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Pharm II > Final > Flashcards

Final Flashcards

1
Q

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?

A

around age 8

massage the tragus

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2
Q

Ear drops are best for what type of infection? example?

A

otitis externa

ciproflaxacin w/dexamethasone

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3
Q

Why do you occlude tear duct when adminstering eye drops?

A

reduce systemic reactions. For example a beta bocker can cause cholinergic effects so keeping them in the eye will help prevent the effects

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4
Q

What is the main indication for timolol? does it take a while to take effect? Side effects?

A

open-angle glaucoma

yes, it’s gradual

hypotension, bradycardia

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5
Q

What are physical symptoms of bone marrow suppression?

A

anemia
infection
bleeding

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6
Q

What are the 4 immunostimulant classes and drug examples for each?

A

interferons: interferon alpha 2b

interleukins: aldesleukin

conony-stimulating factors: filgrastim

vaccines: hep B vaccine

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7
Q

What are the 4 immunosuppressant classes and drug examples for each?

A

calcineurin inhibitors: cyclosporine

cytotoxic/antimetabolites: azathioprine

antibodies: basiliximab

corticosteroids: hydrocortisone

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8
Q

What is the drug class for aldesleukin? what does it treat and how? What are the AE? Nursing considerations?

A

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

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9
Q

What is the main purpose of prescibing filgrastim? What is it’s worst AE?

A

stimulates neutrophil production to offset the effects of drugs that have suppressed the immune system

bone pain

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10
Q

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?

A

interferon alpha 2b

the proteins would be metabolized

Crappy–flu-like, hair loss, bone marrow suppression

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11
Q

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?

A

cyclosporine/tacrolimus
azathioprine

IBD, Crohn’s

increased risk of cancer/lymphoma, bone marrow supression, resistant HTN

must be on it for life, compliance

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12
Q

What is a med in the monoclonal antibody class of immunosupressants? Is it a broad or targeted therapy? What is it indicated for?

A

basiliximab

targeted

prophylaxis of kidney transplant rejection

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13
Q

Which vaccines should be avoided in immunosuppressed clients?

A

attenuated live vaccines

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14
Q

How long does it take for immunoglobulins to take effect? Immunizations? How long do they last?

A

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

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15
Q

What are the live vaccines (3)?

A

rotavirus
MMR
varicella

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16
Q

What are inactive vaccines (3)?

A

tatanus
hepatitis B
polio

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17
Q

what are the recombinant vaccines (4)?

A

meningococcal
pneumococcal
herpes zoster
HPV

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18
Q

What is the immunoglobulin vaccine highlighted this term? When is it used?

A

Rhogam

used in rH-negative pregnant women to prevent hemolytic anemia in subsequent pregnancies

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19
Q

What are the 5 highlighted antineoplastic drugs? CVTDM

A

cyclophosphamide
vincristine
tamoxifin
doxorubicin
methotrexate

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20
Q

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?

A

tamoxifen

DVT, menopausal symptoms

uterine cancer

unusual uterine bleeding

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21
Q

What is the MOA of methotrexate? what must be given to offset this? What are the 4 big AEs of methotrexate?

A

blocks folic acid conversion

leukovorin (folic acid)

hepatotoxicity, bone marrow suppression, GI bleeds, teratogenic

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22
Q

What antineoplastic med is known to cause neuropathies? What are 3 ways neuropathies can present?

A

vincristine

hypoesthesia (reduced sensation)
hyperesthesia (over sensation)
paraesthesia (pins and needles)

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23
Q

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?

A

doxorubicin

has a total lifetime amount a person can receive. Must be monitored for lifetime use

will turn the urine red/orange

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24
Q

What antineoplast med can cause hemmorraghic cystitis? What should the nurse watch for?

A

cyclophosphamide

cystitis, blood in urine

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25
Q

What occurs in the body when the alpha 1 receptor is acted upon (agonist)?

A

vasoconstriction
increased peripheral resistance (in terms of blood flow)
increased blood pressure
mydriasis (dilated pupil)
bladder sphincters close

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26
Q

What occurs the the alpha 2 receptors are acted upon (agonist)?

A

inhibits norepinephrine release
inhibits ACh release
inhibits insulin release

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27
Q

What occurs when the beta 1 receptors are acted upon (agonist)? *Remember 1 heart

A

increased heart rate
increased contractility
increased renin
increased lyposysis

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28
Q

What occurs when the beta 2 receptors are acted upon (agonist)? *Remember 2 lungs

A

vasodilation
decreased peripheral resistance
bronchodilation
increased glycogenolysis and glucagon release
relaxes uterine muscle

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29
Q

What are the functions of the neurotransmitter Ach? Epinephrine? Norepinephrine? Dopamine?

A

parasympathetic response
memory
skeletal muscle

sympathetic response

vasoconstriction
increase BP

treats heart failure
increased inotropy
increased chronotropy

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30
Q

What are alpha 1 agonist meds? Antagonist? What are the major tissues affected?

A

phenylephrine
norepinephrine
epinephrine

prazosin

smooth muscle
sphincters

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31
Q

What are alpha 2 agonist meds? What is the main tissue they act upon?

A

epinephrine
clonidine

nerve endings

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32
Q

What is the beta 1 agonist med? Antagonist? What are the main tissues acted upon?

A

epinephrine

propranolol

cardiac muscle, kidney

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33
Q

What are beta 2 agonists? Antagonist? What are the mains tissues acted upon?

A

epinephrine
terbutaline

propranolol

smooth muscle, bronchi, liver skeletal muscle

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34
Q

What are AEs for alpha 1 agonist phenylephrine? What should be instructed then? What is the drug class?

A

rebound nasal congestion, hypotension

only use nasal spray 3-5 days to prevent rebound congestion

vasoconstrictor

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35
Q

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?

A

propranolol

bradycardia and fatgue

asthmatics/COPD and DM

it is nonselective and restricts bronchi
masks hypoglycemia symptoms

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36
Q

What is the apha 1 antagonist? What is it used for? Why? AEs of note?

A

prazosin

HTN, BPH, Raynaud’s

vasodilator, opens the vessels

OH, 1st dose phenomenon, reflex tachycardia

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37
Q

What anticholinergiti is used for bladder control? What patient teaching would be helpful? Who would this med be contrainticated for? Why?

A

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

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38
Q

What helps relieve urinary retention? Why/how does it do that?

A

bethanechol

it is a cholinergic agonist so it relaxes the bladder muscle

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39
Q

What is the anticholinergic med used as an antidote for nerve gas and insecticides? Who is it contraindicated in? Why?

A

atropine

acute closed-angle glaucoma

the relaxing of vessels can exasperate the problem

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40
Q

What is an Ach inhibitor used to treat myasthenia gravis?

A

pyridostigmine

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41
Q

What cholinergic drug blocks neuromuscular receptors? How is it used then? Does it have antichoinergic AEs? In addition to what?

A

succinylcholine

as a surgical muscle relaxant in conjunction with an pain killer
manage secretions in palliative patients

yes

malignant hypothermia

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42
Q

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?

A

it’s an acid

metabolic alkalosis to restore pH, acidifying urine

acidosis

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43
Q

What is used to treat metabolic acidosis in the duodenum? What electrolyte imbalance can it help to correct as well?

A

sodium bircarbonate

hyperkalemia

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44
Q

What is the high-pressure, osmotic diuretic mannitol good for? What are AE?

A

high-pressure issues such as
intracranial pressure
intraocular pressure

hypovolemia, electrolyte imbalances, dizziness, shock, HF

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45
Q

What is the loop diuretic? does it cause hypo or hypervolemia (AE)? What is it indicated for? What is the significant AE to consider?

A

furosemide

HYPOvolemia

CHF, pulmonary edema, edema from cirrhosis, CKD

tinnitis, hearing loss, ototoxicity

46
Q

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.?

A

HTN

sulfa sensitivity, gout

HYPOvolemia

47
Q

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?

A

spironolactone

furosimide

hyperkalemia

heart

48
Q

What is the big thing to remember when administering potassium chloride?

A

DO NOT PUSH

49
Q

What is given with low magnesium levels and preclampsia or preterm labor? AEs? Who is it contraindicated in?

A

magnesium sulfate

DTR, diarrhea, hypotension

cardiac and CKD

50
Q

What are 4 meds for gestational HTN? MNHL

A

methyldopa
nifedipine
hydralazine
labetalol

51
Q

What is albuterol indicated for? What receptor does it affect? SE

A

asthma, COPD

Beta 2 agonist

like taking an energy drink–palpitations, tachycardia, increased BP, HA

52
Q

What med can help with bronchodilation but acts a lot like caffeine? Why is it rarely used?

A

theophylline

Has a narrow therapeutic window and can quickly cause N/V and tachycardia

53
Q

What is an anticholinergic used for bronchospasms and emphysema? AEs?

A

ipratropium

Dry mouth, constipation, blurry vision (dilation), urinary retention, tachycardia,

54
Q

When cromolyn is added to athma treatment, what does it do in the body?

A

stabilizes mast cells and calms the bronchospasms

55
Q

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?

A

antiinflammatory

fluticasone, beclomethasone

daily

oral candidiasis

wash the mouth out

hoarse voice (dysphonia)

56
Q

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?

A

it blocks the leukotriene receptors to block inflammation

daily

SI, psychiatric events

57
Q

Why is fexfofenidine (allegra) a better choice than diphenhydramine for seasonal allergies?

A

does not have sedating effects because it is second generation and does not cross the blood-brain barrier

58
Q

acetylcysteine is the antidote for acetminphen, but what else is it good for? What is gross about it?

A

breaking up thick viscous secretions with cystic fibrosis

rotten egg odor

59
Q

In terms of cholesterol, which needs to be lower? Higher (good)?

A

LDL

HDL

60
Q

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?

A

atorvastatin

muscle breakdown leading to rhabsomyolysis

liver, LFTs

grapefruit juice

61
Q

What vitamin/med is good to add to lower triglycerides? What is added 30 minutes before to prevent GI side effects?

A

Vit B3: nicotinic acid or niacin

aspirin 30 minutes before

62
Q

What meds affect gout?

A

hydrochlorithiazide
niacin (B3)

63
Q

How does cholestyramine help lower the amount of cholesterol? What else is affected? What other drug works similarly?

A

blocks it from being absorbed by increasing bile production and removing it through feces

fat soluble vitamins

ezetimibe

64
Q

What is ACE inhibotr the acronym for? What does it block? What does that do?

A

angiotensin converting inhibitor

it block angiotensin from converting to angiotensin II

opens up the vessels

65
Q

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?

A

captopril, “pril”s

cough from increased bradykinin

angioedema (similar to anaphylaxis)

hyperkalemia

pregnancy

66
Q

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?

A

losartan (the ARBs, “sartan”s)

the cough from “prils”s

yes

hyperkalemia, angioedema, contraindicated in pregancy, fatigue, dizziness, HA

67
Q

What are 3 Beta 1 blockers? What organ do the affect? MAE

A

metoprolol
atenolol
esmolol

heart (remember: 1 heart, beta 1)

68
Q

What are 2 nonselective beta blockers (beta 1 and 2)?

A

propranolol
nadolol

69
Q

What are 2 alpha and beta blockers?

A

carvedilol
labetalol

70
Q

What is the primary ability of metroprolol? If you have reduced the hear rate what AEs would you then expect?

A

reduce HR in HTN
a fib, angina, reflex tachycardia

fatigue, dizziness, bradycardia, reduced contractility

71
Q

What is the calcium channel blocker that aids in a fib, angina and HTN control? why?

A

verapamil

it affects both the blood vessels and the heart because it is a nondihydropyradine

72
Q

Clonidine is similar to what 2 other meds? What receptor does it affect? How? What else would happen if you took away norepinephrine?

A

guanfacine, methydopa

alpha 2 agonist

turns OFF the norepinephrine, which decreases heart rate

OH, bradycardia, depression, sedation, dry mouth

73
Q

What is the reason to use hydralazine? How does it work? As a result, what are the AEs from the vasodilation?

A

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

74
Q

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?

A

nitroprusside

hydralazine

risk of thiocyanate poisoning

75
Q

What is the treatment for a heart attack?

A

oxygen
aspirin
nitroglycerin
morphine

76
Q

What is nitroglygerin for? What cannot be taken with it?

A

angina

sildenafil (viagra)

77
Q

What does an inotrope affect? What med is an inotrope for advanced CHF?

A

inotrope: contractility

milrinone

78
Q

What drug class can be used as an antidysrhythmic? Examples? How does it affect the heart?

A

beta blockers

atenolol

it is a negatave inotrope, chromotrope and dromotrope

79
Q

amiodarone is used for what? What is the strange effect?

A

atrial and ventricular dysrythmias
ventricular tachycardia and fib

blue face

80
Q

What are the 2 CCBs good for a fib and arrythmias? How do they affect other smooth muscle besides the heart

A

verapamil
ditiazam

GI: constipating

81
Q

What is used in emergency situations for supraventricular tachycardia? What are the AEs of note? Is it short acting or long?

A

adenosine

sense of impending doom, flushing, dyspnea

very short while it resets the heart

82
Q

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?

A

afib, decreased CO and HF

tanking potassium and causing hypokalemia

digibind

halos and vision changes

83
Q

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?

A

timolol

beta blocker

4-6 weeks

84
Q

What medication opens of the canels to let more aquesous humor out with open angle glaucoma? What is the weird side effect?

A

lantanaprost

pigmentation of eyelashes and eyelids

85
Q

dorzolamide

A
86
Q

What happens if clients are not compliant with glaucoma eye drops?

A

1 cause of blindness in people over 65

risk of permanent blindness

87
Q

What med is used for otitis media? Otitis exyerna

A

amoxacillin

ciprofloxacin/dexamethasone drops

88
Q

What is the med for metal toxicity? What is the route?

A

dimercaprol

IM, multiple times

89
Q

What is the contraindication with vitamin A?

A

pregnancy

90
Q

That is vitamin B1? What is an AE of B1 deficiency? Who is at risk?

A

thiamine

Warrneke Korsikoff syndrome

alcoholics

91
Q

What is vitamin B12? What is its use? Whose at risk for deficiency?

A

cyanocobalamin

RBC production and nervous system

vegans, alcoholics, upper GI issues (not lower GI, absorption doesn’t happen there), Crohn’s, stomach surgery

92
Q

What is the rule of administration with iron? What does it do to stool? If liquid what do they use to consume? why?

A

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

93
Q

What is used for weight loss? What absorption does it block? What are AE?

A

orlistat

fat soluble vitamins

diarrhea, greasy stool, wet farts

94
Q

What is the term for heartburn like sysptoms?

A

dyspepsia

95
Q

What are 3 types of antacids? What are the side effect for each? Are they PRN? What does it do to other meds?

A

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

96
Q

What drug class is omeprazole and other “azole”s? What do they treat? What are the SE?

A

PPI

GERD, PU, h. pylori (with antibiotics)

risk for nutritional deficiencies with calcium and iron, infections

97
Q

What is metoclopramide used for? How does it work? What is the concerning AE and contraindication
?

A

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

98
Q

Who is ondansetron contraindicated in?

A

heart issue and dysrhythmias, QT prolongation

99
Q

Whatis pancrelipase used for? Who cannot use it?

A

cystic fibrosis helps break down food

pork sensitivity

100
Q

What can reintroduce good bacteria into the GI tract? What can it help protect against? Who is it contraindicated in?

A

probiotic

C Diff

immunocompromised

101
Q

What is sucralfate used for? What does it do? When should it be taken?

A

ulcers, GERD

stimulates a coating to protect the stomach

1 hour before eating

102
Q

What is used for infertility? By doing what?

A

clomiphene

increase egg release

103
Q

What is used for ulcers and inducing labor?

A

misoprostol

104
Q

What is the big contraindication with estrogen?

A

breast cancer, DVT

105
Q

Is testonterone a schedule drug? Why?

A

yes

potential for abuse

106
Q

What is used for BPH and alopecia? What is in contraindicated in? Will it affect blood pressure?

A

finasteride

pregnancy

no, does not affect pressure

107
Q

What drug is good for HTN and BPH? What class is the med? Does it affect the heart rate? Will it cause hypotension?

A

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

108
Q

Does sildenafil cause vasodilation? Who should not use it?

A

yes

nitroglycerin use and low blood pressure

109
Q

What blocks H2 receptors to decrease stomach acid production to treat GERD, h. pylori and PU?

A

famotidine

110
Q

What is the risk of smoking and contraceptions?

A

DVT

Pharm II (8 decks)

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