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Module 7 (Critical Care) > Exam 3 Pharmacology > Flashcards

Exam 3 Pharmacology Flashcards

Fentanyl, Warfarin, Enoxaparin, Prednisone, Promethazine, Pantoprazole, Mannitol, Metronidazole (73 cards)

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1
Q

Fentanyl MOA

A

synthetic opioid agonist
100x more potent than morphine
- changing the brain and CNS response to pain

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2
Q

Fentanyl expected effects

A

relaxation
euphoria
pain relief
sedation
confusion
drowsy
dizzy
N/V
urinary retention
pupillary constriction
respiratory depression

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3
Q

Fentanyl adverse effects

A

dysrhythmias, increase HR
agitation, hallucinations, fever, sweating, confusion
n/v, loss of appetite, weak or dizzy
inability to keep erection or a period
seizure
chest pain
extreme drowsiness

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4
Q

Fentanyl nursing interventions

A

Monitor respirations and O2 for depression
- neuro

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5
Q

Fentanyl is used for

A

Pain
Sedative for mechanical ventilation

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6
Q

Fentanyl Routes

A

Transdermally (long-lasting)
- 72 hours max then remove and apply the next one

Lollipops
SL
Buccal
Sprays
injections

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7
Q

Fentanyl is a type of

A

Narcotic analgesic (opiate)

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8
Q

How to use lozenges with Fentanyl?

A

place within cheek and gum
actively suck and move around in the mouth using the handle (twirl often)
- do not chew, crush, or bite
- do not eat or drink while it is in your mouth
- Finish within 15 minutes

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9
Q

If the patient has a fentanyl lozenges, and starts to feel dizzy, sleepy, or nauseous, then

A

remove and dispose of properly
- out of reach of children
- hot running water to dissolve

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10
Q

Fentanyl OD antidote?

A

Naloxone

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11
Q

Fentanyl OD s/s

A

excessive drowsiness or sleepiness
slow or shallow breathing
difficulty breathing
cold, clammy skin
narrowing or widening of the pupils (black circles in the middle of the eyes)
unable to respond or wake up
slowed heartbeat
unusual snoring

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12
Q

Fentanyl Contraindications medical

A

severe asthma or other breathing problems
stomach or bowel obstructions (paralytic ileus)

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13
Q

Warfarin MOA

A

inhibits essential enzyme for activating the vitamin K available in the body
- reduces clotting factors

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14
Q

Warfarin expected outcomes

A

decrease clotting
- No DVT, stroke or PE
BRUISE EASILY

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15
Q

Warfarin adverse effects

A

uncontrollable bleeding
hemoptysis
bleeding gums
hematuria
bloody stool
dizzy,weak
fever
nosebleed

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16
Q

Warfarin nursing interventions

A
  • limit vitamin K consumption (green and leafy)
  • careful about bleeding, OTC, alcohol
    don’t stop unless directed
  • ID bracelet
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17
Q

Warfarin used for

A

prevention of DVT and stroke
a fib (irregular HR)
prosthetic heart valves
patients of an MI

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18
Q

Warfarin drug type

A

Anticoagulant

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19
Q

Warfarin contraindications

A

erythromycin
phenytoin decrease
NSAIDs, steroids,tylenol

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20
Q

Warfarin INR LEVEL

A

2-3 x therapeutic levels

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21
Q

Warfarin antidote

A

Vitamin K AND FFP

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22
Q

Warfarin onset

A

slow acting
5 days

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23
Q

Warfarin lab levels to monitor

A

PT/INR

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24
Q

Enoxaparin MOA

A

binds and potentiates antithrombin (circulating anticoagulant) to stop the clotting factors

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25
Enoxaparin expected outcomes
no DVT, PE, ors ischemic cardiac complications - bleeding - bruising - pain/irritation at the injection site
26
Enoxaparin adverse effects
bleeding (gums, nosebleeds, bruising) injection site reaction anaphylaxis thrombocytopenia osteoporosis N/V/D HA
27
Enoxaparin nursing interventions
Digoxin toxicity (N/V)
28
Enoxaparin labs to monitor
Platelets <150000 and CBC Half-life 3-6 hours Do not rub/massage after injection site Monitor for constipation soft bristle toothbrush,tarry stools, hematuria
29
Enoxaparin used for
preventing blood clots prophylactic on surgically, bedrest patients unstable angina, MI
30
Enoxaparin precautions
bleeding disorders kidney/liver pts NSAIDs/ASA elderly
31
Enoxaparin contraindications
HIT (Heparin) active bleeding (GI and hemorrhagic stroke) endocarditis spinal anesthesia - thrombolytics, SSRI/SNRI, NSAIDs, antiplatelet, digoxin - garlic, ginger, ginkgo biloba, vitamin E, fish oil, danshen, dong quai, saw palmetto
32
Enoxaparin drug type
antithrombotic
33
Prednisone MOA
lowers inflammation by reducing the activity and volume of the immune system
34
Prednisone expected outcomes
low immune system high blood sugar low inflammation weight gain nausea HA mood swings
35
Prednisone adverse effects
blurry vision dizzy fainting fast and irregular HR increased urination/thirst irritable
36
Prednisone nursing interventions
no crowds/live vaccines insulin not for diabetes
37
Prednisone used for
inflammation flare ups arthritis asthma adrenal crisis
38
Prednisone contraindications
blood thinners (Warfarin and NSAIDs) desmopressin other immunosuppressants
39
Prednisone drug type
corticosteroids
40
Prednisone labs to monitor
blood sugars CBC wt gain urea and electrolytes sweeling in lower extremity
41
Promethazine MOA
histamine antagonist alpha adrenergic - prevent nausea/vomiting short term for insomnia relieve allergies s/s
42
Promethazine EXPECTED OUTCOMES
induction of sleep which can be easily aroused again if needed - drowsy - dizzy - constipation - blurred vision - dry mouth **(anticholinergic)** **sedation** - nightmares - confused - respiratory depression - **extrapyramidal (dystonia, akathisia, and parkinsonism)**
43
Promethazine adverse effects
trouble urinating extravasation
44
Promethazine nursing interventions
large bore IVs patency monitor for tissue necrosis
45
Promethazine used for
tx allergic reactions anxiety and tension N/V
46
Promethazine contraindications
pregnancy and lactating coma tx of asthma
47
Promethazine drug type
Antihistamine - sedating
48
Promethazine labs to monitor
VS - BP and HR Blood sugar
49
Pantoprazole MOA
reduces the amount of stomach acid made
50
Pantoprazole expected outcomes
no ulcers or hematuria HA, dizzy stomach pain, gas, N/V/D joint pain fever, rash, cold s/s
51
Pantoprazole adverse effects
stomach cramps bloated diarrhea fever N/V unusual tiredness
52
Pantoprazole nursing interventions
diarrhea = infection oliguria hemturia More likely to break a bone if long term -**increase risk of fx in the hips, wrist and spine**
53
Pantoprazole used for
esophagitis GERD Ulcers tx and prevention allows the digestive system to rest
54
Pantoprazole contraindications
long term = harder to digest B12 osteoporosis Digoxin, diuretic, methotrexate
55
Pantoprazole drug type
Proton pump inhibitor
56
Pantoprazole monitor labs
BUN and Creatinine I&Os bowel sounds
57
Mannitol MOA
elevates blood plasma osmolality - enhanced flow of water from tissues to brain and CSF into interstitial fluid and plasma
58
Mannitol expected outcomes
neuro status improved - 1st transient hyponatremia then hypernatremia as water is lowers ICP and cerebral edema raises HTN during dialysis
59
Mannitol onset and duration
within 5-10 minutes last up to 6 hours
60
Mannitol adverse effects
worsening cerebral edema - confusion - lethargy - HA heart failure diuresis - low Na, K, Ca dyspnea hypotension anaphylaxis
61
- Mannitol nursing interventions
extravasation I&Os strict (30-50mL/hr or 0.5mL/kg/hr) ICP NEURO STATUS dysrhythmias (K imbalance) fluid shifts = hemodynamic instability
62
Mannitol used for
decreasing ICP, IOP, and cerebral edema excrete toxins improve BP during dialysis Acute renal failure in oliguric phase
63
Mannitol contraindications
pulmonary edema active cranial bleeding significant hypovolemia heart and kidney failure kidney insufficiency electrolyte imbalances CAUTION with Digoxin
64
Mannitol drug type
osmotic diuretics - crosses the blood brain barrier
65
Mannitol monitor labs
electrolytes (Na and K) SERUM osmolality
66
Metronidazole MOA
inhibits protein synthesis by interacting with DNA and breaks down bacteria to prevent or stop infections *cytotoxic*
67
Metronidazole expected outcomes
no fever, normal WBCs dizzy lightheaded N/V/D slight metallic taste in the mouth
68
Metronidazole adverse effects
encephalopathy meningitis aseptic neutropenia peripheral neuropathy
69
Metronidazole nursing interventions
Call HCP if s/s of liver damage or renal damage NEURO STATUS ER - without food 1 hour before or 2 hours after a meal - do not break or crush
70
Metronidazole used for
- not for colds, flu, or other viruses skin infections, rosacea, mouth infections - infected gums and dental abscesses bacterial vaginosis and pelvic inflammatory disease *stds)
71
Metronidazole contraindications
pregnant/breastfeeding liver problems dialysis drinking alcohol
72
Metronidazole drug type
Antibiotic
73
Metronidazole monitor labs
WBC liver enzymes triglycerides

Module 7 (Critical Care) (22 decks)

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