ATI PHARMACOLOGY: Tested Medications + Lab Values
Drug Name Important Information
Digoxin
(cardiac glycoside, used to treat dysrhythmias and heart
... [Show More] 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 [Show Less]