Test 1 Medications Flashcards

1
Q

second- generation antihistamines

A
  • non-sedating
  • fewer anticholinergic symptoms
  • laratadine (claritin)
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2
Q

___, __ blockers can cause ___ ____ ___ and impaired ____

A
antihistamines 
h1
drowsiness
dizziness
fatigue 
coordination
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3
Q

first generation antihistamine

A

diphenhydramine (Benadryl)

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4
Q

____ (__) works by ___ with ___ for receptor sits preventing a ____ response. this reduces nasopharyngeal secretions, itching, and sneezing

A

Diphenhydramine(Benadryl)
competing
histamine
histamine

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5
Q

Diphenhydramine (Benadryl) can be administered ___ ___ or ___. When taken with alcohol and ___ ____ ___ it ____ ___ ____. avoid ____

A
oral
iv 
im
other CNS depressants 
increases CNS depression 
MAOIs
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6
Q

Side effects of Diphenhydramine(Benadryl)

A
drowsiness
dry mouth
dizziness
blurred vision
wheezing
photosensitivity 
urinary retention
constipation
GI distress
blood dycrasias
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7
Q

elderly more sensitive to side effects of ___ (_) plus decreased ___ and ____. therefore give __ dose and consider ___ ____

A
Diphenhydramine(Benadryl)
BP 
confusion 
lower
2nd generation
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8
Q

____(_) is a ___ ____ receptor ___. it has a ___ onset of action, ___ duration of action, and ____ side effects

A
albuterol (proventil)
Selective 
Beta 2
Antagonist 
rapid 
longer 
few
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9
Q

____ ____ receptor ___ work with the ___ recptors in the bronchi causing ____. this increases ___/__ and decreases __/____ ___ ___

A
selective 
beta2 
antagonists 
beta2
bronchodilation 
BP/HR 
GI/ renal blood flow
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10
Q

Propranolol (Inderal) is a ___ ___ ___, this will ___ ___ and ___. adverse reactions are ____ and ___. The nurse should monitor __ ___ in early tx and assess lungs because it can cause ____

A
nonselective (b1 and b2) 
beta blocker 
decrease
HR
BP
bronchoconstriction and impotence 
vital signs 
bronchospasm
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11
Q

do not use ___(_), which is a _____ ___ beta blocker in a patient with ____, ___,___, or___

A

Propranolol (Inderal)

non-CARDIOselective 
COPD 
asthma 
CHF
DM
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12
Q

____ (__) is a ____ (mostly b1) beta blocker. it causes a __ in ___ and ___ by decreasing ____,___ ___ ___, and ___ release

A
metoprolol (lopressor)
selective 
decrease 
HR 
BP
CO
systemic vascular resistance 
renin
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13
Q

___ (_) is contraindicated in patients with DM

A

metoprolol (lopressor)

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14
Q

Metoprolol (lopressor) side effects

A
Dizziness
Fatigue, weakness
N/V, diarrhea
Nasal stuffiness
Impotence
Decreased libido
Depression 
Mental changes
Bradycardia/heart block
Thrombocytopenia
Agranulocytosis
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15
Q

___ ____ are contraindicated in those with second or third ___ ___, sinus ____. heart failure

A

beta blockers
av block
sinus bradycardia

heart failure but may Be prescribed for early use in chronic HF

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16
Q

atorvastatin (lipitor) can be used in children older than ___ y/o.

A

8

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17
Q

contraindications of atorvastatin

A
  • active liver disease

- pregnancy

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18
Q

use atorvastatin cautiously in those with

A
  • hx of liver disease
  • increased alcohol ingestion
  • trauma
  • sever metabolic endocrine disorders
  • uncontrolled seizures
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19
Q

side effects of atorvastatin (lipitor)

A
Headache
Rash
Pruritus 
Diarrhea or constipation
Sinusitis
Pharyngitis
Lag cramps
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20
Q

adverse reactions of atorvastatin

A

Rhabdomyolysis – breakdown of myoglobin = kidney damage*
Myalgia
Photosensitivity
Cataracts

*Rare

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21
Q

statins reduce ___ by inhibiting the enzyme HMG COA reductase, which is the ___ for cholesterol synthesis. it slightly increases __, and lowers __

A

cholesterol
precursor
HDL
LDL

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22
Q

drug interactions of atrovastatin (lipitor)

A

May ↑ digoxin level, oral contraceptives
↑ effects with macrolide antibiotics, antifungals
↓ effect with antacids, propranolol

High protein-binding

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23
Q

___(_) is the most potent calcium channel blocker, used for __ term tx of ___. it can cause profound ___

A

nifedipine (procardia)
long
angina
hypotension

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24
Q

nifedipine (procardia) promotes ___ ____. side effects include lightheadedness, __, orthostatic hypotension, ___, ____, flush, and ___ ___

A
peripheral vasodilation
dizziness 
tachycardia 
palpitations
GI distress
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25
ca channel blockers are highly ___ ___
protein bound
26
a newer calcium channel blocker is ___. it has a half life of 30-60 hours dosed daily
Amlodipine (Norvasc)
27
side effects of amlodipine (norvasc)
``` Peripheral edema Headache Flushing Dizziness Nausea Fatigue Flush, dizziness, Ankle edema, bradycardia ```
28
adverse reactions of amlodipine (norvasc)
Hypotension Angina Angioedema Heart block
29
do not take __ with grape fruit juice d/t reduced ___ clearance of the drug and subsequent increase in bioavalabilty that can lead to __
amlodipine (norvasc) presystemic hypotension
30
Atenolol (Tenormin) is a ____ mostly __ ____ ____. it decreases ___ and ___contraindicated in those with _
``` selective b1 beta blocker HR BP dm ```
31
Furosemide is a ___ ___. it promotes __ and __ depletion thereby decreasing ____ ___ ____. it is effective as a 1st line of tx in ___ ___
``` loop diuretic na water extracellular fluid volume mild htn ```
32
furosemide can cause
nausea diarrhea electrolyte imbalances like hypokalemia
33
procainamide (Pronestyl, Procan SR) is a class ___ ____. it is a fast ___ channel blocker
1A | antidysrhythmic
34
class 1A ___ depress the phase __ of the ___ leading to ___ ___ and ___re-polarization
``` antidysrhythmic 0 AP slow conduction prolonged ```
35
class 1a antidysrhythmic uses
ventricle and atrial dysrhythmias like paroxysmal atrial tachycardia, supra ventricular dysrhythmias
36
procainamide (pronestyl) absorption
oral extended release- 90-120 minutes | IM- 15-60 minutes
37
procainamide (pronestyl) metabolism and excretion
converted by liver to N-acetylprocainamide (NAPA), an active anti arrhythmic compound (may vary among population)
38
half life of procainamide (pronestyl)
- 2.5-4.7 hours - NAPA 2.5 to 4.7 hours. - half life prolonged in renal impairment
39
side effects of procainamide (pronestyl)
Dose-related nausea, anorexia, vomiting, dizziness, drowsiness, heart blocks, hypotension, and CHF Note: avoid citrus juices and fruits when taking quinidine
40
long term use of ___ can cause lupus like syndrome with __ and __ ___ pain. pericarditis with __. notify provide immediately bc may need to be dc
procainamide rash small joint tamponade
41
adverse reactions of procainamide
LIFE THREATENING caused by high concentrations (>10 micrograms/ml) - hypotension - marked slowing of conduction - torsade de pointes
42
torsade de pointes
uncommon form of vtach characterized by changes in the QRS complexes. it is associated with prolonged QT interval and may evolve into V FIB (cardiac arrest)
43
drugs that prolong QT interval
Amiodarone | Thioridazine
44
therapeutic level of procainamide
Procainamide: 4-10 mcg/mL NAPA: 15-25 mcg/mL Combined levels: 10 – 30 mcg/mL Toxicity may occur at procainamide levels > 10 mcg/ml
45
amiodarone (cordarone) is a
class 3 antidysrhythmic
46
amiodarone (cordarone) mechanism of action is unclear; it blocks _ and slows upward movement of k during phase __ of the __. it prolongs ____ and slows the ___ and conduction of the heart. it is structurally similar to the ___ ____
``` k k 3 repolarization rate conduction thyroid hormone ```
47
amiodarone side effects
- Related to size of dose and cumulative dose - N/V GI distress, dizziness, hypotension, arrhythmia - ↓ HR can proceed to 2nd or 3rd degree heart block (increases PR interval, QRS duration, and QT intervals
48
adverse reactions of amiodarone
- Hypothyroidism or hyperthyroidism - Corneal microdeposits - Hepatic dysfunction - Pulmonary fibrosis - Rarely seen with low dose 200mg/day - Peripheral neuropathy - Proximal muscle weakness
49
Amiodarone sounds similar to the drug
amlodippine (norvasc, ca channel blocker)
50
amiodarone half life
weeks to months
51
amiodarone drug interaction
Interacts with multiple drugs such as quinidine or digoxin Increased risk of QT prolongation with fluoroquinolones, macrolides, and azole antifungals Increases blood levels of Class I Antidysrhythmics including procainamide Increases blood level warfarin (Coumadin)
52
avoid ___ ___ __ with amiodarone because it increases the levels of the drug and there is a risk of toxicity. It causes the enzymes in the gut that metabolize amiodarone to be inhibited
grape fruit juice
53
amiodarone nursing considerations
For IV amiodarone – monitor IV site frequently Teach patient how to take pulse, monitor vitals Assess for neurotoxicity, monitor thyroid function, eye exams Note timing of meds – with or without food Monitor ECG during IV therapy or initiation of PO therapy Heart rate & rhythm, prolonged PR & QT intervals, QRS widening Assess for signs of pulmonary toxicity (shortness of breath) Monitor Chest X-Ray & Pulmonary Function Tests
54
clopidogrel (plavix) is thieophyridine , which is an ___ ____ drug
anti platelet
55
clopidogrel (Plavix) prevents ___ ____ by blocking ____ from binding to the platelet recetor
platelet aggregation ADP
56
patients allergic to __ can take plavix
aspirin
57
plavix has similar side effects and adverse reactions as _
ASA
58
onset of plavix action is ___ days and drug effects last for ___ days
several | 7
59
lorazepam is benzodiazepine
``` used for anticonvulsants -sedative hypnotics -pre-op drugs -anxiolytics ```
60
Lorazepam (Ativan) enhances ____ effects, decreasing signs and sx of anxiety
GABA
61
LOAZEPAM pharmacokinetics
Rapid GI absorption High PB 91% T ½ : 12-14 hours Excreted in urine
62
side effects of lorazepam (ativan)
``` Drowsiness, dizziness Weakness, confusion, blurred vision N/V, anorexia Sleep disturbance Restlessness Hallucinations ```
63
adverse reactions of lorazepam
Hypertension Hypotension Do not D/C benzodiazepines abruptly Withdrawal symptoms: agitation, muscle tremors, cramps, nausea, sweating; drug is tapered over time
64
fluoxetine (proxac) is an SSRI and blocks the __ of __ and enhances ____.
reuptake seratonin transmission
65
SSRIs like prozac do not block uptake of __, ____, , ____ and ____ ___ ___
dopamine norepinephrin cholinergic alpha1 adrenergic receptors
66
uses of fluoxetine
MDD mainly | anxiety and migranes
67
__ is used in acute and allergic rhinitis, ___, as a pre-med prior to blood infusions. It is contraindicated in those with severe __ disease, ___ ____ glaucoma, and ___ ____
``` Diphenhydramine (benadryl) Antitussive Liver Narrow angle Urinary retention ```