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51 Cards in this Set
- Front
- Back
Insulins
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R - Humulin and Novolin O-30m-1h, peak- 2-4h, d-5-7h
NPH - Humulin and NovolinO-1-2 h, P- 8-12h, D-18-24h Lispro- Humalog- O-15m, P-30-90 m, D - 5 h - less hypogl Lantus - insulin glargine- sustained release - SQ at bed-never mix! inhaled - O-15m, P-30-90m, D-4-6h ----------------------------- increase: Ace inhibitors,alcohol,anaboli steroids,antidiabetic drugs,oral, beta blockers decrease: adrenergics, corticosteroids, estrogens, glucagon, propranolol/Inderal thiazide diuretcs |
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Oral Hypoglycemics Agents
use with pts with Type 2 with some insulin - never on type 1 |
Biguanides-metformin/Glucophage works at cell level- Mala
Glitazones- rosiglitazone/Avandia - cell level - may cause CHF - liver dysfunctions - Meglitinides- repaglinide/Prandin - excreted by kidney not liver drug intera & not elderly pt neuroendocrine Hormone- symlin/amylin - CNS requlates bld. glucose levels-do not mix in same syr P1-2h, D3-5h |
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Thyroid Hormones
+O2, +heat prod, +CO, -Chol.,lose wgt |
Thyroid & Parathyroid
Anterior & Posterior Pituitary Gonadal -----------------------------drugs that decrease the effect: antihypertensives, estrogens, propranolo (inderal) phenytoin, rifampin |
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Hypothyroidism
Hyperthyroidism |
levothyroxine sodium/Synthroid-T4, life long, requlated based on TSH levels cause +BP, +Diarrhea, Tachycardia/palpitations, Exopthalmus
increase-capillary fragility decrease CO, BP & HR cardiac enlargement CHF anemia ----------------------------- tachycardia, Increases CO,BV,systolic BP dysrythmias, CHF antithyroid drugs- PTUs Iodine, propranolol/Inderal |
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anti-thyroid drugs
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propylthiouracil (PTU) -inhibits thyroid hormones- takes 1 yr to decrease- assess for agranulocytosis (sore throat & fever)-can't fight infection
Iodine- inhibits release-accumulate in thyroid gland - radioactive Iodine- destroys thyroid tissue-warn family members propranolol/Inderol |
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Calcium Regulators
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Hypocalcemia- treat with Vitamin D analogues
1.alters absorption of Ca from GI tract 2.alters renal excretion of Ca 3. reabsorbs bone Chvosteks sign or Trousseaus sign- can cause osteoporosis, kidney stones ----------------------------- increase effects: Vit.D, Thiazide diuretics decrease eff: corticosterooids, |
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Acute Hypocalcemia
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IV Calcium Gluconate - ER drug - when parathyroid glands removed
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Hypercalcemia
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calcitonin/Miacalcin- promotes buildup of calcium in bone- monitor serum ca levels-drink lots of fluids
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Growth Hormone
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anterior pituitary hormone
given IM -may cause allergic reaction-skin sensitivity test b4 admin watch for severe hip or knee pain or for limp |
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Posterior Pituitary Hormone
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ADH- Anti-Diuretic hormone'used in treatment of Diabetes Insipidus- watch for, hypertension/angina, pulmonary crackles, peripheral edema, increased specific gravity
drugs: Oxytocin/Pitocin - induces labor, stimulates uterine cont. Vasopressin/Pitressin-& Desmopressin -diabetes insipidus |
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Androgenic & Anabolic Steriods
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Sch. III
anab. used for muscle wasting cause-liver-tumor & hepititus Cns-aggression acne, Na & fluid retention, cardiac disease, wgt gain ----------------------------- do not use with calcitonin & barbiturates |
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Estrogens
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Estrogen/Estace- produced by ovaries, long bone growth, treats prostate cancer, menopause
+ breast cancer, +bl.clotting +hypertension, edema |
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Progestins
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medroxyprogesterone/Provera
prod. by ovaries, bl.clot risk, -do not smoke, migraines, thrombosis-contraindicators drug interaction do not use with Rifampin (TB), anticonvulsants, antibiotics |
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Caton-Exchange Resins
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Sodium polystyrene/Kayexalate
decreases K+ levels in pts with hyperkalemia, Monitor K+ levels and Na levels |
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Ammonia Detoxicating Agents
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lactulose (laxative)/Cephulac
caused by liver disease lowers serum ammonia levels with pts with hepatic encephalopathy & to treat constipation |
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Cardio Drugs
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Inotropic-Contraclitity
Chronotropic-Automaticity Dromotropic-Conductivity Exitability-Readiness to respond |
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Low CO
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releases renin from Kidneys, which release angiotension 1 & 2 which cause vasodilation and aldosterone secretion which increase P. resistence and water retention which cause high BP & angina
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Glycosides
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Lanoxin/digoxin - increase contractions (inotropic), decrease HR (chronotropic), decrease conductivity (dromotropic)so +CO, -renin release, +NA excretion, + urine - BV, -Preload,-workload,-angina,-arrythmia
toxcity- anorexia, NVD, Visual distur, bradycardia (low HR |
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anti-dig med
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Digibind- reverses the affects of Dig, but levels remain high,
------------------------------increase eff. Adrenergic drugs, antidysrhythmics, calcium preparations, ca channel blockers decrease: antacids, cholestyramine, laxatives, oral aminoglycosides |
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Antiarrythmics
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Sodium channel blockers - 1A Quinidine Sulfate - decrease all 4 ...tropics -does not sustain survival - given sustained release-
work by decreasing the O2 need of the heart which decreases the workload and/or increasing the O2 supply to the heart which stops angina and arrythmia |
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Antiarrythmic con't
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Lidocaine 1B- ER med, IV push, decreases automaticity in the ventricles, stops arrythimia - S&S - paresthesias, light head., visual and hearing distur. confusion,
do not give if: allergy to local anesthestics, or heartblock |
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Antiarrythimic con't 2
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class II- Beta Adrenergic Blockers (or BB or beta adrenergic antagonists or beta antagonists) stop arrythimia - gives negative: chronotro.,inotro., dromot., decreases renin response (beta 1) decreases glucose release (beta 2)
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Antiarrythimic con't 3
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Cardioselective Beta Blockers - only work on beta 1 receptors (cardiac cells) it does not cause bronchoconstriction (no wheezing)
non-selective BB- cause, bradycardia, hypoten. bronchconstriction (will have wheezing) hypoglycemia, impotence- do not stop abruptly causes rebound. hold if BO <90, or HR <60,do not give to asthmatics |
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Antiarrythimics con't 4
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class IV calcium channel blockers - verapamil/Isoptin
dilates perip.& coronary art. -decrease workload and increase O2 to heart to stop arrythimias, assess for hypotension, bradycardia (low HR) pedal edema and flushing ----------------------------- for all antiarrythemia drugs that increase: other antiarrythemic/antidysrhythimic drugs, antihypertensives, diurecitcs, |
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Antianginals
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not enough oxygen to heart
Nitrates Beta Blockers Calcium Channel Blockers- work by decreasing workload and increase O2 or both ----------------------------- drug that increase: antiarrythmics, antihypertensive, diuretics, digoxin decrease: adrenergic drugs(epinephrine), calcium salts, rifampin |
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Antianginal- Nitrate
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Nitroglycerin - dilates periph.vessels, causes decreaded preload and afterload-dilates healthy cardiac arteries, can give many ways- most sublingual- replace tabs ev.3mths, keep cool and dark, expect stinging under tongue, max-3 tabs ev 5 min,
side eff. hypotension, headache, flushing cause vasodilation |
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Antianginal - Beta Blockers and Ca channel blockers
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lower HR, workload, contractivity, oxygen demand, stops angina-
Ca channel bl. work same way but also cause coronary vasodilation |
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Antihypertensives, blood pressure regulation
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A ce Inhibitors
B eta Blockers C a channel blockers D iuretics -----------------------------increase eff: other antihypertensives, alcohol, digoxin decrease: adrenergics, antacids, oral contraceptives |
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BP reg.
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Ace -Angiotensin Converting Enzyme Inhibitors - use for hypertension, heart failure, decreae renal impairment in diabetic pts
side eff: persistent cough, hyperkalemia in pts with renal dysfunction- do not use with lithium, ARBs Angiotension II receptor antagonist, block angiotenstion II at receptor sites, does not cause cough and rarely causes hyperkalemia |
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Antihypertensives, BP regs con't
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Beta Blokers - propranolol/Inderal- decreases BP by decreasing HR and contractility(volume)
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Antihypertensives/BP regs con't 2
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Ca channel blockers - Procardia/nifedipine -decreases BP by dilating peripheral vessels
1. Alpha 1 blocker- prazosin/Minipress- cause dilation of bl. vessels, decrease perph.resistance, 1st dose often causes orthostatic hypotension 2. Alpha 2 blockers- clonidine/Catapres- stilmulates alpha 2 receptors in brain, peripheral bl.vess.dilation, decreases HR and BP |
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Antihypertensives/BP regs
con't 3 |
Diurectics: decrease BP by decreasing blood volume
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Antihyp/BP regs/Diurectics
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Thiazides- Diuril/chlorothiazide
Loop Diurectics-Lasix/furosemide Aldosterone Antagonist Osmotic Diuretics-Mannitol ----------------------------- drugs not to be used with: increase: antihypertensive agents decrease: oral contraceptives, vasopressors (epinephrine,norep.) |
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Antihyp/BP regs/Diurectics
con't |
Thiazides- Diuril/chlorothiazide- & Loop- Lasix/furosemide (more powerful of the two) inhibits Na reab. increases K+ excretion
side effect- hypokalcemia, hyponatremia, intravascular volume depletion resulting in hypotension contraindicators: oliguria (no urine), hypokalemia, hyponatremia |
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Antihyp/BP regs/Diurectics
con't 2 |
Aldosterone Antagonist- K+ sparing - increases excretion of Na without excreting K+, blocks hypokalemia when used with other diuretics-its major use
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Antihyp/BP regs/Diurectics
con't3 |
Osmotic diuretic- Mannitol
increases osmolatily of plasma and renal tubular fluids, use in ICP, & oliguria, IV only, |
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Antihyp/BP regs/Diurectics
con't 4 |
nursing intervention:
I&O monitor labs-K+ & Na assess for S&S of Hypo/hyperkalemia and hyponatremia assess BP |
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Antilipemics- statins
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used to treat elevated serum lipid levels
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Antilipemics- statins
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HMG-COA Reductase Inhibitors
Cholesterol Synthesis Inhibitors- Mevacor/lovastatin block enxyme required for hepatic synthesis of cholesterol - reduces LDL chol, after 4-6 wks therapy side eff: NCD (cramp), hepatotoxicity and muscle destruction, monitor liver function studies |
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Antilipemics - not statin
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Bile Sequestering agents- cholestyramine/Questran- -binds with bile acids in the intestines and exc. in feces - reduces LDL, often used with statins
side eff- bloating, flatulence, constipation, drug interactions |
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Antilipemics - not statin
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Fibrates- gemfibrozil/Lopid- decreases triglycerides,
side eff: GI discomfort, diarrhea, gallstones |
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Antilipemics - not statin
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Niacin- B vitamin- decrease chol. and trigly. only high doses so causes flushing, pruritus and gastric irritation, most eff. when used with another antilipemic
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Hematology agents
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Iron preps. used to treat iron deficiency anemia, oral admin except with pts with ulcers or intestinal problems, give by straw, causes dark stools and consti. IM inject admin via Z-tract to stop discoloration of skin, if given by Z-tract can give to pts with stomach problems
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Hematology agents- con't
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Vitamin B12- IM injection- treats pernicious anemia, monthly for life of pts who had gastrectomy b/c they no longer have the intrinsic factor to absorb B12-
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Hematology agents con't 2
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Anticoagulants - Heparin- parenteral- prevents thrombosis form or enlargement and embolization
for ER- IV or SQ, use pump for IV, Abdomen site for SQ contraindication: PUD, bowel dis. server hypertension, and bleeding side eff: bleeding, thromobocytopenia (hits) Antidote: Protamine Sulfate short half-life monitor Ptt |
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Hematology agents - con't 3
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Lovenox/enoxaparin- cousin to heparin- prevent thrombosis in knee and hip surgery- and other conditions that make pt at risk for thrombosis
labs not requ. does not bleed given SQ onset longer than heparin do not use with parenteral anticoagulants |
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Hematology agents - con't 4
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Coumadin/warfarin- by PO - used long-term to prevent thrombosis formation- atrial fib, thromboembolic disorders, prosthetic heart valves-
onset 2-7 days so can give with heparin acts as K+ antagonist, stops clotting factors major side eff: bleeding proteinbound- drug reactions monitor PT and/or INR data PT 1.5x control, INR 2-3 x control antidote: vit K or fresh frozen plasma nursing imp: any thing that is traumatic and will cause bleeding-also green leafy vegs |
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Hematology agents- antiplatelite agents
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aspirin- prevents thrombosis formation, blocks enzyme in platelets which causes platelet aggregation,
side eff: bleeding PUD dosage 81 mg |
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Hematology agents- Thrombolytic agents
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streptokinases/Streptase- IV med, used to dissolve or breakdown thrombi in an active situation- used to dissolve clots in IV catherers
side eff: bleeding-may be severe because fibrinolysis is non-selective contraindicaitons-severe HTN- recent trauma or CVA, PUD |
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Drugs not to use with Anticoagulants, antiplatelet and thrombolylic agents
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any other drug that affects homestatis,
increase the eff. of heparin: antiplatlet drugs, warfarin, parenteral penicillins decrease eff. of heparin: antihistamines, digoxin, tetracyclines increase eff. of warfarin: analgesics, androgens and ana. steriods, cardiovascular drugs of all kinds thyroid preparations gastrointestinal drugs |
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Drugs that affect Statins,
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niacin, , bile acid drugs, rifampin, antacids, isradipine
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