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STUDY CARDS > HARD TIME > Flashcards

HARD TIME Flashcards

1
Q

Which antiparkinsonian drug is contraindicated in hot weather/ exercise?

A

Benztropine/ antichollinergic

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2
Q

Which antiparkinsonian drug is contraindicated in angle-closure glaucoma?

A

Levodopa (DOPAMINE REPLACEMENT DRUGS)

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3
Q

Which antiparkinsonian drug is contraindicated in ischemic/ PVD and erythromycin?

A

bromocriptine (non dopamine dopamine receptor agonists)

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4
Q

Which antiparkinsonian drug is contraindicated to antichollinergic drugs?

A

amantadine and antichollinergic (benztropine)

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5
Q

What is contraindicated to selegiline and rasagiline?

A

Meperidine

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6
Q

Which antihyperglycemic medication can cause hypoglycemia when given with DPP4 enzymes?

A

Sulfonylureas

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7
Q

Which antihyperglycemic medication increases HDL and LDL?

A

Sodium-glucose cotransporter 2 inhibitor (dapagliflozin)

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8
Q

Drugs that cause hyperglycemia when given with insulin? (antagonizes insulin)

A

corticosteroids
diuretics
sympathomimetic
niacin
thyroid drugs

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9
Q

Drugs that cause hypoglycemia when given with insulin?

A

alcohol
sulfa antibiotics
anabolic steroids
MAOIs
salicylates

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10
Q

Drugs that mask hypoglycemia symptoms when given with INSULIN?

A

non-selective beta blockers

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11
Q

Functions of the drug INSULIN

A

metabolize carbohydrates, fats, and proteins
stores glucose in the liver
convert glycogen into fat stores
substitute for endogenous insulin

Does not reverse defects in insulin receptors

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12
Q

OA and malnourished patients may adversely affect which antihyperglycemic medication?

A

Biguanides

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13
Q

What is important to note when giving sulfonylureas and glinides?

A

Baseline glucose
Conditions that may predispose patients to hypoglycemia [drop in caloric intake, alcohol use, exercise]
Allergy to sulfonamides
Not allowed in patients with type 1 diabetes

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14
Q

What is a major contraindication in thiazolidinediones/ glitazones?

A

Class III or IV heart failure

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15
Q

Contraindication for a glucosidase inhibitor

A

IBS
Malabsorption

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16
Q

Incretin mimetics are used to treat?

A

Typer 2 diabetes
Poor control with metformin, sulfonylutreas, or glitazones

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17
Q

Glucagon injection may induce?

A

vomiting so assess for LOC and prevent aspiration

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18
Q

If insulin is is to be used within 1 month

A

it may be stored at room temperature

administer at room temperature

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19
Q

angle to administer insulin?

A

90 degrees unless they are emaciated (thin) do 45 degrees

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20
Q

Injecting air into vial process of mixing insulin?

A

Inject air into intermediate-acting acting then into rapid-acting

BUT always draw up rapid/ regular acting insulin first then intermediate acting (clear before cloudy)

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21
Q

If lispro is mixed with NPH, when would you give it?

A

give combination 15 minutes before meals because lispro has an onset of 10 to 15 minutes.

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22
Q

When to give (meals) in intermediate-acting insulin with an onset of 1 to 2 hours?

A

meals should be given 30 to 45 minutes prior to administration

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23
Q

In hospital settings, give insulin when?

A

when tray arrives

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24
Q

How often to check glucose when a patients is on SC?

A

every 4 hours, 6, or several times per day to obtain fasting/ preprandial glucose levels

Used in variable caloric intake, drastic changes to glucose levels due to infections/ stress, receives TPN

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25
Q

Insulin in BBT

A

Long acting
Rapid acting

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26
Q

Oral antihyperglycemic are usually given __ minutes before meals?

A

30 minutes

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27
Q

Glitazones adverse effect

A

It causes weight gain/ edema so weigh patients

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28
Q

Incretin mimetics (exenatide) are not given with?

A

Insulin

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29
Q

Sitagliptin (DPP 4 I) is not given with?

May be given with or without?

A

Insulin

Food

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30
Q

Key diagnostic criterion of hyperglycemia

A

Fasting glucose: greater than 7mmol/L

Non-fasting glucose: greater than 11.1 mmol/L

A1C of equal to/ greater than 6.5%

[A1C of 6.5% is the threshold for micro and macrovascular complications]

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31
Q

Diabetes Canada Reccomends

A

A1C of less than 7%

F PG of 4 to 7 mmol/L

2 hour postprandial of 5 to 10 mmol/L

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32
Q

Bowel assessment

A

Inspection
Auscultation (1st to prevent stimulation of peristalsis and BS)
Percussion
Palpation

33
Q

Hypoactive BS

Normoactive

A

less than 6 sounds per minute

6 to 32 sounds per minute

34
Q

Overuse of diphenoxylate hcl with atropine sulphate may cause?

A

dry mouth
abd pain
tachycardia
blurred vision

35
Q

Prior to use of hyperosmotic laxatives, assess for?

A

baseline fluid and electrolyte imbalances
thorough and assessment

Older adults react adversely to hyperosmotic so avoid use

36
Q

Saline laxatives are used in caution in OA because?

May also cause?

A

possible dehydration and electrolyte loss

MG toxicity in those with compromise renal function

37
Q

Bismuth subsalicylate effects on feces?

A

dark or grey feces

38
Q

If tablet Bismuth subsalicylate is used they must be?

A

chewed thoroughly before swallowing and must be taken with at least 180 mL of fluid

39
Q

How to give Diphenoxylate hcl and loperamide

A

without regard to food but must be given with adequate fluid

40
Q

Bulk forming once stirred with 240 mL of water must be

A

taken immediately to avoid choking

never give in a dry form

41
Q

Bisacodyl is best taken

how to give whole tablets

do not give with?

A

in an empty stomach

whole tablets must not be crushed

do not take milk, juices or antacids with the dose or an hour or taking this medication

42
Q

Soft rectal suppositories

A

place in a medicine cup with ice, apply lubricant

lay on the left side for at least 15 to 30 minutes to allow drug to dissolve

43
Q

Lactulose may be given with

A

juice, milk, or water to increase palatability (taste)

pale yellow color

44
Q

Retention enema with dilution

A

retain 30 to 60 minutes

lubricate tip of the apparatus, nozzle pointed towards the umbilicus, lying on the left side

release fluid gradually

discontinue if pt experiences severe abd pain

45
Q

AE of dry mouth… encourage?

A

frequent mouth care
increased fluid intake
sugarless gum/ candy

46
Q

Taking senna

A

avoid other medications within 1 hour of taking it

it takes 6 to 12 hours to work

47
Q

Antichollinergics for antidiarhheals mechanism of action

AE

A

decrease peristalsis through their parasympathetic blocking effects

AE: urinary retention, headache, confusion, dry skin, rash, and blurred vision

48
Q

Opiates

A

decrease bowel motility, permits longer contact of intestinal contents, reduce pain and spasms

49
Q

stool softeners and bulk forming are

A

preferred due to fewer problems with fluid and electrolyte loss

50
Q

Oral antihyperglycemic can cause

A

photosensitivity, use sunblock and appropriate clothing when exposed to sun

51
Q

Insulin main function

A

removal of glucose form the plasma and store it as glycogen in the liver

52
Q

Bovin and porcine insulin are associated with?

A

higher incidence of allergic reaction and insulin resistance

53
Q

mixing short and intermediate-acting insulin color

A

will appear uniformly cloudy

54
Q

Antichollinergic dry mouth

A

artificial saliva drops/ gum
mouth care
drink fluids
sugarless gum/ hard candy

55
Q

entacapone can cause ____ urine

A

dark

56
Q

non ergot ropinirole can cause

A

drowsiness
fatigue
syncope

57
Q

COMT I must be taken with

A

meal or snack to minimize GI upset or without regard to food

58
Q

COMT I can cause

A

Liver dysfunction

monitor for jaundice, back/ abd pain

dark urine

59
Q

COMT I plus levodopa results in

A

reduced wearing off phenomenon

60
Q

Common AE of antiparkinsonian drugs

A

Dyskenesias

61
Q

Which medication does it require the nurse to check the BP (ORTHOSTATIC HYPOTENSION)

A

Amantadine
Levodopa & Ropinirole

62
Q

Alkaline phosphate levels are indicators of?

A

Liver function
AST, ALT

63
Q

BUN (blood urea nitrogen), creatinine

A

measure kidney function

64
Q

Amantadine onset

A

delayed for several days or longer

lose effectiveness after 6 to 12 months

65
Q

What systems to assess when giving anticholinergic medications?

A

GI
GU
Visual
Cardiac
Neurological

66
Q

2 prolactin inhibitor

A

Amantadine and bromocriptin

67
Q

Amantadine can cause

A

dizziness, headache, insomnia, and anxiety
assess CNS

orthostatic hypotension and dizziness- for longterm

68
Q

Selegiline or other indirect acting antiparkinson drugs

A

assess cardiac status due to risk of hypo or hypertension and chest pain

69
Q

Entacapone (COMT inhibitor)

A

assess for orthostatic hypotension and syncope

70
Q

Administration time of Levodopa and COMT-I

A

Give 1 to 2 hours after Levodopa due to bioavailability effects

71
Q

Assess ALT when giving

A

COMT inhibitors due to increased risk of liver failure

72
Q

Levodopa contraindication

A

control protein portion and take it an hour before eating high protein meals

73
Q

Antichollinergic administration time

Do not give anticholinergics to patients with?

A

do not take anticholinergics at the same time as other meds

may take several weeks for the therapeutic effect to show

take with food

take at night due to sedation effects

Glaucoma

74
Q

MAOs

what to avoid

Pt instructions

A

avoid tyramine rich foods to reduce the risk of hypertension

move slowly and purposefully due to to orthostatic hypotension

75
Q

Which anti parkinson medication works peripherally and does not cross blood brain barrier

A

COMT I

76
Q

Hot weather and exercise, alcohol is contraindicated with which anti parkinson medication?

A

Antichollinergic

77
Q

What do anti cholinergic medications treat?

A

muscle rigidity and tremors

78
Q

Take COMT with which kind of MAOI

A

non selective due to risk of HTN

STUDY CARDS (17 decks)

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