Study hints exam 3 Flashcards
valium (diazepam)
treats seizures in progress (status epilepticus)
valium (diazepam) Side effects
most serious adverse effect is cardiovascular collapse; assess for hypotension (SBP drops 20 mm HG hold), tachycardia, and edema
assess for respiratory status depression
valium overdose treatment
flumazenil [romazicon]
never give valium within 14 days of
maois
dilantin (phenytoin)
anti seizure- treats all but absence seizures
dilantin therapeutic range
10-20 mcg/mL
s/sx of dilantin toxicity
nystagmus, confusion, ataxia, coma, seizures
which anti seizure med causes gingival hyperplasia
dilantin
what color is your pee on dilantin?
pinkish red to reddish brown
what do you report to HCP if on dilantin?
blood dyscrasia (fever, sore throat, nose bleeds, bruising, rash) or hepatoxicity (jaundice)
what affect does dilantin have for diabetes?
monitor serum glucose bc dilantin inhibits insulin release and so may cause hyperglycemia
What is the therapeutic range for valproic acid [depakote]?
50-100 mcg/mL
what are adverse effects of valproic acid [depakote]?
photosensitivity and pulmonary edema
what is overdose treatment for valproic acid [depakote]?
naloxone [narcan]
what can lower serum drug levels of depakote?
hemodialysis
how do you treat a od of tegretol [carbamezepine] for anit seizure?
activated charcoal with gastric lavage
what is adverse effect with tegretol [carbamezepine]?
stevens johnsons syndrome (fever, sore throat, and fatigue)
treat myanthenia gravis with
reganol; anticholinesterase
reganol toxicity
severe cholinergic reaction-give atropine
reganol and food
give with foods to ENHANCE absorption and decrease GI upset
how to diagnose myanthenia gravis
tensilon test (edrophonium)
Parkinsons Disease
levodopa and carbidopa (SInemet) dopamine agonist
levodopa treats well
tremors, bradykinesia, gait and muscle rigidity
urine and perspiration may darken with which med?
simemet (levodopa and carbidopa)
which med do you avoid foods high in pyridoxine (vit B6) such as beef, liver, pork, ham, egg yolks, whole-grain or fortified cereals, or multivitamins bc they decrease the effects?
Sinemet (PD drug) levodopa/carbidopa
which drug cant be taken with food/bevs high in protein
Sinemet (PD drug) levodopa/carbidopa
which drugs whould you keep a food journal to assist HCP with dosage?
Sinemet (PD drug) levodopa/carbidopa
Which drug may take months for full therapeutic effects to take place?
Sinemet (PD drug) levodopa/carbidopa
what is another drug besides Sinemet (PD drug) levodopa/carbidopa to treat PD?
Mirapex (dopamine replacement) pramipexole
which PD drug causes EPS?
mirapex [treat with cogentin]
what is an anticholinergic agent that treats PD and EPS caused by PD meds?
benztropine [cogentin]
what is dose of cogentin
0.5-1 mg at bedtime; increase by .5 mg q 5-6 days; max 6mg/day
which anti PD med must you be careful in hot weather?
cogentin
which drug treats alzheimers
aricept [donepezil] reversible cholinesterase inhibitor that causes elevated ach levels in the cortex, which slows the neuronal degradation of alzheimers disease
which med do you monitor for suicide?
aricept for alzheimers
what does interferon beta 1a betaseron treat?
Multiple sclerosis
which MS drug do you handle with gloves gown, and goggles and clean spills with calcium hydrochlorite?
mitoxantrone [novatrone]
which muscle relaxants are used to treat MS?
Baclofen [lioresal] dantrolene [dantrium] diazepam [valium]
What durg treats ALS
Riluzole [rilutek]
what special consideration for Rilutek for ALS?
avoid high fat meals immediately before or after administration
baclofen [lioresal] for als
treats muscle spasms
wha do you assess for with lidocaine and bronchoscopy
gag reflex
which anesthetic is useful for young patients?
ketamine/ketalar
why use EPI with lidocaine for local anesthesia
epi causes vasoconstriction and prolongs the effects of local anesthesia, but dont use it on the ends of body areas or necrosis may happen. Toxic if applied to open skin or mucous membranes
can prolong labor by depressing uterine contractions
Malignant hyperthermia
inhalation agents (except nitrous oxide) with succinylcholine unexplained tachycardia, jaw muscle spasms and rigidity, dramtic increased temp, rhabdomyolysis indicated by cola colored urine, dysrhythmias, potential death
carbamezepine [tegretol] od
activated charcoal and gastric lavage
opioids od
narcan, trexan
digoxin od
digibind
tylenol od
mucamyst
Cox2 adverse effects
celebrex increases risk for MI, CVA, HTN, and preipheral edema
stevens johnson syndrome
Cox 2 treat what?
NSAIDS but with no risk for platelet aggregation
adverse effects of asa
gi bleed, reyes syndrome, tinnitus, toxicity [>200mcg/mL]
caution vit K deficiency and pts with asthma-hypersensitivity: bronchospasm, laryngeal edema and anaphylaxis
adverse effects of tylenol
hepatotoxic >2g/24h
not anti inflammatory
signs of opioid od
cold clammy skin, drowsy, dizzy, restless, confused, miosis (pinpoint pupils) decreased HR, BP, RR
PUD lifestyle treatment
decrease use of NSAIDS, ASA, corticosteriods
PUD pharmacology
antacids, h2 blockers, PPIs, antibiotics, cytotec, carafate
H2 antagonist administration
with food or one hour before antacid
ranitidine [zantac]
cimetidine
carafate administration
before meals
cytotec administration
with meals
PPI administration
before meals
antacids administration
after meals
what does cytotec treat
PUD assoc with long term use of NSAIDS or steriods
may cause spontaneous abortion
REglan and Zofran treat
n/v associ with chemo
Aluminum toxicity
caution use with renally impaired–> aluminum toxicity
carafate
H. pylori treatment
pepto, flagyl, amox, tetra
EPS symptoms with which meds?
reglan, compazine (antiemetics)
which med has anticholinergic effects? reduce gastric motility
gastrozepine [perenzepine]
which med dissolves gall stones
ursiodol-actigall
which med prevents gall stones
chenex
which meds interfere with fat soluble vitamin absorption
lubricant laxative-mineral oil
besides fat soluble vit absorption, what else is negatively absorbed when taking lubricant laxatives such as mineral oil?
anticoagulants
who gets pancreatic enzymes
those with pancreatitis, cystic fibrosis, and steatorrhea
what is patient teaching for pancreatic enzymes
pork allergy
iron
antacids
PPIs
prazoles’ suppress secretion of HCL IRREVERSIBLY
treat short term gastric ulcers, active PUD and duodenal ulcers, erosive esophagitis, GERD
give at bedtime
H2 blockers
tidines; prevent release of Hcl in response to gastrin;
treat PUD, GERD, reflux, esophagitis, prevent stress ulcers
Use of antacid in renal disease
prevent hyperphosphatemia in renal failure
muscle cramps, tetany
phoslo [calcium acetate], tricalcium phosphate, TUM [calcium carbonate] CRF phosphorus levels
Lactulose for GI and hepatic d/o
treat constipation
decrease ammonia production and absorption with liver disease
Monitor electrolytes with which meds
antacids, osmotic laxatives, stool softeners, stimulants
antiflatulent
simethicone
most commonly used absorbant drug
activated charcoal
use of lomotil
decrease peristalsis in the intestines (antidiarrhea)
can enhance depressant effects of barbituates, alcohol, narcotics and sedatives
lomotil se
dizziness, lethargy, anticholinergic effect in high doses, additive effects with CNS depressants
sulfasalazine [azulfidine]
antiinflammorty med for IBS
iron replacement for bleeding and folate replacement
what med can be used with viagra
ranolazine [ranexa]
