Pharm study guide Flashcards
I am an isotonic intravenous saline solution.
0.9 % normal saline (NS) or (NaCl)
I can be given orally or as an enema to treat hyperkalemia. (styrofoam calms big kalema)
Sodium polystyrene sulfonate (potassium exchange resin) - THIS IS KAYEXOLATE
I am a blood product used for patients with coagulation disorders.
Fresh frozen plasma
I am a natural protein used to expand plasma volume
albumin
I am a hypertonic intravenous saline solution.
3% sodium chloride
I am the principle cation located inside cells.
potassium
I am the principle cation located outside cells.
sodium
I am used to increase the oxygen-carrying capacity of an individual’s blood, but I do not contain plasma. (packed so tight there’s no room for plasma)
packed RBC
I am a derivative of sugar, and am used to increase plasma volume by drawing fluid into the intravascular space from the interstitial space.
dextran
I am known as “half normal” saline and am given intravenously.
0.45 % saline solution
montelukast (LTRA) - is it prophyaxis or chronic? (Luke is everywhere)
used for prophylaxis and chronic treatment of asthma
Provide a spacer if the patient has
difficulty coordinating breathing with inhaler activation
furosemide caution - about standing…
caution to rise slowly after lying or sitting to a standing position due to hypotension
60% of adult body weight is water. Death can occur when
20-25% of total body water is lost
pink puffer meds
ACH
triggers bronchoconstriction, mucus secretion and inflammation
montelukast trade name
Singulair®
montelukast is prophylaxis or chronic treatment? (Luke is always with me)
Prophylaxis and chronic treatment of asthma
can use montelukast for children 2 and older for what?
allergic rhinitis. otherwise it’s
montelukast MOA (Luke)
prevent leukotrines from attaching in lungs and circulation
albuterol adverse effects (Al could have anxiety or be calm)
hypo or hypertension, vascular headache, tremors
How long to wait in between albuterol and fluticasone (steroid) inhalations***
several minutes
Acetylcystine - trade name (Ace has mucus)
Mucomyst
Mucomyst*** and trade name (Ace has mucus)
breaks up the mucus in the respiratory tract and reduces its viscosity, making it easier to cough up and clear from the lungs.
Acetylcysteine Solution
normal GFR rates (GFR doesn’t watch 120 min)
90 - 120 mL/min.
Potassium-wasting diuretics ex. (Thia’s wasting is LOC o)
Thiazide and thiazide-like
Loop or high-ceiling
Osmotic
Carbonic-anhydrase inhibitor
loop diuretics ex (I’de do the loop if I were you)
Bumetanide (Bumex®)
Furosemide (Lasix®) *
Ethacrynic acid (edecrin®)
Torsemide (Demadex®)
loop diuretics and diabetes - can cause what?
Hyperglycemia
loop diuretics - risk of what? (pee out what?)
hypokalemia
furosemide used for
hypertension, acute congestive heart failure, edema
furosemide precautions - what happens when you lose too much water? and what else?
dehydration and hyperglycemia
thiazide diuretics - end in
azide, ex Hydrochlorothiazide (HCTZ®)
thiazide diuretics precautions (thia has too much calcium)
hypercalcemia
Hydrochlorothiazide - peak (thia peaked at 46)
4 -6 hours
Hydrochlorothiazide - used for what disorders (thia is insipidous)
diabetes insipidous, hypertension, CHF
Hydrochlorothiazide - when does it not work? (Thia doesn’t like GFR)
when GFR is low
spironolactone peak (spiro is slow as hell)
48 hours
spironolactone MOA (excretes what and retains what)
excretes Na in distal, but retains K and H
mannitol trade name (Oz the man is a troll)
Osmitrol®
mannitol - MOA (man, oz is fast) - think - it’s an osmotic
osmotic diuretic, increases osmotic pressure. RAPID. immediate onset.
mannitol uses (Oz is serious)
serious stuff - elevated ICP, renal failure, spinal cord pressure, intraocular pressure
mannitol precautions (Man, Oz and cold don’t mix)
may crystallize at low temps, filtered IV only
acetazolamide trade name (Zola has diamonds)
Diamox®
acetazolamide type of drug (Ana and Zola)
carbonic anhydrase inhibitor (diuretic)
acetazolamide onset (Zola for just an hour)
1 - 1.5 hrs
acetazolamide uses (Zola on the mountain)
glaucoma, seizures, CHF, edema, altitude sickness.
acetazolamide precautions (Zola has Ca issues too)
hypercalciuria
acetazolamide adverse effects (Zola has kidney stones)
kidney stones. numbness and tingling in the fingers and toes, and taste alterations
(parageusia), especially for carbonated drinks.
take diuretics at what time of day?
morning to avoid nocturia
extracellular
Interstitial fluid (ISF): fluid in space between cells, tissues, and organs
crystalloids ex. (Krystal likes saline and sugar)
saline and dextrose
blood products Pull fluid from (blood is extra)
extravascular space into intravascular space (plasma expanders)
Cryoprecipitate and plasma protein factors (PPF) when (plasma is serious)
Management of acute bleeding (greater than 50% slow blood loss or 20% acutely)
Fresh frozen plasma (FFP) (if it’s frozen, it’s clotting)
Increase clotting factor levels in patients with demonstrated deficiency
PRBC
packed RBCs
PRBCs and whole blood (Packed with oxygen)
To increase oxygen-carrying capacity in patients with anemia, substantial hemoglobin deficits
PRBCs: for blood loss up to____ of total blood volume
PRBCs: for blood loss up to 25% of total blood volume
Whole blood: for blood loss over_____of total blood volume
Whole blood: for blood loss over 25% of total blood volume
colloids are
protein substances, increase COP (colloid osmotic pressure)
colloids move fluid from
interstitial compartment to
plasma compartment
ex of colloids - AND
albumin (from humans) dextran (glucose)
crystalloids good for treating what? (krystal is good for dryness)
Better for treating dehydration rather than expanding plasma volume
crystalloid ex. (Krystal has saline, ringers, and D5)
Normal saline (0.9% sodium chloride)
Half normal saline (0.45% sodium chloride)
Hypertonic saline (3% sodium chloride)
Lactated Ringer’s solution
D5W
Plasma-Lyte
reasons to take colloids (collide with my liver, nephros, and burns) think, youre out of protein when what happens?
liver failure, nephrosis, burns
adverse effects of crystalloids (Krystal makes you puffy)
edema, may be short lived
hyponatremia symptoms (tu in kitchen)
Lethargy, stomach cramps, hypotension, vomiting, diarrhea, seizures
hypernatremia symptoms (red man salt makes my muscles weak)
muscle weakness, confusion, edema, Red, flushed skin; dry, sticky mucous membranes; increased
thirst; elevated temperature; decreased urine output
mild hyponatremia treatment
oral sodium and fluid restriction
severe hyponatremia treatment
Treated with intravenous normal saline or lactated Ringer’s solution
Burns pts can have what? (Kalema has burns)
burn patients can
have either hypokalemia
or hyperkalemia
what combined with digoxin can cause digtoxicity?
hypokalemia
hyperkalemia symptoms (Kalema is opposite)
Muscle weakness, paresthesia, paralysis, cardiac rhythm
irregularities (leading to possible ventricular fibrillation
and cardiac arrest)
Treatment of severe hyperkalemia (big kalema is severely bi)
IV sodium bicarbonate, calcium salts, dextrose with insulin
hypomagnesium treatment? (maggie hospital)
glue
K rate of infusion
Rate should not exceed 20 mEq/hour (only if on heart monitor) 10 if not
oral K must be
Must be diluted in water or fruit juice to minimize GI distress
or irritation
K IV - NEVER EVER
NEVER give as an IV bolus or undiluted
K with renal disease?
Impaired kidney function leads to higher serum levels, possibly toxicity
GFR rates
90, 60, 30, 15
albuterol trade name (albuterol provents)
proventil
what type of beta agonist is albuterol?
selective Beta 2
ex of Nonselective beta-adrenergics (the met doesn’t select)
metaproterenol (Alupent®)
metaproterenol trade name (I’ll repent at the met)
Alupent®
does Sudafed cause rebound?
pseudoephedrine - nope. Orals don’t cause rebound
can’t use antihistamines with what illnesses?
asthma and pneumonia (or lower resp. diseases)
anticholernagenics ex (anti-IT)
Ipratropium bromide (Atrovent®) and tiotropium
(Spiriva®)
asthma - Alveolar ducts - open or closed?
open, but air is trapped
decongestant rebound happens with what?
with inhaled or topical.
non-opioid anti-tussives work how? (tuss has stretched my patience)
Suppress the cough reflex by numbing the stretch
receptors in the respiratory tract and preventing
the cough reflex from being stimulated
ex antitussive - what is the generic name?
dextromethorphan (Vicks Formula 44®,
Robitussin-DM®)
Vicks generic (Vick is an orphan)
dextromethorphan
Luke and drug interactions - just check what before taking it?
there are many, and be sure to check liver before starting
use antitussives with what types of cough?
Used only for nonproductive coughs!
Beta2 (albuterol) - side effects (Al can go high or low with tension)
hypo or hypertension
Anticholinergics side effects (Colte makes me nervous)
dry mouth, palpitations, headache, anxiety
topical decongestants ex.
flunisolide (Nasalide®)
fluticasone (Flonase®)
tiotropium trade name (Tito has spirit)
(Spiriva®)
Ipratropium bromide trade name (Pro-vent pee with atro-vent)
(Atrovent®)
anticcccholernegics - anti-cccccecretions
you can’t pee with em tropium
H2 famotidine trade name (Pepcid if fam)
famotidine (Pepcid)
H2 , ranitidine trade name (rant about zant)
ranitidine (Zantac)
H2 - cimetidine trade name (cemented in tagamet)
cimetidine (Tagamet)
antihistamine contraindications (antihistamines hurt my heart, eyes, and kidneys)
Use with caution in increased intraocular pressure,
cardiac or renal disease, hypertension, asthma,
COPD, peptic ulcer disease, BPH, or pregnancy
antihistamine H2 (2 dine on my stomach)
H2 blockers or H2 antagonists
Used to reduce gastric acid in peptic ulcer diseasef
Examples: cimetidine (Tagamet), ranitidine (Zantac),
famotidine (Pepcid)
benzonatate - what is it? (coughing on my benz)
anti-tussive
benzonatate trade name (Tesla is not a benz)
Tessalon Perles®
guaifenesin trade name
Mucinex
expectorants - implications - caution with who?
Expectorants should be used with caution in the elderly
if you take chewables, how long to wait before eating or drinking?
30 - 35 min
nasal decongestants - (think ephedrine) precaution with what patients?
Decongestants may cause hypertension,
palpitations, and CNS stimulation—avoid in
patients with these conditions
3 types of decongestants (AAC the decongestants on the test)
Adrenergics
Anticholinergics
corticosteroids
nonselective adrenergics (epi pen no beta)
alpha, beta 1, beta 2 - epinephrine
Nonselective beta-adrenergics (metros are nonselective, if you know what I mean)
beta 1 and beta 2 - metaproterenol (Alupent®),
Selective beta2
albuterol (Proventil®, others)
bronchodilators mimic what?
they sympathetic system
colloids - are they superior?
Superior to crystalloids in PV expansion, but more
expensive
types of crystalloids (Krystal can hydrate, isolate, maintain or go hyper with relationships)
Hydrating solutions
Isotonic solutions
Maintenance solutions
Hypertonic solutions
crystalloids are good for (Krystal lite is good for fluid loss)
fluid loss and promotes urine
Metabolic acidosis = you need what? (acid needs K)
K+
things that cause hypokalemia
Alkalosis
Ketoacidosis
vomiting
diarrhea
treatment for hypermagnesium *** (maggie in the hospital)
IV magnesium, calcium gluconate
Before giving potassium
assess ECG
one side effect of steroids (little kalema can’t take steroids)
hypokalemia
Loop and thiazide diuretics cause (just peeing out what)
hypokalemia
H1 antihistamines ex (the 2 you have in the closet right now)
Examples: diphenhydramine (Benadryl®), loratadine (claritin®)
anti-histamines more effective (good preventative)
in preventing the actions of histamine rather than reversing them
when to give antihistamines?
should be given early in treatment, before all the histamine binds to the receptors
metaproterenol trade name (U repent at the metro)
Alupent®
disadvantage of colloids
May cause altered coagulation, resulting in bleeding Have no clotting factors or oxygen-carrying capacity
too much licorice makes kalema
little
never administer K how?
as an IV bolus or undiluted
what can be used with low GFR?
furosemide
what can be used with low GFR?
furosemide
Osmotic for..(renal disease)
oliguria
hyponatremia symptoms - what will BP be like?
hypotension
hypernatremia symptoms - temperature? (too much salt gives me a fever)
elevated temp
hyperkalemia -heart?
vfib and cardiac arrest
hypokalemia - legs and arms?
leg and arm cramps
hypomagnesium
loss of DTR
hypercalcemia
bone pain
hypermagnesium
usually asymptomatic
GFR levels below…
60 mL/min for 3 or more months are a
sign of chronic kidney disease. below 15 kidney faliure.
furious and Thia can’t take
NSAIDs
thia causes…
gout - hyperuricia
what to monitor for with mannitol? (man oz makes me dehydrated)
dehydration bc it works so quickly
for fast expansion, use
colloids
packed red blood cells for
anemia
how to raise hemoglobin?
packed RBC
