Stimulates smooth muscle contraction of the uterus, blood vessels and mammary glands
Use: induce labor, TREATS BOGGY UTERUS- TONES IT UP AFTER CHILDBIRTH.
Side effects: uterine contractions, N&V, fetal distress, Hyper/hypotension, water intoxication, dehydration, postpartum hemorrhage
Interaction: anesthetics, monitor BP vasopressors can result in severe HTN, HR and rhythm closely
reduce depression. reduce anxiety, anti inflammatory
-interacts with CNS depressants and opioid analgesics, warfarin, selective serotonin reuptake receptors and tricyclic antidepressants.
Side effects: PHOTOSENSITIVITY, serotonin syndrome: agitation, diaphoresis, tremors, nausea (symptoms are sudden onset, like a panic attack) when used with other serotonin stimulants (SSRIs, MAOIs, tricyclic antidepressants)
Keep supplement out of the light and heat (alters chemical compound)
Used medically as an anit-inflammatory agent (ALLERGIC REACTIONS, ASTHMA). Mask symptoms of infection.
I&Os, weight, BP, electrolytes, HYPERGLYCEMIA, and hydration status must be monitored.
Suppresses immunity, avoid large crowds, avoid stressful situations
Vitamin D and calcium may need to be increased
Steroid use should not be stopped abruptly and should be tapered off. WEAN OFF DRUG SLOWLY.
Side effects: MOOD CHANGE, HUNGRY, HIGH BLOOD SUGAR. electrolyte imbalance (hypokalemia), fluid accumulation, susceptible to infection, slow wound healing, behavioral changes, hyperglycemia, peptic ulcer.
Interactions: diuretics (hypokalemia), warfarin (decreases effectiveness), antidiabetic drugs my need to be adjusted.
LONG TERM USE=FRAGILE THIN SKIN
EXAMPLES: PREDNISONE, SOLUMEDROL, DECADRON
diphenhydramine; antihistamine; tx sneezing, runny nose, itching, watery eyes, hives, rashes itching & other symptoms of allergies & the common cold; suppress coughs to treat motion sickness, to induce sleep & to treat mild forms of Parkinson's disease.
Side effects: sedation, constipation, blurred vision
Use with caution in asthma, prostatic enlargement, and glaucoma patients
DRIES YOU UP (ANTICHOLINERGIC): CAN'T SEE, SPIT, POOP
Rapid-acting (Lispro, aspart) ==> onset 10 minutes, peak 1-3 hours, duration 3-5 hours.
"Lispro question:The wording is directly from the book and states "aspart, lispro, and glulisine are usually administered within 10 to 15 minutes of a meal". They work so quickly that they can be given with a meal or after a meal has started to combat the effects of eating"
Short-acting (regular) ==> onset 30 minutes, peak 2.5-5 hours, duration 5-10 hours ==> used pre-prandial The only insulin that CAN BE GIVEN IV
intermediate-acting (NPH) ==> onset 4 hours, peak 4-12 hours, duration 16-24 hours
Long-acting (lantus) ==> onset 1 hour, no peak, 24 hours (at bedtime) GREAT OVERALL CONTROL OF BLOOD SUGAR=NO PEAK
'THE SUPER ASPIRIN"
"PLAVIX SAVED BRIENNA FROM PE" - BRIENNA
ANTI PLATELET AGENT FOR CEREBRAL VASCULAR DISEASE, INHIBIT BLOOD CLOTS, PREVENT MI, CORONARY ARTERY DISEASE.
A blood thinner approved for the treatment of mild heart attacks. Works by preventing blood platelets from sticking together to form clots that would restrict blood flow. Reduce frequency of transient ischemic attacks (TIAs), stroke, myocardial infarction, and complications from peripheral vascular disease
Side effects: THROMBIC THROMBOCYTOPENIA PURPURA (TTP) (rare, but usually occurs within 2 weeks of treatment causing CHANGE OF LOC, neurologic abnormalities, fever, and renal impairment= CALL YOUR DOCTOR), neutropenia, bleeding.
GI SIDE EFFECTS, RASH
RISK FOR BLEEDING BECAUSE OF ANTIPLATELET PROPERTIES. LASTS FOR THE LIFE OF THE PLATELET, SO DRUG HAS TO BE OUT OF SYSTEM BEFORE SURGERY
"SAVES BRI FROM PE, BUT TAKES FOREVER TO WORK, SO SHE HAS TO GET HEPARIN AND LOVENOX UNTIL IT IS IN THE THERAPEUTIC RANGE"
"SUPPOSED TO BE 2-3, BUT NOT ME" - BRIENNA
PREVENT DVT, PE
Uses: for the treatment and prophylaxis of venous thrombosis, embolism associated with atrial fibrillation or heart valve replacement, pulmonary embolism, and coronary occlusion.
Prevents and treats thromboembolic associated with Afib, stroke, myocardial infarction, cardiac valve replacement.
Always check the most recent PT and INR results to determine if they are in the recommended range.
Antidote: VITAMIN K OR FRESH FROZEN PLASMA
Common adverse effects: Bleeding
USED FOR SUPERVENTRICULAR TACHYCARDIA (fast narrow complex dysrythmia)
Naturally occurring chemical found in every cell with in the body.
Uses: Because of its strong depressant effects on the SA and AV nodes, adenosine is recommended for the treatment of PSVT that involves conduction of the SA node, atrium, AV node. It does not convert atrial flutter, atrial fibrillation, or ventricular tachycardia to normal sinus rhythm.
Therapeutic outcome: is conversion of supraventricular tachycardia's to normal sinus rhythm.
Common AE: flushing of the face, SOB, chest pressure, nausea, headache, and light-headedness. Because the half-life of adenosine is less than 10 seconds, adverse effects are very short lived.
NICE SATIN-Y TONGUE
Antifungal and antibiotic. Common topical fungal infections are tinea pedis( athletes foot) and tinea cruris(jock itch), tinea corporis(ring worm), and tinea versicolor. Candida albicans is the most common cause of oral candidiasis (thrush), cutaneous candidiaisis (eg diaper rash), and vaginal candidiasis (moniliasis [yeast infection]).
Therapeutic outcome: Elimination of fungal infection
Common AE: Irritation, redness, swelling, blistering , and bruising.
THRUSH OFTEN DEVELOPS IN PATIENTS WITH RENAL COMPROMISE/ TRANSPLANT MEDICATIONS, DIABETICS, PEOPLE ON STERIODS, CHRONIC ANTIBIOTIC USE.
CHECK BP HR
NOT FOR PEOPLE WITH RESPIRATORY ISSUES (EMPHYSEMA/BRONCHITIS/COPD)=IT CAN CAUSE BRONCHO CONSTRICTION.
One of the primary actions is vasoconstriction, it would be expected that alpha-blocking agents are indicated for patients with disease that are associated with vasoconstriction. Beta adrenergic blocking agents are used extensively to treat hypertension, post myocardial infarction, angina pectoris, cardiac dysrhythmias, symptoms of hyperthyroidism, and stage fright. Should be used cautiously with patients with diabetes and those susceptible to hypoglycemia. Should be used only in patients with controlled heart failure.
Common A/E: Patients with diabetes, monitor for symptoms of hypoglycemia, including headache, weakness, decreased coordination, general apprehension, diaphoresis, hunger, and blurred or double vision.
Serious AE: Bradycardia, peripheral constriction, bronchospasm, and wheezing.
CHECK WEIGHT, I & O, POTASSIUM WASTING. CHECK K+ LEVELS. CHECK BP
Uses: Pulmonary Edema, edema w/CHF, hepatic(renal) disease, nephrotic syndrome, ascites, hypertension, cirrhosis of the liver.
Serious Adverse Effects: Circulatory Collapse, Renal Failure, Anemia, Neutropenia, Leukopenia, Thrombocytopenia, Agranulocytosis, Stevens - Johnson syndrome
Common Adverse Effects: Hypokalemia, hyponatremia, hyperglycemia, nausea, polyuria, rash, pruritus, headache, fatigue, weakness, and dry mouth
Monitor daily weight/I&O in CHF Patients, Monitor BP (& orthostatic vitals), Can cause tinnitus/hearing loss when taking high doses;
**Teach the need for a high potassium diet (or replacement w/provider), rise slowly, recognize adverse reactions (muscle cramps, weakness, nausea, dizziness), take w/food/milk to avoid GI symptoms, take early in the day.
Labs value to Monitor: Electrolytes, BUN/Cr, ABGs, uric acid, CBC, Blood Glucose
ANALGESIC , ANTIPYRETIC, ANTIPLATELET EFFECT. PROPHYLACTIC MI OR STROKE. NORMAL 81 MG. MI=4 BABY ASPIRIN.
Relief of slight to moderate pain, analgesic, antipyretic, inflammatory and antiplatelet.
Use: Symptomatic relief of discomfort, pain inflammation or fever. Reduce the rick of recurrent TIAs, stroke and MI. Headaches, muscle aches, rheumatoid arthritis.
Common adverse effects: gastric irritation (give med with food, milk, glass of water and antacids 1 hour after med administration).
Serious adverse effects: Gastrointestinal bleeding (black tarry stool, bright red or coffee-ground emesis may occur). Increased risk of bleeding in older adults in the form of GI bleeding or a hemorrhage stroke.
Precautions: Extreme caution w/ hx of peptic ulcer, liver disease or coagulation disorders.
Not recommended for children due to the risk of Reye's syndrome.
Consciousness level not dulled; no memory loss, mental sluggishness, hallucinations, euphoria, or sedation.
No antidote exists for aspirin toxicity.
BIGUANIDE. LONG TERM=CHECK B12 LEVELS.
FIRST LINE FOR TYPE II DM. OVERWEIGHT PEOPLE WITH NORMAL KIDNEY FUNCTION. DOES NOT CAUSE HYPOGLYCEMIA B/C IT WORKS IN STOMACH. USED FOR POS, FATTY LIVER, PREMATURE PUBERTY. REDUCES CANCER RISK. GI SIDE EFFECTS (WORKS IN STOMACH)= FLATULENCE, BELCHING, DIARRHEA.
Decreases hepatic glucose production, reduces absorption of glucose from the small intestine, and increases insulin sensitivity improving glucose uptake in the peripheral muscles and adipose cells.
Common adverse effects: N&V, anorexia, abdominal cramps and flatulence.
Serious adverse effects: Malaise, myalgia, respiratory distress, hypotension, and lactic acidosis.
Interactions: Causes renal toxicity when used with contrast. Discontinue 24-48 hours before procedure and should not be reinitiated for 2-3 days until normal function has been proven.
Use: For type 2 diabetes, used when diet and exercise alone are not effective, as an adjunct to the diet to lower blood glucose levels in pts with type 2 diabetes.
Advantage: It will not cause hypoglycemia. It does not cause weight gain and it may cause weight lose, favorable effect on triglycerides.
CAN'T USE WITH CONTRAST
NARCOTIC. PAIN CONTROL. CAUSES CONSTIPATION, URINARY RETENTION, HYPOTENSION, RESPIRATORY DISTRESS.
Stimulating the opiate receptors in the CNS, blocks the pain sensation.
Use: Relive acute or chronic moderate/severe pain, Can be used preoperatively or to supplement anesthesia
Common adverse effects: Lightheadedness, sedation, sweating, confusion, disorientation, orthostatic hypotension, N&V and constipation.
Serious adverse effects: Respiratory depression, urinary retention and excessive use or abuse.
Precautions: prolonged use can produce drug tolerance or addiction (may develop after 3-6 weeks of use).
Drug interactions: tranquilizers, tricyclic antidepressants, antihistamines, alcohol.
Antidotes: Naloxone and naltrexone. NARCAN
Hold medication if respirations are below 10/min or according to age-related respiratory parameters and consult with health care provider. Check bowel sounds and consistency of stool.
OTHER NARCOTICS ARE FENTANYL, DILAUDID
CLOTTING--SMOKING INCREASES RISK FOR DVT, PE, CVA
Estrogens block th epituitary release of FSH, Progestins inhibit pituitary release of LH
Uses: induce contraception by inhibiting ovulation
Common adverse effects: nausea, weight gain, depression
Serious adverse effects: breakthrough bleeding, yeast infections, blurred vision, severe headaches, dizziness, leg pain, chest pain, shortness of breath, acute, abdominal pain.
Combination pill - taken for 21 days of the menstrual cycle; contains estrogen and progestin. Subdivided into three classes: monophasic, biphasic, triphasic.. Minipill - taken every day; contains only progestin.
Extended and continuous-cycle - 24-day or 84-day cycles can be followed by a short placebo period
Assess Hx, wt, BP, pregnancy test
Instructions for use: Missed pills and discontinuation, adverse effects, medication interactions, contraindications
Smoking increases the risk of serious blood clots.
BIRTH DEFECTS. 2 FORMS OF BIRTH CONTROL. CAUSES ...DISCOLORED TEETH- PREGNANCY, INFANCY TO 8 YO..
INACTIVATED BY CALCIUM- NO DAIRY.
HAVE TO BE OFF DRUG FOR 1 MONTH BEFORE TRYING TO GET PREGNANT.
SIDE EFFECTS: PHOTOPHOBIA, TINNITUS
Effective against gram-negative and gram-positive bacteria.
Uses: Getting rid of bacterial infections. Often used in patients allergic to the penicillins and for the treatment of certain STD's, UTIs, URIs, pneumonia, and meningitis. Specifically effective against acne(skin), rickettsial, and mycoplasmic infections. ^^If given during the last half of pregnancy to about 8 years of age it can cause a discoloring/staining of the teeth.
Common AE: N/V/D, anorexia, abdominal cramps, photosensitivity, diarrhea.
Nursing Assessment: Baseline assessment (temp, BP, RR, HR, and hydration status), GI disturbances prior to starting therapy, allergies, Baseline lab studies
*Take this med 1 hour before or 2 hours after ingesting antacids, milk, or other dairy products, or products containing calcium, aluminum, magnesium, or iron (vitamins for example); Nursing mothers must switch their babies to formula while taking tetracycline's.*
FOR DEPRESSION, ANXIETY, PSYCHOSIS, ADHD, BIPOLAR, MIGRAINE, POSTHERPATIC NEURALGIA (SHINGLES), INSOMNIA, PAIN ISSUES, PHANTOM PAIN.
ANTICHOLINERGIC (CAN'T SEE, SPIT, POOP), LOW GI MOTILITY, ORTHOSTATIC HYPOTENSION, DECREASED LIBIDO.
Prolong action of the norepinephrine, dopamine, and serotonin by blocking reuptake.
Common AE: orthostatic hypotension, sedative effects, blurred vision, constipation, dryness of the mouth, throat, and nose.
Serious AE: tremors, Parkinsonism symptoms, seizure activity, dysrhythmias, tachycardia, heart failure, suicidal actions.
Has an anticholinergic activity.
Key characteristics are the presence of type 2 diabetes mellitus, abdominal obesity, hypertriglyceridemia, low levels of high-density lipoproteins (HDL's) and hypertension. People with metabolic syndrome are three times more likely to have (and twice as likely to die from) a heart attack or stroke as compared with people without the syndrome. Also have a fivefold greater risk of developing type 2 diabetes. Risk factors for the development of metabolic syndrome include poor diet, sedentary lifestyle (lack of exercise) and genetic predisposition. Other negative lifestyle choices such as excessive consumption of alcohol and smoking g aggravated metabolic syndrome. A family history of first degree relatives (parents/siblings) that includes type 2 diabetes, hypertension, and early heart disease (angina, "heart attack") greatly increases the likelihood that an individual will develop metabolic syndrome. Lifestyle management is critical to prevent and treat the comorbidities that make up the metabolic syndrome. Weight loss and increased physical activity are usually the first steps of treatment. Drugs that are used to treat metabolic syndrome are: thiazide diuretics, beta-blockers, statins, angiotensin-converting enzyme inhibitors, and oral hypoglycemics. (aspirin) should not be administered to pediatric pts from infancy through adolescence. These children are susceptible to a life threatening illness known as Reye's syndrome if they ingest aspirin at the time of or shortly after viral infection with chickenpox or influenza. Salicylates are the most common analgesics used for the relief of slight to moderate pain.
Three primary pharmacologic effects: as analgesic, antipyretic, and anti-inflammatory agents.
do not dull consciousness level and do not cause mental sluggishness, memory disturbances, hallucinations, euphoria, and sedation. The combination of pharmacologic effects makes salicylates the drug of choice for symptomatic relief of discomfort, pain, and inflammation, or fever associated with bacterial and viral infections, headache, muscle ache, and rheumatoid arthritis. Aspirin is also used to reduce the risk of MI in pts with previous MI or unstable angina pectoris.
SALICYLATE TOXICITY: TINNITUS, IMPAIRED HEARING, DIMMING OF VISION, SWEATING, FEVER, LETHARGY, DIZZINESS, MENTAL CONFUSION, NAUSEA/VOMITING...NO ANTIDOTE. USE GASTRIC LAVAGE, FORCE FLUIDS, ALKALIZE THE URINE WITH IV SODIUM BICARBONATE.