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NUR 213 > Medications - exam 3 > Flashcards

Medications - exam 3 Flashcards

1
Q

Use: work by blocking epinephrine. Used to treat SVT, A-FLUTTER, A-FIB, Sinus Tach, SVT, cardiomyopathy
Effects: Lowers HR and decreases cardiac workload
Special considerations:
* Do not give if HR is less than 60, remember to use apical pulse
* Monitor for hypotension after 1st dose
* Teach pt to rise slowly from seated or lying positions to avoid orthostatic hypotension
* Use cautiously in pt’s w/ HF and asthma

A

Beta blockers

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2
Q

Use: prevent clot formation
Effects:
Special considerations:
* Monitor CBC
* Bleeding precautions

A

Anticoagulants

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3
Q

Use: to treat infection, In sepsis use broad spectrum first, then narrow
Effects: offending microorganisms
Special considerations:
* Blood cultures should be obtained before abx are given
* Give 1 hr after arrival to hospital for sepsis

A

antibiotics

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4
Q

Use: First drug of choice for BP – unresponsive to adequate fluid resuscitation
Effects:
* Increase BP, MAP, CVP, SVR, Cardiac stimulation, peripheral vasoconstriction, renal and splanchnic vasoconstriction
* Can increase or decrease cardiac output
Special considerations:
* Administer via central line
* Monitor pt for dysrhythmias

A

Vasopressors - Norepinephrine

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5
Q

Use: Prevent seizures, used in treatment of pre-eclampsia
Effects: Depresses CNS
Special considerations:
* Has a narrow window of therapeutic effect so must be monitored closely for S/S of toxicity

A

Magnesium Sulfate

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6
Q

Use: To treat dysrhythmias like: Sinus Brady, a-fib, a-flutter, SVT, Junctional rhythms, Symptomatic 2nd & 3rd degree heart block, HTN, CAD and angina
Effects: Bradycardia, hypotension, and peripheral edema
Special considerations:
* These drugs are contraindicated in patients who are allergic to eggs.
* Patients should also avoid taking these with grapefruit juice.
* Use cautiously in HF patients

A

Calcium Channel Blockers

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7
Q

Use: Treat SVT. Restoration of normal sinus rhythm. Antiarrythmic
Effects: MI, ventricular tachycardia, seizures, stroke, hypersensitivity reactions
Special considerations:
* Monitor HR, Asystole may occur following injection, resolve quickly.
* Use cautiously in patients with asthma (May induce bronchospasm)
* Teach patient to change positions slowly.
* Maximum dose: NO MORE THAN 2 DOSES
* May result in asystole

A

Adenosine

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8
Q

antihyperlipoproteinemic
Use: Treat high cholesterol, increases clearance of LDL in bloodstream
Effects: Reduces Cholesterol synthesis in liver
Special considerations:
* These drugs are contraindicated for patients with active liver disease and pregnant patients.
* S/E: myalgia, myopathy, rhabdomyolysis
* Should also not be given with grapefruit juice because the effects can be increased to an unsafe level, leading to harmful side effects like muscle damage, liver and kidney damage

A

Atorvastatin

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9
Q

Effects: Dilates coronary arteries allowing for more blood/oxygen to cardiac cells
Use: treating sudden onset of angina; can be given prophylactically prior to activities that may cause angina i.e. exercise. Both caused by CAD
Special considerations:
o Can be given sublingual, Transdermal patch, or as spray
o Tablets can be given every 5 minutes for up to a total of 3 doses in 15 minutes. If 3 doses are taken and/or pain persists, medical attention should be sought immediately
o Also given via a transdermal patch. Remember whenever you are replacing a patch, you need to date and time the new patch, remove the old one, apply the new one and document the location in the MAR

A

Nitroglycerin - nitrate

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10
Q

Use: Increases contractility= Increased stroke volume, Decreases HR
Effects: positive inotrope which means that is increases cardiac contractility
Special considerations:
* Never give if apical HR is less than 60, always check labs before admin
* Major concern for Toxicity; Theraputic range: 0.5-2ng/mL
* S/S of toxicity: vomiting, HA, visual disturbances – yellow halos around lights
* Bradycardia
* Dysrhythmias

A

Cardiac glycoside – Digoxin(Lanoxin)

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11
Q

Use: First line medication used to treat HTN, HF, MI. Used to treat cardiomyopathy
Effects: Reduces afterload, relaxes blood vessels, decreases BP
Special considerations:
* Can cause K retention so be careful when administering K sparing diuretics, potassium supplements, and check labs
* Can cause dry, persistent cough
* Angioedema
* Do not give to pregnant pt

A

Ace Inhibitors

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12
Q

What medication class is this?

  • Lisinopril (Prinivil/Zestril)
  • Benazepril (Lotensin)
  • Enalapril (Vasotec)
A

Ace inhibitors

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13
Q

Digoxin is an example of what medication class

A

Cardiac Glycoside

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14
Q

Alteplase or t-PA is an example of what medication class

A

Fibrolytics

ends in -Plase -Ase

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15
Q

These are all different kinds of what?

  • Nitrate
  • Nitrostat
  • Nitromist
  • Nitrotab
A

Nitroglycerin

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16
Q

Adenosine is an example of what medication class?

A

Antiarrythmic

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17
Q

Atropine is an example of what medication class?

A

Calcium Channel blockers

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18
Q

Norepinephrine is what medication class?

A

Vasopressors

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19
Q
  • Metoprolol(Lopressor)
  • Labetalol(Trandate)
  • Propranolol(Inderal)
  • Carvedilol(coreg)

The following are all examples of what medication class?

A

Beta blockers

20
Q

Special considerations for Beta blockers

Metoprolol

A
  • Do not give if HR is less than 60, remember to use apical pulse
  • Monitor for hypotension after 1st dose
  • Teach pt to rise slowly from seated or lying positions to avoid orthostatic hypotension
  • Use cautiously in pt’s w/ HF and asthma
21
Q

Special consideratoins for anticoagulants

A
  • Monitor CBC
  • Bleeding precautions
22
Q

Special considerations for abx therapy

A
  • Blood cultures should be obtained before abx are given
  • Give 1 hr after arrival to hospital
23
Q

Special considerations for Vasopressors

Norepinephrine

A
  • Administer via central line
  • Monitor pt for dysrhythmias
24
Q

Special considerations for Mag sulfate

A
  • Has a narrow window of therapeutic effect so must be monitored closely for S/S of toxicity
25
Q

S/S of magnesium sulfate toxicity

A

o Hypotension
o Decreased urine output
o Respiratory depression
o Depressed DTR’s
o Flushing

26
Q

What is the antidote for magnesium sulfate

A

Calcium gluconate

27
Q

Special considerations for Atropine

Calcium channel blockers

A
  • These drugs are contraindicated in patients who are allergic to eggs.
  • Patients should also avoid taking these with grapefruit juice.
  • Use cautiously in HF patients
28
Q

Special considerations for Adenosine

A
  • Monitor HR, Asystole may occur following injection, resolve quickly.
  • Use cautiously in patients with asthma (May induce bronchospasm)
  • Teach patient to change positions slowly.
  • May result in asystole – the client should be monitored, and a transcutaneous pacer should be readily available if asystole is prolonged.
29
Q

Special considerations for atorvastatin

A
  • Contraindicated for patients with active liver disease and pregnancies
  • S/E: myalgia, myopathy, rhabdomyolysis
  • Do not give with grape fruit juice
30
Q

Special considerations for Niroglycerin

A

o Can be given sublingual, Transdermal patch, or as spray
o Tablets can be given every 5 minutes for up to a total of 3 doses in 15 minutes. If 3 doses are taken and/or pain persists, medical attention should be sought immediately
o Nitroglycerin is also given via a transdermal patch. Remember whenever you are replacing a patch, you need to date and time the new patch, remove the old one, apply the new one and document the location in the MAR

31
Q

Special considerations for Fibrinolytics

A
  • Instruct patients to report hypersensitivity reactions (rash, dyspnea) bleeding or bruising.
  • No shaving and vigorous tooth brushing
32
Q

Special considerations for Digoxin

A
  • Never give if apical HR is less than 60, always check labs before admin
  • Major concern for Toxicity; Theraputic range: 0.5-2ng/mL
  • Monitor for S/S of toxicity
  • Bradycardia
  • Dysrhythmias
33
Q

S/S of digoxin toxicity

A

vomiting, HA, visual disturbances – yellow halos around lights

34
Q

Theraputic rance for Digoxin

A

0.5-2ng/mL

35
Q

Special considerations for ACE Inhibitors

A
  • Can cause K retention
  • Can cause dry, persistent cough
  • Angioedema
  • Do not give to pregnant pt
36
Q

What are ACE Inhibitors used to treat?

A
  • HTN
  • HF
  • MI
  • Cardiomyopathy
37
Q

What rhythm does an diagnostic antiarrythmic (Adenosine) treat?

A

SVT

38
Q

What rhythm does an antiarrhythmic treat?

A

VTach, VFib, A-fib

39
Q

List anti-arrythmics

A

Amiodarone (Cordarone, Pacerone)

Dronedarone (Multaq)

Dofetilide (Tikosyn)

40
Q

What rhythm does an anti cholinergic treat?

Atropine

A

Sinus Brady

41
Q

What rhythms are anticoags used to treat?

A

A-fib, A-flutter

42
Q

What rhythms are Beta blockers used to treat?

A

ST, A-fib w/ RVR

43
Q

What rhythms do calcium channel blockers treat?

Diltazem

A

A-fib, A-flutter

44
Q

Cardiac glycoside is used to treat what rhythms?

Digoxin

A

Sinus tachy, A-fib, A-flutter

45
Q

Vasopressors are used to treat what rhythm?

Epinephrine

A

VTach, VFib

46
Q

Dosing for Adenosine through a peripheral line

A
  • Rapid IVP pg 6 mg followed by a 20mL NS flush
  • Can be repeated in 1-2 min w/ 12 mg followed by 20 mg flush
47
Q

Dosing for Adenosine given via central line

A
  • Regular IVP is cut in half if given through central line.
  • 1st dose is 3 mg 2nd dose is 6 mg

NUR 213 (29 decks)

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