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What should you teach a patient about omeprazole?
not take aluminum hydroxide within an hour of taking it
The patient with GERD had minimal relief with cimetidine. Omeprazole was started instead. What should the nurse share?
Long term therapy may be needed
A patient is taking warfarin and PPI omeprazole concurrently. The nurse should anticipate what?
Warfarin effects to be increased, dt/INR will be elevated, and there is an increased risk of bleeding
A patient stops their omeprazole after 6 weeks due to a foul smelling diarrhea and weakness. What should the nurse tell the patient?
Contact your primary care provider to be tested for Clostridium difficile (C. diff)
What does sucralfate do?
treatment of peptic ulcer by acting as a barrier to gastric secretions
What are medication administrations of sucralfate?
give 1-2 hors before meals
What is the prepared route of administration for promethazine? What is it never given as?
oral preparation, never given as SQ
What drug family is the first line of treatment of post-op nausea and vomiting?
SETRON family
How does metoclopramide work?
accelerating gastric emptying
What can metoclopramide cause?
tardive dyskinesia with involuntary and abnormal facial movements
What are the two common side effects of ondansetron?
headache and dizziness
What type of laxative is psyllium?
bulk laxative
What is the action of psyllium?
bulks up mass and water content of stool
What is psyllium used for?
constipation
How should you administer psyllium?
with a full glass of water
What type of laxative is bisacodyl?
stimulant laxative
What can occur as a result from bisacodyl or other stimulant laxatives?
dependency, fluid and electrolyte imbalances, and incontinence
What two medications are used as a bowel prep for a procedure like a colonoscopy?
-Polyethylene glycol/Golytely
-Magnesium citrate
What should the patient be taught in terms of medication administration of bulk forming laxatives?
take each dose with a full glass of water
What laxative is most likely prescribed to decrease straining for a postpartum client with a laceration from childbirth?
stool softener
What type of laxative is Lactulose?
osmotic laxative
Lactulose is a laxative but it also can do what? Who is it used for?
-decrease ammonia levels and are used for hepatic encephalopathy
What antidiarrheal medication has few adverse effects? Why?
Loperamide because it does not cross the BBB
What is a bismuth subsalicylate commonly known as and what are two common adverse reactions of bismuth subsalicylate that should be taught to the patient?
pepto bismol that can turn your tongue and bowel movements black
What is alosetron used for?
diarrhea
What are serious adverse effects of alosetron?
ischemic colitis and bowel obstructions that cause hospitilization or death
What is bismuth subsalicylate used to treat?
diarrhea
What must be assessed before giving bismuth subsalicylate to a patient?
allergy to aspirin
What medication is known to cause a diabetic's blood sugar to rise?
Prednisone (Deltasone)
How should insulin be administered to a patient with type 1 DM for life?
Mix NPH and regular insulin in 1 syringe
What antidiabetic drug is a rapid acting drug?
repaglinide/Prandin
When should repaglinide/Prandin be given?
no more than 30 minutes before meals
What is metformin used for?
diabetes
What are contraindications of metformin/Glucophage?
older adults, IV contrast, and high serum lactate levels
How does pramlintide/Symlin decrease blood sugar levels and how should it be administered?
Administered SQ with a meal immediately after in order to slow gastric empyting
How does Acarbose work?
delays complex carb digestion
What symptoms does Acarbose cause?
gross GI symptoms
When should Acarbose be given?
with the first bite of a meal
If 15 grams of carb are given for hypoglycemia, what symptoms happen at the insulin's peak action?
clammy and shakey
What is monitored when a patient is taking rosiglitazone/Avandia?
weight gain, crackles, and edema
What is contraindicated for rosiglitazone/Avandia?
patients with CHF
What cardiac medications can mask symptoms of hypoglycemia?
beta blockers
What is a very important teaching point to a newly diagnosed type 1 diabetic receiving insulin injections?
rotate injection sites preventing complications and inadequate absorption
What type of drug is glyburide?
sulfonylureas
What should be avoided when taking sulfonylureas' like glyburide and why?
alcohol because a disulfiram like reaction can occur
When is glargine given and why?
once daily, at the same time every day to maintain insulin throughout the day
What type of insulin is Insulin R?
short acting
What is Insulin R given for?
extremely high glucose due to diabetic ketoacidosis
What can insulin R be mixed with?
insuline NPH (Humulin N)
What medication releases insulin evenly throughout the day?
glargine (Lantus)
What is route of administration for glargine (Lantus)? Why?
SQ injection because stomach acid would destroy the PO insulin
What is the correct way to mix intermediate acting insulin NPH with regular insulin?
push air into NPH vial, then push air into regular vial, then draw up regular insulin, then draw up NPH insulin
What type of sliding scale insulin is given for a high fasting glucose level?
Lispro
What is Levothyroxine? What is it commonly prescribed for? What type of patients is it given to?
Medication that is commonly used to treat hypothyroidism, and given to patients who have taken sodium iodine131 or had a thyroidectomy
What is a medication administration consideration for Levothyroxine?
do not take with food
What drug is used to destroy the thyroid gland?
Sodium iodine131 because it is radioactive
What medication is the best option for a pregnancy in the 1st trimester before a thyroidectomy?
Propylthiouracil
When should PO Propylthiouracil be given?
every 8 hours
When is levothyroxine given and why?
In the morning to prevent insomnia
What medication is given to a patient with Graves disease for radioactive sodium iodine131 post treatment?
Levothyroxine
What is Desmopressin used for?
diabetes insipidus
What can desmopressin cause? Why?
electrolyte imbalance, such as hyponatremia, due to decreasing urine output
What criterion must be met for a child prescribed somatotropin? Why?
the child must have not begun puberty because long bones are still open
What is the regulatory function of desmopressin/DDAVP?
water balance
What adverse effect from taking alendronate should be reported immediately?
difficulty swallowing
What does calcitonin help treat?
osteoporosis
What is the ROA for calcitonin? What type of patient usually takes it his way?
intranasally, usually postmenopausal women
What does calcium citrate help treat?
osteoporosis
What is the ROA for calcium citrate?
PO
What vitamin can help with osteoporosis?
vitamin D
Why should the nurse reinforce correct administration of alendronate?
reduces risk of esophageal bleeding
What is teriparatide used for? What is its ROA?
osteoporosis used in a Pen SQ
How long is each pen of teriparatide stable for?
28 days
What is unique about teriparatide in terms of osteoporosis medications?
only drug that increases new bone formation
What should be taught to patients taking bisphosphonates like the dronate family?
Take in the morning on an empty stomach with a full glass of water and sit upright for 30 mins after taking
What medication is used to treat myasthenia gravis? What does this medications family class do for patients with myasthenia gravis?
pyridostigmine/Mestinon increases skeletal muscle tone and strength
Why is a sustained release Stigmine family drug be taking at night?
allows the patient with myasthenia gravis to awaken with the ability to swallow
What crisis can pyridostigmine cause?
cholinergic crisis
What is given to a patient experiencing a cholinergic crisis/what is the antidote to pyridostigmine?
atropine
How is transdermal donepezil used?
Put the patch on for 7 days, take it off, clean and dry site and then do not use that site for 14 days
What should be avoided and taught to the patient about transdermal donepezil pathces?
do not place patch on reddened, irritated, or opened skin
What medication is used if donepezil is not as effective as it once was?
memantine
What does memantine do?
decreases glutamate
What serious adverse effect is related to memantine?
increase seizure acitivty
What is the first line drug for Alzheimer's?
Donepezil
How/when should donepezil be given?
once daily at bedtime
What two things interfere with the absorption of carbidopa levodopa?
high protein diets and iron supplements
How long does it take carbidopa levodopa to work?
3 weeks to decrease symptoms
What 2 things can carbidopa levodopa cause in a patient?
a drop in BP with position change and darkened bodily fluids
What drug cause orange urine, risky gambling, and sleep attacks?
ropinirole/Requip
