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NU 308 Pharmacology > Pharm Exam 2 > Flashcards

Pharm Exam 2 Flashcards

1
Q

What are decongestants used to treat?

A

Stuffiness from rhinitis or common colds

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2
Q

What is an example (or the prototype) of a decongestant?

A

Phenlepherine

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3
Q

What are adverse effects of decongestants?

A

Rebound congestion
*CNS stimulation-agitation, nervousness, uneasiness
*Vasoconstriction
*Can produce effects like amphetamines

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4
Q

What are contraindications/precautions of decongestants?

A

Closed-angle glaucoma
Caution with HTN
CVD
Dysrhythmias
CAD

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5
Q

What are expectorants used for?

What conditions?

A

Chest decongestant
Treats colds, allergic or no allergic
Rhinitis
Cough from lower respiratory disorders

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6
Q

What is the action of expectorants?

A

Thins mucous secretion

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7
Q

What are adverse effects of expectorants?

A

GI upset
Headache
Drowsiness, dizziness
Allergic reaction/rash

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8
Q

What is an example of an expectorant?

A

Guaifenesin

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9
Q

What is an example of a mucolytic?

A

Acetylcysteine

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10
Q

What is the action of a mucolytic like acetylcysteine?

A

Thin and enhance flow of secretions

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11
Q

what are adverse effects of mucolytic (acetylcysteine)?

A

Aspiration
Bronchospasms
Dizziness
Drowsiness
Hypotension
Tachycardia
Heptotoxicity

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12
Q

What do we use acetylcysteine for for?

What conditions?

A

Cystic fibrosis
Acetaminophen antidote
Acute/ chronic pulmonary disorder

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13
Q

what are decongestants used for?

A

Relieve nasal stuffiness

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14
Q

What is the action of decongestants?

A

Stimulates alpha 1 adrenergic receptors causing reduction in inflammation

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15
Q

what is an example of a decongestant?

A

Phenylephrine

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16
Q

What are adverse effects of decongestants?

A

Rebound congestion
Nervousness
Uneasiness
Can produce effects like amphetamines

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17
Q

What are actions of antihistamines antagonist

A

Block histamine release

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18
Q

What do we use antihistamine antagonists for?

What Conditions?

A

Allergic reaction
Anaphylaxis
Motion sickness
Insomnia

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19
Q

What are the adverse effects of antihistamine antagonists?

A

cause anticholinergic
effects-
dry mouth,
urinary
retention,
constipation

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20
Q

What are examples of gen 1 antihistamines?

A

Diphenhydramine
Promethazine
Dimenhydrinate

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21
Q

A pediatric patient presents to the ED with c/o SOB, dyspnea, and a cough. The patient is A&Ox3, skin is pink, warm and dry, BP 112/68, T 99, P106, R 32, O2sat 90% on room air. Lung sounds are diminished lung throughout all lung fields. The patient has a past medical history of a peanut allergy. The mother tells you that they were at a birthday party and after eating a cupcake, the symptoms started.
The nurse anticipates that which of the following medication will be likely ordered for this patient?
a. Diphenhydramine
b. Epinephrine
c. Cetirizine
d. Guaifenesin

A

b) Epinephrine. Epinephrine is used to rapidly treat severe allergic reactions.

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22
Q

What effect do 1st gen antihistamines have?

A

Drowsiness

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23
Q

What is the antidote for anaphylaxis?

A

Epinephrine

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24
Q

What class of drug is guaifenesin?

A

Expectorant

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25
Q

What is a major contraindication/precaution with mannitol?

A

Closed angle glaucoma

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26
Q

What kind of drug is timolol?

A

Beta blocker

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27
Q

What side effect does atropine have?

A

Dilates pupils

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28
Q

What is an indication for oflaxacin?

A

Ruptured tympanic membrane

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29
Q

T or F, live viruses are administered in vaccines to kids?

A

False

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30
Q

What is the antidote for benzo?

A

Flumazenil

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31
Q

What drug class is bupropion?

A

Atypical antidepressant

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32
Q

What drug schedule are benzodiazepines?

A

Schedule IV

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33
Q

What is lithium used for?

A

Bipolar
Mania side

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34
Q

What do you treat narcolepsy with?

A

Stimulants

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35
Q

What do you use for opioid withdrawal?

A

Benzos for acute (lorazepam, chlorodiazepoxide)

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36
Q

What precautions do you take for someone with alcohol withdrawal?

A

Seizure risk

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37
Q

What is a side effect of disulfiram?

A

Makes you sick

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38
Q

What symptoms accompany opioid use?

A

Flu like symptoms

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39
Q

What is the antidote for opioids?

A

Narcan

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40
Q

What are allergies?

A

When your body responds to a foreign substance

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41
Q

What is histamine?

A

first chemical mediator to be released in immune and
inflammatory responses

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42
Q

What does histamine do when it binds to H1 receptors?

Pathophysiology

A

Smooth muscle contraction in bronchi and bronchioles (bronchoconstriction and
airway distress)
* Vagus nerve stimulation
* Increased permeability of veins and capillaries- edema
* Increased mucus secretion- nasal congestion
* Stimulation of sensory peripheral nerve endings (pain, pruritis)
* Dilation of skin capillaries- flushing

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43
Q

What does histamine do when it binds with H2 receptors?

A

increased gastric acid and pepsin secretion
* increased rate and force of myocardial contraction
* decreased immunologic and proinflammatory reactions

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44
Q

What is the infection of the upper respiratory tract caused by many types of viruses

No cure has been found

A

Common Cold

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45
Q

What are s/s of the common cold?

A

Runny or stuffy nose
* Sore throat
* Cough
* Congestion
* Slight body aches or a mild headache
* Sneezing
* Low-grade fever
* Generally feeling unwell (malaise

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46
Q

A pediatric patient presents to the ED with c/o SOB, dyspnea, and a cough. The patient is A&Ox3, skin is pink, warm and
dry, BP 112/68, T 99, P106, R 32, O2sat 90% on room air. Lung sounds are diminished lung throughout all lung fields. The
patient has a past medical history of a peanut allergy. The mother tells you that they were at a birthday party and after
eating a cupcake, the symptoms started.
The nurse anticipates that which of the following medication will be likely ordered for this patient?
a. Diphenhydramine
b. Epinephrine
c. Cetirizine
d. Guaifenesin

A

b) Epinephrine. Epinephrine is used to rapidly treat severe allergic reactions.

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47
Q

_____________ block histamine at the H1 receptor

A

Old (first-generation) H1-receptor antagonists

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48
Q

What is asthma?

A

a chronic disease characterized by inflammation, edema, wheezing,
chronic cough, and bronchospasm of the airways

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49
Q

What can trigger bronchospasms?

What factors?

A

environmental factors such as dust, pollen, pet hair, or dander;
weather;
mold;
smoke;
respiratory infections;
exercise; and stress.

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50
Q

What are s/s of asthma?

A

Dyspnea
* Wheezing
* Cough
* Chest
tightness/retractio
ns
* Sputum production

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51
Q

What are important treatments for asthma?

A

bronchodilators and anti-inflammatory drugs

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52
Q

What is a chronic inflammatory lung disease that causes obstructed airflow out
of the lungs?

A

COPD

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53
Q

What are s/s of COPD?

A

dyspnea,
cough,
sputum production, and wheezing.
Often caused by long-term exposure to irritating
gases or dust, and most often due to smoking.

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54
Q

What is a condition in which the alveoli at the end of the smallest air passages (bronchioles) of the lungs are destroyed and hyperinflated?

A

Emphysema

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55
Q

What is nflammation of the lining of the bronchial tubes, characterized by daily cough and sputum production?

A

Chronic bronchitis

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56
Q

What is is an inflammation of the lining of the bronchial tubes, which carry air to and from the lungs. it can be either acute or chronic?

A

Acute Bronchitis

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57
Q

What are s/s of acute bronchitis?

A

Cough
* Production of mucus (sputum), which can be clear, white, yellowish-gray, green or may be streaked with blood
* Fatigue
* Shortness of breath
* Slight fever and chills
* Chest discomfort

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58
Q

What are examples of B2- adrenergic agonists?

A

Albuterol/levalbuterol
(-erol is common)

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59
Q

What is the action of B2 adrenergic agonists? albuterol

A
  1. Relax smooth muscles
  2. Bronchodilation
  3. Vasodilation
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60
Q

What are indications for B2 adrenergic agonists? albuterol

A
  1. Lower respiratory disorders
  2. Asthma
  3. COPD
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61
Q

What are some adverse effects of B2 adrenergic agonists? albuterol

(albuterol)

A
  • Muscle tremors
  • Tachycardia, angina
  • Anxiety
  • Cardiac/CNS stimulation in elderly
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62
Q

What are contraindications of B2-adrenergic agonists? albuterol

A
  • Do not take with Beta Blockers
  • Contraindicated with tachydysrhythmias.
  • Caution with DM, heart disease, HTN,
  • angina
  • Caffeine may increase AE
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63
Q

What is an example of a methylxanthines?

A

theophylline
(-ine)

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64
Q

What are indications for methylxanthines?

Theophylline

A

COPD
Asthma
Emphysema

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65
Q

What are adverse effects of methylxanthines?

A

GI complications
Seizures
Dysrhthmias

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66
Q

What are interactions for methylxanthines?

A
  1. Phenobarbital and rifampin decrease levels
  2. Fluoroquinolone antibiotics increase levels
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67
Q

What does theophylline do?

A

Bronchodilation

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68
Q

When is the onset for B2 adrenergic agonists?

A

5-15 minutes

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69
Q

What are examples of inhaled anticholingerics?

A

ipratropium

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70
Q

What is the action of inhaled anticholingerics?

A
  1. Block action of acetylcholine
  2. Relaxes smooth muscles
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71
Q

What are indications for inhaled anticholingerics?

A
  1. Asthma
  2. COPD
  3. Chronic bronchitis
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72
Q

What are adverse effects of Inhaled Anticholinergics?

Ipratropium

A
  1. Dry mouth and nasal area
  2. Cough
  3. Hoarseness
  4. dizziness
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73
Q

What are contraindications for inhaled anticholingerics?

A
  1. Peanut allergy
  2. Caution with narrow-angle glaucoma
  3. Caution in elderly
  4. Avoid caffeine
  5. Monitor for angioedema
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74
Q

T or F, inhaled anticholinergics are not rescue inhalers

A

True

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75
Q

What is an important nursing intervention for Inhaled Anticholinergics

A

Observe for angioedema

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76
Q

What are some examples of glucocorticoids?

A

Beclomethasone (Inhalation)
Prednisone (PO)

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77
Q

What is the action of glucocorticoids like beclomethasone?

A

Suppress airway mucus production
reduce inflammation

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78
Q

What indications of glucocorticoids?

A

Asthma, COPD, Emphysema, Acute & Chronic Bronchitis

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79
Q

What are adverse effects of glucocorticoids?

A
  • Difficulty speaking,
  • hoarseness, and
  • candidiasis (rinse mouth after use). * Prednisone: suppress adrenal gland
  • function,
  • bone loss,
  • hyperglycemia/glycosuria,
  • myopathy,
  • PUD,
  • Infection,
  • Fluid
  • and
  • Electrolyte disturbances
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80
Q

What are contraindications of glucocorticoids?

beclamethasone

A
  • Contraindicated if received a live
    vaccine or fungal infection.
  • Caution with children,
  • DM,
  • HTN,
  • Hyperglycemia,
  • Peptic Ulcer
  • Disease,
  • osteoporosis,
  • kidney dysfunction
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81
Q

What are examples of Antileukotrienes (Leukotriene
Receptor Antagonist)?

A

Monetlukast

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82
Q

What is mmune system produces antibodies to antigens over weeks to months – long-lasting?

A

Active immunity

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83
Q

What is when the body produces antibodies to
killed or attenuated (live) virus via vaccination?

A

Active-artifical immunity

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84
Q

What is An antigen enters the body
naturally, producing antibodies?

A

Active-natural immunity

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85
Q

What do vaccinations do?

A
  • Cause the immune system to produce antibodies for
    active artificial immunity.
  • Can take months to have an effect but give long-
    lasting protection against infectious diseases.
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86
Q

What are indications of vacinations?

A
  • Eradication of infectious diseases (polio, smallpox)
  • Prevention of childhood and adult infectious diseases
    (measles, diphtheria, mumps, rubella, tetanus, H.
    influenzae) and their complications
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87
Q

What are contraindications and precautions of vaccines?

A

naphylaxis to a vaccine or any of its components contraindicates further doses
Do not administer live virus vaccines (varicella or MMR), if severely immunocompromised
or if severe febrile illness
Provider to analyze data and weigh the pros and cons of immunization. Discussion with
caregivers.
Use caution if moderate or severe illnesses with or without fever
Common colds and other minor illnesses are not contraindicated.

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88
Q

What injection site should young children get vaccines?

A

IM Vastus lat, and ventroglut

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89
Q

What site should older children get vaccines?

A

deltoid

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90
Q

Where should subcut vaccines be injected?

A

outer aspect of upper arm
or anterolateral thigh

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91
Q

Where do Im immunizations go for adults?

A

deltoid

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92
Q

Where do subcut injections go for adults?

A

outer aspect of the upper arm or anterolateral thigh

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93
Q

What is the mucous membrane lining the eyelids?

A

conjunctiva

94
Q

What is group of diseases characterized by optic nerve damage and changes in visual fields, which is characterized by increased
intraocular pressure (IOP) (greater than 22 mm Hg)?

A

Glaucomaa

95
Q

What is pressure inside the eye; normally less than 21 mm Hg (average 15–16 mm Hg?

A

Intraocular pressure (IOP)

96
Q

What is pupil constriction?

A

miosis

97
Q

What is pupil dilation?

A

mydriasis

98
Q

What is application of pressure to the tear duct?

A

nasolacrimal occlusion

99
Q

What is deflection of light rays in various directions according to the density of the ocular structures through
which they pass?

A

Refraction

100
Q

What is myopia?

A

Nearsightedness

101
Q

What is hyperopia?

A

Farsightedness

102
Q

What is tonometry?

A

diagnostic test to measure the pressure inside the eye to determine if glaucoma is present

103
Q

What is allergic, viral, bacterial, contact
* Inflammation of the conjunctiva?

A

Conjunctivitis

104
Q

What is chronic infection of glands and lash follicles on the
margins of the eyelids?

A

Blepharitis

105
Q

What is inflammation of the cornea?

A

Keratitis

106
Q

How do we treat conjunctivitis?

A

Topical mast cell stabilizers, with or without antihistamines, are the preferred treatment for allergic
conjunctivitis.

107
Q

What are common meds to treat conjunctivitis?

A

Ciprofloxacin (quinolone)
* Erythromycin

108
Q

What condition occurs when when the eye does not produce tears properly or
when the tears are not of the correct consistency and evaporate too
quickly?

A

Dry eye

109
Q

What are signs and symptoms of glaucoma?

A

blurred vision
* A halo around lights
* difficulty focusing
* Headache
* loss of peripheral vision
* aching around the eye

110
Q

What is an example of an anticholinergic for opthalmic use?

A

Atropine sulfate

111
Q

What does atropine sulfate do (action)?

A

produces mydriatic effects by relaxing the pupil of the eye and prevents accommodation of near vision

112
Q

What are the adverse effects of atropine sulfate?

A

may cause local transient stinging

113
Q

What are contraindications for atropine sulfate?

A

Glaucoma

114
Q

What nursing interventions should you include for atropine sulfate?

A

Assess for pain and stinging; assess for blurred vision and sensitivity to light
* Teach effects should diminish and are reversible over time
* Teach to wear sunglasses after administration

115
Q

What is an example of prostaglandin analogs? (for the eyes)

A

imatoprost (Latisse, Lumigan)
* Latanoprost (Xalatan)

116
Q

What is the action of prostaglandin analogs

A

produces ocular hypotensive effects to lower IOP;
* Bimatoprost can increase the percent and duration of the growth phase of eyelash growth

117
Q

What are indications for prostaglandin analogs?

A

glaucoma and ocular HTN

118
Q

What are adverse effects of prostaglanding analogs?

A

conjunctival inflammation, erythema of the eyelid, allergic conjunctivitis, iris pigmentation, blurred vision, migraine

119
Q

What are examples of beta blocking agents (for the eye)?

A

Blocks beta receptors to reduce the IOP by reducing aqueous humor production and increasing outflow

120
Q

What is the action of beta blocking agents?

A

Blocks beta receptors to reduce the IOP by reducing aqueous humor production and increasing outflow

121
Q

What are indications for beta blocking agents? (eyes)

A

Burning and stinging

122
Q

What are contraindications of beta blocking agents?

A

Asthma, COPD, heart failure, and bradycardia (as with systemic beta blockers) can interfere with insulin effects, so patient must
monitor glucose closely

123
Q

What are examples alpha2-adrenergic agonists?

A

Brimonidine (ophthalmic) Alphagan P

124
Q

What are the actions for alpha2-adrenergic agonists?

A

reduces aqueous humor production and increasing uveoscleral outflow

125
Q

What are uses for alpha2-adrenergic agonists?

A

lower IOP with patients with open-angle glaucoma and ocular HTN

126
Q

What are the adverse effects of alphra2-adrenergic agonists?

A

bradycardia, hypotension, headache, somnolence, stinging, and burning of the eye

127
Q

What are examples of carbonic anhydrase inhibitors?

A

Acetazolamide (Diamox)
Brinzolamide (Azopt)

128
Q

What is the action of carbonic anhydrase inhibitors?

A

Reduce the rate of aqueous humor production and reduce IOP by causing diuresis through renal
effects

129
Q

What are carbonic anhydrase inhibitors used for?

A

second line for open-angle glaucoma, emergency med before surgery for closed-angle glaucoma,

130
Q

What are examples of osmotics agents?

A

Mannitol

131
Q

What is the action of osmotic agents?

A

Action: Decrease intraocular pressure by making the plasma hypertonic, thus drawing fluid from the anterior chamber of the
eye

132
Q

What are osmotic agents used for?

A

Tx rapid progression of closed-angle glaucoma to prevent blindness

133
Q

What are adverse effects of osmotic agents?

A

hyperosmolar nonketotic coma. Confusion, headache, syncope, cardiac dysrhythmias, nausea, vomiting,
and severe dehydration

134
Q

What are patients teachings to maintain eye health?

A

To prevent eye disorders, try to avoid long periods of reading and computer work; minimize exposure to dirt, smog, and
cigarette smoke; wash hands often and avoid touching eyes to decrease the risk of infection
* Do not use nonprescription eye drops (e.g. Visine) on a regular basis longer than 48 to 72 hours.
* If you wear contacts, wash your hands before putting them in and follow instructions for care
* If you wear contact lenses, you must take them out before administering medication, and they should be instilled in 15 mins.
Or longer before inserting soft contacts.
* Never use someone else’s eye medications

135
Q

What is any discharge from the ear (clear to purulent) following perforation of the tympanic membrane called?

A

Otorrhea

136
Q

What is disorder of the external ear that produces inflammation; can be caused by
bacteria, moisture in the canal, allergies, or trauma related to itching or scratching, purulent
discharge

A

Otitis externa

137
Q

What is acute infection or middle ear inflammation; more common in children than
adults; caused by bacteria, upper respiratory congestion, inflammation, or allergic reaction?

A

Otitis media

138
Q

What medications are used for otitis externa?

A

Neomycin, polymyxin B-hydrocortisone (Cortisporin Otic

139
Q

What is the action of Neomycin, polymyxin B-hydrocortisone (Cortisporin Otic)?

A

Neomycin and polymyxin combat bacteria, and hydrocortisone reduces inflammation,
redness, and swelling.

140
Q

What are Neomycin, polymyxin B-hydrocortisone (Cortisporin Otic) used for?

A

treatment of otitis externa; only used in children for otitis externa due to adverse effect of
ototoxicity

141
Q

What are adverse effects of Neomycin, polymyxin B-hydrocortisone (Cortisporin Otic)?

A

Burning, stinging, and ototoxicity

142
Q

What is inflammatory response of skin to injuries, irritants, allergens, or
trauma?

A

Dermatitis (eczema)

143
Q

What is an inflammatory response characterized by skin lesion called wheal
(raised edematous area with pale center and red border) and itches?

A

Urticaria (hives)

144
Q

What is a chronic inflammatory disorder produced by activated T lymphocytes and
stimulates abnormal growth of affected skin cells and blood vessels

A

Psoriasis

145
Q

a chronic disease characterized by erythema, telangiectases (fine, red,
superficial blood vessels), and acne-like lesions of facial skin

A

Rosacea

146
Q

What are examples of retinoids?

A

isotretinoin (Accutane)

147
Q

What is the action of retinoids?

A

suppression of sebum production and inhibition of inflammation

148
Q

What are retinoids used for?

A

severe acne that is nonresponsive to other treatments

149
Q

What are adverse effects of retinoids?

A

dryness and swelling of lips and mouth, n/v, muscle pain and weakness, hyperlipidemia
(elevated triglycerides), depression, aggression, changes in mood, psychosis, suicidal thoughts, and
hepatoxicity

150
Q

What are contraindications of retinoids?

A

dryness and swelling of lips and mouth, n/v, muscle pain and weakness, hyperlipidemia
(elevated triglycerides), depression, aggression, changes in mood, psychosis, suicidal thoughts, and
hepatoxicity

151
Q

What is the purpose of chemotherapy?

A

Kill cancer cells

152
Q

What are Adverse Effects of Traditional Cytotoxic Antineoplastic Drugs?

A

Alopecia, anemia, bleeding

●Fatigue, mucositis

●N/V

●neutropenia, thrombocytopenia

●May damage
●Heart
●Liver, kidneys
●Nerves

153
Q

What are Indications for Use of Traditional Cytotoxic?

A

Cure neoplastic disease

●Relieve neoplastic disease symptoms

●Induce/maintain remissions

●Treatment of nonmalignant conditions
●Rheumatoid arthritis
●Psoriasis

154
Q

What are Safety Precautions With Cytotoxic Antineoplastic Medications?

A

Most are carcinogenic, mutagenic, and teratogenic.
●Avoid exposure while pregnant.

●Parenteral solutions irritate skin mucous membranes—avoid direct contact with skin or respiratory tract; wash hands thoroughly after administration.

●Do not administer injectable medications unless certified.

155
Q

What patient teaching is required for doxorubicin?

A

Avoid crowds and contact with infectious individuals and practice good hand hygiene.

●Prevent pregnancy

●Avoid alcohol

●Consult the provider before receiving vaccinations.

●Practice good oral hygiene and avoid mouthwash
With alcohol, use warm saline mouth rinse

156
Q

What are side effects vincristine?

A

Bone marrow suppression

●Severe tissue damage from vesicants

●Alopecia

●Injury to autonomic nerves (manifested by constipation, urinary hesitancy).

●Peripheral neuropathy (paresthesia, decreased reflexes, and sensory loss).

●Bradycardia, Heart Block, MI, Hypotension

●Severe hypersensitivity

157
Q

What are the side effects Cyclophosphamide/
Cisplatin?

A

Bone Marrow Suppression
●GI- N/V
●Acutely hemorrhagic cystitis
●Sterility or decreased immune response
●Alopecia
●Pulmonary fibrosis
●Liver and kidney toxicity
●Hearing loss (increased risk w/ Cisplatin given w/ Lasix)
●Cisplatin Is Highly emetogenic Nausea. Vomiting begins within one hour after dosing and can persist for several days

158
Q

What are indications for tamoxifen?

A

Estrogen receptor blockers
*treat or prevent breast cancer
*Aromatase inhibitors:
*treat breast cancer after menopause
*Monoclonal antibody
*treat metastatic breast cancer
*used alone or in w/ paclitaxel

159
Q

What are side effects of tamoxifen?

A

Endometrial cancer
●Hypercalcemia (bone pain)
●Nausea and vomiting
●Thromboembolic events (DVT, PE, stroke)..
●Hot flashes
●Vaginal discharge or bleeding
●Muscle and joint pain, Headache
●Increased risk for osteoporosis

160
Q

What is important patient teaching to tamoxifen?

A

Have a yearly gynecological exam and Pap smear

●Report chest pain, leg or calf, edema or SOB

161
Q

What are side effects of interferon?

A

flu-like s/s after
●Bone marrow suppression
●Alopecia
●Cardiotoxicity
●Thyroid dysfunction
●Neurotoxicity w/ prolonged T

162
Q

What are contraindications of beta 2 adrenergic agonists like albuterol?

A

Caffeien

163
Q

What should you monitor for with beta 2 adrengergic agonists like albuterol?

A

a. Tremors
b. Anxiety
c. Tachyardia
d. Angina

164
Q

What is the onset for beta 2 adrenergic agonists like albuterol?

A

5-15 minutes

165
Q

What are s/s of anaphylaxis?

A
  1. Hives/itching/flushed/pale skin
  2. Dizziness/fainting
  3. N/V/D
  4. Hypotension
  5. Wheezing/trouble breathing
166
Q

What is some patient teaching for expectorants like guaifenesin?

A

Don’t crush or chew tabs
Encourage fluids

167
Q

What is important education for iniahled glucocorticoids like belcomethasone?

A

Rinse mouth to prevent thrush

168
Q

What caution should we take for acetylcysteine (mucolytic)?

A

Asthma may cause bronchospasm

169
Q

What is a unique feature of acetylcysteine?

A

It smells like rotten eggs

170
Q

What is open angle glaucoma

A

Gradual loss of vision
few s/s at start

171
Q

Is open angle glaucoma life-long?

A

yes

172
Q

What is the most common type of glaucoma?

A

open-angle

173
Q

T or F, open angle glaucoma can be reversed

A

False

174
Q

What is the treatment for open-angle glaucoma?

A

Timolol- a beta blocking agent

175
Q

What is atropine used for?

A

prevents eye accomodation

176
Q

What does atropine do?

A

dilates pupils before eye exam

177
Q

What are side effects of atropine?

A

local stinging

178
Q

What is a contraindication for atropine?

A

glaucoma

179
Q

What would you teach a patient using atropine?

A

the effects get better with time
wear sunglasses

180
Q

What is closed angle glaucoma?

A

Sudden rise in IOP

181
Q

What are s/s of close angle glaucoma?

A
  1. Halos around lights
  2. Brow pain
  3. Nausea
  4. Blurred vision
  5. Photophobia
182
Q

Whatis the treatment for closed angle glaucoma?

A

mannitol

183
Q

What causes glaucoma?

A

optic nerve damage
increased IOP

184
Q

What are s/s of glaucoma?

A

change in visual fields

185
Q

What IOP puts you at risk for glaucoma?

A

Greater then 21

186
Q

What IOP does glaucoma occur?

A

greater then 22

187
Q

What ist he avg IOP, and the normal?

A

the avg is 15-16
normal is less than 21

188
Q

What is the indication for mannitol? (what is it used for)

A

Closed-angle glaucoma

189
Q

What are adverse effects of mannitol?

A
  1. Hyperosmolar nonketoic coma
  2. Confusion
  3. Headache
  4. Syncope
  5. Cardiac dysrhythmias
  6. Nausea
  7. Vomiting
  8. Severe dehydration
190
Q

What should you monitor with mannitol?

A
  1. Fluid and electrolytes
  2. For dehydration
  3. BP
  4. Pulse
  5. RR
  6. Hyperglycemia
  7. Breath sounds
  8. Pupillary reflexes
191
Q

T or F, you can wear your contacts while taking eye drops

A

False, you have to take them out

192
Q

T or F, it doesn’t matter if you touch the applicator to your eye

A

False; you can contaminate it

193
Q

How long should you wait between two different eye drops?

A

5-10min

194
Q

What patient teaching should you provide to a client pertaining to eye drops and eye health?

A
  1. Avoid long periods of reading, computer work,
  2. Minimize exposure to things that can get in eyes
  3. Wash hands
  4. Do not use non prescription eye drops (visine) for longer than 48-72 hours
  5. Regular eye exams after 40 years
  6. Wash hands before contacts
  7. Never use someone else’s eye meds
195
Q

What is conjunctivitis?

A
  1. Inflammation of the conjunctiva (lining of eyelids)
  2. allergic, viral, bacterial, contact, fungal
196
Q

What is a common example of conjunctivitis?

A

pink eye

197
Q

How do we treat conjunctivitis?

A
  1. topical corticosteroids and nonsteroidal anti-
  2. inflammatory drugs
  3. topical mast cell stabilizers preferred treatment
198
Q

What is Blepharitis?

A

chronic infection of glands and lash follicles on the margins of the eyelids

199
Q

What is keratitis?

A

Inflammation of the cornea

200
Q

What is dry eye?

A

a. Eye does not produce tears
b. Tears incorrect consistency and evaporate

201
Q

What is otitis externa?

A
  1. Inflammation of outer ear
  2. Via bacteria, moisture in canal, allergies, trauma related to itching, purulent discharge
202
Q

What is a common example of otitis externa?

A

simmwers ear

203
Q

What is the treatment for otitis externa?

A
  1. Ear drops
  2. Cortisporin Otic (neomycin)
204
Q

What is important info about cortisporin otic?

A

a. Three in one med
b. Neomycin and polymyxin combat bacteria
c. Hydrocortisone reduces inflammation
d. Can be ototoxic; not for rupture ear drum
e. Shake well prior
f. No more then 10 days

205
Q

What ist he treatment for titis media?

A
  1. Ofloxacin
    a.
206
Q

Wjahat is ofloxacin?

A

a. Quinolone antbiotic ear drop
b. Safe for ruptured ear drum

207
Q

What are tips for ear drop administration?

A
  1. Directly into canal
  2. If suspension;shake before
  3. Tilt head to opposite shoulder
  4. Lie on opposite side of administration for 20 min
  5. Don’t get water in eat
  6. NEVER cold ear drops
  7. Children 3 or less, ear lobe down and back
  8. Children 4 and older, ear up and back
    anti
208
Q

What is the difference in gen 1 and gen 2 antihistamines?

A

gen 1 crosses the blood brain barrier (results in CNS depression)
gen 2 does not

209
Q

What is a unique side effect of promethazine?

A

respiratory depression

210
Q

What can help with the dry effects of antihistamines?

A

sucking on hard candy

211
Q

what are examples of gen 2 fs?

A

Loratadine
 Cetirizine
 Fexofenadine
 Desloratadine

212
Q

What are indications for antihistamines?

A

upper respiratory disorders
allergies
common cold
cough
anaphylaxis

213
Q

What is beclomesthasone used for?

A

asthma
COPD
emphysema
acute/chronic bronchitis
lower resp. stuff

214
Q

What are considerations for antihistamines?

A

monitor with glaucoma

215
Q

What are side effects of beclomethasone?

A

dryness (reduces mucus)
hyperglycemia
hypokalemia
GI ulcerations
bone loss
rinse mouth after (consideration)

216
Q

What are indications for monekulast?

A

asthma
execise induced asthma
(can be used with children)

217
Q

What are adverse effects of monketulast?

A

depression
suicide ideation
liver damage

218
Q

What are some considerations for montekulast?

A

PO tabs best at bedtime

219
Q

What are indications for codeine?

A

cough
upper resp. disorders

220
Q

What is the aciton of codeine?

A

suppress cough by acting on CNS

221
Q

What are the side effects of codeien?

A

dizzy
lighteaded
drowzy
N/V
constipation
decresed resp.

222
Q

What are considerations for codeine?

A

change positions slowly

223
Q

What are precautions for codeien?

A

potential for abuse
caution in elderly and children and history of abuse

224
Q

What is chemotherapy for?

A

use of medications to treat
cancer (rather than surgery, radiation)
 Damage or kill cancer cells

225
Q

What are some general side effects of chemotherapy

A

Alopecia,
anemia,
bleeding (bone marrow suppression),
fatigue,
mucositis,
nausea,
vomiting,
neutropenia,
and thrombocytopenia,
which may damage the heart,
liver, kidneys, and nerves

226
Q

What is important patient teaching for chemotherapy?

A

they will lose their hair in 7-10 days
it will grow back

227
Q

What is important patient teaching for doxorubicin?

A

avoid crowds and infectious individuals
o Good hand hygiene
o Urine will turn red – normal finding
o Prevent pregnancy
o Avoid alcohol
o Use caution with vaccinations (live)
o Avoid mouthwash with alcohol
o Hair loss can occur 7-10 days after the
start of treatment and may last for a max
of 2 months after the last administration.
o Make provider aware of chest pain or SOB

228
Q

What are side effects of vincristine?

A

Severe tissue damage from vesicants & Alopecia
o Injury to the autonomic nerve (constipation and
urinary hesitancy)
o Bone marrow suppression, Peripheral neuropathy,
Bradycardia, heart block, MI, hypotension

229
Q

What are indications for tamoxifen?

A

Breast Cancer

230
Q

What are side effects of tamoxifen?

A

Endometrial cancer
o Hypercalcemia (bone
pain)
o Nausea and vomiting
o Thromboembolic events
(DVT, PE, stroke).
o Hot flashes
o Vaginal discharge or
bleeding
o Muscle and joint pain,
Headache
o Increased risk for
osteoporosis

231
Q

What is important patient teaching for tamoxefin?

A

Have a yearly
gynecological exam and
Pap smear
o Report chest pain, leg or
calf, edema or SOB

232
Q

What are side effects of interferon?

A

flu-like s/s after
o Bone marrow suppression
o Alopecia
o Cardiotoxicity
o Thyroid dysfunction
o Neurotoxicity w/ prolonged Tx
o Depression/anxiety, insomnia, altered mental state

NU 308 Pharmacology (23 decks)

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