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NCLEX Pharm > Pharm Meds > Flashcards

Pharm Meds Flashcards

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1
Q

Ace Inhibitors
Indication
Action
Side effects

A

(-prils)
Indication: Hypertension, CHF
Action: Blocks conversion of angiotensin I to angiotensin II, increases renin levels and decreases aldosterone leading to vasodilation
Side effects use ACE I as a mnemonic
Angioedema - Swelling of the face, lips, tongue
Cough - Due to prevention of breakdown of bradykinin
Excess potassium
Similar to ARBS, inhibs aldosterone
With aldosterone being inhib sodium goes down however potassium goes UP
Teratogens

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2
Q

Angiotensin Renin Blockers
Indication
Action
Nursing Consideration

A 
-Sartans
Indication: Hypertension, DM, neuropathy, CHF
Action: Inhibs vasoconstrictive properties of angiotensin II
Nursing considerations
Monitor BP
Monitor fluid levels
Monitor renal and liver status 
Teratogens
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3
Q

Statins
Indication
Action
Nursing Consideration

A

Used for total cholesterol, triglycerides, LDL, and HDL
Metabolized by the liver
PRIOR to admin, need to check LFTS (AST/ALT)
Drug attacks cholesterol, give drug at BEDTIME
Nasty side effect = MYOPATHY/ Rhabdomyolysis

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4
Q

Calcium Channel Blockers
Indication
Action
Nursing Consideration

A 
-dipines
Indications: Hypertension, Angina
Action: Blocks transport of calcium into muscle cells inhib excitation and contraction
Avoid grapefruit
Monitor BP
Can cause gingival hyperplasia 
Avoid -nafils (Viagra)
Overtime will cause peripheral edema
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5
Q

Adenosine
Indication
Action
Nursing Consideration

A

Indication: SVT
Action: Slows conduction through AV node
There will be a period of asystole after admin, due to pharm cardioversion - restarting the chest
Warn patient - Feels like someone kicked their chest
Warn family - They will flatline on monitor
Rapid push - or it will not work
□ Has to get to heart in about 2 seconds
Pick line closet to heart - pref Central line

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6
Q 
Heparin 
Classification
Uses
Titration
Nursing Considerations
Antidote
A

Classification: Indirect Thrombin Inhibitor
Indirectly inhibs thrombin (Resp for form clots), through inhibition of thrombin III
Uses: to prevent blood clots
Admin: Subcut and IV
Titration
aPTT levels drawn q4-6 hours
20-36 seconds for normal
1.5-2.5x normal for those on heparin
Monitor bleeding
Monitor for Heparin Induced Thrombocytopenia and thrombosis (HITT)
Antidote = Protamine sulfate

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7
Q 
Warfarin
Indication
Action
Nursing Considerations
Antidote
Contraindication
A

Indication: Venous thrombosis, pulmonary embolism, a-fib
Action: Disrupts liver synthesis of vitamin K dependent clotting factors
Monitor for bleeding
Monitor PT and INR
PT: 1.3-1.5
INR: 2.5-3.5
Antidote: Vitamin K
Contraindicated during pregnancy - give enoxaparin instead (LMWH)

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8
Q

Betablocker
Indication
Action
Nursing considerations

A

-lol
Indication: Hypertension, Angina, arrhythmias, cardiomyopathy, alcohol, withdrawal, anxiety
Action: Blocks beta 1 and 2 adrenergic receptors
Do not discontinue abruptly, discontinue slowly
Can mask the signs of hypoglycemia; important to monitor blood sugars
Can cause bronchospasm and bronchoconstriction

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9
Q

Digoxin
Indication
Action
Nursing considerations

A

Indication: Heart failure, a-fib, a-flutter, CHF, cardiogenic shock
Action: Increases contractility and rate.
Monitor for toxicity - Vision changes, blurred vision, yellow/green vision
Therapeutic lab level: .5 - 2 mg/ml
HOLD DIGOXIN IF PULSE LESS THAN 60

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10
Q

Loop Diuretics
MoA
Uses
Nursing considerations

A

-ide
MOA: Act on loop of Henle to inc urine output by affect sodium reabsorption within nephro - Inhib NaCl transporter to cause Na to be excreted in urine
Uses: Inc UO, edema, CHF, BP management
Monitor potassium levels - potassium wasting

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11
Q

Potassium sparing diuretics
MoA
Uses
Nursing considerations

A

(Spironolactone)
MOA: Inhibs Na and K exchange via sodium channels in distal parts of nephron; spares potassium
Uses: Hypertension, edema, swelling, hypokalemia
Monitor potassium levels

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12
Q

Thiazide Diuretics
MoA
Uses
Nursing considerations

A 
-thiazide
MOA: Act on distal tubule to inhib NaCl cotransporter which increases sodium in filtrate and increases water reabsorption
Uses; HTN, CHF
Monitor electrolyte levels
Monitor BP
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13
Q

Tuberculosis Treatment regiment

RIPE

A

Treated with the mnemonic RIPE
Rifampin - Red or orange secretions are expected
Isoniazid (INH) - Severely hepatotoxic - Check AST/ALT
Causes peripheral neuropathy, Give them Vit B6 or pyridoxine
Pyrazinamide
Ethambutol
Starts with an E and so does your Eyes

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14
Q

Antihistamine
Indication
Action
Nursing considerations

A

-ine
Indicates: Allergy, anaphylaxis, sedation
Action: Antagonizes effects of histamine, CNS depression
Monitor for drowsiness
Anticholinergic effects

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15
Q

Proton Pump Inhibitors
Indication
Action
Nursing Consideration

A

Indication: GERD, Ulcers
Action: Prevents transport of H ions into gastric lumen by binding to gastric parietal cells to decrease gastric acid prod
Admin 30-60 mins before meal
Report black, tarry stools - sign GI bleed
Monitor for Ca deficiency
Monitor for C diff

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16
Q

Ondansetron
Indication
Action
Nursing Consideration

A

Indication: Nausea/Vomiting
Action: Blocks effects of serotonin on vagal nerve and CNS
Admin slowly
Fast push can cause QT prolongation and VT

17
Q 
Benzodiazepines
Indication
Action
Nursing Consideration
Short Acting vs Intermediate/Long action
A

Short acting: Midazolam and Diazepam
Intermediate - Long Acting: Clonazepam, Alprazolam, Lorazepam
Indication: Anxiety, sedation, seizures
Action: General CNS depression
Avoid alcohol
Monitor for resp depression - Sedative effect
Antidote - Flumazenil

18
Q 
Phenytoin
Indication
Action
Nursing Considerations
Therapeutic Level
A

Indications: Seizures
Action: Blocks sustained high freq rep firing of action potentials
Therapeutic level: 10-20 mcg/mL
Gingival hyperplasia
Antacids can reduce effect of phenytoin and should be avoided

19
Q

MAOIs
Indication
Action
Nursing Considerations

A

Ex. Tranylcypromine, Isocarboxazid, Phenelzine, Selegiline
Indicated: Severe depression
Action: Increase levels of ALL neurotransmitters (Dopamine, Nore, epine, serotonin)
Avoid foods that are high in tyramine: Aged cheeses, Wine, alcohol or caffeine, Pickled meats, Bananas, Avocados, Raisins (avoid the salad BAR)
Side effect - Hypertensive crisis

20
Q

SSRIs
Indication
Action
Nursing Consideration

A

Ex. Fluoxetine, Sertraline, Escitalopram, Citalopram
Indication: First-line for depression
Action: Prevent reuptake of serotonin
Monitor for serotonin syndrome
Sertraline - Can cause increased toxicity of other drugs due to inhib of CP450
Suicide precautions important for 2-3 weeks

21
Q

Tricyclic Antidepressants
Indication
Action
Nursing Considerations

A

○ Ex. Amitriptyline, Nortriptyline, Protriptyline (-ptyline)
Indication: Depression
Action: Prevents reuptake of nore and serotonin
Monitor for anticholinergic side effects

22
Q 
Lithium
Indication
Action
Nursing Considerations
Therapeutic Levels
A

Indication: Mania
Action: Inhibs excitatory NT and promotes GABA NT
DO not admin with NSAIDS
Monitor drug levels
Therapeutic level: 0.5-1.5
Monitor for hyponatremia - Increases risk of reaching toxic levels
Encourage adequate fluid intake
Side effects: Peeing, Pooping, Paresthesia
Toxic effects: Tremors, Severe diarrhea, Metallic taste

23
Q

Antipsychotics
Indication
Action
Nursing Considerations

A

Ex. Haloperidol, Quetiapine, Olanzapine (-pine & Haldol)
Indication: Schiz, Mania, Aggressive behaviour, Agitation
Action: Inhibs effects of dopamine
Monitor for extrapyramidal side effects: Tremors, slurred speech etc
Tardive dyskinesia - Involuntary repetitive body movements
Neuroleptic malignant syndrome - Fever, muscular rigidity, and altered mental status
Can prolong the QT interval
Weekly EKG

24
Q 
Aminoglycosides
A Mean Old Mycin
Indications
Action
Nursing Consideration
A 
Ex. Gentamicin (-Mycin)
Indication: Gram negative infections
Action: Inhib bac protein synthesis 
Monitor for tinnitus 
Monitor for ototoxicity and nephrotoxicity 
Do not administer with penicillin
25
Q

Fluoroquinolones
Indications
Action
Nursing Consideration

A

Ex. Ciprofloxacin, Levofloxacin (-floxacin)
Indication: Infection
Action: Inhibs synthesis of bacterial DNA
Can cause QT prolongation
Decreases effects of phenytoin

26
Q

Vancomycin
Indication
Action
Nursing Considerations

A

Indication: Serious infections and sepsis
Kills bacteria in the intestines
Similar rules as “A Mean Old Mycin”
Monitor for ototoxicity and nephrotoxicity
Red-man syndrome - Whole body devs diffuse red rash; can be considered a serious allergy
Admin over at least 60 mins; central line preferred

27
Q

Penicillin & Cephalosporins
Indication
Action
Nursing Considerations

A

Ex. Amoxicillin, Ampicillin, Ancef (-cillin)
Indications: Infections; skin, resp, endocarditis
Action: Inhibs synthesis of bac cell wall leading to cell death
Monitor for rash
Monitor kidney function
Do not give if severely allergic to penicillin

28
Q 
Atropine
(Similar rules for dobutamine, dopamine, and benztropine) 
Indications
Action
Nursing Considerations
A

Indication: Excessive secretions, sinus bradycardia, heart block
Action: Inhibs acetylcholine, Inc HR, Bronchodilation and decreases secretions
Monitor for urinary retention and constipation
Anti-cholinergic side effects
Avoid in patients with glaucoma
Increases ICP

29
Q 
Acetaminophen 
Indication
Action
Nursing Considerations
Antidote
A 
Indication: Pain, fever
Action: Inhibs synthesis of prostaglandins which play a role in transmission of pain signals and fever response
Max daily dose =4g
Monitor liver function
Antidote = n-acetylcysteine
30
Q

NSAIDs
Indication
Action
Nursing Considerations

A 
Indication: Pain, inflamm, fever
Action: Block prostaglandin which causes inflamm, pain and fever
Can cause prolonged bleeding
Avoid in trauma and surg pt
Can cause peptic ulcers
31
Q

Aspirin
Indication
Action
Nursing Considerations

A

Indication: Pain - Arthritis, Stroke and MI prophylaxis
Action: Inhibs prod of prostaglandins which leads to reduction of fever and inflamm and decreases platelet aggregation
Risk of bleeding
Don’t admin with other anticoagulants
D/c prior to surgery
Caution with pediatric patients
Reye’s Syndrome can occur with viral infections

32
Q 
Opioids 
Indication
Action
Nursing Considerations
Antidote
A 
Indications: Pain
Action: Binds to opiate receptors in CNS and alters perception of pain while prod a general depression of CNS
Common side effect: Constipation 
CNS depressant: Monitor resp rate
Antidote = Naloxone
33
Q

Oxytocin
Indication
Action
Nursing Considerations

A

Indication: Induction of labour; PPH
Action: Stims uterine smooth muscle causing it to contract
Monitor contractions
Monitor fetus
Warn mother contractions will be more painful
Monitor BP, HR, glucose, and K

34
Q

Magnesium Sulfate
Indication
Action
Nursing Considerations

A

Indication: Hypomagnesemia, Torsade de point, Pre-eclampsia, Seizures, Asthma exacerbation
Action: Relaxes muscles and slows down labour
Monitor for hypermagnesemia
Confusion, Dizziness, Weakness, decreased reflexes
Give IV Slowly

35
Q

Steroids
Indication
Action
Nursing Consideration

A

-sone
Indication: Inflammation, Allergy, autoimmune disorders
Action: Suppress inflamm and normal immune response
Monitor for too much steroids: Cushing’s Symptoms
Side effects - A BIG FIB (Cushings)

NCLEX Pharm (1 decks)

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