Fluoxetine, furosemide, Metropolol, spironolactone, Heparin, enoxaparin, warfarin

What is special about fluoxetine

It is the first choice to treat depression because it has less side effects

How should floxetine be taken

Take medication in the morning. Increase dosage at three weeks.

How does fluoxetine work

Increase neurotrasmitter serotonin in the synapses

Adverse effects of Fluoxetine

Headaches, insomnia, SEXUAL DYSFUNCTION, SEROTONIN SYNDROME

What medication interacts with fluoxetine and why

St. John’s worth because it increases serotonin syndrome

Therapeutic use of furosemide

HTN, pulmonary edema in heart failure

How does furosemide work

Blocks the reabsorption of NA and CL in the loop of henle

side effects of furosemide

cardiac dysrythmia, hypotension. hypokalemia, dehydration, electrolyte imbalances.

Contraindications of furosemide

Oliguria, dehydration, electrolyte imbalances

Interactions of furosemide

No NSAIDS, dig tox due to low K

Client education of furosemide

Give last dose by early afternoon, monitor for K, eat foods rich in K

How does Spironolactone work

blocks aldosterone receptors (increase urinary excretion of Na & H2O and urinary retention of K)

Client education of Spironolactone

monitor labs- K, BUN, serum creatinine. Do not take K supplements or salt substitutes, report signs of high K

(palpitations, muscle twitching, weakness).

Interactions of Spironolactone

drugs that raise K levels (Example - ACE)

Contraindications of Spironolactone

high K level, increased serum creatinine. Or 24-hour urine creatinine clearance

Therapeutic use of metropolol

HTN, angina, heart failure, treatment to decrease mortality following myocardial infarction

How does metropolol work

blocks cardiac beta-1 receptors (decrease pulse & contractility, decrease release of renin)

Side effects of metropolol

bradycardia, heart failure

Contraindications or precautions of metoprolol

sinus bradycardia or blocks, severe heart failure

Interactions of metoprolol

use with other antihypertensives will increase hypotension, antacids decrease absorption, digoxin may increase bradycardia

Nursing interventions of metoprolol

check pulse & hold for less than 60, report SOB, edema, or cough at night (signs of heart failure)

What is the category for Heparin

Anticoagulant

What is heparin Used for

Prophylaxis for DVT

How does Heparin Work

Inactivates Xa and Thrombin

Side effects of heparin

Bleeding and Thrombocytopenia

Contraindications/Precautions

Bleeding, thrombocytopenia, and PUD

What does Heparin Interact with

NSAIDS and antiplatelet drugs.

How do you reverse Heparin

Protamine

aPTT labs Normal and Therapeutic

30-40

45-100 seconds

Platelet Count Normal

150,000-400,000

What adverse effect can heparin cause

Heparin Induced Thrombocytopenia

What is the difference between Enoxaparin and Warfarin

Enoxaparin has a longer half life so client gets less injections and dosage is more predictable.

How does Warfarin differ from enoxaparin and Heparin

Warfarin does its anticoagulation by blocking the action of VItamin K dependent factors so It leads to vutamin K defficiency.

Eating a lot of vitamin K foods will lead Heparin to not work as well.

What labs do we need for Heparin

INR will be longer

PT will also be prolonged