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Pharm trans final
Pharm Trans Final
| Question | Answer |
|---|---|
| SSRI side effects? | Use the nmemonic BADSSRI! Body weight increase,Anxiety,Dizziness,Serotonin syndrome,Stimulated CNS,Reproductive/sexual dysfunction,Insomnia |
| Corticosteroid Side Effects | CUSHINGOID mnemonic Cataracts Ulcers Skin thinning, bruising and striae Hyperglycemia/Hypertension/Hirsutism Infections Necrosis. Avascular necrosis of the femoral head Glycosuria Osteoporosis, Obesity Immunosuppression Diabetes |
| Sulfonamide(sulfasalazine) Side Effects | 4 Ss • Steven-Johnson syndrome • Skin rash • Solubility low (causes crystalluria) • Serum albumin displaced (causes newborn kernicterus and potentiation of other serum albumin-binders like warfarin) |
| Calcium Channel Blocker(nifedipine, amlodipine,deltizem,verapamil) Side Effects | SHED the GAPS mnemonic • Stevens Johnson syndrome • Headache • Edema • Dizziness • Gingival hyperplasia • Angina • Palpitations • Sleepiness |
| Morphine Side Effects | MORPHINE mnemonic • Myosis • Orthostatic hypotension • Respiratory depression • Pneumonia (aspiration) • Hypotension • Infrequent waste release (constipation, urinary retention) • Nausea • Emesis • Sedation |
| Toxic Doses—The Magic 2s | Therapeutic dosage and Toxicity values "The magic 2s" • Digitalis (0.5–1.5) Toxicity ≥ 2.0 • Lithium (0.6–1.2) Toxicity ≥ 2.0 • Theophylline (10–20) Toxicity ≥ 20.0 • Dilantin (10–20) Toxicity ≥ 30.0 • APAP (10–25) Toxicity ≥ 200 |
| Potassium-Altering Medications | K-BANK • K-sparing diuretic • Beta blocker • ACE inhibitor • NSAID • K supplement |
| Phenytoin Side Effects | PHENYTOIN nemonic • P-450 interactions• Hirsutism• Enlarged gums/gingival hyperplasia• Nystagmus• Yellow-browning of skin •Teratogenicity• Osteomalacia • Interference with B12 metabolism (anemia) • Neuropathies such as vertigo, ataxia, headache |
| Anticholinergic Side Effects | The ABCDS mnemonic • Anorexia • Blurry vision • Constipation/Confusion • Dry Mouth • Stasis of urine |
| Osmotic Diuretics | MIG • Mannitol • Isosorbide • Glycerol |
| Antipsychotic Side Effects | iSHADE I•mpotence S•edation, S•eizures H•ypotension A•kathisia (inability to sit still) D•ermatological SEs E•xtrapyramidal reactions (acute dystonias, rigidity, tremor, tachycardia) |
| MAOI Side Effects | HAHA • Hypotension, orthostatic • Anticholinergic side effects • Hypertensive Crisis (avoid certain foods) • Anxiety/Agitation/Anorexia |
| Tricyclic antidepressant (TCA) Side Effects | TCAS • Thrombocytopenia • Cardiac (arrythmia, MI, stroke) • Anticholinergic effects (tachycardia, urinary retention, etc) • Seizures |
| ACE Inhibitor Side Effects | CAPTOPRIL • Cough • Angioedema/Agranulocystosis • Potassium excess • Taste changes • Orthostatic hypotension • Pregnancy contraindication • Renal artery stenosis contraindication • Inflammation-related pain • Lower GFR |
| ARB Side Effects | Angiotensin II Receptor Blockers Halt Dangerous Hypertension (HDH mnemonic) • Headache • Dizziness • Hyperkalemia |
| Statins Side Effects | HMG-CoA reductase inhibitor • Hepatotoxicity/Headache • Myalgia/Myopathy • GI symptoms (Consipation, pain, flatulence) • CPK increased • Atrial Fibrillation |
| Nursing interventions for Corticosteriods | Give with food Monitor for infection |
| Examples of corticosteriods | Prednisone, betamethasone, hydrocortisone,dexamethasone |
| corticosteriods ens in ? | "sone" |
| Cox 2 inhibitor example? | celecoxib |
| COX 2 inhibitor nursing interventions? | Monitor for GI bleeding, blood clots,fluid retention/ edema, Hgb/Hct and Liver function. |
| NSAIDS examples | Ibuprophen, meloxicam,naproxen,ketorlac |
| NSAIDS side effects | nausea and vomitting |
| salicylates side effects | epigastric pain, bleeding, heart burn |
| NSAIDS and salicylates are taken? | with food |
| meloxicam interactions? | ACE inhibitors, diuretics,aspirin,warfarin,lithium, feverfew,garlic,ginger,ginkgo |
| F and the 3 gs? | feverfew,garlic,ginger,ginkgo |
| Don"t give NSAIDS to people with? | GI bleeding, hepatic/renal disease,lactation |
| Examples of ACE inhibitores? | benazepril |
| Examples of ARBs? | valsartan |
| ACE inbibitors end in? | 'pril" |
| ARBs end in? | "sartan" |
| Neuroleptic Malignant Syndrome—Symptoms(NMS) | FEVER mnemonic • Fever • Encephalopathy • Vitals unstable • Elevated enzymes (CK) • Rigidity of muscles |
| what should be checked before administering valsartan? | check BP |
| 7 Rights Of Medication Administration | RIGHT patient, drug, dose,time,route, documentation,assesment |
| FDA | responsible for drug safety and approval of drugs |
| **Schedule drugs | I highest risk(heroin,marijuana,ecstasy) II high risk(hydromorphone,methadone,oxycodone) III moderate(<15mg hydrocodone,ketamine,anabolic steroids) IV lower(alprazolam,diazepam,chonazepam) V lowest(cough preparations <200mg codeine) |
| **Pregnancy Categories | A No risk to fetus B little to no risk to fetus C risk to fetus; risk vs benefit D Proven risk to fetus; used in life threatening situations X Proven risk to fetus;risk outweighs benefits, avoid drug during pregnancy |
| Safe drug administration | Right assessment, documentation,education,evaluation,to refuse |
| Nursing process | -Assessment(subjective/objective) -Planning I-implementation(administration,patient teaching: readiness to learn,culturally sensitive) -Evaluation |
| **Joint commission " Do Not Use List" | U,u IU qd qod trailing zeros .5 (use a leading zero instead) MS or MgSO4 |
| Pharmacologic classification? | How the drug works in the body(Mechanism of action) |
| Factors that effect clients response to drug therapy | age,gender,race,body mass, genetics, current health status |
| Black box warning | serious injury or death resulting fro the drug |
| FDA | responsible for monitoring the safety of drugs, dietary/herbal substances |
| FDA approvals | 1. pre clinical investigation(rats) 2. clinical trial(humans) 3. new application submitted to FDA for re evaluation (if approved the drug goes on the market) 4. Post marketing surveillance to determine if there are any new side effects. |
| Pt's have the right to refuse medication! if they refuse what should you do? | Ask them why they don't want to take it, try to fix the reason why. |
| Hyperkalemia—Signs | MURDER • Muscle weakness • Urine, oliguria or anuria • Respiratory distress • Decreased cardiac contractility • EKG changes (Peaked T waves or small P waves) • Reflexes, hyper or hypo |
| National Patient Safety Goals | Label medication, care of patients on blood thinners, medication reconciliation |
| Hypernatremia—Signs | you are FRIED • Fever • Restless • Increased BP • Edema • Decreased urinary output |
| Attenuated Vaccines | • Rubella • Oral polio vaccine • Measles • Epidemic typhus • Influenza • Mumps • BCG • Plague • Typhoid oral vaccine • Yellow fever |
| How long does it take antacids to begin to work? | 10 minutes |
| Antacids and Milk | <absortion of medications |
| 1 kilogram equals? | 1,000 grams |
| 1 gram equals? | 1,000 mg |
| 1 mg equals | 1,000 mcg |
| 1 Liter equals? | 1,000 mL |
| 1 cup | 8 ounces (oz) |
| 1 ounce (oz) | 30 milliliters (mL) |
| 1 tablespoon (T) | 3 teaspoons (t) or 15 mL |
| 1 teaspoon (t) | 5 milliliters (mL) |
| 1 ounce (oz) | 2 tablespoons (T) |
| If the problem has multiple steps, do not round off until | the end of the problem. |
| Kilograms (Kg) are rounded to | the tenths place. |
| Heparin, insulin or any cardiac drug must be given in exact amounts. If rounding is required, | work the problem to the thousandths and round to the hundredths place. |
| If calculating dosage of a tablet, the dose is rounded? | to tenths place. Only those tablets that are scored in halves or quarters can be given accurately. |
| Use TB syringe for | any amount less than 1 mL that must be given in hundredths. |
| Use a 3 ml syringe for | amounts needed for whole numbers or if rounded to the tenths place. |
| Use only insulin syringes for | insulin and NEVER round off insulin to the next highest unit |
| Osmosis | Movement of water from area of low osmolality to areas of high osmolality |
| Hypertonic intravenous fluid | – Water moves from interstitial space to plasma |
| Hypotonic intravenous fluid | – Water moves from plasma to interstitial space |
| Isotonic intravenous fluid | – No fluid shift |
| Crystalloids | -IV solutions with electrolytes -Used to replace fluids and promote urine output - Capable of leaving plasma and moving to interstitial spaces and intracellular fluid -Compartment entered depends on tonicity of intravenous fluid |
| Colloids | -Molecules too large to easily cross capillary membrane – Stay in intravascular space – Rapidly expand plasma volume - Draw water from intracellular fluid and interstitial spaces into plasma – Increase osmotic pressure |
| Fluid Replacement Agents—Colloids | -Prototype drug: dextran 40 |
| Microdrip (minidrip) set- | small drops (60 gtt/mL) |
| KVO (keep vein open)- | 10 mL/hr |
| Drops per minute rounded to ? | whole numbers only |
| Macrodrip set- | large drops (10-20 gtt/ml) |
| IV Medication Safety | -Check every 30-60 minutes -Check for kinked tubing, infiltration, flow rate and site -Pump- mechanical, battery |
| “fight or flight" Speeds up physiological reactions | sympathetic nervous syste |
| Sympathetic Nervous System primary neurotransmitters? | ◦ Norepinephrine ◦ Epinephrine ◦ Dopamine |
| Sympathetic Nervous System also known as? | Adrenergic system |
| Sympathetic nervous system receptor sites? | Alpha 1 Alpha 2 Beta 1(heart) Beta 2(lungs) |
| Primary neurotransmitter:acetylcholine | parasympathetic nervous system |
| Cholinergic system aka? | parasympathetic nervous system |
| Parasympathetic nervous system | Slows down many physiological responses, “rest and digest”, Actions in opposition of sympathetic |
| Sympathetic responses? | Pupils:dilate Bronchioles: dilate >HR Blood vessels constrict Relax smooth muscles Ureters:Relaxes Salvation: Decreases |
| Parasympathetic response? | Pupils:constrict Oxygen: Bronchioles constrict > secretions < HR Blood vessels:dilate Elimination; > peristalsis Uterus:N/A Salivation: Increases |
| What does antagonist mean? | inhibits or blocks an action |
| What does agonist mean? | initiates or enables an action |
| Beta Adrenergic Blockers(antagonist) examples? | Selective (Beta 1): Atenolol, Metoprolol Non-selective: Nadolol, Propranolol |
| Beta1 (selective)adrenergic blocker (antagonist) causes what? | Beta 1 effects the heart! inhibits effects of epinephrine and norepinephrine. Causes <contractility, <HR, < cardiac conduction. |
| What should be monitored for people on Beta 1 antagonist? | Monitor patient blood pressure, heart rate and for fatigue. |
| Common side effects of beta 1 adrenergic antagonists? | bradycardia, hypotension, activity intolerance, N/V, GI upset, weakness, dizziness, HA, dry mouth |
| Non selective beta antagonist cause what? | Block beta 1 and beta 2 receptors.Beta 1 effects the heart. Beta 2 effects smooth muscle of lungs, arteries and veins. <HR,< myocardial contractility, < BP. Can cause broncoconstriction. |
| Non selective beta antagonist, monitor ? | bloop pressure, heart rate, glucose, not used with asthma or COPD. |
| Cause bronco constriction and is contraindicated for pt with asthma or COPD? | non selective beta blockers such as nadolol, propranolol |
| Alpha 1 and beta 1 adrenergic antagonist examples? | labetolol, carvedilol |
| Alpha 1 and beta 1 adrenergic antagonist side effects? | bradycardia, hypotension, drowsiness, dizziness, palpitations, sexual dysfunction |
| Side effects if Alpha is blocked? | ◦ Orthostatic hypotension ◦ Palpitations ◦ Vertigo ◦ Sexual dysfunction |
| Side effects if Beta is blocked? | ◦ Hypotension ◦ Symptoms of congestive heart failure (CHF) ◦ Bradycardia ◦ Drowsiness; depression |
| Alpha Adrenergic Blocker(antagonist)? | Doxazosin mesylate, Prazosin HCL |
| Alpha Adrenergic Blocker nursing considerations? | Monitor B/P. Can cause nasal vasodilation, GI disturbances, orthostatic hypotension, headache, syncope |
| Thiazide and thiazide like diuretics? | -Derived from sulfonamides -Water, sodium, chloride, potassium, magnesium & bicarbonate excreted -Calcium, uric acid, glucose & serum lipids can elevate different chemical make-up; same therapeutic activity; can be used in renal dysfunction |
| Examples of thiazide and thiazide like diuretics? | ◦ Thiazide- hydrochorthiazide ◦ Thiazide-like- chlorthalidone, metolazone |
| Nursing considerations for thiazide like diuretics? | ◦ Administer a.m. ◦ Urine output, BP ◦ Weight early a.m. Alert 2+ lbs. ◦ Serum Na, Cl, K+, Mg, Ca, Uric acid, glucose & lipids ◦ Urine alkaline- predispose to UTI ◦ Teach pt. K+ & Mg rich foods |
| Carbonic anhydrase inhibitors action? | Blocks enzyme carbonic anhydrase(mild diuretic) > excretion of Water, Na, HCO3 but holds on to Ca, glucose, uric acid and may cause levels to become elevated. |
| Carbonic anhydrase inhibitors action examples? | methazolamide, acetazolamide, dorzolamide |
| hydrochlorthiazide (HCTZ) Interactions? | Hypersensitivity to sulfonamides, anuria, electrolyte imbalance, dehydration Corticosteroids use will cause further hypokalemia. Insulin use will cause worsened hypoglycemia. |
| hydrochlorthiazide (HCTZ) causes the excretion of which electrolytes? | Enhances excretion of Na, Cl, K+, Bicarbonate & water. |
| hydrochlorthiazide (HCTZ) | Hyperglycemia, hyperuricemia, hypokalemia |
| hydrochlorthiazide (HCTZ) is what type of diuretic? | thiazide diuretic. |
| Before giving hydrochlorthiazide what should be checked? | Check B/P Check K+ level |
| Nursing Interventions for thiazide diuretics? | Weigh pt. daily. Report 2 lb. wt. gain. Monitor glucose, electrolytes, BUN, uric acid. Monitor for hypotension, dizziness Monitor I & O; check for edema Change positions slowly. Photosensitivity Teach pt. foods high in K+ & Mg |
| thiazide diuretics should be taken? | Give w/food to reduce GI upset. Give in the AM. |
| Ask patients if they have this before giving thiazide diuretics? | Allergic to sulfa drugs? |
| Anticholinergic side effects? | The ABCDS mnemonic • Anorexia • Blurry vision • Constipation/Confusion • Dry Mouth • Stasis of urine |
| Cholinergic antagonist(anticholinergics) examples? | atropine sulfate, ipratropium bromide, tolterodine tartrate, benztropine |
| Central Acting Adrenergic Blockers | Clonidine HCL |
| clonidine side effects? | dry mouth, urinary retention, edema, impotence. monitor BP and HR. |
| Central Acting Adrenergic Blocker nursing consideration? | Monitor B/P & HR, I/O |
| Calcium Channel Blocker Side Effects | SHED the GAPS mnemonic • Stevens Johnson syndrome • Headache • Edema • Dizziness • Gingival hyperplasia • Angina • Palpitations • Sleepiness |
| Calcium Channel Blockers considerations? | Monitor B/P & HR Avoid grapefruit < myocardial contractility |
| Calcium Channel blockers examples? | amlodipine, nifedipine |
| Angiotensin-Enzyme Converting Inhibitors (ACE Inhibitors) nursing considerations? | Monitor B/P & HR Angioedema Tickling sensation in throat; dry cough > K+, BUN, Creatinine Check serum K+, avoid K+ supplements |
| Benazepril HCL | ACE Inhibitors |
| Angiotensin II Receptor Blockers (ARBs) nursing considerations? | Monitor B/P & HR Angioedema Tickling sensation in throat; dry cough > K+, BUN, Creatinine Check serum K+, avoid K+ supplements |
| Valsartan | ARB |
| atenolol | beta adrenergic antagonist. only block beta 1. no bronchoconstriction. Interactions: anticholinergics > absorption. insulin use will cause hypoglycemia. NSAIDs. |
Created by:
rashan
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