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Posts tagged "pharm"


Aspirin, ibuprofen, naproxen, and many other non-steroidal anti-inflammatory drugs (NSAIDs) work as COX inhibitors.  They suppress the catalytic functions of the enzymes COX1 and COX2.  COX2, which appears up injuries and other inflammatory stimuli, is deemed “bad”.  It catalyzes the synthesis of prostaglandins that, located near sites of injuries, cause pain and inflammation.  Inhibition of COX2 is responsible for the therapeutic effects of reducing pain, inflammation, and fever.  COX1, which is present in many parts of the body, is deemed “good.”  It catalyzes the synthesis of prostaglandins that perform many physiological functions, e.g., maintaining the mucus lining of the stomach or causing platelets in the blood to stick and form clots over wounds.  Inhibition of COX1 is responsible for the drugs’ side effect of stomach irritation.  In reducing the risk of blood clots, it is also responsible for aspirin’s efficacy in heart attack prevention.  A new class of NSAID, COX2 inhibitor, is designed to target bad COX2 selectively and leave good COX1 alone, thus reducing pain and inflammation without upsetting the stomach.



Inhibits prostaglandin synthesis, resulting in analgesia, anti-inflammatory activity, and platelet aggregation inhibition; reduces fever by acting on the brain’s heat-regulating center to promote vasodilation and sweating.



Rapidly and completely absorbed. T max is 1 to 2 h (salicylic acid).


Widely distributed to all tissues and fluids, including CNS, breast milk, and fetal tissues. Approximately 90% of salicylate is protein bound at concentrations of less than 100 mcg/mL and approximately 75% is bound at concentrations of more than 400 mcg/mL.


Rapidly hydrolyzed to salicylic acid (active). Salicylic acid is conjugated in the liver to the metabolites.


Salicylic acid plasma half—life is approximately 6 h, but may exceed 20 h in higher doses. The half—life is approximately 15 to 20 min for aspirin. Elimination follows zero-order kinetics. Renal elimination of unchanged drug depends on urine pH. A pH of more than 6.5 increases renal Cl of free salicylate from less than 5% to more than 80%.

Indications and Usage

Treatment of mild to moderate pain; fever; various inflammatory conditions; reduction of risk of death or MI in patients with previous infarction or unstable angina pectoris, or recurrent transient ischemia attacks (TIAs) or stroke in men who have had transient brain ischemia caused by platelet emboli.

Unlabeled Uses

Prevention of cataract formation; prevention of toxemia of pregnancy; improvement of inadequate uteroplacental blood flow in pregnancy; prophylaxis against thromboembolic events in patients with atrial fibrillation, mitral valve prolapse, peripheral arterial disease, bioprosthetic or mechanical heart valves, and in pregnant patients with prosthetic heart valves; antithrombotic therapy in children with Blalock-Taussig shunt or ischemic stroke, and in children after Fontan surgery.


Hypersensitivity to salicylates or NSAIDs; hemophilia, bleeding ulcers, or hemorrhagic states




Decreases inflammation, pain, and fever, probably through inhibition of cyclooxygenase activity and prostaglandin synthesis.



max is 1 to 2 h (oral). Bioavailability is less than 80% (oral). C max is 39.2 mcg/mL and 72.6 mcg/mL for a 400 and 800 mg IV dose, respectively.


Highly protein bound.


Plasma half-life is 1.8 to 2 h (oral) and 2.22 to 2.44 h (IV). 45% to 79% is eliminated through the urine (oral). Cl is 3 to 35 L/h (oral).

Indications and Usage

IV : In adults for the management of mild to moderate pain and as an adjunct to opioid analgesics in the management of moderate to severe pain. PO : Relief of signs and symptoms of rheumatoid arthritis and osteoarthritis, mild to moderate pain, primary dysmenorrhea, reduction of fever, migraine.


Treatment of perioperative pain in the setting of coronary artery bypass graft (CABG) surgery; patients who have experienced asthma, urticaria, or allergic-type reactions after taking aspirin or other NSAIDs; hypersensitivity to any component of the product.

Tetracycline: teratogenicityTEtracycline is a 
TEratogen that causes staining of 
TEeth in the newborn.
Show Details / Rate It 
Teratogenic drugs: major non-antibioticsTAP CAP:
Aspirin & indomethacin
Show Details / Rate It 
—-Manpreet GMC Amritsar 
Teratogenic drugsWTERATOgenic”:
Epileptic drugs: phenytoin, valproate, carbamazepine
ACE inhibitor
Third element: lithium
OCP and other hormones (eg danazol)

A LOOOoooooNG List of Pharm. Mnemonics… I suggest opening in a new window/tab….

Read More

Insulin Review:

Aspart: Acts fast! Onset 5-15mins, Peak 45min, Duration 3-5hrs
REMEMBER- To administer this insulin you must “see food!”

Regular: Short Acting. Onset 15-30mins, Peak 1-3hrs, Duration 5-7hrs

NPH: Intermediate-acting. Onset 2-4hrs, Peak 8-12hrs, Duration 18-24hrs

Lantus: L for LONG LASTING. Onset 1.5hrs, Peakless, Duration 24hrs.

Pregnancy category of the specific generic scientific name or ingredients. Category may be:

A: Controlled studies in pregnant women demonstrate no fetal risk.

B: Controlled animal studies have not shown a fetal risk but there are no studies done on women OR controlled studies in animals have shown a fetal risk that was not reproduced in controlled human studies.

C: Controlled animal studies have demonstrated adverse fetal effects and there are no human studies or there are no controlled studies in humans or animals

D: Controlled studies in humans demonstrate adverse fetal effects but the benefits of using the drug are greater than the risks (eg, propylthiouracil)

X: Controlled studies in animals and humans have demonstrated adverse fetal effects or there is evidence of fetal risk based on human experience. The risk of using these drugs outweighs any possible benefit. The drug is absolutely contraindicated in pregnancy (eg, misoprostol, warfarin, isotretinoin).

Most drugs prescribed for pregnant women are Category A, B or C.

 Not sure if these are all correct… I am going to put it on my to do list (look up info for all meds listed)

Antidotes to Common Medications

  • Acetaminophen:

    • acetylcysteine or mucomyst•

  • Anticholinesterase:

    • atropine or pralidoxime•

  • Anticholinergics:

    • physostigmine•

  • Antifreeze:

    • fomepizole, ethanol•

  • Benzodiazepines:

    • Romazicon (flumazenil)•

  • Beta-Blocking Agents:

    • Glucagon, epinephrine•

  • Ca++ Channel Blockers:

    • Ca+chloride, glucagon•

  • Carbon Monoxide (CO):

    • hyperbaric, oxygen•

  • Coumadin:

    • phytonadione or vitamin K•

  • Cyanide:

    • amyl nitrite, sodium nitrite, or sodium thiosulfate•

  • Cyclophosphamide:

    • mesna•

  • Digoxin:

    • Digibind or Digoxin Immune Fab•

  • Dopamine:

    • Rigitine•

  • EPS:

    • Benadryl (diphenhydramine)(Extra Pyramidal Symptoms)•

  • Ethylene Glycol:

    • fomepizole•

  • Fluorouracil:

    • leucovorin calcium•

  • Heroin:

    • Narcan (naloxone) or nalmefene•

  • Heparin:

    • protamine sulfate•

  • Insulin Reaction:

    • IV glucose (D50)•

  • Iron (Fe):

    • deferoxamine•

  • Lead:

    • edetate calcium disodium, dimercaprol, or succimer•

  • Malignant Hyperthermia (MH):

    • dantrolene•

  • Methanol:

    • ethanol•

  • Methotrexate:

    • leucovorin calcium•

  • Narcotics:

    • Narcan (naloxone) or nalmefene•

  • Opioid Analgesics:

    • Narcan (naloxone) or nalmefene•

  • Organophosphate (OPP):

    • atropine, pralidoxime•

  • Potassium (K):

    • Insulin and glucose, NaHCO3

    • , albuterol inhaler, or Kayexalate(sodium polystyrene sulfonate)•

  • Rohypnol:

    • Romazicon (flumazenyl)•

  • TCA (tricyclic antidepressants):

    • physostigmine or NaHCO3

  • Tranquilizers-EPS symptoms:

    • Benadryl (diphenhydramine)•

  • Tylenol:

    • acetylcysteine•

  • Warfarin:

    • phytonadione or vitamin K

Found on FB… 


Many hospitals have created versions of a PINCH list to help nurses remember high-alert medications. PINCH stands for:
Patient-controlled analgesiaPotassium challengesInsulin dripsNarcotic dripsChemotherapyHeparin drips
When nurses administer a drug from this list, another nurse must double-check the order. Nurses must double-check the medication and the order at four different stages, including:
when they hang the intravenous (IV) bag
when they change the IV bag
when the medication administration rate changes
when the patient is transferred to another unit

Many hospitals have created versions of a PINCH list to help nurses remember high-alert medications. PINCH stands for:

Patient-controlled analgesia
Potassium challenges
Insulin drips
Narcotic drips
Heparin drips

When nurses administer a drug from this list, another nurse must double-check the order. Nurses must double-check the medication and the order at four different stages, including:

  1. when they hang the intravenous (IV) bag
  2. when they change the IV bag
  3. when the medication administration rate changes
  4. when the patient is transferred to another unit

This med is ALWAYS showing up throughout my nursing exams. I saw it most for the preferred/commonly prescribed to tx pediatric issues regarding Increased ICP (ex: Hydrocephalus) KNOW this drug!!

Osmotic Diuretics Prototype: Mannitol:
Elevates the osmolarity of the glomerular filtrate, leading to a loss of water, sodium, and chloride; creates an osmotic gradient in the eye, reducing intraocular pressure; creates an osmotic effect that decreases swelling after transurethral surgery