Pharmacology final Flashcards
1
Q
What does the pharmacologic class of a drug tell you?
A
how a drug works in the body; a drug’s specific mechanism of action
only one pharmacologic class per drug
2
Q
What does the therapeutic class of a drug tell you?
A
the function of a drug (i.e., antihypertensive, anti-inflammatory, etc.)
a drug may have more than one therapeutic class because many drugs have various uses/functions
3
Q
What is the first-pass effect?
A
a phenomenon in which a drug gets metabolized at a specific location in the body (usually the GI tract) that results in a reduced concentration of the active drug reaching its site of action or systemic circulation
4
Q
What are the side effects and nursing implications of ibuprofen (Advil, Motrin)?
A
SE = dyspepsia, GI bleeding
NI = kidney labs (because of inhibition of COX-1, reduced protection of the kidneys), GI assessment, pain/temperature assessment
5
Q
What is the max dose for ibuprofen (Advil, Motrin)?
A
3200 mg/day
6
Q
What are the side effects and nursing implications for probenecid (Probalan)?
A
SE = aplastic anemia
NI = monitor for joint pain/swelling, I&O, kidney labs (can decrease renal function), CBC
7
Q
What is probenecid (Probalan) used for?
A
long-term management of gout
8
Q
Which route of administration undergoes the first-pass effect?
A
PO medications (not sublingual or buccal because these are rapidly absorbed into the bloodstream)
9
Q
What routes are included in the enteral route of administration?
A
PO (by mouth) or pr (rectal)
10
Q
What routes are included in the topical route of administration?
A
transdermal, ophthalmic, otic, nasal, inhalation, vaginal
11
Q
What routes are included in the parenteral route of administration?
A
intradermal, subcutaneous, intramuscular, intravenous
12
Q
What are the controlled substance categories?
A
range from I (highest abuse potential) to V (lowest abuse potential)
I - used in research, but not prescribed
II - require written prescription (cannot be refilled or prescribed over the phone)
V - may be OTC in some states depending on law
13
Q
What is the therapeutic and pharmacologic class for allopurinol (Zyloprim)?
A
T = antigout agent / antihyperuricemic
P = xanthine oxidase inhibitor
14
Q
What are the side effects and nursing implications of allopurinol (Zyloprim)?
A
SE = rash, SJS, TEN
NI = monitor for joint pain/swelling, kidney labs (can decrease renal function), I&O
15
Q
What is allopurinol (Zyloprim) used for?
A
Long-term management of gout
16
Q
What is the therapeutic and pharmacologic class for colchicine (Colcrys)?
A
T = antigout agent
P = decreases the inflammatory response
17
Q
What are the side effects and nursing implications for colchicine (Colcrys)?
A
SE = adverse GI effects, agranulocytosis
NI = monitor for joint pain/swelling, neutrophil count
18
Q
What is colchicine (Colcrys) used for?
A
acute gout attacks
19
Q
What is the therapeutic and pharmacologic class for probenecid (Probalan)?
A
T = reduction of serum uric acid levels
P = uricosuric
20
Q
What are the side effects and nursing implications for probenecid (Probalan)?
A
SE = aplastic anemia
NI = monitor for joint pain/swelling, I&O, kidney labs (can decrease renal function), CBC
21
Q
What is probenecid (Probalan) used for?
A
long-term management of gout
22
Q
What is the therapeutic and pharmacologic class of indomethacin (Indocin)?
A
T = NSAID (analgesic, antipyretic, anti-inflammatory)
P = inhibits COX-1 and COX-2
23
Q
What are the side effects and nursing implications for indomethacin (Indocin)?
A
SE = dyspepsia, GI bleeding, MI, stroke
NI = kidney labs (because of inhibition of COX-1, reduced protection of the kidneys), GI, cardiac, neuro, and pain assessments
24
Q
What is indomethacin (Indocin) used for?
A
It is the preferred NSAID for acute attacks of gout
25
What are the side effects and nursing implications for all antibiotics?
1. signs and symptoms of infection (fever, chills, fatigue)
2. WBC or CBC with differential
3. GI assessment (GI disturbances)
4. Skin assessment (rash)
5. focused assessment of infection location
26
What is the therapeutic and pharmacologic class of doxycycline, minocycline, and tetracycline?
T = anti-infective
P = tetracyclines
27
What are the side effects and nursing implications for doxycycline, minocycline, and tetracycline?
SE = photosensitivity, yellow/brown discoloration of teeth
NI = sun exposure, patient's age (not recommended for children < 8 or during pregnancy/lactation), and concurrent medication/food schedule
28
Patient education for doxycycline, minocycline, and tetracycline?
Do not take within 1-3 hours of calcium, iron, or antacids
29
What is the therapeutic and pharmacologic class of vancomycin (Vacocin)?
T = anti-infective
P = glycopeptide
30
What are the side effects and nursing implications for vancomycin (Vacocin)?
SE = nephrotoxicity, Red Man Syndrome
NI = trough level and hearing (IV only), kidney labs
31
What is the therapeutic and pharmacologic class of tobramycin, streptomycin, neomycin, and gentamycin?
T = anti-infective
P = aminoglycosides
32
What are the side effects and nursing implications for tobramycin, streptomycin, neomycin, and gentamycin?
SE = nephrotoxicity, ototoxicity
NI = kidney labs, hearing
33
What are aminoglycosides used for?
Antibiotics reserved for serious infections
34
What is the therapeutic and pharmacologic class of metronidazole (Flagyl)?
T = anti-infective
P = nitroimidazole
35
What are the side effects and nursing implications of metronidazole (Flagyl)?
SE = seizures
NI = neuro assessment
36
What is metronidazole (Flagyl) used for?
commonly prescribed for intra-abdominal infections (i.e., C. diff)
37
What is the therapeutic and pharmacologic class of fidaxomicin, azithromycin, clarithromycin, and erythromycin?
T = anti-infective
P = macrolides
38
What are the side effects and nursing implications for fidaxomicin, azithromycin, clarithromycin, and erythromycin?
SE = torsade de pointes
NI = magnesium level
39
What is the therapeutic and pharmacologic class for trimethoprim/sulfamethoxazole (Bactrim)?
T = anti-infective
P = sulfonamide
40
What are the side effects and nursing implications for trimethoprim/sulfamethoxazole (Bactrim)?
SE = agranulocytosis, aplastic anemia
NI = pregnancy status
41
What is the therapeutic and pharmacologic class for nalidixic acid, ciprofloxacin, norfloxacin, levofloxacin, moxifloxacin, etc.?
T = anti-infective
P = fluoroquinolones
42
What are the side effects and nursing implications for nalidixic acid, ciprofloxacin, norfloxacin, levofloxacin, moxifloxacin, etc.?
SE = cartilage toxicity, torsade de pointe's, suicidal thoughts, hepatotoxicity
NI = musculoskeletal and psych assessments, magnesium level, liver labs
43
What is the therapeutic and pharmacologic class of tenofovir/emtricitabine (Truvada)?
T = antiviral
P = nucleotide reverse transcriptase inhibitor (NRTI)
44
What are the side effects and nursing implications for tenofovir/emtricitabine (Truvada)?
SE = acute renal failure, nausea
NI = monitor for HIV exposure and/or lifestyle changes, kidney labs
45
What is tenofovir/emtricitabine (Truvada) used for?
pre-exposure prophylaxis (PrEP) therapy for HIV
46
What is the therapeutic and pharmacologic class for nystatin?
T = antifungal
P = antifungal
47
What are the side effects and nursing implications for nystatin?
SE = fairly safe, contact dermatitis
NI = skin or oral assessment, instructions on administration
48
What is nystatin used for?
used to treat Tinea Cruris (groin infection/jock itch) and oropharyngeal candidiasis (thrush)
49
What are the directions for administration of nystatin (oral suspension and topical powder)?
oral: swish for 30 seconds and swallow if possibly, do not eat or drink for 30 minutes
topical: apply to infected area
50
What is the therapeutic and pharmacologic class for amphotericin B?
T = antifungal
P = polyene antifungal
51
What are the side effects and nursing implications for amphotericin B?
SE = n/v, fever, hypotension, chest pain, nephrotoxicity, hypersensitivity reactions
NI = monitor pt closely 1-2 hours after each dose, CBC, kidney labs, potassium, and magnesium level, vital signs
52
What is amphotericin B used for?
used for serious, life-threatening fungal infections (very toxic, but very effective)
53
What is the therapeutic and pharmacologic class of methotrexate (Trexall)?
T = antineoplastic
P = antimetabolite (of folic acid)
54
What are the side effects and nursing implications for methotrexate (Trexall)?
SE = nephropathy (in about 2-12% of pts)
NI = kidney labs, urine pH monitoring
55
Patients receiving high-dose forms of methotrexate (Trexall) are also on ________ to prevent _______.
continuous sodium bicarb infusion to prevent the urine from becoming too acidic
56
When/what is the nadir period?
7-12 days after chemotherapy treatment; bone marrow activity is decreased resulting in lowered blood cell counts
patients are VERY immunocompromised
57
Patient education for the nadir period (5)?
1. wash hands for 20 seconds
2. thoroughly wash and cook food before consuming
3. eat leftovers within 24 hours
4. avoid contact with those who may carry infection
5. avoid cuts and scratches
58
What is the therapeutic and pharmacologic class of codeine with guaifenesin (Cheratussin AC)?
T = antitussive
P = opioid cough suppressant
59
What are the side effects and nursing implications for codeine with guaifenesin (Cheratussin AC)?
SE = drowsiness, constipation
NI = cough description, respiratory assessment, vital signs
60
What is the therapeutic and pharmacologic class for dextromethorphan (Robitussin)?
T = antitussive
P = non-opioid cough suppressant
61
What are the side effects and nursing implications for dextromethorphan (Robitussin)?
SE = drowsiness and dizziness (high doses only)
NI = cough description, respiratory assessment
62
What drugs are used for a dry, non-productive cough vs. a mucous-y cough?
antitussives are used to suppress a dry, non-productive cough
expectorants are used to clear phlegm and mucous from the throat
63
What is the therapeutic and pharmacologic class of guaifenesin (Mucinex)?
T = expectorant
P = expectorant
64
What are the side effects and nursing implications for guaifenesin (Mucinex)?
SE = n/v, stomach pain
NI = cough description, respiratory assessment
65
What is the therapeutic and pharmacologic class of benzonatate (Tessalon)?
T = antitussive
P = non-opioid cough suppressant
66
What are the side effects and nursing implications for benzonatate (Tessalon)?
SE = chilly sensation
NI = cough description, respiratory assessment
67
What is the therapeutic and pharmacologic class of pseudoephedrine (Sudafed)?
T = decongestant
P = adrenergic
68
What are the side effects and nursing implications for pseudoephedrine (Sudafed)?
SE = nervousness, palpitations, hypertension, cardiovascular collapse
NI = monitor nasal stuffiness and discharge, BP, and pulse
69
What is Coricidin used for?
Coricidin HBP is an OTC cough and cold medicine containing dextromethorphan and other ingredients (i.e., acetaminophen) for individuals with hypertension
70
What is the therapeutic and pharmacologic class of albuterol (Proair, Ventolin)?
T = bronchodilator
P = adrenergic, short-acting beta agonist (SABA)
71
What are the side effects and nursing implications for albuterol (Proair, Ventolin)?
SE = nervousness, palpitations, paradoxical bronchospasm
NI = respiratory assessment
72
What is the difference between albuterol and salmeterol?
albuterol is used for acute attacks of asthma whereas salmeterol is used for long-term management
73
What is the therapeutic and pharmacologic class of salmeterol (Serevent)?
T = bronchodilator
P = adrenergic, long-acting beta-agonist (LABA)
74
What are the side effects and nursing implications for salmeterol (Serevent)?
SE = headache
NI = respiratory assessment
75
What is the therapeutic and pharmacologic class of fluticasone (Flovent) and budesonide (Pulmicort)?
T = anti-inflammatory
P = corticosteroid
76
What are the side effects and nursing implications for fluticasone (Flovent) and budesonide (Pulmicort)?
SE = thrush, bronchospasms
NI = respiratory and oral cavity assessments
77
What is the therapeutic and pharmacologic class of ipratropium (Atrovent) and tiotropium (Spiriva)?
T = bronchodilator
P = anticholinergic
78
What are the side effects and nursing implications for ipratropium (Atrovent) and tiotropium (Spiriva)?
SE = dry mouth, other anti-ACh effects
NI = respiratory assessment
79
Patient education for ipratropium (Atrovent) and tiotropium (Spiriva)?
chew gum, gargle water and suck on hard candy (for anticholinergic effects)
don't swallow the pill whole, crush it in the inhaler
80
What is the therapeutic and pharmacologic class of doxazosin (Cardura), prazosin (Minipress), and terazosin (Hytrin)?
T = antihypertensive
P = peripherally-acting alpha-1 blockers
81
What are the side effects and nursing implications for doxazosin (Cardura), prazosin (Minipress), and terazosin (Hytrin)?
SE = orthostatic hypotension
NI = BP and orthostatic vital signs with the first dose
82
What are doxazosin (Cardura), prazosin (Minipress), and terazosin (Hytrin) used to treat?
often prescribed to individuals with hypertension and BPH
83
What is the therapeutic and pharmacologic class of atenolol, metoprolol, and esmolol?
therapeutic and pharmacologic class of atenolol, metoprolol, and esmolol?
T = antihypertensive
P = selective beta blockers
84
What is the therapeutic and pharmacologic class of propranolol and timolol?
T = antihypertensive
P = non-selective beta-blockers
85
What are the side effects and nursing implications for atenolol, metoprolol, esmolol, propranolol, and timolol?
SE = fatigue, erectile dysfunction, bradycardia
NI = BP and pulse
86
What type of patient would you caution using non-selective beta blockers with?
caution in patients with asthma
since these drugs are non-selective and effect both B1 (heart) and B2 (lungs) receptors, these drugs may cause bronchoconstriction
87
What is the therapeutic and pharmacologic class of hydrochlorothiazide (Microzide)?
T = antihypertensive
P = thiazide diuretic
88
What are the side effects and nursing implications of hydrochlorothiazide (Microzide)?
SE = hypokalemia, dehydration
NI = BP, potassium level, I&O
89
Which drug is considered a first-line treatment for mild to moderate hypertension?
hydrochlorothiazide
90
What is the therapeutic and pharmacologic class of lisinopril, captopril, and enalapril?
T = antihypertensive
P = angiotensin-converting enzyme (ACE) inhibitor
91
What are the side effects and nursing implications for lisinopril, captopril, and enalapril?
SE = cough, hyperkalemia, angioedema
NI = BP, kidney labs, potassium level, presence of cough, skin assessment
92
What is the therapeutic and pharmacologic class of nifedipine, amlodipine, and nicardipine?
T = antihypertensive
P = selective calcium channel blockers
93
What is the therapeutic and pharmacologic class of diltiazem and verapamil?
T = antihypertensive
P = non-selective calcium channel blockers
94
What are the side effects and nursing implications for nifedipine, amlodipine, and nicardipine?
SE = peripheral edema
NI = BP and BLE assessment
95
What are the side effects and nursing implications for diltiazem and verapamil?
SE = peripheral edema, arrhythmias, heart failure
NI = BP, HR, BLE assessment, and Cardiac assessment
96
What is the therapeutic and pharmacologic class of furosemide (Lasix) and bumetanide (Bumex)?
T = diuretics
P = loop diuretics
97
What are the side effects and nursing implications for furosemide (Lasix) and bumetanide (Bumex)?
SE = hypokalemia, dehydration, ototoxicity
NI = BP, potassium level, I&O, peripheral edema and respiratory assessment
98
What are furosemide (Lasix) and bumetanide (Bumex) used for?
they are aggressive diuretics that are often used to help treat pulmonary congestion and peripheral edema
99
What is the therapeutic and pharmacologic class of spironolactone (Aldactone)?
T = diuretic
P = aldosterone receptor antagonist
100
What are the side effects and nursing implications for spironolactone (Aldactone)?
SE = hyperkalemia
NI = BP, potassium level, I&O, pregnancy status
101
What is the MOA for hypotonic solutions?
the solution has LESS salt/solute than the cell, so water is drawn INTO the cell (cell bursting)
102
What are hypotonic solutions used for?
cellular dehydration, hypernatremia
103
What are examples of hypotonic solutions?
0.45% NS, 2.5% Dextrose
104
What is the MOA for hypertonic solutions?
the solution has MORE salt/solute than the cell, so water wants to escape the cell (cell shrinking)
105
What are hypertonic solutions used for?
hyponatremia and hypovolemia
106
What are examples of hypertonic solutions?
3% NS, 5% NS, D10W
107
What is important to know about hypertonic solutions?
it is a high alert medication because it can cause patient to herniate and have osmotic demyelination syndrome
108
What are examples of isotonic solutions?
0.9% NS, lactated ringers, D5W
109
What is the therapeutic and pharmacologic class of atorvastatin, pravastatin, rosuvastatin, and simvastatin?
T = lipid-lowering agents
P = HMG-CoA reductase inhibitors
110
What are the side effects and nursing implications for atorvastatin, pravastatin, rosuvastatin, and simvastatin?
SE = GI related, liver inflammation, rhabdomyolysis
NI = GI assessment, liver labs, BLE assessment, urine color
111
What is the first-line treatment for lowering lipid levels?
HMG-CoA reductase inhibitors (-statins)
112
What are the therapeutic and pharmacologic classes of colesevelam (Welchol) and cholestyramine (Questran)?
T = lipid-lowering agents
P = bile acid sequestrants
113
What are the side effects and nursing implications for colesevelam (Welchol) and cholestyramine (Questran)?
SE = GI related, nutritional deficiencies, drug binding, TG increase
NI = when to administer medication, GI assessment, TG level
114
Patient education for colesevelam (Welchol) and cholestyramine (Questran)?
Take 2 hours before or 4 hours after other drugs (due to drug binding)
115
What is the therapeutic and pharmacologic class of nitroglycerine (Nitrostat)?
T = antianginal
P = rapid-acting nitrate
116
What are the side effects and nursing implications for nitroglycerine (Nitrostat)?
SE = hypotension, tachycardia, headache, dizziness
NI = BP, pain assessment, medication review
117
Patient education for individuals taking short or long-acting nitrates?
do not take concurrently with Viagra or Cialis (risk of life-threatening hypotension)
118
Patient education for nitroglycerine (Nitrostat)?
Sublingual administration 1 tab q 5 minutes x3
Call 911 if chest pain is still occurring after third dose
WEAR GLOVES if you are administering this medication as the nurse
119
What is the therapeutic and pharmacologic class of isosorbide mononitrate/dinitrate?
T = antianginal
P = long-acting nitrate
120
What are the side effects and nursing implications for isosorbide mononitrate/dinitrate?
SE = hypotension, tachycardia, headache, dizziness
NI = BP, pain assessment, medication review
121
Patient education for isosorbide mononitrate/dinitrate?
do not stop taking abruptly; may cause severe angina attack
122
What is the difference between nitroglycerin (Nitrostat) and isosorbide mononitrate/dinitrate?
nitroglycerin is used to abort chest pain
isosorbide mononitrate/dinitrate is used to prevent chest pain
123
What is the therapeutic and pharmacologic class of warfarin (Coumadin)?
T = anticoagulant
P = coumarin (inhibits Vitamin K factors 2, 7, 9, and 10)
124
What are the side effects and nursing implications for warfarin (Coumadin)?
SE = bleeding
NI = review Hgb/HCT, PT/INR, s/s of bleeding
125
What is the reversal agent for warfarin (Coumadin)?
Vitamin K
126
Patient education for warfarin (Coumadin)?
patient cannot change their diet regarding vitamin K foods; must be consistent
127
Which anticoagulants are given PO?
warfarin (Coumadin), rivaroxaban (Xarelto) and apixaban (Eliquis)
128
What is the therapeutic and pharmacologic class of rivaroxaban (Xarelto) and apixaban (Eliquis)?
T = anticoagulant
P = factor Xa (10) inhibitors
129
What are the side effects and nursing implications for rivaroxaban (Xarelto) and apixaban (Eliquis)?
SE = bleeding
NI = review Hgb/HCT, s/s of bleeding
130
What is the reversal agent for rivaroxaban (Xarelto) and apixaban (Eliquis)?
adexanet alfa (AndexXa)
131
What is the therapeutic and pharmacologic class of heparin?
T = anticoagulant
P = antithrombotic
132
What are the side effects and nursing implications for heparin?
SE = bleeding, heparin-induced thrombocytopenia (HIT)
NI = review Hgb/HCT, platelets, s/s of bleeding, PTT/anti-Xa (IV only)
133
What is the reversal agent for heparin?
Protamine sulfate
134
What is the therapeutic and pharmacologic class of enoxaparin (Lovenox)?
T = anticoagulant
P = low molecular weight heparin
135
What are the side effects and nursing implications for enoxaparin (Lovenox)?
SE = anemia, bleeding
NI = review Hgb/HCT, platelets, s/s of bleeding
136
What is the therapeutic and pharmacologic class of aspirin (ASA)?
T = analgesic and antipyretic
P = binds to COX-1 and COX-2; salicylate
137
What are the side effects and nursing implications for aspirin (ASA)?
SE = tinnitus, Reye's syndrome, GI bleeding
NI = platelet level, GI assessment
138
What is the max dose for aspirin (ASA)?
4000 mg/day
139
What is the therapeutic and pharmacologic class of clopidogrel (Plavix)?
T = antiplatelet agent
P = ADP receptor blocker
140
What are the side effects and nursing implications for clopidogrel (Plavix)?
SE = epistaxis, bleeding
NI = review Hgb/HCT, s/s of bleeding
141
What is clopidogrel (Plavix) used for?
prevents thrombus formation in patients who have experienced a thromboembolic event in the past
142
What is the therapeutic and pharmacologic class of alteplase (Activase), streptokinase, and reteplase?
T = thrombolytics
P = plasminogen activators
143
What are the side effects and nursing implications for alteplase (Activase), streptokinase, and reteplase?
SE = ecchymoses, multiple sites of bleeding
NI = review Hgb/HCT, s/s of bleeding
144
What is alteplase (Activase), streptokinase, and reteplase used for?
IV therapy to destroy an already existing clot; d/c of infusion results in immediate termination of thrombolytic activity
145
What is the therapeutic and pharmacologic class of scopolamine (Transdermal Scop)?
T = antiemetic
P = anticholinergic
146
What are the side effects and nursing implications for scopolamine (Transdermal Scop)?
SE = blurred vision, dry mouth, urinary hesitancy (anti-ACh)
NI = when to apply patch, neuro assessment (d/t increased sympathetic side effects)
147
Patient education for scopolamine (Transdermal Scop)?
Apply the patch four hours prior to travel to prevent motion sickness
148
What is the therapeutic and pharmacologic class of meclizine (Antivert), dimenhydrinate (Dramamine), and diphenhydramine (Benadryl)?
T = antiemetic
P = antihistamine
149
What are the side effects and nursing implications for meclizine (Antivert), dimenhydrinate (Dramamine), and diphenhydramine (Benadryl)?
SE = drowsiness
NI = assess for n/v, neuro assessment
150
What is the therapeutic and pharmacologic class of prochlorperazine (Compazine) in low doses?
T = antiemetic
P = phenothiazines (blocks DA in the CNS)
151
What are the side effects and nursing implications for prochlorperazine (Compazine) in low doses?
SE = sedation, blurred vision, dry mouth, constipation, NMS, agranulocytosis
NI = assess for n/v, neuro assessment, CBC
152
Prochlorperazine (Compazine) is contraindicated in what type of patient?
patients with bone marrow suppression
153
What is the therapeutic and pharmacologic class of metoclopramide (Reglan)?
T = antiemetic
P = prokinetic
154
What are the side effects and nursing implications for metoclopramide (Reglan)?
SE = drowsiness, EPS, restlessness, NMS
NI = assess for n/v, neuro assessment
155
What is metoclopramide (Reglan) used for and what is its MOA?
used in the prevention of chemotherapy-induced emesis AND used to treat restless leg syndrome
stimulates motility of the upper GI tract and accelerates gastric emptying
156
What is the therapeutic and pharmacologic class of ondansetron (Zofran)?
T = antiemetic
P = 5HT3 antagonist
157
What are the side effects and nursing implications for ondansetron (Zofran)?
SE = headache, constipation, diarrhea, serotonin syndrome, torsade de pointes, SJS, TEN
NI = assess for n/v, neuro, and GI assessment, magnesium level
158
What is ondansetron (Zofran) used for?
DOC in pregnancy for hyperemesis AND often given prophylactically before antineoplastic therapy
159
What is the therapeutic and pharmacologic class of omeprazole, lansoprazole, pantoprazole, and esomeprazole?
T = antiulcer agent
P = proton pump inhibitor (PPI)
160
What are the side effects and nursing implications for omeprazole, lansoprazole, pantoprazole, and esomeprazole?
SE = headache, abdominal pain, n/v/d, osteoporosis-related fractures, C. diff-associated diarrhea (CDAD)
NI = GI assessment, last BM
161
What are PPIs used for?
DOC for short-term therapy of peptic ulcer disease and GERD; also combined with antibiotics to combat H. pylori
162
Patient education for PPIs?
take before the first major meal of the day
do not crush, swallow whole
163
What is the therapeutic and pharmacologic class of cimetidine (Tagamet) and famotidine (Pepcid)?
T = antiulcer agent
P = histamine 2 blocker
164
What are the side effects and nursing implications for cimetidine (Tagamet) and famotidine (Pepcid)?
SE = confusion (if pt has renal or hepatic issues)
NI = GI assessment
165
Patient education for cimetidine (Tagamet) and famotidine (Pepcid)?
do not take with antiacids
166
What is the therapeutic and pharmacologic class of docusate (Colace)?
T = laxative
P = stool softener
167
What are the side effects and nursing implications for docusate (Colace)?
SE = diarrhea, mild cramps
NI = GI assessment, last BM
168
What is docusate (Colace) used for?
preventative use for surgery d/t constipation from opioids
169
What is the therapeutic and pharmacologic class of sucralfate (Carafate)?
T = antiulcer agent
P = GI protectant
170
What are the side effects and nursing implications for sucralfate (Carafate)?
SE = constipation, hypersensitivity reactions
NI = GI assessment, meal, and other medication schedule
171
Patient education for sucralfate (Carafate)?
take 1 hour before meals and 2 hours after other medications
172
What is the therapeutic and pharmacologic class of senna (Sennakot)?
T = laxative
P = stimulant
173
What are the side effects and nursing implications for senna (Sennakot)?
SE = diarrhea, cramps
NI = GI assessment, last BM
174
What is senna (Sennakot) used for?
short term therapy for constipation (may cause electrolyte imbalance and dependency)
common part of bowel regimen for spinal cord patients
175
Which vitamins are water-soluble?
B & C
176
Which vitamins are fat soluble?
A,D,E,K
177
What are the side effects of thiamine (Vitamin B1)?
weakness, tightness of throat, angioedema
178
What are the side effects of riboflavin (Vitamin B2)?
yellow discoloration of urine (large doses only)
179
What are the side effects of niacin (Vitamin B3)?
niacin flushing, hepatotoxicity (in high doses only, when used for hyperlipidemia)
180
What does folic acid (B9 & Folate) do in the body?
involved in RBC formation and prevents neural tube defects in pregnancy; used to treat folic-deficiency anemia
181
What are the side effects and nursing implications of folic acid (B9 & Folate)?
SE = none commonly reported
NI = RBC, Hgb/HCT, MCV, MCHC, pregnancy status
182
What types of patients are most likely to have vitamin B12 deficiency?
alcoholics and individuals who are unable to produce intrinsic factor
183
What are the side effects and nursing implications for cyanocobalamin (Vitamin B12)?
SE = none commonly reported
NI = RBC, Hgb/HCT, MCV, MCHC
184
What are the side effects and nursing implications for ascorbic acid (Vitamin C)?
SE = diarrhea, flushing
NI = assess wound healing and/or gums and gingiva
185
What is ascorbic acid (Vitamin C) used for?
collagen formation and tissue repair
186
What are the side effects and nursing implications for ergocalciferol (Vitamin D2)?
SE = weakness, pancreatitis
NI = assess bone structure, calcium, phosphorus, and kidney labs
187
What condition is caused by a deficiency in Vitamin D2?
rickets
188
What are the side effects and nursing implications for Vitamin K?
SE = pain at injection site
NI = assess bleeding, liver labs
189
What are the side effects of vitamin E?
weakness, fatigue, headache
190
What is the therapeutic and pharmacologic class of clonazepam, diazepam (Valium), lorazepam (Ativan), temazepam (Restoril), alprazolam (Xanax), and midazolam?
T = anti-anxiety
P = benzodiazepines
191
What are the side effects and nursing implications for clonazepam, diazepam (Valium), lorazepam (Ativan), temazepam (Restoril), alprazolam (Xanax), and midazolam?
SE = drowsiness, dizziness, apnea
NI = vital signs, LOC
192
What is the antidote for benzodiazepines?
flumazenil (Romazicon)
193
What are benzodiazepines used for?
to treat anxiety and/or insomnia
194
What is the therapeutic and pharmacologic class of valproic acid (Depakene)?
T = anticonvulsant
P = increases levels of GABA
195
What are the side effects and nursing implications for valproic acid (Depakene)?
SE = dizziness, sedation, abdominal pain, hepatotoxicity, pancreatitis, suicidal thoughts
NI = neuro/psych/GI assessments, liver labs
196
Patient education for valproic acid (Depakene)?
do not administer with milk or carbonated beverages
197
Valproic acid (Depakene) is contraindicated in what type of patients?
patients with liver disease/issues
198
What is the therapeutic and pharmacologic class of levetiracetam (Keppra)?
T = anticonvulsant
P = pyrrolidines
199
What are the side effects and nursing implications for levetiracetam (Keppra)?
SE = dizziness, drowsiness, agitation, anger, anxiety, suicidal thoughts
NI = neuro and psych assessment
200
What is the therapeutic and pharmacologic class of phenytoin (Dilantin)?
T = anticonvulsant
P = hydantoin
201
What are the side effects and nursing implications for phenytoin (Dilantin)?
SE = ataxia, gingival hyperplasia, lethargy, suicidal thoughts, aplastic anemia, angioedema, cardiac arrest
NI = neuro and psych assessments, assess oral hygiene, CBC
202
What is the therapeutic and pharmacologic class of prochlorperazine (Compazine) in high doses?
T = antipsychotic
P = phenothiazine; antidopaminergic
203
What are the side effects and nursing implications for prochlorperazine (Compazine) in high doses?
SE = anticholinergic effects, EPS, NMS
NI = mental status, EPS, and NMS symptoms
204
What symptoms of schizophrenia does prochlorperazine (Compazine) treat and when can patients expect to see improvements?
treats the positive signs of schizophrenia (i.e., hallucinations); resolved within days to weeks
205
What is the therapeutic and pharmacologic class of acetaminophen (Tylenol)?
T = non-opioid analgesic, antipyretic
P = inhibits prostaglandin synthesis
206
What are the side effects and nursing implications for acetaminophen (Tylenol)?
SE = rash, urticaria, hepatotoxicity
NI = liver labs, pain and/or temperature assessment
207
What is the max dose of acetaminophen? And for those with liver issues?
4000 mg/day for average adult
2000 mg/day for individuals with liver conditions
208
What is the therapeutic and pharmacologic class for baclofen, carisoprodol (Soma), cyclobenzaprine (Flexeril), and metaxalone (Skelaxin)?
T = centrally-acting skeletal muscle relaxant
P = CNS depressant
209
What are the side effects and nursing implications for baclofen, carisoprodol (Soma), cyclobenzaprine (Flexeril), and metaxalone (Skelaxin)?
SE = drowsiness
NI = pain assessment
210
Baclofen, carisoprodol (Soma), cyclobenzaprine (Flexeril), and metaxalone (Skelaxin) is contraindicated in what type of patients?
hypersensitivity reactions, compromised pulmonary function, active hepatic disease and impaired myocardial function
211
What is the therapeutic and pharmacologic class of codeine, hydrocodone, and oxycodone (Oxycontin)?
T = opioid analgesic
P = opioid agonist
212
What are the side effects and nursing implications for codeine, hydrocodone, and oxycodone (Oxycontin)?
SE = sedation, hypotension, constipation, respiratory depression
NI = pain and GI assessments, LOC, vital signs
213
What are codeine, hydrocodone, and oxycodone (Oxycontin) used for?
moderate pain (Schedule II controlled substances)
214
What is the therapeutic and pharmacologic class of naloxone (Narcan)?
T = opioid antidote
P = opioid antagonist
215
What are the side effects and nursing implications for naloxone (Narcan)?
SE = ventricular arrhythmias
NI = pain assessment (post-administration), vital signs, LOC
216
What is the therapeutic and pharmacologic class of sumatriptan (Imitrex)?
T = vascular headache suppressant
P = 5HT-1 receptor agonist; constricts intracranial vessels
217
What are the side effects and nursing implications for sumatriptan (Imitrex)?
SE = dizziness, vertigo, warm sensation, hypersensitivity reactions
NI = pain assessment, vital signs
218
Patient education for sumatriptan (Imitrex)?
do not take with other vasoconstrictive drugs (i.e., vasopressin, epinephrine) d/t risk for HTN
used to abort a migraine; not preventative
219
What is the therapeutic and pharmacologic class of latanoprost (Xalatan), bimatoprost (Lumigan), tafluprost (Zioptan), and travoprost (Travatan)?
T = ocular hypotensive agent
P = prostaglandin analog
220
What are the side effects and nursing implications for latanoprost (Xalatan), bimatoprost (Lumigan), tafluprost (Zioptan), and travoprost (Travatan)?
SE = hypopigmentation, thicker/longer lashes, irritation and burning (first month)
NI = eye assessment
221
What is the therapeutic and pharmacologic class of pilocarpine (Pilocar)?
T = parasympathetic
P = cholinergic agonist
222
What are the side effects and nursing implications for pilocarpine (Pilocar)?
SE = blurred vision, stinging, headache, miosis (pupillary constriction)
NI = eye assessment
223
What is the therapeutic and pharmacologic class of dorzolamide (Trusopt)?
T = ocular hypotensive agent
P = carbonic anhydrase inhibitor
224
What are the side effects and nursing implications for dorzolamide (Trusopt)?
SE = bitter taste, eye irritation
NI = eye assessment
225
What does dorzolamide (Trusopt) have a cross-sensitivity with?
sulfonamides
226
What is the therapeutic and pharmacologic class of timolol (Timoptic, Betimol)?
T = ocular hypotensive agent
P = beta blocker
227
What are the side effects and nursing implications for timolol (Timoptic, Betimol)?
SE = conjunctivitis, decreased visual acuity
NI = eye assessment
228
What happens if systemic absorption of timolol (Timoptic, Betimol) occurs?
monitor for hypotension, bradycardia, and bronchoconstriction
229
Timolol (Timoptic, Betimol) should be cautioned in what type of patient?
Patients with asthma or heart failure
230
What is the peak for lispro (Humalog)?
30 to 60 minutes
231
What is the peak for regular insulin (Humulin R)?
2-4 hours
232
What is the peak for isophane (NPH)?
4-12 hours
233
What is the peak for detemir (Levemir)?
6-8 hours
234
What is the peak for glargine (Lantus)?
no peak
235
When is the patient at the highest risk of a hypoglycemic reaction?
at the peak of the drug
236
which insulin can be administered intravenously?
regular
237
What is the therapeutic and pharmacologic class of chlorpropamide, tolbutamide, tolazamide, glimeperide, glipizide, and glyburide?
T = antidiabetic
P = sulfonylureas
238
What are the side effects and nursing implications for chlorpropamide, tolbutamide, tolazamide, glimepiride, glipizide, and glyburide?
SE = hypoglycemia (BIG risk)
NI = blood glucose level, LFTs (first generation only)
239
What is the therapeutic and pharmacologic class of metformin (Glucophage)?
T = antidiabetic
P = biguanide
240
What are the side effects and nursing implications for metformin (Glucophage)?
SE = diarrhea, n/v, abdominal bloating, lactic acidosis
NI = blood glucose level, GI assessment, upcoming procedures
241
Patient education for metformin (Glucophage)?
hold drug before and 48 hours after any procedures with IV dye/contrast
242
What is the drug of choice for Type II Diabetes Mellitus?
Metformin (Glucophage)
243
What is the therapeutic and pharmacologic class of exenatide (Byetta), liraglutide (Victoza), semaglutide (Ozempic), and dulaglutide (Trulicity)?
T = antidiabetic
P = incretin mimetics/GLP-1 agonists
244
What are the side effects and nursing implications for exenatide (Byetta), liraglutide (Victoza), semaglutide (Ozempic), and dulaglutide (Trulicity)?
SE = diarrhea, n/v, dehydration, pancreatitis
NI = GI assessment, I&O, amylase/lipase
245
When/what route is dextrose (glucose) given?
given po during a hypoglycemic event when the patient is conscious
246
When/what route is glucagon given?
given IM or subQ during a hypoglycemic event when the patient is unconscious
247
What is the therapeutic and pharmacologic class of ferrous sulfate?
T = anti-anemic
P = iron supplement
248
What are the side effects and nursing implications for ferrous sulfate?
SE = nausea, constipation, epigastric pain, black tarry stools
NI = GI assessment, assess nutritional status, Hgb/HCT, RBCs, MCV, MCHC, ferritin, serum iron, total iron binding capacity (TIBC)
249
What lab values would you expect to see in someone with iron-deficiency anemia?
low iron
low ferritin
high TIBC
low MCV
low MCHC
250
What is the therapeutic and pharmacologic class of filgrastim (Neupogen) and pegfilgrastim (Neulasta)?
T = colony-stimulating factor
P = neutrophil stimulator
251
What are the side effects and nursing implications for filgrastim (Neupogen) and pegfilgrastim (Neulasta)?
SE = bone pain, splenic rupture, hypersensitivity reactions
NI = neutrophils, LUQ and pain assessment, s/s of allergic reaction
252
Patient education for individuals who are going to receive colony-stimulating therapy?
H1 blockers are commonly recommended one day prior and a few days after therapy to decrease bone pain
253
What is the therapeutic and pharmacologic class of epinephrine (Adrenaline)?
T = vasopressor
P = adrenergic (high B1 and moderate A1 and B2 activity)
254
What are the side effects and nursing implications for epinephrine (Adrenaline)?
SE = hypertension, tachycardia, hyperglycemia
NI = BP, HR, blood glucose levels
255
What does the nurse need to do after administering epinephrine (Adrenaline)?
check blood glucose q 30 minutes
256
What is the therapeutic and pharmacologic class of norepinephrine (Levophed)?
T = vasopressor
P = adrenergic (high A1 and A2 activity, minor B1 activation)
257
What are the side effects and nursing implications for norepinephrine (Levophed)?
SE = hypertension and bradycardia
NI = BP and HR
258
What is the therapeutic and pharmacologic class of midodrine?
T = vasopressor
P = alpha-1 receptor activation
259
What are the side effects and nursing implications for midodrine?
SE = supine hypertension
NI = BP
260
Patient education for midodrine?
do not take 4 hours before bed
261
What is the therapeutic and pharmacologic class of sildenafil (Viagra) and tadalafil (Cialis)?
T = erectile dysfunction agent
P = phosphodiesterase 5 (PDE-5) inhibitor
262
What are the side effects and nursing implications for sildenafil (Viagra) and tadalafil (Cialis)?
SE = headache, flushing, MI and sudden death (Viagra only)
NI = review additional medications
263
When does sildenafil (Viagra) work and how long does it last?
acts in 30-60 minutes and last 4 hours
264
When does tadalafil (Cialis) work and how long does it last?
acts in 30 minutes and lasts 24-36 hours
265
What is the therapeutic and pharmacologic class of finasteride (Proscar)?
T = hair growth stimulants
P = androgen inhibitor; 5 alpha reductase inhibitor
266
What are the side effects and nursing implications for finasteride (Proscar)?
SE = decreased libido, ED, prostate cancer
NI = N/A
267
Patient education for finasteride (Proscar)?
females should wear gloves as it can be absorbed through the skin (pregnancy category X)
268
What is finasteride (Proscar) used for?
BPH and male pattern baldness
269
What is the therapeutic and pharmacologic class of tamsulosin (Flomax)?
T = non-assigned
P = peripherally-acting anti-adrenergic
270
What are the side effects and nursing implications for tamsulosin (Flomax)?
SE = dizziness, headache
NI = N/A
271
What is tamsulosin (Flomax) used for and when can patients expect to see improvements?
BPH; improvements within 1-2 weeks
272
What is the therapeutic and pharmacologic class of ethinyl estradiol/norelgestromin (Ortho-Evra)?
T = contraceptive hormones
P = estrogen-progestins
273
What are the side effects and nursing implications for ethinyl estradiol/norelgestromin (Ortho-Evra)?
SE = breast tenderness, spotting, nausea, thromboembolic events
NI = patient education
274
Patient education for ethinyl estradiol/norelgestromin (Ortho-Evra)?
Patch location: butt, stomach, upper torso, upper/outer arm
Less effective for patients > 198 lbs
Changed q 7 days for first 3 weeks, patch free 4th week
275
What is the therapeutic and pharmacologic class of etonogestrel (Implanan, Nexplanon)?
T = contraceptive hormones
P = progestins
276
What are the side effects and nursing implications for etonogestrel (Implant, Nexplanon)?
SE = ectopic pregnancy, thromboembolic events
NI = family planning desires, GI assessment
277
How long does etonogestrel (Implanan, Nexplanon) last?
3 years
278
What is the therapeutic and pharmacologic class of medroxyprogesterone (Depo-Provera)?
T = contraceptive hormones
P = progestins
279
What are the side effects and nursing implications for medroxyprogesterone (Depo-Provera)?
SE = spotting, weight gain, delayed return of fertility, bone density loss
NI = determine family planning desires
280
How often should medroxyprogesterone (Depo-Provera) be administered?
one shot q 3 months; not recommended over 2 years
281
What type of patient is the progestin-only ("mini pill") reserved for?
patients at risk of estrogen-related side effects (i.e, DVT); 1-4% failure rate, less effective than estrogen-progestin pill
282
What is the therapeutic and pharmacologic class misoprostol (Cytotec)?
T = cytoprotective agent
P = prostaglandin
283
What are the side effects and nursing implications for misoprostol (Cytotec)?
SE = abdominal pain, miscarriage
NI = assess bleeding and cramping, pain level
284
Patient education for misoprostol (Cytotec) when used as an abortifacient?
take 36-48 hours after mifepristone (Mifeprex)
