response is slow Several hours Peak 05 3days duration 2 5 days Monitoring PT

Response is slow several hours peak 05 3days duration

This preview shows page 10 - 13 out of 24 pages.

response is slow ● Several hours, Peak: 05.-3days, duration: 2-5 days ● Monitoring: ○ PT- prothrombin time ○ Average pretreatment PT = 12 sex ○ INR (international normalized ratio) - target is 2-3 ○ Measure PT q day x 5days, then twice a week for 1-2 weeks, then once a week for 1-2 months, then q 2-4 weeks ○ PT monitoring can be done at home, but meter is expensive ● Adverse Effects: ○ Hemorrhage ■ Overdose is treated with Vitamin K ○ Teratogenic ■ Pregnancy category X ● Many drug interaction ○ Drugs that increase effects of warfarin ■ Aspirin, sulfonamides, acetaminophen, amiodarone, some cephalosporins ○ Drugs that promote bleeding ■ Aspirin, abciximab, clopidogrel, dipyridamole ○ Drugs that decrease effects of warfarin ■ Carbamazepine, phenobarbital, phenytoin, oral contraceptives, cholestyramine, colestipol
Image of page 10
· Antidote : Vitamin K Other anticoagulant drugs: (how do they work?) · ASA: Suppresses platelet aggregation. Irreversible inhibition of cyclooxygenase (COX). Suppresses both TXA2-mediated vasoconstriction and platelet aggregation. Primary or secondary prevention of MI. Prevention of stroke in patients with hx of TIA · Clopidogrel: Inhibits platelet aggregation- prolongs bleeding time. Blocks ADP receptors on platelets, prevents Adp stimulated aggregation Unit VII: Respiratory System Drugs General: · Know proper use, and advantages and disadvantages, of the following delivery methods: metered dose inhaler (MDI), dry powder inhaler (DPI), nebulizer Metered Dose Inhaler (MDI) : Delivers a set amount of drug with each activation, Requires coordination to inhale drug correctly Disadvantage: Even with optimal use only 10% of the drug reaches the lungs/ Environmental Hazard: CFC (Chlorofluorocarbon) propellant can damage the ozone layer Using a spacer will increase the amount of drug that reaches the lungs **Important to wait 1 full minute between puffs , Most frequently prescribed Dry Powder inhaler (DPI): Small, Hand held device delivers a set dose of dry micronized powder with each inhalation Advantage: It does not require coordination Optimally 20% of the drug reaches the lungs No Environmental concerns Important to wait 1 minute between inhalations Nebulizer: Small machine delivers misted droplets of drug into lungs Delivered through mouthpiece or mask Disadvantage: Takes longer time to deliver medication than with MDIs or DPIs For some patients more effective than MDIs or DPIs · Be familiar with the 4 classifications of asthma Mild Intermittent ● 2 OR less days per week with symptoms ● < 2 nights per month with sx ● Patient is asymptomatic and has normal peak flow b/w exacerbations
Image of page 11
● PEFR criteria: Usual peak flow is > 80% or predicted value Mild Persistent ● > 2 days per week with symptoms, but not daily ● >2 nights per month with sx ● Acute exacerbations interfere with ADLs ● PEFR criteria: usual peak flow is >80% of predicted value Moderate Persistent ● Daily daytime sx, Requiring rescue drug (Albuterol) ● Exacerbations affect daily activities ● > 1 night per week with sx ● Exacerbations may last for days
Image of page 12
Image of page 13

You've reached the end of your free preview.

Want to read all 24 pages?

  • Summer '19

  • Left Quote Icon

    Student Picture

  • Left Quote Icon

    Student Picture

  • Left Quote Icon

    Student Picture