Pharmacology, Reduction of Risk & Physiological Adaptation

Right patient, drug, dose, route, time, plus documentation. Additional rights include right reason, response, and patient's right to refuse.

Therapeutic level is commonly 0.5-2 ng/mL (heart-failure targets are lower). Hold and assess if apical pulse < 60. Early toxicity signs: nausea, anorexia, visual halos; hypokalemia potentiates toxicity.

Monitored by PT/INR (therapeutic INR usually 2-3). Vitamin K is the antidote. Teach consistent dietary vitamin K (green leafy vegetables) intake.

Unfractionated heparin is monitored by aPTT (therapeutic ~1.5-2.5x control). Protamine sulfate is the antidote. Watch platelets for heparin-induced thrombocytopenia.

Naloxone reverses opioid-induced respiratory depression and sedation. Its duration may be shorter than the opioid, so monitor for re-sedation and repeat dosing as needed.

ACE inhibitors (-pril) can cause a dry cough, hyperkalemia, first-dose hypotension, and angioedema. Angioedema is a medical emergency requiring drug discontinuation.