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ABSN > drug matrix exam 2 > Flashcards

drug matrix exam 2 Flashcards

1
Q

insulin lispro

A

-rapid
-15min ; 1-2 hr ; 2-4 hr

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2
Q

human regular

A

-short
-30 to 60 min ; 2-6 hr ; 3-8 hr
-can use for meals or longer
-tube feedings

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3
Q

NPH

A

-intermediate
-2 to 4 hr ; 4-10 hr ; 10-20 hr
-cloudy, use immediately
-usually given twice a day
-when combining, pull up 2nd

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4
Q

glargine

A

-long acting
-70 min ; x ; all day
-1x per day , usually night
-never mix

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5
Q

glipizide & glyburide MOA

A

binding and closing the K-ATP channels in the pancreatic beta cells thereby stimulating secretion of insulin [increases sensitivity & reduces release of glucose]
more insulin
(a marriage is binding)

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6
Q

glipizide & glyburide side effects

A

hypoglycemia (brides no longer eat the cake, low sugar)

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7
Q

glipizide & glyburide nursing considerations

A

-do not take during pregnancy
-ETOH, NSAIDS, tagament, sulfa based ATB potentiates side effects
(brides shouldn’t be pregnant or drunk at their wedding & downing NSAIDs)

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8
Q

metformin MOA

A

lowers BG by decreasing production of glucose in the liver & enhances glucose uptake & utilization by muscle
(met for my muscles, min glucose in liver)

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9
Q

metformin side effects

A

-abdominal bloating
-N/V/D
-risk for acidosis in pts w/ elevated creatinine
(contract looks like acid metabolic acidosis and that would cause stomach upset & kidney dys)

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10
Q

metformin nursing considerations

A

-monitor serum glucose
-give 30 mins before meals
-must be held 48 hrs before IV contrast
-do not use in pts w/ elevated ALT levels
-do not use in those w/ HR, kidney disease, liver disease, or excessive alc
-onset is several weeks w/ peak at 2-4 wk
-low risk of hypogly

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11
Q

therapeutic usages of metformin

A

glycemic control, prevent type 2, polycystic ovarian syndrome

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12
Q

linagliptin, sazagliptin & sitagliptin MOA

A

inhibits DPP4 (a hormone that inactivates the incretin hormone)
-increases insulin release by enhancing incretin activity
-reduces glucagon release
-decreases glucose production
-slows down digestion
4 things to reduce BG

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13
Q

linagliptin, sazagliptin & sitagliptin side effects

A

-N/D & stomach pain
-flu like symptoms
-skins reactions
-increased risk for pancreatitis
(zach got panc which caused the flu w/ stomach probs & a rash)

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14
Q

linagliptin, sazagliptin & sitagliptin nursing considerations

A

-indicated in combo w/ diet & life styles changes
-can be used alone or w/ metformin
-low chance of hypoglycemia
(Z&C life, 1 or 2 twins, never low bc hotel buffet)

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15
Q

DPP4 inhibitors

A

linagliptin, sazagliptin & sitagliptin

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16
Q

GLP-1 receptor agonists

A

dulaglutide, exenatide & semaglutide

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17
Q

dulaglutide, exenatide & semaglutide MOA

A

enhances glucose dependent insulin secretion & inhibits postprandial release of glucagon & suppressive appetite (don’t eat a tide pod, the pod release so if we dont eat them they wont, need proper food for insulin)

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18
Q

dulaglutide, exenatide & semaglutide side effects

A

-N/D/V
-injection site reactions
-headache
-upper respiratory infections
-wt loss
(salt water from the tide is irritating when u drink or inject it, can cause infection & wt loss)

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19
Q

dulaglutide, exenatide & semaglutide nursing considerations

A

-BBW: risk of thyroid c cellls tumors (contraindicated for people who have hx of thyroid & endocrine probs)
-not recommended for pt w/ ESRD
-given subQ
-peak in 2 hr
-usually used with metformin
(avoid the glup w/ subQ)

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20
Q

dapafliflozin MOA

A

prevents the kidneys from reabsorbing glucose back into the blood (pee out extra glucose & less is reabsorbed d/t blocking of sodium-glucose transport proteins)

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21
Q

sodium - glucose cotransport ER 2 (SLG2) inhibitors

A

dapafliflozin

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22
Q

dapafliflozin side effects

A

-increased risk for UTI &genital mycotic infections
-hypotension, fainting, dizziness, fatigue
(urine is flozin so dyhydrated)

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23
Q

dapafliflozin nursing considerations

A

-do not give to someone with ESRD
-not FDA approved for T1 DM
-can give w/ other DM meds
-starting to be used for heart failure
(zins are not FDA approved)

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24
Q

what drugs should not be given to renal pts

A

-GLP1
-SLG2
-metformin
-ketorolac
-napronxen [hardest on kidneys]

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25
Q

what is the hypoglycemia antidote

A

glucagon

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26
Q

glucagon MOA

A

activates hepatic glucagon receptors, stimulates glycogenolysis and release of glucose
-short half life so many need multiple doses

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27
Q

orlistat MOA

A

binds to gastric and pancreatic enzymes and blocks these enzymes reduces fat absorption by 30%

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28
Q

orlistat side effects

A

BBW: liver injury
-GI symptoms, oily spotting, flatulence & fecal incontinence [can reduce by reducing fat intake]
-decreases vitamin concentrations
(oils is fat, think signs of fat malab.)

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29
Q

orlistat nursing considerations

A

-3 months to show effect
-must be taking a multi vitamin
-teach diet and lifestyle
-best for BMI >30 or >27 w/ other risks
(low nut in obese so vits, wt loss doesnt happen over night)

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30
Q

cholinesterase inhibitor

A

donzepezil (I get Z’s in a nest)

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31
Q

NMDA receptor antagonist

A

memantine (no more dementia)

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32
Q

donzepezil MOA

A

works centrally in the brain to increase levels of acetylcholine by inhibiting acetylcholinesterasae &relaxes smooth muscle (chol is in class name, increase smaller word)

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33
Q

donzepezil side effects

A

-GI upset
-drowsy
-dizzy
-insomnia
-muscle cramping
-bradycardia & reflex tachy
-syncope

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34
Q

donzepezil nursing considerations

A

-do not take with NSAIDs if GI upset is present
-give at bedtime w/ food
-find way to make sure pt doesn’t forget
-indicated for mild to moderate AD

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35
Q

memantine MOA

A

blocks the stimulation of NMDA receptors believed to be associated w/ AD

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36
Q

memantine side effects

A

uncommon
-confusion, hypotension, headache, dizziness, constipation (take fiber)
-indicated for moderate to severe AD
-can give with or without food
(me take fiber)

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37
Q

centrally acting analgesic

A

tramadol

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38
Q

tramadol MOA

A

-binds weakly to mu opioid receptors
-inhibits re uptake of both norepi and serotonin

39
Q

tramadol indications

A

treat moderate or severe pain (periods are never mild)

40
Q

tramadol side effects

A

usually none
-drowsy, dizzy, headache, nausea, constipation, respiratory depression
-rare: seizures when combined w/ other CNS depressors

41
Q

anti - convulsants

A

gabapentin & pregablin

42
Q

gabapentin & pregablin MOA

A

thought to spontaneously suppress neuronal firing [anti convulsant] (put the neurons in a pen)

43
Q

gabapentin & pregablin indication

A

to complement opioid effects and used specifically neuropathic pain

44
Q

gabapentin & pregablin side effects

A

-drowsy
-dizzy
-vision problems
(the eyes follow the pen light)

45
Q

gabapentin & pregablin nursing considerations

A

can only be partially reversed with naloxone
(the pent up tin man is only partially human)

46
Q

what NSAID has no anti inflammatory property

A

acetaminophen

47
Q

non selective COX inhibitor NSAIDs

A

aspirin, ibuprofen, naproxen, ketorolac
(all words we know: the 1st two and then nap & keto)

48
Q

selective COX inhibitor NSAID

A

celecoxib

49
Q

NSAID MOA

A

anti prostaglandins by blocking key enzyme COX which is crucial for the production of prostaglandins

50
Q

what pills cannot be crushed

A

enteric coated

51
Q

non selective cox inhibitors side effects

A

GI upset & inhibits platelet aggregation
-stomach ulcers & bleeding
-rash
-edema
-kidney failure
-increases BP
-SOA in asthma pts

52
Q

selective cox inhibitors side effects

A

serious cardiovascular thrombotic events

53
Q

black box warning for all NSAIDs

A

cardio risk and increased risk of serious GI adverse events

54
Q

specific aspirin side effects

A

-salicylate poisoning [N/V, seizures, edema -> ringing ears & hearing loss]
-Reye’s syndrome
(“rin” for ring)

55
Q

what med can you not give to children

A

aspirin

56
Q

ketorolac specific considerations

A

-most potent NSAID
-for short term
-mainly post opt
-similar to morphine w/o res depression
-GI ulcers & high risk of renal dysfunction [esp if low renal function or dehydrated]

57
Q

acetaminophen MOA

A

-unknown
-decreases prostaglandin synthesis in the CNS possibly

58
Q

acetaminophen indications

A

mild to moderate pain and fever

59
Q

acetaminophen limitations

A

-ceiling effect
-not anti inflammatory

60
Q

acetaminophen side effects

A

w/ large amounts
-hepatic necrosis, liver failure, mild nephropathy
(ac=alcohol which is processed in the liver)

61
Q

adult acetaminophen dosage

A

4g/24 hr

62
Q

acute ingestion antidote for acetaminophen

A

acetylcysteine [mucomyst]

63
Q

acetaminophen nursing consideration

A

do not mix with alcohol (ac = acholol)

64
Q

advantages to IV acetaminophen

A

manage pain w/ less opioid abuse

65
Q

when is merperidine given

A

only for acute migraines or when a pt is shivering post opt

66
Q

MOA for all anti epileptic drugs

A

1) increase the threshold making it harder for the nerves to come receptive
2) limit the spread of the seizure
3) decrease the speed of nerve impulse

67
Q

anti epileptic drugs

A

phenytoin, valproic acid, topiramate, levetiracetam

68
Q

phenytoin indication

A

first line of defense for epilepsy tonic-clonic seizures and partial focal seizures (Ph=F, F is for First)

69
Q

phenytoin side effects

A

tons
-lethargy
-abnormal movements
-mental confusion
-cognitive changes

70
Q

phenytoin causes what special side effects

A

-gingival hyperplasia teeth -> dentist
-hirsutism
-osteoporosis
-hypertrophy of subQ facial tissue
(pheny T = funny teeth -> teeth are on your head w/ your hair & face tissue)

71
Q

phenytoin nursing consideration

A

monitor therapeutic effect, highly protein bound [rapid rise,CYP450] (ph is for first & fast)

72
Q

valproic acid indication

A

treatment of generalized seizures [absence, myoclonic, tonic clonic & partial] (val can do it all)

73
Q

valproic acid nursing consideration

A

-highly protein bound [CYP 450 + lots of interaction]
-safe for children
(pro for protein)

74
Q

valproic acid adverse effects

A

hepatoxicity, pancreatitis (acid is toxic)

75
Q

what drugs should not be given to liver pt

A

-valproic acid
-metformin
-orlistat
-acetaminophen

76
Q

what drugs should not be given to pancreas pt

A

-valproic acid
-DPP4 meds

77
Q

valproic acid is contraindicated for

A

liver disease, urea cycle disorder (U V in the alphabet are together)

78
Q

can you give valproic acid to children

A

in the delayed release form

79
Q

topiramate indication

A

adjunct therapy for partial and secondary generalized seizures, tonic clonic (mates are 2 people, partial w/o eachother)

80
Q

topiramate adverse reactions

A

general CNS depression, GI upset
watch for vision changes, can cause closed angle glaucoma
(u see ur mate w/ ur eyes)

81
Q

topiramate nursing consideration

A

can interact w/ contraceptive meds & cause cleft lip if taking during pregnancy

82
Q

what seizure med can be taken while pregnant

A

none -> should be on a contraceptive

83
Q

levetiracetam

A

indicated for adjunct therapy for partial seizures w/ or w/o generalization

84
Q

all anti epileptic BBW

A

increased risk for suicidal thoughts, depression and unusual changes in mood

85
Q

gold standard for rapid mgt of seizures

A

if needed (usually stop on their own) IV push benzodiazepines

86
Q

what are the side effects of all opioids

A

nausea, vomiting, constipation and respiratory depression (possibly itching, dry mouth, dizziness & confusion)

87
Q

codeine, hydrocodone and oxycodone help with what else besides pain

A

cough

88
Q

morphine is used for what type of pain

A

moderate to severe

89
Q

hydromorphone is used for what type of pain

A

severe pain (when I have severe pain I go into the water)

90
Q

fentanyl is used for what type of pain

A

most severe pain

91
Q

codeine is used for what type of pain

A

mild to moderate

92
Q

hydrocodone is used for what type of pain

A

mild to moderate

93
Q

oxycodone is used for what type of pain

A

moderate to severe (oxygen has ranges)

94
Q

methodone is used for what

A

pain from detox

ABSN (118 decks)

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