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pharmacology > Condensed > Flashcards

Condensed Flashcards

1
Q

Indications for methadone

A

heroine withdrawal

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2
Q

Indication for disulferam

A

remaining sobriety of alcohol

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3
Q

6 rights of med administration

A

patient, dose, time, route, drug, documentation

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4
Q

Medication reconciliations can be used to prevent

A

drug interactions

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5
Q

We should identify patients using

A

two identifiers

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6
Q

Normal magnesium levels

A

1.5-2.5

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7
Q

Nursing interventions for magnesium sulfate

A

assess DTR (absence = toxicity) and administer calcium gluconate

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8
Q

What is ferrous sulfate

A

iron

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9
Q

Ferrous sulfate patient teaching

A

take liquid iron through straw and rinse mouth, take with vitamin C. avoid coffee, dairy, tea, antacids. Dark stools are normal. Increase fiber fluids and exercise

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10
Q

How to recognize beta blockers

A

-olol

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11
Q

Mechanism of actions

A

block beta 1 (heart) and/or 2 (lung) receptors

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12
Q

Indications for beta blockes

A

HTN, tachycardia

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13
Q

Nursing Considerations

A

monitor HR and hold if less than 50. HR can block signs of hyperglycemia. Monitor for SI and sexual dysfunction

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14
Q

Those on any antihypertensive drugs are at risk of ?

A

rebound hypertension, orthostatic hypotension

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15
Q

How to recognize benzodiazepines

A

lam and pam

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16
Q

Indications for benzodiazepines

A

generalized anxiety disorder, panic disorder, seizures (status epilepticus), induce sedation

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17
Q

Side effects of benzodiazepines

A

REM rebound hangover

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18
Q

adverse effects of benzodiazepines

A

toxicity, withdrawal symptoms, paradoxical response, anterograde amnesia

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19
Q

Withdrawal symptoms of benzodiazepine s

A

MATH IS TIDY
muscle twitches, anxiety, tachycardia, HTN, insomnia, seizures, tremors, irritability, diaphoresis

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20
Q

Nursing considerations for benzodiazepines

A

flumazenil is antidote, monitor LOC, medication reconciliation (opioid risk)

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21
Q

Patient teaching

A

taper off, avoid alcohol CNS depressants opioids, take at night, avoid grapefruit juice, do not take more than 7-10 days

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22
Q

Non-benzodiazepines

A

zolpidem, zaleplon, the other one

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23
Q

Indications for zolpidem

A

acute insomnia

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24
Q

What drug is a hydanoitn

A

phenytoin

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25
Q

Indication for phenytoin

A

seizures

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26
Q

Adverse effects of phenytoin

A

gingival hyperplasia, osteomalacia, stevens-johnson, blood dyscrasias

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27
Q

Patient teaching for phenytoins

A

take at same time each day, avoid OTC meds and herbs, increase vitamin D and calcium, good oral hygeine and frequent dental visits

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28
Q

Carbamazepine indications

A

seizures

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29
Q

therapeutic drug level for carbamazepine

A

4-12

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30
Q

Adverse effects of carbamazepine

A

blood dyscrasias, SI, hepatotoxicity, stevens johnson

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31
Q

bbw with carbamazepine

A

heart failure, fluid overload, blood dyscrasias

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32
Q

nursing considerations for carbamazepine

A

CBC, SI, serum drug levels. edema and lung sounds. EKG. LFT

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33
Q

Donepezil indications

A

alzheimers and dementia

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34
Q

Nursing considerations for donepezil

A

ask orientation (person, place, time) to evaluate effectiveness…… can also cause cholinergic crisis so keep atropine and crash cart near

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35
Q

Indications for carbidopa levodopa

A

parkinsons

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36
Q

Patient teaching for carbidopa levodopa

A

avoid protein but take with food. maintain good oral hygiene. dark urine is normal. avoid multivitamins

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37
Q

Indication for neostigmine

A

myasathenia gravis

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38
Q

Side effect of neostigmine

A

sludges, muscarinic stimulation

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39
Q

adverse effect of neostigmine

A

cholinergic crisis, myasthenic crisis

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40
Q

s/s of cholinergic crisis

A

SLUDGES, bradycardia, dyspnea, meiosis (pupil constriction)

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41
Q

antidote for cholinergic crisis

A

atropinewhat

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42
Q

what drug can be used to determine cholinergic crisis or myasthenic crisis

A

edrophonium

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43
Q

What are the central acting muscle relaxants

A

baclofen, cyclobenzapine, dantrolene

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44
Q

Inidctions for central acting muscle relaxants

A

muscle spasms / strain or sprain of muscle

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45
Q

Evaluation for central acting muscle relaxants

A

decreased pain or increased ROM = effectiveness

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46
Q

What are the neuromuscular blocking drugs

A

vancuronium, pancuronium, succinylcholine

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47
Q

Adverse effect of neuromuscular blocking drug

A

malignant hyperthermia (rigid muscles, high fever, tachycardia, diaphoresis)

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48
Q

Treatment of malignant hyperthermia

A

dantrolene (O2 @ 100, stop administration, cooling blankets)

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49
Q

What drugs are typical antipsychotics

A

chlorpromazine, haloperidol

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50
Q

Indications for antipsychotics

A

schizophrenia, aggressive patients, drug induced psychosis, manic states

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51
Q

Adverse effects of typical antipsychotics

A

neuroleptic malignant syndrome, acute dystonia, tardive dyskinesia, akathisia, parkinsonism (these are extrapyramidal symptoms)

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52
Q

symptoms of neuroleptic malignant syndrome

A

rigid muscles, BP fluctuations, diaphoresis, tachycardia, sudden high grade fever, altered LOC

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53
Q

what symptom of typical antipsychotics has spasms of tongue, neck, and back

A

acute dystonia

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54
Q

Atypical antipsychotic drugs

A

clonzapine, olanzapine, respiridone

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55
Q

Side and adverse effects of atypical antipsychotics

A

DAW HADES
diabetes, anticholinergic, weight gain, hypercholesterolemia, agitation, dizziness elevated prolactin, sexual dysfunction (hypotension) (can cause extrapyramidal symptoms but not as much)

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56
Q

Patient teaching of atypical antipsychotics

A

report s/s of diabetes mellitus (3 P’s), report gynecomastia, galactorrhea, seizures, abnormal movements. anticholinergic teaching. hypotensive teaching.

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57
Q

Adverse effects of benzodiazepines (again)

A

withdrawal, paradoxical response, anterograde amnesia, CNS and respiratory depression, sedation

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58
Q

Patient teaching for benzodiazepines

A

BIG ONE IS TAPER DOSE (prevents withdrawal)

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59
Q

what drugs are SSRIs

A

fluoxetine, paroxetine, citalopram, escitalopram, fluvoxamine or something idk

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60
Q

Indications for SSRIs

A

major depression

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61
Q

Adverse effects of SSRIs

A

big one is sexual dysfunction (causes adherence), SEROTONIN SYNDROME, hyponatremia, withdrawal. increase SI during dosages changes

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62
Q

Symptoms of serotonin syndrome

A

confusion, agitation, fever, tremors

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63
Q

Nursing considerations for SSRI’s

A

assess for masked signs of sexual dysfunction, do not drink grapefruit juice, contraindicated with MAOIs and TCAs, pregnancy category c (paroxetine is d)

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64
Q

What drugs are MAOIs

A

phenelzine, isocarboxid, seligiline, tranylcypromine

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65
Q

Indications for MAOIs

A

neurotic or atypical depression

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66
Q

Interactions for MAOIs

A

tyramine foods (aged cheese, aged meats, yogurt, fermented beer and wine)

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67
Q

What drugs are TCAs

A

amitriptyline, nortriptyline

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68
Q

Side and adverse effects of TCAs

A

okay hear me out… think TRIPping makes you sad…. and you trip with your toes….

SAD TOASS
sedation, anticholinergic, decreased seizure threshold, toxicity, orthostatic hypotension, arrhythmias, sexual dysfunction, sweating

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69
Q

Lithium indications

A

bipolar disorder, mood fluctuations

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70
Q

Advanced lithium toxicity symptoms (2-2.5)

A

hypotension –> seizure–> coma–> death. tinnitus, ataxia, involuntary extremity movements, polyuria, blurred vision

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71
Q

Patient teaching for lithium

A

increase fluids (1.5 L) cause dehydration increases risk of lithium toxicity

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72
Q

What are nsaids

A

ibuprofen, naproxen, ketorolac, indomethacin, diclofenac, meloxicam

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73
Q

Adverse effects of NSAIDs

A

nephrotoxicity, hepatotoxicity, gi bleeding,

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74
Q

Nurisng interventions

A

monitor s/s of bleeding, LFT, RFT, avoid alcohol and G herbs. Take with food and water/milk

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75
Q

Indications for aspirin

A

to prevent MI (81 mg baby aspirin) and for pain management

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76
Q

Drug interactions for aspirin

A

warfarin , avoid g herbs , alcohol

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77
Q

Adverse effects

A

nephrotoxicity, bleeding, salicylism, reyes syndrome

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78
Q

tinnitus while taking aspirin can mean

A

salicylism (also headache, dizziness, sweating, fainitng, AMS)

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79
Q

What is reye’s syndrome

A

when child with virus takes aspirin (liver damage, hypoglycemia, cns effects)

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80
Q

Antigout medications

A

allopurinol, cholchicine, probenecid

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81
Q

Nursing interventions and patient teaching

A

increase fluids, avoid purine foods (scallops, red meat, red wine)

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82
Q

Methotrexate indications

A

slow progression of RA

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83
Q

Contraindications for methotrexate

A

live virus vaccines, infection, pregnancy

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84
Q

What drugs are opioid agonsits

A

morphine, fetanyl, codeine, oxycodone

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85
Q

Adverse effect of opioid agonist

A

constipation can become adverse, urinary rention, sedaiton, RESPIRATORY DEPRESSION, pupillary constriction

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86
Q

What drug is opioid antagonist

A

naloxone

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87
Q

when to give naloxone

A

client too sedated, respirations less than 10

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88
Q

How to recognize cephalosporins and penicillins

A

-cef , -cillin

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89
Q

Indications for cefs and cillins

A

infection (bacterialP

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90
Q

general adverse reactions and treatment of cephalosporins and penicillins

A

mild allergic reaction (rash pruritus hives.. treat with diphenhydramine) advances allergic reaction (angioedema.. treat with epinephrine) superinfections of vagina, mouth, and stomatitis

91
Q

Nursing interventions for abx

A

get C&S before administering abx, monitor for s/s of allergic reaction, monitor for s/s of superinfection, LFT,RFT, cephalosporins monitor for bleeding, increase fluids, take with food

92
Q

antibiotics decrease the effectiveness of? what should nurses teach

A

oral contraceptives ; backup method of birth control

93
Q

Side and adverse effects of vancomycin

A

redman syndrome, thrombophlebitis, ototoxicity, nephrotoxicity, stevens johnson syndrome

94
Q

Nursing interventions for vancomycin

A

monitor s/s of stevens johnson and redman syndrome. monitor RFTs and iv site. Monitor serum peak and trough levels. infuse over 60 minutes

95
Q

How to recognize flourquinolones

A

-oxacin

96
Q

Indications of ciprofloxacin

A

infection

97
Q

Adverse effects of flourquinolones

A

achilles tendon rupture, arthropathy

98
Q

What drug is aminoglycoside

A

gentamicin

99
Q

when to take peak and trough levels of gentamicin

A

30 minutes after infusion finishes (peak), 30 mins b4 next dose (for trough)

100
Q

Indications for INH

A

tuberculosis

101
Q

Side and adverse effects of INH

A

neuropathy, hepatoxicity

102
Q

Nursing interventions / patient teaching for INH

A

avoid foods high in tyramine (aged cheese and meats) , take b6 and pyridoxine, avoid alcohol (Cus liver) and monitor LFTs

103
Q

acyclovir indications

A

herpes simplex type 1 and varicella zoster (viruses)

104
Q

fluconazole indications

A

vag yeast infections (systemic or superficial mycoses)

105
Q

Indications for tamoxifen

A

stop the spread of breasat cancer cells

106
Q

adverse effects of tamoxife

A

blood clots/ pulmonary embolism, hypercalcemia

107
Q

Indication for epoetin alfa

A

low RBC, CKD anemia, HIV/AIDS, chemo

108
Q

Adverse effects of epoetin alfa

A

hypertension, headache

109
Q

Indications for oprelvekin

A

low platelet count (thromBOcytopenia)

110
Q

Evaluating effectiveness for oprelvekin

A

platelets greater than 50,000

111
Q

What drugs are decongestants

A

phenelephrine, pseudophedrine, oxymetazoline, nafazoline, tetrahydrolazine

112
Q

Side effects of decongestants

A

tremors, tachycardia, nervousness, anxiety, restlessness

113
Q

adverse effects of decongestants

A

htn, palpitations, arrhythmias, convulsions, delusions, hallucinations

114
Q

Contraindications of decongestants

A

HTN, glaucoma, hypothyroidism, cardiac issues (take caution if you have diabetes)

115
Q

what drugs are methylxanthines

A

theophylline, aminophylline

116
Q

Indications for methylxanthines

A

asthma and bronchospasm

117
Q

drug interactions for methylxanthines

A

smoking will decrease effectiveness, caffeine will increase side effects

118
Q

What drug is a mucolytic

A

acetylcysteine

119
Q

patient teaching for acetylcysteine

A

smells like rotten eggs (does not mean its bad)

120
Q

What drugs are beta 2 agonists

A

short acting: albuterol, levalbuterol, pirbuterol

121
Q

Indications for short acting

A

treat acute asthma attack, prevent exercise induced asthma

122
Q

Long acting beta agonists

A

treat asthma and COPD

123
Q

Short vs long acting bronchodilators

A

short acting should only be used 2-3 times a week, long acting can be used every day

124
Q

adverse effects of bronchodilators

A

palpitations, angina, tachycardia

125
Q

patient teaching for bronchodilators

A

use a spacer, take it before corticosteroids, tolerance can occur, side effects diminish over time, avoid caffeine

126
Q

How to recognize corticosteroids

A

end in -sone and triamcinolone

127
Q

Indications for inhaled corticosteroids

A

COPD and asthma

128
Q

Patient teaching for inhaled corticosteroids

A

clean mouth and inhaler after, use a spacer, use after albuterol,

129
Q

Cardiac glycosides drug

A

digoxin

130
Q

indications for digoxin

A

afib, atrial flutter, heart failure

131
Q

side / adverse effects

A

cardio: bradycardia CNS: yellow green halos, diplopia GI: anorexia, NV

132
Q

Nursing interventions for digoxin

A

monitor apical pulse for a full minute, hold if <60

133
Q

antidote for digoxin

A

digoxin immune fab

134
Q

what lab value can increase risk of digoxin toxicity

A

hypokalemia

135
Q

What drugs are nitrates

A

have nitrate somewhere in there

136
Q

Indications for nitrates

A

chest pain

137
Q

patient teaching regarding patch

A

take it off at night to prevent tolerance (nitrate free period) rotate sites

138
Q

Side and adverse effects of nitrates:

A

tolerance, headache, hypotension, weak, syncope

139
Q

contraindicaitons for nitrates

A

PDE5 inhibitors (can cause fatal hypotension)

140
Q

What are the potassium sparing diuretics

A

amiloride, spironolactone, eplerenone, triamterene

141
Q

Indications for potassium sparing

A

HTN, CHF, hypokalemia

142
Q

Side and adverse effects of potassium sparing

A

hyperkalemia, androgen effects, gynecomastia, dizziness, hypotension

143
Q

Nursing interventions of potassium

A

monitor potassium levels

144
Q

what drug is thiazide

A

hydrochlorothiazide

145
Q

Evaluation for thiazide diuretic

A

decreased SOB, edema, hypertension, HF

146
Q

what drug is loop diuretic

A

furosemide

147
Q

Indications:

A

acute HF, hypertension, edema

148
Q

Patient teaching

A

eat foods high in potassium, potassium salt substitutes (need to avoid sodium), hypotensive teaching

149
Q

Evaluating effectiveness for loop diuretic

A

decreasaed edema, htn, SOB, hf

150
Q

How to recognize calcium channel blockers

A

-dipine, verapamil, diltiazem

151
Q

indications for CCB

A

hypertension

152
Q

Adverse effects of CCB

A

peripheral edema, bradycardia

153
Q

Patient teaching for calcium channel blockers

A

avoid grapefruit juice and statins, report s/s of edema, monitor heart rate, taper dose because of rebound hypertension

154
Q

Nursing considerations for CCB

A

statins should be avoided, monitor EKG, VS, HR. Monitor edema

155
Q

Indications for clonidine

A

hypertension

156
Q

patient teaching for clonidine

A

leave patch on for 7 days

157
Q

how to recognize ACE inhibitors

A

-pril

158
Q

Indications for ace inhibitors

A

hypertension

159
Q

Side effect of ace inhibitors

A

persistent dry cough

160
Q

Adverse effects of ACE inhibitors

A

hyperkalemia

161
Q

Patient teaching for ACE inhibitors

A

avoid k+ foods, BP, change positions slowly, improve diet and increase exercise

162
Q

Cultural considerations for ACE inhibitors

A

not used as monotherapy in African Americans ?

163
Q

What does warfarin treat

A

blood clots? DVT, PE idek

164
Q

Warfarin Labs and ranges

A

PT: 18-24 sec INR: 2-3 , 3-4.5 if mechanical heart valve

165
Q

Interactions for warfarin

A

highly protein bound, g herbs, aspirin, pregnancy category X

166
Q

patient teaching for warfarin

A

use soft bristled toothbrush and electric razor. Avoid G herbs. wear medic alert ID. use backup method of birth control

167
Q

Nursing considerations for warfarin

A

monitor s/s of bleeding, monitor labs, LFTs

168
Q

Warfarin antidote

A

vitamin K

169
Q

What does heparin treat

A

DVT

170
Q

Labs and therapeutic levels for heparin

A

ptt: 120-140
aPTT: 60-80

171
Q

Interactions with heparin

A

other anticoagulants, antiplatelets

172
Q

Antidote for heparin

A

promatine sulfate

173
Q

HMG-CoA reductase inhibitors

A

-statins

174
Q

Baseline labs for statins

A

creatinine kinase, cholesterol 150-200, LDL<100 HDL>60

175
Q

Nursing interventions for statins

A

monitor for muscle pain, creatinine kinase, cholesterol levels, LFTs, advise patients for yearly eye exams

176
Q

Side and adverse effects of Statins

A

H M G C oa Reductase Inhibitors
hepatotoxicity, myopathy, gi upset, rhabdomyolysis, cataracts

177
Q

What drug is the surfactant laxative

A

docusate sodium

178
Q

indications for surfactant laxatives

A

reduce straining from constipation

179
Q

Mechansim of action docusate sodium

A

reduce surface tension of the stool by increasing water and electrolytes in the stool

180
Q

Lacutlose indications

A

hepatic encephalopathy (reduce ammonia levels)

181
Q

Indications for sucralfate

A

ulcer

182
Q

mechanism of action for sucralfate

A

coats the ulcer and mucosal lining

183
Q

evaluation of sucralfate

A

abdominal pain subsides

184
Q

Misoprostol indications

A

NSAID induced ulcer

185
Q

Mechanism of action for misoprostol

A

secretion of bicarbonate and inhibit release of stomach aid

186
Q

Evaluation of effectiveness for misoprostol

A

reduced abdominal pain

187
Q

What are the different types of antacids

A

magnesium, aluminum, sodium bicarbonate, calcium

188
Q

Patient teaching for antacids

A

take it 1 or 2 hours before or after other drugs

189
Q

H2 receptor blocker drugs

A

famotidine, cametidine

190
Q

Patient teaching for H2 receptor blockers

A

smoking decreases effectiveness, avoid NSAIDs and antacids ?

191
Q

Interactions for famotidine and cametidine

A

smoking decreases effectiveness and alcohol/NSAIDs can increase risk of bleeding

192
Q

How to recognize proton pump inhibitors

A

-prazole (omeprazole)

193
Q

Indications for proton pump inhibitors

A

GERD and acid reflux

194
Q

Adverse effects of PPIs

A

osteoporosis, pneumonia, rebound hypersecretion, hepatoxicity, HYPOMAGnesemia

195
Q

what drugs are antithyroid drugs

A

propylthiouracil, methimazoleEva

196
Q

Evaluation of antithyroid drugs

A

hyperthyroidism symptoms decrease, euthyroid state (0.5-4.2)

197
Q

Levothyroxine indicaiont

A

hypothyroidism

198
Q

Patient teaching for levothyroxine

A

take one hour before breakfast on empty stomach and take four hours before vitamins and other meds

199
Q

Indication for glucocorticoids

A

adrenal insufficiency and addisons disease

200
Q

Adverse effects of glucocorticioids

A

hyperglycemia, infection, osteoporosis, cushings syndrome, peptic ulcer disease, myopathy

201
Q

Patient teaching for glucocorticoids

A

take caution if you are diabetic, monitor for infections, increase calcium and vitamin D, report cushings syndrome symptoms

202
Q

Biphosphonates

A

-dronate

203
Q

Indications of biphosphonates

A

osteoporosis

204
Q

Adverse effects of biphosphonates

A

osteonecrosis of the jaw, esophagitis

205
Q

Patient teaching

A

sit up for 30 minutes after taking, do not take if you have difficulty swallowing, avoid dental work

206
Q

Sulfonylureas

A

start with gly end with ide

207
Q

Indicaitons

A

type 2 dm

208
Q

adverse effects of sulfonulureas

A

hypoglycemia

209
Q

nurisng considerations and patient teachign

A

take it with food, make sure they have meal tray

210
Q

glucagon indications

A

unconscious from hypoglycemia

211
Q

Metformin indications

A

type 2 dm

212
Q

side and adverse effects

A

please be weight loss

213
Q

Insulin mixing

A

inject air into NPH, air into clear, draw clear, draw cloudy

214
Q

rapid insulins (aspart, glulisine, lispro)

A

15-30, 30-2.5, 3-6

215
Q

short acting insulin (regular)

A

30-1hr, 1-5 hours, 6-10

216
Q

intermediate (NPH and Humulin N)

A

1-2 h , 6-14, 16-24

217
Q

Long acting (glargine , determir)

A

70 mins, no peak, 18-24

218
Q

oxybutynin indicaitons

A

overactive bladder

219
Q

Contraindicaitons of oxybutynin

A

glaucoma, urinary retention (think BPH), GI/gu obstruction, paralytic ileus

220
Q

Bethanechol indicaitons

A

urinary retention not caused by obstruction

221
Q

side and adverse effect of bethachol

A

SLUDGES, bradycardia, dyspnea, miosis, hypotension, bronchoconstriction

222
Q

PDE5 inhibitors

A

slidenafil, tadalafil

223
Q

contraindciation of PDE5 inhibitors

A

nitrates (fatal hypotension)

224
Q

what can be used to prevent toxicity in older adult

A

start low and go slow

pharmacology (12 decks)

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