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Pharm 402 > Exam 2 Prototypes > Flashcards

Exam 2 Prototypes Flashcards

1
Q

diphenhydramine (Benadryl) Pharmacological Class

A

H-1 receptor blocker

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2
Q

diphenhydramine (Benadryl) Indications

A 
Allergies
motion sickness
insomnia
pruritus
Parkinson's Disease
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3
Q

diphenhydramine (Benadryl) MOA

A

H-1 receptor antagonist

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4
Q

diphenhydramine (Benadryl) Contraindications

A

elderly more likely to experience delirium, dizziness, inc HR. Children more likely to have paradoxical excitation

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5
Q

diphenhydramine (Benadryl) Adverse Effects

A

drowsiness (develop tolerance to this), dry mouth, inc. HR (anticholinergic effects

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6
Q

diphenhydramine (Benadryl) Other Considerations

A

avoid concurrent use w/ other CNS depressants (opioids, alcohol, etc.)

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7
Q

fluticasone(Flonase) pharmacological class

A

corticosteroids

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8
Q

fluticasone(Flonase) Indications

A

allergic rhinitis, asthma(can be given as an inhaler)

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9
Q

fluticasone(Flonase) MOA

A

decreases inflammation in nasal mucosa

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10
Q

fluticasone(Flonase) adverse effects

A

burning sensation when spraying, epistaxis (nose bleed)

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11
Q

oxymetazoline (Afrin) Pharmacological class

A

sympathomimetic

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12
Q

oxymetazoline (Afrin) Indications

A

allergic rhinitis, nosebleeds

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13
Q

oxymetazoline (Afrin) MOA

A

alpha 1-adrenergic agonist (causes vasoconstriction of blood vessels in nasal mucosa and drying of mucous membranes)

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14
Q

oxymetazoline (Afrin) adverse effects

A

rebound congestion, dry/stinging nasal mucosa

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15
Q

atropine adverse effects

A

Dry mouth, constipation, urinary retention, tachycardia, blurred vision

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16
Q

atropine pharmacological class

A

anticholinergic

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17
Q

atropine indications

A

GI hypermotility, suppress secretions during surgery, symptomatic bradycardia, pupil dilation for exam, antidote for poisoning with nerve gas or organophosphates (insecticides)

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18
Q

atropine contraindications

A

Clients with glaucoma

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19
Q

atropine MOA

A

Blocks cholinergic (muscarinic) receptors, causing increased heart rate, decreased GI motility, mydriasis, bronchodilation, and decreased secretion from glands (salivation)

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20
Q

spironolactone pharmacological class

A

Aldosterone antagonist

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21
Q

spironolactone indications

A

Heart failure , edema with liver failure, HTN, hyperaldosteronism

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22
Q

spironolactone MOA

A

Inhibits aldosterone, increasing the secretion of water and sodium while decreasing the excretion of potassium

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23
Q

spironolactone adverse effects

A

Hyperkalemia, hyponatremia, diarrhea, gynecomastia

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24
Q

spironolactone nursing implications

A

Monitor urine output, BP, potassium levels; educate clients to avoid foods high in potassium or salt substitutes high in potassium

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25
Q

spironolactone therapeutic class

A

Antihypertensive, drug for edema

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26
Q

furosemide therapeutic class

A

Drug for heart failure, hypertension

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27
Q

furosemide pharmacological class

A

Loop diuretic

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28
Q

furosemide indications

A

Heart failure, renal failure, hepatic cirrhosis, pulmonary edema, edema, HTN

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29
Q

furosemide MOA

A

Inhibits reabsorption of sodium and chloride in the ascending loop of Henle. Results in increased excretion of sodium, potassium, chloride, calcium, magnesium, and water

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30
Q

furosemide adverse effects

A

Dehydration, hypotension (low BP), electrolyte depletion (especially K+ and Mg), renal impairment, ototoxicity (higher doses, rapid IV administration)

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31
Q

furosemide nursing implications

A

Monitor urine output, BP, creatinine, K+, Mg (may require electrolyte replacement)
Avoid taking at bedtime
Educate patients on importance of monitoring lab work and BP
Rise slowly when getting up (orthostasis)
Older adults at risk for falls
Related to sulfonamides; watch for cross-sensitivity
Avoid using with other nephrotoxic or ototoxic drugs
If taking digoxin, monitor for toxicity if hypokalemic (low potassium level)

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32
Q

hydrochlorothiazide therapeutic class

A

Antihypertensive, Drug for edema

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33
Q

hydrochlorothiazide pharmacological class

A

Thiazide diuretic

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34
Q

hydrochlorothiazide indications

A

Mild to moderate HTN

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35
Q

hydrochlorothiazide MOA

A

Affects sodium reabsorption at the distal renal tubule, causing increased excretion of sodium and chloride

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36
Q

hydrochlorothiazide adverse effects

A

Electrolyte imbalances (dec. K+, Na, Mg), hypotension, vertigo, renal impairment, hyperglycemia in diabetic patients

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37
Q

hydrochlorothiazide nursing implications

A

Monitor BP, urine output, electrolytes, renal function, administer in morning. Less effective than loop diuretics

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38
Q

lisinopril therapeutic class

A

drug for HTN, heart failure, MI prevention

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39
Q

lisinopril pharmacologic class

A

ACE inhibitor

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40
Q

lisinopril indications

A

HTN, heart failure, acute MI

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41
Q

lisinopril MOA

A

prevents conversion of angiotensin 1 to angiotensin 2, decreases vasoconstriction and aldosterone secretion

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42
Q

lisinopril adverse effects

A

orthostatic hypotension, dizziness, headache, persistent dry cough, renal impairment, hyperkalemia, angioedema

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43
Q

lisinopril nursing considerations

A

discontinue if pregnant (teratogen), patient education (signs of hypotension, angioedema, avoid high sodium and high potassium foods, first dose phenomenon) monitor potassium and renal function (creatinine)

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44
Q

diltiazem therapeutic class

A

antihypertensive, abtianginal, antiarrhythmic

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45
Q

diltiazem pharmacologic class

A

calcium channel blocker

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46
Q

diltiazem indications

A

HTN, angina, tachyarrhythmias

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47
Q

diltiazem MOA

A

blocks transport of calcium into myocardial and vascular smooth muscle cells

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48
Q

diltiazem contraindications

A

heart block, shock

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49
Q

diltiazem adverse effects

A

hypotension, bradycardia, heart failure symptoms, headache, fatigue, n/v, arrhythmias

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50
Q

diltiazem nursing considerations

A

monitor BP, HR, ECG, can be given PO or IV, do not crush extended release tablet, patient education

51
Q

beta blockers indications

A

HTN, heart failure, arrhythmias, MI, many non-cardiovascular uses as well

52
Q

beta blockers MOA

A

block beta receptor site, resulting in decreased HR and myocardial contractility, which in turn decreases BP and myocardial oxygen demand

53
Q

beta blockers adverse effects

A

bradycardia, hypotension, dizziness, fatigue/lethargy, decreased sexual ability, depression, worsening heart failure symptoms, bronchoconstriction

54
Q

beta blockers nursing implications

A

monitor HR and BP, don’t stop medication abruptly, may mask symptoms of hypoglycemia, have patient report dizziness, lightheadedness, avoid in patients with asthma

55
Q

beta blockers black box warning

A

clients with CAD, don’t stop abruptly

56
Q

alpha 1 adrenergic blocker indications

A

HTN, benign prostate hypertrophy

57
Q

alpha 1 adrenergic blocker MOA

A

block the a1 adrenergic receptor, resulting in vasodilation and relaxation of smooth muscles in the prostate

58
Q

alpha 1 adrenergic blocker adverse effects

A

orthostatic hypotension, dizziness/drowsiness, headache, fatigue, syncope, first does phenomenon

59
Q

alpha 1 adrenergic blocker nursing implications

A

take at night to avoid dizziness/drowsiness, rise slowly when getting up

60
Q

alpha 2 adrenergic agonists indications

61
Q

alpha 2 adrenergic agonists MOA

A

stimulating a2 adrenergic receptors results in decreased sympathetic response from the CNS, causing vasodilation and decreased BP

62
Q

alpha 2 adrenergic agonists adverse effects

A

CNS depression, dizziness/ drowsiness, orthostatic hypotension

63
Q

alpha 2 adrenergic agonists nursing implications

A

do not stop abruptly, rotate patch site weekly

64
Q

vasodilators indications

A

hypertensive crisis (> 180/120), during or post-cardiac surgery

65
Q

vasodilators MOA

A

relaxation of venous and arterial smooth muscle, leading to vasodilation and decreased peripheral resistance

66
Q

vasodilators adverse effects

A

flushing, headache, n/v, cyanide and thiocyanate toicity

67
Q

vasodilators nursing implications

A

administered as IV, rapid onset and short half life (2 min), monitor BP, HR, monitor for cyanide/thiocyanate toxicity, transition to oral therapy ASAP

68
Q

therapeutic class of digoxin

A

drug for heart failure

69
Q

pharmacologic class of digoxin

A

cardiac glycoside

70
Q

indications of digoxin

A

heart failure, atrial fibrillation, atrial flutter

71
Q

MOA of digoxin

A

increases intracellular calcium leading to positive inotropic effect, decreases conduction through SA and AV nodes leading to a negative chronotrophic effect and increased diastolic filling time

72
Q

adverse effects of digoxin

A

bradycardia, arrhythmias, fatigue, N/V, blurred/yellow vision (Sign of toxicity), increased risk of toxicity when hypokalemic

73
Q

nursing considerations of digoxin

A

loading dose followed by daily maintenance dose (IV or PO), monitor drug levels (narrow therapeutic range), check apical pulse for one minute before administering

74
Q

carvedilol therapeutic class

A

antihypertensive, drug for heart failure

75
Q

carvedilol pharm. class

A

beta-blocker

76
Q

carvedilol MOA

A

Blocks stimulation of beta1, beta2, and alpha1 adrenergic receptors, leading to decreased heart rate and BP

77
Q

carvedilol indications

A

HTN, heart failure, MI

78
Q

carvedilol ADRs

A

Dizziness, fatigue, depression, bradycardia, weakness, erectile dysfunction, heart failure, bronchospasm/wheezing, diarrhea, hyperglycemia

79
Q

carvedilol other consider.

A

Nursing consid: Monitor BP, HR, weight, signs of worsening heart failure, glucose levels, use with caution in patients with asthma, client eduation (do not stop medication abruptly, monitor BP and HR, change position slowly)

80
Q

hydralazine pharm. class

A

vasodilator

81
Q

hydralazine therapeutic class

A

antihypertensive

82
Q

hydralazine MOA

A

Arteriolar vasodilation leading to decreased BP and afterload

83
Q

hydralazine indications

A

HTN, heart failure unresponsive to other therapies (off-label)

84
Q

hydralazine ADRs

A

Headache, N/V, reflex tachycardia, lupus-like symptoms (with higher doses, rare)

85
Q

hydralazine nursing considerations

A

monitor BP, educate patient to notify provider if lupus-like symptoms develop, take 3-4 times daily, can lead to compliance issues

86
Q

milrinone therapeutic class

87
Q

milrinone pharmacologic class

A

phosphodiesterase inhibitor

88
Q

milrinone indications

A

acute, decomposed HF (short term therapy)

89
Q

milrinone MOA

A

blocking of phosphodiesterase enzyme leads to increased cardiac contractility (positive inotropic effect) and vasodilation (decreased preload and after load). this leads to increased cardiac output

90
Q

milrinone ADRs

A

hypotension, arrhythmias (10% risk) angina

91
Q

milrinone nursing implications

A

administered as continuous IV infusion, short half life, monitor BP, cardiac output/index, ECG

92
Q

digoxin therapeutic class

A

drug for HF

93
Q

digoxin pharm. class

A

Cardiac glycoside

94
Q

digoxin indications

A

Heart failure, atrial fibrillation, atrial flutter

95
Q

digoxin MOA

A

Increases intracellular calcium leading to positive inotropic effect. Decreases conduction through SA and AV nodes, leading to a negative chronotropic effect and increased diastolic filling time

96
Q

digoxin ADRs

A

Bradycardia, arrhythmias, fatigue, N/V, blurred/yellow vision (sign of toxicity); increased risk of toxicity when hypokalemic

97
Q

digoxin other consider.

A

Nursing consid: Loading dose, followed by daily maintenance dose (IV or PO), monitor drug levels (narrow therapeutic range), check apical pulse for one minute before administering (generally hold for HR <60), antidote is digoxin immune fab (Digibind)

98
Q

hydralazine other consider.

A

nursing consid:Monitor BP, educate patient to notify provider if lupus-like symptoms develop, take 3-4 times daily; can lead to compliance issues

99
Q

milrinone therapeutic class

100
Q

milrinone pharm. class

A

phosphodiesterase inhibitor

101
Q

milrinone indications

A

Acute, decompensated heart failure (short term therapy)

102
Q

milrinone MOA

A

Blocking of phosphodiesterase enzyme leads to increased cardiac contractility (positive inotropic effect) and vasodilation (decreased preload and afterload). This leads to increased cardiac output

103
Q

milrinone ADRs

A

Hypotension, arrhythmias (10% risk), angina (chest pain)

104
Q

milrinone other consider.

A

Nursing Imp: Administered as continuous IV infusion; short half-life; monitor BP, cardiac output/index, ECG

105
Q

oxymetazoline (Afrin) contraindications

A

those with HTN, thyroid disorders, diabetes and heart disease should consult with provider

106
Q

oxymetazoline (Afrin) nursing implications

A

instruct clients not to use for more than 3 days.

107
Q

heparin therapeutic class

A

anticoagulant

108
Q

heparin pharmacologic class

A

Indirect thrombin inhibitor

109
Q

heparin indications

A

Prevent formation of clots; often used prophylactically

110
Q

heparin MOA

A

The binding of heparin to antithrombin III blocks clotting through the inactivation of Factor X and inhibition of prothrombin’s conversion to thrombin (thrombin inhibitor)

111
Q

heparin adverse effects

A

Bleeding, heparin induced thrombocytopenia (HIT)
*Heparin Induced Thrombocytopenia leads to a prothrombic stated (increased risk of clotting) and the development of thrombocytopenia (a low platelet count)

112
Q

heparin other consider.

A 
Administered SQ (for prophylaxis) or IV
Monitor for bleeding
Monitor platelets (for HIT)
Monitor PTT (Partial Thromboplastin Time
Goal 1.5-2.5 x normal value
May also monitor anti-Factor Xa levels
Protamine sulfate is antidote
Half life is ~1 hour (for IV)
113
Q

warfarin therapeutic class

A

anticoagulant

114
Q

warfarin pharm. class?

A

vitamin K antagonist

115
Q

warfarin indications

A

Prevent formation of clots; can be used prophylactically

116
Q

warfarin MOA

A

Blocks the generation of vitamin K, thereby inhibiting synthesis of vitamin K dependent clotting factors

117
Q

warfarin ADRs

A

Bleeding, skin necrosis (rare)

118
Q

warfarin other consider.

A

Given orally at same time each day
Takes several days to reach maximum effect (overlaps with heparin therapy)
Monitor PT/INR (Prothrombin Time/Internationalized Ratio)
goal is typically INR of 2-3
INR must be measured regularly on outpatient basis as well
Educate clients about bleeding precautions
Contraindicated in pregnancy
Multiple drug-drug and drug-diet interactions (consistency is key)

119
Q

amiodarone therap. class?

A

antidysrhythmic

120
Q

amiodarone pharm. class?

A

potassium channel blocker

121
Q

amiodarone indications

A

Treatment of life threatening ventricular dysrhythmias, treatment of atrial dysrhythmias (off-label)

122
Q

amiodarone MOA

A

Prolongs action potential and refractory period, slowing the heart rate. Decreases peripheral vascular resistance through vasodilation

123
Q

amiodarone ADRs

A

Worsening of dysrhythmias, pulmonary toxicity, bradycardia, hypotension, N/V, dizziness, fatigue, blue discoloration of skin, increased liver enzymes, effect on thyroid function, photosensitivity, tremors, blurry vision

124
Q

amiodarone other consider.

A

Interactions Multiple drug interactions- increases drug levels of digoxin, warfarin, and carvedilol (just to name a few)
Nursing Considerations Requires loading dose, ECG monitoring if giving IV, monitor HR and BP, assess for signs of pulmonary toxicity (thorough respiratory assessment), monitor liver and thyroid function, avoid grapefruit juice, can be given PO or IV, prolonged half-life (several weeks), pregnancy category D

Pharm 402 (9 decks)

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