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NURS 104 Final Exam > Exam 1 Pink Packet > Flashcards

Exam 1 Pink Packet Flashcards

1
Q

What are the three phases of Drug Action?

A

Pharmaceutic (PO Only)
Pharmacokinetic
Pharmacodynamics

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2
Q

What are the four parts of the Pharmacokinetic Phase?

A

Absorption
Distribution
Metabolism
Excretion/Elimination

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3
Q

What are the three types of absorption?

A

Passive
Active
Pinocytosis

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4
Q

What is the primary site for metabolism?

A

Liver
sn: liver disease can cause decreased drug metabolism, leading to toxicity.

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5
Q

What is the main route for Excretion/Elimination?

A

Kidneys
sn: Drug accumulation can occur with kidney disease.

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6
Q

Normal range Creatinine clearance (lab test to determine kidney function)?

A

85-135 ml/min

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7
Q

Agonist

A

Produces a response

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8
Q

Antagonist

A

Block a response

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9
Q

What is the Pharmacodynamic Phase?

A

Study of drug concentration and it’s effect on the body.
Onset, Peak, Duration of action.

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10
Q

What do Adrenergic Agonists do?

Hint: Similar to Cholinergic Antagonists

A

Dilate Pupils
Bronchiole Dilation
Increased HR
Vasoconstriction
Relax Bladder, GI, uterus

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11
Q

What do Adrenergic Antagonists do?

Hint: Similar to Cholinergic Agonists

A

Pupil Constriction
Bronchiole Constriction
Decreased HR
Vasodilation
Contract Uterus

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12
Q

What do Cholinergic Agonists do?

Hint: Similar to Adrenergic Antagonists.

A

Constrict Pupil
Bronchiole Constriction
Decreased HR
Vasodilation
Contracts Bladder
Increased Peristalsis (Diarrhea)
Increased secretions

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13
Q

What do Cholinergic Antagonists do?

Hint: Can’t Spit

A

Dilated Pupils
Bronchiole Dilation
Increased HR
Urinary Retention
Constipation
Decreased secretions

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14
Q

Mr. Jones has liver and kidney disease. He is given a medication with a half-life of 30 hours. You expect the duration of action of this medication to:
A. Increase
B. Decrease
C. Remain Unchanged
D. Dissipate

A

A. Increase

Due to Mr. Jones’s kidney and liver disease, his body metabolizes the drug at a slower rate.

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15
Q

Which of the following is a correctly written goal?
A. EZ will administer the prescribed dose.
B. EZ will learn to administer insulin.
C. EZ will know how to take insulin correctly.
D. EZ will independently administer prescribed dose of insulin at end of 1 hour of instruction.

A

D. This statement is client centered, states expected change, is realistic and measurable, and has a realistic deadline.

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16
Q

Adverse reactions and drug interactions occur frequently in the older adult due to which of the following. (Select all that apply)
A. Consumption of numerous drugs due to multiple chronic illnesses.
B. Drugs ordered by several health care providers.
C. Increased incidence of allergic responses.
D. Self-medication with OTC preparations.

A

A, B, D.

Polypharmacy is a large risk with older adults. Allergic responses are no more significant in any age bracket.

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17
Q

What are some nonpharmacological treatments to help with sleep disorders like insomnia?

A

Arise at the same time
Avoid daytime naps
Avoid caffeine <6hrs b4 hs
Avoid heavy meals/exercise b4 hs
Warm bath, reading, music, milk
Decrease noise
Decrease large amounts of fluid

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18
Q

Sedative Hypnotics Uses

A

Sedation or hypnotic effect (natural sleep)
High dose anesthesia

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19
Q

Sedative Hypnotics Side Effects/Adverse Reactions

A

Hangover
REM Rebound
Dependence
Tolerance
Withdrawal symptoms
Excessive depression
Respiratory depression
Hypersensitivity

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20
Q

What is the normal respiratory rate for adults?

A

12-20

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21
Q

What are the four categories of sedative hypnotics?

A

Barbituates
Benzodiazepines
Nonbenzodiazepines
Melatonin Agonists

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22
Q

What happens to your blood pressure when you take any medication that affects your brain?

A

Decreases, watch for orthostatic hypotension.

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23
Q

What are the three types of barbituates?

A

Short-acting
Intermediate-acting
Long-acting

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24
Q

What do we use long-acting barbituates, like phenobarbitol, to treat?

A

Seizure disorders, due to the 23 hour half life we do not use these for sleep.

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25
Q

What do we use short-acting barbituates, like secobarbitol or pentobarbitol, to treat?

A

Used to induce sleep for those that have trouble falling asleep. Short half life.

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26
Q

What do we use intermediate-acting barbituates to treat?

A

Used to maintain long periods of sleep. Takes approx 1 hour to take effect.

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27
Q

Which type of barbituate is most prone to a hangover?

A

Intermediate acting

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28
Q

What is the recommended period of time you should use barbituates?

A

<2 weeks to avoid tolerance and side effects

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29
Q

What are some contraindications to barbituates?

A

Hepatotoxicity
Pregnancy
Respiratory Depression
Nephrosis

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30
Q

What are common side effects of barbituates?

A

N/V/D
Lethargy
Drowsiness
Hangover
Dizziness
Rash

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31
Q

What are some adverse reactions of barbituates?

A

Dependence
Tolerance
Urticaria (rash)
Hypotension
Respiratory Depression
Laryngospasm

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32
Q

What two endings do all benzodiazepines have?

A

Pam
Lam

Restoril (temazepam)
Ativan (lorazepam)
Valium (diazepam)

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33
Q

What is the recommended amount of time you should use a benzodiazepine?

A

No longer than 3-4 weeks to prevent REM Rebound.

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34
Q

Which Sedative Hypnotic is a highly protein bound narcotic?

A

Benzodiazepines

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35
Q

What is the main use of Benzodiazepines?

A

To treat insomnia

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36
Q

What are some contraindications for benzodiazepines?

A

Pregnancy
Lactation
Renal diseases
Liver disease
Mental Disorders

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37
Q

What contraindications do Benzodiazepines and Barbituates have in common?

A

Pregnancy
Hepatotoxicity/Liver Disease
Nephrosis/Kidney Disease

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38
Q

What are side effects of benzodiazepines?

A

Drowsiness
Lethargy
Hangover
Dizziness
Confusion
N/V/D

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39
Q

What a side effect for benzodiazepines that is not a side effect for barbituates?

A

Confusion

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40
Q

What is the antidote to benzodiazepines?

A

Flumazenil

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41
Q

What are the adverse reactions to benzodiazepines?

A

Tolerance
Dependence
Depression
Hypotension
Coma with overdose

42
Q

What a side effect for barbituates that is not a side effect for benzodiazepines?

A

Rash

43
Q

What is an adverse reaction to benzodiazepines that is not an adverse reaction to barbituates?

A

Coma with overdose
Depression

44
Q

What is an adverse reaction to barbituates that is not an adverse reaction to benzodiazepines?

A

Urticaria (rash)
Respiratory Depression
Laryngospasm

45
Q

What category of sedative hypnotics does Zolpidem (Ambien) fall in?

A

Nonbenzodiazepines

46
Q

What category of sedative hypnotics does Ramelteon (Rozarem) fall in?

A

Melatonin Agonists

47
Q

Which antihistamine is also used as a sedative hypnotic?

A

Diphenhydramine (Benadryl, Nyquil)

48
Q

What two vital signs are the most important to monitor when giving a sedative hypnotic?

A

Blood pressure
Respiratory Rate (check back in an hour)

49
Q

What two labs will you make sure to check before giving a sedative hypnotic?

A

Liver
Renal

50
Q

Why do patients pre-medicate with a narcotic analgesic (versed) and an anticholinergic (atropine) before surgery?

A

Dries secretions
Relaxes them

51
Q

What combination of medications is given with balanced anesthesia? (3)

A

Short acting barbituate (pentothol)
Inhaled gas (nitrous oxide)
Muscle relaxant

52
Q

What are the different types of anesthesia? (5)

A

Inhalation
IV
Topical ~caine
Local
Spinal - remain flat!

53
Q

What are the 5 cardinal signs of inflammation?

A

Redness
Edema
Drainage
Heat
Pain

54
Q

What chemical mediator triggers inflammation and pain?

A

COX 2

55
Q

What chemical mediator triggers clotting and protects the stomach lining?

A

COX 1

56
Q

What are the three groups of anti-inflammatory drugs?

A

NSAIDs (nonsteroidal anti-inflammatory drugs)
Corticosteroids
DMARDs (disease modifying antirheumatic drugs)

57
Q

Which medication is used for it’s anti-inflammatory, antipyretic, analgesic, and anti-platelet functions?

A

Acetylsalicylic acid (ASA)
Aspirin

58
Q

What interactions does Aspirin have?

A

Anticoagulants
Hypoglycemics (increase risk)

59
Q

What adverse reactions are associated with Aspirin?

A

Tinnitus
Vertigo
Bronchospasm
urticaria
ulceration
thrombocytopenia
bleeding

60
Q

What three adverse reactions are associated with ASA toxicity?

A

Tinnitus
Vertigo
Bronchospasm

61
Q

Can we give Aspirin to children?

A

No, this can lead to Reye’s syndrome

62
Q

What are some interventions for taking Aspirin?

A

Take with food
Monitor for bleeding
Do not crush
Avoid during/2 days before menses
Avoid before surgery
Avoid alcohol
Avoid giving to children with flu-like symptoms

63
Q

What is the main difference between aspirin and NSAIDs?

A

NSAIDs are not an anti-platelet and do not cause ototoxicity

64
Q

What anti-inflammatory drug is given for rheumatoid and osteoarthritis?

A

NSAIDs

65
Q

What interactions do NSAIDs have? (7)

A

Increase effects of warfarin
sulfonamides
certain cephalosporins
phenytoin
insulin
oral hypoglycemics
some herbs

66
Q

What adverse reactions do NSAIDs cause?

A

Bleeding
Gastric upset
N/V
Edema

67
Q

NSAIDs have most of the same adverse reactions as Aspirin, what are the differences?

A

Aspirin can not be given to children.
NSAIDs interact with dong quai, garlic, feverfew, and gingko.

68
Q

Can I take Aspirin and Ibuprofen together?

A

No, avoid taking ASA and NSAIDs.

69
Q

What benefit does selective COX-2 inhibitors have when taking NSAIDs?

A

They decrease GI problems and bleeding

70
Q

What is the one adverse reaction to selective COX-2 inhibitors?

Celecoxib (Celebrex)
Meloxicam (Mobic)

A

Edema

71
Q

What labs will you monitor for selective COX-2 inhibitors?

A

Renal BUN/creatinine

72
Q

What ending do all corticosteroids have?

A

~one

Prednisone
Prednisolone
Dexamethasone

73
Q

The half-life of corticosteroids is 24 hours, how often would some be taking them?

A

Once daily

74
Q

What are some considerations when on steroids? (4)

A

Increase WBC
Taper dose
Elevated blood sugars
Immunosuppression

75
Q

What are the main uses of DMARDs?

A

Rheumatoid Arthritis (Antimalarials)
Cancer suppression (Immunosuppressives)
Delay disease progression (immunomodulators)

76
Q

How long does it take for antimalarials to have a positive effect on RA?

A

4-12 weeks

77
Q

What disease attacks joints, tendons, and other tissues causing hyperuricemia?

A

Gout

78
Q

What is the drug used for gout?

A

Colchicine

79
Q

What are the three main side effects of Colchicine?

A

N/V/D

80
Q

What should be avoided when taking Colchicine?

A

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

ASA - instead take acetaminophen for pain

Make sure to increase fluid intake!!

81
Q

What contraindications are associated with Colchicine?

A

Sever renal disease
GI problems

82
Q

Which drug lowers serum uric acid by getting “all the purines out”?

Used to prevent gout

A

Allopurinol

83
Q

What nursing implications are associated with allopurinol? (3)

A

Increase water intake
Avoid alcohol, caffeine, & thiazide diuretics
Yearly eye exam

84
Q

What drug increases the rate of uric acid excretion by inhibiting its reabsorption?

Used for chronic gout

A

Uricosurics

85
Q

What are the 7 types of pain?

A

Acute - non narcotic and narcotic
Cancer - narcotic
Chronic - non narcotic and narcotic
Somatic - NSAIDs
Superficial
Vascular - non narcotic
Visceral - narcotic

86
Q

What are some nonnarcotic analgesics? (4)

A

ASA
NSAIDs
Acetaminophen (tylenol)
Antipyretics

87
Q

Does tylenol have anti-inflammatory properties?

A

No, tylenol is only an anelgesic and antipyretic.

88
Q

What are adverse reactions to acetaminophen?

A

Overdose is life threatening
Hepatotoxicity (look for N/V/D, abdominal pain)

89
Q

Narcotic analgesics act on the CNS, so what two vitals signs will you watch?

A

Blood Pressure
Respiratory Rate

90
Q

What are some of the uses of narcotic analgesics?

A

Moderate/severe pain
Antitussive (cough)
Antidiarrheal

91
Q

What are some common side effects of narcotic analgesics? (6)

A

N/V
constipation
Decreased BP
Urinary Retention
Tachycardia
Drowsiness

92
Q

What are some common adverse reactions of narcotic analgesics? (5)

A

Orthostatic hypotension
Respiratory depression
Tolerance
Dependence
Abstinence syndrome

93
Q

What is the antidote for narcotic analgesics?

A

Naloxone (Narcan)

94
Q

What different ways can you administer morphine?

A

IV - frequently PCA
PO
SC
IM

95
Q

When giving the opioid morphine via IV push, how quickly are you pushing it?

A

Slowly! Over 4-5 minutes

96
Q

What are some uses of morphine?

A

Acute MI - relaxes coronary vessels
CA
acute pain
Severe pain

97
Q

What is the generic name for hydromorphone?

A

Delaudid

98
Q

Delaudid is six times more potent than morphine, yet has a shorter duration of action. What must you do when giving delaudid IV?

A

IV push slowly over 2-5 minutes

Must dilute with normal saline

99
Q

What are two other types of narcotic analgesics besides morphine and hydromorphone?

A

Combination - hyrdocodone/acetaminophen - vicoden
codeine/acetaminophen - Tylenol #3

Transdermal opioid - fentanyl patch

100
Q

What do all anticonvulsants have in their name?

A

~gaba

101
Q

What drugs help to decrease spasticity and pain related to muscular hyperactivity?

A

Muscle relaxants - no longer than 3 weeks

NURS 104 Final Exam (5 decks)

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