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GI - Nausea, vomitting, diarrhea
I- Increase Glucose Value
A- Alcohol causes vomitting
N- Nephrotoxicity
T- Thrombocytopenia |
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| Nephrotoxicity, Ototoxicity, renal failrue |
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| Most important thing to check before giving Sulfonamides |
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| Major neurotransmitter of adrenergic system (sympathetic system) |
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| Andrenergic Agonists/Sympathomimetics do what? |
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| adrenergic blockers/ symptholytics do what? |
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| dilating pupils, dilting bronchioles, increasing HR, constriction of blood vessels, relaxation of HI Bladder and Uterus are what response? |
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| sympathetic response, from Sympatholytics/ adrenergic agonists |
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| vasoconstriction, dilates pupils |
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| dilates, decrease GI Motility |
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| Which 2 enzymes inactivate norepinephrine? |
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Sympathomimetic drugs
direct acting?
indirect?
mixed? |
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Direct- epinephrine
indirect - amphetamine
mixed - Ephedrine |
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| Epinephrine is a sympathomimetic drug & stimulates Alpha 1, beta 1, and beta 2. What does it do? |
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alpha 1 - vasoconstrict
beta 1 - increase BP & HR
beta 2 - bronchodilation |
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dopamine stimulates?
Sympathomimetic |
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| alpha 1 - (vasoconstrict & increase HR) |
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Pseudophed stimulates?
Sympathomimetic |
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Alpha 1 - vasoconstrict
Beta 1 - increase BP & HR |
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| Isuprel - intended effect and unwanted? |
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beta 2- dilates bronchioles
beta 1 - increase HR |
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| Albuterol/Proventil stimulates? |
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| How do adrenergic blockers (sympatholytics) work? |
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| occupt receptor sites or inhibit release or transmitter |
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| Alpha Adrenergic blockers (Regitine) used for? |
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| Peripheral vascular disease |
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| Alpha Adrenergic blockers do what? |
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Vasodilator & decrease BP
(can be reflex tachycardia) |
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| Alpha Adrenergic blockers additional use? |
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| Result of non-selective beta blockers |
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| decreased HR, decreased BP, bronchoconstriction |
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| Stimulation of the parasympathic system |
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| constricts pupils, constrict bronchioles decreased HR, dilates blood vessels, bladder contraction, increased GI motility |
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| Another term for parasympathetic |
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| neurotransmitter of parasympathetic sysmtem |
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| Drugs that stimulate Parasympathetic sysmtem are called |
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| Cholinergics or cholinergic agonists |
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| drugs that block parasympathetic system are called? |
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| Nicotinic and muscarine effect what? |
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nicotinic - skeletal muscl
emuscarine - smooth muscle (heart rate) |
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| indirect action of cholinergic drugs |
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stimulate release of acetylcholine
inhibit cholinesterase = makes more acetylcholine availble |
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Stimulation of bladder and GI tone
constrict pupils
decrease BP, HR , increase Salivation
are the effects of what? |
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| direct acting cholinergic |
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| Effect of Urecholine, a cholinergic |
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| Polyuria & increased GI activity |
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| Side Effects of cholinergics (direct acting) |
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| hypotension, bradycardia, diarrhea, excessive saliva, dysrthmias |
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What constricts pupils, relieving intraocular pressure caused in glaucoma?
what drugs? |
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Direct acting cholinergics
isopto-carpine, policarpine |
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| Examples of Indirect acting cholinergics? |
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Prostigmin - treats myasthenia gravis
Tacrine - improves memory |
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| What is the result of indirect acting cholinergics |
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| Anticholinergic drug effects |
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| decreased GI & saliva, dilate pupils, decrease bladder contraction, decrease tremors, increase HR |
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| What population are anticholinergics not good for? |
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| What surgery are anticholinergics useful in? |
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| Atropine (anticholinergic) use? |
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| preop to dry secretions & increase HR |
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| Artane (anticholinergic) use |
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| Parkinsons, decrease muscle rigidity |
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| Scopolamine (drug class & use) |
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Anticholinergic,
motion sickness for dry secretions and relaxed GI muscles |
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| What disease is contraindicated for anticholinergic use? |
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| Glaucoma (dilated pupils makes pressure worse) |
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| What do anticholinergics and dopaminergics treat? |
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Levodopa (drug class?)
(only 1% crosses blood brain barrier + high does) |
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+ Inotropic (increased contractility)
- chronotropic (decreased rate)
for CHF and atrial dysrhytmias |
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| What do cardiac glycosides treat? |
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| What drugs increae Dig toxicity? |
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| Lasix & hydroclorathiazides |
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| Digoxin index range & most important assessment |
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.5-.2 ng/ml
HR, <60 don't give! |
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| 3 types of antianginal drug classes |
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| Nitrates, Beta blockers, Ca+ channel blockers |
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Nitrates drug interventions
(work by relaxing coronary arteries and increasing O2 to the heart) |
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Check BP frequently
teach - 3 tabs q 5 min then call 911 |
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| What 3 things do Ca+ channel blockers treat? |
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Angina
dysrhythmias
hypertension |
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Calan, Procardia, Cardiazem, Norvasc, Cardene
(drug class) |
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| Important assessment and S/E of Ca+ channel blockers |
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check liver enzymes
S/E - bradycardia, hypotension, dizziness, flushing |
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| Why do Ca+ channel blockers cause bradycardia |
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relax smooth muscle
-inotropic = decreased workload of heart = slower HR |
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| 4 classes of Antidysrhythmic drugs |
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1 - Fast (NA) channel blockers
2- Beta blockers
3-Prolong repolorization
4 - calcium channel blockers |
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Action of Class 1 - fast NA Channel blockers
Norpace, Pronestyl |
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| slow conduction and prolong repolorization |
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| S/E of Class 1 - Fast NA channel blockers |
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| Beta blocker contraindications? |
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| Nursing assessment before administering beta blockers? |
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| Bretylol, Cordarone (drug class) |
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| Class 3- Prolong Repolorization |
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| Class 3, Prolong Repolorization - use and assmenents |
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Emergencies
-check vitals, monitor heart,
-Cause PHOTOSENSITIVITY |
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| Diuretics - use and action |
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Hypertension & edema
- inhibit sodium & water reabsorption |
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| Where do Thiazide Diuretic work? |
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| What is an additional action of Thiazides? |
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vasodilation
aka- very good to treat hypertension |
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S/E of thiazide diuretics
drug contraindications |
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hyperglycemia
-No for renal failure, No w/ Digoxin |
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| HCTZ, Dyzide (drug class?) |
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| Loop diuretic action, where? |
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Loop of henle
inhibits chloride(loss of sodium, water, potassium, calcium & magnesium)
No Blood Sugar effect |
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| Which diuretic is the best choice for pt's with renal failure |
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| Nursing interventions for Loop Diuretics |
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| monitor weight, BP, electrolytes, avoid Alcohol and other highly protein bound drugs |
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| Osmotic Diuretic - action & use |
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increase osmolarity in tubules = major diuresis
Decrease intracranial pressure,
decrease intraocular pressure,
prevent kidney failure |
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| Nursing interventions for osmotic diuretics (Mannitol) |
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| check bottle for crystals, vital signs, I&O |
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| Carbonic Anhydrase Inhibitor - diuretic |
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| Carbonic Anhydrase Inhibitor (diamox) use |
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| decrease intraocular pressure |
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| Nursing Interventions with Diamox |
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give w/ food or antacids
don't mix with fruit juice (instead use honey or syrup) |
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| Dyrenium, Aldactone (drug class) |
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| Potassium Sparing Diuretic |
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What drug class are Potassium Sparing diuretics combined with and why?
-Aldactazide, dyazide |
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| combined with Thiazides - intensifies diuresis and prevents potassium loss |
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| First line choice for treating hypertension |
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| Thiazide diuretic or combination |
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| First line choice for treating hypertension |
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Definition
| Thiazide diuretic or combination |
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| Lopressor, Tenormin, Coregard (drug class) |
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| Beta blockers (sypatholytics) |
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Definition
adrenergic Neuron Blocker
- very potent in Emergencies
-block norepinehrine at receptor site |
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| Normodyne, Cartol (drug class & action) |
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Definition
alpha 1 & beta 1 blocker
vasodilation and decrease HR |
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| Apresoline, Minoxidil, Nitroprusside (drug class) |
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| direct acting vasodilators |
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| Action and S/E of direct acting vasodilators |
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Definition
decrease BP, but retain water
(often combined w/ diuretics) |
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| Important S/E of Direct acting vasodilators |
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| reflex tachycardia, lupus like symptoms |
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| Important Ace Inhibitor S/E & Nursing Interventions |
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hypotension w/ first dose
monitor electrolytes, vital signs & renal function |
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| Cozaar & Atacand (drug class) |
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Definition
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| How do Ace II blockers work? |
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Definition
block vasoconstriction at receptor sites
-better tolerated & can be used with mild hepatic and renal impairement |
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| What must be monitored when giving heparin? |
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Definition
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Definition
| Low Molecular weight Heparin |
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| Coumadin/Warafin - Monitor INR (should be?) |
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Definition
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| Thrombolytics (Streptokinase & t-PA) use |
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Definition
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| Lipitor, Zocor, Prevachol, Mavacor (drug class) |
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Definition
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| Vasastain use, action, (don't take with?) |
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Definition
decrease Cholesterol by decreasing cholesterol synthesis in liver
don't take with grapefruit juice |
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| Drug class used to treat Raynaud's Disease and Buerger's disease |
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Definition
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| Priscoline & Vasodilan (drug class) |
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Definition
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| Peripheral vasodilator action |
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Definition
alpha andrenergic
beta 2 agonist |
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