Meds – Flashcard

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Pantoprazole (Protonix)
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Antiulcer; proton pump inhibitors
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Pantoprazole (Protonix) Indication
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Indication: Erosive esophagitis associated with GERD
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Pantoprazole (Protonix) Action
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Action: Binds to an enzyme in the presence of acidic gastric pH, preventing the final transport of hydrogen ions into the gastric lumen. Decreased acid secretion in hypersecretory conditions.
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Pantoprazole (Protonix) Contraindications
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Contraindications: hypersensitivity, breastfeeding, pregnancy
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Pantoprazole (Protonix) SE
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SE: headache, abdominal pain, diarrhea, eructation, flatulence, hyperglycemia, hypomagnesemia, bone fracture
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Pantoprazole (Protonix) Safe dose
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Safe dosage: 40 mg/daily
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Pantoprazole (Protonix) Nursing implications
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Nursing Implications: Assess patient for epigastric or abdominal pain, blood in stool.
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Pantoprazole (Protonix) Lab tests
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Lab Tests: liver function tests, increased AST, ALT, alkaline phosphatase, bilirubin
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Pantoprazole (Protonix) Patient Teaching
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Patient Teaching: Avoid alcohol, aspirin, NSAID. Report black, tarry stools, diarrhea, or abdominal pain
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Olemesartan (Benicar)
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Antihypertensive; angiotensin II receptor antagonists
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Olemesartan (Benicar) indication
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Indication: Management of HTN, HF. Prevention of stroke. Treatment of diabetic nephropathy.
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Olemesartan (Benicar) Action
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Action: Blocks vasoconstrictor and aldosterone producing effects of angiotensin II at receptor sites, including vascular smooth muscle and the adrenal glands.
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Olemesartan (Benicar) Contraindications
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Contraindications: Hypersensitivity, Pregnancy, Lactation. Caution in HF, volume or salt depleted patients
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Olemesartan (Benicar) SE
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SE: dizziness, hypotension, hyperkalemia, myalgia, angioedema, nasal congestion, drug induced hepatitis, impaired renal function
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Olemesartan (Benicar) Safe Dose
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Safe Dosage: 20 mg once daily, may increase to 40 mg
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Olemesartan (Benicar) Implications
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Nursing implications: Assess BP and fluid overload (peripheral edema, rales/crackles, dyspnea, weight gain, JVD). Monitor frequency of refill, daily weight. Assess for signs of angioedema (dyspnea, facial swelling)
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Olemesartan (Benicar) Lab Tests
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Lab Tests: Monitor renal function and electrolyte levels. Serum potassium, BUN, serum creatinine may increase. Increased AST, ALT, and serum bilirubin. Increased uric acid, slight decrease in Hgb and Hct.
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Olemesartan (Benicar) Patient Teaching
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Patient Teaching: Avoid salt substitutes containing potassium. Avoid sudden position changes. May cause dizziness so avoid driving. Notify physician if swelling face, eyes, lips, or tongue occurs; difficulty swallowing or breathing.
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Docusate sodium (Colace)
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Docusate sodium (Colace)Laxative; stool softener
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Docusate sodium (Colace) Indication
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Indication: Prevention of constipation. Used as enema to soften fecal impaction. Soften and passage of stool
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Docusate sodium (Colace) Action
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Action: Promotes incorporation of water in stool, resulting in softer fecal mass. May promote electrolyte and water secretion into the colon.
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Docusate sodium (Colace) Contraindications
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Contraindications: Hypersensitivity, abdominal pain, N/V. Caution in excessive or prolonged use
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Docusate sodium (Colace) SE
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SE: throat irritation, mild cramps, diarrhea, rashes
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Docusate sodium (Colace) Safe Dosage
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Safe Dosage: 50-400 mg in 1-4 divided doses
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Docusate sodium (Colace) Nursing implications
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Nursing implications: Assess abdominal distention, presence of bowel sounds, and usual pattern of bowel function. Assess color, consistency, and amount of stool
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Docusate sodium (Colace) Lab Tests
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Lab Tests: None
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Docusate sodium (Colace) Patient Teaching
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Patient Teaching: Advise short term use only because long term may cause electrolyte imbalance and dependence. Encourage increased fluid intake, increased mobility. Avoid straining in cardiac disease patients. Do not use with abdominal pain, N/V, or fever
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Amlodipine (Norvasc); Calcium Channel Blockers
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Antianginal, antiarrhythmics, antihypertensive
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Amlodipine (Norvasc); Calcium Channel Blockers Indication
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Indication: Management of HTN, angina pectoris, vasospastic angina
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Amlodipine (Norvasc); Calcium Channel Blockers Action
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Action: Inhibits the transport of calcium into myocardial and vascular smooth muscle cells, resulting in inhibition of excitation contraction coupling and subsequent contration.
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Amlodipine (Norvasc); Calcium Channel Blockers Contraindications
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Contraindications: Sick sinus syndrome. 2nd or 3rd AV block. Recent MI or pulmonary congestion. HF. Caution in severe hepatic impairment
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Amlodipine (Norvasc); Calcium Channel Blockers SE
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SE: Peripheral edema, increased liver enzymes, erythema multiforme, polyuria, nocturia, increased sweating, photosensitivity, joint stiffness, muscle cramps.
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Amlodipine (Norvasc); Calcium Channel Blockers Safe Dose
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Safe Dosage: 5-10 mg as a single dose.
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Amlodipine (Norvasc); Calcium Channel Blockers Implications
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Nursing implications: Monitor intake/output ratios and daily weight. Assess for signs of HF (peripheral edema, rales/crackles, JVD, weight gain). Assess for rash periodically. Assess angina.
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Amlodipine (Norvasc); Calcium Channel Blockers Lab Tests
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Lab Tests: Serum potassium. Hypokalemia increase risk of arrhythmias. Renal and hepatic functions.
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Amlodipine (Norvasc); Calcium Channel Blockers Patient Teaching
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Patient Teaching: Contact doctor if HR is <50 bpm, swelling of hands and feet, dyspnea, hypotension. May cause dizziness so do not drive. Change position slowly. Good dental hygiene to prevent tenderness, bleeding, and gum enlargement.
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Hydrochlorothiazide (Hydrodiuril); Diuretics (Thiazide)
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Antihypertensive, thiazide diuretics
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Hydrochlorothiazide (Hydrodiuril); Diuretics (Thiazide) Indication
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Indication: Management of mild to moderate HTN. Treatment of edema associate with HF, renal dysfunction, cirrhosis, glucocorticoid therapy, estrogen therapy
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Hydrochlorothiazide (Hydrodiuril); Diuretics (Thiazide) Action
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Action: Increases exretion of sodium and water by inhibiting sodium reabsorption in the distal tubule. Promotes excretion of chloride, potassium, magnesium, and bicarbonate.
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Hydrochlorothiazide (Hydrodiuril); Diuretics (Thiazide) Contraindications
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Contraindications: Anuria, hypersensitivity, lactation. Tartrazine intolerance
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Hydrochlorothiazide (Hydrodiuril); Diuretics (Thiazide) SE
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SE: hypokalemia, dehydration, hypercalcemia, muscle cramps, thrombocytopenia, hyperuricemia, hepatitis, acute angle closure glaucoma, Steven’s Johnson syndrome
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Hydrochlorothiazide (Hydrodiuril); Diuretics (Thiazide) Safe Dose
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Safe Dosage: 12.5 – 100 mg/day in 1-2 divided doses; not to exceed 50 mg/day for HTN; doses above 25 mg may cause electrolyte abnormalities
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Hydrochlorothiazide (Hydrodiuril); Diuretics (Thiazide) Nursing implications
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Nursing implications: Monitor BP, intake/output, daily weight. Assess feet, legs, and sacral area for edema daily. Assess for skin rash. Assess patient for sulfa allergy
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Hydrochlorothiazide (Hydrodiuril); Diuretics (Thiazide) Lab tests
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Lab Tests: Monitor electrolytes, blood glucose, BUN, serum creatinine, uric acid levels.
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Hydrochlorothiazide (Hydrodiuril); Diuretics (Thiazide) Patient TEaching
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Patient Teaching: Take at same time each day. Monitor weight biweekly. Change position slowly. Use sunscreen and protective clothing to prevent photosensitivity. Report rash, muscle weakness, cramps, N/V.
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Rivaroxaban (Xarelto)
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Anticoagulant, antithrombotics, factor Xa inhibitors
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Rivaroxaban (Xarelto) Indication
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Indication: Prevent DVT that may lead to pulmonary embolism following knee or hip replacement therapy. Prevent blood clots
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Rivaroxaban (Xarelto) Action
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Action: Acts as selective factor X inhibitor that blocks the active site of factor Xa, inactivating the cascade of coagulation.
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Rivaroxaban (Xarelto) Contraindications
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Contraindications: Hypersensitivity. Active major bleeding. Severe renal impairment. Moderate to severe hepatic impairment. Lactation
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Rivaroxaban (Xarelto) SE
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SE: Syncope, blister, prutitis, bleeding, wound secretion, extremity pain, muscle spasm
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Rivaroxaban (Xarelto) Safe Dose
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Safe Dosage: 10 mg/day, initiated 6-10 hr post op. continued for 12 days after knee replacement or 35 days after hip replacement.
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Rivaroxaban (Xarelto) Nursing implications
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Nursing implications: Assess for signs of bleeding and hemorrhage. Surgical site bleeding.
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Rivaroxaban (Xarelto) Lab Tests
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Lab Tests: Increased serum AST, ALT, total bilirubin and GGT levels
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Rivaroxaban (Xarelto) Patient Teaching
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Patient Teaching: Report unusual bleeding or bruising and symptoms of spinal or epidural hematoma. Avoid alcohol, aspirin, NSAID.
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Nebivolol (Bystolic)
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Nebivolol (Bystolic)Antihypertensive; selective beta blocker
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Nebivolol (Bystolic) indication
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Indication: HTN
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Nebivolol (Bystolic) Action
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Action: Blocks stimulation of beta adrenergic receptor sites, selective for beta1 receptors in most patients. Lowering of BP
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Nebivolol (Bystolic) Contrainidcations
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Contraindications: Severe bradycardia, heart block, cardiogenic shock, decompensated HF or sick sinus syndrome. Severe hepatic impairment. Bronchospastic disease
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Nebivolol (Bystolic) SE
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SE: Dizziness, Fatigue, headache
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Nebivolol (Bystolic) Safe Dose
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Safe Dosage: 5 mg/day, may increase at 2 wk intervals to 40 mg/day
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Nebivolol (Bystolic) Nursing Implications
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Nursing implications: Monitor BP, ECG, pulse, intake and output ratios, daily weights. Assess for signs and symptoms of HF.
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Nebivolol (Bystolic) Lab Tests
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Lab Tests: Increased BUN, uric acid, triglycerides, and decreased HDL cholesterol and platelet count
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Nebivolol (Bystolic) Patient Teaching
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Patient Teaching: Administer same time. Avoid driving, Avoid breastfeeding. Report difficulty breathing or signs and symptoms of worsening HF. Always have enough available.

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