Pharm week 10

Question 1

How long is replacement therapy for hypothyroidism

Answer 1

lifelong

Question 2

what is used to evaluate progress of hypothyroid therapy

Answer 2

serum TSH levels

Question 3

Vasopressin analog

Answer 3

desmopressin, vasopressin

Question 4

action of vasopressins

Answer 4

increase the reabsorption of water

Question 5

side effects of vasopressins

Answer 5

symptoms of water intoxication*, drowsiness, headache leading to coma and death

Question 6

contraindications of vasopressins

Answer 6

caution in patients with CAD, HTN, hyponatremia*

Question 7

drug effects of vasopressins

Answer 7

increased effect of ADH with NSAIDs; decreased effect of ADH with ETOH, heparin

Question 8

Thyroid hormone

Answer 8

levothyroxine

Question 9

adverse effects of levothyroxine

Answer 9

rare; palpitations, dysrhythmias, anxiety, insomnia, weight loss, heat intolerance

Question 10

nursing for levothyroxine

Answer 10

same time every day in a.m. on empty stomach to prevent insomnia; monitor pulse- hold/call MD if > 100; teach patient med is lifelong

Question 11

drug effects of levothyroxine

Answer 11

increases effects of warfarin; antacids reduce absorption- take 4 hrs apart; antidepressants and anticonvulsants can reduce absorption

Question 12

antithyroid drug

Answer 12

methimazole

Question 13

adverse effects of methimazole

Answer 13

agranulocytosis

Question 14

drug effects of methimazole

Answer 14

increased effects of warfarin, increased effects of digoxin

Question 15

nursing for methimazole

Answer 15

symptoms of hypothyroidism; teach patient to call doctor if fever or sore throat develops; do not stop med abruptly; assess for iodism (vomiting, abdominal pain, metallic taste, sore gums)
Labs: CBC, T3, T4, TSH

Question 16

overdose of methimazole

Answer 16

thyroid hormone, atropine for bradycardia

Question 17

corticosteroid

Answer 17

hydrocortisone, prednisone, dexamethasone

Question 18

side effects of corticosteroids

Answer 18

sodium & fluid retention; CNS(insomnia, anxiety, headache, vertigo, confusion, depression), adrenal suppression, infection, long term can cause PUD & Cushing’s Syndrome

Question 19

nursing for corticosteroids

Answer 19

give at the same time every day with food; if given for more than 2 weeks, must taper dose

Question 20

drug interactions for corticosteroids

Answer 20

NSAIDs and ETOH can increase risk of PUD; anticoagulants can increase or decrease anticoagulants, vaccines can reduce antibody response

Question 21

short-acting hypoglycemic drug

Answer 21

human regular insulin (Humulin R, Novolin R)

Question 22

adverse effects of insulin

Answer 22

Hypoglycemia, tachycardia, confusion, sweating, drowsiness, weight gain

Question 23

nursing for insulin

Answer 23

administer 30 minutes before meals, rotate sites; this is the only insulin that can be given IV

Question 24

Labs for insulin

Answer 24

monitor potassium; insulin can worsen hypokalemia

Question 25

insulin overdose

Answer 25

glucagon, glucose

Question 26

insulin potentiates

Answer 26

ETOH, ASA, MAOI

Question 27

insulin antagonists

Answer 27

corticosteroids, thyroid hormone, epinephrine

Question 28

drugs that may increase glucose

Answer 28

furosemide & thiazides; symptoms of hypoglycaemia may be masked with beta blockers

Question 29

biguanide

Answer 29

metformin

Question 30

adverse effects of metformin

Answer 30

diarrhea, abdominal discomfort, metallic taste, and anorexia

Question 31

nursing for metformin

Answer 31

check fasting blood glucose every 3 months

Question 32

contraindications of metformin

Answer 32

those with renal impairment because the drug can rise to toxic levels

Question 33

drug interactions with metformin

Answer 33

must hold drug for 2 days prior and 2 days after iodine-radiocontrast dye

Question 34

metformin overdose

Answer 34

hemodialysis