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GI - Nausea, vomitting, diarrhea I- Increase Glucose Value A- Alcohol causes vomitting N- Nephrotoxicity T- Thrombocytopenia |
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Nephrotoxicity, Ototoxicity, renal failrue |
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Most important thing to check before giving Sulfonamides |
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Major neurotransmitter of adrenergic system (sympathetic system) |
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Andrenergic Agonists/Sympathomimetics do what? |
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adrenergic blockers/ symptholytics do what? |
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dilating pupils, dilting bronchioles, increasing HR, constriction of blood vessels, relaxation of HI Bladder and Uterus are what response? |
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sympathetic response, from Sympatholytics/ adrenergic agonists |
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vasoconstriction, dilates pupils |
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dilates, decrease GI Motility |
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Which 2 enzymes inactivate norepinephrine? |
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Sympathomimetic drugs
direct acting? indirect? mixed? |
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Direct- epinephrine indirect - amphetamine mixed - Ephedrine |
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Epinephrine is a sympathomimetic drug & stimulates Alpha 1, beta 1, and beta 2. What does it do? |
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alpha 1 - vasoconstrict beta 1 - increase BP & HR beta 2 - bronchodilation |
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dopamine stimulates? Sympathomimetic |
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alpha 1 - (vasoconstrict & increase HR) |
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Pseudophed stimulates?
Sympathomimetic |
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Alpha 1 - vasoconstrict Beta 1 - increase BP & HR |
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Isuprel - intended effect and unwanted? |
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beta 2- dilates bronchioles beta 1 - increase HR |
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Albuterol/Proventil stimulates? |
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How do adrenergic blockers (sympatholytics) work? |
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occupt receptor sites or inhibit release or transmitter |
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Alpha Adrenergic blockers (Regitine) used for? |
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Peripheral vascular disease |
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Alpha Adrenergic blockers do what? |
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Vasodilator & decrease BP (can be reflex tachycardia) |
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Alpha Adrenergic blockers additional use? |
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Result of non-selective beta blockers |
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decreased HR, decreased BP, bronchoconstriction |
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Stimulation of the parasympathic system |
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constricts pupils, constrict bronchioles decreased HR, dilates blood vessels, bladder contraction, increased GI motility |
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Another term for parasympathetic |
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neurotransmitter of parasympathetic sysmtem |
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Drugs that stimulate Parasympathetic sysmtem are called |
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Cholinergics or cholinergic agonists |
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drugs that block parasympathetic system are called? |
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Nicotinic and muscarine effect what? |
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nicotinic - skeletal muscl emuscarine - smooth muscle (heart rate) |
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indirect action of cholinergic drugs |
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stimulate release of acetylcholine
inhibit cholinesterase = makes more acetylcholine availble |
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Stimulation of bladder and GI tone constrict pupils decrease BP, HR , increase Salivation
are the effects of what? |
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direct acting cholinergic |
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Effect of Urecholine, a cholinergic |
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Polyuria & increased GI activity |
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Side Effects of cholinergics (direct acting) |
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hypotension, bradycardia, diarrhea, excessive saliva, dysrthmias |
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What constricts pupils, relieving intraocular pressure caused in glaucoma?
what drugs? |
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Direct acting cholinergics
isopto-carpine, policarpine |
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Examples of Indirect acting cholinergics? |
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Prostigmin - treats myasthenia gravis Tacrine - improves memory |
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What is the result of indirect acting cholinergics |
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Anticholinergic drug effects |
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decreased GI & saliva, dilate pupils, decrease bladder contraction, decrease tremors, increase HR |
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What population are anticholinergics not good for? |
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What surgery are anticholinergics useful in? |
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Atropine (anticholinergic) use? |
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preop to dry secretions & increase HR |
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Artane (anticholinergic) use |
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Parkinsons, decrease muscle rigidity |
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Scopolamine (drug class & use) |
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Anticholinergic, motion sickness for dry secretions and relaxed GI muscles |
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What disease is contraindicated for anticholinergic use? |
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Glaucoma (dilated pupils makes pressure worse) |
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What do anticholinergics and dopaminergics treat? |
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Levodopa (drug class?)
(only 1% crosses blood brain barrier + high does) |
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+ Inotropic (increased contractility) - chronotropic (decreased rate) for CHF and atrial dysrhytmias |
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What do cardiac glycosides treat? |
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What drugs increae Dig toxicity? |
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Lasix & hydroclorathiazides |
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Digoxin index range & most important assessment |
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.5-.2 ng/ml HR, <60 don't give! |
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3 types of antianginal drug classes |
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Nitrates, Beta blockers, Ca+ channel blockers |
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Nitrates drug interventions
(work by relaxing coronary arteries and increasing O2 to the heart) |
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Check BP frequently teach - 3 tabs q 5 min then call 911 |
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What 3 things do Ca+ channel blockers treat? |
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Angina dysrhythmias hypertension |
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Calan, Procardia, Cardiazem, Norvasc, Cardene
(drug class) |
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Important assessment and S/E of Ca+ channel blockers |
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check liver enzymes S/E - bradycardia, hypotension, dizziness, flushing |
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Why do Ca+ channel blockers cause bradycardia |
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relax smooth muscle -inotropic = decreased workload of heart = slower HR |
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4 classes of Antidysrhythmic drugs |
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1 - Fast (NA) channel blockers 2- Beta blockers 3-Prolong repolorization 4 - calcium channel blockers |
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Action of Class 1 - fast NA Channel blockers
Norpace, Pronestyl |
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slow conduction and prolong repolorization |
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S/E of Class 1 - Fast NA channel blockers |
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Beta blocker contraindications? |
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Nursing assessment before administering beta blockers? |
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Bretylol, Cordarone (drug class) |
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Class 3- Prolong Repolorization |
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Class 3, Prolong Repolorization - use and assmenents |
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Emergencies -check vitals, monitor heart, -Cause PHOTOSENSITIVITY |
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Diuretics - use and action |
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Hypertension & edema - inhibit sodium & water reabsorption |
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Where do Thiazide Diuretic work? |
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What is an additional action of Thiazides? |
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vasodilation aka- very good to treat hypertension |
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S/E of thiazide diuretics drug contraindications |
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hyperglycemia -No for renal failure, No w/ Digoxin |
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HCTZ, Dyzide (drug class?) |
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Loop diuretic action, where? |
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Loop of henle inhibits chloride(loss of sodium, water, potassium, calcium & magnesium) No Blood Sugar effect |
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Which diuretic is the best choice for pt's with renal failure |
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Nursing interventions for Loop Diuretics |
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monitor weight, BP, electrolytes, avoid Alcohol and other highly protein bound drugs |
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Osmotic Diuretic - action & use |
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increase osmolarity in tubules = major diuresis Decrease intracranial pressure, decrease intraocular pressure, prevent kidney failure |
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Nursing interventions for osmotic diuretics (Mannitol) |
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check bottle for crystals, vital signs, I&O |
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Carbonic Anhydrase Inhibitor - diuretic |
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Carbonic Anhydrase Inhibitor (diamox) use |
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decrease intraocular pressure |
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Nursing Interventions with Diamox |
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give w/ food or antacids don't mix with fruit juice (instead use honey or syrup) |
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Dyrenium, Aldactone (drug class) |
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Potassium Sparing Diuretic |
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What drug class are Potassium Sparing diuretics combined with and why?
-Aldactazide, dyazide |
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combined with Thiazides - intensifies diuresis and prevents potassium loss |
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First line choice for treating hypertension |
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Thiazide diuretic or combination |
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First line choice for treating hypertension |
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Thiazide diuretic or combination |
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Lopressor, Tenormin, Coregard (drug class) |
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Beta blockers (sypatholytics) |
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adrenergic Neuron Blocker - very potent in Emergencies -block norepinehrine at receptor site |
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Normodyne, Cartol (drug class & action) |
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alpha 1 & beta 1 blocker vasodilation and decrease HR |
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Apresoline, Minoxidil, Nitroprusside (drug class) |
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direct acting vasodilators |
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Action and S/E of direct acting vasodilators |
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decrease BP, but retain water (often combined w/ diuretics) |
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Important S/E of Direct acting vasodilators |
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reflex tachycardia, lupus like symptoms |
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Important Ace Inhibitor S/E & Nursing Interventions |
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hypotension w/ first dose monitor electrolytes, vital signs & renal function |
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Cozaar & Atacand (drug class) |
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How do Ace II blockers work? |
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block vasoconstriction at receptor sites
-better tolerated & can be used with mild hepatic and renal impairement |
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What must be monitored when giving heparin? |
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Low Molecular weight Heparin |
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Coumadin/Warafin - Monitor INR (should be?) |
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Thrombolytics (Streptokinase & t-PA) use |
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Lipitor, Zocor, Prevachol, Mavacor (drug class) |
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Vasastain use, action, (don't take with?) |
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decrease Cholesterol by decreasing cholesterol synthesis in liver don't take with grapefruit juice |
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Drug class used to treat Raynaud's Disease and Buerger's disease |
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Priscoline & Vasodilan (drug class) |
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Peripheral vasodilator action |
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alpha andrenergic beta 2 agonist |
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