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nctc pharm unit 6
| Question | Answer |
|---|---|
| Aluminum- and calcium- containing agents | cause constipation |
| Magnesium preparations | can cause diarrhea |
| significantly decreased when used with antacids | Digoxin (Lanoxin) effects |
| antacid drug reactions | Absorption by the antacid reduces the ability of the other drug from being absorbed |
| Calcium-containing antacids | can cause kidney stones Tums, Maalox Antacid Caplets, ES Alkets Antacid Sometimes produce gas, so are often combined with simethicone |
| Magnesium-containing antacids | MOM, Mag Ox, Gaviscon Liquid and Tablets |
| Sodium-containing antacids | Alka-Selzer, Citra pH |
| Cimetidine (Tagamet) | Used in treatment of PUD, GERD, and pathologic hypersecretion Pregnancy category B smoking is contraindicated |
| Famotidine (Pepcid) | Used in treatment of PUD, GERD, and pathologic hypersecretion Pregnancy category B |
| Ranitidine (Zantac) | Used in treatment of PUD, GERD, and pathologic hypersecretion erosive esophagitis |
| H2 ANTAGONISTS | Cimetidine (Tagamet) Famotidine (Pepcid) Ranitidine (Zantac) |
| Omeprazole (Prilosec) | Administer before meals Take capsule whole; do not open, crush or chew It can be taken with antacids |
| Pantoprazole (Protonix) | Is the only parenterally available PPI – good for patients who are unable to tolerate oral medications |
| PROTON PUMP INHIBITORS | 30-60 min before meal Omeprazole (Prilosec) Pantoprazole (Protonix) |
| PROTON PUMP INHIBITORS - Adverse reactions | Headache, dizziness, diarrhea, cough, fatigue, and others |
| Simethicone (Mylicon) | Used postoperatively to decrease gas formation and associated bloating |
| Teaching - Antacids | Do not take other meds within 1 - 2 hours of taking may cause premature uncoating of enteric-coated meds Chewable forms must be chewed thoroughly Liquid forms must be shaken thoroughly before administration Administer with 8 oz H2O |
| DIARRHEA | Dehydration and electrolyte loss occurs very quickly in peds Measure amounts of diarrhea by the number of diapers or number of stools per day |
| Bismuth subsalicylate (Pepto-Bismol) | Absorbent antidiarrheal Is aspirin-based so contraindicated in children under 12 (Reye Syndrome) or bleeding disorders Harmless side effect is temporary darkening of the tongue and/or stool black harry tongue |
| Attapulgite (Kaopectate) | Absorbent antidiarrheal Pregnancy category C |
| Loperamide (Immodium) | Opiate antidiarrheal similar to Lomotil Pregnancy category B |
| Teaching - laxatives | Do not crush or chew tablets, especially if enteric coated Bulk-forming laxatives should be taken with at least 8 oz cc of water Long term use of laxatives can cause decreased bowel tone of atrophied intestines |
| Anticholinergics - act on vestibular nuclei in the labyrinth of the ear | Scopolamine (Transderm - Scop) |
| Antihistamines - used to control dizziness and motion sickness by action in vestibular nuclei | Meclizine (Antivert) |
| Serotonin blockers - used to control chemo and postoperative nausea and vomiting by blocking serotonin in the CTZ and the vomiting center (VC) | Granisetron (Kytril) more potent than Zofran requiring fewer doses for comparable effectiveness Pregnancy category B Ondansetron (Zofran) - headache |
| Phosphorated carbohydrate solution (Emetrol) | oral solution to relieve nausea Works directly on walls of GI tract to reduce cramping Indicated for mild cases of nausea from “flu” and excessive eating or drinking Unlabeled use is to treat morning sickness during pregnancy |
| Omeprazole (Prilosec) | Has been combined with clarithromycin (Biaxin) for the treatment of Helicobacter pylori infection and duodenal ulcer |
| Diphenoxylate and atropine (Lomotil) | Opiate antidiarrheal related to demerol Pregnancy category C |
| Bulk-forming laxatives - absorbs water to increase bulk, distending bowel to initiate reflex bowel activity | Methylcellulose (Citrucel) Psyllium (Metamucil) |
| Emollient laxatives/Stool softener/lubricant - wetting agent used to soften fecal mass | Docusate salts (Surfak, Colace) Mineral oil |
| Hyperosmotic – increases fecal water content Results in distention, increased peristalsis, and evacuation | Glycerine Polyethylene glycol (GoLytely) Lactulose (Chronulac) |
| Stimulant - increases peristalsis via nerve stimulation in the colon | Overuse can result in atrophied intestines Senna (Senokot) may turn urine pink, red, brown, yellowish-brown Should not take within 1 hour of other meds |
| Saline – inhibits absorption of water, resulting in watery stool | Magnesium salts (MOM, Mag citrate) |
| Drugs for IBS | are pregnancy category B Alosetron (Lotronex) for women only Tegaserod (Zelnorm) for men and women |
| Swallow laxative (Biscodyl or cascara sagrada) tablets whole with at least 120 cc of water | Adverse interaction with milk, antacids, and cimetidine (Tagamet) |
| FAT-SOLUBLE VITAMINS | A,D,E,K |
| A – Aquasol, Retinol - sources | Dietary sources - dairy products, meat, liver, green and yellow vegs, yellow fruit |
| D - Calcifediol (Calderol), Calcitrol (Rocaltrol), dihydrotachysterol (Hytakerol), ergocalciferol (Calciferol) - sources | Dietary sources - fish oils, salmon, sardines, herring, fortified bread and cereals, tuna, eggs, and butter |
| A – Aquasol, Retinol - indications | Indicated for dietary supplements, hyperkeratosis, night blindness, retarded infant growth, xerophthalmia, acne, keratosis fillucularis, psoriasis |
| D - Calcifediol (Calderol), Calcitrol (Rocaltrol), dihydrotachysterol (Hytakerol), ergocalciferol (Calciferol) - indications | Indicated for dietary supplements, rickets, tetany, osteomalacia |
| E - E-Vitamin (Aquasol E)-Dietary sources | eggs, chicken, meats, fish |
| E - E-Vitamin (Aquasol E)Indicated for | dietary supplements, antioxidants, cancer, heart disease, PMS, sexual dysfunction |
| K - Aqua-Mephyton Dietary sources | green leafy vegs, meats, and milk |
| K - Aqua-Mephyton for | deficiency states, prophylaxis in newborns to prevent bleeding, antidote for warfarin |
| WATER-SOLUBLE VITAMINS | B,C |
| B1 - Thiamine -Dietary sources | - Whole grains, liver, and beans |
| B1 - Thiamine -Indicated for | supplement, oral insect repellent, beriberi, Wernicke’s encephalopathy, peripheral neuritis with pellagra, neuritis of pregnancy |
| B2 - Riboflavin - Dietary sources | Dietary sources - leafy green vegs, eggs, nuts, meats, and yeast |
| B2 - Riboflavin -Indicated | for supplement, microcytic anemia, acne, migraine headache, methomoglovinemia, muscle cramps |
| B3 - Niacin -Dietary sources | - meats, beans, yeast, liver, and wheat germ |
| B3 - Niacin | Indications – prevention and treatment of pellagra, hyperlipidemia Contraindicated in allergy, liver disease, severe hypotension, arterial hemorrhage, active PUD |
| B6 - Pyridoxine -Dietary sources | - whole grains, wheat germ, nuts, fish, organ meats, and yeast |
| B6 - Pyridoxine | Indicated in deficiencies resulting from INH, hydralazine, OCPs; seizures unresponsive to usual therapy, morning sickness during pregnancy Unlabeled uses PMS and hyperoxaluria (type of kidney stone disorder) |
| B12 - Cyanocobalamin -Dietary sources | - liver, kidney, fish and shellfish, meat and dairy foods |
| B12 - Cyanocobalamin | Indicated for deficiencies, pernicious anemia Contraindicated in allergy, Leber’s disease (inherited optic nerve atrophy) |
| C - Ascorbic acid | Dietary sources - citrus juices, tomatoes, cabbage, cherries, and liver |
| MINERALS | Calcium Magnesium Phosphorus Zinc |
| Calcium | -foods that decrease ca absorbtion nuts and green leafys Dietary sources - milk and dairy sources are best sources, but available in many sources |
| Calcium - indications | Indicated for deficiencies, osteomalacia, hypothyroidism, infantile rickets or tetany, muscle cramps, osteoporosis, renal insufficiency, pregnancy, lactation Contraindications: allergy, hypercalcemia, ventricular fibrillation |
| Magnesium-Dietary sources | Dietary sources - vegetables and many other foods |
| Magnesium | Indicated for deficiency, anticonvulsant, preeclampsia, tocolysis, pediatric acute nephropathy, cardiac dysrhythmias, constipation Contraindications: allergy, heart block, renal failure, adrenal gland failure, hepatitis |
| Phosphorus | Dietary sources - Widely distributed in many foods so deficiency is rare Indicated for deficiency |
| Zinc | Trace element crucial in enzymatic metabolic reactions of both proteins and carbohydrates Plays a major role in tissue and growth repair and wound healing |
| Polymeric (ensure) | used in people with fully functional gut |
| TPN administration peripheral | Temporary |
| TPN - know why we keep carbs less than 10% | risk for phlebitis |
| TPN what to do if your bag runs out? | if out hang d10 until get more tpn |
| Iron | Dietary sources - meats, vegetables, and grains Orange juice, veal, fish, and ascorbic acid can assist with iron absorption Overdoses can be life-threatening |
| Iron- parential | Administer IM forms deep into gluteal muscles by Z-track due to staining and irritation of the tissues |
| pernicious anemia | IM injections for pernicious anemia (B12) must be taken for life Eat well balanced diet: egg yolks, fish, organ meats, oysters, dairy products, and clams |
| Mupirocin (Bactroban) | impetigo, nasal MRSA |
| Neomycin and polymixin B (Neosporin) | minor skin wounds |
| Silver sulfadiazine (Silvadene) | burns sterile |
| Isotretinoin (Accutane) | severe cystic acne treatment |
| Tretinoin (Retin-A) | acne treatment, wrinkle remover |
| Clotrimazole (Lotrimin) | available in many forms to treat thrush and vaginal candidiasis |
| Acyclovir (Zovirax) and penciclovir (Denavir) | antivirals |
| Topical anesthetics | numb the skin for conditions such as poison ivy, sunburn, insect bites, plant allergies, IV starts |
| Antipruritics | contain antihistamines or corticosteroids for conditions such as chicken pox, widespread poison ivy, psoriasis |
| Antipsoriatic drugs | Tazarotene (Tazorac) Anthralin (Anthra-derm) Calcipotriene (Devonex) |
| Topical ectoparasiticidal drugs | or treating head lice - apply shampoo, rinse, and dry Nits (eggs) should be combed from the hair shaft For treating body lice or scabies, leave on body for 8 - 12 hours and wash off |
| Minoxidil (Rogaine) | Has similar vasodilating effect of the systemic antihypertensive medication |
| Old giezers crave love | Ointments, gels, cream, lotion - effects |
| Wax emulsifiers | Carbamide peroxide (Debrox drops) |
| Teaching - ear drops | Administer ear drops at room temperature |
| Children over 3 and adults: | Administer ear drops with the pinna of the ear held up and back to straighten the ear canal |
| Children 3 and under: | Administer ear drops with the pinna down and back to straighten the ear canal |
| Cholinergic drugs (cholinesterase inhibitors) | systemic effects of bradycardia and bronchoconstriction |
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kcorkinsnctc
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