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Pharm Exam 3
Terms in this set (114)
What cells release histamine?
What are preventers for allergic rhinitis?
mast cell stabilizers
What are relievers for allergic rhinitis?
oral and intranasal decongestants
What is Diphenhydramine classification?
1st generation H1 antagonist
What are the side effect of Diphenhydramine?
sedation- most common
What's the purpose of a spacer?
to get meds deep into the lungs
Which inhaler do you take 1st?
Give steroid LAST
What is Fluticasone classification?
What's the purpose for Fluticasone?
decrease the secretion of inflammation mediators, reduce tissue edema, and cause mild vasoconstriction
Which do you use first: albuterol or fluticasone?
to allow for nasal passages to fully open
Nursing Considerations with Fluticasone
wash mouth out first
not a rescue drug
blow nose BEFORE admin
takes 2-3 wk to work
What device do you use with Fluticasone?
metered-dose spray device
Patient teaching for Fluticasone
increase weight bearing activity- minimize bone loss
Whats the classification of Guaifenesin?
What does an expectorant do?
thins mucus secretions
reduces surface tension
What are the complications with Guaifenesin?
allergic reaction- rash (STOP med)
Special considerations when taking Guaifenesin include
read OTC labels carefully- they can also contain Guaifenesin
What does an antitussive do?
What do you tell patient taking Dextromathorphan?
wait 30 min- 1 hr to drink
sit up for 30 min
What are some non pharm measures to promote respiratory function
What are some special instructions to give pt taking a nasal decongestant?
don't use for more than 3-5 days- REBOUND congestion
What are the 2 types of COPD?
1. chronic bronchitis- blue bloater
2. pulmonary emphysema- pink puffer
What med do you give for COPD?
decreased pH <7.35
increased PCO2 >48
increased pH >7.45
decreased PCO2 <35
What's the purpose of Montelukast?
reduce number of asthma attacks
Nursing Considerations for Montelukast
take once a day in the evening
What's the purpose of albuterol?
How is albuterol administered?
using a spacer- allows med to aerosolize
use before fluticasone
What are the adverse effects of albuterol?
What's the purpose of Epinephrine?
given for shock
What are the adverse effects of Epinephrine?
How do you admin Epinephrine?
through a central line
Whats the classification of Theophylline?
What is Theophylline used for?
long-term control of chronic asthma and COPD
What are the adverse effects of Theophylline?
hepatotoxicity- monitor liver
stimulates HR- monitor vitals
What are the side effects of Beclomethasone?
oropharyngeal candidiasis- thrush
Nursing Considerations for Beclomethason to prevent thrush?
have pt rinse mouth after using
What's the purpose of Colesevelam?
How do you take Colesevelam?
4 hr after any other med
What are some adverse effects of Colesevelam?
GI tract- bloating & constipation
monitor liver fx
caution w PUD
What are important patient teaching for patients on either Atorvastatin or Simvastin?
don't take w grapefruit
Ck liver fx- AST, ALT
What's the classification of Mannitol?
What's the therapeutic effect of Mannitol?
relieves intraocular pressure
What's an adverse reaction of Mannitol?
hypervolemia- fluid leak in lung
What's the classification of Furosemide?
What is the adverse reaction of Furosemide?
Nursing considerations for Furosemide
ck labs- K
monitor for hyperglycemia and hypomagnesia
What's the classification for Bumetanide?
When does the nurse admin Bumetanide?
What are the adverse effects of Bumetanide?
Signs of hypokalemia
What are drug interactions with Bumetanide?
1. digoxin toxicity- hypokalemia
2. antihypertensive- addictive hypotension effect
3. lithium can increase- hyponatremia- due to loop diuretic
4. NSAIDs- decrease blood flow to kidneys- reduce diuretic effect
Whats the classification of hydrocholothiazide?
When do you admin hydrocholothiazide?
Can hydrocholorthiazide be combined w other meds?
Yes- NO risk of hearing loss and can be combined w ototoxic meds
What's the classification of Spirnolactone?
What's an adverse effect of spirnolactone?
Never give Beta blockers to what patient?
What ethnicity does metoprolol effect?
What are nursing considerations for metoprolol?
don't abruptly stop
Hold Propranolol if
Atenolol nursing consideration
ck apical pulse for 1 whole min before admin
What's the purpose of lisinopril?
What's the purpose of Captopril?
Complications w ACE inhibitors?
Losartin drug class?
Purpose of Losartin?
What are the complications of Losartin?
Whats the treatment for too much Losartin?
Whats the MOA for Digoxin?
increase force and efficiency of myocardial contraction
What's the treatment for Digoxin toxicity?
digoxin immune fab
What are the adverse effects of Digoxin?
What do you do before admin digoxin?
ck apical pulse for 1 full min
What is Dopamine used for?
What's the MOA of Dopamine?
causes vasoconstriction everywhere EXCEPT kidneys
What's the adverse effect of Dopamine?
What's the purpose of Nitroglycerin?
relieve chest pain
When do you place Nitroglycerin patch?
What do you do w Nitroglycerin tablet?
do not chew or crush
How many doses of Nitroglycerin can you give?
give 3 doses- should be no pain
if pain continues wait 5 min and call 911
labs for MI
What are the adverse reactions of Norepinephrine?
angioedema- open and dilate airways
extravasation- tissue necrosis if leaked- stop IV!
What are the nursing considerations for Albumin?
watch for hypervolemia
separate in IV line
ck allergic reaction-SOB
Non-pharm treatment for Shock
Treatment for hypovolemia
give albumin, D5W, NS IV fluids
What is the adverse effect of Lidocaine?
What do anticoagulants do?
prevent future clots- does not dissolve clots
What labs do you monitor when taking Warfarin?
PT & INR- effect when drawn in morning
Whats the therapeutic range of Warfarin?
Whats the onset of Warfarin?
takes 8-12 hr
Whats the antidote of Warfarin?
vitamin K, PTT
Patient teaching for Warfarin
shave w electric lazor
Whats the classification of Verapamil?
calcium channel blocker
What do calcium channel blockers do?
affects arterioles and heart
blocks calcium channels in blood vessels leading to vasodilation in heart and peripheral vessels
What are the adverse effects of Verapamil?
Don't take Verapamil with
What labs do you monitor for coagulation meds?
vitals, CBC, PLT, HCT
ck PTT, PT, INR
What are the nursing consideration w anticoagulants
DONT give to pregnant women
general anestesia pt
Foods high in K
broccoli, mayo, Brussel sprouts, cabbage, dark leafy greens, canola/soybeans
MOA for Heparin
prevent future clots
Whats the route of admin for Heparin?
injection ONLY- IV or subQ
Labs to monitor when giving Heparin
PT & INR
Nursing admin of Heparin considerations
double ck dose w another RN
continuous infusion must be on pump
Whats the reverse med for Heparin?
What patients benefit from Enoxaparin?
pt sent home after joint replacement
stops new clots from forming
DONT dissolve clots, they stop new clots from forming
Nursing Considerations for anti platelet and anticoagulant meds
stop 5-10 days before surgery
Clopidogrel patient education
take at night
monitor for bleeding- look for blood in toilet, bleeding gums, bruising
use electric razor
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