Pharm Test #4 Flashcards
1
Q
this is a condition in which heart fails to effectively pump blood throughout the body
A
congestive heart failure
2
Q
this usually involves dysfunction of the cardiac muscle
A
congestive heart failure
3
Q
heart failure can occur with any of the disorders that damage or overwork the heart muscle - 5
A
CAD
cardiomyopathy
hypertension
valvular heart disease
right sided heart failure v left sided heart failure
4
Q
venous return is decreased and causes backup in blood —> jugular vein distention
what is this
A
right sided heart failure
5
Q
this causes dyspnea, tachycardia, pulmonary crackles
A
left sided heart failure
6
Q
underlying problems for heart failure – 3 kinds
A
- muscle damage - atherosclerosis or cardiomyopathy
- increase in workload to maintain efficient output — hypertension or valvular disease
- structural abnormality — congenital cardiac defects
7
Q
compensatory mechanisms of heart failure (medication)
A
cardiotonic drugs
—-cardiac glycosides
8
Q
what is a cardiac glycoside drug
A
digoxin
9
Q
this increases the force of a myocardial infarction
A
digoxin
10
Q
this is used to treat heart failure and rapid/irregular heart rates
A
digoxin
11
Q
this increases the force of a myocardial contraction, cardiac output and renal perfusion and output and decreases blood volume to slow heart rate and conduction velocity through the AV node
A
cardiac glycosides
12
Q
adverse effects of cardiac glycosides
A
-headache, weakness, drowsiness and vision changes
-gi upset and anorexia
-arrhythmia development
-digoxin toxicity
**know
13
Q
rn Assessments for digoxin
A
-lab values including digoxin level,kidney function, ventricular tachycardia, heart block, sic sinus syndrome
-electrolye abnormalities, weight, cardiac status, skin and mucus membranes, affect, orientation, and reflexes
monitor K level if low call MD before giving Digoxin.** know
14
Q
what is the therapeutic digoxin level
***** know
A
0.5-2 ng/mL
15
Q
What are the symptoms of digoxin toxicity?
A
Nausea Vomiting diarrhea
Visual disturbances
Headache
Confusion
Atrial arrythmias
Ventricular tachycardia
16
Q
What is the antidote for digoxin?
A
Digoxin Immune Fab
(Digifab)
17
Q
what are the side effects of electrolyte abnormalities - 6
and which of those are digoxin toxicity
A
bradycardia
dysrhythmias
N/V/D - digoxin toxicity
visual disturbances - dig toxcitiy
headache - dig toxicity
confusion - dig toxicity
18
Q
what precipitates digoxin toxicity
A
hypokalemia
19
Q
what do you do if K+ level is low and you need to give digoxin
A
if low, call MD before giving digoxin
20
Q
rn interventions for digoxin
A
- frequently check dig level and K+ level
- .monitor HR, and HOLD if bradycardia (HR below 60)
21
Q
the primary treatment for congestive heart failure is to make the heart beat harder and faster
true or false
A
false
primary treatment involves increasing muscle contractility, bringing system back into balance
22
Q
What are the condraindications for Digoxin use?
A
Allergy
Ventricular Tachycardia or fibrillation
Sic sinus syndrome
Acute MI (because strengthens force of myocardial contractions)
renal insufficiency
Electrolyte imbalance
23
Q
what is the primary treatment for congestive heart failure
A
allow the heart muscle to contract more efficiently in an effort to bring the system back into balance
24
Q
blood pressure is determined by what 3 things
A
- heart rate
- stroke volume
- total peripheral resistance
25
amount of blood pumped out of ventricle with each heartbeat
stroke volume
26
risks for coronary artery disease related to hypertension
-thickening of heart muscle
-increased pressure generated by muscle on contraction
-increased workload on heart
27
Conditions related to untreated hypertension
CAD and cardiac death
Stroke
Renal failure
Loss of vision
28
for risks of CAD - what do you need to know or do
1. why pt is taking drug
2. what assessing
3. assess after.... ?
29
resistance of the muscular arteries to the blood being pumped through
total peripheral resistance
30
what is stage 1 hypertension
130-139 / 80-89
31
what is stage 2 hypertension
>140 / >90
32
what factors are known to increase blood pressure
1. high levels of psychological stress
2. exposure to high frequency noise
3. high salt diet
4. lack of rest
5. genetic predisposition
33
what can lead to shock
hypotension
34
___ ___ = decreased perfusion to organs
low BP
35
what is the first organ to shut down due to poor perfusion
kidneys
36
when the heart muscle is damaged and unable to pump effectively
BP is too low
37
with severe blood or fluid loss, when volume drops dramatically
hypotension
38
this causes extreme stress and the body's levels of norepinephrine are depleted, leaving the body unable to respond to stimuli to raise BP
hypotension
39
antihypertensive agents - 6
ACE inhibitors
angiotension II receptor blockers
calcium channel blockers
vasodilators
diuretics
sympathetic nervous system blockers
40
what meds end in "ARTAN"
angiotension II receptor bockers
41
what meds end in "PRIL"
ACE inhibitors
42
what meds end in "PINE"
calcium channel blockers
43
ACE inhibitor drugs we are to know - 2
benazepril
lisinopril
44
RN considerations for ACE inhibitors
1. ACE's can HOLD potassium in body
----------Assess K+ levels
2. Dry Cough ----- hacking
PRIL = dry hacking cough **
45
What should RN assess for ACE inhibitors
1. History and physical exam
2. CV assessment AND re-assessment *****
3. impaired kidney function
4. salt/volume depletion and HF
5. baseline status before beginning therapy
-------VS, weight, skin, ECG, CBC with ultrasound and electrolytes
46
side/adverse effects of ACE's
dry cough
hyperkalemia
contraindicated in worsening renal function
photosensitivity
47
What are the condraindications of Ace inhibitors and Angiotensin II receptor blockers?
Known Allergies
Impaired renal function
Pregnancy and lactation
*Caution CHF*
48
what are the lifestyle changes you need to make for hypertension
weight reduction
smoking cessation
increasing aerobic exercises
low sodium diet
49
where are angiotensions metabolized
in the liver
50
what do you assess for angiotensions
HR and BP ------- no stopping BP meds
51
what are the drug to drug interactions for angiotensin II receptor blockers
phenobarbital (anti-seizure)
52
nursing considerations for angiotension II receptor blockers
1. impaired renal and hepatic function
2. hypovolemia,
3. assess baseline status before beginning therapy including - skin, VS, LS, baseline ECG and renal and hepatic function tests
53
calcium channel blockers - what do they do
Inhibits movement of calcium ions across the membranes of cardiac and arterial muscle cells decreasing myocardial contractility
54
how do the names of calcium channel blockers medciations end..
..PINE
ex: amiodipine
55
if drugs are ER, SR, XL, etc -- what do you NOT do
do NOT crush
56
what are the indications for calcium channel blockers
1. treatment of essential hypertension in the extended-release form
2. used to treat angina, HTN, tachycardia
57
Can calcium channel blockers be chewed
NO
58
what is the route of calcium channel blockers
PO - they must be swallowed whole
59
drug to food interactions for calcium channel blockers
grapefruit juice - grapefruit juice interferes with so many drugs.
rule of thumb - don't have pts take meds with grapefruit
60
nursing considerations for calcium channel blockers
CV assessment and RE-ASSESSMENT
61
what is the main reason to use calcium-channel blockers
treatment of angina
62
side/adverse effects of Ca+ channel blockers
hypotension (orthostatic)
bradycardia
peripheral edema
worsening heart failure in pts with HF
fall risk
*assess for edema
63
these are reserved for use in severe hypertension, malignant hypertension, or hypertensive emergencies
vasodilators
64
vasodilators _____ pressure
decrease
65
what vasodilator meds do we need to know - 3
hydralazine
minoxidil
nitroprusside
66
this maintains increased renal blood flow
hydralaine
67
what meds are last resort / used for emergencies
vasodilators
68
this is used for hypertensive crisis; maintain hypertension during surgery
nitroprusside
69
what is minoxidil used for
used only for severe and unresponsive hypertension
70
these increase excretion of sodium and water from the kidney to lower blood pressure
diuretics
71
this is potassium depleting --- need to test before and after
furosemide
72
3 types of diuretics
loop diuretics
thiazide and thiazide like diuretics
potassium sparing diuretics
73
name the potassium sparing diuretic
spironolactone
74
what is the thiazine and thiazide like diuretics - 2
hydrochlorothiazide
metolazone
75
what is the loop diurectic
furosemide
76
what to be aware of if pt is on furosemide
K+ loss, Na+ loss, Mg- loss
Syncope- Fall risk
Elevated lipid levels
77
what does hypokalemia look like
irregular heart rhythm, muscle cramps, N/V, fatigue/weakness, weak pulses
78
waht does hyponatremia look like
confusion, convulsions, decreased mental status, irritability, muscle cramps, fatigue/weakness
79
nursing considerations for loop diuretics
1. IV route must be pushed SLOWLY to prevent tinnitus (ototoxicity). IV push over 1-2 minutes
2. teach pt to take med in AM
80
this slows down/turns off the salt pumps
thiazide diuretics
81
hydrochlorothiazide side effects
loss of K+, Na, Mg-
82
this diuretic is used to treat heart failure and HTN
spironolactone
83
these are used to treat angina, MI, HF, HTN, dysrhythmias with rapid heart rate
beta blockers
84
if HR is below ___ recheck before giving. dont give if it's below this number
60
85
if systolic BP is below _____ don't give.
100
86
this decreases HR, BP, workload of the heart and contractility
beta blockers
87
what beta blocker medication do we need to know
metoprolol
88
rn considerations for beta blockers
1. monitor BP and HR before & after admin
2. "hold" medication if BP & HR too low
3. teach pt to check pulse and BP periodically
4. diabetics should monitor for hypoglycemia **** know
89
this is essential to to producing healthy RBCs
adequate amounts of iron - to form hemoglobin rings to carry the oxygen
90
who's at risk for iron deficiency anemia
1. menstruating women who lose RBCs monthly
2. pregnant and nursing women who have increased demands for iron
3. rapidly growing adolescents, those who don't have a good diet
91
3 types of anemia
1. iron deficiency anemia
2. megaloblastic anemia
3. sickle cell anemia
92
What is the cause of Iron deficiency Anemia?
A negative iron balance occurs
93
What is another name for Megaloblastic anemia?
Pernicious anemia
94
does iron cause diarrhea or constipation
constipation
95
this is when the RBCs are crescent moon shaped and they clump together.
it impacts the liver
sick cell anemia
96
this medication stimulate the bone marrow to make more RBCs
epoetin alfa -- subq injection
97
this acts like natural glycoprotein erythropoietin to stimulate the production of RBCs in the bone marrow
erythropoiesis stimulating agents
98
contraindications of erythropoiesis stimulating agents
uncontrolled hypertension --- this needs to be controlled in order to get medication
99
adverse effects erythropoiesis stimulating agents
CV - hypertension, edema, possible chest pain
100
nursing considerations for erythropoiesis stimulating agents
patients with cancer receiving the drugs to increase hematocrit after antineoplastic chemotherapy
Assess Neuro and CV status, respirations
Anemia and renal function
101
iron deficiency anemia medications start with....
Iron=Iron
ferrous = iron
Ferrous Gluconate is the only IV med
***know
102
this stimulates RBC production in the bone marrow
epoetin alfa
103
adverse effects for medications used for iron deficency anemia
-constipation
-Oral -- GI irritation and CNS toxicity
-parental iron - associated with severe anaphylactic reactions, local irritation, staining of tissues and phlebitis
Drug-Drug
Antacids, tetracycline, cimetadine
all the -oflaxins
Chloramphenicol
104
what food interactions for iron deficiency anemia agents
eggs
milk
coffee
tea
acidic liquids
**know
don't take meds within an hour of eating these foods
105
nursing considerations for iron preparations
lab values - Hb & Hematocrit labs make sure they are sufficient amount
106
Megaloblastic anemia occurs when there is insufficient folic acid or vitamin B12 to support stromal structure of RBC
true or false
true
megaloblastic anemia equals insufficient folic acid or vitamin B12 to create the stromal structure needed in a healthy RBC
107
what is the medication for sickle cell anemia
hydroxyurea
108
-this increases amount of fetal Hb produced in bone marrow
-dilutes formation of abnormal Hb S
-take multiple times a day
hydroxyurea
109
what is the caution for sickle cell anemia meds
impaired liver or renal function
110
adverse effects of sickle cell anemia meds
GI, headache, dizziness, disorientation(Usually seen in patients taking too high of a dose) **, increased cancer risk
111
what are the modifiable risks for CAD
1. gout
2. cigarette smoking
3. sedentary lifestyle
4. high stress levels
5. hypertension
6. obesity
7. diabetes
8. untreated bacterial infections
9. treatment with tetracycline and fluororoentgenography
112
unmodifiable risks for CAD
age
gender
genetic predisposition
113
enter circulation as loosely packed lipids
high density lipoproteins (HDL)
114
enters circulation as tightly packed cholesterol, triglycerides and lipids
low density lipoproteins (LDL)
115
carried by proteins that enter circulation ; broken down for energy or stored for future use as energy
low density lipoproteins (LDL)
116
Enter circulation as loosely packed lipids
High Density Lipoproteins (HDL)
117
used for energy, picks up remnants of fats and cholesterol left in periphery
high density lipoproteins (HDL)
118
the excessive dietary intake of fats causes ___________
hyperlipidemia
119
what are the actions of lipid lowering agents
-lower serum levels of cholesterol and lipids
-prevention of CAD
120
genetic alterations in fat metabolism leading to a variety of elevated fats in blood causes what ........
hyperlipidemia
121
true or false
low density lipoproteins enter circulation as tightly packed unit consisting of cholesterol, triglycerides and lipids
true
122
what type of drug is used to treat hyperlpidemia
bile acid sequestrants
123
what do bile acid sequestrants do
decrease plasma cholesterol levels
124
what medication is a bile acid sequestrants
cholestyramine
125
what do you not give to a pt when giving cholestyramine
carbonated beverages. these will break down the medication and it becomes inactive.
**need to know this
126
What should a patients daily fluid intake be when taking Bile Acid Sequestrants?
2-3L
127
these bind bile acids in the intestine, allows excretion in feces instead of reabsorption, c auses cholesterol to be iodized in the liver, and serum cholesterol levels to fall
bile acid sequestrants
128
what are the nursing considerations for bile acid sequestrants
assess:
-weight, skin, neurological status, pulse, BP and LS
-BS and elimination patterns and appropriate lab values
-*want clients to eat more fiber to promote motility to get medication out**** important
129
what are the indications for cholestyramine
reduction of elevated serum cholesterol in pts with primary hypercholesterolemia, pruritus associated with partial biliary obstruction
130
adverse affects of cholestyramine
Most important:
Headache, fatigue drowsiness
Direct GI irritation- Nausea Constipation
Also:
anxiety, vertigo, exacerbation of hemorrhoids, cramps, increased bleeding tendencies, vitamin A and D deficiency
131
if this enzyme is blocked, serum cholesterol and LDL decrease
HMG-CoA reductase
132
waht medications are HMG-CoA Reductase inhibitors
"statins"
Lovastatin
rosuvastatin
133
*this medication makes ppl nauseous and give them gas pains *** Know this
lovastatin
134
this medication you need to check the labs (liver enzymes, HDL/LDL) at least twice a year to make sure medication is effective and dosage doesn't need reduced *** Know This
rosuvastatin
135
what is the contraindications of HMG-CoA reductase inhibitors ** Know this
active liver disease or history of alcoholic liver disease
136
what are the actions of HMG-CoA reductase inhibitors
inhibits HMG-CoA, **decreases serum cholesterol levels, LDLs, and triglycerides, increases HDL levels**
137
waht are the adverse effects of HMG-CoA reductase inhibitors
GI symptoms: gas, abdominal pain, cramps, nausea, vomiting, constipation
Liver failure
Muscle pain (Rhabdomylosis)
138
Can a patient be easily changed from generic HMG-CoA Inhibitors to Brand?
No, people are very sensitive to the different formulations of these drugs and changing medication must be very carefully managed, even from brand to generic.
139
What are the Drug to Drug interactions with HMG-CoA Inhibitors?
Erythromycin, cyclosporine,gemfibrozil, niacina
Digoxin or warfarin
Estrogen
Grapefruit juice
140
what two things are used to lower lipid levels
1. niacin (vitamin B3)
2. fenofibrates
141
-this causes skin to flush
-breaks down LDLs so don't stick together
niacin
142
-this increased uric acid secretion
-drink lots of water
-will build up in joints
fenofibrates
143
this may stimulate triglyceride breakdown
increased uric acid secretion ---- from fenofibrates
144
**know
what type of medication can cause cataracts
HMG-CoA inhibitors
145
the nurse is caring for a pt taking a HMG-CoA inhibitor. What would be an appropriate intervention for this pt?
A. monitor CBC blood tests before and periodically during therapy
B. Arrange for periodic ophthalmic examinations
C. Admin drug at breakfast
D. Monitor for adverse effecst
B. Arrange for periodic ophthalmic examinations
146
name two blood disorders
1. thromboembolic disorder
2. hemorrhagic disorder
147
this interferes with the clotting cascade and thrombin formation
anticoagulants
148
this alters the formation of the platelet plug
antiplatelets
149
this breaks down the thrombus that has been formed by stimualting the plasmin system
thrombolytic drugs
150
this is a disorder in which excess bleeding occurs
hemorrhagic disorder
151
conditions that predispose a person to the formation of clots and emboli
ex: caused by afib
thromboembolic disorder
152
name two antiplatelet medications
aspirin
clopidogrel
153
this breaks down plaque
clopidogrel
154
this prevents pts at risk for CVA
aspirin
155
what is the adverse effect of antiplatelets
bleeding
156
this blocks the production of platelets in the bone marrow
makes you at risk for hemorrhage
anagrelide
157
inhibits platelet adhesion and aggregation by blocking receptors sites on the platelet membrane
actions of antiplatelets
158
what are the nursing considerations for antiplatelets
-baseline status including body temp, skin color, lesions, and temperature ;
-affect, orientation, and reflexes;
-pulse, BP, and perfusion, ;
-RR and adventitious sounds;
-CBC;
-clotting studies
document skin to notice changes
159
4 anticoagulant medication
1. heparin
2. warfarin
3. rivaroxaban
4. apixaban
160
these two medications you monitor for bruising/bleeding
no lab values for these meds
rivaroxaban & apixaban
161
use soft bristle toothbrush ; no open razors to shave
which type medications would this apply to
anticoagulants
162
lab is PTT
use 25-30 gauge
antidote is protamine sulfate
heparin
163
lab is PT/INR
don't eat leafy green vegys
vitamin K is the antidote
warfarin
164
what are the adverse effects of anticoagulants
gi upset - can develop ulcers
hepatic dysfunction
-dont want pt to have gastric or duodenal ulcers in history
165
drug to drug interactions for anticoagulants
heparin and nitroglycerine --- can cause more bleeding
166
this medication --- the dose is based on weight
-you put subq in love handles
-no antidote
enoxaparin
167
nursing considerations for anticoagulants
-recent history of surgery
-active internal bleeding
-CVA within last 2 mos
168
this anticoagulant doesn't cross breast milk so mom can breastfeed while on it
heparin
169
this breaks down thrombus that has been formed by stimulating the plasmin system
thrombolytic agents
170
thrombolytic agent medication to know
urokinase
--this breaks down clot
171
how long should you monitor for bleeding when on urokinase
24-48 hrs
172
activating plasminogen to plasmin, which in turn breaks down fibrin threads in clot to dissolve a formed clot
thrombolytic agents
173
this inhibits thrombus and clot production by blocking the conversion of prothrombin to thrombin and fibrinogen to fibrin
heparin
174
adverse effects of thrombolytic agent
bleeding
cardiac arrhythmias
hypotension
hypersensitivity
175
this prevents and treats of VTE and PE, treatment of AF with embolization, diagnosis and treatment of DIC, prevention of clotting in blood samples and heparin lock sets
heparin
176
nursing considerations for thrombolytic agents
-recent surgery, active internal bleeding, CVA within last two months, aneurysm, obstetrical delivery, organ biopsy, recent serious GI bleeding, rupture of non-compressible blood vessel, recent major trauma
-known blood clotting defects, cerebrovascular disease, uncontrolled hypertension, liver disease
-baseline status to include VS, Skin, orientation, appropriate lab values and ECG
177
use this for lysis of PE or PE with unstable hemodynamics in adults
urokinase
178
what is an inflammatory response ?
Protects the body from injury and pathogens
Uses chemical mediators to producea reaction that helps destroy pathogens and promotes healing
179
What is the purpose of antiinflammatory drugs?
They prevent or limit the inflammatory response due to injury and are prescribed to increase comfort
180
What are the types of antiinflammatory drugs?
Corticosteroids
Antihistamines
Immune-modulating agents
OTC aniinflammatories (NSAIDS)
181
What special considerations do we need to think about for children?
Dosage is often weight based
No Aspirin and Trisalicylate drugs because it can cause Reyes syndrome
182
What are the therapeutic uses/indications for salicylates?
Block inflammatory response
Have antipyretic properties
Have analgesic properties
considered anti-platelet drug (used in stroke and heart patients)
Used to treat mild to moderate pain and fever
183
Which are the common Salicylates?
Aspirin
Bayer
184
What are the two dosages of aspirin?
81mg/324mg
185
What Labs should the Nurse be checking for a patient taking Salicylates?
Labs relating to bleeding:
* PT/INR
* PTT
* Platelets
Labs relating to Liver and Kidney Function
186
What are the Drug-Drug interactions for Salicylates?
* Should not take Aspirin while taking other anticoaugulants such as Warfarin or Heparin
* Need to be aware of any over the counter medications such as alka seltzer and ecotrin that may also contain aspirin
187
What are the condraindications for taking salicylates?
* Chicken pox/influenza (risk of reyes in children)
* Known allergy
* Bleeding abnormalities
* impaired renal function
* Surgery or other procedures scheduled within one week (bleeding Danger)
* Pregnancy and lactation (crosses placenta and into breast milk)
188
What are the actions of salicylates
Inhibits synthesis of prostaglandin
189
Should Aspirin be taken with food?
Yes, to offset GI irritation
190
What adverse effects should the nurse be assessing for in a patient taking Salicylates?
* Bruising
* Bleeding such as Nosebleeds, Gum bleeding/clotting problems
* Tinnitus or ringing in the ears
* Loss of Kindey function (I&O)
* GI bleeding or discomfort
* Liver function
191
What are the pharmacokinetics of Salicylates?
Absorbed in the stomach
Metabolized in the liver
Excreted in the urine
192
True or False
A person who does not respond to one Salicylate may respond to a different one
True
193
What is the action of NSAIDs?
Blocks two enzymes known as COX -1 and COX-2
194
What are the Indications for NSAIDs?
Antiinflammatory
Analgesic
Antipyretic
Rheumatoid Arthritis
Primary Dysmenorrhea
Osteoarthritis
195
What are the Pharmacokinetics of NSAIDs?
Rapidly absorbed in the GI tract
Metabolized in the Liver
Excreted in the Urine
196
What are the condraindications for NSAIDs
* Allergy to any NSAID or salicylate
* allergy to sulfonamides
* CV dysfunction or hypertension
* peptic ulcer, GI bleeding
* pregnancy, lactation
* renal and hepatic dysfunction
* Do not combine Salicylates and NSAIDs
197
What adverse effects is the nurse assesing for in Patients takin NSAIDs?
* GI irritation, pain or bleeding
* Kidney compromise
* allergic reactions
* Bleeding in gums/epistaxis/bruising/platelet inhibition
* Nausea, dyspepsia
* Constipation, diarrhea or flatulencecaused by GI effects from drug
* Dizzines, somnolence
* Hypertension
* Bone marrow depression
198
What are the Drug to Drug interaction for NSAIDs?
* Decreased diuretic effect when combined with loop diuretics such as Furosemide
* Decreased antihypertensive effect when combined with Beta Blockers such as Metoprolol
* Lithium toxicity especially when combined with ibuprofen
199
What are the main NSAIDs?
Ibuprofen
Ketorolac
Naproxen
Celecoxib
200
What are the Nursing Interventions for NSAIDS?
* Teach patient to take with food
* Do not chew capsule or tablet
* Check urine and feces for blood
* Check gums, Inform dentist
* Shouldnt take with warfarin – interferes with clotting labs
* Check labs that relate to bleeding.
* Check kidney function (BUN & Creatinine) & I/O’s
* Vitals signs (BP since NSAIDS can retain Na+ and H20)
* Assess for allergic reactions and check for sulfa allergies
201
when are NSAIDs Condraindicated?
A. Allergy to penicillin
B. Allergy to sulfonamides
C. Allergy to antihistamines
D. Allergy to thiazines
B. Allergy to sulfonamides
They are also condraindicated in the prescence of an allergy to any NSAID, Salicylate or Celecoxib
202
What are the actions of Acetaminophen?
Acts directly on the thermoregulatory cells of the hypothalamus
203
What are the indications for Acetominophen?
* Treat pain and fever associated with a variety of conditions, including influenza
* Prophylaxis of children receiving diphtheria–pertussis–tetanus (DPT) immunizations
* Relief of musculoskeletal pain associated with arthritis
204
What are the pharmacokinetics of acetaminophen
Absorbed from the GI tract
Metabolized in the liver
Excreted in the liver
205
What are the condraindications for Acetaminophen ?
* Known allergy
* Use with caution in pregnancy and lactation
* Hepatic dysfunction or chronic alcoholism
206
What adverse effects is the Nurse assesing for with patients taking acetaminophen?
* Headache
* hemolytic anemia
* renal dysfunction
* liver failure
* skin rash
* fever
* Hepatotoxicity (usually associated with chronic use and overdose)
207
Which Adverse effect of Acetaminophen is usually associated with Overdose or chronic overuse?
Hepatotoxicity
208
What is the recommended maximum daily dose of Acetaminophen?
4000mg
209
What is the antidote for Acetaminophen overdose?
Mucomyst
210
What are the drug to drug interactions for Acetaminophen?
Nurses to be aware and educate patients that acetaminophen is contained in other medications such as:
Percocet (oxycodone with acetaminophen)
Guafenisin
Nyquil
Alka-selzter plus
211
A potentially debilitating inflammatory process
Arthritis
212
What is the Indication for Antiarthritis agents
Prevent and supress arthritis in selected patients with rheumatoid arthritis
213
Which medications are examples of antiarthritis agents
Gold Compounds
Adalimumab (Humira)
Etanercept (Enbrel)
Tofacitnib (Xeljanz)
214
What are the adverse effects of all Anti-Arthritis drugs?
CV effects
Gingivitis/Stomatitis (inflammation of the mucus membranes in the mouth)
Bone marrow depression- risk of infection
215
WHich Anti- Arthritis medications are Tumor Necrosis Factor Blockers?
Adalimumab (Humira)
Etanercept (Enbrel)
216
What are the specific Adverse effects associated with Tumor Necrosis Factor Blockers?
Risk of serious fatal infections
Development of Lymphomas and other cancers
217
Drug to Drug interactions for Tumor Necrosis Factor Blockers
Immune supressant drugs and live vaccines
