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exam 2 pharm Flashcards

1
Q

Loratadine

A

antihistamine

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2
Q

Cetirizine

A

antihistamine

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3
Q

fexofenadine

A

antihistamine

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4
Q

antihistamine indication

A

allergy and cold, insomnia, motion sickness

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5
Q

antihistamine adverse effects

A

drowsiness, sedation, anticholenergic effecs

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6
Q

antihistamine contraindications

A

children younger than 2

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7
Q

antihistamine caution

A

older adults and children

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8
Q

antihistamine interactions

A

CNS depressants, alcolol

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9
Q

antihistamine patient teaching

A

avoid activities requiring more concentration until aware of effects, avoid alcohol, children are more sensitive and may have paradoxical reactions, may be in combination preparations- read labels.

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10
Q

oxymetazoline

A

Afrin. nasal decongestant

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11
Q

phenylephrine

A

nasal decongestant

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12
Q

pseudoephedrine

A

sudafed, others, systemic decongestion

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13
Q

phenylephrine (oral)

A

systemic decongestant

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14
Q

decongestant action

A

causes vasoconstriction and reduce the size of the nasal mucous membranes

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15
Q

decongestant indication

A

nasal congestion

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16
Q

decongestant adverse effects

A

sympathetic effects, CNS stimulation, rebound nasal congestion

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17
Q

diphenhydramine

A

antihistamine

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18
Q

decongestant contraindications

A

CAD, uncontrolled or severe hypertension

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19
Q

decongestant cautions

A

conditions that may be exacerbated by sympathetic activity

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20
Q

decongestant interactions

A

beta blockers, MAOI’s, caffeine

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21
Q

decongestant patient teaching

A

proper use of nasal spray or drops, do not use more than 3-5 days, do not use oral and topical together, avoid caffeine while taking oral, may be in combination preparations- read labels

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22
Q

fluticasone

A

flonase, veramyst, nasal steroid

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23
Q

mometasone

A

nasonex, nasal steroid

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24
Q

triamcinolone

A

nasacort, nasal steroid

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25
Q

budesonide

A

rhinocort aqua, nasal steroid

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26
Q

nasal steroid action

A

blocks inflammation of the nasal mucosa

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27
Q

nasal steroid indications

A

seasonal allergic rhinitis, nasal polyps

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28
Q

nasal steroids patient teaching

A

administer daily during allergy season, notify provider if nose bleeds occur, may take 7 days or more to achieve relief of symptoms

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29
Q

dextromethorphan

A

non-opioid antitussive

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30
Q

benzonatate

A

tessalon, non-opioid antitussive

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31
Q

codeine

A

opioid antitussive

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32
Q

hydrocodone

A

hycodan, opioid antitussive

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33
Q

antitussive action

A

act directly on the CNS to depress the cough reflex

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34
Q

antitussive indication

A

nonproductive cough

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35
Q

antitussive adverse effects

A

dizziness, drowsiness, GI distress, potential for abuse

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36
Q

antitussive contraindications

A

patients who need to cough to maintain airway, head injury, or impaired CNS

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37
Q

antitussive cautions

A

children and older adults, history of substance abuse

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38
Q

antitussive interactions

A

CNS depressants, MAOI’s

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39
Q

antitussive patient teaching

A

use for short term only, use other measures to help relieve cough, avoid alcohol, may be in combination preparations- read labels.

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40
Q

guafenesin

A

mucinex, expectorant

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41
Q

expectorant action

A

reduce the adhesiveness and surface tension of respiratory fluids, allowing easier removal

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42
Q

expectorant indication

A

cough

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43
Q

expectorant adverse effects

A

GI upset, rash

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44
Q

expectorant caution

A

children less than 6

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45
Q

expectorant interactions

A

none

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46
Q

expectorant patient teaching

A

increase fluid (Water) intake, may be in combination preparations- read labels

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47
Q

acetylcysteine

A

mucolytics

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48
Q

mucolytics action

A

liquefy and loosen respiratory secretions

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49
Q

mucolytics indications

A

large amount of secretions, treatment of acetaminophen overdose

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50
Q

mucolytics patient teaching

A

smells like rotten eggs

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51
Q

obstructive airway diseases

A

COPD and asthma

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52
Q

lower respiratory disorder classes

A

anticholinergics, xanthines, inhaled steroids, leukotriene receptor antagonists, sympathomimetics

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53
Q

albuterol

A

beta2-adrenergic agonist (sympathomimetics)

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54
Q

levalbuterol

A

xopenex, beta2-adrenergic agonist (sympathomimetics)

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55
Q

salmeterol

A

serevent, beta2-adrenergic agonist (sympathomimetics)

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56
Q

formoterol

A

foradil, beta2-adrenergic agonist (sympathomimetics)

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57
Q

epinephrine

A

beta2-adrenergic agonist (sympathomimetics)

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58
Q

beta2-adrenergic agonist (sympathomimetics) action

A

stimulates beta2 adrenergic receptors in bronchial smooth muscle causing bronchodilation

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59
Q

beta2-adrenergic agonist (sympathomimetics) indications

A

bronchospasm- acute, chronic, or preventative

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60
Q

beta2-adrenergic agonist (sympathomimetics) adverse effects

A

nervousness, tremors, tachycardia

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61
Q

beta2-adrenergic agonist (sympathomimetics) contraindications

A

depends on the severity of the underlying condition

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62
Q

beta2-adrenergic agonist (sympathomimetics) cautions

A

arrhythmias, CAD, HTN, diabetes mellitus

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63
Q

beta2-adrenergic agonist (sympathomimetics) interactions

A

beta-blockers, MAOI’s

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64
Q

beta2-adrenergic agonist (sympathomimetics) patient teaching

A

correct use of inhaler or nebulizer, possible adverse effects, do not use more than instructed

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65
Q

ipratroprium

A

atrovent, anticholinergics

66
Q

tiotroprium

A

spiriva, antocholinergics

67
Q

anticholinergics action

A

relax smooth muscle in bronchi, causing bronchodilation

68
Q

anticholinergics indications

A

COPD and asthma

69
Q

anticolinergics adverse effects

A

anticholinergic effects

70
Q

anticholinergics cautions

A

BPH

71
Q

anticholinergic interactions

A

other anticholinergics

72
Q

anticholinergic patient teaching

A

dot for use in acute bronchospasm, rinse mouth after inhalation, take beta-agonist before anticholinergic, take anticholinergic before glucocorticoid, wait 5 minutes between medications

73
Q

theophylline

A

xanthines

74
Q

aminophylline

A

xanthines

75
Q

xanthines actions

A

cause relaxation of bronchial smooth muscle, resulting in bronchodilation

76
Q

xanthines adverse effects

A

need to check levels in blood. toxicity- GI upset, irritability, restlessness, arrhythmias, seizure

77
Q

xanthines caution

A

heart disease, hypertension, thyroid disorder, diabetes, renal or hepatic disease

78
Q

xanthines interactions

A

many drugs, nicotine, caffeine

79
Q

xanthines patient teaching

A

take as directed, do not make up missed dose. get lab work as directed. avoid caffeine. smoking affects levels of medication.

80
Q

montelukast

A

singulair, leukotriene receptor antagonists

81
Q

zafarlukast

A

accolate, leukotriene receptor antagonists

82
Q

leukotriene receptor antagonists action

A

blocks the effects of leukotrienes, suppressing inflammation, bronchoconstriction and edema. works on the allergy factor associated with asthma.

83
Q

leukotriene receptor antagonists indications

A

asthma, including exercise-induced

84
Q

leukotriene receptor antagonists adverse effects

A

URI or flu-like symptoms, liver injury

85
Q

leukotriene receptor antagonists caution

A

hepatic impairment

86
Q

leukotriene receptor antagonists interactions

A

theophylline, warfarin

87
Q

leukotriene receptor antagonists patient teaching

A

take at night. not for acute asthma attacks. do not stop taking other asthma medications.

88
Q

budesonide

A

pulmicort, inhaled steroid

89
Q

fluticasone

A

flovent, inhaled steroid

90
Q

inhaled steroid actions

A

decrease the inflammatory response in the airway

91
Q

inhaled steroid indications

A

asthma

92
Q

inhaled steroid adverse effects

A

oral candidiasis, hoarseness, cough, immune suppression

93
Q

inhaled steroid caution

A

children, elderly, adolescents, infections

94
Q

inhaled steroid interactions

A

other steroids, medications to lower blood sugar

95
Q

inhaled steroids patient teaching

A

not for use in acute asthma attack. take other inhaled medications before steroid. do not mix with other nebulized medications. rinse mouth after taking.

96
Q

advair (diskus or HFA)

A

fluticasone and salmeterol

97
Q

symbicort

A

budesonide and formoterol

98
Q

combivent, duoneb

A

iprapropruim and albuterol

99
Q

vitamins and minerals

A

required for carrying out essential functions. some must be obtained from food.

100
Q

vitamin and mineral deficiency can lead to

A

anemia, scurvy, pellagra, beriberi

101
Q

cyancobalamin (nascobal)

A

vitamin B12

102
Q

vitamin B12 action

A

prevent or correct vit. B12 deficiency

103
Q

vitamin B12 indication

A

pernicious anemia, B12 deficiency or malabsorption

104
Q

vitamin B12 adverse effects

A

Very rare- hypokalemia, diarrhea, flushing, vascular thrombosis

105
Q

vitamin B12 patient teaching

A

proper dosing and administering (usually deep IM), may need lifelong treatment, consume foods high in vit. B12 such as dairy, will need lab work every 3-6 months

106
Q

folic acid

A

water soluble B vitamin

107
Q

folic acid action

A

correct folic acid deficiency, prevent neural tube defects during pregnancy

108
Q

folic acid indication

A

megaloblastic anemia, alcohol use disorder, women of childbearing age

109
Q

folic acid adverse effects

A

GI distress

110
Q

folic acid contraindications

A

sole treatment of vit B12 deficiency

111
Q

folic acid patient teaching

A

consume foods high in folic acid, such as green, leafy vegetables, citrus fruits, dried beans. will need lab work periodically.

112
Q

ferrous sulfate

A

Iron

113
Q

iron dextran

A

iron

114
Q

iron action

A

carries oxygen to blood, supplementation in times of increased growth or high demands of RBC’s.

115
Q

iron dietary sources

A

meats and certain vegs and grains

116
Q

iron indication

A

iron-deficiency anemia, prevention of iron-deficiency

117
Q

iron adverse effects

A

GI distress (take with food), staining of teeth or tissues, constipation, anaphylaxis with parenteral administration, toxicity- shock, acidosis, liver and heart failure.

118
Q

iron contraindications

A

anemia other than iron-deficiency

119
Q

iron toxicity- pediatrics

A

iron overdose is the most common cause of pediatric poisoning

120
Q

iron interactions

A

decreased absorption with calcium, antacids. increased absorption with vitamin C. can decrease absorption of certain antibiotics.

121
Q

iron patient teaching

A

take on empty stomach, unless causes GI upset. space multiple doses throughout the day to avoid toxicity. may turn stool dark green or black. increase water, fiber and exercise to avoid constipation. consume foods high in iron, such as green leafy vegs egg yolks, liver.

122
Q

serum osmolality

A

measures the concentration of all chemical particles found in the fluid part of blood.
Normal range: 275-295 mOsm/kg

123
Q

tonicity

A

compares the concentrations of solutions. Isotonic, hypertonic, hypotonic.

124
Q

isotonic IV fluids

A

0.9% sodium chloride/NS

125
Q

normal saline uses

A

expand volume, dilute medications, keep veins open

126
Q

Lactated Ringers

A

isotonic. used for fluid resuscitation

127
Q

5% dextrose in water

A

D5W, Isotonic. provides calories. may become hypotonic.

128
Q

hypotonic IV fluids

A

0.45 % normal saline (half normal saline). Treats fluid loss

129
Q

hypertonic IV fluids

A

5% dextrose in normal saline (D5NS), 10% Dextrose in water, 3% sodium chloride

130
Q

> O

A

hypotonic IV fluids

131
Q
A

hypertonic IV fluids

132
Q

used to correct potassium excess

A

kayexalate, NS

133
Q

used to correct calcium excess

A

bisphosphonates, diuretics, NS

134
Q

used to correct magnesium excess

A

calcium gluconate, diuretics, NS

135
Q

TPN

A

total parenteral nutrition, hypertonic

136
Q

TPN action and indication

A

provides essential proteins, amino acids, carbohydrates, vitamins, minerals, trace elements, lipids, and fluids to patients unable to take in or absorb enteral nutrition. For patients with small bowel problems and who are NPO for a long period of time.

137
Q

parenteral nutrition adverse effects

A

infection, hyperglycemia, hypoglycemia, fluid volume excess

138
Q

TPN potential complications

A

pneumothorax, hemothorax, emboli ( complications of PICC central line)

139
Q

TPN patient teaching

A

reason for TPN, protecting central line, not to abruptly stop treatment

140
Q

TPN nursing considerations

A

aseptic technique when working with central line (sterile procedure with mask), monitor for infection, breathing difficulties, monitor blood glucose.

141
Q

what are the 2 parts of the autonomic nervous system

A

sympathetic and parasympathetic

142
Q

what response does the sympathetic system provide

A

fight or flight

143
Q

what response does the parasympathetic system provide

A

rest and digest

144
Q

what are 2 parts of the sympathetic nervous system

A

cholinergic and adrenergic

145
Q

what are the effects of the sympathetic system on the body

A

fight or flight; respiration rate, blood pressure will increase. airway passages will widen. blood vessels to muscles and lungs will dilate but constrict to GI system. Motility will decrease.

146
Q

what are the effects of the parasympathetic system on the body

A

pupil constriction, increased salivation and GI motility, decreased HR and BP, bronchoconstriction, relaxation of sphincter for bladder

147
Q

what causes cholinergic effect

A

release of ACTH

148
Q

what causes adrenergic effect

A

release of norepinephrine

149
Q

what are 2 components of adrenergic system

A

alpha and beta

150
Q

what is the alpha response of the adrenergic system

A

smooth muscle constriction, cardiac stimulation, narrowing blood vessels

151
Q

what is the beta response of the adrenergic system

A

bronchioles dilate, blood vessels dilate, increased HR and BP

152
Q

what are medications that are alpha agonists

A

decongestants, epinephrine, dopamine

153
Q

what are some medications that are beta agonists

A

dopamine, epinephrine

154
Q

the nurse assesses that the patient is having a sympathetic response when noting what manifestations

A

Increase in blood pressure, bronchodilation, and decreased bowel sounds

155
Q

how do cholinergic meds work for parasympathetic system

A

stimulate the parasympathetic system at the nerve site

156
Q

how do anticholinergic meds work

A

reduce cholinergic affect at target of body

157
Q

the nurse administers a drug to a pt whose HR is bradycardic aimed at increasing HR and myocardial activity. What adrenergic receptor is this drug stimulating?

A

beta1

158
Q

the nurse administers a drug that stimulates the parasympathetic nervous system. what physiological response would indicate the drug is working

A

increased GI motility

159
Q

a young woman who lives alone comes home at night to find a man in her apartment. what body responses would be expected for the young woman

A

increased BP, increased HR, pupil dilation

160
Q

the sypmathetic nervous system is associated with fight-or-flight reaction. what reaction is the parasympathetic nervous system associated

A

rest and digest

161
Q

the nurse administers a medication that stimulates the parasympathetic nervous system. what manifestations would indicate the med is working

A

hyperactive bowel sounds, increased saliva production, constricted pupils

162
Q

a patient in intensive care has received a high dose of epinephrine. The nurse will monitor for what effects?

A

dysrhythmia, stroke, seizures, bronchospasms, urinary retention, dry eyes

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