EXAM #2: REVIEW QUESTIONS: modules 7-10 Flashcards by Stephanie Loiselle

Unit 7: Cardiac Agents

What are some non-pharmacologic measures that can be used to control or prevent the symptoms of cardiovascular disease?

good diet, reduce fat intake , exercise, no alcohol

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What are some symptoms of digoxin toxicity?

confusion,
loss of appetite,
nausea,
vomiting,
diarrhea,
vision problems
Gi distress
HYPERKALEMIA
LIFE THREATENING DYSRHYTHMIAS
Decrease heart rate lower then 60

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How do beta blockers work?

by decreasing the activity of the heart causing vasodilation to the myocardial muscle

by blocking hormones like adrenaline

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How do calcium channel blockers work? What is a side effect?

Calcium channel blockers work by relaxing blood vessels and reducing pressure on the heart.

side effects=, fatigue and swelling in the abdomen, feet, and legs.

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How do ACE inhibitors work?

They block angiotensin 1 and angiotensin 11

Therapeutic class= anti hypertensive

Electrolyte imbalance: risk for hyperkalemia

They lower BP by relaxing blood vessels

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How do ARBs work?

SARTAN

BLOCK receptors for Angiotension 11

Therapeutic class: antihypertensive

Electrolyte imbalance: risk for hyperkalemia

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What drugs might be used to treat pulmonary edema?

Diuretics= such as furosemide (Lasix), decrease the pressure caused by excess fluid in the heart and lungs.

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What is angina pectoris?

is a type of chest pain caused by reduced blood flow to the heart. Angina is a symptom of coronary artery disease. Angina is also called angina pectoris. Angina pain is often described as squeezing, pressure, heaviness, tightness or pain in the chest.

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What are 3 electrolytes responsible for cardiac action potentials?

sodium (Na+), potassium (K+), and calcium (Ca2+)

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Name some adverse effects of blood thinners.

Excessive bleeding!!!!

passing blood in your urine.
passing blood when you poo or having black poo.
severe bruising.

prolonged nosebleeds (lasting longer than 10 minutes)
vomiting blood or coughing up blood.
sudden severe back pain.
difficulty breathing or chest pain.

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What do anticoagulants do?

Anticoagulants are medicines that help prevent blood clots. They’re given to people at a high risk of getting clots, to reduce their chances of developing serious conditions such as strokes and heart attacks. A blood clot is a seal created by the blood to stop bleeding from wounds.

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How does nitroglycerin spray lower BP?

Vasodilation

Decrease peripheral resistance

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What should you do if nitroglycerin treatment is not effective for chest pain?

If you typically use nitroglycerin to relieve angina and if one dose of nitroglycerin has not relieved your symptoms within 5 minutes, call 911.

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When should digoxin be withheld?

Withhold dose and notify health care professional if pulse rate is <60 bpm in an adult, <70 bpm in a child, or <90 bpm in an infant. Notify health care professional promptly of any significant changes in rate, rhythm, or quality of pulse.

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When getting up a patient on an antihypertensive medication, what should be taken into consideration? Why?

Orthostatic hypotension

Patient needs to get up slowly or else will fall down

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How do patients develop cardiac dysrhythmias?

History of Mi

-electrolyte imbalance

-Blocked arteries in the heart (coronary artery disease)

-Changes to the heart’s structure, such as from cardiomyopathy

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What is rebound hypertension?

Rebound hypertension occurs when blood pressure rises after you stop taking or lower the dose of a drug

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Why should decongestants be avoided with severe hypertension?

Sympathomimetic

They both will increase BP

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What are the catecholamines that stimulate the SNS?

The endogenous catecholamines in humans are:

-dopamine
-norepinephrine
- epinephrine

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What antiplatelet drugs can cause tinnitus?

Medications that can cause tinnitus ·

Aspirin and other NSAIDs
· 2. Benzodiazepines
· 3. Tricyclic antidepressants ·
Certain antibiotics

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What is the pharmacological action of anti-arrhythmic drugs?

BLOCKING the sodium membrane, potassium, and calcium channels

Decreasing myocardial excitability

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What class of drugs acts on the kidneys to reduce fluid in the body, and indirectly reduce BP?

Diuretics, also called water pills, are a common treatment for high blood pressure. Find out how they work and when you might need them. Diuretics, sometimes called water pills, help rid your body of salt (sodium) and water.

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Unit 8: Respiratory Agents

What are some non-pharmacologic measures to prevent or control symptoms of respiratory diseases?

Minimize or stop smoking

Avoid asthma tiggers

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What is the intended effect of expectorants?

Expectorants lubricate your airway. This helps loosen up the mucus and make the secretions in your airway thinner.

By loosening up the mucus, expectorants make your cough more productive.

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What type of medications are more effective in treating acute asthma attacks?

Salbutamol , ventolin Pharmacological class: SABA ( SHORT ACTING BETA 2 AGONIST) Therapeutic class : BRONCHODILATOR

What should a client do after receiving inhaler medication?

Have patient rinse mouth and gargle with warm water about 2 minutes after treatment. Rinsing removes residual medication from mouth and throat, and helps prevent oral candidiasis related to steroid use.

What do antitussives do?

suppressing cough. Antitussives act on the cough center in the brain and decrease the sensitivity of cough receptors.

How do systemic decongestants work?

Vasoconstriction

What should be assessed before and after inhalation?

-Assess pulse -respiratory rate -breath sounds -pulse oximetry / 02 saturation (This determines a baseline respiratory assessment prior to administration of medication)

What do bronchodilators do to the lungs?

Bronchodilators = VASODILATION making breathing easier. They do this by relaxing the muscles in the lungs and widening the airways (bronchi) They're often used to treat long-term conditions where the airways may become narrow and inflamed.

How do antihistamines work?

•BLOCKING the H1 receptors •stopping HISTAMINE from reaching its target. ~This decreases your body's reaction to allergens

What are glucocorticosteroids used to treat?

Treat inflammation + certain allergies ASTHMA + COPD

What is a common side effect of older (first) generation antihistamines?

1st line= DIPHENHYDRAMINE ( Benadryl ) Causes drowsiness can cross the blood brain barrier 2nd line= doesn’t cause drowsiness

What is the difference between controllers and relievers?

Maintenance- controllers ( long term ) Teaching: take everyday even without symptoms Short acting/ fast acting- relievers ( SABA) Interval: 3-5 min

Unit 9: Antipsychotics/Anxiolytics/Antidepressants/Narcotics/Non-Narcotics * What are some non-pharmacologic methods we can use to help us fall asleep?

-acupuncture -guided imagery -yoga -hypnosis -biofeedback -aromatherapy -relaxation -herbal remedies -massage

How long does it take for antidepressants to start having an effect on mood?

2-4 weeks

What is the risk of a patient eating food containing tyramine, when taking MAO inhibitors?

This can cause a serious spike in blood pressure = HYPERTENSIVE CRISIS

Why might certain antidepressants, such as TCAs, be taken at bedtime?

Drowsiness / sedation take a bedtime

What conditions are antipsychotics used to treat?

Schizo , Huntington

What is a major side effect of antidepressants related to blood pressure?

Hypotension

What do barbiturates do?

Anticonvulsant Enhance GABA

What is some important medication teaching to do regarding taking antipsychotics?

Do not discontinue

What are some of the anticholinergic ( think blocking flight or flight ) side effects of antipsychotic drugs?

Sympathetic Central ( brain affects CNS): -Confusion -Impaired memory Peripheral (Physical symptoms) -blurred vision -urinary retention -constipation -palpitation -N/V -dizziness

* What is pseudo parkinsonism?

Resemble symptoms of Parkinson disease

* What is tardive dyskinesia?

Tongue thrusting + involuntary movement -akathisia= severe motor restlessness -dystonia= severe muscle spasms

A side effect of some drugs ie. anticholinergics can be decreased intestinal mobility. What effect might that have on drug absorption?

Increase drug absorption

* How do SSRIs work?

SSRIs treat depression by increasing levels of serotonin in the brain.

What needs to be assessed prior to administration of narcotics?

Resp rate + LOC Asssess for pain if it is a PRN narcotic and check MAR

• What is the difference between: *general anaesthesia and **local anaesthesia?

General- open + major surgery Local - minor + dental surgery * make sure consent is signed *

What needs to be monitored regularly when a patient is taking phenytoin (hydantoin medication)?

Narrow therapeutic range Anticonvulsant Monitor blood level, suicidal , gingival hyperplasia

How do TCAs work?

Inhibit reuptake of norepinephrine , serotonin Therapeutic antidepressant

How do MAOs work ?

Inhibit reliable of Norepinephrine, serotonin, dopamine Therapeutic : antidepressant AVOID TYRAMINE RICH FOOD

1) What is lithium used to treat? 2) What bloodwork needs to be monitored and why?

Manic phase of bipolar disorder Lab works: lithium and sodium •Lithium- low therapeutic range •Sodium - body treats the body as a salt

What medication class is first-line in managing Parkinson’s Disease? + side effects

Levodopa and carbidopa Levodopa + catbidopa = sinemet Side effects= ****Drug induced psychosis **

How do medications for Alzheimer’s Disease work

Anticholinesterase inhibitor -blocks acetylcholine Ex: Aricept Treats symptoms but does not cure

Cholinesterase inhibitors are the medications we give to patients with Alzheimer’s: What are the side effects !?

Treat symptoms but does not cure

cholinergic crisis: side effects = ??

S: Salivation L: Lacrimation U: Urination D: Diaphoresis G: Gastrointestinal upset E: Emesis

What are common medications for seizure disorders?

Barbiturates Benzodiazepines ( ex: diazepam -valium) GABA-agents -gabapentin Phenytoin

S/S from medications given to someone with a seizure disorder !?

feeling tired Gi upset dizziness blurred vision.

Complications after giving a patient a medication for a seizure disorder!?

Cognitive problems problems with thinking, remembering, paying attention or concentrating finding the right words can be due to side effects of some seizure medicines.

Non-pharmacologic measures to control symptoms and prevent complications from PD/seizures/dementia

cognitive stimulation/training, behavioral interventions, physical exercise, therapeutic touch, aromatherapy, bright light therapy, music therapy, multisensory stimulation

Many ___________ respiratory disorders originate in the __________ respiratory tract.

lower Upper

_____________are used to thin bronchial secretions to aid in elimination via the _____________ reflex

Expectorants Cough

_______________ are used to suppress the cough reflex for _________________ cough

Antitussives Non-productive

Your patient states they can't sleep due to a cough from their cold. Which of the following is the best response by the PNL? (Select all that apply) A. What medications have you taken for your cough? B. How long have you had a cough for? C. Do you bring up any secretions with your cough? D. Have you taken your inhaler today? E. WoulditbeokayifIlistenedtoyourlungs? F. Would you like me to ask the doctor for a sleeping aid?

A, B, C, E

Nasal congestion is due to the____________ of vessels in response to infection or an allergen. Decongestants produce ____________________ effect

dilation sympathomimetic

Your patient is to take a decongestant. Which of the following patient teaching points is accurate? A: do not take if using diuretics B: do not take if on antihypertensives C: Take in the morning with food D: Do not take with acetaminophen

B: do not take if on antihypertensives

Rebound nasal congestion can cause what !?

Rhinitis medicamentosa is a type of nasal congestion that occurs when you overuse nasal sprays. It causes irritation and inflammation in your nasal passages.

___________ cause ——————-and swelling of small blood vessels giving us the _____________ of a cold virus.

Histamine Inflammation Symptoms

Diphenhydramine is a first generation _______________ and has ________________ effects

Antihistamine Anticholinergic

_____________respiratory illnesses are often_____________ to upper respiratory illnesse

Lower secondary

__________________ such as _____ ___ _________ are used to treat for asthma

Bronchodilators Beta 2 agonists Anticholinergics

What side effects would you see after giving a beta 2 agonist !?

More common: Anxiety (with epinephrine) headache nervousness tremor Less common: Dizziness feeling of constant movement of self or surroundings sweating trouble in sleeping

______________ are daily medications to control persistent symptoms of lower respiratory disorders

Controllers

_______________ need to be taken daily. They reduce _______________. They are NOT to be taken with _______________ angina attacks.

Controllers Inflammation Acute

Inhaled steroids _____________ _______________ by suppressing the immune system. It is vital that these medications be taken ___________. Oral candidiasis can occur if the mouth is not ____________ after inhalation

Decrease Inflammation Daily Cleaned

Why would diuretics and expectorants be used in COPD?

Fluid shifting occurs due to decrease in cardiac output causes edema. Need Diuretics to rid body of excess fluid. Expectorant used to help rid the airways of secretions. Bronchial constriction causes goblet cells to squeeze secretions into airways. Expectorants help to expel the secretions out by loosing them. Encourage patient to cough

Non- pharmacologic measures to control symptoms + prevent complications from PD/seizures / dementia