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NCLEX > Medications > Flashcards

Medications Flashcards

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1
Q

What is the function of Corticosteroids?

A

Alter normal immune response and suppress inflammation. Produce anti-inflammatory, antiallergic, and anti-stress effects

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2
Q

What are the 6 main side effects of Corticosteroids?

A
  • immunosuppression
  • hyperglycemia (glucose intolerance)
  • fluid and sodium retention
  • hypokalemia
  • hypocalcemia
  • weight gain
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3
Q

What medications need to be tapered off gradually ?

A
  • Steroids (prednisone)
  • antihypertensives (captopril)
  • antiseizure meds (phenytoin)
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4
Q

What antihypertensive medication should not be administered to a client with COPD or who is in an acute asthma attack ?

A

non-selective BB such as propranolol. It will block the beta receptor, causing further bronchoconstriction

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5
Q

What is the nurse’s best action to prevent lithium toxicity in a client?

A

Increase the client’s fluid intake and maintain sodium intake to prevent hyponatremia. (hyponatremia potentiates lithium toxicity)

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6
Q

To which client should the nurse administer lithium?

A

The client diagnosed with bipolar disorder

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7
Q

What medications are ototoxic?

A
  • cisplatin
  • furosemide (IV Push over 1-2 minutes)
  • gentamicin
  • vancomycin
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8
Q

What are the main side effects of antibiotics?

A
  • Gastric irritation
  • ototoxicity
  • superinfection
  • photosensitivity
  • nephrotoxicity
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9
Q

How and when should Tetracyclines be taken?

A

Take with a full glass of water 1 hour before or 2 hours after meals.
Do NOT take with milk or antacids.
Do NOT crush the tablets

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10
Q

What is Benztropine?

A

anticholinergic medication that activates sympathetic nervous system. CONTRAINDICATED in glaucoma because it increases IOP

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11
Q

What are the side effects of atenolol?

A

Atenolol = selective BB

- bradycardia, heart failure, decreased exercise tolerance, gastric pain

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12
Q

What should the nurse assess for in children and adolescents taking medication for ADHD?

A

Assess for weight loss and nutritional status.

common side effect:
- loss of appetite, anorexia, growth suppression

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13
Q

What are some common medications given for treatment of ADHD?

A

Methylphenidate

Atomoxetine

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14
Q

What should the nurse educate the client taking Tamsulosin on?

A

To get up slowly because of orthostatic hypotension

medication to treat BPH

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15
Q

What lab value should the nurse monitor for the client on Ketolorac for severe pain?

A

Monitor serum creatinine because Ketolorac is a nephrotoxic NSAID

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16
Q

What are adverse reactions of isoniazid?

A
  • hepatitis

- peripheral neuropathy

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17
Q

How should the nurse respond when the client asks how long he must take his medications for TB?

A

6-12 months

Non-infectious after 2-3 weeks or 3 negative sputum cultures

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18
Q

How does the nurse know that the atorvastatin is effective in the client with hyperlipidemia?

A

LDL levels < 139

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19
Q

What is an elevated triglyceride level?

A

Normal: < 150
Elevated: > 200

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20
Q

What is normal cholesterol level?

A

Normal: < 200

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21
Q

What is priority for the nurse to monitor for in a client taking SSRIs?

A

monitor for suicidal thoughts/behavior

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22
Q

What are some common SSRIs?

A
  • fluoxetine
  • setraline
  • citalopram
  • escitalopram
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23
Q

Medications that majorly interact with grapefruit juice

A
  • verapamil
  • simvastatin
  • busprione
  • carbamazepine
  • cyclosporine
  • INCREASES serum levels of medications
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24
Q

In which patients is verapamil contraindicated in?

A

Contraindicated in HF patients receiving digoxin

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25
Q

What are the side effects of Cisplatin?

A

tinnitus, hypokalemia, hypocalcemia, hypomagnesemia, nephrotoxicity

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26
Q

What should you teach the client to do after taking beclomethasone?

A

Rinse the mouth out with water after every treatment

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27
Q

What are the side effects of opiates?

A

cough suppression, facial flushing, urinary retention, constipation

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28
Q

Which meds take a few weeks to take effect

A
  • BPH meds (tamsulosin)
  • SSRIs
  • ## antispychotics
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29
Q

What is Nimodipine?

A

Calcium Channel Blocker

used in hypertensive crisis or after strokes

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30
Q

When is the best time to take antacids?

A

after meals

Do not take antacids with other meds because they delay the absorption of the medications

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31
Q

What is a side effect of carbamazepine?

A

causes bone-marrow suppression

  • low RBCs, WBCs, platelets
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32
Q

What is the therapeutic range for Phenytoin?

What are signs of toxicity?

A

normal range: 10-20 mcg/mL (dose given once a day)

long term side effects: acne, hirsutism, gingival hyperplasia

signs of toxicity: ataxia, slurred speech, nystagmus

other side effects:
- rash, increased suicidal tendencies, contraindicated in pregnancy

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33
Q

What nutritional deficiencies can phenytoin cause?

A

Folate and vitamin D deficiencies

eat milk, green leafy veggies, oranges, cantaloupe

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34
Q

What is clozapine?

A

atypical antipsychotic for schizophrenia

can cause bone marrow suppression and agranulocytosis - REPORT sore throat or fever

*report WBCs weekly for first 6 months

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35
Q

What are side effects of Metoclopramide?

A

restlessness, drowsiness, dizziness, insomnia, headache, EPS

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36
Q

When should you take oral corticosteroids?

A

Take in the AM before 9

Take with meals because they have ulcerogenic properties

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37
Q

What is methotrexate?

A

immunosuppressive and chemotherapy drug

  • monitor for low platelet levels
  • NO fresh flowers/plants
  • use electric razors
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38
Q

Uses for diphenhydramine

A
  • allergy rhinitis
  • parkinson’s - to decrease muscle tremors
  • insomnia
  • motion sickness
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39
Q

What is gingko?

A

anti-platelet agent and CNS stimulant

Don’t give w/ NSAIDs - risk for bleeding

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40
Q

What is gabapentin?

How many times a day is it given?

A
  • treats neuropathic pain

- given in 3 divided doses

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41
Q

In what order should insulin be drawn up when mixing short-acting and intermediate-acting?

A

Draw up the clear, short-acting FIRST

and then draw up cloudy, intermediate-acting

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42
Q

What medication should not be administered with phosphodiesterase inhibitors?

A

Do not administer w/ NGT - can cause fatal drop in blood pressure

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43
Q

What are the adverse effects of aspirin overdose?

A

tinnitus and GI upset

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44
Q

What is the onset and peak of short-acting insulin?

A

onset: 30-60 minutes
peak: 2-3 hours

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45
Q

What are adverse effects of metformin?

A
  • nephrotoxicity
  • impairs vitamin B12 absorption
  • use w/ caution in pregnancy
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46
Q

What is the action of morphine in an acute MI?

A
  • decreases preload and afterload
  • causes vasodilation and pooling of blood in extremities
  • relieves anxiety
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47
Q

How should Levothyroxine be taken?

A

take in the morning on empty stomach 30 minutes before breakfast

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48
Q

Symptoms of levothyroxine overdose

A

tachycardia, chest pain, restlessness, nervousness, and insomnia

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49
Q

What immunosuppression drug is used after organ transplant ?

A

cyclosporine - lifelong anti-rejection drug

- take the same time every day

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50
Q

What is disulfiram?

A

antabuse - alcoholism medication
- can take at night to minimize sedative effects

  • DO NOT take with any OTC cough medications
  • avoid any contact with alcohol (even paint or wood fumes)
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51
Q

What medications are contraindicated with St. Johns Wort ?

A
  • digoxin
  • warfarin
  • hydromorphone
  • citalopram
  • nifedipine
  • simvastatin
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52
Q

Purpose of epoetin

A

biologic response modifier

- stimulates RBC production for anemia, CKD, chemotherapy

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53
Q

what is the most common side effect of trimethoprim-sulfamethoxazole

A

urticaria

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54
Q

What is the action of thiazide diuretics

A

inhibits absorption of sodium and water

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55
Q

What electrolyte imbalance potentiates digoxin toxicity?

A

Hypokalemia - don’t give digoxin with furosemide or licorice because both also lower K+

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56
Q

What are foods high in potassium?

A

broccoli, spinach, potatoes, bananas, cantaloupe, oranges, strawberries

57
Q

how to minimize side effects after Dtap immunization?

A

administer antipyretics

58
Q

what lab values need to be monitored after acetaminophen overdose?

A

AST and ALT levels from hepatic toxicity

*toxicity manifests ~1-3 days after ingestion

59
Q

what is the maximum daily dose of acetaminophen?

A

4 grams/day

60
Q

how does calcium affect iron absorption?

A

it decreases iron absorption

  • iron should be taken separately from other foods and medications
61
Q

How should NSAIDS be taken?

A

taken with meals because they cause GI distress

62
Q

How should ABX be taken?

A

generally on an empty stomach, but can be taken with meals if gastric irritation

63
Q

Pain unrelieved by medication is a sign of acute ______.

A

compartment syndrome

  • perform neurovascular assessment!
64
Q

It is most important for the nurse performing CPR to maintain ______ on client’s chest through heel of the nurse’s hands.

Return of client’s pulse should be checked _____.

A

vertical pressure

After every minute

65
Q

what is the action of furosemide?

A

excretes sodium, water, and potassium

66
Q

what is the action of spironolactone ?

A

promotes water and sodium excretion
retains potassium

  • monitor for hyperkalemia
  • don’t give with ACE inhibitors
67
Q

Blood TSH levels will _____ when taking levothyroxine.

A

DECREASE with medication effectiveness

replaces T4 only

68
Q

Metformin should be taken _____.

A

with meals

69
Q

Metformin: use and side effects

A

oral hypoglycemia agent - helps tissues respond to insulin and increase glucose uptake

2 common side effects: bitter, metallic taste and abdominal cramps

70
Q

ACE-inhibitors cause _____ retention.

A

potassium retention

  • avoid foods high in K+
  • take on empty stomach
  • don’t double up on doses
  • can cause orthostatic hypotension
71
Q

garlic can potentiate ______ effects

A

hypoglycemic effects

72
Q

adverse effects of Theophylline:

A

tachycardia, hypotension, N/V

73
Q

imipramine

use and side effects

A

tricyclic antidepressant medication

- sore throat, fever, increased fatigue, vomiting, diarrhea

74
Q

what is a common side effect of gabapentin?

A

fatigue

75
Q

When are statins most effective?

A

At night when cholesterol synthesis is highest

76
Q

interventions for patients on chemotherapy agents:

A
  • administer anti-emetics
  • offer high cal, high fat meals to prevent weight loss
  • cleanse mouth before and after meals to prevent stomatitis
  • increase fluid intake to prevent cystitis
  • encourage moderate exercise to help manage fatigue
77
Q

What is given to reduce ammonia formation in the intestines?

A

lactulose

  • frequently given in cirrhosis
78
Q

what are early and severe adverse effects of lithium?

A

early:
- N/V, slurred speech, muscle weakness

severe:
- coarse hand tremors and ataxia

79
Q

What should NOT be taken with clopidogrel?

A

ginger, gingko, and garlic

80
Q

What are contraindications to Benzotropine?

A

contraindicated in glaucoma because it will increase IOP

it’s an anticholinergic med - also causes urinary retention and dry mouth

81
Q

for patient on heparin

aPTT should be ____ x the normal range

what is the antidote for heparin?

A

1.5 x (46-70 seconds)

protamine sulfate

82
Q

naproxen

A

NSAID

  • take with food, milk, or antacid to decrease GI upset
  • no alcohol
  • watch for signs of GI bleeding
83
Q

clonidine transdermal patch

A

antihypertensive medication
alpha 1 agonist

replace patch every 7 days

84
Q

what 2 drugs can cause a problem for clients with asthma

A

NSAIDs and non-selective BB - bronchospasms

85
Q

what should you administer to someone with signs of EPS?

A

benztropine

trihexphenidyl

86
Q

common NSAIDs

A 
aspirin
ketolorac
meloxicam 
naproxen
sulindac
ibuprofen
indomethacin 
celecoxib
87
Q

oseltamivir

A

treatment for influenza

  • take as soon as symptoms appear
  • can open capsules and mix with flavoring
  • take with foods cuz it can cause stomach upset
  • still take annual flu shots
  • no contraindication for egg allergy
88
Q

amitriptyline hydrochloride

A

tricyclic antidepressant

  • takes 3-4 weeks to reach therapeutic levels
89
Q

what are side effects of amitriptyline hydrochloride?

A 
blurred vision 
dry mouth 
diaphoresis 
postural hypotension
urinary retention
increased appetite

*AVOID tyramines and wear sunblock

90
Q

phenazopyridine

A

UTI analgesic

watch for yellow discoloration of skin or sclera - indicates accumulation of med due to kidney injury

91
Q

what is the peak and onset of NPH?

A

Onset: 2-4 hours
Peak: 6-12 hours

92
Q

Sulfasalazine

A

treats IBD

  • increase fluid intake to prevent crystallization
  • orange-red urine is normal
  • take with foods or after meals
93
Q

normal therapeutic range for digoxin?

A

0.5 -2

half life - 36 hours

94
Q

Terbutaline

A

tocolytic and bronchodilator

administered to DELAY preterm labor
withhold if pregnant mother has high HR

95
Q

Hydralazine

A

vasodilator for HTN

  • watch for anorexia and orthostatic hypotension
  • avoid taking with OTC meds
96
Q

Procainamide

A

anti-dysrhythmic

watch for hypotension and bradycardia

97
Q

aminophylline

A

xanthine bronchodilator

main side effects: palpitations and nervousness

98
Q

what are toxic effects of aminophylline?

A 
N/V
confusion
headache 
flushing 
seizures
99
Q

what is a possible life-threatening reaction with clozapine?

A

Risk of agranulocytosis - monitor WBCs weekly for the 1st 6 months

D/C drug if WBC below 2000

100
Q

clients on warfarin should avoid what ?

A

dark leafy greens because they’re high in vitamin K

101
Q

Verapamil is contraindicated i n which patients?

A

patients with HF and those on digoxin

102
Q

Carbamazepine interferes with what drugs?

A

hormonal contraceptives

serum levels increase when taken with grapefruit juice

103
Q

what is a common side effects of Rantidine?

A

mild diarrhea

acne-like rash

104
Q

fluticasone

A

inhaled glucocorticoid and anti-inflammatory

used on regular basis

rinse and gargle after use to decrease risk of candida infection

105
Q

butorphanol tartrate

A

opioid analgesic

side effects - sedation, diplopia, blurred vision

Monitor vital signs!!

106
Q

side effects of risperidone

A
  • weight gain
  • avoid extreme temperatures
  • photosensitivity
  • orthostatic hypotension
  • causes sleep disturbances
107
Q

what foods should you take with cephalexin?

A

yogurt and acidophilus milk

helps maintain normal intestinal flora which can be altered from this med

108
Q

sucralfate

A

antacid that decreases bonding to GI mucosa

don’t give antacids within 30 minutes of each other

*BEST on an empty stomach

109
Q

side effects of albuterol

A

nervousness
restlessness
palpitations

usually diminishes after 1 week or longer

110
Q

metronidazole

A
  • take with meals
  • don’t drink alcohol
  • metallic taste expected
111
Q

tyramine foods

A 
red wine
organ meat
yogurt
aged-cheese 
bananas 
yeast
avocados
beer

*cream cheese is ok

112
Q

pentamidine isethionate

A

antiprotozoal agent to tx Pneumocystitis PNA - common in AIDS clients

therapeutic response would be decreased crackles and dyspnea

113
Q

urine output will _____ with levothryoxine

A

INCREASE

increased metabolic processes –> better glomerular filtration

114
Q

can enteric coated tablets be broken?

A

no

115
Q

tetracyclines should not be given within 1 hour of _____ because of _______.

clients should take _____ methods of contraceptives during use.

Do not take ____ within 1-3 hours of taking oral tetracyclines.

A

bedtime; esophageal irritation

nonhormonal (condoms)

antacid

116
Q

probenecid

A

uric acid reducer - prevents reoccurrence of gouty arthritis

117
Q

colchicine

A

treats acute gout attacks

  • don’t give with atorvastatin
118
Q

acyclovir

A

used to treat herpes

side effects: N//V
given 5 x a day
don’t apply anything on lesions

119
Q

what lab results should be monitored for client taking clopidogrel

A

anti-platelet med

Hemoglobin and hematocrit

120
Q

daily iron needs

A

pregnant: 30mg/day
12-13 F: 8mg/day
14-18 F: 15mg/day

12-13 M: 8 mg/day
14-18 M: 11 mg/day

121
Q

permethrin

A

treatment of lice

  • leave cream in for 10 min and rinse out
  • only use 1x/week
  • wash linens in hot water and dryer
  • check all family members
  • makes itching stop by killing lice and nits
  • can cause erythema
122
Q

glargine

A

given at same time everyday usually at night

onset: 3-4 hours
lasts for 24 hours

should not be mixed with any other insulin in a syringe

123
Q

signs of digoxin toxicity

A

Halos, N/V, confusion, headache

normal range: 0.5-2.0

124
Q

how should cyclosporine oral solution be stored?

A

tightly closed container protected from light

125
Q

Fluphenazine decanoate

A

treats psychotic disorders
given IM or SQ every 1-6 weeks

onset: 24-96 hours

126
Q

clients that need B12 supplementation

A

pernicious anemia
strict vegan diet
takes metformin
gastrectomy

127
Q

chlorpromazine

A

antipsychotic

  • dry mouth, leukopenia, pink urine
  • takes at least 6 weeks to take effect
  • no alcohol
  • avoid driving until dose stabilized
128
Q

what is commonly given to treat H. Pylori

A

antibiotics :

  • clarithromycin
  • amoxicillin
  • tetracycline
  • metronidazole
129
Q

nystatin

A

antifungal agent in oral suspension

swish around mouth and swallow

130
Q

ethacrynic acid

A

loop diuretic

  • orthostatic hypotension
  • take with meals to minimize GI upset
  • increase K+ rich foods
131
Q

chlordiazepoxide

A

antianxiety med

watch for lethargy and ensure safety!

132
Q

statins

A 
take at night 
use contraception 
NOT during pregnancy
monitor liver function - blood work
optimal cholesterol <200
133
Q

trifluoperazine

A

antipsychotic medication

no breastfeeding
dry eyes, weight gain, EPS, urinary retention

134
Q

hydralazine

A

take with food
talk to HCP about OTC meds
orthostatic hypotension

report any anorexia

135
Q

carbidopa-levodopa

A

parkinson’s medication

take with low-protein to decrease GI upset
orthostatic hypotension
twitching eyelid - early sign of overdose
check with HCP with OTC meds and multivitamins - can reverse actions

136
Q

ciprofloxacin

A 
increase fluids - prevent crystalluria 
no mulitvitamin within 6 hrs
dont take with milk or yogurt 
avoid sun 
avoid caffeine - increases caffeine effects
137
Q

side effects of estrogen

A

changes in libido
change in weight
dry eyes

no smoking

138
Q

medication treatment for multiple sclerosis

A

adrenocorticotropic hormone

cyclophosphamide - alopecia

139
Q

chloral hydrate

A

sedative

can cause paradoxical excitation in children - closely monitor them

NCLEX (5 decks)

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