prescribed to pts with breast cancer and prevent reoccurance - common side effects similar to menopause (hot flashes, vag dryness, menstrual irregularities) - serious side effects: thromboembolic events and endometrial cancer

UWORLD meds Flashcards by Tara C Mandel

sodium polystyrene sulfonate

KAYEXALATE

used to treat hyperkalemia
works in GI tract to trade sodium for potassium, eliminating excess in stool and decr serum levels
*does not impact creatinine, phosphorus or calcium levels**
must have normal bowel function to avoid the risk of intestinal necrosis assess for s/s of constipation, signs of impaction and recent bowel patterns

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methotrexate

for rheumatoid arthritis

adverse effects:
bone marrow suppression (can lead to anemia, leukopenia and thrombocytopenia (characterized by petechiae, purpura and other signs of bleeding)
hepatotoxicity
GI irritation

BM suppression is managed by dose reduction or discontinuation of med

caffeine + folic acid decreases effectiveness

TERATOGENIC !!

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dopamine

outcome: increases HR, BP, CO + UO

Closely monitor VS –> higher doses can lead to dangerous tachycardia and tachyarrhythmias

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Tamoxifen

prescribed to pts with breast cancer and prevent reoccurance

common side effects similar to menopause (hot flashes, vag dryness, menstrual irregularities)
serious side effects: thromboembolic events and endometrial cancer

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clopidogrel (plavix)

antiplatelet medication, should be discontinued 5-7 days before surgery to decr risk for excessive bleeding

** meds (anticoagulants, antiplatelets, NSAIDS, herbal drugs) that incr risk for bleeding should be discontinued 5-7 days before surgery)

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lactulose

given to pts with liver complications such as hepatic encephalopathy (high serum ammonia levels)

med reduces the ammonia by trapping it in the gut and then expelling it
–> improved MS

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antiplatelet medications

prasugrel (effient)
clopidogrel (plavix)
ticagrelor (brilinta)

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niacin (nicotinic acid/B3)

used in large doses for lipid-lowering poroperties

- may produce cutaneous vessel vasodilation

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transdermal fetanyl patch

indicated to treat moderate to severe CHRONIC PAIN
- not recommended to treat acute postoperative, temporary or intermittent pain as it does not provide immediate analgesia when applied

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esomeprazole

long term use of PPI may decrease the absorption of calcium and promote osteoporosis
increased risk of diarrhea caused by c. diff PPIs can suppress acid that would have prevented pathogens from more easily colonizing the upper GI tract… increased risk for pneumonias

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phenothioZinews

1 ND = safety + educating about s/s of infection, report to HCP

major tranquilizers
for our ZANY pts
SEs –> ABCDEFG
anticholinergic, blurred vision, constipation, drowsiness, EPS (tremors, parkinson), foto-sensitivity, aGRANULOCYTOSIS

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names of tricyclic antidepressants + major info

elavil, trofranil, aventyl, desyrel

ELEVATES MOOD, HAPPY PILLS!

med takes 2-4 weeks for beneficial effects

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SE of tricyclic antidepressants

ABCDE

anticholinergic (esp dry mouth)
blurred vision
constipation
drowsiness
euphoria

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benzos info, uses, ending

always have ZEP in the name
valium is the prototype (induction of anesthetic, muscle relaxant, alcohol)

uses:
seizures medications
preop induction of anesthesia
muscle relaxants
etOH withdrawal med 
ventilation (med to relax and calm down pts on vent)

REMEMBER THESE ARE MINOR ANTIPSYCHOLITCS
“what do you find at a zeppelin concert? minors on transquilizers”

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why administer major and minor antipsychotics at the same time?

major –> take longer to work
minor –> start right away
pt usually on valium and elavil at same time, then valium is discontinued
similar to heparain and coumadin

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SE of benzos

ABCD
anticholinergic 
blurred vision 
constipation
drowsiness

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MAOIs uses, teaching points, med beginning

antidepressant, thought to be caused by norepi, dopamine and serotonin in brain
all the beginnings of MAOIs rhyme “MARplan, NARdil, PARnate”

AVOID TYRAMINE-CONTAINING FOODS –> MAY CAUSE HYPERTENSIVE CRISIS

BAR bananas, avacados, raisins
grains except yeast
meats - no organ liver, kidney, tripe, heart, preserved
dairy - no cheese except mozz, cottage cheese
no ETOH, elixers, tinctures, caffeine, chocolate, licorice, soy sauce

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MAOIs SEs

*** same as benzos 
ABCD
anticholinergic 
blurred vision
constipation
drowsiness

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litium

uses, SEs

used for treating bipolar disorder, decreases mania
**se’s act more like an electrolyte - think potassium/lithium
3 P’s
peeing (polyuria)
pooping (diarhea)
parasthesia (earliest sign of electrolyte imbalance)

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what is the earliest sign of electrolyte imbalance

PARESTHESIAS

NUMBNESS AND TINGLING

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toxic effects of lithium

Study These Flashcards

tremors
metallic taste
severe diarrhea

1 NI for pt on lithium pooping and peeing all the time

Study These Flashcards

GIVE FLUIDS!!
monitor sodium, sodium must be normal
too high = ineffective
too low = toxic

prozac (fluoxetine) SEs and special considerations

Study These Flashcards

SSRI - MOOD ELEVATOR 
SEs ABCDE
anticholinergic 
blurred vision
constipation
drowsiness
euphoria 
** causes insomnia so give before noon, if 2x daily then 6am and noon
** when changing doses assess suicidal risk in ADOLESCENTS

haldol (haloperidol) SEs

Study These Flashcards

tranquilizers (basically same as thorazine)
ABCDEFG
anticholinergic, blurred vision, constipation, drowsiness, EPS, fotosensitivity, aGranulocytosis
**teach pts how to look out for s/s of infection, report to HCP
** first gen antipsychotics

haldol might develop what from overdose and risk factors

NMS (neuroleptic malignant syndrome) from OD ** this is a lifethreatening idiosyncratic reaction to antipsychotic drugs characterized by fever, AMS, muscle rigidity and autonomic dysfunction ** SEEN IN ELDERLY + YOUNG WHITE SCHIZO PTS HIGH FEVER OVER 105 DOSE SHOULD BE 1/2 USUAL ADULT DOSE also safety concerns r/t SEs

how to differentiate NMS from EPS

both present with anxiety and tremors NMS will have high fever, 102 and rising call EMRT + NOTIFY HCP

clozaril (clozapine) SE and med type

atypical antipsychotic aGRANULOCYTOSIS ! ** IT IS WORSE THAN CANCER DRUGS AND CAN TRASH PTS BONE MARROW

Geodine (ziprasidone)

BLACK BOX WARNING PROLONGED QT INTERVAL CAUSE CAUSE SUDDEN CARDIAC ARREST DON'T USE IN PTS W CARDIAC CONDITIONS

ending of second gen antipsychotics

- zapine ** metabolic changes as SEs *like weight gain, high chol, high BP, high BG

#1 NI for clozaril (clozapine)

monitor WBCs

Zoloft (sertraline) SEs and drug interactions to avoid

``` SEs "SAD Head" sweating apprehension *impending sense of doom* dizziness headache *can also cause insomnia ``` interact with StJohn's wort and can cause serotonin syndrome warfarin and cause bleeding ** d/t these meds not being metabolized in liver

which meds should the nurse anticipate a lower dose for if on st johns wort and warfarin

ZOLOFT

serotonin syndrome manifestations

``` TOO MUCH SEROTONIN IN BRAIN! mental changes tachycardia tightness in muscles difficulty walking incr in BP and temp ```

tocolytics

STOP CONTRACTIONS, STOP LABOR given to women in premature labor, must be stopped

terbutaline (brethine)

tocolytic SE: maternal tachycardia (don't give with cardiac disease)

magnesium sulfate

tocolytic treatment will induce hypermagnesemia, which will cause everything to go down HR down, BP down, REFLEXES DOWN, RR DOWN, LOC down

NI for hypermagnesia

monitor RR, <12 decrease dose of mag sulfate assess for reflexes normal reflexes 2+ reflexes 0 or 1+ --> decrease dose of mag sulfate reflexes 3+ or 4+ increase dose of mag sulfate

oxytocics

stimulate and strengthen labor

pitocin (oxytocin)

SE: utermine hyperstimulation (longer than 90 seconds, closer than 2 mins) NI: lower dose

methergine

oxytocic causes HTN: increases BP

betamethasone

steroid, fetal/neonate lung med - give to mother IM, can repeat as long as baby is in utero SE: increase glucose (steroid)

surfactant (survanta)

lung med given to baby via transtracheal route given after birth

humalin 70/30

mix of insulin N and R... 70% = N 30% = R | to remember the bigger number, think of a fraction... the numerator N is on top, therefore insulin is the bigger number

can you mix insulin in same syringe and how?

• Yes, insulin can be mixed in the same syringe • How do you mix insulin? (1) Pressurize vial and (2) Draw up insulin (1) To pressurize the vial … Inject air into N, then into R, Draw up R (2) To draw up insulin … Think of RN

needle for injections IM

o Pick answer in which both answers have a “1” in them o “I” in IM looks like the “#1” o Use a 21-gauge, 1-inch long needle

needle for subq injection

o 5 looks like an “S” in “SubQ” o Pick the answer that has “5s” in it o Use a 25-gauge, 0.5 inch needle

max amount of time heparin can be given for?

3 weeks, 21 days | after 21 days body starts making antibodies against heparin

antidote and labs for heparin

protamine sulfate PTT ** can be used during pregnancy, class c med

coumadin info, antidote, labs

``` given only PO takes few days to a week to work (likely 4-5 days) pts can be on coumadin for entire life antidote: vitamin K labs: PT/INR NOT USED DURING PREG ```

what is the only antipsychotic given to preg women

HALDOL!

diuretics

k wasting, k sparing any diuretic ending in X, XES OUT K if it does not end in X it is a sparer lasix --> wastes K *and Diuril is k wasting* ``` Brand vs Generic o Aldactone Spinorolactone** o Adactazide Spinorolacone-Hydrochlorothiazide o Modurectic Amiloride-Hydrochlorothiazide o Lasix** Furosemide o Bumex Bumetanide** o Clotrix Clotrimazole o Esidrex Hydrochlorothiazide** o Demadex Torsemide o Diuril Chlorothiazide ```

2 muscle relaxants to know | SEs + teaching points

brand/generic lioresal/baclofen flexeril/cyclobenzaprine ``` SE: fatigue/drowsiness, muscle weakness (paresis) Teaching: don't drink don't drive don't operate heavy machinery ```

UWORLD meds Flashcards

(52 cards)