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CHOLESTRAMINE (QUESTRAN)
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DC NCLEX-MEDS
NCLEX MEDS TO KNOW
| Question | Answer |
|---|---|
| ACE | -PRIL Tx: HTN and Heart Failure |
| CHOLESTRAMINE (QUESTRAN) | Decreases Cholesterol -take other meds 1 hr before or 4 hours after -take with milk, juice to avoid constipation -take at meal time SE: Decrease Vit C absorption & Constipation |
| ANTIVIRAL | -VIR (in name) Tx: HIV,viral infections, HSV, HEP C, Chicken pox, RSV Ex: Ritonovir (Norvir) |
| BENZOS | -PAM or has AZE or AZO in name Tx: Antianxiety, anitconvulsant, muscle relaxer, hypnotic, sedative Ex: Diazapam, Tegretol (Carpamazine) |
| BETA BLOCKERS | -OLOL Tx: HTN, Dysrythmia, Angia Ex: Atenolol (can cause bronco constriction) |
| CCB | -PINE Tx: HTN, Angina, dysrythmias (like BB) Ex: Anlotapine (Norvasac) Exception: Diltiazam (Cartizine)-has to be given q 4 hrs Varaprimail (Calan) |
| GLUCOCORTICOIDS/CORTICOSTERORIDS | -SONE or contains CORT Take 2nd, Bronchodilators take 1st Alters normal immune response Tx: adrenal insuffency, suppress inflammation, Addisons, Parkinsons, Post x-plant. If taking NPH, increase NPH dose. Can increase BS Ex: Prednisone (taken in AM) |
| H2 ANTAGONISTS | -DINE or TIDINE Decreased secretion of gastric acid Tx: Acid Reflux, GERD, Heart burn, prevent ulcers Adverse Rxn: dizziness, hallucinations, sleepiness Ex: Semetadine (Tagament) |
| NITRATES | -contains NITR Vasodilation Tx: Angina Ex: Nitroglycerin (nitrostat) |
| PPI | -ZOLE -PRAZOLE Suppresses Gastric Acid Secretion (like H2 Antagonists) Tx: Heartburn, Ulcer Dz, GERD, esophageal erosion |
| SULFONAMIDES | -contains SULF Suppresses bacterial growth Tx: Infections Ex: Sulfasazine |
| THIAZIDE DIURETICS | -ZIDE Tx: HTN & Peripheral Edema Ex: HCL thiazide |
| THROMBOLYTIC | -ASE Used to dissolve clots Ex: Altaplase (Actiplase) |
| THYROID HORMONE | -contains THY Tx: replacement therapy, hypothryoidism Ex: Levothryroxine (Synthroid) |
| BRONCHODILATORS | -LINE Tx: disorders that cause bronchoconstiction, Asthma, COPD, Emphazema Ex:Theophyline 10-20 TDL SE: Restlessness & Increased P |
| ABX | -CYLINE, MYCIN, MICIN Take 1 hr before or 2 hrs after meals SE: Photosensitivity, Decreases contraceptive effectiveness Adverse rxn: yellow skin, Hep, Macular rash-STOP MED Ex: Erthromax, vibramycin, tetracycline (cipro) NO albumin, Mg or Ca antacids |
| REVERSE TRANSCRIPTASE or ANTIHYSTAMINE | -INE |
| Mental and Emotional Conditions or N/V | -ZINE Adverse fx: EPS Tx: schizophrenia, N/V (phen and comp) |
| Cardiac Glycosides | -OXIN Tx: CHF and Heart Arythmias |
| ANTICHOLENERGIC | -OPINE EX: Atropine SE: can't see, pee, sit, poo (Activates SNS-flight or fight) NO with GLAUCOMA = Icreases IOP |
| SNS | -Increases BP, HR, RR -Decreases GI, UO (constipation and urinary retention) -dilated pupils (blurry vison) -constricted blood vessels and dry mouth (FLIGHT OR FIGHT)- acts on Increased ACH |
| PNS | -decreased HR -constriced pupils -Relaxed -Increased sex drive -warm, dry skin REST AND DIGEST- acts on Decreased ACH |
| Is DIG K sparing or wasting? | K WASTING |
| Is ADACTONE K sparing or wasting? | K SPARING |
| What can sudden stopping of TEGRETOL cause? | SEIZURES |
| What do you don't want to take with GRAPEFRUIT JUICE? | (Most Benzo, vir meds, depression meds) -BUSPAR -VARAPAMIL -TEGRETOL (CARBAMAZEPINE) |
| CISPLATIN | -CA med -30% can cause OTO TOXICITY -drink 8-10 glasses of water |
| ANALGESIC | -DONE Tx: Pain |
| ANESTHETIC (local) | -CAINE |
| LIDOCAINE HYDROCHLORIDE | Tx: Heart problems (Ventricular arrhythmia's) caused by MI |
| ANTI-ULCER | -DINE |
| DIURETICS | -MIDE -ZIDE |
| ORAL HYPOGLYCEMIC | -IDE |
| STEROID | -SONE |
| NEUROMUSCULAR BLOCKING | -NIUM anesthesia to produce paralysis (inhibits AcH) |
| What age groups are affected by medications the most? | OLD & YOUNG (greater risk of toxicity) - Absorption -Excretion -Distribution -Metabolism |
| Many med are contraindicated in what? | Breastfeeding and Pregnancy |
| What med is not usually administered with other medications? | Antacids (affects the absorption of med) |
| What can RN do in regards to medications? | -GIVE -HOLD (can never stop or dc med, never tell pt to stop abruptly) |
| What kids of meds should not be taken with other prescribed mediations (unless MD approved)? | -OTC -HERBAL |
| METFORMIN | -Oral Hypoglycemic (decreaseds glucose production) -given in combo with repglinidine Adverse Fx: Muscle Pain |
| METOCLOPRAMIDE (Reglan) | -Antiemetic Tx: N/V prevention, Decreases GERD, GI Stimulant DONT Take with: GI disturbance, hemorrhage or perfusion |
| ANTICOAGULANT | -PARIN Tx: PE, MI, DVT |
| ANGIOTENSION RECEPTOR | -SARTIN Vasoconstriction and Aldosterone secretion Tx: Decrease BP |
| BB | -OLOL Tx: Decrease BP, P, CO, Migraines , Glaucoma |
| AMINOGLYCOSIDES | -CIN/MYCIN Kills Bacteria (ABX) OTO and NEPHRO TOXIC Ex: Vancomycin |
| SSRI | Tx: for Depression, anxiety, OCD |
| What does NITRO not relieve? | UNSTABLE ANGINA |
| How should NITRO be taken? | -1 every 5 min for 3 min -if not relieved go to ER DONT give if BP is below 90/60 |
| What are the Sx of ATROPINE OD? | Think Alice in Wonderland -HOT -LOC Changes -RED (flushed face) -DRY/THIRSTY |
| What kids of Meds are COLCHINE and ALLOPURINOL | GOUT MEDS |
| VERAPAMIL (Calan) | CCB Tx: HTN, Angina Adverse Fx: Constipation, N, Diarrhea |
| What med is given for ASYTOLE (no heart beat)? | ATROPINE |
| What med is given for CHF? | ACE |
| What med is given for ANAPHYLACTIC SHOCK? | EPINEPHRINE |
| What med is given for STATUS EPILEPTICS? | VALIUM ATAVAIN |
| What med is given for BIPOLAR? | LITHIUM |
| What med is given for VENTRAL and ATRIAL Complications (A-fib, V-fib, act.)? | AMIODARONE |
| CA MEDS | Massive cell destruction following chemo = Inc. uric acid levels SE: allopecia, decreased resistance to body Need to contact MD before getting vaccinations -NO ASA or ETOH Ex: Elspar, Tamoxifen, Megestrol, alduphosphamide, Busuifan, Vincristine, Beomy |
| TDL of LITHIUM | 0.8-1.5 Toxicity: lethargy, hand tremors, muscle weakness |
| TDL of DILANTIN (Phenytoin) | 10-20 Toxicity: muscle incordination, nastagmus, diplopia Tx: Seizure |
| TDL of DIGOXIN (Lanoxin) | 0.5-2.0 Toxicity: GI disturbance, N/V, anorexia, light flashes and halos Tx; CHF (aflutter) |
| SYNTHROID (Levothyroxine Sodium) | Tx: Hypothyroidism/Myexedema May take several weeks to work. Affects PT time Adverse: Chest pain, nervousness, tremors, D, insomnia, heat intolerance Take on EMPTY STOMACH in AM. -w/h if P is above 100 |
| TDL of THYOPHYLLINE | 10-20 Toxicity: Restless, dizziness, Insomnia, seizure, HA Tx: Asthma/COPD bronchospasms (works by relaxing smooth muscle) |
| Antidote of IRON | DEFEROXAMINE |
| Antidote of ACETAMINOPHEN | N-ACETYLCYSTEINE (MUCOMYST) Liver failure possible for 4 days |
| Antidote of ETOH W/D | LIBRIUM -bad N/V will occur with any ETOH consumption or products (lotions, cough syrup) |
| Antidote of COUMADIN (Warfarin) | VIT K PT 10-12 sec (control) |
| Antidote of HEPARIN/LOVENOX/DALTEPARIN | PROTAMINE SULFATE PTT: 30-45 sec (control) |
| Antidote of DIGOXIN | DIGIBIND -K will make it worse |
| Antidote of MgSO4 (mag sulfate) | CALCIUM GLUTAMATE |
| Antidote to NARCOTIC ADDICTS | METHODONE |
| MAOI Drugs | Think PANAMA PA-Parnate NA-Nardil MA-Marplan Tx: Depression and Bipolar -Increases seratonin, dopamine, NE, Epi -Last resort after SSRI and tricyclic, can have BP problem and DDI DONT use with SINEMET (Parkinson tx) |
| COGENTIN | Tx: Parkinsons and EPS of other drugs Adverse fx: Increased T, confusion and visual hallucinations SE: Constipation, Increased HR, blurry vision, decreased UO NO in GLAUCOMA |
| THEOPHYLLINE | TDL: 10-20 BRONCHODILATOR (give 1st) -Increases the risk of DIG TOX -Decreased effect of LI and DILANTIN, L K & Mg Tx: Ashtma and COPD Give W/FOOD SE: GI upset, Increased HR, HTN, N/V |
| WHICH MED DO YOU GIVE 1ST? | BRONCHODILATORS (before glucocorticoids) |
| INH (Isoniazid) | Tx: TB Risk: Phenotoin TOX if taken w/ DILANTIN, peripheral neuritis, hepatic, Jaundice -take vit B6 to prevent neuritis (monitor LFT's) -BP will Decrease then return |
| PREDNISONE | Tx: BP (similar to DILANTIN) DONT stop abruptly, Decrease dose in elderly SE: weight gain, hyperplasia of gums **Causes K secretion** |
| DILANTIN (Phenytoin) | Tx: Seizures TDL: 10-20 SE: wght gain, hyperplasia of gums, RED URINE Adverse: **RASH-STOP MED** (not abruptly) DONT give with THEOPHYLLINE (decreased effectiveness) or INH (phenytoin tox) **DONT STOP ABRUPTLY ** |
| DIGOXIN | Tx: Afib & HF TDL: 0.5-2.0 W/HOLD: Lower P=60, HR=100 (children) & 48hrs before cardioversion -check apical pulse 1 full min & K -flush H20 (sticky) THEOPHYLLINE increases DIG TOX Sx: visual changes, V/D/N, confusion -Given w/ Lasix (K wasting)- gi |
| MUCOMYST (N-Acetylcytine) | ANTIDOTE for TYLENOL (Acetaminophen) -most common poisoning in children -Admin Orally Sx of Toxic Tylenol: Jaundice, penia, Rash, hypoglycemia |
| RIFAMPIN (Ridadin) | Tx: TB, HIV and Menningitis SE: RED URINE/TEARS -BC doesn't work as well when taking this med |
| What SE do ALL PSYCH meds have? What one is DIFFERENT? | All SE: SNS (flight or fight) but decreased BP Except: LITHIUM (acts different) |
| Mg SULFATE | Stops preterm labor-doesnt affect infant heart, BP or T (decreases R) DONT give if DTR are INEFFECTIVE If mother experiences seizure during Mg admin --> GET BABY OUT ANTIDOTE: Ca GLUTAMATE |
| SINEMET (Levodopa and Carbidopa) | Tx: Parkinsons and Sedative SE: RED URINE and drowsiness DONT give with MAOI or Increased PROTEIN meals KAVA KAVA will DECREASE effectiveness |
| BETHAMETHASONE (Celestone) | Surfactant/Steroid Tx: Lung expansion -give 2nd (bronchodilator 1st-open up lungs) Ex: Glucocorticoid inhaler |
| What medication should you NOT give KIDS for pain? | ASPRIN/NSAID -Associated with Reyes Sx (occurs after viral infection) Sx: V, lethargy, irritability (Baby-D & Increased K) -GIVE TYLENOL |
| When should this med be taken: CARAFATE (Sulcrafate)? | BEFORE MEALS Tx: Duodeal Ulcer (1.5-3 hrs p eating, awakens at night, food helps) -mucomyst barrier |
| When should this med be taken: most ABX? | BEFORE MEALS -1 hr before (or 2 hrs after) |
| When should this med be taken: ZOCOR? | BEFORE MEALS -Tx: hyperlipidemia |
| When should this med be taken: VIBRAMYCIN? | WITH MEALS |
| When should this med be taken: NSAIDS? | WITH MEALS |
| When should this med be taken: CORTICOSTEROIDS? | WITH MEALS |
| When should this med be taken: BIPOLAR MEDS? | WITH MEALS |
| When should this med be taken: CHEPHLOSPORINS? | WITH MEALS |
| When should this med be taken: SULFONAMIDES? | WITH MEALS |
| When should this med be taken: **THEOPHYLLINE**? | WITH MEALS Tx: Asthma/COPD |
| When should this med be taken: **TAGAMENT** (Cimetidine)? | WITH MEALS (daily dose) **BEDTIME** (once daily dose) -H2 antagonist Tx: GERD, Heartburn, Ulcers |
| When should this med be taken: APRESOLINE (hydralazine)? | WITH MEALS Tx: HTN or CHF |
| When should this med be taken: ACYCLOVIR? | WITH MEALS Tx: Herpes |
| When should this med be taken: **K SUPPLEMENTS**? | WITH MEALS |
| When should this med be taken: AMPHOJEL/RENOGEL? | WITH MEALS Tx: Acid Indigestion (antacid) Take 1-2 hrs before Tetracycline (will Dec effectiveness of Tetra) Ex of Tetra: Doxycycline and Vibramycin (Bacterial genital infx) |
| When should this med be taken: MEVACOR (Lovastatin)? | WITH MEALS in PM Tx:Coronary Artery Dz, Hyperlipidemia (decreases Cho) Adverse: muscle pain/tenderness/weakness esp. when with malaise or fever Tx: CA (Chemo med) |
| When should this med be taken: DEXAMETHOSONE? | WITH MEALS Tx: Cerebral Edema, SHOCK, adrenal insufficiency, MS Adverse: Adrenal insufficiency (fatigue, muscle weakness, joint pain, fever, anorexia, N, SOB, dizziness, fainting) |
| When should this med be taken: INDOMETHACIN (Indocin)? | WITH MEALS Tx:RA & Gouty Arthritis -NSAID (decrease inflammation, pain & Temp) Adverse: GI bleed, chest pain, SOB, weakness, slurred speech |
| TETRACYCLINES | DOXYCYCLINE/VIRBAMYCIN/TETRACYCLINE HCL Tx: Bacterial genital infections (gonorrhea, syphilis, rectal infx), Anthrax, Acne, H.pylori, roseasa) -Take WITH MEALS -Avoid direct sunlight/UV, wear protective clothing/sunscreen |
| When should this med be taken: TETRACYCLINES? | WITH MEALS -Take 1h BEFORE BEDTIME to prevent esophageal irritation -Avoid direct sunlight/UV, wear protective clothing/sunscreen |
| When should this med be taken: STEROIDS? | AM MED Tx: Anti-Immflammatory |
| When should this med be taken: DIURETICS? | AM MED Tx: Edema caused by Heart/Liver/Renal Liver Failure |
| When should this med be taken: ARICEPT (Donepezil)? | AM MED Tx: Alzheimers -AVOID OTC Sleep or Cold meds (increase anticholinergic fx) -Tell MD before receiving ANETHESIA |
| When should this med be taken: DEXEDRINE? | AM MED Tx: ADHD & Narcolepsy -DONT drink fruit JUICE with oral solution -Decreases SEIZURE threshold, report Seizures |
| When should this med be taken: ANTACIDS? | AFTER MEALS (p meals) |
| When should this med be taken: most ABX? | AFTER MEALS (2 hrs) **or 1 hr BEFORE** |
| When should this med be taken: GROWTH HORMONE? | PM MED |
| When should this med be taken: SUCRAFATE (Carafate)? | PM MED & BEFORE MEALS Tx: Peptic Ulcer |
| What meds cause RED FLUIDS? | -PREDNISONE- BP med -DILANTIN (phenytoin)- BP med -RIFAMPIN (Rifadin)-TB/Menningococal |
| What is the Tx for EPS? | ANTICHOLENERGICS |
| What meds usually CAUSE EPS? | ANTIPSYCHOTIC MEDS -Atypical won't cause Most Common: Haloperidol (Schizophrenia), Thorazine |
| What are EPS symptoms? | -PSEDOPARKINSONS (tremors, postural instability) -AKINESIA (inability to initiate movement) -TARDIVE DYSKINESIA (inv movement of face and jaw) Tx: BB/Benz -AKATHISIA (inability to remain still) |
| What can you NOT take with MAOI? | -SINTEMET (parkinsons) -ETOH -CHEESE |
| What can you NOT take with EGG allergies? | -MMR -FLU vaccine -Neomycin |
| What interferes with Dilantin (Phenytoin)? | Tx: Epilepsy ***LOTS OF DDI*** (INCREASES PHEYTOIN TOX) -INH (TB infxn), Thyophylline (asthma), disulfuram (ETOH tx), Benzos, Fursemide, St. Johns Wart, ABX, heart meds, anticoagulants |
| What can you NOT take with LEVODOPA/CARBIDOPA (Sinamet)? | Tx: Parkinsons -B6 -MAOI (depression) - |
| If you are ALLERGIC to BAKERS YEAST what VACCINE can you NOT get? | HEP B |
| If you have an MI what med can you NOT use? | -tPA (Tx: ischemic stoke-caused by blood clots) |
| If you have GLAUCOMA what drugs can you NOT take? | -VISINE -LEVODOPA -ATROPINE -ANTICHOLLENERGIC ** Increase IOP** |
| What drugs DECREASE EFFECTIVENESS of THEOPHYLINE? | Tx: Asthma -LI -Dilantin (Epilepsy) |
| What INCREASES the risk of DIGOXIN TOX? | -THEOPHYLINE -DECREASED K -DECREASED MG Dig used to tx CHF (slows HR so it doesn't have to work as hard) |
| What med should INH be taken with? | B6 Tx: TB (also prevent) |
| What CRISIS can DEMOROL (Meperdine) NOT be given in? | SICKLE CELL CRISIS (severe pain, trouble breathing, anemia) Tx: Pancreatitis |
| What med can you NOT give if you have PANCREATITIS? | MORPHINE SULFATE -causes spasm **GIVE DEMEROL** |
| What med is GOOD for PANCREATITIS? | DEMORAL **DONT give MORPHINE** |
| What med can you NOT give if you have no DTR? | Mg SULFATE |
| What BEVERAGES can you NOT have if you are taking ANTIPSYCHOTICS? | -CAFFEINE -APPLE JUICE |
| What DZ can you NOT give ISOTONIC solution to? | -HTN -HEART DZ -RENAL DZ |
| What are ISOTONIC Solutions? | -NS (w/blood prod) -LR (burns-more E) -D5W -D5 1/4 NS Goes into the VASCULAR space Makes FV and BP go UP Tx: N/V, sweating, burns, hemm, trauma |
| What are HYPOTONIC Solutions? | Goes into VASCULAR space then CELLS -1/4 DW -1/2 NS -3% NS with 1/2 NS Hydrating, DOESNT cause BP increase like Iso Tx: Heart/Renal Dz, HTN, Inc Na |
| What DZ can you NOT give HYPOTONIC Solution to? | -CELLULAR EDEMA Watch for decreased BP |
| What are HYPERTONIC Solutions? | Volume Expander(particles)= PULLS from CELLS into VASCULAR -D10W -3% NS -5% NS -TPN -ALBUMIN You can add E to Iso/Hypo = Hyper Tx: Dec Na, 3rd spacing (edema, burns, acities) RETURNS volume to VASCULAR space |
| What SOLUTION would you NOT want to give with PULMONARY EDEMA? | HYPERTONIC (would increase fluid in vascular space which is already increased since they have pulmonary edema) -watch for FVE |
| What are the 4 G's? | -GINKO -GINGER -GENSING -GARLIC |
| What can you NOT take or do if you had the 4 G's? | -GO INTO SURG -PLAVIX -ANTIPLATLET |
| What VITAMIN should you NOT take with ALLOPURINOL? | VIT C Tx: Gout |
| What VS should you HOLD NITROGLYCERINE? | BP below 90/60 |
| What med should you NOT take if you are going into SURGERY? | -NSAIDS -HEPARIN -COUMADIN -4 G'S (Ginko, Gensing, Garlic, Ginger) |
| When can you NOT get the VARICELLA (chicken pox) Vaccine? | -PREGNANT -STEROIDS -ACTIVE INFECTION -IMMUNOCOMPROMISED -ALLERGY to GELATIN or NEOMYCIN |
| What is DILAUDID used for? | PAIN -usually after surg |
| ASA poisoning SX and TX? | Sx: breathing fast and sweating Tx: Emetic or gastric lavage |
| 4 Actions of Glucocorticoids | 1. Changes Mood 2.Alter Defense Mechanism (Decreases Immunity) 3. Breakdown of Protein/Fat --> Ketones --> Acid 4. Inhibit Insulin |
| What Increases Calcium and what Decreases Calcium? | Increases= PTH (parathyroid) Decreases = Calcitonin If there is no PTH the pt can have a seizure due to hypocalcemia (too low Calcium) |
| What does AngiOtensiOn II do in the lungs? | In the lungs it is a potent vasoDILATOR (think O --> Open ) |
| What is the category for Coffee, Tea, ETOH, cigarettes? | Stimulants - none 24-48 hours before EEG (tests brain activity) -no sleep the night before |
| What are some Adverse Fx of Ambien? | AE: sleepiness during the day -there are no side effect of HA, discolored urine or irregular HR |
| What is drug toxicity a cause of? | Renal Failure (the way drugs leave the system) |
| What is the only thing that can be added to a TPN or PPN line? | Insulin NO: -Xanax (not in PN line bc it needs digestive system) -Phenagran (causes precipitation in formula) -Demoral (not with TPN) |
| Where does a PEG tube go to? | Empties formula directly into the stomach to be digested. |
| Where does PN go to? | Directly into the blood stream and bypasses the digestive system bc it is not working properly. |
| Where is a PICC line inserted? | Into a peripheral vein, but is long enough to empty into the large veins going directly into the heart |
| Where does a Subclavian Line go to? | It empties directly into the large vein of the heart, reeducating rip of damage to smaller veins. |
| Where does a CVC go? | It empties just above the heart muscle to be distributed. |
| What does the control refer to when dealing with medication and bleeding times? | Control: Premedication bleeding time -usually 1.5-2 times the control |
| The therapeutic level in regards to bleeding time: | It is usually slightly prolonged so that clotting will not occur. 1.5-2 times the control (pre-bleeding time) |
| Antidote of OPIODS | Naloxone (Narcan) |
| Normal Saline 0.9% | Increases circulating volume when RBC are adequate -Replaces losses w/o altering consentrations -Helpful in Na replacement ISOTONIC |
| LR | Replaces fluid and pH buffers -NS w/ K, Ca, and lactate buffers -seen with surgery ISOTONIC |
| D5W | Increases total fluid volume, rehydrating and extratory purposes -provides 170-200 cal/1,000cc for energy -becomes hypotonic in the body (uses up dextrose fast then only H2O remains) ISOTONIC then HYPOTONIC |
| 1/2 NS 0.45% | Raises total fluid volume -daily matinee but less value for NaCl replacement -Helps est renal fxn -good for diabetic its who don't need extra glucose HYPOTONIC |
| D5 1/2NS | Daily matinee and body fluid nutrition and rehydration -most common post op fluid HYPERTONIC |
| D5 LR | Same as LR + 180 cal/1000cc -watch for FVO HYPERTONIC |
| D5NS | Replaces fluid NaCl and Calories -watch for FVO HYPERTONIC |
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