Pharmacology exam #3 - study guide Flashcards
Dermatological medications/conditions., Cardiac drugs, Antimicrobial medications, Autonomic Nervous System
Acne Vulgaris
formation of papules, nodules and cysts on the facce, neck, shoulders, and back that results not from dirt but from keratin plugs at the base of the pilosebaceous oil glands near the hair follicles
Contact dermatitis
common form of eczema that results when skin is exposed to irritants or allergens
Keratitis
infection and inflammation of the cornea
Keratolysis
horny cell cohesion due to bacterial growth
Macules
flat with varying colors <1 cm
Papules
raised solid not fluid <1cm
Plaques
hard, rough, raised and flat on top
Psoriasis
Multisystem disease with predominant skin and joint disorders
Vesicles
raised, filled with serous fluid, <1cm
what are the different classes of anti-acne drugs for acne vulgaris
Keratolytic (keratin dissolvers)/ Vitamin A derivatives/ Topical antibiotics/ Oral antibiotics/ Oral contraceptives/ Oral Vitamin A derivatives
what are some nonpharmacological approaches for acne vulgaris
prescribed or OTC cleansing agent, avoid vigorous scrubbing, well balanced diet, decrease stress
what is the purpose of benzoyl peroxide
what does salicylic acid do for the skin
exfoliates skin and dissolves skin buildup that promotes inflammatory and non inflammatory acne
keeps the pores clear
examples of keratolytics (keratin dissolvers)
Benzoyl Peroxide, salicylic acid, azelaic acid
how long does it take to see results from benzoyl peroxide
4-6 weeks for the full effect for the resolution of acne
what types of classes of drugs are used for mild to moderate acne
Keratolytics
what is given to treat pharmacologically severe acne
Oral antibiotics
+doxycycline
+minocycline
+tetracycline
{think -cycline antibiotics for severe acne}
Topical glucocortoids
systemic approach isotretinoin
what are the side effects of isotretinoin
Pruritis, nosebleeds, inflammation of eye/lips, teratogenic effects
ADVERSE EFFECTS
Exacerbation of depression. suicidal behaviors
preventable measures
monitoring of bloodwork
what is part of isotretinoin
IPLEDGE program to promise you will not become pregnant on the medication and your birth control will have 2 types of contraceptives.
what are some characteristics of psoriasis
chronic autoimmune skin disorder/ erythematous papules and plaques covered with silvery scales/ appears on scalp, elbows, palms of hands, knees, and soles of feet/ epidermal cell growth and turnover are accelerated @5x the normal rate/ periods of remission and exacerbation
what are some non pharmacological approaches for psoriasis
Ultraviolet light
UVA & UVB
what are some pharmacological approaches for psoriasis mild to moderate
Keratolytic, topicl glucocortoids, other topicals (anthralin, calcpotriene, tarzotene, coal tar), phototherapy,
what are some pharmacological approaches for severe psoriasis
Systemic biologic response modifers
(methotrexate, cyclosproine, tumor necrosis factor inhibitors, alefacept, inflixamab, adalimumab,
ustekinumab)
monoclonal antibodies -mab
pharmacological approach for verruca vulgaris
salicyclic acids, podophyllum resin
give an examples of different medications that can cause drug-induced dermatitis
Penicillin hypersensitivity, mood stabilizer/ anticonvulsant therapy/ phenytoin, Lamotrigine
what are the characteristics of drug-induced dermatitis
Rash, urticaria, papules and vesicles
what are life thereatening drug-induced dermatitis
erythema multiforme/ steven-johnson syndrome/ toxic epidermal necrolysis
what is contact dermatitis
skin rash with itching, swelling, blistering, oozing, or scaling at the affected skin sites causes can be chemical (cosmetics, perfume, soap, dyes) or from plants (poison ivy, oak and sumac)
non pharmacological measures for contact dermatitis
Avoid direct contact, protective clothing, oatmeal baths, oil stripping soaps
Pharmacological approach for contact dermatitis
alumium acetate/ calamine lotion/ glucocortiod oitments, creams or gels such as dexamethasone
different sunscreens
Chemical (absorbs UV radiation)/ Physical (scatter UV radiation)
Sunscreen after applied 30 minutes before going outside the sunscreen gives protection for 2 hours
what the different degree of burns
First, seconf, third
what are first degree burns
Superficial epidermal (erythema, painful)
what are second degree burns
Deep thickness (blistering, very painful)
what are thrid degree burns
full thickness (pearly white skin, charred, may have no pain)
topical drugs for burns
Mafenide/ silver sulfadiazine
Mafenide
used for treatment of burns
SE/ AE:
burning sensation, blistering, superinfection, metabolic acidosis
why would you be taking an antihyperlipidemic?
If the patients serum lipid values HDL >60, LDL <100, Cholesterol 150-200, and triglycerides 40-150.
The patients genetics
Some of the modifiable factors of the patient is Diet (reduce saturated fat adn total cholesterol), Smoking, exercise
Nursing contraindications of antihyperlipidemic
If the patient has a liver disorder or Pregnant clients
Antihyperlipidemic
-statins
inhibits cholesterol synthesis in the liver and decreases the concentration of cholesterol, decreases LDL, and slightly increases HDL cholesterol.
Reduction of cholesterol can be seen as early as 2 weeks after initiating therapy.
what should the nurse monitor for in statins?
Serum lab values (fasting / Q3-6 months), liver function, diet modification, sudden onset of weakness (Rhabdomyolysis)
why would you have a patient on Diuretics?
Heart failure from hypertension from fluid overload/ to promote sodium and chloride reabsorption=decrease in volume/ Edema (fluid overload
Some renal and liver disorders
what are the different classes of diuretics
Loop, Thiazide (thiazide-like), Potassium-sparing, Osmotic, Carbonic anhydrase inhibitors
what is the ending for loop diuretics
-semide
what is the ending or suffix for thiazide diuretics
thiazide
what can loop diuretics affect in the patient
affect blood glucose levels, increase uric acid production so be cautious with patients who have gout, can cause depletion of water and electrolytes so watch for electrolyte imbalance
what are the different classes of antihypertensives
Beta-blockers, Calcium channel blockers, angiotensin-converting enzyme inhibitors, angiotensin II- receptor blockers, Alpha-adrenergic blockers, Vasodilators, Diuretics
what is the ending for beta-blockers? and what is important to teach and assess on a patient prescribed a beta-blocker?
-olol
Teaching: do not abruptly discontinue medication can cause rebound hypertension, Never use in patients with heart blocks, Avoid OTC drugs while taking beta blockers
Assessment: check Labratory values BUN, Serum creatinine, AST, LDH, obtain the patients drug history OTC and herbal, vital signs this medication can decrease blood pressure and also in rare occassions cause bronchial constriction leading to Respiratory distress
What is the first line antidote for beta-blockers considered
When symptomatic bradycardia and hypotension are present a high-dose of glucagon is the first line antidote
What are the side effects and adverse effects of Beta-blockers
SE: decreased pulse rate, markedly decreased blood pressure
(from abrupt discontinuation of medication can cause palpitations, arrhythmias and angina with the hypertension)
AE: Respiratory distress
What is the ending and suffix for Calcium channel blockers? what patients do you not give calcium channel blockers to and what do you watch for when you administer the medication?
-tiazem,-ipine
Patients with an AV block
prevent vasospasm
Watch the heart rate
what are the side effects of the medication and what would you teach a patient about calcium channel blockers?
SE: flushing, headache, and dizziness
AE: ankle edema, bradycardia, and AV block
Teaching: rise slowly when sitting to standing it can cause a dramatic drop in blood pressure upon standing, when you take any cold medicines read the label to check if the OTC medication has pseudoephedrine and phenylephrine as this can decrease the effects of medication lowering your blood pressure
what is a common calcium channel blocker by mouth
Amlodipine
what is the ending for Angiotensin-Converting Enzyme Inhibitors? what are the side effects and adverse effects of the medication?
what would you teach the patient about this medication?
explain this medication
-pril
SE: dizziness, headache, blurred vision, and weakness
AE: Angioedema, Dry nagging cough,
Teaching: if you start to experience a nagging dry cough contact us immediately so we can put you on an alternative medication, if you are to become pregnant call your provider for an alternative medication to regulate your blood pressure, If the dizziness persists past the second week call your provider immediately.
these cause little change in heart rate/ these are the first line of antihypertensive therapy
this medication should not be taken with potassium sparing diuretics due to increased risk of hyperkalemia
what are some important lab value ranges to know for cardiac medications?
BUN
Potassium K
what cardiac medication lower the heart rate?
Beta blockers, calcium channel blockers, Angiotensin II- Receptor blockers.
what cardiac medication can possibly increase the heart rate
Alpha-adrenergic blockers
what is the ending for angiotensin II receptor blockers? Purpose or action made to lower blood pressure? side effects v adverse effects? what to teach the patient? what is it combined with often?
ending : -artan
Side effects: dizziness, drowsiness, cough, palpitation, blurred vision, erectile dysfunction
Adverse effects: Orthostatic hypotension,chest pain, hyperkalemia, rhabdomyolysis
Purpose: vasodilate and decrease peripheral resistance
often combined with HCTZ
what are some examples of vasodilators?
Alpha-Adrenergic blockers, Hydralzine, Antianginals
what is an examples of cardiac glycosides? what is the purpose of cardiac glycosides? what are the side effects and adverse effects?
Digoxin
Purpose: treat heart failure when the heart is too weak it increases contractility, but decreases the heart rate
Side effects: anorexia, nausea, vomiting, headache, weakness
Adverse effects: bradycardia, hallucinations, palpitations
With this medication monitor vital signs and always check digoxin level it can become toxic and monitor kidney and liver
What are antianginals?
what are they used for? and what do they do to the body?
Nitrates, CCBs, Beta Blockers
what are they used for? used to treat angina pectoris ( acute cardiac pain caused by inadequate blood flow to the myocardium from plaque or spasms in coronary arteries)
what they do? increase supply of O2 or decreases O2 demand by the myocardium
what is an examples of a nitrate? what do they do? -what are they treatment for? when do you not give this medication? and common side effect?
Nitroglycerin
what they do: decreases myocardial demand and increases supply of O2
Treatment: acute MI, post heart Cath, chronic angina
do not give this medication if the patient has right ventricular infarction or phosphodiesterase inhibitor use within 48 hours
what are antidysrhythmics? what are their purpose?
Beta blockers, calcium channel blockers, sodium channel blockers, and prolong repolarization such as adenosine and amiodarone
their purpose to correct the electrical activity of the heart
what is a sodium channel blocker
Lidocaine
what medications prolong repolarization
Adenosine/ Amiodarone
how do you administer adenosine for IV
Fast push and Fast flush
what should you know about antiarrhythmics at this point?
monitor vital signs and EKG, can cause low blood pressure/ Teach patient how to check thier heart rate/ avoid tobacco and caffeine/ sleep study sleep apnea can cause arrhythmias
what is the only class of diuretics that do not lower a persons potassium
Potassium Sparing - Spironolactone
what is an osmotic diuretic
Mannitol
decreases intracranial pressure and used with extreme caution in HF patients
what do carbonic anhydrase inhibitors do
decrease intraocular pressure
what are the signs of electrolyte imbalance
muscle weakness and/or cramps, Cardiac arrhythmias, Diet (alcohol, salt)
what is the normal range for potassium
3.5-5.0
what is the normal range for Magnesium
1.3-2.1
what is the normal range for sodium
136-145
what is the problem identifications for furosemide
Fluid volume overload, decreased cardiac output, Fluid and electrolyte imbalance
what is education you will provide to a patient starting furosemide?
take in the morning preferably with food, monitor vital signs and weight and urine output, watch for signs of electrolyte imbalance, and manage diet and promote mobility to reduce edema.
what are some of the differences between thiazide diuretics and loop diuretics
more cost effective, loop diuretics provide faster diuresis and work faster in patients with heart failure, but thiazides can be used first in patients.
what do you monitor when your patient is on antihyperlipidemic medication
Liver function (and rhabdomyolysis), pregnancy status and lipid panel
what are you supposed to educate you patient on who is taking antihyperlidemic medication
diet, exercise, smoking cessation, side effects of medication (gi upset, mobility issues)
bacteriostatic
inhibit the growth of bacteria
when can you give flu medications?
within 2 days that symptoms begin
-ivir
what antitubercular medication can you take daily only?
what antitubercular medication can you take once a week or daily?
Rifampin on an EMPTY stomach
Isoniazid once a week or daily
what is contraindicated with antitubercular medications
Hepatic disease
what is the antitubercular medication teaching consist of
the typical drug regimen will be from 2 months daily then 4 months of isoniazid + Rifampin 2-3 times per week
(1-6 month treatment follow as prescribed by provider)
Tuberculosis is what type of precaution
Droplet wear an N95 mask
Isoniazid adverse reactions? class of drug? teaching to patient?
class: antitubercular medication
Adverse reactions: can cause b12 deficiency, liver damage, when you check labs on the patient it is every month for the liver, interferes with birth control effectiveness
Teaching: this medication will change the color of your urine, tears, to a reddish brown color do not be alarmed by this it is normal/
this medication can stain contact lenses/
NEVER double up on the dose in a day take it the following next day to avoid doubling up on the medication schedule/
do not take with antacids as it can decrease the effectiveness of the medication.
what anti-infective cause ototoxicity?
-mycin medications and aminoglycosides
what medication do you not give to patients with renal failure
Macrotides, -mycin meds, aminoglycosides, antiviral flu medications, chloroquine, peptides
what are the mild symptoms of allergic reaction
rash, hives, itching
how do you administer antifungal nystatin?
oral or topical
swish the liquid in your mouth and then gargle or swallow within a few minutes
what do superinfections result from
antibiotics
broad spectrum antibiotic use
C diff+
what medications have a peak and trough level lab test
-mycin medications
(vancomycin, gentamycin)
what is the ending for tetracyclines? what are the side effects and adverse reactions of the medication? what is part of the teaching of this medication?
ending : -cycline
SE: N/V/D, photosensitivity,
AE: Superinfection,
Teaching:
do not take with penicillin medications, do not administer with a aminoglycoside (mycin medication)
what is the ending for influenza antiviral medications? what is the side effects and adverse effects of the medication? what is part of the teaching of the medication?
ending: -ivir
SE: dizziness, headache, insomnia, vertigo
AE: Delirium, self-injury
Teaching:
these are not substitutes for the influenza vaccine
what is the anitdote for aspirin
sodium bicarbonate
what is the antidote for acetaminophen
N-acetylcysteine
what is the anidote for warfarin
phytonadione (vitamin K)
what treats malaria? what are the side effects and adverse effects of the medication?
Chloroquine
SE:
AE:
what is the antidote for opiod
Naloxone
what is the antidote for heparin
protamine
what is antidote for iron
deferoxamine
what is the antidote for potassium
sodium polystyrene
what do you do if you are transfusing blood to a patient their vital signs before the transfusion was T 36.8 HR 90 RR 14 BP 112/72 after 30 minutes after the blood is transfused the vital signs are T 38.8 HR 110 RR 19 BP 98/80 what is the first priority action the nurse will perform
STOP THE BLOOD PRODUCT TRANFUSION
of blood and administer
Diphenhydramine and monitor IV site if it is not showing signs of redness or swelling maintain the IV line with normal saline
what are the transfusion reaction of blood products
Fever. chills, headache, low back pain, rash/hives, itching, tachycardia, tachypnea, decreased blood pressure
what are the medications used for antiheminthic?
Ivermectin
topical or PO
se: gi upset, wheezing
what are peptides and what is their spectrum of action and what are you supposed to monitor with this medication
Bacitracin/ Metronidazole
Broad spectrum bactericidal action (inhibits growth of bacteria)
Monitor:
Liver and kidney function (AST,ALT,BUN, creatinine clearance), I&O and altered level of consciousness
what are cephalosporins? SE and AE? what is part of the teaching of this medication?
ending or prefix: -ceph or -cef
SE: N/V/D, abdominal cramps, dizziness, edema
AE: superinfection, bleeding, palpitation
Teaching:
If you start to experience rash, itching or hives go to your emergency department because this is a mild allergic reaction and if it is not immediately treated it can prolong to anaphylactic shock, complete the course of medication as prescribed even if symptoms have stopped, eat some yogurt to prevent a superinfection of your intestinal flora, if you see any mouth ulcers or abnormal discharge from genital area report to doctor this could be another sign of yeast infection or a superinfection it must be treated.
if you are allergic to cephalosporin then what might you also be allergic to?
Penicillin
what are penicillin medications? Side effects and adverse reactions?
what is part of the teaching?
-cillin
SE: N/V/D, anorexia, tooth and tongue discoloration
AE: allergic reaction (rash, hives, itching), bronchoconstriction
Teaching:
decreased effectiveness of drug with acidic fruits and juices
what is the test given for antibacterials
C & S
sputum for flu/tb
what is the normal lab values for BUN
10-20
Normal creatinine
males 0-1.2 mg/dl
females 0.5-1.1 mg/dl
what are adrenergic antagonists?
give an examples of these medications
Beta-Blockers
examples (-olol)
Metoporol, labetalol
what is an examples of an adrenergic agonist
what is the purpose of this medication
what do I need to monitor for with this medication?
is this medication used long term?
Epinephrine
MOA: stimulate the sympathetic nervous system (think slow down and relax)
alpha1(hypotension), , beta1(HF, cardiogenic shock), and beta2 (bronchospasm)
Purpose: allergic reaction, cardiac arrest, hypotension, bradycardia
Vital signs, IV site, lung sounds to watch for Pulmonary edema and dyspnea, Cardiac rhythm, Peripheral blood flow, Urine output, FSBS for hyperglycemia.
This medication is a rescue medication is not meant to be used long-term
what are cholinergic medications? what do they do?
What to monitor for?
patient teaching will include what?
What is the antidote for cholinergic medications?
these are located in smooth muscles, heart, gi, gu, glands
they mimic the parasympathetic neurotransmitter acetylcholine
Metoclopramide (increase gastric emptying), Pilocarpine (constrict pupils reduces IOP), and bethanechol chloride (increase urination)
SYMPTOMATIC BRADYCARDIA
teaching: rise slowly when sitting to standing to prevent a significant drop in your blood pressure
ANTIDOTE: IV ATROPINE
what does anticholinergics do to the body? what is an examples of an anticholinergic? what can they be used for?
they increase your heart rate
Scopolamine patch
used to decrease involuntary movements in Parkinson’s, peptic ulcers, IBS
what do you monitor for in patients with anticholinergics - atropine
HR, cardiac rhythm this will not work in a patinet with heart block or 2nd degree block type 2, BP, urine output administration of medication can cuase urinary retention.
Problem identification
symptomatic bradycardia
what are some anticholinergic interventions?
monitor pupils, teach patient about avoiding OTC drugs that are contraindicated in glaucoma, no driving, use sunglasses (photophobia), provide interventions for constipation, urinary retention, and dry mouth
What food do you avoid when taking CCBs
Grapefruit
what medication do you avoid another mineral products with
Tetracyclines
-cycline
what different medications are antibiotics or antibacterials
Penicillin, Cephalosporins, Macrolides, Lincosamides/ glycopeptides, tetracylines, Aminoglycosides, Fluoroquinolones, SUlfonamides
what medications have a peak and trough level
Vancomycin and gentamycin
due to their narrow therapeutic index
what is the ending for aminoglycosides
what teaching would you include about aminoglycosides
-mycin but that does not include VANCOMYCIN
encourage patient to increase fluid intake unless they have a fluid restriction/
if you start to have any sudden problems with your hearing including hearing loss stop the medication immediately/
we will monitor your kidneys as well weekly to make sure your kidneys stay working properly
what is a medication for macrolides? what is the se and ae?
what would you include in the teaching of this medication?
-romycin (azithromycin/erythromycin)
SE: N/V/D, abdominal cramping,
AE: Superinfection
Teaching: avoid taking anything that contains acetaminophen it can cause damage to the liver/ this medication will mess with your stomach but if you experience more than 20 stools a day visit the doctor because this could be a sign of superinfection like clostridium difficile
what are the classes of vasodilators
Alpha-adrenergic blockers/ Hydralazine/ Antianginals
why would someone need to be on antihyperlipidemic
statin medication
what do they do
> 60 HDL
<100 LDL
cholesterol 150-200
Triglycerides 40-150
genetics
or modifiable factors that influence
they reduce cholesterol synthesis
what medication treat hepatitis B? what are the signs and symptoms? what is part of the patient education for this medication?
when the disease is chronic Adenovir
SE: N/V, increased bleeding time, rash, urticaria, anxiety
AE: Gingival Hyperplasia (red swollen gums)
TEACHING: maintain adequate fluid intake and counsel patient to use condoms during sexual encounters
What do they use to treat Hepatitis C if it becomes chronic?
Peginterferon and Rivabirin
what medication treats Malaria? what are the side effects and adverse effects what would you teach your patient about this medication?
Chloroquine Phosphate
SE: N/V/D, cramps, headache, photosensitivity, insomnia
AE: LOC, heart block and cardiac arrhythmias, seizures
teaching: do not drive on this medication until you are adusted to this medication, if you experience any weird movement of rolling your tongue in and out of your mouth or your arms become as stiff as a lead pipe go to your nearest emergency room/ take this medication with food to avoid stomach upset
what is the medication for anthelminthic treatment? what are the side effects and adverse effects?
what is part of the teaching provided to the patient?
Ivermectin
SE: fever, dizziness, N/V/D, tremor, vertigo
AE: angioedema, steven-Johnsons’ syndrome, visual impairment
Teaching: explain the importance of washing hands before meals/ take daily showers not baths/ Always read the whole label on OTC medication before taking it/ take on an empty stomach
what is the creatinine clearance value
87-107
antidote for magnesium sulfate
calcium gluconate
what is the antidote for potassium
sodium polystrene
what is the antidote for iron
deferoxamine
what is the antidote for warfarin
phytonadione (vitamin K)
what is the antidote for heparin
Protamine
what medication treats Herpes? what are the teaching included for this medication?
Acyclovir
treatment for herpes 1 2 3 (varicella-zoster viruses)
Teaching:
drink adequate amount of fluids/ continue therapy for full length, use gloves and avoid sexual intercourse during duration of lesions present to prevent the spread of Herpes/
This is not the cure for Herpes it just treats the symptoms present for the patient
what medications are ototoxic and nephrotoxic?
-mycin medications
all of the medicatoins with -mycin
what flu medication is contraindicated with patients who have COPD?
Zanamivir
what flu medication is caution advised for renal impairment?
Oseltamivir
what antigen do flu medication treat?
A/B
