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107 Cards in this Set
- Front
- Back
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Identtify MOA for ACE Inhibitors
(Captopril-Capoten) |
Regulate HTN through RAS in kidneys. Ace blocks conversion of Angiotensin I to II
High risk for blood dyscrasia, monitor for dry cough r/t bradykinin monitor for hyperkalemia |
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Active Immunization
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2 types toxoids & vaccines
Toxoids made from bacterial endotoxins Vaccines made from actual organism, no longer toxic Both provide life long immunity |
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Passive Immunization
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Antibodies are manufactured by someone else (or animal); can be passed from mother to newborn
Immunoglobulin injections (rabies, tetanus, hepatitis) provides only temporary immunity; give to very old, young |
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Indications for Acyclovir/Zovirax
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HSV, Chicken pox, Shingles
Inhibits viral enzyme that allows for DNA synthesis; Will prevent spreading but NOT cure Give around the clock (PO, IV, Topical) Side effects: Nephrotoxicity, painful inflammation - at site, Has short 1/2 life |
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What are the side effects of ADH (Vasopressin-Pritessin)?
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Bradycardia
Premature atrial contractions Heart block Fluid overhydration |
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What are major side effects of aminoglycosides - (Gentamicin - Garamycin)
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Nephrotoxicity (renal failure) check BUN & Creatinine
1st symptom - weight gain, decreased UAO, edema Ototoxicity - vertigo, hearing loss, tinnitus; reversible if caught early |
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What are symptoms associate w/drug induced anaphylaxis?
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Laryngeal edema
Bronchoconstriction Difficulty breathing Vasodilation Severe hypotension and possible shock |
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Identify MOA for antileukotrienes (Zileuton-Zyflo)
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Stops production of leukotrienes which are involved in inflammation, bronchoconstriction, edema, mucus secretion
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Identify contraindications for various antacid preparations (Tums, Mylanta, Maalox, Milk of Magnesia)
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Sodium solutions - contraindicated in CHF
Aluminum solutions - cause constipation & phospate depletion Magnesium - hypermagnesemia in renal disease Sodium Bicarb - metabolic alkalosis Calcium Preps - rebound hyperacidity & metabolic acidosis |
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When is antidiarrhea medications contraindicated (Atropine/diphenoxylate-Lomotil)?
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Hypersensitivity to drug
severe hepatic impairment Obstructive jaundice Diarrhea associated w/C. diff |
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What is the MOA for Glipizide-Glucotrol, and Repaglinide - Prandin?
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Promotes insulin release from the pancreas
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What is the MOA for Metformin - Glucophage?
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Reduces production of glucose within liver through suppression of glyconeogenesis
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What is the MOA for Arcabose - Precose?
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Slows down absorption of sugars from the gut
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What is the MOA for Combination Insulin?
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More closely simulates the varying levels of endogenous insulin that occur normally in non-diabetic people (intermediate and short acting insulin)
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What is the MOA for Insulin (regular - short acting) isophane (intermediate acting) and ultralente (long acting)?
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Restores ability of cells to use glucose as an energy source; acts by stimulating cellular uptake of glucose as well as amino acids, nucleotide, and potassium; promotes synthesis of complex organic molecules, such as fatty acids, which are incorporated into tryglycerides
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When should antidysrhytmic therapies be prescribed? (Metroprolol-Lopressor)?
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Based o impact of CO; BP changes, LOC changes, Renal impairment, Tissue & organ ischemia
Lidocaine - Xylocaine - Emergency situation |
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What are the side effects associated w/antinause medication? (Promethazine-Phenergan)
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CNS: drowsiness, EPS (extrapyramidal symptoms)
CV: hypotension GI: dry mouth, salivation, nasal congestion |
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Identify MOA of antiparkinsonism?
(Caribidopa/levodopa-Sinement) Amantadine - Symmetrel |
Increase dopamine levels in the CNS, stimulate dopamine receptors in the brain and inhibit dopamine breakdown in neurons
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What is the goal of Antiretroviral therapy?
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Reduction of HIV in blood
Increase Life span Higher quality of life |
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What is the MOA for antiseizure medications?
(Carbamazepine-Tegretol) (Phenytoin-Dilantin) |
Affect condution of ions across sodium and calcium channels; by altering these channels, the drug suppresses irritable neurons and inhibits repetitive neuron firing;
turns CNS down to prevent seizures |
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What factors affect patient adherence to antiTB drugs?
INH, Riphampine |
Living condtions - homeless, shelters, prison
Avoid foods w/tyramine NO ETOH Treatment is long and complex |
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What is the patient education associated w/expectorants?
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No smoking
Liberal fluid intake Turn, Cough, Deep breathe |
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Identify indications for ASA
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Prevent platelet aggregation
Pain, antipyretic, anti-inflammatory Prevent HA and CVA |
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What are the side effects for barbiturates? (Phenobarbital - Luminal)
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Drowsiness, lethargy, dizziness, hang-over, reduces REM sleep, N/V/D, respiratory depression, hypotension
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Identify the MOA for benzodiazepines
(Diazepam/Valium) (Lorazepam-Ativan) |
Antianxienty agents that depress the CNS and enhance GABA
Used for anxiety r/t crisis, drug and ETOH withdrawal, seizures, induction of anesthesia |
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What are beta adrenergic antagonists used for? "olol"drugs - Metrolprolol-Lopressor
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Angina, HTN
Decrease demand for myocardial energy/02 consumption; cardioprotective from catecholimines; slow cardiac conduction |
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What patient education is associated with adrenergic agonist?
Phenylephrine-Neosynephrine Pseudoephedrine-Sudafed |
Report palpitations, dizziness, SOB or HA
Take as prescribed, don't double up Monitor BP, pulse, temperature Limit use to avoid rebound nasal congestion |
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Identify major types of blood dyscrasias
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Anemia - decreased erythrocytes
Infection - decreased leukocytes Hemorrhage - decreased thrombocytes (platelets) |
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What patient education is associated w/xanthine bronchodilators?
(Theophyline-Theodur) |
Limit use of food, beverage, OTC meds w/caffeine
Report signs of decrease appetite, N/V, dizziness, restlessness, hypotension, seizures Take exactly as prescribed, same time Qday, no changes Limit/omit tobacco, diminishes effectiveness of drug Attend appts for f/u labs |
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What are the indications for calcium channel blockers? (Nifedipine-Procardia)
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Angina, HTN, Premature labor, migraines
Causes hypotension, constipation, nausea, palpitaitons |
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What is the patient education associated w/Cephalosporins?
(Keflex, Rocephin) |
Notify provider is symptoms worsen
D/C if rash, SOB, swelling of face Check skin daily Report bleeding Contact provider before taking any antidiarrheal Drink/eat cultured diary products No fruit juice or ETOH - antabuse like reaction |
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What patient education is associated w/corticosteroids? (predinsone-deltasone)
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Report fever, cough, sore throat, joint pain, increase weakness
No immunizations DO abruptly stop taking Daily weight Monitor wound healing Report mental status changes |
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What side effects are associcated w/Warfin-coumadin?
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Bleeding - major risk
Cholesterol emobli - purple toe synrome - gangrene or amputation Risk for CVA, pulmonary embolism Risk for osteoporosis/bone fractures Note: Vitamin K is antidote |
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List side effects for Demerol
(meperidine-demerol) |
Constipation, drowsiness, sedation, irritability, tremors or seizures
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Identify MOA for Digoxin
(Digoxin-Lanoxin) USED to treat CHF |
Increases myocardial contractility; slows HR and decreases electrical impulses
Strong, steady heartbeat, improve peripheral circulation Adverse effects: N/V, yellow vision, K+ levels |
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What pre-administration assessment are associated w/digoxin?
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VS - listen to apical pulse for 1 minute
If HR is <60 or >120 DO NOT GIVE Record I & O Daily weight Check serum K+ level - hypokalemia predisposes pt to dig toxicity |
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Define types of drug dependence
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Physicial - results in withdrawal manifestations of stopped abruptly
Psychological - pattern of compulsive use, continued craving, used for other than pain relief |
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What is the patient education associated w/drug induced immunosuppression?
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Avoid crowds, wear shoes, change dressings/bandages, keep supplies separate from others, don't drink standing water, avoid fresh fruit, vegetables or uncooked foods
Report sore throat, fever, chills, joint pain |
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How does the nurse determine if drug tolerance is present?
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Large dose of medication needed to achieve pain relief
Seen in pts w/chronic pain Always monitor/document pain scale rating Pain is what the patient says it is Always supplement w/positional, psychosocial and isolation variables |
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What are the side effects associated w/antilipedemia drugs?
(Cholestyramine-Questran) |
Flatulence, Constipation, Belching, steatorrhea, bruising (vitamin K), cholelithiasis, abnormal LFT's, N/D, myalgia
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When should Eltamivir-Tamiflu be administered?
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Given for influenza within 48 hours after onset of symptoms
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Identify types of EPS - extrapyrimidal symptoms
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Acute dystonic - spasm in major muscle groups of the neck, back and face
Akinethesia - uncontrollable inner restlessness - need to be in motion Drug induced Parkinson's - mask-like face, drooling, tremors, pill rolling, shuffling gait, stooped posture Tardive dyskinesia - tongue protrusion, lip smacking, puckering, chewing, blinking |
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What are the indications for expectorants?
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Increase bronchial secretions and facilitate expulsion through coughing
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What factors affect drug absorption?
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Route (oral, parenteral)
Rate (topical, sublingual, IV) Solubility - Liquids - fast to Capsules - slow) Design of drug - enteric, SR, XL Enteral drugs must go through 1st pass, where drug is inactivated in the liver |
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Why is first pass important?
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Enteral meds go through 1st pass, passage of drug to liver where it is inactivated. Enteral meds have higher dose (b/c of 1st pass) than parenteral
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Identify the MOA fluroquinolones (Ciprofloxacin-Cipro)
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Inhibits an enzyme (DNA gyrase & topoisomerase) required for bacterial replication & repair; does not affect human DNA, broad spectrum
1st oral antibiotic effective against gram negative bacteria May be bacteriocidal or bacteriostatic - depends on dose |
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Why is HAART therapy used?
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Best combination of drug therapy to delay disease progression, prolong survival & maintain quality of life through maximal viral suppression; give multiple drugs to prevent resistance/mutation
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What is the significance of drug half life?
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Half life determines the frequency of administration.
When taken at interval shorter than drugs 1/2 life, toxicity occurs 1/2 life is the amount of time required for 1/2 of the original amount of drug to be removed from the body |
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What pre-administration assessments are associated w/heparin therapy?
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Obtain HH, VS and baseline aPTT, PT or INR
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What are the side effects associated w/histamine-1 antagonist?
(diphenhydramine- benadryl) (promethazine-phernergan) |
Drowsiness, dizziness, HA, loss of appetite, stomach upset, vision changes, irritability, dry mouth/nose, urinary retension
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List interventions use to promote adherence to antiretroviral therapy?
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Monitor for hypersensitivity
Monitor WBC/Infection Monitor for stomatitis Monitor BP Drug/drug & drug/food interactions Monitor for severe pancreatitis Monitor for rash |
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What are the side effects associated w/hyperthyroid therapy?
Propythiouracil-Propacil |
Dizziness, neuritis, weakness, paresthesia, fatigue, HA, bradycardia
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What patient education is associated w/hypothyroid therapy?
(Levothyroxine-Synthroid) |
Take meds at same time each day - before breakfast
Avoid foods that inhibit thyroid secretion (strawberries, peaches, pears, cabbage, turnips, brussel sprouts, kale, cauliflower, radishes, peas) Monitor weight |
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List patient education concepts appropriate for immunosuppressant care
(Cyclosporine-Sandimmune) |
Handwashing
Frequent mouth care protect skin from abrasions wear shoes avoid invasive procedures avoid fresh fruits, vegetables, uncooked foods in diet don't drink standing water Report sore throat, fever, chills, and joint pain |
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What are the side effects of insulin?
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Hypoglycemia
GI: N/D, heartburn Injection site reaction, general urticaria & swollen lymph nodes |
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List nursing interventions for insulin administration
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DO NOT give if blood sugar is <70 or if s/s of hypoglcemia
Increase blood glucose monitoring if patient has fever,N/V/D Adjust dose during times of stress, infection or pregnancy Check urine for ketones if BG >300 Monitor VS and weight and K+ Insulin causes hypokalemia |
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Identify contraindications for insulin
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Blood sugar <70 or hypoglycemia
Dosage is not ordered on sliding scale |
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Differentiate between different IV solutions
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Dextrose - (variety of concentrations) provides calories for energy, flushes kidneys w/water to excrete solutes & improve LFT
Can be used to treat dehydration (decrease Na/K+ levels) dilutents and to treat hypoglycemia |
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Lactated Ringers
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Electrolyte fluids provides hydration and for those who cannot take food or liquid orally - severe vomiting, diarrhea, dieresis
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Normal Saline
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Closest to osmolality of plasma
Temporary expands extracellular compartments during times of circulatory insufficiency, replenish Na and chloride losses, treatment of burns |
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List side effects associated w/various laxatives
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Metoclopramide-Reglan
CNS: EPS CV: HTN ENDO: gynomastia, galactorrhea, menstrual irregularities GI: diarrhea Hypoglycemia in diabetics Possible drug interaction w/digoxin |
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Psyllium-Metamucil
Bulk-forming laxative |
Abdominal fullness, flatus
Important for patient to take w/adequate fluids May take 12 to 72 hrs to work |
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Stimulant laxative
Biscodyl-dulcolax |
Contraindiated in pregnancy (can induce labor) & severe CV disease
May become habit-forming w/prolonged use |
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Identify contraindications for local anethesia
Lidocaine - Xylocaine |
Never goes - fingers, toes, penis, ears and nose
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What are the side effects of Lithium?
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HA, lethargy, fatigue, N/N, dry mouth, muscle weakness
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Identify major side effects of chemotherapy
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Bone marrow suppression - panacytopenia
Nadir is lowest point of WBC level - patient at highest risk for infection Anemia - minimize energy Thrombocytopenia - avoid dental floss, parental injections, avoid ASA GI- anorexia - offer foods patient likes N/V - pre-medicate, avoid odors Stomatitis- use analgesic before meals Alopecia - encourage short hair/wig |
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What are indications for microlides?
(Erythormycin-Emycin) |
Good choice for those allergic to PCN
Broad spectrum Bacteriocidal or bacteriostatic take on empty stomach |
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What are the side effects of MAOI's?
(Phenelzine-Nardil) |
Wide variety of drug interactions
Most common orthostatic hypotension Avoid foods w/tyramin - beer, wine, chocolate |
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List nursing assessment for morphine
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Avoid in patients w/biliary spasms & gallbladder or pancreatic disease
Watch for respiratory depression |
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Identify indications for narcan
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Suspected narcotic OD
CV or resp depression after narcotic dose Administer IV and repeat Q 5 mins |
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What are the side effects associated w/nasal decongestants?
(Phenytoin-Neosynephrine) |
HA, nervousness, tachycardia, palpitations, HTN, rebound effect
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Identify common side effects related to neuroleptics
(Chlorpromazine-Thorazine) (Haloperidol-Haldol) |
EPS - acute dystonic reaction, akinethesia, drug induced parkinsons, tardive dyskinesia
Sedation, drowsiness, orthostatic hypotension, tachycardia, palpatations |
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List patient education for nitrate therapy
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Change position slowly
Protect medication from heat, light, cold & moisture Burning under tongue indicates potency Replace Q6 months; wear Medic alert bracelet Sublingual - take routinely Q 6-8 hrs or Q 5 mins x3 then stop Check BP/HR |
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What are the side effects associated w/nitrate therapy?
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Reflex tachycardia from hypostension, HA, blurred vision, vertigo, flushing/syncope
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What patient education is associated w/NSAIDs?
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Overuse can cause liver/renal damage, hard on stomach - ulcers, bleeding, decrease anti-hypertensive effects, diuretics- decrease effect
steroids/ETOH - increased risk for bleeding |
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List nursing interventions for the side effects of chemotherapies
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Help anorexia - offer foods patient likes, small servings
Pre-medicate to prevent nausea Oral care for stmatitis Minimize energy expenditure Talk w/family regarding hair loss Avoid infection Minimize trauma |
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What are the general nursing interventions associated w/antibiotic therapy?
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Check VA & signs of infection; allergies
Watch for hypersensitivity/photosensitivity Watch for severe diarrhea - C.diff Watch for superinfection Administer around the clock Check OTC meds - BCP Avoid juices Renal function |
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What is the indication for Omeprazole-Prilosec?
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Blocks the proton pump - decreasing acid production
Take approx, 4 days to receive maximum action after 1st dose |
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What patient education is associated with orthostatic hypotension?
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Move slowly, dangle feet at side of bed
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What is the MOA for osmotic diuretics?
(Manitol-Osmitorl) |
Pulls water from intercellular (inside cells) and interstitial (surrounding cells) into vascular space through high osmotic concentration
Used to reduce ICP and intraocular pressure-glaucomma |
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List nursing considerations w/pain management using drugs
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Treat before pain becomes severe
Elderly @ risk for hypotension, CNS effects, and respiratory depression Check allergies, LOC, VS, time since last narcotic administration Supplement w/positional, psychosocial and isolation varialbes Rate on scale 0-10 - get baseline |
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List nursing assessment associated w/ Patient controlled analgesia
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Patient must be alert and able to use pump
Only for patient to press Maintains consistent amount of narcotic Programmed to preven OD Document # of attempts, # of deliveries and total amount of drug received each shift |
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What is the purpose of peak and trough drug level?
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Peak is highest level in blood; Trough is lowest level in blood; tests excretion rate
Important to maintain steady state, keep peak below toxic level and trough above minimum for effective concentration. Blood draw for peak 15-30 mins after IV Blood draw for trough just before next infusion (no more than 30 minutes before) |
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List dietary teaching for PCN
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Avoid acidic fruit juices- will decrease effectiveness
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What is the patient education associated w/drug induced photosensitivity?
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Avoid direct sunlight, tanning beds, wear sunscreeen & protective clothing
Notify provider of any rash Stop taking if signs of rash till evaluated |
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What is the patient education for potassium sparing diuretics?
(Spironolactione-Aldactone) |
Avoid foods high in K+ - hyperkalemia
(nausea, fatigue, muscle weakness, tingling) bradycardia & weak pulse Monitor BP daily, keep records Diuretic effects may not occur until several days after therapy and dieresis may continue for 2-3 days after drug is d/c Weigh 2-3 times per week Do not drive or operate heavy equipment b/c may cause drowsiness/dizziness |
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List pre-administration assessment for KCL
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Complete HH
Assess electrolyte status (serum K+ levels) Assess cardiac status (EKG) Asses renal status |
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What is the purpose of pre-medicating?
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To prevent adverse/side effects of medications
Treatment w/anti-nausea medication Pre-operative sedation |
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Identify indications for Protamine-sulfate
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Protamine-sulfate is an antidote for heparin toxicity
Used to prevent hemorrahging |
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What types of drugs cause reflex tachycardia?
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Vasodilators
Nitrates |
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What are the side effects of immunizations?
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Minor- fever, localized inflammatory reactions - soreness, erythema, increased warmth @ injection
Serious - Fever >103, difficulty breathing, CNS effects (convulsions/encephalitis) Anaphylactic (eggs) |
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List signs of hypersensitivity reaction
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Urticaria (hives), Swelling of lips/tongue
Subjective: Pruritis (itching), Nervousness/Anxiety, SOB |
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List patient education concepts for skeletal muscle relaxants
(Flexaril) |
Decrease muscle tone & movement
Cannot drink ETOH Do not take any other CNS depressants Do not drive or operate heavy machinery due to altered LOC |
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What is the indication for SSRI (Fluoxetine/Prozac)?
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Depression, OCD, social anxiety, panic disorder
Blocks the re-uptake of one neurotransmitter associated w/mood - serotonin Only work after they have achieved a steady state Side effects=GI upset, anorexia, Impotence |
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What is the patient education associated w/sulfonamides?
(Sulfamethozazole-Bactrim) |
Photosensitivity
Crystaluria - drink at least 2 liters of fluid/day Stevens-Johnson syndrome - life threatening; cell death causes epidermis to separate from dermis |
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What symptoms would indicate a superinfection?
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C. Diff, Fungal infection - yeast;
thrush in kids, black hairy tongue |
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What are the contraindications for TCN? (Tetracycline-Sumycin)
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Binds to calcium, magnesium, aluminum, and iron
NO calcium, iron or antacid products - absorption will be reduced DO not give to pregnant women - retards fetal growth DO not give to children < 8 yrs old - affect teeth |
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What are the side effects of tricyclic antidepressants?
(Amitriptyline-Elavil) |
Dy, urinary retention, sedation, and orthostatic hypotension
TCA overdoses lethal |
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Identify the MOA Tylenol
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Blocks transmission of pain impulses to brain, inhibits prostaglandin synthesis
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What is idiosyncratic?
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Reactions which are unexpected have no apparent relationship to reason drug is given
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What is Paradoxical
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Reactions are effects that are opposite of intended effects
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What is Synergistic?
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Combined effect is greater than sum of individual agents
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Identify the indications for vitamin K (Vitamin K-Phytonadione)
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Antidote for Warfarin-Coumadin
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Ranitidine - Zantac
Histamine-2 antagonist |
Blocks histamine-2 receptor sites in the gastric mucosa, reducing secretion of gastric acid
Used in treatment of GERD/esophagitis; helps prevent PUD Side effects: HA, dizziness, arrhythmia, elevated LFT's, N/V/D Should not be taken long term |
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Flagyl (Metronindazole)
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Used to treat Amebiasis, Giardias
Pt. may have metalic taste; excreted in saliva Note: has antibacterial, antiprotozoal, antihelmitic action |
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TPN - Total Parenteral Nutrition
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TPN- via central line, has a glucose concentration of 25%
PPN - peripheral parenteral nutrition, given via vein in arm, differs from TPN in lower glucose 10% to prevent phlebitis |
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Nursing interventions for TPN
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Weigh pt daily
Monitor electrolyte and protein levels - severely malnourished - potential cardiac problems Check renal function Monitor LFT - for metabolism Change IV site/tubing - prevent infection When weaning, document dietary intake |
