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Pharm test #4

pharm test 4

RDW always ^ in anemia
Polycythemia Vera too many RBCs, clotting risk-do not give iron
Microcytic Anemia low levels, give iron
Safe Admin of Iron take w/ food-NOT antacids or coffee-eggs-milk, w/ OJ/Vit C, dark stools/constipation, stains teeth, takes 2-3+ wks to work, keep away from children
Iron Deficiency Anemia post hemorrhage procedure, ferrous sulfate
Pernicious Anemia lack of intrinsic factor in the stomach/poor diet, vit B12/hydroxocobalamin
Folic Acid Anemia increased demand-pregnancy or growth spurts, malnutrition due to alcoholism/absorption probs, folic acid/folvite, vit B9
Diuretic agent that increases urine secretion
Diuresis to urinate, the secretion and passage of large amounts of urine
Diurese to cause diuresis quickly
HCTZ/hydrochlorothiazide for HTN, thiazide diuretic, check potassium before giving, SE: hypokalemia, dry mouth, hypotension, ETE: reduce B/P, NOT w/ allergy to sulfa
Lasix/furosemide acute CHF/pulmonary edema, loop diuretic, check potassium before giving/don’t give if muscle twitching, SE: hypokalemia, hypotension, ototoxicity, Report: muscle cramps/pain, loss/gain >3lbs in 1 day, unusual swelling, bleeding, bruising
Potassium Replacement IVPB never exceeds 10 mEq/hr and must be diluted in 100ml, NEVER direct IV push, monitor K laboratory value prior to admin of K+ or furosemide, SE: burning
Diamox/acetazolamide chronic open-angle glauc, carbonic anhydrase inhibitor-results in decreased formation of aqueous humor, SE: metabolic acidosis, hypokalemia, parathesias of extremities, don’t give if allergic to sulfa or thiazides,effective if reports good eye exams
Aldactone/spironolactone HTN, potassium-sparing diuretic, SE: hyperkalemia, ETE: reduce B/P
Osmitrol/mannitol reduction of intracranial pressure, osmotic diuretic, cardinal sign-altered mental status, SE: hypovolemia
UTI-S/Sx burning/dysuria, urgency, frequency, pain/discomfort
Ditropan/oxybutynin overactive bladder, urinary tract antispasmodic, SE: anticholinergic, parasympatholytic effects, ETE: reduction in times voiding over 24hrs
Anticholinergic/Parasympatholytics SE: blurred vision, pupil dilation/photophobia, dry mouth, tachycardia/palpitations, urinary hesitancy/retention, decreased sweating, DON’T give if glaucoma, heart arrhythmias, BPH(can give if void first)
Pyridium/phenazopyridine urinary tract analgesic, direct topical analgesic effect on urinary bladder, SE: GI upset, reddish-orange coloring of urine
Flomax/tamsulosin benign prostatic hyperplasia/hypertrophy, alpha1-adrenergic blocker, MOA-relax sphincter muscles at the base of urinary bladder and prostate, SE: CNS-h/a, fatigue, dizziness, postural dizziness, hypotension
Tums/calcium salts sodium bicarbonate, antacid, goal is to raise stomach pH to min 3.5, act quickly/short duration/ do not promote ulcer healing, SE: constipation/diarrhea, acid rebound
Antacids-Nursing Interventions take at least 2hrs before other PO meds, 1hr before meals/at least 2hrs after meals, may decrease absorption of efficacy of other meds-tetracycline’s, seek medical attn. if sx persist or recur, don’t take w/ iron
Helicobacter pylori gram – bacteria, usually cause of peptic ulcer disease, Tx: two antibiotics, PPI, bismuth subsalicylate/Pepto-Bismol
Pepcid/famotidine histamine-2 antagonist, help heal ulcer in 4-8wks, suppress gastric acid secretion, begin to work w/in hr, for up to 12hrs so take BID, absorption not affected by food intake
Prilosec/omeprazole PPI, help heal ulcer in 4-8wks, suppress gastric acid secretion, delayed onset of action but last 24hrs w/ effects up to 3days, except for Previcid Not recommended for <18yo, ^risk for C-diff, used w/ other meds for tx of helicobacter pylori
H2-Receptor Antagonists and PPI-Nursing Interventions freq used prevent/prophylaxis stress ulcers in ICU/critically ill pts, block release hydrochloric acid response to gastrin, H2-receptors located parietal cells/stomach, long-term use ^risk C-diff, used in combo w/ other meds tx of helicobacter pylori
Laxatives should be used for short term relief of constipation & to prevent straining when clinically undesirable, routinely avoid constipation first by proper diet, fluid intake & exercise, desire is to avoid lazy gut/bowel syndrome
Constipation the state in which an individual experiences stasis of the large intestine resulting in infrequent elimination and/or hard/dry feces
Dulcolax/bisacodyl chemical stimulants, castor oil, senna/senokot
MiraLax/polyethylene glycol bulk/osmotic stimulants, ^ the motility of the GI tract by ^ the fluid in the intestinal contents, which enlarges bulk, stimulates local stretch receptors, and activates local activity
Colace/Surfak/docusate sodium lubricants, reduce surface tension of feces allowing water and fat penetration leading to a softer stool, to prevent straining in post-op, post-MI, and post-partum
Constipation-Nursing Interventions monitor number and type of stools, diet-fiber/bulk & adequate liquid intake, privacy, establish reg time for elimination, ID what helps individual produce stool, emphasize need for reg exercise, know what is norm for individual
Phenergan/promethazine phenothiazine, SE: anticholinergic, sedating, nasty to tissue-must be diluted, given slowly, check IV patency
Reglan/metoclopramide nonphenothiazine/GI stim/prokinetic agents, ^mvmnt GI content prevent N/V, heartburn, persistent fullness after meals, anorexia,tx N/V SP surg, cancer chemo, not sedating,IV PO, SE: drowsiness, not for coma/severe CNS depression/those w/ recent brain inj
Zofran/ondansetron serotonin 5-HT3 receptor blockers, N/V associated w/ antineoplastic chemotherapy and postoperative N/V, SE: drowsiness, NOT for use w/ coma or severe CNS depression or brain injury
Emetics/Antiemetic’s expl cause naus/duration if known, teach how reduce: restrict fl w/ meals, avoid noxious smells/stim, lying flat at least 2hrs after eating, antiemetic’s PRN,assess expec therap effect, safety, SE:drows, NOT w/coma/severe CNS depression/recent brain inj
Milk of Magnesia/magnesium hydroxide a combination bulk stimulant and/or antacid
Carafate/sucralfate coats injured area of stomach, tx of active duodenal ulcer, used w/ other medications in tx of Helicobacter pylori
Sennokot-S combination chemical stimulant and lubricant
Antivert/meclizine Tx of N/V w/ SE of drowsiness, NOT for use in clients w/ coma or severe CNS depression or recent brain injury
Imodium/loperamide reduces number of bowel movements related to gastrointestinal viral infections
GoLYTELY/polyethylene glycol-electrolyte solution promotes a thorough bowel evacuation
Unproductive Cough antitussive-OTC dextromethorphan/Benylin/ Vicks 44, Rx codeine, hydrocodone, depresses the cough reflex in the medulla, SE: drying effect on mucus membranes resulting in thicker secretions, GI upset, high dose can lead to dizziness, sedation
Nasal Congestion decongestion, nose congested when tissue lining nose swollen due to inflamed blood vessels, sympathomimetic effects cause local vasoconstriction results in shrinking of swollen membranes and opening of clogged nasal passages
Nasal Decongestion-nonsteroidal oxymetazoline/Afrin/Allerest/NeoSynephrine, work on alpha1 receptor sites in nasal passages, SE: local stinging & burning, avoid rebound congestion, 3-5 days only
Oral Decongestants-nonsteroidal pseudoephedrine/Sudafed, shrink the nasal mucus membrane by stimulating alpha-adrenergic receptors in nasal mucus membranes, more likely to have cardiac stimulation and feelings of anxiety because taken systemically
Antihistamines H1 receptor antag, for seasonal/ perennial aller rhinitis, allerg conjunctivitis, uncomplicated urticarial, angioedema, block action antihistamines on H1 receptors->decreasing allerg response->result decreased secret/open airways, SE: anticholinergic
Antihistamine-First Generation diphenhydramine/Benadryl, sedating
Antihistamine-Second Generation loratatdine/Claritin, less sedation
Antitussives suppress cough reflex acting centrally to suppress medullary cough center/locally as anesthetic/to ^secretion and buffer irritation,cause CNS depression inc drowsiness/sedation, used w/ caution in situation which coughing important for clearing airways
Unproductive Cough w/ Need for Expectoration guaifenesin/Mucinex/Robitussin, reduces adhesiveness of and liquefies lower respiratory tract secretions, SE: GI symptoms
Robitussin DM dextromethorphan, combination drug, antitussive, cough suppressant and expectorant
Expectorant cough less but effectively, liquefies lower respiratory tract making it easier to cough out secretions
Thick Secretions-Mucolytic acetylcysteine/Mucomyst, generally reserved individ have most diff coughing up secret(COPD, cystic fibrosis, pneumonia,TB), protects liver after acetaminophen OD, NGtD prevent radiocontrast-induced renal dysfun-protects kidneys, SE:GI upset, smell/sulfur
Topical Steroid Nasal Medication fluticasone/Flovent/Flonase/Advair-decongest, preferred patients who need to avoid systemic adrenergic effects associated w/ oral decongestants, prevention of bronchospasm, tx for asthma for pts w/ asthma who do not respond to trad bronchodilators
Fixed Combination Respiratory Drug fluticasone/salmeterol, Advair Diskus
albuterol/Proventil sympathomimetic, adrenergic agonist
ipratropium/Atrovent anticholinergic bronchodilator
How to take MDI shake canister, exhale, place spacer in mouth/or hold device 1” from open mouth, compress canister while inhaling, hold breath as long as possible, exhale through pursed lips, RINSE MOUTH!, wash spacer
Created by: neffielewis