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31 Cards in this Set
- Front
- Back
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How can the rate of absorption be changed?
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Inc gastric emptying time
Change gastric pH Form drug complexes |
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Which drugs are not absorbed primarily in the small intestines?
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barbiturates, salicylates, theophylline
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What should be avoided when taking tetracycline?
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Mild products and antacids should be avoided 1hr before and 2hrs after tetracycline consumption, becayse they may form a complex and the tetracycline may not be absorbed.
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What are examples of other drugs that cause complexes with drugs?
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kaolin-pectin, certain hypocholesterol drugs such as cholestyramine and colestipol and activated charcoal
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What influences the displacement of drugs in distribution?
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Drug concentraion in the blood, protein-binding power of the drug, bolume of distribution (Vd)
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What happens when you have two drugs that are highly bound to protein or albumin?
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They will compete for protein or albumin sites in the plasma. This results in dec protein binding of one or both drugs; more free drug circulates and can lead to toxicity
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What are examples of drugs that are highly protein bound?
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warfarin (anticoagulant), certain anticonvulsants such as phenytoin and valproic acid; clofibrate; most NSAIDs; sulfonamids; tolvutamide; and quinidine
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How does enzyme inducers affect drug action?
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Inc metabolism promote drug elimination and dec plasma concentration of the drug
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What are examples of enzyme inducers?
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Barbiturates (eg phenobarbital), anticonvulsant drugs phenytoin and carbamazepine, alcohol and rifampin, cigarette smoking
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How does chronic alcohol and acute alcohol use compare in enzyme activities?
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Chronic: inc enzyme activities
Acute: metabolism inhibited |
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How does cimetidine affect theophylline?
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Antiulcer drug cimetidine dec the metabolism of certain drugs such as theophylline (antiasthmatic). Theophylline doses need to be dec to avoid toxicity.
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How does quinidine affect digoxin?
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The antidysrhythmic drug quinidine dec the excretion of digoxin.
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What are examples of diuretics?
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Furosemide (Lasix) hydrochlorothiazide (HydroDiuril)
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How does potassium affect digoxin?
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Hypokalemia can enhance the action of digoxin leading to toxicity.
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What are examples of desirable additive drug effects?
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diuretic and beta blocker are given for hypertension; lower BP and act as antihypertensive drugs
Two analgesics, asprin and codeine for inc pain relief |
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What are examples of undesirable additive effects?
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Two vasodilators: hydralazine (Apresoline) prescribed for HTN and nitroglycerin prescribed for angina -> severe hypotensive response
Aspirin and alcohol -> prolong bleeding time, gastric bleeding, |
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What are examples of desirable and undesirable synergistic drug effects?
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meperidine (Demoral, narcotic analgesic) and promethazine (Phenergan, an antihistamine)
Promethazine enhances the effect of meperidine. Less meperidine is required for desirable effect. Alcohol and sedavie-hypnotic drug such as chlordiazepoxide (Librium or diazepam (Valium) -> CNS depression |
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What are examples of antagonistic drug effects?
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With morphine overdose, nalozone is given as an antagonist to block the narcotic response.
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What foods must be avoided when taking an antidepressant of the monoamine oxidase (MAO) inhibitor type (Marplan)?
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Tyramine rich foods such as cheese, wine, organ meats, beer, yogurt, sour cream or bananas. What results is a hypertensive crisis.
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What can cause digoxin toxicity?
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dec srum potassium and magnesium levels, or inc serum calcium level
thiazide diuretic group - hydrochlorothiazide (HydroDiuril) can dec serum potassium magnesium and sodium levels and inc calcium levels -> toxicity |
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What aspects of ibuprofen must be considered?
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It inc the serum digoxin level and can lead to toxicity.
It inc fluid retention which could worsen the condition of a client with CHF The use of ibuprofen in a long term basis may dec the effectiveness of antihypertensive drugs |
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What aspects of aspirin must be considered?
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Aspirin can trigger an acute asthma episode.
It is not recommended for children with flu symptoms of chickenpox bc of Reye syndrome |
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Which clients should avoid aspirin, acetaminophen and ibuprofen?
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impaired renal function
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Which drugs inc the effects of oral anticoagulants>
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aspirin and ibuprofen
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Which clients should avoid OTC cold and cough Remedies without approval from their health care provider?
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ht dz, HTN, thyroid dz
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What are side effects of cold and cough OTC drugs?
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headache, nervousness, inc BP, insomnia for sympathomimetic
drowsiness for antihistamine |
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What does OTC sleep aids contain? What should be avoided with OTC sleep aids?
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antihistamine with or without an analgesic (aspirin, acetaminophen)
A depressent -> CNS depression |
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What does OTC weight control drugs contain?
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amphetamines which suppress the appetite, this is for short term as they were effective as long as the therapeutic blood level of the drug is maintained.
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What are side effects of OTC weight control drugs?
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nervousness, ht palpitations, inc BP, insomnia
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What are OTC weight control drugs contraindicated for?
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ht dz, HTN, DM, thyroid dz
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What are nursing assessments for drug interactions?
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1) Obtain a drug history of the OTC drugs client currently takes.
2) Assess for drug reaction when two highly protein bound drugs are taken together daily e.g. anticoagulant warfarin (Coumadin) and antiinflammatory sulindac (Clinoril). Warfarin is displaced leading to possible inc in bleeding 3) Determine if potential for drug interaction problems related to an inc or dec absorption rate of two drugs. 4) Assess for drug toxicity when a drug enzyme inducer is discontinued or a drug enzyme inhibitor is taken concurrently with other drugs. 5) Determine if cleint is a cigarette smoker. Tobacco inc the metabolic rate of drugs. Dosage needs to be inc. 5) Determine renal function by checking for adequate urine output, it should be greater than 600ml daily, 25ml/h for adults |
