Week 3 Pharmacology Flashcards
whats mannitol
- sugar-alcohol that is not effectively metabolized
- excreted largely unchanged in urine
whys mannitol used in emergency settings
lowers ICP when due to cerebral edema
when should you not use mannitol
crystals are present
what is the MOA of mannitol
pulls excess fluid from CNS into the vascular space Via osmotic gradietn
what are adverse rxns of mannitol
fluid overload (worsening HF, pulmonary edema, etc.)
renal failure
confusion
coma
sedation
whats the function of antiplatelet drugs
prevent platelet adhesion (needed to form thrombus)
ex. ASA (Aspirin), Clopidogrel (Plavix), Ticagrelor (Brilinta
ASA
- contraindicated in children due to Reyes syndrome
- pain relief properties not worthwhile in era of NSAIDS/acetaminophen
what modification was made to ASA due to its irritating effects
often enteric coated
what are the main indications for antiplatelet drugs?
treatment and prevention of MI/CVA
prevent in-stent re-thrombosis following angioplasty
why are antiplatelets often more beneficial than anticoagulant drugs?
lower bleeding rates
thrombolytic drugs
drugs that break down, or lyse, already formed clots
ex. Alteplase/TPA (Activase, Cathflo), Tenecteplase/TNK (TNKase)
whats the MOA of thrombolytic drugs
activate plasminogen and convert it to plasmin, which lyses the thrombus
what are the indications of thrombolytic drugs?
acute MI (STEMI)
arterial thrombolysis (DVT, PE)
acute ischemic stroke
blocked central line
what are adverse effects of thrombolytic drugs?
bleeding (internal, intracranial, and superficial)
N/V, HTN
hypersensitivity/anaphylactoid reactions
reperfusion cardiac dysrhythmias
what are some nurisng implications for thrombolytic drugs
- follow institutional guidelines for preparation and administration
- monitor IV sites for bleeding, redness, pain
- monitor bleeding from gums, mucous membranes, nose, and injection sites
- watch for signs of internal bleeding (decreased BP, restlessness, increased pulse, worsening neurological status)