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Krystan: Semester Two Nursing School > 2820 Pharmacology Exam Three > Flashcards

2820 Pharmacology Exam Three Flashcards

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1
Q

Cancer drugs can be split into what two categories?

A

Cytotoxic and noncytotoxic

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2
Q

Mechanism of action for alkylating agents

A

Forming bonds/links with DNA, preventing normal cellular division, leading to cell death

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3
Q

What type of cells are very sensitive to the actions of alkylating agents?

A

Blood cells (bone marrow suppression is limiting factor)

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4
Q

What symptoms do alkylating agents cause due to damage to GI epithelial cells?

A

N/V/D

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5
Q

What is a common drug classification for alkylating agents?

A

Nitrogen mustards

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6
Q

What effect do nitrogen mustards have on cells?

A

They kill rapidly growing cells by alkylating DNA and RNA

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7
Q

Mechanism of action for antimetabolites

A

Structurally similar to cell proteins/nucleic acids, but when cells try to make DNA or RNA with them, cells die or growth is very hindered

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8
Q

What is the main dose-limiting effect of antimetabolites?

A

Bone marrow toxicity

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9
Q

How do antitumor antibiotics work?

A

They bind to DNA and affect its function

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10
Q

What are the potential damages if antitumor antibiotics infiltrate the IV?

A

Damage to skin, subcutaneous tissue, and nerves

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11
Q

What is the major dose limiting adverse effect of antitumor antibiotics?

A

Cardiac toxicity

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12
Q

Mechanism of action for antimitotic cancer drugs

A

Prevention of cell division

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13
Q

What nerves may be damaged by antimitotic cancer drugs?

A

Autonomic nerves

Can also cause peripheral neuropathy

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14
Q

When are gonadotropin releasing hormone agonists used?

A

In palliative therapy of advanced prostate cancer when patient doesnt want surgical castration

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15
Q

Mechanism of action for androgen receptor blockers?

A

Blocking testosterone at the receptor site

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16
Q

When are androgen receptor blockers used?

A

Prostate cancer treatment (often in conjunction with gonadotropin releasing hormone agonists)

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17
Q

Mechanism of action for estrogen receptor blockers

A

Stops growth of breast cancer cells in estrogen receptor positive cancers

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18
Q

Mechanism of action for aromatase inhibitors

A

Stops breast cancer cell growth by blocking estrogen production

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19
Q

Monoclonal antibody mechanism of action

A

Targets breast cancer cells, prevents cell growth, and causes cell death in HER-2 positive tumors (human epidermal growth factor)

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20
Q

Tamoxifen: class

A

Estrogen receptor blocker

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21
Q

Interferon alfa 2b: class

A

Biologic response modifier

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22
Q

What is the serious side effect that interferon alfa 2b can cause?

A

Depression/suicidal ideation

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23
Q

Mechanism of action: monoclonal antibodies

A

Binds to target cells, triggering cell death or marking it for destruction by other immune cells

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24
Q

Therapeutic uses of estrogens

A

Contraception
Acne
Control of postmenopausal manifestations
Control of dysfunctional uterine bleeding

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25
Q

What effects can estrogen have on coagulation?

A

Can either suppress it or promote it, depending on genetics. Increased DVT risk (contraindicated in history of thromboembolism)

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26
Q

What thromboembolic events can occur with progesterone?

A

MI
Pulmonary embolism
Thrombophlebitis
Stroke

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27
Q

Pharmacological action of hormonal contraceptives

A

Prevents ovulation and alters endometrial lining to reduce chance of fertilization

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28
Q

What thromboembolic events may occur with hormonal contraceptives?

A

MI
pulmonary embolism
Thrombophlebitis
Stroke

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29
Q

What are some things to teach patients about hormonal contraceptives?

A

Not 100% effective
Follow regimen exactly
Not STD preventative
Use backup contraceptive for first 30 days

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30
Q

Therapeutic use of androgens

A

Hypogonadism or delayed puberty in males

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31
Q

Describe androgenic effects for males

A

Acne
Priapism
Increased hair growth
Penile enlargement

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32
Q

Androgenic effects for females

A 
Irregular or no menstruation
Hirutism
Weight gain
Lowering of voice 
Clitoris growth
Vaginitis
Baldness
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33
Q

Pharmacological action of 5 alpha reductase inhibitors

A

Decreasing usable testosterone by inhibiting the conversion enzyme

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34
Q

Therapeutic use of 5 alpha reductase inhibitors

A

BPH

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35
Q

5 alpha reductase exemplar drug

A

Finasteride

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36
Q

Pharmacological action of alpha one adrenergic antagonists

A

Decreased mechanical obstruction of urethra by relaxing smooth muscle of prostate and bladder

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37
Q

Therapeutic uses of alpha 1 adrenergic antagonists

A

BPH

HTN

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38
Q

Alpha 1 adrenergic antagonists

A

Tamsulosin

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39
Q

Pharmacological action of uterine stimulants

A

Increased strength, frequency, and length of uterine contractions

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40
Q

Therapeutic use for oxytocin

A

Labor induction/enhancement
Placental delivery
Postpartum hemorrhage

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41
Q

Nursing actions when administering oxytocin

A

Monitor mom’s vitals closely
Monitor contractions closely
Assess fetal status

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42
Q

Terbutaline: class

A

Tocolytic medication

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43
Q

Terbutaline: mechanism of action

A

Activation of beta 2 receptors to cause uterine smooth muscle relaxation

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44
Q

Therapeutic use of terbutaline/tocolytic medications

A

Delay labor (can be used for up to 48 hours but is not for preventing labor)

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45
Q

Possible maternal effects of tocolytic meds?

A

Tachycardia
Chest pain
Palpitations
Hypotension

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46
Q

Possible fetal effects of tocolytic meds

A

Tachycardia

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47
Q

Lispro: type of insulin

A

Rapid acting

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48
Q

Regular insulin: type

A

Short acting

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49
Q

NPH insulin: type

A

Intermediate acting

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50
Q

Glargine insulin: type

A

Long acting

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51
Q

Pharmacological actions of insulin

A

Promotes cellular uptake of glucose
Conversion of glucose to glycogen
Moves potassium into cells

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52
Q

Which patients require insulin treatment?

A

All type 1 diabetics and some type 2 diabetics

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53
Q

What might make a client with T2DM require insulin?

A

Diabetes not being controllable by diet, exercise, and oral antidiabetics
Renal or liver disease
Surgery or stress
Neuropathy

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54
Q

Possible causes of hypoglycemia

A 
Too much insulin
Too little food
Vomiting or diarrhea
Alcohol intake
Extreme exercise 
Childbirth
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55
Q

What are some signs of abrupt onset hypoglycemia (sympathetic nervous system effects)?

A

Tachycardia
Palpitations
Sweating
Shakiness

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56
Q

What are some signs and symptoms of gradual onset hypoglycemia (parasympathetic effects)?

A 
Headache
Tremors
Weakness 
Lethargy
Disorientation
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57
Q

What should the nurse administer to a conscious patient experiencing hypoglycemia?

A

15 grams of carbs

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58
Q

What should be given to a hypoglycemic patient who is not fully conscious?

A

Paraenteral, subcutaneous, or IM glucose or glucagon

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59
Q

Pharmacological action of sulfonylureas (glipizide and glyburide)

A

Increase insulin release from pancreas

Clean increase tissue sensitivity to insulin

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60
Q

Possible complications of sulfonylureas

A

Hypoglycemia

Weight gain

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61
Q

Metformin: class

A

Biguanides

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62
Q

Biguanides: pharmacological action

A

Glycogenesis suppression (reducing liver production of glucose)
Increase glucose uptake and use in fat and muscle
Decreased GI glucose absorption

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63
Q

Possible complications of metformin

A

GI issues
Lactic acidosis
B12/folic acid deficiencies

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64
Q

What are some signs and symptoms of lactic acidosis?

A

Hyperventilation
Myalgia
Sluggishness
Somnolence

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65
Q

Contraindications for metformin

A 
DKA
Shock
Severe infection
Kidney impairment
Hypoxia
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66
Q

In general, what do amylin mimetics do?

A

Mimic the peptide hormone amylin

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67
Q

Amylin mimetics: pharmacological action

A

Decrease gastric emptying time
Inhibit glucagon secretion
Cause satiety, decreasing caloric intake

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68
Q

Amylin mimetics: therapeutic use

A

Supplemental glucose control for types 1 and 2

Insulin supplement

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69
Q

Amylin mimetics: contraindications

A

Kidney failure/dialysis

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70
Q

In general, what do incretin mimetics do?

A

Mimic glucagon-like peptide incretin

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71
Q

Incretin mimetics: pharmacological action

A

Promote insulin release
Decrease glucagon secretion
Slow gastric emptying
Decrease appetite

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72
Q

Incretin mimetics: use

A

Supplemental glucose control in T2DM

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73
Q

Glucagon: pharmacological action

A

Increase breakdown on glycogen into glucose

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74
Q

For what emergency situation is glycogen given?

A

Insulin toxicity (hypoglycemic reactions)

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75
Q

Levothyroxine: pharmacological action

A 
Increases:
Metabolism
Cardiac output
Renal perfusion
Oxygen use
Temperature
Blood volume 
Growth
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76
Q

Levothyroxine: therapeutic use

A

Hypothyroidism
Goiter
Cretinism
Myxedema coma

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77
Q

Possible complications of levothyroxine (thyroid hormone)

A 
Overmedication (causing thyrotoxicosis)
Chronic over treatment (can cause a fib and bone loss)
Anxiety
Tachycardia
Chest pain
Nervousness
Tremors
Palpitations 
Fever
Diaphoresis 
Weight loss
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78
Q

What are signs of cardiac excitability related to thyroid hormone?

A

Angina
Chest pain
Palpitations
Dysrhythmias

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79
Q

When should thyroid hormone be administered?

A

Daily on an empty stomach 30-60 min before breakfast

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80
Q

Propylthiouracil: class

A

Thionomides

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81
Q

Propylthiouracil: pharmacological action

A

Blocks synthesis of TH
Prevents oxidation of iodine
Blocks conversion of T4 into T3

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82
Q

Propylthiouracil: therapeutic use

A

Graves’ disease
Prep for thyroid removal surgery
Emergency treatment of thyrotoxicosis
Adjunct to irradiation of thyroid

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83
Q

Signs and symptoms of overmedication with propylthiouracil

A 
Drowsiness 
Depression
Weight gain
Edema
Bradycardia
Anorexia
Cold intolerance
Dry skin
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84
Q

When should propylthiouracil be taken?

A

Consistent times each day with meals

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85
Q

Why should propylthiouracil not be stopped abruptly?

A

Risk of thyroid crisis

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86
Q

What foods should be avoided when taking propylthiouracil?

A

Shellfish and other iodine containing foods

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87
Q

Radioactive iodine: pharmacological action

A

Destroys some thyroid hormone producing cells

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88
Q

Radioactive iodine: therapeutic use with high doses

A

Hyperthyroidism

Thyroid cancer

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89
Q

Radioactive iodine: therapeutic use with low doses

A

Thyroid function studies

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90
Q

What are s/s of radiation sickness caused by radioactive iodine?

A

Hematemesis
Epistaxis
N/V

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91
Q

What are signs of hypothyroidism caused by radioactive iodine?

A 
Cold intolerance
Edema
Bradycardia
Weight gain
Depression
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92
Q

Pharmacological action of strong iodine solution

A

Reduce iodine uptake and inhibit thyroid hormone production

Blocks release of TH into bloodstream

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93
Q

Strong iodine solution: therapeutic uses

A

Reduction of thyroid size prior to removal

Emergency treatment of thyrotoxicosis

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94
Q

What is iodism?

A

Early iodine toxicity

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95
Q

What are some other complications that can occur with iodine products?

A

Metallic taste in mouth
Stomatitis
Sore teeth and gums

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96
Q

Somatropin: class

A

Anterior pituitary hormone/growth hormone

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97
Q

Somatropin: pharmacological action

A

Stimulate growth and protein production

Decrease glucose use

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98
Q

Somatropin: use

A

Pediatric and adult GH deficiency

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99
Q

For whom is somatropin contraindicated and why?

A

Those who are severely obese or have severe respiratory impairment like sleep apnea, because of a higher fatality risk

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100
Q

Why is somatropin used cautiously in diabetic clients?

A

Risk of hyperglycemia

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101
Q

When should somatropin med therapy be stopped?

A

Prior to epiphyseal plate closure

102
Q

Erythropoietin: action

A

Acts on bone marrow to increase RBC production

103
Q

Erythropoietin: use

A

Anemia related to CKD

104
Q

Filgrastim: class

A

Leukopoietic growth factor

105
Q

Filgrastim: action

A

Stimulates bone marrow to increase neutrophil production

106
Q

Filgrastim: use

A

Help in decreasing infection risk in clients who have neutropenia from cancer or other conditions

107
Q

Sargramostim: class

A

Granulocyte macrophage colony stimulating factor

108
Q

Sargramostim: action

A

Acts on bone marrow to increase white blood cell production

109
Q

Sargramostim: use

A

Older adults with acute myelogenous leukemia

After chemo induction to increase neutrophil recovery and decrease infection risk

110
Q

Oprelvekin: class

A

Thrombopoietic growth factor

111
Q

Oprelvekin: action

A

Increases production of platelets

112
Q

Oprelvekin: use

A

Decrease thrombocytopenia and need for platelet transfusions of clients receiving chemo

113
Q

Donepezil: class

A

Cholinesterase inhibitor

114
Q

Donepezil: action

A

Prevents cholinesterase from inhibiting acetylcholine, increasing the amount of ACh available at the receptor site. Sympathetic responses then last longer

115
Q

Donepezil: use

A

Treatment of Alzheimer’s (behavior and cognition improvement)
Treatment of Parkinson’s

116
Q

Donepezil: complications

A

Excessive muscarinic stimulation (increased GI motility,sweating, etc)
Cholinergic crisis/toxicity
N/V/D
Weight loss in older adults

117
Q

What are some signs and symptoms of cholinesterase inhibitor (donepezil) toxicity?

A

Salivation
Diaphoresis
Diarrhea

118
Q

Levodopa/carbidopa: class

A

Antiparkinsonian/dopamine synthesis medication

119
Q

Levodopa/carbidopa: action

A

Helps maintain balance between dopamine and acetylcholine

120
Q

Levodopa/carbidopa: use

A

Relief from dyskinesias (bradykinesia, resting tremors, rigidity) associated with Parkinson’s to increase ability to do ADLs

121
Q

What are some common complications with levodopa/carbidopa?

A 
N/V
Drowsiness
Dyskinesias
Orthostatic hypotension 
Tachycardia/palpitations 
Lack of impulse control 
Psychosis
Wearing off after a long time of use
122
Q

Client education for levodopa/carbidopa?

A 
Effects can take weeks to months 
Avoid high protein meals and foods
Take with food to avoid GI distress
Avoid pregnancy
Avoid Kava
123
Q

Phenytoin: class

A

Antiepileptic

124
Q

Phenytoin: action

A

Slows entrance of sodium and calcium back into the neuron, giving it longer to repolarization

125
Q

Phenytoin: use

A

Prevention/treatment of seizures

126
Q

Phenytoin: complications

A 
Rash
Sedation
Cognitive impairment 
Gingival hyperplasia 
Dysrhythmias 
Hypotension
Ataxia
127
Q

Phenytoin: nursing considerations

A

Narrow therapeutic range

Monitor for bleeding

128
Q

Phenytoin: patient education

A 
Do not discontinue suddenly 
Keep a seizure diary
Avoid CNS depressants 
Avoid pregnancy 
Can decrease oral contraceptive use
129
Q

Carbamazepine: class

A

Anti-epileptic

130
Q

Carbamazepine: action

A

Slows entrance of sodium and calcium back into the neuron, allowing for longer repolarization

131
Q

Carbamazepine: use

A

Prevention and treatment of seizures

132
Q

Carbamazepine: complications

A 
Blood dyscrasias
Double vision
Vertigo
Headache 
Edema
Skin disorders
Staggering gait
133
Q

Carbamazepine: patient education

A

Avoid pregnancy
Can decrease oral contraceptive use and warfarin levels
Avoid other CNS depressants

134
Q

Topiramate: class

A

Anti-epileptic

135
Q

Topiramate: action

A

Enhances the effects of GABA

136
Q

Topiramate: use

A

Prevention/treatment of seizures

137
Q

Topiramate: complications

A 
Vision loss
Vertigo
Fatigue
Death
Worsening seizures
Decreased sweating/increased temperature 
Metabolic acidosis
Angle closure glaucoma
138
Q

Topiramate: patient education

A

Avoid pregnancy
Don’t discontinue suddenly
Keep seizure diary
Avoid CNS depressants

139
Q

What do anticoagulants do?

A

Prevent clot formation

140
Q

What do hemostatic drugs do?

A

Replace missing clotting factors

141
Q

What is fibrinolysis?

A

Removal of an already formed clot (can be done by the body or by drugs if necessary)

142
Q

Heparin: class

A

Anticoagulant

143
Q

Heparin: action

A

Activation of antithrombin to inhibit clotting

144
Q

Heparin: use

A

Conditions needing prompt anticoagulation
Surgery
Dialysis adjunct
Disseminated intravascular coagulation treatment

145
Q

How is heparin administered?

A

IV

146
Q

Heparin: complications

A

Toxicity
Hemorrhage
Hematoma
Thrombocytopenia

147
Q

Enoxaparin: class

A

Anticoagulant

148
Q

Enoxaparin: action

A

Inactivation of factor Xa to prevent clotting

149
Q

Enoxaparin: use

A

Prevent DVT
Treat DVT and PE
Prevent angina and complications of MI

150
Q

Enoxaparin: administration

A

Usually given subcutaneous

151
Q

Enoxaparin: complications

A

Hemorrhage
Toxicity
Neurological damage from hematoma
Thrombocytopenia

152
Q

Client education for heparin and enoxaparin?

A

Use an electric razor and soft toothbrush
Monitor for signs and symptoms of bleeding
Avoid herbs that affect coagulation and other anti platelet drugs

153
Q

What are contraindications for heparin and enoxaparin?

A

Thrombocytopenia
Uncontrollable bleeding
Not to be used during or after brain, eye, or spinal surgery

154
Q

Warfarin: class

A

Oral anticoagulant/vitamin K inhibitor

155
Q

Warfarin: action

A

Antagonizes vitamin K to prevent synthesis of clotting factors

156
Q

Warfarin: use

A

Prevention of PE and venous thrombosis
Prevention of thrombotic events
Reduce risk of recurrent MI/stroke/TIA

157
Q

Warfarin: complications

A 
Hemorrhage
Hepatitis 
Toxicity 
Bruising/petechiae 
Black tarry stools
158
Q

What is the antidote to warfarin?

A

Vitamin K

159
Q

How long can warfarin take to achieve full effects?

A

3-5 days

160
Q

What are contraindications for warfarin?

A 
Pregnancy 
Low platelet count
Liver disorder
Bleeding disorder 
Vitamin K deficiencies 
Eye/brain/spinal surgery
161
Q

Warfarin: client education

A 
Avoid alcohol and OTC drugs
Avoid long periods of sitting
Get a regular PT/INR
Use a soft toothbrush and electric razor 
Avoid foods high in vitamin K
162
Q

What are some examples of foods high in vitamin K?

A

Spinach
Broccoli
Canola oil
Soybean oil

163
Q

Rivaroxaban: class

A

Direct inhibitor of factor Xa

164
Q

Rivaroxaban: action

A

Inhibits factor Xa to prevent thrombin formation

165
Q

Rivaroxaban: use

A

Stroke prevention in a-fib patients
Prevention of post-op PE/DVT
Reduce risk of emboli formation for patients undergoing knee or hip surgery

166
Q

Rivaroxaban: complications

A

Bleeding
Elevated liver enzymes or bilirubin
Rash

167
Q

Clopridogrel: class

A

Antiplatelet

168
Q

Clopidogrel: action

A

Inhibits platelet aggregation at onset of clotting process (will prolong bleeding time)

169
Q

Clopidogrel: use

A

Prevention of acute MI/TIA/stroke
Prevention of MI recurrence
Cardiac stent surgery/post-op treatment
Prevention of post-op DVT

170
Q

Clopidogrel: complications

A 
Bleeding 
Diarrhea
Dyspepsia 
Pain
Flu-like symptoms
Headache
171
Q

Clopidogrel: client education

A

Discontinue 5-7 days before any surgery (including dental surgery)
Monitor for bleeding
Avoid herbs that affect coagulation

172
Q

Alteplase: class

A

Thrombolytic medication

173
Q

What else is alteplase called?

A

TPA

174
Q

Alteplase: action

A

Conversion of plasminogen to plasmin to dissolve already formed clots

175
Q

Alteplase: use

A

Acute MI
Massive PE
Acute ischemic stroke (MAIN USE)
Restore patency to central IV catheter

176
Q

Alteplase: considerations for administration

A

IV only
Give within 3 hours of onset of stroke symptoms for best results
Has no reversal agent - monitor closely

177
Q

Alteplase: contraindications

A 
Prior hemorrhagic stroke 
Internal bleeding 
History of ischemic stroke (thats not the current one)
Recent trauma
Severe hypertension
178
Q

Whole blood: use

A

Increase circulating blood volume as replacement for acute blood loss
Volume expansion in burn injury, dehydration, or shock

179
Q

Packed red blood cells: use

A

Severe anemia
Hemoglobinopathies
Hemolytic anemias
Erythroblastosis fetalis

180
Q

Platelets: use

A

Thrombocytopenia caused by aplastic anemia or chemo

Active bleeding with low platelet count

181
Q

Fresh frozen plasma: use

A 
Replacement of coagulation factors in things like..
Active bleeding
Burns 
Shock
Disseminated intravascular coagulation 
Warfarin reversal
Coagulation factor replacement
182
Q

Albumin: uses

A 
Hypovolemia 
Hypoalbuminemia 
Burns 
Adult respiratory distress
Cardiopulmonary surgery 
Hemolytic disease in newborns
183
Q

Chlorpromazine: class

A

Antipsychotic (first gen)/dopamine 2 receptor antagonist

184
Q

Chlorpromazine: action

A

Blocks dopamine, ACh, histamine, and norepinephrine receptors in the brain

185
Q

Chlorpromazine: uses

A

Positive manifestations of psychotic disorders like schizophrenia and bipolar

186
Q

What are the main adverse effect of first generation antipsychotics?

A

Extrapyramidal symptoms

187
Q

What is included in extrapyramidal symptoms?

A

Dystonia
Pseudoparkinsonism
Akathisia
Tardive dyskinesias

188
Q

What is included in acute dystonia?

A

Grimacing, involuntary eye movement, muscle spasms, laryngeal spasms

189
Q

What is akathisia?

A

Restlessness
Pacing
Having trouble standing still

190
Q

What are tardive dyskinesias?

A

Protrusion/rolling of the tongue
Sucking and smacking of the mouth and lips
Chewing motion with the mouth
Involuntary movement

191
Q

What are other complications of chlorpromazine?

A 
Neuroleptic malignant syndrome
Anticholinergic effects
Seizures
Sedation
Drowsiness
192
Q

What patient population has a high death risk with first generation antipsychotics?

A

Older dementia patients

193
Q

How long can full effects take for chlorpromazine and other first gen antipsychotics?

A

7-8 weeks

194
Q

What drug counteracts chlorpromazine?

A

Levodopa

195
Q

What herbal supplements should patients taking chlorpromazine be taught to avoid?

A

Kava and St. John’s wort

196
Q

Risperidone: class

A

Atypical antipsychotic

Dopamine 2 receptor and serotonin receptor antagonist

197
Q

Risperidone: action

A

Blocks serotonin in the brain (and also dopamine, histamine, norepinephrine, and acetylcholine)

198
Q

Risperidone: use

A 
Positive and negative manifestations of schizophrenia 
Levodopa induced psychotic episodes 
Bipolar
Impulse control disorders 
Psychosis
199
Q

Risperidone: complications

A 
Weight gain
Mild EPS
Agitation
Dizziness
Sedation
Anticholinergic effects 
Sexual dysfunction
200
Q

What are contraindications to risperidone?

A

Dementia

Alcohol use

201
Q

How long can therapeutic effects take with risperidone?

A

3 weeks

202
Q

What herbs should be avoided with risperidone?

A

Kava
Valerian
Chamomile

203
Q

Methylphenidate: class

A

CNS stimulant

204
Q

Methylphenidate: action

A

Raises levels of epinephrine and norepinephrine in the CNS

205
Q

Methylphenidate: use

A

ADHD
Conduct disorder
Narcolepsy
Obesity

206
Q

Methylphenidate: complications

A 
CNS stimulation
Decreased appetite and weight loss 
Chest pain, hypertension, dysrhythmias 
Tolerance/withdrawal
Toxicity
207
Q

What should clients be taught about taking methylphenidate?

A

Avoid alcohol or other stimulants
Monitor weight
Give last dose before 4 PM

208
Q

Methylphenidate: contraindications

A 
Substance abuse disorders
Hypertension 
Cardiovascular disorder
Anxiety/psychosis
Hyperthyroidism
209
Q

Bupropion: class

A

Norepinephrine selective reuptake inhibitor

210
Q

Bupropion: action

A

Blocks reuptake of norepinephrine and dopamine at CNS synapses

211
Q

Bupropion: use

A

ADHD and depression

212
Q

Bupropion: complications

A 
Weight loss
Decreased growth and appetite 
N/V
Suicidal ideation in kids and teens
Hepatotoxicity 
Seizure activity
213
Q

What drugs should not be taken concurrently with bupropion?

A

MAOIs

214
Q

How long can bupropion take for full effect?

A

Up to 6 weeks

215
Q

Imipramine: class

A

Tricyclic antidepressant

216
Q

Imipramine: action

A

Blocks reuptake of norepinephrine and serotonin, increasing their effects

217
Q

Imipramine: use

A

Depression
Autism
ADHD
OCD

218
Q

Imipramine: complications

A 
Increased suicide risk at start of treatment 
Sedation
Decreased seizure threshold
Toxicity 
Anticholinergic effects
219
Q

Client education for imipramine

A

Take daily
Don’t discontinue suddenly
Continue taking even when symptoms improve
Take at bedtime

220
Q

Fluoxetine and sertraline: class

A

Selective serotonin reuptake inhibitors

221
Q

Fluoxetine and sertraline: action

A

Blocks reuptake of serotonin and intensifies monoamine to increase concentration

222
Q

Fluoxetine and sertraline: use

A

Autism
OCD
Major depressive disorder
Bulimia

223
Q

Fluoxetine and sertraline: complications

A 
Serotonin syndrome 
Weight changes
Withdrawal
EPS
Suicidal ideation 
Sexual dysfunction
224
Q

What are some signs of serotonin syndrome?

A

Agitation
Confusion
Hallucinations

225
Q

When will maximum effects of SSRIs be seen?

A

Around 12 weeks after beginning treatment

226
Q

What other medications can cause serotonin syndrome if taken with SSRIs?

A

MAOIs
SNRIs
St John’s wort

227
Q

Timolol: class

A

Beta adrenergic blocker

Antiglaucoma

228
Q

Timolol: action

A

Decrease intraocular pressure by decreasing amount of aqueous humor produced

229
Q

Timolol: use

A

Primary open angle glaucoma

230
Q

Timolol: complications

A 
Stinging eyes
Dry eyes
Blurred vision
Photophobia
Heart issues
Bronchospasm
231
Q

Timolol: administration

A

One drop per eye
Hold pressure on nasolacrimal duct for 30-60 seconds to minimize systemic effects
May take 2-4 weeks for therapeutic effects

232
Q

What are contraindications for timolol?

A

Sinus bradycardia
AV heart block
Asthma
COPD

233
Q

Brimonidine: class

A

Alpha-2 adrenergic agonist/antiglaucoma

234
Q

Brimonidine: action

A

Decreased production and outflow of aqueous humor to decrease IOP

235
Q

Brimonidine: use

A

Topical treatment of primary open angle glaucoma

236
Q

Brimonidine: complications

A 
Stinging in eyes
Dilated pupils
Blurred vision
Dry mouth
Reddened sclera
Hypotension
237
Q

With brimonidine, what should the nurse closely monitor?

A

Blood pressure

238
Q

Latanoprost: class

A

Prostaglandin analog

Antiglaucoma

239
Q

Latanoprost: action

A

Reduce IOP by relaxing ciliary muscle to increase aqueous humor outflow

240
Q

Latanoprost: use

A

PAOG

Ocular hypertension

241
Q

Latanoprost: complications

A 
Bulging of ocular blood vessels 
Increased iris pigmentation
Blurred vision
Itching
Irritation 
Thicker/darker eyelashes
242
Q

Latanoprost: client education

A

Remove contacts before administering

Wait 5 minutes between eyes

243
Q

Mannitol: class

A

Osmotic agent

244
Q

Mannitol: action

A

Decrease IOP by making plasma hypertonic, drawing fluid from the anterior chamber of the eye

245
Q

Mannitol: use

A

Rapidly progressing acute closed angle glaucoma

Cerebral swelling from a stroke

246
Q

Mannitol: complications

A

Headache
N/V
Edema
Fluid/electrolyte imbalance

247
Q

What is primarily used to treat Otis media?

A

Amoxicillin

248
Q

What is the most serious adverse effect that amoxicillin can cause?

A

Anaphylaxis

249
Q

Otis externa is also known as

A

Swimmers ear

250
Q

What is usually used to treat Otis externa?

A

Ciprofloxacin with hydrocortisone ear drops

251
Q

What are best practices when giving ciprofloxacin with hydrocortisone ear drops?

A

Have the patient lay on side for 10 minutes to allow for distribution

Krystan: Semester Two Nursing School (13 decks)

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