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Pharmacology Flashcards

1
Q

average peak times for PO, IM, IV

A

1-2 hours
1 hour
30 mins

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2
Q

what is a trough level and when is it drawn

A

the lowest concentration of the drug obtained 15 mins prior to giving the next scheduled dose.

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3
Q

how to prevent infiltration and how to treat

A 
Prevent by using the smallest catheter possible. 
Treatment: 1. stop infusion
2.cold compress
3.elevate
4.new IV in opposite extremity
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4
Q

how to treat extravasation

A
  1. stop infusion
  2. aspirate drug if possible
  3. cold compress
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5
Q

Prevention and treatment of Phlebitis

A 
Prevent
1.rotate site every 96 hours (5 days)
2.avoid excessive activity with extremity
Treatment
1.stop
2.Hot compress
3.new IV in opposite extremity
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6
Q

embolus treatment

A
  1. apply tourniquet high on extremity to limit venous flow

2. prepare for xray removal

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7
Q

complications of CVC

A
  1. pneumothorax
    - give oxygen
  2. Air embolism
    - place in left lateral trendelenburg and administer oxygen
  3. Lumen occlusion
    - use a 10 mL syringe with a pulsing motion
  4. Infection
    - change entire infusion system, get cultures
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8
Q

how to prevent air embolism during CVC therapy

A
  1. have client lie flat when changing set or connectors

2. ask client to perform valsalva

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9
Q

complications associated with PICC line

A
  1. catheter occlusion
    - reposition arm
    - confirm blood return
    - flush regularly
  2. Catheter dislodges
    - watch for discomfort in jaw, chest, or ears
  3. Phlebitis
    - apply heat
  4. Catheter embolism
  5. Infection
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10
Q

TPN

A
  1. need to verify with another nurse
  2. daily weights and I&Os
  3. accu check every 4-6 hours
  4. dressing change every 3 days
  5. tubing change every 24 hours
  6. admin D10W if TPN is temporarily unavaiable to prevent hypoglycemia
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11
Q

Antidotes

  1. acetaminophen
  2. benzodiazepine
  3. curare
  4. Cyanide poisioning
A
  1. Acetylcysteine
  2. flumazenil
  3. edrophonium
  4. methylene blue
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12
Q

More antidotes

  1. Digitalis
  2. Ethylene poisioning
  3. Heparin and enoxaparin
  4. Iron
A
  1. Digoxin immune FAB
  2. Fomepizole
  3. protamine sulfate
  4. deferoxamine
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13
Q

More antidotes

  1. Lead
  2. Magnesium sulfate
  3. Narcotics
  4. Warfarin
A
  1. Succimer
  2. Calcium gluconate 10%
  3. Naloxone
  4. Phytonadione (Vitamin K)
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14
Q

Theraputic drug levels

  1. Aminophylline
  2. Carbamazepine
  3. Digoxin
  4. Gentamicin
A
  1. 10-20 mcg/mL
  2. 5-12 mcg/mL
  3. 0.5 - 0.8 ng/mL
  4. 5-10 mcg/mL
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15
Q

theraputic drug levels

  1. Lidocaine
  2. Lithium
  3. Magnesium sulfate
  4. Phenobarbital
A
  1. 1.5 - 5.0 mcg/mL
  2. 0.4 - 1.4 mEq/L
  3. 4 - 8 mg/dL
  4. 10-30 mcg/mL
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16
Q

Theraputic drug levels

  1. phenytoin
  2. theophylline
  3. Tobramycin
A
  1. 10-20 mcg/mL Salicylate: 100 to 250 mcg/mL
  2. 10-20 mcg/mL
  3. 5-10 mcg/mL
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17
Q

Trough levels

  1. gentamicin
  2. Tobramycin
  3. Vancomycin
A
  1. 1-2 mcg/mL
    2.1-2 mcg/ml
    15-20 mcg/mL
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18
Q

drug suffixes
1.calcium channel blockers

  1. erectrile dysfunction
  2. anesthetics
  3. ACE inhibitors
  4. Benzo
  5. Antilipidemic
  6. Corticosteroids
  7. Bblockers
A
  1. dipine
  2. afil
  3. caine
  4. pril
  5. pam, lam
  6. statin
  7. asone/ solone
  8. olol
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19
Q

Drug suffixes

  1. Penicillin
  2. Oral hypoglycemics
  3. PPIs
  4. antivirals
  5. thrombolytics
  6. antiemetics
  7. bronchodilators
  8. anticoagulants
A
  1. cillin
  2. ide
  3. prazole
  4. vir
  5. ase
  6. azine
  7. phylline
  8. arin
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20
Q

Drug suffixes

  1. antiulcers
  2. antihistamine
  3. antibiotic
  4. aminoglycoside
  5. Antibiotic
  6. TCAs
  7. SSRIs
A
  1. dine
  2. zine
  3. cycline
  4. mycin
  5. floxacin
  6. tyline
  7. pram/ ine
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21
Q

what is the number 1 cause for venous spasm and how do fix it

A

the infusion is to cold therefore warm it.

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22
Q

who should avoid hot tubs and saunas

A

HTN patients

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23
Q

action of ACE inhibitors and ARBs

A
  1. blocks the conversion of angiotensin 1 to angiotensin 2

2. blocks the binding of angiotensin 2 to receptors

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24
Q

uses of ACE and ARBS

A
  1. HTN
  2. HF
  3. MI
  4. diabetic nephropathy
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25
Q

ACE precautions

A
  1. use with caution if diuretic therapy is in place

2. monitor potassium levels

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26
Q

side effects ACE inhibitors

A
  1. nonproductive cough
  2. angioedema
  3. should not be used after first trimester of pregnancy
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27
Q

interventions ace inhibitors

A
  1. captopril should be taken 1 hr BEFORE meals
  2. monitor BP
  3. treat angioedema with 0.5 mL of 1:1000 epi administered SubQ
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28
Q

prototypes calcium channel blockers

A
  1. nifedipine
  2. verapail
  3. diltiazem
  4. amlodipine
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29
Q

Calcium channel blocker uses

A
  1. angina and HTN

2. verapamil and diltiazem may be used for Afib, A flutter, or SVT

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30
Q

main sign of salicylsim

A
  1. tinnitus
  2. sweating
  3. headache
  4. dizziness
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31
Q

phenytoin can decrease the effectiveness of which drug?

A

oral contraceptives by stimulating hepatic medication metabolizing enzymes

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32
Q

people with penicillin allergies are probably also allergic to which antibiotic class

A

cephalosporins

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33
Q

risedronate interventions

A

Actonel

  1. need to remain upright atleast 30 mins after admin to minimize esophagitis
  2. take on empty stomach atleast 30 mins before
  3. drink plenty of water with medication to minimize esophagitis
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34
Q

what class of drug are OTC oral decongestants

A

Sympathomimetics
they activate the sympathetic nervous system causing constriction of blood vessels which relieves congestion. topical nasal decongestants should be limited to 5 days to prevent rebound congestion

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35
Q

what kind of drug is tranylcypromine

A

aka Parnate is a MAOI

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36
Q

What kind of antibiotic is Doxycycline and what is a major consideration

A

(Doxycin) is a tetracycline and should not be used during pregnancy b/c of its adverse effects on developing bones and teeth

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37
Q

Statins interventions

A
  1. Monitor Creatinine kinase (CK) and for muscle pain
  2. do not drink grapefruit juice
  3. take it at night b/c cholesterol production generally increases overnight
  4. minimize alcohol
  5. expect to take it lifelong
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38
Q

phenytoin interventions

A
  1. theraputic level is 10-20
  2. avoid calcium foods as they decrease absorption
  3. check for gingival hyperplasia
  4. report Nystagmus immediately
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39
Q

Exenatide class and interventions

A

(Byetta) is an incretin mimetic and can cause pancreatitis which should be reported immediately

40
Q

Tamoxifen SEs

A

A estrogen blocker

  1. Menstrual irregularities
  2. Hot flashes
  3. Vaginal discharge
41
Q

ranitidine safety concern

A

it decreases gastric pH which increases the risk of bacterial colonization of the stomach and secondarily the respiratory tract leading to pneumonia. watch for green/yellow sputum

42
Q

what is zidovudine and what is the most serious side effect of Zidovudine

A

(Retrovir) is an antiviral that can cause severe anemia

43
Q

what would indicate toxicity of procainamide

A

(pronestyl)

A QRS widening greater then 50% you can also look for a prolonged QT interval

44
Q

Ergotamine interventions

A
  1. take on the onset of headache or aura

2. up to 3 tablets i na 24 hour peroid

45
Q

what is pilocarpine and what are the interventions

A

it is a cholinergic agonist and causes constriction of the pupil leading to decreased ICP when used as an eye drop.

  1. can interefre with vision temporarily so dont drive until vision clears
  2. can cause eye pain but this usually goes away within 2 weeks
  3. Lifelong medication
46
Q

allopurinol drug interaction

A

Intereferes with hepatic drug metabolizing enzymes that are responsbile for inactivating warfarin thereby increasing warfarin levels.

47
Q

name a centrally acting alpha 2 agonist then name a alpha drenergic blocker then name a sulfonylurea

A
  1. clonidine
  2. -zosin
  3. -zide
48
Q

how do the following diuretics work

  1. osmotic diuretics
  2. potassium sparing
  3. loop
  4. thiazide
A
  1. reduce ICP and IOP by raising serum osmolality and drawing fluids back into the vascular and extravascular space
  2. block the action of aldosterone(which causes sodium and water retention) which results in potassium retention and secretion of sodium and water
  3. work on the ascending loop of henle blocking the reabsorption of sodium, chloride and water.
  4. work in the early parts of the distal convoluted tubule to block reabsorption of of sodium, chloride, and water.
49
Q

what do the following drugs do

  1. oprelvekin
  2. sargramostim
  3. epoetin alfa
  4. filgrastim
A
  1. thrombopoietic growth factor that increases the production of platelets
  2. acts on bone marrow to increase neutrophils, monocytes, macrophages, eosinophils
  3. increases RBCs
  4. stimulates bone marrow to increase only neutrophils
50
Q

precautions for calcium channel blockers

A
  1. use cautiously for patients taking drugs that lower HR (digoxin and bblockers)
  2. contraindicated in HF, heart block, sinus brady
  3. do not drink grapefruit juice
51
Q

Calcium channel blockers SEs

A
  1. reflex tachycardia
  2. constipation
  3. peripheral edema
52
Q

Alpha blockers prototypes

A
  1. prazosin

2. doxazosin

53
Q

alpha blockers action

A

block alpha 1 adrenergic receptors resulting in peripheral arterial and venous dilation

54
Q

uses of alpha blockers

A
  1. HTN

2. doxazosin may be used for BPH

55
Q

alpha blockers interventions

A
  1. dont use with NSAIDs b/c they reduce the effect of prazosin
  2. need to taper off to prevent that reflex tachycardia
56
Q

centrally acting alpha 2 agonists action

A

stimulates alpha 2 receptors in the brain to reduce

  1. peripheral vascular resistance
  2. HR
  3. systolic and diastolic pressure
57
Q

centrally acting alpha 2 agonists prototype

A
  1. clonidine
  2. methyldopa
  3. Guanfacine
58
Q

centrally acting alpha 2 agonists uses

A
  1. HTN
  2. HTNive crisis
  3. severe cancer pain (via epidural)
59
Q

centrally acting alpha 2 agonists interactions

A
  1. contraindicated with anticoagulant therapy
  2. contraindicated in hepatic failure
  3. contraindicated with MAOIs
  4. do not admin methyldopa in the same line as a barbiturate or sulfonamide
  5. do not use during lactation
60
Q

centrally acting alpha 2 agonists SEs

A
  1. dry mouth
  2. sedation (resolves over time)
  3. rebound HTN
  4. black or sore tongue
  5. leukopenia
61
Q

centrally acting alpha 2 agonists interventions

A
  1. monitor CNS
  2. monitor CBC, HR, BP
  3. monitor weight (edema)
  4. monitor for rebound HTN for 48 hours after d/c
  5. notify provider of any involuntary jerky movements, prolonged dizziness, rash, or jaundice
62
Q

Bblockers actions

A 
inhibit stimulations of beta receptors resulting in
decreased
1.cardiac excitability
2.CO
3.myocardial oxygen demand
4.BP (decreasing the release of renin)
63
Q

where are beta 1 receptors found vs beta 2

A

beta 1 are primarily in cardiac and kidney tissue

Beta 2 are in lungs, GI, Liver, Uterus, Vascular smooth muscle and skeletal muscle

64
Q

ferrous sulfate teaching

A
  1. take on an empty stomach with vitamin C
  2. expect black stools
  3. increase your fiber intake
65
Q

acetazolamide SEs

A 
a carbonic anhydrase inhibitor which helps reduce the amount of fluid in the eye and reduce adverse symptoms when at high altitudes 
1.parasthsia 
2.diarrhea 
3.anorexia 
polyuria
66
Q

Clindamycin interventions

A

A macrolide which can cause

  1. jaundice
  2. watery diarrhea leading to c-diff
67
Q

tdap 5 step schedule

A

age 2,4,6
15-18 months
4-6 years

68
Q

Sumatriptin action and teaching

A

A serotonin agonist used to treat migranes. Serotonin causes vasoconstriction of blood vessels in the brain.
Patients should report
1.chest pain (coronary artery spasm)
2.sedation

69
Q

what is ketorolac

A

(Toradol) it is an NSAID

70
Q

what is amitriptyline

A

an anticholinergic

71
Q

what is epi

A

a beta adrenergic agonist

72
Q

myasthesia gravis

A

an autoimmune disease resulting in the breakdown of nicotinic acetylcholine receptors leading to weakness in voluntary muscles

73
Q

Neostigmine

A

A cholinesterase inhibitor which prevents the breakdown of acetylcholine and can reverse the effect of paralytic agents such as vecuronium. Because of the excessive muscarinic stimulation it can cause

  1. It can cause Miosis (pupillary constriction) leading to difficulty with accommodation
  2. increased salivation
  3. Urinary urgency
  4. bradycardia
74
Q

Neostigmine

A

A cholinesterase inhibitor which prevents the breakdown of acetylcholine and can reverse the effect of paralytic agents such as vecuronium. Because of the excessive muscarinic stimulation it can cause

  1. It can cause Miosis (pupillary constriction) leading to difficulty with accommodation
  2. increased salivation
  3. Urinary urgency
  4. bradycardia
75
Q

what is cyclobenzaprine

A

(flexeril) a muscle relaxor. should be tapered to prevent the return of the musculoskeletal condition and has anticholinergic effects

76
Q

Safety consideration for amphotericin B

A

an antifungal that can cause severe kidney damage which can lead to hypokalemia

77
Q

contraceptive patch teaching

A
  1. apply the patch within 7 days of menses to prevent ovulation
  2. apply the patch once a week for 3 weeks then no patch for 1 week to promote menstruation
  3. fold the sticky sides of the old patch together for disposal
78
Q

what lab value should you check before giving an antipsychotic such as clozapine…. what about after?

A

total cholesterol level b/c it can cause hyperlipidemia. After the drug is started CBC should be monitored as the drug can cause agranulocytopenia and myalgia

79
Q

statin teaching

A
  1. report muscle pain and avoid grapefruit juice as this can increase the risk for muscle injury
  2. take it at night b/c cholesterol production generally increases over night
80
Q

what is a contraindication to taking ciprofloxacin. What is an adverse effect of this medication.

A

a quinolone should be taken if patient has tendonitis. This med can also cause diarrhea

81
Q

what do the sulfonylureas end in

82
Q

what drugs cause accelerated inactivation of oral contraceptives

A

anti-epileptics

83
Q

isotretinoin uses and contraindications

A

Vitamin A derivative used for acne. Contraindicated in pregnancy

84
Q

what is Xanthopsia

A

causes vision to appear yellow. most common in digoxin toxicity and cataracts which can form from digoxin

85
Q

TCA SEs

A

anticholinergic

  1. dry mouth, eyes
  2. photosenstivity (due to dilation of pupils)
  3. urinary retention/hesistancy
  4. constipation
  5. decreased libido
86
Q
  1. name vitamins B1
  2. B2
  3. B6
  4. Folic acid and why they are important
A
  1. Thiamine
    - defiency can cause beriberi or Wernicke-Korsakoff syndrome
  2. Riboflavin
    - can help treat migraines
  3. Pyridoxine
    - Can help Pts who are predisposed to neuropathy from diabetes or alcohol
87
Q

What is dantrolene

A

A direct acting skeletal muscle relaxer used for the prevention and treatment of malignant hyperthermia. You should dilute this medication with 60 mL of sterile water without a bacteriostatic agent (prevents the reporduction of bacteria) and inject rapidly

88
Q

Isoniazid safety considerations

A
  1. hepatotoxic

2. retino toxic

89
Q

ranitidine teaching

A

hepatotoxic

90
Q

what is Bisacodyl

A

A stimulant laxative. Works mostly on the large intestine

  1. take it at night b/c it takes 8 hours to work. Once it starts it works very quickly
  2. do not take with antacid or milk as it may destroy the coating and irritate the stomach
91
Q

what common drug can significantly increase lithium levels

92
Q

major risk with fluoxetine

A

1.decreased platelet aggregation

93
Q

why is betamethasone given to mothers in labor

A

to promote the development of fetal lungs by stimulating surfactant production

94
Q

what assessment is critical for patients that are receiving mannitol and why

A

lung sounds b/c it can precipitate HF -> pulmonary edema

95
Q

during an acute infection what would you expect a dr to do to a client who is on long term prednisone

A

increase the dose.

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