Shared Flashcard Set

Details

Pharm Final Exam
Various drugs from different classes
384
Pharmacology
Professional
12/17/2013

Additional Pharmacology Flashcards

 


 

Cards

Term
Which organ is involved in excretion?
Definition
Kidney
Term
What lab tests would you check for kidney function? 
Definition
BUN/Creatinine
Term
Absorption
Definition
movement of a drug from its site of administration into the blood stream for distribution to the tissues
Term
Which organ is involved in metabolism?  
Definition
Liver
Term
Metabolism
Definition
AKA biotransformation.  Next step after absorption and distribution.  Biochemical alteration of a drug into an inactive metabolite, a more soluble compound, a more potent active metabolite or a less active metabolite
Term
Enzyme inhibitors
Definition

                                                             drugs that decrease/delay drug metabolism result in accumulation of drug and prolongation of the effects of the drug; may lead to drug toxicity

Term
Excretion
Definition
elimination of drugs from the body
Term
Enteral
Definition

Drug absorbed into the systemic circulation thru the mucosa of the stomach and/or small or large intestine.  Orally administered

Term
Half-life
Definition
time required for half of an administered dose of drug to be eliminated by the body or the time it takes for the blood level of a drug to be reduced by 50% 
Term
Onset of action
Definition

a.       time required for a drug to elicit a therapeutic response after dosing

Term
Peak effect
Definition

a.       time required for a drug to reach its maximum therapeutic response in the body

Term
Duration of action
Definition

a.       length of time the concentration of a drug in the blood or tissues is sufficient to elicit a response

Term
Tolerance
Definition
decreased response to repeated drug doses
Term
Cascade
Definition
giving medication to treat adverse effects of other medication
Term
Polypharmacy
Definition

use of many different drugs concurrently in treating a patient, who often has several health problems

Term
Sodium lab value
Definition

135 – 145 mEq/L      

Term
Potassium lab value
Definition

3.5 – 5.0mEq/L

Term
BUN
Definition

10 – 20 mg/dL          

Term
Creatinine lab value
Definition
0.6 – 1.2 mg/dL
Term
Magnesium lab value
Definition

1.3 – 2.1 mEq/L

Term
Ethno:
Definition

Understanding specific impact of cultural factors on patient drug response (hampered by lack of clarity of race, ethnicity, culture)

Term
Drug polymorphism
Definition

effects of specific patient characteristics on the pharmacokinetics of specific drugs characteristics: diet/cultural/genetic

Term
Medication reconciliation process
Definition

getting all information on a patient’s medications

Term
Cognitive
Definition
what you actually know/understand.  Ex - watching tv
Term
Affective 
Definition
feelings, attitudes, opinions, values.  Ex - active listening,
Term
Psychomotor
Definition

integration of knowledge and physical skills.  Ex – giving an insulin injection

Term
Analgesics
Definition

 relieves pain without loss of consciousness

Term
Opioid analgesics
Definition
used to manage moderate to severe pain
Term
Adjuvant analgesic drugs
Definition

drugs from other chemical categories to aid in pain management

 

 

Term

Morphine drug class

Definition

Opioid agonists

Term

Morphine MOA

Definition
release histamine and can cause itching
Term
Morphine adverse effects
Definition

CNS depression. Can irritate the GI tract/chemoreceptor trigger zone in CNS/causing nausea and vomiting/slow peristalsis & increase absorption of water. Urinary retention

Term
Morphine interactions
Definition

alcohol/antihistamines/benzos/CNS depressants; additive respiratory depression

 

 

Term
Hydromorphone drug class
Definition
opioid analgesic agonist
Term
Fentanyl drug class
Definition
opioid agonist
Term
Fentanyl indications
Definition

used commonly in transdermal patches (pp. 148) long-term control of malignant; non-malignant chronic pain

 

 

Term
adrenergic contraindications
Definition

ü  Severe asthma (suppresses respiratory system)

ü  Drug allergy (discuss true vs. expected allergy)

       Itching is expected due to opioid histamine release, not a true allergy

       Nausea is expected due to GI suppression, not a true allergy

 

 

Term
Adrenergic adverse effects
Definition

 

ü  Most serious is CNS depression (respiratory suppression)

       Cardiovascular – hypotension, flushing, bradycardia

       CNS – sedation (mental clouding), disorientation, euphoria, lightheadedness, dysphoria

       GI – nausea, vomiting, constipation, spasms,

       Genito-urinary- urinary retention

       Integumentary –itching, rash, wheal formation

 

       Respiratory – depression and aggravation of asthma

Term
opioid analgensic antidote
Definition

Narcan (naloxone) must be given in severe respiratory distress from opioid overdose, regardless of withdrawal syndrome

Term
Codeine Sulfate 
Definition
suppresses cough. only opioid with a ceiling effect (more drug will not increase response)
Term

 Acetaminophen (Tylenol) drug class

Definition

Non-opioid Analgesics

Term

   Acetaminophen (Tylenol)  Mechanism of action

Definition

ü  Blocks pain by inhibition of prostaglandin synthesis; acts on hypothalamus to lower body temperature; vasodilation/increased peripheral blood flow. Lacks anti-inflammatory effects as opposed to NSAID’s

Term

      Acetaminophen (Tylenol)      Indications

 

Definition

ü  Mild to moderate pain and fever

 

ü  Used for contraindications of aspirin

Term

       Acetaminophen (Tylenol) Contraindications

Definition

ü  liver disease/drug allergy (can cause liver damage)

Term

       Acetaminophen (Tylenol) Adverse effects

Definition

ü  Normally well tolerated

 

ü  Rash, nausea, vomiting

Term

       Acetaminophen (Tylenol)

Definition

ü  Potentially lethal

ü  7-10 grams to cause hepatic necrosis

ü  Acetylcysteine (acetadote) is the antidote for Tylenol toxicity

ü  Max dose: 4g average person/2g those elderly patients and patients with liver dysfunction and chronic heavy alcohol abusers

 

ü  Acetadote: IV is available

Term

Opioid analgesic  Nursing Diagnoses 

Definition

ü  Impaired gas exchange related to opioid induced CNS/respiratory depression

ü  Acute pain related to disease process

ü  Chronic pain related to disease process

ü  Constipation related to CNS depressant effects on GI

 

ü  Deficient knowledge related to lack of familiarity with opioids

Term
Adrenergic agonists
Definition

ü  Stimulate the sympathetic nervous system

ü  Mimic the effects of the neurotransmitters (epinephrine/norepinephrine/dopamine)

 

ü  These neurotransmitters are also known as catecholamine.

Term

Alpha-Adrenergic Receptors response

Definition

ü  Vasoconstriction & CNS stimulation

Term
  • A1 Receptors effects on blood vessels, liver, GI, bladder, penis, uterus
Definition

§  Blood vessels   (A1): vasoconstriction (increase BP)

§  Liver               (A1): glycogenolysis (more sugar)

§  GI Tract         (A1): Decreased motility

§  Bladder           (A1): constriction

§  Penis                (A1): ejaculation

 

§  Uterus                         (A1): contraction

Term
  • A2 Receptors
Definition

ü  Control release of neurotransmitters

Term
Beta-Adrenergic Receptors response
Definition

ü  Bronchial/GI/Uterine relaxation

 

ü  Cardiac stimulation

Term
  • B1 Receptors (One Heart)
Definition

ü  In the heart

ü  Cardiac muscle: increased contractility

 

ü  Sinoatrial/Atrioventricular node: increased heart rate

Term
  • B2 Receptors (Two Lungs)
Definition

ü  In smooth muscle of bronchioles, arterioles and visceral organs

§  Lungs              (B2): Relaxation of bronchial smooth muscles (dilation)

§  Uterus             (B2): relaxation

 

§  GI Tract         (B2): relaxation of smooth muscle

Term

Dopaminergic Receptors

Definition

Dilation of arteries

ü  Kidney

ü  Heart

ü  Brain

 

Increases blood flow

Term

 

When stimulated by dopamine

Definition
these receptors cause vessels to dilate which increase blood flow to these tissues.  Dopamine is the only substance that can stimulate these receptors
Term
Direct acting sympathomimetic
Definition
  • binds directly to the receptor causing a physiologic response
Term
Indirect acting sympathomimetic
Definition
causes releases of the catecholamine from the storage sites
Term
Mixed-acting sympathomimetic 
Definition
  • stimulates the receptor by binding to it and indirectly stimulates the receptor causing the release of the neurotransmitter

                                                                                                    

 

 

Term

Dobutamine (dobutrex) MOA

Definition

B1 Adrenergic
ü  Stimulates the heart muscle
What does it do?
ü  Increases cardiac output by increasing contractility which increases stroke volume (increase BP/HR)
ü  Used for patients with heart failure/weight based drug…..mcg/kg/min (weight based)
ü  IV only
 

 

Term
Epinephrine (Adrenalin) warning
Definition
Kills Kidneys
Term
Epinephrine (Adrenalin) MOA
Definition
  • Alpha and Beta receptors (can activate both depending on route)
  • What does it do?

ü  Alpha-1 receptors: continuous IV infusion: for vasoconstriction to elevate BP

ü  Beta-1 receptors: used for cardiac arrest: 1 milligram IV push every 3 minutes

ü  Beta-2 receptors: subcutaneous injection to treat anaphylactic shock (epi-pen)

 

 

Term
Midodrine (ProAmatine) Indication
Definition
used for Orthostatic HTN
Term
Midodrine (ProAmatine)    MOA  
Definition
  • A1 Adrenergic

ü  Vasoconstrictor

§  Constriction of both arterioles and veins = peripheral vasoconstriction

 

§  Used for treatment of symptomatic orthostatic hypotension

Term
Midodrine (ProAmatine)   Dosage
Definition

§  10 mg PO three times a day (TID).

§  Maximum daily dose is 40 mg

 

§  PO Only

Term
Assessment for adrenergic drugs
Definition

 

ü  Heart problems – (hyper/hypo tension; tachycardia; heart failure; heart attack

ü  Renal function – Alpha adrenergics (epinephrine/continuous IV infusion) can cause decreased renal function/renal damage

 

ü  Vital signs

Term
Implementation for adrenergic drugs
Definition

ü  IV Site (Central line)

§  As soon as possible get a central line for your patient. Using these drugs through a peripheral line can cause vasoconstriction around site and eventual tissue necrosis.

ü  Cardiac monitoring

ü  Patient teaching

 

§  Observe for adverse effects: chest pain, palpitations, blurred vision, headache

Term

§  Carvedilol (Coreg) MOA

Definition

§Alpha-1/Non-selective beta blocker

§Decreases cardiac output, exercise induced tachycardia

 

§Heart failure primarily (can be used for hypertension/angina)

Term

Carvedilol (Coreg) indications

Definition

·         used primarily for treatment of heart failure but also beneficial for hypertension and angina. 

Term

Carvedilol (Coreg) MOA

Definition
Slows progression of heart failure and decreases the frequency of hospitalization in patients with mild to moderate heart failure
Term

Carvedilol (Coreg) assessment

Definition

·         obtain baseline vital signs from patient or family members and ask for BP/pulse parameters

Term
Metoprolol (Lopressor, Toprol XL) MOA
Definition

·         Beta1 blocker

Term

Metoprolol (Lopressor, Toprol XL) Indications

Definition
acute MI, dysrhythmias, hypertension, angina
Term

§  Tamsulosin (Flomax) MOA 

Definition

§Alpha blocker

Term

        

 

§  Tamsulosin (Flomax) Indications 

Definition

§Symptoms of Benign Prostatic Hyperplasia (BPH)

 

§Increase Urine output

Term
Tamsulosin (Flomax) conraindications
Definition

§Hypersensivity, prostate cancer

Term
Beta blockers effect on angina
Definition
beta blockers decrease the demand for oxygen consumption allowing more supply of oxygen to reach the heart muscle
Term
Beta blockers effect on MI
Definition

o   circulates catecholamines and prevents them from stimulating the heart. Catecholamines are released after a heart attack; unopposed stimulation would further increase oxygen demand/force of contraction

Term
Beta blockers effects on dysrhythmias
Definition

o   slow down conduction in SA/AV node with decreases heart rate. Heart failure

Term
Beta blockers Adverse effects
Definition

[image]GI: nausea, vomiting, diarrhea

Term
Cholinergic Drugs effects on GI, GU, cardio, alzheimers
Definition

·         GI: increase gastric secretions, increase GI motility

·         GU: urinary frequency

·         Cardio: reduces heart rate

 

·         Alzheimer’s: increases amount of acetylcholine in the brain; helps to maintain memory and learning capabilities

Term
Cholinergic Drugs adverse effects
Definition

[image]GI: abdominal cramps, nausea, vomiting

Term

Bethanechol (urecholine) MOA

Definition

·         causes increased bladder and GI tract tone and motility, which increases the movement of contents through these areas. It also causes the sphincter in the bladder and GI tract to relax, allowing them to empty

Term

Bethanechol (urecholine) indications

Definition
 it is a direct-acting cholinergic agonist used in the treatment of acute postoperative and postpartum non-obstructive urinary retention 
Term

Bethanechol (urecholine) adverse effects

Definition
Hypotension, headache, GI upset
Term

Donepezil (Aricept) MOA

Definition

·         Mild-moderate Alzheimer’s  

·         Increases levels of acetylcholine in the brain increasing memory function

 

Term

Donepezil (Aricept) adverse effects

Definition
insomnia, muscle cramps, GI upset
Term

Donepezil (Aricept) teaching

Definition

·         May take up to 6 weeks for therapeutic effects

Not a cure for Alzheimer’s disease

Term

       Parasympathomimetics 

Definition

      Parasympathetic Nervous System (PSNS) theme is ‘rest and digest’

      Mimic the effects of the neurotransmitter; Acetylcholine

      Receptors are located throughout the body.

 

      Receptors are called nicotinic and muscarinic 

Term

       Rest & Digest

Definition

      GI: Increased gastric secretions/increased GI motility

      GU: urinary frequency

      Cardiovascular: reduced heart rate

      Alzheimer's: : increase the amount of acetylcholine in brain; helps to maintain memory and learning capabilities

 

      Cholinergic Drugs 

Term

Atropine indications

Definition

§  For symptomatic bradycardia

Term
Cholinergic blocker effects on GI, GU, cardio
Definition

§  GI: decrease in motility/peristalsis and smooth muscle relaxation

§  GU: decreased bladder contraction resulting in urinary retention

 

§  Cardiovascular: : increase in heart rate 

Term

Atropine nursing implications 

Definition

§  Telemetry/vital sign monitoring; notify physician

Term

Dicyclomine (bentyl) indications 

Definition

§  Treatment for Irritable Bowel Syndrome (IBS)

Term

Dicyclomine (bentyl) nursing implications

Definition

§  Use caution in patients that have? (Obstruction/Ileus)

Term

Tolterodine (detrol) indications

Definition

§  Used for Bladder leakage caused by overactive bladder

Term

Tolterodine (detrol) adverse effects

Definition

§  Headache, dizziness, dry mouth

Term

§  Diphenhydramine (Benadryl) drug class

Definition

§Nonselective antihistamine

Term

§  Diphenhydramine (Benadryl) indications

Definition

§Allergy symptoms, rhinitis, motion sickness, night time sedation, nonproductive cough

§Peripherally/centrally acting; often used as a hypnotic

Term

§  Loratidine (Claritin) MOA

Definition
Binds to peripheral histamine receptors, thereby providing antihistamine action without sedation (not for children under 6) 
Term

§  Benzonatate (Tessalon Pearles) drug class

Definition

§Non-opioid antitussive

Term

§  Benzonatate (Tessalon Pearles) MOA

Definition

§Benzonatate is thought to act as a local anesthetic, numbing stretch receptors in the lower airway and lungs, thereby reducing the drive to cough after taking a deep breath.

Term

§  Benzonatate (Tessalon Pearles) indications

Definition

§Used for non-productive cough

Term

§  Dextromethorphan (Robitussin DM) drug class

Definition

§Non-opioid antitussive

Term

§  Dextromethorphan (Robitussin DM) MOA

Definition

§Depresses cough center in CNS by direct effect on the medulla

Term

§  Dextromethorphan (Robitussin DM) Indications

Definition

§Nonproductive cough caused by colds or inhaled irritants

Term

§  Dextromethorphan (Robitussin DM) toxicity

Definition

§Robo-tripping (CNS depressant)

Term

§  Guaifenesin (Mucinex) drug class

Definition

§Expectorant

Term

§  Guaifenesin (Mucinex) MOA

Definition

§Reflex stimulation(loosing/thinning secretions)

 

§Increases the volume & reduces the viscosity of secretions in the trachea and bronchi to facilitate secretion removal

Term

§  Guaifenesin (Mucinex) indications

Definition

§Beneficial to productive cough

Term

§  Albuterol drug class

Definition

Bronchodilator

Selective or non-selective adrenergic agonist

Term

§  Atrovent (Ipratropium) drug class

Definition

§Anticholinergic blocking acetylcholine; bronchodilator

Term

§  Atrovent (Ipratropium) MOA

Definition

§Inhibits action of acetylcholine at receptor sites on the bronchial smooth muscle resulting in bronchodilation

Term

§  Atrovent (Ipratropium) indications

Definition

§NOT for acute use because actions are prolonged

 

§To manage chronic bronchitis, emphysema or COPD

Term

§  Atrovent (Ipratropium) conraindications

Definition

§Hypersensitivity to atropine, bromine, soybean or peanut products

Term

§  Atrovent (Ipratropium) adverse effects

Definition
anxiety, dizziness, headache, nervousness
Term

§  Theophylline (elixophyllin) drug class

Definition

§Xanthine derivatives (bronchodilator)

Term

§  Theophylline (elixophyllin) indications

Definition

§For chronic issues, NOT acute symptoms

§Bronchial asthma, bronchospasm of COPD, chronic bronchitis, emphysema

Term

§  Theophylline (elixophyllin) MOA

Definition

§Relaxes smooth muscle of respiratory system by blocking phosphodiesterase which increases cAMP

Term

§  Theophylline (elixophyllin) teaching

Definition

§For chronic issues, NOT acute symptoms

§Hard to “come off” of this drug

Term

§  Methylprednisolone (Solu-Medrol) indications

Definition

§  Methylprednisolone (Solu-Medrol)

Term

§  Methylprednisolone (Solu-Medrol) drug class

Definition

Corticosteroids (Anti-inflammatory)

Term
Prednisone drug class
Definition

Corticosteroids (Anti-inflammatory)

 

 

Term

§  Prednisone cautions

Definition

§Taper drug DO NOT just stop (can cause adrenal gland failure or death)

§Px on Pred. can have paper thin skin

 

 

Term

§  Prednisone indications

Definition

§Oral corticosteroid after tapering Solu-medrol

Term

           

 

§  Flonase (Fluticasone) drug class

Definition

Corticosteroids (Anti-inflammatory)

Term

§  Flonase (Fluticasone) indications

Definition

§Asthma (prophylaxis/maintenance)

§Prevention of chronic asthma, nasal symptoms of seasonal allergies/nonallergenic rhinitis

Term

Corticosteroids (Anti-inflammatory) assessment

 

                                     

Definition

ü  Assess for bradycardia, hypotension, dizziness

Term

Digoxin (lanoxin) drug class

Definition

 

 

       Cardiac glycoside

Term

Digoxin (lanoxin) indications

Definition
Heart failure and help control ventricular response atrial fibrillation
Term

Digoxin (lanoxin) inotrope, chronotrope, dromotrope effects

Definition

       Positive inotropic/Negative chronotropic/Negative dromotropic

Term

Digoxin (lanoxin)  adverse effects

Definition
Dysrhythmias, hypotension, headache, fatigue
Term
Digoxin (lanoxin) MOA
Definition

       Augments PSNS (cholinergic) stimulation via the vagus nerve

 

       Increased diastolic filling

Term
Digoxin (lanoxin) administration
Definition

       Check apical pulse rate for one full minute. If pulse is less than 60/HOLD

       Can be given PO/IV. PO dose is usually written in micrograms                          (250 micrograms = 0.25 milligrams)

       If given IV; dose needs to be given over at least five minutes.

       Note baseline assessment of patient.

 

 

 

Term

Digoxin (lanoxin) toxicity causes

Definition

       Low therapeutic index

       Therapeutic dose and toxic dose is SMALL. Normal ranges are 0.5-2.0 mg/mL

       Hypokalemia/Decreased renal function

 

       Hypokalemia/low magnesium levels/decreased renal function: can increase potential for digoxin toxicity

Term

Digoxin toxicity s/s

Definition

       confusion, fatigue, blurred vision, perception of green/yellow halos

Term

Digoxin toxicity treatment

Definition

       Digibind is the treatment for digoxin toxicity. It is only available in 40 milligram vial; dosed on digoxin level and weight of patient; given IV over thirty minutes

Term

Milrinone (primacor) drug class

Definition

       Phosphodiesterase inhibitor (PDI)

Term

Milrinone (primacor) indications

Definition

       Vasodilator - reduces reduction force against which the heart must pump to eject blood

 

       Positive inotropic - more calcium available to for heart contraction

Term

Milrinone (primacor)  MOA

Definition

       Intracellular release of cAMP

Term
Milrinone  (primacor) adverse effects
Definition
– other Dysrhythmia
Term
Milrinone (primacor) indications
Definition
Short-term management of acute heart failure
Term
Milrinone (primacor) administration
Definition
IV Only, weight-based, monitor intake and output; vital signs, daily weight
Term
Lidocaine drug class
Definition

ü  Block sodium channel; decrease action potential

Term
Lidocaine indications 
Definition
ventricular dysrhythmias
Term
Lidocaine adverse effects
Definition

ü  Can cause seizures, confusion, bradycardia, hypotension (Assess for)

Term
Lidocaine administration
Definition
IV Only; has extensive first pass effect; short half life (8-minutes)
Term
Lidocaine antidote 
Definition
Diazepam (valium) reverses toxicity
Term
Metropolol drug indications 
Definition
atrial and ventricular dysrhythmias
Term
Metropolol MOA 
Definition

ü  Depresses SNS stimulation (beta blocker/antagonist)

 

ü  Catecholamine protector: Cates released after MI can make heart more irritable

Term
Metropolol assessment 
Definition

ü  Assess for hypotension, bradycardia

Term
Metropolol route 
Definition

 ü  IV/PO

 

Term
Amioderone indications 
Definition
atrial and ventricular dysrhythmias
Term
Amioderone MOA 
Definition

ü  Increases action potential duration

Term
Amioderone interactions 
Definition

ü  Increases the effect of Coumadin/Digoxin; grapefruit juice can inhibit

Term
Amioderone assessment
Definition

ü  Assess for bradycardia, dizziness, photosensitivity, hypo/hyper thyroidism (75%) and pulmonary toxicity (dyspnea, cough, fibrosis)

Term
Amioderone adverse teaching
Definition

ü  May upset GI, take with food; wear sunglasses

Term
Diltiazem indications 
Definition
atrial dysrhythmias and tachycardia
Term
Diltiazem drug class 
Definition
calcium channel blocker
Term
Diltiazem  routes
Definition

ü  Oral for maintenance

 

ü  Give IV for Tachycardia

Term

       Chronic stable angina

Definition

       Atherosclerosis is primary cause.

ü  Triggers: exercise, emotions, nicotine, alcohol, caffeine, cocaine.

 

ü  Pain can be intense and is gone with patient rest or medications (nitroglycerine ER capsules/TD patch) 

Term

       Unstable angina

Definition

       Pain increases in severity and frequency of attacks increase.

       End result of unstable angina is heart attack.

       Pain can occur at rest.

 

       Early progressive of coronary artery disease (not getting better/gets worse)

Term

       Vasospastic angina

Definition

       Spasms in smooth muscle that surrounds plaque-filled arteries.

 

       Occurs at rest without any precipitating cause. 

Term
Nitroglycerin long lasting indications
Definition
Prevention of episodes (chronic stable)
Term
Nitroglycerin short acting indications 
Definition

       Acute attacks (IV, sublingual)

Term
Nitroglycerin MOA 
Definition

       Nitrates dilate all blood vessels (arteries/veins)

       Dilate large and small coronary arteries;

       Redistribute blood and oxygen to previously ischemic tissue.

 

       Atherosclerotic arteries can benefit from nitrates 

Term
Nitroglycerin contraindications 
Definition
hypotension; men using erectile dysfunction drugs
Term
Nitroglycerin adverse effects 
Definition
Headache; hypotension; reflex tachycardia
Term
Nitroglycerin assessment 
Definition

       Monitoring blood pressure/heart rate (systolic less than 90/pulse less than 60). Assess pain (level, location, duration)

Term
Nitroglycerin patient education 
Definition

       Patients should avoid alcohol, hot tubs, hot showers, hot environment

 

       Heat can exacerbate vasodilation; this leads to dizziness, syncope, orthostatic hypotension

Term
Metropolol  inotrope, chronotrope, dromotrope effects
Definition

       Negative, Negative, Negative

Term
Metropolol effects
Definition

§  Reduces myocardial oxygen demand; aides in treatment of angina by reducing workload of heart, increases oxygen supply

 

§  Slows heart rate; coronary arteries have more diastolic time to fill with oxygen/nutrient-rich blood

Term
Metropolol indications 
Definition
Exertional angina. “Exercise” is individualized
Term
Metropolol adverse effects 
Definition

       Bradycardia/hypotension, dizziness, drowsiness. Non-selective beta blockers and asthma.

Term
Metropolol  teaching
Definition

       Do not stop abruptly; daily weight; reduce orthostatic hypotension

 

 

Term
Diltizem drug class
Definition
calcium channel blocker
Term
Diltizem MOA 
Definition

§  Blocking calcium prevents muscle contraction, promotes myocardial relaxation, coronary arteries dilate; blood flow increases, oxygen supply increases. Dilation of systemic arteries occur as well; decrease in force (resistance); decreases workload of heart and subsequent oxygen demand

Term
Diltizem  indications
Definition
Vasospastic angina
Term
Diltizem adverse effects
Definition

       hypotension

Term

o   Doxasozin (Cardura) drug class

Definition
Alpha 1 blocker
Term

o   Doxasozin (Cardura) MOA

Definition

§  Dilate arteries and veins, reduces peripheral vascular resistance, decreases blood pressure

Term

o   Clonidine (catapres) drug class

Definition

[image]Centrally acting adrenergic drugs

Term

o   Clonidine (catapres) MOA

Definition

§  Stimulating alpha 2 receptors in the brain; receptor stimulation actually reduces sympathetic outflow; results in lack of norepinephrine production; reduces blood pressure

Term

o   Doxasozin (Cardura) indications

Definition
hypertension
Term

o   Clonidine (catapres) indications

Definition
hypertension
Term

o   Clonidine (catapres) contraindicaitons

Definition

§  Those with asthma need to be careful with nonselective beta blocker can cause airway constriction

Term

o   Clonidine (catapres) adverse effects

Definition

[image]Orthostatic hypotension (tell patients to change positions slowly), drowsiness, dizziness. Also rebound hypertension if discontinued abruptly

Term

·         Angiotensin-converting enzyme (ACE) inhibitor

Definition

o   First line treatment for heart failure and hypertension 

Term

·         Angiotensin-converting enzyme (ACE) inhibitor patient adherence

Definition

§  Is more likely because most ACE inhibitors can be given just once a day (longer half-life/duration of action)

Term

·         Angiotensin-converting enzyme (ACE) inhibitor MOA

Definition

§  Inhibit conversion of angiotensin I to angiotensin II. Angiotensin II is potent vasoconstrictor, includes aldosterone, stimulates sodium/water resorption, raise blood pressure. Also prevents breakdown of vasodilator bradykinin

Term

·         Angiotensin-converting enzyme (ACE) inhibitor protective effect on kidneys

Definition

§  Reduced filtration pressure

Term

·         Angiotensin-converting enzyme (ACE) inhibitor contraindications

Definition

§  Baseline potassium level of 5 or higher

 

§  Chronic kidney disease

Term

·         Angiotensin-converting enzyme (ACE) inhibitor adverse effects

Definition

§  Dry, non-productive cough; hyperkalemia (ACE inhibitors promote potassium resorption in the kidney), angioedema (acute)

Term

·         Angiotensin-converting enzyme (ACE) inhibitor interactions

Definition
NSAID’s  can reduce effects of ACEs
Term

·         Angiotensin II Receptor blockers (ARB’s)

Definition

o   The ‘Tan’s

Term

·         Angiotensin II Receptor blockers (ARB’s) MOA

Definition

§  Block binding of angiontensin II to type I angiotensin II receptors (these receptors are located in primarily vascular smooth muscle and adrenal gland. They block vasoconstriction/aldosterone secretion also). ARBS do not cause a cough

Term

·         Angiotensin II Receptor blockers (ARB’s) adverse effects

Definition

§  Upper respiratory infections, headache, occasional dizziness

Term

o   Amlodipine (Norvasc) drug class 

Definition

[image]Calcium-channel blockers

Term

·         Angiotensin II Receptor blockers (ARB’s) indications

Definition
hypertension
Term

o   Amlodipine (Norvasc) MOA 

Definition

§  Smooth muscle relaxation, preventing contraction from occurring

Term

o   Amlodipine (Norvasc) indications

Definition
hypertension
Term

o   Hydralazine hydrochloride drug class

Definition
vasodilator
Term

o   Hydralazine hydrochloride MOA

Definition

§  Directly elicit peripheral vasodilation; reduces systemic vascular resistance, lowers blood pressure. They do not work on adrenergic  receptors, there are not adrenergic-receptor blockers

Term

o   Hydralazine hydrochloride adverse effects

Definition

§  Dizziness, headache, nasal congestion

Term

o   Hydralazine hydrochloride indications

Definition
hypertension
Term
antihypertension assessment
Definition

vital signs, lab tests: sodium, potassium, calcium, magnesium, BUN, creatinine. Also try to find underlying cause for hypertension

o   Assess patient for dizziness, fatigue, orthostatic hypotension

Term
antihypertensive patient teaching
Definition

·         Rebound hypertension:

o   When patient stops taking medications abruptly; can put patient at risk for stroke

·         Patient teaching:

 

o   Daily weight, journaling of blood pressures; monitoring medication side effects, diet, exercise, stress, not smoking

Term

·         Loop diuretics MOA

Definition

o   Block Na/Cl resorption

 

o   Dilation of numerous blood vessels (kidney, lung, peripheral)

Term

o   Furosemide (Lasix) drug class 

Definition

·         Loop diuretic

Term

o   Furosemide (Lasix) indications 

Definition

·         Edema associated with heart failure; hypertension

Term

o   Furosemide (Lasix) adverse effects 

Definition

·         Dizziness, tinnitus, hypokalemia

Term

o   Furosemide (Lasix) administration 

Definition

·         10 mg/minute IV

 

·         If given too fast, patient can lose hearing

Term

·         Osmotic Diuretics MOA

Definition

§  Works along entire nephron

Term

o   Mannitol (osmitrol) drug class

Definition

·         Osmotic Diuretics

Term

 

o   Mannitol (osmitrol) indications

Definition
Cerebral edema, reducing intracranial pressure
Term

o   Spironolactone (aldactone) drug class 

Definition

·         Potassium-sparing Diuretics

Term

o   Spironolactone (aldactone) indications 

Definition

§  Hypertension, cardio-protective; prevents remodeling of ventricle walls

Term

o   Spironolactone (aldactone) adverse effects 

Definition

[image]Hyperkalemia

Term

o   Spironolactone (aldactone) contraindications 

Definition

§  Kidney failure

Term

o   Hydrochlorothiazide (Hydrodiuril) drug class

Definition

·         Thiazide Diuretics

Term

o   Hydrochlorothiazide (Hydrodiuril) MOA

Definition

§  Reduces peripheral vascular resistance; decreased systemic vascular resistance;

§  As renal function decreases, thiazide diuretic lose their efficiencydecreased blood pressure

Term

o   Hydrochlorothiazide (Hydrodiuril) indications

Definition

§  Hypertension, edema

Term

o   Hydrochlorothiazide (Hydrodiuril) adverse effects

Definition
Hypokalemia, impotence
Term
antidiuretic assessment
Definition

o   Obtain baseline electrolyte levels, baseline renal function, vital signs

 

o   Evaluate for orthostatic hypotension

Term
antidiuretic teaching
Definition

·         Dietary teaching

o   Foods high in potassium: bananas, oranges, potatoes, broccoli

 

·         Daily weight, journaling of blood pressures, change positions slowly

Term

o   Hyperkalemia causes

Definition

·         ACE inhibitors, burns, infections, potassium supplementation, potassium-sparing diuretics, renal failure

Term

o   Hyperkalemia symptoms

Definition

·         Muscle weakness, paralysis, cardiac dysrhythmias, cardiac arrest

Term
Hyperkalemia treatment
Definition

·         Sodium polystyrene sulfonate (Kayexelate)

o   Can give PO and rectally

o   Potassium excreted through feces

·         IV administration of D50 with insulin (causes rapid intracellular shift of potassium)

·         Sodium bicarbonate

 

·         Calcium gluconate/chloride

Term

o   Hypokalemia causes

Definition

·         Vomiting, diarrhea, crash diets, loop diuretic use, thiazide diuretic use, malabsorption

Term

o   Hypokalemia early symptoms

Definition

o   Anorexia, hypotension, lethargy, mental confusion, muscle weakness, nausea

Term
Hypokalemia late symptoms
Definition

o   Cardiac dysrhythmias, neuropathy, paralytic ileus, secondary alkalosis

Term
Hypokalemia treatment
Definition

·         Potassium chloride (Klor-Con)

 

o   IV and PO

Term

o   Hypernatremia causes

Definition

·         Poor renal excretion

Term
Hypernatremia symptoms
Definition

·         Dry mucous membranes, weakness, confusion increased thirst, fever, low urine output

Term

o   Hypernatremia treatment

Definition

·         IV fluids (5% or 10% Dextrose in water; producing intravascular sodium dilution and enhanced urine output); diuretics (used to enhance sodium excretion)

Term

o   Hyponatremia causes

Definition

·         Prolonged vomiting, diarrhea, excessive perspiration

Term
Hyponatremia symptoms
Definition

·         Lethargy, confusion, muscle weakness

Term

o   Hyponatremia treatment

Definition

·         Fluid restriction, salt tablets, hypertonic saline (3% or 5%) 

Term
Potassium administration
Definition

Never give potassium replacement in a push or bolus infusion (can cause cardiac arrest)

must be diluted

10 mEq/ hour

Term
Hemostasis
Definition

o   Any process that stops bleeding

Term

·         Coagulation

Definition

o   Hemostasis that occurs by physiologic clotting of blood

Term

·         Thrombus

Definition

o   Technical term for blood clot

Term

·         Embolus

Definition

o   Thrombus that moves from point of origin (can end up anywhere; but if they get in heart, lung, brain)

Term
Extrinsic pathway
Definition
blood vessels are damaged by penetration from outside (knife/ bullet wound)
Term
Intrinsic pathway
Definition
: there is internal damage to blood vessel
Term

·         Anticoagulants MOA

Definition

o   Inhibit action & formation of clotting factors; prevent clots from forming

Term
Antiplatelets
Definition

o   Prevent platelet plugs; inhibiting platelet aggregation

Term
Thrombolytics
Definition

o   Break down clots, or thrombi that have already formed

Term

o   Heparin drug class

Definition

·         Anticoagulant

Term
Heparin MOA
Definition

o   These drugs have no effect on a blood clot that is already formed. By thinning blood; prevent intravascular thrombosis; preventing extension of an established clot or a thrombus

Term
Heparin indications
Definition
High probability of clot formation; MI, atrial fibrillation (prophylaxis)
Term

o   Heparin dosing

Definition

·         Prophylaxis for patients at risk for DVT: for treatment in patients who already have DVT/PE dosing is Continuous IV infusion.

 

·         Weight based

Term
Heparin assessment
Definition

·         Need to check PTT every 6 hours

Term

o   Heparin adverse effects

Definition

·         heparin induced thrombocytopenia

 

o   acute fall in the number of platelets more that 50% from baseline

Term
Heparin toxicity 
Definition

·         signs and symptoms

o   hematuria, blood in stool, eccymoses, bleeding from gums)

 

·         protamine sulfate is antidote for heparin

Term
Heparin half-life
Definition
1-2 hours
Term

o   Warfarin (Coumadin) MOA

Definition

·         Inhibits vitamin K synthesis in GI tract

Term

o   Warfarin (Coumadin) drug class

Definition
anticoagulant
Term

o   Warfarin (Coumadin) interactions

Definition

·         Warfarin and amiodarone; 50% increase in INR

Term

o   Warfarin (Coumadin) administration teaching

Definition

§  Long-acting

·         It takes many days to get Coumadin level therapeutic

 

·         INR is lab value that evaluated Coumadin level

Term

o   Warfarin (Coumadin) toxicity

Definition

·         Stop medication

·         May take 36-42 hours for liver to regenerate clotting factors

·         Vitamin K reverses effects of Warfarin , once given, warfarin resistance will occur for up to 7 days

 

·         Fresh frozen plasma works faster

Term

o   Enoxaparin (lovenox) drug class

Definition
anticoagulant
Term

o   Enoxaparin (lovenox) indications

Definition

§  Bridge therapy

 

·         Given in conjunction with Coumadin until INR is therapeutic; once INR is therapeutic, lovenox is discontinued

Term

o   Enoxaparin (lovenox) toxicity

Definition

·         Protamine sulfate can also be given to reverse effects

Term

·         Antiplatelet drugs MOA

Definition

§  Inhibit platelet aggregation(platelets run to site of injection; recruit other platelets to come to site of injury) disruption of blood flow, trauma, rupture of plaque from vessel wall; they vasoconstrict; limit blood flow to the damaged blood vessel

Term

·         Antiplatelet drugs indications

Definition

§  Stroke, MI prevention; thrombosis

Term

·         Antiplatelet drugs adverse effects

Definition
Thrombocytopenia, GI bleeding
Term

o   Aspirin indications 

Definition
MI/stroke prevention
Term

o   Clopidogrel (Plavix) indications

Definition

§  Stroke prevention/post MI-prevention of thrombosis

Term
Thrombolytic drugs MOA 
Definition

§  Lyse thrombin in the blood vessels in heart/brain. Before stent and coronary intervention; this was the treatment of choice. Natural thrombolytic system takes several days to break down a clot

Term

·         Thrombolytic drugs indications

Definition

§  Acute MI, acute ischemic stroke

Term

·         Thrombolytic drugs adverse effects

Definition

[image]Bleeding

Term

o   Alteplase (t-PA) assessment

Definition
Signs and symptoms of bleeding: gums, stool, urine, shaving
Term

o   Alteplase (t-PA) drug class

Definition

·         Thrombolytic

Term

o   Alteplase (t-PA) implementation

Definition

o   Double or triple check dosing of any coagulation modifier drug

Term

o   Alteplase (t-PA) injections

Definition

o   No injections two inches from umbilicus

Term
HMG-CoA reductase inhibitors The “statins” 
Definition

·         First line of therapy

o   Reduce LDL by 30-40%

o   Reduce triglycerides

 

o   Increase HDL

Term

§  HMG-CoA reductase inhibitors The “statins” teaching

Definition

·         6-8 weeks

 

o   Before therapeutic effect is seen

Term

§  HMG-CoA reductase inhibitors The “statins” adverse effects

Definition

o   Decreased liver function

 

o   Muscle pain which can lead to rhabdomyolysis (breakdown of muscle protein that is excreted in urine; which can cause severe strain on kidneys) patient should report muscle pain or discomfort immediately

Term

§  Bile Acid sequestrants 

Definition

·         Second line of defense

Term

·         Cholestyramine (questran) drug class

Definition

§  Bile Acid sequestrants

Term

·         Cholestyramine (questran) MOA

Definition

o   Prevent resorption of bile acids from small intestine.

 

o   Bile acids are excreted in feces resulting in liver converting cholesterol to bile acids

Term

·         Cholestyramine (questran) adverse effects

Definition

[image]Constipation, bloating, patients need to increase amount of fiber intake)

Term
Gastric mucous
Definition

o   Protective coating against digestive process of hydrochloric acid/digestive enzymes

Term

·         Gastric parietal

Definition

o   Secrete hydrochloric acid; primary site of action for many drugs used to treat acid-related enzymes

Term

·         Gastric chief

Definition

o   Secrete

 

§  1) pepsinogen 2) exposed to acid 3) becomes pepsin 4) breaks down proteins

Term

·         Helicobacter pylori

Definition
Helicobacter Pylori implicated in patho of PUD
Term
Helicobacter pylori  presence
Definition
Age, Increased presence with ulcers, Found in 90% of duodenal ulcers
Term
Helicobacter Pylori treatment
Definition
proton-pump inhibitor for 10-14 days
Term

·         Stress ulcer factors

Definition

§  Decreased perfusion, NG tube placement; patients on ventilators, ICU stays; steroid use

Term
Stress ulcer treatment 
Definition
H2 blocker/proton pump inhibitor
Term
Antacids MOA
Definition

§  Neutralize stomach secretions

§  Reduction of symptoms associated with acid-related disorders (pain/heartburn)

 

§  Do not prevent overproduction of acid

Term
Antacids adverse effects
Definition

[image]Magnesium-containing: diarrhea

Term

o   Magnesium hydroxide (milk of magnesia) drug class

Definition
Antacid
Term

·         H2 receptor-antagonists MOA

Definition

§  Block H2 receptor of acid-producing parietal cells; less responsive to histamine AND less stimulation of HCl

 

§  Reduce acid secretions

Term

·         H2 receptor-antagonists indications

Definition

§  Treatment of : GERD, PUD, erosive esophagitis

Term

·         H2 receptor-antagonists adverse effects

Definition

[image]Central nervous system seen in the elderly (confusion/disorientation)

Term

o   Famotidine (Pepcid) drug class 

Definition

·         H2 receptor-antagonists

Term

·         Proton Pump inhibitors MOA

Definition

§  Blocking pump prevents movement of hydrogen ions out of parietal cells; blocks HCL production

Term

·         Proton Pump inhibitors indications

Definition

[image]Symptomatic treatment of GERD that is not responding to H2-receptor blockers; short term treatment of active ulcers

Term

o   Pantoprazole (protonix) drug class 

Definition

·         Proton Pump inhibitors

Term

·         Diarrhea causes acute and chronic

Definition

§  Acute: drugs, bacteria, viruses

 

§  Chronic: tumors, AIDS, diabetes, IBS 

Term

o   Opiates MOA

Definition

·         Decrease transit time of food through GI tract; increases absorption of water/electrolytes

Term
Opiates indications
Definition

·         Used in more severe cases of diarrhea

Term
Opiates interactions
Definition

[image]Additive CNS depressant effects; respiratory depression and potential for dependency

Term

§  Loperamide (Imodium) drug class

Definition
opioid antidiarrheal
Term

o   Intestinal flora modifiers MOA

Definition

·         Replenishing good bacteria in GI tract; which can be destroyed from use of antibiotics

Term

o   Intestinal flora modifiers indications

Definition

·         Antibiotic-associated diarrhea

Term

§  Lactobacillus acidophilus (bacid) drug class

Definition

o   Intestinal flora modifiers

Term

o   Emollient MOA

Definition

·         Directly lubricate, soften stool and intestines, lowering surface tension of GI fluids; more water and fat are absorbed into stool

Term
Emollient indications
Definition

fecal impaction, acute and chronic constipation

does not cause patient to defecate, they simply soften the stool to ease its passage

Term

§  Docusate sodium (colace) drug class

Definition
Emollient
Term

o   Hyperosmotic MOA

Definition

·         Increasing fecal water content, distention, increased peristalsis and evacuation

Term

o   Hyperosmotic indications

Definition

·         bowel prep for diagnostic/surgical procedures

Term
Hyperosmotic adverse effects
Definition

[image]Abdominal bloating, rectal irritation

Term

§  Polyethylene glycol (golytely/miralax) drug class

Definition
Hyperosmotic
Term

o   Stimulant MOA

Definition

·         Stimulate nerves that innervate intestines; increased peristalsis; increased bulk

Term
Stimulant indications
Definition
acute constipation
Term
Stimulant adverse effects
Definition

[image]Gastric irritation/rectal irritation

Term

§  Senna (senokot) drug class

Definition
Stimulant
Term
assessment for anticonstipation drugs
Definition

§  Inspection, auscultation, percussion, papation. Stool assessment

Term

o   Scopolamine (transderm-scop) drug class

Definition
anticholinergic anti-emetic
Term

o   Scopolamine (transderm-scop) MOA

Definition

[image]Also block transmission of nauseating stimuli from the reticular formation to the VC

Term

o   Meclizine (antivert) drug class

Definition
Histamine 1 receptor blocker/ anti-nausea
Term

o   Meclizine (antivert) MOA

Definition

§  Block H1 receptors; which inhibits vestibular stimulation

Term

o   Meclizine (antivert) indications

Definition
vertigo
Term

o   Promethazine (Phenergan) drug class 

Definition
antiemetic/antinausea antidopaminergic
Term

o   Promethazine (Phenergan) MOA 

Definition
Block dopamine receptors primarily in the chemoreceptor trigger zone
Term

o   Promethazine (Phenergan) adverse effects 

Definition
Sedation, hypotension, respiratory depression
Term

o   Metoclopramide (reglan) drug class

Definition
prokinetics
Term

o   Metoclopramide (reglan) MOA

Definition

§  Primarily: stimulate peristalsis on GI tract; enhances emptying of stomach contents;

 

§  Secondary: blocking dopamine receptors in CTZ

Term

o   Metoclopramide (reglan) indications

Definition

§  gastroparesis/GERD

Term

o   Metoclopramide (reglan) adverse effects

Definition

[image]Tardive dyskinesia

Term

o   Ondansetron (Zofran) drug class

Definition

·         Serotonin blockers

Term

o   Ondansetron (Zofran) MOA

Definition

§  Block receptors in GI tract, CTZ, and vomiting center

Term

o   Ondansetron (Zofran) indications

Definition

§  Chemotherapy induced nausea and vomiting

 

§  Nausea and vomiting associated with pregnancy

Term
Phenergan IV
Definition
given IV, diluted in at least 10 ml of fluid and run at the port furthest from vein. If burning and pain develops, stop immediately
Term

·         Vitamins

Definition

o   Organic molecules, normal metabolism and growth and repair of tissues

Term

·         Minerals

Definition

o   Inorganic elements found naturally in the earth

Term

·         Enzymes

Definition

o   Proteins secreted by cells

 

o   Act as catalysts to induce chemical changes

Term

·         Coenzymes

Definition

o   Enhances/necessary for action of enzymes

Term

·         Fat soluble

Definition

o   Stored longer in liver/adipose tissues

o   Present in plant, animal foods

 

o   Excreted via feces

Term

       Water-soluable 

Definition

       easily excreted in urine

Term

Vitamin A indications

Definition

       essential for night vision/normal vision

Term

Vitamin A deficiency s/s

Definition

       night blindness; keratomalacia (softening of cornea); generalized weakness

Term

Vitamin A toxicity s/s

Definition
drowsiness/delirium/coma
Term

Vitamin D  indications

Definition
proper utilization of calcium and phosphorous in body/bone calcification
Term

Vitamin D deficiency 

Definition
long-term: rickets/tetany/osteomalacia (softening of bones)
Term

Vitamin D toxicity 

Definition
weakness/fatigue/metallic taste
Term

Thiamine indications

Definition

       integrity of peripheral nervous system, cardiovascular, & GI systems

Term

Thiamine deficiency

Definition

       seen in patients with malabsoption issues (etoh use, liver cirrhosis, GI diseases) - alcoholics 

Term

Vitamin B12 indications 

Definition

       a lot of things: fat/carbohydrate metabolism/protein synthesis/growth/cell replication/blood cell production 

Term

Vitamin B12  deficiency

Definition

       resulting of: malabsorption and/or poor dietary intake (strict vegetarian diet). Deficiency: if not treated leads to pernicious anemia -decrease in RBC that occurs when your intestines cannot properly absorb vitamin B12. The goal of treatment is to increase your vitamin B12 levels.

       Treatment involves a  shot of vitamin B12 once a month. Persons with severely low levels of B12 may need more shots in the beginning.

 

 

 

Term

Vitamin C (ascorbic acid) indications

Definition

       Erythropoiesis (RBC production)/protein & lipid synthesis ALSO for prevention and treatment of scurvy

Term

Vitamin C megadosing 

Definition
can lead to acidification of the urine; resulting in renal stones
Term

Vitamin C deficiency

Definition
skurvy
Term

Calcium indications

Definition

       development and maintenance of bones/teeth; nerve impulse transmission/contraction of cardiac, smooth, and skeletal muscle 

Term
Calcium toxicity
Definition
cardiac irregularities/delirium/coma; may require hemodialysis
Term

Lorazepam (Ativan) drug class

Definition
Benzodiazepine 
Term

ü  Lorazepam (Ativan) MOA

Definition

                                                                i.      Depresses activity in the central nervous system (CNS)

 

                                                              ii.      Thought to be GABA receptors

Term
Ativan adverse effects
Definition

                                                                i.      Dizziness, drowsiness, confusion, cognitive impairment, vertigo, lethargy

Term
benzodiapepine antidote
Definition
Flumazenil (romazicon)
Term
Ativan indications
Definition
anxiety
Term
Ambien drug class
Definition
non benzo hypnotic
Term
Ambein MOA
Definition
CNS depressant; Inhibits stimulation of brain
Term
Ambien adverse effects 
Definition
Sleep walking, amnesia, hallucination, high dose cause rebound insomnia, headache
Term
Ambien implementations 
Definition

§  have someone present when starting medication, fall precautions, avoid alcohol/driving/using heavy equipment

Term
Ambien assessment 
Definition
– HR, RR, confusion, dependency
Term
Phenobarbital drug class 
Definition
Barbiturate
Term
Phenobarbital indications 
Definition
epileptic seizures
Term
Phenobarbital MOA 
Definition
Brain stem, depresses excitable tissue
Term
Phenobarbital adverse effects 
Definition

§  Dizz/Drowz, Liver/Leth, low RR/HR

Term
Phenobarbital IV 
Definition
give slowly, Pain-Stop IV, Extravasation-Stop IV
Term
Flexeril indications 
Definition
tense muscles
Term
Flexeril  MOA
Definition

§  CNS depressant; central acting muscle relaxant; sedation rather than stimulation

Term
Flexeril adverse effects 
Definition

§  – Lightheaded; drowz; fatigue; muscle weakness; confusion

Term
Flexeril assessment
Definition
patent airway, rr, level of consciousness
Term
Ritalin MOA 
Definition

§  CNS stimulation through mental alertness; blocks reuptake norepi/dopamine; mood elevation; euphoria; decreased fatigue; prolonged wakefulness

Term
Ritalin adverse effects 
Definition

§  Tachycardia; anxiety/insomnia; chest pain/headache; tremors; GI distress; Increased ab pain/vomiting

 

§  TACT GI

Term
Ritalin indications 
Definition
ADHD
Term

ü  Caffeine Supplement MOA 

Definition

§  stimulant that inhibits breakdown cAMP; affects medulla/spinal cord

Term

ü  Caffeine Supplement adverse effects 

Definition

§  diarrhea, tachycardia, dsrythmia, tachypnea, tremors, flush/sweating, insomnia, muscular tension/tremors, reduced deep tendon reflexes

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