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Pharmacology > Drug Cards MOD C Part 2 > Flashcards

Drug Cards MOD C Part 2 Flashcards

1
Q

Trade Names for Insulin

A

Humulin N & R, Novolin N & R, Apidra, Humalog, Novolog, Lantus, Levemir

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2
Q

Therapeutic Classification for Insulins

A

Antidiabetic Hormones

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3
Q

Pharmacologic Classification for Insulins

A

Pancreatics

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4
Q

Preg. Category for Insulins

A

B or C

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5
Q

Indications for Use for Mixtures, Long-Acting, and Rapid-Acting?

A

Control of hyperglycemia in Type 1 & Type 2 Diabetics

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6
Q

Indications for Use for NPH & Regular Insulins

A

Control of hyperglycemia in diabetics

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7
Q

Contraindications for insulins

A
  • hypoglycemia
  • allergy/hypersensitivity to a particular type of insulin
  • preservatives or other additives
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8
Q

Precautions for insulins

A
  • Stress & infections
    (may temporarily increase insulin requirements)
  • renal/hepatic impairments
    (may decrease insulin requirements)
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9
Q

Routes for Insulin

A

SUBQ & IV

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10
Q

AR/SE of Insulins

A 
Hypoglycemia
Erythema
Lipodystrophy
Pruritis
Swelling
Allergic Reactions including Anaphylaxis
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11
Q

Nursing Implications for Insulins

A
  • Assess for symptoms of hypo/hyperglycemia periodically during therapy
  • Monitor weight
  • Monitor blood glucose q6hr
  • Available in diff. strengths & types (Check x 2)
  • Use only insulin syringes
  • Rotate SQ injection sites (abd. wall, thigh, arm)
  • Instruct proper admin. technique
  • Pt. should carry a source of glucose (candy, glucose gel)
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12
Q

Trade name for Heparin

A

Hepalean, Hep-Lock, Hep-Lock U/P

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13
Q

Therapeutic Classification for Heparin

A

Anticoagulants

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14
Q

Pharmacologic Classification for Heparin

A

Antithrombotics

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15
Q

Indications for use for Heparin

A
  • Prophylaxis & Tx of various thromboembolic disorders including..
  • venous thromboembolism
  • pulmonary emboli
  • arterial fib w/ embolization
  • acute & chronic consumptive coagulopathies
  • peripheral arterial thromboembolization
  • used in low doses to maintain potency of IV cath (heparin flush)
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16
Q

Contraindications of Heparin

A
  • Hypersensitivity
  • Uncontrolled bleeding
  • Severe thrombocytopenia
  • Open wounds (full dose)
  • Avoid use of products containing benzyl alcohol in premature infants
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17
Q

Precautions of Heparin

A
  • Severe kidney/liver disease
  • Retinopathy
  • Untreated HTN
  • Ulcer disease
  • Spinal cord/brain injury
  • Hx of congenital/acquired blood disorder
  • GERI: women >60yrs old ^ risk of bleeding
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18
Q

Routes of Heparin

A

IV & SQ (NEVER PO or IM)

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19
Q

AR/SE of Heparin

A
  • Drug-induced Hepatitis
  • Alopecia (long-term use)
  • Bleeding
  • Heparin-induced thrombocytopenia (HIT) w/ or w/o thrombosis
  • Anemia
  • Pain @ injection site
  • Osteoporosis (long-term use)
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20
Q

Nursing Implications for Heparin

A
  • Assess for signs of bleeding/hemorrhage
  • *Notify MD Immediately
  • Assess for evidence of additional or ^ thrombosis
  • Monitor hypersensitivity
  • Monitor platelet count q2-3 days thru out therapy
  • No meds containing Aspirin or NSAIDs
  • Use soft toothbrush & electric razor
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21
Q

Antidote for Heparin

A

Protamine Sulfate

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22
Q

Trade Names for Warfarin

A

Coumadin, Jantoven

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23
Q

Therapeutic classification for Warfarin

A

Anticoagulants

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24
Q

Pharmacologic classification for Warfarin

A

Coumarins

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25
Q

Preg. Category for Warfarin

A

X

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26
Q

What does X mean with Preg. Category?

A

Contraindicated in Pregnancy: positive evidence of fetal abnormalities or risk which clearly outweighs any possible benefits to the patient

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27
Q

Indications for use for Warfarin

A
  • Prophylaxis & Tx of venous thrombosis
  • Pulmonary embolism
  • Atrial Fib w/ embolization
  • Mgmt of MI
  • Decrease risk of death
  • Decrease risk of future thromboembolic events
  • Prevt. of thrombus formation & embolization after prosthetic valve placement.
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28
Q

Contraindications for Warfarin

A
  • Uncontrolled bleeding
  • Open wounds
  • Active ulcer disease
  • Recent brain, eye, spinal cord injury of surgery
  • Severe liver/kidney disease
  • uncontrolled HTN
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29
Q

Precautions for Warfarin

A
  • Malignancy
  • Pts. w/ Hx of ulcer/liver disease
  • Hx of poor compliance
  • Women w/ childbearing potential
  • GERI: due to >expected anticoagulant response
  • initiate & maintain @ lower doses
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30
Q

AR/SE of Warfarin

A
  • Cramps
  • Nausea
  • Dermal Necrosis
  • Bleeding
  • Fever
31
Q

Nursing Implications for Warfarin

A
  • Assess for bleeding/hemorrhage
  • Additional or ^ thrombosis
  • GERI: pts >60yrs. exhibit > expected PT/INR response.
  • Lg. # of meds capable of significantly altering warfarin effects
  • Administer med @ same time each day
  • Review foods high in Vit. K
  • Consistent limited intake of food w/ Vit. K
32
Q

Patient Teaching of Warfarin

A
  • Avoid cranberry juice/products during therapy
  • Pts. should try to avoid IM inj. & activities leading to injury
  • Use soft toothbrush, no floss, & electric razor
  • Report to DR any signs of unusual bleeding/bruising & pain, color, or temp changes to any area of the body
  • Do not drink alcohol/take any RX, OTCs, or herbal products or stopping & starting any new meds during therapy
  • Inform DR before labs, Tx, or surgery that pt is taking warfarin
33
Q

Antidote for Warfarin

A

Vitamin K

34
Q

Trade Name for Hepatitis B Vaccine

A

HepB, Engerix-B, Recombivax HB

35
Q

Indications for use for HepB Vaccine

A

*High Risk patients:
-Household contacts/sex partners of persons with chronic HepB virus infection
-IV drug users
-Sexually active persons not in a long-term monogamous relationship having >1 sex partner in past 6 mo.
-Men who have sex w/ men, HIV, STDs
-End-stage renal disease, Hemodialysis
-H/C workers
-Inmates
-Chronic liver disease
*Patients who travel to endemic areas
*All unvaccinated adolescents
*Unvaccinated adults (19-59) w/ diabetes
(admin @ prescriber’s discretion to adults >60yrs w/ diabetes)

36
Q

Contraindications/Precautions for HepB Vaccine

A

Anaphylactic Allergy to Yeast

37
Q

Routes of HepB Vaccine

A

IM

38
Q

AR/SE of HepB Vaccine

A

Local soreness

39
Q

Nursing Implications for HepB Vaccine

A
  • Assess previous immunization Hx & Hx of hypersensitivity
  • Assess for latex allergy
  • Some syringes (prefilled) may use latex components & should be avoided w/ hypersensitivity
  • Inform pt. of potential & reportable side effects of immunizations
  • Review next scheduled immunizations w/ pt or parent
40
Q

With HepB, what signs do you Notify DR about?

A
  • Fever higher than 39.4C (103F)
  • Diff. breathing (dyspnea)
  • Hives
  • Itching
  • Swelling of eyes, face, or inside nose
  • Sudden, severe tiredness
  • Weakness
  • Convulsions
41
Q

Trade Name for Ondansetron

A

Zofran, Zofran ODT, Zuplenz

42
Q

Therapeutic classification of Ondansetron

A

Antiemetics

43
Q

Pharmacologic classification of Ondansetron

A

5-HT3 antagonists

44
Q

Preg. Category for Ondansetron

A

B

45
Q

Indications for use for Ondansetron

A
  • Prevt. of N & V assoc. w/ highly/moderately emetogenic chemotherapy
  • PO: Prevt. of N/V assoc. w/ radiation therapy
  • Prevt. & Tx of post-operative N/V
46
Q

Contraindications for Ondansetron

A
  • Hypersensitivity
  • ODT contains aspartame & should not be used in patients w/ phenylketonuria
  • Congenital long QT syndrome
  • Concurrrent use of apomorphine
47
Q

Precautions for Ondansetron

A
  • Hepatic impairment (daily dose not to exceed 8mg)

- Abd. surgery (may mask ileus)

48
Q

Routes for Ondansetron

A

PO, IM, IV

49
Q

AR/SE of Ondansetron

A
  • HA
  • Torsade De Pointes
  • QT interval prolongation
  • Constipation
  • Diarrhea
  • ^ liver enzymes
  • extrapyramidal reactions
50
Q

Nursing Implications for Ondansetron

A
  • Assess for N, V, abd. distention & bowel sounds
  • Prior to & following admin. assess for extrapyramidal effects
  • Monitor ECG in Pts. w/ hypokalemia or hypomagesemia
  • HF
  • Bradyarrhythmias
  • Pts. taking concomitant meds that prolong QT interval
51
Q

Patient Teaching with Ondansetron

A
  • PO: (ODT)
  • do not attempt to push through foil backing
  • w/ dry hands, peel backing & remove tablet
  • immediately place tablet on tongue, tablet will dissolve in seconds, then swallow with saliva
  • Instruct pt. to take as directed
  • Notify DR if symptoms of irregular heartbeat or involuntary mvmt of eyes, face, or limbs occur.
52
Q

Trade Names for Penicillin G or V

A

Pfizerpen, Permapen, Crystapen

53
Q

Therapeutic classification of PCN G/V

A

Anti-infectives

54
Q

Pharmacologic classification of PCN G/V

A

Penicillins

55
Q

Preg. Category for PCN G/V

A

B

56
Q

Indications for use for PCN G/V

A
  • Tx of wide variety of infections including:
  • Pneumococcal pneumonia
  • Streptococcal pharyngitis
  • Syphilis
  • Gonorrhea strains
  • Tx of enterococcal infections (requires addition of amino glycoside)
  • Prevt. of rheumatic fever
  • should not be used as single agent to treat anthrax
57
Q

Contraindications for PCN G/V

A

-Previous hypersensitivity to PCN
(cross-sensitivity to cephalosporins)
-Hypersensitivity to procaine/benzathine
-some products may contain tartrazine & avoid w/ hypersensitivity

58
Q

Precautions for PCN

A
  • Severe renal insufficiency (dose decrease recommended)
  • GERI:
  • consider decrease body mass
  • age-related decrease in renal, hepatic, & cardiac function
  • Comorbidities & concurrent drug therapy when prescribing & dosing
59
Q

Routes for PCN

A

IM IV <—-V

60
Q

AR/SE of PCN

A
  • Seizures
  • pseudomembranous colitis
  • allergic reactions including anaphylaxis & serum sickness
  • D, N, V
  • epigastic distress
  • rashes
  • pain @ IM site
  • phlebitis @ IV site
61
Q

Nursing Implications for PCN

A
  • Assess for infection
  • Obtain Hx to determine previous use of & reactions to PCN, Cephalosporins, Beta-Lactam antibiotics
  • Obtain Specimen for C&S
  • Observe S/S of anaphylaxis
  • Use calibrated measuring devices
  • Admin. around the clock, Finish ALL Meds
  • oral contraceptives need additional non hormonal method of contraceptives
62
Q

Patient teaching for PCN

A
  • Report any signs of super infections & allergy.
  • Pt should carry an ID w/ allergy info
  • If fever, diarrhea develop, especially if stool contains blood, pus, or mucus –Notify DR
63
Q

What are the signs of a superinfection?

A
  • black, furry overgrowth on tongue
  • vaginal itching/discharge
  • loose foul-smelling stools
64
Q

Trade name for Metformin

A

Glucophage, Glucophage XR, Glumetza, Riomet, Portamet

65
Q

Therapeutic classification for Metformin

A

Antidiabetics

66
Q

Pharmacologic classification for Metformin

A

Biguanides

67
Q

Preg. Category for Metformin

A

B

68
Q

Indications for use for Metformin

A
  • Mgmt of Type 2 Diabetes

- May be used w/ diet, insulin, or sulfonylurea oral hypoglycemics

69
Q

Contraindications for Metformin

A
  • Hypersensitivity
  • Metabolic acidosis
  • Dehydration
  • Sepsis
  • Hypoxemia
  • Hepatic impairment
  • Excessive alcohol use
  • Renal dysfunction
  • HF
  • Radiographic studies requiring IV iodinated contrast media (w/hold metformin)
70
Q

Precautions for Metformin

A
  • Concurrent renal disease
  • GERI:
  • decrease doses may be required
  • avoid in pts.>80yrs unless renal funct. is normal
  • chronic alcohol use/abuse
  • serious medical conditions (stroke, MI)
  • Pts. undergoing stress (infections/surgical procedures)
  • Hypoxia
  • Pituitary deficiency
  • Hyperthyroidism
71
Q

Routes for Metformin

A

PO

72
Q

AR/SE of Metformin

A
  • Abd. bloating
  • D, N, V
  • Unpleasant metallic taste
  • hypoglycemia
  • lactic acidosis
  • decrease VitB12 levels
73
Q

Nursing Implications for Metformin

A

-pts. who have been well controlled on metformin who develop illness/lab abnormalities should be assessed for ketoacidosis/lactic acidosis
(if acidosis– d/c metformin)
-Assess Renal Fnct before & yearly during therapy
-D/C if stress, fever, trauma, infection, surgery
-Admin. w/ meals to minimize GI effects

74
Q

Patient Teaching for Metformin

A

XR: swallow whole -do not crush,chew,break

  • instruct pt. to take @ same time every day
  • Does not cure diabetes, helps control hyperglycemia, long-term therapy
  • Review S/S of hyperglycemia & hypoglycemia
  • IF hypoglycemia occurs: Take w/ glass of OJ or 2-3 tsp of honey, sugar, or corn syrup dissolved in water & notify DR
  • Instruct proper testing of blood glucose & urine ketones

Pharmacology (8 decks)

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