Help
Options
Didn't know it?
click below
click below
Knew it?
click below
click below
Don't Know
Remaining cards (0)
Know
retry
shuffle
restart
0:00
Embed Code - If you would like this activity on your web page, copy the script below and paste it into your web page.
Normal Size Small Size show me how
Normal Size Small Size show me how
pharm 2 final review
tara's pharm part 2 final review
| Question | Answer |
|---|---|
| pt on 5th day vanco and gent, tv is really loud | investigate for ototoxicity |
| vancomycin-iv only (PK) ABSORPTION AND EXCRETION | (A) NOT ORALLY ABSORBED (E) RENAL EXCRETION-IF DECREASE RENAL FUNCTION-LONGER DOSING INTERVAL |
| VANCO (PD) | CELL WALL LYTIC-COVERS GRAM + ONLY (MRSA, C-DIFF) |
| S/E VANCO | IF TOXIC-RISK FOR NEPHRO/OTO TOXICITY-SO IT CAN AFFECT IT'S OWN HALF LIFE IN TOXIC DOSES, REDMAN SYNDROME-SYSTEMIC WILL CAUSE HIVES, HYPOTENSION |
| IF REDMAN SYNDROME WITH VANCO | SHOULD BE SLOWER INFUSION RATE |
| VANCO (PK) | THERAPEUTIC WINDOW-SO CHECK CP EX;PEAKS AND TROUGHS(BE ACCURATE WITH TIME) |
| RIBOSOMALS-AMINOGLYCOSIDES EX;GENTAMYCIN, TOBRAMYCIN (PD) | PREVENT PROTEIN SYNTHESIS, COVERS GRAM - ONLY,EXCEPT WHEN ADDED TO TO BETA-LACTAMS OR VANCO B/C RIBOSOME IS INSIDE CELL AND THOSE BETA-LACTAMS AND VANCO CAN BREAK CELL WALL-COMBO=SYNERGY(1+1=3) |
| RIBOSOMALS (PK) | THESE DRUGS HAVE THERAPEUTIC WINDOWS AS WELL,SO NEED PEAKS AND TROUGHS, NOT ORALLY ABORSBED, iV ONLY,HALF LIFE UPON RENAL FUNCTION |
| S/E RIBOSOMALS | TOXICITY-OTO/NEPHRO TOXICITY |
| MACROLIDES-ERYTHROMYCIN EX;CLARITHROMYCIN, AZITHROMYCIN(Z-PACK) (PD) | RIBOSOMAL-COVER GRAM + AND - BUT THEY TEND TO BE BACTERIOSTATIC, DON'T KILL BACTERIA, JUST STOP GROWTH |
| (PK) MACROLIDES | ALL ARE POTENT (METABOLIC ENZYME INHIBITORS) SO AVOID OTHER DRUGS W/ THERAPEUTIC WINDOW B/C IT WILL INCREASE OTHER DRUGS AFTER TIME (TOXICITY) |
| AZITHROMYCIN (PK) | HAS THE LONGEST HALF LIFE OF ALL ABX APPROX EQUAL TO 65 HOURS-SO GET MORE DAYS OUT OF LESS PILLS |
| CLIENT HAD 10 DAYS THERAPY OF ABX-FAILED AND WANTS TO KNOW WHY Z-PACK IS ONLY COUPLE DAYS | TELL THEM IT STAYS IN THEIR BODY LONGER THEN MOST ABX |
| CLARITHROMYCIN S/E | METALLIC TASTE ALL CHEMICAL SIMILAR TO GUT...DIARRHEA |
| SULFONAMIDES-BACTRIM SEPTRA(AVOID SUN) (PD) | COVERS GRAM - ONLY-NEAR TOXIC DOSES MAY COVER COMMUNITY ACQUIRED MRSA |
| SULFONAMIDES (PK) | RENALLY EXCRETED |
| SULFONAMIDES S/E | PHOTOSENSITIVITY FOR ALL-IF SHADOW IS SHORTER IN SUN, STAY OUT, CRYSTALURIA-STAY WELL HYDRATED-NOALCOHOL, W/ GERIATRICS-RISK OF HYPERKALEMIA |
| QUINOLONES-"FLOXACIN" | DO OPPOSITE OF PCN AND CEPHS, EARLY;CIPRO G- > + , NEWER;LEVAQUIN G+ = - |
| QUINOLONES (PK) | CAN INHIBIT CAFFEINE AND THEOPHYLLINE METABOLISM |
| QUINOLONES S/E | PHOTOSENSITIVTY BLACK BOX WARNING- UNUASUAL MORBIDITY AND MORTALITY-EX;RISK OF TENDON RUPTURE UP TO 6 MONTHS AFTER THE LAST DOSE |
| TUBERCULOSIS-ACID FAST MYCOBACTERIA | DIVIDES SLOW-NEED LONG TERM TREATMENT > 6 MONTHS TO YEARS, FAR SPREAD- NEED MULTIPLE MEDS-ALL TB REGIMENS SHOULD BE 3 DRUGS OR MORE |
| PORBLEMS WITH TB TX | DRUGS CAN MAKE YOU FEEL WORSE THEN THE DX THEREFORE COMPLIANCE IS PROBLEM, ALL REGIMENS ARE HEPATOTOXIC TO SOME DEGREE-S/S YELLOWING OF SKIN/EYES, ASH COLORED STOOLS-AVOID ALCOHOL AND ACETAMINOPHEN |
| SPECIFIC REGIMENS FOR TB ALL SHOULD CONTAIN | 1)RIFAMPIN-CAUSES RED/ORANGE STAINING OF URINE AND TEARS 2) ISONIAZID (INH)-CAN CAUSE PERIPHERAL NEUROPATHY-TINGLING/NUMBNESS OF FINGERS/TOES-SO ADD VIT B6/PYRIDOXINE |
| TB COMMON 3RD DRUG | ETHAMBUTOL/MYAMBUTOL-CAN CAUSE TRANSIENT RED/GREEN COLOR BLINDNESS-DON'T DRIVE |
| ANTIFUNGAL AGENTS-"AZOLES" (PD) | ACT LIKE BETA-LACTAMS ON FUNGAL YEAST CELL WALLS AND MEMBRANES |
| ANTIFUNGAL (PK) | ALL ARE POTENT ENZYME INHIBITORS, CAN ALL AFFECT HOW OTHER DRUGS ARE METABOLIZED |
| ANTIFUNGAL WEAKEST TO STRONGEST | WEAKEST-KETOOCONAZOLE/NIZORAL....FLUCONAZOLE/DIFLUCAN...STRONGEST- ITRACONAZOLE/SPORONOX....SHOULD START W/ THE WEAKEST HOWEVER KETOCONAZOLE NEEDS AN ACIDIC ENVIRONMENT TO BE ABSORBED |
| CLIENT FAILS ON ONE WEEK NIZORAL | SWITCH TO DIFLUCAN |
| ANTIVIRALS(HERPETICS) "CLOVIR" ACYLOVIR/ZOVIRAX AND GANCICLOVIR/CYTOVENT (PD) | INHIBIT vdna replication(failed chemotherapy agents) |
| antivirals s/e | take as directed otherwise toxic s/s-risk for bone marrow suppression, which leads to decreased rbc,wbc, and platelets, gi ulcerations which can lead to n/v, hair loss |
| ganciclovir | by law has biohazard-so if it leaks or spills on you-wash thoroughly-if first trimester can cause neural tube defects, males- can cause aspermia |
| HIV | UNINHIBITED CAN MEK 5 BILLION COPIES IN 24 HOURS- 80%NORM/NULL 19% FATAL MUTATION <1% BENEFICIAL TO VIRUS MUTATION -SO TAKE DRUGS ON TIME TO PREVENT 1% MUTATION EX 3X/DAY= Q8HOURS(IMPORTANT) |
| TX OF SHOCK-DECREASED BP=DECREASED PERFUSION | FOR GENERIC SHOCK CONSIDER SNS AGONISTS-PROMOTES ENERGY EXPENDITURE BY CELLS AND TISSUES |
| ALPHA EX;TETRAHYDRALOZINE | ^BP=V-CONSTRICTION |
| BETA 1 | ^HR AND ^ STRENGTH |
| BETA 2 | BRONCHODILATOR (LUNGS) |
| EPINEPHRINE | IS A ALPHA ,BETA 1 AND BETA 2 AGONISTS-DRUG OF CHIOCE TO TX ANAPHLACTIC SHOCK |
| NOREPINEPHRINE | ALPHA AND BETA 1 AGONISTS |
| DOPAMINE | SNS AGONIST ^BP TITRATEABLE=DIFFERENT DOSES DO DIFFERENT THINGS |
| DOPAMINE IV MCG/KG/MIN | LOW DOSE-AGONIST AT DOPAMINE RECEPTOR IN THE SPLANCHIC BEDS.. RENAL DOSE(VASODILATOR)..... MED DOSE-BETA 1 AGONIST=^HR,^STRENGTH (CARDIAC)... HIGH DOSE=BETA 1 AND ALPHA AGONIST |
| DOBUTAMINE ^BP | BETA 1 AGONIST= ^STRENGTH OF HR > ^HR |
| ^ STRENGTH OF HEART | POSITIVE INOTROPIC EFFECT |
| DECREASE STRENGTH OF HEART | NEGATIVE INOTROPIC EFFECT |
| ^HR | POSITIVE CHRONOTROPIC |
| DECREASED HR | NEGATIVE CHRONOTROPIC |
| COMPENSATORY MECHANISMS OF HEART FOR LOW BP | VESSELS-CONSTRICT FAST.. .KIDNEYS- RETAIN FLUID (SLOW) |
| BETA BLOCKERS -OLOL(-ILOL,ALOL) EX;METOPROLOL/LOPRESSOR XL | (PK) SNS ANTAGONIST, BETA 1 AND BETA 2, WILL HAVE NEGATIVE CHRONOTROPIC AND INOTROPIC EFFECTS |
| S/E BETA BLOCKERS | FLAT AFFECT, NIGHTMARES |
| CONTRAINDICATIONS FOR BETA BLOCKERS | ASTHMA (IF IT ENDS IN -OLOL IT BLOCKS DILATION) AND TREATED DIABETES (MASKS THE S/S OF HYPOGLYCEMIA |
| OLD CA CHANNEL BLOCKERS EX;VERAPAMIL/CALAN DIALTIAZEM/CARDIZEM | (PD) NEG CHRONO/INOTROPIC- MAKES CA LESS AVAILABLE FOR MYOCARDIAL CONTRACTIONS AND SLOWS IMPULSE CONDUCTION-IF SOMEONE IS DX W/ DIABETES 2, YOU CAN SWITCHED THE PERSON TO THIS DRUG |
| OLD CA CHANNEL BLOCKERS S/E | (PO) CONSTIPATION |
| COMPENSATORY FOR VASODILATORS (DECREASE BP) | POSITIVE CHRONO/INOTRO (FAST) AND FLUID RETENTION (SLOW) |
| ALPHA BLOCKERS (-ZOSIN) EX TERAZOSIN/HYTRIN | (PK) SNS ANTAGONIST ALPHA, VASODILATOR |
| ALPHA BLOCKERS S/E | 1ST DOSE EFFECT-ORTHOSTATIC HYPOTENSION-TAKE AT BEDTIME TO PREVENT INJURY |
| NEW CA CHANNEL BLOCKERS (-DIPINE) EX; DIFEDIPINE/PROCARDIA | (PD) BLOCKS CA FROM PARTICIPATING IN SMOOTH MUSCLE CONTRACTION.. VASODILATION |
| NEW CA CHANNEL BLOCKERS S/E | ORTHOSTATIC HYPOTENSION, CONSTIPATION-STAY HYDRATED, MILD EDEMA |
| ACE INHIBITORS "PRIL" EX CAPTOPRIL/CAPOTEN S/E | DRY COUGH ORTHOSTATIC HYPOTENSION MILD EDEMA POTASSIUM RETENTION MORE IN ELDERLY |
| ANGIOTENSION 2 RECEPTOR BLOCKERS "SARTAN" EX; VALSARTAN/DIOVAN S/E | ORTHOSTATIC HYPOTENSIION MILD EDEMA ANGIO-EDEMA POTASSIUM RETENTION MORE IN ELDERLY |
| DIURETICS "SALT LOSS AGENTS" BY SALT MEANING ANY ELECTROLYTE | WORKS ON KIDNEYS (PD) WHERE SALT GOES WATER FOLLOWS |
| DIURETICS STRONGEST TO WEAKEST | STRONGEST-LOOP DIURETICS; FURESIMIDE/LASIX (LAST 6 HOURS)-LOSE ALOT OF ELECTROLYTES AVAIL PO/IV....THIAZIDES;CHLORTHALIDONE/HYGROTON DO RETAIN CALCIUM...K+ SPARING;SPIROMALACTONE/ALDACTONE-LOSE NA RETAIN K+-RETENTION WILL INCREASE WITH AGE |
| CLIENT NEEDS FLUID LOSS NOW GIVE | LASIX IV |
| LOOPS AND THIAZIDE DIURETICS | ARE SULFA RELATED |
| ALL DIURETICS GET | ELECTROLYTE PANELS-LOOP/THIAZIDE= GREATEST RISK FOR ELECTROLYTE IMBALANCE |
| COMPENSATORY FOR DIURETICS | ^HR ^STRENGTH AND VASOCONSTRICTION |
| CAD/ANGINA | MISMATCH OF O2 SUPPLY TO DEMAND IN THE MYOCARDIUM TX;PREVENTION-LONG ACTING MEDICATIONS WHICH TEND TO HAVE LONG ONSETS SO WON'T TX ACUTE |
| NEW CA+ CHANNEL BLOCKERS AND ACE INHIBITORS | ^O2 SUPPLY(VASODILATION) AND DECEASE O2 DEMAND(DECREASE PRELOAD) |
| BETA BLOCKERS AND OLD CA+ CHANNEL BLOCKERS | DECREASE O2 DEMAND (NEG CHRONOTROPIC NEG INOTROPIC) |
| ANGINA ATTACK=CRUSHING CHEST PAIN | TX;NITROGLYCERIN SL OR BUCCAL SPRAY-DECREASES DIASTOLIC UP TO 40 MMHG |
| NTG (PD) | MASSIVELY POTENT VASODILATOR-^O2 SUPPLY (MICRO) AND DECREASES O2 DEMAND (MACRO) |
| NTG TEACHING | NEED TO BE SITTING DOWN, GOOD UNTIL EXPIRATION HOWEVER, KEEP EXTRA UNOPENED BOTTLE HANDY, IF IT'S GOOD IT WILL TINGLE-CHECK POLICY-TAKE ONE Q 5MIN TIMES 3-CALL 911 AFTER 3RD DOSE-DON'T KEEP IN GLOVE BOX OF CAR |
| NTG SL | UNDER TONGUE-IF SWALLOWED HAS A LARGE 1ST PASS EFFECT-WHICH MEANS NO DRUG WILL GET IN BODY HALF LIFE AROUND 1 MIN |
| NTG PATCH | LONG ONSET-PREVENTION (PD) SAME AS PO-AVOID HEAT AND ALCOHOL CONSUMPTION, TRIM HAIR W/ SCISSORS-NEED A NITRATE FREE INTERVAL OF ABOUT 8 HOURS TO DECREASE TOLERANCE TO NTG |
| CHF | INABILITY OF THE HEART TO KEEP UP WITH THE DEMANDS OF THE BODY (PERFUSION)-PROGRESSIVE DISEASE-DISEASE OF THE ENTIRE CARDIOVASCULAR SYSTEM |
| EARLY/LATE TX OF CHF | ACE INHIBITORS/ANGIOTENSION RECEPTOR BLOCKERS -PRIL/-SARTANS AND THEN EVENTUALLY ADD DIURETICS...LATE ADD DIGOXIN/LANOXIN (^QUALITY, NOT QUANTITY)-MAKES YOU FEEL BETTER, BUT NOT LIVE LONGER |
| DIGOXIN/LANOXIN (TABLET) (PD) | SLOWS AND STRENGTHENS THE HEART, NEG CHRONATROPIC, POSITIVE INOTROPIC TO IMPORVE HEART EFFICIENCY-INHIBITS NA/K+ PUMP, SHUTS ELECTROLYTES AWAY FROM NA/K+ AND TOWARD CALCIUM(WHICH ALL SLOWS HEART AND INCREASES STRENGTH) |
| DIGOXIN | NARROW THERAPEUTIC INDEX-EASY TO OVERDOSE ON, ALSO TELL "DON'T DOUBLE UP, BUT IF W/IN 8 HOURS THEY CAN STILL TAKE IT" "SAME TIME EACH DAY" "KEEP ALL LAB APPTS" "TRY TO GET LOCALLY" |
| DIGOXIN (PK) | (A)-PO TABLET...NO (D)..NO (M)..(E)-GOES STRAIGHT TO RENAL EXCRETION SO B4 START NEED TO KNOW RENAL FUNCTION (BUN/CREAT) |
| DIGOXIN | ^BUN/CREAT=LONGER HALF LIFE, HALF LIFE TAKES ABOUT 24 HOURS W/ NORMAL RENAL FUNCTION, WHEN STARTING IT TAKES A LIL TIME TO BUILD UP TO THERAPEUTIC (2-3 DAYS) B/C THERAPEUTIC WINDOW |
| DIGOXIN | NEED DAILY SELF ASSESSMENTS "TAKE PREDOSE HR IF <60-HOLD AND CALL MD" "TAKE PULSE FOR ONE FULL MINUTE"(AS NURSES TAKE AT APICAL) CAN TELL PT TO TAKE FROM CAROTID"ONE SIDE" "DON'T RUB OR MASSAGE OR RUB CAROTID"-IF SUSTAINED RACING HR OR WGHT^>2LBS CALL MD |
| DIGOXIN | NEED TO KEEP TRACK OF SODDIUM INTAKE |
| DIGOXIN S/S OF TOXICITY (FOR NURSE) | ^ OR DECREASE K+= ^DIG TOXICITY |
| DIGOXIN S/S TOXICITY (PT) | EARLIEST-ANOREXIA, 1ST S/S THAT CAUSES PT TO CALL MD IS N/V/D, WHICH CAN AFFECT K+ LEVELS... LATER AS THESE PROGRESS- ALTERED MENTAL STATUS & YELLOW/GREEN HALOS AROUND OBJECTS- ENCOURAGE FAMILY TO READ D/T ALTERED MENTAL STATUS |
| DIGOXIN | BY MEDIC ALERT BRACLET, WEEKLY PILL ORGANIZER, KEEP TRACK OF NA, IF YOU LOSE DOPPLER GET ANOTHER ONE( CHILD) |
| DIGOXIN ANTIDOTE-DIGOXIN IMMUNE FAB/DIGIBIND | FAB=FRAGMENTED ANTIBODY-OVINE ORIGIN (SHEEP)- THERE IS A SIGNIFICANT RISK OF ANAPHYLAXIS (SHEEP) |
| ANTIARRHYTHMICS(FAST) | CLASS 1=SODIUM CHANNEL BLOCKERS.. .CLASS 2= BETA BLOCKERS... CLASS 3= AMIODARONE/CORDARONE (BEST ONE) |
| PT A-FIB ON B-BLOCKER W/ NEW DIABETES DX | CAN CHANGE TO OLD CA+ CHANNEL BLOCKERS AKA CLASS 4 |
| ANTIARRHYTHMICS (PK) | ALL HAVE THERAPEUTIC WINDOW- IF TOO MUCH CAN ALSO CAUSE ARRHYTHMIAS-ONLY WORK ABOUT 50% OF THE TIME |
| BETA BLOCKERS CAN BE TAKEN FOR MANY REASONS | IF THEY DON'T KNOW WHY-THATS A PROBLEM |
| AMIODARONE/CORDARONE (PD) | NEGATIVE CHRONOTROPIC NEGATIVE INOTROPIC |
| AMIODARONE/CORDARONE (PK) | (M) IS SUBJECT TO ENZYME INDUCTION/INHIBITION HALF LIFE;LOADING DOSE PHASE; SHORT HALF LIFE... MAINTENENCE;HALF LIFE ABOUT 35 DAYS=ADR COULD LAST LONG TIME |
| AMIODARONE/CORDARONE S/E | ORTHOSTATIC HYPOTENSION "RISE SLOWLY", ALTERED THYROID FUNCTION "NEED BASELINE/FOLLOW UP", RARE-RETINAL DEPOSITS(D/C DRUG-COULD LEAD TO BLINDNESS)"IF ANY EYE SIGHT C/O CALL MD, PULMONARY FIBROSIS (SPIROMETRY-BASELINE/FOLLOW UP) AND BLUE/GRAY DISCOLORATION |
| PRIMARY S/E OF AMIODARONE | PULMONARY FIBROSIS |
| LABS AMIODARONE | NEED DRUG LEVEL AND THYRIOD PANEL |
| BLOOD MODIFIERS ANTICOAGULANTS | IF IN ARTERIAL=PLATELTS W/ FIBRIN, VENOUS=FIBRIN W/ PLATELTS EX HEPARIN PREVENTS CLOT FORMATION AND OR EXISTING CLOT GROWTH |
| PLATELET MODIFIERS | PREVENT PLATELET ACTIVATION EX ASPIRIN OR PLAVIZ |
| ANTICOAGULANTS INPATIENT | IV/SQ HEPARIN/ LMWH- SQ-ENOXAPORIN/LOVENOX |
| ANTICOAGULANTS OUTPATIENT | WARFARIN/COUMADIN DAGIBACTRAN/PRADAXA |
| HEPARIN | (PD) INHIBITS COAGULATION FACTOR 10 (PK) SHORT HALF LIFE, SO CONTROLLABLE LAB=PTT |
| HEPARIN SQ (PK) | HETEROGENOUS MIXTURE- ABSORPTION VARIES FROM BATCH TO BATCH D/T SIZE AND ACTIVITY USE PTT AS A CHECK |
| ENOXAPORIN/LOVENOX (PK) | LMWH-LOW MOLECULAR WGHT HEPARIN- CUT TO UNIFORM SIZE,SHAPE AND ACTIVITY (EMZYMATICALLY)... SQ-ABSORPTION UNIFORMED RATE- MUCH MORE PREDICTABLE DOSE TO RESPONSE RELATIONSHIP- PTT IS UNRELIABLE AT BEST |
| INPATIENT ORDERED SQ COAGULATION BUT NO PTT ORDERED | LOVENOX |
| INPATIENT HEPARIN AND LOVENOX S/E | RED/ORANGE TINGE URINE, BLK TARRY/BLOODY STOOL-INSPECT URINE/STOOL DAILY & SKIN DAILY- UNEXPLAINABLE BRUISES-CALL MD...GET FAMILY INVOLVED-MENTAL STATUS CHG..USE ELECTRIC RAZORS, CLOSED TOE SHOES, SLIP/FALL PROFF HOME,NO ALCOHOL, SOFT BRISTLE TOOTHBRUSH |
| OUTPATIENT COUMADIN (PD) | DEFECTIVE FORM OF VIT K, LEADS TO FORMATION OF DEFECTIVE VIT-K DEPENDENT CLOTTING FACTORS- LESS CONTROLLABLE THEN HEPARIN |
| ON DAY 4 OF COUMADIN 2.8 INR WHAT WOULD IT BE BY DAY 8 | OVER THERAPEUTIC RANGE |
| WARFARIN AND VIT K (FAT SOLUBLE)-CAN STORE IN LIVER | YOU MUST OVER COME THE VIT-K RESERVOIR (AVG OVER MONTHS)- KEEP INTAKE THE SAME, TELL MD ABOUT DIETARY CHANGES NOW!! |
| VIT-K RICH FOODS | SPINACH BROCCOLI CAULIFLOWER CABBAGE BRUSSEL SPROUTS KALE... ASPARAGUS(MOST VIT-K) AVOID EXCESS CONSUPMTION |
| PT IS ON WARFARIN THEIR DIET SHOULD BE | THE SAME |
| WARFARIN AND DRUG INTERACTION | RULE- ASSUME ALL DRUGS INTERACT W/ WARFARIN THEREFORE NEED OF ALL DRUGS LIST AND CHANGE OF DOSES TO BE REPORTED TO MD |
| SALICYLATES | BISMUTH SUBSALICYLATE/PEPTO BISMAL METHYL SALICYLATE. OIL OF WINTERGREEN AND ASPERCREAM.. .ALL NEED TO BE AVOIDED WHEN ON WARFARIN B/C IT WILL ^ BLEEDING |
| PLATELET MODIFIERS | PREVENTS PLATELETS ACTIVATION |
| ASA (PD) | PREVENTS PROSTOGLANDINS SYNTHESIS.. IS TITRATABLE |
| CLOPIDOGRE/PLAVIX (PD) | WORKS INSIDE PLATELET |
| ASA WORKS MORE ON STUFF | OUTSIDE THE PLATELET, PLAVIX WORKS MORE ON INSIDE- SO CAN BE ON BOTH |
| ASA | LOW DOSE INHIBITS TX SYNTHESIS ONLY.. HIGH DOSE INHIBITS BOTH PROSTOGLANDINS AND IS USED FOR ANTI-INFLAMMATORY |
| HOW DOES ASA WORK...IS IT TITRATABLE...PRIMARY PREVENTION IS WHICH DOSE | INHIBITS PROSTAGLANDIN SYNTHESIS.. YES-TITRATABLE.. 81MG DOSE- PRIMARY PREVENTION |
| PLAVIX "DOGREL" (PD) WORKS INSIDE PLATELETS | (PK) KNOWN AS A PRODRUG (IT NEEDS HEPATIC METABOLISM (ONCE TO BE ACTIVATED.. IF YOU INHIBIT (M) IT WON'T BE ACTIVATED..ACTIVATION IS INHIBITED BY PRILOSEC..SLIGHTLY STRONGER THEN ASA |
| PLAVIX | SAME ASSESSMENT AS IF ON COUMADIN "SOFT BRISTLE TOOTHBRUSH" PT MAY TAKE IF ALREADY HAD MI |
| TX OF HIGH CHOLESTEROL | DIET AND EXERCISE(MINOR EFFECT)- COMMON MED CLASS "STATINS" |
| STATINS | (PD) INHIBIT HEPATIC CHOLESTEROL SYNTHESIS.. CHOLESTEROL BINDING RESINS- SHOULD TAKE W/ MEALS, TAKE OTHER MEDS -+2 HOURS |
| SSTATINS EX SIMVASTATIN/ZOCOR AND ATORVASTATIN/LIPITOR | HAVE LONG HALF LIFE, STRONGEST ONES |
| STATINS S/E | RISK OF HEPATIC DAMAGE- MORE PREVELANT (FAR EAST,MEDERTERRAIN)- CHECK LIVER FUNCTION- CALL MD IF SKIN/SCLERA YELLOWING AND IF STOOL IS ASHTEN COLOR AND CONSISTENTLY DARK URINE- MALAISE- RHABDOMYOLYSTS(CALL MD IF UNEXPLAINED MUSCLE PAIN) AVOID ETOH/TYLENOL |
| ASTHMA; PAROXYSMAL BRONCHIAL CONSTRICTION AND INFLAMMATION | TO TX; RESCUE INHALER (SHORT ONSET B2 AGONIST EX; ALBUTEROL/VENTOLIN... MAINTENENCE INHALER; STEROID (1ST CHOICE) EX; BETCLOMETHASONE/BECLOVENT.. 2ND-LONG ACTING B2 AGONIST EX SOLMETERAL/SEREVENT FOMEDEROL/PORADIL |
| ASTHMA ATTACK GIVE?......1ST CHOICE PREVENTATIVE GIVE? | ALBUTEROL ACUTE...STEROID PREVENTATIVE |
| SHORT ACTING RESCUE INHALER ALBUTEROL/VENTOLIN | B2 AGONIST (THERAPEUTIC) AND B1 AGONISTS (^HR ^BP)..SNS AGONISTS |
| MAINTENENCE B2 AGONISTS-DON'T OVERUSE B/C LONG ACTING CAN CAUSE HEART TO ^ TOO MUCH | BLACK BOX WARNING |
| CLIENT ADMITS TO OVERUSE OF OF MAINTENENCE INHALER EXPECT TO SEE | ^HR AND ^BP |
| STEROID INHALERS BECLOMETHASONE LONG ONSET LONG DURATION S/E | ORAL CANDIDIASIS/THRUSH- THEREFORE RINSE MOUTH AFTER INHALATION |
| PNS ANTAGONIST/ANTICHOLINERGIC | MORE COMMONLY USED W/ COPD BUT STILL FOR ASTHMA EX IPOTROPIUM/STROVENT TIOTROPIUM/SPIREVA |
| IPOTROPIUM/ATROVNET TIOTROPIUM/SPIREVA | MAKE B2 AGONIST WORK BETTER |
| W/ INHALERS | TELL TO HOLD BREATH FOR AS LONG AS COMFORTABLE WHEN INHALING S/E-DRY MOUTH |
| TYPE 2 DIABETES | STILL MAKE INSULIN "NON RESPONDERS TO INSULIN" |
| OLD SCHOOL HYPOGLYCEMIC DRUGS | SULFAMYLUREAS; GLIPIZIDE/GLUCOTROL= ^INSULIN RELEASE... "GLINIDE" "GLITIZONE" = NEWER CLASS |
| NEW SCHOOL DIABTETIC MEDS | ^ INSULIN RELEASE AND DECREASE GLUCAGON RELEASE- HAVE A LOWER RISK OF HYPOGLYCEMIA- CALLED THE INCRETIN MIMICS |
| MODERN | W/ TYPE 2 DIABETES HAVE TO TREAT INSULIN AND GLUCAGON-SULFANYLUREAS ADDRESS INSULIN |
| GREATER RISK OF HYPOGLYCEMIA | OLD SCHOOL |
| METFORMIN/GLUCOPHAGE-EU- GLYCEMIC AGENT | TENDS TO NORMALIZE BLOOD SUGAR, SAFER DRUG, COMMONLY 1ST DRUG NEW TYPE 2 DIABETES PUT ON |
| (PD) METFORMIN/GLUCOPHAGE | DECREASE GLUCONEOGENISIS- DECREASE GLYCOGENOLYSIS- INCREASE GLUCOSE UPTAKE BY MUSCLES... WORK ON THE LIVER-CAN'T PREVENT OTHER DRUGS FROM CAUSING HYPOGLYCEMIA |
| METFORMIN + GLIPIZIDE=METOGLIP | C/O SWEATING, CONFUSED=HYPO= GLIPIZIDE CAUSING IT |
| S/E FISHY TASTE-DON'T EAT AS MUCH | METFORMIN |
| MUST D/C METFORMIN | 24-48 HOURS PRIOR TO MAJOR SURGERY AND/OR IODINE DYE STUDIES OR IF RENAL IMPAIRED-IF YOU DON'T CAN CAUSE LACTIC ACIDOSIS (RIGIDITY/PAIN ABD.) |
| EPILEPSY-KINDLING THERAPY | MICROSCOPIC DEFECT-DISPLAYS AUTOMATICITY, PAROXYSMAL, RECRUITS OTHER PORTIONS OF THE BRAIN |
| EPILEPSY | NEED TO RECORD ACCURATE- DISTINGUISH TYPE OF SEIZURE (STRONG,ETC) TX IS TO DECREASE NEURONAL FIRING SO SEDATION IS A SIDE EFFECT, OVERDOSE- WORRIED ABOUT RESP SUPPRESSION/DEPRESSION |
| THE PRIMARY 4 DRUGS FOR EPILEPSY | PHENTOIN/PHT/DILANTIN... CARBAMAZEPINE/CBZ/TEGRETOL... PHENOBARBITAL/LUMINOL.. VALPORIC ACID/DEPOKOTE..ADD ON(ADJUNCT)- GABAPENTIN/NEURONTIN (S/E SEDATION) |
| WHICH MED FOR EPILEPSY NEEDS TO BE COMBINED W/ OTHER MED | GABAPENTIN/NEURONTIN |
| EPILEPSY MED ON BLOOD | (PK) ALL PRIMARY MEDS HAVE THERAPEUTIC WINDOWS |
| IF CLIENT EXPLAINS OF MORE SEIZURES | GET LEVEL B/C IT COULD BE TOXIC OR TOO LITTLE, CALL MD RIGHT AWAY |
| S/E EPILEPSY MEDS | ALL PRIMARY MEDS HAVE A RISK OF FOLATE DEFIENCY ANEMIA (TIRED UPON EXERTION)- DISCUSS FOLATE SUPPL W/ MD..RARE-APLASTIC ANEMIA-IF ANY UNUSUAL BRUISING-REPORT TO MD NOW! IF FLU-LIKE S/S OR SORE THROAT-CALL MD |
| EPILEPSY MEDS ON ORGAN-LIVER/HEART | ALL EPILEPSY MEDS HAVE A RISK OF LIVER DAMAGE S/S JAUNDICE AND ASHTON COLORED STOOLS AVOID ETOH AND APAP...HEART=TOXICITY-ALTER HR AND RHYTHM |
| (PK) DILANTIN, PHENOBARB, CARBAMEZEPINE | ENZYME INDUCERS (DECREASE THE LEVEL OF OTHER DRUGS) |
| (PK) VALPORIC ACID | ENZYME INHIBITOR (INCREASE LEVELS OF OTHER DRUGS)- THEREFORE TELL MD OF ALL MEDS BEING TAKEN |
| EPILEPSY MEDS ON SKIN | ALL MEDS CAN CAUSE PHOTOSENSITIVITY "WEAR SUNSCREEN" ALL CAN CAUSE RASHES, IT IS COMMON FOR THEM TO CAUSE A SELF-LIMITING RASH (DOESN'T LAST LONG)... RARE-STEVEN JOHNSONS SYNDROME- USUALLY OCCURS 1ST 6 MONTHS OF STARTING-PROGRESSING- CALL MD |
| PHENYTOIN/DILANTIN SPECIFIC | (PK) ZERO ORDER KINETICS HALF LIFE HAS NO MEANING, SO ONLY WAY TO FIND OUT IS TO TAKE LEVEL, SMALL CHANGES IN DOSE CAN CAUSE LARGE CHANGES IN CP-KEEP OUT OF REACH OF CHILDREN |
| PHENYTOIN/DILANTIN S/E | SIGNIFICANT # GET HIRSUITISM, COARSENING OF FACIAL FEATURES, GINGIVAL HYPERPLASIA (PAINFUL SWELLING OF GUMS)-NEED TO FLOSS > 2TIMES/DAY |
| OPIATES S/E | SEDATION EUPHORIA CONSTIPATION TELL INCREASE FLUIDS AND FIBER/BULK LAXATIVES AVOID STIMULANT LAXATIVES CAN CAUSE RASH/PSEUDOALLERGY (IMMUNE SYSTEM NOT INVOLVED) VASODILATION (ORTHOSTATIC HYPOTENSION) NSG DX-CONSTIPATION |
| OPIATES CONTROLLED SUBSTANCES DEPENDENCE 2 TYPES | PHYSICAL- LONG TERM WILL NEED HIGHER DOSES TAPER DOSES WHEN STOPING), PSYCHOLOGICAL- ATC DOSING(DON'T WAIT TILL PAIN) |
| PHYSICAL AND PSYCHOLOGICAL DEPENDENCE | PHYSICAL- REACTIVE FASHION DEPENDENCE... PSYCHOLOGICAL- ATC DOSING PROACTIVE- SHOULD HAVE SCHEDULE SET UP |
| ACETAMINOPHEN NARROW THERAPEUTIC EFFECT | (PD) ANALGESIC, ANTIPYRETIC... (PK) METABOLISM REQUIRES SULFUR- THEREFORE NO SULFUR - END UP W/ HEPATOTOXIC METABOLITE WHICH WILL LEAD TO LIVER DAMAGE MONITOR ALT/AST IF >150-200-GET WORRIED |
| ANTIDOTE TO ACETAMINOPHEN | CYSTEIN(MUCOMYST) |
| NON TOXIC IN GENERAL FOR TYLENOL | <4G/DAY-CHRONIC...7G@ ONE TIME-ACUTE |
| NSAIDS (PD) | ANALGESIC, ANTIPYRETIC, ANTI-INFLAMMATORY- BETTER THEN TYLENOL FOR RHEUMATOID ARTHRITIS- INHIBITS PROSTAGLANDIN SYNTHESIS |
| S/E APAP | SHORT TERM-GI ULCERATION... LONG TERM- RENAL DAMAGE (TAKES DECADES) |
| POLYPHARMACY | ON MORE THEN ONE DRUG THEN IS NEEDS-LASIX FROM ONE MD AND FURESOMIDE FROM OTHER MD |
| IBUPROFEN | SHORT ONSET SHORT DURATION NSAID TO CHOSE FOR HEADACHES AND MENSTRAL CRAMPS |
| MAPROXEN | LONG ACTING AND LONG ONSET GOOD FOR KEEPING PAIN AWAY |
| 200MG IBUPROFEN PO QMORNING AND 275MG NAPROXEN PO Q12H | IBUPROFEN TO GET RID OF PAIN NOW.. NAPROXEN TO KEEP PAIN AWAY.. SO THEREFORE RIGHT AMOUNT ORDERED |
| SEDATIVES/HYPNOTICS | SEDATIVE GOAL IS CALM...HYPNOTIC GOAL IS SLEEP-CAN BE USED FOR 2 THINGS (SLEEP/CALM) |
| BENZODIAZEPINES-HYPNOTIC LOTTA | LORAZEPAM/ATIVAN.. OXAZEPAM/SERAX.. TEMAZEPAM/RESTORIL.. TRIAZOLAM/HALCION.. ALPRAZOLAM/XANEX- ALL HAVE SHORT ONSET(<1H) AND SHORT DURATION(<8H) |
| ATIVAN,SERAX, RESTORIL | NO REAL CHANGE IN HALF LIFE W/ AGE |
| HALCION, XANEX | LONGER HALF LIFE W/ AGE SO SHOULD BE AVOIDED IN ELDERLY |
| 4 CLIENTS-IF NOT LOTTA, SHORT ONSET, LONG DURATION | SO WILL HAVE HANGOVER EX VALIUM, AMBIEN |
| BENZOS (PD) | SUPRESS NEURONAL FIRING-WIDE THERAPEUTIC INDEX TILL YOU ADD ETOH B/C ETOH CAN AMPLIFY 2X-200X THE EFFECT S/E SOME HAVE MILD ANTICHOLINERGIC EFFECTS, OTHERS ANTEROGRADE AMNESIA (CAN'T REMEMBER WHATS HAPPENS WHILE ON DRUG) DON'T TEACH PT WHILE USING THESE |
| ANTIPSYCHOTICS | TYPICALS- HALOPERIDOL/HALDOL.. .ATYPICALS- OLANZAPINE/ZYPREXA |
| ANTIDEPRESSANTS | CLASS CALLED TRI-CYCLIC ANTIDEPRESSANTS AMITRYPTILINE/ELAVIL |
| GENERAL S/E FOR ANTIPSYCHOTICS | ANTICHOLINERGIC (DRY MOUTH) ALPHA BLOCKING (VASODILATORS/ ORTHOSTATIC HYPOTENSION) SEDATING |
| EX HALDOL S/E | DRY EYES DRY MOUTH WOBBLY WHEN GETTING UP |
| ALL ANTIPSYCHOTICS ANTIDEPRESSANTS | CNS ANTIHISTAMINE- DECREASE SATIETY- WGHT GAIN- NEED TO ASSESS FOR TYPE 2 DIABETES & SODIUM CHANNEL BLOCKERS LEAD TO CARDIAC ARRHYTHMIAS (MOST SERIOUS S/E) |
| HOW LONG DOES IT TAKE FOR ANTIPSYCHOTIC/ANTIDEPRESSANTS TO WORK | 3 WEEKS TO 3 MONTHS (FOR MORE ORDERED THOUGHT OR RAISED MOOD) |
| THERAPEUTIC WINDOW | PK |
| THERAPEUTIC INDEX | PD |
| B-BLOCKERS W/ DIABETES | CHANGE TO OLD CA CHANNEL BLOCKERS |
| PHARMACEUTICS | PATCH PO IV SL ETC |
| ASTHMA ATTACK IN FRONT OF YOU | GIVE ALBUTEROL |
| CARDIOVASCULAR-HTN 3 PARTS KIDNEYS HEART VESSELS | KIDNEYS-DIURETICS ACE INHIBITORS... HEART-B-BLOCKERS,OLD CA CHANNEL BLOCKERS.. VESSLES-ALPHA BLOCKERS,NEW CA CHANNEL BLOCKERS, ACE INHIBITORS |
| HTN TX KIDNEYS COMPENTASORY:DIURETICS,ACE INHIBITORS,ARB's | ^HR AND STRENGTH (FAST) AND CONSTRICTION OF VESSLES(FAST) |
| HTN TX HEART COMPENTASORY:B-BLOCKERS,OLD CA CHANNEL CLOCKERS | VESSLES CONSTRICT(FAST) KIDNEYS RETAIN FLUID(SLOW) |
| HTN TX VESSELS COMPENTASORY:ALPHA BLOCKERS,NEW CA CHANNEL BLOCKERS,ACE INHIBITORS,ARB's | ^HR AND STRENGTH(FAST) AND KIDNEYS FLUID RETENTION(SLOW) |
| ACE INHIBITORS | -PRIL. CAPTOPRIL/CAPOTEN |
| ARB's | -SARTAN.. VALSARTAN/DIOVAN |
| B-BLOCKERS | -OLOL,ALOL... METOPROLOL/LOPRESSOR |
| OLD CA CHANNEL BLOCKERS | VERAPAMIL/CALAN DIALTIAZEM/CARDIZEM |
| ALPHA BLOCKERS | -ZOSIN..TERAZOSIN/HYTRIN |
| NEW CA CHANNEL BLOCKERS | -DIPINE..DIFEDIPINE/PROCARDIA |
| FINALLY THE END- GOOD LUCK:) |
Created by:
lmtherrera
Popular Nursing sets