N233 Medications Flashcards
1
Q
lorazepam
A
- intermediate-acting benzodiazepine
- PO, IV, IM
- excellent absorption and bioavailability when given IM, but is irritating to muscle and must be diluted
- conversion between injectable and oral dosage forms is 1:1
- can be given by IV push (useful in tx of acutely agitated patient)
- often administered as a continuous infusion to agitated patients who are undergoing mechanical ventilation.
- may be used to treat or prevent alcohol withdrawal
- has fewer active metabolites and less drug interactions
2
Q
Ranitidine hydrochloride
A
- H2 receptor antagonist (impedes/blocks)
- most widely used H2 receptor antagonist d/t it not being associated with concerns regarding drug interactions.
- available OTC
- administered parenterally
- can raise pH in 1 hr; effects can last for up to 12 hrs
- available PO & IV forms
- Dosing is different for different forms: PO = 150mg QID / 300 mg at bedtime; IV = 50mg Q8H
3
Q
Sodium Citrate
A
Indications:
- mgmnt of chronic metabolic acidosis associated with chronic renal insufficiency or renal tubular acidosis
- alkalization of urine
- prevention of cysteine and urate urinary calculi
- prevention of aspiration pneumonitis during surgical procedures
- used as a neutralizing buffer
Action:
- converted to bicarbonate in body –> increased BP –> as bicarbonate is renally excreted, urine is alkalinized –> solubility of cysteine and uric acid increased –> gastric acids neutralized.
Therapeutic Effects:
- provision of bicarbonate in metabolic acidosis
- alkalization of urine
- prevention of cysteine and urate urinary calculi
- prevention of aspiration pneumonitis
Distribution:
- rapidly and widely
Available: PO
Contraindications:
- severe renal insufficiency
- severe sodium restriction
- HF, untreated HTN, edema, or toxemia of pregnancy
Adverse Reactions / Side Effects:
- diarrhea
- fluid overload, hypernatremia (severe renal impairment), hypocalcemia, metabolic alkalosis (large dose only)
- tetany
Assessment:
- signs of alkalosis (confusion, irritability, paresthesia, tetany, altered breathing patterns) or hypernatremia (edema, weight gain, HTN, tachycardia, fever, flushed skin, mental irritability)
- renal dysfunction for fluid overload (discrepancy in intake and output, weight gain, edema, rales/crackles, and HTN)
Labs:
- Q4M
- hct, hgb, Lytes, pH, creatinine, urinalysis, 24-hr urine for citrate
- monitor urine pH if used to alkalinize urine
Potential Nursing Dx:
- deficient knowledge r/t medication regimen
(pt/family teaching)
Desired Outcomes:
- correction of metabolic acidosis
- maintenance of alkaline urine with resulting decreased stone formation
- buffering the pH of gastric secretions, thereby preventing aspiration pneumonitis associated with intubation and anasthesia
4
Q
Nitrous Oxide
A
- “laughing gas”
- the only inhaled gas currently used as a general anaesthetic
- weakest of general anaesthetic drugs
- used primarily for dental procedures or as a useful supplement to other, more potent anaesthetics.
5
Q
Isoflurane
A
- fluorinated ether
- rapid onset of action
- causes less cardiovascular depression
- has little or no toxicity
