Shawn's Pharmacology Study Guide
Under what conditions should digoxin administration be withheld?
1. Serum digoxin levels above 2.0 ng/mL indicating potential toxicity. 2. Signs of digoxin toxicity, such as gastrointestinal disturbances (nausea, vomiting, diarrhea), visual changes (blurred vision, seeing yellow or green halos), confusion, and irregular heart rhythms. 3. Significant bradycardia (slow heart rate) with a heart rate typically below 60 beats per minute in adults. 4. Uncontrolled hypokalemia (low potassium levels), as it can exacerbate digoxin toxicity. 5. Electrolyte imbalances, particularly of potassium and magnesium, need to be corrected before administration.
What are the side effects of Epinephrine (ep-ih-NEF-rin)?
1. Tachycardia 2. High blood pressure (hypertension) 3. Nervousness or anxiety 4. Tremors 5. Dizziness or headache 6. Palpitations 7. Sweating 8. Nausea and vomiting 9. Difficulty breathing (if too much is given or if administered improperly)
What are the uses of Amantadine (a-MAN-ta-deen)?
1. Treating and preventing influenza A virus infection. 2. Managing symptoms of Parkinson's disease and parkinsonism-like symptoms caused by other conditions or drugs. (treatment of EPS due to antipsychotics) 3. It may also be used off-label for treating fatigue in multiple sclerosis and other conditions.
What are the uses of Lactulose (LAK-tyoo-lohss)?
1. Treating constipation by increasing stool water content and softening stools. 2. Managing hepatic encephalopathy (a liver disease affecting the brain) by reducing blood ammonia levels.
What are the uses of Nifedipine (nye-FED-i-peen)?
1. Treating high blood pressure (hypertension). 2. Managing angina (chest pain). 3. Sometimes used off-label for Raynaud's phenomenon or to stop preterm labor contractions.
What are the uses of Tamoxifen (ta-MOX-i-fen)?
1. Treatment and prevention of breast cancer in men and women. 2. Reducing the risk of developing breast cancer in individuals at high risk. 3. Sometimes used to treat infertility in women by stimulating ovulation. It works as a selective estrogen receptor modulator (SERM), blocking estrogen's effects on breast tissue.
How is pain best assessed?
1. Utilizing pain scales (e.g., Numeric Rating Scale, Visual Analog Scale, Faces Pain Scale) to quantify pain intensity. 2. Asking about the location, duration, and characteristics (sharp, dull, throbbing) of the pain. 3. Evaluating the impact of pain on activities of daily living and quality of life. 4. Assessing both physical and psychological factors contributing to the patient's pain experience. 5. Regularly re-evaluating pain to adjust management strategies accordingly. This comprehensive approach ensures individualized and effective pain management.
What laboratory tests are monitored for patients on heparin therapy?
1. aPTT (activated Partial Thromboplastin Time) - to assess the blood's clotting ability and adjust heparin dosage. 2. Platelet count - to monitor for heparin-induced thrombocytopenia (HIT), a significant drop in platelets indicating a possible adverse reaction to heparin. 3. Hemoglobin and hematocrit - to detect any bleeding complications. 4. Anti-Xa levels - may also be used to monitor the efficacy of heparin therapy, particularly in low molecular weight heparin.
What are the adverse effects (AEs) of long-term use of glucocorticoids in children?
1. growth suppression 2. increased risk of infections, 3. Cushingoid features (moon face, central obesity) 4. HTN
What are the side effects (SE) of oxybutynin (ox-i-BYOO-ti-nin)?
anticholinergic effects Dry mouth Constipation Blurred vision Dizziness Drowsiness Urinary retention Dry skin Heat intolerance Confusion or hallucinations
How should oxytocin be titrated for labor induction?
until a regular pattern of strong, effective contractions is established (a contraction every 2 to 5 min)
How should dantrolene (DAN-troe-leen) be administered for malignant hyperthermia?
Preparation: it must be reconstituted with sterile water (without a bacteriostatic agent) As rapidly as possible.
How should a telephone order from a healthcare provider be taken?
Prepare: Be ready to document the order. Verify: Confirm the identity of the healthcare provider giving the order and your own identity. Write Down the Order: Carefully record the order, including the patient's full name, date, time, the medication name, dosage, frequency, route of administration, and duration of therapy. Read Back: Repeat the order back to the provider to ensure accuracy. This includes spelling out the medication's name and clarifying dosages and instructions. Clarify: Ask for clarification on any orders that are unclear, unusual, or potentially harmful. Document: Clearly document the order in the patient's medical record, including the fact that it was a telephone order, the name of the provider who gave the order, and your name. Sign Off: Ensure that the healthcare provider cosigns or approves the order in the patient's medical record within the required timeframe, as per institutional policy.
What are the uses of Filgrastim (fil-GRA-stim)?
1. Increasing white blood cell count in patients with neutropenia, often due to chemotherapy or other medical conditions. 2. Facilitating the recovery of the immune system after bone marrow transplantation. 3. Mobilizing stem cells in the blood for collection before a stem cell transplant. 4. Treating severe chronic neutropenia (SCN) to reduce the risk of infections.
What are the adverse effects (AE) of ciprofloxacin (SIP-ro-FLOX-a-sin)?
GI upset Central Nervous System effects: Headache, dizziness, confusion, and in rare cases, seizures. Tendonitis and tendon rupture: Particularly the Achilles tendon Photosensitivity QT interval prolongation Peripheral neuropathy Altered blood glucose levels
What are the adverse effects (AE) of intravenous (IV) erythromycin (eh-rith-row-MY-sin)?
GI upset (N&V / abdominal pain) Phlebitis at the injection site Transient liver enzyme elevations Ototoxicity (rare) QT prolongation and potential for causing cardiac arrhythmias (e.g., torsades de pointes) Allergic reactions, including rash and anaphylaxis (rare)
What are the adverse effects (AE) of sodium polystyrene sulfonate (SO-dee-um poly-STY-rene sul-FOE-nate)?
(Constipation, diarrhea, nausea, and vomiting). Electrolyte imbalances: hypernatremia, hypokalemia, hypocalcemia
What are the adverse effects (AE) of fluoxetine (floo-OX-e-teen)?
Gastrointestinal upset Central Nervous System effects: (Headaches, dizziness, insomnia, and nervousness.) Sexual dysfunction Weight changes: (Weight loss initially, which may be followed by weight gain with long-term use). Dry mouth Sweating Fatigue Serotonin syndrome Suicidal thoughts in children, adolescents, and young adults under 25 years
What are the adverse effects (AE) of gemfibrozil (jem-FYE-broe-zil)?
Gastrointestinal upset Muscle pain and weakness: Hepatotoxicity Gallstones Blood dyscrasias Dizziness and headache
What are the guidelines for Psyllium (SIL-ee-um) administration?
1) Mix the psyllium powder or granules with a full glass (8 ounces) of water 2) Drink another glass of water 3) Take psyllium at least 30 minutes before or after other medications to prevent interference with absorption.
How is heparin administered subcutaneously (SQ)?
1. Abdomen, at least 2 inches away from the belly button. 2. Do not expel the air bubble in pre-filled syringes 3. 45 to 90-degree angle 4. Do not rub the injection site
When should medication reconciliation be done?
1. Admission to a hospital or healthcare facility 2. Transfer between units or facilities: 3. Discharge from a hospital or healthcare facility:
What medications are used to treat Delirium Tremens?
1. Benzodiazepines (e.g., diazepam, lorazepam) - First-line treatment for managing symptoms and preventing complications. 2. Antipsychotics (e.g., haloperidol) - Used cautiously for severe agitation or hallucinations. 3. Thiamine (vitamin B1) - To prevent or treat Wernicke-Korsakoff syndrome, a brain disorder due to thiamine deficiency. 4. Electrolyte and fluid replacement - To correct imbalances resulting from chronic alcohol use. 5. Multivitamins - To address nutritional deficiencies common in alcohol dependence.
What are the adverse effects (AE) of Zolpidem (zole-PI-dem)?
1. Drowsiness or dizziness (also during the daytime) 2. Headache 3. Nausea or gastrointestinal disturbances 4. Sleep activities (e.g., walking, driving, eating, or making phone calls while not fully awake) 5. Amnesia or memory impairment 6. Dependency or withdrawal symptoms with long-term use 7. Rarely, hallucinations or abnormal thinking and behavior changes
What are the signs and symptoms (s/sx) of superinfections?
1. Fever or increased temperature 2. Increased or persistent diarrhea 3. Oral or vaginal thrush (candidiasis) 4. Black, "hairy" tongue or abnormal changes in tongue color 5. Persistent cough or new respiratory symptoms 6. Unusual discharge or odor 7. New rashes or changes in skin condition Superinfections occur when antibiotics disrupt the body's normal flora, leading to overgrowth of resistant organisms or fungi.
What are the adverse effects (AE) of Sulfasalazine (SUL-fa-SAL-a-zeen)?
1. Gastrointestinal discomfort (nausea, vomiting, diarrhea) 2. Headache and dizziness 3. Skin rash or itching 4. Changes in blood counts (leukopenia, anemia) 5. Hepatotoxicity (Jaundice) 6. Photosensitivity (increased sensitivity to sunlight) 7. Possible allergic reactions in patients with sulfa drug allergy 8. Rarely, aseptic meningitis or severe hypersensitivity reactions
What are the adverse effects (AE) of spironolactone?
1. Hyperkalemia (high potassium levels) 2. Hyponatremia (low sodium levels) 3. Gynecomastia (breast enlargement in men) 4. Menstrual irregularities 5. Gastrointestinal disturbances (nausea, vomiting, diarrhea) 6. Dizziness or headache 7. Rash 8. Renal dysfunction 9. Dehydration and hypovolemia (particularly when used with other diuretics)
How can Chlorothiazide (klor-oh-THY-a-zide) affect electrolytes?
1. Hypokalemia due to increased potassium excretion in the urine. 2. Hyponatremia, though less commonly. 3. Hypercalcemia by decreasing the amount of calcium excreted in the urine. 4. Potentially leading to magnesium depletion (hypomagnesemia).
What are nursing actions for administering Alendronate (a-LEN-dro-nate)?
1. Instruct the patient to take the medication with a full glass of water first thing in the morning, at least 30 minutes before eating, drinking, or taking any other medication to enhance absorption. 2. Advise the patient to remain upright (sitting or standing) for at least 30 minutes after taking the dose to prevent esophageal irritation or damage. 3. Monitor the patient for signs of esophageal irritation, such as difficulty swallowing, pain on swallowing, or chest pain. 4. Educate the patient about the importance of adequate calcium and vitamin D intake. 5. Check for any contraindications, such as esophageal abnormalities, inability to stand or sit upright for at least 30 minutes, and severe renal impairment. 6. Report and monitor for side effects, including musculoskeletal pain, gastrointestinal issues, and rare cases of osteonecrosis of the jaw and atypical femur fractures.
What labs need to be monitored while taking Amphotericin B (am-foe-TER-i-sin B)?
1. Kidney function tests (creatinine, BUN) due to potential nephrotoxicity. q3-4 days. 2. Electrolytes (especially potassium and magnesium) because of the risk of electrolyte imbalances. 3. Complete blood count (CBC) to monitor for anemia. 4. Liver function tests (LFTs) as it can affect liver enzymes. 5. Urine output to assess kidney function and hydration status.
What patient teaching should be provided to decrease the risk of lithium toxicity?
1. Maintain a consistent salt intake to avoid fluctuations in lithium levels. 2. Stay hydrated by drinking adequate amounts of water, especially in hot weather or during exercise, to prevent dehydration. 3. Regularly monitor serum lithium levels as directed by their healthcare provider. 4. Recognize signs of lithium toxicity (e.g., diarrhea, vomiting, tremor, drowsiness, muscle weakness, and lack of coordination) and report them immediately. 5. Avoid using NSAIDs without consulting a healthcare provider, as they can increase lithium levels. 6. Inform healthcare providers about all medications being taken, including over-the-counter drugs and supplements, to avoid interactions. 7. Avoid alcohol consumption, as it can affect lithium levels and increase the risk of dehydration.
What are the signs and symptoms of theophylline toxicity?
1. Nausea and vomiting 2. Diarrhea 3. Headaches 4. Insomnia 5. Irritability 6. Tachycardia (rapid heart rate) 7. Palpitations 8. Tremors 9. Seizures (in severe cases) 10. Hyperglycemia 11. Hypokalemia (low potassium levels) It's crucial to monitor serum theophylline levels and observe for these symptoms, as the therapeutic range is narrow.
What are the adverse effects (AE) of Gentamicin (jen-tuh-MY-sin)?
1. Nephrotoxicity (kidney damage) 2. Ototoxicity (hearing loss or balance problems) 3. Rarely, neuromuscular blockade leading to respiratory depression 4. Allergic reactions, including rash and itching 5. Possible increase in serum creatinine and blood urea nitrogen (BUN) indicating kidney impairment 6. Vestibular toxicity, leading to dizziness or vertigo
What are common tocolytic medications?
1. Nifedipine (nye-FED-i-peen) - a calcium channel blocker. 2. Indomethacin (in-doe-METH-a-sin) - a nonsteroidal anti-inflammatory drug (NSAID). 3. Magnesium sulfate (mag-NEE-zee-um SUL-fate) - an inorganic salt used intravenously. 4. Terbutaline (ter-BYOO-ta-leen) - a beta-adrenergic agonist.
Thyroid-Stimulating Hormone (TSH) level interpretation
1. Normal TSH: Typically around 0.4-4.0 mIU/L, indicating balanced thyroid function. 2. Low TSH: Suggests hyperthyroidism (overactive thyroid), as the thyroid gland is producing too much thyroid hormone, suppressing TSH production. 3. High TSH: Indicates hypothyroidism (underactive thyroid), where insufficient thyroid hormone production leads to increased TSH secretion by the pituitary gland to stimulate the thyroid.
What are the adverse effects (AE) of Phenazopyridine (fen-ay-zoe-PEER-i-deen)?
1. Orange or red discoloration of urine (harmless but can stain clothing) 2. Headache 3. Dizziness 4. Stomach upset or pain 5. Rarely, skin rash, itching, or a severe allergic reaction 6. Hemolytic anemia (in patients with G6PD deficiency) 7. Renal and hepatic toxicity (very rare, with prolonged use)
What are the side effects of long-term Prednisone (PRED-ni-sone) use?
1. Osteoporosis 2. Increased risk of infections 3. Muscle weakness 4. Skin thinning and easy bruising 5. Cataracts and glaucoma 6. High blood pressure 7. Mood swings, memory problems, and behavioral changes 8. Weight gain and fat redistribution 9. High blood sugar and diabetes 10. Suppression of adrenal gland hormone production
When is Metoclopramide (me-toe-KLOE-pra-mide) contraindicated?
1. Patients with a known hypersensitivity to metoclopramide. 2. Individuals with pheochromocytoma, as it may cause a hypertensive crisis. 3. Patients with gastrointestinal obstruction, perforation, or hemorrhage. 4. Patients with epilepsy or seizure disorders, as metoclopramide may increase the frequency and intensity of seizures. 5. Patients with a history of tardive dyskinesia or other movement disorders when treated with medications that increase central dopaminergic tone. 6. It should be used with caution in patients with Parkinson's disease, as it may exacerbate symptoms.
What medications should not be given to a patient with a penicillin allergy?
1. Penicillins (e.g., amoxicillin, ampicillin). 2. Cephalosporins, especially first and second-generation ones, due to potential cross-reactivity. 3. Certain beta-lactam antibiotics, unless allergy testing confirms they're safe. 4. Carbapenems may be used with caution after evaluating the risk and considering allergy testing.
What are the uses of Ergotamine (UR-guh-TAM-een)?
1. Preventing or treating vascular headaches, such as migraine and cluster headaches. 2. It works by constricting blood vessels in the brain, helping to alleviate the pain associated with migraine headaches.
What are the signs and symptoms (s/sx) of hypersensitivity to a drug?
1. Rash or hives 2. Itching 3. Swelling of the face, lips, or tongue 4. Difficulty breathing or wheezing 5. Fever 6. Joint pain 7. Anaphylaxis (a severe, potentially life-threatening allergic reaction)
What is the effect of Ginkgo Biloba on platelets?
Ginkgo Biloba can inhibit platelet-activating factor, leading to decreased platelet aggregation and potentially increasing the risk of bleeding.
What are the normal magnesium levels in the blood?
1.3 to 2.1 mg/dL
If a nurse is administering oxytocin to a patient and observes late decelerations on the fetal heart rate (FHR) monitor, what should be the nurse's first action?
1st - Position the patient on her left side to improve uteroplacental circulation.
What are the normal serum potassium levels?
3.5 and 5.0 mEq/L.
How long should a nitroglycerin patch be worn?
A nitroglycerin patch is typically worn for 10-12 hours, followed by a patch-free period of 12-14 hours each day to prevent the development of tolerance to the medication.
What is an over-the-counter (OTC) pain reliever that does not increase the risk of bleeding?
Acetaminophen (uh-SEET-uh-MIN-uh-fen), also known as Tylenol, is an OTC pain reliever that does not increase the risk of bleeding and is safe for patients concerned about bleeding risks.
Should Acetylsalicylic Acid (ASA) be given to children?
Acetylsalicylic Acid (ASA), also known as aspirin, should not be given to children or teenagers with viral infections due to the risk of Reye's syndrome, a rare but serious condition that causes swelling in the liver and brain. It is generally avoided in individuals under 18 years old unless specifically recommended by a healthcare provider for certain medical conditions.
How is a cholinergic crisis caused by neostigmine treated?
Administration of Atropine: Atropine sulfate is used to counteract muscarinic effects such as bradycardia, excessive salivation, and bronchial secretions. It does not reverse nicotinic effects such as muscle weakness.
What drugs can interact with oral contraceptives?
Antibiotics Anticonvulsants: Medications like phenytoin, carbamazepine, barbiturates, primidone, topiramate, and oxcarbazepine can decrease the effectiveness of oral contraceptives. Antifungal agents Anti-HIV drugs Antidepressants: Some SSRIs and SNRIs have been reported to interact with oral contraceptives, though the clinical significance is variable. St. John's Wort
What allergies need to be considered before vaccine administration?
Any component of the vaccine, including adjuvants, preservatives, stabilizers, and culture media (e.g., egg protein in some influenza vaccines, gelatin, and antibiotics like neomycin).
What is salicylism, and what are its signs and symptoms?
Aspirin overdose Tinnitus/Hearing loss Nausea and vomiting Dizziness Headache Hyperventilation Sweating
Which disease's signs can be masked by the use of Beta-Blockers?
Beta-Blockers can mask the signs of hypoglycemia, especially in people with diabetes.
What are the signs and symptoms of heparin toxicity?
Bleeding/Bruising/Hematoma Hematuria Melena: Black, tarry stools indicating bleeding in the gastrointestinal tract. Epistaxis Gum bleeding Hypotension and tachycardia Thrombocytopenia: A decrease in platelet count, which can be a sign of heparin-induced thrombocytopenia (HIT)
What is the mechanism of action (MOA) of nifedipine?
Nifedipine (ny-FED-ih-peen) works as a calcium channel blocker by inhibiting the influx of calcium ions through L-type calcium channels in the smooth muscle of the heart and blood vessels. This action leads to the dilation of coronary and peripheral arteries, reducing myocardial oxygen demand and lowering blood pressure, making it effective in treating hypertension and angina.
Is Cromolyn (KROH-muh-lin) used for emergencies?
No, Cromolyn is not used for emergency treatment. It is a preventive medication used to treat symptoms of allergies, asthma, and certain other conditions by inhibiting the release of substances that cause inflammation. It is used regularly to prevent asthma attacks or allergic reactions, not for immediate relief during an emergency.
What are the normal serum digoxin levels?
Normal serum digoxin (dih-JOX-in) levels typically range from 0.8 to 2.0 ng/mL. Levels above 2.0 ng/mL may indicate digoxin toxicity, which requires immediate medical attention.
What are the adverse effects (AE) of sumatriptan (SOO-ma-TRIP-tan)?
Chest pain or tightness: (coronary vasospasms) Paresthesias: Dizziness and vertigo: Nausea and vomiting: Fatigue and weakness: Flushes:
What are the adverse effects (AE) of verapamil (ver-AP-a-mil)?
Constipation (common) Headache Edema Bradycardia Orthostatic Hypotension Fatigue Gingival hyperplasia Heart block
What are the adverse effects (AE) of enalapril (e-NAL-a-pril)?
Cough Hyperkalemia Renal impairment Hypotension Dizziness and fatigue. Nausea and diarrhea
What are the adverse effects (AE) of captopril (KAP-toe-pril)?
Cough Hyperkalemia Renal impairment Hypotension Taste disturbances Neutropenia/agranulocytosis Dizziness and fatigue
What are the adverse effects (AE) of Amitriptyline (Am-ee-trip-ty-leen)?
Dry mouth Sedation Blurred vision Urinary retention Constipation Weight gain Orthostatic hypotension Tachycardia (EKG Changes) Potential for cardiac toxicity (especially with overdose) Confusion and hallucinations in the elderly
What is the mechanism of action (MOA) of Epoetin Alfa (e-POE-e-tin AL-fa)?
Epoetin Alfa works by stimulating the bone marrow to produce more red blood cells (RBCs). It is a synthetic form of erythropoietin, a hormone naturally produced by the kidneys that encourages RBC production. This action helps to increase hemoglobin levels and improve oxygen transport in patients with anemia due to chronic kidney disease, chemotherapy, or certain other medical conditions.
What to do if a patient refuses medication?
Explore the Reason why Provide Information: Clearly explain the medication's benefits, side effects, and the importance of adherence to their treatment plan. Respect Autonomy Notify the Healthcare Provider Document refusal Follow-Up for AE
What are the side effects (SE) of metoclopramide (me-toe-KLOE-pra-mide)?
Extrapyramidal symptoms (EPS) Tardive dyskinesia Drowsiness and fatigue: May affect the ability to drive or operate machinery. Restlessness Depression Nausea and diarrhea Hypotension Neuroleptic Malignant Syndrome (NMS)
What are the adverse effects (AE) of haloperidol (HAL-oh-PER-i-dol)?
Extrapyramidal symptoms (EPS): Such as dystonia, akathisia, and Parkinsonism. Tardive dyskinesia Neuroleptic malignant syndrome (NMS) QT prolongation Sedation Anticholinergic effects Orthostatic hypotension Agranulocytosis: A rare but serious reduction in white blood cell count.
What are some key drug interactions with simvastatin (SIM-va-STAT-in)?
Fibrates (gemfibrozil, fenofibrate) and ezetimibe increase the risk of myopathy and liver and kidney injury. Medications that suppress CYP3A4 (erythromycin, ketoconazole), along with HIV protease inhibitors, amiodarone, and cyclosporine can increase levels of some statins when taken concurrently. . Grapefruit juice suppresses CYP3A4 and can increase levels of statins. NURSING ACTIONS: Clients taking statins should avoid grapefruit and grapefruit juice
What laboratory tests are monitored for patients on warfarin therapy?
For patients on warfarin (WAR-fa-rin) therapy, the primary laboratory test monitored is the INR (International Normalized Ratio), which assesses the blood's clotting tendency to ensure it is within the therapeutic range, typically between 2.0 and 3.0 for most indications. Additionally, a complete blood count (CBC) may be monitored to detect any bleeding complications or side effects.
What are the signs and symptoms of neutropenia?
Frequent infections Fever Mouth ulcers Sore throat Skin abscesses Pneumonia symptoms Unusual redness, pain, or swelling: Around wounds or at the site of an injury, indicating infection.
What medical conditions can mannitol precipitate or worsen?
Heart Failure: can increase extracellular fluid volume Pulmonary Edema: The increase in extracellular fluid can also lead to fluid accumulation in the lungs Renal Failure Electrolyte Imbalances: such as hyponatremia or hyperkalemia Dehydration Intracranial Bleeding Diabetes
What are the adverse effects (AE) of rifampin (RIF-am-pin)?
Hepatotoxicity Discoloration of bodily fluids: Rifampin can cause red-orange discoloration of urine, sweat, saliva, and tears, which is harmless but can stain contact lenses and clothing. Gastrointestinal upest Flu-like symptoms Thrombocytopenia
What are the signs and symptoms of neuroleptic malignant syndrome (NMS)?
High fever: Sudden, severe increase in body temperature. Muscle rigidity: Severe Altered mental status: Confusion, agitation, delirium, or coma. Autonomic dysfunction: Fluctuating BP, tachycardia, diaphoresis, and dyspnea. Tremor: Shaking or trembling. Incontinence: Loss of bladder or bowel control. Lab abnormalities: Elevated creatine phosphokinase (CPK) indicating muscle breakdown, leukocytosis (increased white blood cell count), and possible electrolyte imbalances.
What are the adverse effects (AE) of tamoxifen (ta-MOX-i-fen)?
Hot flashes and night sweats Vaginal discharge or bleeding Risk of endometrial cancer Blood clots: Increased risk of deep vein thrombosis (DVT) and pulmonary embolism (PE). Cataracts Mood swings and depression Nausea and vomiting Bone density
What time of the day should Hydrochlorothiazide (hye-droe-klor-oh-THY-a-zide) be given?
Hydrochlorothiazide is usually recommended to be taken in the morning. This timing helps to avoid nocturia (the need to wake up at night to urinate), ensuring the diuretic effect does not disturb the patient's sleep pattern.
How do potassium imbalances affect an EKG?
Hyperkalemia - tall, peaked T waves. Hypokalemia - U waves (which follow the T wave), and possibly a prolonged QT interval.
When should isosorbide mononitrate (eye-so-SOR-bide mono-NYE-trate) be held?
Hypotension (<120/80?) Severe Hypovolemia Recent Sildenafil (Viagra) Use Severe Aortic or Mitral Valve Stenosis:
What are the SE of starting a patient on Enalapril (e-NAL-a-pril)?
Hypotension after the first dose of Enalapril can be most problematic within the first few hours after administration, particularly in patients who are volume-depleted (e.g., from diuretic therapy or dialysis). Close monitoring is advised during this period.
What are the advantages of using a spacer with inhaled corticosteroids?
Improved Drug Delivery Reduced Oral Deposition: They decrease the amount of medication that lands in the mouth and throat, reducing the risk of local side effects like oral candiasis and dysphonia.
What are the adverse effects (AF) of glucocorticoids?
Increased risk of infection (fever/sore throat) Hyperglycemia (high blood sugar) Osteoporosis (bone loss) Muscle weakness Peptic ulcer/GI upset Cushing's syndrome (due to prolonged therapy) Hypertension (high blood pressure) Delayed wound healing Fluid retention, leading to edema
What are the adverse effects (AE) of amphetamine-based ADHD medications?
Insomnia Decreased appetite Weight loss Abdominal pain Increased heart rate (Palpitations) Elevated blood pressure Anxiety Irritability Potential for misuse and addiction
What are the side effects (SE) of bupropion (byoo-PRO-pee-on)?
Insomnia Dry mouth Headache Nausea and vomiting Constipation. Increased sweating Agitation or anxiety Tremor Tachycardia Seizures
What is normal creatinine clearance labs?
Men: 97 to 137 mL/min Women: 88 to 128 mL/min
What are the physical side effects of neostigmine (nee-oh-STIG-meen)?
Muscle cramps and twitching Increased salivation and sweating Nausea and vomiting Diarrhea Abdominal cramps Bradycardia Miosis (Excessive pupil constriction) Increased bronchial secretions
What are the adverse effects (AE) of simvastatin (SIM-va-STAT-in)?
Muscle pain and weakness (myopathy rhabdomyolysis). Elevated liver enzymes Gastrointestinal issues Hyperglycemia. Headache and dizziness: Can occur but are generally less common. Risk of developing diabetes: A slight increase in the risk
How do NSAIDs affect lithium levels?
NSAIDs can increase lithium levels in the blood, leading to an increased risk of lithium toxicity. This interaction occurs because NSAIDs reduce the kidney's ability to excrete lithium, resulting in higher plasma levels
What are the adverse effects (AE) of aminoglycoside antibiotics? (gentamicin, neomycin, sereptomycin)
Nephrotoxicity Ototoxicity Neuromuscular blockade: In rare cases, aminoglycosides can cause muscle weakness by interfering with the neuromuscular junction, potentially leading to respiratory depression.
What causes Neuroleptic Malignant Syndrome (NMS)?
Primarily caused by the use of antipsychotic medications, particularly first-generation (typical) antipsychotics, but it can also occur with second-generation (atypical) antipsychotics.
What are the guidelines for administering trimethoprim/sulfamethoxazole (try-meth-oh-PRIM/sul-fa-meth-OX-a-zole)?
Renal Function Assessment: Adjust dose in patients with renal impairment to prevent accumulation and toxicity. Adequate Hydration: 8 to 10 glasses water per day to reduce the risk of crystalluria. Monitoring CBC and kidney function Sun Exposure: photosensitivity reactions.
How should allopurinol (al-oh-PYOOR-i-nol) be administered?
Start with a low dose: To minimize adverse effects Adjust dose based on uric acid levels and renal function Take after meals Maintain adequate hydration: 2L/day Water
When should ergotamine (UR-goe-TAM-in) be taken
Take it at the first sign of a migraine for best results
What are the guidelines for taking Sucralfate (Soo-kral-fate)?
Take on an empty stomach, at least 1 hour before or 2 hours after meals and at bedtime. Avoid taking it with or within 30 minutes of antacids. Maintain adequate hydration to prevent constipation Sucralfate can interfere absorption of other medications
What are the adverse effects (AEs) of Alteplase (al-TEP-lase)?
The adverse effects of Alteplase include bleeding complications (the most significant risk)
What is the first-line drug for treating anaphylaxis?
The first-line drug for treating anaphylaxis is epinephrine (ep-ih-NEF-rin). It should be administered immediately upon recognition of anaphylactic symptoms to counteract the severe allergic reaction.
How long does it take for Morphine to cause respiratory depression?
The onset of respiratory depression caused by Morphine can vary depending on the route of administration. When given intravenously (IV), effects can be seen within 5 to 10 minutes. With oral administration, it may take 30 minutes to an hour. The risk remains as long as the drug is in the system and can be particularly high at peak plasma concentrations. Continuous monitoring is essential, especially in opioid-naïve patients or when used in higher doses.
If a medication is scheduled at 0930 when can it be given?
Up to 30 min before or after 0930. One hour window.
How can the systemic effects of lidocaine (LYE-doe-kane) be reduced?
Use the lowest effective dose Avoid broken or irritated skin
What are the uses of Verapamil (ver-AP-a-mil)?
Verapamil is used to treat hypertension, prevent angina, and control certain types of arrhythmias (irregular heartbeats). It is also used in the management of supraventricular tachycardia and in the prophylaxis of migraine headaches.
What is the normal range for activated Partial Thromboplastin Time (aPTT) and what actions should be taken if it is high?
aPTT is typically about 30-40 seconds: 1. Evaluating for bleeding disorders or anticoagulant use (e.g., heparin). 2. Adjusting anticoagulant dosage if the patient is on such medication. 3. Investigating other potential causes of prolonged aPTT, such as liver disease or vitamin K deficiency. 4. Call Provider
What are the adverse effects (AEs) of Epoetin Alfa (eh-POH-eh-tin AL-fah)?
hypertension headache fever nausea diarrhea arthralgia (joint pain) edema DVT
What are the signs and symptoms (S/sx) of internal bleeding?
pain at the bleed site swelling or tightness in the affected area dizziness or fainting low blood pressure weakness shortness of breath tachycardia (rapid heart rate) pale or clammy skin fatigue, and in severe cases, shock.