Meds Flashcards

1
Q

Uppers and Downers

A
  • Uppers
    • overdose on upper, everything goes up
    • withdrawal on upper, everything goes down
  • Downers
    • overdose on downers, everything goes down
    • withdrawal on downers, everything goes up
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2
Q

Aminoglycosides

A
  • Powerful abx
  • Trough and Peaks
  • Administered Q8H (IM or IV)
    • Administered PO w/ hepatic encephalopathy (kill e-coli and reduce ammonia)
    • Administered PO pre-op with bowel surgery (clear out bowels)
    • PO administered to sterilize bowels (Neomycin & kanamycin)
  • “a mean old mycin for a mean old infection”
  • all end in - mycin except the -thro mycins (not aminoglycosides)
    • Azithromycin
    • Clarithromycin
    • Erythromycin
  • Examples
    • Streptomycin
    • Cleomycin
    • Tobramycin
    • Gentamycin
    • Vancomycin
    • Clindamycin
  • Toxic effects
    • “mice = ears”
      • ototoxicity
        • monitor hearing, balance, tinitus
    • human ear is shaped like a kidney
      • nephrotoxicity
        • monitor creatinine
    • Toxic to cranial nerve #8
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3
Q

Trough and Peak

A
  • Draw trough 30 minutes before the next dose
  • Draw peak of sublingual meds 5-10 minutes after drug dissolves
  • Draw peak of IV meds 15-30 minutes after medication is finished
  • Draw peak of IM meds 30-60 minutes after injecting it
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4
Q

Calcium Channel Blockers

A
  • “Like valium for your heart”
    • relaxes the heart
    • → Given for tachy arrhythmias
    • not given when heart needs stimulating
  • Negative inotrope
  • Indications
    • Antihypertensive
    • Anti-Angina (imbalance between O2 supply and demand
    • Anti Atrial Arrhythmic (Aflutter & Afib, SVT)
  • Side effects
    • Headache, hypotension
  • Meds
    • ending in -dipine
    • verapamil
    • Cardizem (gtt) - measure BP and hold if systolic <100, titrate
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5
Q

Negative inotrope vs. Positive inotrope

A
  • Positive inotrope (stimulants)
    • Atropine, epinephrine and norepinephrine
  • Negative inotrope (depressant)
    • Calcium channel blockers, beta blockers
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6
Q

Insulin overview

A
  • Check expiration date
  • Refrigerate only when unopened
    • teach patients to refrigerate at home
  • Drawing up mixed insulin
    1. Draw up total dose in air
    2. Put air in N vial
    3. Put air in R vial
    4. Draw up R dose
    5. Draw up N dose
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7
Q

Insulin Type: R

A
  • Humulin R, Novolin R
  • Times
    • Onset: 1 hours
    • Peak: 2 hours
    • Duration: 4 hours
  • R = Regular, Rapid acting, Run (IV drip)
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8
Q

Insulin Type: NPH

A
  • N = NPH, Not in the bag (No IV), Not so fast, not clear (cloudy)
  • Times
    • Onset: 6 hours
    • Peak: 8-10 hours
    • Duration: 12 hours
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9
Q

Insulin Type: Humalog

A
  • Lispro
  • With meals
  • Fastest
  • Times
    • Onset: 15 minutes
    • Peak: 30 minutes
    • Duration: 3 hours
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10
Q

Insulin Type: Lantus

A
  • Long-acting
  • Glargine
  • Slow absorption
  • Times
    • No Peak
    • Duration: 12-24 hours
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11
Q

Toxicities

A
  • Lithium
    • Therapeutic: 0.6-1.2
    • Toxic: 2+
  • Lanoxin (Digoxin)
    • Therapeutic: 1-2
    • Toxic: 2+
  • Aminophylline
    • Therapeutic: 10-20
    • Toxic: 20+
  • Bilirubin (babies)
    • Therapeutic: 10-20 (elevated in babies compared to adults)
    • Toxic: 20+
    • Kernicterus
      • bilirubin in the CSF
    • Opisthotonos
      • position of slight extension in the neck seen in patients with kernicterus
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12
Q

Injections

A
  • IM
    • length and gauge
      • 1 in both gauge and length (ex. 21 gauge, 1” length)
  • SQ
    • length and gauge
      • 5 in both gauge and length (ex. 25 gauge, 5/8” length)
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13
Q

Heparin vs. Coumadin

A
  • Heparin
    • Given IV or SQ
    • Works immediately
    • Can only take for 21 days (except for lovenox)
    • Antidote - Protamin sulfate (heParin)
    • Labs - PTT and all clotting and bleeding times (“HTTP”)
    • Can use in pregnancy (class C)
  • Coumadin
    • Given PO
    • Takes days to work
    • Can take for entire life
    • Antidote - Vitamin K
    • Labs - PT, INR
    • Can not use in pregnancy (class x)
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14
Q

Baclofen (Lioresal) & Flexeril

A
  • Muscle relaxants
  • S/E
    • fatigue
    • paresis (muscle weaknesS)
  • Teachings
    • Do not drink alcohol
    • Do not drive/operate heavy machinery
    • do not watch kids under age 12
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15
Q

K sparing and wasting diuretics

A
  • Wasting
    • Diuretics ending in x will “x out k” plus diuril
      • ex/ Lasix
  • Sparing
    • all others
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16
Q

Guessing strategies - pharm

A
  • Side effects most commonly tested
    • Pick s/e of system medication is working on
      • ex. tachycardia for heart meds
  • For PO meds, pick a GI s/e
  • Never tell a child medicine is candy
17
Q

Oncology Meds

A
  • Cyclophosphamide (Cytoxan)
    • s/e - hemorrhagic cystitis
  • Bleomycin
    • s/e - pulmonary fibrosis
  • Cisplatin
    • s/e - peripheral neuropathy, constipation, ototoxicity
  • Doxorubicin (Adriamycin)
    • s/e - cardiotoxicity
  • Vincristine
    • s/e - peripheral neuropathy, constipation
  • DTIC-dome
    • s/e - Flu-like symptoms
  • Methotrexate
    • s/e - toxic to every organ except heart
      • toxicity made worse with ASA
18
Q

Chemo Man

A
19
Q

Digitalis

A
  • Toxic effects
    • Anorexia
    • N/V
    • HA
    • Yellow/green vision
    • Arrhythmia
20
Q

Theophylline

A
  • Bronchodilator
  • Used to treat asthma
  • Toxicity
    • N/V
    • Coffee ground emesis
    • Tachycardia
    • Tremors
  • Therapeutic level 10-20