Pharm II Exam I

Question 1

What are the characteristics of acute pain?

Answer 1

onset: sudden
duration: until treated or limited
treatment: analgesics, tissue repair
examples: injury, trauma, spasm, tissue damage

Question 2

What are the characteristics of chronic pain?

Answer 2

onset: slow or insidious
duration: lasts at least 3-4 months, persists or reoccurs
characteristics: irritability, depression, withdrawal, altered sleep & ADLs
treatment: variable with cause
examples: prolonged acute pain, chronic disease, cancer

Question 3

What is the nurse’s responsibility when administering controlled substances?

Answer 3

document wasted medication w/ witness, verification & disposed properly, and give as prescribed

Question 4

What is the reversal agent for opioid overdose?

Answer 4

narcan (naloxone)

Question 5

What is an important nursing consideration for narcan (naloxone)?

Answer 5

narcan has a shorter half-life than opioid agonists, so the medication may need to be redosed

Question 6

What are the adverse effects of opioids?

Answer 6

CNS depression, N/V, urinary retention, diaphoresis, flushing, pupil constriction “pinpoint”, constipation, itching

Question 7

What are the medications and their routes used to treat or prevent influenza A & B

Answer 7

oseltamivir PO
zanamivir inhalation
peramivir PO
balomavir single dose PO

Question 8

What are the contraindications for the antiviral medications used to treat influenza A & B?

Question 9

What is important patient education for the medication Ribavarin?

Answer 9

pregnant women should not be in the room when it is administered to babies

Question 10

What medication is recommended for the prevention of HIV transmission to fetus in pregnancy?

Answer 10

Zidovudine

Question 11

What is the treatment for ASA overdose with metabolic acidosis?

Answer 11

gastric aspiration & lavage to removed unabsorbed pill fragment and activated charcoal, IV fluids

Question 12

What is the treatment for acetaminophen overdose?

Answer 12

gastric lavage, activated charcoal, acetylcyteine (mucomist)

Question 13

What are the severe adverse effects of all NSAIDs?

Answer 13

CVA, MI, renal failure, bronchospasm, rash, anaphylaxis

Question 14

What is the medication that may be prescribed to protect patients on long-term NSAIDs from GI adverse effects & its important contraindication?

Question 15

What are the most common signs of salicylate toxicity?

Answer 15

dizziness, tinnitus, mental confusion, tachypnea, metabolic acidosis, bleeding, seizures, pulmonary edema, fever, coma, cardiovascular collapse

Question 16

What are some possible medications that interact with probenecid?

Question 17

What is a potential use of the medication Probenecid other than gout?

Question 18

What information should be included in patient education for the medication Allopurinol?

Question 19

What is a requirement for the use of bacteriostatic medications?

Question 20

What is a danger in using trade names for antibiotic medications?

Question 21

What are the criteria for an infection to be considered healthcare acquired?

Answer 21

the symptoms of infection will appear 48 hours after hospital admission

Question 22

What are the Beta-Lactam Antibiotics?

Answer 22

penecillin, cephalosporin, carbapenems, monobactam

Question 23

What is a beta-lactamase inhibitor and what is an example?

Answer 23

drugs w/ beta-lactam structure, but minimal antibacterial activity – they bind w/ and inactivate the beta-lactam enzymes produced by many bacteria
(ex. clavulanate)

Question 24

What antibiotics may have cross-sensitivity/allergy in patients allergic to PCN?

Answer 24

cephalosporins and carbapenems; each possess the characteristics bicyclic core structure

Question 25

What cephalosporin crosses the blood brain barrier making it useful in treating bacterial meningitis?

Answer 25

Third Generation

Question 26

Which cephalosporin is commonly used for surgical prophylaxis?

Answer 26

1st gen -- cefazolin -- includes less frequent dosing

Question 27

What is the difference in the indication for the use of oral and IV vanco

Answer 27

oral: used for CDIF IV: MRSA or endocarditis

Question 28

What is the purpose of drawing trough level around aminoglycoside antibiotics?

Answer 28

used to assess how much drug is in the drug in the system and makes sure the dose is not too high

Question 29

Name 2 of the aminoglycosides

Answer 29

gentamycin and tobramycin

Question 30

What are the potential toxicities of aminoglycosides?

Answer 30

nephrotoxicity, ototoxicity, rash, edema

Question 31

What are the potential toxicities of vancomycin?

Answer 31

red man syndrome

Question 32

What is "red man syndrome" and why does it occur?

Answer 32

occurs when vancomycin is given too fast resulting in the release of histamine leading to hypotension, flushing, and rash

Question 33

What is a possible severe adverse effect of carbapenems?

Answer 33

gastric disturbances and seizures

Question 34

Name 2 specific medications that are quinolones?

Answer 34

ciprofloxacin and levofloxacin

Question 35

What are he severe adverse effects of quinolones?

Answer 35

N/V, dizziness, headache, skin reaction, photosensitivity, hypersensitivity, tendon rupture, prolonged QT, neuropathy, exacerbation of MG

Question 36

What adverse effect is commonly associated w/ antibiotics, especially clindamycin and what are symptoms?

Answer 36

C-DIFF; frequent, loose BMs

Question 37

What are the adverse effects of tetracyclines?

Answer 37

photosensitivity, tooth discoloration, and fetal skeletal retardation

Question 38

What drugs and food interact with tetracyclines?

Answer 38

do not take w dairy, antacids, and iron products

Question 39

Which antibiotic poses a risk for Serotonin Syndrome?

Answer 39

Linezolid -- should not be given w/ MH meds

Question 40

What antibiotic is commonly used to treat Legionnaire's Disease

Answer 40

macrolides (erythromycin, clarithromyin, and fidaxomicin)

Question 41

What should be included in the patient education for the medication Trimethroprim/Sulfamethoxazole?

Answer 41

take with full glass of water and drink 2-3L fluid/day

Question 42

Wht medications may be used for patients who are allergic to PCN?

Answer 42

tetracyclines (doxycycline), quinolones (ciprofloacin), sulfanimides

Question 43

What is the mnemonic and associated drugs for first line treatment of TB?

Answer 43

RIPE (rifampin, isoniazid, pyrazinamide, and ethambutol)

Question 44

What is the minimal duration of treatment for active TB that is responsive to first line medications?

Answer 44

6-24 mo

Question 45

What is a severe adverse effect that may occur wit all TB abx?

Answer 45

hepatotoxicity

Question 46

What are the adverse effects of each of the first line TB medications?

Answer 46

rifampin: red orange urine isoniazid: vit D deficiency pyrazinamide: gout attack ethambutol: optic neuritis

Question 47

What types of pts are predisposed to the development of candidiasis infections?

Answer 47

immunocompromised and pts on abx