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Practicum Review > Med Summary St. B > Flashcards

Med Summary St. B Flashcards

1
Q

ASA administration

A

Chewed

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2
Q

ASA cautions (3)

A

Do not administer with salicylate allergy, GI bleed, thrombocytopenia

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3
Q

Calcium Chloride uses

A

Cardiac Resuscitation
Hyperkalemia
Hypocalcemia
Calcium channel blocker overdose

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4
Q

Calcium chloride administration

A

IV push - central route preferred

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5
Q

Dextrose 50% administration

A

IV push (central preferred)

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6
Q

Dextrose cautions

A

Local pain and vein irritation if infused rapidly

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7
Q

Diazepam use (4) - SAAS mnemonic

A

Sedation
Agitation
Alcohol withdrawal
Status epilepticus

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8
Q

Diazepam admin

A

Slow IV push into large vein, flush afterwards

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9
Q

Diazepam cautions

A
  • thrombophlebitis
  • drowsiness
  • ataxia
  • resp depression
  • hypotension
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10
Q

Diphenhydramine use

A

Anaphylaxis

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11
Q

Diphenhydramine admin

A

IV push

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12
Q

Diphenhydramine cautions

A
  • CNS effects
  • urinary retention
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13
Q

Epinephrine use

A

Anaphylaxis and cardiac arrest

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14
Q

Epinephrine admin

A

IV push, if given peripherally, flush with 20ml to ensure complete drug delivery

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15
Q

Epinephrine cautions

A
  • hypertension
  • tachycardia
  • palpitations
  • angina
  • arrhythmias
  • anxiety
  • swearing
  • headache
  • hyperglycaemia
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16
Q

Furosemide admin

A

IV push into infusing IV solution

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17
Q

Furosemide cautions

A
  • electrolyte depletion
  • hypovolemia
  • thrombophlebitis
  • ototoxicity
  • caution in patients allergic to sulfa drugs
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18
Q

Hydralazine use

A

Hypertension, heart failure

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19
Q

Hydralazine admin

A

IV push

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20
Q

Hydralazine cautions

A
  • hypotension
  • palpitations
  • tachycardia
  • angina
  • dizziness
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21
Q

Hydrocortisone use

A

Anaphylaxis
Sepsis
Refractory hypotension
Adrenal insufficiency

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22
Q

Hydrocortisone admin

A

IV push - only up to 500mg

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23
Q

Hydrocortisone cautions

A
  • Sodium retention, edema
  • hypokalemia, hyperglycaemia
  • hypertension
  • CNS side effects
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24
Q

Naloxone cautions

A

Opioid withdrawal symptoms

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25
Q

Nitro spray (use, admin, cautions

A
  • use: opioid antagonist
  • admin: sublingual
  • cautions: hypotension, dizziness
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26
Q

Phenytoin use

A

Seizures

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27
Q

Phenytoin route

A

Max rate 50mg/min, DO NOT COMBINE WITH DEXTROSE, Infuse with fluids into large vein, big flush

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28
Q

Phenytoin cautions

A
  • Bradycardia
  • hypotension
  • arrhythmias
  • resp depression
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29
Q

Sodium Bicarbonate use

A

Hyperkalemia, acidosis

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30
Q

Sodium bicarbonate cautions

A
  • CNS effects
  • electrolyte disturbances
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31
Q

Adenosine use

A

SVT

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32
Q

Adenosine admin (2)

A
  • Fast push (worse sx with slow push)
  • Continuous EKG monitoring required
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33
Q

Adenosine cautions

A
  • sx common but short term
  • contraindications: AV block, sick sinus, symptomatic brady, asthma/COPD (wheezing occurs)
  • sx: AV block, transient arrhythmias, hypotension, tachycardia
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34
Q

Amiodarone use

A

Atrial/ventricular arrhythmias

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35
Q

Amiodarone admin (2)

A

Push in cardiac arrest only (dilute in 20ml D5W)

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36
Q

Amiodarone cautions (2)

A
  • Hypotension
  • bradyarrhythmias
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37
Q

Atropine use

A

Symptomatic bradycardia

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38
Q

Atropine admin

A

IV push

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39
Q

Atropine cautions (5)

A
  • palpitation
  • tachycardia
  • dilated pupils
  • blurred vision
  • urinary retention
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40
Q

Lidocaine use

A

Ventricular arrhythmias

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41
Q

Lidocaine admin

A

IV push

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42
Q

Lidocaine cautions (4)

A
  • CNS effects
  • seizures
  • resp arrest
  • hypotension
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43
Q

Vasopressin use

A

Cardiac arrest
Shock

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44
Q

Vasopressin admin

A

IV push in cardiac arrest

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45
Q

Vasopressin cautions (3)

A

Bradycardia
Arrhythmias
Angina

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46
Q

Indication for use of antipsychotics

A
  • Severe/disabling hallucinations, paranoia, delusions
  • aggression poses safety risk to self/others
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47
Q

Contraindication for antipsychotics

A

Not effective for wandering/calling out

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48
Q

How does antipsychotic use for agitation impact mortality

A

Increased risk of mortality

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49
Q

Side effects of antipsychotics (8)

A
  • somnolence
  • increased confusion
  • postural hypotension
  • falls
  • Parkinsonian symptoms, akathisias
  • metabolic disorders
  • arrhythmias
  • neuroleptic malignant syndrome
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50
Q

How often should patients on antipsychotics for dementia be re-evaluated

A
  • minimum q3 months
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51
Q

List three common atypical antipsychotics

A
  • risperidone
  • quetiapibe
  • olanzapine
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52
Q

Risperidone cautions

A

Most likely atypical antipsychotic to cause Parkinsonian symptoms

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53
Q

Risperidone benefits

A

Least likely atypical antipsychotic to cause drowsiness

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54
Q

Quetiapine cautions

A

Most likely atypical antipsychotic to cause drowsiness

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55
Q

Quetiapine benefit and preferred population

A

Least likely atypical antipsychotic to cause Parkinsonian symptoms (choice for Parkinson’s disease/Louis body dementia

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56
Q

Olanzapine caution

A

Most likely atypical antipsychotic to cause postural hypotension

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57
Q

What is a typical antipsychotic

A

Haldol

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58
Q

Haldol cautions (2)

A

Avoid in patients with Parkinson’s/Lewis body dementia
QT prolongation - caution with patients on anti-arrhythmic meds

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59
Q

Beta blocker examples

A

All end with ‘olol’ except carvedilol
- most common: metoprolol, atenolol, bisoprolol, labetolol

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60
Q

Beta blockers secondary uses

A
  • rate control for a. Fib
  • prophylaxis against variceal bleed, migraine
  • hyperthyroidism
  • eye drop for glaucoma
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61
Q

Beta blocker side effects

A
  • Fatigue
  • insomnia
  • decreased libido
  • bronchospasm
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62
Q

Calcium channel blocker (non-dihydropyridine) examples

A
  • Diltiazem
  • Verapamil
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63
Q

Calcium channel blocker
(dihydropyridine) example

A

Nifepidine
Felopidine
Amlodipine

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64
Q

Calcium channel blocker (dihydropyridine) cautions

A
  • only amplodipine can be chewed
  • nifepidine appears undigested in stool
  • sx: dizziness, headache, constipation, fatigue
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65
Q

ACE-inhibitor examples

A

All end with PRIL
Common: Ramipril

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66
Q

ACE-inhibitor side effects

A
  • hyperkalemia
  • cough
  • initial worsening of renal function (renal protective long term)
  • rare: Angioedema
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67
Q

Angiotensin receptor blocker examples

A

End with ‘sartan’
Common: irbesartan

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68
Q

Angiotensin receptor blocker considerations

A
  • consider for patients with cough from ace inhibitors
  • sx include hyperkalemia, initial worsening of renal function, angioedema
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69
Q

Alpha blocker examples

A

End with ‘zosin’
- terazosin
- prazosin
- doxazosin

70
Q

Alpha blocker side effects

A
  • Postural hypotension (intense, consider HS dosing)
  • dizziness
  • headache
  • muscle weakness
  • peripheral edema
71
Q

Central acting vasodilator example

A

Clonidine

72
Q

Central acting vasodilator side effects

A

Dizziness
Drowsiness
Dry mouth
Weakness
Constipation

73
Q

Venous vasodilator example

A

Nitroglycerin

74
Q

Venous vasodilator considerations

A
  • sx: hypotension, dizziness, headache, patchy skin reactions
  • nitro patch tolerance develops within 72 hours - need vacations
75
Q

Arterial vasodilator examples

A
  • Hydralazine
  • Minoxidil
76
Q

Hydralazine considerations

A

May cause reflex tachycardia and lupus-like syndrome

77
Q

Minoxidil considerations

A

MY cause excess hair growth

78
Q

Thiazide diuretic examples (4)

A

Hydroclorothiazide
Metolazone
Chlorthalidone
Indapamide

79
Q

Thiazide diuretic indications

A

Treats hypertension and synergizes with loop diuretics in treatment of CHF

80
Q

Thiazide considerations

A
  • give in AM (++HS elimination)
  • sx: low k, Na, Mg, elevated Ca+, dehydration, hypotension, photosensitivity, anorexia, gout
  • low glomerular filtration = ineffective
81
Q

Loop diuretic examples

A

Furosemide
Ethacrynic Acid

82
Q

Loop diuretic considerations

A
  • admin AM
  • sx: low K, Na, Mg, Ava
  • dehydration, bad renal function, hypotension, photosensitivity, gout, hearing impairment with high IV dose
  • Ethacrynic acid used for furosemide allergy
83
Q

Potassium sparing diuretic examples

A

Spironolactone
Amiloride
Triamterene

84
Q

Potassium sparing diuretic secondary uses

A

Hyperaldosteronism (spironolactone)

85
Q

K sparing diuretic considerations

A
  • Give in AM
  • Spironolactone sx hyperkalemia, gynecomastia, dehydration, worsening renal function
86
Q

Cardiac glycosides example

A

Digoxin

87
Q

Digoxin use

A
  • CHF
  • A. Fib (rate control)
88
Q

Digoxin considerations

A
  • sx: NV, visual disturbances, bradycardia, anorexia, arrhythmias
  • hypokalemia predisposes to Brady
89
Q

Which anti-arrhythmic drug has the lowest potential to cause new arrhythmias and is safest for heart failure

A

Amiodarone

90
Q

Unfractioned Heparin/Dalteparin indication (very specific)

A

Used for patients unable to ambulate 50m 3x day

91
Q

Dalteparin alternative name?

A

Low molecular weight heparin

92
Q

Dalteparin dosing

A

<50kg = 2500
50-100kg = 5000
100-150kg = 7500

93
Q

Heparin dosing

A

<100kg = 5000 q12h
>100kg = 5000 q8h

94
Q

Dalteparin contraindications

A
  • Caution in renal dysfunction (eGFR <30), particular caution if used more than 7 days
  • HIT
95
Q

Factor XA Inhibitor example

A

Fondaparinux

96
Q

Fonxaparinux use

A

Patients with history of HIT

97
Q

Fondaparinux contraindications

A

May accumulate with renal dysfunction.

98
Q

SABA examples

A

Salbutamol (ventolin)
Terbutaline

99
Q

SABA secondary uses

A

Anaphylaxis
Hyperkalemia

100
Q

Respiratory anticholinergic examples

A

Ipatropium (atrovent)
Tiotropium (spiriva)

101
Q

Anticholinergic uses

A
  • Reduces airway secretions/bronchodilates
  • Asthma (acute and chronic)
102
Q

Anticholinergic considerations

A

Ipatropium therapy must fail in order to try other types

103
Q

LABA examples (2)

A
  • salmeterol (serevent)
  • formoterol
104
Q

Salmeterol onset of action

A

30min-2hrs

105
Q

Salmeterol considerations

A

Should not be used as mono therapy - use with steroid

106
Q

Corticosteroid examples

A

Fluticasone (Flovent)
Budesonide (pulmicort)
Ciclesonide
Beclomethasone

107
Q

Corticosteroid considerations

A

Rinse mouth after each use to reduce risk of thrush

108
Q

Resp Combination product examples

A

Advair (salmeterol/fluticasone)
Symbiocort (formeterol/budesonide)
Combivent (Salbutamol/ipatropium)
Zenhale (folmeterol/mometasone)

109
Q

Advair considerations

A

Salmeterol content is different in MDI vs. Diskus

110
Q

Classes of oral resp meds (4)

A
  • corticosteroids
  • leukotriene receptor antagonist
  • phosphodiesterase 3+4 inhibitor
  • phosphodiesterase 5 inhibitor
111
Q

Corticosteroid sx

A

GI upset
Mood changes/insomnia
Hyperglycaemia
Fluid retention
HTN
Osteoporosis
Cataracts

112
Q

Leukotriene receptor antagonist example

A

End with Lukast
Example: montelukas

113
Q

Leukotriene receptor antagonist uses

A
  • Asthma
  • Allergic rhinitis
114
Q

Leukotriene receptor antagonist considerations

A

Sx: headache and behavioural changes

115
Q

Phosphodiesterase III + IV inhibitor examples

A

Theophylline

116
Q

Phosphodiesterase III + IV inhibitor use

A

Asthma

117
Q

Phosphodiesterase III + IV inhibitor sx

A
  • lots of drug interactions
  • sx: GI, insomnia, Tachy, urinary retention
118
Q

Phosphodiesterase IV inhibitor example

A

Roflumilast

119
Q

Phosphodiesterase IV inhibitor use

A

Severe COPD

120
Q

Phosphodiesterase IV inhibitor considerations

A
  • Not covered by pharmacare, expensive
  • considered when people have maxed out on puffers
  • sx: depression, insomnia, suicidal thoughts, NVD
121
Q

Classes of acid suppressing meds (3)

A

Antacids
H2 blockers
PPIs

122
Q

Antacid examples

A

Diovol (aluminum/magnesium)
Alugel (aluminum hydroxide)

123
Q

Antacid considerations

A
  • Sx: diarrhea, constipation
  • Binds with floxacin, cycline abx
124
Q

H2 blocker examples

A
  • Ranitidine
  • Famotidine
125
Q

PPI Inhibitor examples

A
  • Pantoprazole
  • Esomeorazole
  • Omeprazole
  • Lansoprazole
126
Q

Describe the PPI auto sun policy

A

All patients get switched to panto, esomeprazole on admission
- eso more likely for tube feeds

127
Q

When is panto IV used?

A

Continuous infusion for acute GI bleed

128
Q

Prokinetic agent examples (3)

A
  • Metoclopramide
  • Domperidone
  • Erythromycin
129
Q

Metoclopramide sx

A
  • Crosses blood brain barrier, pseudoparkinson symptoms, myoclonus, drowsiness
  • sx more common with older adults, high dose, impaired renal function
130
Q

Domperidone considerations

A

Does not cross blood brain barrier

131
Q

Erythromycin considerations

A

Drug interactions frequent, rarely used

132
Q

Antinauseant classes (8)

A

Antihistamines
Dopamine blockers
Serotinergic agents
Anticholinertics
Neurokinin inhibitor
Corticosteroids
Somatostatin analogues
Cannabinoid receptor binders

133
Q

Antihistamine examples

A

Gravol and Benadryl

134
Q

Dopamine blocker examples

A
  • Metoclopramide/Domperidone
  • haldol
  • ‘zine’ drugs, eg. chlorpromazine, promethazine
135
Q

Serotinergic agent examples

A

Ondansetron, granisetron (subcut)

136
Q

Anticholinergic agent examples

A

Scopolamine patches

137
Q

Neurokinin inhibitor example and use

A

Aprepitant (emend) - for chemo associated nausea and vomiting

138
Q

Corticosteroid example and use

A

Dexamethasone for chemo associated nausea and vomiting

139
Q

Somatostatin analogue example and use

A

Octerotide for chemo associated NV

140
Q

Cannabinoid receptor binder examples

A

Dronabinol, nabilone

141
Q

Antidiarrheal drugs (5)

A

Loperamide
Opioids
Lomotil
Pepto-bismol
Octerotide

142
Q

Loperamide use

A

Antidiarrheal used in chemo protocols

143
Q

Lomotil drug components

A

Diphenoxylate - opioid
Atropine - anticholinergic

144
Q

Pepto-bismol considerations

A

Contraindicated in ASA allergy

145
Q

Octerotide use

A

Antisecretory agent used in patients with high ostomy output refractory to other agents

146
Q

Laxative/anti-constipation drug classes

A

Stool softeners
Stimulant laxatives
Osmotic agents
Fibre substances
Opioid antagonists

147
Q

Stool softener example and consideration

A

Docusate sodium - takes 72h to take full effect, best hard with plenty of fluids

148
Q

Stimulant laxative examples

A

Sennosides
Bisacodyl
Do not co-administer (not synergistic)

149
Q

Senna + bisacodyl onset of action

A

Senna: 6-12 hours
Bisacodyl: 6-10
Best given at HS

150
Q

Osmotic agent examples

A

Lactulose
Milk of magnesium
PEG
PicoSalax

151
Q

Fibre supplement examples

A

Metamucil
Benefibre (more palatable)

152
Q

Opioid antagonist examples

A

Methylnaltrexone

153
Q

Drugs for c. Diff (examples)

A

Metronidazole
Vancomycin

GIVE PO NOT IV

154
Q

Drugs for BPH (examples)

A

Alpha blockers
5-alpha reductase inhibitors

155
Q

Alpha blocker for BPH examples

A

Tamulosin (flomax)
Prazosin

156
Q

Alpha blocker MOA

A

Relax smooth muscle of bladder neck and prostate
- may facilitate passing kidney stones

157
Q

Alpha blocker onset

A

Slow: 3-7 days, max effect in 4 weeks

158
Q

Alpha blocker sx

A

Postural hypotension

159
Q

5-alpha reductase inhibitor examples

A

Finasteride

160
Q

5-alpha reductase inhibitor MOA

A

Hormonally Reduce the size of prostate (only effective if enlarged)

161
Q

5-alpha reductase inhibitor onset

A

3-6 months

162
Q

Which drugs work for urinary retention?

A

Cholinergic drugs
- bethanechol

163
Q

Bethanechol sx

A

Bradycardia, resp secretions, bronchospasm

164
Q

Drugs for urgency incontinence/overactive bladder (class)

A
  • Anticholinergic agents
  • beta 3 agonists
165
Q

Anticholinergics for incontinence - examples

A

Tolteradine
Oxybutynin
Dicyclomine

166
Q

Anticholinergic for incontinence MOA

A

Relax detrusor muscles and reduce sensation of urgency

167
Q

Anticholinergic for incontinence sx

A
  • hypotension
  • tachycardia
  • dry mouth
  • constipation
  • confusion
168
Q

Beta 3 agonist examples

A

Mirabegron

169
Q

Beta 3 agonist MOA

A
  • activate receptors in the bladder resulting in relaxation of detrusor smooth muscle during urine storage phase = increase bladder capacity
170
Q

Mirabegron sx

A

HTN, may impact QT interval

Practicum Review (4 decks)

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