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Pharm (Test 3)
Drugs: Lipidemics, Coagulants, Lax/Carth, Vit/Min, Opthal, Immun, AD, Wt. Mgmt
| Question | Answer |
|---|---|
| COAGULANTS -AE/Antidotes/Monitoring/Considerations | AE: Bleeding Antidotes: -Warfarin: potassium (K+) -Heparin: protamine sulfate* *adv effect: incl. serious CV/Pulm. effects Monitor Blood Levels: -Warfarin: INR -Heparin: aPTT *exc.⇓mol.wt.heparins (enoxaparin/Lovenox) |
| CLOT FORMATION -Risk factors/Effects of ABNORMAL clot formation | Arterial (Thrombi): Atherosclerosis: obstruct BV -> tissue necr. Venous (Thrombi): -Stasis of blood flow: local swelling -If clot brks loose => Lungs(PE) => sud. death |
| ANTICOAGULANTS: General -Action/Uses/Prototypes | Action: - to prevent formation of new clots and ext. of existing clots Uses: - to prevent/tx thrombophlebitis, DVT & PE Prototypes: Warfarin, Heparin |
| DYSLIPIDEMIAS: Bile Acid Sequesterants (cholecystramine) -Action/AE/Pt. Teaching/Other | Action: - ⇑ brkdwn of cholesterol Adverse Effects: - GI - Interferes w/ absorp. of many po meds Pt. Teaching: - take other meds 1 hr a or 4 hr p cholestyramine ** Often Rx w/ |
| DYSLIPIDEMIAS: Fibrates -Action/Use/AE/Caution | Action: -⇓ hepatic prod of TG/VLDL's; ⇑HDL's Use: - to ⇓ TG Adverse Effects: - GI CAUTION: ⇑serum Warfarin levels ⇒ Warfarin must be ⇓ |
| DYSLIPIDEMIAS: HMG-CoA Reductase Inhibitors (Statins) -Action/Adverse Effects/Pt. Teaching | Action: ⇓ synth. of cholesterol Adverse Effects: -GI* -serious, but rare: hepatotoxicity/myopathy Pt. Teaching: -promptly report muscle/tenderness |
| ANTICOAGULANTS: Anti-Platelet Drugs -Action/Protypes | Action: Inhib. platelet activation, adhesion aggregation or procoagulant activity. Prototypes: - Aspirin: used to prevent MI, CVA & tx inflammation. - clopidogrel (Plavix): prev. platelet aggreg.; prevent MI, CVA & vascular |
| ANTICOAGULANTS: Thrombolytics -Use/Prototypes | Use: to restore blood flow via dissolving clots Prototypes: streptokinase/urokinase |
| BLOOD COAGULATION -Thrombus/Embolus/Hemostasis/Plasmin | Thrombus: blood clot Embolus: an unattached thrombus in bloodstream Hemostasis: cessation of bleeding via an injured BV. Plasmin: enzyme that dissolves blood clots p bleeding ceases |
| LAXATIVES/CATHARTICS: -How do they differ? | Laxatives: mild effects; elim. of soft, formed stool Cathartic: strong effects and elim. of liquid or semi-liquid stool * Diff. depends more on dose, so may be used interchangable |
| LAXATIVES/CATHARTICS: Surfactants | Allows water & fat to penetrate/soften stool. Little true laxative effect. |
| LAXATIVES/CATHARTICS: Saline | Osmotic; distends bowel and stimulates peristalsis. May cause F&E d/o's. |
| LAXATIVES/CATHARTICS: Bulk-Forming | Adds mass to feces -> stim. peristalsis/defecation. Best for Long-term use. |
| LAXATIVES/CATHARTICS: Stimulant | Irritates GI mucosa, draws water, stimulates peristalsis. May cause electrolyte imbalances. |
| LAXATIVES/CATHARTICS: Polyethelene Glycol | Distends the bowel causing rapid emptying. Used for bowel cleansing/GI procedures. |
| LAXATIVES/CATHARTICS: Lubriprostone (Amitiza) | ⇑ intestinal fluid; used for chronic idiopathic constipation. |
| LAXATIVES/CATHARTICS: Lactulose | Osmotic; draws water into colon. Softens stool/stimulates peristalsis. Used to treat hepatic encephalopathy. |
| LAXATIVES/CATHARTICS: Sorbitol | Promotes expulsion of potassium-resin complex. Used w/ Kayexelate to tx hyperkalemia. |
| LAXATIVES/CATHARTICS: Lubricant | Lubricates fecal mass. Can ⇓ absorption of fat-soluble vitamins. |
| ANTICOAGULANTS: Direct-Thrombin Inhibitors Use/Feature/Prototype | -Newest anticoagulants!! -Short-term use (i.e., venous TE, AF) -Prototype: lepirudin |
| ANTICOAGULANTS: Implementation/Teaching | -use electric razor -avoid trauma incl. invasive procedures -watch for bleeding -carry a MedicAlert card and/or bracelet -avoid large amts. of K+-Rich veggies -check INR a each dose; withold warfarin if INR >3. |
| OPTHALMIC DRUGS: Uses/Forms/Labels/Other | Uses: tx d/o of eye; dilate/constrict pupils Forms: solutions, suspensions, ointments *Wait > 5 min b/t drugs when >1 eye Rx ordered Labels: color-coded -some pts. take >1 opth. drug; adhere closely to scheduled time for ea |
| OPTHALMIC DRUGS: Classes | -Anesthetics -Anti-inflammatory agents -Anti-microbials -ANS drugs -Diuretics -Lubricants * Opthalmic Beta-blockers** => Glaucoma * some opth. drugs absorb.⇒system effects * some pts >1 opth. drg; adh. clos 2 sched time |
| OPTHALMIC DRUGS: Administration of topical drops | -Confirm exp. date -Tilt head back; look up -Pull lower lid down ⇒ create pch conjunctiva -Admin drops/thin line oint ⇒pouch w/o ->med cont ⇒eye/skin -Look ⇓(sevl secs) -⇓syst ⇒cls eye p instill; ap pres tear dct,3-5m |
| DERMATOLOGIC DRUGS: Types | * Treats skin/mucous membranes -Antimicrobials -Antiseptics -Corticosteroids -Emollients/Moisterizers -Enzymes -Immunosuppressants -Keratolytics -Retinoids |
| DERMATOLOGIC DRUGS: Features | -Sign. absorption can occur esp. if covered w/ occlusive dressing - Do NOT cover w/ an occlusive dressing topical steroids unless specifically ordered. -Acne is tx w/ topical/systemic ANTIMICROBIALS and RETINOIDS. |
| DERMATOLOGIC DRUGS: Antiseptics | kills/inhibits growth of microbes; MOST PREVENTATIVE. |
| DERMATOLOGIC DRUGS: Corticosteroids | Tx inflammation |
| DERMATOLOGIC DRUGS: Antimicrobials | Tx infections |
| DERMATOLOGIC DRUGS: Emollients/Moisturizers | Tx dry skin/pruritis |
| DERMATOLOGIC DRUGS: Enzymes | To debride necrotic tissue |
| DERMATOLOGIC DRUGS: Immunosuppressants | Tx inlammatory conditions (i.e., sun damage) |
| DERMATOLOGIC DRUGS: Keratolytics | Tx keratin containing conditions |
| DERMATOLOGIC DRUGS: Retinoids | Retinoids such as Accutane, acne initially becomes worse, than improves. *isotretinoin (Accutane): -teratogenic -female pt must use contracepion during and a use -Liver fx mst b mnitrd -Advised to report depression/suicidal th |
| IMMUNIZING AGENTS: Features | -Used to protect against infectious dz -Active immunity req admin of an antigen to induce pts immune serum (contains antibodies) from people who are immune to the antigen. -Depending on vaccines rec'd in childhood, young/middle adults hav dif vacc needs |
| IMMUNIZING AGENTS: Older Adult Immunizations | Include: -Tetanus-diptheria booster (DPT): q 10 yrs -Annual influenza vaccine -Pneumococcal vaccine (usu. one time) -Shingles prevention vaccine |
| IMMUNIZING AGENTS: Adverse Effects | -Pain, tenderness @ inj site -Fever, muscle aches -Anaphylaxis: when giving immunizations, have epi avail for subcutaneous use for STAT tx. * LIVE VACC SHOULD NOT BE GIVEN TO PTS W/ ACTIVE MALIGNANT DX! |
| ANTIDIARRHEALS: Non-Specific Tx | -addresses the sx Most Effective Prototypes: -opiates/opiate derivatives *diphenoxylate w/atropine (Lomotril) *loperamide (Imodium) *both above: contraindicated in kids under age 2 |
| ANTIDIARRHEALS: Specific Tx | - Addresses the CAUSE of the sx (i.e., diarrhea) *Enzymatic replacements *Antimicrobial Agents |
| ANTIDIARRHEALS: When to administer anti-diarrheals | -Main AE: constipation -Prototype: * Alsoetron (Lotronex)- used in women w/ severe diarrhea predominant IBS. -Serious AE include: *GI obstruction, perf, hemmorage, ischemic colitis *Contraind. w/ numerous d/o *A pt-physician agreement req' |
| DRUGS ASSOC W/ WEIGHT GAIN: | -Antidepressants -Antidiabetic drugs -Antiepileptic Drugs -Statins -Corticosteroids -PPI's -Lithium **Drug therapy for obesity should be part of a program diet, physical activity and behavior modification. |
| DRUGS ASSOC W/ WEIGHT GAIN: Approved for Long-Term Use | *Sibutramine (Merida) -ACTION: ⇑ serotonin/epinephrine -EFFECTS: ⇑satiety, ⇓food intake, ⇑metabolic rate -AE: ⇑HR, ⇑BP -CONTRA: CVD, Renal or Liver Dz -Many drug interactions |
| DRUGS ASSOC W/ WEIGHT GAIN: Approved for Long-Term Use | *orlistat (Xenical, Alli) -ACTION: ⇑ serotonin/epinephrine -EFFECTS: ⇑satiety, ⇓food int, ⇑metab. rate -AE: flatulance, fecal urgency/incont., fatty stools -usu. subside p few weeks -Interf. w/absorp. fat-soluble vit; multi-vits needed (2hrs a/p use) |
| DYSLIPIDEMIAS: Niacin | - Most effective drug: ⇑ HDL levels - ⇓ serum TG/LDL's - AE: itching, hepatoxcity, flushing * Flushing can be ⇓ via: - starting w/ ⇓ dose, and gradually ⇑ - taking w/ meals - taking aspirin (325mg), 30 min a niacin |
| DYSLIPIDEMIAS: Cholesterol Absorption Inhibitor (ezetimibe) | - Inhibits absorption of cholesterol - AE: allergy, rash, nausea |
| DYSLIPIDEMIAS: Key Points | - Works via inhibiting absorption of dietary lipids/⇓ cholesterol synthesis via the liver - Most common SE: GI - Niacin causes flushing - Statins cn cause dmg - Drg Interactions: *Admin cholestyramine 1hr a/4hrs p othr drgs *Fibrates enhance Warfa |
| Why is mineral oil NOT advised to be administered w/ fat-soluble vitamins? | Mineral oil absorbs vitamins, prev. systemic absorption. |
| VITAMINS/MINERALS (ELECTROLYTES) | |
| VITAMINS/MINERALS (ELECTROLYTES) | |
| VITAMINS/MINERALS (ELECTROLYTES) | |
| VITAMINS/MINERALS (ELECTROLYTES) | |
| Why is mineral oil NOT advised to be administered w/ fat-soluble vitamins? | Mineral oil absorbs vitamins, prev. systemic absorption. |
| Why should undiluted Potassium (K+) never be administered intravenously (IV)? | |
| VITAMINS/MINERALS (ELECTROLYTES) | Oral Niacin causes vasodilation ⇒ may result in injury. |
| The Z-tecnique is used to give iron dextran to prevent...? | -Discomfort/staining of subQ tissue/skin |
| Nutrients can be obtained orally, enterally, parenterally or is best obtained...? | -From diet (food) |
| Nutrient deficiencies are common in people with...? | -Health problems |
| Who can benefit from daily vitamins? | -Most people |
| Large doses of vitamins can be dangerous, therefore.... | -DO NOT EXCEED MAXIMUM RECOMMENDED DOSE. |
| What difference is there between synthetic and natural vitamins? | None |
| Nutrient deficiencies are common in people with...? | -Health problems |
| Who can benefit from daily vitamins? | -Most people |
| Large doses of vitamins can be dangerous, therefore.... | -DO NOT EXCEED MAXIMUM RECOMMENDED DOSE. |
| What difference is there between synthetic and natural vitamins? | None |
Created by:
rprefume
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