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Questions and Answers
1 tablespoon (Tbsp) is equivalent to _____ teaspoons (tsp).
3 tsp
How many ounces are there in a pint?
16 fluid ounces
What is the common dosage calculation formula used in nursing?
An IV flow rate can be calculated with the formula Total Volume (mL) / Total Time (hr).
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A microgram is equivalent to _____ grams.
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What is the antidote for Warfarin?
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Which of the following routes is the most rapid for medication administration?
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Diuretics can lead to low potassium levels in the body.
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What is the abbreviation for 'administered orally'?
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The 'Z-track' method is used for injecting _____ medications.
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What is one potential side effect of long-term corticosteroid use?
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Which of these medications should NOT be given to heart failure patients?
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Digoxin affects blood pressure but not heart rate.
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What is the therapeutic range for Digoxin?
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Calcium channel blockers are used to treat _________ and angina.
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Match the medication with its primary side effect:
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Bile acid sequestrants lower LDL cholesterol by binding bile acids in the gut.
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What should patients avoid when taking HMG-CoA reductase inhibitors?
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What is a common side effect of vasodilators?
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When should transdermal patches be removed?
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Digoxin can cause toxicity if potassium levels are ______.
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Study Notes
Measurement Equivalents
- 3 teaspoons (tsp) equals 1 tablespoon (Tbsp).
- 1 tablespoon equals 1 fluid ounce.
- 8 ounces (oz) equals 1 cup.
- 2 cups equals 1 pint.
- 2 pints equals 1 quart.
- 4 quarts equals 1 gallon.
- 1 juice glass equals 4 oz.
- 1 teacup equals 6 oz.
- 1 teaspoon equals 5 mL.
- 1 tablespoon equals 15 mL or 3 tsp.
- 1 gram equals 1000 mg.
- 1 microgram equals 0.000001 grams.
- 1 kilogram equals 2.2 lbs.
- 1 mg equals 1000 mcg or 0.001 grams.
- 1 lb equals 16 oz.
Dosage Calculations
- Basic formula: Dose Required × Quantity = Dose on Hand × X.
- Example: For 25 mg of Metoprolol available as 50 mg tablets, administer 0.5 tablets.
- Infusion time calculation: Total Volume ÷ mL/hr = Total Time.
- Example: Infuse 1L of NS at 125 mL/hr to run for 8 hours.
- Calculate drops per minute using: Total Volume × Drop Factor ÷ Total Time (in minutes).
Medication Administration Routes
- Topical: Application through skin; forms include ointments, gels, and patches.
- Nasal: Administered for allergies and congestion; forms are sprays and inhalers.
- Oral: Medications taken by mouth; insulin cannot be administered orally.
- Vaginal: Includes gels, foams, and IUDs for birth control.
- Otic: Directly instilled into the ear; administration varies between adults and children.
- Ophthalmic: For eye conditions; follow proper application techniques to avoid contamination.
- Inhalants: Includes MDIs and nebulizers, proper inhalation techniques are crucial.
- Buccal: Medications placed in the cheek; avoid eating/drinking for 15-20 minutes post-administration.
- Sublingual: Under the tongue for rapid absorption.
- NG Tube: Needs are met with liquids or crushed tablets, ensuring proper placement.
- Rectal: Includes enemas, suppositories, and ointments.
- Intradermal: Used for testing, requires specific administration techniques.
- Subcutaneous: Injection into fatty tissue; rotate sites, and do not aspirate.
- Intramuscular: Used for various medications with specific sites and techniques.
- Intravenous: Rapid administration of medications or fluids; monitor closely for complications.
7 Rights of Safe Medication Administration
- Right person
- Right drug
- Right dose
- Right time
- Right route
- Right technique
- Right documentation
Skin Disorders & Their Treatments
- Skin disorders classified as inflammatory, infectious, or cancerous.
- Treatment for bacterial infections includes antibiotics and topicals containing benzoyl peroxide.
- Antifungals for yeast infections (e.g., Clotrimazole for Tinea; Nystatin for candidiasis).
- Inflammatory skin conditions like eczema treated with topical corticosteroids (Hydrocortisone acetate).
- Psoriasis managed with topical treatments and phototherapy.
- Skin cancers including basal cell carcinoma (most common, treated surgically) and malignant melanoma (more aggressive, requiring extensive treatment).
Musculoskeletal System Medications
- Glucocorticosteroids: Decrease inflammation; associated with several side effects including Cushing's syndrome.
- DMARDs: Slow disease progression in rheumatoid arthritis. Methotrexate is a common treatment.
- Muscle Relaxants/Skeletal Muscle Spasm Treatment: Includes Cyclobenzaprine and Baclofen.
- Gout Treatment: NSAIDs and anti-inflammatory medications to relieve acute symptoms.
Opioids
- Strong pain relief with higher addiction potential; monitored for overdose risk.
- Examples include Morphine, Fentanyl, and the antidote Naloxone.
Antiseizure Medications
- Various classes including Barbiturates and GABA analogs.
- Common medications are Phenytoin and Benzos like Diazepam.
Insulin and Diabetes Medications
- Different insulin types: Rapid-acting, Short-acting, Intermediate-acting, Long-acting, and Inhaled insulin.
- Various oral hypoglycemic agents (e.g., Metformin, Sulfonylureas).
- Regular insulin is the only type administered IV.
Antihypertensives
- ACE Inhibitors: -pril suffix drugs reduce BP and have renal protective effects.
- ARBs: -sartan suffix drugs block angiotensin receptors.
- Beta-Blockers: Reduce heart rate and BP; important to monitor pulse and BP before administration.
Diuretics
- Thiazide, Loop, and Potassium-sparing diuretics each have specific mechanisms and potassium considerations.
- Monitor for signs of electrolyte imbalance and renal function throughout diuretic therapy.
These notes summarize key medication facts and administration methods vital for effective pharmacological management and patient safety.### Calcium Channel Blockers (CCBs)
- Primarily used for treating hypertension (HTN), angina, and coronary artery spasm
- Mechanism: Block calcium (Ca²⁺) entry into vascular smooth muscle cells, leading to relaxation
- Effects: Reduces myocardial contraction force, heart rate, and peripheral vascular resistance
- Benefits: Dilates coronary arteries, increases myocardial oxygen delivery, and decreases oxygen demand
- Common side effects: Edema, dysrhythmias
- Administration consideration: Do not crush or open capsules; monitor for orthostatic hypotension
- Contraindication: Not suitable for patients with heart failure (HF)
- Monitor heart rate (HR) and blood pressure (BP) before administration; withhold if BP < 90 or HR < 60
- Common medications include Amlodipine (Norvasc), Diltiazem (Cardizem), Nefidipine (Procardia XL), and Verapamil Hydrochloride (Isoptin, Calan)
Vasodilators
- Indicated in managing heart failure and hypertension; can prevent and treat angina
- Actions: Relaxes smooth muscle, lowers BP, enhances oxygen delivery to major organs
- Administration: Rotate transdermal patches; patches should be removed after 12-14 hours and be patch-free for 10-12 hours
- Monitor potassium (K) levels; assess for hypotension before administration
- Side effects: Headaches, flushing, and hypotension
- Important drug interactions: Avoid using with Viagra (sildenafil)
- Key medications include Nitroglycerin, Nitroprusside, Isosorbide, and Hydralazine (Apresoline)
Cardiac Glycosides
- Used for heart failure, potentially as an antiarrhythmic
- Does not significantly affect blood pressure; primarily influences heart rate
- Therapeutic range: 0.5 - 2.0 ng/mL for Digoxin
- Positive inotropic effect: Improves myocardial contractility and output
- Negative chronotropic and dromotropic effects: Reduces HR and slows AV conduction
- Considerations: Monitor potassium (K⁺) and Digoxin levels as low K⁺ increases toxicity risk
- Toxicity symptoms: Visual disturbances, dizziness, nausea/vomiting, irregular pulse, and confusion
- Commonly prescribed medication: Digoxin (Lanoxin)
Dysrhythmias Treatment
- Sodium Channel Blockers: Includes Propafenone (Rhythmol), Flecainide (Tambocor), Quinidine (Quinidex)
- Beta Blockers: Includes Atenolol (Tenormin), Propranolol (Inderal)
- Potassium Channel Blockers: Includes Amiodarone (Cordarone), Sotalol (Betapace), Bretylium
- Calcium Channel Blockers: Includes Diltiazem (Cardizem), Verapamil (Isoptin)
Key Treatment Insights
- All medications except Digoxin may lower BP
- Beta blockers and calcium channel blockers may reduce HR
- Avoid giving calcium channel blockers to heart failure patients
- Digoxin, beta blockers, vasodilators, and diuretics are appropriate for heart failure
- ACE inhibitors/ARBs are contraindicated in pregnancy
Lipid Disorders Overview
- HDL (High-Density Lipoprotein): Considered "good" cholesterol
- LDL (Low-Density Lipoprotein): Considered "bad" cholesterol
- VLDL (Very Low-Density Lipoprotein): Also considered "bad" cholesterol
Statins (HMG-CoA Reductase Inhibitors)
- Reduce blood lipid levels by decreasing liver cholesterol production
- Increase LDL receptors and inhibit the HMG-CoA reductase enzyme
- Watch for side effects: Liver toxicity, myopathy, rhabdomyolysis
- Monitor liver function tests (LFTs) and creatine kinase (CK) levels; avoid alcohol and grapefruit juice
- Take statins in the evening for optimal effect; common medications include Atorvastatin (Lipitor), Rosuvastatin (Crestor), Simvastatin (Zocor)
Bile Acid Sequestrants
- Reduce LDL cholesterol by binding bile acids in the gut, promoting their excretion
- Patients should increase fiber and fluid intake; medication may interfere with absorption of fat-soluble vitamins (A, D, E, K)
- Side effects: Constipation, flatulence, gastrointestinal disturbances
- Common medications include Colesevelam (Welchol), Cholestyramine (Questran)
Fibric Acid Derivatives
- Lower triglyceride synthesis in the liver and increase HDL cholesterol levels
- Monitor LFTs and CK levels for hepatotoxicity and myopathy risks
- Side effects: Gallstones and gastrointestinal upset
- Common medications include Fenofibrate (Tricor) and Gemfibrozil (Lopid)
General Considerations for Hyperlipidemic Medications
- All medications that affect the liver and lipid profile; most are contraindicated during pregnancy
- Routine monitoring of liver function tests is critical to ensure safety and efficacy.
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Description
This quiz tests your knowledge of various medical calculations and conversions, including dosage calculations, IV flow rates, and unit conversions.
