Archer: Pharmacology and Meds Questions with 100% Correct Solutions

antianxiety agents class - -short acting --midazolam --diazepam -intermediate to long acting ---clonazepam ---alprazolam *---Lorazepam (ativan)* (end in pam) SAD PAM Ativan = *Lorazepam* - focus on lorazepam name it is generic - most common antianxiety agent indication: seizures general CNS depression *ANTIDOTE = flumazenil* -avoid alcohol (double CNS = bad) Antiarrhythmic class - -amiodarone -*adenosine* -procainamide Adenosine - for supraventricular tachycardia considerations: -period of asystole after administration (bc it restarts heart) -RAPID PUSH or it will not work -use w caution in asthmatic patients Anticoagulant class - -*heparin -*warfarin* -clopidogrel (Plavix) -enoxaparin (end in -rin sorta) Heparin - Heparin enhances antithrombin III which inhibits thrombin (thrombin works in a cascade to coagulate) end result is it slows down clotting administration IV or subcutaneous used: strokes, chronic a-fib, post operatively watch labs:* (drawn every 4-6 hr) -normal aPTT: 20 to 35 seconds -on heparin aPTT: 1.5x to 2.0x normal biggest side effect to monitor is BLEEDING -hematuria (pink urine), hematemesis, bruising also possible is: heparin induced thrombocytopenia (low platelet) and thrombosis (clotting) (HITT): 5-10 days after heparin exposure = dramatic drop in platelet and clotting = complications include clotting (DVT, PE (improper clotting bc of heparin))= treat by discontinuing all heparin and start diff anticoagulant *ANTIDOTE=protamine sulfate* warfarin - more for at home disrupts liver synthesis of vitamin K dependent clotting factors monitor bleeding for warfarin monitor PT and INR PT is normally: 10-13 seconds *INR normal: less than 1-2 therapeutic: 2-3 ANTIDOTE OF warfarin is VITAMIN K contraindicated during pregnancy Anticonvulsants class (for seizures + epilepsy - decr hyperactivity of brain) - *-phenytoin* *-Gabapentin* *-levetiraceptam* -carbamazepine -divalproex -lamotrigine Phenytoin - for seizures therapeutic level: 10-20 mcg/mL -side effect gingival hyperplasia (overgrown gums, sensitive) --dental checks and soft bristle tooth brush -antacids (aka calcium carbonate) can reduce the effect of phenytoin Antidepressant class - 3 types 1. SSRIs 2. TCAs 3. MAOIs SSRIs - selective serotonin reuptake inhibitors -ex: *fluoxetine*, *sertraline*, escitalopram, citalopram nursing considerations: -monitor serotonin syndrome (causes hypertension, confusion, anxiety, tremors, ataxia (loss of body movement control), sweating) -suicide precaution for 2-3 weeks TCAs (end in -tyline) - tricyclic antidepressants -ex: amitriptyline, nortriptyline, protriptyline monitor anticholinergic side effects (dry mouth, constipation, urinary retention) MAOIs - monoamine oxidase inhibitors