Study Guide
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| show | monitor HR, report ↑ 20-30 bpm; do not use beta2 agonist (albuterol-bronchodilator) w/ beta-adrenergic blocker (propranolol-bronchoconstriction), avoid caffeine
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| show | caution w/ antihypertensive ie beta blockers, Ca channel blockers, diuretics; do not take w/ Viagra. Can repeat if not relieved in 5 minutes, no alcohol
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| show | use lowest dose possible; can repeat in 5 minutes for a total of 3 doses, take prior chest pain causing activity; remove patch at night, no alcohol
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| show | not prescribed to children <8 (stains teeth), ↓ effects of BC, photosensitivity, hepatotoxicity
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| show | hepatotoxicity can prolong QT intervals; toxicity w/ asthma meds, antihistamines, anticonvulsants, anticoagulants
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| antibiotic affecting proteins synthesis, monitoring for interaction- Aminoglycocides (gentamicin, Garamycin) bactericidal (kills bacteria by disrupting protein synthesis); ototoxicity (tinnitus), nephrotoxicity (BUN, creatine).... | show 🗑
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| show | may result in allergic response (monitor 30 min) anaphylaxis (allergic to sephalosporins and/or imipenem)
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| show | antidote VIT K, injection deep in large muscle, rotate site
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| show | could lead to rhabdomyolysis, hepatotoxicity→ anorexia, N/V, jaundice, peripheral neuropathy
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| what to remember about controlled substances | show 🗑
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| show | diaphoresis = excessive sweating
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| SSRIs ↑ bleeding, no NSAIDs or anticoagulants; SSRIs→TCA→MAOIs | show 🗑
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| show | >1.5 may cause toxicity; <1.5 early sign of toxicity (GI upset); 1.5-2.5 toxicity; 1.5-2.0 advance signs of toxicity, all early + poor coordination and tremors; >2 severe toxicity (polyuria, tinnitus, blurred vision, hypotension; >2.5 hemodialysis, death
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| bisphosphonate- alendronate sodium (Fosomax, Boniva); MOA ↓ # and action of oesteoclasts inhibiting bone reabsorption; post menopausal osteoporosis, Pagat's disease of bone, and hypercalium of malignancy; S/E esophagitis, GI upset-... | show 🗑
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| Cardiac glycosides (Digoxcin); can cause hypokalemia-dysthrimia-monitor K+ levels (3.5-5.0), Dig serum levels (0.5-2), with HF levels 0.5-0.8; teach to monitor pulse may be irregular with extra beats | show 🗑
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| chronological neurologic disorder – Phenytoin (Dilantin) adverse reactions: CNS effects, nystagmus, sedation, ataxia, double vision, cognitive impairment, gingival hyperplasia, clients need good oral hygiene... | show 🗑
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| Diagnosis of myasthenia gravis | show 🗑
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| drugs used as reversal of nondepolarizing neuromuscular blocking agents | show 🗑
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| interactions with neostigmine | show 🗑
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| depression client teaching: orthostatic hypotension, ways to minimize anticholinergic effects i.e. sugarless candy, gum, sips of water... | show 🗑
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| DM discharge teaching: | show 🗑
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| Endocrine disorders- document... | show 🗑
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| eye disorders- nonselective beta blocker (beta 1 and beta2) used to decrease intraocular pressure (IOP) by decreasing aqueous humor production, may cause conjunctivitis, blurred vision, phototobia, dry eyes REPORT to HCP | show 🗑
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| older adults >65 years, decreased GI function (lower stomach acidity, slower GI motility, gastric emptying, decreased systemic blood flow), impaired memory, vision & hearing changes, decreased motility/dexterity, reduced financial resources… | show 🗑
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| show | verapamil & diltiazem also work on myocardium-SA & AV node decreased force of contraction & lower heart rate (slows rate of conduction through AV node)
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| meds affecting BP monitor ECG, observe for edema, monitor BP & weight, can cause constipation (increase fiber & liquids)… | show 🗑
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| HTN crisis nitroprusside sodium (nitropress) can also use nitroglycerin, direct vasodilation of arteries & veins results in rapid reduction of BP (decreased preload & afterload); administer slowly so BP doesn’t drop too quickly, monitor BP & ECG... | show 🗑
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| meds affecting coagulation (heparin sodium) enoxaparin (Lovenox, low molecular weight) MOA inhibits fibrin formation, administer SC every 12h or IV intermittent, continuous; instruct client S/S bleeding, increased HR, decreased BP, bruising, petechia, bla | show 🗑
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| heparin therapeutic level aPTT 60-80 seconds, PT 18-24 seconds, INR 2-3 target range… | show 🗑
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| show | digoxin toxicity can occur in presence of hypokalemia (may use potassium-sparing diuretic with loop diuretic to treat) monitor I&O and weight
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| thiazide diuretic hydrochlorothiazide (Hydrodiruil) work in early distal convoluted tubule, blocks reabsorption of Na & Cl, prevents reabsorption of H2O, watch electrolyte levels, (K, Na, Cl... | show 🗑
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| potassium-sparing diuretics spironolactone (Aldactone), blocks action of aldosterone (Na & H2O retention), results in K+ retention and secretion of Na & H2O, monitor... | show 🗑
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| show | (as high as 109.4º F)- monitor vitals, stop succinylcholine & other anesthetics, use ice or infuse iced saline to cool, admin dantrolene to ↓ metabolic activity of skeletal muscle
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| airflow disorders: methylxanthines teach patient to | show 🗑
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| show | peanut allergies - avoid, rinse mouth after use
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| airflow disorders: glucocorticoids teach patient to | show 🗑
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| show | take medication 15 minutes before exercise or exposure to allergen, not a bronchodilator, not intended for asthma attack
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| show | do not take with food, take 1 hour before or 2 hours after meals
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| show | once daily at bedtime
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| show | usual adult dose is 2 puffs, wait prescribed length of time between puffs, 2 different meds...wait 5 minutes between each medication
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| patient teaching MDI, concurrent beta2 adrenergic agonist & glucocorticoids use: | show 🗑
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| managing asthma Beta2 adrenergic agonist - Albuterol | show 🗑
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| managing asthma Beta2 adrenergic agonist - Formoterol/Salmeterol | show 🗑
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| managing asthma Beta2 adrenergic agonist -Terbutaline | show 🗑
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| show | long term control of asthma
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| managing asthma inhaled anticholinergics | show 🗑
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| show | decreases frequency/severity of exacerbations in acute attacks, treatment of acute attacks
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| show | chronic asthma, prophylaxis of exercise/allergy induced asthma
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| show | long term therapy in patients 15+ years, prevent exercised induced bronchospasms
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