Pharm test 3

What is the number one concern with Tylenol

Liver damage

Early manifestations of liver damage

Nausea, vomiting, abdominal pain, diaphoresis

Tylenol antidote

Acetylcysteine

First gen NSAIDs

Ibuprofen, aspirin, and ketorolac

Second gen NSAIDs

Celecoxib

What complications do first gen and second gen NSAIDs cause?

Potential GI bleed, nausea, vomiting, heart burn and abdominal pain

Caution use of NSAIDs

Smokers, alcohol abuse disorders, and peptic ulcers

Salicylism symptoms

tinnitus, nausea, vomiting, diaphoresis, and respiratory alkalosis

What does salicylism indicate?

Salicylism occurs before full toxicity of aspirin occurs

Symptoms of aspirin toxicity

Diaphoresis, dehydration, electrolyte imbalance, respiratory depression, high fever, acidosis and potential coma

What is an important precaution when administering any opioid?

Vital signs must be checked before and after administration

What type of insulin is Lispro?

Rapid acting, 10 mins

What is the peak duration for Lispro

1-3 hours

What type of insulin is "regular” insulin

Short acting, 30 mins

What type of insulin is NPH

Intermediate acting, 4 hours

What is the peak for NPH

4-12 hours

What is the peak for “regular” insulin

2.5-5 hours

What type of insulin is Glargine?

Long acting, 1 hour

What is the peak for Glargine?

Peakless

How should you store insulin

in a cool place, typically the refrigerator, and avoid freezing.

Sulfonylureas

Glipizide, glyburide, glimepride

Method of action for glipizide

Stimulates insulin secretion from the pancreas

Adverse effects of glipizide

Hepatotoxicity, hypoglycemia, blood dyscrasias and skin reactions

Biguanide, Metformin method of action

Decreases hepatoglucose production inhibiting glycogenesis and reduces insulin absorption in the intestine

What type of diabetes does Biguanide and Metformin

Type 2 diabetes mellitus

Levothyroxine

Thyroid hormone replacement

Administration of Levothyroxine

Must be given 30-60 mins prior to food for max absorption

Iodine 131

Antithyroid, selectively destroys hyperactive thyroid

Iodine 131 drug interactions

Lithium Carbonate

Methimazole

Antithyroid, blocks synthesis of t3 and t4

Adverse effects of Methimazole

Hepatotoxicity, nephrotoxicity, bone marrow suppression, lymph node enlargement, purpuric, and maculopapular rash

Mineralocorticoids

Maintain fluid and electrolyte balance in the body.

What do mineral corticosteroids treat

Renal insufficiency caused by hypopituitarism and Addison’s disease

Fludrocortisone

Affects fluid electrolyte balance causing sodium and water retention

Side effects of Fludrocortisone

Hypernatremia and hypokalemia

Glucocorticoids action

Anti-inflammatory and immunosuppression

Indications of glucocorticoids

Treats cancers, treat organ transplantation auto immune, allergies and shock

Why should not steroids be abruptly

Can cause renal insufficiency

Adverse effects of Estrogen

Hypertension, thrombophlebitis, hyperglycemia, and breakthrough bleeding

Drug interaction between Estrogen and Warfarin

Diminish anticoagulant effects

Drug interaction between Estrogen and Phenytoin

Inhibit metabolism of Phenytoin which can cause Phenytoin toxicity

Adverse effects of progestin

Amenorrhea, breakthrough bleeding, endometriosis and contraception