Pharm HESI Flashcards by Savannah Sales

If two different inhaled meds are prescribed and one is a glucocorticoid which med should come first?

first the bronchodilator, then the steroid

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Which methylxanthine increases risk of Digoxin toxicity?

Theophylline

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What body system is in danger when taking a bronchodilator?

cardiac

palpitations and dysrhythmias

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Bronchodilators are contraindicated in individuals with

PUD
Cardiac px
HYPERthyroidism
seizure

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When should you give medications with regard to meals?

at least 30 minutes before meals

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1 side effect of antihistamines?

sleepy

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Who should definitely not take Benadryl?

those with narrow-angle glaucoma

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Who probably won’t enjoy taking antihistamines?

COPD patients because it dries out their airways

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What patient education should be provided with antihistamines?

Do not drink alcohol or take opioids with it because it can cause hardcore CNS depression

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What is a big problem with monoclonal antibody administration?

Injection site reactions

viral and allergic complications

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What should the patient avoid while taking Omalizumab?

live vaccines

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What is the most important side effect of cromolyn sodium?

bronchospasm

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Nasal decongestants should be used no longer than 48 hours because _____

they cause tolerance and rebound nasal congestion

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TB patients are treated for how long?

6-9 months

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How long does it take before TB patients taking meds are no longer UBER contagious?

2-3 weeks

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What are the big side effects of TB meds?

hepatotoxicity
nephrotoxicity 
neurotoxicity
ototoxicity 
optic neuritis

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Which patients would use second-line TB?

those with liver failure

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What harmless side effect of some TB meds should be mentioned to the patient?

red/orange body secretions

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What is the primary concern for patients taking any anticoagulant?

bleeding

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Early signs of digoxin toxicity present as:

GI problems

THEN heart rate and visual problems occur

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What type of diuretic are -thiazides

potassium WASTING

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What type of diuretic are LOOP diuretics?

potassium WASTING

they inhibit the reabsorption of sodium and chloride in the loop of Henle

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Which kind of diuretic can cause hearing loss?

loop diuretic (Furosemide)

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Which 2 diuretics are potassium SPARING?

Spironolactone

Eplerenone

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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?

1. assess respiratory status 2. STOP medication 3. contact HCP 4. give oxygen 5. 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