Reading...
Play button
Play button
Use LEFT and RIGHT arrow keys to navigate between flashcards;
Use UP and DOWN arrow keys to flip the card;
H to show hint;
A reads text to speech;
109 Cards in this Set
- Front
- Back
|
Morphine Classification
|
Opioid (narcotics)
Analgesic Schedule II – high abuse potential |
|
|
Morphine Drug Interactions
|
Increased CNS depression when given with other CNS depressants
Note: Two weeks between MAO inhibitors and opiods |
|
|
Morphine Nursing Implications
|
Indication: relief of moderate to severe pain
ADE: CNS depressant, slows GI motility, sedation Monitor: Pain level, Resp rate (hold for RR < 8), BP (hypotension), Bowel sounds, sedation, euphoria Nsg care: C&DB q 2hr, prevent constipation, safety issues |
|
|
Morphine Route and Dose
|
PO: 10-30 mg q4hr
IM/SC: 5-20 mg q 4hr IV: 2.5-15mg q 4hr PCA: 0.01-0.04 mg/kg/hr NOTE: Morphine is a non-ceiling drug |
|
|
Demerol Classification
|
Opioid (narcotics)
Analgesic Schedule II – high abuse potential |
|
|
Demerol Interactions
|
Increased CNS depression when given with other CNS depressants
Note: Two weeks between MAO inhibitors and opioids |
|
|
Demerol Nursing Implications
|
Indication: relief of moderate to severe pain
ADE: CNS depressant, slows GI motility, sedation Monitor: Pain level, Resp rate (hold for RR < 8), BP (hypotension), Bowel sounds, sedation, euphoria Nsg care: C&DB q 2hr, prevent constipation, safety issues |
|
|
Demerol Route and Dose
|
IM/SC/PO/slow IV: 50-150 mg q3-4hr
|
|
|
Narcan Classification
|
Opioid Antagonist
(Opioid antidote) |
|
|
Narcan Interactions
|
No action if no opioids
|
|
|
Narcan Implication
|
Indication: Opioid overdose
ADE: Instant withdraw if pt is addicted to opioids Monitor: Narcan has a shorter duration of action than most opioids so dose may need to be repeated so monitor RR, LOC, and BP Nsg care: watch for s&s of withdrawal in the opioid dependent pat |
|
|
Narcan Route and Dose
|
IV/IM/SC/ET 0.4-2mg, repeat q2-3hrs PRN
|
|
|
Asprin Classification
|
NSAID
|
|
|
Asprin Interaction
|
Oral anticoagulants, aminoglycosides, ACE inhibitors, beta blockers, digoxin, Dilantin, steroids, and others
|
|
|
Asprin Implications
|
ndications: relief of mild to moderate pain
ADE: bleeding, gastric ulcers, N/D, pedal edema Monitor: pain level, S&S of bleeding, CBC, PT, platelet count, bronchospasm in pts with NSAID hypersensitivity or asthma. Nsg Care: give with meals or antacids, assess for bleeding, not for children < 12 |
|
|
Asprin Dose and Route
|
For pain relief PO: PO/PR 325-650mg q4-6hr PRN
For TIA or MI prophylaxis PO: 81-325mg q day |
|
|
Ibuprofen Classification
|
NSAID
|
|
|
Ibuprofen Interaction
|
Oral anticoagulants, aminoglycosides, ACE inhibitors, beta blockers, digoxin, Dilantin, steroids, and others
|
|
|
Ibuprofen Implications
|
Indications: relief of mild to moderate pain
ADE: bleeding, gastric ulcers, N/D, pedal edema Monitor: pain level, S&S of bleeding, CBC, PT, platelet count, bronchospasm in pts with NSAID hypersensitivity or asthma. Nsg Care: give with meals or antacids, assess for bleeding |
|
|
Ibuprofen Route and Dose
|
PO: 200-800 mg 4 times a day
|
|
|
Epinephrine Classification
|
Adrenergic (stimulates SNS alpha and beta 1&2)
AKA sympathomemetic or catecholamine or Inotrope |
|
|
Epinephrine Interaction
|
Phenothiazines
|
|
|
Epinephrine Implication
|
Indications: + inotropic, + chronotropic, bronchodilation so used to treat bradycardia, hypotension, bronchoconstriction, cardiac arrest
ADE: tachycardia, arrhythmias, hypertension, peripheral vasoconstriction, hyperglycemia, angina Monitor: ECG, HR, BP, blood sugar, breath sounds Nsg Care: titrate to keep HR and BP WNL |
|
|
Epinephrine Route and Dose
|
Cardiac arrest: IV 0.5-1mg q 3-5 min
Asthma/Anaphylaxis: SC 0.1-0.5 mg or IV 0.1-0.25 mg IV prep: 1 mg in 250 mL D5W or NS |
|
|
Beta Blockers:
Prototype: Propranolol (Inderal) Classification |
Beta adrenergic blocker (block the action of the SNS)
AKA antidysrhythmic, Antianginal, antihypertensive |
|
|
Propranolol Interactions
|
none
|
|
|
Propranolol Implication
|
Indications: treats HTN, angina, Migraines, some tachyarrhythmia,
ADE: postural hypotension, bradycardia, fatigue, bronchoconstriction – avoid use w/ asthma & COPD, avoid abrupt withdrawal, masks symptoms of hypoglycemia Monitor: BP, HR, breath sounds, chest pain Nsg Care: change position slowly, hold if systolic < 90 or HR (apical) is < 50. |
|
|
Propranolol Route and Dose
|
PO or IV dose determined by the individual drug and what is being treated
|
|
|
Digoxin Classification
|
Cardiac glycoside
AKA Antidysrhythmic, Inotrope |
|
|
Digoxin Interactions
|
Multiple Drugs!!
|
|
|
Digoxin Implication
|
Indications: heart failure, atrial fib & flutter
ADE: bradycardia, n/v, visual disturbances: diplopia, “halos” Monitor: HR, serum K & Ca level, dig level (therapeutic is 0.5-2.0) Nsg Care: hold if apical HR < 60 bpm, Hold 24-48 hr prior to cardioversion, excreted almost entirely unchanged by the kidney |
|
|
Digoxin Route and Dose
|
Loading dose: 0.75mg divided into 3 doses given over a24 hr. period.
Maintenance: PO/IV 0.125-0.5mg If IV give slowly over 5 minutes, dilute with 4 fold or > D5W or NS |
|
|
Catapres Classification
|
Antihypertensive
|
|
|
Catapres Interactions
|
none
|
|
|
Catapres Implications
|
Indications: HTN
ADE: hypotension, dry mouth, drowsiness Monitor: Nsg Care: Do not stop suddenly |
|
|
Ctapres Route and Dose
|
PO 0.1-0.3 mg BID
SL 0.2-.4 mg BID Ext Rel 0.17 mg PO q HS Transdermal 100mcg, change q wk |
|
|
Nitroglycerine Classification
PO IV: Tridil SL: NitroStat Transdermal (patch): Nitro-Dur |
Nitrates
Antianginal |
|
|
Nitroglycerine Interactions
|
W/in last 24 hrs if sildenafil (Viagra) was taken → hypotension
|
|
|
Nitroglycerine Implications
|
Indications: Angina
ADE: headache, hypotension, tachycardia, flushing, dizziness, N/V Monitor: ECG, HR, BP, chest pain Nsg Care: Assess chest pain |
|
|
Nitroglycerine Dose and Route
|
PO 2.5-9mg q 8-12 hr
IV: 50 mg in 250 mL D5W or NS, give 3mL/hr (10mcg/min) SL: 0.3-0.6 mg q 5 min Patch: 1 patch q day, remove at night. |
|
|
Lasix Classification
(furosemide) |
Loop diuretic
|
|
|
Lasix Interactions
|
none
|
|
|
Lasix Implication
|
Indications: Edema, HTN, acute pul edema, CHF
ADE: hypokalemia, FVD Monitor: serum K, I&O, daily wt Nsg Care: give in the morning, assess breath sounds, urine output, increase K in diet or by supplement |
|
|
Lasix Rose and Dosage
|
PO 20-320 mg q day or BID
IV 20-40mg over 1-2 minutes |
|
|
Heparin Classification
|
Anticoagulant
(Best at preventing venous clot formation) |
|
|
Heparin Interactions
|
Oral anticoagulants, NSAIDs, ASA increase risk of bleeding.
Multiple drug incompatibilities IV or in the syringe. |
|
|
Heparin Implications
|
Indications: prophylaxis & tx of venous thrombus, Pul emboli
ADE: bleeding, thrombocytopenia Monitor: S&S of bleeding, platelet count, Nsg Care: Antidote is Protamine, safety: “U” must be written out “units” |
|
|
Heparin Route and Dosage
|
IV: loading dose IV bolus 5000 unit s
IV drip: 25,000 units in 500 mL D5W, adjust rate to keep aPTT in therapeutic range (38-70 sec) of 1.5-2.5x norm (25-35 sec) SC: 2500-10,000 units q 12 hr. (prophylactic low dose SC may not need to check aPTT) |
|
|
Coumadin (warfarin) classification
|
Oral Anticoagulant
(Best at preventing venous clot formation) |
|
|
Coumadin interactions
|
Diet hi in Vit K decreases effect
Multiple drug interactions |
|
|
Coumadin implications
|
Indications: prevention in hi risk for or hx of DVT, pul emboli, atrial fib, mechanical heart valve replacement
ADE: bleeding Monitor: PT/INR Nsg Care: Antidote is Vit K, INR/or PT must be regularly checked |
|
|
Coumadin route and dosage
|
PO 2-15 mg based on PT or INR(best!)
(INR therapeutic level 2.0-3.0) PT: norm -12-13 sec, therapeutic 1.5-2x norm = 18 -26 sec) |
|
|
Fragmin (dalteparin) Classification
|
Anticoagulant
Low-molecular-weight heparin (Best at preventing venous clots) |
|
|
Fragmin Interaction
|
none
|
|
|
Fragmin Implications
|
Indications: prevention of DVT
ADE: thrombocytopenia Monitor: does not require monitoring of aPTT Nsg Care: |
|
|
Fragmin Dosage and Route
|
SC: 2500-5000 IU qd
|
|
|
Aminophylline Classification
|
Methylxanthines
Bronchodilator |
|
|
Aminophylline Interactions
|
none
|
|
|
Aminophylline Implications
|
Indications: asthma, chronic bronchitis, emphysema
ADE: tachycardia, N, CNS excitement, insomnia, tremor, seizures Monitor: therapeutic levels: 10-20 mg/L Nsg Care: HR, breath sounds, O2 sat, color, RR, use of accessory muscles, push fluids |
|
|
Aminophylline Route and Dosage
|
IV/PO: Load 6-7 mg/kg
Maintenance: IV 0.4-0.6 mg/kg/hr. PO 3.125mg/kg q6 |
|
|
Aminoglycosides Classification
gentamycin sulfate |
Antibiotic
(Bactericidal) |
|
|
Gentamycin Sulfate Interactions
|
Do not mix with PCN, give 2 hrs. apart
|
|
|
Gentamycin Sulfate Implications
|
Indications: gram-negative bacilli infections, Kanamycin & Neomycin given PO as part of pre-op bowel prep
ADE: ototoxicity (damage to 8th CN), nephrotoxicity Monitor: peak (4-12 mg/L), trough (1-2 mg/L), renal & auditory function Nsg Care: check C&S, assess hearing, tinnitus; BUN & Creatine, urine output |
|
|
Gentamycin Sulfate Route and Dosage
|
IV: 3-6 mg/kg/day ÷ q 8 hr.
Dose often based on lean body weight and serum Creatine Mix dose in 50-200 mL NS or D5W, infuse over ½-2 hrs. |
|
|
Septra Classification
Trimethoprim/ Sulfamethoxazole |
Antibiotic
(Bacteriostatic) Sulfonamide |
|
|
Septra Interactions
|
Not in late pregnancy, infants < 2 months, lactating mothers → kernicterus
|
|
|
Septra Implications
|
Indications: UTI
ADE: crystalluria, stone formation Monitor: Nsg Care: BS as hypoglycemic meds can decrease BS |
|
|
Septra Dosage and Route
|
PO: 160 mg BID
|
|
|
Prednisone Classification
|
Corticosteroid
|
|
|
Prednisone Interactions
|
Contraindicated in pts w/ systemic fungal infection or TB
|
|
|
Prednisone Implications
|
Indications: treat Allergic rx, anti-inflammatory, immune suppressive
ADE: HTN, gastric ulcers, Cushing’s, DM, delayed wound healing, osteoporosis, mood swings Monitor: BP, S&S of infection, Bl sugar, Nsg Care: pt education |
|
|
Prednisone Route and Dosage
|
PO 5-60 mg/day div BID-QID, decreasing the dose each day
|
|
|
Xanax Classification
|
Benzodiazepine
Anxiolytic CNS depressant |
|
|
Xanax Interactions
|
none
|
|
|
Xanax implications
|
Indications: anxiety, panic disorder
ADE: sedation, resp depression, Monitor: Nsg Care: Antidote: Romazicon, slowly taper to discount long term use |
|
|
Xanax dosage and route
|
PO: 0.25-2 mg TID/QID
|
|
|
Dilantin Classification
(phenytoin) Schedule IV |
anti seizure
|
|
|
Dilantin Interactions
|
Do not mix w/ D5NS, D5W, LR, 1/2NS
|
|
|
Dilantin Implications
|
Indications: seizures – tx or prevention, status epilepticus,
ADE: gingival hyperplasia, drowsiness, fatigue, Monitor: dental check q 3-6 months Nsg Care: pt ed to not stop meds |
|
|
Dilantin Dosage and Route
|
IV: slowly, no more than 50 mg/min
IV loading: 10-15 mg/kg at 25-50 mg/min, then 100 mg IV/PO q6-8 hr. Only mix w/ NS PO 100mg BID-QUID |
|
|
Phenothiazine Classification
Prototype: Thorazine (chloropromazine) |
Antipsychotic
“Typical” or 1st generation Also antiemetic |
|
|
Phenothiazine Interactions
|
CNS depressant, avoid concomitant use of other CNS depressants
|
|
|
Phenothiazine Implications
|
Indications: psychosis, N/V (Compazine), intractable hiccoughs
ADE: CNS depressant, sedation, extrapyramidal effects, postural hypotension, leucopenia, avoid skin contact w/ liquid – an irritant. Monitor: WBC, safety 2nd to sedation, BP Nsg Care: Can be a chemical restraint – if so, need an order. |
|
|
Phenothiazine Route and Dosage
|
PO 200-800 mg/d
Best given before bed IM: 25-50mg |
|
|
Cytoxan (cyclophosphamide) Classification
|
Antineoplastic
(Alkylating agent) Works by interfering with DNA replication |
|
|
Cytoxan Interactions
|
+ Aminoglycoside = kidney toxicity
+ Furosemide = ototoxicity |
|
|
Cytoxan Implications
|
Indications: treats cancer, chemotherapy
ADE: N/V, alopecia, bone marrow suppression, GI toxicity, hemorrhagic cystitis Monitor: CBC, platelets, K, I&O, renal function, & hearing or tinnitus Nsg care: hydration, prevent hypokalemia, give antiemetic. Follow hospital guidelines . |
|
|
Cytoxan Dosage and Route
|
IV: 40-50 mg/kg in ÷ doses
PO 1-5 mg/kg |
|
|
Rapid Insulin
|
Humalog
|
|
|
Humalog onset
|
10-15 min
|
|
|
Peak and Duration of Humalog
|
1h peak
3h duration |
|
|
Indication of Humalog
|
rapid reduction of BS
|
|
|
Short Action Insulin
|
Regular R
|
|
|
Regular R insulin onset
|
1/2-1 hour
|
|
|
Regular R Insulin peak and duration
|
peak 2-3 hours
duration 4-6 hours |
|
|
Regular R insulin indication
|
20-30 min ac
|
|
|
Intermediate acting insulin
|
NPH
Humulin N Lente Humulin L |
|
|
Intermediate acting Insulin onset
|
3-4 hours
|
|
|
Intermediate acting Insulin peak and duration
|
4-12 peak
16-20 duration |
|
|
Intermediate acting insulin implication
|
give pc
|
|
|
Long acting insulin
|
Ultralente
|
|
|
Long acting insulin onset
|
6-8 hours
|
|
|
Long acting insulin peak and duration
|
peak 12-16 h
duration 20-30 |
|
|
Long acting insulin implications
Cloudy |
control FPG
|
|
|
Long Acting Clear
|
glargine (lantus)
|
|
|
glargine onset
|
1h
|
|
|
glargine peak and duration
|
no peak
24 hour duration |
|
|
glargine implication
|
do not mix with other insulin
|
|
|
general rules about insulin
|
– 70/30 Insulin: 70% NPH & 30% Regular
– Rapid & short acting Insulin cover meals immediately AFTER the injection – Intermediate acting Insulin is expected to cover subsequent meals – Long acting Insulin provides a relatively constant level of Insulin and act as a basal Insulin – Only Regular Insulin is given IV – Rotate sites – When mixing Insulins withdraw Regular and then the NPH. The rule is:“clear to cloudy” |
