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3. Nursing Pharmacology > Misc Meds Comp 11 > Flashcards

Misc Meds Comp 11 Flashcards

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1
Q

What are BRMs?

A

biologic disease modifiers

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2
Q

Hematopoietic CSFs action

A
  • proteins stimulate or regulate growth, maturations, and differential of bone marrow stem cells
  • not tumericidal but help protect immune system
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3
Q

Hematopoietic CSFs TE

A
  • decreases SE of chemo

- allows for higher levels of chemo

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4
Q

Hematopoietic CSFs ind

A
  • PT with neutropenia - IV or SQ

- adjunct treatment in cancer PT, or renal failure (ESA)

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5
Q

Erythropoietin Stimulating agents (ESA) Concern

A
  • increased risk of death for cancer PT compared to RBC transfusion- use with caution
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6
Q

Erythropoietin is… and examples

A
  • produced in the kidneys and stimulates RBC production
  • Epoetin (Epogen or Procrit)
  • Darbepoetin (Aranesp)
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7
Q

Erythropoietin ind

A

anemia due to chronic illness, surgery, and cancer chemo

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8
Q

ESA SE/AE

A
  • target HMG should not exceed 12 g/dL due to increased death, serious CV problems, and increased tumor production
  • HTN and Edema
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9
Q

ESA critical assessment

A

Hmg >12 g/dL

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10
Q

ESA NI

A
  • assess BP during treatment- may be increased in CRF PTs
  • watch HCT elevation
  • DO NOT SHAKE vial , store in fridge- DO NOT FREEZE
  • must change needles after drawing up into syringe
  • SQ not IM
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11
Q

Granulocyte (leukopoetic) Growth Factor (GCSF) examples

A
  • Filgrastim (Neupogen)

- Pegfilgrastim (Neulasta)

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12
Q

GCSF uses

A

increase WBC in chemo PT, bone marrow transplant, severe neutropenia

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13
Q

GCSF SE/AE

A

-skeletal pain (due to expanding bone marrow-where WBC is created)

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14
Q

GCSF NI

A
  • dosing based on neutrophil count (ANC)- must be >1500 cells/mm for 3 days
  • KEEP MED REFRIDGERATED- DON’T FREEZE, DON’T SHAKE
  • expensive
  • IV SQ
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15
Q

Thrombopoietic Growth factor (TGF) example and use

p. 327

A
  • Oprelvekin (Neumega)

- Chemo induced thrombocytopenia- low platelets

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16
Q

TGF critical assessment

A

assess platelet counts > 150, 000 don’t give

- normal range 150k-450k

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17
Q

TGF NI

A
  • SQ
  • drug int: DIURETICS (inc. risk of hypokalemia)
  • store in fridge, do not shake vial
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18
Q

Active acquired immunity

A
  • immunization/ vaccine -sm. amount of antigen
  • slower process to develop antibodies
  • long-lasting effects
  • may need booster shots
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19
Q

vaccinations involve

A

the admin of a small amount of antigen which stimulates an immune response without the person getting the disease

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20
Q

passive immunity is when we receive antibodies (troops) from…

A

another source

  • no immune response
  • 2 types: maternal or other human and animal sources
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21
Q

Passive native immunity

A
  • maternal antibodies-thru placenta
  • automatic process
  • temporary effects
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22
Q

passive acquired immunity

A
  • animal and other human source: anti-toxin, immune globulin, anti-venin
  • quick process
  • temporary effects (weeks-months)
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23
Q

Active natural immunity

A
  • antigen-antibodies-memory
  • immune system response
  • slow process to develop memory cells
  • long-lasting effects
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24
Q

Vaccine-preventable diseases (7)

A
  1. Hep A, B
  2. Influenza
  3. Meningococcal disease
  4. Pneumococcal disease
  5. tetanus
  6. TB
  7. Varicella
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25
Q

national childhood vaccine injury act 1986

A
  • national vaccine injury compensation program (NVICP)- adult and child
  • compensation for vaccine injury or death
  • does not req. proof of negligence on the part of the provider
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26
Q

MMR and varicella not to be given prior to

A

12 months

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27
Q

vaccine contraindications**

A
  • mod- severe illness
  • anaphylaxis component, food, or vaccine med
  • ALWAYS REVIEW VACCINE INFO SHEET (VIS) PRIOR TO ADMIN
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28
Q

vaccines may be given in these cases…(4)

A
  • mild illness or convalescent phase
  • antimicrobial therapy
  • exposure to infectious disease
  • premature birth
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29
Q

vaccine discomfort , interventions

A
  • use muscle

- massage area

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30
Q

vaccine documentation(6)

A
  • date, route, site
  • any adverse reactions
  • vaccine type
  • manufacturer
  • lot number, expiration date
  • your name and title, business address
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31
Q

increased vitamin use indications

A
  • PT with rapid body growth
  • pregnant or breastfeeding
  • malnourished
  • debilitated
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32
Q

fat soluble

A
  • excreted in urine at a slow rate and metabolized slowly

- can be stored in fatty tissue, liver , and muscle

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33
Q

fat soluble vitamins

A
  • Vit A, D, E, and K

- Vit A and D toxic if taken in excessive amounts over time

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34
Q

water soluble vitamins

A
  • Vit B complex :
    • B1- thiamine
    • B2-riboflavin
    • B3-niacin
    • B6- pyridoxine
  • Vit C- citrus and green vegetables
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35
Q

Vitamin A function

A

bone growth & maintenance of epithelial tissues, skin, eyes, and hair

36
Q

Vitamin D function

A
  • regulates calcium and phosphorous metabolism which helps with bone health
  • needed for calcium absorption from the intestines
  • given with calcium
37
Q

Vitamin E function and sources

A
  • antioxidant

- whole grains, vegetable oils, sunflower seeds, eggs, meats, avocados, asparagus

38
Q

Vitamin K - phytonadione function

A
  • needed for synthesis of prothrombin and clotting factors

- used to treat Coumadin (Warfarin) overdose

39
Q

B complex foods

A

enriched breads and cereals, liver, fish, milk

40
Q

B1 thiamine

A
  • def: polyneuritis, cardiac pathology

- treats WERNICKE-KORSAKOFF syndrome

41
Q

B2 riboflavin

A

treats dermatitis , migraines

42
Q

B3 nicotinic acid , niacin

A
  • treats HYPERLIPIDEMIA & pellagra

- excess: flushing

43
Q

B6- pyridoxine

A
  • treats vit B6 def, neuritis, anemias
44
Q

Vit C function

A
  • carb metabolism and protein and lipid synthesis

- aids in absorption of iron

45
Q

Vit C deficiency and excess

A
  • poor wound healing
  • bleeding gums
  • scurvy
  • predisposition to infection
  • excess: crystal formation in urine
46
Q

Folic acid (folate) function

A

-body growth , DNA synthesis

47
Q

Folic acid (folate) deficiency and excess

A
  • neural tube defects (spina bifida) in developing fetus

- excess: mask signs of of Vit B12 def

48
Q

Vit B12 function

A

-DNA synthesis, development of RBCs

49
Q

Vit B12 deficiency

A

Crohn’s, liver, kidney disease

-treatment: Cyanocobalamin (SQ or PO) to correct deficiency

50
Q

Iron use

A
  • needed for hemoglobin regeneration
51
Q

Iron SE/AE

A
  • black tarry stools

- discolored teeth enamel and eyes (oral form take with straw)

52
Q

give oral form of iron with

A

vitamin C

53
Q

potassium range and use

A
  • range 3.5-5.3 mEq/L
  • used for cardiac, skeletal, and smooth muscles
  • K+ poorly stored in body
54
Q

hypokalemia < 3.5 mEq/L

A
  • cause: K+ wasting diuretics - Loop)
  • symptoms: NV, dysrhythmias, abdominal distention, soft flabby muscles
  • DO NOT give IV push
55
Q

foods high in K+

A
  • potato, sweet potato
  • green leafy veggies
  • lentils
  • beets, broccoli
  • clams
  • pumpkin, parsnips, brussel sprouts
  • banana
56
Q

Hyperkalemia > 5.3 mEq/L

A
  • cause: K+ sparing diuretics

- symptoms: tachycardia, later bradycardia, nausea, abdominal cramps, oliguria, weakness, numbness, tingling

57
Q

correction for hyperkalemia

A
  • Kayexalate - oral suspension -powder

- moves K+ into GI tract excretion

58
Q

hyponatremia causes

A
  • vomiting, diarrhea, surgery, diuretics, excess H2O
59
Q

hyponatremia signs and symptoms

A
  • muscular weakness
  • HA, lethargy
  • confusion
  • seizures
  • abdominal cramps
  • NV
  • tachycardia
  • HoTN
60
Q

Hypernatremia > 145 mEq/L

signs and symptoms

A
  • flushed dry skin
  • increased body temp
  • agitation
  • NV
  • anorexia
  • tachycardia
  • HTN
  • hyperreflexia
  • muscle twitching
61
Q

Calcium function

A
  • promotes normal nerve and muscle activity
  • heart contractions
  • blood clotting
  • bone and teeth formation
62
Q

Hypocalcemia < 8.5 mg/dl symptoms

A

-bone fractures, anxiety, irritability, tetany

63
Q

hypercalcemia > 10.5 mg/dL causes

A
  • hyperparathyroidism
  • bone tumors
  • prolonged immobilization
64
Q

hypercalcemia symptoms

A
  • flabby muscles
  • pain over bony areas
  • kidney stones
  • treatment: calcitonin
65
Q

magnesium function and range

A
  • cardiac contraction, transmission of neuromuscular activity
  • 1.8-3 mEq/L
66
Q

treatment for hypermagnesemia

A

stop laxatives/antacids

67
Q

Chloride function and range

A
  • maintains acid-base balance

- 95-108 mEq/L

68
Q

Hypochloremia < 95 mEq/L

A
  • tremors
  • twitching
  • slow/shallow breathing
  • HoTN
69
Q

hyperchloremia > 108 mEq/L

A
  • weakness
  • lethargy
  • deep/rapid breathing
70
Q

Phosphorus function and range

A
  • bone and teeth formation
  • neuromuscular activity
  • components of DNA and RNA
  • acid-base balance
  • range : 1.7-2.6 mEq/L
71
Q

Criteria for OTC status

A
  • indication for use
  • safety profile
  • practical for OTC use
72
Q

Use of OTCs

A
  • may delay effective treatment of more chronic disease states
  • may delay treatment of serious and/or LT disorders
  • may relieve symptoms of a disorder but not the cause
73
Q

Dietary Supplement Health and Education Act 1994

A
  • Herbs reclassified as “dietary supplements”
  • no pre-market test req
  • manuf. not standardized
  • clarified marketing regulations (physiologic effects to be noted)
  • no claims of prevention or curing of specific conditions
74
Q

requirements for herbal labels

A
  • scientific names
  • part of plant used
  • dosage
  • SE
  • contraind
  • manufacturer’s name and address
  • batch and lot number
  • date of manufacture and expiration
75
Q

echinacea

A
  • stimulates immune system
  • for colds, flu, recurrent respiratory and UTIs
  • limit use to 2 weeks
76
Q

ginkgo biloba

A
  • antioxidant
  • peripheral vasodilator and increased blood flow to CNS (improve age-related memory)
  • decreases platelet aggregation
  • hold for surgery
77
Q

Garlic

A
  • detoxifies and increases immune function
  • decreases platelet aggregation
  • for hypercholesterolemia
  • for mild HTN
78
Q

Ginger

A
  • stimulates digestion/ reduces nausea
  • reduces morning sickness-take in small doses for 4 DAYS
  • suppresses platelet aggregation
79
Q

St. John’s Wort

A
  • antidepressant and antiviral
  • for depression, anxiety, sleep disorders, effects in 4-8 weeks
  • drug interactions: antidepressants & oral contraceptives(decrease effect)
  • not effective in PTs with HIV- being studied
80
Q

Ginseng

A
  • improve cognitive function
  • lower blood glucose
  • boosts energy
  • improve mood
  • decrease platelet aggregation
81
Q

Aloe vera

A
  • external : relief of pain, promotes burn healing

- internal: treat constipation, may cause arrhythmias, neuropathies, edema

82
Q

chamomile

A
  • relief of digestive complaints

- may have sedative effects

83
Q

evening primrose

A
  • natural estrogen promoter

- may lower seizure threshold of taken with an anticonvulsant

84
Q

Peppermint

A
  • Internal: stimulates appetite and aids in digestion
  • external: relief of tension HA when rubbed on forehead (Germany- comparable acetaminophen)
  • ENERGY
85
Q

Kava

A
  • CNS sedation without loss of mental acuity or memory

- may be hepatotoxic (liver enzymes)

86
Q

Herbal interactions with meds

A
  1. anticoagulants
  2. antidiabetics
  3. antihypertensives
  4. digoxin
  5. corticosteroids

3. Nursing Pharmacology (22 decks)

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