week 3 Flashcards
OTC
NON PRESCRIPTION
60% of all meds
Criteria for OTC Status
Consumer must be able to clearly diagnosis his/her condition (ie. Abdo pain, fever, cough)
Consumer must be able to monitor the effectiveness of the drug
Indication for use should be clearly listed
Safety profile should be limited to drug interaction and a low rate for abuse
Practical for OTC use (easy to use and easy to monitor)
tylenol dont need to know this
is the most toxic medication because it effects the liver and it is the most misused medication
*if you self medicate dont need to know this
you can wait two days before seeking medical therapy
About — % of all modern drugs are derived from plants.
30%
Dietary Supplement and Health Education Act (DSHEA) of 1994
NOT FDA APPROVED
Herbal products are known as “alternative medicine”
Herbal products are considered “dietary supplements”
No proof of efficacy or safety requirements
No standards for quality control
May claim effective but do not have to promise a specific cure
These are not FDA approved
Patient’s need to do there own research and educate themselves
Generally not endorsed by the health care team
does not have to be passed through inspection
Herbal Supplements
Herbal medications are often perceived as natural agents, therefore harmless, but this is not the case.
They are indeed medications and should be respected as such
Very little is known about these remedies because there is no law to report side effects, toxic effects, effectiveness etc. when compared to synthetic drugs.
Echinacea
Used to improve immune function, known to increase T-cell production.
May have anti-inflammatory properties
Contraindicated:
In patients with TB, M.S., diabetes or autoimmune diseases. It may increase inflammation in patients with autoimmune diseases.
Ginseng
Used to increase physical endurance and reduce fatigue.
May decrease blood sugar
Contraindications:
People with diabetes should monitor their blood sugar closely
Interacts with anticoagulants, antidiabetic agents, caffeine and theophylline. May cause irregular heart beats.
theophylline
for COPD and a lot of interactions
Ginkgo Biloba
Improve circulation, especially in the nervous system. Improves cerebral circulation and cognitive function in patients with cerebrovascular disease. To improve memory
Contraindications:
May increase bleeding time and other coagulation factors.
May decrease the effectiveness of anticonvulsants and increase the effects of anticoagulants.
Garlic
May reduce cholesterol (only for 6 months).
Anti-infective properties, may be effective in the treatment of Helicobacter Pylori of the stomach.
Contraindications:
may increase bleeding time, may inhibit iodine absorption (should not be taken by people with hypothyroidism)
Anticoagulants, oral anti-diabetic and insulin interact with garlic.
St John’s Wart
Provides antidepressant effects
Contraindications:
Used with prescription antidepressants, ie: Prozac, Paxil and Zoloft can lead to toxicity.
May interact with diuretics, NSAID’s, oral contraceptives, digoxin and coumadin.
homeopathic meds
NOT HERBAL DRUGS are non toxic, highly diluted, low doses, will make the body go back to normal state.
very little drug-drug interactions.
the higher the number the more diluted it is.
used to treat allergies, ibs, arthritis, fever, skin
not considered for cancer, infection, and emergencies.
can be combined with a lot of other drugs because its safe
no FDA
include in history
Enteral Nutrition
Provision of food or nutrients through the GI tract
Available in a digested form, partially digested or indigested form
Parenteral Nutrition
Nutrients are delivered directly into the circulation by means of an intravenous solution (TPN)
PN- Peripheral administration (PICC peripherally inserted central catheter)
Temporary, short term (less than 2 weeks)
Dextrose concentration generally less than 10%
PN-Central administration
Long-term use (7 to 10 days) or months
Dextrose concentrations may be 10% to 50%
Delivered through a large central vein
Subclavian
Internal jugular
Parenteral Nutrition aka
total parenteral nutrition (TPN) or hyperalimentation
piggy back system.
cannot give in peripheral veins because they will pop.
glucose over 10%
should not be given peripherally
Central TPNSide/Adverse Effects
Infection
Catheter induced trauma
Technical and mechanical problems
Metabolic complications (concentrated volumes are being delivered)
Hyperglycemia (dextrose concentrations of 10%-50%)
Nursing ImplicationsTPN
Ensure that a complete nutritional assessment is taken, including a dietary history, weekly and daily food intake, and weight and height measurements
Consult with a registered dietitian
Monitor blood glucose levels with a glucometer
Monitor for hyperglycemia (more common)
– Headache, dehydration, weakness, confusion, ketoacidosis
Monitor for hypoglycemia
– Cold, clammy skin, dizziness, tachycardia, tingling of the extremities
While on TPN, the pancreas is providing increased amounts of insulin to cover the increased glucose levels
If TPN is discontinued abruptly, rebound hypoglycemia may occur until the pancreas has time to adjust to changing glucose levels
If TPN must be discontinued abruptly, then infuse 5% to 10% glucose to prevent hypoglycemia
Monitor for fluid overload while on TPN
– Weak pulse, hypertension, tachycardia, confusion, decreased urine output, pitting edema
Monitor daily weights and intake and output volumes
Monitor for therapeutic responses to nutritional supplementation
– Improved well-being, energy, strength, and performance of activities of daily living
– Increased weight
– Laboratory studies that reflect a more positive nutritional status
