pharm final review

oral dose= Higher dose because

first pass

Meds w/ Narrow Therapeutic index

watch for toxicity

Do not take B6 + Iron salts (protein)

Effects of Parkinson’s Meds

Rise slowly, do not stop abruptly (orthostatic Hypotension)

Parkinson’s Med’s

For skin acne, Antibacterial+Anti fungal

Tea tree oil

Prevents UTI

Cranberry

(Herbal) Helps w/ Nausea

Ginger Lolipops’s

(Herbal)Helps w/ tension Headaches

Herbal peppermint tea

Antidepressants (SSRI+St.Jhon’s Wart)

Serotonin Syndrome

see pt w/ allergy (Rash) on Antibiotic

Anaphylaxis Risk

Gliberi De (T2)+ UTI med Bactrim

If taken together may cause more confusion

No if Pt has a family history of thyroid cancer

Leroglutide (GLP1)

Gliberi De adverse Effect

Hypoglycemia

can mask hypoglycemia in diabetic pt

Propanolol

Steroids (prednisone)

Check sugar; Hyperglycemia risk

Acarbose (diabetic med)

Hard on liver; Report Jaundice Immediately

Expected out come of albuterol

1) clear lung sounds 2)pt on tele (cardiac monitoring)

Gluticord Inhalers

Rinse mouth after use to prevent thrush

1st gen halodol Adverse effect

NMS - Neuro malignat syndrome

Treatment for NMS

1) Cooling Blanket 2)Antipyretic

Risperidon 2nd gen Atypical Antipsychotic

Can cause EPS

Lithium Range

0.6-1.2

Lithium + Furosemide (Lasix)

Lithium Toxicity (Dehydration)

pt w/ HR of 42 Bpm + bad headache hold and call HCP

Don’t give Digoxin if (call HCP)

Hold Digoxin if ?

HR less > 60 + Apical pulse 55 (Full Min)

Therapeutic outcome (Furosemide)

Clear Lung Sounds

Potassium Range

(3.5-5); if 2.5 Hold Lasix

Antidote for Benzos (Lorazepam)

Flumazenil (Ben has the flu)

Epoten Alfa (procrit)

Anemia drug injection stimulates bone marrow chemo drug

Megoblastic Anemia + Folic Acid

Make sure RBC are within normal limits (expected finding)

Folic Acid to pregosto

Prevent neural tube defects

When epotein alfa is given, how and check what beforehand?

Sub Q + check BP beforehand

Take ferrous sulfate (iron) w/ ?

Vitamin C (Orange Juice) *helps absorption

may hurt/burn

injection site of B12 (cyanocobalamin)

Metoclopramid (Reglan)

Speed up GI, Motility, decrease N/V

Used in thyroid storm to reduce thyroid hormone conversion T4 to T3

Glucocorticoids

St. John's Wort interacts w/

Fluoxetine, Kava, Digoxin, Theophenolyine, antivirals (funny kids dig the antivirals)

Long Term PPI use

increases risk for C.diff + osteoporosis

when to take PPI

Daily before breakfast on an empty stomach

When do you hold NSAIDS

Dark Tarry Stools, Upper GI bleed

Psyllium if pt has an ileostomy

Give w/ full glass of water

Enoxaparan route

Sub Q injection

Lab and antidote for Heparin

(60-100 sec’s) apTT Antidote:promaine sulfate

Lab and antidote for Warfarin

INR (2.0-3.0) Antidote:vitamin K

Heparin + Warfarin are both what?

Anticoagulants, slow clotting caucade

Recent spinal procedure, why hold anticoagulant?

Bloody Nose INR=5

If patient has had many bloody noses

Hold Ibuprofen (bleeding Risk)

Ibuprofen+Garlic=

Increased Bleeding risk

No Aspirin for Patients

less then < less than 18 yo increases reye syndrome risk

Monitor for tinnitus+hyperventilation

Aspirin toxicity

Never combine antiplatelets with pt that has

Active bleeding or Peptic ulcer disease

Loop diuretics+ Thiazide diuretics can lead to

Hypokalemia(low k+) + Dysrhythmias

When do you take Pot Wasting Diuretics

(AM) Prevent falls + Nocturia

How do you push K+ wasting diuretics

slowly; ototoxicity risk

Client w/ renal failure we are worried about

spironolactone (kspring)

Do not combine Ace inhibitors because?

increases k+

How do we know spironolactone worked

BP dropped +Lungs clear

w/ spironalactone avoid

salt substitutes

A/E of ACE inhibitor (lisinopril)

Dry cough

Priority Pt is

ABC’S 1st (Swollen throat pt)

headache + see’s halos

Hold digoxin if pt has (digoxin toxicity)

Ace Inhibitors Adverse effects

1) Localized swelling 2)rash 3)cough 4)hypotension (CRASH)

Bactrim + Prill (ACE)=

watch potassium

Labatolol Adverse Effects

1)hypotension 2) vertigo 3)bronchospasm (LAB)

(ARB’S) Losartan

1) swelling(Angioedema) 2)Hypotension 3)Back pain SBH

Order of bronchodilator+steroid for asthma attack

Albuterol (broncho) 1st 5mins steroid 2nd

Albuterol is for

rescue asthma attacks

Albuterol side effects

1) Tachycardia 2) Palpitations 3)tremors

Ipratropium causes what type of affects

Anticholinergic (dry mouth)

SSRI+MAOI 1st week watch for?

Suicidal ideation

Avoid what w/ MAOI

Tyramine foods (Aged cheese, wine) are fatal hypertensive crisis

Risk for what w/SSRI

Serotonin syndrome (Fever,Agitation)

Clozapine can cause what?

Agranulocytosis (low WBC) monitor

MOA of metformin (biguanides)

Decreasing glucose production in the liver does not stimulate insulin (Rarley causes hypoglycemia)

Metformin risk

Lactic acidosis (especially renal pt)

IV contrast dye you?

hold metformin for 48 hrs

glyburide risk

Hypoglycemia

prednisone leads to

Hyperglycemia increases the glucose taper dose (adrenal crisis risk)

Prednisone increase

Bp + BG (hypers)

Pt on Prednisone warn?

1) weight gain, 2)mood swing, 3)need for weight-bearing exercises (osteoporosis) (big mood, big body, big bones)

substances that the body requires to carry out reactions in the body

multivitamin

Ginsinge causes

1) bruise more easily 2) irritable

fludocortoson

Addison’s med (Adrenal insufficiency) MOA: Helps the body hold onto sodium +water

Gentomycin

Drink lots of water (hard on kidneys) (Acyclovir)

Flugazonal

Antifungal; If you develop jaundice, stop (hold)

Gentomicin if ringing in ears

stop (hold); ototoxicity

No Teragenic prego safe med is

Gentomicin

Tetracyclines (doxycycline) need further education when pt takes

1) no milk 2) steroids 3)antacids 4)iron decreases absorption (MSAI)

Amoxicillin should be held if pt develops

severe diarrhea

Amoxicillin is for high risk for

1) Anaphylaxis monitor for hives swelling and wheezing

Gentomicin labs =

Peak Through

Flubroquinolones black box warning for?

Tendon rupture

Tetracycline (doxycycline) Adverse Effect?

1) tooth discoloration 2)photosensitvity 3)teratogenic

TB meds=

No alcohol, + will take more than 1 meds

TB meds harmful to?

Liver (Hepatotoxicity)

Isoniazide

if on pt drug list pt has TB

TB med Rifampin normal=

Red/Orange bodily fluids

Opioids #1 concern

respiratory depression

respiratory rate of 4/min

Bag valve mask vent

side effect of morphine give what

constipation give laxative