pharm week 3

Question 1

furosemide

Answer 1

brand: lasix

med class: loop diuretic

indication:
- HTN
- Edema relating to heart failure & renal failure

s/e:
- increased urinary frequency
- hypokalemia
- dizziness
- photosensitivity
- rash

Question 2

chlorthalidone

Answer 2

brand: hygroton/thalitone

med class: thiazide diuretic

indication:
- HTN
- edema

s/e:
-increased urinary frequency
- hypokalemia
- dizziness
- photosensitivity
- rash

Question 3

hydrochlorothiazide (hctz)

Answer 3

brand: Esidrix

med class: thiazide diuretic; antihypertensive

indication:
- HTN
- Edema

s/e:
- increased urinary frequency
- hypokalemia
- dizziness
- photosensitivity
- rash

Question 4

triamterene/hydrochlorothiazide (trim/hctz)

Answer 4

brand: Dyazide, Maxdize

med class: Potassium Sparing/thiazide diuretics combination

indication:
- HTN
- edema

s/e:
- increased urinary frequency
- hypokalemia
- dizziness
- photosensitivity
- rash

Question 5

Potassium Chloride (KCl)

Answer 5

brand: Klor-con

med class: potassium, electrolyte

indication:
- hypokalemia
- prophylaxis hypokalemia

s/e:
- nausea
- indigestion
- arrhythmias (rare but serious)

Question 6

spironolactone

Answer 6

brand: aldactone

med class: potassium sparing diuretic/ selective aldosterone blocker

indication:
- Heart failure class III-IV
- edema w/ HF
- hypokalemia
- HTN
- nephrotic syndrome

s/e:
- hyperkalemia
- hyponatremia
- gynecomastia
- dizziness

Question 7

D5W (dextrose 5% in water)

Answer 7

brand:

med class: isotonic IV fluid

indication:
- provides free water when dextrose is metabolized (making it a hypotonic solution)
- expands the ECF and ICF, helpful in rehydrating and excretory purposes
- used to treat hypernatremia

s/e:
- should nOT be used for fluid resuscitation b/c hyperglycemia can result
- should be avoided in pt at risk for increased intracranial pressure

Question 8

d5lrs (lactated ringers solution in 5% dextrose)

Answer 8

brand: ringer’s lactate or hartmann solution

med class: isotonic iv fluid

indication:
- prevents acidosis & administered to pt w/ metabolic acidosis
- correction of dehydration, sodium depletion, and replace GI tract fluid losses
- fluid loss d/t burns, fistula drainage, and trauma
- the choice for first-line resuscitation for certain pt

s/e:
- do not give to pt who cannot metabolize lactate (liver disease and lactic acidosis pt
- used cautiously for pt with heart failure and renal failure

Question 9

ringers

Answer 9

brand:

med class: isotonic IV solution

indication:
- prevents acidosis & administered to pt w/ metabolic acidosis
- correction of dehydration, sodium depletion, and replace GI tract fluid losses
- fluid loss d/t burns, fistula drainage, and trauma

s/e:
- no lactate effects
- used cautiously for pt with heart failure and renal failure

Question 10

45 NaCl (0.45% sodium chloride solution for infusion)

Answer 10

brand: half-strength normal saline (1/2 NS)

med class: hypotonic solution

indication:
- used to replace water in patients who have hypovolemia w/ hypernatremia

s/e:
- hyponatremia d/t dilution of sodium

Question 11

33 NaCl (0.33% Sodium Chloride Solution)

Answer 11

brand: 5% dextrose in 0.33 sodium chloride, 1/3 strength normal saline

med class: hypotonic solution

indication:
- used to allow kidneys to retain needed amounts of water
- (free water helps kidneys eliminates solutes)
- typically administered with dextrose to increase tonicity

s/e:
- used cautiously in pt with heart failure and renal failure

Question 12

0.225% NaCl (0.225 Sodium chloride solution)

Answer 12

brand: 5% in dextrose in 0.255 sodium chloride

med class: hypotonic solution

indication:
- used as maintenance fluid for pediatric patients as it is most hypotonic fluid available
- typically administered with dextrose to increase tonicity

s/e:
- bc it is a hypotonic solution, it can make cells swell, so be careful of increase intracranial pressure
- contraindicated in hypovolemia pt and hypotension –> causing cardiovascular collapse
- avoid using in pt with liver disease, trauma, or burns
- monitor for s/s of confusion in older adults, or dizziness (manifestations of volume deficit)
- excessive infusion of hypotonic IV= intravascular fluid depletion, creased BP, cellular edema, and cell damage

Question 13

d2.5w (2.5% dextrose in water)

Answer 13

brand:

med class: hypotonic solution

indication:
- used to treat dehydration and decrease levels of sodium and potassium

s/e:
- DO NOT administer with blood products as it can cause hemolysis of red blood cells

Question 14

Hyper NaCl (hypertonic sodium chloride)

Answer 14

brand:
- 3% NaCl
- 5% NaCl

med class: hypertonic solution

indication:
- acute treatment for severe hyponatremia and should only be used in critical situations to treat hyponatremia
- used in pt with cerebral edema
- some pt may need diuretic therapy to assist in fluid excretion

s/e:
- should be infused at a very low rate to avoid risk of pulmonary edema
- if administered in large quantities and rapidly, may cause ECF excess and circulatory overload

Question 15

Hypertonic dextrose solutions

Answer 15

brand:

med class: hypertonic solution

indication:
- to provide kilocalories for the pt in short term

s/e:
s/e: (for all hypertonic solutions)
- hypervolemia (swelling in extremities, increase breath, high BP, discomfort in body like HA & cramping)
- administer via centraline
- monitor blood glucose (can lead to hyperglycemia)…use w/ caution in pt w/ DM

know that:
5% dextrose are slightly hypertonic but dextrose is quickly metabolized and only isotonic solution remains–> any effect of ICF is temporary

higher concentrations of dextrose are strong hypertonic solutions and must be administered into central veins so that they can be diluted by rapid blood flow

Question 16

d10w (dextrose 10% in water)

Answer 16

brand:
med class: hypertonic IV solution

indication:
- tx for ketosis of starvation and provides calories, free water, and no electrolytes

s/e:
- do not infuse using same line as blood products as it can cause RBC hemolysis
- should be administered using central line

Question 17

d20w (dextrose 20% in water)

Answer 17

brand:
med class: hypertonic IV solution

indication:
- diuresis: osmotic diuretic that causes fluid shifts between fluid compartments

s/e: (for all hypertonic solutions)
- hypervolemia (swelling in extremities, increase breath, high BP, discomfort in body like HA & cramping)
- administer via centraline
- monitor blood glucose (can lead to hyperglycemia)…use w/ caution in pt w/ DM

Question 18

d50w (dextrose 50% in water)

Answer 18

brand: dextrose 50% in water

med class: hypertonic IV solution

indication:
- treat severe hypoglycemia
- administered rapidly via IV bolus

s/e: (for all hypertonic solutions)
- hypervolemia (swelling in extremities, increase breath, high BP, discomfort in body like HA & cramping)
- administer via centraline
- monitor blood glucose (can lead to hyperglycemia)…use w/ caution in pt w/ DM

Question 19

H Alb (Human Albumin)

Answer 19

brand:
med class: colloid solution

indication:
- increase circulating volume and restore protein levels in burns, pancreatitis, and plasma loss through trauma

• 25% albumin is used together with sodium and water restriction to reduce excessive edema

s/e:
- contraindicated in pt with severe anemia, heart failure, or known sensitivity to albumin
- ACE inhibitors are withheld for at least 24 hours before administering albumin
- hypervolemia, hypertension, dyspnea, crackles, and edema
- monitor coagulation index (increase bleeding times)

Question 20

Lmwd (low molecular weight dextron)

Answer 20

brand: dextran 40

med class: colloid iv solution

indication:
- used to improve microcirculation in patients with poor peripheral circulation
- treats shock related to vascular volume loss (burns, hemorrhage, trauma, surgery)
- prevents venous thromboembolism on certain surgical procedures

s/e:
- contraindicated in pt with thrombocytopenia, hypofibrinogenemia, and hypersensitivity to dextran

Question 21

hmwd (high molecular weight dextran)

Answer 21

brand: dextran 70, dextran 75

med class: colloid

indication: used for pt with hypovolemia and hypertension

s/e:
- contraindicated in pt w/ hemorrhagic shock
- s/e for all colloids/nursing considerations: hypervolemia, hypertension, dyspnea, crackles, and edema
- monitor coagulation index (increase bleeding times)

Question 22

eth starch (etherified starch)

Answer 22

brand: EloHAES, hyperHAES, voluven

med class: colloid iv solution

indication:
- increase intravascular fluid but can interfere with normal coagulation

s/e: n/a

-nursing considerations: hypervolemia, hypertension, dyspnea, crackles, and edema
- monitor coagulation index (increase bleeding times)

Question 23

gelatin

Answer 23

brand:
med class: colloid iv solution

indication: have lower molecular weight than dextrans and therefore remain in circulation for a shorter period of time

s/e:

Question 24

ppf (plasma protein fraction)

Answer 24

brand:
med class: colloid iv solution

indication:
- prepared from plasma, and like albumin is heated before infusion
- infuse slowly to increase circulating volume

s/e:

Question 25

nss

Answer 25

brand: normal saline solution

med class: isotonic IV fluid

indication:
- when you need to expand extracellular fluid (ECF volume) aka ECF volume deficit
- replaces large sodium losses in burn injuries and trauma
- used alongside administration of blood products

s/e:
- hypernatremia (Na retention)
- swelling/edema
- pulmonary edema
- renal impairment