ATI (chp 5) Flashcards
adverse effects on CNS
excitement or depression
If CNS stimulation is expected, clients may be at risk
for seizures, and precautions should be taken.
› If CNS depression is likely, advise clients not to
drive or participate in other activities that can
be dangerous.
EPS
Extrapyramidal symptoms (EPS) (abnormal
body movements) may include involuntary
fine-motor tremors, rigidity, uncontrollable
restlessness, and acute dystonias (spastic
movements and/or muscle rigidity affecting the
head, neck, eyes, facial area, and limbs). These
may occur within a few hours or may take
months to develop.
-more common in mental health disorders that affect CNS
Anticholinergic effects
result of muscarinic receptor blockade. Most
effects are seen in the eyes, smooth muscle,
exocrine glands, and the heart.
NSAIDs
Nonsteroidal anti-inflammatory drugs aspirin ibuprofin naproxen -can cause GI upset
Hematologic effects
Bone marrow depression/suppression is generally
associated with anticancer medications and
hemorrhagic disorders with anticoagulants and
thrombolytics. Educate clients taking anticoagulants
about bleeding (bruising, discolored urine/stool,
petechiae, bleeding gums).
Nephrotoxicity
Nephrotoxicity may occur with a number of
medications, but it is primarily the result of
certain antimicrobial agents and NSAIDs.
Damage to the kidneys may interfere with
medication excretion, leading to medication
accumulation and adverse effects.
Nursing intervention for nephrotoxicity
Aminoglycosides injure cells in the renal tubules of
the kidney. Monitor serum creatinine and BUN, as
well as peak and trough medication levels for clients
taking medication that is nephrotoxic.
Drug that may be used to minimize liver damage when toxicity occurs
acetylcysteine
diphenhydramine
used to treat allergic reactions
diphenhydramine
How would you treat an Anaphylactic reaction?
Treat with epinephrine, bronchodilators, and
antihistamines
Immunosuppression
decreased or absent immune response
example: glucocorticoids
-can mask the usual manifestations of
infection, such as fever
Example of increased therapeutic effects using drug-drug interaction with albuterol (proventil) for asthma
albuterol (Proventil), a beta2
-adrenergic
agonist inhaler, 5 min prior to using triamcinolone acetonide (Azmacort), a
glucocorticoid inhaler, to increase the absorption of triamcinolone acetonide.
How do diazepam and hydrocodone bitartrate interact together?
Adverse effect:
Diazepam (Valium) and hydrocodone bitartrate 5 mg/acetaminophen 500 mg
(Vicodin) both have CNS depressant effects. When these medications are used
together, clients have an increased risk for CNS depression.
Ondansetron hydrochloride
Zofran - often given to decrease the side effects of primary drug. In this case, decrease nausea from chemotherapy
If a medication can decrease the metabolism of a second medication then what is happening to the serum levels of the second medication
increase the serum level of the second medication, which can lead to toxicity
Fluconazole
(Diflucan) inhibits hepatic medication-metabolizing enzymes
OTC Antiacids
Antiacids relieve heartburn from stomach acid.
antacids can interfere with the absorption of ranitidine (Zantac) and other medications.
Consuming foods with tyramine
otentially spoiled or pickled, aged, smoked, fermented, or marinated (some fish, poultry, and beef); most pork (except cured ham); chocolate; alcoholic beverages; and fermented foods, such as most cheeses (except ricotta, cottage, cream and Neufchâtel cheeses), sour cream, yogurt, shrimp paste, soy sauce, soybean condiments, teriyaki sauce, tempeh, miso soup, sauerkraut, kimchi, broad (fava) beans, green bean pods, Italian flat (Romano) beans, snow peas, edamame, avocados, bananas, pineapple, eggplants, figs, red plums, raspberries, peanuts, Brazil nuts, coconuts, processed meat, yeast, and an array of cacti.
Consuming foods with tyramine while taking _______________ drugs can lead to hypertensive crisis (high BP w/ acute impairment of 1+ organ system)
monoamine oxidase inhibitors (MAOIs)
Warfarin
(Coumadin)
anticoagulant (blood thinner). It reduces the formation of blood clots.
Warfarin is used to prevent heart attacks, strokes
Pregnancy X category
What vitamin should you avoid while taking warfarin?
Vitamin K to avoid blood clots
Tetracycline
Tetracycline is an antibiotic used to treat bacterial infections such as urinary tract infections, chlamydia and acne
What type of food should you avoid within 2 hours of taking tetracycline?
dairy products or chelating agents
Grapefruit juice
inhibits medication metabolism in the small bowel, thus increasing the amount of medication available for absorption of certain oral medications.
Precautions to avoid when giving Morphine (Duramorph)
depresses respiratory function, so it should be used with caution for
clients who have asthma or impaired respiratory function.
Category A
There is no evidence of risk to fetus during pregnancy based on adequate and
well-controlled studies.
Adverse effects have been demonstrated on animal and human fetuses based on
studies and data from investigational or marketing experience. The use of the medication is
contraindicated during pregnancy because the risks outweigh the potential benefits.
Category X
Category D
Adverse effects have been demonstrated on human fetuses based on data from
investigational or marketing experience, but use of the medication during pregnancy may be warranted based on the potential benefits.
Category B
There is no evidence of risk to animal fetuses based on studies, but there are no
adequate and well-controlled studies in pregnant women.
Category C
Adverse effects have been demonstrated on animal fetuses. There are no adequate and
well-controlled studies in pregnant women, but use of the medication during pregnancy may be
warranted based on the potential benefits.
Glucocorticoid (GC)
GCs are part of the feedback mechanism in the immune system that turns immune activity (inflammation) down. They are therefore used in medicine to treat diseases caused by an overactive immune system, such as allergies, asthma, autoimmune diseases, and sepsis.
Prescribing glucocorticoid when there is a fungal infection is an example of _______
Contraindication
Acetaminophen is contraindicated in people with ___________________
liver disorder
Orthostatic hypotension is a common adverse effect in ______________ medication
antihypertensive medications
orthostatic hypotension
postural hypotension — is a form of low blood pressure that happens when you stand up from sitting or lying down.
extrapyramidal effects are ______ disorders
movement disorders – affect CNS
Oxycodone and ibprufin
increase pain-relieving effects. Oxycodone is a narcotic analgesic, and ibuprofen is an NSAID. They work by
different mechanisms, but pain is better relieved when they are taken together
naproxen
aleve
-Naproxen and other NSAIDs may cause renal insufficiency
Antibiotic that can injure cells of the proximal renal tubules
getamicin
BUN test
A common blood test, the blood urea nitrogen (BUN) test reveals important information about how well your kidneys and liver are working. A BUN test measures the amount of urea nitrogen that’s in your blood.
Here’s how your body typically forms and gets rid of urea nitrogen:
Your liver produces ammonia — which contains nitrogen — after it breaks down proteins used by your body’s cells.
The nitrogen combines with other elements, such as carbon, hydrogen and oxygen, to form urea, which is a chemical waste product.
The urea travels from your liver to your kidneys through your bloodstream.
Healthy kidneys filter urea and remove other waste products from your blood.
The filtered waste products leave your body through urine.
Serum Creatinine Test
A creatinine test reveals important information about your kidneys.
Creatinine is a chemical waste product that’s produced by your muscle metabolism and to a smaller extent by eating meat. Healthy kidneys filter creatinine and other waste products from your blood. The filtered waste products leave your body in your urine.
If your kidneys aren’t functioning properly, an increased level of creatinine may accumulate in your blood.
Specific gravity of urine
Urine SG can be used to assess the kidney’s ability to concentrate or dilute urine. However, because protein, glucose, and contrast dye have molecular masses that are relatively large compared to other major components of urine (eg, sodium, chloride, potassium), they disproportionately affect SG. In these cases, urine osmolality is a better measure of urine concentration.
