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ACE -PRIL Tx: HTN and Heart Failure
CHOLESTRAMINE (QUESTRAN) Decreases Cholesterol -take other meds 1 hr before or 4 hours after -take with milk, juice to avoid constipation -take at meal time SE: Decrease Vit C absorption & Constipation
ANTIVIRAL -VIR (in name) Tx: HIV,viral infections, HSV, HEP C, Chicken pox, RSV Ex: Ritonovir (Norvir)
BENZOS -PAM or has AZE or AZO in name Tx: Antianxiety, anitconvulsant, muscle relaxer, hypnotic, sedative Ex: Diazapam, Tegretol (Carpamazine)
BETA BLOCKERS -OLOL Tx: HTN, Dysrythmia, Angia Ex: Atenolol (can cause bronco constriction)
CCB -PINE Tx: HTN, Angina, dysrythmias (like BB) Ex: Anlotapine (Norvasac) Exception: Diltiazam (Cartizine)-has to be given q 4 hrs Varaprimail (Calan)
GLUCOCORTICOIDS/CORTICOSTERORIDS -SONE or contains CORT Take 2nd, Bronchodilators take 1st Alters normal immune response Tx: adrenal insuffency, suppress inflammation, Addisons, Parkinsons, Post x-plant. If taking NPH, increase NPH dose. Can increase BS Ex: Prednisone (taken in AM)
H2 ANTAGONISTS -DINE or TIDINE Decreased secretion of gastric acid Tx: Acid Reflux, GERD, Heart burn, prevent ulcers Adverse Rxn: dizziness, hallucinations, sleepiness Ex: Semetadine (Tagament)
NITRATES -contains NITR Vasodilation Tx: Angina Ex: Nitroglycerin (nitrostat)
PPI -ZOLE -PRAZOLE Suppresses Gastric Acid Secretion (like H2 Antagonists) Tx: Heartburn, Ulcer Dz, GERD, esophageal erosion
SULFONAMIDES -contains SULF Suppresses bacterial growth Tx: Infections Ex: Sulfasazine
THIAZIDE DIURETICS -ZIDE Tx: HTN & Peripheral Edema Ex: HCL thiazide
THROMBOLYTIC -ASE Used to dissolve clots Ex: Altaplase (Actiplase)
THYROID HORMONE -contains THY Tx: replacement therapy, hypothryoidism Ex: Levothryroxine (Synthroid)
BRONCHODILATORS -LINE Tx: disorders that cause bronchoconstiction, Asthma, COPD, Emphazema Ex:Theophyline 10-20 TDL SE: Restlessness & Increased P
ABX -CYLINE, MYCIN, MICIN Take 1 hr before or 2 hrs after meals SE: Photosensitivity, Decreases contraceptive effectiveness Adverse rxn: yellow skin, Hep, Macular rash-STOP MED Ex: Erthromax, vibramycin, tetracycline (cipro) NO albumin, Mg or Ca antacids
Mental and Emotional Conditions or N/V -ZINE Adverse fx: EPS Tx: schizophrenia, N/V (phen and comp)
Cardiac Glycosides -OXIN Tx: CHF and Heart Arythmias
ANTICHOLENERGIC -OPINE EX: Atropine SE: can't see, pee, sit, poo (Activates SNS-flight or fight) NO with GLAUCOMA = Icreases IOP
SNS -Increases BP, HR, RR -Decreases GI, UO (constipation and urinary retention) -dilated pupils (blurry vison) -constricted blood vessels and dry mouth (FLIGHT OR FIGHT)- acts on Increased ACH
PNS -decreased HR -constriced pupils -Relaxed -Increased sex drive -warm, dry skin REST AND DIGEST- acts on Decreased ACH
Is DIG K sparing or wasting? K WASTING
Is ADACTONE K sparing or wasting? K SPARING
What can sudden stopping of TEGRETOL cause? SEIZURES
What do you don't want to take with GRAPEFRUIT JUICE? (Most Benzo, vir meds, depression meds) -BUSPAR -VARAPAMIL -TEGRETOL (CARBAMAZEPINE)
CISPLATIN -CA med -30% can cause OTO TOXICITY -drink 8-10 glasses of water
LIDOCAINE HYDROCHLORIDE Tx: Heart problems (Ventricular arrhythmia's) caused by MI
NEUROMUSCULAR BLOCKING -NIUM anesthesia to produce paralysis (inhibits AcH)
What age groups are affected by medications the most? OLD & YOUNG (greater risk of toxicity) - Absorption -Excretion -Distribution -Metabolism
Many med are contraindicated in what? Breastfeeding and Pregnancy
What med is not usually administered with other medications? Antacids (affects the absorption of med)
What can RN do in regards to medications? -GIVE -HOLD (can never stop or dc med, never tell pt to stop abruptly)
What kids of meds should not be taken with other prescribed mediations (unless MD approved)? -OTC -HERBAL
METFORMIN -Oral Hypoglycemic (decreaseds glucose production) -given in combo with repglinidine Adverse Fx: Muscle Pain
METOCLOPRAMIDE (Reglan) -Antiemetic Tx: N/V prevention, Decreases GERD, GI Stimulant DONT Take with: GI disturbance, hemorrhage or perfusion
ANGIOTENSION RECEPTOR -SARTIN Vasoconstriction and Aldosterone secretion Tx: Decrease BP
BB -OLOL Tx: Decrease BP, P, CO, Migraines , Glaucoma
SSRI Tx: for Depression, anxiety, OCD
What does NITRO not relieve? UNSTABLE ANGINA
How should NITRO be taken? -1 every 5 min for 3 min -if not relieved go to ER DONT give if BP is below 90/60
What are the Sx of ATROPINE OD? Think Alice in Wonderland -HOT -LOC Changes -RED (flushed face) -DRY/THIRSTY
VERAPAMIL (Calan) CCB Tx: HTN, Angina Adverse Fx: Constipation, N, Diarrhea
What med is given for ASYTOLE (no heart beat)? ATROPINE
What med is given for CHF? ACE
What med is given for BIPOLAR? LITHIUM
What med is given for VENTRAL and ATRIAL Complications (A-fib, V-fib, act.)? AMIODARONE
CA MEDS Massive cell destruction following chemo = Inc. uric acid levels SE: allopecia, decreased resistance to body Need to contact MD before getting vaccinations -NO ASA or ETOH Ex: Elspar, Tamoxifen, Megestrol, alduphosphamide, Busuifan, Vincristine, Beomy
TDL of LITHIUM 0.8-1.5 Toxicity: lethargy, hand tremors, muscle weakness
TDL of DILANTIN (Phenytoin) 10-20 Toxicity: muscle incordination, nastagmus, diplopia Tx: Seizure
TDL of DIGOXIN (Lanoxin) 0.5-2.0 Toxicity: GI disturbance, N/V, anorexia, light flashes and halos Tx; CHF (aflutter)
SYNTHROID (Levothyroxine Sodium) Tx: Hypothyroidism/Myexedema May take several weeks to work. Affects PT time Adverse: Chest pain, nervousness, tremors, D, insomnia, heat intolerance Take on EMPTY STOMACH in AM. -w/h if P is above 100
TDL of THYOPHYLLINE 10-20 Toxicity: Restless, dizziness, Insomnia, seizure, HA Tx: Asthma/COPD bronchospasms (works by relaxing smooth muscle)
Antidote of ACETAMINOPHEN N-ACETYLCYSTEINE (MUCOMYST) Liver failure possible for 4 days
Antidote of ETOH W/D LIBRIUM -bad N/V will occur with any ETOH consumption or products (lotions, cough syrup)
Antidote of COUMADIN (Warfarin) VIT K PT 10-12 sec (control)
Antidote of DIGOXIN DIGIBIND -K will make it worse
Antidote of MgSO4 (mag sulfate) CALCIUM GLUTAMATE
MAOI Drugs Think PANAMA PA-Parnate NA-Nardil MA-Marplan Tx: Depression and Bipolar -Increases seratonin, dopamine, NE, Epi -Last resort after SSRI and tricyclic, can have BP problem and DDI DONT use with SINEMET (Parkinson tx)
COGENTIN Tx: Parkinsons and EPS of other drugs Adverse fx: Increased T, confusion and visual hallucinations SE: Constipation, Increased HR, blurry vision, decreased UO NO in GLAUCOMA
THEOPHYLLINE TDL: 10-20 BRONCHODILATOR (give 1st) -Increases the risk of DIG TOX -Decreased effect of LI and DILANTIN, L K & Mg Tx: Ashtma and COPD Give W/FOOD SE: GI upset, Increased HR, HTN, N/V
INH (Isoniazid) Tx: TB Risk: Phenotoin TOX if taken w/ DILANTIN, peripheral neuritis, hepatic, Jaundice -take vit B6 to prevent neuritis (monitor LFT's) -BP will Decrease then return
PREDNISONE Tx: BP (similar to DILANTIN) DONT stop abruptly, Decrease dose in elderly SE: weight gain, hyperplasia of gums **Causes K secretion**
DILANTIN (Phenytoin) Tx: Seizures TDL: 10-20 SE: wght gain, hyperplasia of gums, RED URINE Adverse: **RASH-STOP MED** (not abruptly) DONT give with THEOPHYLLINE (decreased effectiveness) or INH (phenytoin tox) **DONT STOP ABRUPTLY **
DIGOXIN Tx: Afib & HF TDL: 0.5-2.0 W/HOLD: Lower P=60, HR=100 (children) & 48hrs before cardioversion -check apical pulse 1 full min & K -flush H20 (sticky) THEOPHYLLINE increases DIG TOX Sx: visual changes, V/D/N, confusion -Given w/ Lasix (K wasting)- gi
MUCOMYST (N-Acetylcytine) ANTIDOTE for TYLENOL (Acetaminophen) -most common poisoning in children -Admin Orally Sx of Toxic Tylenol: Jaundice, penia, Rash, hypoglycemia
RIFAMPIN (Ridadin) Tx: TB, HIV and Menningitis SE: RED URINE/TEARS -BC doesn't work as well when taking this med
What SE do ALL PSYCH meds have? What one is DIFFERENT? All SE: SNS (flight or fight) but decreased BP Except: LITHIUM (acts different)
Mg SULFATE Stops preterm labor-doesnt affect infant heart, BP or T (decreases R) DONT give if DTR are INEFFECTIVE If mother experiences seizure during Mg admin --> GET BABY OUT ANTIDOTE: Ca GLUTAMATE
SINEMET (Levodopa and Carbidopa) Tx: Parkinsons and Sedative SE: RED URINE and drowsiness DONT give with MAOI or Increased PROTEIN meals KAVA KAVA will DECREASE effectiveness
BETHAMETHASONE (Celestone) Surfactant/Steroid Tx: Lung expansion -give 2nd (bronchodilator 1st-open up lungs) Ex: Glucocorticoid inhaler
What medication should you NOT give KIDS for pain? ASPRIN/NSAID -Associated with Reyes Sx (occurs after viral infection) Sx: V, lethargy, irritability (Baby-D & Increased K) -GIVE TYLENOL
When should this med be taken: CARAFATE (Sulcrafate)? BEFORE MEALS Tx: Duodeal Ulcer (1.5-3 hrs p eating, awakens at night, food helps) -mucomyst barrier
When should this med be taken: most ABX? BEFORE MEALS -1 hr before (or 2 hrs after)
When should this med be taken: ZOCOR? BEFORE MEALS -Tx: hyperlipidemia
When should this med be taken: VIBRAMYCIN? WITH MEALS
When should this med be taken: NSAIDS? WITH MEALS
When should this med be taken: CORTICOSTEROIDS? WITH MEALS
When should this med be taken: BIPOLAR MEDS? WITH MEALS
When should this med be taken: CHEPHLOSPORINS? WITH MEALS
When should this med be taken: SULFONAMIDES? WITH MEALS
When should this med be taken: **THEOPHYLLINE**? WITH MEALS Tx: Asthma/COPD
When should this med be taken: **TAGAMENT** (Cimetidine)? WITH MEALS (daily dose) **BEDTIME** (once daily dose) -H2 antagonist Tx: GERD, Heartburn, Ulcers
When should this med be taken: APRESOLINE (hydralazine)? WITH MEALS Tx: HTN or CHF
When should this med be taken: ACYCLOVIR? WITH MEALS Tx: Herpes
When should this med be taken: **K SUPPLEMENTS**? WITH MEALS
When should this med be taken: AMPHOJEL/RENOGEL? WITH MEALS Tx: Acid Indigestion (antacid) Take 1-2 hrs before Tetracycline (will Dec effectiveness of Tetra) Ex of Tetra: Doxycycline and Vibramycin (Bacterial genital infx)
When should this med be taken: MEVACOR (Lovastatin)? WITH MEALS in PM Tx:Coronary Artery Dz, Hyperlipidemia (decreases Cho) Adverse: muscle pain/tenderness/weakness esp. when with malaise or fever Tx: CA (Chemo med)
When should this med be taken: DEXAMETHOSONE? WITH MEALS Tx: Cerebral Edema, SHOCK, adrenal insufficiency, MS Adverse: Adrenal insufficiency (fatigue, muscle weakness, joint pain, fever, anorexia, N, SOB, dizziness, fainting)
When should this med be taken: INDOMETHACIN (Indocin)? WITH MEALS Tx:RA & Gouty Arthritis -NSAID (decrease inflammation, pain & Temp) Adverse: GI bleed, chest pain, SOB, weakness, slurred speech
TETRACYCLINES DOXYCYCLINE/VIRBAMYCIN/TETRACYCLINE HCL Tx: Bacterial genital infections (gonorrhea, syphilis, rectal infx), Anthrax, Acne, H.pylori, roseasa) -Take WITH MEALS -Avoid direct sunlight/UV, wear protective clothing/sunscreen
When should this med be taken: TETRACYCLINES? WITH MEALS -Take 1h BEFORE BEDTIME to prevent esophageal irritation -Avoid direct sunlight/UV, wear protective clothing/sunscreen
When should this med be taken: STEROIDS? AM MED Tx: Anti-Immflammatory
When should this med be taken: DIURETICS? AM MED Tx: Edema caused by Heart/Liver/Renal Liver Failure
When should this med be taken: ARICEPT (Donepezil)? AM MED Tx: Alzheimers -AVOID OTC Sleep or Cold meds (increase anticholinergic fx) -Tell MD before receiving ANETHESIA
When should this med be taken: DEXEDRINE? AM MED Tx: ADHD & Narcolepsy -DONT drink fruit JUICE with oral solution -Decreases SEIZURE threshold, report Seizures
When should this med be taken: ANTACIDS? AFTER MEALS (p meals)
When should this med be taken: most ABX? AFTER MEALS (2 hrs) **or 1 hr BEFORE**
When should this med be taken: GROWTH HORMONE? PM MED
When should this med be taken: SUCRAFATE (Carafate)? PM MED & BEFORE MEALS Tx: Peptic Ulcer
What meds cause RED FLUIDS? -PREDNISONE- BP med -DILANTIN (phenytoin)- BP med -RIFAMPIN (Rifadin)-TB/Menningococal
What meds usually CAUSE EPS? ANTIPSYCHOTIC MEDS -Atypical won't cause Most Common: Haloperidol (Schizophrenia), Thorazine
What are EPS symptoms? -PSEDOPARKINSONS (tremors, postural instability) -AKINESIA (inability to initiate movement) -TARDIVE DYSKINESIA (inv movement of face and jaw) Tx: BB/Benz -AKATHISIA (inability to remain still)
What can you NOT take with MAOI? -SINTEMET (parkinsons) -ETOH -CHEESE
What can you NOT take with EGG allergies? -MMR -FLU vaccine -Neomycin
What interferes with Dilantin (Phenytoin)? Tx: Epilepsy ***LOTS OF DDI*** (INCREASES PHEYTOIN TOX) -INH (TB infxn), Thyophylline (asthma), disulfuram (ETOH tx), Benzos, Fursemide, St. Johns Wart, ABX, heart meds, anticoagulants
What can you NOT take with LEVODOPA/CARBIDOPA (Sinamet)? Tx: Parkinsons -B6 -MAOI (depression) -
If you are ALLERGIC to BAKERS YEAST what VACCINE can you NOT get? HEP B
If you have an MI what med can you NOT use? -tPA (Tx: ischemic stoke-caused by blood clots)
If you have GLAUCOMA what drugs can you NOT take? -VISINE -LEVODOPA -ATROPINE -ANTICHOLLENERGIC ** Increase IOP**
What drugs DECREASE EFFECTIVENESS of THEOPHYLINE? Tx: Asthma -LI -Dilantin (Epilepsy)
What INCREASES the risk of DIGOXIN TOX? -THEOPHYLINE -DECREASED K -DECREASED MG Dig used to tx CHF (slows HR so it doesn't have to work as hard)
What med should INH be taken with? B6 Tx: TB (also prevent)
What CRISIS can DEMOROL (Meperdine) NOT be given in? SICKLE CELL CRISIS (severe pain, trouble breathing, anemia) Tx: Pancreatitis
What med can you NOT give if you have PANCREATITIS? MORPHINE SULFATE -causes spasm **GIVE DEMEROL**
What med can you NOT give if you have no DTR? Mg SULFATE
What DZ can you NOT give ISOTONIC solution to? -HTN -HEART DZ -RENAL DZ
What are ISOTONIC Solutions? -NS (w/blood prod) -LR (burns-more E) -D5W -D5 1/4 NS Goes into the VASCULAR space Makes FV and BP go UP Tx: N/V, sweating, burns, hemm, trauma
What are HYPOTONIC Solutions? Goes into VASCULAR space then CELLS -1/4 DW -1/2 NS -3% NS with 1/2 NS Hydrating, DOESNT cause BP increase like Iso Tx: Heart/Renal Dz, HTN, Inc Na
What DZ can you NOT give HYPOTONIC Solution to? -CELLULAR EDEMA Watch for decreased BP
What are HYPERTONIC Solutions? Volume Expander(particles)= PULLS from CELLS into VASCULAR -D10W -3% NS -5% NS -TPN -ALBUMIN You can add E to Iso/Hypo = Hyper Tx: Dec Na, 3rd spacing (edema, burns, acities) RETURNS volume to VASCULAR space
What SOLUTION would you NOT want to give with PULMONARY EDEMA? HYPERTONIC (would increase fluid in vascular space which is already increased since they have pulmonary edema) -watch for FVE
What can you NOT take or do if you had the 4 G's? -GO INTO SURG -PLAVIX -ANTIPLATLET
What VITAMIN should you NOT take with ALLOPURINOL? VIT C Tx: Gout
What VS should you HOLD NITROGLYCERINE? BP below 90/60
What med should you NOT take if you are going into SURGERY? -NSAIDS -HEPARIN -COUMADIN -4 G'S (Ginko, Gensing, Garlic, Ginger)
What is DILAUDID used for? PAIN -usually after surg
ASA poisoning SX and TX? Sx: breathing fast and sweating Tx: Emetic or gastric lavage
4 Actions of Glucocorticoids 1. Changes Mood 2.Alter Defense Mechanism (Decreases Immunity) 3. Breakdown of Protein/Fat --> Ketones --> Acid 4. Inhibit Insulin
What Increases Calcium and what Decreases Calcium? Increases= PTH (parathyroid) Decreases = Calcitonin If there is no PTH the pt can have a seizure due to hypocalcemia (too low Calcium)
What does AngiOtensiOn II do in the lungs? In the lungs it is a potent vasoDILATOR (think O --> Open )
What is the category for Coffee, Tea, ETOH, cigarettes? Stimulants - none 24-48 hours before EEG (tests brain activity) -no sleep the night before
What are some Adverse Fx of Ambien? AE: sleepiness during the day -there are no side effect of HA, discolored urine or irregular HR
What is drug toxicity a cause of? Renal Failure (the way drugs leave the system)
What is the only thing that can be added to a TPN or PPN line? Insulin NO: -Xanax (not in PN line bc it needs digestive system) -Phenagran (causes precipitation in formula) -Demoral (not with TPN)
Where does a PEG tube go to? Empties formula directly into the stomach to be digested.
Where does PN go to? Directly into the blood stream and bypasses the digestive system bc it is not working properly.
Where is a PICC line inserted? Into a peripheral vein, but is long enough to empty into the large veins going directly into the heart
Where does a Subclavian Line go to? It empties directly into the large vein of the heart, reeducating rip of damage to smaller veins.
Where does a CVC go? It empties just above the heart muscle to be distributed.
What does the control refer to when dealing with medication and bleeding times? Control: Premedication bleeding time -usually 1.5-2 times the control
The therapeutic level in regards to bleeding time: It is usually slightly prolonged so that clotting will not occur. 1.5-2 times the control (pre-bleeding time)
Antidote of OPIODS Naloxone (Narcan)
Normal Saline 0.9% Increases circulating volume when RBC are adequate -Replaces losses w/o altering consentrations -Helpful in Na replacement ISOTONIC
LR Replaces fluid and pH buffers -NS w/ K, Ca, and lactate buffers -seen with surgery ISOTONIC
D5W Increases total fluid volume, rehydrating and extratory purposes -provides 170-200 cal/1,000cc for energy -becomes hypotonic in the body (uses up dextrose fast then only H2O remains) ISOTONIC then HYPOTONIC
1/2 NS 0.45% Raises total fluid volume -daily matinee but less value for NaCl replacement -Helps est renal fxn -good for diabetic its who don't need extra glucose HYPOTONIC
D5 1/2NS Daily matinee and body fluid nutrition and rehydration -most common post op fluid HYPERTONIC
D5 LR Same as LR + 180 cal/1000cc -watch for FVO HYPERTONIC
D5NS Replaces fluid NaCl and Calories -watch for FVO HYPERTONIC
Created by: drcady
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