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ATI Pharmacology Review Flashcards

1
Q

Antipsychotic Medications

A

Risperidone (Risperdal)
Olanzapine (Zyprexa)
Quetiapine (Seroquel)

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2
Q

What should the nurse monitor for in a patient receiving antipsychotic medications?

A
  • seizures
  • extrapyramidal symptoms
  • neuroleptic malignant syndrome
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3
Q

Neuroleptic Malignant Syndrome

A 
Reaction to antipsychotic drugs
-fever
-tremors
-elevated blood pressure
-tachycardia
(If untreated it is potentially fatal)
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4
Q

What should the nurse monitor for in a patient receiving olanzapine?

A

The nurse should monitor for orthostatic hypotension.

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5
Q

Bipolar Disorder Medications

A

Lamotrigine (Lamictal)
Lithium (Lithobid)
Divalproex (Depakote)

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6
Q

What should the nurse monitor in a patient receiving lithium?

A

The nurse should monitor lithium levels. Therapeutic range is 0.5 - 1.5 mEq/L.

The nurse should monitor intake/output.

Monitor sodium levels. If sodium levels rise, it increases risk for toxicity.

Monitor for seizures and arrhythmias.

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7
Q

What are the signs of lithium toxicity?

A
  • vomiting
  • diarrhea
  • drowsiness
  • decreased coordination
  • muscle weakness
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8
Q

Selective Serotonin Reuptake Inhibitors (SSRIs)

A 
Citalopram (Celexa)
Escitalopram (Lexapro)
Paroxetine (Paxil)
Fluoxetine (Prozac)
Sertaline (Zoloft)
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9
Q

What are SSRIs used to treat?

A

Depression

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10
Q

What should the nurse monitor in patients taking SSRIs?

A
  • insomnia
  • drowsiness
  • constipation
  • nausea, sweating
  • tremors
  • headache
  • sexual dysfunction.
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11
Q

MAOIs Inhibitors

A

Phenelzine (Nardil)

Tranylcypromine (Parnate)

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12
Q

What are MAOIs used to treat?

A

Depression

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13
Q

What should the nurse monitor for in patients receiving MAOIs?

A

-seizures and hypertensive crisis.

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14
Q

What foods must a patient receiving MAOIs avoid?

A

These patients must avoid foods that contain tyramine.

Patients cannot eat cheeses, processed meats, wine, yogurt, beer, chocolate.

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15
Q

NSAIDs

A

Ibuprofen (Advil; Motrin)

Acetominiphen (Tylenol)

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16
Q

What should the nurse monitor in a patient receiving NSAIDS?

A
  • GI irritation
  • GI bleeding
  • Renal failure
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17
Q

What should the nurse monitor for in a patient receiving acetaminophen?

A
  • s/s of hepatotoxicity such as
  • sweating
  • nausea, vomiting
  • diarrhea
  • anorexia
  • abdominal pain
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18
Q

What is the antidote for acetaminophen overdose?

A

acetylcysteine (Mucomyst)

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19
Q

How much acetaminophen can be given in 24 hours?

A

Do not administer more than 4g of acetaminophen per 24 hours.

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20
Q

What is the general antidote for oral non-narcotic analgesics?

A

Activated charcoal.

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21
Q

Narcotic Analgesics (Opioids)

A 
Codeine
Morphine
Oxycodone (OxyContin)
Hydromorphone (Dilaudid)
Fentanyl (Duragesic)
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22
Q

What should the nurse monitor for in patients receiving opioid analgesics?

A
  • hypotension
  • respiratory depression
  • nausea, vomiting
  • constipation.
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23
Q

What is the antidote to opioid overdose?

A

Naloxone (Narcan)

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24
Q

Antimigraine Medications

A

Usually end in -triptan.

Sumatriptan (Imitrex)
Eletriptan (Replax)
Zolmitriptan (Zomig)

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25
Q

What should the nurse monitor for in patients receiving antimigraine medications?

A
  • dizziness
  • vertigo
  • paresthesias
  • myalgias
  • chest tightness
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26
Q

What can occur when taking Sumatriptan (Imitex)

A

MI

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27
Q

Antiparkinson Medications

A
  • Benztropine mesylate (Cogentin)
  • Carbidopa/levodopa (Sinemet)
  • Pramipexole (Mirapex)
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28
Q

When is carbidopa/levodopa (Sinemet) given?

A

It needs to be given before meals and at bedtime for the best effects.

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29
Q

What should the nurse monitor in patients receiving Sinemet?

A
  • constipation
  • dry mouth
  • dizziness, drowsiness
  • confusion
  • insomnia
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30
Q

Sleeping Agents

A

Zolpidem (Ambien)
Temazepam (Restoril)
Eszopiclone (Lunesta)
Ramelteon (Rozerem)

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31
Q

What side effects can occur from sleeping agents?

A

Daytime drowsiness, dizziness.

Use cautiously in older adults.

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32
Q

What should the nurse teach to patients taking sleeping agents?

A

The nurse should teach alternative sleep aids such as keeping the room dark and quiet. Avoiding alcohol/caffeine/nicotine, and don’t exercise before bedtime.

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33
Q

Antiseizure Medications

A
  • Divalproex (Depakote): Bipolar disorder
  • Phenytoin (Dilantin)
  • Gabapentin (Neurontin): neuropathic pain treatment
  • Carbamazepine (Tegretol)
  • Diazepam (Valium):
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34
Q

What should the nurse monitor in patients taking antiseizure medications?

A
  • confusion
  • drowsiness
  • ataxia

The nurse should monitor carbamazepine and phenytoin levels and CBC for toxicity or aplastic anemia and agranulocytosis.

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35
Q

What are the therapeutic levels of carbamazepine?

A

6-12mcg/ml.

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36
Q

What are the therapeutic levels of phenytoin?

A

10-20mcg/ml.

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37
Q

What adverse effects can phenytoin cause?

A

Phenytoin can cause gingival hyperplasia.

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38
Q

Toxicity symptoms of phenytoin

A
  • nystagumus
  • ataxia
  • confusion, dizziness
  • nausea
  • Stevens-Johnson syndrome
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39
Q

If phenytoin is given IV, what should the nurse watch for?

A

The nurse should monitor for dysrhythmias.

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40
Q

When should phenytoin be given if given PO?

A

Phenytoin should be given before or after tube feedings.

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41
Q

Anti-Tuberculosis Agents

A
  • Isonicotinic acid (Isoniazid)
  • Ethambutol (Myambutol
  • Nicotinamide (Pyrazinamide)
  • Rifampin (Rifadin)
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42
Q

What are the adverse effects of isonicotinic acid (Isoniazid)?

A

-pyridoxine deficiency

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43
Q

What should patients taking isonicotinic acid (isonizaid) be prescribed to avoid pyridoxine deficiency

A

Patients should be prescribed vitamin B6 to avoid this.

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44
Q

What adverse effects does ethambutol have?

A

-decreases in color vision

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45
Q

What adverse effects does rifampin cause?

A

-body fluids such as urine, sweat, and saliva to be red/orange color

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46
Q

What should the nurse monitor for in a patient receiving antituberculosis agents?

A

The nurse should monitor for signs of gout and hepatitis.

Check LFTs and uric acid levels.

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47
Q

How long are antituberculosis medications used for?

A

These medications are used in combination for 12 to 18 months.

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48
Q

Bacteriostatic/Bactericidal Medications

A 
Gentamycin (Garamycin)
Vancomycin (Vancocin)
Metronidazole (Flagyl)
Ampicillin/clavulanate (Augmentin)
Azithromycin (Zithromax)
Cefazolin (Ancef)
Cephalexin (Keflex)
Erythromycin (E-Mycin)
Levofloxacin (Levaquin)
Penicillin V (Pen-Vee-K)
Trimethorpim/sulfamethoxazole (Bactrim)
Tetracycline (Tetracap)
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49
Q

What are general adverse effects of antibiotics?

A

Antibiotic use can result in bacterial overgrowth resulting in yeast infections or GI disturbances.

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50
Q

What can occur when antibiotics are administered too rapidly?

A

increase risk of hypotension

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51
Q

What adverse effects do gentamycin and vancomycin have?

A

They are nephrotoxic and ototoxic

Monitor for ringing of the ears

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52
Q

What adverse effects can metronidazole have?

A

Seizures

-patient should avoid alcohol

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53
Q

What adverse effects does tetracycline have?

A

Patients should avoid sun exposure due to increased photosensitivity.

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54
Q

Antihistamines

A

Diphenhydramine (Benadryl)

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55
Q

What is diphenhydramine used for?

A

It is used to treat anaphylaxis, seasonal allergies, and allergic skin rashes.

It is also used as a mild sleep sedative and for motion sickness.

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56
Q

What should the nurse monitor for in a patient taking diphenhydramine?

A
  • drowsiness
  • anorexia
  • dry mouth

-may causes falls in elderly patients

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57
Q

Antitussive

A

A type of medication used to relieve coughing. (Dextromethorphan)

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58
Q

Expectorant

A

A type of medication used to help remove mucous from airways. (Guafenesin:)

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59
Q

Decongestant

A

Decongestant

Reduces nasal congestion and swelling. (Pseudoephedrine)

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60
Q

Glucocorticoids

A

Prednisone (PO)

Methylprednisolone (IV)

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61
Q

When are glucocorticoids used?

A

Glucocorticoids produce anti-inflammatory and immunosuppressive effects.

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62
Q

What are the adverse effects of glucocorticoids?

A
  • hyperglycemia
  • poor wound healing
  • decreased immune function
  • increased risk of infection
  • -osteoporosis
  • sodium/water retention
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63
Q

Can glucocorticoids be stopped abruptly?

A

No, glucocorticoid treatment needs to be tapered off prior to discontinuing.

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64
Q

Inhaled Glucocorticoids

A
  • Albuterol (beta 2 agonist adrenergic)
  • Proventil (Salbutamol)
  • Ipratropium (Atrovent)
65
Q

What should the nurse teach the patient after taking inhaled glucocorticoids?

A

The nurse should teach the patient to rinse their mouth after each use to reduce risk for candidiasis.

In addition, they should dry the chamber after each use.

66
Q

What should the nurse monitor in a patient receiving Proventil (Salbutamol)?

A

increased heart rate and tremors.

67
Q

How does ipratropium work as a respiratory agent?

A

Ipratropium relaxes bronchial smooth muscle. It is slower acting than albuterol and does not produce tachycardia.

68
Q

What is levothyroxine (Synthroid) used for?

A

It is used to improve symptoms of hypothyroidism.

69
Q

How long must patients receive levothyroxine?

70
Q

What should the nurse and patient monitor for when receiving levothyroxine?

A

symptoms of hyperthyroidism, insomnia, irritability, nervousness, tachycardia, and cardiovascular collapse.

TSH levels should be monitored peridocally

71
Q

At what time should levothyroxine be taken?

A

Levothyroxine should be taken before breakfast.

72
Q

Rapid Acting Insulin

A

Lispro (Humalog)

73
Q

When should a patient take lispro?

A

The patient should take lispro 15 minutes prior to eating.

74
Q

Regular Insulin

75
Q

How long does it take for humulin R to peak?

76
Q

NPH Insulin

77
Q

How long does it take for humulin N to peak?

A

6-12 hours

78
Q

Long Acting Insulin

A

Glargine (Lantus)

79
Q

How often is glargine given?

A

Glargine is given once a day. This insulin lasts for 24 hours.

80
Q

What are the signs and symptoms of hypoglycemia?

A
  • cool, clammy
  • confused
  • weakness
  • palpitations
  • hunger
81
Q

What are the signs and symptoms of hyperglycemia?

A
  • dry, flushed skin
  • polyuria
  • polydipsia
82
Q

What should the nurse monitor and teach the patient about when taking insulin?

A

about blood glucose monitoring

83
Q

What is the antidote to hypoglycemia?

A
  • dextrose tab under the tongue or eat something contain sugar
  • dextrose 50% IV
  • glucagon IM
84
Q

Oral Hypoglycemics

A

Metformin (Glucophage)
Glipizide (Glucotrol)
Glyburide (Micronase)

85
Q

What are the adverse effects of oral hypoglycemics?

A

-diarrhea, bloating

  • liver dysfunction
  • photosensitivity
  • hypoglycemia
  • aplastic anemia
86
Q

What allergies should the nurse assess for prior to administering oral hypoglycemic?

A

sulfonamide allergys

87
Q

What should the nurse monitor when administering oral hypoglycemic?

A

The nurse should monitor CBC and Hg A1C

88
Q

Cholesterol Absorption Inhibitors

A

Ezetimibe (Zetia)

works in small intestine by decreasing cholesterol absorption in digestive tract

89
Q

What should the nurse monitor for in patients receiving ezetimibe?

A

angioedema

90
Q

Hyperlipidemics

A

Usually end in -statin.

Atorvastatin (Lipitor)
Simvastatin (Zocor)
Lovastatin (Mevacor)

These medications lower cholesterol levels.

91
Q

What food should patients receiving hyperlipidemics avoid?

A

-anything containing grapefruit as it decreases metabolism

92
Q

What should the nurse monitor in patients receiving hyperlipidemics?

A
  • muscle pain (myalgia)
  • rhabdomyolysis

-liver function test should be checked before and during therapy

93
Q

Rhabdomyolysis

A

Breakdown of muscle tissue that leads to release of muscle fiber into the blood.

Causes muscle pain and dark red or cola colored urine.

If untreated it can lead to kidney failure and death.

94
Q

Anticoagulants

A

Heparin

Warfarin (Coumadin)

95
Q

What are the indications for heparin?

A
  • pulmonary embolisms
  • MI
  • DVT
  • CVA
96
Q

What are therapeutic blood levels for heparin?

A

Therapeutic levels are generally 1.5 - 2.5 times normal control level

aPTT (1.5-2.5)

97
Q

What are the adverse effects of heparin?

A
  • bleeding
  • anemia
  • thrombocytopenia
98
Q

What should the nurse monitor in patients receiving heparin?

A
  • aPTT
  • PTT
  • hematocrit
99
Q

What is the antidote of heparin?

A

protamine sulfate

100
Q

What is enoxaparin (Lovenox)?

A

Enoxaparin is a low molecular weight heparin. It is similar to heparin but has a longer half-life and causes less thrombocytopenia.

101
Q

What are the indications for warfarin?

A
  • venous thrombus
  • pulmonary embolism
  • MI
  • A-fib
  • prosthetic valve replacement
102
Q

What are the therapeutic levels of warfarin?

A

INR 0.7-1.8

2.0-3.0

103
Q

What should the nurse monitor in patients receiving warfarin?

A
  • PT (11-12.5 sec)

- INR

104
Q

What is the antidote to warfarin?

105
Q

Antidysrhythmics

A

Digoxin (Lanoxin)

Calcium channel blockers and beta blockers are also used to treat dysrhythmias.

106
Q

What does Digoxin treat

A
  • chronic HF
  • A-fib
  • proxysmal atrial tachycardia
107
Q

What is the digoxin therapeutic level?

108
Q

What are the signs and symptoms of digoxin toxicity?

A
  • abdominal pain
  • anorexia
  • nausea, vomiting
  • visual disturbances
  • bradycardia
109
Q

What must the nurse do before administering digoxin?

A

The nurse must take the patient’s apical heart rate.

110
Q

When would a nurse hold administering digoxin?

A

If the patient’s apical HR is below 60 or above 100.

111
Q

What should the nurse monitor in a patient receiving digoxin?

A

-potassium level

a decrease in potassium precipitates digoxin toxicity

112
Q

What is given if the patient is suffering from digoxin toxicity?

A

The patient receives digoxin immune fab (Digibind)

113
Q

What are nitrates used for?

A

They are used to decrease angina pain.

114
Q

Nitrates

A

Nitroglycerin

115
Q

When would a patient take nitroglycerin?

A

A patient experiencing angina, MI (given IV), or suffering from chronic heart failure.

116
Q

How do nitrates work?

A

Nitrates lower blood pressure which improves blood flow to the myocardium.

117
Q

When a patient is having an angina episode, what is the protocol for taking sublingual nitroglycerin?

A

The patient should take one tab under the tongue every 5 minutes up to three times.

If no relief is acquired, they should immediately call 911 and get transported to the ER.

118
Q

What should the nurse monitor in patients receiving nitrates?

A
  • hypotension
  • headache
  • rebound tachycardia due to vasodilation
119
Q

What teaching should the nurse include in patients taking cardiac medications?

A

Education should include having the patients changing position slowly, reporting
-facial swelling
-dyspnea
-dizziness
-signs of digoxin toxicity, weight loss or gain
and change in mental status

120
Q

What is an indication that nitroglycerin is working

A

A headache or tingling under the tongue confirms that nitroglycerin in is working.

121
Q

Where should nitroglycerin be stored?

A

A dark container and replaced every 6 months.

122
Q

Diuretics

A

These are used for both antihypertensive effects and to control edema.

123
Q

What should the nurse monitor in a patient receiving diuretics?

A
  • digoxin and lithium toxicity
  • hyperglycemia
  • electrolytes
  • dehydration
  • orthostatic hypotension
124
Q

In what type of patient should diuretics be used cautiously?

A

Patients with renal impairment

125
Q

Thiazide Diuretics

A

Hydrochlorothiazide (HCTZ)

126
Q

Loop Diuretics

A

Furosemide (Lasix)

Bumetanide (Bumex)

127
Q

What should the nurse monitor in patients receiving loop diuretics?

A
  • hypotension
  • ototoxicity
  • potassium depletion
128
Q

What allergy should the nurse check for in a patient receiving loop diuretics?

A

if they are allergic to sulfa based medications

129
Q

Potassium-Sparing Diuretics

A

Spironolactone (Aldactone)

130
Q

What are potassium-sparing diuretics used for?

A

They are used to treat edema.

131
Q

What should the nurse monitor for in patients receiving potassium-sparing diuretics?

A

Signs of hyperkalemia.

132
Q

Osmotic Diuretics

A

Mannitol (Osmitrol)

133
Q

What are osmotic diuretics used for?

A

patients with increased intracranial pressure

-acute renal failure

134
Q

What route are osmotic diuretics given in?

A

Osmotic diuretics are given IV with a filter.

135
Q

What should the nurse monitor for in patients receiving osmotic diuretics?

A

monitor IV site and for CONFUSION

136
Q

Potassium Replacement

A

Potassium (K-Dur) is a supplement given with loop diuretics to prevent hypokalemia.

137
Q

Hyperkalemia Treatment

A

Sodium polystyrene sulfonate (Kayexalate) is given to treat hyperkalemia.

138
Q

ACE Inhibitors

A

Usually end in -pril.

Enalapril (Vasotec)
Lisinopril (Zestril)
Captopril (Capoten)

139
Q

What are adverse effects of ACE Inhibitors?

A
  • hypotension
  • dry cough
  • angioedema
140
Q

What should the nurse monitor for in patients receiving ACE Inhibitors?

A

renal function

141
Q

Treatment for angioedema

A

epinephrine

142
Q

ARB Inhibitor

A

Usually end in -artan.

Losartan (Cozaar)
Valsartan (Diovan)
Irbesartan (Avapro)

143
Q

How do ARB Inhibitors work?

A

These work by blocking angiotensin II receptors in the angiotensin loop.

144
Q

What should the nurse monitor in a patient receiving ARB Inhibitors?

A
  • potassium level

- renal function

145
Q

What adverse effect may occur from ARB Inhibitors?

A

Angioedema

146
Q

Calcium Channel Blockers

A

Verapamil (Calan)
Dilitiazem (Cardizem)
Amlodipine (Norvasc)
Nifedipine (Procardia)

147
Q

What is a common adverse effect caused by verapamil (Calan)?

A

Constipation

148
Q

What should the nurse monitor in a patient receiving calcium channel blockers?

A

Edema and hypotension

149
Q

Alpha 1 blocker

A

Clonidine (Catapres)

150
Q

What affects do alpha 1 blockers cause?

A

They cause systemic vasodilation by directly acting on smooth muscle of arteries.

151
Q

What adverse effects can alpha 1 blockers cause?

A

hypotension
dizziness
sedation

152
Q

In what form are alpha 1 blockers usually administered?

A

Alpha 1 blockers are generally administered as a patch and are changed once a week.

153
Q

Betablockers

A

Usually end in -olol.

Propranolol (Inderal)
Atenolol (Tenormin)
Metoprolol (Lopressor)

154
Q

What additional effects of betablockers should the nurse monitor?

A

broncho constriction and bronchospasms

155
Q

In what population should betablockers be used cautiously in?

A

asthma patients

Beta blockers can mask tachycardia in patients suffering from hypovolemia and hypoglycemic symptoms seen in diabetic patients.

156
Q

Antihypertensives

A
  • Betablockers
  • Alpha 1 Blockers
  • Calcium Channel blockers
  • ACE Inhibitors
  • ARB Inhibitors
  • Diuretics
157
Q

What do antihypertensives do

A

Affect both the blood pressure and the rhythm of the heart.

lowers BP

158
Q

Common side effect of antihypertensives

A

orthostatic hypotension

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