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
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
- ototoxicity
- human ear is shaped like a kidney
- nephrotoxicity
- monitor creatinine
- nephrotoxicity
- Toxic to cranial nerve #8
- “mice = ears”
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
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
5
Q
Negative inotrope vs. Positive inotrope
A
- Positive inotrope (stimulants)
- Atropine, epinephrine and norepinephrine
- Negative inotrope (depressant)
- Calcium channel blockers, beta blockers
6
Q
Insulin overview
A
- Check expiration date
- Refrigerate only when unopened
- teach patients to refrigerate at home
- Drawing up mixed insulin
- Draw up total dose in air
- Put air in N vial
- Put air in R vial
- Draw up R dose
- Draw up N dose
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)
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
9
Q
Insulin Type: Humalog
A
- Lispro
- With meals
- Fastest
- Times
- Onset: 15 minutes
- Peak: 30 minutes
- Duration: 3 hours
10
Q
Insulin Type: Lantus
A
- Long-acting
- Glargine
- Slow absorption
- Times
- No Peak
- Duration: 12-24 hours
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
12
Q
Injections
A
- IM
- length and gauge
- 1 in both gauge and length (ex. 21 gauge, 1” length)
- length and gauge
- SQ
- length and gauge
- 5 in both gauge and length (ex. 25 gauge, 5/8” length)
- length and gauge
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)
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
15
Q
K sparing and wasting diuretics
A
- Wasting
- Diuretics ending in x will “x out k” plus diuril
- ex/ Lasix
- Diuretics ending in x will “x out k” plus diuril
- Sparing
- all others