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Pharm 2024 > Exam 3- Pharm > Flashcards

Exam 3- Pharm Flashcards

1
Q

Class: Growth Hormone
Name: Somatotropin (Genotropin)

Nursing/ Medical Interventions

A

Assess baseline Height and weight
Monitor glucose in patients who have diabetes
Route: IM or Sub Q

If antibodies to GH our produced resulting in inactive GH use mecasermin for further treatment

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2
Q

Class: Growth Hormone
Name: Somatotropin (Genotropin)

Adverse effects

A

Hyperglycemia
glucocorticoids oppose growth
Carpal tunnel syndrome
fatality in Prader-Willi syndrome (PWS)

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3
Q

Class: Growth Hormone Antagonists
Name: Octreotide (Sandostatin)

Nursing/ Medical Interventions

A

Give without food or at bedtime to minimize GI Issues
Suppresses GH release
Monitor glucose
Route: IM or Sub Q

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4
Q

Class: Growth Hormone Antagonists
Name: Octreotide (Sandostatin)

Adverse effects

A

Diarrhea
N/V

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5
Q

Antidiuretic Hormone aka desmopressin (DDAVP)

Nursing/ Medical Interventions

A

Route: most common intranasal
Given for DI
Obtain baseline I&O
Reduce water intake/ monitor water intoxication
assess edema
Monitor electrolytes

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6
Q

Antidiuretic Hormone aka desmopressin (DDAVP)

Adverse effects

A

Water intoxication
(sleepiness, Headaches)
Convulsions
electrolyte imbalance

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7
Q

Insulin
Short acting (Lispro/aspart)
Intermediate (NPH)
Long (Glargine)

Nursing/ Medical Interventions

A

Short-acting
Lispro+ Aspart (Only give if you’re eating/ before meal, if given after a meal cut the dose of that according to BS in 1/2)

Intermediate
NPH ( Should never be mixed)

Long-acting
Glargine (Lantus) ( Can be given at bedtime or morning ) Sugar will be highest in the morning right before medication

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8
Q

What are the names of lispro ,aspart, and intermediate

A

Humalog, NovoLog, NPH or Neutral protamine Hagedorn,

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9
Q

Which is the only insulin given via IV

A

Regular insulin
Humulin, Novolin
IV (u-100 only)

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10
Q

Insulin
Short acting (Lispro/aspart)
Intermediate (NPH)
Long (Glargine)

Adverse effects

A

Hypoglycemia: tachycardia, dizziness, sweating (B.S. below 70) - Rapid treatment necessary
Liphohypertrophy (subQ fat deposits from too many insulins injections @ same site

Hypokalemia (insulin promotes uptake of K+ cells = lower levels

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11
Q

Peak and onset of Short-acting, regular, intermediate and long-acting

Know chart

A

Short-acting
Peak: 1/2 hr -2.5 hr
Onset: 15-30 min

Regular
Peak: 1-5hr
Onset: .5 hr - 1hr

Intermediate
Peak:6-14 hr
Onset: 1-2 hr

Long-acting
Peak: none
Onset: 70 min

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12
Q

Class: Biguanides
Name: Metformin

Nursing/ Medical Interventions

A

Can not be given with IV contrats dye, can not have metformin 24 hours after dye
Given for prevention T2DM, Gestational diabetes, PCOS,

Does not have to be taken with food

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13
Q

Class: Biguanides
Name: Metformin

Adverse effects

A

GI upset, wt loss, lactic acidosis
Interacts with : EtOH, Iv contrast dye, cimetidine

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14
Q

What is the most common medication that causes hypoglycemia?

A

Sulfonylureas
(Glipizide, glyburide, glimepiride)

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15
Q

Class: Sulfonylureas
Name: Glipizide, glyburide, glimepiride

Nursing/ Medical Interventions

A

Must be taken with food

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16
Q

Class: Sulfonylureas
Name: Glipizide, glyburide, glimepiride

Adverse effects

A

Hypoglycemia
Weight gain
Interacts with: EtOH, NSAIDS, Beta-blockers, sulfonamide antibiotics, cimetidine

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17
Q

Class: Thiazolidinediones
Name: Pioglitazone

Nursing/ Medical Interventions

A

Add on to metformin used for T2DM

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18
Q

Class: Thiazolidinediones
Name: Pioglitazone

Adverse effects

A

Black box warning for heart failure

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19
Q

Class: SGLT-2
Name: Jardiance, Farxiga

Nursing/Medical Interventions

A

It can be used for chronic kidney disease, heart failure, and diabetes
taken once daily B4 breakfast
low profile risk’
If the glomerular filtration rate is less than 30 (stages 4-5) do not administer

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20
Q

Class: SGLT-2
Name: Jardiance, Farxiga

Adverse effects

A

caution in renal disease. because you’re peeing everything out sugar etc.

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21
Q

Class: GLP1
Name: Ozempic, Victoza

Nursing/ Medical Interventions

A

They all end in tide

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22
Q

Class: GLP1
Name: Ozempic, Victoza

Adverse Effects

A

Delays gastric emptying( gastroparesis )
pancreas releases more insulin (pancreatitis)

Weight loss

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23
Q

You have a patient that comes in for heart failure they’re discharging on diabetic medication. Which of the following medications would be contraindicated to give them?

A

Pioglitazone (Thiazolidinedione)
(Because it causes heart failure)

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24
Q

What causes weight gain?

A

insulin and sulfonylureas

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25
Q

What causes weight loss?

A

Metformin, GLP-1, SGLT-2

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26
Q

A Nurse is caring for a client with a BMI of 15 the family is concerned about weight loss with their diabetes medication which of the following would encourage weight gain?

A

sulfonylureas
(Glipizide, glimepiridede, glyburide)

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27
Q

DKA, explain abg

A

Metabolic acidosis
abg problem high ph bicarb eventually co2 becomes acidic can become respiratory alkalosis due to kussmauls respirations

Initial treatment of DKA: Fluids (dehydrated from peeing so much) Lactated ringers it become bicarbonate helps bring down acidosis

Bicarb rarely given

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28
Q

One lab we always look at for DKA

A

anion gap

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29
Q

HHS

A

should not have that much of an abg problem
glucose much higher

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30
Q

What can the artery teach us that a vein can not

A

oxygen

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31
Q

Levothyroxine (Synthroid)
Nursing/Medical Interventions

A

Drug choice for all forms of hypothyroidism
Take on empty stomach in morning 30-60 minutes before meal

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32
Q

Levothyroxine (Synthroid)
Adverse effects

A

thyrotoxicosis

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33
Q

Methimazole (Tapazole)

Nursing/Medical Interventions

A

Treatment for thyroid storm
1st line for hyperthyroid
Safer and easier than PTU

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34
Q

Methimazole (Tapazole)
Adverse effects

A

Agranulocytosis (Very low WBC -neutrophils)

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35
Q

Propylthiouracil (PTU)
Nursing/ medical interventions

A

2nd line treatment for hyperthyroidism
6-12 months for full benefits
BITD/TID dosing
preferred for pregnant women 1st trimester, methimazole intolerance

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36
Q

Propylthiouracil (PTU)

Adverse effects

A

Severe liver injury
agranulocytosis

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37
Q

Radioactive iodine

Nursing/Medical Interventions

A

2-3 months full effect
used in graves disease
low cost

38
Q

Radioactive iodine
Adverse effects

A

delayed effect significant delayed hypothyroid
contraindicated: children, pregnancy, lactation

39
Q

Propranolol (Inderal)

Nursing/ medical interventions

A

suppress tachycardia & other symptoms of Graves disease
beneficial in thyrotoxic crisis

40
Q

Propranolol (Inderal)
Adverse effects

A

ED, fatigue, dizziness

41
Q

Class: Corticosteroids
Name: Hydrocortisone
Prednisone
Dexamethasone

Nursing/ medical interventions

A

Monitor BP, glucose, mood swings, wt gain, monitor s/s of infection, monitor GI bleed
Increase calcium to help against osteoporosis
do not stop abruptly
take with food, milk or meal to prevent GI Upset

Hydrocortisone: adrenal insufficiency, allergic reactions, inflammation, cancer

Prednisone/ Dexamethasone:(high doses to suppress inflammatory & immune response)
Arthritis, asthma, allergies, IBS/chrons/ulcerative colitis, topical for psoriasis

42
Q

Class: Corticosteroids
Name: Hydrocortisone
Prednisone
Dexamethasone

adverse effects

A

To prevent gradually taper off until discontinued + lowest dose possible
*Cushing’s syndrome *
sodium/ fluid retention
CNS effects: insomnia, anxiety, headache, confusion
HTN, Tachycardia, Cataracts

43
Q

Explain cushings syndrome

A

To much cortisol > elevated glucose
Buffalo hump between shoulders, moon face, truncal obesity, wt gain, emotional instability
you will look like a cushion

44
Q

ACTH – Cosynotropin (Cortosyn)

Nursing/ medical interventions

A

Give medication wait 30-60 minutes measure cortisol levels
if it rises after the dose adrenal glands are good and it’s a pituitary issue (secondary insufficiency)
if levels don’t rise it’s an adrenal gland issue (primary insufficiency)

45
Q

ACTH – Cosynotropin (Cortosyn)

Adverse effects

A

allergic reaction/ anaphylaxis

46
Q

Morphine

Nursing/ medical intervention

A

Can give a warm feeling when given through IV
Asses before and after given

47
Q

Morphine

Adverse effect

A

Respiratory depression, constipation, many patients have allergies, N/V, sedation

48
Q

Fentanyl

Nursing/ medical intervention

A

100x more potent than morphine
available 3 routes: Most common IV- and transdermal
Im lasts 1-2 hours

49
Q

Fentanyl

Adverse effect

A

Sedation, cough suppression

50
Q

Methadone

Nursing/ medical intervention

A

For pain & opioid addicts
suppressive therapy
help with the first 3 days

51
Q

Methadone
Adverse effect

A

slow breathing
D/V/N

52
Q

Hydromorphone (Dilaudid)

Nursing/ medical intervention

A

More rapid onset
I might have to give more frequently since it works quickly and wears off

53
Q

Hydromorphone (Dilaudid)

Adverse effect

A

Euphoria, sedation, mental clouding

54
Q

Hydrocodone/Oxycodone
Oral opiates with moderate effectiveness

Nursing/ medical intervention

A

When given PO opioid and mixed with Tylenol they last longer and more effective at burst dosing than IV
Oxy lasts 4-6 hours

55
Q

Hydrocodone/Oxycodone
Oral opiates with moderate effectiveness

Adverse effects

A

Urinary retention, lightheadedness

56
Q

Buprenorphine (Suboxone)

Nursing/ medical intervention

A

Seen with opiate withdrawal independence to get these patients off oc opioids like heroin
transdermal/sl im/iv

57
Q

Buprenorphine (Suboxone)

Adverse effects

A

no respiratory depression

58
Q

Naloxone (Narcan)

Nursing/Medical Intervention

A

Only given for respiratory depression due to opioids
Only lasts for a little while

59
Q

Naloxone (Narcan)

Adverse effect

A

irratibility, nausea vomitting

60
Q

Key take away any patient that’s overdosing and has severe respiratory depression

A

treat with Narcan, if narcan is not working they may need an airway placed

61
Q

Dexmedetomidine (Precedex)

Nursing/ medical intervention

A

Great IV med. given to sedate and provide some pain relief
given to all ages*
easier and safer than other sedations like profopol

62
Q

Dexmedetomidine (Precedex)

Adverse effect

A

Hypotension and bradycardia

63
Q

Class: Triptains (easy name)
Med: Sumatriptan

Nursing/ medical intervention

A

Po or intranasal, do not give to someone with high blood pressure

64
Q

Class: Triptains (easy name)
Med: Sumatriptan

Adverse effect

A

tingling, malaise, coronary vasospasm, teratogenesis

for people with no Hx except headache

65
Q

Propofol
Nursing/ medical intervention

A

Most widely used IV anesthetic
goes away very quickly

66
Q

Propofol
Adverse effect

A

Risk for abuse, hypotension, resp, depression, high-risk bacterial infection

67
Q

Ketamine
Nursing/ medical intervention

A

Does not cause respiratory depression and can be given to kids
beta-agonist- stimulates the beta to increase in HR

68
Q

Ketamine
Adverse effect

A

Psych reactions: hallucinations, delirium, bad dreams

69
Q

Succinylcholine
Nursing/medical intervention

A

The patient will cease breathing thus you must be breathing for them.
Short-acting

70
Q

Succinylcholine

Adverse effects

A

Avoid use in clients with hyperkalemia

71
Q

Lidocaine (xylocaine) Local anesthetic

Nursing/medical intervention

A

local injection
you cant have epinephrine in your local anesthetic if it’s at a distal site

72
Q

Lidocaine (xylocaine) Local anesthetic

Adverse effect

A

Allergic reaction
cv issues

73
Q

Chlordiazepoxide (Librium) use in alcohol withdraw

Nursing/ medical intervention

A

Benxodiazepine
decreases symptoms, prevents seizures & delirium

74
Q

Chlordiazepoxide (Librium) use in alcohol withdraw

Adverse effect

A

fatigue, headache

75
Q

Banana bag

Nursing/ medical intervention

A

for alchol withdrawal
thiamine, folate, multivitamin, in isotonic saline 5% dextrose

76
Q

Nicotine replacement

Nursing/ medical intervention

A

Smoking cessation 5As Ask, Advise, Assess, Assist, Arrange
Patch- Nicoderm
Gum- Nicorette
Lozenge- Nicorette lozenge
Nasal spray- Nicotrol NS
Inhaler- Nicotrol Inhaler

77
Q

Nicotine replacement
Adverse effect

A

local irritation

78
Q

Bupropion (Wellbutrin)

Nursing/ medical intervention

A

antidepressant that also reduces the urge to smoke reduces some symptoms of nicotine withdrawal

Adjust if the patient is on antidepressants

79
Q

Bupropion (Wellbutrin)
Adverse effect

A

Dry mouth and insomnia

80
Q

Midazolam (versed)

Nursing/ medical intervention

A

IV: Conscious sedation, unconsciousness within 80 seconds
benzo- despite primary use for anxiety

81
Q

Midazolam (versed)
Adverse effect

A

cardiorespiratory effects

82
Q

Acetaminophen (Ofirmev)
Nursing/ medical intervention

A

Nonopioid pain management
nonaddictive up to 4g a day
watch patients with poor liver function (excretion)

83
Q

Acetaminophen (Ofirmev)
Adverse effect

A

risk of acute liver failure

84
Q

Ketorolac (Toradol)
Nursing/ medical intervention

A

Ibuprofen similar
Be careful with anticoagulants
we have to make sure there is intact kidney function since is excreted through the kidney

85
Q

Ketorolac (Toradol)
Adverse effect

A

Kidney failure

86
Q

Management of hypernatremia

A
87
Q

Management of hyponatremia

A
88
Q

Management of DKA

A
89
Q

Management of malignant hyperthermia

A

increase risk with paralytics, especially inhalation anesthetics

Cool down patients, give IV dantrolene, stop succinylcholine

90
Q

Management of Migraine

A

You might get an aurora
triggers

Triptans (serotonin receptor agonists- they cause vasoconstriction of intervascular vessels won’t give to patients with high BP

Migraine cocktail
Give Iv fluids- dark room
Give toradol (ketorolac) anti-inflammatory
Give Benadryl so they sleep
Give IV anti-emetics for nausea

opiates not 1st line management

Pharm 2024 (2 decks)

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