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Module 7 > UNIT 3: MEDS TO KNOW > Flashcards

UNIT 3: MEDS TO KNOW Flashcards

1
Q

What should we keep readily avail when administering fentynal?

A

Narcan and resp. equipment

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2
Q

What are some teaching points when administering fentanyl?

A
  1. Do not drink grapefruit juice while using this drug.
  2. You may experience these side effects: dizziness, sedation, drowsiness, impaired visual acutity (ask for assistance if you need to move) nausea, loss of appetite,constipation
  3. Report severe n/v, palpitations, SOB or difficulty breathing
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3
Q

What are indications for the need of warfarin?

A
  1. Venous thrombosis and its extension, treatment, and prophylaxis
  2. Treatment of thromboembolic complications of afib with embolization, and cardiac valve replacement
  3. PE, TX and prophylaxis
  4. Prophylaxis of systemic embolization after acute MI
  5. UNLABED: prevention of recurrent TIA’s, prevention of recurrent MI, Adjunct to therapy in small cell carcinoma of the lung
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4
Q

What are the nursing interventions for warfarin

A
  1. Monitor labs- PT, LEFT, Renal function tests
  2. Evaluate pt regularly for signs of blood loss (petechiae, bleeding gums, bruises, dark stool, dark urine
  3. Maintain PT ratio
  4. Double check drugs for contraindications to Warfarin.
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5
Q

What are teaching points for warfarin?

A
  1. Many factors may change your bodies response to this drug- fever, change of diet, change of environment, other medications, **your dosage may need be changed. **
  2. Do not start or stop taking any medication without consuling your HCP. Other drugs can affect your anticoagulant.; starting or stoping can increase bleeding
  3. Carry or wear medicaal ID tag to alert medical staff you are taking this drug
  4. Avoid situations in which you could be easily injuried
  5. Have blood tested periodically.
  6. Avoid pregnancy.
  7. Report unusal bleeding, black or bloody stool, cloudy or dark urine, sore throat, fever, severe headache…
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6
Q

What are therapeutic inidcations for prednisone?

A

Short-term managment of various inflammatory and allergic disorders, such as rheumatoid arthritis, collagen diseases, dermatologic diseases, status asthmaticus and autoimmune disorders.

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7
Q

What are adverse effects of prednisone?

A
  1. Insomnia
  2. Nervousness
  3. Increased appetite
  4. Hyperglycemia
  5. Edema/weight gain
  6. Headache
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8
Q

What are some nursing considerations for prednisone?

A
  1. Taper doses when discontinuing high-dose or long-term therpy to avoid adrenal insufficiency
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9
Q

What are teaching points of prednisone?

A
  1. Do not stop taking the drug without consuling your health care provider
  2. Avoid exposure to infections
  3. Report unusual weight gain, swelling of extremities, muscle weakness, black or tarry stool, fever, prolonged sore throat, colds or infections.
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10
Q

What drug class does fentanyl belong to?

A

Opioid agonist, analgesic

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11
Q

What is the MOA of fentanyl?

A

Opiod agonist- bind to and activate opioid receptors which are found in the CNS.

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12
Q

What are side effects of fentanyl?

A
  1. resp. depression
  2. constipation
  3. dizziness
  4. headache
  5. sedation/decreased loc
  6. hallucinations
  7. drug dependancy
  8. urinary retention
  9. dry mouth

CNS DEPRESSANT

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13
Q

What are some clinical indications for the use of fentanyl?

A
  1. Managment of break through cancer pain
  2. For patients already recieving opiod therapy experiencing break through pain
  3. IV and IM injections of fentaynl are indicated for short term analgesia during induction, maintences and recovery from general or regenial anesthesia
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14
Q

What is the best around the clock medication delievery of fentanyl?

A

Transdermal patch.

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15
Q

What should we know about the dosing of fentanyl?

A

Very potents
1. 80-100x more potent than morphine. Often seen in mcg instead of mg

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16
Q

Fentanyl is contraindicated in what patients

A
  1. Opiod naive patients
  2. Bowel obstructions
  3. Acute resp. distress
  4. Head injury
  5. Increased ICP
  6. Caution with pts in history of chemial dependance.
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17
Q

What considerations should we note about the use of fentanyl?

A
  1. High alert drug- often requres 2 nurse verification
  2. Hold if RR are less than 12/min
  3. Increased hydration & bulk forming foods to avoid constipation
  4. Taper gradulally never stop abruptly
  5. know narcan protcol.
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18
Q

What pharm class does Warfarin belong to?

A

Anticoagulant

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19
Q

What is clincal use of Warfarin?

A

Prevent the formation of DVTs, PE, heart attacks, and strokes in patients who are at high risk of developing blood clots.

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20
Q

What are side effects of warfarin?

A
  1. Causes bleeding- increased risk for uncontrolled bleeding
    • Watch for signs of uncontrolled bleeding like bruising, tarry stools or sudden drop in bp
  2. Teratogenic- can lead to various birth defects
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21
Q

What labs should be monitored on a patinet taking Warfarin?

A
  1. PT- monitors the effectiveness of warfarin by giving a measurement of the time it takes for the blood to clot. Should be 2 to 3 times higher than pts baseline
  2. INR-
    • Derived from the PT,
    • INR of 1 is normal. INR of 2 means it takes twice as long to clot compared to the normal person.
    • The INR level for a patient on warfarin should be between 2-3. Between 2-3 means they are having a good therapeutic effect. If it is below 2 this means they are still at risk for developing clots. If above 3 this puts them at a higher risk of uncontrolled bleeding.
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22
Q

What is the antidote for warfarin?

A

Vitmain K (Vitamin KALE)

Patients on Warfarin should avoid leafy greens of foods high in vitamin K- reverses blood thinning effects.

23
Q

What is the pharm class of Prednisone?

A

Corticosteriod

24
Q

What is the MOA of corticosteriods like prednisone?

A

Anti-inflammatory help reduce inflammation in people who have inflammatory autoimmune conditions like RA, Lupus, Ulcertive Colitis…

25
Q

What are the clinical uses of corticosteriods like prednisone?

A

Effective in the treatment of
1. RA
2. Ulcerative colitis
3. LUPUS
4. preventing organ transplant rejection
5. Adrenal insufficenicy (ADDISONS)-condition in which the body doesnt produce enough cortisol in the adrenal glands leading to reduced energy… replaces hormones that the adrenal glands dont make enough off.

26
Q

What are some side effects of corticosteriods like prednisone?

A
  1. Immunosuppressant-
    • they suppress or weaken the immune system. This keeps the body from attacking itself.
    • This is extremely important for patients who are getting organ transplants.
    • However, this puts them at risk for infections. Report s/s of Illness IMMEDIATELLY
  2. Infection Risk
  3. Hyperglycemia
    • esp. important in diabetic patinets may need to increaase insuline
  4. Causes fluid retention
    • leading to HTN, swelling and weight gain. May experience peripherial edema
    • CAUTION: CHF pts
  5. Osteoprosis
    • Long term use- increased risk of developing osteoprosis and bone fractures
  6. Causes cataracts
    • Rare side effect that develops as a long term use of corticosteriods
  7. Nausea/vomiting/Diarrhea and abdominal distention.
    • Take with food to avoid
  8. Muscle Weakness
    • seen in long term use… can cause breakdown in muscle and skin
  9. Can cause cushings syndrome
    • r/o overdose of corticosteriods (moon face, pedal edema, puffy eyelids)
27
Q

What pharm class does enoxaprain belong to?

A

LMWH

28
Q

What is the MOA of Enoxaparin?

A

Decrease blood clotting by inhibbiting clotting factors. Clotting factors are protiens in the blood that make up 1 of 2 important steps that cause our blood to clot
the other being platelet aggregation.

Specifically it enhances the inhibitory effects of antithombin III which prevents the production of fibrin (an insoluble protien) prevents cloths from forming or getting bigger

29
Q

What are the clinical uses of exnoxaprin?

A
  1. Prevention & treatmetn of abnormal clotting (ex. DVT, PE),
  2. Adjunt therapy in unstable angina
  3. Prophalactily given in the hospital to prevent blood clots
30
Q

What are side effects & contraindications?

A
  1. Bleeding/Bruising
  2. Thrombocytopenia,
  3. Decreased renal function
  4. Osteoprosis
31
Q

What do we need to check before administering exnoxaparin?

A

1.Platelets

32
Q

What are our nursing considerations for enoxaparin?

A
  1. Monitor for bleeding and bruising
  2. Elextric razors, Soft bristle toothbrush education
  3. Do not lyse pre-existing clots
  4. Prefilled,
  5. SC injection
  6. DO NOT expel bubble or aspirate needle
33
Q

What is the antidote for enoxaparin?

A

Protamine sulphate

34
Q

What is the pharm class for promethazine?

A

Antiemetic/antihistamine

35
Q

What is the MOA of promethazine?

A

Phenothiazine deriviative, blocks postsynaptic dopaminergic receptors in the brain and has a strong adrenergic blocking effect. It completely binds to h1-receptors

36
Q

What are the clinical indications for the use of promethazeine

A
  1. Tx of motion sickness
  2. Prevention & control of n/v
37
Q

What are some adverse reactions of promethazine

A
  1. CNS depression
  2. dry mouth
  3. blurry visiion
  4. retention of urine
  5. constipation
  6. glaucoma
  7. tachycardia
  8. Headache
  9. HYPOtension
  10. tinnitus
38
Q

What are some contraindicatons to promethazine?

A
  1. BLACK BOX warning: do not give tablets or recal suppositories to children under 2
  2. Do not admin SUBQ: tissue necrosis may occur
  3. Do not admin intra-arterialy; arteriospasm and gangrene of the limb may result
39
Q

What are some teaching points for promethizene?

A
  1. Take as prescribed
  2. Avoid using alcohol
  3. Avoid driving or engaging in other dangerous activities if dizziness, drowsiness, or vision changes occur
  4. Avoid prolonged exposure to sun
  5. Maintain fluid intake,
  6. Report sore throat, fever, unusual bleeding, or bruising, rash, weakness, tremors, imapired vision, dark urine, pale stools, yellowing of the skin or eyes
40
Q

What pharm class does pantoprazole belong to?

A

PPI (proton pump inhibitor)

41
Q

What is the MOA of PPIs like pantoprazole?

A

Work to suppress production of stomach acid, which can be used to treat and prevent stomach ulcers and acid reflux, also known as GERD.

42
Q

What are side effects of Pantoprazole?

A
  1. Osteoporosis/bone fractures
  2. Increased risk of c.diff infection
  3. may cause Pneumonia
43
Q

What are clinical uses of pantoprazole?

A
  1. tx and prevents Gastric ulcers
  2. Tx gastroesophegeal reflux disease GERD
44
Q

What pharm class is mannitol

A

Osmotic diuretic

45
Q

What is the MOA of mannitol

A

Works to pull water from tissues by increasing osmalarity and puts water into the blood and eventually into the urine

46
Q

When are clinical uses of mannitol

A
  1. Tx high intracranial pressure/ICP
  2. Treats High intraocular pressure/IOP
    3
47
Q

What are some adverse effects of mannitol?

A
  1. May cause pulmonary edema
    • Lung sounds (crackles)
48
Q

What pharm class is metronidazole (flagyl)?

A

Antibiotic

49
Q

What is metrondiazole used for?

A

Treat bacterial infections like cdiff, trichomoniasis.

50
Q

What is the moa of metronidazole?

A

works to induce bacterial cell death by inducing the production of toxin free radicals. It is not effective agaisnt viruses or funguses.

51
Q

What should patients avoid when taking metronidazole?

A
  1. Alcohol- can cause advere effects… do not use while taking or atleast 48 hours after treatment.
52
Q

What are side effects of metronidazole?

A
  1. Causes metallic taste
  2. Causes red/brown urine discoloration

Both of these are benign so patients should be consoled to not worry when they occur.

53
Q
A

Module 7 (22 decks)

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