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Pharmacology-NRSE-3010-001 > Exam 5 > Flashcards

Exam 5 Flashcards

1
Q

What may occur to the insulin dose of a diabetic taking a corticosteroid (prednisone)? Why?

A

increase because steroids can cause increase in blood glucose

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2
Q

What is true concerning the discontinuation of steroid medications (dexamethasone)?

A

avoid discontinuing abruptly

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3
Q

What may be indications for medications such as triamcinolone, methylprednisolone, betamethasone (corticosteroids)?

A

RA, lupus, Crohn’s, Addison’s

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4
Q

What are indications for inhaled corticosteroids?

A

maintenance drugs, NOT rescue. asthma, COPD (chronic inflammation), rhinitis

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5
Q

When may those taking life-long corticosteroids require an increase dose?

A

high stress* or illnesses

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6
Q

What symptoms should those taking hydrocortisone report that may indicate the development of Cushing’s syndrome?

A

moon face, buffalo hump, muscle weakness, purple striae

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7
Q

what education should be provided to those taking corticosteroids (fludrocortisone, cortisol) to prevent osteoporosis, what should be increased in the diet to aid in this?

A

weight-bearing exercises
vitamin D and calcium

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8
Q

What time should hydrocortisone be taken?

A

in the morning while waking w/food

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9
Q

When is the onset of lispro/aspart/glulisine (rapid acting insulins)?

A

15-30mins

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10
Q

What is the duration of action for rapid acting insulins (lispro, aspart, glulisine)?

A

3-6 hrs

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11
Q

When is the highest risk for hypoglycemia (peak) for lispro (rapid acting)?

A

30 mins-2.5 hrs

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12
Q

When is the onset for regular insulin (short acting)?

A

30-60mins

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13
Q

What is the duration of action for short acting (regular) insulin?

A

6-10 hrs

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14
Q

How long after administration is the peak of regular insulin?

A

1-5 hrs

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15
Q

when is the onset of action for NPH (intermediate acting) insulin?

A

1-2hrs

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16
Q

How long does NPH (intermediate) work (duration)?

A

16-24hrs

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17
Q

When is the expected peak for NPH?

A

6-14hrs

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18
Q

what type of insulins should never be mixed with others?

A

long acting (detemir and glargine)

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19
Q

when is the onset for glargine/detemir?

A

70mins

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20
Q

How long does glargine last (duration)?

A

18-25hrs

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21
Q

What is the peak for detemir and glargine (long acting)?

A

there is no peak

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22
Q

What are complication of insulin?

A

hypoglycemia*, lipohypertrophy, hypokalemia

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23
Q

What are the indications for insulin?

A

glycemic (blood sugar) control of diabetes (1, 2, and gestational)

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24
Q

When are sulfonylureas (glipizide, glyburide, and glimepiride) used?

A

treatment of type 2 diabetes for patients that metformin is contraindicated in

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25
Q

If those taking glyburide (sulfonylurea) drink alcohol what may occur?

A

disulfiram-like reaction

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26
Q

What allergy is prevalent to glimepiride/glyburide?

A

sulfa allergy (those allergic to furosemide, Bactrim, etc)

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27
Q

Sulfonylureas (glipizide, glimepiride) are contraindicated in the treatment of which condition?

A

DKA

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28
Q

Why should muscle cramps, body aches, exhaustion, fast/deep breathing be reported by those taking metformin?

A

these could represent lactic acidosis

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29
Q

What teaching should the nurse give to a patient taking for metformin who is scheduled for a scan that requires IV contrast dye?

A

discontinue for 24-48 hrs before and 48hrs after

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30
Q

Which medication is used to treat BPH by making it easier to pee through relaxing the muscles in bladder?

A

tamsulosin

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31
Q

Why is it important for those taking tamsulosin for BPH to move positions slowly?

A

hypotension

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32
Q

Sildenafil and Tadalafil are PDE5 inhibitors used to treat which male reproductive condition?

A

erectile dysfunction

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33
Q

What are examples of medications that are contraindicated with sildenafil and tadalafil?

A

nitroglycerin and isosorbide mononitrate (nitrate meds)

34
Q

What medication is used in the treatment of BPH by slowing growth of prostate tissue and used to stimulate hair growth?

A

finasteride

35
Q

True or False: Finasteride is not effective immediately.

A

true, it can take up to 6 months or more

36
Q

Who should avoid touching finasteride?

A

pregnant women (can cause birth defects in male babies)

37
Q

Individuals taking finasteride shouldn’t donate blood for how long?

A

at least one month after discontinuation

38
Q

If taking finasteride, what education should be provided concerning hypotension?

A

dangle legs, change positions slowly, sit if dizzy, and general safety

39
Q

If a patient is severely hypoglycemic and cannot take oral glucose, what should be administered?

A

glucagon

40
Q

What are examples of bisphosphonates?

A

alendronate, ibandronate, risedronate, zoledronate

41
Q

What condition may alendronate be utilized in?

A

osteoporosis (prophylaxis, treatment of, paget disease)

42
Q

How long should those taking risedronate or ibandronate remain upright? What time is it taken?

A

at least 30 mins after taking, this med is taken on empty stomach first thing in the morning

43
Q

What medications are first generation antihistamines?

A

diphenhydramine, hydroxyzine, meclizine, promethazine

44
Q

What are the indications for first generation antihistamines?

A

allergic rhinitis, motion sickness, induce sleep, decrease itching/sneezing/runny nose

45
Q

What are common side effects of diphenhydramine?

A

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

46
Q

What adverse effects may occur as a result of taking first generation antihistamines?

A

sedation, urinary retention

47
Q

When would medications such as meclizine and promethazine be contraindicated?

A

in clients with BPH and narrow angle glaucoma

48
Q

What drug class are fexofenadine, azelastine, loratadine, cetirizine, and levocetirizine?

A

2nd generation antihistamines

49
Q

What medications are the first line therapy for mild/moderate allergic rhinitis and used for symptoms like itchy eyes/runny nose?

A

2nd generation antihistamines (fexofenadine, cetirizine, etc)

50
Q

What should those taking cetirizine avoid?

A

Juice (apple, grapefruit, and orange)

51
Q

What should 2nd generation antihistamines be taken with?

A

with food, while avoiding juice

52
Q

Due to the risk of anticholinergic effects, what teaching should the nurse provide to those taking fexofenadine (2nd generation antihistamines)?

A

use hard candy, gum, ice chips, increase fluids/fiber, use caution in heat (due to limited diaphoresis)

53
Q

What type of medications are phenylephrine and pseudoephedrine?

A

decongestants

54
Q

How are decongestants like pseudophedrine effective?

A

vasoconstriction within nasal passages, shrinking of tissue, and reduction of secretions

55
Q

What are potential adverse effects that may occur with decongestants?

A

cardio (palpitations, arrythmias, and HTN) and CNS (hallucinations, convulsions, delusions)

56
Q

What are contraindications and precautions with decongestants?

A

contra: preexisting HTN, cardiac disease, hyperthyroidism, glaucoma
precaution: diabetes (hyperglycemia)

57
Q

What are examples of topical (intranasal) decongestants?

A

tetrahydrozoline, xylometazoline, naphazoline, oxymetazoline

58
Q

What would be more effective for *quicker relief of nasal congestion than pseudoephedrine?

A

topical decongestants such as oxymetazoline because they act directly on the nasal passages

59
Q

How often should topical decongestants be taken?

A

for no more than 3 days at a time, every 12 hrs

60
Q

What effects may occur with tetrahydrozoline (topical decongestants)?

A

dry mucus membranes, rebound congestion with overuse, dependance, systemic effects if medication is swallowed

61
Q

When should guaifenesin be used (expectorant)?

A

to help clear mucus/phlegm and make cough more productive

62
Q

What education should be provided for a patient receiving an expectorant medication?

A

coughing/deep breathing, increase fluids (8 glasses a day), and use in caution w/asthma due to bronchospasm

63
Q

What type of medications are benzonatate, codeine, and dextromethorphan?

A

antitussives

64
Q

What type of cough should antitussive medications be used in?

A

dry non productive cough

65
Q

What effects may occur with codeine?

A

respiratory depression, dependance, drowsiness, dizziness, irritability/restlessness

66
Q

What should be prescribed in case of respiratory depression with codeine (antitussive)?

A

naloxone

67
Q

What are effects that may occur with dextromethorphan?

A

dizziness, nausea, sedation

68
Q

What should be reported to the provider for a patient taking codeine?

A

rash/fever or cough that lasts longer than a week

69
Q

What type of medications are used in the *maintenance of asthma and COPD, but not for acute attacks?

A

inhaled corticosteroids such as, ciclesonide, mometasone, flunisolide, triamcinolone, beclomethasone, budesonide

70
Q

What are the contraindications of inhaled corticosteroids (budesonide, triamcinolone)?

A

active fungal infection, altered immune system, live virus vaccine, acute asthma

71
Q

How can oral yeast be prevented for those using inhaled beclomethasone?

A

rinsing mouth with water

72
Q

What may montelukast be used for?

A

prophylactic/chronic treatment of asthma

73
Q

This adverse effect of leukotriene modifiers should be reported immediately and pt should go to ED?

A

SI - suicidal ideation

74
Q

Ipratropium and tiotropium may be used in the treatment of what conditions?

A

pulmonary emphysema, bronchitis, and asthma

75
Q

What are contraindications of ipratropium and tiotropium?

A

peanut allergies

76
Q

For which present conditions should we assess before administering ipratropium or tiotropium (precautions)?

A

narrow angle glaucoma and BPH

77
Q

What type of medications are theophylline and aminophylline?

A

methylxanthines (these relax airways, and reduce airway responsiveness to allergens)

78
Q

What adverse effects may occur with a serum level of 20-25 mcg/ml of aminophylline?

A

insomnia, irritability, N/V/D, headaches

79
Q

What adverse effects may occur with greater than 30 mcg/ml of theophylline?

A

seizures, arrythmias, brain damage, hypotension, hyperglycemia, and death

80
Q

Patients taking a methylxanthines should avoid?

A

smoking and caffeine (tea, soda, chocolate, and coffee)

81
Q

What s/s may represent a thromboembolic event, which could occur while taking estrogen medications?

A

A- abdominal pain
C- chest pain
H- headaches
E- eye changes
S- severe leg pain

82
Q

What should the nurse do if the pts HR is over 100 and they are due for a dose of levothyroxine?

A

hold the med

Pharmacology-NRSE-3010-001 (12 decks)

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