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Nursing Pharmocology > GI/Cardial/Renal Meds > Flashcards

GI/Cardial/Renal Meds Flashcards

(43 cards)

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1
Q

Calcium carbonate

A

Antacid
MOA: neutralize gastric acidity and elevate PH of stomach which inactivates pepsin ( digestive enzyme)
Indication: relieve heart burn, acid indigestion, & upset stomach
NSG considerations: Pt should drink glass of water after administration, Do not administer w/i 1-2 hrs of other meds bc calcium may reduce effectiveness, may be contraindicated w/ preexisting kidney disease bc it may cause hypercalcemia
Side Effects: constipation, rebound acidity

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2
Q

Famotidine/ Cemetidine

A

H2 receptor agonist
MOA: binds to hydrogen-potassium ATPase enzyme (proton pump), inhibit secretion of hydrochloric acid and antisecretory effect lasts longer than 24 hrs
Indications: GERD, Ulcers
NSG considerations: delayed release must be mixed, may interfere with liver metabolism of other drugs, long term use may cause hypomagnesemia
Side Effects: Abd pain, N/V/D, constipation, AKI, osteoporosis, Zinc, magnesium & B12 deficiencies

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3
Q

Omeprazole/esomeprazole/pantoprazole

A

Proton pump inhibitor (PPI)
MOA: PPIs bind to hydrogen-potassium ATPase enzyme system of parietal cell (proton-pump), PPIs inhibit secretion of hydrochloric acid and antisecretory effect longer than 24 hrs
Indications: GERD, Ulcers
NSG considerations: delayed release must be mixed with applesauce, IV PPI may exacerbate zinc deficiency, long term use can cause hypomagnesemia
Side effects: Headache, ABD pain, N/V/D, constipation, AKI,

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4
Q

Sulcrafate

A

Gi protectant
MOA: covers ulcer site in GI and protects it against further attack by acid,Pepsi on and bile
Indications: tx of ulcers
NSG considerations: administer on empty stomach 1-2 hrs before meals, use cautiously w/ CKD/dialysis
Side effects: constipation

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5
Q

Simethicone

A

Antiflatulent
MOA: alters elasticity of mucus-coated gas bubbles, causing them to break into smaller bubbles, reducing pain & facilitating expulsion
Indications: Gas, Bloating, fullness
NSG considerations: Usually taken 4X/d, after meals & bedtime
Side effects: N/D,headache, constipation

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6
Q

Bismuth Subsalicylate

A

Antidiarrheal/ anti ulcer
MOA: coats walls of GI tract and binds causative bacteria or toxins for elimination, reduces flow of fluids and electrolytes into bowel reducing inflammation w/i intestine
Indications: used to treat conditions that involve excess gas or toxins in digestive system
NSG Considerations: avoid concurrent use w/ aspirin, Do not use if pt has ulcers, GI bleed, medication can cause black or darkened tongue, Contact HCP if pt has fever, tinnitus, or diarrhea
Side effects: black/darkened tongue

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7
Q

Hyoscyamine

A

Anticholinergic
MOA:works on smooth muscle of GI tract to inhibit propulsive motility and decreases gastric acid secretion
Indications: IBS, chronic diarrhea
NSG Considerations: contraindications (glaucoma, paralytic lieu’s),
Side effects: dry mouth, constipation, blurred vision, confusion

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8
Q

Loperimide

A

Opioid-like medications
MOA: decreases flow of fluids and electrolytes into bowel by slowing down the movement of the bowel to decrease number of bowel movements
Indications:
NSG considerations: not for kids younger than 2y/o, higher doses can cause abnormal heart rhythm and can lead to death
Side effects: constipation, abdominal discomfort, N/V, dizziness, drowsiness

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9
Q

Lactobacillus

A

probiotic
MOA: replenish normal bacteria for digestive health
Indications:
NSG considerations: SHould be tailored to individuals needs
Side effects: Gas, Bloating,Diarrhea

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10
Q

Diphenoxylate/Atropine

A

Antidiarrheal/anticholinergic
MOA: Inhibits excess GI motility
Indications: adjunctive therapy in TX of diarrhea
NSG Considerations: do not use for CDIFF, Dehydrated pts, angle closure glaucoma,
Side effects: tachycardia, blurred vision, dry eyes, constipation, confusion

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11
Q

Clarithromycin

A

Anti-infective
MOA: inhibits protein synthesis ( Active against H.Pylori)
Indications: Combo treatment for ulcer disease d/T H.Pylori
NSG Considerations: do not use in QT prolongation,hypokalemia, hypomagnesemia, bradycardia
Side effects: Hepatotoxicity, CDAD, Torsades de pointes

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12
Q

Doxazosin

A

Class: Antihypertensive
MOA: Dilates both arteries and veins by blocking postsynaptic alpha1 andrenergic receptors
Indications: Hypertension in combo w/ other antihypertensives
NSG considerations: NSAIDs may reduce effects, risk of hypotension w/ other antihypertensives
Side effects:arrhythmias, chest pain, edema, epistaxis, sexual dysfunction

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13
Q

cloNIDine

A

Class:antihypertensives
MOA: Stimulates alpha-adrenergic receptors in CNS which result in decreased sympathetic outflow inhibiting cardio acceleration and vasoconstriction centers
Indications: Hypertension
NSG Considerations: Additive sedation w/ CNS depressants, Additive hypotension w/ other antihypertensives
Side effects: Bradycardia, heart block, dry mouth, reduced fertility, weight gain

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14
Q

Methyldopa

A

Class: Antihypertensives
MOA: Stimulates CNS alpha-Adrenergic receptors, producing a decreased sympathetic outflow to heart, kidneys and blood vessels
Indications: Moderate to severe hypertension
NSG considerations: do not use w/ active liver disease,
Side effects: Bradycardia, dry mouth, hepatitis, sedation, erectile dysfunction

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15
Q

Metoprolol

A

Class: Beta blockers (beta 1 selective)
MOA: blocks stimulation of beta 1 adrenergic receptors
Indications:HTN, Angina pectoris
NSG considerations: do not use in uncompensated HF, Pulmonary edema, bradycardia, heart block
Side effects: Bradycardia, HF, erectile dysfunction, pulmonary edema, fatigue

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16
Q

Captopril/ Lisinopril

A

Class: Ace inhibitor
MOA: ACE inhibitors block conversion of angiotensin 1 to the vasoconstrictor angiotensin 2
Indications: HTN (in combo with other antihypertensives), HF
NSG considerations: do not use w/ Hx of angioedema
Side effects: hypotension, angioedema, hyperkalemia, N/V/D

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17
Q

Carvedilol

A

Class : beta blocker non selective
MOA:Blocks stimulation of Beta 1 and beta 2 adrenergic receptors sites
Indications: HTN, HF
NSG considerations: Do not use in bradycardia, severe hepatic impairment, asthma
Side effects: Bradycardia, HF, hyperglycemia, erectile dysfunction, dizziness

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18
Q

Losartan

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A

Class: Antihypertensives (ARB) Angiotensin 2 receptor blocker
MOA: blocks vasoconstrictor & aldosterone secreting effects of angiotensin 2
Indications: HTN, prevention of stroke
NSG considerations: Contraindicated in pregnancy & lactation
Side effects: Diarrhea, hypoglycemia, weight gain, renal impairment

19
Q

Hydralazine

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A

Class: Antihypertensives
MOA: Direct acting peripheral arteriolar vasodilator
Indications: Moderate to severe HTN
NSG considerations: use cautiously in CVA, severe renal/ hepatic impairment
Side effects: N/V/D, Dizziness, drowsiness, tachycardia, angina

20
Q

Furosemide

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A

Class: Loop diuretic
MOA: inhibits reabsorption of sodium & chloride from loop of Henle and distal renal tubule, increases renal excretion of H2O, Na, K+, Mag, CHL, Ca
Indications: Edema d/t HF, HTN
NSG considerations: Administer in the morning, monitor electrolytes (K+), Advise potassium rich diet, monitor daily weights, I&O, & renal function
Side effects: Dehydration, ototoxicity, renal impairment, electrolyte depletion

21
Q

Hydrochlorothiazide

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A

Class: thiazide diuretic
MOA: Thiazide diuretics work near the distal tubule to promote the excretion of sodium and water, thus causing diuresis
Indications: HTN, Edema associated w/ HF, renal impairment, cirrhosis
NSG considerations: Assess BP,
Monitor electrolytes (K+)
Promote potassium-rich diet
Assess renal function, dehydration, I&O,Monitor weight
Slide effects : Electrolyte depletion,Dehydration,
Hypotension, Renal impairment

22
Q

Spironolactone

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A

Class: K+ sparing diuretic
MOA: Spironolactone causes increased amounts of sodium and water to be excreted, while potassium is retained
Indications: HTN
NSG considerations: Assess BP,
Monitor electrolytes (K+),
Assess renal function,dehydration, I&O,Monitor weight
Side effects: Hyperkalemia, hyperglycemia, and hyperuricemia, Dehydration, Hypotension,Renal impairment, Gynecomastia

23
Q

Digoxin

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A

Class: Antiarrythmic / cardiac glycoside
MOA: increases force of myocardial contraction
Indications: HF, AFIB
NSG considerations: take apical pulse for 60 secs, hold if HR <60, monitor serum digoxin levels & K+, Monitor for dig toxicity
Side effects: Digoxin toxicity; early signs inc N/V/D
Bradycardia, arrhythmias
Headache, weakness, dizziness, ALC,Gynecomastia

24
Q

Digibind

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A

Class: Antidote
MOA: Binds antigenically to unbound digoxin in serum
Indications life threatening over dose on digoxin
Side effects: Hypokalemia, re-emergence of HF & AFIB

25
Dobutamine
Class: Inotropic/ adrenergic MOA: Stimulates beta1 adrenergic receptors with relatively minor effect on HR or peripheral blood vessels Indications: Short term management of HF NSG considerations: do not use in idiopathic hypertrophic sub aortic stenosis Side effects: N/V, SOB, HA, HTN, Tachycardia
26
Milrinone
Class: Inotropics MOA: increased myocardial contractility, decrease preload & afterload by dilating effect on vascular smooth muscle Indications: Short term tx of HF unresponsive to digoxin, & diuretics Side effects: angina, hypotension, ^ liver enzymes, ventricular arrhythmias
27
Atorvastatin
Class: Lipid lowering agent MOA: which reduces low-density lipoprotein (LDL) Indications: This medication is used for hyperlipidemia and the prevention of cardiovascular disease NSG considerations: Take at the same time each day, with or without food Report muscle weakness, feeling tired, abdominal pain, or yellowing of skin or eyes, Do not use in pregnancy or lactation Side effects: Rhabdomyolysis, myalgia, and muscle spasms,Abnormal liver enzymes, May increase blood glucose, N/D, dyspepsia
28
Ezetimibe
Class: Cholesterol absorption inhibitor MOA: inhibits absorption of cholesterol in small intestine Indications: This medication is used for treatment of hyperlipidemia and familial hypercholesterolemia NSG considerations: Take at the same time each day, with or without food,Report muscle weakness, feeling tired, abdominal pain, or yellowing of skin or eyes Side effects: rhabdomyolysis,Hepatic impairment,Dizziness,Upper respiratory infection,Diarrhea
29
Nitroglycerin
Class: antianginal MOA: relieves angina by relaxing vascular smooth muscle, resulting in vasodilation Indications: relieve angina due to coronary artery disease, during times of an acute attack, or prophylactically NSG considerations: contraindicates w/ concurrent se of viagra, Lactation, OB, anemia, ICP SE: hypotension, palpitations, headache, weakness, sweating, flushing, nausea, vomiting, or dizziness.
30
Procainamide
Class: Antiarrhythmic MOA: Decrease myocardial excitability Indications: Vtach, AFIB NSG considerations: do not use in lactation, AV block SE: A-systole, seizures, Heart block, N/V/D
31
Quinidine
Class: Antiarrhythmic MOA: Quinidine slows conduction and prolongs depolarization by decreasing sodium influx into cardiac cells. The conduction rate and automaticity are decreased. This medication also has alpha-antagonistic properties that cause peripheral vasodilation. Indications: restore & maintain sinus rhythm in pts w/ A-fib or a flutter NSG considerations: Monitor blood pressure, heart rate, and QT with administration Avoid grapefruit juice Maintain consistent sodium intake SE: arrhythmia, dizziness, and headache Thrombocytopenia, N/V/D
32
Lidocaine
Class: Antiarrhythmic MOA : Suppresses automaticity & spontaneous depolarization of ventricles during diastole Indications: Ventricular arrhythmias NSG considerations: Do not use in 3rd degree heart block SE: cardiac arrest, N/V, stinging, confusion, drowsiness, Seizures
33
Flecainide
Class: Antiarrhythmic MOA: slows conduction in cardiac tissue by altering transport of ions across cell membranes Indications: Ventricular arrhythmias NSG considerations: do not use in cariogenic shock SE: Arrhythmias, HF, Blurred vision, Constipation, dizziness
34
Amiodarone
Class: Anti-arrhythmic MOA: prolong repolarization by blocking the potassium channels in cardiac cells that are responsible for repolarization Indications: treatment of life-threatening recurrent ventricular arrhythmias NSG considerations : Black box warning, Monitor BP/ HR SE: Fatal toxicities Neurological impairments, GI upset Worsening arrhythmia,bradycardia,hypotension,Thyroid abnormalities,Vision changes
35
Adenosine
Class: Anti-arrhythmic MOA:slow conduction through the AV node to restore normal sinus rhythm. Indications: SVT NSG considerations:Place the client in a supine position and inject medication rapidly followed by saline flush SE: Prolonged asystole, arrhythmias, palpitations, facial flushing, hypotension, bronchospasm, shortness of breath, and dizziness Seizures, loss of consciousness, numbness, and tingling to upper extremities Nausea
36
Diltiazam
Class: antianginal/antiarrhythmic Calcium Chanel blocker MOA: Inhibits transport of calcium into myocardial and vascular smooth muscle cells, resulting in inhibition of excitation-contraction coupling and subsequent contraction. Indications: HTN, Angina, AFIB NSG considerations: monitor BP & HR SE: Worsening HF, hypotension, bradycardia, edema, HA
37
Aspirin
Class: Anti platelet MOA: decrease platelet aggregation Indications: Prophylaxis of transient ischemic attacks & MI NSG: avoid after 30 was gestation SE: Dyspepsia, ABD pain, GI bleeding, Hepatotoxicity
38
Clopidogrel
Class: Antiplatelet MOA: Inhibits platelet aggregation by inhibiting binding of ATP to platelet receptors Indication: Acute STEMI, recent MI, Stoke NSG: Do not use w/ PPI’s, Monitor CBC, DC 5-7d before surgery SE: Edema, Gi bleeding, epistaxis
39
Rivaroxaban
Class: Anticoagulant MOA: Selective factor x inhibitor that inactivates the cascade of coagulation Indications: reduction in stroke in pts with AFIB, reduction in MI NSG: do not use in renal impairment, prosthetic heart valves SE: Pruritus, bleeding, wound secretion, muscle pain
40
Dabigatran
Class; Anticoagulants MOA: direct inhibitor of thrombin Indications: reduction in risk of MI, CVA NSG: do not use in prosthetic heart valves, pregnancy, lactation SE: ABD Pain, Diarrhea, dyspepsia, gastritis, bleeding
41
Heparin
Class: anticoagulants MOA: potential es inhibitory effect of antithrombin on factor Xa & thrombin Indications: Prophylaxis & Tx of various thromboembolic disorders (Ex DVT, PE, AFIB,) NSG: Do not use in uncontrolled bleeding SE: Hyperkalemia, Anemia, osteoporosis, ^ liver enzymes
42
Enoxaparin
Class: anticoagulants MOA: Potentiates inhibitory effect of antithrombin on factor Xa & thrombin Indications: Prevention of ischemic complications from unstable angina & NSTEMI, Acute tx of STEMI NSG: do not use in major bleeding, hypersensitivity to benzoyl alcohol SE: edema, hyperkalemia, ^ liver enzymes, Bleeding, Anemia
43
Alteplase
Class: Thrombolytic MOA: Converts plasminogen to plasminogen, which degrades clot bound fibrin Indications: Acute MI/ Ischemic stroke NSG: do not use in active bleeding, hx of CVA, Uncontrolled HTN, SE: hypotension, bleeding, fever, urticaria, epistaxis

Nursing Pharmocology (1 decks)

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