Exam 3 Flashcards
1
Q
Hemostasis
A
Process to 🚫🛑 bleeding
2
Q
Coagulation
A
Process of 🩸 clot formation
3
Q
Thrombus
A
🩸 clot
4
Q
Embolus
A
Thrombus located in a blood vessel 🪢
5
Q
A clot forming substance
A
Fibrin
6
Q
Fibrinolysis breaks down thrombi by?
A
Activating plasminogen, converting to plasmin.
Plasmin digests 🫃🏻the fibrin clot
7
Q
streptokinase
A
thrombolytic drug 💊
Made w/ beta-hemolytic strep
Allergic reaction‼️
👩⚖️Off market
8
Q
t-PA
A
Thrombolytic 💊
Naturally in 🩸 system
Clot specific📍
9
Q
alteplase
A
Thrombolytic 💊
💊 form of t-PA
IV
Short 1/2 life (5min) ⏳
Can give w/ heparin to 🚫reocclusion
10
Q
Anti thrombolytic drugs…
A
Promote clot formation
🚫🩸 post surgical or hemophilia
11
Q
Anti thrombolytic drugs…
A
Promote clot formation
🚫🩸 post surgical or hemophilia
12
Q
Oxidized cellulose (Surgacel)
commercial
A
Topical Antifibrinolytics
13
Q
aminocaproic
A
anti thrombotic/fibrinolytic 💊
🚫excessive🩸 post surgical
💉Antidote for thrombolytics
14
Q
tranexamic acid
A
Anti thrombolytic 💊
Hemophilia- prior to surgery & dental
Use 2nd form of BC 👶🏻
Adverse:
Hypotension
15
Q
Hemophilia is..
A
X-linked recessive 💙
More common in boys 👦🏻
16
Q
Classic 🎼Hemophilia A
A
Most common
📉deficient in factor 8
17
Q
Christmas 🎄 Hemophilia B
A
⬇️Deficient in factor 9
18
Q
Christmas 🎄 Hemophilia B
A
⬇️Deficient in factor 9
19
Q
Hemophilia C
A
⬇️ Factor 11
20
Q
Desmopressin
A
Hemophilia drug 💊
Anti diuretic hormone
Nocturnal enuresis 🌜
Releases factor 8 (type A)
Clot formation
Adverse effects:
Fluid retention 💧🦵🏻🫁
Hyponatremia ⬇️🧂
21
Q
Factor
A
Hemophilia 💊
Acute episodes of 🩸
Can premedicate w/benadryl for allergic reaction
Can give w/ desmopressin
22
Q
Nursing implications for coagulation modifier drugs
A
☑️vitals
🩸= ⬇️BP, ⬆️ HR, then ⬇️ HR
CBC
PT= 11-13
INR= 1
Avoid:
Invasive procedures
No IM injections
23
Q
methylphenidate
A
Treats ADHD & Narcolepsy
commonly abused 📚
Adverse effects:
Insomnia 😳🌜-🚫4-6hrs before bed
Slows growth
24
Q
Amphetamines
A
Adderall
Treate ADHD & Narcolepsy
Adverse:
Insomnia
25
Atomoxetine
Treats ADHD
Non-stimulant
SNRI
Adverse effects:
ED 🥺
Suicidal thoughts 💭
26
Modafinil
Treats Narcolepsy 💤
Shift work sleep disorder
Improves wakefulness 😳🙂
27
phentermine
Anorexiants 💊
Not as addictive as amphetamines
Not fen-phen (recalled for 🫀)
28
orlistat
Anorexiants 💊
Binds to pancreatic enzymes
Blocks fat absorption
Take ADEK vitamin
Adverse effects:
💩incontenance, oily spotting, gas
⬆️LFT- ☑️ q 6m
29
Migraines
Unilateral
4-72 hours ⏳
Pain
🤢🤮
Photophobia 💡
Photophobia 👂🏼
Can have aura
30
Sumatriptan
Doesn’t reduce # of migraines
🚫 after starts w/in 2 hrs ⏳
Take w/1st sign of migraine
31
ergotamine
Treatment of migraines and 🍇 cluster HAs
Can use w/ Triptan med
Adverse effects:
Vasoconstriction 🪢
⬇️throbbing pain.
⬆️BP
32
Analeptic response respiratory depression syndromes are caused by?
General anesthesia
Neonatal apnea
Breath holding
COPD
33
caffeine
Stimulates CNS to control respiration
Long 1/2 life
Caffeine citrate 👶🏻
30 min before feeding 🍼👶🏻
Caffeine sodium benzoate- 🫁adults
Contraindicated in-
Dysrhythmias, peptic ulcer disease
Recent MI 🫀
34
Doxapram
Treatment of COPD
Monitor:
deep tendon reflexes 🔨🦵🏻💪🏽
Heart rhythm 🥁
35
Sedatives
Inhibits effect on CNS ⬇️:
Nervousness 🥴
Excitability 🫨
Irritability w/o causing sleep
Can become a hypnotic in large doses
36
Hypnotics
Causes sleep 😴
A sedative can become a hypnotic if it is given in large enough doses
37
Barbiturates
End in -barbital
Habit forming
⬇️therapeutic index
⬇️REM sleep= daytime fatigue
Nightmares 😱when coming off 💊
Contraindicated in suicidal patients
🚨No Antidote ‼️
🫁 and BP support
38
Chloral hydrate
Nonbarbiturate sedative-hypnotic drug
Does NOT suppress REM sleep
🚫REM rebound
Short term use
- Tachyphylaxis- rapid⬇️ in response to repetitive administration
39
Benzodiazepines
End in -zepam & -Zolam
Calming effect on CNS
Useful in controlling anxiety &
Induction of sleep 😴 &
Skeletal 💪🏽 relaxation
Adverse effects:
Hangover 🤕, exhausted, 🥱 fatigue
Antidote‼️- Flumazenil
🫁support
40
Triazolam
Benzodiazepine💊
Use smallest 🤏🏽dose possible
1 dose
🚫longer than 3wks
⬆️doses= hallucinations, seizures, suicidal tendencies
41
Eszopiclone (Lunesta)
Long term use
8 hrs of sleep 😴 or sleepiness
30 min before bed
🚫heavy machinery 🚜
Non-benzo but works on receptors
Dark, cool room, 🚫tv or 📱
42
Zolpidem
Non-benzodiazepine but activates same receptor
Most used hypnotic
🚫rebound insomnia
⬇️Daytime drowsiness compared to other Benzos
☑️long term use
Adverse effect:
Somnambulation (sleep walking🚶🏽 )
43
Zaleplon
Non-benzodiazepine 💊
Short 1/2 life
Can re-dose as long as you have 4 hours to sleep ⏳🛌
Also for women w/ menopause
44
Nursing implications of Benzodiazepines
Sleep hygiene 🌑🚫📱💻💡
Give 15-30min before bed
Caution in 65yrs + 👵🏽
Avoid with ETOH 🥃🍷
🚫🚬🔥
45
Muscle 💪🏽 Relaxants
Relieves pain from skeletal 💪🏽spasms
Most are central acting Vs the actual muscle
46
baclofen
Muscle relaxant💊
Treats spasticity from:
MS, spinal cord injury, cerebral palsy
Oral & intrathecal
Pump
Replace with growth 📏
47
Cyclobenzaprine
Acts w/spinal cord to suppress hyperactive reflexes
For back pain 😫and occupational injuries 👷🏽♂️
48
dantrolene
Treats malignant hyperthermia 🥵
Relaxes shivering 🫨💪🏽,
Lowering temp 🤒
49
Psychotherapeutics treat?
Emotional and mental disorders
50
alprazolam (Xanax)
Shortest acting benzodiazepine
Most common anxiolytic
Adverse effects:
Confusion, ataxia (coordination), and headache
🚫🍷🥃
51
diazepam (Valium)
Benzodiazepine 💊
Most commonly used
Longest acting ⏳
Other use: status epilepticus, ETOH withdraw, post-op sedation, 💪🏽spasm
Adverse effects:
HA, confusion, slurred speech 🎤
52
Lorazepam (Ativan)
Benzodiazepine 💊
Other use: Chemo related to N/V, mechanical ventilation, ETOH 🍷 withdraw, severe agitation
53
Buspirone
Scheduled drug ⌚️
Delayed therapeutic effect
Less addictive
Adverse effects:
Paradoxical anxiety, dizziness, HA, nausea
Avoid serotonin syndrome ‼️
Wait 14d after MAOI (busoirone)
Don’t give w/anything
54
Clonazepam
Benzodiazepine💊
Other anxiolytic drug
Common use
55
Clonazepam
Benzodiazepine💊
Other anxiolytic drug
Common use
56
Antidote to benzodiazepines
Flumazenil
57
Antipsychotics
Blocks dopamine receptors
Improves positive symptoms of schizophrenia (hallucinations, disorganization)
Not good in treating negative symptoms of schizophrenia (apathy, social withdrawal, monotone speech, Catatonia)
58
Adverse effects of Antipsychotics
▪️warning‼️
Kids & young adults ⬆️suicidal 💭
⬆️death in 👵🏽w/ dementia
Adverse:
Metabolic syndrome- ⬆️weight
Shaking- similar to Parkinson’s
Neuroleptic malignant syndrome
(⬆️🥵, unstable BP
59
Haloperidol
Antipsychotics 💊
Every 2-4 weeks
For Tourette’s 🗣️
60
Aripiprazole
Antipsychotic 💊
For bipolar disorder, major depression, and agitation in autism
☑️BS 🩸
61
risperidone
Antipsychotic💊
Agitation in autism
62
Lurasidone
(Latuda)
Antipsychotic 💊
63
Lithium
Mood stabilizer💊
Antimania for bipolar
Gains weight, hard on 🫀
Monitor lithium q 2-3months
Maintaine 🧂level (135-145 mEq)
Narrow 🪟
0.6-1.2 mEq
>1.5 mEq
🫀dysthymia, slurred speech, ataxia, GI, 💪🏽 twitching
64
Antidepressants
Continue for at least 12 months
▪️warning‼️
⬆️risk for suicide
Regular monitoring
65
3 classes of antidepressants
SSRI
TCA
MAOI
66
SSRI
More commonly used
Expensive 💰
4-6 wks for effectiveness
⬇️Less side effects
Adverse effects:
Insomnia ⬇️REM 🌜
Weight gain
Sexual dysfunction
Slow taper off or:
Flu sx, ⬇️concentration, GI sx
🚫w/ MAOI
67
Serotonin syndrome
⬆️ doses of 💊
Delirium 😵💫
Agitation
Tachy 🫀dysrhythmias
Tremors
Seizure
Renal failure
Rhabdomyolysis
68
Serotonin syndrome
⬆️ doses of 💊
Delirium 😵💫
Agitation
Tachy 🫀dysrhythmias
Tremors
Seizure
Renal failure
Rhabdomyolysis
69
Fluoxetine
SSRI💊
Panic disorder
70
Citalopram
SSRI💊
OCD
71
Sertraline
SSRI💊
Premensteual dysohoric disorder
72
Paroxetine
SSRI💊
PTSD
73
Paroxetine
SSRI💊
PTSD
74
Bupropion
SSRI💊
Smoking cessation 🚬
75
Bupropion
SSRI💊
Smoking cessation 🚬
76
Escitalopram
SSRI💊
Seasonal affective disorder ❄️⛄
77
Escitalopram
SSRI💊
Seasonal affective disorder ❄️⛄
78
Duloxetine
SSNRI💊
Also blocks norepinephrine
Peripheral neuropathy pain and fibromyalgia
79
Mirtazapine
SSRI💊
Reduces sexual adverse effects
80
Mirtazapine
SSRI💊
Reduces sexual adverse effects
81
Tricyclic Antidepressants (TCA)
Cheap
Balances serotonin and norepinephrine
Adverse effects: (slows⬇️system)
Constipation
Urinary retention 💛
Drowsiness 😴
Sexual dysfunction
Hypotension
82
TCA overdose
Caused w/ ETOH 🍻🍷
Seizures
🫀Dysrhythmias
Life support
Activated charcoal 🪨
Physostigmine- help w/ anticholinergic symptoms
83
TCA overdose
Caused w/ ETOH 🍻🍷
Seizures
🫀Dysrhythmias
Life support
Activated charcoal 🪨
Physostigmine- help w/ anticholinergic symptoms
84
Imipramine
TCA💊
Adverse effects:
Constp, 💛retention, 😴, sexual dysf, hypotension
🚫🍷🍻
85
Amitriptyline
TCA💊
Most commonly used TCA
For: trigeminal neuralgia, neuropathic pain, insomnia 🌜
Adverse effects:
Constp, 💛retention, 😴, sexual dysf, hypotension
🚫🍷🍻
86
MAOIs are used for…
Those who 🚫respond to SSRIs & TCA
➕food interactions
➕side effects
Malignant HTN crisis 180/120
Tyramine= toxic levels= stroke
Aged🧀, 💨🥩, yeast, 🍷, fava 🫘, ripe 🥑, 🍻, and dark 🍫
SSRI- 2-5wk wash period
TCA- 14day wash period
87
Phenelzine
MAOI💊
Common
➕food interactions
➕side effects
88
Tranylcypromine
MAOI💊
➕food interactions
➕side effects
89
Isocarboxazide
MAOI💊
➕food interactions
➕side effects
90
Selegiline
MAOI💊
Transdermal patch
Also for parkinsons
➕food interactions
➕side effects
91
Disulfiram (antabuse)
For ETOH addiction
Last resort treatment
1dose= 2 weeks
7mL = unpleasant effects
🍷🍻 w/in 10 min can lead to:
Flushed, red hot skin, HA, N/V, sweating, dyspnea, hyperventilation, vertigo, blurred vision, confusion
Acetaldehyde syndrome
92
Alcohol 🍷🍻 withdraw may be….
Deadly 😵
93
Alcoholics may need a(n)
Detoxification program
94
A daily dosing if this eases withdraw from opioids?
Methadone
95
Long acting oral opioid
Methadone
96
What is the generic if Revia?
Naltrexone
97
You should decrease a dose of this to live opioid free
Methadone
98
What is the generic injection if Vivitrol?
Naltrexone
99
Drug abuse
Using of a drug that is inconsistent w/ medical norm
Drug usage that is harmful to the person
100
Addiction
Disease process characterized by the continued use of a specific psychoactive substance despite physical, psychological, Or social harm
101
Tolerance
Repetitive exposure to a drug, over time, induces Ah anges in drug receptors that reduce the drugs effects
102
Withdraw
A substance specific mental disorder characterized by physical symptoms, following the cessation or reduction in use of a psychoactive substance that has been taken regularly.
103
Symptoms of nicotine 🚬withdraw
Headache
Irritability
⬆️ BP
⬆️ apetite
104
What is CAGE?
Screen for 🍷🍻 addiction
Cut down
Annoyed
Guilt
Eye opener
105
Do not chew
Nicotine lozenges
106
Nicotine transdermal system
Highest compliance
107
Nicotine gum
Best for withdraw
Quick release
108
Varenacline (chantix)
Reduces pleasurable effects of nicotine
Greater efficacy
109
Bupropion SR
Sustained release antidepressant
Fast line therapy for 🚬cessation
