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NR pharm hesi
pharm hesi
| Question | Answer |
|---|---|
| Pharmacokinetics | |
| Pharmacodynamics | |
| Pharmacotherapeutics | |
| Narrow Therapeutic Index: | monitor drug levels |
| Half Life: | dose a drug before half life is over; amount of time it take for half of the medication to be excreted from medication system; after 5 half life’s have passed the medication is eliminated |
| Indications: | what medication used for |
| Contraindications: | something that means the medication shouldn’t be used in that specific patient (i.e. Tylenol use and liver failure patients) |
| Adverse effects: | |
| Patient variables: | Pediatric, Gerontology, Pregnancy/Breast-feeding, Gender, and Cultural/Ethnic variations |
| Assessments to include: | vital signs, physical assessment, labs, & diagnostics |
| Drug administration: | safety, route considerations, med orders |
| Drug toxicity | (signs/symptoms) and antidote if applicable |
| Patient teaching | |
| Oral, suspension, injectable, IV | (ml/hr and gtt/min) |
| Metric and household conversions | |
| Synergestic effects | |
| Agonistic | |
| Antagonistic effects | |
| Tolerance: | need more medication to get therapeutic effect |
| Addiction: | cannot function without drug; psychical: (i.e. alcohol) need to physically function; psychological: think they need the drug to function |
| Anaphylaxis: | it is an adverse effect where pt goes into state of shock from overexposure to medication |
| Adverse effects vs. Side effects: | used interchangeably; an unintended effect of medication |
| Opioids/Pain Management: | Schedule II narcotics (have high rate of addition and potential for abuse; side effect of euphoric/high feeling) |
| Risk for constipation/antidote | Oxycodone (Percocet)—Narcan/Nalozone is antidote |
| Acetaminophen (Tylenol)/antidote: | found in many OTC meds; hepatotoxic; many accidental ODs; antidote is Mucomyst—N-Acetylcistine |
| Fentanyl (Duragesic) | |
| Aspirin and NSAIDs: | Ketorelac (Toradol) |
| Romazicon and Flumazenil are antidotes for | Benzodiazepines |
| Narcan and Romazicon= | drug it is used as an antidote to may have longer half life so may need to give alternate doses of antidote |
| Muscle Relaxants: | Baclofen (administered through implantable pump or IV); Dantrolene |
| Baclofen | Cause muscles to relax; usually because of spasms or muscle injury |
| Dantrolene | used as treatment for malignant hyperthermia to relax muscle rigidity |
| Neuromuscular blockers/Anesthetics: | Nalbuphine (Nubain) |
| Paralytic medications- | do not give to awake patient (sedate first) o Used most commonly in conjunction with anesthesia and critical care units o Will need mechanical support (cannot breathe on their own) |
| Local Anesthesia- | used for small area; patient not asleep; lidocaine and epinephrine—keeps localized; i.e. stitches |
| General anesthesia- | inhaled and IV meds to do surgery; artificially ventilated |
| Cholinergics: | Tensilon |
| Conscious (moderate) sedation- | pt able to follow commands and breathe on own but unaware of procedure being done (systemic effect); i.e. colonoscopy, EGD |
| Antiepileptics: | Depakote |
| Stimulants: | Amphetamine (Adderall) |
| Antidepressants: SSRIs: | Fluoxetine (Prozac) |
| Antipsychotics: | Clozapine (Clozaril), Haloperidol (Haldol) |
| Osteoporosis tx: | Miacalcin |
| Leukotrienes | allergic reaction mediators; designed to prevent allergic reaction from happening |
| Anticongestants/Antitussives/Expectorants: | used to relieve cold symptoms; cannot treat cold but can treat symptoms |
| Bronchodilators/Inhaled corticosteroids: | given in conjunction—give bronchodilators first because it will open airway allowing corticosteroid to relieve inflammation |
| Antianginals: | Nitrates/Nitroglycerin |
| Antidysrhythmics: | |
| Digoxin- | slows heart electrical conduction and rate, increases contractility (+inotrope, -chromotrope/dromotrope); check apical pulse 60sec (60+bmp) |
| Cordarone (Amiodorone)- | decreases ventricular dysrhythmias but can slow conduction of atrial excitability; half life 90 days |
| Lidocaine- | ventricular dysrhythmias only |
| Antihypertensives: | Calcium Channel Blockers |
| Antiplatelets- | prevent platelet aggregation |
| Anticoagulants- | stop clot from getting bigger, do not break clots |
| **Warafarin/Coumadin—Vitamin K; | check PT/INR |
| **Heparin—Protamine Sulfate; | check PTT/aPTT |
| Thrombolytics- | break clots apart |
| Antilipemics: | Statins- monitor liver; affect how liver deals with cholesterol |
| Diuretics: | Loop: Furosemide (Lasix); watch K+; potassium wasting |
| Osmotics: | Mannitol; primarily used for glaucoma (decrease intraocular pressure) and decrease ICP; pull fluid into vasculature and then excreted by kidneys |
| Anti-infectives | **may need to do a C&S to find out which one to use (may take up to 72 hours so treat with broad spectrum antibiotic in mean time) **complications: superinfections, yeast infections (vaginal or thrush), etc. |
| Antibiotics: | Tetracycline Cephalosporins Metronidazole (Flagyl) Piperacillin + tazobactam (Zosyn |
| Piperacillin + tazobactam (Zosyn) | Beta lactamase antibiotics; given to inhibit the breakdown of the beta lactam ring to protect atntibiotic from breaking down before getting to site of infection (given in conjunction) |
| Sulfa drugs: | Bactrim (SMZ-TMP) |
| Drugs for treating UTI: | -Nitrofurantoin (Macrodantin) -Pyridium |
| Antivirals: | HSV and hepatitis tx |
| HIV Drugs: | Protease inhibitors |
| Antitufungals: | Terbinafine (Lamisil) |
| Antituberculars: | Rifampin |
| Antihelminthics: | Vermox |
| GI drugs | **Pts may take antacids to treat symptoms which may be a symptom for a bigger underlying cause |
| **laxatives | may cause decreased absorption because flushed out quickly; analgesics and antidiarrheals may increase absorption because in GI tract longer |
| **Too much Sodium Bicarb | can cause metabolic alkalosis |
| **medications taken with antacids | may decrease breakdown of medication |
| **H2 Blockers: | decrease hydrochloric acid secretions; smoking decreases effectiveness |
| **PPI: | completely stop secretion of hydrochloric acid (pantproazole, omeprazole, etc); recommended for short term use only (*long |
| **antacids: | neutralize stomach acid |
| GERD/PUD Tx: | -Sucralfate (Carafate) -Aluminum hydroxide (Amphojel) |
| Laxatives: | -Bulk-forming- only one for long term use; drink water!! -Enulose (Lactulose)- excrete Ammonia (hepatic encephalopathy) |
| Vitamins & Mineral Supplements: | Iron Vitamin C Vitamin D |
| Antidiabetics: | Insulin-Only insulin that can be given IV is Regular |
| Antidiabetics | Glimepiride (Amaryl) |
| Adrenal drugs: | ACTH |
| Thyroid drugs: | -PTU -Radioactive Iodine |
| Immunologic Drugs | **HIV treat with a retroviral not antiviral |
| Immunologic Drugs | • Immunosuppressants: Cyclosporine • Biologic Response Modifiers (BRMS): Filgrastim (Neupogen) |
| Reproductive Drugs | Steroids (anabolic) |
| Ophthalmic Drugs | Beta-blockers Miotics |
| Dermatologic Drugs | Anti-Acne: Isotretinoin (Accutane) |
Created by:
lalad13
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