Wk #4 (Ch. 26, 27, 28, 30, 31, 32, 33)

The coagualtion system is what type of system

What are the pathways of the coagulation system

what is the result of the coagulation pathway

what is the extrinsic pathway and to what does it respond

what are the factors that respond to the extrinsic pathway?

what is the intrinsic pathway and to what does it respond

what are the factors that respond to the intrinsic pathway?

what are the settings where clot formation is likly and anticouagulats may be used

Prevention of further clot formation is useful in

Do anticoagulants have direct effect on a blood clot that is already formed

Do anticoagulants lyse existing clots?

What class of drugs are used to prophylactically used to prevent clot formation (thrombus) and/or air embolus (dislodged clot)

Which group of anticoagulants turn off coagulation pathway and prevent clot formation

Adverse effects of anticoagulants

What is heparin induced thrombocytopenia (HIT)

What is the tx for heparin induced thrombocytopenia (HIT)

What lab needs to be monitored when a pt is on heparin therapy

What is the reversal agent for heparin

What should aPTT be for a pt on heparin therapy

T or F:
SQ heparin should be given in areas of deep subq fat

How often should aPTTs be drawn on a pt recieving heparin therapy?

Do not giev SQ doses of heparin with in 2 inches of ?

T or F
You should not aspirate SQ injections of heparin or massage the site

what are the advatages of low molecular wt. heparins over traditional heparin

What are the LMWH drugs

Antidote for LMWHs

What is the Route of administration, site(s) of administration, and why this site(s) for LMWHs?

What labs need to be monitored during warfarin (Coumadin) therapy

Route of administration for warfarin (coumadin)

Antidote for warfarin (Coumadin)

What is the range for INR in pts taking warfarin (coumadin)

Can Warfarin (Coumadin) be started while pt is still on heparin

HOw long could it take for warfarin(Coumadin) to reach full therapeutic effect

What are some of the herbal supplements that interact with warfarin (Coumadin)

What are the Xa inhibitor drugs

is dabigatran (Pradaxa) a pro drug

dabigatran (Pradaxa) dosing rate

% of renal clearence for dabigatran (Pradaxa)

dabigatran (Pradaxa) indications

Is rivaroxaban (Xarelto) a pro drug

Dosing for rivaroxaban (Xarelto)

% of renal clearance for rivaroxaban (Xarelto)

is apixaban (Ellquis) a pro drug

Dosing for apixaban (Ellquis)

% of renal clearance for apixaban (Ellquis)

dabigatran (Pradaxa) drug interactions

Can dabigatran (Pradaxa) capsules be broken open

Is there and lab values to be monitored for dabigatran (Pradaxa)

Tx of overdose of dabigatran (Pradaxa)

What foods should be avoided while taking anticoagulants

anticoagulant pt ed:

Goal of antiplatelet drugs

What class of drug alters platelet function w/o compromising their blood clotting properties

Antiplatelet drugs

Does the platelet reaction occur b4 or after the clotting cascade??

Vasoconstriction leads to dec. blood flow & that will decrease blood loss, what class of drugs stops this action

What class of drugs inhibit prostaglandins so TXA2 cannot be manufactured

Life span of a platelet

GP llb/llla inhibitor drug indications

antiplatelet drug indications

T or F:
dipyridamloe (Persantine) should be taken on an empty stomach

antifibrionolytic drugs goal

what are the antifibrionlytic drugs

aminocaproic (Amicar) indications

desmopressin (DDAVP) indications

anitifibrionolytic adverse effects

thrombolytic drugs purpose

What class of drugs activate plasminogen & convert it to plasmin, which can digest fibrin

thrombolytic drugs

How is tenecteplase (TNKase) dosed

thrombolytic MOA

Thrombolytic drug indications

thrombolytic drug adverse effects

two primary forms of lipids in the blood

What is a lipoprotien

What are the different lipoprotiens

What are very-low-density lipoprotein (VLDL)

Why would you not want many VLDLs

what are LDL

Why do you want the LDLs low

What are HDLs

Why do we want a large amt of HDLs

the risk of CHD in pts w/cholesterol levels of 300mg/dL are how many more times greater than those w/levels < 200mg/dL

what is a negative (beneficial) risk factor for CHD

positive (bad things) risk factors for CHD

Antilipemics: HMG-CoA reductase inhibitors (statins) drugs

What class of drugs are the most potent LDL reducers

What must be monitored when taking Antilipemics: HMG-CoA reductase inhibitors (statins) drugs

Which Antilipemics: HMG-CoA reductase inhibitors (statins) drug may actually decrease the size of a plaque that is already formed

What is HMG-CoA reductase used for

Antilipemics: HMG-CoA reductase inhibitors (statins) drugs indications

by how much do Antilipemics: HMG-CoA reductase inhibitors (statins) drugs lower LDLs

by how much do Antilipemics: HMG-CoA reductase inhibitors (statins) drugs lower triglycerides

by how much do Antilipemics: HMG-CoA reductase inhibitors (statins) drugs increased HDLs

Antilipemics: HMG-CoA reductase inhibitors (statins) drugs adverse effects

Antilipemics: HMG-CoA reductase inhibitors (statins) drugs interactions

Bile Acid Sequestrant drugs

Bile Acid Sequestrant are also called

Bile Acid Sequestrant MOA

Bile Acid Sequestrant can be mixed in but never mixed in what

Bile Acid Sequestrant indications

Bile Acid Sequestrant adverse effects

Niacin (Nicotinic Acid) is

niacin (Vit B3) dose lower or higher when used as a lipid lowering tx vs. a vitamin

niacin (Vit B3) MOA

niacin (Vit B3) indications

niacin (Vit B3) are effective at?

niacin (Vit B3) adverse effects

niacin (Vit B3) adverse effects can be lessened by what

Fibric Acid Derivatives (fibrates) drugs

Fibric Acid Derivatives (fibrates) MOA

Fibric Acid Derivatives (fibrates) indications

Fibric Acid Derivatives (fibrates) effects

Fibric Acid Derivatives (fibrates) adverse effects

Fibric Acid Derivatives (fibrates) interactions

Fibric Acid Derivatives (fibrates) lab test reactions

Cholesterol Absorption Inhibitor drug

Cholesterol Absorption Inhibitor: ezetimibe (Zetia) MOA

Cholesterol Absorption Inhibitor: ezetimibe (Zetia) drug effects

Cholesterol Absorption Inhibitor: ezetimibe (Zetia) is only recommended when

Herbal antilipemics

Garlic uses

Garlic adverse effects

Garlic interactions

Flax uses

Flax interactions

Omega-3 fatty acid uses

Omega-3 fatty acid adverse effects

Omega-3 fatty acid interactions

Antilipemic contraindications

Pts on long term therapy with Antilipemic may need what supplement

Antilipemic should be taken how long before or after meals

two main uses for diuretics

where are the greatest amts of sodium reabsorbed in the body

Types of diuretic drugs

what are Carbonic Anhydrase Inhibitors (CAIs) drugs

most commonly used CAI

Should CAIs be used in diabetic pts or pts taking Digoxin

Carbonic Anhydrase Inhibitors (CAIs) MOA

Carbonic Anhydrase Inhibitors (CAIs) indications

acetazolamide (Diamox) indications

why are Carbonic Anhydrase Inhibitors (CAIs) less potent than loop or thiazide diuretics?

Carbonic Anhydrase Inhibitors (CAIs) adverse effects

Loop diuretic drugs

Where to loop diuretics work in the body

A fatal skin problem associated with loop diuretics

Because of their potent diuretic effect what safety issue would need to be considered for a patient being started on a loop diuretic

what electrolyte is at risk of being depleted once a is placed on a loop diuretic

Loop diuretic MOA

loop diuretics drug effects

loop diuretic indications

CNS adverse effects from loop diuretics

GI adverse effects from loop diuretics

Hematologic adverse effects from loop diuretics

Metabolic adverse effects from loop diuretics

what is an osmotic diuretic drug

what special precaution needs to be taken admin mannitol (Osmitrol)?

Can we absorb osmotic diuretic

Where do osmotic diuretic mainly act in the body

osmotic diuretic MOA

osmotic diuretic drug effects

osmotic diuretic indications

osmotic diuretic adverse effects

Potassium-Sparing Diuretics drugs

Potassium-Sparing Diuretics are also known as

why are these drugs useful in hepatic failure with ascites?

Can Potassium-Sparing Diuretics be used in children

Why should amiloride (Midamor) b used with caution in the elderly

Which Potassium-Sparing Diuretic is a synthetic steroid used to tx ascites

Potassium-Sparing Diuretic MOA

Potassium-Sparing Diuretics drug effects

Potassium-Sparing Diuretic indications for spironolactone (Aldactone);
triamterene (Dyrenium)

Potassium-Sparing Diuretic indications for amiloride (Midamor)

CNS adverse effects for Potassium-Sparing Diuretic

GI adverse effects for Potassium-Sparing Diuretic

other adverse effects for Potassium-Sparing Diuretic

adverse effects for spironolactone (Aldactone)

Thiazide & Thiazide-like diuretic drugs

Thiazide & Thiazide-like diuretic MOA

Thiazide & Thiazide-like diuretic drug effects

T or F:
Thiazide & Thiazide-like diuretic should not be used if creatinine clearance in < 30-50 mL/min (normal is 125mL/min)

Does metolazone remain effective to a creatinine clearance of 10 mL/min

Thiazide & Thiazide-like diuretic indications

CNS adverse effects for Thiazide & Thiazide-like diuretic

GI adverse effects for Thiazide & Thiazide-like diuretic

GU adverse effects for Thiazide & Thiazide-like diuretic

integumentary adverse effects for Thiazide & Thiazide-like diuretic

Metabolic adverse effects for Thiazide & Thiazide-like diuretic

Why should pts be instructed to take diuretics in the morning

What lab needs to be monitored during diuretic therapy

What should be monitored in pts taking Thiazide & Thiazide-like diuretic

Hypothalamus is part of what system and is thought to control what

the hypothalamus and pituitary gland work together in what system

what are the two glands that make up the pituitary gland

Most hormone secretion is regulated by what

What hormones are secreted by the posterior lobe of pituitary gland

anterior pituitary agents

posterior pituitary drugs

cosyntropin (Cortrosyn, Solu Cortef) MOA

cosyntropin (Cortrosyn, Solu Cortef) indications

cosyntropin (Cortrosyn, Solu Cortef) route of admin.

Somatropin (Genotropin) & Somatrem (Protropin) MOA

Somatropin (Genotropin) & Somatrem (Protropin) indications

Somatropin (Genotropin) & Somatrem (Protropin) mimic what

octreotide (Sandostantin) MOA

octreotide (Sandostantin) indications

octreotide (Sandostantin) route of admin

octreotide (Sandostantin) adverse effects

vasopressin (Pitressin) MOA

vasopressin (Pitressin) indications

vasopressin (Pitressin) therapeutic effect

vasopressin (Pitressin) route of admin

Demopressin (DDAVP) indications

Demopressin (DDAVP) route of admin

RN indications for Cosyntropin (Cortrosyn, Solu Cortef)

RN implications for desmopressin (DDAVP)

RN implications: monitoring for therapeutic responses for cosyntropin (Cortrosyn, Solu cortef)

RN implications: monitoring for therapeutic responses for somatropin (Protropin)

RN implications: monitoring for therapeutic responses for desmopressin (DDAVP) & vasopressin (Pitressin)

RN implications: monitoring for therapeutic responses for octreotide (Sandostatin)

Thyroid is responsible for secretion of

T3 (triodothyronine), T4 (Thyroxine), & Calcitonin regulate what

T3 (triodothyronine), T4 (Thyroxine), & Calcitonin are needed for what

3 types of hypothyroidism

what is cretinism

what is myxedema

S & S of hypothyroidism

what is primary hypothyroidism

what is secondary hypothyroidism

what is tertiary hypothyroidism

what is a goiter

thyroid drugs natural form

thyroid replacement drug for T4

what is the most prescribed thyroid hormone replacement agent

what is the hormone replacement for T3

what is the combo drug that is replacement for T3/T4

RN implications: thyroid replacement

does thyroid replacement therapy need to be taken on empty stomach

why should thyroid replacement brands not be switched during therapy

What is hyperthyroidism

hyperthyroidism disorders

what is thyroid storm

what is the most common form of hyperthyroidism

what is graves disease

S & S of hyperthyroidism

Antithyroid drugs indications

antithyroid drugs adverse effects

antithyroid drugs

how long for propylthiouracil (PTU) therapy for results

RN implications: antithyroid drugs

What is euthyroid

Glucagon is released form

Insulin is released from

Glucagon causes:

what is the stimulus for the pancreas to release insulin

insulin causes glucose to

optimal blood glucose levels

Diabetes Mellitus is a reading of

What is a disorder of carb metabolisim involving either a deficiency of insulin, resistance or tissue to insulin or both

S & S of diabetes mellitus

Type I diabetes mellitus

Type I diabetes mellitus usual onset

treatment for type I diabetes

Etiology of type I diabetes

what is type II diabetes

general onset of type II diabetes

tx for type II diabetes

% of pt that had gestational diabetes develop type II DM w/in 10-15 yrs

Insulin measurements

What type of insulin mimics insulin release with a meal

What insulin type should have dietary try b4 admin.

Rapid acting insulin should not be given more than how many min b4 a meal

rapid acting insulin onset

Rapid acting insulin peak

rapid acting insulin duration

what are the short acting insulins

What are the rapid acting insulins

What is the only insulin suitable for IV admin

Short acting insulins can be mixed with all other insulins except

short acting insulin onset

short acting insulin peak

short acting insulin duration

Intermediate acting insulin

Why are intermediate acting insulins cloudy

Onset of intermediate acting insulin

intermediate acting insulin peak

intermediate acting insulin duration

Long acting insulins

insulin glargine (Lantus) onset

insulin glargine (Lantus) peak

insulin glargine (Lantus) duration

When should insulin glargine (Lantus) be given

Insulin detemir (Levimir) should be given how much

Can Insulin detemir (Levimir) be mixed with other insulins in same syringe

Insulin detemir (Levimir) peak

Insulin detemir (Levimir) onset

Insulin detemir (Levimir) duration

Insulin adverse effects:

Mgmt of hypoglycemia

Insulin drug interactions

Insulin: Pt ed

SQ insulin injection sites

A biguanide oral antidiabetic drug

metformin (Glucophage) MOA

What is the biggest concern when taking metformin (Glucophage)

metformin (Glucophage) side effects

Sulfonylureas MOA

Sulfonylureas side effects

Sulfonylureas drugs

is glipizide (Glucotrol) contraindicated in renal failure

is glipizide (Glucotrol) short or long duration

glyburide (DiaBeta, Micronase, Glynase) long or short acting

Decreased enzymes & BF in geriatrics effect what

Glinides drugs

repaglinide (Prandin)
&
nateglinde (Starlix)

Glinides dosing

Glitazone type/Thiazolidinediones drugs

Glitazone type/Thiazolidinediones drugs MOA

Glitazone type/Thiazolidinediones drugs monitoring needs

Glitazone type/Thiazolidinediones drugs contraindications

alpha-glucosidase inhibitor drugs

alpha-glucosidase inhibitors MOA

alpha-glucosidase inhibitor side effects

alpha-glucosidase inhibitor must be taken when

dipeptydyl peptidase IV inhibitors (DPP-IV) MOA

dipeptydyl peptidase IV inhibitors (DPP-IV) side effects

Don't give dipeptydyl peptidase IV inhibitors (DPP-IV) with what

dipeptydyl peptidase IV inhibitors (DPP-IV) drug

pramlintide (Symlin) MOA

drug that mimics hormones from intestines that cause an inc. in insulin secretion from the pancreas, dec. abs. of glucose, & dec. production of glucose in liver & suppressed appetite . Not insulin

Glucose elevating drugs

diazoxide MOA

Glucagon as a drug indications

Glucagon as a drug dosing

When drawing up 2 types of insulin in same syringe which one should be drawn up first

adrenal glands two parts

adrenal cortex
&
adrenal medulla

adrenal medulla make up

which part of the adrenal gland secretes the corticosteroids

adrenal cortex secretes what corticosteroids

How do mineralcorticoids regulate e-lytes

what does "moon face" result from

Glucocorticosteroids do what for us

Glucocorticosteroids effects

mineralcorticoid effects

Increased aldosterone leads to

what is Addison's disease

What is Cushing's disease

corticosteroids are preg. cat. what

Adrenal agents need to be taken with?

what class of drugs decrease WBC (leukopenia) by increasing the life & stimulation of growth of the RBCs

adrenal agent indications

adrenal agent adverse effects

adrenal agents contraindications

use adrenal agents cautiously with:

long acting synthetic glucocorticosteroids could cause development of

long acting synthetic glucocorticosteroid drugs

what drug is a mineralocorticoid exclusive

fludrocortisone (Florinef) indications

dexamethasone (decadron, Hexadrol) indications

what is the preferred long acting synthetic glucocorticosteroids for anti inflammation and immunosuppressant

short acting natural glucocorticosteroid drugs

Adrenal steroid inhibitors MOA

antiadrenal drug

antiadrenal aminoglutethimide (cytadren) indication

Adrenals are naturally suppressed when

adrenals should be taken when

what is sometimes given with adrenals to prevent ulcer formation

Inhaled glucocorticoids can lead to what

IV push adrenals should be given fast or slow

IM adrenals should be given where

T or F:
oral adrenals should be given with milk or food

antiadrenal side effects

Adrenals: pt ed