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31 Cards in this Set

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Uses of Ibuprofen and Naproxen
Rheumatoid Arthritis
Osteoarthritis
Dysmenorrhea
Fever Control (Ibuprofen only)
General Pain
IBUPROFEN
Half Life - 3.5 hrs
Anti-inflammatory
Analgesic
Antipyretic
Prostaglandin inhibitor (reduces swelling)
NAPROXEN
Half Life - 10-20 hours
Anti-inflammatory
Analgesic
Prostaglandin inhibitor (reduces swelling)
Pediatric Dosing for Ibuprofen
Based on weight
Temp under 102.5 - 5mg/kg
Temp over 102.5 - 10 mg/kg

Max. sngl dosage - 40 mg/kg
NAPRELAN
Controlled-released naproxen
Dosing is ONCE daily
Preg Cat C

Drug interactions - inhibition of renal prostaglandin synthesis
CELECOXIB (Celebrex)
Selective for COX2 inhibition/blockage
No CV benefit

Uses: Rheumatoid Arthritis, Osteoarthritis, Pain, Dysmenorrhea
Adv. Effects: GI Upset, Nausea, Renal Complications
*Sulfa Allergy - contraindicated
ACETAMINOPHEN (Tylenol)
Limited to blocking/inhibiting prostaglandins in CNS only

Half Life - 2 hrs
*High doses can cause liver damage due to toxic metabolites released when metabolized by liver
Dosing for Acetaminophen
Peds - weight based
- under 12 yrs: 10-15 mg/kg q4 hrs

Adults (over 12 yrs) - 325-600 mg q4-6 hrs

Max. dosage - 4 gm/daily
ACETYLCYSTEINE (Mucomyst)
Overdose Treatment for Acetaminophen

Converts toxic by-product to non-toxic product
Needs to be given ASAP after overdose ingestion
Type 1 Diabetes
Destruction of pancreatic Beta cell
Type 2 Diabetes
Insulin resistance in major target areas
ex. Liver, muscle, and fat cells
Diabetes Management
*Diet
*Exercise
*Insulin
INSULIN LISPRO (Humalog)
Rapid Acting
Onset: 15-30 min
Peak: .5-2.5 hr
Duration: 3-6.5 hr

**immediate
REGULAR INSULIN
Short Acting
Onset: 30-60 min
Peak: 1-5 hrs
Duration: 6-10 hrs

**works soon
NPH (Humulin N)
Intermediate Acting
Onset: 60-120 min
Peak: 6-14 hrs
Duration: 16-24 hrs

**slight delayed response usu. given with regular insulin
INSULIN GLARGINE (Lantus)
Long Acting
Onset: 70 min
Peak: None
Duration: 24 hrs

**usu. given at night before bed to prevent hypoglycemia in am
Signs and Symptoms of Hypoglycemia
Blood glucose level: below 70

Sympathetic: shaking, tremors, palpitations
Cholinergic: diaphoresis
Neuroglycopenic: H/A, confusion (irriatability), weak, faint feeling, warm flushed feeling
Factors effecting Insulin Needs
Increased Needs:
Infection
Stress
Obesity
Adolescent Growth Spurt
Pregnancy (after 2nd trimester)

**Increased Metabolism=Increased Need

Decreased Needs:
Pregnancy (1st trimester)
Exercise
SULFONYLUREAS
(-ide)
Oral Agents for Type 2
- promotes insulin secretion by the pancreas
- promotes tissue response to insulin (by changing barrier to incr. absorption)

Onset: 1-2 hrs of ingestion
typically taken with breakfast

- Glipizide (Glucotrol)
- Glyburide (Micronase)

Adv Effects: GI: N/V, heartburn
Endocrine: hypoglycemia
BIGUANIDES
(Metformin)
- reduces glucose by decreasing production of glucose in liver
- increase uptake of glucose by muscle
- **does nothing in pancreas

Can be combined with Sulfonylureas

Adv Effects: N/V and diarrhea
ROSIGLITAZONE (Avandia)
- Insulin resistance inhibitor (improving target responses and decreasing cellular insulin resistance)

**Sig. Caution with pts with heart disease and increased risk potential for CHF
Ketoacidosis
Type 1 patients only
Caused by increased lipolysis (breaking itself down for glucose) - increasing free fatty acids - causing formation of keto acids
Signs and Symptoms of Ketoacidosis
Increased glucose levels
N/V
Polyuria
Possible cardiac changes secondary to increased K+
Fruity Breath (due to acetone)
Kussmaul breathing (blowing off excess CO2 - long expiratory phase)
Fluid shift secondary to Na+ decrease
Treatment of Ketoacidosis
1. Correct acidosis by:
- IV regular insulin followed by insulin infusion
2. Replace fluid loss by:
- IV fluids .9% NS with 5% dextrose and poss. CaCl to assist with K+
3. Restore K+/glucose levels to normal
Hypothyroidism
Malfunction of Thyroid Gland
- Iodine insufficiency
- Autoimmune Thyroiditis
- Secondary to radiation or surgical removal

Diagonostically TSH>3
LEVOTHYROXINE (Synthroid, Levothroid, Levoxyl)
Narrow Therapeutic Range

Controls protein synthesis, increases metabolic rate, cardiac output, renal blood flow, O2 consumption, body temp, blood volume

Tx is lifelong, individually determined, and can take 3-6 months to see benefits
Hyperthyroidism
Malfunction of Thyroid Gland
- Excessive thyroid hormone excretion
- caused by autoimmune response
- Toxic Nodular Goiter (by secretory tumor)
TAPAZOLE (Methamazole)

PROPYLTHIOURACIL (PTU)
Inhibits thyroid hormone synthesis and prevents oxidation of iodine
Treatment for Hyperthyroidism
Step 1:
- Reduce hyperthyroid state with PTU or Methimazole
- Control secondary symptoms (tachycardia, diarrhea, etc.)
Step 2:
- Destroy thyroid gland with radioactive Iodine (I-131)
- Surgically remove gland
DESMOPRESSIN
Used for:
- Maintenance for diabetes insipidus (PO, causes reabsorption of H2O due to ADH insufficiency)
- Noctural enuresis (bedwetting) decreases urine production
- von Willebrand's disease

**patients to decrease water intake (fluid restriction) to prevent H2O intoxication AND watch for hypertension
VASOPRESSIN
Used for:
- diabetes insipidus (acute tx)
- post-op abdominal distention
- radiographic contrast clearance
- resuscitation (IV)

**patients to decrease water intake (fluid restriction) to prevent H2O intoxication AND watch for hypertension