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Quiz 4 Flashcards

1
Q

Heparin
Action
Use
Administration
Antidote

A

Bind with antithrombin III (inhibit clot formation, stops coagulation cascade)
Prevent venous thrombosis
SubQ: prevention
IV: treatment
Protamine sulfate

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2
Q

Adverse effects of heparin

A

Nosebleeds, blood urine and stool, bloody gums
Heparin-induced thrombocytopenia (low platelets caused by heparin)

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3
Q

Antidote of warfarin

A

Vitamin K

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4
Q

Direct Factor Xa
Antagonist
Prototype
Action
Use

A

Rivaroxaban (Xarelto)
Inhibits platelet activation
Prevention of VTE and stroke

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5
Q

Adverse reactions of alteplase
Antidote

A

Hemorrhage
Aminocaproic acid

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6
Q

3 factors the predispose pts to thrombosis

A

Stasis: blood slow = > cot
Vascular damage
Hypercoagulability: > chance of coagulation

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7
Q

Arterial clot formation vs venous clot formation

A

Arterial: damaged vessels
Venous: caused by circulatory stasis

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8
Q

Heparin lab (what is it)
Therapeutic

A

apTT: how long it takes for a clot to form (activated thromboplastin time)
45-70 sec

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9
Q

Enoxaparin (lovenox)
What is it?
Administration
Labs

A

Low-molecular-weight heparin (having a low molecular weight)
SubQ
Frequent lab monitoring not required

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10
Q

Contraindication of enoxaparin

A

renal impairment

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11
Q

Side effects of enoxaparin

A

lower risk of bleeding

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12
Q

Vitamin K antagonist
Prototype
Action
Use

A

Warfarin (Coumadin)
Inhibits hepatic synthesis of Vitamin K
Prevent thromboembolic events

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13
Q

Labs for warfarin

A

INR (international normalized ratio). Time it takes to clot
Therapeutic range: 2-3
(calculated from PT (prothrombin time))

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14
Q

Antiplatelet
Prototype
Action
Use
OTC

A

Clopidogrel (plavix)
Action: irreversibly suppresses platelets (platelet lifespan is 7-10 days)
Prevents new clots or prevent them from getting bigger
Aspirin

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15
Q

Thrombolytic
Prototype
Action
Use

A

Alteplase (Activase)
Bind to fibrin promoting conversion of plasminogen to plasmin (plasmin digests fibrin)
Disintegrates clots

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16
Q

When do we give alteplase

A

Severe cases where leg isn’t being perfused
Ischemic stroke

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17
Q

Erythropoiesis-stimulating agents
Prototype
MOA
Use

A

Epoetin alfa (procrit)
Mimics hormone erythropoietin. Only give if benefits > risk
Anemia secondary to chemotherapy or kidney disease

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18
Q

Granulocyte colony stimulating factor
Prototype
MOA
Use
Administration

A

Filgrastim (neupogen)
Tell bone marrow to make more neutrophils
Neutropenia secondary to marrow transplant or chemo
SubQ or IV

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19
Q

Adverse effects of filgrastim

A

Flu-like symptoms
Arthralgia (joint stiffness)
Splenomegaly

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20
Q

Interferons
Prototype
MOA
Use
Administration

A

Interferon alfa 2B
Antiviral, destroys viruses
Antineoplastic, boost immune response
SubQ or IM (3 times a week)

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21
Q

What are interferons
Functions

A

Proteins naturally occurring in the body (alpha, beta, gamma)
Slow growth of cancer cells, stimulate certain WBCs to fight cancer, antiviral effects

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22
Q

Black box warning on Epoetin alfa

A

Hemoglobin must be < 10 g/dl
Avoid if hemoglobin > 12g/dl = > blood clots

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23
Q

Epoetin alfa
Administration

A

SubQ, IV

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24
Q

Nursing interventions of filgrastim

A

Palpating abdominal in case of splenomegaly

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25
Function of triglycerides
Store unused calories and provide your body with energy
26
Nonpharmacological methods for cholesterol reduction
< saturate fats and cholesterol < total fat intake to 30% or less of caloric intake < cholesterol intake to 300mg/day or less Exercise Stop smoking
27
HMG CoA Reductase Inhibitors Prototype Action Use
Atorvastatin Inhibit enzyme HMG CoA reductase (responsible for cholesterol biosynthesis) Reduce amount of cholesterol the body makes. < LDLs, > HDL
28
Side effects of HMG CoA reductase inhibitors
GI distress, constipation, fatigue, cataracts, liver impairment, muscle cramps, rhabdomyolysis (skeletal muscle destruction) brown colored pee
29
Bile acid sequestrants Prototype Action Use
Cholestyramine Binds with bile acids in the intestine to be excreted out Remove bile (cholesterol) from the body. Causes cholesterol to be pooped out
30
Side effects of bile acid sequestrants
Constipation, flatulance, cramping
31
Fibrates Prototype Action Use
Fenofibrate Increases breakdown of fatty acids Reduces triglycerides
32
Adverse effects of fibrates
GI upset, liver dysfunction, gallstones
33
Intervention of fibrates
Get liver checked out, labs
34
Cholesterol Absorption inhibitor Prototype Action Adverse effects
Ezetimibe acts on the cells in the small intestine to inhibit cholesterol absorption Diarrhea
35
Misc. Antihyperlipidemics Prototype Action
Nicotinic acid/ Niacin/ Vitamin B Reduces VLDL and LDL
36
Side effects of Misc. Antihyperlipidemics
GI distress, flushing, hepatic dysfunction, hyperglycemia, hyperuricemia
37
Nursing interventions for dyslipidemia medications
Blood lipid levels Monitor lab values for liver function Take several weeks before blood lipid levels decline Instruct pt to have annual eye exams and report changes in visual acuity
38
Function of cholesterol
Cell membrane Steroid hormones Bile salts: digestion of fats
39
HDL vs LDL
High-density lipoprotein: removes cholesterol from blood-->liver for elimination Low-density lipoprotein: Fat leaks out into bloodstream = plaque buildup
40
Should you suddenly stop taking HMG CoA reductase inhibitors?
No, taper Abrupt discontinuation may lead to rebound effect
41
Interventions for bile acid sequestrants
Drink with water Stay hydrate Eat more fiber
42
Why do we not want to administer antihyperlipidemics
Large doses are required Leads to bad reactions/toxicity
43
Nursing responsibilities for immunosuppressants
Monitor for infection
44
Autoimmune disorders
Crohn's Disease: bowel inflammation Rheumatoid arthritis Psoriasis: plaque lesions Myasthenia Gravis
45
Function of antigens
recognize self vs pathogens
46
What happens after an organ transplant
Graft rejection reaction: fight the organ and rejecting it Can lead to organ failure
47
Why do clients that receive transplanted tissue require immunosuppressants?
So body doesn't deny it
48
Anti-rejection therapy Drugs MOA Adverse effects How long?
Mycophenolate Mofetil (CellCept), Cyclosporine Suppress the immune system Increase risk for infection For life
49
contraindications of cyclosporine
Grapefruit juice Cause toxicity
50
Administration of cyclosporine
Mix cyclosporine with juice to make it palatable
51
Corticosteroids Drugs Use How long?
Prednisone, hydrocortisone Asthma, COPD, joint pain Short term, Tapered
52
Side effects of corticosteroids
Anti-inflammatory effects, immunosuppressive effects, moodswings, increased appetite Long term: moon face, weight gain
53
Antibody (immunoglobulin) preparations Route MOA Drugs
Parenterally Block cell receptors or inhibit inflammatory cytokines Monoclonal antibodies Polyclonal antibodies. Muromonab-CD3, infliximab, basiliximab
54
Antibody (immunoglobulin) preparations Use Side effects
Reduces damage caused by inflammation Prevent rejection Risk for infection
55
How is antibody preparations preapred?
Make multiple antigens, put in a bottle, and given to redirect their immune system
56
Side/Adverse effects of chemotherapy
Affects normal cells (rapidly growth tissues) Alopecia, infertility, anemia, myelosuppression (< in WBC, platelets, RBC), dry/flaky skin, nosebleeds
57
How long till the body starts feeling the effects of chemotherapy?
7-10 days Try to avoid people because immunocompromised
58
Anticancer drugs
Alkylating agents (prevent DNA replication) Antitumor antibiotics Hormones Antimetabolites Vinca alkaloids
59
Function of combination chemotherapy
Enhances tumoricidal activity (destroys tumor cells) > chance of affecting cancer cells in all phases of cell cycle > synergestic effects to kill cancer cells < drug resistance
60
Why are 2 anticancer drugs used instead of just 1?
Synergistic effect when combined

Pharmacology (10 decks)

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