PHARMACOLOGY
GENERAL GUIDELINES IN ADMINISTERING DRUGS
1. MEDICATION ORDER: 5 RS
1.1 RIGHT PATIENT: 2 PATIET IDENTIFIERS
(Name of the patient and the birthday)
1.2 RIGHT DRUG: order, confirm with another
nurse if needed. Avoid using abbreviation;
Confirm the order from the physician (BETTER
OPTION)
Ex NO MSO4, MgSO4
NO OD, QD
1.3 RIGHT DOSAGE: Dosage and Solution,
Computation
D/S x Q or V
Gtts/min or cc/hr
10-15-20 gtts (ADULT MACROSET; Most
Common is 15)
60 gtts (PEDIATRIC MICROSET)
1.4 RIGHT ROUTE OF ADMINISTRATION:
Oral/ Parenteral/ Topical
IV Is the Fastest Route
*IV INSULIN:
DKA or HHNS (Blood sugar as high as 1000-2000)
IV: REGULAR INSULIN ONLY
Certain drugs cannot be given in a particular
route
INSULIN: can be deactivated by gastric juices,
meaning it cannot be given per orem
DO NOT CRUSH: meds that are enteric coated
(FILM COATED), sustained release, extended
release; Most of these medications are
GASTRIC IRRITATANTS; if giving enteric
coated, ask doctor to change if with NGT;
SUSTAIN RELEASE/PROLONGED:
medicines used for long periods; gradually
released in the body; ALSO, do not crush.
*COULD BE CRUSHED:
FR: Fast release
DS: Double Strength
ER: Extra Strength
*Potassium Preparations: DO NOT CRUSH
1.5 RIGHT TIME: Give 30 minutes before and
after the schedule time;
STAT ORDERS: Time frame within half hour
the medication must be administered
Specific Time for certain medication
*ISCHEMIA: Lack of Blood Supply
*INFARCTION: Absence of blood supply
*LIVER PRODUCES CHOLESTEROL AT NIGHT: 10 pm
until 2 am ; All drugs ending in –statin are anti-lipinic drugs;
This is why we must administer these drugs by 10 pm to 2am
*All hormones including steroids are produced in the morning;
and drugs of the same nature must be given in the morning
UNIVERSITY OF SANTO TOMAS – COLLEGE OF NURSING | FJCP 2017 |α NOTES 1
GUIDELINES
1. ASSESS FOR ALLERGIES
MILD/SEVERE
Anaphylactic Shock- Bronchospasm: Give
EPINEPHRINE/IV Push ASAP: Potent
Bronchodilator; Also given to status epilepticus
2. MEASURE VS (BP, PR, RR)
*Do not give Medication when BP systolic is 90 and below
*Do not give drugs that PR is lower than 60 and higher than
120; Increased HR increases Myocardial Oxygen Demand;
* Do not give drugs if RR is less than 12
*PULSE DEFICIT: Difference of the Peripheral (Radial
Pulse) and Apical Pulse
*BEST OPTION: APICAL PULSE
3. MEDICATION ADJUSTMENT
ADULTS: Based in weight (mg/kg body weight)
PEDIA
GERIATRIC CONSIDERTAION
4. Drugs can be toxic to certain Organs
HEPATOXIC: Check liver enzymes (ALT, AST,
BILIRUBIN)
NEPHROTOXIC: BUN & CREATININE
OTOTOXICITY: Monitor for CN 8 damage,
TINNITUS and VERTIGO
MEDICATION INTERACTION
1. Drug food interaction: All drugs are taken without
food because it delays absorption not unless the
drug is a gastric irritant.
*IRON: Gastric irritant; The BEST way to take is without but
taken with food
2. Impact of food on drug toxicity: ex. MAO
inhibitors and tyramine rich foods:
HYPERTENSIVE CRISIS will occur if taken
together (200-300 systolic)
*COTTAGE CHEESE AND CREAM CHEESE: only
cheese could be consumed since it is not aged
3. Impact of food on drug action
*WARFARIN is an anticoagulant; Side effect is Bleeding;
ANTIDOTE: Vitamin K; If you keep eating rich in Vitamin K:
Green leafy vegetables: advise do not eat these foods since the
effect will be lowered
4. Drug to drug interaction: Combination of drugs,
compatible or not; Including herbal medication
ADDITIVE: Add on to each other (1+1=2)
ANTAGONIST: counteracts the effect of the other
POTENTIATE: Strengthens the actions of the other drug
 PHARMACOLOGY

*DOH HERBAL APPROVED: Sambong, Akapulko, Vitamin C increases absorption (ORAL)

Niyognyugan, Tsang Gubat, Ampalaya, Lagundi, Ulasimang ADMIN IM IRON per Z-tract method
Bato, Bawang, Bayabas, Yerbo Buena Side effect: Black stool

5. Creation of unique response: drugs combined in IV *Ventral or Dorsal GLUTEAL MUSCLE: Z track Method
Solution can form precipitate * SOURCES OF IRON: Combine folic acid and vitamin B12
(CRYSTALLIZATION) sources (galing lolz)

*You cannot absorb if it is not liquid *DO NOT GIVE CLIENTS IRON WHEN IN
*Mannitol Dilantin (Phenytoin) with Dextrose = crystalize CHEMOTHERAPY REGIMENT, INSTEAD GIVE Epogen
(ONLY USE NSS) (Erythropoietin: normally produced in the kidneys [similar
anemic if having kidney failure])
VITAMINS AND MINERAL REPLACEMENT
1. FAT SOLUBLE AUTONOMIC NERVOUS SYSTEM
Needs Bile to be able to absorb these vitamins 1. SYMPATHETIC NERVOUS SYSTEM (From
Excessive amounts can lead to toxicity Adrenaline: ADRENERGIC SYSTEM)
VIT ADEK • STRESS, EXCITED, STIMULATED
• AGONIST: stimulates
*VITAMIN ADEK ADDED: for hepatitis of liver failure • ATAGONIST: Counteracts
*HYPERVITAMINOSIS: excessive vitamins
* VITAMIN A: teratogenic *All drugs and all hormones needs a chemical and a receptor
*Vitamin D: Hypercalcemia for it to work

2. WATER SOLUBLE SNS RESPONSE

Can be excreted out of our body High BP Low UO Midriasis
Vit C, B High HR Dry Mouth
Peristalsis Dilated
2.1 VITAMIN C: aids in absorption of iron and
conversion of FOLIC ACID; excess dose causes 1.1 ALPHA SPECIFIC (Adrenergic Agonist)
GI upset and Diarrhea ALPHA 1: phenylephrine (neosynphrine)
ALPHA 2: Catapres
2.2 VITAMIN B: needed for DNA synthesis
(formation of the cell), Blood production, and 1.2 BETA SPECIFIC (Adrenergic Agonist)
Nerve system development B1 & B2: Isoprotenerol: bronchodilate but increase HR
*FOLIC ACID: Green leafy vegetable; problems with the BETA 2: TOCOLYTIC; only: salbutamol (Ventolin),
Nervous system and blood problems (CNS of fetus in first terbutaline (brecanyl);
trimester Neural tube defects and spina bifida):
*FOLIC ACID FOR PREGNANT: 400mcg/day
ALPHA AND BETA ADRENERGICS
MEGALOBLASTIC ANEMIA: Folic Acid EPI NOREPI DOPAMINE
and B12
Used for Shock and INOTOPIC
treatment of cardiac Low dose:
*VITAMIN B12: same as Folic acid effects; Sources are meat
shock arrest vasodilation
products; NEEDS INTRINSIC FACTOR: produced by
bronchospasm High Dose:
stomach; lacks in those clients post gastrectomy or intestinal
and glaucoma Vasoconstriction
problem
(increase BP HR)
*Pernicious Anemia: IM CYANOCOBALAMIN: EVERY
Increase renal
MONTH, LIFETIME
perfusion increase UO
*-Blastic: Immature RBC

3. IRON: For hemoglobin regeneration; needs iron,

pregnant, children, adolescents, menstruating women,
alcoholics (interferes absorption of iron)
Food decreases absorption but can cause GI
discomfort so take it with food
LIQUID PREPARATION: take with a straw since
it strains its teeth
UNIVERSITY OF SANTO TOMAS – COLLEGE OF NURSING | FJCP 2017 |α NOTES 2
 PHARMACOLOGY

AGONIST TO RECEPTORS MYASTHENIC CRISIS CHOLINERGIC CRISIS

RECEPTORS EFFECT ON ATTACHING Under dosing Overdosing
CHEMICALS
SAME SYMPTOMS:
More receptors than A1 To differentiate use TENSILON TEST
A1 Vasoconstriction: increased BP
If the patient gets better If the patient gets worse
FOR SHOCK
ANTIDOTE: ANTIDOTE:
Antagonist to A1 Neostigmine and Atropine SO4
A2 Vasodilation: Decreased BP Pyrostigmine
ANTI HYPERTENSIVE
• Promotes Peristalsis and Urinary Retention
“You Have B1 HEART AND B2 Lungs and Uterus” Bethanicol (urecholine): Derived from ACH:
USED FOR NON-OBSTRUCTIVE URINARY
Increases heart INCONTINENCE; In other word give to clients with
B1
ADRENERGIC DRUGS Neurogenic bladder or SCI problems in urination
Bronchodilation +
Relax Uterus *Neurogenic Bladder: Bladder not contracting due to SCI
B2
ADRENERGIC DRUGS + FLOW OF AQEOUS HUMOR
TOCOLYTIC PODUCED IN THE CILLIARY BODY
1.3 ADRENERGIC BLOCKERS
Decrease BP: Posterior chamber
Beta Blocker: -OLOLS
Alpha Blocker: -ZOSINS (Terazosin)
Anterior chamber
SLOW HR:
Reabsorbed in the Trabecular Meshwork
-OLOLS
(Specifically in the Canal of Schlemm
DECREASE IOP:
-TIMOPTIC OPEN ANGLE GLAUCOMA:
1. Over production of aqueous humor; As the volume
*BAWAL OLOL SA ASTHMA! goes up the pressure goes up: GIVE DIURETIC
EYEDROPS (Acetazolamine [Diamox])
*ONLY BETA BLOCKER THAT BLOCKS B1: Metoprolol; 2. Trabecular meshwork is blocked: Surgery
Can be given with patients with asthma
CLOSE ANGLE GLAUCOMA: Pilocarpine (Cholinergic;
2. PARASYMPATHETIC NERVOUS SYSTEM Myotic Drug); The more dilated the eyes are the
more obstructed
ACETYLCHOLINE
*MEDICAL EMERGENCY: the patient will become blind
Neurotransmitter important for muscle contraction
*EYE DROPS: place in the lower conjiunctiva and press on
the nasolacrimal duct
MYOTICS
*EYE DROPS AND EYE OINTMENT: 5-10 minutes apart
of administration
Increase ACH
Endrophromnium (Tensilon): Short Acting acts in 5 PARKINSON’S DISEASE
minutes and gone by 20 minutes; only a DOPAMINE: produced in substantia nigra
DIAGNOSTIC DRUG BASAL GANGLIA: for smooth muscle voluntary
(+) Tensilon test: the symptoms are lessened or movements
improves 3 CARDINAL SUYMPTOMS: Tremors, Muscle
Rigidity & Bradykinesia
Neostigmine & Pyridostigmine: Long acting LEVODOPA (L-DOPA): precursor of Dopamine
cholinergic Most of the L-DOPA CONNECTS TO THE
ALWAYS GIVE ON TIME! HEART, GI & GU (PERIPHERAL ABSORPTION);
*Remind you of Time: ALARM CLOCK ONLY 1 % GOES TO THE BRAIN
LEVIDOPA + CARBIDOBA (SINEMET): Allows
*MG: skeletal muscle weakness not smooth muscles; Your more L-Dopa be converted in the brain
diaphragm is the main problem in MG (s/sx of dyspnea;
Mechanical Ventilator); Ineffective breathing pattern IF GIVEN TOO MUCH DOPAMINE, ACH NOW
IS IN EXCESS:

UNIVERSITY OF SANTO TOMAS – COLLEGE OF NURSING | FJCP 2017 |α NOTES 3

 PHARMACOLOGY

DOPAMINE: Bromocriptine & Amantidine REMOVE DRUG DURING NIGHT: activities are at
the daytime
*MAO: Enzyme that breaks epi, norepi and dopamine;
Normally when the 3 SNS hormones are released it attaches to *Comes also in patch and ointment: PATCHES are place in
A1, the normal counter response is it attaches to A2 to counter the Morning; DO NOT TOUCH THE PATCH (causes
the increase vasoconstriction. Another mechanisms is the hypotension & H/A)
release of MAO which degenerates epi, norepi and dopamine. * If the area to be paced is hairy choose another site since the
drug is absorbed systemically
MAOI: selegine (eipedryl) – DECREASES THE
AMOUNT OF DOPAMINE Don’t give with ED drugs (VIAGRA): do not mix
BENZTROPINE (COGENTIN), Diphenhydramine NTG since Viagra is also a vasdilator; the only time
that the patient had angina due to exertion; if given
ANTI HYPERTENSIVES the client will go to SHOCK
Central acting A2 Agonist:
Clonidine, Aldomet *The antidote for VIAGRA is Epinephrine
Alpha Blocker:
“zosins” BETA BLOCLERS DECREASES HR although it CAUSE
Doxazosin BRONCHOSPASM
Prazosin
Beta-Blockers: CA-CHANNEL BLOCKER
“olol” propanalol Atenolol Calcium is needed for muscle contraction
Vasodilators: So reduce the influx decreases HR
Hydrlazine, Apresoline Treat angina decreases BP
Ace Inhibitors:
Catopril
Calcium Channel Blockers: VERY NICE DRUG (VND):
Amlodipine, Felodipine Verapamil, Nifidipine, Diltiazem
ARBS:
Telmesartan, Losartan *IF YOU DECREASE HR you also DECREASE BP
(Benadryl) (So HR drugs also antihypertensives)
*ANTIHISTAMINE HAS ANTICHOLINERGIC
EFFETCS MYOCARDIAL INFARCTION
MONA
CARDIAC MEDICATIONS MORPHINE: Reduce oxygen Demand; Also a
ASHD VASODILATOR (Releases histamine in effect)
*Ischemia: decrease blood supply; no tissue damage vs OXYGEN: 2-4 liters
INFARCTION no blood supply NITROGLYCERIN: (so nagbiigay ka pa rin kanina
*INCREASE BLOOD SUPPLY (Increase HR) will sa Angina but in a different Route) Give per IV
DECREASE OXYGEN SUPPLY ASPIRIN: antiplatelet that decreases the continual
blockage of the site since the plaque scratches the
NITRATES: decrease myocardial O2 needs; coronary arteries Or given CLOPIDOGREL
VASODILATOR; Dilate large coronary vessels TECLOPIDINE: since some clients are allergic to
GIVEN: SL X 3 q5 mins. ASA

If taken 3 NTG in 15 minutes turning to MI: MONA + WARFARIN

*LOCAL: Go to the hospital
*NCLEX: call 911
Dark glass amber containers; Cool storage; STORED
IN ONLY 3 MONTHS; Wash, do not touch
VASODILATING EFFECTS/ May also be used
for HTN:
H/A, (give a mild analgesic like Tylenol),
Hypotension (for HTN), Tolerance (Ceiling effect:
you have reached the ceiling and means you need to
increase the dosage; DO NOT USE IT ALL THE
TIME)
1. HEPARIN: PTT (partial Thromblastin Time) &
APTT (Activated PTT); ANTIDOTE:
Protamine Sulfate
2. WARFARIN:PT/INR (International Normalized
Ratio); ANTIDOTE: Vitamin K
Heparin: SC and IV
Warfarin (Coumadin): ORAL
*PT: has a control value (10-15) which is simply the normal
value and then therapeutic value (1.5-2.5 x) refers to the body

UNIVERSITY OF SANTO TOMAS – COLLEGE OF NURSING | FJCP 2017 |α NOTES 4

 PHARMACOLOGY

not making clots. So multiply the control value to the Slows and strengthens the heart; increase blood
multiplier to determine drug’s efficacy supply to organs; Long acting;
(+) INOTROPIC: strengthens the contraction or
*PTT: has a control value (30-45 seconds) therapeutic value FORCE of the heart
(2.0-2.5 x) (-) CHRONOTROPIC: slow BR
Long half life: 24 hours
*INP: if not 2-3 seconds (Normal THERAPEUTIC Value)
then you can still make clots *HALF LIFE: the time it takes that the half of the drug will
be absorbed by the body
*Warfarin takes 2-3 days for it takes its effect, meaning It is
only when the INP reaches 2.0-3.0 seconds the transfer to DIGITALIS TOXICITY: 0.5-2 ng/ml
WARFARIN could be discharged and stop the Heparin IV BANDAV&M (Bradycardia, Anorexia, N/V,
Diarrhea, Abdominal Pain, Visual illusions [Yellow-
THROMBOLYTIC: Dissolves clots green halos around white lights])
Alteplase, Streptokinase, Urokinase ANDA- GI
Adverse effect B – Heart
T-PA: Tissue Plasminogen Activator V – Visual illusion
M – Male: Gynecomastia

MI: MUST be given given within 4-6 hours of Check K levels prone to toxicity
infarct
CVA: Must be given within 3-4 hours of episode *Hypokalemia predisposes you to Digoxin toxicity; You may
give Diuretic but check the potassium
Antidote for Thrombolytics:
AMINOCARPRIOIC ACID (AMICAR) ANTIDOTE: DIGIBIND

Most Important Question: When did the symptoms DIURETICS

start? *The nearer the glomerulus, the stronger the potency of the
drug

*You cannot drink ASA and Warfarin together: INCREASE 1. GLOMERULUS:

BLEEDING CAI: Acetylzolamide (Diamox): Open Angle
Claucoma
ANTI ARRYTHMICS Osmotic Diuretics: Mannitol: Increase ICP
P-Wave: ATRIAL DEPOLARIZARIZATION
QRS: VENTRICULASR DEPOLARIZATION 2. LOOP OF HENLI
T-Wave: VENTRICULAR REPOLARIZATION Loop diuretic: Furosemide (Lasix): best for CH;
fast acting; rebound HTN
TOO FAST OR TOO SLOW: BAD PERFUSION; Diuresis in:
Arrhythmias: Decreased Tissue Perfusion; Slow: the IV: 5 mins
circulation is slow; Fast: the heart still not filled up the heart Oral: 30 min
already contracts
* These Three drugs cannot be used to lower BP since their
Atropine SO4: bradycardia effects are too fast; RAAS will be activated as an immediate
Quinidine: Atrial response, which will increase BP [REBOUND
Lidocaine: ventricular (dysrhythmia) HYPERTENSION]
Bretylium
Adenosine 3. DISTAL TUBULES
Amiodarone (Cordarone) Thiazide: Hydroclorthiazide: best for HTN; SE:
hyperglycemia
Epinephrine: NO HR (Ventricular tachycardia)
4. POTASSIUM SPARRING
HEART BLOCK: Pacemaker SPIRINOLACTONE (Aldactone)

CONGESTIVE HEART FAILURE *ORTHOSTATIC VS: one lying down, sitting up, standing
*If you can’t go down, it goes back down up: done if giving drugs that decrease BP or Hypotension; 5-
10 minutes apart for each set; If you lost an accumulation of
Cardiac Glycoside (DIGITALIS: DIGOXIN) 20-30 mmHg of BP, you are positive to Orthostatic
Hypotension
UNIVERSITY OF SANTO TOMAS – COLLEGE OF NURSING | FJCP 2017 |α NOTES 5
 PHARMACOLOGY
* I LITER = 1 KILO: Best parameter of diuretic effect
*Weight is a better indicator than UO since the UO can be
transmuted to weight
ACE INHIBITORS: -Pril
*SE: Dry cough may cause BRONCHITIS; if you have dry
cough, report to the doctor
ANGIOTENSIN II RECEPTORBLOCKERS (ARBS): -Sartan
*blocks the receptor of Angiotensin II
*best drug for HTN: ARBS with Thiazide
*PHENYLEPHRINE is A1 Agonist which can cause HTN
ANTILIPEMIC AGENTS: -Statin
Cholyestyramine (Questran): Reduces the absorbtion
of fate from GI tract stops bile; SE: Steaorrhea (fatty
stool); You will not absorb fat soluble vitamins
(ADEK)
Atorvastatatin; Simvastatin; Lovastatin: Reduces
production of cholesterol by the liver (Hepatotoxic:
Check liver enzyme) & Given at Night (10 pm –
2am)
*DO NOT DRINK ALCOHOL WITH –STATINS
RESPIRATORY (COPD)
CO2 yields carbonic acid: RESPIRATORY ACIDOSIS
Every time the body is exposed to INJURY or
INJURIOUS SUBSTANCE, a MAST CELL
COMES out and release a chemical Mediators
HISTAMIN, PROSTAGLANDIN, BRADYKININ
& LEUKOTRIENES; The Mast cell disintegrates
and release these mediators at the site toward to the
blood and causes INCREASED CAPILLARY
PERMEABILITY and triggering VASODILATION;
From intervascular to interstitial movement of water
RUBOR: vasocongestion
COLOR: vasocongestion
DOLOR: due to prostaglandins are release
TUMOR: Swelling
RHINITIS: inflammation of the nasal passage due to
allergens
ORAL DECONGESTANTS: prolonged
decongestant effect but delayed onset; NO
REBOUND CONGESTION; Exclusively
Adrenergic; PHENYLPHRINE (neozep or
Decolgen): Decongestants may cause HTN,
palpitation and CNS stimulants
NASAL DECONGESTANTS: Localized nasal
decongestant; Both adrenergics and steroids; Prompt
onset; Potent; Sustained use over several days causes
rebound congestion, making the condition worse; The
more you use it the more you get congested
(REBOUND CONGESTION or RHINITIS
MEDICAMENTOSA); Ex. Nasal Spray
UNIVERSITY OF SANTO TOMAS – COLLEGE OF NURSING | FJCP 2017 |α NOTES 6
ANTITUSSIVE/ COUGH SUPPRESSANT
*OPIOIDS: Opium; CNS DEPRESSANT; Cough Center
effect; Has an effect on the Respi center; LONG TERM
EFFECT: decreased peristalsis or constipation
*RESPIRATORY CENTER/ COUGH CENTER: Medulla
Oblongata
1. OPIOID: Suppressive cough reflex and respirations;
reduces peristalsis; CNS depression; Robitussin AC
with CODEINE (OPIOID; Family of Morphine)
2. NONOPIOID: Dextromethorphan (Vicks Formula
44, Robitussin DM[Dextromethorphan])
EXPECTORANTS: Drugs that aid in expectoration
(removal) of mucus; Reduce the viscosity of secretions;
disintegrate and thin secretion; FINAL RESULT: thinner
mucus that is easier to remove
Guiafenesin (Robitussin)
Acetylceisteine (Fluimicil, Mucomyst): Antidote to Tylenol
OVERDOSE
Carbocysteine (Solmux, Bisolvon)
*Best Expectorant is PLAIN ROBITUSSIN
*BEST Mucolytic: Water
COPD
BRONCHODILATORS
1. ALPHA & BETA AGONIST: Epinephrine;
Isoproterenol;
2. B2 ONLY: SALBUTAMOL/ ALBUTEROL (All
bronchodilators causes tachycardia except
salbutamol)
3. XANTHINE DERIVATIVES: Theophylline (per
orem) and Aminophylline (IV) (same family as
caffeine); causes CNS stimulation; increase HR and
BP
*THEOPHYLLINE therapeutic level:
10-20 mcg/ml; because if it is too high and may cause cardiac
arrest same family as caffeine
*EPMHYSEMA; BULLAE: Alveoli with trapped air;
Surgery: BULLECTOMY
ASTHMA: hypersensitivity reaction (allergy);
(1) HYPERRESPOSIVENESS OF THE AIRWAY
(2) MUCUS FORMATION;
(3) BRONCHOSPASM
WHEEZING: emergency
STATUS ASTHMATICUS (Emergency):
Epinephrine
BRONCHODILATORS: Relaxes the smooth muscle of the
bronchioles
1. LONG TERM STEROID; INHALED
STEROIDS: rinse mouth with water after use
(prevent oral thrush)
 PHARMACOLOGY

*Health teaching fro INHALERS: Open technique for
STEROID which will cause
*Oral steroid: After Meals, Antacids, at night
*OPEN METHOD INHALER (FOR STEROIDS):
Shake
Exhale
Inhale with 2-3 inches away to puff
Hold your breathe -10 seconds
Rinse your mouth (gargle) : ORAL CANDIDIASIS
2. ANTI-LEUKOTRIENES: Monteleukast (Singular)
*LEUKOTRIENE: Causes the bronchoconstriction
3. MAST CELL STABILIZER: Cromolun Na
(Intal); Bronchospasm; IF YOU DON’T WANT
THEM TO BREAK AND RELEASE THE
MEDIATORS INTO THE BLOOD
TUBERCULOSIS
1. RIFAMPICIN: reddish orange secretion,
hepatotoxic (LFT)
2. ISONIAZID: LFT, PYRIDOXINE (B6) TO
PREVENT PERIPHERAL NEURITIS (S/SX:
Paresthesia [Numbness and tingling sensation])
3. PYRAXINAMIDE: raises uric acid, monitor LFT
4. ETHAMBUTOL: Optic Neuritis
5. STREPTOMYCIN: ototoxic (8th CN: Tinnitus and
Vertigo) and Nephrotoxic (BUN & creatinine)
*MULTIDRUG THERAPY: several months for 6-9 months
*Prophylaxis (1-3 months): ISONIAZID when the patient’s
relative or family is in the same area
RIPE: ORAL
S: IM
R is for Red
I is for neuRItis
PZACID uric Acid
E is EYES optic neuritis
RIP: Hepatotoxic
*NO ALCOHOL FOR RIPES REGIMENT
ANTI ULCER: basta may sugat ka
Ang sugat hindi lang dumudugo pero lumalalim pa
CONCEPTS
1. If you don’t eat anything, you only have HCL in the
stomach
2. Gastric Ischemia: lack of blood supply due to SNS
response called Curling’s Ulcer (Stress ulcer);
Cushing’s Ulcer – ICP
3. Acidic food affects the stomach as well as
medications like ASA, NSAIDS
4. NO. 1 cause of ULCER is BACTERIA: H. PYLORI
(GIVE ANTIBIOTIC+PPI [BEST TREATMENT
according to WHO])
UNIVERSITY OF SANTO TOMAS – COLLEGE OF NURSING | FJCP 2017 |α NOTES 7
*Gastric mucosa (Gastric Ulcer) and duodenal
(MC Ulcer; Higher HCL)
GASTRIC ULCER: Decrease mucus with decreased HCL
production
- INCREASES MUCUS PRODUCTION:
Misoprostol (Cytotec): Abortiofacient; AFTER
MEALS
DUODENAL ULCER: Too much ACID
1. NEUTRALIZE GASTRIC ACID; GIVE AFTER
MEALS: Antacids (Magnesium: Diarrhea,
Aluminum: constipation, Calcium)
2. DECREASE ACID PRODUCTION
2.1 PROTON PUMP INHIBITOR:
Esoprazole; Before Meals
2.2 H2 BLOCKER: Cimetidine, Ranitidine;
After meals
3. PROVIDE PROTECTIVE COVERING OR COAT
OVER ULCERATIVE AREA: Sulcralfate
(carafate); Before Meals (so before eating there is a
cover)
LAXATIVES: Do not use frequently: rebound constipation;
1. BULK-FORMING: Psyllium (Fibrocil) (usually
mixed with waters); FIBER ABSORBS WATER: the
more you eat fiber without water, the more you are
constipated
2. STIMULANT CATHARTIC: Biscadyl (Dulcolax,
Castor Oil) (Stimulate Peristalsis)
3. LUBRICANTS: Glycerin, lactulose, Fleet Enema
(makes the passage easier since the lubricant absorbs
the water); LACTULOSE GIVEN FOR LIVER
CIRRHOSIS: to remove ammonia
4. STOOL SOFTENERS: Docusate Na (Colace)
(Absorbs water to move stool) : given to prevent
straining [MI (Valsava maneuver); Give to patient
with increased Pressure: Hernia, Increased ICP and
IOP; Aneurysm]
ANTI-DIARRHEA
OPIOIDS: Decrease intestinal motility and
peristalsis; CONTRAINDICATION: WHEN
POISONS, INFX or BACTERIAL TOXINS are
the cause of diarrhea, opioids worsen the condition
Diphenoxylate HCL with Atropine So4 (Lomotil)
Ioperamide HCL (imodium): Cause less CNS
Depression
EMETICS: syrup of IPECAC; induces vomiting; Indication:
DRUG OD and Poisoning; CL: ingestion of petroleum or
corrosive substances, volatile petrolatum, comatose
*If you cant give IPECAC: LAVAGE or ARTIVATED
CHARCOAL or GIVE THE ANTIDOTE
 PHARMACOLOGY

ANTI EMETICS 2.1.1 DIURETICS& FLUID RESTRICTION

VOMIT CENTER: Medulla Oblongata; Acting on the 2.1.2 NA Tablets/ Hypertonic Solutions
Chemoreceptor trigger center (CTZ) in the medulla 2.2 Too Little: Diabetes Insipidus: POLYURIA,
POLYDIPSIA
CONCEPTS 2.2.1 Vassopressin (Pitressin)
1. Too much ACH (Cholinergic): ANTIHISTAMINE 2.2.2 Lypressin (Diapid): Nasal (MOST
(Dramamine [Bonamine]) COMMON ROUTE and Most effective
due to proximity of pituitary)
*ANTICHOLINERGIC = ANTIHISTAMINE = 2.2.3 Desmopressin (DVAP): oral IV, Nasal
ANTIEMETIC Spray

2. If not PSNS then it must be SNS (Epi, Norepi,
Dopamine): the drugs in these action decreases
DOPAMINE (less dopamine = Extrapyramidal
symptoms or similar to Parkinson’s or
Pseudoparkinsons); Dopamine Antagonist:
promethazine (phenergan), Droperidol (Inapsine)
[MONITOR FOR EPS]
*CAN CAUSE DROWZINESS: Safety is IMPORTANT
EXTRAPYRAMIDAL SYMPTOMS:
1. Dystonia
2. Akathesia
3. Pseudo-Parkinson’s
4. Tardive Dyskinesia
*Grieving time or process: 6 months time
*Grieving in the PHILIPPINES: 1 year (Babang Luksa)
CHEMICAL IMBALANCE
If HIGH EPI, NOREPI, DOPAMINE: PSYCHOTIC
IF LOW EPI, NOREPI, DOPAMINE: DEPRESSION
Blocks Dopamine: ATYPICAL ANTIPSYCHOTICS
A 4th SNS HOMONE: Serotonin; If you don’t to block
dopamine, then block Serotonin; Serotonin Antagonists
(blocks serotonin receptors): Odansetron (Zofran),
Granisetron
*To increase DOPAMINE
TCA (tricyclic Antidepressant)
MAOI (Breaks down EPI, NOREPI, DOPAMINE)
*FLUID DEPRIVATION TEST: deprive for 12 hours;
Even if you deprive they will still urinate 20-30 LITERS of
H20; Patient will go to SHOCK due to losing pressure;
DEHYDRATION PROBLEM
ANTERIOR
1. FSH & LH: Infertility Problem
2. Growth Hormone: growth of ALL CELLS AND
TISSUES + Bones
2.1 Too Much: Gigantism: only if the emphysis is
still open; ACROMEGALY: if the epiphysis is
closed and the bones and all tissue will widen
(lalapad) [MC cause of death - CARDIAC
ARREST: too big of a heart will make the heart
work hard]; Even taking the medication ANTI
GROWTH HORMONES, the physical
appearance will not change
2.1.1 Octreotide Acetate (Sandostatin): inhibits
release of GH; SQ 3X/ weeks; IM 2-4 weeks
2.2 Too Little: Dwarf
2.2.1 Somatropin (omnitrope); Daily SQ
injection; SE: Fluid retention and
Myalgia; Usually taken by Body
Builders, you will grow but don’t grow
taller (similar to acromegaly)
*XRAY: to determine the epiphysis is open
3. TSH: Thyroid Stimulating Hormone; Stimulates the
Thyroid hormone to release T3 (triiodothyronine) &
T4 (Thyroxine); Thyroid hormones are important for
METABOLISM: burn calories, create heat &
STIMULATE SNS + Physical and Mental Growth
(not only GH)

*To increase SEROTONIN *Even if I don’t have Iodine, there will be no Thyroid
SSRI (Selective Serotonin Receptor inhibitor) Hormones; People leaving in mountains have low sources of
iodine or may be that they eat foods that block iodine or
ENDOCRINE MEDICATION GOITROGENIC FOODS: Cabbage, Cauliflower, Broccoli,
PITUITARY GLAND: the master gland; responsible for all Radish & Strawberry
the hormones in the body; In the middle of the brain; middle
of the head and MC site of TUMOR GROWTH (Surg: 3.1 Too much T3, T: Hyperthyroidism
Transphenoidal Approach; HYPOPHYSECTOMY 3.2 Too little: Hypothyroidism: CRETINISM
[HYPOPHYSIS]) (Pediatrics: that stunts growth and development);
Severe hypothyroidism: MYXEDEMA
POSTERIOR 3.2.1 Levothyroxine (Synthroid):
1. Oxytocin T4
2. ADH (Vasopressin): important for water reabsorption 3.2.2 Liothyronine (Cytommel): T3
2.1 too much: SIADH: CONGESTED, due to water 3.2.3 Liotrix (Euthroid)
accumulation
UNIVERSITY OF SANTO TOMAS – COLLEGE OF NURSING | FJCP 2017 |α NOTES 8
 PHARMACOLOGY
*In the endocrine, if there is a tumor there will be an
excessive disorder
*Thyroid is highly vascular and may cause of death if
removed: LUGOL’s SOLUTION/ Saturated solution of
Potassium Iodide (SSKI): Taken with a straw (stains the
mouth) and Reduces size and vascularity of organ pre-ops +
inhibit formation of thyroid hormones;
PROPYLTHIOURACIL: inhibits the production of Thyroid
hormone (SE: Agranulocytosis producing signs of infection;
monitor for cough sore throat and fever); PTU is
contraindicated in pregnancy
*TOTAL THYROIDECTOMY: Not recommenced;
Parathyroid is removed now obtaining Hypocalcemia:
CALCIUM GLUCONATE must be on the bedside after
surgery
4. ACTH: Stimulating the adrenal gland
4.1 MEDULLA: PHEOCHROMOCYTOMA
4.1.1 Epi & Norepi
4.2 CORTEX (GMA)
4.2.1 Glucocorticoid (form glucose)/ Cortisol/
Steroids
4.2.2 Mineralocorticoids/ Aldosterone
4.2.3 Androgens (Sex Hormones:
Testosterone)
4.2.4 Too much: Cushing’s Disease (Due to
a tumor: Pheochromocytoma)
(Cushing’s Syndrome: due to
increased external steroids)
* When G goes out, M&A goes out as well
* If I take to much steroids/ meaning androgen: hirsutism,
Deeper Voice, Pimples (stimulate sebaceous skin
*Aldosterone is H20 and Sodium Retention: Too much water
and sodium but potassium is decreased; DIET: low sodium
water retention and high potassium; You are CONGESTED
(SIADH high water and low sodium)
CONCEPTS:
1. Steroids are catabolic (breakdown all energy sources:
CHO, CHON, Fats) may increase energy: Causing
hyperglycemia (you do not report if CBG is less than
200)
2. Deposition of Fats in the BELLY: CENTRAL OR
TRUNCHAL OBESITY; Cervical pads:
BUFFALO HUMP
3. Proteins are now broken down even in the BONES:
OSTEOPOROSIS; in the Skin: it will thin it out and
cause STRETCH MARKS; in the blood: Albumin is
broken down, DECREASED COLLOIDAL
PRESSURE to EDEMA to MOONFACIES;
Immunoglobulins are also protein:
IMMUNOSUPPRESSION being prone to infections
SALT (High) SUGAR (High), SICK (Immunosuppressed) &
SEX (Androgen)
*Good but sooo many side effects!
UNIVERSITY OF SANTO TOMAS – COLLEGE OF NURSING | FJCP 2017 |α NOTES 9
4.2.5 Too Little: Addisons
*ADDISONIAN CRISIS: Dies of SHOCK due to decreased
water and sodium in the body at the same time there is
Hyperkalemia; From external steroids and then stop abruptly
will cause this: Remember to TAPER STEROID DOSES
DIABETES MELLITUS
INSULIN
1. RAPID ACTING: Lispro (Humalog): 10-15
minutes, 1 hour peak; Duration 3 Hours
2. SHORT ACTING: Regular: Onset: 30 – 1 hour. P:
2-4hrs; D: 6-8hrs
3. INTERMEDIATE ACTING: NPH and Lente O: 2-
4 hrs; P: 8-12 hrs; D: 12-16hrs
4. LONG ACTING INSULIN: Glargine (Lantus) no
PEAK; 24 hours duration
*MIXING: Regular (CLEAR) to NPH (CLOUDY)
*Measurement of Insulin: Units/ ml
*AT THE PEAK: hypoglycemia while duration is how long it
lasts
*INSULIN PER VV: HHNS, DKA REGULAR INSULIN
*ROTATE SITE OF INJECTION: Move 1 inch away (2.54
m)
*ABDOMEN: Fastest absorption; followed by arms; Do not
inject cold insulin (Lipodystrophy); STORE IN ROOM TEMP
(if going to use in 30 days) or place in ref; if in the
refrigerator, it can last for 3 months
*Moving from left then right would change the absorption of
the INSULIN
TYPE I: Absolute loss of Insulin
TYPE II: Lack of Insulin; Insulin Resistance (problem with
the receptor)
*FOR PATIENT WITH HYPOGLYCEMIA that is
CONSCIOUS, give LIQUIDS that have simple sugars:
Orange Juice
*FOR PATEINT THAT DID SLEEPY AND DOES NOT
WAKE UP (UNCONSCIOUS), see if there is IV LINE:
DEXTROSE 50% IV (Unconscious IV access): D50-50
(usually one is enough but at times they need 2 injections);
THE CLIENT HAS NO IV: GLUCAGON SQ/IM: increase
blood sugar by stimulating glycogenolysis
ANTIBIOTICS
1. PENICILLIN: GI Symptoms; hypersensitivity
reaction; SAFEST among all the antibiotics; Most
popular;
2. CEPHALOSPORINS: same structure as PCN
(Beta-Lactam: chemically related); more prone to
superinfection (broad spectrum); You may develop
cross resistance and allergic to penicillin
*Ceph & kef: are cephalosporins
 PHARMACOLOGY
3. TETRACYCLINE: yellowish discoloration of teeth
(do not use for last half of pregnancy till 8 years of
age; PERMAMENT DISCOLORATION of teeth in
utero; Tetracycline attaches to anything that has Bone
and may cause skeletal bone deformation);
photosensitivity; For pregnant women and children
popular question;
*Tetracycline: Yellow Teeth and Yellow sun
Sunscreen
Sun block
Umbrella
Long sleeve shirts
4. AMINOGLYCOSIDES: Nephrotoxic (Creatinine
and BUN); Ototoxic (8th CN: VERTIGO AND
TINNITUS)
*Mycin, Neomycin, Gentamycin, Streptomycin,
*Aminoglycoside: SON (Streptomycin, Ototoxicity)
5. QUINOLONE: Crytalluria (increase fluid intake);
photosensitivity; Drug choice for MDR-TB; Respi
tract, UTI
*Quinolone: Floxacin, Ciprofloxacin, Levofloxacin
6. MACROLIDES: GI irritant; Take with (redness,
hypotension when infused too fast)
*Erythromycin: oldest one
*Azithromycin: normally give for CAP; given only OD only
for 3 days; causes gastric irritation
7. VANCOMYCIN: red man syndrome (start neck
down; Releases histamine due to the vacomycin;
causes vasodilation; redness; hypotension when
infused too fast [unused over 2 hrs]); For MRSA
(methicillin resistant staphylococcus aureus)
8. SULFONAMIDES: Crystalluria, Photosensitivity,
Steven-Johnson’s Syndrome (Looks like 2nd degree
burnm; Blister in the entire body even mucous
membrane); respiratory, UTI; Drug of choice for Skin
infections
*Co-trimoxazole (Bactrim): combination sulfonamide
*Sulfonamides: Silver sulfadiazine/ Silver Nitrate
REASONS TO DEVELOP RESISTANCE
1. Taking antibiotics even if you don’t need it.
2. Take antibiotics for a long period of time; Normally
around 7 days (2 weeks before); It is harder to
become resistant if we take different drugs
3. When you take antibiotics and you don’t finish the
dose
3.1 BACTERIOSTATIC: they inhibit microbial
growth
3.2 BACTERICIDAL: continual usage of a
bacteriostatic may have a bactericidal effect.
3.3 CULTURE AND SENSITIVITY: to detect
what particular microorganisms
UNIVERSITY OF SANTO TOMAS – COLLEGE OF NURSING | FJCP 2017 |α NOTES 10
3.4 BROAD SPECTRUM: both gram positive and
negative bacteria;
3.5 SUPERINFECTION: is an infection sets in
when we don’t have our normal flora
(OPPORTUNISTIC infection) an example is
taking inhaled steroids then if you don’t perform
oral care and may cause candidiasis
3.5.1 CLOSTRIDIUM DIFFICLE: may
cause diarrhea due to superinfection
ANTI FUNGAL MEDICATION
1. AMPHOTERICIN B: Shake and Bake (Chills and
High fever); for systemic fungal infection
2. NYSTATIN: Administered orally or topically to treat
candida infection; SWISH & SWALLOW or SWISH
& SPIT; Suspension, powder, cream, ointment (used
for the areas that are below the fat folds) and vaginal
tablets
*Oral cavity: it may go to the stomach
*Yeast Infection (vaginal): Cheesy and foul smelling drainage
coming out of the vagina; CAUSES: Hormonal Changes;
Altered pH, not compatible pH
3. IMIDAZOLE: Ketoconazole (Nizorale);
Miconazole, clotrimazole, Flucanaozole (difflucan);
Tinea or ringworm infections
GOUT
HYPERURICEMIA:
1. Eat food in high purine food and by product is uric
acid (Organ Meats; Shellfish; Beer and Red Wine;
Nuts [most nuts]; Generally, all legumes)
2. The kidneys are the ones that excrete uric acid;
Kidney damage, you can’t excrete uric acid; Stays in
the blood or Uric acid stones are formed
*The stone that you pass through must be processed for
laboratory testing
Uric Acid (MGMT: Alkaline Ash) and Calcium Stone
(MGMT: Acid Ash)
*Can deposit in cartilage (small joints of fingers and the big
toe)
1. COLCHICINE (Zyloprim): Severe inflammation or
ACUTE attack; GI, rash, bone marrow reaction
2. ALLOPURINOL: reduce uric acid formation; force
fluids; give with meals
3. PROBENICID (Benemid): excretes Uric acid
ANALGESISCS
NARCOTIC ANALGESICS
1. CONCEPTS
1.1 Opioids/ Narcotics are CNS depressant
1.1.1 Drowsy; no mental exercises (drive or
heavy machinery)
1.1.2 Addictive in nature (BOTH Spine and
Brain RECEPTORS); Prescribed
 PHARMACOLOGY

1.1.3 Medulla Oblongata: Respiratory 2.2 Caffeine

Depression (Monitor RR); Cough
Center as well, No cough reflex (mixed
with Rubitussin + Codeine = Anti-
tussive/ Cough suppresant)
1.2 Reduces GI movement: Constipation (increase
fluid intake); Imodium has opioid component
and also causes drowsiness
1.3 Constricts Pupils
2. DRUGS:
2.1 Meperidine (DEMEROL)
2.2 Morphine: don’t give in cholecystitis and
pancreatitis (Spasm of Sphincter of Oddi);
Before no morphine so give demerol; but now
reverse. Simply Answer Meperidine as substitute
but not very effective
*Naloxone (NARCAN): Antidote to Opioids
3. USES:
3.1 NARCOLEPSY: Always sleeping
3.2 ADHD: A PARADOXYCAL EFFECT (reverse
effect): instead of stimulation, they make them
focus and relaxed; METHYPHENIDATE
(RITALIN)
3.3 OBESITY APPETITE CONTROL: Increased
Metabolism (in diet pills but may cause
Arrhythmia and death)
CNS DEPPRESANTS (DOWNERS)
1. CONCEPTS
1.1 SEDATIVE: It keeps you calm and relax
1.2 HYPNOTIC: Increase the amount of drug will
make you sleepy or hypnotic effect
1.3 Decrease or slows down impulses to the brain
1.4 SE: Residual Drowsiness; drug dependence and
tolerance; Withdrawal

PROSTAGLANDIN INHIBITORS *ALL ANTI-CONVULSANTS are CNS depressants

1. SALICYLATES (ASA)
1.1 Reduces Pain; reduces Fever; Anti- 2. DRUGS
Inflammatory; Anti-Platelet 2.1 BARBITURATES: Thiopental; Phenobarbital
1.2 Causes Bleeding, GI irritation, ototoxic (8th CN) (long acting not used for anesthesia but for
1.3 Don’t give to children: REYE’S SYNDROME anticonvulsant);
(15 years old and younger; A type of Liver
Damage; DO NOT GIVE TO ANYONE WITH *Barbiturates: Barbi
VIRAL INFECTION)
2.2 BENZODIAZEPINE (Diazepam): Status
2. NSAIDS (same as salicylate MINUS 1 which is anti Epileticus use VALIUM
platelet)
2.1 Mefanamic; Abuprofen, Ketoralac (Toradol) Used for sedation, anxiety, OCD’s, hypnotics
Also used as anti-convulsant
*ASA and NSAIDS: Gastric Irritants: Give with food!
ANTICONVULSANT
3. ACETOMINOPHEN/ PARACETAMOL (same as 1. CONCEPT & OTHER DRUGS: Same as CNS
salicylate MINUS 2 only antipyretic and analgesics) depressant (Barbiturates and Benzodiazepines)
3.1 Hepatotoxic: 4 gms per day (Maximum dosage);
liver enzymes 2. DRUGS
2.1 Hydantoin: Phenytoin (Dilantin)
*ACETYLCEISTEINE: Antidote for Acetaminophen 2.1.1 Gingival Hyperplasia & Gum bleeding
(Massage the gums & Soft bristle tooth
4. 2ND GENERATION: COXIB (less gastric irritation brush)
vs traditional NSAIDS) 2.1.2 Pinkish Urine
4.1 Arcoxia; Celecoxib 2.2 Succinamide
2.3 Carbemazipine (Tegretol)
CNS STIMULANTS (UPPERS: high or wakes you up) 2.4 Valproic Acid
1. CONCEPTS
1.2 SNS STIMULANTS: Restlessness: All awake; *The level of Dilantin and Theophylline: 10-20 mcg/mL
insomnia; HTN, tachycardia, drug dependence PSYCH DRUGS
and tolerance
1.3 CEILING EFFECT: you reach the ceiling and
up the dosage to receive the effects;
1.4 WITHDRAWAL SYNDROME IS
REVERSE: when you don’t take, you will
decrease BP HR and other effects
2. DRUGS
2.1 Amphetamine (Adderall)
UNIVERSITY OF SANTO TOMAS – COLLEGE OF NURSING | FJCP 2017 |α NOTES 11
 PHARMACOLOGY

SNS: EPI, NOREPI, DOPAMINE

Endogenous Depression: Chemical imbalance; low of the
three ATYPICAL PSYCHOTICS
Exogenous Depression: Form external causes; Someone 1. Causes less or no EPS
died 2. Blocks negative symptoms
TOO HIGH: PSYCHOTIC 3. Blocks more of Serotonin
TYPICAL Too High Dopamine so decrease but may 4. Clozapine, Resperidone, Olanzapine: BLOOD
cause: EPS; For POSITIVE SYMTOMS DYSCRASIA: Agranulocytosis: check WBC
ATYPICAL: block serotonin; for NEGATIVE (Clozipine)
SYMPTOMS
LITHIUM CARBONATE (ESKALITH)
TOO LOW: DEPRESSED 1. Effective in controlling the MANIC PHASE
Too Low Dopamine: TCA & MAOI 2. Has a calming effect without impairing intellectual
Too Low Serotonin: SSRI activity
3. Controls flight of ideas and hyperactivity
ANTIDEPRESSANTS 4. Narrow Therapeutic Level: 0.8 – 1.5 mEq/L
MOA:
1. Block dopamine receptors in the brain *RITALIN: For pediatrics lithium

I. TCA (Amitrip) *DIET: Increased Fluid intake but regular salt

1. highly sedating (Given at night)
2. Palpitations (report to the MD since may cause 5. Lithium TOXICITY: N/V, Severe diarrhea and may
CARDIAC ARRHYTHMIAS) go to SHOCK
3. Orthostatic Hypotension
4. Palpitations *LITHIUM LEVEL SCHEDULE (BLOOD TESTING):
Monitored 2x in a week in a month; Twice a month after the
II. MAOIs first month
PANAMA/ PAMANA
PA-PArnate *Lithium depletes SERUM SODIUM: inversely proportional
NA-NArdil
MA- MArplan
SE
1. Highly dangerous
2. Thyramine will cause HTN Crisis (STROKE)
α
III. SSRI: Second Generation Antidepressant
1. Insomnia and Anxiety (Given in the morning)

*Last resort is MAOI; FIRST SSRI

*EFFECTS: seen after 2-4 weeks
*If the drug still has no effect in 2-4 weeks switch; DO NOT
INCREASE!: SSRI à TCA à MAOI

EPS:
1. ACUTE DYSTONIA: occurs early in the treatment:
Acute muscle spasm, oculogyric crisis (only white of
the eyes can be seen); Ophisthotonus, Torticollis
2. AKATHESIA: (MAKATI) Develops in the 1st 2
months: restlessness: uncontrolled need to move
foot, tapping and pacing
3. PSEUDOPARKINSONISMS: Tremors, Rigidity
and Bradykinesia
4. TARTADIVE DYSKINESIA: Needs you to stop
doses; MAY BECOME IRREVERSIBLE; Bizarre
face and tongue movements

TX: ANTICHOLINERGIC DRUGS: Benzotropine,

Trihexylphenidine, Diphenhydramine

UNIVERSITY OF SANTO TOMAS – COLLEGE OF NURSING | FJCP 2017 |α NOTES 12