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OCTH 1031 > FINAL EXAM - Common Medications > Flashcards

FINAL EXAM - Common Medications Flashcards

1
Q

Adverse drug reactions (ADR) will be seen in

A

the vital signs

ALWAYS check clients vitals

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2
Q

Parkinson’s L-dopa

A

when optimal tone effect is reached is the time to treat for therapy

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3
Q

The more medications a person takes, the more….

A

ADRs a person will experience

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4
Q

Reasons for ADRs(6)

A
  1. risk/benefit of drug not recognized
  2. hx of drug allergy
  3. wrong drug name or dosage form
  4. lack of education
  5. failure to obtain adequate pt. hx and drug hx
  6. pt compliance issues
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5
Q

Pharmacokinetics (Pk) ADME

A
  1. Absorption
  2. Distribution
  3. Metabolism
  4. excretion
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6
Q

Absorption

A

through stomach and intestinal wall - not fully absorbed

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7
Q

distribution

A

travels to liver and active in blood stream = travels all around

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8
Q

metabolism

A

liver first before where it needs to go = partially deactivated

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9
Q

excretion

A

removed through urine

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10
Q

Pk can be affected by exercise because

A

the blood goes to the skin and muscles so the drug is not being absorbed by the blood is not going to the GI tract

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11
Q

Side effects are caused by

A

the drug binding to other areas besides its target organ

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12
Q

Why do we NEVER heat the injection site?

A

increases absorption

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13
Q

Acidic drugs enter through the

A

stomach

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14
Q

Transdermal route is

A

slow - patches for pain, estrogen, nicotine

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15
Q

NEVER put a hot pack over a transdermal patch because

A

increases absorption and can lead to death!

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16
Q

Intravenous

A

goes directly to the site - 100% is absorbed

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17
Q

intrathecal

A

spinal canal - epidural

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18
Q

implanted devices

A

reservoir implanted- morphine/insulin pump

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19
Q

Common ADR for antimicrobials (3)

A
  1. diarrhea
  2. rash
  3. pruritus (itching)
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20
Q

Common ADR for Anticoagulants (2)

A
  1. hemorrhage
  2. Bruising
    * fine line between enough and too much
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21
Q

Common ADR for Chemotherapy (6)

A
  1. bone marrow suppression
  2. alopecia
  3. nausea
  4. infection (decrease in WBC)
  5. fatigue (decrease in RBC)
  6. anemia (decrease in RBC)
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22
Q

Common ADR for cardiovascular (3)

A
  1. heart block
  2. arrhythmias
  3. edema
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23
Q

Common ADR for Diabetic medication (3)

A
  1. hypoglycemia (sends people to hospitals)
  2. diarrhea
  3. GI complications
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24
Q

Common ADR for NSAIDS (3)

A
  1. GI Ulceration and bleeding
  2. renal insufficiency
  3. MI
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25
Q

Common ADR for Diuretics (3)

A
  1. hypokalemia (low K+)
  2. hyperglycemia
  3. dehydration
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26
Q

diabetes and diuretics are not good because

A

risk of hyperglycemia

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27
Q

body structures and functions commonly affected by ADRs (6)

A
  1. hematological system
  2. skin and related structures
  3. metabolic
  4. musculoskeletal
  5. respiratory
  6. sensory
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28
Q

Affects to the hematological system (2)

A
  1. anemias

2. thrombocytopenia

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29
Q

Affects to the skin and related structures (5)

A
  1. pruritus
  2. urticaria
  3. alopecia
  4. rash
  5. petechiae
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30
Q

Affects to the metabolic system(2)

A
  1. osteoporosis

2. fluid and electrolyte imbalance

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31
Q

Affects to the musculoskeletal system (4)

A
  1. myalgia
  2. arthralgia
  3. neuropathy
  4. rhabdomyolysis (muscle breakdown)
32
Q

Affects to the respiratory system (5)

A
  1. bronchospasm
  2. allergic rhinitis
  3. respiratory depression
  4. pulmonary fibrosis
  5. dyspnea
33
Q

Affects to the sensory system (5)

A
  1. impaired vision
  2. ototoxicity
  3. tinnitus
  4. diplopia
  5. periperal neuropathy
34
Q

Peripheral vascular resistance caused by plaque causes

35
Q

What factors increase BP? (3)

A
  1. fluid overload
  2. narrowed arteries
  3. high heart rate
36
Q

Beta blockers

A

lower BP by slowing down the heart rate. binds to beta receptors so adrenaline cannot. decreases HR and contractility of the heart

37
Q

Beta Blocker ADRS (6)

A
  1. fatigue
  2. bad cholesterol
  3. orthostatic hypotension
  4. excessive slowing of the HR and contractility
  5. masks symptoms of hypoglycemia (not good for diabetic pts)
  6. less effective when given with arthritis medicine
38
Q

Beta blockers and exercise

A

beta blockers lower HR which mean exercise HR will be lower; only add 20 to the RHR.
Ex: RHR normally 80, only bring HR up to 100 during exercise

39
Q

Diuretics

A

inhibit the sodium pumps preventing reabsorption of fluid back into the body. Affordable - not necessarily the best option

40
Q

ADR of diuretics (5)

A
  1. fluid depletion
  2. loss of electrolytes
  3. orthostatic hypotension
  4. hyperglycemia
  5. increase in LDL
41
Q

All drugs for HTN cause

A

orthostatic hypertension

42
Q

dehydration causes (7)

A
  1. fatigue
  2. altered mental status
  3. fainting
  4. headaches
  5. dry mouth
  6. skin turgor (skin stays pinched)
  7. increased HR
43
Q

clinical signs to watch for with diuretics (10)

A
  1. hypotension
  2. dizziness
  3. orthostatic hypotension
  4. dehydration
  5. cramping
  6. arrhythmia
  7. incontinence
  8. muscle cramps
  9. thready pulse
  10. elevated K+ and BUN levels
44
Q

Rehab and diuretics (8)

A
  1. ankle pumps for circulation
  2. monitor pulse
  3. skin inspection
  4. fall prevention
  5. watch for signs of dehydration
  6. prolonged exercise in the heat is contraindicated
  7. geriatrics more sensitive to affects
  8. NSAIDS make diuretics less effective
45
Q

Diuretic toxicity (6)

A
  1. anorexia
  2. nausea
  3. vomiting
  4. confusion
  5. weakness
  6. paresthesia of extremities (tingling)
46
Q

Calcium Channel Blockers

A

make vessels wider, used for HTN

47
Q

Clinical signs to watch for with Calcium channel blockers (4)

A
  1. hypotension
  2. orthostatic hypotension
  3. dizziness/syncope
  4. lower extremity edema
48
Q

Rehab implications with Calcium channel blockers (2)

A
  1. less effect on exercise performance than beta blockers

2. fall prevention activities

49
Q

Vasodilators

A

block production of ACE I and ARBs, reduce peripheral vascular resistance

50
Q

Vasodilators may produce a

A

hacking cough

51
Q

Therapeutic concern with all HTN medications

A
  1. excessively low BP (notify MD if systolic is below 90)
  2. orthostatic hypotension
  3. precautions when using heat modalities
  4. Beta Blockers, CCBs and vasodilators all DECREASE exercise performance
52
Q

First choice for HTN because it does not decrease exercise performance is

A

ACE I and ARBs

53
Q

Rehab implications for all Anti-Hypertensive agents (8)

A
  1. take BP often (BP
54
Q

Nitroglycerin

A

dilates arteries and veins making it easier for the heart to pump - treats angina

55
Q

ADRS for nitroglycerin

A
  1. dizziness
  2. orthostatic hypotension
  3. headaches
56
Q

If nitroglycerin is active a pt should feel

A

burning under their tongue

57
Q

Nitroglycerin needs to be stored properly

A

because it deactivates itself in 3 months and needs to be in a brown container

58
Q

Clot preventers (5)

A
  1. aspirin
  2. heparin
  3. warfarin
  4. Plavix
  5. Brilinta
59
Q

heparin - used for (3) conditions emergently

A

used when anticoagulation is needed immediately
DVT
pulmonary embolism
acute MI

60
Q

Warfarin

A

blocks production of clotting factor. Drug-food interactions cause emergency hospitalization in seniors (broccoli)

61
Q

Clot prevention ADRs (4)

A

GI upset
bleeding
bruising
precautions for deep tissue work

62
Q

NSAIDs treat (3)

A

inflammatory conditions like

  1. rheumatoid arthritis
  2. tendonitis
  3. arthritis
63
Q

NSAIDs ADRs (4)

A
  1. minor stomach discomfort to hemorrhaging
  2. ulcers
  3. hypertension
  4. cognitive dysfunction
64
Q

Celebrex (NSAID) increases the risk for

65
Q

High doses of acetaminophen are toxic to the

66
Q

Acetaminophen can elevate

67
Q

Statins reduce

(2) drugs

A

reduce LDL cholesterol
Lipitor
Crestor

68
Q

Statin ADR (1)

A

muscle pain

69
Q

Insulin facilitates…

(5) types

A

glucose entry into cells; w/o insulin cells are not fed and glucose stays in blood stream (blood glucose levels)

  1. ultra-short acting - 5 min before meals - all goes to cells
  2. short-acting - 30 min. before meal
  3. intermediate
  4. long
  5. peakless - injection @ night
70
Q

Normal glucose range

71
Q

Need to match insulin with food in order to avoid

A

hypoglycemia

72
Q

Subcutaneous insulin injections need to be rotated between these locations (4)

A
  1. lower abdomen
  2. upper outer arm
  3. upper outer thigh
  4. buttocks
73
Q

Rehab precautions with insulin administration

A
  1. don’t exercise area of injection or don’t inject into area going to be exercised
  2. do not use PAM near injection site
  3. No massage in the area
74
Q

ADRs for insulin (3)

A
  1. hypoglycemia
  2. lipohypertrophy or lipoatrophy at injection site
  3. weight gain
75
Q

symptoms of hypoglycemia

A
  1. headache
  2. fatigue
  3. tachycardia
  4. sweating anxiety
  5. confusion
  6. weakness
  7. faintness
  8. numbness in the fingers and around mouth
76
Q

treatment for hypoglycemia; three examples

A

ingest foods containing glucose:

  1. soft drinks
  2. fruit juice
  3. glucose tablets (20 grams of D-glucose)
77
Q

three ways to recognize any ADRs

A
  1. vital signs
  2. mental status change
  3. abnormal bleeding

OCTH 1031 (22 decks)

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