FINAL EXAM - Common Medications Flashcards
1
Q
Adverse drug reactions (ADR) will be seen in
A
the vital signs
ALWAYS check clients vitals
2
Q
Parkinson’s L-dopa
A
when optimal tone effect is reached is the time to treat for therapy
3
Q
The more medications a person takes, the more….
A
ADRs a person will experience
4
Q
Reasons for ADRs(6)
A
- risk/benefit of drug not recognized
- hx of drug allergy
- wrong drug name or dosage form
- lack of education
- failure to obtain adequate pt. hx and drug hx
- pt compliance issues
5
Q
Pharmacokinetics (Pk) ADME
A
- Absorption
- Distribution
- Metabolism
- excretion
6
Q
Absorption
A
through stomach and intestinal wall - not fully absorbed
7
Q
distribution
A
travels to liver and active in blood stream = travels all around
8
Q
metabolism
A
liver first before where it needs to go = partially deactivated
9
Q
excretion
A
removed through urine
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
11
Q
Side effects are caused by
A
the drug binding to other areas besides its target organ
12
Q
Why do we NEVER heat the injection site?
A
increases absorption
13
Q
Acidic drugs enter through the
A
stomach
14
Q
Transdermal route is
A
slow - patches for pain, estrogen, nicotine
15
Q
NEVER put a hot pack over a transdermal patch because
A
increases absorption and can lead to death!
16
Q
Intravenous
A
goes directly to the site - 100% is absorbed
17
Q
intrathecal
A
spinal canal - epidural
18
Q
implanted devices
A
reservoir implanted- morphine/insulin pump
19
Q
Common ADR for antimicrobials (3)
A
- diarrhea
- rash
- pruritus (itching)
20
Q
Common ADR for Anticoagulants (2)
A
- hemorrhage
- Bruising
* fine line between enough and too much
21
Q
Common ADR for Chemotherapy (6)
A
- bone marrow suppression
- alopecia
- nausea
- infection (decrease in WBC)
- fatigue (decrease in RBC)
- anemia (decrease in RBC)
22
Q
Common ADR for cardiovascular (3)
A
- heart block
- arrhythmias
- edema
23
Q
Common ADR for Diabetic medication (3)
A
- hypoglycemia (sends people to hospitals)
- diarrhea
- GI complications
24
Q
Common ADR for NSAIDS (3)
A
- GI Ulceration and bleeding
- renal insufficiency
- MI
25
Common ADR for Diuretics (3)
1. hypokalemia (low K+)
2. hyperglycemia
3. dehydration
26
diabetes and diuretics are not good because
risk of hyperglycemia
27
body structures and functions commonly affected by ADRs (6)
1. hematological system
2. skin and related structures
3. metabolic
4. musculoskeletal
5. respiratory
6. sensory
28
Affects to the hematological system (2)
1. anemias
| 2. thrombocytopenia
29
Affects to the skin and related structures (5)
1. pruritus
2. urticaria
3. alopecia
4. rash
5. petechiae
30
Affects to the metabolic system(2)
1. osteoporosis
| 2. fluid and electrolyte imbalance
31
Affects to the musculoskeletal system (4)
1. myalgia
2. arthralgia
3. neuropathy
4. rhabdomyolysis (muscle breakdown)
32
Affects to the respiratory system (5)
1. bronchospasm
2. allergic rhinitis
3. respiratory depression
4. pulmonary fibrosis
5. dyspnea
33
Affects to the sensory system (5)
1. impaired vision
2. ototoxicity
3. tinnitus
4. diplopia
5. periperal neuropathy
34
Peripheral vascular resistance caused by plaque causes
HTN
35
What factors increase BP? (3)
1. fluid overload
2. narrowed arteries
3. high heart rate
36
Beta blockers
lower BP by slowing down the heart rate. binds to beta receptors so adrenaline cannot. decreases HR and contractility of the heart
37
Beta Blocker ADRS (6)
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
Beta blockers and exercise
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
Diuretics
inhibit the sodium pumps preventing reabsorption of fluid back into the body. Affordable - not necessarily the best option
40
ADR of diuretics (5)
1. fluid depletion
2. loss of electrolytes
3. orthostatic hypotension
4. hyperglycemia
5. increase in LDL
41
All drugs for HTN cause
orthostatic hypertension
42
dehydration causes (7)
1. fatigue
2. altered mental status
3. fainting
4. headaches
5. dry mouth
6. skin turgor (skin stays pinched)
7. increased HR
43
clinical signs to watch for with diuretics (10)
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
Rehab and diuretics (8)
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
Diuretic toxicity (6)
1. anorexia
2. nausea
3. vomiting
4. confusion
5. weakness
6. paresthesia of extremities (tingling)
46
Calcium Channel Blockers
make vessels wider, used for HTN
47
Clinical signs to watch for with Calcium channel blockers (4)
1. hypotension
2. orthostatic hypotension
3. dizziness/syncope
4. lower extremity edema
48
Rehab implications with Calcium channel blockers (2)
1. less effect on exercise performance than beta blockers
| 2. fall prevention activities
49
Vasodilators
block production of ACE I and ARBs, reduce peripheral vascular resistance
50
Vasodilators may produce a
hacking cough
51
Therapeutic concern with all HTN medications
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
First choice for HTN because it does not decrease exercise performance is
ACE I and ARBs
53
Rehab implications for all Anti-Hypertensive agents (8)
1. take BP often (BP
54
Nitroglycerin
dilates arteries and veins making it easier for the heart to pump - treats angina
55
ADRS for nitroglycerin
1. dizziness
2. orthostatic hypotension
3. headaches
56
If nitroglycerin is active a pt should feel
burning under their tongue
57
Nitroglycerin needs to be stored properly
because it deactivates itself in 3 months and needs to be in a brown container
58
Clot preventers (5)
1. aspirin
2. heparin
3. warfarin
4. Plavix
5. Brilinta
59
heparin - used for (3) conditions emergently
used when anticoagulation is needed immediately
DVT
pulmonary embolism
acute MI
60
Warfarin
blocks production of clotting factor. Drug-food interactions cause emergency hospitalization in seniors (broccoli)
61
Clot prevention ADRs (4)
GI upset
bleeding
bruising
precautions for deep tissue work
62
NSAIDs treat (3)
inflammatory conditions like
1. rheumatoid arthritis
2. tendonitis
3. arthritis
63
NSAIDs ADRs (4)
1. minor stomach discomfort to hemorrhaging
2. ulcers
3. hypertension
4. cognitive dysfunction
64
Celebrex (NSAID) increases the risk for
MI
65
High doses of acetaminophen are toxic to the
liver
66
Acetaminophen can elevate
BP
67
Statins reduce
| (2) drugs
reduce LDL cholesterol
Lipitor
Crestor
68
Statin ADR (1)
muscle pain
69
Insulin facilitates...
| (5) types
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
Normal glucose range
90-120
71
Need to match insulin with food in order to avoid
hypoglycemia
72
Subcutaneous insulin injections need to be rotated between these locations (4)
1. lower abdomen
2. upper outer arm
3. upper outer thigh
4. buttocks
73
Rehab precautions with insulin administration
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
ADRs for insulin (3)
1. hypoglycemia
2. lipohypertrophy or lipoatrophy at injection site
3. weight gain
75
symptoms of hypoglycemia
1. headache
2. fatigue
3. tachycardia
4. sweating anxiety
5. confusion
6. weakness
7. faintness
8. numbness in the fingers and around mouth
76
treatment for hypoglycemia; three examples
ingest foods containing glucose:
1. soft drinks
2. fruit juice
3. glucose tablets (20 grams of D-glucose)
77
three ways to recognize any ADRs
1. vital signs
2. mental status change
3. abnormal bleeding
