Spring 2014 Final Medication Review Flashcards Preview

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Flashcards in Spring 2014 Final Medication Review Deck (59):


Therapeutic: opioid analgesics
Pharmacologic: opioid agonists
For: moderate to sever pain
Side Effects: Seizures, Allergic reactions, confusion, sedation, hypotension, N/V, constipation.



Therapeutic: anti-inflammatoires (Steroidal), immunosupressant
Pharmacologic: corticosteroids
For: Suppression of inflammation and modification of the normal immune response. Replacement therapy in adrenal insufficiency.
Side Effects: Peptic Ulceration, Thromboembolism, depression, euphoria, hypertension, anorexia, N/V, acne, decreased wound healing, ecchymoses, fragility, hirsutism, petachiae, adrenal suppression, muscle wasting, osteoporosis, cushingoid appearance (moon face, buffalo hump)



Therapeutic: antihypertensives
Pharmacologic: ACE inhibitors
For: management of HF. Reduction of risk of death or development of HF following an MI. Decrease progression of diabetic neuropathy.
Side Effects: Agranulocytosis, angioedema, hypotension, cough, taste disturbances.

Decrease BP watch for non productive dry irritating cough, agranulocytosis (decrease in WBC), kidney failure, HA, and dizziness.
TEACH: how to avoid orthostatic hypotension.



Therapeutic: diuretics
Pharmacologic: Potassium-sparing diuretics
For: weak diuretic and antihypertensive response when compared with other diuretics. Conservation of potassium.
Side Effects: Stevens Johnson Syndrome, Toxic Epidermal Necrolysis, hyperkalemia, clumsiness, headache.
Watch for Hyperkalemia
F/E loss
Give in AM so they have several hours to pee before bed.



Part of HAART regimen
Therapeutic: antiretrovirals
Pharmacologic: nucleoside reverse transcriptase inhibitor.
For: HIV infection (with other antiretrovirals) Reduction of maternal/fetal transmission of HIV.
Side Effects: Seizures, Hepatomegaly, Pancreatitis, Lactic Acidosis, headache, weakness, abdominal pain, diarrhea, nausea, anemia, granulocytopenia.
Resistance to medication if missed dose!!



Part of HAART regimen
Therapeutic: antiretrovirals
Pharmacologic: nucleoside reverse transcriptase inhibitor.
For: HIV infection (with other antiretrovirals) Reduction of maternal/fetal transmission of HIV.
Side Effects: Seizures, Hepatomegaly, Pancreatitis, Lactic Acidosis, headache, weakness, abdominal pain, diarrhea, nausea, anemia, granulocytopenia.
Resistance to medication if missed dose!!



Therapeutic: bronchodilators.
Pharmacologic: adrenergics
For: Bronchodilation.
Side Effects: Paradoxical Bronchospasm, nervousness, restlessness, tremor, chest pain, palpitations.



Therapeutic: anticoagulants
Pharmacologic: antithrombotics
Prevents a thrombin from converting to fibrinogen to fibrin. prevents clots

Side Effects: Bleeding, heparin-induced thrombocytopenia(little clots) (HIT), anemia, osteoporosis.
Monitor APTT&PTT want higher than control since they are clotting you want their blood thinner.
Antidote is protamine sulfate!

Fast acting, does not dissolve clot! sometimes used with Coumadin until Coumadin can reach therapeutic effect.

Reteplace is not compatible!!!!



Therapeutic: allergy, cold, and cough remedies (Antitussives), opioid analgesics.
Pharmacologic: opioid agonists.
For: moderate to severe pain, antitussive
Side Effects: Confusion, sedation, hypotension, constipation.



Therapeutic: alcohol abuse therapy adjuncts
Pharmacologic: enzyme inhibitors
For: Alcohol abstinence
Side Effects: Hepatoxicity, drowsiness, fatigue, headache, psychoses, metallic/garlic-like taste.



Therapeutic: antiparkinson agents
Pharmacologic: anticholinergics
For: Treatment of drug-induced extrapyramidal effects and acute dystonic reactions. Treatment of Parkinson's disease.
Side Effects: blurred vision, dry eyes, constipation, dry mouth, (can't see, can't pee, can't sit, can't shit)
Married to Diphenhydramine.



Therapeutic: antidotes (for opioids)
Pharmacologic: opioid antagonists
Reversal of CNS depression and respiratory depression because of suspected overdose.
Side effects: ventricular arrhythmias, hypertension, hypotension, nausea, vomitting



Therapeutic: antitubrculars
For: First-line therapy of active tuberculosis, in combination with other agents. Prevention of tuberculosis in clients exposed to active disease (alone).
Side effects: Drug-induced hepatitis. Peripheral neuropathy.



Therapeutic: allergy, cold, and cough remedies, expectorant.
For: Coughs associated with viral upper respiratory tract infections.
Side Effects: dizziness, headache, nausea, diarrhea, stomach pain, vomiting, rash, uticaria


Robitussin DM

Therapeutic: allergy, cold, and cough remedies, antitussives.
For: Symptomatic relief of coughs caused by minor viral upper respiratory tract infections or inhaled irritants. Most effective for chronic nonproductive coughs.
Side Effect: high dose- dizziness, sedation. nausea.


Tessalon Perles

Therapeutic: allergy, cold, and cough remedies, antitussives (local anesthetic)
For: relief of nonproductive cough due to minor throat or bronchial irritation from inhaled irritants or colds.
Side Effects: headache, mild dizziness, nasal congestion, constipation, chest numbness


codine elixir

Therapeutic: allergy, cold, and cough remedies, antitussives, opioid analgesics.
For: Management of mild to moderate pain. Antitussives.
Side Effects: confusion, sedation, hypotension, constipation, nausea, vomitting,



Therapeutic: antiplatelet agents
Pharmacologic: platelet aggregation inhibitors
For: decreased occurrence of atherosclerotic events in clients at risk.
GI Bleeding, Thrombotic Thrombocytopenic Purpura, Bleeding, Neutropenia.



Classification: anticoagulant
Pharmacologic: antithrombotics
For: Prevention of thrombus formation.
Side Effects: bleeding, anemia, dizziness, headache, insomnia, edema.



Therapeutic: anti-diabetics, hormones
Pharmacologic: pancreatics
For: Control of hyperglycemia in diabetic clients.
Side Effects: Hypoglycemia, Allergic reactions
Rapid Acting Insulin



Therapeutic: antihypertensive
Pharmacologic: ACE inhibitors.
For: Lowering of BP in hypertensive clients. Improved symptoms in clients with HF. Decrease development in overt heart failure.
Side Effects: hypotension, agranulocytosis, angioedema, taste disturbances, cough

Watch for dry non productive cough., agranulocytosis, kidney failure, and dizziness.
Teach how to avoid orthostatic hypotension.



Therapeutic: mood stabilizer
For: Prevents/decreases incidences of acute manic episodes.
Side Effects: sizers, fatigue, headache, impaired memory, ECG changes, abdominal pain, anorexia, bloating, diarrhea, nausea, polyuria, folliculitis, hypothyroidism, leukocytosis, muscle weakness, tremors
**From notes pg. 89**
Bipolar disorder/ Mood stabilizer: may require multiple medications. Lithium is 1st choice of treatment,
Therapeutic blood levels in 7-14 days.
During acute phase, 300-600mg orally is given 2-3 times a day.
maintenance blood level is 0.3-1.3mEq/L.



Therapeutic: antipsychotics
Pharmacologic: butyrophenones
Nausea and vomiting from surgery or chemotherapy.
For: Acute and chronic psychotic disorders including: Schizophrenia: manic states: drug-induced psychoses.
Side Effects: Seizures, extrapyramidal reactions, blurred vison, dry eyes, constipation, dry mouth, Agranulocytosis, Neuroleptic Malignant Syndrome.



Therapeutic: anti-Alzheimer's agents
pharmacologic: cholinergics
Therapeutic: may temporarily lessen some of the dementia associated with Alzhiemers disease. Enhances cognition. Does not cure disease!
Side Effect: headache, diarrhea, nausea.
**From notes pg 102 Alzheimer Disease**5mg P.O. daily at bedtime. After 4-6 weeks increase to 10mg. Classification: cholinesterase inhibitor. Action: improves cholinergic function by inhibition acetylcholinesterase. Improves cognitive function. Missed doses should be skipped and regular schedule returned to the following day.



Therapeutic: anti-alzeimer's agents
Pharmacologic: cholinesterase inhibitors.
May temporarily lessen some of the dementia associated with Alzheimer's disease. Enhances cognitive disease.


NPH Insulin

(isophane insulin suspension)
Therapeutic: antidiabetics, hormones
Pharmacologic: pancreatics
For: control on hyperglycemia in diabetic clients.
Side Effects: Hypoglycemia, Allergic reactions
Novalin N or Humulin N
Starts working in 2-4 hours. peak: 4-10hours: Duration: 10-18 hours.



Therapeutic: antidiabetics
Pharmacologic: biguanides
For: maintenance of blood glucose



Therapeutic: bronchodilators
Pharmacologic: xanthines
For: long term control of reversible airway obstruction caused by Asthma or COPD.



Therapeutic: analgesic adjuncts, anti anxiety agents, sedatives/hypnotics.
Pharmacologic: benzodiazepines
For: Anxiety disorder. Preoperative sedation. Decreases preoperative anxiety and provides amnesia.
Side Effect: Apnea, cardiac arrest, dizziness, drowsiness, lethargy.



Therapeutic: antihypertensive
Pharmacologic: adrenergics
For: Decreases BP. Decreases pain. Improves ADHD symptoms.
Side Effects: drowsiness, dry mouth, withdrawal phenomenon, depression, dizziness, nervousness, bradycardia, hypotension.



Therapeutic: anti anxiety agents
For: Relief of anxiety
Side Effects: Dizziness, drowsiness, excitement, fatigue, headache, insomnia, nervousness, weakness, blurred vision, nasal congestion, sore throat, tinnitus, chest pain, palpitations, tachycardia, rashes, myalgia, incoordination, numbness, paresthesia, clamminess, sweating.



Therapeutic: central nervous system stimulants
For: Increased motor activity, mental alertness, and decreased fatigue in narcoleptic clients, Increased attention span in ADHD.
Side Effects: hyperactivity, insomnia, restlessness, tremor, sudden death, palpitations, tachycardia, anorexia



Therapeutic: anti-anxiety agents
Pharmacologic: benzodiazepines
For: Generalized anxiety disorder. Panic disorder. Anxiety associated with depression.
Side Effects: dizziness, drowsiness, lethargy, psychological dependance.

Delirium Tremens



Therapeutic: anticoagulants
Pharmacologic: coumarins
For: prevention of thromboembolic events.
Side Effects: Bleeding, cramps, nausea, dermal necrosis

Cant take up to 5 days to take therapeutic effect, so heparin may be used initially. Neither one increases the effect of the other.
Start low, go slow. motor PT/INR frequently!
INR needs to be between 1.5-2
to prevent further bleeding
PT: needs to be between 11.0-12.5
Check guiac for bleeding in stool, urine for blood
avoid aspirin and other nsaids
avoid large quantities of green leafy vegetables.

Vit K is the antidote.


Vitamin K

Therapeutic: antidotes, Vitamins
Pharmacologic: fat-soluble vitamins

Antidote for Coumadin

For: Prevention and treatment of hypoprothrombinemia, which may be due to excessive doses of anticoagulants, Salicylates, Certain anti-infective agents, nutritional deficiencies, prolonged total parenteral nutrition, prevention of hemorroagic event.
Side Effects: gastric upset, usual taste, flushing, rash, uticaria, pain at injection site, swelling, allergic reactions.


Protamine Sulfate

Therapeutic: antidotes
Pharmacologic: antiheparins
For: Acute management of severe heparin overdosage. Used to neutralize heparin received during dialysis, cardiopulmonary bypass, and other procedures.

Antidote to Heparin

Side Effects: Anaphylaxis, angioedema, pulmonary edema, dyspnea, bradycardia, hypertension.



Nitroglycerin sublingual tablets
Therapeutic: antianginals
Pharmacologic: nitrates
For: acute and long-term prophylactic management of angina pectoris.
Side Effects: dizziness, headache, hypotension, tachycardia.



Therapeutic: anti-anxiety agents, sedative/hypnotics.
Pharmacologic: benzodiazepines
For: Adjunct management of anxiety. Treatment of alcohol withdrawal. Adjunct management of anxiety associated with acute myocardial infarction.
Side Effects: dizziness, drowsiness, mental depression, constipation, weight gain. physical and psychological dependance.



Therapeutic: vitamins
Pharmacologic: water-soluble vitamins.
(Vitamin B1)
For treatment of thiamine deficiencies (beriberi). Prevention of warnicke's encephalophathy.
Side Effects: Vascular collapse, angioedema, GI bleeding, restlessness, weakness, pulmonary edema, respiratory distress.



Therapeutic: antidepressants
Pharmacologic: selective serotonin reuptake inhibitors.
For: Major depressive disorder, obsessive compulsive disorder, bulimia nervosa, panic disorder, depressive episodes associated with bipolar I disorder.
For: Neuroleptic malignant syndrome, serotonin syndrome, seizures, suicidal thoughts, anxiety, drowsiness, headache, insomnia, nervousness, diarrhea, sexual dysfunction, increased sweating,pruritus, tremor.


vitamin B6

Therapeutic: vitamins
Pharmacologic: water soluble vitamins.
For: treatment and prevention of pyridoxine deficiency (may be associated with poor nutritional status or chronic debilitating illnesses) Treatment and prevention of neuropathy, which may develop from isoniazid, penicillamine, or hydrazine therapy. Management of isoniazid overdose > 10g.
Side Effects: sensory neuropathy, paresthesia, pyroxine-dependancy syndrome.


Tetanus Toxoid

Tetanus toxoid is used to prevent tetanus, that can cause seizures and severe muscle spasms, and muscle rigidity causing a "locking" sensation on the muscles, most commonly the jaw.
An initial dose is given, repeated in 6 weeks, and then again 6months later to build immunity in the body. Boosters are then needed every 10 years after.


Lithium Levels

Maintenance blood level is .4-1.3mEq/L.
Blood levels above 1.5mEq/L may be toxic.
Blood levels above 2mEq/L are life-threatening.
Blood specimen drawn monthly. Once 6 months stable, every 3 months.
Draw specimen 8-12 hours after last dose.
Major risk: hypothyroidism, impairment of kidneys to concentrate urine.



*Fingers Stick Blood Sugar:
80-120mg/dL pre-meal
*Fasting Blood Sugar FBS: 70-110mg/dL
*Critical: male: less than 50mg/dL and greater than 400mg/dL
*Critical: Female: less than 40mg/dL and greater than 400mg/dL
*HGBA1C: less than 7 according to notes. Less than 6.5 according to review lecture.



detects antibodies related to HIV it is a cost effective screening test


Western Blot

detects antibodies related to HIV it is a more expensive confirmatory test usually used to confirm a reactive ELISA test


Viral Load

The amount of virus in the blood. The higher the viral load the more contageous they are, the lower the viral load the less contagious they are. They are still contagious 100% of the time with HIV just less with lower viral loads.



*White Blood cell Count: 5000-10000mm3
Critical less than 2500mm3, and greater than 30000
*Neutrophils 55-70% or 2500-8000mm3
*Lymphocytes 20-40% or 1000-4000mm3
*Monocytes 2-8% or 100-700mm3
*Eosinophils 1-4% or 50-500mm3
*Basophils .5-1.0% or 25-100mm3



*Complete Blood cell Count:
Male: 4.7-6.1
Female 4.2-5.4
*Hgb 12-15g/dL in women; 13.5-17 g/dL in men
*Hct 40-54% in men; 36-46% in women
*Platelet 150-400,000/mm3
RBC, Hct, Hgb levels confirm anemia


Magnetic Resonance Imaging

noninvasive diagnostic technique that provides valuable information about the body's anatomy. Evaluations are used for (Head and surrounding structures, spinal cord and surrounding structures, face and surrounding structures, neck, mediastinum, heart and great vessels, liver, kidney, prostate gland, bone and joints, breasts, extremities and soft tissues, and the most common uses is visualization one the CNS, bony spine, joints, extremities, and breast.)



blood urea nitrogen. an indirect and rough measurement of renal function and glomerular filtration rate (if normal liver function exists). It is also a measurement of liver function. It is performed on clients undergoing routine laboratory testing.
*Normal Findings 10-20mg/dL or 3.6-7.1 mmol/L
*Critical greater than 100mg/dL it indicates serious impairment of the renal function.



Alkaline Phosphatase:
Used to detect and monitor diseases of the liver or bone.
Normal findings: 30-120 units/L or .5-2.0 ukat/L


Thallium Stress Test

Similar to exercise stress test, but client receives radioactive isotope 1 min before peak of test. After test, images are made by a gamma camera that indicate what part of heart is or is not perfusing.
repeat injection of isotope and repeat images made
3 hours later

Results: well perfused= high concentration of Thallium
Ischemic= cold spots that fill in on delayed images.
Infarcted or scarred = cold spots that remain cold


Echocardiogram/Doppler Studies

uses ultrasound waves to record motion and structure of heart.
Can make a 2 dimensional, continuous picture and record it on videotape.
Can be done through chest wall or look at back of heart by means of an endoscope equipped with a transducer placed inside the esophagus.


Coronary Angiography

Involves injection of IV contrast dye into the coronary arteries during a cardiac catheterization.
Xray films are obtained to identify areas of reduced or no-flow in the coronary arteries.
Client is NPO several hours prior to test
Assess for allergies


Lipid Panel

HDL want >40
LDL want <150mg/dL
Homocysteine: want Within normal limits
taking vit B6, B12, and folate may help to decrease
N High Sensitivity CRP
can detect an inflammatory process caused by atherosclerosis, esp in the coronary arteries.


Cardiac Enzymes & Isoenzymes

Troponin I -elevates within 3 hours of MI or cardiac damage
CPK-MB elevates within 4-6 hours of MI and peak 18-24
LDH elevates within 12-24 hours of MI and peak 2-5 days.


Delirium Tremens

the shakes caused by withdrawal from alcohol. Benzodiazepines are the treatment


Tardive Dyskinesia

repetitive involuntary body movements occurs as result of long-term, high dose of antipsychotic drugs.
Cogentin = Benadryl