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189 Cards in this Set

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How old is a neonate?
0 - 30 days
should you increase/decrease the dosage for neonates
decrease
Why must you decrease the dosage for neonates?
kidney and liver function is immature
How old in an infant
30 - 1 year
Should you increase/decrease the dosage for infants
increase
What is the metabolism of an infant like
an adult
How do you figure dosage for an infant
mg/kg of body weight
Describe medicine administration for a child
dont threaten, apply the childs developmental level, sweeten/flavor med, give options
What must you consider with medicine administration and geriatric patients
decreased liver and kidney function
What is the most commonly given hormone for ADH
vasopressin
What is the action of vasopressin?
acts on collecting ducts in renal tubule to increase water reabsorption, which increases concentration of urine and spec. grav. and decrea. urine volume.
What do higher doses of vasopressin do?
stimulate contraction of vascular smooth muscle and smooth muscle in the GI tract
How is vasopressin given?
nasal spray
What happens if you have too much ADH
water intoxication
S/S water intoxication
drowsiness, listlessness, H/A, convulsions coma
What do you do for a pt with water intoxication
restrict intake, and give diuretics
What is the action of thyroid hormone
stimulates energy use and elevates basal metabolic rate, stim. the heart, promotes growth and development
what are signs of an elevated basal metabolic rate
increases 02 use and heat producation
How long with a person with hypothyroidism be on medication
forever
When do you take your thyroid meds?
in am before breakfast or 2 hours after
What are some s/s of hyperthyroidism
tachycardia, palpitations, angina, dysrhythmias, HTN, MI
What labs do you watch with a thyroid
TSH and T4
What are some drugs for hyperthyroidism
propylthiouracil or inderal
what is the action of propylthiouracil or inderal
blocks synthesis of thyroid hormone, suppresses conversion of T4 into T3
How long does it take for the effects of hyperthyroidism to become evident
1-3 weeks
What are the SE of propylthiouracil or inderil ?
bone marrow depression or agranulocytosis
Why is indural preferred?
decreases heart rate, and controls tachycardia
Inflammatory diseases that adrenal steroid use is indicated
asthma, arthritis, lupus, rhinitis, poison ivy,
When are steroids taken
must be taken with meals, 2/3 am and 1/3 pm
what happens with steroids if the pt is under a ton of stress
must increase the dosage
Can any med be stopped abruptly?
NO
What are some SE of steroid useage?
fluid retention and edema watch for hypovolemic shock
Diet for a person on adrenal steroid use
low in Na high in K+
What should a person under steroid therapy avoid
stress, infection
Action of estrogen and progesterone combo
controls vasomotor symptoms, prevents tissue atrophy,osteoporosis, keeps cholesterol in check
What is the most common SE of HRT
thrombus
other SE of HRT
nausea, fluid retention, weight gain, breast tenderness
What occurs from unopposed estrogen
uterine cancer
what increases when just progesterone used
breast cancer
what HRT are you given if you have an hysterectomy with ovaries left
progesterone
When do you give calcium
throughout the day
how much ca can the body process at one time
600 mg
What helps to incrase Ca absorption
Vitamin D
what is a cheap way to get extra Ca
Tums
What is the action of Vit D
inhibits renal excretion of Ca, increases Ca absorption from intestine, increases serum Ca levels which stimulates osteoblast activity
How is calcitonin given
SC or nasal spray
what does calcitonin do?
prevents removal of bone Ca, decreases serum ca leves, increases renal excretion of Ca
What must you have to be put on calcitonin?
osteoporosis
If you are on calcitonin, what must you also be taking?
calcium
What is the action of fosamax?
inhibit bone resorption by osteoclasts, treats and prevent osteoporosis
What are the nsg imp of fosamax
cause GERD, so take am on an empty stomach with full glass of water and remain upright for 30 minutes. Must report difficulty swallowing or pain swallowing, worsening heartburn
What are the brands of regular insulin we need to know?
Humulin R and Novolin R
What is the onset time of regular insulin
30 - 60 min and 30 min
When does regular insulin peak
2-3 and 3-4 hours
What is the duration of regular insulin
6-8 hours
What are the nsg implications for regular insulin?
make sure pt has food coming, teach s/s hypoglycemia
What is the action of humalog
rapid acting insulin
What is the onset of humalog
5-10 min
what is the peak of humalog
40-50 min
What is the duration of humalog
3.5 hours
What are the nsg imp of humalog
make sure pt has food in front of them, s/s hypoglycemia, teach pt about peaks with med
what is NPH
intermediate acting insulin with long lag time
What is the onset for NPH
2 hours
What is the peak of NPH
6-8 hours
what is the duration of NPH
10-12 hours
nsg imp of NPH
teach pt about peaks and troughs, s/s hypoglycemia
What is lantus
long acting insulin with no peaks just steady dose of insulin
What is the onset of lantus
+/- 2/3 hours
what is the peak of lantus
none
what is the duration of lantus
16-24 hours
what are the nsg imp of lantus
must be taken same time everyday
what does exercise do to insulin
decreases it
what is the onset time of D50
IV - 30 sec, IM 15-20 min
What do you you when pt comes out of it after giving glucagon
snack
What is the action of glyburide
lowers glucose by stim the release of insulin from pancreas and increasing sensitivity to insulin at receptor sites
SE of glyburide
hypoglycemia and weight gain
nsg imp for glyburide
monitor for hypoglycemia
where does glyburide stim. insulin from
beta cells
What is the action of metformin?
decreased hepatic glucose prod. decreased intestinal glucose absorption, increases sensitivity to insulin
SE of metformin
abdominal discomfor, nausea, diarrhea, metallic taste, lactic acidosis, hypoglycemia
what are the nsg imp for metformin
monitor for hypoglycemia, must have good O2 and renal function helps them lose weight
what must you have for metformin to work
some insulin
what medication helps block the hepatic glucose dump
metformin
what is the action of rosiglitazone
improves sensitivity to insulin by acting as an agonist at receptor sites involved in insulin responsiveness and subsequen glucose prod and util. reques insulin
what are SE of rosiglitazon
increased cholesterol, weight gain
what are the Nsg imp for rosiglitazone
monitor for hypoglycemia
what do you use for a petite mal or tonic/colonic seizure
pheytoin
what is a SE of phenytoin
ginigval hyperplasia
how do you give phenyltoin
50mg/ml over 10 min
what happens if you push phenytoin to fast
cause HTN and cardiovascular collapse
what is status epilepticus
seizure that does not stop after 30 min
S/S of status epilepticus
tach, eleveated BP, hyperthermia leading to hypoglycemia
what can status epilepticus casue
permanent cognitive impairment, memory loss, worsening of seizure disorder and death
what do you give for status epilepticus
lorazepam or diazepam
how fast do you push lorazepam
.1mg/ks pushed 2 mg/min
how fast do you push diazepam
10mg/2ml 2 mg/min
action of levodopa
converted to dopamin in CNS where is seves as neurotransmitter
what does levodopa do
increases dopamine in CNS
SE of levodopa
ortho hypo, involuntary movement, hallucination
nsg imp of levodopa
give with food to minimize GI irritation
What is the action of carbidopa
prevents breakdown of levadopa, increases dopamin in CNS so can use a smaller does
SE of carbidopa
involuntary movements, hallucination
nsg imp with carbidopy
assess for parkinsonina sx
what dopamine croiss blood brain barrier
no
can levodopa cross BB barries
yes
how do you differentiate between a sedative and hypnotic
dose
what does barbituates do?
inhance GABA
when are barbituates used
alcohol withdrawl
SE of sedative hypnotics
most common decreased mental alertness, tolerance, dry mouth,
nsg imp of sedative hypnotics
bp, do not take more than 1 sedative hypnotic at a time
action of theophylline
relaxes smooth muscle of bronchi to produre bronhcodilation and ups strength of diaphragm contractions
what is theophylline used to treat
moderate to sever asthma
what do you give IV aminophylline
only in emergencies
range for theophylline
10-20
S/S of theophylline toxicity
N/V, nervousness, anxiety, shaking, insomnia, seizure, tachy, arrhythmias, death (3 pots coffee)
what reduces theophylline levels
smoking
what intensifies adverse effects of theophylline
caffeine
action of a beta 2 agoist
powerful bronchodilaors relax smooth muscle and surround airway
how long to beta 2 agonists take to work
rapid onset 15 min
how long do beta 2s take to work
4-6 hours
what are beta 2s used for
acute asthma sx, rescue inhaler
SE of beta 2 agonist
nervousness, anxiety, tremor, tachy increased BP
fast acting beta 2
albuterol
slow acting beta 2
salmeterol
what is salmeterol use to treat
chronic COPD not effective in acute attacks
When is salmeterol usually given
at night
What is a pt uses albuterol canister in less than a month
start them on corticosteroids
action of steroid inhailors
reduces sx of asthma by suppressing inflammation of airways
SE of steroid inhalors
yeast, dysphonia
action of antihistamines
blocks effects of histamine at H1 receptor sites
SE of antihistamines
drowsiness, antislud can cause oppostie effects in child and elderly
1 gen antihist
benadryl
2 gen anti hist
claritin
when does an antihistamine work best
before exposure to allergen
What generation has less side effects but costs more
2nd
action of decongestants
vasoconstriction of capillaries in nasal mucosa
what do decongestants not do
relieve sneezing, itching runny nose
excessive use of decongestant spray
excessive use of spray causes rebound nasal congestion
what are SE of decongestants
increase in BP, use cautiously in pt with HTN, CAD, hyperthyroidism, and DM to prevent sever elevation of BP
action of expectorants
decreases viscosity of sputum and promote removal
what is the best agent to liquegy secretions
water
What is an antitussive
cough suprressant
what must you be careful with antitussives
watch acetaminophen intake
how do opioids and dextromethorphan antitussives do
suppress cough within the CNS equally and effective in combo
How does benzonatate work
suppresses cough by decreasing the sensitivity of stretch receptors in the cough reflex pathway.
What must you make sure of with tessalon pearls?
swallow pills intact
action of reglan
blocks dopamine and serotonin receptors in the CTZ and increases motility in pts with slowed motility
what do you sue reglan for
treat NV for chemo
SE of reglan
drowsiness EPS and restlessness
zantac action
inhibits gastric secretions by H2 receptor blockade in gastric parietal cells
SE of zantac
dizziness, h/a, diarrhea, confusion, gynecomastia and reduced sperm count major nes
what is zantac used to treat
peptic ulcs, stress ulcers GERD
What is the action of sucralfate
binds to damaged mucosa to coat and protect stomach from acid and allow ulcer to heal
name soem antacids
tums, rolaids
what do antacids do
neutralize acid already secreted
When are antacids most effective
1-3 hours after a meal
action of Proton pump inhib
blocks the proton pump of parietal cells
what are PPIs used for
peptic ulcers , GERD stress ulcers
name some bulk forming laxatives
metamucil and citrucel
action of bulk form lax
absorbs water thereby softening and enlarging fecal mass,
what does fecal swelling promote
peristalisis
how do you take bulk forming laxatives
with a large glass of water
name a surfactant laxative
docusate sodium
action of surfactant lax
stimulates peristalisis by lowering surface tension to allow penetration of water also causes secretion of water and electrolyes into intesting
zantac action
inhibits gastric secretions by H2 receptor blockade in gastric parietal cells
SE of zantac
dizziness, h/a, diarrhea, confusion, gynecomastia and reduced sperm count major nes
what is zantac used to treat
peptic ulcs, stress ulcers GERD
What is the action of sucralfate
binds to damaged mucosa to coat and protect stomach from acid and allow ulcer to heal
name soem antacids
tums, rolaids
what do antacids do
neutralize acid already secreted
When are antacids most effective
1-3 hours after a meal
action of Proton pump inhib
blocks the proton pump of parietal cells
what are PPIs used for
peptic ulcers , GERD stress ulcers
name some bulk forming laxatives
metamucil and citrucel
action of bulk form lax
absorbs water thereby softening and enlarging fecal mass,
what does fecal swelling promote
peristalisis
how do you take bulk forming laxatives
with a large glass of water
name a surfactant laxative
docusate sodium
action of surfactant lax
stimulates peristalisis by lowering surface tension to allow penetration of water also causes secretion of water and electrolyes into intesting
what type of laxative can be used long term
surfactant (doc sod)
what are some stimulant lax
dulcolax exlax
action of stimulant lax
stimulates peristalsis and softens feces by increasing secretion of water and electrolytes into the intesting and decreased water and electrolye abs
how do you take stim lax
swallow tabs whole
what does long term suppository use cause
proctitis burning sensations
how long does castor oil take to work
2-6 hours
name some osmotic lax
MOM and fleets
action of osmotic laxatives
osmotic action retrains and draws water to soften feces, fecal swelling promotes peristalsis
when are osmotic lax contraindicated
hrt fail, htn, edema and renal dys
when do you absolutely NOT give a laxative
ABD pain, undx