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Pharm.Final.

Pharmacology

QuestionAnswer
Pharmacodynamics Study of biochemical and physiological effects of drugs and their molecular mechanisms by which those effects are produced.
pharmacokinetics drug mvmt through body
bioavailability Amt of drug absorbed into blood stream
pharmacogenetics study of the influence on an individual’s response to drugs
agonist stimulate cell function
antagonist inhibit cell function by occupying receptor site
Opioid: Morphine action Binds to Opioid receptors in brain and spinal chord
Morphine Indications o acute and chronic pain (MI Burns, CA, traumatic injury) o pre and post surgery o pre and post diagnostic procedures o L&D o TX  Pulmonary edema, GI gisorders, severe cough
Morphine AE o Constipation o resp distress o urinary retention o N/V o Hypotension o Sedation o Itch o pinpoint pupils (Toxic)
Morphine RN Implications oSmallest effective dose oreduce amt for those recieing other CNS depressants; Give 30 before tx or dressing change; Observe s/s withdrawal anxiety, aggressiveness, insomnia, N&V, diarrhea, elevated temp, elevated resp rate and bp.
Morphine Antidote Narcan
Opioid: Demerol action, indications, AE (same as morphine's)
Demerol AE same as morphine's+metabolite (seizures, tremors, hallucinations)
Demerol RN Implications has a ceiling where as morphine does not
Demerol antidote Narcan
Narcotic Antagonist Narcan
Narcan Action reverse analgesia and depressive effects of opiates by displacing opiates from receptor sites to specific opiates
Narcan Indications opioid toxicity
Narcan AE may cause withdrawal symptoms in opiate dependent people( sweating, redness, diarrhea)
Narcan RN Implications needs repeated injections
NSAID •inhibit synthesis of prostaglandins both in CNS and periphery •higher daily doses of these increase a women’s risk for HTN
NSAID prototype Aspirin (analgesic, anti-pyretic, anti-inflammatory)
Aspirin Action inactivation or the COX-1 and COX-2 , inhibits formation of prostaglandins
Aspirin Indications inflammation, analgesia, antipyretic, Dysmenorrhea, prevent colorectal CA, suppression of platelet aggregation low dose ASA indications •prevent MI, ischemic stroke, TIA’s, acute MI, chronic stable angina, unstable angina, angioplasty
Aspirin AE GI •heart burn, nausea, gastric ulceration, perforation and bleeding •Bleeding •renal impairment •salicysim (tinnititus, headache, dizziness, sweating)
Aspirin RN Implications Teach name of drug, reason for use, prescribing info, adverse affects, storage and prep
Ibuprofen/Advil Action reversible inhibition of Cox 1 and Cox 2
Ibuprofen/Advil Indications inflammation, analgesia, antipyretic, anti platelet effect only when drug present in blood, mild/mod pain and or inflammation with OA, RA, gout, bursitis, head ache, minor trama, minor surgery, dysmenorrhea
Ibuprofen/Advil AE GI, nephrotoxicity, increased bleeding tendencies, htn, hypersensitivity w, dyspnea, bronchospasms, skin rash
Ibuprofen/Advil RN Implications NSAIDS don’t protect against MI and stroke
Acetaminophen Tylenol
Tylenol Action Inhibits prostaglandin synthesis in CNS only, NOT and anti-inflammatory just analgesia and antipyretic. Metabolized in liver
Tylenol AE liver damage oS/S Tylenol poisoning V/N/D, sweating, abd discomfort Hepatic failure, coma & death
Tylenol RN Implications Do not take with ETOCH, monitor amount given (not to exceed 2 gm max daily)
Tylenol Antidote Acetylcysteine (mucomyst)
Cycolobenzaprine skeleteal muscle relaxant
Cycolobenzaprine Prototype Flexeril
Flexeril Action odepression of CNS may also block nerve impulses that increase muscle tone and contraction
Flexeril Indications oadjunct to other tx measures, muscle spasms and spasticity
Flexeril AE odrowsiness, blurred vision, dizziness, lethargy, flushing, N/V resp depression, Hypotension, ataxia
Flexeril RN Implications oWatch clients for sedation, Use in caution with clients with renal or liver issues, Resp depression, glaucoma, urinary retention, and cardiac arrhythmias
Describe antibiotic use: TX infection, prophylactic use: Pre and post surgery, Bacterial endocarditis, neutropenia: chemo or transplant clients, UTI`s, exposure to STD, prevention of: tb, HIV, type A influenza, group B strep,
What are some examples of penicillin? methicillin (staphcillin) , amoxicillin (amoxil) ticarcilin (Ticar)
Penicillin action inhibit bacterial call wall synthesis
PCN indications pneumococcus, streptococcus, gonorrhea, syphilis, prevent bacterial endocarditis
PCN AE Allergy, cross sensitivity with cephalosporin’s
PCN RN implications Ask about allergy to PCN, obtain a C&S (culture and sensitivity) if ordered, monitor kidney function, evaluate effect, monitor for AE, if client has PCN allergy: Mark chart, and advise client to wear alert bracelet
What are some examples of anti-infectives from cephalosporins? cefazolin (ancef) cefotetan (cefotan) cefuroxime (zinacef) and ceftriaxone (rocephin)
Cephalosporins action inhibit bacterial cell wall synthesis
Cephalosporins indications broad spectrum against gram pos and negative bacteria. Less active against +, more active to -, than PCN
Cephalosporins AE PCN reaction, bleeding due to vit K metabolism, thrombophlebitis (during IV infusion) and Pseudomembranous colitis (s/s: fever, abd pain, severe diarrhea with mucus
Cephalosporins RN implications PCN allergy? IM injections into large muscle mass to decrease pain, observe iv site: phlebitis, dilute solution give slowly. PO- take with food or milk, Report diarrhea (esp bloody with mucus) peri op use: 30-60 min prior
What are some examples of anti-infectives from amnioglycosides? amikacin (amikin) gentamicin (garamycin) kanamycin (Kantrex), Neomycin, and Streptomycin
amnioglycosides action inhibit protein synthesis
Amnioglycosides indications serious aerobic gram negative infections, anti-pseudomal tb, and PO-suppresses bowel flora
Amnioglycosides AE ototoxicity and nephrotoxocity
Amnioglycosides RN implications Limit use to 10 days, Monitor BUN and creatinine, id high fisk pts for renal impairment, teach s/s ototoxicity
What are some examples of the anti-infective tetracycline? demeclocycline (declomycin) Doxycycline (vibramycin) and tetracycline hydrochloride (achromycin)
tetracycline action inhibits protein synthesis
Tetracycline indications TX: rocky mt spotted fever, Chlamydia, cholera, mycoplasma pne (walking pne) anthrax, lyme disease. Used for acne, peptic ulcer disease and brucellosis
Tetracycline AE gi irritation, bones and teeth, hepatoxicity, c. diff-supra infection, photosensitivity, renal toxcicity
Tetracycline RN implications Don’t use if client had renal disease or pregnant or kids under 8. Tooth enamel discoloration and depresses bone growth
What are some examples of sulfonamides? o Examples: sulfasalazine (azulfidine) sulfisoxazole (gantrisin) sulfamethaxazole-trimethprim (bactrim) and mafeide (sulfamylon)
Sulfoniamide action inhibits cell metabolism (folic acid)
sulfonamide indications UTI, ulcerative colitis, e. coli
sulfonamide AE N/V rash, fever (Stevens Johnson) anemia, pallor, jaundice, renal damage. Kernicterus-bili in new borns
sulfonamide RN implications do not give to pregnant or BF mothers, not for infants under 2 months. Monitor renal labs, encourage fluids, teach client to monitor for rash, and to avoid prolonged sunlight exposure
What are some examples of a anti-infective macorlide? oazithromycin (zithromax) and clarithromycin (biaxin)
Erythromycin action inhibits protein synthesis
erythromycin indications OCN substitute, resp infections, skin, STD and conjunctivitis
Erythromycin AE N/V/D
Erythromycin RN implication take w/ full glass H20 do not take with antacid
Metronidazole prototpe Flagyl
Flagyl action inhibits DNA synthesis
Flagyl indications infections: anaerobic, protozoa and intra-abdominal, amebiasis, giardia, trich, H.pylori, c. dif
Flagyl AE N/V/D and metallic taste, antabuse effects: with ETOCH, seizures, HA, and paresthesia
Flagyl RN Implications caution with liver impairment
Describe anti-viral drugs oViruses live and reproduce only when inside another living cell oClassified according to nucleic content (DNA vs RNA) shell composition, serological typing and morphology
What are the steps to a viral infection? attachment, penetration, uncoating Viral repli./synthe of viral componentce assembly and release of virus,Viral infections occur s ss or illness and virus cn pass s knowledge,Relieve symptoms or slow progress. DO NOT KILL or CURE,Inhibit viral reproduct
What are some anti-viral drugs? AZT, Tenofovir, Indinavar, Delaviridline, enfuvirtide
AZT prototypes Zidovudine, Retrovir
What type of antiviral is AZT? NRTIs (nucleotide reverse transcriptase inhibitor)Antiviral
Retrovir action supresses DNA synthesis(used in HIV clients)
Delaviridine protoype rescriptor
What type of antiviral is delaviridine? NNRTIs (non-nucleotide reverse transcriptase inhibitor)
Rescriptor action supresses DNA synthesis, binds directly to reverse transcriptase, reversing its function(used in HIV clients)
Tenofovir prototype Viread
What type of antiviral is Tenofovir? NRTIs antiviral
Viread action supresses DNA synthesis, inhibits reverse transcrtiptase enzyme (used in HIV clients)
Indinavar prototype Crixivan
What type of antiviral is Indinavar? protease inhibitor
Crixivan action prevents virus from penetrating into cell (used in HIV clients)
Enfuvirtide protoype Fuzeon
What type of antiviral is Enfuvirtide? fusion inhibitor
Fuzeon action prevents virus from penetrating into cell (used in HIV clients)
___ ___ is mose often cause of infection et supra infections candida albicans
What are superficial infections normally caused by? dermatophytes: tinea pedis (athletes foot), tinea corporis (ringworm), tinea curis (jock itch), tinea capitis (lice)
How are antifungal meds used? use is long term, weeks to months, dose depends on severity and C&S needed usually
Antifungal RN implications dry all areas, wear flip flops in community shoering areas, do not share hair brushes or hats, prevent pts from having live flowers or plants in room, avoid exposure to bat et chicken poop, do not irritate skin
Amphotericin B prototype Nystatin-topical
Nystatin action disrupts fungal cell membrane
Ketoconazole prototype Nizoral or Azole
Nizoral or Azole action inhibits sunthesis of defective cell membrane
CAspofungin prototype cancidas
Cancidas action inhibits glucan synthesis et disrupts cell wall
Grisefluvin action interferes c cell division
Furosemide prototype Lasix
What is Lasix? a loop diuretic
Lasix action blocks reabsorption of Na et Cl in ascending loop of Henley
Lasix indications for rapid diuresis
Lasix AE OTOTOXICITY, dehydration, HYPOKALEMIA, hypotension, hyperglycemia, hyperuricemia (causes gout), hypernetremia, hypocholoremia
Lasix RN implications administer in am, PO has a 30 min onset, IV has a 5-10 min onset, monitor K+, teach s/s of hypokalemia, daily weights, postural hypotension
What type of drug is Enalapril? ACE inhibitor
Enalapril prototype Vasotec
Vasotec action prevent formation of angiotensin II, results in vasodilation, decrease blood volume, decreased cardiac et vascular remodeling
Vasotec indications HTN, CHF, diabetic neuropathy, MI, prevention of CVA, in high risk patient
Vasotec AE fetal injury, COUGH, ANGIOEDEMA, 1st dose hypotension, hyperkalemia, renal failure
Vasotec RN implications avoid pregnancy et Vit K supplements, call Dr if cough or early s/s infection, minimize NSAID use
What are two Ca+ Channel blockers? Verapamil et Nifedipine
Verapamil action blocks Ca+ channel in blood vessel et heart resulting in vasodilation
Verapamil indications angina, HTN, dysrhythmias
Verapamil AE constipation, edema, dizziness, facial flushing, HA
Verapamil RN implications do not chew sustained release, cauting use c digoxin
Nifedipine action blocks Ca+ channel in blood vessel (lowers BP)
Nifedipine indications angina, HTN
Nifedipine AE edema, facial flushing, dizziness, reflex tachycardia (a beta blocker might prevent this)
Nifedipine RN implications do not chew sustained release, caution use c digoxin
What type of drug is digitalis? cardiac glycoside
Digitalis prototype Digoxin
Digoxin action incrase CO, decrease sympathetic tone
Digoxin indications CHF, A-Fib, A-Flutter
Digoxin AE cardiac dysrhythmias elevate dig level, OD, renal function, CHF
Digoxin RN implications monitor K+, renal fucntion, know client baseline data (ekg, labs like BUN et creatinine, ejection fraction)
S/S of Digoxing TOXICITY N/V, anorexia, fatigue, visual disturbances: blurred vision, halos around dark objects et yellow tinge to vision
Nitro prototype Nitrate
Nitrate action causes vasodilation, decreases preload et O2 demands
Nitrate indications for acute angina attack et to prevent anginal attacks
Nitrate AE HA, REFLEX TACHYCARDIA, HYPOTENSION
Nitrate RN implications administer as soon as pain states, may repeat tablet q5min for a total of 3 tablets, store in tightly closed dark container effective for 24 months
What type of drug is Lipitor? Statins
What is prototype of Atorvastatin? Lipitor
Lipitor action inhibit cholesterol synthesis
Lipitor indications reduced LDL, elevate HDL, promote plaque stability, reduce inflammation of plaque sites, slow progression of artery calcifications, enhance vasodilation, hypercholesterolemia, preven CVA (may reduce CAD), reduce CV events in clients c Type 2 DM
Lipitor AE myopathy, rhabdomyolysis (muscle pain), hepatotoxicity
Lipitor RN implications not pregnant, check liver functions et ck
What are 3 anticoagulants? heparin, LMWH, warfarin
Heparin action enhangce activity of antithrombin inactivating thrombin et X factor resulting in fibrin progression; prevent clot development or formation; does not break clots down
Heparin indications pregnancy, PE, evolving stroke, DVT, open heart surgery, renal dialysis, DIC, acute MI, post op venous thrombosis
Heparin AE hemorrhage, heparin induced thrombocutopenia (HIT), hypersensitivity
Heparin RN implications IV or Sub Q, read labels, monitor for bleeding, low BP, high pulse, hypoxic, brusing, blood in urine et stool, pelvic pain, lumbar pain, HA et monitor APTT
Heparin is a __ ___ med. Should be verified c anonther RN. high alert
Heparin contraindications not for clients c liver or renal disease, thrombocytopenia post brain, eye, or spinal cord surgery or lumbar puncture
Heparin antidote Protamine Sulfate
LMWH (enoxaparin) prototype Lovenox
Lovenox action inactivate Xa
Lovenox indication prevent et tx of DVT, prevent ischemic complications in pt c unstable angina or non Q wave MI
Lovenox AE bleeding, thrombocytopenia, severe neuro injury including permanent paralysis (in a client undergoing a spinal puncture)
Lovenox RN implications no labs to monitor, can be used at home, high bio availability, longer half life
Warfarin prototype Coumadin
Coumadin action antagonist of Vit K
Coumadin indication prevent PE et venous thrombosis
Coumadin AE bleeding, fetal hemorrhage, enters breast milk
Coumadin RN implications PT/INR labs, teach s/s hemorrhage, medical alert bracelet, avoid ETOH, soft toothbrush, electric razor, tell other doctors of use
Coumadin antidote Vit K
What type of drug is prednisone? coritcosteroid
Prednisone prototypes medrol et solumedrol
Prednisone action short term use to suppress inflammation (adrenal gland)
prednisone indications RA, SLE, IBS, OA, tendonitis, gout, arthritis, bursitis, inflammatory disorders of eye, allergic conditions, asthmas, dermatologic disorders, neoplasms prevent respiratory distress
Prednisone AE F&E imbalance, retardation, peptic ulcer disease, myopathy, hyperglycemia, infection, osteoporosis, psychological disturbances
Prenisone RN implications avoid those c communicable disease, take c food, don't stop abruptly, rinse mouth, s/s of fluid retention, give in times of stress especially illnes, trauma or surgery
Regular Insulin onset time .5-1 hour
Regular Insulin peak time 5 hours
Lispro (Humalog) onset time 15-30 min
Lispro (Humalog) peak time .5-2.5 hours
Aspart (Novolog) onset time 10-20 min
Aspart Novolog peak time 1-3 hours
Neutral Protamine Hegedorn (NPH) Insulin onset time 1-2 hours
NPH insulint peak time 6-14 hours (8 hour peak test)
Insulin Glargine (Lantus) onset time 70 min
What type of drug is Glyburide? sulfonylureas
Glyburide action promote insulin secretion by pancreas, may increase tissue response to insulin
Glyburide indication diabetic
Glyburide AE hypoglycemia, avoid if pregnant, cautiong c liver or kidney disease
Glyburide RN implication take c food to avoid GI upset, teach s/s hypoglycemia, avoid ETOH
What type of drug is Dilantin? antiepileptic/anticonvulsant
Dilantin prototype Phenytoin
Dilantin action decrease mvmt of ions into nerve cells et ot alter neurotransmitter activity, increase GABA, prevent impulse spread of normal neurons
Dilantin indication epilepsy, some cardiac dysthrhythmias
Dilantin AE GINGIVAL HYPERPLASIA, ataxia, drowsiness, N/V, rash on skin
Dilantin RN implications avoid if pregnant, therapeutic range can be quick, monitor serum levels
Anticholinergic AE o dry mouth, tachycardia, palpitations, sedation, drowsiness, constipation, urinary retention, blurrd vision, photo phobia, excess CNS stimulant o can’t speak, can’t see, can’t shit, can’t piss
What type of drug is Isotinoin? acne medication
Isotinoin prototype Accutane
Accutane action decreases sebum production, sebaceous gland size, inflammation, keratinization and lowers # p. acnes
Accutane indication severe nodulocystic acne vulgaris
Accutane AE nose bleeds, inflammation: lips and eyes, skin dryness, itching, photosensitivity, depression
Accutane RN implication clients can’t get pregnant!
What type of drug is midazolam? Benzodiazepine (hypnotic/anti-anxiety/
midazolam prototype Versed
Versed action binds w/GABA receptor complex (does not mimic)
Versed indication insomnia, anxiety, seizures, pre opt sedation, ETOH withdraw, muscle spasms, panic disorder
Versed AE excessive sedation, hypotension, resp depression, impired physical and mental activities, abuse, aggression, hallucinations
Versed RN implications not to pregnant women, avoid ETOCH, watch for abuse and dependence, watch for S/S withdrawal: high anxiety, insomnia, sweating, tremors, dizziness, panic, paranoia, delirum, htn, convulsions
Versed antidote flumazenil (romazicon, mazicon)
What type of drug is propranolol? non-selective beta blocker et antiadrenergic
Propranolol prototype Inderal
Inderal action blocks beta 1 and beta 2 receptors preventing catecholamines and sympathomimetics from acting
Inderal indications HTN, angina, cardiac dysrhythmias, MI, Migraine HA, stage frigh
Inderal AE allergy, depression, hypoglycemia, bronchospasms, ortho hypotension, nasal congestion, inhibits ejaculation, reflex tachycardia
Inderal implications monitor heart rate, BP and respirations, teach client about S/S: or heart failure and postural hypotension, monitor for any drug interactions, ID any high risk clients, Caution use in diabetic clients
Inderal CONTRAINDICATED/CAUTIONED if client has heart failure, AV heart block, asthma, or sinus brady
What type of drug is methylphenidate? CNS stimulant
methylphenidate prototype Ritalin
Ritalin action facilitate initiation and transmission of nerve impulses that excite other cells
Ritalin indication ADHD and narcolepsy
Ritalin AE physical dependence, increased CNS stimulation: hyperactivity, nervousness and anxiety, GI effencts: anorexia, gastritis, weight loss. Monitor childrens growth charts. Psychosis, Cardiovascular: HTN, angina, dysrhythmias
Ritalin RN implication use smallest doses possible, do not crush or chew tablets, avoid taking late in day: 1st dose early am and last dose in late afternoon , minimize caffeine intake, call pcp if cardiovascular issues arise.
What type of drug is a cholinergic? Autonomic Nervous system parasympathetic drug
Name the three cholinergic drugs for various indications bethanechol (Urecholine)- urinary retention neostigme (Prostigmin) – slows break down of acetylcholine donepezil (Aricept)- alzheimers
UPA action promote action of acetylcholine (HR SLOWS,Increases resp secretions--causes bronchodialation,Increases saliva and GI secretions,Increase tone and contractility of GI smooth muscle, relax sphincter,Exocrine glands-decrease sensations,constrict pupils (mio
UPA indication open angle glaucoma, post op bowel obstruction, paralytic ileus, urinary retention, myasthenia gravis, Alzheimer’s, use for antidote of atropine and neuromuscular blocking agent
UPA AE (Too much stimulation) miosis, CNS: convulsions, dizziness, HA, drowsiness. Bronchospasms, increased resp secretions, dysrhythmias, hypotention, N/V/D, cramping, GI secretions
UPA RN implication urinary and bladder distention, check bowel sounds, assess for myasthenia gravis, Alzheimer’s, take as perscrbed, monitor for reaction to medication, make sure client knows about AE
What type of drug is an anticholinergic? autonomic nervouse system medication
Anticholinergic prototype Atropine
Atropine action BLOCKS. Prevents receptor activation by acetylcholine in high doses it can block nicotinic receptors
Other actions of atropine (focused) •Heart Rate- increases •Smooth muscle: bronchodialation, decrease tone and mobility of GI tract, decrease tone of urinary bladder detrusor •Exocrine glands-decrease sensations •Eye: dilate pupils •CNS: excite
Atropine indication preanesthesia medication-dry secretions, dilate eye before eye surgery, bradycardia, intestinal hypertonicity and hypermobility, Parkinson’s disease (decrease salivation and tremors) emphysema ad asthma: reverse bronchospasms
Atropine AE dry mouth, blurred vision , photophobia, increases inter optical pressure, urinary retention, constipation, tachycardia, anhiaiosis-absence of sweat
Atropine RN implication Client to wear dark glasses in strong light, sugar free gum or candy, oral hygiene, caution against blurry vision, prevent constipation by fibers and fluid intake, minimize risk for heart exhaustion, tell client to void prior to taking med.
Atropine antidote cholinergic agent
What is an adrenergic agent? ANS medication
Adrenergic prototypes Albuterol et Epinephrine
Epi et albuterol actio stimulate cell function
Epi et Albuterol indication taken orally
Epi et albuterol AE HTN, necrosis-bad blood flow, bradycardia
Epi et Albuterol RN implication not for IV use, monitor EKG, BP and pulse
What type of drug is Epoetin Alfa? hematopoietic agent
Epoetin Alfa prototype Epogen
Epogen action stimulate RBC production
Epogen indication anemia, renal failure, HIV
Epogen AE HTN
Epogen RN implication general nutrition, ADL`s and coping, know baseline labs: CBC and diff, platelets, high risk for infection: hand washing, sterile technique, isolation if Neutrophils are less than 500, personal hygiene
What type of drugs are Interferon Alfa, Aldesleukin? immunouppresants
Interferon Alfa, aldesleukin prototype interleukin-2
Interferon Alfa action enhance host immune response and reduce proliferation of cancer cells
Interferon Alfa indication oHairy cell leukemia, malignant melanomas, AIDS related Kaposi sarcoma
Interferon Alfa RN diagnosis/implicaion Infection, Bleeding, nutrition less than body requires (wt loss), altered sleep an exercise, ineffective coping
What type of drug is Imuran? immunosuppresant
Imuran action act on helper t lymphocytes to suppress production of immune response components resulting in the suppression of the proliferation of B cells and cytotoxic T cells
Imuran indication autoimmune disorder TX: RA. Lupus, myasthenia gravis, early stages or type 1 diabetes. Prevent organ rejection in transplant clients. LIFELONG if these are taken due to organ transplant
Imuran Rn Diagnosis infection, fluid imbalances, bleeding, nutrition less than body requires, ineffective coping
What type of drug is albuterol? Beta 2 Adrenergic Agonist
Albuterol action selectively activates beta 2 receptor in bronchial smooth muscle resulting in bronchodialation
Albuterol indication prevent asthma, TX of asthma, Long term control of asthma
Albuterol AE tachycardia, angina, tremors
Albuterol RN implication teach clients proper dosing and to take as directed, observe for SS of impending asthma attacks and keep a log of attacks in a journal, contact PCP if there is an increase in frequency of attacks
What type of drug are Metoprolol & Propranolol? Beta adrenergic blockers
Metoprolol prototype Lopressor
Lopressor action block beta 1 adrenergics in the myocardium and in the electrical conduction of the heart Slows heart rate, lowers myocardial contractility and lowers rate of conduction through AV node
Lopressor indication angina pectoris, HTN, dysrhythmias, MI, heart failure
Lopressor AE bradycardia, lower cardiac output, AV block, orthostatic hypotension, rebound myocardium excitation, bronchoconstriction, inhibited glycogenolysis
Lopressor RN implication Monitor clients vitial signs, hold if pulse is below 60beats/min, use cautiously in pt with diabetes, teach s/s of heart failure and orthostatic hypotension, take as directed, do not stop abruptly
What type of drug are Psyllium (Metamucil) Docusate sodium (Colace), Bisacodyl, (dulcolax), Milk of Magnesia (magnesium hydroxide)? Laxatives
Docusate sodium prototype colace
Colace action soften fecal mass ins increase bulk, allow water to penetrate to soften stool, intestinal peristalsis, osmotic laxative-draw h2o into intestine to increase mass of stool to stimulate peristalsis
Colace indication decrease diarrhea (IBS and diverticulosis) control stool amt foe pt with colostomy, promote deification in elderly, constipation, prevent straining (post surgery) post diagnostic procedure (colonoscopy)
Colace AE Gi Irritation, dehydration, rectal burning, sodium absorption and fluid retention
Colace RN implication do not crush or chew tablet, do not use a suppository on a daily basis,monitor I and O`s, SS of dehydration, encourage fluids
Laxative concerns for renal patient... read labels carefully avoid laxative if it contains magnesium
Laxative concerns for heart patient... read labels carefully avoid laxative if it contains sodium
What type of drug is Acetylcysteine? mucolytic
Acetylcysteine prototype Mucomyst
Mucomyst action enhances flow of secretions in resp passages
mucomyst indication acute and chronic pulmonary disorders, cystic fibrosis, antidote for acetaminophen poisoning
mucomyst AE aspiration et bronchospasm
mucomyst RN implication smells like rotten eggs, dilute med in juice, teach that med makes nasal and bronchial secretions watery and will make them cough, suction equipment if inpatient
What type of drug is loratadine? anti-histamine
Loratadine prototype Claritin
Claritin action block histamine release in small blood vessels and nerves during allergic reaction
claritin indication allergic reaction, anaphylaxis, motion sickness, insomnia
Claritin AE sedation, dry mouth, constipation, GI: N/V
claritin RN implication take med at night, avoid ETOH and driving, take with h20, increase fluids, call pcp if symptoms continue.
Claritin toxicity flushed face, high fever, tachycardia, urinary retention, seizures, hallucinations
What type of drugs are (zocor) Simvastatin, (mevacor) lovastatin, (crestor) tosuvastatin? anti-hyperlipidemia
Tosuvastatin prototype crestor
Crestor action lower LDL, increase HDL, promote vasodilatation, decrease plaque site inflammation, decrease risk of thromboembolism
Crestor indication o hypercholesterolemia, prevent coronary events, protect against MI`s and strokes for pt w/diabetes, raise HDL levels
Crestor AE hepatotoxity, Myopathy, peripheral neuropathy
Crestor RN implications take with meals, monitor liver functions, avoid ETOH, monitor for muscle aches and pains, avoid grapefruit, monitor CK, and liver functions
What type of drug is Hydrocholorothiazide? Thiazide diuretic
HCTZ action blocks reabsorption of Na and Cl in early segment of distal convoluted tubule
HCTZ indication HTN et Edema
HCTZ AE Dehydration, HYPOKALEMIA, hypotension, hyperglycemia, hyperuricemia, hyponatremia, hypochloremia Fetal harm (avoid if breast feeding)
HCTZ RN implication Administer in am,Monitor K levels, Teach s/s of hypokalemia,Weigh daily,Teach about postural hypotension
Created by: melissaaclark
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