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Drug Quiz Flashcards

1
Q

Atropine (class/action)

A

anticholinergic (or muscarinic antagonist)

blocks muscarinic (Ach) receptors causing decreased parasympathetic nervous system activation

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2
Q

Atropine (AE)

A

decreased GI/GU
dry mouth
mydriasis

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3
Q

Atropine (CI/Nurs)

A

CI: Hypersensitivity, Narrow-Angle Glaucoma, Severe Gastrointestinal Obstruction, Myasthenia Gravis, Prostatic Hypertrophy, Certain Cardiovascular Conditions

Nursing: Monitor Vital Signs, Assess for Side Effects, Monitoring for Toxicity, Temp regulation

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4
Q

Adenosine (class/action)

A

Class V antidysrhythmic
hyperpolarize cardiac membranes = no AP can occur

(kinda stops the heart for a sec!)

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5
Q

Adenosine (AE)

A

flushing
transient hypotension
transient flat line
transient chest pain

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6
Q

Adenosine (CI/Nurs)

A

Admin: rapid IV push followed immediately by rapid saline flush,
CI: Hypersensitivity, Second- or Third-Degree AV Block, Sick Sinus Syndrome, Bronchoconstrictive Diseases

Nursing: Continuous ECG Monitoring, Vital Signs, Monitor for Respiratory Effects, patient is often positioned in a supine

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7
Q

Nitroglycerine (class/action)

A

Organic nitrates
Vasodilation → decreases preload (decreased O2 demand)
decreases coronary artery spasm

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8
Q

Nitroglycerine (AE)

A

headaches (cerebral vasodilation), postural hypotension, reflex tachycardia (can prevent with beta adrenergic antagonist or calcium channel antagonists)

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9
Q

Nitroglycerine (CI/Nurs)

A

sublingual ASAP
Q5mins, take another dose if no relief (up to 3 doses)

*pt should be calling 911 as an outpatient after the first dose

Transdermal – rotate patch sites, take off at night bc tolerance can develop

Drug Interactions: other drugs that < BP, Sildenafil, Tadalafil, Veradenafil super contraindicated

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10
Q

Dopamine (class/action)

A

catecholamine and a vasopressor
Activates dopaminergic receptors → renal and mesenteric vasodilation,

beta-1 adrenergic receptors → increases cardiac contractility and HR, → increased cardiac output,
alpha-1 adrenergic receptors → vasoconstriction and increasing systemic vascular resistance

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11
Q

Dopamine (AE)

A

Common: Tachycardia, Hypertension, Nausea and Vomiting, Headache
Serious:Arrhythmias, Excessive Vasoconstriction, Angina, Gangrene

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12
Q

Dopamine (CI/Nurs)

A

CI: Pheochromocytoma, Arrythmias Hypovolemia

Nursing: ECG Monitoring, Infusion Site, Administer via a central line, Renal/Cardiac Function

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13
Q

Epinephrine (class/action)

A

catecholamine and a sympathomimetic drug and alpha- and beta-adrenergic agonist
alpha-1 receptors: Causes vasoconstriction → increased blood pressure.
Alpha 2: specific blood vessles that need to vasodilate, acts as a negative feedback loop
Beta-1 receptors: Increases heart rate and myocardial contractility.
Beta-2 receptors: Causes bronchodilation, useful in conditions like asthma or anaphylaxis

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14
Q

Epinephrine (AE)

A

Common:Tachycardia,
Hypertension,
Palpitations, Anxiety or nervousness, Tremors, Dizziness, Headache

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15
Q

Epinephrine (CI/Nurs)

A

CI: Absolute: Hypersensitivity to the drug
Relative Contraindications:Patients with severe hypertension, Tachyarrhythmias, Coronary artery disease, Hyperthyroidism, Diabetes mellitus, Glaucoma

Nursing: Monitor vital signs Assess for signs of an allergic reaction, Observe cardiac function, Monitor blood glucose levels

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16
Q

Norepinephrine (levophed) (class/action)

A

Sympathomimetic (Adrenergic Agonist)
Alpha-1 receptors: Causes vasoconstriction, leading to increased systemic vascular resistance and elevated blood pressure
Beta-1 receptors: Increases heart rate and myocardial contractility

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17
Q

Norepinephrine (levophed) (AE)

A

Hypertension, Bradycardia, Arrhythmias, Peripheral ischemia, Anxiety or nervousness, Headache, metabolic acidosis

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18
Q

Norepinephrine (levophed) (CI/nurs)

A

CI: Relative Contraindications:Hypovolemia, Patients with peripheral vascular disease, Recent myocardial infarction, Pregnancy

Nursing: Monitor vital signs, Assess perfusion, Monitor IV site (risk for tissue necrosis with extravasation), Phentolamine to reverse, Fluid resuscitation, Taper dosing carefully, Monitor urine output

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19
Q

Calcium Channel blockers dihydropyridines (mechanism and AE)

A

-dipine
calcium channels on vascular smooth muscle blocked → arteriole vasodilation → vasodilation and decreased vascular resistance
Hypotension, Dizziness or lightheadedness, Headache, Peripheral edema, Flushing, Reflex tachycardia

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20
Q

Calcium channel blockers, nondihydropyridines (mechanism and AE)

A

arteries (arterial vasodilation) AND on the heart (decreased contractility, HR, AV node conduction)
bradycardia, hypotension, AV block, HF, peripheral edema, constipation, liver/kidney disease > risk of toxicity

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21
Q

CCB (CI/Nurs)

A

Drug Interactions:
Beta blockers (additive cardiac depressant and elevates digoxin levels)
CI: Absolute: Severe hypotension or cardiogenic shock.
Second- or third-degree AV block, Sick sinus syndrome, Severe heart failure

Nursing: Monitor vital signs, Assess cardiac rhythm, Monitor for signs of heart failure, Avoid grapefruit juice, Titrate doses carefully, Assess renal and hepatic function

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22
Q

Digoxin (class/mechanism of action)

A

cardiac glycoside
Na+/K+ ATPase inhibition = increased Na+ and therefore increased Ca++
= increased contractility

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23
Q

Digoxin therapeutic level

A

0.5 - 2.0 ng/mL

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24
Q

digoxin (CI/Nurs)

A

Contrindications: heart block
hypokalemia (can lead to drug toxicity)
WPW
advanced CKD
Acute MI
renal impairment

Nursing: Monitor digoxin levels
Loading doses
Assess heart rate
Monitor for signs of toxicity: confusion, loss of appetite, nausea, vomiting, diarrhea, or vision problems.
Monitor electrolytes: Particularly monitor potassium, magnesium, and calcium levels
Renal function assessment
Monitor for drug interactions
Patient education: Instruct patients to report symptoms of toxicity

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25
Beta blockers (mechanism of action and AE)
-lol block B1 receptors causing decreased HR, decreased contractility, and decreased conduction thru the AV node AE: bradycardia, hypotension
26
Beta blockers (CI/Nurs)
CI: Absolute Contraindications: Severe bradycardia or heart block Cardiogenic shock. Severe heart failure Hypersensitivity to the drug or other beta-blockers. Nursing: Monitor blood pressure and heart rate Assess for signs of heart failure Monitor for bronchospasm Educate diabetic patients Do not abruptly discontinue Monitor renal and hepatic function Assess for depression
27
Selective Beta-1 Blockers
Atenolol, Metoprolol, Bisoprolol, Acebutolol: Primarily affect the heart, with a focus on reducing heart rate and blood pressure
28
Non-Selective Beta-Blockers
Propranolol, Nadolol, Pindolol: Affect both heart and lungs, and can have additional effects such as bronchoconstriction.
29
Beta-Blockers with Alpha-1 Blocking Activity
Carvedilol, Labetalol: Provide additional vasodilation effects and are useful in conditions like heart failure and severe hypertension.
30
ACE inhibitors (drug/mechanism)
-pril inhibits ACE (angiotensin-converting enzyme) causing decreased blood volume (aldosterone decrease), vasodilation, decreased SNS adrenergic activity → decreased myocardial oxygen supply, prevention of CV remodeling
31
ACE-I (AE)
dry persistent cough, first dose hypotension, hyperkalemia, renal failure Rare: angioedema and neutropenia
32
ACE-I (CI/Nurs)
Note first dose hypotension can occur (limit other hypotension causing drugs and educate patients) avoid drugs that can elevate levels of K+ or that are heavily impacted by K+ levels Toxic to fetus – avoid in pregnancy caution in patients with renal issues
33
Only IV ACE-I
Enalapril (vasotec)
34
ARBs (drugs/mechanism)
-artan Angiotensin II receptor blocker Blocks the effects of angiotensin II at the receptor causing decreased blood volume (aldosterone decrease), vasodilation, decreased SNS adrenergic activity → decreased myocardial oxygen supply, prevention of CV remodeling; difference from ACE-I – doesn’t block kinase II → less side effects, and more aldosterone is released causing lower risk of hyperK+
35
ARBs (AE)
first dose hypotension, hyperkalemia (but lower risk than ACEs), renal failure, dizziness headache, fatigue Rare: angioedema and neutropenia
36
ARBS (CI/Nurs)
Note first dose hypotension can occur (limit other hypotension causing drugs and educate patients) avoid drugs that can elevate levels of K+ or that are heavily impacted by K+ levels Toxic to fetus – avoid in pregnancy caution in patients with renal issues Less evidence to reduce CV morbidity and mortality, so ACEs are first line
37
Heparin (Mechanism of action/class)
Anticoagulant Inhibition of Thrombin and Factor Xa: reducing the formation of fibrin and preventing clot formation
38
Heparin (AE)
Bleeding or easy bruising Pain or irritation at the injection site Elevated liver enzymes thrombocytopenia
39
aspirin (class/mechanism of action)
Nonsteroidal Anti-Inflammatory Drug (NSAID) irreversible (aka lasts entire lifetime of platelet), inhibition of Cyclooxygenase (COX) → decreased platelet aggregation/activation, decreases vasoconstriction
40
Heparin (CI/Nurs)
CI: Absolute Contraindications Severe Thrombocytopenia Hypersensitivity to Heparin Known allergic reactions to heparin or its components. Relative Contraindications: Recent Surgery History of HIT Renal or Hepatic Impairment Nursing Monitor Activated Partial Thromboplastin Time (aPTT): Monitor Platelet Counts Assess for Signs of Bleeding Injection Site Care Prepare for Reversal - protamine
41
Aspirin (AE)
Gastrointestinal symptoms Mild gastrointestinal bleeding or ulcers rarely: hemorrhagic stroke
42
Aspirin (CI/Nurs)
CI: Absolute Contraindications: Active Peptic Ulcer Disease Allergy to Aspirin or Salicylates: Known hypersensitivity or allergic reactions to aspirin or other salicylates Severe Renal or Hepatic Impairment Avoid use in children or adolescents with viral infections due to the risk of Reye's syndrome. Relative Contraindications: History of Gastrointestinal Bleeding or Ulcers Asthma Pregnancy Nursing Monitor for Gastrointestinal Symptoms: Assess for Signs of Allergic Reaction: Be vigilant for signs of hypersensitivity reactions, including rash, itching, or respiratory symptoms. Patient Education: Adherence to Dosage Bleeding Risks Avoid Alcohol Drug Interactions Monitor Renal and Hepatic Function Monitor Tinnitus or Salicylism:
43
Clopidigrel (Plavix) (class/mechanism)
Antiplatelet Agent Inhibition of ADP-Induced Platelet Aggregation: This inhibition reduces platelet activation and aggregation, decreasing the risk of clot formation
44
Clopidigrel (Plavix) (AE)
Bleeding or easy bruising Gastrointestinal symptoms Rash
45
Clopidigrel (Plavix) (CI/Nurs)
CI: Absolute Contraindications: Active Bleeding .Hypersensitivity to Clopidogrel: Known allergic reactions or hypersensitivity to clopidogrel or any of its components. Relative Contraindications: History of Bleeding Disorders Severe Liver Disease Pregnancy Nursing: Monitor for Signs of Bleeding Inform About Bleeding Risks: Adherence to Medication Avoid Certain Activities Drug Interactions Monitor for signs of hematologic reactions, including thrombocytopenia and TTP. Management of Gastrointestinal Symptoms
46
Protoamine Sulfate (class/mechanism)
Anticoagulant Reversal Agent Reversal of Heparin: It binds to heparin, neutralizing its anticoagulant effect. This is achieved through the formation of a stable, inactive heparin-protamine complex
47
Protoamine Sulfate (AE)
Flushing Nausea
48
Protoamine Sulfate (CI/nurs)
CI: Absolute Contraindications: Known Allergic Reactions: History of severe allergic reactions to protamine sulfate or any of its components. Relative Contraindications: Fish Allergy Severe Renal or Hepatic Impairment Nursing Slow Administration Monitor for Allergic Reactions Monitor Blood Pressure Check for Bleeding
49
Retaplase and altaplase (class and mechanism)
thrombolytic, shorter duration binds plasminogen → plasmin → digests fibrin meshwork and degrades clotting factors
50
Retaplase and altaplase (AE and Nurs)
bleeding Nursing – minimize manipulation of the patient, avoid IM/sub Q injections, minimize invasive procedures, minimize use of concurrent anticoagulants,
51
retaplase vs altaplase
retaplase is faster and has a shorter duration
52
Morphine sulfate (class/mechansim)
Opioid Analgesic produces most of its analgesic effects by binding to the mu-opioid receptor within the central nervous system (CNS) and the peripheral nervous system (PNS).
53
Morphine Sulfate (AE)
Nausea, vomiting, constipation. Drowsiness, dizziness, and lightheadedness. Respiratory Effects
54
Morphine Sulfate (CI/Nurs)
CI: Absolute Contraindications: Hypersensitivity: Known hypersensitivity or allergy to morphine or other opioids. Acute or Severe Asthma Severe Respiratory Depression Relative Contraindications: Pregnancy and Lactation Liver or Renal Impairment Concurrent Use with Other CNS Depressants Nursing: Monitoring Pain Relief, Respiratory Status, Gastrointestinal Effects, Dependence and Abuse
55
Regular
onset 30 mins, peak 2 hrs
56
Novolog (aspart)
onset 15 mins, peak 1 hr
57
NPH
onset 1 hr, peak 4-6
58
70/30
onset 45 mins, peak 1-4 hrs
59
Lantus (glargine)
Onset 1 hr, no peak
60
Levimir (detemir)
onset 1 hr, peak 6-8 hrs
61
mixing insulins
Air into NPH, then air into regular or short acting, then withdraw regular/short acting, then withdraw NPH (cloudy, clear, clear, cloudy. You’re Not Retired, you’re an RN - NPH regular, regular, NPH)
62
Dextrose (class/mechanism)
intravenous sugar solution Increase blood glucose levels, when given with insulin, can cause K+ absorpition in cells to treat hyperkalemia
63
dextrose (AE)
hyperglycemia, hypokalemia, weight gain if prolonged
64
Dextrose (CI)
Use with caution: Diabetes or Hyperglycemia (high blood sugar) or Hypokalemia (low potassium in the blood) or Peripheral edema (swelling of the arms, feet, or lower legs) or Pulmonary edema (fluid in the lungs) May make these conditions worse
65
Silvadene (class/mechanism)
broad antimicrobial cream used for burns prevent wound sepsis by inhibiting the growth of microbes
66
Silvadene (AE)
main: leukopenia skin necrosis, erythema multiforme, skin discoloration, burning sensation, rashes, and interstitial nephritis.
67
Silvadene (CI/Nurs)
CI: pregnant women approaching or at term, on premature infants, or on newborn infants during the first 2 months of life. apply after wound cleaning
68
Lactulose (class/mechanism)
osmotic Laxative synthetic disaccharide that works by increasing the water content and volume of the stool, which promotes bowel movements
69
Lactulose (AE)
Bloating, gas, abdominal cramping, and diarrhea. Nausea
70
Lactulose (CI/Nurs)
CI: Relative Contraindications: Diabetes Mellitus Bowel Obstruction Nursing: Monitoring: Bowel Movements Electrolyte Levels Hydration Status
71
Kayexalate (class/mechanism)
Potassium Binder exchanges sodium ions for potassium ions in the gastrointestinal tract. This process helps to reduce elevated potassium levels (hyperkalemia) by facilitating the excretion of potassium in the feces
72
Kayexalate (AE)
Constipation Diarrhea Nausea or Vomiting
73
Kayexalate (CI/Nurs)
CI: Absolute Contraindications: Bowel Obstruction Gastrointestinal Motility Disorders Nursing: Monitoring: Potassium Levels Electrolyte Levels Bowel Function
74
Xanthine derivatives (drugs/mechanism)
-phylline Aminophylline and theophylline works by relaxing bronchial smooth muscle, leading to bronchodilation and improved airflow. It also has mild anti-inflammatory properties
75
Xanthine derivatives (AE)
Nausea and Vomiting Tachycardia (and dysrhythmias) vasodilation and diuresis → hypotension Headache CNS excitation → Insomnia, seizures
76
Xanthine derivitives (CI/nurs)
Relative Contraindications: Severe Cardiovascular Disorders Liver Disease Seizure Disorders Peptic Ulcer Disease CYP450 inhibitors/inducers (tobacco, grapefruit juice, marijuana) Nursing Monitoring: Theophylline Levels: Regular monitoring of plasma theophylline levels to avoid toxicity. Heart Rate and Rhythm Respiratory Status CYP450 metabolism SLOW IV ADMIN (can cause fatal CV event)
77
Aminophylline vs Theophylline
Aminophylline is more stable (bc it has one added drug) than theophylline
78
Anticholinergics (drugs/action)
-opium Tiotropium (Spiriva) Ipratropium (atrovent) blocking muscarinic receptors in the airways, leading to bronchodilation. It helps to relax the muscles around the airways, which reduces airway constriction and improves airflow
79
anticholinergics (AE)
Dry Mouth Pharyngitis Cough: Constipation
80
Anticholinergics (CI/nurs)
CI: Relative Contraindications: Glaucoma Prostatic Hyperplasia Kidney Disease Nursing: Monitoring:Respiratory Status Side Effects Educate on inhaler Technique
81
Tiotropium (Spiriva) vs Ipratropium (atrovent)
Tiotropium (Spiriva) is long acting while Ipratropium (atrovent) is short acting
82
Short acting beta-adrenergic (drug/class)
Albuterol and xopenex (levabuterol) beta-2 adrenergic agonist that works by stimulating beta-2 receptors in the bronchial smooth muscle, leading to relaxation and bronchodilation. This helps to open the airways and improve airflow
83
Long acting beta-adrenergic (drugs/mechsanism)
salmeterol (servant) formoterol (perforomist) stimulating beta-2 adrenergic receptors in the bronchial smooth muscle, leading to prolonged bronchodilation. It helps to relax the muscles around the airways and prevent them from constricting
84
Long acting beta-adrenergic (AE)
Tremors Palpitations Headache Muscle Cramps
85
Long acting beta-adrenergic (CI/Nurs)
CI: Relative Contraindications: Cardiovascular Disease Diabetes Hyperthyroidism Nursing: Monitoring:Respiratory Status Cardiovascular Effects Side Effects Patient Education Inhaler Technique Not for Acute Relief
86
salmeterol (servant) vs formoterol (perforomist)
formoterol (perforomist) is faster
87
Statins (class/mechanism)
Statins (HMG CoA reductase inhibitors) Lowers LDL and cholesterol by blocking HMG CoA reductase → compensatory increase of HMG CoA reductase meaning the liver makes/uses more cholesterol, also increases the number of LDL hepatocyte receptors causing an increased uptake of LDL by the liver
88
Statins (AE)
Hepatotoxicity, myopathies, rhabdomyolysis → aches, tenderness, weakness (big deal bc it can cause renal damage, due to high K+ and CK)
89
Statins (CI/Nurs)
CI: elevated CK, liver problems Nurs: take by mouth at night Measure CK at the beginning of therapy and again if become syptomatic (d/c statin if more than 10x the orginal). Educate patients about s/s of rhabdomyolysis
90
Questran (Cholestyramine) (class/mechanism)
Bile-acid Resins binding bile acids in the intestine, preventing their reabsorption into the bloodstream. This causes the liver to use cholesterol to produce more bile acids, which lowers LDL cholesterol levels in the blood.
91
Questran (Cholestyramine) (AE)
Constipation, bloating, gas, and abdominal discomfort. Nausea and Vomiting
92
Questran (Cholestyramine) (CI/Nurs)
CI: Absolute Contraindications: Bowel Obstruction Relative Contraindications: Pregnancy and Lactation Certain Drug Interactions Nursing: Usually taken with meals to maximize effectiveness and minimize gastrointestinal side effects. Monitoring: Lipid Levels Monitor for signs of malabsorption or vitamin deficiencies; consider vitamin supplementation if needed. Gastrointestinal Function

ICU (2 decks)

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