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Please respond to each post in 137 words elaborating and adding new information.

by | Jan 2, 2022 | Nursing | 0 comments

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Please respond to each post in 137 words elaborating and adding new information.
Angiotensin-converting enzyme inhibitors include medications such as Lisinopril, captopril and enalapril. These medications prevent conversion of angiotensin I to angiotensin II, a potent vasoconstrictor. Besides decreasing vasoconstriction and thus reducing peripheral arterial resistance, inhibiting angiotensin II decreases adrenocortical secretion of aldosterone. Side effects include dry cough, dysgeusia, fatigue, headache, hyperkalemia, hypotension, rash and tachycardia. Severe hypotension may occur at toxic drug levels. This medication should not be used during pregnancy and patient should be instructed to stop medication and during breastfeeding during therapy. (Nursing 2021 drug handbook 2020)
Beta blockers compete with beta agonists for available beta receptors; individuals drugs differ in their ability to affect beta receptors. Some drugs are nonselective: they block beta 1 receptors in cardiac muscle and beta 2 receptors in bronchial and vascular smooth muscle. Several drugs are cardioselective and, in lower doses, inhibit mainly beta 1 receptors. Some beta blockers have intrinsic sympathomimetic activity and stimulate and block receptors and thereby have less effect on slowing HR. Others stabilize cardiac membranes, which affects cardiac action potential. Therapeutic dose my cause bradycardia, dizziness, fatigue, and erectile dysfunction; some may cause other CNS disturbances such as depression. Toxic dose can produce severe memory loss and nightmares. (Nursing 2021 drug handbook 2020)
There are 5 generation of Cephalosporins medications. They are chemically and pharmacologically like penicillin; they act by inhibiting bacterial cell-wall synthesis, causing rapid cell destruction. Their sites of action are enzymes known as penicillin-binding proteins. The affinity of certain cephalosporins for these proteins in various microorganisms help explain the differing actions of these drugs. They are bactericidal. They act against many aerobic gram-positive and gram-negative bacterial and some anaerobic bacteria but don’t kill fungi or virus. Many cephalosporins have similar adverse effects. Hypersensitivity reactions range form mild rashes, fever, and eosinophilia to fatal anaphylaxis and more common in patients with penicillin allergy. (Nursing 2021 drug handbook 2020)
Selective serotonin reuptake inhibitors treat major depression, OCD, bulimia nervosa, premenstrual dysphoric disorders, panic disorders, posttraumatic stress disorders. They inhibit the reuptake of serotonin with little or no effects on other neurotransmitters in the CNS, such as norepinephrine and dopamine. Common adverse effects include headache, tremor, dizziness, sleep disturbances, GI disturbances and sexual dysfunction. Less common adverse effects include bleeding, breast tenderness or enlargement, weight gain or loss, rash, urticaria and pruritus. (Nursing 2021 drug handbook 2020)
Biguanides check renal function and hematologic values before starting therapy and at least annually thereafter. If patient has impaired renal function, don’t use metformin because it may cause lactic acidosis. Monitor response to therapy by periodically evaluating fasting glucose and HbA1c levels; a patient home monitoring of glucose levels helps monitor compliance and response. Monitor vitamin B12 level every 2 to 3 years. (Nursing 2021 drug handbook 2020)
Angiotensin converting enzyme (ACE) helps to reduce blood pressure, preserve cardiac output and increase renal blood flow. The medications for ACE inhibitors are: captopril, enalapril, lisinopril, ramipril. The side effects of ACE inhibitors include: nausea, diarrhea, fatigue, headache, dizziness, weakness, faintness, chronic cough, hypersensitivity, hyperkalemia, nephrotoxicity. The nursing education includes: Obtain baseline status for weight, vital signs, overall skin condition and CBC. Educate patient on importance of healthy lifestyle choices which include regular exercise, weight loss, smoking cessation, and low-sodium diet.
“Beta blockers agents inhibits cardiac response to sympathetic nerve stimulation by blocking the beta receptors as a result, the heart rate, cardiac output and consequently the blood pressure are reduced” (Clayton, B. D., & Willihnganz, M. J. 2017). The examples of beta blockers are: atenolol, metoprolol, propranolol, nadolol, bisoprolol. The side effects of beta blockers are: bradycardia, weight gain, bronchospasm, wheezing, crackles, edema, peripheral vasoconstriction. The nursing education includes: encourage the patient to change the position slowly, educate the patient about the action, indication, common side effects and adverse reactions, educate patient on importance of healthy lifestyle choices.
The cephalosporin’s act by inhibiting cell wall synthesis in bacteria. It may be used with caution as alternatives when patients are allergic to the penicillins. The example of cephalosporins are: cefaclor, cefadroxil, ceftriaxone, cephalexin, ceftibuten. The side effects are: diarrhea, oral thrush, hepatotoxicity, nephrotoxicity, hypoprothrombinemia, electrolyte imbalance. The nursing education are: educate the patient to take the drug with food and complete the full course, educate the patient about uses, adverse effects and report any severe diarrhea, difficulty breathing, educate to avoid alcohol while taking cephalosporin.
“Selective serotonin reuptake inhibitors (SSRI) inhibits the reuptake of serotonin from the synaptic cleft, thereby increasing the serotonin concentration that enhances neurotransmission” (Clayton, B. D., & Willihnganz, M. J.2017). The examples of SSRIs are: citalopram, fluoxetine, sertraline, paroxetine, fluvoxamine. The side effects of SSRI are: restlessness, agitation, anxiety, insomnia, sedation, nausea, anorexia, suicidal ideation. The nursing education are: educate patient to take medications as directed, monitor patient for any suicidal ideation, educate patient to report any possible signs of infections.
“Biguanides decreases hepatic glucose production by inhibiting glycogenolysis and gluconeogenesis which reduces absorption of glucose from the small intestine and increases insulin sensitivity, improving glucose uptake in peripheral muscle and adipose cells” (Clayton, B. D., & Willihnganz, M. J.2017). The example of biguanide is metformin. The side effects of biguanide includes: nausea, vomiting, anorexia, malaise, respiratory distress, hypotension, abdominal cramps, flatulence. The nursing education are: advise patients to notify prescriber if abdominal pain, cramping, diarrhea with blood, teach correct administration for PO or enema.
Bisphosphonates are the most common type of osteoporosis medications which are typically taken for at least 3-5 years. The examples are: alendronate, ibandronate, risedronate, zoledronic acid. The side effects of bisphosphonates are: fatigue, fever, nausea, vomiting, anemia, bone or joint pain, osteonecrosis.
REFERENCES
Clayton, B. D., & Willihnganz, M. J. (2017). In Basic pharmacology for Nurses (pp. 239–240,
554–555, 695–697, 349–351). essay, Elsevier.
Sabrina
Posted: Dec 30 2021
Hi Jashmine, very thorough post. To add to your post, I thought I’d discuss adrenergic-blocking therapy implementation and assessments to keep in mind. Prior to administration, it is important to establish a baseline. The nurse should obtain a complete health history including cardiovascular, cerebrovascular, respiratory diseases, or diabetes. Make sure to illicit a drug history including allergies, as well as any current prescriptions, over the counter medications, herbal preparations, and alcohol use of the patient. While doing so, be alert for possible drug interactions. Evaluate labs such as electrolytes, glucose, and liver and kidney function. Assess baseline weight, vital signs, cardiac monitoring (such as EKG, ECG, cardiac output, etc.). Of high importance, it is important to assess the patients ability to receive and understand instructions, including the family and caregivers if needed.
As a nurse, it is important to continue frequent assessments for therapeutic effects “dependent on the reason the drug therapy is given” (Adams, M. P., Holland, N., & Urban, C., 2013, p. 144). Daily weights should be assessed and remain as close as possible to the baseline weight. For ophthalmic preparations, it is important to follow appropriate administration techniques, and assess the patients or caregivers knowledge in proper administration by assessing teach-back. Continuously monitor vital signs, including assessment for orthostatic hypotension by assessing blood pressure when laying down, sitting, and standing. “Teach the patient to rise from lying to sitting or standing slowly to avoid dizziness or falls” (Adams, M. P., Holland, N., & Urban, C., 2013, p. 144).

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