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Week 2 stufffff Flashcards

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1
Q

Why might adverse affects occur?

A

Drug has other effects other than therapeutic effect
Pt may be sensitive to the drug
Pt may be taking too much or too little of the drug

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2
Q

What is a primary action?

A

Type of adverse effect
Extension of desired effect
Ex: Anticoagulant worked too good and now pt has spontaneous bleeding

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3
Q

What can cause primary actions?

A

High or low body weight
Sometimes kidney impairment causes drug to accumulate in body and have toxic effects

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4
Q

What are secondary actions?

A

Undesired effects produced in addition to pharmacological effect
Ex: Antihistamines may cause drowsiness

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5
Q

Can a patient be allergic to a drug they have never taken?

A

No
It is possible they might have cross allergies to drugs within the same drug class

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6
Q

Types of drug allergies

A

Type 1: Immediate hypersensitivity disorders
Type 2: Antibody mediated disorders
Type 3: Immune complex mediated disorder
Type 4: Cell mediated hypersensitivity disorder

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7
Q

What are signs Type 1 allergy?

A

Hives: OTC antihistamines
Rash: same as hives
Anaphylaxis: Use epipen and maintain airway and BP

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8
Q

What are signs of type 2 allergies?

A

Renal or liver dysfunction
Notify provider

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9
Q

What are some dermatologic reactions of drugs?

A

Rashes/ Hives: Exfoliative dermatitis; fever, enlarged lymph nodes, enlarged liver, Stevens Johnson Syndrome

Stomatitis: Gingivitis, swollen red tongue, difficulty swallowing, bad breath

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10
Q

What interventions for rash and stomatitis?

A

Rash/ Hives: Provide frequent skin care; if severe then stop medication and notify provider

Stomatitis: Provide frequent mouth care, antifungals

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11
Q

What are some signs of GI irritation?

A

Nausea
Diarrhea
Constipation
Heart Burn
Bloating

Interventions may include taking the med with food

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12
Q

What are superinfections?

A

Destruction of the body’s normal flora
Usually antibiotics destroy the normal flora

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13
Q

Signs and interventions of superinfections

A

fever
Diarrhea
Black tongue
vaginal discharge without itchiness

Frequent care of the area
Antifungals as appropriate

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14
Q

What is blood dyscrasia?

A

Bone marrow suppression caused by drugs
Drugs that cause cell death like antibiotics and antineoplastics

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15
Q

Signs and interventions of blood dyscrasia?

A

Fevers
Chills
Sore throat
Weakness
Back pain
Dark urine
Anemia

Monitor blood counts

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16
Q

Hepatotoxicity

A

Oral drugs run more a risk for liver toxicity because of first pass effect

Fever
malaise
Nausea
Jaundice
Change in urine color or stool
Elevated liver enzymes

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17
Q

Nephrotoxicity

A

Gentamicin is frequently associated with renal toxicity

Elevated BUN, creatinine
Decreased output
fatigue

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18
Q

What is poisoning?

A

When overdose of a drug damages multiple body systems
Leads to potential for fatal reactions

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19
Q

Hypoglycemia

A

Glipizide and Glyburide are antidiabetic meds that lower glucose but can accidentally lower too far

Fatigue
Drowsiness
Anxiety
Hunger
Increased HR

Restore glucose orally or IV
Safety measures to prevent falls

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20
Q

Hyperglycemia

A

Prednisone can cause hyperglycemia
Fatigue
Increased urination
Increased thirst
Deep respirations

Insulin therapy

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21
Q

Neurologic

A

Corticosteroids have varying effects on CNS

Confusion
Delirium
Insomnia
Drowsiness
Hallucinations

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22
Q

Anticholinergic effects

Study These Flashcards
A

DRYNESS
Blurred visions

Sugarless lozenges and mouth care
Safety measures if there are vision changes
Have pt void before administering

23
Q

Who is at risk for iron deficiency anemia

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A

Menstruating people
Pregnant and lactating ppl
Rapidly growing adolescents
GI bleed

24
Q

Who’s at risk for folate deficiency anemia?

Study These Flashcards
A

Malabsorption states like celiac
Malnutrition related to alcoholism
Repeated pregnancies
Extended treatment with antipileptic meds

25
Whose at risk for vitmanin b12 deficiency?
Strict vegetarians Inability of GI to absorb it
26
Why might erythropoiesis stimulating agents be beneficial?
For patients who are no longer able to produce enough erythropoietin in their kidneys
27
What drugs fall under erythropoiesis stimulating agents?
Epoetin alfa (Epogen,Procrit,Retacrit) Darbepoetin alfa (Aranesp)
28
What must you make sure of before giving erythropoiesis stimulating agents?
That patient has adequate levels of components required to make RBC's Such as adequate iron
29
What's the usual dose of epoetin alfa?
For kidney disease: 0.45 mcg/kg IV or subq once a week. Or 0.75 mcg/kg IV or subq every 2 weeks
30
What's the usual dose of Darbepoetin Alfa?
IV or subq Varies based on indication and individual response
31
Whats the therapeutic action of ESA's?
To act as natural glycoprotein erythropoietin which stimulates the production of RBC's in bone marrow
32
What are the indications of ESA's
Anemia associated with Chronic Kidney Disease Medication therapy for pt with HIV Cancer chemotherapy that suppresses the bone marrow
33
Contraindications to ESA's
Uncontrolled Hypertension Known hypersensitivity Pregnancies or lactation
34
What are some adverse effects of ESA's?C
CNS effects like headaches, fatigue, dizziness Nausea Vomiting Diarrhea CV symptoms like hypertension, edema, chest pain THROMBOEMBOLISM!
35
What are the drug- to drug interactions of ESA's
Never be mixed in solution with other drugs
36
What are drugs used for iron deficient anemias?
Ferrous Fumarate (Feostat)(Oral) Ferrous Gluconate (Fergon)(Oral) Ferrous Sulfate (Feosol)(Oral) Ferrous Sulfate Exsiccated (Ferralyn Lanacaps, Slow FE)(oral) Ferumoxytol (Feraheme)(IV) Iron Dextran (InFed) (IV) Irone Sucrose (venofer)(IV) Sodium ferric gluconate complex (Ferrlecit)(IV)
37
Indications for the drugs used in iron deficient anemias
For iron deficiency anemia As an adjunctive therapy in pt's recieving ESA's
38
Pharmakokinetics of iron deficient anemia drugs
Are absorbed in the small intestine by active transport Transported in the blood bound to transferrin
39
Contraindications of iron deficient anemia drugs
Allergy Hemochromatosis (excessive iron) Anemias that are not iron deficiency Normal iron balance Peptic ulcer colitis
40
Adverse effects of iron deficient anemia drugs
Oral: GI irritation like anorexia, vomitting, nausea CNS: Can be toxic to cns which causes coma and sometimes death Parenteral: anaphylectic reactions, local irritation, phlebitis
41
Drug to drug interactions of iron deficient anemia drugs
Antacids Substances with calcium and magnesium Tetracyclines Cimetidine Levodopa Use these drugs are to be used they should be spaced out 2 hours
42
Food to drug interactions of iron deficient anemia drugs
Milk Eggs Calcium containing shi Antacids Vitamin C enhances absorption such as orange juice, Phyates and fibers like whole grains, raw veggies, bran, reduce iron absorption too Inadequate vitamin A can lead to iron dificiency
43
What are some of the meds used for folic acid anemia?
Folic acid (generic) Leucovorin (generic) Levoleucovorin (Fusilev, Khapzory)
44
What are some meds for vitamin b12 anemia?
Hydroxocobalamin (generic) Cyanocobalamin (calomist, nascobal, vibisone)
45
Therapeutic action for the megaloblastic anemia medications
Folic acid: Necessary for production of DNA, RBC, WBC, platelets B12: Necessary for maintenance of myelin sheath in nerve tissues
46
Indications of Megaloblastic anemia meds
Replacement therapy for dietary deficiency and high demand states like pregnancy Treatment for megaloblastic anemia Folic acid can be used as rescue drug for some cells exposed to chemotherapeutic agents
47
What are hemolytic anemias and what is an example?
Hemolytic anemia means the blood cells break down faster than body can replace them Ex: Sickle cell
48
What should you check for when giving Procrit or ESA's?
Increases HCT and HgB Watch for hypertension, headache, and nausea
49
Creatinine levels
0.7-1.4
50
BUN levels
10-20
51
Extrapyramidal Symptoms
Is a neurological symptom Muscle tremors or stiffness Changes in gait Rigidity Stop the medication as appropriate
52
Neuropoleptic malignant syndrome
Hyperthermia autonomic disturbances Altered mental status Vital Sign Instability Discontinue med Reduce patient body temp
53
What is teratogenicity?
Any drug that causes harm to the developing fetus or embryo

Pharmacology shi (25 decks)

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