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Pharm > Pharm Exam 1 > Flashcards

Pharm Exam 1 Flashcards

1
Q

Pharmacology

A

The study of drugs and their interaction with living systems

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2
Q

Properties of an ideal drug

A

effectiveness and selectivity

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3
Q

Effectiveness

A

a drug that elicits the response it was meant to

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4
Q

Selectivity

A

a drug that elicits only one response for which it was given

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5
Q

Therapeutic classification

A

what the drug does

Examples:
antihypertensives = lower blood pressure
anticoagulants = influence blood clotting
antihyperlipidemics = lower blood cholesterol
antidysrhythmics = restore normal cardiac rhythm
antianginals = treat anginas

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6
Q

Tachyphylaxis

A

quick and rapid decrease in drug responsiveness regardless of time

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7
Q

Tolerance

A

decreased drug responsiveness over time

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8
Q

Drug naming conventions

A

chemical, generic, and brand naming

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9
Q

Chemical naming

A

used by chemists and manufacturers

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10
Q

Generic naming

A

used by healthcare providers and written in lowercase

Ex: ibuprofen

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11
Q

Brand naming

A

assigned by drug manufacturers and start with CAPITAL letter

Also proprietary and trade name

Ex: Advil

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12
Q

Non-prescription medication

A

Over-the-counter medication (OTC meds)

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13
Q

First line of defense medications

A

Over-the-counter meds

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14
Q

Do OTC meds requires a prescription?

A

No

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15
Q

Where can you purchase OTC meds?

A

drug stores (CVS, Walgreens) and grocery stores (Publix)

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16
Q

FDA regulation that states these meds are relatively safe to take without supervision

A

OTC meds

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17
Q

OTC med examples

A

diphenhydramine (Benadryl)
acetaminophen (Tylenol)
ibuprofen (Advil)

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18
Q

Medications that are considered potentially harmful if there is no supervision over administration. Prescribed by a licensed healthcare professional.

A

Prescription medications

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19
Q

Prescription med examples

A

antibiotics (ceftriaxone)
antihypertensives (lisinopril)
narcotics (fentanyl)

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20
Q

Types of PO meds

A

tablet, capsules, powder, liquid

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21
Q

Medication release time is dependent on

A

the type of PO medication

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22
Q

Enteric-coated drugs (EC)

A

barrier to prevent GI upset

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23
Q

Extended-release drugs (ER)

A

last longer in the body

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24
Q

Extended-length drugs (EL)

A

release slowly over 24-48 hours

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25
Q

Sustained release drugs

A

lasts longer in the body

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26
Q

Can you crush or chew enteric-coated tablets?

A

No- can cause drug toxicity and lead to fatal OD or oropharyngeal irritation

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27
Q

A nurse is caring for a client who is having difficulty remembering to take their prescribed drug three times a day. The nurse should identify that which of the following alternate forms of the drug can help promote adherence to the prescribed dosage?

A. Immediate-release capsule
B. Extended-release tablet
C. Liquid suspension
D. Powder form

A

B. Extended-release tablet

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28
Q

A nurse is teaching a client about naproxen enteric-coated tablets. Which of the following statements should the nurse include in teaching?

A. “You should allow the tablet to dissolve in your mouth”
B. “Drug absorption occurs in the stomach
C. “Do not crush or chew the tablet”
D. “You should expect immediate absorption of the medication”

A

C. “Do not crush or chew the tablet”

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29
Q

Six Rights of Safe Medication Administration

A
  1. Right drug
  2. Right patient
  3. Right dose
  4. Right route
  5. Right time
  6. Right documentation
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30
Q

Additional guidelines to Safe Medication Administration

A

● Check expirations dates
● NEVER leave medication unattended
● Two patient identifiers
● Stay with the patient until medication is fully administered
● Record results and effectiveness
● Only administer drugs that you prepared

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31
Q

What is a medication error?

A

Any avoidable event that may cause/lead to incorrect medication use or patient harm

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32
Q

Nurses Rights to Safety & Quality for Med Administration

A

● Complete or clear orders
● Six rights
● Access to information
● Policies to guide safe administration
● Administer medications safely and to identify system problems
● Stop, think, and be vigilant when administering medication

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33
Q

Common routes of med administration

A

Oral/enteral, intravenous, intramuscular, subcutaneous, topical, transdermal, inhaled, rectal, ocular, aural, vaginal

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34
Q

Drug-Drug Interactions

A

-Intensified effectiveness
-Reduction in effectiveness
-Unique response

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35
Q

Drug-Food Interactions

A

● Increase or decrease the absorption
● Increase the risk of toxicity
● Impact drug action
● Alter metabolism

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36
Q

What is the grapefruit juice effect?

“Only pervs eat grapefruit” -Oleg

A

Instead of the drug being metabolized in the body, more drug enters the bloodstream, resulting in too much drug in the body

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37
Q

The use of medication to prevent, mitigate, or cure disease

A

Pharmacotherapeutics

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38
Q

The intended response of the drug

A

Therapeutic effect

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39
Q

Physiological effects not related to the desired effect

A

Side effect

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40
Q

More severe reaction, than a side effect

A

Adverse effect

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41
Q

Types of adverse effects

A

Allergic reactions, idiosyncratic effect, latrogenic disease, physical dependence, carcinogenic effect, teratogenic effect

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42
Q

Pharmacokinetics

A

the process of drug movement throughout the body necessary to achieve drug action

What the BODY does to the drug

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43
Q

Absorption

A

movement of the drug outside of the body to the bloodstream

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44
Q

Distribution

A

the journey of the drug through the bloodstream to various tissues of the body

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45
Q

Metabolism

A

how the drug is broken down; biotransformation

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46
Q

Where does metabolism primarily take place?

A

liver

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47
Q

Excretion

A

how the drug leaves the body; elimination

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48
Q

Routes of excretion/elimination

A

urine, breastmilk, saliva, hair, sweat

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49
Q

Where does excretion primarily take place?

A

kidneys

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50
Q

First pass effect

A

Oral medications from the GI tract pass the intestinal lumen via the portal vein. The liver then metabolizes some of the drug that in turn reduces the concentration of active drug.

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51
Q

Minimum effective concentration (MEC)

A

The lowest level of concentration of drug in the bloodstream,
needed for the intended therapeutic effect

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52
Q

DNA testing to predict the likely drug response to assist with medication selection

A

Pharmacogenetics

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53
Q

Pharmacodynamics

A

what drugs do to the body and how they do it

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54
Q

The start of the desired effect of drug

A

onset

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55
Q

Point of maximum strength of drug

A

peak

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56
Q

How long it works

A

duration

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57
Q

Half life

A

time required for amount of drug to decrease by 50%

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58
Q

Therapeutic index

A

the relationship between the therapeutic dose and the toxic dose

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59
Q

Activates the desired response

A

agonist

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60
Q

Less effect than a full agonist

A

partial agonists

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61
Q

Blocks a response

A

antagonist

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62
Q

When two or more drugs are given together to have a greater therapeutic effect

A

synergistic effect

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63
Q

Two drugs combined causes an equal therapeutic effect

A

additive effect

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64
Q

A nurse is teaching a client who has a prescription for a drug that has a receptor agonist effect. Which of the following information should the nurse include in the teaching?

A. “This will increase the effects of normal cellular function”
B. “This minimizes the risk of that the medications you take will become toxic”
C. “This prevents cells in your body from performing certain actions”
D. “This prevents hormones in your body from attaching to cell receptor sites”

A

A. “This will increase the effects of normal cellular function”

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65
Q

Drug toxicity

A

drug level exceeds the therapeutic range

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66
Q

The health of the fetus is dependent on

A

the health of the mother

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67
Q

The process by which congenital malformations are produced in embryo or fetus

A

Teratogenesis

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68
Q

Which trimester is the fetus most vulnerable?

A

first trimester

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69
Q

Drug therapy considerations during pregnancy

A

● Placental transfer
● Adverse reactions
● Physiological changes related to pregnancy
● Breastfeeding consideration

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70
Q

Teratogenic med categories

A

● Category A: fails to show risk to fetus
● Category B: animal studies shows no risk to fetus
● Category C: studies in animals have shown adverse effects to fetus
● Category D: confirmed human fetal risk (risk v. benefit)
● Category X: animal and human studies have shown fetal risk (contraindicated)

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71
Q

Why is pharmacology research limited re: children?

A

Limited research due to the risk

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72
Q

More specific dosage calc for children because

A

children are less developed than adults

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73
Q

Pharmacology consideration for older adults

A

more vulnerable due to the aging process

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74
Q

Polypharmacy

A

occurs when a person is taking many different medications at the same time

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75
Q

Increased number of drugs leads to an

A

increased risk of adverse side effects

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76
Q

A nurse is providing teaching to a pregnant client who is taking captopril, an ACE inhibitor, to treat hypertension. The nurse informs the client that captopril is a teratogenic drug. The nurse should explain that teratogenic drugs can cause which of the following?

A. Maternal bleeding
B. Maternal blood clots
C. Fetal malformation
D. Gestational diabetes mellitus

A

C. Fetal malformation

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77
Q

Adherence concerns in older adults

A
  1. Patient may not fully understand drug regimen.
  2. Nonadherence may cause underdosing.
  3. Nonadherence may cause overdosing.
  4. Barriers to effective drug use by the older adult
  5. Medication education extremely important
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78
Q

Rate of absorption by type of PO drug type – fast to slow

A

liquid, suspension, powder, capsule, tablet, coated tablet, enteric-coated tablet

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79
Q

What is complementary and alternative medicine (CAM)?

A

Medical therapies used instead of or in addition
to pharmacotherapies

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80
Q

Does CAM have positive or negative effects?

A

both

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81
Q

Types of CAM

A

● Herbal supplements
● Botanicals
● Nutritional products

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82
Q

Drug-herb interactions: St. John’s Wort taken in addition to SSRIs can lead to

A

serotonin syndrome

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83
Q

St. John’s Wort interacts w/

A

cyclosporine, indinavir, oral contraceptives, warfarin, digoxin, benzodiazepines (and other drugs)

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84
Q

General guidelines for CAM

A

● Natural therapies do not mean SAFE therapies
● Speak with your provider before taking supplements
● Do not take if you are pregnant or breastfeeding
● Do not give to children
● Follow instructions
● If you experience side effect, stop the supplement and contact your provider
● Not all ingredients may be listed

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85
Q

Organic substances necessary for tissue growth and healing; made by plants and animals; obtained through diet

A

vitamins

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86
Q

Elements that come from soil and water that is then absorbed by the plants and animals we consume

A

minerals

Ex: Potassium, Sodium, Calcium, Chloride, Magnesium, Iron

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87
Q

Instances for increasing vitamin intake

A

● Pregnancy/breastfeeding
● Illness
● Malabsorption diseases
● Malnourishment
● Inadequate diet

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88
Q

Megadoses of vitamins

A

condition specific; generally not toxic, but must be monitored for toxicity

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89
Q

Fat soluble vitamins

A

Fat-soluble vitamins (vitamin A, vitamin D, vitamin E, and vitamin K) dissolve in fat and tend to accumulate in the body.

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90
Q

Water soluble vitamins

A

Water-soluble vitamins (vitamin C and the B-complex vitamins, such as vitamin B6, vitamin B12, and folate) must dissolve in water before they can be absorbed by the body, and therefore cannot be stored. Any water-soluble vitamins unused by the body is primarily lost through urine.

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91
Q

Can you overdose on fat soluble or water soluble vitamins?

A

fat soluble vitamins

92
Q

Why would someone need nutritional support?

A

Unable to receive enough nutrition by simply eating or drinking

93
Q

Types of nutritional support

A

oral feeding, parenteral nutrition, enteral nutrition

94
Q

When is oral feeding used?

A

when the pt can swallow and has a working GI tract

95
Q

Nutritional supplements are used to

A

increase calories or nutritional intake

96
Q

The administration of nutrition to the bloodstream, not the GI tract directly (IV nutrition)

A

parenteral nutrition

97
Q

Tube that delivers nutritional intake directly to the GI tract

A

enteral nutrition

98
Q

Complications of enteral nutirtion

A

rate, temperature, placement, NVD, aspiration, and r/o dehydration

99
Q

Complications of parenteral nutrition

A

pneumothorax/hemothorax during insertion, air embolism, infection, blood sugar

100
Q

Types of enteral nutritional support

A

a. nasogastric (delivers food directly to stomach)
b. nasoduodenal/ nasojejunal (after the stomach or below the pyloric sphincter)
c. gastrostomy (directly to stomach)
d. jejunostomy (after the stomach or below the pyloric sphincter)

If after stomach, used for pt at risk for aspiration

101
Q

Reason for short term use of enteral nutrition

A

pt who cant swallow or has no appetite

102
Q

Reason for long term use of enteral nutrition

A

malabsorption disorders or increase catabolism (fast metabolism)

103
Q

Why is enteral nutrition preferred over parenteral nutrition?

A

enteral is more natural

104
Q

Central nervous system includes the

A

brain and spinal cord; the master

105
Q

Peripheral nervous system includes the

A

autonomic and somatic nervous systems

106
Q

The Autonomic nervous system includes the

A

sympathetic and parasympathetic nervous systems

107
Q

Fight or Flight

A

sympathetic

108
Q

PNS regulates

A

HR, BP, and vascular constriction

109
Q

Rest and digest

A

parasympathetic

110
Q

Adrenergics impact the __________ nervous system

A

sympathetic

111
Q

Norepinephrine is the

A

adrenaline hormone

112
Q

What neurotransmitter is used by the SNS?

A

norepinephrine

113
Q

Four receptor types that norepi binds to?

A

alpha1, alpha2, beta 1, and beta2

114
Q

Where are alpha receptors located?

A

smooth muscles (blood vessels, eyes, bladder, prostate)

115
Q

vasoCONSTRICT (stimulatory)

A

Alpha1

116
Q

Alpha1 constrict the blood vessels and cause

A

Increased peripheral resistance, arteries constrict –> INCREASED BP

117
Q

vasoDILATE (inhibitory)

A

Alpha2

118
Q

Alpha2 inhibit norepi release causing the

A

arteries to dilate –> DECREASED BP

more space for the blood to move

119
Q

Alpha2 also inhibits

A

insulin

120
Q

Impacts the heart and juxtaglomerular cells

A

Beta1

121
Q

Beta1 increases myocardial contractility and HR, stimulates RAAS leading to

A

increased BP and HR

122
Q

Impacts bronchioles, eyes, uterine muscle, GI tract, arteries of skeletal muscles

A

Beta2

123
Q

Beta2 causes

A

Relaxation of smooth muscles of lungs (BRONCHODILATION), decrease in GI tone and motility, uterine relaxation (decrease in uterine contraction)

124
Q

Agonists that stimulate the SNS are also called

A

adrenergics or sympathomimetics

125
Q

Adrenergics that increase HR and BP

A

Epinepherine, Norepinephrine, Dopamine

126
Q

Adrenergic med that dilate bronchi

A

Albuterol

127
Q

Antagonists that block the SNS are also called

A

adrenergic blockers or sympatholytics

128
Q

Meds ending in -olol are

A

beta blockers

129
Q

Adrenergic blocker med that lowers blood pressure

A

Atenolol

130
Q

What causes side effects when using adrenergic agonists?

A

Side effects frequently result when adrenergic drug dosage is increased or when the drug is nonselective

131
Q

Adverse effects of adrenergic agonists

A

tachycardia, hypertension, palpitations, restlessness, dysrhythmias, CNS excitation and seizures, dry mouth, nausea and vomiting, anorexia

132
Q

How many adrenergic receptors does epinephrine stimulate?

A

more than one; so it is non-selective

133
Q

Epinephrine responses include

A

CNS stimulation

increase in BP, pupil dilation, increase in HR, bronchodilation

134
Q

When is epinephrine used?

A

Used in anaphylactic shock to increase BP, HR, and airflow through lungs

135
Q

Onset of action and peak concentration time of epinephrine is __________.

A

rapid

136
Q

Primary use of adrenergic antagonists

A

Treat hypertension, dysrhythmias, angina, heart failure, benign prostatic hypertrophy, narrow-angle glaucoma

137
Q

Adverse effects of adrenergic antagonists

A

dizziness, drowsiness, headache, loss of energy and strength, palpitations, dry mouth

138
Q

Promote vasodilation, causing a decrease in BP

A

alpha antagonists

139
Q

Cause decrease in HR, followed by decrease in BP

A

Beta-adrenergic antagonists (beta blockers)

140
Q

Other therapeutic applications of beta-adrenergic antagonists (beta blockers)

A

Angina pectoris, Migraines, Heart failure

141
Q

A cardioselective beta1 blocker that decreases sympathetic outflow to periphery and suppresses RAAS response (which will DECREASES BP)

A

Atenolol

142
Q

Atenolol is used to treat

A

HTN, angina, prophylaxis and treatment of acute MI

143
Q

Side effects of Atenolol

A

bradycardia, hypotension, headache, dizziness, bronchospasm

144
Q

Before administering Atenolol, you should always check the pt’s HR & BP. If HR is below 50 you should

A

hold meds and notify provider

145
Q

Cholinergics impact the

A

Parasympathetic nervous system

146
Q

Receptors of PNS are either

A

nicotinic or muscarinic

147
Q

Nicotinic

A

stimulate smooth muscle & slow HR

148
Q

Muscarinic

A

affects skeletal muscles

149
Q

What neurotransmitter is used by the PNS?

A

acetylcholine

150
Q

Cholinergic agonist __________ the PNS

A

stimulate

151
Q

Cholinergic agonists are also called

A

Parasympathomimetics

152
Q

Cholinergic agonists are used to treat

A

glaucoma, urinary retention, myasthenia gravis, Alzheimer’s disease

153
Q

Adverse effects of cholinergic agonists

A

○ Profuse salivation
○ Sweating
○ Increased muscle tone
○ Urinary frequency
○ Bradycardia

154
Q

Wet side effects

A

cholinergic agonists

155
Q

Bethanechol Chloride is a

A

direct acting cholinergic agonist

156
Q

Bethanechol Chloride is the treatment for? Causes?

A

Urinary Retention & Neurogenic Bladder

Acts on detrusor muscle to contract bladder → Increases urination

157
Q

Side effects and adverse reactions of Bethanechol Chloride

A

hypotension, increased gastric acid secretion, abdominal cramps, diarrhea, bronchospasm

158
Q

Cholinergic antagonist _________ the PNS

A

inhibit/block

159
Q

Cholinergic antagonists are also called

A

parasympatholytics

160
Q

Primary uses of cholinergic antagonists

A

peptic ulcers, irritable bowel syndrome, mydriasis and cycloplegia during eye examination, bradycardia, preanesthetic, asthma

161
Q

Adverse effects of cholinergic antagonists

A

tachycardia, CNS stimulation, urinary retention, dry mouth, dry eyes, decreased sweating, photophobia

162
Q

Dry side effects

A

cholinergic antagonists

163
Q

Atropine is a

A

cholinergic antagonist

164
Q

Atropine is used as a __________ med to reduce respiratory & salivary secretions

A

pre-op

165
Q

Side effects and adverse reactions of atropine

A

xerostomia (dry mouth), nasal dryness, blurred vision, tachycardia, constipation, urinary retention

166
Q

These drugs stimulate the CNS and are typically prescribed to treat ADHD,
narcolepsy and to reverse respiratory depression.

Include amphetamines, analeptics, and anorexiants

A

stimulants

167
Q

Side effects of stimulants

A

tachycardia, headache, restlessness, insomnia, pruritus (itching)

168
Q

What type of stimulant has a high abuse potential?

A

anorexiants

169
Q

What is the primary use of an analeptic?

A

stimulate respiration

170
Q

These drugs cause varying levels of CNS depression based on the amount of the drug taken. Sedative hypnotics are typically ordered to treat sleep disorders.

Include phenobarbital, benzodiazepines, and anesthetics

A

depressants

171
Q

Side effects of depressants

A

slurred speech, confusion, headache, dizziness, dry mouth

172
Q

Why are barbiturates less commonly prescribed?

A

Dangerous, respiratory depression, and potential dependency

173
Q

Can you stop depressants abruptly?

A

no!

174
Q

Anesthetics are used to cause complete or partial loss of sensation. What is the difference between general, regional, and local anesthetics?

A

general- affects the whole body
regional- affects larger areas of the body
local- affects small part of the body

175
Q

Antiseizure drugs act in three ways:

A

Increase action of GABA (GABA will calm the brain down), suppress sodium influx, or suppress calcium influx

176
Q

Phenytoin is a(n)

A

antiseizure medication that inhibits sodium influx

177
Q

Side effects & adverse effects of Phenytoin

A

S/E: chest pain, diaphoresis, N/V, constipation, drowsiness, depression, &suicidal ideation

A/E: gingival hyperplasia, Stevens-Johnson syndrome

178
Q

What is the therapeutic serum level for Phenytoin?

A

10-20 mcg/mL

179
Q

Valproate is a(n)

A

antiseizure medication that decreases calcium influx

Use: absence, tonic clonic, and partial seizures

180
Q

Side effects of Valproate

A

hepatotoxicity, N/V, diarrhea, tremors, headache, weight gain, &stomatitis

181
Q

Do not give Valproate to children under 2

A

true

182
Q

Phenobarbital is a(n)

A

antiseizure medication that enhances GABA activity; barbiturate

Use: myoclonic, tonic clonic and partial seizures, and status epilepticus

183
Q

Side effects of Phenobarbital

A

hepatotoxicity, agitation, confusion, ataxia, dizziness, insomnia, hypotension, bradycardia, syncope

184
Q

Do not give Phenobarbital to children under 2

A

true

185
Q

Diazepam is a(n)

A

antiseizure medication that enhances GABA activity; benzo

Use: status epilepticus

186
Q

Side effects of Diazepam

A

drowsiness, confusion, sedation, respiratory depression

187
Q

A nurse is monitoring a client who is receiving phenytoin IV for the treatment of status epilepticus. Which of the following findings should the nurse identify as an adverse effect of the medication?

a. Hypertension
b. Cardiac dysrhythmias
c. Gastric discomfort
d. Tachycardia

A

b. Cardiac dysrhythmias

188
Q

A nurse is caring for a child who has epilepsy and is scheduled to receive a dose of phenytoin. The nurse notes the child’s serum phenytoin level is 14 mcg/mL. Which of the following actions should the nurse take?

a. Administer the dose
b. Administer half the dose
c. Hold the dose
d. Clarify the dose with the provider

A

a. Administer the dose

189
Q

A nurse is providing teaching to a client who has a new prescription for diazepam. Which of the following instructions should the nurse include in the teaching?

a. Expect this medication to make you feel anxious
b. This medication can be habit-forming
c. Take this medication on an empty stomach
d. This medication needs to be taken for 2 to 3 weeks to reach the full therapeutic effect

A

b. This medication can be habit-forming

190
Q

A nurse is assessing a client who has ADHD and reports abruptly discontinuing his amphetamine treatment. Which of the following assessments indicates that the client is physically dependent on the amphetamines?

a. The client exhibits paranoia
b. The client reports having insomnia
c. The client reports eating excessively
d. The client has an increased heart rate

A

c. The client reports eating excessively

191
Q

Rivastigmine is used to treat

A

mild to moderate Alzheimer’s Disease

Goal: slow disease process, decrease S/Sx, & improve cognitive function/ADL’s

192
Q

Action of Rivastigmine

Rivastigmine is an acetylcholinesterase inhibitors. Acetylcholinesterase is an enzyme that digests ACh. This drug will block the enzyme from digesting ACh which leads to an

A

increase of ACh at synapses

193
Q

Side effects and adverse reactions of Rivastigmine

A

S/E: GI Sx, dizziness, orthostatic hypotension, HA, nystagmus
(repetitive eye movements), dehydration

A/R: hepatotoxicity, bradycardia, dysrhythmias, heart failure,
seizures, suicidal ideation

194
Q

Directly observed therapy for Alzheimer’s Disease

A

watch pt take medication

195
Q

Alzheimer’s Meds - Patient Teaching

A
  • Take as prescribed
  • Do not crush extended-release tablets
  • Report S/E or A/R to provider
  • Take w food or milk to avoid GI distress
  • S/sx of OD: NV, sweating, hypotension, excess salivation, bradycardia, seizures, muscle weakness
196
Q

In Parkinson’s disease, dopamine is __________ and acetylcholine is __________.

A

low, high

197
Q

Benztropine is used to treat

A

Parkinson’s disease

198
Q

Benztropine is a(n)

A

anticholinergic that blocks the release of ACh

199
Q

Benztropine is contraindicated for pts w/

A

glaucoma

200
Q

Side effects of Benztropine

A

dry mouth, constipation, urinary retention, N/V, restlessness/anxiety,
tachycardia, blurred vision, confusion

201
Q

Can you abruptly stop Benztropine

A

no! could increase S/Sx

202
Q

Carbidopa-levodopa is used to treat

A

Parkinson’s disease

203
Q

Carbidopa-levodopa is a

A

dopaminergic

204
Q

Levodopa is converted to __________ in the brain. Carbidopa helps Levodopa cross the blood brain barrier.

A

dopamine

205
Q

Side effects of Carbidopa-levodopa

A

dizziness, fatigue, N/V/C, orthostatic hypotension, dystonia,
dyskinesia, psychosis, depression, sleep disturbances

206
Q

Carbidopa-levodopa patient teaching

A
  • Take as prescribed & don’t crush extended-release tablets
  • Do not take w/ high protein foods, Vit B6, or alcohol
  • Don’t stop abruptly
  • May cause urine & sweat to turn brown
  • Assess Sx status & “on-off” phenomenon (drug holiday)
207
Q

Rasagiline is used to treat

A

Parkinson’s disease

208
Q

Rasagiline is a

A

monoamine oxidase-B inhibitor

209
Q

Increases dopamine by inhibiting MAO-B & delays wearing off of Levodopa

A

Rasagiline

210
Q

When taking rasagiline, food w/ _________ should be avoided. Can cause hypertensive crisis.

A

tyramine

Foods: aged cheese, red wine, bananas, smoked meats, chocolate

211
Q

A nurse is administering rivastigmine (Exelon) to a client with Alzheimer’s disease. As the nurse prepares the medication, the client says, “I know how to take my pill, why do you have to watch me take it?” Which of the following is the best response by the nurse?

a. I will watch to make sure you do not choke on the medication.
b. Please don’t make this difficult, just take the pill.
c. I will ensure your medication is taken appropriately so it is effective.
d. You are always confused, so I will make sure you know how to take your medication properly.

A

c. I will ensure your medication is taken appropriately so it is effective.

212
Q

A client with Parkinson’s disease is taking rasagiline (Azilect) to treat their
Parkinson’s disease. After taking their medication, they prepare to order their dinner. Which of the following indicates the client needs further teaching?

a. Grilled chicken with green beans and mashed potatoes
b. Smoked sausage with broccoli and a chocolate milkshake
c. Steak with brown rice and carrots
d. Lasagna and apple pie

A

b. Smoked sausage with broccoli and a chocolate milkshake

213
Q

The nurse is teaching a client with a new prescription for carbidopa-levodopa (Sinemet) for Parkinson’s disease. Which of the following instructions should the nurse include?

a. Increase intake of protein-rich foods.
b. Expect muscle twitching to occur.
c. Take this medication with food.
d. Anticipate relief of symptoms in 24 hours.

A

c. Take this medication with food.

214
Q

Pyridostigmine is used to treat

A

Myasthenia gravis

215
Q

Pyridostigmine is a(n)

A

acetylcholinesterase inhibitor that increases muscle strength by preventing destruction of ACh

216
Q

Side effects of Pyridostigmine

A

NVD, abdominal cramping, miosis (pupil constriction),
increased salivation & tear production, blurred vision, bradycardia,
hypotension
- “Wet” symptoms

217
Q

OD of Pyridostigmine can cause

A

cholinergic crisis
- Muscle weakness can → respiratory paralysis & arrest

218
Q

Interferon beta 1a is used to treat

A

Multiple Sclerosis

219
Q

Interferon beta 1a is a(n)

A

immunomodulator that slows disease progression and prevents relapses

220
Q

Can cause flu-like sx

A

Interferon beta 1a

221
Q

What is the biggest risk associated w/ immunomodulators?

A

infection

222
Q

Relieve muscle spasticity and pain in pts w/ MS, stroke, cerebral palsy, head & spinal cord injuries

A

skeletal muscle relaxants

223
Q

Side effects of muscle relaxants

A

drowsiness (CNS depression), dizziness, headaches, GI upset

224
Q

Drugs that improve spasticity

A

baclofen, dantrolene, tizanidine

225
Q

Drugs that improve muscle spasms

A

metaxalone, cyclobenzaprine, chloroxazone

226
Q

Why are barbiturates less commonly prescribed?

A

Dangerous, respiratory depression, and potential dependency

Pharm (19 decks)

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