Pharm Test #2 Flashcards
1
Q
what is the second most common infection in the US
A
UTI
2
Q
are UTIs more common in men or women
A
women
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
4
Q
signs and symptoms of UTI
A
urinary frequency
urgency
burning
chills, fever, tenderness —- from acute pyelonephritis (inflammation of the kidneys)
5
Q
how do you treat UTIs
A
antibiotics
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
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
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
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
10
Q
what are the caution and contraindications of UTI meds
A
contrain - allergies
caution - renal dysfunction
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
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
13
Q
meds used to treat UTIs are known as
A
antiinfectives
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
15
Q
these block the spasms of urinary tract muscles caused by various conditions
A
urinary tract antispasmodics
16
Q
what are the urinary tract antispasmodic medications
A
oxybutynin (ditropan XL) - oral/patch
tolterodine (detrol)
mirabegron (mirbetriq) - incontinence/overactive bladder
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
18
Q
what are the indications of urinary tract antispasmodics
A
bladder spasm and dysuria
19
Q
what are the pharmacokinetics of urinary tract antispasmodics
A
rapidly absorbed, widely distributes
metabolized in liver and excreted in urine
20
Q
contraindication of urinary tract antispasmodics
A
allergy
pyloric / duodenal obstruction
obstructive urinary tract problems
glaucoma - could increase pressure
21
Q
urinary tract antispasmodics
cautions and drug to drug interactions
A
caution - rental or hepatic dysfunction
drug to drug - phenothiazines and haloperidol
22
Q
nursing considerations for antispasmodics - UTI
A
- pyloric or duodenal obstruction or obstructions of other GI lesions lower urinary tract
- Glaucoma
- Skin, CNS, urinary elimination pattern, any complaints of freq, urgency, pain or difficulty voiding
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
24
Q
what is phenazopyridine and what are examples
A
a dye that is used to relive urinary tract pain
ex: azo-standard, baridium
25
actions of urinary tract analgesia
when phenazopyridine is excreted in urine, it exerts a direct topical analgesic effect on urinary mucosa
26
what are the indications for urinary tract analgesia
relieve symptoms related to urinary tract irritation from infection, trauma, or surgery
27
pharmacokinetics of urinary tract analgesia
-rapidly absorbed and has a very rapid onset of action
-metabolized in liver and excreted in urine
28
adverse effects of urinary tract analgesia
-GI upset, headache, rash, reddish-orange coloring of urine and staining of contact lenses
-renal and hepatic toxicity
29
nursing considerations for urinary tract analgesia
-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
30
these is used to coat or adhere to bladder mucosal wall and protect it from irritation related to solutes in urine
bladder protectant
31
bladder protectant medication
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
32
waht are the intended responses of bladder protectants medications
decrease urinary frequency
decrease urgency
decrease incontinence
33
side effect of bladder protectant
***know
dry mouth
dry eyes
headache
dizziness
constipation
34
adverse effects of bladder protectant
***know
chest pain
fast or irregular HR
shortness of breath
swelling (edema)
rapid weight gain
confusion
hallucinations
decreased urine output
35
*** know
what do you do right before administrating bladder protectant
need baseline vitals: weight, HR, BP
36
***know
what do you do right after administrating bladder protectant
watch for adverse effects
check BP and HR again
monitor fluid intake and output
37
actions of bladder protectants
-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
38
pharmacokinetics of bladder protectants
-coats bladder
-very little of drug is absorbed
39
contraindication of bladder protectants
condition involve risk of bleeding
heparin induced thrombocytopenia
40
bladder protectants cuations
hepatic or splenic dysfunction
41
adverse effects of bladder protectants
bleeding may progress to hemorrhage
headache
alopecia - loss of hair
GI disturbances
42
what are drug to drug interactions of bladder protectants
increase risks of following:
anticoagulants, aspirin, NSAIDS
43
nursing considerations bladder protectants
appropriate lab values - PT, PTT, INR, CBC
skin, VS, urinary elimination patterns
history of bleeding abnormalities, splenic disorders
hepatic dysfunction
44
patient teaching for bladder protectants
1. swallow capsules WHOLE
2. take on empty stomach with water
3. avoid becoming overheated or dehydrated
45
enlargement of gland surrounding urethra leads to discomfort, difficulty in initiating stream of urine, feelings of bloating, and increased incidence of cystitis
benign prostatic hyperplasia
46
what 2 class of drugs assist in decreasing benign prostatic h.yperplasia
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
47
*** know
symptoms of BPH
-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
48
intended responses of BPH drugs
1. decreased pressure on urethra and improved urine flow Tamsulosin (Flomax)
49
side effects of BPH drugs
decreased libido
erectile dysfunction
decreased seminal fluid
reduced fertility
lower blood pressure
50
adverse effects of BPH drugs
higher blood levels
DHT could affect hormones
birth defects
allergic reactions
drug interactions
51
nursing considerations frug drugs to treat BPH
-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
52
what should not be taken with testosterone blockers
saw palmetto
53
these are chemicals that act at the same site as the neurotransmitter acetylcholine (ACh)
cholinergic drugs
54
these are often called parasympathomimetic drugs b/c of their action mimics action of parasympathetic nervous system
cholinergic drugs
55
these react with enzyme acetylcholinesterase and prevent it from breaking down the ACh that was released from nerve
indirect acting cholinergic agonists
56
similar to ACh and react directly with receptor sites to cause same reaction as if ACh had stimulated receptor
direct acting cholinergic agonsts
57
these increase tone of bladder and helps with urinary excretion
cholinergic agonists
58
what are direct acting cholinergic agonists used for
-increase bladder tone
-urinary excretion
-ophthalmic agents to relieve increased intraocular pressure of glaucoma
59
drugs for direct acting cholinergic agonists
bethanechol - used for post operative and post partum urinary retention, neurogenic bladder atony
carbachol (miostat) - relieves increased intraocular pressure of glaucoma
60
pharmacokinetics of direct acting cholinergic agonists
short life of 1-6 hours
61
what is important to know for direct acting cholinergic agonists
baseline of vitals
62
drug to drug interaction with direct acting cholinergic agonists
don't combine with acetylcholinesterase inhibitors (neostigmine)
63
contraindications for direct acting cholinergic agonists
use sparingly due to toxic effects
64
know ****
what do you teach pts about direct acting cholinergic agonists
renal or liver impairment - give smaller doses to prevent toxicity
bronchoconstriction for COPD and asthma pts must watch for
65
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
indirect acting cholinergic agonists
66
what is the indications of indirect acting cholinergic agonists
alzheimers disease
67
pharmacokinetics of indirect acting cholinergic agonists
metabolized in liver and excreted in urine
68
contraindications for indirect acting cholinergic agonists
allergy
bradycardia
intestinal or urinary tract obstruction
69
this is a progressive disorder involving neural degeneration in the cortex, destroy brain cells
alzheimers disease
70
this leads to a marked loss of memory and the ability to carry on activities of daily life
alzheimers disease
71
what drugs are used to treat alzheimers disease
-cholinesterase/acetylcholinesterase inhibitors
-donepezil (aricept) - dont use NSAID with drug --- no anti inflammatory
-memantine (namenda) - cause pt to become anemic --- monitor for this
72
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
indirect acting cholinergic agonists
73
what are the adverse effects of indirect acting cholinergic agonists
bradycardia - SOB
increased GI secretions and activity bleeding
worry about bleeding and ulcers
74
drug to drug interactions for indirect acting cholinergic agonists
NSAIDs, cholinergic drugs
75
nursing considerations for indirect acting cholinergic agonists
-get complete medication list
-VS, ECG as appropriate, urinary output
- renal/liver function tests
76
what do you need to know before and after administering indirect acting cholinergic agonists
***know these
-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
77
what do you need to teach a pt regarding indirect acting cholinergic agonists
-dont crush extended release drugs
-take with food to avoid GI upset
78
this is used to treat mild to moderate alzheimer disease
it's adverse effects is insomnia, fatigue, fash, nausea, muscle cramps, vomiting
donepezil
79
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
donepezil
80
this is the unpleasant sensory and emotional experience associated wtih actual or potential tissue damage
pain
81
what drugs are used to relieve pain
narcotics - opium derivatives used to treat many types of pain
82
when a pt requires higher dosage bc body used to drug
tolerance
83
relant on medication -- needing it, craving it
addiction
84
if on drug long term, you get these coming off the drug
withdrawal
85
combination two drugs for more relief if pt gets tolerance of drug
adjunctive therapy
86
where are the opioid receptors
CNS
nerves in periphery
cells in GI tract
87
what narcotics are not to be used on children
levorphanol, oxymorphone and oxycodone
88
what narcotics can be used on children
codeine, fentanyl, hydrocodone, meperidine, and morphine
89
can the fentanyl patch be used on children
no
90
when do you give codeine to children:
as a cough suppressant bc it has anti tussed properties
91
when do you use fentanyl
for pre op
92
when do you use codeine
anti tussed
93
when do you use hydromorphone
used for pain. sickle cell oncology/cancer pt
94
this is used a lot for end of life. is in liquid, IV, and pill form
morphine
95
when do you use methadone
to help ppl detox
96
this is highly addictive, dont life to increase frequently
tramadol
97
another name for oxycodone
OxyContin. this is sustained release. every 8-12 hrs
98
what are the pharmacokinetics for narcotics
-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
what do you check before administering analgesic drugs
pain intensity using preferred pain scale
100
what do you check after administering analgesic drugs
-checking pain level before you give drug
-always reassess pt
-dont give pts drugs too close together
-opioids cause constipation
101
what is the patient teaching for analgesic drugs
take with food, dont drive/operate heavy machinery, change positions slowly, sudden drop of BP
102
what are the side effects of narcotics
hypotension
constipation
narcotics slow everything down inside
nausea/vomiting
drowsiness
103
adverse effects of narcotics
respiratory depression
addiction
dependence
withdrawal
104
what is the narcotic antagonist
naloxone - nullifies all opioids
comes in IV, nasal and injection. releases in 1 min
105
adverse effect of narcotic antagonist
tachycardia
BP changes
dysrhythmias
106
what can help manage pain associated with inflammation, bone pain, cancer pain, and soft tissue
NSAIDS
107
-this is effective for pain relief
-is given orally, IV, liquid or suppository
-risk for permanent liver or kidney damage
acetaminophen
108
this will create tylenol toxicity
mucamix / acetylcysteine
109
these reduce some types chronic and cancer pain
anticonvulsants
110
common anticonvulsant drugs
gabapentin (Neurontin) - common side effect - fighting
111
these doses for pain control are often higher than those used to control seizures
anticonvulsants
112
what is used for neuropathic pain
anticonvulsants
113
these require nerve stimulation to depolarize and contract
skeletal muscles
114
involuntary contraction of single muscle group of related muscles or just a part of a muscle
muscle spasms
115
what is locked jaw
tetney
116
what diseases have constant spasms
parkinsons
cerebral palsy
117
drug of choice if a child needs to be treated for tetanus
methocarbamol
118
while child is on dantrolene child should be screened for what
CNS and GI, hepatic toxicity
119
this is used to treat upper motor neuron spasticity in children
dantrolene
120
this is the only skeletal muscle relaxant safe for kids. less toxic to the body
methocarbamol
121
the skeletal muscle relaxant used to relieve muscle spasticity associated with cerebral palsy
baclofen
122
action of skeletal muscle relaxant
depress CNS
123
chemical structure of cyclobenzaprine (Flexeril) is very similar to
tricyclic antidepressants
124
what drug changes influence of serotonin in the spinal cord
skeletal muscle relaxants
125
*** know
what don't give with skeletal muscle relaxants or it will cause pt to have a seizure
cyclobenzaprine
126
this treats muscle spasticity.
use with pt MS or spinal cord injuries.
can be on long term
baclofen (lioresal)
127
this is used to alleviate tetanus in children
methocarbamol (robaxin)
**know this
128
this you can't use in pts with seizure disorders.
relax you a lot, worry about pts falling, tired and hypotension
cyclobenzaprine (Flexeril)
129
use this for phantom pain
baclofen (Lioresal)
130
what is the contraindications of centrally acting skeletal muscle relaxants
rheumatic disorders - not use muscle relaxants bc this is inflammation
131
what are the cautions for centrally acting skeletal muscle relaxants
epilepsy
cardiac dysfunction - don't want to relax heart
132
what are the intended responses for centrally acting skeletal muscle relaxants
skeletal muscle relaxation and reduced spasms
sedation, pain relief, increased mobility
133
waht are the adverse effects of centrally acting skeletal muscle relaxants
amnesia & angioedema
cardiac dysrhythmias
prolonged cardiac conduction
hypotension
anticholeragnics
134
what is the drug to drug interactions for centrally acting skeletal muscle relaxants
alcohol
135
what do you do before giving centrally acting skeletal muscle relaxants
-assess level of consciousness, cognition, and muscle reactivity
-ask about seizure disorders/epilepsy
-assess BP and radial/apical pulses
136
what do you do after giving centrally acting skeletal muscle relaxants
-assess for level of consciousness and degree of skeletal msucle relaxation
-prevent falling
137
nursing considerations for centrally acting skeletal muscle relaxants
liver and renal function tests
138
what do you teach patients about centrally acting skeletal msucle relaxants
-avoid operating heavy machinery/driving/making critical decisions
-avoid alcohol
-use sunscreen and hats, wear protective clothing
139
these are used to block the effects of acetylcholine
anticholinergic agents
140
use these to decrease GI activity and secretions
anticholinergic agents
141
with these you worry about constipation, dry mouth bc of GI slow downs
anticholinergic agents
142
what are anticholinergics derived from... what plant
belladonna (atropine)
143
medications that are anticholinergic agents
meclizine (Bonine) - used for vertigo, motion sickness
oxybutynin chloride (Ditropan XL, Gelnique, Oxytrol)
Atropine - used in critical care
144
what are the doses and routes of administration of atropine
0.4-0.6 mg
IM, subq, IV
145
what drug type dont you use on men with benign prostate hypertrophy
anticholinergic agents
146
what are the indications for anticholinergic agents
-decrease secretions
-restore cardiac rate and BP after vagal stimulation during surgery
147
which drug specifically restores cardiac rate and BP after vagal stimulation during surgery
atropine
148
what group is more likely to experience adverse effects associated with anticholinergic agents
older adults
149
what kind of impairment could older adults have with anticholinergic agents
renal impairment - making problems excreting these drugs
150
what adverse effects will older adults have when on anticholinergic agents
confusion, hallucinations, psychotic syndromes
151
what kind of weather should older adults avoid if on anticholinergic agents
hot weather. avoid extreme temp on exertion in warm temperatures - drink plenty of fluids
152
contraindication of anticholinergic agents
glaucoma
153
caution of anticholinergic agents
breast feeding possible suppression of lactation, possible adverse effects to fetus
154
adverse effects of anticholinergic drugs
*know
-blurred vision
-photophobia
-palpitation, tachycardia
-dry mouth
-urinary hesitancy and retention
-decreased sweating, predisposition to heat exhaustion
-weakness, dizziness, mental confusion
155
anticholinergic drugs drug to drug interactions
exacerbate these effects
-antihistamines
-antiparkinsonisms drugs
-MAOIs-Monoamine oxidase inhibitors
-TCAs - tricyclic antidepressants
156
nursing considerations for anticholinergic drugs
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
this is the most common and most uncomfortable complaints
nausea and vomiting
158
centrally acting antiematic drug
phenothiazine
159
these depress various areas of CNS
phenothiazines
160
waht are the indications of phenothiazines
treatment of nausea and vomiting
161
antianxiety drug that blocks the responsiveness of CTZ to stimuli, leading to a decrease in nausea and vomiting
phenothiazines
162
phenothiazine medications - 3
prochlorperazine
chlorpromazine
perphenazine
163
RN assessments before administering phenothiazine
1. abdominal assessment
2. know fluid electrolyte balance
164
contraindications of phenothiazines
coma, severe CNS depression, brain damage or injury
severe hypotension
hypertension
165
what phenothiazine medication turns urine red/brown
prochlorperzine
166
prevention of nasuea and vomiting associated with emetogenic cancer chemotherapy, prevention of postoperative nausea and vomiting
nonphenothiazines
167
what medication is a nonphenothiazine
metoclopramide (reglan)
ondansetron (zophran) - works quickly
168
what effects does metoclopramide have
extrapyramidal symptoms
**dont use drug long term. only put on this drug if nothing else is effective
169
these act to reduce repsonsiveness of nerve cells in CTZ to circulating chemicals that induce vomiting
nonphenothiazine
170
what are the indications of nonphenothiazines
prevent nausea and vomiting
171
what are the adverse effects of nonphenothiazines
drowsiness
fatigue
restlessness
extrapyramidal symptoms
172
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
ondansetron
173
what are the actions of ondansetron
block specific receptor sites associated with nausea and vomiting; peripherally and in CTZ
174
What are the miscellaneous drugs and what do they do - 3
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
what anticholinergic antiemetic recommeded for vestibular problems (inner ear)
meclizine
buclizine, cyclizine and meclizine - black transmission of impulses to CTZ. are associated with motion sickness and vestibular problems
176
true or false
emetic medciations are used to induce vomiting and should be kept in the home in case of accidental poisoning
false
177
what are the effects of drugs on GI secretions
-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
what are the actions of histamine 2 antagonist
selectively blocks histamine 2 receptors = decrease in gastric acid secretion
179
actions of antacids
neutralize stomach avid by direct chemical reaction
180
Proton pump inhibitors actions
act at specific secretory surface receptors to prevent final step in acid production
181
GI protectants actions
forms an ulcer adherent complex at duodenal ulcer sites and protects the sites against acid, pepsin and bile salts
182
what are the indications histamine 2 antagonist
short term treatment of ulcers and prophylaxis for GI bleeds
183
what are the adverse effects of histamine 2 antagonist
GI symptoms
CNS effects
cardiac arrythimas
184
histamine 2 antagonist side effects
confusion
dizziness/drowsiness
constipation
neutropenia
thrombocytopenia
impotence
185
antacids indications
symptomatic relief of upset stomach related hyperacidity
186
adverse effects of antacids
alkalosis
hypercalcemia
rebound acidity
187
antacids side effects
constipation
diarrhea
188
proton pump inhibitors indications
short term treatment of duodenal ulcers, GERD, esophagitis
189
indications GI protectants
promote healing ulcers
190
what are the Actions of Histamine 2 Agonists (Cimetidine Ranitidine FamotidineNizatidine)
Selectively Blocks
Histamine 2 receptors= decrease
in gastric acid secretion
191
Which Medications are Histamine 2 Agonists?
Cimetidine Ranitidine Famotidine Nizatidine
192
what are the Indications for Histamine 2 Agonists (Cimetidine Ranitidine FamotidineNizatidine)
Short term
treatment of ulcers
and prophylaxis for
GI bleeds
193
what are the possible adverse reactions of Histamine 2 Agonists (Cimetidine Ranitidine FamotidineNizatidine)
GI Symptoms
CNS Effects
Cardiac Arrythmias
194
what are the possible side effects of Histamine 2 Agonists (Cimetidine Ranitidine FamotidineNizatidine)
Confusion
Dizziness/drowsiness
Constipation
Neutropenia
Thrombocytopenia
Impotence
195
What is the advantage of using Nizatidine?
No First past through liver so
medication of choice for those with liver
impairment.
196
What is a side effect of ranitidine that we need to be concerned with?
Causes dark stool. Important to check for occult blood in GI patients
197
what is a possible adverse effect of Cimetidine
drug induced
hepatitis
198
What are the actions of Antacids? (Sodium Bicarbonate, Calcium Carbonate, Magnesium Salts, Aluminum Salts)
Neutralize Stomach
Acid by direct
chemical reaction
199
which medications are antacids?
Sodium Bicarbonate
Calcium Carbonate
(TUMS)
Magnesium Salts
(Milk of magnesia))
Aluminum Salts
(Amphogel)
200
What are the indications for antacids?
Symptomatic relief
of upset stomach
related to
hyperacidity
201
What are the possible adverse effects of Antacids?
Alkalosis
Hypercalcemia
Rebound Acidity
202
what are the possible side effects of antacids?
Constipation or
diarrhea
203
what are the specific adverse effects of Magnesium?
diarrhea,
dysuria, restlessness,
N/V
204
What are the specific adverse effects of Calcium and Aluminum
constipation-bone pain,
decrease appetite
muscle weakness.
205
what are the actions of proton pump inhibitors? (Omeprazole, Esomeprazole, Lansoprazole, Pantoprazole)
Acts at specific secretory surface
receptors to prevent final step in acid production
206
which medications are the Proton Pump Inhibitors?
Omeprazole (Prilosec)
Esomeprazole
(Nexium)
Lansoprazole
(Prevacid)
Pantoprazole
(Protonix)
207
What are the indicators for proton pump inhibitors? (Omeprazole, Esomeprazole, Lansoprazole, Pantoprazole)
Short Term
Treatment of
Duodenal Ulcers,
GERD, esophagitis
208
What are the possible adverse effects of proton pump inhibitors? (Omeprazole, Esomeprazole, Lansoprazole, Pantoprazole)
CNS
GI effects
Upper Respiratory
Infection
Electrolyte
imbalances
209
What are the possible side effects of proton pump inhibitors? (Omeprazole, Esomeprazole, Lansoprazole, Pantoprazole)
Dizziness, insomnia
Diarrhea, bleeding
Abdominal pain
Alopecia
Decreased Mag
levels
210
Which PPI is used to treat H.Pylori?
Omeprazole
It reduces inflammation whils antibiotics work on the infection
211
which Drug to drug interactions do we have to be aware of with PPI?
Cannot take at same time as Antacid
212
Are PPI for long or short term use?
Short term only
213
What are the actions of GI protectants (sucralfate)
Forms an ulcer adherent complex at duodenal ulcer sites and protects the sites against acid, pepsin and bile salts
214
What are the indications for GI protectants
Promote healing of ulcers
215
What are the possible adverse effects of GI protectants (sucralfate)
GI effects-
constipation,
diarrhea, dry mouth
216
What are the possible side effects of GI protectants (sucralfate)
Dizziness, sleepiness
vertigo
217
Which drugs are GI Protectants?
Sucralfate (Carafate)
218
What important Drug to Drug interactions do we need to know with GI Protectants?
Should not be taken with an aluminum
Salt as it can cause aluminum toxicity
219
What are the nursing considerations for medications affecting GI secretions?
* History and Physical
* Pregnancy and Lactation
* Abdominal Assessment
* Neurological Status
* Respiratory Assessment
220
What are the main Actions of Drugs Used to Affect Motor Activity of the GI Tract
* 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
What are the four types of laxatives?
* Chemical Stimulants
* Bulk Stimulants
* Osmotic
* Lubricants
222
What is the action of chemical stimulant laxatives?
They irritate the nerve plexus which stimulates motility
223
What is the action of Bulk Stimulant Laxatives
Increase motility by increasing fecal matter which will increase fluid in GI
system
224
What is the action of Osmotic laxatives?
Draw more water into the GI tract
225
What is the action of Lubricant laxatives?
Coats fecal matter to ease passage of stool
226
Which drugs are chemical stimulant laxatives?
* Bisacodyl
* Castor Oil
* Senna
227
Which drugs are bulk laxatives?
* Methylcellulose
* Polycarbophil
* Psyllium
228
Which drugs are osmotic laxatives?
* MOM
* Magnesium Sulfate
* Lactulose
* Polyethylene glycol
229
which drugs are lubricant laxatives?
* Docusate
* Glycerin
* Mineral Oil
230
What are the nursing considerations for laxatives?
* 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
Which are the antidiarrhial drugs?
* Bismuth Subsalicylate
* Loperamide
* Opium Derivatives
* Diphenoxylate with atropine
232
Which are the two types of antiemetics?
* Phenothiazines
* Non-Phenothiazines
233
Which are the phenothiazine antiemetics?
* Prochlorperazine
* Chlorpromazine
* Perphenazine
234
which are the non- phenothiazine antiemetics?
* Ondansetron (Zophran)
* Metoclopramide
235
Which side effect specific to prochlorperazine do we need to educate patient on?
Red coloring to urine
236
What are the potetial adverse effects of non- phenothiazine antiemetics
Extra-pyramidal effects (dyskinesia and CNS symptoms)
237
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. Meclizine (Antivert)
238
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
D. Constipation
239
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
B. Tachycardia
240
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
C. Improvement of cognition and function
241
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
C. bethanechol
242
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)
B. Methocarbamol (Robaxin)
243
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. "This will likely make you drowsy, so don't take it before doing anything that would require alertness."
244
Which medication would the nurse expect to administer if
prescribed to achieve skeletal muscle relaxation?
A. Baclofen
B. Allopurinol
C. Alendronate
D. Hydroxychloroquine
A. Baclofen
