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Pharm 2 > Final > Flashcards

Final Flashcards

1
Q
  1. What are the 4 effects of GI drugs on secretions?

2. Describe what peptic ulcer disease (PUD) is, and three major causes of it:

A
  1. They decrease, block, form protective coverings, or replace missing GI enzymes
  2. Erosions in the lining of the stomach and adjacent areas of the GI tract. Caused by H-pylori, stress, and NSAID
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2
Q
      1. Name 5 different drug types that treat GERD and PUD, and brief descriptions of their actions
A
  1. H2 antagonists - blocks release of hydrochloric acid in response to gastrin
  2. Antacids - Interact with acids at the chemical level to neutralize them
  3. Proton pump inhibitors - Suppress the secretion of hydrochloric acid into the lumen of the stomach
  4. GI protectants - Coat any injured area in the stomach to prevent further injury from acid
  5. Prostaglandins - Inhibit the secretion of gastrin and increase the secretion of the mucous lining of the stomach, providing a buffer.
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3
Q
  1. what is gastrin and why would we want to inhibit it?
A
  1. a peptide hormone that enhances gastric mucosal growth, gastric motility, and secretion of hydrochloric acid (HCl) into the stomach.
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4
Q
  1. Name 4 H2 blockers, and where do they work:
  2. name a prostaglandin and where is works:
  3. name 5 antacids and where they work:
A
  1. cimetidine, famotidine, nizatidine, ranitidine. They work on the stomach’s parietal cells
  2. misoprostol. Works in stomach
  3. aluminum and calcium salts, magaldrate, magnesium salts, sodium bicarbonate. Work in stomach.
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5
Q
  1. Name 5 proton pump inhibitors, and where do they work in the body?
  2. Name a pancreatic enzyme
  3. Name the antipeptic agent that works on the duodenum
A
  1. esomeprazole, lansoprazole, omeprazole, pantoprazole, rabeprazole. Work on the stomach
  2. pancrelipase
  3. sucralfate
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6
Q
  1. What is the action of H2 antagonists?
  2. What are H2 blockers indicated for?
  3. What is Zollinger - Ellison syndrome?
  4. What are the adverse effects of H2’s
  5. What are the nursing considerations for H2’s?
A
  1. Selectively block histamine 2 receptors leading to reduction in gastric acid and pepsin.
  2. short-term tx of active duodenal ulcers or benign gastric ulcers. Treatment of Zollinger - Ellison. Prophylaxis of stress-induced ulcers, upper GI bleeds, GERD, heartburn, sour stomach.
  3. A syndrome of excess acid secretion
  4. GI and CNS effects, hypotension, and cardiac arrhthmias
  5. Biggest is allergy. Look for History/physical, impaired renal/hepatic, skin, pregnancy, lactation, neuro sta, cardiopulmonary
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7
Q
  1. what does SCAM stand for?
  2. Aside from being an antacid, what else does milk of magnesia do?
  3. What is the action of antacids?
  4. Indication
  5. contraindication:
  6. cautions:
  7. Should other meds be taken with antacids?
A
  1. acronym or for antacids. Sodium bicarb, Calcium carbonate, Aluminum salts, Magnesium salts
  2. laxative
  3. immediately neutralizes stomach acid.
  4. symptomatic relief of upset stomach associated with hyperacidity and hyperactivity
  5. allergy
  6. GI obstruction and conditions exacerbated by electrolyte imbalance
  7. NO!
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8
Q
  1. What are the adverse effects of antacids (7)?
  2. T or F, antacids mess with the efficacy of other drugs?
  3. Can we take antacids with heart failure?
A 
1. Constipation
Diarrhea 
Upset stomach
Hypercalcemia/ hypophosphatemia
Rebound acidity
Alkalosis
  1. TRUE take 1 hour before other drugs.
  2. No. Nothing OTC is for heart failure
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9
Q
  1. Indications for proton pump inhibitors:
  2. Action of PPIs
  3. Contraindications for PPIs:
  4. Cautions for PPIs:
  5. Drug to drug (on test):
A
  1. Heartburn
    GERD
    peptic and duodenal ulcer prophylaxis and tx
    Erosive esophagitis
    benign active gastric disease
    Long-term treatment of pathological hypersecretory conditions
  2. suppresses secretion of hydrochloric acid into the lumen of the stomach
  3. allergy
  4. pregnancy and lactation
  5. phenytoin, warfarin, theophylline, clopidogrel. Interacts with many meds, especially blood thinners and breathing meds.
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10
Q
  1. What is Sucralfate?

2. Indications:

A
  1. It’s a GI protectant. Forms a thick layer over ulcers

2. short term management of duodenal ulcers, management of GERD

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11
Q
  1. Name 5 different laxatives:
  2. Describe the 3 types of laxatives (as far as their actions)
  3. What is important for nurses to think about prior to administration of laxatives?
  4. Can castor oil be given to pregnant ladies?
A 
1. Lactulose
Magnesium citrate
Magnesium sulfate
Docusate
Mineral oil
  1. Chemical Stimulants:
    Chemically irritate the lining of the GI tract

Bulk Stimulants:
Cause the fecal matter to increase in bulk

Lubricants
Help the intestinal contents move more smoothly

  1. There could be fecal impaction or obstruction that won’t allow laxatives to do their job
  2. No. They may stimulate contractions
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12
Q
  1. Name a few chemical stimulants:
  2. what is the prototype chemical stimulant?
  3. T or F, chemical stimulants cause dependence?
A
  1. Senna (Senokot): Reliable drug, similar to cascara (OTC)
    Bisacodyl (Dulcolax): Very popular OTC laxative
    Cascara (Generic): Reliable agent that leads to intestinal evacuation
    Castor Oil (Neoloid): Old standby for thorough evacuation of the intestine
  2. Castor oil
  3. yes, cause dependence
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13
Q
  1. Which type of laxative is best used on immobile patients?
  2. Are bulk laxatives absorbed systemically?
  3. contraindications for bulk stimulants:
  4. cautions:
  5. Adverse effects of bulk laxatives:
A
  1. bulk stimulants
  2. no
  3. allergy, acute abdominal disorders
  4. Heart block, CAD, debilitation
    Pregnancy and lactation. Watch out for CHF
  5. diarrhea, abdominal pain, cramping, nausea, dizziness, headache, weakness, sweating, flushing, palpitations, fainting
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14
Q
  1. How do lubricating laxatives work? What is the prototype? Name a couple other examples:
  2. Contraindications:
  3. cautions:
  4. Frequent use of these interferes with absorption of what?
A
  1. Draw more water into GI tract and stimulate increased GI motility without going systemic. Mineral oil is the prototype. Docusate (colace) and gylcerine are others.
  2. Allergies and acute abdominal disorders
  3. pregnancy, lactation, heart block, CAD, and debilitation
  4. diarrhea, abdominal cramping, nausea, dizziness, weakness, headache, sweating, palpitations, flushing, fainting, leakage and staining (with mineral oil).
  5. fat soluble vitamins like, A, D, E, and K.
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15
Q
  1. Name a few osmotic laxatives and the prototype (7):
  2. Which of these is also a med for liver disease to get rid of excess ammonia from the brain?
  3. Contraindications for lactulose:
  4. Cautions for lactulose, magnesium, and polyethylene:
A 
1. Lactulose (Constilac)
Polyethylene glycol electrolyte solution (GoLYTELY)
Magnesium sulfate (Epsom salts)
Magnesium citrate (Citrate of Magnesia)
Magnesium hydroxide (Milk of Magnesia)
Polyethylene glycol (MiraLAX)
Sodium picosulfate with magnesium oxide (Prepopik)
 Magnesium citrate is the prototype
  1. Lactulose (constilac)
  2. appendicitis, acute surgical abdomen, fecal impaction, intestinal obstruction
  3. lactulose: diabetes
    magnesium: renal insufficiency
    polyethylene glycol: seizures
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16
Q
  1. What are the adverse effects of osmotic laxatives?
  2. What are the drug to drug interactions in general for this group, and specifically for magnesium?
  3. How do osmotic laxatives work?
A
  1. GI: diarrhea, abdominal cramping, abdominal bloating, nausea; dehydration: dry mouth, dizziness, light-headedness
    CNS: dizziness, headache, weakness
    Sweating, palpitations, flushing, fainting
    Rectal irritation
  2. Other prescriptions
    Magnesium: neuromuscular junction blockers
  3. They pull water into the intestinal contents, which enlarges bulk and stimulates stretch receptors
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17
Q
  1. What does metoclopramide (Reglan) treat and how does it work?
  2. Does metoclopramide treat post op n/v? What might be a better choice?
A
  1. Treats GERD, gastroparesis, and chemo induced nausea and vomiting. It stimulates the upper GI to increase the rate that food goes into intestines from stomach.
  2. Yes, but ondansetron (Zofran) is better. Metoclopramide is for chemo n/v
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18
Q
      1. Name and describe 4 antidiarrheal drugs and how they work:
A
  1. Bismuth Subsalicylate (Pepto-Bismol): Coats the lining of the GI tract
  2. Crofelemer (Fulyzaq): Symptomatic relief of noninfectious diarrhea in adults on HIV/AIDS antiretroviral medication
  3. Loperamide (Imodium): directly effects the muscle layers of the GI tract; slows peristalsis and allows increased time for absorption of fluid and electrolytes
  4. Opium Derivatives (Paregoric): stops peristalsis and diarrhea
19
Q
      1. Name the 5 groups of cetrally acting antiemetics:
A
  1. Phenothiazines – psych meds that double as antiemetics
  2. Nonphenothiazines (ondasteron, Zofran)
  3. Serotonin (5-HT3) Receptor Blockers
  4. Substance P/Neurokinin 1 Receptor Antagonists
  5. Miscellaneous Group
20
Q
  1. What drug is used to treat PONV and to a lesser degree chemo induced N/V?
  2. Indications:
  3. action:
  4. adverse:
A
  1. Ondansetron (Zofran)
  2. prevention of post-op AND chemo induced nausea and vomiting (mostly Post OP.
  3. Reduces responsiveness of the nerve cells in the CTZ to circulating chemicals that induce vomiting
  4. Drowsiness
    Fatigue
    Restlessness
    Extrapyramidal symptoms
21
Q
      1. name 3 other miscellaneous agents that treat nausea and vomiting:
A
  1. Dronabinol (Marinol) and nabilone (Cesamet)
    Contain the active ingredient of cannabis. Used for cancefr patients. One of last choices for n/v
  2. Hydroxyzine (Vistaril)
    May suppress cortical areas of the CNS
  3. Trimethobenzamide (Tigan)
    Not associated with as much sedation and CNS suppression as other agents
22
Q
  1. Name the prototype anti-diarrheal:
  2. Indications:
  3. contra:
  4. caution:
  5. adverse:
A
  1. Loperamide (immodium)
  2. reduce volume of discharge from ileostomies, relieve acute, chronic, and traveler’s diarrhea.
  3. allergy
  4. preg/lac, hx of GI obstruction, hx of acute GI conditions, diarrhea due to poisoning or infections
5. Constipation
Abdominal distension
Abdominal discomfort
Nausea
Dry mouth
Toxic megacolon
Fatigue
Weakness
Dizziness
23
Q
  1. What is cytotec (misoprostol)? What are its indications?

2. Action:

A
  1. Its a prostaglandin used to treat ulcers (as well as labor induction). Prevents gastric injury from NSAIDs
  2. decreases gastric acid secretion by acting as a prostaglandin
24
Q
      1. Name and describe the 4 major activities of the GI system:
A
  1. Secretion: enzymes, bicarb, and mucus
  2. Absorption: of water and almost all nutrients needed by the body
  3. Digestion: of food into usable components
  4. Motility: movement of food and secretions through the system
25
Q
  1. What is trichamoniasis?
  2. What happens when we drink alcohol with antabuse?
  3. What is the most dangerous type of plasmodium (malaria)?
A
  1. A parasitic sexually transmitted infection coming from Africa. Women have smelly discharge and men may not have any symptoms.
  2. Disulfiram reaction. Involves flushing of the face, headache, nausea, vomiting, chest pain, weakness, blurred vision, mental confusion, sweating, choking, breathing difficulty, and anxiety
  3. plasmodium falciparum
26
Q
  1. What was the first drug found for tx of malaria? Is it still used today? Name a few other antimalarials:
  2. When should malaria prophylaxis be initiated? Why?
  3. what are contraindications for antimalarials?
  4. Are antimalarials effective against covid?
A 
1. Quinine (Qualaquin)
First drug found effective in treatment of malaria
Absent from the market for a while but now available for treating uncomplicated malaria. 
Hydroxychloroquine (Plaquenil)
Chloroquine (Aralen)
Mefloquine (generic)
Primaquine (generic)
Pyrimethamine (Daraprim)
  1. prior to travel because if infection gets in, it will destroy the liver which is needed to metabolize the antimalaria meds!
  2. Known allergy, liver disease, alcoholism, pregnancy and lactation
  3. NO
27
Q
  1. What does metronidazole (Flagyl) treat?
  2. Name the only antiprotozoal that is nebulized and breathed in, and what it treats:
  3. Regarding antihelminth meds, what is important?
A
  1. Treats amebiasis, trichomoniasis, and giardiasis. Commonly prescribed for GI infections
  2. Pentamidine (Pentam 300, NebuPent). Treats PCP, trypanosomiasis, and leishmaniasis
  3. Drugs should be selectively toxic against parasite and not the host
28
Q
  1. What are the 2 categories of worms?
  2. Name the nematodes (roundworms):
  3. Name the platyhelminths (flatworms):
  4. Which of these invade the intestines?
  5. What is River Blindness?
  6. What is the tx for River Blindness?
A
  1. Nematodes (roundworms) and Platyhelminths (flatworms).
  2. Pinworms, whipworms, threadworms, Ascaris, and hookworms
  3. Cestodes (tapeworms) and flukes (schistosomes)
  4. All
  5. Onchocerciasis. It’s a tropical disease caused by worms and transmitted through black fly bites
  6. Ivermectin (Stromectol)
29
Q
  1. Name the most commonly used anti-helminth medication:
  2. Which antihelminth is contraindicated for kids <2y.o?
  3. What are the contraindications of all anti-helminths?
A
  1. Mebendazole (Emverm, Vermox)
  2. Pyrantel (Antiminth, Pin-Rid, Pin-X, Reese’s Pinworm). OTC med
  3. allergy, pregnancy, lactation, renal and hepatic disease
30
Q
  1. What is the most deadly side effect of chemo?
  2. what are the effects of bone marrow suppression? Which of these is most dangerous?
  3. What do we advise our patients against when taking chemo?
  4. which vital is a priority when someone is having bone marrow suppression?
A
  1. bone marrow suppression
  2. infection and anemia. LOw rbc, low wbc (<4000 is leukopenia), low platelets (<100,000 is thrombocytopenia). Leukopenia is most dangerous.
  3. avoid cuts (like shavng), don’t bear down to poop, avoid falls
  4. Temp. If over 103, person is having an infection
  5. reverse isolation, no flowers, pets, plants, no sick visitors
31
Q
  1. What happens to blood sugar on chemo?
  2. are rectal temps allowed when a person is on chemo?
  3. what should the nurse do if patient gets nauseated while on chemo?
A
  1. hyperglycemia because chemo makes us less sensitive to insulin
  2. no. bleed risk
  3. stop infusion. flush line. admin of zofran
32
Q
  1. What is important for the nurse to consider for the patient undergoing chemo (Cisplatin, for example), as far as N/V, mouth care, fluid intake, and energy levels?
  2. Since chemo is nephrotoxic, it is important to monitor …………… . What do we assess for to ensure proper hydration?
A
  1. Antiemetics prophylactically
    Saline rinse before and after meals
    Increase fluid intake for the next 3 days
    Teach the patient how to manage fatigue
  2. BP
    Turgor
    Urine output
33
Q
  1. Name 4 chemo drugs:

2. Which one does not cause bone marrow suppression? Can it be used in combo with other drugs?

A
  1. doxorubicin hydrochloride, cisplatin, cyclophosphamide (cytoxan), and Vincristine (Oncovin)
  2. Vincristine (Oncovin). Yes.
34
Q
  1. Anaplasia-
  2. Autonomy-
  3. Metastasis-
  4. Angiogenesis-
A
  1. lose cellular differentiation & organization, unable to function normally
  2. cells grow without usual homeostatic restrictions that regulate cell growth, allows cells to form a tumor
  3. cancer cells travel from place of origin to develop new tumors in other areas
  4. abnormal cells release enzymes that generate blood vessels and supply oxygen and nutrients to cells for growth, cancer cells rob host cells of energy and nutrients to block normal lymph
35
Q
  1. What is the hormone of pregnancy?
  2. When can a woman have a baby after contraceptives?
  3. What are the side effects of raloxifene?
  4. What med or class of meds is contraindicated with Viagara (sildenafil)?
A
  1. Hcg
  2. 3 mos
  3. DVTs
  4. nitrates
36
Q
  1. Name 5 contraceptives:
  2. What is the biggest dangerous adverse effect of hormonal contraceptives?
  3. What is contraindicated with hormonal contraceptives?
  4. What habit increases risk of DVT?
A 
1. Progestins are used as contraceptives
o	Progesterone
o	Drospirenone
o	Etonogestrel
o	Lovenogestrel
o	Medroxyprogesterone
  1. DVTs
  2. DVT
    o Pregnancy
    o Lactation
    o Smoking
  3. smoking
37
Q
  1. Name fertility 4 drugs, and what would be contraindicated?
  2. What is the adverse effect of these drugs?
A 
1. o	Cetrorelix
o	Chorionic gonadotropin
o	Clomiphene
o	Menotropins
DVT would be contraindicated
  1. mulitple fetuses
38
Q
  1. What are the nursing interventions for a pitocin infusion?
  2. What can be given to relax the uterus?
  3. When should this infusion be discontinued?
  4. What drug can be given to slow contractions?
  5. What are 2 adverse effects of oxytocin?
A
  1. Monitor contractions ( < 60 seconds, every 2-3min)
    Monitor maternal and fetal BP & pulse
  2. Magnesium can relax uterus
  3. D/C infusion if contractions > 90 seconds
  4. terbutaline
  5. uterine hypertonicity and severe water intoxication (oxytocin has an antidiuretic effect)
39
Q
  1. what are the side effects of testosterone (8)?
A 
1. o	Fatigue
o	Acne
o	Deep voice
o	Oily skin
o	Hepatocellular carcinoma
o	High cholesterol
o	Polycythemia
o	Premature epiphyseal closure
40
Q
  1. what vaccines are given to baby < 1 y.o (7)?

2. Should immunosuppressed patients have live vaccines? What can they have?

A 
1. o	D-Tap
o	Rotavirus
o	Poliovirus
o	Meningitis
o	Haemophilus B
o	Hep B
o	Hep A

They can’t have MMR, Varicella, or HPV

  1. NO! Flu and pneumonia
41
Q
  1. What are the indications for marijuana (7)?

2. Can CBD help relieve seizures?

A 
1. o	Pain
o	Inflammation
o	Muscle spasm
o	CINV
o	Slow cancer growth
o	Seizures
o	anxiety
  1. yes (people have moved to weed friendly places for this reason)
42
Q
  1. What are the instructions for use of the Epi-Pen?
A
  1. one shot in thigh (stabbing motion)
    o repeat q 10-15 mins until symptoms resolve
    o hold for 10 seconds
43
Q
  1. What are the side effects of herbal supplements (4)?

2. What is contraindicated with estrogen (5)?

A
  1. hypoglycemia for diabetics
    o St. John’s wort interacts with SSRI’s - serotonin syndrome
    o Bleeding
    o Cardiac / BP
2. Estrogen dependent cancer (breast etc)
Idiopathic vaginal bleeding
Pregnancy and lactation
Smoker
HTN

Pharm 2 (4 decks)

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