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ABSN > mod 3 pharm - E2 > Flashcards

mod 3 pharm - E2 Flashcards

1
Q

BCG vaccine

A

a live vaccine given weekly for 6-12 wks for bladder cancer

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2
Q

BCG MOA

A

Stimulates inflammatory response in the bladder -> goal is for immune system to recognize cancerous cells & attack

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3
Q

BCG adverse reactions

A

-Bladder irritation
-Systemic infection

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4
Q

BCG patient instruction

A

1) empty bladder
2) instill vaccine into bladder (dwell time 2 hrs)
3) change position q15 mins

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5
Q

BCG nursing consideration

A

-do not give to immuncomp pt bc live vaccine
-disinfection urine for 6hr post treat

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6
Q

when lowering BP for CKD, what is our goal

A

reduce BP to less than 140/90 but do not want too low bc the kidneys are used to that higher pressure

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7
Q

when treating hyperlipidemia, what is our goal

A

cholesterol <200 statin

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8
Q

we control BP for CKD w/ what meds

A

ACE or ARBs

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9
Q

ACE

A

-prils
-Blocks angiotensin converting enzyme (ACE) which inhibits production of angiotensin 2 (a power vasoconstrictor) and inhibits aldosterone secretion leading to less water retention
-first dose hypotension , cough, angioedema esp in AA
-do not give to pregnant women
-risk for hyperK
-renally dose
-can cause neutropenia

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10
Q

ARBs

A

-satan
-Block the action of angiotensin 2 after it is formed causing vasodilation & increased sodium and water excretion
-well tolerated
-do not give to pregnant pts need to be on BC
-never give w/ ACE

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11
Q

Statins

A

-statin
-Inhibits HMG-CoA reductase which reduces the amount of cholesterol made by the liver and then the liver makes more LDL receptors
-myopathy & rhabdo
-2 wks to see affect
-interacts w/ GI & alc/drugs

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12
Q

Erythropoietin

A

for anemia
do not give if hgb is <10

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13
Q

loop diuretics

A

for fluid overload & hyperK
-furosemide
-Inhibits the kidneys ability to reabsorb sodium in the loop of henle & makes kidneys put more sodium in the urine
-hypoK, ototoxicity

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14
Q

sodium bicard

A

for metabolic acidosis
-an alkaline agent used to slow progression of CKD, prevent bone loss, & improve nutritional status
-initiate when HCO is <15, goal is 18-20
-SE: bloating

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15
Q

calcium carbonate

A

for hyperphosphatemia
-phosphate binder (tums)
-take w/ meals
-SE: hypercalcemia, monitor Ca levels

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16
Q

calcitriol

A

for renal osteodystrophy
-MOA: activated form of vit D, stimulates intestinal absorption of Ca/Phos & bone mineralization
-SE: HyperCa, HyperPhos

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17
Q

signs of hyperCa

A

-upset stomach
-nausea
1) Reduced excitability of muscles and nerves
2) Confusion, psychosis
3) Seizures, coma

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18
Q

signs of hyperPhos

A

Typically only symptoms of hypocalcemia: muscle spasms, paresthesia, tetany, +Chvostek’s/Trousseau’s sign

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19
Q

what drugs are a particular concern w/ CKD bc we have lack of clearance

A

-digoxin
-diabetic agents (glyburide, metformin)
-abx (vanc)
-opioids (morphine) -> inc risk for resp depression
renal dosing

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20
Q

what class is finasteride & dutasteride

A

5-a-reductase inhibitor

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21
Q

finasteride & dutasteride MOA

A

Blocks conversion of testosterone to DHT & decreases epithelial tissue in prostate

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22
Q

finasteride & dutasteride indication

A

Mechanical obstruction of urethra

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23
Q

finasteride & dutasteride SE

A

Increase hair growth
Impotence
Decreased libido
Gynecomastia

24
Q

finasteride nursing considerations

A

Does not decrease overall testosterone levels

Works best for pt whose prostate is very enlarged and doesn’t work on smaller prostates

Takes 6-12 months for drug to work & need to take for rest of life (PSA should be measured before starting the drug & 6 months later)

women handle w/ caution bc teratogenic effect that is harmful to male children

If taking, cannot give blood

25
Q

what class is Tamsulosin

A

A1-aderenergic antagonists

26
Q

Tamsulosin MOA

A

Relaxes smooth muscle cells by blocking alpha 1 receptors in bladder, neck, prostate & urethra

27
Q

Tamsulosin indication

A

Dynamic obstruction of urethra

28
Q

Tamsulosin SE

A

Abnormal ejaculation

29
Q

Tamsulosin nursing considerations

A

Results happen rapidly

Take life long

30
Q

what class is Sildenafil

A

PDE-5 inhibitors

31
Q

Sildenafil MOA

A

Inhibits PDE5 & increases/preserves cGMP levels
only enhances the normal response to sexual stimuli

32
Q

Sildenafil indications

A

Relief of ED
Pulmonary arterial htn
BPH

33
Q

Sildenafil SE

A

HA
Flushing
Dyspepsia

34
Q

Sildenafil nursing considerations

A

No enhancement effect on men w/o ED

Up to 4 hrs before sexual activity w/ 30-60 min onset

Caution if you have preexisting CVD, if on nitrate & if you have hypotension
sil + nitrate = significant drop in BP

Call 911 if chest pain during sex

1x per day

Erection >4 hr is called priapism & is a medical emergency

35
Q

main point when giving optic meds

A

have to keep them localized in the eye to help prevent systemic effects hold pressure for 2 mins

36
Q

what class is timolol

A

beta blocker non selective

37
Q

what class is betaxolol

A

beta 1 blocker

38
Q

beta blockers MOA

A

Blocks sympathetic nervous system stimulation of beta receptors

decrease aqueous humor production

39
Q

beta blocker indications

A

-open angle glaucoma maintenance treatment
-if acute close, need drops asap + other interventions

40
Q

beta blockers SE

A

Transient burning & discomfort
Systemic effects if not localized

41
Q

beta blockers nursing considerations

A

Do not give timolol to persons w/ asthma, COPD, sinus brady or heart failure

Have to take or blindness

Apply nasolacrimal pressure

42
Q

what class is Iatanoprost

A

Prostaglandin analogs

43
Q

Iatanoprost MOA

A

Increased outflow drainage of aqueous humor
increase AH drainage

44
Q

Iatanoprost indications

A

-open angle glaucoma
-ocular hypertension

45
Q

Iatanoprost nursing considerations

A

Apply nasolacrimal pressure

46
Q

what class is Brimonidine

A

Alpha2 adrenergic agonist

47
Q

Brimonidine MOA

A

Decreased AH production, may increase drainage/outflow

48
Q

Brimonidine indications

A

Used for open angle glaucoma & increased intraocular pressure

49
Q

Brimonidine SE

A

Burning/stinging
Dry mouth
Fatigue
HA
Blurred vision
Hypotension

50
Q

Brimonidine nursing considerations

A

Apply nasolacrimal pressure

51
Q

what class is Dorzolamide

A

Carbonic anhydrase inhibitor

52
Q

Dorzolamide MOA

A

Decreased production of aqueous humor

53
Q

Dorzolamide indications

A

Second line open angle & increase IOP

54
Q

Dorzolamide SE

A

Stinging
Bitter taste
Allergic rx

55
Q

Dorzolamide nursing considerations

A

Apply nasolacrimal pressure

56
Q

Thiazide Diuretic

A

-hydrochlorothiazide
-Works on distal convoluted tubule to inhibit resorption of Na/K/Chloride -> decreasing cardiac output
-can cause elevated glucose, cholesterol & TAGs
-

ABSN (118 decks)

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