Final Exam Flashcards
(338 cards)
1
Q
transdermals
A
provides more consistent blood levels with no GI upset
2
Q
pharmacogenetics
A
the study of genetic factors that influence an individuals response to a specific drug
3
Q
pharmacokinetics
A
the process of drug movement throughout the body that is necessary to achieve drug action
4
Q
pharmacology
A
study or science of drugs
5
Q
6 rights of medication administration
A
right patient right drugright doseright route right time right documentation
6
Q
OTC drugs
A
over the counter drugs: drugs that have been found safe and appropriate for use without the need of a health care provider
7
Q
Pharmacodynamics
A
the study of the effects of drugs on the body
8
Q
What are the 3 types of medications that need to be recorded for a patients medication list?
A
prescription drugsOTC drugs CAMs
9
Q
What are the things that OTC drugs must provide on their label?
A
active and inactive ingredientspurpose of productuse of product warnings dosage instructions (who can use it and how often)
10
Q
drug
A
any chemical that affects the physiological process of a living organism
11
Q
What must a patient do before taking CAMs?
A
check with their HCP if the CAM can be mixed with their prescription drugs
12
Q
chemical name of a drug
A
describes the chemical structure of the drug
13
Q
generic name of a drug
A
official, nonproprietary name (acetaminophen)
14
Q
brand/trade name of drug
A
proprietary name (Tylenol)
15
Q
generic brand drugs
A
contain the same active ingredients, but may have inactive/inert ingredients to change the tablet shape and control release time
16
Q
What is important when using a generic drug?
A
the health care provider needs to say on the prescription if using the generic brand is okay, or if the patient needs to use name brand
17
Q
extended release, enteric coated, time release capsules/tablets
A
should NEVER be crushed or split in half, they must be swallowed whole
18
Q
What are the rules for sublingual and buccal drugs?
A
the drug should remain in place until it is fully absorbeddo not let patient eat or drink when the medication is in place
19
Q
What are the pharmacokinetic phases?
A
absorption distributionmetabolism excretion
20
Q
absorption
A
movement of the drug from the GI tract into the bloodstream after administration
21
Q
distribution
A
movement of drugs from circulation into body tissues
22
Q
metabolism (biotransformation)
A
body chemically changes drugs to a form that can be excreted
23
Q
potency
A
Amount of drug necessary to elicit a specific physiological response to a drug
24
Q
excretion
A
elimination of drugs from the body
25
What is the first pass effect?
After oral administration, many drugs are absorbed intact from the small intestine and transported first via the portal system to the liver, where they undergo extensive metabolism, therefore usually decreasing the bioavailability of certain oral medications.
26
bioavailability
bioavailability
percent of administered drug available for activity what reaches systemic circulation (blood stream)
27
What happens when 2 highly protein bound drugs are administer together?
the drugs will compete for protein binding sites and this will lead to an increase in the free drugs of the drug that had the lower percent of protein binding
28
free drugs
can exit blood vessels and reach their site of action causing pharmacological response (too high of free drug accumulation can cause side effects, adverse effects, or toxicity)
29
half life (t1/2)
time it takes for the amount of drug in the body to be reduced by half
30
loading dose
a large initial dose given to achieve a rapid minimum effective concentration in the plasmatherapeutic effects can be obtained while steady state is reached
31
What lab test help determine if liver function is good?
aspirate transaminase (AST)alanine aminotransferase (ALT) alkaline phosphate (ALP)
32
What helps determine kidney function?
creatinine clearance BUNGFR
33
What labs are taken to test kidney function?
creatinine (CR)blood urea nitrogen (BUN)
34
therapeutic index
relationship between therapeutic and toxic dose
35
onset
time it takes for drug to reach minimum effective concentration (therapeutic response)
36
peak
highest concentration in the blood
37
duration
length of time for a drug to exert a therapeutic effect
38
peak drug level
the highest plasma concentration of a drug at a specific timeindicates the rate of absorption
39
trough drug level
the lowest plasma concentration of a drugmeasures the rate at which the drug is eliminated
40
drug toxicity
occurs when drug levels exceed the therapeutic range
41
tolerance
decreased responsiveness of a drug over the course of therapy (this individual would require a higher dosage of a drug to achieve the same therapeutic response)
42
additive effects
sum of the effects of the two drugs
43
synergistic effect
effect of the two drugs given together is much greater than effects of either drug alone
44
drug induced photosensitivity
skin reaction caused by exposure to sunlight
45
genomics
study of all the genes in the human genome together, including their interactions with one another with one another, their interactions with the environment and the influence of other cultural and psychosocial factors
46
What is the purpose of knowing a patients genomic information?
so that treatments can be tailored/personalized per patient
47
people of European descent
poor metabolizers of antidepressants, anti psychotics, cardiovascular agents, and isoniazid which can lead to toxicity
48
people of African descent
diminished therapeutic effects from beta blockers, Ace inhibitors and warfarin
49
people of Native American descent
increased vasomotor response to alcohol
50
people of Asian descent
diminished therapeutic effects of codeine; rapid metabolizers of isoniazid
51
people of Middle Eastern descent
many genetic diseases such as thalassemia
52
What do you document after administering a medication/drug?
name of the drugdoseroutetime and date nurse initials or signature
53
When should you check your drug label and how many times?
3 times:at contact with the dug bottlebefore measuring the drugafter measuring the drug
54
What is the culture of safety?
ANA encourages organizations to avoid punitive approaches in drug error reporting
55
What is Just Culture?
fair and not punitive encourages reporting of errorsgoal is to repair system
56
What is the focus of the Joint Commission? What did they develop
focuses on healthcare safety problems and resolutions TJC developed National Patient Safety Goals
57
What is the strongest form of warning?
Black box warning label
58
What is the first thing you think about when a medication error is made?
THE PATIENTS SAFETY! do not leave the patient
59
informed consent
clients have right to be informed and participation is voluntary
60
autonomy
right to self-determination
61
beneficence
obligation of RN to protect the client from harm (do good to patient)
62
justice
equitability or equal selection of research participants
63
the Federal Food, Drug, Administration Cosmetic Act
act that empowered the FDA to ensure a medication is safe prior to marketing
64
the Harrison Act
increased record keeping for narcotics and requires a prescription for a client to be administered narcotics
65
Pediatric Research Equity Act
act that authorized the FDA to require drug manufactures to test drugs and biological products for safety and effectiveness in children"children are NOT small adults
66
Tuskegee Experiment
Infamous historical study in which core values of research (respect for persons, beneficence, and justice) were violated - studied the effects of syphilis in african-american men if left untreated
67
Nuremberg Trials
Trials of the Nazi leaders, showed that people are responsible for their actions, even in wartime, cannot use prisoners of war for experiments NUREMBERG CODE OF ETHICS
68
Thalidomide
drug was marketed to help with nausea "safely" in pregnancy, can produce a variety of malformations of the limbs (stunted limbs) , eyes, ears, and heart.
69
epinephrine classification
Sympathomimetic: adrenergic agonist
70
epinephrine action
alpha 1: increases BP
beta 1: increases HR
Beta 2: promotes bronchodialation
71
epinephrine uses
anaphylactic shock and cardiac arrest
72
epinephrine adverse effect
tissue necrosis at IV site
73
epinephrine lab interactions
increase blood glucose
74
epinephrine food interactions
caffeine containing herbs (cola nut, guanara, mate, tea, coffee) increase stimulant effect
75
epinephrine nursing implications
watch IV sites and monitor blood glucose in diabetic patients
76
epinephrine drug interactions
increased effects with TCAs and MAOIs
77
albuterol classification
B2 adrenergic agonist
78
albuterol action and uses
causes bronchodialation
treatment of asthma
79
albuterol lab interactions
may increase glucose levels (stimulates gluconeogenesis in the liver)
80
albuterol nursing implications
monitor pulmonary function
81
bethanechol
Urecholine
82
Bethanechol (Urecholine) classification
cholinergic agonist: parasympathomimetic
83
Bethanechol (Urecholine) uses
Urinary retention and neurogenic bladder
84
Bethanechol (Urecholine) contraindications
intestinal and urinary tract obstruction, IBS, peptic ulcer
pt w asthma (as it causes bronchoconstriction
85
Bethanechol (Urecholine) nursing implications
baseline VS (IF BP IS LOW, CANNOT ADMINISTER)
monitor AST, bilirubin, amylase, lipase
86
atropine classification
anticholinergic
87
atropine uses
pre-op to reduce salivation so that you do not aspirate
increase HR for Bradycardia
88
atropine side effects
anticholinergic SE (dry mouth, photophobia, urinary retention)
89
atropine contraindications
glaucoma, obstructive GI disorders
90
atropine nursing implications
provide mouth care, tell pt, to wear sunglasses, chew gum or suck on candies to help with dry mouth
91
alprazolam
Xanax
92
Alprazolam (Xanax) classification
Benzodiazepine anxiolytic sedative hypnotic
93
Alprazolam (Xanax) use
anxiety and panic disorder
94
Alprazolam (Xanax) food and CAMs
food: grapefruit increases effects, green tea decreases effect
CAMs: do not combine with kava kava, valerian, chamomile
95
antidote for Alprazolam (Xanax)
Flumazenil
96
Alprazolam (Xanax) nursing implications
gradually withdrawal/wean off
antidote: flumenazil
instruct not to drive
97
lorazepam
Ativan
98
Lorazepam (Ativan) classification
Benzodiazepine anxiolytic sedative hypnotic
99
Lorazepam (Ativan) use
anxiety
status epilepticus
sedation induction for insomnia
100
antidote for Lorazepam (Ativan)
flumazenil
101
Lorazepam (Ativan) nursing implications
taper off
no driving or operating machinery
no alcohol (will further depress CNS)
102
Zolpidem
Ambien
103
Zolpidem (Ambien) classification
nonbenzo
sedative hypnotic
104
Zolpidem (Ambien) use
insomnia
105
Zolpidem (Ambien) side effects
hangover (residual sedation)
anterograde amnesia, nightmares, binge eating
106
Zolpidem (Ambien) nursing implications
teach patient to use non-harm method for sleep first
take medication 15-30 mins before bedtime
suggest patient to urinate before bed to prevent sleep disruption
do not drive
107
phenytoin
Dilantin
108
Phenytoin (Dilantin) classification
Anticonvulsant or antiepileptic drug/ anti seizure
109
Phenytoin (Dilantin) side effects
GINGIVAL HYPERPLASIA
110
Phenytoin (Dilantin) therapeutic range
10-20 mcg/mL
111
Phenytoin (Dilantin) contraindication
pregnancy (teratnogenic)
112
Phenytoin (Dilantin) drug interactions
decreased effects with antacids, folic acid, calcium
113
Phenytoin (Dilantin) CAMs interaction
ginkgo decreases effect
114
Phenytoin (Dilantin) nursing implications
monitor therapeutic serum levels (10-20 mcg/mL)
tell pt. to use extra contraceptive method
must be taken at the same time everyday, lifelong
115
fluoxetine
Prozac
116
Fluoxetine (Prozac) classification
SSRI
117
Fluoxetine (Prozac) use
depression
118
Fluoxetine (Prozac) food interaction
grapefruit juice can lead to toxicity
119
Fluoxetine (Prozac) CAMs interactions
St. Johns Wort can increase risk of serotonin syndrome
120
Fluoxetine (Prozac) drug interactions
alcohol and other CNS depressants increase respiratory depression
MAOIs and TCAs increase risk of serotonin syndrome
121
Venlafaxine
Effexor
122
Venlafaxine (Effexor) classification
SNRI
123
Venlafaxine (Effexor) use
depression, generalized anxiety, social and panic anxiety
124
Venlafaxine (Effexor) drug interaction
SSRI (may increase risk of NSM)
MAOIs (hypertensive crisis and death
St. Johns Wort (serotonin syndrome)
125
Tricyclic Antidepressants (TCAs) use
major depression
if it doesn't work, then use an MAOI
126
Monoamine Oxidase Inhibitors (MAOIs) food interactions
hypertensive crisis from tyramine (aged cheeses, coffee, yogurt, red wine, sausage, cream, chocolate, bananas, beer)
127
Monoamine Oxidase Inhibitors (MAOIs) CAMs
FATAL w St. Johns Wort
128
Cyclobenzaprine
Flexeril
129
Cyclobenzaprine (Flexeril) classification and use
muscle relaxant
used for short term treatment of muscle spasm
130
Salicylate
aspirin
131
Salicyclate (aspirin) classification and action
nalgesic- antiinflammatory; NSAID
inhibits COX 1 and COX 2
132
Salicyclate (aspirin) therapeutic serum level
15-30 mg/mL
133
Salicyclate (aspirin) adverse effects
tinnitus
GI ulceration and bleeding w prolonged use
increase bleeding risk
134
Salicyclate (aspirin) contraindications
do not give to pt who is below the age of 19 if they have flu symptoms- can cause Reyes syndrome
135
Ibuprofen
Motrin
136
Ibuprofen (Motrin) dose level
3200mg/day
137
Ibuprofen (Motrin) adverse effect
hearing loss and tinnitus
138
what is the most widely used NSAID
Ibuprofen
139
Ibuprofen (Motrin) CAM interactions
dong quai, fever few, garlic, ginger, ginkgo may cause bleeding w NSAID
140
Ibuprofen (Motrin) nursing implication
observe pt. for bleeding gums, petechiae, ecchymoses, black tarry stool
141
when should Ibuprofen (Motrin) not be used
2 days before menstrual cycle
142
Celecoxib
Celebrex
143
Celecoxib (Celebrex) classification and action
selective COX 2 inhibitor NSAID (so there will be no GI distress)
144
Celecoxib (Celebrex) uses
Osteoarthritis
Rheumatoid arthritis
145
Celecoxib (Celebrex) CAM interaction
ginkgo increase bleeding risk
146
Celecoxib (Celebrex) nursing implications
Assess for skin rash
147
Remicade
Infliximab
148
Remicade (infliximab) use
treat psoriasis, RA, UC Chrons, autoimmune type disorders
149
Remicade (infliximab) drug interactions
may decrease effectiveness of live vaccines
150
Remicade (infliximab) administration
IV over 2 hours
151
Remicade (infliximab) nursing implications
med supresses immune system
NEED NEGATIVE TB SKIN TEST
152
what is the difference between allopurinol and colchicine?
colchicine: only for initial inflammation and pain
allopurinol: prevention of gout attacks
153
Allopurinol action
Inhibits uric acid production (but doesn't help w inflammation)
154
Allopurinol use
lowers serum uric acid levels, prevent gout attacks
155
Allopurinol adverse effects
urticaria (FIRST SIGN OF RASH DISCONTINUE)
156
Allopurinol Nursing Implications
increase fluid intake (so kidney stones don't form)
DO NOT eat foods w purines (beer, yeast, organ meats, deli meats)
157
acetaminophen
Tylenol
158
Acetaminophen (Tylenol) classification and action
Non-opioid analgesic, NOT AN NSAID
inhibits prostaglandin synthesis
159
Acetaminophen (Tylenol) use
muscular aches and pain, fever, NOT FOR INFLAMMATION
160
Acetaminophen (Tylenol) max dose
4000mg/day
4g/day
161
Acetaminophen (Tylenol) side effects
rash, HA, insomnia, low incidence of GI distress
162
Acetaminophen (Tylenol) adverse effects
hepatotoxicity and renal failure (nurse would see uligaria/ really low UO)
163
Acetaminophen (Tylenol) nursing implications
check liver/hepatic enzymes as toxicity can occur
164
Indomethacin
Indocin
165
Indomethacin (Indocin) use
relieve mild to severe pain, gut, tendinitis, OA, RA
166
Indomethacin (Indocin) contraindications
avoid if allergic to aspirin
167
Indomethacin (Indocin) nursing implications
check hepatic and renal labs
PO: DO NOT BREAK CRUSH OR CHEW
168
Ketorolac
Toradol
169
Ketorolac (Toradol) use
SHORT TERM management (5 days or less)
170
Tramadol
Ultram
171
Tramadol (Ultram) use
moderate to severe pain
172
Tramadol (Ultram) side effects
anxiety, agitation, drowsiness
173
Tramadol (Ultram) nursing implications
educate patient not to operate have machinery or drive because of the sedative effect
174
morphine classification and action
opioid
decreases severity of pain by altering perception of a response to painful stimuli while producing generalized CNS depression
175
morphine side effect
CONSTIPATION, respiratory depression
176
morphine drug interactions
EXTREME caution with MAOIs
177
morphine CAM interaction
decreased effects with St. johns wort
178
morphine nursing implications
antidote: Naloxone (Narcan)
monitor RR
if BP is elevate hold e med and contact HCP
pinpoint pupils may indicate OD
do not give in patient who have a head injury
179
opioid antidote
Naloxone (Narcan)
180
Naloxone (Narcan) nursing implications
monitor vitals, RR, repeat doses may be necessary if respiratory depression shows again
antidote to opioids
nasal spray
181
Fentanyl side effect
constipation, dry mouth, N/V
182
Fentanyl nursing implications
MUST BE DISPOSED IN A SAFETY CONTAINER WITH A LOCK ON IT AT A PHARMACY.
more potent Han morphine by 100x
183
Hydromorphone
Dilaudid
184
Hydromorphone (Dilaudid) action
binds to opiate receptors in the CNS alters perception of and response to painful stimuli while producing CNS depression
suppresses cough reflex
185
Hydromorphone (Dilaudid) drug interaction
EXTREME caution with MAOId
186
Hydromorphone (Dilaudid) CAM interaction
kava kava, valerian, chamomile, increase CNS depression
st. johns wort
187
Oxycodone
Oxycontin
188
Oxycodone (Oxycontin) side effects
unusual dreams, confusion dizziness, floating feeling, HA
189
Oxycodone (Oxycontin) drug interactions
EXTREME caution w MAOIs
190
Oxycodone (Oxycontin) nursing implications
take w food to avoid GI distress
TAPER OFF!!! (do not abruptly discontinue)
BROKEN, CHEWED, CRUSHED TABLETS GET ABSORBED TOO FAST AND MAY BE FATAL
191
Oxycodone with Acetaminophen
Percocet
192
Percocet nursing implications
take w food
watch for dependence and tolerance
193
Nalbuphine
Nubain
194
Nalbuphine (Nubain) classification and action and use
opioid agonist-antagonist (helps decrease opioid abuse)
increases pain threshold
pain and anesthesia induction and maintenance
195
Nalbuphine (Nubain) adverse effects
respiratory depression
196
Nalbuphine (Nubain) nursing implications
DO NOT use alcohol, VS, UO, bowel movements for constipation
197
Sumatriptan
Imitrex
198
Sumatriptan (Imitrex) classification, action, and use
anti-migraine, 5-HT agonist
causes vasoconstriction of cranial arteries
to treat migraine and cluster HA
199
sumatriptan (Imitrex) adverse effects
hypo/hypertension, AV block, angina, dysrhythmias, stroke, thromboembolism
200
Digoxin classifications and use
cardiac glycoside
use for heart failure
201
Digoxin Therapeutic Serum Level
0.5-1 ng/mL (for heart failure)
202
Digoxin toxicity S/S
Digitalis toxicity: green to yellow halos, blurred vision, anorexia, vomiting, diarrhea, Bradycardia, abnormal heart rhythms
203
Digoxin antidote
digoxin immune FAB
204
digoxin nursing implications
check vitals BEFORE ADMIN if HR is below 60 BOM DO NOT ADMINISTER
report hypokalemia and tell patient to heat foods high in potassium (hypokalemia increases the risk of digoxin toxicity)
205
Nitroglycerin classification, action, and use
antianginal
decreases myocardial demand for oxygen
to control angina
206
nitroglycerin nursing implications
3 doses every 5 minutes, call 911 after 1st dose if anginal pain hasn't subsided then administer second dose
remove nitro patch nightly to prevent tolerance
207
atenolol
Tenormin
208
Atenolol (Tenormin) classification and use
beta-adrenergic blocker
used for HTN, angina, prophylaxis and treatment of acute MI
209
Atenolol (Tenormin) side effects
cool extremities, erectile dysfunction (impotence), GI and CNS
210
Atenolol (Tenormin) adverse effect
Bradycardia, hypotension, bronchospasm
211
Atenolol (Tenormin) nursing implications
WATCH BUN AND CREATININE
should be weaned off
do not drive until patient knows reaction to drug
orthostatic hypertension so help with ambulation
212
Diltiazem
Cardizem
213
Diltiazem (Cardizem) classification and use
CCB
used for atrial dysrhythmias and HTN
214
Diltiazem (Cardizem) side effects
edema of ankles and feet , Brady cardia, hypotension, ABRUPT WITHDRAWAL CAN CAUSE ACUTE ANGINA EPISODE
215
Diltiazem (Cardizem) CAM interactions
Parsley can decrease effect
216
Hydrochlorothiazide
Hydrodiuril
217
Hydrocholorothiazide (HydroDiuril) classification, action, and use
thiazide diuretic
excretes sodium, chloride, and water, but KEPPS calcium
used to increase UO and treat HTN
218
Hydrocholorothiazide (HydroDiuril) side effects
hyperglycemia, rash, photosensitivity, blurred vision, muscle cramps
219
Hydrocholorothiazide (HydroDiuril) adverse effects
hyponatremia, hypokalemia, hypercalcemia
220
Hydrocholorothiazide (HydroDiuril) nursing implications
DAILY WEIGHTS, watch electrolytes
TAKE IN MORNING TO PREVENT NOCTURIA
change positions slowly
221
Furosemide
Lasix
222
Furosemide (Lasix) classification, action and use
loop diuretic
sodium water, potassium, magnesium and calcium excreted
for heart failure, HTN, used in pt w renal failure
223
Furosemide (Lasix) side effects
electrolyte imbalances, blurred vision, photosensitivity
224
Furosemide (Lasix) adverse effects
ectrolyte imbalances, hearing loss, BUN, creatinine
225
Furosemide (Lasix) drug interaction
aminoglycosides increase ototoxicity
226
Furosemide (Lasix) food and CAM interactions
food: licorice may increase potassium loss
CAM: Hawthorne may potentiate hypotension
ginseng decrease effects
227
Furosemide (Lasix) nursing implications
daily weights, watch electrolytes, UO
administer IV slowly or hearing loss may happen
instruct potassium replacement w food
228
Spironolactone classification, action and use
potassium sparing diuretic
excrete sodium and water, keeps potassium
used for peripheral and pulmonsry edema, HTN, circulation overload, heart failure
229
Spironolactone adverse effect
severe hyperkalemia, hepatotoxicity
230
Spironolactone drug interactions
LIFE THREATENING WITH ACE INHIBITOR (they both spare potassium)
231
Spironolactone nursing implications
avoid food high in potassium, and watch serum potassium levels
232
Metoprolol
Lopressor
233
Metoprolol (Lopressor) classification and use
beta 1 blocker
treat HTN acute MI and heart failure
234
Metoprolol (Lopressor) side effects
dry mouth, HA, blurred vision, insomnia, tinnitus, peripheral edema, ED, depression BRADYCARDIA
235
Metoprolol (Lopressor) nursing implications
instruct patient to comply w drug regimen and DO NOT abruptly stop as it can cause rebound HTN
236
Prazosin
Minipress
237
Prazosin (Minipress) classifcation and use
antihypertensive: alpha-adrenergic blocker
control HTN
238
Prazosin (Minipress) side effects
tinnitus, depression, dry mouth, peripheral edema, ED, urinary incontinence
239
Prazosin (Minipress) nursing implications
educate pt to not take OTC cold cough or allergy meds without consuming HCP first
DO NOT ABRUPTLY STOP TAKING MEDICATION CAN CAUSE REBOUND HTN
take weekly BP at home
decrease salt intake
240
Lisinopril
Prinvil
241
Lisinopril (Prinivil) classification and use
ACE inhibitor for HTN
242
Lisinopril (Prinivil) side effects
"ACE cough" CNS, orthostatic hypotension
243
Lisinopril (Prinivil) adverse effects
angioedema
244
Lisinopril (Prinivil) contraindications
hyperkalemia, pregnancy
245
Lisinopril (Prinivil) Drug and food interaction
drug: hyperkalemia with potassium sparing diuretics
food: hyperkalemia with foods high in potassium
246
Valsartan classification and use
ngiotensin II receptor blocker (ARB)
for HTN and heart failure
247
Valsartan side effects
abdominal and back pain, arthralgia, fatigue, ED, diarrhea, blurred vision
248
Valsartan advert effects
hyperkalemia, ,rhabdomyolysis, elevated hepatic enzymes
249
Heparin classification, action and use
anticoagulant
inhibits thrombin preventing conversion of fibrinogen to fibrin
prevent thrombosis assoc. w PE, MI, treat DIC
250
Heparin route use
IV: for acute thrombosis
SQ: prophylactically
251
Heparin antidote
protamine sulfate
252
Heparin nursing implications
monitor PTT/aPTT
antidote: protamine sulfate
253
Warfarin
Coumadin
254
Warfarin (Coumadin) classification action use
anticoagulant
depresses vitamin K clotting factors
thrombosis assoc. w PE MI,treat a-fib
255
Warfarin (Coumadin) adverse effects
purple toe syndrome
256
Warfarin (Coumadin) antidote
Vitamin K
257
Warfarin (Coumadin) nursing implications
monitor INR and PT
antidote: vitamin K
watch client for bleeding, soft tooth brushed, electric razor
watch foods rich in vitamin K
258
Clopidogrel
Plavix
259
Clopidogrel (Plavix) classification and use
antiplatelet
prevent thrombosis assoc, with unstable angina, acute MI stroke
260
Clopidogrel (Plavix) side effects
flulike symptoms, bleeding, bronchospasms
261
Clopidogrel (Plavix) CAMs
ginger garlic gingko, feverfew, green tea may increase bleeding risk
262
Clopidogrel (Plavix) nursing implications
check BP before admin
watch for excessive bleeding
263
Alteplase
tPA
264
Alteplase (tPA) classification action and use
thrombolytic agent
promotes conversion of plasminogen to plasmin
clot bluster
promote fibrinolysis with thrombosis, MI, PE< ischemic stroke, occluded IV catheter
265
Alteplase (tPA) antidote
aminocaproic acid
266
Alteplase (tPA) nursing implications
ONLY USE FOR ISCHEMIC STROKE NOT HEMORHAGIC
monitor client 24 hours after therapy discontinues
watch fro bleeding
267
Rosuvastatin
Crestor
268
Rosuvastatin (Crestor) classification and use
antihyperlipidemic: HMG-CoA Reductase inhibitor
decrease cholesterol levels especially LDL and triglycerides
269
Rosuvastatin (Crestor) nursing implications
take with sufficient water or with meal to alleviate GI upset
DO NOT ABRUPTLY STOP as rebound effects may occur could lead to acute MI and possible death
tell pt to report unexplained muscle tenderness (may be rhabdomyolysis)
270
Cilostazol
Pletal
271
Cilostazol (Pletal) classification and use
direct acting vasodilator
treat PBD and intermittent claudication
272
Cilostazol (Pletal) side effects
melena, back and abd. rain, peripheral edema, increases susceptibility to infection TACHYCARDIA
273
Cilostazol (Pletal) contraindications
tobacco smokers and pregnancy
274
Cilostazol (Pletal) Drug interactions
decrease effects w St. johns wort
increase bleedingitme with gingko
275
Cilostazol (Pletal) nursing implications
educate pt. therapeutic response may take 1.5-3 months
NO SMOKING can cause vasospasms
NO ALCOHOL
take with meals to alleviate GI distress
276
amoxicillin classification and use
antibacterial: broad spectrum penicillin
treats OM, tonsilitis, sinusitius, skin, respiratory and UTI
277
amoxicillin side effects
stomatitis, tongue and tooth discoloration, edema
can cause C diff
278
amoxicillin adverse effects
superinfection (vaginitis)
anaphylaxis
279
amoxicillin contraindications
allergic to penicillins
280
amoxicillin drug interaction
antibiotics decrease effects of contraceptives (use extra contraceptive method)
281
amoxicillin nursing implications
watch for superinfection and anaphylaxis (have epi available for severe reaction)
TAKE ENTIRE ANTIBIOTIC
WBC LEVELS
increase fluid intake
282
ceftriaxone
Rocephin
283
Ceftriaxone (Rocephin) classification and uses
third generation cephalosporin
OM, meningitis, appendicitis, gonorrhea, septicemia, surgical infection prophylaxis, skin respiratory and UTI infection
284
Ceftriaxone (Rocephin) side effects
injection site reaction and stomatits (mouth sore)
285
Ceftriaxone (Rocephin) drug interaction
alcohol- may cause disulfiram like reaction
gout drugs (uricosurics)- decrease cephalosporin excretion
286
Ceftriaxone (Rocephin) nursing implications
culture the infected are
tell patient to report signs of superinfection
TAKE W FOOD to prevent GI irritation
watch for a temp, decreased UO, increase fluid outake
287
azithromycin
Zithromax, Zmax
288
Azithromycin (Zithromax, Zmax) classification and use
antibacterial macrolides
bacterial conjuntivitis, STI, skin and respiratory infection
289
Azithromycin (Zithromax, Zmax)side effects
ocular irritation, tinnitus, tongue discoloration, pruritus, conjunctivitis
c diff
290
Azithromycin (Zithromax, Zmax) adverse affection
superinfection (c diff)
hearing loss
291
Azithromycin (Zithromax, Zmax) works well for
those allergic to penicillin
292
Azithromycin (Zithromax, Zmax) trig interaction
levels reduced by antacids (administer two hours before or after)
293
Azithromycin (Zithromax, Zmax) nursing implications
obtain sample
monitor labs and for LIVER DANAGE
report side effects of loose stools (c diff)
294
doxycycline classification and use
antibiotic Tetracycline
acne, anthrax, gingivitis, STI, Ricketts, respirator and UTO and skin infection
295
doxycycline side effects
tooth/ nail discoloration
glossitis (tongue discoloraition)
296
doxycycline drug and food interactions
MILK products and antacids- decrease absorption
decreases oral contraceptive
decrease penicillins
aminoglycosides (increase nephrotoxicity)
297
doxycycline nursing implications
can cause teratogenic effects in pregnancy so warn patients
WOMEN IN LAST TRIMESTER AND KIDS UNDER THE AGE OF 8 SHOULDN'T TAKE BECAUSE PERMANENT TOOTH DISCOLORATION
298
gentamicin classification and use
amino glycoside antibaterial
endocarditis, meningitis, bacteremia, septicemia
bone/joint skin
299
gentamicin side effects
ototoxicity and nephrotoxicity
tinnitus
photosensitivity
300
gentamicin drug interactions
loop diuretics increase risk for ototoxicity and nephrotoxixty
301
amino glycoside toxic effects
ototoxicity and nephrotoxicity
302
gentamicin lab interactions
decrease serum potassium nd magnesium level
303
gentamicin nursing implications
CHECK HEARING AND RENAL FUNCTION
NEED TO DRAW PEAK AND TROUGH LEVELS BECAUSE OF TOXICITY
304
Levofloxacin
Levaquin
305
Levofloxacin (Levaquin) classification and use
fluoroquinolone antibacterial
sinusitis cellucitis, impetigo, plague , anthrax
respiratory skin and UT
306
Levofloxacin (Levaquin) side effects
nightmares, insomnia, tremor rash, injection side tinnitus photosensitivity
307
Levofloxacin (Levaquin) drug interactions
decrease absorption with antacids and iron
can increase effects of warfarin
308
Levofloxacin (Levaquin) nursignimplications
monitor I&Os
check renal and lab values
use sun protection
FLUID INTAKE IS IMPORTANT
309
Trimethoprim/Sulfamethoxazole TMPSMZ
Bactrim
310
TMP-SMZ (Bactrim) classification and use
sulfonamide antibacterial
OM gastroenteritis, MRDA
respiratory and UTI
311
TMP-SMZ (Bactrim) side effects
rash tinnitus photosensitivity vertigo
312
TMP-SMZ (Bactrim) lab interactions
may increase BUN CR, AST ALT ALP
313
TMP-SMZ (Bactrim) nursing implications
ADMINISTER W A FULL GLASS OF WATER
do not take with antacids
tell patient about proper sun protection
CBC
314
Isoniazid (INH) classification and use
antitubercular
treat and prophylaxis for TB
315
Isoniazid (INH) side effects
injection side reaction with IM admin
316
Isoniazid (INH) adverse effects
vitamin b6 deficiency
317
Isoniazid (INH) food interactions
foods high in histamine (aged cheese, tuna)
tyramine (aged cheese, bananas, avocados, smokes meat, fish, soy sauce, yeast)
caffeine
increase effects
318
Isoniazid (INH) CAM interactions
green tea, guaranan and ginseng count increase effects
319
Isoniazid (INH) nursignimplication
`TB skin test required if in contact w person w TB
1 hour before or 2 hours after meal
PYRIDOXINE (vitamin B 6 ) prescribed to prevent peripheral neuropathy
take for like or (24 mots ) until sputum is negative for acid bacilli for 2-3 moths
320
nystatin
Mycostatin
321
Nystatin (Mycostatin) classifaction and use
antifungal antibiotic
to treat candiasis THRUSH
322
Nystatin (Mycostatin) nursing implications
monitor UP check BUN and CR
323
fluconazole
Diflucan
324
Fluconazole (Diflucan) classifcation and use
azalea antifungal
candida infections and cryptococcal meningitis
prophylaxis fro client undergoing bone marrow transplant and radiation therapy
325
Fluconazole (Diflucan) CAMS
NO CAFFIENE (green tea, soft drink, guarna)
326
acyclovir
Zovirax
327
Acyclovir (Zovirax) classification and use
antiviral
treat HSV and VZV
328
Acyclovir (Zovirax) side effects
Philebitis at iv site
gi distress prurtis
329
Acyclovir (Zovirax) nursing implications
check renal and hepatic
sed ed
fluid intake to increase UO
330
chloroquine phosphate classification and use
antimalarial
treat and prophylaxis for malaria
331
chloroquine phosphate nursing implications
use prophylactically if going to malaria endemic countries
take w food if GI dust happens
dont drive and avoid sun
332
Ivermectin
Stromectol
333
Ivermectin (Stromectol) classification and use
amtihelmintic
parasitic worms
334
Ivermectin (Stromectol) drug lab food
take on empty stomach w water
monitor opthalamic exams
follow up with stool exams
335
Ivermectin (Stromectol) nursing implications
trach importance of hand washing
peds dose not determined
take on empty stomach w water
336
Metronidazole
Flagyl
337
Metronidazole (Flagyl) classification and use
peptide amebicide
bacterial anaerobic infections
338
Metronidazole (Flagyl) nursing implications
NO ALCOHOL
may cause disulfiram like reaction
