test one Flashcards
What is considered high alert drugs list 4 and why
high risk of causing injury when misused
anticoags-bleeding
insulin-low blood glucose and coma
narcotics and opiates-addiction and LOC/coma
sedatives- addiction and LOC/coma
What is the treatment for over dose with in one hour list 3
topical decontamination
prevention of absorption-gastric lavage or activated charcoal
neutralization- administer acid or base
what is the tx for overdose after one hour 3
hemodialysis, peritoneal dialysis, chelating agents, antidote
Two things to remember about activated charcoal
Mix-it is clumpy and may taste bad and assess bowel sounds first
Acetaminophen overdose procedure 3
Activated charcoal, watch liver labs, N-acetylcysteine as antidote
What would you do for asprin overdose? 5 plus two drugs
Activated charcoal, seizure precautions, thermal management, electrolyte replacement, alkalize urine, n-acetylcysteine amd mucomyst
What would you do for benzo overdose? 4
Activated charcoal, flumazenil 0.2mg titrate as needed, seizure
What would you do for opioid OD 2
Respiratory support, naloxone 0.4mg watch for re-admin
What should you do for a dig overdose?
Dig level right away and 6 hrs after, activated charcoal, fluid/e, digibind, watch dysrhythmias
Def for schedule 1 drug
No medical use, high pot for addiction, lack of accepted safety
Liver fail and drugs 4
slow drug metabolism-build up of drugs in system- toxic levels
Liver damage
reduced effectiveness with prodrugs which have to be metabolized in the liver
not making proteins- competing or build up=toxic
potency
Amount needed to have specific effect
efficacy
Maximum response that can be produced by the drug
steady state
quantity of drug eliminated in the unit of time equals the quantity of drug that reaches the systemic circulation in the unit of time
it takes about four half lives to reach a steady state
so 4X 1/2 (measured in time)=steady state
Half life
The time it takes for a drug to be at 50 percent in plasma levels
If you make a med error as a nurse what steps would you take
Assess the patient, implement interventions, notify with SBAR, fill out an incident report but do not document
What about ionized drugs and what does that mean?
They don’t pass through cell walls acid in base is ionized in excretion you need ionized
First pass effect
Straight to liver less at the site then
Inter-patient drug response
Dosing is based on the ED50 which is the dose required to elicit the desired response in 50 percent of patients
ED-therapeutic TD-toxic LD-lethal
Therapeutic index
Range between ED50 to TD50
Direct or physical interactions
IV crystals
Pharmacokinetics interactions
Alter the drug process absorption…
interactions Pharmacodynamics
Same or different sites
Combined toxicity
Toxic to the same organ
Who are at most risk for drug Drug interactions 2
Someone with 2 or more chronic diseases and the elderly
Dairy binds with what drug
Tetracycline
What does grapfruit juice do to metabolism
increase or decrease
2 drugs that produce high B{P
tryamine and MAO inhib
What drug is effected by vit k and how?
and what together increases vit k
warfarin it reduces it
potassium diuretics and salt substitutes
Idiosyncratic reaction
uncommon effect related to genetic predisposition
What to do for digoxin overdose 6
Drug level immediately, and at 6 hrs. activated charcoal fluid and e digibind-monitor potassium drop tx dysrythmias atropine
one thing about adrenergic receptors
Complex so better specificity
Alpha 1
Alpha 2
Beta 1
Beta 2
nasal mydriasis
HTN
heart and kidneys
asthma
What are the non-selective adrenergic agonists how to remember 5
whats the outcast and what does it do?
epinephrine, dopamine, droxidopa, ephedrine, norepi
Ephedrine-nasal
What are the alpha selective adrenergic agonists 4 and mneumonic
phenylephrine, intranasal decongestants, ocular decongestants, midodrine
a penny in the nose makes your eyes water down your midline and causes anxiety
What are the beta adrenergic agonists 4 and mneumonic
Isoproterenol, bronchodilators, dobutamine, tocolytics
isolating the broncos causes doubt and anxiety to Coloradans (toco)
what are the selective alpha 1 adrenergic antagonist drugs and whats special
mneumonic
prazosin tx high bp and the others help pee
end in sin/pee/antagonizing
non-selective beta blockers end in and two exceptions
propan for lungs the rest is htn
atenolol and metrapropolol is selective
lol
selective beta 1 blocker anf one thing mnemonic
metoprolol and atenolol
tx htn and no lung involvement
there is a ten at metrostate
What does muscarinic
Cholinergic
3 cholinergic agonists mnemonic and exception
Bethanechol, carbachol, pilocarpine
The cars are for glaucoma
chol-chol car-car
cant drive if you cant see
What are stigmines and what do they do?
for what?
Cholenergic agonists blocks acetolcholine erysterace increases mm contraction
myasthenia gravis
what does succinylcholine do
what is it used for?
CI?
competes with acetocholine= long depolarization of mm=decrease ca=no mm movement
Surg
Malignant hypothermia
cholenergic antag name 3 and what they tx
Atropine, oxybutynin, scopolamine
I look at the pines they give me oxygen and I eat a scoop of ice cream
A-blocks cholenergic effects and all that goes with it
O-over active bladder
S-sick car
one thing about scopolamine
Causes sedation and urine retention used surg
what to drugs do you need to be careful with?
carvendilol and isoproterenol
