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