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Module 7 > UNIT 2: MEDS TO KNOW > Flashcards

UNIT 2: MEDS TO KNOW Flashcards

1
Q

What pharm. Class is furosemide?

A

Loop diuretic

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2
Q

What is the MOA of a loop diuretic like furosemide?

A

Loop diuretics work by acting at the loop of henle in the kidney in order to block sodium and other ions from being reabsorbed, which eventually leads to reduced water reabsorption and fluid loss in the urine.

Most powerful diuretics and fastest acting diuretic acts within 30mins to 1 hour after administration making it good for emergent uses.

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3
Q

What is the purpose of a loop diuretics like furosemide?

A

Remove excess fluid/diuresis- increase production of urine to remove excess fluid from the body

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4
Q

What are common uses of loop diuretics like furosemide?

A
  1. Peripherial edema
  2. Pulmonary edema
  3. HTN
  4. Acities

All of the above are situations of fluid overload which can be removed by removing fluid by the body.

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5
Q

When should you avoid giving diuretics like furosemide?

A
  1. In the evening
  2. keep in mind for order of med admin. If possible give last so that they dont have to use the bathroom while finishing med admin/assessments
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6
Q
A
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7
Q

What do you want to make sure your patient has easy accsess to when taking a diuretic like furosemide?

A

Easy bathroom accsess

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8
Q

What should we closely monitor with a patient taking furosemide?

A
  1. I&O/Daily weights
  2. Electrolyte levels
  3. Report a urine output less than 30ml/min because a poor urine output even after taking a diuretic can be a sign of a more serious issue
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9
Q

What are some adverse effects furosemide?

A
  1. Ototoxicity- high dose or administered too quickly. May require dose adjustment.
  2. Hypokalemia-
    • low k+ can lead to life-threatening affects (disrythmias)
    • DO NOT give if levels are below 3.5.
    • Usually have a k+ protocol.
    • Teach patinet to eat foods high in k+
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10
Q

What is the pharm class of Heparin?

A

Anticoagulant

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11
Q

What is Heparin?

A

It is an anticoagulant meaning it is given to prevent blood clot formation by thinning the blood. It does not break up exisiting clots rather prevent new ones from forming.

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12
Q

Who is given haparin?

A
  1. Patients who are at high risk for developing blood clots like patients with a history of DVTs and PE, storke, Heart attacks.
  2. Used to flush central lines to prevent blood inside from clotting and blocking assess to the line.
  3. Used to prevent clotting during long procedures like open heart surgery

Prevents blood clots

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13
Q

What are potential side effects of taking heparin?

A
  1. Can cause life- threatening bleeds
    • high alert drugs
    • Look for s/s of bleeding- hypotension.
  2. Can lower platelets- Thrombocytopenia (HIT)
    • Monitor platelets.
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14
Q

What should we monitor when a patient is taking Heparin?

A
  1. PTT
    • used to measure how long the blood takes to clot and can be a good tool to tell us how well heparin is working
    • Check baseline PTT… when on heparin the level should be 1.5- 2x bigger. meaning it clots 1.5-2x longer to clot…
  2. Monitor platelets.
    • Assess for signs of HIT
    • Drop in more than 50% of platelets or platelets under 150k
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15
Q

What do we want our PTT levels to do when a patient is on heparin?

A

Needs to be 1.5-2x greater than their baseline

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16
Q

What do we do if a patient on heparin has a PTT level is greater than 2?

A

This patient is at risk for uncontrolled bleeding… stop the heparin and call the provider

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17
Q

What do we do if a patient on heparin has a PTT level less than 1.5

A

Call the provider for an increase in dose. Anything less than 1.5 the patient is not being anticoagulated sufficently.

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18
Q

What is the antidote for heparin?

A

Protomin sulfate given IV

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19
Q

What is the pharm class of lisiopril?

A

Ace inhibitor

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20
Q

What is the MOA of Lisinioprin (ace inhib)

A

Work by blocking angiotensin converting enzyme (ACE) which blocks the conversion of (inactive form) angiotensiin I to its active counterpart (active form) angiotensin II. Reduced angiotensiin II cause vasodilation, and reduced downstream signaling of aldosterone further reducses blood volume. The overall effect is lowering blood pressure

Note the function of Angiotensin II- constricts blood vessels and increases blood volume… which increases blood vessels– so when lisinopril is taken this function is blocked

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21
Q

What are the clincial uses of ACE inhibitors like lisinopril?

A
  1. Treat HTN
  2. Heart failure
22
Q

What are side effects of a ace inhibitors like lisinopril?

A
  1. DRY cough
  2. Hypotension- monitor for to rapid of a decrease
  3. angioedema (sweeling from leaking of fluid)- can become life threatening.
    • Teach pt to report any facial swelling ASAP
  4. Hyperkalemia
    • Monitor electrolytes during treatments
    • Teach pt to avoid k+ supplements, salt substitutes, diuretics
  5. Can cause terotogenic effects
  6. Can cause dizziness (orthostatic hypotension)
    • Fall bundle, change postions slowly
23
Q

How do ace inhibitors treat heart failure?

A
  1. The left ventricle pumps blood out of the aorta passing through a valve called the aortic valve just as the left ventricle contracts to sqeezes to push blood forward the blood pressure in the aorta pushes back to keep the aortic valvue shut. A healthy heart is able to overcome the pressure and open the valvue with each venttricular contraciton pumping blood out to the rest of the body. (normal physiology)
  2. In heart failure the heart is failing to pump enough blood out to the body. The left ventricle becauses too weak to sqeeze and pump blood forward against the pressure of the blood making it harder to open up the aoritc valve. Since ace inhibitors lower blood pressure there is less pressure or resistence pressing back agaisnt the aortic valve. making it easier for the heart to pump forward throught the aortic valve and out to the body.
  3. Another word for the resistence pushing back.. is afterload.
24
Q

What is the pharm class of Metorprolol?

A

Beta blocker (antihypertensive)

25
Q

What is the action of Metoprolol?

A

Blocks beta adrenergic receptors in the sympathetic nervous system. Selective to beta-1 at low doses. If we block beta 1 we see a decrease in HR, BP, and CO. This is why it is used as a antihypertensive mediction

Beta 1- increases HR, BP, Increases CO
Beta 2- Bronchodilation

26
Q

What are the uses of metroprolol?

A
  1. Managment of HTN
  2. CHF
  3. Angina
  4. MI
  5. Tachy arrythmias (over 100bpm)
  6. Possible migrane treatments
27
Q

What are the side effects of metoprolol?

A
  1. Bradycardia
  2. Orthostatic hypotension
  3. Dizziness
  4. Insomnia
  5. If dose is high enought it can block beta 2 receptors causing bronchoconstriction. which may present as wheezing and SOB
28
Q
A
29
Q

Contraindications for giving metorprolol?

A

Patients with…
1. Asthma
2. COPD
3. Bradycardia
4. Hypotension
5. Cardiogenic shock
6. Acute heart failure
7. Acute pulmonary edema

Due to the risk of the beta 2 receptor being affected

30
Q

What is the antidote of metoprolol?

A

Glucogon, norepinephrine/Epinephrine

31
Q

What are nursing considerations for metoprolol?

A
  1. monitor HR and BP. Make sure within normal limits before administering.
  2. Avoid abrupt discontinuaiton
    • Abrupt stop can cause rebound HTN. Must be tapered off even if BP is improving.
32
Q

What is meropenem?

A

Antibiotic is used to treat infections caused by bacteria. It works by killing the bacteria or prevententing their growth.

33
Q

What type of antibiotic is meropenem?

A

Carbapenem-type antibiotic.

34
Q

What are side effects of meropenem?

A
  1. Upset stomach
  2. Headache
  3. N/V/D
  4. Constipation.
35
Q

What are some nursing considerations for meropenem?

A
  1. Ask pt to report history of brain disorders (seizures, head injury, tumor, kidney disease, stomach, intestinal diseases
  2. Medication may cause headaches, numb/tingling skin or seizures. Do NOT drive, use machinery, or do any activity that requires alertness or clear vision until you are sure you can do so safely.
  3. Meropenem may cause live bacterial vaccines (such as typhoid vaccine) to not work well.
36
Q

What is thiamine used for?

A

Thiamine is used to treat or prevent vitamine B1 deficiency.

Thiamine is used to treat beriberi (tingling and numbness in feet and hands, muscle loss, and poor reflexes caused by a lack of thiamine

Used to treat wernicke-karsaskoff syndrome (tingling and numbness in hands and feet, memory loss, confusion caused by a lack of thiamine.

37
Q

Who is most at risk for thiamine deficiency?

A

1.Older adults
2. Alcohol dependant
3. HIV/Aids
4. Diabetics
5. Malabsorpiton syndrome patients
6. Bariatric surgery patients

38
Q

Why is thiamine important?

A

It is needed by the body to turn foods into energy, which is important for growth, development and function of cells. Thiamine is needed for the breakdown of carbohydrates.

39
Q

What are side effects of thiamine?

A
  1. Flushing
  2. Hives
  3. Itching
  4. Weakness
  5. Sweating
  6. Nausea
  7. Restlessness
40
Q

What class of medication is Thiamine?

A

Vitamin

41
Q

What conditions may increase your need for thiamine?

A
  1. alcoholism
  2. burns
  3. Diarrhea (continuing)
  4. Fever (continuing)
  5. Illness (continuing)
  6. Intestinal disease
  7. Liver disease
  8. Overactive thyroid
  9. Stress (Continuing)
  10. SUrgical removal of stomach

Patients using an artifical kidney on hemodialysis and individuals who do heavy manual labor on a daily basis may have a deficiecny of thiamine

42
Q

What are s/s of berberi

A
  1. Loss of appetite
  2. constipation
  3. muscle weakness
  4. pain or tingling in arms or legs
  5. mental depression
  6. memory problems
  7. weakness
  8. sob
  9. fast heart beat

Beriberi is a condition where you are low in thiamine

43
Q

What is the MOA of nicardipine?

A

Like other calcium channel blockers, nicardipine acts by blocking the influx of calcium ions into vascular smooth muscle and cardiac cels during depolorization. The inhibitition of calcium flux results in a vasodilation and decrease in cardiac work and oxygen consumption.

Used for short-term tx of HTN and chornic stable angina. prophylacticly used for migranes

44
Q

What are side effects of nicardipine?

A
  1. Flushing
  2. Swelling of the feet
  3. Headache
  4. dizziness
  5. Weakness
  6. Chest Pain
  7. Racing Heart
  8. Dry mouth
  9. Drowsiness
45
Q

What should we do before administering nicardipine?

A

Monitor bp and pulse prior to therapy.
Monitor intake and output and daily weights
Assess for signs of HF.

46
Q

What class is dobutamine?

A

Inotropic agent

47
Q

What is dobutamine?

A

Dobutamine stimulates heart muscle and improves blood flow by helping the heart pump better.

Used short term to tx cardiac decompensation due to weakened heart muscle

48
Q

What are side effects of dobutamine?

A
  1. N/V
  2. Fever, tingly feeling
  3. headache
  4. leg cramps
49
Q

Tell patients to report which adverse effects of dobutamine immediately?

A
  1. SOB even mild with exertion, swelling or rapid weight gain
  2. chest pain, fast or pounding heartbeats
  3. light-headed feeling, like you might pass out
  4. Weezing, chest tightness
  5. Dangeriouly high blood pressure- severe headache, blurred vision, buzzing in ears, anxiety, confusion, uneven heartbeats, seizure
    6.
50
Q

As the nurse what should we monitor when a patient is recieving dobutamine?

A
  1. RR
  2. bp
  3. oxygen
  4. vitals signs
51
Q

What exam may a patient get when taking dobutamine?

A

EKG

52
Q
A

Module 7 (22 decks)

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