Drug Functions Flashcards
Antacids
Neutralize gastric acids (Do NOT take with other oral drugs, take with other fluids, check Calcium levels if taking TUMS)
Milk of Magnesia
Laxative Effect
Aluminum Hydroxide
Constipating effect
H2 Blockers
Reduce gastric acid production
(Take before meals or at bedtime; decrease intake of gastric irritants; increase intake of Vit. B12; raise head of bed; inform provider of bleeding)
Protein pump inhibitor
Stop gastric Production
(Increase fluids/fiber/activity to prevent constipation; take 30 minutes before meals; decrease foods that cause gastric irritation; use short term; interact with dilantin (seizures), digoxin, anticoagulants, benzos due to liver metabolism.
Benzodiazepines
Used to treat anxiety. Enhance soothing/inhibiting neurotransmitter GABA to depress CNS.
Abuse potential/ Controlled substances. Don’t mix with alcohol. Monitor BP and HR. Watch for orthostatic hypotension/ dizziness; don’t abruptly stop drug; decrease dose if liver or renal disease; don’t use if pregnant; no smoking or caffeine
Anti-emetic
Treats nausea. Block neurotransmission of signals to the CTZ/ brain(vomiting center of brain) for nausea and vomiting.
Maintain hydration, oral care, patient safety, no driving NO alcohol, monitor BP, use non-pharmacologic methods
Promethazine(Antiemetic)
Sedation, drowsiness, confusion, dry mouth, constipation, urinary retention, low BP
Ondansetron(Antiemetic)
Drowsiness, headache, constipation, diarrhea
Dimenhydrinate(Antiemetic)
Sedation, Dry mouth, blurry vision. Encourage to not drive.
Anticoagulants
Inhibit blood clotting
Check bleeding, monitor platelet, let dentist know, limit high K food if using coumadin, consider herbs (start with G) that can interfere, fall precautions
Heparin
Given SQ or IV NOT orally. Stops conversion of fibrinogen to fibrin. SLOW DOWN clot formation.
Monitor effect with aPTT(activated partial thromboplastin time) *time it takes blood to clot
25-40 seconds normal. 2X for therapeutic effects (60-80 seconds)
Enoxaparin
Fractioned heparin. Given SQ.
No lab test, more predictable
Warfarin
Stops liver synthesis of Vitamin K Factors 2,7,9,10. Given PO
Monitor effect with PT (Prothrombin time) and INR (International normalizing ratio)
PT: 12-15 sec. 2X normal for therapeutic effect
INR: 1.3-2 is normal. 2-3 if coumadin, 3-4 if artificial heart valve
Perfusion formula for high BP
CO (usually 4-10 liters per minutes) X SVR (systemic vascular resistance/ tone of blood vessels) = BP
CO
SV (70mL per beat) X HR (70 bpm)
What drugs treat BP?
Ace Inhibitors, Beta Blockers, Calcium Channel Blockers, ARBs, Nitrates
Beta Blockers
Decreases SNS effect on BP
Decrease HR and contractility of heart, decrease renin release —-> decrease BP
Check BP and HR; hold if too low; change positions slowly; watch glucose level if too low; watch for lethargy/depression/ heart failure
Ace Inhibitors
Inhibit RAAS (renin angiotensin aldosterone mechanism), decrease formation of angiotensin II, and decreases release of aldosterone.
Causes vessel dilation. Also causes H20 and Na excretion—> decreased BP; causes K retention
Check B/P; hold if too low;check for dizziness/orthostasis ; monitor for cough and angioedema; monitor Vitamin K levels; decrease foods high in K
Calcium Channel Blockers
Blocks calcium contractile effect on muscle. Causes vessel dilation and decreases myocardial contractility—-> decrease BP
Check BP, hold if too low; check for orthostasis; change positions slowly; watch for constipation, edema, heart failure, and cardia dysrhythmias
ARBS
Block angiotensin II at angiotensin II receptors
Cause vessel dilation —-> decreases BP; causes K retention
Monitor BP; watch for orthostatic hypotension and dizziness; watch for first dose effect, fatigue, diarrhea, and increased Vitamin K
Nitrates (nitroglycerin)
Vasodilation, relaxes vessel tone. Decreases BP.
Monitor BP. Do NOT mix with ED (erectile dysfunction) drugs or alcohol. Watch for headaches due to vessel dilation. Patient in reclining position on first dose
What drugs increase urinary output?
Thiazides, Loops, and K Sparing
Thiazides
Cause Na, H20, K, and Cl excretion from kidney
Monitor Urinary Output(30 mL/hr minimum output); maintain hydration; monitor weight, BP, and blood glucose; watch Na, Cl, K, Ca, levels. Patient may need K in diet
Give in AM with Food because urinary output will go up
Loops
More potent than Thiazides. Bumex is more potent than Lasix. Cause Na, H20, K, and Cl loss from kidney.
Monitor Urinary output weight; I&(30mL/hr minimum); maintain hydration; , BP; watch for dizziness and electrolyte levels especially K., patient will likely need K supplement.
Give Lasix slowly IV to prevent oxotoxicity— tinnitus, hearing loss, vertigo, give in AM with food
K sparing
Causes Na and H20 loss from the kidney, causes retention of K
Monitor BP, weight K levels; maintain hydration; check I&Os (30mL/hr minimum)
Given in AM with food
What are the drugs for the heart?
Cardiac Glycoside
Cardiac Glycoside
Inhibits Na/K-ATPase, more Ca available to promote cardiac muscle contractility
Stronger cardiac contraction; improved CO, blood flow, and tissue perfusion with oxygenated blood
Monitor HR- hold drug if HR <60bpm. Count Full minute of apical pulse
Check serum levels (therapeutic levels .8-2.0ng/mL, narrow TI drug with long half-life- may need peaks and troughs, in heart failure(therapeutic level is .5-1.0 ng/ml, toxic level if >2.2 ng/mL)
Due to long half life may need loading dose
Monitor for signs of toxicity-anorexia, blurry vision, bradycardia
Maintain good K intake in diet; if low K intake greater risk of digoxin toxicity
Monitor EKG and cardiac rhythm for dysrhythmias
