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Patho/Pharm Module 5/6 > Module 5 > Flashcards

Module 5 Flashcards

1
Q

Sodium Bicarbonate
MOA

A

Dissociates to provide ion to neutralize ion concentration which raised blood and urinary pH.
Also increases concentration of Na in plasma

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2
Q

Sodium bicarbonate
Indications

A

Metabolic acidosis
Hyponatremia

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3
Q

Sodium bicarbonate
Side effects

A

Edema, cerebral hemorrhage, electrolyte abnormalities, metabolic alkalosis, flatulence, tetany, pulmonary edema, heart failure exacerbation

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4
Q

Sodium bicarbonate
Nursing considerations

A

PO ONLY!
Monitor cardiac ABGs and electrolytes
Give 1-3 hours before or after meals
Lots of drug interactions if given with anything that includes Na

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5
Q

Potassium chloride (KCl)
MOA

A

Adds K and Cl

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6
Q

Potassium chloride (KCl)
Indications

A

Treat/prevent K depletions when dietary measures fail

Hypokalemia

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7
Q

Potassium chloride (KCl)
Side effects

A

Renal failure
May cause phlebitis, N/V, GI ulcers, bleeding

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8
Q

Potassium chloride (KCl)
Nursing Considerations

A

Pt must have urine output!!!Never give IV Push!!!!!!
IV must be given slowly!!! 10-20 mEq/hr
PO must be diluted to lower GI distress, tastes awful, very large pills

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9
Q

Think Potassium (K) think

A

Heart

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10
Q

Sodium polystyrene sulfonate (Kayexalate)
MOA

A

Binds to K in digestive tract replacing K ions for Na ions. Potential to drop K by 0.5-1.0 mEq/L in 4-6 hrs

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11
Q

Sodium polystyrene sulfonate (Kayexalate)
Indications

A

Hyperkalemia

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12
Q

Sodium polystyrene sulfonate (Kayexalate)
Side effects

A

Constipation, N/V/D, hypokalemia
Serious- intestinal obstruction or necrosis

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13
Q

Sodium polystyrene sulfonate (Kayexalate)
Nursing Considerations

A

Pt must have normal bowel functions
Pt will poop a lot!!!

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14
Q

D50/insulin
MOA

A

Shifts K into the cells temporarily

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15
Q

D50/insulin
Indications

A

Hyperkalemia

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16
Q

D50/insulin
Side effects

A

Hypokalemia

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17
Q

D50/insulin
Nursing considerations

A

For emergencies!!!!!
Check glucose levels before and after administering
Called a Lytic cocktail

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18
Q

Magnesium sulfate & magnesium oxide
MOA

A

Replaces magnesium

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19
Q

Magnesium sulfate & magnesium oxide
Indications

A

Hypomagnesemia
Prevent/treat seizures I. Pre-eclampsia, treat cardiac rhythm disturbances
Constipation

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20
Q

Magnesium sulfate & magnesium oxide
Side effects

A

Hypermagnesemia
Presents as confusion, sluggish, slow movements, SOA, nausea, dizzy (from low calcium) and abnormal heart rhythm

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21
Q

Magnesium sulfate & magnesium oxide
Nursing considerations

A

Can burn when given by IV
Mag Oxide (antacid) can be give for long term low mag

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22
Q

Think Magnesium think

A

Muscle and movement

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23
Q

Think sodium (Na) think

A

Brain

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24
Q

Calcium (Ca)
MOA

A

Replaces calcium

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25
Q

Calcium (Ca)
Indications

A

Hypocalcemia

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26
Q

Calcium (Ca)
Side effects

A

Hypercalcemia
Acts like a sedative, fatigue, lethargy, confusion, weakness, leading to seizures and coma, can also cause kidneys stones

27
Q

Calcium (Ca)
Nursing considerations

A

IV - given thru central line
Oral - elemental, calcium carbonate (tums), may also need vitamin D

28
Q

Phosphate
MOA

A

Replaces phosphate

29
Q

Phosphate
Indications

A

Hypophosphatemia

30
Q

Phosphate
Side effects

A

Increased risk of calcifications
Take care with CVD or Hypercalcemia

31
Q

Phosphate
Nursing considerations

A

IV/Oral - given over a long time
Increase oral intake

32
Q

Calcium & phosphate are linked oppositely

A

Low calcium = high phosphate
High calcium = low phosphate

33
Q

nystatin (Mycostatin)
Class

A

Polyene

34
Q

nystatin (Mycostatin)
Indication

A

Treatment of superficial candida infections of mouth (thrush), oral mucosa, vagina & skin

35
Q

nystatin (Mycostatin)
Side effects

A

Toxic if given parental
Mild skin irritation, N/V/D when given orally w poor GI absorption

36
Q

nystatin (Mycostatin)
Nursing considerations

A

Many forms - creams, powder, topical, vaginal, liquid (swish & spit or swish & swallow)

37
Q

amphotericin B
Class

A

Polyene

38
Q

amphotericin B
MOA

A

Bind to ergosterol in fungal cell membranes & cause then to become leaky & destroys cell wall of the fungus

39
Q

amphotericin B
Indications

A

Agent of choice for most systemic mycoses

40
Q

amphotericin B
Side effects

A

Hard on Kidneys

41
Q

amphotericin B
Nursing considerations

A

Route: PO or parental (usually IV)
MUST be diluted & infused slowly
Monitor BUN & creatine
Pt must be on cardiac monitor
Given every other day for several months (7 weeks to leave body)
Pretreat w diphenhydramine, acetaminophen or aspirin to decrease infusion symptoms : fever, pain, nausea & headache

42
Q

flucytosine (Ancobon)
Class

A

Pyrimidine

43
Q

flucytosine (Ancobon)
MOA

A

Inhibits fungal DNA synthesis

44
Q

flucytosine (Ancobon)
Indication

A

Allows for a lower dose of amphotericin B to be used

45
Q

flucytosine (Ancobon)
Nursing considerations

A

Helps decrease the side effects related to amphotericin B.
Rarely given alone

46
Q

fluconazole (Diflucan)
Class

A

Azole

47
Q

fluconazole (Diflucan)
MOA

A

Interrupts the integrity of the cell wall by interfering w the synthesis of ergosterol

48
Q

fluconazole (Diflucan)
Indications

A

Used for both superficial and less serious systemic fungal infections

49
Q

fluconazole (Diflucan)
Side effects

A

Topical - redness, burning, itching
Systemic- severe GI upset N/V/D, liver toxicity

50
Q

fluconazole (Diflucan)
Nursing Considerations

A

Monitor AST & ALT for liver function
Take with food
Wait 2 hrs before or after admin to give antacids. Needs acidic environment to absorb

51
Q

grisefulvicin (Fulvicin)
MOA

A

Inhibits fungal mitosis by binding to keratin. Has no effect on cell wall

52
Q

grisefulvicin (Fulvicin)
Indications

A

Resistant dermatophyte infection of scalp, ski. & nails

53
Q

grisefulvicin (Fulvicin)
Side effects

A

Bone marrow suppression, rash, CNS changes, N/V/D, anorexia

54
Q

grisefulvicin (Fulvicin)
Nursing consideration

A

Inexpensive older drug

55
Q

filgrastim (Neupogen)
Class

A

Hematopoietic agent

56
Q

filgrastim (Neupogen)
MOA

A

Promotes proliferation, differentiation, activation of cells that make granulocytes

57
Q

filgrastim (Neupogen)
Indications

A

Malignancies, chemo induced leukopenia, bone marrow transplant, harvesting of hematopoietic stem cells, chronic neutropenia

58
Q

filgrastim (Neupogen)
Side effects

A

Bone pain
Leukocytosis

59
Q

filgrastim (Neupogen)
Nursing considerations

A

IV or subq (most frequent)
Drug is made with recombinant DNA tech

60
Q

pegfgrastim (Neulasta)
Class

A

Hematopoietic agent

61
Q

pegfgrastim (Neulasta)
MOA

A

Increased production of neutrophils

62
Q

pegfgrastim (Neulasta)
Indications

A

Malignancies, chemo induced leukopenia, bone marrow transplant, harvesting of hematopoietic stem cells, chronic neutropenia

63
Q

pegfgrastim (Neulasta)
Side effects

A

Bone pain

64
Q

pegfgrastim (Neulasta)
Nursing considerations

A

Subq
Pegylated = delayed excretion by kidneys
Long acting version of filgrastim

Patho/Pharm Module 5/6 (4 decks)

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