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NUR 325 PATHO > Final Exam Drugs PT. 1 > Flashcards

Final Exam Drugs PT. 1 Flashcards

1
Q

Heparin: MOA

A

-Indirectly inactivates thrombin and factors Xa

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2
Q

Heparin: Indications

A

-Needs prompt anticoagulant activity. (Evolving stroke, PE, massive DVT)

-Adjunct therapy for patient having open heart surgery or dialysis where blood is leaving the body

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3
Q

Heparin: Adverse reactions

A

-Bleeding

-Hematoma with spinal epidural

-Thrombocytopenia

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4
Q

Heparin: What do you monitor?

A

-Bleeding - Vitals - Bruising - Petechiae - Black tarry stools

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5
Q

Heparin: Nursing Considerations

A

-High risk medication: Need nurse to double check calculations

-Starts working within 20-30 min

-Protamine sulfate is antidote

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6
Q

Heparin: Labs

A

Anti-xa

aPTT

make sure to stop IV for 15 min and flush throughly before drawing lab

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7
Q

Enoxaparin: Class

A

LMW Heparin

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8
Q

Enoxaprin: MOA

A

Indirectly inactivates factors Xa

Prevent clotting

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9
Q

Enoxaparin: Indications

A

Given Prophylaxis and for treatment

Home use if needed

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10
Q

Enoxaparin: Adverse reactions

A

-Can cause HIT

-Thrombocyopenia and bleeding

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11
Q

Enoxaparin: BBW

A

Potential Spinal hematoma if patient has epidural catheter

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12
Q

Enoxaparin: Nursing considerations

A

-Do not give with other anti coags

-Can give with warfarin to treat PE or DVT

-Slower onset and longer half life than heparin

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13
Q

Warfarin: Class

A

Anticoagulant

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14
Q

Warfarin: MOA

A

-Vitamin - K inhibitor

Prevent synthesis of VII - IX - X and II (prothrombin)

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15
Q

Warfarin: Indications

A

-Prevention of VTE - DVT - PE

-Patients with A-fib

-Reduce recurrence of MI

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16
Q

Warfarin: Adverse Reactions

A

-Muscle pain

-Purple toes

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17
Q

Warfarin: Antidote

A

-Give IV vitamin K

-Give fresh frozen plasma

-Give whole blood

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18
Q

Warfarin: Nursing considerations

A

-HOLD before surgeries

-AVOID foods high in Vit K because they will reduce the effects

-Wear medical alert bracelet and use soft tooth brush and electric razor

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19
Q

Warfarin: Labs

A

-Monitor PT/INR –> prothrombin time, international normalized ration

-Once therapeutic range is hit patients must monitor monthly

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20
Q

Normal INR without warfarin

A

1

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21
Q

Therapeutic INR with warfarin

A

2-3.5

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22
Q

Apixaban
&
Rivaroxaban: Class

A

Anticoagulant

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23
Q

Apixaban
&
Rivaroxaban: MOA

A

Direct inhibitor of factor Xa

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24
Q

Apixaban
&
Rivaroxaban: Indications

A

-Prevent stroke with patient with AFIB

-Post op thrombo-prophylaxis

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25
Q

Apixaban
&
Rivaroxaban: BBW

A
  1. Spinal hematoma with epidural catheter
  2. Risk of thrombosis if drugs abruptly stopped
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26
Q

Apixaban
&
Rivaroxaban: Nursing considerations

A

-Decrease effect if taking phenytoin, carbamazepine, rifampin, and st johns wart

-Increase effect: CYP3A4 inhibitors (GRAPEFRUIT JUICE)

-No monitoring

-Heavily envolved in liver so watch liver labs

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27
Q

Apixaban
&
Rivaroxaban
antidote

A

-Andexxa

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28
Q

Aspirin: Class

A

NSAID

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29
Q

Aspirin: MOA

A

-Blocks prostaglandin synthesis through the COX enzyme pathways (blocks platelet aggregation)

30
Q

Aspirin: Indications

A

-Prevent/Treat MI

-Prevent ischemic (blood clot in brain) stroke

31
Q

Aspirin: Nursing indications

A

-In an acute event, chew a baby aspirin (cannot be enteric coated) (Chew white not orange)

32
Q

Aspirin: Antidote

A

DDAVP

Desmopressin

33
Q

Clopidogrel
&
Ticagrelor: Class

A

Anti-platelet

34
Q

Clopidogrel
&
Ticagrelor: MOA

A

-Antiplatelet ADP inhibitor

-Alters platelet membrane so the do not receive signal to aggregate

35
Q

Clopidogrel
&
Ticagrelor: Adverse Reactions

A

-Chest pain

-Flu Like symptoms

-Abdominal Pain

-Epistaxis

-Purities

36
Q

Contraindications for all antiplatelets

A

Thrombocytopenia and Bleeding Disorders

37
Q

Clopidogrel
&
Ticagrelor: BBW

A

-Patient with certain genetic abnormalities may have higher rate of CV events due to reduced conversion to the active metabolite

38
Q

Clopidogrel: Nursing consideration

A

-Effectiveness reduced by CCB’s, NSAIDS, and PPI’s

39
Q

Ticagrelor: Nursing consideration

A

-Increased bleeding risk with aspirin doses of 100 mg

40
Q

Clopidogrel
&
Ticagrelor: Antidote

41
Q

Argatroban
&
Bivalirudin: Class

A

Direct Thrombin Inhibitors

42
Q

Argatroban
&
Bivalirudin: MOA

A

-Inhibit Thrombin factor IIA

43
Q

Argatroban
&
Bivalirudin: Indications

A

Treat HIT

and for patients undergoing procedures who are at high risk of HIT

44
Q

Argatroban
&
Bivalirudin: Nursing considerations

A

IV only

Watch for heptaic dyfunction

Labs: Anti-Xa, H&H, Platlets

45
Q

DDAVP desmopressin

A

Antidote for Aspirin

Antidote for Clopidogrel and Ticagrelor

46
Q

Andexxa

A

Antidote for Apixaban and Rivaroxaban

47
Q

Vitamin K

A

Antidote for warfarin

48
Q

Protamine Sulfate

A

Antidote for heparin and enoxaparin

49
Q

Why do we give steriods

A

-Replacement (problem with adrenal gland) (over stress)

-Anti-inflammatory (Systemic inflammatory response)

-Immunosuppression (Organ transplant) (trying to depress immune system)

50
Q

Steroids given for

A

-Allergies (decrease immune response)

-Asthma (inhaled steroids)

-COPD exacerbation (trying to lessen inflammatory disorder)

-Post transplant (wean patient off)

51
Q

Hydrocortisone: ALL

A

GCC

-Same as endogenous cortisol

-Not many side effects in small doses

-Oral or IV

52
Q

Prednison

A

GCC

Used for chronic disease states like COPD

53
Q

Dexamethasone

A

GCC

Used when we need to monitor the adrenal functions. This steroids doesn’t show up as cortisol in blood

54
Q

Fludrocortisone

A

-Mineralocortocoid

-Only MCC replacement

Used with Prednisone and Dexamethasone to prevent salt waisting

55
Q

Short Term Glucocorticoid Adverse Reactions

A

Increase intraocular pressure

Fluid retention

HTN

Mood swing

Weight gain (always hungry)

56
Q

Long Term Glucocorticoid Adverse reactions

A

High blood sugar

Increase risk of WBC suppression

-Thinning of bones and skin

-Suppressed adrenal gland hormone production

57
Q

Glucocorticoid: Nursing implications

A

-Do not abruptly stop taking

-Tell patient to take at same time

-Increase steroids when stressed

-Wear medical alert bracelet

-Monitor weight and blood sugar

58
Q

Trimethorpim-suflamethozaole

A

First line antibiotic to treat UTI’s

59
Q

Ciprofloxacin

A

Antibiotic used for UTI’s

60
Q

Nitrofurantoin

A

Antibiotic used for recurring lower UTI’s

61
Q

Phenazopyridine: Class

62
Q

Phenazopyridine: MOA

A

-Unknown but exerts topical analgesic effect on the mucosa of urinary tract to relieve pain

63
Q

Phenazopyridine: Indicaitons

A

-Relief of PAIN due to UTI

64
Q

Phenazopyridine: Adverse Reactions

A

Well tolerated: Reddish Orange

65
Q

Mirabegron: Class

A

Antispasmodic

66
Q

Mirabegron: MOA

A

-Seleticitevly stimulates beta-3 adrenergic receptors, relaxing bladder smooth muscle

67
Q

Mirabegron: Adverse effects

A

-HTN - UTI

68
Q

Oxybutynin: Class

A

Anti-cholinergic

69
Q

Oxybutynin: MOA

A

-Block the action of acetylcholine. Acetylcholine activates smooth muscle contractions

70
Q

Oxybutynin: Indications

A

Overactive bladder and incontinence

71
Q

Oxybutynin: Adverse Effects

A

-Dry mouth

-Constipation

NUR 325 PATHO (44 decks)

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