Exam One medications Flashcards

1
Q

What drugs increase the risk of falling

A

CATS MAN
major tranquilizers, anticholinergic drugs, tricyclic antidepressants, corticosteroids, NSAIDs, sedative-hypnotic and anxiolytic

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2
Q

What type of drugs are sedative-hypnotics?

A

benzodiazepines, barbituates, and ‘z drugs’

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3
Q

Why do benzos, barbiturates, and ‘z drugs’ increase risk of falls

A

-CNS depression, help induce sleep, etc

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4
Q

What drugs are benzodiazepines

A

chlordiazepoxide, -lams and -pams

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5
Q

What drugs are barbiturates

A

end in -barbitol

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6
Q

What drugs are ‘Z drugs’

A

Zolpidem, zaleplon, eszopiclone

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7
Q

What drugs are tricyclic antidepressants

A

doxepin, amoxipine, amitriptyline, nortiptyline, trimipramine, etc

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8
Q

Tricyclic antidepressants place our clients at risk of what three things?

A
  1. anticholinergic effects
  2. orthostatic hypotension
  3. sedation
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9
Q

What are different cardiac medications that increase risk for orthostatic hypotension

A

ACE inhibitors
ARBs
CCBs
Beta Blockers
Alpha 1 blockers

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10
Q

suffix for ACE inhibitors

A

-pril

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11
Q

suffix for ARBS

A

-sartan

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12
Q

suffix for CCB

A

-dipine

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13
Q

suffix for beta blockers

A

-olol

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14
Q

suffix for alpha 1 blockers

A

-zosin

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15
Q

What drugs are corticosteroids?

A

most end in -sone and -solone

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16
Q

why do corticosteroids increase risk of falls in the older adult

A

-osteoporosis

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17
Q

What drugs are NSAIDs

A

ketorolac, aspirin, diclofenac, meloxicam, naproxen, ibuprofen

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18
Q

How do NSAIDs cause falls in the older adult

A

increases dizziness

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19
Q

What are the hypoglycemic agents

A

-metformin
-sulfonylureas (begin with gly-)

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20
Q

What med is a stool softener

A

docusate sodium

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21
Q

What meds are osmotic laxatives?

A

polyethylene glycol (miralax), magnesium hydroxide, lactulose

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22
Q

What meds are stimulant laxatives>

A

bisacodyl suppositories, golytely, Senna

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23
Q

Stimulants should be given as a last resort to constipation caused by

A

narcotics

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24
Q

Polyethylene glycol is an osmotic laxative that increases the risk for

A

dehydration

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25
Q

what is the bulk forming laxative

A

psyllium

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26
Q

important considerations with psyllium

A

-take with full glass of water to prevent bulk formation in the throat

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27
Q

Urge incontinence is often treated with

A

oxybutynin

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28
Q

is oxybutynin an anticholinergic>

A

yes

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29
Q

How does oxybutynin work?

A

relaxes muscles in the bladder increasing urine capacity

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30
Q

Oxybutynin can cause vasodilation which increases the risk of

A

orthostatic hypotension and slow reaction times

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31
Q

What are the alpha 1 adrenergic antagonists used to treat BPH

A

-tamsulosin, terazosin, doxazosin (FloMax and Hytrin)

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32
Q

How does tamsulosin and terazosin work?

A

decreases smooth muscle tone which relaxes the bladder and prostate

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33
Q

Complications of tamsulosin and and terazosin

A

-hypotension
-decreased / failure to ejaculate

34
Q

Should alpha 1 adrenergic antagonists be used before cataract surgery?

A

No ; increases risk for floppy iris syndrome

35
Q

What should we monitor when our patient is taking tamsulosin, terazosin, and doxazosin?

A

-BP
-LOC

36
Q

When should tamsulosin be taken?

A

30 minutes after a meal

37
Q

When should doxazosin be taken?

A

same time each day

38
Q

Alpha 1 adrenergic antagonists are contraindicated in

A

liver and renal impairment

39
Q

What is the 5- alpha reductase inhibitor used to treat BPH?

A

finasteride

40
Q

How does finasteride work?

A

-reduces testosterone which reduces prostate size (also used to fix baldness in males)

41
Q

How long can it take before we see improvements with finasteride?

A

6 months

42
Q

complications of finasteride include?

A

-decreased libido
-gynecomastia

43
Q

Client education while taking finasteride

A

-pregnant women should not touch the medication
-do not donate blood until 1 month after discontinuation

44
Q

What tests should be monitored while taking finasteride?

A

liver function tests

45
Q

How many g / day of carbs do older adults need

A

130 g (adds brain and nervous system fuel)

46
Q

Carbohydrates should be what percent of older adult diet?

A

45-65

47
Q

Fiber is what kind of carbohydrate

A

polysaccharide

48
Q

Carbohydrates and insulin production

A

-glucose elevates blood sugar –> pancreas releases insulin –> converts glucose to energy

49
Q

Fiber, which is a carbohydrate, does what four things?

A

lowers cholesterol, stabilizes blood sugar (decreases abortion rate of glucose), increases ease of BM, and decreases risk of intestinal CA

50
Q

What may older adults take to increase their fiber

A

Metamucil and fiber tablets

(foods like sweet potatoes make you feel more full)

51
Q

Lipids increase function of what organ systems

A

cardiac and neuro

52
Q

Omega 3 acids (such as avocoado) decrease risk of

A

cardiovascular problems

53
Q

Normal LDL level should be

A

less than 100

54
Q

Normal HDL level should be

A

> 60 males , >70 females

55
Q

Normal triglyceride level should be

A

< 200

56
Q

increased LDL puts patient at risk for?

A

CAD –> plaque buildup in arteries –> stroke

57
Q

Male and female caloric needs 51 and older

A

Male : 2000
Female : 1600

58
Q

Fruit requirements male and female 51 and older

A

Male: 2 cups
Female: 1.5 cups

59
Q

Vegetable requirements male and female 51 and older

A

Male: 2.5
Female: 2

60
Q

Grains requirements male and female 51 and older

A

Male: 6 oz
Female: 5 oz

61
Q

Protein requirements male and female 51 and older

A

Male: 5 1/2 oz
Female: 5 oz

62
Q

Milk requirements male and females 51 and older

A

Male: 3 cups
Female: 3 cups

63
Q

Oils requirement male and female 51 and older

A

Male: 6 tspp
Female: 5 tsp

64
Q

How much calcium do older adults require in a day?

A

1200 mg

65
Q

What medications are dopaminergics and used to treat Parkinson’s disease?

A

levodopa and carbidopa

66
Q

Does levodopa potentially speed the progression of Parkinson’s disease?

A

yes

67
Q

Side effects of levodopa?

A

-N and V
-orthostatic hypotension
-dry mouth
-dyskinesia

68
Q

Nutritional factors of levodopa nurses should be aware of?

A

-take 1 hr before or 2 hr after meal
-protein heavy meals limit drug absorption

69
Q

How does combined carbidopa levodopa change the drug?

A

-carbidopa decreases amount of levodopa is converted to dopamine (more drug available)
-helps with nausea

70
Q

What is the on off syndrome?

A

when sx of Parkinson’s (specifically dyskinesia) appear despite treatment

71
Q

What drug class may be used as the rescue drugs for the ‘off times’ in Parkinson’s?

A

dopamine agonists

72
Q

What drugs are dopamine agonists?

A

pramipraxole, bromocriptine, ropinorole

73
Q

Can dopamine agonists be used before or with levodopa?

A

yes

74
Q

Dopamine agonists such as pramipraxole, bromocriptine, and ropinorole have a high risk for?

A

hypotension and decreased LOC (also dyskinesias and hallucinations according to UTI)

75
Q

What drug class may be given to patients with Parkinson’s to control tremors and rigidity?

A

anticholinergics (benztropine, trihexylphenidyl)

76
Q

What are catechol - O - methyltransferase (COMT) inhibitors used for when treating Parkinson’s disease?

A

-increase duration of levodopa by preventing its breakdown
-extends benefit of levodopa for patient

77
Q

What drugs is a COMT inhibitor?

A

entacepone

78
Q

Do COMT inhibitors themselves help reduce symptoms of Parkinson’s disease?

A

no

79
Q

Side effects of COMT inhibitors?

A

diarrhea, hypotension, nausea

-potential to develop dyskinesias and hyperkinesia

80
Q

Is dark urine considered a normal finding when taking entacepone?

A

yes