exam 3

what is the only insulin we can give iv?

regular insulin

what is the natural pacemaker of the heart?

sa node

diuretics for heart failure

-decrease peripheral and pulmonary edema -reduce preload and afterload drugs: -loop diuretics (MAIN) -mild HF (thiazides) -spironolactone (aldosterone antagonism & potassium sparing)

hyperglycemia symptoms

-dry mouth -increased thirst -weakness -headache -blurred vision -frequent urination -nausea/vomiting *3 p's

beta blockers for angina

-stable angina prophylaxis -reduces cardiac workload by decreasing bp and heart rate metoprolol: -beta 1 selective -check bp and hr propranolol: -non selective -will cause lung effects -check bp and hr

oxytocics (labor and delivery medications)

-stimulates contractions oxytocin (pitocin): -induces labor - if baby is in stress dont give methylergonovine(methergine/ HYPERTENISON) & carboprost (hemabate/ASTHMA): -reduces post partum hemorrhage

hypoglycemia symptoms

-sweating -pallor -hunger -sleepiness -lack of coordination -irritability *more profound/obvious symptoms

transdermal patch (long acting hormonal contraceptives)

-swimming/bathing concern -avoid heat or broken skin

asthma treatment

-triggers cause asthma -AVOID triggers goals of tx: -rescue and prevention

other nitrates for angina

isosorbide dinitrate: -long acting: decrease frequency and severity of angina -taken daily

1. A nurse is caring for a client is who has a deep vein thrombosis and is prescribed heparin by continuous IV infusion at 1,200 units/hr. Available is heparin 25,000 units in 500 mL D5W. The nurse should set the IV pump to deliver how many mL/hr? (Round the answer to the nearest tenth/whole number. Use a leading zero if it applies. Do not use a trailing zero.) _____mL/hr 2. A repeat PTT result is 39 sec - what should the nurse do? 3. 6 hours later the PTT result is 100, what should the nurse do now?

1) 1200 divided by 25000 then multiplied by 500= 24ml/hr 2) rebolus with 2500 units IV and increase infusion rate by 100 units/hr (1ml/hr), new rate would be 25ml/hr 3) no bolus, decrease infusion rate by 100 units/hr (1ml/hr), new rate would be 24ml/hr

how to mix 2 types of insulin?

1. wash hands 2. roll the insulin, do NOT shake 3. wipe off the tops of both vials 5. inject air into the NPH vial 6. inject air into the regular insulin vial 7. withdraw regular insulin 8. withdraw the NPH insulin *withdraw the clear solution (regular) before the cloudy solution (NPH)

bile acid sequestrants prototype drug SIDE EFFECTS? EDUCATION?

Cholestyramine (Questran): -bind bile and secrete cholesterol via the bowl (not absorbed or metabolized) side effects: -GI (nausea, bloating) education: -give other drugs 2 hours before or 4 hours after -effects absorption of vitamins

insulin glargine (lantus, toujeo) ACTION? ONSET? PEAK? DURATION? ADMIN/TIMING? COMPATABILITY?

action: -long onset: -1.5 hour (lantus) -6 hours (toujeo) peak: -no peak (lantus) -12 hour (toujeo) duration: -up to 24 hours admin/timing: -sub q -once daily, given at same time each day compatibility: -don not mix with any other insulin

insulin aspart (fiasp, novolog) ACTION? ONSET? PEAK? DURATION? ADMIN/TIMING? COMPATIBILITY?

action: -rapid onset: -10 to 20 min peak: -1 to 3 hours duration: -3 to 5 hours admin/timing: -sub q -5 to 10 min before meal compatibility: -can give with NPH; draw aspart up first and give immediately

a patient with heart failure has an order for lisinopril. which condition in the patient's history would lead the nurse to confirm the order with the provider? a) a history of hypertension previously treated with diuretic therapy b) a history of seasonal allergies currently treated with antihistamines c) a history of angioedema after taking enalapril d) a history of alcoholism, currently abstaining

a history of angioedema after taking enalapril

insulin lispro (admelog, humalog) ACTION? ONSET? PEAK? DURATION? ADMIN/TIMING? COMPATIBILITY?

action: -rapid onset: -15 to 30 min peak: -30min to 1 hour duration: -3 to 5 hours admin/timing: -sub q -5 to 10 min before meal compatibility: -can give with NPH; draw lispro up first and give immediately

insulin isophane (NPH, humulin N, novolin N, reliOn N) ACTION? ONSET? PEAK? DURATION? ADMIN/TIMING? COMPATABILITY?

action: -intermediate onset: -1 to 2 hours peak: -4 hours duration -18 hours admin/timing: -sub q -30 min before first meal of the day and 30 min before supper if necessary compatibility: -can mix with aspart, lispro, or regular -do not mix with glargine *has cloudy appearance

insulin regular (humulin R, novolin R) ACTION? ONSET? PEAK? DURATION? ADMIN/TIMING? COMPATIBILITY?

action: -short onset: -30 to 60 min peak: -2 to 4 hours duration: -5 to 8 hours admin/timing: -sub q or IV (only one) -30 to 60 min before meal compatibility: -can mix with NPH; sterile water or normal saline -do not mix with glargine

potassium channel blocker prototype TREAT? SIDE/ADVERSE EFFECTS? AVOID?

amiodarone: -prolongation of refractory period treats: -atrial and ventricular dysthymias side/adverse effects: -bradycardia -hypotension -liver damage avoid: -grapefruit juice

prototype HMG-CoA reductase inhibitors (statins) SIDE EFFECTS? ADVERSE EFFECTS? EDUCATION? OTHER DRUGS?

atorvastatin: -1st line treatment of hyperlipidemia -reduce LDLs (bad) and triglycerides -increase HDLs (good) -prevent MI and stroke (CVA) side effects: -GI discomfort adverse effects: -myopathy (muscle breakdown) can lead to rhabdomyolysis (bad for kidneys, cola urine) education: -avoid grapefruit juice -if develop muscle pain, tell provider immediately other drugs: simvastatin -short half life -administer in evening

what is asthma?

bronchospasms and inflammation

ezetimibe (zetia)

cholesterol absorption inhibitor

SGLT2 inhibitors prototype drug DRUG ENDINGS? MOA? SIDE EFFECTS?

canagliflozin (invokana) drug endings: -gliflozin moa: -secretion of glucose via urine side effects: -uti -yeast infection

drugs for bph CLASSIFICATION? MOA? DRUGS? SIDE EFFECTS?

classification: -alpha adrenergic antagonists moa: -relax smooth muscle in prostate to relieve obstruction drugs: -doxazosin -tamsulosin (flomax) doxazosin: -side effect of orthstatic hypotension (dizziness, h/a) -first dose phenomenon tamsulosin (flomax): -bladder selective -side effect of sexual dysfunction

heparin gtts CLASSIFICATION? ADVERSE EFFECTS? LAB MONITORING? REVERSAL AGENT?

classification: -anticoagulant adverse effects: -heparin induced thrombocytopenia -intense bleeding lab monitoring: -aptt reversal agent: -protamine sulfate

drugs for erectile dysfunction CLASSIFICATION? DRUGS? MOA? ONSET? DURATION? ADVERSE EFFECTS? CONTRAINDICATION?

classification: -phosphodiesterase-5 inhibitors drugs: -sildenafil (viagra) -tadalafil (cialis) moa: -increase blood flow onset of action: -less that 1 hour duration: -4 hours adverse effects: -hypotension -priaprism (prolonged erection) contraindication: -nitroglycerin

calcium works to affect muscle?

contraction

ADH prototype drug TREATS? INCREASES? ADVERSE EFFECTS?

desmopressin: -synthetic form of ADH treats: -diabetes insipidus -nocturia increases: -clotting factors to manage bleeding adverse effects: -hyponatremia -fluid overload

prototype calcium channel blocker for angina SIDE EFFECTS? OVERDOSE TREATMENT?

diltiazem: side effects: -dizziness -edema overdose treatment: -calcium chloride -give atropine to raise heart rate -give fluids or symmpathomemtics to increase blood pressure

pharm for anaphylaxis MOA? SIDE EFFECT? ROUTE? METHODS?

epinephrine: -adrenergic agonist moa: -increase heart rate and blood pressure -bronchodilation (open up lungs) -decreases swelling by constricting vessels side effects: -raised bp -raise heart rate -pain at site of injection route: -sub q methods: -epipen -auvi q (expensive)

fibric acid drugs *not priority for test

gemfibrozil (lopid): -reduce triglycerides and LDL -increase HDL -doesn't work as good as statins

hypothyroidsim treatment DRUG? TREATS? HOW LONG? SIDE EFFECT? EDUCATION? LABS?

levothryoxin (synthroid): treats: -hypothyroidism (replaces t4) how long: -life long therapy side effect: -hyperthyroidism education: -take in the morning before food -right when you wake up labs: -monitor TSH

sodium channel blockers prototype drug TREATS? SIDE EFFECTS? ADVERSE SIDE EFFECTS?

lidocaine IV: treats: -atrial and VENTRICULAR (main) dysrhythmias -blockage of sodium channels = prevention of depolarization and reduction of automaticity side effects: -reduced heart rate -anticholinergic effects adverse effects: -dysrhythmia -bradycardia -hypotension -dizziness -syncope

incretin mimetics (GLP-1 agonists) prototype drug DRUG ENDINGS? MOA? ROUTE? DOESN'T CAUSE?

liraglutide (victoza) drug endings: -tide/glutide moa: -trigger insulin release and stop production of glucagon; increase satiety and slow gastric emptying route: -sub q doesnt cause: -hypoglycemia

fish oil (omega 3 fatty acids)

lowers triglycerides

beta blocks for heart failure SIDE EFFECTS? NURSING CONSIDERATIONS? PATIENT ED?

moa: -decrease cardiac workload -decrease heart and blood pressure carvedilol (coreg) & metoprolol: side effects: -hypotension -bradycardia -mask hypoglycemia nursing considerations: -assess heart rate and blood pressure patient ed: -check blood sugar more often -careful when getting up

a patient has been using a fluticasone (flovent) inhaler as a component of his asthma therapy. he returns to his healthcare provider's office complaining of a sore mouth. on inspection, the nurse notices white patches in the patient's mouth. what is a possible explanation for these findings? a) the patient has been consuming hot beverages after the use of the inhaler b) the patient has limited his fluid intake, resulting in a dry mouth c) the residue of the inhaler propellant is coating the inside of the mouth d) the patient has developed thrush as a result of the fluticasone

the patient has developed thrush as a result of the fluticasone

Thrombolytics for MI

what do thrombolytics do? -clot busters what would be the purpose of giving these to someone with an MI? -it will break up the clot and allow oxygen to get to the heart again adverse effects: -bleeding

other medications/treatments for anaphylaxis

-crystalloids (fluids) -diphenhydramine & H2 blockers -albuterol -oxygen -glucocorticoids *given if not as severe

antitussives (opioid and non opioid)

-cough suppressants opioid: codeine -big side effect is CONSTIPATION non opioid: -dextromethorphan (delsym, robitussin) -benzonatate (tessalon)

normal blood sugar level

-60 to 100 -70 to 110

heart failure key concepts

-CO= HR x SV -preload -afterload -contractility (ionotropic effects) ionotropic effects: -drugs that effect contractility positive ionotropic agents: -increase contractility -example: sympathomemetics negative ionotropic agents: -decrease contractility -example: beta blockers

what 2 drugs can decrease effectiveness of birth control?

-antibiotics -antiepiletics

common drugs that cause anaphylaxis CONTRAINIDCATION? PRETREATMENTS?

-antibiotics -opioids -contrast (assess for shrimp allergy) contraindication: -previous hypersensitivity pretreatments: -antihistamines -corticosteroids

insulin administration (sites)

-anywhere with good adipose tissue -given subq -rotate sites to prevent lipodystrophy -if not being used keep in fridge -once up/being used keep room temp sites: -upper outer arms -abdomen -buttocks -upper outer thighs

how does the body normally produce insulin?

-basal bolus -basal rate is continuous and when eating a meal is bolus rate, more insulin is produced to breakdown foods

insulin USE? THERAPEUTIC EFFECT? GOAL? SIDE/ADVERSE EFFECTS? BEWARE?

-been around for 100 years -before found patients who suffered from diabetes died use: -T1 dm (required) -T2 dm therapeutic effect: -reduces blood glucose level goal: -right amount of insulin is based on amount of glucose present in the blood side/adverse effects: -too low hypoglycemia can lead to seizures beware: -alcohol decreases blood glucose

inhaled anticholinergics SIDE EFFECTS? EDUCATION?

-block PNS leads to bronchodilation ipratropium (atrovent): -slower/less intense than inhaled beta adrenergic -combo= greater/prolonged effect (duoneb) side effects: -few systemic effects education: -avoid contact with eyes

antidysrhythmic drugs

-block conduction -alter automaticity (ability of certain cells to generate an action potential) -low therapeutic range (corrects dysrhythmias but also create new ones)

inhaled beta 2 adrenergic agonists

-bronchodilate -may see tachycardia (beta 1 effect) -longterm use builds up tolerance short acting (SABA): -rescue drugs -albuterol long acting (LABA): -do not rescue -everyday use/prevention of flare ups -salmeterol (combo)

histamine 1 receptor antagonists (antihistamine) and mast cell stabilizers ROUTES? DRUGS?

-eliminate allergic symptoms routes: -IV (more severe) -IM (more severe) -topical (itching, rashes) -oral (everyday things) -intranasal (directly affect source) -ophthalmic (eye drops) drugs: first generation -diphenhydramine (Benadryl) second generation -loratadine (claritin) & certirizine (zyrtec):

diphenhydramine (Benadryl) PATIENT TEACHING? RARE SIDE EFFECT? SIDE EFFECT?

-first generation antihistamine, causes DROWSINESS -used more for severe cases patient teaching: -AVOID alcohol, CNS depressants, opioids rare side effect: -CNS excitement in children side effect: -anticholinergic effects (DRY)

Humalog sliding scale

-for rapid acting insulins

expectorants

-gets rid of mucus guaifenesin (mucinex): -most effect expectorant -take with full glass of water

intrauterine device (IUD) (long acting hormonal contraceptives) HORMONAL? COPPER?

-highly reliable -lasts 3 to 7 years, typically around 5 -LOCAL effects hormonal: -act in area of ovaries and uterus -painful during implantation -lower risk than oral contraceptives with systemic affects -lighter bleeding copper: -alters uterus environment -uterus becomes unhospital to sperm -heavier bleeding -not good for people with bad periods

indications for hormone pharmacotherapy

-hormone replacement -production of an exaggerated response of the typical hormone action -hormone antagonism

positive inotropic drugs DRUGS? NURSING CONSIDERATIONS?

-increase the strength of myocardial contraction drugs: -dobutamine -digoxin nursing considerations: -monitor heart rate

hormonal contraceptives: progestin only (minipills)

-inhibit implantation -less effective -more likely to cause menstrual irregularities such as spotting other: -weight gain may occur -discontinue if pregnancy occurs -headaches-decreased sex drive

tocolytics (labor and delivery medications)

-inhibits contractions terbutaline: -preterm labor suppression -side effects: tachycardia/shaking

depot injections (long acting hormonal contraceptives)

-injection that provides three months of contraceptive protection -fertility may take 12 months to return -6 months of bleeding in beginning -stuck with it for 3 months -don't use for more than 3 years -decrease bone density

leukotriene modifiers

-leukotrienes promote edema, inflammation, and bronchoconstriction montelukast (singulair): -block leukotriene receptors -asthma prophylaxis (not a rescue drug) moa: -reduce bronchoconstriction and inflammation

non pharm management of angina

-limit alcohol -limit foods high in "bad fats" (LDL, triglycerides, decrease saturated and trans fat) -no smoking -bp management -weight management -exercise -low sodium diet -euglycemia (consistent blood sugar)

calcium channel blockers for angina

-limit muscular contraction/relax smooth muscle of arteries/decrease vascular resistance -similar effects as beta blockers -evaluate bp and heart rate when giving calcium channel blockers it will: -reduce after load -decrease cardia workload -dilate coronary arteries

niacin

-lowers triglycerides and LDL -increase HDL side effects: -flushing/hot flashes (pretreat with aspirin)

lipids and lifestyle (lower cholesterol)

-maintain healthy weight -exercise -reduce intake of saturated/trans fat -stop smoking

theophylline ADVERSE EFFECT?

-methylxanthine classification -bronchodilator -taken prophylaxically when other treatments aren't working -narrow safety margin -multiple drug interactions adverse effects (toxicity: -N/V -CNS stimulation -dysrhythmias

treatment of hypoglycemia

-oral glucose (simple sugar, apple juice, fruit snacks) -50% dextrose IV -glucagon IM

hormonal contraceptive: combo (estrogen & progestin) RISKS? AVOID?

-prevent ovulation and make endometrium environment less favorable risks: -risk of blood clots and breast cancer avoid: -avoid smoking and sitting for long periods of time other: -weight gain may occur -discontinue if pregnancy occurs -headaches-decreased sex drive

hormonal contraceptives ORAL VERSION? EDUCATION? COMMON ISSUE?

-prevent pregnancy and regulate periods oral version: -the pill -oral contraceptives (OCs) education: -take at the same time daily common issue: -forgetfulness, take 2 pills the following day if forgotten one day and use alternative methods of contraception for 7 days

corticosteroids

-prevention of asthma moa: routes: -inhaled -PO -IV

emergency contraceptive (EC)

-prevention of implantation following unprotected intercourse/contraception failure -not an abortion

inhalation of drugs

-rapid onset of action -can provide immediate relief of bronchospasm (lungs clamping down) -delivered via aerosolized liquid or particles -some systemic effects occur

albuterol SIDE EFFECTS?

-rescue inhaler/nebulizer -short acting beta agonists side effects: -palpitations/tachycardia -nervousness

subdermal implants (long acting hormonal contraceptives)

-rod containing progestin implanted in upper arm -3 year of contraception -delay in fertility returning -be aware of time for removal

loratadine (claritin) & certirizine (zyrtec)

-second generation antihistamine -typically taken daily as preventative -not too many side effects unlike first generation

ace inhibitors for heart failure

-slow progression and reduce mortality -reduce preload and afterload -cardiac output effect = enhance/improve ace inhibitors: drugs/ending: -pril (lisinopril) common side effect: -cough -lower bp additional side effect: -hyperkalemia adverse effect: -angioedema

beta blockers as antidysrhythmics TREATS? CONTRAINDICATION? DRUG?

-slows heart rate -decreases contractility -reduce automaticity treats: -atrial arrhythmias contraindication: -severe bradycardia or AV block (due to reducing conduction through AV node) drug: -metoprolol

vaginal ring (Nuvaring) (long-acting hormonal contraceptives)

-used for 3 weeks of contraceptive protection -change after 3 to 4 weeks -can remove when having sex up to 2 hours -some will not come off during period time, continue to take hormone to avoid period

prednisone pack/taper (PO or IV)

-used for unstable asthma (not rescue inhaler) -taper off drug, slowly decrease dose -don't skip doses -will raise blood sugar -take with food, to prevent ulcers -take in the morning, to prevent ulcers -increases appetite -drinking more

decongestants

-vascular tissues of nasal mucosa= controlled by ANS -SNS= arteriole constriction= opening of airway -sympathomimetics= relieve nasal congestion

treating shock with IV fluids

1st step for hypotension: -crystalloids (normal saline and lactate ringers) colloids -albumin (plasma expander/pulls water back into vessels) blood products: -whole blood (plasma volume & RBCs) -packed RBCs -platelets -fresh frozen plasma/FFP (clotting factors)

before giving insulin with a pen, how many units should you prime it with?

2 units

the patient is to begin taking atorvastatin (lipitor) and the nurse is providing education about the drug. which symptom related to this drug should be reported to the healthcare provider? a) constipation b) increasing muscle or join pain c) hemorrhoids d) flushing or "hot flash"

increasing muscle or joint pain

Inhaled Corticosteroids: inhaled beclomethasone (qvar)

inhaled beclomethasone (qvar): -systemic effects rare -not used for rescue -preventative treatment side effects: -oral candiasis (thrush) -cataracts patient education: -rinse mouth contraindication: -active infection

insulin determir (levemir) ACTION? ONSET? PEAK? DURATION? ADMIN/TIMING? COMPATABILITY?

action: -long onset: -1.6 hour peak: -no peak duration: -up to 24 hours admin/timing: -sub q -with evening meal or at bedtime compatibility: -do not mix with any other insulin

cardiac glycosides for heart failure MOA? NURSING CONSIDERATIONS? ADVERSE EFFECTS? OVERDOSE TREATMENT?

digoxin: moa: -increase cardiac contractility (positive ionotropic effect), leads to slow heart rate nursing consideration: -hold drug if heart rate is below 60 -narrow therapeutic range (monitor serum levels) -monitor potassium levels (hypokalemia increases risk of digoxin toxicity) adverse effects: -dysrhythmias -N/V -fatigue -anoerexia -seeing yellow halos overdose treatment: -digoxin immune fab (digibind)

cervical ripening (labor and delivery medications)

dinoprostone (vervidil): -cervical dialtion -intra vaginal route

prototype biguanide? DOC for? MOA? PROMOTES? SIDE EFFECTS? ADVERSE EFFECTS? CONTRAINDICATIONS?

drug of choice: -for type 2 diabetes MOA: -reduces production of glucose from the liver -does not increase insulin release -does not cause hypoglycemia promotes: -weight loss and lowers cholesterol side effect: -gi issues (common) adverse effect: -lactic acidosis contraindications: -chronic kidney issues/damage -hold metformin when needing to give contrast (2 days before and 2 days after)

CCBs (calcium channel blockers) as antidysrhythmics DRUGS? TREAT? SIDE EFFECTS? AVOID?

drugs: -diltiazem -verpamil (blocks calcium channels in heart and arterioles) treat: -atrial arrhythmias (a-fib) side effects: -hypotension -bradycardia -edema avoid: -grapefruit juice

sulfonylureas DRUGS? MOA? SIDE EFFECTS? AVOID?

drugs: -glipizide (MAIN) -glyburide -glimepiride moa: -stimulate the release of insulin from the pancreas side effects: -hypoglycemia (MOST DANGEROUS) -weight gain -hepatotoxicity (liver) avoid: -alcohol, can cause extreme vomiting

hormone replacement therapy for menopause MAIN & ADVERSE EFFECT? ALTERNATIVE (CAM)?

estrogen: -symptomatic relief of menopause -decreased risk of osteoporosis adverse effect: -increased risk of breast cancer and thromboembolism alternative (CAM): black cohosh

5-alpha reductase inhibitors prototype MOA? SIDE EFFECT?

finasteride: moa: -shrink prostate -delayed (several months) action side effects: -sexual dysfunction -increase risk of prostate cancer

treatment for type 2 diabetes mellitus

first line: -diet/exercise next: -oral (or injectable) antidiabetic drugs (hypoglycemics) insulin: -may be given if poor management or sickness

Loop Diuretics KIDNEY CONSIDERATIONS? SIDE EFFECTS? ADVERSE EFFECTS? PATIENT ED?

furosemide kidney considerations: -kidneys don't need to work side effects: -increase urination -hypokalemia adverse effect: -ototoxicity (tinnitus) patient ed: -don't take at night -take potassium supplements (don't crush)

Vasopressors (pressors) GIVEN? VASOPRESSORS =? USE? GOAL? DRUGS? NURSING CONSIDERATIONS? ADVERSE EFFECTS?

given: -after fluid resuscitation (DON'T give if hypotension is due to volume deficit) vasopressors = sympathomimetic vasoconstrictors use: -maintain (increase) bp goal: -profuse vital organs drugs: -norepinephrine (levophed) -epinephrine -dopamine -phenylephrine nursing considerations: -titrate -monitor bp adverse effects: -initial reflex bradycardia -digital necrosis (takes weeks)

why are spacers good on inhalers?

gives very similar effect to a nebulizer

goals of pharmacological management of angina

goal: -reduce myocardial oxygen demand examples: -slow heart rate -reduce preload (volume) -reduce contractility -reduce afterload (resistance) common drugs to use: -statins (help reduce cholesterol, which leads to plaque, to reduce/prevent angina)

corticorsteroids for Addison's disease DRUG? THERAPEUTIC USE? SIDE EFFECT?

hydrocortisone: therapeutic use: -replacement therapy in adrenocortical insufficiency side effects: -insomnia -weight gain -thirst -cataracts -hyperglycemia (MAIN) -gi upset/ulcers -osteoporosis -mood swings

mild heart failure: thiazides SIDE EFFECT? PATIENT ED?

hypothaizide side effect: -increase urination -hypokalemia patient ed: -increase potassium in diet -don't take at night

heart failure

inability of ventricles to pump enough blood to meet demands of the body

intranasal corticosteroids SIDE EFFECTS? CONTRAINDICATED? MOA?

intranasal fluticasone (flonase): -less incidence of side effects -preventative treatment side effects: -nasal dryness (epistaxis/nose bleed) contraindicated: -active infection MOA: -reduction of inflammation

nitrates for angina MOA?

moa: -formation of nitric acid= potent vasodilator -reduce preload and afterload -dilation of coronary arteries -common side effects are headaches, will cause DROP in bp, reflex tachycardia

digoxin (dysrhythmia drug) MOA? TOXICITY SYMPTOMS? ANTIDOTE?

moa: -increases contractility, which lowers heart rate toxicity symptoms: -yellow halos -vomiting antidote: -digibind

acute MI drugs (MONA B)

morphine: -dilates coronary arteries oxygen: nitroglycerin: -dilates coronary arteries aspirin: (clopidogrel, ticagrelor) -OD symptom is tinnitus beta blockers: -decrease workload/afterload of the heart

route for allergies?

nasal route

best way to get inhaled medication in the body?

nebulizers

prototype nitrate for angina DRUG? ROUTE? NURSING CONSIDERATION? PATIENT ED? OINTMENT CONSIDERATION?

nitroglycerin: -abortive route: -sublingual: short acting, terminate anginal attacks in 2 to 4min -ointment on chest -IV (typically given when having an MI) nursing consideration: -if medication does not work at 5min, take a second pill and call the ambulance, 5min later take a 3rd dose patient education: -Q5 min up to 3 doses, room temp, dark -do not use with sildenafil (viagra) or tadalafil (cialis) -check bp ointment considerations: -will decrease bp, use gloves when applying

afrin is known as?

oxymetazoline

Allergic Rhinitis Treatment PATHO? GOALS OF TX?

patho: -occurs due to release of histamine and mast cells goals of tx: -prevention (remove trigger) -relief (sympathomimetics)

decongestant drugs SIDE EFFECTS? EDUCATION?

phenylephrine: -treatment of hypotension and nasal congestion pseudoephedrine: -treatment of nasal congestion side effects: -rebound congestion -elevated bp education: -use for no longer than 5 days -only take prescribed/recommend about

prototype emergency contraceptive DRUG? INTENTION? MOA? WHEN TO TAKE?

plan b: intention: -not intended to replace regular methods of contraception -will not terminate pregnancy if implantation has already occured moa: -prevents ovulation and inhibits implantation when to take: -ASAP -24 hours best, 72 still effective -after 7 days, plan b is not effective side effects: -nausea -vomiting -abdominal pain -heavy vaginal bleeding factors: -weight can alter effectiveness

hyperthyroid treatment DRUGS? ADVERSE EFFECTS/PRECAUTIONS?

propylthiouracil (PTU): adverse effect: -hepatotoxicity radioactive iodine: precautions: -avoid close contact with person/bodily fluids

the patient is being discharged with nitroglycerin for sublingual use. while planning patient education, what instruction will the nurse include? a) swallow three immediately for pain and call 911 b) put one tablet under your tongue for chest pain. if pain does not subside, call 911 c) call your healthcare provider when you have chest pain. she will tell you how many tablets to take d) place three tablets under your tongue and call 911

put one tablet under your tongue for chest pain. if pain does not subside, call 911

spironolactone SIDE EFFECT? PATIENT ED?

side effect: -hyperkalemia patient ed: -avoid salt substitutes or potassium supplements

prototype growth hormone STIMULATES? TREATS? ROUTE? WHEN TO GIVE? PRICE? SIDE EFFECT? NURSING CONSIDERATION?

somatotropin: stimulates: -growth and metabolism treats: -growth hormone deficiency/dwarfish route: -sub q when to give: -before growth plates closed -before 15 years old price: -expensive side effect: -hyperglycemia nursing consideration: -monitor weight/height to see if drug is effective

testosterone TREATS? FORMS? THERAPEUTIC EFFECTS? SIDE EFFECTS? ABUSE?

treats: -hypogonadism forms: -injection (IM or sub q, once a week) -gel (everyday, topically to areas with hair) -implant (every 3 months) therapeutic effects: -increased sex drive -correction of erectile dysfunction -masculinization (body hair, deepening of voice, improved strength side effects: -acne -vaginal atrophy (treat with vaginal estrogen) -increased risk of blot clots -baldness abuse: -HIGH abuse rate -will stockpile medication and then take large doses -anabolic steroids: build muscle mass -adverse effects: hyperlipidemia, impotence/low sperm count, hepatoxcitiy, aggression, dependence, testicular atrophy, teratogenic, cancer

adenosine (dysrhythmia drug) USE? GOAL? CONSIDERATIONS? EXPECTATION? PATIENT ED?

use: -supraventricular tachycardia (SVT) goal: -get heart back into sinus rhythm considerations: -short half life -gets out of body extremely fast -around 10 seconds -infuse over 1 to 2 seconds expectation: -patient will go from heart beating extremely fast to flat lining and then the heart restarting in normal sinus rhythm patient education: -educate patient they will feel a little funny