Condensed Flashcards
Indications for methadone
heroine withdrawal
Indication for disulferam
remaining sobriety of alcohol
6 rights of med administration
patient, dose, time, route, drug, documentation
Medication reconciliations can be used to prevent
drug interactions
We should identify patients using
two identifiers
Normal magnesium levels
1.5-2.5
Nursing interventions for magnesium sulfate
assess DTR (absence = toxicity) and administer calcium gluconate
What is ferrous sulfate
iron
Ferrous sulfate patient teaching
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
How to recognize beta blockers
-olol
Mechanism of actions
block beta 1 (heart) and/or 2 (lung) receptors
Indications for beta blockes
HTN, tachycardia
Nursing Considerations
monitor HR and hold if less than 50. HR can block signs of hyperglycemia. Monitor for SI and sexual dysfunction
Those on any antihypertensive drugs are at risk of ?
rebound hypertension, orthostatic hypotension
How to recognize benzodiazepines
lam and pam
Indications for benzodiazepines
generalized anxiety disorder, panic disorder, seizures (status epilepticus), induce sedation
Side effects of benzodiazepines
REM rebound hangover
adverse effects of benzodiazepines
toxicity, withdrawal symptoms, paradoxical response, anterograde amnesia
Withdrawal symptoms of benzodiazepine s
MATH IS TIDY
muscle twitches, anxiety, tachycardia, HTN, insomnia, seizures, tremors, irritability, diaphoresis
Nursing considerations for benzodiazepines
flumazenil is antidote, monitor LOC, medication reconciliation (opioid risk)
Patient teaching
taper off, avoid alcohol CNS depressants opioids, take at night, avoid grapefruit juice, do not take more than 7-10 days
Non-benzodiazepines
zolpidem, zaleplon, the other one
Indications for zolpidem
acute insomnia
What drug is a hydanoitn
phenytoin
Indication for phenytoin
seizures
Adverse effects of phenytoin
gingival hyperplasia, osteomalacia, stevens-johnson, blood dyscrasias
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
Carbamazepine indications
seizures
therapeutic drug level for carbamazepine
4-12
Adverse effects of carbamazepine
blood dyscrasias, SI, hepatotoxicity, stevens johnson
bbw with carbamazepine
heart failure, fluid overload, blood dyscrasias
nursing considerations for carbamazepine
CBC, SI, serum drug levels. edema and lung sounds. EKG. LFT
Donepezil indications
alzheimers and dementia
Nursing considerations for donepezil
ask orientation (person, place, time) to evaluate effectiveness…… can also cause cholinergic crisis so keep atropine and crash cart near
Indications for carbidopa levodopa
parkinsons
Patient teaching for carbidopa levodopa
avoid protein but take with food. maintain good oral hygiene. dark urine is normal. avoid multivitamins
Indication for neostigmine
myasathenia gravis
Side effect of neostigmine
sludges, muscarinic stimulation
adverse effect of neostigmine
cholinergic crisis, myasthenic crisis
s/s of cholinergic crisis
SLUDGES, bradycardia, dyspnea, meiosis (pupil constriction)
antidote for cholinergic crisis
atropinewhat
what drug can be used to determine cholinergic crisis or myasthenic crisis
edrophonium
What are the central acting muscle relaxants
baclofen, cyclobenzapine, dantrolene
Inidctions for central acting muscle relaxants
muscle spasms / strain or sprain of muscle
Evaluation for central acting muscle relaxants
decreased pain or increased ROM = effectiveness
What are the neuromuscular blocking drugs
vancuronium, pancuronium, succinylcholine
Adverse effect of neuromuscular blocking drug
malignant hyperthermia (rigid muscles, high fever, tachycardia, diaphoresis)
Treatment of malignant hyperthermia
dantrolene (O2 @ 100, stop administration, cooling blankets)
What drugs are typical antipsychotics
chlorpromazine, haloperidol
Indications for antipsychotics
schizophrenia, aggressive patients, drug induced psychosis, manic states
Adverse effects of typical antipsychotics
neuroleptic malignant syndrome, acute dystonia, tardive dyskinesia, akathisia, parkinsonism (these are extrapyramidal symptoms)
symptoms of neuroleptic malignant syndrome
rigid muscles, BP fluctuations, diaphoresis, tachycardia, sudden high grade fever, altered LOC
what symptom of typical antipsychotics has spasms of tongue, neck, and back
acute dystonia
Atypical antipsychotic drugs
clonzapine, olanzapine, respiridone
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)
Patient teaching of atypical antipsychotics
report s/s of diabetes mellitus (3 P’s), report gynecomastia, galactorrhea, seizures, abnormal movements. anticholinergic teaching. hypotensive teaching.
Adverse effects of benzodiazepines (again)
withdrawal, paradoxical response, anterograde amnesia, CNS and respiratory depression, sedation
Patient teaching for benzodiazepines
BIG ONE IS TAPER DOSE (prevents withdrawal)
what drugs are SSRIs
fluoxetine, paroxetine, citalopram, escitalopram, fluvoxamine or something idk
Indications for SSRIs
major depression
Adverse effects of SSRIs
big one is sexual dysfunction (causes adherence), SEROTONIN SYNDROME, hyponatremia, withdrawal. increase SI during dosages changes
Symptoms of serotonin syndrome
confusion, agitation, fever, tremors
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)
What drugs are MAOIs
phenelzine, isocarboxid, seligiline, tranylcypromine
Indications for MAOIs
neurotic or atypical depression
Interactions for MAOIs
tyramine foods (aged cheese, aged meats, yogurt, fermented beer and wine)
What drugs are TCAs
amitriptyline, nortriptyline
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
Lithium indications
bipolar disorder, mood fluctuations
Advanced lithium toxicity symptoms (2-2.5)
hypotension –> seizure–> coma–> death. tinnitus, ataxia, involuntary extremity movements, polyuria, blurred vision
Patient teaching for lithium
increase fluids (1.5 L) cause dehydration increases risk of lithium toxicity
What are nsaids
ibuprofen, naproxen, ketorolac, indomethacin, diclofenac, meloxicam
Adverse effects of NSAIDs
nephrotoxicity, hepatotoxicity, gi bleeding,
Nurisng interventions
monitor s/s of bleeding, LFT, RFT, avoid alcohol and G herbs. Take with food and water/milk
Indications for aspirin
to prevent MI (81 mg baby aspirin) and for pain management
Drug interactions for aspirin
warfarin , avoid g herbs , alcohol
Adverse effects
nephrotoxicity, bleeding, salicylism, reyes syndrome
tinnitus while taking aspirin can mean
salicylism (also headache, dizziness, sweating, fainitng, AMS)
What is reye’s syndrome
when child with virus takes aspirin (liver damage, hypoglycemia, cns effects)
Antigout medications
allopurinol, cholchicine, probenecid
Nursing interventions and patient teaching
increase fluids, avoid purine foods (scallops, red meat, red wine)
Methotrexate indications
slow progression of RA
Contraindications for methotrexate
live virus vaccines, infection, pregnancy
What drugs are opioid agonsits
morphine, fetanyl, codeine, oxycodone
Adverse effect of opioid agonist
constipation can become adverse, urinary rention, sedaiton, RESPIRATORY DEPRESSION, pupillary constriction
What drug is opioid antagonist
naloxone
when to give naloxone
client too sedated, respirations less than 10
How to recognize cephalosporins and penicillins
-cef , -cillin
Indications for cefs and cillins
infection (bacterialP