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NUR 311: Pharm > Pharm Exam 4 > Flashcards

Pharm Exam 4 Flashcards

1
Q

When is the best time to take a triptan medication?

A

When a headache starts!

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2
Q

When taking aspirin to prevent an MI, what should a patient report to a provider in fear of possible toxicity?

A

Tinnitus

think ototoxicity

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3
Q

How many grams of acetaminophen is the max to be taken per day by a healthy adult?

A

4g / day (for purposes of the exam)

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4
Q

COX2 inhibitors are best known for decreasing inflammation

A

True.
COX2 enzyme causes inflammation.
COX2 inhibitor does opposite

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5
Q

When is the best time of day for a patient to take levothyroxine?

A

1 hour before meals

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6
Q

How long does it take to achieve a therapeutic effect of levothyroxine (Synthroid)?

A

Several weeks

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7
Q

What are the signs of overdose of thyroid replacement hormone?

A

Tachycardia, chest pain, anxiety, nervousness

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8
Q

Why should hypothyroidism be treated during pregnancy?

A

A child could have neuropsychological defects

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9
Q

What are the clinical symptoms (physical assessment) of hypothyroidism?

A

Brittle hair, pale skin, low temperature

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10
Q

How do levothyroxine (Synthroid) and warfarin (Coumadin) interact?

A

Synthroid requires a decrease in warfarin

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11
Q

What is a side effect of low-dose radioactive iodine when used to treat Graves’ disease?

A

Nausea, dry mouth, dry eyes, swollen salivary glands

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12
Q

When is the best time to take sumitriptan (Imitrex - serotonin-selective agonist) for the management of symptoms?

A

Take as soon as headache starts

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13
Q

What are the signs of acute salicylates (aspirin) poisoning?

A

Headache, tinnitus, GI distress

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14
Q

Why is acetaminophen (Tylenol) not effective for the treatment of rheumatoid arthritis?

A

Not meant for inflammation

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15
Q

Think of examples of physical conditions that would be appropriate for a nonsteroidal anti-inflammatory agent.

A

RA, osteoarthritis, tendonitis, muscle aches, backaches, dental pain, gout, bursitis, menstrual cramps, fever, aches, ankle sprain

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16
Q

When should high-dose aspirin be discontinued prior to surgery?

A

7 to 14 days

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17
Q

Which medication may cause Reye’s syndrome?

A

Aspirin

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18
Q

Understand early sign of salicylate toxicity (aspirin overdose).

A

Headache, tinnitus, GI distress

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19
Q

Acetaminophen (Tylenol) should not exceed what max daily dose

A

4 g

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20
Q

What do COX-2 inhibitors do?

A

Decrease inflammation, pain, fever

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21
Q

What is the reversal agent for morphine?

A

Narcan (naloxone)

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22
Q

What are constipation treatment options for someone on chronic morphine treatment?

A

Laxative or stool softener

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23
Q

What are life threatening symptoms of an opioid overdose?

A

Respiratory depression

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24
Q

What are serious side effects of long-term opioid use?

A

Potential medical risks include serious fractures, breathing problems during sleep, hyperalgesia, immunosuppression, chronic constipation, bowel obstruction, myocardial infarction, and tooth decay secondary to xerostomia.

25
Q

What are considerations when converting a morphine dose from the intravenous to the oral route?

A

Increased dose due to digestion

26
Q

What are the risks of giving a mixed opioid agonist-antagonist with a opioid agonists?

A

Withdrawal

27
Q

What needs to be assessed prior to administering morphine?

A

RR and BP

28
Q

What is the reversal agent for Tylenol toxicity?

A

Acetylcysteine (NAC)

29
Q

What are symptoms of normeperidine toxicity?

A

Tremor

meperidine= tramadol (narcotic analgesic)

30
Q

What is the reversal agent for aspirin?

A

None

31
Q

What is the ideal way for someone to wean off anti-seizure medications?

A

Eradicating all seizure activity then weaning off medication once patient is seizure-free for 3 months

32
Q

When is the best time to take trazodone (Desyrel)?

A

Bed time

33
Q

Which drugs are appropriate to treat inflammation?

A

COX 2 inhibitors

34
Q

What are the contraindications for acetaminophen (Tylenol)?

A

Cirrhosis d/t alcohol use

35
Q

A common drug ending for a Serotonin-receptor agonist?

A

Triptans

36
Q

What labs must be monitored for Valproic Acid (Depakote)?

A

Liver and platelets

37
Q

What is a common, non-serious side effect of imipramine (Toframil)?

A

Sedation

imipramine is a tricyclic antidepressant (TCA)

38
Q

How long will it take to achieve a therapeutic response from imipramine (Tofranil)?

A

1-3 weeks

39
Q

What is a common, non-serious side effect of tricyclic antidepressant that would most likely diminish over time?

A

Drowsiness

40
Q

Between bupropion (Wellbutrin) and serotonin selective reuptake inhibitors (SSRIs) which would have less adverse sexual side effects?

A

Wellbutrin

41
Q

What is the interaction between an SSRI, fluoxetine (Prozac) and St. John’s Wort?

A

Serotonin syndrome

42
Q

After symptoms are controlled, how long does one continue antidepressant medications?

A

One year

43
Q

What is the interaction of monoamine oxidase inhibitors (MAOIs) and foods containing tyramine?

A

Hypertensive crisis

44
Q

What are the anticholinergic effects associated with antidepressant agents?

A

Constipation, dry mouth, urinary retention

45
Q

What symptoms should a patient seek emergency care for when taking a monoamine oxidase inhibitor (antidepressant)?

A

Chest pain, dizziness, headache

46
Q

What is general patient education regarding lithium and fluids and salt intake?

A

Drink 2-3L of fluid

47
Q

What drug counteracts benzodiazepine, chlordiazepoxide (Librium)?

A

Flumazenil/Romazicon

48
Q

What are common contraindications for benzodiazepines?

A

COPD, bronchitis, sleep apnea, myasthenia gravis

49
Q

When is the best time to take trazodone (Desyrel)?

A

Bedtime

50
Q

What are common side effects of the benzodiazepine, diazepam (Valium)?

A

Drowsiness, dizziness, fatigue, constipation

51
Q

What is the effect of buspirone (BuSpar) on the central nervous system?

A

No effect

52
Q

Drug endings to indicate a benzodiazepine

A

-pam

clonazepam (klonopin)

53
Q

What side effects are classified as anticholinergic effects?

A

Constipation, dry mouth, urinary retention

54
Q

What antidepressant medication is contraindicated for those with a history of seizures?

A

Bupropion/wellbutrin

55
Q

What are signs of Steven Johnson Syndrome?

A

Rash, fever, coughing, redness, itching, sore throat, swelling, mouth blisters

56
Q

What are the effects of an Amitriptyline overdose?

A

Cardiac arrest, dangerously low blood pressure, seizures

57
Q

At what dose of amitriptyline could a patient experience adverse side effects?

A

Initiating with high doses (low initial doses minimize adverse reactions and help promote adherence), 150 mg/day is max dose

58
Q

What are dietary considerations for those taking MAOI medication?

A

Foods high in tyramine: aged cheese, chicken, beef, avocado, beer, figs, fava beans

59
Q

What is the black box warning for SSRIs?

A

Suicidality in ages 15-24

NUR 311: Pharm (4 decks)

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