NURS 180 PHARM MIDTERM STUDY GUIDE WEEK 5.

NURS 180 PHARM MIDTERM STUDY GUIDE WEEK 5.Prototype Drugs to know (Focus on indications, adverse effects, contraindications, BBW, and patient teaching) Omeprazole (Prilosec) Omeprazole (Prilosec) – Prototype Drug – prazole – indication of drug class for PPIs • Therapeutic class: antiulcer agent • Pharmacological class: PPI o Used at higher doses for longer periods of time for patients with Zollinger-Ellison syndrome • Weight loss or difficulty swallowing should be reported as these may indicate gastric cancer • Omeprazole o Decreases the effects of antiseizure drugs and CNS depressants causing sedation o Can increase bleeding if combined with warfarin and alcohol Decreases effect of anticoagulant clopifogrel (Plavix) and increase for MI and stroke o Gingko and St. John’s Wort can decrease effectiveness of this med o Available OTC but need prescription for higher doses IV administration for active bleeding ulcer – photonics Psyllium mucilloid (Metamucil) • Psyllium mucilloid (Metamucil) – Prototype Drug o Therapeutic classification: Laxative o Pharmacologic Classification: Bulk-type laxative o Contains psyllium an insoluble fiber that is not absorbed by the GI tract o Psyllium mucilloid decreases the absorption of warfarin, digoxin, antibiotics, and apsrin Diphenoxylate with atropine (Lomotil) • Diphenoxylate with atropine - (anticholinergic) SNS stimulation slowing down peristalsis – causing constipation (Lomotil) – Prototype Drug o Therapeutic Classification: Antidiarrheal o Pharmacological Classification: Opioid (schedule V (5)) o Monitor ▪ Dehydration, dry mouth, dizziness, drowsiness, or tachycardia ▪ Not safe for pediatric and those with liver disease ▪ Combined with CNS depressants and alcohol, diphenoxylate with atropine can increase sedation ▪ Antidote: naloxone (Narcan) ▪ Do not give opioids with those with liver damaged Sulfasalazine (Azulfidine) • Sulfasalazine (Azulfidine) – Prototype Drug – contains sulfa (cannot take if allergic to sulfa) o Therapeutic Classification: Anti- inflammatory o Pharmacological Classification: 5-ASA, disease modifying anti pneumatic drug (DMARD) o given to patients 6 and up o patients with urinary obstruction should not take sulfasalazine since it increases risk for urinary crystalluria (crystals in the urine) and renal failure o avoid patients with liver failure o can interfere with iron and folic acid (vitamin C) absorption Prochlorperazine (Compazine) • Prochlorperazine (Compazine) – Prototype Drug - Severe cases o Therapeutic Classification: antiemetic (vomit) o Pharmacological Classification: Phenothiazine antipsychotic, Dopamine antagonist (anti-psychotic – could cause Parkinson’s) o Given rectally for faster absorption o Side effects ▪ Anticholinergic effects - deceases peristalsis/gastric acid production o High doses for extended amount of time causes adverse effects such as extrapyramidal symptoms (EPS) can occur and become permanent o Black Box Warning – increased risk of death when used in older adults with dementia