FINAL EXAM - Common Medications Flashcards Preview

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Flashcards in FINAL EXAM - Common Medications Deck (77)
1

Adverse drug reactions (ADR) will be seen in

the vital signs
ALWAYS check clients vitals

2

Parkinson's L-dopa

when optimal tone effect is reached is the time to treat for therapy

3

The more medications a person takes, the more....

ADRs a person will experience

4

Reasons for ADRs(6)

1. risk/benefit of drug not recognized
2. hx of drug allergy
3. wrong drug name or dosage form
4. lack of education
5. failure to obtain adequate pt. hx and drug hx
6. pt compliance issues

5

Pharmacokinetics (Pk) ADME

1. Absorption
2. Distribution
3. Metabolism
4. excretion

6

Absorption

through stomach and intestinal wall - not fully absorbed

7

distribution

travels to liver and active in blood stream = travels all around

8

metabolism

liver first before where it needs to go = partially deactivated

9

excretion

removed through urine

10

Pk can be affected by exercise because

the blood goes to the skin and muscles so the drug is not being absorbed by the blood is not going to the GI tract

11

Side effects are caused by

the drug binding to other areas besides its target organ

12

Why do we NEVER heat the injection site?

increases absorption

13

Acidic drugs enter through the

stomach

14

Transdermal route is

slow - patches for pain, estrogen, nicotine

15

NEVER put a hot pack over a transdermal patch because

increases absorption and can lead to death!

16

Intravenous

goes directly to the site - 100% is absorbed

17

intrathecal

spinal canal - epidural

18

implanted devices

reservoir implanted- morphine/insulin pump

19

Common ADR for antimicrobials (3)

1. diarrhea
2. rash
3. pruritus (itching)

20

Common ADR for Anticoagulants (2)

1. hemorrhage
2. Bruising
*fine line between enough and too much

21

Common ADR for Chemotherapy (6)

1. bone marrow suppression
2. alopecia
3. nausea
4. infection (decrease in WBC)
5. fatigue (decrease in RBC)
6. anemia (decrease in RBC)

22

Common ADR for cardiovascular (3)

1. heart block
2. arrhythmias
3. edema

23

Common ADR for Diabetic medication (3)

1. hypoglycemia (sends people to hospitals)
2. diarrhea
3. GI complications

24

Common ADR for NSAIDS (3)

1. GI Ulceration and bleeding
2. renal insufficiency
3. MI

25

Common ADR for Diuretics (3)

1. hypokalemia (low K+)
2. hyperglycemia
3. dehydration

26

diabetes and diuretics are not good because

risk of hyperglycemia

27

body structures and functions commonly affected by ADRs (6)

1. hematological system
2. skin and related structures
3. metabolic
4. musculoskeletal
5. respiratory
6. sensory

28

Affects to the hematological system (2)

1. anemias
2. thrombocytopenia

29

Affects to the skin and related structures (5)

1. pruritus
2. urticaria
3. alopecia
4. rash
5. petechiae

30

Affects to the metabolic system(2)

1. osteoporosis
2. fluid and electrolyte imbalance

31

Affects to the musculoskeletal system (4)

1. myalgia
2. arthralgia
3. neuropathy
4. rhabdomyolysis (muscle breakdown)

32

Affects to the respiratory system (5)

1. bronchospasm
2. allergic rhinitis
3. respiratory depression
4. pulmonary fibrosis
5. dyspnea

33

Affects to the sensory system (5)

1. impaired vision
2. ototoxicity
3. tinnitus
4. diplopia
5. periperal neuropathy

34

Peripheral vascular resistance caused by plaque causes

HTN

35

What factors increase BP? (3)

1. fluid overload
2. narrowed arteries
3. high heart rate

36

Beta blockers

lower BP by slowing down the heart rate. binds to beta receptors so adrenaline cannot. decreases HR and contractility of the heart

37

Beta Blocker ADRS (6)

1. fatigue
2. bad cholesterol
3. orthostatic hypotension
4. excessive slowing of the HR and contractility
5. masks symptoms of hypoglycemia (not good for diabetic pts)
6. less effective when given with arthritis medicine

38

Beta blockers and exercise

beta blockers lower HR which mean exercise HR will be lower; only add 20 to the RHR.
Ex: RHR normally 80, only bring HR up to 100 during exercise

39

Diuretics

inhibit the sodium pumps preventing reabsorption of fluid back into the body. Affordable - not necessarily the best option

40

ADR of diuretics (5)

1. fluid depletion
2. loss of electrolytes
3. orthostatic hypotension
4. hyperglycemia
5. increase in LDL

41

All drugs for HTN cause

orthostatic hypertension

42

dehydration causes (7)

1. fatigue
2. altered mental status
3. fainting
4. headaches
5. dry mouth
6. skin turgor (skin stays pinched)
7. increased HR

43

clinical signs to watch for with diuretics (10)

1. hypotension
2. dizziness
3. orthostatic hypotension
4. dehydration
5. cramping
6. arrhythmia
7. incontinence
8. muscle cramps
9. thready pulse
10. elevated K+ and BUN levels

44

Rehab and diuretics (8)

1. ankle pumps for circulation
2. monitor pulse
3. skin inspection
4. fall prevention
5. watch for signs of dehydration
6. prolonged exercise in the heat is contraindicated
7. geriatrics more sensitive to affects
8. NSAIDS make diuretics less effective

45

Diuretic toxicity (6)

1. anorexia
2. nausea
3. vomiting
4. confusion
5. weakness
6. paresthesia of extremities (tingling)

46

Calcium Channel Blockers

make vessels wider, used for HTN

47

Clinical signs to watch for with Calcium channel blockers (4)

1. hypotension
2. orthostatic hypotension
3. dizziness/syncope
4. lower extremity edema

48

Rehab implications with Calcium channel blockers (2)

1. less effect on exercise performance than beta blockers
2. fall prevention activities

49

Vasodilators

block production of ACE I and ARBs, reduce peripheral vascular resistance

50

Vasodilators may produce a

hacking cough

51

Therapeutic concern with all HTN medications

1. excessively low BP (notify MD if systolic is below 90)
2. orthostatic hypotension
3. precautions when using heat modalities
4. Beta Blockers, CCBs and vasodilators all DECREASE exercise performance

52

First choice for HTN because it does not decrease exercise performance is

ACE I and ARBs

53

Rehab implications for all Anti-Hypertensive agents (8)

1. take BP often (BP

54

Nitroglycerin

dilates arteries and veins making it easier for the heart to pump - treats angina

55

ADRS for nitroglycerin

1. dizziness
2. orthostatic hypotension
3. headaches

56

If nitroglycerin is active a pt should feel

burning under their tongue

57

Nitroglycerin needs to be stored properly

because it deactivates itself in 3 months and needs to be in a brown container

58

Clot preventers (5)

1. aspirin
2. heparin
3. warfarin
4. Plavix
5. Brilinta

59

heparin - used for (3) conditions emergently

used when anticoagulation is needed immediately
DVT
pulmonary embolism
acute MI

60

Warfarin

blocks production of clotting factor. Drug-food interactions cause emergency hospitalization in seniors (broccoli)

61

Clot prevention ADRs (4)

GI upset
bleeding
bruising
precautions for deep tissue work

62

NSAIDs treat (3)

inflammatory conditions like
1. rheumatoid arthritis
2. tendonitis
3. arthritis

63

NSAIDs ADRs (4)

1. minor stomach discomfort to hemorrhaging
2. ulcers
3. hypertension
4. cognitive dysfunction

64

Celebrex (NSAID) increases the risk for

MI

65

High doses of acetaminophen are toxic to the

liver

66

Acetaminophen can elevate

BP

67

Statins reduce
(2) drugs

reduce LDL cholesterol
Lipitor
Crestor

68

Statin ADR (1)

muscle pain

69

Insulin facilitates...
(5) types

glucose entry into cells; w/o insulin cells are not fed and glucose stays in blood stream (blood glucose levels)
1. ultra-short acting - 5 min before meals - all goes to cells
2. short-acting - 30 min. before meal
3. intermediate
4. long
5. peakless - injection @ night

70

Normal glucose range

90-120

71

Need to match insulin with food in order to avoid

hypoglycemia

72

Subcutaneous insulin injections need to be rotated between these locations (4)

1. lower abdomen
2. upper outer arm
3. upper outer thigh
4. buttocks

73

Rehab precautions with insulin administration

1. don't exercise area of injection or don't inject into area going to be exercised
2. do not use PAM near injection site
3. No massage in the area

74

ADRs for insulin (3)

1. hypoglycemia
2. lipohypertrophy or lipoatrophy at injection site
3. weight gain

75

symptoms of hypoglycemia

1. headache
2. fatigue
3. tachycardia
4. sweating anxiety
5. confusion
6. weakness
7. faintness
8. numbness in the fingers and around mouth

76

treatment for hypoglycemia; three examples

ingest foods containing glucose:
1. soft drinks
2. fruit juice
3. glucose tablets (20 grams of D-glucose)

77

three ways to recognize any ADRs

1. vital signs
2. mental status change
3. abnormal bleeding