Pharmacology

Question 1

cyclobenzaprine hycrochloride (Flexeril)

Answer 1

skeletal muscle relaxant; side effects include drowsiness, dizziness, nervousness, urinary retention, rash, arrhythmias; nsg- caution with ambulation, esp with older adults, advise pt to avoid alcohol, sleep-inducing, or OTC drugs

Question 2

Mixing Insulin

Answer 2

to combine reg insulin with NPH insulin in the same syringe, draw the same amt of air into the syringe as NPH insulin, inject this air into the NPH bottle, withdraw needle, draw same amt of air into syringle as reg insulin, inject into reg insulin bottlw, draw up reg insulin first to avoid contaminating the reg vial with NPH, which potentially decreses the effectiveness of the reg insulin, insert needle into NPH bottle and pull plunger down until it equals the total amt of prescribed insulin. Draw clear before cloudy (nph=cloudy)

Question 3

pilocarpine

Answer 3

miotic eye prep, causes pupil constriction which opens channels for aqueous humor drainage, relieving glaucoma pressure. Also used to counteract mydriatic drugs in surgery and ophlalmoscopic exams. SEs= painful eye muscle spasm, blurred or poor vision in dim light, photophobia. NSG= apply light pressure on the lacrimal sac for 1 min after medication instilled

Question 4

spironolactone (Aldactone)

Answer 4

diuretic, potassium sparing; often used with other diuretics and antihypertensive agents; SEs= hyperkalemia, hyponatremia, rash, dizziness, HA, deepening of voice, hirsutism. NSG= monitor electrolytes, give with meals and not at bedtime, avoid salt substitutes containing potassium, limit foods high in potassium, weigh pt daily, I&Os

Question 5

Retrovir

Answer 5

antiviral; used in HIV infection and prevention of maternal to fetal HIV transmission; SEs= anemia, HA, GI upset, paresthesias, dizziness, insomnia, agranulocytosis. NSG= teach pt to comply strictly with dosage sched

Question 6

Scchedule Drugs

Answer 6

classification system categorizing drugs by their potential for abuse or addiction. Schedule 1 has highest potential, schedule V has lowest potential; Schedule 2 drugs have high potential for abuse and severe psychological or physical dependence; require nonrenewable prescription; have legit medical use (unlike sched 1, which do not). Sched 2 drugs include amphetamines, cocaine, meperidine, morphine, secobarbital

Question 7

Risperidone

Answer 7

atypical antipsychotic. Appears to improve neg symptoms of schizophrenia, such as blunted affect, emotional withdrawal, apathy. SEs= HA, drowsiness, orthostatic hypotension, dry mouth, rhinitis, photosensitivity, sexual dysfunction, arrhythmias, neuroleptic malignant syndrome

Question 8

isosorbide dinitrate (Isordil)

Answer 8

nitrate vasodilator used in tx and prevention of angina. SEs= HA, dizziness, weakness, postural hypotension, syncope, flushing, N/V. NSG= sublingual tab used, teach to sit, place tab under tongue or in buccal pouch, do not chew or swallow, if pain not relieved with first tab, can repeat at 5-10 min intervals to maximum of 3 doses, if not relieved get emergency help

Question 9

Isoniazid (INH)

Answer 9

antituberculosis agent. SEs= toxic hepatitis, peripheral neuritis, rash, fever, blood dyscrasias, GI upset, local irritation at injection site; NSG= include teach signs of hepatitis, check liver function tests, monitor for resolution of TB symptoms, give before meals on empty stomach, give pyridoxine (vit B6) as ordered

Question 10

Metered Dose Inhaler and Dry Powder Inhaler

Answer 10

give bronchodilators first; remove cap and shake inhaler vigorously five or six times immediately before use; breathe out all the way, then put the inhaler in the mouth 1-2 inches in front of the mouth and depress the inhaler while inhaling deeply and slowly 3-5 secons; hold breath for several seconds after inhalation is complete; exhale slowly through pursed lips. If repeating, wait 2-5 mins, rinse mouth with water after steroids

Question 11

Aluminum Hydroxide (Amphojel)

Answer 11

antacid that neutralizes gastric acids, raises gastric pH, inactivates pepsin. SEs= constipation that may lead to impaction, phosphate depletion, acid rebound btwn doses, metabolic acisosis; NSG- encourage fluids, monitor for sx of phosphate deficiency (malaise, weakness, tremors, bone pain). assess whether pt is on sodium restricted diet, as med contains sodium

Question 12

morphine sulfate/hydroxyzine (Vistaril)

Answer 12

Morphine SEs= frequent dizziness, hypotension, sedation, disorientation, N/V, constipation, urinary retention, resp depression, bradycardia, cardiac arrest. Vistaril is an antianxiety, antihistamine med. SEs= sedation, drowsiness, HA, dry mouth, wheezing, dyspnea. NSG= Z-track technique for IM admin, scrupulous mouth care if given orally. Both morphine and vistaril can be used for preoperative sedation and forsupport of anesthesia

Question 13

haloperidol (Haldol)

Answer 13

antipsychotic; SEs= EPS, TD, blurred vision, dry mouth, dystonic reactions treated with IV benadryl

Question 14

Iron Supplements

Answer 14

SEs= nausea, constipation, black or dark green stools; NSG= monitor hgb and hct, dilute liquid prep in juice but not milk or antacids; use straw to avoid staining teeth

Question 15

Potassium

Answer 15

SEs= n/v/d, abdominal pain, confusion, paresthesias, muscle weakness, flaccid paralysis, oliguria, resp distress, dysrhythmias, cardiac arrest. NSG= monitor I&Os and EKG and serum electrolytes, client education: avoid potassium sources in foods, including salt subs and licorice

Question 16

acetylsalicylic acid (Aspirin)

Answer 16

SEs= bleeding, hemorrhage, heartburn, nausea, salicylism including tinnitus, urticaria, bronchospasm, anaphylactic shock. NSG= observe for bleeding gums, bloody stools, blood in urine, hemoptysis, bruises, give with milk, water, or food, use enteric coated tabs to minimize gastric distress

Question 17

cimetidine (Tagamet)

Answer 17

histamine H2 antagonist, inhibits gastric acid secretion and decreases total pepsin output. SEs= diarrhea, confusion and dizziness, HA, dysrhythmias. NSG= avoid antacids within 1 hour of dose, be alert to onset of confusion, bedtime doses suppress nocturnal acid production, compliance may increase with single dose regimen

Question 18

Stomatitis

Answer 18

inflammation of the mouth, lips, tongue, mucus membranes. NSG= provide symptomatic tx, oral hygiene, admin oral or systematic analgesics

Question 19

prednisone

Answer 19

short-acting synthetic steroid given for severe inflammation or immunosuppression. SEs= hyperglycemia, gastric and duodenal ulcers, muscle wasting, fluid retention, K+ excretion, moon face. NSG= assess for diabetes and ulcers, monitor BP and labs, check for infections

Question 20

Instilling Eye Medication

Answer 20

instruct client to look at ceiling, expose lower conjunctival sac, drop eye med approximately 1/2 to 3/4 inch above conjunctival sac, ask client to close eye, apply gentle pressure to nasolacrimal duct for 30 sec if med causes systemic effects

Question 21

ABO compatability

Answer 21

A, B, AB, O. O is universal donor to O, A, B, AB but can only receive type O blood. A can donate to A and AB and can receive from O and A, B can donate to B and AB and can receive from O and B, AB is universal recipient but can only donate to AB

Question 22

heparin

Answer 22

inactivates thrombin and prevents conversion of fibrinogen to fibrin; leave needle in place for 10 s and don’t massage after SQ; dosage is adjusted according to PTT, therapeutic range is 1.5- 2 times the normal value, SEs= hemorrhage with excessive dosage, thrombocytopenia, hypersensitivy reactions. Antagonist= protamine sulfate

Question 23

Tegretol

Answer 23

anticonvulsant. SEs= myelosuppression, dizziness, drowsiness, ataxia, diplopia, rash. NSG= supervise ambulation, monitor CBC, take with meals and wear protective clothing due to photosensitivity, do not decrease dose or discontinue abruptly