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Pharm > Pharmacology 3 > Flashcards

Pharmacology 3 Flashcards

1
Q

What medications are
used for Iron Deficiency
anemia?

A

Ferrous Sulfate
Iron Dextran

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2
Q

What medications are used for pernicious anemia?

A

Vitamin B12
Cyancobalamin

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3
Q

What medications are used for megaloblastic anemia?

A

Folic Acid
B12+Cyanocobalamin

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4
Q

What does iron deficiency anemia cause?

A

RBCs to be small and pale

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5
Q

What does nuclear (megaloblastic) anemia cause?

A

RBCs to be longer in shape
missing intrinsic factor

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6
Q

Does does hemolytic anemia cause

A

RBCs to be destroyed (inside or outside cell)

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7
Q

What is a normal HGB level?

A

13-18 for males
12-16 for females

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8
Q

What is a normal HCT level?

A

45-52% for males
37-48% for females

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9
Q

What type of iron is ferrous sulfate given for?

A

ONLY IRON DEF.

Do not give if pt does not have this specific type or has iron overload

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10
Q

Side effects of Iron Dextran ?

A
  • Stains the skin black and permanently
  • orthostatic hypotension
  • fatal anaphylaxis
  • Elderly responds better to lower doses
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11
Q

What method is used to give Iron Dextran?

A

Z-track

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12
Q

What can happen with iron dextran?

A

Anaphylaxis
GIVE A TEST DOSE

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13
Q

What are s/s of iron poisoning?

A

melena, hematemesis, n/v, diarrhea
shock = hypotension, tachypnea, pallor, coma, acidosis

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14
Q

Treatment of iron poisoning

A

bowel irrigation, defoxamine (Desferal)

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15
Q

What causes pernicious anemia?

A

Vitamin B12 deficiency

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16
Q

S/S of pernicious anemia?

A
  • Beefy red tongue
  • Skin and mucous membranes affected (GI disturbances)
  • Neurological changes (Numbness, tingling hands feet , CNS damage)
    Dysrhythmias, heart failure, infection, bleeding
  • Signs of anemia (Fatigue, pallor)
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17
Q

Cardinal signs of pernicious anemia?

A

Beefy red tongue, pallor, neuropathy

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18
Q

Side effects of cyancobalamin?

A

itching, diarrhea, fever, hypokalemia

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19
Q

What causes folic acid (megaloblastic) anemia?

A

Folate (B9) deficiency

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20
Q

What do you treat this Megaloblastic (Macrocytic) Anemia with?

A

Folic Acid (B9)
Do not give this with other anemias

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21
Q

Types of bleeding disorders?

A

hemophilia, genetic disorders, limited/absent coagulation factors

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22
Q

Which factor is hemophilia A missing?

A

factor VIII

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23
Q

What factor is hemophilia B (Christmas Disease) missing?

A

Factor IX

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24
Q

S/S of hemophilia

A

easy bruising, excessive/prolonged bleeding, internal bleeding with “slight” injuries

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25
Q

What lab levels to get for hemophilia?

A

Coagulation labs

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26
Q

What are examples of anticoagulants ?

A

Warfarin (coumadin)
Low-molecular-weight heparins (LMWHs)
Heparin

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27
Q

What does heparin help with?

A
  • for quick anticoagulation needs (stroke, pulmonary embolism, massive DVT)
  • prevent clots
  • prevents post-op venous thrombosis
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28
Q

What needs to be done with admin of heparin?

A

Check IV doses w/ another nurse

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29
Q

What is an example of a low molecular weight heparin (LMWH)?

A

Lovenox

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30
Q

When is LMWH
used?

A
  • Emergency anticoagulation therapy
  • Situations where clot formation is a risk
  • Slowed blood flow
  • Prevent AND/OR Treat DVT and PE
  • Anticoagulation “Bridge”
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31
Q

Where do you admin Lovenox?

A

2 inches from umbilicus

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32
Q

Side effects of LMWH

A

low platelets, hemorrhage, hypersensensity, neurological damage

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33
Q

What is the half-life of heparin and LMWH?

A

Heparin: 1-2 hours
LMWH: 4.5-7 hours

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34
Q

What to give for heparin/LMWH toxicity?

A

protamine, replace lost blood

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35
Q

Side effects of warfarin?

A

bleeding, hepatitis, muscle pain purple toe syndrome

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36
Q

What to do for warfarin overdose?

A

d/c warfarin
start Vitamin K

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37
Q

What is a normal aPTT time?

A

45-70 seconds

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38
Q

What is a normal PT time?

A

18-24 seconds

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39
Q

What is a normal INR while taking warfarin?

A

2-3

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40
Q

What is an antiplatelet?

A

aspirin

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41
Q

When to use an antiplatelet?

A

Prevent acute MI

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42
Q

side effects of aspirin

A
  • n/v
  • dyspepsia
  • hemorrhagic stroke
  • prolonged bleeding
  • gastric bleeding
  • thrombocytopenia
  • tinnitus
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43
Q

What are other examples of antiplatelets?

A

Antiplatelet ADP inhibitors
- Clopidogrel
- Ticlopidine
Antiplatelet Glypoprotein Inhibitors
- Eptifibatide
- Tirofiban

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44
Q

Side effects of Clopidogrel and Ticlopidine ?

A

chest pain, bleeding, low platelets, flu-like symptoms

45
Q

What are glycoprotein inhibitors used for?

A

unstable angina/MI

46
Q

Examples of glycoprotein inhibitors?

A

Eptidibatide (Integrilin)
Tirofiban (Aggrastat)

47
Q

Examples of centrally acting alpha2 adrenergics?

A

Clonidine (Catapres)
Methyldopa

48
Q

What are centrally acting alpha2 adrenergics used for?

A

decrease HR, decrease force of cardiac contraction, make heart “chill out”
Hypertension

49
Q

Side effects of CAAAs

A

bradycardia, orthostatic hypotension, drowsiness, rebound HTN (if d/c’ed too fast)

50
Q

What do we assess when giving clonidine?

A

Apical heart rate don’t give if less than 60

51
Q

When do we not give clonidine?

A

HR <60

52
Q

Example of cardiac glycosides?

A

Digoxin (Lanoxin)

53
Q

What does Digoxin treat?

A

heart failure, atrial fibrillation

54
Q

Side effects of Digoxin?

A

bradycardia, hypotension
green/purple/yellow vision (toxicity)
halo vision (toxicity)

55
Q

What is the therapeutic range of Digoxin?

A

0.5-0.8 ng/mL

56
Q

How to treat Digoxin overdose?

A

Atropine
hold next dose

57
Q

When do we not give Digoxin?

A

HR <60

58
Q

Potency of diuretics from most to least potent

A

Loop diuretics
Mannitol (osmotic) diuretics
Thiazide diuretics
Potassium sparing diuretics

59
Q

Example of a loop diuretic?

A

Lasix (furosemide)

60
Q

When are loop diuretics used?

A

Rapid diuresis needed
control HTN
Manage edema r/t HF
hepatic or renal disease

61
Q

Side effects of Lasix?

A

dehydration, ototoxicity, hypokalemia, hypochloremia, hyponatremia, decrease in HDL, increase in LDL

62
Q

When to not give loop diuretics?

A

anuria, severe electrolyte depletion

63
Q

Lab levels to asses w/ loop diuretics?

A

BUN & Creatinine

64
Q

Examples of Thiazide diuretics?

A

HCTZ
Chlorothiazide
metolazone

65
Q

Thiazide diuretics used for?

A

HTN, mild to mod HF, edema, hepatic cirrhosis

66
Q

Side effects of thiazide diuretics?

A

decrease sodium & potassium
increase calcium & LDL
decrease libido

67
Q

Contraindications of thiazide diuretics?

A

sulfa allergy
anuria/severe renal failure

68
Q

S/S of hypokalemia?

A

s/s
- hypotension*
- general weakness/fatigue
- muscle cramps
- n/v
- constipation
- irritable, confused *
- arrhythmia/tachycardia **
- shallow respiration **

  • early signs
    *** late signs
69
Q

Examples of osmotic diuretics?

A

Mannitol (osmotrol)

70
Q

Osmotic diuretics used for?

A

Cerebral edema, increased intracranial & intraocular pressure

71
Q

Contraindications of Mannitol?

A

Pulmonary edema
severe kidney disease
intracranial bleeding

72
Q

Normal potassium values?

A

3.5-5.0

73
Q

S/S of hyperkalemia?

A

s/s:
- general weakness
- muscle fatigue, twitches, cramps, paralysis
- abdominal cramps
- distention
- nausea
- diarrhea
- irritable, anxious
- hypotension
- arrhythmias

give kayexalate for hyperkalemia

or IV sodium bicarbonate may be used to help lower hyperkalemia

74
Q

How is potassium chloride administered?

A

Orally

75
Q

Example of potassium sparing diuretic

A

Spironolactone
Triamterene

76
Q

What is spironolactone used for?

A

To decrease loss of K+
edema of multiple etiologies
left ventricular MI

77
Q

Side effects of spironolactone

A

endocrine effects, increased urinary frequency

78
Q

Side effect specific to Triamterene?

A

Turns urine blue
anemia
low folate

79
Q

What is important to monitor with K+ sparing diuretics?

A

LOC

80
Q

Examples of Nitrates/Nitrites meds?

A

Nitroglycerin
Isosorbide Dinitrate
Isosorbide Mononitrate

81
Q

Side effects of nitro?

A

headache, hypotension, reflex tachycardia

82
Q

Contraindications of nitro?

A

Use of ED meds
closed-angle glaucoma

83
Q

What is the max dose of nitro?

A

3 - 0.4 mg tabs or sprays

84
Q

How often should sublingual nitro tabs be replaced?

A

every 3 months

85
Q

What are examples of osmotic laxatives?

A

miralax
milk of mag

86
Q

what are side effects of osmotic laxatives

A

rectal bleedings, diarrhea, abdominal cramps

87
Q

Contraindications of milk of mag?

A

hypermagnesia
hypocalcemia

88
Q

Are osmotic laxatives used short or long term?

A

short term

89
Q

examples of saline laxatives?

A

fleets enema

90
Q

Side effects of a fleets enema?

A

arrhythmias, cramping, N/V, hypokalemia, sodium retention

91
Q

Is a fleets enema for short or long term?

A

short

92
Q

examples of stimulant laxatives?

A

Bisacodyl (Ducolax)

93
Q

Side effects of Ducolax?

A

abdominal cramps, nausea, diarrhea

w/ long-term use: hypokalemia, muscle weakness

94
Q

Is ducolax used short or long term?

A

short term

95
Q

What laxative can be taken long term?

A

Metamucil (psyllium)

96
Q

Other examples of laxatives?

A

Mag citrate
mineral oil
pericolace
colace

97
Q

side effects of laxatives?

A

cramps, diarrhea, n/v, electrolyte imbalances

98
Q

Examples of antiemetics?

A

odanestron (Zofran)
promethazine (Phenegran)
prochlorperazine (Compazine)
metoclopramide (Reglan)

99
Q

Side effects of antiemetics

A

sedation, neuro issues, heartbeat irregularities, anticholinergic effects

100
Q

Contraindications of antiemetics

A

Zofran- long QT interval, phenylketonuria
Phenegran/Compazine- <2 yrs old, allergy to phenothizines
Reglan- GI obstruction, seizures, Parkinson’s

101
Q

Examples of antidiarrheals?

A

loperamide hydroxychloride (Imodium)
bismuth-subsalicylate (Peptop-Bismul)
diphenoxylate HCL (Lomotil)

102
Q

Side effects of antidiarrheals?

A

constipation, drowsiness, dizziness, cardiac irregularities

Pepto- tinnitus

103
Q

Side effects of antidiarrheals?

A

constipation, drowsiness, dizziness, cardiac irregularities

Pepto- tinnitus

104
Q

Contraindications of antidiarrheals?

A

hypersensitivity, constipation
Imodium- alcohol intolerance
Pepto- children w/ viral infection
Lomotil- infectious diarrhea

105
Q

Contraindications of antidiarrheals?

A

hypersensitivity, constipation
Imodium- alcohol intolerance
Pepto- children w/ viral infection
Lomotil- infectious diarrhea

106
Q

Examples of anticholinergics/antihistamines

A

scopolamine (Transderm-Scop)
hydroxyzine hydrochloride (Visteral)
meclizine hydrochloride (Antivert)
dimenhydrinate (Dramamine)

107
Q

Side effects of anticholinergics/antihistamines

A

anticholinergic effects, drowsiness, blurred vision, palpitations

108
Q

Anticholinergics/antihistamines used for….

A

N/V, motion sickness

109
Q

Contraindications of anticholinergics/antihistamines?

A

hypersensitivity, cardiac irregularities, pregnancy/lactation

use caution w/ geriatric pts

Pharm (14 decks)

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