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pharm FINAL REVIEW
| Question | Answer |
|---|---|
| Opioid Drugs | Synthetic drugs that bind to the opiate receptors to relieve pain Mild agonists: codeine, hydrocodone |
| Opioid Drugs strong agonists | morphine, hydromorphone, oxycodone, meperidine, fentanyl, and methadone Indications: ◦ Main use: to alleviate moderate to severe pain ◦ Often given with adjuvant analgesic drugs to assist primary drugs with pain relief |
| opioids are also used for | Cough center suppression ◦ Treatment of diarrhea ◦ Balanced anesthesia |
| Opioid Analgesics Adverse Effects | CNS depression ◦ Leads to respiratory depression-Most serious adverse effect! Nausea and vomiting Urinary retention Diaphoresis and flushing Pupil constriction (miosis) Constipation, itching |
| opioid Toxicity and Management of Overdose | Naloxone (Narcan) Naltrexone (ReVia) Regardless of withdrawal symptoms, when a patient experiences severe respiratory depression, an opioid antagonist should be given. |
| Naloxone Hydrochloride | Pure opioid antagonist •Drug of choice for the complete or partial reversal of opioid-induced respiratory depression •Indicated in cases of suspected acute opioid overdose |
| Acetaminophen (Tylenol) | Analgesic and antipyretic effects •Little to no antiinflammatory effects •Available over-the-counter (OTC) and in combination products with opioids •Indicated for fever, mild pain |
| Acetaminophen (Tylenol) not taken in presence of | Drug allergy ◦ Liver dysfunction ◦ Possible liver failure ◦ G6PD deficiency Dangerous interactions may occur if taken with alcohol or other drugs that are hepatotoxic. lethal when overdosed |
| acetaminophen overdose, whether intentional or resulting from chronic unintentional misuse, causes | hepatic necrosis: hepatotoxicity Long-term ingestion of large doses also causes nephropathy. |
| Recommended antidote for toxicity acetaminophen | acetylcysteine regimen |
| Benzodiazepines | Sedative-hypnotic ◦ Anxiolytic (medication that relieves anxiety) Effects: Calming effect on the CNS Useful in controlling agitation and anxiety Reduce excessive sensory stimulation, inducing sleep Induce skeletal muscle relaxation |
| Benzodiazepines antidote | Flumazenil as an antidote |
| Benzodiazepines indications | Sedation Sleep induction Skeletal muscle relaxation Anxiety relief Anxiety-related depression Treatment of acute seizure disorders Treatment of alcohol withdrawal Agitation relief Balanced anesthesia |
| Nonbenzodiazepine: Zolpidem (Ambien) | short-acting non benzodiazepine hypnotic Lower incidence of daytime sleepiness compared with benzodiazepine hypnotics Ambien CR is a longer acting form with two separate drug reservoirs. Somnambulation- sleep walking may occur |
| Muscle Relaxants | pain associated with skeletal muscle spasms Majority are centrally acting. ◦ CNS is the site of action. ◦ Similar in structure and action to other CNS depressants Direct acting ◦ Act directly on skeletal muscle ◦ Closely resemble GABA |
| Muscle Relaxants effects | Euphoria ◦ Lightheadedness ◦ Dizziness ◦ Drowsiness ◦ Fatigue ◦ Muscle weakness |
| Valproic Acid | treatment of generalized seizures, bipolar disorder, and controlling partial seizures Adverse effects: -drowsiness -GI disturbances -tremor, -weight gain, hair loss -hepatotoxicity, pancreatitis |
| Valproic Acid contraindications | Liver impairment, urea cycle disorders |
| Antiepileptics | adhere closely to the drug dose and frequency of dosing in order to attain therapeutic levels. •Take medication at the same time •If one or more doses of the antiepileptic drug is missed, provider must be notified due to increase in risk for seizure r |
| Antiepileptics effect | GI upset-frequent adverse effect • Take with food and 6-8 oz of water |
| Benzodiazepines meds | Alprazolam, Diazepam, Lorazepam -Largest and most commonly prescribed anxiolytic -Used to treat alcohol withdrawal, insomnia, and muscle spasms as well as adjunct for depression |
| Benzodiazepines effects | Decreased CNS activity, sedation Hypotension Drowsiness, loss of coordination, dizziness, headaches Nausea, vomiting, dry mouth, constipation |
| Benzodiazepines overdose | Dangerous when taken with other sedatives or alcohol Treatment is generally symptomatic and supportive. Flumazenil (Romazicon) may be used to reverse benzodiazepines’ effects. |
| Benzodiazepines interactions | Oral Contraceptives, opioids, azole antifungals-causes impaired hepatic elimination of the benzodiazepine and enhanced sedative effects. |
| Buspirone (Buspar) | Unknown mechanism of action Administered on a scheduled basis Lacks sedative properties and dependency potential as other benzodiazepines (non habit forming) |
| Buspirone (Buspar) effects | Paradoxical anxiety -Blurred vision -Headache -Nausea |
| Antipsychotics | Block dopamine receptors in the brain. areas associated with emotion, cognitive function, motor function -Dopamine levels in the CNS decreased. tranquilizing effect in psychotic patients Examples: Haloperidol, Risperidone, Olanzipine, Quetiapine |
| Antipsychotics effects | hemolytic anemia -Drowsiness -Neuroleptic malignant syndrome (NMS)-potentially life threatening! S/S High fever, unstable blood pressure, myoglobinemia -Extrapyramidal symptoms (EPS): pseudoparkinsonism-akathisia -Tardive Dyskinesia |
| Selective Serotonin Reuptake Inhibitors (SSRIs) | Inhibit serotonin reuptake ◦ Second generation drugs have better adverse effect profiles and are 1st line drugs for depression ◦ Examples: Buproprion, Citalopram, Duloxetine, Trazodone |
| Selective Serotonin Reuptake Inhibitors (SSRIs) effects | Common: bleeding, insomnia, weight gain, sexual dysfunction ◦ Serotonin Syndrome Delirium Agitation Tachycardia Sweating Myoclonus (muscle spasms) Hyperreflexia Shivering Course tremors |
| Selective Serotonin Reuptake Inhibitors (SSRIs) interactions | Warfarin, Phenytoin- when taken with SSRIs, will have more pronounced drug effect **must taper SSRIs due to withdrawal syndrome |
| opioid abuse | Synthetic versions of pain-relieving substances • Heroin: One of the most commonly abused opioids, Codeine, Hydrocodone,Hydromorphone, Morphine, Oxycodone |
| stimulant abuse | Racemic amphetamine, Dextroamphetamine, Methamphetamine, Cocaine, methylphenidate, dextroamphetamine, phenmetrazine, and methamphetamine, “Ecstasy” |
| depressant abuse | Benzodiazepines, Barbiturates, Marijuana |
| alcohol abuse | Prolonged/chronic use of drug includes vitamin deficiencies (B vitamins, thiamine), seizures, hepatitis, cardiomyopathy, Wernicke’s encephalopathy & Korsakoff’s psychosis |
| Methadone | goal is to reduce the patient’s dosage gradually so that eventually the patient can live permanently drug free • Relapse rates are often high; Methadone can be abused. |
| Ethanol Withdrawal s/s | Elevated blood pressure, pulse rate, and temperature • Insomnia • Tremors • Agitation • Classified as mild, moderate, and severe |
| Ethanol Withdrawal treat | benzodiazepines are the treatment of choice • Diazepam (Valium), lorazepam (Ativan), or chlordiazepoxide (Korsakoff’s psychosis) • Dosage and frequency depend on severity • For severe withdrawal, monitoring in an intensive care unit is recommended. |
| Treatment for alcoholism | Disulfiram (Antabuse) Naltrexone Acamprosate (Campral) Counseling-Individual or Alcoholics anonymous |
| Hypothyroidism | Primary: abnormality in the thyroid Secondary: when the pituitary gland is dysfunctional and does not secrete thyroid- stimulating hormone (TSH) Tertiary: results when the hypothalamus gland does not secrete thyrotropin-releasing hormone |
| Hypothyroidism s/s | Thickened skin -Hair loss -Constipation -Lethargy -Anorexia |
| Hypothyroidism treat | -Levothyroxine (Synthroid, Levoxyl)- most standardized and widely used -Liothyronine (Cytomel) -Liotrix (Thyrolar) |
| ask patient about recent | myocardial infarction when placing on thyroid replacement drugs-Recent MI is CONTRAINDICATION. |
| Hypothyroidism effects | Cardiac dysrhythmia is the most significant adverse effect. -Tachycardia, palpitations, angina, hypertension, insomnia, tremors, headache, anxiety, nausea, diarrhea, menstrual irregularities, weight loss, sweating, heat intolerance, fever, others |
| Hypothyroidism admin | Best taken in the morning on an empty stomach -Morning dosing avoid potential sleep disturbances -Dosed in micrograms (mcg)!!! NOT mg |
| Hyperthyroidism | Excessive Thyroid Hormones -Caused by several diseases: -Graves’ disease -Multinodular disease -Plummer’s disease (rare) -Thyroid storm (induced by stress or infection)- Severe and potentially life threatening |
| Hyperthyroidism s/s | Diarrhea Flushing Increased appetite Muscle weakness Sleep disorders Altered menstrual flow. Fatigue Palpitations Nervousness Heat intolerance Irritability |
| Hyperthyroidism treat | Radioactive iodine works by destroying the thyroid gland -Surgery to remove all or part of the thyroid gland Lifelong thyroid hormone replacement will be needed. Antithyroid drugs: thioamide derivatives |
| Diabetes treatment | Type 1 • Insulin therapy ◦ Type 2 • Lifestyle changes • Oral drug therapy • Insulin when the above no longer provide glycemic control |
| Oral Antidiabetic Drugs | Used for type 2 DM • Effective treatment involves several elements. • Careful monitoring of blood glucose levels • Therapy with one or more drugs • Treatment of associated comorbid conditions such as high cholesterol and high blood pressure |
| Metformin (Glucophage) | First-line drug and is the most commonly used oral drug for the treatment of type 2 DM • Not used for type 1 DM |
| diabetes drugs effects | gastrointestinal (GI) tract: abdominal bloating, nausea, cramping, diarrhea, feeling of fullness -May also cause metallic taste, reduced vitamin B12 levels -Lactic acidosis is rare but lethal if it occurs. -Does not cause hypoglycemia |
| Hypoglycemia | Abnormally low blood glucose level (below 50 mg/dL) • Mild cases can be treated with diet—higher intake of protein and lower intake of carbohydrates—to prevent rebound postprandial hypoglycemia. |
| Hypoglycemia early symptoms | Confusion, irritability, tremor, sweating Late symptoms: • Hypothermia, seizures • Coma and death will occur if not treated. |
| Hypoglycemia treat | Glucose-Elevating Drugs ◦ Oral forms of concentrated glucose • Buccal tablets, semisolid gel ◦ 50% dextrose in water (D50W) ◦ Glucagon |
| Hypoglycemia implications | Assess the patient’s ability to consume food. • Assess for nausea or vomiting. • Hypoglycemia may be a problem if antidiabetic drugs are given and the patient does not eat. |
| Penicillins | enter the bacteria via the cell wall. -Inside the cell, they bind to penicillin-binding protein. -Once bound, normal cell wall synthesis is disrupted. -Result: Bacteria cells die from cell lysis. -Penicillins do not kill other cells in the body. |
| Penicillins caution | Patients allergic to penicillins have an increased risk of allergy to other beta-lactam antibiotics. Only patients with a history of throat swelling or hives from penicillin should not receive cephalosporins. |
| Penicillins prevent | and treatment of Gram-positive bacteria, including Streptococcus spp., Enterococcus spp., Staphylococcus spp. |
| Tetracyclines | Bacteriostatic: inhibit bacterial growth -Inhibit protein synthesis -Stop many essential functions of the bacteria Ex: Doxycycline, Tetracycline, Minocycline, Tigecycline |
| Tetracyclines effects | Vaginal candidiasis -Gastric upset -Enterocolitis -Maculopapular rash |
| Tetracyclines should not | be used in children younger than age 8 years or in pregnant or lactating women because tooth discoloration will occur if the drug binds to the calcium in the teeth |
| Tetracyclines implications | Avoid milk products, iron preparations, antacids, bc of chelation and drug- binding that occur. -Take all medications with 6 to 8 oz of fluid -Pts on contraceptives should use an alternative form of bc -Because of photosensitivity, avoid sunlight |
| Sulfonamides | One of the first groups of antibiotics -Often combined with another antibiotic Ex: Sulfamethoxazole-trimethoprim known as Bactrim, Septra, or co-trimoxazole and often abbreviated as SMX-TMP |
| Sulfonamides indications | Effective against both gram-positive and gram- negative bacteria -Treatment of urinary tract infections (UTIs) -Pneumocystis jiroveci pneumonia -Upper respiratory tract infections -Outpatient Staphylococcus infections |
| Sulfonamides effects | Hemolytic/aplastic anemia Photosensitivity Stevens-Johnson Syndrome **Caution in patients with glucose-6-phosphate dehydrogenase (G6PD) deficiency |
| Vancomycin | Treatment of choice for MRSA and gram- positive -Oral vancomycin is indicated for the treatment of (C. difficile) and for the treatment of staphylococcal enterocolitis. -Must monitor blood levels to ensure therapeutic levels and prevent toxicity |
| vancomycin effects | Flushing or itching of head, neck, face -Bothersome, but not usually harmful, can alleviate by slowing the infusion. -Antihistamine may be ordered to reduce these effects. -Should be infused over at least 1 hour, sometimes longer for higher doses. |
| vancomycin effects pt 2 | May cause ototoxicity and nephrotoxicity -Rapid infusions may cause hypotension. |
| Quinolones | Effective against complicated urinary tract, respiratory, bone and joint, GI, skin, and sexually transmitted infections, anthrax Common quinolones: Ciprofloxacin (Cipro) Levofloxacin (Levaquin) Moxifloxacin (Avelox |
| Quinolones effects | Prolonged QT interval, h/a, dizziness, insomnia, depression, rash, pruritus, urticaria, flushing, ruptured tendons, tendonitis, fever, chills, blurred vision, tinnitus ***Black box warning: increased risk of tendonitis and tendon rupture*** |
| Antiviral Drugs | Block the activity of a polymerase enzyme that normally stimulates the synthesis of new viral genomes Viruses controlled by current antiviral therapy -Cytomegalovirus (CMV) -Hepatitis -Herpesviruses -HIV flu -Respiratory syncytial virus (RSV) |
| Hepatitis C | leading cause of liver failure leading to liver transplantation Symptoms- initially mild but progress to chronic liver disease in majority of patients Transmission: infected blood and sexual contact Alcoholic disease=hepatitis C. |
| Hepatitis C treat | interferon, ribavirin, simeprevir, and sofosbuvir |
| Oseltamivir (Tamiflu) and zanamivir (Relenza) | Active against influenza types A and B -Reduce duration of illness Oseltamivir: causes nausea and vomiting Zanamivir: causes diarrhea, nausea, sinusitis ***Treatment should begin within 2 days of influenza symptom onset. |
| Antifungal Drugs meds | Amphotericin B, caspofungin, fluconazole, flucytosine, griseofulvin, itraconazole, ketoconazole, micafungin, nystatin, terbinafine, posaconazole. Topical -Ophthalmic: natamycin |
| Antifungal Drugs indications | Vaginal candidiasis -Oral candidiasis -Onchomycosis -Systemic fungal infections |
| Antifungal Drugs contraindications | Most common: drug allergy, liver failure, kidney failure, and porphyria (for griseofulvin) -Voriconazole can cause fetal harm in pregnant women. |
| Amphotericin B | -Drug of choice for the treatment of many severe systemic fungal infections Route: IV infusion |
| Amphotericin B effects | dysrhythmias.Neurotoxicity; tinnitus; visual disturbances; hand or feet numbness, convulsions -Renal toxicity, potassium loss, hypomagnesemia -Fever, chills, headache, nausea, occasional hypotension, gastrointestinal (GI) upset, anemia |
| Amphotericin B prevention adverse rx | premedications: antiemetics, antihistamines, antipyretics, and corticosteroids. -Prevent or minimize infusion-related reactions to amphotericin B -Likelihood of such reactions can also be reduced by using longer-than-average drug infusion times |
| NSAIDS | Analgesic ◦ Antiinflammatory ◦ Antipyretic ◦ Aspirin-platelet inhibition Examples:Celecoxib, ibuprofen, indomethacin, ketorolac -Uses: headaches, myalgias, neuralgia, arthralgia, postoperative pain, gout |
| NSAIDS renal function | Use of NSAID can compromise existing renal function NSAID use can precipitate acute or chronic renal failure |
| NSAID black box warning | regarding an increased risk of adverse cardiovascular thrombotic events, including fatal MI and stroke NSAIDS cause an increased risk for serious GI adverse events including bleeding, ulceration, and perforation of the intestines |
| Antigout Drugs | Allopurinol-prevents uric acid production to decrease levels ◦ Indicated for patients whose gout is caused by excess production of uric acid |
| Antigout Drugs pt 2 | Colchicine-reduces inflammatory response to the deposits of urate crystals in joint tissue. ◦ short term management or prevention of gout |
| Antacids | DO NOT PREVENT THE OVERPRODUCTION OF ACID BUT HELP TO NEUTRALIZE ACID -PROMOTE GASTRIC MUCOSAL DEFENSE MECHANISMS -STIMULATE MUCUS:PROTECTIVE BARRIER AGAINST HCL BICARBONATE PROSTAGLANDINS: PREVENT ACTIVATION OF PROTON PUMP |
| Antacids indication | ACUTE RELIEF OF SYMPTOMS ASSOCIATED WITH PEPTIC ULCER, GASTRITIS, GASTRIC HYPERACIDITY, AND HEARTBURN USED ALONE OR IN COMBINATION • ALUMINUM SALTS • MAGNESIUM SALTS • CALCIUM SALTS • SODIUM BICARBONATE |
| ALUMINUM SALTS: | HAVE CONSTIPATING EFFECTS • OFTEN USED WITH MAGNESIUM TO COUNTERACT CONSTIPATION • OFTEN RECOMMENDED FOR PATIENTS WITH RENAL DISEASE (MORE EASILY EXCRETED) • EXAMPLES: ALUMINUM CARBONATE: BASALJEL, HYDROXIDE SALT: ALTERNAGEL, COMBINATION PRODUCT |
| MAGNESIUM SALTS: | COMMONLY CAUSE DIARRHEA; USUALLY USED WITH OTHER DRUGS TO COUNTERACT THIS EFFECT • DANGEROUS WHEN USED WITH RENAL FAILURE; THE FAILING KIDNEY CANNOT EXCRETE EXTRA MAGNESIUM, RESULTING IN ACCUMULATION |
| Proton Pump Inhibitors (PPIs) | Blocks gastric acid secretion Examples:Lansoprazole, Omeprazole, Pantoprazole, Esomeprazole Indications: -GERD -Erosive Esophagitis -Short term treatment Duodenal/gastric ulcers -NSAID induced ulcers -H Pylori induced ulcer |
| PPI effects | infections: Clostridium Difficile ***OSTEOPOROSIS AND RISK OF WRIST, HIP, AND SPINE FRACTURES IN LONG-TERM USERS -Pneumonia -Depletion of magnesium -Link between PPIs and Dementia as well as development of Lupus Erythematous |
| Hyperosmotic laxative | Increase fecal water content -Results in bowel distension, increased peristalsis, and evacuation. ◦ Lactulose (also used to reduce elevated serum ammonia levels) , Polyethylene Glycol (PEG), Sorbitol, Glycerin |
| Saline laxative | Increase osmotic pressure within the intestinal tract, causing more water to enter the intestines ◦ Results in bowel distension, increased peristalsis, and evacuation ◦ Examples: magnesium hydroxide (milk of magnesia), magnesium citrate (citroma) |
| bulk forming laxative | Increase water absorption, which results in greater total volume of intestinal contents. produce normal stools. ◦ Patient must take with liberal water ◦ Available OTC, among safest types available, and ONLY type that is recommended for long term use. |
| Emollient laxative | Stool softeners and lubricants ◦ Promote more water and fat in the stools ◦ Lubricate the fecal material and intestinal walls ◦ Examples: Stool softeners (Colace, surfak), Lubricants (mineral oil) |
| Antidiarrheals types | 1- ADSORBENTS-used for milder cases 2-ANTIMOTILITY DRUGS (ANTICHOLINERGICS AND OPIATES) 3-PROBIOTICS (ALSO KNOWN AS INTESTINAL FLORA MODIFIERS AND BACTERIAL REPLACEMENT DRUGS) |
| Antidiarrheals absorbants | COAT THE WALLS OF THE (GI) TRACT • BIND TO THE CAUSATIVE BACTERIA OR TOXIN, WHICH IS THEN ELIMINATED THROUGH THE STOOL • EXAMPLES: BISMUTH SUBSALICYLATE (PEPTO- BISMOL), ACTIVATED CHARCOAL, AND ANTILIPEMIC DRUGS COLESTIPOL AND CHOLESTYRAMINE |
| ADVERSE REACTIONS Antidiarrheals | increased bleeding time (Interactions when taking with blood thinners) • Constipation, dark stools • Confusion • Tinnitus • Metalic taste • Blue tongue |
| TETRAHYDROCANNABINOIDS | Dronabinol (Marinol)-used for nausea and vomiting associated with chemotherapy and for anorexia associated with weight loss in AIDS patients |
| PROKINETIC DRUGS | block dopamine receptors in the CTZ •Cause CTZ to be desensitized to impulses stimulate peristalsis, enhancing emptying •GERD, delayed gastric emptying Example: Metoclopramide ***Long term use may cause irreversible Tardive Dyskinesia |
| SEROTONIN BLOCKERS | Block Serotonin receptors in the GI tract, CTZ, and VC. •Used for nausea and vomiting in patients receiving chemotherapy and for postoperative nausea and vomiting. • Example: Ondansetron (Zofran)-Most commonly used |
| Ondansetron | Prior to administering, assess for signs and symptoms of dehydration and electrolyte disturbances. • Administer 30-60 minutes prior to chemotherapy. • Risk for cardiac dysrhythmias, headaches |
| Water Soluble Vitamins | B-complex group and vitamin C -Can be dissolved in water -Easily excreted in the urine -Cannot be stored by the body in large amounts -Daily intake required to prevent deficiencies |
| Fat Soluble Vitamins | Vitamins A, D, E, and K -Stored in the liver and fatty tissues -Deficiencies occur only after prolonged deprivation from an adequate supply or from disorders that prevent their absorption. -Daily intake not required, unless one is deficient. |
| Vitamin B12 (Cyanocobalamin) | Water soluble -Synthesized by microorganisms present in the body -Food sources: Liver, kidney, fish, shellfish, poultry, milk, Eggs, blue cheese, fortified cereals -Contained in minimal amounts in plants |
| B12 deficiency | Deficiency leads to: Neurologic damage Megaloblastic anemia Deficiency states caused by: Malabsorption Poor dietary intake (vegetarians) |
| Required for many metabolic pathways B12 | Fat and carbohydrate metabolism Protein synthesis Growth, cell replication Hematopoiesis Nucleoprotein and myelin synthesis |
| Vitamin K | Fat soluble -Three types: phytonadione (vitamin K1), menaquinone (vitamin K2), and menadione (vitamin K3) -Body does not store large amounts of vitamin K. -Vitamin K2 is synthesized by the intestinal flora |
| Dietary sources of K1 | Green leafy vegetables (broccoli, cabbage, spinach, kale), cheese, soybean oils |
| vitamin k functions | Essential for synthesis of blood coagulation factors in the liver -Vitamin K–dependent clotting factors |
| vitamin k indications | Dietary supplementation -Treatment of deficiency states (rare) -Malabsorption -Given prophylactically to newborn infants -Reverses the effects of certain anticoagulants (warfarin) |
| **The patient will be unresponsive to warfarin | therapy for 1 week after the vitamin K is given. |
| Vitamin B1 (Thiamine) | Water soluble -Food sources: Enriched whole grain breads and cereals, liver, beans, yeast -Deficiencies: caused by alcoholism, hyperthyroidism, pregnancy, extended fever, poor diet |
| Vitamin B1 (Thiamine) Beriberi Disease | Brain lesions, polyneuropathy of peripheral nerves, serous effusions, cardiac anatomic changes Wernicke’s encephalopathy Also known as Cerebral beriberi, |
| Iron | Essential mineral in the body -Oxygen carrier in hemoglobin and myoglobin -Stored in the liver, spleen, and bone marrow -Iron deficiency results in anemia. Dietary sources: meats, certain vegetables, and grains |
| -Dietary iron must be | converted by gastric juices before it can be absorbed |
| Foods that enhance iron absorption | Orange juice Veal Fish Ascorbic acid |
| iron indications | Prevention and treatment of iron-deficiency syndromes -Administration of iron alleviates the symptoms of iron-deficiency anemia, but the underlying cause of the anemia should be corrected. |
| iron adverse effects | Nausea, constipation, epigastric pain, black tarry stools, vomiting |
| iron toxicity | Suction and maintenance of the airway; correction of acidosis; control of shock and dehydration with IV fluids or blood, oxygen, and vasopressors -In patients with severe symptoms of iron intoxication, such as coma, shock chelation therapy |
| iron overload | Deferiprone is used in iron overload. |
| Folic Acid (Folate) | -Water-soluble, B-complex vitamin -Essential for erythropoiesis Primary uses -Folic acid deficiency -During pregnancy to prevent neural tube defects -Malabsorption syndromes are the most common causes of deficiency. |
| FOLATE considerations | Should not be used until actual cause of anemia is determined!!! -May mask symptoms of pernicious anemia, which requires treatment other than folic acid -Untreated pernicious anemia progresses to neurologic damage. |
Created by:
cwehner125