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Pharm.Final.
Pharmacology
| Question | Answer |
|---|---|
| Pharmacodynamics | Study of biochemical and physiological effects of drugs and their molecular mechanisms by which those effects are produced. |
| pharmacokinetics | drug mvmt through body |
| bioavailability | Amt of drug absorbed into blood stream |
| pharmacogenetics | study of the influence on an individual’s response to drugs |
| agonist | stimulate cell function |
| antagonist | inhibit cell function by occupying receptor site |
| Opioid: Morphine action | Binds to Opioid receptors in brain and spinal chord |
| Morphine Indications | o acute and chronic pain (MI Burns, CA, traumatic injury) o pre and post surgery o pre and post diagnostic procedures o L&D o TX Pulmonary edema, GI gisorders, severe cough |
| Morphine AE | o Constipation o resp distress o urinary retention o N/V o Hypotension o Sedation o Itch o pinpoint pupils (Toxic) |
| Morphine RN Implications | oSmallest effective dose oreduce amt for those recieing other CNS depressants; Give 30 before tx or dressing change; Observe s/s withdrawal anxiety, aggressiveness, insomnia, N&V, diarrhea, elevated temp, elevated resp rate and bp. |
| Morphine Antidote | Narcan |
| Opioid: Demerol action, indications, AE | (same as morphine's) |
| Demerol AE | same as morphine's+metabolite (seizures, tremors, hallucinations) |
| Demerol RN Implications | has a ceiling where as morphine does not |
| Demerol antidote | Narcan |
| Narcotic Antagonist | Narcan |
| Narcan Action | reverse analgesia and depressive effects of opiates by displacing opiates from receptor sites to specific opiates |
| Narcan Indications | opioid toxicity |
| Narcan AE | may cause withdrawal symptoms in opiate dependent people( sweating, redness, diarrhea) |
| Narcan RN Implications | needs repeated injections |
| NSAID | •inhibit synthesis of prostaglandins both in CNS and periphery •higher daily doses of these increase a women’s risk for HTN |
| NSAID prototype | Aspirin (analgesic, anti-pyretic, anti-inflammatory) |
| Aspirin Action | inactivation or the COX-1 and COX-2 , inhibits formation of prostaglandins |
| Aspirin Indications | inflammation, analgesia, antipyretic, Dysmenorrhea, prevent colorectal CA, suppression of platelet aggregation low dose ASA indications •prevent MI, ischemic stroke, TIA’s, acute MI, chronic stable angina, unstable angina, angioplasty |
| Aspirin AE | GI •heart burn, nausea, gastric ulceration, perforation and bleeding •Bleeding •renal impairment •salicysim (tinnititus, headache, dizziness, sweating) |
| Aspirin RN Implications | Teach name of drug, reason for use, prescribing info, adverse affects, storage and prep |
| Ibuprofen/Advil Action | reversible inhibition of Cox 1 and Cox 2 |
| Ibuprofen/Advil Indications | inflammation, analgesia, antipyretic, anti platelet effect only when drug present in blood, mild/mod pain and or inflammation with OA, RA, gout, bursitis, head ache, minor trama, minor surgery, dysmenorrhea |
| Ibuprofen/Advil AE | GI, nephrotoxicity, increased bleeding tendencies, htn, hypersensitivity w, dyspnea, bronchospasms, skin rash |
| Ibuprofen/Advil RN Implications | NSAIDS don’t protect against MI and stroke |
| Acetaminophen | Tylenol |
| Tylenol Action | Inhibits prostaglandin synthesis in CNS only, NOT and anti-inflammatory just analgesia and antipyretic. Metabolized in liver |
| Tylenol AE | liver damage oS/S Tylenol poisoning V/N/D, sweating, abd discomfort Hepatic failure, coma & death |
| Tylenol RN Implications | Do not take with ETOCH, monitor amount given (not to exceed 2 gm max daily) |
| Tylenol Antidote | Acetylcysteine (mucomyst) |
| Cycolobenzaprine | skeleteal muscle relaxant |
| Cycolobenzaprine Prototype | Flexeril |
| Flexeril Action | odepression of CNS may also block nerve impulses that increase muscle tone and contraction |
| Flexeril Indications | oadjunct to other tx measures, muscle spasms and spasticity |
| Flexeril AE | odrowsiness, blurred vision, dizziness, lethargy, flushing, N/V resp depression, Hypotension, ataxia |
| Flexeril RN Implications | oWatch clients for sedation, Use in caution with clients with renal or liver issues, Resp depression, glaucoma, urinary retention, and cardiac arrhythmias |
| Describe antibiotic use: | TX infection, prophylactic use: Pre and post surgery, Bacterial endocarditis, neutropenia: chemo or transplant clients, UTI`s, exposure to STD, prevention of: tb, HIV, type A influenza, group B strep, |
| What are some examples of penicillin? | methicillin (staphcillin) , amoxicillin (amoxil) ticarcilin (Ticar) |
| Penicillin action | inhibit bacterial call wall synthesis |
| PCN indications | pneumococcus, streptococcus, gonorrhea, syphilis, prevent bacterial endocarditis |
| PCN AE | Allergy, cross sensitivity with cephalosporin’s |
| PCN RN implications | Ask about allergy to PCN, obtain a C&S (culture and sensitivity) if ordered, monitor kidney function, evaluate effect, monitor for AE, if client has PCN allergy: Mark chart, and advise client to wear alert bracelet |
| What are some examples of anti-infectives from cephalosporins? | cefazolin (ancef) cefotetan (cefotan) cefuroxime (zinacef) and ceftriaxone (rocephin) |
| Cephalosporins action | inhibit bacterial cell wall synthesis |
| Cephalosporins indications | broad spectrum against gram pos and negative bacteria. Less active against +, more active to -, than PCN |
| Cephalosporins AE | PCN reaction, bleeding due to vit K metabolism, thrombophlebitis (during IV infusion) and Pseudomembranous colitis (s/s: fever, abd pain, severe diarrhea with mucus |
| Cephalosporins RN implications | PCN allergy? IM injections into large muscle mass to decrease pain, observe iv site: phlebitis, dilute solution give slowly. PO- take with food or milk, Report diarrhea (esp bloody with mucus) peri op use: 30-60 min prior |
| What are some examples of anti-infectives from amnioglycosides? | amikacin (amikin) gentamicin (garamycin) kanamycin (Kantrex), Neomycin, and Streptomycin |
| amnioglycosides action | inhibit protein synthesis |
| Amnioglycosides indications | serious aerobic gram negative infections, anti-pseudomal tb, and PO-suppresses bowel flora |
| Amnioglycosides AE | ototoxicity and nephrotoxocity |
| Amnioglycosides RN implications | Limit use to 10 days, Monitor BUN and creatinine, id high fisk pts for renal impairment, teach s/s ototoxicity |
| What are some examples of the anti-infective tetracycline? | demeclocycline (declomycin) Doxycycline (vibramycin) and tetracycline hydrochloride (achromycin) |
| tetracycline action | inhibits protein synthesis |
| Tetracycline indications | TX: rocky mt spotted fever, Chlamydia, cholera, mycoplasma pne (walking pne) anthrax, lyme disease. Used for acne, peptic ulcer disease and brucellosis |
| Tetracycline AE | gi irritation, bones and teeth, hepatoxicity, c. diff-supra infection, photosensitivity, renal toxcicity |
| Tetracycline RN implications | Don’t use if client had renal disease or pregnant or kids under 8. Tooth enamel discoloration and depresses bone growth |
| What are some examples of sulfonamides? | o Examples: sulfasalazine (azulfidine) sulfisoxazole (gantrisin) sulfamethaxazole-trimethprim (bactrim) and mafeide (sulfamylon) |
| Sulfoniamide action | inhibits cell metabolism (folic acid) |
| sulfonamide indications | UTI, ulcerative colitis, e. coli |
| sulfonamide AE | N/V rash, fever (Stevens Johnson) anemia, pallor, jaundice, renal damage. Kernicterus-bili in new borns |
| sulfonamide RN implications | do not give to pregnant or BF mothers, not for infants under 2 months. Monitor renal labs, encourage fluids, teach client to monitor for rash, and to avoid prolonged sunlight exposure |
| What are some examples of a anti-infective macorlide? | oazithromycin (zithromax) and clarithromycin (biaxin) |
| Erythromycin action | inhibits protein synthesis |
| erythromycin indications | OCN substitute, resp infections, skin, STD and conjunctivitis |
| Erythromycin AE | N/V/D |
| Erythromycin RN implication | take w/ full glass H20 do not take with antacid |
| Metronidazole prototpe | Flagyl |
| Flagyl action | inhibits DNA synthesis |
| Flagyl indications | infections: anaerobic, protozoa and intra-abdominal, amebiasis, giardia, trich, H.pylori, c. dif |
| Flagyl AE | N/V/D and metallic taste, antabuse effects: with ETOCH, seizures, HA, and paresthesia |
| Flagyl RN Implications | caution with liver impairment |
| Describe anti-viral drugs | oViruses live and reproduce only when inside another living cell oClassified according to nucleic content (DNA vs RNA) shell composition, serological typing and morphology |
| What are the steps to a viral infection? | attachment, penetration, uncoating Viral repli./synthe of viral componentce assembly and release of virus,Viral infections occur s ss or illness and virus cn pass s knowledge,Relieve symptoms or slow progress. DO NOT KILL or CURE,Inhibit viral reproduct |
| What are some anti-viral drugs? | AZT, Tenofovir, Indinavar, Delaviridline, enfuvirtide |
| AZT prototypes | Zidovudine, Retrovir |
| What type of antiviral is AZT? | NRTIs (nucleotide reverse transcriptase inhibitor)Antiviral |
| Retrovir action | supresses DNA synthesis(used in HIV clients) |
| Delaviridine protoype | rescriptor |
| What type of antiviral is delaviridine? | NNRTIs (non-nucleotide reverse transcriptase inhibitor) |
| Rescriptor action | supresses DNA synthesis, binds directly to reverse transcriptase, reversing its function(used in HIV clients) |
| Tenofovir prototype | Viread |
| What type of antiviral is Tenofovir? | NRTIs antiviral |
| Viread action | supresses DNA synthesis, inhibits reverse transcrtiptase enzyme (used in HIV clients) |
| Indinavar prototype | Crixivan |
| What type of antiviral is Indinavar? | protease inhibitor |
| Crixivan action | prevents virus from penetrating into cell (used in HIV clients) |
| Enfuvirtide protoype | Fuzeon |
| What type of antiviral is Enfuvirtide? | fusion inhibitor |
| Fuzeon action | prevents virus from penetrating into cell (used in HIV clients) |
| ___ ___ is mose often cause of infection et supra infections | candida albicans |
| What are superficial infections normally caused by? | dermatophytes: tinea pedis (athletes foot), tinea corporis (ringworm), tinea curis (jock itch), tinea capitis (lice) |
| How are antifungal meds used? | use is long term, weeks to months, dose depends on severity and C&S needed usually |
| Antifungal RN implications | dry all areas, wear flip flops in community shoering areas, do not share hair brushes or hats, prevent pts from having live flowers or plants in room, avoid exposure to bat et chicken poop, do not irritate skin |
| Amphotericin B prototype | Nystatin-topical |
| Nystatin action | disrupts fungal cell membrane |
| Ketoconazole prototype | Nizoral or Azole |
| Nizoral or Azole action | inhibits sunthesis of defective cell membrane |
| CAspofungin prototype | cancidas |
| Cancidas action | inhibits glucan synthesis et disrupts cell wall |
| Grisefluvin action | interferes c cell division |
| Furosemide prototype | Lasix |
| What is Lasix? | a loop diuretic |
| Lasix action | blocks reabsorption of Na et Cl in ascending loop of Henley |
| Lasix indications | for rapid diuresis |
| Lasix AE | OTOTOXICITY, dehydration, HYPOKALEMIA, hypotension, hyperglycemia, hyperuricemia (causes gout), hypernetremia, hypocholoremia |
| Lasix RN implications | administer in am, PO has a 30 min onset, IV has a 5-10 min onset, monitor K+, teach s/s of hypokalemia, daily weights, postural hypotension |
| What type of drug is Enalapril? | ACE inhibitor |
| Enalapril prototype | Vasotec |
| Vasotec action | prevent formation of angiotensin II, results in vasodilation, decrease blood volume, decreased cardiac et vascular remodeling |
| Vasotec indications | HTN, CHF, diabetic neuropathy, MI, prevention of CVA, in high risk patient |
| Vasotec AE | fetal injury, COUGH, ANGIOEDEMA, 1st dose hypotension, hyperkalemia, renal failure |
| Vasotec RN implications | avoid pregnancy et Vit K supplements, call Dr if cough or early s/s infection, minimize NSAID use |
| What are two Ca+ Channel blockers? | Verapamil et Nifedipine |
| Verapamil action | blocks Ca+ channel in blood vessel et heart resulting in vasodilation |
| Verapamil indications | angina, HTN, dysrhythmias |
| Verapamil AE | constipation, edema, dizziness, facial flushing, HA |
| Verapamil RN implications | do not chew sustained release, cauting use c digoxin |
| Nifedipine action | blocks Ca+ channel in blood vessel (lowers BP) |
| Nifedipine indications | angina, HTN |
| Nifedipine AE | edema, facial flushing, dizziness, reflex tachycardia (a beta blocker might prevent this) |
| Nifedipine RN implications | do not chew sustained release, caution use c digoxin |
| What type of drug is digitalis? | cardiac glycoside |
| Digitalis prototype | Digoxin |
| Digoxin action | incrase CO, decrease sympathetic tone |
| Digoxin indications | CHF, A-Fib, A-Flutter |
| Digoxin AE | cardiac dysrhythmias elevate dig level, OD, renal function, CHF |
| Digoxin RN implications | monitor K+, renal fucntion, know client baseline data (ekg, labs like BUN et creatinine, ejection fraction) |
| S/S of Digoxing TOXICITY | N/V, anorexia, fatigue, visual disturbances: blurred vision, halos around dark objects et yellow tinge to vision |
| Nitro prototype | Nitrate |
| Nitrate action | causes vasodilation, decreases preload et O2 demands |
| Nitrate indications | for acute angina attack et to prevent anginal attacks |
| Nitrate AE | HA, REFLEX TACHYCARDIA, HYPOTENSION |
| Nitrate RN implications | administer as soon as pain states, may repeat tablet q5min for a total of 3 tablets, store in tightly closed dark container effective for 24 months |
| What type of drug is Lipitor? | Statins |
| What is prototype of Atorvastatin? | Lipitor |
| Lipitor action | inhibit cholesterol synthesis |
| Lipitor indications | reduced LDL, elevate HDL, promote plaque stability, reduce inflammation of plaque sites, slow progression of artery calcifications, enhance vasodilation, hypercholesterolemia, preven CVA (may reduce CAD), reduce CV events in clients c Type 2 DM |
| Lipitor AE | myopathy, rhabdomyolysis (muscle pain), hepatotoxicity |
| Lipitor RN implications | not pregnant, check liver functions et ck |
| What are 3 anticoagulants? | heparin, LMWH, warfarin |
| Heparin action | enhangce activity of antithrombin inactivating thrombin et X factor resulting in fibrin progression; prevent clot development or formation; does not break clots down |
| Heparin indications | pregnancy, PE, evolving stroke, DVT, open heart surgery, renal dialysis, DIC, acute MI, post op venous thrombosis |
| Heparin AE | hemorrhage, heparin induced thrombocutopenia (HIT), hypersensitivity |
| Heparin RN implications | IV or Sub Q, read labels, monitor for bleeding, low BP, high pulse, hypoxic, brusing, blood in urine et stool, pelvic pain, lumbar pain, HA et monitor APTT |
| Heparin is a __ ___ med. Should be verified c anonther RN. | high alert |
| Heparin contraindications | not for clients c liver or renal disease, thrombocytopenia post brain, eye, or spinal cord surgery or lumbar puncture |
| Heparin antidote | Protamine Sulfate |
| LMWH (enoxaparin) prototype | Lovenox |
| Lovenox action | inactivate Xa |
| Lovenox indication | prevent et tx of DVT, prevent ischemic complications in pt c unstable angina or non Q wave MI |
| Lovenox AE | bleeding, thrombocytopenia, severe neuro injury including permanent paralysis (in a client undergoing a spinal puncture) |
| Lovenox RN implications | no labs to monitor, can be used at home, high bio availability, longer half life |
| Warfarin prototype | Coumadin |
| Coumadin action | antagonist of Vit K |
| Coumadin indication | prevent PE et venous thrombosis |
| Coumadin AE | bleeding, fetal hemorrhage, enters breast milk |
| Coumadin RN implications | PT/INR labs, teach s/s hemorrhage, medical alert bracelet, avoid ETOH, soft toothbrush, electric razor, tell other doctors of use |
| Coumadin antidote | Vit K |
| What type of drug is prednisone? | coritcosteroid |
| Prednisone prototypes | medrol et solumedrol |
| Prednisone action | short term use to suppress inflammation (adrenal gland) |
| prednisone indications | RA, SLE, IBS, OA, tendonitis, gout, arthritis, bursitis, inflammatory disorders of eye, allergic conditions, asthmas, dermatologic disorders, neoplasms prevent respiratory distress |
| Prednisone AE | F&E imbalance, retardation, peptic ulcer disease, myopathy, hyperglycemia, infection, osteoporosis, psychological disturbances |
| Prenisone RN implications | avoid those c communicable disease, take c food, don't stop abruptly, rinse mouth, s/s of fluid retention, give in times of stress especially illnes, trauma or surgery |
| Regular Insulin onset time | .5-1 hour |
| Regular Insulin peak time | 5 hours |
| Lispro (Humalog) onset time | 15-30 min |
| Lispro (Humalog) peak time | .5-2.5 hours |
| Aspart (Novolog) onset time | 10-20 min |
| Aspart Novolog peak time | 1-3 hours |
| Neutral Protamine Hegedorn (NPH) Insulin onset time | 1-2 hours |
| NPH insulint peak time | 6-14 hours (8 hour peak test) |
| Insulin Glargine (Lantus) onset time | 70 min |
| What type of drug is Glyburide? | sulfonylureas |
| Glyburide action | promote insulin secretion by pancreas, may increase tissue response to insulin |
| Glyburide indication | diabetic |
| Glyburide AE | hypoglycemia, avoid if pregnant, cautiong c liver or kidney disease |
| Glyburide RN implication | take c food to avoid GI upset, teach s/s hypoglycemia, avoid ETOH |
| What type of drug is Dilantin? | antiepileptic/anticonvulsant |
| Dilantin prototype | Phenytoin |
| Dilantin action | decrease mvmt of ions into nerve cells et ot alter neurotransmitter activity, increase GABA, prevent impulse spread of normal neurons |
| Dilantin indication | epilepsy, some cardiac dysthrhythmias |
| Dilantin AE | GINGIVAL HYPERPLASIA, ataxia, drowsiness, N/V, rash on skin |
| Dilantin RN implications | avoid if pregnant, therapeutic range can be quick, monitor serum levels |
| Anticholinergic AE | o dry mouth, tachycardia, palpitations, sedation, drowsiness, constipation, urinary retention, blurrd vision, photo phobia, excess CNS stimulant o can’t speak, can’t see, can’t shit, can’t piss |
| What type of drug is Isotinoin? | acne medication |
| Isotinoin prototype | Accutane |
| Accutane action | decreases sebum production, sebaceous gland size, inflammation, keratinization and lowers # p. acnes |
| Accutane indication | severe nodulocystic acne vulgaris |
| Accutane AE | nose bleeds, inflammation: lips and eyes, skin dryness, itching, photosensitivity, depression |
| Accutane RN implication | clients can’t get pregnant! |
| What type of drug is midazolam? | Benzodiazepine (hypnotic/anti-anxiety/ |
| midazolam prototype | Versed |
| Versed action | binds w/GABA receptor complex (does not mimic) |
| Versed indication | insomnia, anxiety, seizures, pre opt sedation, ETOH withdraw, muscle spasms, panic disorder |
| Versed AE | excessive sedation, hypotension, resp depression, impired physical and mental activities, abuse, aggression, hallucinations |
| Versed RN implications | not to pregnant women, avoid ETOCH, watch for abuse and dependence, watch for S/S withdrawal: high anxiety, insomnia, sweating, tremors, dizziness, panic, paranoia, delirum, htn, convulsions |
| Versed antidote | flumazenil (romazicon, mazicon) |
| What type of drug is propranolol? | non-selective beta blocker et antiadrenergic |
| Propranolol prototype | Inderal |
| Inderal action | blocks beta 1 and beta 2 receptors preventing catecholamines and sympathomimetics from acting |
| Inderal indications | HTN, angina, cardiac dysrhythmias, MI, Migraine HA, stage frigh |
| Inderal AE | allergy, depression, hypoglycemia, bronchospasms, ortho hypotension, nasal congestion, inhibits ejaculation, reflex tachycardia |
| Inderal implications | monitor heart rate, BP and respirations, teach client about S/S: or heart failure and postural hypotension, monitor for any drug interactions, ID any high risk clients, Caution use in diabetic clients |
| Inderal CONTRAINDICATED/CAUTIONED | if client has heart failure, AV heart block, asthma, or sinus brady |
| What type of drug is methylphenidate? | CNS stimulant |
| methylphenidate prototype | Ritalin |
| Ritalin action | facilitate initiation and transmission of nerve impulses that excite other cells |
| Ritalin indication | ADHD and narcolepsy |
| Ritalin AE | physical dependence, increased CNS stimulation: hyperactivity, nervousness and anxiety, GI effencts: anorexia, gastritis, weight loss. Monitor childrens growth charts. Psychosis, Cardiovascular: HTN, angina, dysrhythmias |
| Ritalin RN implication | use smallest doses possible, do not crush or chew tablets, avoid taking late in day: 1st dose early am and last dose in late afternoon , minimize caffeine intake, call pcp if cardiovascular issues arise. |
| What type of drug is a cholinergic? | Autonomic Nervous system parasympathetic drug |
| Name the three cholinergic drugs for various indications | bethanechol (Urecholine)- urinary retention neostigme (Prostigmin) – slows break down of acetylcholine donepezil (Aricept)- alzheimers |
| UPA action | promote action of acetylcholine (HR SLOWS,Increases resp secretions--causes bronchodialation,Increases saliva and GI secretions,Increase tone and contractility of GI smooth muscle, relax sphincter,Exocrine glands-decrease sensations,constrict pupils (mio |
| UPA indication | open angle glaucoma, post op bowel obstruction, paralytic ileus, urinary retention, myasthenia gravis, Alzheimer’s, use for antidote of atropine and neuromuscular blocking agent |
| UPA AE | (Too much stimulation) miosis, CNS: convulsions, dizziness, HA, drowsiness. Bronchospasms, increased resp secretions, dysrhythmias, hypotention, N/V/D, cramping, GI secretions |
| UPA RN implication | urinary and bladder distention, check bowel sounds, assess for myasthenia gravis, Alzheimer’s, take as perscrbed, monitor for reaction to medication, make sure client knows about AE |
| What type of drug is an anticholinergic? | autonomic nervouse system medication |
| Anticholinergic prototype | Atropine |
| Atropine action | BLOCKS. Prevents receptor activation by acetylcholine in high doses it can block nicotinic receptors |
| Other actions of atropine (focused) | •Heart Rate- increases •Smooth muscle: bronchodialation, decrease tone and mobility of GI tract, decrease tone of urinary bladder detrusor •Exocrine glands-decrease sensations •Eye: dilate pupils •CNS: excite |
| Atropine indication | preanesthesia medication-dry secretions, dilate eye before eye surgery, bradycardia, intestinal hypertonicity and hypermobility, Parkinson’s disease (decrease salivation and tremors) emphysema ad asthma: reverse bronchospasms |
| Atropine AE | dry mouth, blurred vision , photophobia, increases inter optical pressure, urinary retention, constipation, tachycardia, anhiaiosis-absence of sweat |
| Atropine RN implication | Client to wear dark glasses in strong light, sugar free gum or candy, oral hygiene, caution against blurry vision, prevent constipation by fibers and fluid intake, minimize risk for heart exhaustion, tell client to void prior to taking med. |
| Atropine antidote | cholinergic agent |
| What is an adrenergic agent? | ANS medication |
| Adrenergic prototypes | Albuterol et Epinephrine |
| Epi et albuterol actio | stimulate cell function |
| Epi et Albuterol indication | taken orally |
| Epi et albuterol AE | HTN, necrosis-bad blood flow, bradycardia |
| Epi et Albuterol RN implication | not for IV use, monitor EKG, BP and pulse |
| What type of drug is Epoetin Alfa? | hematopoietic agent |
| Epoetin Alfa prototype | Epogen |
| Epogen action | stimulate RBC production |
| Epogen indication | anemia, renal failure, HIV |
| Epogen AE | HTN |
| Epogen RN implication | general nutrition, ADL`s and coping, know baseline labs: CBC and diff, platelets, high risk for infection: hand washing, sterile technique, isolation if Neutrophils are less than 500, personal hygiene |
| What type of drugs are Interferon Alfa, Aldesleukin? | immunouppresants |
| Interferon Alfa, aldesleukin prototype | interleukin-2 |
| Interferon Alfa action | enhance host immune response and reduce proliferation of cancer cells |
| Interferon Alfa indication | oHairy cell leukemia, malignant melanomas, AIDS related Kaposi sarcoma |
| Interferon Alfa RN diagnosis/implicaion | Infection, Bleeding, nutrition less than body requires (wt loss), altered sleep an exercise, ineffective coping |
| What type of drug is Imuran? | immunosuppresant |
| Imuran action | act on helper t lymphocytes to suppress production of immune response components resulting in the suppression of the proliferation of B cells and cytotoxic T cells |
| Imuran indication | autoimmune disorder TX: RA. Lupus, myasthenia gravis, early stages or type 1 diabetes. Prevent organ rejection in transplant clients. LIFELONG if these are taken due to organ transplant |
| Imuran Rn Diagnosis | infection, fluid imbalances, bleeding, nutrition less than body requires, ineffective coping |
| What type of drug is albuterol? | Beta 2 Adrenergic Agonist |
| Albuterol action | selectively activates beta 2 receptor in bronchial smooth muscle resulting in bronchodialation |
| Albuterol indication | prevent asthma, TX of asthma, Long term control of asthma |
| Albuterol AE | tachycardia, angina, tremors |
| Albuterol RN implication | teach clients proper dosing and to take as directed, observe for SS of impending asthma attacks and keep a log of attacks in a journal, contact PCP if there is an increase in frequency of attacks |
| What type of drug are Metoprolol & Propranolol? | Beta adrenergic blockers |
| Metoprolol prototype | Lopressor |
| Lopressor action | block beta 1 adrenergics in the myocardium and in the electrical conduction of the heart Slows heart rate, lowers myocardial contractility and lowers rate of conduction through AV node |
| Lopressor indication | angina pectoris, HTN, dysrhythmias, MI, heart failure |
| Lopressor AE | bradycardia, lower cardiac output, AV block, orthostatic hypotension, rebound myocardium excitation, bronchoconstriction, inhibited glycogenolysis |
| Lopressor RN implication | Monitor clients vitial signs, hold if pulse is below 60beats/min, use cautiously in pt with diabetes, teach s/s of heart failure and orthostatic hypotension, take as directed, do not stop abruptly |
| What type of drug are Psyllium (Metamucil) Docusate sodium (Colace), Bisacodyl, (dulcolax), Milk of Magnesia (magnesium hydroxide)? | Laxatives |
| Docusate sodium prototype | colace |
| Colace action | soften fecal mass ins increase bulk, allow water to penetrate to soften stool, intestinal peristalsis, osmotic laxative-draw h2o into intestine to increase mass of stool to stimulate peristalsis |
| Colace indication | decrease diarrhea (IBS and diverticulosis) control stool amt foe pt with colostomy, promote deification in elderly, constipation, prevent straining (post surgery) post diagnostic procedure (colonoscopy) |
| Colace AE | Gi Irritation, dehydration, rectal burning, sodium absorption and fluid retention |
| Colace RN implication | do not crush or chew tablet, do not use a suppository on a daily basis,monitor I and O`s, SS of dehydration, encourage fluids |
| Laxative concerns for renal patient... | read labels carefully avoid laxative if it contains magnesium |
| Laxative concerns for heart patient... | read labels carefully avoid laxative if it contains sodium |
| What type of drug is Acetylcysteine? | mucolytic |
| Acetylcysteine prototype | Mucomyst |
| Mucomyst action | enhances flow of secretions in resp passages |
| mucomyst indication | acute and chronic pulmonary disorders, cystic fibrosis, antidote for acetaminophen poisoning |
| mucomyst AE | aspiration et bronchospasm |
| mucomyst RN implication | smells like rotten eggs, dilute med in juice, teach that med makes nasal and bronchial secretions watery and will make them cough, suction equipment if inpatient |
| What type of drug is loratadine? | anti-histamine |
| Loratadine prototype | Claritin |
| Claritin action | block histamine release in small blood vessels and nerves during allergic reaction |
| claritin indication | allergic reaction, anaphylaxis, motion sickness, insomnia |
| Claritin AE | sedation, dry mouth, constipation, GI: N/V |
| claritin RN implication | take med at night, avoid ETOH and driving, take with h20, increase fluids, call pcp if symptoms continue. |
| Claritin toxicity | flushed face, high fever, tachycardia, urinary retention, seizures, hallucinations |
| What type of drugs are (zocor) Simvastatin, (mevacor) lovastatin, (crestor) tosuvastatin? | anti-hyperlipidemia |
| Tosuvastatin prototype | crestor |
| Crestor action | lower LDL, increase HDL, promote vasodilatation, decrease plaque site inflammation, decrease risk of thromboembolism |
| Crestor indication | o hypercholesterolemia, prevent coronary events, protect against MI`s and strokes for pt w/diabetes, raise HDL levels |
| Crestor AE | hepatotoxity, Myopathy, peripheral neuropathy |
| Crestor RN implications | take with meals, monitor liver functions, avoid ETOH, monitor for muscle aches and pains, avoid grapefruit, monitor CK, and liver functions |
| What type of drug is Hydrocholorothiazide? | Thiazide diuretic |
| HCTZ action | blocks reabsorption of Na and Cl in early segment of distal convoluted tubule |
| HCTZ indication | HTN et Edema |
| HCTZ AE | Dehydration, HYPOKALEMIA, hypotension, hyperglycemia, hyperuricemia, hyponatremia, hypochloremia Fetal harm (avoid if breast feeding) |
| HCTZ RN implication | Administer in am,Monitor K levels, Teach s/s of hypokalemia,Weigh daily,Teach about postural hypotension |
Created by:
melissaaclark
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