Ace Your Pharmacology and the Nursing Process, 9th Ed., Lilley, Rainforth Collins & Snyder, 2019 Classes and Exams with Picmonic: #1 Visual Mnemonic Study Tool for Nursing (RN) Students

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Pharmacology and the Nursing Process, 9th Ed., Lilley, Rainforth Collins & Snyder, 2019 Nursing (RN) School Study Aid


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2 - Pharmacologic Principles
54 Picmonics to Learn | 1 hr 21 mins

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Routes of Administration Part One
Enteral Administration
Oral
Sublingual
Buccal
Rectal
Tubes
Topical or Mucous Membrane Administration
Transdermal
Drops/Spray
Vaginal
Inhalation Administration
Inhalation
1 min
Alendronate (Fosamax)
Mechanism
Inhibits Osteoclasts
Indications
Osteoporosis
Paget's Disease
Side Effects
Esophageal Ulcers
Musculoskeletal Pain
Vision Changes
Atrial Fibrillation
Osteonecrosis of the Jaw
Considerations
Take on Empty Stomach
Remain Upright
1 min
Carbamazepine (Tegretol)
Mechanism
Inactivates Na+ Channels
Indications
Seizures
Bipolar Disorder
Trigeminal Neuralgia
Side Effects
Nystagmus
Ataxia
Hepatotoxicity
Blood Dyscrasias
Water Retention
Stevens-Johnson Syndrome
Considerations
Avoid Grapefruit Juice
1 min
Iron (Ferrous Sulfate)
Mechanism
Ferrous Salts
Indications
Anemia
Side Effects
GI Distress
Nausea and Vomiting
Dark Stools
Considerations
Take with Food
Liquid can Stain Teeth
Keep out of Reach from Children
Caution with GI Disorders
Avoid Antacids
2 mins
Hydralazine (Apresoline)
Indications
Severe Hypertension
CHF
Reduced Afterload
Pregnancy
Mechanism of Action
Vasodilates Arterioles
Side Effects
Drug-induced Lupus
Reflex Tachycardia
Hypotension
Considerations
Combined with Diuretic and Beta Blocker
1 min
Spironolactone (Aldactone)
Mechanisms
Inhibition of Aldosterone
Potassium Retention
Indications
Hypertension
Edema
Heart Failure
Side Effects
Hyperkalemia
Endocrine Effects
Consideration
Avoid Potassium Supplements
1 min
Lithium
Mechanism of Action
Mood Stabilizer
Unknown Mechanism
Indications
Bipolar Disorder
Side Effects
Nephrogenic Diabetes Insipidus
Hypothyroidism
Tremor
Heart Block
Contraindication
Pregnancy
Considerations
Monitor Plasma Levels
1 min
NSAIDs
Indications
Anti-inflammatory
Analgesic
Fever
Closure of PDA
Mechanism of Action
Reversible Inhibition of COX-1 and COX-2
Block Prostaglandin Synthesis
Side Effects
Interstitial Nephritis
Gastric Ulcer
Renal Ischemia
1 min
Theophylline (Theo-24)
Mechanism
Bronchial Smooth Muscle Relaxation
Indications
Asthma
Side Effects
Insomnia
Restlessness
Arrhythmias
Seizures
Considerations
Narrow Therapeutic Range
Monitor Plasma Levels
1 min
Macrolides
End in "-thromycin"
Mechanism of Action
Bacteriostatic
Indications
Alternative for Penicillin Allergy
Respiratory Infections
Pneumonia
Side Effects
QT Prolongation and Sudden Death
C.Diff Overgrowth
GI Distress
Considerations
Slow IV Infusion
1 min
Routes of Administration Part Two (Parenteral)
Parenteral Administration
Intradermal
Subcutaneous
Intramuscular (IM)
Intravenous
Epidural
Intrathecal
Intraosseous
Intraperitoneal
1 min
Transdermal Medication Administration
Application
Patch or Disc
Directly on Skin of Arms, Chest, Upper Back
Benefits
Avoids First Pass Metabolism
Sustained Administration of Medication
Nursing Considerations
Clean Skin After Removal
Rotate Sites of Patches
Apply to Dry Skin
Avoid Shaved Skin
Avoid Heat
Nitro Effects Lost After 24 Hours
1 min
Needle Sizes and Uses
Adjust Size Based on Height/Weight
Subcutaneous Injections
3/8 or 5/8 inch
Intramuscular (IM)
1-1.5 inches
1 min
Intramuscular Medication (IM) Administration
Risks
Injury to Nerves, Bone, and Blood Vessels
Sites
Deltoid
Vastus Lateralis
Ventrogluteal
Nursing Considerations
Selection of Needle Length
Aseptic Technique for Drawing Up
Z-Track
90 Degree Angle
Max Amount (2-5 mL Adult, 1 mL Child)
Techniques to Reduce Pain
2 mins
Acetaminophen
Indications
Fever
Pain
Mechanism of Action
Reversibly inhibits COX
Acts primarily in CNS
Side Effect
Hepatic Necrosis
N-acetylcysteine Antidote
51 secs
Warfarin (Coumadin)
Mechanism of Action
Inhibits Clotting Factors
Indications
Atrial Fibrillation
Venous Thrombosis
Pulmonary Embolism
Assessment
PT/INR Levels
Observe for Bleeding
Contraindications
Pregnancy
Nursing Considerations
Vitamin K and Fresh Frozen Plasma
Prolonged Therapeutic Onset
Maintain Same Diet
1 min
Ibuprofen (Advil, Motrin)
Mechanisms
NSAID
COX Inhibitor
Indications
General Pain
Fever
Inflammatory Conditions
Side Effects
GI Ulcers
Nephrotoxicity
Rash
Considerations
Avoid with Alcohol
Risk of Thrombotic Event
1 min
Phenytoin (Dilantin)
Mechanism
Blocks Na+ Channels
Indications
Tonic-clonic Seizures
Side Effects
Ataxia
Nystagmus
Sedation
Gingival Hyperplasia
Purple Glove Syndrome
Hirsutism
Rash
Anemia
Considerations
Individualized Dosing
1 min
Diazepam (Valium)
Indications
Anxiety
Seizures and Status Epilepticus
Muscle Spasms
Alcohol Withdrawal
Side Effect/Assessment
Dizziness/Vision Changes
Confusion/Amnesia
Urinary Incontinence
Behavioral Changes
Respiratory Depression
Antidote
Flumazenil (Romazicon)
Nursing Considerations
Fall Precaution
Do Not Stop Abruptly
1 min
Omeprazole (Prilosec)
"-prazole" Suffix
Indications
Zollinger-Ellison Syndrome
Gastritis
Peptic Ulcer
Gastroesophageal Reflux Disease (GERD)
Mechanism
Proton Pump Inhibitor (PPI)
Inhibit H+/K+/ATPase
Side Effects
Hip Fracture
Pneumonia
1 min
Codeine
Mechanism
Opioid Receptor Agonist
Indications
Mild to Moderate Pain
Cough Suppressant
Side Effects
Sedation
Constipation
Miosis
Considerations
Close Monitoring When Breast Feeding
Often Combined with Non-Opioids
1 min
Fluoxetine (Prozac)
Mechanism of Action
Inhibits Reuptake of Serotonin
Indications
Depression
Side Effects
Sexual Dysfunction
CNS Stimulation
Weight Gain
Serotonin Syndrome
Contraindications
No MAO-Is
No Anticoagulants / Antiplatelets
Considerations
Suicide Risk
Delayed Onset of Action
1 min
Calcium Channel Blockers (Verapamil and Diltiazem)
Mechanism of Action
Slows AV Conduction
Indications
Angina Pectoris
Essential Hypertension
Arrhythmias
Side Effects
Bradycardia
Hypotension
Constipation
Peripheral Edema
Gingival Hyperplasia
Nursing Consideration
Medication Education
1 min
Cyclosporine (Sandimmune) Overview
Mechanism
Immunosuppressant
Inhibits Calcineurin, Decreasing IL-2
Indications
Prevent Transplant Rejection
Psoriasis
Rheumatoid Arthritis
Considerations
Monitor Plasma Levels
Avoid Grapefruit Juice
Increased Risk of Lymphoma
1 min
Lidocaine
Mechanism
Blocks Na+ Channels
Indications
Ventricular Arrhythmia
Anesthetic
Side Effects
Paresthesias
Seizures
Respiratory Depression
Drowsiness
Consideration
Anesthetic Effects Extended with Epinephrine
1 min
Phenobarbital (Barbiturates)
Mechanism
Barbiturate
Indications
Seizures
Side Effects
Ataxia
Paradoxical Excitement
Fatigue/Drowsiness
Considerations
Monitor Plasma Levels
High Potential for Abuse
1 min
Azoles (Ketoconazole)
"-azole" suffix
Indications
Local and Less Serious Systemic Mycosis
Mechanism
Inhibits Ergosterol Synthesis
Inhibits P450
Side Effects
Liver Dysfunction
Inhibition of Testosterone Synthesis
1 min
Renal Corpuscle
Characteristics
Arterioles
Glomerulus
Capillaries
Fenestrations
Plasma Solutes and Other Small Molecules Become Ultrafiltrate
Bowman's Capsule Encapsulates Glomerulus
1 min
Proximal Tubule
Characteristics
Na+ Reabsorbed Via Active Transport
Water Follows Na+
Most Of Glucose Reabsorbed
Most Of Amino Acids Reabsorbed
Bicarbonate Exchanged For H+
Drugs and Toxins Excreted
Filtrate Osmolarity Same As Plasma
Leads To Loop Of Henle
1 min
Loop of Henle
Characteristics
Descending Limb
Water Follows Na+
Medullary Hypertonicity
Increased Water Reabsorption
Vasa Recta
Na+ Reabsorbed Via Active Transport
Ascending Limb
Reabsorbs Na+, K+, Cl-
Decreased Concentration of Filtrate
Impermeable to Water
Distal Tubule
2 mins
Distal Tubule
Characteristics
Hormonally Regulated
Aldosterone Causes Na+ Reabsorption
Na+ Reabsorbed Via Active Transport
Water follows Na+
Parathyroid Hormone Causes Ca2+ Reabsorption
Leads to Collecting Duct
1 min
Collecting Duct
Characteristics
Na+ Reabsorption via Passive Transport
Vasopressin Causes Water reabsorption
Concentrates Filtrate
1 min
Peak and Trough
Peak
Highest Concentration
Trough
Lowest Level of Therapeutic Range
Obtain Before Next Dose
Half-Life
1 min
Benzodiazepine Intoxication Assessment
Drowsiness
Confusion
Respiratory Depression
Hypotension
Coma
Treatment
Flumazenil (Romazicon)
1 min
Fluoroquinolones
End in "-floxacin"
Mechanism of Action
Bactericidal
Indications
Variety of Infections
Side Effects
GI Distress
Photosensitivity
Achilles Tendon Rupture
Contraindications
Pregnancy
Children
Myasthenia Gravis
Considerations
Avoid Milk Products or Antacids
Slow IV Infusion
1 min
Tetracyclines Overview
End in "-cycline"
Mechanism of Action
Bacteriostatic
Indications
Infectious Diseases
Acne
Periodontal Disease
Nursing Considerations
Avoid Milk, Antacids, Iron
Sunlight Protection
1 min
Buspirone (Buspar)
Mechanism
Increases Serotonin
Indications
Anxiety
Side Effects
Dizziness
Insomnia
Considerations
Delayed Effect
No Alcohol Interaction
No CNS Effects
Low Abuse Potential
1 min
Tacrolimus (Prograf) Overview
Mechanisms
Immunosuppressant
Inhibits Calcineurin, Decreasing IL-2
Indications
Transplant Rejection
Atopic Dermatitis
Considerations
Increased Lymphoma Risk
Avoid Grapefruit Juice
1 min
Statins
Rhabdomyolysis
Hepatotoxicity
HMG-CoA reductase inhibitors
Decrease LDL
Decrease Triglycerides
Increase HDL
1 min
Atorvastatin (Lipitor)
-statin suffix
Mechanism
HMG-CoA Reductase Inhibitors
Indications
High Cholesterol
Side Effects
Hepatotoxicity
Rash
Rhabdomyolysis
Myopathy
Considerations
Monitor Liver Enzymes
Administer at Bedtime
Avoid Grapefruit
2 mins
Hypersensitivity Type I
Previous Antigen Exposure
Immediate Reaction
IgE Cross-linking
Presensitized Mast Cells
Histamine Release
Vasodilation
Anaphylaxis
Allergies
Treatment
Epinephrine
1 min
Humoral Adaptive Immunity
Characteristics
B Cell Binds Free Floating Antigen
B Cell Presents Antigen to Helper T Cell
Helper T Cells Help B Cells Develop Antigen Specificity
Plasma B Cells Secrete Antibodies
Memory B Cells Cause Faster Secondary Response
1 min
Acetaminophen Antidote
Antidote
N-Acetylcysteine
33 secs
Atropine
Mechanism of Action
Muscarinic Antagonist
Indications
Bradycardia
Increased Exocrine Secretions
Smooth Muscle Spasms
Side Effects
Tachycardia
Dry Mouth
Urinary Retention
1 min
Tricyclic Antidepressant (TCA) Antidote
Antidote
Sodium Bicarbonate (NaHCO3)
26 secs
Iron Antidote
Antidote
DeFEroxamine
22 secs
Acute Digoxin Toxicity
Clinical Symptoms
Hyperkalemia
Cholinergic (Nausea, Vomiting, Diarrhea)
Blurry Yellow Green Vision with Halo of Light
Arrhythmia
Bradycardia
EKG Changes
Prolonged PR interval
Decreased QT
Scooping on EKG
T Wave Inversion
2 mins
Digoxin Toxicity Treatment
Activated Charcoal
Slowly Normalize K+
Digibind (Anti-Digoxin Fab)
Magnesium Sulfate
Lidocaine
Cardiac Pacing
1 min
Benzodiazepine Antidote
Antidote
Flumazenil
29 secs
Beta Blockers
"-olol" suffix
Mechanism
Decreases Heart Rate and Contractility
Decreases Peripheral Vascular Resistance
Decreases Renin Release
Indications
Hypertension
Heart Failure
Angina Pectoris
Contraindications
Asthma and Heart Block Patients
Nursing Considerations
Assess Blood Pressure and Heart Rate
Masking Signs of Hypoglycemia
Do Not Stop Abruptly
1 min
Beta Blocker Antidote
Antidote
Glucagon
28 secs
Opioid Antidote
Antidote
Naloxone
28 secs
Naloxone (Narcan)
Mechanism
Competitive Opioid Receptor Antagonist
Indications
Opioid Induced CNS Depression
Side Effects
Severe Nausea and Vomiting
Excitable State
Opioid Withdrawal Symptoms
Considerations
Repeated Dosing Often Required
1 min
Monoamine Oxidase Inhibitors (MAO-Is)
Indications
Atypical Depression
Mechanism of Action
Increase Levels of Amine Neurotransmitters
Drugs
"Takes Pride In Shanghai"
Tranylcypromine
Phenelzine
Isocarboxazid
Selegiline
1 min

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