NCLEX pharm

Question 1

netupitant/ palonosetron

Answer 1

oral antiemetic given prophylactically for chemo related nausea. take one pill one hour before, prevents acute and delayed N/V

Question 2

sevelamer hydrochloride

Answer 2

phosphate binder used in hypocalcemia, binds phosphate and when phosphate decreases, ca will increase

Question 3

magnesium antidote

Answer 3

calcium glutinate, given IVP slowly- max 2mL/min

Question 4

given for hypercalcemia

Answer 4

sodium phosphate (inverse relationship with phosphorous)
steroids (cause Ca excretion)
calcitonin (drives serum Ca into bones- lowers serum calcium)

Question 5

sodium polystyrene sulfonate

Answer 5

Kayexalate- enema that exchanges Na for K in GI tract for hyperkalemia, can cause dehydration, so push fluids

Question 6

given to decrease arrhythmia associated with hyperkalemia

Answer 6

calcium gluconate

Question 7

thiazides

Answer 7

hydrochlorothiazide for example, diuretic that cause you to lose potassium- risk for hypokalemia, but retain Ca- risk for hypercalcemia

Question 8

enzymatic drugs

Answer 8

topical agents that eat dead tissue (debride) on burn injury. ex sutilains or collagenase.
don’t use on face, over large nerves, near opening to body cavity or if pregnant.

Question 9

netupitant/ palonsetron

Answer 9

oral concentration antiemetic that prevents acute and delayed N/V from chemo! only need 1 pill 1 hour before chemo to prevent nausea during and after.

Question 10

amiodarone

Answer 10

anti-arrhythmic drug given to prevent second occurrence of Vfib, may give with epi if first shock from defibrillator did not work. s/e hypotention- must monitor BP! also contains high levels of iodine, so may affect thyroid fxn

Question 11

radioactive iodine

Answer 11

can be given to hyperthyroid pt to destroy thyroid cells- given liquid or tablet (no pg pts), will become hypothyroid, will be radiating for 24 hours. watch for thyroid storm= rebound hyperthyroid X100.

Question 12

Nitro

Answer 12

causes venous and arterial dilation to decrease preload and after load- decreasing work of heart and dilating coronary arteries- getting them more 02. keep in dark glass bottle, it may or may not burn or fizz, will get a HA, , renew every 3-5 pos (spray 2 yrs). sit down when taking- will drop BP. If angina not relieved by first dose after 5 minutes, take second dose and call ambulance

Question 13

beta blockers

Answer 13

decrease BP,P and contractility= decreased workload of heart, but also decreased CO. unstable client. used to prevent angina

Question 14

Calcium channel blockers

Answer 14

to prevent angina- nifedipine, verapamil, amlodipine, diltiazem. dilate arteries, lower BP (by decreasing after load) and increase O2 to the heart

Question 15

acetylcysteine

Answer 15

mucomyst- used to protect kidneys when using dye. this is also the antidote for acetaminophen (tylenol) which is toxic to liver. (so kinda protects both!)

Question 16

thrombolytics

Answer 16

end in -ase. give within 6-8 hours of myocardial pain. bleeding precautions.

Question 17

ACE Inhibitors

Answer 17

Drug of Choice for HF.
suppress Renin angiotensin system (aldosterone! nephrotic syndrome). results in arterial dilation and increased stroke volumeinhibiting aldosterone so excreting H2O and Na, retaining potassium- monitor for HYPERKALEMIA. check serum potassium and BP before admin

Question 18

ARBs

Answer 18

end in SARTAN, block angiotensin 2 receptor cause decrease in arterial resistance and decrease in BP. inhibiting aldosterone so excreting H2O and Na, retaining potassium- HYPERKALEMIA. check serum potassium and BP before admin

Question 19

Digoxin

Answer 19

used in sinus rhythm or A fib with chronic HF. usually with a ACE I, ARB, BB, or diuretic. increases contractility and slows HR (take apical pulse!) more time to fill.

Question 20

nesiritide

Answer 20

vasodilator veins and arteries and has a diuretic effect- given short term (no > 48hrs) IV therapy maybe for pulmonary edema. just remember to discontinue it for 2 hours before drawing BNP level (test for HF)

Question 21

anticonvulsants

Answer 21

long or short term therapy for seizures
rapid acting -lorazepam (Lora’s Z fastest!)
long acting- phenytoin or phenobarbital
want lowest effective dose because have toxic s/e
monitor drug levels for toxicity - warn abrupt w/drawl can cause a seizure

Question 22

octreotide

Answer 22

lowers BP in liver. for esophageal varices which are caused by portal HTN- hepatic portal

Question 23

methimazole

Answer 23

anti-thyroid drug of choice, stops thyroid from making hormones, used pre op to stun the thyroid (need to remove hyperthyroid) also give iodine compound to reduce the size and vascularity of the thyroid pre op.

Question 24

med for hypothyroid

Answer 24

levothyroxine. take on empty stomach, start low dose and increase gradually- worry about MI, people with hypothyroid then to have CAD. be aware of chest pain. must take this med for life.

Question 25

sevelamer

Answer 25

phosphate binder- used in kidney d/s and hypoparathyroid because both cause hyperphosphatemia which= hypocalcemia. binding the phosphate decreases the level and increases the serum calcium. take with meals, not with Ca supps, can cause GI problems/constipation

Question 26

Drugs for Addison’s d/s

Answer 26

Addisons is insufficient steroids- give prednisolone (glucocorticoid) twice a day with 2/3 of dose in morning and 1/3 in evening.
also fludrocrotisons- aka aldosterone

Question 27

metformin

Answer 27

first choice in type 2 and some pre diabetics because it reduces glucose reductions AND enhances its entering the cell. It does not stimulate insulin release- so NO risk of hypoglycemia! just hold it before surgery or contrast dye- may resume after 48 hours if kidney function tests normal.

Question 28

biologic response modifiers

Answer 28

BRMs- enhance our own immune system to fight cancer. HPV vaccine is an example because it gives us immunity to HPV to prevent cervical, anal, and oral cancers.

Question 29

Levothyroxine

Answer 29

for hypothyroidism. take on an EMPTY stomach, start with low dose and gradually increase-maybe 8 weeks full effect. thyroid prob=CAD, worry about chest pain. monitor tachycardia, chest pain, nervous or tremors dose may be too high.

Question 30

Statins AE

Answer 30

can cause myopathy (D/s of muscle) causing generalized muscle aches and weakness. teach pt to call. dr will check serum creatinine kinase, if elevated will d/c the drug

Question 31

methotrexate

Answer 31

given to stop embryo growth with ectopic pregnancy

Question 32

Mycin- vancomycin

Answer 32

think nephro and ototoxiciry, red man syndrome - flush, itch, hypotension- see hives, swelling, wheezing think anaphylaxis. A/E to monitor for hypotension and EcG- can prolong QT interval

Question 33

can prolong QT interval

Answer 33

vancomycin, amiodaron, stall, haloperidol, riprasidone

Question 34

what has cross sensitivity with penicillin

Answer 34

cephalosporin- is c/i if pt has anaphylactic rxn to penecillin

Question 35

A/E of floxacin antibiotics

Answer 35

tendon rupture- achillies

Question 36

IV potassium max rates

Answer 36

max rate peripheral 10 mEq/Hr

central line 40 mEq/Hr

Question 37

potassium sparing diuretic

Answer 37

spironolactone/ aldactone