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15 Cards in this Set
- Front
- Back
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Alteplase (t-Pa)
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Tissue plasminogen activator/thrombolytic
Indications: acute MI/CVA/pulmonary emboli/acute ischemic stroke Mechanism of action: binds fibrin and converts plasminogen to plasmin which breaks fibrin, dissolving the thrombus. SE: INTRACRANIAL HEMORRHAGE/BLEEDING/ANAPHYLAXSIS, Nursing considerations:Tx for CVA w/in 3HR. of onset of symptoms Monitor blood pressure/HR/ and minimize bleeding Continuous ECG for arrhythmias [sudden reperfusion of myocardium] Advise pt to limit physical activity to ↓risk of injury/bleeding |
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Delavirdine (Rescritor)
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Nonnucleoside reverse transcriptase inhibitor (NNRTI)
Category: antiviral Indications: tx HIV infection SE: rash, liver function changes, pruritis Nursing considerations: Monitor hepatic enzymes [hepatotoxicity], BUN/serum creatnine [impaired renal function], and IV site for phlebitis/pain [d/t ↑pH of solution]. Monitor for s/s of opportunistic infections Antacids will ↓antiviral absorption [administer 1hr. before and 2hr. after]. Oral contraception may be ineffective. |
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Dexamethasone (Decadron)
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Synthetic adrenocortical steroid
Class: anti-inflammatory/diagnostic aid/immunosuppressant Indications: acute episodes/exacerbations of rheumatic disorders [RA/systemic lupus erythematosus] Mechanism of action: binds intracellular glucocorticoid receptors and suppresses inflammatory and immune response. ↓neutrophil/monocyte accumulation at site of inflammation Stabilize lysosomal membrane ↓AG response of macrophage/T cells ↓synthesis of cytokines, IL, and prostaglandins that promote inflammation. SE: problems with vision, swelling/rapid weight gain/ feeling SOB, depression, convulsive seizure, blood in sputum, hypokalemia [confusion/arrhythmias/extreme thirst/↑urination/muscle weakness], ↑BP [severe HA/blurred vision/anxiety/confusion/chest pain/SOB/seizure], n/v, insomnia, dry/thinning/bruising/discoloration of skin. Nursing implications: Give in am to correspond w/natural Cortisol secretion Avoid SQ injection [may cause atrophy & sterile abscess] Do not stop abruptly; taper. Prolonged use may cause adrenal suppression Monitor I/O and daily weight. Assess for crackles/dyspnea/peripheral edema/steady weight gain Monitor hematology |
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Disulfiram (Antabuse)
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Alcohol abuse tx
Indications: adjunct for chronic alcoholism Mechanism of action:↓hepatic oxidation of acetaldehyde to acetate (EtOH catabolism) SE: HEPATIC TOXICITY/drowsiness/HA/peripheral neuropathy/psychotic rx/garlic or metallic taste/optic atrophy/rash Nursing implications: Only for pt that are highly motivated Check pt EtOH levels Don’t give w/in 14 days of alcohol ingestion EtOH ingestion >500mg/day may cause respiratory depression/arrhythmias/cardiac arrest |
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Etanercept (Enbrel)
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Tumor necrosis factor receptor
Disease modifying antirheumatoid (DMARD) Indications: To slow disease progression of RA Mechanism of action: soluble TNF receptor binds circulating TNF before it binds cell surface SE: INFECTION/HA/rhinitis/upper resp. tract infection/site rx Nursing considerations: Avoid live virus vaccines [↓immune response/↑2dary transmission] Monitor immunosuppression for acute infection |
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Mannitol (Osmitrol)
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Diuretic/osmotic
Indications: ↓intracranial/intraocular pressure Mechanism of action: ↑plasma osmolality causing water to flow from tissues [brain/eyes/CNS] into extracellular fluid = ↓in pressure SE: transient volume expansion/ chills/dizziness/fever/HA/seizures/HTN/↑HR/n/v/diarrhea/urinary retention/dehydration/hyper-kalemia/natremia/volemia/metabolic acidosis Nursing indications: Monitor VS, central NS pressure, fluid I/O q1hr, monitor BUN/creatnine/electrolyte levels Mouth care for dry mouth |
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Methadone (Methadose)
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Opiate agonist
Indications: management of narcotic detoxification Mechanism of action: binds/activates opioid receptors in spinal cord/high levels of CNS to produce feelings of analgesia/euphoric effects SE: confusion/sedation/hypotension/constipation Nursing considerations: Assess current drug use [prescription/illicit/OTC] Monitor for excessive drowsiness/unsteadiness/confusion. Monitor cardiopulmonary status [frequent tx can cause resp. /circ. depression, cardiac/resp. arrest/shock/hypotension Monitor for tolerance |
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Methotrexate (Trexall)
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Antirheumatic (DMARDs)
Indications: rapid anti-inflammatory to ↓clinical symptoms of RA Mechanism of action: ↓folic acid metabolism↓immunosuppressive effects by ↓replication/function of T cells. SE: anorexia/hepatoxicity/n/v/anemia/leukopenia/thrombocytopenia/nephropathy/APLASTIC ANEMIA Nursing implications: Monitor CBC/chemistry panel/liver function test Encourage 2-3L of fluid intake daily Report to PCP if bruising/chills/cough/fever/dark or bloody urine/SOB/mouth sores/or jaundice eyes occur Tell female pt that pregnancy is contraindicated [harmful to fetus] Report WBC counts <5000/mm3 [SE: leucopenia] |
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Naltrexone (reVia)
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Opioid antagonist
Indications: to tx opioid dependence, EtOH craving/dependence Mechanism of action: displaces/blocks opioid agonists from binding receptors; reverses euphoric effect of endogenous opioids [↓EtOH craving] SE: nausea and hepatotoxicity Nursing implications: To avoid withdrawal symptoms wait 7-10days after last dose Give w/food or antacids to ↓GI rx Some pt may require tx up to 1yr. |
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Phenytoin (Dilantin)
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Anticonvulsant
Indications: to tx tonic-clonic/simple/or complex partial seizures in pt with no prior tx Mechanism of action: ↓spread of seizure activity; ↓ start of new seizures by regulating voltage dependent Na+ and Ca++ channels SE: ataxia/diplopia/nystagmus/hypotension/nausea/rash/AGRANULCYTOSIS/APLASTIC ANEMIA/STEVENS-JOHNSONS SYNDROME Nursing Implications: Assess for hypersensitivity syndrome [fever/skin rash/lemphadenopathy] Monitor cardiopulmonary, CBC/serum Ca++/albumin/hepatic function tests |
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Prednisone (Deltasone)
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Systemic short acting corticosteroids
Indications: anti-inflammatory/autoimmune Mechanism of action: ↓inflammation and modify normal immune response SE: depression/euphoria/HTN/anorexia/nausea/↓wound healing/muscle wasting/PEPTIC ULCERATON/THROMBOEMBOLI Nursing implications: Monitor C-reactive protein for changes in inflammation Monitor I/O, daily weight. Observe for peripheral edema. |
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Saquinavir (Invirase)
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Protease inhibitor/antiretroviral
Indications: ART-HIV Mechanism of action: ↓HIV protease and prevents viral polyproten in cleavage [↑CD4+ ↓viral load] SE: SEIZURES/STEVENS-JOHNSONS SYNDROME/abd discomfort/diarrhea/↑liver enzymes/jaundice/nausea Nursing implications: Assess for infection Monitor CD4+ and viral load May cause hyperglycemia Take w/in 2hr of a meal [↓food =↓blood concentrations = no antiviral activity] |
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Sulfasalazine (Azulfidine)
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DMARDs
Indications: tx for RA pt unresponsive/intolerant to salicylates/NSAIDs Mechanism of action: ↓prostaglandin synthesis = ↓inflammation SE: HA/anorexia/diarrhea/n/v/fever/SERUM -SICKNESS/STEVENS-JOHNSONS SYNDROME/APLASTIC ANEMIA/AGRRANULOCYTOSIS Nursing implications: Take w/food+water May cause dizziness w/driving Notify HCP if skin rash/sore throat/fever/mouth sores/unusual bleeding, bruising, wheezing, hives, acute abd pain, cramping, bloody diarrhea, photosensitivity, orange-yellow urine occur |
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Valproate (Depakote)
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Anticonvulsant
Indications: tx for simple-complex/complex partial/absent seizures Mechanism of action: ↑GABA and ↓ of seizure activity SE: agitation/dizziness/HA/insomnia/sedation/visual disturbance/anorexia/diarrhea/indigestion/n/v/tremor/HEPATOTOXICITY/PANCREATITIS/HYPERAMMONEMIA Nursing implications: Take w/food Notify HCP if anorexia, abd pain, sever n/v, jaundice eye/skin, fever, sore throat, malaise, weakness, facial edema, lethargy, unusual bleeding/bruising, pregnancy. Monitor hepatic function [LDH/AST/ALT/bili], serum NH3+ |
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Zidovudine (AZT)
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Nucleoside reverse transcriptase inhibitor/antiretroviral
Indications: HIV/↓maternal-fetal transmission Mechanism of action: ↓viral RNA synthesis by ↓DNA polymerase /prevents viral replication SE: HA/weakness/abd pain/diarrhea/nausea/anemia/granulocytopenia/SEIZURE Nursing implications: Assess for infection Monitor viral load and CD4+ |
