patho last minute need to know

basal insulin

no peaks

includes long acting insulin (determir, glargine)

does not need to be administered w/ meals

Bolus insulin

rapid acting (aspart, linspro)

regular insulin

peaks in 1-3 hrs

needs to be given w/ meals

metformin

oral med for type 2 DM

hold before using contrast - A/E lactic acidosis

causes diarrhea (take w food)

Benzodiazepines

Pam and Lam = benzo fam!

PRN

S/E - sedation, respiratory depression

reversal agent - flumazenil

barbituates

end in barbital

like a benzo, more dangerous

S/E - respiratory depression, sedation, agranulosis

zolpidem

Sedative hypnotic, works on GABA

2For short term insomnia

Give immediately beÿore bed, rapid onset

Controlled substance

SE: nocturnal eatinĀ and sleep walkinĀ, depression, dizziness

buspirone

For anxiety and insomnia, balances dopamine and serotonin

Works slowly: not a PRN

Not a controlled substance

SE: drowsiness, dizziness

Phenytoin

seizure med

must be given slowly IV

many many SE

atorvostatin

lowers LDL increases HDL

AE - rhabdo (check kidney levels)

Cholestyramine

increase water intake

AE- anything w belly

niacin/B3

cannot give OTC b3

AEs: flushing (give aspirin 30 mins before to prevent)

Omeprazole

stops acid completely

take on an empty stomach first thing in

the morning (6 am med)

dont use long term!

famotidine

decreases acid

shorter acting than PPIs

Sucralfate

coats stomach

don’t take w/ food (1 hr before) or other meds

misoprostol

GI protectant

no pregnancy

Metoclopramide

treats GERD and nausea

BBW - tardicative dyskinesia (reversal agent benztropine or

diphenhydramine)

Antacids

Aluminum Hydroxide: antacid, don’t take with other meds

- AEs: constipation

- Calcium Carbonate: antacid, don’t take with other meds

- AEs: constipation, milk-alkali syndrome (when taken w/ milk)

- These neutralize stomach acid

- Education: give 2 hrs apart from other meds and 1 hr after

meals/bedtime

- Caution w/ renal pts

Scopolamine (transdermal patch):

treats motion sickness

- Change patch every 3 days, apply 20-60 mins before travel

Prochlorperazine

psych med for N/V

BBW -psychosis in elderly

Ondansetron:

used for chemo

BBW - prolonged QT interval

Psyllium

increases size of fecal mass

mix with 8oz liquid

Lactulose

Decreases ammonia to treat hepatic encephalopathy

- NEVER hold ÿor diarrhea in pts with hepatic encephalopathy (that’s the desired

effect)

acetaminophen

potentially nephrotoxic if overdose

3-4 g per day MAX

reversal agent = Acetylcysteine

Ibuprofen

BBW: increase risk oÿ MI/Stroke in those w/ cardiac hx

Ketorolac:

IV/IM/PO rx NSAID, only 5 days

not before surgery/active bleeding

morphine

SEDATION + RESPIRATORY DEPRESSION