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Nursing > NRS 115 Drug Cards > Flashcards

NRS 115 Drug Cards Flashcards

Exam 2

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1
Q

Phenothiazine

A

Anti-psychotic drug that depress CNS
*Anti-anxiety drug that blocks the responsiveness of the CTZ to stimuli- leading to decreased n/v

Antagonizes D2-dopamine receptors in the postrema of midbrain- decreases the effect of dopamine

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2
Q

PROMETHAZINE

A

Phenothiazide- Prototype
Oral 12.5 - 25 mg every 4-6 hours
Used to prevent/ treat nausea and vomiting.

Contraindicated: in children younger than 2 years bc of fatal respiratory depression*

  • CAUTION in pt with glaucoma bc of antimuscarinic activity*
  • pregnant/ young/old/ postoperative pt

Adverse Effects: anticholinergic effects

  • blurred vision, urinary retention, dry mouth, photosensitivity, drowsiness confusion, extrapyramidal symptoms(spasms, rigidity, tremors)
  • interference with CNS- pt is at risk for injury- teach safety.

NO SUBQ

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3
Q

HYDROXYINE

A

Antihistamine- h1 receptor blocking agents

Used to treat nausea/ vomiting and prevent/treat MOTION SICKNESS. Used as sedative for anxiety.

Oral/ IM (into deep large muscle)
IV will cause sterile abscess- damage to tissue.

Older adults: BEERS- reduced dose bc of sedative potential (risk for falls)

Adverse Effects: drowsiness, confusion, dry mouth, thickened respiratory secretions, blurred vision, urinary retention, tachycardia.

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4
Q

ONDANSETRON

A

5HT3/ Serotonin Receptor Antagonist
*first choice for postop nausea/ vomiting.

*ORAL 8mg given day chemo is administered.

Used to prevent/ treat moderate to severe nausea/ vomit associated with CANCER CHEMO, RADIATION THERAPY, POSTOP STATUS.

can be used in children YOUNGER than 6 months.

Adverse Effects: diarrhea, headache, dizziness, constipation, fatigue, transient elevation of liver enzymes and pain at injection site.

Don’t remove from blister pack until given. Gentle removal.

Teach: may impair thinking/ reactions

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5
Q

Substance P/ Neurokinin 1 antagonist

A

peptide neurotransmitter in neurokinin family.

Plays a role in mediating acute chemotherapy-induced nausea/ vomit. Believed to be primary mediator of delayed n/v

Blocks activity of sub P an NK1 receptors in brain.

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6
Q

APREPITANT

A

Substance P/ Neurokinin 1 Antagonist
Prototype. Parenteral version (fosaprepitant)

Oral. 125mg 1 hour before chemo

Used in combo with 5HT3/ glucocorticoid for highly emetic chemo.
Used in combo to treat acute and delayed n/v from chemo.

Adverse Effect: well tolerated. fatigue, weakness, dizziness, abnormal heart rhythm, HA, hiccups.

*GRAPEFRUIT- decreases metabolism.

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7
Q

Dronabinol

A

Cannabinoid used in the management of nausea and vomiting associated with chemo unrelieved by other antiemetic drugs.

schedule 3 drug

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8
Q

PSYLLIUM

A

LAXATIVE: bulk forming: soluble fibers that are largely unabsorbed by the intestine.
- When water is added- substances swell and become gel like.

Most physiologic laxative bc effect is similar to increased fiber.

Action: works by mechanical action to absorb excess water while stimulating normal bowel.

Tx: occasional constipation/ bowel irregularity. Help lower cholesterol when combined with low cholesterol diet/ low sat fat.

Older: overused. Bulk forming psyllium compound (Metamucil) is best.

Adverse: severe flatulence/ bloating. Ab cramping

Contraindications: Undiagnosed ab pain. May cause inflamed organ to rupture/ spill GI content in ab cavity- life threatening.
- QSEN: difficulty swallowing/ esophageal stricture/ narrow of GI - shouldn’t take it

Administer: 8 ounces water- obstruction in GI tract when not taken w enough water.

Assess: trouble swallowing/ severe stomach pain/ cramp/ n/v/ rectal bleeding/ constipation longer than 7 days.

QSEN: may contain sugar, sodium, potassium, artificial sweetener- concern for high BP, renal disease, phenylketonuria.

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9
Q

Surfactant Laxatives

A

Stool Softners

  • Docusate calcium
  • Docusate Sodium (Colace, docusil, Docuprene)

Allows water to penetrate stool*

  • Decreases surface tension of fecal mass to allow water to penetrate stool.
  • Has little if any laxative effect
  • PREVENT straining
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10
Q

Lubricant Laxatives

A
  • Lubricate the fecal mass and slow colonic absorption of water from fecal mass.
  • May interfere with absorption of fat soluble vitamins- may result in lipid aspiration pneumonia.

Should be taken daily- act w/i 1-3 days

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11
Q

Cathartics

A

Strongest / most abused laxative.

  • Irritate GI mucosa- pull water into the colon and stimulate peristalsis.
  • May lead to fluid electrolyte imbalance.

Stimulate
Saline: increase osmotic pressure in the intestinal lumen- resulting in the retention of water- distend the bowel and stimulate peristalsis- Polyethylene glycol solution (PEG)

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12
Q

BISCODYL

A

Cathartics - Ducolax

Action: Acts by irritating the GI mucosa and pulling water into the bowel lumen. Feces move through bowel too rapidly to allow colonic absorption of fecal water.

Use: constipation/ bowel prep before medical exam. Management of neurogenic bowel dysfunction.

Children: avoided. Can be used for short term- rescue therapy. * not for children younger than 6 years*

Dose: PO 10-15mg/ rectal suppository- 10mg.

Adverse: Ab pain, cramping, nausea, diarrhea, weakness.

Should not be used longer than 1 week bc it produces serum electrolyte imbalances, hypocalcemia, hypokalemia, metabolic acidosis, alkalosis.

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13
Q

Stimulant Cathartics

A

Glycerin
Castor Oil
Senna Prep

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14
Q

Saline Cathartics

A

Magnesium citrate- milk of magnesia
Contains: phosphate, sodium, magnesium, potassium salts

Must be used cautiously.

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15
Q

Polethylene glycol solution (MiraLax)

A

oral laxative OTC
should not be taken longer than 2 weeks

refrigerate- retains potency.

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16
Q

Lactulose

A

osmotic effect- pulling water into the colon and stimulating peristalsis.

useful in treating hepatic encephalopathy by decreasing the production of waste product ammonia.

17
Q

Lubiprostone

A

Aids in treating chronic idiopathic constipation by increasing intestinal fluid secretion- stimulating intestinal motility and defecation.

18
Q

Polyethylene glycol- electrolyte solution

A

non-absorbable oral solution that rapidly evacuees the bowel w/I 4 hours.

Useful for bowel cleansing before GI procedures

19
Q

Alosteron

A

Selective 5HT3 receptor antagonist

Treating women w chronic severe diarrhea predominant IBS that has no responses to conventional therapy.

20
Q

Antibiotic Associated Colitis

A

Serous condition that results from oral/ parenteral antibiotic therapy.

By suppressing normal flora in the colon, antibiotics allows proliferation of other bacteria. - C. Diff*

Produce toxin that causes fever, ab pain, inflammatory lesions of the colon, severe diarrhea w mucus, pus, blood.

21
Q

DIPHENOXYLATE WITH ATROPINE

A

Opiate- Related Antidiarrheals

Treat mod- severe diarrhea. Schedule V- requires prescription.

Action: slows peristalsis by acting on smooth muscles in intestine.

Children: Overdose may occur* Under 2 should not take it. 2-13 yrs should take liquid prep to enhance accuracy in dose.

EXTREME* caution in pt with severe hepatorenal disease bc hepatic coma can occur.

Dose: 5mg PO * with liquid must use calibrated dropper made by manufacturer

Adverse: Dizziness*, tachycardia, HA, flushing, n/v, dry skin, mucous membranes and urinary retention.

Hypotension/ respiratory depression may occur- larger doses

22
Q

Beta-lactam antibacterial drugs

A

inhibit synthesis of bacterial cell walls by binding to protein in bacteria cell membranes.

Commonly used in critical care units to treat pneumonia bloodstream infections, wound infections, and others.
- Renal, hepatic and organ functions should be monitored in critically ill clients- drug doses reduced^

Penicillin
Cephalosporin
Carbapenems
Monobactams

23
Q

Penicillin

A

safe and effective- most comely prescribed antibacterial.

First ATB developed.

Most effective against gram positive organisms.

24
Q

AMPICILLIN

A

Beta- Lactam antibacterial- Penicillin

Action: inhibits bacterial cell wall synthesis by binding to one or multiple penicillin binding proteins.

Use: Bacterial infections. In treatment or prophylaxis of infective endocarditis.
- Broad spectrum useful in skin, soft tissue, respiratory, GI, and genitourinary infections.

Children: caution in neonates bc immature kidney function slows drug elimination.

Dose: PO, IM, IV 250-500 mg

Older: dosages should be adjusted based on pt’ creatine clearance- caution with renal impairment.

Adverse: Hypersensitivity- rash/ anaphylactoid reaction. GI- ab pain, diarrhea, n/v

Contraindications: Hypersensitivity/ allergic reaction to any penicillin class.

  • potential for cross allergenicity- allergy to drug of another class w similar chemical structure.
  • Cephalosporins/ Carbapenems have same characteristics- allergy should be avoided.

Teach: take oral penicillins for the full, prescribed course of treatment to prevent complications

25
Q

Cephalosporins

A

widely used group derived from a fungus and closely related chemically to the penicillins.

They are broad spectrum agents with activity against BOTH positive and negative gram bacteria.

  • Less active with gram positive.
    5 subgroups
26
Q

CEFAZOLIN

A

Cephalosporins

Drug choice for surgical prophylaxis.

Action: Inhibits the 3rd and last step of bacterial wall synthesis by binding to one or more penicillin binding proteins.

Use: surgical prophylaxis and tx of infections:

  • Respiratory tract
  • Skin/ soft tissues
  • Bones/ joints
  • Brain/ spinal cord and blood stream.

Dose: IM, IV 1-1.5g

Children: safe- cautioning neonates- dose based on age, weight, severity, and renal function.

Adverse: GI, Hypersensitivity/ superinfection.

Contraindications: Previous severe anaphylactic reaction to penicillin- risk of cross sensitivity.

Interactions: decreased in prothrombin activity - may be due to depletion of vitamin K.

27
Q

Carbapenems

A

Broad spectrum/ bacterial beta lactic antimicrobials.

28
Q

IMIPENEM- CILASTATIN

A

Carbapenems - 4 medications

Action: inhibit synthesis of bacterial cell walls by binding with penicillin binding proteins.

Use:  Infections caused by wide range bacteria.  Main use is to treat infections caused by organisms resistant to other drugs.
Treats infections:
- lower respiratory
- urinary tract
- intra abdominal infection
- bones/ joints
- skin/ skin structure
- polymicrobial infections, bacterial septicemia, endocarditis.

Caution- renal impairment- seizures.

Adverse: risk of cross sensitivity in pt w hypersensitivity/ gastric disturbances
- CNS toxicity- seizures

Dose: IV 250-1000mg

29
Q

AZTREONAM

A

Monobactam

Active against aerobic gram negative bacteria- Enterobacteriaceae and P. aeruginosa- and many strains that are resistant to multiple antibiotics.

Action: inhibits synthesis of bacterial cell walls by binding with penicillin binding proteins.
SAFE to administer to pt with penicillin allergy.

Use: infections caused by N. gonorrhoeae, H. influenza, and most Enterobacter–Klebsiella–Serratia species, and it is often active against P. aeruginosa.

Treats: infections in:

  • urinary tract
  • skin/ skin structures
  • lower respiratory tracts
  • intra ab
  • gynecologic infections
  • septicemia

Dose: IM, IV 0.5-1g
Children: can be used in older than 1 month.

Adverse: Hypersensitivity- rash, localized thrombophlebitis.
- prolonged use can use fungal/ bacterial super infections.

Nursing (3 decks)

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