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Flashcards in N398 Meds Midterm Deck (40):
1

Aspirin

Classification: Nonopioid Analgesics

Use: inflammation suppression, Analgesia for mild/moderate pain, fever reduction

Action: COX1 and COX2 inhibitor

Adverse effects and rxns: GI, Impaired kidney function (decreased urine output, increased BUN and creatinine levels), Salicylism (tinnitus, sweating, headache, dizziness, respiratory acidosis)

Nursing considerations:
-Aspirin toxicity should be managed as a medical emergency, activated charcoal given to decrease absorption
-Reverse acidosis and promote salicylate excretion with bicarbonate






2

Oxycodone/Morphine (MS Contin)

Class: Opioid agonist

Use: Produces analgesia, respiratory depression,euphoria, sedation

Action: Acts on the mu receptors and to a lesser degree the kappa receptors

Adverse Effects: respiratory depression, constipation, orthostatic hypotension, urinary retention

Nursing Considerations: assess pain level on a regular basis
-take baseline vital signs and monitor them periodically
-double check opioid doses with another nurse prior to administering them

3


Amoxicillin (Amoxil)

Class: broad spec. antibiotic

Use: Treats infections due to gram positive and gram negative bacteria

Action: destroys cell walls of bacteria

Adverse Effects: allergies, diarrhea

Nursing Considerations:
-take with meals
-watch for interactions with oral contraceptive use

4

Amoxicillin + clavulanic acid
(penicillin and beta-lactamase inhibitor) (Augmentin, Zosyn)

Class: Broad-spectrum antibiotic

Use: Treats infections due to gram-positive and gram negative cocci (helps with amoxicillin resistance)

Action: destroys the cell wall of bacteria

Adverse Effects:
--allergies, anaphylaxis
-diarrhea

Nursing Considerations:
-take medication with meals,
-report any signs of allergies right away,
-complete entire course of therapy

5


Cephalexin (Keflex)

Class: Cephalosporin 1st gen antibiotic

Works on gram positive infections, narrow spectrum soft tissue and skin infection

Action: destroys bacterial cell walls

Adverse Effects: N/V/diarrhea

Nursing Considerations:
-take with food
-often given prophylactically before surgery

-

6


Ceftriaxone (Rocephin)

Class: Cephalosporin 3rd generation

Good for gram positive or some gram negative, *great CNS penetration (crosses blood brain barrier)

Action: destroy bacterial cell walls

Adverse Effects: -allergies, anaphylaxis
-may increase bleeding tendencies

Nursing Considerations:
-given IM or IV
-do NOT give to neonates due to bilirubin/albumin binding

7


Azithromycin (Zithromax)

Class: Macrolide antibiotic

inhibit microorganism growth *can cover “atypical” organisms

Action: inhibit protein synthesis of microorganisms
*(binds to the ribosome of the bacteria so it can’t do protein synthesis)

Adverse Effects:
-GI discomfort
-prolonged QT intervals (cardiac)

Nursing Considerations:
used for clients who have a penicillin allergy



8


Doxycycline (Vibramycin)

Class: Tetracycline broad-spectrum antibiotic

Covers both gram pos and gram neg bacteria such as chlamydia

Action: inhibit protein synthesis of microorganisms

Adverse Effects:
-GI discomfort
-hepatotoxicity
-photosensitivity (intense sunburn)

Nursing Considerations:
monitor for nausea, vomiting, diarrhea
-binds to cations; separate 2 hrs from any cation ingestion
wear sunscreen


9


Metronidazole (Flagyl)

Class: antiprotozoals antibiotic

Treatment of protozoal infections (intestinal amebiasis)

Action: nucleic acid synthesis inhibitor

Adverse Effects:
-GI discomfort
-metallic taste

Nursing Considerations:
-severe reaction with alcohol!
-use condoms if treating for STD and finish entire course of medication
-drug interactions


10


Fluconazole

Class: anti fungal

Action:
inhibits the formation of the fungal cell membrane;
slows growth of the fungus or destroys it

Adverse Effects:
-nausea, headache, rash
-rare hepatic necrosis

Nursing Considerations:
-complete the prescribed course of therapy
-drug interactions



11


Unfractionated heparin

Class: anticoagulant

Action: inactivates thrombin & factor Xa

Adverse Effects:
-bleeding
-heparin-induced thrombocytopenia

Nursing Considerations:
unpredictable bioavailability, short half life, monitor labs aPTT

12


Enoxaparin

Class: anticoagulant

Action: inactivates factor Xa

Adverse Effects:
-bleeding
-heparin induced thrombocytopenia

Nursing Considerations:
-cautious in pts with renal dysfunction b/c of elimination
-less protein binding

13

Warfarin

Class: anticoagulant
Vitamin K antagonist

Action: Inhibits synthesis of vitamin K-dependent clotting factors (suppresses production of Factors II, VII, IX, X)

Adverse Effects:
bleeding (watch for getting hit, cuts)

Nursing Considerations:
-monitor labs (PT, INR)
-lots of food and drug interactions
-long half life, delayed onset



14


Dabigatran

Class: anticoagulant

Action: Direct Thrombin inhibitor

Adverse Effects:
bleeding, GI effects (abdominal pain)

Nursing Considerations:
-watch for drug interactions (i.e. amiodarone)

15

Rivaroxaban

Class: anticoagulant

Action: Factor Xa inhibitor

Adverse Effects:
-BLEEDING, cuts, getting hit, unexplained bruising

Nursing Considerations:
-active immediately (helpful)

16

Ferrous sulfate

Class: Ferrous sulfate

Action: provides iron

Adverse Effects:
-GI disturbances
-constipation
-can turn stools dark green/black

Nursing Considerations:
-Reduced absorption if taken with antiacids, increased absorption if taken with Vitamin C

17

Iron dextran

Class: Parenteral iron

complex of ferric hydroxide and dextrans (glucose polymers)

Adverse Effects:
-anaphylactic reactions
-hypotension
-circulatory failure
-cardiac arrest

Nursing Considerations:
IV infusion


18

Cnocobalamin

Class: iron supplement- Vitamin B12 product

Action: purified, crystaline form of vitamin B12

Adverse Effects:
-may see hypokalemia due to increased erythrocyte production

19

Folic Acid

Class: nutritional supplement

Need B12 to fix the neurologic effects of anemia

Action: helps treat anemia- folic acid is necessary for formation of many coenzymes in many metabolic systems required for erythropoiesis and folate deficiency anemia

20

Erythropoietin

Class: anemia treatment

Action: induces erythropoiesis (production of RBCs)

21


Lisinopril

Class: ACE inhibitor

Action: angiotensin converting enzyme inhibitor
(no vasoconstriction, body will not hold onto salt, you will diurese)

Adverse Effects:
-persistent cough, hyperkalemia, teratogenic, angioedema (big tongue)

Nursing Considerations:
shown to slow progression of kidney injury in pts with diabetes

22


Losartan

Class: Angiotensin Receptor Blocker

Action: prevents fluid retention, vasodilation, activation of RAAS system

Adverse Effects:
-teratogenic, angioedema, hyperkalemia

Nursing Considerations:
often used in combination therapy

23

Amlodipine

Class: Calcium Channel Blocker
anti- hypertensive agent

Action:
-suppresses smooth muscle contractions by preventing vasoconstriction

Adverse Effects:
-reflexive tachycardia
-peripheral edema


Nursing Considerations:
-watch for swelling; do not want to start another medication to treat swelling when the swelling is caused by the med

24

Hydralazine

Class: Vasodilator, hypertensive agent

Adverse Reactions:
-reflexive tachycardia (heart will increase rate to make up for lack of vasoconstriction)
-can cause a systemic lupus erythematosus

Nursing Considerations:
-watch when administering to pregnant mothers

25

Metoprolol

Class: Beta Adrenergic Blocker

Action:
-decreases cardiac output
-suppresses reflex tachycardia caused by vasodilators
-reduces release of renin (in kidneys, reduces the RAAS system input)
-lowers HR
-long term use reduces peripheral vascular resistance

Adverse Reactions:
bradycardia, heart block, bronchoconstriction

Nursing Considerations:
monitor heart rate
-watch for patients with asthma, COPD

26

Labetalol

Class: Combination Beta & Alpha Blocker hypertensive agent

Action:
-decreases cardiac output
-suppress reflex tachycardia caused by vasodilators
-reduces release of renin
-long term use reduces peripheral vascular resistance

Adverse Reactions:
-bradycardia, heart block, bronchoconstriction

Nursing Considerations:
-monitor heart rate
-watch for patients with asthma, COPD

27

Nitrofurantoin

Class: Nitrofuran Antibiotic
Bacteriostatic antibiotic; covers some gram pos and some gram neg

Action: damages bacterial cell DNA

Adverse Effects:
can turn urine brown
-GI disturbances
-pulmonary rxns (acute and subacute)
-agranulocytosis

Nursing Considerations:
-only used for UTIs as therapeutic levels are only seen in the urine
-first line go to for pregnancy UTIs

28

Trimethoprim/Sulfamethoxazole (Bactrim, Septra)

Class: Sulfonamide Antibiotic
effective against gram positive and gram negative

Action:
-metabolism inhibitor (folate antagonist)
-bacteriostatic

Adverse Effects:
-hyperkalemia
-thrombocytopenia, neutropenia, megaloblastic anemia
-renal dysfunction; potassium sparing diuretic

Nursing Considerations:
drug interactions with Warfarin (increasing levels)!!!

29

Sodium Bicarbonate (NaHCO3)

Class: electrolyte replacement

Used for severe metabolic acidosis, hyperkalemia

Action:
trying to shift potassium into the cell and get H+ to come out of the cell

Adverse Effects:
-can be caustic to the vasculature
-can cause hypokalemia
-can cause metabolic alkalosis

Nursing Considerations:
watch for pt going into metabolic alkalosis


30


Potassium Chloride/Phosphate

Class: electrolyte replacement
Helps reverse hypokalemia

Adverse Effects:
PO: GI effects- nausea, vomiting, diarrhea, abdominal discomfort, esophagitis (should give w food
and lots of water)

IV: can cause local irritation and pain

Nursing Considerations:
-watch serum potassium levels, monitor for signs and sx of hyperkalemia
-watch IV site

31


Magnesium Sulfate

Class: IV electrolyte replacement therapy

helps treat hypomagnesemia, preeclampsia and eclampsia, migraines, status asthmaticus

Nursing Considerations:
-use w caution in renal dysfunction
-monitor pts cardiac and neuromuscular status

32

Calcium Chloride

Class: electrolyte replacement
more elemental calcium than gluconate
1 g of chloride= 3 g of gluconate

Helps with calcium replacement and also hyperkalemia

Adverse Effects:
-more caustic to the vasculature than gluconate
-should be administered centrally (central not periph line)

Nursing Considerations:
-hyperkalemia- 10-30 min, 1g/hr

33

Calcium Gluconate

Class: electrolyte replacement
Helps with calcium replacement

Nursing Considerations:
-peripheral administration
-hyperkalemia- 10-30 min, 1g/hr

34


Albuterol

Class: Short acting beta2 agonist,
helps reverse hyperkalemia
"ATP pump energy booster"

Action:
-binds to beta 2 receptors in lungs- causes bronchodilation
Binding to beta 2= activates adenylate cyclase which then stimulates production of cAMP
-cAMP is used by the Na-K pumps

Nursing Considerations:
-Monitor potassium levels (hypokalemia), heart rate

35


Dextrose 50% Injection

Class: electrolyte replacement; concentrated dextrose
"ATP pump booster"
Helps treat hyperkalemia

Action:
Treatment of diabetes and hyperkalemia, essential for cellular uptake of glucose
*cells can grab the glucose and the pumps can work to rid the K from ECF back to the ICF

Nursing Considerations:
Monitor BG

36


Insulin, regular

Class: Class: electrolyte replacement; concentrated dextrose
"ATP pump booster"
Helps treat hyperkalemia

Action:
Treatment of diabetes and hyperkalemia, essential for cellular uptake of glucose
*cells can grab the glucose and the pumps can work to rid the K from ECF back to the ICF

Adverse Effects:
can accumulate in renal dysfunction

Nursing Considerations:
Monitor BG

37

Kayexalate

Class: electrolyte replacement
helps reverse hyperkalemia (not fast acting)

Action:
-Resin that exchanges Na for K in the gut
-Onset of action: a few hours, not for use in emergencies

Nursing Considerations:
-May be given orally or rectally
-Has been associated with intestinal necrosis and other serious GI effects

38

BacterioCIDAL

lethal to bacteria at clinically achievable conc.

39

BacterioSTATIC

slows growth of bacteria but does not cause cell death

40

Piperacillin-Tazobactam

Class: penicillin antibiotic
broad spectrum that covers gram pos and gram neg bacteria

Action: destroys cell wall of bacteria
beta lactamase inhibitor

Adverse Effects:
Hypersensitivity Reactions
Diarrhea