Pharmacology Flashcards
(127 cards)
1
Q
What lab is required to monitor Heparin levels?
A
Partial Thromboplastin Time (PTT). The goal of PTT is 1.5-2.5 times the control.
2
Q
What is the use and mechanism of action of alpha-glucosidase inhibitors?
A
are oral anti-diabetic drugs used for diabetes mellitus type 2 that work by preventing the digestion of carbohydrates. Carbohydrates are normally converted into simple sugars, which can be absorbed through the intestine. The medication is only effective if taken with the meal. Ex: Miglitol, Acarbose.
3
Q
What type of insulin is Humalog (Lispro)? What is its onset, peak, and duration?
In same category is Novolog and Apidra.
A
Rapid acting. Onset: 15 min. Peak: 0.5-2.5 hours. Duration: 2-5 hours.
4
Q
What is Levothyroxine used for? When should it be taken? Why?
A
It is a thyroid replacement (synthetic hormone). It must be taken every morning before breakfast to optimize absorption. Use of antacids is contraindicated.
5
Q
What is the use of Odansetron and what are the common side effects?
A
Nausea. SE: H/A, dizziness, diarrhea, constipation and fever.
6
Q
How long does it take for Metformin related GI issues to resolve?
A
Gi issues usually resolve within 2 weeks of starting this med.
7
Q
What is the use and mechanism of action of Metformin?
A
Metformin is a biguanide that decreases glucose production in the liver and reduces glucose absorption in the GI tract. It also improves insulin sensitivity.
8
Q
What is a rare, but serious side effect of Metronidazole? What are some common ones?
A
Rare/serious: seizures. Common: GI, dizziness, h/a, dry mouth, candidas, and metallic taste
9
Q
What type of infections is Metronidazole used to treat?
A
fungal and bacterial
10
Q
What is Propylthiouracil used for? What are serious side effects?
A
Treatment of Grave’s disease: reduction of thyroid hormone. Serious SE: agranulocytosis and aplastic anemia.
11
Q
What are the dietary restrictions associated with taking Propylthiouracil?
A
Propylthiouracil blocks the synthesis of thyroid hormones. Iodine is utilized in the synthesis of thyroid hormone and will interfere in the action , therefore should be reduced or eliminated.
12
Q
What is urticaria?
A
hives
13
Q
What are the symptoms associated with an adverse reaction to penicillin?
A
Type 1 hypersensitivity reaction: urticaria - hives, n/v, pruritis (itching), tachycardia, dyspnea, and diaphoresis.
14
Q
What are the drugs used to treat C.diff?
A
C.diff may be a secondary/opportunistic infection resulting from long term use of antibiotics. Tx: I.V. Flagyl, oral vancomycin, or fidaxomicin (Dificid).
15
Q
What is allopurinol used for? What are nursing considerations associated?
A
Long term gout treatment. NC: Decrease urates by avoiding use of alcohol, increase fluid intake to 3L/day, consuming a diet low in sodium, calcium and oxilate-rich foods. take drug 30 min after meals
16
Q
What change in vital signs can we expect to see after giving a dose of nitroglycerine?
A
Nitro. is a vasodilator, which decreases blood pressure. this cause a decrease in preload leading to a decrease in cardiac output. this causes a reflex response by the sympathetic nervous system to increase the heart rate to maintain cardiac output.
17
Q
What are the s/s of Digoxin toxicity?
A
Cardiac arrhythmias, n/v, diarrhea, visual disturbance, h/a, lethargy, irritability and abdominal cramps.
Calcium overload and an imbalance of K+ concentration induce arrhythmias and atrial systolic tachycardia with atrioventricular blockade. Low levels of potassium in the body increase the risk of digitalis toxicity.
18
Q
What is the mechanism of action of Digoxin
A
Digoxin increases the force of contraction of the muscle of the heart by inhibiting the activity of an enzyme (ATPase) that controls movement of calcium, sodium, and potassium into heart muscle. Calcium controls the force of contraction.
19
Q
What is the therapeutic range of Digoxin?
A
The therapeutic effect of digoxin in doses between 1 and 2ng/ml involves the alpha 2 isoform of Naþ/Kþ-ATPase. Toxic effects occur at doses of digoxin exceeding 3ng/ml.
20
Q
What is the classification and mechanism of action of Phenylphrine?
A
Phenylphrine is an alpha agonist. Stimulation of alpha receptors causes vasoconstriction. It is used to treat shock/low BP
21
Q
What is one important nursing consideration for Phenylphrine?
A
This drug can become unstable if it is exposed to light. It should always be covered with an opaque cover.
22
Q
What class of antibiotics have a black box warning for “increased risk of tendon rupture”?
A
fluoroquinolones such as ciprofloxacin. patients should be instructed to avoid high impact activities while on this medication, and to rest if they experience pain or edema around their tendons.
23
Q
What are the common side effects of Statins?
A
Myalgia, h/a, fatigue, flu-like symptoms, constipation, abdominal pain, diarrhea, edema, insomnia, eczema. Rare: increased liver enzymes.
24
Q
What is the mechanism of action of Statins (HMG CoA Reductase)?
A
Statins act by competitively inhibiting HMG-CoA reductase, the first and key rate-limiting enzyme of the cholesterol biosynthetic pathway. Statins mimic the natural substrate molecule, HMG-CoA, and compete for binding to the HMGCR enzyme. This competition slows the rate of mevalonate production, the next molecule in the serial steps to produce cholesterol.
25
What are the onset, peak and duration of Morphine PO?
Onset 15-60 min, peak 30-60 min, duration 3-7 hours.
26
What is the purpose of giving a Kayexalate enema? How long does it need to be retained?
A Kayexalate enema is given to people who have elevated potassium levels. It exchanges the excess potassium from the bowel and replaces it with sodium. The enema must be retained for 30 min. Diarrhea will follow, which increases potassium loss.
27
What is the class and mechanism of action of cholestyramine?
Cholestyramine is a bile acid sequestrate used to treat hyperlipidemia. This type of drug lowers the level of triglycerides and cholesterol by increasing bile acid excretion and decreasing lipid absorption.
28
What is the class and mechanism of action of Ropinirole?
Ropinirole is a dopaminergic used to treat parkinson's disease. It acts by stimulating dopamine receptors in the brain. Because it increases dopamine in the brain, an action opposite of antipsychotics, the side effects include psychosis, somnolence and hallucinations.
29
What is the most common side effect of magnesium hydroxide (antacids)?
Magnesium hydroxide commonly causes diarrhea. Constipation can occur from other types of antacids - i.e. aluminum hydroxide.
30
Under what circumstances would you administer charcoal to intervene in a drug overdose?
If the drug was taken PO and is still in the stomach.
31
Under what circumstances do you administer Digibind?
This is given to patients in Digitalis toxicity that are also unstable. It is an antidote for Digitalis toxicity that binds to Digitalis in the blood.
32
What are Sulfonylureas used for and what is their mechanism of action?
Sulfonylureas are used to treat diabetes. they stimulate insulin secretion from the pancriatic beta cells and increase insulin sensitivity.
33
What is the most common side effect of Sulfonylureas? (ex: glipizide)
Weight gain, hypoglycemia, GI upset, diarrhea, rash, dizziness, nervousness, and tremors.
34
what are some examples of chelation interactions?
Drug/food interactions that remove the therapeutic effect: tetracyclines/calcium; bile acid sequestrates/bile; charcoal/some poisions, drugs, alcohol; grapefruit juice/drugs that interact with certain liver enzymes (blocks liver enzyme that metabolizes the drug)
35
List and explain the potential adverse effects of diuretics.
1. electrolyte imbalances: diuretics work by removing the Na+ from the blood, which pulls out water and other positive ions with it. excessive losses of the other electrolytes, especially K+ must be monitored for.
2. Hyperglycemia: diuretics can cause the blood sugar to spike, which may have an important effect on diabetics who use insulin; especially brittle diabetics.
3. Hyperuricemia: people with gout may have a flare up with less fluid volume.
4. orthostatic hypotension: common with fast drop n BP / fluid - Fall Risk
5. hypotension, lipid abnormalities, ototoxicity, photosensitivity
36
Diuretics work by decreasing Na+ resorption in the kidneys which decreases plasma volume, which reduces stroke volume, which decreases cardiac output, which decreases blood pressure and peripheral vascular resistance. After a while the body adjusts to the drug and retains more fluid. Why does the drug continue to lower blood pressure even after the body adjusts and retains more fluid?
Sodium causes stiffening of the vascular system. When we restrict sodium, whether with diuretics or sodium restriction, the peripheral vascular resistance decreases because the arteries will get softer over time.
37
What makes the different types of diuretics different?
Ex: hydrochlorothiazide, furosemide, ethacrynic acid
The various types remove sodium from different places in the kidney (ex: distal convoluted tubule) each area determines how much sodium, potassium and water will be lost. Loop diuretics (furosemide - lasix), for example, are the most potent and take out the most water.
38
What is a diuretic that can be used in pts with sulfur allergies?
Ethacrynic acid (Edecrin)
39
What are Beta receptors?
Beta receptors are adrenergic receptors [receptors for the catecholamines, especially norepinephrine (noradrenaline) and epinephrine (adrenaline).]found in many parts of the body.
40
Describe the location and function of Beta1 receptors.
Beta1: located in heart & kidney: Chronotropic (change the heart rate) /inotropic (change the force of contractility: stroke volume) and increases renin from the kidneys. so, if activated by norepinephren, etc, you get these effects.
41
Describe the location and function of Beta2 receptors.
Beta2: Lungs, gastrointestinal tract, liver, uterus, vascular smooth muscle, and skeletal muscle: Relaxation of smooth muscle, dilates arteries to skeletal muscle – more blood flow, aids in breathing (A beta 2 blocker would have a reverse effect, less circulation, difficulty breathing.)
42
Describe the location and function of Beta3 receptors.
Beta3: Adipose tissues and bladder: responsible for Lipolysis and relaxation of bladder smooth muscle
43
What does it mean if a drug is low lipophylic? high lipophylic?
A high lipophylic drug can cross the blood brain barrier, placenta, and other membranes more easily than one that is low lipophylic.
44
What is niacin prescribed for? What are common side effects?
Niacin is a water soluble vitamin that decreases lipoprotien and triglyceride synthesis. Common side effects are flushing of the face and neck, rash, diarrhea, cough, pruritis, nausea and vomiting, hypotension and hyperglycemia.
45
What is the classification, use, and common side effects of Alendronate?
Alendronate is a bisphosphonate used to treat osteoperosis and paget's disease (bone disease that results in large misshapen bones.) common side effects are GI Irritation, hypocalcemia, headache, and musculoskeletal pain.
46
What are some adverse reactions of Beta blockers?
Ex: atenolol, metoprolol, propranolol, carvedilol.
Side effects of beta blockers depend on the type of beta that is being blocked. The receptor that is being blocked will cause various physiological changes. Different drugs block different combinations of receptors. Exacerbation of asthma and COPD, Hypoglycemia and decreased sexual function may be cause by beta 2 receptors being blocked; blocking beta 1 an 2 receptors may result in bradycardia and fatigue; blocking beta 3 receptors may increase serum lipids.
47
Why is abruptly stopping use of beta blockers contraindicated?
Abrupt disuse may precipitate unstable angina and MI.
48
Where are calcium channels located?
In smooth muscle and cardiac muscle. there are many types of calcium channels but calcium channel blockers target the L-type because they are the channels that admit Ca+ and cause depolarization. (contraction of vascular smooth muscle and elevation of blood pressure)
49
What do calcium channel blockers do?
| Ex: amlodipine, felodipine, nicardipine, verapamil, diltiazem.
Depending on the CCB, it will cause the blod vessles to relax, and/or, it will cause the heart rate to slow and/or the stroke volume to decrease.
50
What do ACE Inhibitors do?
Ex: (ending in -pril) benazepril, enalapril, fosinopril, lisinopril, moexipril, perindopril, quinapril, ramipril, trandolapril. Lisinopril is generic and most used. major differences are side effects.
HTN, systolic HF, post MI, proteinuric chronic kidney disease *
Contraindication: angioedema, pregnancy
51
What are the common side effects of ace inhibitors?
Cough (dry hacking cough due to increased bradykinin – will never go away), rash, angioedema (emergency room – cant retry ace inhibitors again, can try receptor blockers), hyperkalemia , Interaction with NSAIDs (nephrotoxic) –nsaid causes retaining of sodium ++, Lower sexual dysfunction side effects
52
Why is chronic cough a side effect of ace inhibitors?
Bradykinin from the med creates irritation in the throat.
53
what do you need to monitor for when taking Ace inhibitors?
Potassium: hyperkalemia is a side effect.
54
Name drug(s) given to a patient in v-tach
Lidocaine (anti-arrhythmic) to address myocardial irritability, angina, and fainting.
55
Why is morphine given for an MI?
to decrease the pain caused by the MI by decreasing the preload and after-load pressure.
56
how does nitroglycerine treat angina?
dilates the blood vessels
57
what is the effect of dopamine on the heart?
increases myocardial contractility and stroke volume.
58
What is terazosin and what is it used for?
alpha 1 adrenergic blocker used for benign prostatic hypertrophy.
59
MMR, IPV, and Varicella vaccines contain ______, which makes it contraindicated for some people.
neomycin; ppl w/ neomycin hypersensitivity should not take this vaccine.
60
People that are allergic to penicillins should not take ____ because there is a potential cross allergy.
cephalosporins
61
The flu vaccine is contraindicated in people who are allergic to ____.
eggs
62
s/s of lithium toxicity
TOXICITY:
Early sign (1.5-2meq/L): slurred speech, muscle weakness, thirst, blurred vision, ataxia, tinnitus, persistent nausea and vomiting, severe diarrhea
Advanced Signs (2-3.5meq/L): incoordination
Excessive output of dilute urine, increasing tremors - hands, muscular irritability, psychomotor retardation, mental confusion, giddiness.
At serum levels above 3.5: impaired consciousness, nystagmus, seizures, coma, oliguria/anuria, arrhythmias, myocardial infarction, cardiovascular collapse.
Expected: mild thirst
RX: withhold med, obtain blood lithium level, re-evaluate dose.
Note: anti-manic used to treat bi-polar.
63
what food is contraindicated for patients taking digoxin?
licorice: it can increase K+ loss and may cause Dig toxicity. (also contraindicated for warfarin, cisplatin, estrogens, ethycrynic acid, furosemide, high bp meds , corticosteroids, and more)
64
What is glucagon, how does it work and what is the procedure for giving it?
Glucagon is a hormone produced by the pancreas that, along with insulin, controls the level of glucose in the blood. (opposite of insulin) Glucagon raises blood glucose levels by preventing the liver from storing glucose, increasing glucose formation in the liver from dietary proteins and fats, and increasing the release of glucose from the liver into blood. Give SubQ if hypoglycemic
65
What is aluminum hydroxide and how does it work?
antacid - increases gastric ph and inactivates pepsin. best taken after eating has begun but before stomach has emptied (1h). contains sodium so is contraindicated in sodium restriction.
66
what immunization is most important for a college bound young adult ?
meningitis. important, but not currently required. close contact.
67
what is carbadopa-levodopa used for and what are some nursing considerations?
Treats symptoms of Parkinson's disease and parkinsonism, such as shaking, stiffness, and slow movement.
causes dizziness so move slowly at first.
report muscle twitching to hcp
multivitamins esp B6 can reverse action, so ask hcp before taking over the counter meds.
68
what is the loading dose and the maintenance dose for digoxin?
1mg over a few doses is the typical loading dose and the maintenance dose is usually between .125-.5mg daily, usually .25mg. Peak digoxin body stores of 8 to 12 mcg/kg generally provide a therapeutic effect with minimum risk of toxicity in most patients with heart failure and normal sinus rhythm.
69
why is it important to stop metformin before surgery or ct with contrast?
risk of lactic acidosis. must be dc'ed 48h prior - risk kidney damage and death
70
what is ma huang in western med?
ephedra
71
if a patient is allergic to penicillin, what other medications should they avoid?
any other penicillin (aminopenicillins, amoxicillin, ampicillin, and anythin ending in -illn) as well as cephalosporins, carbapenems, and monobactams..
The cephalosporin medications that are likely to cross-react after penicillin allergies have been established and include:
```
Cephalexin
Cefadroxil
Ceflaclor
Cephradine
Cefprozil
Ceftriaxone
Cefpodoxime
```
72
what are the 2 primary classifications of over the counter pain meds?
NSAIDS and acetaminophen (tylenol)
73
What are the 3 types of NSAIDS that are available?
Aspirin (Bayer, Bufferin, Excedrin..(Salicylates))
Ibuprofen (Advil, Motrin IB)
Naproxen (Aleve)
74
if a patient is allergic to aspirin or another NSAID, what other medication should they avoid?
They could have a hypersensitivity reaction to another NSAID, so all NSAIDS should be avoided, even thought they are composed of different things.
75
What is Reye's syndrome? what is one important risk factor / how is it developed?
Children and teenagers who are recovering from a viral infection such as the flu or chickenpox should not take aspirin (aka. Salicylates). It has been linked to Reye’s syndrome, a serious but rare condition that can result in brain, kidney, and liver damage.
76
At what age is Naproxen considered safe to take?
2 years and older
77
At what age is Ibuprofen considered safe to take?
6 months and older in the correct dose
78
what nursing action is required before administering gentamicin?
Monitor BUN and creatinine because this medication is nephrotoxic.
common side effects are : proteinuria, oliguria, hematuria, thirst, decreased creatinine clearance, increased BUN.
it is also ototoxic. most people have a temporary or reversible form that does not result in a major or long-term disruption in their lives.
79
what are the expected side effects of hydrocortisone?
ex: prednisone
suppression of immune system (not a decrease in the WBC count), hypertension from salt/water retention, increased blood sugar, calcium and potassium loss
long term: cataracts, glaucoma, eye infections, growth inhibition
do not: receive live vaccines or expose to ill people.
80
what is epinephrin used for ?
May treat: Allergic shock, Allergy, Asthma, Cardiac arrest, Low blood pressure, Slow heartbeat, Ventricular fibrillation, Ventricular tachycardia, Bronchospasm, Septic shock, Airway obstruction, Heart block, Open-angle glaucoma
81
what is disulfram used for?
it is antabuse, and is used to help people quit drinking alcohol by making them sick if they drink alcohol. illness will occur even with tiny amounts. * effects last 2 weeks, so must d/c for 2 weeks before drinking otherwise sickness will ensue.
82
which antibiotics cause photosensitivity?
Tetracyclines, Fluoroquinolones (e.g. ciprofloxacin, cephalosporin), Sulfonamides
83
what is polycythemia?
abnormally high concentration of hematocrit in the blood. often due to low fluid volume.
84
what is terbutaline used for?
Treats asthma, bronchitis, and other lung disorders.
85
what is propranolol?
It is a beta - blocker: Beta blockers block the action of endogenous catecholamines epinephrine (adrenaline) and norepinephrine (noradrenaline) -in particular on adrenergic beta receptors, of the sympathetic nervous system, which mediates the fight-or-flight response.
Treats high blood pressure, angina (chest pain), irregular heartbeat, migraine headaches, tremors, and lowers the risk of repeated heart attacks.
86
what do diabetics have to worry about when taking beta blockers?
beta blockers mask the symptoms of hypoglycmia. must take extra care to track blood sugars.
87
What is the purpose/action of Morphine given to a patient with an MI?
To decrease preload and afterload and to decrease the work of the heart. it causes vasodilation and pooling of blood in the extremities. Provides relief from anxiety.
88
what is clozapine and what are its side effects?
atypical antipsychotic. treats schizophrenia. side effects: leukopenia, gram-negative septicemia, drowsiness, tachycardia, hypotension. at risk for agranulocytosis: if WBCs fall below 2000 mm3 the med must be d/c'ed - life threatening
89
what type of insulin is cloudy?
NPH - (Neutral Protamine Hagedorn also known as Humulin N, Novolin N among others) is an intermediate-acting insulin.
NPH has an onset of 1–4 hours. Its peak is 6–10 hours and its duration is about 10–16 hours.
90
what is the proper way to combine NPH and short acting insulin?
dont combine until you are ready to administer. draw up the clear first, then the cloudy - the cloudy will contaminate the clear and cause a binding reaction.
91
what is atenolol and what are important nursing considerations?
atenolol is a selective beta blocker used to treat hypertension
side effects are gastric pain, bradycardia, heart failure, decreased exercise tolerance, and nightmares.
if stopped abruptly may cause life threatening arrhythmias, HTN, or MI - should be tapered off over 2 weeks
should be taken with meals
92
What is the best type of therapy for an abusing spouse?
group therapy
93
what is pentamidine isethionate
med used to treat pnumocystitis jirovecti, a common opportunistic infection in HIV patients.
94
What is atorovastatin used for? what are important nursing considerations?
Lowers high cholesterol and triglyceride levels. Reduces the risk of chest pain, stroke, heart attack, or certain heart and blood vessel problems. This medicine is a statin.
grapefruit juice and propranolol (beta-blocker; both increase anti-hypertensive channel blocking.) will decrease effectiveness
must have liver enzymes regularly checked; avoid alcohol
must adhere to low cholesterol diet for best results
take at the same time every day, with or without food
95
what is Streptokinase?
Streptokinase is an enzyme secreted by several species of streptococci that can bind and activate human plasminogen. SK is used as an effective and inexpensive thrombolysis medication in some cases of myocardial infarction and pulmonary embolism. it can also be used to unclog a central catheter clot (with Dr order)
96
What is the correct procedure if one of the lumens from a central catheter is clogged and the diluted heparin that is ordered to keep patent didn't work to unclog?
what must never be done?
secure lumen with a luer-lock cap. Notify the Dr, he may order streptokinase to unclog. If unsuccessful, the lumen will be labeled "clogged off" you must never aspirate blood to unclog.
97
side effects of tricyclic antidepressants?
| s/s of toxicity/overdose?
antimuscarinic properties : dry mouth, dry nose, blurry vision, lowered gastrointestinal motility or constipation, urinary retention, cognitive and/or memory impairment, and increased body temperature.
Other: drowsiness, anxiety, emotional blunting (apathy/anhedonia), confusion, restlessness, dizziness, akathisia, hypersensitivity, changes in appetite and weight, sweating, sexual dysfunction, muscle twitches, weakness, nausea and vomiting, hypotension, tachycardia, and rarely, irregular heart rhythms.
Twitching, hallucinations, delirium and coma are also some of the toxic effects caused by overdose. (kaplan says excitability and tremors)
98
what is doxepen HCL?
tricyclic antidepressant (1st gen.)
99
what is ritodrine HCL?
it is a tocolytic. it is used to delay labor. discontinued in the US
100
How long does it take for an SSRI to begin to work properly?
1-3 weeks
101
What is alendronate?
Treats and prevents osteoporosis.
Alendronate is a bisphosphonate. It works by slowing bone loss.
102
What is Alprazolam?
xanax - benzodiazepine - treats anxiety and panic. It works by slowing down the movement of chemicals in the brain that may become unbalanced. This results in a reduction in nervous tension (anxiety).
Must not stop abruptly or may cause withdrawl symptoms such as: depression, insomnia, anxiety, abdominal and muscle cramps, tremors, vomiting, sweating, convulsions, and delirium.
Do not drink alcohol while taking alprazolam. This medication can increase the effects of alcohol.
common side effects: Drowsiness, confusion, and lethargy
103
Nursing considerations for erythromycin?
macrolide antibiotic.
assess for s/s of liver problems such as nausea, increased stomach pain, itching, tired feeling, loss of appetite, dark urine, clay-colored stools, or jaundice.
Fruit juices such as apple juice or grapefruit juice can interfere with absorption of this medication.
take on empty stomach - 1 hour prior/2h after meals.
104
What are Sulfonylureas used for? What is their mechanism of action? When should they be withheld?
Sulfonylurea derivatives are a class of antidiabetic drugs that are used in the management of diabetes mellitus type 2. They act by increasing insulin release from the beta cells in the pancreas.
They should not be given if the blood sugar is less than 100.
105
Type, onset, peak, duration of NPH
Lente in same category
intermediate acting, onset of 1–4 hours. Its peak is 6–10 hours and its duration is about 10–16 hours.
106
onset, peak, duration of regular insulin
onset 30–45min, peak 2–3.5 h, duration 5–7 h
107
Type, onset, peak, duration of Lantus
```
Long acting (designed for flatter and longest action, background insulin action for keeping your BG flat when fasting)
onset 1–2 h, peak 6 hr, duration 18–26 h
```
108
Type, onset, peak, duration of Levemir
Long acting, onset 1–3 h, peak 8–10, duration 18–26 h
109
what is phenelzine? nursing considerations?
MAOI antidepressant. don't use with SSRIs (serotonin syndrome - must wait 5 weeks) or st. johns wart. avoid tyramine containing foods, asses for orthostatic hypotension q shift., assess liver function , full onset -4 weeks, abrupt d/c causes withdrawal.
110
what is fluoxetine? nursing considerations?
SSRI - antidepressant (prozac) must not take with MAOI (there is a waiting period before either can be introduced after the other is d/c'ed or st john's wart or other serotonin increaser.
111
what meds can be not given with verbal orders only?
```
Verbal Orders must not be given for:
Epidural boluses - unless authorised Acute Pain Management Service (APMS) Nursing Staff
Blood/blood products (verbal orders may occur in theatre or ED under emergency situations)
Chemotherapy
Children/Neonates
Patients with significant renal disease
Abortion inducing medications
Labour inducing medications
```
112
what might a prominent u-wave mean?
hypokalemia. might mean other things as well.
113
what does potassium sparing mean? name 1 potassuim sparing drug.
potassium remains in the body. spirolactone.
114
what is sucralfate?
Sucralfate is a cytoprotective agent, an oral gastrointestinal medication primarily indicated for the treatment of active duodenal ulcers. it contains aluminum and its mechanism of action involves binding to the mucosa, which prevents absorption of stomach acids as well as other meds. wait 30 min before administering other meds.
115
what is Lansoprazole?
proton pump inhibitor. same class as Omeprazole, Pantoprazole. Treats stomach ulcers, gastroesophageal reflux disease (GERD), and conditions that cause your stomach to make too much acid, such as Zollinger-Ellison syndrome.
116
What is Aripiprazole? side effects?
Atypical antipsychotic. Treats schizophrenia, bipolar disorder, and depression. Also treats irritability associated with autism.
hyperglycemia w/ 3 p's - polyuria, polydipsia, polyphagia
take with or without food
117
what should a patient do if they miss a dose of their med at home?
never double the dose unless the instructions specifically state to do so. usually if there is 6 hours between doses , it is ok (ie. if the med is q24) to still take the med. This is true even for antibiotics and anticoagulants. I have not found a med that was ok to double.
118
side effects of SSRIs
```
Nausea
Nervousness, agitation or restlessness
Dizziness
Reduced sexual desire or difficulty reaching orgasm or inability to maintain an erection (erectile dysfunction)
Drowsiness
Insomnia
Weight gain or loss
Headache
Dry mouth
Vomiting
Diarrhea
sweating
```
119
how often should the eGFR be assessed in clients at high risk for kidney disease?
annually
120
what is the normal range for eGFR?
60-120
121
what is DDAVP nasal spray used for?
Desmopressin Acetate - it is a hormone replacement for ADH. its use is indicated in DI, evidenced by extreme loss of dilute urine. Vasopressin is also used for DI
122
what is the result of taking MAOIs with otc cold meds?
potential serotonin syndrome. mild (shivering and diarrhea) to severe (muscle rigidity, fever and seizures). Severe serotonin syndrome can be fatal if not treated.
123
what happens if you take antiseizure meds (ex: phenobarbitol) and antihistimines?
both cause CNS depression , so they are contraindicated - may cause changes in LOC
124
what drugs should be avoided for the patient taking antiseizure meds? they lower the seizure threshold.
antibiotics: esp penicillins, cephalosporins, amphotericin, imipenem
anaesthetics: propofol and potentially others
antihistamines, cough and cold meds, potentially stimulants
narcotics: pethidine and fentynal, immunomodifyer: cyclosporin
potentially hormonal preparations: oral contraceptives/ hormone replacement, bronchodilators: aminophylline, theophylline, antipsychotics: clozapine and potentially others
potentially antidepressants
125
what is a brand name for warfarin? what labs are used to assess warfarin levels?
INR and PT
126
what lab is used to assess heparin levels?
aPTT or PTT
127
what is calcium gluconate used for? one nursing consideration.
Treats calcium deficiency. Also treats black widow spider bites, lead colic, overdose of magnesium or certain heart medicines, and a condition called rickets. This medicine is also used in life support and life-threatening heart conditions. if injected into extravascular tissue, can cause severe chemical burn.
