Exam 3 Prototypes Flashcards

1
Q

desmopressin(DDAVP) Pharm Class

A

ADH

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2
Q

desmopressin(DDAVP) Indications

A

Diabetes Insipidus, von Willebrand’s disease (blood clotting disorder), bed wetting

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3
Q

desmopressin(DDAVP) MOA

A

Acts on the kidneys to reabsorb water; controls bleeding in certain clotting disorders; contraction of smooth muscle in vascular system

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4
Q

desmopressin(DDAVP) ADRs

A

Symptoms of hyperthyroidism (tachycardia, anxiety, insomnia, weight loss, heat intolerance, diaphoresis, menstrual irregularities)

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5
Q

desmopressin(DDAVP) Other Consid.

A

Administer 30-60 minutes before breakfast (empty stomach; prevent insomnia). Narrow therapeutic range; blood levels monitored. Long half-life; given once a day and steady state is achieved in 6-8 weeks. Many drug interactions. Use with caution in elderly with heart disease. Educate clients that this is life-long therapy (does not cure hypothyroidism). Monitor TSH levels

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6
Q

levothyroxine (Synthroid) Pharm Class

A

thyrid hormone

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7
Q

levothyroxine (Synthroid) Indications

A

hypothyroidism

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8
Q

levothyroxine (Synthroid) MOA

A

Synthetic T4; increases metabolic rate of body tissues

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9
Q

levothyroxine (Synthroid) ADRs

A

Symptoms of hyperthyroidism (tachycardia, anxiety, insomnia, weight loss, heat intolerance, diaphoresis, menstrual irregularities)

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10
Q

levothyroxine (Synthroid) Other Consid.

A

Administer 30-60 minutes before breakfast (empty stomach; prevent insomnia). Narrow therapeutic range; blood levels monitored. Long half-life; given once a day and steady state is achieved in 6-8 weeks. Many drug interactions. Use with caution in elderly with heart disease. Educate clients that this is life-long therapy (does not cure hypothyroidism). Monitor TSH levels

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11
Q

metformin (Glucophage) Pharm. Class

A

Biguanide

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12
Q

metformin (Glucophage) Indications

A

Type II Diabetes (1st line drug)

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13
Q

metformin (Glucophage) MOA

A

Decreases hepatic production of glucose and reduces insulin resistance (benefit is that it does not cause hypoglycemia; also lowers triglyceride and LDL levels and promotes weight loss)

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14
Q

metformin (Glucophage) ADRs

A

N/V, diarrhea, abdominal bloating, metallic taste. Black box warning for increased risk of lactic acidosis (may be fatal) with liver/renal disease, excess alcohol intake, or serious infection

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15
Q

metformin (Glucophage) Other Consid.

A

Contraindicated with impaired renal function, heart failure, liver failure, serious infection. Must be held 2 days before and 2 days after receiving IV contrast

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16
Q

regular insulin (Humulin R, Novolin R) Pharm. Class

A

Hormone, drug for diabetes

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17
Q

regular insulin (Humulin R, Novolin R) Indications

A

Treatment of hyperglycemia, treatment of acute ketoacidosis; treatment of hyperkalemia (off-label use)

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18
Q

regular insulin (Humulin R, Novolin R) MOA

A

Short acting insulin to promote entry of glucose into cells

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19
Q

regular insulin (Humulin R, Novolin R) ADRs

A

Hypoglycemia (tachycardia, confusion, sweating, restlessness; coma and death if severe hypoglycemia goes untreated), hypokalemia

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20
Q

regular insulin (Humulin R, Novolin R) Other Consid.

A

Can be given SC or IV. Only use insulin syringe. Administer 30 minutes before meal

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21
Q

carbidopa/levodpa (Sinemet) pharm. class

A

dopamine agonist

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22
Q

carbidopa/levodpa (Sinemet) indications

A

Parkinson’s disease

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23
Q

carbidopa/levodpa (Sinemet) MOA

A

Levodopa is converted to dopamine in the CNS where it serves as a neurotransmitter; carbidopa prevents peripheral destruction of levodopa; relieves tremor and rigidity

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24
Q

carbidopa/levodpa (Sinemet) ADRs

A

Uncontrolled and purposeless movements, N/V, orthostatic hypotension, dark urine/sweat, hepatotoxicity, cardiac arrhythmias, psychosis

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25
Q

carbidopa/levodpa (Sinemet) Other Consid.

A

Monitor liver function, instruct clients to rise slowly when standing, taking with high protein foods may decrease absorption of the medication, Vitamin B6 promotes breakdown of levodopa, avoid abrupt withdrawal of medication

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26
Q

donepezil (Aricept) pharm. class

A

acetylcholinesterase inhibitor

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27
Q

donepezil (Aricept) Indications

A

Alzheimer’s disease

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28
Q

donepezil (Aricept) ADRs

A

N/V, diarrhea, poor appetite, GI bleeding, abnormal dreams, muscle cramps

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29
Q

donepezil (Aricept) Other Consider.

A

Can take weeks to notice any effect, maximum benefit may take up to 6 months, administer at bedtime

30
Q

donepezil (Aricept) MOA

A

Inhibits acetylcholinesterase making more acetylcholine available; enhances effects of acetylcholine in neurons that have not yet been damaged improving memory and cognition in mild to moderate dementia

31
Q

baclofen (Lioresal) pharm. class

A

GABA(B) receptor agonist

32
Q

baclofen (Lioresal) indications

A

muscle spasticity

33
Q

baclofen (Lioresal) MOA

A

GABAB receptor agonist; general CNS depression; exact MOA unknown (thought to inhibit transmission of mono/polysynaptic reflexes)

34
Q

baclofen (Lioresal) ADRs

A

Hypotension, N/V, constipation, poor muscle tone, dizziness, sedation

35
Q

baclofen (Lioresal) other consider.

A

Avoid activities requiring mental alertness until effects are known, avoid stopping abruptly, avoid alcohol and other CNS depressants, may be administered via intrathecal pump,

36
Q

phenobarbital (Luminal) pharm. class

A

Barbiturate, GABA(A) receptor drug

37
Q

phenobarbital (Luminal) indications

A

seizure, sedation

38
Q

phenobarbital (Luminal) MOA

A

Enhances action of GABA, suppressing abnormal neuronal discharges

39
Q

phenobarbital (Luminal) ADRs

A

Drowsiness, respiratory depression, vitamin deficiencies (D, folate, B9, B12), N/V

40
Q

phenobarbital (Luminal) other consider.

A

Schedule IV drug, Pregnancy category D. Avoid use with other CNS depressants. Overdose: CNS depression, coma, death.

41
Q

diazepam (Valium) pharm. class

A

Benzodiazepine, GABA receptor drug

42
Q

diazepam (Valium) indications

A

Seizure, sedation, anxiety, muscle spasm, alcohol/benzo withdrawal

43
Q

diazepam (Valium) MOA

A

Enhances action of GABA, suppressing abnormal neuronal discharges

44
Q

diazepam (Valium) ADRs

A

Hypotension, muscle weakness, drowsiness, respiratory depression; adverse effects are more pronounced when given IV

45
Q

diazepam (Valium) other consider.

A

Schedule IV, Pregnancy category D May take 1-2 weeks to reach max concentration when taken orally. Quick onset and lasts ~20 minutes when given IV. Avoid use with other CNS depressants. For short term use. Can be given rectally

46
Q

phenytoin (Dilantin) Pharm. class

A

Hydantoin

47
Q

phenytoin (Dilantin) Indications

A

seizures

48
Q

phenytoin (Dilantin) MOA

A

Desensitizes sodium channels in CNS, preventing abnormal neuronal discharges

49
Q

phenytoin (Dilantin) ADRs

A

Drowsiness, nausea, gingival hypertrophy, hirsutism, suicidal thoughts, ataxia (lack of muscle coordination), hematologic toxicities (RBC, WBC, platelets)

50
Q

phenytoin (Dilantin) Other Consid.

A

Many drug-drug interactions. Never administer IV in same line as another drug or with dextrose solution (normal saline only). Monitor drug levels. Can cause tissue necrosis if there is IV infiltration. IV administration requires a filter. Hold tube feeding for 2 hours before and after administration

51
Q

sertraline (Zoloft) Pharm. class

A

SSRI

52
Q

sertraline (Zoloft) Indications

A

Depression, anxiety, OCD, panic disorder, premenstrual dysphoric disorder, PTSD, social anxiety disorder

53
Q

sertraline (Zoloft) MOA

A

Inhibits the reuptake of serotoni

54
Q

sertraline (Zoloft) ADRs

A

Insomnia, headache, dizziness, fatigue, dry mouth, sexual dysfunction, nausea

55
Q

sertraline (Zoloft) Other Consid.

A

Many drug-drug interactions (digoxin, warfarin, diazepam, aspirin, NSAIDS), avoid use with alcohol, monitor for suicidal ideation, avoid abrupt discontinuation. Do not give concurrently with MAO

56
Q

lithium carbonate (Eskalith) Pharm. class

A

antimanic

57
Q

lithium carbonate (Eskalith) Indications

A

antimanic???**not listed on slides

58
Q

lithium carbonate (Eskalith) MOA

A

Exact mechanism unknown. Affects synthesis, release, and reuptake of acetylcholine, dopamine, GABA, norepinephrine; alters Na transport in nerve cells

59
Q

lithium carbonate (Eskalith) ADRs

A

Metallic taste, tremors, polyuria, polydipsia, diarrhea, fatigue, weight gain

60
Q

lithium carbonate (Eskalith) Other Consid.

A

Nursing Considerations Monitor serum drug levels (narrow therapeutic index, patients vary widely in absorption and excretion), alcohol and diuretics increase risk of dehydration (é risk of toxicity), take with food to ê N/V, consistent salt intake, therapeutic effects take 7-10 days, contraindicated in pregnancyBlack Box Warning Monitor serum levels (high risk of toxicity)Signs of Toxicity Unsteady gait (ataxia), vomiting, diarrhea, drowsiness, tremor, muscle weakness, blurred vision, large volume diuresis

61
Q

methylphenidate (Ritalin) Pharm. class

A

CNS stimulant

62
Q

methylphenidate (Ritalin) indications

A

ADHD, narcolepsy

63
Q

methylphenidate (Ritalin) MOA

A

Activates reticular activating system (increasing alertness); blocks uptake of norepinephrine and dopamine

64
Q

methylphenidate (Ritalin) ADRs

A

HTN, tachycardia, hepatotoxicity, decreased appetite, anxiet

65
Q

methylphenidate (Ritalin) Other Consid.

A

Nursing Considerations Symptoms typically improve within a few weeks, Schedule II drug, periodic drug-free holidays are recommended to reduce dependence and assess patient for underlying disorders, take early in day to prevent disruption of sleep pattern Black Box Warning for cardiovascular effects

66
Q

sildenafil (Viagra-ED, Revatio-pulmonary HTN) Pharm. class

A

Phosphodiesterase-5 inhibitor

67
Q

sildenafil (Viagra-ED, Revatio-pulmonary HTN) indications

A

Erectile dysfunction, pulmonary arterial hypertension

68
Q

sildenafil (Viagra-ED, Revatio-pulmonary HTN) MOA

A

Inhibiting PDE-5 increases levels of cGMP, which produces smooth muscle relaxation and increases blood flow to the corpus cavernosum (Viagra) or vasodilation of the pulmonary vascular bed (Revatio).

69
Q

sildenafil (Viagra-ED, Revatio-pulmonary HTN) contraindications

A

Concurrent use of nitrates may cause refractory, life-threatening hypotension.

70
Q

sildenafil (Viagra-ED, Revatio-pulmonary HTN) ADRs

A

Headache, dizziness, facial flushing, nasal congestion, hypotension

71
Q

sildenafil (Viagra-ED, Revatio-pulmonary HTN) other consider.

A

Dosing Viagra dosing is generally higher (50 mg) and is taken 30 min to 1 hour before sexual activity and only once a day. Revatio dosing is generally lower (5-20 mg) and is taken 3 times a dayNursing Implications Viagra: There is no effect in the absence of sexual stimulation, seek medical attention if erection lasts more than 4 hours (priapism), counsel on STI/HIV prevention. Revatio: Monitor vital signs, cardiac function, exercise tolerance prior to and during therapy