Medications - Unit 4 exam Flashcards
All of the following are examples of what drug class?
- Metoprolol(Lopressor)
- Labetalol(Trandate)
- Propranolol(Inderal)
- Carvedilol(coreg)
Beta Blockers
- Action: increased cardiac contractility, mild vasodilation
- Dose: 5-15 mcg/kg/min
Doputamine or Inotropic
When administering epinephrine, if wheezing is heard what needs to be done?
Hold med and notify HCP immediately
- 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
S/E of Calcium Channel Blockers
- Orthostatic hypotension
- Dizziness
- Flushing
- HA
- Peripheral Edema
- Constipation
All of the following are part of what medication class?
- Sertaline
- Citalopram
- Escitalopram
- Fluoxetine
- Vilazodone
SSRI’s
-atlopram, -oxetine, -zodone
- 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
A/E of Baclofen
- Visual hallucination
- Dizziness
S/S of Baclofen OD
o Drowsiness
o Vomiting
o vision issues
o difficulty breathing
o seizures
o weak muscle tone
- 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
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
A/E of epinephrine
- Paradoxical bronchospasms w/ excessive use of inhalers
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
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
S/S of OD with Epinephrine
- Persistent agitation
- Angina
- Decreased BP
- Dizziness
- Hyperglycemia
- Hypokalemia
- Seizures
- Tachyarrythmia’s
- Persistent trembling
- Vomiting
A/E of Benzos
- Drowsiness
- Lightheadedness
- Ataxia
- Visual disturbances
- Anger
- Restlessness
- Nausea
- Constipation
- Lethargy
- Apathy
- Dry Mouth
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
