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Pharmacology NUR 161 > Exam 1 Pharm Maps > Flashcards

Exam 1 Pharm Maps Flashcards

1
Q

What are some examples of opioid drugs (8)?

A

Morphine, Hydromorphone (Dilaudid), Fentanyl, Oxycodone (Oxycontin), Hydrocodone, Codeine, Hydrocodone/Acetaminophen (Vicodin), & Oxycodone/Acetaminophen (Percocet)

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2
Q

What are the reasons for taking opioids?

A

Moderate Pain
Severe Pain
Sedation

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3
Q

What is the action of opioids?

A

Binds to MU receptors in the central nervous system. Slows down CNS

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4
Q

What are the contraindications for opioids (3)?

A
  1. Decreased LOC, BP, or HR
  2. Severe Asthma
  3. Mixing with other opioids or CNS depressants
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5
Q

What are adverse reactions to Opioids (7)?

A
  1. Respiratory depressant
  2. Hypotension
  3. Bradycardia
  4. Purititis
  5. Sedation
  6. Addiction
  7. Chronic Constipation
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6
Q

When taking opioids, monitor what (3)?

A

RR, BP, & LOC

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7
Q

When taking opioids, assess pt.’s what?

A

Pain level

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8
Q

When taking opioids, check __ before administering.

A

Level of consciousness

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9
Q

When taking opioids, monitor for s/s of__.

A

Overdose

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10
Q

Opioid pt. education. May cause ___/___. Therefore pt. should do these 2 things.

A

May cause dizziness/lightheadedness
1. Stand or change positions slowly
2. Caution when driving or operating heavy machinery

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11
Q

Opioid pt. education. May cause ___. Recommend using a ___.

A

May cause constipation
Recommend using a stool softener daily

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12
Q

Avoid ___ or ___ when taking opioids.

A

Alcohol or other CNS depressants (benzo)

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13
Q

____ is often used in surgical procedures.

A

Fentanyl

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14
Q

Respiratory rate ___ hold and notify MD. (Opioid)

A

Less than 10

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15
Q

S/S of opioid overdose

A

Decrease LOC & decreased respirations

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16
Q

Antidote for opioid is ___.

A

naloxone (Narcan)

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17
Q

Naloxone (Narcan) has what kind of half-life?

A

Short half-life, and may need more than one dose

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18
Q

Monitor how much ___ with Percocet

A

Tylenol when Percocet is given with Tylenol

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19
Q

Non-opioid analgesics drug names (2)

A

Acetaminophen (Tylenol)
Tramadol (Ultram)

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20
Q

Reason for taking non-opioid analgesics

A

Mild to moderate pain

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21
Q

What non-opioid analgesics is given as a fever reducer?

A

Tylenol

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22
Q

What is the action of non-opioid analgesics?

A

Decreases prostaglandin synthesis = blocks pain impulses

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23
Q

Non-opioid analgesics contraindication

A

Liver disease

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24
Q

What should be avoided when taking tramadol?

A

SSRIs and MAOIs

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25
Non-opioid analgesics adverse reactions (2)
1. Hepatotoxicity 2. GI upset
26
Assess ___ prior to administering non-opioid analgesics and ___ after
Pain level, 30 minutes after
27
How much Tylenol can be given in a 24 hour period?
3 grams
28
Non-opioid analgesics pt. education (4)
1. Take as directed 2. Caution if you have renal or liver problems 3. Take with food 4. Avoid alcohol
29
Antidote for acetaminophen is ___
Acetylcysteine
30
Tramadol is considered a ___ opioid
Weak opioid - inhibits the reuptake of serotonin
31
Tramadol can cause ___ if taken with an MAOI or SSRI's
Serotonin toxicity (hyperreflexia, tremors, tachycardia)
32
NSAIDS drug names (4)
Salicylate Acid (Aspirin) Ibuprofen (Motrin) Ketorolac (Tordal) Celecoxib (Celebrex)
33
Reasons for taking NSAIDS (4)
1. Analgesic 2. Anti-inflammatory 3. Antipyretic 4. Antiplatelet (aspirin)
34
NSAIDS action
Decreases production of prostaglandin release by blocking COX enzymes
35
NSAIDS contraindications (3)
1. Peptic Ulcer Disease 2. GI bleeding 3. Vitamin K deficiency
36
NSAIDS adverse reactions (4)
1. GI bleeding 2. Stomach ulcers 3. Nephrotoxicity with Tordal 4. Hepatoxicity in some cases
37
Aspirin can cause __ in children.
Reye Syndrome
38
When taking NSAIDS monitor for ___
Unusual bleeding
39
Assess ___ before and ___ after administration of NSAIDS
Pain level, 30 minutes
40
Monitor ___ & ___ if taking Toradol
ALT/AST & BUN, Creat
41
Take NSAIDS with ___
Food or milk
42
Avoid ___ and ___ with NSAIDS
Alcohol and other hepatoxic drugs
43
Report any ____ or ___ to MD (NSAIDS)
Any black stools or noticeable bleeding
44
NSAIDS may cause ___
Kidney damage
45
Do not give ___ to children
Aspirin
46
Tordal should only be given for __
5 days
47
Do not ____ enteric coated aspirin
Crush
48
Aspirin is also used as an ___
Antiplatelet
49
S/S of Reye Syndrome (4)
Bleeding, tachycardia, seizures, & coma
50
What is another name for Feverfew?
Chrysanthemum parthenium
51
Reasons for taking Feverfew (2)
Arthritis & Migraines
52
Action of Feverfew
Reduces prostaglandin release = decrease inflammation (arthritis) Inhibits vascular smooth muscle (reduce migraines)
53
Contraindications of Feverfew (2)
1. Any blood thinner medications 2. Pregnant or breastfeeding
54
Feverfew adverse reactions
An allergy to ragweed may be sensitive
55
Feverfew takes up to a ___ to work
Month
56
Why should pt.s NOT eat fresh feverfew leaves?
Causes mouth sores
57
The pt. is a young married female, what do you tell her about Feverfew?
Can bring on contractions if pregnant & can bring on menstrual cycle
58
What is another name for Gingko?
Gingko Biloba
59
Reason for taking gingko
Improves circulation
60
Action of gingko
Protect neurons from oxidation
61
Contraindications of gingko (2)
1. Bleeding disorders 2. Seizure disorders
62
Gingko adverse reactions (6)
1. Headache 2. Dizziness 3. Heart palpitations 4. Constipation 5. Upset stomach 6. Skin irritations
63
Do not eat ___ of gingko
Raw leaves
64
Monitor for ___ , __ & ___ when taking gingko
Bleeding Sz activity Skin irritations
65
What is another name for St. John's Wort?
Hypericum perforatum
66
Reasons for taking St. John's Wort (2)
Depression & Menopausal symptoms
67
Action of St. John's Wort
Decreases serotonin receptors which affects the area of the brain associated with depression
68
St. John's Wort contraindications
Warfarin (Coumadin) - Reduces the effect
69
St. John's Wort Adverse reactions (5)
1. Anxiety & agitation 2. Dizziness 3. Dry mouth 4. Photosensitivity 5. Serotonin syndrome
70
When should pt.s taking St. John's Wort notify their MD?
Chronic or sever GI symptoms
71
Reason for taking Echinacea
Common cold
72
Pt. on St. John's Wort has muscle rigidity, dilated pupils, & confusion. What do you suspect is happening?
Serotonin Syndrome
73
Action of echinacea
Stimulates macrophages & other cells of the innate immune system, causing them to become activated and release cytokines
74
Echinacea contraindication
Warfarin
75
Echinacea adverse reactions (3)
1. GI upset 2. Jitteriness 3. Tachycardia
76
What do we tell our pt.s when they start echinacea
Take at first sign of cold Call MD if fast heart rate
77
What is another name for ginseng?
Panaxquinquefolius
78
Reasons for taking ginseng (3)
Reduces stress Builds immunity Increases memory
79
Action of ginseng
Prostaglandin inhibitor
80
Ginseng contraindication
Warfarin - reduces effectiveness of this drug
81
Ginseng adverse reactions (2)
1. Nervousness 2. Insomnia
82
What happens when women use ginseng regularly?
Changes to menstrual cycle
83
What lab should be monitored with ginseng?
Serum glucose or FSBG (can increase glucose levels)
84
What should be avoided with ginseng?
Caffiene
85
Stop taking ginseng after _. Why?
3 months Increases the risk of side effects
86
What is another name for ginger?
Zingiber officinale
87
Reasons for taking Ginger (2)
Nausea Vomiting
88
Action of ginger?
Decreases serotonin receptors and releases antiemesis affects on the nausea center of the brain
89
Ginger contraindications (2)
1. Bleeding disorders 2. Warfarin
90
Ginger adverse reaction (2)
1. Belching 2. GI discomfort
91
Why is ginger avoided in patients with bleeding disorders? What would I caution those pt. about?
Slow blood clotting = increase bleeding Shaving w/razors, holding pressure on wounds and/or call MD
92
Pt. who are to have __ or a __need to make sure to tell their MD if they are taking ginger
Surgery or a procedure
93
Assess ____ & ____ before & after administering (All CNS depressants)
Level of consciousness & vital signs
94
Caution in ___ and ____ (All CNS depressants)
Elderly and sleep apnea
95
Caution in pt. with __ or __ problems (All CNS depressants)
Kidney or liver
96
Caution with other ___ (All CNS depressants)
CNS depressants
97
Caution while ____ or ____ (All CNS depressants, pt. teaching)
Driving or operating heavy machinery
98
Avoid ____ & ____ (All CNS depressants, pt. teaching)
Alcohol & other CNS depressants
99
DO NOT STOP ___ (All CNS depressants, pt. teaching)
ABRUPTLY
100
Take ____ due to a high abuse rate (All CNS depressants, pt. teaching)
As directed
101
Benzodiazepines drug names (4)
1. alprazolam (Xanax) 2. midazolam (Versed) 3. clonazepam (Klonopin) 4. diazepam (Valium)
102
Reasons for taking Benzodiazepine (4)
1. Anxiety 2. Alcohol withdrawal, seizure activity - diazepam (Valium) - alprazolam (Xanax) 3. Sedation - midazolam (Versed 4. Panic disorder - clonazepam (Klonopin)
103
Benzodiazepine action
Thought to enhance GABA
104
Benzodiazepines contraindications (2)
1. Pregnancy 2. Narrow-angle glaucoma
105
Benzodiazepines adverse reaction (4)
1. Drowsiness 2. Loss of coordination 3. Dry mouth 4. Constipation
106
What do you need to monitor before and after administering Benzodiazepines?
Vital signs, LOC
107
Pt. is lethargic with shallow respirations what medication are you anticipating administering benzodiazepines?
Flumazenil (Ramazicon)
108
What is the "caution" with Flumaxenil?
Pt. with seizure disorders
109
How do you know the pt. is going through withdrawal?
Confusion, tremors, irritable, elevated HR & BP
110
What is the difference bt. midazolam (Versed) & other benzodiazepines?
Midazolam is fast acting, short half-life and used for sedation
111
Non-benzodiazepine drug name
Zolpidem (Ambien)
112
Reason for taking Ambien
Insomnia
113
Action of Ambien
Binds to neuroreceptors that slows brain activity
114
Ambien contraindications (2)
1. Kidney disease 2. Other CNS depressants - Opioids - Benzodiazepines - Alcohol
115
Ambien adverse reaction (3)
1. Decreased LOC 2. Confusion 3. Short term memory loss
116
Usual dose of Ambien is __ and can titrate up to ___
5mg 10mg
117
What is different about zolpidem (Ambien) CR?
Has 2 components. Part of drug is released immediately to fell asleep. The rest is released overnight to help stay asleep
118
What do you need to teach your patient about Ambien before discharge?
Keep a regular bedtime schedule, may cause somnambulance (sleepwalking), avoid large meals at night, NO activity at least one hour before (TV, screen, DRIVING, etc.), don't take another sleep aid with Ambien
119
What should you assess before and after administering Ambien?
LOC, risk of injury, vitals
120
Muscle relaxants drug name
cyclobenzaprine (Flexeril)
121
Reason for taking Flexeril
Several skeletal muscle conditions like Multiple Sclerosis, muscle spasms, orthopedic surgeries
122
Action of Flexeril
Relaxes smooth muscles to help alleviate pain d/t muscle tension or spasms
123
Flexeril contraindications
Caution with other CNS depressants
124
Flexeril adverse reactions (3)
1. Weakness 2. Fatigue 3. Drowsiness
125
Felxeril works better along the side of ___
Physical therapy
126
How do you treat a muscle relaxants overdose? What do you monitor?
Supportive Monitor LOC, EKG, airway and fluids
127
Increase fluids when taking muscle relaxants to avoid ___
Crystalloid (mineral salts)
128
What are you assessing/monitoring with Flexeril as the nurse?
Ambulation, LOC, coordination
129
What are you teaching your pt. about Flexeril at discharge
Increase fluids, may cause loss of coordination, don't drive or operate machinery while taking
130
CNS Stimulants drug name
sumatriptan (Imitrex) (Triptans)
131
Reason for taking sumatriptan
Migraine headache
132
Action of sumatriptan
Stimulates 5-HT1 receptors in cerebral arteries causing vasoconstriction Helps decrease the production of inflammatory neuropeptides
133
Sumatriptan contraindications
Pregnancy
134
What are you going to assess as the nurse (sumatriptan)?
Pain, effectiveness of drug
135
What are you going to teach your pt. before discharge about sumatriptan?
- Take at the onset of a headache - Avoid bright lights and noise after taking - Another tablet can be taken in 2 hours if the headache still persists - If pregnant or pain to become pregnant, notify MD immediately
136
Assess/monitor ____ (All Antiepileptics)
Level of consciousness
137
Monitory for ___ activity (All Antiepileptics)
Seizure
138
Medication list for ___ (All Antiepileptics)
other CNS depressants
139
Notify MD if you start to have ___ (All Antiepileptics, pt. teaching)
suicidal thoughts
140
Caution while ___ because it may cause ____ (All Antiepileptics, pt. teaching)
Driving Drowsiness
141
Take at the ___ (All Antiepileptics, pt. teaching)
Same time every day w/food
142
Can decrease the effectiveness of __ (All Antiepileptics, pt. teaching)
Birth control
143
Avoid___ (All Antiepileptics, pt. teaching)
Alcohol
144
What's another name for phenytoin
Dilantin
145
Reason for taking phenytion
Seizure disorders
146
Action of phenytoin
Thought to work on GABA to decrease impulses along the neuro pathway
147
Contraindications to phenytoin (2)
1. Teratogenic 2. Multiple drug interactions
148
Phenytoin adverse reactions (3)
1. Gingival hyperplasia 2. Ance 3. Hirsutism (women grow dark, coarse facial hair)
149
Push phenytoin IV slowly over ___ to avoid ___
50mg/min Cardiac arrest
150
What lab values do we need to monitor for phenytoin?
Serum drug levels (10-20mcg/mL)
151
What is another name for Tegretol?
carbamazepine
152
Reason for taking Tegretol
Seizure disorders
153
Action of Tegretol
Thought to work on GABA to decrease impulses along the neuro pathway
154
Tegretol contraindications
Multiple drug interactions
155
Tegretol adverse reaction (3)
1. Bilsters around the mouth 2. Aplastic Anemia 3. Anaphylactic reaction
156
What labs are you going to monitor with Tegretol(4)?
Serum drug levels (4-12mcg/mL), platelets, WBC, RBC
157
Inform pt. taking Tegretol to notify MD if they have any ___
Unusual bleeding
158
Report __ or ___ to MD (Tegretol)
Fever or sore throat
159
Tegretol can also be given for ___
Neuropathic pain
160
What is another name for Keppra?
levetiracetam
161
Reason for taking Keppra
Seizure disorders
162
Action of Keppra
Thought to work on GABA to decrease impulses along the neuro pathway
163
Keppra adverse reactions (2)
1. Suicidal thoughts 2. Steven-Johnson Syndrome
164
Keppra must be ___ to an effective dose
Titrated
165
What is the max dose of Keppra
3000mg/day
166
What is another name for gabapentin?
Neurontin
167
Reason for taking gabapentin
Seizure disorders
168
Action of gabapentin
Inhibits over-excitement of brain activity by synthesizing GABA
169
gabapentin contraindications (3)
1. Avoid alcohol 2. Pregnancy 3. Other CNS depressants
170
gabapentin adverse reactions (3)
1. Respiratory depression 2. Dizziness or drowsiness 3. Edema
171
Gabapentin is used most often in pt. with ___
Neuropathic pain
172
What is another name for Depakote?
valproic acid
173
Reason for taking Depakote
Seizure disorders
174
Action of Depakote
Inhibits over-excitement of brain activity by synthesizing GABA
175
Depakote contraindications (2)
1. Liver disease 2. Pancreatitis
176
Depakote adverse reactions (4)
1. Dizziness or Drowsiness 2. Hair loss 3. Hepatoxic 4. Pancreatitis
177
Depakote is also used to treat ___
Bipolar disorder
178
What labs are you going to monitor for Depakote?
Serum drug levels (50-100mcg/mL), ALT, & AST
179
Increase ___ when taking Depakote
protein intake

Pharmacology NUR 161 (4 decks)

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