Pharm Exam 1 Flashcards
Hypokalemia symptoms/abnormalities
Gi upset (ileus), dysrhythmias (depressed STs, gives us U-waves)
Hyperkalemia symptoms/abnormalities
dysrhythmias, elevated T waves
Hypermagnesemia symptoms/abnormalities
hyporeflexia, dec DTRs, depressed respiratory rate, muscle weakness, hypotension
Hypomagnesemia symptoms/abnormalities
seizures, hyperreflexia
Special considerations when given potassium via IV route:
- DO NOT PUSH
- Dilute
the fastest route of administration?
IV
the slowest route of medical administration
oral
Where to inject an IM injection
big large muscle groups
what not to do with sublingual
don’t swallow it
Subq administration?
rotate sites, 45 vs 90 degrees
Isotonic: Saline 0.9%: purpose and effects
for fluid resuscitation, stays in the vascular; can also give lactated ringers
Hypotonic: D5W: purpose and effects
(drops sodium level), 0.45% NaCl (fluid goes into tissue cells)
Hypertonic: 3% Saline
inc. sodium level very rapidly, pulling from cells into vascular space (fluid out of cells)
best drugs for hypertension during pregnancy aka preclampsia (in order)
magnesium first
then Labetalol
what is the “ideal drug”
effective, safe, selective
When to give a patient grapefruit juice?
NEVER! DON’T BE DUMB
it contradicts and messes up so many meds, better safe than sorry
What is the MONA acronym used for?
Goal for treating a heart attack
what does MONA stand for?
M – morphine (pain med)
O – oxygen (if needed)
N – Nitro (affects pre-load, so don’t give to r-side, it’ll open up vessels and reduce pre-load)
A – Aspirin (antiplatelet)
4 steps if you give the patient the wrong med
- Assess! (make sure they’re not dead)
- Call the provider
- Document VS and that patient is OK
- Make sure you call the pharmacy team and ask them what I should watch for – “Are any of their current medications going to interact with what I just accidentally gave them?”
6 patient rights:
right patient. …
right medication. …
indication for use. …
right dose. …
right time. …
right route.
which category of drug do you not give to a pregnant woman?
category X
which category of drug is safe and good to give a pregnant woman?
category A- yay folic acid
what to do before prescribing a woman a medication
have them take a pregnancy test! doesn’t matter what they say about their sexual history
best way to ensure patient compliance
- only a once-a-day medication
- combination drugs
difference between schedule 1 and 2 drugs
schedule 1 is not prescribed or used for medical use
schedule 2 is used for medicine
what is ROME?
respiratory opposite metabolic equal
what ABG is needed for metabolic acidosis?
PH low
HCO3 low
what ABG is needed for metabolic alkalosis
PH high
HCO3 high
what ABG is needed for respiratory acidosis
PH low
PCO2 high
what ABG is needed for respiratory alkalosis
PH high
PCO2 low
normal PH range
7.35-7.45
normal CO2 range
35-45
normal HCO3 range
22-26
where does excretion primarily happen?
kidneys
what should we do with a dose if someone has renal injury/failure
lower the dose
medication consideration when a mother is breastfeeding
excretion can happen in breast milk too. Make sure it’s safe for both mom AND baby
what is the first-pass effect?
a phenomenon where medication metabolizes and becomes less strong
which medications have a first-pass effect
oral meds- metabolize in GI
what is a loading dose?
giving patients more than possible necessary to hit the therapeutic range faster
what do we do after a loading dose?
once in the therapeutic range, then we drop the dose down
agonist vs antagonist drug
- Agonist: stimulates
- Antagonist: blocks
what is nitro used for?
angina aka during heart attack
who shouldn’t get nitro and why
people on viagra, their BP will drop
purpose of ACE inhibitors
lower BP
ACE inhibitors have unintended side effects
- Unintended: angioedema (will kill you)*, cough
*stridor and inability to control secretions
BEERS criteria
-used for geriatric patients
-list of potentially dangerous medications considering the patient
what to do if the patient fits the BEERS criteria
- Monitor them closely (don’t take them off just because u want to; not necessarily recommended, but its better for THEM)
Digoxin what are the nursing interventions
Monitor apical pulse for a full min (must be above 60)
PMI – 5th ICS MCL
what is digoxin used for
myocardial infarction
Which medications are options for ventricular rhythms
Ventricular: Lidocaine and amnio
Which medications are options for atrial rhythms
Atrial: calcium channel blockers and beta blockers
Ezetimibe
-2nd line drug for cholesterol management
-Used for patients w/ myopathies they have really bad muscle cramps)
how to dose for pediatrics
BSA body surface area
how to dose for geriatrics
lowest dose w/ greatest effect
what are diuretics used for
used for patients with fluid excess
Statins – who should be on them? Who should not be prescribed a statin?
For high cholesterol (high LDL); pregnant people shout NOT be on statins
Adenosine – expected findings and use
- Asystole: blocks cardiac conduction for 10 seconds
- Used for SVT (supraventricular tachycardia)
heart stoppy med
Side effects of centrally acting Alpha2 (Clonidine)
- Reflex HTN
- Benefit of med: its oral! (so cool)
Calcium channel blockers which ones are mainly used for lower blood pressure peripherally versus controlling the heart rate?
- Verapomil and Cardiziam
which one is which???
- Blood pressure meds usually end with what spelling
: end in -pine
(ex. Amlodipine; good for BP management on patients w/ bad kidneys)
Diuretics – potassium sparing versus non potassium sparing
- Potassium sparing: spironolactone (NOT. FOR. RENAL. FAILURE)
- Non sparing: Lasix (monitor; AE: ototoxicity) and hydrochlorothiazide
Beta blocker usage – which medications are cardio versus non cardio selective? Why would one be favored over the other?
Nonselective: Propanolol (watch for b2 antagonist bronchoconstriction).
selective: Metoprolol, Carvedilol (best for BP; acts on alpha)
HR is expected to decrease w/ beta blockers
