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150 terms

test 3 combination

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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
amidarone patients should call doctor if
skinn turns blue gray,