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Adv. PHARMTest3study
anemia,anticoagulation,upperresp,lowerresp,diuretics
| Question | Answer |
|---|---|
| Clopidogrel class | antiplatelet |
| clopidogrel mech of action | platelets can't stick |
| Clopidogrel Adverse | BLEEDING |
| Clopidogrel Contraindications | liver dz, recent/upcoming surgery, active bleeding, closed head trauma, in labor/pregnant (can pass 2 baby); thrombocytopenia |
| Clopidogrel interactions | interacts with other anti |
| Nursing indications for Clopidogrel | Antidote - platelet infusion check platelets Check LFTs |
| Normal platelets | 150-450 |
| Heparin class | anticoagulant IV or SQ |
| Heparin mech of action | Inhibits conversion of prothrombin to thrombin |
| Heparin adverse | Bleeding HIT |
| Heparin contraindications | invasive surgery/trauma, spinal anesthesia, active GI ulcers |
| Normal aPTT | 30-40 |
| Therapeutic aPTT | 60-80 |
| H&H | 12 & 37 |
| Heparin Induced Thrombocytopenia antidote | Protamine sulfate (admin slowly) |
| Heparin Nursing Indications | know s/s of bleeding: bruising, coffee ground vomit, pink pee, tarry stools, etc. |
| Warfarin class | Anticoagulant |
| Warfarin mech of action | lower liver production of Vit K based clotting factors |
| Warfarin Adverse | BLEEDING |
| Warfarin Interactions | EVERYTHING |
| Warfarin contraindications | invasive surgery/trauma, spinal anesthesia, active GI ulcers |
| Normal INR | 1.0 |
| Therapeutic INR | 2.0-3.0 |
| Nursing Indications for Warfarin | Antidotes: Vitamin K, Fresh Frozen plasma monitor for signs of bleeding |
| Dabigatran class | anticoagulant |
| Dabigatran mech of action | inhibits thrombin action |
| Dabigatran adverse | BLEEDING |
| Dabigatran contraindications | invasive surgery/trauma, spinal anesthesia, active GI ulcers |
| TPA class/action | Clot buster |
| TPA adverse | BLEEDING |
| TPA contraindications | Sx onset is unknown Acute/previous intracranial hemorrhage liver dz Prior stroke/head injuries/surgery Pregnant Intercranial neoplasm Persistent increased BP GI malignancy/GI bleed w/in 21 days Active internal bleeding Recent surgery/procedure |
| TPA contraindication: Coagulopathy | Platelets = <100,000 INR >1.7 aPTT > 40 PT > 15 seconds |
| Ferrous sulfate class | Iron supplement |
| Ferrous sulfate Route | PO, IV, IM |
| Ferrous Sulfate PO adverse | GI irritation, dark stools (different from tarry stools), neurotoxicity (rare) |
| Ferrous Sulfate Parenteral adverse | anaphylaxis, tissue staining, phlebitis |
| Ferrous Sulfate contraindications | GI obstructive/malabsorptive processes (Crohn's, colitis, colostomy) |
| Ferrous Sulfate interactions | Poor absorption if taken with: antacids, tetracyclines, eggs, dairy, coffee, tea Increased absorption with acidic liquids |
| Iron | leafy greens, chocolate, red meat, beans |
| B12 | animal proteins, eggs, cheese |
| Folate | leafy greens, organ meats, milk, eggs |
| Epoetin alfa mech of action | increased RBC production |
| Epoetin alfa route | parenteral admin, intermittent, long-term |
| Epoetin alfa adverse | HTN, H/A, CP, increased risk for DVT and cancer if Hgb > 11 mg/dL; increased risk for clotting |
| Epoetin alfa nursing | no IV compatibility monitor H&H and BP |
| Dextromethorphan class | antitussive |
| Dextromethorphan mech of action | helps stop coughing acts centrally on the brain |
| Dextromethorphan adverse | CNS depression, N/V/dry mouth, increased viscosity of secretions |
| Dextromethorphan contraindications | those who need to cough |
| Dextromethorphan give to | those who don't need to cough |
| Dextromethorphan interactions | MAOIs - seizure, coma, death, Serotonin syndrome ETOH (Nyquil etc.) |
| Serotonin syndrome | increased temperature, agitated, tremors, tachycardia, onset w/in couple days Treat symptoms - IVF, cool down, O2, Tylenol, safety |
| Dextromethorphan Nursing | only for certain coughs - dry, nagging, etc. monitor lung sounds, CNS/respiratory status; length of cough |
| Diphenhydramine and Loratadine class | Antihistamines |
| Diphenhydramine and Loratadine action | decrease inflammatory response |
| Diphenhydramine and Loratadine adverse | anticholinergic side effects, drowsiness/sedation (specifically diphenhydramine) |
| Diphenhydramine and Loratadine interactions | MAOIs |
| Pseudoephedrine class | alpha 1 agonist |
| Pseudoephedrine action | constricts periphery, decreases congestion |
| Pseudoephedrine concerns | possible HTN, rebound congestion |
| Pseudoephedrine contraindication | PVD |
| Pseudoephedrine nursing | use for only 3 days |
| Fluticasone class | corticosteroid |
| Fluticasone action | decrease systemic inflammation; decrease drainage |
| Fluticasone route | nasal spray |
| Fluticasone adverse | some rebound congestion |
| Fluticasone nursing | rotate nares |
| Guaifenesin action | makes mucus thinner and easier to cough up |
| Guaifenesin adverse | H/A, N/V |
| Guaifenesin nursing | if used for longer than 1 week, probably a different problem OTC multi-symptom drugs |
| Theophylline action | decrease inflammation |
| Theophylline route | PO/IV = long-term |
| Theophylline Toxicity Symptoms | 20-25 mcg/mL - N/V/D, insomnia, diaphoresis, H/A, irritability > 30-35 mcg/mL - hyperglycemia, hypokalemia, hTN, dysrhythmias, tachycardia, seizures, brain damage and death |
| Theophylline contraindications | cardiac dz, hyperthyroidism, ETOH |
| Theophylline interactions | multiple - trough levels smoking increases metabolism - COPD'er = increased dose |
| Montelukast action | SM relaxation |
| Montelukast adverse | H/A, dizzy, N/V, increased LFTs, myalgias |
| Montelukast interact | increased toxicity of theophylline, warfarin |
| Albuterol class | Beta 2 agonist |
| Albuterol action | SM relax |
| Albuterol adverse | tachycardia, palpitations, restlessness, h/a |
| Albuterol contraindications | cardiac dz, hyperthyroidism, DM |
| Albuterol interactions | -fluranes (cardiac irritability) |
| Ipratropium class | anticholinergic |
| Ipratropium action | increased PNS stimulation |
| Ipratropium adverse | Anticholinergic effects, increased HR |
| Ipratropium contraindications | narrow angle glaucoma, bladder obstruction/BPH, allergy to soy/peanuts |
| Ipratropium interactions | other anticholinergics |
| Budesonide class | corticosteroid |
| Budesonide action | decrease inflammation |
| Budesonide adverse | sore throat, xerostomia, oral candidiasis |
| Budesonide contraindications | active infection, oral lesions |
| Hydrochlorothiazide action | retains Cl, Na, H20 BP control |
| Hydrochlorothiazide adverse | lowered Na, K; increased Ca, uric acid, glucose increased risk for UTI |
| Hydrochlorothiazide interactions | increased risk for digoxin toxicity due to lowered K increased risk for lithium toxicity due to lowered Na |
| Hydrochlorothiazide nursing | Trough lvls Fix digoxin tox = increased K fix lithium tox = electrolytes, BP |
| Furosemide action | retain Na, Cl, water |
| Furosemide adverse | lowers K, Ca metabolic alkalosis hTN ototoxicity, nephrotoxicity |
| Furosemide interactions | aminoglycosides - vancomycin, gentamycin - ototoxicity |
| Furosemide contraindications | ESRD |
| Spironolactone action | blocks aldosterone Na goes out, K reabsorbs = volume loss, BP control, retains K |
| Spironolactone adverse | hyperkalemia, gynecomastia, hTN |
| Spironolactone interactions | drugs that alter K |
| High K foods | avocados, bananas, potatoes, spinach, tomatoes, OJ, beans |
| Low K foods | apples, asparagus, berries, lettuce, cucumbers |
| Mannitol action | osmosis = epic water loss |
| Mannitol indications | IV, emergency only = ICP |
| Mannitol adverse | phlebitis shock - hTN |
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