Chapters 21, 24, and 25

Question 1

This uric acid biosynthesis inhibitor is used in patients with severe arthritis.

Answer 1

Febuxostat

Question 2

This drug works by inhibiting prostaglandin synthesis like traditional NSAIDS, but contains greater antiinflammatory and analgesic properties

Answer 2

ketorolac (toradol)

Question 3

What are the five characteristics of inflammation

Answer 3

1. redness
2. swelling (edema)
3. heat
4. pain
5. loss of function

Question 4

This drug works by relieving muscle spasms through a central action

Answer 4

cyclobenzaprine (flexeril)

Question 5

What are the characteristic traits of myasthenia gravis?

Answer 5

Weakness and fatigue of skeletal muscles, dysphagia, dysarthria, respiratory muscle weakness

Question 6

What is a self-administered pain relief system administered through an IV?

Answer 6

PCA (patient-controlled analgesia)

Question 7

This drug works by blocking reabsorption of uric acid

Answer 7

Probenecid (benemid)

Question 8

Name precautions for a patient taking ibuprofen

Answer 8

1. don’t take on an empty stomach
2. don’t drink alcohol
3. don’t consume with aspirin or tylenol
4. must stop within 7 days of a procedure

Question 9

What are the functions of COX-1 and COX-2?

Answer 9

COX-1 protects the stomach lining and regulates blood platelets COX-2 triggers inflammation and pain

Question 10

What are the major concerns in a patient taking cyclobenzaprine (flexeril)

Answer 10

1. respiratory depression - leads to hypoxia, altered level of consciousness.
2. sedation - contributes to respiratory depression, and risk for aspiration

Question 11

What medications are utilized to control myasthenia gravis?

Answer 11

ACHE inhibitors (cholinesterase inhibitors) to allow more acetylcholine to activate cholinergic receptors and promote muscle contraction

Question 12

Who would be appropriate to receive a fentanyl patch?

Answer 12

Not helpful in acute or postoperative pain. Utilized for patients with chronic pain.

Question 13

What is the antidote for an acetaminophen (Tylenol) overdose?

Answer 13

acetylcysteine (Mucomyst)

Question 14

This drug works by selectively blocking COX-2

Answer 14

Celecoxib (Celebrex)

Question 15

What occurs when COX-1 and -2 are inhibited?

Answer 15

COX-1: decreased platelet aggregation and decreased protection of stomach lining

COX-2: reduction in pain and fever, suppression of inflammation

Question 16

What is the antidote for opiates?

Answer 16

Naloxone (Narcan)

Question 17

How can you tell if a patient is in a cholinergic or myasthenic crisis?

Answer 17

If medication is given, and symptoms worsen, cholinergic (treatment is atropine)

If the symptoms improve, myasthenic

Question 18

This drug works by causing vasoconstriction of cranial arteries

Answer 18

Sumatriptan (Imitrex)

Question 19

Which lab is most important to assess for a patient taking acetaminophen tablets regularly

Answer 19

LFT’s (AST, ALT, ALP)

Question 20

This drug works by binding to TNF - blocks from attaching to TNF receptors on synovial cell surface

Answer 20

Infliximab (Remicade)

Question 21

Can you administer aspirin to a child

Answer 21

You should never administer aspirin to a child exhibiting flu or virus symptoms due to risk of Reye’s syndrome.

Question 22

What is the antidote for benzodiazepines

Answer 22

Flumazenil (Romazicon)

Question 23

This drug works by preventing destruction of acetylcholine through transmission of neuromuscular impulses.

Answer 23

Pyridostigmine (Mestinon)

Question 24

When is the most appropriate time to take Sumatriptan (Imitrex)

Answer 24

As soon as the onset of begins

Question 25

Your patient just received morphine after a MVA (motor vehicle accident), and is now complaining of itchiness. as the nurse, what is your best response?

Answer 25

This is actually very common with morphine, and does not indicate an allergic reaction. If the patient had concurrent hives, then that would indicate an allergic reaction. If the pruritus doesn't settle, the patient may b e able to take diphenhydramine.

Question 26

What are the major concerns for a patient taking immunomodulators?

Answer 26

1. immune suppression (need to ensure patient washes hands, avoids crowds and those ill)

Question 27

Name some teaching points for a patient taking aspirin

Answer 27

1. higher risk of bleeding - no contact sports, electric razor, soft-bristle toothbrush 2. must stop taking one week before dental procedures or surgical procedures. 3. do not take with alcohol 4. notify HCP should tinnitus develop

Question 28

How long until you begin to see signs of withdrawal from opiates?

Answer 28

Between 24-48 hours after the last dose received

Question 29

Which drug is an analgesic, with effects 6x more potent than morphine

Answer 29

hydromorphone (Dilaudid)

Question 30

Why is it important to be on a bowel regimen for a patient taking narcotics?

Answer 30

Opiates cause constipation, this can be severe and must be managed appropriately as this can cause a sequel of events to occur.