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1231 Final BP

Question	Answer
Special Teaching about expectorants:	pt should be aware that these drugs will make sputum more liquid, use a humidifier and drink at least 2qts of water daily. This will help get mucus out. Notify if cough is present w/high fever, or persistent HA or if cough returns!
Decongestents along with HTN	Decongestants increase BP and HR
Antitussives may cause	drug dependence. Some are Schedule 2 Controlled Substances. They should only be used a short time.
Give oral doses of antihistamines with	meals or milk to limit GI s/e.
Start the amount of dose of antihistamines as	low as tolerated and needed. With ELDERLY start low and stay low.
Antihistamines have what kind of effect on the CNS	Sedative effect. and it is increased when other CNS depressants are used along with antihisamines.
How are antibiotics chosen?	depends on the infectious organism (identified by cultures or smears)
Important Patient teaching for Differin Gel	Wash face then apply a thin film of gel once daily to affected areas. An exacerbation of acne may initially be seen; therapeutic results usually seen in 8-12wk.
Agents that are Bactericidal	kill bacteria
Aderse reactions to anti-infectives?	Neuropathy (nerve damage), fixed drug eruptions (single spot that itches), N/V, epigastric distress, anemia, blood dyscrasias, rash, Erythema, urticaria, angina, edema, swelling of skin and mucous membranes, laryngeal edema and anaphylaxis
What is the treatment for active TB	Rifampin and Isoniazid - 6mo - 1 year, most be compliant
Penicillin Action	Broad spectrum, interferes with creation of cell wall.
Penicillin is used to	treat infections.
Adverse reactions of Penicillin	neuropathy, fixed drug eruptions, NV, epigastric distress, blood dyscrasias, rash, urticaria, edema, anaphylaxis.
Drug interactions of Penicillin	bacteriostatic antibiotics, bacteriocidal antibiotics, birth control produces menstrual irregularities, and unplanned pregnancies
Thiazide diuretics	Keeps the kidneys from reabsorbing Sodium, Potassium, and Chloride. First treatment for HTN.
Treatment for HTN diabetics	ACE inhibitors
Special teaching for pts on antibiotics and birth control medications	Use backup contraceptive, antibiotics lessens the affects.
Use of ampicillin and oral contraceptives together has produced	menstrual irregularites and unplanned pregnancies.
Cephalosporin and penicillin with allergies causes	nephrotoxicity >incidence in elderly or pt w/poor renal function.
What are broad spectrum antibiotics?	Antiinfective drugs effective against a wide variety of organisms.
Tetracycline special teaching	take on an empty stomach, avoid sunlight, DO NOT take w/milk, grayed teeth, black hairy tongue, avoid milk iron supplements and antacids.
Teaching needed with all antibiotic medications	Take until prescription is over, add another form of contraceptive, antibiotics provide an overgrowth of yeast, could cause superinfection and bacterial changes in bowel
Adverse reactions to Penicillin	hypersensitivity reactions, hematological reactions, transient neutropenia, leucopenia, thrombocytopenia, bleeding can occur with high dose extended-spectrum penicillins
Cromolyn sodium helps treat asthma by	slowing down the destruction of sensitized mast cells
Cromolyn and nedocromil sodium, a drug with actions similar to those of cromolyn, are used to manage	bronchial asthma in some pts.
Penicillin, amoxicillin, cloxacillin	Common Penicillins
How do you know if aminoglycosides are working	▼BP, HR, WBC, when symptoms subside and pt starts feeling better.
Zovirax (acyclovir) Purpose	For initial and recurrent mucosal and cutaneous HSV1, HSV2, and varicella-zoster infections in immunocompromised individuals. Severe acute and recurrent genital herpes in pts not immunocomprimised. Acute treatment of herpes zoster and chickenpox lesions.
Zovirax (acyclovir) Dosage	Initial parenteral infusion followed by oral therapy. Dosage depends on condition, acuity, and severity. Dose is usually 800mg PO 5times daily for 7-10 days.
Nystatin Action	Most commonly used polyene antibiotic with fungistatic or fungicidal activity. Drug may allow intracellular components to leak through fungal cell membrane by binding to sterols in cell membrane.
Nystatin Uses	Used to treat intestinal, vaginal, and oral fungal infections caused by susceptible strains of Candida albicans and other Candida species.
Nystatin Adverse Effects	Nausea, vomiting, diarrhea.
What is a superinfection?	Viral infection in addition to the infection the pt is on medication for, yeast being the most common, diarrhea and other GI symptoms are common.
When would you develop a superinfection?	Results when using broad spectrum antibiotics.
Atineoplastic Adverse Reactions	Depend on the dose given. NV, Anorexia, and diarrhea are seen w/almost all products. Other common reactions include alopecia, and bone marrow depression. Renal tox, Hepatic tox, ototox, ocular effects, peri neurotox, and hypersensitivity are common.
Antineoplastic agents are some of the most dangerous drugs given to pts. However, they may save the pts life, so the benefit outeighs the risk. You must always watch the	pt and look for changes that might be the onset of serious adverse reactions.
What are common treatments for nausea associated with atineoplastic meds?	Antiemetics may be prescribed for nausea, special skin care may be needed and analgesics or narcotics may be required.
Why get immunizations?	to Decrease chance of getting diseases
What is PPD?	PPD: TB test, if PPD is positive you have been exposed to TB
What are toxoids?	Part of the disease altered.
artifically acquired passive immunity	the type of immunity you get from vaccines
Muscle relaxants are used in treatment of	spasticity.
Muscle relaxants Adverse Effects	nervousness, insomnia, weakness, speech disturbance, photosensitivity, urinary frequency or retention, nocturnal diuresis, erectile dysfunction, depression, seizures.
Quinine is for	leg cramps.
Dantrium treats	spasticitiy
Colchicine Treats	gout. Antiinflammatory; effects specific for gout.
Colchicine Adverse Effects	NV, diarrhea, abdominal pain
NSAIDs treats	pain
allopurinol prevents	gout
Adverse reactions, side effects, and precautions to ASA	GI bleeding, ototoxicity, gums bleeding, check all products for aspirin, visual disturbances, edema
Gout is	for of arthritis where uric acid accumulates in increased amounts in the blood and is often deposited in joints.
Metotrexate is used for	varoius cancerous and psoriatic conditions. Decreases joint swelling and tenderness in 3-6 weeks. Has many contraindications, used for RA, malaria, abortion.
anorectal preps: dibucaine (Nupercainal)	Pt should apply ointment morning and night after each bowel movement. For suppositories, one should be inserted after each bowel movement.
anorectal preps: hydrocortisone acetate (anusol-HC)	contains hydrocortisone
anorectal preps: zinc sulfate monohydrate (anusol, preparation H)	Suppository should be inserted in the morning and at bedtime for 3-6 days or until inflamation subsides; or cream may be applied to anal area and gently rubbed in 3-04 times daily for 3-6 days
anorectal preps: hydrocortisone foam (Proctofoam-hc)	steroid used for antiinflammatory treatment of ulcerative proctitis and distal ulcerative colitis. Contains hydrocortisone. Pt would insert one applicatorful in rectum daily or twice daily for 2-3wks. Then every other day, decreasing gradually.
Anorectal preparations include	emollients, foams, and gels for topical anesthesia or healing of the rectal area. They are used for symptomatic relief of discomfort of hemorrhoids. They may be used for short term or long term.
Use the pain intensity scale for	adults.
Use the wong-baker face scale for	children and pts with a language barrier.
Flomax treats	symptoms of BPH by selective inhibition of alpha1A receptors
Flomax Adverse Effects	postural hypotension, dizziness, somnolence, rhinitis, diarrhea, abnormal ejaculation.
Flomax drug interactions	potentiates other alpha adrenergic blcoking agents
Flomax Nursing Imps and pt teaching	take at the same time every day, approx 1/2 hour AFTER eating, may take 2-4wks before response is seen.
Flomax is an alpha-adrenergic antagonist	a non-diuretic drug used to treat urinary problems
Lopressor	anti HTN, anti-anginal, prevents MI
Pyridium	treats UTI, orange urine
Diuretics and hypertension	First choice for treatment
Elderly pts are more susceptible to to the development of the adverse reactions associated with diuretics such as	postural hypotension, impaired mentation, hypokalemia (except with potassium sparing diuretics), and increased serum glucose levels.
Lower doses of diuretics are advised in the	elderly population, with dosage increases based on the pts individual therapeutic response and/or the development of adverse reactions.
Pts taking diuretics must be observed for symptoms of Potassium loss. This is often seen when the pt develops	muscle weakness and other symptoms of dehydration. Many pts require potassium replacement while taking diuretics and digitalis.
Diuretics indirectly reduce blood pressure by	producing sodium and water loss and lowering the tone or rigidity of the arteries
Zocor Side Effects	Abdominal cramps, GI problems
Statin Medications	Hyperlipidema - lowers cholesterol
Ativan	aka Lorazepam treats anxiety disorders
Teaching when taking migraine meds	take with meals or milk, keep arms and legs warm, lay down in a dark room
Elavil	antimigraine, tension HA
Valium	aka Diazepam. Sedative, status epilepticus
Imitrex	antimigraine
Dilantin	treat tonic clonic and psychomotor seizure, increased ventricular force, dental care - massage gums to prevent hyperplasia.
Aircept	used in alzheimers mild/moderate dementia
What are some common Parkinson meds and what is the goal of treatment?	anticholinergic and dopaminergic are used to control parkinsons by changing the transmitters produced in the braine. Levedopa and Carbidopa, early signs of blephrospasms and muscle twitching.
Elimite	pediculocyte, use again 7-10 days, use in 1-2 applications, don't use on pets and babies. report to school nurse.
Nicotine patches special teaching	don't smoke, alternate application site
Antipsoriatics	accelerates scaling in chronic psoriasis
Miotic drugs	open-angle glaucoma, constricts pupils
Mydriatic drugs	dilate pupils, contraindicated in glaucoma
Treatment of calluses	salicylic acid
Proparacaine	topical anesthetic used for cataract surgery
Codeine	narcotic antitussive
Mucomyst	(acetylcholine) antidote for acetaminophen overdose
When to take pain meds?	First sign of pain.
Timoptic	beta blocker that decreases intraocular pressure
Accutane	treats severe acne, avoid sun and pregnancy
Anticoagulants	prevent clots
Thrombolytics	break down clots
protamine sulfate	antidote for heparin
vitamin k	antidote for coumadin
PT	coumadin (norms 1.5-2.5)
PTT	Heparin (norms 2.5-3x the control volume)
Protonix	proton pump inhibitor for gastric and duodenal ulcers take 1 hour before meals
Antispasmodics and anticholinergics	work antacids in continuing the therapeutic benefits of both (irritable bile syndrome) (dry up)
Simethicone ACtion	Antiflatulents! defoaming action
simethicone use	relief for excess gas (takes air out of stomache
Simethicone adverse effects	typically causes diarrhea
Disulfiram action	(antialcoholic) used only for the mgmt of alcoholism, discourage alcohol intake and force pt to be sober.
Disulfiram Side effects	drowsiness, fatigue, HA, psychoses, optic neuritis, hepatic toxicity, metallic/garlic like taste, erectile dysfunction,
Disulfiram: Notify dr of signs of	hepatoxicity, yellow eyes or skin, dark urine, light-gray colored stools or severe stomach pain
Strokes and ASA	dose 1xday for men
Foods that affect coagulation	green leafy veggies
Heparin	short term IV use, prevention of clots
Coumadin	most often used for long term use
Corticosteroid therapy	used to control long term asthma
Hormone replacement therapy	increased risk for cancer
Progestin action	transform proliferate endometrium into secretory endometrium (causes early menopause) Necessary for the development of the placenta and inhibits the secretion of pituitary ganadotropins, preventing maturation of the ovarian follicle and ovulation.
Progestin uses:	amenorrhea, endometriosis, functional uterine bleeding, contraception
Progestin adverse effects:	breakthrough bleeding, spotting, changes in menstrual flow, amenorrhea, tender breast, edema, wt increase or decrease, acne, chloasma, melasma, depression
Levothyroxin	used for hypothyroidism
ACE inhibitors	interfere with renin-angiotensin-aldosterone-system, decrease BP.
Ace Inhibitor drugs	catapril, benzapril, enalapril, quinapril, ramipril, lisinopril
Ace inhibitors adverse effects	most common dry hacking cough, HA dizziness, tachycardia, palpations, 1st dose syncope
Lanoxin (digoxin)	used for arrythmias. Monitor closely, check apical pulse if <60 hold meds.
Nitroglycerin	keep in a dark bottle, out of sun
What does a narrow margin for digoxin mean	.5 to 2 ngmg
Paxil treats	depression, panic and eating disorders, obsessive compulsion, premenstrual dysphoria, ptsd, bipolar, alcohol dependence, premature ejac, diabetic neuropathy.
Paxil adverse effects	GI complaints, HA, dizziness, somnolence, sexual dysfunction, tremors, less common: tender breast or enlargement, fever, palpations, wt gain or loss, rash, hieves, itching
Lithium	an antimanic acts by altering sodium transport in nerve and muscle cells and inhibits the norepinephrine and dopamine release
lithium adverse effects	metallic taste, dizziness, ha, confusion, recent memory loss, drying and thinning , wt loss or gain, edema of hands and ankles, reversible leukocytosis, cardiac dysrhythmias, nephrotox, toxicity
Lithium special teaching	Monitor sodium levels carefully! encourage fluid intake.
When a diuretic is discontinued it is recommended that the drug be	reduced gradually to avoid the development of serious edema.
Thiazides work to prevent the reabsorption of	sodium and chloride through direct action on the end of the ascending loop and the beginning of the distal tubule of the loop of Henle.
Thiazides block the sodium and chloride	reabsorption and slightly limit carbonic anhydrase.
Thiazides have a long half-life that may lead to the loss of large amounts of	potassium.
Thiazides also act directly to dilate the smooth muscles in the	arterioles, the smallest vessels in the areterial system.
When the arterioles are made larger, the heart does not have to pump so hard to get blood into them. This helps keep	blood pressure lower.
permethrin (Elimite, Nix, Acticin) is a	scabicide/pediculicide. Sprinkle lotion into dry hair and rub into scalp.
Permethrin (Elimite) action	causes repolarization and paralysis in lice by disrupting sodium transport in normal nerve cells. DEATH TO PARASITES!!!
proparacaine (Alcaine) is a	local opthalmic anesthetic. Use 1-2 drops immediately before tonometry, 2-3 minujtes before suture removal or removal of foreign body.
codeine (Codeine Phosphate, Codeine Sulfate) is a	Narcotic Agonist Analgesic. Schedule 2 drug.
Codeine indications	management of mild to moderate pain. Antitussive (in smaller doses).
Codeine Actions	Binds to opiate receptors in the CNS. ALters the perception of and response to painful stimuli while producing generalized CNS depression. Decreases cough reflex and GI motility.
Codeine Side Effects	confusion, sedation, hypotension, constipation, nausea, vomiting
Codeine Nursing Imps include checking vital signs regularly and assess sedation if respiratory rate is <10/min. Assess bowel function regularly. Assess type, location and intensity of pain before and	1 hour (peak) after administration. Prolonged use may lead to dependance and tolerance.
Codeine overdose antidote	Narcan
Morphine (Duramorph, MS Contin, MSIR) is a schedule	2 drug that is a narcotic agonist analgesic.
Morphine is the primary narcotic analgesic used for relief of	severe pain. Morphine is the narcotic analgesic against which all others are compared.
Morphine produces	sedation and euphoria when pain is present. Traditionally used for preop sedation and post op analgesia.
Morphine is more effective against	dull, continuous pain than sharp, spasmodic pain.
IV meds of Morphine should be given	slowly over 4-5mins. Protect drug from light and freezing.
Morphine adult dose	5-20mg subq or IM Q4hr as indicated. IV admin range from 2-15mg/5mL
Morphine Child dose	0.1-0.2 mg/kg per dose subq q4hr max not to exceed 15mg.
acetaminophen overdose antidote	Mucomyst!
Silver sulfadiazine (Silvadene) is a	burn preparation. apply once or twice daily to a thickness of approx 1 1/16 inch. No dressing required.
Timolol (Timoptic)is an	ophthalmic anti-glaucoma beta blocker. Use 1 drop .25% solution twice daily.
Ophthalmic NSAIDs for cataracts	Voltaren, Ocufen, Acular, Profenal
Special teaching with Cataract meds	minimize use of concurrent NSAIDs during topical therapy. Instruict to avoid covering lesion with occlusive dressing and to avoid applying sunscreen or cosmetics to the affected area. Advise t that it may take up to 1 mo for complete healing to occur.
pantraprazole (Protonix) dosage	Adults dose: 40 mg delayed-release capsule once daily for 8wk also available as an IV infusion
Protonix Indications	Erosive esophagitis a/w GERD. Decrease relapse rates of daytime and nighttime heartburn symptoms on pts with GERD. Atreatment of duodenal ulcers a/w Heliobacter pylori
Protonix actions	Binds to an enzyme in the presence of acidic gastric pH, preventing the final transport of hydrogen ions into the gastric lumen.
Protonix Adverse Effects	aha, abdominal pain, diarrhea, eructation, flatulence
Protonix Pt teaching	take as directed for full course of therapy. No booze or aspirin, NSAIDS, or food that would irritate GI. REport black, tarryt stools; diarrheal or abdominal pain to health care professional IMMEDIATELY!
The most common adverse reaction from heparin is	excessive bleeding and thrombocytopenia.
Early signs of overdosage or internal bleeding of heparin include	bleeding from gums while brushing teeth, excessive bleeding or oozing from cuts, unexplained bruising or nosebleeds, and unusually heavy or unexpected menses (in women).
Heparin is the anticoagulant of choice when what effect is needed?	immediate!
Low-intensity coumadin therapy greatly decreases the risk of	stroke from nonrheumatic atrial fibrillation and has few side effects.
Foods that interfere with the anticoagulant effect:	green leafy vegetables: broccoli, cabbage, collard greens, lettuce, spinach. or consumption of a nutritional supplement or multiV containing vita.K.
Estrogens are used for	hormone replacement therapy in menopause or other conditions in which the natural estrogens are decreased, such as ovarian failure, primary amenorrhea, and oophorectomy.
Hormone replacement therapy may	increase risk for cancers.
levothyroxine (Levothroid, Synthroid, Unithroid) are thyroid supplements or replacements.. dosage:	synthetic prep is the drug of choice because effect is predictiable. Initial therapy is .05-.1 po daily with increase of .05-.1mg at 2 week intervals until effect is achieved.
Levthyroxine Evaluation	Response to therapy is not immediate. Most pt.s begin to feel better within to weeks and the therapeutic results are often seen in 3 months.
If side effects on a thyroid supplement occur	therapy will be withdrawn for 2-6 days and then restarted at a lower dosage.
Pts over 50 are sensitive to throid hormones and should be monitored closely for	Cardiovascular disease before dosage is increased.
Laboratory tests for serum T4 and TSH are used to confirm	hypothyroidism
Levothyroxine is usually the drug of choice for	thyroid replacement
Alpha Adrenergic blocking agent:	dapiprazole (ophthalmic prep) use 2 drops follwed 5 min later by an additional 2 drops.
Dapiprazole is used to	reverse mydriasis (dilation) after eye examination.
Loop Diuretics	act by blocking active transport of chloride, sodium, and potassium in the thick ascending loop of Henle
POtassium-sparing diuretcis	increase the exrcretion of water and sodium but save potassium.
Most popular Thiazide diuretic	hydrochlorothiazide (HydroDIURIL, Microzide)
Most popular Loop diuretic	furosemide (Lasix)
most popular Potassium sparkingdiuretic	spironolactone (Aldactone)
digoxin (Lanoxin) USE	atrial flutter, atrial fibrillation, PAT, CHF
digoxin (Lanoxin) ADVERSE REACTIONS	digitalis toxicity
The elderly often have a reduced tolerance for	Digitalis.
Digoxin (Lanoxin) is a	cardiotonic

Created by: christinego

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