N398 Meds Midterm Flashcards

(40 cards)

1
Q

Aspirin

A

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
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2
Q

Oxycodone/Morphine (MS Contin)

A

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
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3
Q

Amoxicillin (Amoxil)

A

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
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4
Q

Amoxicillin + clavulanic acid

penicillin and beta-lactamase inhibitor) (Augmentin, Zosyn

A

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
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5
Q

Cephalexin (Keflex)

A

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

-

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6
Q

Ceftriaxone (Rocephin)

A

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
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7
Q

Azithromycin (Zithromax)

A

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

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8
Q

Doxycycline (Vibramycin)

A

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

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9
Q

Metronidazole (Flagyl)

A

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
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10
Q

Fluconazole

A

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
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11
Q

Unfractionated heparin

A

Class: anticoagulant

Action: inactivates thrombin & factor Xa

Adverse Effects:

  • bleeding
  • heparin-induced thrombocytopenia

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

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12
Q

Enoxaparin

A

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
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13
Q

Warfarin

A

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
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14
Q

Dabigatran

A

Class: anticoagulant

Action: Direct Thrombin inhibitor

Adverse Effects:
bleeding, GI effects (abdominal pain)

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

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15
Q

Rivaroxaban

A

Class: anticoagulant

Action: Factor Xa inhibitor

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

Nursing Considerations:
-active immediately (helpful)

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16
Q

Ferrous sulfate

A

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

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17
Q

Iron dextran

A

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
Q

Cnocobalamin

A

Class: iron supplement- Vitamin B12 product

Action: purified, crystaline form of vitamin B12

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

19
Q

Folic Acid

A

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
Q

Erythropoietin

A

Class: anemia treatment

Action: induces erythropoiesis (production of RBCs)

21
Q

Lisinopril

A

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
Q

Losartan

A

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
Q

Amlodipine

A

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
Q

Hydralazine

A

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