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121 Cards in this Set
- Front
- Back
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what are cardiac glycosides
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antirhythmics, inotropics - increases the focre of myocardial contraction by ncreasing the strength of the contraction and slowing the conduction or velocity. Prolongs refractory period of the AV node. Decreases conduction through the SA and AV nodes. Increases cardiac output and slows the heart.
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name a cardiac glycoside
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digoxin (Lanoxin)
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What are s/s of digoxin
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hyper or hypokalemia, fatigue, bradycardia, arrhythmia, nausea and vomiting
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what are nurisng considerations for digoxin
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monitor apical pulse. do not administer digoxin if HR is below 60.
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What is the inotropic, chronotropic and dromotropic action of digoxin
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+ ino
- chrono - dromo |
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what is the therapeutic serum level for digoxin
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0.5 - 2 ng/mL. it has a 36 hr half life, takes 7 days for digitalization and is excreted by the kidnys unchanged
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what are fibric acids
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lipid-lowering agents. Primarily inhibits triglyceride synthesis. lowers cholesterol and triglycerides with subsequent decreased risk of pancreatitis. Peripheral lipolysis inhibiting
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what are the s/s of fibric acids such as fenofibrate (Tricor)
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dyspepsia, gallstones, myopathy, unexplained non-CHD deaths, fatigue and weakness, rash
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what are statins for
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HMG-CO-A reductase inhibitors/mortality significanty reduced when combined with aspirin and beta blockers or ACE.
Lipid lowering agent. Inhibits an enzyme which is responsible for catalyzing an early steop in the synthesis of cholesterol. They lower the total and LDL cholesteral and tris while slightly ncreaseing HDL. Slows progression of atherosclerosis with resultant decrease in CHD - related events |
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what are the s/s of statisn
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myopathy, increased liver enzyme levels, abdominal cramps, constipation, diarrhea, flatus, heartburn, rashes
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what are some stain durgs
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lovastatin (1st agent in the class)
prevastatin simvastatin fluvastatin atorvastatin calcium rosuvastatin (increased risk of myopathy and rhabdomyolsis) |
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what is digitalization -
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saturation of the body tissues w/enough digoxin to improve s/s of heart failure or atrial fibrillation
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Toxicity of digitalization
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> 3 gn/ml
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what are diuretics
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reduce the increase in blood volume and edema
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what are ACE inhibitors
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prescribed for left-ventricular systolic dysfunction
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what are ARBs
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angiotensis II blockers, used for left ventricular systolic dysfunction. They decrease peripheral vascular resistance (afterload) pulmonary cpillary wedge pressure (preload), pulmonary vascular resistance and secretion of aldosterone
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what are vasodilators (nitrates)
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they pool blood in the extremities and so reduce blood return or preload, as well as arterial vasodilators that decresase arterial resistance and reduce afterload
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what are antagonist of aldosterone
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spironolactore - k+ sparing diuretic. also effective in HF mangement
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What is prednisone
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oral glucocorticoid acting as antiinflammatory agent reducing edema of the airway
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is prednisone a quick relief or slow acting mediation
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quick relief and intermediate ating.
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What are nicotinic acid derivatives
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lipid lowering agents/required as coenzymes for lipid metabolism, glycogenolysis and tissue respiration. Derease Blood lipids.
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what does niacin do in regards to fatty acids
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niacin, a nicotinic acid derivative, inhibits lipolysis in adipose tissue. It inhibits the freeing of fatty acids
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what are nitrates
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antianginals - vasodilators, reduces preload
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name some nitrates
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nitroglycerin
isosorbide dinirate |
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what are nitrates used for
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acute treatment of angina attacks (can be used prophylactically 5-10 min before activities that may precipitate an acute attack
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what are s/s of nitrates
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Headache, dizziness, hypotension, tachycardia
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what are bile acid sequestrants
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lipid-lowering agents. binds bile acids in the GI tract, forming an insoluble complex. result is increased clearance of cholesterol. decreases plasma cholesterol and LDL
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what is the name of a bile aid sequestrant
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cholestramien (Questran)
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what ar the s/s of bile acid sequestrants
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GI distress, constipation , drecreased absorption of other durgs, ABD discomfort, constipation , nausea, headache
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what is an antitumor antibotic
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nonspecific cell cycle antineoplastic agent. It interferes with DNA synthesis by binding DNA, preventing RNA synthsis
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What antitumor antibiotic can have cardiac toxicity and what is the antidote
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Doxorubican (cumulative lifetime dose limit of 550) and daunrubicin (600mg dose limit)
Dextazoxane |
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What antitumor antibiotic can hurt lung function with too high of a dose
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bleomycin
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unique about doxorubican or daunrubican
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cardiac toxicity
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unique about bleomycin
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lung function
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what are nonspecific cell cyle antineoplastic agents
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antitumor antibiotics
Nitrosureas alkylating agents |
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what are nitrosureas
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nonspecific cell cycle antineoplastic agent
similar to alkylating agents, but CROSSES THE BLOOD-BRAIN BARRIER |
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name some nitrosureas
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carmustine (lung toxicity-pulmonary fibrosis)
lomustine semustine streptozocin |
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which antineoplastic agent crosses the blood-brain barrier
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nitrosureas
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what are topoisomerase I inhibitors
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the are S Phase cycle specific antineoplastic agents - prevents cells from dividing by making breaks in the DNA
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name a topoisomerase I inhibitor
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irinotecan
topotecan |
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what type of toxicity can happen with a topoisomerase I inhibitor
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hepatotoxicity
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what are alkylating agents
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nonspecific antineoplastic agents alter DNA
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name some alkylating agents
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ciplatin (renal toxicity, hearing loss)
cyclophosphamide -hemorrhagic cystitis ifosfamide - bladder toxicity |
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what is Mesna used for
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to reduce risk of bladder toxicity for ifosfamide
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what is Ethylo - amifostine, used for
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reduce renal toxicity with cisplatin.
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important nursing consideration with cisplatin for the patient before therapy
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aggresive prhydration of IV fluids (1-2 liters)
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are alkylating agents vesicant
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cisplatin, nitrogen mustard are
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what are antimetbolites
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s phase antineoplastic agents, interfere with biosynthesis of metabolites or nucleic acids necessary for RNA and DNA synthesis
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name a antimetbolite that has renal toxicity
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methotrexate
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Name 2 S sepcific cell cycle antineoplastic agent classifications
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antimetbolites - methotrexate, 5-azacytadine, 5-fluorouracil, capecitabine, cytarabine, edatrexate fludarabine, hydroxyurea
topoisomerase I inhibitors - irinotecan, topotecan |
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What antineoplastic agent is cell cyle specific M phase
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mitotic spindle poisons
- Plant alkaloids |
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what is a mitotic spindle poision
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M phase specific antineoplastic agent that arrests metaphase by inhibiting mitotic tubular formation. Plant Alkaloids
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name some Plant alkalodis (mitotic spindle poisons)
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VinCRistine, vinblastine
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what is unique about Vincristine
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exhibits a dose limiting Neurotoxicity.
vesicant |
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what is eopetin (Epogen)
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antianemic - stimulates erythropoiesis RBCs
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what is a side effect of epogen
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besides seizures and hypertension, High doses of epogen may cause bone pain
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what is coumadin
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warfarin - anticoagulant. helps inhibit blood clots. prophylaxis. PO. hard to control. long term. PT INR, no grapefruit juice, Vit K
Pt > 13 or INR . 30 means you are taking too long to form a clot |
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what is cyclophophamide (Cytoxan) used for
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cancer, CLL, Thrombocytopenia
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what is filgrastim
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filgrastim or Neupogen is conolony stimulating fatoc - stimulates immature neurtrophils to divide and differentiate. used after bone marrow transplant.
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what is heparin
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anticoagulant, prophylaxis for new blood clots. protamine sulfate is antidose, stops DIC and production of platelets. aPTT
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what is HIT or HAT
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Heparin induced thrombocytopenia. may develop on 8th day. May reduce platelet count to 5000 mm3,
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what is enoxaprin (Lovenox)
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low molecular weight heparin
Anticoagulant - prevention of DVT |
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what is ibuporphen
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NSAID, inhibits prostaglandin synthesis. reduction of pain, inflammation, and fever
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what are side efffects of ibuprophen and its limit
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bleeping
3600 max /day |
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what is azathioprine Muran
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immunesuppressant - anatgoize purine metabolism - inhibits DNA/RNA synthesis
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what is azathiporine used for
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suppresses T and B cell production
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What is vit B9 - folic acid used for in hematology
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reslution of symptoms of Megaloblastic anemia
Deficiency results in a macrocytic anemia, and elevated levels of homocysteine. Deficiency in pregnant women can lead to birth defects. Supplementation is often recommended during pregnancy. Researchers have shown that folic acid might also slow the insidious effects of age on the brain. |
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what is vit B12 - cobalamin
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Deficiency results in a macrocytic anemia, elevated homocysteine, peripheral neuropathy, memory loss and other cognitive deficits. It is most likely to occur among elderly people, as absorption through the gut declines with age; the autoimmune disease pernicious anemia is another common cause. It can also cause symptoms of mania and psychosis. In rare extreme cases, paralysis can result.
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what is arginie used for
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Used in patients w/sickle cell disease. antisickling properties enhancing the availability of nitric oxide (vasodilator) resulting in decreased pulmonary artery pressure. Arginine is a synergistic with hydroxyurea and can be useful as combination therapy for managing pulmonary hypertension
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hydroxyurea (Hydrea)
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antineoplastic - therapeutic effecdt - death of rapidly replicating cells particulary malignant ones. decreased frequency of painful crisisand decreased need for transfusions in sickle cell anemia
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for sickle cell anemia crisis, how much Hydrea is usually prescribed
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around 2 g / day.
most take only 500mg - makes them feel sick, weak |
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If hydroxyurea is given for Leukemia, what is a good nurisng consideration -
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Encourage fluid intake of 2-3 L/day to flush through liver and kidneys
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what is dexamethasone (Decadron) used for
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antiasthmatic corticosteroid - suppresses inflammation
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What is zafirlukast (Accolate)
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leukotriene inhibitor
used for long term control |
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What is theophylline and aminophylline
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xanthines
a bronchodilator |
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What is an important nursing consideration with theophylline or aminophylline
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drink 2L+ day, minimize intake of other xanthines (caffine) monitor theophylline serum levels (Therapeutic 10-15-asthma)
Do not administer with B2 adrenergic agonists. |
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what is Zyflo
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broncodilator Beta 2 agonist
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what is salmeterol (servent diskus)
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bronchodilator adrenergic - Long term control Long acting in maintenace treatment of COPD. Not for acute asthma attacks.
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what is ipratopriumbromide (Atrovent)
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anticholinergic-
quick relief medication inhalant benefit in severe exacerbations of asthma - COPD |
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what is a quick relief anticholinergic medication
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atrovent - ipratopriumbromide
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what is alupent
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metaproter (Alupent) - a broncodilator Beta2 agonist.
Short term control agent. Inhibits release of mediators from mast cells short acting |
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what is albuterol
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broncodilator beta2 agonist.
short term control agent - inhibits release of mediatrs from mast cells Onset 5-15 min |
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what are proventil, ventolin, volmax - are the long acting or short
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they are beta 2 agonists albuterol.
short acting |
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what are some s/s of beta 2 agonists
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nervousness, restlessness, tremors, palpitations.
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what inhaler should be used first if using others also
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albuterol. Allow 5 min to elapse before administering other inhalant meds unless otherwise directed.
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what is monelukast
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Singular - leukotriene antagonist - prevents broncho constriction.
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If a pt can't have inhaled corticosteroids for mild persistent asthma - what is a good alternative
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Singular - montelukast
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what is Solu-Medrol - methyiprednisolone
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Intermediate acting corticosteroid - suppresses inflammation
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Is solu-Medrol a long acting short acting or intermediate acting medication
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intermediate acting
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Advair is a combination of what
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salmeterol and fluticasone.
a corticosteroid and a beta 2 |
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what is a common side effect of advair?
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headache
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What pt is isoniazid contrindicated in?
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hypersensitivity or acute liver disease, use caution in chronic liver diseases, alcoholism or renal impairment. Those taking niacin.
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Why is Pyridoxine prescribed with isoniazid?
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To reduce the risk of neurotoxicity.
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How is isoniazid taken in regards to meals?
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1-hrs, before or 2 after meal and before antacids
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Rifampin in hibits the bacterial RNA synthesis but has several side effects. Name some.
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hypersensitivity, fever, chills, shivering, ehadache, Red-orage colored secretions, vision changes, hepatotoxicity, increased uric acid levels,
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What are second line drugs for TB
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capreomycin, ethionamide,para-aminoslicylate sodium and cycloserine
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How long are 1st line medications taken for?
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8 weeks.
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Which 1st line medication may be stopped first after 8 weeks?
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Pyrazinamide.
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If cultures indicate sensitivity, to mediations which 1st line med can be stopped?
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Streptomycin or Ethambutol.
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Which medications are continued for the full 6 months
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INH and Rifampin
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Due to neruopathy of INH, which vitamin can be given?
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Vit B
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meds - unique effects
INH - neuropathy rifampin - Pyrazinamide - Streptomycin - Ethambutol - |
INH - neuropathy
rifampin - reddish brown fluids Pyrazinamide - gout, purines monitored Streptomycin - ototoxicity, nephrotoxicity, neurotoxicity - monitor peaks/troughs Ethambutol - Visual acity red/green |
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hormonal agents used in antineoplastic agent capacity - what cell cyle is it used in?
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non specific cell cycle
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how do hormonal agents work as antineoplastic agents
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bind to hormone receptor sites that alter cellular growth. suppress aromatase of P450 system. decreasing estrogen level.
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what type of cancers are hormonal agents used in
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used in a number of cancers, but most often used in cancers with receptors for estrogens or adrogens
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s/s of hormonal agents
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hypercalcemia, jaundice increased appetitie, masculinization, feminization, sodium & fluid retention, N&V, hot flashes, vaginal dryness
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what are some hormonal agents
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adrogens (breast cancer)
anti-androgens (prostate ) estrogens and antiestrogens (breast Tamoxifen) protestins (endometrial cancers) aromatase inhibitors (postpartum w/breast cancer will increase risk of osteoporosis) luteinizing hormone steroids - treatment of leukemia & lymphoma |
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asparaginase is an antineoplastic agent, what is it used in treatment of
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leukemia
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furosemide - what is the classification/action
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loop diuretic - inhibits the reabsorption of sodium and chloide from the loop of henle and distal renal tubal. increases renal excretion of water, sodium, chloride, mg, k and ca
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What is furosemide used for
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cardiac overload
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acetaminophen
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max 4 g. pyrogenic reactions - fever
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corticosteroids
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antiasthmatic/immunosuppressant/antiinflammatory
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epinephrine
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for anaphylaxis/shock - cardiac
inhibits release of mediators of immediate hypersensitivity reactions from mast cells |
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diphenhydramine
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Benadryl - relief of allergic symptoms
antihistamine given before blood transfusions sometimes to reduce allergic response |
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how are chemo drugs dose based
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pts total body surface area
previous response to chemo or rad therapy function of major organ systems |
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what is dose limiting effects
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adverse effects that prevent a drug from being administered in higher doses that indicate caution in continuing to admin the drug at the current dosage.
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does prednisone demonstrate any bone marrow suppression or neurotoxicity
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no
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what does a visicant drug do
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extravation. If suspected: stop med, attempt to aspirate any remaining med through existing needle, application of heat/cold dependent upon durg, raise arm
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what is amifostine (Ethyol)
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scavenger of free radicals that prevents damage to DNA. Protects normal tissue from radiation damage
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what is Mesna for
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ifosfamide toxicity
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what is dexrazoxane for
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doxorubicin toxicity
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