meds

Question 1

seizures

Answer 1

acute phase: valium or ativan

prevention: Phenytoin “Dilantin”

Question 2

Dilantin

Answer 2

admin slowly
will precipitate in D5W
monitor for dysrhythmias, respiratory fxn
monitor serum levels (Therapeutic range 10-20 mg/L
osteoporosis, osteomalacia, hyperparathyroidism, gingival hyperplasia, nystagms

Question 3

Panic and generalized anxiety disorder

Answer 3

1. benzodiazepines (Xanax (Alprazolam), Valium (Diazepam), Ativan (Lorazepam)
2. buspar
3. antidepressants (prozac and zoloft) TCA’s SSRIs, SNRIs
4. Anti HTN (propranolol and clonidine

Question 4

phobia

Answer 4

antianxiety: Benzodiazepams
antidepressants (tofranil=imipramine=TCA and Nardil=phenezine=MAOI)
anti-HTN (propranolol and atenolol)

Question 5

HSV

Answer 5

acyclovir (Zovirax)

Question 6

MS

Answer 6

Interferon beta-1a (Avonex): flu like symptoms
Copaxone: decreases the number of plaques; increases time between relapses
Methylprednisone: administered for acute exacerbations
Benzodiazepines for spasticity
bowel and bladder issues may require anticholinergics and alpha-adrenergic blockers, and antispasmotic agents

Question 7

OCD

Answer 7

SSRI: SE sleep disturbances, HA, restlessness

Clomipramine (TCA) is more selective for serotonin reuptake than any other TCA

Question 8

Body Dysmorphic DO

Answer 8

Antidepressants: clomipramine and Prozac

Question 9

Trichotillomania

Answer 9

chlorpromazine
amitriptyline
lithium
SSRI's Pimozide
Olanzapine

Question 10

PTSD

Answer 10

SSRI’s and group therapy

Question 11

depression

Answer 11

TCA’s=”ipramine” Elavil, Tofranil (imipramine)
MAOI’s Nardil (Phenelzine)
SSRI’s: Prozac (Fluoxetine), Zoloft (Sertaline), Paxil, Lexapro

Question 12

BiPolar DO

Answer 12

antimanic: Lithium
anticonvulsants: carbamazepine (tegretol)
Clonazepam
Valproic Acid (50-150 mcg/mL)
Gabapentin
CCB’s: Verapamil
Antipyschotics: Olanzapine
Aripiprazole (Abilify)
Chlorpromazine (Thorazine)
Seroquel
Risperdal

Question 13

Somatice Symptom DO and Illness Anxiety

Answer 13

TCA, SNRI’s venlafaxin and duloxetine
anticonvulsants: Phenytoin (Dilantin), carbamezepine (Tegretol), Clonazepam (Klonopin) to treat neuropathic and neuralgic pains

Question 14

Dissociative Amnesia

Answer 14

IV amobarbital is useful to retrieve lost memories

Question 15

Myasthenia Gravis

Answer 15

Pyridostigmine bromide (Mestinon) prevents the breakdown of acetylcholine
Plasma Phoresis (plasma exchange to reduce circulating antibodies)
IV immunoglobulin

Question 16

Bell’s Palsy

Answer 16

analgesics and corticosteriods

protect the eye bc of paralysis (cover eye at night)

Question 17

CCB’s

Answer 17

HA, hypotension, dizziness, edema, nausea, constipation, tachycardia, HF, DRY COUGH
avoid grapefruit juice, take before meals, high fat meals may elevate serum levels

Question 18

ACE Inhibitors PRILS

Answer 18

useful with clients diagnosed with diabetes
proteinuria, neutropenia, skin rash, cough
observe for acute renal failure, remain in bed 3 hours after first dose

Question 19

ARBS SARTANS

Answer 19

hypotension, fatigue, hepatitis, renal failure, hyperkalemia

monitor liver enzymes, electrolytes, monitor for angioedema if ACE inhibitor was taken previously

Question 20

Beta Blockers OLOL’S

Answer 20

bradycardia, fatigue, insomnia, hypertriglyceridemia, decreased HDL
check apical or radial pulse daily, do not dc abruptly, watch for SOB and give cautiously if bronchospasm, may mask symptoms of hypoglycemia, contraindicated if asthma

Question 21

Carvedilol (Coreg) is a combined alpha/beta blocker

Answer 21

produces decrease in BP without reflex tachycardia or bradycardia

Question 22

Alpha blockers ZOSINs

Answer 22

peripheral vasodilator used in extreme HTN of pheochromocytoma
SE: orthostatis hypotension, weakness, palpitations

Question 23

Thiazide diuretics
Chlorthalidone
Hydrochlorothiazide

Answer 23

to decrease fluid volume by increasing excretion of water, sodium, potassium, and chloride; useful in severe HTN and enhances other antihypertensives
hypokalemia–> digoxin toxicity, glucose intolerance, administer potassium supplements and encourage increased foods with potassium

Question 24

Loop Diuretics
Furosemide (Lasix)
Torsemide (Demadex)
Bumetanide (Bumex)

Answer 24

rapid action (work when thiazides fail)
hypokalemia--> digoxin toxicity, glucose intolerance, encourage increased potassium intake

Question 25

Hypokalemia symptoms

Answer 25

dry mouth, thirst, weakness, drowsiness, lethargy, muscle aches, tachycardia

Question 26

``` Potassium Sparing Diuretics Spironolactone (Aldactone) Amiloride (Midamor) Triamterene (Dyrenium) Eplerenone (Inspra) ```

Answer 26

hyperkalemia and renal failure (esp if ACE inhibitors or NSAIDs) gynecomastia increases lithium levels give AFTER meals to decrease GI upset

Question 27

Heparin

Answer 27

administered SC or IV as an antagonist to thrombin to prevent the conversion of fibrinogen to fibrin hemorrhage, agranulocytosis leukopenia, hepatitis, thrombocytopenia Assess PTT, Hbg, Hct, platelets assess stools for occult blood notify anyone performing diagnostic test of medication Antagonist: Protamine sulfate

Question 28

Warfarin (Coumadin)

Answer 28

blocks the formation of prothrombin from vit K hemorrhage, agranulocytosis, leukopenia, hepatitis Assess PT antagonist: vit K

Question 29

TCA SE

Answer 29

dry mouth, constipation, sedation, orthostatic hypotension, decreased seizure threshold

Question 30

MAOI symptoms of Hypertensive Crisis

Answer 30

occipital HA, palpitations, N/V, nuchal rigidity, fever, sweating, increased BP, chest pain, coma--> Hypertensive crisis avoid tyramine and OTC cold meds and diet pills

Question 31

Initial signs of lithium toxicity

Answer 31

mild: blurred vision, ataxia, tinnitus, n/v/d Med: excessive dilute urine output, increasing tremors, muscular irritability, phychomotor retardation, mental confusion, giddiness Hight: impaired consciousness, nystagmus, seizures, coma, oliguria, arrhythymias, MI, cardiovascular collapse

Question 32

Prozac special instructions

Answer 32

symptom relief is not immediate | avoid migraine drugs called triptans

Question 33

Serotonin Syndrome

Answer 33

changes in mental status, restlessness, muscle jerks, hyperreflexia, tachycardia, High BP, diaphoresis, shivering, tremors physician may prescribe meds to block serotonin receptors, relieve hyperthermia and muscle rigidity, and prevent seizures. Cyproheptadine (a histamine 1 receptor blocker) often is used to treat SS

Question 34

No smoking

Answer 34

with TCA's

Question 35

No alcohol

Answer 35

with antidepressants

Question 36

trazodone

Answer 36

prolonged erection

Question 37

Anticonvulsants SE clonazepam, carbamazepine (Tegretol), Valproic Acid (deptakote), Gabapentin (Neurontin), Lamotrigine, Topiramate, Oxcarbazepine

Answer 37

``` n/v drowsiness, dizziness blood dyscrasias prolonged bleeding time (valproic Acid) risk of severe rash (lamotrigine) decreased efficacy of BCP's (topiramate) risk of suicide with all antiepileptic drugs ```

Question 38

Antipsychotics SE | Aripiprazole (abilify), Chlorpromazine, Olanzapine, Seroquel, Risperdal

Answer 38

``` drowsiness, dizziness dry mouth, constipation increases appetite, weight gain ECG changes EPS Hyperglycemia and diabetes smoking increases metabolism of antipsychotic drugs ```

Question 39

antianxiety SE

Answer 39

drowsiness, confusion, lethargy tolerance potentiates effects of other CNS depressants (no concommitant use of alcohol or other CNS depressants) orthostatic hypotension paradoxical excitement-notify physician immediately dry mouth n/v: take with food or milk blood dyscrasias-sore throat, fever, malaise, easy bruising, or unusual bleeding should be reported to the physician immediately decreased effects with smoking or caffeine

Question 40

daunorubicin and doxorubicin

Answer 40

anthracycline class of anticancer drugs which are known to cause Dilated Cardiomyopathy

Question 41

Methotrexate

Answer 41

treats RA (administered weekly)_ immunosuppressive agent cytotoxic monitor pt for mouth sores, pneumonitis, liver inflammation, and bone marrow suppression take with folic acid 1mg/day to decrease toxicity (Methotrexate inhibits degradation of folic acid, which inhibits DNA synthesis of inflammatory cells) evaluate renal fxn before therapy n/d and stomatitis are common teach pt s/sx of pneumonitis, a serious side effect

Question 42

hydroxychloroquine (Plaquenil)

Answer 42

treats RA, inform pt of need for eye exams before therapy and q6mos-retinal damage may cause blindness

Question 43

Sulfasalazine (azulfidine)

Answer 43

treats RA, assess for sulfa allergy, monitor for neurologic and GI toxicity, leukopenia, anemia, and SJS educate pt about need for CBC and liver fxn tests throughout therapy

Question 44

Azathioprine (Imuran)

Answer 44

treats RA; immunosuppressant; monitor for blood dyscrasias, hepatitis, and pancreatitis. CBC is necessary as a baseline and throughout treatment

Question 45

Adalimumab (HUmira)

Answer 45

treats RA; monotherapy or combined with methotrexate; SC injections weekly; monitor for URI, CHF, optic neuritis, increased risk of infection, development of autoantibodies

Question 46

sulfasalazine (Azulfidine)

Answer 46

encourage fluids as sulfa crystallizes in kidney if dehydrated treats IBD

Question 47

mesalamine

Answer 47

rectal administration for IBD | check kidney fxn, cause blood disorders in older adults, SE severe ha sudden severe stomach pain

Question 48

imuran

Answer 48

watch for bone marrow toxicity (immunosuppressant)