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Beta1 agonists help with

heart failure

ACE Inhibitor side effects

dry cough,

best drug for heart failure drug for african american

CCB with thiazine

patient is taking digoxin and has Supraventricular tachycardia, what lab values are important

potassium levels; hypokalemia increases risk for digoxin toxicity

patient asks why he is on heparin after MI

it is to prevent clotting

patient comes into the ER with an angina attack, what is prescribed

sublingual nitroglycerin.

nitroglycerin side effect

dizziness

patient is taking warfarin, which diagnostic test is used

PT/INR

what test is used to evaluate heparin

aPTT

Negative chronotropic drugs

decrease heartrate

adverse effect of starting antidysrhythmias

new dysrhythmias

when administering topical nitroglycerin treatment..

make sure old ointment is removed and skin is cleaned before applying new ointment

This in IV causes Phlebitis

potassium

giving magnesium sulfate IV too fast can cause

asystole

avoid NSAIDs with

warfarin, digoxin, aspirin

grapefruit should be avoided when taking

CCBs, Statins, erectyle disfunction drugs

patients on antithyroid drugs should avoid

iodine rich foods

patients on warfarin should monitor

vitamin k (leafy greens) intake

digoxin patients diet

high fiber foods such as bran can slow the absorption of digoxin

inotropic

increase force of contraction

chronotropic

increase heart rate

dromotropic

accelerate cardiac conduction

heart failure drugs ( AABCDD)

ACE inhibitors
ARBs
Beta-Blockers
CCBs
Diuretics
Digoxin

Nestiride

used in severe life threatening heart failure

A systolic blood pressure of 120 to 139

prehypertension

A diastolic blood pressure between 80 and 89

prehypertension

digoxin

positive ino, negative chrono, negative dromo,
serum drug level should be 0.5-2.0 ng/ml

digoxin adverse effects

dysrhythmias, headache, halo vision,

digoxin immue fab (digibind)

digoxin antidote, used when potassium serum levels are greater than 5mg/ml

normal potassium levels

3.5-5

implementation digoxin

check apical pulse for 1 min. if below 60 or above 100 , hold dose,

ACE inhibitor side effects

dry cough, headache,

best african american heart failure treatment

CCB with thiazine

Beta1

heart

Beta2

lungs

sildenafil

viagra, only allowed 10 pills per month on insurance, nitroglycerin must be tapered down before viagra use

mens health assessment

focus on BP, Pulse

Estrogens

given during menopause, without estrogen women become osteoporitic

estrogen contraindications

family history of breast cancer, thromboembolic disorders

contraceptive adverse effects

increase risk for DVT

osteoporosis

asians/whites most affected. also slender body type, smokers, alcohol consumption,

fertility drugs

clomiphene- ovarian stimulants

URI

upper respiratory infection

common cold

caused by virus, treated with antihistamines and cough suppressants, pallative not curative treatment.

H1 antagonists

benadryl, claritin
antihistimic, anticholinergic, sedative properties

H2 antagonists

zantac, pepcid, tagamet,
decrease gastric acid

antihistamine contraindications

patients with acute asthma attacks and pneumonia

antitussive drugs

treat non productive cough

decongestants

adrenergics, anticholinergics, corticosteroids

oral decongestant

sudafed

nasal spray

phenylephrine -adrenergic
flunisolide- intranasal steroid

opoid antitussive

codeine

nonopiod antitussive

dextromethorphan

expectorants

guifanesin
bad gi upset, n&V

emphysema

destruction of alevolar walls.
barrel chested patients, smokers.

brhonchitis

excessive mucus production

asthma

bronchospasm, wheezing,

beta2adrenergic agonist

sympathetic bronchodilators
albuterol, epinephrine

anticholinergics

ipatropium
used on emphysema patients or COPD

xanthine derivates

aminophylline
used in acute asthma, adjuct to COPD
serum levels must be tested for drug levels

non bronchodilating drugs

leukotrines

cordicosteroids

antiinflammatory, enchances activity of beta agonists
*too much can cause oral thrush

COPD, Emphysema patient teaching

tripod effects, pursed lip breathing,

diabetes symptoms

elevated fasting blood glucose (higher than 110 mg/dl) 3 P's
Polyuria- increase urination, Polydipsia- excessive thirst, polyphagia- excessive hunger

Type 1 diabetes

lack of insulin production, usually diagnosed in kids, need insuilin.
complications- diabetic ketoacidosis (DKA)

type 2 diabetes

most common form,( 90% )
insulin-resistance syndrome, syndrome x,

healthy glucose levels

70-110

rapid acting insulin

lispro, aspart,
Onset- 5min
Peak- 1 hour
Duration- 2-4 hours

regular or Short acting insulin

Humulin R , Regular
Onset- 30 min
Peak-2-3 hours
Duration-3-6 hours

intermediate acting insulin

Humulin N, Novolin,
Onset- 1 hour
Peak-4-8 hours
Duration-18 hours

long acting insulin

lantus
onset- 2-4 hours
no peak, work evenly over 24hours

important about peaks

patient can develop hypoglycemia

oral hypoglycemics

used for type 2 diabetes,

biguanides

metformin

Sulfonylureas

amaryl, glipizide, glyburide,
*beta cell function must be present

Thiazolidinediones

actos, avandia
* insulin sensitizing drugs
DO NOT USE ON CHF PATIENTS

incretin mimetics

byetta, jenuva
*injection pen

D50W

50%dextrose in water, given to patients to elevate glucose (glucagon)

hypoglycemia intervention

give OJ and sugar, recheck sugar levels in 15 min

marker for chronic diabetes

ALC level- blood glucose

NPO patients before surgery

withhold insulin to avoid hypotension

high alert meds

insulin, lovenox, heparin,
*need to be double checked by second RN

RBC lifespan

120 days

types of anemias

hemolytic anemia- excessive RBC destruction
maturation defects.

iron foods

meats, veggies, grains, OJ, veal, fish, ascorbic acid

Oral anemia drugs

ferrous fumerate, ferrous gluconate

parenteral anemia drug

dextran
* may cause anaphlactic reaction, test dose is given in first hour, have cpr equipment near.

ferric gluconate, iron sucrose

used in renal disease, less risk for anaphylaxis,
adverse effects is hypotension

Folic acid

vitamin b6, used in pregnancy, malabsorptive syndromes

Cyanocobalamin

vitamin b12 Intramuscular injection

erythropoietin

subcut injection, usually for renal patients

lab values to check

Hgb, Hct, RBC, WBC, reticulocytes

patient teaching

patients need to sit upright 15-30 minutes after oral dosages

thyroid gland secretes these 3 hormones

T3, T4, calcitonin

goiter

enlargement of thyroid gland

levothyroxin

synthetic T4

lithothyronine

Synthetic T3

adverse effects of hypothyroid drugs

cardiac dysrhythmia

Hyperthyroidism

graves disease, thyroid storm

hyperthyroid treatment

radioactive iodine, surgery, and antithyroid drugs (propylthiouracil / PTU)

PTU patient teaching

avoid foods high in iodine, seafood, soy sauce, iodized salt, tofu, cabbage.

Anterior pituitary drugs

somatotropin, octreotide,

posterior pituitary drugs

vasopressin

Somatotropin

growth hormone (GH) for dwarfism,
*parents should keep journal of childs growth

octreotide (sandostatin)

reduces severe diarrhea, flushing, hypotension that occur with carcinoid crisis (cancer).
*may impair gallbladder function
*monitor patients glucose

Vasopressin

vasocontrictor used in hypotensive emergencies, gi bleeding, pulseless cardiac arrest.
*used in ER, ICU

HDL

good cholesterol

hypertension bp

140/90 or higher

antilipemic drug categories

statins, bile acid sequestrants, Niacin, Fibrates, Zetia,

Foods high in cholesterol

Butter, cream, egg yokes,

Statins

Most potent LDL reducers, first line of drug therapy for hypocholesteremia ,

Statin adverse effect

muscle pain

Bile Acid sequestrants

cholestryamine, prevent resorption of bile acids in small intestine. Used with partial bilary obstruction.

niacin

vitamin b3. lipid lowering properties,

niacin adverse effects

flushing, itching
* aspirin 30 min before dose can help alleviate

Fibrates

fenofibrate, activates lipase which breaks down cholesterol,

fibrate adverse effects

gi upset, increased risk for gallstones

zetia

cholesterol absorption inhibitor, recommended only when patients dont respond to other therapy

Omega 3

interacts with anticoagulant drugs, found in fish oil, used to reduce cholesterol

prevention of a blood clot also prevents

Stroke, MI, DVT, Pulmonary embolisms

Anticoagulants

Prevent clot formation

anticoagulant drugs

Heparin, warfarin, levonox

Anticoagulant adverse effects

bleeding, heparin-induced thrombocytopenia

Lab values to monitor heparin

aPTT

heparin antidote

protamine sulfate

lab values to monitor warfarin

PT/INR

warfarin antidote

vitamin K

Antiplatelets

prevent clot formation,

antiplatelet drugs

aspirin, dipyridamole

antifibrinolytics

promote clot formation

antifibrinolytic drugs

aminocarproic acid,
* used with blood loss, surgical complications

thrombolytics

breakdown existing clots

thrombolytic drugs

streptokinase, urokinate, T-PA
* used with acute MI, acute ischemic stroke

thrombolytic adverse effects

bleeding

clotting modifier assessment

check allergies! baseline values.

patient education for clotting drugs

prevent bruising, bleeding, tissue injury, no sitting for too long (ex. plane rides, road trips.

Vitamin K foods

tomatoes, dark green leafy veggies,

*interfere with warfarin.

signs for internal bleeding

low BP, restlessness, increased pulse

with this drug, test dose is given in first hour

dextran

sodium levels

135-145

ace inhibitors help in CHF by

decreasing preload/ decreasing work required by heart

inamirone should not be mixed with

dextrose

iv digozin is to be administered IV...

over 5 mins, 0.25ng/min

dig immune fab vials expire after

4 hours refrigerated

if dig patient misses dose..

can still take it if it has been less than 12 hours, if it has been more than 12 hrs call DR

use of lidocane requires assessment of

heart rate/ pulse

use of amiodarone requires assessment of

repiratory, thyroid, hepatic, hypertensive conditions

lidocaine is stable for.

24 hours

ecg monitoring for first 3 days is required with

dofitilide

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