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pharm test 3
Lidocaine
Mechanism
Blocks Na+ Channels
Indications
Ventricular Arrhythmia
Anesthetic
Side Effects
Paresthesias
Seizures
Respiratory Depression
Drowsiness
Consideration
Anesthetic Effects Extended with Epinephrine
1 min
Digoxin (Lanoxin)
Mechanism of Action
Increases Inotropy
Indications
Heart Failure
Atrial Fibrillation
Side Effects
Bradycardia
Fatigue
Contraindications
Heart Block
Nursing Considerations
Heart Rate Below 60
Hypokalemia
Monitor for Toxicity and Visual Changes
Digibind
2 mins
Insulin
Rapid Acting
Insulin Lispro (Humalog)
Insulin Aspart (Novolog)
Insulin Glulisine (Apidra)
Short Acting
Regular Insulin (Humulin R)
Intermediate Acting
Isophane NPH (Humulin N)
Long Acting
Detemir (Levemir)
Glargine (Lantus)
2 mins
Pioglitazone (Thiazolidinediones)
-glitazones Suffix
Mechanism
Binds PPAR-Gamma
Decreases Insulin Resistance
Indications
Type 2 Diabetes
Side Effects
Weight Gain
Heart Failure
Myalgia
Hypoglycemia
Upper Respiratory Infection
Considerations
Increased Risk of Bladder Cancer
Increased Fracture Risk in Women
Monitor Liver Enzymes
2 mins
Glyburide and Glipizide (2nd Generation Sulfonylureas)
Mechanisms
2nd Generation Sulfonylureas
Blocks Potassium Channels in Beta Cells
Stimulate Release of Insulin
Indications
Type 2 Diabetes
Side Effects
Hypoglycemia
Considerations
More Potent
Beta Blockers Reduce Effects
Avoid Alcohol
Avoid Breastfeeding
2 mins
Repaglinide and Nateglinide (Meglitinides)
Mechanisms
Meglitinides
Increased Insulin Release
Indications
Type 2 Diabetes
Side Effect
Hypoglycemia
Considerations
Eat Within 30 Minutes
Gemfibrozil Increases Risk of Hypoglycemia
Short Half-Life
2 mins
Chlorpropamide and Tolbutamide (Orinase) (1st Generation Sulfonylureas)
Mechanisms
1st Generation Sulfonylureas
Stimulate Release of Insulin
Indications
Type 2 Diabetes
Side Effects
Hypoglycemia
Possible Cardiovascular Toxicity
Weight Gain
Considerations
Exacerbated Hypoglycemia with Beta-blockers
Avoid During Pregnancy and Breast Feeding
Avoid Alcohol
2 mins
Metformin (Glucophage)
Mechanism
Decrease Glucose Production
Increase Insulin Sensitivity
Indications
Type 2 Diabetes
Polycystic Ovary Syndrome (PCOS)
Side Effects
GI Distress
Decreased Appetite
Lactic Acidosis
Considerations
IV Contrast
Limit Alcohol Consumption
2 mins
Acarbose (Precose) and Miglitol (Glyset) (Alpha Glucosidase Inhibitors)
Mechanisms
Alpha Glucosidase Inhibitors
Delays Absorption of Carbohydrates
Indications
Type 2 Diabetes
Side Effects
Flatulence
Diarrhea
Anemia
Cramps
Considerations
Monitor LFTs
Oral Glucose for Hypoglycemia
2 mins
Sitagliptin (Januvia) and Saxagliptin (Onglyza) (DPP-4 Inhibitors)
-gliptin Suffix
Mechanisms
DPP-4 Inhibitor
Increases Insulin Release
Indications
Type 2 Diabetes
Side Effects
Pancreatitis
Upper Respiratory Infection and Inflammation
Stevens-Johnson Syndrome
Considerations
Used as Add-on Agents
2 mins
Nitroglycerin
Mechanism of Action
Decreases Preload
Indications
Angina
Up to 3 doses q 5 mins
Side Effects
Headache
Hypotension
Contraindications
Viagra (Sildenafil)
Nursing Considerations
Assess Blood Pressure
Protect From Light
Use Glass Bottle and Special Tubing
Gloves for Applying Topically
2 mins
Hypoglycemia Assessment
Mechanism
Too much insulin
Decreased glucose
Assessment
< 70 mg/dL
Change in LOC
Lethargic
Confusion and Irritability
Tremors
Diaphoresis
Tachycardia
Vision Changes
Weakness
Seizures
2 mins
Hypoglycemia Intervention
Interventions
Mild to Moderate Hypoglycemia
Simple Carbohydrate (Oral Dextrose, Fruit Juice, Candies)
Complex Carbohydrate (Whole Grains, Vegetables)
Severe Hypoglycemia or Unconscious
50% Dextrose
Glucagon
Considerations
Monitor Blood Glucose Q 10-15 Minutes
Give Small Meal After Intervention
Patient Education
Hypoglycemia Prevention
Encourage Self-Monitoring
3 mins
Vitamin B1 (Thiamine)
Mechanism
Carbohydrate Metabolism
Indications
Dietary Deficiency
Beriberi
Wernicke-Korsakoff
Considerations
Alcoholics Highest Risk
Give Before Glucose
Give IM or IV
Enriched Whole Grains
Pork
2 mins
Cobalamin (Vitamin B12)
Mechanism
Vitamin B12
Indications
Vitamin Deficiency
Pernicious Anemia
Side Effects
Hypokalemia
Arthralgia
Dizziness
Considerations
IM Injection for Pernicious Anemia
Never Give IV
2 mins
Vitamin B6 (Pyridoxine)
Mechanism
Amino Acid and Protein Metabolism
Heme Synthesis
Neurotransmitters
Indications
Adjunct to Isoniazid
Dietary Deficiency
Premenstrual Syndrome (PMS)
Side Effects
Ataxia
Peripheral Neuropathy
Contraindications
Levodopa
Considerations
Cereals and Meats
3 mins
Vitamin B3 - Niacin (Nicotinic Acid)
Mechanism
Decreases Triglycerides
Decreases LDL
Increases HDL
Indications
Dyslipidemia
Pellagra
Diarrhea
Dermatitis
Dementia
Side Effects
Flushing
GI Distress
Hepatotoxicity
2 mins
Hyperglycemia
Mechanism
Insulin Resistance
Too Little Insulin/Medication
Infection/Illness
Corticosteroids
Assessment
Elevated Blood Glucose
Polyphagia
Polydipsia
Polyuria
Hypotension
Fatigue/Drowsiness
1 min
Glucagon (GlucaGen)
Mechanism
Increases Glucose
Indications
Hypoglycemic Emergency
Side Effects
Nausea and Vomiting
Considerations
Reconstitute Powder
Consume Oral Carbohydrates
50% Dextrose IV (If No Effect)
2 mins
Diabetes Assessment
Assessment Type 1
Juvenile Onset
Absent Insulin Production
Ketosis Prone
Assessment Type 2
Adult Onset
Insulin Resistance
Obesity
Gestational Diabetes
Onset During Pregnancy
Glucose Intolerance
Complications
Retinopathy
Peripheral Vascular Disease
Nephropathy
Neuropathy
2 mins
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