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Pharmacology > Exam 5 > Flashcards

Exam 5 Flashcards

1
Q

what drugs are in the first generation antihistamine class?

A

diphenhydramine, hydroxyzine, meclizine, and promethazine

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2
Q

indications for first gen antihistamines

A

allergic rhinitis, motion sickness, induce sleep, runny nose

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3
Q

side effects for first gen antihistamines

A

sedation and anticholinergic effects (can’t see, can’t pee, can’t spit, can’t poop)

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4
Q

adverse effects of 1st gen antihistamines

A

sedation

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5
Q

contraindications for first gen antihistamines

A

narrow-angle glaucoma, BPH, older adults; precautions for urinary retention

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6
Q

what drugs are in the second generation antihistamines class

A

loratadine, fexofenadine, cetirizine, azelastine

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7
Q

indications for second gen antihistamines

A

allergic rhinitis, does not cross the blood-brain barrier

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8
Q

nursing interventions for second gen antihistamines

A

do not give with orange, apple, and grapefruit juice, check for allergies, give with food, avoid operating machinery/driving, avoid alcohol/other CNS depressants, increase fluids, avoid sun/heat

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9
Q

pt teaching for second gen antihistamines

A

increase fluids, avoid apple, orange,and grapefruit juice, avoid alcohol, sun/heat, use ice chips for dry mouth, eye drops for dry eyes, fiber and exercise

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10
Q

what drugs are in the decongestant class

A

pseudophedrine and phenylephrine
naphazoline, oxymetazoline, tetrahydrozoline, and zylometazoline

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11
Q

indications for decongestants

A

relief of temporary nasal congestion

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12
Q

mechanism of action for decongestants

A

causes nasovascular vasoconstriction

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13
Q

side effects of decongestants

A

sympathomimetic effects on CNS and Cardio systems
Tachycardia, nervousness, restlessness, anxiety, dry mucous membranes, tremor, weakness

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14
Q

contraindications/precautions for decongestants

A

glaucoma and those with preexisting HTN, cardiac disease, and Hyperthyroidism; diabetes should talk to provider first

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15
Q

what drugs are in the topical decongestant class

A

naphazoline, oxymetazoline, tetrahydrozoline, and zylometazoline

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16
Q

indications for topical decongestants

A

Faster, sprays in at the site of congestion, systemic= lasts longer

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17
Q

pt teaching for topical decongestants

A

Do not use for more than 3 days consecutively= dependence

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18
Q

side/adverse effects for topical decongestants

A

Palpitation, HTN, arrhythmias, hallucinations, delusions, ,convulsions

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19
Q

what drugs are in the expectorant drug class

A

Guaifenesin (Mucinex)

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20
Q

indications for expectorant

A

Mucus not dislodging from lungs

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21
Q

pt teaching for expectorant

A

Coughing, deep breathing exercises, take with full glass of water- does not help with cough, reduces adhesiveness and surface tension of mucus use cautiously with asthma, will not work without increased fluids

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22
Q

what drugs are in the antitussive class

A

Dextromethorphan, codeine, benzonanate (tessalon perles)

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23
Q

indications for antitussives

A

Suppress cough reflex, but only for dry, non productive cough

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24
Q

side effects of antitussives

A

Drowsiness, dizziness, irritability, constipation, restlessness (a/e of respiratory depression and dependence - codeine)

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25
Q

pt teaching for antitussives

A

Increases fiber fluids exercise, avoid alcohol, report to provider if cough greater than week or if rash/fever,change positions slowly, hard candies for dry mouth, avoid activities that require alertness

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26
Q

what drugs are in the inhaled corticosteroid class

A

Beclomethasone, budesonide, flunisolide, fluticasone, mometasone, triamcinolone, ciclesonide

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27
Q

indications for inhaled corticosteroids

A

Bronchial tree inflammation, prophylactic tx for asthma and management of COPD- maintenance drugs- NOT useful for acute attacks

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28
Q

Contraindications for corticosteroids

A

Active fungal infection,live virus vaccines
Precautions in those with current infection, herpes, and altered immune system

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29
Q

adverse effects of inhaled corticosteroids

A

Sore throat, hoarseness, coughing , dry mouth, fungal infections (pharyngeal and laryngeal)
Long-term use in children causes delayed growth and decreased adrenal function-decreased bone mass

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30
Q

pt teaching for corticosteroids

A

Use every day at same time regardless of s/s. Peak= 1-2 weeks can take 4 weeks for therapeutic effect

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31
Q

what drugs are in the systemic corticosteroid class

A

Methylprednisolone and prednisone

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32
Q

indications for systemic corticosteroids

A

Exacerbations may require IV doses, stress

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33
Q

contraindications for systemic corticosteroids

A

Infection , fungal infection, live virus vaccines

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34
Q

what drugs are in the leukotriene modifiers class

A

Zafirlukast and montelukast(Singulair)

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35
Q

indications for leukotriene modifiers

A

Oral prophylaxis and chronic tx for asthma- NOT acute attacks

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36
Q

adverse effects of leukotriene modifiers

A

Depression, SI , bleeding, seizures, can affect liver
S/e=HA, pharyngitis, and rhinitis

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37
Q

what drugs are in the anticholinergic class for respiratory drugs?

A

Ipratropium (short acting) and tiotropium ( long acting)
Tx for asthma, bronchitis, pulmonary emphysema

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38
Q

contraindications/precautions for anticholinergics respiratory drugs

A

Allergy to peanuts, cautiously in those with narrow-angle glaucoma and BPH

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39
Q

what drugs are in the methylxanthines class

A

Theophylline and aminophylline

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40
Q

indications for methylxanthines

A

Reversal for bronchospasm s, tx for asthma and chronic airway limitation; second-line drug bc requires serum level monitoring(a/e at therapeutic doses)

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41
Q

side effects/adverse effects for methylxanthines

A

20-25mcg= GI sympoms-N/V/D
>30mcg=CNS effects- HA, insomnia, irritability,hypotension, hyperglycemia, arrhythmias, seizures, Brian damage, death

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42
Q

drug interactions for methylxanthines

A

Smoking decreases serum levels of med and caffeine is a stimulant= worse s/e
Report s/s toxicity=N/V/D and restlessness

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43
Q

Serum levels for Methylxanthines

A

5-15mcg/mL

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44
Q

what drugs are in the bronchodilators/Beta 2 agonists class

A

Albuterol, levalbuterol, pirbuterol(short acting/rescue)
Arformoterol, formoterol, indacaterol, olodaterol, salmeterol(long acting)

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45
Q

indications for bronchodilators/Beta 2 agonists

A

Prevent asthma attack, acute asthma attack (short acting) or tx for pneumonia and COPD

46
Q

side effects/ adverse effects for bronchodilators/Beta 2

A

Inhaled= throat irritation, sinus tachycardia, HTN, anxiety, nervousness, tremor, dizziness, palpitations, angina, hyperglycemia. Bronchospasm, urticaria, angioedema=rare

47
Q

pt teaching for bronchodilators/Beta 2 agonists

A

Use bronchodilator before steroid, use as ordered (rescue= 2-3 times per week, not effective maintenance), use a spacer, tolerance, Side effects diminish, avoid/limit caffeine intake (soda, chocolate, tea, coffee)

48
Q

spacer for bronchodilators/Beta 2 agonists

A

All MDI; press, inhale and hold for 5-10 sec or as long as able, exhale softly

49
Q

what drug is used for thyroid hormone replacement therapy

A

Levothyroxine

50
Q

drug interactions for levothyroxine

A

Warfarin (increases effect of levothyroxine) and digoxin (decreases effect of levothyroxine)
Some vitamins/supplements decrease absorption of levothyroxine

51
Q

pt teaching for levothyroxine

A

Take in AM before breakfast on empty stomach, four hours before vitamins/supplements
List of meds
Medic alert
Report s/s hyperthyroidism
Read labels
Lifeline replacement therapy
Do not abruptly stop

52
Q

adverse effects for levothyroxine

A

Hyperthyroidism s/s, thyroid storm
Overmedication and chronic overtreatment
Contraindicated in those with thyrotoxicosis, adrenal insufficiency, and post MI
Hold if HR>100

53
Q

Those on methimazole should avoid

A

Seafood (iodine)

54
Q

what are the drugs in the antithyroid class

A

Methimazole, Propylthiouracil

55
Q

assessment/interventions for antithyroid medications

A

Monitor VS, daily weight, thyroid hormones, CBC, s/s infection, s/s hypothyroidism
Assess s/s thyroid crisis/storm= tachycardia, fever, flushed skin, restlessness, confusion, behavior changes

56
Q

what drugs are used in the antidiuretic hormones class

A

Vasopressin an desmopressin

57
Q

indications for antidiuretic hormone meds

A

Diabetes insipidus
Contraindicated in those with CAD, creatinine clearance <50, decreased peripheral circulation, chronic nephritis

58
Q

nursing interventions for antidiuretic hormone drugs

A

Monitor for overhydration, reduce fluid intake, smallest effective dose, s/s MI
Monitor labs(K, Na, creatinine, BUN, specific gravity,osmolality) I&O, water intoxication (HA, ALOC, EKG)

59
Q

adverse effects for antidiuretic hormone drugs

A

Reabsorption of too much water, MI, hyponatremia, black box warning:severe hyponatremia

60
Q

evaluation for antidiuretic hormone drugs

A

Increased specific gravity, decreased output, decrease thirst

61
Q

what is the drug we talked about in the calcitonin-Salmon class

A

Calcitonin

62
Q

side effects/ adverse effects of calcitonin-salmon drugs

A

Gi disturbances, skin rash, flushing, nasal irritation.
A/e=hypocalcemia(tetany and seizures)

63
Q

how do you recognize the drugs in the Biphosphonate drug class

A

-dronate

64
Q

indications for biphosphonates

A

Prophylaxis tx of post menopausal osteoporosis, male clients with osteoporosis, prophylaxis and treatment of osteoporosis caused by glucocorticoids, pts with Paget’s disease

65
Q

Biphosphonate mechanism of action

A

Inhibit osteoclast activity and decrease bone turnover/resorption

66
Q

pt teaching for biphosphonates

A

Take on empty stomach, remain upright for 30 min, take with 8 oz water, report visual changes, avoid dental work,notify HCP-GI issues prevent intake,weight-bearing exercises, diet high in calcium and vitamin D

67
Q

Contraindications for biphosphonates

A

Preexisting swallowing or esophageal issues, severe kidney impairment, hypocalcemia, cannot sit or stand upright for 30 min

68
Q

what drugs are in the corticosteroid class

A

Glucocorticoids and mineralocorticoids

69
Q

What drugs are in the glucocorticoids class

A

Dexamethsone, prednisone, fluticasone, betamethasone, methylprednisolone, prednisolone, triamcinolone

70
Q

What drugs are in the mineralocorticoids class

A

Fludrocortisone

71
Q

what corticosteroids have the same potency as glucocorticoids?

A

Cortisol and hydrocortisone

72
Q

indications for corticosteroids

A

Glucocorticoids:inhibit inflammatory and immunological response
Mineralocorticoids:salt and water balance

73
Q

adverse effects of glucocorticoids

A

Glucocorticoids:suppression of adrenal gland function, Cushing’s syndrome, osteoporosis, hyperglycemia and glycosuria, myopathy, PUD, infection, fluid and electrolyte imbalances, growth suppression in children

74
Q

Adverse effects for mineralocorticoids

A

Retention of Na and water= HTN, edema, HF, hypokalemia

75
Q

pt teaching for corticosteroids

A

Taper when d/cing,illness or high stress may need higher doses,take with food in am, wear medical ID, anti inflammatory=every other day,report s/s acute adrenal insufficiency, avoid NSAIDS report s/s bleeding, weight bearing exercises and diet high in calcium and vitamin D report s/s infection , muscle weakness, s/s Cushing’s

76
Q

S/s Cushing’s disease

A

Moon face, buffalo hump, muscle weakness, cutaneous Striations

77
Q

S/s of acute adrenal insufficiency

A

Anorexia, hypoglycemia, N, lethargy, malaise, restlessness

78
Q

what are the different type of insulins

A

Rapid-acting, sort-acting, immediate-acting, long-acting, combinations

79
Q

Rapid-acting insulins

A

Lispro, as part, insulin glulisine

80
Q

Short-acting insulin

A

Regular

81
Q

Intermediate-acting insulin

A

NPH

82
Q

Prolonged duration insulin

A

Insulin detemir and insulin glargine

83
Q

Rapid onset, peak, duration rapid-acting insulin

A

Onset=15-30 min
Peak-30min-2.5hrs
Duration=3-6 hrs

84
Q

Short-acting insulin onset, peak, duration

A

Onset=30-60 min
Peak=1-5 hrs
Duration=6-10 hrs

85
Q

Intermediate-acting insulin onset, peak ,duration

A

Onset=1-2hrs
Peak=6-14 hrs
Duration=16-24 hrs

86
Q

Long-acting insulin onset, peak, duration

A

Onset=70 min
Peak=none
Duration=18-24 hrs

87
Q

action of insulin

A

Promote use of glucose by body cells, store glucose as glycogen in muscles, reduces blood glucose

88
Q

pt teaching for insulin

A

Keep snacks, glucagon administration, s/s hypoglycemia, how to administer, keep refrigerated, wear medic alert bracelet, diet/exercise, use meds as prescribed , how to check blood sugar

89
Q

sliding scale for insulin

A

Dependent on blood glucose, AC/HS, rapid or short-acting insulin

90
Q

complications for insulin

A

Hypoglycemia, hyperglycemia,lipohypertrophy, hypokalemia, somogyi effect, dawn phenomenon

91
Q

mixing insulin process

A

Inject air into NPH (cloudy first), then regular and draw up regular followed by NPH

92
Q

what drugs are in the sulfonylureas class

A

Glimepiride, glipizide, glyburide

93
Q

indications for sulfonylureas

A

Type 2 DM, releases insulin from the pancreas

94
Q

pt teaching for sulfonylureas

A

Monitor s/s hypoglycemia, keep snacks (15 g carbs), keep BG log, take with breakfast, avoid alcohol refer to dietician or diabetic educator

95
Q

contraindications for sulfonylureas

A

Tx of DKA, sulfa allergy

96
Q

indications for metformin

A

Control blood glucose levels in those with type 2 DM
Three actions: reduce liver glucose production, decrease intestinal absorption of glucose, and increase insulin sensitivity

97
Q

pt teaching for metformin

A

Take with food, eat prescribed diet, s/s hypoglycemia, encourage drug compliance, warn to avoid alcohol, teach about IV dye

98
Q

indications for glucagon

A

Emergency management of insulin induced hypoglycemia

99
Q

estrogens, progesterones, and combined oral contraceptives

A

estrogens=Estradiol, estriol
Progestines= progesterone, hydroxyprogesterone, medroxyprogesterone, megestrol, norgestrel
Combined=ethinyl estradiol and norelgestromin

100
Q

adverse effects of estrogens

A

N/V, breast tenderness, endometrial hyperplasia, hyperpigmentation, edema, weight gain
Endometrial and ovarian cancers, potential risk for estrogen-dependent breast cancer, emboli events

101
Q

Adverse effects of progestins

A

Weight gain, edema, depression , thromboembolism, breast cancer, jaundice, migraine headaches, birth defects and spontaneous abortions

102
Q

adverse effects of estrogen-progestin combinations

A

Breast fullness, N/V, depression and edema, increased risk of abnormal clotting, thrombolytic events, HTN, uterine/vaginal bleeding, breast cancer, hyperglycemia, hyperkalemia

103
Q

contraindications for estrogens

A

pregnancy category X, heart disease/family hx, vaginal bleeding, certain cancers, hx of thrombotic disease, fibroid tumors, tobacco use
Black box warning: start at lowest dose and use for shortest duration

104
Q

contraindications for oral contraceptives

A

Smoking and over 35 y/o, hx of thromboembolus or CV events, family hx or risk factor for breast cancer, experience abnormal vaginal bleeding

105
Q

indications for tamsulosin

A

Treat BPH by relaxant smooth muscles, highly protein bound

106
Q

adverse effects for tamsulosin

A

Hypotension , dizziness, nasal congestion , sleepiness, faintness, problems with ejaculation, floppy iris syndrome

107
Q

mechanism of action for tamsulosin

A

Relaxing smooth muscles

108
Q

indications for PDE5 inhibitors

A

Erectile dysfunction
Onset of action is 20-60 min and duration is 4 hours

109
Q

PDE5 inhibitor contraindications

A

Alcohol, preexisting HTN, and on alpha-adrenergic blockers
Interacts with grapefruit juice,nitrates, alcohol, antihypertensives, and alpha-adrenergic blockers

110
Q

indications for finasteride

A

Tx for BPH

111
Q

pt teaching for finasteride

A

Therapeutic effects are not immediate, pregnant women should avoid, do not donate blood, antihypertensive teaching

Pharmacology (12 decks)

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