Summary NUR 2407L - Exam 2 Study Guide.

Pharmacology Exam #2

[Unit 7: Pain and Inflammation Management Drugs]

 Nonsteroidal Antiinflammatory Drugs (NSAIDS):
o Aspirin (ASA)- (Salicylates)
 used to reduce pain and inflammation symptoms, decreased fever, and inhibit platelet
aggregation; for osteoarthritis and rheumatoid arthritis
 Side Effects:
 Dizziness
 Drowsiness
 loss of appetite (anorexia)
 nausea and vomiting
 diarrhea
 heartburn
 abdominal pain
 rash

 Adverse Reactions:
 Tinnitus
 hearing loss
 G.I. ulceration and bleeding
 Life Threatening:
 hemolytic anemia
 bronchospasm
 anaphylaxis
 hepatotoxicity
 Drug Interaction:
 increased risk of bleeding with anticoagulants and other NSAIDs
 increased risk of hypoglycemia with oral hypoglycemic drugs
 effects are decreased by corticosteroids
 increased ulcerogenecid effect with glucocorticoids
 Contraindications:
 hypersensitivity to salicylates or NSAIDs
 flu or virus symptoms in children
 G.I. bleeding
 Caution: renal or hepatic disorders, gout, alcoholism, anticoagulant therapy, G.I.
bleeding, bone marrow suppression, head trauma, immunosuppression, pregnancy.
 Anemia
 Measles
 Chicken Pox
 Reye Syndrome
 Decreased prothrombin levels (clotting factor)
 Salicylate Poisoning:
 tinnitus (ringing in ears)
 elevated temperature
 nausea and vomiting
 dehydration/disorientation
 hyperventilation
 severe toxicity –
o metabolic acidosis

, o seizures
 severe toxicity occurs with 300 to 500 mg/kg acute ingestion of aspirin

 Steroids:
o reverse inflammation systemic in a profound way
o They suppress the anti-inflammatory response of the body (Increased risk of infection)
o NSAIDs reverse inflammation (and related pain) in a more limited way (not steroid)
o steroids may treat diarrhea caused by ulcerative colitis
o Take in the morning (AM) with food
o What is the role for steroids in the treatment of anaphylaxis?
 Dilate airways to assist with breathing and also decrease inflammation
o Side Effects and Adverse Reactions-
 Increased risk of Infection
 Hyperglycemia (high blood sugar)
 Hypertension (High BP)
 Hypokalemia
 sodium retention
 Puffy face (moon face)
 edema (slow weight gain not rapid-often fluid retention)
 Increased bleeding risk
 gastric erosion
 poor wound healing
 Addison’s disease:
 Occurs when the adrenal glands do not produce enough cortisol and often insufficient
levels of aldosterone. It can because by prolonged use of steroids
 another common cause of secondary adrenal insufficiency occurs when people who take
corticosteroids for treatment of chronic conditions, such as asthma or arthritis, abruptly
stopped taking their corticosteroids
o Drug Interactions-
 Avoid caffeine
 Do not take with NSAIDS
 Increased risk of bleeding and gastric ulcers
o Nursing Priorities-
 Take with food
 Take in morning (insomnia)
 What does a fever indicate?
 Infection (due to immunodepression)
 Very sick take seriously
 Gradually discontinue dose

 Corticosteroids:
o Use- treatment of adrenocortical deficiency, other endocrine disorders, allergic states, collagen diseases,
dermatological diseases, G.I. disorders, hematological disorders, respiratory disease, rheumatoid
disorders.
o Side Effects and Adverse Reactions-
 Seizures
 edema due to sodium retention
 hypertension
 poor wound healing
 moon face
 hyperglycemia

,  G.I. perforation
 pancreatitis
o Contraindications-
 live viral vaccines
 immunosuppressive drugs
 use can exacerbate fungal infections
 PO use can induce peptic ulcers and should be given with meals/antacids
 long-term use can result in osteoporosis, related fractures, tendon ruptures
 use can increase blood pressure, water retention, potassium excretion
o Drug Interactions-
 use with aspirin, NSAIDs produces additive effects
 antidiabetic drugs may require increase in dosage
 use with toxoid/vaccines decreased their antibody formation
o Prednisone/Hydrocortisone (Short-acting corticosteroids)
 Use: used in a variety of chronic illnesses, including inflammatory, allergic, hematologic,
neoplastic, and autoimmune diseases
 Side Effects and Adverse Reactions:
 Hypertension
 hyperglycemia
 fluid retention (long-term high dosages)
 hypokalemia
 peptic ulceration
 anorexia
 Cushingoid appearance (moon face, buffalo hump)
 increased susceptibility for infection
 weight gain (often fluid retention)
 Contraindications:
 active untreated infections
 administration of live virus vaccines
 May mask signs of potential infection
 Nursing Priorities:
 administer PO with food
 avoid administration at bedtime (insomnia)
 avoid exposure to infection
 Sudden withdrawal can be deadly do not take with aspirin or other NSAIDs




[Unit 8: Antimicrobial Drugs]

Antibiotics (Fights Infection)-

 Antibacterals/Antibiotics:
o Antibacterial/Antimicrobial- Substances that inhibit bacterial growth or kill bacteria and other
microorganisms.
o Antibiotic-