Exam 2 Drugs Flashcards

Question

Cannabidiol CBD Oil Drop

Answer 1

Category Class: -Schedule V (no risk of abuse) Sep 2018 Indication: -2 types of rare & severe epilepsy in patients 2 years and older Side effects: - Sleepiness, sedation, lethargy, liver failure, decreased appetite, diarrhea, rash, weakness - No euphoria, no psychoactive (THC component <0.1%) Nursing Interventions (monitoring): - There are many other brands of CBD but unapproved by FDA - Marijuana is Schedule I compound “Some Friends Like Weed. Austin Reed Does Like Smoking”

Answer 2

Medication: - Diphenhydramine - Promethazine - Has 3 MOA's- you should be scared of it Indication: - Secondary use - Insomnia, motion sickness Contraindication: - Pregnancy - Lactation - Newborn - Children - Older adults - Anticholinergic effects: retention, glaucoma, HTN, BPH Side effects, Adverse reactions: - Crossing BBB: CNS depressant- drowsiness, dizziness, fatigue, disturbed coordination, FALL - Anticholinergic effects (PNS) - Hangover effect - Promethazine - Is vesicant (causes blistering, tissue injury, damage to intima layer of veins) dilute IV form in a large-bore IV and very slow IV push, deep IM if you have to give IM Medication Administration: -PO, IV, IM (PRN) Nursing Interventions (monitoring): -Toxicity: excitation, hallucination, seizure Assess -Breathing (CNS depression --> respiratory depression --> shallow/diminished) -VS (for anticholinergic effects) -I/Os (for anticholinergic effects) -Warn against combination medications (decongestant A1 agonist) -Vesicant: ensure for IV patency Patient Education: -CNS depression: avoid driving or operating dangerous machinery Interactions (with drugs/food/UV light): -Avoid other CNS depressants: ETOH, codeine

Answer 3

Medication: - Cetirizine - Fexofenadine Medication Administration: PO, Nasal Spray (PRN) Nursing Interventions (monitoring): - Little to no sedative effect - Little to no anticholinergic effect

Answer 4

Medication: - Ephedrine (PO, inhalation mist) - Limited sale with ID - Pseudoephedrine (PO) - Limited sale with ID Category Class: -non-specific a agonist (sympathomimetic) OTC Mechanism of Action: - a (peripheral vasoconstriction) decongestant effects= decrease swelling, stuffiness, rhinorrhea - a & B (worsening HTN, BPH, tachycardia) Side effects, Adverse reactions: -CNS effect: restlessness, jitteriness, nervousness Medication Administration: -nasal spray, inhalation mist, ophthalmic, IM, SubQ, IV, PO (PRN) Nursing Interventions (monitoring): - Nasal spray/drop apply while sitting/lateral not supine, tilt head forward, sniff gently - To avoid swallowing & systemic effect - Avoid frequent use of nasal spray/drop - Multiple doses may cause paradoxical congestion by irritation on nasal mucosa (not the PO form) - Causes tolerance, must always taper off to avoid rebound congestion (only < 3-5 days) - Precautions due to vasoconstriction (a): CVA, dysrhythmia & tachycardia, HTN, CAD, RF - Precautions due to adrenergic responses - Hyperglycemia for diabetic patients - Avoid in glaucoma, BPH patients - Works against antidepressants (CNS alpha blockers) - Combination cold remedies often contain decongestants & antihistamines (OD risk)

Answer 5

-antitussive Mechanism of Action: -local anesthetic obtained from mint Medication Administration: -throat lozenges

Answer 6

-antitussive - Benzonatate (Rx, PO soft gel) - Dextromethorphan (OTC syrup, lozenges) Mechanism of Action: - suppresses the cough center in medulla - Related to opioids structurally but has no analgesic properties Side effects, Adverse reactions: - Drowsiness - Dizziness - Euphoria with high dose (risk of abuse)

Answer 7

- antitussive - often in combination with antihistamine, decongestant, or expectorant Mechanism of Action: -suppress cough by increasing cough threshold in CNS (prodrug) Contraindication: - Respiratory disease - Alcohol - Head trauma Side effects, Adverse reactions: - Drowsiness - Respiratory depression - Dizziness (fall, driving) - Nausea - Constipation - hypotension Nursing Interventions (monitoring): - Risk of abuse (short term only) - Reversed by naloxone (for resp depression)

Answer 8

- expectorant - PO (tab, capsule, syrup) Contraindication: -never to children < 4 YO Nursing Interventions (monitoring): - increase hydration to promote drug action - Various combinations with analgesics/antihistamines/decongestants/antitussive (OTC cold drugs) - Patients are at high risk of OD

Answer 9

- expectorant/antitussive - OTC Side effects, Adverse reactions: - Drowsiness - Dizziness ``` Nursing Interventions (monitoring): -want you to cough up mucus, but don’t want you to cough too much because it's irritating ```

Answer 10

``` Medication: Intranasal -Budesonide (Rhinocort) -Fluticasone (Flonase) IV -Methylprednisolone (Solu-Medrol) PO -Methylprednisolone (Medrol) -Prednisone (Deltasone) Inhalation (DPI, MDI, Neb) -Budesonide (Rhinocort) -Fluticasone (Flovent) ``` Mechanism of Action: -anti-inflammatory (similar to body's cortisol, negative feedback) Indication: - IV - Acute exacerbation of inflammatory disorders (requires loading dose) - PO - To wean from IV and to continue to wean - End-stage disease for maintenance - DPI/MDI/Neb - Maintenance therapy (scheduled), avoid OD (not a rescue drug, not PRN) - It takes 1-4 weeks to reach max result - If concurrent with a B2 adrenergic agonist, always take B2 adrenergic agonist first - Rinse mouth after each use to avoid throat/oral candidiasis - After rinsing the mouth, drink water to avoid pharyngitis - Nasal spray - UR inflammation & congestion associated with allergic rhinitis Contraindication: - Intranasal - Pregnancy- C - URI Side effects, Adverse reactions: - Intranasal - Dryness of nasal mucosa (epistaxis) - Hyperglycemia (in diabetic patients) - Leukocytosis (yet immunosuppressant) - Immunosuppressant (anti-inflammatory mechanism- higher risk of infection) - Water/Na retention (worsening of HF, edema, HTN) --> hypokalemia (dysrhythmia) - Water/Na retention --> increased IOP (worsening of glaucoma) - SubQ tissue loss with chronic use --> "paper skin" or "steroid skin" - Adrenal suppression (never stop abruptly to avoid adrenal crisis) requires weaning - Osteoporosis (take Vitamin D, Ca++, and exercise) Medication Administration: -Nasal Spray, IV, PO, Inhalation Nursing Interventions (monitoring): - Intranasal - Scheduled, maintenance drug (not rescue) - It takes 7-21 days for peak effect - Must shorten the length of use to prevent opportunistic infection (candidiasis) - Manage dryness by saline nasal spray - Must always wean off “Did Evan Bring Lily Her Inflammation Already Omg”

Answer 11

Medication: - Short acting, rescue inhaler - Albuterol (MDI/Neb) - Levalbuterol (MDI/Neb) - Long acting maintenance therapy - Salmeterol (Diskus DPI) Category Class: -B2 Adrenergic Agonist Mechanism of Action: - Bronchodilation - Decrease histamine - Increase ciliary motility Contraindication: - Pregnancy - Tachycardia - Hyperthyroidism Side effects, Adverse reactions: - Can cause B1 activation --> tachycardia, dysrhythmia, HTN, palpitation, angina - Nervousness, tremors, HA, increased BG Nursing Interventions (monitoring): - Tolerance - Do not increase the frequency, instead call the provider to ask for a new drug or call 911 - Use before inhaled corticosteroids Patient Education: - Do not use more than prescribed - OD --> paradoxical airway resistance Interactions (with drugs/food/UV light): -Stimulants: caffeine, nicotine

Answer 12

Medication: - Ipratropium, tiotropium - Albuterol + ipratropium - Synergistic effect when combined with B-agonists Category Class: -Anticholinergic, maintenance treatment Mechanism of Action: -Anticholinergic (PNS) --> bronchodilation Contraindication: - Peanut allergy - Glaucoma - BPH Side effects, Adverse reactions: - No cardiac adverse effects because of local effect as an inhaler - Large doses may cause systemic anticholinergic effects Medication Administration: -MDI, Neb Patient Education: - rinse mouth (taste), - allow at least 5 minutes between various inhalers

Answer 13

Medication: - Budesonide + formoterol - Fluticasone + salmeterol Category Class: -long-acting B2 agonist and corticosteroid Indication: -maintenance therapy only, scheduled only

Answer 14

Category Class: - Leukotriene Modifiers - Leukotriene is an inflammatory mediator Indication: -maintenance therapy (not for acute SOB) Side effects, Adverse reactions: - Depression - Suicidal ideation - Liver failure - Causes drug toxicity because "first-pass" doesn't occur - Do liver function tests - Don't take hepatotoxic drugs (acetaminophen, alcohol) - Drug interactions Medication Administration: PO ``` Nursing Interventions (monitoring): -consider age limits (for 1-year & up) ```

Answer 15

Mechanism of Action: -Inhalation: mucolytic- breakdown protein structure of bronchial secretions (different from expectorant) Indication: - cystic fibrosis, COPD, bronchitis - Secondary uses - IV/PO: acetaminophen OD and liver failure - PO: prevent nephrotoxicity prior and after IV contrast agent Contraindication: -children <7 years of age Side effects, Adverse reactions: -Dizziness, drowsiness, orthostatic hypotension, tachycardia, hepatotoxicity “Did David Offer Her Helpful Tissues” Medication Administration: -inh, PO, IV Nursing Interventions (monitoring): - Encourage hydration throughout the day - Strong rotten egg smell (liquid po form) - Powder to mix with drinks to manage the smell

Answer 16

Indication: - Continuous (long-term) - PRN for DOE (dyspnea on exertion) and QHS (at bedtime) - Acute SOB Side effects: - Vasoconstriction - Loss of (hypoxia) which is the respiratory drive for CO2 retainers - Administer nebulizers with pressurized air (medical air) not with O2 Medication Administration: - Tank (portable) - Condenser (at home) - Piped (in medical facilities) Patient Education: - Safety of oxygen use at home - Fire hazard, projectile hazard