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Marie- NUR 120 > Final Exam Study Guide- Meds > Flashcards

Final Exam Study Guide- Meds Flashcards

1
Q

What are the prototypes of first generation NSAIDs?

A

aspirin and ibuprofen

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2
Q

What class are first generation NSAIDs?

A

COX-1 and COX-2 inhibitors

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3
Q

What is the pharmacologic action of first generation NSAIDs?

A

inhibit the action of COX-1 and COX-2 which stimulates the release of prostaglandins

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4
Q

What are adverse reactions of first generation NSAIDs?

A
  • gastric upset
  • heartburn nausea
  • gastric ulceration
  • bleeding tendencies
  • renal dysfunction
  • increased thromboembolic events
  • aspirin toxicity
  • Reye’s syndrome
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5
Q

What are interventions for first generation NSAIDs?

A
  • monitor for signs of bleeding such as dark stool, hematemesis, bruising, and excessive bleeding from minor injury such as shaving
  • monitor I/O, creatinine, BUN
  • assess for signs of toxicity such as tinnitus, dizziness, headache, diaphoresis, and tachypnea
  • use acetaminophen instead of aspirin for children under 18 yo
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6
Q

What is the correct administration of first generation NSAIDs?

A
  • swallow
  • do not crush or chew enteric coated or sustained release
  • avoid alcohol
  • take with food, milk, or water
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7
Q

What are contraindications of first generation NSAIDs?

A
  • teratogenic
  • peptic ulcer disease
  • hemophilia
  • vitamin D deficiency
  • current diagnosis of chickenpox or flu
  • older adults
  • smokers
  • alcohol use disorders
  • impaired kidney function
  • heart failure
  • hypertension
  • helicobacter pylori
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8
Q

What are precautions for first generation NSAIDs?

A

discontinue a week before surgery

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9
Q

What are interactions of first generation NSAIDs?

A
  • use of aspirin with anticoagulants
  • glucocorticoids and alcohol increase risk for bleeding
  • use with ACE inhibitors and angiotensin receptor blockers increase risk of renal failure
  • toxicity of lithium carbonate and methotrexate
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10
Q

What is the prototype of second generation NSAIDs?

A

celecoxib

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11
Q

What is the class of second generation NSAIDs?

A

COX-2 inhibitors

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12
Q

What is the pharmacologic action of 2nd generation NSAIDs?

A

inhibit the action of COX-2 which stimulates the prostaglandins

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13
Q

What are adverse reactions of 2nd generation NSAIDs?

A
  • renal dysfunction
  • increased thromboembolic events
  • cardiovascular events
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14
Q

What are interventions for 2nd generation NSAIDs?

A
  • monitor for signs of bleeding such as dark stool, hematemesis, bruising, and excessive bleeding from minor injury such as shaving
  • monitor I/O, creatinine, BUN
  • assess for signs of myocardial infarction and cerebrovascular accident
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15
Q

What is the correct administration of 2nd generation NSAIDs?

A
  • take 2 hours before or after magnesium or aluminum based antacids
  • take with food, milk, or water
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16
Q

What are contraindications of 2nd generation NSAIDs?

A
  • teratogenic
  • children under the age of 18
  • alcohol use disorders
  • impaired kidney or liver function
  • heart failure
  • hypertension
  • Helicobacter pylori
  • allergy to sulfonamides
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17
Q

What are precautions to 2nd generation NSAIDs?

A
  • changes in weight gain
  • signs of fluid retention, such as edema and bloating
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18
Q

What are interactions of 2nd generation NSAIDs?

A
  • use with furosemide decreases its diuretic effect and decreases the effect of antihypertensives
  • increases the effect of warfarin and lithium levels increasing the chance of toxicity
  • glucocorticoids and alcohol increase the risk of bleeding
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19
Q

What is the prototype of acetaminophen?

A

acetaminophen

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20
Q

What class is acetaminophen?

A

nonopiod analgesic

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21
Q

What is the pharmacologic action of acetaminophen

A

inhibit the action of COX-1 and COX-2 but is limited to the CNS, therefore relieves pain and reduces fever but does have anti-inflammatory or anti-coagulant effects

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22
Q

What are some adverse reactions of acetominophen?

A

liver damage with toxic doses and hypertension when taken daily

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23
Q

What are some interventions for acetaminophen?

A
  • Monitor for signs of overdose or poisoning such as abdominal discomfort, nausea, vomiting, sweating and diarrhea
  • Monitor blood pressure if taking on a regular basis.
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24
Q

What is the correct administration of acetaminophen?

A
  • do not take more than 4 g in 24 hours
  • Often is found in combination cold and flu products so be careful reading labels
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25
Q

What are contraindications of acetaminophen?

A

alcoholism

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26
Q

What are precautions for taking acetaminophen?

A
  • anemia
  • immunosuppression
  • liver or kidney disease
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27
Q

What are interactions of taking acetaminophen?

A
  • increases risk of bleeding when also taking warfarin
  • if reduced absorption when taking cholestyramine
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28
Q

What is the prototype of centrally acting nonopioids?

A

tramadol

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29
Q

What is the class of centrally acting non opioid?

A

centrally acting non opioid

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30
Q

What is the pharmacologic action of centrally acting non opioids?

A

binds to selected opioid receptors and blocking reuptake of of norepinephrine and serotonin in the CNS

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31
Q

What are adverse reactions of centrally acting non opioids?

A

rare but include:
- sedation and dizziness
- headache
- nausea
- constipation
- seizures

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32
Q

What are interventions for centrally acting non opioids?

A
  • monitor during ambulation
  • vital signs particularly respiratory rate
  • seizure activity
  • urinary retention
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33
Q

What is the correct administration of centrally acting nonopiods?

A
  • effects typically not felt until an hour after administration
  • swallow extended release do not chew or crush
34
Q

What are some contraindications for centrally acting non opiods?

A
  • alcoholism
  • taking opioids or psychotropics
  • seizure disorders
  • respiratory depression
  • under the age of 12
  • liver or kidney disease
  • increased intracranial pressure
35
Q

What are precautions for taking centrally acting non opioids?

A
  • avoid taking before driving or performing activities
  • change positions slowly
36
Q

What are interactions of taking centrally acting non opioids?

A
  • taking with MAOIs increased risk for hypertensive crisis
  • increases effects of CNS depressants
  • taking with St. Johns wort increases its sedative effects
37
Q

What is the prototype of opioid agonists?

A

morphine

38
Q

What class are opioid agonists?

A

opioid agonists

39
Q

What is the pharmacologic action of opioid agonists?

A

mimics naturally occurring opioids, endorphins, and enkephalins by binding with the mu receptors

40
Q

What are some adverse reactions of taking opioid agonists?

A
  • respiratory depression
  • sedation
  • dizziness
  • lightheadedness
  • drowsiness
  • constipation
  • orthostatic hypotension
  • high potential for abuse
41
Q

What are some interventions for taking opioid agonists?

A
  • monitor vital signs particularly respiration rate and oxygen saturation
  • if RR less than 12 hold medication and consider administering naloxone
  • monitor for constipation
  • urinary retention
  • dependence
42
Q

What is the correct administration of opioid agonists?

A
  • orally, intramuscularly, intravenously, subcutaneously, rectally, or epidurally
  • have naloxone and resuscitation equipment readily available
43
Q

What are contraindications for taking opioid agonists?

A
  • pregnant women because it can cause newborn respiratory depression or neonatal withdrawal syndrome
  • renal failure
  • increased intracranial pressure
  • biliary surgery
44
Q

What are precautions for taking opioid agonists?

A
  • avoid taking before driving or performing activities
  • change positions slowly
45
Q

What are interactions of taking opioid agonists?

A
  • interact with CNS depressants causing increased CNS suppression
  • anticholinergics: increases risk for constipation and urinary retention
  • taking with MAOIs increases risk for hyperpyrexic syndrome
  • taking with St. John’s wort increases its sedative effects
46
Q

What are the prototypes of opioid agonists-antagonists?

A

butorphanol and pentazocine

47
Q

What class are opioid agonists-antagonists?

A

opioid antagonists

48
Q

What is the pharmacologic action of opioid agonists-antagonists?

A

mu receptors antagonists and kappa receptor agonists

49
Q

What are adverse reactions of opioid agonists-antagonists

A
  • respiratory depression and sedation
  • dizziness
  • lightheaded
  • drowsiness
  • headache
  • nausea
  • increased cardiac workload
50
Q

What are interventions for opioid agonists-antagonists?

A
  • ask if they are taking an opioid before administering as it can precipitate withdrawal symptoms
  • monitor vital signs particularly respiratory rate and oxygen saturation
  • if RR less than 12 hold medication
51
Q

What is the correct administration of opioid agonists-antagonists

A

intramuscularly, intravenously, intranasally

52
Q

What are contraindications for taking opioid agonists-antagonists?

A
  • acute myocardial infarction
  • renal or liver disease
  • increased intracranial pressure
  • cardiac insufficiency
  • hypertension
53
Q

What are precautions of taking opioid agonists-antagonists?

A
  • avoid taking before driving or performing activities
  • change positions slowly
54
Q

What are interactions of taking opioid agonists-antagonists?

A
  • interact with CNS suppressants causing increased CNS suppression
  • if given with opioids will decrease the effect of the opioid
55
Q

What is the prototype of opioid antagonists?

A

naloxone

56
Q

What is the class of opioid antagonists?

A

opioid antagonists

57
Q

What is the pharmacologic action of opioid antagonists?

A

block opioid receptors reversing or antagonizing the effects of opioids

58
Q

What are adverse reactions of opioid antagonists?

A

ventricular arrhythmias and abstinence syndrome in opioid dependent including hypertension, vomiting, and tremors

59
Q

What are interventions for opioid antagonists

A
  • closely monitor for dangerous elevations in blood pressure and abnormal heart rhythms
60
Q

What is the correct administration of opioid antagonists?

A

intramuscularly, intravenously, or subcutaneously

61
Q

What are contraindications of opioid antagonists?

A
  • acute myocardial infarction
  • renal or liver disease
  • increased intracranial pressure
  • cardiac insufficiency
  • hypertension
62
Q

What are precautions for opioid antagonists?

A
  • caution in use on cardiac irritability
  • head injury with increased intracranial pressure
  • brain tumor
  • seizure
63
Q

What are interactions for opioid antagonists

A

will decrease the effect of opioids

64
Q

What is the prototype of antiuricemics?

A

allopurinol

65
Q

What is the class of antihyperuricemics

A

antigout/antihyperuricemic

66
Q

What is the pharmacologic action of antihyperuricemics?

A

inhibit the conversion of hypoxanthine and xanthine into uric acid and inhibit the reabsorption of uric acid by the kidneys promoting excretion

67
Q

What are adverse reactions of antihyperuricemics?

A
  • generally tolerated well but some may experience hypersensitivity syndrome
  • liver and kidney dysfunction
  • GI disturbances
  • bone marrow depression
  • metallic taste in mouth
  • cataracts if taken for an extended period of time
68
Q

What are interventions for antihyperuricemics

A
  • monitor for hypersensitivity syndrome if taking greater than 2-4 weeks
  • monitor kidney and liver function and CBC
  • give after meals if GI disturbance occur
  • visit opthamologist regularly
69
Q

What is the correct administration of antihyperuricemics?

A
  • Orally or intravenously
  • Tablets can be crushed and mixed with fluid or food
  • drink at least 3 L of fluid daily
70
Q

What are contraindications for antihyperuricemics

A
  • bone marrow depression
  • liver or kidney disease
  • peptic ulcers
  • lower GI tract diseases
71
Q

What are precautions for antihyperuricemics

A

minimize exposure of eyes to bright sunlight

72
Q

What are interactions of antihyperuricemics

A
  • increases the anticoagulant effect of warfarin
  • increase risk of toxicity if taken with mercaptopurine, theophylline, and azathioprine
  • increases risk for rash if taken with ampicillin
73
Q

What is the prototype of glucocorticoids?

A

prednisone

74
Q

What class are glucocorticoids

A

glucocorticoids

75
Q

What is the pharmacologic action of glucocorticoids

A

mimic cortisol by suppressing inflammation and the immune response resulting in decreasing pain and swelling

76
Q

What are adverse reactions of glucocorticoids

A
  • hyperglycemia
  • myopathy
  • peptic ulcer disease
  • GI distress
  • bone loss
  • cataracts
  • increased risk for infection
77
Q

what are interventions for glucocorticoids

A
  • monitor hypertension and fatigue
  • monitor glucose levels
  • observe for sign of infection
    monitor I/O
  • monitor edema and weight gain
78
Q

What is the correct administration of glucocorticoids

A

orally, intramuscularly, intravenously, subcutaneously, topically, intranasally or inhalation. Start with larger doses and progressively decrease doses. Do not stop abruptly.

79
Q

What are contraindications of glucocorticoids

A

systemic fungal infection, cataracts, heart failure, peptic ulcer disease, diabetes, hypertension, renal dysfunction, myasthenia gravis and osteoporosis.

80
Q

What are precautions for glucocorticoids

A

long term effects even if given for a short period of time

81
Q

What are interactions of glucocorticoids

A

prevent the body from responding appropriately to vaccines. Increased risk of hypokalemia if taking furosemide. Increased risk of dysrhythmias when taking digoxin. Increased risk of GI bleed and ulceration if also taking NSAIDs and effects of insulin and oral hypoglycemics decreased

Marie- NUR 120 (4 decks)

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