4391096
Description
Flashcards by tera_alise, updated more than 1 year ago
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Created by tera_alise
almost 9 years ago
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| Question | Answer |
| When do you take acarbose (precose)? | With the first bites of each meal |
| What does acarbose (precose) do? | Interferes with carbohydrate absorption |
| Side effects of acarbose (precose) | Flatulence, abdominal distention, diarrhea |
| Who can't take acarbose (precose) | IBS |
| What is dextrose 50% given for? | Acute and severe hypoglycemia in patients who can't swallow |
| Route for dextrose 50% | IV push |
| Example of incretin mimetic | Exendatide (Byetta injection) |
| What does exendatide (byetta inj) do? | Stimulates release of insulin but IS NOT INSULIN ITSELF |
| What do you not take with exendatide (byetta inj)? | Insulin |
| SIde effects of exendatide (byetta inj) | Decreased food intake, decreased gastric emptying |
| Onset of glargine (lantus) | 1-2 hours |
| Peak of glargine (lantus) | No peak (long acting) |
| Duration of glargine (lantus) | 24+ hours |
| What should you not do with glargine (lantus)? | Mix it with any other solution |
| How often do you give glargine (lantus)? | Once a day |
| What do glipizide (glucotrol) and glimepiride (amaryl) do? | Stimulate insulin production in the pancreas |
| What are some side effects of glipizide and glimiperide? | Altered taste, dizziness, drowsiness, weight gain, constipation |
| What does glucagon do? | Increases blood glucose |
| What is a side effect of glucagon? | Rebound hypoglycemia |
| Onset of humulin N | 2-4 hours |
| Peak of Humulin N | 4-10 hours |
| Duration of Humulin N | 10-16 hours |
| When do you take humulin N? | Before a meal |
| Onset of Humulin R (regular insulin) | 0.5-1 hour |
| Peak of humulin R (reg insulin) | 2-3 hours |
| Duration of humulin R (regular insulin) | 3-6 hours |
| Which type of insulin can be given via IV? | Humulin R (regular insulin) |
| Onset of lispro (humalog) | 15 minutes |
| Peak of lispro (humalog) | 1-1.5 hours |
| Duration of lispro (humalog) | 3-4 hours |
| What does metformin (glucophage) do? | Reduces glucose production in liver (DOES NOT STIMULATE INSULIN) Enhances glucose sensitivity and transport to tissues and cells |
| When should you not take metformin (glucophage)? | In any procedure requiring contrast, you have to cancel the med 24 hours before and 48 hours after Could cause lactic acidosis, kidney failure |
| Examples of meglitinides | Nateglinide (Starlix) Repaglinide (Prandin) |
| What do nateglinide (Starlix) and repaglinide (Prandin) do? | Increases insulin production from pancreas |
| When do you take nateglinide (starlix) and repaglinide (Prandin)? | 30 minutes before a meal |
| When should you not take nateglinide (starlix) and repaglinide (Prandin)? | If the pt skipped the meal |
| Which oral agent is most effective in insulin resistant diabetic patients? | Pioglitazone (Actos) |
| What does pioglitazone (actos) do? | Increases insulin sensitivity, transport and utilization at target tissues |
| What route of administration is used for pramlintide (symlin)? | SubQ injection |
| What is amylin? | A hormone secreted from beta cells along with insulin in the pancreas |
| What is pramlintide (symlin) used for? | Type I and type II DM |
| What does amylin/pramlintide (symlin) do? | Slows gastric empyting, reduces postprandial glucagon secretion and increases satiety |
| What do sitagliptin (Januvia) and saxagliptin (Onglyza) do? | Slows inactivation of incretin hormone, potential for hypoglycemia |
| What is aqeuous vasopressin (Pitressin) used for? | Chronic ADH replacement therapy in diabetes insipidus patients |
| What symptoms does aqueous vasopressin (Pitressin) address? | It decreases urine output and thirst |
| What is desmopressin (DDAVP)? | ADH |
| How can desmopressin (DDAVP) be given? | Oral, IV, SubQ, nasal |
| What does desmopressin (DDAVP) do? | Decreases urine output, thirst Given to diabetes insipidus patients |
| What does octreotide (Sandostatin) do? | Stops growth hormone |
| Who takes octreotide (Sandostatin)? | Patients with hyperactive pituitary gland |
| How is Octreotide (Sandostatin) given? | SubQ 3x/week |
| What is Somatropin (Omnitrope, Genotropin, Humatrope)? | Growth hormone |
| How is somatropin (omnitrope,etc.) administered? | SubQ injection every day in the evening |
| Who takes somatropin (omnitrope, etc.)? | Patients with hypoactive pituitary gland |
| When should calcium gluconate be made readily available? | After a thyroidectomy |
| How is calcium gluconate administered? | Slow IV push - can cause hypotension and cardiac arrest |
| What is calcium gluconate used to treat? | Tetany, pts with hypoparathyroid and hypocalcemia |
| What does iodine do? | Inhibits synthesis of T3 and T4 |
| When and why is iodine administered? | Used pre-surgery to reduce vacularity (and therefore bleeding) of thyroid gland |
| When is the maximal effect of iodine seen? | 1-2 weeks |
| When do you use ipratropium (Atrovent)? | Quick relief when pt has symptoms of acute exacerbation |
| Indication for tiotropium (Spiriva) | COPD pts along with other drugs |
| When do you use Albuterol (ProAir, Proventil, Ventolin) and Pirbuterol (Maxair)? | Quick relief for COPD and asthma |
| What should you monitor when giving Albuterol (ProAir, Proventil, Ventolin) and Pirbuterol (Maxair)? | BP and HR |
| What do Albuterol (ProAir, Proventil, Ventolin) and Pirbuterol (Maxair) do? | Bronchodilators |
| How long does Albuterol (ProAir, Proventil, Ventolin) and Pirbuterol (Maxair) last? | 4-8 hours |
| When do you use salmeterol (serevent) and albuterol (VoSpire ER)? | NOT FIRST MED USED Use in conjunction with other meds if others are ineffective |
| Side effects of salmeterol (serevent) and albuterol (VoSpire ER) | Headache, dry throat, tremors, dizziness, pharyngitis |
| What is the difference between salmeterol (serevent) and albuterol VoSpire ER? | Salmeterol is inhaled, albuterol VoSpire ER is oral |
| How long do salmeterol (serevent) and albuterol VoSpire ER last? | 12 hours |
| How do fluticasone (Flovent), budesonide (Pulmicort), and triamcinolone acetonide (Azmacort) work? | Suppress inflammatory response (anti-inflammatory corticosteroids) Reduces bronchial hyperresponsiveness, decreases mucus production |
| Side effects of fluticasone (Flovent), budesonide (Pulmicort), and triamcinolone acetonide (Azmacort) | Oropharyngeal candidiasis, hoarseness, dry cough |
| Why would you use inhaled corticosteroids? | Long term control of bronchial constriction, taken on a fixed schedule |
| How do you reduce side effects of inhaled corticosteroids? | Using a spacer Gargling mouth after use |
| When should you be cautious about using inhaled corticosteroids? | Adrenal and liver problems Hypersensitivity to corticosteroids |
| What do leukotrienes do? | Bronchoconstriction |
| Which meds block the action of leukotrienes? | Leukotriene modifiers - zafirlukast (accolate), montelukast (singulair) Leukotriene synthesis inhibitors - sileuton (Zyflo CR) |
| When should you NOT use zafirlukast (accolate), montelukast (singulair) and sileuton (Zyflo CR)? | In the event of an acute attack |
| What are zafirlukast (accolate), montelukast (singulair) and sileuton (Zyflo CR) used for? | Prophylactic and maintenance therapy |
| When do you take zafirlukast (accolate), montelukast (singulair) and sileuton (Zyflo CR)? | 1-2 hours before meals |
| Side effects of zafirlukast (accolate), montelukast (singulair) and sileuton (Zyflo CR) | Headache, abdominal pain and diarrhea |
| Examples of methylxanthines | Oral - theophylline (Theo-Dur) IV - aminophylline (Truphylline) |
| Margin of safety for oral theophylline (Theo-Dur) and aminophylline (truphylline) | 10-20 is therapeutic |
| What can happen in the event that pt has >20 after the use of oral theophylline or aminophylline? | Seizures Signs of toxicity = N/V, seizures, insomnia |
| What do oral theophylline (Theo-Dur) and aminophylline (truphylline) do? | Less effective bronchodilator, little effect on bronchial hyperresponsiveness |
| When could you need to use calcium gluconate emergently? | Post-thyroidectomy |
| What type of patient receives calcium gluconate? | Hypoparathyroid and hypocalcemic patients |
| What symptom would prompt the use of calcium gluconate? | Tetany |
| How should calcium gluconate be administered? | IV push SLOWLY May cause hypotension and cardiac arrest |
| What is the mechanism of action of iodine? | Rapidly inhibits synthesis of T3 and T4 |
| When do you give iodine? | Pre-thyroidectomy to reduce vascularity and minimize bleeding |
| When will you see the maximum effect of iodine? | 1-2 weeks |
| In relation to meals, when do you give iodine? | After meals through a straw with juice or water |
| What is the drug of choice for hypothyroidism? | Levothyroxine (Synthroid) |
| What VS should you check prior to giving levothyroxine (synthroid)? | Apical HR If >100, HOLD and provide intervention for tachycardia |
| When do you take levothyroxine (synthroid)? | In the morning to mimic circadian rhythm |
| When do you start to see the effects of levothyroxine (synthroid)? | 2 weeks If they stop taking it---HYPOTHYROID SX If they take too much ---HYPERTHYROID SX |
| What does Lugol's solution do? | Rapidly inhibits synthesis of T3 and T4 |
| When do you use Lugol's solution? | Pre-thyoidectomy to reduce vascularity of tissue and reduce bleeding |
| How do you take Lugol's solution? | With juice or water through a straw after meals |
| When do you see the effect of Lugol's solutions? | 1-2 weeks |
| How often do you taken methimazole (tapazole)? | Once a day |
| Who takes methimazole (tapazole)? | Hyperthyroid patients |
| What is the MOA of methimazole (tapazole)? | Blocks iodine reuptake |
| When do you take methimazole (tapazole)? | In the event of a thyroid storm |
| Side effects of methimazole (tapazole) | Fever, dizziness, loss of taste |
| What should you monitor if your patient is taking methimazole (tapazole)? | WBC - agranulocytosis could increase chance of infection |
| What does propylthiouracil (PTU) do? | Blocks peripheral conversion of T4-T3 |
| How often do you take propylthiouracil (PTU) and how? | 3X a day orally |
| What is propylthiouracil (PTU) used for? | Tx of hyperthyroidism |
| Which type of patients usually receive propylthiouracil (PTU) as opposed to tapazole? | Pregnant women |
| What does dexamethasone (Decadron), methylprednisolone (Solu-Medrol) and Prednisone (Deltasone) do? | Stops, controls, and reduces anti-inflammatory response |
| What are potential complications due to long term use of dexamethasone (Decadron), methylprednisolone (Solu-Medrol) and prednisone (Deltasone)? | Cushing's syndrome |
| When do you take dexamethasone (Decadron), methylprednisolone (Solu-Medrol), and prednisone (Deltasone)? | In the morning DO NOT abruptly stop taking it |
| What is the most common indication for dexamethasone (Decadron), methylprednisolone (Solu-Medrol) and prednisone (Deltasone)? | Addison's disease |
| Side effects of dexamethasone (Decadron), methylprednisone (Solu-Medrol) and prednisone (Deltasone) | Edema, peptic ulcers, delayed wound healing, osteoporosis, infections |
| What type of diet is needed for a patient taking dexamethasone (Decadron), methylprednisonolone (Solu-Medrol) and prednisone (Deltasone)? | High in protein, calcium, and potassium |
| Which antihistamines are 2nd generation? | Cetirizine (Zyrtec) Fexofenadine (Allegra) Hydroxyzine (Vistaril) Loratidine (Claritin) |
| Which antihistamines are 1st generation? | Diphenhydramine (Benadryl) Promethazine (Phenergan) |
| Which 2nd gen. antihistamine is used for motion sickness and vertigo along with sneezing, rhinorrhea, PND? | Cetirizine (Zyrtec) |
| Side effects of cetirizine (Zyrtec) | Pharyngitis, dry mouth, dry nose/throat, drowsiness |
| Which antihistamine can be given via IM injection? | Hydroxyzine (Vistaril) |
| Which 1st gen. antihistamine is used for motion sickness/sedation? | Promethazine (Phenergan) |
| What does acetylcysteine (Mucomyst) do? | Liquifies mucus by breaking links that bind mucus together; makes it easier to cough up |
| When should you use acetylcysteine (Mucomyst)? | OD on acetaminophen |
| Side effects of acetylcysteine (Mucomyst)? | Nausea, rhinorrhea, bronchospasms, dizziness |
| What is the indication for Benzonatate (Tessalon)? | Reduction of a non-productive cough |
| Side effects of benzonatate (tessalon)? | Drowsiness, GI upset, constipation |
| What does guaifenesin (Robitussin) do? | Expectorant: irritates mucus membranes to release mucus Creates a productive cough |
| Side effects of guaifenesin (Robitussin) | GI upset, nausea, drowsiness |
| How does oseltamivir (Tamiflu) work? | Prevents from viruses budding and spreading to other cells (esp. respiratory) |
| Which types of influenza are indications for oseltamivir (Tamiflu)? | Influenza A and B |
| When should you take oseltamivir (Tamiflu)? | Within first 2 days of symptoms |
| What do decongestants do? | Stimulate adrenergenic in blood vessels which promotes vasoconstriction Reduces edema rhinorrhea |
| Side effects of decongestants | Insomnia, headache, increased BP and ocular pressures, palpitations, tachycardia |
| Which decongestants are offered as nasal sprays? | Phenylephrine hydrochloride (Neosynephrine) Oxymetazoline (Afrin) Pseudoephedrine (Sudafed) |
| Which decongestants are offered PO? | Pseudoephedrine (Sudafed) |
| Indications for inactivated flu vaccines | 6mo and older Safe for anyone except Guillain-Barre, hypersensitivity to eggs GIVEN VIA INJECTION |
| Indications for live attenuated flu vaccines (LAIV) | 2-49 yrs Non-pregnant, healthy people INTRANASAL |
| When should you start taking intranasal corticosteroids (i.e. fluticasone [Flonase, Flovent] and triamcinolone [Nasacort])? | 2 weeks before seasonal allergies begin |
| How often should you take intranasal corticosteroids (i.e. fluticasone [Flonase, Flovent] and triamcinolone [Nasacort])? | Daily - DO NOT USE PRN |
| Side effects of intranasal corticosteroids (i.e. fluticasone [Flonase, Flovent] and triamcinolone [Nasacort]) | Mild nasal burning stinging Watch for infection |
| What is an example of a mast cell stabilizer? | Cromolyn spray (NasalCrom) |
| What does Cromolyn spray (NasalCrom) do? | Inhibits degranulation of sensitized mast cells Prevents allergy symptoms |
| Side effects of Cromolyn spray (NasalCrom) | Nasal burning, irritation |
| When should you start Cromolyn nasal spray (NasalCrom)? | 2 weeks before pollen season OR 10-15 minutes before exposure to allergen (used prophylactically) |
| What is amoxicillin used for? | Skin infection, respiratory infections, GU/GI infections, otitis media, peptic ulcer, H. Pylori |
| What is amoxicillin's mode of action? | Bactericidal |
| Side effects of amoxicillin | N/V/D |
| How can azithromycin (Zithromax) be given? | IV, PO |
| What does azithromycin (Zithromax) do? | Binds to receptor sites in susceptible organisms to prevent protein synthesis |
| What is azithromycin (Zithromax) used for? | Pneumonia, mucobacterium avius complex, COPD, chlamydia, pharyngitis, tonsilitis, skin infections, STDs |
| Indications for penicillin | Gonorrhea, UTI, peronitis, pneumonia and other respiratory infections, septicemia, meningitis |
| Mode of action of penicillin | Bacteriostatic or bactericidal |
| Side effects of penicillin | GI distress, oral/vaginal candidiasis, generalized rash, anaphylaxis |
| Indications for pneumococcal vaccine | Pt with chronic illness (COPD, DM) >65yo Pt recovering from illness |
| What does STRIPE stand for? | Streptomycin Rifampin (Rifadin) Isoniazid (NIH) Pyrazinamide (PZA) Ethambutol (Myambutol) |
| Side effects of streptomycin | Ototoxicity, nephrotoxicity, neurotoxicity |
| Side effects of Rifampin | Hepatitis, thrombocytopenia, orange discoloration of bodily fluids (urine, sputum, sweat, tears) |
| What test should be done before giving isoniazid (INH)? | Liver function test |
| Instructions for patients receiving isoniazid | DO NOT drink alcohol - causes B6 deficiency Take all pills, do not discontinue |
| Route of isoniazid (INH) | IM, PO |
| Side effects of isoniazid | Hepatitis, clumsiness, jaundice, epigastric distress muscle ache, peripheral neuritis |
| Side effects of pyrazinamide (PZA) | Hepatitis, arthralgia, hyperuricemia |
| Side effects of ethambutol (Myambutol) | Ocular toxicity (decreased red and green discrimination) |
| What should you monitor in patients taking pyrazinamide (Myambutol)? | Visual acuity and color discrimination |
| What does omalizumab (Xolair) do? | Monoclonal antibody to IgE Decreases circulating and free IgE levels Prevents IgE from attaching to mast cells - prevents release of chemical mediators |
| How often do you give omalizumab (Xolair)? | SQ q2-4 weeks |
| What is the black box warning for omalizuman (Xolair)? | Increases ischemic heart disease, arryhthmias, cardiomyopathy and cardiac failure |
| When should you NOT use omalizumab (Xolair)? | Case of acute bronchospasms |
| When should you use omalizumab (Xolair)? | Moderate to severe persistent allergic asthma |
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