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NURS120 > Medications > Flashcards

Medications Flashcards

1
Q

what is heparin used for

A

anticoagulant; prevent blood clots in VTE/PE, A.fib, stroke, surgery; emergency

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2
Q

how is heparin used

A

IV or subQ injection

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3
Q

side effects of heparin

A

bleeding
bruising
HIT
osteoporosis (long term, high dose)
hair loss
rashes
injection site necrosis

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4
Q

how does heparin work

A

enhances antithrombin III

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5
Q

therapeutic range of heparin

A

1.5 - 2.5x normal range(30-40sec) -> 60-80secs aPTT test

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6
Q

what to monitor when using Heparin

A

decreased Hgb & Hct
decreased platelets

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7
Q

what not to take with Heparin

A

aspirin, NSAIDs, OTC
Digoxin, antihistamines

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8
Q

contraindications for Heparin

A

hx of HIT, hypersensitivity to pork (works for pregnant women)

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9
Q

antidote for heparin

A

protamine sulfate

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10
Q

what is coumadin also known as

A

Warfarin

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11
Q

what is coumadin used for

A

anticoagulant; treat PE,MI,A.fib, venous thrombosis, heart valve replacement

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12
Q

how does coumadin work

A

vitamin K antagonist

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13
Q

how is coumadin used

A

oral tablets

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14
Q

what to monitor for coumadin use

A

international normalized ratios (INR): clotting time 2-3
decreased INR increase dose
prothrombin time

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15
Q

contraindictions for coumadin

A

active bleeding, surgery, renal/liver failure, pregnant

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16
Q

nursing education for coumadin

A

no alcohol, no excessive green leafy veg, avoid NSAIDs aspirin OTC

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17
Q

adverse effects of coumadin

A

bleeding, bruising, nausea, bloating, ab.cramping

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18
Q

antidote for coumadin

A

vit K and fresh frozen plasma

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19
Q

what is Lovenox also known as

A

enoxaparin

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20
Q

how does enoxaparin work

A

binds with antithrombin III

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21
Q

how is lovenox given

A

subQ or IV then subQ injections

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22
Q

adverse reactions with lovenox

A

A.fib, anemia, PE, embolism,

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23
Q

what does lovenox treat

A

DVT, PE, acute MI, unstable angina

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24
Q

contraindications for lovenox

A

active major bleeding, hypersensitivity to benzyl alcohol & heparin & pork products, pregancy, prosthetic heart valves, epidural/spinal anesthesia

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25
Q

interactions with lovenox

A

NSAIDs, oral anticoagulants, aspirin, garlic, ginger

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26
Q

what is ACE inhibitor used for

A

antihypertensives; hypertension, heart failure, post MI

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27
Q

how does ACE inhibitor work

A

inhibits the RAAS (renin angiotensin aldosterone system)

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28
Q

adverse reactions with ACE inhibitors

A

persistent dry cough (normal), dizziness, hyperkalemia, angioedema (life threatening), kidney&liver issues

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29
Q

interactions with ACE inhibitors

A

K+ sparing diuretics such as spironolactone

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30
Q

what to look out for when using ACE inhibitors

A

Ekg with tall peaked t-waves
BUN (5-20) & creatine (0.6-1.2)
K level (3.5 -5)
echocardiograms, MRI of heart

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31
Q

nursing education for ACE inhibitors

A

avoid salt and K rich foods, rebound hypertension when suddenly stop meds

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32
Q

how are ACE inhibitors taken

A

oral tabs; end with “pril”

33
Q

antidote for ACE inhibitors

A

IV fluids for hypotension, oral activated charcoal

34
Q

what does aldosterone do to the body

A

increase blood volume, vasoconstriction
keep Na & water
excrete K
so antihypertensives blocking aldosterone would excrete Na & water and keep more K

35
Q

what are beta blockers used for

A

antihypertensive; disrhythmias, tachycardia, glaucoma, hypertension, stable angina and compensated heart failure

36
Q

adverse effects of beta blockers

A

bradycardia, edema, heart failure, JVD, ED
severe drowsiness, dyspnea

37
Q

contraindications with beta blockers

A

unstable heart failure
asthma, COPD, diabetes

38
Q

what test is done to make sure a pt can continue to take beta blockers

A

ekg: look for tall t waves indicating secondary or tertiary heart block

39
Q

how do beta blockers work

A

NE&E can’t bind to beta receptors and no SNS response (adrenaline)

40
Q

how does beta blockers affect ionotropic effect

A

negative, decrease

41
Q

compare beta1, 2, 3 blockers

A

1: heart, kidneys RAAS system
2” lungs, GI, vascular smooth muscle, skeletal muscle, eye
3: fatty/adipose tissue

42
Q

selective beta 1 blocker target

A

cardiac nodal tissue to decrease HR
cardiac myocytes to decrease contraction strength

43
Q

selective beta 2 blocker target

A

intraocular pressure decrease
bronchoconstriction, hypo/hyperglycemia, peripheral vasoconstriction

44
Q

adverse effects for beta blockers

A

fatigue, dizziness, cold extremities
bradycardia, hypotension, heart block, mental status change, ED

45
Q

what to monitor for pt taking beta blockers

A

Ekg for tall T-waves for secondary or tertiary heart block
bradycardia

46
Q

client education for taking beta blockers

A

will mask tachycardia in pts having hypoglycemia
orthostatic hypotension

47
Q

what are calcium channel blockers used for

A

antihypertensives; hypertension, angina, dysrhythmias, A.fib

48
Q

how do calcium channel blockers work

A

vasodilation causes decreased SVR and afterload
affects vascular smooth muscle, cardiac myocytes, cardiac nodal tissue

49
Q

interactions with calcium channel blockers

A

grapefruit
digoxin

50
Q

contraindications with calcium channel blockers

A

heart failure

51
Q

side effects of taking calcium channel blockers

A

constipation, dizziness, ankle swelling

52
Q

what to monitor for calcium channel blockers

A

Ekg
bradycardia, hypotension, dw

53
Q

purpose of cardiac glycoside - Digoxin

A

digitalis glycoside - inhibits Na/K pump to decrease conduction rate and increase refractory period of AV node; antiarrhythmic, heart failure, A.fib
increase contractions, decrease heart rate, slows rate of conduction

54
Q

therapeutic range for digoxin

A

0.5-2 ng/mL; above is toxic

55
Q

contraindications with digoxin

A

renal/liver function issues

56
Q

adverse effects of digoxin

A

N&V, anorexia, vision changes
arrhythmias, heart block, electrolyte imbalances
toxicity first signs are GI issues

57
Q

interactions with digoxin

A

loop diuretics such as Lasix
beta blockers, calcium channel blockers
dronedarone: sudden death
high fiber foods decrease absorption
bradycardia

58
Q

what to monitor for digoxin

A

bradycardia can’t give meds
hypokalemia
hypomagnesemia
hypercalcemia

59
Q

how are digoxin administered

A

IV, oral tab/soln

60
Q

how does thiazide diuretics for

A

inhibit Na/Cl cotransporter (NCC); stops reabsorption of Na&water; hypertension, heart failure, renal calculi

61
Q

adverse reactions of thiazide diuretics

A

dehydration, electrolyte imbalances, hypotension
hyponatremia, hypokalemia, hyperglycemia,
hyperuremia -> gout

62
Q

contraindications with thiazide diuretics

A

compromised glomerular filtration rate <30mL/hr

63
Q

interactions with thiazide diuretics

A

digoxin
lithium
NSAIDs (aspirin, ibuprofen)

64
Q

client education for thiazide diuretics

A

K supplements and K rich foods

65
Q

how do loop diuretics work

A

inhibits NKCC2 cotransporter; heart failure, liver impairment, PE, hypertension, hypercalciemia

66
Q

adverse effects with loop diuretics

A

dehydration, electrolyte imbalances, hypokalemia, ear damage, gout

67
Q

contraindications with loop diuretics

A

anuria (can’t produce urine)
severe electrolyte imbalances
pregnant & breastfeeding

68
Q

interactions with loop diuretics

A

digoxin toxicity

69
Q

client education for loop diuretics

A

healthy foods with vitamin K
don’t take at night
DW, change positions slowly

70
Q

how are loop diuretics taken

A

oral tab
IV

71
Q

how do potassium sparing diuretics work

A

inhibit Na&K exchange via Na channels; hypertension, edema, hypokalemia

72
Q

adverse effects with potassium sparing diuretics

A

hyperkalemia
dehydration
gynecomastia, menstrual irregularities
sexual dysfunction

73
Q

contraindications with potassium sparing diuretics

A

renal failure

74
Q

interactions with K sparing diuretics

A

ace inhibitor, NSAIDs, Lithium

75
Q

what to monitor when taking K sparing diuretics

A

BUN, Creatine
EKG

76
Q

client education for potassium sparing diuretics

A

no high K foods

77
Q

potassium rich foods

A

potatoes/pork
oranges
tomatoes
avocados
strawberries
spinach
fish
mushrooms
melons (cantaloupe)

78
Q

strength of all the diuretics

A

loop diuretic > thiazide diuretic > K-sparing diuretic

NURS120 (38 decks)

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