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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

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

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 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

5 Ps of Fracture: Pain, pallor, pulseless, paresthesia, paralysis Hypoventilation => Resp Acidosis ( CO2) Retain CO2 Hyperventilation=> Resp Alkalosis ( CO2) Blow off CO2 (think Cushings Triad: (Indicates ed ICP) HR, RR, BP of preg breathing) Lasix/Bumex = K+ Wasting (can cause hypokalemia) Aldactone = K+ Sparing (can cause hyperkalemia) Tx of DIC = Heparin (safe during preg) Post Masectomy Care: BREAST BP NOT on affected side Reach Recovery Elevate affected side Abduction and external rotation no initial exercise (initial is extension/flexion) Self Breast Exam (1x month 7 day after period) Try to promote a (+) self-image Autosomal Recessive: Cystic Fibrosis, PKU, Tay-Sachs, Albinism, 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 2 c = 1 pt = 16 oz 1 oz = 30 mL= 8 drams 1 mg = 1000 mcg 2 pt = 1 qt= 32 oz 1 g = 15 gr 4 qt =1 gal = 128 oz 1 gr = 60 mg 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 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 Folic Acid Rich Foods (FOL) o F= Fish o O=Organ Meats, Oranges o L=Leafy green veggies K+ Foods (ROYGBIV-Rainbow colors) o Red= Strawberries, Tomatoes (not apples) o Orange= Oranges o Yellow=Banana o Green= Avocado, green veggies o Blue= Fish from the BLUE sea o Indigo/Violet= Raisins

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) Who needs Dialysis? Vowels: AEIOU A: Acid/Base Problems E: Electrolyte Problems I: Intoxications O: Overload of fluids U: Uremic Symptoms

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 o Seen in Non-Hodgkins Lymphoma o Hot dog mass in RUQ o Red Currant Jelly Like mucous and bloody stool Sweat Chol o > 60 = CF o 40-60 = Borderline CF Ostomy = pouch opening 1/8 in larger than stoma Macule = flat and round Papule = rounded and red Vesicle = filled with fluid Impetigo = 1:20 Burrows Soln, honey colored crusts Permethrin [NIX] => 10% for lice tx and 5% for Scabies tx o (Scabies = mites bury under skin)

Cushings Dx o (Cushion too much Cortisone) o (3 Ss = high Steriods, high Sugars (hyperglycemia), high Sodium o Moon Face, Buffalo Hump, Trunkal obesity, thin skinny extremities, slow wound healing, osteoporosis, HTN, muscle wasting RUQ: Right upper quadrant o K+ Cholelithiasis (gallstones) Cholecystitis (inflamm of gallbladder) Cretenism = Congential Hypothyroidism (appears 3-6 mo in Addisons Dx Hepatitis bottlefed infants and later in breastfed infants) o Need to ADD steroids Pancreatitis (severe knifelike pain; worse with eating/lying down; Hepatitis: low fat, high cal/carbs/protein, no alcohol o (3 Ss = Low Steroids, Low Sugars, Low Sodium) some relief with fetal position) Hypothryoid: High Protein, low cal diet o Low vascular volume (Not holding salt and H20 like in Cushings), Cystic Fibrosis: High Protein Diet and Pancr enzyme replacement low BP RLQ: Hital Hernia: Fundopliction (tighten cardiac sphincter on stomach) o Hyperkalemia ( K+) Crohns Dx (Ileum, Rt Colon; pain after meals) dont lie down for 1 hr after meals, HOB 4-8 in when sleepy, no o Bronze Skin, Hyperpigmentation Appendicitis food before bed o Pain at McBurneys Point Papable olive shaped tumor in epigastrim = pyloric stenosis ALLEN TEST (1/2 b/w umbilicus and right iliac crest) (projectile vomiting) o B4 drawing ABGs do an Allens Test o In adults from peptic ulcers; in infants from hypertrophy of o Compress both radial and ulnar arties (wrist) at same time on 1 LLQ: pylorous (symp 2nd-4th wk after birth) hand Ulcerative Colitis (Rectum, left colon; pain pre-defecation) o Release the ULNAR side (pinky side) and hand should turn Diverticulitis PEDS discolored and should be able to see blood flow back into it o Relieved by passage of stool/flatulus Toddler: Fear of separation (give simple directions) (Radial is located on the thumb side and ulnar is on the pinky Preschooler: Fear mutilation (Allow to play with equipment) side) Duodenal Ulcer: Pain 2-3 hrs after meals and nighttime (relieve pain School Agers: Fear loss of control (allow to play with equipment) o Minutes of press on the ABG site after drawing blood? with FOOD INTAKE) Adol: Fear loss of independence 5-10 min or 15-20 min if on anti-coagulants Gastric Ulcer: Pain 1 hr after meal/when fasting; relieve pain with After a liver biopsy place patient on the RIGHT Side vomiting, not with food intake Pneumothorax Symp (P-Thorax) (Starve the gastric ulcer and feed the duodenal) o P-Pleurtic Pain Mobility o T-Trachea Deviation o Cane Diverticular Dx: Cramping in LLQ relived by passage of stool and o H-Hyperresonance COAL = Cane Opp Affected Leg flatus (constipation alternates with diarrhea (from def in diet fiber) o O-Onset Sudden o 2 point gait high fiber diet o R-Reduced breath sounds (dyspnea) One leg and 1 crutch touch ground at same time Meckels Diverticulum: congen sac or pouch in ileum, symp seen by o A-Absent Fremitus Weight bearing age 2; painless rectal bleeding, abd, hematechezia, (currant jelly like o X-X-Rays show collapse o 3 point gait stool), s/s of appendicitis (tx = remove diverticulum) Both crutches and 1 foot are on the ground Pul Edema Tx (MAD DOG) Non-weight bearing Cirrhosis:

Biliary obstruction, alcohol, Hepatitis Early stage: high protein/carbs and Vit B Adv stage: low fiber/salt/fat/protein, high cal, fluid restriction Esophageal Varices o Sengstaken Blakemore Tube or Minnesota Tube Balloon on Esophagus and stomach to apply direct press on bleeding veins o TIPS (transesophegal intrahepatic post systemic shunt) Balloon Catheter inserted via jugular vein with angiography to 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 cirrhotic liver) and relieves press on esoph varicies Jaundice (Icterus) Hemolytic o RBCs are destroyed (release bilirubin) Hemolytic transfusion rxn Hemolytic Anemia Sickle Cell Crisis Hepatocellular o The impaired liver cell (hepatocyte) doesnt allow bilirubin to convert from the unconjugated to the conjugated form Obstructive o Bile flow is obstructed Tumors EKGS Nml Sinus o 60-100 o PQRST nml EKG Strip Sinus Brady o < 60 o Tx: Atropine o (can be nml in physically fit/trainer person = then no tx needed) 1st degree AV Block 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 slowing conduction system (slows conduction from SA node to AV node to Purnjee Fibers = see slowed PR (Atrial Response) o Usu dont see symp, so usu not treated Atrial Flutter o Saw Tooth Appearance o Atrium racing away, blood pools and can throw a clot => stroke o Treat with Cardioversion 20-50 Jules (NURSE must hit Synchronize button) o Ventricle beats are regular Atrial Fib o Ventricle beats are irregular o Atrium quivers, not good pump o Cardiovert 50-100 Jules o If in hospital and were stable b4 going into a fib = give cardizem

drip and beta blockers b4 cardioversion

B9 - For Pregnant Patients B12 - Pernicious anemia, Vegetarians. V-Tach Complications of Coumadin - 3Hs - Hemorrhage, hematuria & o Wide QRS complexes hepatitis o V Tach and awake drugs I must take (Amiodarone or Lidocaine) FFP is administered to DIC(disseminated intervascular coagulation) o V Tach and a nap (unconscious) zap zap zap (defibrillate) b/c of the clotting Fx o Can only stay in for 2-3 min (can die) Mannitol (osmotic diuretic [Head injury]) crystallizes at room temp use a filter needle V Fib Antianxiety medication is pharmacologically similar to alcohol o Irreg makes no sense used for weaning Tx o Only way to tx = defribillate start at 360 Jules Administrate Glucagon when pt is hypoglycemia and unresponsive o Epi (to HR) Phenazopyridine ( Pyridium)--Urine will appear orange Stroke Rifampicin -- Red-urine, tears, sweat) Right Sided: Impatient, easily distracted, impulsive, less concerned Hot and Dry = sugar high (hyperglycemia) about life events, safety is a big issue (impulse) Cold and clammy = need some candy (hypoglycemia) Med of choice for V-tach is = lidocaine Left Sided: Slow, cautious, particular, very aware of deficits, greater Med of choice for SVT = adenosine or adenocard depression/anxiety Med of choice for Asystole = atropine Med of choice for CHF is = Ace inhibitor. (Think rt brain = creative, left brain = logical, math, science) Med of choice for anaphylactic shock= is Epinephrine Med of choice for Status Epilepticus = is Valium. Pharm Facts Med of choice for bipolar is =lithium. Dont give non-selective beta-blockers NSBB to patients Give ACE inhibitors w/food to prevent stomach upset w/respiratory problems Administer diuretics in the morning Vitamin C can cause false +ive occult blood Give Lipitor at 1700 since the enzymes work best during the evening Avoid the G herbs (ginsing, ginger, ginko, garlic) when on antiCommon Tricyclic Meds - 3 syllabes (pamelor, elavil) clotting drugs (coumadin, ASA, Plavix, etc) Common MAOIs - 2 syllables (Parnate, marplan, emsan, nardil, ,) ASA toxicity can cause ringing of the ears Ototoxicity TPN has a dedicated line & cannot be mixed ahead of time No narcotics to any head-injury victims RHoGAM -- Given at 28 weeks & 72 hrs postpartum Mg2+ toxicity is treated with Calcium Gluconate Do not administer erythromycin to Multiple Sclerosis pt Do not give Calcium-Channel Blockers with Grapefruit Juice Benadryl and Xanax taken together will cause additive effects. Oxytocin is never administered through the primary IV Can't take Lasix if allergic to Sulfa drugs. Lithium (Mood) patients must consume Na extra sodium to prevent Acetaminophen can be used for headache when the client is using toxicity nitroglycerin. MAOI Patients should avoid thyramine: (Aacados, bananas, Dilantin - can not give with dextrose. Only give with NS. 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 Addison is skinny ( hypoglycemic, you get weight loss, you got Dont give ant-acids with food -- b/c it delays gastric emptying. weakness, and you get postural hypotonic) Dont give Stadol to Methadone/Heroin Preggos -- cause instant Cushing is fat ( hyperglycemic, you get moon face, big cheeks, and withdrawal symptoms you retain a lot of Na and fluid, weight) Insulin clear before cloudy Never Give via IVP: Dont give Meperidine (Demerol) to pancreatitis patients oKCL Always verify bowel sounds when giving Kayexelate oHeparin Hypercalcemia Ca = Phos hypophosphatemia oIbuprofen Radioactive Dye urine excretion oInsulin Signs of toxic ammonia levels is Asterixis (hands flapping) oDobutamine D10W can be substituted for TPN (temporary use) oASA Dopamine and Lasix are incompatible oAlbumin Hypoglycemic shivers can be stopped by holding the limb, seizures oAcetaminophen cannot (infants) Common symptom of Aluminum hydroxide constipation Insulin: Thiazide diuretics may induce hyperglycemia oRapid: (lispro/humalg) onset <15 min. Peak: 1hr. Dur 3hr Take Iron with Vit C it enhances absorbtion Do not take with oShort: Reg (humulin/novolin) onset - 1hr. Pk: 2-3hr. D:4-6 milk oInt: (NPH/Lente)onset: 2hr. Peak 6-12 hr. Duration: 16-24hr B1 - For Alcoholic Patients (to prevent Wernickes encephalopathy oLong: (Ultralente ) onset 4-6 hr. Peak: 12-16 hr. Dura: >24hr & Korsakoffs syndrome) oV.Long: (Lantus/glargine) onset 1hr. Peak: None. Dur: 24hr B6 - For TB Patients

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 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. breathing, night cough, swelling of extremities, slow pulse, Should teach pt to change position slowly and lie down if dizziness confusion, depression, rash and sore throat. occurs. GI upset may occur, teach pt to eat smaller more frequent meals. Should tell the pt to report FREQUENT faintness or dizziness. Mental Health: 2. Aminoglycosides end in mycin and another imp. that they try to throw in to confuse you is amikacin sulfate.. Clozaril, Cogentin, Dalamane, Dexedrine, Elavil, Eskalith, Haldol, teach pt to take full course of drugs and drink plenty of fluids,tell Luminal, Navane, Phenergan, Ritalin, Serax, Sinequan, Surfak, them they may report these Thorazine SE..RINGING IN EARS, headache, dizziness, N/V, loss of appetite. They should report pain at the injection site and severe headache, OB: dizziness, loss of hearing, changes in urine pattern, difficulty breathing, rash or skin lesions, Aldomet, Ampicillin, Cortef, Ergometrine, Magnesium sulfate, Pitocin, Premarin, Primaxin, Yutopar 3. ACE inhibitors end in pril take these drugs 1 hour before or 2 hours after meals, do NOT take w/ food (captopril, moexipril). Peds: SE These drugs will give a false pos. for urine acetone, NOT pregnant women can cause serious fetal effects. patient may Kewll, Nix, Oncovin (plus the med-surg drugs) experience GI upset, appetite loss, dizziness fast heart rate, change in 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 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 -ase = thrombolytic -azepam = benzodiazepine -azine = antiemetic; phenothiazide -azole = proton pump inhibitor, antifungal -barbital = barbiturate -coxib = cox 2 enzyme blockers 6. Antivirals end in VIR. -cep/-cef = anti-infectives SE pt may experience are n/v/d, loss of appetite, HA, dizziness. -caine = anesthetics REPORT: difficulty urinating, skin rash, or freq. recurrences. -cillin = penicillin -cycline = antibiotic 7. Barbituates end in barbital. Teach pt that these drugs make you -dipine = calcium channel blocker drowsy and less anxious dont try to get up after receiving this drug -floxacin = antibiotic and they may experience drowsiness, dizziness , impaired thinking, -ipramine = Tricyclic antidepressant hangover, ...AVOID DRIVING. GI upset, dreams (nightmares) diff. -ine = reverse transcriptase inhibitors, antihistamines concentrating, fatigue. -kinase = thrombolytics SE Report severe dizziness, drowsiness, and weakness and -lone, pred- = corticosteroid pregnancy -mab = monoclonal antibiotics -micin = antibiotic, aminoglycoside 8. Benzodiazepines end in pam and lam and in the middle have -navir = protease inhibitor either azo or aze. nitr-, -nitr- = nitrate/vasodilator SE are same as above drowsiness, dizziness etc. REPORT: SEVERE -olol = beta antagonist drowsiness, dizziness, swelling in extremities, diff. voiding, -oxin = cardiac glycoside palpitations -osin = Alpha blocker -parin = anticoagulant -prazole = PPIs 9. Beta Blockers end in LOL. -phylline = bronchodilator SE You may experience dizziness, drowsiness, light headed, blurred -pril = ACE inhibitor vision, n/v, loss of appetite, impotence, depression. REPORT: diff. -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"