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Pharmacology > Exam 4 > Flashcards

Exam 4 Flashcards

1
Q

aspirin indications

A

Pain, fever, inflammation , prophylactic for MI, platelet aggregation

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2
Q

Drug interactions for aspirin

A

Warfarin (increases absorption and increases risk for bleeding)
Other anticoagulants and anti platelet drugs
Alcohol, increases risk of gastric bleeding

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3
Q

Contraindications/ nursing interventions for aspirin

A

Contraindicated in those bleeding or risk of
Monitor for bleeding, give with food, stop one week before invasive procedures, dont give to children/adolescents with viral illness

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4
Q

Side/adverse effects for aspirin

A

GI effects (N/V, ulcers)
Bleeding
Renal impairment
Salicylism
Reye’s syndrome
Nephrotoxic in high doses

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5
Q

What drugs are in the NSAIDs class?

A

Ibuprofen,naproxen, ketorolac,meloxicam,indomethacin

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6
Q

Contraindications for NSAIDs

A

Renal impairment, GI issues, heart issues

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7
Q

Indications for NSAIDs

A

Pain, fever

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8
Q

What is Naproxen used for?

A

Migraines; rapid absorption and analgesia

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9
Q

What adverse effect does Ketorolac cause?

A

Kidney damage if used for about five days

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10
Q

Nursing interventions for NSAIDs

A

Increase fluids, monitor for s/s bleeding, give with food, teach to avoid alcohol, s/s stroke or MI, avoid G herbs

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11
Q

Side/adverse effects of NSAIDs

A

Bleeding (GI ulcers- but not as much as aspirin), GI upset(N/V), can be nephrotoxic and hepatotoxic

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12
Q

Black box warning for NSAIDs

A

Risk for cardiovascular event and GI bleeding

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13
Q

What do you do for older adults and NSAIDs

A

Monitor renal function beforehand, encourage adequate fluids, use lower dose to decrease risk of complications

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14
Q

Anti-gout meds

A

Allopurinol,probenecid, colchicine

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15
Q

Indications for anti-gout meds

A

Acute attack (colchicine) prophylactically (probenecid and allopurinol-urate lowering agent)

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16
Q

Contraindications of anti-gout medications

A

Severe renal, cardiac, hepatic, or GI dysfunction

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17
Q

Pt teaching for anti-gout medications

A

Avoid salicylates (with probenecid), alcohol, grapefruit juice, foods high in purine (red meat, scallops,alcohol), increase fluid intake, monitor for bleeding and infection, allopurinol has s/e of metallic taste

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18
Q

S/e of allopurinol

A

Metallic taste

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19
Q

What drugs are DMARDs?

A

Entanercept,methotrexate, infliximab, adalimumbab

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20
Q

Indications for DMARDs

A

rheumatoid arthritis pain(when NSAIDs do not control pain), slows degeneration of joints

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21
Q

A/e of DMARDs

A

Injection site pain, risk for infection, blood dyscrasias, s/s HF, skin rxns (stevens-Johnson)

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22
Q

Nursing interventions for DMARDs

A

Monitor injection site, and skin for rxns, risk for infection(avoid crowds and sick ppl-bone marrow suppression),s/s of HF, monitor CBS and s/s of blood dyscrasias; phototoxic-sunscreen

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23
Q

Drug interactions for DMARDs

A

Live virus vaccines

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24
Q

Methotrexate teaching

A

Pregnancy category X
Monitor for ulcerative stomatitis, take with folic acid, birth control=important, take with food

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25
Opioid analgesics
Morphine sulfate, fentanyl, hydrocodone, codeine, heroin, methadone, oxycodone,etc Schedule 2 drugs
26
Indications for opioids
Tx for acute/chronic pain
27
Side/adverse effects opioids
“MORPHINE” and “DESIGNER” Myosis (pinpoint pupils), out of it (sedation), respiratory depression, physical dependence, hypotension(orthostatic), infrequency(constipation and urinary retention), nausea, emesis, dry mouth,euphoria, itch
28
Drug interactions for opioid
CNS depressants ie alcohol, other opioids, muscle relaxants
29
Nursing interventions for Opioids
Monitor and assess tolerance, resp status and LOC, pulm function , VS, output, monitor pain level, use cautiously in pregnancy, labor and delivery, lactation
30
Opioid overdose triad
Coma, pinpoint pupils, respiratory depression—-> naloxone!!!
31
Pt teaching for opioids
S/s hypotnsion- change positions slowly, constipation (increase fiber, fluids, exercise), tolerance and cross-tolerance with other opioids- euphoric effects
32
PCA pump-opioids
Fentanyl given by patient controlled analgesia, dont let anyone touch but the pt!!! Have naloxone nearby and assess for overdose and pain levels frequently!
33
Acetaminophen
Non-opioid analgesic Analgesic and antipyretic actions, but no anti-inflammatory /anti thrombotic action- no GI upset
34
Indications for acetaminophen
Pain, fever; drug of choice for older adults and children
35
Pharmacokinetics of acetaminophen
Metabolized by liver, excreted by kidneys
36
Tx for acetaminophen overdose
Acetylcysteine Within 8 hours of ingestion, gastric Lavage within 4 hours
37
Fasting and alcohol increase the risk for _______ with acetaminophen
Acute toxicity S/s= N/V/D, sweating, abd pain, coma, death, liver damage (within 48 hrs)
38
Max daily dose for acetaminophen
4 grams for healthy liver, 2 for 3 drinks or more in a day
39
Triptans indications
1st line med for migraines; both for acute migraines or abortive therapy
40
Mechanism of action for triptans
Relieves pain by constricting blood vessels and suppressing inflammation
41
Pt teaching for triptans
Change positions slowly, dangle feet (dizziness=s/e) Take when migraine first sensed, second dose 2 hours later if s/s persist, do not exceed 100 mg in single dose; subcutaneous-administer, no more than 2/24 hrs Nasal spray- single dose, may repeat in 2 hrs Lie down in a dark and quiet room
42
Naloxone
Antidote for opioid overdose S/s of overdose: coma, pinpoint pupils, respiratory depression , works in minutes
43
Metoclopramide mechanism of action
Blocks dopamine receptors(antiemetic), promotes gastric emptying (constipation)
44
Indications for metoclopramide
Prevention of chemo induced N/V, constipation, diabetic gastroparesis(delayed gastric emptying), GERD (for those who can’t tolerate standard tx)- may cause extrapyramidal symptoms
45
Psyllium husk pt teaching
Bulk forming; increase fluid intake(2-3 L Q day) and fiber diet, mix powder in 8 oz of water and follow with another 8 oz,ask if have trouble swallowing (risk of esophageal obstruction)
46
Indications for psyllium husk
Decrease diarrhea in diverticulitis, IBS, control stool in ileostomy/colostomy bags, promote defecation in older adults
47
Safest laxative
Psyllium husk
48
Cardiac safe laxative
Psyllium husk
49
Antihistamines/anticholinergic drugs
Hydroxyzine(sedation and anxiety), scopolamine(motion sickness), and doxylamine and pyridoxine(B6) combo( pregnant women and morning sickness)
50
Pt teaching for antihistamines/anticholinergics
Hard candy for dry mouth, avoid heat (can’t sweat), increase fluids, fibers exercise, bland diet to reduce nausea , eye drops , retention risk, I/O
51
Side/adverse effects antihistamines and anticholinergics
Can’t see, can’t pee, can’t spit, can’t poop Fatigue, dizziness, drowsiness, urinary retention, constipation, dry mouth, blurred vision
52
Contraindications for antihistamines or anticholinergics
Those with glaucoma or BPH(risk of urinary retention)
53
Stimulant laxatives
Bisacodyl, senna, castor oil
54
Pt teaching for stimulant laxatives
Avoid chronic use (dependence), dont crush or chew enteric coated, milk and antacids destroy enteric coating- take 1 hr apart, take and bedtime (BM in am), reddish brown urine is s/e of senna, increase fiber and fluids with exercise
55
Contraindications to laxatives
Dependence, s/s of appendicitis, regional enteritis, diverticulitis, ulcerative colitis, acute surgical abd, fecal impaction or bowel obstruction , bowel perforation, caution in pregnancy
56
Surfactant laxatives
Docusate Sodium
57
Indications for surfactant laxatives
Hard stool(constiation, prevents painful elimination and straining) decreases risk for fecal impaction and promotes defecation in older adults
58
Mechanism of action for surfactant laxatives
Increases water and electrolytes in intestines , promotes defecation by softening stool-NOT making them go
59
pt teaching to prevent constipation
Increase fiber(bran, flakes, fruits, vegetables), fluids(2-3L Q day, exercise
60
Saline laxatives
Magnesium hydroxide and magnesium sulfate
61
Pt teaching for saline laxatives
Milder and slower acting laxatives ; increase fluids
62
Complications for saline laxatives
Absorbed systemactially; Dehydration, hypermagnesemia, sodium retention, exacerbate HF, HTN , edema
63
Nursing interventions for saline laxatives
Monitor skin turgor, daily weight, I/O, monitor renal function
64
Osmotic laxatives
Polyethylene glycol (miralax) and polyethylene glycol electrolyte solution (golytely)
65
Indications for osmotic laxatives
Occasional constipation (miralax) and bowel prep(golytely)
66
Promethazine (phenergran)
N/V
67
Pt teaching for promethazine
Can cause extrapyramidal symptons(restlessness, anxiety , spasms of face and neck) , avoid alcohol and opioids, increase fiber, fluids, exercise, eye drops, avoid sunlight,report EPS, report s/s of extravasation
68
Antidiarrheals
Diphenoxylate with atropine(opiate related diarrhea symptomatic tx), loperamide(acute and chronic diarrhea)
69
Indications for antidiarrheals
Diphenoxylate-severe diarrhea NOT c-diff, dehydration , severe electrolyte imbalance or pt <2 yrs old Loperamide-travelers diarrhea, IBS
70
Antacids indications
Aluminum hydroxide with magnesium hydroxide;Neutralizes stomach acid—> GERD, indigestion, heart burn
71
Side/adverse effects antacids
calcium=constipation Magnesium=diarrhea sodium=fluid retention Aluminum hydroxide: hypophosp hatemia, hypomagnesemia
72
Contraindications for antacids
GI perforation,/ obstruction , abd pain
73
Sucralfate(mucosal protectant) indications
GI ulcer
74
Sulcralfate mechanism of action
Coats mucosa and protects the ulcer, minimally absorbed, major s/e constipation; one hour before meals and at bedtime
75
Sucralfate evaluation
Reduced pain
76
H2 blockers
Prevents histamine induced acid release ; Cimetidine, famotidine
77
H2 blocker drug interactions
smoking decreases effectiveness,increases levels and effects of warfarin, lidocaine, and phenytoin
78
Pt teaching for H2 blockers
Avoid smoking, diet to decrease heart burn, rest, avoid stress, NSAIDs avoid except for low dose aspirin, report s/s GI bleeding and resp infection, take 30 min to before to 1 hr eating
79
Misoprostol indications
Tx for NSAID-induced ulcer
80
Mechanism of action for misoprostol
Increases bicarbonate and mucin release, reduced acid secretion and protects the lining of the stomach and helps to repair the ulcer
81
Contraindications for misoprostol
Pregnancy (cat X)
82
Proton pump inhibitors
Omeprazole, esomeprazole, pantoprazole
83
Proton pump inhibitor indications
Ulcers, erosive esophagitis,reflux
84
Proton pump inhibitor drugs- recognize?
-prazole
85
Mechanism of action for proton pump inhibitors
Reduces acid secretion
86
Proton pump inhibitor pt teaching
Bone density screenings needed, quit smoking, tx=2-8 weeks, avoid alcohol and NSAIDs, report s/s GI bleeding, take once a day in morning
87
Adverse effects for proton pump inhibitors
HA, diarrhea, N/V with short-term use Long-term= pneumonia, osteoporosis/fractures, rebound acid hyper secretion, hepatotoxicity, hypomagnesimia
88
Iron pt teaching
Take on empty stomach, Prevent teeth staining with water rinsing and juice, with a straw Stool will be dark green or black Increase fiber, fluids, exercise Avoid caffeine, tea, dairy Take with vitamin C Do not take with anti acids
89
Side/adverse effects for iron
GI distress(heart burn, N, const), teeth staining, staining of skin (IM), anaphylaxis, hypotension, fatal Iron toxicity in children
90
Folic acid indications
Pregnancy and breastfeeding
91
Folic acid pt teaching
Okra, spinach, Asparagus, liver, seeds, OJ (iron high)
92
Magnesium sulfate overdose
Tx calcium gluconate
93
Potassium chloride nursing interventions
EKG, continuous cardiac monitoring , monitor IV site, dilute, no after than 10 mEq/hr
94
S/s of hypokalemia
Muscle weakness, cramps, GI issues, cardiac issues, flat/inverted T wave, U wave
95
S/s hyperkalemia
GI issues, paresthesia, cardiac issues
96

Pharmacology (12 decks)

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