Rx Final Flashcards

Question

IV FLUIDS: Crystalloids

Answer 1

solution of small molecules that flow easily across cell membranes: interstitial and intravascular

Answer 2

IV FLUIDS: Crystalloids NaCl pH=5 osmolarity=300 distribution: extracellular fluid (250 in intravascular and 750 in interstitial) will raise ECF volume and BP use: fluid depletion (hypovolemia), low extracellular fluid: shock, hemorrhage, n/v, wound drainage, mild hyponatremia, metabolic acidosis risk: hyperchloremia, metabolic acidosis, dec renin/aldosterone, impaired coagulation, renal vasoconstriction and dec GFR, volume overload

Answer 3

IV FLUIDS: Crystalloids shift fluid into cells use: hypernatremia, DKA, hyperosmolar hyperglycemic state risk of hyponatremia in extracellular volume depletion pts (post surgical, trauma, burns); increased cerebral edema, hypotension, hypovolemia

Answer 4

IV FLUIDS: Crystalloids rarely used use: severe hyponatremia, cerebral edema risk: fluid volume overload and pulmonary edema

Answer 5

IV FLUIDS: Crystalloids glucose, can be metabolized to intracellular/extracellular pH=4 osmolarity=250, isotonic distribution: free diffusion (60 in intravascular, 240 in interstitial, 700 in cells) use: NPO pt’s risk of osmotic diuresis and extracellular volume depletion in diabetics; volume overload and renal failure, cerebral edema

Answer 6

IV FLUIDS: Crystalloids (K, HCO3, Mg, Ca) pH= 6.5 osmolarity= 275 (close to serum) use: fluid replacement: burn patients, n/v/d, fistula drainage, acute blood loss, third-space shifts pro’s:lower incidence of imbalance, improved gastric perfusion risk for hyperkalemia in renal failure pts do not use in liver disease, lactic acidosis, or pH>7.5

Answer 7

solution with large molecules that don’t pass the cell membrane (stay intravascular). increase oncotic pressure and draw fluids in from extravascular space pro’s: long duration, less volume

Answer 8

IV FLUIDS: Colloids increase oncotic pressure and draw fluids in from extravascular space charged use: shock side effects: loss of capillary barrier and hyperalbuminema risk in hypoalbuminemic pts (cirrhosis, neph syndrome)

Answer 9

IV FLUIDS: Colloids increase oncotic pressure and draw fluids in from extravascular space risk: allergic reactions

Answer 10

IV FLUIDS: Colloids | use: volume replacement, low hematocrit

Answer 11

DIURETICS: Thiazides inhibits distal tubule Na/Cl reabsorption; eliminates H2O *first choice* use: HTN, CHF, nephrotic syndrome, edema, diabetes insipidus very strong side effects: electrolyte imbalance (inc loss of K and Mg), inc uric acid, *hyponatremia and hypokalemia

Answer 12

``` DIURETICS: Thiazides use: inc Ca resorb and vasodilation side effect: hypercalcemia, hyperuricemia, hyperglycemia, drug interactions (NSAID) dec GFR not in pregnancy (dec placental flow) ```

Answer 13

DIURETICS: Loop inhibit thick ascending loop Cl reabsorption (Na/K+2Cl inhibitor) side effect: electrolyte imbalance, dehydration dec effective circulating volume hypokalemia, hyperuricemia

Answer 14

DIURETICS: Loop Use: low GFR pts, HTN emergency, CHF, edema, diabetes, nephrotic syndrome, hyperkalemia, hypercalcemia also vasodilates oral or IV side effects: loss of Ca, Mg, and K in urine, electrolyte imbalance, ototoxicity, dec response over time

Answer 15

DIURETICS: Potassium Sparing Na/H2O excretion at collecting tubule retain K side effects: hyperkalemia

Answer 16

DIURETICS: Potassium Sparing increase distal convoluted tubule Na excretion and dec K secretion **principal cells in collecting duct use: metabolic alkalosis rapid onset side effect: hyperkalemia (EKG changes), Na/water depletion diabetes= glucose intolerance

Answer 17

DIURETICS: Potassium Sparing aldosterone receptor antagonist (only diuretic that works from outside tubule) =dec Na resorb use: edema, CHF, HTN, post MI, ascities side effects: endocrine imbalances, hyperkalemia, gynecomastia diabetics/renal insufficiency=anuria

Answer 18

``` DIURETICS: Potassium Sparing aldosterone receptor antagonist K sparing diuretic use: edema, CHF, HTN **lower affinity for other steroid hormone receptors than spironolactone = less side effects ```

Answer 19

``` DIURETICS: Potassium Sparing inhibits collecting tubule Na reabsorption and K/H secretion rapid absorbed/excreted side effect: turns urine blue dec renal blood flow not in hyperaldosteronism highly toxic, renal fail ```

Answer 20

DIURETICS: Carbonic Anhydrase Inhibitors blocks proximal tubule’s carbonic anhydrase (blocks HCO3- resorb) use: CHF, pulmonary edema, glaucoma, metabolic alkalosis, high altitude PO/IV side effect: acidosis, rash, hypersensitivity metabolic acidosis, inc Cl and NH4+, hepatic cirrhosis, renal stones

Answer 21

DIURETICS: Osmotic inhibits H2O reabsorption throughout nephron use: acute renal fail, glaucoma, brain edema, drug overdose generates high osmotic pressure to draw in H2O IV side effect: initial inc plasma volume and BP, can= HF headache, n/v, chills, dizziness hypernatremia

Rx Final Flashcards

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