pharmacology Flashcards
What are the rights
patient
drug
dose
route
time
documentation
sub q sites
lateral aspect of lower part of the upper arm
abdoment in the umbilical region
thighs
posterior aspect of upper arm
back
lower loins
angle of of sub 2 injection
45
Im sites for adults
deltoid
ventrogluteal site
rectus femoris
vastus lateralis
Im infection angle
90
intradermal angle
10-15q
what drug should asthmatics avoid why
beta-blockers
may cause bronchospasm
What drugs should people with hypertension avoid and why
NSAIDS
increased blood pressure due to sodium retention
what drugs should people with Parkinson’s avoid and why
COX-2 inhibitors
worsening of Parkinson’s symptoms
what drugs should people with respiratory failure avoid and why
neuroleptics
respiratory depression
what drugs should people with epilepsy avoid and why
reduced seizure threshold
what drugs should people with chronic liver disease avoid and why
warfarin
increased sensitivity and bleeding
list anticoagulants
heparin
clopdogrel
warfarin
enoxaprin
uses for heparin
prevent blood clots
strokes
chronic a-fib
post op
normal and therapeutic aPTT
20-35s
1.5-2x normal
how often should aPTT levels be drawn to titrate
q4-6hrs
heparin antidote
protamine sulfate
side effects of bleeding
hematuria
hematemesis
bruising
downtrending H&H
complications of heparin
heparin induced thrombocytopenia and thrombosis
when does HITT usually occur
5-10 days after heparin exposure
when should you expect HITT
unexplained platelet drop
clinical manifestations of HITT
skin lesions at heparin injection site
fever
chills
dyspnea
chest pain
normal PT
10-13s
normal and therapeutic INR
normal <1-2
therapeutic 2-3
warfarin antidote
vitamin k
contraindicated during pregnancy
anticonvulsants
phenytoin
carbamezepine
divalproex
gabapentin
lamotrigine
levetiracetam
Therapeutic level for phenytoin
10-20mcg/ml
side effects of phenytoin
gingival hyperplasia
nursing considerations phenytoin
antacids can reduce effects
short acting antianxiety
midazolam
onset:rapid
duration 1-2 hours
intermediate acting antianxiety
alprazolam, intermediate, D 6-12hrs
clonazepam, intermediate, d 18-50hrs
lorazepam, rapid iv, intermediate po, 2-6 hrs
long acting antianxiety
diazepam, rapid, 20-50 hours
indication for lorazepam
anxiety, sedation, seizures
lorazepam nursing consideration
avoid alcohol
monitor respiratory depression
antidote flumazenil
types of antipsychotics
haloperidol
quetiapine
olanzapine
types of antihistamines
diphenhydramine
promethazine
cimetidine
famotidine
ranitidine
nursing considerations for diphenhydramine
monitor for drowsiness
anticholinergic effects
Types of ace inhibitors
captopril
enalapril
lisinopril
angiotensin 2 receptor blocker
lorsartan
calcium channel blockers
amlodipine
diltiazem
nifedipine
verapamil
nursing consideration for enalapril
discontinue if causes a dry cough
monitor bp
contraindicated in pregnancy
enalapril indications
hypertension
chf
Lorsartan indications
hypertension
dm neuropathy
CHF
losartan nursing considerations
monitor BP
monitor fluid levels
monitor renal and liver status
contraindicated during pregnancy
amlodipine indications
hypertension
angina
nursing considerations for amlodipine
avoid grapefruit
monitor BP - orthostatic hypotension
cause gingival hyperplasia
beta blockers
propranolol
atenolol
metoprolol
propranolol indications
hypertension
angina
arrhythmias
mi
cardiomyopathy
alcohol withdrawal
anxiety
nursing considerations for propranolol
do not discontinue abruptly
can mask the signs of hypoglycemia
caution with asthma and cold-bronchospasm
antiarrhythmics
amiodarone
adenosine
procainamide
atropine
adenosine indications
SVT
adenosine nursing considerations
systole after administration
rapid push or won’t work
warn it may feel like they get kicked in the chest
warn family about systole
caution with asthmatics
atropine indications
excessive secretions
sinus bradycardia
heart block
nursing considerations for atropine
monitor for urinary retentions and constipation
avoid in patients with glaucoma
Cardiac glycoside
digoxin
digoxin indications
heart failure
a-fib
a-flutter
CHF
cariogenic shock
signs of digoxin toxicity
vision changes
blurred vision
yellow green vision
bradycardia>arrhythmias
therapeutic digoxin levels
.5-2ng/ml
Risk factors for digoxin toxicity
hypokalemia
loop diuretics
licorice extract acts like aldosterone (black licorice)
hypomagnesemia
hypercalcemia
eldery
classes of anti-infectives
ahminoglycosides
fluoroquinolones
macrolides
vanco
penicillins and cephalosporins
antivirals
antifungals
an amino glycoside
gentamicin
fluoroquinolones
ciprofloxacin
levofloxacin
macrolides
erythromycin
azithromycin
penicillins and cephalosporins
amoxicillin
ampicillin
ancef
antifungals
amphotericin b
metronidazole
nystatin
gentamicin indications
gram negative infections
nursing considerations for gentamycin
monitor for tinnitus
do not administer wit penicillin
ciproflaxicin indication
infection
ciprofloxacin nursing indications
can cause qt prolongation
decreases effects of phenytoin
vancomycin indications
infection,
sepsis
nursing considerations for vancomycin
monitor for ototoxicity and nephrotoxicity
red-man syndrome
administer over at least 60 minutes, central line preffed
amoxicillin indication
infections, skin, respiratory, endocarditis
nursing considerations for amoxicilliin
monitor for rash
monitor kidney function
Rescue meds
albuterol
ipratropium
long term respiratory meds
guaifenesin-expectorant
montelukast-
theophyline
albuterol nursing considerations
be cautions with heart disease, diabetes, glaucoma or seizures
causes tachycardia
loop diuretics
bumetanide
furosemide
torsemide
potassium sparing diuretics
triamterene
amlioride
spirolactone
thiazide diuretics
chlorothiazide
clorthalidone
hydrochlorothiazide
indapamide
uses of loop diuretics
increase urinary output, edema, chf, blood pressure management
nursing considerations of loop diuretics
monitor potassium levels
uses for potassium spring diuretics
hypertension
edema
swelling hypokalemia
nursing considerations for potassium sparing diuretics
monitor potassium levels
not as strong as other diuretics, may combine with others
uses for thiazide diuretics
hypertension, chf
nursing considerations for thiazide diuretics
monitor electrolyte levels
monitor BP
GI medications
bisacodyl
lactulose
metoclopramide
ondansetron
omeprazol
pantoprazole
ondansetron indications, nursing considerations
nausea vomiting
administer slowly
fast push can cause qt prolongation and vt
omeprazole indications
GERD, ulcers
omeprazole nursing considerations
administer 30-60 minutes before meal
report black, tarry stools
NSAIDS
aspirin
ibuprofen
naproxen
Acetaminophen max daily dose
4g
acetaminophen antidote
n-acetylcysteine
NSAID uses
pain, inflammation, fever
nursing considerations for NSAIDS
can cause prolonged bleeding
can cause peptic ulcers
acetylsalicylic acid (asprin) nursing considerations
risk of bleeding
reyes syndrome can occur wit viral infections
only use with meds for Kawasaki disease
opioids
morphine
fentanyl
hydromorphone
methadone
oxycodone
morphine nursing considerations
CNS depressant
constipation is a side effect
monitor respiratory rate
antidote is naloxone
What do tocolytics do
slow contractions
types of tocolytics
terbutaline
magnesium-sulfate
indomethacin
nifedipine
what to oxytocin’s do
stimulate contractions
types of oxytocics
oxytocin
ergometrine
misprostol
magnesium sulfate indications
hypomagnesemia, torsade de point, preeclampsia, preterm labor, seizures, asthma exacerbation
nursing considerations for magnesium sulfate
monitor for hypermagnesemai
give IV slowly
oxytocin indications
induction of labor, PPH
nursing considerations for oxytocin
monitor contractions
monitor fetus
warn mother contractions will be more painful
monitor BP, HR, glucose, and k
Steroids
betamethasone
dexamethasone
cortisone
fluticasone
methylprednisolone
methylprednisolone indications
inflammation, allergy, autoimmune disorders
nursing considerations of methylpredisolone
monitor for cushings
immunosupression
hyperglycermia
osteoporosis
delayed wound healing