finals!!! Flashcards
Bulk forming Laxatives (drug names)
metamucil, polycarbophil, methycellulos
take 12 hours to 3 days to work
Stool softeners (drug names)
docusate (colace)
take 1-3 days to work
Saline Laxatives (drug names)
citrate of magnesium, milk of magnesia
USED FOR BOWEL CLEANSING
Stimulant cathartics (drug names)
Bisacodyl, caster oil, senna products
irritates GI mucosa pulling water into the bowel, works quick!!! STRONGEST! can cause electrolyte imbalances
intestinal obstruction leads to..
abdominal distention and F&E loss. May lead to strangulation, bowel perforation, necrosis.
S/S of intestinal obstruction
abd pain, absolute constipation, abd distention, vomiting, borborygmus,
Peritonitis
acute inflammation of peritoneum, caused by bacterial invasion of chemical irritation.
S/S of peritonitis
rigid abdomen, vomiting, pain, tenderness, paralytic ileus, increase in WBC
treatment for peritonitis
nothing by mouth, NG suction, antibiotics, pain meds
Vasopressin
ADH used to increase coronary blood flow and availability of O2 to myocardium; raises blood volume and BP; stress hormone
H2 receptor blocker
Histamine: acts on gastric mucosal receptors.
When stimulated it increases the production of HCl acid from parietal cells.
Used to prevent and treat GERD, PUD, esophagitis, GI bleeding
increases the risk for pneumonia
H2RA blocks
both basala secretion and gastric secretion stimulated by histamine, acetylcholine, gastrin
Traditional antihistamines (H1 antagonists)
do not block gastric acid production and are used to treat allergies
H2 receptor drug names
Famotidine, ranitidine, cimetidine, nizatidine
-IDINE (histamine idine)
Antacids contain compounds such as
aluminum, mag, calcium
Antacid examples:
aluminum hydroxide/mag hydroxide (maalox)
Aluminum hydroxide.mg hydroxide.simethicone (mylanta)
Simethicone (Mylicon) antiflatulant
AE of antacids
diarrhea, constipation and can bind with other drugs preventing their absorption
make sure to give meds 1-2 hours before or after other meds
PPI drug examples
omeprazole, pantoprazole, lansoprazole, esomeprazole, rabeprazole
ZOLE!!
PPi drugs
prevent pumping of gastric acid into the stomach, inhibit daytime and nocturnal HCl, most effective first line drug for PUD and GERD
Minimal AE
increases risk for pneumonia
what two meds increase the risk for pneumonia
PPI and H2
Sucralfate
binds to normal and ulcerated mucosa and forms a protective layer
prevents and treats duodenal ulcers
acts locally
Dissolves in water and can bind to other drugs preventing their actions so give 2 hours before other meds
Phenothiazides
antiemetic blocks receptor sites in CTZ CNS depressant AE: sedation, cognitive impairment, extrapyramidial reactions Does NOT WORK ON MOTION SICKNESS
Phenothiazide medication examples
chlopromazine, prochloraperazine, promethazine
ZINE!!!
Antihistamines
antiemetics
H1 receptor blocker to block acetylcholine in the brain
EFFECTIVE FOR MOTION SICKNESS
AE: similar to anticholinergic effects such as dry mouth, blurred vision, tachycardia, etc
Antihistamine drug names
promethazine, dimenhydrinate, scolpamine patch
Promethazine is considered
both an antiemetic and phenothiazide
Corticosteroids
antiemetic
blocks prostaglandin
used for chemo therapy induced nausea
Benzodiazapine to relive anxiety
lorazepam
Prokinetic agents
increases gastric motility, increases acetylcholine release, depletes dopamine,
AE: sedation, restlessness, extrapyramidial sxs
Example: Metoclopramide (Reglan)
Serotonin receptor antagonist
antagonize serotonin receptors preventing the action of emetogenic drugs and blocks activation of CTZ
EX: Ondanestrone
antidiarrheal meds: opiate related derivatives
decrease intestinal motility
loperamide (Immodium)
AE: antichol; CNS depressant, constipation
antidiarrheal meds: bulk forming laxatives
absorb water into gel like mass so firm up liquid stool
EX: psyllium (metamucil)
Antidiarrheal meds: Bismuth salts
contains aspirin so make sure they do not have an allergy to aspirin
Has antibacterial and antimicrobial properties
Can cause darkened tongue.
PEPTO BISMOL AND KAOPECTATE
Bulk forming laxatives
Absorb water to make a gel-like mass and increase size of stool leading to peristalsis
Take 12 hours to 3 days to work
EX: psyillum
Stool softener
Docusate
decreases surface tension of stool, allowing water to enter stool and can take 1 -3 days to work.
Saline Laxatives
distend bowel, increase osmotic pressure so water can be retained, stimulates peristalsis and defecation
Short term use for rapid bowel evacuation
CHF patients are at risk for fluid retention
Citrate of Mag and mag hydroxide (Milk of Mag)
Stimulant cathartics
irritate GI mucosa pulling water into bowel
works quick
strongest!!!
Bisacodyl
HAART
not a cure for HIV just maintenence drug that will be taken everyday
Increases the CD4 count and decreases the viral load
Start treatment early (350-500) CD4
prevents the HIV transmission
Check CD4 count every 3-12 months
NRTIS
inhibits reverse transcriptase by entering its protein to prevent viral replication
check CBC often
EX: zidovudine
Mitochondrial toxicity (lactic acidosis, steeatosis, bone marrow suppression)
Integrase inhibitor
blocks action of integrase so HIV RNA cannot be inserted into host cell DNA.
AE: headache, nausea, vomiting
NNRTIS
directly binds to reverse transcriptase so virus cannot convert HIV RNA into DNA.
prevents HIV/viral replication
AE: rash, stevens johnson syndrome
Protease inhibitor
prevents viral mutation
cuts viral proteins into virions
EX: atazanazvir
AE: diarrhea, nausea, muscle weakness, insulin resistance
fusion inhibitor
prevents HIV from fusing with CD4 cell and blocks HIV from inserting genetic info into CD4
Hypertonic IV fluids
will tend to cause a fluid shift out of cells and into extracellular spaces such as blood and fluid
Mannitol
used to decrease cellular edema
3%normal saline!
hypotonic IV fluids
low solute concentration than icells
tends to cause a shift out of extracellular and into intracellular
D5W 0.45, , NaCl or 1/2 NS
Used TKO (to keep open) used to rehydrate cells
Isotonic IV Fluids
expands ECF only
does not cause significant fluid or electrolyte shifts
Lactated Ringers and Normal Saline (0.9% NAcl or NS)
Used for fluid volume replacement and expands blood volume
NS is used during blood administration
potassium replacement
given frequently, KCL given po or IV
IV K must be administered carefully and patient monitored carefully
NO IV PUSH
May give up to 40meq/hr
check K every 4-6 hours
K must be diluted in IV solution
K is irritating to veins so check for phlebitis
Sodium polysteryrene
should be stopped when the patient is hyperkalemic
prednisone uses!
allergic or hypersensitivity reactions and blood transfusions,
collagen disorders such as lupus,
dermatologic disorders such as herpes zoster, skin rashes,
endocrine disorders such as adrenocortical insufficiency and can be given to replace or substitute for natural hormones.
corticosteroid patient teaching
monitor weight frequently and at least weekly during long term maintenance. Later weight gain can mean fluid retention.
dose may need to be increases when patient is sick
desmopressin uses
can be used to treat diabetes insipidus
desmopressin
increases water permeability, decreases urine volume and increases osmolality.
ADH medication– IM IV or SubQ
assess for what fluid and electrolyte imbalance when taking desmopressin
hyponatremiam fluid volume deficit
levothyroxine
drug of choice for long term treatment of hypothyroidism
increases metabolic rate increaing oxygen consumption, resp rate and heart rate.
suppresses TSH, manages thyroid cancer, hypothyroidism
AE of levothyroxine
similar to that of hyperthyroidism, cardiac dysrrhythmias, angina pectoris.
SHOULD NOT BE GIVEN WITH ADDISONS
PROPYLTHIOURACIL
inhibits thyroid hormones, does not interfere with the release of throid hormones previously produced.
Used to treat hyperthyroidism, part of prep for thyroidectomy
AE: hypothyroidism S/S like bradycardia, anemia, slow speech and body movements, excessive sleeping, increased weight
methimazole
used to treat hyperthyroidism and as a preop med before thyroidectomy
should be taken with food or milk
may cause join or muscle pain
potassium iodide
Potassium iodide is also used along with antithyroid medicines to prepare the thyroid gland for surgical removal, to treat certain overactive thyroid conditions (hyperthyroidism), and to protect the thyroid in a radiation exposure emergency
. It works by shrinking the size of the thyroid gland and decreasing the amount of thyroid hormones produced.
Cyclophophamide : nitrogen mustard
Akylating agent- breaks down DNA helix strand interfereing with replication- CCNS
INCREASE FLUIDS
AE hemorrhagic cystitis (hematuria, bladder pain)
(alkylating agent) CARMUSTINE
nitrosourea; breaks down the DNA helix, CCNS
crosses BBB
Fluorouracil and Methotrexate
antimetabolities, CCS, during DNA synthesis and RNA growth (S phase)
leukemia, ovarian, breast CA, Gi cancers
Doxarubacin
antitumor antibiotic, CCNS
Cardiotoxic if given long time
Binds with DNA interfering wtih enzymes and inhibiting DNA to RNA sythesis
Vinblastine- VINCA
plant alkaloids, CCS, mitotic inhibitors, disrupt mitosis and acts late in the G2 phase preventing cell division
AE: neuropathaties, numbness, tingling
Paclitaxel (TAXANE)
plant alkaloid, inhibits cell division, effective in G! and M phase, allergic reactions can occur and must be monitored closely
Tamoxifen
treats breast cancer and block estrogen receptors, can be treatment for osteoporosis.
Anti-estorgen- block estrogen receptors forming a complex that inhibits DNA synthesis
Epoeitin Alpha
increases RBC
hbg 12
Biologic response modifier
Filgrastim
increases WBC (neupogen)
Biologic response modifier
nitroglycerin
vasodilates, increases blood flow to myocardium and decreases preload, afterload and cardiac workload
give up to 3 tabs every 3-5 min
call doc after first tab given
no chest pain is okay
do not take with Viagra
Morphine
opiate analgesic can be given for chest pain when unresponsive to sublingual NTG
produces venodilation leading to decreased preload, afterload
nitro patch
take off at night wear for 12014 hours a day switch areas spot free of hair wear gloves if nurse
propanolol and metrolol
beta blocking agents that decrease the contractility of the heart and decrease BP
antianginal and antihypertensive
avoid use in bronchospastic diseases
diltiazem
ca ch blocker
prevents movement of ECF Ca into the cell
antianginal, antihypertensive and antidysrhythmic
decreased afterload and increased blood flow by dilating coronary arteries
Catopril
Ace inhibitor, blocks production of angiotensin 2, decreases vasoconstriction which leads to decrease afterload and workload on heart.
AE: postural hypotension, cough
Enoxaparin
anticoagulant- LMWH
used first few days of a post MI
inactivates clotting factors, inhibits conversion of prothrombin to thrombin, prevents thrombus formation, inhibits platelet aggregation
Monitor platelet counts
clopidogrel, ASA
anti-platelet
acts by inhibiting platelet activation
reduction of incidence of MI or stroke
contraindicated in bleeding patietns
ASA
anti-platelet
inhibits Thromboxin A2
give ASAP upon arrival, chew rather than swallow
do not give in pateints who are taking warfarin, head trauma, active bleeds or allergies
Heparin
anticoagulant that inactivates specific clotting factors and conversion of prothrombin to thrombin
tPA
thrombolytic therapy,
clot buster dissolves a thrombi
stimulates conversion of plasminogen to plasmin
most common adverse effect is bleeding
can be given if patient has chest pain that has lasted 15 min to 12 hours.
do not give if pt has intracranial hemorrhage, aneurysm, facial trauma within past 3 months,
abciximab
prevents binding of clotting factors
used for post MI and stent placements
