Exam 4 Flashcards
What disorder may occur in children who have a viral illness (flu, chicken pox) and take aspirin? What may occur as a result of this condition?
Reye Syndrome
swelling of brain and liver, vomiting, confusion, seizures, coma and death
What are the therapeutic uses of aspirin?
reduce fever/inflammation, relieve pain, prevent platelet aggregation, and prophylactic usage (81 mg of baby aspirin)
What are symptoms of salicylism (aspirin toxicity)?
tinnitus, dizziness, sweating, fever
What are the effects of ibuprofen?
GI injury, hepatotoxicity/nephrotoxicity
N/V, prolonged bleeding
What drug class are naloxone and naltrexone?
opioid antagonists
What adverse effects may occur with naloxone?
withdrawal symptoms (pain comes back full force), drowsiness, decreased respirations
What are the indications for fentanyl (opioid analgesic)?
surgical analgesia, chronic pain control, and
control of breakthrough pain
What are the indications for naloxone?
harmful respiratory depression, unconsciousness from opioid analgesics
What medications are 1st line effective in acute migraines?
triptans
What medication helps treat migraines by constricting blood vessels and
suppressing inflammation?
triptans
When should triptans first be taken?
when migraine is first sense (many patients know when a migraine is approaching)
When can the second dose of a triptan be taken?
2hrs after first dose, if symptoms have persisted
After taking a triptan medication for migraine, what should the patient do?
lie down in dark, quiet room
What is the overdose treatment for acetaminophen?
-Administer oral or IV acetylcysteine
within 8 hours of ingestion
-Gastric lavage within 4 hrs
of ingestion
What is the max daily dose of acetaminophen for an individual with a healthy liver?
4g
What is the max daily dose of Tylenol per day for individuals who have 3 or more alcoholic drinks?
2g/day
What medication can be used to treat diabetic gastroparesis, nausea, and vomiting by increasing the rate of gastric emptying?
metoclopramide
How does metoclopramide have an antiemetic (cancels nausea/vomiting) effect?
blocks dopamine receptors
What are the indications for psyllium husk (bulk forming laxative)?
diarrhea in pt w/diverticulosis or IBS, control stool in those w/ ileostomy/colostomy, and to promote defecation in older adults
What education should be provided to those taking psyllium husk?
high fiber diet, 2-3L/day, and exercise
Who should avoid psyllium husk? Why?
pt w/history of difficulty swallowing due to the risk for an esophageal obstruction
What kind of drugs are hydroxyzine, scopolamine, and dramamine?
antihistamines/anticholinergics
What are possible effects of antihistamines?
can’t see, can’t pee, can’t spit, can’t poop
sedation, dizziness, fatigue
What are antihistamine drugs contraindicated?
pt w/BPH due to the risk of urinary retention
What patient teaching should be provided with scopolamine?
place patch behind ear 4hr before motion-sickness inducing activity, can leave for up to 3 days
What general patient education should be provided for antihistamine drugs?
eye drops, hard candy, fluid, fiber, and exercise, hydrate, avoid being in intense sun/heat (they arent sweating)
What kind of medications are bisacodyl, castor oil, and senna?
stimulant laxatives
When are laxatives contraindicated?
bowel obstruction
What is an expected side effect of senna, a stimulant laxative?
reddish/brown urine
When should stimulant laxatives be taken?
at bedtime
What kind of laxative is docusate sodium?
surfactant laxative (stool softener)
How does docusate sodium (surfactant laxative/stool softener) work?
increased the amount of water the stool absorbs in the intestines, making it softer/easier to pass
What are examples of osmotic laxatives?
miralax (polyethylene glycol)
golytely (polyethylene glycol electrolyte solution)
and lactulose
What are potential complications for saline or osmotic laxatives (miralax, golytely, lactulose, magnesium hydroxide and magnesium citrate)?
dehydration, hypermagnesemia, and sodium retention
What kind of laxatives are magnesium hydroxide and magnesium citrate?
saline laxatives
True or false: Bowel movements must occur daily.
false
What is generic name for Phenergan?
promethazine
What are the indications for promethazine?
N/V, need for sedation,
What is the indication for sucralfate?
GI ulcers
How does sucralfate work?
protecting the ulcer by coating the ulcer
What would indicate sucralfate is effective?
reduced pain
When is misoprostol used?
treatment of NSAID-induced ulcer
What pregnancy category is misoprostol?
Category X
What is the primary contraindication of misoprostol?
pregnancy
How does misoprostol treat GI ulcers?
increases mucin release, reducing acid secretion
-protects lining, repairs ulcer
What type of drug is famotidine (pepcid) and cimetidine?
H2 Receptor Blocker
What drug interaction may occur with cimetidine or famotidine (H2 Receptor antagonists)?
decreases the effectiveness of warfarin, by reducing metabolism
How are proton pump inhibitors recognized?
-prazole
omeprazole, esomeprazole, and pantoprazole
When are proton pump inhibitors used?
ulcers, erosive esophagitis, reflux
How do PPIs (proton pump inhibitors) work?
reducing acid secretion
What are some potential short term effects of omeprazole?
headache, diarrhea, n/v
What are potential effects with long-term use of proton pump inhibitors (-prazole)?
osteoporosis & fractures, rebound acid hypersecretion, hepatotoxicity, pneumonia, hypomagnesemia
What effects may occur with bethanechol chloride (urinary stimulant)?
SLUDGES, overdose
What medication is often used to decrease urinary incontinence in those with OAB (overactive bladder)?
oxybutnin
What medication may be prescribed to combat pain, burning or discomfort related to UTI?
phenazopyridine
What reactions may occur with phenazopyridine?
hepatitis, acute renal failure, and hemolytic anemia (very low RBC)
Because it depresses the CNS, what precautions should those taking promethazine be placed on?
fall precautions
What medications should not used while taking potassium chloride supplements?
ACE inhibitors (-pril) and K+Sparing Diuretics (spironolactone)
What would sumatriptan be prescribed for?
abort a migraine
What medication does APAP refer to?
acetaminophen
What should be administered for pts with a RR <10 who are taking an opioid?
naloxone
Why would docusate be prescribed for someone taking an opioid?
to prevent constipation
What may someone who has an opioid tolerance require?
increase dose
What may ketorolac (NSAID)cause?
Kidney damage
