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69 Cards in this Set
- Front
- Back
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Digoxin
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Ch 21
Digoxin is effective for the treatment of both heart failure and atrial fibrillation and flutter. Very narrow therapeutic window Drug levels must be monitored Low potassium levels increase its toxicity Electrolyte levels must be monitored Adverse effects include anorexia nausea vomiting, diarrhea GI problems Count apical pulse for 1 full minute |
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thiazide
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NA
Ch 25 Thiazide diuretics, like several of the loop diuretics, are chemical derivatives (benzothiadiazines) of sulfonamide antibiotics. |
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antacids
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Ch 51
Antacids are basic compounds used to neutralize stomack acid. Antacids work primarily by neutralizing gastric acidity, they do nothing to prevent the overproduction of acid byt instead help to neutralize acid secretions. |
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stimulents
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Ch 8
Include Amphetamines, cocain, methylphenidate (ritalin), methamphetamines etc Often known as designer drugs Effects that lead to abuse are elevation of mood reduction of fatigue, sense of increased alertness, can lead to physical and spychologic dependence Stimulant withdrawl peaks at 1-3 days duration 5-7days signs are social withdrawal, psychomotor retardation, hypersomnia, hyperphagia Symptoms are depression, suicidal thoughts and behavior, paranoid delusions |
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naloxone
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Ch 10
Opiate antagonist Bind to opiate receptors and prevent a response Used for complete or partial reversal of opiod-induced respiratory depression |
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epinephrine
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Ch 17
also known as ADRENALIN. an endogenous vasoactive catecholamine. It is drug of choice for asthma attacks and anaphylactic shock. Mimic the effects of the SNS neurotransmitters |
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bethanechol
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Ch 19
Direct acting Cholinergic Increases tone and motility of bladder and GI tract Relaxes sphincters in bladder and GI tract, allowing them to empty Helpful for postsurgical atony of the bladder and GI tract Oral dose or SC injection |
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scopolamine
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NA
Ch 53 Primary anticholinergic Atimetic One of the most commonly used drugs fro the treatment and prevention fo the nausea and vomiting associated with motion sickness |
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loop diuretics
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Ch 25
drugs bumetanide, ethacrynic acid, furosemide (Lasix), torsemide Are considered the most effective diuretic; very potent that act along the thick ascending limb of the loop of Henle blocking chloride and secondarily, sodium reabsorption They are particularly useful when rapid diuresis is needed, b/c of their rapid onset of action. Even when kidney function diminishes, they often can still work. Has the following CV effects: reduced bp reduced pulm vas resistance reduced systemic vas resistance reduced CVP reduced left vent end diastolic press Common adverse affects: dizziness, H/A, tinnitus, blurred vision, N/V/D, agranulocytosis, thrombocytopenia, neutropenia, hypokalemia, hyperglycemia, hyperuricemia |
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warfarin
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Ch 27
Coumadin Most commonly prescribed oral anticoagulant and is ontly available for oral use. Requires careful monitoring of ptt and INR. Warfarin prevents clot formation by inhibiting vitamin K-dependent clotting factors and is used prophylactically to prevent clots from forming, it cannot lyse preformend clots |
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protamine sulfate
potassium sulfate |
N/A
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penicillins
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Ch 37
Penicillin’s are called B-lactam antibiotics because they have the ring Antibiotic that there is most likely to have a anaphalatic reaction to (along with sulfonamides) Adverse effects of penicillin’s-Allergic reactions to penicillin occur in 0.7% to 4% of treatment courses. The most common reactions are uticaria(itching), pruritus(itching), and angioedema(red spots). Anaphylactic reactions are much less common, occurring in 0.004% to 0.015% of patients. Patients who are allergic to penicillins have a fourfold to sixfold increased risk of allergy to other B-lactam antibiotics. The incidence of cross-reactivity between cephalosporin’s and penicillins is reported between 1% and 18%.These allergies generally occur not on the first time you took the drug but on the subsequent times because you have to build up antibodies from the first time and then the body reacts to them the next time. |
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cephalosporins
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Ch 37
12. Cephalosporins are the largest group of antibiotics. There are over 30 different ones used today. There are four generations of cephalosporins. Depending on the generation, these drugs may be active against gram-positive, gram-negative, or anaerobic bacteria. In general, the level of gram-negative coverage increases with each successive generation. So first generation antibiotics are most active against gram positive bacteria same as the penicillins, but as you go one to 2nd 3rd and 4th generation you have more levels of gram negative, some become more broad spectrum they effect more kinds of bacteria. |
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ampicillin
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Ch 37
is the prototypical aminopenicillin, and it differs from penicillin G only in that it has the amino group in its molecular structure |
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insulin
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Ch 31
Rapid acting insulin lispro/aspart--5-15min onset, 1-2hr peak, 4-6hr duration Short Acting human regular--30-60min onset, 2-4hr peak, 6-10hr duration Intermediate Acting NPH--1-2hr onset, 4-8hr peak, 10-18hr duration Long Acting glargine--1-2hr onset, flat action, 24hr duration |
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penicillin
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Ch 37
Indications for penicillin-for the prevention and treatment of infections caused by susceptible bacteria. The microorganisms most commonly destroyed by penicillin are gram-positive bacteria, includes Streptococcus, enterococcus, and staphylococcus |
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opiates
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Ch 8
Similar to opiod analgesics except that they occur in nature |
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depressants
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Ch 8
Drugs tha relieve anxiety, irritability, and tension Benzodiazepines and barbiturates, Flunitrazepam (Rohypnol), date rape drug, used to enhance a heroin high or to ease the coming down from a cocaine high Mixing benzodiazepines with ethanol or barbiturates can be lethal, death results from respiratory arrest, flumzenil may be used to reverse the acute sedative effects of benzodiazepines |
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fentanyl
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Ch 10
Synthetic opiod used to treat moderate to severe pain, has a high abuse potential Available in several dosage forms, parenteral injections, transdermal patches, buccal lozenges, and most recently a lollipop lozenge on a stick. injectable is used most commonly in perioperatice setting, induction fo general anesthesia and in intensive care unit settings for sedation during mechanical ventilation. A new patch should be applied ever 72 hrs. After first patch is applied it will take 6 to 12 hours to reach steady-state pain control again, short acting therapy is required during this time. |
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beta-blocker
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Ch 18
SLOW decrese blood pressure and pulse Beta blockers include: propranolol (Inderal), side effects: hypotension, bradycardia, fatigue, depression, hypoglycemia. SympatheticBeta 1 receptors are blocked. decreases HR resulting in decreased myocardial oxygen demand and increased oxygen delivery to the heart. NOTE: Side affects include constipation, H/A, lightheadedness, hypotension, dizziness, After an MI, a high level of circulating catecholamines are irritating the heart causing an imbalance in supply and demand ration and even leading to life threatening dysrhythmias. Beta blockers block harmful effect of catecholamines improving survival after MI |
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dobutamine
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Ch 17
shock syndrome, cardiopulmonary arrest (Intropin)- a naturally occuring catecholamine neurotransmitter in the SNS. It has potent dopaminergic and B1- and A1-adrenergic receptor activity, depending on the dosage. in low doses can dilate blood vessels in the brain, heart, kidneys, and mesentary, whick increases blood flow to these areas. in higher infusion rades can improve cardiac contractility and output. *Dopaminergic receptors: respond only to dopamine |
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physostigmine
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Ch 19
Indications: Myasthenia gravis, reversal of anticholinergic drug effects and TCA overdose. Antilirium- It is an indirect-acting cholinergic drug that works to increase ACh by inhibiting the enzyme tha breaks it down Shown to inprove muscle strength (myasthenia gravis |
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vitamin K
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Ch 54 and Ch 27
Important about Vitamin K-infants born in hospitals are often given prophylactic intramuscular dose of Vitamin K on arrival to the nursery. Also needed for clotting of the blood. Increasing anticoagulant activity by decrease in vitamin K absorption or synthesis by the bacteria flora of the large intestines. |
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heparin
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Ch 27
Is a natural anticoagulant obtained from the lungs, intestinal mucosa, oro other sutable tissues of primarily sheep, cows and pgs. Used for IV flush and as a anticoagulant |
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tetracyclines
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Ch 37
Tetracycline’s- is unique because it causes photosensitivity, they also cause GI upset, they should not be given with dairy products, antacids, sodium bicarbonate, kaolin-pectin, or iron, because these chelate or bind with the antibiotic and decrease the antibiotic effect. These interacting foods and drugs may be given 2 hours before or 3 hours after the tetracycline to avoid this interaction. |
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Statins-
impenem-cilastatin |
NA
Ch 28 Statins lower the blood cholesterol level by decreasing the rate of cholesterol production. Contraindicatons include known drug allergy, pregnetcy, liver disease or elevation of liver enzymes Adverse effect is myopathy (muscle pain), which may progress to a serious condition known as rhabdomyolysis. |
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doxycycline
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Ch 37
is a tetracycline Broad antibacteral coverage, including treatment of skin infections and respiratory, GI, and GU tract infections It is useful in the treatment of rickettsial infections such as rocky mountain spotted fever, chlamydial and mycoplasmal infections, spirochetal infections, and many infections with gram-negative organisms. Contraindicated in pregnetcy and children under 8 because it binds to calcium and can prevent normal bone growth and cause tooth enamel hhypoplasia in the fetus |
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nitroglycerine
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NA
Ch 23 Nitrate antianginal drugs can produce additive hypotensive effects when taken in combination with alcohol, B-blockers, phenothiazines, and erectile-dysfunction drugs such as viagra Nitrates dilate all blood vessels |
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histamine
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Ch 35
Is involved in nerve impulse transmission in the CNS, dilation of capillaries, contraction of smooth muscles, stimulation of gastric secretion, and acceleration of the heart rate. The release of excessive amounts of histamine can lead to anaphylaxis and severe allergic symptoms |
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alcohol
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Ch 8
Ethanol, causes CNS depression by dissolving in lipid membranes in the CNS. Chronic excessive ingestion of ethanol is directly associated with serious neurologic and mental disorders. Nutritional and vitamin deficiencies, especially of the B vitamins, can occur and can lead to Wernicke's encephalopathy, Knorsakoff's psychosis, polyneuritis, and nocotinic acid deficiency encephalopathy |
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morphine
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Ch 10
Opioid analgesia Strong potential for misue and abuse, is classified as a Schedule II controlled substance Highly constipating, and softners or laxatives are often required as adjunct medications |
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acetaminophen
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Ch 10
Acetaminophen is indicated fro the treatment of mild to moderate pain and fever, it is an appropriate substitute for aspirin because of its analgesic and antipyretic properties. Is the antipyretic drug of choice in children and adolescents with flu syndromes, because the use of aspirin in such populations is associated with a brain wasting condition known as Reye's syndrome. Acetylcysteine is the recommended antidote for acetaminophen toxicity. |
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atenolol
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Ch 18
Atenolol Tenormin is a cardioselective B-blocker that is commonly used to prevent future MIs in patients who have had an MI. It is also used in the treatment of hypertension and angina Pt should report weight gain of more than 2 pounds in 1 day or 5 lb withing 1 week, edema of the feet or ankles, shortness of breath, excessive fatigue or weakness, syncope or dizziness |
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atropine
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Ch 20
is a anticholinergics antidote for cholinergics Preop control of secretions, therapeutic anticholinergic effect Naturally occuring antimuscarininc. Used preoperatively to reduce salivation and GI secretions. Effect dosent last to long Indications: used primaryly for cardiovascular disorders Diagnosis of sinus node dysfunction Symptomatic second-degree heart block Sever sinus bradycardia with hemodynamic compromise (advanced life support) Contraindicated in patients with angle-closure glaucoma, adhesions between the iris and lens, certain types of asthma, renal dysfunction etc. |
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aspirin
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Ch 27
Salicylate antiplatelet Indicated for MI prophylaxis, TIA prophylaxis Contraindicated for use in children and teenagers with flulike symptoms: This situation is associated with cases of Reye's syndrome, a rare, acute, and sometimes fatal condition involving hepatic and central nervous system damage Adverse effects include a risk for inducing a serious bleeding episode. |
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aldosterone
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Ch 25
A mineralocorticoid steriod hormone produced by the adrenal cortex that mediate the actions of the renal tubule in the regulation of sodium and potassium balance in the blood. |
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vitamin E
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NA
Ch 54 Four bilogically active chemicals called tocopherols (alpha, beta, gamma, and delta) make up the vitamin E compounds. Fat soluble vitamin Antioxidant |
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antihistamine
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Ch 35
have several properties-antichistaminic, anticholinergic, sedative Action-Block action of histamine at the H1 receptor sites, compete with histamine for binding at unoccupied receptors, the binding of H1 blockers to the histamine receptors prevents the adverse consequences of histamine stimulation, vasodilation, Increased GI and respiratory secretions, Increased capillary perneability, should be given eary in treatment Indications-parkinsons disease:anticholinergic, sleep disorders have a drying effect benadryl, alegra, claritin, zyrtec- newer drugs are less sedative |
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sulfonamides
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Ch 37
They were one of the first groups of druds used as antibiotics. Sulfonabides do not actually destroy bacteria but inhibit heir growth. For this reason they are considered bacteriostatic antibiotics. They prevent bacterial synthesis of folic acid. 592 For sulfonamides, inform the patient to take the antibiotic with plenty of fluids (2000 to 3000 mL/24 hr) to prevent drug-related crystalluria or precipitation in the kidneys, and to take these drugs with food. For tetracycline’s, the patient should be advised to avoid expo-sure to tanning beds and direct sunlight or to use sunscreen and/or wear protective clothing because of drug-related photo-sensitivity. How do you know if an antibiotic is effective or not? Because normally occurring bacteria are killed during antibiotic therapy, super infections may arise during treatment. These may be manifested by the following signs and symptoms: fever, perinial itching, oral lesions, vaginal irritation and discharge, cough, and lethargy. How do you tell if an antibiotic is effective or not? WBC count |
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antacids
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Ch 51
Antacids-calcium based, not prescribed real often because too much calcium can cause kidney stones. Sodium bicarbonate Antacids work primarily by neutralizing gastric acidity. They do nothing to prevent the overproduction of acid but instead help to neutralize ac id secretions. The primary drug effect of antacids is the reduction of symptoms associated with various acid-related disorders, such as pain and reflux. Both the aluminum- and calcium-containing formulations can result in constipation. Calcium products can also cause kidney stones. The problem with sodium bicarbonate- Use of sodium bicarbonate may lead to metabolic alkalosis if the drug is abused or used over the long term. Alkalosis is manifested by irritability, muscle twitching, numbness and tingling, cyanosis, slow and shallow respirations, headache, thirst, and nausea. To much sodium if you have heart problems can lead to congestive heart failure. |
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vancomycin
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Ch 38
Vancomycin- is the antibiotic of choice for the treatment of MRSA infection and infections caused by many other gram-positive bacteria. It is not active against gram-negative bacteria, fungi, or yeast. Indicated for the treatment of pseudomembranous colitis (can be caused by drugs because they can kill off the normal flora) and for the treatment of staphylococcal enterocolitis. Adverse effect of vancomycins that is bothersome by usually not harmful is known as red man syndrome. This involves flushing and or itching of the head, face, neck and upper trunk area. Counteract by giving antihistamines (Benadryl). |
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erythromycin
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Ch 37
NA Natural macrolide Indicated for infections of respiratory and GI tracts and skin caused by various gram-positive, gram-negative, and miscellaneious organisms These drugs are highly protein-bound and will cause sever interactions with other protein-bound drugs The absorption of oral erthromycin is enhanced when taken on an empty stomach, but because of the high incidence of GI upset, many drugs are taken after a meal or snack |
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famotidine
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Ch 51
Pepcid, Pepcid AC H2 antagonist Indicated for dyspepsia, heartburn, ulcers, pathologic hypersecretion How dose smoking effect H2 receptor antagonist? Lessens the effects of them. |
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calcium carbonate
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Ch 51
Calcium-containing antacid Indicated for hyperacidity Calcium carbonate is your Tums |
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ducosate
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NA
No such thing????? |
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senna (senokot)
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Ch 52
Stimulant-irritant laxative- most likely to become dependent on, most abused, senna (Senokot) |
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imodium
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Ch 52
Not an opiate is loperamide (Imodium A-D)- there is no physical dependence with this med. |
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hyperosmotic laxative
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Ch 52
Hyperosmotic laxative- Glycerin- works by osmotic pressure, draws fluid into the colon, keeps it going |
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beta-lactam
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Ch 37
The name for a broad, major class of antibiotics that includes four subclasses: penicillins, cephalosporins, carbapenems, and monobactams. B-Lactam Antibiotics-named because of the B-lactam ring that is part of their chemical structure. Commonly used drugs. Bacterial strains produce the enzyme B-lactamase, provides a mechanism for bacterial resistance to these antibiotics. B-lactam is the structure of the antibiotic, B-lactamase is the enzyme that is produced by the bacterial that breaks down the B-lactam ring, if the ring is broken the antibiotic is no longer effective |
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aluminum hydroxide
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Ch 52
Maalox, Mylanta Combination antacid Indicated for Hyperacidity Both the aluminum- and calcium-containing formulations can result in constipation. |
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simethicone
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Ch 51
Mylicon is used to reduce the discomforts of gastric or intestinal gas and aid in its release via the mouth or rectum. Classified as an antiflatulent drug. Works by altering the elasticity of mucus-coated gas bubles, which causes them to break into smaller ones. |
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glycerin
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Ch 52
Hyperosmotic laxative- Glycerin- works by osmotic pressure, draws fluid into the colon, keeps it going |
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emollient laxative
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Ch 52
Emollient laxative-mineral oil, problem is you can’t absorb vitamins as you should, don’t get the Vitamin K, D, E. Fat soluble vitamins are reduced with emollient laxatives. Mineral oil, Kondermul Plain, Fleet Oil-Retention Enema |
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stimulant laxative
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Ch 52
Stimulant-laxative- most likely to become dependent on, most abused, senna (Senokot) |
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aminoglycocide
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Ch 38
Aminoglycosides are any drugs with –micin on the end of the name. main one is gentamicin. With above normal troughs in -Aminoglycosides you are at greater risk for both ototoxicity (toxicity to the ear) and nephrotoxicity (toxicity to the kidneys). Ototoxicity often manifests as some degree of temporary or permanent hearing loss. Nephrotoxicity manifests in varying degrees of reduced renal function. Mechanism of action and drug effects of Aminoglycosides- often AGs are used in combination with other antibiotics such as beta-lactams or vancomycin in the treatment of various infections because the combined effect of the two antibiotics is greater than that of either drug alone. This is known as a synergistic effect. |
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magnesium hydroxide
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Ch 52
Dulcolax Magnesia Tablets, Phillips Magnesia Tablets, Phillips Milk of Magnesia, MOM |
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polethylene glycol
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Ch 52
Polyethylene glycol- GoLYTELY is Hyperosmotic-draws the fluid out of the wall of the large intestine, causes the feces to be lubricated. |
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milk of magnesia
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Ch 51
MOM in larger quantities can be used as a laxative, in smaller quantities as an antacid. |
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lomotil
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Ch 52
drug is diphenoxylate with atropine (Lomotil)- slows down the GI track |
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bulk-forming laxative
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Ch 52
Bulk-forming laxative-safest and more natural Citrucel, Metamucil, Fiberall Mix at bedside, drink right away |
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Describe pharmacologic and nonpharmacologic approaches for the management and treatment of acute and chronic pain
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Ch 10
Pain management strategies should include an emphasis on the type of pain and it rating as well as pain quality, duration, precipitating factors, and interventions tha help the pain. Nonpharmacologic measures for pain management should always be used, either as a beginning mode of treatment or as an adjuvant to pharmacologic theraapy and include relaxation therapy, guided imagery, music distraction, exercise, transcutaneous electrical stimulation, and massage. General principals of pain management include: 1) management of mild to moderate pain often begins with the use of nonnarcotic drugs such as acetaminophen, tramadoln and NSAIDs. 2) moderate to sever pain is generally not managed with nonnarcotics but is usually treated with narcotis. 3) drug selection for treatment of moderate to severe pain should be based on variables such as the characteristics of the individual patient, cultural influences, the disease process, and the use of other therapies(homeopathic, folk, herbal) |
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Discuss the use of nonopioids, nonsteroidal antiinflammatory drugs (NSAIDs), and opioids (opioid agonists and partial opioid agonists and antagonists) in the management of acute and chronic pain.
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Ch 10
Nonopiod analgesics-analgesics that are not classified as opiods, most widely used is acetaminophen, used to manage pain especially pain associated with inflammatory conditions. all drugs in the NSAID class- NSAIDs- a large, chemically diverse group of drugs that are analgesics and also possess antiinflammatory and antipyretic activity but are not steroids. Opiods-synthetic narcotic drugs that bind to opiate receptors to relieve pain but are not themselves derived from the opium plant. agonist binds to an opioid pain receptor in the brain and causes analgesic response- the reduction of pain sensation. partial agonist-binds to a pain receptor but causes a weaker neurologic response that a full agonist. antagonist binds to a pain receptor but does not reduce pain signals, it competes with and reverses the effects of agonist and partial agonist drugs at the receptor sites |
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Identify the various drugs that are classified within the nonnarcotic and narcotic drug groups. (NSAIDs are discussed in Chapter 44.)
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Ch 10
Narcotics are drugs that produce insensibiliy or stupor, the term is applied most commonly to the opoid analgesics. Opiate analgesic's are natural narcotic drugs Opiod analgesic's are synthetic narcotic drugs Nonopoiod analgesics are nonnarcotis such as all drugs in the NSAID class, which includes aspirin,acetaminophen, etc. Tramadon is NOT currently classified as a controlled substance. |
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Discuss the difference between opioid agonist, agonist-antagonist, and antagonist drugs and their specific use in the management of acute and chronic pain.
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Ch 10
opiod agonist-binds to an opioid pain receptor in the brain and causes an analgesic respones-reduction of pain sensation. opiod agonist-antagonist- binds to a pain receptor but causes a weaker neurologic respones tha a full agonist(aka partial agonist) An antagonist binds to a pain receptor but does not reduce pain signals, also functions as a competitive antagonist because it competes with and reverses the effects of agonist and partial agonist drugs at the receptor sites. OPIATE ANTAGONIST- used for complete or partial reversal of opiod-induced respiratory depression. NALOXONE (narcan) NALTREXONE (rivia) |
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Compare the mechanisms of action, drug effects, indications, adverse effects, cautions, contraindications, drug-drug and drug-food interactions, dosages, and routes of administration for narcotic drugs (agonist and partial agonist-antagonist narcotics).
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Ch 10
action-pain relievers (see agonist, antag- etc) indications,-alleviate moderate to sever pain adverse effects-unwanted effects of opiod analgesis are related to their effects on parts of the body other tha the CNS caution-respiratory insufficiency, respiratory insufficiency, elevated intracranial pressure, morbid obesity, sleep apnea, myasthena gravis, pregnancy contraindications-known drug allergy and sever asthma drug-drug-significant w/ caadministration of opiods with alcohol, antihistamines, barbiturates, benzodiazepines, and othe CNS depressants results in additive respiratory deppressant. combined with MAOIs can result in respiratory depression, seizures, and hypotension. dosages-varies depending on drug routes of administration-PO,SC. IM, IV, transdermal patch, PR, PCA pump, epidural |
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Six Elements of a Drug Order
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Ch 1
Patients name Date order is written Name of medication Dosage (Includes size, frequency, and number of doses Route of delivery Signature of the prescriber |
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Discuss the process of pharmacokinetics and associated changes in elderly patients.
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Ch 3
Absorption: gastric pH less acidic, slowed gastric emptying, movement through GI tract slower, Reduced blood flow to the GI tract, reduced absorptive surface area due to flattened intestinal villi. Distribution: TBW % lower, fat content increased, decreased production of proteins by the liver, resulting in decreased protein binding of drugs and increased circulation of free drugs Metabolism: Decreased glomerular filtration rate, decreased number of intact nephrons |
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Discuss the ethical aspects of drug administration as they relate to drug therapy and the nursing process.
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Ch 4
Legal and Ethical Principles Automony-self determination Benefience- doing and promoting good Confidentiality- respect privileged information Justice- being fair or equal Nonmalefience- do no harm Veracity- duto to tell the truth |
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Identify the possible consequences of a medication error on a pt physiologic and psychologic well-being.
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Ch 5
Effects can range from no significant effect to directly causing disability or death. Most common type of drugs that cause adverse effects are Antibiotics and Cancer drugs. |
