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pharm exam 3 Flashcards

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1
Q

disease that affects person’s brain behavior and leads to inability to control legal and illegal drugs

A

substance use disorder

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2
Q

what are the 4 qualifiers of D5M5?

A

mental disorders
1. deviance
2. dysfunction
3. distress
4.danger

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3
Q

taking meds that aren’t prescribed, wrong dose, someone else’s Rx, or just to feel the affects

A

misuse

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4
Q

physical vs phycological withdraw from addiction

A

physical: increased HR & n/v
phycological: emotional or angry or mood swings

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5
Q

patients reduced reaction to a drug following its repeated use

A

tolerance

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6
Q

unpleasant sensory & emotional experience caused by stimuli

A

pain

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7
Q

what is pain stimulation based on?

A

opioid receptors in the nervous system & stimulation from chemical mediators

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8
Q

minimum point at which something causes your pain

A

threshold

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9
Q

maximum amount of pain that you can handle

A

tolerance

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10
Q

class of drugs designed to relieve pain without causing loss of consciousness

A

analgesia

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11
Q

abnormal sensation

A

dysesthesia

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12
Q

pain from a normally non-painful stimuli

A

allodynia

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13
Q

describe the drug schedules

A

1 = most potential for abuse
4 = least potential for abuse

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14
Q

what are the medicine steps of pain management? (mild to severe)

A

1- mild pain
(non opioid meds)
2- moderate pain
(weak opioid med, non opioid meds, adjuvant analgesia)
3- severe pain
(strong opioid med, non opioid meds, adjuvant analgesia)

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15
Q

what meds are non opioids?

A

NSAIDS & Acetaminophen(tylenol)

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16
Q

what meds are NSAIDS?

A

1st generation:
ASA(aspirin)
mortin(ibuprofen)
advil
toradol
naproxen

2nd generation:
celebrex

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17
Q

what are NSAIDS used for?

A

mild to moderate pain:
decrease pain, inflammation, and platelet aggregation (by inhibiting COX enzymes)

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18
Q

NSAID side effects

A

GI upset, GI bleeding, ulcers, tinnitus

*second generation (Celebrex) doesn’t affect GI tract and platelet function

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19
Q

NSAID nursing considerations

A

dont give to active bleeding pts
dont give to kidney disease pts (monitor BUN & creatinine increases)

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20
Q

what is acetaminophen(tylenol) used for?

A

mild to moderate pain
h/a
fever (antipyretic)

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21
Q

acetaminophen(tylenol) side effects

A

generally no SE but possible rash, n/v, and anorexia

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22
Q

acetaminophen(tylenol) nursing considerations

A

can cause liver damage (check AST & ALT)(jaundice)
can cause cyanosis (blue) if take a toxic dose

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23
Q

morphine
meperide (demerol)
hydromorphine (dilaudad)
codeine
Lortab
oxycontin
Percocet
methadone

A

opioids

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24
Q

opioid side effects

A

n/v
constipation
hypotension (& orthostatic)
decrease RR
urine retention
itching

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25
Q

what are opioids used for?

A

to block painful stimuli in nervous system, suppress respirations, & cough

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26
Q

what are opioids made from?

A

opium poppy plant

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27
Q

opioid nursing considerations

A

dont give to pts with low BP (hypotension)
monitor BP & RR

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28
Q

what is the opioid reversal agent?

A

naloxone (narcan)

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29
Q

what are the 4 signs of inflammation?

A

heat, redness, swelling, pain

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30
Q

what are the 2 inflammatory mediators?

A

prostaglandins & COX enzyme

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31
Q

what are the 4 anti-inflammatory meds?

A

NSAIDS
Steroids
DMARDS (disease modifying anti-rheumatic drugs)
Antigout drugs

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32
Q

what do steroids do?

A

suppress inflammation & adrenal function

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33
Q

what are steroid meds?

A

“-sone”
hydrocortisone (cortef)
methylprednisolone (Solu-medrol)
prednisone
dexamethasone (decadron)

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34
Q

steroid side effects

A
  • increase BG, BP, HR, appetite, risk for infection
  • Na & water retention
  • decrease K
  • osteoporosis
  • mood changes
  • irritability
  • insomnia
  • moon face
  • HTN
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35
Q

steroid teaching

A

short term
must be tapered to quit
decrease salt intake
take w meals
watch for hypokalemia

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36
Q

steroid nursing considerations

A
  • dont give a live vaccine to someone on steroids
  • monitor BG, BP, WBCs
  • observe for hyperglycemia
  • dont crush prednisone
  • to decrease or prevent GI upset: take w food; may need to take with H2-receptor antagonist [cimetidine or ranitidine]
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37
Q

used to alleviate pain and cause loss of consciousness by depression of CNS through decreasing firing of neurons and other mechanisms

A

anesthetics

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38
Q

what 4 anesthetic states come from general anesthesia?

A
  1. unconscious - not aware of self or environment
  2. sedation - dont move
  3. analgesia - dont feel pain
  4. amnesia - dont remember
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39
Q

general anesthesia side effects

A

cardiac and respiratory depression
hypotension
n/v
dysrhythmias
hyperthermia

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40
Q

general anesthesia nursing considerations

A

monitor ABC’s, BP, HR

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41
Q

nitrous oxide
midazolam (versed)
fentanyl (innovar, sublimaze)
propofol (diprivan)

A

general anesthetics

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42
Q

anesthetics that are IV & inhaled

A

general anesthesia

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43
Q

anesthetics that are topical route

A

local anesthesia

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44
Q

what do local anesthetics do?

A

only block pain in a specific part
DONT affect consciousness

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45
Q

lidocain (Xylocaine)

A

local anesthetic

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46
Q

bupivacaine (Marcaine)

A

regional anesthetic

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47
Q

local and regional anesthetic side effects

A

h/a
hypotension
rash

48
Q

severe vomiting can lead to what

A

electrolyte imbalance and dehydration

49
Q

promethazine (phenergan)

A

antiemetic GI med for n/v

50
Q

ondansetron (zofran)

A

antiemetic GI med for n/v

51
Q

inflammatory erosion of stomach or duodenum lining

A

peptic ulcer disease

52
Q

decreased muscular tone of esophageal sphincter that causes regurgitation of stomach contents that irritate the esophagus

A

GERD

53
Q

ulcer that causes pain right after eating

A

gastric ulcer

54
Q

ulcer that causes pain between meals

A

duodenal ulcer

55
Q

diphenoxylate (Lomotil)

A

antidiarrheal med

56
Q

loperamide (immoddium)

A

antidiarrheal med

57
Q

hyperosmolar laxative that pulls water from the gut to move feces

A

osmotic laxative

58
Q

laxative that irritates the lining of the intestines

A

stimulant laxative

59
Q

laxative that gives fiber to the patient

A

bulk forming laxative

60
Q

laxative that brings water to the stool to soften it

A

emollient laxative

61
Q

name the 4 types of laxatives

A

osmotic
stimulant
bulk forming
emollient

62
Q

antacid that slows the GI tract

A

calcium carbonate (tums)

63
Q

antacid that speeds up the GI tract

A

magnesium hydroxide

64
Q

when do patients need to take magnesium hydroxide?

A

1-3 hours after a meal or at bedtime

65
Q

sucralfate (carafate)

A

pepsin inhibitor

66
Q

why do you have to wait to take other drugs when taking carafate?

A

this medicine creates a protective lining and other medicines wont be able to absorb accurately

67
Q

examples of H2 blockers

A

“-idine”
cimetidine (tagamet)
famotidine (pepcid)
nizatidine (axid)
ranitidine (zantac)

68
Q

what do H2 blockers do?

A

block histamine to decrease acid production

69
Q

H2 blocker nursing considerations

A

watch with patients with renal and liver disease
take during the day or at bedtime

70
Q

what do PPIs do?

A

block acid production in parietal cells

71
Q

examples of PPIs

A

“-zole”
esmeprazole (nexium)
lansoprazole (prevacid)
omeprazole (prilosec)
pantoprazole (protonix)

72
Q

PPI nursing considerations

A

proton pump inhibitors
take before meals
longterm use can cause osteoporosis (bc it disturbs Ca absorption)

73
Q

cystitis or urethritis

A

lower UTI

74
Q

upper pyelonephritis

A

upper UTI

75
Q

what are the common bacteria from UTIs

A

e. coli
proteus
staph
candida

76
Q

nitrofuration (macrobid)
fosfomycin (monurol)

A

anti-infectives that suppress bacteria growth in urinary tract

77
Q

what does the urine anti-infective methenamine do

A

acidify the urine

78
Q

trimethoprim- sulfamethoxazole (batrium)(sulfonamides)

A

antibiotic that kills both gram + and gram - bacteria

79
Q

ciprofloxacin (cipro) (fluoroquinolones)

A

urinary antibiotic

80
Q

phenazopyridine (pyridium/azo)

A

urinary analgesic that decreases pain thats associated with UTI

81
Q

what produces hormones that regulate body functions

A

endocrine gland

82
Q

name the 7 endocrine glands

A
  1. hypothalamus
  2. pituitary
  3. thyroid
  4. parathyroid
  5. adrenals
    6.pancreas
  6. ovaries and testies
83
Q

what gland coordinates ANS & activity of the pituitary gland

A

hypothalamus

84
Q

what gland is the “master gland” and helps other glands secrete hormones

A

pituitary

85
Q

what gland regulates T3 & T4

A

thyroid gland

86
Q

2 glands in the neck on the thyroid that regulate calcium

A

parathyroid gland

87
Q

what gland secretes steroids needed for homeostasis (fluid and electrolyte regulation)

A

adrenal gland

88
Q

what gland secretes insulin and glucagon

A

pancreas

89
Q

what steroid produced by adrenal gland promotes sodium retention and potassium secretion

A

corticosteroids

90
Q

thyroid dysfunction can cause what

A

hypothyroidism & hyperthyroidism

91
Q

myxedema

A

hypothyroidism

92
Q

levothyroxine sodium (Synthroid)

A

medication for hypothyroidism

93
Q

exopthamos

A

bulging of eyes

94
Q

graves disease is from what

A

hyperthyroidism

95
Q

methiamozole (tapazole)
propylthiouracil (PTU)
potassium iodine

A

medication for hyperthyroidism

96
Q

what is crushing’s syndrome from

A

hyper-secretion of corticosteroid

97
Q

addison’s disease is from what?

A

hypo-secretion of corticosteroid

98
Q

uncontrolled DM can lead to what

A
  • kidney failure
  • blindness
  • peripheral arterial disease (PAD)
  • HTN
99
Q

what is the normal BS level

A

60-100

100
Q

what are the symptoms of diabetes

A

polyuria - urine
polydipsia - thirst
polyphasia - hungry

101
Q

insulin is used to help what

A

type 1 DM and hyperglycemia

102
Q

what is Amylin analogue (Symlin)

A
  • anti-diabetic med used with insulin to help control BS in type 1 & 2 DM
  • given SQ before meals
  • never given in the arm
103
Q

how do you treat hypoglycemia?

A

eat 10-15g of a simple carbohydrate

104
Q

what should you educate your hypoglycemic patients on?

A

to have a snack with them in case their BS drops too low

105
Q

oral anti-diabetic agents are used for what?

A

type 2 DM

106
Q

what are the 3 drug classes of oral anti-diabetic agents

A
  • sulfonylureas
  • biguanides
  • sodium-glucose CO transporter 2
107
Q

medication that stimulates beta cells to produce more insulin

A

sulfonylureas

108
Q

medication that decreases hepatic production of glucose from stored glycogen

A

biguanides

109
Q

what medication do you educate to hold for 48 hours before and after IV contrast dye

A

biguanides

110
Q

what anti-diabetic medication works with the kidneys to excrete glucose in the urine

A

sodium-glucose CO transporter 2

111
Q

invokana

A

sodium-glucose CO transporter 2

112
Q

metformin (glucophage)

A

Biguanide

113
Q

glipizide (glucotrol)
glycuride (DiaBeta)
glimepride (amaryl)

A

“gl…ide”
sulfonylureas

114
Q

exenatide (byetta, bydureon)

A

glucagon-like peptide-1 agonists (GLP-1)/ (incretin mimetics)

115
Q

trulicty

A

once a week injection to help with type 2 DM

116
Q

what are glucagon-like peptide-1 agonists (GLP-1)/ (incretin mimetics)

A

pre-filled injection pens used BID for managing type 2 DM

nursing (15 decks)

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