Condensed Flashcards
1
Q
Indications for methadone
A
heroine withdrawal
2
Q
Indication for disulferam
A
remaining sobriety of alcohol
3
Q
6 rights of med administration
A
patient, dose, time, route, drug, documentation
4
Q
Medication reconciliations can be used to prevent
A
drug interactions
5
Q
We should identify patients using
A
two identifiers
6
Q
Normal magnesium levels
A
1.5-2.5
7
Q
Nursing interventions for magnesium sulfate
A
assess DTR (absence = toxicity) and administer calcium gluconate
8
Q
What is ferrous sulfate
A
iron
9
Q
Ferrous sulfate patient teaching
A
take liquid iron through straw and rinse mouth, take with vitamin C. avoid coffee, dairy, tea, antacids. Dark stools are normal. Increase fiber fluids and exercise
10
Q
How to recognize beta blockers
A
-olol
11
Q
Mechanism of actions
A
block beta 1 (heart) and/or 2 (lung) receptors
12
Q
Indications for beta blockes
A
HTN, tachycardia
13
Q
Nursing Considerations
A
monitor HR and hold if less than 50. HR can block signs of hyperglycemia. Monitor for SI and sexual dysfunction
14
Q
Those on any antihypertensive drugs are at risk of ?
A
rebound hypertension, orthostatic hypotension
15
Q
How to recognize benzodiazepines
A
lam and pam
16
Q
Indications for benzodiazepines
A
generalized anxiety disorder, panic disorder, seizures (status epilepticus), induce sedation
17
Q
Side effects of benzodiazepines
A
REM rebound hangover
18
Q
adverse effects of benzodiazepines
A
toxicity, withdrawal symptoms, paradoxical response, anterograde amnesia
19
Q
Withdrawal symptoms of benzodiazepine s
A
MATH IS TIDY
muscle twitches, anxiety, tachycardia, HTN, insomnia, seizures, tremors, irritability, diaphoresis
20
Q
Nursing considerations for benzodiazepines
A
flumazenil is antidote, monitor LOC, medication reconciliation (opioid risk)
21
Q
Patient teaching
A
taper off, avoid alcohol CNS depressants opioids, take at night, avoid grapefruit juice, do not take more than 7-10 days
22
Q
Non-benzodiazepines
A
zolpidem, zaleplon, the other one
23
Q
Indications for zolpidem
A
acute insomnia
24
Q
What drug is a hydanoitn
A
phenytoin
25
Indication for phenytoin
seizures
26
Adverse effects of phenytoin
gingival hyperplasia, osteomalacia, stevens-johnson, blood dyscrasias
27
Patient teaching for phenytoins
take at same time each day, avoid OTC meds and herbs, increase vitamin D and calcium, good oral hygeine and frequent dental visits
28
Carbamazepine indications
seizures
29
therapeutic drug level for carbamazepine
4-12
30
Adverse effects of carbamazepine
blood dyscrasias, SI, hepatotoxicity, stevens johnson
31
bbw with carbamazepine
heart failure, fluid overload, blood dyscrasias
32
nursing considerations for carbamazepine
CBC, SI, serum drug levels. edema and lung sounds. EKG. LFT
33
Donepezil indications
alzheimers and dementia
34
Nursing considerations for donepezil
ask orientation (person, place, time) to evaluate effectiveness...... can also cause cholinergic crisis so keep atropine and crash cart near
35
Indications for carbidopa levodopa
parkinsons
36
Patient teaching for carbidopa levodopa
avoid protein but take with food. maintain good oral hygiene. dark urine is normal. avoid multivitamins
37
Indication for neostigmine
myasathenia gravis
38
Side effect of neostigmine
sludges, muscarinic stimulation
39
adverse effect of neostigmine
cholinergic crisis, myasthenic crisis
40
s/s of cholinergic crisis
SLUDGES, bradycardia, dyspnea, meiosis (pupil constriction)
41
antidote for cholinergic crisis
atropinewhat
42
what drug can be used to determine cholinergic crisis or myasthenic crisis
edrophonium
43
What are the central acting muscle relaxants
baclofen, cyclobenzapine, dantrolene
44
Inidctions for central acting muscle relaxants
muscle spasms / strain or sprain of muscle
45
Evaluation for central acting muscle relaxants
decreased pain or increased ROM = effectiveness
46
What are the neuromuscular blocking drugs
vancuronium, pancuronium, succinylcholine
47
Adverse effect of neuromuscular blocking drug
malignant hyperthermia (rigid muscles, high fever, tachycardia, diaphoresis)
48
Treatment of malignant hyperthermia
dantrolene (O2 @ 100, stop administration, cooling blankets)
49
What drugs are typical antipsychotics
chlorpromazine, haloperidol
50
Indications for antipsychotics
schizophrenia, aggressive patients, drug induced psychosis, manic states
51
Adverse effects of typical antipsychotics
neuroleptic malignant syndrome, acute dystonia, tardive dyskinesia, akathisia, parkinsonism (these are extrapyramidal symptoms)
52
symptoms of neuroleptic malignant syndrome
rigid muscles, BP fluctuations, diaphoresis, tachycardia, sudden high grade fever, altered LOC
53
what symptom of typical antipsychotics has spasms of tongue, neck, and back
acute dystonia
54
Atypical antipsychotic drugs
clonzapine, olanzapine, respiridone
55
Side and adverse effects of atypical antipsychotics
DAW HADES
diabetes, anticholinergic, weight gain, hypercholesterolemia, agitation, dizziness elevated prolactin, sexual dysfunction (hypotension) (can cause extrapyramidal symptoms but not as much)
56
Patient teaching of atypical antipsychotics
report s/s of diabetes mellitus (3 P's), report gynecomastia, galactorrhea, seizures, abnormal movements. anticholinergic teaching. hypotensive teaching.
57
Adverse effects of benzodiazepines (again)
withdrawal, paradoxical response, anterograde amnesia, CNS and respiratory depression, sedation
58
Patient teaching for benzodiazepines
BIG ONE IS TAPER DOSE (prevents withdrawal)
59
what drugs are SSRIs
fluoxetine, paroxetine, citalopram, escitalopram, fluvoxamine or something idk
60
Indications for SSRIs
major depression
61
Adverse effects of SSRIs
big one is sexual dysfunction (causes adherence), SEROTONIN SYNDROME, hyponatremia, withdrawal. increase SI during dosages changes
62
Symptoms of serotonin syndrome
confusion, agitation, fever, tremors
63
Nursing considerations for SSRI's
assess for masked signs of sexual dysfunction, do not drink grapefruit juice, contraindicated with MAOIs and TCAs, pregnancy category c (paroxetine is d)
64
What drugs are MAOIs
phenelzine, isocarboxid, seligiline, tranylcypromine
65
Indications for MAOIs
neurotic or atypical depression
66
Interactions for MAOIs
tyramine foods (aged cheese, aged meats, yogurt, fermented beer and wine)
67
What drugs are TCAs
amitriptyline, nortriptyline
68
Side and adverse effects of TCAs
okay hear me out... think TRIPping makes you sad.... and you trip with your toes....
SAD TOASS
sedation, anticholinergic, decreased seizure threshold, toxicity, orthostatic hypotension, arrhythmias, sexual dysfunction, sweating
69
Lithium indications
bipolar disorder, mood fluctuations
70
Advanced lithium toxicity symptoms (2-2.5)
hypotension --> seizure--> coma--> death. tinnitus, ataxia, involuntary extremity movements, polyuria, blurred vision
71
Patient teaching for lithium
increase fluids (1.5 L) cause dehydration increases risk of lithium toxicity
72
What are nsaids
ibuprofen, naproxen, ketorolac, indomethacin, diclofenac, meloxicam
73
Adverse effects of NSAIDs
nephrotoxicity, hepatotoxicity, gi bleeding,
74
Nurisng interventions
monitor s/s of bleeding, LFT, RFT, avoid alcohol and G herbs. Take with food and water/milk
75
Indications for aspirin
to prevent MI (81 mg baby aspirin) and for pain management
76
Drug interactions for aspirin
warfarin , avoid g herbs , alcohol
77
Adverse effects
nephrotoxicity, bleeding, salicylism, reyes syndrome
78
tinnitus while taking aspirin can mean
salicylism (also headache, dizziness, sweating, fainitng, AMS)
79
What is reye's syndrome
when child with virus takes aspirin (liver damage, hypoglycemia, cns effects)
80
Antigout medications
allopurinol, cholchicine, probenecid
81
Nursing interventions and patient teaching
increase fluids, avoid purine foods (scallops, red meat, red wine)
82
Methotrexate indications
slow progression of RA
83
Contraindications for methotrexate
live virus vaccines, infection, pregnancy
84
What drugs are opioid agonsits
morphine, fetanyl, codeine, oxycodone
85
Adverse effect of opioid agonist
constipation can become adverse, urinary rention, sedaiton, RESPIRATORY DEPRESSION, pupillary constriction
86
What drug is opioid antagonist
naloxone
87
when to give naloxone
client too sedated, respirations less than 10
88
How to recognize cephalosporins and penicillins
-cef , -cillin
89
Indications for cefs and cillins
infection (bacterialP
90
general adverse reactions and treatment of cephalosporins and penicillins
mild allergic reaction (rash pruritus hives.. treat with diphenhydramine) advances allergic reaction (angioedema.. treat with epinephrine) superinfections of vagina, mouth, and stomatitis
91
Nursing interventions for abx
get C&S before administering abx, monitor for s/s of allergic reaction, monitor for s/s of superinfection, LFT,RFT, cephalosporins monitor for bleeding, increase fluids, take with food
92
antibiotics decrease the effectiveness of? what should nurses teach
oral contraceptives ; backup method of birth control
93
Side and adverse effects of vancomycin
redman syndrome, thrombophlebitis, ototoxicity, nephrotoxicity, stevens johnson syndrome
94
Nursing interventions for vancomycin
monitor s/s of stevens johnson and redman syndrome. monitor RFTs and iv site. Monitor serum peak and trough levels. infuse over 60 minutes
95
How to recognize flourquinolones
-oxacin
96
Indications of ciprofloxacin
infection
97
Adverse effects of flourquinolones
achilles tendon rupture, arthropathy
98
What drug is aminoglycoside
gentamicin
99
when to take peak and trough levels of gentamicin
30 minutes after infusion finishes (peak), 30 mins b4 next dose (for trough)
100
Indications for INH
tuberculosis
101
Side and adverse effects of INH
neuropathy, hepatoxicity
102
Nursing interventions / patient teaching for INH
avoid foods high in tyramine (aged cheese and meats) , take b6 and pyridoxine, avoid alcohol (Cus liver) and monitor LFTs
103
acyclovir indications
herpes simplex type 1 and varicella zoster (viruses)
104
fluconazole indications
vag yeast infections (systemic or superficial mycoses)
105
Indications for tamoxifen
stop the spread of breasat cancer cells
106
adverse effects of tamoxife
blood clots/ pulmonary embolism, hypercalcemia
107
Indication for epoetin alfa
low RBC, CKD anemia, HIV/AIDS, chemo
108
Adverse effects of epoetin alfa
hypertension, headache
109
Indications for oprelvekin
low platelet count (thromBOcytopenia)
110
Evaluating effectiveness for oprelvekin
platelets greater than 50,000
111
What drugs are decongestants
phenelephrine, pseudophedrine, oxymetazoline, nafazoline, tetrahydrolazine
112
Side effects of decongestants
tremors, tachycardia, nervousness, anxiety, restlessness
113
adverse effects of decongestants
htn, palpitations, arrhythmias, convulsions, delusions, hallucinations
114
Contraindications of decongestants
HTN, glaucoma, hypothyroidism, cardiac issues (take caution if you have diabetes)
115
what drugs are methylxanthines
theophylline, aminophylline
116
Indications for methylxanthines
asthma and bronchospasm
117
drug interactions for methylxanthines
smoking will decrease effectiveness, caffeine will increase side effects
118
What drug is a mucolytic
acetylcysteine
119
patient teaching for acetylcysteine
smells like rotten eggs (does not mean its bad)
120
What drugs are beta 2 agonists
short acting: albuterol, levalbuterol, pirbuterol
121
Indications for short acting
treat acute asthma attack, prevent exercise induced asthma
122
Long acting beta agonists
treat asthma and COPD
123
Short vs long acting bronchodilators
short acting should only be used 2-3 times a week, long acting can be used every day
124
adverse effects of bronchodilators
palpitations, angina, tachycardia
125
patient teaching for bronchodilators
use a spacer, take it before corticosteroids, tolerance can occur, side effects diminish over time, avoid caffeine
126
How to recognize corticosteroids
end in -sone and triamcinolone
127
Indications for inhaled corticosteroids
COPD and asthma
128
Patient teaching for inhaled corticosteroids
clean mouth and inhaler after, use a spacer, use after albuterol,
129
Cardiac glycosides drug
digoxin
130
indications for digoxin
afib, atrial flutter, heart failure
131
side / adverse effects
cardio: bradycardia CNS: yellow green halos, diplopia GI: anorexia, NV
132
Nursing interventions for digoxin
monitor apical pulse for a full minute, hold if <60
133
antidote for digoxin
digoxin immune fab
134
what lab value can increase risk of digoxin toxicity
hypokalemia
135
What drugs are nitrates
have nitrate somewhere in there
136
Indications for nitrates
chest pain
137
patient teaching regarding patch
take it off at night to prevent tolerance (nitrate free period) rotate sites
138
Side and adverse effects of nitrates:
tolerance, headache, hypotension, weak, syncope
139
contraindicaitons for nitrates
PDE5 inhibitors (can cause fatal hypotension)
140
What are the potassium sparing diuretics
amiloride, spironolactone, eplerenone, triamterene
141
Indications for potassium sparing
HTN, CHF, hypokalemia
142
Side and adverse effects of potassium sparing
hyperkalemia, androgen effects, gynecomastia, dizziness, hypotension
143
Nursing interventions of potassium
monitor potassium levels
144
what drug is thiazide
hydrochlorothiazide
145
Evaluation for thiazide diuretic
decreased SOB, edema, hypertension, HF
146
what drug is loop diuretic
furosemide
147
Indications:
acute HF, hypertension, edema
148
Patient teaching
eat foods high in potassium, potassium salt substitutes (need to avoid sodium), hypotensive teaching
149
Evaluating effectiveness for loop diuretic
decreasaed edema, htn, SOB, hf
150
How to recognize calcium channel blockers
-dipine, verapamil, diltiazem
151
indications for CCB
hypertension
152
Adverse effects of CCB
peripheral edema, bradycardia
153
Patient teaching for calcium channel blockers
avoid grapefruit juice and statins, report s/s of edema, monitor heart rate, taper dose because of rebound hypertension
154
Nursing considerations for CCB
statins should be avoided, monitor EKG, VS, HR. Monitor edema
155
Indications for clonidine
hypertension
156
patient teaching for clonidine
leave patch on for 7 days
157
how to recognize ACE inhibitors
-pril
158
Indications for ace inhibitors
hypertension
159
Side effect of ace inhibitors
persistent dry cough
160
Adverse effects of ACE inhibitors
hyperkalemia
161
Patient teaching for ACE inhibitors
avoid k+ foods, BP, change positions slowly, improve diet and increase exercise
162
Cultural considerations for ACE inhibitors
not used as monotherapy in African Americans ?
163
What does warfarin treat
blood clots? DVT, PE idek
164
Warfarin Labs and ranges
PT: 18-24 sec INR: 2-3 , 3-4.5 if mechanical heart valve
165
Interactions for warfarin
highly protein bound, g herbs, aspirin, pregnancy category X
166
patient teaching for warfarin
use soft bristled toothbrush and electric razor. Avoid G herbs. wear medic alert ID. use backup method of birth control
167
Nursing considerations for warfarin
monitor s/s of bleeding, monitor labs, LFTs
168
Warfarin antidote
vitamin K
169
What does heparin treat
DVT
170
Labs and therapeutic levels for heparin
ptt: 120-140
aPTT: 60-80
171
Interactions with heparin
other anticoagulants, antiplatelets
172
Antidote for heparin
promatine sulfate
173
HMG-CoA reductase inhibitors
-statins
174
Baseline labs for statins
creatinine kinase, cholesterol 150-200, LDL<100 HDL>60
175
Nursing interventions for statins
monitor for muscle pain, creatinine kinase, cholesterol levels, LFTs, advise patients for yearly eye exams
176
Side and adverse effects of Statins
H M G C oa Reductase Inhibitors
hepatotoxicity, myopathy, gi upset, rhabdomyolysis, cataracts
177
What drug is the surfactant laxative
docusate sodium
178
indications for surfactant laxatives
reduce straining from constipation
179
Mechansim of action docusate sodium
reduce surface tension of the stool by increasing water and electrolytes in the stool
180
Lacutlose indications
hepatic encephalopathy (reduce ammonia levels)
181
Indications for sucralfate
ulcer
182
mechanism of action for sucralfate
coats the ulcer and mucosal lining
183
evaluation of sucralfate
abdominal pain subsides
184
Misoprostol indications
NSAID induced ulcer
185
Mechanism of action for misoprostol
secretion of bicarbonate and inhibit release of stomach aid
186
Evaluation of effectiveness for misoprostol
reduced abdominal pain
187
What are the different types of antacids
magnesium, aluminum, sodium bicarbonate, calcium
188
Patient teaching for antacids
take it 1 or 2 hours before or after other drugs
189
H2 receptor blocker drugs
famotidine, cametidine
190
Patient teaching for H2 receptor blockers
smoking decreases effectiveness, avoid NSAIDs and antacids ?
191
Interactions for famotidine and cametidine
smoking decreases effectiveness and alcohol/NSAIDs can increase risk of bleeding
192
How to recognize proton pump inhibitors
-prazole (omeprazole)
193
Indications for proton pump inhibitors
GERD and acid reflux
194
Adverse effects of PPIs
osteoporosis, pneumonia, rebound hypersecretion, hepatoxicity, HYPOMAGnesemia
195
what drugs are antithyroid drugs
propylthiouracil, methimazoleEva
196
Evaluation of antithyroid drugs
hyperthyroidism symptoms decrease, euthyroid state (0.5-4.2)
197
Levothyroxine indicaiont
hypothyroidism
198
Patient teaching for levothyroxine
take one hour before breakfast on empty stomach and take four hours before vitamins and other meds
199
Indication for glucocorticoids
adrenal insufficiency and addisons disease
200
Adverse effects of glucocorticioids
hyperglycemia, infection, osteoporosis, cushings syndrome, peptic ulcer disease, myopathy
201
Patient teaching for glucocorticoids
take caution if you are diabetic, monitor for infections, increase calcium and vitamin D, report cushings syndrome symptoms
202
Biphosphonates
-dronate
203
Indications of biphosphonates
osteoporosis
204
Adverse effects of biphosphonates
osteonecrosis of the jaw, esophagitis
205
Patient teaching
sit up for 30 minutes after taking, do not take if you have difficulty swallowing, avoid dental work
206
Sulfonylureas
start with gly end with ide
207
Indicaitons
type 2 dm
208
adverse effects of sulfonulureas
hypoglycemia
209
nurisng considerations and patient teachign
take it with food, make sure they have meal tray
210
glucagon indications
unconscious from hypoglycemia
211
Metformin indications
type 2 dm
212
side and adverse effects
please be weight loss
213
Insulin mixing
inject air into NPH, air into clear, draw clear, draw cloudy
214
rapid insulins (aspart, glulisine, lispro)
15-30, 30-2.5, 3-6
215
short acting insulin (regular)
30-1hr, 1-5 hours, 6-10
216
intermediate (NPH and Humulin N)
1-2 h , 6-14, 16-24
217
Long acting (glargine , determir)
70 mins, no peak, 18-24
218
oxybutynin indicaitons
overactive bladder
219
Contraindicaitons of oxybutynin
glaucoma, urinary retention (think BPH), GI/gu obstruction, paralytic ileus
220
Bethanechol indicaitons
urinary retention not caused by obstruction
221
side and adverse effect of bethachol
SLUDGES, bradycardia, dyspnea, miosis, hypotension, bronchoconstriction
222
PDE5 inhibitors
slidenafil, tadalafil
223
contraindciation of PDE5 inhibitors
nitrates (fatal hypotension)
224
what can be used to prevent toxicity in older adult
start low and go slow
