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Pharm 2 > Pharm 2 Exam 1 > Flashcards

Pharm 2 Exam 1 Flashcards

1
Q

Thiazide Diuretic

hydrochlorothiazide (HCTZ) Indications

A

Edema, HF, Diabetes, HTN, Idiopathic Hypercalciuria

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2
Q

Loop Diuretic

furosemide (lasix) indications

A

Management of edema in HF, Hepatic or Renal disease, HTN, Hypercalcemia

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3
Q

*Potassium-Sparing Diuretic

spironolactone (Aldactone) indications

A

Hyperaldosteronism, HTN,
Reversing of hypokalemia casued by Potassium-Wasting diuretics,
heart failure in pediatric patient.

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4
Q

Thiazide Diuretic
hydrochlorothiazide (HCTZ)
Contraindications/Precautions

A

Allergy, Hepatic Coma, Anuria, Severe Renal Failure

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5
Q

Loop Diuretic
furosemide (lasix)
Contraindications/Precautions

A

Allergy, hepatic coma, severe electrolyte loss

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6
Q

Potassium-Sparing Diuretic
spironolactone (Aldactone)
Contraindications/Precautions

A

Allergy, Hyperkalemia, Renal Failure, Anuria

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7
Q

Thiazide Diuretic
hydrochlorothiazide (HCTZ)
Side/Adverse Effects

A

Hypokalemia, Hypercalcemia, Hyperglycemia, Elevated Lipids, Elevatid Uric Acid

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8
Q

Loop Diuretic
furosemide (Lasix)
Side/Adverse Effects

A

Hypokalemia, photosensitivity, dizziness, headache

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9
Q

Potassium-Sparing Diuretic
spironolactone (Aldactone)
Side/Adverse Effects

A

Gynecomastia, amenorrhea, irregular menses, postmenopausal bleeding, hyperkalemia, dizziness, headache

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10
Q

*Thiazide Diuretic

hydrochlorothiazide (HCTZ) Interactions

A

Corticosteroids,
digoxin,
oral hypoglycemics

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11
Q

*Loop Diuretic

furosemide (Lasix) interactions

A

*NSAIDs - nephrotoxic - Increased BUN/Creatinine
*Vancomycin: nephrotoxic!!
Corticosteroids
*Digoxin - Increased levels - risk for toxicity
*Lithium - Increased levels - risk for toxicity
Aminoglycoside antibiotics

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12
Q

Potassium-Sparing Diuretic

spironolactone (Aldactone) interactions

A

ACE Inhibitors, Lithium, NSAIDs

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13
Q

*Thiazide Diuretic - hydrochlorothiazide (HCTZ) & Loop Diuretic
furosemide (Lasix) education

A

Potassium wasting so watch for Hypokalemia symptoms (Alkalosis, Shallow Resp., Irritability, Confuson, Weakness, Arrhythmias, Lethargy, Thready Pulse, Reduced Bowel Sounds

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14
Q

*Potassium-Sparing Diuretic

spironolactone (Aldactone) education

A

*watch for Hyperkalemia (muscle twitching -> cramps -> parasthesia, irritability and anxiety, reduced BP, EKG changes, Dysrhythmias & Irregular Rhythm, Abdominal Cramping, Diarrhea)

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15
Q

older adults & diuretics

A

Start with lower doses and gradually increase - goal is a lowest effective dose
Monitor for s/s of hyperkalemia, hypokalemia, dehydration, o/s hypotension
Change positions slowly
Have alternate methods for urination available (i.e. bedside commode, urinal)

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16
Q

Cardiac Glycoside

digoxin (Lanoxin) indications

A

Systolic heart failure, atrial fibrillation

Action: Positive inotropic, negative chronotropic, negative dromotripic

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17
Q

Cardiac Glycoside
digoxin (Lanoxin)
Contraindications/Precautions

A

Allergy, second or third-degree heart block, ventricular tachycardia or vibrilation, diastolic HF, subaortic stenosis

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18
Q

Cardiac Glycoside
digoxin (Lanoxin)
Side / Adverse Effects

A

Brady/Tachycardia, Hypotension, Headache, fatigue, confusion, convulsions, colored vision, halo vision, anorexia, nausea, vomiting, diarrhea

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19
Q

Cardiac Glycoside

digoxin (Lanoxin) Interactions

A

Amiodarone, quinidine, verapamil, these can increase levels by 50%

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20
Q

Cardiac Glycoside

digoxin (Lanoxin) Admin

A

Low therapeutic index, levels are 0.5-2ng/mL

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21
Q

Cardiac Glycoside
digoxin (Lanoxin)
Interventions / Considerations

A

*Low K+/Mg+ may increase toxicity
*Admin of Digoxicine immune Fab needed for severe toxicity
*Steps to manage Toxicity:
Discontinue, Begin ECG Monitoring & Give antidysrhythmics as ordered, Determine serum digoxin and electrolyte levels, admin K+ supplements for hypokalemia if indicated, institute supportive therapy for GI symptoms (N/V/D), Admin antidote (digoxin immune Fab) if indicated

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22
Q

*digoxin (Lanoxin) s/s toxicity Education

A

Bradycardia, Headache, Dizziness, Confusion, Nausea, Blurred/Yellow Vision

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23
Q

Order of Prescription for HF

A

Order of Prescription - ACE Inhibitors -> ARBs -> Beta Blockers -> Loop Diuretics -> Digoxin

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24
Q

phosphodiesterase inhibitor

*milrinone (Primacor) indications

A

*ICU Setting for acute heart failure

Action: Positive inotropic, causes vasodilation

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25
Q

phosphodiesterase inhibitor

milrinone (Primacor) Contraindications/Precautions

A

Allergy, aortic or pulmn. vasc. disease, diastolic HF

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26
Q

phosphodiesterase inhibitor

milrinone (Primacor) Side / Adverse Effects

A

Vent. dysrhythmia in 12% of patients, angina, hypokalemia, tremor, thrombocytopenia

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27
Q

phosphodiesterase inhibitor

milrinone (Primacor) Interactions

A

Using with diuretics can cause Hypovolemia and reuced cardiac filling
Additive inotropic effects if used with digoxin

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28
Q 
Class 1A (sodium channel blocker)
quinidine (Quinidex) Indications
A

Long term treatment of atrial fibrilation and atrial flutter

Action: Blocks sodium entry into cells, slowing impulse conduction

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29
Q 
Class 1A (sodium channel blocker)
quinidine (Quinidex) Contraindications/Precautions
A

Allergy, severe heart block, severe HF, asthma, myasthenia gravis, low WBCs

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30
Q 
Class 1A (sodium channel blocker)
quinidine (Quinidex) Side / Adverse Effects
A

GI, Hypotension, ventricular dysrhythmias (from toxicity), arterial embolism, cinchonism (tinnitus, visual disturbances, headache, N/V)

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31
Q 
Class 1A (sodium channel blocker)
quinidine (Quinidex) interactions
A

Anticholinergics, antidysrhythmics, cholinergic, antihypertensives, digoxin, grapefruit juice

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32
Q 
Class 1A (sodium channel blocker)
quinidine (Quinidex) interventions/ considerations
A 
Monitor pulse, bp, and GI
Keep patient supine during IV therapy
Monitor ECG periodically with oral and constantly with IV
Monitor toxicity
Use IV Pump!
Monitor s/s of cinchonism
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33
Q 
Class 1C (sodium channel blocker)
flecainide (Tambocor) indicaitons
A

Serious uncontrolled superventricular and ventricular tachydysrhythmias
Long-term for some supraventricular dysrhythmias

Action: Blocks sodium into cardiac cells

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34
Q 
Class 1C (sodium channel blocker)
flecainide (Tambocor) Contraindications/Precautions
A

Allergy, second or third degree AV block, prolonged QT interval, recent MI, shock, electrolyte imbalance

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35
Q

flecainide (Tambocor) Side / Adverse Effects

A

Blurry vision/difficulty focusing
edema in lower extremities
widening or prolongation of QT interval
weight increase

worsening HF, the potential for 1st deg. av block and multple dysrhytmias

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36
Q 
Class 1C (sodium channel blocker)
flecainide (Tambocor) interactions
A

digoxin, beta blockers, calcium channel blockers

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37
Q 
Class 1C (sodium channel blocker)
flecainide (Tambocor) Admin
A

Oral route only - pill

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38
Q 
Class 1C (sodium channel blocker)
flecainide (Tambocor) Interventions / Considerations
A

Montior for visual disturbances/changes in vision
Monitor for crackles in lungs, edema, wt. gain
Periodic ECG monitoring
Monitor blood levels to detect toxicity
Begin with the lowest dose and increase no more than every 4 days

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39
Q 
Class III (potassium channel blocker)
amiodarone (Cordarone, Pacerone) Indications
A

Life-threatening ventricular tachycardia or fibrillation that’s resistant to other drugs
Treats atrial fibrillation

Action: Block potassium channels, decreases automaticity, decreases contractility, dilates coronary and peripheral vessels

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40
Q 
Class III (potassium channel blocker)
amiodarone (Cordarone, Pacerone) Contraindications/Precautions
A

Pregnancy, lactation, allergy, shock, bradycardia, heart block, sinus node dysfunction, severe hepatic disease

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41
Q

*amiodarone (Cordarone)

Side / Adverse Effects

A

GI, pulmonary toxicity, visual, cardiac, blue-grey discoloration of skin, CNS

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42
Q 
Class III (potassium channel blocker)
amiodarone (Cordarone, Pacerone) Administration
A

PO/IV
During IV, monitor cardiac rhythm constantly
IV needs central line to prevent thrombophlebitis

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43
Q

*amiodarone (Cordarone) Interventions / Considerations

A

Monitor GI Symptoms
Baseline and periodic chest x-ray and pulm. function tests - Monitor for cough, dyspnea, difficulty breathing*
Auscultate breath sounds and report changes
Monitor vision or light sensitivity changes
HR/BP
Monitor wt. change, edema, skin discol and CNS effects

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44
Q

*verapamil (Calan) Indications

A
  • Rapid ventricular response to atrial flutter
  • Convert supraventricular tachycardia to regular sinus rhythm
  • slow HR of atrial fibrillation and flutter*

action: Block calcium channels in myocardium, prolong PR interval

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45
Q 
Class IV (calcium channel blocker) 
verapamil (Calan) Contraindications/Precautions
A

Allergy, severe hypotension, cardiogenic shock, liver or kidney dysfunction

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46
Q 
Class IV (calcium channel blocker) 
verapamil (Calan) Side / Adverse Effects
A

Hypotension, bradycardia, HF, peripheral edema of ft/legs, lightheadedness, dizziness

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47
Q 
Class IV (calcium channel blocker) 
verapamil (Calan) Interactions
A

Antihypertensives, lithium, grapefruit juice

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48
Q 
Class IV (calcium channel blocker) 
verapamil (Calan) Administration
A

PO with food

IV - monitor vitals and cardiac rhythm continuously

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49
Q

Antidysrhythmics
Class IV (calcium channel blocker)
verapamil (Calan) Interventions / Considerations

A

Keep pt supine 1h following dose
Monitor BP carefully
Withold dose and notify for: BP < 90mmHg Sys OR pulse <60
Monitor for and report edema, low urine output, crackles in lungs, lightheadedness
Give PO dose with food

50
Q

Unclassified Antidysrhythmic

adenosine (Adenocard) Indications

A

Convert PSVT to sinus rhythm

Action: Slows conduction through AV, <10sec half life

51
Q

Unclassified Antidysrhythmic

adenosine (Adenocard) Contraindications/Precautions

A

Allergy, 2nd or 3rd degree heart block

52
Q

Unclassified Antidysrhythmic

adenosine (Adenocard) Side / Adverse Effects

A

Causes brief period of asystole

All other s/e minimal due to short half life

53
Q

Unclassified Antidysrhythmic

adenosine (Adenocard) Interactions

A

rare

54
Q

*For All Antidysrhythmics

Contraindications/Cautions

A 
* drug Allergy
2nd or 3rd deg AV block
Bundle branch block
Cardiogenic shock
Sick Sinus syndrome
ECG changes based on Cardiologist 
other antidysrhythmics
55
Q

*For All Antidysrhythmics

AE/SE

A 
ALL antidysrhythmics can cause dysrhythmias!
Hypersensitivity reactions
N/V/D
Dizziness
Headache
Blurred Vision
Prolongation of the QT interval
56
Q

*For All Antidysrhythmics

Therapteutic Response

A 
Decreased BP in HTN pts
Decreased Edema
Decreased Fatigue
Regular HR
Improved regularity of rhythm
Improved Cardiac Output
Decreased occurrence of dysrhythmias
57
Q

For All Antidysrhythmics

Assessments (during)

A

Monitor Cardiac Rhythm, HR, BP, general well-being, skin color, temp, heart & lung sounds
Assess plasma drug levels
Monitor for AE & toxic effects

58
Q

For All Antidysrhythmics Assessments (Pre)

A 
Thorough drug&med history
Baseline BP, HR, IO, Cardiac Rhythm
Serum Potassium lvls before starting
Contraindications
Interactions
59
Q

For All Antidysrhythmics Education

A

Take as scheduled
Do not skip or double doses
Contact provider if dose missed
Do not crush/chew sustained-release preps
Notify provider in case of: SOB, Edema, Dizziness, syncope, chest pain, gi distress, blurred vision, edema

60
Q

Nitrate

nitroglycerin (Nitro-Bid, Nitrostat) Indications

A

Treatment and prophylaxis of angina pectoris

61
Q

Nitrate

nitroglycerin (Nitro-Bid, Nitrostat) Contraindications/Precautions

A

Allergy, severe anemia, closed-angle glaucoma, hypotension, severe head injury

62
Q

*Nitrate

nitroglycerin Side / Adverse Effects

A

Severe headaches (at first), orthostatic hypotension, tachycardia, tolerance

63
Q

Nitrate

nitroglycerin (Nitro-Bid, Nitrostat) Interactions

A

Antihypertensives, alcohol, viagra, anticholinergics may decrease absorption of sublingual

64
Q

*nitroglycerin Administration

A

*Sublingual - Tab under the tongue, 5 min, 911 then second tab, 5 min, 3rd tab
Sit or lie after taking first tab
*Sublingual spray - no more than 3 doses in 15 min
*Oral - do not swallow, dissolve
*Patches - prevention only - rotate sites, 10-12 hours a day
*Topical - Gloves, administer by inch
IV - Glass bottle with special tubing. must be protected from heat and light.

65
Q

Nitrate

nitroglycerin (Nitro-Bid, Nitrostat) Interventions / Considerations

A

Avoid touching ointment during application
Monitor baseline orthostatic BP and pulse
Monitor HR
May prescribe beta-blockers or calcium channel blockers to suppress tachycardia
Drug tolerance very fast
Check for interactions esp ED drugs

66
Q

Nitrate

nitroglycerin (Nitro-Bid, Nitrostat) Education

A

Take OTC analgesics to relieve headache pain
Report dizziness or syncope
Change positions slowly
Monitor HR and report Tachycardia
Remove patch each day, never more than one patch at a time

67
Q

*Know proper storage of nitroglycerin tablets:

A

Comes in a glass bottle
Must be protected from heat and light
Should not be left in a room where the temperature is warmer than 86 degrees Fahrenheit

68
Q

*Nitrate

nitroglycerin (Nitro-Bid, Nitrostat) Rapid and long acting

A
  • Rapid acting trats acute angina attacks. SubL/IV

* Long acting for preventions. PO/TD

69
Q

*Anticoagulant

heparin (Heparin Sodium) indications

A

DVT & pulm. embolism prophylaxis, atrial fibrilation with embolization

action: Inhibit clotting factors & prevent dev. of fibrin

70
Q

Anticoagulant

heparin (Heparin Sodium) Contraindications/Precautions

A

Uncontrolled bleeding, severe thrombocytopenia, bleeding, hematoma, anemia

71
Q

*Anticoagulant

heparin (Heparin Sodium) Side / Adverse Effects

A

Thrombocytopenia, heparin-induced thrombocytopenia, bleeding, hematoma, anemia

72
Q

Anticoagulant

heparin (Heparin Sodium) Interactions

A

NSAIDs, aspirin, antiplatelet drugs increase bleeding rist; Herbals: ginger, ginko biloba, feverfew, evening primrose oil; IV nitro reduces anticoag. properties

73
Q

Anticoagulant

heparin (Heparin Sodium) Administration

A 
*Assess baseline vitals & blood values
Goal: aPTT at 1.5-2x baseline
Doublecheck all doses!*
Injection: Subq in abd 2" from umb.
Do not aspirate or massage, apply pressure for 1-2 min., rotate sites
*IV Bolus - immediate effect
*Antidote = IV protamine sulfate
1 mg can reverse 100 units of heparine
74
Q

*Anticoagulant

heparin (Heparin Sodium) Interventions / Considerations

A

Freq. monitor aPTT, doses are adjusted based on the aPTT level, bolus dose admin first
For toxicity/od - stop drug & admin antidote
Toxicity s/s: Hematuria, melena, petechia, eccymosis, gum/mucus membrane bleed.

75
Q

heparin Education

A

Report bruising, petechiae, hematomas, black tarry stools, calf pain, tenderness, swelling, shorness of air

76
Q

Heparin-Induced Thrombocytopenia Info type 1 and 2

A

Type 1: Gradual reduction in platelets, therapy can generally continue

Type 2: Acute fall in number of platelets (more than 50% from baseline, discontinue heparin

77
Q

*Anticoagulants (heparin, enoxaparin, warfarin)

A

Inhibit the action or formation of clotting factors

Prevent clot formation

78
Q

*Antiplatelet drugs (clopidogrel)

A

Inhibit platelet aggregation

Prevent platelet plugs

79
Q

*Thrombolytic drugs (alteplase)

A

Lyse (break down) existing clots

80
Q

Anticoagulant

enoxaparin (Lovenox) indications

A
  • Anticoagulant Bridge Therapy*; Prophylaxis and treatment of DVT/PE
    action: Inhibits clotting factors and prevents clot dev.
81
Q

Lovenox Contraindications/Precautions

A

Allergy, uncontrolled *bleeding, use of an *Alcohol

82
Q

lovenox SE/AE

A

Bleeding, thrombocytopenia, hematoma, anemia

83
Q

lovenox interactions

A

Other anticoags. increase risk for bleeding; NSAIDs, asprin & antiplatelets also increase bleed risk

84
Q

*lovenox Admin

A

Subq in prefilled syringe, do not expel air bubble, one-time use syringe - self adminstering at home. (teach pt)

85
Q

lovenox Interventions / Considerations

A

No labs needed

Monitor for bleeding/bruising

86
Q

Anticoagulant

warfarin (Coumadin) indications

A

Prevention of venous thrombosis and PE; ischemic CVAs secondary to afib, thromboembolism in pts w/ prosthetic heart valves, recurrent MI and TIA

action: Inhibit vitamin K dependent clotting factors

87
Q

warfarin (Coumadin) Contraindications/Precautions

A

Allergy, pregnancy (teratogenic), *uncontrolled bleeding, liver disease, *alcoholism, vitamin k deficiency, clients prepping for lumbar puncture, brain, or spinal surgery

88
Q

warfarin Side / Adverse Effects

A

Bleeding, lethargy, muscle pain, purple toes

89
Q

warfarin interactions

A

Heparin, aspirin, acetaminophen, glucocorticoids, sulfonamides & cephalosporins increase anticoag effects; phenobarbital, carbamazepine, phenytoin & vitamin K decreases anticoag effects; excessive intake of foods high in vitamin K decrease anticoag effects

90
Q

warfarin Admin

A

PO
Measure baseline PT/INR and continue to monitor through therapy
Target INR 2-3, report outside range
Monitor INR every 2-4wk once the dose is correct
Can take 5 days to reach full effects, use heparin or enoxaparin as a bridge

91
Q

warfarin Interventions / Considerations

A

Monitor PT/INR, know normal values and therapeutic ranges
Toxicity: Discontinue warfarin, may take 36-42 hours before liver can resynth enough clotting factors to reverse effects; vitamin K can hasten return, high doses of vitamin K (10mg) given IV will reverese within 6 hrs

92
Q

warfarin education

A

Importance of regular labs, signs of abnormal bleeding, bleed prevention, medical alert bracelet, avoid high vitamin K foods,

93
Q

Antiplatelet

*clopidogrel (Plavix) indicaitons

A
  • Reduce risk for MI, ischemic CVA, angina; prevent reocclusion of coronary stents*
    action: Inhibit platelet aggregation
94
Q 
Antiplatelet
clopidogrel (Plavix) Contraindications/Precautions
A

Peptic ulcer disease, *bleeding disorders, thrombocytopenia, intracranial bleeding, *Alcohol

95
Q 
Antiplatelet
clopidogrel (Plavix) Side / Adverse Effects
A

*Gastric upset, abd. cramping, n/v, diarrhea, small risk for *gastric ulcers and bleeding; risk for TTP > causes clots in small vessels > impairs blood supply to vessels

96
Q 
Antiplatelet
clopidogrel (Plavix) Interactions
A

Anticoagulants, NSAIDs, glucocorticoids, alcohol increase bleed risk; ginger, ginko biloba, feverfew & evening primrose oil increase bleed risk; proton pump inhibitors decrease effectiveness

97
Q 
Antiplatelet
clopidogrel (Plavix) Administration
A

PO once daily w/ or w/o food
Check platelet counts periodically
Stop drug 5-7 days before elective surgery

98
Q

*Antiplatelet

clopidogrel (Plavix) Education

A

Report: gastric irritation, easy bruising/bleeding, sudden severe headache, weakness/numbness/paralysis, vision changes, N/V, seizures
Can take with food, milk or water to minimize GI effects, Avoid alcohol

99
Q

*Thrombolytics

alteplase (Activase) indications

A

DVT, massive PE,
reestablish patency of occluded central iv caths
arterial thrombolysis

actions: Activates fibrinolytic system: bust clots

100
Q

Thrombolytics

alteplase (Activase) Contraindications/Precautions

A

Intracranial hemorrhage, hemorrhagic CVA, known cerebrovascular lesion such as arteriovenous malform. or aneurysm, active internal bleeding, suspected aortic dissection, facial/head trauma w/in 3 mos, brain tumor, pericarditis

101
Q

Thrombolytics

alteplase (Activase) Side / Adverse Effects

A

Internal bleeding (intracranial, GI); superficial (needle puncure sites, wounds)

102
Q

Thrombolytics

alteplase (Activase) Interactions

A

Anticoags, NSAIDs, heparin, warfarin, antiplateletes and other thrombolytics increase bleed risk

103
Q

Thrombolytics

alteplase (Activase) Administration

A

IV infusion - typically given
Give w/in 4-6 hours of symptoms or 3-4.5 hours of CVA symptoms
Assess baseline clotting and vitals
Ensure IV access for emergency drugs
Following ateplase, give heparin or aspirin to avoid re-thrombosis

also used to reverse the s/s of an ischemic CVA (stroke) with 3 hrs of the onset of stroke s/s for max effectiveness

104
Q

alteplase (Activase) education

A

Report unusual, prolonged bleeding, unilateral weakness, headache, dizziness

105
Q
  • Anticoug (warfarin)

* normal therapeutic ranges of PT/INR

A

PT Normal Levels: 11-13 seconds
PT Therapeutic Levels: target is about 1.5 times the normal value or about 18 seconds
INR Normal Levels: 1.1 or below
INR Therapeutic Levels: 2.0-3.0 with average of 2.5
For those with recurring clots 2.5-3.5 with an average of 3.0

106
Q

what is one s/s of ALL anticoagulants to report!!

A

excessive bleeding

107
Q

HMC-CoA Reductase Inhibitor statin

*atorvastatin (Lipitor) Indications

A

Elevated blood cholesterol
Elevated triglycerides
hyperlipidemia - 1st therapy,
signs of atherosclerotic cardiovascular disease

108
Q

*atorvastatin Contraindications/Precautions

A

Allergy, pregnancy, liver disease, elevated liver enzymes, children <8

109
Q

*atorvastatin Side / Adverse Effects

A

Myopathy (muscle pain, aches),
if left untreated (rhabdomyolysis) -kidney failure hepatotoxicity - dark red or cola-colored urine

GI, headache, rash, dizziness, blurred vision, fatigue, insomnia,

110
Q

atorvastatin Administration

A

PO, in evening w/ or w/o food

111
Q

*atorvastatin Education

A

*This drug can commonly cause muscle aches and pains (myopathy) - report immediately. - discontinue statin therapy

Grapefruit juice increases the risk for drug toxicity. Frequent evaluation of liver function tests (LFT’s) will need to be completed during drug therapy
Any onset of muscle pain/soreness, changes in urine color, fever, or malaise should be reported immediately!
may take 6-8 weeks to reach max therapeutic outcome.*

*patients with end stage liver disease should not take antilipemics, such as atorvastatin

112
Q

Fibrate

gemfibrozil (Lopid) indications

A

Treatment of Type III, IV & V hyperlipidemia; reduce high levels of plasma triglycerides & increase HDL cholestorl

action: Activate lipoprotein lipase, breaking down cholestorl

113
Q

Fibrate

gemfibrozil Contraindications/Precautions

A

Allergy, severe liver/kidney disease, cirrhosis, gallbladder disease

114
Q

*gemfibrozil Side / Adverse Effects

A
  • GI discomfort, N/V/D,

* increase risk for gallstone so avoid fatty foods* dev; liver toxicity; myopathy

115
Q

gemfibrozil Interactions

A

Warfarin increases risk for bleeding; statn and fibrate increases myopathy risk

116
Q

gemfibrozil Administration

A

PO twice daily before bfast and evening meal

117
Q

*gemfibrozil Education

A

Patients may not begin therapy with antilipemic until 6 months of attempting lifestyle changes!

118
Q

Antilipemic Interventions

A

Monitor and teach to report AE/SE: s/s liver dys (increased liver enzymes, yellow discorloration of skin or sclera, dark urine or pale stool, fatigue, N/V, anorexia, excessive brusiing, pruritus), muscle or joint pain, abd. pain, fatigue

119
Q

Antilipemic Education

A

Lifestyle&Diet changes, how to admin; liver function labs; monitor chol and triglyceride levels

120
Q

*Coagulation modifiers contraindications

A

Bleeding
Alcohol especially w/ clopidogrel (plavix) and enoxaparin (lovenox)
Elevated lab levels PT/INR

Pharm 2 (3 decks)

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