Drug Safety & Monitoring
Patient with worse AE
Adult aged 65 and over are at increased risk of AE; Multiple health conditions leading to polypharmacy and risk of drug-drug interactions.
Nonselective agonist drug
Epinephrine (stimulates alpha and both beta receptors)
Bethanechol contraindication
Obstruction urinary retention
Parkinson’s Disease – why Levodopa and Carbidopa
Carbidopa prevents the loss of Levodopa in the periphery
Adverse effects of strong opioids
Respiratory depression = DEATH
Narrow therapeutic range
Margin between an amount that drug level is toxic and amount that the drug is effective
Nonspecific beta agonist – SE
Asthma attack, angina, tachyarrythmias, anxiety, tremors
Bronchoconstriction, tachycardia, palpitations, tremors, arrhythmias, hyperglycemia
Patient forgetful with Overactive bladder – best form of medication
Bethanechol transdermal patch, change weekly
Medication added to Levodopa/Carbidopa for Potentiative effects
Entacapone
Performing an excellent pain assessment
OPQRSTU or COLDSPA
The patient is immune to medication
Build tolerance
Anticholinergic SE
Dry mouth, blurred vision, urinary retention, constipation, confusion, tachycardia
Use of Atropine for eye exam
Paralyzes the iris sphincter
MOA of Donepezil for Alzheimer’s Disease
Increase ACH by inhibiting cholinesterase
Non-pharmacological treatments for pain
Physical therapy, massage, biofeedback, hot or cold packs, meditation or prayer
Indication for Narcan
Used for opioid overdose (respiratory depression, decreased LOC, DEATH)
Antidote for Atropine
Physotigmine; antilibrium
Muscarinic antagonist toxicity
Severe hypotension/HR
1st-line drug for status epilepticus
1st Lorazepam
Adult maximum dosage of acetaminophen
4000mg adult; 2000mg elderly
Pros of enteral medications
Safer, more physiological, convenient and less costly.
Potentiative effects
When a patient is taking two medications, one drug may intensify
Benztropine contraindication
Don’t use with glaucoma or urinary retention
2nd-line drug for status epilepticus
2nd Diazepam