Lecture six- PHARMACOLOGY Flashcards
5 drug toxicities
- Lithium
- Digoxin/Lanoxin
- Aminophylline
- Dilantin/phenotoyin
- Billirubin
Lithium tx
antimania/bipolar
therapeutic lvl .6-1.2
lithium toxicity is
> 2
Lanoxin/digoxin purpose and therapeutic range
afib/chf
therapeutic lvl 1-2
Digoxin toxicity
> 2
Aminophylline purpose and therapeutic range
relieves airway spasms
therapeutic lvl 10-20
Aminophylline toxicity
≥20
Dilantin/fenatoid purpose and therapeutic range
seizures
terapeutic lvl 10-20
Dilantin/fenatoid toxicity
≥20
Billirubin in newborns elevated lvl
10-20
≥20 toxic
if a newborns billi is 14-15 bring them to the
hospital
kernicterus
billirubin in brain lvl 20
apistotonus
position bby assumes when billi is too high in brain; hyperextension; heels to ears
apistotonus positon ix
place on side
pathologic jaundice is
bad first 24hrs
physiologic jaundice is
okay 48-72hrs q birth
dumping syndrome
usually follows a gastric surgery; stomach contents dump into jejunum
gastric contents move in right direction but wrong rate (too fas)
dumping syndrome ss
drunk in shock, acute abdominal distress, cramps, guarding, borborigmi, diarrhea
dumping syndrome tx
eat flat on side, decrease fluids w meals, decrease carbs, increase protein
carbs and proteins are
opposites
hiatal hernia
regurgitation of acid into esophagus due to upper part of stomach herniating into diaphragm
gastric contents move in the wrong direction at correct rate
hiatal hernia ss
GERD heartburn/indigestion
hiatal hernia tx
raise hob during and after meals, increase fluids w meals, increase carbs, decrease proteins
kalemias do the same as the prefix except for
heartrate and urine output
hyperkalemia
high K+
HR low, urine output low
hypokalemia
low K+
HR high, urine output high
K+ lvl
3.5-5.0
Hyperkalemia ss
agitation, restless, tachypnea, bradycardia, peaked T & ST waves, borborigomi, diarrhea, muscle spasms, +3+4 reflexes
Hypokalemia ss
decreased loc, tachycardia, bradypnea, constipation, flaccid muscles, +1 reflexes
clonus is
irritability
obtundant is
lethargic;severe
calcemias do the opposite of the
prefix
hypercalcemia
everything low
hypocalcemia
everything high
hypocalcemia ss
chvostek sign
trousseaus sign
chvostek sign
tap cheek and assess ofr facial spasm=+
trousseaus sign
inflate bp cuff and assess for hand spasm=+
magnesimias do opposite of
prefix
hypermagnesia everything goes
down
hypomagnesia everything goes
up
in a tie between electrolytes on a question usually dont pick
magnesium
if the question focuses on muscles/nerves its prob
calcium
anything else k+
tetany
muscle contractions/spasms
dehydration is associated with
hypernatremia
admin iv fluids
fluid vol overload is associated with
hyponatremia
fluid restriction/lasix
earliest sign of an electrolyte imbal
numbness/tingling
circamural paresthesia around lips
paresis muscle weakness
K+ tx tips
never push iv
no more than 40 k+ in one liter of iv fluids
how to lower k+
admin d5w w reg insulin (fast but temporary)
kexalate; full of Na+ and causes K+ to exit through bowels
Na+ and K+ balance
eachother
