Final Review B1 Flashcards
Furosemide
Loop Diuretic
Works in loop of HENLE
Watch for:
HYPOkalemia
Ototoxicity
Spironolactone
PSD
Blocks action of aldosterone = potassium retention
HYPERkalemia
Deepen voice - Gynecomastia - Hirustism
Beta Blockers
MOA: Increase nitric oxide and block stimulation of beta-1 receptors
AF: Bradycardia
NSG: Can mask hypoglycemia
Wean when discontinuing
ACE inhibitors
MOA: Blocks ACE from converting ant 1 into ant 2
AF: Cough - First dose hypotension - ANGIOEDEMA AA’s
Given in conjunction with thiazide diuretics
ARBS
Losartan
Blocks angiotensin 2 after it is formed (Vasodilate)
Watch for angioedema
Requires use of contaception
HMG-CoA Reductase Inhibitors
Statins
Liver makes more LDL so more LDL is removed from the blood
AF: Myopathy - Rhabdomyolysis
NSG: Takes two weeks to see change. Take at night and avoid alcohol
lispro
aspart
Onset: 15 min
Peak: 1 hr
Duration: 2-4hrs
Insulin regular (short)
Onsest: 30-60 min
Peak: 2-6 hrs
Duration: 3-8 hours
NPH (intermediate)
Onset: 2-4 hr
Peak: 4-10 hr
Duration: 10-20 hr
DRAW CLEAR BEFORE CLOUDY (rapid or short acting first)
glargine (long)
Onset: 70 min
Peak: None
Duration: ALL DAY
biguanides
Metformin
Metformin
Lower blood glucose by decreasing production in the liver
Onest is several days
Do not use in liver failure or kidney failure
MUST BE HELD FOR 48 HOURS POST CONTRAST USAGE
GLP-1 Receptor Angonists
duglutide
exenatide
semaglutide
Enhance glucose dependent insulin secretion and slow gastric emptying
BBW: Risk of thyroid c-cell tumors. Contraindicated for people who have a history of thyroid problems
Do not use if history of pancreatitis or ESRD
Hypoglycemia Antidote
Glucagon: Activate hepatic glucagon receptors, stimulates glycogenolysis and release of glucose
Has short duration of action: May need multiple doses. Check finger stick 15 min post administation
AD drugs
Donepezil
Memantine
CNS pain drugs (anti-convulsants)
gabapentin - Pregabalin (suppress neuron firing)
List of the NSAIDS
Ibuprofen
Naproxen
Aspirin
ketorolac
celecoxib
Ibuprofen and Naproxen
Non selective cox inhibitor (anti-prostaglandin)
BBW: Cardiovascular and Gastrointestinal Risk
aspirin
Can cause chronic tinnitus
Never give to children: Especially with viral infection
REYES syndrome
acetaminophen
4 grams/24 hour rule
Hepatotoxic (necrosis)
IV tylenol
Ofirmev
Given time of incision or pre-opp
Number pain medication used of med surg floors
oxycodone
Opioid antidote
Naloxone
AED’s (All)
Anti-Epileptic Drugs
1. Increase the threshold
2. Limit the spread
3. Decrease the speed
Teratogenic
BBW: Increase risk of suicidal ideation, increase or worsening depression
Never abruptly stop
phenytoin
AED
Tonic-Clonic Seizures and partial focal seizures
Gingival Hyperplasia
Hirsutism
Osteoporosis
Hypertrophy of subcutanous facial tissue
orlistat
Binding to gastric and pancreatic enzymes and BLOCKS them. Reduces fat absorption
For obesity and weight loss
Oily spotting, flatulence, and fecal incontinence
Must take for 3 MONTHS to start seeing effect
BBW: LIver injury
Drug for hyponatremia and metabolic acidosis
Sodium bicarbonate
Sodium polystyrene sulfonate
Kayexalate: Binds to potassium in the digestive tract
Drug for Emergen Hyperkalemia
D50/Insulin
Give 1 unit of regular insulin and 1 ampule of D50
Check sugar 5 min after
Azoles
Interrupt the integrity of the cell wall by interfering with synthesis of ergosterol
SEVER GI AND LIVER TOXICITY
Take with food to minimize SE. Separate at least 2 hours from antacids and drugs that decrease stomach acid
Drug for cancer and leukopenia
Filgrastim (Increases all) (Granulocyte Colony Stimulating Factor)
Watch fo bone pain and leukocytosis
Drug that just increases the neutrophils
Pegfilgrastim
Heparin
Prevent clotting by activating antithrombin –> indirectly inactivate thrombin and factors xa
Used for prompt emergencies
Monitor platelet count and stop if below 100,000
HIGH RISK: Double check with RN
Before Drawing ANTI-XA and PTT lab stop IV for 15 min and flush with 2-3 syringes
Heparin antidote
Protamine sulfate
Enoxaparin
LMWH
Prophylaxis
Can cause HIT. Do not give with any other anticoags. Can give with warfarin to treat PE or DVT
BBW: Spinal hematoma if patient has epidural catheter
Warfarin
Vitamin K inhibitor (VII-IX-X-II)
Muscle pain and purple toes
Antidote: Vitamine K (IV)
Hold before surgeries
Monitor PT/INR
Apixaban and Rivaroxaban antidote
Andexxa
In an acute cardiac event you should
Chew a baby asprining (white not orange)
Aspirin Antidote
DDAVP
SSRI’s
fluoxetine
Inhibitor of serotonin re-uptake at nerve endings.
Weight gain-NVD-Sexual dysfunction
Suicidal Risk
Serotonin syndrome: 2-72 hours after treatment and altered mental status.
Withdrawal Syndrome: Dizziness H/A tremors anxiety and dysphoria
SRNI
Venlafazine
TCA
amitriptyline
Anticholinergic effects
FATAL overdoses
Interact with MAOI –> HTN crisis
phenelzine
MAO
Depression
HYPERTENSIVE crisis
Tyramine rich foods: Age, smoked, yest, wine)
Drug that rapidly helps with suicide and depression
Ketamine
Benzodiazepines
Lam and Pams
Enhance GABA in the CNS (Relaxation)
CNS depression - Decrease LOC - Withdrawal effects
Schedule 4 medication
DO NOT MIX WITH OTHER CNS DEPRESSANTS
Benzo antidote
flumazenil
When is the RAAS system activated
With blood loos or drop in BP
HTN Urgency
Above 180 or above 120 with no symptoms
HTN Emergency
Above 180 or above 120 with symptoms
Primary HTN
No Known Cause
RF:
Smoking
Sodium
Sedentary Lifestyle
Hyperlipidemia
Stress
ETC
Secondary HTN
Known cause
Renal disorder
Adrenocortical tumors
Adrenomedullary Tumors
Diurestics
Increase Urinary output
Decrease circulating volume
Decrease arterial resistance
Atherosclerosis
Elevated LDL (bad) and cholesterol
Thickening or hardening of the arterial wall
Starts with injury to the artery or vessel wall
HMG-CoA Reductase Inhibitors: MOA
Inhibiting reductase
Less cholesterol is produced by the liver
Liver makes more LDL receptors
More LDL is removed from the blood
Pancreas Alpha cells
Secrete glucagon in response to low blood sugar
Glucagon stimulates the liver to release stored glucose
Pancreas Beta cells
Produce insulin, which lowers glucose levels by stimulating the movement of glucose into the body tissue
Type 1 Diabetes
Born with the disease and is autoimmune
COMPLETE lack of ENDOGENOUS INSULIN
Type 2
Genetic and environment aspect usually responsible
INSULIN RESISTANCE (some decrease insulin secretion)
Diabetic Microvascular Disease
Diabetic Neuropathy
Diabetic Retinopathy
Diabetic Nephropathy
Metbolic Syndrome
Must have 3 risk factors
Waist: >40m / >35f
Triglycerides: > 150 or treatment
HDL: <40 m / <50 f or treatment
BP >130 or >85 or treatment
FBG >110 or treatment
Treatment of Delirium
Identify cause and remove causative agents; Modify risk factors
DELIRIUM CAN BE PREVENTED
A delta fibers
Small and myelinated
well-localized and rapid transmission of pain
C fibers
Small and unmyelinated
Poorly localized
What fibers are we stimulating in the gate control theory of pain
A-alpha
A-beta
Steroid Side Effects
Increased IOP
Fluid retention
High blood pressure
Mood swings
Weight gain and fat deposits central
Clouded eye lens
High blood sugar
Increased risk of infection
Thinning bones
ETC
Type 1 Hypersensitivity
IgE
Immediate reaction due to pet dander, bee sting, nuts, shellfish
(Typically allergic reaction)
Type II hypersensitivity
Cytotoxic Reaction (Wrong blood type)
IgG and IgM
Immune complexes cell surface
Type III Hypersensitivity
Immune complex reaction (RA)
Antigen-antibody complexes form and deposit into tissues
IgM
Immune complexes deposit into tissue
Type IV hypersensitivity
Delayed Hypersensitivity
Poison Ivy
Postive TB skin test
Jellyfish
Allergic reaction to jewelry
