Final Exam Study Guide Flashcards
Nausea and chemotherapy – important actions for you to take
Give antiemetics, educate to eat small frequent meals, dietitian consult
Doxorubicin – precautions
Antineoplastic antibiotic
Given IV; known as the “red death” which is reddening, swelling, numbness on palms of hands and soles of feet
Alkylating agents – pancytopenia
Antineoplastic agent (cancer drug)
Causes pancytopenia
PCA – functions and benefits
Pt can control amt of pain med, speeds up recovery, do not have to wait on med to be given by RN
Corticosteroids – immune suppression, infection, and organ transplants
Corticosteroids work to block the inflammatory and immune systems
This can cause immune suppression and an increased risk of infection
These can be used after organ transplantation to help prevent the organ being rejected
Tylenol – liver?
Tylenol is liver toxic, do not drink while taking
Ringing in the ears – salicylates?
Salicylates (Aspirin) are ototoxic
GI bleeds, PUD – type of pain relievers - I.e. NSAIDs
Do not take NSAIDs if you have GI bleed and PUD
COX-2 inhibitors – nurse assessments
GI effects, urinary retention, changes in bleeding time
NSAIDS and a loop diuretics, blood pressure
NSAIDs decreases the effectiveness of loop diuretics
Leukemia, immune modulators, females of childbearing age
Use barrier contraceptives
Absence seizures
Abrupt 3-5 seconds that does not involve muscle contractions
Phenobarbital Tx
Tx of tonic-clonic seizures
Tx for Status Epilepticus
Benzodiazepine
Reversal agent – flumazenil
Therapeutic phenytoin level – seizure precautions – when?
Range: 10-20 mg/mL
High: do not give med and contact HCP
Low: give med, institute seizure precautions, contact HCP
Dicyclomine
IBS medication
Anticholinergic
Flumazenil
Reversal agent of benzodiazepine
Edrophonium and cholinergic crisis
Indirect-acting cholinergic agonist
Overdose can lead to cholinergic crisis
Anticholinergic drugs – contraindications
Myasthenia Gravis
Hyperthyroidism
Glaucoma
BPH
Hypertension
Urinary tract blockage
Tachycardia
How to take carbidopa levodopa
Dopaminergic agent (levodopa)
Decarboxylase inhibitor (carbidopa) [jnhibits side effects of levodopa]
Typically given as a fixed combination drug (Sinemet)
Treats Parkinson’s disease
Benztropine
Anticholinergic
Treatment of parkinson’s
Confusion, fall risk, dry out body
Cyclobenzaprine – discharge teaching
Muscle relaxant
Do not drink alcohol, no CNS depressants, do not operate heavy machinery
Sumatriptan
Triptan
Given for migraines
Has less side effects than ergot meds
Sympathomimetic drug administration – expected findings
Increase in VS, hypertension, tachycardia, tachypnea
OTC cold and allergy preparations contain phenylephrine, contraindications
Not for pts with hypertension, will make BP worse
Alpha-specific adrenergic agonist – priority assessment
CNS effects, vasoconstriction
Ex: clonidine, midodrine, phenylephrine
Sympathomimetic drug – stimulates which receptors?
Stimulates adrenergic receptor sites
Mimics the effects of sympathetic nervous system (fight or flight)
Tamsulosin
Alpha 1 antagonist
Dilates and lowers BP
Labetalol – selective, or no? Safe with asthma?
Nonselective beta blocker
Not safe with asthma due to the bronchoconstriction effect
Beta blockers – hypo/hyperglycemia
Masks the symptoms of hypo/hyperglycemia
Pyridostigmine
Cholinergic agonist
Controls myasthenia gravis
Myasthenia gravis and edrophonium
Used to diagnose myasthenia gravis
Bethanechol
Cholinergic agonist
Treats urinary retention (post op and postpartum) and neurogenic bladder atony
Elderly client, benztropine, side effects
Anticholinergic
Neurological (weakness), cardiac (tachycardia), and GI (constipation)
Dries you out
Scopolamine transdermal patch – side effects
Anticholinergic
Treats motion sickness
PNS blocked, pupils dilate, HR increases, GI activity and urinary bladder tone and function decrease
Interferon alfa-2b
Interferons are naturally produced by cells that have been invaded by viruses
Prevent viruses from replicating inside cells
Interferon alfa-2b (Intron-A)
Tx of Hepatitis C and Hepatitis B
Donepezil – assessment
Cholinergic agonist
Check LOC every hour
Glucocorticoids – when to take, risks, contraindications
Short-term tx of inflammatory disorders, relieve discomfort give body chance to heal from effects of inflammation
Contraindications: acute infection, pregnancy/lactation, diabetes, acute peptic ulcers
CCBs – Side effects
Dizziness, light-headedness, headache, fatigue, nausea, hepatotoxicity, hypotension, bradycardia, peripheral edema, skin flushing, rash
Grapefruit juice
Blocks the effects of CCBs
Digoxin (cardiac glycoside) toxicity
Extreme bradycardia, blurred vision, hypokalemia
Negative chronotrope (rate), positive inotrope (contraction, strength)
Sublingual nitroglycerin
Take up to 3 tabs every 5 minutes to treat angina
Sip of water first
If after 3 tabs, pain is not relieved, call ambulance
Cholesterol-lowering agents – goal
Cholestyramine, atorvastatin
Lower cholesterol in blood
Enoxaparin
Low-molecular weight heparin
Diabetic nephropathy – consequences
Anemia; decreased erythropoietin production in kidneys
Ferrous gluconate (iron) - how to take?
Tx of iron deficiency anemia
Take with vitamin C (increases absorption)
Thiazide diuretics
Block chloride pump = lost Na
CAUTIs
Catheter-associated urinary tract infections
Finasteride precautions
Can cause abortions / use with caution (wear gloves)
Urine culture and sensitivity
Tells us what drug needs to be given
BPH – medications, contraindications
Finasteride, Alpha 1 adrenergic blockers (terazosin and doxazosin)
UTI tx
Phenazopyridine (urinary tract analgesic)
Turns urine orange
Persistent cough – advice?
If over two weeks, see HCP
Children and OTC cold/allergy meds – teaching?
read the labels
Nasal steroids – immediate or delayed action?
Delayed action (2 weeks)
OTC cold/flu preparations and MAOIs
Can lead to hypertensive crisis
MAOI – phenelzine (Nardil)
Theophylline – contraindications
Do not smoke while taking
COPD tx
Beta-2 agonist (bronchodilator)
Epinephrine – actions
Relaxes lungs, vasoconstriction
Surfactant administration
Given to neonates to keep alveoli open
How to use an inhaler
MDI (shake), 1-2 min between puffs
DPI (don’t shake), rinse mouth out after
Albuterol side effects
CNS stimulation, GI upset, cardiac arrythmias, hypertension, bronchospasm, sweating, pallor, flushing
Untreated HTN consequences
MI
CVA
Angina
Kidney disease
Vision problems
PAD
High risk of hypertensive crisis
Stiff heart valves
Losartan with a diuretic
ARB inhibitor
Taken with diuretic (combination therapy) for tx of HTN
PPI’s
Proton pump inhibitors
Suppress secretion of HCl acid into stomach
Tx: GERD, ulcers
Cytotec
Prostaglandin
Protect the stomach lining
Inhibits gastric acid secretion and increases bicarb and mucus production
Used to prevent NSAID-induced gastric ulcers
How do anti-infectives work?
anti-infectives interfere with biosynthesis of the pathogen’s cell wall
Interfering with protein synthesis
Interfering with ability of pathogen to obtain needed nutrients
Prophylactic anti-infectives
Given in advance to prevent infection (dental procedures, abdominal procedures, etc.)
Penicillin – mechanism of action
Interferes with synthesis of the cell membrane
Tetracycline precautions
BC, sunscreen, yellow teeth, sit up for 30 minutes after
Aminoglycosides adverse effects
-Mycins
Severely toxic – oto/nephrotoxicity
Selectively toxic anti-infective
Does not kill everything indiscriminately (targets specific cells)
Gentamicin – adverse effects
Ototoxic and nephrotoxic
Antiviral drugs – side effects, teaching
Cough, dry mouth, diarrhea, dizziness, fatigue, headache, insomnia, joint/muscle pain
Side rails bc CNS effects
Take all of the med
Systemic antifungals – priority assessments
Toxicity – liver
AIDs, NRTIs, and GI effects
Leaky gut, malabsorption
Rifampin – teaching
Antituberculosis drug
Used in combination with 2 or more agents
Tx must continue 6 months to 2 years
TB drugs know three main ones
Isoniazid
Rifampin
Pyrazinamide
Hypothyroid medication – administration and patient understanding
Thyroid replacement hormone
Ex: levothyroxine
Admin: PO or IV (in extreme situations)
Life-long medication, take in morning 30-60 min before breakfast
