Page 1
S&S of Salicylism:
tinnitus
sweating
HA
dizziness
resp alkalosis
PTT range for a pt on coumadin therapy:
60-80 sec
What are gold salts used for and what are two potential adverse effects of gold salts:
Gold salts are antirheumatics.
Watch for renal toxicity and stomatitis/mouth sores
propylthiouracil is for what and what are its effects:
PTU is for treating hyperthyroidism.
- lower serum T4
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- lower HR
Toradol (ketorolac):
- for short term pain
- not anti-inflammatory
- if used with opioids, analgesia is enhanced and adverse opioid effects are eliminated
2 major adverse effect of ACE inhibitors:
- dry cough
- hyperkalemia
Lipitor (atorvastatin) adverse effects:
- hepatotoxicity
- myopathy (check, CK lvls)
- peripheral neuropathy
therapeutic digoxin levels should be:
Page 3
0.5-2.0 ng/ml
3 major adverse effects of SSRI's:
- sexual dysfxn
- weight gain
- serotonin syndrome (confusion, agitation, anxiety, tremors, hallucin.)
how should tetracyclines be taken?
- on an empty stomach
- avoid all antacids, iron, milk, etc
what is echinacea used for?
immune-stimulation
what's Compazine used for?
- non-psychotic anxiety
- schizo
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- severe N/V
what's Tigan used for?
post-op N/V associated with gastroenteritis
digitalis toxicity can be caused by a combo of digoxin and what serum electrolyte imbalances?
- low K and Mg
- high Ca
T/F. Lactated Ringer is a colloid solution.
False.
It's a crystalloid solution.
what are the 2 types of antihistamines and what do they do?
- H1-blockers decrease smooth muscle constriction
- H2-blockers decrease gastric secretions
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Is benadryl a 1st-gen or 2nd-gen antihistamine? and what does that mean?
Benadryl is 1st-generation, which means anticholinergic symptoms such as dry mouth & drowsiness.
What class is Allegra and Claritin?
2nd-generation antihistamine
besides pain, what else do narcotics suppress?
cough
what's Benadryl used for?
- nasal congestion
- cough
- sleep problems
- itching
Contraindications for Benadryl:
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- asthma
- liver problems
- pregnancy, breastfeeding
- narrow-angle glaucoma
- alcohol, other depressants
Side effects of Robitussin:
dizziness and drowsiness
T/F. Robitussin suppresses respirations as well as coughs.
False.
It suppresses coughs but not respiration. It's a nonnarcotic, but pts should avoid alcohol and narcotics and other depressants.
Clonidine (Klonopin) lower BP and belongs to what general class?
it's an alpha-agonist.
what class is Albuterol?
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beta agonist
T/F. Respiratory depression is an adverse effect of Diazepam (Valium).
True.
taking viagra and ImDur together can cause what adverse effect?
severe hypotension
when treating asthma, do glucocorticoids induce bronchodilation?
No.
Glucocorticoids decrease airway inflammation only.
therpeutic INR range when on Warfarin:
3-4
normal PTT range:
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30-45 sec
normal PT range:
12-15 sec
1 pint = how many fl oz?
1 pint = 16 fl oz
how many tablespoons are in 8 fluid oz?
16 Tbsp = 8 fl oz = 1 cup
2 Tbsp = 1 fl oz
T/F. leukotriene receptor antagonists can be used to treat exercise-induced asthma in kids.
False.
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how does Singuilar and other leukotriene receptor antagonists help to treat asthma?
- reduces inflammation in lungs
- decreases mucus, airway edema, and bronchoconstriction
how do you calculate the child dose from the adult dose?
child dose = adult dose x kid's BSA / 1.73
how many mls are in 1 tablespoon?
1 Tbsp = 15 mls
1 quart = how many liters?
1 quart = 1 liter
how many fluid ounces are in cup?
8 fluid ounces = 1 cup
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1 fluid ounce equals how many ml?
30 ml
frequent use of what can increase risk of DM, cataracts, and osteoporosis in elderly?
glucocorticoids
what's the antidote for heparin?
protamine sulfate
what's the antidote for digoxin?
digibind
what are 6 side effects to digoxin?
- yellow vision
- photophobia
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- bradycardia
- drowsiness
- N/V
- anorexia
what's the drug that causes a flat line then fixes the dysrhythmia?
Adenosine
T/F. dopamine, epinephrine, norepinephrine, and dobutamine can all be used to correct hypertension.
False.
They can all be used to correct hypotension.
T/F. thiazides (HCTZ) can cause hyperglycemia.
True.
what must you verify before giving an osmotic diuretic?
UO
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T/F. You can take ampicillin if you're allergic to penicillin.
True.
what adverse effects do you watch for when on Levoquine (Levofloxacin?
tendon rupture
Acyclovir (for Herpes), when taken with what can increase risk for nephro- and neuro-toxicity?
aminoglycosides
what do you always give along with Rifampin to prevent peripheral neuropathy?
vit B6
3 adverse effects of vancomycin?
- redman syndrome
- nephrotoxicity
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- ototoxicity
what to monitor for when taking TMP, SMZ, or bactrim?
- monitor UO
- increases bleeding w/ warfarin
Sulfonamides (TMP, SMZ, bactrim, septra) are used for ppl allergic to what?
penicillin
who should not take tetracyclines?
- kids under 8
- pregnant ppl
- ppl with liver or renal disease
2 adverse effects of cephalosporins:
- nephrotoxicity
- bleeding
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what contraindicates cephalosporin use?
penicillin allergy
quinolones are the 1st line tx for what?
anthrax
what class is Ciprofloxacin?
quinolone
how should you take quinolones?
- empty stomach
- no antacids or iron (decreases absorption of quinolones)
name 2 adverse effects of amionoglycosides:
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- nephrotoxicity
- ototoxicity
what is used to treat myxedema coma?
- cortisol
- glucose
- IV synthroid
- electrolytes
WHat can be used to treat thyroid storm?
- beta blocker
- iodine
- amiodarone
What's Nitroprusside for?
to treat hypertensive emergencies
- immediate vasodilation
- BP increases as soon as it is discontinued
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What is given to treat insulin-induced hypoglycemia or insulin shock?
- Dextrose 50% IV bolus
- Glucagon (IV, IM, SQ) for severe cases, or when Dex50% is unavailable or no IV line
which drug is usually administered with epinephrine for anaphylactic shock?
Benadryl - antihistamine
(to treat histamine-induced tissue swelling)
Dopamine is used to treat hypotensive shock states not caused by what?
not cause by hypovolemia
What F&E imbalance is sodium bicarbonate used to treat?
metabolic acidosis
What is indicated for thyroid storm, A-fib, pulseless V-tach and V-fib?
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Amiodarone
besides its use as a topical anesthetic, what else is Lidocaine used for?
treat ventricular dysrhythmias (also local anesthetic effects on heart)
what's the treatment of choice for anaphylactic shock?
epinephrine
Caster oil can be used as what?
laxative
What's Zofran for?
antiemetic, esp for chemo
What is Phenergan?
Page 18
what do you watch out for?
- pre-op or post-op antihistamine antiemetic
- watch for EPS and resp depression
What OTC drug can prevent traveler's diarrhea by coating the GI and absorbing toxins?
Pepto-Bismol
T/F. Metallic taste and edema are side effects of lithium therapy.
True.
Lithium therapy depletes which electrolyte?
sodium
T/F. Asian and Hispanic pts need higher doses of antidepressants.
False.
THey need lower doses.
Page 19
antidepressants are contraindicated for what condition?
glaucoma
(due to anticholinergic effects)
Prozac belongs to what drug class?
SSRI antidepressant
T/F. Prozac may cause suicidal ideations.
True.
MAOI's can cause hypertensive crisis if used with what?
- CNS stimulants / sympathomimetics
- tyramine rich foods
- ginseng and st. john's wort
Elavil belongs to what drug class? what should you watch out for?
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- class: TCA (antidepressant)
- watch for EPS, anticholinergic effects, cardiac toxicity, and ortho hypotension
Anticholinergics and Dopaminergics for treating Parkinsons is bad for what eye condition?
glaucoma
How should you take Levodopa?
PO, with food
what class of drugs can improve cognitive fxning of alzheimers?
ACE inhibitors
(e.g. Cognex/Tacrine)
What oral problem can Dilantin cause?
gingival hyperplasia
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What is a common urine characteristic when taking anticonvulsants?
red-brown pee
What do you give first to control seizure activity? followed by what else?
- Ativan for immediate control of convulsions (sedative)
- followed by Dilantin for maintenance (antiepileptic)
antidote for narcotics is:
narcan (naloxone)
generic names for narcotic antagonists begin with what?
"Nal-"
(e.g. Naloxone, Naltrexone)
how do narcotic and nonnarcotic analgesics differ in terms of their target system?
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- narcotic acts on CNS
- nonnarcotic acts on PNS
inhalation (general) anesthetics often end in what?
"-thane" or "-rane"
Lidocaine (Xylocaine) belongs to what class?
local anesthetic (allows consciousness)
Diprivan (Propofol) and Versed (Midazolam) belong to what class? What do you monitor for Diprivan?
- Class: short-term IV anesthetic
- For Diprivan, monitor for microbial growth (it's lipid based)
Ambien is a sleep aide that belongs to what class?
a non-benzo sedative
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Ativan and Valium belong to what drug class? and are used for what?
- class: benzodiazepine sedative
- used to treat anxiety and insomnia
- often ends in "-am" or "-pam"
what's the antagonist to benzodiazepines?
Ramazicon (flumazenil)
Dexedrine belongs to what class? and is used to treat what?
- class: amphetamines
- treats ADHD and obesity (anorexiant)
Adderall belongs to what class? and is used to treat what?
- class: amphetamines
- treats ADHD and narcolepsy
T/F. Dopamine is an adrenergic.
True.
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what other drug do you avoid when taking Albuterol?
MAOI's
(to avoid hypertensive crisis)
T/F. Anticholinergics can be used to treat Parkinson tremors.
True.
T/F. Atropine is a cholinergic.
False.
It's an ANTIcholinergic and increases the HR.
fight or flight drug class:
adrenergics
T/F. Reglan is a cholinergic.
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True.
It speeds up GI motility.
inhalants are stimulants or depressants?
CNS depressants
What are the general actions of cannabis?
- slows down brain
- speeds up cardio & resp systems
MOOD: relaxation and disinterest
is opioid a stimulant or depressant?
depressant
is amphetamine a stimulant or depressant?
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stimulant
Is nicotine a stimulant or depressant?
stimulant
is cocaine a stimulant or depressant?
stimulant
T/F. Singulair is only for prophylactic and maintenance use, not for acute asthma attacks.
True.
What class is Singulair? and what does it do?
- Leukotriene receptor antagonist
- inhibits smooth muscle contraction
Given an anticholinergic, a B-agonist, and a steroid, what order should they be given to treat COPD?
Page 27
1. beta-agonist
2. anticholinergic
3. steroid
Atrovent belongs to what class?
anticholinergic
Methylxanthines such as caffeine and theophylline can increase the risk of which 2 toxicities?
- digitalis toxicity
- lithium toxicity
T/F. sympathomimetics, anticholinergics, and glucocorticoids can all be used for COPD Tx.
True.
besides being the antidote to Tylenol overdose, what else does Mucomyst do?
liquifies and loosens thick mucus (mucolytic)
Page 28
what class is Albuterol?
beta agonist
Clonidine (Klonopin) lower BP and belongs to what general class?
it's an alpha-agonist.
T/F. Robitussin suppresses respirations as well as coughs.
False.
It suppresses coughs but not respiration. It's a nonnarcotic, but pts should avoid alcohol and narcotics and other depressants.
Side effects of Robitussin:
dizziness and drowsiness
Contraindications for Benadryl:
Page 29
- asthma
- liver problems
- pregnancy, breastfeeding
- narrow-angle glaucoma
- alcohol, other depressants
what's Benadryl used for?
- nasal congestion
- cough
- sleep problems
- itching
besides pain, what else do narcotics suppress?
cough
What class is Allegra and Claritin?
2nd-generation antihistamine
Is benadryl a 1st-gen or 2nd-gen antihistamine? and what does that mean?
Page 30
Benadryl is 1st-generation, which means anticholinergic symptoms such as dry mouth & drowsiness.
what are the 2 types of antihistamines and what do they do?
- H1-blockers decrease smooth muscle constriction
- H2-blockers decrease gastric secretions
T/F. Lactated Ringer is a colloid solution.
False.
It's a crystalloid solution.
digitalis toxicity can be caused by a combo of digoxin and what serum electrolyte imbalances?
- low K and Mg
- high Ca
what's Tigan used for?
post-op N/V associated with gastroenteritis
Page 31
what's Compazine used for?
- non-psychotic anxiety
- schizo
- severe N/V
what is echinacea used for?
immune-stimulation
how should tetracyclines be taken?
- on an empty stomach
- avoid all antacids, iron, milk, etc
3 major adverse effects of SSRI's:
- sexual dysfxn
- weight gain
- serotonin syndrome (confusion, agitation, anxiety, tremors, hallucin.)
Page 32
therapeutic digoxin levels should be:
0.5-2.0 ng/ml
Lipitor (atorvastatin) adverse effects:
- hepatotoxicity
- myopathy (check, CK lvls)
- peripheral neuropathy
2 major adverse effect of ACE inhibitors:
- dry cough
- hyperkalemia
Toradol (ketorolac):
- for short term pain
- not anti-inflammatory
- if used with opioids, analgesia is enhanced and adverse opioid effects are eliminated
Page 33
propylthiouracil is for what and what are its effects:
PTU is for treating hyperthyroidism.
- lower serum T4
- lower HR
What are gold salts used for and what are two potential adverse effects of gold salts:
Gold salts are antirheumatics.
Watch for renal toxicity and stomatitis/mouth sores
PTT range for a pt on coumadin therapy:
60-80 sec
S&S of Salicylism:
tinnitus
sweating
Page 34
HA
dizziness
resp alkalosis