Term
what is the fourth leading COD? |
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Definition
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Term
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Definition
absorption, distribution, metabolism, excretion |
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Term
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Definition
drug receptor interaction, patient's functional state, plaecbo effects |
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Term
pharmokinetics and pharmodynamics are dependent on what? |
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Definition
individual: genetics, pathology, physiology, drug-drug interaction |
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Definition
140- Age x Kg x .85 (if female) / 72 x Cr |
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Term
what is a physiologic variable? |
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Definition
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Term
what is a pathological variable? |
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Definition
Diminished function of kidneys and liver |
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Term
how do genetic variable effect drug efficacy? |
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Definition
Can alter metabolism of drugs and predispose patient to unique interactions, i.e. allergies, hypersensitvity |
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Definition
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generic drug names are derived from.. |
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Definition
they are derived from the chemical name |
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Term
why do drug companies make the drug names so hard? |
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Definition
so the trade name is used instead |
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Term
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Definition
60% of all drugs administered |
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Term
which drug routes should take effect within 1-3 minutes? |
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Definition
4 i's- inhalers, IV, intraosseus, intrathecal |
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Term
which drug routes should take 15-30 min to take effect? |
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Definition
SL/PR, sublingual or bottom of mouth |
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Term
which drugs routes should take 45 min to an hour to take effect? |
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Definition
SPIT- subq, PO, IM, topical |
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Term
only unbound (free) drug molecules can.. (non protein binding) |
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Definition
leave the vascular system |
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Definition
Defined as the time required for the amount of drug in the body to decrease by 50% |
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Definition
arterial thrombosis, venous thrombosis |
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Term
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Definition
Anaphylaxis, psychosis, insomnia, increased bg, cushinoid s/s. usually most deadly ADRs are rare. |
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Term
is unfractioned heparin iv and regular heparin (sub q) protein bound? |
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Definition
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Term
half life of heparin? pregnancy? |
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Definition
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Term
bleeding rate for heparin patients |
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Definition
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Term
how many pts get heparin induced thrombocytopenia? |
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Definition
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Term
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Definition
suppress production of fibrin |
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Term
advantage of LOVENOX/enoxaparin |
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Definition
no labs needed because of fixed dose |
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Term
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Definition
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Term
warfarin coumadin prevents.. |
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Definition
thromboembolism, by suppressing vitamin K dependent clotting factors |
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Term
is warfarin coumadin teratogenic? |
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Definition
YES, causes fetal hemorrhage, category X |
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Term
major problems with warfarin |
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Definition
99% protein bound, Vitamin K will change INR, delayed action (doesnt effect clotting factors already circulating), NSAIDS increase risk for bleeding |
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Term
dosing regimen for coumadin |
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Definition
1mg on even day, 3 mg on odd days, 5 mg every Sun |
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Definition
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Definition
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Definition
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ASA lasts the lifetime of a.. |
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Definition
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Term
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Definition
nsaids may block some effects of ASA |
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Term
low therapeutic dose of ASA |
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Definition
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Term
anti-inflammatory dose of ASA |
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Definition
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Definition
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Definition
Bleeding; GIB and hemorrhagic stroke |
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Term
is ASA ok with pregnancy, kids with febrile diseases, or hypersensitive/allergy |
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Definition
NO (category D), no and NO. |
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Term
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Definition
prevents blockage of cornary artery stents, reduces thrombotic events in patients with acute coronary synrdromes, MI, ischemic stroke |
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Term
adverse effect of clopidorgel |
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Definition
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Term
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Definition
dilates the vascular bed, and prevents platelet aggregation (like riot police) |
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Term
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Definition
minimum effective concentration of a drug |
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Term
4 major categories of diuretics |
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Definition
high ceiling (loop), thiazide, osmotic and potassium sparing |
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Term
two types of potassium sparing |
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Definition
aldosterone antagonists (spiralactone), non aldersterne antagonists (triamterene) |
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Term
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Definition
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Term
therapeutic ptt (pt on heparin) |
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Definition
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Term
number one use of baby aspirin.. |
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Definition
to prevent CV events, MI attacks |
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Term
goal for htn on antihypertensives |
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Definition
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Term
goal for htn w/kidney disease |
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Definition
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Term
there is no antidote for.. |
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Definition
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Term
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Definition
low BP and increase vasoconstriction to compensate |
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Term
diuretics make everything go down, except.. |
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Definition
acid/base and glucose, H&H |
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Term
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Definition
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Term
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Definition
hypokalemia, dehydration, lowers Cl, Na, lower BP, increase BG, it can be ototoxix. |
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Definition
it augments other BP meds, dagoxin, NSAIDS, can lead to LITHIUM toxicity |
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Term
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Definition
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Term
beginning (and end) dose for lasix.. |
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Definition
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Term
hydrochlorathiazide (gentler than lasix) |
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Definition
hypokalemia, dehydration, |
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Term
thiazides wont work for people who have.. |
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Definition
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Term
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Definition
it can potentiate any other medicine that can decrease BP |
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Term
Spironolactone (Aldactone) uses |
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Definition
Therapeutic uses Hypertension Edematous states Heart failure (decrease mortality in severe failure) Primary hyperaldosteronism Premenstrual syndrome Polycystic ovary syndrome Acne in young women |
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Definition
potassium sparing, so watch for extra potassium intake |
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Term
PNS/cholinergic system major neurotransmitter |
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Definition
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Definition
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Term
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Definition
HTN, relaxes smooth muscle bladder (for hypertrophic prostate- makes it easier to pee) |
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Term
alpha blocker side effects |
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Definition
1% lose consciousness, know prazosin (Minipress) |
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Term
alpha agonist name and uses |
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Definition
clonidine (Catapres) used for HTN, and pain |
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Term
the big problem with clonidine is that it.. |
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Definition
causes a rebound HIGH BP if taken off of it (education: you cannot run out of this medicine!!) |
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Term
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Definition
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Term
nonselective Beta Blockers |
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Definition
blocks B1 and B2, propranlol - will cause more effecs on the entire body than selective |
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Term
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Definition
Angina, HTN, arrythmias, MI, CHF, hyperthroidism |
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Term
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Definition
bradycardia, reduce cardiac output, don't withdraw quickly |
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Term
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Definition
same as B1, plus bronchoconstriction, inhibition of glycogenolysis, CNS side effects |
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Term
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Definition
60 mg bid, interferes with epinephrine antidote for anaphylactic reaction, effects glycogenolysis, |
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Term
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Definition
inhbits RAAS system, WHICH constricts blood vessels, acts on kidneys to promote retention of NA and K and water and excretion of K. so it reverses all that. |
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Term
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Definition
teratogenic, first dose hypotension, cough (5-10% pts), hyperkalemia, renal failure, angioedema |
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Term
calcium channel blockers.. |
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Definition
prevent calcium ions from entering cells, slow down AV and SA node, treats HTN, angina, cardiac dysrhythmias |
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Term
CCb are divided into two classes.. |
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Definition
dihydropyridines-nifedipine, amlopidine nondihydropyridines-verapamil, diltiazem |
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Term
hydralazine can cause sle syndrome, which can cause.. |
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Definition
kidney problems, along with other SLE symptoms |
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Term
digoxin is a positive inotrope which.. |
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Definition
increases CO and increases UO |
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Term
therapeutic uses of digoxin.. |
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Definition
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Term
digoxin is no longer first line drug for.. |
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Definition
CHF< lowers life expectancy in women |
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Term
digoxin is contraindicated with.. |
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Definition
diuretics, except K sparing. abx, CCBs, amiodarone |
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Term
antidotes to dig toxicity.. |
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Definition
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Term
make sure with digoxin that.. |
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Definition
full minute of apical pulse, hold if less than 60 bpm, check for potassium levels, watch for dysrhythmias- normally brady |
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Term
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Definition
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Definition
ace inhibitors and RAAS meds |
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Definition
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Definition
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Definition
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Definition
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Definition
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Definition
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Definition
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Definition
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Definition
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Definition
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Definition
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Term
nurses are involved in which part of the therapeutic obejective of drug therapy? |
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Definition
assessing the pt for adverse effects of drug therapy (not prescribing or recommending or any crap like that) |
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Term
with antihypertensive meds, if pt's bp is 110/70, should you adminster med? |
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Definition
check to see if data is congruent with previous measurements, if its a sudden drop, dont give |
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Term
if pt has low respirations of 9 breaths/min what post op med should you avoid giving? |
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Definition
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Term
nursing dx for patient on opiate analgesic |
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Definition
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Term
when changing pt from trade to generic, what should you monitor? |
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Definition
blood levels to insure avoidance of toxic levels |
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Term
protein bounds drugs in circulation are not able to |
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Definition
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Term
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Definition
the reduction of the effectivness of a drug by the time it reaches systemic circulation (mostly caused by liver and gut wall) these drugs should go iv or im instead |
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Term
sublingual is a good way to admister orally without the effects of.. |
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Definition
first pass effect, sublingual allows for direct absorption |
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Term
while administering an iv push morphine, pts breathing drops from `15 to 11, what do you do? |
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Definition
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Term
excretion of a drug may be impaired if.. |
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Definition
patients GFR is below 30 m/l |
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Term
in pacu, what can promote excretion of most anesthetics? |
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Definition
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Term
for drugs with a narrow therapetic range you should.. |
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Definition
carefully monitor pt for therapeutic and toxic effects, be diligent about timing of adminstering the drug, monitor blood levels to see if its in therapeutic range |
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Term
what inhibits the CYP3A4/drug metabolizing enyzyme? |
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Definition
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Term
inhibiting CYP3A4 can cause what? |
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Definition
excessive levels of the drug in the blood bc its not metabolized as well |
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Term
an order of "peak and trough levels" indicates the need for what? |
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Definition
draw blood at peak hour:1.5 hours after infusion, trough level:30 minutes before next dose |
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Term
why cant heparin be given orally |
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Definition
because its large and negatively charge - limiting absorption |
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Term
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Definition
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Term
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Definition
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Term
PTT result indicating heparin therapy is in therapeutic range.. |
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Definition
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Term
a Rx for lovenox is based upon.. |
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Definition
pts weight, if ordered twice a day, should be every 12 hours |
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Term
pt prescribed aspirin should take it how if experiencing chest pain? |
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Definition
chew and swallow a tablet with a glass of water (any dose size) |
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Term
high doses of aspirin should be discontinued how long before a surgery? |
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Definition
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Term
aspirin can cause what in children w a possible viral infection |
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Definition
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Term
there may be no sxs for a person on longeterm aspirin who has a |
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Definition
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Term
pts with high levels of ASA may exhibit |
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Definition
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Term
baby w ASA toxicity, breaths: 14, what would lab results look like? ph |
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Definition
low breathing rate= low pH, increased CO2, |
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Term
a pt with aspirin rx should avoid.. |
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Definition
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Term
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Definition
irritate the stomach the least |
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Term
alpha receptor antagonists end in what? |
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Definition
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Term
minipress should be taken in the.. |
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Definition
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Term
viagra and alpha adrenergic antagonists can cause what |
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Definition
hypotension and vascular collapse |
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Term
beta receptor antagonists ends in what? |
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Definition
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Term
what would warrant withholding a beta blocker and contacting the prescriber? |
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Definition
apical pulse of 48 beats per minute |
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Term
metoprolol can cause excessive cardiosuppression if taken with.. |
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Definition
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Term
the most common adverse affect with clonidine is.. |
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Definition
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Term
clonidine patients should take a larger dose at.. |
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Definition
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Term
diabetic on lasix should be monitored for |
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Definition
increased thirst confusion and dry hot skin |
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Term
lab tests for high ceiling diueretics |
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Definition
electrolytes, glucose, LDL/HDL, uric acid |
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Term
signs of hypokalemia for pts on lasix |
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Definition
muscle weakness and constipation |
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Term
which OTC can counteract diuretics? |
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Definition
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Term
diuretic recommended for early HTN |
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Definition
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Term
spironalactone+ what? may increase risk for hyperkalemia |
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Definition
-pril, -sartan (A I's, angiotensin receptor blockers) |
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Term
ARB drugs end in what suffix? angiotensin receptor blockers. |
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Definition
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Term
ACE i"s end in what suffix? |
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Definition
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Term
adverse effect of ACE i's |
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Definition
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Term
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Definition
fasting blood sugar, Na, K |
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Term
Ace-i, plus salt substitute can show up as what on an EKG |
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Definition
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Term
do not take what with ACEi's |
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Definition
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Term
lab result that could increase the risk for lithium toxicity |
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Definition
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Term
a less selective drug means.. |
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Definition
it affects more areas, therefore MORE side effects |
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Term
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Definition
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Term
dihydropyridine CCBs primarily effect |
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Definition
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Term
verapamil and diltiazem causes |
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Definition
reduce force of contraction, av node suppression |
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Term
dihydropyridine CCB drug suffix is |
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Definition
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Term
priority assessment before adminstering diltizem/cardizem |
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Definition
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Term
verapamil and beta blocker- check for.. |
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Definition
crackles in lungs, SOB, weight gain of 3 lbs in 24hr |
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Term
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Definition
anorexia and nausea, low potassium |
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Term
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Definition
reducing the work of the heart by expanding the space in vessel into which the heart is ejecting blood |
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Term
orthostatic hypotension is more likely to occur in a patient who is receiving a venous vasodilator or arteriole vasodilator? |
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Definition
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Term
an adverse reaction hydralazine that should be reported |
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Definition
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Term
reflex tachycardia can be treated by which drug |
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Definition
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Term
which drug is prescribed for pts w heart failure who are prescribed hydralazine (which causes sodium retention)? |
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Definition
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Term
when a patient is NOT ambulatory, where would signs of edema first normally appear? |
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Definition
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Term
BP is best assessed when patient is in what position? |
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Definition
sitting with feet flat on floor |
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Term
reflex tachy would be most likely experienced by a pt on which med? |
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Definition
a direct acting vasodilator |
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Term
what is the most important part of pt education with hypertensive meds? |
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Definition
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Term
which is the most alarming respiratory finding? |
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Definition
high pitched musical inspiration, AIRWAY! |
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Term
the recommended time goal for lowering BP when a pt is in acute congestive heart failure |
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Definition
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Term
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Definition
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Term
CHF drug that decreases aldosterone production that results in vasodilation and mild reduction in blood volume |
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Definition
ARBS- sartan sisters- angiotensin receptor blockers |
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Term
chf drug that is effective when kidney function is impaired |
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Definition
furosemide/lasix, high ceiling loop diuretics |
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Term
CHF drug that increases force of contraction, decreases heart rate reduces vasoconstriction and increases urine production |
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Definition
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Term
CHF drug that increases level of kinins and decrease aldosterone- resulting in vasodilation |
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Definition
ACE i's- pril!, angiotensin converting enzyme inhibitors |
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Term
CHF drug that prolongs survival of HF pts by blocking aldosterone receptors and preventing heart remodeling, heart and vascular fibrosis, baroreceptor dysfunction, and dysrythmias - excretes water and sodium, conserves K |
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Definition
- aldosterone receptor antagonists- spironolactone |
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Term
Chf drug that reduces blood volume, can cause hypokaelmia and increase the risk of digitalis toxicity- not effective when kidney function is impaired |
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Definition
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Term
Chf drug that slightly reduces blood volume by causing loss of Na, and water with conservation of K |
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Definition
K sparing diuretics- triameterene |
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Term
chf drug that slows the heart rate and can reduce the force of contraction if dose not carefully titrated |
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Definition
beta adrenergic blockers, metoprolol- BAB lol |
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Term
BNP elevation- b-natriuretic peptide suggests Hf because.. |
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Definition
bnp is released when the hearts chambers stretch |
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Term
if nurse cannot hear apical pulse of patient with HF, she should move the stethoscope to the.. |
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Definition
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Term
nitrogylcerin and isosorbide reduce the workload of the myocardium by.. |
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Definition
decreasing the amount of blood returning to the heart |
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Term
drug induced lupus like syndrome can cause.. |
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Definition
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Term
anorexia and nausea are signs of which electrolyte imbalance? |
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Definition
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Term
blocking this ion from entering slows depolarization.. |
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Definition
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Term
blocking this ion from exiting can reduce the force of contraction |
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Definition
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Term
blocking this ion from exiting increases the amount of time when the cell cannot be stimulated to contract |
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Definition
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Term
primary nursing dx for a pt w dysrhythmia |
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Definition
alteration in cardiac output |
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Term
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Definition
a 100, but better below 70 |
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Term
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Definition
more than 60, less than 40 is bad |
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Term
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Definition
below 150 is desirable, 600 is crazy. |
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Term
which complication of diabetes causes the most deaths? |
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Definition
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Term
what defines intensive insulin therapy? |
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Definition
requires four injections of a rapid acting insulin each day in addition to an injection of a basal insulin |
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