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Pharmacology > Drug Cards MOD C Part 2 > Flashcards

Drug Cards MOD C Part 2 Flashcards

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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
Preg. Category for Warfarin
X
26
What does X mean with Preg. Category?
Contraindicated in Pregnancy: positive evidence of fetal abnormalities or risk which clearly outweighs any possible benefits to the patient
27
Indications for use for Warfarin
* 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.
28
Contraindications for Warfarin
- Uncontrolled bleeding - Open wounds - Active ulcer disease - Recent brain, eye, spinal cord injury of surgery - Severe liver/kidney disease - uncontrolled HTN
29
Precautions for Warfarin
- 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
30
AR/SE of Warfarin
* Cramps * Nausea * Dermal Necrosis * Bleeding * Fever
31
Nursing Implications for Warfarin
* 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
Patient Teaching of Warfarin
- 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
Antidote for Warfarin
Vitamin K
34
Trade Name for Hepatitis B Vaccine
HepB, Engerix-B, Recombivax HB
35
Indications for use for HepB Vaccine
*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
Contraindications/Precautions for HepB Vaccine
Anaphylactic Allergy to Yeast
37
Routes of HepB Vaccine
IM
38
AR/SE of HepB Vaccine
Local soreness
39
Nursing Implications for HepB Vaccine
- 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
With HepB, what signs do you Notify DR about?
- Fever higher than 39.4C (103F) - Diff. breathing (dyspnea) - Hives - Itching - Swelling of eyes, face, or inside nose - Sudden, severe tiredness - Weakness - Convulsions
41
Trade Name for Ondansetron
Zofran, Zofran ODT, Zuplenz
42
Therapeutic classification of Ondansetron
Antiemetics
43
Pharmacologic classification of Ondansetron
5-HT3 antagonists
44
Preg. Category for Ondansetron
B
45
Indications for use for Ondansetron
- 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
Contraindications for Ondansetron
- Hypersensitivity - ODT contains aspartame & should not be used in patients w/ phenylketonuria - Congenital long QT syndrome - Concurrrent use of apomorphine
47
Precautions for Ondansetron
- Hepatic impairment (daily dose not to exceed 8mg) | - Abd. surgery (may mask ileus)
48
Routes for Ondansetron
PO, IM, IV
49
AR/SE of Ondansetron
- HA - Torsade De Pointes - QT interval prolongation - Constipation - Diarrhea - ^ liver enzymes - extrapyramidal reactions
50
Nursing Implications for Ondansetron
- 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
Patient Teaching with Ondansetron
* 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
Trade Names for Penicillin G or V
Pfizerpen, Permapen, Crystapen
53
Therapeutic classification of PCN G/V
Anti-infectives
54
Pharmacologic classification of PCN G/V
Penicillins
55
Preg. Category for PCN G/V
B
56
Indications for use for PCN G/V
* 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
Contraindications for PCN G/V
-Previous hypersensitivity to PCN (cross-sensitivity to cephalosporins) -Hypersensitivity to procaine/benzathine -some products may contain tartrazine & avoid w/ hypersensitivity
58
Precautions for PCN
- 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
Routes for PCN
IM IV <----V
60
AR/SE of PCN
- Seizures - pseudomembranous colitis - allergic reactions including anaphylaxis & serum sickness - D, N, V - epigastic distress - rashes - pain @ IM site - phlebitis @ IV site
61
Nursing Implications for PCN
- 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
Patient teaching for PCN
- 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
What are the signs of a superinfection?
- black, furry overgrowth on tongue - vaginal itching/discharge - loose foul-smelling stools
64
Trade name for Metformin
Glucophage, Glucophage XR, Glumetza, Riomet, Portamet
65
Therapeutic classification for Metformin
Antidiabetics
66
Pharmacologic classification for Metformin
Biguanides
67
Preg. Category for Metformin
B
68
Indications for use for Metformin
- Mgmt of Type 2 Diabetes | - May be used w/ diet, insulin, or sulfonylurea oral hypoglycemics
69
Contraindications for Metformin
- 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
Precautions for Metformin
- 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
Routes for Metformin
PO
72
AR/SE of Metformin
- Abd. bloating - D, N, V - Unpleasant metallic taste - hypoglycemia - lactic acidosis - decrease VitB12 levels
73
Nursing Implications for Metformin
-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
Patient Teaching for Metformin
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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