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Pharmacology II > Exam 1 Review > Flashcards

Exam 1 Review Flashcards

1
Q

What order is expected to be made before administering antibiotic treatment?

A

Culture and sputum (C&S) testing

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2
Q

Can RNs delegate piggyback IV administration to LVN?

A

No

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3
Q

What type of antibiotic should be administered if a culture sputum test cannot be retrieved right away? A greater potential for obtaining what when using this antibiotic?

A

A broad-spectrum antibiotic, higher risk for superinfection

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4
Q

Narrow spectrum antibiotic is specifically for?

A

A targeted causative agent of the infection

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5
Q

Broad-spectrum is also called? and used for?

A

Empirical antibiotic, used when the microorganism is not identified

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6
Q

To replace normal intestinal flora, what can an RN give to the patient? (3)

A

A probiotic yogurt, buttermilk, or acidophilus supplement

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7
Q

Patient teaching about antibiotics? (3)

A
  • Must take the entire dose
  • Take with plenty of fluid unless contraindicated in patients with HF
  • S/S: GI distress, diarrhea (esp in young children), can possibly obtain C. diff infection
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8
Q

Why do we give multidrug therapy to TB patients? How many should be given?

A

To prevent drug-resistance, at least 3-4 medications

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9
Q

What should an RN assess for female patients on antibiotic therapy?

A

If the patient has backup contraceptives because antibiotics could decrease the effectiveness of oral contraceptives (ex: ensure usage of condom)

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10
Q

A patient has a rash/itching after past antibiotic use, what should the RN do before administering antibiotics?

A

Assess the extent of the reaction (could indicate allergy or anaphylaxis)

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11
Q

Amoxicillin is used commonly for? What type of antibiotic is it? What is its chemical structure, which is similar to? If this patient is allergic to amoxicillin, they may be allergic to?

A
  • to treat gram + and - bacteria
  • penicillin antibiotic
  • beta-lactam structure similar to cephalosporin drugs
  • allergy to penicillin = allergy to cephalosporin
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12
Q

What is a common side effect of amoxicillin? Example?

A

Superinfection: kills normal flora along with infective bacteria; ex) female patients may develop yeast infection along with initial infection

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13
Q

Gentamicin is an antibacterial that is? Use precaution with which population of patients?

A

Nephrotoxic, use caution with patients with kidney disorders. Caution with older or diabetic patients

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14
Q

Trimethoprim-sulfamethoxazole is an antibiotic that primarily treats? Patient teaching includes (2)

A
  • uncomplicated UTIs
  • limit exposure to sunlight because of photosensitivity side effect
  • increase fluid intake because urine becomes crystal urea
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15
Q

Nystatin is an antibiotic used to treat? Patient teaching includes (1)

A
  • oral candidiasis

- direct the patient to swish in the mouth for a few minutes

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16
Q

Acyclovir sodium is what type of drug? It is used to treat? What teaching should be made and why?

A
  • antiviral
  • herpes virus
  • educate the patient to increase fluid intake to filter because drug is nephrotoxic
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17
Q

Phenytoin is an antiseizure/anticonvulsant drug used to treat?

A

Tonic-clonic seizures

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18
Q

Phenytoin is used with caution because it has a? Must monitor for toxicity using?

A

Narrow-therapeutic index: need enough medication to be effective but not toxic; monitor peak and trough levels

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19
Q

Side effects of phenytoin include? (3)

A
  • teratogenic (HCP must change the order if the patient is pregnant)
  • brown urine
  • anticholinergic side effects
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20
Q

Anticholinergic side effects include? (5)

A
  • dry mouth
  • urinary retention
  • constipation
  • dilated pupils
  • increased HR
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21
Q

Atenolol is what type of drug? Used to treat?

A

Adrenergic antagonist (selective beta-blocker) used to treat hypertension

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22
Q

What are the clinical manifestations before and after atenolol use?

A

Before: hypertension
After: drop in BP

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23
Q

1 side effect of atenolol? Educate patient to monitor? (2)

A
  • hypotension

- monitor HR and BP

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24
Q

Epinephrine is what type of drug? Which receptors does it activate? Which route can this drug be given?

A

Adrenergic agonist; activates A1, A2, B1, B2 receptors; IV or IM route only (cannot be given orally)

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25
Q

What is expected to see if a patient is on epinephrine? (3)

A
  • increase HR
  • bronchodilation
  • high glucose levels for energy
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26
Q

Atropine is what type of drug? Its purpose is to do what? (2) What is a side effect?

A
  • Anticholinergic that works on muscarinic receptors
  • purpose is to increase heart rate when bradycardia is present and used pre-operatively to decrease saliva
  • anticholinergic side effects (dry mouth, decreased peristalsis)
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27
Q

All NSAID drugs are toxic to which organ? Can also cause?

A
  • kidneys

- cause GI distress because it inhibits COX1 and COX2

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28
Q

Ibuprofen is what type of drug? (3) Used for what type of pain? Side effects include? Brand name for ibuprofen?

A
  • NSAID, analgesic, antipyretic
  • mild to moderate pain in muscles; decreases fever
  • GI bleeds/distress
  • Advil
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29
Q

Aspirin is considered (4)?

A
  • antiplatelet
  • antipyretic
  • NSAID
  • analgesic
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30
Q

How does aspirin function as an antiplatelet? It does not do what action?

A

keeps platelets from sticking together (aggregation) but does NOT stop coagulation

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31
Q

How does aspirin function as an analgesic?

A

reduces the prostaglandins (COX1 and 2) to decrease inflammation and pain

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32
Q

Side effects of aspirin? (2) Cannot be given to which population of patients?

A
  • GI distress
  • risk for bleeding
  • cannot give to children because it can cause Reye’s syndrome
33
Q

Acetaminophen is considered what type of drug? What does it not do?

A
  • analgesic and antipyretic

- does not address inflammatory response, is NOT an NSAID

34
Q

Acetaminophen is used to treat? Favorable in doing this because? It is toxic to which organ? Brand name for acetaminophen?

A
  • mild to moderate pain (ex: 4/10)
  • decreases risk for bleeding unlike aspirin
  • liver
  • Tylenol
35
Q

Acetaminophen can be given to which population of patients? Is it possible to take too much acetaminophen?

A
  • children

- too much can lead to liver shutdown which can cause a painful death

36
Q

Morphine sulfate is what type of drug? How is it measured? Used to treat what type of pain? (2)

A
  • opioid
  • given in milligrams
  • moderate to severe pain; anxiety and pain associated with myocardial infarction
37
Q

The greatest concern when using opioids is? What is used as an antidote for overdose? What other side effect

A
  • respiratory depression (ex: may show resp rate of 10 or below)
  • Narcan or naloxone
  • severe constipation with long-term use
38
Q

What is expected to see in a patient who is using morphine?

A

Decreased level of pain

39
Q

Itching is a general side effect for what reaction? What should be given to treat the reaction? What should be given to treat itching?

A
  • anaphylaxis
  • epinephrine should be given for anaphylactic reaction
  • Benadryl (antihistamine) is used to treat itching as a common side effect
40
Q

What should the RN assess to determine if a patient should receive an oral opioid or an IV push of morphine?

A

Pain assessment for severity or effectiveness of drug; more severe pain may require an IV push for a faster onset

41
Q

Morphine can be given through a PCA, what if a family member tries to control the device?

A

RN must intervene and educate that patient is the only person that can control PCA

42
Q

What if a patient asks to leave medication in the room to take at a later time?

A

RN cannot leave medication in the room unsupervised

43
Q

What factors must be assessed during pain assessment? (3)

A
  • has the patient felt this pain before
  • aggravating factors
  • relieving factors
44
Q

If a patient is drug-seeking, where might an RN find track marks other than the arms? (2)

A
  • legs

- in between toes

45
Q

What should a nurse do before sending a patient that is on opioid use to palliative care? If a patient is on IV use, how much of the drug should be given orally?

A
  • wean the patient off the medication

- higher oral morphine dosage should be given because it goes through liver bypass

46
Q

What receptors does morphine work on? (3)

A

Mu, Kappa, Delta

47
Q

If the opioid is a partial agonist-antagonist, what does it do?

A

Activates 2 of the 3 receptors

48
Q

Dilaudid or hydromorphone must be measured in? Expect what order to be made for this drug?

A
  • Micrograms

- peak and trough order because of narrow therapeutic index

49
Q

Lithium is used to treat? (2) What order would be made for this drug? A side effect is?

A
  • treat bipolar disorder, decrease manic disorder
  • peak and trough order because of narrow therapeutic index
  • metallic taste
50
Q

Haloperidol is used to? (2)

A
  • calm agitated patients (ex: ICU patients who are intubated and trying to exubate themselves)
  • psychotic breakdown in patients with schizophrenia
51
Q

Haloperidol should not be used often as one of the side effects is?

A

Widens QRS complex (prolonged ventricular contraction) on ECG

52
Q

How might we know if a patient has a reaction to haloperidol? (2) What should be done if the reaction is observed?

A

facial grimacing, eyes are looking upwards; must contact HCP immediately

53
Q

Rifampin is used to treat? Must educate the patient that?

A
  • active TB

- red-orange urine is expected

54
Q

On its own, Isoniazid is used to treat what type of TB?

A

prophylaxis or for latent/exposure to TB (ex: given to a nurse who was exposed to TB)

55
Q

Carbidopa-levodopa is used to treat?

A

Parkinson’s disease: lack of dopamine production

56
Q

What effect does carbidopa have? What happens to levodopa if it is given on its own?

A

Carbidopa assists levodopa so that less levodopa can be given and can last for a longer period of time; levodopa loses effect over time on its own

57
Q

Levodopa does what to the body?

A

produce more dopamine

58
Q

A side effect of carbidopa-levodopa include?

A

Insomnia

59
Q

Benztropine is given to patients with Parkinson’s disease to treat?

A

Involuntary shaking/tremors

60
Q

What might be a reason why a patient should NOT take benztropine?

A

Patients with glaucoma cannot take benztropine because of its anticholinergic side effects (blurred vision, dilated pupils, dry mouth)

61
Q

Zolpidem tartrate is used to treat? It can cause the patient to? When is the best time to take this medication?

A
  • Insomnia
  • perform actions unknowingly (ex: drive)
  • take 30 mins before bedtime because it makes the patient feel sleepy/drowsy and the onset is rapid
62
Q

Interferon-B is used to slow which degenerative disorder?

A

RRMS or relaxing-remitting multiple sclerosis (becomes better than worse) to decrease the frequency of clinical exacerbations

63
Q

What is the difference between a 1st gen and a 5th gen cephalosporin?

A

As the generations evolve, the usage broadens

64
Q

1st and 2nd generation cephalosporins are used for/have resistance against? (2)

A
  • prophylaxis

- post-op surgical patients (ex: surgery on stomach) because it is anticipated that an infection can occur

65
Q

Rivastigmine is used to treat? What should the RN expect to see?

A

Alzheimer’s disease; slow progression of memory loss

66
Q

Febuxostat is used to treat?

A

Gout

67
Q

What is gout? Primarily seen in which patients?

A

a buildup of uric acid that causes pain in the joints and big toe; primarily in people who eat poorly/have an unhealthy diet

68
Q

Patient teaching for febuxostat use? (2)

A
  • the patient should not be drinking alcohol because it is cautioned in patients with hepatic disorder
  • should increase fluid intake because it can cause adverse reaction of renal impairment
69
Q

Tolterodine tartrate is used to treat? Making it what type of drug?

A
  • used to decrease urinary incontinence, frequency, urgency

- anticholinergic

70
Q

Side effects of tolterodine tartrate include (2) What is the most concerning?

A
  • rebound retention can lead to edema
  • anticholinergic effects could slow peristalsis and lead to constipation
  • most concerning would be paralytic ileus (muscles of intestines do not allow food to pass result in blockage)
71
Q

How should an RN assess for paralytic ileus?

A

Auscultate bowel sounds (will present decreased sounds)

72
Q

Sumatriptan is used to treat? The drug is used when during the attack? A side effect of this drug would be?

A
  • migraines and cluster headaches
  • used during the attack
  • hypertensive crisis
73
Q

What is given to prevent migraines before it occurs?

A

Propranolol: non-selective beta-blocker (beta1 and 2)

74
Q

How might a nurse know if a drug has a narrow therapeutic range?

A

There is an order for a peak and trough level

75
Q

What is a consideration for an RN to make when giving meds to older patients?

A

Start slow, go slow

76
Q

What should the RN do first if a patient reacts to IV drug administration?

A

Stop the IV immediately

77
Q

What is an expected sign of a post-op patient who is on opioid treatment? (2)

A
  • atelectasis

- resp depression

78
Q

which might indicate that a medication should be held? What should be done?

A

for example, the patient has chronic kidney disease and is ordered to take a medication that has a risk for nephrotoxicity; hold the medication and contact the HCP

Pharmacology II (7 decks)

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