Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Pharmacology > Exam Two > Flashcards

Exam Two Flashcards

1
Q

4 Upper respiratory infections

A
  1. Common cold
  2. Acute rhinitis
  3. Sinusitis
  4. Acute pharyngitis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

How many colds a year do adults have?

A

2-4

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

How many colds a year do children have?

A

4-12

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

T/F: 50% of colds are experienced in the winter.

A

True

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What causes the common cold?

A

Rhinovirus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What is acute rhinitis?

A

acute inflammation of the mucous membranes of the nose

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

T/F: acute rhinitis usually accompanies a common cold.

A

True

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What is allergic rhinitis?

A

Hay fever, caused by pollen or foreign substance. Not the same thing as acute rhinitis.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

When is the common cold most contagious?

A

1-4 days before the onset of symptoms (incubation period)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

T/F: transmission of the common cold is caused mainly by viral droplets released when sneezing.

A

False; occurs more frequently from touching contaminated surfaces and then touching the nose or mouth.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What are symptoms of the common cold?

A

nasal congestion, nasal drainage (rhinorrhea), cough, and increased mucosal secretions

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What are the four groups of drugs used to treat cold symptoms?

A
  1. Antihistamines (H1 blocker)
  2. Decongestants (sympathomimetic amine)
  3. Antitussives (suppresses coughing)
  4. Expectorants
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What happens when histamine is released from mast cells?

A

Vascular smooth muscle contraction, which leads to runny nose and congestion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What effect does H1 blockers have?

A

PREVENTS constriction of the smooth muscles lining the nasal cavity.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What effect does H2 blockers have?

A

PREVENTS increase of gastric acid secretion, thereby preventing peptic ulcers. (not used for respiratory disorders)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What side effects are associated with first generation antihistamines?

A

drowsiness, anticholinergic effects (dry mouth, blurred vision, urine retention, decreased secretions which is good for runny noses)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What should clients be advised not to do while taking1st gen antihistaimines?

A

Drive motor vehicles/use heavy equipment due to sedative effects

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

T/F: the most popular first generation antihistamine is diphenhydramine (Benadryl).

A

True

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What receptor does diphenhydramine (Benadryl) effect?

A

It blocks the H1

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

T/F: Benadryl is okay to be used as a sleep aid in the elderly.

A

False

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Which group of drugs does diphenhydramine (Benadryl) have an increased effect with?

A

CNS Depressants (ETOH, narcotics, sedatives, barbiturates)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

T/F: Benadryl is sometimes used to pre-medicate prior to blood tranfusions to avoid common minor blood reactions

A

True

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What is another common name for second-generation antihistamines?

A

nonsedating antihistamines

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

T/F: second-generation antihistamines have fewer anticholinergic effects than first generations do.

A

True

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

Name one second-generation antihistamine

A

cetirizine (Zyrtec)
fexofenadine (Allegra)
oratadine (Claritin)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

T/F: antihistamines can be used in emergency situations, such as anaphylaxis.

A

False

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

What causes nasal congestion?

A

Dilation of nasal blood vessels

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

What is the action of decongestants?

A

stimulate the alpha-adrenergic receptors to produce vasoconstriction or capillaries, thereby shrinking nasal mucous membranes and decreasing nasal fluid secretions (runny nose)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

What classification are decongestants?

A

Alpha-adrenergic agonists/ sympathomimetics

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

What is rebound nasal congestion?

A

rebound vasodilation instead of vasoconstriction caused by frequent use of decongestants. Caused by irritation of the nasal mucosa

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

What is an example of a systemic decongestant?

A

ephedrine, phenylephrine, and pseudoephedrine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

What are the side effects of decongestants?

A

Same as any adrenergic drug: stimulation of CNS, increased BP, HR, and blood glucose

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

What are decongestants contraindicated in?

A

hypertension, cardiac disease, and hyperthyroidism, and DM

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

What are glucocorticoids used for?

A

treatment of allergic rhinitis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

How do glucocorticoids work?

A

Decrease local immune response/antiinflammatory action

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

Example of a glucocorticoid?

A

Beconase, Vanceril, Flonase, Nasacort

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

What do antitussives act on?

A

cough center in the medulla to suppress cough reflex

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

With what kind of cough can an antitussive be used?

A

nonproductive and irritating

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

Examples of nonarcotic antitussives?

A

Dextromethorphan, romilar, robitussin DM

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

Examples of narcotic antitussive?

A

Codeine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

What is the purpose of expectorants?

A

loosen bronchial secretions so they can be eliminated by coughing

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

T/F: it is questionable if expectorants are clinically effective

A

True

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
43
Q

What is the best expectorant?

A

Hydration

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
44
Q

What is the most common expectorant preparation?

A

guaifensein

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
45
Q

What are two pathophysiologic changes than occur with restrictive lung disease?

A

Decrease in total lung capacity/elasticity of lung tissues and decreased ability to take a full inhalation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
46
Q

Examples of restrictive lung diseases?

A

pulmonary fibrosis, pneumonitis, lung tumors, scoliosis, myasthenia gravis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
47
Q

What are the pathophysiologic changes that occur with COPD?

A

airway obstruction with increased airway resistance of airflow to lung tissues

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
48
Q

Name the 4 causes/types of COPD

A
  1. chronic bronchitis
  2. Bronchiesctasis (dilation of bronchi)
  3. emphysema
  4. chronic asthma
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
49
Q

Why is treatment for COPD focused on symptom control?

A

Permanent irreversible damage to lung tissue may occur

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
50
Q

What is the etiology of asthma?

A

hypereractive immune system, stimulated by a trigger

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
51
Q

The hallmark symptoms of asthma, wheezing and difficulty breathing, are due to what?

A

bronchospasm

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
52
Q

What are the 3 signs of COPD?

A

Dyspnea, bronchoconstriction, and mucus secretion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
53
Q

When allergens attach themselves to mast cells, what is the result?

A

antigen-antibody reaction, which stimulates the release of chemical mediators: histamines, leukotrienes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
54
Q

What do the chemical mediators (histamines, leukotrienes) stimuate?

A

Bronchoconstriction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
55
Q

What is the goal of an acute asthmatic attack?

A

Stop bronchospasm and prevent continued hyperimmune response

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
56
Q

What is the first line of defense for an acute asthmatic attack?

A

Sympathomimetics

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
57
Q

Which drug is given SC to promote bronchodilation and elevate blood pressure in the event of an acute asthmatic attack?

A

Epinephrine (adrenaline)- used for emergencies

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
58
Q

T/F: epinephrine is dangerous to use except in life threatening situations

A

True

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
59
Q

What is a medication that is for acute asthmatic attacks, but is rarely used because of its side effects?

A

Isoproterenol (Isuprel)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
60
Q

What type of drug is isoproterenol (Isuprel)?

A

non-selective adrenergic agonist (stimulates beta 1 and 2)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
61
Q

Which drug can have tolerance with excess use and have paradoxical spasm with overuse?

A

Metaproterenol (alupent)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
62
Q

Which drug is preferred for emergency tx or rescue inhaler for home?

A

albuterol (Proventil)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
63
Q

What type of drug is albuterol?

A

Beta 2 agonsit

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
64
Q

T/F: high doses of beta 2 agonists can cause some degree of beta 1 stimulation.

A

True

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
65
Q

What two side effects may be seen with albuterol?

A

increase in heart rate and blood glucose

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
66
Q

What type of drug is ipratropium bromide (Atrovent) and what is its purpose?

A

anticholinergic, dilates bronchioles

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
67
Q

T/F: Atrovent has more side effects compared to traditional anticholinergics.

A

False; it has less side effects

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
68
Q

If a patient is using a B agonist in addition to Atrovent, which should be used FIRST?

A

B agonist, then Atrovent

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
69
Q

If a patient is using a corticosteroid in addtion to Atrovent, which should be given FIRST?

A

Atrovent

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
70
Q

What two drugs make up Combivent?

A

ipratropium (Atrovent) and albuterol

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
71
Q

What is the action of methylxanthine (xanthine)?

A

stimulates CNS and respiration, dilates coronary and pulmonary vessels, leading to bronchodilation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
72
Q

What are the three methylxanthine derivatives?

A

aminophylline, theophylline, and caffeine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
73
Q

What are side effects of theophylline?

A

GI disturbances, nervousness,

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
74
Q

T/F: tobacco increases the metabolism of theophylline, giving it a short half life and producing less effect/

A

True

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
75
Q

What is the drug action for Leukotriene receptor antagonists?

A

reduce inflammatory process and decrease bronchoconstriction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
76
Q

Why are leukotriene receptor antagonists not used for acute asthma attacks?

A

The effects last for 24 hours

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
77
Q

Which leukotriene receptor antagonist is used for kids 6 years and older

A

montelukast (Singulair)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
78
Q

Which leukotriene receptor antagonists are used for adults and children over 12?

A

zileuton (Zyflo) and zafirlukast (Accolate)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
79
Q

What is the drug name for the aerosol inhaler of the glucocorticoid?

A

beclomethasone (Vanceril, Beclovent)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
80
Q

T/F: inhaled steroids have less systemic effects.

A

True

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
81
Q

T/F: patients should NOT wash their spacers and mouths after using a inhaler.

A

False; they should wash things things to prevent left behind drug deposits, which may lead to candida albicans

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
82
Q

T/F: glucocorticoids must be tapered when stopping

A

True

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
83
Q

What do mast cell stabilizers do?

A

stabilize the mast cell membrane to suppress the release of histamine, resulting in an anti-inflammatory response

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
84
Q

Do mast cell stabilizers have a bronchodilator effect?

A

No, and they should not be used for an acute asthmatic attack

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
85
Q

Examples of mast cell stabilizers.

A

comolyn (Intal) and nedocromil (Tilade)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
86
Q

What is the action of Mucolytics?

A

liquidfy and loosen thick mucus secretions

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
87
Q

acetylcysteine (Mucomyst) is what type of drug?

A

Mucolytic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
88
Q

What two things can acetylcysteine (Mucomyst) be used for if given orally?

A
  1. Antidote for acetaminophen overdose

2. Protect kidney in radiology dye studies

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
89
Q

T/F: acetylcysteine (Mucomyst) smells and tastes awful.

A

True

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
90
Q

What is preferred to give in Step 1 of the treatment program for asthma?

A

SABA PRN

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
91
Q

What is preferred to give in step 6 of the treatment program for asthma?

A

High-dose ICE+LABA+oral corticosteroid

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
92
Q

What are diuretics used to treat?

A

hypertension and edema in heart failure and liver or kidney failure

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
93
Q

What is natriuresis and what drugs have the greatest effect in causing it?

A

sodium loss in the urine; drugs that act on the tubules closest to the glomeruli

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
94
Q

How do diuretics produce antihypertensive effects?

A

by blocking Na and H2O reabsorption, which leads to loss through urine.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
95
Q

Which tube do thiazide diuretics act on?

A

the distal tube

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
96
Q

T/F: thiazide should be used cautiously in patients with decreased renal function.

A

True

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
97
Q

What hypo lab abnormality might thiazide cause?

A

hypokalemia (K) **enhances digoxin, can cause digitalis toxicity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
98
Q

What hyper lab abnormalities might thiazide cause?

A

Hypercalcemia (calsium), hyperglycemia, and hyper uricemia (serum uric acid)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
99
Q

If a patient has more urine output, should you expect an increase or decrease in electrolyte levels?

A

Decrease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
100
Q

Because it may cause hypokalemia, thiazide should not be used with…

A

steroids

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
101
Q

Where do loop diuretics work and what do they do?

A

Act on ascending loop and inhibit Na reabsorption= water loss

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
102
Q

T/F: loop diuretics are dose dependent. the higher the dose, the greater the effect of the drug

A

True, this is called the high ceiling

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
103
Q

T/F: loop diuretics are less potent than thiazides.

A

False; loop diuretics are more potent, causing 2-3x more water loss

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
104
Q

Name the most common loop diuretic

A

furosemide (Lasix)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
105
Q

What lab changes may occur with loop diuretics?

A

Hypokalemia, hypoatremia (sodium), and hypocalcemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
106
Q

What is the onset of loop diuretics orally? IV?

A

Oral: 30 minutes; IV: 3-5 minutes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
107
Q

If a patient is on loop diuretics, a nurse should do what two things?

A
  1. watch electrolytes

2. make safe path to restroom

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
108
Q

In high or rapid doses, loop diuretics are associated with…

A

otoxicity; damage to the 8th cranial nerve

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
109
Q

What is the action of osmotic diuretics?

A

increase osmolality of plasma and fluid in renal tubules, which leads to an increase in excretion of Na, Cl, K, and water b/c it is pulled into the blood and ultimately the urine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
110
Q

T/F: osmotic diuretics are used for emergencies and are short term with a short drug action.

A

True

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
111
Q

What two types of pressure are decreased by osmotic diuretics?

A

intracranial and intraocular

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
112
Q

Which diuretic is used to prevent renal failure?

A

Osmotic diuretics

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
113
Q

Example of a osmotic diuretic?

A

Mannitol

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
114
Q

How is mannitol administered?

A

IV

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
115
Q

What is a problem that is common with mannitol and should be watched out for?

A

Mannitol with crystalize if exposed to a low temp. Vial must be warmed to dissolve crystals before administration. Do not give mannitol if crystals are present

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
116
Q

T/F: osmotic diuretics pulls water from interstitial space to vascular space, then moves to the kidney where we get rid of it

A

True

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
117
Q

Why might pulmonary edema result from an osmotic diuretic use?

A

rapid fluid shift can overload a weak heart

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
118
Q

How does fluid loss effect HR and BP

A

Will lead to tachycardia and hypotension

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
119
Q

What do potassium sparing drugs interfere with?

A

Na-K pump controlled by aldosterone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
120
Q

T/F: potassium-sparing diuretics are aldosterone agonists.

A

False; they are aldosterone antagonists, they interfere with the pump controlled by aldosterone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
121
Q

Which diuretic is the least potent?

A

potassium-sparing

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
122
Q

Example of a potassium-sparing diuretic

A

spironolactone (Aldactone)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
123
Q

Which diuretic are potassium-sparings typically paired with?

A

Thiazide to lessen K+ loss

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
124
Q

What is a side effect of potassium-sparing diuretics?

A

hyperkalemia; do not take a potassium supplement if on this drug

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
125
Q

What types of drugs should not be taken with potassium-sparing diuretics?

A

Any drug that holds on to K (like ACE inhibitors)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
126
Q

What is the most effective way to monitor fluid volume?

A

daily weights

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
127
Q

Besides weight, what can be used to monitor fluid volume?

A

I & O, BP, fatigue, weakness, breath sounds and edema (last two not best)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
128
Q

T/F: fall risk is increased if a patient is on diuretics.

A

True

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
129
Q

Name 4 medically approved uses for CNS stimulants

A

ADHD, Narcolepsy, obesity (sort of), reveral of respiratory distress

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
130
Q

Do CNS stimulants increase or decrease the level of NTs?

A

Increase

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
131
Q

Which two NTs do Amphetamines stimulate the release of?

A

norepinephrine and dopamine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
132
Q

What two problems are treated with amphetamines?

A

ADHD and narcolepsy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
133
Q

What is a common amphetamine?

A

amphetamine (Adderall)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
134
Q

Four side effects of amphetamines?

A
  1. sleeplessness
  2. restlessness
  3. tremors
  4. irritability
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
135
Q

What cardiovascular problems may occur while taking amphetamines?

A

tachycardia, palpitations, dysrhythmias, and hypertension (can be dangerous for people w/ high HR or BP)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
136
Q

T/F: long term use of amphetamines does not typically lead to dependence and tolerance

A

False

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
137
Q

T/F: amphetamine use is associated with substance abuse problems later in life

A

True

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
138
Q

What should you do if toxicity is suspected to cause excretion of amphetamines?

A

decrease the urine pH

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
139
Q

Name a common amphetamine-like drug

A

methylphenidate (Ritalin)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
140
Q

T/F: Ritalin should not be given 6 hours before bed

A

True

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
141
Q

What is a common amphetamine-like drug given for narcolepsy?

A

modafinial (Provigil)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
142
Q

What four things should be assess for with patients taking Ritalin?

A

BP, pulse, weight, and judgment (May produce false sense of well-being)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
143
Q

T/F: patients taking Ritalin should take a drug holiday

A

True

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
144
Q

What are two purposes of a drug holiday?

A
  1. chance to reevaluate without drug to see if still needed

2. prevent tolerance- can start drug back up again at a lower dose

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
145
Q

T/F: patients on ritalin should avoid alcohol, but not caffeine

A

False; they should avoid both

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
146
Q

Name of a anorexiant

A

dextroamphetamine (Dexedrine)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
147
Q

T/F: dexedrine is associated with problems of tolerance, dependence, and abuse

A

True

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
148
Q

T/F: dexedrine is recommended as an appetite supressant

A

False; it is not recommended

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
149
Q

Due to its association with causing hemorrhagic strokes in women, which drug was taken out of OTC cold and weight loss drugs?

A

phenylpropanolamine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
150
Q

What is the primary purpose of analeptics?

A

stimulate respiration

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
151
Q

Two examples of analeptics

A

Caffeine and theophylline (bronchodilator)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
152
Q

What are analeptics most commonly used for?

A

newborn respiratory distress

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
153
Q

Example of a respiratory CNS stimulant

A

Doxopram (dopram)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
154
Q

Doxopram should be used cautiously with…

A

neonatal apnea- mechanical ventilation is better

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
155
Q

What is the pathophysiology of headaches/migranes

A

inflammation and dilation of blood vessels in the head

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
156
Q

Preventative treatment for headaches includes…

A

Beta-adrenergic blockers (propanolol), anticonvulsants (valproic acid), and tricyclic antidepressants (amitriptyline)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
157
Q

What are triptans used to treat?

A

headaches

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
158
Q

Example of a triptan

A

zolmitriptan (Zomig)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
159
Q

What type of drug is a triptan?

A

selective serotonin receptor agonist

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
160
Q

Triptans must be used cautiously if the patient has a history of…

A

Mi or hypertension

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
161
Q

What is the drug of choice for treating insomnia?

A

Sedative-hypnotics

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
162
Q

During which stage of sleep does most recallable dreams occur?

A

REM

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
163
Q

What is the most mild form of CNS depression?

A

Sedation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
164
Q

What types of effects do low doses of sedative-hypnotics produce?

A

Sedative effects: diminishes responses but does not alter consciousness

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
165
Q

What types of effects do high doses of sedative-hypnotics produce?

A

Hypnotic (sleep) effects

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
166
Q

T/F: hypnotic drug therapy should be short-term to prevent drug tolerance and dependence

A

True

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
167
Q

Which controlled substance class do barbiturates belong to?

A

Class II (accepted medical use, but highly addictive)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
168
Q

Which herbal supplements will produce an additive type effect with barbiturates?

A

Kava kava and Valerian

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
169
Q

T/F: barbiturates should not be used for less than one month

A

False; they should not be used for MORE than two weeks (is okay for sleep, but not seizures)

170
Q

What is thiopental sodiam (pentothal) used for?

A

General anesthetic, truth serum, and euthanasia of animals

171
Q

Which barbiturate is ultrashort-acting?

A

thopental sodium (Pentothal)

172
Q

This type of drug works by increase the action of inhibitory NT GABA to the GABA receptors

A

benzodiazepines

173
Q

What is the result of the action of benzodiazepines?

A

neuron excitability is reduced- can also be used as an anticonvulsant and for ETOH withdrawal (uses same receptors)

174
Q

What controlled substance class are benzodiazepines?

A

Class IV

175
Q

What is flumazenil and what is it used for?

A

A benzodiazepine ANTAGONIST; used for benzodiazepine overdose

176
Q

T/F: although it uses the same receptors as alcohol, withdrawal symptom will not occur if benzodiazepines are suddenly stopped.

A

False; withdrawal syndrome will occur

177
Q

What are three goals of using benzodiazepines as hypnotics?

A
  1. decrease anxiety
  2. pre-op sedation
  3. treat insomnia
178
Q

Example of a benzodiazepine used as a hypnotic?

A

Alprazolam (Xanax)

179
Q

Nonbenzodiazepines are used to treat what?

A

insomnia

180
Q

Example of an nonbenzodiazepine?

A

zolpidem (Ambien) should not be used for more than 10 days

181
Q

Before giving sedatives/hypnotics to older adults, what should the nurse first assess?

A

Cause of insomnia, eliminate it. (may be pain, nocturia, or other drug use)

182
Q

T/F: sedative-hypnotics must be used cautiously in older adults

A

True

183
Q

What are important nursing interventions for an older adult taking a sedative-hypnotic?

A

Start at 50% less dose, start low, go slow
Use drugs with shorter half lives
increased risk for confusion and falls
Should not take benzodiazepines more than 4 nights a week.

184
Q

T/F: even if a person has isolated seizures, they still are identified as having epilepsy.

A

False; the are not identified as having epilepsy if they have isolated seizures

185
Q

50% of seizures are caused by what?

A

unknown causes

186
Q

What is common in all causes of seizures?

A

Na, K, and Ca cannot move across cell membranes as they should, resulting in hyper excitability, with abnormal electrical charges

187
Q

If an isolated seizure is caused by fever, alcohol intox, or electrolyte imbalance, how is it treated?

A

Treat the underlying problem, and the seizure will resolve.

188
Q

What are the peak periods of seizures?

A

puberty and pregnancy

189
Q

Which part of the brain is involved with generalized seizures? Are they convulsive or non convulsive?

A

Involves BOTH hemispheres of the brain; may be BOTH convulsive or non.

190
Q

What part of the brain is involved in partial seizures? Will there be a loss of consciousness?

A

Involves ONE hemisphere of the brain; may or may not be loss of consciousness

191
Q

Tonic generalized seizures

A

sustained muscle contraction

192
Q

Clonic generalized seizures

A

dysrhythmic muscle contraction

193
Q

Atonic generalized seizures

A

w/o muscle tone: dead drop, loss of posture

194
Q

What is the definition of a status epileptic?

A

Seizure lasting longer than 30 mins: repeated seizures w/o return to baseline neuro status

195
Q

What will happen if a seizure is not stopped?

A

person may become hypoxic and sustain anoxic brain injury

196
Q

What is the first choice of drug to use to treat status epileptics?

A

Benzodiazepines (valium and ativan)

197
Q

What is lorazepam (Ativan) IV preferred over valium?

A

shorter duration

198
Q

What is a side effect of benzodiazepines?

A

Respiratory depression

199
Q

What is the second choice of drug used to treat status epileptics?

A

Barbiturates- sustain “brain rest”

200
Q

T/F: with febrile (fever) seizures, anticonvulsants are not used in children

A

True

201
Q

T/F: epilepsy develops in approximately 2.5% of children who have had one or more febrile seizure

A

True

202
Q

Should phenytoin (Dilantin) be used in pregnant women for the treatment of seizures?

A

NO- may cause teratogenic effects on fetus, contraception is required if on this drug

203
Q

Why are seizures more likely in pregnancy?

A

Changes in metabolism and hormone changes can alter seizure threshold.

204
Q

What is the action of Anticonvulsants (AEDs)?

A

Suppress abnormal electrical impulses from spreading, thereby preventing seizures

205
Q

T/F: anticonvulsants eliminate the cause of seizures

A

False; they do not

206
Q

Which of the following do anticonvulsants increase and decrease: Na, Ca, action of GABA

A

Decrease Na and Ca

Increase action of GABA (which creates an inhibitory effect)

207
Q

What does drug choice for anticonvulsants depend on?

A

seizure pattern, EEG, and patient tolerance/response

208
Q

How do you know when to stop increasing the dose of an anticonvulsant?

A

when there are either: no seizures or side effects become intolerable

209
Q

T/F: sudden stop of anticonvulsants can cause rebound seizures

A

True

210
Q

What type of drug is phenytoin (Dilantin)?

A

Anticonvulsant

211
Q

Because Dilantin has a low therapeutic index, it must be monitored closely. What range should the serum level fall into?

A

10-20 mcg/ml

212
Q

What pharmacokinetics/pharmacodynamics are important to know for Dilantin?

A

Absorbed slow/differently in person to person, long half life (22 hours), highly protein bound (long duration and more drug interactions)

213
Q

What is important for the nurse to know when IV use of phenytoin (Dilantin) is being administered?

A
  1. Dilated with normal saline ONLY
  2. must be filtered in line to avoid precipitation
  3. should be slow and IVPB
  4. Monitor EKG if loading dose or cardiac problems
214
Q

What are side effects of phenytoin (Dilantin)?

A

Gingival hyperplasia (overgrowth of gum tissue), thrombocytopenia, hyperglycemia

215
Q

T/F: Dilantin may increase or decrease with use of digoxin and coumadin

A

True

216
Q

T/F: the preferred way of administering phenytoin (Dilantin) is with a meal.

A

False; preferred on empty stomach

217
Q

For which anticonvulsant is bone marrow depression a major side effect?

A

carbamazepine (Tegretol)

218
Q

Can carbamazepine (Tegretol) be used to treat ETOH withdrawal and some psychiatric disorders?

A

Yes, but it is not approved by the FDA

219
Q

Can valproate be used to treat most types of seizures?

A

Yes

220
Q

What is a big concern for the drug valproate?

A

Hepatoxicity- monitor liver enzymes

221
Q

Why is phenobarbital not used as the first choice for an anticonvulsant?

A

causes sedation and poor pt. tolerance

222
Q

What should NOT be taken with Phenobarbital?

A

Alcohol, will cause an additive effect

223
Q

Why are barbiturates like phenobarbital used as anticonvulsants?

A

puts the brain to sleep to decrease metabolic activity to allow ppl to recover and prevent them from becoming brain dead.

224
Q

Which drug is used to treat petit mal (absent) seizures?

A

Succinimides (like Zarontin)

225
Q

What must patients taking anticonvulsants wear?

A

an ID bracelet

226
Q

T/F: it is okay for a patient on an anticonvulsant to switch to the generic brand

A

False; should get OKed by a MD

227
Q

What are the cardinal symptoms of parkinson’s disease?

A

rigidity, tremor, and bradykinetics (abnormal movements)

228
Q

What is the pathophysiology of parkinson’s diease?

A

Decreased dopamine, so Ach takes over and over stimulates motor neurons

229
Q

What is the goal of treatment for parkinson’s?

A

Increase dopamine, which has an inhibitory effect on the muscles

230
Q

Example of an antichoinergic used to treat parkinsons

A

Benztropine mesylate (Cogentin)

231
Q

T/F: anitcholinergics are sympatholytics that inhibit the release of Ach

A

True

232
Q

How do dopaminergics treat parkinson’s?

A

convert to dopamine and increase the amount of dopamine available

233
Q

What is a precursor of dopamine?

A

Levodopa

234
Q

What is levodopa converted to?

A

dopamine

235
Q

Why must high doses of levodopa be given to be effective?

A

To get more past the blood brain barrier and into the CNS, this causes significant side effects

236
Q

What are the side effects of high doses of levodopa?

A

GI upset, dyskinesia, orthostatic hypotension, cardiac dysrhythmias, psychosis

237
Q

What is the on-off phenomenon?

A

symptoms come and go depending on the level of dopamine (low drug level= symptoms on, high drug level= symptoms off)

238
Q

What are the advantages of combining carbidopa with levodopa?

A

more dopamine reaches basal ganglia, and smaller doses of levodopa can be used

239
Q

What does carbidopa do

A

inhibits enzyme breakdown of levodopa in the periphery

240
Q

What is it called when levodopa is combined with carbidopa?

A

Sinemet

241
Q

T/F: Sinemet is available is several different doses, so the nurse must be careful because the pt. will get different doses at different times of the day

A

True

242
Q

What do MAO-B inhibitors do?

A

prevent breakdown of dopa

243
Q

Example of a MAO-B inhibitor

A

Selegiline (eldepryl)

244
Q

Example of a dopamine agonist

A

Amantadine hcl (Symmetrel)

245
Q

What is dyskinesia?

A

impaired voluntary movement, sometimes a side effect with parkinson’s drugs

246
Q

T/F: patients can take carbidopa-levodopa with food to decrease nausea and it will not effect absorption

A

False; they can take with food, but will decrease absorption

247
Q

Is alzheimer’s curable?

A

No :(

248
Q

Alzheimer’s is associated with a deficiency of which NT?

A

Ach

249
Q

What is the progression of symptoms seen in alzheimer’s?

A

confusion> memory loss> dementia> personality changes

250
Q

What are ACE inhibitors?

A

Drugs used to inhibit cholinesterase, which decreases the amount of Ach (therefore, ACE inhibitors increase amount of Ach)

251
Q

Example of a ACE inhibitor

A

donepril (Aricept)

252
Q

T/F: drugs may decrease rate of progression of Alzheimer’s, but do not prevent disease progression

A

True

253
Q

How many people see improvement with Alzheimer’s?

A

1/3

254
Q

What type of teaching is important for Alzheimer’s?

A

family safety: falls, wandering (2nd stage) and inability to monitor own meds

255
Q

Which disease is the autoimmune deficiency of ACH receptors, leading to decrease neuromuscular transmission?

A

Myasthenia Gravis

256
Q

What is thought to cause the symptoms of psychosis?

A

imbalance (probably a lack) of dopamine

257
Q

T/F: antipsychotic agents can be used to treat both anxiety and depression

A

False; they can treat neither, only psychotic disorders

258
Q

Which receptors are affected by antipsychotic agents?

A

Blocks D2 Dopamine receptors (may cause psuedoparkinson’s)

259
Q

Phenothiazines falls into which drug category?

A

Antipsychotic agents

260
Q

What are phenothiazines more commonly used for?

A

antiemetic (control of nausea and hiccups)

261
Q

Why are phenothiazines not often used?

A

They cause significant sedation and ortostatic hypotension

262
Q

What is the neuroleptic malignant syndrome?

A

rare but fatal condition where person loses autonomic control; cannot control BP or temp.

263
Q

Examples of phenothiazines

A

chorpromazine (Thorazine)
Fluphenazine (Prolixin)
Thioridazine (Mellaril)

264
Q

What can atypical antipsychotics be used for?

A

positive and negative symptoms of schizophrenia and dementia

265
Q

Example of a serotonin/dopamine antagonist

A

risperidone (Risperdal)

266
Q

Which antipsychotic has an adverse reaction of agranulocytosis?

A

clozapine (Clozaril)

267
Q

What are adverse effects of antipyschotic agents called?

A

EPS: extrapyramidal reactions (pseudoparkinsonism)

268
Q

T/F: even if an antipsychotic is stopped, parkinson-like side effects may not go away

A

True

269
Q

How long might the full therapeutic effects for phenothiazines take?

A

3-6 weeks for psychosis, immediate for antiemetic

270
Q

Which drug might make the urine pinkish or red-brown?

A

Phenothiazines

271
Q

Do antipsychotics have side effects that are like sympathetic or parasympathetic drugs?

A

Sympathetic/anticholinergic

272
Q

How long after starting meds can EPS be seen?

A

5-30 days

273
Q

Why should patients taking antipsychotics avoid sunlight?

A

marked photosensitivity occurs

274
Q

Antipsychotics increase/decrease the seizure threshold

A

Decrease- will make it easier for pts prone to seizures to have them

275
Q

Will alcohol have an additive or antagonist effect with antipsychotics

A

Additive

276
Q

T/F: two antipsychotics may be taken together

A

False; should NOT be given together

277
Q

What should the nurse do if a patient is coming off an antipsychotic?

A

taper them, slowly come off, start at 1/4-1/2 usual adult dose

278
Q

How do antipsychotic doses change for older adults?

A

require 25-50% less, and are at an increased risk for side effects

279
Q

What is the difference between primary and secondary anxiety?

A

Secondary is related to a drug and is NOT treated with anxiolytics; primary is not related to a drug and IS treated with anxiolytics

280
Q

In what time frame can drug tolerance to anti anxiety drugs occur?

A

less than 2-3 months

281
Q

Which drugs can be used for anxiety, but are also anticonvulsants (AED)

A

Benzodiazepines: Valium, Xanax

282
Q

How should the dose be adjusted for benzodiazpines if the patient has liver or renal disease

A

Less should be given

283
Q

This is very important to not take with benzodiazepines

A

ETOH

284
Q

In the event of a benzodiazepine overdose, the nurse should…

A

maintain airway and give and emetic followed by charcoal or flumazenil, unless the person is just simply sedated

285
Q

What is the pathophysiology behind depression?

A

an insufficient amount of NTs (norepinepherine, serotonin, and dopamine)

286
Q

Which herbal supplements may be used for depression?

A

St. John’s wort and ginkgo

287
Q

T/F: herbal supplements for depression should be D/C 1-2 week before surgery to decrease the bleeding risk

A

True

288
Q

Explain the action of TCAs

A

BLOCKS UPTAKE of NTs so more chemicals stay in neuro synapse and there can be more transmission of impulses

289
Q

How long do TCAs take to be therapeutic?

A

2-4 weeks

290
Q

TCAs may cause fatal overdoses in which body system?

A

Cardiac

291
Q

What is the prototype TCA?

A

nortriptyline (Aventyl)

292
Q

TCAs have cholinergic/anticholinergic side effects

A

anticholinergic

293
Q

Name 3 important side effects of TCAs

A

drowsiness, orthostatic hypotension, and dysrhythmias

294
Q

How do SSRIs work?

A

BLOCK the REUPTAKE of serotonin, enhancing transmission

295
Q

Which drugs should SSRIs not be used with?

A

MAO-I

296
Q

Why are SSRIs used more often than TCAs?

A

they have less sedation and anticholinergic side effects and an overdose in not likely to be fatal (but they cost more :()

297
Q

T/F: SSRIs can be used for the prevention of migraine headaches

A

True

298
Q

What is the prototype SSRI?

A

fluoxetine (Prozac): effective in 50-60% of clients who do not respond to TCAs

299
Q

What is the most common SSRI prescribed?

A

sertraline (Zoloft)

300
Q

How long do SSRIs take to be therapeutic?

A

1-4 weeks

301
Q

What is a big reason for noncompliance with SSRIs?

A

sexual dysfunction

302
Q

How do MAO-Is increase levels of NE, dopamine, and serotonin?

A

inhibit the enzyme monoamine oxidase

303
Q

What must be avoided when on MAO-Is?

A

Foods that contain Tyramine (cheese, cream, yogurt, coffee, chocolate, bananas, raisins, soy sauce, beer, red wine)

304
Q

What could result from consuming foods containing tyramine or sympathomimetics while on MAO-Is?

A

Hypertensive crisis

305
Q

Which group of drugs are contraindicated for MAO-Is?

A

TCAs

306
Q

Lithium is also commonly called what type of drug?

A

Antimania

307
Q

What is the toxic range for lithium?

A

1.5-2 mEq/L, this is very narrow

308
Q

How often should serum levels be monitored when on lithium?

A

Biweekly, then monthly when drug is started

309
Q

Lithium toxicity is more likely when which electrolyte is low?

A

Na; this sometimes occurs with increase perspiration or dehydration, diuretic therapy

310
Q

T/F: patients taking lithium should also be put on a Na restricted diet

A

False; in fact, they may need to take salt tablets

311
Q

T/F: lithium can be taken with NSAIDS

A

False

312
Q

What is regular cardiac output?

A

3.5-5 L/min

313
Q

Blood in ventricle at end of diastole; volume of blood in heart

A

preload

314
Q

Resistance to flow out of ventricle

A

Afterload

315
Q

Increasing which 4 things will increase cardiac workload

A

preload, afterload, rate, and contractility

316
Q

Inotrope

A

drug that effects CONTRACTILITY

317
Q

Chronotrope

A

drug that effects HEART RATE

318
Q

Dromotrope

A

drug that effects CONDUCTION (+ will increase contractility, - will decrease contractility)

319
Q

What are the 3 goals of cardiovascular drugs?

A
  1. Improve pump function
  2. decrease cardiac oxygen requirements
  3. improve blood flow to body tissues
320
Q

Which 3 drugs are most commonly used for shock/hypotension

A
  1. Epinephrine (adrenaline)
  2. dopamine
  3. dobutamine
321
Q

Which CV drug is most powerful to increase HR, contractility, vasoconstriction, and oxygen needed by the heart

A

Epinephrine (adrenalin)

322
Q

What are low doses of dopamine used for?

A

improving renal blood flow by dilating the renal artery

323
Q

What are high doses of dopamine used for?

A

action similar to epinephrine, increase HR and BP

324
Q

Which group of drugs is used to improve pump function?

A

Cardiac glycosides

325
Q

Digitalis/digoxin (Lanoxin) is used for what?

A

improve pump function, it is a cardiac glycoside

326
Q

Digoxin is positive/negative: inotrope, chronotrope, dromotrope

A

positive inotrope, but negative chromo-and-dromotropes (increases contractility, but slows the rate to allow the ventricles to fill up)

327
Q

What are side effects related to digoxin?

A

Rhythm and rate issues, “yellow” vision, headache, nausea and vomiting.

328
Q

At what number is digoxin toxic?

A

> 2.0 mg/dL

329
Q

T/F: digoxin is highly protein bound and has many interactions with other drugs

A

True

330
Q

What are some indications that digoxin is working?

A

improved mental status, urine output of 30ml/hr, improved activity tolerance, controlled heart rate

331
Q

If digoxin is not effective, what is used to treat CHF?

A

phosphodiesterase inhibitors

332
Q

What type of drug is Primacor?

A

a phosphodiesterase inhibitor

333
Q

T/F: K levels should be around 4, because decreed K increases the effects of digoxin

A

True

334
Q

Which 3 electrolytes should be watched while on digoxin?

A

K, Ca, and Magnesium

335
Q

Why are many drugs that are used to treat angina also used to treat hypertension?

A

They both cause vasodilation, decreasing pressure

336
Q

What is angina caused by?

A

lack of blood flow to heart tissues (Ischemia- decreased flow, no damage)

337
Q

Chronic stable angina

A

due to stress or exertion

338
Q

Unstable angina

A

chest pain for no apparent reason

339
Q

Vasospastic angina

A

occurs at rest

340
Q

Why are nitrates unique?

A

they affect both veins and arteries

341
Q

nitroglycerine (NTG) is what class of drug?

A

Nitrate

342
Q

Venous dilation decreases what?

A

Preload (decreased return to the heart)

343
Q

Arterial vasodilation decreases what?

A

afterload (heart doesn’t have to push as hard)

344
Q

What is the overall goal of nitrates?

A

decrease O2 demand and increase O2 supply

345
Q

Atenolol, propanolol and metoprolol are what types of drugs?

A

Antianginal- beta blockers (decrease symp. effect)

346
Q

Verapamil and diltizem, Ca channel blockers, prevent what?

A

movement of Ca across membrane= less muscle contraction

347
Q

T/F: Calcium channel blockers will cause hypocalcemia

A

False; will not change serum Ca level

348
Q

what are the side effects of Nitrates?

A

hypotension and headache (HA)

349
Q

How would the nurse decide if it is okay to give NTG

A

check blood pressure

350
Q

How will beta blockers affect HR and O2 demand?

A

Decrease both

351
Q

What are the side effects of beta-blockers?

A

decreased BP & HR, sexual dysfunction, fatigue, bronchospasm, glucose problems, rebound angina or high BP if not tapered off

352
Q

Are Ca channel blockers positive or negative ionotropes? Dromotropes?

A

negative ino, negative dromo

353
Q

Cardizem, Calan, and Norvasc are all what types of drug

A

Antianginal-beta blockers

354
Q

What are the side effects of Ca channel blockers?

A

bradycardia, peripheral edema, hypotension, constipation, headache, liver and renal changes

355
Q

Hypertension is described at what number?

A

140/90, but interventions are required before that

356
Q

T/F: hypertension requires individualize treatment plans and may require many types of drugs

A

True

357
Q

What do adrenergic agents do to alpha 1 receptors and why

A

Block alpha 1 to dilate periphery

358
Q

Besides hypertension, what are adrenergic agents also used to treat?

A

benign prostate hypertrophy

359
Q

What do adrenergic agents do to alpha 2 receptors and why?

A

stimulate alpha 2 to dilate CNS

360
Q

If a patient has high lipid levels, which choice of drug may be best for hypertension?

A

adrenergic agents

361
Q

What 2 herbal supplements interact with adrenergic agents to stimulate the CNS?

A

Ma huang, ephedra

362
Q

How do antihypertensive vasodilators acts?

A

directly on arteriolar smooth muscle to cause relaxation and vasodilation to decrease BP

363
Q

Example of a vasodilator

A

hyralazine (Apresoline)

364
Q

If bloodflow/pressure is low, what will happen?

A

aldosterone will be secreted and cause sodim and water retention, which will increase BP

365
Q

What do ACE inhibitors do?

A

prevent conversion of angiotensin I to angiotension II so vascoconstriction and fluid retention are decreased

366
Q

T/F: ACE inhibitors are especially good for tx of HF

A

True

367
Q

What are the side effects of ACE inhibitors?

A

HYPERkalemia, dry “ACE” cough, hypotension, angioedema (severe swelling of tongue, lips: go to ER)

368
Q

Why are ARIIB’s different from ACE inhibitors?

A

they work at the receptor

369
Q

PTT and APTT monitoring is used for what drug?

A

Heparin

370
Q

PT monitoring is used for what drug?

A

Warafarin

371
Q

What is the prefered lab test to measure the effects of heparin and warafarin?

A

INR

372
Q

What is the normal value for INR?

A

1.0

373
Q

What do PTT and APTT measure?

A

deficiencies in certain clotting factors

374
Q

What does PT measure?

A

the time it takes blood to clot in the presence of certain clotting factors

375
Q

What do the results of a clot depend on?

A

Where is is formed

376
Q

A clot formed in an artery will cause what?

A

inhibited blood flow, ischemia and necrosis (platelet aggregation, atherosclerosis)

377
Q

A clot formed in a vein will cause what?

A

decreased venous return, edema (due to stasis, vessel injury, coagulation factors, oral contraceptive, smoking, obesity)

378
Q

What type of drug is heparin?

A

Anticoagulant

379
Q

What does heparin do?

A

Prevent thrombin- so fibrin is not formed and there is no clot

380
Q

What are low dose SubQ heparin used for?

A

prophylaxis of DVT

381
Q

What are high dose IV heparin used for?

A

prevent growth of clot, DOES NOT DISSOLVE CLOT

382
Q

T/F: heparin is available in several different concentrations

A

True

383
Q

What is the half life of heparin?

A

Short, 4-6 hours

384
Q

T/F: heparin is for short term use, if needed for longer, the patient should be put on coumadin

A

True

385
Q

Lovenox and Fragmin are…

A

Low molecular weight heparins

386
Q

LMWHs are used more for…

A

home use due to longer action, bridge between heparin and coumadin

387
Q

What are doses for LMWHs based on?

A

weight and reason for giving

388
Q

What are contraindications of heparin?

A

active/recent bleeding, strokes, ulcers, scheduled surgery

389
Q

Doses for heparin should be based on

A

WEIGHT, WEIGHT

390
Q

T/F: heparin can be IV, SC, or oral

A

False; no oral

391
Q

If normal PTT/APTT is 20 seconds, the therapeutic value for heparin would be…

A

30-60 seconds (1.5-2.5 times normal)

392
Q

T/F: if heparin is being taken for prophylaxis, PTT should barely be altered

A

True

393
Q

What are the side effects of heparin?

A

bleeding at site, thrombocytopenia, heparing induced thrombocytopenia (never give pt heparin again)

394
Q

This drug is an oral anticoagulant

A

Warfarin (Coumadin)

395
Q

How does warfarin act?

A

inhibits VITAMIN K clotting factors

396
Q

Does warfarin have a short or long half life?

A

Long, several days

397
Q

T/F: warfarin is highly protein bound and takes several days to reach therapeutic effects

A

True

398
Q

How many days before invasive procedures must warfarin be stopped?

A

2-3 days (use LMWH or heparin in meantime)

399
Q

What is the therapeutic range for INR?

A

2-3 (normal is 1)

400
Q

Is coumadin highly protein bound?

A

yes

401
Q

T/F: ginger, ginko, garlic, and ginseng increase the action of warfarin

A

True

402
Q

Vitamin K is an agonist/antagonist of warfarin

A

ANTAgonist

403
Q

What should be used in an emergency to reverse the effects of heparin

A

protamine sulfate

404
Q

What should be used to immediately reverse the effects of coumadin?

A

Fresh frozen plasma, which contains clotting factors

405
Q

What should be used to slowly reverse the effects of coumadin?

A

Vitamin K

406
Q

Which foods have high vitamin K content?

A

dark leafy vegetables

407
Q

If a patient is allergic to heparin, what is used instead?

A

Direct thrombin inhibitors, like Acova or Refludan

408
Q

Antiplatelet drugs are used for prophylaxis for what ?

A

CVA, MI

409
Q

T/F: aspirin inhibits platelet aggregation

A

True, will take 81-325mg/day

410
Q

T/F: if a patient is taking aspirin once a day, it is for pain

A

False; it is for prophylaxis of artery thrombosis

411
Q

What do antilipemics do?

A

Lower blood lipid levels

412
Q

A high risk cholesterol level is…

A

> 240

413
Q

A moderate risk cholesterol level is…

A

200-240

414
Q

What do statins do?

A

interfere with how lipids are metabolized/formed in the liver.
Increase HDL and decrease LDl

415
Q

What is included in important teaching about statins?

A

monitor liver function, report muscle weakness, pain, rhabdomyolysis is a serious reaction (breakdown of protein in skeletal muscles, causes renal failure), avoid pregnancy

416
Q

What is the prototype statin?

A

atrovastatin calcium (lipitor)

417
Q

How does resin, cholestryamine (Questran), work?

A

collects cholesterol in the gut, binds with bile

418
Q

T/F: do not give Questran with other meds, it might prevent absorption

A

True

419
Q

Which drug makes RBCs more flexible?

A

pentoxifylline (Trental)

420
Q

Why should a patient not smoke while taking Trental?

A

it is the biggest risk factor for peripheral arterial disease

421
Q

T/F: viagra is reported to be associated with transient ischemic attack

A

True

Pharmacology (5 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions