoid 5Gs; ASA; Anticoagulants.
> Report s/s of GI bleeding tarry stools, coffee-ground emesis, severe GI
> pain. Report bleeding gums, excessive bruising, frequent nose bleeds,
> hematuria. Bleeding prevention soft toothbrush; electric razor. No
> ETOH. Avoid with hx of GI bleed. Report edema elevate legs or use
> compression stocking to prevent. Do not take if pregnant. Avoid during
> menstruation to minimize excessive bleeding. Notify provider prior to
> surgery. Increase fluid intake. Do not take if you have kidney failure.
# NSAID
## Review Prototype
## pg. 288
COX-2:
Causes pain and
inflammation
(vasodilation )
Inhibits COX-2 only
(Vasoconstriction)
Celecoxib
(selective)
Used to treat
Osteoarthritis,
Rheumatoid, Moderate
to severe pain
Bleeding
Hypertension
Stroke/MI
Nephrotoxicity
Headache
Dizziness
GI Upset
Peripheral Edema
Monitor vital signs
Cautions/Contraindications:
Patients with chronic hepatic or renal impairment;
Patients with cardiac history;
Patients on anticoagulant therapy
Patient Teaching : Report edema and BP
monitoring.
# Salicylates
## Review Prototype on
## pg. 284 & Nursing
## process on
## pg. 285
Inhibits prostaglandin
synthesis, hypothalamic
heat regulator center, and
platelet aggregation
Decreases inflammation,
fevers, pain, and blood
clotting.
Aspirin
Pain Relief
Fever Reduction
Block Inflammation
Antiplatelet
Bleeding
Hearing loss
Tinnitus
GI ulceration
Reyes Syndrome
(children)
Bruising
GI Upset
Drowsiness
Headache
Monitor for bleeding and salicylism
Cautions/Contraindications:
Patients on antiplatelet or anticoagulant therapy; 5Gs,
Children under the age of 16
(Do not give for fever reduction) Reyes Syndrome ;
Pregnant women (last trimester); Bleeding disorders.
Patient Teaching (Page 285) :
Report ringing in the ears s/s salicylism. Bleeding
prevention. s/s of GI bleeding or excessive bleeding.
Avoiding 5 Gs. Stop prior to surgery. Avoid if taking
anticoagulants. Do not combine w/NSAIDs read OTC
labels. Avoid during pregnancy and menstruation. Do not
give to children.
# Anti-Gout
## Review Nursing
## Process on pg. 293
Increases uric acid
excretion in the urine and
block uric acid production
Prevents uric acid crystal
formation in the joints.
Allopurinol Prophylactic treatment
of gout & hyperuricemia
Elevated liver enzymes
Elevated BUN and
Creatinine
Stevens-Johnsons
Syndrome (SJS)
GI Upset
ABD Discomfort
Monitor patients with renal disease, and hepatic disorder.
Uric Acid levels . Pain assessment .
(Monitor ALT, AST, Liver enzymes, BUN/Crt & UOP)
Patient Teaching (Page 293):
Educate RE dietary restriction (avoid purines shellfish,
organ meats, ETOH, etc.). Increase fluid intake. Take w/food
to decrease GI upset. Take daily as prescribed (lifetime
therapy). s/s kidney failure decreasing UOP. s/s liver
failure jaundice, itchy skin or rash, ABD pain and
tenderness. Report skin changes. Yearly eye exams vision
changes.
# Non-Opioid
## Analgesic
## Review Prototype on
## pg. 298 & Nursing
## Process pg. 299
Weakly inhibits
prostaglandin synthesis,
which decreases pain
sensation. No impact on
inflammation or
coagulation.
Decreases temperature
and pain.
Acetaminophen Used to treat pain and
fever.
Oliguria
Elevated Liver
Enzymes
Hepatotoxicity
N/V
Monitor for s/s liver failure, LFTs, & dosing.
Cautions/Contraindications:
Patients with liver disease; a history of alcoholism;
Patients with renal impairment
When acetaminophen toxicity occurs:
Acetylcysteine is the antidote .
Patient Teaching (Page 299):
Dosing guidelines 4 grams /day if healthy; 2
grams /day if frail, elderly or taking numerous others .
Avoid ETOH. Read labels of OTC meds . Notify the
prescriber if pain persists for longer than 10 days. s/s
of hepatotoxicity See above . Report changes in
UOP. Pharmacologic Drug Class Action Drug Examples Indication
(Areas of Use)
Adverse
Reactions Side Effects Nursing Implications &
Patient Education
# Opioids
## Review Prototype on
## pg. 301 & Nursing
## process pg. 302
Depression of the CNS;
depression of pain
impulses by binding with
opiate receptors in the
CNS
CNS Depression
Morphine Used to treat moderate
to severe pain
Hypotension
Respiratory depression
Dependency
Hypotension
Decreased RR
Drowsiness
Dizziness
Sedation
GI Upset
Constipation
Blurred Vision
Confusion
Urinary Retention
Pruritis
Monitor for tolerance vs dependence. Pupil changes.
Close monitoring of Respiratory Status and vitals
and LOC ; Monitoring GI and GU Function (UOP);
Pain assessment timing; PCA Management;
Naloxone Availability
Safety Precautions
Cautions/Contraindications:
Patients with CNS depression Increased ICP;
Elderly Confusion and sedation;
Respiratory depression, sleep apnea and renal or
hepatic impairment; Breastfeeding and pregnancy
Patient Teaching (Page 302) :
Constipation management increase fluids, stool
softener. Do driving. Do not combine with ETOH or
other CNS depressants. Educate RE need to take
prior to the pain becoming severe. Educate on risks
with long-term use: tolerance, addiction, bowel
changes or urinary pattern changes. Report changes
in breathing and blurred vision. Do not discontinue
abruptly. Take w/food to decrease GI upset. Non-
pharmacological strategies for pain management.
Monitor BP. Change positions slowly.
Do not take if pregnant or breastfeeding .
# Opioid
# Antagonist
## Pg. 306
Displaces opioids from
receptor sites.
Reverses the effects of
opioids.
Naloxone Used to treat opioid
overdose or reverse
opioid depression.
Tachycardia
Hypertension
Bleeding
GI Upset
Return of Pain
**Available via multiple routes**
Monitor for bleeding, the return of pain, and
withdrawal symptoms. Monitor for narcotic
abstinence syndrome : HTN; Tachycardia;
Increased Pain. Consider the need for
redosing.
***Naloxone is the antidote for opioid
overdose***
Patient Teaching: Anticipate the return of
pain. Nonpharmacologic pain management.
# Anti-migraine
## 5-HT receptor
## Agonist
## Review Prototype
## pg. 309
Causes vasoconstriction of
cranial arteries to relieve
migraine attacks.
Promotes vessel
constriction.
Sumatriptan Used to treat migraines
or cluster headaches
BP Changes
Bradycardia
Elevated hepatic
enzymes,
Thromboembolism,
Seizures; CVA; MI
Hearing Loss
N/V
Flushing
Drowsiness
Dizziness
Paresthesia
Fatigue
Monitor Vitals and s/s migraines; Complete
medication history and medical exam prior to
prescribing.
Cautions:
Hypersensitivity, CAD, peripheral vascular disease,
hypertension, cerebrovascular disease; Renal or
hepatic dysfunction, obesity, DM, smoking ,
seizures, older adults
Interactions: St. Johns Wort and SSRI
Patient Teaching :
Take at the first sign of a migraine or when you
develop an aura (sensitivity to light or sound, GI
upset). Monitor BP and HR. Keep migraine diary.
Avoid triggers caffeine, dehydration, bright lights,
strong smells; STRESS; lack of sleep , specific
foods, skipping meals, etc. Report increasing need
for use. Report changes in hearing.