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mood stabilizers
Carbamazepine (Tegretol) Valproic Acid (Depakote) Gabapentine (Neurontin)
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Absorption
time the drug enters the body until it gets into the bloodstream. affected by dosage form, route, GI motility
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ACE inhibitor works
Renin - angiotensinogen - Angiotnesin - ACE - ANGIOTENSIN II - vasoconstriction - aldosterone - increased Na/water
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ACE inhibitors
Inhibits the ACE in the lungs and prevents the formation of angiotensin II, this stops vasoconstriction and aldosterone
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ACE inhibitors SE
cough, angioedema, proteinuria, taste changes, orthostatic hypotension, pruritus, renal failure, rash, hyperkalemia
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AIDS
NRTI - Zidovudine (AZT) NNRT - Delavirdine, Nevirapine PI - Saqinavir, Ritonavir, Indinair
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Alpha 1 Blockers (-zosin)
Blocks the effects of the SNS by binding to alpha 1 receptor sites. antihypertensive/BPH
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Angiotensin II Blockers (-sartan)
binds to angiotensin II receptor sites
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Antacids
neutralizes gastric acid. Mg-diarrhea. avoid in renal pts. Ca & aluminum - constipation
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Anti-Infectives
antibiotic, anti-tuberculars, antiviral agents, AIDS, Antifungal Agents (-azole)
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Anti-Tuberculars
Isoniazid (INH) - Pyridoxine (Vit B6) to prevent peripheral neuritis. Ethambutol (myambutol), Pyrazinamide, Rifampin, Streptomycin
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Antibiotics
Penicillins (allergies. inhibit bacterial cell wall synthesis). Cephalosporins (-Cef - cross sensitivity) Vancomycin (Vancocin). Tetracyclines (-cycline. discoloration & bone abnormalities contraindication for pregnancy & children). aminoglycosides - (KNOW nephrotoxicity and Ototoxicity). Quinolones (-floxacin - for serious infection - cidal). Sulfonamids (-Sul - allergy - inhibit -static - UTI)
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Anticoagulant
Heparin: monitor PTT. Antidote: Protamine Sulfate Enoxaparin (Lovenox) Warfarin Sodium (Coumadin): Monitor PT/INR. antidote (Vit K)
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Anticoagulant SE
hemorrhage
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Antidiabetic Agents
Insulin, Sulfonylureas, Biguanides, Theazolidinediones, Alpha-Glucosidase Inhibitors, meglitinides
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Antidiabetic MOA
Insulin binds to receptor sites o cells and allows glucose to enter the cell for energy
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Antidiabetic Nursing Considerations
roll gently, rapid first only IV, monitor BS. always listen to pt. errors with this drug can cause death
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Antidiabetic SE
hypoglycemia (know onset, peak and duration), ketoacidosis
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Antiepileptics
Phenytoin (Dilantin - prototype). monitor therapeutic levels 10-20. must be given IV - only in NS and administered slowly
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Antifibrinolytics
Aminocaproic Acid (Amicar)
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Antifungal Agents (-azole)
Griseofulvin. Amphotericin B. Diflucan (Fluconazole). Nystatin
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Antiplatelet
ASA, Dipyridamole (Persantine, Ticlopidine (Ticlid)
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Antiviral Agents
Amantadine and Rimantadine (influenza A). Acyclovir (Zovirax) HSV. Cidofovir, Ganciclovir, Foscarnet, CMV
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Barbiturates
(antiepileptic) potentiates GABA. phenobarbital most frequently prescribed
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Benzodiazepines
lams and pam. Suppress CNS activity Clonazepam (Klonopin) also used as a MOOD STABILIZER
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Beta Blockers MOA
blocks the effects of SNS at beta receptor sites
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Beta Blockers NU Considerations
monitor HR & BP, I&O, and weight
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Beta Blockers SE
heart block, bradycardia, insomnia, dizziness, drowsiness, hypotension, and rash
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Cardiac Glycosides
Digoxin (Lanoxin). used for CHF (Congestive Heart Failure) and atrial fibrillation. positive inotrope, negative chronotrope
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Cardiac Glycosides Antidotes
Digoxin Immune Fab (Digibind)
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Cardiac Glycosides NU Considerations
AP 60-100. nl level 0.5-2.0 mg/ml
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Cardiac Glycosides SE
Anorexia, N/V, visual disturbances, arrhythmias, bradycardia, dig. toxicity with hypokaemia
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Centrally acting Agents
Binds to alpha 2 receptor sites and decreases outflow of the SNS from the brain (decreases BP) Clonidine (Catapres)
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CNS agents
Barbiturates, Benzodiazepines, Anti-epileptics Mood Stabilizers, Antipsychotics
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Culture and Sensitivity
Identifying organisms and teh drugs that kill the bugs
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Distribution
drug distributed to site of action. protein binding. blood brain barrier
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Diuretics
MOA: inhibit the reabsorption of Na and H2O. NU consideration: Monitor K
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Drug Resistant Organisms
MRSA, VRE
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Drugs affecting coagulation
anticoagulants, antiplatelets, antifibrinolytics, and thrombolytic drugs
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Drugs with FPE
are given by routes other than oral
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Excretion
drugs eliminated from body primarily by kidneys but also intestines, lungs, and mammary, sweat, and salivary glands (leaving the body). half-life: the time required for total amount of drug to decrease by 50%
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GI Drugs
Antacids, H2 Agonist (-tidine), Proton pump Inhibitors (-prazole), Antiflatulents, Anti-diarrheals, laxatives, Antiemetics
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Glucagon
possible antidote for beta-blocker OD
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H2 Antagonist (-tidine)
binds to H2 receptor sties to decrease HCL acid production
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IV doses of drugs
are going to be smaller because they bypass FPE (100% bioavailability)
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Loop Diuretics
(-amide) - furosamide (Lasix) lose K
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Metabolism
primarily liver. hepatic FPE. infants and elderly have a decreased ability to metabolized drugs
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Narcotic Analgesic
Morphine Sulfate, Meperidine (Demerol), Methadone
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Narcotic Antagonist
Nalaxone hydrochloride (Narcan)
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Narcotic MOA
Binds to opioid receptors to decrease pain perception. CNS: (Brainstem) controls respiratory rate
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Narcotic SE
RESPIRATORY DEPRESSION, N/V constipation! (know) sedation, confusion, euphoria, impaired coordination, urinary retention, pupil constriction
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Nitrate NU considerations
large FPE, teach to take one 1/4 grain tablet when chest pain occurs. Lie down and rest. Take 1 tab every 5 minutes up to 3 tab. Call 911 if no relief after first tab.
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Nitrates - Vasodilators
Nitroglycerin. SE - postural hypotension, HA, and tachycardia
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Non narcotic Analgesics
Acetaminophen (Tylenol, APAP) non-narcotic analgesic. not an NSAID because of no anti-inflammatory properties. hepatotoxicity with acute OD (CP 450 metabolite problems). antidote for OD: acetylcysteine (Mucomyst - respiratory drug)
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Normal flora
bacteria, fungi, or protozoa in the oropharynx, upper and lower intestine, lower GU tract, conjuctiv and skin. These microbial agents prevent pathogens from causing infection when normal flora are killed during broad spectrum antibiotic therapy (sensitive)
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NSAID SE
Tinnitus, GI bleeding, N/V (prostaglandins good in stomach. acid irritating to stomach)
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NSAIDS
Acetylsalicylic Acid (Aspirin, ASA - prototype) Ibuprofen (Motrin, Advil). antiplatelet properties with daily dosing: 81-325mg. Inhibits prostaglandin synthesis and thromboxane
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Nursing Considerations (Narcotic Analgesics)
Always assess respiratory rate before giving, assess pt pain perception, evaluate effectiveness of medication
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Pharmacodynamics
what the drug does to the body (drug action)
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Pharmacokinetics
What the body does to the drug
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Potassium-Sparing diuretics
Spirolactone (Aldactone) keep K
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Receptor interactions
Agonist: binds to receptor site & causes reaction Antagonist: binds to receptor and blocks the reaction that normally occurs Enzyme interactions. non specific interactions
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Sodium Channel Blockers
Lidocaine (Xylocaine) SE: drowsiness, V-tach, heart block, HTN, bradycardia NU considerations: monitor pulse and BP
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Superinfection
secondary infection caused from use of antibiotics in first infection?
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Thrombolytics
Streptokinase (Streptase), Alteplase (Activase)
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