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Pharmacology > Final Exam Blueprint Part 1 > Flashcards

Final Exam Blueprint Part 1 Flashcards

1
Q

What is the indication for disulfiram?

A

Alcohol use disorder ;maintenance of alcohol sobriety after detox

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2
Q

What is the indication of methadone?

A

Opioid use disorder ; supress heroin withdrawal and block euphoric effects

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3
Q

What are the normal levels for magnesium sulfate?

A

1.5-2.5 mEq/L

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4
Q

Nursing interventions for magnesium sulfate overdose?

A

administer calcium gluconate for overdose

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5
Q

Nursing interventions for IV magnesium

A

monitor cardiac and neuromuscular status, monitor VS, assess DTR, teach foods high in magnesium

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6
Q

What food are high in magnesium

A

whole grain cereals, legumes, green leafy vegetables, bananas

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7
Q

What is ferrous sulfate?

A

iron

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8
Q

Patient teaching for ferrous sulfate

A

take on empty stomach if tolerable, rinse mouth and use straw to prevent teeth staining, dark stool is normal, increase water fiber and exercise to prevent constipation

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9
Q

What food should we take with ferrous sulfate? Which foods should we avoid?

A

take with vitamin C ; avoid antacids, dairy, coffee, caffeine, and tea

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10
Q

What foods high in iron should our patients on ferrous sulfate be taught to eat?

A

tofu, green leafy vegetables, dried peas and beans, dried fruit

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11
Q

How to recognize beta blockers?

A

end in -olol

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12
Q

Mechanism of action for selective beta blockers?

A

block beta 1 receptors (1 heart)

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13
Q

Mechanism of action for nonselective beta blockers?

A

block beta 1 and 2 receptors (2 lungs)

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14
Q

Who should not take a non-selective beta blocker?

A

those with respiratory disease (can cause bronchoconstriction)

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15
Q

Indications for beta blockers?

A

hypertension

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16
Q

Nursing considerations for beta blockers (-olol)

A

monitor VS (BP and HR), HOLD medication if HR less than 50; nonselective monitor blood glucose, taper dose to prevent rebound hypertension, monitor for orthostatic hypotension, monitor BUN/creatinine/LFTs

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17
Q

Those on beta blockers should be monitored for what two adverse effects?

A

depression (beta-blocker blues) and sexual dysfunction

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18
Q

How to recognize benzodiazepines?

A

end in -lams and -pams

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19
Q

Indications for benzodiazepines?

A

Generalized anxiety disorder and panic disorder (trauma/stress disorders, hyperarousal, seizures), to induce sleep

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20
Q

Side effects of benzodiazepines

A

hangover, REM rebound (vivid dreams and nightmares)

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21
Q

Adverse effects of benzodiazepines

A

CNS and respiratory depression, anterograde amnesia, paradoxical response, withdrawal and dependence, hypersensitivity

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22
Q

Symptoms of oral benzodiazepine toxicity

A

drowsy/lethargy, confusion

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23
Q

Symptoms of IV benzodiazepine toxicity

A

respiratory depression, hypotension, cardiac and respiratory arrest

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24
Q

What is a paradoxical response that can occur from benzodiazepines?

A

opposite reaction from expected: symptoms include euphoria, anxiety, excitation,agitation

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25
Q

Black box warning for benzodiazepines

A

risk of serious A/E if given with opioids

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26
Q

Nursing considerations for benzodiazepines

A

medication reconciliation, VS and LOC, fall precautions, renal function tests

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27
Q

Nursing considerations for benzodiazepine toxicity

A

gastric lavage, activated charcoal, saline cathartics. Flumazenil, VS, airway, floods for BP, crash cart

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28
Q

What is the reversal agent for benzodiazepines

A

flumazenil

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29
Q

What is anterograde amnesia

A

memory loss where you cannot remember new memories

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30
Q

Patient teaching for benzodiazepines

A

take only as ordered, take no more than 7-10 days, take before bed, go to ER if CNS/respiratory depression, avoid activities requiring alertness, avoid other CNS depressants, report amnesia and paradoxical response, s/s of withdrawal and tapering can prevent this, good sleep hygiene, avoid grapefruit juice

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31
Q

What drugs are nonbenzodiazepines

A

zolpidem, zaleplon, eszopiclone

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32
Q

What is the indications for nonbenzodiazepines

A

acute insomnia

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33
Q

What drugs are hydantoins?

A

phenytoin, ethotoin, fosphenytoin

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34
Q

Indications for phenytoin (hydantoins)

A

anticonvulsant

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35
Q

What are adverse effects of phenytoin? (hydantoins)

A

gingivial hyperplasia, CNS symptoms, blood dyscrasias, osteomalacia, Stevens-johnsons syndrome, liver damage, cardiac collapse, endocrine effects

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36
Q

What CNS effects can our patients on phenytoin see?

A

nystagmus, ataxia, slurred speech, confusion, dizziness, insomnia, nervousness

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37
Q

What endocrine effects can be seen in those with phenytoin

A

hirsutism

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38
Q

What is the blackbox warning for phenytoin

A

cardiac collapse, SI, raised BG levels

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39
Q

What are patient teachings for phenytoin?

A

take calcium and vitamin D, avoid herbs and OTC meds, take at same time each day. Similar to other anti seizure meds (do not drive, wear medical ID, do not abruptly stop, seizure precautions, contraceptives, avoid CNS depressants and grapefruit juice, monitor for skin rash/blisters)

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40
Q

Indications for carbamazepine

A

anticonvulsant

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41
Q

What is the therapeutic drug level for carbamazepine?

A

4-12 mcg/mL

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42
Q

What are adverse effects of carbamazepine?

A

stevens johnson, suicidal ideation, blood dyscasias, hepatotoxicity

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43
Q

What is the blackbox warning for carbamazepine

A

blood dycrasias, heart failure, fluid overload

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44
Q

Nursing considerations for carbamazepine

A

monitor for suicidal ideation. monitor CBC for blood dycrasias (anemia, thrombocytopenia, agranulocytosis, infections, bleeding) monitor serum drug level. monitor CNS changes, ECG, electrolytes. Lung sounds and edema (heart failure). Seizure precautions. LFT.

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45
Q

What is the indication for donepezil

A

alzheimers disease/ mild to moderate dementia

46
Q

What are nursing considerations for donepezil

A

cholinergic crisis treated with atropine, crash cart in case of cholinergic crisis, assess for improvement in cognitive function

47
Q

Donezepil should be used with caution in those that have?

A

respiratory disease (increased mucous can affect their breathing)

48
Q

What indications for carbidopa-Levodopa

A

Parkinson’s disease

49
Q

What patient teaching should be provided to those on cabidopa levodopa

A

take as directed with evenly spaced intervals. do not stop abruptly. eat food after taking and avoid protein and multivitamins. change positions slowly (hypotension) and avoid activities requiring alertness. have good oral hygiene. darkening of urine is normal. risk of falls is high. increase fiber and fluids

50
Q

What symptoms should those on carbidopa-levodopa report to the provider

A

palpitations, retentions, involuntary movements, behavioral changes, N/V, skin lesions

51
Q

What is on-off syndrome seen in carbodopa levodopa

A

‘On’ means levodopa is working well and symptoms are subsided. ‘off’ means levodopa is not working and patients can experience tremors, rigidity, and slow movements

52
Q

What is neostigmine used to treat

A

myasthenia gravis, diagnose MG, reverse neuromuscular blockade

53
Q

What are side and adverse effects of neostigmine

A

excessive muscarininc stimulation, cholinergic crisis, myasthenic crisis (under medication) and cholinergic crisis (overmedication)

54
Q

What are symptoms of myasthenic crisis ?

A

muscle weakness, quadriparesis/plegia, SOB, respiratory insufficiency, difficulty swallowing

55
Q

How is myasthenic crisis treated

A

more medication

56
Q

Symptoms of cholinergic crisis i

A

increased GI motility, diarrhea, cramping, bradycardia, pupillary construction (meiosis)

57
Q

How is cholinergic crisis treated

A

atropine

58
Q

How can nurses tell the difference between myasthenic and cholinergic crisis

A

administration of edrophonium IV can determine : if symptoms worsen treat with atropine, if symptoms improve need more cholinergic

59
Q

What should we keep next to the patients bed while on neostigmine

A

crash cart and mechanical ventilation in case of cholinergic crisis. Bedpan/urinal.

60
Q

What drugs are central acting muscle relaxants

A

baclofen, dantrolene, cyclobenzaprine

61
Q

What is the indication for central acting muscle relaxants

A

muscle spasms

62
Q

How to evaluate that central acting muscle relaxants have been effective?

A

pain decreases and ROM increases

63
Q

What are the neuromuscular blocking drugs

A

succinylcholine,vancuronium, pancuronium

64
Q

Adverse effects of succinylcholine

A

respiratory arrest, malignant hyperthermia, hyperkalemia

65
Q

How to treat malignant hyperthermia caused by neuromuscular blocking drug

A

stop medication, administer dantrolene, administer o2 @ 100, do whatever we can to reduce body temp

66
Q

symptoms of malignant hyperthermia

A

high fever, rigid muscles, tachycardia, sweating

67
Q

What drugs are first generation typical antipsychotics

A

haloperidol, chlorpromazine

68
Q

Indications of typical antipsychotics

A

acute and chronic psychotic disorders (schizophrenia, manic states, drug induced psychosis, management of aggressive patients)

69
Q

Adverse effects of atypical antipsychotics?

A

DAW HADES
diabetes mellitus, anticholinergic effects, weight gain, hypercholesterolemia, agranulocytosis (clozapine) dizziness, elevated prolactin, sexual dysfunction

70
Q

What are signs/symptoms of neuroleptic malignant syndrome

A

sudden high grade fever, blood pressure fluctuations, dysrhythmias, muscle rigidity, diaphoresis, tachycardia, changes in LOC leading to coma

71
Q

What drugs are atypical (second generation) antipsychotics

A

olanzapine, clozapine, risperidone

72
Q

side and adverse effects of typical antipsychotics

A

neuroleptic malignant syndrome, acute dystonia (sudden movements of face, neck, back, and tongue), parkinsonism, tardive dyskinesia

73
Q

patient teaching for atypical antipsychotics

A

report abnormal movements, may cause drowsiness, avoid CNS depressants, report s/s of DM, diet and exercise, change positions slowly, ways to manage anticholinergic effects

74
Q

How to recognize benzodiazepines

A

end in -lams and -pams

75
Q

Adverse affects of benzodiazepines for anxiety

A

CNS depression, anterograde amnesia, toxicity, paradoxical response, withdrawal effects

76
Q

Patient teaching for benzodiazepines

A

dependence can occur, avoid other CNS depressants, avoid driving, must be tapered, administer with food and at bedtime, avoid grapefruit juice, pregnancy category D NEED TO ADD INTERACTIONS

77
Q

What is the antidote for benzodiazepines

A

flumazenil

78
Q

What drugs are SSRI’s?

A

fluoxetine, sertraline, citalopram, escitalopram, fluvoxamine, paroxetine

79
Q

Indications of SSRI’s

A

treat major depression

80
Q

adverse effects of SSRIs

A

CNS stimulation, sexual dysfunction, weight loss (early then gain), serotonin syndrome, rash, GI bleeding, bruxism, hyponatremia, withdrawal syndrome, sleepiness

81
Q

What is serotonin syndrome that can occur with SSRIs

A

confusion, agitation, tachycardia, fever and diaphoresis, NVD, abdominal pain, seizures

82
Q

What symptoms can occur from withdrawal syndrome on SSRIs

A

HA, nausea, tremors, anxiety, visual changes

83
Q

How is serotonin syndrome treated with SSRIs

A

based on symptoms

84
Q

How can we treat withdrawal symptoms of SSRIs

A

tapering dose

85
Q

What drugs are MAOIs

A

phenelzine, isocarboxazid, selegiline transdermal, tranylcypromine

86
Q

Indications for MAOIs

A

neurotic or atypical depression

87
Q

Drug interactions with MAOIs

A

CNS stimulants, sympathomimetics, vasopressors, TCAs, SSRIs, general anesthetics

88
Q

What drugs are CNS stimulants?

A

amphetamines

89
Q

What drugs are sympathomimetics?

A

epinephrine, norepinephrine, phenylephrine, dopamine, dobutamine, ephedrine, isoproterenol, metoproterenol, and isoetharine

90
Q

Food Interactions with MAOIs?

A

anything with tyramine (aged cheese, yogurt, coffee, chocolate, pickled foods, yeast, beer and red wine, liver, smoked meats, bananas

91
Q

FINISH LITHIUM

A
92
Q

What drugs are TCAs

A

amitriptyline, nortriptyline

93
Q

Side and adverse effects of TCAs

A

orthostatic hypotension, anticholinergic effects, sedation, toxicity, decreased seizure threshold, excessive sweating, sexual dysfunction, arrhthymias

94
Q

What are the indications for aspirin?

A

prevent heart attack (81 mg baby aspirin) , 325 mg for pain, platelet aggregation for bleeding

95
Q

Aspirin suppresses?

A

inflammation, pain,fever

96
Q

Drug interactions with aspirin?

A

warfarin increased risk of bleeding, alcohol increases risk of gastric ulcer, G herbs increase risk of bleeding

97
Q

Adverse effects of Aspirin

A

bleeding, renal impairment, salicylism (overdose), Reye’s syndrome

98
Q

What is salicylism?

A

overdose of aspirin ; tinnitus, dizziness, headache, fever, AMS, sweating

99
Q

What is Reye’s syndrome?

A

occurs when children with a virus take aspirin. causes liver damage, hypoglycemia, CNS damage

100
Q

What drugs are NSAIDs?

A

ibuprofen, naproxen, ibuprofen, indomethacin, ketorolac, diclofenac, meloxicam

101
Q

Adverse effects of NSAIDs?

A

GI injury (ulcers, bleeding), nephrotoxic and hepatotoxic , prolonged bleeding

102
Q

NSAIDs have a black box warning for>

A

cardiovascular event, GI bleeding

103
Q

Nursing interventions for NSAIDs

A

take with food, increase fluid to flush kidneys, avoid alcohol, avoid G herbs, s/s of bleeding, may be prescribed with H2 blocker or PPI, s/s of stroke or MI

104
Q

How long can patients take ketorolac? Why

A

limited to 5 day use. Can cause kidney damage

105
Q

Indications for methotrexate?

A

slow or delay worsening of RA

106
Q

contraindications of methotrexate

A

pregnancy, liver failure, alcohol use disorder, blood dycrasias

107
Q

What are the anti-gout drugs?

A

colchicine (acute attack), allopurinol, probenecid

108
Q

Nursing interventions/patient teaching for anti-gout drugs?

A

avoid salicylates with probenecid, the with food, avoid grapefruit juice/alcohol and foods high in purine, increase fluids, monitor for bleeding and infections, metallic taste with allopurinol is normal

109
Q

What labs should nurses monitor if our patient is on anti-gout meds

A

uric acid, CBC (infection), LFTs, RFTs

110
Q
A

Pharmacology (12 decks)

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