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Pharm Final Exam Flashcards

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1
Q

What drug is used for heroin withdrawal that is only given at approved centers?

A

Methadone

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2
Q

What drug is used for alcohol use disorder and for maintenance of sobriety?

A

Disulfiram

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3
Q

What drug produces unpleasant hangover-like symptoms when alcohol is consumed?

A

Disulfiram

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4
Q

What are some nursing interventions for magnesium sulfate?

A

Monitor cardiac and neuromuscular status, labs, and VS

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5
Q

What is used for magnesium toxicity?

A

Calcium gluconate

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6
Q

What is ferrous sulfate?

A

Iron preparation; RBC development and O2 transport

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7
Q

What should be used to prevent teeth staining when taking ferrous sulfate?

A

Straw

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8
Q

Ferrous sulfate should be taken

A

On an empty stomach
But if GI distress, with food but prolonged treatment due to poor absorption

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9
Q

What happens if Beta 1 is blocked?

A

Decreased BP and HR

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10
Q

What happens if Beta 2 is blocked?

A

Bronchoconstriction

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11
Q

What is Beta Blocker used for?

A

HTN, reflex tachycardia

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12
Q

What is the main nursing consideration for Beta Blockers?

A

Change position slowly (orthostatic hypotension)

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13
Q

How do you recognize Benzodiazepines?

A

~lam, ~pam

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14
Q

What is Benzodiazepines used for?

A

General anxiety disorder, panic disorder, trauma/stressor related disorder, hyperarousal, seizure, insomnia, muscle spasm, ETOH withdrawal

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15
Q

What do you use for Benzodiazepine toxcitity?

A

Gastric lavage, activated charcoal, saline cathartics, flumazenil, crash cart

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16
Q

What should you teach patient on Benzodiazepine?

A

S/S CNS/respiratory depression, avoid activities that requires alertness, avoid other CNS depressants, report paradoxical response, s/s withdrawal, taper med off when dc, limit continuous use, avoid grapejuice

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17
Q

What should you avoid with all of the psych meds?

A

Grapefruit juice

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18
Q

What are some s/e & a/e of Benzodiazepines?

A

Hangover feeling, REM rebound, CNS/respiratory depression, anterograde amnesia, toxicity, paradoxical response, physical dependence, tolerance, withdrawal effects, hypersensitivity

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19
Q

Benzodiazepines causes

A

Reduced anxiety & sedation

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20
Q

What are some drugs for non-benzodiazepines?

A

Zolpidem, Zaleplon, Eszopiclone

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21
Q

What do you use non-benzodiazepines for?

A

Short-term insomnia management

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22
Q

What are Hydantoins for?

A

Antiseizure

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23
Q

What drugs are in Hydantoins?

A

Phenytoin, Ethotoin, Fosphenytoin

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24
Q

What are some a/e of Hydantoins?

A

Cardiac collapse, CNS symptoms, blood dyscrasias, Stevens-Johnson syndrome, liver damage, SI

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25
Q

What do you need to teach for patients who are on Hydantoins?

A

No pregnancy (pregnancy cat D), take calcium and vitamin D, avoid herbs and OTC meds, take at same time each day, keep seizure log, wear medic bracelet, don’t drive until Dr. confirms

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26
Q

What are Carbamazepines used for?

A

Epilepsy, seizure

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27
Q

What’s the therapeutic drug level for Carbamazepine?

A

4 - 12 mcg/mL

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28
Q

What are a/e for Carbamazepine?

A

Stevens-Johnson Syndrome, SI, hepatotoxicity

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29
Q

What do you need to monitor in pt using Carbamazepine?

A

LFT, CBC, Serum drug level, SI, CNS changes, EKG, electrolytes, lung sounds, edema, seizure precaution

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30
Q

What is Donepezil used for?

A

Alzheimer’s and mild to moderate dementia

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31
Q

What are some nursing considerations for Donepezil?

A

It’s a cholinergic (SLUDGES)
Assess for improved cognitive function. if not improved, med not working.
Crash cart in case of cholinergic crisis

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32
Q

What do you use when pt is experiencing cholinergic crisis?

A

Atropine

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33
Q

Carbidopa/levodopa treats what?

A

Parkinson’s

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34
Q

What do you need to teach for pt on carbidopa/levodopa?

A

Don’t stop abruptly, urine and sweat may turn red/brown/black, take with food, avoid high protein diet, change position slowly, avoid activities requiring alertness, avoid multivitamins, notify HCP of a/e, on/off syndrome

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35
Q

What do you use Neostigmine for?

A

To treat Myasthenia Gravis, reverse neuromuscular blockade

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36
Q

Excessive muscarinic stimulation and cholinergic crisis is a s/e / a/e of this medication

A

Neostigmine

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37
Q

What’s the difference between cholinergic crisis and myasthenic crisis?

A

Cholinergic is when overmedicated while myasthenic is when undermedicated.

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38
Q

What can be used to decide whether pt is experiencing cholinergic or myasthenic crisis?

A

IV Edrophonium, which is a cholinergic

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39
Q

What do you need to provide the pt when giving cholinergics?

A

Bedpan, urinal (SLUDGES)

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40
Q

What drugs are in central-acting muscle relaxants?

A

Baclofen, Dantrolene, Cyclobenzaprine

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41
Q

How do you evaluate central-acting muscle relaxants’ effectiveness?

A

Pt reports decreased pain and increased ROM

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42
Q

What are some a/e of neuromuscular blocking drugs?

A

Respiratory arrest, muscle pain, malignant hyperthermia, hyperkalemia

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43
Q

What is the antidote for neuromuscular blocking drug?

A

Neostigmine

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44
Q

Haloperidol and Chlorpromazine are in what drug class?

A

Typical antipsychotics

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45
Q

Haloperidol and chlorpromazine are used for

A

Acute & chronic psychotic disorder

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46
Q

What are some a/e for typical antipsychotics?

A

Acute dystonia, parkinsonism, akathisia, tardive dyskinesia, neuroleptic malignant syndrome, neuroendocrine, seizures, agranulocytosis, liver impairment, severe dysrhythmias, sexual dysfunction, anticholinergic effects

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47
Q

What drugs are in atypical antipsychotics?

A

Olanzapine, clozapine, risperidone

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48
Q

What drug class can cause DM, weight gain, hypercholesterolemia, orthostatic hypotension, elevated prolactin level, and mild EPS?

A

Atypical antipsychotics

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49
Q

What do you need to teach in pt using atypical antipsychotics?

A

Report abnormal muscle movements, avoid CNS depressants, report s/s DM, diet and exercise, change position slowly, may cause drowsiness, management of anticholinergic effects, may cause seizures

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50
Q

What do you need to teach pt on Benzodiazepines?

A

Can cause dependence (long term), avoid driving and CNS depressants, must be tapered, take with food, take at bedtime, avoid tobacco, caffeine, and sympathomimetics because it decreases effect of benzo

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51
Q

What is the most important thing that nurses have to monitor for in patients on antidepressants?

A

SI. Antidepressants can mask SI

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52
Q

What are SSRIs used for?

A

To treat major depression, OCD, ODD, Bulimia, PTSD, social anxiety, general anxiety

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53
Q

Fluoxetine, Sertraline, Citalopram, Escitalopram, Fluvoxamine, and Paroxetine are in this drug class

A

SSRIs

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54
Q

What are some a/e of SSRIs?

A

CNS stimulation (don’t take at bedtime), sexual dysfunction, weight loss then gain, serotonin syndrome, rash, GI bleed, Bruxism, hyponatremia, withdrawal syndrome, sleepiness

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55
Q

What are the nursing considerations for SSRIs?

A

Assess for SI & adherence.
Poor adherence due to sexual dysfunction

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56
Q

Phenelzine is in this drug class

A

MAOIs

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57
Q

What are MAOIs for?

A

To treat neurotic or atypical depression

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58
Q

What are some drug interactions with MAOIs?

A

Any CNS stimulant, any sympathomimetics, vasopressors, TCAs, SSRIs, general anesthetics

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59
Q

What are some food interactions with MAOIs?

A

Foods high in tyramine.
Aged cheese, beer, red wine, smoked meat, yogurt, coffee, chocolate, pickled foods, yeast, bananas, liver

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60
Q

Which antidepressant is known for several drug/food interactions?

A

MAOIs

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61
Q

What are lithium used for?

A

To decrease mood fluctuations, to treat bipolar disorder

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62
Q

What do you need to teach pt on Lithium?

A

Taper off, it will take days to reach desired effect

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63
Q

What’s the normal serum drug level for lithium?

A

0.6 - 1.2 mEq/L

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64
Q

Lithium level < 1.5 can manifest

A

N/V/D, thirst, polyuria, muscle weakness, fine hand tremor, slurred speech, lethargy

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65
Q

Lithium level 1.5 - 2 indicates

A

Early indication of lithium toxicity.
Manifests ongoing GI distress, confusion, poor coordination, coarse tremors, sedation. Hold dose

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66
Q

Lithium level 2 - 2.5 indicates

A

Advanced indication of lithium toxicity.
Extreme polyuria with dilute urine, tinnitus, involuntary extremity movements, blurred vision, ataxia, seizures, severe hypotension, respiratory complications (can lead to death). Emetics, gastric lavage

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67
Q

Lithium level > 2.5

A

Severe toxicity.
Oliguria, seizures, rapid progression of manifestations. Possibly death. Requires hemodialysis

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68
Q

Amitriptyline and nortriptyline are in this drug class

A

TCAs

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69
Q

What are the s/a/e of TCAs?

A

Orthostatic hypotension, anticholinergic effects, sedation, toxicity, decreased seizure threshold, excessive sweating, sexual dysfunction, arrhythmias

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70
Q

What drugs are in Anti-gout medications?

A

Colchicine, Allopurinol, Probenecid

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71
Q

What do you need to teach patient taking Anti-gout drugs?

A

Avoid food high in purine (red meat, alcohol, scallop), increase fluid intake (promote uric acid secretion and prevent kidney stones), take with food, stop if rash occurs, avoid grapefruit juice and salicylates. Can have metallic taste

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72
Q

Corticosteroids, Ibuprofen, and Aspirin are in this drug class

A

NSAIDs

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73
Q

What are some a/e of NSAIDs?

A

Bleeding, GI injury, nephro/hepatotoxic

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74
Q

What are some nursing interventions for NSAIDs?

A

Monitor for bleeding, increase fluid intake, take with food, avoid alcohol and G herbs

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75
Q

What are aspirin for?

A

MI prevention (baby aspirin), decrease inflammation, pain, fever, prevent blood clot

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76
Q

Aspirin interacts with these drugs

A

Warfarin (increase bleeding and absorption)
Alcohol (increase risk of GI bleeding)
G herbs (increase bleeding)

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77
Q

What are some a/e of Aspirin?

A

GI effects, bleeding, nephrotoxicity in high dose, renal impairment, salicylism (overdose), Reye’s syndrome (in children with viral illness)

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78
Q

What are methotrexate used for?

A

Slow or delay worsening of RA

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79
Q

What drug class is methotrexate in?

A

DMARDs

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80
Q

What are the contraindications of Methotrexate?

A

Liver failure, alcohol use disorder, blood dyscrasias

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81
Q

What drugs are in opioid agonist?

A

Morphine, fentanyl, codeine, heroin, hydrocodone, hydromorphone, meperidine, methadone, oxycodone, oxymorphone, tramadol

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82
Q

What are the a/e of opioid agonists?

A

Respiratory depression, cardiac arrest, neurotoxicity

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83
Q

Naloxone and naltrexone are in this drug class

A

Opioid antagonist

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84
Q

How would you know you need to give naloxone to a patient?

A

When opioid taking patient’s respiration rate decreases

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85
Q

What are the general a/e for cephalosporins and penicillin?

A

Hypersensitivity reactions, bleeding, superinfections, C.diff

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86
Q

If patient is allergic to cephalosporins, then it is likely that the patient is also allergic to

A

Penicillin

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87
Q

What are the nursing interventions for Cephalosporins and Penicillins?

A

History of allergy, C&S before starting, RFT & LFT, s/s superinfection, bleeding. Report bloody diarrhea, multiple liquid stools

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88
Q

What are the s/a/e of Vancomycin?

A

Ototoxicity, Red-man syndrome, nephrotoxicity, Stevens-Johnson syndrome, IV site pain, thrombophlebitis

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89
Q

What are some nursing interventions for Vancomycin?

A

Check serum drug level, infuse over 60 minutes, check hearing, infusion site, s/s superinfection

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90
Q

What’s the only abx that you don’t have to worry about C. diff?

A

Vancomycin

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91
Q

What are fluoroquinolones used for?

A

Broad spectrum abx

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92
Q

What are the a/e of fluoroquinolones?

A

Achilles tendon rupture, superinfection, crystalluria, hypersensitivity reactions

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93
Q

Gentamicin, Tobramycin, Amikacin, Kanamycin, Neomycin, Streptomycin are in this drug class

A

Aminoglycosides

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94
Q

Aminoglycosides have narrow therapeutic index meaning it needs

A

peak and trough levels

95
Q

INH is used for

A

TB

96
Q

What are the s/a/e of INH?

A

Neuropathy, hepatotoxicity, hepatitis

97
Q

INH is taken with what to prevent neuropathy?

A

Vitamin B6 (pyridoxine)

98
Q

When taking INH, limit the intake of this kind of food

A

Tyramine high food such as avocados, aged cheese, smoked meat, chocolate, etc.

99
Q

Acyclovir is used for

A

Herpes simplex viruses, varicella zoster virus (shingles)
It’s an anti-viral

100
Q

Fluconazole is used for

A

Systemic mycoses

101
Q

Tamoxifen is used for

A

Breast cancer

102
Q

What are the a/e for Tamoxifen?

A

Endometrial cancer/vaginal bleeding, hypercalcemia, blood clot

103
Q

Epoetin alfa is used to

A

Increase production of RBC.
For chronic kidney disease, chemo, those taking meds for HIV & AIDs, elective surgeries

104
Q

HTN, risk for thrombotic events, DVT, headache and body ache are s/a/e of

A

Epoetin alfa

105
Q

Oprelvekin is used to

A

Increase the production of platelets
To treat thrombocytopenia

106
Q

How do you know if Oprelvekin is effective?

A

Platelet > 50,000

107
Q

How do decongestants work?

A

Vasoconstriction

108
Q

Pseudoephedrine and Phenylephrine are in this drug class

A

Decongestants

109
Q

What are s/a/e of decongestants?

A

Related to sympathomimetic effects on CNS & cardio systems

110
Q

Decongestants are contraindicated in

A

Glaucoma and pt with preexisting HTN, cardiac disease, and hyperthyroidism

111
Q

What drugs are in Methylxanthines?

A

Theophylline and aminophylline

112
Q

What are Methylxanthines used for?

A

Asthma & bronchospasms

113
Q

What are some drug interactions of Methylxanthines?

A

Smoking and caffeine

114
Q

What drugs are in Mucolytic?

A

Acetylcysteine

115
Q

What should you teach about Mucolytics?

A

It smells like rotten eggs

116
Q

What drugs are in Beta 2 agonist group?

A

Albuterol, Levalbuterol, Pirbuterol, Arformoterol, Formoterol, Indacaterol

117
Q

What are Beta 2 agonists used for?

A

Bronchodilate

118
Q

What’s the difference between short acting vs long acting Beta 2 agonist?

A

Rescue drug vs preventing asthma symptoms

119
Q

What should you teach about Beta 2 agonists?

A

Don’t use short-acting more than 2-3 times per week
Use this before using corticosteroids
Use as ordered
Use with spacer
Tolerance can occur

120
Q

What are the a/e of Beta 2 agonists?

A

Sinus tachycardia, HTN, palpitations, angina

121
Q

How do you recognize inhaled corticosteroids?

A

Beclomethasone, Budesonide, Flunisolide, Fluticasone, Mometasone, Triamcinolone, Ciclesonide
Steroids usually -one

122
Q

What are inhaled corticosteroids used for?

A

Maintenance drug for Asthma & COPD

123
Q

What should you teach the patient who uses inhaled corticosteroids?

A

Rinse mouth after use, use after Beta 2 agonist, use every day. Can take 4 weeks

124
Q

What drugs are in cardiac glycosides?

A

Digoxin, Digitalis, Digitoxin

125
Q

What are cardiac glycosides used for?

A

For HF, A.fib, A.flutter

126
Q

What are some s/a/e of cardiac glycosides?

A

Drug toxicity, cardiotoxicity, GI effects, CNS effects

127
Q

What are some nursing interventions when using cardiac glycosides?

A

Monitor serum drug level, K+ level, check apical pulse, s/s heart failure, s/s digoxin toxicity

128
Q

What indicates digoxin toxicity?

A

Apical pulse < 60bpm

129
Q

What is the big risk factor for digoxin toxicity?

A

Hypokalemia

130
Q

Nitroglycerin, Amyl nitrate, Isosorbide dinitrate, Isosorbide mononitrate are in this drug class

A

Nitrates

131
Q

What are nitrates used for?

A

Antianginal; decrease cardiac oxygen demand and vasodilate

132
Q

What are some s/a/e of nitrates?

A

Headache, Hypotension, dizziness, syncope, flushing, peripheral edema, orthostatic hypotension, reflex tachycardia, palpitations, dyspnea

133
Q

What are contraindicated in nitrate use?

A

Concurrent use of PDE5 inhibitors (fatal hypotension)

134
Q

What do you need to teach the patient about nitrate transdermal patch?

A

Usually for chronic angina; so slower than other routes
longer duration of action
date, time, initial
rotate site
Take it off at bedtime to decrease tolerance

135
Q

What drugs are in K+ sparing diuretics?

A

Spironolactone, Triamterene

136
Q

K+ sparing diuretic is used for

A

Hypokalemia. Used with other diuretics to help maintain K+ balance

137
Q

What are some s/a/e of K+ sparing diuretics?

A

Hyperkalemia, dizziness, androgen effects, gynecomastia

138
Q

What are some nursing interventions when using K+ sparing diuretics?

A

S/S hyperkalemia, avoid K+ rich foods and salt substitutes, check K+ levels

139
Q

What drugs are in Thiazides?

A

Hydrochlorothiazide (HCTZ), chlorothiazide

140
Q

What are thiazides used for?

A

Central HTN, edema, HF

141
Q

How do you evaluate the effectiveness of thiazides?

A

Decreased BP (in normal range), decreased edema, dyspnea, crackles

142
Q

What drugs are in loop diuretics?

A

Furosemide, Bumetanide

143
Q

What are loop diuretics used for?

A

CHF, edema, HTN, acute renal failure, acute pulmonary edema, hypertensive crisis

144
Q

What do you need to teach patient on loop diuretic?

A

Change positions slowly, take in the morning, be ready to go to bathroom, eat K+ rich foods and supplements, s/s hypokalemia, take with food, wear sunscreen, avoid foods high in Na+, keep daily weight and BP log

145
Q

How do you evaluate effectiveness of a loop diuretic?

A

Decreased BP (in normal range), Decreased edema, dyspnea, crackles.
Same as Thiazides

146
Q

How do you recognize Calcium channel blockers?

A

Diltiazem, Verapamil, ~dipine

147
Q

What are CCBs for?

A

Antihypertensive

148
Q

What are a/e of CCB?

A

Edema, hypotension, bradycardia, CHF

149
Q

What are some nursing considerations for CCB?

A

VS, EKG, I&O, Daily weight
Labs (LFT, RFT, CBC, Glucose, K+ level)
Edema & flushing

150
Q

What do you need to teach patient on CCB?

A

Taper dose, report chest pain, avoid statins and grapefruit juice

151
Q

Clonidine is used for

A

Hypertension. It’s an Alpha 2 agonist

152
Q

What do you need to teach patient on Clonidine?

A

Taper dose, Daily weight, self check BP, I&O, mental depression can occur, swelling legs & feet, vivid dreams/nightmares, It’s a transdermal patch; put on same time each day, change every 7 days, rotate site

153
Q

How do you recognize ACE inhibitors?

A

~pril

154
Q

ACE inhibitors are for

A

Antihypertensive

155
Q

What are some s/a/e of ACE inhibitors?

A

Angioedema, Cough, Elevated potassium

156
Q

What do you need to teach patient on ACE inhibitors?

A

Taper dose, avoid K+ foods and salt substitutes, check BP, blackbox warning for pregnancy.
Cough is a s/e, but if can’t tolerate, notify and change to ARBs

157
Q

How do you treat HTN in African Americans?

A

They don’t respond to ACE inhibitors. Treat with diuretics first and add Beta blocker or ACE inhibitor

158
Q

Warfarin is used to treat

A

DVT, prevent blood clots in pt with A.fib, prosthetic heart valves. Prevent MI, TIA, PE and DVT

159
Q

What labs do you check when using Warfarin?

A

PT & INR

160
Q

What’s the therapeutic level of Warfarin labs?

A

PT: 1.5 - 2
INR: 2 -3

161
Q

What drug/food interacts with Warfarin?

A

Highly protein bound drugs

162
Q

What’s the antidote for Warfarin?

A

Vitamin K

163
Q

What does Heparin treat?

A

Prevents blood clots

164
Q

What are the labs drawn for Heparin?

A

aPTT/PTT

165
Q

What are the therapeutic levels of Heparin lab?

A

aPTT: 1.5 - 2

166
Q

What’s the antidote for Heparin?

A

Protamine sulfate

167
Q

How do you recognize HMG-CoA Reductase Inhibitors?

A

~Statins

168
Q

What are the baseline labs for HMG-CoA Reductase Inhibitors?

A

Cholesterol: 150-200
HDL: >60
LDL: <100
Triglyceride: 40-150
Liver function (statins can increase level)
Kidney function
Creatine kinase (rhabdomyolysis)
Homocysteine
CRP
Eye exam

169
Q

What are the nursing interventions when using HMG-CoA Reductase Inhibitors?

A

LFT, s/s hepatotoxicity, CK level for myalgia, avoid grapefruit juice, report muscle pain, take before bedtime, report pregnancy, avoid alcohol, eye exam

170
Q

What are the s/a/e of HMG-CoA Reductase Inhibitors?

A

Myopathy, hepatotoxicity, rhabdomyolysis, myalgia, GI issues

171
Q

What drug is in surfactant laxative?

A

Docusate sodium

172
Q

Surfactant laxative is used for

A

Stool softener; relieve constipation, prevent painful elimination, prevent straining, decreases risk for fecal impaction, promote defecation

173
Q

How does surfactant laxative work?

A

Allows water to penetrate in poop

174
Q

Lactulose is used for

A

Lowering ammonia level in patient with portal HTN and hepatic encephalopathy

175
Q

What are the different types of antacids?

A

Aluminum & calcium compounds: constipation
Magnesium compounds: diarrhea, possible toxicity and hypermagnesemia
Sodium containing: fluid retention
Aluminum hydroxide: hypophosphatemia, hypomagnesemia

176
Q

How does sucralfate work?

A

Coats mucosa and protects the ulcer

177
Q

How does Misoprostol work?

A

Increases bicarbonate and mucin release and reduces acid secretion, protects lining of the stomach and helps repair ulcer

178
Q

What drugs are in H2 receptor blockers?

A

Cimetidine, famotidine (~tidine)

179
Q

What are H2 receptor blockers used for?

A

First choice of drug for ulcers

180
Q

What are some drug/food interactions of H2 receptor blockers?

A

Smoking

181
Q

What do you need to teach patient taking H2 receptor blockers?

A

Eat at regular schedule, don’t over eat, avoid spicy food, caffeine, decaf, alcohols, smoking. Rest, avoid stress and NSAIDs, GI bleeding, s/s respiratory infection, take 30-60 min before eating

182
Q

How do you recognize PPIs?

A

~prazole

183
Q

What are PPIs used for?

A

Reduces acid secretion and suppress last phase of gastric acid production

184
Q

What are a/e of PPIs?

A

Headache, N/V/D with short term
PNA, osteoporosis & fractures, rebound acid hypersecretion, hepatotoxicity, hypomagnesemia with long term

185
Q

What drugs are in antithyroid?

A

Methimazole

186
Q

How do you evaluate effectiveness of antithyroid drugs?

A

Decrease thyroid level (in normal range)

187
Q

What are glucocorticoids used for?

A

Replacement therapy to treat Addison’s

188
Q

What are some a/e of glucocorticoids?

A

Suppression of adrenal gland function, Cushing’s syndrome, Bone loss/osteoporosis, hyperglycemia and glycosuria, myopathy, PUD, infection, fluid & electrolyte disturbances, growth suppression in children

189
Q

What do you need to teach patients on glucocorticoids?

A

Take with food, wear medic bracelet, take it every other morning, avoid NSAIDs, don’t stop abruptly, perform weight bearing exercises, report s/s infection, muscle weakness, s/s cushing’s

190
Q

Levothyroxine is used for

A

Treat hypothyroidism, goiter

191
Q

When should you take levothyroxine?

A

First thing in the morning, on an empty stomach

192
Q

How do you recognize bisphosphonates?

A

~dronate

193
Q

Bisphosphonates are used for

A

Prophylaxis & treatment of osteoporosis

194
Q

What are the a/e of bisphosphonates?

A

Esophagitis, esophageal ulceration, visual disturbances, bisphosphonate-related osteonecrosis of the jaw, kidney toxicity

195
Q

What do you need to teach patients on bisphosphonates?

A

Take on empty stomach, remain upright for 30 minutes, take with 8oz water, report visual changes, avoid dental work

196
Q

What drugs are in sulfonylureas?

A

Glimepiride, glipizide, glyburide (~ide)

197
Q

What are sulfonylureas used for?

A

Oral hypoglycemics. Insulin release from the pancreas

198
Q

What are a/e of sulfonylureas?

A

Hypoglycemia, weight gain

199
Q

What are some nursing considerations & patient teaching when using sulfonylureas?

A

Monitor s/s hypoglycemia, assess POC glucose, teach pt about snacks (15g carb), keep BG log, take with breakfast

200
Q

What are some s/a/e of Metformin?

A

weight loss, GI effects, vitamin B12 and folic acid deficiency, lactic acidosis

201
Q

What is Oxybutynin used for?

A

Decrease urinary incontinence AKA Overactive bladder
It’s an anticholinergic

202
Q

What are some contraindications of Oxybutynin?

A

Glaucoma, myasthenia gravis, paralytic ileus, GI/GU obstruction, urinary retention

203
Q

Bethanechol is used for

A

Increasing bladder tone; urinary stimulant. It’s a cholinergic. Used for nonobstructive urinary retention

204
Q

What are s/a/e of Bethanechol?

A

SLUDGES, overdose

205
Q

What drugs are in PDE5 inhibitors?

A

Sildenafil, Tadalafil (~afil). used to treat erectile dysfunction

206
Q

What are the contraindications of PDE5 inhibitors?

A

Preexisting cardiac disease, hypersensitivity

207
Q

Buthanechol is contraindicated in

A

Asthma

208
Q

Alpha 1

A

Dilation of vessels and decrease in BP

209
Q

Tetracycline

A

Take on empty stomach; iron, calcium, dairy products, antacids, magnesium decreases absorption

210
Q

Sulfa allergy

A

Contraindicated in hydrochlorothiazide, loop diuretics, sulfonylureas

211
Q

Nitrofurantoin

A

Observe for bruising on skin, take with milk or meals, expect brown urine

212
Q

Rifampin

A

Causes bodily fluids to turn red (s/e)
Treatment for TB

213
Q

Ethambutol

A

Needs baseline and periodic eye exam because it can induce optic neuritis
Part of RIPE

214
Q

Amphotericin B

A

For serious systemic mycotic disease
High risk of developing nephrotoxicity

215
Q

What’s contraindicated in NSAID therapy?

A

Peptic ulcer disease

216
Q

What’s the expected s/e of metformin therapy?

A

Weight loss

217
Q

This insulin peaks in 1-5 hours

A

Regular

218
Q

A/e of ACE inhibitors

A

Hyperkalemia

219
Q

Major s/e of opioids that can become an a/e

A

Constipation

220
Q

Diuretic with an a/e of HF

A

Mannitol

221
Q

This indicates salicylate toxicity

A

Tinnitus

222
Q

A/e of gentamicin and vancomycin

A

Nephrotoxicity

223
Q

Contraindication to and a/e of epoetin alfa therapy

A

HTN, blood clot

224
Q

Clonidine transdermal patch should be left on for this period of time

A

1 week

225
Q

PDE5 + nitrates can cause

A

Fatal hypotension

226
Q

What’s a desired effect of Beta blocker therapy?

A

Decrease HR

227
Q

This should be avoided in those taking methylxanthines

A

Caffeine

228
Q

This medication should be taken 1 hour before breakfast and 4 hours before other meds

A

Levothyroxine

229
Q

Ferrous sulfate should be taken with this to increase absorption

A

OJ (vitamin C)

230
Q

What can increase pt’s risk of lithium toxicity and what should you teach them?

A

Dehydration, increase fluid intake

231
Q

This antiseizure drug can cause gingival hyperplasia

A

Phenytoin

232
Q

Potentially serious a/e of clozapine

A

Agranulocytosis

233
Q

Evaluate effectiveness of donepezil

A

Assess LOC

Nursing Struggle Bus (8 decks)

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