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AHII > Meds - Test 1 > Flashcards

Meds - Test 1 Flashcards

1
Q

Use: Acute and chronic pain
Dose/route considerations: sev diff routes
Morphine considered “gold standard” for dosing opioids - earlier ones created
not all opioids same potency - fentanyl very potent
IV push considerations:
Follow facility protocol
Push slowly when given via IV push; Deliver over 4-5 min (do not infuse rapidly and not incurring AE during admin of med); some dilute via NS (follow protocol)
Monitor closely for adverse effects! Which is why push slowly

A

Morphine

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2
Q

decrease acid prevent digestive enzymes from being activated - how whole biochem process happens - enzymes come through pancreas where contact happens with stomach acid and increases activation and decreasing acid decreases activation
Administer drugs to decrease acid secretion and activating digestive enzymes

A

PPIs, H2 blockers, antacids -

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3
Q

MoA: blocks serotonin peripherally, centrally and small intestine; blocks chemoreceptor trigger zone (CTZ)
Indications: Nausea and vomiting (post-op, chemotherapy, viral illnesses)
Caution: cardiac arrhythmias, CNS depression
AE: drowsiness, dizziness, headache, diarrhea, prolonged QTc/causes dysrhythmias - cautious about administering to those with underlying cardiac arrhythmias because worsens

A

Zofran/Ondansetron

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4
Q

antineoplastic agent used in combination with tegafur to treat various cancers, including breast, prostate, and liver cancer.
an antineoplastic agent used in combination with tegafur to treat various cancers, including breast, prostate, and liver cancer.
AE: Subgingival: Headache; common cold; gum discomfort, pain or soreness, loss of attachment, or increased pocket depth; toothache or pressure sensitivity; periodontal abscess, exudate, infection, drainage, extreme mobility, or suppuration; thermal tooth sensitivity.

A

Uracil

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5
Q

is used to treat hepatitis B and C, lymphoma (lymph node cancer), malignant melanoma (skin cancer), genital warts, hairy cell leukemia (blood cell cancer), and Kaposi sarcoma (AIDS-related tumor). Interferons are substances produced by cells in the body to help fight infections and tumors.
injections 3 X weekly 16-24 weeks
is used to treat hepatitis B and C, lymphoma (lymph node cancer), malignant melanoma (skin cancer), genital warts, hairy cell leukemia (blood cell cancer), and Kaposi sarcoma (AIDS-related tumor). Interferons are substances produced by cells in the body to help fight infections and tumors.
AE: bruising, bleeding, pain, redness, swelling, or irritation in the place you injected interferon alfa-2b; muscle pain; change in ability to taste; hair loss; dizziness; dry mouth; concentration problems; feeling cold or hot.

A

Alpha-interferon

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6
Q

MoA: inhibits hepatitis B virus DNA polymerase; causes viral DNA deaths
Used for chronic HBV
AE: lactic acidosis, severe hepatomegaly with steatosis, headache, dyspepsia
antiviral agents
is an antiviral medication used in the treatment of hepatitis B virus infection. In those with both HIV/AIDS and HBV antiretroviral medication should also be used.
AE: Abdominal or stomach discomfort; decreased appetite; difficulty with swallowing; fast heartbeat; fast, shallow breathing; general feeling of discomfort; hives, itching, or rash; muscle pain or cramping

A

Entecavir

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7
Q

MoA: inhibits replication of HIV virus
Used for HBV; HIV-1
AE: headache, asthenia, n&v, diarrhea, flatulence, abdominal pain, pancreatitis, renal failure, renal tubular acidosis/necrosis, Fanconi’s syndrome, rash, angioedema, lactic acidosis
antiviral agents
is a medication used to treat chronic hepatitis B and to prevent and treat HIV/AIDS. It is generally recommended for use with other antiretrovirals.
AE: diarrhea; headache; depression; rash; itching; fever; difficulty falling asleep or staying asleep; gas, heartburn, or indigestion.

A

Tenofovir

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8
Q

MoA: aldosterone antagonist (norm action: reabsorp Na into bloodstream so lose K); blocks action of aldosterone in the distal tubule: loss of Na (leave more in renal tubule) & increased retention of K - K exchanged so have the potential for hyperkalemia
Indications: Conditions of fluid overload (CHF and liver disease)
Route/dose: Oral
Contraindications: See general
AE: hyperkalemia (weakness, cardiac arrhythmias, n/v/d); photosensitivity; androgen effects - blocks androgen like hormones - secondary effect of blocking those: impotence, hirsutism, irregular menses, gynecomastia
Nursing: EXCEPTIONS: monitor for high K - not low; Teach: avoid high K foods, use sunscreen

A

Spironolactone

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9
Q

MoA: inhibits microtubule formation lactic acid leukocytes decreases phagocytosis and inflammation in joints
Used for gout, gouty arthritis, arrest progression of MS and Mediterranean fever
AE: N&V, anorexia, agranulocytosis, thrombocytopenia, aplastic anemia, pancytopenia

A

Colchicine/Statins

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10
Q

antioxidant properties
People mainly use the supplement to treat liver conditions.

A

Thistle

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11
Q

MoA: Pulls fluid out of venous system and into lumen of small intestine; Inhibits diffusion of ammonia back to blood, excreting more ammonia in stool; if not have liver disease/cirrhosis - apply as would for laxatives; if for liver disease - does MoA for ammonia
Indications: hepatic encephalopathy, constipation
Route: oral or enema; hepatic encephalopathy: might be scheduled to prevent it; if acute and elevated ammonia levels given frequently; constipation: 1/day
AE: n/v/d; electrolyte imbalances; potential dehydration
Nursing: Titrate as directed (# of loose stools - to excrete enough ammonia to bring down their levels) or scheduled dose; monitor ammonia levels closely because goal is to bring them down, I & O, electrolytes, mental status, skin rectal area; use caution w/additional laxatives; Teach: bad taste; compliance if have liver disease - have lot loose stools every day not ideal - uncomfy, lot trips to bathroom, rectal irritation; not taste great so lot barriers to compliance get hepatic encephalopathy quickly and readmitted frequently; not have be loose but frequent enough pace to keep ammonia levels down

A

lactulose

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12
Q

Antihypertensives
Medications that help relax the veins and arteries to lower blood pressure. ACE inhibitors prevent an enzyme in the body from producing angiotensin II, a substance that narrows blood vessels.
AE: Dry cough; Increased potassium levels in the blood (hyperkalemia); Fatigue; Dizziness from blood pressure going too low; Headaches; Loss of taste

A

ACE inhibitors

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13
Q

sometimes called water pills, help rid your body of salt (sodium) and water. Most of these medicines help your kidneys release more sodium into your urine. The sodium helps remove water from your blood, decreasing the amount of fluid flowing through your veins and arteries. This reduces blood pressure.
Antihypertensives
Hydrochlorithiazide

A

Diuretics

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14
Q

MoA: inhibits reabsorption of NaCl in distal tubule kidneys; remains in tubule for excretion (water follows Na)
Indications: First line treatment for HTN
Route/dose: oral
Contraindications: Allergy to sulfa drugs
AE: photosensitivity; GI effects (n/v/d); Hypotension; Dehydration (fluid volume deficit); Fluid and electrolyte disturbances: Sodium and potassium; Fluid rebound
Nursing: use sunscreen

A

Hydrochlorithiazide

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15
Q

ASA
Antiplatelet
MoA: Inhibit platelet aggregation (COX inhibitor)
Indication: Prevention of MI, TIA, ischemic CVA in high-risk populations (primary or secondary prevention)
Dose: 81-325 mg PO daily (81 mg is a “baby aspirin”)
AE: GI irritation (N/V, epigastric pain); bleeding - GI bleeding, hematuria, easy bruising; tinnitus (with toxicity)
Nursing: take as directed, take with food, hold 1 week prior to procedure, monitor for s/s GI bleed (dark/bloody stools)

A

Aspirin/Clopidogrel (aka plavix)

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16
Q

MoA: Replacement of endogenous insulin
Promote cellular uptake of glucose, amino acids, potassium; protein synthesis, glycogen formation/storage, fatty acid storage
Indication: T1DM, T2DM, DKA (regular insulin only), hyperkalemia
AE: Hypoglycemia; lipohypertrophy, lipodystrophy at injection site; diarrhea, hypokalemia

A

Insulin

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17
Q

(used in combo with warfarin stroke due to afib)
Anticoagulants
MoA: Disrupts clotting cascade ; prolongs bleeding time
Indications: Prevent or treat DVT (SQ); treat PE (IV)
Contraindication: Pork allergy; Pork abstention religion (Judaism, Muslim)
AE: Bleeding, heparin-induce thrombocytopenia (HIT), bruising at injection site
Nursing: Rotate/monitor injection sites for SQ (do not admin IM), monitor platelet count; monitor aPTT (therapeutic 45-70 sec)
Reversal agent: protamin sulfate (heparin short half-life, stop infusion)

A

Heparin

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18
Q

(used in combo with heparin stroke due to afib)
Anticoagulants
(Atrial Fibrillation) - blood thinner to go through brain
MoA: Interfere with hepatic synthesis of vitamin K-dependent clotting factors; prolongs bleeding time
Indications: Chronic a-fib; artificial heart valves; prevent/treat DVT, PE
AE: GI effects (n/v), bleeding
Drug-drug: antibiotics (monitor INR during therapy), amiodarone, herbals
Nursing: Monitor PT/INR (therapeutic INR 2.0-3.0); see special considerations on next slide; first oral anticoagulant drug on market
Reversal agent: vitamin K

A

Warfarin

19
Q

MoA: Stimulates alpha-1 sites (sympathomimetic/vasoconstriction); Shrink mucous membrane and decrease mucous production in UR
Indications: Promotion of sinus drainage and decrease mucous production
Route: oral; immediate and extended release available
Contraindications: condition exacerbated by sympathetic activity
AE: hypertension (BIG ONE; alpha1 receptor on blood vessels which helps vasoconstrict but if orally has systemic effects on blood vessels and vasoconstricts all over so increases BP so particularly problematic for pat with history HTN or problematic with having HTN for longer periods of time), insomnia, dizziness, anxiety
Nursing: OTC behind pharmacy counter - use to make meth; track how much buy

A

Neosynephrine

20
Q

MoA: Inhibits flow of calcium ions into myocardial cells and vascular smooth muscle; slows HR, lowers BP
Indication: HTN, A-fib, A-flutter, supraventricular tachycardias
Route: Maintenance: oral ; acute: IV infusion
Caution: hypotension, acute MI, pulmonary congestion
AE: Hypotension, bradycardia/heart block, peripheral edema
Nursing: teach- avoid grapefruit juice (increases levels)

A

Nicardipine

21
Q

not have to push and cause ICP
Incorporates water into stool

A

Stool Softeners

22
Q

Crosses blood brain barriers; prevents vaso and arterial spasms
MoA: Inhibits flow of calcium ions into myocardial cells and vascular smooth muscle; slows HR, lowers BP
Indication: HTN, A-fib, A-flutter, supraventricular tachycardias
Route: Maintenance: oral ; acute: IV infusion
Caution: hypotension, acute MI, pulmonary congestion
AE: Hypotension, bradycardia/heart block, peripheral edema
Nursing: teach- avoid grapefruit juice (increases levels)

A

Nimodipine - Calcium Channel Blocker

23
Q

is a medication used to treat myasthenia gravis and underactive bladder. It is also used together with atropine to end the effects of neuromuscular blocking medication of the non-depolarizing type.
is used to decrease muscle weakness resulting from myasthenia gravis.
Pyridostigmine may cause the following side effects: Stomach upset such as abdominal cramps, feeling or being sick and diarrhea

A

Pyridostigmine

24
Q

MoA: Restores dopamine concentration in brain
Indication: Parkinson’s disease
Drug-drug: antihypertensives (inc. hypotension); CNS dep (increase sedation)
Caution: CV disease, asthma, urinary obstruction, peptic ulcer disease
AE: orthostatic hypotension, dry mouth, constipation, urinary retention, confusion, agitation, insomnia
Nursing: Abrupt cessation may cause parkinsonism crisis; take as prescribed and do not double doses

A

Levodopa

25
Q

MOA: Enhances the effects of acetylcholine in neurons in cerebral cortex that have not been damaged
Indication: Alzheimer’s disease
AE: n/v/d, insomnia or drowsiness, bradycardia/AV block
Nursing: Assess BP/HR; monitor mental status; give at bedtime unless insomnia occurs; Teach - not to increase or decrease dose abruptly; Risk cholinergic crisis

A

Donepezil (Aricept)

26
Q

MoA: Stabilize nerve membranes throughout CNS-less excitability
AE: see general; gingival hyperplasia
Drug-Drug: Many - highly protein bound, hepatic enzyme inducer; warfarin - bleeding
Nursing: therapeutic blood level: 10-20 mcg/mL; see next slide for IV administration

A

Phenytoin/Dilantin

27
Q

is an anticonvulsant medication used in the treatment of epilepsy and neuropathic pain. It is used as an adjunctive treatment in schizophrenia along with other medications and as a second-line agent in bipolar disorder
Nausea, vomiting, dizziness, drowsiness, constipation, dry mouth, or unsteadiness may occur.

A

Carbamazepine/Tegretol

28
Q

Use: anxiety disorders, acute agitation, acute alcohol withdrawal, pre-operative sedation
Route: oral or IVP (rate 2 mg/min)
AE: drowsiness, dizziness, lethargy, fatigue, hypotension; overdose: respiratory depression (more common when taken with other CNS depressants)
Nursing: Fall risk

A

Lorazepam

29
Q

Use: anxiety disorders, acute agitation, acute alcohol withdrawal, pre-operative sedation
Route: oral or IVP (rate 2 mg/min)
AE: drowsiness, dizziness, lethargy, fatigue, hypotension; overdose: respiratory depression (more common when taken with other CNS depressants)
Nursing: Fall risk

A

Diazepam

30
Q

MoA: Stabilize nerve membranes throughout CNS-less excitability
AE: see general; gingival hyperplasia
Drug-Drug: Many - highly protein bound, hepatic enzyme inducer; warfarin - bleeding
Nursing: therapeutic blood level: 10-20 mcg/mL; see next slide for IV administration

A

Phenytoin

31
Q

is a short-acting barbiturate typically used as a sedative, a preanesthetic, and to control convulsions in emergencies. It can also be used for short-term treatment of insomnia but has been largely replaced by the benzodiazepine family of drugs.
AE: drowsiness, dizziness; loss of balance or coordination; nausea, vomiting, constipation; overactive reflexes; sleep problems (insomnia), nightmares; or feeling restless or excited (especially in children or older adults).

A

Pentobarbital coma

32
Q

Indications: Herpes, varicella zoster
AE: oral: malaise, headache, n/v/d; IV: nephrotoxicity/neurotoxicity possible
Nursing: Oral: adm. ATC with food; topical: use gloves when applying; IV: infuse over 1 h to decrease renal damage; ensure patient hydrated
Treatment: Pyridostigmin

A

Acyclovir

33
Q

MoA: increases osmolarity of glomerular filtrate (sugar molecule); inhibits reabsorption of water and electrolytes and increases urinary output; Profound and rapid diuresis
Indications: reduce intracranial pressure of cerebral edema
Route/dose: IV only
Contraindications: Can worsen edema; used with caution; pul. edema, renal failure, CHF, stroke…exacerbated by the large shifts in fluid
Adverse effects: hypovolemia (hypotension, light-headedness, confusion, headache, electrolyte imbalance….cardiac decompensation and shock)
Nursing: see general; monitor VS closely

A

Mannitol

34
Q

MoA: Anti-inflammatory and immunosuppressive effects

A

Corticosteroids

35
Q

MoA: inhibits spinal reflexes in CNS
Indications: spinal cord injury, multiple sclerosis, spinal cord disease
Contraindications: epilepsy, cardiac dysfunction
Drug-drug: CNS depressants, alcohol
AE: drowsiness, dizziness, nausea, constipation, hypotension, urinary frequency
Nursing: Many other drugs in class used for acute musculoskeletal disorders; monitor CNS; do not operate heavy machinery

A

Baclofen

36
Q

is a synthetic glucocorticoid, primarily prescribed for its anti-inflammatory and immunosuppressive effects. It is either used at low doses for chronic illnesses or used concomitantly at high doses during acute flares.
AE: Black, tarry stools; blindness; bloating; bloody vomit; bone pain; change in vision; chest pain; darkening of the skin

A

Methylprednisolone

37
Q

MoA: Anti-inflammatory and immunosuppressive effects
Indication: Inflammatory and allergic disorders
Contraindications: Acute infection, diabetes mellitus, acute peptic ulcers, CHF, older adult
AE: short term: gastric irritation, immunosuppression, edema (hypertension, weight gain), insomnia, appetite increase, masks s/s infection, steroid psychosis
Long term: Cushing’s syndrome; hypernatremia, hypokalemia; growth suppression (children); adrenal suppression
Prednisone PO - use when not on ACUTE exacerbation; go after IV to taper off steroids: taper steroids to prevent rebound that could happen

A

Prednisone

38
Q

A natural substance that helps the body’s immune system fight infection and other diseases, such as cancer. Interferons are made in the body by white blood cells and other cells, but they can also be made in the laboratory to use as treatments for different diseases.
are a group of signaling proteins made and released by host cells in response to the presence of several viruses. In a typical scenario, a virus-infected cell will release interferons causing nearby cells to heighten their anti-viral defenses.
AE: swelling or other reactions at the injection site; flu-like symptoms such as headache, tiredness, and weakness; chills; fever; trouble sleeping; nausea; vomiting; diarrhea
Can use IV interferons - just for prevention; keep on steady basis

A

Interferons

39
Q

is a medication used to treat amyotrophic lateral sclerosis and other motor neuron diseases. Riluzole delays the onset of ventilator-dependence or tracheostomy in some people and may increase survival by two to three months. Riluzole is available in tablet and liquid form.
AE: Bladder pain; bloody or cloudy urine; blurred vision; difficult, burning, or painful urination; fast, pounding, or irregular heartbeat or pulse; frequent urge to urinate; general feeling of discomfort or illness; increased cough

A

Riluzole

40
Q

are a type of medicine used to treat clinical depression. They can also be used to treat a number of other conditions, including: obsessive compulsive disorder (OCD) generalised anxiety disorder.
AE: may trigger hypomania or mania in some people; Nausea; Increased appetite, weight gain; Fatigue, drowsiness; Insomnia; Dry mouth; Constipation; Dizziness; Agitation, restlessness, anxiety

A

Anti-depressives

41
Q

PO - not primary treatment of MS
MoA: reduces fever by direct action of hypothalamus and dilation of peripheral blood vessels
Indications: Reduce pain and fever (No effect on inflammation)
Contraindication: chronic alcoholism, reduced liver function
AE: C: headache, skin rash (generally well-tolerated) Rare: liver toxicity (overdose or liver disease)
Toxicity: delirium, n/v, chills; acute liver failure; antidote: acetylcysteine
Nursing: max dose is 4 grams/day (4000 mg/day); consider combo meds

A

Acetaminophen

42
Q

Works on the ANS
(heavier - block beta-adrenergic system - which overreacted to stimulus); the -olol goal
MoA: Block beta-1 and beta-2 receptors of the SNS; slows HR and lowers BP
Indications: HTN, Heart failure, s/p MI, A-fib/flutter
Drug-drug: Beta-agonist inhaler (albuterol)

A

beta blocker

43
Q

Status epilecutis
used - prefer given IV; rectal 2; seizures - stay on meds; not remove
MoA: Depress activity of CNS through GABA receptors
Contraindications: Pregnancy (X)/lactation; COPD; older adults
Black Box Warning: Schedule IV; CNS depressants: alcohol, opioids, others
AE: CNS depression; Overdose: respiratory depression, coma
Nursing: Caution with IV route; Long term use must taper discontinuation (withdrawal syndrome); addictive

A

Benzodiazepine:

AHII (47 decks)

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