Skills test! Flashcards
what therapeutic class is glycopyrrolate
Antipasmodics (suppresses muscle spasm)
what pharmacological class is glycopyrrolate
anticholinergics (blocks acetylcholine NT’s - inhibit parasympathetic nerve impulse)
what is the indications for glycopyrrolate
inhibits salivation & excess respiratory secretions when given preoperatively or for palliative care.
(Reverses some of the secretory & vagal actions of cholinesterase inhibitors used to treat non depolarizing neuromuscular blockade) (Adjunctive management peptic ulcer disease)
What is the action of gylcopyrrolate
Inhibits the action of acetylcholine @ postganglionic sites located in smooth muscle, salt. glands & CNS. Low doses decrease sweating, salivation & respiratory secretions. Intermediate doses increase HR & large doses decrease GI & GU motility.
what is the therapeutic effect of glycopyrrolate
Decreased GI & resp secretions. Not well absorbed orally. Crosses placenta
Onset of glycopyrrolate
15-30 minutes or longer
peak of glycopyrrolate
30-45 minutes or longer
duration of glycopyrrolate
2-7 hours
half life of glycopyrolate
~2 hours
when is glycopyrolate contraindicated
hypersensitivity, glaucoma, hemorrhage, tachycardia, ulcerative colitis, toxic megacolong
what are side effects of glycopyrollate
headache, congestion, tachycardia, dry mouth, vomiting, urinary hesitancy, flushing
interactions of glycopyrollate
increased GI mucosal lesions with oral potassium chloride, may alter absorption of oral drugs by slowing motility
what to assess before giving glycopyrolate
HR, BP, RR, Intake/output in geriatric, bowel sounds, LBM, may cause decreased uric acid
what is the antidote for glycopyrolate
Neostigmine
What should you teach the patient
will decrease respiratory secretions. Avoid extreme temperatures, may cause dizziness, notify if eye pain.
what is the T class of dimenhydrinate
Antiemetics, antihistamines
what is the indication for dimenhydrinate
N/V, Dizzy, vertigo w/ motion sickness
what is the action of dimenhydrinate
Inhibits vestibular stimulation, significant CNS depression, anticholinergics, antihistaminic, antiemetic
what is the therepeatuci effect of Dimenhydrinate
decrease vestibular stimulation - prevent motion sickness
what is the onset of dimenhydrinate
20-30 minutes
what is the peak of dimenhydrinate
1-2 hours
what is the duration of dimenhydrinate
3-6 hours
what is cautioned for dimenhydrinate
glaucoma, seizure, prostatic hyperplasia
what are the side effects of dimenhydrinate
Drowsiness, anorexia, hypotensioon, diarhea, dry mouth
what are the interactions of dimenhydrinate
increased CNS depression w/ antihistamines alcohol or opiod
what is the normal dose of dimenhydrinate
50 mg Q 4 hours
what should you assess for dimenhydrinate
N/V, Bowel sounds, abdominal pain, emesis, input, output, dehydration, avoid alcohol & may cause drowsiness
what T class is insulin
Antidiabetics, hormones
what P class is insulin
Pancreatics
What indication is insulin
control hyperglycaemia
what is the action of insulin
lower bg by stimulations. glucose uptake in skeletal muscle & fat, inhibit gluconeogenisis, lypolysis, proteolysis, enhances protein synthesis
what is the therapeutic effect of insulin
control hyperglycaemia
what should be known about insulin requirements
stress increases requirements
beta blockers, clonidine, resepin mask hypoglycememia symptoms
alcohol decreases insulin requirements
what should you assesss for
Hypoglycemia ( Anxiety, restless, tingles, chills, sweat, confusion, drowsy, hungry, headache, nervous, tachycardia
All about lispro
Onset: 10-15 minutes Peak: 60-90 minutes Duration: 3-5 hours Give immediately before meals can be mixed
all about NPH
onset: 1-3 hours
peak: 5-8 hours
duration: 12-18 hours
don’t give IV
can be mixed with rapid or reg
storing insulin
28 days once open - don’t forget to label
keep out of sunlight & heat
how long to label tubing for
96 hours (4 days)
how much fluid to flush `
3-5mls
what gauge for sub cut
25
what length for sub cut 90 degrees
1/2 or 12 mm
what length for sub cut 45 degrees
5/8 inch of 16mm
what amounts to grasp for different angles
5cm to do 90, 2.5 cm to do 45
storage of insulin
28 days room temp
unopened in the fridge
void heat & sun
less pain at room temp
what gauge needle for IM
20-25 gauge needle for aqueous, 18-21 for oil
what is the max volume sub cut
1-1.5 ml
what is the mac volume for IM
2-3 is ideal, can do up to 5
what length needle IM
1-1.5 inch but usually 1.5
