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PHARM 334 > EXAM 1 STUDY GUIDE > Flashcards

EXAM 1 STUDY GUIDE Flashcards

class activities/exam review

1
Q

Prevented by NOT giving aspirin to children

A

Reyes

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2
Q

Side effects of opioids

A

Euphoria

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3
Q

Needs a pregnancy test

A

Teratogenic

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4
Q

NSAID given via IV/IM/PO route

A

Ketorolac

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5
Q

Most important assessment when giving opioids

A

Respirations

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6
Q

Providers order for treatment

A

Prescription

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7
Q

When a drug needs a higher dose to work

A

Tolerance

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8
Q

A sign the kidneys are in trouble

A

Oliguria

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9
Q

Pain that is NOT treated with opioids

A

Adjuvant

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10
Q

What happens from too much of a drug

A

Overdose

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11
Q

Substances that are NOT regulated by the FDA

A

CAMs

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12
Q

Effects of steroids

A

Hyperglycemia

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13
Q

Medication assisted therapy (not methadone)

A

Buprenorphine

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14
Q

A method to increase medication compliance

A

Education

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15
Q

Name for a drug that there can be many of

A

Trade

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16
Q

Weakest opioid

A

Codeine

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17
Q

Grouping of drugs by disease they treat

A

Therapeutic

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18
Q

Test for GI bleed

A

FOBT (Fecal Occult Blood Test)

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19
Q

Reliever of Pain

A

Analgesia

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20
Q

How long a drug lasts

A

Duration

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21
Q

How much of a drug is given

A

dose

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22
Q

The organ that excretes most medications

A

Kidney

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23
Q

The organ that metabolizes most medications

A

Liver

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24
Q

Something that ACTIVATES a receptor in the body

A

Agonist

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25
Q

When a drug is used for something other than it official indication

A

OLU (Off-label-use)

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26
Q

When a medication or treatment does NOT work

A

Refractory

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27
Q

When a drug is placed on a list due to having a high risk for abuse and dependency

A

Controlled Substance

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28
Q

A term for a medication that is used to treat an overdose

A

Reversed Agent

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29
Q

When a larger amount of medication is given as the first dose.

A

Loading Dose

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30
Q

A medication that blocks a receptor in the body.

A

Antagonist

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31
Q

The correct term for someone that is not allergic to any meds, but is allergic to bees

A

NKDA

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32
Q

When a medication cannot be given to a patient

A

Contraindication

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33
Q

How well a medication will work

A

Efficacy

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34
Q

The range of medication levels in the body between helpful and toxic

A

Therapeutic range

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35
Q

The term for a medication that is safe to obtain without a prescription

A

OTC (Over-the-counter)

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36
Q

When a patient needs more and more of a medication to work

A

Tolerance

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37
Q

When a medication dose is slowly decreased until it is stopped

A

Taper

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38
Q

The time when a medication begins to help the patient

A

Onset

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39
Q

The drug name that companies market a medication as

A

Trade/Brand

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40
Q

An order for a medication or treatment given by a provider

A

RX (medical prescription)

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41
Q

What needs to be monitored when taking drugs with a narrow therapeutic index

A

Labs

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42
Q

The term for when the fluid given via the IV route leaks into the local tissue

A

Infiltration

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43
Q

Place the medication between the cheek and the gums

A

Buccal

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44
Q

Make sure to rotate sites when using this route

A

Subcutaneous

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45
Q

You should make sure the skin is clean, dry, and hairless, when using this route

A

Transdermal

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46
Q

This is considered the most localized route of administration

A

Topical

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47
Q

The route is used often the least preferred by nurses

A

Rectal

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48
Q

TB test is one of the only uses for this route

A

Intradermal

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49
Q

You should advise your patient to let the medication sit and dissolve, they should not swallow it.

A

Sublingual

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50
Q

Your patient needs to take deep breaths for this route to work

A

Inhalation

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51
Q

This route requires you to cover one nostril during administration

A

Intranasal

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52
Q

You may use this route for otitis externa but not otitis media

A

Otic

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53
Q

This is the most common route of treating conjunctivitis

A

Ophthalmic

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54
Q

Inject the medication at a 90 degree angle in the muscle

A

IM (Intramuscular)

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55
Q

Use this route only when you cannot establish IV access in an emergency

A

IO (Intraosseous - directly into bone marrow)

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56
Q

This route is the most common route of all for medication administration

A

Oral

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57
Q

This route is used to avoid extravasation

A

CVC (Central venous catheter)

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58
Q

The fastest route of medication administration

A

IV

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59
Q

Parenteral route not on this list

A

Vaginal

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60
Q

The way drugs are grouped by their mechanism of action

A

Drug class

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61
Q

The way a drug moves through the body

A

Pharmacokinetics

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62
Q

The way a drug has its effect on the body

A

Pharmacodynamics

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63
Q

Meds (weakest ———> strongest)

A
  1. Ibuprofen
  2. Ketorolac
  3. Tramadol
  4. Codeine
  5. Morphine
  6. Hydromorphone
  7. Fentanyl
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64
Q

Adverse effects of systemic steroids

A
  1. weight gain
  2. mood disorders
  3. Hyperglycemia
  4. Hypertension
  5. Immunosuppression
  6. Loss of bone density (osteoporosis)
  7. weakness
  8. sleep disturbance
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65
Q

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

A

Localized as possible ( Ex: if it’s a rash give a cream vs pill)

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66
Q

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

A
  1. Chronic coughing
  2. Diarrhea
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67
Q

What is the most common side effect of opioids?

A

Euphoria (getting high)

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68
Q

What is the second most common side effect of opioids?

A

Constipation

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69
Q

4 recommendations to address constipation

A
  1. Increase activity
  2. Increase Fluids
  3. Increase fiber
  4. Last - give stool softener
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70
Q

3 types of pain

A
  1. Phantom
  2. Chronic
  3. Nociceptive (caused by damage to body tissue. Ex: stubbing your toe)
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71
Q

Which pain is treated different from other pains?

A

Neuropathic = Adjuvant therapy
(facilitate better pain control w/ a reduction in analgesic consumption)

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72
Q

A patient is dehydrated and receiving fluids. The order is to give 1500ml over 1 hr followed by 250ml an hr. The 1500 is referred to as the _________ dose & the hourly rate is referred to as the _________ dose.

A
  • Loading
  • Maintenance
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73
Q

What is the relationship between titrate vs taper?

A

They are OPPOSITE of each other

Titrate = slow INCREASE of a dose
Taper = slow DECREASE of a dose

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74
Q

What medication routes are ALWAYS SYSTEMIC?

A
  • PO
  • IV
  • IM
  • SubQ
  • Rectal
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75
Q

What is the primary indication for administering Naloxone?

A

Respiratory depression related to an opioid use

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76
Q

What do we use metformin for?

A
  • treat type 2 diabetes
  • treat gestational diabetes
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77
Q

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

A
  • Therapeutic communication
  • Patient education
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78
Q

What safety education would you provide to a patient that takes CAMs

A
  1. Tell me (your nurse) & provider what you are taking
  2. Tell patient to take it AS PRESCRIBED on bottle
  3. Be aware of where they are getting it from & only from REPUTABLE sources
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79
Q

Duration vs. Half life

A
  • Usually the SAME thing
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80
Q

Duration

A

How long the med & effects last

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81
Q

Half-life

A

How long a med in the blood DROPS by HALF

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82
Q

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

A
  1. Ergot Alkaloids
  2. Serotonin 5ht Agonist
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83
Q

What OTC options are available for acute migraines?

A

NSAIDS (like Tylenol)

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84
Q

What drug class is most effective for inflammation?

A

Steroids

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85
Q

What drug is related to Reyes syndrome?

A

Aspirin

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86
Q

Why is Reyes syndrome uncommon today?

A
  • We DO NOT GIVE aspirin to anyone under 18 yrs old
  • NO KIDS
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87
Q

What does synergism mean?

A
  • 2 things together are more than a sums of there parts
  • (1+ 1 = 3)
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88
Q

Black box warning vs Contraindication

A

Black box = Caution

Contraindication = DO NOT GIVE

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88
Q

Ex: of synergism in body

A
  • physicians treat bacterial heart infections with ampicillin & gentamicin
  • cancer patients receive radiation & chemotherapy (or more than one chemo drug at a time
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89
Q

What is the HIGHEST PRIORITY nursing assessment for the patient that is treated with an opioid?

A

Respiratory

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90
Q

2 opioids that are available PO only?

A
  • Vicodin
  • Percocet
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91
Q

What medication can cause ringing in the ears

A

Aspirin

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92
Q

What is the goal in pain relief?

A
  • Minimize
  • Not eliminate (we have goals for a reason)
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93
Q

Can a patient that is allergic to naproxen take ibuprofen?

A

NO - Because same drug class

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94
Q

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

A

Please tell me how you are taking your meds

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95
Q

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

A
  • Therapeutic communication
  • Patient education
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96
Q

Name the two most significant differences between acetaminophen and NSAIDs

A

Acetaminophen = Hepatotoxic (liver)
NSAIDs = Nephrotoxic (kidney)

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97
Q

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

A
  1. These are gonna give you your meds at fixed
  2. If you need additional additional medication you can push
  3. It will not overdose you
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98
Q

What’s the most commonly used NSAIDs?

A

Ibuprofen

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99
Q

What can be given IV/IM/PO?

A

Ketorolac

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100
Q

What med is by prescription only?

A

Indomethacin

101
Q

What med does not block cyclooxyrgenase?

A

Celecoxib

102
Q

Why can come medications NOT BE CRUSHED up for the patient?

A
  • If they are sustained released, extend released or enteric coated can not be crushed
  • Protects our stomach from the pill or pill from your stomach.
103
Q

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

A
  1. Physical
  2. Psychological
104
Q

Which withdrawal is treated with methadone or Buprenorphine?

A

physical (also called medication assisted therapy)

105
Q

Which withdrawal is treated with therapy or narcotics anonymous?

A

Psychological

106
Q

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

A

Nothing - NO effect

107
Q

What if you do have opioids in their system with naloxone?

A
  • opioid withdrawal syndrome
  • S/S - tremors, anxiety, nausea, headache, hypertension
108
Q

Which drug name does the healthcare system use?

A

Generic

109
Q

Which drug name do patients usually use?

A

Trade or Brand

110
Q

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

A
  1. Methadone
  2. Buprenorphine

(doesn’t get person high)

111
Q

Name 4 components of a respiratory assessment?

A
  1. lung sounds
  2. SPO2
  3. Respiration Rate
  4. Respiratory Depth
112
Q

What is the sign that the kidneys are in trouble?

A

Oliguria + Anuria = med emergency!!!

113
Q

What is the difference between CAMs and OTCs?

A

CAMS = Approved as being safe but no proof of efficacy (Not FDA approved)
OTC = Regular meds, safe effective, appropriate/available to the public without prescription

114
Q

What are 3 contraindications of sumatriptan?

A
  1. Patient has uncontrolled hypertension
  2. Patient has already taken 9 pills
  3. Patient has certain cardiac disease
115
Q

What are 5 CAMS and their uses

A
  1. Echinacea
  2. Chamomile
  3. Ginkgo
  4. St Johns warts
  5. Ginger
116
Q

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

A

NO

117
Q

Name 3 OTC NSAIDS

A
  1. Naproxen
  2. Aspirin
  3. Ibuprofen
118
Q

What drug class is known to cause GI bleeding?

A

NSAIDS

119
Q

Name 3 ways to assess for GI bleeding?

A

Sign = Blood & Stool
Symptom = Abdominal pain lab (FOBT)

120
Q

What is the primary organ of excretion?

A

Kidney

121
Q

What is the primary organ of metabolism?

A

Liver

122
Q

What is the importance of the kidney and liver working properly?

A

If not working you need to adjust the dose

123
Q

You should always use the strongest medication to treat your patient.

A

False (Most effective, Not most Potent)

124
Q

You should use therapeutic communication to address treatment refusals

A

True

125
Q

The strongest medication is the most effective?

A

False

126
Q

A medication that is by prescription is always better than an OTC option?

A

False

127
Q

You should still use non pharm interventions if the patient is getting a drug?

A

True

128
Q

You do not need to ask patients about their OTC or herbal meds?

A

False

129
Q

All drugs have the same potency or efficacy?

A

False

130
Q

Holistic treatment may involve prescribing meds?

A

True

131
Q

A prescription can be referring to more than just medication orders?

A

True

132
Q

The 1st past effect is most significant for medications given via which route?

A

PO

133
Q

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

A

We have to give EXACT RIGHT DOSE
- To little will not do anything
- To much will hurt them
(Frequent Lab testing)

134
Q

Required assessment for - Sumatriptan?

A

Hypertension

135
Q

Required assessment for - Aspirin?

A

Ringing in the ears

136
Q

Required assessment for - Morphine?

A

Bradypnea

137
Q

Required assessment for - Indomethacin?

A

Black stool

138
Q

Required assessment for - Acetaminophen?

A

Liver failure

139
Q

What are 3 contraindications for most NSAIDS.

A
  1. Antipyretic
  2. Analgesic
  3. Anti inflammatory
140
Q

What enzyme do NSAIDs act on?

A

cyclooxygenase cox 1

141
Q

Can a patient take NSAIDs and Acetaminophen?

A

Yes

142
Q

What assessments are needed before administering a teratogenic medication?

A
  • HCG = pregnancy test
  • Last menstrual cycle = if provider trust patients word
143
Q

What drug classes might be recommended for someone having 8 migraine per month? (chronic meds)

A
  • Beta blockers
  • SNRIs
144
Q

What are the 6 rights of medication administration?

A
  1. Right patient
  2. Right dose
  3. Right time
  4. Right drug
  5. Right route
  6. Right documentation.
145
Q

What are 5 conditions treated with steroids?

A
  • Asthma
  • COPD
  • Covid 19
  • Gout
  • Rheumatoid Arthritis
146
Q

What is half life?

A

How long does it take until drug levels drop in half

147
Q

How is half life related to drug dosing frequency?

A

When drug level drops in half you give there next dose

148
Q

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

A

Assessment related to any side effects that the med can cause.

149
Q

When to not reposition someone?

A

Someone you had hip surgery

150
Q

When to not turn on the news for someone?

A

3 year old

151
Q

When to not call the patients family?

A

Patient hard of hearing

152
Q

When to not go on a walk in the hall?

A

Patient that is bed bound

153
Q

When to not use guided imagery for someone?

A

Patient who has dementia?

154
Q

When to not use massage therapy on someone?

A
  • Rash
  • Religion
155
Q

When to not turn off the lights for someone?

A

Kid afraid of the dark

156
Q

Pharmacodynamics

A

How med changes Body

157
Q

Pharmacokinetics

A

How drug moves through body

158
Q

Do oral steroids always need to be tapered?

A

yes

159
Q

What is the relationship between alcohol & opioids?

A
  • alcohol = CNS depressant
  • Opioids = also CNS
  • avoid taking together
  • these 2 can have synergistic effect & amplify another
160
Q

A patient reports they are pregnant and asks about their prescribed daily teratogenic

A
  • Tell doctor immediately
  • You are NOT a Dr.
161
Q

What is the term for a large 1st dose of a med?

A

Loading dose

162
Q

What is correct about administering IV opioids?

A

You need to administer the drug over several mins

163
Q

What education should the nurse provide when administering naproxen to avoid neg GI effects?

A

Take with food

164
Q

_______ is to the US as _______ is to Nevada as ________ is to Vegas

A
  • Therapeutic drugs
  • Drug class
  • Drug
165
Q

Onset

A

When the drug takes effect

166
Q

Indication

A

What a drug is used for

167
Q

First line

A

The most recommended treatment

168
Q

Alternative

A

Other than first line choice

169
Q

Refractory

A

Unresponsive to

170
Q

What enzyme causes inflammation?

A

Cycoxygenase (through production of prostate gland)

171
Q

What other chemical in the body is famous for causing inflammation?

A

Histamine

172
Q

Agonist

A

Activates (opioids)

173
Q

Antagonist

A

Inhibits (NSAIDs or Naloxone)

174
Q

Renal function goes down as your age increases

A

BUN & creatinin will go up

175
Q

What two assessments are critical before any med admin & what two after?

A

What are you treating & adverse effects

176
Q

What is the first step in the process of pharmacokinetics?

A

Absorption

177
Q

Wheezing is a ____

A

Sign of respiratory depression

178
Q

How long after administering the drug should you monitor for adverse effects

A

First 15 - 30 mins

179
Q

Four categories of pharmacokinetics

A
  1. Absorption
  2. Distribution
  3. Metabolism
  4. Excretion
180
Q

Give an example of a drug that is an antagonist

A

Ex: naloxone/narcan

181
Q

What is a teratogen?

A

Substance to which an embryo or fetus is exposed that causes abnormalities or retardation or death.

182
Q

What is nociceptor pain?

A

Injury to tissues

183
Q

Somatic pain

A
  • sharp
  • localized sensation
184
Q

Visceral pain

A
  • dull
  • throbbing
  • aching pain
185
Q

Primary use of opioid agonists

A
  • Relieve moderate to severe pain
  • Some used for anesthesia
186
Q

What do opioids put patients at high risk for?

A

Physical & psychological dependence

187
Q

Morphine is a _____

A

opioid analgesic

188
Q

Naloxone is a _______

A

treatment pf acute opioid overdose & misuse

189
Q

Aspirin/Acetylsalicylic

A
  • non opioid analgesic
  • NSAID
  • Antipyretic
190
Q

Morphine side effects

A
  • Lethargic
  • Dizziness
  • itching
  • constipation
  • nausea/ vomiting
191
Q

morphine routes for admin?

A
  • PO
  • subQ
  • IV
  • IM
192
Q

morphine - adverse effects

A
  • restlessness
  • anxiety
  • hallucinations
  • RESPIRATORY DEPRESSION
  • CARDIAC ARREST
  • death
193
Q

Naloxone - adverse effects

A
  • increased BP
  • hypertension
  • nausea/ vomiting
  • drowsiness
194
Q

corticosteroids - adverse effects

A
  • suppression of adrenal gland function
  • mood changes
  • cataracts
  • peptic ulcers
  • electrolyte imbalances
  • osteoporosis
195
Q

Sumatriptan/ imitrex

A
  • dizzy
  • drowsiness
  • warming sensation
196
Q

If a pt is using this med, they should be monitored for at least 24 hrs if given as an epidural ____

A

morphine

197
Q

sumatriptan/imitrex - contraindications

A
  • recent medical information
  • hypertension
  • diabetes
  • acute kidney injury
  • hepatic impairment
198
Q

morphine - contraindications

A
  • can mask or intensify pain of gallbladder disease
  • avoid in with acute or severe asthma
  • GI obstructions
  • severe kidney pr liver impairment
199
Q

three MAT programs

A
  • methadone
  • combination of buprenorphine + naloxone
  • naltrexone
200
Q

MAT programs - methadone

A
  • standard treatment
  • will help with withdrawal symptoms, but not with pain
201
Q

10x stronger than morphine

A

hydromorphone/dilaudid

202
Q

100x stronger than morphine

A

fentanyl

203
Q

“morphine in PO form”

A

oxycodone

204
Q

highest risk of abuse due to potency

A

fentanyl

205
Q

naloxone

A

opioid receptor antagonist

206
Q

Which of the following meds requires me to educate a patient on diet & exercise / reducing salt?

A

Steroids

207
Q

Naloxone should be administered when RR is fewer then ____ breaths/min

A

10

208
Q

Is acetaminophen an NSAID?

A

no

209
Q

aspirin can reduce fevers

A

true

210
Q

aspirin is an NSAID

A

true

211
Q

aspirin is a ___

A

cox inhibitor

212
Q

aspirin/ acetylsalicylic acid treats ______ pain

A

mild to moderate

213
Q

aspirin/ acetylsalicylic -MOA

A
  • inhibits COX
  • Inhibits platelet aggregation (anti platelet)
214
Q

what is the only NSAID that inhibits platelet aggregation

A

aspirin

215
Q

what med do you need to STOP 1 week BEFORE surgery

A

aspirin

216
Q

Aspirin - Adverse effect

A
  • GI upset (take with food)
  • bleeding
217
Q

What does a positive occult blood test mean?

A

GI bleed

218
Q

Aspirin - toxicity / Overdose

A

tinnitus

219
Q

what pharmacological class is ibuprofen?

A

cox inhibitor

220
Q

Ketorolac (Toradol)

A
  • for pain after surgery
  • non - narcotic non habit forming
  • IM, PO, IV
221
Q

Triptans (pharmacological class)

A
  • serotonin agonists
  • constricting certain intracranial vessels
222
Q

Medication is metabolized in the liver causing a reduction in the active drug concentration

A

first pass effect

223
Q

This drug is a

  • NSAID
  • cox inhibitor
  • given on empty stomach but can be given w/ food
  • taking with aspirin increases GI bleed
A

Ibuprofen

224
Q

This med is

  • oral opioid
  • constipation
  • include stool softner
A

oxycodone

225
Q

The major route for drug extortion and impaired function will decrease drug excretion

A

kidneys

226
Q

Requires a higher dose to achieve a therapeutic effect

A

oral route

227
Q

Produces a therapeutic effect at a lower dose

A

Potency

228
Q

Most controllable pain?

A

Localized

229
Q

This med is a

  • NSAID
  • Cox inhibitor
  • Antiplatelet
  • don’t give to kids (Reyes syndrome)
  • toxicity - tinnitus
A

Aspirin

230
Q

Second opioid when used in combo w/ other opioids will speed up tolerance and increased risk of addiction

A

Hydromorphone

231
Q
  • Toxic epidermal necrosis
  • characterized by blister lesions & skin sloughing
A

Stevens johnson syndrom

232
Q

adverse effect thats can cause serious injury or death

A

black box warning

233
Q

long term use can cause
- fractures
- osteoporosis
- hyperglycemia (need to increase insulin)
- impaired wound healing
- cataracts
- Cushing syndrome
- taper off

A

steroids

234
Q

number 1 side effect of taking morphine (Goldstein lecture)

A

euphoria

235
Q
  • highest risk of abuse due to high potency
  • 100x morphine
A

Fentanyl

236
Q
  • NSAID
  • non habit forming
  • come IM/ IV/ PO
A

Ketoroloac

237
Q
  • better to use this with KIDNEY disease than NSAIDs
  • most serious effect from overdose is hepatotoxicity
A

acetaminophen

238
Q
  • common use is fever
  • mild to moderate pain
A

NSAID

239
Q
  • used as supplest but not replacement for opioids in treating severe cancer pain
  • used for neuropathic pain to
A

adjacent analgesics

240
Q

maximum response can be produced from a drug

A

efficacy

241
Q

rapidly achieves therapeutic response

A

loading dose

242
Q
  • opioid
  • avoid other CNS depressants like alcohol
  • adverse is respiratory depression
  • naloxone as antidote
  • injected over 4 - 5 mins
A

morphine

243
Q

an opioid med used to treat opioid dependency because it causes less euphoria

A

methadone

244
Q

MAT programs 2 meds

A
  • methadone
  • naltrexone
245
Q

cam therapy safety

A
  • check w provider
  • seek info from reputable sources
  • take recommended or lower doses
246
Q
  • meds that relieve acute pain for migraine or are abortive therapy
A
  • triptans
  • ergot alkaloids

-OTC

247
Q

those effects after naloxone is administered

A
  • tremors
  • vomiting
  • increased BP
248
Q

the elderly have an increased production of auto antibodies

A
  • decreased serum creatinine level
  • decreased dermal thickness
  • experience blunted responses
  • no fever
249
Q

meds for prophylactic treatment of migraines

A
  • anti seizure meds
  • beta adrenergic blockers
  • calcium channel blockers
  • tricyclic anti depressants

PHARM 334 (2 decks)

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