Meds Flashcards
(65 cards)
1
Q
codeine sulfate
A
- opioid agonist
- ceiling effect (the more you give won’t make a difference)
- GI tract upset
- 15-30 min onset
- do not exceed 120 mg/ day
- take with food or milk
2
Q
what is an opioid agonist?
A
bind to opioid receptors to give full effect
3
Q
fentanyl
A
-opioid agonist
-moderate to severe pain
-patches mainly used for chronic pain only
-not for acute settings
-6-12 hours before seeing difference —> needs to be
changed every 72 hours
-IV/ IM used for moderate sedation
-rapid onset
4
Q
hydromorphone
A
- Diluad
- opioid agonist
- very potent
- rapid onset
5
Q
meperidine hydrochloride
A
- demerol
- opioid agonist
- use w/ extreme caution with the elderly, long term analgesia requirements, and kidney dysfunction
- active metabolite can accumulate and become toxic so it causes seizures
- used in ER for migraines and post op for shivering
- rapid onset
6
Q
methadone hydrochloride
A
- dolophine
- opioid agonist
- detoxification of opioid addicts
- half life longer than duration of action
- easy for overdosing and deaths
7
Q
morphine sulfate
A
- opioid agonist
- for severe pain and helps decrease preload and afterload pressure
- extended release = MS Contin & Kadian
- contraindicated in patients with renal failure due to metabolite that can build up
- check respirations when giving
- adverse effects: weakness, flushing, sweating, bradycardia, constricted pupils, cardiac arrest
8
Q
oxycodone hydrochloride
A
- opioid agonist
- moderate to severe pain
- commonly combined with acetaminophen to create Percocet tablets
- sustained release is known as oxycontin
- cannot be crushed
9
Q
what is an opioid antagonist
A
competes with opioids for CNS receptor sites
10
Q
naloxone hydrochloride
A
- narcan
- opioid antagonist
- blocks rewarding effects of opioids
- complete or partial reversal of respiratory depression
- rapid onset - less than 2 minutes
11
Q
naltrexone hydrochloride
A
- opioid antagonist
- helps maintain opioid free life for former addicts
- treats alcoholism
- reverses post op respiratory depression
- adverse effects = nausea & tachycardia
- contradicted w/ known liver disease or hepatitis
12
Q
acetaminophen
A
- NSAID
- mild to moderate pain & fever
- contraindicated w/ liver disease
- alcoholics should avoid bc can cause liver toxicity
13
Q
what is a glucocorticosteroid
A
- decrease edema
- suppress severe inflammation
- adverse effects: hyperglycemia, peptic ulcers, fluid retention, moon face, depression, weight gain, delayed wound healing, restlessness, dry mouth
- need to monitor blood pressure, I&O, daily weights, LOC, signs of infections, do not (crush break or chew) tablets,
- do not drink grapefruit juice, taper meds to discontinue, diet high in protein, calcium, and potassium, low in carbs & sodium
14
Q
prednisone
A
- glucocorticosteroid
- intermediate acting
- stress will cause a higher dose
15
Q
cortisone
A
- short acting corticosteroid
- for severe inflammation
- assess for diabetes and ulcers
16
Q
hydrocortisone
A
- short acting corticosteroid
- use to manage adrenocortical insufficiency, inflammation, allery, autoimmune disorders, prevents organ transplant rejection
- caution with cirrhosis, stress, and hypothyroidism
- need to taper dose to stop, test for blood in stool
17
Q
betamethasone
A
- long acting corticosteroid
- inflammation, allergies, autoimmune disease
- need to monitor for pulmonary and peripheral edema
18
Q
dexamesathone
A
- long acting corticosteroid
- stimulates formation of glucose and decreases use by body cells
- used for addison disease, chron disease, COPD, lupus, leukemia, lymphomas, head trauma, tumors, prevent/treat cerebral tumors
- caution with hx of TB
19
Q
acyclovir
A
- antiviral
- used for genital herpes and varicella
- adverse effects: HA, dizziness, motor seizures, and diarrhea
- encourage fluids
- check liver and kidney function tests
20
Q
interferon alpha - 2b
A
- antiviral
- used for hepatitis B & C, kaposi sarcoma, malignant melanoma
- adverse effects: dizziness, seizures, coma, amnesia, mood changes, depression, paranoia, anxiety, edema, hypotension, heart failure, MI, stroke, rash, weight loss, alopecia, taste changes
- fever associated with med so watch for masked infections
21
Q
Zidoduvine
A
- antiviral
- used for HIV infection and prevention of maternal to fetal HIV
- adverse effects: anemia, ha, upset stomach, diarrhea, insomnia
- patient needs to adhere closely to dosage schedule
22
Q
Baclofen
A
- muscle relaxant
- can cause constipation, drowsiness, fatigue, weakness, urinary retention
23
Q
Pentobarbital
A
- CNS depressant
- anticonvulsant, sedative
- adverse: drowsiness, serum sickness, hangover, broncho & laryngospasm, constipation, diarrhea, N&V, rash, delirium, depression, physical and physiological dependence
- do not stop abruptly
- avoid alcohol
- use contraceptives
24
Q
phenobarbital
A
- CNS depressant
- anticonvulsant
- adverse: sedation, inattention, irritability
- drowsiness will diminish after first several weeks of therapy
- folic acid supplements for long term use
25
what are the 5 types of laxatives
bulk forming, surfactant, stimulant, osmotic, chlorine channel activator
26
polycarbophil
- bulk forming
- combines with water in colon to make softer & bulkier stool and increase peristalsis
- follow with 8 oz of water
- need to discontinue if N/V occurs or rectal bleeding
- chew tab completely before swallowing
27
psyllium
- bulk forming
- can cause bronchospasm
- take with 240 mL liquid
- do not chew granules
28
docusate
- surfactant
- prevents development of constipation
- adverse: bitter taste, diarrhea, mild cramping
- short term only
- make take fews days to notice softer stool
29
bisacodyl
- stimulant
- short term constipation relief & bowel prep
- adverse: mild abdominal cramps, diarrhea, weakness, dizziness, fluid and electrolyte imbalances
- need to swallow whole
- do not take with milk or antacid
- 1 hour before or after another med
30
lactulose
- osmotic
- for hepatic encephalopathy
- helps decrease blood ammonia
- adverse: cramping, distention, flatulence
- mix with fruit juice, milk, or carbonated beverage
31
lubiprostone
- chlorine channel activator
- for chronic idiopathic constipation
- adverse: ha, anxiety, depression, chest pain, peripheral edema, UTI, back pain
- take with food
32
cimetidine
- histamine receptor 2 antagonist
- used for PUD
- inhibits gastric acid secretion
- adverse: hepatic abnormalities, dysrhythmias, diarrhea, confusion, headache
- rapid infusion causes bradycardia or cardiac arrest
- large doses cause confusion in older adults
33
famotidine
- -histamine receptor 2 antagonist
- used for PUD, GERD
- inhibits gastric acid secretion
- adverse: aplastic anemia, drowsiness, low sperm counts, constipation, N/V, neutropenia, thrombocytopenia
- administer with meals
- smoking interferes with action
- avoid alcohol, aspirin, NSAIDS
34
Esomeprazole
- PPI
- binds to enzymes in presence of gastric pH to prevent hydrogen ion going into stomach
- used for erosive esophagitis, gastroesophageal reflux,
- adverse: dry mouth, flatulence, vomiting
- monitor for rash
35
lansoprazole
- PPI
- binds to enzymes in presence of gastric pH to prevent hydrogen ion going into stomach
- used for erosive esophagitis, gastroesophageal reflux
- adverse: N/V, rash
- do not crush or chew capsules
- avoid alcohol, anti inflammatories
36
aluminum hydroxide
- neutralizes gastric acids
- antacid
- take between meals
37
misoprostol
- prevents gastric injury caused by NSAIDS
- ripens cervix and induces labor
- adverse: ha, abdominal pain, diarrhea, N/V, menstrual problems
- take when starting NSAIDS or at meal or bed times
- avoid alcohol
38
sucralfate
- protects stomach lining
- adverse: constipation, N/V, dry mouth, dizziness, gastric discomfort, rash
- administer on empty stomach
- 4-8 week onset
39
heparin
- anticoagulant
- short term therapy
- adverse: hemorrhage with excessive dosage, thrombocytopenia, hypersensitivity
- agonist : protamine sulfate
40
enoxaparin
- anticoagulant
- prevents VTE & pulmonary emboli
- adverse: hemorrhage, tissue irritation, anemia, thrombocytopenia, fever
- give deep never IM or IV
41
warfarin
- anticoagulant
- interferes with synthesis of vitamin k dependent clotting factors
- adverse: hemorrhage and alopecia
- watch for petechiae, bleeding gums, bruises, dark stools
- antidote: vitamin k
42
Vitamin B1
- Thiamine
- treats anorexia from B1 deficiency, neuritis of pregnancy, alcoholism
- adverse: feeling of warmth, weakness, sweating, restlessness, nausea, anaphylaxis
- avoid alcohol
43
Vitamin B2
- Riboflavin
- found in milk products, whole grain, fortified and enriched grains, liver
- deficiency looks like inflammation of membranes of mouth, skin, eyes, and GI
44
Vitamin B3
- Niacin
- lipid lowering agent
- adverse: flushing of face and neck, pruritus, GI upset, hepatotoxicity, dizziness, nervousness, burning & stinging, dry skin, hyperglycemia, dry mouth, hunger, rash, orthostatic hypotension
- take with milk or food
- to decrease ha or flushing take aspirin 30 min prior
- change positions slowly
- diet low in fat and cholesterol
- food sources: meats, eggs, dairy products
45
Vitamin B6
- Pyrindoxine
- used for high protein diets, early pregnancy use, oral contraceptives
- if have deficiency will show signs of: motor seizures, depressed immunity, anorexia, N/V, dermatitis on face, depression
- food sources: meat, fish, poultry, liver, kidneys, nuts, fortified cereal grains, bran, yeast, egg yolks, starchy veggies, non citrus fruit, bananas
46
Vitamin B12
- Cyanocobalamin
- binds with intrinsic factor in stomach
- food sources: meat, milk, cheese, eggs, liver, fortified cereals
47
Vitamin C
- ascorbic acid
- helps form cartilage in connective tissue and maintain intercellular cement
- deficiency signs: scurvy, imperfect formation of fetal skeleton, defective teeth, anemia, potential injury to bones and cells and blood vessels
- food source: raw cabbage, young carrots, lettuce, celery, onions, tomatoes, radishes, green peppers, citrus fruits, strawberries, apples, pears, plums, peaches, pineapples, apricots
48
digoxin
- decreases heart rate & increases force of contraction
- adverse: bradycardia, dig toxicity, anorexia, N/V, dysrhythmias, diaphoresis
- take apical pulse for one full minute
- pulse falls below 60 withhold and contact HCP
- observe k bc hypokalemia increases risk for toxicity
49
bumetadine
- loop diuretic meaning inhibits reabsorption of sodium, potassium, chloride, and water
- adverse: thrombocytopenia, arthritic pain, pruritus
- need to monitor weight and electrolyte levels
- glucose in diabetic patients
- monitor blood pressure
50
furosemide
- loop diuretic meaning inhibits reabsorption of sodium, potassium, chloride, and water
- adverse: hyperglycemia, GI upset, photosensitivity
- need to have daily weights
- watch for potassium containing foods
- wear sunscreen when outside
51
hydrochlorothiazide
-inhibits reabsorption of sodium, chloride, potassium, and water
-has lower diuresis than loop
-used for hypertension
-adverse: hypokalemia, hyperglycemia, orthostatic hypotension, dizziness, fatigue, N/V, pancreatitis, photosensitivity, hypovolemia, thrombocytopenia, rash
-increase foods high in potassium
-bananas, citrus and dried
fruits, potatoes, pumpkin,
tomatoes, melons, spinach,
avocado, meats
- monitor BP
- use sun protection
52
spironolactone
- k sparing diuretic
- blocks sodium reabsorption in kidney
- adverse: hyperkalemia, hyponatremia, rash, dizziness, ha
- monitor I & O
- do not take at bedtime
- daily weights
53
mannitol
- osmotic diuretic
- inhibits reabsorption of water in the kidney by creating osmotic pressure
- used for edema, systematic diuresis, improve the kidney function, decrease intraocular pressure
- adverse: motor seizures, rebound ICP, hypotension, angia, loss of hearing, metabolic acidosis, dehydration, N/V, diarrhea, thirst, pulmonary congestion
- daily weights / I & O
- cannot use with active brain bleed, heart failure, severe dehydration
54
loratadine
- antihistamine
- for signs and symptoms of allergic reaction
- adverse: dry mouth, blurred vision, confusion, drowsiness, GI upset, weight gain, photosensitivity
- monitor the lung sounds
- maintain fluid intake of 1500-2000 mL daily
- avoid alcohol
- use sunscreen
- maintain good oral hygiene
- sugarless gum or candy
55
isoniazid
- tuberculosis treatment
- adverse: toxic hepatitis, peripheral neuritis, rash, fever, gi upset
- give b6 to prevent peripheral neuritis
- check liver function tests
- before meals on empty stomach
56
ethambutol
- tuberculosis treatment
- adverse: optic neuritis, blurred vision, color perception change, hepatitis, dizziness, hallucinations, ha, stomach ache, anorexia, N/V, peripheral neuritis, fever
- use with caution for renal and hepatic impairment
- need to have regular vision and liver tests
- take with food or milk
- may take months or years for course treatment
57
rifampin
- tuberculosis treatment
- need to use in combo w/ other antitubercular agents otherwise resistant strains emerge
- adverse: ha, drowsiness, pruritus, hepatitis, thrombocytopenia, reddish orange color of urine, sweat, tears, sputum, feces
- monitor liver function
- if on hormonal contraceptive need to add another form
58
diphenoxylate plus atropine
- antidiarrheal
- opioid/controlled substance
- for acute diarrhea
- adverse: confusion, blurred vision, pancreatitis, paralytic ileus, respi depression, anaphylaxis
- do not use with antibiotic caused diarrhea
59
loperamide
- chronic inflammatory bowels
- adverse: constipation, N/V, stomach pain or distention
- need to have frequent oral care
- avoid alcohol
60
rifamixin
- antidiarrheal
- for travel diarrhea
- adverse: fever, ha, stomach ache, constipation, defecation urgency, N/V
- do not use if pt has blood in stool or fever
61
metoclopramide
- antiemetic
- for chemotherapy, diabetic gastroparesis, GERD
- adverse: restlessness, insomnia, nausea, diarrhea
- need to immediately report involuntary movements of body or face
- avoid alcohol or CNS depressants
62
ondansetron
- antiemetic
| - adverse: dry mouth and diarrhea
63
promethazine
- antiemetic
- adverse: sedation, leukopenia, respiratory depression, apnea
- monitor for altered mental status and stop meds 4 days before skin testing
- take with milk or food
64
prochlorperazine
- antiemetic
- adverse: dry eyes & mouth, blurred vision, hypotension, tachycardia, UTI, reddish brown or pink urine, photosensitivity, dysrhythmias, anorexia, hyperthermia
- cannot give to pt with angle-closure glaucoma
- do not stop abruptly
- sunscreen
- good oral hygiene
65
disulfiram
- for alcohol abuse
- when patients take this with alcohol it produces flushing, increased pulse, difficulty swallowing, ha, N/V, palpitation, hyperventilation, hypotension, confusion, resp depression, dysrhythmias, and motor seizures
- symptoms start in 5-15 min
- clients feel like they are having a heart attack or dying
