Osmotic Diuretics, Anticoagulants, and Ophthalmic Drugs

Comprehensive vocabulary flashcards covering osmotic diuretics, anticoagulants, thrombolytics, and ophthalmic medications based on lecture notes.

Mannitol

A drug classified as an osmotic diuretic used to reduce ICP and IOP by pulling water from brain tissue into the bloodstream.

Mechanism of Action (Mannitol)

Pulls water from brain tissue into the blood stream, reducing ICP and IOP.

Contraindications for Mannitol

Severe dehydration, pulmonary edema / HF, active intracranial bleeding, renal impairment, electrolyte imbalance, heart disease, and hypovolemia.

Normal Dosage & Route (Mannitol)

IV: $0.20-1\,g/kg$ over $30-60$ mins, varying by indication.

Nursing Implications (Mannitol Administration)

Use an in-line filter and inspect for crystals before administration; monitor ICP, IOP, I&Os, electrolytes, renal function, BP, and serum osmolality.

Heparin

An anticoagulant that enhances antithrombin to inhibit clotting factors, typically used for immediate anticoagulation either IV or SQ.

Warfarin

An oral anticoagulant that inhibits vitamin K dependent clotting factors ($II, VII, IX, X$) with a slow onset of $2-5$ days for long-term anticoagulation.

aPTT

The laboratory test used to monitor the therapeutic effects of Heparin.

PT/INR

The laboratory tests used to monitor the therapeutic effects of Warfarin.

Protamine Sulfate

The antidote used for Heparin overdose.

Vitamin K

The antidote used for Warfarin overdose.

Heparin-induced thrombocytopenia (HIT)

A specific side effect associated with Heparin use characterized by a drop in platelet count.

Alteplase (Activase)

A thrombolytic agent (tPA) used for acute ischemic strokes that converts plasminogen to plasmin to break down fibrin clots.

Normal Dosage & Timing (Alteplase)

IV only: $0.9\,mg/kg$ (max $90\,mg$) within $4.5$ HRS of symptom onset ($10\%$ as bolus, remainder over $60$ mins).

Nursing Implications (Alteplase)

Obtain a CT prior to administration; monitor neuro status and vital signs; avoid IM injections or invasive procedures for at least $24\,HR$ after.

Timolol

A beta-blocker ophthalmic drug used for open-angle glaucoma and ocular HTN by lowering aqueous humor production.

Contraindications for Timolol

Asthma / COPD, severe bradycardia, 2nd/3rd heart block, cardiogenic shock, heart disease, diabetes, and HF.

Punctal Occlusion

A nursing teaching technique for ophthalmic drugs like Timolol to prevent systemic absorption.

Ophthalmic Administration Rules

Do NOT touch the eye with the dropper and wait $6\,mins$ between different eye drops.

Side Effects of Alteplase

Bleeding, bruising, nausea, intracranial hemorrhage, GI bleed, and anaphylaxis.