Y?

Therapeutic Effect Action/ Pharmakinetics! Intervention/ Nursing implications Safe Dose Time /Therapeutic level

Brand Name: Generic name: Coumadin Warfarin Treatment for VT, PE, A fib with embolism. Prevention of thrombus formation and embolization Prevention of thromboembolic Contraindications: events Recent surgery Metabolized by the liver Toxic/SE: Cramps, nausea, dermal necrosis, bleeding

Assess for signs of bleeding; black stools; hematuria, fall in hematocrit or BP; PT/ INR readings; INR normal = 0.8-1.2. INR at 2.5-3.5 rec for patients with high risk for embolization; anti-dote is vitamin K; Adults: 2-5mg/day for 3-5 days Onset Peak Duration 3-4 days 5-7 days 2-5 days

Y?

Therapeutic Effect Action/ Pharmakinetics!

Intervention/ Nursing implications Safe Dose Time /Therapeutic level Unknown

Brand Name: Generic name: Levonax enoxaparin Treatment of acute ST-segment-elevation MI (with thrombolytic or percutaneous coronary intervention Prevention of thrombus formation Contraindications: History of HIT Potentiate the inhibitory effect of Toxic/SE: antithrombin on factor XA and Edema; insomnia; urinary retention; anemia thrombin Assess for signs of bleeding and hemorrhage (bloody stools, unusual bleeding or bruises); for overdose = protamine sulfate 1 mg for each 1 mg of lovenax bu slow IV injection. 30 mg q 12 h Onset Peak Duration 3-5 h 12 h

Y? Therapeutic Effect Action/ Pharmakinetics!

Intervention/ Nursing implications Safe Dose 120-180 mg/day Time Onset /Therapeutic level Unknown

Brand Name: Generic name: Solumedrol methylprednisolone Corticosteroids, antiasthmatics Suppression of inflammation and Contraindications: modification of the normal Active untreated infections; lactation; immune responses All agents suppress inflammatory Toxic/SE: response and promote normal Depression; euphoria; thromboembolism; immune response peptic ulceration; Assess for signs of adrenal insufficiency. Monitor I and O ratios daily and weigh. Do not stop medication abruptly.

Peak 1-2 hr

Duration 1.25 1.5 days

Y? Therapeutic Effect Action/ Pharmakinetics!

Brand Name: Spiriva Bronchodilator, anticholinergics Decrease incidence and severity of bronchospasm

Generic name: tiotropium

Intervention/ Nursing implications Safe Dose 18 mcg daily Time Onset /Therapeutic level Rapid

Contraindications: CCr < 50ml/min; hypersensitivity to tiotropium, atropine Inhibits m3 receptors in smooth Toxic/SE: muscle of airways. Angioedema; dry mouth; paradoxical bronchospasm Assess before and at peak of med (lung assessment);

Peak 5 min

Duration 24 hour

Y? Therapeutic Effect Action/ Pharmakinetics! Intervention/ Nursing

Brand Name: Advair Corticosteroid Fluticasone acts as a steroid to prevent inflammation. Salmetrol is a bronchodilator

Generic name: fluticasone and salmeterol Contraindications:

Toxic/SE:

implications

Safe Dose

Time Onset /Therapeutic level

Peak

Duration

Y? Therapeutic Effect Action/ Pharmakinetics! Intervention/ Nursing implications Safe Dose Time /Therapeutic level

Brand Name: Generic name: Provental albuterol Used as a bronchodilator to control and prevent reversible airway obstruction Bronchodilation Contraindications: Hypersensitivity to adrenergic amines Binds to b2-adrenergic receptors in airway smooth muscle Toxic/SE: Paradoxical broncospasm (excessive use); chest pain, palpitations Observe for paradoxical bronchospasm (wheezing); do not double dose; advise to use albuterol first is using other inhalation meds and allow 5 min to elapse. Po: adult: 2-4 mg 3-4 times daily Onset Peak 15-30 min Inhale: 5-15 min 2-3 hr 60-90 min

Duration 4-6 hour 3-6 hour