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Nursing 111 & Pharmacology > Pharm Test #2 > Flashcards

Pharm Test #2 Flashcards

1
Q

what is the second most common infection in the US

A

UTI

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2
Q

are UTIs more common in men or women

A

women

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3
Q

which patient is most at risk for a UTI

diabetic
pt with a fistula for dialysis
pt with indwelling catheter
pt with upper respir infec

A

pt with indwelling catheter

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4
Q

signs and symptoms of UTI

A

urinary frequency
urgency
burning
chills, fever, tenderness —- from acute pyelonephritis (inflammation of the kidneys)

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5
Q

how do you treat UTIs

A

antibiotics

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6
Q

what do the drugs that treat UTIs do

A

-block spasms of the urinary tract muscles
-decrease urinary tract pain
-protect cells of the bladder from irritation
-treat enlargement of prostate gland in men

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7
Q

what are the names of the meds that treat UTIs that are antiinfectives

A

nitrofurantoin (furadantin) - treats UTIs from bacteria
ciprofloxacin (cipro)
levofloxacin (levaquin)
trimethoprim-sulfamethoxazole (bactrim) – check for sulfur allergies

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8
Q

what actions do the UTI drugs do

A

-act specifically within the urinary tract to destroy bacteria
-act either through direct antibiotic effect or through acidification

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9
Q

what are the indications of UTI meds

A

-chronic UTI
-adjunctive therapy in acute cystitis and pyelonephritis
-prophylaxis with urinary tract anatomical abnormalities and residual urine disorders

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10
Q

what are the caution and contraindications of UTI meds

A

contrain - allergies

caution - renal dysfunction

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11
Q

what are the adverse effects of UTI meds

A

nausea, vomiting, anorexia, bladder irritation, and dysuria

pruitus, urticaria, headache, dizziness, nervousness, and confusion

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12
Q

what are the nursing considerations for antiinfectives

A

liver or renal dysfunction
skin, cns function, urinary elimination patterns, complaints of frequency, urgency, pain, difficulty voiding and lab values

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13
Q

meds used to treat UTIs are known as

A

antiinfectives

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14
Q

if an older person gets a UTI - what are the medications more likely to create

A

renal or hepatic impairments – requires caution in the use of these drugs

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15
Q

these block the spasms of urinary tract muscles caused by various conditions

A

urinary tract antispasmodics

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16
Q

what are the urinary tract antispasmodic medications

A

oxybutynin (ditropan XL) - oral/patch
tolterodine (detrol)
mirabegron (mirbetriq) - incontinence/overactive bladder

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17
Q

what are the actions of urinary tract antispasmodics

A

-block spasms of urinary tract muscles
-blocking parasympathetic activity
-relaxing the detrusor and other urinary tract muscles

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18
Q

what are the indications of urinary tract antispasmodics

A

bladder spasm and dysuria

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19
Q

what are the pharmacokinetics of urinary tract antispasmodics

A

rapidly absorbed, widely distributes
metabolized in liver and excreted in urine

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20
Q

contraindication of urinary tract antispasmodics

A

allergy
pyloric / duodenal obstruction
obstructive urinary tract problems
glaucoma - could increase pressure

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21
Q

urinary tract antispasmodics

cautions and drug to drug interactions

A

caution - rental or hepatic dysfunction

drug to drug - phenothiazines and haloperidol

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22
Q

nursing considerations for antispasmodics - UTI

A
  1. pyloric or duodenal obstruction or obstructions of other GI lesions lower urinary tract
  2. Glaucoma
  3. Skin, CNS, urinary elimination pattern, any complaints of freq, urgency, pain or difficulty voiding
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23
Q

urinary tract analgesia fix what

A

pain involving urinary tract can be very uncomforable and lead to urinary retention and increase risk of infection

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24
Q

what is phenazopyridine and what are examples

A

a dye that is used to relive urinary tract pain

ex: azo-standard, baridium

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25
Q

actions of urinary tract analgesia

A

when phenazopyridine is excreted in urine, it exerts a direct topical analgesic effect on urinary mucosa

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26
Q

what are the indications for urinary tract analgesia

A

relieve symptoms related to urinary tract irritation from infection, trauma, or surgery

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27
Q

pharmacokinetics of urinary tract analgesia

A

-rapidly absorbed and has a very rapid onset of action
-metabolized in liver and excreted in urine

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28
Q

adverse effects of urinary tract analgesia

A

-GI upset, headache, rash, reddish-orange coloring of urine and staining of contact lenses
-renal and hepatic toxicity

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29
Q

nursing considerations for urinary tract analgesia

A

-renal insufficiency
-skin, sclera, GI and hepatic function urinary elmination patterns - color, amount, and complaints of freq, dysuria, or difficulty voiding
-lab values & urine cultures

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30
Q

these is used to coat or adhere to bladder mucosal wall and protect it from irritation related to solutes in urine

A

bladder protectant

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31
Q

bladder protectant medication

A

pentosan polysulfate sodium (Elmiron) – heparin like qualities
oxybutynin - pts could be at risk for heat stroke bc cant perspire
-tolterodine (Detrol) - antichlorengenic drug – dont use if pt has glaucoma
-darifenacin
-potassium chloride

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32
Q

waht are the intended responses of bladder protectants medications

A

decrease urinary frequency
decrease urgency
decrease incontinence

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33
Q

side effect of bladder protectant

***know

A

dry mouth
dry eyes
headache
dizziness
constipation

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34
Q

adverse effects of bladder protectant

***know

A

chest pain
fast or irregular HR
shortness of breath
swelling (edema)
rapid weight gain
confusion
hallucinations
decreased urine output

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35
Q

*** know

what do you do right before administrating bladder protectant

A

need baseline vitals: weight, HR, BP

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36
Q

***know

what do you do right after administrating bladder protectant

A

watch for adverse effects
check BP and HR again
monitor fluid intake and output

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37
Q

actions of bladder protectants

A

-heparin like compound has anticoagulant and fibrinolytic effects
-adheres to bladder wall mucosal membranes and acts as buffer to control cell permeability, preventing irritating solutes in urine from reaching bladder wall cells

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38
Q

pharmacokinetics of bladder protectants

A

-coats bladder
-very little of drug is absorbed

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39
Q

contraindication of bladder protectants

A

condition involve risk of bleeding
heparin induced thrombocytopenia

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40
Q

bladder protectants cuations

A

hepatic or splenic dysfunction

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41
Q

adverse effects of bladder protectants

A

bleeding may progress to hemorrhage
headache
alopecia - loss of hair
GI disturbances

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42
Q

what are drug to drug interactions of bladder protectants

A

increase risks of following:
anticoagulants, aspirin, NSAIDS

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43
Q

nursing considerations bladder protectants

A

appropriate lab values - PT, PTT, INR, CBC
skin, VS, urinary elimination patterns
history of bleeding abnormalities, splenic disorders
hepatic dysfunction

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44
Q

patient teaching for bladder protectants

A
  1. swallow capsules WHOLE
  2. take on empty stomach with water
  3. avoid becoming overheated or dehydrated
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45
Q

enlargement of gland surrounding urethra leads to discomfort, difficulty in initiating stream of urine, feelings of bloating, and increased incidence of cystitis

A

benign prostatic hyperplasia

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46
Q

what 2 class of drugs assist in decreasing benign prostatic h.yperplasia

A
  1. alpha adrenergic blockers - doxazosin (Cardura), tamsulosin (Flomax)
  2. drugs that block testosterone production - finasteride (Proscar) - herbal remedy - saw palmetto contraindication—> toxic effects of drug
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47
Q

*** know

symptoms of BPH

A

-increased freq of urination and nocturia
-difficulty starting and continuing urination
-reduced force and size of urine stream
-feeling of incomplete bladder emptying
-dribbling after urinating
-signs and symptoms of BPH are same as for prostate cancer
-rapid or severe enlargement, bladder can become compeltely blocked

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48
Q

intended responses of BPH drugs

A
  1. decreased pressure on urethra and improved urine flow Tamsulosin (Flomax)
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49
Q

side effects of BPH drugs

A

decreased libido
erectile dysfunction
decreased seminal fluid
reduced fertility
lower blood pressure

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50
Q

adverse effects of BPH drugs

A

higher blood levels
DHT could affect hormones
birth defects
allergic reactions
drug interactions

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51
Q

nursing considerations frug drugs to treat BPH

A

-history of heart failure or coronary heart disease cardiopulmonary status - including vital signs especially BP and pulse rate, auscultate heart sounds and assess tissue perfusion
-urinary elimination pattern, prostate

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52
Q

what should not be taken with testosterone blockers

A

saw palmetto

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53
Q

these are chemicals that act at the same site as the neurotransmitter acetylcholine (ACh)

A

cholinergic drugs

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54
Q

these are often called parasympathomimetic drugs b/c of their action mimics action of parasympathetic nervous system

A

cholinergic drugs

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55
Q

these react with enzyme acetylcholinesterase and prevent it from breaking down the ACh that was released from nerve

A

indirect acting cholinergic agonists

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56
Q

similar to ACh and react directly with receptor sites to cause same reaction as if ACh had stimulated receptor

A

direct acting cholinergic agonsts

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57
Q

these increase tone of bladder and helps with urinary excretion

A

cholinergic agonists

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58
Q

what are direct acting cholinergic agonists used for

A

-increase bladder tone
-urinary excretion
-ophthalmic agents to relieve increased intraocular pressure of glaucoma

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59
Q

drugs for direct acting cholinergic agonists

A

bethanechol - used for post operative and post partum urinary retention, neurogenic bladder atony

carbachol (miostat) - relieves increased intraocular pressure of glaucoma

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60
Q

pharmacokinetics of direct acting cholinergic agonists

A

short life of 1-6 hours

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61
Q

what is important to know for direct acting cholinergic agonists

A

baseline of vitals

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62
Q

drug to drug interaction with direct acting cholinergic agonists

A

don’t combine with acetylcholinesterase inhibitors (neostigmine)

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63
Q

contraindications for direct acting cholinergic agonists

A

use sparingly due to toxic effects

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64
Q

know **

what do you teach pts about direct acting cholinergic agonists

A

renal or liver impairment - give smaller doses to prevent toxicity

bronchoconstriction for COPD and asthma pts must watch for

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65
Q

these block ACh at the synaptic cleft, which allows the accumlation of ACh released from nerve endings and leads to increased andprolonged stimulation of ACh

A

indirect acting cholinergic agonists

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66
Q

what is the indications of indirect acting cholinergic agonists

A

alzheimers disease

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67
Q

pharmacokinetics of indirect acting cholinergic agonists

A

metabolized in liver and excreted in urine

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68
Q

contraindications for indirect acting cholinergic agonists

A

allergy
bradycardia
intestinal or urinary tract obstruction

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69
Q

this is a progressive disorder involving neural degeneration in the cortex, destroy brain cells

A

alzheimers disease

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70
Q

this leads to a marked loss of memory and the ability to carry on activities of daily life

A

alzheimers disease

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71
Q

what drugs are used to treat alzheimers disease

A

-cholinesterase/acetylcholinesterase inhibitors
-donepezil (aricept) - dont use NSAID with drug — no anti inflammatory
-memantine (namenda) - cause pt to become anemic — monitor for this

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72
Q

these block ACh at the synaptic cleft, which allows the accumulation of ACh released from the nerve endigns and leads to increased and prolonged stimulation of ACh

A

indirect acting cholinergic agonists

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73
Q

what are the adverse effects of indirect acting cholinergic agonists

A

bradycardia - SOB
increased GI secretions and activity bleeding
worry about bleeding and ulcers

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74
Q

drug to drug interactions for indirect acting cholinergic agonists

A

NSAIDs, cholinergic drugs

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75
Q

nursing considerations for indirect acting cholinergic agonists

A

-get complete medication list
-VS, ECG as appropriate, urinary output
- renal/liver function tests

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76
Q

what do you need to know before and after administering indirect acting cholinergic agonists

***know these

A

-complete list of drugs pt is using including OTC and herbal
-baseline cognitive function
-baseline vital signs, weight, GI status, urinary status, hemoglobin and hematocrit
-swallowing ability
-ask about liver/kidney problems

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77
Q

what do you need to teach a pt regarding indirect acting cholinergic agonists

A

-dont crush extended release drugs
-take with food to avoid GI upset

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78
Q

this is used to treat mild to moderate alzheimer disease

it’s adverse effects is insomnia, fatigue, fash, nausea, muscle cramps, vomiting

A

donepezil

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79
Q

the actions of this drug - reverseible cholinesterase inhibitor causes elevated ACh levels in the cortex, which slows neuronal degradation of alzheimers disease

what drug is this

A

donepezil

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80
Q

this is the unpleasant sensory and emotional experience associated wtih actual or potential tissue damage

A

pain

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81
Q

what drugs are used to relieve pain

A

narcotics - opium derivatives used to treat many types of pain

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82
Q

when a pt requires higher dosage bc body used to drug

A

tolerance

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83
Q

relant on medication – needing it, craving it

A

addiction

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84
Q

if on drug long term, you get these coming off the drug

A

withdrawal

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85
Q

combination two drugs for more relief if pt gets tolerance of drug

A

adjunctive therapy

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86
Q

where are the opioid receptors

A

CNS
nerves in periphery
cells in GI tract

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87
Q

what narcotics are not to be used on children

A

levorphanol, oxymorphone and oxycodone

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88
Q

what narcotics can be used on children

A

codeine, fentanyl, hydrocodone, meperidine, and morphine

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89
Q

can the fentanyl patch be used on children

A

no

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90
Q

when do you give codeine to children:

A

as a cough suppressant bc it has anti tussed properties

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91
Q

when do you use fentanyl

A

for pre op

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92
Q

when do you use codeine

A

anti tussed

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93
Q

when do you use hydromorphone

A

used for pain. sickle cell oncology/cancer pt

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94
Q

this is used a lot for end of life. is in liquid, IV, and pill form

A

morphine

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95
Q

when do you use methadone

A

to help ppl detox

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96
Q

this is highly addictive, dont life to increase frequently

A

tramadol

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97
Q

another name for oxycodone

A

OxyContin. this is sustained release. every 8-12 hrs

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98
Q

what are the pharmacokinetics for narcotics

A

-IV most reliable way to achieve therapeutic response
-IM and subq rate of absorption varies btwn sexes
-hepatic metabolism and generally excreted in urine and bile

99
Q

what do you check before administering analgesic drugs

A

pain intensity using preferred pain scale

100
Q

what do you check after administering analgesic drugs

A

-checking pain level before you give drug
-always reassess pt
-dont give pts drugs too close together
-opioids cause constipation

101
Q

what is the patient teaching for analgesic drugs

A

take with food, dont drive/operate heavy machinery, change positions slowly, sudden drop of BP

102
Q

what are the side effects of narcotics

A

hypotension
constipation
narcotics slow everything down inside
nausea/vomiting
drowsiness

103
Q

adverse effects of narcotics

A

respiratory depression
addiction
dependence
withdrawal

104
Q

what is the narcotic antagonist

A

naloxone - nullifies all opioids

comes in IV, nasal and injection. releases in 1 min

105
Q

adverse effect of narcotic antagonist

A

tachycardia
BP changes
dysrhythmias

106
Q

what can help manage pain associated with inflammation, bone pain, cancer pain, and soft tissue

107
Q

-this is effective for pain relief
-is given orally, IV, liquid or suppository
-risk for permanent liver or kidney damage

A

acetaminophen

108
Q

this will create tylenol toxicity

A

mucamix / acetylcysteine

109
Q

these reduce some types chronic and cancer pain

A

anticonvulsants

110
Q

common anticonvulsant drugs

A

gabapentin (Neurontin) - common side effect - fighting

111
Q

these doses for pain control are often higher than those used to control seizures

A

anticonvulsants

112
Q

what is used for neuropathic pain

A

anticonvulsants

113
Q

these require nerve stimulation to depolarize and contract

A

skeletal muscles

114
Q

involuntary contraction of single muscle group of related muscles or just a part of a muscle

A

muscle spasms

115
Q

what is locked jaw

116
Q

what diseases have constant spasms

A

parkinsons
cerebral palsy

117
Q

drug of choice if a child needs to be treated for tetanus

A

methocarbamol

118
Q

while child is on dantrolene child should be screened for what

A

CNS and GI, hepatic toxicity

119
Q

this is used to treat upper motor neuron spasticity in children

A

dantrolene

120
Q

this is the only skeletal muscle relaxant safe for kids. less toxic to the body

A

methocarbamol

121
Q

the skeletal muscle relaxant used to relieve muscle spasticity associated with cerebral palsy

122
Q

action of skeletal muscle relaxant

A

depress CNS

123
Q

chemical structure of cyclobenzaprine (Flexeril) is very similar to

A

tricyclic antidepressants

124
Q

what drug changes influence of serotonin in the spinal cord

A

skeletal muscle relaxants

125
Q

*** know
what don’t give with skeletal muscle relaxants or it will cause pt to have a seizure

A

cyclobenzaprine

126
Q

this treats muscle spasticity.
use with pt MS or spinal cord injuries.
can be on long term

A

baclofen (lioresal)

127
Q

this is used to alleviate tetanus in children

A

methocarbamol (robaxin)

**know this

128
Q

this you can’t use in pts with seizure disorders.

relax you a lot, worry about pts falling, tired and hypotension

A

cyclobenzaprine (Flexeril)

129
Q

use this for phantom pain

A

baclofen (Lioresal)

130
Q

what is the contraindications of centrally acting skeletal muscle relaxants

A

rheumatic disorders - not use muscle relaxants bc this is inflammation

131
Q

what are the cautions for centrally acting skeletal muscle relaxants

A

epilepsy
cardiac dysfunction - don’t want to relax heart

132
Q

what are the intended responses for centrally acting skeletal muscle relaxants

A

skeletal muscle relaxation and reduced spasms
sedation, pain relief, increased mobility

133
Q

waht are the adverse effects of centrally acting skeletal muscle relaxants

A

amnesia & angioedema
cardiac dysrhythmias
prolonged cardiac conduction
hypotension
anticholeragnics

134
Q

what is the drug to drug interactions for centrally acting skeletal muscle relaxants

135
Q

what do you do before giving centrally acting skeletal muscle relaxants

A

-assess level of consciousness, cognition, and muscle reactivity
-ask about seizure disorders/epilepsy
-assess BP and radial/apical pulses

136
Q

what do you do after giving centrally acting skeletal muscle relaxants

A

-assess for level of consciousness and degree of skeletal msucle relaxation
-prevent falling

137
Q

nursing considerations for centrally acting skeletal muscle relaxants

A

liver and renal function tests

138
Q

what do you teach patients about centrally acting skeletal msucle relaxants

A

-avoid operating heavy machinery/driving/making critical decisions
-avoid alcohol
-use sunscreen and hats, wear protective clothing

139
Q

these are used to block the effects of acetylcholine

A

anticholinergic agents

140
Q

use these to decrease GI activity and secretions

A

anticholinergic agents

141
Q

with these you worry about constipation, dry mouth bc of GI slow downs

A

anticholinergic agents

142
Q

what are anticholinergics derived from… what plant

A

belladonna (atropine)

143
Q

medications that are anticholinergic agents

A

meclizine (Bonine) - used for vertigo, motion sickness
oxybutynin chloride (Ditropan XL, Gelnique, Oxytrol)
Atropine - used in critical care

144
Q

what are the doses and routes of administration of atropine

A

0.4-0.6 mg
IM, subq, IV

145
Q

what drug type dont you use on men with benign prostate hypertrophy

A

anticholinergic agents

146
Q

what are the indications for anticholinergic agents

A

-decrease secretions
-restore cardiac rate and BP after vagal stimulation during surgery

147
Q

which drug specifically restores cardiac rate and BP after vagal stimulation during surgery

148
Q

what group is more likely to experience adverse effects associated with anticholinergic agents

A

older adults

149
Q

what kind of impairment could older adults have with anticholinergic agents

A

renal impairment - making problems excreting these drugs

150
Q

what adverse effects will older adults have when on anticholinergic agents

A

confusion, hallucinations, psychotic syndromes

151
Q

what kind of weather should older adults avoid if on anticholinergic agents

A

hot weather. avoid extreme temp on exertion in warm temperatures - drink plenty of fluids

152
Q

contraindication of anticholinergic agents

153
Q

caution of anticholinergic agents

A

breast feeding possible suppression of lactation, possible adverse effects to fetus

154
Q

adverse effects of anticholinergic drugs

*know

A

-blurred vision
-photophobia
-palpitation, tachycardia
-dry mouth
-urinary hesitancy and retention
-decreased sweating, predisposition to heat exhaustion
-weakness, dizziness, mental confusion

155
Q

anticholinergic drugs drug to drug interactions

exacerbate these effects

A

-antihistamines
-antiparkinsonisms drugs
-MAOIs-Monoamine oxidase inhibitors
-TCAs - tricyclic antidepressants

156
Q

nursing considerations for anticholinergic drugs

A

Know baseline or if know of:
1. toxic megacolon
2. prostatic hypertrophy
3. bladder obstruction
4. bowel and bladder patterns
5. Renal function labs

157
Q

this is the most common and most uncomfortable complaints

A

nausea and vomiting

158
Q

centrally acting antiematic drug

A

phenothiazine

159
Q

these depress various areas of CNS

A

phenothiazines

160
Q

waht are the indications of phenothiazines

A

treatment of nausea and vomiting

161
Q

antianxiety drug that blocks the responsiveness of CTZ to stimuli, leading to a decrease in nausea and vomiting

A

phenothiazines

162
Q

phenothiazine medications - 3

A

prochlorperazine
chlorpromazine
perphenazine

163
Q

RN assessments before administering phenothiazine

A
  1. abdominal assessment
  2. know fluid electrolyte balance
164
Q

contraindications of phenothiazines

A

coma, severe CNS depression, brain damage or injury
severe hypotension
hypertension

165
Q

what phenothiazine medication turns urine red/brown

A

prochlorperzine

166
Q

prevention of nasuea and vomiting associated with emetogenic cancer chemotherapy, prevention of postoperative nausea and vomiting

A

nonphenothiazines

167
Q

what medication is a nonphenothiazine

A

metoclopramide (reglan)
ondansetron (zophran) - works quickly

168
Q

what effects does metoclopramide have

A

extrapyramidal symptoms

**dont use drug long term. only put on this drug if nothing else is effective

169
Q

these act to reduce repsonsiveness of nerve cells in CTZ to circulating chemicals that induce vomiting

A

nonphenothiazine

170
Q

what are the indications of nonphenothiazines

A

prevent nausea and vomiting

171
Q

what are the adverse effects of nonphenothiazines

A

drowsiness
fatigue
restlessness
extrapyramidal symptoms

172
Q

the indications of this drug are:
control of severe nasuea and vomiting associated with emetogenic cancer chemotherapy, radiation therapy, treatment of postoperative nausea and vomiting

A

ondansetron

173
Q

what are the actions of ondansetron

A

block specific receptor sites associated with nausea and vomiting; peripherally and in CTZ

174
Q

What are the miscellaneous drugs and what do they do - 3

A
  1. dronabinol (marinol) and nabilone (Cesamet) - contain active ingredient in cannabis
  2. hydroxyzine (Vistaril) - may suppress cortical areas of CNS. is an antihistamine
  3. trimethobenzamide (Tigan) - not much sedation and CNS suppression as others
175
Q

what anticholinergic antiemetic recommeded for vestibular problems (inner ear)

A

meclizine

buclizine, cyclizine and meclizine - black transmission of impulses to CTZ. are associated with motion sickness and vestibular problems

176
Q

true or false

emetic medciations are used to induce vomiting and should be kept in the home in case of accidental poisoning

177
Q

what are the effects of drugs on GI secretions

A

-decrease GI secretory activity
-block action GI secretions
-form protective coverings on GI lining to prevent erosion from GI secretions
-replace missing GI enzymes that GI tract or ancillary glands and organs can no longer produce

178
Q

what are the actions of histamine 2 antagonist

A

selectively blocks histamine 2 receptors = decrease in gastric acid secretion

179
Q

actions of antacids

A

neutralize stomach avid by direct chemical reaction

180
Q

Proton pump inhibitors actions

A

act at specific secretory surface receptors to prevent final step in acid production

181
Q

GI protectants actions

A

forms an ulcer adherent complex at duodenal ulcer sites and protects the sites against acid, pepsin and bile salts

182
Q

what are the indications histamine 2 antagonist

A

short term treatment of ulcers and prophylaxis for GI bleeds

183
Q

what are the adverse effects of histamine 2 antagonist

A

GI symptoms
CNS effects
cardiac arrythimas

184
Q

histamine 2 antagonist side effects

A

confusion
dizziness/drowsiness
constipation
neutropenia
thrombocytopenia
impotence

185
Q

antacids indications

A

symptomatic relief of upset stomach related hyperacidity

186
Q

adverse effects of antacids

A

alkalosis
hypercalcemia
rebound acidity

187
Q

antacids side effects

A

constipation
diarrhea

188
Q

proton pump inhibitors indications

A

short term treatment of duodenal ulcers, GERD, esophagitis

189
Q

indications GI protectants

A

promote healing ulcers

190
Q

what are the Actions of Histamine 2 Agonists (Cimetidine Ranitidine FamotidineNizatidine)

A

Selectively Blocks
Histamine 2 receptors= decrease
in gastric acid secretion

191
Q

Which Medications are Histamine 2 Agonists?

A

Cimetidine Ranitidine Famotidine Nizatidine

192
Q

what are the Indications for Histamine 2 Agonists (Cimetidine Ranitidine FamotidineNizatidine)

A

Short term
treatment of ulcers
and prophylaxis for
GI bleeds

193
Q

what are the possible adverse reactions of Histamine 2 Agonists (Cimetidine Ranitidine FamotidineNizatidine)

A

GI Symptoms
CNS Effects
Cardiac Arrythmias

194
Q

what are the possible side effects of Histamine 2 Agonists (Cimetidine Ranitidine FamotidineNizatidine)

A

Confusion
Dizziness/drowsiness
Constipation
Neutropenia
Thrombocytopenia
Impotence

195
Q

What is the advantage of using Nizatidine?

A

No First past through liver so
medication of choice for those with liver
impairment.

196
Q

What is a side effect of ranitidine that we need to be concerned with?

A

Causes dark stool. Important to check for occult blood in GI patients

197
Q

what is a possible adverse effect of Cimetidine

A

drug induced
hepatitis

198
Q

What are the actions of Antacids? (Sodium Bicarbonate, Calcium Carbonate, Magnesium Salts, Aluminum Salts)

A

Neutralize Stomach
Acid by direct
chemical reaction

199
Q

which medications are antacids?

A

Sodium Bicarbonate
Calcium Carbonate
(TUMS)
Magnesium Salts
(Milk of magnesia))
Aluminum Salts
(Amphogel)

200
Q

What are the indications for antacids?

A

Symptomatic relief
of upset stomach
related to
hyperacidity

201
Q

What are the possible adverse effects of Antacids?

A

Alkalosis
Hypercalcemia
Rebound Acidity

202
Q

what are the possible side effects of antacids?

A

Constipation or
diarrhea

203
Q

what are the specific adverse effects of Magnesium?

A

diarrhea,
dysuria, restlessness,
N/V

204
Q

What are the specific adverse effects of Calcium and Aluminum

A

constipation-bone pain,
decrease appetite
muscle weakness.

205
Q

what are the actions of proton pump inhibitors? (Omeprazole, Esomeprazole, Lansoprazole, Pantoprazole)

A

Acts at specific secretory surface
receptors to prevent final step in acid production

206
Q

which medications are the Proton Pump Inhibitors?

A

Omeprazole (Prilosec)
Esomeprazole
(Nexium)
Lansoprazole
(Prevacid)
Pantoprazole
(Protonix)

207
Q

What are the indicators for proton pump inhibitors? (Omeprazole, Esomeprazole, Lansoprazole, Pantoprazole)

A

Short Term
Treatment of
Duodenal Ulcers,
GERD, esophagitis

208
Q

What are the possible adverse effects of proton pump inhibitors? (Omeprazole, Esomeprazole, Lansoprazole, Pantoprazole)

A

CNS
GI effects
Upper Respiratory
Infection
Electrolyte
imbalances

209
Q

What are the possible side effects of proton pump inhibitors? (Omeprazole, Esomeprazole, Lansoprazole, Pantoprazole)

A

Dizziness, insomnia
Diarrhea, bleeding
Abdominal pain
Alopecia
Decreased Mag
levels

210
Q

Which PPI is used to treat H.Pylori?

A

Omeprazole
It reduces inflammation whils antibiotics work on the infection

211
Q

which Drug to drug interactions do we have to be aware of with PPI?

A

Cannot take at same time as Antacid

212
Q

Are PPI for long or short term use?

A

Short term only

213
Q

What are the actions of GI protectants (sucralfate)

A

Forms an ulcer adherent complex at duodenal ulcer sites and protects the sites against acid, pepsin and bile salts

214
Q

What are the indications for GI protectants

A

Promote healing of ulcers

215
Q

What are the possible adverse effects of GI protectants (sucralfate)

A

GI effects-
constipation,
diarrhea, dry mouth

216
Q

What are the possible side effects of GI protectants (sucralfate)

A

Dizziness, sleepiness
vertigo

217
Q

Which drugs are GI Protectants?

A

Sucralfate (Carafate)

218
Q

What important Drug to Drug interactions do we need to know with GI Protectants?

A

Should not be taken with an aluminum
Salt as it can cause aluminum toxicity

219
Q

What are the nursing considerations for medications affecting GI secretions?

A
  • History and Physical
  • Pregnancy and Lactation
  • Abdominal Assessment
  • Neurological Status
  • Respiratory Assessment
220
Q

What are the main Actions of Drugs Used to Affect Motor Activity of the GI Tract

A
  • Speed up or improve movement of intestinal contents
    when movement becomes slow or sluggish
    (constipation)
  • Increase the tone of the GI tract and stimulate motility
    throughout the system
  • Decrease movement along the GI tract when rapid
    movement decreases the time for absorption of
    nutrients (diarrhea)
221
Q

What are the four types of laxatives?

A
  • Chemical Stimulants
  • Bulk Stimulants
  • Osmotic
  • Lubricants
222
Q

What is the action of chemical stimulant laxatives?

A

They irritate the nerve plexus which stimulates motility

223
Q

What is the action of Bulk Stimulant Laxatives

A

Increase motility by increasing fecal matter which will increase fluid in GI
system

224
Q

What is the action of Osmotic laxatives?

A

Draw more water into the GI tract

225
Q

What is the action of Lubricant laxatives?

A

Coats fecal matter to ease passage of stool

226
Q

Which drugs are chemical stimulant laxatives?

A
  • Bisacodyl
  • Castor Oil
  • Senna
227
Q

Which drugs are bulk laxatives?

A
  • Methylcellulose
  • Polycarbophil
  • Psyllium
228
Q

Which drugs are osmotic laxatives?

A
  • MOM
  • Magnesium Sulfate
  • Lactulose
  • Polyethylene glycol
229
Q

which drugs are lubricant laxatives?

A
  • Docusate
  • Glycerin
  • Mineral Oil
230
Q

What are the nursing considerations for laxatives?

A
  • H and P
  • Current Medications
  • Do not administer to a patient with abdominal pain
  • Perform abdominal assessment
  • Check labs
  • Educate on laxatives ( Do not take for more than 1 week unless directed)
  • Take with a full glass of water
  • Record BM
231
Q

Which are the antidiarrhial drugs?

A
  • Bismuth Subsalicylate
  • Loperamide
  • Opium Derivatives
  • Diphenoxylate with atropine
232
Q

Which are the two types of antiemetics?

A
  • Phenothiazines
  • Non-Phenothiazines
233
Q

Which are the phenothiazine antiemetics?

A
  • Prochlorperazine
  • Chlorpromazine
  • Perphenazine
234
Q

which are the non- phenothiazine antiemetics?

A
  • Ondansetron (Zophran)
  • Metoclopramide
235
Q

Which side effect specific to prochlorperazine do we need to educate patient on?

A

Red coloring to urine

236
Q

What are the potetial adverse effects of non- phenothiazine antiemetics

A

Extra-pyramidal effects (dyskinesia and CNS symptoms)

237
Q

A 54-year-old patient is going on an ocean cruise. What medication
would be most effective for motion sickness?
A. Meclizine (Antivert)
B. Diphenhydramine (Benadryl)
C. Hydroxyzine (Atarax)
D. Metoclopramide (Reglan)

A

A. Meclizine (Antivert)

238
Q

Question 1
* An older adult has been taking a calcium-based antacid on an
increasingly frequent basis. When teaching this client, the nurse
should include suggestions for the prevention of which adverse
effect?
A. Urinary frequency
B. Fatty stools
C. Nausea
D. Constipation

A

D. Constipation

239
Q

A 27-year-old male is taking an anticholinergic drug as adjunctive
therapy to treat his peptic ulcer disease. The client comes to the
clinic and tells the nurse that he “feels his heart beating.” What
adverse effect is the client experiencing from the anticholinergic
medication?
A. Tachypnea
B. Tachycardia
C. Hypotension
D. Urinary frequency

A

B. Tachycardia

240
Q

An older adult client has been diagnosed with early-stage
Alzheimer’s disease and has begun treatment with donepezil. When
providing health education to the client and the client’s spouse, the
nurse should identify what goal of treatment?
A. Remission of Alzheimer’s disease
B. Cure of Alzheimer’s disease
C. Improvement of cognition and function
D. Resolution of memory and cognitive deficits

A

C. Improvement of cognition and function

241
Q

The health care provider is preparing to write a prescription for a
client diagnosed with urinary retention. Which medication does the
nurse expect to be prescribed?
A. donepezil
B. neostigmine
C. bethanechol
D. ambenonium

A

C. bethanechol

242
Q

Which is the drug of choice in children who need to be treated with
tetanus?
A. Dantrolene (Dantrium)
B. Methocarbamol (Robaxin)
C. Baclofen (Lioresal)
D. Carisoprodol (Soma)

A

B. Methocarbamol (Robaxin)

243
Q

A client who is experiencing lower back pain has been prescribed cyclobenzaprine. The nurse should provide what health education in order to ensure safe and effective treatment?
A. “This will likely make you drowsy, so don’t take it before doing anything that would require alertness.”
B. “Don’t use this for more than five consecutive days to prevent damage to your liver.”
C. “If you experience sedation, seek care promptly since it could be a sign of a serious drug reaction.”
D. “Make sure to avoid grapefruit juice and fresh grapefruit until treatment is complete.”

A

A. “This will likely make you drowsy, so don’t take it before doing anything that would require alertness.”

244
Q

Which medication would the nurse expect to administer if
prescribed to achieve skeletal muscle relaxation?
A. Baclofen
B. Allopurinol
C. Alendronate
D. Hydroxychloroquine

A

A. Baclofen

Nursing 111 & Pharmacology (12 decks)

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