Pharm Exam 1 Flashcards
1
Q
Vassopressor Indications
A
Sub q: added to local anesthetics
Intra-muscular: anaphylaxis
Inhaled: asthma (non routine)
Intravenous: push for asystole in Advanced Cardiac Life Support, titratable drips - used for shock, hypotension, bradycardia
2
Q
Vassopressor MOA
A
Binds non-specifically to all Alpha and Beta receptors
3
Q
Vassopressor Adverse Effects
A
Vesicant - harms tissue around veins
Tachycardia
Vasoconstriction- hypertension, lack of blood supply to extremities
4
Q
Vassopressor nursing implications
A
Monitor that IV stays in vein
Antidote - phentolamine
Monitor hr, EKG, BP(IV route)
Monitor extremities
5
Q
Vassopressor contra-indications
A
None if needed for life support
Tachycardia, hypertension, narrow angle glaucoma
6
Q
Vassopressors
A
Epinephrine (EpiPen)
Norepinephrine (levophed)
Dopamine
Phenylephrine (neosynephrine)
7
Q
Selective beta-1 blockers
A
A-M, “Lol” except carvedilol, Labetelol, Atenolol, bisoprolol
Metoprolol
8
Q
Selective beta-1 blockers therapeutic use
A
Cardiac related:
Heart dysrhythmia, MI, compensated heart failure, hypertension, symptoms of hyperthyroidism/thyroid storm
Non-cardiac:
Anxiety, eye drops, glaucoma (IOP)
9
Q
Selective beta-1 blockers MOA
A
Antagonist, Block beta-1 receptors primarily in the heart but also the eyes
10
Q
Selective Beta-1 Blockers Adverse Effects
A
BLACK BOX WARNING: DONT STOP SUDDENLY, MAY INCREASE RISK FOR MI
Cardiac: bradycardia, hypotension, heart failure exacerbation (fluid retention), dizziness (change positions slowly)
Non-cardiac: sexual dysfunction/impotence, mood-depression, insomnia, decreased libido, may mask s/s of hypoglycemia - diabetes patients must be careful
11
Q
Selective Beta-1 Blockers Client Safety Teaching and Administration
A
Asses BP, hold if <90/60
Asses HR, hold if <60
Don’t stop taking suddenly
May cause orthostatic hypotension and dizziness, change positions slowly
May block signs of hypoglycemia in diabetics, test glucose
Patients with heart failure should weigh daily, if they gain >5 lbs in a week or 2 lbs in a day they may be retaining fluid meaning their heart failure is now uncompensated= call provider
12
Q
Selective Beta-1 Blockers Nursing Considerations
A
Assess, monitor, evaluate HR and BP
Daily weight checks in heart failure patients
13
Q
Selective Beta-1 Blockers Contra-indications
A
Bradycardia, hypotension, heart block, uncompensated heart failure
14
Q
Non-selective Beta Blockers
A
N-Z “lol” plus carvedilol, propranolol, Labetelol, timolol,
15
Q
Non-selective Beta Blockers Indications
A
Cardiac:
Heart dysrhythmias, myocardial infarction, compensated heart failure, hypertension, symptoms of hyperthyroidism, thyroid storm
Non-cardiac:
Anxiety, eye drops = glaucoma
Carvedilol equals cardiac, propranolol equals professionals, labetalol equals labor, timolol equals Timmy’s glaucoma
16
Q
Non-selective beta blockers MOA
A
All block beta 1 receptors
Some may block beta 2 like propanolol carvedilol and labetolol
Some may block alpha 1 like carvedilol and Labetolol
Some may release nitric oxide like nebivolol
17
Q
Nonselective beta blockers adverse effects
A
BLACK BOX WARNING: NEVER STOP SUDDENLY SUDDEN STOPPAGE CAN INCREASE AND RISK FOR MYOCARDIAL INFARCTION ESPECIALLY FOR THOSE USING FOR CARDIAC CONDITIONS
Cardiac:
Bradycardia, hypotension, heart failure exacerbation fluid retention, dizziness - change positions in bed slowly
Non cardiac
Sexual dysfunctional impotence, mood- depression, insomnia, decreased sexual libido, May mask signs and symptoms of hypoglycemia and diabetic patients.
18
Q
Non selective beta blockers client safety teaching administration
A
Assess blood pressure hold if below 90/60
Assess heart rate hold it below 60
Do not take do not stop taking suddenly especially for adverse effects like sexual dysfunction skip a dose if heart rate or BP are low but not indefinitely without notifying provider
Any medication that lowers blood pressure may cause orthostatic hypotension dizziness change position slowly
Educate patients with diabetes that they cannot rely on usual signs and symptoms of hypoglycemia need to rely on glucose checks
Heart failure patients should weigh daily if gain more than 5 lb in one week or 2 lb in one day call provider might be in heart failure on compensated
19
Q
nonselective beta blockers Nursing considerations and implications
A
Assess monitor and evaluate heart rate and blood pressure, daily weight checks for heart failure patients
20
Q
Non selective beta blockers contract indications
A
Special - asthma and COPD (beta 2 affects heart), bradycardia, hypotension, heart block, uncompensated heart failure
21
Q
Alpha-1 blockers
A
“sin”
Tamulosin, prazosin, terazosin, silodosin, doxazosin
22
Q
Alpha-1 blockers indications
A
Benign pratostatic hydroplasia, urinary retention, bladder obstruction kidney stones, hypertension - rare
23
Q
Alpha-1 blockers moa
A
Prevent activation of A1 receptors throughout the body. Some drugs selectively only work in certain areas of the body.
Alpha 1 receptors are found in vascular smooth muscle arteries
Alpha 1 receptors are found in the smooth muscle of the bladder and prostate
24
Q
Alpha-1 blockers adverse effects
A
First dose phenomenon - orthostatics/postural hypertension, hypotension, reflex tachycardia, sexual dysfunction decreased libido and impotence
25
Alpha-1 blockers nursing considerations
Assess monitor and evaluate blood pressure, assess urine output for relief of benign pratostatic hyperplasia
26
Alpha - 1 blockers contraindications
Priapism, floppy Iris syndrome
27
Serotonin agonists
Sumatriptan
28
Serotonin agonists indications
Migraines acute not daily use
29
Serotonin agonists moa
Vasoconstriction on cranial arteries
30
Serotonin agonist adverse effects
Chest pain, increase heart rate and blood pressure, CNS depression - dizzy asthenia drowsy dose dependent
31
Serotonin agonist client safety teaching administration
Administered at onset of migraine symptoms - one oral tablet readministered every 2 hours, one spray in one nostril-readminister after 1 hours, subcutaneous injection - re-administer after 1
Max of two doses per day max of 10 doses per month
may experience tingling flushing congestion in the chest
32
serotonin agonist Nursing considerations and implications
Serotonin syndrome - interacts with ergots ssris and mais
Monitor headache severity bphr and chest pain
33
Serotonin agonist contraindications
Heart disease, uncontrolled hypertension, pregnancy - teratogenic
34
Allopurinol indications
Chronic gout, tumor license syndrome, tophi
35
Allopurinol moa
Xanthine oxidase inhibitor
Decrease uric acid production by conversion to active metabolite
Prodrug
36
Allopurinol adverse effects
Steven Johnson syndrome, hepadoxicity, rebound gout attack
37
Allopurinol client safety teaching and administration
Take after a meal, drink lots of fluid, watch for signs of sjs, do not discontinue abruptly
38
Allopurinol nursing considerations
Monitor uric acid, hydration, GI or urinary bleeding, hepatotoxicity
39
Allopurinol contraindications
Hypersensitivity- hla-b * 5801 positive patience
40
Colchicine indication
Acute gout attack
41
Colchicine moa
Reduces inflammatory response to urate crystals by inhibiting chemotaxis
42
Colchicine adverse effects
GI symptoms nausea and vomiting, lump in throat sensation, rhabdomyolysis- muscle breakdown that can harm the heart and kidneys, Myelosuppression - harms bone marrow and makes blood cell formation stop
43
Colchicine client safety teaching and administration
Per oral on empty stomach with lots of fluids, take with food if GI symptoms, avoid grape juice
44
Colchicine nursing considerations
Monitor uric acid renal and hepatic function and complete blood cell count
45
Colchicine contraindications
Hyper sensitivity, severe renal and hepatic disorder, blood count issues, pregnancy
46
Direct acting cholenergic
Bethanechol, pilocarpine
47
Bethanechol indications
Urinary retention neurogenic bladder difficulty voiding
48
Bethanechol moa
Increases cholinergic activity by stimulating muscarinic receptors primarily those found in the bladder and GI tract
49
Bethanechol adverse effects
Sludgem and the killer bees
Increased salivation gastric secretion, abdominal cramps and diarrhea, bronco constriction
Extremely rare - hypotension and or bradycardia
50
Bethanechol client safety teaching and administration
GI motility, recommended to administer 1 hour before or 2 hours after meals to prevent vomiting up food
Dizziness and fall risk recommend change positions slowly, report any issues with bradycardia or hypotension, look for signs of cholinergic crisis-sludgem
51
Bethanechol nursing considerations and implications
Monitor heart rate and blood pressure, monitor urine output - patients should urinate 60 minutes after taking, monitor for cholinergic crisis - antidote is atropine
52
Bethanechol contraindications
Bradycardia, hypotension, asthma, peptic ulcer disease
53
Pilocarpine indications
Xerostomia systemic, eyeI drops glaucoma
54
Pilocarpine moa
Agonist of cholinergic muscarinic receptors, causes increased secretions - sweating salivation and GI tract,
eye= causes meiosis, decreases intraocular pressure
55
Pilocarpine adverse effects
Sludge m and the killer bees
Increased salivation, gastric secretion, abdominal cramps and diarrhea, bronco constriction
Cholinergic crisis
Rare - hypotension and or bradycardia
56
Pilocarpine administration client safety and teaching
Dizziness and fall risk change positions slowly, cardiac problems such as bradycardia and hypotension, cholinergic crisis symptoms
57
Pilocarpine nursing considerations
Assess and monitor heart rate and blood pressure, assessment monitor salivation and interocular pressure, monitor for cholinergic crisis - antidote atropine
58
Pilocarpine contraindications
Bradycardia, hypotension, asthma, does not include peptic ulcer disease but still affects the GI tract
59
Indirect acting cholinergics
Paretastigmine neostigmine physiostigmine Rivastigmine and donepezil
60
Indirect acting cholinergics indications
Pyridostigmine - myasthenia gravis, recovery of muscle strength
Others - alzheimer's, reversing anticholinergic effects, reversing neuromuscular blocking agents, pretreatment for exposure to nerve gas
61
Indirect acting cholinergics moa
Inhibits acetylcholinesterase, pyrido stigmine works at the neuromuscular junction, rivastigmine works in the central nervous system and is used for Alzheimer's
62
Indirect acting cholinergics adverse effects
Sludge m and the killer bees
Increased salvation gastric secretion abdominal cramps and diarrhea bronco constriction hypotension Android
63
Indirect acting cholineergics nursing considerations
Monitor heart rate and blood pressure especially if given IV, patient should have improved muscular strength, monitor for cholinergic crisis - antidote's atropine
64
Indirect acting cholinergics contraindications
Black box warning bradycardia, hypotension, asthma, peptic ulcer s disease not listed but still affects GI
65
Atropine indications
Drops - reduce elevation and secretions for palliative care
Systemic or IV - symptomatic bradycardia, cholinergic crisis antidote
66
Atropine moa
Antagonist at various muscarinic receptors in the parasitic division of the body particularly the heart , this allows the sympathetic division to take control
67
Atropine adverse effects
Can't see can't pee can't spit can't s*** can't switch
Mydriasis and blurred vision, urinary retention and hesitation, zerostomia, constipation, hypohidrosis
Anticholinergic tox syndrome may cause patients to flush due to overheating from lack of sweating
68
Atropine nursing considerations
Monitor heart rate and blood pressure, be careful insensitive populations like older adults and outdoor workers
69
Atropine contraindications
Glaucoma because it increases ocular pressure, benign protostatic hyperplasia because of urinary retention
70
Anticholinergics for overactive bladder
Oxybutynin solifenacin tolterodine
71
Anticholinergics for overactive bladder indications
Used for overactive bladder or urinary incontinence
72
Anticholinergics for overactive bladder moa
Antagonist at various muscarinic receptors in the parasympathetic division of the body
73
Anticholinergics for overactive bladder adverse effects
Can't see can't pee can't spit can't s*** can't schvitz
My drynesses, dry eyes, blurred vision, urinary retention and hesitation, zero stormia, constipation, hypohidrosis
Anti-collinergic toxodrome patients will flush due to overheating from lack of sweating
74
Anticholinergic for overactive bladder administration
Protect ice from sunlight, notify provider if difficulty voiding, chewing sugar-free gum, fluid fiber and frequency exercise, stay hydrated and avoid hot weather sauna extreme exercises etc
75
Anticholinergics for overactive bladder contraindications
Glaucoma, benign prosthetic hyperplasia Plus urinary retention
76
Anticholinergics for overactive bladder nursing considerations
Be careful insensitive populations like older adults and outdoor workers, monitor patient intake and I'll take watch for urinary retention and bladder distention
77
Neuromuscular blockers
Succinylcholine, vecuronium
78
Neuromuscular blockers indications
Paralyzing agent for intubation, causes respiratory arrest patient must be ventilated
79
Neuromuscular blockers moa
Antagonist at The nicotinic receptors at the nmj
80
Neuromuscular blockers adverse effects
Skeletal muscle paralysis including respiratory muscles, malignant hyperthermia
FDA boxed warning - only adequately trained individuals should use
81
Neuromuscular blocker client safety training and administration
Give only if artificial inventilation is available patient cannot breathe on their own, give only if patient is appropriately sedated
82
Neuromuscular blockers nursing considerations
Only paralyzes, patient could still be awake so co-administer with sedative, monitor for signs of malignant hyperthermia - management is dantrolene
83
Neuromuscular blockers contraindications
History of malignant hyperthermia
84
Docusate sodium indications
Stool softener, used for constipation, sometimes used for ear wax removal
85
Docusate sodium moa
Reduces surface tension of the oil water interface of the stool resulting in enhanced in corporation of water and fat allowing for stool softening, does not cause patients to defecate just soften stool to allow for easier
MUSH
86
Docusate sodium adverse effects
Do not use with bowel obstruction, diarrhea, electrolyte loss
87
Docusate sodium client safety teaching and administration
Recommend the three f's fluid fiber and frequent exercise, each patient's bowel routine is different some may only go once every 3 days some may go many times a day something is not necessarily wrong if not daily
Encourage hydration one cup of water with medication
Not particularly effective when compared to placebo
88
Docusate sodium nursing considerations
Least likely to cause fluid and electrolyte loss
89
Docusate sodium contraindications
Bowel obstruction can cause bowel perforation
90
Fiber laxatives
Psyllium and methylcellulose
91
Fiber laxatives indications
Chronic constipation- only laxative used long-term
92
Fiber laxatives moa
Psyllium is a soluble fiber it absorbs water in the intestines to form a viscous liquid which promotes peristalsis and reduces Transit time
93
Fiber laxatives adverse effects
Avoiding bowel obstruction can cause perforation, diarrhea, electrolyte loss
94
Fiberlaxatives client safety teaching and administration
Follow the apps fluid fiber and frequent exercise, each patient has their own bowel routine, encourage hydration
95
Fiberlaxatives nursing considerations
Least likely to cause fluid and electrolyte loss
96
Fiber laxatives contraindications
Bowel obstruction can cause bowel perforation
97
Polyethylene glycol-3350 indications
Constipation including opioid induced constipation, bowel prep for procedure like colonoscopy
98
Polyethylene glycol-3350- moa
Osmotic laxative causes water retention in stool increases stool frequency
99
Propylene glycol 3350 adverse effects
Avoid bowel destruction, diarrhea, electrolyte loss - strong laxative
100
Polyethylene glycol - 3350 client safety teaching and administration
Follow f's fluid fiber and frequent exercise, patients have their own normal bowel routine, encourage hydration, if using for bowel prep add Golytely to a 1 gallon jug and finish entire bottle
101
Polyethylene glycol-3350 nursing considerations
Opioid induce constipation laxative, assess for dehydration and electrolyte loss
102
Polyethylene glycol 3350 contraindications
Bowel obstruction can cause bowel perforation
103
Lactulose indications
Constipation and hepatic encephalopathy
104
Lactulose moa
Osmotic laxative, convert NH3 to nh4 Plus keeping it in the gut and producing an osmotic effect in the colon promoting peristalsis
105
Lactulose adverse effects
Avoiding bowel obstruction, diarrhea, electrolyte imbalances
106
Lactulose client safety teaching administration
Follow the fluid fiber and frequent exercise, each patient has their own normal bowel routine, if used for hepatic encephalopathy do not miss a dose missing a dose could result in buildup of ammonia levels leading back to hepatic encephalopathy, encourage hydration
107
Lactulose considerations for nursing
Ammonia levels should be lower to a normal level, assess for dehydration and electrolyte loss
108
Lactulose contraindications
Bowel obstruction
109
Magnesium hydroxide and citrate laxative indications
Heartburn and constipation
110
Magnesium hydroxide and citrate moa
Osmotic retention of fluid distends the colon and increases peristaltic activity
111
Magnesium hydroxide and magnesium citrate laxative adverse effects
Avoid and bowel obstruction, diarrhea, electrolyte loss - strong laxative
112
Magnesium hydroxide and magnesium citrate client safety teaching and administration
Follow the apps, patients have their own bowel routine, encourage hydration
113
Magnesium hydroxide and magnesium citrate laxative nursing considerations
Be aware of renal impairment - magnesium can accumulate, evaluate for dehydration and electrolyte depletion
114
Magnesium hydroxide and magnesium citrate laxatives contraindications
Bowel obstruction
115
Stimulant laxatives
Senna and biscodyl
116
Stimulant laxatives indication
Constipation including opioid induced constipation
bowel prep for procedures like colonoscopy
117
Stimulant laxatives moa
Induced navigation by stimulating peristaltic activity by direct action on intestinal mucosa or nerve plexuses
increases motility
118
Stimulant laxatives adverse effects
Avoid and bowel obstruction, diarrhea, electrolyte loss - strong laxative
119
Stimulant laxatives client safety teaching and administration
3f's, patients have their own normal bowel routine, do not crush bisacodyl it has enteric coating, Senna should be taken alone do not take with other medications within 1 hr
120
Stimulant laxatives nursing considerations
Can be used for opioid induced constipation, oral stimulants can take 6 to 12 plus hours to work, rectal suppositories will work within 30 minutes, assess for dehydration and electrolyte loss
121
Stimulant laxatives contraindications
Bowel obstruction
122
Morphine related opioids
Codeine, hydromorphone, hydrocodone, oxycodone
123
Morphine related opioids indications
Moderate to severe pain, not mild, cough/antitussive- prescription only
124
Morphine related opioids moa
Agonist at Mu and kappa opioid receptors
125
Morphine related opioids adverse effects
MORPHINE
126
Morphine related opioids client safety teaching and administration
Keep medication secured and locked, most are scheduled to substances, never share, take with food to reduce nausea, change positions slowly dizziness risk, patience should urinate, keep track of bowel movements and be proactive and preventing constipation, don't drive or operate machinery, don't mix with bees and z drugs
127
Morphine related opioids nursing considerations
Monitor bladder look for retention distention might need to cast plus bowels look for distention, acutely assess vital signs, blood pressure hold for hypotension, heart rate hold for bradycardia, respiratory rate hold for Brady penia under 12 breaths per minute, oxygen saturation hold if under 90%, pain score give only If For above, mental / sedation status hold it overly sedated
128
Morphine related opioids contraindications
Breastfeeding, Biloary colic, elevated entercrainial pressure
129
Tramadol indications
Moderate and or severe pain not mild, some prescribers do use for mild pain as it's not a true opioid
130
Tramadol moa
Binds to opioid receptors and increases serotonin and norepinephrine in the nociceptive pathway, different from other opioids because it increases serotonin
131
Tramadol adverse effects
M o r p h i n e, seizures, serotonin syndrome
132
Tramadol client safety teaching and administration
Keep locked up, never share, take with food, change position slowly, urinate and keep track of bowel movements, don't operate machinery, b and z drugs
133
Tramadol nursing considerations
Monitor and evaluate bladder and bowels for retention and distension may need to cast, hold for hypotension bradycardia Bradypnea oxygen saturation under 90% or overly sedated
134
Tramadol contraindications
Breast affiliating biliary colic and elevated entertainial pressure, caution if history of seizures not contraindicated
135
Meperidine indications
Post-operative shivering, moderate to severe pain not mild
136
Meperidine moa
Binds to opioid receptors as an agonist
137
Meperidine adverse effects
M O R P H I N E, seizures, serotonin syndrome
138
Meperidine administration
Keep secure and locked up, never share, take with food, change positions slowly, urinate, bowel movements, don't drive, don't mix with bnz
139
Meperidine nursing considerations
Assess bladder and bowels for retention and distension, assess vital signs hold for hypotension bradycardia Brady pnea oxygen saturation under 90% check paying score and mental / sedation status
140
Meperidine contraindications
Breastfeeding, biliary colic, elevated intracranial pressure, history of seizures caution not contraindicated
141
Methadone indications
Moderator severe pain, especially you substance use disorders example heroin
142
Methadone moa
Binds to opioid receptors as agonist
143
Methadone adverse effects
M O R P H I N E, QT prolongation - cardiac dysrhythmia risk
144
Methadone client safety teaching and administration
Keep locked up, never share, take with food, dizziness, urinate, keep track of bowels, don't drive machinery, no b and z drugs
145
Methadone nursing considerations
Check bladder and bowels for distension and retention, hold for hypotension bradycardia Brady pnea under 90% oxygen saturation low-pain score or overly sedated,
check EKG for QT
146
Methadone contraindications
Breastfeeding, biliary colic, elevated intracranial pressure
147
Fentanyl indications
Moderate to severe pain
148
Fentanyl moa
Opioid receptor agonist
149
Aspirin indications
Prevent or treat myocardial infarction, mild pain fever and inflammation, kawasaki disease pediatrics
150
Aspirin moa
Preventsynthesis and release of prostaglandins by interrupting the cyclooxygenase pathway - cocks one and Cox 2
Irreversible platelet effect
151
Aspirin adverse effects
BLACK BOX WARNING INCREASED RISK FOR BLEEDING AN GI ULCERS
Asthma, salicylism poisoning, premature closing of pda, platelet desegregation, peptical to disease, intestinal bleeding, reye's syndrome, idiosyncratic reaction, ringing in the ears, wrinkle impairment, rapid breathing, noise - tinnitus, nephropathy
152
Aspirin client safety training teaching and administration
Separate at least 1 hour from other NSAIDs - low affinity, take with food Plus enteric coated to reuse reduce GI upset - don't crush, report any adverse effects - tinnitus rapid breathing nausea and vomiting, do not self-medicate with NSAIDs if taking other blood thinners
153
Aspirin nursing implications.
Avoiding children except for Kawasaki disease, recognize signs and symptoms of salicylate toxicity or salicylicism, watch out for GI harm review administration tips
154
Reversible NSAIDs
Ibuprofen naproxen caterolac indomethacin diclofena ciloxib
155
Reversible instead indications
My variety of pain, mild pain, fever, inflammatory conditions
156
Reversible NSAIDs moa
Reversible, first gen dash presents synthesis and release of prostaglandins by interrupting the Cox I and Cox II pathway,
CELOXCIB second gen dash prevents synthesis and release of prostaglandins by interrupting just Cox II
157
Reversible NSAIDs adverse effects
BLACK BOX WARNING - INCREASE RISK FOR BLEEDING AND GI ULCERS
BLACK BOX WARNING - INCREASED RISK FOR CARDIO THROMBOTIC EVENTS
Vasoconstriction increases blood pressure and chance for myocardial infarction or stroke, tinnitus, decreased blood flow to kidneys salt water retention acute kidney injury
158
Reversible NSAIDs client safety teaching and administration
Take with food plus enteric coated if available to reduce GI upset don't crush, report any adverse effects like tinnitus GI pain decreased urine output, don't self medicate with NSAIDs if taking blood thinners like warfarin or heparin, in case of caterolac usage is 5-day Max in a row
159
Reversible NSAIDs nursing considerations
Monitor kidney function blood pressure, celoxib has a sulfa group do not give if patient has a sulfa allergy
160
Reversible NSAIDs contraindications
Avoid in heart failure kidney disease and kidney injuries GI ulcers PUD can't increase BP not ideal for people with hypertension or history of myocardial infection
161
Acetaminophen indications
My pain or fever no anti-inflammatory action
162
Acetaminophen moa
Weak prostaglandin synthesis inhibition in the CNS also works on heat regulating center of the brain hypothalamus pain and fever reduction not an anti-inflammatory
163
Acetaminophen adverse effects
BLACK BOX WARNING - HEPAT TOXICITY INCLUDING LIVER FAILURE AND DEATH
164
Acetaminophen client safety teaching and administration
Max single dose is 1000 mg in a 6-hour window lower if low body weight, older adult recommended Max is 3 g per day general Max fourth grams per day, FDA encourages 3 g per day, no alcohol - Max is 2,000 mg per day if alcohol consumption, lots of other products contain acetaminophen other than Tylenol
165
Acetaminophen nursing considerations and implications
Watch for single dose and 24-hour dose limit, if suspected overdose evaluate signs and symptoms liver labs and timing is crucial, antidote is acetylcysteine
166
Acetaminophen contraindications
Liver disease
167
Herbal pain Management
Feverfew, glucosamine
168
Herbal pain Management indications
Glucosamine for joint health, feverfew for variety of anti-inflammatory conditions
169
Herbal for pain management adverse effects
Possible inhibition of platelet aggregation
170
Herbal for pain management client safety teaching and
Notify provider if taking any herbals
171
Herbal for pain management nursing considerations and implications
Notify provider if taking herbals can have increased risk of bleeding if taking fgs herbals and on blood thinners
172
Herbal for pain management contraindications
Don't combine with anticoagulants anti platelets
173
Muscle relaxants indications
Spasticity-baclofen dantroline
Spasm - cyclobenzaprine
Malignant hyperthermia - dantroline
174
Muscle relaxants moa
Work directly on brain or skeletal muscle
175
Muscle relaxants adverse
Dizziness sedation drowsiness fatigue, can be developed to dependence intolerance, if taken chronically must take her off, bnz rule, baclofen and cyclobenzaprine have gi anticolinergic properties dry mouth constipation
176
Muscle relaxants client safety teaching administration
Don't operate in every machinery, don't mix with other CNS depressants, it taking chronically do not stop suddenly can cause withdrawal including seizures
177
Muscle relaxants nursing considerations and implications
monitor for anticholinergic effects, monitor for appropriate use in CNS sedation
