DRUGS Flashcards
action of morphine
relaxes vascular smooth muscle, reducing preload and after load
common side effects of morphine
respiratory depression, hypotension, bradycardia, sedation, confusion, constipation, nausea, vomiting
pre and post of morphine
- assess pain
- respirations
- BP
- pulse
- level of sedation
- bowel function
why is atorvastatin (lipitor) used
management of primary cholesterol and mixed dyslipidemia
actions of atorvastatin (lipitor)
- lowers total and LDL cholesterol and triglycerides
- slightly increases HDL
- slows progression of atherosclerosis
common side effects of atorvastatin (lipitor)
- abdominal cramps
- constipation
- diarrhea
- flatus
- heart burn
- confusion
- memory loss
pre and post for atorvastatin (lipitor)
- diet history
- monitor liver function
- LDL and triglycerides
what is atorvastatin (lipitor) contraindicated in?
not good for pt’s with active liver disease
why is altepase used?
acute MI, ischemic stroke, pulmonary embolism, DVT
class of altepase?
thrombolytics
action of altepase
directly converts plasminogen to plasmin, degrading clot bound fibrin, dissolving the clot
class of nitroglycerin
nitrates
indication of nitroglycerin
acute/long term prophylactic management of angina
action of nitro
increase coronary blood flow by dilating coronary arteries
SE of nitro
dizziness, headache, hypotension, tachycardia
what is something to know when using nitroglycerin?
CAN ONLY USE 3 TIMES
pre and post assessment of nitro
assess angina pain, BP, and pulse
class of metoprolol
beta blocker
indications of metoprolol
treatment of angina and HTN, lowers HR
action of metoprolol
reduction in cardiac output (stroke volume) by blocking beta receptors
SE of metoprolol
bradycardia, inadequate cardiac output, bronchospasm, fatigue, weakness, HF, pulmonary edema
pre and post of metoprolol
- BP
- pulse
- intake/output
- signs of HF
- angina attacks
contraindicated of metoprolol
- not good in uncompensated HF and bradycardia and heart block
- diabetics must closely monitor BG
hydroclorothiazide class
diuretic (thiazide)
actions of hydroclorothiazide
- increasing excretion of sodium
- promotes excretion of chloride, potassium, magnesium and bicarbonate
indications of hydroclorothiazide
lowering BP and diuresis
SE of hydroclorothiazide
- hypokalemia
- dehydration
- hypotension
- hyperG
- weakness
- rash
pre and post for hydroclorothiazide
- BP
- intake/output
- electrolytes (Na, K)
- hydration status
- BP and pulse
- any rash
- renal and hepatic function
class of furosemide
diuretic
indications of furosemide
- diuresis and modularization of excess fluid (edema due to HF, hepatic impairment or renal disease)
- decreases BP
MOA of furosemide
- inhibits reabsorption of sodium and chloride
- increases renal excretion of water, sodium, chloride, magnesium, potassium and calcium
SE of furosemide
- electrolyte imbalances
- hypotension
- dehydration
- metabolic alkalosis
- muscle cramps
- hypotension
- diarrhea
- rash
pre and post furosemide
- electrolytes (na, K)
- hydration status
- BP and pulse
- any rash
- renal and hepatic function
what is something to know with furosemide
diabetics must monitor BG closely as it can raise levels
insulin lispro (humalog) indication
rapid acting insulin
MOA of lispro (humalog)
lowering BG by: stimulating uptake in skeletal muscle and fat and inhibiting hepatic glucose production
SE of lispro (humalog)
hypoG, anaphylaxis, hypokalemia, swelling
pre and post for lispro humalog
assess for S+S of hypoG, monitor body weight, assess for allergic reactions
onset, peak and duration for humalog?
onset: 10-15 min
peak: 60-90 min
duration: 3-5 hours
insulin glargine (lantus) indications
long acting insulin
MOA of glargine lantus
lowering BG by: stimulating uptake in skeletal muscle and fat and inhibiting hepatic glucose production
SE of glargine lantus
S+S of hypoG etc
pre and post for glargine lantus
same as for other insulins
what do you need to know for glargine lantus
CANNOT MIX WITH ANY OTHER INSULINS
whats the onset and duration of glargine lantus
onset: 90 min
duration: 24hr
class of warfarin
anticoagulant
indications of warfarin
prevention of thrombolytic events
MOA of warfarin
interferes with the production of vitamin K dependent clotting factors
SE of warfarin
- cramps
- nausea
- bleeding
- fever
pre and post of warfarin
- BP and HR
- monitor PT-INR
- assess for signs of bleeding/bruising
what to consider with warfarin?
- can take 3-5 days to reach therapeutic level
- long half life: 1-3 days
- antidote is vitamin K
ramipril class
ACE inhibtors
indications of ramipril
management of HTN and HF, reduction of risk of MI and stroke
MOA of ramipril
blocks angiotensin 1 to converting to 2 (works with vasoconst.)
-if we block angio 2, we dilate the vessels which allows heart to not work as hard and decreases BP
SE of ramipril
- cough
- hypotension
- taste disturbances
- fatigue
- headache
- drowsiness
- hyperkalemia
- angioedema
- creatinine and electrolyte levels
class of digoxin
antiarrhythmics, inotropic
indications of digoxin
when you have heart failure, a-fib, and atrial flutter
MOA of digoxin
- increases cardiac output (pos. inotrope) and slows HR
- increases force of myocardial contractions
- prolongs refractory period of the AV node and decreases conduction through the SA and AV node
SE of digoxin
fatigue, bradycardia, arrhythmias, nausea, vomiting, anorexia, electrolyte imbalances
pre and post of digoxin
- monitor pulse (withhold if less than 60bpm)
- BP
- electrolytes levels
- renal and hepatic function
what to know with digoxin
- narrow therapeutic index
- contraindicated in uncontrolled ventricular arrhythmias, AV heart block, constrictive pericarditis
- administer 1 hour before meals or 2 hours after
class of metformin
biguanides
indications of metformin
management of type 2 diabetes
MOA of metformin
- decreases hepatic glucose production
- decreases intestinal glucose absorption
- increases sensitivity to insulin
SE of metformin
abdominal bloating, diarrhea, N+V
pre and post of metformin
hypoG, lactic acidosis, assess glucose levels, renal Fx
things to know for metformin
- contraindicated with patients with renal impairment, HF, recent MI and stroke
- monitor creatinine, >133 men and >112 women
- metformin does not stimulate insulin release from the pancreas and therefor does not actively drive BG levels down
glipizide class
sulfonylureas
indication for glipizide
control of blood sugar in T2 DM
MOA of glipizide
- stimulates the pancreas to secrete insulin
- improves insulin action at receptor sites
- may decrease hepatic insulin metabolism (break down)
SE of glipizide
hypoG, mild nausea, diarrhea, constipation, dizziness, drowsiness, skin, rash, redness, or itching
pre and post for glipizide
assess for hypoG, monitor glucose, CBC
phenytoin class
antiarrhythmic, anticonvulsants
indications of phenytoin
treatment/prevention of tonic clonic (grand mal) seizures and complex partial seizures
MOA of phenytoin
limits seizure propagation by altering ion transport
-shortens action potentials (anti-arrhythmic)
SE of phenytoin
suicidal thoughts, ataxia, diplopia, nystagmus, hypotension, nausea, rash
pre/post of phenytoin
- hypersensitivity
- mental status
- seizures assessment
- BP, ECG, resp
- monitor CBC, calcium, hepatic function
things to know about phenytoin
use caution in hepatic and renal disease
