Test 2 Miscellaneous

Question 1

codeine: class

Answer 1

• allergy, cough, cold remedy
• antitussive (cough suppressant)
• opioid
• analgesic

Question 2

codeine: MOA

Answer 2

• Binds to opiate receptors in the CNS. Alters the perception of and response to painful stimuli while producing generalized CNS depression.
• Decreases cough reflex.
• Decreases GI motility.

Question 3

codeine: indications

Answer 3

• mild to moderate pain
• cough suppressant

Question 4

codeine: SEs

Answer 4

• hypotension
• confusion
• sedation
• constipation
• nausea
• vomiting

Question 5

codeine: ADRs

Answer 5

• risk for abuse
• toxicity in breast fed infants whose mothers are taking codeine (S/S sleepiness, breathing difficulty, lethargy, poor feeding)
• respiratory depression

Question 6

codeine: nursing implications

Answer 6

• contraindicated if patients have a hypersensitivity to drug and premature infants
• less abuse potential and less analgesic effects than morphine
  
  • but it does convert to morphine, and it converts more in whites than blacks
• need to be careful if pregnant or breast feeding
• do not increase dose or discontinue abruptly
• warn pts about orthostatic hypoTN and respiratory sedation
• encourage pts to void every 4 hours, b/c drug may suppress awareness of bladder stimuli
• do not use alcohol or other depressants

Question 7

nitroglycerin: class

Answer 7

• organic nitrates
• antianginal

Question 8

organic nitrates: MOA

Answer 8

• acts directly on smooth muscle of vessels (VSM) to promote vasodilation
  
  • mostly acts on veins
  • VSM uptakes nitrate and converts it to nitric oxide in the presence of sulfhydryl source which activates guanylyl cyclas which catalyzes formation of cGMP
    
    • elecation of cGMP leads to dephosphorylation of light chain myosin VSM, so myosin can’t bind with actin, and VSM relaxes and leads to vasodilation

Question 9

organic nitrates: indications

Answer 9

• angina: nitroglycerin
  
  • ​can be used in acute situations of severe chest pain

Question 10

organic nitrates: ADRs

Answer 10

• headache (severe)
• orthostatic hypoTN (due to relaxation of VSM which causes blood to pool in veins when person stands, so it decreases venous return to heart, dec CO, and causes blood pressure to fall)
• reflex tachycardia (when drug lowers BP by decreasing venous return, it can activate baroreceptor reflex to cause sympathetic stimulation of the ehart, so it inc heart rate)

Question 11

organic nitrates: nursing implications

Answer 11

• do not give to pt on an erectile dysfunction medication b/c life threatening hypoTN can result
• do not abruptly withdrawal tx
• take aspirin or acetaminophen if experience headache
• avoid alcohol
• can give up to 3 of these to a pt