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Pharm Exam 4 > Exam 4 > Flashcards

Exam 4 Flashcards

1
Q

What is the schedule for the Hepatitis A vaccine for children?

A

First dose between 12 and 23 months, second dose at least 6 months after the first

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2
Q

When should the Hepatitis B vaccine be administered?

A

Within 12-24 hours after birth, additional doses at 1-2 months and 6-18 months, third dose should not be given prior to 24 weeks of age

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3
Q

What are the two formulations available for the Rotavirus vaccine?

A

RV-5 (three-dose series at 2, 4, 6 months) and RV-1 (two-dose series at 2 and 4 months)

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4
Q

What is the maximum age for the final dose of the Rotavirus vaccine?

A

8 months, 0 days

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5
Q

What is the DTaP vaccine schedule for children? (5 doses)

A

Doses at 2, 4, 6, 15-18 months, and 4-6 years

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6
Q

What does the Haemophilus influenzae type b (Hib) vaccine prevent?

A

A serious type of meningitis commonly seen in children

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7
Q

How many doses are in the Hib vaccine series?

A

4-dose series at 2, 4, 6, and 12-15 months

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8
Q

At what ages is the Inactivated poliovirus (IPV) vaccine administered? (4 doses)

A

2, 4, and 6-18 months, and 4-6 years

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9
Q

What does the pneumococcal vaccine (PCV) prevent?

A

Meningitis, pneumonia, and middle ear infections caused by streptococcus pneumoniae

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10
Q

What is the MMR vaccine schedule? (2 doses)

A

Doses at 12-15 months and 4-6 years

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11
Q

What is the vaccination schedule for Varicella (chickenpox)? (2 doses)

A

One dose at 12-15 months and 4-6 years, or two doses at least 4 weeks apart if after age 13

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12
Q

At what age should the Tdap booster be given?

A

Between ages 11 and 12 after completing the DTaP series

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13
Q

What is the HPV vaccine recommended for?

A

Adolescents ages 11-12 (3 doses)

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14
Q

What is the schedule for MenACWY vaccine?

A

1st dose at 11-12 years, 2nd dose (booster) at 16 years

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15
Q

What is the frequency of the Tetanus & diphtheria (TD) vaccine for adults?

A

Every 10 years

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16
Q

What is the indication for Methotrexate?

A

Severe psoriasis, acute lymphoblastic leukemia, polyarticular juvenile idiopathic arthritis

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17
Q

What is the action of Methotrexate?

A

Folate antagonist; inhibits dihydrofolate reductase, blocking folic acid synthesis

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18
Q

What are common adverse effects of Methotrexate?

A

Hepatic fibrosis, severe bone marrow suppression, GI ulceration, pneumonitis

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19
Q

What is the definition of ‘Nadir’ in chemotherapy?

A

Time following chemotherapy when blood cell counts reach their lowest level

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20
Q

What causes nausea and vomiting during chemotherapy?

A

Stimulation of the chemoreceptor trigger zone (CTZ) in the brain

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21
Q

What is the prototype drug for nitrogen mustards?

A

Cyclophosphamide

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22
Q

What are the side effects of Doxorubicin?

A

Severe bone marrow suppression, N/V, red coloration to urine and sweat

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23
Q

What is the action of gonadotropin-releasing hormone agonists like Leuprolide?

A

Prevents the release of luteinizing and follicle-stimulating hormones to prevent testosterone production

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24
Q

What is the expected pharmacological action of Tamoxifen?

A

Blocks estrogen receptors to treat estrogen-receptor-positive metastatic breast cancer

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25
Q

What are the nursing actions for monitoring patients on Tamoxifen?

A

Monitor for abnormal bleeding, leg pain, chest pain, and cholesterol levels

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26
Q

What are isotonic solutions?

A

Fluids that resemble plasma, keeping cells in the vascular space, with osmolality of 250 to 375 mOsm/L

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27
Q

What are examples of isotonic solutions?

A
  • 0.9% sodium chloride
  • 5% dextrose in water
  • Lactated Ringer’s (LR)
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28
Q

What is the osmolality of hypertonic solutions?

A

Equal to or greater than 375 mOsm/L

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29
Q

What is the drop factor for micro-drip IV tubing?

A

Delivers 60 drops/ml

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30
Q

What is the importance of monitoring I/O in patients receiving nitrogen mustard drugs?

A

To ensure adequate hydration and monitor for kidney toxicity

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31
Q

What are the two types of IV tubing sets?

A

Macro-drip and micro-drip sets

Macro-drip delivers 10, 15, or 20 gtts/ml; micro-drip delivers 60 gtts/ml.

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32
Q

When is micro-drip IV tubing primarily used?

A

In pediatric or neonatal care

It is used when small amounts of fluids are to be administered over a long period.

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33
Q

What should be verified before accessing a central venous access device (CVAD)?

A

CXR verifies the tip is positioned near the cavo-atrial junction (CAJ)

The CAJ is where the lower third of the SVC meets the upper RA.

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34
Q

List some risks associated with central line access.

A
  • Blockage
  • Pain
  • Bleeding
  • Infection
  • Blood clots
  • Migration or kinking
  • Accidental removal
  • Collapsed lung
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35
Q

What is the primary use of peripheral IV lines?

A

Short-term treatments

Peripheral IV lines can only be used for a few days.

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36
Q

What is the first-line drug for rheumatoid arthritis (RA)?

A

Methotrexate

It is considered a Disease Modifying Antirheumatic Drug (DMARD).

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37
Q

Name two types of glucocorticoids used for RA.

A
  • Short-acting: hydrocortisone, cortisone
  • Intermediate-acting: methylprednisolone, prednisolone, prednisone, triamcinolone
  • Long-acting: betamethasone, dexamethasone
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38
Q

What are the two main classes of anti-inflammatory agents for gout?

A
  • NSAIDs (first line treatment)
  • Glucocorticoids (alternative treatment)
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39
Q

What is the action of allopurinol?

A

Inhibits uric acid formation

Testing for HLA-B*5801 is recommended for specific ancestries to prevent severe adverse reactions.

40
Q

What is the primary treatment goal for osteoporosis?

A

Maintain or increase bone strength

41
Q

What is the significance of a T-score of -2.5?

A

Indicates osteoporosis

It represents 20% bone loss compared to the mean.

42
Q

List some adverse effects of alendronate.

A
  • Esophagitis
  • Atypical femoral fractures
  • Esophageal cancer
  • Musculoskeletal pain
  • Ocular problems
  • Osteonecrosis of the jaw
43
Q

What are the primary cholinesterase inhibitors used for dementia?

A
  • Donepezil
  • Galantamine
  • Rivastigmine
44
Q

What is the mechanism of action of memantine?

A

Blocks calcium influx at NMDA receptors

It modulates the effects of glutamate, critical for memory and learning.

45
Q

What is the first-line drug for Parkinson’s disease?

A

Levodopa/carbidopa

46
Q

What are the main types of pain classified in pain management?

A
  • Somatic
  • Visceral
  • Neuropathic
47
Q

What is the mechanism of action for gabapentin?

A

Binds to voltage-gated calcium channels in the CNS

This stabilizes neuronal membranes and affects the transport of neurotransmitters.

48
Q

What are the two classes of local anesthetics?

A
  • Ester-type
  • Amide-type
49
Q

What is the primary use of lidocaine?

A

Most widely used local anesthetic

It can be used for both topical and injectable applications.

50
Q

What is a common adverse effect of local anesthetics?

A
  • CNS excitation followed by depression
  • Cardiovascular suppression
  • Allergic reactions
51
Q

What should be avoided when applying topical anesthetics?

A
  • Large areas of skin
  • Broken skin
  • Strenuous activity
52
Q

What is the action of dopamine replacement therapy in Parkinson’s?

A

Increases dopamine synthesis in the striatum

53
Q

What are vasoconstrictive medications primarily used for?

A

Reuptake of norepinephrine by adrenergic neurons

Think CNS.

54
Q

What are the therapeutic uses of topical vasoconstrictive medications?

A

Relief from pain, itching, and soreness in:
* Skin (sunburn, insect wounds)
* Mucous membranes (ENT, trachea, anal fissures, hemorrhoids)

If absorbed systemically, it can be toxic.

55
Q

What precautions should be taken when using topical vasoconstrictive medications?

A

Use small amounts, avoid large areas, broken skin, strenuous activity, and do not wrap or heat the site.

56
Q

What is a significant risk when injecting vasoconstrictive medications?

A

Injury to arteries or veins; aspirate prior to injections to check for blood return.

57
Q

What is the Black Box Warning associated with ibuprofen?

A

GI Bleed

Less GI bleeding compared to aspirin but still a risk.

58
Q

List contraindications for ibuprofen use.

A
  • Hypersensitivity (including aspirin)
  • Active GI bleed/ulcer
  • CABG surgery
  • History of MI
  • Severe heart failure
  • Avoid after 30 weeks of pregnancy.
59
Q

What are common adverse effects of ibuprofen?

A
  • Constipation
  • Dyspepsia
  • Nausea
  • Vomiting
  • Headache
  • Renal failure
  • SJS
  • Intraventricular hemorrhage.
60
Q

What should patients be educated about when taking ibuprofen?

A
  • Do not take concurrently with aspirin
  • Take with food or water/milk
  • Avoid alcohol
  • Maximum doses: Adults 3200 mg/day; Children 2.4 g/day.
61
Q

What is the definition of a controlled substance according to the DEA?

A

Drugs, substances, and certain chemicals classified into five categories based on acceptable medical use and abuse potential.

62
Q

What are Schedule I drugs characterized by?

A

No currently accepted medical use and a high potential for abuse.

Examples include heroin, LSD, marijuana.

63
Q

What are examples of Schedule II drugs?

A
  • Hydrocodone (e.g., Vicodin)
  • Cocaine
  • Methamphetamine
  • Oxycodone (e.g., OxyContin)
  • Fentanyl.
64
Q

What defines Schedule III drugs?

A

Moderate to low potential for physical and psychological dependence.

65
Q

What are common examples of Schedule IV drugs?

A
  • Xanax
  • Valium
  • Ambien
  • Tramadol.
66
Q

What is the indication for Schedule V drugs?

A

Lower potential for abuse, used for antidiarrheal, antitussive, and analgesic purposes.

67
Q

What are the common adverse reactions to opioids?

A
  • Hypotension
  • Constipation
  • Confusion
  • Sedation
  • Respiratory depression.
68
Q

What nursing considerations should be taken for opioid administration?

A
  • Start low for opioid naïve patients
  • Assess pain before and after administration
  • Monitor LOC, BP, HR, RR, and pulse oximetry.
69
Q

What are the indications for COX 1 inhibitors?

A
  • Analgesia
  • Reduction of inflammation
  • Fever reduction
  • Decreased incidence of TIA & MI.
70
Q

What are the adverse effects of COX 1 inhibitors?

A
  • GI bleeding
  • Dyspepsia
  • Hepatotoxicity
  • Hypersensitivity.
71
Q

What is the main function of COX 2?

A

Mediates inflammation and sensitizes receptors to painful stimuli.

72
Q

What distinguishes first-generation NSAIDs from second-generation NSAIDs?

A

First-generation NSAIDs inhibit both COX 1 & 2, while second-generation NSAIDs selectively inhibit COX 2.

73
Q

What are the indications for acetaminophen?

A
  • Mild pain
  • Fever
  • Moderate/severe pain (IV only).
74
Q

What are the contraindications for acetaminophen?

A
  • Hypersensitivity to certain substances
  • Severe hepatic impairment.
75
Q

What is the primary use of acetaminophen?

A

Pain relief and fever reduction

Acetaminophen is commonly used to relieve mild to moderate pain and reduce fever.

76
Q

What are the contraindications for acetaminophen?

A
  • Hypersensitivity to alcohol
  • Severe hepatic impairment
  • Acute liver disease
  • Drug-drug interactions with other hepatotoxic substances

These contraindications are important to consider to avoid serious health risks.

77
Q

What are common adverse effects of acetaminophen?

A
  • SJS (Stevens-Johnson syndrome)
  • Constipation
  • Hepatotoxicity
  • Renal failure
  • Agitation in children

Awareness of these adverse effects is critical for patient safety.

78
Q

What nursing considerations should be taken when administering acetaminophen?

A
  • Assess liver and kidney function
  • Monitor alcohol use
  • Do not exceed maximum daily dose
  • Limit duration of use (10 days for adults, 5 days for children)
  • Avoid alcohol consumption

These considerations help prevent overdose and liver damage.

79
Q

What is the antidote for acetaminophen overdose?

A

N-Acetylcysteine (Acetadote)

This antidote is crucial in treating acetaminophen overdose effectively.

80
Q

Which type of immunity does the MMR vaccine provide?

A

Artificial active immunity

This type of immunity is developed through vaccination.

81
Q

What is a contraindication for taking tamoxifen?

A

Deep-vein thrombosis

Patients with a history of deep-vein thrombosis should not take tamoxifen due to increased risk.

82
Q

What adverse effects should a client on maraviroc report?

A
  • Paresthesia
  • Cough
  • Jaundice
  • Fever

Reporting these symptoms can help detect serious complications early.

83
Q

What instructions should a nurse give for self-administering enfuvirtide?

A

“Allow the vial to sit until the solution is completely clear and without particulates.”

Proper preparation of the medication is essential for effective treatment.

84
Q

Which over-the-counter drug should be avoided by a client on topotecan therapy?

A

Ibuprofen

Ibuprofen can increase the risk of renal toxicity when taken with topotecan.

85
Q

What instructions should be included for a client taking mercaptopurine?

A
  • Use contraception if pregnancy is a risk
  • Perform oral hygiene frequently
  • Perform hand hygiene frequently
  • Avoid activities that can cause injury

These precautions help minimize the risk of infection and complications.

86
Q

What condition is maraviroc used to treat?

A

Chemokine receptor 5 (CCR5)-tropic HIV-1

Maraviroc specifically targets this type of HIV.

87
Q

What should a nurse monitor for in a client receiving vincristine?

A

Weak hand grasps

This could indicate neurological adverse effects of the drug.

88
Q

What drug should be administered alongside intrathecal cytarabine to reduce neurotoxicity?

A

Dexamethasone

Dexamethasone is used to mitigate potential side effects of cytarabine.

89
Q

What is the purpose of combining zidovudine with ritonavir in HIV treatment?

A

To prevent drug resistance

This combination is effective in managing HIV-1.

90
Q

What immunization should a client receive starting at 50 years of age?

A

Herpes zoster vaccine

This vaccine is recommended to prevent shingles in older adults.

91
Q

What laboratory value should be reported for a client on zidovudine?

A

Hemoglobin 7.1 g/dL

This low hemoglobin level indicates possible anemia, a common side effect of zidovudine.

92
Q

What actions should a nurse take when administering paclitaxel IV?

A
  • Give the client an antihistamine
  • Administer the drug through non-PVC tubing
  • Use an in-line filter

These steps help prevent allergic reactions and ensure proper drug delivery.

93
Q

What immunization should a nurse include for a 4-month-old infant?

A

Haemophilus influenzae type B vaccine (Hib)

This vaccine is part of the recommended immunization schedule for infants.

94
Q

What adverse reactions should a client on delavirdine/efavirenz therapy report?

A

Rash

A rash may indicate a serious drug reaction that requires immediate attention.

95
Q

What age range should be included for the human papillomavirus (HPV) vaccine?

A

11 to 12 years old

Vaccination in this age range is recommended for optimal protection against HPV.

Pharm Exam 4 (1 decks)

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