final from quizlet Flashcards

Question

Leukotriene Receptor Antagonist indications for use

Answer 1

Used for the prophylaxis and long-term treatment and prevention of asthma Seasonal allergies/asthma

Answer 2

montelukast (Singulair) zafirlukast (Accolate) Both dosed once daily

Answer 3

Nausea Diarrhea Headache Nightmares Liver dysfunction

Answer 4

Respiratory assessment Environmental exposures & allergens Smoking habits Emotional status (anxiety, stress, fear) Allergies Caffeine intake

Answer 5

- Discuss adherence to medication regimen - Demonstrate proper administration of inhaled drugs - Reassess respiratory status & breath sounds - Instruct patient to rinse mouth with water after use of inhaler or nebulized drug esp steroid and anticholinergic to prevent dryness and mucosal irritation - Wash inhaler, spacer and nebulizer Q weekly with warm soapy water - PATIENT EDUCATION

Answer 6

Adrenal gland Adrenal cortex ( 80-90%) Medications working on it include: Corticosteroids Glucocorticoids Mineralocorticoids Adrenal medulla (10-20%) medications working on it include: Epinephrine Norephinephrine

Answer 7

They are synthesized as needed

Answer 8

the hypothalamic-pituitary-adrenal gland axis regulates corticosteroids

Answer 9

Level of corticosteroid low → corticotropin releasing hormone released from hypothalamus → anterior pituitary →ACTH released → adrenal cortex → production of corticosteroids stimulated → corticosteriods reach peak level → signal sent to hypothalamus → HPA inhibited

Answer 10

Major Anti-inflammatory actions Regulates carbohydrate, protein & lipid metabolism Maintenance of normal BP Stress effects Immune response Examples: Adrenocorticotropic hormone (ACTH), cortisone, hydrocortisone, methylprednisone, prednisolone

Answer 11

BP control Maintenance of pH levels in blood Maintenance of serum K levels Sodium & water reabsorption Examples: fludrocortisone 21- acetate (drug replacement

Answer 12

Cushing's syndrome Over secretion of adrenal hormones Glucocorticoid hypersecretion - redistribution of body fat from arms & legs to face, shoulders, trunk, & abdomen Characteristic 'moon face' Aldosterone hypersecretion- increased water & Na retention & muscle weakness from K loss Causes: tumor, excessive administration of steroids (medication)

Answer 13

Addison's disease Under secretion of adrenal hormones Decreased blood Na and glucose levels, increased K levels Signs & symptoms: Hyperpigmentation, weakness, headache, fatigue, N & V, anorexia, dehydration, weight loss, confusion, fever, abd pain, >hr, diaphoresis, low B/P Often vague, chronic and nonspecific complaints

Answer 14

Acts on distal kidney tubule → sodium reabsorption into blood → pulls water & fluid with it → help regulate edema & B/P (HTN) Promotes H & K excretion Helps regulate blood PH Used for addison's disease

Answer 15

Inhibition of inflammatory & immune responses Inhibit or control inflammatory response by: (1) stabilizing cell membranes of inflammatory cells (2) decreasing permeability of capillaries to inflammatory cells (3) decreasing migration of WBCs into inflamed areas Promote breakdown of protein, production of glycogen in liver, & redistribution of fat Some mineralocorticoid-like activity such as fluid and water retention

Answer 16

Adrenocortical deficiency Bacterial meningitis Cerebral edema Collagen diseases (systemic lupus erythematosus) Dermatological diseases Endocrine diseases (thyroiditis) GI diseases (ulcerative colitis) Ocular disorders Leukemia & lymphoma

Answer 17

Bronchospasms (via inhalation route i.e. fluticasone-Flovent) Allergic rhinitis (via nasal route i.e. fluticasone-flonase) Inflammations of ear, eye, & skin (via topical route i.e. betamethasone) Exacerbations of chronic respiratory illnesses (asthma & COPD) PO and IV not interchangeable

Answer 18

This develops when Addison's Disease isn't treated. In addisonian crisis, the patient has extremely LOW CORTISOL levels (life threatening).

Answer 19

Early morning (0600-0900) as it minimizes adrenal suppression

Answer 20

Avoid alcohol, caffeine, aspirin, & NSAIDs Healing may be decreased with long term therapy Avoid contact with people with infections Assess therapeutic response & adverse effects to monitor effectiveness

Answer 21

CNS depressants with similar effects

Answer 22

Decrease anxiety, promote relaxation

Answer 23

Promote relaxation, induce sleep

Answer 24

sedative-hypntoics.

Answer 25

Benzos are the main drug used to treat anxiety and insomnia Antidepressants are becoming more used (trazodone) Barbituates were used but because they got you a little too turnt and addicted we stopped using them

Answer 26

The clinical presentation of both anxiety and insomnia often coexist - Daytime anxiety can manifest as a nighttime sleep disturbance -unable to turn off their worries - And lack of sleep can present as anxiety, fatigue and decreased functioning

Answer 27

A very common disorder which is on the increase in Western society Often described as nervousness, tension, worry Is an unpleasant feeling It occurs when the individual perceives a situation as threatening to physical, emotional, social or economic well being

Answer 28

Not really understood Basically there is an excess of excitatory neurotransmitters (e.g. norephinephrine) or a deficiency of inhibitory neurotransmitters (e.g. gamma-aminobutyric acid or GABA) Neuroendocrine factors also play a role - when under stress, corticotropin releasing factor (CRF) increases release of norephinephrine Serotonin system is also involved, hence the effectiveness of SSRI's in treating anxiety

Answer 29

A recurrent period of decreased mental and physical activity REM sleep is most important for mental and emotional restoration Non REM is physically restorative

Answer 30

A prolonged period of difficulty falling asleep

Answer 31

They potentiate, or promote the activity of GABA by binding to a specific receptor on the GABA(a) receptor complex. Gaba is inhibitory, if you'll recall The mom neurotransmitter, because I'd like to fu- think about the consequences of actions before I act

Answer 32

Anti-anxiety Hypnotic Anticonvulsant Prevention of agitation and delirium tremens (DT's) Anxiety/agitation associated with depression, psychosis or mania Often given concurrently with anti-depressants, anti-psychotics and mood stabilizer

Answer 33

Non REM Causes effects of CNS depression including Sedation Impairment of physical and mental activities respiratory depression

Answer 34

Various benzos have different half lifes Diazepam, Flurazepam form active metabolites which mess up livers in older adults Lorazepam, Clonazepam have intermediate half lives which don't have active metabolites Trialozam does not accumulate

Answer 35

Those with shorter half-lives

Answer 36

Diazepam (valium) for GAD, muscle relaxant, alcohol withdrawal Lorazepam (ativan) for GAD, agitation, alcohol withdrawal Clonazepam (Rivotril) indicated for seizure disorder, panic disorder, agitation and anxiety (takes longer than ativan, but less addictive)

Answer 37

Therapeutic dose has little effect on consciousness Relatively safe Few interactions with many other drugs

Answer 38

Potentially habit forming and addictive - limit to two weeks use Some have long half lives and can accumulate Memory and intellectual impairment Hangover Reduced motor coordination (driving hazard) Paradoxical confusion agitation insomnia

Answer 39

Mild symptoms occur with 6-12 weeks of use Severe symptoms occur when regularly taken for 4 or more months Withdrawal symptoms are caused by abrupt removal of benzo molcecules resulting in a decrease of GABA

Answer 40

anxiety, panic, hand tremors, sweating, restlessness, insomnia, weakness, aches and pains, blurred vision and palpitations

Answer 41

irritability, agitation, rage, nervousness, diarrhea, vomiting, sweating

Answer 42

24 hours for short acting 4-5 days with long acting

Answer 43

Taper the benzodiazepine

Answer 44

Chloral Hydrate (Noctec) Zoplicone (imovane)

Answer 45

Oldest sedative hypnotic Relatively safe, inexpensive and effective Does not suppress REM Tolerance builds fast May cause physical dependence

Answer 46

Structurally different but functionally the same as Benzos Indicated for short term insomnia Delays onset of REM but does not reduce total duration of REM periods Several drug interactions (suck my squick Carbamazepine) Dosage: 7.5mg /24 hours half in elderly

Answer 47

Should not be prescribed in quantities larger than one month - Risk of dependence - Overdose can be fatal - Rebound insomnia common - Taper slowly - Less side effects than other sedative hypnotics

Answer 48

Antihistamine with sedative and anti-emetic properties sometimes used to treat anxiety Primarily hydroxyzine (Atarax), but also diphenhydramine (Benadryl) and dimenhydrinate (Gravol) Indicated for anxiety, preoperative sedation, nausea and vomiting associated with surgery or motion sickness, pruritus and urticaria associated with allergic dermatoses

Answer 49

Kava - Shrub from south america. Suppresses emotional excitability and may produce mild euphoria Melatonin - Hormone produced in pineal gland, derived from amino acid tryptophan Valerian - Herb used as a sedative hypnotic

Answer 50

-Use with caution in the elderly and pediatric populations - Baseline vitals - including postural B/P - Hypnotics: 15-30 minutes pre bedtime for maximum effectiveness - Avoid ETOH and other CNS depressants - Avoid grapefruit juice. It just tastes bad - Pregnancy and breast feeding - Assessment, Diagnosis, Planning, Implementation, Evaluation

Answer 51

Formation of blood cells

Answer 52

Manufactured in bone marrow Immature RBCs are reticulocytes Lifespan is 120 days More than 1/3 of RBCs are made of hemoglobin Heme: Red pigment, contains iron Globin: Protein chain

Answer 53

Maturation defects: Cytoplasmic, nuclear Excessive destruction of RBCs (hemolytic anemias): intrinsic RBC abnormalities, extrinsic mechanisms

Answer 54

production of red blood cells

Answer 55

Epoetin alfa (Epogen)

Answer 56

Biosynthetic form of the natural hormone erythropoietin * Used for treatment of anemia associated with endstage renal disease, chemotherapy-induced anemia, and anemia associated with zidovudine therapy (antiretroviral medication). * Medication is ineffective without adequate body iron stores and bone marrow function. * Most patients receiving epoetin alfa need to also receive an oral iron preparation.

Answer 57

darbepoetin (Aranesp)

Answer 58

drug allergy; uncontrolled hypertension hemoglobin levels that are above 100 mmol/L for cancer patients and 130 mmol/L for patients with kidney disease head and neck cancers risk of thrombosis

Answer 59

Most frequent adverse effects: hypertension, fever, headache, pruritus, rash, nausea, vomiting, arthralgia, and injection site reaction

Answer 60

Essential mineral in the body * Oxygen carrier in hemoglobin and myoglobin * Stored in the liver, spleen, and bone marrow * Deficiency results in anemia

Answer 61

Dietary sources: meats, certain vegetables and grains Dietary iron must be converted by gastric juices before it can be absorbed.

Answer 62

orange juice, veal, fish, ascorbic acid

Answer 63

eggs, corn, beans, cereal products containing phytates

Answer 64

Yes, but it's a touch more rare

Answer 65

Ferrous Sulfate Ferrous Fumarate Ferrous Gluconate

Answer 66

iron dextran (Dexiron®, Infufer®) iron sucrose (Venofer®) ferric gluconate (Ferrlecit®) ferumoxytol (Feraheme®)

Answer 67

Prevention and treatment of iron-deficiency syndromes Administration of iron alleviates the symptoms of iron-deficiency anemia, but the underlying cause of the anemia should be corrected

Answer 68

Most common cause of pediatric poisoning deaths- what drug schedule is iron? - schedule 2 Causes nausea, vomiting, diarrhea, constipation, and stomach cramps and pain. Causes black darkened stools. Liquid oral preparations temporarily discolour teeth. Injectable forms cause pain upon injection.

Answer 69

Symptomatic and supportive measures Suction and maintenance of the airway; correction of acidosis; control of shock and dehydration with IV fluids or blood, oxygen, and vasopressors In patients with severe symptoms of iron intoxication, such as coma, shock, or seizures, chelation therapy with deferoxamine mesylate is initiated.

Answer 70

Iron dextan... May cause anaphylactic shock! Used less frequently because it sucks! More often we use ferric gluconate and iron sucrose!

Answer 71

Indicated for repletion of total body iron content in patients with iron deficiency anemia who are undergoing hemodialysis! Risk of anaphylaxis is much less than with iron dextran, and a test dose is not required.! Doses higher than 125 mg are associated with increased adverse effects including abdominal pain, dyspnea, cramps and itching

Answer 72

a water soluble, B complex vitamin Essential for production of red blood cells Primary use: Folic acid deficiency, during pregnancy (1 month beforehand)

Answer 73

Malabsorption frequently related to alcohol use

Answer 74

Not until actual cause of anemia is determined It may mask the symptoms of pernicious anemia which can lead to brain damage

Answer 75

Used to treat pernicious anemia and other megaloblastic anemias (large, abnormal, immature RBCs) * Administered orally or parentally. * Usually administered by deep intramuscular injection to treat pernicious anemia

Answer 76

Assess patient history and medication history, including drug allergies. * Assess potential contraindications. * Assess baseline laboratory values, especially hemoglobin, hematocrit, reticulocytes, and others. * Obtain nutritional assessment.

Answer 77

Ferrous salts are contraindicated for patients with ulcerative colitis, peptic ulcer disease, liver disease, and other gastrointestinal disorders. * Keep away from children, because oral forms may look like candy. * Iron dextran is contraindicated in all anemias except for iron-deficiency anemia.

Answer 78

* For liquid iron preparations, follow the manufacturer's guidelines on dilution and administration. * Instruct the patient to take liquid iron preparations through a straw to avoid staining tooth enamel. * Oral forms of iron should be taken between meals for maximum absorption but may be taken with meals if gastrointestinal distress occurs. * Oral forms should be given with juice but not with milk or antacids. (Milk coats the inside of the absorption place) * To avoid esophageal corrosion, patients should remain upright for up to 30 minutes after taking oral iron doses. * Patients should be encouraged to eat foods high in iron and folic acid.

Answer 79

*General term for any process that stops bleeding *Coagulation is hemostasis that occurs because of the physiological clotting of blood. *Complex relationship between substances that promote clot formation and either inhibit coagulation or dissolve a formed clot *Thrombus: technical term for a blood clot *Embolus: thrombus that moves through blood vessels

Answer 80

Works as a "Cascade" Each activated factor serves as a catalyst that amplifies the next reaction. Result is fibrin, a clot-forming substance Intrinsic pathway and extrinsic pathway

Answer 81

*An aggregation of platelets, fibrin clotting factors and the cellular elements of the blood that is attached to the interior wall of a vein or artery.Tr

Answer 82

Trouble, usually. A blood clot that has been dislodged from the wall of a blood vessel and is traveling through the bloodstream. If an embolus lodges in a coronary artery, it causes a myocardial infarction If it obstructs a brain vessel, it causes a stroke (a cerebrovascular accident). If it travels to the lungs, it is a pulmonary embolus. If it travels to a vein in the leg, it is a deep vein thrombosis (DVT). Collectively, these complications are called "thromboembolic events."

Answer 83

Anticoagulants - Inhibit action or formation of clotting factors - Prevent clotting factor Antiplatelet drugs - inhibits platelet aggregation - Prevents platelet plugs Thrombolytic agents break down formed clots Antifibirnolytic agents promote blood coagulation and clot formation

Answer 84

*Also known as antithrombotic drugs *Have no direct effect on a blood clot that is already formed *Prevent intravascular thrombosis by decreasing blood coagulability *Used prophylactically to prevent: Clot formation (thrombus) An embolus (dislodged clot)

Answer 85

inhibit clotting factors IIa (thrombin), Xa, and IX Factors XI and XII are also inactivated but do not play as important of a role as the other three factors

Answer 86

Unfractioned heparin is known as "Heparin" Low-molecular-weight heparins: enoxaparin (Lovenox) dalteparin (Fragmin) nadroparin calcium (Fraxiparine) tinzaparin sodium (Innohep)

Answer 87

Relatively large molecule that is derived from animal sources *Frequent laboratory monitoring for bleeding times such as aPTT (how long does it take for a blood clot to form in sec) *Heparin for catheter flush (10-100 units/mL): no monitoring is needed

Answer 88

Natural anticoagulant obtained from the lungs or intestinal mucosa of pigs 10 to 10 000 units/mL DVT prophylaxis: 5 000 units subcutaneously two or three times a day. Does not need to be monitored when used for prophylaxis. Weight-based protocol When heparin is used therapeutically (for treatment), continuous IV infusion. Measurement of activated partial thromboplastin time (aPTT) (usually every 6 hours until therapeutic effects are seen) is necessary.

Answer 89

- heparin leo - small vial of aqueous heparin IV flush solution - risk of the development of heparin-induced thrombocytopenia has caused most institutions to use 0.9% normal saline as a flush for heparin-lock IV ports - heparin flushes (100 units/mL) are still used for central catheters

Answer 90

Synthetic smaller molecular structure (fractionated) More predictable anticoagulant response; more specific for activated factor X Frequent laboratory monitoring of bleeding times using tests such as aPTT not needed

Answer 91

Action: Inhibit factor fondaparinux (Arixtra); rivaroxaban (Xarelto); apixaban (Eliquis)

Answer 92

Dabigatran

Answer 93

Inhibits vitamin K synthesis by bacteria in the gastrointestinal tract Action: inhibit vitamin K-dependent clotting factors II, VII, IX, and X which are normally synthesized in the liver Final effect is the prevention of clot formation

Answer 94

Most commonly prescribed oral anticoagulant *Careful monitoring of the prothrombin time(PT)/international normalized ratio (INR)

Answer 95

0.8-1.2 seconds

Answer 96

2-3.5 seconds depending on indication for use

Answer 97

It's for blood clotting speed because we can't just say blood clotting speed

Answer 98

Dietary considerations Age considerations Maintenance dose determined by the INR Natural health product cautions

Answer 99

Vary, depending on drug Work on different points of the clotting cascade Prevent intravascular thrombosis by decreasing blood coagulability Do not lyse existing clots

Answer 100

*Used to prevent clot formation in certain settings in which clot formation is likely *Myocardial infarction *Unstable angina *Atrial fibrillation * Indwelling devices, such as mechanical heart valves *Conditions in which blood flow may be slowed and blood may pool (e.g., major orthopedic surgery, prolonged periods of immobility

Answer 101

Drug allergy *Any acute bleeding process or high risk of such an occurrence *Warfarin is strongly contraindicated in pregnancy. *Other anticoagulants are rated in lower pregnancy categories. *Low-molecular-weight heparins are contraindicated in patients with an indwelling epidural catheter risk of epidural hematoma.

Answer 102

Bleeding -Risk increases with increased dosages -May be localized or systemic May also cause: -Heparin-induced thrombocytopenia -Nausea, vomiting, abdominal cramps, thrombocytopenia, other effects

Answer 103

Aimed at reversing the underlying cause *Symptoms: hematuria, melena (blood in the stool), petechiae, ecchymoses, and gum or mucous membrane bleeding *Stop drug immediately. *Intravenous (IV) protamine sulphate: 1 mg of protamine can reverse the effects of 100 units of heparin (1 mg of protamine for each milligram of lowmolecular-weight heparin given).

Answer 104

Bleeding Lethargy Muscle pain Skin necrosis "Purple toes" syndrome

Answer 105

-Discontinue the warfarin. -May take 36 to 42 hours before the liver can resynthesize enough clotting factors to reverse the warfarin effects -Vitamin K1 (phytonadione) can hasten the return to normal coagulation. -High doses of vitamin K (10 mg) given IV will reverse the anticoagulation within 6 hours. Severe bleeding: transfusions of human plasma or clotting factor concentrates Intravenous vitamin K: risk of anaphylaxis. Risk is diminished by diluting it and giving it over 30 minutes.

Answer 106

Beyond the fact that Vitamin K is the antidote for anticoagulants? (Vitamin K)

Answer 107

Prevents clot formation by inhibiting platelet adhesion at the beginning of the cascade. * Acetylsalicylic acid (ASA) 81-325mg * clopidogrel bisulfate (Plavix) * ticagrelor (Brilinta)

Answer 108

Affect the normal function of platelets to prevent platelet adhesion to the site of blood vessel injury

Answer 109

Stroke, TIA, and post MI thrombo prevention *Some antiplatelets used in conjunction with anticoagulant Warfarin as a prophylaxis for CVA, PE, DVT.

Answer 110

ASA Side Effects *nausea, vomiting, GI bleeding, diarrhea, thrombocytopenia, agranulocytosis, anemia Clopidrogel Side Effects * chest pain, abdominal pain, diarrhea, epistaxis, headache, dizziness, fatigue (flue like symptoms)

Answer 111

Assess... Patient history, medication history, allergies Contraindications Baseline vital signs, laboratory values (PT/INR or PTT) Potential drug interactions History of abnormal bleeding conditions No IM injections with anticoagulants

Answer 112

Intravenous doses are usually double-checked with another nurse; high alert *Ensure that subcutaneous doses are given subcutaneously, not intramuscularly. *Subcutaneous doses should be given in areas of deep subcutaneous fat, and sites should be rotated Do not give subcu injection within 5cm of belly-button, incisions, open wounds (HOLES. JUST LEAVE HOLES ALONE) Do not aspirate or massage subcu site -First of all it shouldn't be anywhere NEAR a vein -Second you'll make a hematoma IV doses may be given by bolus or IV infusions. Anticoagulant effects are seen immediately. Laboratory values are done daily to monitor coagulation effects (aPTT).

Answer 113

*Protamine sulphate

Answer 114

*Given subcutaneously in the abdomen \ *Rotate injection sites. *Protamine sulphate can be given as an antidote in case of excessive anticoagulation

Answer 115

May be started while the patient is still on heparin until PT/INR levels indicate adequate anticoagulation (called cross-over therapy or bridging therapy) *Full therapeutic effect takes several days. *Monitor PT/INR regularly; keep follow-up appointments Many herbal products have potential interactions; increased bleeding may occur including: Capisicum pepper Garlic Ginger Ginkgo St John's Wort Feverfew

Answer 116

* Importance of regular laboratory testing if needed *Signs of abnormal bleeding *Measures to prevent bruising, bleeding, and tissue injury *Wearing a medical alert bracelet *Avoiding foods high in vitamin K (tomatoes, dark leafy green vegetables) if taking Warfarin

Answer 117

Two primary forms of lipids in the blood

Answer 118

As an energy source and stored in adipose tissue

Answer 119

Used to make steroid hormones, cell membranes and bile acids

Answer 120

combination of triglyceride or cholesterol with apolipoprotein

Answer 121

Very-low-density lipoprotein *Produced by the liver Transports endogenous lipids to peripheral cells*Intermediate-density lipoprotein *Low-density lipoprotein (LDL) *High-density lipoprotein (HDL) Responsible for "recycling" of cholesterol Also known as "good cholesterol"

Answer 122

The risk of coronary heart disease in patients with cholesterol levels of 5.2 mmol/L is three to four times greater than that in patients with levels less than 4 mmol/L.

Answer 123

*Farmingham Risk Score *Heart Age Calculator *Medications to treat dyslipidemia *Drug choice based on the specific lipid profile of the patient (phenotyping) All reasonable nondrug means of controlling blood cholesterol levels (e.g., diet, exercise) *Drug therapy based upon the specific lipid profile of the patient

Answer 124

Hydroxymethylglutaryl-coenzyme A (HMG-CoA) reductase inhibitors (statins) *Bile acid sequestrants *B vitamin niacin (vitamin B3, nicotinic acid) *Fibric acid derivatives (fibrates) *Cholesterol absorption inhibitor ezetimibe (Ezetrol®)

Answer 125

First-line therapy for hypercholesterolemia (elevated LDL)* Treatment of type IIa and IIb *Reduces plasma concentrations of LDL cholesterol by 30 to 40% *Decrease in plasma triglycerides by 10 to 30%*Increase in HDL cholesterol by 2 to 15% *Dose dependent

Answer 126

Inhibit HMG-CoA reductase enzyme, which is used by the liver to produce cholesterol *Lower the rate of cholesterol production thereby increasing the amount of LDL receptors in the liver.

Answer 127

Mild, transient GI disturbances i.e. constipation *Rash *Headache *Myopathy (muscle pain), possibly leading to rhabdomyolysis, a serious condition

Answer 128

*Breakdown of muscle protein *Myoglobinuria: urinary elimination of the muscle protein myoglobin *Can lead to acute kidney injury and even death*When recognized reasonably early, rhabdomyolysis is usually reversible with discontinuation of the statin drug. *Instruct patients to immediately report any signs of toxicity, including muscle soreness or changes in urine colour (tea-coloured). *Avoid Grapefruit juice

Answer 129

*oral anticoagulants *erythromycin Grapefruit juice

Answer 130

Two of the most commonly used drugs to lower cholesterol levels These lower LDLs and trigylcerides while raising HDL Dosed once daily. Usually at night

Answer 131

cholestyramine resin (Olestyr®) *colestipol hydrochloride *colesevelam *Also called bile acid-binding resins and ion-exchange resins

Answer 132

-prevent resorption of bile acids from small intestine -bile acids are necessary for absorption of cholesterol

Answer 133

Vimtain B3 Lipid-lowering properties require much higher doses than when used as a vitamin. Effective, inexpensive, often used in combination with other lipid-lowering drugs

Answer 134

Reduces the metabolism or catabolism of cholesterol and triglycerides *Effective in lowering triglyceride, total serum cholesterol, and LDL cholesterol levels *Increases HDL levels *Effective in the treatment of types IIa, IIb, III, IV, and V dyslipidemia

Answer 135

Flushing (caused by histamine release) Pruritus GI distress

Answer 136

AKA Fibrates Bezafibrate Gemfibrozil Fenofibrate

Answer 137

Believed to work by activating lipoprotein lipase, which breaks down cholesterol Also suppress the release of free fatty acid from adipose tissue, inhibit the synthesis of triglycerides in the liver, and increase the secretion of cholesterol in the bile

Answer 138

Treatment of types III, IV, and V hyperlipidemias The fibric acid derivatives bezafibrate, gemfibrozil, and fenofibrate decrease the triglyceride level and increase the HDL cholesterol level by as much as 25%. All are given with a statin, which increases risk of myositis, myalgia, and rhabdomyolysis

Answer 139

Abdominal discomfort, diarrhea, nausea Blurred vision, headache Increased risk of gallstones Prolonged prothrombin time Increased enzyme levels perhaps shown by liver studies

Answer 140

ezetimibe (Ezetrol) Inhibits absorption of cholesterol and related sterols from the small intestine Results in reduced total cholesterol, LDL cholesterol, apolipoprotein B, and triglyceride levels Also increases HDL cholesterol levels Often combined with a statin drug Can be used as monotherapy

Answer 141

Used as a antihypertensive, antiplatelet, and lipid reducer *Adverse effects: dermatitis, vomiting, diarrhea, anorexia, flatulence, antiplatelet activity *Possible interactions with warfarin, diazepam, and protease inhibitors *May enhance bleeding when taken with nonsteroidal anti-inflammatory drugs (NSAIDs)

Answer 142

Both the seed and oil of the plant are used. *Uses: atherosclerosis, hypercholesterolemia, hypertriglyceridemia, gastrointestinal distress, menopausal symptoms, bladder inflammation, others *May cause diarrhea and allergic reactions *Possible interactions: antihyperglycemic drugs, anticoagulant drugs

Answer 143

Fish oil products *Used to reduce cholesterol *May cause rash, belching, allergic reactions Potential interactions with anticoagulant drugs Not good while pregnant. You'll have fish babies

Answer 144

Obtain health history prior to starting Assess dietary patterns, substance use, exercise Assess for contraindications including liver dysfunction, bile concerns Obtain baseline liver function

Answer 145

Patients on long-term therapy may need supplemental fat-soluble vitamins (A, D, E, K) with Bile Acid Sequestrants Counsel patient concerning diet and nutrition on an ongoing basis.* Instruct patient on proper procedure for taking the medications. *Powder forms must be taken with a liquid, mixed thoroughly but not stirred, and never taken dry. *Other medications should be taken 1 hour before or 4 to 6 hours after meals to avoid interference with absorption.

Answer 146

To minimize adverse effects of niacin, start on a low initial dose and gradually increase it, and have the patient take the medication with meals. *Small doses of aspirin or NSAIDs may be taken 30 minutes before niacin to minimize cutaneous flushing. *Provide teaching regarding the use of NSAIDs and aspirin. *Inform patients that these medications may take several weeks to show effectiveness

Answer 147

Instruct patients to report persistent gastrointestinal upset, constipation, abnormal or unusual bleeding, and yellow discoloration of the skin. *Monitor for adverse effects, including increased liver enzyme studies or signs of myalgias. *Monitor for therapeutic effects. *Reduced cholesterol and triglyceride levels

Answer 148

Medication that treats bacterial infections

Answer 149

Sulfonamides B-Lactam (4 diff classes) macrolides Tetracyclines Aminoglycosides Quinolones Miscellaneous

Answer 150

Nausea, vomiting, diarrhea Photosensitivity, dermatitis Nercolysis

Answer 151

Penicillins Cephalosporins Carbapenems Monobactams

Answer 152

Penicillin enters via the cell wall and binds to cell-wall proteins thus causing destruction of said cell wall

Answer 153

nausea, vomiting, diarrhea, abdominal pain

Answer 154

Warfarin Oral contraceptives NSAIDs

Answer 155

Five generations Bactericidal Broad spectrum Structurally related to penicillin

Answer 156

Bind (chelate) to Ca+++ and Mg++ and Al+++ ions to form insoluble complexes

Answer 157

No. Dairy products, antacids, and iron salts reduce oral absorption of tetracyclines

Answer 158

No. It kinda messes up teeth, bones

Answer 159

- handwashing (most important) - disinfectants - antiseptics

Answer 160

kills organisms used only on nonliving objects cidal agent

Answer 161

inhibits growth of microorganisms = necessarily not kill them - applied exclusively to living tissue - static agent

Answer 162

cultured to identify organism & potential antibiotic susceptibilities

Answer 163

TX of infection b4 specific culture info obtained

Answer 164

antibiotic therapy tailored to treat organism identified w/ culture

Answer 165

TX antibiotics to prevent infection

Answer 166

decrease in signs & symptoms of infection

Answer 167

signs & symptoms of infection DO NOT improve

Answer 168

penicillins & sulfonamides 2 classes which ppl allergic too

Answer 169

difficulty breathing, significant rash, hives, GI intolerance

Answer 170

allergies, kidney & liver function, pregnancy status, genetic characteristics, site of infection & host defences

Answer 171

penicillins cephalosporins carbapenems monobactams

Answer 172

- interferences with cell wall & protein synthesis - interferences w/ DNA & RNA - acting as metabolite to disrupt critical metabolic reactions inside bacterial cell

Answer 173

kill bacteria

Answer 174

inhibit growth of susceptible bacteria rather than killing them immediately = eventually leads to bacterial death

Answer 175

- bacteriostatic action - prevent bacterial synthesis of folic acid required for synthesis of purines & DNA, RNA

Answer 176

own folic acid & does not affect microorganisms that use exogenous folic acid

Answer 177

effective against gram + & gram - - TX of UTI - pneumonia

Answer 178

- blood: agranulocytosis, thrombocytopenia, hemolytic & aplastic anemia - skin: photosensitivity**, stevens-johnson syndrome - GI: N & V**, diarrhea**, hepatotoxicity, pancreatitis - toxic nephrosis, headache, convulsions, cough

Answer 179

- enter bacteria via cell wall & bind to penicillin-binding protein - then disrupt normal cell wall synthesis = bacteria cell die from lysis

Answer 180

- prevent & TX of infections caused by (gram + ..) - treat health-care acquired infections (pneumonia, intra-abdo infections, sepsis)

Answer 181

- allergy - medication errors

Answer 182

- allergic (urticaria, pruritus, angioedema) - nausea, vomiting, diarrhea, abdo pain

Answer 183

- nonsteroidal anti-inflammatory drugs - oral contraceptives - warfarin

Answer 184

- semisynthetic ABX - structure/pharma r/t penicillins - broad spectrum

Answer 185

bactericidal action

Answer 186

antimicrobial activity

Answer 187

- good gram + coverage/ poor gram -

Answer 188

surgical prophylaxis & susceptible staph infections

Answer 189

cefazolin (IV, IM) cephalexin (PO)

Answer 190

- good gram +/decent gram -

Answer 191

prophylactically for abdo or colorectal surgeries (KILLS ANAEROBES)

Answer 192

surgical prophylaxis DOES NOT KILL ANAEROBES

Answer 193

* cefaclor * cefoxitin * cefuroxime * cefprozil

Answer 194

- most potent against gram - - less active against gram +

Answer 195

* cefotaxime sodium * cefixime * cefpodoxime proxetil * ceftizoxime * ceftazidime * ceftriaxone

Answer 196

* IV and IM, long half-life, once-a-day dosing * Elimination is primarily hepatic * Easily passes meninges and diffused into cerebrospinal fluid to treat central nervous system infections

Answer 197

* IV and IM forms * Excellent gram-negative coverage * Used for difficult-to-treat organisms such as Pseudomonas spp. * Excellent spectrum of coverage

Answer 198

* Broader spectrum of antibacterial activity than thirdgeneration cephalosporins, especially against grampositive bacteria

Answer 199

complicated & uncomplicated UTI

Answer 200

mild diarrhea, abdo cramps, rash, pruritus, redness, edema

Answer 201

broadest antibacterial action bactericidal (gram +/-)

Answer 202

complicated body cavity & connective tissue infections in acutely ill hospital pts (MRSA)

Answer 203

60 mins & may cause drug-induced seizures

Answer 204

bone, joint, skin, and soft tissue infections

Answer 205

- imipenem/cilastatin - meropenem - ertapenem

Answer 206

- synthetic B-lactam antibiotic - bactericidal - primarily active against aerobic gram -

Answer 207

management of cystic fibrosis pts w/ chronic pulmonary infections

Answer 208

- erythromycin - azithromycin - clarithromycin - fidaxomicin

Answer 209

- prevent protein synthesis within bacterial cells - bacteriostatic

Answer 210

- strep infections - mild to moderate upper & lower resp infection - syphilis & lyme disease - gonorrhea, chlamydia, mycoplasma

Answer 211

nausea, vomiting, GI bleed

Answer 212

c. difficile - associated diarrhea

Answer 213

- N & V, diarrhea, hepatotoxicity, anorexia, heartburn

Answer 214

fewer GI effects, longer duration of action, better efficacy, better tissue penetration

Answer 215

chest pain, palpitations, dizziness, jaundice, hearing loss

Answer 216

bacteriostatic: inhibit bacterial growth, inhibit protein synthesis stop many essential functions of bacteria

Answer 217

dairy products, antacids, iron salts

Answer 218

calcium, magnesium, and Al

Answer 219

- strong affinity for calcium = children 8 or less (discolouration teeth) - change intestinal flora - diarrhea - vaginal candidiasis - gastric upset - enterocolitis - coagulation irregularities

Answer 220

- assess allergies, renal liver & cardiac function - health history - contraindications - drug interactions

Answer 221

- obtain cultures from sites BEFORE beginning ABX therapy - take ABX exactly as prescribed & until gone - watch signs of superinfection or secondary infection (fever, perineal itching, cough) - assess adverse effects (N & V, diarrhea)

Answer 222

- 2,000 to 3000mL fluid/24hr - PO w/ food - STAT report worsening abdo cramps, stomach pain, diarrhea, hematuria, worsening rash, SOB, fever

Answer 223

- PO w/ H2O bc acidic fluids may decrease antibacterial action - monitor for allergic for 30 mins - lactobacillus supplement

Answer 224

- assess allergy (cross allergy w/ pen) - PO admin w/ food to decreased GI upset even tho delay absorption - acute alcohol intolerance reaction when taken with alcohol

Answer 225

- highly protein bound & cause severe interactions with protein-bound drugs (carbamazepine, cyclosporine, warfarin) - take with meal

Answer 226

- organisms that produce ESBL resistant to all B lactam ABX only be treated with carbapenems or quinolones

Answer 227

not given PO d/t poor oral absorption very potent ABX w/ serious toxicity

Answer 228

bactericidal = prevent protein synthesis kill gram - & some gram +

Answer 229

gentamicin sulphate streptomycin sulphate tobramycin sulphate neomycin sulphate

Answer 230

- kill gram - - used in combo w/ other ABX for synergistic effects - parenterally

Answer 231

topical antibacterial

Answer 232

- serious: nephrotoxicity, ototoxicity (auditory impairment & vestibular impairment) - headache - paresthesia - fever - vertigo - skin rash

Answer 233

- serum levels measured to prevent toxicity - serum level needs to be higher than min inhibitory concentration to kill bacteria

Answer 234

- peak: highest drug levels for once-daily regimens (not measured) - trough: lowest, ensure adequate renal clearance of drug & avoid toxicity

Answer 235

- oral absorption - absorption reduced by antacids, calcium, magnesium, iron - effective against gram - & +

Answer 236

- bactericidal - alter DNA of bacteria causing death - not affect human DNA

Answer 237

- gram - & + - complicated urinary, resp, bone & joint, GI, skin

Answer 238

PO & injection

Answer 239

GU infections

Answer 240

- antacids, calcium, mag, iron, zinc (take 1hr before/after) - dairy - enteral tube feedings - probenecid - nitrofurantoin - oral anticoagulants

Answer 241

central nervous: headache, dizziness, insomnia, restlessness, convulsions GI: N & V, diarrhea, constipation, oral candidiasis skin: rash, pruritis, urticaria, flushing other: ruptured tendons, tendonitis, blurred vision, tinnitus, fever

Answer 242

chronic bone infections, GU infections, intra-abdo infectionsc

Answer 243

pseudomembranous colitis (ABX-associated colitis), c. diff

Answer 244

treat vancomycin resistant (VRE), MRSA

Answer 245

- strenghens effects of vasopressive drugs - serotonin syndrome if taken with SSRI - reactions if taken with tyramine-containing foods

Answer 246

- anaerobic organisms - intra-abdo & gynecological infections - protozoal infections - several drug interactions

Answer 247

- used UTO - caution w/ kidney impairment - drug concentrates in urine - may cause heptatotoxicity

Answer 248

- 30:70 combo, works synergistically - used bacteremia & infections caused VRE & complicated skin infections (MRSA) - may cause arthralgias & myalgias

Answer 249

- TX of choice for MRSA & gram + - c. diff

Answer 250

blood levels to ensure therapeutic levels & prevent toxicity may cause ototoxicity & nephrotoxicity

Answer 251

red man syndrome (flushing or itching of head, neck, face)

Answer 252

over 60 mins rapid infusions may cause hypotension

Answer 253

- polypeptide ABX penetrates & disrupts bacterial membrane of gram - - serious adverse effects - IV IM inhalation

Answer 254

dermatophytes

Answer 255

- cutaneous - subcutaneous - superficial - systemic (life threatening, immunocompromised host)

Answer 256

- may follow ABX therapy, corticosteroids - may result in overgrowth or systemic infection

Answer 257

- bind to sterols in cell membrane lining = fungal death

Answer 258

- inhibit fungal cell cytochrome P450 enzymes, resuting in cell membrane leaking = altered cell metabolisn & fungal cell death

Answer 259

- systemic & topical fungal infections

Answer 260

- cardiac dysrhythmias - nephrotoxicity, tinnitus, visual disturbances, convulsions - potassium loss - pulmonary infiltrates - shake & bake fever, headache, nausea, hypotension, tachycardia, anemia

Answer 261

nausea, vomiting, diarrhea, stomach pain, increased liver enzymes

Answer 262

nausea, vomiting, anorexia, diarrhea, rash, urticaria

Answer 263

- allergies, contraindications - baseline VS, CBC, liver & renal function, ECG - assess meds (OTC & prescribed)

Answer 264

- follow directions for reconstituation & admin - montior VS of pt IV infusions 15-30mins - monitor input & output

Answer 265

- reduce severity of infusion reactions = pretreat w/ antipyretic, antihistamines, antiemetics, corticosteroids - use IV pumps & most distal veins - at home = document weight (gain 1kg or more in 24hr or 2.3kg in week = kidney damage)