Paradoxical bronchospasms w/ excessive use of inhalers

Drowsiness Lightheadedness Ataxia Visual disturbances Anger Restlessness Nausea Constipation Lethargy Apathy Dry Mouth

Medications - Unit 4 exam Flashcards by Courtney Quintana

All of the following are examples of what drug class?

Metoprolol(Lopressor)
Labetalol(Trandate)
Propranolol(Inderal)
Carvedilol(coreg)

Beta Blockers

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Action: increased cardiac contractility, mild vasodilation
Dose: 5-15 mcg/kg/min

Dobutamine or Inotropic

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When administering epinephrine, if wheezing is heard what needs to be done?

Hold med and notify HCP immediately

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Use: First drug of choice for BP – unresponsive to adequate fluid resuscitation
Effects:
o Increase BP, MAP, CVP, SVR,
o Cardiac stimulation
o peripheral vasoconstriction
o renal and splanchnic vasoconstriction
o Can increase or decrease cardiac output
Special considerations:
o Administer via central line d/t risk of ischemia
o Requires CVP monitoring
o Monitor pt for dysrhythmias
o Notify HCP if urine OP is <30
o Needs to be discontinued gradually

Vasopressors or norepinephrine

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S/E of Calcium Channel Blockers

Orthostatic hypotension
Dizziness
Flushing
HA
Peripheral Edema
Constipation

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All of the following are part of what medication class?

Sertaline
Citalopram
Escitalopram
Fluoxetine
Vilazodone

SSRI’s

-atlopram, -oxetine, -zodone

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Action: inhibits uptake of serotonin – increased serotonin
Uses: depression, anxiety, ocd, eating disorders
S/e: Headache , tremors, difficulty sleeping, nausea, dry mouth/thirst, constipation, urinary retention, sexual dysfunction
A/e: serotonin syndrome
Considerations: may take 4-6 weeks to take effect, take in the morning, first line for depression and anxiety

SSRI’s

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A/E of Baclofen

Visual hallucination
Dizziness

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S/S of Baclofen OD

o Drowsiness
o Vomiting
o vision issues
o difficulty breathing
o seizures
o weak muscle tone

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Purpose: vasodilation of renal, mesenteric and coronary arteries
Typical dose 2-10 MCG/KG/MIN
S/e: Arrhythmias, hypotension, angina, palpitations
High risk for toxicity
Do not admin with beta blockers, general anesthetics, and phenytoin

Dopamine

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Special considerations with beta blockers

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

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A/E of epinephrine

Paradoxical bronchospasms w/ excessive use of inhalers

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Special considerations for gabapentin

Monitor plasma levels
DO NOT admin with within 2 hr of antacids
Renal dosing for those with renal impairment
Monitor for suicidal thoughts

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Special considerations for SSRI’s

May take 4-6 weeks to take effect, take in the morning
First line for depression and anxiety
Can cause serotonin syndrome

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S/S of OD with Epinephrine

Persistent agitation
Angina
Decreased BP
Dizziness
Hyperglycemia
Hypokalemia
Seizures
Tachyarrythmia’s
Persistent trembling
Vomiting

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A/E of Benzos

Drowsiness
Lightheadedness
Ataxia
Visual disturbances
Anger
Restlessness
Nausea
Constipation
Lethargy
Apathy
Dry Mouth

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If excessive HTN occurs when giving dopamine what needs to be done?

rate of infusion should be decreased or temporarily d/c’d until BP is decreased

All of the following are examples of what drug class?

Verapamil
Nifedipine
Diltiazem
Amlodipine
Nicardipine

Calcium channel blockers

A/E of SSRI’s

Serotonin syndrome

Action: peripheral vasoconstriction, increased cardiac contractility, smooth muscle relaxation
Used to treat: Hypotension associated with septic shock, severe allergic rxn, cardiac arrest, inhalation injury
S/E: angina, arrhythmias, HTN, Tachycardia, nervousness, restlessness, tremor
A/E: Paradoxical bronchospasms w/ excessive use of inhalers-If wheezing is heard hold med and notify HCP immediately
High risk for toxicity
Can cause increased glucose
Dose 2-10mcg/min

Epinephrine

Action: binds to cell receptors enhancing the effects of GABA., slows/ calms activity of the nerves in the brain
Uses: acute anxiety, sedation/muscle relaxant ,siezures, etoh
A/e: Drowsiness, lightheadedness, ataxia, visual disturbances, anger, restlessness, nausea , constipation, lethargy, apathy , dry mouth.
Considerations: Monitor for s/s of withdrawals, not meant for long term use, must be tapered off,

Benzos

-zepam, -zolam

Special considerations for calcium channel blockers

Avoid grape fruit juice
Elevate legs to compress & reduce edema
Monitor for constipation

Action: arterial vasoconstriction- increases BP
Dose: 40-200 mcg/min

Phenylephrine

Special considerations for baclofen

Do not give with MAO inhibitors, alcohol, antihistamines, opioid analgesics
Can increase glucose, alkaline phosphatase, AST, and ALT
Needs to be discontinued over 2 weeks or more

S/E of baclofen

* Dizziness * Weakness * Confusion * HA * Nausea * Constiption * Insomnia * Tiredness * Frequent urination

Special considerations for Benzos

* Monitor for s/s of withdrawals, not meant for long term use, must be tapered off,

Special considerations for norepi (vasopressors)

o Administer via central line d/t risk of ischemia o Requires CVP monitoring o Monitor pt for dysrhythmias o Notify HCP if urine OP is <30 o Needs to be discontinued gradually

S/E of Epinephrine

* Angina * Arrythmias * HTN * Tachycardia * nervousness * restless * tremor

* Purpose: decreased muscle spasticity * Action: inhibits reflexes * S/e : dizziness, weakness, confusion, headache, nausea, constipation, difficulty falling asleep, tiredness, frequent urination * A/E: visual / audio hallucinations, seizures * Do not give with MAO inhibitors, alcohol, antihistamines, opioid analgesics * Can increase glucose, alkaline phosphatase, AST, and ALT * Needs to be discontinued over 2 weeks or more

Baclofen

A/E of Gabapentin | CNS effects

* Somnolence * Dizziness * Ataxia * Fatigue * Nystagmus * Peripheral edema diminish in time

Benzos usually end in what?

- Zepam, - Zolam

# All of the following are part of what medication class? * Lisnopril (Prinivil/Zestril) * Benazepril (Lotensin) * Enalapril (Vasotec)

ACE Inhibitors

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

Ace Inhibitors | -pril

# The following are S/S of what? o Drowsiness o Vomiting o vision issues o difficulty breathing o seizures o weak muscle tone

Baclofen OD

* Use: lowers HR and BP , angina , dysrhythmias * Action: blocks calcium allowing vessels to relax and open * S/E : Ortho hypotension, dizziness, flushing,HA, Peripheral edema , constipation * Considerations: avoid grape juice , elevate legs to & compression to reduce edema, to help with constipation give ( all F’s Fluids, fiber, fruits)

Calcium channel blockers | -amil, -dipine, -zem

* Use: work by blocking epinephrine. * 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

Beta blocker | -olol

Purpose: control seizure disorders , neuropathic pain, restless legs syndrome Action: Slowing the entrance of sodium and calcium back into the neuron, thus extending the time it takes for the nerve to return to its active state and slows the frequency of neuron firing A/E: Somnolence, dizziness, ataxia, fatigue, nystagmus, peripheral edema diminish in time Special considerations: Monitor plasma levels, no admin within 2 hrs of antacid, renal dosing for renal impairment, monitor for SI

Gabapentin

# All of the following are S/S of what? * Persistent agitation * Angina * Decreased BP * Dizziness * Hyperglycemia * Hpokalemia * Seizures * Tachyarrythmia's * Persistent trembling * Vomiting

Epinephrine OD

* Action : black the action of the vagus nerve in the parasympathetic nervous system increasing HR * used in neurogenic shock to treat bradycardia

Atropine

* Action: vasoconstriction of vascular smooth muscle * Dose: 0.04 unit/min

Vasopressin