Pharmmmmm

Infants are at risk for drug toxicity due to
Decreased liver enzymes, reduced kidney function and reduced liver perfusion
Anaphylactic rations
Wheezing, swallowing difficulty, itching, tachycardia, angiogram facial swelling
A patient is having difficulty remembering taking a med. what form should be given
Extended release because they release over a lengthy period of time a patients can take less often
Preg cat D
Require use of contraception in women of childbearing age, can cause fetal malformations, can pass through the umbilical cord, weight benefits against risk
History of renal insufficiency is taking lithium what should be monitored?
Drug toxicity
Topical med is no longer effective
Tolerance to the drug
OTC meds
Do not require PCp supervision, can interact with other drugs, should be included in history, and may consist toxicity
Naproxen enteric coated
Do not crush or chew meds, drug is supposed to reach small intestine
Small margin of safety with drugs such as Dilantin
Periodic la. Tests, monitor for indications of toxicity, take smallest effective dose
Hospitalized with chest pain, when should discharge plan begin
As soon as possible
Itching
Can indicate drug hypersensitivity and allergic reaction
Fastest rate of absorption
IV
Peak and trough levels help monitor for
Drug tox, max effective dose, constant therapeutic level
Can decrease a patients ability to learn
Cognitive level, language, comfort level, readiness to learm
Peak time
Time it takes drug to demonstrate full therapeutic effect. Blood glucose is lowest at peak drug time
vasotec,ndrug eliminated in kidneys for hypertension, before taking meds
Check creatinine clearance which checks renal and liver function
Calculating drug dosages for children
Older kids have a higher metabolism and metabolize drugs faster
Taking Tylenol and codeine
Achieve desired effect with using lower dosages, both drugs gave similar actions
Tegretol and grapefruit juice
Causes drug toxicity. Inhibits enzyme in liver that metabolizes drugs
Digoxin adverse effect
Cardiac dysrythmias, non therapeutic
Infant drug absorption
Delayed gastric emptying is slower in infants, which can increase absorption in the stomach but not the intestine
Teratogenic drug
Fetal malformation
Patient receiving nitro IV and is changing to oral form, oral dose will be higher because
Decreased bioavailability because of the first pass effect
Parenteral routes
IV, subcutaneous, and IM
OTC and newborn consideration
Newborns weight, how much child breast feeds, benefits to mom outweigh risks to baby, properties of drug
Patient taking modanifil (pro vigil)to treat narcolepsy what considerations
Take drug in morning, non amphetamine stimulant, taking in morning will help to improve wakefulness. Taken1 hr before work
Zolpidem/ambien history of benzo abuse, caution patient drug can cause
Memory impairment
Adverse effects of interferon beta-1a (Avon ex) minimize adverse effects by
Interferon beta drugs can cause feve, chills, headaches and muscle aches. Premedication with acetaminophen or an NSAID can help minimize this
Levodopa dopar will help control parkinson symptoms
Increases dopamine in extra pyramidal center of brain
Adverse effects of depakote
Drowsiness, sedation, rash is a side effect of anti epileptic drugs
Potentially serious adverse effect to interferon
Because of the potential for bone marrow suppression and decreased platelet count patients should report bruising bleeding or fatigue
Ritalin
Increased focus
Memantine namenda for Alzheimer’s instructions
Notify PCP if they start taking OTC antacids that contain sodium bicarbonate because that can decrease excretion leading to toxicity
Adderall adverse effects
Tachycardia
Dopar levodopa for Parkinson’s
Change position slowly because it can cause orthostatic hypotension
Danteolene dantrium for skeletal muscle spasms. What lab test?
Liver function serious adverse effect of dantrolene. Regular intervals and advise patient to report jaundice or abdominal pain
Pramipexole (mirapex) Parkinson’s
Monitor CPK creatinine phosphor insane enzyme found in the heart brain and skeletal muscle. Monitoring CPK can allow possibility of skeletal muscle damage from the drug
Baclofen lioresal instructions
Centrally acting muscle relaxant. Avoid driving
Aricept donepezil for Alzheimer’s. Monitor for
Nausea vomiting and diarrhea. Taking drug with food can help
Temazepam Restoril instructions
Avoid alcohol and other cns depressants, take 30 min before bedtime, taper drug slowly
Imitrex sumatriptan adverse effects
Chest pain is number 1. Should report any tightness in jaw, chest, or back. Not an appropriate choice for history of coronary artery disease
Depakote and Dilantin drug interaction
Valproate acid can cause an increase in phenytoin blood levels causing toxicity
Due to potential for adverse effects tegretol should be
Titration from the lowest possible dosage, visual disturbances, vertigo and ataxia can occur. Dosage should be low
Midazolam versed
Causes amnesia and anti anxiety
Pentothal thiopental what should be monitored
Short acting barbiturate can cause respiratory depression. Mechanical ventilation and monitoring are essential
Lidocaine for spinal anesthesia serious adverse effect
When systemically absorbed lidocaine can cause HYPOTENSION especially when used as a spinal anesthetic
Dantrolene dantrium for muscle spasms
Prolonged diarrhea can cause dehydration and is an adverse effect of dantrolene . Need to report
Valproate acid monitor for what adverse effect
Jaundice abdominal pain and nausea
Selegiline and eldepryl for Parkinson’s and Demerol meperidine can result in
Muscle rigidity, stupor agitation, hypertension, and fever
Installing pilocarpine pilocarpine for glaucoma
apply gentle pressure to nasolacrimal duct for 1 min. Do not touch tip of dropper, remove contact lenses
Thorazine chloropromazine
Wear sunscreen, limit exposure to sunlight
Amitryptiline leaving
Change positions slowly, do not stop taking abruptly, take at bedtime to prevent daytime drowsiness, increase fluid and fiber intake
Lithium for bipolar
Monitor thyroid function tests because hypothyroidism is an adverse effect, patients should report neck enlargement weight gain and lethargy
Nardil phenelzine avoid tyramine amine because
They can trigger hypertension in patients taking phenelzine. Headache nausea and lethargy
Betaxolol eye drops adverse effects
Bradycardia,can also expect some ocular stinging upon admin
Echothiophate glaucoma, monitor for development of of
Cataracts or opacity of the lens, report any changes in vision, cloudiness or halos around the eyes
Wellbutrin
Seasonal affective disorder, smoking cessation, and depression
Prozac
Report suicidal thoughts
A health care professional should question the use timolol for which patient
Asthmatic because a beta blocker can cause bronchospasm
Thorazine for schizo experiencing muscle spasms
Acute dystopia can develop during the first few days of treatment with Thorazine, treatment includes admin if Benadryl
Xanax adverse effects
Anxiety, respiratory depression, sedation and tolerance. Avoid alcohol
Avoiding lithium toxicity
Avoid NSAIDS because they increase the renal absorption of lithium and sodium. Concurrent use is contraindicated
Risperdal, risperidone adverse effects
Polyurethane, can cause new-onset DM. Check glucose regularly
Lithe and furosemide
Lithium toxicity in the form of hypertension, LASIK increases sodium loss and can cause lithium absorption.
Head trauma and Wellbutrin
Can cause seizure activity when patients have a cns tumor or hx of head trauma
bus par
Allow 2 to 4 weeks to feel effects
During and immediately following IV Thorazine what should be monitored
Blood pressure… At risk for hypotension. Should remain supine for 3o min. Essential to infuse slowly
Prozac agitation and confusion
Serotonin syndrome can begin 2 to 72 hours after taking Prozac. Mental confusion, agitAtion
Orthostatic hypotension is common in
Imipramine tofranil.
Effexor venalafaxine and phenelzine/Nardil
Should not be taken together. Phenelzine is an maoi.
malignant hyperthermia what should you do?
Provide cooling measures, discontinue anesthesia
Post-op needs vent, received panchromatic ism, provider should expect prolonged paralysis from
Gentamicin, an amino glycoside, which can interact with neuromuscular blocker increasing prolonged paralysis
Calcitonin-salmon
Make sure not allergic to fish, report rash or itching, prime the pump, report nasal, irritation
Neostigmine ( prostigmin) to increase muscle strength after myasthenia gravis, serious adverse action
Bradycardia, measure apical pulse and notify if below 60 bpm. It is essential to have atropine on hand
Succinylcholine anecdote is a depolarizing neuromuscular blocker
Causes muscle paralysis by binding with cholinergic receptors at the neuromuscular junction. Mimics acetylcholine
Fosamax (alendronate) osteoporosis, adverse effects
Joint pain and muscle pain, nausea, visual disturbance and esophagitis
Enbrel etanercept report which?
Skin rash can cause serious infection such as Steven Johnson syndrome
Neostigmine prostigmin for myasthenia gravis
Keep atropine on hand
Raloxifene evista therapeutic action
Mimics the effects of estrogen on bone tissue. Minimizing or stopping bone loss
Questions thee use of enbrel with DIabetes because the risk of
Infection from both med and disease process
Neostigmine prostigmin contraindicated in
Asthma because ain’t can cause bronchospasm. A monitor breath sounds and have atropine on hand
Rosa max alendronate monitor for what?
Jaw pain, blurred vision, and muscle pain
Calcium supplements
Reports flank pain which indicated renal calculi, patient should increase water intake and report blood in urine or flank Paine
Anectine succinylcholine, develops rigid muscles, tachycardia and spike in temp
Malignant hyperthermia is suspected
Fosamax alendronate
Decreases activity a of osteoclasts
Prednisone and calcium carbonated
Drink 8 oz of water with calcium tabs, chew calcium tabs before swallowing, take drugs 1hour apart, divide doses in 3 doses
Fosamax is contraindicated
Should remain flat on bed rest, patient has to sit or stand for 30 minutes to prevent esophagitis
Raloxifene evista serious adverse reaction to drug
Calf pain indicates DVTa
Enbrel can cause hearts failure, monitor for
Shortness of breath, cough elevated BP and heart rate
Methotrexate
Drink 2 to 3 L per day, can cause kidney damage so you need to drink a lot of water o
Methotrexate teaching
Avoid people who are sick, periodic lab tests, report bruising or Petechia, avoid drinking alcohol
Muscle relaxants such a anectine require cautious use in
Hyper kalmia myasthenia gravis, and respiratory depression
Lithium toxicity
Tremors, confusion, nausea, muscle weakness
Methotrexate monitor for
Can cause gastric irritation so watch for black Garry stools
Evista raloxifene monitor for
Increase activity such as walking, use a contraceptive if there is any chance of pregnancy increase intake of calcium and vitamin