Pharm midterm
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| opioid analgesics | prevent constipation by providing fluid and fiber, prevent respiratory depression, provide instruction for clients about drug admin and position changes.
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| analgesic agents | salicylates(ASA), Acetaminophen, combination narcotic and non narcotic analgesics
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| anti-inflammatory analgesic agents | (NSAIDs) Nonsteroidal anti inflammatory drugs
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| ASA (aspirin) adverse effects | gastrointestinal bleeding and irritation, increases bleeding time, tinnitus, Reye's syndrome in children
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| acetaminophen adverse effects | acute overdose causes hepatic necrosis, long term ingestion can result in nephropathy
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| treatment for acute overdose of acetaminophen | acetylcysteine- oral form, iv form now approved, prevents the formation of hepatotoxic metabolites
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| uses for NSAIDs | analgesic, antigout, anti-inflammatory, antipyretic, relief of vascular headaches, platelet inhibition
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| common NSAIDs | ibuprofen, ketoprofen, ketorolac, naproxen
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| 1st gen, NSAIDs GI adverse effects | dyspepsia, heartburn, epigastric distress, nausea, GI bleeding, mucosal leasions
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| 2nd gen, NSAIDs Cardio adverse effects | Cardiac arrhythmias, heart attack, stroke, (Celebrex)
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| Don't take NSAIDs | had stomach ulcers or bleeding, asthma, allergic response to aspirin, severe kidney problems, severe liver problems, or pregnant.
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| NSAIDs renal adverse effects | creatinine clearance reduced, renal failure, acute tubular necrosis
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| Before beginning therapy with NSAIDs | assessment for GI lesions or peptic ulcer disease, bleeding disorders, heart disorders, perform lab studies to include cbc, platelet count, cardiac, renal, and liver.
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| NSAIDs serious drug interactions | alcohol, heparin and warfarin, phenytoin, steroids, sulfonamides
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| Salicylates | do not give to children under 12, give with food and milk
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| gout | a metabolic disease associated with the development of high uric acid in the blood.
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| uric acid | is formed from the breakdown of proteins, the accumulation of this causes a problem in the joints and kidneys, kidney stones, kidney failure, gouty arthritis, hyperuricemia
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| acute attacks of gout are treated with | NSAIDs, Corticosteroids, colchicine/probenecid
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| Colchicine/Probenecid | drink plenty of fluids and take with food if stomach upset occurs, can cause N,V,D, loss of appetite, dizziness, alopecia, headaches, frequent urination,
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| Allopurinol | most commonly used agent for gout, prevents formation of uric acid, adverse effects; hepatoxicity and skin rash
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| most commonly used for gouty arthritis | NSAIDs; indomethacin, naproxen, sulindac
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| Uricosuric agents | Probenecid-AE;headaches,dizziness, Sulfinpyrazone-AE; N&V, Diarrhea
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| Secretory functions of the stomach lining | parietal cells secrete hydrochloric acid, chief cells secrete pepsinogen, mucoid cells secrete mucus
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| stomach hyperchlorhydria | produced from eating high fat meals, increased alcohol intake, emotional turmoil
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| goal of antacid therapy | neutralize the acid, inhibit pepsin activity, increased resistance of the stomach lining, increase tone of the lower esophageal sphincter
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| antacids | three forms; aluminum, magnesium, calcium.
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| systemic antacids | useful in short term therapy, rapid onset, prolonged use causes an overload on the kidneys, ex sodium bicarbonate
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| nonsystemic antacids | remain in gi tract, useful in longterm therapy, will not alter acid base system, ex calcium carbonate(Tums, Rolaids)
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| magnesium adverse | diarrhea
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| aluminum and calcium adverse | constipation
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| antacids interactions | binding of other drugs causes reduced availability of the other drugs to the client, chemical inactivation, increases stomach and urine ph which will decrease the absorption and excretion of certain drugs
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| histamine receptor antagonists | cimetidine(Tagamet), Famotidine(Pepcid), Nizatidine(Axid), Ranitidine(Zantac)
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| Proton pump inhibitors | Omeprazole(Prilosec)-blocks the final step of acid production in the stomach.
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| Prilosec indication | clients with Gastroesophageal reflux disease(GERD), Gastric hypersecretory condition
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| Prilosec interactions | causes warfarin(an anticoagulant) action to be increased
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| helicobacter pylori | an organism associated with the development of peptic ulcer disease
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| TX for H.pylori | metronidazole (Flagyl), an antimicrobial agent along with bismuth subsalicylate(Pepto) and tetracycline for 4 weeks to eradicate
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| metoclopramide(Reglan) | a drug that stimulates the motility of the upper gi tract without stimulatin the production of gastric, biliary, or pancreatic solutions. Action, increases peristalsis in the duodenum and jejunum and decreses gastroesophageal reflux
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| metoclopramide(Reglan) adverse effects | produces extrapyramidal(Parkinson like symptoms)effects, CNS depression, GI upset
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| Emetics | agents that induce vomiting, used in overdoses, ex ipecac syrup, inappropriate for use in bulimics
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| Antiemetics | anticholinergics, antihistamines, neuroleptic agents, prokinetic agents, serotonin blockers
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| anticholinergics | bind to and block acetylcholine receptors to prevent nausea stimuli from being transmitted
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| antihistamines | block h2 receptors to prevent cholinergic stimulation.
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| neuroleptic and prokinetic agents | bind to dopamine receptors and block action, block dopamine and stimulate acetylcholine to increase gastric emptying
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| Anticholinergics | Scopolamine(Trans Scop)
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| Antihistamines | Promethazine(Phenergen), Meclizine(Antivert)
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| Antiemetics and Emetics | Neuroleptic agents-Chlorpromazine(Thorazine), Prokinetic agents-Metoclopramide(Reglan), Serotonin blockers-Ondansetron(Zofran)
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| antiemetics, and emetics adverse effects | dizziness, drowsiness, dry mouth, headache
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| Stimulant laxatives | increase motility of the gi tract, increase secretion of water into the large and small intestine, ex bisacodyl
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| Saline laxatives | increase osmotic pressure within the intestinal tract, cause more water to enter the intestines, result in bowel distention, increased peristalsis, and evacuation, ex fleet enema
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| saline laxatives adverse | contain salt, unpleasant taste, systemically absorbed result in poor client compliance, risk for dehydration, risk for congestive heart failure.
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| bulk forming laxatives | absorbs water to increase bulk, distends bowel to initiate reflex bowel activity, high fiber, natural or semisynthetic, ex Metamucil, Fibercon, Citrucel, must be followed with a large amount of fluid, if chewed or taken in dry powder for, can cause esopha
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| lubricant laxatives | oils lubricate fecal material and intestinal walls, therby promoting fecal passage, prevent fat soluble vitamins from being absorbed, ex mineral oil
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| stool softeners | detergent like drugs, permit mixing of fats and fluids with fecal mass, stool becomes softer and is passed much easier, takes several days to work, ex docusate salts (Colace and Surfak)
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| Suppositories | usually in a wax base, administered rectally, absorbed systemically, available containing stimulant drugs, ex glycerin-absorbs water from tissues creating more mass, bisacodyl- induces peristaltic contraction by direct stimulation of sensory nerves.
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| lactulose laxatives | two monosaccharides that are not digested or absorbed, digested in the colon by bacteria to form acid substances, acid substances cause water to be drawn into the colon
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| enemas | hyperosmotics, solution contains salt, administered rectally and cause a laxative effect by osmotically drawing fluid into the colon to initiate defecation
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| long term use of laxatives | often results in decreased bowel tone and may lead to dependency, encourage a healty high fiber diet and increased fluid intake.
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| adsorbents | claylike materials administered in a tablet or liquid suspension form after each loose bowel movement, bind to the causitive bacteria or toxin and are eliminated through the stool, ex kaopectate
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| antidiarrheals | reduce gi motility, opium is a narcotic, decreases transit time through the bowel, more time for water and electrolytes to be absorbed. Paragoric is an opium tincture, may cause physical dependence.
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| common antidiarrheals | loperarmide (imodium) made from chemicals related to meperidine, a narcotic, diphenoxylate hcl and atropine sulfate (lomotil) narcotic and anticholinergic drug, reduces gi motility
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| anticholinergics | decrease intestinal muscle tone and peristalsis of gi tract. result is slows the movement of fecal matter through the gi tract ex belladonna alkaloids (donnatal)
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| anemia | decreased number of circulating red blood cells, decreased hemoglobin, decreased oxygen capacity, many causes
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| iron deficiency anemia | nutritional deficit is common cause, clients with bleeding disorders, menses, pregnant, infants, blood donors.
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| iron deficient therapies | ferrous sulfate, ferrous fumarate, ferrous gluconate, IV or IM
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| side effects of iron therapies | Gi upset, constipation
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| Epogen or Procrit | synthetic products, generic name-epoetin alfa recombinant, erythropoietin is synthesized by the liver and stimulates red blood cells.
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| megaloblastic anemias | large red blood cells, neutrophil and platelet changes, treated with vitamin B12 by IM.
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| folic acid deficiency | needed for proper neural development, products enriched include grain
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| protein | essential for synthesis, maintenance, and repair of body tissue for energy production, made of amino acids
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| fat | a very concentrated dietary source of energy and a carrier of fat soluble vitamins, made of fatty acids
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| carbohydrates | made up of glucose molecules and is a rapidly produced energy source
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| vitamins | chemical substances that regulate and participate in chemical reactions within the body
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| water soluable vitamins | B complex and C, need daily replacement, excreated in the urine
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| fat soluable vitamins | A,D,E,and K stored in the liver and fatty tissues, excreted in the feces.
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| vitamin A (Retinol) | found in foods of animal origin, such as liver, milk fat, and egg yolk, excessive use is a problem
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| hypervitaminosis A | irritability, vomiting, loss of appetite, and loss of body hair, Children-delirium and coma
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| vitamin D | fish oil is a rich source, works in conjunction with parathyroid hormone and calcitonin to absorb and utilize calcium and phosphorous
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| vitamin D | used to treat rickets in children and osteomalacia in adults
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| hypervitaminosis D | weakness, lethargy, nausea and Vomiting, and behavioral changes
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| vitamin E | found in vegetable oils and green leafy veges, known as the tocopherols, prevention and treatment of MD, cancer, infertility, toxic effects of oxygen therapy in premature infants
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| vitamin K | stored in the liver, small amount synthesized by intestinal flora, essential for blood coagulation, used for the treatment of hypoprothrombinemia in newborns.
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| vitamin B1 (thiamine) | required for CHO metabolism, contained in whole grain and enriched breads, cereals, pork, and organ meat, deficiency results in beriberi-polyneuropathy of peripheral nerves and brain lesions
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| vitamin B2 (riboflavin) | essential for CHO, fat, and protein metabolism and tissue respiration, found in organ meats, dairy products, yeasts, eggs, and green leafy veges.
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| vitamin B2 deficiency | results in ocular changes, skin disorders, and inflammation of the mouth, treat migraine headaches and burning feet syndrome.
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| vitamin B3 (niacin/nicotinic acid) | found in liver, lean meats, fish, poultry, and enriched flour and cereals, essential for synthesis of fat and tissue respiration, peripheral vasodialator, lowers cholesterol
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| vitamin B3 deficiency | produces pellagra, psychotic changes, neural changes, erythema, oral, and vaginal lesions, and diarrhea
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| vitamin B6 (Pyridoxine) | found in whole grain cereals, beef, liver, and pork. Metabolizes protein
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| vitamin B6 deficiency | results in neurological disorders, dermatological disorders.
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| vitamin B12 (Cyanocobalamin) | contains cobalt, required to form red blood cells, found in meat, fish and dairy products
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| vitamin B12 deficiency | pernicious anemia, megaloblastic anemia, irreversible neurological damage.
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| vitamin C (ascorbic acid) | found in citrus fruits, green leafy vegetables, tomatoes, and other foods, assists in the formation and maintenance of collagen, assists in forming teeth, bone, and hormones.
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| vitamin C deficiency | scurvy, gingivitis, loss of teeth, anemia, bone lesions and delayed healing
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| sodium | major positively charged ion in the extracellular fluid
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| potassium | major positively charged ion in the intracellular fluid
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| sodium and potassium | control electrical potential across cell membranes, assist in fluid regulation
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| hyponatremia | low sodium, below 135 mEq/L, causes confusion, agitation, weakness, muscle cramping, and/ or convulsions
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| hypernatremia | high sodium, above 145 mEq/L, causes elevated body temp, flushed skin, and dry mucous membranes
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| hypokalemia | low potassium, below 3.5 mEq/L, causes serious cardiac arrhythmias
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| hyperkalemia | high potassium, above 5.0 mEq/L, causes muscular weakness, cardiac arrhythmias, and/or paresthesia, leading to paralysis
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| Calcium | required for blood coagulation, muscle contraction, nerve excitation, found in dairy and vegetables
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| calcium deficiencies | produce tetany, osteoporosis, and rickets. Excess leads to kidney stones
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| allopurinol | is a drug used primarily to treat hyperuricemia (excess uric acid in blood plasma) and its complications, including chronic gout.[1] It is a xanthine oxidase inhibitor which is administered orally.
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