final Flashcards
(119 cards)
1
Q
rapid acting insulins (3)
A
- lispro
- aspart
- glulisine
2
Q
rapid acting peak
A
•0.5-1 hr
3
Q
short acting insulin
A
•regular
4
Q
short acting peak
A
•2-3 hr
5
Q
intermediate acting insulins (2)
A
- NPH
* detemir
6
Q
intermediate acting peak
A
•4-12 hr
7
Q
long-acting insulin
A
•glargine
*no peak
8
Q
mixing insulin
A
•draw up short first, then long
*glargine and detemir CANNOT be mixed
9
Q
thiazide diuretics and glucocorticoids interaction w/ insulin
A
•raise blood glucose, so counteract insulin effects
10
Q
beta blockers and insulin
A
- mask SNS response to hypoglycemia
* difficult to ID tachy, tremor s/sx of hypoglycemia
11
Q
sulfonylureas (4)
A
- tolbutamide
- glipizide
- chlorpropamide
- glyburide
12
Q
sulfonylurea considerations
A
•take 30 min before meal
*avoid alcohol
13
Q
meglitinides (2)
A
- repaglinide
* nateglinide (starlix)
14
Q
repaglinide considerations
A
- eat w/in 30 min
- tid
- no GF
15
Q
biguanide
A
•metformin (glucophage)
16
Q
biguanide considerations
A
•GI effects •B12/folic acid deficiency •lactic acidosis •r/o kidney fail if use w/ iodine •contra in infection, shock, hypoxia *also used for PCOS
17
Q
thiazolidinedione
A
•pioglitazone (actos)
18
Q
pioglitazone considerations
A
- fluid retention (contra in HF)
- raises LDL
- r/o hepatotoxicity
19
Q
alpha glucosidase inhibitors
A
- acarbose
* miglitol
20
Q
acarbose considerations
A
- GI effects (contra)
- anemia
- hepatotoxicity
- tid w/ first bite
21
Q
gliptin
A
•sitagliptin (Januvia)
22
Q
NSAIDS interactions
A
- inc. hypoglycemic effect w/ insulin/OHAs
- inc. lithium levels
- dec. effects of diuretics b/c reduce UOP
23
Q
OHA important facts
A
- ALWAYS contra in DKA
- only used in type 2
- combined w/ diet/exercise
24
Q
meds safe in diabetics
A
- ACE inhibitors
- ARBs
- CCBs
25
meds contraindicated in diabetics
* NSAIDS
* diuretics
* beta blockers
* Niacin
26
furosemide (lasix)
•high ceiling loop diuretic
| *ototoxicity, hyperglycemia b/c inhibits insulin release
27
torsemide
ethacrynic acid
bumetanide
•high ceiling loop diuretics
28
hydrochlorothiazide (hydrodiuril)
•thiazide diuretic
•hyperuricemia
*does NOT work in renal-insufficient
29
Spironolactone (Aldactone)
•K+ sparing diuretic (r/o hypERkal)
•preferred HF drug
*endocrine, acne, lethargy, diarhhea
30
mannitol (Osmitrol)
•osmotic diuretic
| *caution in HF pt
31
diuretic considerations
* r/o hyponat, hypokal, hypoten, dehydration, hyperglycemia
* take in AM
* additive hypotensive w/ anti-HTN
* hypokal w/ dig.
32
"...prils"
•ACE inhibitors (dec. BP)
| *cough, angioedema, neutropenia, hyperK, distorted taste
33
"...sartans"
•ARBs (dec. BP)
* angioedema
* DONT take w/ food
34
sodium nitroprusside (Nitropress)
•vasodilator
* MAJOR r/o cyanide toxicity (delirium)
* keep away from light
35
"...olol"
•beta-blocker
* bronchoconstriction, inhibited glycogenolysis
* avoid anti-acids and vit. C
36
Nitroglycerin
•nitrate (angina)
* reflex tachy, ortho, HA
* lie down when take
37
verapamil
diltiazem
nifedipine
•CCB
* constipation, peripheral edema, ortho
* avoid GF juice
* antidote is calcium gluconate or beta blocker
38
Digoxin
•cardiac glycoside (dysrhythmias)
| *dysrhythmias, N/V/D, fatigue, visual disturb
39
dig therapeutic range
•0.5-2.0
| *toxicity occurs at 1.75 in some
40
s/sx dig toxicity
* fatigue
* GI distrubances (anorexia)
* visual changes
41
dig and diuretics r/o...
•hypokalemia
42
dig and ACEI/ARB r/o...
•hyperkalemia
43
dig r/o toxicity w/...
* quinidine
| * verapamil
44
dig and anti-acids r/o...
•decreased effectiveness
45
dig and sympathomimetics r/o...
•inc. FOC
46
quinidine
•Na+ channel blocker (dysrhyth)
* diarrhea, cinchonism
* PO w/ meals
47
amiodarone
•K+channel blocker (dysrhyth)
* pulmonary tox, liver dys, hypothyroid, photosensitivity
* draw up slowly
48
adenosine (Adenocard)
•anti-dysrythmic
* flushing
* caution in OA & asthmatics
49
colesevelam
•lowers LDL
* take w/ food
* safest lipid lowering
50
"...statins"
•lower LDL, HDL, and TG
* myopathy, HA, GI, rash
* take in PM, lifelong, no GF
51
niacin
•lowers LDL, HDL, TG
* flushing, hyperglycemia
* NO myopathy
52
Gemfibrozil (Lopid)
•lowers TG
•raises VLDL and HDL
*GI, rash, myopathy, gallstones
53
Ezetimibe (Zetia)
•lowers LDL
54
bethanechol (urecholine)
•muscarinic agonist
| *bronchoconstriction
55
SLUDGE BAM
```
*muscarinic agonist effects
Salivation, secretion, sweating
Lacrimation
Urination
Defecation
GI effects
Emesis
Bradycardia
Abd pain
Myosis
```
56
atropine
•muscarinic antagonist (anti-cholinergic)
| *inc. IOP
57
succinylcholine Anectine)
•NMB during intubation (sedate 1st)
| *caution w/ abx & burns
58
neostigmine
•cholinesterase inhibitor
* urinary urgency, nausea
* assess muscle (swallow) status 1st
59
epinephrine & norepinephrine
•catecholamine
| *vasoconstriction, HTN, hypergly
60
dopamine
•catecholamine
* avoid K+, whole grain, protein
* get Hct 1st
61
prazosin (minipress)
•sympatholytic adrenergic blocker
| *ortho hypo
62
clonidine & methyldopa
•central adrenergic blocker
| *drowsiness, dry mouth
63
heparin & enoxaparin
•anti-coagulant
| *antidote is protamine sulphate
64
labs to monitor heparin therapy
•aPTT
•60-80
*norm is 30-40
65
warfarin (Coumadin)
•anti-coagulant (long term)
| *antidote is vit. K
66
labs to monitor warfarin therapy
•PT of 22-26
*norm is 11-13
•INR of 2-3
*norm is 0.8-1.1
67
Dabigatran (Pradaxa)
•thrombin inhibitor
* dyspepsia
* less freq. blood testing
68
Bivalirudin & Lepirudin
•thrombin inhibitors
69
argatroban
•thrombin inhibitor
70
rivaroxaban
•clotting factor inhibitor
71
aspirin (Ecotrin)
•anti-platelet
| *GI, tinnitus
72
Clopidogrel (Plavix)
•anti-platelet
* gastric bleed
* contra in thrombocytopenia; PUD
73
altepase
•thrombolytic (MI)
| *HA (-> IC bleed)
74
epoetin alpha (Epogen, Procrit)
•erythropoietic stimulating agent
•anemia; CRF
*hypertension
75
morphine, Demerol, & Fentanyl
* strong pure opioid
| * Mu activation
76
Mu activation causes...
* analgesia
* resp. depression
* myosis
* dec. peristalsis
* euphoria
* dependence
77
Codeine, Hydrocodone, Oxycodone
•moderate pure opioid
78
Butorphanol, Buprenorphine
* agonist/antagonist opioid
* kappa agonist
* Mu antagonist
79
kappa activation causes...
* analgesia
* resp. depression
* myosis
* sedation
80
Naloxone (Narcan)
•opioid antagonist
| *tachy, increased pain, inc. bleeding, N/V
81
DiazePAM (Valium)
•benzodiazepine
| *antidote is flumazenil
82
benzodiazepine therapeutics
* anti-anxiety
* anti-convulsant
* muscle relaxant
* sedative
83
PhenobarbiTAL
•barbiturate
84
barbiturate therapeutics
•sedation
85
Halothane, Isoflurane
•inhaled anesthetics
| *hypotension
86
Propofol (Diprivan)
•IV anesthetic
| *euphoria
87
LidoCAINE
•local anesthetic
| *seizure
88
Phenytoin
•AED
•partial, generalized, tonic-clonic
*nystagmus*, gingival hyperplasia, endocrine,
89
Carbamazepine (Tegretol)
•AED
•partial, generalized, tonic-clonic
*FVE, leukopenia/anemia
90
Gabapentin (Neurontin)
•AED
•partial, generalized
*peripheral edema
91
Oxcrbazepine
•AED
•partial, generalized
*skin, HA
92
ethosuximide (Zarontin)
* AED
| * absence
93
Valproic acid (Depakene)
•AED
•all seizures
*GI effects, thrombocytopenia
94
Lamotrigine (Lamictal)
* AED
| * all seizures
95
common AE of AEDs
* nystagmus
* sedation
* double vision
* rash
* dysrhythmias
* hypotension
* drowsiness
* dizziness
* N/V
* dec. OCP effects
96
Baclofen (Lioresal)
•CENTRALLY acting muscle relaxant
| *urinary retention, drowsiness
97
Dantrolene (Dantrium)
•PERIPHERALLY acting muscle relaxant
| *hepatotoxicity, weakness
98
NMBs do NOT...
* decrease pain
| * cause LOC
99
activation of alpha 1 receptor causes...
* vasoconstriction
* mydriasis
* urinary retention
100
alpha 1 agonist therapeutics
* hemostasis
* nasal decongestion
* anesthesia adjunct
* elevate BP
* anaphylaxis
101
alpha 1 agonist AE
* hypertension
* necrosis
* bradycardia
102
activation of beta 1 receptors causes...
* inc. FOC
* inc. HR
* inc. conduction
* renin release
103
beta 1 agonist therapeutics
* cardiac arrest
* HF
* AV block
* shock
* elevates BP
* anaphylaxis
104
beta 1 agonist AE
* dysrhythmias
| * angina
105
activation of beta 2 receptors causes...
* bronchodilation
* uterine smooth muscle relaxation
* vasodilation
* glycogenolysis
106
beta 2 agonist therapeutics
* asthma
| * delay of preterm labor
107
beta 2 agonist AE
* hyperglycemia
| * tremor
108
main muscarinic poisoning symptom
•blurred vision
109
anticholinergics are often used to treat
•overactive bladder
110
how do barbiturates/phenytoin affect drug metabolism
* stimulate liver enzymes so cause faster metabolism
| * may need to increase therapeutic doses
111
normal HgbA1C
* 3.9-6%
| * diabetic goal is < 7%
112
normal BUN
* 7-22
* high= kidney dz
* low= liver dz
113
normal Cr
•0.5-1.4
| *most important lab in OA
114
trough level
* lowest level of drug in a person
| * should be obtained just before next dose
115
morphine onset times
* IV: 7 min
* IM: 30 min
* SQ: 90 min
116
drug for hyperkalemia
•Kayexalate
117
if platelets < 1,000...
•discontinue heparin
118
anti-dysrhythmic for short term ONLY
•Procainamide
| -too many AEs
119
propryothiouracil AE
* sore throat
* bradycardia
* muscle pain
* rash
