Pharm Meds Flashcards
Ace Inhibitors
Indication
Action
Side effects
(-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
Angiotensin Renin Blockers
Indication
Action
Nursing Consideration
-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
Statins
Indication
Action
Nursing Consideration
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
Calcium Channel Blockers
Indication
Action
Nursing Consideration
-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
Adenosine
Indication
Action
Nursing Consideration
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
Heparin Classification Uses Titration Nursing Considerations Antidote
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
Warfarin Indication Action Nursing Considerations Antidote Contraindication
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)
Betablocker
Indication
Action
Nursing considerations
-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
Digoxin
Indication
Action
Nursing considerations
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
Loop Diuretics
MoA
Uses
Nursing considerations
-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
Potassium sparing diuretics
MoA
Uses
Nursing considerations
(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
Thiazide Diuretics
MoA
Uses
Nursing considerations
-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
Tuberculosis Treatment regiment
RIPE
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
Antihistamine
Indication
Action
Nursing considerations
-ine
Indicates: Allergy, anaphylaxis, sedation
Action: Antagonizes effects of histamine, CNS depression
Monitor for drowsiness
Anticholinergic effects
Proton Pump Inhibitors
Indication
Action
Nursing Consideration
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
Ondansetron
Indication
Action
Nursing Consideration
Indication: Nausea/Vomiting
Action: Blocks effects of serotonin on vagal nerve and CNS
Admin slowly
Fast push can cause QT prolongation and VT
Benzodiazepines Indication Action Nursing Consideration Short Acting vs Intermediate/Long action
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
Phenytoin Indication Action Nursing Considerations Therapeutic Level
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
MAOIs
Indication
Action
Nursing Considerations
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
SSRIs
Indication
Action
Nursing Consideration
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
Tricyclic Antidepressants
Indication
Action
Nursing Considerations
○ Ex. Amitriptyline, Nortriptyline, Protriptyline (-ptyline)
Indication: Depression
Action: Prevents reuptake of nore and serotonin
Monitor for anticholinergic side effects
Lithium Indication Action Nursing Considerations Therapeutic Levels
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
Antipsychotics
Indication
Action
Nursing Considerations
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
Aminoglycosides A Mean Old Mycin Indications Action Nursing Consideration
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
Fluoroquinolones
Indications
Action
Nursing Consideration
Ex. Ciprofloxacin, Levofloxacin (-floxacin)
Indication: Infection
Action: Inhibs synthesis of bacterial DNA
Can cause QT prolongation
Decreases effects of phenytoin
Vancomycin
Indication
Action
Nursing Considerations
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
Penicillin & Cephalosporins
Indication
Action
Nursing Considerations
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
Atropine (Similar rules for dobutamine, dopamine, and benztropine) Indications Action Nursing Considerations
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
Acetaminophen Indication Action Nursing Considerations Antidote
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
NSAIDs
Indication
Action
Nursing Considerations
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
Aspirin
Indication
Action
Nursing Considerations
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
Opioids Indication Action Nursing Considerations Antidote
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
Oxytocin
Indication
Action
Nursing Considerations
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
Magnesium Sulfate
Indication
Action
Nursing Considerations
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
Steroids
Indication
Action
Nursing Consideration
-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)
