pharm 2 final review Word Scramble
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| Question | Answer |
| pt on 5th day vanco and gent, tv is really loud | investigate for ototoxicity |
| vancomycin-iv only (PK) ABSORPTION AND EXCRETION | (A) NOT ORALLY ABSORBED (E) RENAL EXCRETION-IF DECREASE RENAL FUNCTION-LONGER DOSING INTERVAL |
| VANCO (PD) | CELL WALL LYTIC-COVERS GRAM + ONLY (MRSA, C-DIFF) |
| S/E VANCO | IF TOXIC-RISK FOR NEPHRO/OTO TOXICITY-SO IT CAN AFFECT IT'S OWN HALF LIFE IN TOXIC DOSES, REDMAN SYNDROME-SYSTEMIC WILL CAUSE HIVES, HYPOTENSION |
| IF REDMAN SYNDROME WITH VANCO | SHOULD BE SLOWER INFUSION RATE |
| VANCO (PK) | THERAPEUTIC WINDOW-SO CHECK CP EX;PEAKS AND TROUGHS(BE ACCURATE WITH TIME) |
| RIBOSOMALS-AMINOGLYCOSIDES EX;GENTAMYCIN, TOBRAMYCIN (PD) | PREVENT PROTEIN SYNTHESIS, COVERS GRAM - ONLY,EXCEPT WHEN ADDED TO TO BETA-LACTAMS OR VANCO B/C RIBOSOME IS INSIDE CELL AND THOSE BETA-LACTAMS AND VANCO CAN BREAK CELL WALL-COMBO=SYNERGY(1+1=3) |
| RIBOSOMALS (PK) | THESE DRUGS HAVE THERAPEUTIC WINDOWS AS WELL,SO NEED PEAKS AND TROUGHS, NOT ORALLY ABORSBED, iV ONLY,HALF LIFE UPON RENAL FUNCTION |
| S/E RIBOSOMALS | TOXICITY-OTO/NEPHRO TOXICITY |
| MACROLIDES-ERYTHROMYCIN EX;CLARITHROMYCIN, AZITHROMYCIN(Z-PACK) (PD) | RIBOSOMAL-COVER GRAM + AND - BUT THEY TEND TO BE BACTERIOSTATIC, DON'T KILL BACTERIA, JUST STOP GROWTH |
| (PK) MACROLIDES | ALL ARE POTENT (METABOLIC ENZYME INHIBITORS) SO AVOID OTHER DRUGS W/ THERAPEUTIC WINDOW B/C IT WILL INCREASE OTHER DRUGS AFTER TIME (TOXICITY) |
| AZITHROMYCIN (PK) | HAS THE LONGEST HALF LIFE OF ALL ABX APPROX EQUAL TO 65 HOURS-SO GET MORE DAYS OUT OF LESS PILLS |
| CLIENT HAD 10 DAYS THERAPY OF ABX-FAILED AND WANTS TO KNOW WHY Z-PACK IS ONLY COUPLE DAYS | TELL THEM IT STAYS IN THEIR BODY LONGER THEN MOST ABX |
| CLARITHROMYCIN S/E | METALLIC TASTE ALL CHEMICAL SIMILAR TO GUT...DIARRHEA |
| SULFONAMIDES-BACTRIM SEPTRA(AVOID SUN) (PD) | COVERS GRAM - ONLY-NEAR TOXIC DOSES MAY COVER COMMUNITY ACQUIRED MRSA |
| SULFONAMIDES (PK) | RENALLY EXCRETED |
| SULFONAMIDES S/E | PHOTOSENSITIVITY FOR ALL-IF SHADOW IS SHORTER IN SUN, STAY OUT, CRYSTALURIA-STAY WELL HYDRATED-NOALCOHOL, W/ GERIATRICS-RISK OF HYPERKALEMIA |
| QUINOLONES-"FLOXACIN" | DO OPPOSITE OF PCN AND CEPHS, EARLY;CIPRO G- > + , NEWER;LEVAQUIN G+ = - |
| QUINOLONES (PK) | CAN INHIBIT CAFFEINE AND THEOPHYLLINE METABOLISM |
| QUINOLONES S/E | PHOTOSENSITIVTY BLACK BOX WARNING- UNUASUAL MORBIDITY AND MORTALITY-EX;RISK OF TENDON RUPTURE UP TO 6 MONTHS AFTER THE LAST DOSE |
| TUBERCULOSIS-ACID FAST MYCOBACTERIA | DIVIDES SLOW-NEED LONG TERM TREATMENT > 6 MONTHS TO YEARS, FAR SPREAD- NEED MULTIPLE MEDS-ALL TB REGIMENS SHOULD BE 3 DRUGS OR MORE |
| PORBLEMS WITH TB TX | DRUGS CAN MAKE YOU FEEL WORSE THEN THE DX THEREFORE COMPLIANCE IS PROBLEM, ALL REGIMENS ARE HEPATOTOXIC TO SOME DEGREE-S/S YELLOWING OF SKIN/EYES, ASH COLORED STOOLS-AVOID ALCOHOL AND ACETAMINOPHEN |
| SPECIFIC REGIMENS FOR TB ALL SHOULD CONTAIN | 1)RIFAMPIN-CAUSES RED/ORANGE STAINING OF URINE AND TEARS 2) ISONIAZID (INH)-CAN CAUSE PERIPHERAL NEUROPATHY-TINGLING/NUMBNESS OF FINGERS/TOES-SO ADD VIT B6/PYRIDOXINE |
| TB COMMON 3RD DRUG | ETHAMBUTOL/MYAMBUTOL-CAN CAUSE TRANSIENT RED/GREEN COLOR BLINDNESS-DON'T DRIVE |
| ANTIFUNGAL AGENTS-"AZOLES" (PD) | ACT LIKE BETA-LACTAMS ON FUNGAL YEAST CELL WALLS AND MEMBRANES |
| ANTIFUNGAL (PK) | ALL ARE POTENT ENZYME INHIBITORS, CAN ALL AFFECT HOW OTHER DRUGS ARE METABOLIZED |
| ANTIFUNGAL WEAKEST TO STRONGEST | WEAKEST-KETOOCONAZOLE/NIZORAL....FLUCONAZOLE/DIFLUCAN...STRONGEST- ITRACONAZOLE/SPORONOX....SHOULD START W/ THE WEAKEST HOWEVER KETOCONAZOLE NEEDS AN ACIDIC ENVIRONMENT TO BE ABSORBED |
| CLIENT FAILS ON ONE WEEK NIZORAL | SWITCH TO DIFLUCAN |
| ANTIVIRALS(HERPETICS) "CLOVIR" ACYLOVIR/ZOVIRAX AND GANCICLOVIR/CYTOVENT (PD) | INHIBIT vdna replication(failed chemotherapy agents) |
| antivirals s/e | take as directed otherwise toxic s/s-risk for bone marrow suppression, which leads to decreased rbc,wbc, and platelets, gi ulcerations which can lead to n/v, hair loss |
| ganciclovir | by law has biohazard-so if it leaks or spills on you-wash thoroughly-if first trimester can cause neural tube defects, males- can cause aspermia |
| HIV | UNINHIBITED CAN MEK 5 BILLION COPIES IN 24 HOURS- 80%NORM/NULL 19% FATAL MUTATION <1% BENEFICIAL TO VIRUS MUTATION -SO TAKE DRUGS ON TIME TO PREVENT 1% MUTATION EX 3X/DAY= Q8HOURS(IMPORTANT) |
| TX OF SHOCK-DECREASED BP=DECREASED PERFUSION | FOR GENERIC SHOCK CONSIDER SNS AGONISTS-PROMOTES ENERGY EXPENDITURE BY CELLS AND TISSUES |
| ALPHA EX;TETRAHYDRALOZINE | ^BP=V-CONSTRICTION |
| BETA 1 | ^HR AND ^ STRENGTH |
| BETA 2 | BRONCHODILATOR (LUNGS) |
| EPINEPHRINE | IS A ALPHA ,BETA 1 AND BETA 2 AGONISTS-DRUG OF CHIOCE TO TX ANAPHLACTIC SHOCK |
| NOREPINEPHRINE | ALPHA AND BETA 1 AGONISTS |
| DOPAMINE | SNS AGONIST ^BP TITRATEABLE=DIFFERENT DOSES DO DIFFERENT THINGS |
| DOPAMINE IV MCG/KG/MIN | LOW DOSE-AGONIST AT DOPAMINE RECEPTOR IN THE SPLANCHIC BEDS.. RENAL DOSE(VASODILATOR)..... MED DOSE-BETA 1 AGONIST=^HR,^STRENGTH (CARDIAC)... HIGH DOSE=BETA 1 AND ALPHA AGONIST |
| DOBUTAMINE ^BP | BETA 1 AGONIST= ^STRENGTH OF HR > ^HR |
| ^ STRENGTH OF HEART | POSITIVE INOTROPIC EFFECT |
| DECREASE STRENGTH OF HEART | NEGATIVE INOTROPIC EFFECT |
| ^HR | POSITIVE CHRONOTROPIC |
| DECREASED HR | NEGATIVE CHRONOTROPIC |
| COMPENSATORY MECHANISMS OF HEART FOR LOW BP | VESSELS-CONSTRICT FAST.. .KIDNEYS- RETAIN FLUID (SLOW) |
| BETA BLOCKERS -OLOL(-ILOL,ALOL) EX;METOPROLOL/LOPRESSOR XL | (PK) SNS ANTAGONIST, BETA 1 AND BETA 2, WILL HAVE NEGATIVE CHRONOTROPIC AND INOTROPIC EFFECTS |
| S/E BETA BLOCKERS | FLAT AFFECT, NIGHTMARES |
| CONTRAINDICATIONS FOR BETA BLOCKERS | ASTHMA (IF IT ENDS IN -OLOL IT BLOCKS DILATION) AND TREATED DIABETES (MASKS THE S/S OF HYPOGLYCEMIA |
| OLD CA CHANNEL BLOCKERS EX;VERAPAMIL/CALAN DIALTIAZEM/CARDIZEM | (PD) NEG CHRONO/INOTROPIC- MAKES CA LESS AVAILABLE FOR MYOCARDIAL CONTRACTIONS AND SLOWS IMPULSE CONDUCTION-IF SOMEONE IS DX W/ DIABETES 2, YOU CAN SWITCHED THE PERSON TO THIS DRUG |
| OLD CA CHANNEL BLOCKERS S/E | (PO) CONSTIPATION |
| COMPENSATORY FOR VASODILATORS (DECREASE BP) | POSITIVE CHRONO/INOTRO (FAST) AND FLUID RETENTION (SLOW) |
| ALPHA BLOCKERS (-ZOSIN) EX TERAZOSIN/HYTRIN | (PK) SNS ANTAGONIST ALPHA, VASODILATOR |
| ALPHA BLOCKERS S/E | 1ST DOSE EFFECT-ORTHOSTATIC HYPOTENSION-TAKE AT BEDTIME TO PREVENT INJURY |
| NEW CA CHANNEL BLOCKERS (-DIPINE) EX; DIFEDIPINE/PROCARDIA | (PD) BLOCKS CA FROM PARTICIPATING IN SMOOTH MUSCLE CONTRACTION.. VASODILATION |
| NEW CA CHANNEL BLOCKERS S/E | ORTHOSTATIC HYPOTENSION, CONSTIPATION-STAY HYDRATED, MILD EDEMA |
| ACE INHIBITORS "PRIL" EX CAPTOPRIL/CAPOTEN S/E | DRY COUGH ORTHOSTATIC HYPOTENSION MILD EDEMA POTASSIUM RETENTION MORE IN ELDERLY |
| ANGIOTENSION 2 RECEPTOR BLOCKERS "SARTAN" EX; VALSARTAN/DIOVAN S/E | ORTHOSTATIC HYPOTENSIION MILD EDEMA ANGIO-EDEMA POTASSIUM RETENTION MORE IN ELDERLY |
| DIURETICS "SALT LOSS AGENTS" BY SALT MEANING ANY ELECTROLYTE | WORKS ON KIDNEYS (PD) WHERE SALT GOES WATER FOLLOWS |
| DIURETICS STRONGEST TO WEAKEST | STRONGEST-LOOP DIURETICS; FURESIMIDE/LASIX (LAST 6 HOURS)-LOSE ALOT OF ELECTROLYTES AVAIL PO/IV....THIAZIDES;CHLORTHALIDONE/HYGROTON DO RETAIN CALCIUM...K+ SPARING;SPIROMALACTONE/ALDACTONE-LOSE NA RETAIN K+-RETENTION WILL INCREASE WITH AGE |
| CLIENT NEEDS FLUID LOSS NOW GIVE | LASIX IV |
| LOOPS AND THIAZIDE DIURETICS | ARE SULFA RELATED |
| ALL DIURETICS GET | ELECTROLYTE PANELS-LOOP/THIAZIDE= GREATEST RISK FOR ELECTROLYTE IMBALANCE |
| COMPENSATORY FOR DIURETICS | ^HR ^STRENGTH AND VASOCONSTRICTION |
| CAD/ANGINA | MISMATCH OF O2 SUPPLY TO DEMAND IN THE MYOCARDIUM TX;PREVENTION-LONG ACTING MEDICATIONS WHICH TEND TO HAVE LONG ONSETS SO WON'T TX ACUTE |
| NEW CA+ CHANNEL BLOCKERS AND ACE INHIBITORS | ^O2 SUPPLY(VASODILATION) AND DECEASE O2 DEMAND(DECREASE PRELOAD) |
| BETA BLOCKERS AND OLD CA+ CHANNEL BLOCKERS | DECREASE O2 DEMAND (NEG CHRONOTROPIC NEG INOTROPIC) |
| ANGINA ATTACK=CRUSHING CHEST PAIN | TX;NITROGLYCERIN SL OR BUCCAL SPRAY-DECREASES DIASTOLIC UP TO 40 MMHG |
| NTG (PD) | MASSIVELY POTENT VASODILATOR-^O2 SUPPLY (MICRO) AND DECREASES O2 DEMAND (MACRO) |
| NTG TEACHING | NEED TO BE SITTING DOWN, GOOD UNTIL EXPIRATION HOWEVER, KEEP EXTRA UNOPENED BOTTLE HANDY, IF IT'S GOOD IT WILL TINGLE-CHECK POLICY-TAKE ONE Q 5MIN TIMES 3-CALL 911 AFTER 3RD DOSE-DON'T KEEP IN GLOVE BOX OF CAR |
| NTG SL | UNDER TONGUE-IF SWALLOWED HAS A LARGE 1ST PASS EFFECT-WHICH MEANS NO DRUG WILL GET IN BODY HALF LIFE AROUND 1 MIN |
| NTG PATCH | LONG ONSET-PREVENTION (PD) SAME AS PO-AVOID HEAT AND ALCOHOL CONSUMPTION, TRIM HAIR W/ SCISSORS-NEED A NITRATE FREE INTERVAL OF ABOUT 8 HOURS TO DECREASE TOLERANCE TO NTG |
| CHF | INABILITY OF THE HEART TO KEEP UP WITH THE DEMANDS OF THE BODY (PERFUSION)-PROGRESSIVE DISEASE-DISEASE OF THE ENTIRE CARDIOVASCULAR SYSTEM |
| EARLY/LATE TX OF CHF | ACE INHIBITORS/ANGIOTENSION RECEPTOR BLOCKERS -PRIL/-SARTANS AND THEN EVENTUALLY ADD DIURETICS...LATE ADD DIGOXIN/LANOXIN (^QUALITY, NOT QUANTITY)-MAKES YOU FEEL BETTER, BUT NOT LIVE LONGER |
| DIGOXIN/LANOXIN (TABLET) (PD) | SLOWS AND STRENGTHENS THE HEART, NEG CHRONATROPIC, POSITIVE INOTROPIC TO IMPORVE HEART EFFICIENCY-INHIBITS NA/K+ PUMP, SHUTS ELECTROLYTES AWAY FROM NA/K+ AND TOWARD CALCIUM(WHICH ALL SLOWS HEART AND INCREASES STRENGTH) |
| DIGOXIN | NARROW THERAPEUTIC INDEX-EASY TO OVERDOSE ON, ALSO TELL "DON'T DOUBLE UP, BUT IF W/IN 8 HOURS THEY CAN STILL TAKE IT" "SAME TIME EACH DAY" "KEEP ALL LAB APPTS" "TRY TO GET LOCALLY" |
| DIGOXIN (PK) | (A)-PO TABLET...NO (D)..NO (M)..(E)-GOES STRAIGHT TO RENAL EXCRETION SO B4 START NEED TO KNOW RENAL FUNCTION (BUN/CREAT) |
| DIGOXIN | ^BUN/CREAT=LONGER HALF LIFE, HALF LIFE TAKES ABOUT 24 HOURS W/ NORMAL RENAL FUNCTION, WHEN STARTING IT TAKES A LIL TIME TO BUILD UP TO THERAPEUTIC (2-3 DAYS) B/C THERAPEUTIC WINDOW |
| DIGOXIN | NEED DAILY SELF ASSESSMENTS "TAKE PREDOSE HR IF <60-HOLD AND CALL MD" "TAKE PULSE FOR ONE FULL MINUTE"(AS NURSES TAKE AT APICAL) CAN TELL PT TO TAKE FROM CAROTID"ONE SIDE" "DON'T RUB OR MASSAGE OR RUB CAROTID"-IF SUSTAINED RACING HR OR WGHT^>2LBS CALL MD |
| DIGOXIN | NEED TO KEEP TRACK OF SODDIUM INTAKE |
| DIGOXIN S/S OF TOXICITY (FOR NURSE) | ^ OR DECREASE K+= ^DIG TOXICITY |
| DIGOXIN S/S TOXICITY (PT) | EARLIEST-ANOREXIA, 1ST S/S THAT CAUSES PT TO CALL MD IS N/V/D, WHICH CAN AFFECT K+ LEVELS... LATER AS THESE PROGRESS- ALTERED MENTAL STATUS & YELLOW/GREEN HALOS AROUND OBJECTS- ENCOURAGE FAMILY TO READ D/T ALTERED MENTAL STATUS |
| DIGOXIN | BY MEDIC ALERT BRACLET, WEEKLY PILL ORGANIZER, KEEP TRACK OF NA, IF YOU LOSE DOPPLER GET ANOTHER ONE( CHILD) |
| DIGOXIN ANTIDOTE-DIGOXIN IMMUNE FAB/DIGIBIND | FAB=FRAGMENTED ANTIBODY-OVINE ORIGIN (SHEEP)- THERE IS A SIGNIFICANT RISK OF ANAPHYLAXIS (SHEEP) |
| ANTIARRHYTHMICS(FAST) | CLASS 1=SODIUM CHANNEL BLOCKERS.. .CLASS 2= BETA BLOCKERS... CLASS 3= AMIODARONE/CORDARONE (BEST ONE) |
| PT A-FIB ON B-BLOCKER W/ NEW DIABETES DX | CAN CHANGE TO OLD CA+ CHANNEL BLOCKERS AKA CLASS 4 |
| ANTIARRHYTHMICS (PK) | ALL HAVE THERAPEUTIC WINDOW- IF TOO MUCH CAN ALSO CAUSE ARRHYTHMIAS-ONLY WORK ABOUT 50% OF THE TIME |
| BETA BLOCKERS CAN BE TAKEN FOR MANY REASONS | IF THEY DON'T KNOW WHY-THATS A PROBLEM |
| AMIODARONE/CORDARONE (PD) | NEGATIVE CHRONOTROPIC NEGATIVE INOTROPIC |
| AMIODARONE/CORDARONE (PK) | (M) IS SUBJECT TO ENZYME INDUCTION/INHIBITION HALF LIFE;LOADING DOSE PHASE; SHORT HALF LIFE... MAINTENENCE;HALF LIFE ABOUT 35 DAYS=ADR COULD LAST LONG TIME |
| AMIODARONE/CORDARONE S/E | ORTHOSTATIC HYPOTENSION "RISE SLOWLY", ALTERED THYROID FUNCTION "NEED BASELINE/FOLLOW UP", RARE-RETINAL DEPOSITS(D/C DRUG-COULD LEAD TO BLINDNESS)"IF ANY EYE SIGHT C/O CALL MD, PULMONARY FIBROSIS (SPIROMETRY-BASELINE/FOLLOW UP) AND BLUE/GRAY DISCOLORATION |
| PRIMARY S/E OF AMIODARONE | PULMONARY FIBROSIS |
| LABS AMIODARONE | NEED DRUG LEVEL AND THYRIOD PANEL |
| BLOOD MODIFIERS ANTICOAGULANTS | IF IN ARTERIAL=PLATELTS W/ FIBRIN, VENOUS=FIBRIN W/ PLATELTS EX HEPARIN PREVENTS CLOT FORMATION AND OR EXISTING CLOT GROWTH |
| PLATELET MODIFIERS | PREVENT PLATELET ACTIVATION EX ASPIRIN OR PLAVIZ |
| ANTICOAGULANTS INPATIENT | IV/SQ HEPARIN/ LMWH- SQ-ENOXAPORIN/LOVENOX |
| ANTICOAGULANTS OUTPATIENT | WARFARIN/COUMADIN DAGIBACTRAN/PRADAXA |
| HEPARIN | (PD) INHIBITS COAGULATION FACTOR 10 (PK) SHORT HALF LIFE, SO CONTROLLABLE LAB=PTT |
| HEPARIN SQ (PK) | HETEROGENOUS MIXTURE- ABSORPTION VARIES FROM BATCH TO BATCH D/T SIZE AND ACTIVITY USE PTT AS A CHECK |
| ENOXAPORIN/LOVENOX (PK) | LMWH-LOW MOLECULAR WGHT HEPARIN- CUT TO UNIFORM SIZE,SHAPE AND ACTIVITY (EMZYMATICALLY)... SQ-ABSORPTION UNIFORMED RATE- MUCH MORE PREDICTABLE DOSE TO RESPONSE RELATIONSHIP- PTT IS UNRELIABLE AT BEST |
| INPATIENT ORDERED SQ COAGULATION BUT NO PTT ORDERED | LOVENOX |
| INPATIENT HEPARIN AND LOVENOX S/E | RED/ORANGE TINGE URINE, BLK TARRY/BLOODY STOOL-INSPECT URINE/STOOL DAILY & SKIN DAILY- UNEXPLAINABLE BRUISES-CALL MD...GET FAMILY INVOLVED-MENTAL STATUS CHG..USE ELECTRIC RAZORS, CLOSED TOE SHOES, SLIP/FALL PROFF HOME,NO ALCOHOL, SOFT BRISTLE TOOTHBRUSH |
| OUTPATIENT COUMADIN (PD) | DEFECTIVE FORM OF VIT K, LEADS TO FORMATION OF DEFECTIVE VIT-K DEPENDENT CLOTTING FACTORS- LESS CONTROLLABLE THEN HEPARIN |
| ON DAY 4 OF COUMADIN 2.8 INR WHAT WOULD IT BE BY DAY 8 | OVER THERAPEUTIC RANGE |
| WARFARIN AND VIT K (FAT SOLUBLE)-CAN STORE IN LIVER | YOU MUST OVER COME THE VIT-K RESERVOIR (AVG OVER MONTHS)- KEEP INTAKE THE SAME, TELL MD ABOUT DIETARY CHANGES NOW!! |
| VIT-K RICH FOODS | SPINACH BROCCOLI CAULIFLOWER CABBAGE BRUSSEL SPROUTS KALE... ASPARAGUS(MOST VIT-K) AVOID EXCESS CONSUPMTION |
| PT IS ON WARFARIN THEIR DIET SHOULD BE | THE SAME |
| WARFARIN AND DRUG INTERACTION | RULE- ASSUME ALL DRUGS INTERACT W/ WARFARIN THEREFORE NEED OF ALL DRUGS LIST AND CHANGE OF DOSES TO BE REPORTED TO MD |
| SALICYLATES | BISMUTH SUBSALICYLATE/PEPTO BISMAL METHYL SALICYLATE. OIL OF WINTERGREEN AND ASPERCREAM.. .ALL NEED TO BE AVOIDED WHEN ON WARFARIN B/C IT WILL ^ BLEEDING |
| PLATELET MODIFIERS | PREVENTS PLATELETS ACTIVATION |
| ASA (PD) | PREVENTS PROSTOGLANDINS SYNTHESIS.. IS TITRATABLE |
| CLOPIDOGRE/PLAVIX (PD) | WORKS INSIDE PLATELET |
| ASA WORKS MORE ON STUFF | OUTSIDE THE PLATELET, PLAVIX WORKS MORE ON INSIDE- SO CAN BE ON BOTH |
| ASA | LOW DOSE INHIBITS TX SYNTHESIS ONLY.. HIGH DOSE INHIBITS BOTH PROSTOGLANDINS AND IS USED FOR ANTI-INFLAMMATORY |
| HOW DOES ASA WORK...IS IT TITRATABLE...PRIMARY PREVENTION IS WHICH DOSE | INHIBITS PROSTAGLANDIN SYNTHESIS.. YES-TITRATABLE.. 81MG DOSE- PRIMARY PREVENTION |
| PLAVIX "DOGREL" (PD) WORKS INSIDE PLATELETS | (PK) KNOWN AS A PRODRUG (IT NEEDS HEPATIC METABOLISM (ONCE TO BE ACTIVATED.. IF YOU INHIBIT (M) IT WON'T BE ACTIVATED..ACTIVATION IS INHIBITED BY PRILOSEC..SLIGHTLY STRONGER THEN ASA |
| PLAVIX | SAME ASSESSMENT AS IF ON COUMADIN "SOFT BRISTLE TOOTHBRUSH" PT MAY TAKE IF ALREADY HAD MI |
| TX OF HIGH CHOLESTEROL | DIET AND EXERCISE(MINOR EFFECT)- COMMON MED CLASS "STATINS" |
| STATINS | (PD) INHIBIT HEPATIC CHOLESTEROL SYNTHESIS.. CHOLESTEROL BINDING RESINS- SHOULD TAKE W/ MEALS, TAKE OTHER MEDS -+2 HOURS |
| SSTATINS EX SIMVASTATIN/ZOCOR AND ATORVASTATIN/LIPITOR | HAVE LONG HALF LIFE, STRONGEST ONES |
| STATINS S/E | RISK OF HEPATIC DAMAGE- MORE PREVELANT (FAR EAST,MEDERTERRAIN)- CHECK LIVER FUNCTION- CALL MD IF SKIN/SCLERA YELLOWING AND IF STOOL IS ASHTEN COLOR AND CONSISTENTLY DARK URINE- MALAISE- RHABDOMYOLYSTS(CALL MD IF UNEXPLAINED MUSCLE PAIN) AVOID ETOH/TYLENOL |
| ASTHMA; PAROXYSMAL BRONCHIAL CONSTRICTION AND INFLAMMATION | TO TX; RESCUE INHALER (SHORT ONSET B2 AGONIST EX; ALBUTEROL/VENTOLIN... MAINTENENCE INHALER; STEROID (1ST CHOICE) EX; BETCLOMETHASONE/BECLOVENT.. 2ND-LONG ACTING B2 AGONIST EX SOLMETERAL/SEREVENT FOMEDEROL/PORADIL |
| ASTHMA ATTACK GIVE?......1ST CHOICE PREVENTATIVE GIVE? | ALBUTEROL ACUTE...STEROID PREVENTATIVE |
| SHORT ACTING RESCUE INHALER ALBUTEROL/VENTOLIN | B2 AGONIST (THERAPEUTIC) AND B1 AGONISTS (^HR ^BP)..SNS AGONISTS |
| MAINTENENCE B2 AGONISTS-DON'T OVERUSE B/C LONG ACTING CAN CAUSE HEART TO ^ TOO MUCH | BLACK BOX WARNING |
| CLIENT ADMITS TO OVERUSE OF OF MAINTENENCE INHALER EXPECT TO SEE | ^HR AND ^BP |
| STEROID INHALERS BECLOMETHASONE LONG ONSET LONG DURATION S/E | ORAL CANDIDIASIS/THRUSH- THEREFORE RINSE MOUTH AFTER INHALATION |
| PNS ANTAGONIST/ANTICHOLINERGIC | MORE COMMONLY USED W/ COPD BUT STILL FOR ASTHMA EX IPOTROPIUM/STROVENT TIOTROPIUM/SPIREVA |
| IPOTROPIUM/ATROVNET TIOTROPIUM/SPIREVA | MAKE B2 AGONIST WORK BETTER |
| W/ INHALERS | TELL TO HOLD BREATH FOR AS LONG AS COMFORTABLE WHEN INHALING S/E-DRY MOUTH |
| TYPE 2 DIABETES | STILL MAKE INSULIN "NON RESPONDERS TO INSULIN" |
| OLD SCHOOL HYPOGLYCEMIC DRUGS | SULFAMYLUREAS; GLIPIZIDE/GLUCOTROL= ^INSULIN RELEASE... "GLINIDE" "GLITIZONE" = NEWER CLASS |
| NEW SCHOOL DIABTETIC MEDS | ^ INSULIN RELEASE AND DECREASE GLUCAGON RELEASE- HAVE A LOWER RISK OF HYPOGLYCEMIA- CALLED THE INCRETIN MIMICS |
| MODERN | W/ TYPE 2 DIABETES HAVE TO TREAT INSULIN AND GLUCAGON-SULFANYLUREAS ADDRESS INSULIN |
| GREATER RISK OF HYPOGLYCEMIA | OLD SCHOOL |
| METFORMIN/GLUCOPHAGE-EU- GLYCEMIC AGENT | TENDS TO NORMALIZE BLOOD SUGAR, SAFER DRUG, COMMONLY 1ST DRUG NEW TYPE 2 DIABETES PUT ON |
| (PD) METFORMIN/GLUCOPHAGE | DECREASE GLUCONEOGENISIS- DECREASE GLYCOGENOLYSIS- INCREASE GLUCOSE UPTAKE BY MUSCLES... WORK ON THE LIVER-CAN'T PREVENT OTHER DRUGS FROM CAUSING HYPOGLYCEMIA |
| METFORMIN + GLIPIZIDE=METOGLIP | C/O SWEATING, CONFUSED=HYPO= GLIPIZIDE CAUSING IT |
| S/E FISHY TASTE-DON'T EAT AS MUCH | METFORMIN |
| MUST D/C METFORMIN | 24-48 HOURS PRIOR TO MAJOR SURGERY AND/OR IODINE DYE STUDIES OR IF RENAL IMPAIRED-IF YOU DON'T CAN CAUSE LACTIC ACIDOSIS (RIGIDITY/PAIN ABD.) |
| EPILEPSY-KINDLING THERAPY | MICROSCOPIC DEFECT-DISPLAYS AUTOMATICITY, PAROXYSMAL, RECRUITS OTHER PORTIONS OF THE BRAIN |
| EPILEPSY | NEED TO RECORD ACCURATE- DISTINGUISH TYPE OF SEIZURE (STRONG,ETC) TX IS TO DECREASE NEURONAL FIRING SO SEDATION IS A SIDE EFFECT, OVERDOSE- WORRIED ABOUT RESP SUPPRESSION/DEPRESSION |
| THE PRIMARY 4 DRUGS FOR EPILEPSY | PHENTOIN/PHT/DILANTIN... CARBAMAZEPINE/CBZ/TEGRETOL... PHENOBARBITAL/LUMINOL.. VALPORIC ACID/DEPOKOTE..ADD ON(ADJUNCT)- GABAPENTIN/NEURONTIN (S/E SEDATION) |
| WHICH MED FOR EPILEPSY NEEDS TO BE COMBINED W/ OTHER MED | GABAPENTIN/NEURONTIN |
| EPILEPSY MED ON BLOOD | (PK) ALL PRIMARY MEDS HAVE THERAPEUTIC WINDOWS |
| IF CLIENT EXPLAINS OF MORE SEIZURES | GET LEVEL B/C IT COULD BE TOXIC OR TOO LITTLE, CALL MD RIGHT AWAY |
| S/E EPILEPSY MEDS | ALL PRIMARY MEDS HAVE A RISK OF FOLATE DEFIENCY ANEMIA (TIRED UPON EXERTION)- DISCUSS FOLATE SUPPL W/ MD..RARE-APLASTIC ANEMIA-IF ANY UNUSUAL BRUISING-REPORT TO MD NOW! IF FLU-LIKE S/S OR SORE THROAT-CALL MD |
| EPILEPSY MEDS ON ORGAN-LIVER/HEART | ALL EPILEPSY MEDS HAVE A RISK OF LIVER DAMAGE S/S JAUNDICE AND ASHTON COLORED STOOLS AVOID ETOH AND APAP...HEART=TOXICITY-ALTER HR AND RHYTHM |
| (PK) DILANTIN, PHENOBARB, CARBAMEZEPINE | ENZYME INDUCERS (DECREASE THE LEVEL OF OTHER DRUGS) |
| (PK) VALPORIC ACID | ENZYME INHIBITOR (INCREASE LEVELS OF OTHER DRUGS)- THEREFORE TELL MD OF ALL MEDS BEING TAKEN |
| EPILEPSY MEDS ON SKIN | ALL MEDS CAN CAUSE PHOTOSENSITIVITY "WEAR SUNSCREEN" ALL CAN CAUSE RASHES, IT IS COMMON FOR THEM TO CAUSE A SELF-LIMITING RASH (DOESN'T LAST LONG)... RARE-STEVEN JOHNSONS SYNDROME- USUALLY OCCURS 1ST 6 MONTHS OF STARTING-PROGRESSING- CALL MD |
| PHENYTOIN/DILANTIN SPECIFIC | (PK) ZERO ORDER KINETICS HALF LIFE HAS NO MEANING, SO ONLY WAY TO FIND OUT IS TO TAKE LEVEL, SMALL CHANGES IN DOSE CAN CAUSE LARGE CHANGES IN CP-KEEP OUT OF REACH OF CHILDREN |
| PHENYTOIN/DILANTIN S/E | SIGNIFICANT # GET HIRSUITISM, COARSENING OF FACIAL FEATURES, GINGIVAL HYPERPLASIA (PAINFUL SWELLING OF GUMS)-NEED TO FLOSS > 2TIMES/DAY |
| OPIATES S/E | SEDATION EUPHORIA CONSTIPATION TELL INCREASE FLUIDS AND FIBER/BULK LAXATIVES AVOID STIMULANT LAXATIVES CAN CAUSE RASH/PSEUDOALLERGY (IMMUNE SYSTEM NOT INVOLVED) VASODILATION (ORTHOSTATIC HYPOTENSION) NSG DX-CONSTIPATION |
| OPIATES CONTROLLED SUBSTANCES DEPENDENCE 2 TYPES | PHYSICAL- LONG TERM WILL NEED HIGHER DOSES TAPER DOSES WHEN STOPING), PSYCHOLOGICAL- ATC DOSING(DON'T WAIT TILL PAIN) |
| PHYSICAL AND PSYCHOLOGICAL DEPENDENCE | PHYSICAL- REACTIVE FASHION DEPENDENCE... PSYCHOLOGICAL- ATC DOSING PROACTIVE- SHOULD HAVE SCHEDULE SET UP |
| ACETAMINOPHEN NARROW THERAPEUTIC EFFECT | (PD) ANALGESIC, ANTIPYRETIC... (PK) METABOLISM REQUIRES SULFUR- THEREFORE NO SULFUR - END UP W/ HEPATOTOXIC METABOLITE WHICH WILL LEAD TO LIVER DAMAGE MONITOR ALT/AST IF >150-200-GET WORRIED |
| ANTIDOTE TO ACETAMINOPHEN | CYSTEIN(MUCOMYST) |
| NON TOXIC IN GENERAL FOR TYLENOL | <4G/DAY-CHRONIC...7G@ ONE TIME-ACUTE |
| NSAIDS (PD) | ANALGESIC, ANTIPYRETIC, ANTI-INFLAMMATORY- BETTER THEN TYLENOL FOR RHEUMATOID ARTHRITIS- INHIBITS PROSTAGLANDIN SYNTHESIS |
| S/E APAP | SHORT TERM-GI ULCERATION... LONG TERM- RENAL DAMAGE (TAKES DECADES) |
| POLYPHARMACY | ON MORE THEN ONE DRUG THEN IS NEEDS-LASIX FROM ONE MD AND FURESOMIDE FROM OTHER MD |
| IBUPROFEN | SHORT ONSET SHORT DURATION NSAID TO CHOSE FOR HEADACHES AND MENSTRAL CRAMPS |
| MAPROXEN | LONG ACTING AND LONG ONSET GOOD FOR KEEPING PAIN AWAY |
| 200MG IBUPROFEN PO QMORNING AND 275MG NAPROXEN PO Q12H | IBUPROFEN TO GET RID OF PAIN NOW.. NAPROXEN TO KEEP PAIN AWAY.. SO THEREFORE RIGHT AMOUNT ORDERED |
| SEDATIVES/HYPNOTICS | SEDATIVE GOAL IS CALM...HYPNOTIC GOAL IS SLEEP-CAN BE USED FOR 2 THINGS (SLEEP/CALM) |
| BENZODIAZEPINES-HYPNOTIC LOTTA | LORAZEPAM/ATIVAN.. OXAZEPAM/SERAX.. TEMAZEPAM/RESTORIL.. TRIAZOLAM/HALCION.. ALPRAZOLAM/XANEX- ALL HAVE SHORT ONSET(<1H) AND SHORT DURATION(<8H) |
| ATIVAN,SERAX, RESTORIL | NO REAL CHANGE IN HALF LIFE W/ AGE |
| HALCION, XANEX | LONGER HALF LIFE W/ AGE SO SHOULD BE AVOIDED IN ELDERLY |
| 4 CLIENTS-IF NOT LOTTA, SHORT ONSET, LONG DURATION | SO WILL HAVE HANGOVER EX VALIUM, AMBIEN |
| BENZOS (PD) | SUPRESS NEURONAL FIRING-WIDE THERAPEUTIC INDEX TILL YOU ADD ETOH B/C ETOH CAN AMPLIFY 2X-200X THE EFFECT S/E SOME HAVE MILD ANTICHOLINERGIC EFFECTS, OTHERS ANTEROGRADE AMNESIA (CAN'T REMEMBER WHATS HAPPENS WHILE ON DRUG) DON'T TEACH PT WHILE USING THESE |
| ANTIPSYCHOTICS | TYPICALS- HALOPERIDOL/HALDOL.. .ATYPICALS- OLANZAPINE/ZYPREXA |
| ANTIDEPRESSANTS | CLASS CALLED TRI-CYCLIC ANTIDEPRESSANTS AMITRYPTILINE/ELAVIL |
| GENERAL S/E FOR ANTIPSYCHOTICS | ANTICHOLINERGIC (DRY MOUTH) ALPHA BLOCKING (VASODILATORS/ ORTHOSTATIC HYPOTENSION) SEDATING |
| EX HALDOL S/E | DRY EYES DRY MOUTH WOBBLY WHEN GETTING UP |
| ALL ANTIPSYCHOTICS ANTIDEPRESSANTS | CNS ANTIHISTAMINE- DECREASE SATIETY- WGHT GAIN- NEED TO ASSESS FOR TYPE 2 DIABETES & SODIUM CHANNEL BLOCKERS LEAD TO CARDIAC ARRHYTHMIAS (MOST SERIOUS S/E) |
| HOW LONG DOES IT TAKE FOR ANTIPSYCHOTIC/ANTIDEPRESSANTS TO WORK | 3 WEEKS TO 3 MONTHS (FOR MORE ORDERED THOUGHT OR RAISED MOOD) |
| THERAPEUTIC WINDOW | PK |
| THERAPEUTIC INDEX | PD |
| B-BLOCKERS W/ DIABETES | CHANGE TO OLD CA CHANNEL BLOCKERS |
| PHARMACEUTICS | PATCH PO IV SL ETC |
| ASTHMA ATTACK IN FRONT OF YOU | GIVE ALBUTEROL |
| CARDIOVASCULAR-HTN 3 PARTS KIDNEYS HEART VESSELS | KIDNEYS-DIURETICS ACE INHIBITORS... HEART-B-BLOCKERS,OLD CA CHANNEL BLOCKERS.. VESSLES-ALPHA BLOCKERS,NEW CA CHANNEL BLOCKERS, ACE INHIBITORS |
| HTN TX KIDNEYS COMPENTASORY:DIURETICS,ACE INHIBITORS,ARB's | ^HR AND STRENGTH (FAST) AND CONSTRICTION OF VESSLES(FAST) |
| HTN TX HEART COMPENTASORY:B-BLOCKERS,OLD CA CHANNEL CLOCKERS | VESSLES CONSTRICT(FAST) KIDNEYS RETAIN FLUID(SLOW) |
| HTN TX VESSELS COMPENTASORY:ALPHA BLOCKERS,NEW CA CHANNEL BLOCKERS,ACE INHIBITORS,ARB's | ^HR AND STRENGTH(FAST) AND KIDNEYS FLUID RETENTION(SLOW) |
| ACE INHIBITORS | -PRIL. CAPTOPRIL/CAPOTEN |
| ARB's | -SARTAN.. VALSARTAN/DIOVAN |
| B-BLOCKERS | -OLOL,ALOL... METOPROLOL/LOPRESSOR |
| OLD CA CHANNEL BLOCKERS | VERAPAMIL/CALAN DIALTIAZEM/CARDIZEM |
| ALPHA BLOCKERS | -ZOSIN..TERAZOSIN/HYTRIN |
| NEW CA CHANNEL BLOCKERS | -DIPINE..DIFEDIPINE/PROCARDIA |
| FINALLY THE END- GOOD LUCK:) |
Created by:
lmtherrera
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