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Schoolcraft Nursing 104 Pharmacology > Exam 1 Drug Facts > Flashcards

Exam 1 Drug Facts Flashcards

The nursing process info, nursing considerations, etc.

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1
Q

Tamazepam, Lorazepam, Diazepam

A

Benzodiazepenes -

Anxiolytic, tranquilizer​

Highly protein bound​

Benzodiazepine antidote flumazenil​

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2
Q

Name 3 Benzodiazepenes -Pam

A

Tamazepam, lorazepam, diazepam

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3
Q

Tamazepam is generic for

A

Restoril

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4
Q

Lorazepam is generic for

A

Atavan

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5
Q

Diazepam is generic for

A

Valium

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6
Q

What are benzodiazapenes used for?

A

Use- treat insomnia​

​

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7
Q

Aspirin is an example of

A

Salicylates

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8
Q

What are the functions of salicylates?

A

anti-inflammatory, antiplatelet, antipyretic, analgesic​

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9
Q

Other sedatives that aren’t benzos are:

A

Hypnotics and melatonin agonists

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10
Q

An example of a nonbenzo hypnotic is:
a melatonin agonist is:

A

Zolpidem (Ambien)​
Ramelteon (Rozerem)​

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11
Q

Nursing Assessment for sedatives

A

baseline vitals, labs (renal and liver), sleeping problems, drug history (highly protein bound- benzo)​

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12
Q

Nursing Diagnosis for sedatives

A

disturbed sleep pattern

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13
Q

Nursing Planning for sedatives

A
  • Client will remain asleep for 6-8 hours (benzo)​
  • Client will receive adequate sleep w/o hangover effect when taking hypnotic (barb)​
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14
Q

Nursing interventions for sedatives

A

Avoid other CNS depressants, herbs, alcohol​

  • Prevent injury​
  • Report side effects​
  • Nonpharmacological methods​
  • Avoid driving​
  • Assess effectiveness​
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15
Q

Nursing evaluation for sedatives

A

​

  • Effectiveness​
  • Side effects (hangover, barb)​
  • Resp depression
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16
Q

Describe balanced anesthesia

A

Combination of drugs for general anesthesia​

Hypnotic night before​

Premed w/ narcotic analgesic (versed) and anticholinergic (atropine)-relaxes & decreases secretions​

Short acting barbiturate (pentothal)​

Inhaled gas administered (nitrous oxide)​

A muscle relaxant prn

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17
Q

What are the stages of anesthesia?

A

There are four:
Analgesia- induction stage​

Excitement or delirium​

Surgical- surgical procedure is performed during this stage​

Medullary paralysis- toxic stage, ventilatory assistance required

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18
Q

What are the types of anesthesia?

A

Inhalation anesthesia- 3rd stage of balanced​

IV anesthesia- Induction of balanced or as general​

Topical- decrease sensitive nerve endings of affected area​

Local- block pain at the site where injected​

Spinal- local anesthetic injected into subarachnoid space. Remain flat after surgery, Monitor BP

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19
Q

Describe the nursing process for anesthesia?

A

Assessment- VS, Drug hx., health hx.​

Diagnosis- Pain​

Plan- VS will remain stable, understand care​

Interventions- monitor VS, U/O, side effects, post op recovery. Teach.​

Evaluation

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20
Q

An example of a salicylate is

A

Acetylsalicylic Acid - Aspirin

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21
Q

What are the interactions of salicylates?

A

anticoagulants, hypoglycemics (increase risk of hypoglycemia)​

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21
Q

What are the adverse reactions and cautions of salicylates?

A

tinnitus, vertigo, bronchospasm*,urticaria, ulceration, thrombocytopenia, bleeding * = ASA toxicity​

Caution: Avoid during third trimester, do not give to children with flu/viral symptoms (Reye’s syndrome)​

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21
Q

What are the labs to monitor with salicylates?

A

PT, bleeding time, platelets

22
Q

What are the contraindications for Benzodiazepines?

A

Contraindications- pregnancy, lactation, renal, liver, mental disorders​

​

23
Q

What has interactions with benzodiazepines?

A

Interactions- avoid alcohol, other CNS depressants, increases liver enzymes​

24
Q

What are side effects of benzodiazepines?

A

drowsiness, lethargy, hangover, dizziness, anxiety, confusion, N/V/D​

25
Q

What are adverse effects of benzodiazepines?

A

tolerance, dependence, depression, hypotension, coma w/ od​

26
Q

What are 3 catagories of anti-inflammatories?

A

NSAIDS - inhibit COX 1&2
Corticosteroids
Disease-modifying antirheumatic drugs (DMARDs)​

27
Q

What are nursing interventions for acetylsalicylic acid?

A

There are 7
Take with food/milk​

Monitor for bleeding (dark tarry stools, bleeding gums, petechiae, ecchymosis, purpura)​

Do not crush or break enteric coated ASA​

Avoid taking 2 days before & during menses, ​

Avoid before surgery​

Avoid Alcohol​

Avoid giving to children with flu-like symptoms (risk of Reye’s Syndrome)​

28
Q

Name two NSAIDS

A

Ibuprofen (Advil)
Ketorolac (Toradol)

29
Q

Ibuprofen and Ketorolac are both examples of:

A

NSAIDS

30
Q

What are the functions of NSAIDS?

A

Function: Antiinflam., Analgesic, Antipyretic; Given for Rheumatoid and Osteoarthritis​

31
Q

What are the interactions of NSAIDS?

A

Interactions: Increase effects of Warfarin (Coumadin), sulfonamides, certain cephalosporins, phenytoin, insulin, oral hypoglycemics, some herbs ​

32
Q

What are the adverse effects of NSAIDS?

A

Adverse Effects: gastric upset, GI bleed, N, V, edema, (bleeding gums, petechiae, ecchymosis, black, tarry stools)​

33
Q

What are nursing interventions for NSAIDS?

A

Educate:​

Side effects​

Avoid taking ASA with NSAIDS​

Avoid use 2 days before and and first 2 days of menses​

Avoid during 3rd trimester​

Avoid before surgery​

Avoid alcohol​

Administer with food​

Interactions with following herbs:​

Dong quai, garlic, feverfew, ginko

34
Q

What do COX 1 and COX 2 inhibitors affect?

A

COX-1​Inhibition leads to decreased stomach lining protection and decreased clotting time.​

COX-2​ Inhibition leads to decreased inflammation & pain​

Introduction of selective COX-2 inhibitiors have decreased GI problems (and bleeding) associated with NSAIDS

35
Q

What are two examples of selective COX-2 inhibitors?

A

Celecoxib (Celebrex) & Meloxicam (Mobic)​

36
Q

What are the adverse effects of selective COX-2 inhibitors? What labs are important?

A

Less incidence of GI problems & bleeding but higher risk of problems associated with clots​

AE: edema​

Labs: renal​

37
Q

Name three Corticosteroids ~one

A

Prednisone, prednisolone, dexamethasone​

38
Q

What is the T1/2 of corticosteroids?

A

T1/2 > 24h

39
Q

What are corticosteroids used for?

A

Frequently used as anti-inflammatory​

May be used for arthritic flare-ups​

40
Q

What are steroid considerations?

A

Do not stop abruptly; important to be tapered; gradually weaned off​

May elevate blood sugars (hyperglycemia)​

Causes immunosuppression​

Lab Interactions: Elevated blood glucose, elevated WBC’s

41
Q

Name 3 DISEASE-MODIFYING ANTIRHEUMATIC DRUGS (DMARDS)

A

Imuran, Cytoxan, methotrexate

42
Q

What are DMARDS used for?

A

As anti-inflammatory for Rheumatoid Arthritis (RA)

primarily used to suppress cancer growth and proliferation, but might also be used to suppress the inflammatory process of RA​

43
Q

What are 3 types of DMARDS (not drug names -types)

A

Immunosuppressive, Immunomodulators, Antimalarials​

44
Q

Discuss Immunosupressive DMARDS

A

Disrupt the inflammatory process and delay disease progression​

Predispose patient to severe infection​

TNF (Tumor necrosis factor )Blockers​

Bind to TNF and block it from attaching to TNF receptors on synovial cell surfaces​

Etanercept (Enbrel), influximab (Remicade), (Humira)​

Interleukin (IL-1) receptor antagonists​

IL-1 is a proinflammatory cytokine that contributes to synovial inflammation and joint destruction​

Anakinra (Kineret)

45
Q

Name 4 Immunosuppresive DMARDs

A

Etanercept (Enbrel), influximab (Remicade), Adalimumab (Humira)​
Anakinra (Kineret)

46
Q

Things to know about antimalarial DMARDS

A

Action: anti-inflammatory, analgesic for RA (Rheumatoid Arthritis)​

Response: May take up to 4-12 weeks​

May be used in combination with NSAIDS

47
Q

What is gout?

A

uric acid metabolism disorder and defect in purine metabolism that leads to hyperuricemia​

48
Q

Name an anti-inflamatory gout drug:

A

Colchicine

49
Q

Considerations for Colchicine

A

Action: Inhibits migration of leukocytes​

Side effects: N, V, D (75% taking high doses)​

Contraindications: Severe renal, GI problems​

Nursing Implications: ​

Avoid foods rich in purines (wine, alcohol, organ meats, sardines, salmon, gravy)​

Increase fluid intake​

Take acetaminophen for pain; Not ASA​

50
Q

How do you prevent REM rebound when using Benzodiazepines?

A

Do no tuse for longer than 3-4 weeks.

51
Q

Benzodiazepines are Schedules IV Narcotics- True or False

A

True

52
Q

3 chemical mediators of inflammation:

A

Prostaglandins​

COX: enzyme that promotes synthesis of prostaglandins​

COX 2 – triggers inflammation & pain

53
Q

Three complications of hyperuricemia

A

pain, urinary calculi, gouty nephropathy

54
Q

What are the five stages of the inflammatory response?

A
55
Q
A

Schoolcraft Nursing 104 Pharmacology (12 decks)

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