Case Study Things Flashcards
Morphine classification (therapeutic and pharmacologic)
Thera - Opioid analgesic
Pharma - Opioid agonist
Morphine indications
- Mod to severe pain
- Pulmonary edema
- Pain r/t MI
Action of Morphine
Binds to opiate receptors in the CNS. Alters the perception of and response to painful
stimuli while producing generalized CNS depression
Onset, peak, duration of PO Morphine
Onset - unknown
Peak - 60 min
Duration - 4–5 hr
Onset, peak, duration of IV Morphine
Onset - rapid
Peak - 20 min
Duration - 4–5 hr
Nursing considerations of Morphine
Assess level of consciousness, BP, pulse, and respirations before and
periodically during administration
Atrovastatin classifications (thera and pharma)
Thera - lipid-lowering agents
Pharma - HMG-CoA reductase inhibitors
Atrovasatin indications
- Adjunctive management of primary hypercholesterolemia and mixed dyslipidemia.
- Primary prevention of coronary heart disease
Action of Atrovastatin
Inhibits 3-hydroxy-3-methylglutaryl-coenzyme A (HMG-CoA) reductase, an enzyme
which is responsible for catalyzing an early step in the synthesis of cholesterol
Onset, peak, duration of PO Atrovastatin
Onset - unknown
Peak - unknown
Duration - 20–30 hr
Metoprolol classification (thera and pharma)
Thera -
Pharma -
Metoprolol indications
- Hypertension, to lower blood pressure
- Angina Pectoris
- Heart Failure
Action of Metoprolol
Blocks stimulation of beta1 (myocardial) -adrenergic receptors
Classification of Hydrochlorothiazide (thera and pharma)
Thera - antihypertensives, diuretics
Pharma - thiazide diuretics
Indications of Hydrochlorothiazide
- Management of mild to moderate hypertension.
- Treatment of edema associated with: HF, Renal dysfunction, Cirrhosis, Glucocorticoid therapy, Estrogen therapy.
Action of Hydrochlorothiazide
- Increases excretion of sodium and water by inhibiting sodium reabsorption in the distal tubule.
- Promotes excretion of chloride, potassium, hydrogen, magnesium, phosphate, calcium and bicarbonate.
- May produce arteriolar dilation.
Onset, peak, and duration of Hydrochlorothiazide
Onset - 2 hr
Peak - 3–6 hr
Duration - 6–12 hr
Nursing implications for Hydrochlorothiazide
Monitor BP, intake, output, and daily weight and assess feet, legs, and sacral area for edema daily
Classification of Furosemide (thera and pharma)
Thera - diuretics
Pharma - loop diuretics
Indications of Furosemide
- Edema due to heart failure, hepatic impairment or renal disease.
- Hypertension.
Action of Furosemide
- Inhibits the reabsorption of sodium and chloride from the loop of Henle and distal renal tubule.
- Increases renal excretion of water, sodium, chloride, magnesium, potassium, and calcium.
- Effectiveness persists in impaired renal function.
Onset, peak, and duration of PO Furosemide
Onset - 30–60 min
Peak - 1–2 hr
Duration - 6–8 hr
Onset, peak, and duration of IV Furosemide
Onset - 5 min
Peak - 30 min
Duration - 2 hr
Nursing implications of Furosemide
- Assess fluid status. Monitor daily weight, intake and output ratios, amount and location of edema, lung sounds, skin turgor, and mucous membranes.
- Monitor BP and pulse before and during administration.
Classification of Insulin Lispro (aka Humalog) (thera and pharma)
Thera - antidiabetics, hormones
Pharma - pancreatics
Indications of Humalog
Control of hyperglycemia in patients with type 1 or type 2 diabetes mellitus
Action of Humalog
- Lower blood glucose by: stimulating glucose uptake in skeletal muscle and fat, inhibiting hepatic glucose production.
- Other actions: inhibition of lipolysis and proteolysis, enhanced protein synthesis
Onset, peak, and duration of Humalog
Onset - 15 - 30 min
Peak - .5 - 1.5
Duration - 3 - 5
*these values were from the skills and technologies textbook…I hope they’re the right ones because every resource says something different…
Nursing implications for Humalog
- Assess for symptoms of hypoglycemia
Classification of Insulin glargine (aka Lantus) (thera and pharma)
Thera - hormones
Pharma - pancreatics
Indications of Lantus
Control of hyperglycemia in patients with type 1 and type 2 diabetes mellitus.
Action of Lantus
- Lowers blood glucose by : stimulating glucose uptake in skeletal muscle and fat, inhibiting hepatic glucose production.
- Other actions of insulin: inhibition of lipolysis
and proteolysis, enhanced protein synthesis.
Onset, peak, and duration of Lantus
Onset - 1.5 hour
Peak - None identified
Duration - Greater than 24
*These values were also taken from the skills and technology textbook…
Nursing implications of Lantus
- Assess for symptoms of hypoglycemia
Classification of Warfarin (thera and pharma)
Thera - anticoagulants
Pharma - coumarins
Indications of Warfarin
- Prophylaxis and treatment of: venous thrombosis, pulmonary embolism, atrial fibrillation with embolization. - Management of myocardial infarction: decreases risk of
death, decreases risk of subsequent MI, decreases risk of future thromboembolic events.
Action of Warfarin
Interferes with hepatic synthesis of vitamin K-dependent clotting factors
Onset, peak, and duration of Warfarin
Onset - 36–72 hr
Peak - 5–7 days
Duration - 2–5 days
Nursing implication of Warfarin
Assess for signs of bleeding and hemorrhage
Classification of Ramipril (thera and pharma)
Thera - antihypertensives
Pharma - ACE inhibitors
Indications of Ramipril
- Alone or with other agents in the management of hypertension.
- Reduction of risk of MI, stroke, or death from cardiovascular causes in patients at least 55 years of age who are at high risk of developing a major cardiovascular event
Action of Ramipril
Angiotensin-converting enzyme (ACE) inhibitors block the conversion of angiotensin I to the vasoconstrictor angiotensin II
Onset, peak, and duration of Ramipril
Onset - 1–2 hr
Peak - 3–6 hr
Duration - 24 hr
Nursing implication of Ramipril
Monitor BP and pulse frequently during initial dose adjustment and periodically during therapy
Classification of Digoxin (thera and pharma)
Thera - antiarrhythmics, inotropics
Pharma - digitalis glycosides
Indications of Digoxin
- Heart failure.
- Atrial fibrillation and atrial flutter (slows ventricular rate).
- Paroxysmal atrial tachycardia.
Action of Digoxin
- Increases the force of myocardial contraction.
- Prolongs refractory period of the AV node.
- Decreases conduction through the SA and AV nodes
Onset, peak, and duration of PO Digoxin
Onset - 30–120 min
Peak - 2–8 hr
Duration - 2–4 days
Onset, peak, and duration of IV Digoxin
Onset 5–30 min
Peak - 1–4 hr
Duration - 2–4 days
