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Pharmacology For Nursing > Pharm Exam 1 > Flashcards

Pharm Exam 1 Flashcards

1
Q

Vassopressor Indications

A

Sub q: added to local anesthetics
Intra-muscular: anaphylaxis
Inhaled: asthma (non routine)
Intravenous: push for asystole in Advanced Cardiac Life Support, titratable drips - used for shock, hypotension, bradycardia

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2
Q

Vassopressor MOA

A

Binds non-specifically to all Alpha and Beta receptors

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3
Q

Vassopressor Adverse Effects

A

Vesicant - harms tissue around veins
Tachycardia
Vasoconstriction- hypertension, lack of blood supply to extremities

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4
Q

Vassopressor nursing implications

A

Monitor that IV stays in vein
Antidote - phentolamine
Monitor hr, EKG, BP(IV route)
Monitor extremities

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5
Q

Vassopressor contra-indications

A

None if needed for life support
Tachycardia, hypertension, narrow angle glaucoma

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6
Q

Vassopressors

A

Epinephrine (EpiPen)
Norepinephrine (levophed)
Dopamine
Phenylephrine (neosynephrine)

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7
Q

Selective beta-1 blockers

A

A-M, “Lol” except carvedilol, Labetelol, Atenolol, bisoprolol
Metoprolol

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8
Q

Selective beta-1 blockers therapeutic use

A

Cardiac related:
Heart dysrhythmia, MI, compensated heart failure, hypertension, symptoms of hyperthyroidism/thyroid storm

Non-cardiac:
Anxiety, eye drops, glaucoma (IOP)

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9
Q

Selective beta-1 blockers MOA

A

Antagonist, Block beta-1 receptors primarily in the heart but also the eyes

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10
Q

Selective Beta-1 Blockers Adverse Effects

A

BLACK BOX WARNING: DONT STOP SUDDENLY, MAY INCREASE RISK FOR MI

Cardiac: bradycardia, hypotension, heart failure exacerbation (fluid retention), dizziness (change positions slowly)

Non-cardiac: sexual dysfunction/impotence, mood-depression, insomnia, decreased libido, may mask s/s of hypoglycemia - diabetes patients must be careful

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11
Q

Selective Beta-1 Blockers Client Safety Teaching and Administration

A

Asses BP, hold if <90/60
Asses HR, hold if <60
Don’t stop taking suddenly
May cause orthostatic hypotension and dizziness, change positions slowly
May block signs of hypoglycemia in diabetics, test glucose

Patients with heart failure should weigh daily, if they gain >5 lbs in a week or 2 lbs in a day they may be retaining fluid meaning their heart failure is now uncompensated= call provider

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12
Q

Selective Beta-1 Blockers Nursing Considerations

A

Assess, monitor, evaluate HR and BP

Daily weight checks in heart failure patients

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13
Q

Selective Beta-1 Blockers Contra-indications

A

Bradycardia, hypotension, heart block, uncompensated heart failure

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14
Q

Non-selective Beta Blockers

A

N-Z “lol” plus carvedilol, propranolol, Labetelol, timolol,

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15
Q

Non-selective Beta Blockers Indications

A

Cardiac:
Heart dysrhythmias, myocardial infarction, compensated heart failure, hypertension, symptoms of hyperthyroidism, thyroid storm

Non-cardiac:
Anxiety, eye drops = glaucoma
Carvedilol equals cardiac, propranolol equals professionals, labetalol equals labor, timolol equals Timmy’s glaucoma

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16
Q

Non-selective beta blockers MOA

A

All block beta 1 receptors
Some may block beta 2 like propanolol carvedilol and labetolol
Some may block alpha 1 like carvedilol and Labetolol
Some may release nitric oxide like nebivolol

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17
Q

Nonselective beta blockers adverse effects

A

BLACK BOX WARNING: NEVER STOP SUDDENLY SUDDEN STOPPAGE CAN INCREASE AND RISK FOR MYOCARDIAL INFARCTION ESPECIALLY FOR THOSE USING FOR CARDIAC CONDITIONS

Cardiac:
Bradycardia, hypotension, heart failure exacerbation fluid retention, dizziness - change positions in bed slowly

Non cardiac
Sexual dysfunctional impotence, mood- depression, insomnia, decreased sexual libido, May mask signs and symptoms of hypoglycemia and diabetic patients.

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18
Q

Non selective beta blockers client safety teaching administration

A

Assess blood pressure hold if below 90/60
Assess heart rate hold it below 60
Do not take do not stop taking suddenly especially for adverse effects like sexual dysfunction skip a dose if heart rate or BP are low but not indefinitely without notifying provider
Any medication that lowers blood pressure may cause orthostatic hypotension dizziness change position slowly
Educate patients with diabetes that they cannot rely on usual signs and symptoms of hypoglycemia need to rely on glucose checks
Heart failure patients should weigh daily if gain more than 5 lb in one week or 2 lb in one day call provider might be in heart failure on compensated

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19
Q

nonselective beta blockers Nursing considerations and implications

A

Assess monitor and evaluate heart rate and blood pressure, daily weight checks for heart failure patients

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20
Q

Non selective beta blockers contract indications

A

Special - asthma and COPD (beta 2 affects heart), bradycardia, hypotension, heart block, uncompensated heart failure

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21
Q

Alpha-1 blockers

A

“sin”
Tamulosin, prazosin, terazosin, silodosin, doxazosin

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22
Q

Alpha-1 blockers indications

A

Benign pratostatic hydroplasia, urinary retention, bladder obstruction kidney stones, hypertension - rare

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23
Q

Alpha-1 blockers moa

A

Prevent activation of A1 receptors throughout the body. Some drugs selectively only work in certain areas of the body.

Alpha 1 receptors are found in vascular smooth muscle arteries

Alpha 1 receptors are found in the smooth muscle of the bladder and prostate

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24
Q

Alpha-1 blockers adverse effects

A

First dose phenomenon - orthostatics/postural hypertension, hypotension, reflex tachycardia, sexual dysfunction decreased libido and impotence

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25
Q

Alpha-1 blockers nursing considerations

A

Assess monitor and evaluate blood pressure, assess urine output for relief of benign pratostatic hyperplasia

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26
Q

Alpha - 1 blockers contraindications

A

Priapism, floppy Iris syndrome

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27
Q

Serotonin agonists

A

Sumatriptan

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28
Q

Serotonin agonists indications

A

Migraines acute not daily use

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29
Q

Serotonin agonists moa

A

Vasoconstriction on cranial arteries

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30
Q

Serotonin agonist adverse effects

A

Chest pain, increase heart rate and blood pressure, CNS depression - dizzy asthenia drowsy dose dependent

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31
Q

Serotonin agonist client safety teaching administration

A

Administered at onset of migraine symptoms - one oral tablet readministered every 2 hours, one spray in one nostril-readminister after 1 hours, subcutaneous injection - re-administer after 1
Max of two doses per day max of 10 doses per month
may experience tingling flushing congestion in the chest

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32
Q

serotonin agonist Nursing considerations and implications

A

Serotonin syndrome - interacts with ergots ssris and mais
Monitor headache severity bphr and chest pain

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33
Q

Serotonin agonist contraindications

A

Heart disease, uncontrolled hypertension, pregnancy - teratogenic

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34
Q

Allopurinol indications

A

Chronic gout, tumor license syndrome, tophi

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35
Q

Allopurinol moa

A

Xanthine oxidase inhibitor
Decrease uric acid production by conversion to active metabolite
Prodrug

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36
Q

Allopurinol adverse effects

A

Steven Johnson syndrome, hepadoxicity, rebound gout attack

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37
Q

Allopurinol client safety teaching and administration

A

Take after a meal, drink lots of fluid, watch for signs of sjs, do not discontinue abruptly

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38
Q

Allopurinol nursing considerations

A

Monitor uric acid, hydration, GI or urinary bleeding, hepatotoxicity

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39
Q

Allopurinol contraindications

A

Hypersensitivity- hla-b * 5801 positive patience

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40
Q

Colchicine indication

A

Acute gout attack

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41
Q

Colchicine moa

A

Reduces inflammatory response to urate crystals by inhibiting chemotaxis

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42
Q

Colchicine adverse effects

A

GI symptoms nausea and vomiting, lump in throat sensation, rhabdomyolysis- muscle breakdown that can harm the heart and kidneys, Myelosuppression - harms bone marrow and makes blood cell formation stop

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43
Q

Colchicine client safety teaching and administration

A

Per oral on empty stomach with lots of fluids, take with food if GI symptoms, avoid grape juice

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44
Q

Colchicine nursing considerations

A

Monitor uric acid renal and hepatic function and complete blood cell count

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45
Q

Colchicine contraindications

A

Hyper sensitivity, severe renal and hepatic disorder, blood count issues, pregnancy

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46
Q

Direct acting cholenergic

A

Bethanechol, pilocarpine

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47
Q

Bethanechol indications

A

Urinary retention neurogenic bladder difficulty voiding

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48
Q

Bethanechol moa

A

Increases cholinergic activity by stimulating muscarinic receptors primarily those found in the bladder and GI tract

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49
Q

Bethanechol adverse effects

A

Sludgem and the killer bees
Increased salivation gastric secretion, abdominal cramps and diarrhea, bronco constriction
Extremely rare - hypotension and or bradycardia

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50
Q

Bethanechol client safety teaching and administration

A

GI motility, recommended to administer 1 hour before or 2 hours after meals to prevent vomiting up food
Dizziness and fall risk recommend change positions slowly, report any issues with bradycardia or hypotension, look for signs of cholinergic crisis-sludgem

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51
Q

Bethanechol nursing considerations and implications

A

Monitor heart rate and blood pressure, monitor urine output - patients should urinate 60 minutes after taking, monitor for cholinergic crisis - antidote is atropine

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52
Q

Bethanechol contraindications

A

Bradycardia, hypotension, asthma, peptic ulcer disease

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53
Q

Pilocarpine indications

A

Xerostomia systemic, eyeI drops glaucoma

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54
Q

Pilocarpine moa

A

Agonist of cholinergic muscarinic receptors, causes increased secretions - sweating salivation and GI tract,

eye= causes meiosis, decreases intraocular pressure

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55
Q

Pilocarpine adverse effects

A

Sludge m and the killer bees
Increased salivation, gastric secretion, abdominal cramps and diarrhea, bronco constriction
Cholinergic crisis
Rare - hypotension and or bradycardia

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56
Q

Pilocarpine administration client safety and teaching

A

Dizziness and fall risk change positions slowly, cardiac problems such as bradycardia and hypotension, cholinergic crisis symptoms

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57
Q

Pilocarpine nursing considerations

A

Assess and monitor heart rate and blood pressure, assessment monitor salivation and interocular pressure, monitor for cholinergic crisis - antidote atropine

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58
Q

Pilocarpine contraindications

A

Bradycardia, hypotension, asthma, does not include peptic ulcer disease but still affects the GI tract

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59
Q

Indirect acting cholinergics

A

Paretastigmine neostigmine physiostigmine Rivastigmine and donepezil

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60
Q

Indirect acting cholinergics indications

A

Pyridostigmine - myasthenia gravis, recovery of muscle strength

Others - alzheimer’s, reversing anticholinergic effects, reversing neuromuscular blocking agents, pretreatment for exposure to nerve gas

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61
Q

Indirect acting cholinergics moa

A

Inhibits acetylcholinesterase, pyrido stigmine works at the neuromuscular junction, rivastigmine works in the central nervous system and is used for Alzheimer’s

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62
Q

Indirect acting cholinergics adverse effects

A

Sludge m and the killer bees
Increased salvation gastric secretion abdominal cramps and diarrhea bronco constriction hypotension Android

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63
Q

Indirect acting cholineergics nursing considerations

A

Monitor heart rate and blood pressure especially if given IV, patient should have improved muscular strength, monitor for cholinergic crisis - antidote’s atropine

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64
Q

Indirect acting cholinergics contraindications

A

Black box warning bradycardia, hypotension, asthma, peptic ulcer s disease not listed but still affects GI

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65
Q

Atropine indications

A

Drops - reduce elevation and secretions for palliative care
Systemic or IV - symptomatic bradycardia, cholinergic crisis antidote

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66
Q

Atropine moa

A

Antagonist at various muscarinic receptors in the parasitic division of the body particularly the heart , this allows the sympathetic division to take control

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67
Q

Atropine adverse effects

A

Can’t see can’t pee can’t spit can’t s*** can’t switch

Mydriasis and blurred vision, urinary retention and hesitation, zerostomia, constipation, hypohidrosis
Anticholinergic tox syndrome may cause patients to flush due to overheating from lack of sweating

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68
Q

Atropine nursing considerations

A

Monitor heart rate and blood pressure, be careful insensitive populations like older adults and outdoor workers

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69
Q

Atropine contraindications

A

Glaucoma because it increases ocular pressure, benign protostatic hyperplasia because of urinary retention

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70
Q

Anticholinergics for overactive bladder

A

Oxybutynin solifenacin tolterodine

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71
Q

Anticholinergics for overactive bladder indications

A

Used for overactive bladder or urinary incontinence

72
Q

Anticholinergics for overactive bladder moa

A

Antagonist at various muscarinic receptors in the parasympathetic division of the body

73
Q

Anticholinergics for overactive bladder adverse effects

A

Can’t see can’t pee can’t spit can’t s*** can’t schvitz

My drynesses, dry eyes, blurred vision, urinary retention and hesitation, zero stormia, constipation, hypohidrosis

Anti-collinergic toxodrome patients will flush due to overheating from lack of sweating

74
Q

Anticholinergic for overactive bladder administration

A

Protect ice from sunlight, notify provider if difficulty voiding, chewing sugar-free gum, fluid fiber and frequency exercise, stay hydrated and avoid hot weather sauna extreme exercises etc

75
Q

Anticholinergics for overactive bladder contraindications

A

Glaucoma, benign prosthetic hyperplasia Plus urinary retention

76
Q

Anticholinergics for overactive bladder nursing considerations

A

Be careful insensitive populations like older adults and outdoor workers, monitor patient intake and I’ll take watch for urinary retention and bladder distention

77
Q

Neuromuscular blockers

A

Succinylcholine, vecuronium

78
Q

Neuromuscular blockers indications

A

Paralyzing agent for intubation, causes respiratory arrest patient must be ventilated

79
Q

Neuromuscular blockers moa

A

Antagonist at The nicotinic receptors at the nmj

80
Q

Neuromuscular blockers adverse effects

A

Skeletal muscle paralysis including respiratory muscles, malignant hyperthermia
FDA boxed warning - only adequately trained individuals should use

81
Q

Neuromuscular blocker client safety training and administration

A

Give only if artificial inventilation is available patient cannot breathe on their own, give only if patient is appropriately sedated

82
Q

Neuromuscular blockers nursing considerations

A

Only paralyzes, patient could still be awake so co-administer with sedative, monitor for signs of malignant hyperthermia - management is dantrolene

83
Q

Neuromuscular blockers contraindications

A

History of malignant hyperthermia

84
Q

Docusate sodium indications

A

Stool softener, used for constipation, sometimes used for ear wax removal

85
Q

Docusate sodium moa

A

Reduces surface tension of the oil water interface of the stool resulting in enhanced in corporation of water and fat allowing for stool softening, does not cause patients to defecate just soften stool to allow for easier
MUSH

86
Q

Docusate sodium adverse effects

A

Do not use with bowel obstruction, diarrhea, electrolyte loss

87
Q

Docusate sodium client safety teaching and administration

A

Recommend the three f’s fluid fiber and frequent exercise, each patient’s bowel routine is different some may only go once every 3 days some may go many times a day something is not necessarily wrong if not daily
Encourage hydration one cup of water with medication
Not particularly effective when compared to placebo

88
Q

Docusate sodium nursing considerations

A

Least likely to cause fluid and electrolyte loss

89
Q

Docusate sodium contraindications

A

Bowel obstruction can cause bowel perforation

90
Q

Fiber laxatives

A

Psyllium and methylcellulose

91
Q

Fiber laxatives indications

A

Chronic constipation- only laxative used long-term

92
Q

Fiber laxatives moa

A

Psyllium is a soluble fiber it absorbs water in the intestines to form a viscous liquid which promotes peristalsis and reduces Transit time

93
Q

Fiber laxatives adverse effects

A

Avoiding bowel obstruction can cause perforation, diarrhea, electrolyte loss

94
Q

Fiberlaxatives client safety teaching and administration

A

Follow the apps fluid fiber and frequent exercise, each patient has their own bowel routine, encourage hydration

95
Q

Fiberlaxatives nursing considerations

A

Least likely to cause fluid and electrolyte loss

96
Q

Fiber laxatives contraindications

A

Bowel obstruction can cause bowel perforation

97
Q

Polyethylene glycol-3350 indications

A

Constipation including opioid induced constipation, bowel prep for procedure like colonoscopy

98
Q

Polyethylene glycol-3350- moa

A

Osmotic laxative causes water retention in stool increases stool frequency

99
Q

Propylene glycol 3350 adverse effects

A

Avoid bowel destruction, diarrhea, electrolyte loss - strong laxative

100
Q

Polyethylene glycol - 3350 client safety teaching and administration

A

Follow f’s fluid fiber and frequent exercise, patients have their own normal bowel routine, encourage hydration, if using for bowel prep add Golytely to a 1 gallon jug and finish entire bottle

101
Q

Polyethylene glycol-3350 nursing considerations

A

Opioid induce constipation laxative, assess for dehydration and electrolyte loss

102
Q

Polyethylene glycol 3350 contraindications

A

Bowel obstruction can cause bowel perforation

103
Q

Lactulose indications

A

Constipation and hepatic encephalopathy

104
Q

Lactulose moa

A

Osmotic laxative, convert NH3 to nh4 Plus keeping it in the gut and producing an osmotic effect in the colon promoting peristalsis

105
Q

Lactulose adverse effects

A

Avoiding bowel obstruction, diarrhea, electrolyte imbalances

106
Q

Lactulose client safety teaching administration

A

Follow the fluid fiber and frequent exercise, each patient has their own normal bowel routine, if used for hepatic encephalopathy do not miss a dose missing a dose could result in buildup of ammonia levels leading back to hepatic encephalopathy, encourage hydration

107
Q

Lactulose considerations for nursing

A

Ammonia levels should be lower to a normal level, assess for dehydration and electrolyte loss

108
Q

Lactulose contraindications

A

Bowel obstruction

109
Q

Magnesium hydroxide and citrate laxative indications

A

Heartburn and constipation

110
Q

Magnesium hydroxide and citrate moa

A

Osmotic retention of fluid distends the colon and increases peristaltic activity

111
Q

Magnesium hydroxide and magnesium citrate laxative adverse effects

A

Avoid and bowel obstruction, diarrhea, electrolyte loss - strong laxative

112
Q

Magnesium hydroxide and magnesium citrate client safety teaching and administration

A

Follow the apps, patients have their own bowel routine, encourage hydration

113
Q

Magnesium hydroxide and magnesium citrate laxative nursing considerations

A

Be aware of renal impairment - magnesium can accumulate, evaluate for dehydration and electrolyte depletion

114
Q

Magnesium hydroxide and magnesium citrate laxatives contraindications

A

Bowel obstruction

115
Q

Stimulant laxatives

A

Senna and biscodyl

116
Q

Stimulant laxatives indication

A

Constipation including opioid induced constipation
bowel prep for procedures like colonoscopy

117
Q

Stimulant laxatives moa

A

Induced navigation by stimulating peristaltic activity by direct action on intestinal mucosa or nerve plexuses
increases motility

118
Q

Stimulant laxatives adverse effects

A

Avoid and bowel obstruction, diarrhea, electrolyte loss - strong laxative

119
Q

Stimulant laxatives client safety teaching and administration

A

3f’s, patients have their own normal bowel routine, do not crush bisacodyl it has enteric coating, Senna should be taken alone do not take with other medications within 1 hr

120
Q

Stimulant laxatives nursing considerations

A

Can be used for opioid induced constipation, oral stimulants can take 6 to 12 plus hours to work, rectal suppositories will work within 30 minutes, assess for dehydration and electrolyte loss

121
Q

Stimulant laxatives contraindications

A

Bowel obstruction

122
Q

Morphine related opioids

A

Codeine, hydromorphone, hydrocodone, oxycodone

123
Q

Morphine related opioids indications

A

Moderate to severe pain, not mild, cough/antitussive- prescription only

124
Q

Morphine related opioids moa

A

Agonist at Mu and kappa opioid receptors

125
Q

Morphine related opioids adverse effects

A

MORPHINE

126
Q

Morphine related opioids client safety teaching and administration

A

Keep medication secured and locked, most are scheduled to substances, never share, take with food to reduce nausea, change positions slowly dizziness risk, patience should urinate, keep track of bowel movements and be proactive and preventing constipation, don’t drive or operate machinery, don’t mix with bees and z drugs

127
Q

Morphine related opioids nursing considerations

A

Monitor bladder look for retention distention might need to cast plus bowels look for distention, acutely assess vital signs, blood pressure hold for hypotension, heart rate hold for bradycardia, respiratory rate hold for Brady penia under 12 breaths per minute, oxygen saturation hold if under 90%, pain score give only If For above, mental / sedation status hold it overly sedated

128
Q

Morphine related opioids contraindications

A

Breastfeeding, Biloary colic, elevated entercrainial pressure

129
Q

Tramadol indications

A

Moderate and or severe pain not mild, some prescribers do use for mild pain as it’s not a true opioid

130
Q

Tramadol moa

A

Binds to opioid receptors and increases serotonin and norepinephrine in the nociceptive pathway, different from other opioids because it increases serotonin

131
Q

Tramadol adverse effects

A

M o r p h i n e, seizures, serotonin syndrome

132
Q

Tramadol client safety teaching and administration

A

Keep locked up, never share, take with food, change position slowly, urinate and keep track of bowel movements, don’t operate machinery, b and z drugs

133
Q

Tramadol nursing considerations

A

Monitor and evaluate bladder and bowels for retention and distension may need to cast, hold for hypotension bradycardia Bradypnea oxygen saturation under 90% or overly sedated

134
Q

Tramadol contraindications

A

Breast affiliating biliary colic and elevated entertainial pressure, caution if history of seizures not contraindicated

135
Q

Meperidine indications

A

Post-operative shivering, moderate to severe pain not mild

136
Q

Meperidine moa

A

Binds to opioid receptors as an agonist

137
Q

Meperidine adverse effects

A

M O R P H I N E, seizures, serotonin syndrome

138
Q

Meperidine administration

A

Keep secure and locked up, never share, take with food, change positions slowly, urinate, bowel movements, don’t drive, don’t mix with bnz

139
Q

Meperidine nursing considerations

A

Assess bladder and bowels for retention and distension, assess vital signs hold for hypotension bradycardia Brady pnea oxygen saturation under 90% check paying score and mental / sedation status

140
Q

Meperidine contraindications

A

Breastfeeding, biliary colic, elevated intracranial pressure, history of seizures caution not contraindicated

141
Q

Methadone indications

A

Moderator severe pain, especially you substance use disorders example heroin

142
Q

Methadone moa

A

Binds to opioid receptors as agonist

143
Q

Methadone adverse effects

A

M O R P H I N E, QT prolongation - cardiac dysrhythmia risk

144
Q

Methadone client safety teaching and administration

A

Keep locked up, never share, take with food, dizziness, urinate, keep track of bowels, don’t drive machinery, no b and z drugs

145
Q

Methadone nursing considerations

A

Check bladder and bowels for distension and retention, hold for hypotension bradycardia Brady pnea under 90% oxygen saturation low-pain score or overly sedated,
check EKG for QT

146
Q

Methadone contraindications

A

Breastfeeding, biliary colic, elevated intracranial pressure

147
Q

Fentanyl indications

A

Moderate to severe pain

148
Q

Fentanyl moa

A

Opioid receptor agonist

149
Q

Aspirin indications

A

Prevent or treat myocardial infarction, mild pain fever and inflammation, kawasaki disease pediatrics

150
Q

Aspirin moa

A

Preventsynthesis and release of prostaglandins by interrupting the cyclooxygenase pathway - cocks one and Cox 2
Irreversible platelet effect

151
Q

Aspirin adverse effects

A

BLACK BOX WARNING INCREASED RISK FOR BLEEDING AN GI ULCERS

Asthma, salicylism poisoning, premature closing of pda, platelet desegregation, peptical to disease, intestinal bleeding, reye’s syndrome, idiosyncratic reaction, ringing in the ears, wrinkle impairment, rapid breathing, noise - tinnitus, nephropathy

152
Q

Aspirin client safety training teaching and administration

A

Separate at least 1 hour from other NSAIDs - low affinity, take with food Plus enteric coated to reuse reduce GI upset - don’t crush, report any adverse effects - tinnitus rapid breathing nausea and vomiting, do not self-medicate with NSAIDs if taking other blood thinners

153
Q

Aspirin nursing implications.

A

Avoiding children except for Kawasaki disease, recognize signs and symptoms of salicylate toxicity or salicylicism, watch out for GI harm review administration tips

154
Q

Reversible NSAIDs

A

Ibuprofen naproxen caterolac indomethacin diclofena ciloxib

155
Q

Reversible instead indications

A

My variety of pain, mild pain, fever, inflammatory conditions

156
Q

Reversible NSAIDs moa

A

Reversible, first gen dash presents synthesis and release of prostaglandins by interrupting the Cox I and Cox II pathway,

CELOXCIB second gen dash prevents synthesis and release of prostaglandins by interrupting just Cox II

157
Q

Reversible NSAIDs adverse effects

A

BLACK BOX WARNING - INCREASE RISK FOR BLEEDING AND GI ULCERS

BLACK BOX WARNING - INCREASED RISK FOR CARDIO THROMBOTIC EVENTS

Vasoconstriction increases blood pressure and chance for myocardial infarction or stroke, tinnitus, decreased blood flow to kidneys salt water retention acute kidney injury

158
Q

Reversible NSAIDs client safety teaching and administration

A

Take with food plus enteric coated if available to reduce GI upset don’t crush, report any adverse effects like tinnitus GI pain decreased urine output, don’t self medicate with NSAIDs if taking blood thinners like warfarin or heparin, in case of caterolac usage is 5-day Max in a row

159
Q

Reversible NSAIDs nursing considerations

A

Monitor kidney function blood pressure, celoxib has a sulfa group do not give if patient has a sulfa allergy

160
Q

Reversible NSAIDs contraindications

A

Avoid in heart failure kidney disease and kidney injuries GI ulcers PUD can’t increase BP not ideal for people with hypertension or history of myocardial infection

161
Q

Acetaminophen indications

A

My pain or fever no anti-inflammatory action

162
Q

Acetaminophen moa

A

Weak prostaglandin synthesis inhibition in the CNS also works on heat regulating center of the brain hypothalamus pain and fever reduction not an anti-inflammatory

163
Q

Acetaminophen adverse effects

A

BLACK BOX WARNING - HEPAT TOXICITY INCLUDING LIVER FAILURE AND DEATH

164
Q

Acetaminophen client safety teaching and administration

A

Max single dose is 1000 mg in a 6-hour window lower if low body weight, older adult recommended Max is 3 g per day general Max fourth grams per day, FDA encourages 3 g per day, no alcohol - Max is 2,000 mg per day if alcohol consumption, lots of other products contain acetaminophen other than Tylenol

165
Q

Acetaminophen nursing considerations and implications

A

Watch for single dose and 24-hour dose limit, if suspected overdose evaluate signs and symptoms liver labs and timing is crucial, antidote is acetylcysteine

166
Q

Acetaminophen contraindications

A

Liver disease

167
Q

Herbal pain Management

A

Feverfew, glucosamine

168
Q

Herbal pain Management indications

A

Glucosamine for joint health, feverfew for variety of anti-inflammatory conditions

169
Q

Herbal for pain management adverse effects

A

Possible inhibition of platelet aggregation

170
Q

Herbal for pain management client safety teaching and

A

Notify provider if taking any herbals

171
Q

Herbal for pain management nursing considerations and implications

A

Notify provider if taking herbals can have increased risk of bleeding if taking fgs herbals and on blood thinners

172
Q

Herbal for pain management contraindications

A

Don’t combine with anticoagulants anti platelets

173
Q

Muscle relaxants indications

A

Spasticity-baclofen dantroline
Spasm - cyclobenzaprine
Malignant hyperthermia - dantroline

174
Q

Muscle relaxants moa

A

Work directly on brain or skeletal muscle

175
Q

Muscle relaxants adverse

A

Dizziness sedation drowsiness fatigue, can be developed to dependence intolerance, if taken chronically must take her off, bnz rule, baclofen and cyclobenzaprine have gi anticolinergic properties dry mouth constipation

176
Q

Muscle relaxants client safety teaching administration

A

Don’t operate in every machinery, don’t mix with other CNS depressants, it taking chronically do not stop suddenly can cause withdrawal including seizures

177
Q

Muscle relaxants nursing considerations and implications

A

monitor for anticholinergic effects, monitor for appropriate use in CNS sedation

Pharmacology For Nursing (2 decks)

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