Term
| what is the fourth leading COD? |
|
Definition
|
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Term
|
Definition
| absorption, distribution, metabolism, excretion |
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Term
|
Definition
| drug receptor interaction, patient's functional state, plaecbo effects |
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|
Term
| pharmokinetics and pharmodynamics are dependent on what? |
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Definition
| individual: genetics, pathology, physiology, drug-drug interaction |
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Term
|
Definition
| 140- Age x Kg x .85 (if female) / 72 x Cr |
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Term
| what is a physiologic variable? |
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Definition
|
|
Term
| what is a pathological variable? |
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Definition
| Diminished function of kidneys and liver |
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Term
| how do genetic variable effect drug efficacy? |
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Definition
| Can alter metabolism of drugs and predispose patient to unique interactions, i.e. allergies, hypersensitvity |
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Term
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Definition
|
|
Term
| generic drug names are derived from.. |
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Definition
| they are derived from the chemical name |
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Term
| why do drug companies make the drug names so hard? |
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Definition
| so the trade name is used instead |
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Term
|
Definition
| 60% of all drugs administered |
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|
Term
| which drug routes should take effect within 1-3 minutes? |
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Definition
| 4 i's- inhalers, IV, intraosseus, intrathecal |
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Term
| which drug routes should take 15-30 min to take effect? |
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Definition
| SL/PR, sublingual or bottom of mouth |
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Term
| which drugs routes should take 45 min to an hour to take effect? |
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Definition
| SPIT- subq, PO, IM, topical |
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|
Term
only unbound (free) drug molecules can..
(non protein binding) |
|
Definition
| leave the vascular system |
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Term
|
Definition
Defined as the time required for the
amount of drug in the body to
decrease by 50% |
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Term
|
Definition
| arterial thrombosis, venous thrombosis |
|
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Term
|
Definition
Anaphylaxis, psychosis, insomnia, increased bg,
cushinoid s/s. usually most deadly ADRs are rare. |
|
|
Term
| is unfractioned heparin iv and regular heparin (sub q) protein bound? |
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Definition
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|
Term
| half life of heparin? pregnancy? |
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Definition
|
|
Term
| bleeding rate for heparin patients |
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Definition
|
|
Term
| how many pts get heparin induced thrombocytopenia? |
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Definition
|
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Term
|
Definition
| suppress production of fibrin |
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|
Term
| advantage of LOVENOX/enoxaparin |
|
Definition
| no labs needed because of fixed dose |
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|
Term
|
Definition
|
|
Term
| warfarin coumadin prevents.. |
|
Definition
| thromboembolism, by suppressing vitamin K dependent clotting factors |
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|
Term
| is warfarin coumadin teratogenic? |
|
Definition
| YES, causes fetal hemorrhage, category X |
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|
Term
| major problems with warfarin |
|
Definition
| 99% protein bound, Vitamin K will change INR, delayed action (doesnt effect clotting factors already circulating), NSAIDS increase risk for bleeding |
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|
Term
| dosing regimen for coumadin |
|
Definition
| 1mg on even day, 3 mg on odd days, 5 mg every Sun |
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Term
|
Definition
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Term
|
Definition
|
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Term
|
Definition
|
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Term
|
Definition
|
|
Term
| ASA lasts the lifetime of a.. |
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Definition
|
|
Term
|
Definition
| nsaids may block some effects of ASA |
|
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Term
| low therapeutic dose of ASA |
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Definition
|
|
Term
| anti-inflammatory dose of ASA |
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Definition
|
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Term
|
Definition
|
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Term
|
Definition
| Bleeding; GIB and hemorrhagic stroke |
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|
Term
| is ASA ok with pregnancy, kids with febrile diseases, or hypersensitive/allergy |
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Definition
| NO (category D), no and NO. |
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Term
|
Definition
| prevents blockage of cornary artery stents, reduces thrombotic events in patients with acute coronary synrdromes, MI, ischemic stroke |
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|
Term
| adverse effect of clopidorgel |
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Definition
|
|
Term
|
Definition
| dilates the vascular bed, and prevents platelet aggregation (like riot police) |
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Term
|
Definition
| minimum effective concentration of a drug |
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|
Term
| 4 major categories of diuretics |
|
Definition
| high ceiling (loop), thiazide, osmotic and potassium sparing |
|
|
Term
| two types of potassium sparing |
|
Definition
| aldosterone antagonists (spiralactone), non aldersterne antagonists (triamterene) |
|
|
Term
|
Definition
|
|
Term
| therapeutic ptt (pt on heparin) |
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Definition
|
|
Term
| number one use of baby aspirin.. |
|
Definition
| to prevent CV events, MI attacks |
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|
Term
| goal for htn on antihypertensives |
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Definition
|
|
Term
| goal for htn w/kidney disease |
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Definition
|
|
Term
| there is no antidote for.. |
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Definition
|
|
Term
|
Definition
| low BP and increase vasoconstriction to compensate |
|
|
Term
| diuretics make everything go down, except.. |
|
Definition
| acid/base and glucose, H&H |
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Term
|
Definition
|
|
Term
|
Definition
| hypokalemia, dehydration, lowers Cl, Na, lower BP, increase BG, it can be ototoxix. |
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Term
|
Definition
| it augments other BP meds, dagoxin, NSAIDS, can lead to LITHIUM toxicity |
|
|
Term
|
Definition
|
|
Term
| beginning (and end) dose for lasix.. |
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Definition
|
|
Term
| hydrochlorathiazide (gentler than lasix) |
|
Definition
| hypokalemia, dehydration, |
|
|
Term
| thiazides wont work for people who have.. |
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Definition
|
|
Term
|
Definition
| it can potentiate any other medicine that can decrease BP |
|
|
Term
| Spironolactone (Aldactone) uses |
|
Definition
Therapeutic uses
Hypertension
Edematous states
Heart failure (decrease mortality in severe failure)
Primary hyperaldosteronism
Premenstrual syndrome
Polycystic ovary syndrome
Acne in young women |
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Term
|
Definition
| potassium sparing, so watch for extra potassium intake |
|
|
Term
| PNS/cholinergic system major neurotransmitter |
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Definition
|
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Term
|
Definition
|
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Term
|
Definition
| HTN, relaxes smooth muscle bladder (for hypertrophic prostate- makes it easier to pee) |
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|
Term
| alpha blocker side effects |
|
Definition
| 1% lose consciousness, know prazosin (Minipress) |
|
|
Term
| alpha agonist name and uses |
|
Definition
| clonidine (Catapres) used for HTN, and pain |
|
|
Term
| the big problem with clonidine is that it.. |
|
Definition
| causes a rebound HIGH BP if taken off of it (education: you cannot run out of this medicine!!) |
|
|
Term
|
Definition
|
|
Term
| nonselective Beta Blockers |
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Definition
| blocks B1 and B2, propranlol - will cause more effecs on the entire body than selective |
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Term
|
Definition
| Angina, HTN, arrythmias, MI, CHF, hyperthroidism |
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Term
|
Definition
| bradycardia, reduce cardiac output, don't withdraw quickly |
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Term
|
Definition
| same as B1, plus bronchoconstriction, inhibition of glycogenolysis, CNS side effects |
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Term
|
Definition
| 60 mg bid, interferes with epinephrine antidote for anaphylactic reaction, effects glycogenolysis, |
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Term
|
Definition
| inhbits RAAS system, WHICH constricts blood vessels, acts on kidneys to promote retention of NA and K and water and excretion of K. so it reverses all that. |
|
|
Term
|
Definition
| teratogenic, first dose hypotension, cough (5-10% pts), hyperkalemia, renal failure, angioedema |
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|
Term
| calcium channel blockers.. |
|
Definition
| prevent calcium ions from entering cells, slow down AV and SA node, treats HTN, angina, cardiac dysrhythmias |
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|
Term
| CCb are divided into two classes.. |
|
Definition
dihydropyridines-nifedipine, amlopidine
nondihydropyridines-verapamil, diltiazem |
|
|
Term
| hydralazine can cause sle syndrome, which can cause.. |
|
Definition
| kidney problems, along with other SLE symptoms |
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|
Term
| digoxin is a positive inotrope which.. |
|
Definition
| increases CO and increases UO |
|
|
Term
| therapeutic uses of digoxin.. |
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Definition
|
|
Term
| digoxin is no longer first line drug for.. |
|
Definition
| CHF< lowers life expectancy in women |
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|
Term
| digoxin is contraindicated with.. |
|
Definition
| diuretics, except K sparing. abx, CCBs, amiodarone |
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|
Term
| antidotes to dig toxicity.. |
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Definition
|
|
Term
| make sure with digoxin that.. |
|
Definition
| full minute of apical pulse, hold if less than 60 bpm, check for potassium levels, watch for dysrhythmias- normally brady |
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|
Term
|
Definition
|
|
Term
|
Definition
| ace inhibitors and RAAS meds |
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|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
| nurses are involved in which part of the therapeutic obejective of drug therapy? |
|
Definition
| assessing the pt for adverse effects of drug therapy (not prescribing or recommending or any crap like that) |
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|
Term
| with antihypertensive meds, if pt's bp is 110/70, should you adminster med? |
|
Definition
| check to see if data is congruent with previous measurements, if its a sudden drop, dont give |
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|
Term
| if pt has low respirations of 9 breaths/min what post op med should you avoid giving? |
|
Definition
|
|
Term
| nursing dx for patient on opiate analgesic |
|
Definition
|
|
Term
| when changing pt from trade to generic, what should you monitor? |
|
Definition
| blood levels to insure avoidance of toxic levels |
|
|
Term
| protein bounds drugs in circulation are not able to |
|
Definition
|
|
Term
|
Definition
| the reduction of the effectivness of a drug by the time it reaches systemic circulation (mostly caused by liver and gut wall) these drugs should go iv or im instead |
|
|
Term
| sublingual is a good way to admister orally without the effects of.. |
|
Definition
| first pass effect, sublingual allows for direct absorption |
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|
Term
| while administering an iv push morphine, pts breathing drops from `15 to 11, what do you do? |
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Definition
|
|
Term
| excretion of a drug may be impaired if.. |
|
Definition
| patients GFR is below 30 m/l |
|
|
Term
| in pacu, what can promote excretion of most anesthetics? |
|
Definition
|
|
Term
| for drugs with a narrow therapetic range you should.. |
|
Definition
| carefully monitor pt for therapeutic and toxic effects, be diligent about timing of adminstering the drug, monitor blood levels to see if its in therapeutic range |
|
|
Term
| what inhibits the CYP3A4/drug metabolizing enyzyme? |
|
Definition
|
|
Term
| inhibiting CYP3A4 can cause what? |
|
Definition
| excessive levels of the drug in the blood bc its not metabolized as well |
|
|
Term
| an order of "peak and trough levels" indicates the need for what? |
|
Definition
| draw blood at peak hour:1.5 hours after infusion, trough level:30 minutes before next dose |
|
|
Term
| why cant heparin be given orally |
|
Definition
| because its large and negatively charge - limiting absorption |
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
| PTT result indicating heparin therapy is in therapeutic range.. |
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Definition
|
|
Term
| a Rx for lovenox is based upon.. |
|
Definition
| pts weight, if ordered twice a day, should be every 12 hours |
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|
Term
| pt prescribed aspirin should take it how if experiencing chest pain? |
|
Definition
| chew and swallow a tablet with a glass of water (any dose size) |
|
|
Term
| high doses of aspirin should be discontinued how long before a surgery? |
|
Definition
|
|
Term
| aspirin can cause what in children w a possible viral infection |
|
Definition
|
|
Term
| there may be no sxs for a person on longeterm aspirin who has a |
|
Definition
|
|
Term
| pts with high levels of ASA may exhibit |
|
Definition
|
|
Term
| baby w ASA toxicity, breaths: 14, what would lab results look like? ph |
|
Definition
| low breathing rate= low pH, increased CO2, |
|
|
Term
| a pt with aspirin rx should avoid.. |
|
Definition
|
|
Term
|
Definition
| irritate the stomach the least |
|
|
Term
| alpha receptor antagonists end in what? |
|
Definition
|
|
Term
| minipress should be taken in the.. |
|
Definition
|
|
Term
| viagra and alpha adrenergic antagonists can cause what |
|
Definition
| hypotension and vascular collapse |
|
|
Term
| beta receptor antagonists ends in what? |
|
Definition
|
|
Term
| what would warrant withholding a beta blocker and contacting the prescriber? |
|
Definition
| apical pulse of 48 beats per minute |
|
|
Term
| metoprolol can cause excessive cardiosuppression if taken with.. |
|
Definition
|
|
Term
| the most common adverse affect with clonidine is.. |
|
Definition
|
|
Term
| clonidine patients should take a larger dose at.. |
|
Definition
|
|
Term
| diabetic on lasix should be monitored for |
|
Definition
| increased thirst confusion and dry hot skin |
|
|
Term
| lab tests for high ceiling diueretics |
|
Definition
| electrolytes, glucose, LDL/HDL, uric acid |
|
|
Term
| signs of hypokalemia for pts on lasix |
|
Definition
| muscle weakness and constipation |
|
|
Term
| which OTC can counteract diuretics? |
|
Definition
|
|
Term
| diuretic recommended for early HTN |
|
Definition
|
|
Term
| spironalactone+ what? may increase risk for hyperkalemia |
|
Definition
| -pril, -sartan (A I's, angiotensin receptor blockers) |
|
|
Term
| ARB drugs end in what suffix? angiotensin receptor blockers. |
|
Definition
|
|
Term
| ACE i"s end in what suffix? |
|
Definition
|
|
Term
| adverse effect of ACE i's |
|
Definition
|
|
Term
|
Definition
| fasting blood sugar, Na, K |
|
|
Term
| Ace-i, plus salt substitute can show up as what on an EKG |
|
Definition
|
|
Term
| do not take what with ACEi's |
|
Definition
|
|
Term
| lab result that could increase the risk for lithium toxicity |
|
Definition
|
|
Term
| a less selective drug means.. |
|
Definition
| it affects more areas, therefore MORE side effects |
|
|
Term
|
Definition
|
|
Term
| dihydropyridine CCBs primarily effect |
|
Definition
|
|
Term
| verapamil and diltiazem causes |
|
Definition
| reduce force of contraction, av node suppression |
|
|
Term
| dihydropyridine CCB drug suffix is |
|
Definition
|
|
Term
| priority assessment before adminstering diltizem/cardizem |
|
Definition
|
|
Term
| verapamil and beta blocker- check for.. |
|
Definition
| crackles in lungs, SOB, weight gain of 3 lbs in 24hr |
|
|
Term
|
Definition
| anorexia and nausea, low potassium |
|
|
Term
|
Definition
| reducing the work of the heart by expanding the space in vessel into which the heart is ejecting blood |
|
|
Term
| orthostatic hypotension is more likely to occur in a patient who is receiving a venous vasodilator or arteriole vasodilator? |
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Definition
|
|
Term
| an adverse reaction hydralazine that should be reported |
|
Definition
|
|
Term
| reflex tachycardia can be treated by which drug |
|
Definition
|
|
Term
| which drug is prescribed for pts w heart failure who are prescribed hydralazine (which causes sodium retention)? |
|
Definition
|
|
Term
| when a patient is NOT ambulatory, where would signs of edema first normally appear? |
|
Definition
|
|
Term
| BP is best assessed when patient is in what position? |
|
Definition
| sitting with feet flat on floor |
|
|
Term
| reflex tachy would be most likely experienced by a pt on which med? |
|
Definition
| a direct acting vasodilator |
|
|
Term
| what is the most important part of pt education with hypertensive meds? |
|
Definition
|
|
Term
| which is the most alarming respiratory finding? |
|
Definition
| high pitched musical inspiration, AIRWAY! |
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|
Term
| the recommended time goal for lowering BP when a pt is in acute congestive heart failure |
|
Definition
|
|
Term
|
Definition
|
|
Term
| CHF drug that decreases aldosterone production that results in vasodilation and mild reduction in blood volume |
|
Definition
| ARBS- sartan sisters- angiotensin receptor blockers |
|
|
Term
| chf drug that is effective when kidney function is impaired |
|
Definition
| furosemide/lasix, high ceiling loop diuretics |
|
|
Term
| CHF drug that increases force of contraction, decreases heart rate reduces vasoconstriction and increases urine production |
|
Definition
|
|
Term
| CHF drug that increases level of kinins and decrease aldosterone- resulting in vasodilation |
|
Definition
| ACE i's- pril!, angiotensin converting enzyme inhibitors |
|
|
Term
| CHF drug that prolongs survival of HF pts by blocking aldosterone receptors and preventing heart remodeling, heart and vascular fibrosis, baroreceptor dysfunction, and dysrythmias - excretes water and sodium, conserves K |
|
Definition
| - aldosterone receptor antagonists- spironolactone |
|
|
Term
| Chf drug that reduces blood volume, can cause hypokaelmia and increase the risk of digitalis toxicity- not effective when kidney function is impaired |
|
Definition
|
|
Term
| Chf drug that slightly reduces blood volume by causing loss of Na, and water with conservation of K |
|
Definition
| K sparing diuretics- triameterene |
|
|
Term
| chf drug that slows the heart rate and can reduce the force of contraction if dose not carefully titrated |
|
Definition
| beta adrenergic blockers, metoprolol- BAB lol |
|
|
Term
| BNP elevation- b-natriuretic peptide suggests Hf because.. |
|
Definition
| bnp is released when the hearts chambers stretch |
|
|
Term
| if nurse cannot hear apical pulse of patient with HF, she should move the stethoscope to the.. |
|
Definition
|
|
Term
| nitrogylcerin and isosorbide reduce the workload of the myocardium by.. |
|
Definition
| decreasing the amount of blood returning to the heart |
|
|
Term
| drug induced lupus like syndrome can cause.. |
|
Definition
|
|
Term
| anorexia and nausea are signs of which electrolyte imbalance? |
|
Definition
|
|
Term
| blocking this ion from entering slows depolarization.. |
|
Definition
|
|
Term
| blocking this ion from exiting can reduce the force of contraction |
|
Definition
|
|
Term
| blocking this ion from exiting increases the amount of time when the cell cannot be stimulated to contract |
|
Definition
|
|
Term
| primary nursing dx for a pt w dysrhythmia |
|
Definition
| alteration in cardiac output |
|
|
Term
|
Definition
| a 100, but better below 70 |
|
|
Term
|
Definition
| more than 60, less than 40 is bad |
|
|
Term
|
Definition
| below 150 is desirable, 600 is crazy. |
|
|
Term
| which complication of diabetes causes the most deaths? |
|
Definition
|
|
Term
| what defines intensive insulin therapy? |
|
Definition
| requires four injections of a rapid acting insulin each day in addition to an injection of a basal insulin |
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