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-dipine
Calcium Channel Blocker (nifedipine, amlodipine)
Therapeutic Use: Angina, HTN
-afil
Erectile Dysfunction
-caine
Anesthetics
-pril
ACE Inhibitor (Captopril, lisinopril)
Therapeutic Use: HTN, HF, MI, Diabetic Neuropathy
-pam, -lam
Benzodiazepine
-statin
Antilipidemic (lovastatin, simvastatin)
Therapeutic Use: Hypercholesterolemia, Prevention of Coronary Events, Protection against MI and stroke in clients with disbetes
-asone, -solone
Corticosteroid (prednisone, prednisolone)
Therapeutic Use: status asthmaticus, acute asthma attack, asthma attack PPX
-olol
Beta Blocker (propranolol, metoprolol)
Therapeutic Use: HTN, Angina, Tachydysrhythmia, HF, MI
-cillin
Penicillin
-ide
Oral Hypoglycemic (Biguanides, glipizide)
Therapeutic Use: Used in conjunction of diet and exercise to control blood glucose levels in type 2 diabetes mellitus
-prazole
Proton Pump Inhibitor (omeprazole, lansoprazole)
Therapeutic Use: gastric and peptic ulcer, GERD, Zollinger-Ellison syndrome
-vir
Antiviral
-ase
Thrombolytic
-azine
Antiemetic (promethazine)
Therapeutic Use: Postoperative, Chemotherapy, N/V associated with disease process
-phylline
Bronchodilator (aminophylline, theophylline)
Therapeutic Use: Relief of bronchospasm, long-term control of asthma
-arin
Anticoagulant (heparin, enoxaparin)
Therapeutic Use: Evolving stroke, PE, DVT, Cardiac Cath, MI, DIC
-zine
Antihistamine
-cycline
Antibiotic
-mycin
Aminoglycoside
-floxacin
Antibiotic
-tyline
Tricyclic Antidepressant (amitriptyline, imipramine, nortriptyline)
-pram, -ine
SSRIs (fluoxetine, sertraline, paroxetine, citalopram, escitalopram)
-zosin
Alpha Adrenergic Blockers (Sympathomimetics) ((prazosin, doxazosin mesylate))
Therapeutic Use: HTN
*doxazosin mesylate may be used to treat BPH*
Antidote/Reversal Agent: Acetaminophen
Acetylcysteine
Antidote/Reversal Agent: Benzodiazepine
flumazenil (Romazicon – GABA receptor antagonist)
Antidote/Reversal Agent: Digitalis
digoxin immune FAB
Antidote/Reversal Agent: Heparin and enoxaparin (Lovenox)
Protamine Sulfate
Antidote/Reversal Agent: Warfarin
phytonadione (vitamin k)
Antidote/Reversal Agent: Narcotics
naloxone (narcan)
decongestants
can constrict blood vessels; causing Hypertension
tamoxifen (side effects)
menstrual irregularities
hot flashes
bruising
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cefazolin allergic reaction (tx)
parenteral epinephrine (induce vasoconstriction and bronchodilation)
metoprolol use post MI (what to monitor)
bilateral crackles in the lungs (sign of heart failure)
over the counter drug to AVOID when taking Lithium
NSAIDs (increases lithium levels)
therapeutic value for INR
2 to 3; for coumadin
sulfa allergy (cross sensitivity to which drugs)
thiazide diuretics
enalapril use for Heart failure (what to monitor)
hyperkalemia
methotrexate (what to monitor/report)
fever, sore throat, sores in mouth, infection
pilocarpine
Tx: glaucoma, Sjogren syndrome
Class: saliva production stimulator & glaucoma rx
Teaching: eye drops for glaucoma need to be taken for the rest of their life
When should Oxytocin IV post-term pregnancy be discontinued? (contractions)
uterine contractions last > 60 sec
when should Oxytocin IV post-term pregnancy be discontinued? (resting uterine pressure)
greater than 15-20mmHg
when should Oxytocin IV post-term pregnancy be discontinued? (uterine contraction frequency)
more than every 2-3 mins
trimethoprim/sulfamethoxazole (Bactrim) (adverse effect to report)
vesicular, crusty rash (Steven Johnson syndrome)
trimethoprim/sulfamethoxazole (teaching)
drink 8-10 glasses of water daily to prevent renal damage from CRYSTALLURIA
donepezil (adverse effects)
dyspnea (priority), dizziness, diarrhea, dyspepsia
spironolactone (adverse effect)
lethargy r/t HYPERKALEMIA
potassium-sparing diuretic (drug)
spironolactone
digoxin toxicity (sign to monitor and report)
yellow-tinged vision (halo), tinnitus
TSH therapeutic level
0.5-2 microunits
T3 therapeutic level
0.0001-0.0002 mcg
T4 therapeutic level
4.5-11.2 mcg
methotrexate toxicity (sign to monitor and report)
sores in mouth (stomatitis)
oxybutynin (adverse effects)
dry mouth
blurred vision
photophobia
constipation
TACHYCARDIA (anticholinergic effects)
urinary incontinence (tx drug)
oxybutynin (anticholinergic)
Isotretinoin (required test before use/obtaining a refill)
pregnancy test (teratogenic)
severe nodulocystic acne vulgaris (tx drug)
Isotretinoin
Dopamine IV (therapeutic use during cardiogenic shock)
increased blood pressure (catecholamine effect)
increased HR
increased renal output/voiding
candidiasis (tx drug)
Fluconazole (antifungal)
Sodium Polystyrene Sulfate (Kayexalate) (therapeutic use)
decrease serum potassium to prevent cardiac dysrhythmias r/t HYPERKALEMIA
warning for chemo Pt. trying to get pregnant
high risk of fetal malformations while on chemotherapy
Sucralfate (therapeutic use)
forms a protective barrier over ulcers (mucosal protectant); gel-like substance; PEPTIC ULCER tx
Isosorbide mononitrate
Tx: CHF, atherosclerosis
Class: nitrates
AE: hypotension (BP <90/60); hold drug; NOTIFY MD
Neostigmine
Tx: MYASTHENIA GRAVIS
Class: cholinesterase inhibitor
AE: increased salivation, bradycardia, ***NAUSEA, diarrhea
Cyclosporine
Tx: psoriasis, liver (organ) transplant (graft vs host disease), lupus, aplastic anemia
Class: immunosuppressant
AE: NEPHROTOXICITY (elevated SERUM CREATININE)
serum creatinine therapeutic level
0.6-1.3 mg/dL
Allopurinol (drug to avoid)
Warfarin; CONTACT MD; risk for bleeding
Ferrous Sulfate (administration teaching)
take on an empty stomach (for better absorption)
Warfarin (antidote)
Vitamin K
Furosemide (lab findings of adverse effect/hold drug)
K+ level <3.5 mEq/L; HYPOKALEMIA; hold drug; NOTIFY MD
Magnesium therapeutic level
2 mEq/L
when Magnesium levels are HIGH
Calcium levels are LOW
Hypermagnesemia (s/s)
hypotension (LOW BP)
AV heart block
respiratory paralysis (Mg 12-15 mEq/L)
muscle weakness
(HYPOCALCEMIA)
Hypercalcemia (s/s)
tetany
kidney stones
(HYPOMAGNESEMIA)
Morphine Sulfate use 24hr post-op (adverse effect to monitor)
urinary retention
Ergotamine
Tx: migraine headaches
Class: ergot alkaloids
Teaching: take one tablet at onset of MIGRAINE SL
Insulin Glargine for type 1 DM (administration instructions)
do not mix this medication in a syringe with other insulins
Risedronate (risedronic acid)
“-dronate”
Tx: OSTEOPOROSIS
Class: bisphosphonate
Teaching: sit up for at least 30-60min after taking the drug to reduce adverse GI effects of esophagitis and dyspepsia
Tetracycline PO (adverse effect teaching)
take the medication with applesauce (food) to reduce GI distress
Aspirin toxicity/ salicylate poisoning (s/s to report to MD immediately)
hyperventilation (priority)/RESPIRATORY ALKALOSIS;
tinnitus
cholinergic crisis r/t MYASTHENIA GRAVIS (drug tx)
Atropine (anticholinergic); respiratory support
Insulin Lispro + Metoprolol (adverse effect)
sweating (HYPOGLYCEMIA)
Predisone/Glucocorticoids (long-term use adverse effect to assess)
edema d/t sodium and water retention
how to administer NPH insulin & Regular insulin in one syringe
1. inject air into the NPH insulin vial (cloudy)
2. inject air into the Regular insulin vial (clear)
3. draw up the Regular insulin into the syringe
4. draw up the NPH insulin into the syringe
Gentamicin antibiotic (adverse effect to report immediately)
tinnitus
Sumatriptan
Tx: MIGRAINES
Class: 5-HT agonist
AE: angina d/t coronary vasospasm
Levothyroxine (therapeutic use)
tx for HYPOTHYROIDISM
Indomethacin (therapeutic use)
reduces pain & inflammation
Chlordiazepoxide (therapeutic use r/t alcohol withdrawal)
prevents delirium tremens
Acetazolamide (adverse effect to monitor and report)
tingling of fingers (PARESTHESIA)
HYPERGLYCEMIA
Acetazolamide (therapeutic use)
tx for CHRONIC OPEN ANGLE GLAUCOMA
Furosemide (adverse effects r/t HF)
HYPOKALEMIA
dizziness (d/t LOW BP)
urinary frequency
HYPERGLYCEMIA
Magnesium Sulfate (IV) for preterm labor Toxicity (s/s)
decreased LOC
CNS depression (LOW BP, lethargy)
depressed DEEP TENDON REFLEX
Diazepam overdose (antidote)
Flumazenil
Flumazenil (therapeutic use)
Benzodiazepine drugs (Diazepam) toxicity
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Acute asthma attack (tx drug)
Albuterol
Phenytoin (lifestyle teaching)
inform the dentist about medication use; d/t gingival hyperplasia
Baclofen (therapeutic use)
decrease in flexor and extensor spasticity in tx of Spinal Cord Injury; improved muscle function
Enalapril (adverse effect to monitor r/t HF)
HYPERKALEMIA d/t Potassium retention/sparing diuretic effects
Salmeterol (therapeutic use)
improved breathing; prevents BRONCHOSPASM; long
Propylthiouracil/PTU (therapeutic use)
increased ability to focus; tx for GRAVES’ DISEASE
increased amount of sleep
decreased appetite
PTU myelosuppression (lab findings of adverse effect)
decrease in WBC
Oprelvekin (therapeutic lab findings in chemo tx)
increased platelet count
Platelet count (normal range)
150,000 – 400,000
Hemoglobin (normal range)
female: 12-16
male: 14-18
Hematocrit (normal range)
female: 37-47%
male: 42-52%
WBC (normal range)
5,000 – 10,000
RBC (normal range)
4.2 – 6.2 million
Calcium (normal range)
8.2 -10
Serum Osmolality (normal range)
280-310
Magnesium (normal range)
1.5 – 2.5
Potassium (normal range)
3.5 – 5.0
LDL level
<130
HDL level
>45
Oral contraceptives (medications to AVOID)
Warfarin
Carbamazepine (anticonvulsant)
Digoxin (adverse effect to monitor and report)
yellow-tinged vision r/t toxicity
levels > 2
Valproic acid/Depakote (therapeutic use)
Tx: EPILEPSY (SEIZURE), BIPOLAR DISORDER, MIGRAINE PPX
Class: Anticonvulsants
AE: jaundice r/t liver failure
Tamoxifen
Tx: BREAST CANCER
Class: antiestrogen
AE: menstrual irregularities, hot flashes, bruising
Fluticasone Propionate
Tx: CHRONIC ASTHMA
Class: corticosteroid
Teaching: use spacer to minimize the risk of Candidiasis of the mouth; dysphonia (difficulty speaking)
Clindamycin (adverse effect Pt needs to report to MD)
watery diarrhea r/t C-diff
Verapamil
Tx: SVT, Afib, Aflutter, angina
Class: calcium channel blocker
AE: HYPOTENSION, palpitations, GI distress (take with food)
Teaching: change positions slowly r/t hypotension and dizziness, DO NOT D/C ABRUPTLY
metronidazole (Flagyl) (what to AVOID during course of tx)
Tx: bacterial vaginosis, vaginitis, trichomoniasis, pelvic inflammatory disease, seborrheic dermatitis, gastritis, diverticulitis
Class: antibiotic
Teaching: beer (alcohol); can cause Disulfiram-like reaction
Disulfiram-like reaction (s/s)
severe vomiting
HYPOTENSION
weakness
Epoetin alfa
Tx: ANEMIA, chemotherapy-induced Anemia, chronic RENAL FAILURE, HIV Pts. taking Zidovudine
Class: colony-stimulating factor
AE: HTN
Teaching: DO NOT shake vial
benztropine (Cogentin)
Tx: Parkinson’s
Class: anticholinergic
AE: TACHYCARDIA, blurred vision, dry eyes
Antiobiotics to AVOID during pregnancy
Doxycycline; Tetracycline antibiotics; d/t adverse effects on developing bones and teeth
Mannitol
Tx: GLAUCOMA
Class: osmotic diuretic
MOA: decrease intraocular pressure by increase urine output
AE: peripheral edema r/t risk of HF (IV use)
TB (tx drugs)
Isoniazid
Rifampin
Pyrazinamide
Ethambutol
TB 4 tx drugs (reason)
to eliminate various combinations of resistant strains of TB
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diagnostic tests d/t long-term use of Prednisone
bone density scans r/t osteoporosis
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Atorvastatin
Tx: high cholesterol, HLD, CAD, stroke
Class: statin
Teaching: monitor Creatinine Kinase (elevated CK = muscle injury)
Haloperidol
Tx: psychosis, schizophrenia, bipolar disorder
Class: antipsychotic
AE: akathisia (EPS), acute dystonia, Parkinsonism, tardive dyskenesia
Fluoxetine (Prozac)
Tx: depression, OCD, bulimia nervosa, panic disorder
Class: SSRI
Teaching: DO NOT take St. John’s Wort, may cause RASH, DO NOT use NSAIDs
Ferrous sulfate (teachings)
DO NOT take with Antacids;
take the tablet on an EMPTY STOMACH for best absorption; can take with food to minimize GI distress
Metoclopramide (Reglan)
Tx: GERD, gastroparesis, post-op nausea
Class: Antiemetic
AE: sedation (CNS effect), EPS, diarrhea
Hydroxyurea
Tx: SICKLE CELL ANEMIA
Class: chemotherapy
AE: low Hemoglobin, low Platelets, neutrophils; indicates toxicity to Hydroxyurea; report to MD
Desmopressin (lab values to monitor)
Tx: diabetes insipidus
Class: antidiuretic hormone
Teaching: monitor Specific Gravity, Creatinine clearance, Serum osmolality
Opioid addiction (drug tx)
Methadone
Nicotine addiction (drug tx)
Bupropion
Alcohol addiction (drug tx)
Disulfiram
Methamphetamine addiction (drug tx)
Modafinil
Pegfilgrastime (therapeutic use)
increased WBC; tx for CANCER
Tranlycypromine
Tx: depression
Class: antidepressant
Teaching: move slowly; report Orthostatic HYPOTENSION
Lithium (over the counter drugs to AVOID)
Ibuprofen (NSAIDs)
Ciprofloxacin tx for UTI (contraindications)
tendonitis/deep tendon rupture
Spironolactone (adverse effects)
lethargy r/t HYPERKALEMIA
diarrhea
Timolol
Tx: glaucoma
Class: beta blocker
AE: BRADYCARDIA, HYPOTENSION
Nitroglycerin patch (teachings)
check BP 1 hour AFTER applying patch
call MD to report headaches
rotate location of patch
diphenoxylate-atropine (Lomotil)
Tx: diarrhea
Class: antidiarrheal; anticholinergic
MOA: slows the movement of the intestines
AE: abdominal distention
Allopurinol (drug to AVOID)
Warfarin
zidovudine (Retrovir)
Tx: HIV
Class: antiretroviral
AE: paresthesia, N/V, lactic acidosis,
Teaching: monitor hemoglobin
Cephalosporin
-broad spectrum
-ceph/cefs
-Similar to PCN/ don’t give if PCN allergy
-can cause bleeding w/ other bleeding meds monitor bleeding time (tonsil story)
– Disulfiram reaction (puke & puke & puke) just like Flagyl, the protozoal drug
– Store in fridge & take with food
ALL antibiotics have these side effects
– allergy, hypersensitivity
– suprainfection
– organ (kidney & ear) toxicity
– lowers oral contraceptive effectiveness
Vancomyocin
– serious infections like MRSA
– colitis by c-diff
– ototoxicity: get hearing test, tell dr. if hearing getting worse
-given over 60 minutes
Tetracyclines
– Sumycin, Doxycycline (Vibramycin)
– broad, rocky mtn fever, lyme disease, acne, GI infections by H. Pylori
– bad GI discomfort
– Don’t give to kids ≤8; teeth permanently yellow
– Bad photosensitivity- wear sunscreen!
– Can’t take with milk, iron, or antacids
– Take on empty stomach with a full glass of water
erythromycin
Tx: gonorrhea, pink eye, scarlet fever, strep throat, acne
Indication: When pt allergic to PCN and needs abx
Class: antibiotic
MOA: Bacteriostatic inhibitor
AE: GI issues
Aminoglycosides
ototoxicity, Renal toxicity, Can’t take with PCN at all!
– gentamicin, neomycin, streptomycin
sulfamethoxazole/trimethoprim (Bactrim)
Tx: UTI
Class: antibiotic
Teaching: contains Sulfa; Blood problems (get CBC baseline); photosensitivity wear sunscreen and glasses; empty stomach with a full glass of water
Isoniazid (INH)
-antiTB
– take daily for 6-12 months and most likely with other meds too
-worked if 3 neg. sputum cultures, no temp.
– Liver toxicity (hepato) check liver fxn
– Don’t take with alcohol (liver fxn remember?)
– Take on empty stomach
Antiviral: Acyclovir, Ganciclovir
Teratogenic preg. X; put on rubber gloves if topical! remember my purple glove experience
-thrombocytopenia, lowers WBC
What class of drugs if Flagyl? What is the weird effect it has?
protozoal. works on C. diff & H. Pylori PUD. Antibuse effect if taken with alcohol
Amphotericin B
anti-fungal
HIGHLY TOXIC
– infusion rxns (fever and chills)
– nephrotoxicity
– hypokalemia
– hepatoxicity
– gynecomastia
– C/I with aminoglycosides (just like PCN)
-azole
Fungal
______ causes malignant hyperthermia. Use ____ to stop it
succinylcholine, Dantrium/Dantrolene.
Morphine adverse effects
SLOWS EVERYTHING DOWN
– Constipation
– Resp depression
– Urinary retention
– Sedation
– Orthostatic HTN
– Cough suppression
Morphine drug-drug interactions (think of what morphine does to the body)
– MAOIs
-anticholinergics
-CNS depressants
-hypotensive drugs
-opiod antagonists (narcan)
– antihistamines
Morphine patient education re how to take
Take with food for N/V, lie still will help
Opioid withdrawal sx (if stopped abruptly after ≥ 6 weeks). Is it life-threatening? Will it subside?
sweating, restless, agitated, dilated pupils, tremors, tachycardia, increased BP, N/V, cramps, muscle spasms with kicking movements. NO, subside in 7-10 days.
Migraine medications? Can you take them right after each other?
vasoconstriction, ergot’s and triptans.
NO, space out ergot and triptan by at least 24 hours.
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What pain med reduces platelet aggregation?
NSAIDS (aspirin), reduce thrombus but will bleed easier, too
What pain med reduces fever but has NO anti-inflammatory effect and NO platelet effect?
tylenol
What can give child Reye’s syndrome if they have viral illness?
Aspirin
NSAIDS education w/ how to take med. NSAIDS=
with food, milk, or full glass of water to reduce gastric discomfort. Ibuprofen, Celebrex, Naproxen, Aspirin
acetaminophen max dose/day?
4 grams
When to withhold morphine/opiates
RR <12/min & notify Dr
Triptans (for migraines) & pregnancy
Triptan= Teratogenic. Pregnancy X
Rheumatoid Arthritis Drugs name potent toxic drug
DMARDs, 1st choice: methotrexate. Bone Marrow Suppression and Fetal Death
Methotrexate: most concerned about…
bone marrow suppression; Baseline CBC and platelet counts,
What are the s/s of circulatory overload? Seen if giving too much fluids
flush, SOB, cough, heart palpitations
What type of diuretic is not effective in renal failure?
Thiazide – HCTZ
Bumex is ___x more potent than lasix
40
Thiazide diuretics are good for the ___ and perfect for the eldery __ with HTN
bones, woman
Lasix drug-drug interaction: for manic depressive ppl it’ll get to toxic levels in the body
Lithium will become toxic
Signs of hypokalemia
weakness, dysrhythmias, increased cardiac sensitivity of digoxin, ileus, Flat T wave
Aspirin toxicity symptoms
Tinnitus, HA
Glucocorticoids adverse effects
potent; suppress adrenal glad fxn, hyperglycemia, osteoporosis, if taken with NSAIDS, increase risk of GI ulcer, mask infection and suppress immune system
Reo Pro (-mab) what is it for & adverse effects. What other use does Reo Pro have?
Immunosuppressant for RA, Lupus. toxic to bone marrow, acute pulm edema, infection risk, neoplasia risk. Antiplatelet action.
Classic CNS depressant drug classes and what they’re used for
Benzodiazepines, Barbituates. Anxiety.
-lam & -pam are the endings for ________
Benzodiazepines
Benzodiazepine Lorazepam (ativan) increases the possibility of ______.
seizures
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Other anxiolytics: and what they’re for
-Valproic Acid: anti-seizure, bi-polar
-Phenergan: NV, anxiety, extrapyramidal effects
Amitriptiyline (Elavil) drug drug interactions and how to take med
Anticholinergics b/c TCA already have anticholinergic effects
– void prior to dosing & take at bedtime to sleep through fatigue side effect
MAOI’s ___ line of choice for depression b/c of the adverse effects with ___, which can cause ___
2nd or 3rd, tyramine, hypertensive crisis
MAOI adverse effects are related to stimulation of the _____ and include:
SNS, CNS stimulation,
CV-hypertensive crisis, palpitations, Liver toxicity
1st drugs of choice for depression ___, which is equally as effective as ___, but without the SE of ___ & ___
SSRI, TCA, hypotension and sedation
SSRI drug examples: prototype and 2 popular drugs
Prozac, Celexa, Zoloft
Atypical antidepressant _______ better use in elderly
Wellbutrin
SSRI uses
depresssion
OCD
bulimia
PTSD
Panic attacks
Social phobias
PMDD
What time of day to give SSRI
Give in the AM for optimal effects
Lithium is used for
Bipolar Disorder
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Lithium and Diuretics
toxicity if taking diuretics
Anti-depressants have ___________ effects
anticholinergic: dry mouth, constipation, lack of sweat, lack of voiding
Antidepressants and anti-anxiety meds may take ___ to ___ weeks to take effect
2-3 weeks
all anti-depressants have _____ ______ effect and pt must have their __ monitored
orthostatic hypotension. BP
If patient taking an antihypertensive and just got ordered MAOI, Nardil, Marplan, or Parnate, then…
monitor their BP and call the Dr if theres a significant drop and may need to reduce the anti-htn dosage
Lithium and Triptans? Safe in pregnancy?
NO both lithium and triptans are teratogenic
Therapeutic Levels of Lithium
0.4-1.0 mEq/L. Take 2-3 times a day.
Chemotherapy Agents
neosar (cyclophosphamide), methotrexate, doxorubicin, tamoxifen
Cyclosporine is an _________
immunosuppressive drug
PTT lab value should stay at >_________ for what medication? What is the therapeutic PTT level?
2 times the baseline, Heparin. 60-80 seconds
To prevent HIT, stop heparin at platelet count of <________
100,000
How to inject heparin, starting from drawing up
draw up with 22-25 ga needle from vial, then use 25 or 26 ga to put into abdomen 2in from umbilicus.
Drug to help with heparin overdose
Protamine Sulfate
Warfarin C/I (2)
liver failure (no clotting proteins will lead to too much bleeding), alcoholism (additive risk of bleeding)
Lab values to watch with Warfarin
-PT (18-24 sec)
-INR (2-3)
patient education with aspirin (food-wise)
take with food
Prevention of strokes, MI, and reinfarctions can be accomplished with low-dose aspirin of ___mg
81 mg
Thrombolytic drug prototype
Streptokinase, dissolves clots that have already been formed
When should thrombolytics, streptokinase, be given?
4-6hr of onset of symptoms
Do/Do not mix any medications in IV with thrombolytic agents
DO NOT
What medications are usually given with thrombolytics, streptokinase? (think when this drug is used)
Beta-blockers to lower myocardial oxygen consumption
H2 antagonists like Zantac or
PPI like Prilosec to prevent GI bleeding
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Ferrous Sulfate
Tx: iron deficiency anemia
Class: mineral & electrolytes
Teaching:
– GI distress however can’t take with food b/c that will decrease it’s absorption greatly;
– Teeth staining (drink w/ straw or dilute in water or juice and rinse mouth after swallowing);
– Don’t take with tetracycline or antacids;
– Poop will be a harmless dark green or black color;
– Drink more water and exercise more to counter constipation effects
why would a patient be given vitB12-cyanocobalamin
pernicious anemia, partial removal of stomach
What vit/min masks the signs of Vit b12 deficiency?
folic acid
E-alfa, hematopoietic growth factor, is dependent on adequate levels of ___ ___ & ___
Iron, Folic acid, Vitamin B12
In giving whole blood, what do you do before and during?
obtain vital signs, stay with the client and monitor VS q5 min for 15 minutes
When giving whole blood, what do you need the 2nd person for?
check identification of the donor blood and recipient, blood compatibility and expiration date.
Only give blood products with what type of IV fluid?
0.9% NS. anything else will cause lysis of the RBC
Bronchodilator albuterol: therapeutic uses
Prevention of asthma attack
long-term control of asthma
Short acting treatment for asthma attack
Bronchodilator side effects; overall stimulation of the B2-adrengeric receptors…
tachycardia, angina
How to use a MDI (metered dose inhaler)
shake the inhaler, 1/2-2 in away from mouth and tilt head back slightly and open mouth wide. press inhaler same time you breath in deep. Hold breath for 10 seconds. Wait 1 full minute b4 another puff.
When prescribed a beta-2 agonist and an glucocorticoid, which do they inhale first?
the beta-2 agonist promotes bronchodilation and enhances absorption of the glucocorticoid
What does the med theophylline do? short term or long-term control?
relaxes bronchial smooth muscle and does bronchodilation. Long-term control of asthma attacks.
Inhaled atrovent what class of medication is it
anti-cholinergic used for long term control of asthma
Glucocorticoids for asthma are used for _____ and oral glucocorticoids are only give for ___-___ days
long-term control of asthma attacks. 3-10 days
Codeine is used for ___. classification of drug?
Tx: chronic, non-productive cough
Class: opioid
AE: CNS effects, GI effects (take with food)
Teaching: increase fluids
Mucomyst (Acetylcysteine) is a mucolytic and it’s therapeutic effect is to:
Tx: cystic fibrosis, emphysema, bronchitis, pneumonia, TB
Class: mucolytic
MOA: make nasal and bronchial secretions watery to enhance their passage
AE: aspiration and bronchospasm
Teaching: smells like rotten eggs, dilute with water or juice
What do nasal decongestants like phenylephrine do to the body?
CNS stimulation b/c they stimulate alpha-1 adrenergic receptors.
Vasoconstriction-watch HTN and CAD patients!
How fast do you infuse K chloride in IV pump?
no faster than 10 mEq/hr
You should dilute ___and give no more than 40 mEq/L to prevent vein irritation
KCl. remember in clinical he said it was really burning his vein.
SERMS raloxifene is used for _______
osteoporosis and prevent bone fractures
raloxifene (Evista)
Tx: osteoporosis
Class: estrogen modulator
AE: hot flashes, DVTs
Bisphosphonates, like Fosamax or Boniva
sit or stand for 30 minutes after taking
-have enough vit d and calcium
phenytoin (Dilantin)
Tx: epilepsy, subarachnoid hemorrhage, trigeminal neuralgia
Class: anti-seizure
AE: gingivial hyperplasia, blurred vision, bad rash, beardy chesty, teratogenesis, dysrhythmias
Which vitamin promotes iron absorption but increases its side effects?
Vit C
Carbamazipine (Tegretol) 1) Use 2) cannot be used with _____ ______ (all of these meds can’t)
anti-convulsant
-oral contraceptives
PTU is given for ______ & clinically see its working by:
hyperthyroidism
lowered Hr, weight gain, lowered T4 levels
-opril -april
ACE inhibitor
All ACE inhibitors cause: (2)
dry, persistant, cough AND hyperkalemia (increases body’s uptake of K+)
70% of patients on an SSRI experience _____ ______
sexual dysfunction
Fentanyl is used for:
severe cancer pain, will cause constipation
____ will increase the toxicity of Lithium
NSAIDS, tylenol is NOT an NSAID
Carbonic Anhydrase inhibitor use
glaucoma
Metoclopramide
Ulcers, GERD,
Bupropion (Zyban) to help stop smoking has what action on the CNS system?
Stimulation
Therapeutic level of Digoxin?
0.5-2.0
Gold Salts for RA toxicity. RA drugs dosing
rash, sores in mouth, intense itching
– once-a-week at first then down to once-a-month
HBA1c goal for DM
<7%
Amitryptyline (Elavil) has _______ effects. What is Elavil drug class?
“-triptyline or -pramine”
anticholinergics. Tricyclic antidepressant (TCA)
Lithium adverse effects
hand tremors, thirst, GI upset
Digoxin toxicity can occur in the presence of ________ which can happen with what medication?
Hypokalemia, Lasix
Name 4 NSAIDS
Aspirin, celebrex, ibuprofen, naproxen
Antidote/Reversal Agent: Neostigmine
Atropine
Dilantin (phenytoin) is used for _____ and it’s side effects are
seizures, double vision, hirsuitism, skin rash, teratogenesis, dysrhythmias,
Dilantin (phenytoin) cannot be used with what two other drugs?
oral contraceptives and warfarin
Beta 1 heart meds are used to treat
Heart Failure and Cardiac arrest
Alpha 1 agonists like epinepherine is used for __
raising BP
Beta 1 activation in the heart can cause ________
dysrhythmias
Dopamine is used for ____ and ____
shock
Heart Failure
Multiple drug interactions with Heart medications:
MAOI, TCA enhance epinephrine effect (vasocontriction)
– Phentolamine -A blocker
– Propanolol B blocker
Alpha Adrenergic Blockers (“-zosin;” prazosin/Minipress) all have a first-dose ___ effect. What OTC analgesics counteracts the anti-hypertensive effect?
orthostatic hypotension b/c venous dilation
-NSAIDS
Clonidine (catapress) does what to the pt’s BP and CO?
decrease BP and CO
Clonidine (catapress) and ______ (alpha blocker) counteract each other
Prazosin (Minipress)
Which Beta blocker is non-selective and causes bronchoconstriction, too?
Propanolol
-pril ACE inhibitors block Ang I from becoming II resulting in:
vasodilation, excretion of water & sodium, retain K,
DELETE
DELETE
-sartan
Angiotensin II Receptor Blockers (ARBs)
-statins
Cholesterol drugs
-pine, -amil (verapamil: non-selective)
Ca channel blocker
DELETE
DELETE
The main difference between ARB’s and ACE inhibitros is that ______ and _______ are not side effects of ARB
-cough
– hyperkalemia
Ca Channel Blocker (-ipine/-amil) vasodilate and adverse effects (2)
– reflex tachycardia
– Peripheral edema
Dysrhythmias are seen as a ________ QRS interval
widened
Action of Digoxin (2)
increase myocardial contraction
Lower Heart Rate giving ventricles more time to fill
The most dangerous adverse effect of Digoxin is it’s ability to create ________, particularly in patients who have _______
Dysrhythmias
– hypokalemia
ACE inhibitors (-prils), ARBs (-sartan), Thiazide & looop diuretics increase the likelihood of ________ and it’s level should be monitored when taking _______ with these meds.
hypokalemia
-digoxin
Cimetidine (tagamet) is for
ulcers
cyclosporine is an
immunosuppressant
Clonidine (catapress) is a alpha agonist and has what two adverse effects
dry mouth
drowsiness & sedation
Ca Channel Blockers adverse effects are related to __________ & the immediate-acting drugs can cause _____ ________
vasodilation: headache, dizziness, edema, flushing
-reflex tachycardia
Ranitidine Hydrochloride (Zantac) is a __ ____ ______ and is used for _____ and _____
H2 receptor antagonist
-PUD and GERD by suppressing the secretion of gastric acid
-tidines and -prazole’s lowers gastric pH which promotes bacteria in the stomach and _______ _______ so use cautiously in pts who are at high risk for ______
-respiratory tract
-pneumonia
-tidine
H2 receptor antagonist used for ulcers and GERD
-prazole. is the gastric acid lowering reversible?
PPI. Irreversible inhibiting of gastric acid
Don’t take -prazoles with ____ and ____
antibiotics and digoxin
Aluminum hydroxide gel (amphojel), Milk of Mag, Sodium Bicarb are all
antacids
Aluminum and Calcium cause ______ while milk of mag causes _______
-constipation
– diarrhea
How many times does the patient take antacids?
7 times a day! it’ll relieve their pain and heal the ulcer
Take all medications at least ___hr b4 or after antacids
1 hour
Misoprostol: who used them & intended use
-ppl taking long-term NSAID therapy and pregnant women
-prevent ulcers and induce labor
examples of anti-emetics
-Ondansetron (zofran)
-Dexamethasone
– Prochlorperazine (Compazine)
– Dramamine prevents motion sickness
-phenergan
– metoclopradmie (reglan)
All anti-emetics should not be used with these 3 medications b/c they intensify anti-emetic side-effects
opiods- intensify CNS depression
anti-HTNs
Anticholinergics
Anti-diarrheals
diphenoxylate (lomotil)
loperamide (Imodium)
Caffeine makes diarrhea worse or better?
worse
Insulin moves __ into cells along with Glucose
K+
Can synthroid be given to a pregnant woman?
yes- its a pregnancy level A
Is PTU safe to use in pregnancy? What side effects are there for PTU
NO c/i b/c neonatal hypothyroidism can occur
– overmedication goes to hypothyroidism
-can increase anticoagulant effects
Estrogens can decrease the effectiveness of ______, an anticoagulant drug
warfarin
What medication class lower the effectiveness of birth control? (4)
-benzodiazepines/ phenobarbital
-phenytoin (dilantin)
– rifampin (TB drug)
-antibiotics
True/False: TSH at 2 micro units indicates good treatment of hypothyroidism
True
True/False: Photosensitivity and blurred vision are anti-cholinergic side effects?
True
What are signs of an “infusion reaction” with amphotericin B?
fever and chills
Antifungals are safe to use with Warfarin?
False; antifungals inhibit the degradation of warfarin
pancrealipase
for pancreative enzyme deficiency used every time they eat
Stevens-Johnson Syndrome
dry,crusty rash and should be reported to the PCP
INR therapeutic range: what about mechanical heart valve patients?
2-3.
3.5-4.5
PTT therapeutic range
60-80
What is the only immunization given at birth?
Hepatitis B vaccine
It could take __ to __ months for a person on RA drugs to start to feel better
4 to 6 months
Anticholinergic effects
dry mouth
constipation
photophobia
blurred vision
Tachycardia
Bisphosphanates for osteoporosis should be taken with food or on an empty stomach?
Empty stomach

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