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Questions and Answers
Questions and Answers
When calculating IV drip rates using the "vtc" method, which formula is applied?
When calculating IV drip rates using the "vtc" method, which formula is applied?
- Dose (mg) / Concentration (mg/mL) = Volume (mL)
- Weight (kg) * Dose (mcg/kg/min) / Concentration (mcg/mL) = Rate (mL/hr)
- Total volume (mL) / Time (hours) = Drip rate (gtts/hr)
- Volume in mL * gtts/mL set / time in minutes = gtts/min (correct)
In medication administration, what is the primary reason for using two unique patient identifiers?
In medication administration, what is the primary reason for using two unique patient identifiers?
- To ensure the correct medication is administered to the correct patient. (correct)
- To reduce the workload on nursing staff.
- To streamline the medication administration process.
- To comply with hospital accreditation standards.
How does the first-pass effect influence drug bioavailability?
How does the first-pass effect influence drug bioavailability?
- It increases the rate of drug absorption in the small intestine.
- It decreases the bioavailability of the drug due to liver metabolism. (correct)
- It prolongs the duration of drug action.
- It enhances drug distribution to target tissues.
Which lifespan consideration is most important to remember when administering medications to infants and young children?
Which lifespan consideration is most important to remember when administering medications to infants and young children?
What is the most important consideration when administering medications via the intradermal route?
What is the most important consideration when administering medications via the intradermal route?
Why is it important to use aseptic technique when accessing central venous access devices?
Why is it important to use aseptic technique when accessing central venous access devices?
Which assessment finding is critical to monitor when administering hypertonic fluids?
Which assessment finding is critical to monitor when administering hypertonic fluids?
A patient exhibits mental status changes and muscle weakness. Which electrolyte imbalance should the nurse suspect?
A patient exhibits mental status changes and muscle weakness. Which electrolyte imbalance should the nurse suspect?
What adrenergic receptor is responsible for bronchodilation?
What adrenergic receptor is responsible for bronchodilation?
For a patient experiencing anaphylactic shock, why is epinephrine the drug of choice?
For a patient experiencing anaphylactic shock, why is epinephrine the drug of choice?
Which drug is used to counteract tissue death from ischemia after an epinephrine injection?
Which drug is used to counteract tissue death from ischemia after an epinephrine injection?
Why might a patient on a beta-blocker not respond to epinephrine during anaphylaxis, and what is the recommended alternative treatment?
Why might a patient on a beta-blocker not respond to epinephrine during anaphylaxis, and what is the recommended alternative treatment?
What is the significance of administering a cholinergic drug like Mestinon one hour prior to activity for a patient with myasthenia gravis?
What is the significance of administering a cholinergic drug like Mestinon one hour prior to activity for a patient with myasthenia gravis?
An elderly patient is prescribed an anticholinergic drug. What potential side effect requires careful monitoring?
An elderly patient is prescribed an anticholinergic drug. What potential side effect requires careful monitoring?
A patient is prescribed clonidine for hypertension. What is its mechanism of action?
A patient is prescribed clonidine for hypertension. What is its mechanism of action?
Why are ACE inhibitors often prescribed for heart failure, and what common side effect should be monitored?
Why are ACE inhibitors often prescribed for heart failure, and what common side effect should be monitored?
A patient with angina is prescribed nitroglycerin. What should the patient be taught regarding administration and when to seek emergency help?
A patient with angina is prescribed nitroglycerin. What should the patient be taught regarding administration and when to seek emergency help?
A patient taking Digoxin is also prescribed a diuretic. What electrolyte imbalance increases the risk of Digoxin toxicity?
A patient taking Digoxin is also prescribed a diuretic. What electrolyte imbalance increases the risk of Digoxin toxicity?
Which laboratory value is essential to monitor in a patient receiving heparin for anticoagulation?
Which laboratory value is essential to monitor in a patient receiving heparin for anticoagulation?
A patient is prescribed warfarin. What vitamin can reverse the effects of warfarin?
A patient is prescribed warfarin. What vitamin can reverse the effects of warfarin?
What class of medications is used to treat upper respiratory tract conditions like nasal congestion?
What class of medications is used to treat upper respiratory tract conditions like nasal congestion?
What is a desired effect of central nervous system (CNS) depressants?
What is a desired effect of central nervous system (CNS) depressants?
What is a potential side effect of CNS stimulants that warrants careful monitoring?
What is a potential side effect of CNS stimulants that warrants careful monitoring?
A patient taking phenytoin (Dilantin) for seizure control develops gingival hyperplasia. What is the primary reason for this side effect?
A patient taking phenytoin (Dilantin) for seizure control develops gingival hyperplasia. What is the primary reason for this side effect?
What is the reversal agent for opiate-induced respiratory depression?
What is the reversal agent for opiate-induced respiratory depression?
What potentially life-threatening complication is associated with the use of Zofran?
What potentially life-threatening complication is associated with the use of Zofran?
What instructions should be given to a client who is prescribed Metformin?
What instructions should be given to a client who is prescribed Metformin?
A patient with diabetes insipidus is prescribed DDAVP (desmopressin). What is the primary action of this medication?
A patient with diabetes insipidus is prescribed DDAVP (desmopressin). What is the primary action of this medication?
What is a significant risk of using tetracycline antibiotics?
What is a significant risk of using tetracycline antibiotics?
A patient receiving intravenous vancomycin develops Red Man Syndrome. What is the cause of this reaction?
A patient receiving intravenous vancomycin develops Red Man Syndrome. What is the cause of this reaction?
Why is prompt initiation of Tamiflu important?
Why is prompt initiation of Tamiflu important?
Which antifungal medication is commonly used as an oral treatment for vaginal yeast infections?
Which antifungal medication is commonly used as an oral treatment for vaginal yeast infections?
What is the primary concern when administering antineoplastic agents, given their mechanism of action?
What is the primary concern when administering antineoplastic agents, given their mechanism of action?
What is the primary mechanism of drugs used to treat glaucoma?
What is the primary mechanism of drugs used to treat glaucoma?
A patient has a cerumen impaction. Which type of solution is best for softening the impacted wax?
A patient has a cerumen impaction. Which type of solution is best for softening the impacted wax?
What is the main concern regarding the use of estrogen and progesterone hormone-based medications for contraception or post-menopausal symptoms?
What is the main concern regarding the use of estrogen and progesterone hormone-based medications for contraception or post-menopausal symptoms?
A patient is prescribed a phosphodiesterase inhibitor for erectile dysfunction. What medication is contraindicated with this treatment?
A patient is prescribed a phosphodiesterase inhibitor for erectile dysfunction. What medication is contraindicated with this treatment?
Which hormone is used in transgender hormone therapy to induce masculinizing effects?
Which hormone is used in transgender hormone therapy to induce masculinizing effects?
Which of the following intravenous fluids is considered isotonic?
Which of the following intravenous fluids is considered isotonic?
Which of the following beta-blockers would be safest to use in a patient who has COPD?
Which of the following beta-blockers would be safest to use in a patient who has COPD?
What is the antidote for a patient overdosing on a CHOLINERGIC medication?
What is the antidote for a patient overdosing on a CHOLINERGIC medication?
Questions and Answers
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Flashcards
Flashcards
Solve for X
Solve for X
Using fractions, ratios, the formula is D/H*Q=X.
IV drip rate calculation
IV drip rate calculation
mL * gtts/mL set / time in minutes = gtts/min (or “vtc” method).
Rights of medication administration
Rights of medication administration
Always use two unique patient identifiers. Always check allergies. Always look up what you don't know for certain.
Medication errors
Medication errors
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Absorption
Absorption
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First-pass effect
First-pass effect
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Distribution
Distribution
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Metabolism
Metabolism
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Excretion
Excretion
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Pregnancy considerations
Pregnancy considerations
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Infants and children considerations
Infants and children considerations
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Elderly considerations
Elderly considerations
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Site evaluation should include
Site evaluation should include
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Saline well
Saline well
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Running IV
Running IV
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PICC lines
PICC lines
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Isotonic fluids
Isotonic fluids
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Hypotonic fluids
Hypotonic fluids
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Hypertonic fluids
Hypertonic fluids
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Potassium
Potassium
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Sodium
Sodium
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Adrenergic (adrenal medulla)
Adrenergic (adrenal medulla)
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Alpha adrenergic
Alpha adrenergic
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Beta-1 adrenergic
Beta-1 adrenergic
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Beta-2 adrenergic
Beta-2 adrenergic
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Alpha blockers
Alpha blockers
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Beta Blockers action
Beta Blockers action
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Cholinergic action
Cholinergic action
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Anticholinergic action
Anticholinergic action
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Alpha drugs action
Alpha drugs action
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Beta-blockers "OLOL" action
Beta-blockers "OLOL" action
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Diuretic action
Diuretic action
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ACE-Inhibitors “pril” action
ACE-Inhibitors “pril” action
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Nitro/Isosorbide action
Nitro/Isosorbide action
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Beta blockers action
Beta blockers action
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Heparin, Lovenox, Fragmin action
Heparin, Lovenox, Fragmin action
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Upper respiratory tract treat with:
Upper respiratory tract treat with:
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Lower respiratory tract treat with:
Lower respiratory tract treat with:
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CNS depressants
CNS depressants
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Flashcards
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Study Notes
Study Notes
Math
- Solve for X using fractions, ratios, or the formula D/H*Q=X.
- IV drip rate is calculated using: Volume in ml * gtts/ml set / time in minutes = gtts/min (vtc method).
- Confirm the safe daily/dose limits by calculating low and high amounts for 24-hour period and divide to find range per dose.
- Heparin and Dopamine drips need to be reviewed in detail.
- Dosage conversions between pounds/kg and ounces/ml are important.
Fundamentals of Medication Administration
- Always follow the "rights" of medication administration.
- Verify you have two unique patient identifiers.
- Check for allergies.
- If unsure, research the medication before administering.
- Medication errors are frequent and can harm patients.
- Nurses, pharmacists, and physicians are legally responsible for correct and safe orders.
- Always report medication-related errors as an event report.
Pharmacological Principles
- Absorption describes how the medication enters the bloodstream.
- IV administration is the fastest, topical/transdermal is typically the slowest.
- The liver decreases the bioavailability of a drug due to the first-pass effect.
- Absorption is impacted by route, formulation, patient condition, and stomach contents.
- Distribution indicates how the medication moves around the body
- Relies on blood flow; better perfused organs receive the medication first.
- Target organ therapy, like eye drops, is helpful.
- Metabolism explains how the medication is broken down.
- Usually occurs in the liver transforming the medication, usually inactivating it.
- Some medications have active metabolites.
- Excretion is how the medication is removed from the body..
- Usually occurs in the kidney, removing waste from the body.
Lifespan Considerations
- When administering to pregnant patients:
- Consider if medications cross the placenta.
- Consider if medications cross into breast milk after delivery.
- When administering to infants and children:
- Developing organs and thin skin increase the risk of toxicity.
- When administering to elderly patients:
- Decreasing effectiveness of the liver and kidneys increases the risk for toxicity.
Safe Medication Administration
- Review proper technique and placement for Intradermal administration.
- Consider how to administer to pediatric and dysphagic patients for Oral administration.
- Use patch placement and safe disposal practices for Transdermal administration.
- Be familiar with parenteral injection routes, including:
- Insulin
- Heparin
- Enoxaparin
- IM injection sites
- Z-track method
Managing IV Access
- Site evaluation should include monitoring for infiltration and phlebitis, and checking the dressing is dry and intact.
- Saline wells should be flushed with saline every shift.
- For running IVs, check rate, fluids, IV site, and patient response (FVO) every hour.
- Central Venous Access devices (PICC, IJ, Subclavian, etc.) are:
- Used for administering caustic agents like chemo and antibiotics, without irritating smaller vessels.
- Require proper aseptic technique, and flushing as per agency policy.
Shock, Fluids, Electrolytes, and Acid-Base
- Isotonic fluids have the same tonicity as human blood includes 0.9% NS, LR, whole blood, some colloids 5% albumin, dextran 70, and hetastarch.
- Hypotonic fluids contain fewer particles than human blood which includes 0.45% NS and 0.225%NS
- Hypertonic fluids contain more particles than human blood, which includes 3% NS, D10W, D5NS, D5LR, 25% albumin, Packed RBCs and FFP.
- If giving blood products, monitor for transfusion reactions.
- Normal Potassium levels are 3.5-5 mEq/L, watch for cardiac and mental status changes, plus muscle weakness, Potassium is a primary intracellular ion.
- Normal Sodium levels are 135-145 mEq/L, watch for seizures, mental status changes and muscle weakness, Sodium is a primary extracellular ion.
- Normal pH Levels: acid is 7.35 - 7.45 is base
- Normal CO2 Levels: base is 35 - 45 is acid
- Normal HCO3 Levels: acid is 22 - 26 is base
- Respiratory Opposite Metabolic Equal
Adrenergic Drugs
- Adrenergic drugs (adrenal medulla) include epi, norepi, dopamine, and synthetic dobutamine and phenylephrine.
- Alpha vasoconstricts vessels and releases glucagon to increase blood glucose levels.
- Beta₁ increases heart rate, force, and automaticity (increases CO), and releases renin to stimulate RAAS cascade and further increase CO.
- Beta₂ dilates bronchi, releases insulin to utilize glucose, and dilates some vessels.
- Epinephrine contains Alpha, Beta₁, and Beta₂ and is best for anaphylactic shock because it constricts leaking capillaries, increases blood pressure and cardiac output, and decreases edema, urticaria, wheezing, and stridor.
- Administer epinephrine 1:1000 strength IM (0.3 mg adult, 0.15 mg pediatric).
Alpha Blockers
- Alpha blockers decrease ability to vasoconstrict (also work on certain sphincters like prostate) and work against the effects of norepinephrine.
- Phentolamine can be used if someone injects themselves in the thumb/finger with an epi-pen to avoid tissue death from ischemia.
- The "...zosin” drugs are used to control blood pressure.
- Tamsulosin (Flomax) is used for BPH/kidney stones.
Beta Blockers
- Beta-blockers reduce heart rate, force, and automaticity.
- "olol" drugs control blood pressure, tachycardia, headaches, etc.
- Non-selective beta-blockers can cause bronchoconstriction (dangerous in COPD patients).
- Patients on a beta blocker may not respond to epinephrine for anaphylaxis because of competition for receptor sites; treatment is to administer glucagon to knock the beta blocker off the receptor.
Cholinergic Drugs
- Cholinergic "WET" drugs stimulate the parasympathetic nervous system:
- Symptoms include: Diaphoresis/Diarrhea, Urination, Miosis (contraction of pupils), Bradycardia, Bronchospasm, Bronchorrhea, Emesis, Lacrimation and Salivation
- Cholinergic medications include: Aricept, Namenda, Urecholine, and Mestinon
- Used to treat urinary retention, constipation, dry mouth, and glaucoma
- Given one hour prior to activity for most strength or eating to aid with chewing and swallowing for Neuromuscular disorders related to ACH like myasthenia gravis
- Also used for Alzheimer's therapy
- Overdose or poisoning can lead to death (organophosphate, Sarin or Tabun), antidote is 2-PAM chloride and Atropine (an anticholinergic)
Anticholinergic Drugs
- Anticholinergics "DRY” drugs have the following symptoms:
- Blind as a bat (mydriasis), Red as a beet (flushed, dry skin), Hot as a hare (hyperthermia), Dry as a bone (dry mucosa), Mad as a Hatter (altered mental) and Bloated as a bladder (urinary retention)
- Atropine, glycopyrrolate, and scopolamine are used to decrease GI activity (nausea, vomiting, secretions, GI motility, diarrhea) and are often given in the OR/PACU setting, delirium and urinary retention are possible.
- Ipratropium (Atrovent) blocks the cholinergic effects in the bronchial tree.
- Detrol decreases bladder contractions and “over-active bladder” symptoms, but has a lot of side effects like dry mouth.
Antihypertensive Drugs
- Alpha drugs:
- Alpha 2 (Clonidine) turns off Alpha 1.
- Alpha 1 blockers “zosin” prevent vasoconstriction.
- Beta-blockers “OLOL" Reduce rate, force, and automaticity.
- Calcium Channel Blockers:
- Cause arterial dilation with a slow heart rate.
- Medications include: Verapamil and Diltiazem.
- Diuretics:
- HCTZ, Lasix, Spironolactone to reduce preload, therefore SV, CO and afterload.
- ACE-Inhibitors “pril”:
- Block ACE receptor sites and create excess bradykinins.
- Can cause a dry cough and angioedema.
- ARBs "sartan":
- Blocks Angiotensin II receptor sites.
- For patients who cannot tolerate ACE-I therapy.
- Direct Renin Blocker (aliskiren): Prevents activation of RAAS.
Cardiac Drugs
- For Angina/Chest pain:
- Nitro/Isosorbide dilates veins and coronary arteries while decreasing preload, stroke volume, and myocardial oxygen demand.
- Patients should call 911 if pain is not relieved with rest and nitro (normal measures).
- Beta blockers decrease myocardial oxygen demand by reducing rate, force, and automaticity.
- Calcium channel blockers decrease myocardial oxygen demand by reducing heart rate and dilating coronary arteries.
- Nitro/Isosorbide dilates veins and coronary arteries while decreasing preload, stroke volume, and myocardial oxygen demand.
- For Heart Failure:
- Often caused by Hypertension, therefore management often involves the use of antihypertensives: ACE-I, ARBs, Beta-blockers, and Aldosterone antagonists.
- Milrinone is a phosphodiesterase inhibitor, a positive inotrope and vasodilator used IV.
- Digoxin, a Cardiac Glycoside, is a positive inotrope that reduces heart rate and automaticity.
- Hypokalemia increases Digoxin toxicity.
Coagulation Modifiers
- Aspirin, Plavix, Pletal, Integrilin, and Aggrastat inhibit platelet aggregation, monitor H/H for signs of bleeding and PLT for risk of bleeding.
- Heparin, Lovenox, and Fragmin inhibit thrombin (IIa) and Xa the blood test is PTT (aPTT), reversal agent is Protamine Sulfate.
- Coumadin/Warfarin inhibits vitamin-K dependent factors (II, VII, IX, X), blood test is PT, INR, the reversal agent is Vitamin K.
Respiratory Drugs
- Upper respiratory tract: AIRWAY.
- Treat with ALPHA drugs and ANTICHOLINERGICS (Antihistamines): NeoSynephrine, Afrin, Racemic epinephrine, Allegra/Claritin/Zyrtec, and Benadryl.
- Goal is to shrink capillaries and decrease mucosal edema/inflammation, stop nasal bleeding and stridor, and open nasal passages.
- Lower respiratory tract: BREATHING.
- Treat with BETA2 agonists and BRONCHODILATORS (Anticholinergics): Albuterol, Xopenex, Ipratropium (Atrovent), and Dextromethorphan (cough suppressant).
- Both can be treated with steroids (local/inhaled or oral) to decrease edema, mucolytics (guaifenesin) to help clear secretions, and antibiotics as needed for infection.
- Chronic lower respiratory diseases are treated with LABA, Anticholinergics, and Steroids.
Central Nervous System
- CNS depressants are used to induce sleep, promote relaxation, and decrease muscle spasticity, Benzodiazepines and Opiates are also used for procedural sedation and Benzos can stop seizure activity.
- CNS depressants decrease mental status, respiratory rate and depth.
- Opiates (reversal is Narcan/Naloxone).
- Benzodiazepines (reversal is flumazenil/Romazicon).
- Barbiturates has no reversal.
- Anticholinergics (like Benadryl).
- Centrally acting muscle relaxants (baclofen, cyclobenzaprine, and tizanidine).
- CNS Stimulants are used for ADD/ADHD, as appetite suppressants, for certain seizures like narcolepsy, neonatal respiratory depression, and migraine headache management
- ADHD: Amphetamines, Strattera, and Ritalin.
- Obesity: Phentermine, Xenical, and Methamphetamine.
- Narcolepsy: Provigil and Dextroamphetamine.
- Respiratory depression: Caffeine and Theophylline.
- Migraine HA: Triptans and ergotamines.
- Stimulation of the CNS results in hypertension, tachycardia, weight loss, angina, anxiety, insomnia, mania, aggression, and psychosis, monitor patients carefully.
Antiepileptic/Anticonvulsant Drugs
- Barbiturates: Phenobarbital, long half-life maintains a therapeutic level even if a dose is late or missed
- Hydantoins: Phenytoin (Dilantin) and Phosphenytoin (Cerebyx).
- Watch for gingival hyperplasia.
- Drug is protein bound, will get toxic with hypoalbuminemia.
- Routine blood work is necessary.
- Watch for gingival hyperplasia.
- Iminostilbenes: Tegretol and Trileptal.
- Other: Gabapentin, Lamictal, Keppra, Lyrica, Topamax, and Depakote, also used for neuropathic pain and headaches.
- General thoughts: Don't miss doses, take the same time every day, check therapeutic ranges.
- If the patient has a seizure, protect them from injury.
Analgesia
- Opiates: Centrally acting causing pinpoint pupils, respiratory depression, and AMS, drugs include Morphine, Dilaudid, Oxycodone, Hydrocodone, Fentanyl, and Methadone.
- Reversal agent: naloxone/Narcan.
- Naltrexone is used to maintain sobriety, not for acute reversal.
- Acetaminophen undergoes Liver metabolism.
- NSAIDS (Aspirin, Ibuprofen, Naprosyn) cause GI Bleeding, and require Renal clearance.
- Aspirin overdose: Tinnitus, bleeding, petechiae, and respiratory alkalosis.
- Local anesthesia (lidocaine) and general anesthesia (gases) are available for procedures.
- Consider non-pharmacological pain management options.
Gastrointestinal Medications
- For GERD: Antacids, H2 blockers, PPIs, sucralfate, and simethicone.
- Rule out cardiac, and H. Pylori, watch for decreased calcium and iron absorption.
- For Diarrhea: Bismuth (Pepto contains aspirin), Atropine, and Codeine.
- Rule out infectious causes, do not give to febrile patient or concern of C. Diff.
- For Constipation: Laxatives (bulk, emollient, hyperosmotic, saline, and stimulant).
- Only bulk-forming laxatives are safe for long-term use.
- Other laxatives can cause fluid and electrolyte imbalances and problems with peristalsis.
- Only bulk-forming laxatives are safe for long-term use.
- Antiemetics: Anticholinergics, Serotonin blockers (Zofran), prokinetics (Reglan), and antidopaminergics (Phenergan and Compazine):
- Watch for side effects: Phenergan/Compazine/Reglan and EPS- give Benadryl slow IV first.
- Zofran prolongs the QT interval and causes fetal development problems.
Anti-hyperglycemics
- Aspart (Rapid) trade names include Novolog and Humalog administered 15 minutes before meals on a sliding scale.
- Regular (Short) trade names include Novolin and Humulin administered 30 minutes before meals, set dose or sliding scale.
- Glargine (Long) trade name is Lantus given as basal dosing, 1-2 times a day.
- Do not give metformin within 48 hours of CT Scan dye, or with kidney failure.
- Watch for hypoglycemia when giving sulfonylureas.
- Teach proper dosing, timing, and s/s of hyper and hypoglycemia, and infection, monitor HgbA1C, Diet and Exercise.
Endocrine Drugs
- Pituitary drugs replace missing hormones from the pituitary gland includes DDAVP/Desmopressin for Diabetes Insipidus, excessive urination, and Somatropin to replace growth hormone.
- Thyroid drugs replace T3 and T4 for life, monitor TSH and Free T4 levels and watch for Hyperthyroidism includes Levothyroxine (T4).
- Antithyroid drugs prevent the effects of hyperthyroidism, Methimazole and propylthiouracil block the production of T3 and T4 and Radioactive iodine destroys the thyroid gland cells.
- Adrenal drugs such as Corticosteroids- Prednisone (Glucose), Florinef (Salt) for Adrenal Crisis- use IV Solu-Cortef or Solu-Medrol.
Antibiotics
- Obtain a culture, gram-stain.
- Start with the most logical medication, check sensitivity, and adjust as needed.
- Sulfonamides, Penicillins, and Cephalosporins work well on many infections and more frequent reactions, around 40% cross reactivity in a patient allergic to penicillin and sulfa who takes a cephalosporin.
- Carbapenems, monobactams, macrolides, and ketolides have specific uses.
- Tetracyclines- avoid UV light and dairy/antacids.
- Aminoglycosides- ototoxicity and nephrotoxicity.
- Vancomycin- used for MRSA and can cause Red Man Syndrome, ototoxicity, and nephrotoxicity.
Antivirals
- Herpes- Acyclovir and Valacyclovir are still contagious despite treatment.
- Hepatitis-. "vir" drugs and interferons.
- Influenza- Tamiflu works best if started within 48 hours of onset of symptoms.
- RSV- Ribavirin nebulized, teratogen, no pregnant people or caregivers in the room.
- HIV- uses a combination of medications to decrease cell count and slow progression of disease.
Other Infections
- TB:
- Can be used for ACTIVE infections, PREVENTION of infection, or to treat LATENT disease findings to prevent recurrence of disease.
- Treat patients with MULTIPLE medications for 6-12 months to prevent resistant organisms.
- Includes medications such as Isoniazid and Rifampin (turns everything orange- urine, saliva, tears, and sweat.)
- Can be used for ACTIVE infections, PREVENTION of infection, or to treat LATENT disease findings to prevent recurrence of disease.
- FUNGAL- Candida, Tinea, or systemic yeasts/molds:
- Amphotericin B is effective in treating systemic infections but has many side effects.
- Fluconazole/Diflucan is an oral treatment for vaginal yeast infections.
- Topicals are less effective with more resistant tinea.
Integumentary and Burns
- Skin infections include bacterial, viral, and fungal/yeast:
- Medications can be oral or topical depending on microbe and extent of infection.
- Provide teaching on medication administration, prevention of spread and recurrence.
- Medications can be oral or topical depending on microbe and extent of infection.
- Burn patients are at risk for:
- Infection, fluid and electrolyte imbalances, hypothermia, pain, and inadequate nutrition.
- Use sterile technique for wound care and provide pain relief prior to procedures.
- Infection, fluid and electrolyte imbalances, hypothermia, pain, and inadequate nutrition.
Antineoplastic Agents
- Disrupt cell division and also interfere with normal cell division.
- Pancytopenia is a concern with Anemia, Neutropenia, and Thrombocytopenia
- As well as Hypoxia, and Infection, and Bleeding:
- Use appropriate Hematopoietic Drugs to stimulate RBC, WBC, and PLT growth.
- Do not give at the same time as a medication that inhibits marrow or neither will work.
- Use appropriate Hematopoietic Drugs to stimulate RBC, WBC, and PLT growth.
- DMARDS and Immunosuppressants used for RA and Autoimmune disorders have similar side effects, monitor for Infection.
Ophthalmic Drugs
- Glaucoma a problem with draining aqueous humor from the anterior chamber of the eye with treatment to increase drainage and decrease aqueous humor production
- Cholinergics, Mydriatics, Beta blockers, and Osmotic diuretics help increase drainage.
- Mydriatics, Beta blockers, and Carbonic anhydrase inhibitor decrease.
- Infections of the eye are treated with drops, ointments, or oral antibiotics.
- Pain and inflammation of the eye from irritation, allergy, or injury is treated with anti-inflammatory or anesthetic drops or ointments.
- Antihistamine eye drops are also available for allergic conjunctivitis/seasonal allergies.
Otic Drugs
- Infections of the ear can be treated with local (topical) drops instilled into the ear, or oral antibiotics.
- Patients with cerumen impactions warm water, Debrox, and docusate liquid will all soften the wax.
- Be sure patients can recognize EAR versus EYE drops; many companies are now adding a picture of an EAR or an EYE on the bottle.
- Teach the correct technique, positioning and timing for otic administration.
Women's Health
- Contraception (regulation of menses, prevention of pregnancy, termination of pregnancy, and treatment of post-menopausal symptoms) is hormone-based medications such as Estrogens, Progesterones, and Prostaglandins and come with increased risk of blood clots, heart attack, stroke, and cancers in some people.
- Medication has improved Osteoporosis (loss of bone density), but use has been linked to esophageal burns, osteonecrosis of the jaw and pathological hip fractures. SIT UP FOR AT LEAST 30 MINUTES AFTER TAKING.
- Clomid stimulates ripening of follicle and ovulation to improve Fertility.
Men's Health
- Benign Prostatic Hyperplasia: Flomax and Finasteride.
- Erectile Dysfunction: Phosphodiasterase inhibitors “fil” drugs , DO NOT MIX WITH NITRO = LIFE THREATENING HYPOTENSION.
Transgender Health
- Masculinizing hormones (Testosterone.) cause Desired effects such as Amenorrhea 6mo and facial hair, monitor hormone levels and H/H.
- Feminizing hormones (Estrogen and Progesterone) use Antiandrogens and Spironolactone/Finasteride with Desired effects such as decreased facial hair and breast tissue enlargement, monitor hormone levels, BUN/Cr, K+.
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