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Pharmacology Try 2 > Administration > Flashcards

Administration Flashcards

1
Q

ACE Inhibitors

A
  • monitor potassium levels if taking diuretic

- administer epinephrine for angioedema

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2
Q

ARB Inhibitors

A

-monitor potassium levels if taking diuretic

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3
Q

Calcium Channel Blockers

A
  • use caution with digoxin and beta blockers
  • contraindicated in heart failure, heart block, bradycardia
  • do not consume grapefruit juice
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4
Q

Alpha Adrenergic Blockers

A
  • monitor heart rate and blood pressure

- take at bedtime to minimize effects of hypotension

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5
Q

Centrally Acting Alpha 2 Agonists

A
  • monitor CBC
  • monitor heart rate and blood pressure
  • monitor for weight gain, edema
  • do not skip dose
  • take at bedtime to minimize effects of hypotension
  • contraindicated with anticoagulants and liver failure
  • use caution in CVA, MI, diabetes mellitus, major depression, chronic renal failure
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6
Q

Beta Adrenergic Blockers

A
  • hold medication if SBP less than 100 mmHg or pulse less than 60 bpm
  • monitor diabetic patients for hypoglycemia
  • contraindicated in heart block or bradycardia
  • do not administer nonselective beta blockers to clients with asthma
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7
Q

Vasodilators

A
  • protect from light
  • continuous heart rate and blood pressure monitoring
  • use caution with hepatic or renal disease
  • use caution in electrolyte imbalances
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8
Q

Digoxin

A
  • assess apical pulse for 1 min prior to administration and notify provider if less than 60 bpm
  • maintain therapeutic digoxin level (0.8-2 ng/mL)
  • monitor for signs of digoxin toxicity
  • monitor for hypokalemia and hypomagnesemia which may precipitate digoxin toxicity
  • digoxin immune FAB for toxicity
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9
Q

Nitrates/Nitroglycerine

A

sublingual: at chest pain administer tablet and rest for 5 min, if pain not relieved take second tablet and call 911, if pain still not relieved may take up 3rd tablet; keep covered and replace every 6 months; may use prophylactically before exercise; erectile dysfunction drugs cause life threatening hypotension; wear patch 12-14 hr then remove

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10
Q

Adenosine

A

rapid IV push (1-2 seconds) close to body, flush with normal saline

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11
Q

Amiodarone

A
  • incompatible with heparin
  • may be given PO for maintenance dose
  • monitor for respiratory depression
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12
Q

Atropine

A

-when used for life-threatening emergency, has no complications

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13
Q

Statins

A
  • do not administer with grapefruit juice
  • multiple drug interactions
  • take in the evening when cholesterol synthesis increases
  • monitor liver and renal function labs
  • low fat and high fiber diet
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14
Q

Cholesterol Absorption Inhibitor

A
  • take in the evening when cholesterol synthesis increases
  • monitor liver and renal function labs
  • low fat and high fiber diet
  • take 2 hr before or 4 hr after antilipemics
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15
Q

Beta 2 Adrenergic Agonists

A

beta blockers will reduce effects

-contraindicated with tachydysrhythmias

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16
Q

Methylxanthines

A
  • monitor therapeutic levels (10-20 mcg/mL)
  • avoid caffeine intake
  • monitor for toxicity
  • activated charcoal for toxicity
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17
Q

Inhaled Anticholinergics

A
  • maximum effects may take up to two weeks
  • do not use for treatment of acute bronchospasms
  • contraindicated for peanut allergy
  • use extreme caution with narrow angle glaucoma and BPH
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18
Q

Glucocorticoids

A
  • diabetic clients may require higher doses
  • administer with meals
  • do not discontinue abruptly
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19
Q

Leukotriene Modifiers

A
  • do not use for acute asthma attack
  • take daily in the evening
  • take packets within 15 minutes of opening
  • do not mix oral granules with liquids
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20
Q

Antitussives

A
  • monitor characteristics of cough and lung sounds

- promote fluid intake

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21
Q

Expectorants

A
  • monitor characteristics of cough and lung sounds

- promote fluid intake

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22
Q

Mucolytics

A
  • monitor characteristics of cough and lung sounds

- promote fluid intake

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23
Q

Decongestants

A
  • monitor blood pressure
  • take at night
  • assess for hypokalemia
  • teach management of anticholinergic effects
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24
Q

Antihistamines

A
  • monitor blood pressure
  • take at night
  • assess for hypokalemia
  • teach management of anticholinergic effects
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25
Q

Alpha Glucosidase Inhibitors

A

-contraindicated in intestinal disease due to gas formation

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26
Q

Biguanides

A
  • hold 48 hr before/after contrast media

- contrindicated with severe infection, shock, hypoxic conditions

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27
Q

Gliptins

A

-use caution with impaired renal function

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28
Q

Meglitinides

A
  • short acting
  • administer before each meal
  • risk of hypoglycemia
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29
Q

Sulfonylureas

A
  • extreme high risk of hypoglycemia in renal, hepatic, adrenal disorders
  • can cause disulfiram like reaction with alcohol injestion
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30
Q

Thiazolidinediones

A

-exacerbate heart failure

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31
Q

Short Acting Insulin

A

-only regular insulin is given IV

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32
Q

Intermediate Acting Insulin

A

when mixing regular and NPH, draw up regular first (cloudy before clear, clear before cloudy)

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33
Q

Long Acting Insulin

A

-administer at bedtime

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34
Q

Glucagon

A
  • administer for unresponsive client

- monitor blood glucose levels

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35
Q

Levothyroxine

A
  • overmedication can result in signs of hyperthyroidism
  • initate therapy with low doses
  • take in early morning
  • monitor tyroid levels and cardiac system
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36
Q

Methimaxole

A
  • administer with food at the same time each day
  • drink 3L of fluid
  • avoid products containing iodine
  • monitor for signs of hypothyroid
  • discontinue prior to radioactive iodine reuptake testing
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37
Q

Somatropin

A
  • monitor growth patterns and administer individualized dose
  • discontinue prior to epiphyseal closure
  • administer subcutaneously
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38
Q

Desmopressin and Vasopressin

A
  • monitor urine output, specific gravity, blood pressure
  • prevent hyponatremia due to water intoxication
  • education regarding nasal spray administration
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39
Q

Epoetin Alpha

A

monitor Hct and Hgb, do not agitate vial, subcutaneous or IV administration

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40
Q

Filgrastim and Pegfilgrastim

A

monitor CBC

  • do not agitate vial
  • subcutaneous or IV administration
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41
Q

Oprelvekin

A
  • administer within 6 to 24 hr after chemotherapy

- subcutaneous administration

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42
Q

Iron Preparations

A
  • dilute liquid preparations with juice or water and administer with plastic straw or syringe to avoid staining teeth
  • encourage vitamin C intake to increase absorption
  • avoid antacids, coffee, tea, dairy, whole grains which decrease absorbtion
  • use z-track for IM injections and do not use deltoid muscle
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43
Q

Anticoagulants

A
  • administer subcutaneous, IV, oral depending on medication
  • avoid NSAIDS, aspirin, or other medications which increase bleeding
  • pregnancy category X
  • contraindications include thrombocytopenia and vitamin K deficiency
  • monitor aPTT/PT/INR
  • protamine sulfate for heparin toxicity and vitamin K for warfarin toxicity
  • bleeding precautions
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44
Q

Antiplatelets

A
  • monitor for bleeding
  • contraindicated in thrombocytopenia
  • use caution with peptic ulcer disease
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45
Q

Thrombolytics

A
  • administration must take place within 4-6 hr of symptom onset
  • continuous monitoring is required
  • clients will begin anticoagulation therapy to prevent repeat thrombotic event
  • contraindicated for intracranial hemorrhage, active bleeding, aortic dissection
  • use caution with severe hypertension
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46
Q

Antacids

A

prolonged use can cause hypophosphatemia, can decrease medication absorption –> take other medications 1 hr before or after, renal impairment should only use aluminum based preparations, do not self prescribe for longer than 2 weeks

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47
Q

Proton Pump Inhibitors

A
  • give prior to eating
  • use caution in COPD
  • seek appropriate care over OTC preparations
  • do not crush/chew/break tablets
  • notify provider of signs of GI bleeding
  • modify diet as prescribed
48
Q

Histamine 2 Receptor Antagonists

A
  • give prior to eating
  • use caution in COPD
  • seek appropriate care over OTC preparations
  • do not crush/chew/break tablets
  • notify provider of signs of GI bleeding
  • modify diet as prescribed
49
Q

Sucralfate

A
  • administer on empty stomach at least 1 hr before meals

- do not administer within 30 min of antacids

50
Q

Promethazine

A
  • monitor vital signs
  • institute safety precautions
  • give IM with large needle
51
Q

Metoclopramide

A
  • instruct client about rapid GI emptying

- discontinue if signs of EPS

52
Q

Ondansetron

A
  • risk for dysrhythmia

- do not administer if prolonged QT interval

53
Q

Scopolamine

A
  • apply transdermal patches behind the ear

- use lubricating eye drops

54
Q

Antidiarrheals

A
  • monitor fluids and electrolytes
  • avoid caffeine intake which increases GI motility
  • increased risk for megacolon for clients who have IBS
  • preparations may contain opioids
55
Q

Stool Softeners

A
  • contraindicated with fecal impaction, bowel obstruction, acute surgical abodomen
  • encourage regular exercise and promote regular bowel elimination
  • monitor for chronic use/abuse
  • provide adequeate fluid and fiber intake
  • contraindicated with ulcerative colitis and diverticulitis
56
Q

Loop Diuretics

A
  • monitor I/Os and fluid/electrolytes
  • monitor vitals
  • administer in morning to prevent nocturia
  • consume foods high in potassium
  • use caution in diabetes mellitus
  • contraindicated in pregnancy
  • NSAIDs reduce diuretic effect
57
Q

Thiazide Diuretics

A
  • monitor I/Os and fluid/electrolytes
  • monitor vitals
  • administer in morning to prevent nocturia
  • consume foods high in potassium
  • use caution in diabetes mellitus
  • contraindicated in pregnancy
  • NSAIDs reduce diuretic effect
58
Q

Potassium Sparing Diuretics

A
  • monitor I/Os and fluid/electrolytes
  • monitor vitals
  • administer in morning to prevent nocturia
  • avoid foods high in potassium and salt substitutes
  • use caution in diabetes mellitus
  • contraindicated in pregnancy
  • NSAIDs reduce diuretic effect
59
Q

Osmotic Diuretics

A
  • monitor I/Os and fluid/electrolytes
  • monitor daily weight
  • monitor for signs of hypovolemia
  • monitor neurological status
  • use caution with heart failure
60
Q

-Alpha Adrenergic Blockers for Urinary Hesitancy

A
  • must rule out bladder cancer prior to administration
  • contraindicated with urinary tract obstruction
  • contraindicated with hypotension or decreased cardiac output
  • take at the same time every day
  • do not take with food
  • if dose is missed for several days restart on the lowest dose
  • can cause orthostatic hypotension
61
Q

Anticholinergic Medications for Overactive Bladder

A
  • do not use with intestinal obstruction
  • use with caution with other anticholinergics
  • report constipation lasting longer than 3 days
  • monitor for anticholinergic effects
62
Q

Erectile Dysfunction Medication

A
  • contraindicated if taking nitrage drugs
  • contraindicated in history of a stroke, uncontrolled diabetes mellitus, hypo or hyper tension, heart failure
  • administer 1 hr before sexual activity
  • do not use more than once daily
  • stop taking medication and notify provider of erection lasting more than 4 hr or vision loss
63
Q

Aminoglycosides

A

-risk of ototoxicity and nephrotoxicity
monitor creatinine, BUN
-monitor trough levels

64
Q

Cephalosporins

A
  • cross sensitivity with penicillins

- monitor for signs of C. difficile

65
Q

Fluoroquinolones

A

use caution with hepatic, renal, or seizure disorder

66
Q

Macrolides

A
  • used for clients with penicillin allergy

- administer with meals

67
Q

Nitrofurantoin

A
  • broad spectrum
  • contraindicated in renal dysfunction
  • urine will have brown discoloration
68
Q

Penicillins

A

hypersensitivity with possible anaphylaxis

69
Q

Sulfonamides

A
  • consume at least 3 liters/day of fluid
  • use back up contraception
  • avoid sun exposure
70
Q

Tetracyclines

A
  • consume at least 3 liters/day of fluid
  • use back up contraception
  • avoid sun exposure
  • permanent tooth discoloration if given to children younger than 8 years
71
Q

Glycopeptide

A

contraindicated in corn allergy, can cause ototoxicity and nephrotoxicity, administer over 1 hr IV to prevent red man syndrome, monitor trough levels

72
Q

Antifungal

A
  • monitor hepatic and renal function
  • refrigerate suspensions
  • increased risk of bleeding for clients taking anticoagulants
73
Q

Antimalaria

A
  • increased risk of psoriasis

- monitor for drug induced retinopathy

74
Q

Antiprotozoal

A
  • take with food

- do not consume alcohol during therapy or 48hr after completing regimen

75
Q

Antitubercular

A
  • risk of neuropathy and hepatotoxicity
  • consume foods high in vitamin B6
  • avoid foods with tyramine
  • increased risk of phenytoin toxicity
  • avoid alcohol
  • red discoloration of body fluid
  • breaks down disposable plastic contact lenses
76
Q

Antiretroviral

A
  • administer with food
  • increase fluid intake
  • begin therapy with first onset of symptoms
77
Q

Bisphosphonates

A
  • contraindicated during lactation
  • use caution with esophageal stricture or difficulty swallowing
  • absorption is decreased when taken with calcium supplements, antacids, orange juice, caffeine
  • administer in the morning on an empty stomach with water and remain upright for 30 min following administration
  • consume adequate amounts of vitamin D
78
Q

Disease-Modifying Antirheumatic Drugs

A
  • contraindicated in pregnancy, kidney failure, liver failure, psoriasis, alcohol use disorder, hematological disease
  • instruct client about measures to prevent infection, monitor liver function
  • use reliable contraception
  • may take 3-6 weeks for initial effects and up to 6 months for full effects
  • administer with food
  • regular eye exams with hydroxychloroquine
79
Q

Antigout

A
  • avoid foods high in purines to reduce uric acid
  • monitor CBC and uric acid levels
  • avoid aspirin
  • administer with meals
  • use caution with renal, cardiac, or GI dysfunction
80
Q

Antianxiety

A
  • use caution with substance use disorder and liver disease
  • monitor vital signs
  • do not abruptly discontinue medication
  • monitor for adverse effects
  • instruct cleints to avoid alcohol
81
Q

Selective Serotonin Reuptake Inhibitors

A
  • avoid alcohol
  • do not discontinue abruptly
  • monitor for serotonin syndrome (agitation, confusion, hallucinations) within the first 72 hrs
82
Q

Serotonin and Norepinephrine Reuptake Inhibitor

A
  • avoid alcohol
  • do not discontinue abruptly
  • monitor for serotonin syndrome (agitation, confusion, hallucinations) within the first 72 hrs
83
Q

<p>Tricyclic Antidepressants</p>

A

<p>-do not administer with MAOIs or St. John's wort

- must avoid alcohol
- contraindicated for clients with seizure disorders</p>

84
Q

<p>Mono-Amine Oxidase Inhibitors</p>

A

<p>-CNS stimulation

- orthostatic hypotension
- hypertensive crisis with intake of tyramine, SSRI, tricyclics
- 2 weeks separation between MAOI and other antidepressants to avoid serotonin syndrome</p>

85
Q

Lithium

A

use caution with renal dysfunction/heart disease/hyponatremia/dehydration, monitor sodium levels, NSAIDs will increase lithium levels, monitor therapeutic (0.4-1.4 mEq/L), therapeutic effects take 7-14 days, administer with food to decrease GI distress

86
Q

<p>Typical Antipsychotics</p>

A

<p>-contraindicated in severe depression, Parkinson's, seizure disorder

- monitor for side effects within 5 hr to 5 days of administration
- monitor CBC
- encourage fluids
- stop medications if signs of neuroleptic malignant syndrome</p>

87
Q

<p>Atypical Antipsychotics</p>

A

<p>-contraindicated in severe depression, Parkinson's, seizure disorder

- monitor for side effects within 5 hr to 5 days of administration
- monitor CBC
- encourage fluids
- stop medications if signs of neuroleptic malignant syndrome</p>

88
Q

<p>ADHD Stimulants</p>

A

<p>-administer in early morning

- give with or after meals
- do not abruptly discontinue
- monitor for signs of abuse
- monitor for signs of agitation
- consider medication holidays</p>

89
Q

<p>ADHD Nonstimulants</p>

A

<p>-take medication daily

- do not crush or chew
- instruct client to immediately report worsening anxiety or agitation
- do not take with MAOIs</p>

90
Q

<p>Benzodiazepines</p>

A

<p>-use cautiously in clients with severe depression

- avoid use with alcohol or other CNS depressants
- take immediately before bedtime as medication causes sleepiness
- may cause sleep activities without recall</p>

91
Q

<p>Disulfiram</p>

A

<p>-ingestion of large amounts of alcohol may cause respiratory depression, dysrhythmias, cardiac arrest

- must wait 12 hrs between time of last alcohol intake and starting medication
- consumption of alcohol causes flushing, throbbing head and neck, nausea/vomiting, sweating, chest pain, palpitations, dyspnea, hyperventilation, tachycardia, hypotension, syncope, blurred vision, confusion
- undesirable effects last 30 minutes to several hours following alcohol consumption
- may stay in the body several weeks after discontinuing therapy
- therapy may last months to years</p>

92
Q

Methadone

A

do not use with severe asthma/chronic respiratory disease/history of head injury, avoid in clients with QT syndrome, monitor for signs of drug tolerance and psychological dependence, monitor for respiratory depression, discontinue medication slowly, monitor through treatment center

93
Q

<p>Cholinesterase Inhibitors</p>

A

<p>-do not administer if pulse less than 60 bpm

- dose must be individualized
- monitor for cholinergic crisis</p>

94
Q

<p>Anti-Parkinson's Medications</p>

A

<p>-do not use levodopa within 2 weeks of MAOI use

- vitamin B6 decreses effects of levodopa
- discontinue 6-8 hr before anesthesia
- notify providers if effects of medication is suddenly lost
- 4-6 weeks for full effects
- monitor for signs of adverse reactions
- avoid high protein meals and snacks
- keep medication from heat, light, moisture
- if pills become darkened they have lost potency and must be discarded</p>

95
Q

<p>Anticonvulsants</p>

A

<p>-monitor for therapeutic effects

- monitor phenytoin for toxic effects and serum levels (10-20 mcg/mL)
- enforce medication compliance
- treatment for status epilepticus: diazepam/lorazepam IV push followed by IV phenytoin or fosphenytoin</p>

96
Q

<p>Antiglaucoma</p>

A

<p>-use caution in clients taking oral beta blocker or calcium channel blocker

- use sterile technique when handling applicator
- hold pressure to nasolacrimal duct for 30-60 seconds to prevent systemic effects
- monitor pulse rate and rhythm</p>

97
Q

<p>Nonsteroidal Anti-inflamatory drugs</p>

A

<p>-administer with food and full glass of water

- avoid lying down for 30 min after administration
- monitor for GI ulceration
- instruct client to use sunscreen</p>

98
Q

<p>Acetaminophen</p>

A

<p>-use caution in clients who consume 3+ alcoholic beverages a day

- monitor liver and kidney function
- be aware of OTC sources of acetaminophen
- take as prescribed and do not exceed 4,000 mg/24 hrs
- treat overdose with acetylcysteine</p>

99
Q

<p>Opioid Analgesics</p>

A

<p>-monitored for potentiation of effects with other CNS depressants

- monitor vitals
- monitor for respiratory depression
- administer naloxone for respiratory depression/overdose
- monitor for constipation or urinary retention</p>

100
Q

<p>Cervical Ripening Drugs</p>

A

<p>-contraindicated in clients with acute PID, history of pelvic surgery, abnormal fetal position

- maintain bedrest for at least 2 hr after insertion
- monitor maternal vital signs and fetal heart rate
- monitor for uterine contractions
- oxytocin augmentation might be needed</p>

101
Q

<p>Oxytocin</p>

A

<p>-contraindicated with placental abnormalities, fetal malpresentation, previous uterine surgery, fetal distress

- require Bishop Score of 6 or greater when planning induction
- administer as secondary infusion via IV pump
- continuously monitor uterine contractions and fetal heart rate
- discontinue if maternal or fetal distress or uterine hyperstimulation
- administered oxygen via face mask 10 L for signs of hyperstimulation
- monitor for uterine bleeding when used postpartum</p>

102
Q

<p>Methylergonovine</p>

A

<p>-continuously monitor blood pressure

| -assess uterine bleeding and uterine tone</p>

103
Q

<p>Terbutaline</p>

A

<p>-monitor contractions and fetal heart tones

- monitor vital signs
- do not administer if pulse rate greater than 130 bpm or chest pain
- administer beta blocking agent as antidote</p>

104
Q

<p>Nifedipine</p>

A

<p>-monitor blood pressure

- avoid concurrent use with magnesium sulfate
- monitor contractions and fetal heart tones
- prevent hypotension complications</p>

105
Q

<p>Magnesium Sulfate</p>

A

<p>-monitor vital signs and deep tendon reflexes

- monitor magnesium levels (therapeutic range 4-8 mg/dL)
- administer via infusion pump in diluted form
- use indwelling catheter to monitor urinary elimination
- calcium gluconate for signs of toxicity</p>

106
Q

<p>Betamethasone</p>

A

<p>-administer two IM doses 24 hr apart if premature delivery is expected
-provide emotional support to the family</p>

107
Q

<p>Saw Palmetto</p>

A

<p>-allow 4-6 weeks for effects

- additive effect with anticoagulants
- discontinue prior to surgery</p>

108
Q

<p>Valerian Root</p>

A

<p>-additive effects with barbiturates and benzodiazepines

- advise against driving or operating heavy machinery
- advise against longterm use
- discontinue at least 1 week prior to surgery</p>

109
Q

<p>St. John's Wort</p>

A

<p>-interacts with many medications including: oral contraceptives, cyclosporine, warfarin, digoxin, calcium channel blockers, antidepressants

- do not use to treat severe depression
- use with medical guidance</p>

110
Q

<p>Echinacea</p>

A

<p>-long term use may cause immunosuppression</p>

111
Q

<p>Garlic</p>

A

<p>-contact provider if taking antiplatelet or anticoagulant medications, cyclosporine, or saquinavir
-monitor for bleeding precautions</p>

112
Q

<p>Ginger Root</p>

A

<p>-use caution in pregnancy as high doses can stimulate uterine contractions

- interacts with medications that cause anticoagulation
- can increase hypoglycemia effects in diabetes</p>

113
Q

<p>Ginkgo</p>

A

<p>-may increase effects of MAOIs, anticoagulants, antiplatelets

- discontinue 2 weeks prior to surgery
- overdose may cause seizures</p>

114
Q

Glucosamine

A

may increase resistance to antidiabetic agents and insulin, may increase risk of bleeding, use caution with shellfish allergy, frequent glucose monitoring in diabetes mellitus, often used in combination with chondroitin, allow extended time to see effects

115
Q

<p>Omega-3 fatty acids</p>

A

<p>-may increase risk of vitamin A or D overdose

- found in fish oils, nuts, vegetable oils
- some fish contain methymercury and polychlorinated biphenyls that can be harmful in large amounts especially in pregnancy and lactation</p>

116
Q

<p>Melatonin</p>

A

<p>-do not use in pregnancy or lactation</p>

Pharmacology Try 2 (6 decks)

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