Drugs Flashcards
(71 cards)
Following spinal anesthesia, what should you do if a Pt complains of a HA?
Lay hob FLAT, NO pillows
What drug would likely be administered with fentanyl for conscious sedation and amnesia?
Midazolam
If following spinal anesthesia, a Pt becomes hypotension, what should you do?
Elevate hob
What drug is likely to be administered for induction of anesthesia, maintenance of anesthesia, or sedation for mechanical ventilation?
Propofol
How do thiopental and Propofol differ in terms of onset and duration?
Thiopental-onset within seconds, duration 10-20 min.
Propofol-duration is even shorter..3-5 min.
What drug can prolong the effects of IV lidocaine?
Epinephrine
What four things does nitroglycerin decrease by vasodilation?
1) decrease venous return (preload)
2) decrease ventricular filling
3) decrease wall tension
4) decrease O2 demand
What 2 drugs would be contraindicated with nitrates?
1) hypotension drugs
2) phosphodiesterase inhibitors (ED Rx)
What are the two main AE of Nitroglycerin?
1) Hypotension
2) reflex tachycardia
What would be an example of protecting from “unintentional harm”, in a patient receiving IV lidocaine?
Making sure the pt’s gag reflex is intact is an example of unintentional harm.
What non-anesthetic adjunct often given for pain , is given 30 minutes prior to the OR, and exhibits anticholinergic effects? (what are anticholinergic effects?)
Morphine.
Anticholinergic effects: decreases r/f decreased HR and dry secretions by vasodilation.
The nurse knows that in large doses, Diazepam (valium) will result in…
loss of consciousness
Antianginal drugs work by what 3 factors?
1) Restore supply&demand of O2
- Improve blood oxygen delivery to the heart by
2) dilating vessels and..
3) decreased work load of the heart
Why is nitroglycerin not given PO often?
because of the first pass effect; heavily metabolized by the liver. Doses must be large, and are given prophylactically for angina.
Lidocaine is a local anesthetic, as well as an antiarrhythmic drug. What anti arrhythmic properties does it have, and what is it indicated for?
Lidocaine IM or IV is indicated for SHORT-TERM Tx of Ventricular Dysrhythmias.
What potential side effect does the nurse know can occur when giving high doses of lidocaine?
- Dizziness
- Resp. Depression
- Paresthesias**
- Seizure**
List the four prototype anti arrhythmic drugs according to their class.
Class I–Na+ channel blocker–Lidocaine
Class II–B-Blocker–Propanolol
Class III–K+ channel blocker– Amiodarone
Class IV–Ca2+ channel blocker–Verapamil
Beta 1 receptors innervate the __________.
Beta 2 receptors innervate the __________.
Beta 1–heart
Beta 2–bronchioles
What can be given IV to treat hypokalemia? Are there special NIs to note?
KCL–MUST be diluted to <40mEq/L, and NO FASTER than 10 mEq/hr
What may be given to treat hyperkalemia?
Glucose and insulin infusion, calcium gluconate (for cardiac effects), kayexelate (PO, rectal), and if life threatening, hemodialysis
What IV solution may be given to treat hypocalcemia?Are there special NIs to note? (rate? monitoring? administration?)
IV calcium gluconate
- MUST GIVE SLOWLY–0.6-2 mL/min
- Dedicated IV line
- Cardiac monitoring
What may be given to treat hypercalcemia? What non-pharmaceutical interventions can you instruct the pt to do?
- Rx: loop diuretic
- Teach pt: adequate hydration to promote excretion, and mobilization to promote reabsorp. to bone
____calcemia is associated with hyperactive reflexes.
____calcemia is associated with muscle twitching.
Hypocalcemia is associated with hyperactive reflexes
Hypercalcemia is associated w/ muscle twitching.
What are the most important AEs to monitor for in a hypokalemia?
- ECG changes
- Postural hypotension
- Bradycardia
- Digitalis tox.
