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Drugs & Tests Flashcards

1
Q

betablockers

A

used in hyperthyroidism in thyroiditis typically for abnormal heart rate and anxiety.

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2
Q

methimazole and propylthiouricil

A

reduces peripheral T4 to T3 conversion; decrease thyroid hormone synthesis

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3
Q

phenoxybenzamine

A

an alpha-receptor blocker w/ a pt. w/ pheochromocytoma

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4
Q

dopamine agonists

A

to treat dopamine deficiency in Parkinson’s, inhibiting growth of prolactinomas

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5
Q

Metformin

A

commonly used diabetic tx. that decreases hepatic gluconeogenesis

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6
Q

sulfonylureas

A

increase insulin secretion

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7
Q

thiazolinediones

A

decrease insulin resistance

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8
Q

Methotrexate

A

antagonist of folate

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9
Q

Schilling Test

A

to figure out cause of B12 deficiency. Pt. gets intramuscular injection of nonradioactive B12. B12 receptors are saturated. Then ingests radioactive B12. Phase 2: B12 + IF (intrinsic factor)
normal: secreted in urine
pernicious anemia: not in urine, because never absorbed d/t no intrinsic factor
problems in ileum: on phase 2, no B12 in urine

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10
Q

opportunistic infections

A

pneumocystis carinii, cryptosporidium, toxoplasmosis, MAI-myobacterium avium intracellulare, cryptococcus, histoplasmosis, m. tuberculosis, cytomegalovirus- CMV

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11
Q

Reed-Sternberg cell

A

Hodgkin’s lymphoma

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12
Q

Alagesics: Mild

A

acetoinophen (tylenol), aspirin

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13
Q

Analgesics: Narcotic

A

codine, hydromorphone (Dilaudid), meperidine (demerol), morphine, ocycodone (percodan), propoxyphene (Darvon)

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14
Q

Analgesic: NSAID

A

Diclofenac (voltaren), ibuprofen (motrin, advil), indomethacin (indocin), naproxen (naprosyn)

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15
Q

Anesthetics: General

A

ether, halothane (fluothane), nitrous oxide, thiopental (pentothal)

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16
Q

Anesthetics: Local

A

hydrocortisone acetate (orabase), lidocaine (xylocaine), procaine (novacaine)

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17
Q

SSRI (Selective Serotonin reuptake inhibitors): ACTION

A
  • decrease the reuptake of serotonin at selected nerve terminals in the central nervous system (CNS)
  • have a weak effect on the reuptake of norepinephrine and dopamin
  • increase availability of serotonin at the receptors results in mood elevation and reduced anxiety
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18
Q

SSRIs: uses & CIs

A

uses: -mild to moderate depression
-OCD
-panic disorder
CIs: hypersensitivity to SSRIs
-concurrent use of monoamine oxidase inhibitors (MAO)

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19
Q

SSRIs: caution! + side effects (SE)

A
  • Zoloft may cause delusional and aggressive behavior

- insomnia, anxiety, palps, HA, dyspepsia, diarrhea, tremor, excessive sweating, sexual dysfunction, seizures, pruritus

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20
Q

SSRIs: nursing implications

A
  1. monitor liver function
  2. do not tak w/ MAO inhibitors
  3. check history for seizure disorder, d/t low seizure threshold
  4. do not stop taking. withdrawal should be gradual, not abrupt
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21
Q

MAO (monoamine oxidase) inhibitors: action

A

inhibits monoamine oxidase, the enzyme involved in the metabolism of amines that are found in the body such as epinephrine, norepinephrine, tyramine, and serotonin. MAO inhibitors help increase these transmitters to relieve the effects of depression.
-depression is thought to be associated w/ low levels of epinephrine and norepinephrine.

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22
Q

MAO inhibitors uses

A
  • relieve symptoms of clinical depression, manic depression, and psychosis
  • severe depression in patients who have failed to respond to other tx
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23
Q

MAO inhibitors CIs and caution

A
  • impaired renal or hepatic function
  • CAD, CHF, hypertension,cerebro-vascular defects
  • possible hypertensive crisis with ingestion of caffeine and tyramine
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24
Q

MAO inhibitors: side effects

A

orthostatic hypotesion, seizures, hypertensive crisis, weight gain, sexual dysfunction, edema, blurred vision, diarrhea

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25
Q

MAO inhibitors: nursing impl.

A
  1. check blood work for effects on platelets
  2. avoid food w/ caffeine and tyramine to prevent hypertensive crisis
  3. pt. should not take any other meds unless they check with their provider
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26
Q

Tricyclic antidepressants: ACTION

A

decrease reabsorption of norepinephrine and serotonin, which allows more of the neurotransmitters to be available at postsynaptic receptors.

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27
Q

Tricyclics: USE

A
  • endogenous, reactive depression
  • depression related to alcohol and cocaine withdrawal
  • pts. failed w/ other antidepressants
28
Q

Tricyclics: caution! + side effects

A

acute recovery phase of myocardial ischemia or severe CAD

  • hyperthyroidism
  • history of suicidal behavior or ideations
29
Q

Tricyclics: side effects

A

-sedation, orthostatic hypotension, arrhythmias, cholinergic effects: dry mouth, HA, urinary retention

30
Q

Tricyclics: nurse impl.

A

older clients more susceptible to orthostatic hypertension

  • administer at bedtime
  • stop smoking and avoid alcohol
31
Q

Antihistamines: ACTION

A

competitively block H1 receptor sites on effector cells and impede histamine-mediated responses

32
Q

Antihistamines: USE

A
  • prevent ad treat allergic reactions
  • allergic transfusion reactions
  • motion sickness and insomnia
  • used w/ epinephrine in management of anaphylaxis
33
Q

Antihistamines: CI + cautions

A

sensitivity to antihistamines

  • hx. acute asthmatic problem
  • pregnancy and lactation
  • urinary obstruction
  • glaucome
34
Q

Antihistamines: side effects of BENADRYL

A

sedation, disturbed coordination, epigastric distress, thickening of brochial secretions, dry mouth, drowsiness; not recommended for injection ORAL use ONLY!

35
Q

VISATRIL side effects

A

antihistamine: drowsiness, dry mouth, hypotension, potentiates barbiturates and narcotics

36
Q

ANTIVERT side effects

A

antihistamine: Drowsiness, dry mouth ORAL use ONLY!

37
Q

Bronchodilators: ACTION

A
  • Beta2-selective adrenergic agonists

- sympathomimetic agents relax the beta2-receptors to relax the smooth mm in the bronchioles, producing dilation

38
Q

Bronchodilators: USE

A
  • short-acting preparations to treat acute exacerbations of asthma
  • short term relief of bronchocontsriction d/t bronchitis and emphysema
  • long term control of chronic airway problems (severe PO)
39
Q

Bronchodilators: CI + precautions

A
  • Cardiovascular dz, thyroid dz, diabetes mellitus
  • Lactation, sensitivity, seizure disorders
  • sensitivity to sympathomimetics
  • Terbutaline: not given to children 12 yrs. or under
40
Q

Bronchodilators: Side FX

A

Tremors, anxiety, convulsions, Tachycardia, HA, blood pressure changes

41
Q

NSAIDS: ACTION

A
  • suppress inflammation by inhibition of coclooxygenase, an enzyme that is responsible for synthesis of prostaglandins
  • NSAIDs inhibit the formation and release prostaglandin
42
Q

NSAIDS: USES

A
  • Mild to moderate pain relief

- reduce inflammation

43
Q

NSAIDS: Contraindications + cautions

A

CI-Hypersensitivity to aspirin
-Clients with viral illness
CAUTION!-upper GI disorders
-renal and hepatic impairment

44
Q

NSAIDS: SIDE FX

A

Dyspepsia, anorexia, nausea, vomiting, rash, dizziness, heartburn, GI bleeding

45
Q

Diuretics: Action

A

Loop: inhibit Na and Cl reabsorption through direct action primarily in the ascending loop of Henle but also in the proximal and distal tubules.
Thiazide: act primarily on the distal tubules, inhibiting Na and Cl reabsorption

46
Q

Diuretics: USES

A

Treat edema that involves fluid volume excess resulting from a number of disorders of the heart, liver or kidney

47
Q

Diuretics: CI and cautions

A

hypersensitivity to sulfonamides, severe adrenocortical impairment, anuria, progressive oliguria, hepatic cirrhosis and coma, renal dysfunction, brochial asthma

48
Q

Diuretics: side FX

A

unusual tiredness, weakness, dizziness, irregular HT beat, weak pulse orthostatic hypertension, tinnitus, hearing loss (Lasix)

49
Q

Hypertension (ABC): Classification

A
  • Blood pressure is regulated by cardiac output (CO) and peripheral vascular resistance (PVR)
  • meds that influence either one of these systems leads to blood pressure control
  • Body systems that regulate CO, PVR, and blood pressure include the vascular, cardiac, and renal systems and the sympathetic nervous system.
  • antihypertensive drugs that influence these systems to lower BP are Angiotensin converting enzyme (ACE) inhibitors, beta-andrenergic blockers, calcium channel blockers (CCBs)
50
Q

Hypertension: ACTION

A

A- ACE inhibitors block the conversion of angiotensin I to angiotensin II, a vasoconstrictor. Vasodilation occurs and decreases PVR, resulting in decreased BP. ex. LISINOPRIL
B- beta andrenergic blockers prevent sympathetic stimulation of the heart, reducing heart rate and contractibility. ex. METROPOLOL, LOPRESSOR, TOPROL XL
C- CCBs block calcium influx into the beta-receptors, decrease the force of myocardial contraction, reduce HR, decrease PVR

51
Q

Antihypertensives: USES

A
  • mild to moderate ESSENTIAL hypertension
  • frequently in combo either as separate drugs or in a combination drug
  • most widely used
52
Q

Beta blockers: examples

A

indernal, tenormin, lopressor, corgard

53
Q

Beta blockers: action

A
  • blocks sympathetic nervous system catecholamines, resulting in reduced renin and aldosterone release and fluid balance.
  • vasodilation of arterioles leads to decrease in PVR and blood pressure
54
Q

Beta blockers: uses

A

hypertension, antianginal agents in long term tx of angina

dysrhythmias- suppress sinus and atrial tachydysrhythmias

55
Q

Betas blockers CI and caution

A

CI: pregnancy and lactation
Caution: can cause bronchoconstriction, use in caution w/ diabetes, thyrotoxicosis, cerebrovascular insufficiency, renal or hepatic dysfunction

56
Q

beta blockers: side FX

A

hypotension, bradycardia, drowsiness, depression, symptoms of CHF, insomnia, wheezing, dyspnea, malaise, lethargy

57
Q

Nitroglycerin: classification
vs.
Digitalis: classification

A

Nitro: nitrate vasodilator
Digi: cardiac glycoside

58
Q

Nitroglycerin: action

A 
relaxes vascular (arterial and venous) w/ more prominent effects on veins, which decreases preload
-arteriolar relaxation reduces systemic vascular resistance, which decreases afterload
59
Q

Digitalis: action

A
  • affects mechanical and electrical actions of the HT, increase myocardial contractility
  • alters the electrical activity in noncontractile tissue and ventricular muscle (e.g. automaticity, refractoriness, and impulse conduction)
  • inhibits Na-K ATPase
60
Q

Nitroglycerin: uses

A
  • relief of anginal pain

- in conjunction w/ beta blockers or calcium channel blockers to suppress tachycardia

61
Q

Digitalis: uses

A
  • HT failure- improves cardiac output

- Atrial fibrillation and flutter

62
Q

Nitoglycerin: CI and caution

A

CI: hypertensive clients, severe anemia, acute MI, cardiomyopathy, head trauma, cerebral hemorrhage
caution: severe hepatic or renal dz

63
Q

Digitalis: CI and caution

A

CI: hypersensitivity, ventricular tachycardia
caution: renal insufficiency, hypokalemia, advanced HT dz, acute MI, incomplete atrioventricular block, pregnancy

64
Q

Nitoglycerin: side FX

A

orthostatic hypotension, dry mouth, blurred vision, tachycardia, HAs

65
Q

Digitalis: side Fx

A

dizziness, HA, malaise, fatigue, mm weakness, visual disturbances, anorexia, hypokalemia, arrythmias, bradycardia

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