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NCLEX YOU GOT THIS! > UWORLD meds > Flashcards

UWORLD meds Flashcards

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1
Q

sodium polystyrene sulfonate

A

KAYEXALATE

  • used to treat hyperkalemia
  • works in GI tract to trade sodium for potassium, eliminating excess in stool and decr serum levels
  • *does not impact creatinine, phosphorus or calcium levels**
  • must have normal bowel function to avoid the risk of intestinal necrosis assess for s/s of constipation, signs of impaction and recent bowel patterns
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2
Q

methotrexate

A

for rheumatoid arthritis

adverse effects:
bone marrow suppression (can lead to anemia, leukopenia and thrombocytopenia (characterized by petechiae, purpura and other signs of bleeding)
hepatotoxicity
GI irritation

BM suppression is managed by dose reduction or discontinuation of med

caffeine + folic acid decreases effectiveness

TERATOGENIC !!

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3
Q

dopamine

A

outcome: increases HR, BP, CO + UO

Closely monitor VS –> higher doses can lead to dangerous tachycardia and tachyarrhythmias

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4
Q

Tamoxifen

A

prescribed to pts with breast cancer and prevent reoccurance

  • common side effects similar to menopause (hot flashes, vag dryness, menstrual irregularities)
  • serious side effects: thromboembolic events and endometrial cancer
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5
Q

clopidogrel (plavix)

A

antiplatelet medication, should be discontinued 5-7 days before surgery to decr risk for excessive bleeding

** meds (anticoagulants, antiplatelets, NSAIDS, herbal drugs) that incr risk for bleeding should be discontinued 5-7 days before surgery)

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6
Q

lactulose

A

given to pts with liver complications such as hepatic encephalopathy (high serum ammonia levels)

med reduces the ammonia by trapping it in the gut and then expelling it
–> improved MS

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7
Q

antiplatelet medications

A

prasugrel (effient)
clopidogrel (plavix)
ticagrelor (brilinta)

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8
Q

niacin (nicotinic acid/B3)

A

used in large doses for lipid-lowering poroperties

- may produce cutaneous vessel vasodilation

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9
Q

transdermal fetanyl patch

A

indicated to treat moderate to severe CHRONIC PAIN
- not recommended to treat acute postoperative, temporary or intermittent pain as it does not provide immediate analgesia when applied

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10
Q

esomeprazole

A

long term use of PPI may decrease the absorption of calcium and promote osteoporosis
increased risk of diarrhea caused by c. diff PPIs can suppress acid that would have prevented pathogens from more easily colonizing the upper GI tract… increased risk for pneumonias

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11
Q

phenothioZinews

A

1 ND = safety + educating about s/s of infection, report to HCP

major tranquilizers
for our ZANY pts
SEs –> ABCDEFG
anticholinergic, blurred vision, constipation, drowsiness, EPS (tremors, parkinson), foto-sensitivity, aGRANULOCYTOSIS

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12
Q

names of tricyclic antidepressants + major info

A

elavil, trofranil, aventyl, desyrel

ELEVATES MOOD, HAPPY PILLS!

med takes 2-4 weeks for beneficial effects

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13
Q

SE of tricyclic antidepressants

A

ABCDE

anticholinergic (esp dry mouth)
blurred vision
constipation
drowsiness
euphoria
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14
Q

benzos info, uses, ending

A

always have ZEP in the name
valium is the prototype (induction of anesthetic, muscle relaxant, alcohol)

uses:
seizures medications
preop induction of anesthesia
muscle relaxants
etOH withdrawal med 
ventilation (med to relax and calm down pts on vent)

REMEMBER THESE ARE MINOR ANTIPSYCHOLITCS
“what do you find at a zeppelin concert? minors on transquilizers”

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15
Q

why administer major and minor antipsychotics at the same time?

A

major –> take longer to work
minor –> start right away
pt usually on valium and elavil at same time, then valium is discontinued
similar to heparain and coumadin

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16
Q

SE of benzos

A 
ABCD
anticholinergic 
blurred vision 
constipation
drowsiness
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17
Q

MAOIs uses, teaching points, med beginning

A

antidepressant, thought to be caused by norepi, dopamine and serotonin in brain
all the beginnings of MAOIs rhyme “MARplan, NARdil, PARnate”

AVOID TYRAMINE-CONTAINING FOODS –> MAY CAUSE HYPERTENSIVE CRISIS

  • BAR bananas, avacados, raisins
  • grains except yeast
  • meats - no organ liver, kidney, tripe, heart, preserved
  • dairy - no cheese except mozz, cottage cheese
  • no ETOH, elixers, tinctures, caffeine, chocolate, licorice, soy sauce
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18
Q

MAOIs SEs

A 
*** same as benzos 
ABCD
anticholinergic 
blurred vision
constipation
drowsiness
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19
Q

litium

uses, SEs

A

used for treating bipolar disorder, decreases mania
**se’s act more like an electrolyte - think potassium/lithium
3 P’s
peeing (polyuria)
pooping (diarhea)
parasthesia (earliest sign of electrolyte imbalance)

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20
Q

what is the earliest sign of electrolyte imbalance

A

PARESTHESIAS

NUMBNESS AND TINGLING

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21
Q

toxic effects of lithium

A

tremors
metallic taste
severe diarrhea

22
Q

1 NI for pt on lithium pooping and peeing all the time

A

GIVE FLUIDS!!
monitor sodium, sodium must be normal
too high = ineffective
too low = toxic

23
Q

prozac (fluoxetine) SEs and special considerations

A 
SSRI - MOOD ELEVATOR 
SEs ABCDE
anticholinergic 
blurred vision
constipation
drowsiness
euphoria 
** causes insomnia so give before noon, if 2x daily then 6am and noon
** when changing doses assess suicidal risk in ADOLESCENTS
24
Q

haldol (haloperidol) SEs

A

tranquilizers (basically same as thorazine)
ABCDEFG
anticholinergic, blurred vision, constipation, drowsiness, EPS, fotosensitivity, aGranulocytosis
**teach pts how to look out for s/s of infection, report to HCP
** first gen antipsychotics

25
Q

haldol might develop what from overdose and risk factors

A

NMS (neuroleptic malignant syndrome) from OD

** this is a lifethreatening idiosyncratic reaction to antipsychotic drugs characterized by fever, AMS, muscle rigidity and autonomic dysfunction **

SEEN IN ELDERLY + YOUNG WHITE SCHIZO PTS
HIGH FEVER OVER 105
DOSE SHOULD BE 1/2 USUAL ADULT DOSE

also safety concerns r/t SEs

26
Q

how to differentiate NMS from EPS

A

both present with anxiety and tremors
NMS will have high fever, 102 and rising call EMRT
+ NOTIFY HCP

27
Q

clozaril (clozapine) SE and med type

A

atypical antipsychotic
aGRANULOCYTOSIS !
** IT IS WORSE THAN CANCER DRUGS AND CAN TRASH PTS BONE MARROW

28
Q

Geodine (ziprasidone)

A

BLACK BOX WARNING

PROLONGED QT INTERVAL CAUSE CAUSE SUDDEN CARDIAC ARREST
DON’T USE IN PTS W CARDIAC CONDITIONS

29
Q

ending of second gen antipsychotics

A
  • zapine

** metabolic changes as SEs *like weight gain, high chol, high BP, high BG

30
Q

1 NI for clozaril (clozapine)

A

monitor WBCs

31
Q

Zoloft (sertraline) SEs and drug interactions to avoid

A 
SEs "SAD Head"
sweating 
apprehension *impending sense of doom*
dizziness 
headache 
*can also cause insomnia

interact with StJohn’s wort and can cause serotonin syndrome
warfarin and cause bleeding
** d/t these meds not being metabolized in liver

32
Q

which meds should the nurse anticipate a lower dose for if on st johns wort and warfarin

A

ZOLOFT

33
Q

serotonin syndrome manifestations

A 
TOO MUCH SEROTONIN IN BRAIN! 
mental changes 
tachycardia 
tightness in muscles 
difficulty walking 
incr in BP and temp
34
Q

tocolytics

A

STOP CONTRACTIONS, STOP LABOR

given to women in premature labor, must be stopped

35
Q

terbutaline (brethine)

A

tocolytic

SE: maternal tachycardia (don’t give with cardiac disease)

36
Q

magnesium sulfate

A

tocolytic

treatment will induce hypermagnesemia, which will cause everything to go down

HR down, BP down, REFLEXES DOWN, RR DOWN, LOC down

37
Q

NI for hypermagnesia

A

monitor RR, <12 decrease dose of mag sulfate

assess for reflexes
normal reflexes 2+
reflexes 0 or 1+ –> decrease dose of mag sulfate
reflexes 3+ or 4+ increase dose of mag sulfate

38
Q

oxytocics

A

stimulate and strengthen labor

39
Q

pitocin (oxytocin)

A

SE: utermine hyperstimulation (longer than 90 seconds, closer than 2 mins)
NI: lower dose

40
Q

methergine

A

oxytocic

causes HTN: increases BP

41
Q

betamethasone

A

steroid, fetal/neonate lung med
- give to mother IM, can repeat as long as baby is in utero

SE: increase glucose (steroid)

42
Q

surfactant (survanta)

A

lung med
given to baby via transtracheal route
given after birth

43
Q

humalin 70/30

A

mix of insulin N and R… 70% = N 30% = R

to remember the bigger number, think of a fraction… the numerator N is on top, therefore insulin is the bigger number

44
Q

can you mix insulin in same syringe and how?

A

• Yes, insulin can be mixed in the same
syringe
• How do you mix insulin?

(1) Pressurize vial and (2) Draw up insulin
(1) To pressurize the vial … Inject air into N, then into R, Draw up R
(2) To draw up insulin … Think of RN

45
Q

needle for injections IM

A

o Pick answer in which both answers
have a “1” in them
o “I” in IM looks like the “#1”
o Use a 21-gauge, 1-inch long needle

46
Q

needle for subq injection

A

o 5 looks like an “S” in “SubQ”
o Pick the answer that has “5s” in it
o Use a 25-gauge, 0.5 inch needle

47
Q

max amount of time heparin can be given for?

A

3 weeks, 21 days

after 21 days body starts making antibodies against heparin

48
Q

antidote and labs for heparin

A

protamine sulfate
PTT
** can be used during pregnancy, class c med

49
Q

coumadin info, antidote, labs

A 
given only PO
takes few days to a week to work (likely 4-5 days)
pts can be on coumadin for entire life 
antidote: vitamin K 
labs: PT/INR
NOT USED DURING PREG
50
Q

what is the only antipsychotic given to preg women

A

HALDOL!

51
Q

diuretics

A

k wasting, k sparing
any diuretic ending in X, XES OUT K
if it does not end in X it is a sparer

lasix –> wastes K and Diuril is k wasting

Brand vs Generic
o Aldactone Spinorolactone**
o Adactazide Spinorolacone-Hydrochlorothiazide
o Modurectic Amiloride-Hydrochlorothiazide
o Lasix** Furosemide
o Bumex Bumetanide**
o Clotrix Clotrimazole
o Esidrex Hydrochlorothiazide**
o Demadex Torsemide
o Diuril Chlorothiazide
52
Q

2 muscle relaxants to know

SEs + teaching points

A

brand/generic

lioresal/baclofen
flexeril/cyclobenzaprine

SE: fatigue/drowsiness, muscle weakness (paresis)
Teaching:
don't drink
don't drive
don't operate heavy machinery

NCLEX YOU GOT THIS! (14 decks)

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