Flashcards Mark K/Dr. Sharon TOP 50 NCLEX DRUGS

Spironolactone

-potassium sparing diuretic

-monitor for hyperkalemia

SE: frequent urination

Hydralazine

-direct vasodilator

- tx for hypertension

LisinoPRIL

ACE inhibitor, antihypertensive

-contraindicated with kidney failure

- can cause DRY COUGH should be discontinued if this happens

-can cause angioedema (face, tongue swelling)

LoSARTAN

-Angiotensin receptor blocker (ARB), tx for hypertension and DM neuropathy

-monitor BP and fluid level

-monitor renal and liver status

-contraindicated during pregnancy

Metoprolol

-Beta- Blocker

-slows heart rate

- hold med if HR < 60, SBP < 90

FurosemIDE

-Potassium wasting diuretic, loop diuretic

- end in IDE or X

-tx for edema, CHF etc

-frequent bathroom trips

-Adverse effect: hyponatremia, -kalemia, -chloremia MONITOR K+, OTOTOXICITY (affect Na, K and Cl co transporter in loop that's why all three are at risk of being hypo) + block other electrolytes like calcium and magnesium

Thiazide Diuertics

ex. metolazone, chlorothiazide etc.

end in -IDE or -ONE

work at distal tubules, increase excretion of Na, Cl, and K

- blocks the sodium chloride symporter from reabsorbing ions back into blood.

- this causes more Na to be reabsorbed further down the line, which causes more K to be exchanged out for those Na.

- Overall, Cl and more Na is still excreted, and also more K distally.

but since Na is at least reabsorbed back, there is higher risk of hypokalemia than hyponatremia (also applies to loop diuretics)

more likely to cause hyponetremia than loop diuretics despite being weaker sodium waster due it more disproportionately lose sodium relative to water unlike loop diuretics where a lot of water is also lost so relative concentration between the two remain.

When does regular insulin peak?

2 hours after administration

When does intermediate/ NPH insulin peak?

8-10 hours after administration, has to be given with a snack if at bedtime

When does fast acting insulin peak? (Lispro, Aspart)

30 minutes after administration

When does long acting insulin peak? (Glargine)

NO PEAK

insulin tips

long acting insulin - only given 1 or 2 times a day so never AC and HS at same time (unsafe, doesn't peak for meals etc)

Regular insulin can be given AC and HS

N or intermediate insulin can be given 2 times a day

need to give insulin that has peak times with a snack if at bedtime. but no need for glargine because long acting with no peak.

with any procedure that has a -gram in it, it probably involves a dye. almost always gives iodine as a dye

metformin is contraindicated with any dye procedure - need to question orders if has scheduled metformin before dye involving procedures.

side effect vs adverse effect

Side effect: predictable secondary effect of medication; bothersome but not fatal eg constipation.

- no need to stop med or alert doctor, we treat it if standing orders

Adverse effect: serious, can be fatal eg anaphylactic shock.

we stop med and alert doctor

Nitroglycerin

-tx for angina, MI

-can be given repeatedly every 5 min (if no relief) for a max of 3 doses if SBP>90

- vasodilator

-SE: HEADACHE, Hypotension

-Contraindicated w/ erectile dysfunction medications (can cause sharp drop in BP)

Digoxin

-tx for HF, inotropic agent (strengthens the. heart)

-SE:bradycardia,

- make effects of HYPOKALEMIA more dangerous. increases risk of digoxin toxicity with hypokalemia

-toxicity: > 2, heart block, blurred vision, yellow/green halo around objects

-antidote: Digoxin - Immune FAB (IV)

Lithium

-standard mediation for pts with bipolar disorder

-monitor sodium, "as the sodium goes up the lithium goes down (at risk for mania), as the sodium goes down the lithium goes up (at risk for toxicity)

-think of it as an electrolyte

-SE: paresthesia (common to all electrolyte imbalance)

-toxicity: > 2, tremor, lethargy, hyperreflexia

Warfarin

-anticoagulant, oral (chronic, can be on med for a long time)

-desired INR 2-3 with this medication therapy

-SE: bleeding

-Contraindication: stroke, severe HTN, pregnancy

-adverse effect: purple toe syndrome

-antidote: Vitamin K, fresh frozen plasma

in a potency question

route doesn't matter much, its mostly dose

ex. need only 0.1mg of fentanyl for pain relief but need 650 mg of Tylenol so fentanyl is more potent

for adverse effects

GI symptoms and headache etc. are common SIDE effects (don't need to call doctor, just symptom manage it usually)

RASH would be an adverse effect as it could mean allergy so pick that as something you would call HCP for. Also, WHEEZING or respiratory symptoms also wouldn't be expected so select that too. basically anything that shows ABC problems etc. or signs of allergies

Haloperidol (haldol)

- 1st gen antipsychotic

- pt at risk for neuroleptic malignant syndrome (NMS - potentially fatal high fever with EPS symptoms) , elderly at risk

-CHECK pt temperature

elevated BNP

congestive heart failure

>100 indicates CHF

Methotrexate

- anti rheumatic drug (immunosuppressant) used to tx rheumatoid arthiritis (which is an autoimmune disorder where immune system is attacking own body)

-monitor WBC

Levothyroxine

-tx for hypothyroidism (Hashimoto's)

- give even if NPO - because they only get thyroid hormone from the med, they'll be too lethargic and sedating them for proceedures without thyroid med would make them not wake up.

-monitor for hyperthyroidism

Adenosine

-treatment for supra ventricular arrhythmias, given RAPID IV PUSH - less than 8 sec and 20ml NS flush (think ABCD treatment for atrial arrhythmias)

-SE: ASTOYLE, "impending doom"

Atropine

-tx for bradycardia (symptomatic bradycardia, when BP is also low, not just HR)

-SE: anticholinergic effects DRY (can't see, can't pee, can't spit, can't sh*t)

Amiodarone

-tx for ventricular dysrhythmia

- anti arrhythmic - primarily blocks potassium channels but can also block calcium and sodium

can also use lidocaine but nclex now says amiodarone

Diltiazem

-calcium chanel blocker, relaxes blood vessels, TX FOR AFIB

-SE: dizziness, headache, BRADYCARDIA

Fentanyl

-pain medication, very potent

-SE: drowsiness

Sertraline

-antidepressant

-SE: xerostomia (dry mouth)

dry mouth

xerostomia - most common side effect of psych drugs except lithium.

for status epilepticus (longer than 5 min seizure)

never give med oral

phenytoin is used to prevent seizures but doesn't treat it

for treating, give benzodiazepines IV like lorazepam

Albuterol

- short acting bronchodilator (rapid open airway)

-SE: tachycardia

Vancomycin

-antibiotic for severe infections

-SE: "Red Man" syndrome - facial flushing, erythematous rash on neck and torso , tx is to SlOW DOWN infusion

-adverse effect: tinnitus

Methylprednisolone

-steroid, tx for Addison's disease

-SE: hyperglycemia

Lorazepam

-benzodiazepine, calms CNS - drug of choice for status epilepticus (seizure lasting longer than 5 minutes)

-SE:

phenytoin

toxicity >20

prevents seizures

- not usually given during a seizure (Benzodiazipines are the first line during a seizure)

Aminophylline

-toxicity: > 20 brochodilator

Piperacillin/Tazobactam (Zosyn)

-antibiotic

-SE: nausea, diarrhea, headache

Verenicline (chantix)

-tx for smoking cessation

dutasteride

benign prostatic hyperplasia BPH

Sildenafil (Viagra)

s/s: headache, heartburn, diarrhea, flushing, nosebleeds, parathesias, changes in color vision

Contradicted in clients taking nitrates, anticoags, anti HTN

1h prior to sex

Fluticasone

- corticosteroid nasal spray to tx allergic rhinitis

Clopidogrel (plavix)

-antiplatelet "super aspirin", yes, can take with aspirin

Pantoprazole

-proton pump inhibitor, used to tx acid reflux (reducing acid in stomach)

Risperidone and Aripiprazole (Abilify)

-atypical antipsychotic (2nd gen)

-SE: AGRANULOCYTOSIS (LOW WBC) ANTICHOLINERGIC SIDE EFFECTS (dry mouth, constipation, urinary retention etc)

have worse agranulocytosis than the 1st gen antipsychotics (very rare there). in 2nd gen, clozapine is the popular one that can cause this, pts even have to get blood work weekly for 1st 6 months, then biweekly or monthly after.

Zolpidem (ambient)

-tx for insomnia (sleep medication)

Methylergonovine (Methergine)

-tx/prevention for postpartum hemmorage, IM

-also helps deliver the placenta

-BREAST FEEDING CONTRAINDICATED FOR FIRST 12 HOURS AFTER ADMINISTRATION (must pump and dump)

Epoetin

-tx to promote production of red blood cells, given IM

think lance Armstrong

its produced in kidneys so people with kidney diseases can sometimes take this.

with kidney diseases

don't pick answers that say take an OTC med with electrolytes in them because kidneys are messed up and can affect its excretion

Levofloxacin

-antibiotic

Atorvastatin

-tx for cholesterol

-taken in the EVENING

Gabapentin

-drug of choice for peripheral neuropathy

- anticonvulsant used for "nerve pain"

-originally for seizure, off label for paresthesia

Pregabalin (Lyrica)

- anti convulsant used for nerve pain and seizures

- pain med that is drug of choice for fibromyalgia

Risedronate

-tx for osteoporosis

Enoxaparin

-lovenox

-SQ injection to prevent and tx blood clots

-must be given in abdomen,

-air goes in last (air in the vial that does NOT get pushed out) the air helps hold the medication in

Sildenafil

-viagra

-tx for erectile dysfunction

-CONTRAINDICATED W/ HEART PROBLEMS

Donepezil

-tx for alzheimers --improves thinking ability , DOES NOT cure or stop from getting worse

-may slow progression

Rifampin

-tx for tuberculosis

-usually taken for about 6 months - don't just stop once u feel better

-SE: bodily fluids will turn ORANGE (sweat, urine, salvia)

Dustasteride

-tx for benign prostatic hypertrophy (BPH)

antivirals end in what

vir

Gentamicin

-antibiotic, amino glycoside

-toxicity : ototoxic, kidney failure

Azithromycin

-antibiotic

-NOT an amino glycoside because it has "thro"

Metronidazole (Flagyl)

-flagyl

-antibiotic

-CANNOT drink alcohol on this med, will make pt sick

don't eat green leafy vegetables with what

warfarin (Coumadin)

Montelukast

for asthma