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58 Cards in this Set

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HEPARIN:

Inhibits formation of new ___.
Rapid _____.

Does NOT lyse ____ thrombi but may prevent clot extension & propagation.

Used as anticoagulant in:
____, extracorporeal circulation, ___ procedures, prophylaxis in ___ & ___ surgery, maintains potency of indwelling IV ___ in intermittent IV therapy or blood sampling.
clots
anticoagulant

existing transfusions
dialysis
hip & knee
catheters
Heparin:

Category "___"

Contraindications:
thrombophlebitis
advanced kidney disease
liver or biliary disease
TB
threatened abortion
suspected intracranial ___ severe ___
recent eye surgery
brain, spinal cord,spinal tap SHOCK

Antidote: Have protamine sulfate (1% solution) on hand.
C
hemorrhage
hypertension


******Antidote: Have protamine sulfate
HEPARIN:

Note:

CHECK___ lab value b/f admin

DO NOT use w/solutions containing ___ ___

DO NOT use in neonates.

Heparin may prolong PT used to monitor therapy

ORAL ANTICOAGULANTS, ASPIRIN, & NSAIDs increase risk of ___

NITRA-TRIDIL may decrease ____ activity

PROTAMINE antagonizes effects of heparin

Herbal: Feverfew, ginkgo, ginger, VALERIAN may potentiate bleeding.
coagulation

benzyl alcohol
bleeding
anticoagulant
LEPIRUDIN (C):

Anticoagulation in Pt's w/ heparin-___ thrombocytopenia

Contraindications:
lactation & pregnancy intracranial bleeding
Pt's w/increased risk of bleeding or recent ___, CVA, & advanced ___ impairment.

Adverse effects:
intracranial bleeding,& MI.

Use w/Warfarin, NSAIDS, SALICYLATES, ANTIPLATELET AGENTS increases risk of ___
induced
B
surgery
kidney
bleeding
ENAXOPARIN-LOVENOX:

Effective ____ agent
Used for prophylactic Tx as ____ agent following certain types of surgery

Prevention of DVT after ___, ___, or ___ surgery
Tx for DVT & pulmonary ____

Mngmnt of acute ____ syndrome.

Contraindications:
Pt's w/ active major ___, GI bleeding, hemophilia, heparin hypersensitivity, & heparin induced thrombocytopenia.

Report signs of unexplained bleeding such as: pink, red, or dark brown ___; red or dark brown vomitus; bleeding ___ or bloody sputum; dark, ___ stools.
anticoagulation
antithrombotic
hip, knee, or abdominal
embolism
coronary

bleeding
urine
gums
tarry
CHOLESTYRAMINE-QUESTRAN:

Lowers serum total cholesterol by decreasing (LDL) ___ & reducing bile acid deposit in dermal tissues & decreasing pruritus.

Used as adjunct to ___ therapy in mngmnt of Pt's w/ primary ____ w/a significant risk of ____ heart disease & MI, & relief of ____ secondary to partial biliary stasis.

Unlabeled use is to control diarrhea caused by excess bile acids in colon.
cholesterol
diet
hypercholesterolemia (hyperlipidemia)
atherosclerotic
pruritus
CHOLESTYRAMINE-QUESTRAN (C):

Contraindications:
Pt's w/complete biliary ____
hypersensitivity to bile acid sequestrants, ___ & ___.
obstruction
pregnancy, & lactation
CHOLESTYRAMINE-QUESTRAN (C):

Take w/water or other preferred ___.

Permit drug to hydrate by standing ___stirring 1–2 min, twirling glass occasionally, then stir until suspension is ___.
Rinse glass w/small amount of liquid & have patient drink remainder to ensure entire ___ is taken.

Administer ___meals.
Always ___ cholestyramine powder before administration b/c it is irritating to ___ membranes & may cause ____ impaction if administered dry.
liquid
without
uniform
dose
before
esophageal
dissolve
mucous
CHOLESTYRAMINE-QUESTRAN (C):

___ absorption of ORAL ANTICOAGULANTS, digoxin, TETRACYCLINES, penicillins, phenobarbital, THYROID HORMONES, THIAZIDE DIURETICS, IRON SALTS, FAT-SOLUBLE VITAMINS (A, D, E, K) from the GI tract.

Administer cholestyramine ___ before or __ after these drugs.

***Report ____ immediately to physician.

___ diet w/adequate fluid intake is an essential adjunct to cholestyramine treatment & & generally resolves problems w/constipation & ___ sensation.

GI adverse effects usually subside after ___month of drug therapy.

*** Sudden withdrawal can promote uninhibited absorption of other drugs taken concomitantly, leading to toxicity or ____.
decreases
4 h
2 h
constipation
High-bulk
bloating
first

overdosage
Monitor therapeutic effect of CHOLESTYRAMINE-QUESTRAN(C).

Serum ___ levels are reduced w/24–48 h after Tx starts & may continue to decline for a ___.

After withdrawal of use cholesterol levels usually return to baseline level in __ to ___.

Be alert to early symptoms of hypoprothrombinemia & S&S of petechiae, ecchymoses, abnormal bleeding from mucous membranes, tarry stools & report promptly.

Long-term use of can increase ___ tendency.
Preexisting ____ may be worsened in the older adult, women, & in those taking >24 g/d.
cholesterol
2 to 4 wk
year
bleeding
constipation
CLOFIBRATE (C):

Reduces very low density ____ (VLDL)

Used as adjunct Tx for severe ____ & ___.

Contraindicated in impaired renal or hepatic function, cirrhosis, ___ & ___.

Safe use in children <14 y not established.

Caution in Pt's w/history of jaundice or hepatic disease, gallstones, peptic ulcer, hypothyroidism & ____ disease.
lipoproteins

hyperlipidemia & management of diabetes insipidus

pregnancy & lactation
cardiovascular
CLOFIBRATE (C):

Take w/___ if gastric distress is a problem.

Taken w/ORAL ___ increases hypoprothrombinemia & increase risk of ___, probenecid increases effects of clofibrate

HYPOGLYCEMIC effects are increased when taken w/____.
meals
ANTICOAGULANTS
bleeding
SULFONYLUREAS
CLOFIBRATE(C):

Have baseline & periodic ___ profile, periodic liver function tests, CBC, renal function tests, plasma & urine steroid levels, serum electrolyte levels, & ___ ___.

The therapeutic response occurs during the ___ or ___ month of therapy.
Rebound may occur in second or third month, followed by a further decrease, & may also occur w/ sudden withdrawal of drug.
lipid
blood glucose
first or second
CLOFIBRATE:

Report ____ symptoms promptly.

Other reportable conditions include leukopenia, pulmonary edema, renal insufficiency, ___ pain, nausea & vomiting.

*** Women of childbearing years should be on ___ ___ ___.

*** If pregnancy is desired, therapy should be discontinued at least ___ before conception.
flu-like
gastric
birth control regimen
2 months
LOVASTATIN (X):

Reduces plasma cholesterol levels by interfering w/body's ability to produce ___ & it lowers LDL & VLDL.

Adjunct to ___for Tx of primary moderate hypercholesterolemia when diet & other nonpharmacologic measures have failed.
cholesterol
diet
LOVASTATIN (X):

Contraindications:
liver disease, cholestasis, hepatic encephalopathy, hepatic disease, hepatitis, jaundice; rhabdomyolysis; surgery, trauma; ___, renal failure, & ___ , lactation.
X
hypotension
pregnancy
LOVASTATIN (X)

CAUTION in Pt who consumes substantial quantities of ___. ____ ____ may increase risk of myopathy

Ensure extended-release tablets are not crushed or ___.

They must be swallowed ___.

PROTEASE INHIBITORS increase risk of ___myopathy
alcohol
chewed
whole
GRAPEFRUIT JUICE
ZIDOVUDINE-RETROVIR (C):

Antiviral action against ___, the causative agent of AIDS, & lymphadenopathy. Pt's who are HIV positive & have a CD4 count ____, ____ HIV infection, & prevention of perinatal transfer of HIV during ___.

Unlabeled Use for ____ Pt's postexposure chemoprophylaxis.
HIV
500/mm3
asymptomatic
pregnancy
Pediatric
ZIDOVUDINE-RETROVIR (C):

Contraindications:

Life threatening __ reactions.

Safe use of ZIDOVUDINE - RETROVIR during pregnancy & ____, is unknown.

Caution use w/impaired ___ or hepatic function & bone marrow depression.

**Do not expose capsules & syrup to ___ during drug preparation.
allergic
lactation
renal
light
ZIDOVUDINE-RETROVIR (C):

Evaluate Pt at least ___ during the first month of therapy.
•Monitor for common adverse effects, especially severe headache, nausea, insomnia, & myalgia
weekly
NEVIRAPINE-VIRAMUNE (C):

Prevents ____ of HIV-1 virus but does not inhibit HIV-2 reverse transcriptase & DNA polymerases.
Resistant strains appear ___rapidly.

Use in combination w/nucleoside analogs for treatment of HIV.

Contraindications:
Hormonal ____, ___, ___, & ___.

Cautious use w/liver or renal disease, hepatitis B or C; CNS disorders.
replication
rapidly
contraceptives, pregnancy, lactation, & neonates
NEVIRAPINE-VIRAMUNE (C):

may decrease plasma concentrations of ____ INHIBITORS & ORAL ____.

It may ___ methadone levels inducing opiate withdrawal. ____ may decrease antiretroviral activity.
PROTEASE
CONTRACEPTIVES
decrease
St. John's wort
NEVIRAPINE-VIRAMUNE (C):

Monitor Pt's carefully during first ___ of therapy for severe ___ w/or w/out fever, blistering, oral lesions, conjunctivitis, swelling, joint aches, or general malaise.

*** Withhold drug & notify physician if severe ___ appears.

*** There is a high potential for drowsiness & fatigue.

*** Use or add barrier contraceptive if using ___ ___.
6 wk
rash
rash
hormonal contraceptive
SAQUINAVIR-INVIRASE:

Indicated by reduced viral ___ & increased number of CD4 T cells.

Used w/an ____ HIV infection & usually in combination w/ ____ or zalcitabine.

**Give w/or up to ___ after full meal to ensure adequate absorption & bioavailability.

DO NOT administer to anyone taking ____ or ____ because these drugs significantly ___ the plasma level of saquinavir.
load
advanced
zidovudine - retrovir

2 h

rifampin or rifabutin
decrease
SAQUINAVIR-INVIRASE:

Assess Pt for buccal mucosa ___ or other distressing GI S&S.

Monitor ____ periodically.

Monitor for toxicity if any of calcium channel blockers, clindamycin, dapsone, quinidine, triazolam, or simvastatin is taken.

***Take drug within ___ of a full meal.
ulceration
weight

2 h
CYCLOBENZAPINE-FLEXERIL (B):

Has antidepressant, sedative effect, potent central & peripheral anticholinergic activity.

Short-term adjunct to rest & physical therapy for relief of muscle ___ assoc. w/acute ____ conditions.

***Not effective in tx of spasticity assoc. w/ cerebral palsy or cerebral or cord disease.

Spasmolytic effect usually begins within ___ or ___
spasm
musculoskeletal
1 or 2 d
CYCLOBENZAPINE-FLEXERIL B):

DO NOT administer if Pt is receiving an ___ ___.

Supervision of ____ may be indicated, especially in the older adult because of risk of drowsiness & ____.

Withhold drug & notify physician if signs of hypersensitivity, e.g., pruritus, urticaria, rash, appear.
MAO INHIBITOR

ambulation
dizziness
TETRACYCLINE:

Effective against ___ & ___ bacteria & against most chlamydiae, mycoplasmas, rickettsiae,certain protozoa & suppresses growth of propionibacterium acnes w/in sebaceous ____, chronic bronchitis; Lyme disease; pericardial effusion.

Contraindications:
severe renal or hepatic impairment, common bile duct obstruction, lactation, during tooth development in ___ half of pregnancy, during ___ & childhood to the ___ year.
gram-positive & gram-negative
follicles

last
infancy
8th
TETRACYCLINE:

Take w/full glass of water on ___ stomach at least 1 h before or 2 h after meals. Food, milk, & milk products can reduce absorption by ___ or more.

Do not give immediately before bed.

Give w/food if Pt is having GI symptoms.

DO NOT give w/foods high in ___ such as milk or milk products.

Ask Pt if allergic to any of the "___" local anesthetics

Give Inj. deep into body of a relatively ___ muscle mass such as ___ ___ or ___ ___.

Forewarn Pt IM admin. may cause local irritation & is extremely painful.
empty
50%
calcium

caine
large
gluteus maximus or midlateral thigh
TETRACYCLINE:

Effects decreased by ____.

ORAL ANTICOAGULANTS potentiate _____.

AGENTS w/kaolin & pectin may ___ absorption.

Effectiveness of ORAL CONTRACEPTIVES ___.

Methoxyflurane may produce fatal ____.

Dairy products &__ supplements decrease absorption

Be alert to potential ____
antacids
hypoprothrombinemia
decrease
decreased
nephrotoxicity
iron
superinfection
Tetracycline:

Report onset of ___ & superinfection to physician.

Avoid ___.

Tetracycline therapy for brucellosis or spirochetal infections may cause a ___-___ reaction. Reaction usually mild & appears abruptly w/in ____ after initiation of therapy. It is manifested by malaise, fever, chills, headache, adenopathy, leukocytosis, exacerbation of skin lesions, arthralgia, transient hypotension.
Tx is symptomatic; recovery generally occurs within 24 h.

Response to acne therapy usually requires ___, maximal results may not be apparent for up to ___.
diarrhea
sunlight
Jarisch-Herxheimer
6–24 h

2–8 wk
12 wk
Dobutamine-Dobutrex:

Used for ____ shock w/ severe sytolic dysfxn & CHF

Used for ____ shock if Pt has normal cardiac output

Increases ___, ___ perfusion, & ___ excretion.
Cardiogenic
Septic
cardiac output
renal
Na+
Phenylepherine-NeoSynepherine:

Used for:
____ shock
Vaso____
Vascular failure

increases entire ___ cycle including BP, pulse, HR

**Causes ____ if infiltrated
Neurogenic
constrictor
cardiac
extravasation (necrosis)
DOPAMINE-INTROPIN:

Used for:
____ shock

pre-cursor to Epi & Nor Epi
increases HR, BP, ___ & ___ output

Use ___ ___ of anticubital fossa

Antidote: STOP

Corrects hemodynamic imbalance in shock due to MI, trauma, septic shock, & CHF
Cardiogenic
cardiac & urinary
large vein
Nitrogylcerin-Tridil:

used for ____ shock
vasodilator-coronary arteries

***Contraindicated in ___ ___

***Caution w/___ & ___
Use GLASS containers
cardiogenic
HEAD TRAUMA
hypovolemia & hypotension
Epinepherine-Adrenaline (C):
(bronkaid mist,Epi-Zen, Primatine Mist)

used for ____ shock

peripheral ____
cardiac stimulant/increase ___
increases BP & HR
may ___ diastolic pressure

constricts bronchiole ___
reduces congestion & edema

contraindicated in ___, ___, or ___ shock

CONTRAINDICATED in ages ,

Use cardiac ___ & ___ ___available

monitor every ___min
anaphylactic
vasoconstrictor
contrxn
decrease
arterioles
hemmorhagic, traumatic, or cardiogenic
<6yrs
monitor & have crash cart
3-5
Sodium-Nipride:

used in ____ shock
arterial & venous vaso____
decreases BP, HR, & CO
antihypertensive
works on ___ muscle

Contraindicated w/____

relieve adverse affects by ___ ___

protect from ___
cardiogenic
dilator
smooth
Dobutamine
slowing infusion
light
Nori Epi-Levophed:

Used for ___, ___, ___.

cardiac stimulant
peripheral vaso_____.
increases BP & MAP

ANTIDOTE:
for extravasation use ____
cardiogenic, septic, neurogenic
constrictor
phentolamine
LR:

Should not be used in Pt's w/ _____
liver failure
Fluid replacements:

Name 3.
CRYTALLOIDS:
(initial vol. replacememt)

NS & LR
no oxygen carrying capacity

COLLOIDS:
Hetactarch, Albumin, Dextran, Plasmanate
Lg moles pull fluid into tiss
No 02 carrying capacity
some risk for bleeding
watch for allergic reaction


BLOOD:
Whole or Packed
02 carrying capacity
cross match
Intropin-Dopamine

Dobutrex-Dobutamine

These are:

a) vassopressors

b) vasodilators
vassopressors
Nipride (nitroprusside)

Tridil (nitroglycerine)

These are:

a) vassopressors

b) vasodilators
vasodilators
Blocks HIV replication:

a) AZT, ZDV, Retrovir

b) Interferon
AZT, ZDV, Retrovir
Boosts the immune system:

a) AZT, ZDV, Retrovir

b) Interferon
Interferon
EVISTA-RALOIXFENE HCL:

Increases ___ ___ ___

Prevention & Tx of ____ in postmenopausal women
bone mineral density

osteoporosis
DIDRONEL-ETIDRONATE:

primary action on ___

slows ___ ___
bone

bone reabsorption
FOSAMAX-ALENDROANTE SODIUM:

minimizes loss of bone ____
density
Used for PCP pneumonia?
Bactrim
DEXTRAN:

Used for ___ ___ & shock caused by hemmorhage, burns, surgery, trauma.

Prophylaxis for ____ & ____.

Titrated to prevent pulmonary ____.
compartment syndrome
(expands plasma vol & provides fluid replacement)

thrombosis & pulmonary
embolism

congestion
ANTICHOLENERGICS-ATROVENT:

____dilator; works on neurotransmitters to decrease ____
broncho
inflammation
B ADRENERGIC ANTAGONISTS - ALBUTEROL:
(anticholenergic)

B1 for ____

B2 for ____
heart

lungs
Meds for COR PULMONALE:

Name 2
Digitalis
Diuretics
PREDNISONE:

anti-____

decreases ____
inflammatory

scaring
DRUGS for CVA:

Heparin:
SQ, IV, drip, short term

Lovenox:
low mole weight
SQ, IV, short term

Coumadin-Warfarin:
oral, long term antocoag
green leafy's affect

SIDE EFFECTS:
bleeding
caution w/___ risk activity
high
MANNITOL & LASIX:

decrease ____ pressure (ICP)
intracranial
ISOTONIC SOLUTIONS:

same [] as of solutes as plasma; restores ____ volume

NS - NaCl
5% DSW
LR - electrolytes
vascular
HYPERTONIC SOLUTIONS:

NOT for HEAD injury !!!

greater [] of solutes than plasma

draws fluid out of intracellular & interstitial spaces into vascular compartment

5% dextrose in NS
5% dextrose in NS
5% dextrose in LR
NOT for HEAD injury !!!
NOT for HEAD injury !!!
NOT for HEAD injury !!!
HYPOTONIC SOLUTIONS:

lesser [] than solutes, treats ____ dehydration

o.45% in NaCL (half NS)
0.33% in NaCL (1/3 NS)
cellular