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Pharmacology > Exam > Flashcards

Exam Flashcards

1
Q

What is Fluoxetine?

A

An SSRI that inhibits the reuptake of serotonin so it stays in synapses longer for receptors to collect and use.

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2
Q

what are the indications for fluoxetine?

A

major depressive disorder, OCD, bulimia and panic disorder

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3
Q

what is a typical dosage of fluoxetine?

A

10-20mg/day

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4
Q

what are overexpression effects of fluoxetine?

A

anxiety, headache, drowsiness, insomnia, increased sweating, tremor, serotonin syndrome, NMS, suicidal thoughts, mania, hypomania

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5
Q

what are some nursing considerations when administering fluoxetine?

A

monitor mood changes and SI, monitor for NMS and serotonin syndrome, give in the morning to lower the chance of insomnia

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6
Q

what is Venlafaxine?

A

it is an SNRI that inhibits the reuptake of serotonin and norepinephrine

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7
Q

what are the indiciations for venlafaxine?

A

major depressive disorder, GAD, panic disorder, and social anxiety

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8
Q

what is a typical dosage of venlafaxine?

A

75 mg/day in 2-3 divided doses

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9
Q

what are overexpression effects in venlafaxine?

A

anxiety, dizziness, insomnia, anorexia, nausea, constipation, headache, NMS, serotonin syndrome, suicidal thoughts

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10
Q

what are some nursing considerations when administering venlafaxine?

A

assess SI, monitor appetite, assess for serotonin syndrome, administer with food to decrease GI upset

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11
Q

what is lithium?

A

a mood stabilizer that alters cation transport in nerve and muscle decreasing incidence of acute mania

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12
Q

what are the indications for lithium?

A

acute mania and bipolar I

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13
Q

what is a typical dosage of lithium?

A

greater than 12 years = 400-900 mg 2x a day or 300-600 mg 3x a day

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14
Q

what are overexpression effects of lithium?

A

fatigue, headache, ECG changes, polyuria, muscle weakness, serotonin syndrome, seizures

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15
Q

what are nursing considerations when administration lithium?

A

administer with food, monitor serum lithium levels, assess mental status, monitor intake and output ratios

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16
Q

what is the range you want serum lithium levels to be?

A

0.5-1.2 mEq/L

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17
Q

what is Lorazepam?

A

a Benzodiazepine that depresses the CNS by increasing the power and effect GABA

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18
Q

what are the indications for lorazepam?

A

anxiety disorders, epileptics

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19
Q

what is a typical dosage for lorazepam?

A

1-3 mg 2-3x a day (dose can be up to 10mg/day)

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20
Q

what are overexpression effects of lorazepam?

A

dizziness, drowsiness, lethargy, constipation, weight gain, dependence

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21
Q

what are nursing considerations when administering lorazepam?

A

assess the degree of anxiety, prolonged treatment can lead to dependence. avoid alcoholic beverages for 24-48 hours after, have caution when performing activities requiring attention and coordination until drug effects subside. stopping abruptly may cause withdrawal symptoms

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22
Q

what is Ibuprofen?

A

a nonopioid analgesic that inhibits prostaglandin synthesis and decreases pain and inflammation. it blocks both the COX-1 and COX-2

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23
Q

what are indications for Ibuprofen?

A

mild-moderate pain, fever, RA, OA

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24
Q

what is a typical dosage for Ibuprofen?

A

400-800 mg 3-4x a day for adults

30-50 mg/kg/day in 3-4 divided doses for children 6mo-12 yr

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25
Q

what are adverse effects of ibuprofen?

A

headache, MI, stroke, constipation, nausea, vomiting

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26
Q

what are some nursing considerations when administering Ibuprofen?

A

PO administer with food, assess for skin rash, assess for signs of GI impairment, tablets can be crushed or mix with fluid or foods

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27
Q

what is prednisone?

A

a corticosteroid that suppresses inflammation and normal immune response. it replaces endogenous cortisol in deficiency states. has mainly glucocorticoid properties with minimal mineralocorticoid activity

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28
Q

what are the indications for prednisone?

A

inflammation, autoimmune disorders, allergic, hematologic

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29
Q

what is a typical dosage of prednisone?

A

5-60 mg/day

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30
Q

what are adverse effects of prednisone?

A

depression, euphoria, hypertension, anorexia, nausea, decrease wound healing, adrenal suppression, muscle wasting

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31
Q

what are nursing considerations when administering prednisone?

A

assess involved systems prior to beginning therapy, assess for adrenal insufficiency, monitor intake and output

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32
Q

what is Metformin?

A

a biguanide that encourages the liver to store more glucose and release less and try to make the receptors more sensitive to insulin

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33
Q

what are the indications for metformin?

A

type 2 diabetes

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34
Q

what are adverse effects of metformin?

A

lactic acidosis, bloating, diarrhea, nausea, vomiting, decreased vitamin B12 levels, metallic taste

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35
Q

what are nursing considerations for metformin?

A

administer at meals XR tablets must be swallowed whole, assess for lactic acidosis and ketoacidosis

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36
Q

what is glyburide?

A

a sulfonylurea that lowers blood sugar by stimulating the release of insulin from the pancreas and increasing sensitivity to insulin at receptor sites

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37
Q

what are the indications for glyburide?

A

PO control of blood sugar in type 2 diabetes

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38
Q

what are adverse effects of glyburide?

A

hypoglycemia, aplastic anemia, photosensitivity, increased appetite, nausea, rash, cramps

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39
Q

what are nursing considerations for glyburide?

A

assess for S&S of hypoglycemia, monitor CBC, administer w/meals but do not administer after last meal of day

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40
Q

what is pharmocogenetics?

A

studying the changes in enzyme structure and function based on genetic presentation

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41
Q

what are idiosyncratic responses?

A

how some people respond in an expected and unexplained way to medications

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42
Q

what is an allergy to medications?

A

a hyper-response of the immune system.
signs vary in severity
require a previous exposure to the drug

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43
Q

what is toxicity to medications?

A 
harmful effects of drugs
can be acute or chronic
reversible or irreversible
effects on the body may vary
some toxicities are managed with antidotes such as Narcan and acetylcysteine for Tylenol overdose
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44
Q

what drugs cause bone marrow toxicities?

A

Antineoplastics (chemo), NSAIDs, Anticonvulsants.

they deplete RBC and WBC’s being produced

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45
Q

what drugs cause cardiotoxicity?

A

antineoplastics

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46
Q

what drugs cause dermatological toxicity?

A

penicilins, cephalosporings

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47
Q

what drugs cause skeletal muscle toxicities?

A

statins, they decreases cholesterol

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48
Q

what drugs cause hepatotoxicity?

A

statins, acetaminophen

Hepatotoxicity causes all drugs to be toxic since the liver won’t be able to metabolize drugs

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49
Q

what drugs cause nephrotoxicity?

A

ACE inhibitors, NSAIDs, loop diuretics

drugs won’t get excreted as easily when nephrotoxicity occurs

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50
Q

what drugs cause neurotoxicity?

A

loop diuretics

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51
Q

what is pharmcodynamics?

A

is what the drug does to the body

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52
Q

what are receptor sites?

A

the components on the cell surface that can react with drugs, viruses, and other chemicals

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53
Q

what is the therapeutic window?

A

where the safest and most effective treatment will occur

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54
Q

what is a half-life?

A

the time it takes the drug in the body to reach half its dose

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55
Q

what is tolerance?

A

a biological condition that occurs when the body adapts to a substance after repeated administration. Over time, higher doses are required to produce the same initial effect

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56
Q

what are antagonists?

A

a drug that attaches to a receptor and blocks the normal action of the cell

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57
Q

what is a loading dose?

A

a ‘jump start’ in order to reach the therapeutic effect of a drug. a higher dose is given at first

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58
Q

what are agonists?

A

a drug that attaches toa. receptor and mimics the normal action of the cell

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59
Q

what is polypharmacy?

A

taking multiple medications concurrently

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60
Q

what is affinity?

A

the binding strength of a medication

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61
Q

what is potency?

A

refers to the amount of medication required to produce a desired effect

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62
Q

what is efficacy?

A

the ability of a medication to produce a desired

or intended result

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63
Q

what is absorption?

A

occurs after medications enter the body and travel from site of administration into body’s circulation

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64
Q

what is distribution?

A

process by which medication is distributed throughout the body

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65
Q

what is metabolism?

A

breakdown of drug molecules

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66
Q

what is excretion?

A

process by which body eliminates waste

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67
Q

explain the first-pass effect

A

drugs that are administered orally or enterally face difficulties in the GI tract. they may be quickly deactivated by enzymes as they pass through the stomach and duodenum. if the drug makes it to the blood from the intestines then part of it will be broken down by liver enzymes. when that happens some of the drug will escape to general circulation and become protein-bound (inactive) or stay free and create action at the receptor site

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68
Q

what is transdermal?

A

drugs delivered enter blood via a meshwork of small arteries, veins and capillaries in the skin

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69
Q

what are neonatal and pediatric considerations regarding absorption of medications?

A
  • the acid-producing cells in the stomach are immature until 1-2y/o
  • gastric emptying is slow or irregular
  • the liver continues to mature experiencing a decrease in first-pass elimination which results in increased drug levels in blood stream
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70
Q

what are older adult considerations regarding absorption of medications?

A
  • experience decreased blood flow to tissues in the GI system
  • changes in stomach gastric pH alter absorption of some meds
  • decreased drug absorption occurs when peripheral circulation is decreased
  • variations in available plasma proteins impact drug levels of meds that are protein-bound
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71
Q

what happens after a drug enters systemic circulation?

A

it must be distributed into interstitial and intracellular fluids to reach target cells.

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72
Q

what factors is distribution dependant on?

A

blood flow, plasma protein binding, lipid solubility, blood-brain barrier and placental barriers

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73
Q

what is a free drug?

A

a free drug is what traverses cell membranes and gives desired effects

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74
Q

what is a protein-bound drug?

A

acts as a drug resevoir that release drug slowly and prolong its effect

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75
Q

what is the blood-brain barrier?

A

blockade built from the tightly woven mesh of capillaries that protect the brain from dangerous substances

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76
Q

what are neonatal and pediatric considerations regarding distribution?

A
  • fat content is decreased
  • liver is still forming and protein binding capacity is decreased
  • developing blood-brain barrier allows more drugs through
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77
Q

what are older adult considerations regarding distribution?

A
  • body fat is increased meaning longer duration of drug action
  • decreased serum albumin levels meaning more active free drug
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78
Q

what do the liver enzymes do in regards to metabolism of medications?

A

each enzyme has a specific job, some breakdown molecules apart and some link molecules into small chains

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79
Q

what are prodrugs?

A

prodrugs have chemical activities of their own

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80
Q

what are neonatal and pediatric considerations regarding metabolism of medications?

A
  • developing liver produces decreased levels of microsomal enzymes and causes decreased ability to metabolize meds
  • older kids have increased metabolism and need increased doses
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81
Q

what are older adult considerations regarding metabolism of drugs?

A
  • hepatic metabolism declines
  • first-pass metabolism decreases, meaning they will have increased levels of free circulating drug concentrations which put that at an increased risk for side effects and toxicities
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82
Q

what happens to remaining drugs and metabolites in the bloodstream?

A

they are filtered by the kidneys. a portion is reabsorbed into the bloodstream and a portion is excreted in the urine

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83
Q

what does the liver do in excretion of drugs?

A

some drugs are transported by hepatocytes to bile. as the bile goes through the bile duct into the gallbladder and small intestine, some of the bile gets absorbed by intestine back to the bloodstream and the unabsorbed drugs are excreted in the feces

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84
Q

what are neonatal and pediatric considerations regarding the excretion of drugs?

A
  • immature kidneys, and decreased glomerular filtration, resorption and tubule secretion. they don’t clear drugs as efficiently
  • increased levels of free circulating drugs can cause toxicity
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85
Q

what are older adult considerations regarding excretion of drugs?

A
  • decreased kidney and liver function

- prolonged half-life greater chance for toxicity

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86
Q

what is the onset?

A

refers to when medication first begins to take effect

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87
Q

what is peak?

A

the maximum concentration of medication in the body and the patient shows greatest therapeutic effect

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88
Q

what is duration?

A

length of time medication produces a desired effect

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89
Q

what is titration?

A

working the way up to a dosage that is in the therapeutic window. it is accomplished by monitoring blood levels of a drug

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90
Q

when is the peak level of a drug drawn?

A

drawn at a time when the medication is administered and known to be at the highest level in bloodstream

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91
Q

when is the trough level of drugs drawn?

A

drawn when drug is at its lowest level in bloodstream right before next dose is given

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92
Q

what is the therapeutic index?

A

quantitative measurement of the relative safety of a drug

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93
Q

what is dopamine?

A

it influences impulses, motor impulses, cognition and how you think, and also motivation. increased levels of dopamine cause manic behaviour

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94
Q

what is 5HT?

A

5HT is serotonin. it has to do with levels of alertness, attention, mood. it is an anti-impulsive NT. lower levels result in bipolar, depression and anxiety

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95
Q

what is Norepinephrine?

A

it is the adrenaline of the brain. it increases metabolism. low levels cause depression, panic, and anxiety

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96
Q

what is GABA?

A

it is an inhibitory NT. it exerts it’s effects which help calm and settle.

97
Q

what is acetylcholine?

A

it is an NT that is present with dopamine in a balanced way. it affects motor function and cognition

98
Q

what are antipsychotics?

A

there are conventional antipsychotics and atypical antipsychotics. they primarily block dopamine

99
Q

what are anticholinergic effects of atypical antipsychotics?

A

when the antipsychotics block too much dopamine and affect the balance of dopamine and acetylcholine which causes overexpression effects such as dystonia.

100
Q

what are anticholinergic agents?

A

they manage EPS by blocking excitory cholinergic pathways. it restores the dopamine/acetylcholine balance

101
Q

what are anticholinergic overexpression?

A

dry eyes, urinary retention, constipation, dilated pupils, dry mouth and hypotension

102
Q

what is the antidote to benzodiazepines?

A

flumazenil. it is a benzo receptor blocker. has a higher affinity so can get to the receptor before the benzo does and reverses its effects

103
Q

what are amino acids?

A
  • they have their own receptors and do not interact with each other
  • they are eliminated from the synapse by reuptake, a pump, or neighbouring glial cells so they can be recycled, repackaged and released again
104
Q

what are biogenic amine?

A
  • enzymatically made from amino acids

- includes dopamine, norepinephrine, and epinephrine

105
Q

what are benzodiazepines and the indications for their use?

A

they bind to specific GABA receptors to potentiate GABA effects. the indications for use are sedation, antianxiety and anticonvulsant effects.

106
Q

difference between conventional antipsychotics and atypical antipsychotics?

A

conventional antipsychotics block dopamine receptors in certain areas and atypical antipsychotics block dopamine 2 receptors and specific serotonin 2 receptors

107
Q

what is NMS?

A

life-threatening, includes high fever unstable BP, and myoglobinuria

108
Q

what is EPS?

A

involuntary motor symptoms like akathisia and acute dystonia

109
Q

what is tardive dyskinesia?

A

involuntary contraction of oral and facial muscles and wavelike movements of extremities

110
Q

what happens when the inflammatory response is activated?

A

swelling, redness, warmth. it is a normal body process and stimulates nerve fibres which causes pain

111
Q

what are prostaglandins?

A

they help with the chain events leading to inflammation. they produce pain and fever and have a role in blood clotting

112
Q

what are NSAIDs?

A

their main action is to inhibit prostaglandin action by blocking COX which is a key enzyme involved in the synthesis of prostaglandins (anti inflammatory)

113
Q

what is COX-1 enzyme?

A

it is present in many tissues, involved in blood clotting, protecting the stomach and maintaining sodium and H2O balance in kidneys

114
Q

what is COX-2?

A

it is more active at sites of trauma

115
Q

what are the properties of the NSAID Ibuprofen?

A

anti-inflammatory, antipyretic and analgesic

116
Q

what are overexpression effects of ibuprofen?

A

more susceptible to stomach issues such as GI upset and ulcers, can cause kidney failure and clotting issues

117
Q

what are effects of glucocorticoids?

A
  • powerful metabolic effects/stress response
  • glucose metabolism
  • reduce inflammation
  • suppression of the immune system
  • influence sleep pattern and mood
  • decrease bone formation and increase bone breakdown
  • increase calcium excretion
  • causes lipogenesis
118
Q

what are the effects of mineralocorticoids?

A

retention of sodium and water and excretion of potassium; essential for maintenance of fluid and electrolyte balance, blood pressure and blood volume.

119
Q

what do beta cells do?

A

they release insulin to decrease blood glucose

120
Q

what do alpha cells do?

A

they release glucagon to increase blood glucose

121
Q

what is insulin?

A

it primarily facilitates the transfer of glucose into cells for cellular metabolism. it also promotes storage of glucose as glycogen and inhibits gluconeogenesis

122
Q

what is glucagon?

A

it is used in an emergency to manage hypoglycemia when oral intake is inappropriate or not possible. it increases serum glucose and encourages glycolysis. overexpression is hyperglycemia

123
Q

what is the release of aldosterone prompted by?

A

it is prompted by the negative feedback when the hypothalamus triggers release of ACTH

124
Q

what does aldosterone do?

A

it targets the kidneys and increased excretion of K+ and retention of NA+. causes retenion of H2O which increases BP and blood volume

125
Q

what is a disorder caused by hypersecretion of cortisol?

A

Cushing’s Disease

126
Q

what is a disorder caused by hyposecretion of corticosteroids?

A

addison’s disease

127
Q

what are indications for corticosteroids?

A

adrenal insufficiency, respiratory conditions

128
Q

what are indications for mineralocorticoids?

A

regulation of H2O and electrolyte balance

129
Q

what are indications for glucocorticoids?

A

anti-inflammatory, immunosuppressive, anti-proliferative

130
Q

what is basal insulin?

A

long-acting or immediate acting

131
Q

what is prandial insulins?

A

used w/meals and may be rapid or short acting

132
Q

what is glipizide?

A

an oral antihyperglycemic that stimulates insulin secretion from beta cells of pancreatic islet tissue. it should be taken at the same time every day

133
Q

what is the onset, peak and duration of humalog (rapid) insulin?

A 
onset = within 15 mins
peak = 1-2 hr
duration = 3-4 hr
134
Q

what is the onset, peak and duration of Humulin R (short) insulin?

A 
onset = 30-60 min
peak = 2-4 hr
duration = 5-7 hr
135
Q

what is the onset, peak and duration of Humulin N/NPH (intermediate) insulin?

A 
onset = 2-4 hr
peak = 4-10 hr
duration = 10-16 hr
136
Q

what is the onset, peak and duration of glargine (basal or long-acting) insulin?

A 
onset = 3-4 hr
peak = none
duration = 24 hr
137
Q

what is digoxin?

A

a cardiac glycoside that inhibits Na/K pump and results in increased intracellular Na and influx of Ca into cardiac cells. it causes cardiac muscle fibres to contract more efficiently and increased CO

138
Q

what are the indications for digoxin?

A

it is a 2nd line treatment for those who have HF or atrial fib

139
Q

what the O/E of digoxin?

A

bradycardia (the biggest worry)) and fatigue

140
Q

what are nursing considerations for digoxin?

A 
nausea and visual changes (halos), 
therapeutic level of 0.8-1.2, 
monitor serum K levels b/c hypokalemia increases risk for digoxin toxicity
K levels of 3.5-5.0
report pulse <60 BPM
do not mix with other meds
digibind treats digoxin toxicity
141
Q

what is nitroglycerin?

A

it is a nitrate that relaxes smooth muscle and results in vasodilation, slow blood return which decreases work of heart, and arterial dilation which lowers BP

142
Q

what is nitroglycerin used for and what are the O/E?

A

it is used for angina and the O/E are hypotension and severe headaches

143
Q

what are nursing considerations of nitroglycerin?

A

can give 3 sprays Q 5 mins
check BP each time
have pt. sit b/c hypotension and teach them the signs of hypotension
goal is 0/10 pain, symptoms vary between genders

144
Q

what is furosemide?

A

it is a diuretic that inhibits absorption of Na in the loop of Henle which results in fluid losee, loss in NA and other electrolytes like K and Ca

145
Q

what are the uses and O/E of furosemide?

A

it is used to treat hypertension and edema. the O/E are dehydration, hypotension, electrolyte imbalances (hyponatermia, hypokalemia)

146
Q

what are nursing considerations for furosemide?

A

may take K+ supplements
assess BP
change positions slowly due to hypotension
drink fluids to decrease dehydration
take in the morning so the need to urinate does not interfere with sleep
if BID, 2nd dose by 4 pm
toxicity includes renal toxicity and ototoxicity

147
Q

what is metoprolol?

A

it is a beta-blocker that blocks beta 1 receptors in the heart, lowering HR and BP. high doses can block beta 2 receptors which can result in bronchoconstriction

148
Q

what are the uses and O/E of metoprolol?

A

it is used for HTN, Fast HR, chest pain due to poor BF to heart, and early intervention for MI. the O/E is hypotension, bradycardia, fatigue and SOB (beta 2)

149
Q

what are nursing considerations for metaprolol?

A

check BP and HR every time and report if <60 bpm or BP is < 100/60
change positions slowly

150
Q

what is lisinopril?

A

it is an ACE inhibitor that blocks the conversion of Angio 1 to angio 2, leading to vasoconstriction, Na/H20 excretion, which lowers BV and BF, leading to decreased BP. it also retains K+

151
Q

what are the uses and O/E of lisinopril?

A

it is used for hypertension and HF. the O/E are hypotension, cough and hyperkalemia

152
Q

what are nursing considerations for lisinopril?

A

monitor BP
switch to ARB if cough is intolerable
watch for hyperkalemia

153
Q

what is Losartan?

A

it is an ARB that blocks angio 2 receptors to promote vasodilation

154
Q

what are the uses and O/E of losartan?

A

it is used for hypertension and the O/E is hypotension

155
Q

what are considerations of losartan?

A

check BP every time

change positions slowly

156
Q

what is dilitiazem?

A

it is a calcium channel blocker that inhibits Ca+ during depolarization to decrease workload of the heart and to increase O2 supply to myocardium, it relaxes smooth muscle which results in decreased BP and decreased HR

157
Q

what are the uses and O/E of dilitiazem?

A

it is used for angina, hypertension, and supraventricular tachycardias. the O/E are hypotension, bradycardia, fatigue and arrhythmias

158
Q

what are nursing considerations for dilitiazem?

A

take BP and HR each time
change position slowly
no grapefruit juice

159
Q

what is artovastatin?

A

it is an antilipidemic that inhibits HMG-CoA reductase and cholesterol synthesis which lowers LDL

160
Q

what are the uses and O/E of artovastatin?

A

it is used for hyperlipidemia and prevention of CVD. the O/E are myalgia, and muscle cramps and aches

161
Q

what are nursing considerations for artovastatin?

A

routine liver assessments
take same time each day
report jaundice and/or muscle weakness

162
Q

what is aspirin?

A

it is an antiplatelet what inhibits platelet activation and aggregation

163
Q

what are the uses and O/E of aspirin?

A

it is used for PAD, MI, stroke and those with a history of MI. the O/E is bleeding

164
Q

what are nursing considerations for aspirin?

A

the effects last the lifetime of the platelet (7-10 days)
avoid NSAID’s and alcohol
report tinnitus and bleeding
educate on S&S of bleeding

165
Q

what is warfarin?

A

it is an anticoagulant that inhibits the synthesis of vit.K dependent clotting factors and anticoagulant proteins

166
Q

what are the uses and O/E of warfarin?

A

it is used for DVT, and pulmonary emboli. the O/E is bleeding and hemmorhage

167
Q

what are nursing considerations for warfarin?

A 
vit K is the reversal agent
monitor PT, want it 2.0-3.5
avoid alcohol, grapefruit juice and sharp objects
floss gently
teach signs of bleeding
168
Q

what is heparin?

A

it is an anticoagulant that inhibits activated coagulation factors involved in clotting sequence (Xa and LLa). it prevents the formation of stable fibrin clots by inhibiting the activation of stabilizing factors but it does not break down existing clots.

169
Q

what are the uses and O/E of heparin?

A

it is used for DVT, pulmonary emboli and active MI. the O/E is hemorrhage, decreased BP and increased HR

170
Q

what are nursing considerations for heparin?

A

the antidote is protamine sulfate slow infusion
watch for bruising that spreads and bleeding gums
there is no PO form

171
Q

what is erythmocin?

A

it is a macrolide that inhibits RNA synthesis and suppresses the reproduction of bacteria

172
Q

what are the uses and O/E of erythmocin?

A

it is used for respiratory infections, otitis media, pelvic inflammatory infections and chlamydia. the O/E is that it kills good bacteria so can result in nausea, vomiting and GI upset

173
Q

what are nursing considerations for erythmocin?

A

timing of doses
finish full prescription
take w/food
can cause superinfection as it kills good bacteria

174
Q

what is calcium carbonate?

A

it is an antacid that neutralizes gastric acid and elevates the pH of the stomach

175
Q

what are the uses and O/E of calcium carbonate?

A

it is used for GERD and ulcers. the O/E is rebound hyperacidity

176
Q

what are nursing considerations for calcium carbonate?

A 
acid rebound effect when used long term
do not give 1-2 hr around other meds
smoking cessation can reduce stomach acid
avoid foods and drinks with high acidity
drink full glass of water after taking
177
Q

what is ranitidine?

A

It is an H-2 receptor antagonists that blocks histamine action at H-2 receptors of parietal cells and lowers production of HCL

178
Q

what are the uses and O/E of ranitidine?

A

it is used for GERD, peptic ulcer disease, erosive esophagitis, hypersecretory conditions, and upper GI bleeding. it does not have any O/E

179
Q

what are nursing considerations for ranitidine?

A

may require dose adjustment if preexisting liver/kidney dysfunction
smoking interferes
take 15-60 mins before eating/drinking that might cause heartburn

180
Q

what is pantoprazole?

A

it is a proton pump inhibitor that binds to the H+/K+ ATPase enzyme system in the parietal cells, inhibiting HCL secretion for >24 hrs

181
Q

what are the uses and O/E of pantoprazole?

A

it is used for GERD, preventing further damage and allowing to heal, and for H.pylori infections. the O/E is too much reduction of produciton of acid

182
Q

what are nursing considerations for pantoprazole?

A

do not take with other meds, use of GI irritants is discouraged

183
Q

what is lactobacellus?

A

it is a probiotic that helps replenish normal gut flora

184
Q

what are the uses and O/E of lactobacellus?

A

it is used to prevent and treat diarrhea. the O/E is gas and bloating

185
Q

what are nursing considerations for lactobacellus?

A

take this med when taking an antibiotic

186
Q

what is loperamide?

A

it is an opioid-like medication that decreases flow of fluid and electrolytes in the bowel and slows peristalisis.

187
Q

what are the uses and O/E of loperamide?

A

it is used for diarrhea and the O/E is constipation

188
Q

what are nursing considerations for loperamide?

A

do not exceed recommended dose
can lead to abnormal heart rhythm
avoid CNS depressants

189
Q

what is polyethylene glycol?

A

it is an osmotic agent that causes H2O to be retained in stool, it softens stool an increases number of BM

190
Q

what are the uses and O/E of PEG?

A

it is used for constipation and the O/E is diarrhea

191
Q

what are nursing considerations for PEG?

A

stir and dissolve in drink

produces a BM in 1-3 days

192
Q

what is bisacodyl?

A

it is a stimulant that stimulants the lining of the stomach to contract and increase peristalsis

193
Q

what are the uses and O/E of bisacodyl?

A

it is used for constipation and the O/E is diarrhea

194
Q

what are nursing considerations for bisacodyl?

A

BM within 15 mins

oral and rectal forms may cause cramps, dizziness and rectal bleeding

195
Q

what is dimenhydrinate?

A

it is an antihistamine that blocks H1 receptors in vestibular center

196
Q

what are the uses and O/E of dimenhydrinate?

A

it is used for nausea and vomiting associated with motion. the O/E is drowsiness

197
Q

what are nursing considerations for dimenhydrinate?

A

contraindicated with glaucoma, enlarged prostate

avoid CNS depressants

198
Q

what is metocloprimide?

A

it is a prokinetic that blocks dopamine and increases peristalsis to empty GI and decrease nausea

199
Q

what are the uses and O/E of metocloprimide?

A

it is used for nausea and vomiting. the O/E are diarrhea, EPS and GI upset

200
Q

what are nursing considerations for metocloprimide?

A

good for surgery/chemo/anesthesia related nausea
don’t use when GI motility is dangerous (blockage, perforation, hemorrhage)
due to EPS, don’t use if epileptic

201
Q

what is acetaminophen?

A

it is a non-opioid analgesic that inhibits synthesis of prostaglandins

202
Q

what are the uses and O/E of acetaminophen?

A

it is used for mild pain and fever. the O/E is toxicity

203
Q

what are nursing considerations for acetaminophen?

A 
do not take with alcohol
do not exceed rec. dosage of 4000 mg/day
3000 mg/day if elderly
2000 mg/day if an alcohol user
check if other meds contain acetaminophen
204
Q

what is Salbutamol?

A

it is a beta 2 agonist bronchodilator that binds to beta 2 adrenergic receptors in airway smooth muscle which results in bronchodilation to open and widen airway

205
Q

what are the use and O/E of salbutamol?

A

it is used for bronchospasms in asthma pts., COPD and exercise-induced bronchospasm. the O/E are tachycardia and cough

206
Q

what are nursing considerations for salbutamol?

A

it is used as a rescue med

give prior to giving to an inhaled corticosteroid

207
Q

what us Ipratropium?

A

it is an anticholinergic bronchodilator that inhibits cholinergic receptors in bronchial smooth muscle resulting in decreased concentrations of cGMP and results in bronchodilation

208
Q

what are the uses and O/E of Ipratropium?

A

it is used for bronchospasms, and reversible airway obstruction due to COPD and emphysema. the O/E are

209
Q

what are nursing considerations for ipratropium?

A

give at the same time as salbutamol
caution pt. not to exceed 12 doses in 24 hrs
rinse mouth after use

210
Q

what is amoxicillin?

A

it is a penicillin antibiotic that binds to bacteria cell wall causing cell death

211
Q

what are the uses and O/E of amoxicillin?

A

it is used for respiratory infections, skin infections, and sinusitis. the O/E are diarrhea

212
Q

what are nursing considerations for amoxicillin?

A

it is important to space out the doses (BID, Q12 is best for kids)
take a probiotic to decrease chance of super infection

213
Q

what is fluticasone?

A

it is an inhaled corticosteroid that is a locally acting anti-inflammatory and immune modifier that decreases frequency and severity of asthma attacks

214
Q

what are the uses and O/E of fluticasone?

A

it is used for the maintenance treatment of asthma. the O/E are immune suppression, hoarseness and cough

215
Q

what are nursing considerations for fluticasone?

A

it takes a few days to see changes
pts. need to take everyday
does not have the long-term risks that oral corticosteroids have

216
Q

what is prednisone?

A

it is an oral corticosteroid that suppresses inflammation and normal immune response

217
Q

what are the uses and O/E of prednisone?

A

it is used for chronic disease and adrenal insufficiency. the O/E is that it suppresses the immune

218
Q

what are nursing considerations for a prednisone?

A

monitor input and output ratio

give in morning as it increases energy and so it is with body’s normal secretion of cortisol

219
Q

what is morphine sulfate?

A

it is an opioid agonist that binds to opioid receptors in the CNS altering the perception of and response to painful stimuli while producing CNS depression

220
Q

what are the uses and O/E of morphine?

A

it is used for severe pain and the O/E are sedation, respiratory depression, constipation, nausea and vomiting and urinary retention

221
Q

what are nursing considerations for morphine?

A

extended-release lasts 12 hours and takes longer to work
assess RR before and after
assess LOC and BM
prolonged use can lead to dependence

222
Q

what is ondansetron?

A

it is an antiemetic/serotonin agonist that blocks the effect of serotonin at receptor sites located in vagal nerve terminals and chemoreceptor trigger zone

223
Q

what are the uses and O/E of ondansteron?

A

it is used for nausea and vomiting. the O/E are diarrhea, constipation, dizziness, headache and fatigue

224
Q

what are nursing considerations for ondansteron?

A

monitor for S & S of serotonin syndrome

assess nausea and bowel sounds

225
Q

what is docusate?

A

it is a laxative/stool softener that promotes H2O into stool resulting in softer fecal matter, it also promotes electrolyte and water secretion into the colon

226
Q

what are the uses and O/E of docusate?

A

it is used for constipation and the O/E are diarrhea, cramps, dehydration, and electrolyte imbalances

227
Q

what are nursing considerations for docusate?

A

assess abdominal distension and bowel sounds
give with a full glass of H2O or juice
do not give within 2 hours of other laxatives

228
Q

what is naloxone?

A

it is an opioid antagonists that attaches to opioid receptors to block and reverse response to opioids

229
Q

what are the uses and O/E of naloxone?

A

it is used for reversal of CNS and respiratory depression due to opioid overdose. the O/E are nausea and vomiting

230
Q

what are nursing considerations for naloxone?

A

pt. code status does not alter the administration of naloxone
monitor RR and vitals
assess Signs and symptoms of opioid withdrawal symptoms

231
Q

what is haloperidol?

A

it is a conventional antipsychotic that alters the effects of dopamine in the CNS, it also has anticholinergic and alpha-adrenergic blocking activity

232
Q

what are the uses and O/E of haloperidol?

A

it is used for schizophrenia, manic states, psychosis and tourettes. the O/E are EPS

233
Q

what are nursing considerations for haloperidol?

A

assess positive and negative symptoms of schizophrenia
give w/food and H2O
monitor for akathisa

234
Q

what is rispiradone?

A

it is an antipsychotic that antagonizes dopamine and serotonin in the CNS and decreases symptoms of psychosis and mania

235
Q

what are the uses and O/E of rispiradone?

A

it is used for schizophrenia, acute mania and bipolar I. the O/E is EPS

236
Q

what are nursing considerations for rispiradone?

A

monitor behaviour and signs of EPS

237
Q

what is benzotropine?

A

it is an anticholinergic agent that blocks cholinergic activity in CNS and restores balance between NT in the CNS

238
Q

what are the uses and O/E of benzotropine?

A

it is used for extrapyramidal side effects.

239
Q

what are nursing considerations for benzotropine?

A

give w/food or right after food

Pharmacology (6 decks)

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