Pharm HESI Flashcards
If two different inhaled meds are prescribed and one is a glucocorticoid which med should come first?
first the bronchodilator, then the steroid
Which methylxanthine increases risk of Digoxin toxicity?
Theophylline
What body system is in danger when taking a bronchodilator?
cardiac
palpitations and dysrhythmias
Bronchodilators are contraindicated in individuals with
PUD
Cardiac px
HYPERthyroidism
seizure
When should you give medications with regard to meals?
at least 30 minutes before meals
1 side effect of antihistamines?
sleepy
Who should definitely not take Benadryl?
those with narrow-angle glaucoma
Who probably won’t enjoy taking antihistamines?
COPD patients because it dries out their airways
What patient education should be provided with antihistamines?
Do not drink alcohol or take opioids with it because it can cause hardcore CNS depression
What is a big problem with monoclonal antibody administration?
Injection site reactions
viral and allergic complications
What should the patient avoid while taking Omalizumab?
live vaccines
What is the most important side effect of cromolyn sodium?
bronchospasm
Nasal decongestants should be used no longer than 48 hours because _____
they cause tolerance and rebound nasal congestion
TB patients are treated for how long?
6-9 months
How long does it take before TB patients taking meds are no longer UBER contagious?
2-3 weeks
What are the big side effects of TB meds?
hepatotoxicity nephrotoxicity neurotoxicity ototoxicity optic neuritis
Which patients would use second-line TB?
those with liver failure
What harmless side effect of some TB meds should be mentioned to the patient?
red/orange body secretions
What is the primary concern for patients taking any anticoagulant?
bleeding
Early signs of digoxin toxicity present as:
GI problems
THEN heart rate and visual problems occur
What type of diuretic are -thiazides
potassium WASTING
What type of diuretic are LOOP diuretics?
potassium WASTING
they inhibit the reabsorption of sodium and chloride in the loop of Henle
Which kind of diuretic can cause hearing loss?
loop diuretic (Furosemide)
Which 2 diuretics are potassium SPARING?
Spironolactone
Eplerenone
Big side effects of an ACE inhibitor?
dry cough
angioedema
fetal harm
How long are nitroglycerin tablets good for?
6 months
Suffix for CCBs?
-pine
What should someone taking antilipemic medication report?
muscle pain
What is a big side effect of Sulfonamides?
rash and fever
Most common side effect of cyclosporine?
nephrotoxicity
Side effect of prednisone?
it’s a glucocorticoid;
HYPERglycemia
HYPOkalemia
Why should people with glaucoma avoid atropine?
it increases intraocular pressure
Levodopa should never be taken with _____
an MAOI (antidepressant) can cause a hypertensive crisis
Abrupt cessation of an anticholinergic medication can lead to what?
S&S of Parkinson’s
- rigidity and tremors
- bradykinesia
- masked face
Which drugs must be administered slowly to prevent HYPOtension and dysrhythmia?
Phenytoin and Benzos
What client education should be administered about Phenytoin (an antiseizure med)?
It may decrease the effectiveness of birth control and have teratogenic effects
What drug is given to reverse the effects of benzos? and who can you NOT give it to?
Flumazenil
patients with increased ICP or epileptic patients treated with benzodiazepines
What drug is given to reverse the effect of acetaminophen OD?
Mucomyst
What drug is given to reverse the effects of a cholinergic crisis?
atropine sulfate
What drugs are used to treat resistant seizures?
Iminostilbenes
also for trigeminal neuralgia
Who should not take Aspirin? why?
children with flu symptoms - risk of Reye’s syndrome
What drug should you give in the event of an opioid OD?
Naloxone
What is the #1 concern with morphine sulfate?
respiratory depression
When is acetaminophen contraindicated?
liver failure or alcoholism
What should never be combined with opioids?
benzodiazepines
What is the #1 concern for patients taking a muscle relaxant?
safety
What should be monitored when a patient is taking a muscle relaxant?
liver function
What shouldn’t be taken with antigout medication? why?
aspirin because it increases uric acid levels
take acetaminophen instead
What are some patient instructions for osteoporosis meds? What is the class of medications called?
Bisphosphonates
Take it before breakfast and don’t lay down for 30 minutes after taking
Which class of antibiotics has an adverse effect of ototoxicity?
aminoglycosides
all end in -mycin
Every antibiotic has an adverse effect of _____
GI irritation
Which class of antibiotics has an adverse effect of fever, rash, and photosensitivity?
Fluoroquinolones
all end in -floxacin
Which antibiotic class has an adverse effect of furry tongue?
Penicillins
all end in -cillin
Which antibiotic class has an adverse effect of teeth staining?
Tetracyclines
all end in -cycline
Which antibiotic class has an adverse effect of pseudomembranous colitis?
Cephalosporins
all begin with Cefa-
Which two classes of antibiotics have an adverse effect of nephrotoxicity?
aminoglycosides and cephalosporins
Which immunosuppressant class is also a topical anti-inflammatory?
glucocorticoids
where are topical glucocorticoids most readily absorbed?
scalp, axilla, face, neck, eyelids, perineum
NOT the palms, soles, or back.
What should the nurse do before administering a topical glucocorticoid?
wash the area
When is UV light at its peak?
10am-4pm
Which acne medication is HIGHLY teratogenic?
Isotretinoin
the client must follow the iPLEDGE program
Which acne medication is HIGHLY teratogenic?
Isotretinoin
the client must follow the iPLEDGE program
What are the steps, in order, you would take if an anaphylactic reaction to a medication occurs?
- assess respiratory status
- STOP medication
- contact HCP
- give oxygen
- maintain IV access with normal saline
What can the “Nitrogen Mustard” chemotherapeutic agents cyclophosphamide and ifosfamide cause?
hemorrhagic cystitis (bladder inflammation) encourage hydration
What can be given to reduce uric acid levels after chemo administration?
allopurinol
What is “leucovorin rescue”?
having leucovorin on hand when administering methotrexate in case of toxicity
Which class of meds has a side effect of iodism? What is that?
antithyroid meds
metal taste in the mouth and sore gums
What should a patient do if they’re taking propylthiouracil (PTU) and they get a sore throat and fever?
call the HCP, it’s a sign of agranulocytosis
Which gland regulates calcium? Hypocalcemia causes what symptom?
parathyroid gland
tetany
If someone is hypocalcemic, what can they eat to help up their calcium?
vitamin D
For what condition should a patient be taking corticosteroids?
Addison’s disease
they replace the lack of cortisol hallmarked in this condition
What could abrupt corticosteroid cessation result in?
adrenal insufficiency
If someone decides to stop taking birth control to become pregnant, she should use an alternate, nonhormonal form for how long? Why?
2 months
To ensure complete excretion of hormonal agents before contraception
Viagra should NOT be taken with _____
nitrates
doubling down on vasodilation = priapism
What is the antidote for Warfarin OD?
Vitamin K
What is the antidote for Heparin OD?
protamine sulfate
What labs do we look at for Warfarin?
PT and INR
What labs do we look at for Heparin?
aPTT
What needs to be held for 48 hours after any contrast dye study?
Metformin
risk of nephropathy and lactic acidosis
Which insulin can NOT be mixed with any other types of insulin?
Long-acting Glargine
What are the only two types of insulin that may be administered via IV?
rapid and short-acting
How long should you wait to take an antacid before taking any medicine?
1 hour
What condition is contraindicated with a bile-acid sequestrant?
bowel obstruction
What is the #1 concern with antiemetics?
drowsiness
What is the primary concern for a patient taking a laxative?
dehydration
H2 receptor agonists all end in _____ and function to ______
-dine
decrease secretion of stomach acid
What is the normal ammonia level (important to check when administering lactulose)?
10-80
What drug is used to control hypertension, especially during a withdrawal?
clonidine
What is a big side effect of -statins
muscle weakness
What beta agonist is good to increase contractility during premature labor?
Dobutamine
Which anti-inflammatory is good for spinal cord compression?
Dexamethasone
What is etanercept used for?
rheumatoid arthritis
What is dantrium used for?
reduces muscle spasm by suppressing calcium release
Which vitamin increases iron absorption in the body?
vitamin C
