Medicamentos Quiz # 1 Flashcards
What are some side effects of opiod analgesics
Sedation, dizziness, confusion, hypotension, respiratory depression, constipation, nausea, vomiting, bradycardia
Opiod analgesics
Hydrocodone, Codeine Sulfate, Hydromorphone, Morphine Sulfate
What are some other uses for opiod analgesics?
Allergy, cold, cough, anntitussive (except morphine)
Why would you use opid analgesics?
To supress severe pain and cough reflex. Morphine-pulmonary edema and MI
What are some laboratory values you should be concerned about when using opiod analgesics?
Increase plasma amylase and lipase concentrations
Hydromorphone
Dilaudid
Hydrocodone/APAP
Norco
What are some contarindications of opiod analgesics?
Respiratory rate
What antidote can you use when opiod analgesic toxicity occurs?
Naloxone (narcan) Use 0 .4-mg in 10-ml of 0.9% NaCl
What are some recommendation for opiod analgesic users?
Avoid drving, ambulating without assistance, and other CNS depressants, change slowly. If immobilized, turn , cough, and breathe deeply every 2hr to prevent atelectasis.
How would you know naloxone is doing its job?
Alertness, adequate ventilation, and reversal of opiod excess signs
Naloxone
Antidote for opiods (Narcan)
What are some side effects of Naloxone?
Hypertension, hypotension, nausea, vomiting and VENTRICULAR ARRHYTMIAS
When can you not give naloxone?
Cardiovascular disease, and in opiod dependent patients
What laboratory values should you be looking at when administering Naloxone?
Renal & hepatic functions, CBC, K+, LDH, glucose, Plt
What are some recomendations for Naloxone users?
Monitor respiratory rate, rythm, and depth . Monitor puls, ECG, BP and level of consciousness frequently for 3-4 hr after peak. Assess for opiod withdrawal symptoms
What are some anti-infectives?
Cefazolin, Ampicillin/sulbactam, Levofloxacin, Metronidazole
What are some uses for anti-infectives?
Skin/Skin structure infections, (burn, wounds); Respiratory (pneumonia), bone/joint infections
Anthrax infection
Levofloxacin
What are some side effects of anti-infectives?
Dizziness, headache, nausea, vomiting, diarrhea, rahes, supreinfection and phlebitis
What are some serius side effects of anti-infectives?
Anaphylaxis, stens-Johnson Syndrome, Pseudomembranous colitis, sizures; (torsade de pointes & elevated intracraneal pressure aslo for Levofloxacin)
What are some containdications for anti-infectives?
Seizures; Pseudomembranous colitis s/s (Abdominal cramping, fever, bloody stools), Anaphylaxis s/s (rash, pruritus, laryngeal edema, wheezing, skin rash
What are some laboratory values for anti-infectives?
Liver/hepatic functions, WBC, LDH, electrolytes
What are some recommendations to patients using anti-infectives?
Avoid alcohol, driving/ambulating without assistance, report s/s of superinfection (black/furry overgrowth on tongue, vaginal itching or discharge, loose or foul-smelling stool) Report s/s neprotoxicity (cloudy & pink urine) and of those contraindicated
Antitubercular
Rifampin
Rifampin
Rifadin
What woud you use Rifampin?
To treat tuberculosis, elimination of meningococcal carriers, prevent Haemophilus influenza type B
What are some side effects of Rifampin?
Red/discoloration of tears and urine, Abdominal pain, drowsiness, nausea, vomiting, diarrhea, heartburn
How would you know Rifampin is working?
Decrease in fever, night sweats, cough, sputum production, fatigue; increased apetite, weight and sense of well-being
What are some labs for Rifampin?
CBC, Hepatic/renal functions, urinalysis, uric acid, alkaline phosphate
What are some recomendations for Rifampin?
Report s/s of hepatitis and thrombocytopenia or flue-like symptoms, Inform that saliva,sweat, sputum, tears, urine, and feces may become red-orange to red-brown and contacts may become permanently discolored. Avoid driving, take medication on empty stomach 1-2 hr after meals with full glass of water.
Corticosteroids/Antiinflammatory
Hydrocortisone, Prednisone, dexamethasone, Fluticasone
Antiasthmatichs/bronchodilator
Epinephrine
Epinephrine, fluticasone, dexamethasone, Prednisone
Adrenalin, flovent diskus, Dioptrol, Prednisone Intensol
Fluticasone
Flovent Diskus
Dexamethasone
Dioptrol
Why would you use corticosteroids?
Management of inflammation, pruritus, edema Cerebral edema, nausea, vomiting from chemotherapy, treatment of croup and airway edema
Why would you use epinephrine and fluticasone?
Management of asthma & COPD, and sever allergic reaction
What are some effects of epinephrine?
Bronchodilatiion, maintenance of heart rate and BP
Why would you use corticosteroids?
inflammation (edemas Dexamethasone-cerebral), allergic, hematologic, neoplastic, , autoimmune disorders
What are some effects of Fluticasone?
Decreased frequency/severy of asthma symptoms
What are some side effects of corticosteroids?
Depression, restlessness, euphoria, headache, hypertension, nausea vomiting, adrenal supression, muscle wasting, decreased wound healing
What are some contraindications of Epinephrine?
Wheezing (paradoxical bronchospasm)
What are some contraindicaion for antiasthmatics?
s/s of adrenal insufficiency (anorexia, weakness, fatigue, dyspnea, hypertension, hypoglycemia). s/s of hypersensitivity
What are some labs for corticosteroids/antiasthmatics?
Adrenal test ((HPA) supression. Adrenal function, glucose, electrolytes e.g. k+ and Ca2+
What are some serious side effects fo dexamethasone?
Thromboembolism and peptic ulceration
What are some recommendations for corticosteroids/antiasthmatic users?
Avoid grapefruit, alcohol, sick people (Dexamethasone), Rinse mouth frequently and avoid smoking. Administer promptly after bronchospasm. Hydrocortisone( avoid using cosmetics, bandage, dressing over treated area, no dipers)
What are some antiretrovirals?
Zidovudine and Nevirapine
Nevirapine
Viramune
Zidovudine
AZT, Retrovir
Whay would you use a antiretroviral?
To treat HIV infectoin
How do you know a retroviral is doing its job?
Decreased HIV viral load & opportunistic infections and increased CD4 counts
What are some side effects of Zidovudine?
Headache, weakness, abdominal pain, diarrhea, nausea. Other seroiuos side effects: SEIZURES, HEPATOMEGALY, PANCREATITIS, LACTIC ACIDOSIS
What are some side effects of Nevirapine?
Headache, liver enzymes, nausea, fiver. Other serious side effects: HEPATOXICITY, RASH, STEVENS-jOHNSON SYNDROME 7 EPIDERMAL NECROLISIS
What are some lab values to consider for antiretrovirals?
Viral load and CD4 counts, CBC hepaticfunction, pancreatitis (amylase, triglycerides, lipase)
What are some recomendations for antiretroviral users?
Caution to use condom during sex. Avoid driving and crowds and people with infections. Use soft toothbrush and avoid dental work, toothpicks and dental flosss. Report and symptoms of hepatitis, muscle aches, shortness of breath, fever, and hypersensitivity reactions
Colony-stimulator factor
Filgastrim
What would you use Filgastrim?
To treat/prevent of febrile neutropenia in patients involved in bone marrow and chemotheraphy
What are some side effects of Filgastrim?
Medulary bone pain, excessive leukocytosis
Positive effects of Filgastrim
Decreased incidence of infection in patients who are neutropenic from chemotherapy
What are some lab values to Filgastrim (Neupogen)?
CBCdiff including blast cells and plt count before chemo twice weekly during therapy
What are some recomendations to Filgastrim?
Monitor vitals before and after therapy. Do not freeze nor shake but may warm to room temperature before use.
What are some antiemetics?
Ferrous Sulfate and Epoetin?
Epoetin
Epogen
What would you use antianemics?
Ferrous sulfate;: piron defficieny anemi; Epoetin: treat anemia with chronic kidney failure, from chemotherapy
How do you knoe antianemics are working?
Increased hemoglobing and hematocrit, decreasing rates of transfusions.
What are some side effects of antianemics?
SEIZURES, hypertension, hypotension, headache; Epoetin(THROMBOLITIC EVENTS, CHF, MI STROKE) Ferrous Sulfate(ANAPHYLAXIS, skin sataining, dark syools, nausea, diarrhea, epigastric pain)
What are some lab values for antianemics?
Hemoglobin hgb, hct, reticulocyte values renal function, erythropoietin(Epoetin)
What are some contraindication for antianemics?
Ferrous sulfate-antiacids, and s/s of hypersensitivity; EPOETIN (Hypertesion and pt receiving erythropoietin)
Ferrous sulfate toxicity/overdose s/s
Stomach pain, fever, nausea, vomiting, diarrhea; late symptoms: blue lips, fingernails, and palms, drowsiness, seizures
What are some recomendations to antianemics users?
Ferrous sulfate (1-2 after meals with full glass, may stain teeth, avoid antiacids, coffe, tea, dairy products, eggs, whole grain breads within 1hr after administration to prevent malabsorption. Report anaphylaxis s/s) Epoetin ( Report s/s of blod clot, prevent self-injury from seizures, comply with dietary restrictions)
What is the antidote for antianemics?
Use sodium bicarbonate for gastric lavage and Deferoxamine
What are some antihistamines?
Fexofenadine, Diphenhydramine, and promethazine
Why would you use antihistamines?
Allergic reactions such as urticaria, rhinitis. Promethazine (analgesia/anesthesia adjuct). Diphenhydramine (antitussive)
What are you expecting when using antihistamines?
Decreased sneezing, rhinorrhea, itchy eyes/nose/throat Promethazine (sedation and antiemesis)
What are some side effects of antihistamines?
Drowsiness, sedation, fatigue, dizziness, hypotension. Promethazine, (NEUROLEPTIC MALIGNANT SYNDROME, brady/tachycardia, hypo/hypertension). Diphenhydramine (dry mouth, photorsensitivity)
What are some overdose symptoms of antihistamine?
Renal function, Promethazine: (Neuropatic malignant syndrome: fever, tachycardia, seizures, diaphoresis, hypo/hypertension, pallor, tiredness, severe muscle stiffness.
What are some recomendations for antihistamine users?
Monitor vitals, administer medication with food/milk/water to avoid GI irritation, avoid driving, alcohol, CNS depressants, use sunscreen. Promethazine (change position slowlybecause of orthostatic hypotension, notify fever, jaudince, uncontrolled movement)
What are some nonopiod analgesics/antipyretics?
Aspirin, Ibuprofen, Acetaminophen
What would you use nonopiod analgesics/antipyretics?
Mild to moderate pain, fever and inflammatory arthritis, osteomilitis e.g. Aspirin and Ibuprofen
Ibuprofen
Advil, Motrin
Aspirin/ecotrin
Arthrinol, astrin
Acetaminophen
Tylenol
What are some therapeutic effects of nonopiod analgesics?
Analgesia, inflammation and fever reduction. Aspirin-reduces transient ischemic attacks
What are some side effects of nonopiod analgesics?
Dyspepsia, abdominal pain, drowsiness, renal failure, BLEEDING, ANAPHYLAXIS, TOXIC EPIDERMAL NECROLYSIS, EXFOLIATIVE DERMATITIS, LARiNGEAL EDEMA, STEVENS-JOHNSON SYNDROME, (Acetaminophen-HEPATOXICITY)
What are some contraindications for nonopiod analgesics?
Alcohol-may lead to liver damage, and to prevent GI bleeding and analgesic nephropathy, rash and s/s of hypersensitivity
What are some lab values for nonopiod analgesics?
Monitor hepatic/liver functions, LDH protombin time which may indicate anagesic nephrophaty
What are some recommendations for nonopiod analgesics?
Avoid driving, sunshine, alcohol NAIDs, report rash, itching, visual disturbances, tinnitus, weight gain, epigastric pain or influenza-like symptoms (chills, fever, muscle aches, pain)
