Final Flashcards
What age do you start change how you pull the ear to an adult direction from child direction? What else do you do when administering ear drops?
around age 8
massage the tragus
Ear drops are best for what type of infection? example?
otitis externa
ciproflaxacin w/dexamethasone
Why do you occlude tear duct when adminstering eye drops?
reduce systemic reactions. For example a beta bocker can cause cholinergic effects so keeping them in the eye will help prevent the effects
What is the main indication for timolol? does it take a while to take effect? Side effects?
open-angle glaucoma
yes, it’s gradual
hypotension, bradycardia
What are physical symptoms of bone marrow suppression?
anemia
infection
bleeding
What are the 4 immunostimulant classes and drug examples for each?
interferons: interferon alpha 2b
interleukins: aldesleukin
conony-stimulating factors: filgrastim
vaccines: hep B vaccine
What are the 4 immunosuppressant classes and drug examples for each?
calcineurin inhibitors: cyclosporine
cytotoxic/antimetabolites: azathioprine
antibodies: basiliximab
corticosteroids: hydrocortisone
What is the drug class for aldesleukin? what does it treat and how? What are the AE? Nursing considerations?
interleukin
cancer, it increases T, B and WBC activity like they’re on caffeine
capillary leak (anemia, low BP), low platelets, flu-like
Watch CBS, diet, platelet count, elevate legs and ted hose for capillary leak, only given IV and IM
What is the main purpose of prescibing filgrastim? What is it’s worst AE?
stimulates neutrophil production to offset the effects of drugs that have suppressed the immune system
bone pain
What med is used for both cancer and the treatment of hepatitis C? Why is it not given PO? How is it going to make the client feel?
interferon alpha 2b
the proteins would be metabolized
Crappy–flu-like, hair loss, bone marrow suppression
What immunosuppressants are used as a prophylaxis for transplant rejection? What else are they indicated for? What are the AEs? Why is a difficulty for clients with this med?
cyclosporine/tacrolimus
azathioprine
IBD, Crohn’s
increased risk of cancer/lymphoma, bone marrow supression, resistant HTN
must be on it for life, compliance
What is a med in the monoclonal antibody class of immunosupressants? Is it a broad or targeted therapy? What is it indicated for?
basiliximab
targeted
prophylaxis of kidney transplant rejection
Which vaccines should be avoided in immunosuppressed clients?
attenuated live vaccines
How long does it take for immunoglobulins to take effect? Immunizations? How long do they last?
passive immunity that takes effect immediatley, only lasts a few months
active immunity that takes effect in a few weeks, can last years or a lifetime, may need a booster
What are the live vaccines (3)?
rotavirus
MMR
varicella
What are inactive vaccines (3)?
tatanus
hepatitis B
polio
what are the recombinant vaccines (4)?
meningococcal
pneumococcal
herpes zoster
HPV
What is the immunoglobulin vaccine highlighted this term? When is it used?
Rhogam
used in rH-negative pregnant women to prevent hemolytic anemia in subsequent pregnancies
What are the 5 highlighted antineoplastic drugs? CVTDM
cyclophosphamide
vincristine
tamoxifin
doxorubicin
methotrexate
What antineoplastic is used specifically for breast cancer? What AE must be monitored? Clients are at an increased risk for what? What should they report?
tamoxifen
DVT, menopausal symptoms
uterine cancer
unusual uterine bleeding
What is the MOA of methotrexate? what must be given to offset this? What are the 4 big AEs of methotrexate?
blocks folic acid conversion
leukovorin (folic acid)
hepatotoxicity, bone marrow suppression, GI bleeds, teratogenic
What antineoplastic med is known to cause neuropathies? What are 3 ways neuropathies can present?
vincristine
hypoesthesia (reduced sensation)
hyperesthesia (over sensation)
paraesthesia (pins and needles)
What is the antineoplastic known to cause congestive heart failure? As a result, what must be followed with this med? Along with typical AE, what would be good for the patient to know about one of the side effects?
doxorubicin
has a total lifetime amount a person can receive. Must be monitored for lifetime use
will turn the urine red/orange
What antineoplast med can cause hemmorraghic cystitis? What should the nurse watch for?
cyclophosphamide
cystitis, blood in urine
What occurs in the body when the alpha 1 receptor is acted upon (agonist)?
vasoconstriction
increased peripheral resistance (in terms of blood flow)
increased blood pressure
mydriasis (dilated pupil)
bladder sphincters close
What occurs the the alpha 2 receptors are acted upon (agonist)?
inhibits norepinephrine release
inhibits ACh release
inhibits insulin release
What occurs when the beta 1 receptors are acted upon (agonist)? *Remember 1 heart
increased heart rate
increased contractility
increased renin
increased lyposysis
What occurs when the beta 2 receptors are acted upon (agonist)? *Remember 2 lungs
vasodilation
decreased peripheral resistance
bronchodilation
increased glycogenolysis and glucagon release
relaxes uterine muscle
What are the functions of the neurotransmitter Ach? Epinephrine? Norepinephrine? Dopamine?
parasympathetic response
memory
skeletal muscle
sympathetic response
vasoconstriction
increase BP
treats heart failure
increased inotropy
increased chronotropy
What are alpha 1 agonist meds? Antagonist? What are the major tissues affected?
phenylephrine
norepinephrine
epinephrine
prazosin
smooth muscle
sphincters
What are alpha 2 agonist meds? What is the main tissue they act upon?
epinephrine
clonidine
nerve endings
What is the beta 1 agonist med? Antagonist? What are the main tissues acted upon?
epinephrine
propranolol
cardiac muscle, kidney
What are beta 2 agonists? Antagonist? What are the mains tissues acted upon?
epinephrine
terbutaline
propranolol
smooth muscle, bronchi, liver skeletal muscle
What are AEs for alpha 1 agonist phenylephrine? What should be instructed then? What is the drug class?
rebound nasal congestion, hypotension
only use nasal spray 3-5 days to prevent rebound congestion
vasoconstrictor
What is the 1-generation nonselective Beta antagonist (1 and 2)? What are the AEs of note? Who should not be using this type of med? Why?
propranolol
bradycardia and fatgue
asthmatics/COPD and DM
it is nonselective and restricts bronchi
masks hypoglycemia symptoms
What is the apha 1 antagonist? What is it used for? Why? AEs of note?
prazosin
HTN, BPH, Raynaud’s
vasodilator, opens the vessels
OH, 1st dose phenomenon, reflex tachycardia
What anticholinergiti is used for bladder control? What patient teaching would be helpful? Who would this med be contrainticated for? Why?
oxybutynin
increase fiber and fluids because of anticholinergic effects such a constipation
paralytic ileus, GI obstruction
It slows down the body’s response and can aggravate a symptom where motility is already affected
What helps relieve urinary retention? Why/how does it do that?
bethanechol
it is a cholinergic agonist so it relaxes the bladder muscle
What is the anticholinergic med used as an antidote for nerve gas and insecticides? Who is it contraindicated in? Why?
atropine
acute closed-angle glaucoma
the relaxing of vessels can exasperate the problem
What is an Ach inhibitor used to treat myasthenia gravis?
pyridostigmine
What cholinergic drug blocks neuromuscular receptors? How is it used then? Does it have antichoinergic AEs? In addition to what?
succinylcholine
as a surgical muscle relaxant in conjunction with an pain killer
manage secretions in palliative patients
yes
malignant hypothermia
What is the chemical nature of ammonium chloride? What does that make it useful to treat? If too much is adminishter what is the risk?
it’s an acid
metabolic alkalosis to restore pH, acidifying urine
acidosis
What is used to treat metabolic acidosis in the duodenum? What electrolyte imbalance can it help to correct as well?
sodium bircarbonate
hyperkalemia
What is the high-pressure, osmotic diuretic mannitol good for? What are AE?
high-pressure issues such as
intracranial pressure
intraocular pressure
hypovolemia, electrolyte imbalances, dizziness, shock, HF
What is the loop diuretic? does it cause hypo or hypervolemia (AE)? What is it indicated for? What is the significant AE to consider?
furosemide
HYPOvolemia
CHF, pulmonary edema, edema from cirrhosis, CKD
tinnitis, hearing loss, ototoxicity
What is hydrochlorothiazide diuretic most commonly indicated for? What is a contraindication of note? Can this med cause hypo or hypervolemia and sunsequent effects such as OH, electrolyte imbalances, etc.?
HTN
sulfa sensitivity, gout
HYPOvolemia
What is the potassium sparing diuretic? What diuretic does it most commonly counteract? What is it’s AE of note? What organ are we worried about when we’re messing with potassium?
spironolactone
furosimide
hyperkalemia
heart
What is the big thing to remember when administering potassium chloride?
DO NOT PUSH
What is given with low magnesium levels and preclampsia or preterm labor? AEs? Who is it contraindicated in?
magnesium sulfate
DTR, diarrhea, hypotension
cardiac and CKD
What are 4 meds for gestational HTN? MNHL
methyldopa
nifedipine
hydralazine
labetalol
What is albuterol indicated for? What receptor does it affect? SE
asthma, COPD
Beta 2 agonist
like taking an energy drink–palpitations, tachycardia, increased BP, HA
What med can help with bronchodilation but acts a lot like caffeine? Why is it rarely used?
theophylline
Has a narrow therapeutic window and can quickly cause N/V and tachycardia
What is an anticholinergic used for bronchospasms and emphysema? AEs?
ipratropium
Dry mouth, constipation, blurry vision (dilation), urinary retention, tachycardia,
When cromolyn is added to athma treatment, what does it do in the body?
stabilizes mast cells and calms the bronchospasms
What is the reason for addind a steriod to asthma treatment? What are two med examples? Is this a daily treatment or PRN? What can is cause? How can you prevent it? What else can it cause?
antiinflammatory
fluticasone, beclomethasone
daily
oral candidiasis
wash the mouth out
hoarse voice (dysphonia)
How is monteleukast used as a supplemental med for COPD and asthma? is it used acutly or daily? What is the concerning risk with this med?
it blocks the leukotriene receptors to block inflammation
daily
SI, psychiatric events
Why is fexfofenidine (allegra) a better choice than diphenhydramine for seasonal allergies?
does not have sedating effects because it is second generation and does not cross the blood-brain barrier
acetylcysteine is the antidote for acetminphen, but what else is it good for? What is gross about it?
breaking up thick viscous secretions with cystic fibrosis
rotten egg odor
In terms of cholesterol, which needs to be lower? Higher (good)?
LDL
HDL
What is the first-line med to lower LDL? What is the biggest risk? Which organ are we especially concerned about monitoring? What food must you avoid?
atorvastatin
muscle breakdown leading to rhabsomyolysis
liver, LFTs
grapefruit juice
What vitamin/med is good to add to lower triglycerides? What is added 30 minutes before to prevent GI side effects?
Vit B3: nicotinic acid or niacin
aspirin 30 minutes before
What meds affect gout?
hydrochlorithiazide
niacin (B3)
How does cholestyramine help lower the amount of cholesterol? What else is affected? What other drug works similarly?
blocks it from being absorbed by increasing bile production and removing it through feces
fat soluble vitamins
ezetimibe
What is ACE inhibotr the acronym for? What does it block? What does that do?
angiotensin converting inhibitor
it block angiotensin from converting to angiotensin II
opens up the vessels
What are HTN ACE inhibitor durgs? What is the notable AE? What happens if this AE gets worse? Who is it contraindicated in? What electrolyte imbalance does it cause?
captopril, “pril”s
cough from increased bradykinin
angioedema (similar to anaphylaxis)
hyperkalemia
pregnancy
Which HTN meds block the angiotensin receptor rather than inhibit the angiotensin itself (like the “pril”s do)? What AE does this prevent? Are the other AEs similar to the “pril”s? What are they?
losartan (the ARBs, “sartan”s)
the cough from “prils”s
yes
hyperkalemia, angioedema, contraindicated in pregancy, fatigue, dizziness, HA
What are 3 Beta 1 blockers? What organ do the affect? MAE
metoprolol
atenolol
esmolol
heart (remember: 1 heart, beta 1)
What are 2 nonselective beta blockers (beta 1 and 2)?
propranolol
nadolol
What are 2 alpha and beta blockers?
carvedilol
labetalol
What is the primary ability of metroprolol? If you have reduced the hear rate what AEs would you then expect?
reduce HR in HTN
a fib, angina, reflex tachycardia
fatigue, dizziness, bradycardia, reduced contractility
What is the calcium channel blocker that aids in a fib, angina and HTN control? why?
verapamil
it affects both the blood vessels and the heart because it is a nondihydropyradine
Clonidine is similar to what 2 other meds? What receptor does it affect? How? What else would happen if you took away norepinephrine?
guanfacine, methydopa
alpha 2 agonist
turns OFF the norepinephrine, which decreases heart rate
OH, bradycardia, depression, sedation, dry mouth
What is the reason to use hydralazine? How does it work? As a result, what are the AEs from the vasodilation?
HTN crisis or gestational HTN (not a first line drug so it is for persistant HTN conditions)
It is a tremendous vasodilator
reflex tachycardia, hypotension, HA, flushing, peripheral edema, palpitation, lupus-like syndrome
What is another med used for HTN crisis? What is it similar to with it’s MOA and AEs? What is the 1 unique SE that must be monitired?
nitroprusside
hydralazine
risk of thiocyanate poisoning
What is the treatment for a heart attack?
oxygen
aspirin
nitroglycerin
morphine
What is nitroglygerin for? What cannot be taken with it?
angina
sildenafil (viagra)
What does an inotrope affect? What med is an inotrope for advanced CHF?
inotrope: contractility
milrinone
What drug class can be used as an antidysrhythmic? Examples? How does it affect the heart?
beta blockers
atenolol
it is a negatave inotrope, chromotrope and dromotrope
amiodarone is used for what? What is the strange effect?
atrial and ventricular dysrythmias
ventricular tachycardia and fib
blue face
What are the 2 CCBs good for a fib and arrythmias? How do they affect other smooth muscle besides the heart
verapamil
ditiazam
GI: constipating
What is used in emergency situations for supraventricular tachycardia? What are the AEs of note? Is it short acting or long?
adenosine
sense of impending doom, flushing, dyspnea
very short while it resets the heart
What is digoxin used for? What is the risk with this med? What is used if there is a digoxin toxicity? What are the S/S of the toxicity?
afib, decreased CO and HF
tanking potassium and causing hypokalemia
digibind
halos and vision changes
What med helps to decrease the production of aqueous humor with open-angle glaucoma? What is the drug class? How long does it take before improvement?
timolol
beta blocker
4-6 weeks
What medication opens of the canels to let more aquesous humor out with open angle glaucoma? What is the weird side effect?
lantanaprost
pigmentation of eyelashes and eyelids
dorzolamide
What happens if clients are not compliant with glaucoma eye drops?
1 cause of blindness in people over 65
risk of permanent blindness
What med is used for otitis media? Otitis exyerna
amoxacillin
ciprofloxacin/dexamethasone drops
What is the med for metal toxicity? What is the route?
dimercaprol
IM, multiple times
What is the contraindication with vitamin A?
pregnancy
That is vitamin B1? What is an AE of B1 deficiency? Who is at risk?
thiamine
Warrneke Korsikoff syndrome
alcoholics
What is vitamin B12? What is its use? Whose at risk for deficiency?
cyanocobalamin
RBC production and nervous system
vegans, alcoholics, upper GI issues (not lower GI, absorption doesn’t happen there), Crohn’s, stomach surgery
What is the rule of administration with iron? What does it do to stool? If liquid what do they use to consume? why?
wants to be absorbed with vitamin C
do not give with other food or meds
constipations, dark and black and hard (not tarry)
straw, it can discolor teeth
What is used for weight loss? What absorption does it block? What are AE?
orlistat
fat soluble vitamins
diarrhea, greasy stool, wet farts
What is the term for heartburn like sysptoms?
dyspepsia
What are 3 types of antacids? What are the side effect for each? Are they PRN? What does it do to other meds?
aluminum, magnesium and calcium-based
mag based: diarrhea
aluminum or calcium based: constipation
yes, they do not affect the stomach in any way, they just neutralize the acid
affects their absorption. Do not take them together
What drug class is omeprazole and other “azole”s? What do they treat? What are the SE?
PPI
GERD, PU, h. pylori (with antibiotics)
risk for nutritional deficiencies with calcium and iron, infections
What is metoclopramide used for? How does it work? What is the concerning AE and contraindication
?
persistent nausea and vomiting, the type with chemotherapy and post-op, hyperemesis
stimulates the muscles of the GI tract to push food through more quickly
dystonia symptoms, Parkinson’s
Who is ondansetron contraindicated in?
heart issue and dysrhythmias, QT prolongation
Whatis pancrelipase used for? Who cannot use it?
cystic fibrosis helps break down food
pork sensitivity
What can reintroduce good bacteria into the GI tract? What can it help protect against? Who is it contraindicated in?
probiotic
C Diff
immunocompromised
What is sucralfate used for? What does it do? When should it be taken?
ulcers, GERD
stimulates a coating to protect the stomach
1 hour before eating
What is used for infertility? By doing what?
clomiphene
increase egg release
What is used for ulcers and inducing labor?
misoprostol
What is the big contraindication with estrogen?
breast cancer, DVT
Is testonterone a schedule drug? Why?
yes
potential for abuse
What is used for BPH and alopecia? What is in contraindicated in? Will it affect blood pressure?
finasteride
pregnancy
no, does not affect pressure
What drug is good for HTN and BPH? What class is the med? Does it affect the heart rate? Will it cause hypotension?
tamsulosin
alpha 1 antagonist, causes vasodilation
no, it only affects the vessels does not affect changes in the heart
yes, this is the only way it will affect the heart
Does sildenafil cause vasodilation? Who should not use it?
yes
nitroglycerin use and low blood pressure
What blocks H2 receptors to decrease stomach acid production to treat GERD, h. pylori and PU?
famotidine
What is the risk of smoking and contraceptions?
DVT
