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Q3 Clin Lab Test 2 (CBC, Drugs, DM, Fluids, Card Enz) > Drug Mgmt > Flashcards

Drug Mgmt Flashcards

1
Q

Virchow’s Triangle is?

A

Trigger for thrombosis:

Hypercoag state
Endothil injury
Circulatory stasis

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2
Q

Warfarin indicated for tx of?

A

Prophy/tx of v thromb, PE, card emboli, thromb complications from a fib or valve placement

Post MI prophy of new MI or thromb events

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3
Q

Warfarin mechanism?

A

inhib vit K activation ->
depleats clotting factors

4-5 day load time

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4
Q

Recommended INR?

A

2 - 3

2.5 -3.5 if heart valve

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5
Q

Warfarin + Heparin standards?

A

Min 5 day overlap

Stop heparin when INR at correct level

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6
Q

Warfarin dosing?

A 
Initiate 5mg (2mg if old, etc)
Titrate w/ daily INR until right level

Monitor INR every 1-4wks

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7
Q

Warfarin contraindicated for?

A

Pregnancy
Alchol/drug abuse
Frequent falls
Unreliable behavior

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8
Q

Warfarin overdose presents?

A

Blood in urine/stool
Bruising
Bloody nose/gums
Heavy flow

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9
Q

Warfarin drug interactions: cause potentiation (bleeding)?

A 
Alcohol w/ liver dz
Aspirin
Acetaminophen
NSAIDs
Sulfa
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10
Q

Warfarin drug interactions: cause inhibition (less effective)?

A

Barbiturates
Bile sequestrants
Anti-convulsants

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11
Q

Tx of warfarin overdose?

A

Stop warfarin, monitor INR 1-2 days

Oral Vit K1 (takes 6-10 hrs)

IV Vit K1 (take few hrs)

Plasma infusion

Prothrombin Complex Concentrate (PCC)

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12
Q

Digoxin toxicity exacerbated by?

A 
hypoK+
hypoxemia
hypothyroid
renal insuff
hypovol
meds
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13
Q

Digoxin toxicity presentation?

A

Arrhythmias, (C) PAT w/ block

N/V/D anorexia

∆d mental state, visual disturbances

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14
Q

Digoxin toxicity tx?

A

Discontinue
Balance K+
Cardiac monitoring
φ cardioversion

Fab antibody fragments

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15
Q

Dilantin is?

A

anticonvulsant

Small ↑ in dose cause large ↑ in serum levels

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16
Q

Dilantin toxicity presentation?

A

(Draw drug level while sxs present)

Nystagmus
Tremor
Ataxia
Dizzy
Slurred speech
17
Q

Digoxin levels peak how long after ingestion?

Plateau?

When do you draw blood to check levels?

A

30-90 min

6-8 hrs

6-8 hrs

18
Q

Digoxin therapeutic range?

19
Q

Digoxin loading dose if faster tx needed?

A

0.25-0.5mg STAT
w/ 0.25mg Q 6hrs
x max 1.5mg/day

20
Q

Digoxin maint dose?

A

0.125-0.25 mg/day

21
Q

Dilantin therapeutic level?

Draw to eval levels when?

A

10-20

Just before next dose

22
Q

Dilantin levels peak when?

A 
4-8 hrs (oral)
15 min (IV)
23
Q

Dilantin S/E?

A 
rash
lethargy
gingival hypertrophy
megaloblastic anemia
benign lymphoid hyperplasia
24
Q

Dilantin toxicity tx?

A

no antidote

Q3 Clin Lab Test 2 (CBC, Drugs, DM, Fluids, Card Enz) (5 decks)

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