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NUR 334 - Pharmacology I > Exam 1 - Review Packet > Flashcards

Exam 1 - Review Packet Flashcards

Goldstein

1
Q

Organize these pain medications from weakest to strongest

A
  1. Ibuprofen
  2. Ketorolac
  3. Tramadol
  4. Codeine
  5. Morphine
  6. Hydromorphone
  7. Fentanyl
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2
Q

Name 5 adverse effects of systemic steroids

A
  1. Immunosuppression
  2. Hyperglycemia
  3. Hypertension
  4. Bone density weakness
  5. Weight gain
  6. Mood disorder
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3
Q

What is common practice in prescribing to address the danger of systemic steroids?

A

Give medication as localized as possible, i.e: rash > cream, lungs > inhaler

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4
Q

Name 2 conditions that opioids are used to treat besides pain.

A

Cough, diarrhea

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5
Q

What is the most common side effect of opiods?

A

Euphoria

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6
Q

What is the second most common side effect of opioids?

A

Constipation

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7
Q

Name 4 recommendations to address this

A
  1. Fiber
  2. Fluids
  3. Activity
  4. Stool softener
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8
Q

Name 3 types of pain

A
  1. Neuropathic
  2. Visceral
  3. Chronic
  4. Acute
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9
Q

Which one is treated different from the others?

A

Neuropathic - treated with adjuvant therapy

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10
Q

A patient is dehydrated and receiving fluids. The order is to give 1500ml over one hour, followed by 250ml an hour. The 1500 is referred to as the ___ dose, and the hourly rate is referred to as the ____ dose.

A

loading, maintenance

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11
Q

What is the relationship between titrate and taper?

A

They are opposites!
Titrate - increases medication dose
Taper - decreases medication dose

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12
Q

What medication routes are always systemic?

A

IV, PO, IM, rectal, subcutaneous

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13
Q

What is the primary indication for administering Nalozone?

A

Respiratory depression related to opioid use

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14
Q

Think about how a metformin question can be on our exam

A

Classic medication for diabetes, HBP spikes insulin, steroids cause HBP

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15
Q

How would you address a concern for addiction relating to a prescribed opioid?

A

Therapeutic communication, patient education

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16
Q

What safety education would you provide to a patient taking CAMs?

A
  1. Tell the patient to take it as prescribed on the bottle
  2. Tell patient to beware where they get it and to only get it from reputable source
  3. Educate us/providers on what they are taking (it’s important!)
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17
Q

What is the relationship between duration and half-life?

A

Same thing!
Duration - how long the drug effect lasts
Half-life - level of drug in blood drops by half

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18
Q

Name 2 prescription drug classes that can be used for an acute migraine?

A
  1. Serotonin 5-HT agonist
  2. NSAIDs
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19
Q

What OTC options are available for migraines?

A

NSAIDs, Tylenol

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20
Q

What drug class is most effective for inflammation?

A

SAIDs (steroids)

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21
Q

What drug is related to Reye’s syndrome?

A

Asprin

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22
Q

Why is this disease uncommon today?

A

Education not to be given to children under the age of 18

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23
Q

What does synergism mean?

A

Where 2 things work well together - more than the sum of their parts (1+1=3)

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24
Q

What is the difference between black-box-warning and contraindication?

A

BBW: Highest level of warning, you can still proceed with caution
Contraindication: Do NOT proceed, this is a no go!

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25
Q

What is the highest priority nursing assessment for the patient that is treated with an opioid?

A

Respiratory assessment

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26
Q

Name 2 opioids that are available PO only?

A

Vicodin, Oxycodone, Percocet

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27
Q

What medication this module can cause ringing in the ears?

A

Aspirin

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28
Q

What is the goal in pain relief?

A

Patient to reach tolerable pain/decreased pain

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29
Q

Can a patient that is allergic to Naproxen take Ibuprofen?

A

NO. SAME DRUG CLASS.

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30
Q

What is the highest priority question to ask when a patient reports that their medication is not working?

A

“Please tell me how you’re taking your medication?

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31
Q

How should a nurse address a patient refusing their prescribed medication?

A

Therapeutic communication, patient education

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32
Q

Name the 2 most significant differences between Acetaminophen and NSAIDS

A

Acetaminophen: anti-inflammatory, non nephrotoxic (hepatotoxic)
NSAIDS: inflammatory, nephrotoxic

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33
Q

Name 3 patient teaching points for someone prescribed morphine via a PCA pump?

A
  1. Medication is set to a fixed interval
  2. Push at anytime
  3. Will not OD, safe to use
    Contact nurse at anytime
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34
Q

Match them up (IBU, Keto, Indo, Ace, Cel)

A

Ibuprofen: most commonly used NSAID
Ketorolac can be given IV/IM/PO
Indomethacin: by RX only
Acetaminophen: does not belong on this list
Celecoxib: does not block cyclooxygenase (COX1)

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35
Q

Why can some medications not be crushed up for the patient?

A

Enteric coded, sustained/extended release > you want to protect patient from stomach discomfort

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36
Q

What are 2 types of withdrawal a patient may experience with opioid addiction?

A

Physical & psychological withdrawl

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37
Q

Which withdrawal is treated with Methadone or Buprenorphine?

A

Physical, also know as medication-assisted therapy

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38
Q

Which withdrawl type is treated with therapy or narcotics anonymous?

A

Psychological withdrawl

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39
Q

What would you expect when giving Naloxone to a patient that has no opioids in their system?

A

NOTHING

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40
Q

If a patient has opioids in their system, what happens?

A

Opioid withdrawal - tremors, anxiety, headache, hypertension

41
Q

Which drug name does that healthcare system use?

42
Q

Which drug name to patients usually use?

A

Trade/brand name

43
Q

What 2 drugs activate opioid receptors without the patient becoming euphoric?

A

Methadone & Buprenorphine

44
Q

Name 4 components of a respiratory assessment

A
  1. Lung sounds
  2. SPO2
  3. RR
  4. RD (respiratory depth)
  5. ABG (extra)
45
Q

What is a sign that the kidneys are in trouble?

A

Oliguria & anuria

46
Q

What is the difference between CAMs and OTC?

A

CAMs - safe but not proof of efficacy (not FDA approved)
OTC - regular meds, safe with proven efficacy (FDA approved)

47
Q

List 3 contraindications of Sumatriptan

A

Cardiac diseases, uncontrolled hypertension, if 9 pills have been consumed

48
Q

What are 5 CAMs and their uses?

A
  1. Echinacea - cold/flu
  2. Camomile - anxiety
  3. Ginger - nausea
  4. Gingko - memory
  5. St. John Wart - mental health
49
Q

Can you take more than 1 drug in the same class?

50
Q

Name 3 OTC NSAIDS?

A

Ibuprofen, Naproxen, Asprin

51
Q

What drug class is known to cause GI bleeding?

51
Q

Name 3 ways to assess for this? (one sign, one symptom, one lab)

A

Abdominal pain, blood in stool, FOBT

52
Q

What is the primary organ of excretion?

53
Q

What is the primary organ of metabolism?

54
Q

What is the importance of the 2 answers above? (liver + kidney)

A

Adjusting dose! Nephrotoxicity, hepatotoxicity

55
Q

T/F: You should always use the strongest medication to treat your patient?

56
Q

T/F: You should use therapeutic communication to address treatment refusals

57
Q

T/F: The strongest medication is the most effective

58
Q

T/F: A medication that is by prescription is always better than OTC option

59
Q

T/F: You should still use non-pharm interventions if the patient is getting a drug

60
Q

T/F: All drugs have the same potency or efficacy

61
Q

T/F: Holistic treatment may involve prescribing drugs

62
Q

T/F: A prescription can be referring to more than just medication orders

63
Q

The first pass effect is most significant for medications given via which route?

64
Q

What is the patient education for a drug that has a narrow therapeutic index?

A

Frequent lab monitoring. Exact right dose

65
Q

Match the drug with the required assessment (sum, asp, mor, indo, ace)

A

Sumatriptan: hypertension
Aspirin: ringing in the ears
Morphine: bradypnea
Indomethacin: black stool
Acetaminophen: liver failure

66
Q

What are 3 indications for most NSAIDs?

A

Antipyretic, analgesic, anti-inflammatory

67
Q

What enzyme do NSAIDs act on?

A

Cyclooxygenase

68
Q

Can a patient take NSAIDs and Acetaminophen together?

69
Q

What assessments are needed before administering a teratogenic medication?

A

HCG, pregnancy test

70
Q

What drug classes might be recommended for someone having 8 migraines per month?

A

Beta blockers, SNIRs

71
Q

What are the 6 rights of medication administration?

A

right patient, right dose, right time, right medication, right documentation, right route

72
Q

What are five conditions treated with steroids?

A

Asthma, gout, COVID-19, COPD, RA

73
Q

What is half life?

A

How long a medication level drops by HALF (100mg > 50mg)

74
Q

What is related to drug dosing frequency?

A

When it drops in half is typically when we give next dose

75
Q

What assessment is only done after giving a medication, not before?

A

Assessment related to any side effects that the medication can cause

76
Q

Are pharmacodynamics and pharmacokinetics the same thing? Any differences?

A

Dynamics: how medication changes the body
Kinetics: how the druh moves through the body

77
Q

Do oral steroids always need to be tapered?

78
Q

What is the relationship between alcohol and opioids?

A

Alcohol: CNS depressant
Opioids: CNS depressant, synergest effect

79
Q

A patient reports they are pregnant and asking about their prescribed daily teratogenic medication. What is an appropriate response by the nurse?

A

Please tell your provider immediately.

80
Q

What is the term for large dose of medication?

A

Loading dose

81
Q

Which is correct about administering IV opioids?

A

You need to administer the drug over several min

82
Q

What education should the nurse provide when administering Naproxen to avoid negative GI effects?

A

Take it with food

83
Q

Regarding drug classifications..
__ is to the US, as __ is to NV, as __ is to LV

A

Therapeutic, drug class, drug

84
Q

Duration….

A

How long a drug lasts

85
Q

Onset….

A

When a drug takes effect

86
Q

Half-life….

A

How long until a drug concentration drops in half

87
Q

Indication…

A

What a drug is used for

88
Q

First line…

A

The most recommended treatment

89
Q

Alternative…

A

Other than first-line choice

90
Q

Refractory…

A

Unresponsive to

91
Q

What enzyme causes inflammation?

A

Cyclooxygenase, through the production of histamine

92
Q

Explain agonist vs antagonist?

A

Agonist: activates
Antagonist: blocks

93
Q

What is an example of each from this module? (agonist vs. antagonist)

A

All opioids

94
Q

What 2 assessments are critical before any med admin and what 2 after?

A

What are you treating +
adverse/side effects

95
Q

What is the first step in the process of pharmacokinetics?

A

Absorption

96
Q

Wheezing…

A

Sign: respiratory depression

97
Q

BONUS: looking ahead at the next module… name a drug that is used to treat cancer and RA?

A

Methotrexate

98
Q

BONUS: Renal function goes down as your age increases.. what does that mean your BUN and creatinine will do as you age?

A

Will go up!

NUR 334 - Pharmacology I (3 decks)

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