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223 Cards in this Set
- Front
- Back
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benzodiazepine antidote
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Flumenazil
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benzodiazepine use as sleep aid- how long can use, how do you stop
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2-4 weeks, gradually stop
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barbituate antidote
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none
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heparin antidote
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protamine sulfate
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diuretic prototype
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furosemide (LAsix)
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5 kinds of diuretics
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carbonic anhydrase inhibitors
loop diuretic osmotic diretics potassium sparing diuretic thiazide and thiazide like diuretics |
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osmotic prototype
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mannitol (Osmitrol)
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loop diuretic prototype
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furosimide
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potassium sparing diuretic prototype
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amiloride (Midamor)
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thizaide diuretic prototype
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hydrochlorothizaide (HydroDIURIL)
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CAI moa
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block carbonic anhydrase and prevent H+ atom exchange with sodium and water
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loop diuretic moa
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inhibit Na and Cl resorption from loop of henle
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Diuretic patient teaching
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eat potassium rich food (except for K sparing ones)
drink fluids postural hypotension keep track of weight (2#/day is bad) |
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osmotic diuretic moa
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osmotic effect in proximal tubule ( used for intraocular and intracranial pressure)
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Cardiac glycosides prototype
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digoxin
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digoxin antidote
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Digibind(digoxin immune fab
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cardiac glycosides moa
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increases myocardial contractility which reduces heart rate and improve efficiency ( reduces heartrate)
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side effects of nitrates
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dizziness, fainting, headache, lightheaded
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contraindication with nitrates
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erectile dysfunction drug
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Beta Blockers effects on heart
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decreases energy demands, slow conduction of heart which decreases workload
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Common Beta Blockers
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atenolol (Tenormin)
metoprolol (Lopressor) |
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beta blocker moa
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block catecholamines effect
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Is lab monitoring required for BB
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no
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CCB prototype
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amlodipine (Norvasc)
diltiazem (Cardizem) |
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Ace inhibitors side effects
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hyperkalemia, dry cough, postural hypotension, dizziness, angioedema
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ace inhibitor prototype
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Enalpril
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angiotension II receptor blockers prototype
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losartAN (Cozaar)
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antihypertensive patient teaching
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take with food
avoid smoking and salt exercise postural hypotension monitor bp avoid hot tubs and alcohol |
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anticoagulant prototype
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heparin
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heparin antidote
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protamine sulfate
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warfarin antidote
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vitmaine k
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warfain teaching
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avoid foods high in vit K
lab monitoring of pt ptt aptt careful with grooming |
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antiplatelet prototype
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clopidogrel (Plavix)
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antidysrhythmics prototype
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quinidine
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biggest risk with antidysrhythmics
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they can cause arrhythmias
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antidysrhythmics are normally used in conjunction with
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anticoagulants
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antifibrionolytic moa and use
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prevent lysis of fibrin
used for tx and prevention of excessive bleeding |
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thrombolytic prototype
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Streptokinase
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Nursing Implications of Heparin
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iv dose double checked with another nurse
give sc 2 inches away from ambilicus may cause hematomas aptt lab done quicly rotate inj sites |
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Warafin lab consideration
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INR
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3 types of decongestants
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adrenergic(sympathomimetic)
anticholinergic (Parasympathomimetic antagonist) corticosteroids |
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decongestants contraindicated
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glaucoma
diabetes hyperthyroid |
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only available expectorant
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guaifensesin (Robitussin)
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adverse effects of bronchodilators: beta adrenergic agonist
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insomnia, anorexia, hyperglycemia, angina, HA
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beta adrenergic agonist moa
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relax smooth muscle
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adverse effect of anticholinergic
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dry mouth, palpitaions, urinary retention, HA, anxiety
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Xanthine Bronchodilator
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theophylline
aminophylline caffeine |
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Rapid-acting (Humalog, Novolog, Apidra)
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15 min 3-5 hours
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Short-acting (Humulin R
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30-60 min 6-10 hours
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NPH (intermediate acting)
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1-2 hours 10-18 hours
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Glargine (Lantus) (long acting)
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1-2 hours 24 hours
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Interacts with insulin
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corticosteroids antagonize hypoglycemic effect
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oral antidiabetics interact with
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adrenergics, corticosteroids, thiazides, alcohol, anabolic steroids
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reactions to antibiotics
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take up to 72 hours to occur
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Who should not take sulfonamides
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pregnant term women, infants
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Sulfonamide teaching
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avoid sunlight
delayed reaction more monitoring for diabetics or warfarin take with fluids to avoid crystalluria |
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Sulfonamide prototype
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Bactrim
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Cardiac glycosides prototype
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digoxin
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What is digoxin used for?
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systolic heart failure and a. fib
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When is Digibind indicated?
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hyperkalemia in digoxin therapy patient, life threatening cardiac dysrhytmias, bradycardia, heart block, digoxin overdose
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Common digoxin adverse effects
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dysrhythmia including tachycardia or bradycardia, hypotension, headage, halo vision, v/d
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Digoxin administration...what does nurse need to do?
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take apical pulse-must be b/w 60-100
double check prescribed dose |
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Taking oral Digoxin
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may be given with food but avoid fiber
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IV Digoxin infuse rate
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0.25mg/min or over longer than 5 minute period
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Examples of antianginals
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nitrates, beta blockers, calcium channel blockers
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Names of antianginals
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nitroglycerin (Nitrobid), isosorbide dinitrate (Isordil), atenolol (Tenormin), Metoprolol (Lopressor), diltiazem (Cardizem), ranolazine (Ranexa)
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Nitrates adverse effects
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headache is most common, tachycardia, postural hypotension
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Beta Blocker adverse effects
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bradycardia, hypo or hyperglycemia, hypotension, dypsnea
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Calcium channel blockers adverse effects
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hypotension, tachycardia or bradycardia, dermatitis
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CCB prototype
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Diltiazem (Cardizem)
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Antianginal administration
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always administer while seated, give oral before meals w/ 6 oz water, sublingual dissolve under tongue, do not rub ointment form in,
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how long is nitro able to be stored?
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3-6 months
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WHat should patient avoid while taking antianginal
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hot tubs, saunas, alcohol, hot temps
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When should patient take nitro?
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before stressful activities, at first chest pain or discomfort
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How many times may nitro be administered for angina
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3 times with 5 min in b/w if no relief call 911
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Iv dosing of antianginal
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only for ER, stable for 96 hours
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adverse effect of loop diuretic
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hypokalemia, tinnitis
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potassium sparing diuretic adverse effect
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cramps, v/d, urinary frequency, gynecomastia, hyperkalemia
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What lab values should be assessed before giving diurectic
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bun, creat, alp, ast, ldh, electrolytes- especially K
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What should be monitored when giving diuretics
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BP, daily weights, I&O, pulse rate.
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What foods should patients on diuretics eat
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high in K foods (except if on K sparing diuretic)
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What should a patient do when taking diuretic
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change positions slowly
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examples of benzodiazepine anxiolytic drugs
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alprazolam (Xanax), lorazepam (Antivan), diazepam (Valium)
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miscellaneous anxiolyitc drug
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buspirone (Buspar)
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adverse effects of benzodiazepine anxiolytics
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hypotension, paradoxical rxns,
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Mood stabilizing drug ex
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lithium
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Indication for lithium
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mania, bipolar disorder
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when is lithium contraindicated
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renal or cardiovascular disease. Renal disease can increase toxicity
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adverse effects of lithium
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cardiac dysrhythmia, confusion, somnolence, seizures, possibly death, ataxia, hypotension
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what do antidepressants react with
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warafin, tyramine containing foods, st johns wart, otc cold/flu medications
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what should a person taking antipsychotics avoid
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hot baths, saunas, hot climates, sun exposure
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what should a person taking lithium be sure to do
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drink lots of water
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what should someone on an antianxiety avoid
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alcohol and other cns depressants. They should avoid all otc's unless talk to doctor
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how do antiemetics work
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block vomiting pathway
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what are six antiemetic drug categories
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anticholinergic, antihistamine, antidopaminergics, prokinetics, serotonin blocker, tetrahydrocannabinoids
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Anticholinergic antiemetic ex
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scopolamine (Transderm-Scop)
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antihistimine antiemetic
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meclizine (Antivert), demenhydrinate (Dramamine)
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antidopaminergic antiemetic
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Prochlorperazine (Compazine)
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prokinectic antiemetic
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metoclopramide (Reglan)
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Serotonin blocker antiemetic
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ondansetron (Zofran)
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Tetrahydrocnnabinoids antiemetic
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dronabinol (Marinol)
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anticholinergic adverse effects
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tachycardia, drymouth, vision problems, difficult urination
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anihistamine adverse effects
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drowsiness, confussion, blurred vision, dry mouth, urination problem
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Antidopaminergic adverse effects
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orthostatic hypotension, extrapyramidal symptoms, blurred vision, urinary retention, dry mouth
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prokinetic adverse effects
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hypotention, dry mouth, sedation, fatigue, headage
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serotonin blocker adverse effect
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headache, diarrhea, broncospasm
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tetrahydrocannabinoids adverse effects
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drowsiness, dizziness, anxiety confusion, euphoria, dry mouth , visual disturbances.
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when and how do you apply scopolamine patches
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4 hours before traveling behind ear
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rate of infusion for benedryl
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25mg/min
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how should reglan be administered
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30 minutes before meals and at bedtime
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when should oral dronabinol and ondansetron be adminstered regarding chemo
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1 to 3 hours prior to chemo
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opiods
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codeine, fentanyl, meperidine (Demerol), methadone (Dolophine), morphine (MSIR, MS Contin), oxycodone (Oxycontin)
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Opiod antagonists (antidote)
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naloxone
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non opiods
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acetaminophen, tramadol
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most severe adverse effect of opiods
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respiratory depression
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Adverse effect of opiods
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sedation, hypotension, bradycardia, euphoria, dysphoria, nausea, vomiting, constipation, urinary retention, respiratory depression, asthma aggrevation
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WHat do you do in opiod overdose or toxicity
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try to arouse, admin Naloxone, ventilate if necessary
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max dose of Tylenol
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4 g/day
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antidote of acetaminophine
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acetylcysteine
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acetominophen can cause
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hepatotoxicity
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what interacts with tylenol
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alcohol can be fatal..also warafin, bb, anticholinergics, phenytoin
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opiods indicated for
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moderate to severe pain
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non opoids indicated for
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mild to moderate pain
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interacts with insulin
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steriods, loop diuretcis, thiazide diuretics, thyroid homones, sympathomimetic drugs
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interacts with insulin
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alcohol, sulfa, moais, salicylates, thyroid meds
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how is insulin admin with regard to food
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before meals
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rapid acting insulin in regard to meals
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15 min before
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regular acting insulin in regard to meals
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30 minutes before meals
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lomg acting insulin in regard to meal
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30-60 min before meals
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how long does insulin last
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1 month
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how do you mix insulin
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roll b/w hands
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which insulins are cloudy
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intermediate acting
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most common oral diabetic drug
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Metformin (glucophage)
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common oral diabetic drug
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Glipizide (Glucotrol)
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who is Metoformin contraindicated in
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renal patients, alcoholics, hepatic disease, heart disease
Those conditions that predispose patients to tissue hypoxia and lactic acidosis |
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how does metoformin work
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decreases glucose production by liver
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how does glipizide work
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stimulates beta cells to release insulin
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adverse effects of oral antidiabetics
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nausea, abdominal bloating, diarrhea, metallic tast
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ace inhibitor adverse effects
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dry cough, fatigue, dizziness, first dose hypotension, hyperkalemia
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what happens to potassium with ace inhibitors
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hyperkalemia
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angiotension 2 receptor blocker adverse effect
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URI's, headache, dizziness, insomnia
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is hyperkalemia more likely to occur with ace inhibitors or angiotension 2 receptor blocers
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ace inhibitors
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Men might flip b/c antihypertensives effect
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sexual dysfunc tion
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why should patients not suddenly stop taking antihypertensive
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rebound hypertension
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What might help with anti hypertensive dry mouth
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sugar free lozenges
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phenobarbital is...
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barbituate
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phenytoin (Dilantin) is a...
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hydantoin
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What negative thoushts should people taking antiepileptics report
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suicidal thoughts
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antiepileptics should avoid what fun but bad habits
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alcohol, caffeine, smoking
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what are most common adverse effects associated with antiepileptics
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drowsiness, gi upsent, cns depressing effects
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What should epileptics do when outside on their meds
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wear sunscreen and glasses
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what do antiepileptics interact with
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everything
ethanol, aspirin, warfarin, antacids |
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symptoms of overdose of anticoagulant
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petechiae, melena, hematuria, bruising
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In addition to antidotes, this might be necessary to tx overdose of anticoagulants
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blood transfusion
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adverse effect of anticoagulants
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bleeding, anemia, hypotension
bleeding is main complication |
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how may heparin not be administered
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im
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Is warafin used with heparin
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yes, heparin is given sq while waiting for the oral warafin's blood levels to rise
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when dose therapeutic effect of warafin occur
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4 to 5 days after first dose
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how is antidote of anticoagulants administered
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iv over 10 minutes- not too rapidly
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how is vitamin k preferabbly given
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sq
although all other forms are avaiable |
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when are anticoagulants d/c prior to sx
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7 days
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what food should be avoided on anticoagulant therapy
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foods high in vit K b/c may interact
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4 things that interact with warfarin
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ginger, garlic, ginkgo, capsicum
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how should anticoagulants be taken
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with 8 oz of water and food to minimize gi upset
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the degree of anticoagulation is measured by
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pt
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Cns depressants- 3 pams
benzodiazepine |
diazepam, midazolam (Versed), temazepam (Restoril)
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benzodiazepine adverse effects- ok or really bad?
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relatively favorable
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benzodiazepine adverse effects
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involve CNS
headache drowiness, dizzines, cognitive imparment, lethargy |
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what might benzodiazepines make an elderly person do?
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fall
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benzodiazepine overdose tx
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usually supportive
maybe activated charcoal Flumazenil |
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Barbituate examples
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phenobarb, pentobarbitol
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interacts with barbituates
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anything that is also cns depressant
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examples of 2 muscle relaxants
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baclofen (Lioresal)
cyclobenzaprine (Flexeril) |
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adverse effects of muscle relaxants
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euphoria, light headedness, dizziness, drowsiness, muscle weakness-----normally short lived
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2 short acting non-benzodiazepine hypnotics
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zaleplon (Sonata)
zolpidem (Ambien) |
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which hypnotic can be taken in middle of night if patient awakens
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Sonata
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special concern for ambien
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sleepwalking
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what is common adverse rxn to sulfa drug
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allergy..usually fever and a rash
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beta-lactam antibiotic examples
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penicillins, cephlasporins, carbapenems
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macrolide moa
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inhibit protein synthesis
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macrolide prototype
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erythromycin
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most common adverse effect to penicillins
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urticaria, pruritus, angioedema
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most common cephlasporin adverse reactions
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pretty much identical to penicillins
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ex of cephlasporins
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cefazolin, cephalexin
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what type of rxn to penicillins contraindicates cephlasporins
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urticaria, throat swelling
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macrolide adverse rxn
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hives, rash, itching, tinnitus
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tetracyclines adverse rxn
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discoloration of tooth enalmel, retard skeletal formation, photosensitivity, alteration of intestinal flora, gastric upset
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what food is recommended to be taken with peniciliin
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yogurt for probiotics
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what should not be taken with penicillin
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juices
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penicillin, tetracylcines, and cephlasporins w/ or w/o food
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w/ food to minimize GI upset if necessary
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what should tetracyclines not be taken with
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dairy products, antacids
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what should be forced with sulfonamides
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oral fluids
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cyclines may interact with what medication women take
|
birth control
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main drugs for adhd
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methylphenidate (Ritalin), amphetamines
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adverse effects of Ritalin and amphetamines
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"speed up" body systems
increased heart rate, angina, insomnia, headache , increased metabolic rate |
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anorexiant
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sibutramine (Meridia)
phentermine (Ionamin) orlistate (xenical) |
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adverse effects of anorexiants
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heart palpitaitons, dysrythmias, raise bp, anxiety
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antimigraine drug ex
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sumatriptan (Imitrex)
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adverse effects of antimigraine drugs
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nausea, vomiting, clammy hands and feet
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adhd drugs take w/ or w/o food
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on empty stomach
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Can you stop adhd drugs
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gradually
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when should adhd drugs be taken
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4 to 6 hours before bed
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when should anorexiants be taken
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4 to 6 hours before sleep
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what should people with migraines avoid
|
tyramine containing foods b/c known to trigger
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adverse effects of theophylline and aminophylline
|
nausea, vomiting, anorexia, gerd, cardiac adverse effects
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xanthine deriviatives react with what
|
macrolide antibiots, oral contraceptives, caffine, st johns wart
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beta adrenergic agonist prototype
|
albuterol (Proventil)
also: salmeterol (Serevent) |
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adverse effects of albuterol
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palpations, anxiety, nausea, tremors, increased heart rate
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how are anticholernergics used for respiratory problems
|
treat or prevent bronchospasms
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anticholernergic common drug
|
ipratropium (Atrovent)
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how is ipratropium (Atrovent) available
|
liquid aerosol and multidose inhaler
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when are xanthines indicated
|
asthma, chronic bronchitis, asthma, emphysema
|
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what does smoking do to xanthines?
|
decrease blood concentration
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how should ipratropium (Atrovent) be taken
|
year round for prophylaxis
|
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What should patients on inhaled steroid do
|
practice good oral hygiene
|
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how long b/w puffs of same inhaled drug
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1 to 2 min
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how long b/w puffs of different inhaled drug
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2 to 5 min
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who is xanthine more sensitive to
|
elderly
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leukotriene receptor antagonist
|
montelukast (Singular)
|
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indications for singular
|
prophy of asthma (PO)
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does singular have many drug interactions
|
no
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beta adrenergic antagonists interact with
|
beta blockers, moai's
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beta adrenergic antagonist interacts with what stimulant
|
caffeine
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