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Scheduled drugs teaching
- DEA schedules drugs according to their potential for abuse.
- Schedule 1 is highest abuse potential, schedule 5 is lowest.
schedule 2 drugs
- Must have prescription, handwritten in ink by physician, no refills - only 30 day supply:
enteral drug administration
assess ability to swallow prior to administering enteral drug
- Refers to what the BODY does with a drug
- Absorption, distribution, metabolism, excretion
- *absorption can be impaired with food or iron
The relationship or point btwn right amount of drug to get therapeutic effect vs where side effects happen
- Evaluation ~ for pharm, this is where drug effectiveness is evaluated. duh
what to do in case of med error
- assess client
- tell physician
- fill out incident report
Prego drug categories
- A- all right, studies show no increased risk
- B- Ok. animal studies show no risk but no adequate studies in humans done OR animals show AE but studies in humans failed to show risk
- C- Use caution. Animals show AE, no adequate studies in human OR No studies done
- D- Adequate studies demonstrate risk to fetus, but benefits may outweigh risks
- X- Contraindicated in preg woman. Ex: accutane
Gender issues affecting success of med tx
- Women seek med care more than man; however, women take longer to get help with heart probs
- Side effects of drugs can be gender specific
Herbs that increase bleeding
- Green tea
- *Not Golden Seal! doesn't interfere with warfarin
- Can be fatal
- S/S of withdrawal: tremors (delerium tremors), seizures, hallucinations, confusion, fatigue, anxiety
- heparin/lovenox: protamin
- Benzos: flumazenil (reverses CNS effects of benzos)
- Opiods: Narcan (Nolaxon)
- Warfarin: Vit K.
- Surface decontamination ~ remove clothes, wash with soap and water
- charcoal, single dose w/in 60 mins of consumption
anticholinergics are used for bradycardia, IBS, PUD, parkinson's (because it lowers acetylcholine).
- 1- Interrupt parasympathetic nerve impulses
- 2. prevent acetylcholine from stimulating cholinergic receptors
- 3- Dont block all cholinergic receptors, just Muscarinic
- drug class that inhibits/disrupts SNS (sympathetic nervous system): adrenergic antagonists.
- Classified according to their site of action: Alpha-adrenergic blockers
- Beta-adrenergic blockers
Benzo's OD tx
give flumazenil to reverse the CNS effects of Benzos.
Gabapentin nursing diagnosis
- risk for falls.
- Gabapentin (Neurontin) is an antiseizure and neurpathy drug.
- Causes dizziness, drowsiness, ataxia (uncoordinated movement, like a drunk), vertigo.
Risperidone use and SE
- Risperidone is an atypical antipsychotic/schizophrenia drug. Antipsychotics treat the positive and negative effects of mental disorder
- SE include:
- NME (Neuroleptic malignant syndrome)
- Agranulocytosis (low WBC count)
- hyperactivity, fatigue
- Nausea, wt gain
- Neuroleptic Malignant Syndrome
- life threatening neuro disorder caused by AE of antipsychotic meds
- S/S include:
- high fever
- unstable blood pressure
- muscular rigidity
- autonomic dysfunction.
- respiratory depression
- urine retention/constipation
Lidocaine with epinephrine mechanism
the epinephrine prolongs the anesthetic effect at the site (b/c it vasoconstricts, keeping the med in the area longer)
- AKA sinemet.
- Used in parkinsons to help pt perform ADLs, leads to dopamine synthesis (which lack of dopamine is cause of park)
- Toxicity of Sinemet is muscle twitching and spasmodic winking.
- must continue gradually
- Take on empty stomach for better absorption
- cyclobenzaprine is for muscle spasm.
- SE:other than
- dry mouth
- blurred vision
- Ataxia (loss of full control of body movements)
- Tongue swelling
Side effects of statins
- GI distress
- *Rhabdomyolysis ~ a breakdown of muscle fibers
- diuretics cause dehydration, orthostatic hypotension, hypokalemia
- teach pt to rise slowly.
- First line of treatment for stage 2 HTN: thiazide diuretic.
- Loop diuretic can cause electrolyte imbalance of potassium hypokalemia
- Taken for hypertension and heart failure.
Beta-blockers side effects
- "Can't run, can't have sex. LOL"
- Will cause depression
- bronchoconstriction (don't use w asthma pt)
With metoprolol, monitor for hypotension and bradycardia.
Nitro patch teaching
If on long term, teach to take patch off at night to help avoid tolerance
- *Used for Heart failure and shock, it affects strength of myocardial contraction
- Increases BP and force of myocardial contraction
- Increases urine output
- SE: can cause dysrhythmias and tachycardia
- Extravasation (med goes into extracellular space instead of vein) in peripheral IV's, causing BAD tissue damage
*Low dopamine causes parkinson's
- *remember dysrhythmia has nothing to do with contraction, but conduction
- Important to monitor HR: pulse, rate, rhythm, quality
Side Effects Coumadin
- bleeding. duh.
- blood tests used to monitor warfarin: PT/INR is lab test
- 1 is the norm, 2-3 is therapeutic
- PR = prothrombin time (time to coagulate)
- INT = internationalize normalized ratio, recall this makes it possible for people to travel out of the country & still be able to have blood levels checked
Oral iron pt teaching
take through straw cause it's nasty and can stain teeth
Types of immunity
- Active immunity - body produces own antibodies in response to exposure. Happens when given vaccines
- Passive immunity - antibodies are donated or transferred from one person to another. Happens w mother/baby
*type of immunity that immunoglobulin gives: artificial passive immunity.
- can cause damage to stomach lining due to lower mucus production.
- can cause GI upset and bleeding, reduce kidney function
- Cox 1: aspirin, IBprof (3200 mx/day), Naproxen
- Cox 2: Celebrex
- *NSAID's block inflammation by inhibiting COX, the key enzyme in making prostaglandins (which are able to promote inflammation)
- penicillin lowers effectiveness of contraceptives (so double up).
- General category of infection caused by antibiotics: superinfection.
AKA Flagyl (used with giardia and Cdiff.) Eliminate alcohol from diet.
Zidovudine side effects
- Used for HIV pts.
- Fever, chills,
- muscle weakness,
- constipation, n/v, weight loss,
- severe bone marrow problems,
- lactic acidosis
Antineoplastic therapy teaching
- instruct family members to not get live vaccines.
- 2 indications of bone marrow problems with chemotherapy: leukocytopenia, agranulocytopenia, thrombopenia
- Use soft toothbrush, use electric razor, avoid commercial mouthwash
- VS every 4hr, even slight fever needs to be reported
- AKA fluticasone
- Drug for allergic rhinitis.
- An intranasal corticosteroid.
- B/c of the systemic effects, with intranasal steroids: teach pt Don't Swallow!
- side effects include headache, nervousness, tachycardia.
- Rinse mouth after
- the proton pump is activated by food to produce acid....
- take omeprazole (Prilosec) before breakfast on an empty stomach
- AKA metamucil.
- Take 1 glass (12 oz.) with drug and 1 glass after.
- folic acid prevents spinabifida.
- Vit B12 prevents pernicous anemia.
if pt is on levothyroxin and heart rate starts to go up..... suspect hyperthyroidism.
- don't mix lantus with anything else.
- When giving lantus and lispro, give them seperately.
Electrolyte, other than glucose, that requires insulin for movement into the cell:
Lab value which indicates blood glucose over last 3 months:
Common diagnosis for the 3 P's (polydipsia, polyuria, polyphasia (eating)-
- Metformin (Glucophage)
- only drug in class
- Is an oral hyperglycemic drug, often used because it is safe and doesn't cause hypoglycemia. decreases glucose production by liver
- doesn't do anything to pancreas
- teach to monitor BS, s/s of infection
Hormonal Contraceptives indications
- don't give contraceptive to women who smoke or have blood clots or history of blood clots.
- Penicillin lowers the effectiveness of contraceptives, so double up.
- AKA Viagra.
- Don't take with nitrates.
- AKA alendronate.
- Osteoporosis drug- A bisphosphonate.
- Give with a full glass of water and stay upright for 30 mins after
- call doc if you have heartburn.
Can cause hypocalcemia, cause it takes calcium out of blood and puts in bone
- AKA isotretinoin
- PREGO CAT X!
- used for severe acne w cysts
- contacts should be kept out for 15 minutes after putting in eye drops.
- Don't mix drugs
- Wait 5 mins btwn drugs
- Place in conjunctiva
- Strongest anti-inflammatory used for asthma.
- Dexamethazone is a steroid.
- Side effect of glucocorticoids which could lead to GI bleed: peptic ulcer.
- Fat, bitchy and pimply
Vitamin K indications
Vit K is the antidote for warfarin.
First thing a prudent nurse will do if client gains excess weight in one day: check BP, assess lungs, check edema
check BP, assess lungs, check edema
IV infusion side effects
Assess BP and listen to lungs for crackles. Also monitor normal blood levels of electrolytes.