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Nursing > N365 Exam 3 > Flashcards

N365 Exam 3 Flashcards

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1
Q

Mucolytic; breaks up mucus & makes it more soluble
ADRs: Fever, some N/V, Stomatitis, Rhinorrhea
Bronchospasm in asthmatics
Rotten egg odor; wash face after use
ANTIDOTE FOR ACETAMINOPHEN OVERDOSE

A

Acetylcysteine (Mucomyst)

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2
Q

Expectorant, bronchomucotropic; increases volume but decreases viscosity of mucus
ADRs: Rare. Occasional GI irritation
HYDRATION is very important

A

Guaifenesin (Robitussin, Mucinex)

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3
Q

Sympathomimetic (non-selective); BRONCHODILATOR; vasoconstriction to dec. mucosal edema, stimulates HR and force of contraction, bronchial smooth muscle relaxation
ADR: Nervousness, insomnia, FEAR, tremors, TACHYCARDIA, headache, dyspnea
Use caution with CAD, HTN, and hyperthyroid
USE WITH MAOIs = SEVERE HTN

A

Epinephrine (Adrenalin)

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4
Q

Sympathomimetic (non-selective beta stimulant); BRONCHODILATOR; b1 & b2 stim.
ADRs: tachycardia, palpitation, headache, nausea, tremor, insomnia; MORE USED, LESS EFFECTIVE
MOST POWERFUL BRONCHODILATOR

A

Isoproterenol (Isuprel)

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5
Q

Sympathomimetic; BRONCHODILATOR (selective B2 stimulant)
Relaxation of bronchial smooth muscles (some B1 action at high doses)
ADR: Few; peripheral dilation = dec. BP & tachycardia; Tremors, nervousness, palpitations, N/V, lethargy, tinnitus
SABA = rescue inhaler
Use caution with diabetes, HTN, cardiac arrhythmias

A

Albuterol (Proventil, Ventolin)

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6
Q

Anticholinergic BRONCHODILATOR, Short-acting muscarinic antagonist (SAMA); blocks cholinergic receptors to dec. bronchial tone
ADRs: Few. Dry mouth, pharyngeal irritation
Combivent and Spiriva in same class

A

Ipratropium (Atrovent)

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7
Q

BRONCHODILATOR, Methylated Xanthine; relaxes bronchial smooth muscle, stim. heart, CNS, & medullary resp. center
ACTS LIKE CAFFEINE
ADRs: GI (anorexia, N/V, abd. discomfort); CNS (insomnia, irritability, SEVERE CONVULSIONS); CV (tachycardia, severe hypotension, arrhythmias); Renal (urinary freq.)
Dec. 1/2 life in smokers; Take with food
THERAPEUTIC LEVEL: 8-15

A

Aminophylline (Theophylline)

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8
Q

Antiallergic (histamine inhibitor); stabilizes mast cell membranes
ADRs: THROAT IRRITATION
Used for ASTHMA PROPHYLAXIS; comes in MDI or Turbo inhaler, nasal spray, & ophthalmic sol’n
RINSE MOUTH AFTER USE
Useful for children and with Exercise Induced Asthma (EIA)

A

Cromolyn sodium (Intal)

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9
Q

Leukotriene receptor antagonist; blocks inflammatory response by leukotrienes
ADRs: GI, headache, ELEVATED LIVER FUNCTION TESTS
MAINT. THERAPY & prophylaxis of asthma; not good for acute attack
With warfarin –> inc warfarin levels
In combo with aspirin –> inc. ____ levels
Take 1hr before or 2hrs after meals

A

Zafirlukast (Accolate)

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10
Q

Inhaled CORTICOSTEROID; blocks inflammatory enzymes
ADRs: Hoarseness, dry mouth, THRUSH
Can have systemic steroid response; LONG- TERM TX of asthma; RINSE MOUTH
Also: Advair, Dulera, Breo

A

Beclomethasone (Vanceril)

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11
Q

Antitussive, non-opioid; suppresses cough center; NO analgesic or addictive properties
ADRs: Infrequent; GI distress and drowsiness
Synthetic opiate derivative w/o analgesic and resp. depressant effects

A

Dextromethorphan (DM)

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12
Q

Decongestant; alpha & beta stimulation releases norepi
Vasoconstriction, bronchial muscle relaxation, dec. uterine activity, shrink mucous membranes
ADRs: Minimal; CV (tachycardia, flushing)
AVOID TAKING NEAR BEDTIME d/t stim. effects

A

Pseudoephedrine (Sudafed)

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13
Q

Antihistamine; bronchodilation, vasodilation
Inhibits release of acetylcholine
Sedative effects –> used as a HYPNOTIC
ADRs: *SEDATION, dizziness, LASSITUDE, blurred vision, EUPHORIA; dec. appetite, N/V/D, dry mouth; urinary freq., palpitations, TINGLING/WEAKNESS OF HANDS)
May cause allergic DERMATITIS
Do NOT take with alcohol; tolerance can occur; used as a hypnotic for kids and adults

A

Diphenhydramine (Benadryl)

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14
Q

Anti-lipid; prevents formation of cholesterol
ADRs: mild, transient GI disturbances, headache, sleep disturbances, Inc. transaminase levels, peripheral neuropathy, lupus-like syndrome, SEVERE MYALGIA, muscle weakness, RHABDOMYOLYSIS
CAUTION IN ALCOHOLICS & LIVER DISEASE
Monitor liver function tests; contraindicated in pregnancy, enhance effects of anticoagulants
GRAPEFRUIT JUICE INHIBITS METABOLISM–> toxic levels of drug

A

Atorvastatin (Lipitor)

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15
Q

Sympatholytic, antihypertensive, a2 adrenergic agonist; reduces NE; dec. peripheral resistance
ADRs: ORTHO HYPOTENSION, sedation, DEPRESSION, dry mouth, dec. WBC & PLT, sexual dysfunction; Na & water retention (unless on diuretic)
CONTRAINDICATED IN LIVER Dx and MAJOR DEPRESSION
Can be used for pregnancy induced HTN (PIH)

A

Methyldopa (Aldomet)

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16
Q

Antihypertensive, a1 adrenergic antagonist; prevents constriction (vasodilation & dec. PVR)
ADRs: ORTHO HYPOTENSION; dizziness, SYNCOPE, tachycardia, peripheral edema, impotence
FIRST DOSE PHENOMENON (severe drop in BP!)

A

Prazosin (Minipress)

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17
Q

Beta blocker; antihypertensive effect, antianginal, antiarrhythmic
ADRs: bradycardia, INTENSIFY AV BLOCK, hypotension, BRONCHOSPASM IN COPD/ASTHMA, cramps, allergic response
CHECK APICAL & RADIAL PULSE AND BP
Use w/ vasodilator and thiazide diuretic
BLACK BOX: do NOT stop abruptly, TAPER!
Caution w/ CHF, asthma, diabetes
Used for migraine & MI prophylaxis, panic attacks, benign essential tremor & PTSD

A

Atenolol (Tenormin)

18
Q

Antihypertensive, vasodilator
ADRs: hypotension, palpitations, tachycardia, anxiety, UNPLEASANT TASTE IN MOUTH, N/V
FREQUENT MONITORING d/t differences in metabolism

A

Hydralazine (Apresoline)

19
Q

Calcium antagonist, antianginal, antiarrhythmic
Inc. in coronary perfusion d/t arteriolar dilation
Inhibits renin release
ADRs: bradycardia, hypotension, SEVERE TACHYCARDIA, abd. discomfort, flushing
CONTRAINDICATED in AV BLOCK, SEVERE HYPOTENSION, & SEVERE CHF
Grapefruit juice INCREASES drug levels!

A

Verapamil (Calan, Isoptin)

20
Q

Angiotensin II inhibitor (ACE inhibitor); reduced vascular tone and lowering of BP; dec. aldosterone release and less Na retention
ADRs: hypotension, pruritus; poss. HYPERKALEMIA; Rare (NEUTROPENIA, AGRANULOCYTOSIS, HEPATOTOXICITY)
BLACK BOX: fetal injury & death during pregnancy
Used for heart failure

A

Lisinopril (Prinivil, Zestril)

21
Q

Angiotensin II antagonist, Antihypertensive; inhibits RAAS (more than ACE inhibitors)
ADRs: insomnia, GI, MUSCLE PAIN, cramps, occasionally inc. LFTs
BLACK BOX: should not use in pregnancy
Max effect seen w/in 3-6 weeks

A

Losartan (Cozaar)

22
Q

Antianginal; dec. myocardial oxygen consumption (doesn’t work for CAD)
ADRs: headache, dizziness, SYNCOPE, REFLEX TACHYCARDIA, flushing, hypotension
USE WITH SILDENAFIL = LIFE-THREATENING HYPOTENSION AND CARDIAC COLLAPSE!

A

Nitroglycerin

23
Q

Thiazide diuretic; promotes excretion of Na, Cl, and water, also K
ADRs: HYPOKALEMIA, anorexia, cramping, JAUNDICE, vertigo, paresthesia
ALLERGIC RXNs IF SENSITIVE TO SULFA (bc sulfonamide derivatives)

A

Hydrocholorthiazide (HCTZ, Hydrodiuril)

24
Q

Loop diuretic; inhibits passive Na transport
ADRs: N/V/D, dermatitis, pruritus, blurred vision, ortho hypotension, HYPOKALEMIA, OTOTOXICITY
SULFONAMIDE derivative (potential allergy!)
Contraindicated: pregnancy and nursing moms, anuria, hepatic coma, and F&E depletion
MORE POTENT THAN THIAZIDES (good for CHF)

A

Furosemide (Lasix)

25
Q

Diuretic, Potassium SPARING; antagonizes aldosterone
ADRs: anorexia, N/V/D, occasional headache, ATAXIA, MENTAL CONFUSION, in males (GYNECOMASTIA w/ tender lumps in breasts), in females (breast soreness and menstrual irreg.)
MOST SERIOUS ADR: HYPERKALEMIA
Often used in combo w/ other diuretics

A

Spironolactone (Aldactone)

26
Q

Osmotic diuretic; high osmolality dec. reabsorption
ADRs: DEPENDS ON AMT OF DRUG AND EFFECT; headache, nausea, chills, mild CHEST PAIN, electrolyte imbalance
DO NOT give to pts w/ severe CHF, HTN, chronic edema
MAY CRYSTALLIZE –> USE A FILTER

A

Mannitol

27
Q

Cardiac glycoside; useful for HF, afib/flutter; + inotropic, - chronotropic, - dromotropic action
ADRs: anorexia, N/V/D, VISUAL DISTURBANCE, nervous irritability, GYNECOMASTIA, DYSRHYTHMIAS (w/ dig toxicity)
MUST CHECK APICAL PULSE before giving
Arrhythmias = sign of LATE toxicity
W/ diuretics = potassium loss –> dig. toxicity
W/ antacids = interfere w/ dig. absorption
ANTIDOTE = DIGOXIN IMMUNE FAB

A

Digoxin (Lanoxin)

28
Q

Electrolyte; plays role in muscle contraction, nerve impulse, cell membrane function
ADRs: HYPERKALEMIA, GI pain, distension, abd. cramps, diarrhea, weakness, PARALYSIS
Oral K+ is used for prophylaxis w/ diuretics
GIVE WITH FULL GLASS OF WATER
Unpleasant taste if liquid/elixir

A

Potassium chloride (K-dur)

29
Q

Antiarrhythmic; direct action on cardiac cell membrane, decreases conduction
ADRs: N/V/D, tinnitus, vertigo, visual disturbances, THROMBOCYTOPENIC PURPURA, urticaria, hypotension; CV (complete heart block & Vfib)
Used with ATRIAL dysrhythmias
Many drug interactions

A

Quinidine- Class 1A

30
Q

Antiarrhythmic; similar properties to quinidine; depresses automaticity of ectopic pacemakers
ADRs: Drowsiness, CNS (agitation, muscle twitching) HEART BLOCK, blurred vision, PARESTHESIAS, tinnitus, euphoria, RESPIRATORY DEPRESSION
Used for VENTRICULAR dysrhythmias
Caution with liver disease

A

Lidocaine- Class 1B (Xylocaine)

31
Q

Iron replacement; used for nL oxygen carrying of RBCs
ADRs: headache, loss of appetite, gastric pain, N/V, constipation
ALWAYS GIVEN ORALLY (take sol’ns w/ a straw)
Black/green stools
Overdose can be lethal (keep away from kids!)
Do NOT take with antacids
Antidote = deferoxamine (Desferal)

A

Ferrous sulfate (Feosol)

32
Q

Vitamin; needed for RBC formation
ADRs: Rare. Possible dec. potassium
Evaluate pt q4-6 months to be sure of effectiveness
If pt lacks intrinsic factor –> must use large oral dose

A

Vitamin B12 (cyanocobalamin)

33
Q

Vitamin; development of enzymes for DNA production; if inadequate –> macrocytic anemia
ADRs: NONTOXIC but allergic rxns can occur
Take for deficiency then dietary sources adequate
IMPORTANT FOR PREVENTING NEURAL TUBE DEFECTS IN FETUS DURING PREGNANCY

A

Folic acid (Folvite)

34
Q

Enhances production of RBCs
ADRs: Hypertension (ENCEPHALOPATHY & seizures), headache, paresthesia, fatigue, SOB, inc. clotting of AV grafts, limb pain and sweating
BLACK BOX- TIAs, MIs, CVAs (THROMBOEMBOLI)
Watch for rapid inc. in hematocrit (>4 points in 2 weeks)
>500U/L: won’t respond; <500U/L: will respond
Adequate iron supplementation is necessary
Increased appetite and wellbeing

A

Erythropoietin (Epogen, Procrit)

35
Q

Anticoagulant; inhibits thrombin mediated conversion of fibrinogen to fibrin
ADRs: HEMORRHAGE; minor bleeding (GI tract, GU tract, PETECHIAE, ecchymosis); major bleeding (CNS or GI tract); hypersensitivity (chills, fever, urticaria, anaphylaxis)
Mild thrombocytopenia
Dose & effectiveness determined by PPT/APTT
Should not be given IM bc risk of hematoma
BLACK BOX: SPINAL HEMATOMAS W/ SPINAL ANESTHESIA
Elderly women more sensitive
Does not decrease PLT aggregation
HEPARIN-INDUCED THROMBOCYTOPENIA (HIT) –> potentially fatal
Antidote = Protamine Sulfate

A

Heparin (unfractionated)

36
Q

Low molecular-weight heparin; inactivates factor Xa
ADRs: bleeding, heparin-induced thrombocytopenia (HIT), edema, injection site pain, angioedema
Avoid in pts with increased risk of hemorrhage
Used for prophylaxis and tx of DVT after hip/knee procedures

A

Enoxaparin (Lovenox)

37
Q

Heparin Antidote; combines with heparin and neutralizes it
ADRs: dyspnea, flushing, bradycardia, hypotension (w/ rapid injection); overdose = anticoagulation, leading to hemorrhage
Hypersensitivity can occur ESP. WITH FISH ALLERGY (drug comes from fish sperm)

A

Protamine Sulfate

38
Q

Anticoagulant, direct factor Xa inhibitor; prevents production of thrombin
ADRs: Hemorrhage (minor to life-threatening), spinal/epidural hematoma), NOT safe in pregnancy
Approved for DVT & PE prevention and stroke prevention in Afib
NO BLOOD MONITORING NEEDED
Antidote = factor Xa (Andexxa)

A

Rivaroxaban (Xarelto)

39
Q

Thrombolytic agent; initiates fibrinolysis
ADRs: bleeding (internal –> GI, GU, retroperitonal, intracranial; superficial –> venipuncture sites); Dysrhythmias, fever, N/V
Higher stroke incidence
Contraindicated in active internal bleeding, CVA, known bleeding problems, severe uncontrolled HTN, pregnancy
Can cause dysrhythmias d/t reperfusion
Electrical instability in ~80% of patients
Give with heparin to reduce risk of rethrombosis
Mix with sterile water then dilute with D5W
EXTREMELY EXPENSIVE

A

Tissue Plasminogen Activator (TPA) (Activase, Alteplase)

40
Q

Antidote, hemostatic agent-antifibrinolytic; prevents formation of plasmin
ADRs: headache, dizziness, nausea, abd. pain, tinnitus, malaise, THROMBOPHLEBITIS, GRAND MAL SEIZURE
Hypotension, bradycardia, arrhythmias (if given too rapidly IV)

A

Aminocaproic acid (Amicar)

41
Q

Granulocyte colony stimulating factor; increases production of neutrophils
ADRs: mainly BONE PAIN; inc. uric acid, lactate dehydrogenase, and alkaline phosphatase
Only 1 dose per vial
Long acting form = pegfilgrastim (Neulasta)
Used for cancer patients during chemo therapy sessions

A

Filgrastim (Neupogen)

Nursing (8 decks)

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