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NUR 311 Pharmacology > NUR 311 Exam 4 Last Exam > Flashcards

NUR 311 Exam 4 Last Exam Flashcards

1
Q

When is the best time for a patient to take levothyroxine?

A

Take on an empty stomach before breakfast, 1 hour before meals.

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2
Q

How long does it take to achieve a therapeutic effect of levothyroxine (Synthroid)?

A

Several weeks (4-6 weeks)

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3
Q

What are the signs of overdose of thyroid replacement hormone?

A

Tachycardia, chest pain, anxiety/nervousness

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4
Q

Why should hypothyroidism be treated during pregnancy?

A

It can cause a decrease in IQ and decrease in neuropsychological function of the child.

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5
Q

What are the clinical symptoms (physical assessment) of hypothyroidism?

A

Pale skin, goiter, constipation, brittle hair/hair loss, low body temperature, fatigue, expressionless face.

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6
Q

How do levothyroxine (Synthroid) and warfarin (Coumadin) interact?

A

Levothyroxine sensitizes you to warfarin and increases bleeding (must reduce dose warfarin).

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7
Q

What is a side effect of low-dose radioactive iodine when used to treat Grave’s disease?

A

Lifelong hypothyroidism

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8
Q

When is the best time to take sumitriptan (Imitrex-serotonin-selective agonist) for the management of symptoms?

A

When the headache starts

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9
Q

What are the signs of acute salicylates (aspirin) poisoning?

A

Hyperventilation (respiratory alkalosis progresses to respiratory acidosis, hypothermia). Also coma, dehydration, and electrolytes imbalance.

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10
Q

Why is acetaminophen (Tylenol) not effective for the treatment of rheumatoid arthritis?

A

Because it only has a weak anti-inflammatory effect.

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11
Q

Think of examples of physical conditions that would be appropriate for a nonsteroidal anti-inflammatory agent.

A

Ankle sprain, arthritis, rheumatoid arthritis, tendonitis, menstrual cramps.

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12
Q

When should high-dose aspirin be discontinued prior to surgery?

A

7 to 14 days

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13
Q

Which medication may cause Reye’s syndrome

A

Aspirin

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14
Q

Understand early sign of salicylate toxicity (aspirin overdose)

A

Tinnitus (in MI patient), sweating, headache, dizziness.

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15
Q

Acetaminophen (Tylenol) should not exceed what max daily dose?

A

4 grams

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16
Q

What do COX-2 inhibitors do?

A

Decreases inflammation. Also relieves pain, reduces fever, and reduces risk of colorectal cancer.

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17
Q

What is the reversal agent for morphine?

A

Narcan (Naloxone)

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18
Q

What are constipation treatment options for someone on chronic morphine treatment?

A

Laxatives and stool softeners (Colace or Docusate)

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19
Q

What are life threatening symptoms of opioid overdose?

A

Respiratory depression (slow, shallow breathing)

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20
Q

What are the serious side effects of long-term opioid use?

A

Inflammatory Bowel Disease, Cardiovascular Complications, sleep-disordered breathing.

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21
Q

What are considerations when converting a morphine dose from the intravenous to the oral route?

A

Doses are different. Greater doses in PO than IV.

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22
Q

What are the risks of giving a mixed opioid agonist-antagonist with an opioid agonist?

A

Withdrawal or pain (acute pain and opioid withdrawal symptoms)

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23
Q

What needs to be assessed prior to administering morphine?

A

Blood pressure, respiration rate, and pulse.

24
Q

What is the reversal agent for Tylenol toxicity?

A

Acetylcysteine

25
Q

What are symptoms of normeperidine toxicity?

A

Irritability, nervousness, tremors.

26
Q

What is the reversal agent for aspirin?

A

No reversal agent counteracts the anti-platelet effect (irreversible)

27
Q

What is the ideal way for someone to wean off anti-seizure medications?

A

Adjusted dose based on the patient’s history and seizure record

28
Q

When is the best time to take trazodone (Desyrel)?

A

Within 30 minutes of bedtime.

29
Q

Which drugs are appropriate to treat inflammation?

A

NSAIDs (Aspirin, Ibuprofen, Naproxen)

30
Q

What are the contraindications for acetaminophen (Tylenol)?

A

Cirrhosis or heavy alcohol use

31
Q

A common drug ending for a Serotonin receptor agonist?

A

Triptan

32
Q

What labs must be monitored for Valproic Acid (Depakote)?

A

Liver enzymes for hepatotoxicity (CBC and liver function tests)

33
Q

What is a common, non-serious side effect of imipramine (Tofranil)?

A

Drowsiness (ends after a few weeks)

34
Q

How long will it take to achieve a therapeutic response from imipramine (Tofranil)?

A

3-6 weeks

35
Q

What is a common, non-serious side effect of tricyclic antidepressant that would most likely diminish over time?

A

Sedation

36
Q

Between bupropion (Wellbutrin) and serotonin selective reuptake inhibitors (SSRIs) which would have less adverse sexual side effects?

A

Wellbutrin because it doesn’t cause erectile dysfunction. It works well for ED patients.

37
Q

What is the interaction between an SSRI, fluoxetine (Prozac) and St. John’s Wort?

A

Do not take St. John’s Wort with SSRI or Fluoxetine because it increases their effects.

38
Q

After symptoms are controlled, how long does one continue antidepressant medications?

A

At least 4-9 months

39
Q

What is the interaction of monoamine oxidase inhibitors (MAOIs) and foods containing tyramine?

A

Tyramine can reach dangerous levels causing a serious spike in blood pressure and requires emergency care.

40
Q

What are the anticholinergic effects associated with antidepressant agents?

A

urinary retention, dry mouth, constipation, blurry vision.

41
Q

What symptoms should a patient seek emergency care for when taking a monoamine oxidase inhibitor (antidepressant)?

A

Hypertensive crisis (chest pain, dizziness, headache)

42
Q

What is the general patient education regarding lithium and fluids and salt intake?

A

Drink fluids to prevent toxicity

43
Q

What drug counteracts benzodiazepine, chlordiazepoxide (Librium)?

A

Flumazenil (Romazicon)

44
Q

What are common contraindications for benzodiazepines?

A

Pregnancy, lactation, respiratory depression, obstructive sleep apnea.

45
Q

When is the best time to take trazodone (Desyrel)?

A

Take it for sleep within 30 minutes of bedtime.

46
Q

What are common side effects of benzodiazepine, diazepam (Valium)?

A

Drowsiness, dizziness, and confusion

47
Q

What is the effect of buspirone (Buspar), an anxiolytic, on the central nervous system?

A

Treats anxiety only. No sedation and does not enhance CNS depression.

48
Q

Drug endings to indicate a benzodiazepine?

A
  • pam

- lam

49
Q

What side effects are classified as anticholinergic effects?

A

SLUD acronym: Decreased salivation (dry mouth), decrease lacrimation (blurry vision), urinary retention, and dry defecation (constipation)

50
Q

What antidepressant medication is contraindicated for those with a history of seizures?

A

Bupropion (Wellbutrin)

51
Q

What are signs of Steven Johnson Syndrome?

A

Blisters of mucous membranes of mouth, nose, eyes that leads to a red rash that spreads causing skin sloughing off and possible organ failure.

52
Q

What is an effect of Amitriptyline overdose?

A

Cardiotoxicity (Conduction disturbances, arrhythmia, hypotension)

53
Q

At what dose could a patient experience adverse side effects with TCA Amitriptyline overdose?

A

8x daily dose

54
Q

What are dietary considerations for those taking MAOI medication?

A

Avoid foods high in Tyramine (hot dogs, beer, wine, chocolate, caffeine, aged/fermented/pickled foods)

55
Q

What is the black box warning for SSRIs (antidepressants)?

A

Increased risk of suicidal thinking, feeling, and behavior in young people ages 15-24.

56
Q

What is general patient education for patients taking LAMOTRIGINE (LAMICTAL)?

A

Watch for Steven Johnson Syndrome (SJS): RASH

57
Q

What range of LITHIUM LEVELS indicates SEVERE TOXICITY?

A

1.5-2.0

NUR 311 Pharmacology (4 decks)

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