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pharm final extra stuff
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48
Pharmacology
Undergraduate 3
07/26/2012

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Term
normal creatinine
Definition
.5-1.5-1.8
Term
nromal creatinine clearance
Definition
85-135 ml/min requires full 24 hour urine sample
Term
with renal impairment, serum creatine ...
Definition
goes up, but urinary clearance will go down
Term
calcium levels
Definition
9-11 mg/dl
Term
phosphorous levels
Definition
3-4.5
Term
when calcium goes up, phosphorous goes..
Definition
down
Term
what does Phoslo do?
Definition
binds to phosphate to decrease serum phosphorous in patients w ESRD. TAKE WITH EACH MEAL
Term
problems with Phoslo
Definition
pts w hypercalcemia, do not use extra calcium supplements
Term
iv calcium supplements, watch for..
Definition
hypotension, vasoconstriction, and arrythmias
Term
po calcium supplements.. watch for..
Definition
nausea, constipation, fecal impactions
Term
sxs hypocalcemia
Definition
chvostek's sign- cheek
trousseau's sign- chek with bp cuff inflated for 3 min
Term
hypercalcemia causes
Definition
cancer, TPN, blood transfusions, excess calcium,
Term
tx of hypercalcemia..
Definition
furosemide+fluids
Term
causes of hypocalcemia
Definition
parathyroid surgery, removal, electrolyte imbalances
Term
tx for hypocalcemia..
Definition
ca gluconate- for Cardiac problems- I amp Calcium Chloride- push reaaaal slow
Term
A low HCT (below 36) indicates
Definition
hemodilution, fluid overload
Term
a hematocrit over 36% is indicative of
Definition
hemoconcentration- dehydration
Term
normal BUn
Definition
10-20
Term
Increased BUN? Decreased BUN?
Definition
increased = dehyrdation, excessive protein intake, and impaired renal function. Decreased= overhydration, liver damage, malnutrition
Term
dehydration will cause your sodium to..
Definition
go hypernatremic
Term
hypotonic solutions shifts fluid..
Definition
out of vessels into cells- hydrates cells- this may worsen hypotension (.45% NS, .25% NS, 5% dextrose+water
Term
isotonic solutions affect fluid how?
Definition
no fluid shift, vascular expansion, replaces electrolytes (lactated ringers) may cause fluid overload
Term
hypertonic solutions affect fluid ..
Definition
by shifting fluids back into circulation- vascular expansion, replaces electrolytes- can cause fluid oveload- may cause hypernatremia- .9% NS
Term
lactated ringers shouldnt be used in pts with renal failure bc..
Definition
it could cause hyperkalemia
Term
normal saline shouldnt be used in pts with..
Definition
heart failure, edema, or hypernatremia- can lead to overload
Term
remedy for severe hyperkalemia..
Definition
calcium salts, glucose and insulin infusion. if acidotic- give sodium bicarbonate
Term
difference between febrile and hemolytic reactions
Definition
febrile- fever chils anxiety, tachy tachypnea, headache..
hemolytic- chest pain, low back pain, decreased BP, increased respiratory rate, fever tachy chills, HEMOGLOBULINURIA
Term
Pts being given narcan should watch for..
Definition
withdrawal, don't administer too quickly
Term
antidote to benzo overdose
Definition
romazicon- flumazenil, needs repeated dosing bc of short half life
Term
fentanyl is stronger than..
Definition
morphine
Term
fentanyl is very easy to..
Definition
overdose on so be careful
Term
demerol is useful for..
Definition
rigors from ampho B, or port anesthesia shivering
Term
problems with demerol..
Definition
interactions, breaks down to a toxic metabolite therefore only give for max of 48 HOURS- and max 600 mg/24 hours.. can cause SEIZURESSS don't mess around with demerol bro.
Term
hydrocodone is more potent than..
Definition
codene- if allergic to codene, may be able to tolerate hydrocodone
Term
codeine may be ineffective on some ppl because..
Definition
unable to convert into morphine bc of lack of specific enzyme - so it has no effect
Term
codeine is what compared to vicodin
Definition
doesn't have the same street value, yo. its less desirable in other words.
Term
oxycodone controlled release tablets are dangerous bc..
Definition
ppl are crushing them and using them all at once- deadly
Term
darvon is??
Definition
opioid thats off the market bc of serious potential heart risks
Term
tramadol can cause..
Definition
seizures
Term
DI for tramdaol
Definition
ssris- serotonin syndrome, maoi-hypertensive crisis
Term
sxs serotonin syndrome
Definition
agitation/restless, confusion, tachy labile BP, fevers, NVD, sweating ataxia, tremors
Term
max recommended dose for tylenol
Definition
3000mg/24hr
Term
apap overdose risks
Definition
alcohol, hep c, leading cause of liver failure- causes hepatic necrosis 48-72hrs after ingestion
Term
antidote for acetlysteine
Definition
mucomyst! dilute w/ juice, give loading dose, then q4hr, very unpleasant to digest, so frequently given by iv or inhalation
Term
caan give higher dose of iburpofen than..
Definition
naproxen
Term
sxs of lidocaine toxicity
Definition
cns excitiation, confusion, seizures, followed by depression in resp rate and cardiac effects- blocks heart conduction-
Term
what is lidocaine also used for
Definition
antiarrhthmic iv after cardiac arrests
Term
what does versed do
?
Definition
used for conscious sedation- watch for resp deprs
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