Ch 29

Question 1

__ appears to have an effect on muscle tone, thereby REDUCING muscle spasm

Answer 1

Cyclobenzaprine

Question 2

__ contraindicated in clients with a recent MI, cardiac conduction disorders, and hyperthyroidism

Answer 2

Cyclobenzaprine

Question 3

__ contraindicated during lactation and in clients with active hepatic disease

Answer 3

Oral dantrolene

Question 4

CNS depressants (4) and effect of interaction with skeletal muscle relaxants

Answer 4

Alcohol, antihistamines, opiates, sedatives
Increased CNS depressant effect

Question 5

These drugs have properties to produce immunosuppression, which in turn decreases the body’s autoimmune response. Therefore, in RA treatment, ___ are useful for their immunosuppressive ability

Answer 5

DMARDs

Question 6

DMARDs are contraindicated in
SATA (5) & should not take methotrexate

Answer 6

Hypersensitivity
Renal insufficiency
Liver disease
Alcohol abuse
Pancytopenia
Folate deficiency

Question 7

__ act primarily on the bone by inhibiting normal and abnormal bone resorption. This results in increased bone mineral density, reversing the progression of osteoporosis

Answer 7

Bisphosphonates

Question 8

Interaction of bisphosphonate with ASA

Answer 8

Increased risk of GI bleeding

Question 9

__ reduces the production of urine acid, thereby decreasing serum uric acid levels and the deposit of urate crystals in joints

Answer 9

Uric acid inhibitors

Question 10

Adverse reactions of __ include severe N/V and bone marrow depression, therefore it is used as a SECOND line of treatment when other drugs fail

Answer 10

Colchicine

Question 11

Colchicine is contraindicated in clients with serious (5)

Answer 11

GI, renal, hepatic, cardiac disorders
Blood dyscrasias

Question 12

Anaphylactic reactions have been seen with ___ therefore __ & __ are used to PREMEDICATE clients

Answer 12

Pegloticase
Antihistamines & corticosteroids

Question 13

When bisphosphonates are administered __ levels are monitored before, during, and after therapy

Answer 13

Serum calcium levels

Question 14

It is important to be alert to reactions such as (4)

Answer 14

Skin rash
Fever
Cough
Easy bruising

Question 15

Specific client complaints that may seem unrelated to drug therapy (3)

Answer 15

Visual changes
Tinnitus
Hearing loss

Question 16

Particular attention is paid to this adverse reaction because __ may occur

Answer 16

Visual changes
Irreversible retinal damage

Question 17

__ is potentially toxic. Therefore, monitor lab tests closely for adverse reactions such as __ & __

Answer 17

Methotrexate
Thrombocytopenia & leukopenia

Question 18

(3) studies monitored with methotrexate every __

Answer 18

Hematology
Liver function
Renal function
1-3 months

Question 19

When taking uric acid inhibitors encourage __. Daily amount should be __ to excreted urates & prevent urate acid stone formation in GI tract

Answer 19

Liberal fluid intake
2L/day

Question 20

May need to administer iv fluids if oral intake is not __

Answer 20

3000L/day

Question 21

Take drug with how many oz of water

Answer 21

6-8

Question 22

Take drug and remain in what position

Answer 22

Upright for at least 30 min

Question 23

DMARDs, uric acid inhibitors, and skeletal muscle relaxants are taken with or __ to minimize gastric distress

Answer 23

Immediately after meals

Question 24

Bisphosphonates are taken with __ and cannot eat or drinks __ after taking and must be in __ position

Answer 24

6-8 oz plain water
30 mins
Upright position

Question 25

Client may not see a therapeutic response until __ of therapy

Answer 25

3-6 weeks

Question 26

When taking drugs to treat gout, notify provider when __ occurs

Answer 26

Skin rash

Question 27

Skeletal muscle relaxants (4) (1 trade)

Answer 27

Baclofen Cyclobenzaprine Methocarbamol (Robaxin) Orphenadrine

Question 28

Baclofen uses

Answer 28

Spasticity caused by MS, spinal cord injuries (intrathecal administration for sever spasticity) Typically orally

Question 29

Cyclobenzaprine dosage

Answer 29

10-60 mg/ orally in divided doses

Question 30

Route of administration for orphenadrine and frequency

Answer 30

IV or IM q12hr

Question 31

DMARDs (4) (2 trades)

Answer 31

Hydroxychloroquine (Plaquenil) Leflunomide Methotrexate Sulfasalazine (Azulfidine)

Question 32

Uses for hydroxychloroquine (Plaquenil)

Answer 32

RA, antimalarial

Question 33

Uses for lefluomide and adverse reaction

Answer 33

RA Alopecia

Question 34

Methodextrate uses and adverse reactions

Answer 34

RA Stomatitis

Question 35

DMARDs biologics SATA (5)

Answer 35

Abatacept Adalimumab (Humira) Anakinra (Kineret) Etanercept (Enbrel) Inflximab (Remicade)

Question 36

Adverse reaction of anakinra

Answer 36

Pancytopenia

Question 37

Dosage range for adalimumab (Humira)

Answer 37

40mg subcut EVERY OTHER WEEK

Question 38

Bisphosphonates (2) (2 trades)

Answer 38

Alendronate (Fosamax) Risedronate (Actonel)

Question 39

Uses for colchicine

Answer 39

Relief of ACUTE attacks of gout, PREVENTS of gout attacks

Question 40

Uses for allopurinol

Answer 40

Management of symptoms of gout

Question 41

Adverse reactions of colchicine

Answer 41

Bone marrow depression

Question 42

Uses for pegloticase

Answer 42

Management of symptoms of gout

Question 43

Adverse reactions of pegloticase

Answer 43

Disease flare up, infusion reaction

Question 44

Uric acid inhibitors (3) (1 trade)

Answer 44

Allopurinol (Zyloprim) Colchicine Pegloticase