Nclex RN June 2011 lets study together.

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Hello to everyone

Everyone is welcome to join this group. lets study together share views and give each other support and encouragement.

Who had passed exam your views, encouragement, advice would be appreciated.

By God grace we will pass this exam.

I am doing content write now. I did questions before I did not pass . So now going to concentrate more on content.

Any advise or tips .

Thanks and you are welcome! If I can be at any help... I realised too many books can hurt as well and cause distraction... for major references I use college books like MED/Surg Nursing by Lewis,Heitkemper, Dirksen is my "Nursing Bible" :-) I try not to cram too much information but little steps over period of time will do the job for me. Remember we all have different abilities for study... some of us are visual learners some might benefit from hearing the lectures... Your brain can function only for short period of time effectively by grasping major points, this why most of our lectures are 45-60 min long. Still at the end of this hour you drift away... your brain is too tired... I know when I'm most active and I use this time accordingly only for my studies... Now I put aside everything else and ask my family for support because we are in one boat!!! :-)

Study, study and study! It will pay off to you when you become an RN!!!

:up::up::up: VERY GOOD. IT'S LIKE IN KARATE PHYLOSOPHY:" WE HAVE EMPTY OUR MIND & STAY FOCUS";)

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Specializes in Neurology/Adult Psych/Case Managment.

One more point for students who graduated many years ago like myself, you can review Anatomy and Pathophysiology through podcasts of Dr. Cizaldo he is doing it for free but he is the best teacher I ever had in this subject!!! Use it in your reviews!!!

http://www.learnoutloud.com/Podcast-Directory/Science/Biology/Biology-2120-Lectures-on-Anatomy-and-Physiology-Podcast/18745

http://itunes.apple.com/us/podcast/biology-3020-pathophysiology/id290779540

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Specializes in Neurology/Adult Psych/Case Managment.

Please don't empty your mind!!! Use it wisely!!! LOL But you got my point!

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THANK U..THANK U,,,,,,,,,,,,THANK U................:):up:

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Please don't empty your mind!!! Use it wisely!!! LOL But you got my point!

LOL...:D :lol2:I MEAN EMPTY FROM EVERYTHING THAT DISTRACTS U FROM POINT TO STUDY & LEARN....:idea::)

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Specializes in Neurology/Adult Psych/Case Managment.

You see... I need to study even harder!!!

Seriously you are absolutely right about that, no distraction's, no excuses like... I will have time for studies... If you never put that time on your schedule, it will never be there.

I was reviewing Labor and Delivery/Maternal Complications/ Health Promotion and Maintenance do you have any difficulties there? My main concerns are meds!!!

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you see... I need to study even harder!!!

Seriously you are absolutely right about that, no distraction's, no excuses like... I will have time for studies... If you never put that time on your schedule, it will never be there.

I was reviewing labor and delivery/maternal complications/ health promotion and maintenance do you have any difficulties there? My main concerns are meds!!!

honestly i have a difficulty with medsurg. Ob/peds quest in nclex not that much,& i think we have to khow complications( like decelarations, pregnancy induse hypertention,problems with placenta,newborn alcohol & narcotics withdrawl peds math, & staff like that.........). Meds like (oxytocin)pitocin,vitk,bethametasone...........try to remember by groups & meds endings, major side effects & adverse effect.........hope this little staff can help ................have a nice study day:)

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[color=#4e4e4e]dear friends. here some little tips 4 meds. hope it'll help[color=#4e4e4e]1.[b]amiodarone hcl (cordarone[/b])- monitor heart rate and rhythm2.[b]entacapone (comtan[/b]) –antiparkinsonian, may cause photosensitivity so protect the eyes in sunlight3.[b]almotriptan maleate (axert[/b])- serotonin receptor agonist, used to treat not to prevent migraine headaches4. [b]pantoprazole ([/b][b][u][font=segoe ui]protonix[/u][/b][color=#4e4e4e])– do not crush the medication5. [b]ibuprofen (motrin[/b]) – best given with meals, report any sign ofbleeding6.[b]carbamazepine (tegretol[/b])- may cause bone marrowsuppression, check the cbc, discontinue gradually7.[b]gentamicin/ tobramycin[/b]- aminoglycosides, check the peak(15 to 30 minutes after administration) and through levels ( within an hour before the next dose) it is best monitored after the third or the fourth dose.8. [b]isoniazid[/b]- prevents spread of tb after 2 weeks of treatment,jaundice indicates hepatotoxicity9.[b]zidovudine (azt[/b])- may decrease blood components, check cbc [color=#4e4e4e]10. [b]gemfibrozil (lopid)- lowers cholesterol[/b], best takenhalf an hour before meals.11. [b]rosuvastatin ([/b][b][u][font=segoe ui]crestor[/u][/b][b])[/b][color=#4e4e4e]–lowers ldl and hdl, heck theast &alt12.[b]pravastatin( pravachol)-[/b] report unexplained muscle pain13.[b][u][font=segoe ui]simvastatin[/u][/b][b] (zocor[/b][color=#4e4e4e])- lowers ldl and triglyceriede, have anannual eye exam14.[b]lovastatin (mevacor[/b]) lowers cholesterol, check the liverfunction tests15.[b]propranolol (inderal[/b])-hold the medication if the heart rateis less then 50 per minute. the drug may cause bronchospasm16.[b]bumetanide (bumex[/b]) – diuresis may cause potassiumdepletion, best taken in the morning17.[b]amniodipine besylate (norvasc[/b])- used to treathypertension, check the bp18.[b]clopidogrel ( [/b][b][u][font=segoe ui]plavix[/u][/b][b])-[/b][color=#4e4e4e] report any sign of bleeding, besttaken with meals19.[b]ticlodipine(ticlid[/b])- used to prevent stroke; monitor for signs ofbleeding and cholestasis (jaundice, dark urine,light colored stools)20.[b]glipizide (glucotrol[/b])- do not drink with alcohol as it may worsenhypoglycemia, best taken 30 minutes before meals.21.[b]insulin glargine (lantus[/b]) – long acting insulin, not indicated for diabetic ketoacidosis22.[b]rosiglitazone (avandia)[/b] – increases insulin sensitivity, may cause hepatotoxicity23.[b]acarbose (precose[/b])- assess blood glucose levels 24. meclizine (antivert)- antiemetic, used to treat the nausea resulting from vertigo, it does not treat vertigo directly.25. [b]aluminum hydroxide and magnesium trisilicate[/b] (riopan)- antacid, report any sign of bleeding26. [b]esomeprazole ( [/b][b][u][font=segoe ui]nexium[/u][/b][b])[/b][color=#4e4e4e] – used to treat gerd, do notchew, may be taken with other antacids27. [b]tadalafil (cialis)-[/b] used to treat [u][font=segoe ui]erectile dysfunction[/u][color=#4e4e4e], do notadminister to clients taking nitroglycerine as the drug combination maycause fatal hypotension.28.[b]finasteride (proscar,propecia[/b])- decreases the prostate gland,pregnant women should avoid contact with the crushed tablet29.[b]risedronate (actonel[/b]) – used to treat osteoporosis andpagets disease,can be taken with vitd,take with a full glass of distilled or plainh2o30.[b]alendronate (fosamax[/b])- can be taken with vitamin d, shouldbe taken separately with other drugs. best taken before meals withwater. avoid orange juice, tea or coffee. remain upright aftertaking the drug31. [b]fluoxetine ( prozac[/b])- the drug may take 3-4 weeks before thetherapeutic effects becomes evident. it can potentiate the effects of:digoxin, coumadin and valium.32. [b]bupropion (wellbutrin[/b])- used to treat depression and smoking, change position slowly, contraindicated for clients withseizures.33. [b]risperidone(risperdal[/b])-may cause agranulocytosis, report fever and sore throat to the physician34.[b]piroxicam (feldene[/b])- avoid concurrent use with aspirin andcoumadin, may worsen bleeding [color=#4e4e4e]35. [b]cyclobenzaprine(flexeril[/b])- relives muscle spasm, avoid activities requiring alertness (avoid driving)36. [b]cromolyn sodium (intal[/b])- treatment for asthma,may cause dizziness37. [b]timolol[/b]- used to treat glaucoma or ocular hypertension38.[b]theophylline(theodur[/b])- used to treat asthma,best taken onan empty stomach, report nausea , vomiting and insomnia, do not crush enteric coated form.39.[b]carbidopa/levodopa(sinemet)[/b]- avoid foods high in vit.b6(wheat, liver, pork), may decrease the absorption of the drug40.[b]diazepam (valium)-[/b] must be administered separately, maycause drowsiness [color=#4e4e4e]miotic gtts = little pupilmydriatic gtts = large pupil[color=#4e4e4e][b][font=arial-boldmt-identity-h]mahuang[/b][font=couriernewpsmt-identity-h]o [font=arialmt-identity-h]cns stimulant[font=couriernewpsmt-identity-h]o [font=arialmt-identity-h]causes addiction[font=couriernewpsmt-identity-h]o [font=arialmt-identity-h]withdrawal symptoms: depression, fatigue, irritability[font=couriernewpsmt-identity-h]o [font=arialmt-identity-h]with ephedra like effect[font=couriernewpsmt-identity-h]o [font=arialmt-identity-h]used to treat asthma[font=couriernewpsmt-identity-h]o [font=arialmt-identity-h]can cause weight loss[font=couriernewpsmt-identity-h]o [font=arialmt-identity-h]not given inpatients with dm [font=wingdings-regular]à [font=arialmt-identity-h]alters the blood sugar level[b][font=arial-boldmt-identity-h]chamomile[/b][font=couriernewpsmt-identity-h]o [font=arialmt-identity-h]for diarrhea, antibacterial,antiviral[font=couriernewpsmt-identity-h]o [font=arialmt-identity-h]ci: bronchial asthma, anticoagulant therapy[b][font=arial-boldmt-identity-h]cranberry[/b][font=couriernewpsmt-identity-h]o [font=arialmt-identity-h]for uti and asthma[font=couriernewpsmt-identity-h]o [font=arialmt-identity-h]not for dm[font=couriernewpsmt-identity-h]o [font=arialmt-identity-h]safe in pregnancy[font=couriernewpsmt-identity-h]o [font=arialmt-identity-h]use with caution in dm[b][font=arial-boldmt-identity-h]echinacea[/b][font=couriernewpsmt-identity-h]o [font=arialmt-identity-h]immune system stimulant[font=couriernewpsmt-identity-h]o [font=arialmt-identity-h]not used for more than 14 days[font=couriernewpsmt-identity-h]o [font=arialmt-identity-h]store it away from direct light[font=couriernewpsmt-identity-h]o [font=arialmt-identity-h]not given in tb and chronic conditions[b][font=arial-boldmt-identity-h]ginger[/b][font=couriernewpsmt-identity-h]o [font=arialmt-identity-h]antiemetic,[font=arialmt-identity-h]tx for colic and flatulence[font=couriernewpsmt-identity-h]o [font=arialmt-identity-h]report bleeding and cns depression[b][font=arial-boldmt-identity-h]ginseng[/b][font=couriernewpsmt-identity-h]o [font=arialmt-identity-h]fatigue, atherosclerosis, depression, ca[font=couriernewpsmt-identity-h]o [font=arialmt-identity-h]report ginseng abuse syndrome, diarrhea, nervousness, edema, insomnia[b][font=arial-boldmt-identity-h]gingko biloba[/b][font=couriernewpsmt-identity-h]o [font=arialmt-identity-h]improves blood circulation[font=couriernewpsmt-identity-h]o [font=arialmt-identity-h]used in alzheimer’s disease[font=couriernewpsmt-identity-h]o [font=arialmt-identity-h]ci [font=wingdings-regular] [font=arialmt-identity-h]pregnancy, lactation and clotting d/o[b][font=arial-boldmt-identity-h]gotu kova[/b][font=couriernewpsmt-identity-h]o [font=arialmt-identity-h]improves memory[font=couriernewpsmt-identity-h]o [font=arialmt-identity-h]for uti, snake bites, rheumatism[font=couriernewpsmt-identity-h]o [font=arialmt-identity-h]ci: pregnancy, lactation and use of sedatives[b][font=arial-boldmt-identity-h]kava[/b][font=couriernewpsmt-identity-h]o [font=arialmt-identity-h]anxiety, menstrual problem, leprosy[font=couriernewpsmt-identity-h]o [font=arialmt-identity-h]ae: cns depression, hepatotoxicity[font=couriernewpsmt-identity-h]o [font=arialmt-identity-h]not given to pts with antipsychotic [font=wingdings-regular] [font=arialmt-identity-h]inc sedative effects of drugs[b][font=arial-boldmt-identity-h]valerian[/b][font=couriernewpsmt-identity-h]o [font=arialmt-identity-h]tranquilizer, sedative[font=couriernewpsmt-identity-h]o [font=arialmt-identity-h]not given with valium[font=couriernewpsmt-identity-h]o [font=arialmt-identity-h]uses: insomnia, mm. spasm[b][font=arial-boldmt-identity-h]drugs[/b][b][font=arial-boldmt-identity-h]iron supplements[/b][font=wingdings-regular]-[b][font=arial-boldmt-identity-h]feso4[/b][font=arialmt-identity-h]c= mineral supplement [font=wingdings-regular] [font=arialmt-identity-h]anemia[font=arialmt-identity-h]h= relief of fatigue / inc strength[font=arialmt-identity-h]e= best before meals, after meals if with gi irritation[font=arialmt-identity-h]c= takes effect after 2-3weeks, inc absorption with orange juice[font=arialmt-identity-h]k= elixiform use straw[font=arialmt-identity-h]injectable [font=wingdings-regular] [font=arialmt-identity-h]z track method (laterally stretch the skin, 10 seconds)[font=arialmt-identity-h]se: constipation and black stools[font=arialmt-identity-h]antidote: deferoxamine hcl (desferal)[b][font=arial-boldmt-identity-h]rhogam[/b][font=arialmt-identity-h]c= prevents rh sensitization[font=arialmt-identity-h]hemolytic reaction[font=arialmt-identity-h]e= 27-28weeks aog, ideally 72 hrs after delivery of baby with rh (+) and ( )[font=arialmt-identity-h]coomb’s[font=arialmt-identity-h]c= pain in injection site[font=arialmt-identity-h]k= check coombs test only in [b][font=arial-boldmt-identity-h]oxytocin[/b][b][font=arial-boldmt-identity-h]pitocin methergine[/b][font=arialmt-identity-h]c= induce labor contracts uterus after placental delivery[font=arialmt-identity-h]increase force of uterine contraction[font=arialmt-identity-h]h= firmly contracted uterus[font=arialmt-identity-h]e= as prescribed[font=arialmt-identity-h]c= report prolonged duration of contraction[font=arialmt-identity-h]k= avoid: blue cohosh[font=arialmt-identity-h]check bp[font=couriernewpsmt-identity-h]o [font=arialmt-identity-h]pitocin initially causes hypotension then rebound hypertension[font=couriernewpsmt-identity-h]o [font=arialmt-identity-h]methergine initially causes hypertension then rebound hypotension[b][font=arial-boldmt-identity-h]tocolytics[/b][font=arialmt-identity-h]c= relaxes the uterine mm. during preterm labor[font=arialmt-identity-h]contractions / relaxed uterus[font=arialmt-identity-h]ritodrine hcl (yutopar)[font=arialmt-identity-h]e= onset of preterm labor[font=arialmt-identity-h]c= report maternal tachycardia[font=arialmt-identity-h]hr > 130 [font=wingdings-regular] [font=arialmt-identity-h]arrhythmia[font=arialmt-identity-h]k= prepare antidote [font=wingdings-regular] [font=arialmt-identity-h]propanolol[b][font=arial-boldmt-identity-h]magnesium sulfate[/b][font=arialmt-identity-h]c= anticonvulsant, ns depressant[font=arialmt-identity-h]seizure[font=arialmt-identity-h]e= as prescribed pih[font=arialmt-identity-h]c= report mgso4 intoxication hypotension, hypocalcemia and h/a[font=arialmt-identity-h]k= check bp, urine output, rr, patellar reflex if dec antidote [font=wingdings-regular] [font=arialmt-identity-h]ca gluconate[font=arialmt-identity-h]therapeutic level:[font=couriernewpsmt-identity-h]o [font=arialmt-identity-h]loading dose [font=wingdings-regular] [font=arialmt-identity-h]4 – 7 meq/l[font=couriernewpsmt-identity-h]o [font=arialmt-identity-h]maintenance [font=wingdings-regular] [font=arialmt-identity-h]1.5 – 3 meq/l[font=couriernewpsmt-identity-h]o [font=arialmt-identity-h]depression of dtr if [font=wingdings-regular] [font=arialmt-identity-h]8 meq/l[font=couriernewpsmt-identity-h]o [font=arialmt-identity-h]dec rr if [font=wingdings-regular] [font=arialmt-identity-h]10 – 12 meq/l[b][font=arial-boldmt-identity-h]coagulation process[/b][font=arialmt-identity-h]vit k dependent clotting factors[font=arialmt-identity-h]thromboplastin fibrinogen [font=wingdings-regular]à [font=arialmt-identity-h]fibrin (clot)[font=arialmt-identity-h]prothrombin thrombin[font=arialmt-identity-h]coumadin heparin[font=arialmt-identity-h](oral) (injectable)[font=arialmt-identity-h]c= anticoagulant[font=arialmt-identity-h]clot formation[font=arialmt-identity-h]e= onset: 2 – 5 days 1- 2days[font=arialmt-identity-h]c= report signs of bleeding[font=arialmt-identity-h]k= avoid green leafy vegetable (contains vit k)[font=arialmt-identity-h]avoid hard bristle toothbrush[font=arialmt-identity-h]antidote: vit k protamine sulfate[font=arialmt-identity-h]lab: pt ptt[b][font=arial-boldmt-identity-h]chemotherapy[/b][b][font=arial-boldmt-identity-h]cell cycle[/b][font=arialmt-identity-h]g0 mitosis[font=arialmt-identity-h]interphase[font=arialmt-identity-h]resting g1 s g2 cell division[font=arialmt-identity-h]rna production dna synthesis rna synthesis[font=arialmt-identity-h]alkalating agents antimetabolites[font=arialmt-identity-h]antibiotic plant alkaloid hormones[font=arialmt-identity-h]interferes dna & inhibit dna & interferes dna interferes rna[font=arialmt-identity-h]replication rna synthesis [font=arialmt-identity-h]* cytoxan *methotrexate *adriamycin *oncovin *tamoxifen[font=arialmt-identity-h]* mustargen (antidote: leucoverin) glenoxane[font=arialmt-identity-h]malignant hyperthermia = parlodel[font=arialmt-identity-h]muscle rigidity = dantrolene, dantrium[font=arialmt-identity-h]administer valium separately = incompatible with any other drugs[font=arialmt-identity-h]avoid kava & valerian = inc resp depression[font=arialmt-identity-h]antidepressants-avoid citrus juices dec absorption of med[font=arialmt-identity-h]avoid st. john wort[font=arialmt-identity-h]acute mania = give antipsychotic with antimanic[font=arialmt-identity-h]c= [b][font=arial-boldmt-identity-h]check signs of toxicity:[/b][font=arialmt-identity-h]mild moderate severe[font=arialmt-identity-h]1.5 meq/l 2.5 meq/l > 2.5 meq/l[font=arialmt-identity-h]thirst nausea[font=arialmt-identity-h]ataxia anorexia[font=arialmt-identity-h]h/a vomiting[font=arialmt-identity-h]irritability diarrhea[font=arialmt-identity-h]beginning fine hand tremors coorifice hand tremors[font=arialmt-identity-h]abdominal cramps coma [font=wingdings-regular] [font=arialmt-identity-h]death[font=arialmt-identity-h]k= monitor lithium level early morning (before breakfast)[font=arialmt-identity-h]out patient at least once a month[font=arialmt-identity-h]drug of choice for toxicity diamox, mannitol ci:[font=arialmt-identity-h]1.) pregnancy[font=arialmt-identity-h]2.) lactation[font=arialmt-identity-h]3.) renal failure[font=arialmt-identity-h]dietary modification [font=wingdings-regular] [font=arialmt-identity-h]inc na (6–10 gm) and inc fluid ( 3l or more)[font=arialmt-identity-h]acute dose: .5 – 1.5 meq/l[font=arialmt-identity-h]maintenance: .5 – 1.2 meq/l[font=arialmt-identity-h]elderly : not exceed 1.0 meq/l [font=wingdings-regular] [font=arialmt-identity-h]due to poor renal excretion[b][font=arial-boldmt-identity-h]musculoskeletal drugs[/b][font=arialmt-identity-h]c= focus: gold therapy[font=arialmt-identity-h]suppresses arthritis[font=arialmt-identity-h]inflammation[font=arialmt-identity-h]e= im [font=wingdings-regular] [font=arialmt-identity-h]weekly[font=arialmt-identity-h]lie supine for 10 mins to prevent oh[font=arialmt-identity-h]c= check:[font=arialmt-identity-h]signs of stomatitis[font=arialmt-identity-h]dermatitis unusual bleeding unusual bruisingfever[font=arialmt-identity-h]sore throat[font=arialmt-identity-h]k= monitor renal function test[font=arialmt-identity-h]c= antiinflammatory[font=arialmt-identity-h]ibuprofen aspirin[font=arialmt-identity-h](nsaid’s)[font=arialmt-identity-h]antiinflammatory[font=arialmt-identity-h]antipyretic[font=arialmt-identity-h]analgesic [font=arialmt-identity-h]for ra & oa antiplatelet aggregate[font=arialmt-identity-h]antirheumatic[font=arialmt-identity-h]inflammation, pain, ra fever, platelet aggregation[font=arialmt-identity-h]e= pc – after meals[font=arialmt-identity-h]c= report:[font=arialmt-identity-h]visual disturbances ringing in the ears[font=arialmt-identity-h]allergy nausea & vomiting[font=arialmt-identity-h]sore throat rapid breathing[font=arialmt-identity-h]fever hyperpnea [font=wingdings-regular]t[font=arialmt-identity-h]oxicity[font=arialmt-identity-h]black stool[font=arialmt-identity-h]k= annual eye exam[font=arialmt-identity-h]check bleeding time[font=arialmt-identity-h]c= antigout agents[font=arialmt-identity-h]probenecid colchicine allopurinol[font=arialmt-identity-h]acute chronic[font=arialmt-identity-h](8-12hrs) (13weeks)[font=arialmt-identity-h]excretion of u.a. prevent deposition of u.a. prevent formation of u.a.[font=arialmt-identity-h]antiinflammatory[font=arialmt-identity-h]h= decrease uric acid[font=arialmt-identity-h]e= given with food[font=arialmt-identity-h]c= navda bruising h/a, drowsiness[font=arialmt-identity-h]allergy agranulocytosis[font=arialmt-identity-h]k= inc fluid intake 2 – 3 l/day[font=arialmt-identity-h]frequently check serum uric acid level[font=arialmt-identity-h]cardiac drugs[font=arialmt-identity-h]nitrate[font=arialmt-identity-h]a. nitroglycerine[font=arialmt-identity-h]sublingual[font=arialmt-identity-h]transmucosal = between gums, cheecks and lips[font=arialmt-identity-h]b. isordil[font=arialmt-identity-h]sustained release, with water and don’t crush[font=arialmt-identity-h]patch[font=arialmt-identity-h]nasal spray[font=arialmt-identity-h]c= caridac drug (nitrate)[font=arialmt-identity-h]dilate coronary arteries and arterioles dec preload anginal pain[font=arialmt-identity-h]e = give before onset of pain[font=arialmt-identity-h]3 x at 5 mins intervalafter 15 mins ( + ) pain report [font=wingdings-regular] [font=arialmt-identity-h]may indicate mi[font=arialmt-identity-h]c= 1. ointment = cover with plastic and put adhesive tape[font=arialmt-identity-h]2. patch = non hairypart[font=arialmt-identity-h]3. oral spray = 3 sprays in 15 mins[font=arialmt-identity-h]s.e. facial flushing, h/a, hypotension[font=arialmt-identity-h]k= rise slowly to prevent oh[font=arialmt-identity-h]tablet on dry, dark container,6 months [font=wingdings-regular] [font=arialmt-identity-h]discard[font=arialmt-identity-h]burning sensation [font=wingdings-regular]à [font=arialmt-identity-h]indication that the drug is still potent[font=arialmt-identity-h]c= cardiac glycoside[font=arialmt-identity-h]digoxin digitoxin[font=arialmt-identity-h]h= strengthen myocardial contraction[font=arialmt-identity-h]nakpump is converted to nacapump thus increasing force of contraction[font=arialmt-identity-h]e= onset 5 – 20 mins onste 30 mins – 2 hrs[font=arialmt-identity-h]observe gi irritation[font=arialmt-identity-h]c= excreted by kidneys excreted by the liver[font=arialmt-identity-h]normal level 14 – 26 antidote: digibive[font=arialmt-identity-h]normal level 5- 2 ug/dl[font=arialmt-identity-h]k= check hr = adult 60[font=arialmt-identity-h]older children = 70[font=arialmt-identity-h]infants = 90 – 110[b][font=arial-boldmt-identity-h]dopamine and dobutamine[/b][font=arialmt-identity-h]inc force of contraction[font=arialmt-identity-h]correct hemodynamic[font=arialmt-identity-h]for emergency situation[font=arialmt-identity-h]h= adequate urine output[font=arialmt-identity-h]e= emergency situation[font=arialmt-identity-h]c= always in diluted form[font=arialmt-identity-h]k= compute the drugs properly[font=arialmt-identity-h]c= [b][font=arial-boldmt-identity-h]antiarrythmics[/b][font=arialmt-identity-h]lidocaine quinidine (xylocaine) atrial fibrillation for pvc’s[font=arialmt-identity-h]arrythmia,slow ventricular rate,slow atrial rate[font=arialmt-identity-h]e= given as prescribed[font=arialmt-identity-h]c= rash blurring of vision[font=arialmt-identity-h]convulsion tinnitus/ototoxicity[font=arialmt-identity-h]k= check hr[font=arialmt-identity-h]evaluate ecg[font=arialmt-identity-h]c= [b][font=arial-boldmt-identity-h]thrombolytics[/b][b][font=arial-boldmt-identity-h]streptokines[/b][b][font=arial-boldmt-identity-h]tpa[/b][font=arialmt-identity-h]dissolves the clot by preventing the formation of fibrin(fibrinolysis)[font=arialmt-identity-h]clot formation[font=arialmt-identity-h]clot dissolved[font=arialmt-identity-h]e= effective within 6 hours[font=arialmt-identity-h]after mi [font=wingdings-regular] [font=arialmt-identity-h]within 24 hrs[font=arialmt-identity-h]c= report bleeding monitor vs[font=arialmt-identity-h]k= contraindicated to clients that are prone to bleeding[font=arialmt-identity-h]c= [b][font=arial-boldmt-identity-h]antilipemic agents[/b][b][font=arial-boldmt-identity-h]lovastatin questran[/b][font=arialmt-identity-h](tablet) (powder)[font=arialmt-identity-h]h= dec ldl = 30 – 80 (hdl should be > 80 and ldl < 80)[font=arialmt-identity-h]e= before meals or at night time[font=arialmt-identity-h]c= caution: hepatotoxic[font=arialmt-identity-h]k= questran 1 pack of powder+4–6oz of fluid (water,milk or juice)[font=arialmt-identity-h]check liver function test,rash and bleeding[font=arialmt-identity-h]c= [b][font=arial-boldmt-identity-h]peripheral vasodilator[/b][font=arialmt-identity-h]paracid[font=arialmt-identity-h]smooth muscle relaxant [font=wingdings-regular] [font=arialmt-identity-h]facilitates blood circulation[font=arialmt-identity-h]ischemia[font=arialmt-identity-h]e= after meals[font=arialmt-identity-h]c= instruct patient that drug may cause h/a and sob[font=arialmt-identity-h]k= long term use is individual[font=arialmt-identity-h]c= [b][font=arial-boldmt-identity-h]betablocker[/b][font=arialmt-identity-h](timolol, esmolol, nadolol)[font=arialmt-identity-h]h= dec bp, for hyperthyroidism, dec sympathetic (autonomic) nervous system stimulation[font=arialmt-identity-h]e= before meals[font=arialmt-identity-h]c= rise slowly: lie down for 30 mins after medication.[font=arialmt-identity-h]instruct patient that meds may cause bronchospasm[font=arialmt-identity-h]k= do not give chamomile and aspirin[font=arialmt-identity-h]c= [b][font=arial-boldmt-identity-h]anticholinergic[/b][font=arialmt-identity-h]atropine sulfate vasolytic agent[font=arialmt-identity-h]h= inc heart rate (check complete heart rate)[font=arialmt-identity-h]e= before meals[font=arialmt-identity-h]c= avoid hot environments[font=arialmt-identity-h]k= check for rashes and sob[b][font=arial-boldmt-identity-h]neurodrugs[/b][font=arialmt-identity-h]c= anticonvulsants dilantin[font=arialmt-identity-h]h= decrease seizure threshold[font=arialmt-identity-h]e= after meals[font=arialmt-identity-h]c= epilepsy [font=wingdings-regular] [font=arialmt-identity-h]maintenance[font=arialmt-identity-h]chronis use [font=wingdings-regular] [font=arialmt-identity-h]gingivitis[font=arialmt-identity-h]visit dentist at least once a year soft bristle toothbrush, massage the gums urine is pink tinged[font=arialmt-identity-h]k= sas ( saline flush [font=wingdings-regular]à [font=arialmt-identity-h]administer drug saline flush[font=arialmt-identity-h]to prevent precipitate[font=arialmt-identity-h]c= [b][font=arial-boldmt-identity-h]cholinesterase[/b][b][font=arial-boldmt-identity-h]neostigmine tensilon cognex[/b][font=arialmt-identity-h]myasthenia gravis alzeihmers[font=arialmt-identity-h]long acting short acting maintenance[font=arialmt-identity-h]treatment diagnostic treatment[font=arialmt-identity-h]h= inc muscle strength inc mental functioning[font=arialmt-identity-h]e= before activity at bedtime[font=arialmt-identity-h]before meals use muscles of mastication[font=arialmt-identity-h]c= chewing becomes stronger dec dizziness[font=arialmt-identity-h]medication is lifetime[font=arialmt-identity-h]report s/s of hepatotoxicity[font=arialmt-identity-h]k= check liver fxn test[font=arialmt-identity-h]keep at bedside [font=wingdings-regular] [font=arialmt-identity-h]neostigmine [font=wingdings-regular] [font=arialmt-identity-h]antidote: atropine sulfate[font=arialmt-identity-h]do not give echinicea[font=arialmt-identity-h]prepare tracheostomy[font=arialmt-identity-h]c= [b][font=arial-boldmt-identity-h]antitb[/b][b][font=arial-boldmt-identity-h]rifampicin inh streptomycin ethambutol[/b][font=arialmt-identity-h]infection[font=arialmt-identity-h]e= before meals[font=arialmt-identity-h]c= red orange urine peripheral neuritis oto,nephro,neuro hepatotoxic[font=arialmt-identity-h]don’t use contact lenses (give b6) toxic psychotic like sx[font=arialmt-identity-h]k= take the complete treatment as prescribed by the doctor ( 6 – 12 months )[font=arialmt-identity-h]incomplete tb treatment [font=wingdings-regular] [font=arialmt-identity-h]lead to mdrtb[font=arialmt-identity-h]c= [b][font=arial-boldmt-identity-h]antiasthma[/b][font=arialmt-identity-h]theophylline cromolyn na[font=arialmt-identity-h]adult = 10 – 20 mg/dl prevents antihistamine release[font=arialmt-identity-h]peds = 5 – 10 mg/dl[font=arialmt-identity-h]dilates bronchioles[font=arialmt-identity-h]h= ease breathing[font=arialmt-identity-h]e= in the morning [font=wingdings-regular] [font=arialmt-identity-h]because it causes insomnia[font=arialmt-identity-h]c= nausea and vomiting rashes[font=arialmt-identity-h]theophylline toxicity[font=arialmt-identity-h]k= check the pulse rate[font=arialmt-identity-h]avoid chamomile [font=wingdings-regular]à [font=arialmt-identity-h]cause bronchospasm[font=arialmt-identity-h]avoid aspirin ?[font=arialmt-identity-h]cause bronchospasm[font=arialmt-identity-h]inhaler [font=wingdings-regular] [font=arialmt-identity-h]acute[font=arialmt-identity-h]steroid [font=wingdings-regular] [font=arialmt-identity-h]chronic[font=arialmt-identity-h]c= [b][font=arial-boldmt-identity-h]mucolytics [/b][font=arialmt-identity-h](mucomyst)[b][font=arial-boldmt-identity-h][/b][font=arialmt-identity-h]h= antidote for aspirin toxicity[font=arialmt-identity-h]dec viscosity of mucous[font=arialmt-identity-h]loose phlegm[font=arialmt-identity-h]e= no specific time[font=arialmt-identity-h]c= inc ofi[font=arialmt-identity-h]s.e. [font=wingdings-regular] [font=arialmt-identity-h]bronchospasm[font=arialmt-identity-h]k= suction[font=arialmt-identity-h]medication has a foul odor that resemble rotten egg[b][font=arial-boldmt-identity-h]c= emetic[/b][font=arialmt-identity-h]syrup of ipecac[font=arialmt-identity-h]h= to induce vomiting [font=wingdings-regular] [font=arialmt-identity-h]noncorrosive[font=arialmt-identity-h]peds below 6 months vomiting[font=arialmt-identity-h]e= dose depends on age[font=arialmt-identity-h]6 mos – 1 yr = 10ml;1 – 12 yrs = 15ml;> 12 yrs = 30ml[font=arialmt-identity-h]c= administer with glass of water to enhance effects of ipecac[font=arialmt-identity-h]cardiotoxic = ensure that child vomits the entire amount[font=arialmt-identity-h]c= [b][font=arial-boldmt-identity-h]antacids[/b][font=arialmt-identity-h]peptic ulcer disease[font=arialmt-identity-h]maalox ranitidine sucralfate[font=arialmt-identity-h]hrs 46;wks 8 wks[font=arialmt-identity-h]neutralizes hcl dec hcl secretion coats git[font=arialmt-identity-h]normal hcl 2 – 5[font=arialmt-identity-h]maximum 10[font=arialmt-identity-h]pain, dec hcl[font=arialmt-identity-h]e= usually on an empty stomach[font=arialmt-identity-h]1 hour before meals 2 hours after meals[font=arialmt-identity-h]c= shake liquid[font=arialmt-identity-h]se: diarrhea[font=arialmt-identity-h]constipation[font=arialmt-identity-h]k= short term therapy [font=wingdings-regular] [font=arialmt-identity-h]electrolyte imbalance[b][font=arial-boldmt-identity-h]endocrine disease[/b][font=arialmt-identity-h]c= [b][font=arial-boldmt-identity-h]insulin oha[/b][font=arialmt-identity-h]type 1 diabetes mellitus type 2[font=arialmt-identity-h]regular – humulin orinase[font=arialmt-identity-h]intermediate – nph diabinase[font=arialmt-identity-h]longacting[font=arialmt-identity-h]– ultra lente metformin[font=arialmt-identity-h]h= inc transfer of glucose to cell membrane pancreas to secrete insulin[font=arialmt-identity-h]e= before breakfast[font=arialmt-identity-h]c= report hypoglycemia:[font=arialmt-identity-h]dizziness[font=arialmt-identity-h]dec loc[font=arialmt-identity-h]diff. of problem solving[font=arialmt-identity-h]k= hypo occurs usually occurs at the peak of action of meds:[font=arialmt-identity-h]before lunch[font=arialmt-identity-h]in the afternoon or before dinner[font=arialmt-identity-h]in midnight or next day[font=arialmt-identity-h]rank: 4 – 8 – 12/16[font=arialmt-identity-h]c= [b][font=arial-boldmt-identity-h]thyroid drugs[/b][b][font=arial-boldmt-identity-h]synthroid ptu[/b][font=arialmt-identity-h](supplement) tapazole ( 10 times greater than ptu)[font=arialmt-identity-h]for hypothyroidism for hyperthyroidism[font=arialmt-identity-h]h= normal bmr dec t3 and t4,adequate appetite and sleep[font=arialmt-identity-h]e= in morning to prevent insomnia round the clock[font=arialmt-identity-h]c= report signs of overdose: report:[font=arialmt-identity-h]insomnia,palpitation & nervousness fever,sore throat,body malaise[font=arialmt-identity-h]k= life time monitor hr & bp[font=arialmt-identity-h]c= [b][font=arial-boldmt-identity-h]steroid[/b][b][font=arial-boldmt-identity-h]cortisone floricef[/b][font=arialmt-identity-h]replacement therapy[font=arialmt-identity-h]addision’s disease[font=arialmt-identity-h]h= correct fluid and electrolyte imbalance[font=arialmt-identity-h]e= in the morning[font=arialmt-identity-h]c= given intramuscularly[font=arialmt-identity-h]avoid abrupt withdrawal[font=arialmt-identity-h]ae: bruising [font=wingdings-regular] [font=arialmt-identity-h]bone marrow depression[font=arialmt-identity-h]k= avoid salty foods [font=wingdings-regular] [font=arialmt-identity-h]edema[font=arialmt-identity-h]maintain a balance diet [font=wingdings-regular] [font=arialmt-identity-h]obesity[font=arialmt-identity-h]avoid crowded areas [font=wingdings-regular] [font=arialmt-identity-h]infection[font=arialmt-identity-h]c= [b][font=arial-boldmt-identity-h]renal drugs[/b][font=arialmt-identity-h]epogen[font=arialmt-identity-h]inc rbc production for chronic renal failure[font=arialmt-identity-h]h= normal hemoglobin[font=arialmt-identity-h]e= as prescribed[font=arialmt-identity-h]c= report polycythemia [font=wingdings-regular] [font=arialmt-identity-h]inc production of rbc [font=wingdings-regular]à [font=arialmt-identity-h]cva[font=arialmt-identity-h]check complete blood count[font=arialmt-identity-h]c= [b][font=arial-boldmt-identity-h]diuretic[/b][b][font=arial-boldmt-identity-h]loop diuretic thiazide diuretic k – sparring diuretic[/b][font=arialmt-identity-h](lasix) (hydrochlorothiazide) (spirinolactone)[font=arialmt-identity-h]duiril aldactone[font=arialmt-identity-h]loop of henle distal tubule blocks aldosterone[font=arialmt-identity-h]prevent na absorption prevents na absorption retains water[font=arialmt-identity-h]h= increase urine output and decrease pt’s weight[font=arialmt-identity-h]e= early morning [font=wingdings-regular]à [font=arialmt-identity-h]prevent nocturia[font=arialmt-identity-h]c= hypokalemia hypokalemia[font=arialmt-identity-h]dec k dec k inc k[font=arialmt-identity-h]dec na dec na dec na[font=arialmt-identity-h]dec ca dec mg[font=arialmt-identity-h]k= inc sodium in diet[font=arialmt-identity-h]check electrolyte level check bp[b][font=arial-boldmt-identity-h]immunuren [/b][font=arialmt-identity-h](azathioprine)[b][font=arial-boldmt-identity-h][/b][font=arialmt-identity-h]c= immunosuppressant -rejection of organs[font=arialmt-identity-h]e= as prescribed[font=arialmt-identity-h]c= report:[font=arialmt-identity-h]nausea, vomiting[font=arialmt-identity-h]thrombocytopenia[font=arialmt-identity-h]bruising[font=arialmt-identity-h]infection[font=arialmt-identity-h]k= check cbc[font=arialmt-identity-h]frequent handwashing[font=arialmt-identity-h]c= [b][font=arial-boldmt-identity-h]miotics mydriatics[/b][font=arialmt-identity-h](pilocarpine) (atso4)[font=arialmt-identity-h]for glaucoma ci for glaucoma[font=arialmt-identity-h]for eye exam[font=arialmt-identity-h]h= normal iop dilatation of pupils[font=arialmt-identity-h]e= lifetimein glaucoma as prescribed[font=arialmt-identity-h]c= lower conjunctival sac report: eye pain & blurring of vision[font=arialmt-identity-h]press inner canthus 1 –2 mins to avoid alertness after medication[font=arialmt-identity-h]prevent systemic se[font=arialmt-identity-h]k= check bp and blood sugar[font=arialmt-identity-h]c= [b][font=arial-boldmt-identity-h]antibiotics[/b][font=arialmt-identity-h]vancomycin penicillin tetracycline[font=arialmt-identity-h]mrsa gonorrhea lymes[font=arialmt-identity-h]syphillis rocky mountain fever infection[font=arialmt-identity-h]e= before meals[font=arialmt-identity-h]with gi irritation [font=wingdings-regular]à [font=arialmt-identity-h]after meals[font=arialmt-identity-h]c= ototoxic, nephrotoxic, allergy hepatotoxic neurotoxic[font=arialmt-identity-h]k= check i and o[font=arialmt-identity-h]peak level = 15 – 30 mins after administration[font=arialmt-identity-h]trough level = 15 – 30 mins before the next dose[font=arialmt-identity-h]antidote: epinephrine deep im and check cbc[font=arialmt-identity-h]given with probenecid[b]types of insulin[/b]-rapid acting (lispro, humalog)-onset= 5 minutes-peak= 30 minutes-short acting (novolog, regular)-onset= 30 minutes-peak= 2 hours-intermediate acting (nph)-onset= 1 hour-peak= 6-12 hours-long acting (humulin) -onset= 4 hours-peak= 16-18 hours[b]iv solutions[/b]isotonic- normal saline, lactated ringers, 5% dextrose in waterhypotonic- 0.45% ns, 0.225% nshypertonic- 5% dextrose in 0.45% ns, 5% dextrose in 0.9% ns[b]med-calc[/b]vol (ml) / time (minutes) x drop factor = flow ratedose order / dose on hand x amount available = amount to give-therapeutic digoxin level= 0.5-2 -therapeutic theophylline level= 10-20 -therapeutic lithium level = 1-1.5- 60 mg= 1 gr-autonomic dyreflexia- check foley first!-mi treatment= mona (morphine, oxygen, nitro, aspirin)-hyperglycemia = dry and drowsy, hypoglycemia = wet and wild-pulse paradoxus- pulse is weak on inspiration and strong on expiration-hypothyroidism: decreased t3 +t4, but increased tsh-hypertyroidism: increased t3 + t4, but decreased tsh-ase = thrombolytic-azepam = benzodiazepine-azine = antiemetic; phenothiazide-azole = proton pump inhibitor, antifungal-barbital = barbiturate-coxib = cox 2 enzyme blockers-cep/-cef = anti-infectives-caine = anesthetics-cillin = penicillin-cycline = antibiotic-dipine = calcium channel blocker-floxacin = antibiotic-ipramine = tricyclic antidepressant-ine = reverse transcriptase inhibitors, antihistamines-kinase = thrombolytics-lone, pred- = corticosteroid-mab = monoclonal antibiotics-micin = antibiotic, aminoglycoside-navir = protease inhibitornitr-, -nitr- = nitrate/vasodilator-olol = beta antagonist-oxin = cardiac glycoside-osin = alpha blocker-parin = anticoagulant-prazole = ppi’s-phylline = bronchodilator-pril = ace inhibitor-statin = cholesterol lowering agent-sartan = angiotensin ii blocker-sone = glucocorticoid, corticosteroid-stigmine = cholinergics-terol = beta 2 agonist-thiazide = diuretic-tidine = antiulcer -trophin = pituitary hormone-vir = anti-viral, protease inhibitors-zosin = alpha 1 antagonist-zolam = benzo/sedative-zine = antihistaminepharm facts-don’t give non-selective beta-blockers to patients w/respiratory problems -vitamin c can cause false +ive occult blood-avoid the ‘g’ herbs (ginsing, ginger, ginko, garlic) when on anti-clotting drugs (coumadin, asa, plavix, etc)-asa toxicity can cause ringing of the ears -no narcotics to any head-injury victims-mg2+ toxicity is treated with calcium gluconate-do not give calcium-channel blockers with grapefruit juice-oxytocin is never administered through the primary iv-lithium patients must consume extra sodium to prevent toxicity-maoi patients should avoid tyramine:oaacados, bananas, beef/chicken liver, caffeine, red wine, beer, cheese (except cottage cheese), raisins, sausages, pepperoni, yogurt, sour cream.-don’t give atropine for glaucoma – it increases iop-don’t give ant-acids with food -- b/c it delays gastric emptying. -don’t give stadol to methadone/heroin preggo’s -- cause instant withdrawal symptoms-insulin – clear before cloudy-don’t give meperidine (demerol) to pancreatitis patients-always verify bowel sounds when giving kayexelate-hypercalcemia = hypophosphatemia (and vice versa)-radioactive dye – urine excretion-signs of toxic ammonia levels is asterixis (hands flapping)-d10w can be substituted for tpn (temporary use)-dopamine and lasix are incompatible-hypoglycemic shivers can be stopped by holding the limb, seizures cannot (infants)-common symptom of aluminum hydroxide – constipation-thiazide diuretics may induce hyperglycemia-take iron with vit c – it enhances absorbtion – do not take with milk-b1 - for alcoholic patients (to prevent wernicke’s encephalopathy & korsakoff’s synd)-b6 - for tb patients -b9 - for pregnant patients-b12 - pernicious anemia, vegetarians. -complications of coumadin - 3h’s - hemorrhage, hematuria & hepatitis-ffp is administered to dic b/c of the clotting fx-mannitol (osmtic diuretic [head injury]) crystallizes at room temp – use a filter needle-antianxiety medication is pharmacologically similar to alcohol –used for weaning tx-administrate glucagon when pt is hypoglycemia and unresponsive-phenazopyridine ( pyridium)--urine will appear orange-rifampicin -- red-urine, tears, sweat)-hot and dry = sugar high (hyperglycemia)-cold and clammy = need some candy (hypoglycemia)-med of choice for v-tach is lidocaine-med of choice for svt = adenosine or adenocard-med of choice for asystole = atropine-med of choice for chf is ace inhibitor.-med of choice for anaphylactic shock is epinephrine-med of choice for status epilepticus is valium.-med of choice for bipolar is lithium.-give ace inhibitors w/food to prevent stomach upset-administer diuretics in the morning-give lipitor at 1700 since the enzymes work best during the evenin-common tricyclic meds - 3 syllabes (pamelor, elavil)-common maoi’s - 2 syllables (nardil, marplan)-tpn has a dedicated line & cannot be mixed ahead of time-rhogam -- given at 28 weeks & 72 hrs postpartum-do not administer erythromycin to multiple sclerosis pt-benadryl and xanax taken together will cause additive effects.-can't take lasix if allergic to sulfa drugs.-acetaminophen can be used for headache when the client is using nitroglycerin.-dilantin - can not give with dextrose. only give with ns.-never give via ivp:okcloheparinoibuprofenoinsulinodobutamineoasaoalbuminoacetaminophen-substance poisoning and antidotesomethanol -- ethanoloco2 -- oxygenodopamine -- phentolamineobenzo’s (versed) -- flumazenilolead -- succimer, calcium disodium oiron -- deferoxamineocoumadin -- vitamin koheparin -- protamine sulfateothorazine -- cogentineowild mushrooms - atropineorat poison - vit k-parkland formula: 4cc * kg * bsa burned = total volume necessaryo1st 8hrs – ½ total volumeo2nd 8hrs – ¼ total volumeo3rd 8 hrs – ¼ total volumes
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Specializes in Neurology/Adult Psych/Case Managment.

Thank you for posting this attachment!!! Lot's of things I learned from it. Great help!!!

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Specializes in Med/Surg Nurse, Homecare, Visiting Nurse.

Taking RN boards next month. Took me four long years to get here. I'm using Exam Cram, LaCharity and Helen Feuer Nursing Review. I did a review course over a year ago, I really can't afford another at this point. Hopefully the knowledge I gained from the review, four years of Med/Surg experience, and the studying I'm doing now will pay off on the exam. I really want to be successful on my first try so I have to put in a lot of effort. I can't wait to get pass this, we can all support each other.... we are all after the same goal.:yeah::yeah::yeah::yeah:

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UR VERY WELCOME

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hey guys i have some more tips:

insulin, coumadin, heparin, antihypertensives, viagra, digitalis, ritalin, actonel, accutane, anti-ulcer medications, nitroglycern, to name a few. try to look at the suffixes:

ace inhibitors end with 'pril (eg: captopril) *note that this drug increases potassium in the blood,

angiotensinogen 2 inhibitors end in 'sartan (eg: losartan),

beta blockers end with 'olol (eg: metoprolol) *caution with patients who are diabetic or who are asthmatic,

cholesterol reducing drugs usually end with 'statin (eg: atorvastatin) * note that if the patient experiences muscular pain, they should stop immediately and report it to the doctor, also not to consume grapefruit juice,

impotence drugs end with "defil (eg: sildenefil-hope i spelled it correctly...if not please excuse the typo) *note that you cannot take this drug if you are taking nitrates such as nitroglycerin or isosorbide and go to the doctor if an erection last longer than 4 hours,

accutane is an acne drug, where a pregnancy test must be done on females before prescribing them

actonel (again, this may be a typo) cannot be taken unless a person is able to sit up for at least 1/2 hour to an hour after adminstration.

know the acting times of insulin, which is fast acting, long acting or the lente. they may ask when will a person become hypoglycemic, and that would be during peak hours.

penicillin: if a person has an allergy to penicillin, they may be at risk for an allergy to a cephalosporin, in that case suggest a macrolide such as clarithromycin. macrolides are known to cause severe stomach pain for some people. also, if a nurse administers penicillin or cephalosporin, that the patient should remain with the nurse for 1/2 hour afterwards to intervene with allergic reactions.

most drugs that end with 'mycin may cause nephrotoxicity or ototoxicity

parameters for digitalis administration, and also that if potassium is low and calcium and magnesium is high, there is a higher chance for digitalis toxicity.

corticosteriods usually end with 'sone (eg: predinsone), may cause medication related diabetes, increase chances of infection, cause cushoid symptoms (buffalo hump in back, thin skin, easy to bruise, etc...)

aspirin should not be consumed with alcohol, increases bleeding, causes ulcers, should be taken with food to diminish gastric distress

antidote for tylenol is mucomyst. dont forget your diuretics ... esp. those are imp. also i have some for now ...

meds that end in -sartan=decrease blood pressure, increase cardiac load (used for those who side effect is cough with ace)

angiotensin ii receptor blockers

side effects 2nd degree av block, angina, muscle cramps monitor bun,bp and pulse

-vastatin(lovastatin)=decrease cholesterol, lower tricycerides (note*lipitor at night only do not take with grapefruit juice)

antihyperlipidemics

side effects muscle weakness, alopecia monitor liver/renal profile

cox=osteoarthritis, rheumatoid arthritis(relieve pain by reducing inflammation)

nsaid/co2 enzyme blocker

side effects tinnitus, dizziness monitor bowel habits (could cause gi bleed, platlet count) increase risk of strokes, heart attacks***

tidine=gerd

histamine 2 antagonist(inhibit gastric acids)

side effects agranulocytosis, brady/tachycardia monitor gastric ph/bun ***if taking antacids take one hour after or before taking these drugs***

-prazole=ulcers, indigestion, gerd (take before meals better absorption)

proton pump inhibitors

side effects gas, diarrhea, hyperglycemia monitor lfts

-parin=thin blood, dvt, m.i.,post surgeries (antidote protamine sulfate--check ptt should be 1.5-2.0x) anticoag. decread vit. k levels

side effects hematuria, bleeding, fever monitor ptt, hematocrit and occult testing q 3mths

-pam

-pate

-aze/azo =benzos/antianxiety/anticonvulsants

side effects incontinence, respiratory depression/ monitor for lft, respirations

-caine (anesthetic)

-mab (monoclonal antibodies)

-ceph or cef (cephalosporins)

-cycline (tetracyclines)

-cal (calciums)

-done (opioids)

ganciclovir sodium causes neutropenia and thrombocytopenia and nurse should monitor for s/s of bleeding just as equiv. to a pt. on anticoag. therapy.

ssris and maois used together potentially fatal

drug

therapeutic and toxic levels

acetaminophen (tylenol)

therapeutic: 1-30 mcg/ml

toxic: >200 mcg/ml

contraindicated in:

liver disease

side effects of toxicity:

hepatic necrosis

alcohol (ethanol)

therapeutic level: 100 mcg/ml

toxic: >400 mcg/ml

amitriptyline (elavil)

therapeutic: 120-250 mcg/ml

toxic: >500 mcg/ml

contraindicated in: narrow-angle glaucoma and potential fatal reactions when used with mao inhibitors

side effects of toxicity:

drowsiness, sedation, lethary, fatigue, dry mouth and eyes, blurred vision, hypotension, and tachycardia.

caution patients to use a sun screen.

therapeutic effects within 2 to 6 weeks of initiating therapy.

carbamazepine (tegretol)

therapeutic: 8-12 mcg/ml

toxic: >15 mcg/ml

contraindicated in:

bone marrow depression

side effects of toxicity:

drowsiness, dizziness, and ataxia.

caution patients to use a sun screen and to carry a medical alert card.

chlordiazepoxide (librium)

therapeutic: 700-1000 mcg/ml

toxic: >5000 mcg/ml

contraindicated in:

comatose patients with cns depression, narrow-angle glaucoma

side effects of toxicity:

drowsiness and dizziness.

alcohol withdrawal treatment: assess patients for signs and symptoms of delirium tremors (dts).

desopyramide (norpace)

therapeutic: variable

toxic: >7 mcg/ml

contraindicated in:

cardiogenic shock, 2nd and 3rd degree heart blocks, sick sinus syndrome

side effects of toxicity:

signs and symptoms of congestive heart failure.

diazepam (valium)

therapeutic: 100-1000 mcg/ml

toxic: >5000 mcg/ml

contraindicated in:

comatose patients with cns depression, narrow-angle glaucoma

side effects of toxicity:

sedation with ataxia, dizziness, and slurred speech.

therapeutic effects within 1 to 2 weeks of initiating therapy.

digitoxin

therapeutic: 20-35 ng/ml

toxic: >45 ng/ml

contraindicated in:

uncontrolled ventricular arrhythmias, av block

side effects of toxicity:

abdominal pain, anorexia, nausea, vomiting, visual disturbances, bradycardia, and other arrhythmias.

digoxin

therapeutic: 0.8-1.5 mcg/ml

toxic: >2 mcg/ml

contraindicated in:

uncontrolled ventricular arrhythmias, av block

side effects of toxicity:

abdominal pain, anorexia, nausea, vomiting, visual disturbances, bradycardia, and other arrhythmias.

doxepin

therapeutic: 30-150 mcg/ml

toxic: >500 mcg/ml

contraindicated in:

narrow-angle glaucoma

side effects of toxicity:

sedation, fatigue, blurred vision, hypotension, dry mouth, and constipation.

caution patients to use a sun screen.

may cause hypotension, tachycardia, and potentially fatal reactions when used with mao inhibitors

therapeutic effects within 2 to 6 weeks of initiating therapy.

glucocorticoids

contraindicated in:

serious infections

signs of adrenal insufficiency: hypotension, weight loss, weakness, nausea, vomiting, anorexia, lethargy, confusion, restlessness.

side effects:

depression or euphoria, personality changes, hypertension, decreased wound healing, petechiae, ecchymoses, hyperglycemia, hypokalemia, hypernatremia, fluid retention, aseptic necrosis of joints, osteoporosis, cushingoid appearance (moon face, and buffalo hump)

monitor blood sugars, bun, creatinine.

advise patients that medication should not be abruptly discontinued by tapered off over 2 to 4 weeks.

imipramine (tofranil)

therapeutic: 125-250 mcg/ml

toxic: >500 mcg/ml

contraindicated in:

narrow-angle glaucoma

side effects of toxicity:

disturbed concentration, confusion, restlessness, agitation, convulsions, drowsiness, mydriasis, arrhythmias, fever, hallucinations, vomiting, and dyspnea.

caution patients to use a sun screen.

therapeutic effects within 2 to 6 weeks of initiating therapy.

lithium

therapeutic: 0.6-1.2 mcg/ml

toxic: >2 mcg/ml

serum levels should be monitored twice weekly during initiation of therapy and every 2 to 3 months durgin chronic therapy.

contraindicated in:

severe cardiovascular or renal disease, dehydrated or debilitated patients

side effects of toxicity:

vomiting, diarrhea, slurred speech, decreased coordination, drowsiness, muscle weakness, and twitching.

therapeutic effects within 1 to 3 weeks of initiating therapy.

lidocaine (xylocaine)

therapeutic: 1.5-6 mcg/ml

toxic: >6-8 mcg/ml

contraindicated in:

advanced av block

side effects of toxicity:

confusion, excitation, blurred or double vision, nausea, vomiting, ringing in ears, tremors, twitching, convulsion, difficulty breathing, severe dizziness or fainting, and slow heart rate.

magnesium sulfate

contraindicated in:

hypermagnesemia, hypocalcemia, anuria, and heart block

side effects of toxicity:

decreased respiratory rate, bradycardia, arrhythmias, hypotension, drowsiness, flushing, sweating, and hypothermia.

monitor neurologic status before and throughout therapy.

institute seizure precautions.

methotrexate

therapeutic: variable

toxic: >454 mcg/ml (48 hours after high dose)

contraindicated in:

pregnancy and lactation (teratogenic effects)

side effects of toxicity:

hyperuricemia, abdominal pain, diarrhea, stomatitis, hepatotoxicity, pulcomary toxicity, nephrotoxicity, anemia, leukopenia, thrombocytopenia, and folic acid deficiency

caution patients to use a sun screen.

rescue drug to prevent fatal toxicity:

leucovorin (folinic acid)

phenobarbital

therapeutic: 15-40 mcg/ml

toxic: varies 35-80 mcg/ml

contraindicated in:

comatose patients with cns depression

side effects of toxicity:

confusion, drowsiness, dyspnea, slurred speech, and staggering.

phenytoin (dilantin)

therapeutic: 10-20 mcg/ml

toxic: varies with symptoms

contraindicated in:

sinus bradycardia and heart block

side effects of toxicity:

nystagmus, ataxia, confusion, nausea, slurred speech, and dizziness.

caution patients to carry a medical alert card.

procainamide (promestyl)

therapeutic: 5-12 mcg/ml

toxic: >15 mcg/ml

contraindicated in:

av block and myasthenia gravis

side effects of toxicity:

confusion, dizziness, drownsiness, decreased urination, nausea, vomiting, and tachyarrhythmias.

primidone (mysoline)

therapeutic: 5-10 mcg/ml

toxic: >15 mcg/ml

contraindicated in:

porphyria

side effects of toxicity:

ataxia, lethargy, changes in vision, confusion, and dyspnea.

caution patients to carry a medical alert card.

propranolol (inderal)

therapeutic: varies

toxic: vaires

contraindicated in:

uncompensated congestive heart failure, pulmonary edema, cardiogenic shock, bradycardia, and heart block

side effects of toxicity:

bradycardia, severe dizziness or fainting, severe drowsiness, dyspnea, bluish fingernails or palms, and seizures.

caution diabetic patients to monitor blood sugar.

quinidine

therapeutic: 2-6 mcg/ml

toxic: >8 mcg/ml

contraindicated in:

conduction defects and digitalis glycoside toxicity

side effects of toxicity:

tinnitus, hearing loss, visual disturbances, headache, nausea, and dizziness.

cardiotoxicity signs include qrs widening, cardiac asystole, ventricular ectopic beats, idioventricular rhythms, paradoxical tachycardia, and arterial embolism.

salicylate

therapeutic: varies

toxic: varies

contraindicated in:

hypersensitivity to aspirin or other salicylates, bleeding disorders or thrombocytopenia

side effects of toxicity:

tinnitus, headache, hyperventilation, agitation, mental confusion, lethargy, diarrhea, and sweating.

may take 2 to 3 weeks for maximum effectiveness.

theophylline

therapeutic: 10-20 mcg/ml

toxic: >20 mcg/ml

contraindicated in:

uncontrolled arrhythmias and hyperthyroidism

side effects of toxicity:

anorexia, nausea, vomiting, stomach cramps, diarrhea, confusion, headache, restlessness, flushing, increased urination, insomnia, tachycardia, arrhythmias, and seizures. tachycardia, ventricular arrhythmias, or seizures may be the first sign of toxicity.

valproic acid (depakene)

therapeutic: 50-100 mcg/ml

toxic: >100 mcg/ml

contraindicated in:

hepatic impairment

side effects of toxicity:

anorexia, severe nausea an dvomiting, yellow skin or eyes, fever, sore throat, malaise, weakness, facial edema, lethargy, unusual bleeding or bruising, or seizures.

antibiotics that require frequent monitoring

(aminoglycosides)

drugs

troughs

peaks

amikacin

5 mcg/ml

35 mcg/ml

gentamicin

2 mcg/ml

10 mcg/ml

kanamycin

5 mcg/ml

35 mcg/ml

neomycin

2 mcg/ml

16 mcg/ml

streptomycin

varies

25 mcg/ml

tobramycin

2 mcg/ml

20 mcg/ml

vancomycin

5-10 mcg/ml

25 mcg/ml

aminoglycosides must be monitored carefully for side effects including ototoxicity (vestibular and cochlear), nephrotoxicity, neurotoxicity, and hypersensitivity reactions. monitor patients for tinnitus, vertigo, hearing loss, rash, dizziness, or difficulty urinating.

renal lab tests that must be monitored include urinalysis, specific gravity, bun, creatinine, and creatinine clearance.

liver lab tests that must be monitored include , ast (sgot), alt (sgpt), serum alkaline phosphatase, bilirubin, creatinien, and ldh concentrations.

trough# levels are referred to as the minimum drug concentration that proceeds the administration of a single dose of medication. trough levels should be drawn just prior to the next dose.

peak* levels are referred to as the maximum drug concentration that follows the administration of a single dose of medication. peak levels should be drawn 1 hour after im injections and 30 minutes after a 30-minute iv infusion is completed.

drugs that require an antidote

drug

antidote

acetaminophen

acetylcysteine

anticholinesterases (cholinergics)

atropine, pralidoxime

antidepressants

(mao inhibitors and tryamine-containing foods may lead to hypertensive crisis including symptoms of chest pain, severe headache, nuchal rigidity, nausea and vomiting, photosensitivity, and enlarged pupils)

phentolamine

benzodiazepines

flumazenil

cyanide

amyl nitrite, sodium nitrite, sodium thiosulfate

digoxin, digitoxin

digoxin immune fasb (digibind)

fluorouracil (5fu)

leucovorin calcium

heparin

portamine sulfate

ifosfamide

(adverse effects cause hemorrhagic cystitis)

mesna

iron

deferoxamine

lead

edetate calcium disodium, dimeraprol, succimer

methotrexate

(adverse effects cause folic acid deficiency)

leucovorin calcium

opioid analgesics, heroin

nalmefene, naloxone

thrombolytic agents

aminocaproic acid (amicar)

tricyclic antidepressants

physostigmine

warfarin (coumadin)

phytonadione (vitamin k)

insulins

insulin

onset

peak

duration

regular iv

10-30 min

15-30 min

30-60 min

regular sc

30 min-1hr

2-4 hr

5-7 hr

nph

1-4 hr

6-12 hr

18-28 hr

lente

1-3 hr

8-12 hr

18-28 hr

ultralente

4-6 hr

18-24 hr

36 hr

monitor patients for onset of hypoglycemia reaction that typically occurs during the peak phase following administration of insulin. signs and symptoms of hypoglycemia include mental confusion, hallucinations, convulsions, pale, cool, clammy skin, tachycardia, and anxiety. [color=#009900]treatment includes the administration of oral glucose. severe hypoglycemia is life-threatening and requires treatment with iv glucose, glucagon, or epinephrine.

signs and symptoms of hyperglycemia include polyuria, polydipsia, and polyphagia, hot, red, and dry skin. [color=#009900]treatment includes insulin administration. severe hyperglycemia is usually caused by missing, miscalculating or mistiming doses of insulin or oral medication or by overeating or drinking. severe hyperglycemia is life-threatening and requires treatment with iv replacement and iv insulin.

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