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Pharmacology-NRSE-3010-001 > LastPharmFinalStudy > Flashcards

LastPharmFinalStudy Flashcards

1
Q

What is methadone used for?

A

heroin withdrawal

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2
Q

What is medication is used in the maintenance of alcohol sobriety by eliciting an unpleasant response if alcohol is consumed?

A

disulfiram

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3
Q

If a patient has a magnesium level of 2.8 mEq/L, absent DTRs, and respiratory depression, what can the nurse suspect to administer?

A

calcium gluconate (antidote for magnesium sulfate overdose)

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4
Q

A patient recently prescribed ferrous sulfate states, “ever since I started taking my iron, my poop has been black and green.” The nurse should:

A

note that this is a common unharmful effect of taking ferrous sulfate

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5
Q

What foods should be recommended to those taking ferrous sulfate to aid in increasing iron levels?

A

tofu, egg yolks, leafy greens (high iron foods)

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6
Q

Vitals: HR-48 bpm, BP 132/92, Temp 98.9, SpO2 99%
Next dose of metoprolol is due now, what action should the nurse take?

A

hold the dose because HR is less than 50 bpm

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7
Q

What is the first line treatment for alcohol withdrawal?

A

chlordiazepoxide (a benzodiazepine)

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8
Q

What are some common indications for benzodiazepines?

A

GAD, panic disorder, seizure disorder, status epilepticus (diazepam)

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9
Q

When is the CIWA assessment used?

A

to determine the dose of benzodiazepine for those taking them for alcohol withdrawal

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10
Q

What should the nurse have available for those taking a benzodiazepine in case of overdose?

A

flumazenil

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11
Q

What would anxiety, rage, insomnia, and excitation indicate in a patient taking benzodiazepines?

A

paradoxical response

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12
Q

what kind of medications are zolpidem, zaleplon, and eszopiclone?

A

Non-benzodiazepines

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13
Q

What medication may be used in the short term management of insomnia?

A

zolpidem

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14
Q

what may phenytoin be used in the treatment of?

A

seizures

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15
Q

if a patient reports inflamed and swollen gums while taking their phenytoin, what may this indicate?

A

gingival hyperplasia

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16
Q

why should patients taking hydantoins be encouraged to take calcium and vitamin D supplements?

A

adverse effect of osteomalacia

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17
Q

What is a fatal adverse effect of hydantoins when given through IV?

A

cardiac collapse

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18
Q

what medication may be used in the treatment of those with seizures r/t to epilepsy?

A

carbamazepine

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19
Q

What are the 3 black box warnings for carbamazepine?

A

blood dyscrasias (monitor for infection, bleeding, anemia), heart failure, and fluid overload

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20
Q

What questions should the nurse ask for those taking carbamazepine (anticonvulsant) to assess for the adverse effect that impacts their mental health?

A

questions about suicidal ideation

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21
Q

what medication is use in the treatment of dementia associated with alzheimers?

A

donepezil

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22
Q

Because donepezil can cause cholinergic crisis, what should the nurse have available?

A

atropine and crash cart

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23
Q

What combination medication is often used in the treatment of Parkinsons disease?

A

carbidopa-levodopa

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24
Q

What should patients receiving carbidopa-levodopa therapy avoid?

A

high protein diet and multivitamins (B6 and iron)

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25
Q

Should the nurse be alarmed if a pt taking carbidopa-levodopa has dark urine?

A

no, this is a harmless side effect

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26
Q

Why should patients taking carbidopa-levodopa report new skin lesions/rashes?

A

this medication can cause Stevens Johnsons

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27
Q

Describe On/Off syndrome with carbidopa-levodopa?

A

period btwn doses when med wears off and dopamine levels are low, causing pt to experience increased Parkinsons s/s

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28
Q

If a patient has neostigmine on their med list, we can likely suspect they have which condition?

A

myasthenia gravis

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29
Q

what effects may occur with neostigmine?

A

SLUDGES; bradycardia

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30
Q

What antidote medication should be available for those taking neostigmine for myasthenia gravis?

A

atropine

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31
Q

Mnemonic to remember central acting muscle relaxants?

A

ABCD

Acting (central A muscle relaxants)
Baclofen
Dantrolene
Cyclobenzaprine

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32
Q

what medications are used in the treatment of muscle spasms?

A

baclofen, dantrolene, cyclobenzaprine

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33
Q

What would decreased pain and increased ROM indicate in those taking baclofen?

A

effective treatment

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34
Q

what is a severe adverse effect that can occur with neuromuscular blocking drugs (succinylcholine)?

A

MH (malignant hyperthermia)

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35
Q

what med should be given for malignant hyperthermia?

A

dantrolene (+stop med immediately, admin O2, decrease body temp)

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36
Q

what is the antidote for neuromuscular blocking drugs?

A

neostigmine

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37
Q

what would indicate need for haloperidol or chlorpromazine (typical antipsychotic)?

A

schizophrenia, drug-induced psychosis

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38
Q

what would indicate development of neuroleptic malignant syndrome in those taking haloperidol (typical antipsychotic)?

A

sudden, high grade fever, BP fluctuations, dysrhythmias, muscle rigidity, diaphoresis, tachycardia, LOC/coma

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39
Q

What class is clozapine?

A

atypical antipsychotics

40
Q

Patient taking urinary frequency, increased thirst and hunger, which effect of atypical antipsychotics may this indicate?

A

diabetes mellitus

41
Q

what is a potential fatal effect of clozapine?

A

fatal agranulocytosis

42
Q

what should pts taking clozapine (atypical antipsychotics) report?

A

abnormal movements, seizures, gynecomastia, galactorrhea, s/s DM

43
Q

Why may a patient be prescribed fluoxetine (SSRI)?

A

depression, PTSD, OCD

44
Q

which adverse effect may cause a patient to avoid taking their sertraline (SSRI)?

A

sexual dysfunction

45
Q

What may indicate serotonin syndrome?

A

confusion, agitation, poor concentration, seizures

46
Q

What should the nurse assess for in a patient taking citalopram (SSRI) to ensure safety?

A

SI

47
Q

what kind of medication is phenelzine?

A

MAOI

48
Q

what pt would benefit from isocarboxazid (MAOI)?

A

depression that doesn’t respond to other modes of therapy

49
Q

what foods should be avoided while taking selegiline/phenelzine/tranylcypromine (MAOIs)?

A

tyramine (aged cheese, yogurts, coffee, chocolate, pickled foods, yeast, beer, red wine, bananas, liver, smoked meats

50
Q

what medication is a mood stabilizer used for bipolar and schizophrenia?

A

lithium

51
Q

what stage of lithium toxicity is indicated by:
extreme polyuria, tinnitus, ataxia, severe hypotension, and seizures?

A

advanced (2-2.5)

52
Q

what drug class is amitriptyline?

A

TCA

53
Q

Because amitriptyline (TCA) can decrease the seizure threshold, what should pt be monitored for?

A

seizures/history of

54
Q

when should methotrexate be avoided?

A

current infection, live virus vaccine, pregnancy (X)

55
Q

what is the minimum infusion time for vancomycin?

A

60 mins

56
Q

what medication could cause achilles tendon rupture and arthropathy?

A

fluoroquinolones (-oxacin)

57
Q

How can crystalluria be prevented with those taking ciprofloxacin?

A

increase fluids

58
Q

what drug class is gentamicin? when should its peak be taken?

A

aminoglycosides
30 mins after completion of infusion

59
Q

what intervention can the nurse implement to prevent peripheral neuropathy in their pt who is taking INH (isoniazid) for Tb?

A

administer pyridoxine (B6)

60
Q

what should be avoided by those taking INH?

A

alcohol (disulfiram reaction), tyramine foods

61
Q

This medication may be indicated for pts with shingles or herpes?

A

acyclovir

62
Q

How may vaginal candidiasis/yeast infection be treated?

A

fluconazole therapy

63
Q

why may a patient being treated for breast cancer experience bone pain?

A

an adverse effect of of tamoxifen is hypercalcemia

64
Q

what adverse effect of tamoxifen should be reported immediately?

A

blood clots

65
Q

This medication may be used in the prevention of need for transfusion w/elective surgeries, CKD-related anemia and may cause hypertension?

A

epoetin alfa

66
Q

Which growth factor is used to increase platelet count, to decrease need for transfusion following chemo?

A

oprelvekin

67
Q

what would a platelet level of 50,000 indicate in oprelvekin therapy??

A

effective therapy

68
Q

what adverse effects may occur with phenylephrine?

A

cardio (palpitations, arrhythmias, and HTN) and CNS (hallucinations, convulsions, delusions)

69
Q

who should avoid decongestants?

A

HTN, glaucoma, cardiac disease, hyperthyroidism

70
Q

which cardiac glycoside used for atrial fibrillation, HF, and atrial flutter?

A

digoxin

71
Q

what must the nurse assess prior to digoxin administration?

A

apical pulse >60 bpm

72
Q

How may hypokalemia impact digoxin therapy?

A

increases risk for digoxin toxicity

73
Q

How can tolerance be prevented in a pt using a transdermal nitroglycerin patch?

A

remove at night/ at least 10-12hrs

74
Q

what should be avoided with amiloride/triamterene, eplerenone?

A

potassium rich foods

75
Q

If a nurse auscultates crackles in a patient receiving HCTZ, what should they suspect is occurring?

A

ineffective treatment

76
Q

How can severe rebound HTN be prevented with clonidine?

A

taper off

77
Q

How long can clonidine patches be worn?

A

1 week

78
Q

what medication is not used as monotherapy for african american pts?

A

ACE inhibitors

79
Q

what medication is used for non-obstructive urinary retention?

A

bethanechol

80
Q

This medication decreases urinary incontinence in pts with overactive bladder?

A

oxybutynin

81
Q

when should oxybutynin be avoided?

A

glaucoma, paralytic ileus, GI/urinary obstruction, myasthenia gravis

82
Q

Case study-
Pt history: type 2 DM, takes metformin
reports: muscle cramps/body ache, fast/deep breathing, exhaustion, N/V

what is this patient likely experiencing?

A

lactic acidosis from metformin

83
Q

what condition would an order for magnesium hydroxide be contraindicated in?

A

renal failure

84
Q

What should be monitored in a pt taking cimetidine and warfarin?

A

PT/INR because cimetidine increases warfarin effect

85
Q

What are the 6 rights of medication administration?

A

med, dose, route, client, time, documentation

86
Q

How can medication interactions be prevented?

A

medication reconciliation

87
Q

What statement by the new grad nurse represents understanding for administration of enteric coated (ER, XR, SR) medications?

A

“do not cut, crush of chew enteric coated medicines”

88
Q

Patient reports: muscle pain, brown/tea-colored urine, stiff muscles.
Med Rec: HMG-CoA Reductase Inhibitor (-statins)
what are the likely experiencing?

A

rhabdomyolysis

89
Q

What medication may a patient with a total cholesterol of 290 mg/dL benefit from?
a. metoprolol
b. lactulose
c. atorvastatin
d. cimetidine

A

c. atorvastatin
HMG CoA-Reductase Inhibitor
(effective treatment is shown by a total cholesterol of <200)

90
Q

what should the PTT level be for those taking heparin?

A

120-140 seconds

91
Q

Why should a patient taking risedronate avoid dental work?

A

bisphosphonates can cause jaw necrosis

92
Q

When should we teach patients to hold their dose of levothyroxine?

A

HR >100 bpm

93
Q

What are the O,P, and D for rapid acting insulins (lispro, aspart, glulisine)?

A

O- 15-30 mins
P- 30-2.5 hrs
D- 3-6 hrs

94
Q

What are O, P, and D for short acting insulin (regular)?

A

O - 30 -60 mins
P- 1-5 hrs
D- 6-10hrs

95
Q

What are O, P, and D for intermediate insulin (NPH)?

A

O- 1-2hrs
P- 6-14 hrs
D- 16 -24 hrs

96
Q

What are the O, P, and D for long acting insulins (glargine and detemir)?

A

O- 70 mins
P- NA
D- 18-24 hrs

97
Q

What would indicate methimazole treatment is effective?

A

antithyroid med, so absence of hyperthyroid manifestations (weight gain, decrease T4, less anxiety)

Pharmacology-NRSE-3010-001 (12 decks)

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