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MISC (Spr 2016) > IPC Final Review (+ medicine) > Flashcards

IPC Final Review (+ medicine) Flashcards

1
Q

Exelon

A

Rivastigmine

Pysch

Alz

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2
Q

Cymbalta

A

Duloxetine

Psych

Depression

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3
Q

Zoloft

A

Sertraline

Psych

Depression

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4
Q

Risperdal

A

Risperdone

Psych

Bipolar, schizo

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5
Q

Seroquel

A

Quetiapine

Psych

Bipolar, schizo

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6
Q

Zyprexa

A

Olanzapine

Psych

Bipolar, schizo

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7
Q

Ambien

A

Zolpidem

Psych

Insomnia

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8
Q

Side effects of Ambien

A 
Clumsiness
Confusion
Daytime drowsiness
Unusual behavior while sleeping
Headache
Dizziness
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9
Q

Counseling points of Ambien

A

Potentially inappropriate for elderly population (beers criteria)

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10
Q

Antipsychotic counseling points

A

Risperal, seroquel, Zyprexa

With Alz increases mortality, so rule out causes of symptoms before initiating treatment

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11
Q

Side effects of antipsychotics

A

Risperal, seroquel, Zyprexa

Sedation
Shuffling gait
Somnolence
Insomnia
Headache
Anxiety
Dizziness
Weight gain
Constipation
Nausea
Tremor
Aka thesis
Increased cholesterol
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12
Q

Acetylcholinesterase inhibitors counseling points

A

Aricept, Exelon

Slows cognitive decline and lengthens ADL ability time

Exelon can be a patch which must be placed on the back

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13
Q

Side effects of Acetylcholinesterase inhibitors

A

Aricept, Exelon

Nausea
Vomiting
Diarrhea
Anorexia

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14
Q

Lanoxin

A

Digoxin

Heart failure, atrial fibrillation

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15
Q

Lopressor/toprol XL

A

Metoprolol tartrate/succinate

Angina, hypertension, myocardial infarction

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16
Q

Coreg

A

Carvedilol

Hypertension, heart failure

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17
Q

Norvasc

A

Amlodipine

Coronary artery disease, hypertension, angina

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18
Q

Lasix

A

Furosemide

Edema

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19
Q

Side effects of Lasix

A 
Hypokalemia
Hupomagnesemia
Loss of electrolytes
Ototoxicity
Renal dysfunction with overdiuresis
Confusion
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20
Q

Counseling points of Lasix

A

Take in morning and monitor electrolytes and renal function

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21
Q

Prinivil

Zestril

A

Lisinopril

Acute myocardial infarction, heart failure, hypertension

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22
Q

Side effects of prinivil/Zestril

A 
Hypotension
Headache
Dizziness
Cough (dry, persistent)
Hyperkalemia
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23
Q

Aspirin

A

Aspirin

Stroke and myocardial infarction prevention

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24
Q

Lipitor

A

Atorvastatin

Dyslipidemia, prevent CVD

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25
Q

Glucophage

A

Metformin

Endocrine

Type 2 diabetes

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26
Q

Synthroid

A

Levothyroxine

Endocrine

Hypothyroidism

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27
Q

Proair HFA/Proventil HFA/Ventolin HFA

A

Albuterol

Lungs

Bronchospasm, asthma

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28
Q

Advair diskus

A

Fluticasone and salmeterol

Asthma, COPD

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29
Q

Aricept

A

Donepezil

Psych

Alz

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30
Q

Norco

A

Hydrocodone and acetaminophen

Pain

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31
Q

Advil/Motrin

A

ibuprofen

pain, fever

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32
Q

Side effects of advil/motrin

A 
edema
dizziness
epigastric pain
heartburn
nausea
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33
Q

Counseling points of Advil/Motrin

A

may cause peptic ulcers and/or bleeding without symptoms

CNS adverse effects seen in overdose or high dose

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34
Q

Flomax

A

tamsulosin

benign prostatic hyperplasia

urinary

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35
Q

Fosamax

A

alendronate

osteoporosis

bone

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36
Q

Side effects of Fosamax

A

hypokalemia
hypophosphatemia
atypical femur fractures
osteonecrosis of the jaw

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37
Q

Counseling points of Fosamax

A

take first thing in the morning with a full glass of water, don’t eat or drink anything and remain upright for 30 minutes after

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38
Q

K -Dur/Micro-K

A

potassium chloride

hypokalemia

supplement

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39
Q

Nexium

A

esomeprazole

GERD, Heartburn

digestive

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40
Q

Side effects of Nexium

A 
diarrhea
nausea
headache
prolonged use may increase risk of hypomagnesemia
fractures
pneumonia
CDiff infections
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41
Q

Counseling points of Nexium

A

best to take first thing in the morning
capsules may be opened and contents sprinkles if swallowed immediately
granules should not be chewed or crushed

42
Q

Miralax

A

PEG 3350

constipation

digestive

43
Q

Case Presentation

Brief synopsis

A

initials
race
age
sex

44
Q

Case Presentation

Social History

A 
marital status
number of children
education
previous occupation
dietary habits
tobacco/alcohol use
social support
hobbies
45
Q

Case Presentation

Family history

A

age and health of parents, sibling, children

ages and causes of death

46
Q

Case Presentation

Allergies

A

allergies and rxn to medications, food, pets, environment

47
Q

Case Presentation

Past medical history

A

serious illnesses
chronic diseases
surgical procedures
injuries

48
Q

Case Presentation

Medications

A

medications and supplements (dose, frequency, indication)

49
Q

Case Presentation

Other treatments

A

physical therapy

occupational therapy

50
Q

Adherence defined.

A

the active voluntary and collaborative involvement of the patient in a mutually acceptable course of behavior to produce a therapeutic result

51
Q

Compliance defined.

A

passively following the provider’s orders, and the treatment plan is not based on a therapeutic alliance or contract established between the patient and the physician

52
Q

Consequences of non-adherence include…

A

increased ER visits and hospitalization rates

53
Q

Healthcare Factors associated with non-adherence include…

A

 Health-care System:
access to care, continuity of care, patient education material is not written in plain language
 Health-care Team:
stress of health-care visits, discomfort in asking providers questions, patient’s belief or understanding, patient’s forgetfulness/carelessness, stressful life events, lack of immediate benefit of therapy

54
Q

Provider Factors associated with non-adherence include…

A

communication skills, knowledge of health literacy issues, lack of empathy, lack of positive reinforcement, number of comorbid conditions, number of medications needed per day, prescribed length of therapy

55
Q

Patient, Condition, and Therapy factors associated with non-adherence include…

A

 Patient-related:
physical, psychological
 Condition-and Therapy-related:
complexity of medication, frequent changes in regimen, treatment requiring mastery of certain techniques, unpleasant side effects, duration of therapy, lack of immediate benefit of therapy, medications with social stigma

56
Q

Economic and Social Factors associated with non-adherence include…

A

 Economic:
health insurance/medication cost
 Social:
limited English proficiency, inability to access or difficulty accessing pharmacy, lack of family/social support, unstable living conditions

57
Q

To what does the acronym SIMPLE relate?

A 
S - simplify the regimen
I - impart knowledge
M - modify patient beliefs and behavior
P - provide communication and trust
L - leave the bias
E - evaluate adherence
58
Q

Types of MTM services

A

Comprehensive medication reviews, pharmacotherapy consults, targeted interventions, anticoagulation management, immunizations, health and wellness programs, etc.

59
Q

Why is MTM needed?

A

Medication-related problems account for preventable adverse effects each year
Multiple players in the healthcare system
Patients see more than one physician
Patients fill prescriptions at more than one pharmacy
Complex medication regimens
MTM is the one opportunity to bring together all of the patient’s medications into one document in order to assess the effectiveness and safety of their regimen

60
Q

Associate types of information needed to give effective MTM.

A

Age and sex: dosage adjustments
Height and weight: BMI, lifestyle/diet issues
Lab values: effectiveness of current therapy or need to initiate therapy
Nicotine, alcohol, and caffeine use/lifestyle issues: drug or disease interactions, effects on meds/overall health
Drug allergies/adverse rxn: avoid reactions
Medical conditions: what conditions the patient thinks they have
All RX/OTC/herbal medications and side effects: determine polypharmacy, drug interactions, possible causes of noncompliance
Prior therapies: history of what has been tried and its successes
Patient goals: determine what is important to the patient
Immunizations: prevent disease

61
Q

Identify challenges of MTM.

A

disruption of workflow
how to obtain payment
physician perception of pharmacist effectiveness

62
Q

Define drug abuse.

A

much like dangerous drinking; able to stop

63
Q

Define chemical dependence.

A

much like compulsive drinking; a brain disease; not able to stop

64
Q

Define compulsive drinking.

A

a brain disease (formerly “alcohol dependence”); not able to stop

65
Q

Define dangerous drinking.

A

binge drinking, risky drinking, (formerly “alcohol abuse”); able to stop

66
Q

A pharmacist is…

A

medication experts (provide medications, tech patients and other health care team members about optimal use of medications, monitor patient health and response to meds, etc.)

67
Q

A nurse provides…

A

direct patient care

68
Q

A doctor…

A

diagnoses and prescribes

69
Q

A pharmacy technician…

A

fills medication orders, enters orders, insurance

70
Q

A hospice worker…

A

usually a social worker who takes care of a patient’s hospice plan, ensures that all of the proper paperwork is filed and that they are getting the proper services

71
Q

A surgical technician…

A

verifies that pre-op instructions were followed

72
Q

Nutritionist/dietician…

A

develops a meal plan to meet adjusted nutritional requirements

73
Q

Phlebotomist…

A

draws blood from patients for testing, donations, etc

74
Q

Nurse practitioner…

A

directly works with patients, diagnoses, and manages illnesses, authorized to perform physical examinations/order and interpret tests/provide counseling/write prescriptions

75
Q

A physician assistant…

A

assists the physician, some have prescribing authority

76
Q

A psychologist…

A

provides professional evaluations on mental health, after Dx can recommend a doctor to Rx from evaluation

77
Q

A nurse assistant…

A

helps with patient hygiene and administers meals

78
Q

A volunteer…

A

provides services without monetary payment (filing, answering, phone, assisting patients, etc.)

79
Q

A radiology technician…

A

if required a Rx with nuclear isotopes, the technician will come by the pharmacy to dropoff scans in order to make a Rx for the current line of therapy

80
Q

A caregiver…

A

is a person who helps care for the patient, ensures that they are getting the proper medication, are fed and cleaned

81
Q

Define primary hypertension and associated risk factors.

A

90-95% of cases

caused by age, race/genetics, diet, smoking, alcohol intake

82
Q

Define secondary hypertension and associated risk factors.

A

5-10% of cases

caused by diseases, medications, “white coat hypertension”

83
Q

What are the consequences of untreated hypertension?

A

cardiovascular disease (heart failure, MI, etc), stroke, renal disease

84
Q

What are some medications used to treat hypertension?

A 
Lisinopril
Furosemide
Amlodipine
Metaprolol
Carvedilol
85
Q

Suggest lifestyle changes to control hypertension.

A

weight control
reduced dietary sodium
reduce excessive alcohol intake
increase physical activity

86
Q

What are the function of lipid components?

A

Triglycerides are for energy and storage
LDL transports triglycerides and cholesterol in the blood to tissues
HDL is good cholesterol that transport cholesterol from arteries to liver for processing/elimination

87
Q

Discuss diet influence on lipid levels.

A

Diets high in fat increase cholesterol and cardiovascular disease, but there is no consistent relationship with egg consumption and cardiovascular disease.

88
Q

What class of medication is commonly used to treat hyperlipidemia?

A

statins

ie atorvastatin

89
Q

How do statins work?

A

reduce liver production of cholesterol by inhibiting HMG-CoA, compensatory increase in LDL receptors in the liver so that the LDL digested in the liver is from the blood stream.

90
Q

What are the adverse effects associated with statins?

A

muscle pain
diabetes
altered CNS

91
Q

List the resident rights of medication administration.

A
  • be treated with respect
  • refuse medication or treatments
  • be given privacy during med pass
  • be free from physical and chemical restraints
92
Q

What is done if controlled medications are missing?

A
  1. follow facility policy
  2. review reports related to medication and patient’s clinical record
  3. medication diverted then contact TSBP, DEA, DPS and notify the facility administrators and state board of nursing
93
Q

Match procedure with right from “rights of medication administration”

Right patient:

A

check name, use 2 identifiers, ask patient to identify himself/herself, when available use technology

94
Q

Match procedure with right from “rights of medication administration”

Right medication:

A

check the medication label, check the order

95
Q

Match procedure with right from “rights of medication administration”

Right dose:

A

check the order, confirm appropriateness of the dose using a current drug reference, calculate dose if necessary

96
Q

Match procedure with right from “rights of medication administration”

Right route:

A

check order and appropriateness, confirm that the patient can take/receive medication by the ordered route

97
Q

Match procedure with right from “rights of medication administration”

Right time:

A

check the frequency of the ordered medication, confirm when last dose was given, double-check you are giving dose at the right time

98
Q

Match procedure with right from “rights of medication administration”

Right documentation:

A

document administration after giving the ordered medication, chart route and any other specific information before giving drug

99
Q

Match procedure with right from “rights of medication administration”

Right reason:

A

confirm rationale, revisit the reasons for long-term medication use

100
Q

Match procedure with right from “rights of medication administration”

Right response:

A

make sure the drug led to the desired effect

MISC (Spr 2016) (5 decks)

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