Pharmmmmm – Flashcards
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Infants are at risk for drug toxicity due to
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Decreased liver enzymes, reduced kidney function and reduced liver perfusion
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Anaphylactic rations
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Wheezing, swallowing difficulty, itching, tachycardia, angiogram facial swelling
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A patient is having difficulty remembering taking a med. what form should be given
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Extended release because they release over a lengthy period of time a patients can take less often
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Preg cat D
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Require use of contraception in women of childbearing age, can cause fetal malformations, can pass through the umbilical cord, weight benefits against risk
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History of renal insufficiency is taking lithium what should be monitored?
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Drug toxicity
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Topical med is no longer effective
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Tolerance to the drug
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OTC meds
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Do not require PCp supervision, can interact with other drugs, should be included in history, and may consist toxicity
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Naproxen enteric coated
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Do not crush or chew meds, drug is supposed to reach small intestine
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Small margin of safety with drugs such as Dilantin
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Periodic la. Tests, monitor for indications of toxicity, take smallest effective dose
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Hospitalized with chest pain, when should discharge plan begin
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As soon as possible
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Itching
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Can indicate drug hypersensitivity and allergic reaction
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Fastest rate of absorption
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IV
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Peak and trough levels help monitor for
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Drug tox, max effective dose, constant therapeutic level
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Can decrease a patients ability to learn
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Cognitive level, language, comfort level, readiness to learm
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Peak time
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Time it takes drug to demonstrate full therapeutic effect. Blood glucose is lowest at peak drug time
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vasotec,ndrug eliminated in kidneys for hypertension, before taking meds
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Check creatinine clearance which checks renal and liver function
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Calculating drug dosages for children
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Older kids have a higher metabolism and metabolize drugs faster
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Taking Tylenol and codeine
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Achieve desired effect with using lower dosages, both drugs gave similar actions
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Tegretol and grapefruit juice
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Causes drug toxicity. Inhibits enzyme in liver that metabolizes drugs
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Digoxin adverse effect
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Cardiac dysrythmias, non therapeutic
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Infant drug absorption
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Delayed gastric emptying is slower in infants, which can increase absorption in the stomach but not the intestine
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Teratogenic drug
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Fetal malformation
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Patient receiving nitro IV and is changing to oral form, oral dose will be higher because
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Decreased bioavailability because of the first pass effect
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Parenteral routes
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IV, subcutaneous, and IM
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OTC and newborn consideration
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Newborns weight, how much child breast feeds, benefits to mom outweigh risks to baby, properties of drug
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Patient taking modanifil (pro vigil)to treat narcolepsy what considerations
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Take drug in morning, non amphetamine stimulant, taking in morning will help to improve wakefulness. Taken1 hr before work
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Zolpidem/ambien history of benzo abuse, caution patient drug can cause
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Memory impairment
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Adverse effects of interferon beta-1a (Avon ex) minimize adverse effects by
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Interferon beta drugs can cause feve, chills, headaches and muscle aches. Premedication with acetaminophen or an NSAID can help minimize this
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Levodopa dopar will help control parkinson symptoms
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Increases dopamine in extra pyramidal center of brain
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Adverse effects of depakote
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Drowsiness, sedation, rash is a side effect of anti epileptic drugs
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Potentially serious adverse effect to interferon
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Because of the potential for bone marrow suppression and decreased platelet count patients should report bruising bleeding or fatigue
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Ritalin
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Increased focus
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Memantine namenda for Alzheimer's instructions
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Notify PCP if they start taking OTC antacids that contain sodium bicarbonate because that can decrease excretion leading to toxicity
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Adderall adverse effects
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Tachycardia
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Dopar levodopa for Parkinson's
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Change position slowly because it can cause orthostatic hypotension
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Danteolene dantrium for skeletal muscle spasms. What lab test?
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Liver function serious adverse effect of dantrolene. Regular intervals and advise patient to report jaundice or abdominal pain
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Pramipexole (mirapex) Parkinson's
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Monitor CPK creatinine phosphor insane enzyme found in the heart brain and skeletal muscle. Monitoring CPK can allow possibility of skeletal muscle damage from the drug
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Baclofen lioresal instructions
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Centrally acting muscle relaxant. Avoid driving
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Aricept donepezil for Alzheimer's. Monitor for
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Nausea vomiting and diarrhea. Taking drug with food can help
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Temazepam Restoril instructions
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Avoid alcohol and other cns depressants, take 30 min before bedtime, taper drug slowly
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Imitrex sumatriptan adverse effects
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Chest pain is number 1. Should report any tightness in jaw, chest, or back. Not an appropriate choice for history of coronary artery disease
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Depakote and Dilantin drug interaction
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Valproate acid can cause an increase in phenytoin blood levels causing toxicity
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Due to potential for adverse effects tegretol should be
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Titration from the lowest possible dosage, visual disturbances, vertigo and ataxia can occur. Dosage should be low
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Midazolam versed
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Causes amnesia and anti anxiety
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Pentothal thiopental what should be monitored
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Short acting barbiturate can cause respiratory depression. Mechanical ventilation and monitoring are essential
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Lidocaine for spinal anesthesia serious adverse effect
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When systemically absorbed lidocaine can cause HYPOTENSION especially when used as a spinal anesthetic
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Dantrolene dantrium for muscle spasms
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Prolonged diarrhea can cause dehydration and is an adverse effect of dantrolene . Need to report
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Valproate acid monitor for what adverse effect
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Jaundice abdominal pain and nausea
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Selegiline and eldepryl for Parkinson's and Demerol meperidine can result in
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Muscle rigidity, stupor agitation, hypertension, and fever
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Installing pilocarpine pilocarpine for glaucoma
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apply gentle pressure to nasolacrimal duct for 1 min. Do not touch tip of dropper, remove contact lenses
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Thorazine chloropromazine
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Wear sunscreen, limit exposure to sunlight
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Amitryptiline leaving
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Change positions slowly, do not stop taking abruptly, take at bedtime to prevent daytime drowsiness, increase fluid and fiber intake
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Lithium for bipolar
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Monitor thyroid function tests because hypothyroidism is an adverse effect, patients should report neck enlargement weight gain and lethargy
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Nardil phenelzine avoid tyramine amine because
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They can trigger hypertension in patients taking phenelzine. Headache nausea and lethargy
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Betaxolol eye drops adverse effects
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Bradycardia,can also expect some ocular stinging upon admin
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Echothiophate glaucoma, monitor for development of of
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Cataracts or opacity of the lens, report any changes in vision, cloudiness or halos around the eyes
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Wellbutrin
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Seasonal affective disorder, smoking cessation, and depression
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Prozac
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Report suicidal thoughts
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A health care professional should question the use timolol for which patient
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Asthmatic because a beta blocker can cause bronchospasm
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Thorazine for schizo experiencing muscle spasms
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Acute dystopia can develop during the first few days of treatment with Thorazine, treatment includes admin if Benadryl
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Xanax adverse effects
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Anxiety, respiratory depression, sedation and tolerance. Avoid alcohol
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Avoiding lithium toxicity
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Avoid NSAIDS because they increase the renal absorption of lithium and sodium. Concurrent use is contraindicated
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Risperdal, risperidone adverse effects
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Polyurethane, can cause new-onset DM. Check glucose regularly
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Lithe and furosemide
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Lithium toxicity in the form of hypertension, LASIK increases sodium loss and can cause lithium absorption.
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Head trauma and Wellbutrin
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Can cause seizure activity when patients have a cns tumor or hx of head trauma
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bus par
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Allow 2 to 4 weeks to feel effects
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During and immediately following IV Thorazine what should be monitored
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Blood pressure... At risk for hypotension. Should remain supine for 3o min. Essential to infuse slowly
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Prozac agitation and confusion
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Serotonin syndrome can begin 2 to 72 hours after taking Prozac. Mental confusion, agitAtion
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Orthostatic hypotension is common in
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Imipramine tofranil.
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Effexor venalafaxine and phenelzine/Nardil
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Should not be taken together. Phenelzine is an maoi.
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malignant hyperthermia what should you do?
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Provide cooling measures, discontinue anesthesia
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Post-op needs vent, received panchromatic ism, provider should expect prolonged paralysis from
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Gentamicin, an amino glycoside, which can interact with neuromuscular blocker increasing prolonged paralysis
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Calcitonin-salmon
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Make sure not allergic to fish, report rash or itching, prime the pump, report nasal, irritation
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Neostigmine ( prostigmin) to increase muscle strength after myasthenia gravis, serious adverse action
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Bradycardia, measure apical pulse and notify if below 60 bpm. It is essential to have atropine on hand
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Succinylcholine anecdote is a depolarizing neuromuscular blocker
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Causes muscle paralysis by binding with cholinergic receptors at the neuromuscular junction. Mimics acetylcholine
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Fosamax (alendronate) osteoporosis, adverse effects
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Joint pain and muscle pain, nausea, visual disturbance and esophagitis
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Enbrel etanercept report which?
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Skin rash can cause serious infection such as Steven Johnson syndrome
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Neostigmine prostigmin for myasthenia gravis
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Keep atropine on hand
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Raloxifene evista therapeutic action
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Mimics the effects of estrogen on bone tissue. Minimizing or stopping bone loss
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Questions thee use of enbrel with DIabetes because the risk of
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Infection from both med and disease process
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Neostigmine prostigmin contraindicated in
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Asthma because ain't can cause bronchospasm. A monitor breath sounds and have atropine on hand
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Rosa max alendronate monitor for what?
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Jaw pain, blurred vision, and muscle pain
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Calcium supplements
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Reports flank pain which indicated renal calculi, patient should increase water intake and report blood in urine or flank Paine
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Anectine succinylcholine, develops rigid muscles, tachycardia and spike in temp
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Malignant hyperthermia is suspected
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Fosamax alendronate
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Decreases activity a of osteoclasts
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Prednisone and calcium carbonated
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Drink 8 oz of water with calcium tabs, chew calcium tabs before swallowing, take drugs 1hour apart, divide doses in 3 doses
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Fosamax is contraindicated
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Should remain flat on bed rest, patient has to sit or stand for 30 minutes to prevent esophagitis
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Raloxifene evista serious adverse reaction to drug
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Calf pain indicates DVTa
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Enbrel can cause hearts failure, monitor for
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Shortness of breath, cough elevated BP and heart rate
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Methotrexate
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Drink 2 to 3 L per day, can cause kidney damage so you need to drink a lot of water o
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Methotrexate teaching
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Avoid people who are sick, periodic lab tests, report bruising or Petechia, avoid drinking alcohol
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Muscle relaxants such a anectine require cautious use in
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Hyper kalmia myasthenia gravis, and respiratory depression
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Lithium toxicity
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Tremors, confusion, nausea, muscle weakness
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Methotrexate monitor for
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Can cause gastric irritation so watch for black Garry stools
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Evista raloxifene monitor for
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Increase activity such as walking, use a contraceptive if there is any chance of pregnancy increase intake of calcium and vitamin
