Medications Flashcards
1
Q
What is the function of Corticosteroids?
A
Alter normal immune response and suppress inflammation. Produce anti-inflammatory, antiallergic, and anti-stress effects
2
Q
What are the 6 main side effects of Corticosteroids?
A
- immunosuppression
- hyperglycemia (glucose intolerance)
- fluid and sodium retention
- hypokalemia
- hypocalcemia
- weight gain
3
Q
What medications need to be tapered off gradually ?
A
- Steroids (prednisone)
- antihypertensives (captopril)
- antiseizure meds (phenytoin)
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
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)
6
Q
To which client should the nurse administer lithium?
A
The client diagnosed with bipolar disorder
7
Q
What medications are ototoxic?
A
- cisplatin
- furosemide (IV Push over 1-2 minutes)
- gentamicin
- vancomycin
8
Q
What are the main side effects of antibiotics?
A
- Gastric irritation
- ototoxicity
- superinfection
- photosensitivity
- nephrotoxicity
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
10
Q
What is Benztropine?
A
anticholinergic medication that activates sympathetic nervous system. CONTRAINDICATED in glaucoma because it increases IOP
11
Q
What are the side effects of atenolol?
A
Atenolol = selective BB
- bradycardia, heart failure, decreased exercise tolerance, gastric pain
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
13
Q
What are some common medications given for treatment of ADHD?
A
Methylphenidate
Atomoxetine
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
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
16
Q
What are adverse reactions of isoniazid?
A
- hepatitis
- peripheral neuropathy
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
18
Q
How does the nurse know that the atorvastatin is effective in the client with hyperlipidemia?
A
LDL levels < 139
19
Q
What is an elevated triglyceride level?
A
Normal: < 150
Elevated: > 200
20
Q
What is normal cholesterol level?
A
Normal: < 200
21
Q
What is priority for the nurse to monitor for in a client taking SSRIs?
A
monitor for suicidal thoughts/behavior
22
Q
What are some common SSRIs?
A
- fluoxetine
- setraline
- citalopram
- escitalopram
23
Q
Medications that majorly interact with grapefruit juice
A
- verapamil
- simvastatin
- busprione
- carbamazepine
- cyclosporine
- INCREASES serum levels of medications
24
Q
In which patients is verapamil contraindicated in?
A
Contraindicated in HF patients receiving digoxin
25
What are the side effects of Cisplatin?
tinnitus, hypokalemia, hypocalcemia, hypomagnesemia, nephrotoxicity
26
What should you teach the client to do after taking beclomethasone?
Rinse the mouth out with water after every treatment
27
What are the side effects of opiates?
cough suppression, facial flushing, urinary retention, constipation
28
Which meds take a few weeks to take effect
- BPH meds (tamsulosin)
- SSRIs
- antispychotics
-
29
What is Nimodipine?
Calcium Channel Blocker
used in hypertensive crisis or after strokes
30
When is the best time to take antacids?
after meals
Do not take antacids with other meds because they delay the absorption of the medications
31
What is a side effect of carbamazepine?
causes bone-marrow suppression
- low RBCs, WBCs, platelets
32
What is the therapeutic range for Phenytoin?
What are signs of toxicity?
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
33
What nutritional deficiencies can phenytoin cause?
Folate and vitamin D deficiencies
eat milk, green leafy veggies, oranges, cantaloupe
34
What is clozapine?
atypical antipsychotic for schizophrenia
can cause bone marrow suppression and agranulocytosis - REPORT sore throat or fever
*report WBCs weekly for first 6 months
35
What are side effects of Metoclopramide?
restlessness, drowsiness, dizziness, insomnia, headache, EPS
36
When should you take oral corticosteroids?
Take in the AM before 9
| Take with meals because they have ulcerogenic properties
37
What is methotrexate?
immunosuppressive and chemotherapy drug
- monitor for low platelet levels
- NO fresh flowers/plants
- use electric razors
38
Uses for diphenhydramine
- allergy rhinitis
- parkinson's - to decrease muscle tremors
- insomnia
- motion sickness
39
What is gingko?
anti-platelet agent and CNS stimulant
Don't give w/ NSAIDs - risk for bleeding
40
What is gabapentin?
| How many times a day is it given?
- treats neuropathic pain
| - given in 3 divided doses
41
In what order should insulin be drawn up when mixing short-acting and intermediate-acting?
Draw up the clear, short-acting FIRST
| and then draw up cloudy, intermediate-acting
42
What medication should not be administered with phosphodiesterase inhibitors?
Do not administer w/ NGT - can cause fatal drop in blood pressure
43
What are the adverse effects of aspirin overdose?
tinnitus and GI upset
44
What is the onset and peak of short-acting insulin?
onset: 30-60 minutes
peak: 2-3 hours
45
What are adverse effects of metformin?
- nephrotoxicity
- impairs vitamin B12 absorption
- use w/ caution in pregnancy
46
What is the action of morphine in an acute MI?
- decreases preload and afterload
- causes vasodilation and pooling of blood in extremities
- relieves anxiety
47
How should Levothyroxine be taken?
take in the morning on empty stomach 30 minutes before breakfast
48
Symptoms of levothyroxine overdose
tachycardia, chest pain, restlessness, nervousness, and insomnia
49
What immunosuppression drug is used after organ transplant ?
cyclosporine - lifelong anti-rejection drug
| - take the same time every day
50
What is disulfiram?
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)
51
What medications are contraindicated with St. Johns Wort ?
- digoxin
- warfarin
- hydromorphone
- citalopram
- nifedipine
- simvastatin
52
Purpose of epoetin
biologic response modifier
| - stimulates RBC production for anemia, CKD, chemotherapy
53
what is the most common side effect of trimethoprim-sulfamethoxazole
urticaria
54
What is the action of thiazide diuretics
inhibits absorption of sodium and water
55
What electrolyte imbalance potentiates digoxin toxicity?
Hypokalemia - don't give digoxin with furosemide or licorice because both also lower K+
56
What are foods high in potassium?
broccoli, spinach, potatoes, bananas, cantaloupe, oranges, strawberries
57
how to minimize side effects after Dtap immunization?
administer antipyretics
58
what lab values need to be monitored after acetaminophen overdose?
AST and ALT levels from hepatic toxicity
*toxicity manifests ~1-3 days after ingestion
59
what is the maximum daily dose of acetaminophen?
4 grams/day
60
how does calcium affect iron absorption?
it decreases iron absorption
- iron should be taken separately from other foods and medications
61
How should NSAIDS be taken?
taken with meals because they cause GI distress
62
How should ABX be taken?
generally on an empty stomach, but can be taken with meals if gastric irritation
63
Pain unrelieved by medication is a sign of acute ______.
compartment syndrome
- perform neurovascular assessment!
64
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 _____.
vertical pressure
After every minute
65
what is the action of furosemide?
excretes sodium, water, and potassium
66
what is the action of spironolactone ?
promotes water and sodium excretion
retains potassium
* monitor for hyperkalemia
* don't give with ACE inhibitors
67
Blood TSH levels will _____ when taking levothyroxine.
DECREASE with medication effectiveness
| replaces T4 only
68
Metformin should be taken _____.
with meals
69
Metformin: use and side effects
oral hypoglycemia agent - helps tissues respond to insulin and increase glucose uptake
2 common side effects: bitter, metallic taste and abdominal cramps
70
ACE-inhibitors cause _____ retention.
potassium retention
- avoid foods high in K+
- take on empty stomach
- don't double up on doses
- can cause orthostatic hypotension
71
garlic can potentiate ______ effects
hypoglycemic effects
72
adverse effects of Theophylline:
tachycardia, hypotension, N/V
73
imipramine
use and side effects
tricyclic antidepressant medication
| - sore throat, fever, increased fatigue, vomiting, diarrhea
74
what is a common side effect of gabapentin?
fatigue
75
When are statins most effective?
At night when cholesterol synthesis is highest
76
interventions for patients on chemotherapy agents:
- 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
What is given to reduce ammonia formation in the intestines?
lactulose
- frequently given in cirrhosis
78
what are early and severe adverse effects of lithium?
early:
- N/V, slurred speech, muscle weakness
severe:
- coarse hand tremors and ataxia
79
What should NOT be taken with clopidogrel?
ginger, gingko, and garlic
80
What are contraindications to Benzotropine?
contraindicated in glaucoma because it will increase IOP
it's an anticholinergic med - also causes urinary retention and dry mouth
81
for patient on heparin
aPTT should be ____ x the normal range
what is the antidote for heparin?
1.5 x (46-70 seconds)
protamine sulfate
82
naproxen
NSAID
- take with food, milk, or antacid to decrease GI upset
- no alcohol
- watch for signs of GI bleeding
83
clonidine transdermal patch
antihypertensive medication
alpha 1 agonist
replace patch every 7 days
84
what 2 drugs can cause a problem for clients with asthma
NSAIDs and non-selective BB - bronchospasms
85
what should you administer to someone with signs of EPS?
benztropine
| trihexphenidyl
86
common NSAIDs
```
aspirin
ketolorac
meloxicam
naproxen
sulindac
ibuprofen
indomethacin
celecoxib
```
87
oseltamivir
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
amitriptyline hydrochloride
tricyclic antidepressant
- takes 3-4 weeks to reach therapeutic levels
89
what are side effects of amitriptyline hydrochloride?
```
blurred vision
dry mouth
diaphoresis
postural hypotension
urinary retention
increased appetite
```
*AVOID tyramines and wear sunblock
90
phenazopyridine
UTI analgesic
watch for yellow discoloration of skin or sclera - indicates accumulation of med due to kidney injury
91
what is the peak and onset of NPH?
Onset: 2-4 hours
Peak: 6-12 hours
92
Sulfasalazine
treats IBD
- increase fluid intake to prevent crystallization
- orange-red urine is normal
- take with foods or after meals
93
normal therapeutic range for digoxin?
0.5 -2
half life - 36 hours
94
Terbutaline
tocolytic and bronchodilator
administered to DELAY preterm labor
withhold if pregnant mother has high HR
95
Hydralazine
vasodilator for HTN
- watch for anorexia and orthostatic hypotension
- avoid taking with OTC meds
96
Procainamide
anti-dysrhythmic
watch for hypotension and bradycardia
97
aminophylline
xanthine bronchodilator
main side effects: palpitations and nervousness
98
what are toxic effects of aminophylline?
```
N/V
confusion
headache
flushing
seizures
```
99
what is a possible life-threatening reaction with clozapine?
Risk of agranulocytosis - monitor WBCs weekly for the 1st 6 months
D/C drug if WBC below 2000
100
clients on warfarin should avoid what ?
dark leafy greens because they're high in vitamin K
101
Verapamil is contraindicated i n which patients?
patients with HF and those on digoxin
102
Carbamazepine interferes with what drugs?
hormonal contraceptives
| serum levels increase when taken with grapefruit juice
103
what is a common side effects of Rantidine?
mild diarrhea
| acne-like rash
104
fluticasone
inhaled glucocorticoid and anti-inflammatory
used on regular basis
rinse and gargle after use to decrease risk of candida infection
105
butorphanol tartrate
opioid analgesic
side effects - sedation, diplopia, blurred vision
Monitor vital signs!!
106
side effects of risperidone
- weight gain
- avoid extreme temperatures
- photosensitivity
- orthostatic hypotension
- causes sleep disturbances
107
what foods should you take with cephalexin?
yogurt and acidophilus milk
helps maintain normal intestinal flora which can be altered from this med
108
sucralfate
antacid that decreases bonding to GI mucosa
don't give antacids within 30 minutes of each other
*BEST on an empty stomach
109
side effects of albuterol
nervousness
restlessness
palpitations
usually diminishes after 1 week or longer
110
metronidazole
- take with meals
- don't drink alcohol
- metallic taste expected
111
tyramine foods
```
red wine
organ meat
yogurt
aged-cheese
bananas
yeast
avocados
beer
```
*cream cheese is ok
112
pentamidine isethionate
antiprotozoal agent to tx Pneumocystitis PNA - common in AIDS clients
therapeutic response would be decreased crackles and dyspnea
113
urine output will _____ with levothryoxine
INCREASE
increased metabolic processes --> better glomerular filtration
114
can enteric coated tablets be broken?
no
115
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.
bedtime; esophageal irritation
nonhormonal (condoms)
antacid
116
probenecid
uric acid reducer - prevents reoccurrence of gouty arthritis
117
colchicine
treats acute gout attacks
- don't give with atorvastatin
118
acyclovir
used to treat herpes
side effects: N//V
given 5 x a day
don't apply anything on lesions
119
what lab results should be monitored for client taking clopidogrel
anti-platelet med
Hemoglobin and hematocrit
120
daily iron needs
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
permethrin
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
glargine
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
signs of digoxin toxicity
Halos, N/V, confusion, headache
| normal range: 0.5-2.0
124
how should cyclosporine oral solution be stored?
tightly closed container protected from light
125
Fluphenazine decanoate
treats psychotic disorders
given IM or SQ every 1-6 weeks
onset: 24-96 hours
126
clients that need B12 supplementation
pernicious anemia
strict vegan diet
takes metformin
gastrectomy
127
chlorpromazine
antipsychotic
- dry mouth, leukopenia, pink urine
- takes at least 6 weeks to take effect
- no alcohol
- avoid driving until dose stabilized
128
what is commonly given to treat H. Pylori
antibiotics :
- clarithromycin
- amoxicillin
- tetracycline
- metronidazole
129
nystatin
antifungal agent in oral suspension
swish around mouth and swallow
130
ethacrynic acid
loop diuretic
- orthostatic hypotension
- take with meals to minimize GI upset
- increase K+ rich foods
131
chlordiazepoxide
antianxiety med
watch for lethargy and ensure safety!
132
statins
```
take at night
use contraception
NOT during pregnancy
monitor liver function - blood work
optimal cholesterol <200
```
133
trifluoperazine
antipsychotic medication
no breastfeeding
dry eyes, weight gain, EPS, urinary retention
134
hydralazine
take with food
talk to HCP about OTC meds
orthostatic hypotension
report any anorexia
135
carbidopa-levodopa
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
ciprofloxacin
```
increase fluids - prevent crystalluria
no mulitvitamin within 6 hrs
dont take with milk or yogurt
avoid sun
avoid caffeine - increases caffeine effects
```
137
side effects of estrogen
changes in libido
change in weight
dry eyes
no smoking
138
medication treatment for multiple sclerosis
adrenocorticotropic hormone
| cyclophosphamide - alopecia
139
chloral hydrate
sedative
can cause paradoxical excitation in children - closely monitor them
