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Pharmacology > Pharmacology Final Study Guide > Flashcards

Pharmacology Final Study Guide Flashcards

1
Q

Questions for pharm final: unanswered

A

What to do with red and syndrome occurs
Metronazole adverse effects
Black box warning for quinolone
What do we use to treat UTIs
How to know an antibiotic is working
Practice infusion rates
What laxative is safe for long term use (bulk)
Adverse effects for PPIs
Contraindications for cyclobenzaprine
Know fastest way to get medication to a patient
Know how a PCA works
Antidote for opioids
A lot of delegation
What to do when a patient is having an allergic reaction
Cultural considerations for pain (how different cultures deal with pain)
Adverse effects of opioids.
Contraindications for acetaminophen
Medications for hypothyroidism
Betablocker nursing considerations.. what to do before you give a beta blocker
Contraindications for beta blockers
Steroid patient education (what are you gonna teach someone on corticosteroids
Adverse effects on cimetidine
Know action of albuterol
How to give a sub-q heparin shot, what to give, and how to monitor
What to give when the dose is too high. (If you gave the wrong med)
Know ethical principles
Herbal supplements that interact with warfarin
Know valerian
What to monitor for when someone is taking a thiazide
Know what poly pharmacy is
What to report for lisinopril
Dietary considerations for statin drug
Weight based calculation
Antidote for heparin
Antidote for warfarin (vitamin k)
Digoxin toxicity symptoms
What to monitor with furosemide

2 Weight math
1 Infusion rate but not drip
Other 5 questions are basic med math

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2
Q

How to take extended release tablets

A

Examples are SR (slow release or sustained release)
SA (sustained action)
CR (controlled release)
XL (extended length)
XT (extended time)
Oral dosages must not be crushed as this could cause accelerated release of drug from the dosage form and possible toxicity
Enteric coated tables also are not recommended for crushing as it would cause disruption of the tablet coating designed to protect the stomach lining from the local effects of the drug and/or protect the drug from being disrupted by stomach acid.

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3
Q

What are normal potassium levels

A

3.5 to 5.2 mEq/L

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4
Q

What are indications for antibiotics

A

Empiric therapy: we don’t know bacteria yet
Definitive therapy: we know the specific bacteria
Prophylactic therapy: give to someone getting abdominal surgery/trauma for infection

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5
Q

Sulfonamides indication

A

Urinary tract infection

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6
Q

Macrolides Indications

A

Treat infections typically treated with penicillin (PCN) in clients with PCN allergy

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7
Q

Quinolones indications

A

Upper respiratory, gastrointestinal, urinary tract, bone, and joint infections

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8
Q

Aminoglycoside examples

A

Gentamicin
Tobramycin
Neomycin
Amikacin

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9
Q

Losartan indication

A

Beneficial in patients with hypertension and heart failure and stroke prevention
These medications block the action of angiotensin 2 in the body resulting in vasodilation (arteriales and veins) and excretion of sodium and water.

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10
Q

Contraindications for phenobarbital

A

Drug under the class of barbiturates. Indication is to slow down the activity of the brain to result in sedation, anesthesia, and control seizure.

Contraindications
Respiratory, kidney, or liver disease
Caution in older adults (higher risk for falls & accumulate more in older adults)

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11
Q

Theophylline and dietary restrictions

A

Theophylline is under Xanthine derivatives
Indication: bronchoconstriction. Has bronchodilating properties NOT for the management of acute asthma attack
Treat asthma and COPD

Dietary Restrictions
Caffeine increases CNS and cardicac adverse effects & increase theophylline levels
Avoid any caffeinated beverages with medication
(Examples: coffee, chocolate, tea, coke)

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12
Q

Signs of hyperthyroidism

A

Nervousness, irritability, tremors, insomnia
Tachycardia, palpitations
Increased appetite, weight loss, diarrhea
Muscle weakness, fatigue
Heat intolerance, flushing

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13
Q

Adverse effects of aspirin

A

Prolonged bleeding time, thrombocytopenia (platelet count lower than 150,000 per/mm3)
Tinnitus, hearing loss (ASA)
N/V, dyspepsia (indigestion/ bloating)
GI bleed

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14
Q

Assessment for allergies

A

Ask everything that the patient is taking even herbs are apart of nursing assessment. Ask a broad question for the patient to answer

Most patients are allergic to morphine but itching is an anticipated reaction .. we worry if an airway closes up

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15
Q

Pharmacotherapeutics definition

A

Clinical use of drugs to prevent and treat diseases. Defines the principles of drug reactions.

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16
Q

Vancomycin indications

A

MRSA (methicillin resistant staphylococcus aureus infection) caused by a type of staph bacteria that’s become resistant to many of the antibiotics used to treat ordinary staph infections)
C. Diff infections

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17
Q

Action of Metoclopramide

A

One of the antiemetic medications that help prevent or relieve nausea and vomiting.
Helps to stimulate peristalsis to get food out quicker

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18
Q

Medications with a side effect of diarrhea

A

Magnesium (antacids)
Antibiotics (common adverse effects)
Montelukast & zafirlukast (leukotriene receptor antagonists for treatment and prevention of asthma)
Antiemetics

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19
Q

Nursing intervention taking calcium carbonate

A

Monitor bowel function
Administer stool softeners
Monitor for severe diarrhea
Monitor phosphorus (can contribute to kidney stones) and magnesium levels (magnesium reduces the risk of kidney stones)

Compliance can be due to the frequency of administration (most people dont want to take medication 7x a day). remind them that medication is for relief of pain and healing of ulcer

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20
Q

What is NPH peak

A

NPH is intermediate acting (cloudy insulin)
Peak time is 4-14 hours

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21
Q

What to do when interrupted while preparing a medication

A

(Not sure what the question is asking… assuming this means to toss any medication that isn’t labeled?? Also dont administer medicine another nurse has prepared)

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22
Q

What to do when someone asks for pain medication

A

Perform a thorough health history, nursing assessment an medication history.
Assess their pain level
- including intensity of pain, including onset, location and quality
- actual rating of the pain using a pain assessment scale
- assess pain before, during, and after the pain intervention

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23
Q

Teaching Diphenoxylate/ atropine

A

Treatment for diarrhea

If experiencing diarrhea, drink small amounts of clear liquids or a commercial oral electrolyte solution to maintain electrolyte balance for the first 24 hr.
Avoid drinking plain water to replace fluids because it does not contain necessary electrolytes that has been lost in stool
Avoid caffeine. Caffeine exacerbates diarrhea by increasing GI motility

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24
Q

Medication to remove mucus

A

Guaifenesin (an expectorant)
-helps to loosen or thin the sputum
-reduce the viscosity of secretions
-disintegrate and thin secretions

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25
Q

What negligence looks like

A

The failure to act in a reasonable and prudent manner or failure of the nurse to give the care that a reasonable cautious nurse would render or use under similar circumstances

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26
Q

Normal glucose levels

A

Between 70 mg/dL and 100 mg/dL

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27
Q

Side effects of nasal decongestants

A

Examples of nasal decongestants:
pseudoephedrine (oral), phenylephrine (topical), beclomethasone, fluticasone (intranasal steroids)

Side effects
Nervousness, tremors
Palpitations, hypertension
Headache, dizziness
Local mucosa dryness and irritation
Insomnia

(Oral and nasal together can cause drug toxicity)

28
Q

complications of long term use of laxatives

A

Fluid and electrolyte imbalance
Hypokalemia: as potassium concentration is high in stool water.
- Hypokalemia can cause muscle weakness.

29
Q

Ondansetron adverse effects

A

Headache, dizziness
Dysrhythmia
Diarrhea

30
Q

What to do with Redman syndrome

A

Infusion related to vancomycin
Red man syndrome occurs if medication is infused too quickly (causing pruritus, hypotension and tachycardia)

Vancomycin infusion should be discontinued immediately ( a dose of diphenhydramine [an antihistamine aka Benadryl] can abort reaction) .

31
Q

Adverse effect of metronidazole

A

Miscellaneous antibiotic
Adverse effects
*Nausea, dry mouth, headache
*Metallic taste

32
Q

Quinolone Black box warning

A

Blackbox warning are required for all quinolones because of the increased risk for tendinitis and tendon rupture

  • As well as peripheral neuropathy central system effects (seizures), and exacerbation of myasthenia gravis.
  • Tendon rupture is more common in older adults, patients with renal failure, and those receiving glucocorticoid therapy
33
Q

What do we use to treat UTIs

A

Sulfonamides indication is to treat urinary tract infection

Fluoroquinolones are also indicated for UTIs

34
Q

How to know if an antibiotic is working

A

Reduction of manifestations (fever, pain, inflammation, and adventitious breath sounds)
Resolution of infection

Antibiotics usually start working right away but take several days to notice an effect.

It is important that patients complete their full course of antibiotics as prescribed, even when their symptoms have improved, to prevent relapse of infection and the development of antibiotic resistance

35
Q

What laxative is safe for long term

A

Bulk forming : psyllium and methylcellulose

36
Q

PPIs adverse effects

A

Pneumonia
Osteoporosis
C. Diff- associated diarrhea
Wrist, spine, hip fracture
Hypomagnesemia

37
Q

Contrainidications for cyclobenzaprine

A

Cyclobenzaprine: muscle relaxant, can treat pain and stiffness caused by muscle spasms

Contraindications
Liver and renal function
- obtain baseline liver function and perform periodic follow-up liver function tests

*hyperthyroidism
*myocardial infarction
*heart failure/ heart block

adverse effects
Eurphoria
Lightheadedness, dizziness, drowsiness
Muscle weakness
Fatigue

38
Q

Fastest way to get medication to a patient

A

Intravenously (IV)

39
Q

Abbreviations

A

AC - Before meals
PC - After meals
Daily - Everyday, daily
bid - Twice a day
tid - Three times a day
qid - Four times a day
qh - every hour
At bedtime - At bedtime
qn - Every night
stat - immediately

Ever other day - every other day
prn - as needed
3 times weekly - three times per week
biw - twice per week

40
Q

Know how a PCA works

A

PCA is a patient controlled analgesia
- a needle attached to an IV (intravenous) line is placed into one of your veins. A computerized pump attached to the IV lets you release pain medicine by pressing a handheld button.

41
Q

Antidote for opioids

A

Naloxone
Other medications:
- Naltrexone
-Methylnaltrexone
-Alvimopan

These medications work on morphine, fentanyl, methadone, codeine, oxy….

42
Q

Delegation

A

The registered nurse cannot delegate responsibilities related to making nursing judgments.

An examples would be:
Anew admission who is highly unstable should be assigned to a registered nurse; the care of a stable chronically ill patient who is relatively stable and more predictable than a serious ill and unstable acute client can be delegated to the licensed practical nurse.

43
Q

What to do when a patient is having an allergic reaction

A

First assess make sure they can breath
Stop administering the medication and notify the providers

44
Q

Cultural considerations for pain

A

African American : believe in the power of healers who rely strongly on the religious faith of people, and often use prayer in the laying of hands for a relief of pain

Hispanic Americans: believe in prayer, the wearing of amulets, and the use of herbs and spices to maintain health and wealth specific herbs are used in teas and therapies often including religious practices, massage and cleanings

Chinese : include acupuncture, herbal remedies, Yin and yang balancing, and cold treatment

Asian and Pacific Islander’s : often reluctant to express their pain because they believe that the pain isn’t Godswill or punishment for past sins

Native Americans: treatments for pain include massage, the application of heat, sweat baths, herbal remedies, and being in harmony with nature

Arab culture : are expected to express their pain openly and anticipate immediate relief, preferably through injections or intravenous drugs

45
Q

Adverse effects of opioids

A

Respiratory depression
Constipation
Orthostatic hypotension
Urinary retention
Cough suppression
Sedation
biliary colic
Nausea, vomiting
Opioid toxicity triad ( coma, respiratory depression, and pinpoint pupils)

46
Q

Contraindications for acetaminophen

A

Bone marrow suppression
- monitor CBC, including platelets
Gastrointestinal (GI) distress
- monitor for bleeding (coffee-ground emesis; bloody stools)
MI or stroke
- Monitor for cardiac status especially in clients with history of cardiac disease

47
Q

Medications for hypothyroidism

A

High TSH
Low TH

Medication: Levothyroxine

48
Q

Beta blocker nursing considerations/ what to do before you give a beta blocker

A

Monitor pulse: if below 50/min hold medication and notify provider
Metoprolol, propranolol: in clients who have diabetes mellitus monitor blood hypoglycemia which can mask tachycardia.
Nursing administration:
-Administer medications orally, usually once or twice a day
-take with food to increase absorption

49
Q

Contraindication for beta blockers

A

Clients who have AV block and sinus bradycardia
Asthma, bronchospasm (non cardio selective drugs such as propranolol)
Metoprolol and atenolol are better since they are cardioselective (alpha 1)

In general, use beta-adrenergic blockers cautiously in clients who have myasthenia gravis, hypotension, peripheral vascular disease, diabetes mellitus, depression, and in older adults with history of allergies

50
Q

Steroid patient education

A

Glucocorticoids: dexamethasone
- Client education:
* eat potassium rich foods ( because of fluid and electrolyte disturbances)
*risk of osteoporosis can be reduced by giving calcium supplements and vitamin D.
* clients should not receive immunizations while on glucocorticoid therapy because they decrease antibody response to vaccines.
*PUD- educate client to take the medication with meals .. and report black tarry stools

Glucocorticoids: beclomethasone
-Client education
* inhalation drug. Rinse mouth or gargle with water after use, monitor for redness, sores, or white patches

Baseline vital signs : respiratory rate 12-24 breath/min

Glucocorticoids: prednisone
-client education
* Perform weight bearing exercises
* consume a diet with sufficient calcium and vitamin D intake
* Report indications of muscle weakness
* Avoid NSAIDs, report for black, tarry stools
*( notify if early manifestation of infection, and avoid large crowds if possible

51
Q

Adverse effect of cimetidine

A

Cimetidine: H2RBs: treatment of acid related disorders, adjunct therapy to control, management of urticaria

Adverse effects
Confusion, disorientation in the elderly
Impotence
Gynecomastia

52
Q

Action of albuterol

A

Beta 2 adrenergic agonist
Short acting : good for an acute attack. Something that’s sudden

Action: Act by selectively activating the beta 2 receptors in the bronchial smooth muscle, resulting in bronchodilator. As a result:
- Bronchospasm is relieved
-Histamine release is inhibited
-ciliary motility is increased

53
Q

How to give Sub- Q heparin shot, what to give and how to monitor. H

A

Enoxaparin - subQ injectable only
— Bridge therapy
— do not expel air bubble

Monitor bleeding time
- Normal activated partial thrombophlebitis time (aPTT): 30-40 sec (60-80 sec during treatment) <— is the goal

Remember contraindications: bleeding, thrombocytopenia (normal 150,000 -400, 000) , and pregnancy

54
Q

What to give when the dose is too high (if you gave the wrong medication)

A
55
Q

Know ethical principles

A

Autonomy:
Beneficence:
Nonmaleficence:
Veracity: telling the truth
Justice: equality
Confidentiality:

56
Q

Herbal supplements that interact with warfarin

A

Ginkgo Bilbao, ginger, spinach, St. John’s Wort, cranberry, green tea, chamomile tea

57
Q

Know valerian

A

Valerian root, consisting of fresh underground plant parts

Common uses: relief of anxiety, restlessness, sleep disorders

Adverse effects: Central nervous system depression, hepatotoxicity, nausea, vomiting, anorexia, headache, restlessness, insomnia

Contraindicated in patients with cardiac disease, liver disease, or those operating heavy machinery including treatment of insomnia, moderate sedation

58
Q

What to monitor for when someone is taking a thiazide

A

Hyponatremia
*Monitor electrolytes and weight
Hypokalemia and hypochloremia
*Monitor cardiac status and K+ levels especially if taking digoxin
Hyperglycemia
*Monitor for an increase in blood glucose levels
Hyperuricemia
*Monitor uric acid, magnesium, hdl and ldl and triglyceride levels

59
Q

What is poly pharmacy

A

The use of many different drugs concurrently in treating a patient, who often has several health problems.

  • As the number of medications a person takes increases, so does the risk for drug interaction and ADRs.

*Recognizing poly pharmacy is important to reduce the incidence of adverse outcomes

60
Q

What to report for lisinopril

A

Lisinopril is an ACE inhibitor: the drug of choice for hypertensive clients with heart failure

Important to report angioedema
Adverse effects also include:
-Orthostatic hypotension
-cough
-neutropenia
-rash
-dysgeusia (metallic taste in mouth)
-hyperkalemia

61
Q

Dietary considerations for statin drugs

A

Statin drugs: Antilipemic agents for high cholesterol (hypercholesteremia)

Examples : Atorvastatin, simvastatin

** Drug food interaction**
— increased levels of statin with grapefruit juice (can lead to rhabdomyolysis —> damage heart & kidneys)

62
Q

Weight based calculation

A
63
Q

Antidote for heparin

A

Protamine sulfate

64
Q

Antidote for Warfarin

A

Vitamin K

65
Q

Digoxin toxicity symptoms

A

Digoxin : Cardiac Glycoside
Action is: positive inotropic (increase force of contraction), negative chronotropic (reduce heart rate), and negative dromotropic effects (reduce conductivity of heart)

Toxicity symptoms

Colored vision, halo vision, flickering lights (Vincent van gough example)
Anorexia, nausea, vomiting, diarrhea

66
Q

What to monitor with furosemide

A

Furosemide (example of a loop diuretic)
-Indication is first line anti hypertensive drug, pulmonary edema caused by heart failure

Monitor
Electrolytes (assess dry mouth, increased thirst, minimal urine output, and weight loss)
Urine output (less than 30 mL/hr stop medication)
Blood pressure since can cause hypotension
Monitor cardiac status and potassium levels
Monitor blood glucose, uric acid, calcium, magnesium and lipid levels

67
Q

Nursing process

A

Assessment
— Data collection, review, and analysis
— subjective info is what the patient verbalizes
— objective data is laboratory results
Human Needs Statement
— statement of client’s response to the illness
Planning
— goals
— outcome criteria
Implementation
— Nursing actions
— client education
Evaluation
— determining the status of the goals and outcomes of care

Pharmacology (5 decks)

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