Exam 1 Review PDF

EXAMIRevi vitamins.ly Dietary supplements Vitaminsdonotserve as a source ofenergy Essentialforenergytransformation a regulation ofmetabolic processes Vitamins mins A D E K need fat to beabsorbed storedin liveruntil its used watersoluble Fitamins needwater tobe absorbed C G B complex thiamin Riboflav...

EXAMIRevi vitamins.ly Dietary supplements Vitaminsdonotserve as a source ofenergy Essentialforenergytransformation a regulation ofmetabolic processes Vitamins mins A D E K need fat to beabsorbed storedin liveruntil its used watersoluble Fitamins needwater tobe absorbed C G B complex thiamin Riboflavin niacin pyridoxine pantothenic acid Biotin folicacid cyanocobalamin Fat soluble Vitamint Retinol hasmultiple functions in they Toxicity toomuchvitaminA birthdefects liverinjury bone relateddisorders Defficiency notenoughvitaminA nightblindness xerophthalmia drythickened conditionofeyeball Keratomalacia softeningulcerationofcornea pregnantwomenshouldnotexceed theUL9 RDAforvitaminA teratogeniceffectstofetus 3000mcgday VitaminDG vitamino phosphorus regulates calcium needed forabsorption ofcalcium Defficiency causesRickets soft deformedbones or Osteomalacia vitamins antioxidantproperties fightsagainstcancer foundin greens seeds oil 200IU day Toxicity may increaseriskforbleeding progression heartfailure cancer all causemortality vitamink o Synthesis forsynthesisof prothrombin toolittlevitamin K otherclotting factors bleeding vitamin K reverses warfarinoverdose Tifferitamins foundincitrusjuices tomatoespotatoesstrawberries melonsspinach therapyforcancer asthma osteoporosis common cold Deficiency lead to scurvy spongy gums looseningofteeth bleeding intoskin mucusmembrane Kitaminecomplex Niacin nicotinicacid Defficiency causesroughskin dermatitis scaling crackingofskin in areasexposeto the sun fukin smallclosesno adverseeffects candecreasecholesterol large doses Therapeutic use onlyforNiacindefficiency Toomuch facial flush i.Ienamaacreaaion iiii.it sorethroat angularstomatitis Therapeuticuses migraine headaches Defficiency ThiaminlvitaminBI. S Actions coenzyme forcarbohydrate metabolism Deficiency Beriberi fluid accumulation in legs wetberiberi CVcomplications Klogical Dryberiberi a neuro motor deficiency importanttoprevent Wernicke Korsakoffsyndrome alcoholism mostcommoncauseofthiamindefficiency is aseriousCNSdisorder neurologic psychologic causeslegtremors confusion lossofmusclecoordination PyridoxinevitaminBI ofaminoacids proteins coenzymeinthe metabolism Defficiencymayresultfrom poordiet rareexceptinalcoholics isoniaziduseforTB 8 94 C givew vitamin Bb inbornerrorsinmetabolism obdaminvitami GFOI.ca d bothneededforDNAsynthesis RBCproduction highVitB dairy Foodw Defficiencysigns beefyredtongue pallor neuropathy manifestasmegaloblasticanemia palloreasyfatigue palpitations paresthesiaofhandsfeet neuro damage Sideeffects VitB12 hypokalemia lowK levels aseffectofRBCproduction Anemia takecyanocobalamin totreatforlifetime nasal cyanocobalamin give Ixweek9 1hr beforeOR aftereatinghot foods FOLICACI 2forms FoodfolateG Defficiency syntheffffir canimpairCnsdevelopmentduring Baffleadditional produces Megaloggff rattubesdefects anencephaly nobraindevelopment Spinabifida 400800mg supplemental CAMproducts Blackcons treatsymptoms of menopause mechanism ofaction unknown aseffective as estrogen might potentiate antihypertensives blood pressurepills insulinmeds AE GIsymptoms hypoglycemic effect oforalagents insulin glucosedown moodswings weightgain loss DONOTusein pregnancy pically boostsup immunity produces antiviral anti inflammatory anti stimulant effects can cause organdamage in transplant chronicuse 6months A E GI symptoms decrease effects of HIV AIDS cancer drugs prophylaxis of migraine to preventmigraine A E mildGI symptoms ibuprofen naproxen GI bleeding caution if taken w NSAIDs canincreasebleeding risk I Hiiiii plantfiber arin constipation Soluble decrease total cholesterol LDL A E bloating cramping take water after take 1hrbefore 12hrsafterother meds Garlic used forSiovascular systemeffects good effects on blood pressure raw 1 2cloves 2xday significant antiplatelet effect preventbloodclots plasma lipids motion sickness cancerchemonausea suppreses nausea vomiting can suppress platelet aggregation keepbloodthin go Gina Enhance mental functioning a memory by increasing blood circulation tothe brain interact w antidepressants antihistamines antipsychotics bleeding 9 97 7 risk w NSAIDs heparin warfarin eatosteoarthritis helps restorejoints movement CAUTION pts w shellfishallergy increased risk for bleeding sawpalmett.be psw bening prostatehyperplasia may have antiplateleteffects 4dilateurethra urine flow Valerian sect five preparation to promote sleep reduceanxiety calming anxiousness drowsiness KAVI promote sleep a relaxmuscles linkto severehepatic liver damage sedationeffect w other CNS deppresants Stewart treat deppression mild noprescription needed moderate accelerate metabolismofmanydrugs Ironsupplemen.ir on needed for hemoglobin production RBC development especially in children pregnancy after blood loss increases hemoglobin ADR fatigue pallor decreased Gidistress nausea vomiting teethstaining liquid constipation iron.de Ekstoot Take w orangejuice if cannot tolerate on empty stomach CAUTION avoid w milk calcium products because blocksabsorption ofiron 1 2 months therapy rinse mouthafter swallowing increase water fiber intake constipation encourage foods eggyolks animalliver musclemeat Rheumatoidarthritis Headache drugs Headaches causesveins arteries to dilate medsgiven to constrictveins arteries in head butalsocoronary arteriesconstrict causing chestpain heartattac Mildheadache OTCmeds aspirin acetaminophen Severe headaches Triptans migraine tension type Migraine headache neurovascular disorderthat involves thedilation 9 inflammation ofintracranialbloodvessels Treatment non specificanalgesics aspirin butorphanol meperidine opioidanalgesics migraine specific serotonin IB ID receptoragonists ergotalkaloids Migraines Serotonin n merge Rizatriptan Maxalt Zolmitriptan Zomig Almotriptan Axert Frovatriptan Frova Elefriptan Relpax IB ID receptoragonists i sumatriptan imitrex useformigraines causes vasoconstrictionof intracranial bloodvessels aborts ongoingmigraineattacks oral intranasal Adverse heavyarms 1 chestpressure vasoconstriction rareangina coronaryvasopasm Preg cat C Verybadtaste Vertigo malaise fatigue tinglingsensations 2Ergotalkatoice treatssubborn migraine headaches strongerconstriction also given whenTriptan is not effective second line drug forongoing migraineattack riskfor dependence ergotism severetissue ischemia secondary to generalized constriction of peripheralarteries causes physical dependence contraindications not taken routinely pregnancy causes uterinecontraction fetalharm I Eii in chronicdisorder w autoimmune a inflammatory components insevere cases itattacks internalorgans affects joint linings causing painful swelling can lead to joint deformity G boneerosion t.jonIItin ITteroida ibuprofen mon naproxen All NSAIDs thin before other NSAIDs t.gg ometningbeforebecause it causes stomachulcers blood Takeaspirin 2hr5 anti inflammatorydrugs Firstgenerations NSAIDs GIbleed inhibitCOX 1 E COX 2 aspirin ibuprofen Motrin naproxen Ketorolac Indeomethacin Second generations NSAIDs inhibit Cox 2 Celocoxib celebrex increase mi astrokes less GI toxicity risk for bloodclots boxwarning 9 41 9 97 tosulfonamide risk ofthromboticevent clots risk ofGI bleed Loxinhibitors imP en tylenol NSAIDs and daminophen most commonly prescribed drugs Cycloxgenasee COX1 01 9 COX2 promotefever pain inflammation thus 1gen NSAIDs inhibit Sis support platelet protect stomach promote kidneyfunction NSAIDSUSI relievepain a inflammation OA RA bursitis treat mild moderate pain minortrauma minor surgery otheracuteor chronic conditions reducefever noaspirin to children Dressplateletaggregator Reye'ssyndrom encephalitistype regular lowdose aspirin effectivefor pts w MI ischemicstroke TIA angina AspirinAdverseeft.e anothernamefor dt ffeI GI bleed a discomfort heartburn occasional nausea Renal dysfunction metabolic acidosis MA Respiratory alkalosis RA hyperventilation py dehydration tinnitus Fluid electrolyte imbalance Reye's syndrome encephalitistype 0 48 severe anemia Vitamin K deff 1 whenaspirinused forfeverreduction in children a adolescents who havea viralillness chickenpox Flu can causeseizures Nursingonsiderationsm Check bleedinggums bloody black Stools bruises give w milk water or food useenteric coated tabletsto minimize gastric distres seates t.fi tinnitus ie Lethargy Respiratory alkalosis severe toxicity metabolicacidosis seizures Aspirindoses lowclose antiplatelet 80mg 1325mg anti pain fever 325mg anti inflammatory 3 49 Efffffernane peptic ulcer disease bleedingdisorder hypersensitivity Children adolescents w viral illness ifeng.IE tEEmiennabin take w food water milk n Do not crush enteric coated tablets Acetaminophen tylenol metabolized in liver lacksanti inflammatory activity Doesnot cause nausea otoodcotting vomiting GIbleeding can cause liver damage or fatal liver necrosis w acute orchronic overdose hepatoxicity tylenolcan cause liver damage w therapeutic doses in those who abuse alcohol Maxdailydose 39 monitor liver functiontests later manifestations jaundice vomiting delirium coma death Tylenoltoxicity overdose treatment gastric lavage activated charcoal 1 2hrsafter ingestion Antidote Acetylcysteine Mucomyst looses thickmucus in pts w treattylenol overdose Beneficial helpal COPD 8 10hr5 after ingestion within 36 hrs Does not reverse damage DONOTTAKEW alcohol slows metabolism of warfarin increases risk ofbleeding 2 DMARDS Diseasemodifying antirneumatic drugs nonbiological traditional DMARDS methotrexate mostrapidacting DMARDS Therapeutic effect 3 6WKS to work AdverseEffects hepaticfibrosis liverdamage bone marrow suppression 1fewerbloodcellsmade GI ulceration pneumonitis renal toxicity Contraindicated Pregnancy Sulfasalazine Used to treatinflammatory bowel disease now used forRAtoo hasanti inflammatory immunomodulatory actions can slowjoint deterioration sideEffects Gl intolerance elmedicamentotiene inhibitorsquese comen a ios factores queprotejen dela necrosis Biological stronger attacks necrosis factors has tumor necrosis factor TNF inhibitors suppresses the immunesystem risk forinfection neutralizes TNF m.is cemre Use for moderate to severe RA ADVERSE Effects seriousinfections severe allergic reactions HF blood disorders Liver injury CNS disorders 3 Glucocorticoids Adrenal corticosteroids increases bloodsugar levels retains water TAPEROFFSlowly DONOTSTOP abruptly ÉÉ Prednisone GOUI inflammatory disorder characterized by hyperurecemia a episodic jointpain excess uric typically in bigtoe acid build upinjoints Meds NSAIDs inflammation glucocorticoid colchicine only forgouthelps w inflammation does not affect uricacid production can cause anemia only hf t decreaseproduction a reabsorption of uricacid given w meals encourage fluids check In c renalfunction 1kidney reduceuricacid can cause hypersensitivity MildGI h uric acid outof kidneys renal excretion longterm prevention avoid aspirin itinactivates drug Allopurid decreases production longterm prevention alters stop the production of uric acid rash fever immediately stop osteoporosis Depletionof bonemassastheyage calcium metabolism disorder primary prevention Diagnosis calcium tiffin bone mineraldensity lifestyle r ii ro postmenopausal osteoporosis piaget'sdiseaseof bone osteoclast reabsorb Oldbone osteoblast buildnew bone Meds Bisphosphonates inhibitbonereabsorptionof oldbone by t the activity of osteoclasts Alendoonate most widelyused oralbiphosphonate take on emptystomach in AM w 6 802water aftermed slowsdown depmon bonemass remain in sitting position for30mins monitor bonedensity averse risedronate a arthralgia pain joint Pain management AFgesicstantipyretic Pain subjective to what pt says it is unpleasantsensory a emotional experience associated w eitheractual or potentialtissuedamage NURSEapproach universalpainscale 0 10 7 severe Analgesics drugs that relievepain w o causing lossof consciousness Opioid Analgesics Usefor moderate to severepain previously known as narcotics mosteffective pain relievers available highly addictive treducepain by attaching to a receptor in the CNS then alters perception responseofpain Ex Opioidagonist hallucinations morphine Fentanyl sublimate 100xmorepotentthan morphine meperidine Demerol decreasecraving for heroin methadone Dolophine codeine cough suppressant Oxycodone Oxycontin Opiaidsreceptorf causes a reaction medattach to body receptors binds to opiate receptors MY Analgesic euphoria a sedation Respiratory depression RR physical dependence KAPPI Analgesic constipation sedation DeHI no pharmacology relatedeffect SIISI.tn m NOT TAKEN alcohol barbiturates benzodiazepines Respiratory depression ans aggravation of asthma Higgyfeppressants effects Rrt monitor stopit CNS depression sedation disorientation pupil constriction pupils smaller puntitonegro enmedio antihistamine anticholinergic infants elderlysensitive Gastrointestinal emesis constipation cardiovascular hypotension lowBP bradycardia HR 260 Urinary retention monitor I 90s increase birth defects Inconsideration have narcan naloxone available constipation increase reverse opioid overdose fluid fiber laxatives opioidantagonist avoid hazardous activities hypotension changeposition slowly 12 t.EEgnistn coma respiratory depression pinpointpupils Treatment Ventilatory support antagonist naloxone narcan monitorfull vitals give as prescribed Fentanyl 100xmore potentthan morphine transdermal patch used in persistent chronic pain management Meperidine sameusesa adverseeffects as morphine lessnausea vomiting neurotoxic metabolism w chronic use CNSagitation confusion hallucinations tremors seizures M.IE Tecravingcorneroin drug of Choice for opioidaddictiondetox heroin one oral dose perday 1 year codeine lessanalgesia G respiratory cough suppressant pairrelief 30mg 325mgacetaminophen tylenol aspirin Oxycodonelhydrocodone hydrocodone mostprescribed in USAoften combined tylenol w ibuprofen aspirin cardiac E increaseworkload Pentazoline Talwin Fewer mueffects Butonphanol buttails s boxone Buprenorphine Useformild to moderatepain lower potential for abuse Tman p id addict contraindicated Ptw angina G MI Opioidsphysi.ca Dependennd Opioids withdrawslowly a dosage tapered over a periodof 3days withdrawal symptoms mental agitation anxiety restlessness insomnia Tachycardia Elevated BP seizures nausea vomiting diarrhea abdominal cramps opioids administeron a fixed schedule OpioidAntagonist Naloxone Narcan antidote for opioid blockopioid receptors reverseeffect routes IV 1M Suba S E tachycardia tachypnea high withdrawal syndrome Administer every 2 to 3 mins n ioidanalges.es use formild to moderate pain BUTcombine w opioid Ex Tylenol Ip Tramad combination ofopioidG non opioid mechanisms non opioid analgesic mild moderatepain Localanesthetiese É conduction of pain impulses in a circumscribed area Parenteral topical S Eff CNSdepression seizure hypotension cardiosuppression urinary retention Lidocaine w Epinephrine used in combination Foconstrictor to preventspeadof local anesthetics Antihyperlipidemic drugs to lower abnormal high blood levels of lipids cholesterol triglycerides with high lipidlevels phospholipids Highrisk for CAD coronaryarterydisease used in combination w properdiet weightloss exercise Cholesterol HDL good LDL bad lessthan 200 morethan 240 Triglycerides carbs Classez Bile sequestering drugs Fibric acid derivatives HMG CoA reductase inhibitors Nicotinicacid Cholesterolabsorption inhibitors i.in iii i Colesevelam an Welchol Colestipol hydrochloride colestic Thesedrugs sit in the intestine Remove excessbile acidsfrom fat depositsunderthe skin wait forfoodto be ingested excreted int foodcholesterolthen Bile sequestering drugs drugof choice for treating in ptswho is not ableto lower LDL levels through Familial Hypercholesterolemia diet changes geneticdisorder lacksreceptors inliver that control bad cholesterol use D.IE ITTsorpnon L of digoxin oralphosphate propranolol furosemide tetracycline option of penicillin G hydrochlorothiazide genfibrozil may reduceabsorption of lipidsoluble vitamins ADER Idkhraseriskforbleedign Adverse reactions Ftermusemild long term use severe fecal impaction vomiting diarrhea encourage fluids hemorroidirritation 9 fiber Assessments check cholesterol levels before therapy monitor effectiveness by checking cholesterol9 triglyceride levels every 4wks monitor CKlevels if complainof musclepain monitor adverse interactions monitor fatsoluble vitamins Patient Teachings Fasprescribed DO not take dryform it can cause powder w beverage mix Esophageal irritation a constipation DONot take w carbonated beverages Drink 2 32 fluid weightcontrol exercise smoking cessation 2 Fibric acid Derivatives rapidhydrolysis Fenofibrate tricot Gemfibrozil reducehightriglyceride levels Lopia LDLlevels high secondary extensive fungi undergoes metabolism in the produced by several absorbed liver fromGItract bothexcreted in urine vets in the blood increases serum capacityto dissolve additional cholesterol take 30 mins beforebreakfast dinner t.YIE.LI Trivativesinteractswi barbiturates phenytoin thyroid derivatives cardiacglycosides iftaken w anticoagulants riskof bleeding Adverse GIeffects epigastricpain now D constipation Adverse reactions Headache dizziness blurred vision arrhythmias rash thrombocytopenia Assessment monitor cholesterol 4WKS 9 triglyceride levels every assess liver function tests beforetherapy Fenofibrate Gwas monitor for muscle pain weakness malaiselfever develop decrease dose tenderness a stoolsoftener discontinuedrug take as prescribed no response w drug after amonthswithdraw HMG COAReductaseinhibi.to enzyme group meds statins important beconcerned Atorvastatin if Lovastatin ptcomplaints Pravastatinsodium of muscle pain Rosuvastatin simvastatin wisfsmyalgi.at Pitavastatin Fluvastatin sodium Myalgia musclepain Lowffhipid levels by interfering w cholestero synthesis arthralgia musclecramps Thestatins inhibitthe enzymethats responsible forthe conversion of HMG CoAto mevalonate STATINS usedto reduce LDL levels butalso produce a mild increase in HDLcholesterol levels alsoindicated forprimary secondary prevention ofcardiovascular events PY TL Faan.myacin conazole gentobrial increase Risk for myopathy musclewasting a weakness rhabdomyolysis breakdownofskeletal muscle renalfailure kidneys shut givestatins 1 hr before or 4 hrsafter bill drugs preferably take at night Estate 9 simvastatin bleeding risk w warfarin Adversereactions may alter liver function studies aspartate Assessments monitor liver function tests before therapy monitorTesterolatriglycerides levels every 4 wks monitor for myalgia musclepain monitor ADEK 9 4 folicacid defficiency Nicotinic water solublevitamin that decreasestrygliarid qincreasesHDL.lv available in immediate or extended release I Niacin f snack Y.to give aspirin 30mins beforegiving Niacin toprevent Wimed low fat bloodsugar hyperglycemia med's avoid hotshower Niacin w facialflushing exercise hot spicy vasodilation foods noalcohol used in pts w hyperlipidemia at risk for pancreatin w hypercholesterolemia not prescribedtopts w diabetes CAM W Niacin Haval hepatoxicity DONotgive w biledrugstoeffectiveness 5 Cholesterol Absorption inhiborts helps lower total cholesterol GLDL helps increase HDL levelsin pts whocan't achievegoals w HMO CoA Ezetimibe Zetia reduces bloodcholesterol alsostays in the intestines Lester resorption inhibits metabolized in small intestines excreted by biliaryandrenal routes Elltimibe diet treatment hypercholesterolemia Elltimibe HMG CoA treats primary hypercholestero 9 familialhypercholestero AFEf.fi chest abdominal pain dizziness headache Diarrhea Pharyngitis Sinusitis Arcalgia myalgia backpain Fibricaciddrugs cyclosporine increase level of ezetemi.be