Drug quiz

  1. Ativan PO pg 799
    • For: Anxiety disorder, sedation
    • Interact: Additive CNS depression (alcohol, antihistamine,opioid analgesics)
  2. Tagamet PO (cimetidine) pg. 661
    • *Increase risk of toxicity with Coumadin (Warfarin)*
    • For: Healing and prevention of ulcers. Decrease GERD symptoms, Decrease secretion of gastric acid.
    • Assess for epigastric or abdominal pain, frank/occult blood stools, emesis, gastric aspirate.
    • Check CBC w/ diff for anemia, agranolocytosis.
    • Administer with meals or at bedtime to prolong effect (one dose/day=hs).
  3. Vicodine pg. 675
    • Reduce moderate-severe pain.
    • Assess pain level
    • Don’t use with MAOI (Marplan, Parnate)
  4. Too much Tylenol/day
  5. Coumadin (Warfarin) pg 1295
    • Prevention of thromboembolic events, blood clots, MI
    • *Check PT (1.3-1.5 % of normal) & INR (2.5-3.5 recommended for therapeutic effect)*
    • Heparin may effect PT, INR but Coumadin PO takes 3-5 days to reach effective level, usually begun still on Heparin.
    • Contraindicated: active ulcer disease, bleeding issues
    • Limit foods high in vitamin K, cranberry juice/products, IM meds, activities that could lead to bleeding, NSAIDs. Use soft toothbrush.
  6. Foods High in Vitamin K
    • Collards
    • Spinach
    • Greens
    • Brussels Sprouts
    • Broccoli
  7. NSAIDs
    • Non-Steroidal Anti-Inflammatory Drugs
    • Aspirin,
    • Celebrex,
    • Ibuprofen,
    • Naproxen
  8. Mylanta pg. 803
    • Use: Neutralization of gastric acid w/ healing of ulcers and decrease in associated pain.
    • Don’t take within 2 hrs of other meds
  9. Nitro Paste pg 929
    • Use: Relief/prevention of anginal attacks. Increase cardiac output. Reduction in BP
    • *Monitor BP before and after *
    • Use gloves
    • Rotate location of topical site
  10. Stadole IM pg 257
    • Use: Decrease the severity of pain moderate-severe. Used in labor, sedation before surgry
    • *assess pain prior to administration*
    • Rotate sites of injection
  11. Promethazine IM (Phenergan) pg. 1061
    • Use: Treatment of allergic conditions, motion sickness, sedation, anti-nausea/vomiting
    • Can cause CNS depression
    • Monitor for EPS
    • IM: Administer deep into well developed muscle. (Can cause severe tissue necrosis)
  12. Lovenox SQ (Enoxaparin) pg. 657
    • Prevention of thrombus formation
    • Assess for signs of bleeding/hemorrhage
    • SQ: Observe injection sites for hematomas, ecchymosis, or inflammation.
    • Administer deep into subcutaneous tissue. Inject in abdomen (rotate sides, stay at least 1” away from belly button). Pinch/bunch skin with thumb and forefinger.
  13. Meperdine IM (Demerol) pg. 820
    • Used for relief of moderate-severe pain.
    • Assess pain level
    • Can cause seizers, CNS depression.
    • Do not use with MAOIs
    • Check respirations and bowel function
  14. Hydroxyzine IM pg. 682
    • Sedation, relief of anxiety, decrease nausea/vomiting, decrease allergic symptoms associated with the release of histamine.
    • Do not use with pregnant women, causes CNS depression, increased fall risk.
    • Assess patient for level of sedation
    • *Use the Z-track, deep into well developed muscle. Do not use deltoid site, extremely painful shot.*
  15. Heparin SQ pg. 654
    • Prevention of thrombus formation. Prevent extension of existing thrombi
    • Assess for uncontrolled bleeding, open wounds, hypertension
    • Avoid NSAIDs
    • Monitor platelet count every 2-3 days.
  16. Assessing pain level
    • Site- Where is the pain?
    • Onset- When did the pain start, and was it sudden or gradual?
    • Character- What is the pain like? An ache? Stabbing?
    • Radiation- Does the pain radiate anywhere?
    • Associations- Any other s/s associated with the pain?
    • Time course - Does the pain follow any pattern?
    • Exacerbating/Relievingfactors - Does anything change the pain?
    • Severity- How bad is the pain?
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