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Nursing 411 > Midterm Drugs > Flashcards

Midterm Drugs Flashcards

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1
Q

What is a common side effect of aluminum hydroxide (amphojel)?

A

constipation

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2
Q

What type of inidividual should not take aluminum hydroxide (amphojel)?

A

a 70 yr old hypophosphatemia

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3
Q

What are the health teachings of aluminum hydroxide (amphojel)?

A

Use only as prescribed NOT every time exp. gastric upset, Drink 2-4 oz of water taking your antacid, & relaxation techniques to deal with stress

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4
Q

Aluminum hydroxide is commonly used as an ingredient for which of the following?

A

Antacid

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5
Q

A client has been taking aluminum hydroxide 30 mL six times per day at home to treat his peptic ulcer. He tells the nurse that he has been unable to have a bowel movement for 3 days. Based on this information, the nurse would determine that which of the following is the most likely cause of the client’s constipation?

  1. The client has not been including enough fiber in his diet
  2. The client needs to increase his daily exercise
  3. The client is experiencing a side effect of the aluminum hydroxide.
  4. The client has developed a gastrointestinal obstruction.
A

3

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6
Q

A client has been taking aluminum hydroxide daily for 3 weeks. The nurse should be alert for which of the following side effects?

  1. Nausea
  2. Hypercalcemia
  3. Constipation
  4. Anorexia
A

3

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7
Q

Aluminum hydroxide should be administered at the same time as other medications. True or false?

A

The answer is false. So aluminum hydroxide is an antacid, and antacids should never be given at the same time as other medications. You need to give them one to two hours before or after other medications.

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8
Q 
Aluminum hydroxide tablets have been prescribed for a client with heartburn, and the nurse reinforces homecare instructions to the client. The nurse tells the client that the most common side effect with use of this medication is: 
1 dizziness 
2 excitability 
3 Constipation 
4 muscle pain
A

3
Rationale: aluminum hydroxide is an antacid. It causes the side effect of Constipation because of its aluminum base. Hypophosphatemia, which is noted by monitoring serum laboratory studies, is the other possible side effect. Options 1,2 and 4 are incorrect.

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9
Q 
The physician has prescribed Reglan. When assessing the client, the nurse would expect to find which of the following responses? 
A Increase in gastric secretions 
B Increase in peristalsis 
C Disorientation 
D drowsiness
A

B

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10
Q

A client with new-onset seizures of unknown cause it started on phenytoin (Dilantin) 750 milligrams IV now and 100 milligrams PO t.i.d which of the following statements best describes the purpose of the loading dose?
1 To ensure the drug reaches cerebrospinal fluid
2 To prevent the need for surgical excision of epileptic focus
3 To reduce secretions in case another seizure occurs
4 To more quickly attain therapeutic levels

A

4

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11
Q

Which of the following adverse effects may occur during phenytoin (Dilantin) therapy?

1 dry mouth
2 furry tongue
3 Somnolence
4 tachycardia

A

3

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12
Q

Which of the following symptoms may occur with a ***** towing level of 32 mg/dl?

1 Ataxia and confusion
2 sodium depletion
3 tonic clonic seizure
4 urinary incontinence

A

1

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13
Q

Aluminum hydroxide (Amphojel)

A

Antacid
Neutralizes gastric HCl, increases stomach pH
Inhibits action of pepsin
Use cautiously in gastric outlet obstruction, hypercalcemia, massive upper GI hemorrhage, pt on dialysis watch for constipation

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14
Q

Aluminum hydroxide (Amphojel) S/E

A 
S/E: CNS Malaise,
Neurotoxicity
Constipation
Anorexia
Intestinal obstruction
hypophosphatemia
osteomalacia
Chronic phosphate deficiency
Bone pain
muscle weakness with prolonged usage
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15
Q

Aluminum hydroxide (Amphojel) Teach

A 
Teach:
Take with water or fruit juice
Take 1 hour after meals and at bedtime
In reflux give 20-40 minutes after meals
Don't take within 1-2 hours of other drugs
Drug contains sodium
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16
Q

Aluminum hydroxide (Amphojel): Indication

A

Given to patient with GERD and PUD

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17
Q

Aluminum hydroxide (Amphojel) class

A

Antacid

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18
Q

Azathioprine (Imuran) Class

A

Immunosuppressant, anti-inflammatory

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19
Q

Azathioprine (Imuran) indication

A

Acts as an anti-inflammatory and immunosuppressant in pt with Crohn’s and Colitis, Myasthenia Gravis, SLF

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20
Q

Azathioprine (Imuran)

A

Allopurinol induces toxicity level with this med

pt needs to periodically check CBC levels

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21
Q

Azathioprine (Imuran) S/E

A

S/E:

Bone marrow suppression, hair loss, loss of appetite, bruising, mouth sores, ulcers

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22
Q

Azathioprine (Imuran) Teach

A

Take with to after food, dose by weight

May take 3-4 months to work when used for RA

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23
Q

Calcium Carbonate plus antacid (Gaviscon) indication

A

Pt with heartburn/indigestion, GERD

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24
Q

Calcium Carbonate plus antacid (Gaviscon)

A

Administer with a laxative to combat constipation
This medication decreases the absorption of Fosamax, iron, and synthroid
Take after meals and at bedtime

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25
Q

Calcium Carbonate plus antacid (Gaviscon) class

A

Antacid

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26
Q

Calcium Carbonate plus antacid (Gaviscon) S/E

A

Constipation, impair taste, nausea, vomit, stomach cramps, diarrhea, rash, itching/swelling (face/tongue/throat), severe dizziness, trouble breathing, bradycardia, constipation

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27
Q

Calcium Carbonate plus antacid (Gaviscon) action

A

Protective layer that sits on top of contents of stomach, stops acid from going up esophagus

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28
Q

Corticosteroids (Prednisolone) class

A

Anti-inflammatory, immunosuppressant

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29
Q

Corticosteroids (Prednisolone) S/E

A 
Increase infection
Increase weight
peptic ulcers
Increase WBC count
hyperglycemia
delay wound healing
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30
Q

Corticosteroids (Prednisolone)

A

Do not stop suddenly
Avoid grapefruit
limit coffee
Monitor I&O, daily wt, edema, glucose, CBC
Take with food in the AM to decrease gastric upset
Do not take with fungal infections, alcohol or other steroids and live vaccines

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31
Q

Corticosteroids (Prednisolone) dose

A

5-60 mg/day

32
Q

Metronidazole (Flagyl) class

A

Antibacterial

33
Q

Metronidazole (Flagyl) action

A

Used to treat crohns, colitis, H. Pylori infection, CDiff, IBD

34
Q

Metronidazole (Flagyl) S/E

A

Nausea, headache, peripheral neuropathy, neurotoxicity, darn urine, metallic taste.
DO NOT TAKE if PREGNANT

35
Q

Metronidazole (Flagyl) Teach

A

Monitor urine for darkness = toxicity
Oral hygiene
Give IV at a slow rate over 1 hr

36
Q

H2 Receptor Blockers “-dine” class

A

stomach acid suppressing agent

37
Q

H2 Receptor Blockers “-dine” action

A

Decrease HCl secretion
decrease conversion of pepsinogen to pepsin
Increase gastric mucous and bicarb production = ulcer healing
Antacids decrease absorption

38
Q

H2 Receptor Blockers “-dine” S/E

A

Granulocytopenia (reduction in WBC granulocytes), thrombocytopenia, gynecomastoid, diarrhea, fatigue, dizziness, rash, mental confusion in older adults, constipation

39
Q

H2 Receptor Blockers “-dine” Teach

A

Can take about an hour to start to work
Lasts 12 hours
Take 1 x /day at bedtime before or with food
Can take 2 months to clear up ulcer

40
Q

H2 Receptor Blockers “-dine”

A

No coffee, smoking, alcohol

check CBC, LFT, BUN with renal disease

41
Q

Tumor necrosis factor (TNF) class

A

Immunosuppressant, anti-inflammatory, antirheumatic

42
Q

Tumor necrosis factor (TNF)

A

Induces and maintains the remission of Crohn’s
Give to pt with RA, Psoriasis, crohns, colitis
All pts on this med should also be on methotrexate

43
Q

Tumor necrosis factor (TNF) teach

A

expensive, TB &HBV test before starting
Do not give to pt with any chronic condition
NO live vaccines
Infusion reactions are common: flu-like symptoms, dyspnea, hypotension, rash, GI Upset to decrease symptoms
pretreat with antihistamine, acetaminophen or glucocorticoid.

44
Q

Tumor necrosis factor (TNF) S/E

A

Bacteria sepsis, heart failure, dark urine= liver failure, heme disorders (fever, bleeding bruising, pallor)disorders, cancer.

45
Q

Lactulose (Duphalac) class

A

laxative
acts on small intestine and colon, poorly absorbed osmotic action retains water = softer poop, fecal swelling = peristalsis (1-3 days)

46
Q

Lactulose (Duphalac)

A

For pateitn with cirrhosis, chronic constipation. given liquid or enema form, given to decrease serum ammonia levels
effective if 2-3 soft stools/day, expensive
NO NOT take with other laxatives, increases excretion of ammonia

47
Q

Lactulose (Duphalac) Teach

A 
very sweet
If stool is watery= toxicity
monitor bowel sounds
ammonia levels less than 25-50%
glucose if diabetic
electrolytes
Take with fluid no food
increase fluids by 2L/day
Dont take at bedtime
48
Q

Lactulose (Duphalac) S/E

A

cramping, watery stool, bloating, hypokalemia, hypernatremia, dehydration,

Prevents absorption of ammonia in colon = acidifying stool = increased waer = soft poop

49
Q

Lactulose (Duphalac)

A

Vomit and suctioning = gain base= metabolic alkalosis = diarrhea = loss of base = met acidosis

50
Q

Magnesium hydroxide (milk of magnesia) class

A

saline laxative, antacid

51
Q

Magnesium hydroxide (milk of magnesia)

A

Increase osmotic gradient in small intestine. Pulls in water to increase distention = stimulates peristalsis and bowel evacuation
As an antacid reacts with HCl acid to form water and increase gastric pH

52
Q

Magnesium hydroxide (milk of magnesia) S/E

A

Nitrofuration, tetracyclines, penicallamine = decrease absorption of these drugs
Can delay or enhance absorption of other drugs
Long term use = laxative dependence
GI Problems, nausea, vomit, cramps, flatulence, anorexia, diaphoresis, hypermagnesemia, hypocalcemia

53
Q

Magnesium hydroxide (milk of magnesia) teach

A

interaction with other drugs and needs to inform HCP of other drugs because it may delay absorption or enhance. Teach about S/E of Mg (Muscle flaccid paralysis, decreased breathing rate, more evident hypotension and bradycardia, so decreased BP and GI upset. hypotension, muscle weakness, dehydration, CNS depression ).

54
Q

Magnesium hydroxide (milk of magnesia)

A 
given to pt pre-op
works on small intestine
produce stool 6-12 hours (low does)
2-6 hours (high dose)
Increase fluid intake
55
Q

Proton Pump Inhibitors (-“zole”) action

A

Blocks ATPase enzyme, decreases HCl acid secretion, increases gastric mucous and bicarb production = ulcer healing
Increase gastric pH by neutralizing HCl acid

56
Q

Proton Pump Inhibitors (-“zole”) S/E

A

Dizziness, headache, nausea, vomit, poop, abdominal pain, skin rash, upper respiratory tract infection.
prolonged use or high dose and increase risk of fractures.
Take Vita D and Calcium due to inhibited calcium absorption

57
Q

Proton Pump Inhibitors (-“zole”) teach

A

30-60 minutes before mean in the AM
Do no chew or crush
can open to mix with apple sauce
monitor driving until concentration and alertness are known
Do not take with ampicillin, cyonocobalamin iron salts = decreased absorption
Diazepam, phenytoin, warfarin prolong elimination and increase effect of drugs
Digoxin = increased digoxin absorption = digoxin toxicity

58
Q

Proton Pump Inhibitors (-“zole”) indication

A

give to pt with GERD and ulcers

59
Q

Phenytoin (Dilantin) class

A

anticonvulsant

60
Q

Phenytoin (Dilantin)

A 
Therapeutic range 10-20 mg/L
Loading dose 10-15 mg bolus must be on heart monitor
Takes 2+ weeks to work
Don't use with ET feeding or other drugs
Direct push 50 mg/min with N/S drip
Very toxic can cause tissue damage, must use deep vein
Monitor ECG, CBC, LFT
Give IV must be on heart monitor
NO Aspirin, warfarin, antidepressants
NO OTHER DRUGS
61
Q

Phenytoin (Dilantin) S/E

A

Nystagmus, drowsy, ataxia, fatigue, gingival hyperplasia (overgrowth of gums), unwanted hair growth, urine discolored

62
Q

Phenytoin (Dilantin)

A

decrease seizures

63
Q

Methotrexate class

A

immunosuppressant

64
Q

Methotrexate

A

Reduces inflammation in the bowel. Treats IBD (Crohns, colitis) RA
Can take more than 3 months to work and you can stay on it for years
check blood work
take 1x/week on the same day
Oral with food and a full glass of water, sitting up
No not crush or chew
Dose 7.5-25 mg/week
NO LIVE VACCINE
NO ALCOHOL

65
Q

Methotrexate S/E

A

Decrease immune system = increased infection
SOB, sore throat, liver failure=jaundice, itchy
can decrease platelet count (bruise, bleed easily)
Anemia
Increase photosensitivity
Take B12 to help with S/E nausea, vomit but not on the same day as Methotrexate

66
Q

Methotrexate

A

Prior to taking get blood test liver and kidneys, liver scan and chest x-ray. Need regular CBC, LFT while on it.
Listen to lungs
monito CBC with differential, liver and renal function and uric acid levels before and during drug therapy

67
Q

Metoclopramide (Reglan) class

A

antiemetic, cholinergic, prokinetic

68
Q

Metoclopramide (Reglan)

A

Acts as prokinetic agent, blocking dopamine receptors and increasing peristalsis and promotes gastric emptying (reducing risk of gastric acid reflux)
Give to pt with GERD
Take 30 mins before meals and at bed

69
Q

Metoclopramide (Reglan) S/E

A 
Tardive Dyskinesia (high dose or chronic use)
Diarrhea (short term)
sedation (short term)
drowsy
70
Q

Metoclopramide (Reglan) teach

A

Do not drive until you manage S/E that affect concentration and alertness
Mix with water, juice, carbonated drink
DO NOT give to pt with Parkinson’s, GI obstruction, history of seizures
protect from extreme temps
maintain hydration
avoid CNS depressants
LAST RESPORT MED

71
Q

Neomycin Sulphate (Neo Fardin) class

A

antibiotic

72
Q

Neomycin Sulphate (Neo Fardin)

A

Serum ammonia reduced by elimination of protein from the diet by admin of antibiotic
decrease level of ammonia forming bacteria in the colon (disinfecting the bowel)
Give to pt with cirrhosis, high ammonia levels

73
Q

Neomycin Sulphate (Neo Fardin) S/E

A

Ototoxicity, nephrotoxicity
MOST oto and nephro toxic drug on the market
hearing loss

74
Q

Salicylazosulfapyrine (Azulfidine) class

A

GI anti-inflammatory, antirheumatic (DMARD)

75
Q

Salicylazosulfapyrine (Azulfidine)

A

Decrease GI Inflammation through direct contact with bowel mucosa
Does not work on small intestine
Give to pt with crohns, coloitis, IBD, RA

76
Q

Salicylazosulfapyrine (Azulfidine) S/E

A

Hepatitis, bone marrow supression, abdmonial pain, rash (hives), arthralgia, yellow/orange skin/urine, increase photosensitivity, renal failure

77
Q

Salicylazosulfapyrine (Azulfidine) teach

A

wear sunscreen
decrease sperm during use
must test for hepatitis, bone marrow suppression (CBC, platelet count)
Take with food and increase fluids 2,500 ml minimum/day
take FOLIC ACID

Nursing 411 (2 decks)

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