Cardiac Rate- Peds Remember: 311 (Fetal HR 120-160) RR -30 90-130 Infant 30-60 -10 80-120 Toddler 20-30

-10 70-110 Preschooler 16-22 Temperature F = (1.8 * C) + 32 (Think of them as being ~ 2 apart) 37C = 98.6 F 38C=100.4 F 39C=102.2 F 40C =104 F Labs BUN/CR = Dehydration BUN/CR = Overhydration El: Na (135-145) K (3.5-5) Mg (1.5-2.5) Ca (9-11) Cl (96-106) Phos (3-4.5) Endocrine BUN (7-22 or to remember put the buns in the oven for 10-20 min) Cr (0.5-1.5) Urine Spec Gravity (1.005-1.030) Glucose: Nml 80-110 Fasting <110 Infant BG 50-90 (<45=hypoglycemia-high pitch cry) HgbA1c= 4-6% (or <7%) Thyroid: T3 (60-180) T4 (5-11) TSH (0.5-5) or 0.5-2 for hypothyroid pts Free T4: 0.8-2.7 ( I remember it .8-2.8 easier to memorize) Hypothyroid: - TSH ; T3 & T4 Hyperthyroid: TSH ;- T3 &T4 ABGs: PH 7.35-7.45 pO2 80-100 pCO2 35-45 HCO3 22-26 ROME: With Acidosis the PH is always and PH is always - in Alkalosis Respiratory Opposite; Metabolic Equal RESP OPP: PH PCO2 - = Resp Acidosis PH - PCO2 = Resp Alkalosis METABOLIC = PH HCO3 = Metabolic Acidosis PH- HCO3 - = Metabolic Alkalosis

Blood: RBC 4.2-6.1 million WBC 5000-10000 (or 4500-11000) Plt 150,000 450,000 Hgb F: 12-16 M: 14-18 Hct F: 37-47% M: 42-52% Amylase: 53-123 Albumin: 3-4.3 Alk Phosphate: 14-100 NH3 (3565) Blood Osmol 280-300 Lipase 14-280 Bilirubin (Total: 0.3-1; Indirect: 0.2-0.8; Direct 0.1-0.3) Phenylalanine: Newborn < 2 Adult < 6 Antidotes Digoxin Digiband Tylenol Mucomist (17 doses + loading dose) Heparin Protamine Sulfate Benzodiazepine Flumzaemil (Romazicon) CoumadinVit K DI ADH, - u/o, Urine Specific Gr, - Na (think - Na = - urine spec gr) SIADH think syndrome of -ed diuretic hormone - ADH, u/o, -urine spec gr Insulins Rapid Reg Interm Very Long Long Acting 5-15m 30-60m 1-3h 1h 6-8h 1-2h 2-4h 6-12h peakless action 12-16h 4-6h 5-7h 16-20h 18-24h 20-30 Novolog Novolin R NPH Lantus Ultra Lente \ Humalog Humulin R Lente Vaccines Hep B 0, 1-2, 6-18mo Hib 2, 4, 6, 12-15 Pneumo 2, 4, 6,12-15 Dtap 2, 4, 6, 15-18, 4-6yrs; Td q 10 yrs IPV 2, 4, 6-18, 4-6yr Varicella 12-15, 4-6yr MMR 12-15, 4-6yr Hep A 12-23 mo (2 doses, 6 mo apart) Mening 9-11 yrs Rota 2, 4, 6 Influenza at 6 mo and then yearly after Random Stuff Thiazides - BG Neupogen = - Neutrophil Epogen = - RBC/Erythocyte Lofenalac Formula = for PKU infants Ototoxic drugs = loop diuretics (Lasix) and Platinol-AO TB Meds (RISE) Rifampin INH Streptomycin Ethambutol GCS Eyes (4 points)

Verbal (5 points) Motor (6 points) Max = 15 (<8=coma) APGAR Score At 1 and 5 min after birth (1st score is the transitional score and 2nd is planning care of newborn) 8-10 = ok 210 Appearance [All pink, pink&blue, blue/pale] Pulse [> 100, < 100, No Response] Grimace [cough, grimace, no response] Activity [flexed, flaccid, limp] Resp [strong cry, weak cry, no cry]

INFECTION CONTROL Airborne (My Chicken Hez TB) Measles (Rubeola) Chicken pox (Varicella) Herpes Zoster (shingles in (immuno compromised ind, or disseminated) Tuberculosis Management: -private room -negative airflow pressure, minimum of 6-12 air exchanges per hour -UV germicide irradiation/ high efficiency air filter is used, mask, N95 mask for TB Droplet (SPIDERMAn) Sars Scarlet fever Sepsis Streptococcal pharyngitis Pertussis Parvovirus B19 Pneumonia Influenza Diphtheria Epiglottitis Rubella Mumps Mycoplasmal/Meningeal Pneumonia AdeNovirus Management: -private room -mask (within 3 ft) Contact (MRS.WEE) Multi-resistant organism Respiratory Syncitial Virus (RSV) Skin Infections VCHIPS (e.g: Varicella zoster

Cutaneous Diphtheria, Herpes Simplex Impetigo Pediculosis Staph infection Scabies) Alex = AIDS Hez= Herpes Zoster 5=5th Dx Coins=Croup HeRe= Hepatitis and RSV Wound Infection Enteric Infection (Clostridium Difficile) Eye Infection (Conjunctivitis) Croup Management: -MRSA: gloves, gown, goggles, face shield -patients should be in a private room Donning 1 Gown 2 Mask 3 Goggle 4 Gloves Removing 1 Gloves 2 Goggle 3 Gown 4 Mask Addisons - hyponatremia, hyperkalemia Cushings - hypernatremia, hypokalemia REMEMBER: VEAL CHOP Variable is Cord compression Early is Head compression Acceleration is Ok Late is Placental Insufficiency

Self Breast Exam (1x month 7 day after period) Try to promote a (+) self-image Autosomal Recessive: Cystic Fibrosis, PKU, Tay-Sachs, Albinism, Sickle Cell Dx, Alpha Anti-Trypsin Deficiency, Galactetsemia Autosomal Dominant: Huntingtons Disease, Marfans, Polydactly, Achandrophic Dwarfism, Polycystic Kidney Disease X-Linked Recessive: Duchennes Muscle Dystrophy, Hemophilia A (Females are carriers in these diseases and males are affected by the disease) Newborn At Term: Nml = wt: 6-9lbs, head circumference: body length, 13-14 in, chest: 12-13in Umbilical cord falls off in 1-2 weeks Stool: 1st stool (Mecconium) black + tarry (passes w/in 12-24 hrs), thin/green/brown day 3, formula feedings (1-2 pale yellow/light brown stools) or breast feeding (loose golden yellow stools with sour milk odor) Hypokalemia: Flat T wave, Depressed ST, and Prominent U wave Hyperkalemia: Tall T wave, Wide QRS, Long PR Wave

Med Trivia Talwan and Stadol=> Avoid (opoid agonist antagonists) much less effective than opoid agonists No Tagamet with Warfarin Erogostat => For Migraine No Quinolones/Tetracyclines with pregnancy No ASA/NSAIDS in Hemophilia A patients Lipitor = PM ONLY, no grapefruit juice tPA= dissolves clots (heparin does not) SLE Tx o Cytotax, Imuran (Immunosupressants) o NSAIDs o Plaquinil (also an anit-malarial drug) More Maternity Fundal Height o Top of Symphis Pubis to top of fundus o Gross estimate of dates o Use a non-stretchable tape measure o 12-14 wks (at level of symphis) o show after week 14 (can tell preg) o 20 wks (~ 20cm) at level of umbilicus o rises 1 cm/wk till 36 weeks then varies Quickening = fetal movement; 16-20 weeks Fetal Heartbeat = 8-12 weeks (by Doppler) and 18-20 weeks by auscultating with stethoscope Preterm: 20-37 weeks Term: 38-42 weeks Post-term: 42 weeks plus Total preg weight gain: 11-14 kg (25-35 lb) - 300 cal during preg (DAILY) and - 200-500 cal during breastfeeding (DAILY) Caffeine < 300 mg/day (500-750 mL/day => - risk of spontaneous abortion or fetal intrauterine growth restriction Uterine contractions can be felt after 4th month = Braxton Hicks Contractions facilitate uterine blood flow through placenta and promote O2 delivery to fetus Amniotic Fluid: o Nml: 800-1200 mL (transparent/clear, no odor) o <300 mL = Olighydrimanos (low amniotic fluid) = Kidney problems o Polyhydrimanos (too much amniotic fluid) Umbilical Cord: 2 arteries and 1 vein Placenta: Fetal lungs in utero Alcohol, caffeine, nicotine, meds = easily cross placenta (viruses can cross, bacteria cannot; exs of viruses (HIV, AIDS, Herpes, Measles, Toxoplasmosis, Hep) AFP Test: measured at 16-18 weeks o -ed Levels = - risk of neural tube/abd wall defects (ex. spina bifida) o ed Levels: - risk of Down Syndrome Fetal Distress o HR < 110 or > 160 o Fetal hyperactivity or no activity o Fetal Blood pH < 7.2

Hypoventilation => Resp Acidosis (- CO2) Retain CO2 Hyperventilation=> Resp Alkalosis ( CO2) Blow off CO2 (think 5 Ps of Fracture: Pain, pallor, pulseless, paresthesia, paralysis of preg breathing) Cushings Triad: (Indicates -ed ICP) HR, RR,- BP Lasix/Bumex = K+ Wasting (can cause hypokalemia) Aldactone = K+ Sparing (can cause hyperkalemia) Tx of DIC = Heparin (safe during preg) CONVERSIONS: 1 lb = 16 oz ; 1 T = 3 tsp = 15 mL 1 t = 5 mL 1c = 8 oz = 240 mL 1 lb = 454 g = 16 oz Post Masectomy Care: BREAST BP NOT on affected side 2 c = 1 pt = 16 oz Reach Recovery 1 oz = 30 mL= 8 drams 1 mg = 1000 mcg Elevate affected side 2 pt = 1 qt= 32 oz 1 g = 15 gr Abduction and external rotation no initial exercise (initial is 4 qt =1 gal = 128 oz 1 gr = 60 mg extension/flexion)

Other Stuff Immed after put pt on a Mech Vent check BP (hypotension) Lesions of midbrain = decerebrate positioning Morphine Toxicity = Pinpoint pupils Corticosteroid Effects: Acne, Hirituism, Mood Swings, ostoporosis and adrenal suppression (in kids = delayed growth) No Paxil with MAOI) Beta Blockers = Mask Effect Of Hypoglycemia SOMogyi Effect = BG sometimes up and sometimes down Dawn Phenomenon = high BG in DAWN hrs (5-8am) AFTER o Post tracheostomy: keep O2 and Suction at bedside o Post pleural biopsy: chest tube and drainage system at bedside o Post parathyroidectomy: tracheostomy at bedside o Tonic Clonic Seizures: Suction apparatus at bedside o Paracentesis: BP Cuff at Bedside RACE-Priority in a fire o R-Rescue o A-Alarm o C-Confine o E-Extinguish PASS To use a fire extinguisher o P-Pull Pin o A-Aim at Base Fire o S-Squeeze Handle o S-Sweep fire from side to side

Preschooler: Fear mutilation (Allow to play with equipment) School Agers: Fear loss of control (allow to play with equipment) Adol: Fear loss of independence Pneumothorax Symp (P-Thorax) o P-Pleurtic Pain o T-Trachea Deviation o H-Hyperresonance o O-Onset Sudden o R-Reduced breath sounds (dyspnea) o A-Absent Fremitus o X-X-Rays show collapse Pul Edema Tx (MAD DOG) o M-Morphine o A-Aminophylline o D-Digitalis o D-Diuretics o O-O2 o G-Gasses in blood (ABGs) Cholecystisis: Gallbladder inflammation (RUQ pain) Cholelithiasis: Gall Stones Pancreatitis o TURNERS SIGN: Flank echymosis o CULLANs SIGN: Bluish periumbical (around the belly button)

discolored and should be able to see blood flow back into it (Radial is located on the thumb side and ulnar is on the pinky side) o Minutes of press on the ABG site after drawing blood? 5-10 min or 15-20 min if on anti-coagulants After a liver biopsy place patient on the RIGHT Side Mobility o Cane COAL = Cane Opp Affected Leg o 2 point gait One leg and 1 crutch touch ground at same time Weight bearing o 3 point gait Both crutches and 1 foot are on the ground Non-weight bearing o 4 point gait Both legs and both crutches touch the ground Weight bearing o Swing through gait Advancing both crutches, then both legs, and requires weight bearing Not as stable as other gaits Laminectomy = removal of 1 or more vertebral laminae need straight back after = LOGROLL and

KEEP BACK STRAIGHT (so flat bed) Intussceptation Folic Acid Rich Foods (FOL) o Seen in Non-Hodgkins Lymphoma Who needs Dialysis? o F= Fish o Hot dog mass in RUQ Vowels: AEIOU o O=Organ Meats, Oranges A: Acid/Base Problems o Red Currant Jelly Like mucous and bloody stool o L=Leafy green veggies E: Electrolyte Problems Sweat Chol I: Intoxications o > 60 = CF K+ Foods (ROYGBIV-Rainbow colors) O: Overload of fluids o 40-60 = Borderline CF o Red= Strawberries, Tomatoes (not apples) U: Uremic Symptoms Ostomy = pouch opening 1/8 in larger than stoma o Orange= Oranges Macule = flat and round o Yellow=Banana Cushings Dx Papule = rounded and red o Green= Avocado, green veggies o (Cushion too much Cortisone) Vesicle = filled with fluid o Blue= Fish from the BLUE sea o (3 Ss = high Steriods, high Sugars (hyperglycemia), high Sodium Impetigo = 1:20 Burrows Soln, honey colored crusts o Indigo/Violet= Raisins o Moon Face, Buffalo Hump, Trunkal obesity, thin skinny Permethrin [NIX] => 10% for lice tx and 5% for Scabies tx extremities, slow wound healing, osteoporosis, HTN, muscle wasting o (Scabies = mites bury under skin) Cretenism = Congential Hypothyroidism (appears 3-6 mo in o K+ bottlefed infants and later in breastfed infants) RUQ: Right upper quadrant Hepatitis: low fat, high cal/carbs/protein, no alcohol Addisons Dx Cholelithiasis (gallstones) Hypothryoid: High Protein, low cal diet o Need to ADD steroids Cholecystitis (inflamm of gallbladder) Cystic Fibrosis: High Protein Diet and Pancr enzyme replacement o (3 Ss = Low Steroids, Low Sugars, Low Sodium) Hepatitis Hital Hernia: Fundopliction (tighten cardiac sphincter on stomach) o Low vascular volume (Not holding salt and H20 like in Cushings), Pancreatitis (severe knifelike pain; worse with eating/lying down; dont lie down for 1 hr after meals, - HOB 4-8 in when sleepy, no low BP some relief with fetal position) food before bed o Hyperkalemia (- K+) Papable olive shaped tumor in epigastrim = pyloric stenosis o Bronze Skin, Hyperpigmentation RLQ: (projectile vomiting) Crohns Dx (Ileum, Rt Colon; pain after meals) o In adults from peptic ulcers; in infants from hypertrophy of ALLEN TEST Appendicitis pylorous (symp 2nd-4th wk after birth) o B4 drawing ABGs do an Allens Test o Pain at McBurneys Point o Compress both radial and ulnar arties (wrist) at same time on 1 (1/2 b/w umbilicus and right iliac crest) hand PEDS Toddler: Fear of separation (give simple directions) o Release the ULNAR side (pinky side) and hand should turn LLQ:

 Ulcerative Colitis (Rectum, left colon; pain pre-defecation) Diverticulitis o Relieved by passage of stool/flatulus

o Prolonged PR interval o Nml PR interval: 0.12-0.20 o Conduction Problem o Drugs (Dig, Beta Blockers, Ca Channel Blockers) can cause by Duodenal Ulcer: Pain 2-3 hrs after meals and nighttime (relieve pain slowing conduction system (slows conduction from SA node to AV with FOOD INTAKE) node to Purnjee Fibers = see slowed PR (Atrial Response) Gastric Ulcer: Pain 1 hr after meal/when fasting; relieve pain with o Usu dont see symp, so usu not treated vomiting, not with food intake (Starve the gastric ulcer and feed the duodenal) Atrial Flutter Diverticular Dx: Cramping in LLQ relived by passage of stool and o Saw Tooth Appearance flatus (constipation alternates with diarrhea (from def in diet fiber) o Atrium racing away, blood pools and can throw a clot => stroke high fiber diet o Treat with Cardioversion 20-50 Jules (NURSE must hit Meckels Diverticulum: congen sac or pouch in ileum, symp seen by Synchronize button) age 2; painless rectal bleeding, abd, hematechezia, (currant jelly like o Ventricle beats are regular stool), s/s of appendicitis (tx = remove diverticulum) Atrial Fib o Ventricle beats are irregular o Atrium quivers, not good pump Cirrhosis: Biliary obstruction, alcohol, Hepatitis o Cardiovert 50-100 Jules Early stage: high protein/carbs and Vit B o If in hospital and were stable b4 going into a fib = give cardizem Adv stage: low fiber/salt/fat/protein, high cal, fluid restriction drip and beta blockers b4 cardioversion Esophageal Varices o Sengstaken Blakemore Tube or Minnesota Tube V-Tach Balloon on Esophagus and stomach to apply direct press on o Wide QRS complexes bleeding veins o V Tach and awake drugs I must take (Amiodarone or Lidocaine) o TIPS (transesophegal intrahepatic post systemic shunt) o V Tach and a nap (unconscious) zap zap zap (defibrillate) Balloon Catheter inserted via jugular vein with angiography to o Can only stay in for 2-3 min (can die) create a metal stent b.w portal vein to vena cava channel (provides a pathway for blood b/w portal vein and hepatic vein = bypasses V Fib cirrhotic liver) and relieves press on esoph varicies o Irreg makes no sense o Only way to tx = defribillate start at 360 Jules o Epi (to - HR) Jaundice (Icterus) Stroke Hemolytic Right Sided: Impatient, easily distracted, impulsive, less concerned o RBCs are destroyed (release bilirubin) about life events, safety is a big issue (impulse) Hemolytic transfusion rxn Hemolytic Anemia Left Sided: Slow, cautious, particular, very aware of deficits, greater Sickle Cell Crisis depression/anxiety Hepatocellular o The impaired liver cell (hepatocyte) doesnt allow bilirubin to (Think rt brain = creative, left brain = logical, math, science) convert from the unconjugated to the conjugated form Obstructive Pharm Facts o Bile flow is obstructed Dont give non-selective beta-blockers NSBB to patients Tumors w/respiratory problems Vitamin C can cause false +ive occult blood Avoid the G herbs (ginsing, ginger, ginko, garlic) when on anti EKGS Nml Sinus clotting drugs (coumadin, ASA, Plavix, etc) o 60-100 ASA toxicity can cause ringing of the ears Ototoxicity o PQRST nml EKG Strip No narcotics to any head-injury victims Mg2+ toxicity is treated with Calcium Gluconate Sinus Brady Do not give Calcium-Channel Blockers with Grapefruit Juice o < 60 Oxytocin is never administered through the primary IV o Tx: Atropine Lithium (Mood) patients must consume Na extra sodium to o (can be nml in physically fit/trainer person = then no tx needed) prevent toxicity MAOI Patients should avoid thyramine: (Aacados, bananas, 1st degree AV Block beef/chicken liver, caffeine, red wine, beer, cheese (except cottage

cheese), raisins, sausages, pepperoni, yogurt, sour cream) Dont give atropine for glaucoma it increases IOP Dont give ant-acids with food -- b/c it delays gastric emptying. Dont give Stadol to Methadone/Heroin Preggos -- cause instant withdrawal symptoms Insulin clear before cloudy Dont give Meperidine (Demerol) to pancreatitis patients Always verify bowel sounds when giving Kayexelate Hypercalcemia Ca = Phos hypophosphatemia 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 Wernickes encephalopathy & Korsakoffs syndrome) B6 - For TB Patients B9 - For Pregnant Patients B12 - Pernicious anemia, Vegetarians. Complications of Coumadin - 3Hs - Hemorrhage, hematuria & hepatitis FFP is administered to DIC(disseminated intervascular coagulation) b/c of the clotting Fx Mannitol (osmotic 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 evening Common Tricyclic Meds - 3 syllabes (pamelor, elavil) Common MAOIs - 2 syllables (Parnate, marplan, emsan, nardil, ,) 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.

Addison is skinny ( hypoglycemic, you get weight loss, you got weakness, and you get postural hypotonic) Cushing is fat ( hyperglycemic, you get moon face, big cheeks, and you retain a lot of Na and fluid, weight) Never Give via IVP: oKCL oHeparin oIbuprofen oInsulin oDobutamine oASA oAlbumin oAcetaminophen Insulin: oRapid: (lispro/humalg) onset <15 min. Peak: 1hr. Dur 3hr oShort: Reg (humulin/novolin) onset - 1hr. Pk: 2-3hr. D:4-6 oInt: (NPH/Lente)onset: 2hr. Peak 6-12 hr. Duration: 16-24hr oLong: (Ultralente ) onset 4-6 hr. Peak: 12-16 hr. Dura: >24hr oV.Long: (Lantus/glargine) onset 1hr. Peak: None. Dur: 24hr

oUrine olyguria, anuria oRespiratory distress oDecreaed cardiac contractility oECG Changes oReflexes hyperreflexia, or flaccid Substance Poisoning and Antidotes oMethanol -- Ethanol oCO2 -Oxygen oDopamine -- Phentolamine oBenzos (Versed) -- Flumazenil oLead -- Succimer, Calcium Disodium oIron -Deferoxamine oCoumadin -- Vitamin K oHeparin -Protamine Sulfate oThorazine -- Cogentine oWild Mushrooms - Atropine oRat Poison - Vit K Parkland Formula: 4cc * Kg * BSA Burned = Total Volume Necessary o1st 8hrs total volume o2nd 8hrs total volume o3rd 8 hrs total volumes 1. Alpha 1-adrenergic Blockers end in zosin and losin. SE are dizziness, weakness may occur when changing position. Should teach pt to change position slowly and lie down if dizziness occurs. GI upset may occur, teach pt to eat smaller more frequent meals. Should tell the pt to report FREQUENT faintness or dizziness. 2. Aminoglycosides end in mycin and another imp. that they try to throw in to confuse you is amikacin sulfate.. teach pt to take full course of drugs and drink plenty of fluids,tell them they may report these SE..RINGING IN EARS, headache, dizziness, N/V, loss of appetite. They should report pain at the injection site and severe headache, dizziness, loss of hearing, changes in urine pattern, difficulty breathing, rash or skin lesions,

doesnt go away, Report feelings of heat flushing tiredness, sickness swelling of lips and eyelids. SE you may experience are: dizziness and drowsiness, numbness feelings of tightness or pressure 6. Antivirals end in VIR. SE pt may experience are n/v/d, loss of appetite, HA, dizziness. REPORT: difficulty urinating, skin rash, or freq. recurrences. 7. Barbituates end in barbital. Teach pt that these drugs make you drowsy and less anxious dont try to get up after receiving this drug and they may experience drowsiness, dizziness , impaired thinking, hangover, ...AVOID DRIVING. GI upset, dreams (nightmares) diff. concentrating, fatigue. SE Report severe dizziness, drowsiness, and weakness and pregnancy 8. Benzodiazepines end in pam and lam and in the middle have either azo or aze. SE are same as above drowsiness, dizziness etc. REPORT: SEVERE drowsiness, dizziness, swelling in extremities, diff. voiding, palpitations

Acetylcholine Neurotransmitter (PNS muscle mov CNS Alzheimers) ACh Receptor Agonists are used to treat myasthenia gravis and Alzheimer's disease. Anticholergic S/E: given for Ach S/E (dicycloverine/atropine) oCant See (blurred vision) oCant Pee (anuria) oCant Spit ( oral secretions) oCant Sh*t ( peristalsis vagus nerve) HypoCalcemia Ca+ CATS oConvulsions oArrythmias oTetany oSpasms & Stridor Hyper Kalemia Causes K+: MACHINE oMedicational (ace inhibitors, NSAIDS) oAcidosis (metabolic & repiratory) oCellular destruction (burns, traumatic injury) oHypoaldosteronism, Hemolysis oNephrons, renal failure oExcretion (impaired) Signs of increased K Murder oMuscle weakness

9. Beta Blockers end in LOL. SE You may experience dizziness, drowsiness, light headed, blurred vision, n/v, loss of appetite, impotence, depression. REPORT: diff. breathing, night cough, swelling of extremities, slow pulse, confusion, depression, rash and sore throat.

Mental Health: Clozaril, Cogentin, Dalamane, Dexedrine, Elavil, Eskalith, Haldol, Luminal, Navane, Phenergan, Ritalin, Serax, Sinequan, Surfak, Thorazine OB:

Aldomet, Ampicillin, Cortef, Ergometrine, Magnesium sulfate, 3. ACE inhibitors end in pril take these drugs 1 hour before or 2 Pitocin, Premarin, Primaxin, Yutopar hours after meals, do NOT take w/ food (captopril, moexipril). SE These drugs will give a false pos. for urine acetone, NOT Peds: pregnant women can cause serious fetal effects. patient may experience GI upset, appetite loss, dizziness fast heart rate, change in Kewll, Nix, Oncovin (plus the med-surg drugs) taste. Teach pt to report sore throat, fever, chills swelling of hands and feet, chest pain and irregular heart beats swelling of face and eyes lips tongue difficulty breathing 4. ARBS (Angiotensing II receptor blockers) end in SARTAN. Teach pt they must use an alternate method to birth control while using these drugs. SE May experience dizziness, nausea, abdominal pain, symptoms of URI, cough. Report fever, chills, dizziness and pregnancy 5. Anti migraine Drugs end in triptan. NO take while pregnant Contact MD IMMED. if you experience chest pain or pressure that

-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 inhibitor nitr-, -nitr- = nitrate/vasodilator -olol = beta antagonist -oxin = cardiac glycoside -osin = Alpha blocker -parin = anticoagulant -prazole = PPIs -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 = antihistamine Actonel. Avodart. Boniva. Celebrex. Cialis. Coreg. Crestor. Detrol. Ditropan. Enbrel. Fosamax. Humira. Levitra. Lunesta. Nexium. Paxil.

Plavix. Premarin. Prilosec. Procrit Strattera. Valtrex Vesicare. Viagra. Vioxx. Vytorin. Wellbutrin. Zelnorm. Zocor. Zyprexa. Abilify Alavert Amitiza Aricept Caduet Cymbalta Effexor Enablex Evista Flowmax Gardasil Imitrex Januvia Lyrica Mirapex Mirena Nasonex Neulasta Orencia Reclast Requip Restasis Rozerem Singulair Spiriva Symbicort Some Other Interesting Facts Likely To Be On The Test Thiazide Diuretics BS Diabetics need food K like oranges, bananas and brocholli Vitamine K is a natural coagulant Foods high in Vitamin K like green leafy vegatables should be avoided with blood thinners. Normal potassium levels 3.5 to 5.0 mEq/liter Potassium levels under 3.5 is Hypokalemia Vasodilators: (esp nitroglyerine) innitially have orthostatic hypotension side effect which wears off over time

Diuretic Loop: Calcium Channel Blocker

All listed treat Hypertension All Treat Hypretension and Angina

AngioTension II Receptor Antagonist All listed treat HTN ACE- Inhibitors: 1) Are the primary drug of choice for vasodilation in Heart Failure 2) One side effect of ACE-I is orthostatic hypotension. 3) All ACE-I Listed all treat Hypertension & CHF some, treat MI Beta Blockers : 1) All listed treat Hypertension & Angina 2) Most Treat CHF & Arrythmia 3) Must be taper slowly when discontinued to avoid Angina. "Complications of Hypertension are: 1) Angina 2) stroke 3) Renal failure 4) Heart failure" If digitalis is order "Give digitals if 60 < HR < 120 Hold digitalis if 60 > HR > 120"