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47 Cards in this Set
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antigout meds antiinflammatory
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proto: colchicine (Colcrys)
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antigout meds colchicine (Colcrys) antiinflammatory MOA
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decreases inflammation
colchicine is only effective for inflammation of gout |
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antigout meds colchicine (Colcrys) use
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abort an acute gout attack in response to precursor symptoms
treatment of and decrease incidence of acute attacks for clients who have chronic gout predinisone is used for clietns with acute gout who are unable to take or unresponsive to NSAIDS |
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hyperuricemia agents
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proto: allopurinol (Zyloprim)
other meds: febuxostat (Uloric), probenecid |
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hyperuricemia agents MOA
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allopurinol and febuxostat inhibit uric acid production
probencid inhibits uric acid reabsorption by renal tubules |
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hyperuricemia uses
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hyperuricemia due to chronic gout or secondary to cancer chemotherapy
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colchicine adverse (antigout)
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GI distress, thormbocytopenia, suppressed bone marrow
muscle pain tenderness |
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probenecid adverse (hyperuricemia)
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renal calculi
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allopurinol adverse (hyperuricemia)
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hypersensitivity reaction, rash, fever
kidney injury hepatitis GI distress |
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colchine contraindications (antigout)
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older adults, clients who are debilitated, renal, cardiac, and hepatic or GI dysfunction
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probenecid (hyperuricemia) adverse
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preciptiate acute gout
do not give within 2-3 weeks of an acute attack |
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allopurinol (hyperuricemia) adverse
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idiopathic hemachromatosis
rhabdomyolysis is most likely with long-term use, risk is higher in clients taking statins for high cholesterol and those who have impaired kidneys and liver |
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colchicine interactions
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grapefruit juice
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probenicid interactions
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salicylates may lessen the effectiveness of probenecid and may precipitate gout
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allopurinol interactions
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slows metabolism of warfarin within the liver, which places clients at risk for bleeding- monitor for signs of bleeding
monitor prothrombin time and INR levels and adjust warfarin dosages accordingly |
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antigout meds admin
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monitor uric acid levels, CBC, uric acid levels, urinalysis, liver and kidney function tests
allopurinol should be well-diluted and administered as an infusion over 30-60 min avoid alcohol and food high in purine (red meat, scallops, cream sauces) |
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antigout meds effectiveness
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decrease in number of gout attacks
decrease in uric acid levels |
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migraine meds MOA
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prevent inflammation and dilation of the intracranial blood vessels thereby relieving migraine pain
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migraine meds MOA
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prevent inflammation and dilation of intracranial blood vessels, thereby relieving migraine pain
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migraine meds use
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NSAIDS, and combination anti-inflammatory meds, ergotamine, and triptans are used to stop a migraine after it begins
beta-blockers, anticonvulsants, amitriptyline, calcium-channel blockers and estrogens prevent a migraine headache |
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ergot alkaloids (migraine meds) adverse
ergotamine and dihydroergotamine |
GI discomfort- administer metoclopramide (Reglan)
ergotism (muscle pain, paresthesias in fingers and toes; cold, pale extremties) physical dependence fetal abortion |
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serotonin receptor antagonist (triptans) sumatriptan adverse
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chest pressure
coronary artery vasospasm, angina dizziness or vertigo |
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beta-blockers propranolol adverse
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extreme tiredness, fatigue, depression, and asthma exacerbation
bradycardia, hypotension |
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anticonvulsants: divalproex adverse
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neural tube defects
liver toxicity pancreatitis |
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TCAs amitriptyline adverse
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anticholinergic effects
drowsiness or dizziness |
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calcium channel blockers verapamil adverse
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orthostatic hypotension or bradycardia
constipation |
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migraine meds contraindications (ergotamine)
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renal or liver dysfunction, sepsis, hypertension, history of MI and CAD, pregnancy
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triptans contraindications
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liver failure, ischemic heart disease, MI, hypertension
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propranolol contraindications
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greater than first-degree heart block, bradycardia, bronchial asthma, cardiogenic shock, HF
caution: taking other antihypertensives or who have liver or renal impairment, DM, Wolf-Parkinson- White syndrome |
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divalproex sodium (Depakote) contraindications
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liver disease
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amitriptyline (Elavil) contraindications
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recent MI or within 14 days of MAO inhibitor
caution: seizure history, urinary retention, prostatic hyperplasia, angle-closure glaucoma, hyperthyroidism, |
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verapamil (Calan) contraindications
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greater than first degree heart block, bradycardia, hypotension, left ventricle disease, atrial fibrillation or flutter, HF
caution: liver, renal impairment or increased intracranial pressure |
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ergotamine and dihydroergotamine interactions
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concurrent use with any of the triptans may cause cardiac ischemia- triptans should be taken at least 24 hours apart from ergotamines
some HIV protease inhibitors, antifungal meds, and macrolide antibiotics may increase ergotamine levels, causing increased vasospasm |
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sumatriptan interactions
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concurrent use of MAOI can lead to MAO toxicity
concurrent use with ergotamine or other triptan can cause vasoconstriction and cardiac ischemia SSRIs taken with triptans may cause serotonin syndrome |
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propranolol interactions
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verapamil (Calan) and diazepam (Cardizem) have additive hypotensive effects
propranolol use can mask the hypoglycemic effect of insulin and prevent the breakdown of fat in response to hypoglycemia |
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divalproex interactions
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aspirin, chlorpromazine, and cimetidine may cause divalproex sodium toxicity
benzodiazipines may cause CNS depression divalproex may increase levels of phenobarbital and phenytoin |
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amitriptyline interactions
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barbiturates may cause increased CNS depression
cimetidine may increase amitriptyline levels MAOIs may increase CNS excitation or cause seizures verapamil |
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verapamil interactions
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carbamazepine and digoxin may increase medication levels
atenolol, esmolol, propranolol, and timolol may potentiate medication effects |
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migraine meds admin
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avoid consumption of alcohol and tyramine-containing foods
protect skin from sun |
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migrain meds effectivess
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reduction in intensity and frequency of migraine attacks
prophylaxis against migraine attacks termination of migraine headaches |
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local anesthetics
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proto: lidocaine (Xylocaine)
other: tetracaine (Pontocaine), procaine (Novocain) |
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local anesthetic MOA
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decrease pain by blocking conduction of pain impulses to a circumscribed area
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local anesthetic uses
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parenteral:pain managment
regional anesthesia topical: skin and mucous membrane disorders minor procedures such as IV insertion, injection, wart removal |
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local anesthetic adverse
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CNS excitation
hypotension cardiodepression allergic reaction caution to women in labor spinal headache urinary retention |
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local anesthetic contraindications
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supraventricular dysrhythmias/ heart block
liver, kidney dysfunction, HF, myasenthia gravis epinepherine added to local anesthetic is contraindicated for use in fingers, nose, and other body parts with end arteries, gangrene may result from vasoconstriction |
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local anesthetic interactions
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antihypertensive meds- monitor heart rate and BP
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local anesthetic effectiveness
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undergoes procedure without experiencing pain
pain is relieved |