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NUR 411 Meds > Exam 3 Meds > Flashcards

Exam 3 Meds Flashcards

1
Q

Albumin 5% (Albumarc, Albuminar-5, Albutein 5%, Buminate 5%, Plasbumin-5)

albumin 25% (Albuminar-25, Albutein 25%, Buminate 25%, Plasbumin-25)

A

USES:
Restores plasma volume in burns, hyperbilirubinemia, shock, hypoproteinemia, prevention of cerebral edema, cardiopulmonary bypass procedures, ARDS, hemorrhage; also replacement in nephrotic syndrome

CONTRAINDICATIONS
Hypersensitivity, HF, severe anemia, renal insufficiency, pulmonary edema

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2
Q

Neostigmine (Prostigmin)

A

Cholinesterase inhibitor (long acting)

Action: Block ACh hydrolysis by cholinesterase, resulting in ACh accumulation at the cholinergic synapse (increased cholinergic stimulation)

Uses: treat the symptoms of Myasthenia Gravis, Urinary Retention or Post-Op Distenion, and reversal of Nondepolarizing Neuromuscular Blockade

Contraindications: bradycardiac, hypotension, Intestinal/ Urinary obstruction, hypersensitivity

Nursing:

  1. Monitor HR, RR, and BP (BG for diabetic - hypoglycemia)
  2. Toxicity: assess for bradycardia, hypotension, bronchospasm, headache, dizziness, seizures, respiratory depression; product should be discontinued if toxicity occurs
  3. Antidote: atropine 1-4mg IV q 5-30 min
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3
Q

pyridostigmine (Mestinon)

A

Cholinesterase inhibitor (long acting)

ACTION:
Inhibits destruction of acetylcholine, which increases concentration at sites where acetylcholine is released; this facilitates transmission of impulses across myoneural junction

Therapeutic outcome: increased muscle strength in myasthenia gravis

Contraindications: bradycardia, hypotension, Intestinal/ Urinary obstruction, hypersensitivity

Nursing:

  1. Monitor HR, RR, and BP (BG for diabetic - hypoglycemia)
  2. Toxicity: assess for bradycardia, hypotension, bronchospasm, headache, dizziness, seizures, respiratory depression; product should be discontinued if toxicity occurs
  3. Antidote: atropine 1-4mg IV q 5-30 min
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4
Q

NIFEdipine (Procardia)

A

Calcium channel blocker, antianginal, antihypertensive

ACTION: Inhibits calcium ion influx across cell membrane during cardiac depolarization, produces relaxation of coronary vascular smooth muscle, dilates coronary vascular arteries, increases myocardial oxygen delivery in patients with vasospastic angina, dilates peripheral arteries

Therapeutic outcome: Decreased angina pectoris, decreased B/P in hypertension

USES: Chronic stable angina pectoris, variant angina, hypertension, migraine prophylaxis

Nursing:
Monitor cardiac status: B/P, pulse, respirations, ECG
Monitor potassium, renal/liver function tests
Assess for bruising, petechiae, bleeding

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5
Q

Tetanus toxoid

**Tetanus
Caused by exotoxin produced
by bacterium Clostridium tetani

Enters body through wound

Characterized by generalized
rigidity and convulsive spasms

A

Used for prophylactic treatment of wounds

Burn Pt without tetanus vaccination

CONTRAINDICATIONS: Hypersensitivity, active infection, poliomyelitis outbreak, immunosuppression

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6
Q

Tetanus immunoglobin

A

Action: giving your body the antibodies it needs to protect it against tetanus infection. This passive protection lasts long enough to protect your body until your body can produce its own antibodies against tetanus.

Deep partial thickness burn (25% TBSA) -> get 2 shots (T.immunoglobin + T.toxoid)

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7
Q

LORazepam (Ativan)

A

Sedative-hypnotic, antianxiety agent

ACTION:
Potentiates the actions of GABA, an inhibitory neurotransmitter, especially in the limbic system and reticular formation, which depresses the CNS

NO: pregnancy, breastfeeding, COPD, sleep apnea, drug abuse, co-admin w/ other CNS depressants (opioids)

Watch: orthostatic hypotension (dizziness, drowsiness -> no driving/mechanical machines until tolerated)
RR, seizure activity, hepatic studies (AST, ALT, bilirubin, LDH), suicidal ideation.

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8
Q

methylPREDNISolone (Solu-MEDROL)

A

Corticosteroid

ACTION:
Decreases inflammation by suppression of migration of polymorphonuclear leukocytes, fibroblasts; reverses increased capillary permeability and lysosomal stabilization

Watch:
potassium (hypokalemia), blood glucose, urine glucose (hyperglycemia)
BP, HR, I&O (edema), weight gain

Teach patient to take PO with food, milk, to decrease GI symptoms. **Cushingoid symptoms: buffalo hump, moon face, rapid weight gain, excess sweating

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9
Q

dipyridamole (Persantine)

A

Antiplatelets - Adenosine reuptake inhibitors

Action: inhibition of phosphodiesterase, blockade of uptake of adenosine (which acts at adenosine A2 receptors to stimulate platelet)

USES: prevent myocardial infarction and stroke; coronary syndromes.

Watch: pregnancy, breastfeeding, bleeding disorders. Monitor bleeding from orifices, stool urine
• Monitor blood tests: platelets, Hgb, Hct, PT/APTT, and INR

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10
Q

carBAMazepine (Tegretol)

A

Anticonvulsant

ACTION: Exact mechanism unknown; appears to decrease polysynaptic responses and block post-tetanic potentiation

Therapeutic outcome: Absence of seizures; decreased trigeminal neuralgia pain (sudden severe facial pain)

NO pregnancy, bone marrow suppression

Teach: no grapefruit juice, report double/blurred vision, do not skip meds + take the missed dosed ASAP.

SE: nausea, vomiting, ataxia, diplopia,

Toxicity: nystagmus, gait coordination, cognitive function

Monitor liver function tests (AST, ALT) and urine function tests, BUN, urine protein

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11
Q

edrophonium (Tensilon)

A

The Tensilon test - diagnose myasthenia gravis (MG)

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12
Q

Baclofen

A

Skeletal muscle relaxant, central acting

ACTION:
Inhibits synaptic responses in CNS by stimulating GABAB receptor subtype, which decreases neurotransmitter function, decreasing frequency, severity of muscle spasms

Therapeutic outcome: Decreased spasticity of muscles

USES: Spasticity in spinal cord injury, multiple sclerosis

Monitor B/P, weight, blood glucose, and hepatic function. Assess CNS depression: dizziness, drowsiness, psychiatric symptoms.

Withdrawal symptoms: Agitation, tachycardia, insomnia, hyperpyrexia -> DO NOT discontinue abruptly

Teach patient to avoid hazardous activities (driving) if drowsiness, dizziness occurs; to rise slowly to prevent orthostatic hypotension

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13
Q

interferon beta-1b (Betaseron)

A

Multiple sclerosis agent, immune modifier - use after stopping immunoglobin

Adverse effects: flu-like reactions, hepatotoxicity, myelosuppression, injection site infections, depression, neutralizing antibiotics

Teach: use anaphylactic kit, increase water intake, diet that helps with liver damage, bone marrow suppression (safety, infection), depression, suicidal thoughts

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14
Q

selegiline (Eldepryl)

A

Antiparkinson agent - monoamine oxidase inhibitors

ACTION: monoamine oxidase decreases norepinephrine activity. Inhibits MAO-B breakdown of dopamine in the brain.

CONTRAINDICATIONS: Children/adolescents (suicide/hypertensive crisis), hypersensitivity, breastfeeding, MAOIs

NO tyramine foods (cheese, wince, beer, yogurt)

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15
Q

doxazosin (Cardura)

A

Peripheral α-adrenergic blocker, antihypertensive

ACTION: Peripheral blood vessels are dilated, peripheral resistance lowered; reduction in B/P results from peripheral α-adrenergic receptors being blocked

Therapeutic outcome: Decreased B/P, decreased symptoms of benign prostatic hypertrophy (BPH)

USES: Hypertension, urinary outflow obstruction, symptoms of benign prostatic hyperplasia

Monitor B/P (lying, standing) and pulse, syncope; jugular venous distention, crackles, dyspnea, orthopnea. check for edema in feet, legs daily; I&O; monitor for weight daily

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16
Q

clopidogrel (Plavix)

A

Platelet aggregation inhibitor

ACTION: Inhibits first and second phases of ADP-induced effects in platelet aggregation

NO active bleeding pt

Therapeutic outcome: Decreased possibility of stroke/ transient ischemic attacks (TIA), MI by decreasing platelet aggregation

Monitor: liver function test (AST, ALT, bilirubin), blood test (CBC, Hct, Hgb)

17
Q

atropine

A

Antidysrhythmic, anticholinergic parasympatholytic

ACTION: Blocks acetylcholine at parasympathetic neuroeffector sites; increases cardiac output, heart rate by blocking vagal stimulation in heart; dries secretions by blocking vagus

Therapeutic outcome: Drying of secretions, increased heart rate, cycloplegia, mydriasis

Positive therapeutic outcome
• Decreased dysrhythmias
• Increased heart rate
• Decreased secretions, GI, GU spasms
• Bronchodilatation

Monitor ECG, BP, RR, cyanosis, wheezing, dyspnea, engorged neck veins

TEACH report change in vision; trouble breathing; sweating; flushing, chest pain, allergic reactions, constipation, urinary retention, to use sunglasses to protect the eyes, DO NOT skip dose.

18
Q

Aminocaproic acid (Amicar)

A

Antifibriolytic - blood clotting drug

Antidote for t-PA (tissue plasminogen activator)

Side effects: chest tightening, Headache, stomach pain, loss of appetite, nausea, vomiting, diarrhea, unusual tiredness, dizziness, stuffy nose, or watery eyes

REPORT: sore throat that doesn’t go away, ringing in the ears, vision changes, muscle pain/weakness, signs of kidney problems (such as change in the amount of urine), confusion, slow heartbeat, unusual bleeding or bruising.

19
Q

hydrocortisone sodium succinate (Solu-Cortef)

A

Short-acting glucocorticoid

ACTION: Decreases inflammation by suppressing migration of polymorphonuclear leukocytes and fibroblasts and reversing increased capillary permeability and lysosomal stabilization (systemic); antipruritic, antiinflammatory (topical)

Watch: **Cushingoid symptoms: buffalo hump, moon face, rapid weight gain, excess sweating. Potassium (hypokalemia), blood glucose, urine glucose (hyperglycemia)
BP, HR, I&O (edema), weight gain

20
Q

silver sulfADIAZINE (Silvadene)

A

ACTION: Interferes with bacterial protein synthesis

USES: Skin infections, minor burns, wounds, skin grafts, primary pyodermas, otitis externa

21
Q

levodopa-carbidopa (Sinemet)

A

Dopamine precursors

Carbidopa delays Levodopa conversion until it reaches the brain to allow lower dose.

TEACH: high protein diet interferes with absorption. Pyridoxin (Vit. B6) can interfere with absorption and increases decarboxylase activity.

Watch: B/P, respiration, orthostatic B/P

TOXICITY: muscle twitching, blepharospasm (eye twitching)

22
Q

phenytoin (Dilantin)

A

Anticonvulsant

ACTION:
Inhibits spread of seizure activity in motor cortex by altering ion transport; increases AV conduction to decrease dysrhythmias

NO pregnancy, hormonal contraception

Monitor ECG, B/P, respiratory function, liver function tests for renal failure: ALT, AST, bilirubin, creatinine

TOXICITY: bone marrow depression, nausea, vomiting, ataxia, diplopia, CV collapse, slurred speech, confusion

23
Q 
t-PA
streptokinase (Streptase)
reteplase (Retavase)
anistreplase (Eminase)
tenecteplase (TNKase)
A

thrombolytic

NO hemorrhagic stroke

Indication: within 3 - 4.5 hrs of stroke symptom onset

Followed by heparin

MD checks rectum for HI bleeding.

24
Q

terazosin (Hytrin)

tamsulosin (Flomax)

A

Alpha-Adrenergic blocking agent

Decrease smooth muscle tone of the prostate & bladder neck -> increase urine flow. Not affecting libido.

Causes: hypotension, dizziness, postural hypotension

25
Q

captopril (Capoten)

A

ACE inhibitors -> decreases BP

Action: inhibits ACE; prevents conversion of angiotensin I to angiotensin II

Watch: coughing (adverse effect). Monitor B/P, check for orthostatic hypotension, syncope

26
Q

finasteride (Proscar)

A

5-α-Reductase inhibitor (5-α-Reductase is necessary for conversion of testosterone to dihydrotestosterone)

Reduce prostate size -> increase urine flow.
Decrease libido, erection + increase breastsize (gynecomastia).

Hair stimulant - help w/ hair grow on crown & eyelashes

27
Q

Digoxin

A

antidysrhythmic, cardiac glycoside

ACTION: Inhibits sodium-potassium ATPase -> more calcium available for contractile proteins -> increased CO; increases force of contraction (positive inotropic effect); decreases heart rate (negative chronotropic effect); decreases AV conduction speed

Watch: EKG, electrolytes (K, Na, Cl, Mg, Ca), renal functions

TOXICITY: anorexia, nausea, vomiting, irregular heartbeat and neurological symptoms

28
Q

metFORMIN (Glucophage)

A

Antidiabetic

ACTION: decreases hepatic glucose production, decreases intestinal absorption of glucose, and improves insulin sensitivity by increasing peripheral glucose uptake and utilization.

Monitor for lactic acidosis: hyperventilation, fatigue, malaise, myalgia, chills, somnolence
Monitor for hypoglycemic reactions (sweating, weakness, dizziness, anxiety, tremors, hunger)

29
Q

allopurinol (Zyloprim)

A

Antigout drug, antihyperuricemic

ACTION: Inhibits the enzyme xanthine oxidase, reducing uric acid synthesis

Therapeutic outcome: Decreasing serum uric acid levels, decreasing joint pain

Watch: BP, S&S coronary vasospasm (chest pain, hot sensation, burning, feeling of pressure, numbness, tingling in extremities), LOC

NO tyramine foods (cheese, wince, beer, yogurt)

30
Q

metoprolol (Lopressor)

A

β1-Adrenergic blocker (Antihypertensive)

ACTION: Lowers B/P, reduces elevated renin plasma levels; blocks β2-adrenergic receptors in bronchial & vascular smooth muscle (high doses)

Monitor: EKG, BP, pulse, edema, I&O, daily weight; check for jugular vein distention, crackles bilaterally, dyspnea (HF)

Teach: DO NOT skip dose, discontinue abruptly.

NUR 411 Meds (5 decks)

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