Week 9-Final

Front 1

Normal value of platelets

Back 1

150-400 k per microliter

Front 2

Anticoagulant

Back 2

Prevents clots from forming or extending by interrupting clotting cascade.

Front 3

Heparin and what is it monitored by?

Back 3

Prevent conversion of prothrombin to thrombin. IV therapy is monitored by activated partial thromboplastin time (aPTT)

Front 4

What's therapeutic level of aPTT

Back 4

One and one half to two times the control level

Front 5

Antidote of heparin

Back 5

Protamine Sulfate

Front 6

Enoxaparin (lovenox)

Back 6

Low molecular weight heparin, more bioavailability and longer half life.

Front 7

Administration tips of IV Heparin

Back 7

High alert med, 2x RN to double check initial dose and changes

Front 8

Administration tips for subq heparin and lovenox

Back 8

Proper needle, etc. Watch for air bubbles and do not massage, avoid belly button area.

Front 9

Warfarin (Coumadin)

Back 9

Blocks vitamin K and stops activation of prothrombin. Monitored by INR.

Front 10

What level should PT and INR be

Back 10

PT: one and one half to 2x the control

INR: 2 or 3

Front 11

What category is warfarin in pregnant women

Back 11

Category X

Front 12

Antidote to warfarin

Back 12

Vitamin K

Front 13

Antiplatelet agents

Back 13

Aspirin, Plavix, ReoPro (glycoprotein)

Front 14

Aspirin (ASA) and adverse effects

Back 14

Inhibits cyclooxygenase. Stop taking 5-7 days before surgery (dose therapy is 81-325 mg/day) because adverse effect is risk of GI bleed. No risk for neutropenia.

Front 15

Therapeutic uses of ASA

Back 15

MI, strokes and angina

Front 16

Plavix

Back 16

Prodrug so it metabolizes to its active form. Platelet function starts 7-10 days after last dose of this. Adenosine Diphosphate Receptor Antagonists

Front 17

Therapeutic Uses and Side Effects of Plavix

Back 17

Prevents blocking of coronary stents, prevents thrombolytic events, combine with ASA.

Adverse Effect is bleeding and TTP (Thrombotic Thrombocytopenic Purpura. It interacts with Proton Pump Inhibitors (decrease metabolism of plavix).

Front 18

Thrombolytics

Back 18

Recombinant alteplase (Activase, tPA)

Catalyzes the conversion of plasminogen to plasmin (digests fibrin in clots)

Front 19

Therapeutic and Caution with Thrombolytics

Back 19

Used for MI, Stroke and pulmonary embolism. High risk of bleeding so monitor for that.

Front 20

Statins

Back 20

Prototype: Lovastatin (Mevacor)

Increases HDL and decrease LDL, VLDL, cholesterol and plasma triglycerin.

Front 21

Pregnancy category for Statins

Back 21

Category X for pregnant women

Front 22

Lovastatin (Mevacor) Adverse Effect and metabolism

Back 22

Elevated liver enzymes may occur so monitoring LFTs is essential. Myopathy (injury to muscle tissue) may occur, monitor creatine kinase (ck). Metabolizes via hepatic. Don't take grapefruit cause it may decrease metabolism.

Front 23

Nicotinic Acid

Niacin

Adverse Effects

Back 23

Increases HDL, decreases LDL and triglycerides.

Facial flushing is an adverse effect and keeps from administering therapeutic drug dose. (asa can help)

Front 24

Normal aPTT

Back 24

20-36 seconds

Front 25

Normal PT

Back 25

9.6-11.8 seconds

Front 26

Difference w/ Conventional and Atypical Antipsychotics?

Back 26

Conventional block dopamine receptors. Atypical block serotonin receptors

Front 27

Adverse effects of conventional antipsychotics

Back 27

EPS: Acute dystonia, parkinsonism, akathisia, tar dive dyskinesia. Neuroleptic malignant syndrome (muscle rigidity, fever, changes in cognition; meningitis kinda symptoms) and anticholinergic effects (they dry everything).

Front 28

Onset and Symptoms of Acute Dystonia

Back 28

Onset is hours to days of first dose. Symptoms are spasms of tongue, face, neck or back.

Front 29

Treatment and caution with Acute Dystonia

Back 29

Treatment is ASAP, Anticholinergic med (Cogentin) or Antihistamine (Benadryl). Laryngeal Dystonia can cause impaired respiratory.

Front 30

Clozapine (Clozaril)

Back 30

PO and used for schizophrenia.

Front 31

Adverse effects of Clozapine

Back 31

Sedation, orthostatic hypotension, weight gain, dry mouth, blurred vision, photophobia, constipation and tachycardia.

Also agranulocytosis (WBC), seizures (dose related) and diabetes.

Low risk of EPS.

Front 32

Use for Lithium

Back 32

Bipolar disorder and prevents recurrence

Front 33

Half life of Lithium and where is it excreted?

Back 33

Short half life so it needs divided daily doses. Its excreted in the kidneys so caution in renal impairment.

Front 34

Renal excretion of Lithium is affected by what?

Back 34

Affected by sodium levels. When Sodium levels decrease, lithium excretion decreases because kidney process them the same. Body tries to retain Lithium when sodium decreases.

Front 35

Maintenance level of Lithium and when should levels be measured?

Back 35

.4-1.0

Take lab draws in AM 12 hrs after evening dose

Measure every 2-3 days at beginning of treatment; 1-3 months during maintenance.

Front 36

Normal Sodium Levels

Back 36

135-145

Front 37

Adverse Effects of Lithium

Back 37

GI upset to death. Blurred vision, seizures or trembling, drowsiness, ringing in the ears

Front 38

What pregnancy category is Lithium

Back 38

Category D

Front 39

Effects of Lithium at normal levels?

Back 39

Polyuria and renal toxicity

Front 40

Lithium Drug Interactions

Back 40

Diuretics, NSAIDs, Anticholinergic drugs

Front 41

Treatments of Depression

Back 41

Pharmacotherapy, Depression-specific psychotherapy, Electroconvulsive therapy, Vagus Nerve Stimulation

Front 42

Tricyclic Antidepressants or TCA

Back 42

Ends in ine, takes weeks to work. Not PRN, side effect could be too happy, weight gain (noncompliance), cardiac toxicity and like lithium symptoms.

treatment for overdose is life threatening and use charcoal or Physostigmine for the anticholinergic effects

Front 43

Signs of Neuroleptic malignant Syndrome with Lithium toxicity

Back 43

Lead pipe rigidity, hyperthermia, shuffling gait, dysphagia. Give tylenol lowers fever and dantrolene for malignant hyperthermia. BP drops, give fluids.

Front 44

Common Adverse Effects of SSRI's

Back 44

Sexual dysfunction, Weight gain, Serotonin Syndrome (high fever, seizures, irregular heartbeat)

Withdrawal Syndrome (dysphoria, nausea, tremors, etc.) , Neonatal Withdrawal Syndrome

No OH like the others.

Front 45

What food to avoid when taking MAOI

Back 45

Foods that have tyramine like old cheese

Front 46

Adverse Effects of Benzo's

Back 46

End in Am. sedation (think of too much sedation, resp. issue), ataxia, anticholinergic effects (opp. of SLUGBAM), antegrade amnesia, and an hangover effect.

Reversal is NOT naloxone (Romazicon is!)

Front 47

Sonata

Back 47

Not related to Benzo's but binds to its receptors. Has sedative effects.

Front 48

Ambien

Back 48

Not Benzo but has sedative effect. Doesn't have anticonvulsant or muscle relaxant effects like Sonata and Benzo's though. Just the hypnotic effect.

Front 49

Reversal or antidote to Benzo's

Back 49

Romazicon