pharm test 4
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| RDW | always ^ in anemia
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| Polycythemia Vera | too many RBCs, clotting risk-do not give iron
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| Microcytic Anemia | low levels, give iron
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| 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
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| Iron Deficiency Anemia | post hemorrhage procedure, ferrous sulfate
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| Pernicious Anemia | lack of intrinsic factor in the stomach/poor diet, vit B12/hydroxocobalamin
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| Folic Acid Anemia | increased demand-pregnancy or growth spurts, malnutrition due to alcoholism/absorption probs, folic acid/folvite, vit B9
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| Diuretic | agent that increases urine secretion
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| Diuresis | to urinate, the secretion and passage of large amounts of urine
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| Diurese | to cause diuresis quickly
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| HCTZ/hydrochlorothiazide | for HTN, thiazide diuretic, check potassium before giving, SE: hypokalemia, dry mouth, hypotension, ETE: reduce B/P, NOT w/ allergy to sulfa
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| 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
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| 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
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| 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
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| Aldactone/spironolactone | HTN, potassium-sparing diuretic, SE: hyperkalemia, ETE: reduce B/P
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| Osmitrol/mannitol | reduction of intracranial pressure, osmotic diuretic, cardinal sign-altered mental status, SE: hypovolemia
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| UTI-S/Sx | burning/dysuria, urgency, frequency, pain/discomfort
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| Ditropan/oxybutynin | overactive bladder, urinary tract antispasmodic, SE: anticholinergic, parasympatholytic effects, ETE: reduction in times voiding over 24hrs
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| 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)
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| Pyridium/phenazopyridine | urinary tract analgesic, direct topical analgesic effect on urinary bladder, SE: GI upset, reddish-orange coloring of urine
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| 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
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| 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
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| 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
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| Helicobacter pylori | gram – bacteria, usually cause of peptic ulcer disease, Tx: two antibiotics, PPI, bismuth subsalicylate/Pepto-Bismol
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| 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
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| 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
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| 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
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| 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
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| Constipation | the state in which an individual experiences stasis of the large intestine resulting in infrequent elimination and/or hard/dry feces
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| Dulcolax/bisacodyl | chemical stimulants, castor oil, senna/senokot
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| 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
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| 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
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| 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
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| Phenergan/promethazine | phenothiazine, SE: anticholinergic, sedating, nasty to tissue-must be diluted, given slowly, check IV patency
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| 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
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| 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
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| 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
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| Milk of Magnesia/magnesium hydroxide | a combination bulk stimulant and/or antacid
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| Carafate/sucralfate | coats injured area of stomach, tx of active duodenal ulcer, used w/ other medications in tx of Helicobacter pylori
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| Sennokot-S | combination chemical stimulant and lubricant
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| 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
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| Imodium/loperamide | reduces number of bowel movements related to gastrointestinal viral infections
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| GoLYTELY/polyethylene glycol-electrolyte solution | promotes a thorough bowel evacuation
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| 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
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| 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
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| 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
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| 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
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| 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
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| Antihistamine-First Generation | diphenhydramine/Benadryl, sedating
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| Antihistamine-Second Generation | loratatdine/Claritin, less sedation
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| 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
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| Unproductive Cough w/ Need for Expectoration | guaifenesin/Mucinex/Robitussin, reduces adhesiveness of and liquefies lower respiratory tract secretions, SE: GI symptoms
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| Robitussin DM | dextromethorphan, combination drug, antitussive, cough suppressant and expectorant
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| Expectorant | cough less but effectively, liquefies lower respiratory tract making it easier to cough out secretions
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| 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
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| 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
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| Fixed Combination Respiratory Drug | fluticasone/salmeterol, Advair Diskus
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| albuterol/Proventil | sympathomimetic, adrenergic agonist
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| ipratropium/Atrovent | anticholinergic bronchodilator
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| 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
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