MEDICATIONS Flashcards
Warfarin therapy and the intake of vitamin K:
Sudden increases or decreases in the consumption of Vitamin-K rich foods could inversely alter effectiveness of warfarin.
-Rather than avoid vitamin-K rich foods, the client needs to keep intake consistent.
ADDITIONAL TIPS:
- Take warfarin same time everyday
- Double dosing is contraindicated
- Antibiotics can affect INR level
Therapeutic INR?
2-3
What is albuterol? What is beclomethasone?
Albuterol: (Proventil) short-acting beta agonist administered as quick relief, rescue drug to relieve symptoms associated with persistent or intermittent asthma.
-SABA is a rescue drug, and taken on an as-needed basis and not always taken with the ICS.
Beclomethasone: inhaled corticosteroid; normally used a long-term, first-line drug to control chronic airway inflammation.
-Taken on a regular schedule
What two medications can cause bronchospasms in some clients with asthma?
Ibuprofen and aspirin
Client receiving ACE inhibitors should be monitored for what?
Hyperkalemia: ACE inhibitors decrease the excretion of aldosterone, which promotes sodium retention and causes potassium excretion.
Basal insulin glargine (Latus):
used for glucose control in diabetic clients; has no peak and should be administered even if the current BG level is w/in normal limits.
Serious adverse effect of statins:
Myopathy; muscle aches–> would then want to obtain a creatine kinase level.
Sildenafil =
Viagra
Normal aPTT:
25-35
Therapeutic aPTT:
typically 1.5-2 times the normal value; 46-70
Ipratropium:
anticholinergic agent used to treat acute asthma attacks
Antiplatelet therapy:
Aspirin, clopidogrel, prasugrel, ticagrelor
-Watch for bruising, tarry stools, and other signs of bruising (epistaxis, hematuria)
Serum theophylline level:
Narrow TI: >20 levels are associated with toxicity:
Look for: headaches, insomnia, seizures, N/V, arrhythmias
Alteration in color perception and visual changes:
Dig toxicity
Gum hypertrophy:
Phenytoin toxicity
Hyperthermia and tinnitus
Aspirin overdose
Clients should avoid what when on warfarin therapy?
Aspirin, NSAIDS, alcohol
-Usually administered for 3-6 months following PE
Initial management of PEs:
low-molecular weight heparin (enoxaparin, dalteparin)
-Once PE is resolved, maintenance drug therapy is Xa inhibitors (apixaban, rivaroxban)
*These are anticoags
aka no NSAIDS while on this drug therapy
Loop diuretics:
furosemide, torsemide, bumentanide
ACE inhibitors:
Ex: lisinopril, ACE inhibitor –> does NOT lower HR and can be given to patients w/ bradycardia
Diltiazem:
Lowers HR
Headache is a common SE of HTN. T/F
TRUE
Monitor for presence of what when giving propranolol:
Wheezing
Digoxin TI =
0.5-2
Metoclopramide:
Commonly used antiemetic medication that treats N/V and gastroparesis by increasing gastrointestinal motility and promoting stomach emptying.
What is associated with extended use/high doses of metoclopramide?
Tardive dyskinesia: a movement disorder that is characterized by uncontrolled movements (sucking/smacking lips)
-It is often irreversible
Sucralfate:
- Oral medication that forms a protective layer in the gastrointestinal mucosa, which provides a physical barrier against stomach acids and enzymes.
- Prescribed to treat and prevent stomach and duodenal ulcers
- Prescribed 1 hour before meals and at bedtime and is taken on an empty stomach with a glass of water.
- Proton pump inhibitors should be AVOIDED w/in 30 minutes of taking this med to prevent altered absorption.
Phenytoin: (Dilantin)
Antiseizure medication with a TI of 10-20:
- Tube feedings decrease phenytoin absorption, which reduces serum drug concentration and may precipitate seizures
- The nurse should pause tube feedings 1-2 hours before and after phenytoin administration to ensure adequate absorption.
- Toxicity produces nystagmus, dysarthria, ataxia, and encephalopathy
What is the therapeutic INR for a client with a mechanical heart valve?
2.5-3.5
What is the TI for lithium?
- 6-1.2
- Lithium toxicity produces nausea, vomiting, ataxia and tremors
Sulfasalazine: (Azulfidine)
Contains sulfapyridine and aspirin and is used as a topical gastrointestinal anti-inflammatory and immunomodulatory agent in inflammatory bowel disease.
-Yellow-orange pee is an expected finding when using this drug
-Dehydration is BIG risk when using this med
Anticholinergic side effects:
pupillary dilation, dry mouth, urinary retention, and constipation.
-Contraindications are closed-angle glaucoma, bowel ileus and urinary retention.
NOT CATARACTS
Tricyclic antidepressants:
amitriptyline, nortriptyline, desipramine, imipramine –> commonly used for neuropathic pain.
Most common side effects include: dizziness, dry mouth, constipation, photosensitivity, urinary retention, and blurred vision.
List thrombolytic agents:
- Alteplase, tenecteplase, reteplase: used to resolve acute thrombotic events (ischemic stroke, MI, PE)
- They are contraindicated in clients with active bleeding, recent trauma, aneurysm, AVM, hx of hemorrhagic stroke, and uncontrolled HTN
Most penicillin derivates (ampicillin amoxicillin) and cephalosporins (cephalexin, ceftriaxone) are generally considered safe for pregnant women or lactating. T/F
TRUE
Midazolam (Versed):
benzodiazepine commonly used to induce conscious sedation in clients undergoing endoscopic procedures
-Usually no more than 3.5mg is necessary to induce sedation
ANTIDOTE: Flumazenil (Romazicon)
Orlistat:
Lipase inhibitor that prevents the breakdown and absorption of fats from the intestine.
- This med is prescribed to clients who are obese/having trouble losing weight
- Because orlistat blocks the absoprtion of fats, also interferes with fat-soluble vitamin uptake. –> Clients will need to take a multivitamin that contains vitamin A, D, E and K.
- Most effective, multivitamins should be taken >2hours after taking orlistat
What is the initial treatment for an aspirin overdose?
Activated charcoal: binds with salicylate and inhibits absorption by the small intestine. IV sodium bicarbonate is also used AFTER the activated charcoal
Misoprostol (Cytotec)
synthetic prostaglandin that protects against gastric ulcers by reducing stomach acid and promotion mucus production and cell regeneration.
- Prescribed to prevent gastric ulcers in clients receiving long-term NSAID us.
- Antacids can increase the adverse effects of misoprostol
Metoclopramide (Reglan)
Prescribed for the tx of delayed gastric emptying, GERD, and as an antiemetic. Use of this drug is associated with extrapyramidal adverse effects, including TD.
-Common SE include: sedation, fatigue, restlessness, headache, dry mouth, constipation, and diarrhea and DONT need to be reported to HCP.
What is used for diagnostic purposes and often reduces the intussusceptions in infants?
contrast enema (air enema)
ZOLES =
Proton pump inhibitors
- Long Term use associated with CDIFF
- Also decreases the absorption of calcium and promote osteoporosis