Term
| Inhibits reabsorption of sodium and chloride, blocks chloride pump, increasing the excretion of sodium, chloride, and water by the kidneys. |
|
Definition
| Thiazide Diretics, Hydrochlorothiazide |
|
|
Term
oAdjunctive therapy for edema associated with HF, cirrhosis, corticosteroid or estrogen therapy, and rectal dysfunction
oTreatment of hypertension as monotherapy or in combination with other antihypertensives |
|
Definition
|
|
Term
| What are the side effects of Hryrochlorothiazide |
|
Definition
Hypokalemia
Hyperglycemia
Hyponatremia
Hyperuricemia
Muscle Cramps |
|
|
Term
| What are some contraindications of thiazide diuretics? |
|
Definition
-Not use if creatinine clearance <30 to 50 mL/min (normal is 125 mL/min)
-Allergy to thiazide or sulfonamides
-Fluid and electrolyte imbalance
-Pregnancy:alter baby liver function
-Lactation
-Renal and liver failure
-Gout
-Bipolar disorder:because of use of lithium,increase toxicity |
|
|
Term
| What are some drug-drug interactions of Hydrochlorothiazide? |
|
Definition
-Lithium
-NSAIDS
-Antidiabetic agents
-Digoxin
-Muscle relaxants |
|
|
Term
| What are some signs of OD? |
|
Definition
anorexia, N, lethargy, muscle weakness, mental confusion, and hypotension
|
|
|
Term
| What is the treatment of OD? |
|
Definition
| Treatment: electrolyte replacement |
|
|
Term
| Dosage exceeding____may rarely produce additional clinical results?Why? |
|
Definition
| 50mg/day due to ceiling effect |
|
|
Term
What drug is used to treat edema associated with HF, liver disease, nephrotic syndrome, and ascites
-Acute pulmonary edema
-Hypertension (usually HTN caused by HF) |
|
Definition
|
|
Term
| What is the mechanism of action for Furosemide(Lasix)? |
|
Definition
Inhibits the reabsorption of Na and Cl from the distal renal tubules and the loop of Henle, leading to a sodium rich diuresis
-Potassium wasting
-Increase renal prostaglandins: causing dilation of blood vessels
-Decrease peripheral vascular resistance, fluid volume, BP, pulmonary vascular resistance, systemic vascular resistance, central venous pressure, and left ventricular end-diastolic pressure |
|
|
Term
| What are the adverse effects of Lasix? |
|
Definition
-Hypokalemia
-Hyperglycemia
-Tinnitus
-Thrombocytopenia |
|
|
Term
| Loop diuretics are structuallry similar to ______, this contraindicated with what? |
|
Definition
|
|
Term
| WHat drug is 40x more powerful than Lasix, shorter acting? |
|
Definition
|
|
Term
| Is lasix given fast or slow? |
|
Definition
| slow, if given fast can cause ototoxicity |
|
|
Term
| What kind of supplements are usually given with loop diuretics? |
|
Definition
|
|
Term
| What are some dru-drug interactions for Lasix? |
|
Definition
NSAIDS-decreased diretic activity
Thiazide-increase diuretic activity
neutotoxic and nephrotoxic properties |
|
|
Term
| What are some contraindications for Lasix? |
|
Definition
Allergy
Lactating Women
Infants
Pt. w/anuria and hypovolemia
Severe electrolyte loss |
|
|
Term
What drug Inhibits carbonic anhydrase, which decreases aqueous humor formation in the eye, intraocular pressure, and hydrogen secretion by the renal tubules
-Slows down movement of H ions
-Increases Na, K, and bicarbonate loss in urine |
|
Definition
|
|
Term
Which drug is used for Adjunctive treatment of open angle glaucoma and secondary glaucoma
-Preoperative use in acute angle closure glaucoma when delay of surgery is indicated
-Edema caused by HF
-Drug-induced edema
-High altitude sickness |
|
Definition
|
|
Term
| What are some adverse effects of Acetazolamide (Diamox) |
|
Definition
-Hematuria
-Photosensitivity
-Melena (black tarry feces)
-Hypokalemia
-Paresthesias
-Metabolic Acidosis |
|
|
Term
1.Drug-drug interactions of Diamox?
2.They will increase the effects of what drugs? |
|
Definition
1.Corticosteroids, Didgitalis
2.Amphetamines, Carbamazepine, Cyclosporine, Phytoin, and Quinidine |
|
|
Term
What drug Competitively blocks the effects of aldosterone in the renal tubule, causing loss of sodium and water and retention of potassium
-Decrease BP
-Acts as aldosterone antagonist: competes with aldosterone for receptor sites |
|
Definition
| Spironolactone(Aldactone) |
|
|
Term
What drug is used to treat primary hyperaldosteronism
-Adjunctive therapy in the treatment of edema associated with HF, nephrotic syndrome, hepatic cirrhosis
-Treatment of hypokalemia
-Adjunct with thiazide or loop diuretic
-Hirsutism (polycystic ovary) |
|
Definition
| Spironolactone(Aldactone) |
|
|
Term
| What are some adverse effects of Aldactone? |
|
Definition
-Hyperkalemia
-Hirsutism
-Gynecomastia
-Deepening of the voice
-Irregular menses/amenorrhea
-Postmenopausal bleeding
-Dizziness
-HA |
|
|
Term
| What are some contraindications of Aldactone? |
|
Definition
-Hyperkalemia (> 5.5)
-Severe renal failure
-Anuria |
|
|
Term
| What are some drug-drug interactions of aldactone? |
|
Definition
-Lithium: lithium toxicity
-ACE inhibitors: hyperkalemia
-K supplements: hyperkalemia
-NSAIDs: inhibit renal prostaglandins |
|
|
Term
| WHat are aldactone and lasix given together? |
|
Definition
| To promote diuresis, but decrease risk of hypokalemia |
|
|
Term
| WHats the action of aldactone? |
|
Definition
| Blocks aldosterone excrete water, sodium but retains potassium |
|
|
Term
| What drug has the greatest antihypertensive activity of K sparing diuretics? |
|
Definition
|
|
Term
Which drug Inhibits reabsorption of Na and H2O
-Elevates the osmolarity of the glomerular filtrate, leading to a loss of water, sodium, and chloride |
|
Definition
|
|
Term
| What are adverse effects of Mannitol (Osmitol)? |
|
Definition
-Convulsions
-Thrombophlebitis
-Pulmonary Congestion
-Tachycardia |
|
|
Term
| Treatment with Mannitol (Osmitol) may be terminated if________develops after initiation of therapy? |
|
Definition
| Severe Cardiac or renal Impairment |
|
|
Term
| Mannitol (Osmitol) may _______when exposed to low temp.? |
|
Definition
|
|
Term
| What do you need to check mannitol container for before administering? |
|
Definition
|
|
Term
| When assessing for therapeutic effects of mannitol, the nurse would expect to see? |
|
Definition
| Decreased intracranial pressure |
|
|
Term
| A common clinical manifestation of hypokalemia is_________ |
|
Definition
|
|
Term
| The nurse would question the health care provider if which type of diuretics is prescribed to a patient with gout? |
|
Definition
| Carbonic anhydrase inhibitors |
|
|
Term
| What are some herbs that may increase bleeding? |
|
Definition
•Capsicum
•Garlic (in large doses)
•Ginger
•Ginko
•Ginseng
•Feverfew
•Licorice |
|
|
Term
| What medications are used for prevention and treatment of venous thrombosis and pulmonary emboli; treatment of atrial fibrillation with embplization; diagnosis and treatment of DIC, prevention of clotting in blood samples and heparin locksets. |
|
Definition
|
|
Term
| WHat drug works by ihibiting thrombus and clot production by blocking the conversion of prothrombin to thrombin and fibrinogen to fibrin |
|
Definition
|
|
Term
What drug is Synthetic-fractionated-smaller molecular structure and
Works by ihibiting thrombus and clot production by blocking the conversion of prothrombin to thrombin and fibrinogen to fibrin |
|
Definition
|
|
Term
| This heparin diffes in that if is much more specific for factor X (Xa) in the coagulation cascade therefore has a more predictable anticoagulant response= this means that the frequent aPTT monitoring is not needed with this med |
|
Definition
|
|
Term
This drug is typically derived from animal sources
-Short half life 1-2 hours
-Only given Sub Q or IV
-Monitored by activated partial thromboplastin times (aPTT’s) |
|
Definition
|
|
Term
| The antidote is Protamine sulfate |
|
Definition
|
|
Term
| What should you do with sub-Q doses of LOvenox and Heparin? |
|
Definition
•Give in areas of deep subcutaneous fat and sites are rotated
•Not given within 2” of umbilicus, abdominal incision, open wound, scar, drainage tube, or stoma
•Do not aspirate
•Do not massage site |
|
|
Term
| What is Lovenox contraindicated in? |
|
Definition
| Contraindicated in pts with an indwelling epidural catheter, they can be given 2 hrs after catheter is removed-will get epidural hematoma |
|
|
Term
•Used in thromboprevention and treatment in DVT, PE, atrial fibrillation, post-MI status
•Available in oral form only
•Monitored by Prothrombin time (PT), INR (PT-INR) normal 1, therapeutic 2-3.5 |
|
Definition
|
|
Term
| What is the antidote of Warfarin(Coumadin) |
|
Definition
| •The antidote is Vitamin K (phytonadione) |
|
|
Term
| The nurse would assess which laboratory value to determine the effectiveness of intravenous heparin? |
|
Definition
| Activated partial thromboplastin time (aPTT) |
|
|
Term
| The nurse understands that a patient’s international normalized ratio (INR) value of 2.5 means that? |
|
Definition
| the patient’s warfarin dose is therapeutic |
|
|
Term
| WHat drug is used in the reduction of risk of recurrent transient ischemic attacks (TIA’s) or strokes in men with a history of TIA due to fibrin or platelet emboli; reduction of death or nonfatal MI in pts with a history of infarction of unstable angina, MI prophylaxis, also used for its anti-inflammatory, analgesic, and antipyretic effects |
|
Definition
|
|
Term
| What dose is baby aspirin considered? |
|
Definition
|
|
Term
| While preparing a patient with acute chest pain for an emergency angioplasty, the nurse would anticipate administering which of the following medications to prevent platelet aggregation? |
|
Definition
|
|
Term
| Enoxaparin sodium (Lovenox) is an anticoagulant used to prevent and treat deep vein thrombosis and pulmonary embolism. This drug is in which drug group? |
|
Definition
| Low Molecular Weight Heparin |
|
|
Term
| Before emergency surgery, the nurse would anticipate administering which medication to a patient receiving heparin? |
|
Definition
|
|
Term
| Activase is a _________ drug that can interfere with the body’s clotting ability. Therefore all________ procedures should be completed before administering this drug. |
|
Definition
|
|
Term
| The nurse formulates a plan of care for a patient receiving heparin based upon which nursing diagnosis? |
|
Definition
|
|
Term
| While observing a patient self-administer enoxaparin (Lovenox), the nurse identifies the need for further teaching when the patient |
|
Definition
| Massages the site after medication administration |
|
|
Term
| what is the advantage of taking low molecular weight heparin? |
|
Definition
| Causes fewer systemic adverse effects |
|
|
Term
| What drug Lysis of pulmonary emboli , dissolve thrombi in arteriovenous catheter and IV catheter-this reestablishes blood flow |
|
Definition
|
|
Term
WHat drug has a action to activate the conversion of plasminogen to plasmin, the enzyme that breaks down a clot,(which is capable of digesting fibrin)
Naturally occurring t-Pa , made from ovaries of hamsters
-Short half life, 5 mins
-Opens arteries rapidly, but short lived action, therefore given with heparin to prevent reoccurance of the occlusion |
|
Definition
|
|
Term
What drug is indicated in Acute MI
-Arterial thrombosis
-DVT
-Occlusion of shunts/catheters
-PE
-Acute ischemic stroke |
|
Definition
|
|
Term
| What are some adverse effects of Ateplase? |
|
Definition
-Angioneurotic edema
-Skin rash
-Hypotension
-Internal bleeding |
|
|
Term
| Where should you Monitor for signs of excessive bleeding? |
|
Definition
-IV sites
-Gums while brushing teeth
-Unexplained nosebleeds
-Heavier menstral bleeding
-Bloody/tarry stools
-Bloody urine or sputum |
|
|
Term
| WHat drug is a heparin agonist –used in heparin OD? |
|
Definition
|
|
Term
| How does protmaine sulfate work as an antidote for Heparin? |
|
Definition
| by combining with heparin, protamine causes a dissociation of the heparin-antithrombin III complex, resulting in loss of its anticoagulant activity |
|
|
Term
| What is protmaine sulfate contraindicated in? |
|
Definition
| In allergy or allergy to fish |
|
|
Term
| Protamine is a weak__________when administered in the absence of heparin or in doses larger than those required to neutralize heparin,but it is not used as an ________ |
|
Definition
1.anticoagulant
2.anticoagulant |
|
|
Term
| This is the antidote to warfarin (Coumadin) |
|
Definition
|
|
Term
| What is Vitamin K contraindicated in? |
|
Definition
| hypersensitivity, severe hepatic disease, last few wks of pregnancy |
|
|
Term
| What are some adverse effects of Vitamin K? |
|
Definition
Headache
Brain damage (when used in lg. doses)
Hemolytic anemia
Hemoglobinurina
Hyperbilirubinemia
Rash, urticaria
Bronchospasm
Dsypnea
Respiratory arrest |
|
|
Term
| What drug is Given with the body is deficient in potassium (hypokalemia? |
|
Definition
|
|
Term
| What are some sources of Potassium? |
|
Definition
oBananas, oranges, apricots
oDates, raisins, broccoli
oGreen beans, potatoes
oTomatoes, legumes
oMeats, fish
oWheat bread |
|
|
Term
| For oral potassium chloride, what should you do to minimize GI irritation? |
|
Definition
| Dilute in water or fruit juice |
|
|
Term
| What should the IV rate not exceed for potassium chloride? |
|
Definition
| Rate not exceed 20 mEq/hour |
|
|
Term
| What should you NEVER give as IV bolus or undiluted |
|
Definition
|
|
Term
| What drug is used to treat treat hyperkalemia and usually given orally via NG tube or enema? |
|
Definition
| Sodium polystyrene sulfonate resin (Kayexalate) |
|
|
Term
| How does Kayexalate work? |
|
Definition
| It works in the intestine where potassium ions from the body are exchanged for sodium ions in the resin |
|
|
Term
What drug is used in the treatment for hypercholesterolemia
oMost potent LDL reducer and triglycerides
oAdjunct to diet
oCan increase HDLs |
|
Definition
|
|
Term
WHich drug prevents resorption of bile acid from small intestine
-Bile acid necessary for absorption of cholesterol
-Hypercholesterolemia
-Relief of pruritus associated with partial biliary obstruction
-May be used with statins |
|
Definition
| Cholestyramine (Questran) |
|
|
Term
| While taking Questran, how do you take it? |
|
Definition
| Mix thoroughly in fruit or other fluids |
|
|
Term
| How long should the Questran powder be dissolved? |
|
Definition
|
|
Term
| CAN you take Questran in powder form? |
|
Definition
| NO, you cen never take Questtan in powder form |
|
|
Term
| Cholestyramine(Questran) should never be taken when? |
|
Definition
| Just defore meals or with meals |
|
|
Term
| What kind of patient should not take Questran? |
|
Definition
| A patient with PKU , because os aspartane |
|
|
Term
| Cholestyramine can cause ________thus increasing ________in diet is appropriate |
|
Definition
|
|
Term
| The nurse plans which of the following interventions to decrease the flushing reaction of niacin? |
|
Definition
| Administer aspirin 30 minutes before nicotinic acid |
|
|
Term
| HMG-CoA reductase inhibitors (statins) are generally administered at which time |
|
Definition
|
|
Term
| What is the mechanism of action of ezetimibe (Zetia)? |
|
Definition
| Inhibiting absorption of dietary and biliary cholesterol in the small intestine |
|
|
Term
| Cholestyramine (Questran) decreases lipid levels by |
|
Definition
| binding to bile in the intestinal tract, forming an insoluble complex that is excreted in the feces |
|
|
Term
| Atorvastatin (Lipitor) decreases lipid levels by |
|
Definition
| inhibiting HMG-CoA reductase, the enzyme responsible for the biosynthesis of cholesterol in the liver |
|
|
Term
| Which test will the nurse use to assess for adverse reactions to HMG-CoA reductase inhibitors? |
|
Definition
|
|
Term
| NIacin is also known as vitamin___ |
|
Definition
|
|
Term
| A patient with elevated triglyceride levels unresponsive to HMG-CoA reductase inhibitors will most likely be prescribed which drug? |
|
Definition
|
|
Term
| What is a nursing consideration for QUestran? |
|
Definition
| -Drink 2-3 liters of fluid daily to prevent constipation |
|
|
Term
| With Questran take other meds when_____ |
|
Definition
| Take other meds 1 hour before or 4-6 hours later |
|
|
Term
| With Questran they decrease the absortion of which vitamins? |
|
Definition
|
|
Term
WHich drug is Thought to increase activity of lipase, which breaks down lipids
oReduces metabolism/catabolism of cholesterol and triglycerides
oIncreases HDL
oLowers cholesterol and LDL |
|
Definition
|
|
Term
| What are adverse effects of NIacin |
|
Definition
oFlushing
oPruritus
oGI distress |
|
|
Term
| Which are contraindications of Niacin |
|
Definition
oAllergy
oLiver disease
oHypertension
oPeptic ulcer
oActive hemorrhagic process |
|
|
Term
| WHich drug is used as an adjunct to diet and exercise to lower serum cholesterol levels and treats Hypercholesterolemia |
|
Definition
|
|
Term
| Which drug works in the brush border of the small intestine to inhibit the absorption of cholesterol |
|
Definition
|
|
Term
| What are some adverse effects of Zetia? |
|
Definition
HA
Dizziness
Abdominal pain
Diarrhea
Myalgia
Arthalgia |
|
|
Term
| What is important to emphasize in patient teahcing with antilipemic meds? |
|
Definition
| Report muscle pain immediately |
|
|
Term
| What is the range for potassium |
|
Definition
|
|
Term
| What is the range for sodium |
|
Definition
|
|
Term
| When planning administration of hypertonic saline solution to treat a patient with severe hyponatremia, the nurse monitors for signs and symptoms of overdose as manifested by |
|
Definition
| flushed skin and increased thirst. |
|
|
Term
| 5. The nurse is caring for a patient with an acute renal insufficiency and thrombocytopenia. Along with platelet transfusions, the nurse would expect to administer which substance to increase deficient clotting factors in this patient |
|
Definition
|
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