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44 Cards in this Set
- Front
- Back
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What is the trade/brand name for digoxin?
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Lanoxin, Digitek
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What are the classifications for digoxin?
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(T) Antiarrhythmic, inotropic
(P) digitalis glycoside |
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What is the recommended dosage range for digoxin?
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Loading dose @ 4-8h intervals, then give maitenance dose
-0.063-0.5mg/d tablets (0.125-0.25mg most common) -0.35-0.5 mg/d gelcaps ******Narrow therapeutic index |
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What are the indications for digoxin?
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TX of CHF, tachyarrythmia, Atrial fib & flutter, PAT
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What are the actions & therapeutic effects of digoxin?
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Actions :increases force of myocardial contraction & prolongs refractory period of AV node
TE: Increases cardiac output & slows HR |
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What is contraindicated when using digoxin?
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uncontrolled arrhymias, AV block
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What are some interactions with digoxin?
What do you need to be cautious about? |
-Any drugs that decrease potassium may increase risk of toxicity. (thiazides, loop diuretics, penicillins)
-Beta blockers, other antiarrhythmics may increase bradycardia or risk of toxicity -St. Johns Wart decrease effect -High fiber meal may decrease absorption Be cautious in pt with electrolyte abnormalities, elderly, MI, renal impairment, pregnancy |
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What should you assess before giving digoxin?
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-Check AP for full min. If <60 adult, <70 child, <90 infant, hold dose & contact DR.
-Check labs for electrolytes (K,Mg,Ca), renal & hepatic fxn. Notify DR if abnormal -Monitor I&O, daily weights, lungs for crackles -No antacids or antidiarrheals or eat high fiber meal w/in 2h of digoxin |
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What should you teach your pt about digoxin?
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Notify HCP if abdominal pain, anorexia, N, V confusion, bradycardia, arrhythmias. (may indicate toxicity)
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What is the trade/brand name for warfarin?
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Coumadin
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What are the classifications of warfarin?
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(T) anticoagulant
(P) coumarin "blood thinner" |
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What is the recommended dosage for warfarin?
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2.5-10 mg/day x 2-4d, then adjust based on PT/INR
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What is the half-life, peak, & duration of warfarin?
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Half-life & Peak 0.5-3d
Duration 2-5d |
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What are the indications for warfarin?
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TX or prophylaxis of venous thrombosis, embolization, or pulmonary embolism.
-prosthetic valve replacement Management of MI (prevents blood clots) |
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What is the action and therapeutic effect of warfarin?
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Actions: interferes with hepatic synthesis of Vit K dependendt clotting factors
TE: reduces risk of thromboembolitic events "blood thinner" |
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What is warfarin contraindicated in?
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uncontrolled bleeding or hypertension, active ulcer disease, recent surgery, severe liver diease, pregnancy
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When should you use caution when giving warfarin?
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malignancy, hx of liver or ulcer disease, women of childbearing age
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What are some possible interations with warfarin?
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Alcohol, barbituates, hormones w/estrogen increase response to warfarin
Increased effect w/ chamomile, clove, ginger, ginko, garlic, licorice, vitamin E Decreased effect w/ ST Johns Wart |
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What should you teach your pt about warfarin?
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Narrow therapeutic index so take pills on time.
Foods w/high amounts Vitamin K will antagonize anticoagulant effect -dark green vegies, cauliflower, milk, yogurt, green tea. Must eat fairly consistent amoutn each day or PT/INR will be affected. Avoid any activities that could cause bleeding. Use soft toothbrush, no flossing, Report any s/sx of unusual bleeding. |
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What should you assess before giving warfarin?
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Check PT/INR before giving. Hold if INR >4.5
Assess for s/sx of increases bleeding |
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What are some significant side effects?
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Bleeding, fever
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What is the brand/trade name for morphine?
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MS Contin, MS, MSIR, Duramorph, Kadian. Avinza
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What are the classifications for morphine?
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(T) opiod analgesic
(P) opiod agonist |
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What is the recommended oral dose for MS Contin?
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30mg q3-4h & increase prn
(once 24h dosage is established, change to long acting form |
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What are ome indications for MS Contin?
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Tx of severe pain due to malignancy, MI, trauma, pulmonary edema
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What is the action and therapeutic effects of morphine?
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Action: Binds to opiate receptors in CNS & alters perception & response to painful stimuli, DEPRESSES CNS
TE: deceases severity of pain |
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When should caution be taken while giving MS Contin?
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In pt's with head trauma, increased intercranial pressure, severe kidney, liver, or ulmonary disease & pregnancy.
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What may interact with morphine?
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-MAO inhibitors -use extreme caution
-Increaes CNS depression with alcohol, sedatives, barbituates, tricyclic antidepressnts, antihistamines, St John Wart, Chamomile, hops - Increased anticoagulant effect of warfarin - |
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What should you asses before giving morphine?
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Asses PAIN prior to and 1 hour following oral, rectal, or injectable administration or 20 min after IV aministration.
Assess LOC, BP, P, RR before & afer administration. If RR <10-1, asses level of sedation. Assess bowel fxn. |
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What is the brand/trade name for pantoprazole?
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Protonix
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What are the classifications for Protonix?
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(T) antiulcer
(P) gastric acid pump inhibitor |
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What is the recommended dosage range for pantoprazole?
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Tx GERD 40mg daily
Gastric hypersecretory coditions 40-120mg bid |
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What th indications for pantoprazole?
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Tx of erosive esophagitis R/T GERD & decreased heartburn R/T GERD
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What is the action and therapeutic effects of Protonix?
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Action: binds to enzme in presence of acidic gasric pH, prevents final transportof final H+ ions into gastric lumen
TE: diminish acid in gstric lumen & less reflux. Healing of abdominal ulcers & esophagitis |
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What are interactions associated with Protonix?
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Increases riskof bleeding wih warfarin
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What should you assess before giving pantoprazole?
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assess for epigastric or abdominal pain, s/sx of GI bleeding.
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What the brand/trade name for furosemide?
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Lasix
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What are the classifications for Lasix?
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(T) diuretic
(P) loop diuretic |
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What is the dosage range for furosemide?
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Edema: 20-80mg/d, incr. by 20-40mg q6-8h until desired response
Up to 2g/d tx CHF or renal disease Hypertension: 40mg bid -decr. other antihypertensives by 50% whenLasix added |
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What are indications for Lasix?
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Tx of edema due to CHF, hepatic, or renal disease
Tx of hypertension Tx hypercalcemia of malignancy |
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What are the actions of furosemide?
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-Inhibits reabsorption of Na & Cl from loop of Henle & distal renal tubule
-Increase renal excretion of H2O & electrolytes |
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What are the therapetic effects of Lasix?
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Diuresis & elimination of excess fluid
Decreases BP |
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What is Lasix contraindicated in?
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electrolyte imbalance, hepatic coma, anuria
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When should you use caution with furosemide?
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in pts w/severe lliver disease, electrolyte depletion, griatric pts, diabetes mellitus, pregnancy
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