Chapter 15: Safe Medication Use Flashcards
Why do the elderly have an increased risk for drug toxicity?
They take their medications incorrectly. Polypharmacy, mixing drugs, combining alcohol, inappropriate or unnoted use of herbs & supplements etc…
What do we monitor for a client taking a potassium sparing diuretic and a beta blocker for hypertension?
Electrolyte (esp. Potassium) levels, salt intake, weight or signs of fluid overload. Understand differences in signs of hypo vs hyperkalemia.
The diuretic helps the body get rid of excess fluid and sodium while conserving potassium. However, the beta blocker can reduce the effectiveness of the diuretic, potentially leading to fluid retention and an increase in potassium levels. This interaction can affect the balance of electrolytes in the body.
Herbs that interact with anticoagulants & other medications
All have antithrombotic effects- increasing bleeding/slowing clotting.
1. Garlic: It may increase the risk of bleeding when combined with anticoagulants.
2. Ginger: It can also have blood-thinning effects and may increase the risk of bleeding.
3. Ginkgo Biloba: This herb may interfere with the effectiveness of anticoagulants, NSAIDs, and antipsychotic medications.
4. Ginseng: It may have blood-thinning properties and can interact with anticoagulants and NSAIDs.
When discharging a patient what is the most important statement to communicate regarding medications?
To speak with their provider and initiate interprofessional communication regarding the patient.
What is the most important medication information the nurse should communicate regarding medication safety?
The purpose of their medications
What would demonstrate misuse of medication ?
Patient is reviewing their medications with their provider annually
Pharmacokinetics and related changes
Increases half life for many drugs
Decreased liver and renal function
Concerning finding regarding herbal/supplemental health for patient with uncontrolled hypertension
Saint Johns Wart increases BP and may cause liver damage
Most commonly used drugs in the geriatric population
Antacids
Analgesics
Antihypertensives
What Complementary therapy would not be appropriate for a patient who has N/V from chemo?
Aromatherapy
Why do providers order two antibiotics at the same time?
They are more effective combined rather than separate/individual
Medications used for osteoporosis & kyphosis
Calcium supplements, calcitonin, vitamin D & estrogen
Drug used as an analgesic as a prototype (equianalgesic used when switching analgesics)
Morphine
Signs of digoxin toxicity & what to say to a patient when levels are normal
Seeing halos
If levels are normal, decrease monitoring.
How should a patient take bulk forming laxatives?
With lots of water
First line of tx for Schizophrenia
Antipsychotics
Medications taken to lower cholesterol & most cases of hyperlipidemia
Statins
Medications offered for Alzheimer’s tx
Namenda (memantine)
Aricept (donepizel)
Exalon (rivastigmine)
Foods and vitamins to avoid while on anticoagulants (end with -in)
Vitamin K (asparagus, bacon, beef, liver, cabbage, fish, cauliflower, & green leafy vegetables)
Vitamin E- Increase bleeding risk
Antithrombotics
International Normalised Ratio
INR
A blood test that tells you how long it takes for your blood to clot
Increased by mango + papaya
Medication contraindicated in elderly
Propoxyphene (darvocet)
Which medications causes constipation
Narcotics, opioids
What medication is contraindicated in clients who have a bleeding disorder and peptic ulcer disease?
NSAIDs, especially aspirin are associated with GI bleeding
Big heart medications
Statins- to lower LDL cholesterol.
Aspirin- to prevent blood clots.
Clopidogrel- to prevent blood clots.
Warfarin- to prevent blood clots.
Beta-blockers- to treat heart attack and heart failure and sometimes used to lower blood pressure.
{End in olol; think “beta blockers are funny guys oh, lol” metoprolol, nebivolol etc…}
ACE inhibitors- to treat heart failure and lower blood pressure
{End in pril; think “A-pril” catopril, enalapril, etc…}
Fastest route for medication
IV - Intravenously
What could be happening if a 75 year old woman is having trouble losing weight & continues to gain weight?
Metabolism has slowed, adipose tissue increases
Most commonly used drugs in the geriatric population
cardiovascular agents
antihypertensive
analgesics
antiarthritic agents
sedatives
tranquilizers
laxatives
antacids
Tool used as reference for medications to avoid with elderly patients
Beers criteria
How would a nurse give medication to a client with severe dysphagia?
Crushed and in their choice of applesauce, pudding, jello if they’re into that, etc…
Promotes heart health
Omega 3 fatty acids
