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ATI PHARMACOLOGY: Tested Medications + Lab Values

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ATI PHARMACOLOGY: Tested Medications + Lab Values Drug Name Important Information Digoxin (cardiac glycoside, used to treat dysrhythmias and heart failure) • Therapeutic Levels 0.5-0.8 (Pg. 177) • IV digoxin: infuse over AT LEAST 5min. • WITHHOLD if HR LESS THAN 60min • Toxicity: Yellowing vision, anorexia, fatigue, weakness, N/V, GI effects • Narrow therapeutic range • Positive inotrope, negative chronotrope • Hypokalemia leads to toxicity, hyperK leads to decreased effect • Treatment is cholestyramine (BAR) or Digibind • To prevent “Digoxin-induced dysrythmias, avoid hypokalemia and increased serum digoxin levels o Watch for n/v and general weakness. (hypokalemic) and treat with potassium supplements. • Avoid any drug that affect potassium (loop diuretics, ACE Inh and ARBs) Phenytoin (hydantoin class, used to treat seizures) • Therapeutic levels 10-20 • Narrow therapeutic range • Gingival hyperplasia (notify dentist, use soft brush) • Hirsutism, acne • Enzyme inducer • Toxic levels include nystagmus, ataxia • Do not take with milk, decreases absorption of Vit D and Calcium • May cause thrombocytopenia • Check LFT’s Carbamazepine • Therapeutic levels: 4-12 • Hepatic Autoinducer • Blood dyscrasias (bleeding & bone marrow suppression) /pancytopenia • Stimulates posterior pituitary and promotes secretion of ADH so hypo-osmolarity - essentially a medication induced SIADH • Can cause SJS Valproic Acid • Monitor liver and pancreatic enzymes due to damage • Can be used in any type of seizure • Hepatotoxicity, pancreatitis, thrombocytopenia • Teratogenic • Enzyme inhibitor Methotrexate • Used in chemotherapy, psoriasis, rheumatoid arthritis • Interrupts cell production, so monitor for bleeds in GI/mucosa/gums. Use soft brushes. Protect skin. • Pregnancy Cat X (stops cell production) and is used to dissolve pregnancy. Moms need to be on strict birth control. • Don’t give with folic acid • Give with leucovorin (prevents side effects) • Due to immunosuppression, report fever to provider stat • Dosed weekly • Sores in mouth (stomatitis) indicates toxicity. Mannitol (Osmotic diuretic) • Adverse effects: Peripheral edema, Pulmonary edema (can potentiate HF) • ↓ intracranial and intraocular pressure - used in glaucoma Sucralfate (Mucosal Protectant) • Protects mucosa • Causes constipation, so teach patients to increase fiber and fluid Morphine Sulfate • Primary use is analgesia • Teach patients about side effects: o Respiratory Depression o Constipation o Orthostatic Hypotension o Urinary Retention o Can cause biliary colic Acetazolamide (Carbonic Anhydrase Inhibitor) • Diuretic - carbonic anhydrase • Used to decrease IOP in glaucoma patients • Adverse effects include paresthesias (tingling of the extremities), hyperglycemia

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