P2-Final

Question 1

Symptoms of digoxin toxicity

Answer 1

nausea, vomiting, loss of appetite, and fatigue, yellow-tinged vision

Question 2

Symptoms of salicylism toxicity

Answer 2

sweating, headache, and dizziness, tinnitus

Question 3

AE of Clonidine

Answer 3

severe hypotension, rebound HTN, bradycardia

Question 4

Pre-medication for Ketamine

Answer 4

Sedative-Midazolam/Diazepam

Question 5

AE of Ketamine

Answer 5

hallucinations, disturbing dreams, and delirium

Question 6

AE of propofol

Answer 6

Respiratory depression and hypotension

Question 7

Sulfasalazine (Azulfidine)

Answer 7

fever, nausea, arthralgia, RASH and hematologic disorders (agranulosis, hemolytic anemia, macrocytic anemia).

Question 8

Spironolactone (Aldactone) side effects

Answer 8

hyperkalemia, hirsutism, impotence, gynecomastia, menstrual irregularities, deepening of the voice

Question 9

AE of amiodarone (Cordarone)

Answer 9

pulmonary toxicity, cardiotoxicity, thyroid toxicity, liver toxicity, ophthalmic effects, toxic in pregnancy, dermatologic toxicity, CNS, GI

Question 10

AE of Losartan

Answer 10

angioedema, fetal harm, renal failure

Question 11

Effects of Digoxin on ECG

Answer 11

delays AV conduction (prolongs PR interval, QT interval shortened, ST depression, and T wave inversion)

Question 12

Nursing interventions for signs of extravasation

Answer 12

stop administration of IV fluids immediately, disconnect the IV tube from the cannula, aspirate any remaining drug from the cannula, administer drug-specific antidote, and notify the physician.

Question 13

Effects on the heart and AE of IV amiodarone

Answer 13

slows down AV conduction.

AE: hypotension and brady-dysrhythmias. Can produce phlebitis.

Question 14

Inducers of CYP3A4

Answer 14

glucocorticoids, barbiturates, carbamazepine,

phenytoin, rifampin

Question 15

Inhibitors of CYP3A4

Answer 15

grapefruit juice, erythromycin,

clarithromycin, and verapamil

Question 16

Malignant hyperthermia triggers

Answer 16

isoflurane & succinylcholine

Question 17

early symptoms of malignant hyperthermia

Answer 17

hypercapnia, tachycardia, tachypnea, and increased muscle rigidity

Question 18

Examples of immunosupressants

Answer 18

calcineurin inhibitors (cyclosporine: Sandimmune, Gengraf, Neoral; tacrolimus: Prograf, Astagraf XL); mTOR inhibitors (sirolimus (Rapamune); glucocorticoids such as prednisone (PO version), methylprednisolone (IV version); cytotoxic drugs (azathioprine (Imuran); cyclophosphamide, methotrexate, mitoxantrone, mycophenolate mofetil (CellCept)); Antibodies such as basiliximab (Simulect).

Question 19

Patient teaching for immunosuppressants

Answer 19

1. Need for lab monitoring
2. use contraceptives until drug is discontinued
3. do not take other meds including OTC
4. Take med in the same way, same time everyday
5. Proper hygiene for infection control
6. Avoid exposure to sun d/t increase in skin cancer
7. Notify HCP if experiencing flu like sx
8. Fevers may present as low grade

Question 20

Clopidogrel (Plavix) drug interactions

Answer 20

anything that causes bleeding and PPIs