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189 Cards in this Set
- Front
- Back
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How old is a neonate?
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0 - 30 days
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should you increase/decrease the dosage for neonates
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decrease
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Why must you decrease the dosage for neonates?
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kidney and liver function is immature
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How old in an infant
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30 - 1 year
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Should you increase/decrease the dosage for infants
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increase
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What is the metabolism of an infant like
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an adult
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How do you figure dosage for an infant
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mg/kg of body weight
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Describe medicine administration for a child
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dont threaten, apply the childs developmental level, sweeten/flavor med, give options
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What must you consider with medicine administration and geriatric patients
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decreased liver and kidney function
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What is the most commonly given hormone for ADH
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vasopressin
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What is the action of vasopressin?
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acts on collecting ducts in renal tubule to increase water reabsorption, which increases concentration of urine and spec. grav. and decrea. urine volume.
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What do higher doses of vasopressin do?
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stimulate contraction of vascular smooth muscle and smooth muscle in the GI tract
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How is vasopressin given?
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nasal spray
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What happens if you have too much ADH
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water intoxication
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S/S water intoxication
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drowsiness, listlessness, H/A, convulsions coma
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What do you do for a pt with water intoxication
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restrict intake, and give diuretics
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What is the action of thyroid hormone
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stimulates energy use and elevates basal metabolic rate, stim. the heart, promotes growth and development
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what are signs of an elevated basal metabolic rate
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increases 02 use and heat producation
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How long with a person with hypothyroidism be on medication
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forever
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When do you take your thyroid meds?
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in am before breakfast or 2 hours after
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What are some s/s of hyperthyroidism
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tachycardia, palpitations, angina, dysrhythmias, HTN, MI
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What labs do you watch with a thyroid
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TSH and T4
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What are some drugs for hyperthyroidism
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propylthiouracil or inderal
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what is the action of propylthiouracil or inderal
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blocks synthesis of thyroid hormone, suppresses conversion of T4 into T3
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How long does it take for the effects of hyperthyroidism to become evident
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1-3 weeks
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What are the SE of propylthiouracil or inderil ?
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bone marrow depression or agranulocytosis
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Why is indural preferred?
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decreases heart rate, and controls tachycardia
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Inflammatory diseases that adrenal steroid use is indicated
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asthma, arthritis, lupus, rhinitis, poison ivy,
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When are steroids taken
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must be taken with meals, 2/3 am and 1/3 pm
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what happens with steroids if the pt is under a ton of stress
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must increase the dosage
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Can any med be stopped abruptly?
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NO
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What are some SE of steroid useage?
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fluid retention and edema watch for hypovolemic shock
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Diet for a person on adrenal steroid use
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low in Na high in K+
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What should a person under steroid therapy avoid
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stress, infection
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Action of estrogen and progesterone combo
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controls vasomotor symptoms, prevents tissue atrophy,osteoporosis, keeps cholesterol in check
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What is the most common SE of HRT
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thrombus
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other SE of HRT
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nausea, fluid retention, weight gain, breast tenderness
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What occurs from unopposed estrogen
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uterine cancer
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what increases when just progesterone used
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breast cancer
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what HRT are you given if you have an hysterectomy with ovaries left
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progesterone
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When do you give calcium
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throughout the day
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how much ca can the body process at one time
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600 mg
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What helps to incrase Ca absorption
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Vitamin D
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what is a cheap way to get extra Ca
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Tums
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What is the action of Vit D
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inhibits renal excretion of Ca, increases Ca absorption from intestine, increases serum Ca levels which stimulates osteoblast activity
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How is calcitonin given
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SC or nasal spray
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what does calcitonin do?
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prevents removal of bone Ca, decreases serum ca leves, increases renal excretion of Ca
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What must you have to be put on calcitonin?
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osteoporosis
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If you are on calcitonin, what must you also be taking?
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calcium
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What is the action of fosamax?
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inhibit bone resorption by osteoclasts, treats and prevent osteoporosis
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What are the nsg imp of fosamax
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cause GERD, so take am on an empty stomach with full glass of water and remain upright for 30 minutes. Must report difficulty swallowing or pain swallowing, worsening heartburn
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What are the brands of regular insulin we need to know?
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Humulin R and Novolin R
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What is the onset time of regular insulin
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30 - 60 min and 30 min
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When does regular insulin peak
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2-3 and 3-4 hours
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What is the duration of regular insulin
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6-8 hours
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What are the nsg implications for regular insulin?
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make sure pt has food coming, teach s/s hypoglycemia
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What is the action of humalog
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rapid acting insulin
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What is the onset of humalog
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5-10 min
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what is the peak of humalog
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40-50 min
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What is the duration of humalog
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3.5 hours
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What are the nsg imp of humalog
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make sure pt has food in front of them, s/s hypoglycemia, teach pt about peaks with med
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what is NPH
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intermediate acting insulin with long lag time
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What is the onset for NPH
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2 hours
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What is the peak of NPH
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6-8 hours
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what is the duration of NPH
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10-12 hours
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nsg imp of NPH
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teach pt about peaks and troughs, s/s hypoglycemia
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What is lantus
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long acting insulin with no peaks just steady dose of insulin
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What is the onset of lantus
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+/- 2/3 hours
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what is the peak of lantus
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none
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what is the duration of lantus
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16-24 hours
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what are the nsg imp of lantus
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must be taken same time everyday
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what does exercise do to insulin
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decreases it
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what is the onset time of D50
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IV - 30 sec, IM 15-20 min
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What do you you when pt comes out of it after giving glucagon
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snack
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What is the action of glyburide
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lowers glucose by stim the release of insulin from pancreas and increasing sensitivity to insulin at receptor sites
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SE of glyburide
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hypoglycemia and weight gain
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nsg imp for glyburide
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monitor for hypoglycemia
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where does glyburide stim. insulin from
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beta cells
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What is the action of metformin?
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decreased hepatic glucose prod. decreased intestinal glucose absorption, increases sensitivity to insulin
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SE of metformin
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abdominal discomfor, nausea, diarrhea, metallic taste, lactic acidosis, hypoglycemia
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what are the nsg imp for metformin
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monitor for hypoglycemia, must have good O2 and renal function helps them lose weight
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what must you have for metformin to work
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some insulin
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what medication helps block the hepatic glucose dump
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metformin
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what is the action of rosiglitazone
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improves sensitivity to insulin by acting as an agonist at receptor sites involved in insulin responsiveness and subsequen glucose prod and util. reques insulin
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what are SE of rosiglitazon
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increased cholesterol, weight gain
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what are the Nsg imp for rosiglitazone
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monitor for hypoglycemia
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what do you use for a petite mal or tonic/colonic seizure
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pheytoin
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what is a SE of phenytoin
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ginigval hyperplasia
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how do you give phenyltoin
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50mg/ml over 10 min
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what happens if you push phenytoin to fast
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cause HTN and cardiovascular collapse
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what is status epilepticus
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seizure that does not stop after 30 min
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S/S of status epilepticus
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tach, eleveated BP, hyperthermia leading to hypoglycemia
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what can status epilepticus casue
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permanent cognitive impairment, memory loss, worsening of seizure disorder and death
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what do you give for status epilepticus
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lorazepam or diazepam
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how fast do you push lorazepam
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.1mg/ks pushed 2 mg/min
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how fast do you push diazepam
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10mg/2ml 2 mg/min
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action of levodopa
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converted to dopamin in CNS where is seves as neurotransmitter
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what does levodopa do
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increases dopamine in CNS
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SE of levodopa
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ortho hypo, involuntary movement, hallucination
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nsg imp of levodopa
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give with food to minimize GI irritation
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What is the action of carbidopa
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prevents breakdown of levadopa, increases dopamin in CNS so can use a smaller does
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SE of carbidopa
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involuntary movements, hallucination
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nsg imp with carbidopy
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assess for parkinsonina sx
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what dopamine croiss blood brain barrier
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no
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can levodopa cross BB barries
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yes
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how do you differentiate between a sedative and hypnotic
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dose
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what does barbituates do?
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inhance GABA
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when are barbituates used
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alcohol withdrawl
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SE of sedative hypnotics
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most common decreased mental alertness, tolerance, dry mouth,
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nsg imp of sedative hypnotics
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bp, do not take more than 1 sedative hypnotic at a time
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action of theophylline
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relaxes smooth muscle of bronchi to produre bronhcodilation and ups strength of diaphragm contractions
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what is theophylline used to treat
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moderate to sever asthma
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what do you give IV aminophylline
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only in emergencies
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range for theophylline
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10-20
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S/S of theophylline toxicity
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N/V, nervousness, anxiety, shaking, insomnia, seizure, tachy, arrhythmias, death (3 pots coffee)
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what reduces theophylline levels
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smoking
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what intensifies adverse effects of theophylline
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caffeine
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action of a beta 2 agoist
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powerful bronchodilaors relax smooth muscle and surround airway
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how long to beta 2 agonists take to work
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rapid onset 15 min
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how long do beta 2s take to work
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4-6 hours
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what are beta 2s used for
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acute asthma sx, rescue inhaler
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SE of beta 2 agonist
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nervousness, anxiety, tremor, tachy increased BP
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fast acting beta 2
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albuterol
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slow acting beta 2
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salmeterol
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what is salmeterol use to treat
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chronic COPD not effective in acute attacks
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When is salmeterol usually given
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at night
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What is a pt uses albuterol canister in less than a month
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start them on corticosteroids
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action of steroid inhailors
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reduces sx of asthma by suppressing inflammation of airways
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SE of steroid inhalors
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yeast, dysphonia
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action of antihistamines
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blocks effects of histamine at H1 receptor sites
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SE of antihistamines
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drowsiness, antislud can cause oppostie effects in child and elderly
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1 gen antihist
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benadryl
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2 gen anti hist
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claritin
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when does an antihistamine work best
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before exposure to allergen
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What generation has less side effects but costs more
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2nd
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action of decongestants
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vasoconstriction of capillaries in nasal mucosa
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what do decongestants not do
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relieve sneezing, itching runny nose
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excessive use of decongestant spray
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excessive use of spray causes rebound nasal congestion
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what are SE of decongestants
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increase in BP, use cautiously in pt with HTN, CAD, hyperthyroidism, and DM to prevent sever elevation of BP
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action of expectorants
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decreases viscosity of sputum and promote removal
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what is the best agent to liquegy secretions
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water
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What is an antitussive
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cough suprressant
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what must you be careful with antitussives
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watch acetaminophen intake
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how do opioids and dextromethorphan antitussives do
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suppress cough within the CNS equally and effective in combo
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How does benzonatate work
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suppresses cough by decreasing the sensitivity of stretch receptors in the cough reflex pathway.
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What must you make sure of with tessalon pearls?
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swallow pills intact
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action of reglan
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blocks dopamine and serotonin receptors in the CTZ and increases motility in pts with slowed motility
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what do you sue reglan for
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treat NV for chemo
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SE of reglan
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drowsiness EPS and restlessness
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zantac action
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inhibits gastric secretions by H2 receptor blockade in gastric parietal cells
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SE of zantac
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dizziness, h/a, diarrhea, confusion, gynecomastia and reduced sperm count major nes
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what is zantac used to treat
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peptic ulcs, stress ulcers GERD
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What is the action of sucralfate
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binds to damaged mucosa to coat and protect stomach from acid and allow ulcer to heal
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name soem antacids
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tums, rolaids
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what do antacids do
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neutralize acid already secreted
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When are antacids most effective
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1-3 hours after a meal
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action of Proton pump inhib
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blocks the proton pump of parietal cells
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what are PPIs used for
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peptic ulcers , GERD stress ulcers
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name some bulk forming laxatives
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metamucil and citrucel
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action of bulk form lax
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absorbs water thereby softening and enlarging fecal mass,
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what does fecal swelling promote
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peristalisis
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how do you take bulk forming laxatives
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with a large glass of water
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name a surfactant laxative
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docusate sodium
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action of surfactant lax
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stimulates peristalisis by lowering surface tension to allow penetration of water also causes secretion of water and electrolyes into intesting
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zantac action
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inhibits gastric secretions by H2 receptor blockade in gastric parietal cells
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SE of zantac
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dizziness, h/a, diarrhea, confusion, gynecomastia and reduced sperm count major nes
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what is zantac used to treat
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peptic ulcs, stress ulcers GERD
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What is the action of sucralfate
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binds to damaged mucosa to coat and protect stomach from acid and allow ulcer to heal
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name soem antacids
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tums, rolaids
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what do antacids do
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neutralize acid already secreted
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When are antacids most effective
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1-3 hours after a meal
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action of Proton pump inhib
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blocks the proton pump of parietal cells
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what are PPIs used for
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peptic ulcers , GERD stress ulcers
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name some bulk forming laxatives
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metamucil and citrucel
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action of bulk form lax
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absorbs water thereby softening and enlarging fecal mass,
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what does fecal swelling promote
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peristalisis
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how do you take bulk forming laxatives
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with a large glass of water
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name a surfactant laxative
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docusate sodium
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action of surfactant lax
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stimulates peristalisis by lowering surface tension to allow penetration of water also causes secretion of water and electrolyes into intesting
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what type of laxative can be used long term
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surfactant (doc sod)
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what are some stimulant lax
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dulcolax exlax
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action of stimulant lax
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stimulates peristalsis and softens feces by increasing secretion of water and electrolytes into the intesting and decreased water and electrolye abs
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how do you take stim lax
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swallow tabs whole
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what does long term suppository use cause
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proctitis burning sensations
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how long does castor oil take to work
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2-6 hours
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name some osmotic lax
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MOM and fleets
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action of osmotic laxatives
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osmotic action retrains and draws water to soften feces, fecal swelling promotes peristalsis
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when are osmotic lax contraindicated
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hrt fail, htn, edema and renal dys
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when do you absolutely NOT give a laxative
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ABD pain, undx
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