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Pharmacology > Reproductive, GI, and Immune > Flashcards

Reproductive, GI, and Immune Flashcards

1
Q

Nuva Ring

A

(ovulation suppressant)

intravaginal contraceptive ring

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2
Q

Yaz

A

(ovulation suppressant)

taken po

traditional 28 day pill

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3
Q

Loestrim

A

(ovulation suppressant)

taken po

traditional 28 day pill

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4
Q

Ortho Novum

A

po

28 day pill

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5
Q

Ovulation suppressants

A
  • synthetic estrogen and/or progestin
  • block the follicle stimulating hormone & luteinizing hormone
  • increase vaginal mucus viscosity

Use:

  • prevention of pregnancy
  • treat endometriosis
  • hypermenorrhea
  • post-coital (plan b)
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6
Q

Types of ovulation suppressants

A
  • traditional 28 day pill
  • extended cycle pill (4x/year period)
  • transdermal patch - weekly/monthly
  • intravaginal contraceptive ring
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7
Q

Adverse effects of ovulation suppressants

A
  • HTN/ blood clots, MI, HA, N/V, anorexia, and weight gain.

- breakthrough bleeding (when first getting started on extended)

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8
Q

Nursing implications of ovulation suppressants

A
  • caution women 35+ who smoke
  • educate against possible stroke
  • missed dose = pregnancy can occur
  • weight gain
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9
Q

Drug interactions of ovulation suppressants

A
  • antibiotics

- TB drugs

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10
Q

(Premarin) Conjugated estrogen

A

(estrogen)

  • hormone replacement therapy/menopause
  • oral contraceptive
  • prostate cancer in men
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11
Q

Nursing implications of estrogen

A
  • female characteristics in men
  • check BP
  • advise against smoking
  • only take p.r.n.
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12
Q

Estrogen

A
  • HRT/ menopause
  • treat prostate cancer in men
  • oral contraceptive

*individualized dosing

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13
Q

Risk/adverse effects of estrogen

A

thromboembolism

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14
Q

Ovulation stimulants

A
  • same effects as natural hormones - enhance or enable reproduction
  • treat infertility
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15
Q

clomiphene (Clomid)

A

(ovulation stimulant)

treats infertility

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16
Q

bromocriptine mesylate (Parlodel)

A

treats infertility

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17
Q

Adverse effects of ovulation stimulants

A
  • deep vein thrombosis
  • ovarian hyperstimulation – leaks fluid, tender stomach
  • multiple pregnancies
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18
Q

medroxy progesterone (Depo-Provera)

A
  • inhibit gonadotropin
  • decrease endometrial tissue proliferation

oral or IM

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19
Q

Progestins

A
  • inhibit gonadotropin
  • decrease endometrial tissue proliferation

Contraceptive
uterine bleeding

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20
Q

Adverse effects of progestins

A
  • deep vein thrombosis, liver dysfuntion, N/V
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21
Q

Forms of progestins

A

oral or long acting IM – one shot every 3 months

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22
Q

testosterone (Depo-testosterone)

A

(androgen)

used in delayed puberty

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23
Q

androgens

A
  • maintain muscular and skeletal proteins

- used in delayed puberty

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24
Q

antacids

A
  • alkaline substances that neutralize stomach acids
  • aluminum, magnesium, calcium
  • OTC
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25
Q

adverse effects of antacid

A
  • Magnesium - diarrhea
  • Aluminum - constipation
  • Calcium - intestinal gas, constipation, and acid rebound
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26
Q

Nursing implications of antacids

A
  • interferes with many drugs by binding in GI tract
  • assess pain, check sugar contents for diabetes
  • Calcium most effective for heartburn

Magnesium:

  • not given with renal insufficiency
  • acts rapidly, highly neutralizing, long duration
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27
Q

Histamine-2 receptor antagonist

A
  • po or IV
  • suppress the secretion of gastric acid and decrease pepsin in the stomach
  • GERD - peptic ulcers
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28
Q

ranitidine (Zantac)

A

(Histamine-2 receptor antagonist)

for GERD - peptic ulcers

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29
Q

famotidine (Pepcid)

A

(Histamine-2 receptor antagonist)

for GERD - peptic ulcers

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30
Q

cimetidine (Tagamet)

A

*prototype

(Histamine-2 receptor antagonist)

treat GERD, peptic ulcers, gastric reflux

*may cause infections in elderly

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31
Q

omeprazole (Prilosec)

A

(proton pump inhibitor)

  • po
    for: erosive gastritis, symptomatic GERD, and ulcers
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32
Q

lansoprazole (Prevecid)

A

(proton pump inhibitor)

  • po
    for: erosive gastritis, symptomatic GERD, and ulcers
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33
Q

pantoprazole (Protonix)

A

(proton pump inhibitor)

  • IV
  • stress ulcer prophylaxis for hospitalized patients
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34
Q

Proton pump inhibitors

A
  • Inhibits gastric acid secretions

- prevent pumping of gastric acid from parietal cells

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35
Q

Nursing implications of proton pump inhibitor

A
  • ulcers heal in 4-8 weeks
  • swallow whole
  • give most before food
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36
Q

Helicobactor pylori agents

A

Treatment combination of:

  • 2 antimicrobials (amoxicillin, clarithromycin, metronidazole, or tetracycline)
  • 1 proton pum inhibitor and/or
  • 1 histamine-2

7-14 days of treatment

treat peptic GI ulcers caused by H. Pylori bacteria

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37
Q

misoprostol (Cytotec)

A

synthetic prostaglandin given with NSAIDs to protect gastric mucosa

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38
Q

sucralfate (Carafate)

A

4x/day

acts locally to protect gastric mucosa

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39
Q

mineral oil

A

(lubricant laxative)

softens dry/hard feces

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40
Q

lubricant laxatives

A

soften dry/hard feces

41
Q

stimulant cathartics

A
  • po or glycerine suppository
  • can lead to dependance
  • induce intestinal paristalsis
42
Q

biscodyl (Dulcolax)

A

(stimulant cathartic)

  • po or glycerine suppository
  • can lead to dependance
  • induce intestinal peristalsis
43
Q

magnesium citrate

A

(saline cathartic)

bowel prep

44
Q

saline cathartics

A
  • increase osmotic pressure
  • draws H2O into colon
  • watery stools
45
Q

docusate sodium (Colace)

A

(surfactant laxative)

  • stool softener
46
Q

surfactant laxative

A

facilitate passage of water and lipids into the fecal mass, which softens the stool

  • do not cause the patient to defecate
  • prevent straining
47
Q

psyllium (Metamucil)

A

(bulk forming laxative)

  • can be used long term
  • use water to retain natural & synthetic cellulose derivatives
  • increase water absorption
  • produce normal formed stools
  • OTC
  • also an antidiarrheal
48
Q

Bulk-forming laxatives

A
  • can be used long term
  • use water to retain natural & synthetic cellulose derivatives
  • increase water absorption
  • produce normal formed stools
  • OTC
49
Q

Cathartics

A
  • most abused
  • strong effect to eliminate loose stool
  • irritate the GI mucosa and pull water into the bowel lumen, as a result, the feces moves through the bowel too rapidly to allow water absorption so watery stool is eliminated
50
Q

laxatives

A

mild effect to eliminate soft formed stools

51
Q

Use of laxatives and cathartics

A
  • relieve constipation
  • prevent straining
  • empty bowel
  • eliminate toxic substances
52
Q

Contraindications of laxatives/cathartics

A
  • undiagnosed abdominal pain

- intestinal obstruction

53
Q

Nursing implications of laxatives/cathartics

A
  • Impaction (all the stool may not be coming out)
  • Abuse
  • increase fluids and fibers
54
Q

Bismuth-salts pepto bismol

A
  • antidiarrheal

- caution in kids (aspirin)

55
Q

diaphenovylate (Lomotil)

A
  • synthetic opiate antidiarrheal
  • acts on smooth muscle of the GI tract
  • no analgesic activity
  • abuse/physical dependance can occur
56
Q

loperamide (Imodium)

A
  • opiate antidiarrheal

- OTC

57
Q

antiemetics

A
  • prevent/treat N/V
58
Q

ondansetrone (Zofran)

A

(antiemetic)

  • serotonin blocker
  • post-op N/V (started out as drug for N/V associated with chemotheraphy)
  • po/IV
59
Q

metoclorpramide (Reglan)

A

(antiemetic)

  • prokinetic agent
  • used to treat delayed gastric emptying
  • used for GERD & antiemetic
  • can have EPS symptoms especially with young adults
60
Q

phenothazine

A
  • anti-psychotic (migraine): Compozine and Phenergan
  • used to treat N/V
  • heavily sedative (Phenergan)
  • EPS symptoms and cognitive impairment can occur
  • Phernergan can be given IV - is caustic - have good site
61
Q

Syrup of Ipecac

A
  • emetic: induces vomiting

* can be used in accidental poisoning cases IF APPROPRIATE

62
Q

orlistat (Xenical)

A
  • obesity drug
  • fat blocker
  • diarrhea/bowel movement
63
Q

Drugs affecting vitamin absorption

A
  • laxatives and antibiotics

- decrease fat soluble absorption

64
Q

Nursing implications of Vitamins

A
  • warn against mega doses
  • administer separate from laxatives
  • natural vs synthetic (no big differences)
  • eat a well balanced diet
65
Q

Minerals/Electrolytes

A
  • essential to bone, teeth, cell membrane, connective tissue and enzymes
  • varied well balanced diet provides sufficient minerals
66
Q

Iron

A
  • used to treat/prevent iron deficiency anemia
67
Q

iron dextran injection (InFeD)

A
  • IV

- iron deficiency anemia

68
Q

ferrous sulfate (Feosol)

A
  • iron deficiency anemia

- common treatment

69
Q

Nursing Implications for Iron

A
  • can cause black stools
  • take with meals or after with full glass of water
  • GI upset
  • take liquid with straw
70
Q

Potassium

A
  • K+ and Cl- deficiencies occur together (KCl is taken)
  • replacement for use with diuretic, poor diet, GI losses
  • po or IV
71
Q

Nursing Implications for Potassium

A
  • IV dose diluted and given slowly (Can be mixed wit Lidocaine)
  • po dose with at least 4oz fluid because its caustic
  • best absorbed on empty stomach
72
Q

Hyperkalemia

A
  • can be treated with cation exchange resin
73
Q

Na+ polystyrene sulfonate (Kayexalate)

A
  • po or rectal

- acts in colon to release Na+ and combine with K+ and eliminate in feces

74
Q

Nursing Implications for Hyperkalemia

A
  • stop all forms of K+
  • cardiac monitoring
  • each gram of resin will decrease K+ approx. 1 mEq
  • retain enema for 1 hour
  • may need dialysis
  • also may use IV regular insulin and D50
75
Q

magnesium sulfate

A
  • IM/IV

- for low Mg levels

76
Q

magnesium oxide

A
  • po

- for low Mg levels

77
Q

Magnesium

A
  • used to control convulsions associated with eclampsia (IV push)
78
Q

aldesleukin (Proleukin)

A

(Interleukins)

  • activates cellular immunity, inhibits tumor growth, prevents rapid growth of malignant cells.
  • renal cancer, melanoma, HIV, and Kaposi sarcoma
  • monitor VS, neuro status
  • report bleeding
79
Q

cyclophosphamide (Cytoxan)

A
  • alkylating agent - developed from mustard gas
  • interfere with cell division and structure of DNA during all phases of cell cycle
  • Taken on empty stomach and increase fluids
  • may cause cystitis
80
Q

cisplatin (Platinol)

A
  • alkylating agent - developed from mustard gas
  • used for both hemotological and solid cancers
  • N/V, nephrotoxicity, ototoxicity
  • check renal function
81
Q

doxorubicin (Adriamycin)

A
  • leukemia
  • breast/lung/ovarian cancer
  • may turn urine red
82
Q

Interferons alfa 2a/2b

A

(Roferon-A or Intron-A)

  • inhibits viral replication by reprogramming virus
  • prevents rapid growth of malignant cells
  • increase activity of other cells
  • increase cytotoxic activity of natural killer cells

Use: Kaposi’s sarcoma, hairy cell leukemia, and chronic hepatitis

83
Q

filgrastin G-CSF (Neupogen)

A
  • Colony stimulating agents
  • promotes proliferation, differentiation, and activation of cells that make granulocytes
  • prevent infections and stimulate arteriole growth
  • give 24 hours after chemo
  • avoid infections
  • Side effects: bone pain, redness at injection site
84
Q

epoetin alfa (Epogen)

A
  • hematopoetic
  • not given unless hemoglobin is less than 12
  • athletically abused
  • check blood count/BP
85
Q

vincrintine (Oncovin)

A

(plant alkaloid)

  • Vinca genus plant - cell cycle specific - stops mitosis
  • Hodgkin’s lymphoma
  • acute lymphoblastic leukemia
  • can cause severe tissue damage with infiltrate
  • peripheral nerve toxicity
    may become toxic with patients with hepatic impairment
86
Q

fluorouracil (5-FU)

A

(antimetabolite)

  • cell cycle specfic
  • drink plenty of fluids
87
Q

cyclosporin (Sandimmune)

A
  • prevention of organ rejection
  • arthiritis
  • Irritable bowel syndrome
88
Q

infliximab (Remicade)

A

(monoclonal antibody)

  • rheumatoid arthiritis
  • Crohn’s disease
  • Black box warning: infections

Side effects:
- headache, dizziness, fatigue, anxiety, fever and rash

Nursing Imp:
- administer immediately after reconstitution, do not breastfeed, watch for blood in stools, monitor for TB, and may be premedicated with acetaminophen or diphenhydramine

89
Q

methotrexate (Rheumatrex)

A

(antimetabolite)

  • rheumatoid arthiritis
  • avoid alcohol, sunlight, and aspirin
  • pee it out!
90
Q

Adverse effects of Interferons

A
  • flu like symptoms, depression and suicide
91
Q

Nursing Implications of Interferons

A
  • read label (for appropriate dose)
  • refrigerate
  • photosensitive
  • do not shake
92
Q

Hematopoeitic drugs

A
  • used to prevent anemia (Epogen)
  • given subQ or IV
  • used in renal failure, cancer or HIV
93
Q

Adverse and Nursing Imp of Interleukins

A
  • MI
  • Capillary leak syndrome
  • monitor VS, neuro status
  • stop drug with life threatening adverse reactions
  • report bleeding
94
Q

Adverse effects of Immunosuppressants

A
  • tremors
  • HA
  • oral candidias
  • seizures
95
Q

side effects of immunizing agents

A
  • pain at injection site
  • fever, malaise, muscle ache
  • anaphylaxis
  • serum sickness
96
Q

antineoplastic agents

A
  • interfere with cell replication, with supply of nutrients and genetics in nucleus
  • specific percentage of kills
  • drug resistance
  • harmful to rapid healthy cells
97
Q

antimeabolites

A
  • effective against rapidly growing tumors

- toxic effects: bone marrow suppression, mucositis, GI ulcerations, alopecia

98
Q

Nursing Imp of plant alkaloid

A
  • prepare patient for side effects
  • start anti-emetics before and on a schedule
  • eat!
  • alopecia - wigs/shampoo
  • mucositis (stomatitis) - soft tooth brush, rinse, drink fluids, systematic analgesics
  • bleeding

Pharmacology (7 decks)

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