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Pharmacology > Pharmacology final > Flashcards

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

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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

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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

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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

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5
Q

What is the max dose for ibuprofen (Advil, Motrin)?

A

3200 mg/day

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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

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7
Q

What is probenecid (Probalan) used for?

A

long-term management of gout

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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)

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9
Q

What routes are included in the enteral route of administration?

A

PO (by mouth) or pr (rectal)

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10
Q

What routes are included in the topical route of administration?

A

transdermal, ophthalmic, otic, nasal, inhalation, vaginal

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11
Q

What routes are included in the parenteral route of administration?

A

intradermal, subcutaneous, intramuscular, intravenous

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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

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13
Q

What is the therapeutic and pharmacologic class for allopurinol (Zyloprim)?

A

T = antigout agent / antihyperuricemic
P = xanthine oxidase inhibitor

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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

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15
Q

What is allopurinol (Zyloprim) used for?

A

Long-term management of gout

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16
Q

What is the therapeutic and pharmacologic class for colchicine (Colcrys)?

A

T = antigout agent
P = decreases the inflammatory response

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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

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18
Q

What is colchicine (Colcrys) used for?

A

acute gout attacks

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19
Q

What is the therapeutic and pharmacologic class for probenecid (Probalan)?

A

T = reduction of serum uric acid levels
P = uricosuric

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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

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21
Q

What is probenecid (Probalan) used for?

A

long-term management of gout

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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

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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

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24
Q

What is indomethacin (Indocin) used for?

A

It is the preferred NSAID for acute attacks of gout

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25
Q

What are the side effects and nursing implications for all antibiotics?

A
  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
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26
Q

What is the therapeutic and pharmacologic class of doxycycline, minocycline, and tetracycline?

A

T = anti-infective
P = tetracyclines

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27
Q

What are the side effects and nursing implications for doxycycline, minocycline, and tetracycline?

A

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

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28
Q

Patient education for doxycycline, minocycline, and tetracycline?

A

Do not take within 1-3 hours of calcium, iron, or antacids

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29
Q

What is the therapeutic and pharmacologic class of vancomycin (Vacocin)?

A

T = anti-infective
P = glycopeptide

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30
Q

What are the side effects and nursing implications for vancomycin (Vacocin)?

A

SE = nephrotoxicity, Red Man Syndrome

NI = trough level and hearing (IV only), kidney labs

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31
Q

What is the therapeutic and pharmacologic class of tobramycin, streptomycin, neomycin, and gentamycin?

A

T = anti-infective
P = aminoglycosides

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32
Q

What are the side effects and nursing implications for tobramycin, streptomycin, neomycin, and gentamycin?

A

SE = nephrotoxicity, ototoxicity

NI = kidney labs, hearing

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33
Q

What are aminoglycosides used for?

A

Antibiotics reserved for serious infections

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34
Q

What is the therapeutic and pharmacologic class of metronidazole (Flagyl)?

A

T = anti-infective
P = nitroimidazole

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35
Q

What are the side effects and nursing implications of metronidazole (Flagyl)?

A

SE = seizures

NI = neuro assessment

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36
Q

What is metronidazole (Flagyl) used for?

A

commonly prescribed for intra-abdominal infections (i.e., C. diff)

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37
Q

What is the therapeutic and pharmacologic class of fidaxomicin, azithromycin, clarithromycin, and erythromycin?

A

T = anti-infective
P = macrolides

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38
Q

What are the side effects and nursing implications for fidaxomicin, azithromycin, clarithromycin, and erythromycin?

A

SE = torsade de pointes

NI = magnesium level

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39
Q

What is the therapeutic and pharmacologic class for trimethoprim/sulfamethoxazole (Bactrim)?

A

T = anti-infective
P = sulfonamide

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40
Q

What are the side effects and nursing implications for trimethoprim/sulfamethoxazole (Bactrim)?

A

SE = agranulocytosis, aplastic anemia

NI = pregnancy status

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41
Q

What is the therapeutic and pharmacologic class for nalidixic acid, ciprofloxacin, norfloxacin, levofloxacin, moxifloxacin, etc.?

A

T = anti-infective
P = fluoroquinolones

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42
Q

What are the side effects and nursing implications for nalidixic acid, ciprofloxacin, norfloxacin, levofloxacin, moxifloxacin, etc.?

A

SE = cartilage toxicity, torsade de pointe’s, suicidal thoughts, hepatotoxicity

NI = musculoskeletal and psych assessments, magnesium level, liver labs

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43
Q

What is the therapeutic and pharmacologic class of tenofovir/emtricitabine (Truvada)?

A

T = antiviral
P = nucleotide reverse transcriptase inhibitor (NRTI)

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44
Q

What are the side effects and nursing implications for tenofovir/emtricitabine (Truvada)?

A

SE = acute renal failure, nausea

NI = monitor for HIV exposure and/or lifestyle changes, kidney labs

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45
Q

What is tenofovir/emtricitabine (Truvada) used for?

A

pre-exposure prophylaxis (PrEP) therapy for HIV

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46
Q

What is the therapeutic and pharmacologic class for nystatin?

A

T = antifungal
P = antifungal

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47
Q

What are the side effects and nursing implications for nystatin?

A

SE = fairly safe, contact dermatitis

NI = skin or oral assessment, instructions on administration

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48
Q

What is nystatin used for?

A

used to treat Tinea Cruris (groin infection/jock itch) and oropharyngeal candidiasis (thrush)

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49
Q

What are the directions for administration of nystatin (oral suspension and topical powder)?

A

oral: swish for 30 seconds and swallow if possibly, do not eat or drink for 30 minutes

topical: apply to infected area

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50
Q

What is the therapeutic and pharmacologic class for amphotericin B?

A

T = antifungal
P = polyene antifungal

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51
Q

What are the side effects and nursing implications for amphotericin B?

A

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

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52
Q

What is amphotericin B used for?

A

used for serious, life-threatening fungal infections (very toxic, but very effective)

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53
Q

What is the therapeutic and pharmacologic class of methotrexate (Trexall)?

A

T = antineoplastic
P = antimetabolite (of folic acid)

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54
Q

What are the side effects and nursing implications for methotrexate (Trexall)?

A

SE = nephropathy (in about 2-12% of pts)

NI = kidney labs, urine pH monitoring

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55
Q

Patients receiving high-dose forms of methotrexate (Trexall) are also on ________ to prevent _______.

A

continuous sodium bicarb infusion to prevent the urine from becoming too acidic

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56
Q

When/what is the nadir period?

A

7-12 days after chemotherapy treatment; bone marrow activity is decreased resulting in lowered blood cell counts

patients are VERY immunocompromised

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57
Q

Patient education for the nadir period (5)?

A
  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
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58
Q

What is the therapeutic and pharmacologic class of codeine with guaifenesin (Cheratussin AC)?

A

T = antitussive
P = opioid cough suppressant

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59
Q

What are the side effects and nursing implications for codeine with guaifenesin (Cheratussin AC)?

A

SE = drowsiness, constipation

NI = cough description, respiratory assessment, vital signs

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60
Q

What is the therapeutic and pharmacologic class for dextromethorphan (Robitussin)?

A

T = antitussive
P = non-opioid cough suppressant

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61
Q

What are the side effects and nursing implications for dextromethorphan (Robitussin)?

A

SE = drowsiness and dizziness (high doses only)

NI = cough description, respiratory assessment

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62
Q

What drugs are used for a dry, non-productive cough vs. a mucous-y cough?

A

antitussives are used to suppress a dry, non-productive cough

expectorants are used to clear phlegm and mucous from the throat

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63
Q

What is the therapeutic and pharmacologic class of guaifenesin (Mucinex)?

A

T = expectorant
P = expectorant

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64
Q

What are the side effects and nursing implications for guaifenesin (Mucinex)?

A

SE = n/v, stomach pain

NI = cough description, respiratory assessment

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65
Q

What is the therapeutic and pharmacologic class of benzonatate (Tessalon)?

A

T = antitussive
P = non-opioid cough suppressant

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66
Q

What are the side effects and nursing implications for benzonatate (Tessalon)?

A

SE = chilly sensation

NI = cough description, respiratory assessment

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67
Q

What is the therapeutic and pharmacologic class of pseudoephedrine (Sudafed)?

A

T = decongestant
P = adrenergic

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68
Q

What are the side effects and nursing implications for pseudoephedrine (Sudafed)?

A

SE = nervousness, palpitations, hypertension, cardiovascular collapse

NI = monitor nasal stuffiness and discharge, BP, and pulse

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69
Q

What is Coricidin used for?

A

Coricidin HBP is an OTC cough and cold medicine containing dextromethorphan and other ingredients (i.e., acetaminophen) for individuals with hypertension

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70
Q

What is the therapeutic and pharmacologic class of albuterol (Proair, Ventolin)?

A

T = bronchodilator
P = adrenergic, short-acting beta agonist (SABA)

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71
Q

What are the side effects and nursing implications for albuterol (Proair, Ventolin)?

A

SE = nervousness, palpitations, paradoxical bronchospasm

NI = respiratory assessment

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72
Q

What is the difference between albuterol and salmeterol?

A

albuterol is used for acute attacks of asthma whereas salmeterol is used for long-term management

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73
Q

What is the therapeutic and pharmacologic class of salmeterol (Serevent)?

A

T = bronchodilator
P = adrenergic, long-acting beta-agonist (LABA)

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74
Q

What are the side effects and nursing implications for salmeterol (Serevent)?

A

SE = headache

NI = respiratory assessment

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75
Q

What is the therapeutic and pharmacologic class of fluticasone (Flovent) and budesonide (Pulmicort)?

A

T = anti-inflammatory
P = corticosteroid

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76
Q

What are the side effects and nursing implications for fluticasone (Flovent) and budesonide (Pulmicort)?

A

SE = thrush, bronchospasms

NI = respiratory and oral cavity assessments

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77
Q

What is the therapeutic and pharmacologic class of ipratropium (Atrovent) and tiotropium (Spiriva)?

A

T = bronchodilator
P = anticholinergic

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78
Q

What are the side effects and nursing implications for ipratropium (Atrovent) and tiotropium (Spiriva)?

A

SE = dry mouth, other anti-ACh effects

NI = respiratory assessment

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79
Q

Patient education for ipratropium (Atrovent) and tiotropium (Spiriva)?

A

chew gum, gargle water and suck on hard candy (for anticholinergic effects)

don’t swallow the pill whole, crush it in the inhaler

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80
Q

What is the therapeutic and pharmacologic class of doxazosin (Cardura), prazosin (Minipress), and terazosin (Hytrin)?

A

T = antihypertensive
P = peripherally-acting alpha-1 blockers

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81
Q

What are the side effects and nursing implications for doxazosin (Cardura), prazosin (Minipress), and terazosin (Hytrin)?

A

SE = orthostatic hypotension

NI = BP and orthostatic vital signs with the first dose

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82
Q

What are doxazosin (Cardura), prazosin (Minipress), and terazosin (Hytrin) used to treat?

A

often prescribed to individuals with hypertension and BPH

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83
Q

What is the therapeutic and pharmacologic class of atenolol, metoprolol, and esmolol?

A

therapeutic and pharmacologic class of atenolol, metoprolol, and esmolol?
T = antihypertensive
P = selective beta blockers

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84
Q

What is the therapeutic and pharmacologic class of propranolol and timolol?

A

T = antihypertensive
P = non-selective beta-blockers

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85
Q

What are the side effects and nursing implications for atenolol, metoprolol, esmolol, propranolol, and timolol?

A

SE = fatigue, erectile dysfunction, bradycardia

NI = BP and pulse

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86
Q

What type of patient would you caution using non-selective beta blockers with?

A

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

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87
Q

What is the therapeutic and pharmacologic class of hydrochlorothiazide (Microzide)?

A

T = antihypertensive
P = thiazide diuretic

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88
Q

What are the side effects and nursing implications of hydrochlorothiazide (Microzide)?

A

SE = hypokalemia, dehydration

NI = BP, potassium level, I&O

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89
Q

Which drug is considered a first-line treatment for mild to moderate hypertension?

A

hydrochlorothiazide

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90
Q

What is the therapeutic and pharmacologic class of lisinopril, captopril, and enalapril?

A

T = antihypertensive
P = angiotensin-converting enzyme (ACE) inhibitor

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91
Q

What are the side effects and nursing implications for lisinopril, captopril, and enalapril?

A

SE = cough, hyperkalemia, angioedema

NI = BP, kidney labs, potassium level, presence of cough, skin assessment

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92
Q

What is the therapeutic and pharmacologic class of nifedipine, amlodipine, and nicardipine?

A

T = antihypertensive
P = selective calcium channel blockers

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93
Q

What is the therapeutic and pharmacologic class of diltiazem and verapamil?

A

T = antihypertensive
P = non-selective calcium channel blockers

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94
Q

What are the side effects and nursing implications for nifedipine, amlodipine, and nicardipine?

A

SE = peripheral edema

NI = BP and BLE assessment

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95
Q

What are the side effects and nursing implications for diltiazem and verapamil?

A

SE = peripheral edema, arrhythmias, heart failure

NI = BP, HR, BLE assessment, and Cardiac assessment

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96
Q

What is the therapeutic and pharmacologic class of furosemide (Lasix) and bumetanide (Bumex)?

A

T = diuretics
P = loop diuretics

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97
Q

What are the side effects and nursing implications for furosemide (Lasix) and bumetanide (Bumex)?

A

SE = hypokalemia, dehydration, ototoxicity

NI = BP, potassium level, I&O, peripheral edema and respiratory assessment

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98
Q

What are furosemide (Lasix) and bumetanide (Bumex) used for?

A

they are aggressive diuretics that are often used to help treat pulmonary congestion and peripheral edema

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99
Q

What is the therapeutic and pharmacologic class of spironolactone (Aldactone)?

A

T = diuretic
P = aldosterone receptor antagonist

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100
Q

What are the side effects and nursing implications for spironolactone (Aldactone)?

A

SE = hyperkalemia

NI = BP, potassium level, I&O, pregnancy status

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101
Q

What is the MOA for hypotonic solutions?

A

the solution has LESS salt/solute than the cell, so water is drawn INTO the cell (cell bursting)

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102
Q

What are hypotonic solutions used for?

A

cellular dehydration, hypernatremia

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103
Q

What are examples of hypotonic solutions?

A

0.45% NS, 2.5% Dextrose

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104
Q

What is the MOA for hypertonic solutions?

A

the solution has MORE salt/solute than the cell, so water wants to escape the cell (cell shrinking)

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105
Q

What are hypertonic solutions used for?

A

hyponatremia and hypovolemia

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106
Q

What are examples of hypertonic solutions?

A

3% NS, 5% NS, D10W

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107
Q

What is important to know about hypertonic solutions?

A

it is a high alert medication because it can cause patient to herniate and have osmotic demyelination syndrome

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108
Q

What are examples of isotonic solutions?

A

0.9% NS, lactated ringers, D5W

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109
Q

What is the therapeutic and pharmacologic class of atorvastatin, pravastatin, rosuvastatin, and simvastatin?

A

T = lipid-lowering agents
P = HMG-CoA reductase inhibitors

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110
Q

What are the side effects and nursing implications for atorvastatin, pravastatin, rosuvastatin, and simvastatin?

A

SE = GI related, liver inflammation, rhabdomyolysis

NI = GI assessment, liver labs, BLE assessment, urine color

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111
Q

What is the first-line treatment for lowering lipid levels?

A

HMG-CoA reductase inhibitors (-statins)

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112
Q

What are the therapeutic and pharmacologic classes of colesevelam (Welchol) and cholestyramine (Questran)?

A

T = lipid-lowering agents
P = bile acid sequestrants

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113
Q

What are the side effects and nursing implications for colesevelam (Welchol) and cholestyramine (Questran)?

A

SE = GI related, nutritional deficiencies, drug binding, TG increase

NI = when to administer medication, GI assessment, TG level

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114
Q

Patient education for colesevelam (Welchol) and cholestyramine (Questran)?

A

Take 2 hours before or 4 hours after other drugs (due to drug binding)

115
Q

What is the therapeutic and pharmacologic class of nitroglycerine (Nitrostat)?

A

T = antianginal
P = rapid-acting nitrate

116
Q

What are the side effects and nursing implications for nitroglycerine (Nitrostat)?

A

SE = hypotension, tachycardia, headache, dizziness

NI = BP, pain assessment, medication review

117
Q

Patient education for individuals taking short or long-acting nitrates?

A

do not take concurrently with Viagra or Cialis (risk of life-threatening hypotension)

118
Q

Patient education for nitroglycerine (Nitrostat)?

A

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
Q

What is the therapeutic and pharmacologic class of isosorbide mononitrate/dinitrate?

A

T = antianginal
P = long-acting nitrate

120
Q

What are the side effects and nursing implications for isosorbide mononitrate/dinitrate?

A

SE = hypotension, tachycardia, headache, dizziness

NI = BP, pain assessment, medication review

121
Q

Patient education for isosorbide mononitrate/dinitrate?

A

do not stop taking abruptly; may cause severe angina attack

122
Q

What is the difference between nitroglycerin (Nitrostat) and isosorbide mononitrate/dinitrate?

A

nitroglycerin is used to abort chest pain

isosorbide mononitrate/dinitrate is used to prevent chest pain

123
Q

What is the therapeutic and pharmacologic class of warfarin (Coumadin)?

A

T = anticoagulant
P = coumarin (inhibits Vitamin K factors 2, 7, 9, and 10)

124
Q

What are the side effects and nursing implications for warfarin (Coumadin)?

A

SE = bleeding

NI = review Hgb/HCT, PT/INR, s/s of bleeding

125
Q

What is the reversal agent for warfarin (Coumadin)?

A

Vitamin K

126
Q

Patient education for warfarin (Coumadin)?

A

patient cannot change their diet regarding vitamin K foods; must be consistent

127
Q

Which anticoagulants are given PO?

A

warfarin (Coumadin), rivaroxaban (Xarelto) and apixaban (Eliquis)

128
Q

What is the therapeutic and pharmacologic class of rivaroxaban (Xarelto) and apixaban (Eliquis)?

A

T = anticoagulant
P = factor Xa (10) inhibitors

129
Q

What are the side effects and nursing implications for rivaroxaban (Xarelto) and apixaban (Eliquis)?

A

SE = bleeding

NI = review Hgb/HCT, s/s of bleeding

130
Q

What is the reversal agent for rivaroxaban (Xarelto) and apixaban (Eliquis)?

A

adexanet alfa (AndexXa)

131
Q

What is the therapeutic and pharmacologic class of heparin?

A

T = anticoagulant
P = antithrombotic

132
Q

What are the side effects and nursing implications for heparin?

A

SE = bleeding, heparin-induced thrombocytopenia (HIT)

NI = review Hgb/HCT, platelets, s/s of bleeding, PTT/anti-Xa (IV only)

133
Q

What is the reversal agent for heparin?

A

Protamine sulfate

134
Q

What is the therapeutic and pharmacologic class of enoxaparin (Lovenox)?

A

T = anticoagulant
P = low molecular weight heparin

135
Q

What are the side effects and nursing implications for enoxaparin (Lovenox)?

A

SE = anemia, bleeding

NI = review Hgb/HCT, platelets, s/s of bleeding

136
Q

What is the therapeutic and pharmacologic class of aspirin (ASA)?

A

T = analgesic and antipyretic
P = binds to COX-1 and COX-2; salicylate

137
Q

What are the side effects and nursing implications for aspirin (ASA)?

A

SE = tinnitus, Reye’s syndrome, GI bleeding

NI = platelet level, GI assessment

138
Q

What is the max dose for aspirin (ASA)?

A

4000 mg/day

139
Q

What is the therapeutic and pharmacologic class of clopidogrel (Plavix)?

A

T = antiplatelet agent
P = ADP receptor blocker

140
Q

What are the side effects and nursing implications for clopidogrel (Plavix)?

A

SE = epistaxis, bleeding

NI = review Hgb/HCT, s/s of bleeding

141
Q

What is clopidogrel (Plavix) used for?

A

prevents thrombus formation in patients who have experienced a thromboembolic event in the past

142
Q

What is the therapeutic and pharmacologic class of alteplase (Activase), streptokinase, and reteplase?

A

T = thrombolytics
P = plasminogen activators

143
Q

What are the side effects and nursing implications for alteplase (Activase), streptokinase, and reteplase?

A

SE = ecchymoses, multiple sites of bleeding

NI = review Hgb/HCT, s/s of bleeding

144
Q

What is alteplase (Activase), streptokinase, and reteplase used for?

A

IV therapy to destroy an already existing clot; d/c of infusion results in immediate termination of thrombolytic activity

145
Q

What is the therapeutic and pharmacologic class of scopolamine (Transdermal Scop)?

A

T = antiemetic
P = anticholinergic

146
Q

What are the side effects and nursing implications for scopolamine (Transdermal Scop)?

A

SE = blurred vision, dry mouth, urinary hesitancy (anti-ACh)

NI = when to apply patch, neuro assessment (d/t increased sympathetic side effects)

147
Q

Patient education for scopolamine (Transdermal Scop)?

A

Apply the patch four hours prior to travel to prevent motion sickness

148
Q

What is the therapeutic and pharmacologic class of meclizine (Antivert), dimenhydrinate (Dramamine), and diphenhydramine (Benadryl)?

A

T = antiemetic
P = antihistamine

149
Q

What are the side effects and nursing implications for meclizine (Antivert), dimenhydrinate (Dramamine), and diphenhydramine (Benadryl)?

A

SE = drowsiness

NI = assess for n/v, neuro assessment

150
Q

What is the therapeutic and pharmacologic class of prochlorperazine (Compazine) in low doses?

A

T = antiemetic
P = phenothiazines (blocks DA in the CNS)

151
Q

What are the side effects and nursing implications for prochlorperazine (Compazine) in low doses?

A

SE = sedation, blurred vision, dry mouth, constipation, NMS, agranulocytosis

NI = assess for n/v, neuro assessment, CBC

152
Q

Prochlorperazine (Compazine) is contraindicated in what type of patient?

A

patients with bone marrow suppression

153
Q

What is the therapeutic and pharmacologic class of metoclopramide (Reglan)?

A

T = antiemetic
P = prokinetic

154
Q

What are the side effects and nursing implications for metoclopramide (Reglan)?

A

SE = drowsiness, EPS, restlessness, NMS

NI = assess for n/v, neuro assessment

155
Q

What is metoclopramide (Reglan) used for and what is its MOA?

A

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
Q

What is the therapeutic and pharmacologic class of ondansetron (Zofran)?

A

T = antiemetic
P = 5HT3 antagonist

157
Q

What are the side effects and nursing implications for ondansetron (Zofran)?

A

SE = headache, constipation, diarrhea, serotonin syndrome, torsade de pointes, SJS, TEN

NI = assess for n/v, neuro, and GI assessment, magnesium level

158
Q

What is ondansetron (Zofran) used for?

A

DOC in pregnancy for hyperemesis AND often given prophylactically before antineoplastic therapy

159
Q

What is the therapeutic and pharmacologic class of omeprazole, lansoprazole, pantoprazole, and esomeprazole?

A

T = antiulcer agent
P = proton pump inhibitor (PPI)

160
Q

What are the side effects and nursing implications for omeprazole, lansoprazole, pantoprazole, and esomeprazole?

A

SE = headache, abdominal pain, n/v/d, osteoporosis-related fractures, C. diff-associated diarrhea (CDAD)

NI = GI assessment, last BM

161
Q

What are PPIs used for?

A

DOC for short-term therapy of peptic ulcer disease and GERD; also combined with antibiotics to combat H. pylori

162
Q

Patient education for PPIs?

A

take before the first major meal of the day
do not crush, swallow whole

163
Q

What is the therapeutic and pharmacologic class of cimetidine (Tagamet) and famotidine (Pepcid)?

A

T = antiulcer agent
P = histamine 2 blocker

164
Q

What are the side effects and nursing implications for cimetidine (Tagamet) and famotidine (Pepcid)?

A

SE = confusion (if pt has renal or hepatic issues)

NI = GI assessment

165
Q

Patient education for cimetidine (Tagamet) and famotidine (Pepcid)?

A

do not take with antiacids

166
Q

What is the therapeutic and pharmacologic class of docusate (Colace)?

A

T = laxative
P = stool softener

167
Q

What are the side effects and nursing implications for docusate (Colace)?

A

SE = diarrhea, mild cramps

NI = GI assessment, last BM

168
Q

What is docusate (Colace) used for?

A

preventative use for surgery d/t constipation from opioids

169
Q

What is the therapeutic and pharmacologic class of sucralfate (Carafate)?

A

T = antiulcer agent
P = GI protectant

170
Q

What are the side effects and nursing implications for sucralfate (Carafate)?

A

SE = constipation, hypersensitivity reactions

NI = GI assessment, meal, and other medication schedule

171
Q

Patient education for sucralfate (Carafate)?

A

take 1 hour before meals and 2 hours after other medications

172
Q

What is the therapeutic and pharmacologic class of senna (Sennakot)?

A

T = laxative
P = stimulant

173
Q

What are the side effects and nursing implications for senna (Sennakot)?

A

SE = diarrhea, cramps

NI = GI assessment, last BM

174
Q

What is senna (Sennakot) used for?

A

short term therapy for constipation (may cause electrolyte imbalance and dependency)

common part of bowel regimen for spinal cord patients

175
Q

Which vitamins are water-soluble?

A

B & C

176
Q

Which vitamins are fat soluble?

A

A,D,E,K

177
Q

What are the side effects of thiamine (Vitamin B1)?

A

weakness, tightness of throat, angioedema

178
Q

What are the side effects of riboflavin (Vitamin B2)?

A

yellow discoloration of urine (large doses only)

179
Q

What are the side effects of niacin (Vitamin B3)?

A

niacin flushing, hepatotoxicity (in high doses only, when used for hyperlipidemia)

180
Q

What does folic acid (B9 & Folate) do in the body?

A

involved in RBC formation and prevents neural tube defects in pregnancy; used to treat folic-deficiency anemia

181
Q

What are the side effects and nursing implications of folic acid (B9 & Folate)?

A

SE = none commonly reported
NI = RBC, Hgb/HCT, MCV, MCHC, pregnancy status

182
Q

What types of patients are most likely to have vitamin B12 deficiency?

A

alcoholics and individuals who are unable to produce intrinsic factor

183
Q

What are the side effects and nursing implications for cyanocobalamin (Vitamin B12)?

A

SE = none commonly reported
NI = RBC, Hgb/HCT, MCV, MCHC

184
Q

What are the side effects and nursing implications for ascorbic acid (Vitamin C)?

A

SE = diarrhea, flushing

NI = assess wound healing and/or gums and gingiva

185
Q

What is ascorbic acid (Vitamin C) used for?

A

collagen formation and tissue repair

186
Q

What are the side effects and nursing implications for ergocalciferol (Vitamin D2)?

A

SE = weakness, pancreatitis

NI = assess bone structure, calcium, phosphorus, and kidney labs

187
Q

What condition is caused by a deficiency in Vitamin D2?

A

rickets

188
Q

What are the side effects and nursing implications for Vitamin K?

A

SE = pain at injection site

NI = assess bleeding, liver labs

189
Q

What are the side effects of vitamin E?

A

weakness, fatigue, headache

190
Q

What is the therapeutic and pharmacologic class of clonazepam, diazepam (Valium), lorazepam (Ativan), temazepam (Restoril), alprazolam (Xanax), and midazolam?

A

T = anti-anxiety
P = benzodiazepines

191
Q

What are the side effects and nursing implications for clonazepam, diazepam (Valium), lorazepam (Ativan), temazepam (Restoril), alprazolam (Xanax), and midazolam?

A

SE = drowsiness, dizziness, apnea

NI = vital signs, LOC

192
Q

What is the antidote for benzodiazepines?

A

flumazenil (Romazicon)

193
Q

What are benzodiazepines used for?

A

to treat anxiety and/or insomnia

194
Q

What is the therapeutic and pharmacologic class of valproic acid (Depakene)?

A

T = anticonvulsant
P = increases levels of GABA

195
Q

What are the side effects and nursing implications for valproic acid (Depakene)?

A

SE = dizziness, sedation, abdominal pain, hepatotoxicity, pancreatitis, suicidal thoughts

NI = neuro/psych/GI assessments, liver labs

196
Q

Patient education for valproic acid (Depakene)?

A

do not administer with milk or carbonated beverages

197
Q

Valproic acid (Depakene) is contraindicated in what type of patients?

A

patients with liver disease/issues

198
Q

What is the therapeutic and pharmacologic class of levetiracetam (Keppra)?

A

T = anticonvulsant
P = pyrrolidines

199
Q

What are the side effects and nursing implications for levetiracetam (Keppra)?

A

SE = dizziness, drowsiness, agitation, anger, anxiety, suicidal thoughts

NI = neuro and psych assessment

200
Q

What is the therapeutic and pharmacologic class of phenytoin (Dilantin)?

A

T = anticonvulsant
P = hydantoin

201
Q

What are the side effects and nursing implications for phenytoin (Dilantin)?

A

SE = ataxia, gingival hyperplasia, lethargy, suicidal thoughts, aplastic anemia, angioedema, cardiac arrest

NI = neuro and psych assessments, assess oral hygiene, CBC

202
Q

What is the therapeutic and pharmacologic class of prochlorperazine (Compazine) in high doses?

A

T = antipsychotic
P = phenothiazine; antidopaminergic

203
Q

What are the side effects and nursing implications for prochlorperazine (Compazine) in high doses?

A

SE = anticholinergic effects, EPS, NMS

NI = mental status, EPS, and NMS symptoms

204
Q

What symptoms of schizophrenia does prochlorperazine (Compazine) treat and when can patients expect to see improvements?

A

treats the positive signs of schizophrenia (i.e., hallucinations); resolved within days to weeks

205
Q

What is the therapeutic and pharmacologic class of acetaminophen (Tylenol)?

A

T = non-opioid analgesic, antipyretic
P = inhibits prostaglandin synthesis

206
Q

What are the side effects and nursing implications for acetaminophen (Tylenol)?

A

SE = rash, urticaria, hepatotoxicity

NI = liver labs, pain and/or temperature assessment

207
Q

What is the max dose of acetaminophen? And for those with liver issues?

A

4000 mg/day for average adult

2000 mg/day for individuals with liver conditions

208
Q

What is the therapeutic and pharmacologic class for baclofen, carisoprodol (Soma), cyclobenzaprine (Flexeril), and metaxalone (Skelaxin)?

A

T = centrally-acting skeletal muscle relaxant
P = CNS depressant

209
Q

What are the side effects and nursing implications for baclofen, carisoprodol (Soma), cyclobenzaprine (Flexeril), and metaxalone (Skelaxin)?

A

SE = drowsiness

NI = pain assessment

210
Q

Baclofen, carisoprodol (Soma), cyclobenzaprine (Flexeril), and metaxalone (Skelaxin) is contraindicated in what type of patients?

A

hypersensitivity reactions, compromised pulmonary function, active hepatic disease and impaired myocardial function

211
Q

What is the therapeutic and pharmacologic class of codeine, hydrocodone, and oxycodone (Oxycontin)?

A

T = opioid analgesic
P = opioid agonist

212
Q

What are the side effects and nursing implications for codeine, hydrocodone, and oxycodone (Oxycontin)?

A

SE = sedation, hypotension, constipation, respiratory depression

NI = pain and GI assessments, LOC, vital signs

213
Q

What are codeine, hydrocodone, and oxycodone (Oxycontin) used for?

A

moderate pain (Schedule II controlled substances)

214
Q

What is the therapeutic and pharmacologic class of naloxone (Narcan)?

A

T = opioid antidote
P = opioid antagonist

215
Q

What are the side effects and nursing implications for naloxone (Narcan)?

A

SE = ventricular arrhythmias

NI = pain assessment (post-administration), vital signs, LOC

216
Q

What is the therapeutic and pharmacologic class of sumatriptan (Imitrex)?

A

T = vascular headache suppressant
P = 5HT-1 receptor agonist; constricts intracranial vessels

217
Q

What are the side effects and nursing implications for sumatriptan (Imitrex)?

A

SE = dizziness, vertigo, warm sensation, hypersensitivity reactions

NI = pain assessment, vital signs

218
Q

Patient education for sumatriptan (Imitrex)?

A

do not take with other vasoconstrictive drugs (i.e., vasopressin, epinephrine) d/t risk for HTN

used to abort a migraine; not preventative

219
Q

What is the therapeutic and pharmacologic class of latanoprost (Xalatan), bimatoprost (Lumigan), tafluprost (Zioptan), and travoprost (Travatan)?

A

T = ocular hypotensive agent
P = prostaglandin analog

220
Q

What are the side effects and nursing implications for latanoprost (Xalatan), bimatoprost (Lumigan), tafluprost (Zioptan), and travoprost (Travatan)?

A

SE = hypopigmentation, thicker/longer lashes, irritation and burning (first month)

NI = eye assessment

221
Q

What is the therapeutic and pharmacologic class of pilocarpine (Pilocar)?

A

T = parasympathetic
P = cholinergic agonist

222
Q

What are the side effects and nursing implications for pilocarpine (Pilocar)?

A

SE = blurred vision, stinging, headache, miosis (pupillary constriction)

NI = eye assessment

223
Q

What is the therapeutic and pharmacologic class of dorzolamide (Trusopt)?

A

T = ocular hypotensive agent
P = carbonic anhydrase inhibitor

224
Q

What are the side effects and nursing implications for dorzolamide (Trusopt)?

A

SE = bitter taste, eye irritation

NI = eye assessment

225
Q

What does dorzolamide (Trusopt) have a cross-sensitivity with?

A

sulfonamides

226
Q

What is the therapeutic and pharmacologic class of timolol (Timoptic, Betimol)?

A

T = ocular hypotensive agent
P = beta blocker

227
Q

What are the side effects and nursing implications for timolol (Timoptic, Betimol)?

A

SE = conjunctivitis, decreased visual acuity

NI = eye assessment

228
Q

What happens if systemic absorption of timolol (Timoptic, Betimol) occurs?

A

monitor for hypotension, bradycardia, and bronchoconstriction

229
Q

Timolol (Timoptic, Betimol) should be cautioned in what type of patient?

A

Patients with asthma or heart failure

230
Q

What is the peak for lispro (Humalog)?

A

30 to 60 minutes

231
Q

What is the peak for regular insulin (Humulin R)?

A

2-4 hours

232
Q

What is the peak for isophane (NPH)?

A

4-12 hours

233
Q

What is the peak for detemir (Levemir)?

A

6-8 hours

234
Q

What is the peak for glargine (Lantus)?

A

no peak

235
Q

When is the patient at the highest risk of a hypoglycemic reaction?

A

at the peak of the drug

236
Q

which insulin can be administered intravenously?

A

regular

237
Q

What is the therapeutic and pharmacologic class of chlorpropamide, tolbutamide, tolazamide, glimeperide, glipizide, and glyburide?

A

T = antidiabetic
P = sulfonylureas

238
Q

What are the side effects and nursing implications for chlorpropamide, tolbutamide, tolazamide, glimepiride, glipizide, and glyburide?

A

SE = hypoglycemia (BIG risk)

NI = blood glucose level, LFTs (first generation only)

239
Q

What is the therapeutic and pharmacologic class of metformin (Glucophage)?

A

T = antidiabetic
P = biguanide

240
Q

What are the side effects and nursing implications for metformin (Glucophage)?

A

SE = diarrhea, n/v, abdominal bloating, lactic acidosis

NI = blood glucose level, GI assessment, upcoming procedures

241
Q

Patient education for metformin (Glucophage)?

A

hold drug before and 48 hours after any procedures with IV dye/contrast

242
Q

What is the drug of choice for Type II Diabetes Mellitus?

A

Metformin (Glucophage)

243
Q

What is the therapeutic and pharmacologic class of exenatide (Byetta), liraglutide (Victoza), semaglutide (Ozempic), and dulaglutide (Trulicity)?

A

T = antidiabetic
P = incretin mimetics/GLP-1 agonists

244
Q

What are the side effects and nursing implications for exenatide (Byetta), liraglutide (Victoza), semaglutide (Ozempic), and dulaglutide (Trulicity)?

A

SE = diarrhea, n/v, dehydration, pancreatitis

NI = GI assessment, I&O, amylase/lipase

245
Q

When/what route is dextrose (glucose) given?

A

given po during a hypoglycemic event when the patient is conscious

246
Q

When/what route is glucagon given?

A

given IM or subQ during a hypoglycemic event when the patient is unconscious

247
Q

What is the therapeutic and pharmacologic class of ferrous sulfate?

A

T = anti-anemic
P = iron supplement

248
Q

What are the side effects and nursing implications for ferrous sulfate?

A

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
Q

What lab values would you expect to see in someone with iron-deficiency anemia?

A

low iron
low ferritin
high TIBC
low MCV
low MCHC

250
Q

What is the therapeutic and pharmacologic class of filgrastim (Neupogen) and pegfilgrastim (Neulasta)?

A

T = colony-stimulating factor
P = neutrophil stimulator

251
Q

What are the side effects and nursing implications for filgrastim (Neupogen) and pegfilgrastim (Neulasta)?

A

SE = bone pain, splenic rupture, hypersensitivity reactions

NI = neutrophils, LUQ and pain assessment, s/s of allergic reaction

252
Q

Patient education for individuals who are going to receive colony-stimulating therapy?

A

H1 blockers are commonly recommended one day prior and a few days after therapy to decrease bone pain

253
Q

What is the therapeutic and pharmacologic class of epinephrine (Adrenaline)?

A

T = vasopressor
P = adrenergic (high B1 and moderate A1 and B2 activity)

254
Q

What are the side effects and nursing implications for epinephrine (Adrenaline)?

A

SE = hypertension, tachycardia, hyperglycemia

NI = BP, HR, blood glucose levels

255
Q

What does the nurse need to do after administering epinephrine (Adrenaline)?

A

check blood glucose q 30 minutes

256
Q

What is the therapeutic and pharmacologic class of norepinephrine (Levophed)?

A

T = vasopressor
P = adrenergic (high A1 and A2 activity, minor B1 activation)

257
Q

What are the side effects and nursing implications for norepinephrine (Levophed)?

A

SE = hypertension and bradycardia

NI = BP and HR

258
Q

What is the therapeutic and pharmacologic class of midodrine?

A

T = vasopressor
P = alpha-1 receptor activation

259
Q

What are the side effects and nursing implications for midodrine?

A

SE = supine hypertension
NI = BP

260
Q

Patient education for midodrine?

A

do not take 4 hours before bed

261
Q

What is the therapeutic and pharmacologic class of sildenafil (Viagra) and tadalafil (Cialis)?

A

T = erectile dysfunction agent
P = phosphodiesterase 5 (PDE-5) inhibitor

262
Q

What are the side effects and nursing implications for sildenafil (Viagra) and tadalafil (Cialis)?

A

SE = headache, flushing, MI and sudden death (Viagra only)

NI = review additional medications

263
Q

When does sildenafil (Viagra) work and how long does it last?

A

acts in 30-60 minutes and last 4 hours

264
Q

When does tadalafil (Cialis) work and how long does it last?

A

acts in 30 minutes and lasts 24-36 hours

265
Q

What is the therapeutic and pharmacologic class of finasteride (Proscar)?

A

T = hair growth stimulants
P = androgen inhibitor; 5 alpha reductase inhibitor

266
Q

What are the side effects and nursing implications for finasteride (Proscar)?

A

SE = decreased libido, ED, prostate cancer

NI = N/A

267
Q

Patient education for finasteride (Proscar)?

A

females should wear gloves as it can be absorbed through the skin (pregnancy category X)

268
Q

What is finasteride (Proscar) used for?

A

BPH and male pattern baldness

269
Q

What is the therapeutic and pharmacologic class of tamsulosin (Flomax)?

A

T = non-assigned
P = peripherally-acting anti-adrenergic

270
Q

What are the side effects and nursing implications for tamsulosin (Flomax)?

A

SE = dizziness, headache

NI = N/A

271
Q

What is tamsulosin (Flomax) used for and when can patients expect to see improvements?

A

BPH; improvements within 1-2 weeks

272
Q

What is the therapeutic and pharmacologic class of ethinyl estradiol/norelgestromin (Ortho-Evra)?

A

T = contraceptive hormones
P = estrogen-progestins

273
Q

What are the side effects and nursing implications for ethinyl estradiol/norelgestromin (Ortho-Evra)?

A

SE = breast tenderness, spotting, nausea, thromboembolic events

NI = patient education

274
Q

Patient education for ethinyl estradiol/norelgestromin (Ortho-Evra)?

A

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
Q

What is the therapeutic and pharmacologic class of etonogestrel (Implanan, Nexplanon)?

A

T = contraceptive hormones
P = progestins

276
Q

What are the side effects and nursing implications for etonogestrel (Implant, Nexplanon)?

A

SE = ectopic pregnancy, thromboembolic events

NI = family planning desires, GI assessment

277
Q

How long does etonogestrel (Implanan, Nexplanon) last?

A

3 years

278
Q

What is the therapeutic and pharmacologic class of medroxyprogesterone (Depo-Provera)?

A

T = contraceptive hormones
P = progestins

279
Q

What are the side effects and nursing implications for medroxyprogesterone (Depo-Provera)?

A

SE = spotting, weight gain, delayed return of fertility, bone density loss

NI = determine family planning desires

280
Q

How often should medroxyprogesterone (Depo-Provera) be administered?

A

one shot q 3 months; not recommended over 2 years

281
Q

What type of patient is the progestin-only (“mini pill”) reserved for?

A

patients at risk of estrogen-related side effects (i.e, DVT); 1-4% failure rate, less effective than estrogen-progestin pill

282
Q

What is the therapeutic and pharmacologic class misoprostol (Cytotec)?

A

T = cytoprotective agent
P = prostaglandin

283
Q

What are the side effects and nursing implications for misoprostol (Cytotec)?

A

SE = abdominal pain, miscarriage
NI = assess bleeding and cramping, pain level

284
Q

Patient education for misoprostol (Cytotec) when used as an abortifacient?

A

take 36-48 hours after mifepristone (Mifeprex)

Pharmacology (1 decks)

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