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Pharmacology-RN > Test 3 > Flashcards

Test 3 Flashcards

1
Q

How are obstructive and restrictive diseases different?

How are they managed?

A

Obstructive diseases respond to medications that open the airway.

Restrictive diseases require removal of outer forces that prevent lung expansion

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2
Q

8 causes of dyspnea and note the differences in medication management

A

Heart failure

Asthma

Pneumonia

Clot

Farmers lung

Abd distention

Anemia

Fever

Pain

Metabolic acidosis

Copd

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3
Q

Side effects of spiriva and related precautions

A

Anticholinergic effects

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4
Q

Side effects of advair and related precautions

A

Adrenergic effects and thrush due to steroid immune suppression

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5
Q

Side effects of albuterol and related precautions

A

Adrenergic effects ( tachycardia? HTN, tremors, nervousness )

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6
Q

What is a duoneb and how is it different from combivent

A

They are the same. Combo of albuterol and ipratropium

One is an inhaler and one is a neb tx

Neb is more powerful

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7
Q

Can inhalers be given to people who are having allergic reactions ?

A

Yes but they won’t suppress acute immune flares

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8
Q

How are albuterol and salmetrerol different

A

Salmeterol- is a maintenance Rx

Albuterol is a rescue Rx

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9
Q

How are tiatrooium and ipatropium different

A

Tiatrooium (spariva) is maintenance RX

Ipratropium is more rapid acting

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10
Q

How are fluticasone and Atrovent different ?

A

Flovent - Immune suppressor

Atrovent - ipratropium is a bronchodilator

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11
Q

Risks of aminophylline toxicity ?

A

Seizures and arrhythmias

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12
Q

Normal aminophylline toxicity

A

10-20mcg

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13
Q

Difference between robitussin and guaifensin

A

Guaifensin is the generic name for robitussin

Mucinex and gerituss preparations

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14
Q

3 ways that neurological disturbances can affect respiration

A

Pressure on the brain stem, dropping rate and depth of respiration’s, impairing respiratory muscles and ability to cough

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15
Q

What is carafate ?

What type of compound

A

A coating medication that protects the stomach from acid erosion

Aluminum compound

Adheres to gastric lining

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16
Q

How and when is carafate given?

A

It is going to before eating and apart from other medications, especially reflux meds and antibiotics

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17
Q

How Are carafate and antacids different from H2 blockers and Proton pump inhibitors?

A

H2 blockers and PPis reduce acid production

Carafate protects the stomach from acid erosion

Antacids neutralize acid and can be taken after the meal of heartburn occurs

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18
Q

How is hyperacidity treated in renal patients ??

A

With calcium carbonate, PPIs and H2 blockers

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19
Q

What antiacids should renal patients avoid ??

A

Magnesium and aluminum

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20
Q

Should reflux medications be given with food or on a empty stomach?

A

1/2 hour before meals

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21
Q

What meds should not be given with antacids?

A

Tetracyclines, quinolones, PPIs , Carafate, H2 blockers

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22
Q

What’s meds should NOT be taken on an empty stomach?

A

Prednisone, NSAIDS, Lytes and griseofulvin

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23
Q

What is the difference between Reglan and Zofran ?

A

Reglan has direct acting cholinergic effects and blocks dopamine in the CNS

Zofran acts on the CNS by blocking 5HT3 (serotonin) receptors

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24
Q

Why might a systemic reaction occur after giving prn Compazine?

A

It is a phenothiazine (neuroleptic)

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25
If lomotil is part noneuphiric opiates and part atropine, what might be the side effects?
Anticholinergic effects: constipation, urine retention, tachycardia and pupil dilation
26
How is irritable bowel syndrome treated?
With anticholinergic and perhaps benzodiazepines
27
How are colonic infections treated?
Hydration and probiotics
28
Should people with Cdiff be treated with steroids to suppress inflammation?
No!
29
What causes Cdiff and how is it treated ?
Loss of normal flora due to immune suppression or antibiotics
30
What nursing precautions should be taken when caring for patients with C-Diff
Contact precautions Do not rely on hand sanitizers
31
Which medications cause constipation
Opiates, anti-cholinergics, trazodone, tramadol, psychotropics
32
What situations cause constipation?
Immobility , trauma, hypokalemia
33
Name 5 meds that promote bowel motility
Miralax or Metamucil , colace, senna, milk of magnesia
34
What is the protocol for constipation ?
Miralax or Metamucil , colace, senna, milk of magnesia in that order , then Suppositories, then enemas
35
What are the risks of too many laxatives?
Dependency, dehydration, electrolyte depletion
36
Three problems associated with nitroglycerin
Headache, hypertension, fall risk
37
Three problems associated with calcium channel blocker’s
Edema, constipation, orthostatic hypotension
38
problems associated with beta blockers
Hypotension, Bradycardia , wheezing , and hypoglycemia
39
Ace inhibitor problems
Cough and hyperkalemia
40
Lanoxin problems
Bradycardia, arrhythmias of toxic (level 2.2, green halo vision, gi upset)
41
Problems that can occur with critical drip rates for shock?
Peripheral and renal ischemia and injury
42
Problems that may occur with atropine ?
Tachycardia, dry mouth , constipation, urine retention, blurred vision, dilated pupils
43
Problems that may occur with statins
Muscle break down (rhabdomyolisis) with grapefruit juice , risk of liver injury
44
Problems that may occur with ventricular arrhythmias?
Backward contractions don’t perfusion , systemic hypoxia
45
Supraventricular arrythmias- problems that may occur
drop in cardiac output due to lack of ventricular fill time
46
Problems let me be associated with atrial Fibrillation
Clot formation, drop in cardiac output due to loss of atrial kick
47
Problem is it may be associated with Bradycardia
syncope (falls), drop in cardiac output (poor perfusion) due to c.o=HRxSV
48
What to know when giving or teaching patients about Coumadin
Watch INR Report black tarry stools, bruising , pink urine
49
What to know when giving or teaching patients about lanoxin
Hold of apical pulse below 60 Report visual disturbances Report GI upset Report Less than -Level 2.0
50
What to know when giving or teaching patients about atropine
Don’t feed after giving patient Watch for urine retention (catch PRN) Keep lights low
51
What to know when giving or teaching patients about beta blockers
Check pulse and BP before giving, watch glucose and lung sounds
52
What to know when giving or teaching patients about nitroglycerin
Check BP before giving
53
What to know when giving or teaching patients about lasix
Watch potassium, take potassium unless also taking ace inhibitor, Sparta or potassium sparing diuretic
54
What to know when giving or teaching patients about Potassium
Don’t crush Give with food
55
3 types of meds that reduce risk of plaque development in veins
Anti-hypertensives Statins Anti-platelets
56
Name three measures for chest pain
Lay down or sit Check BP Offer nitro and ASA Call 911 is nitro doesn’t resolve it
57
Name Rx meds to reduce MI risk
Anti-anginals Anti-hypertensives Statins Antiplatelets Anticoagulants
58
What is the cause of pulmonary edema and what can be done to prevent it
Back pressure of fluids into the lungs when the left ventricle can’t keep up with everything coming into it
59
What does the following lab tell us? Troponin ?
Myocardial injury
60
What does the following lab tell us? BNP
Heart failure (atrial stretch)
61
What does the following lab tell us? EKG
Where damage or ischemia is occurring (what part of the heart)
62
What does the following lab tell us? Echocardiogram
Structural damage (heart walk stasis, septal defect or valve damage)
63
What OTC meds should renal patients be counseled not to take?
ASA MOM Fleets Gaviscon
64
When do Renal patients need to go on dialysis?
BUN: 70 Creatine: 7 Potassium greater than 5.5 Metabolic acidosis
65
At what point should fluids be restricted in renal patient
If creatine above 5
66
Who should be on a no added salt diet
Renal patient ? Consider salt substitute but not is retaining potassium
67
What is the difference between LDL and HDL
LDLs turn to plaque HDLs do not
68
How are spironoactone, lasix and dyazide different ?
Potassium sparing vs potassium wasting vs combo RX
69
Report bilat muscle aches in legs
Statins
70
Avoid grapefruit when taking this
Statin
71
Hold if pulse is below 60
Digoxin
72
What meds have no antidote if bleeding
Ibans
73
This med gives you a headache
Nitro
74
Hold if level is above 2 or if see yellow halo vision
Digoxin
75
Do not give with lithium Or NSAIDS
Diuretics
76
Expect constipation and edema with this med
Calcium channel blockers
77
Warn against taking with viagra
Nitro
78
When to give statins
At HS
79
How to give nitro
Every 5 minutes Only when sitting
80
Antidote to herparin
Protamine sulfate
81
What not to give at HS
Diuretics Prils
82
When to give protamine sulfate
If PTT is too high
83
Pril side effect
Cough
84
Cdiff prevention
Take probiotics Flagyl Vancomycin Metronidazole Rifaximin
85
IBS tx
Increase chloride and bicarbonate output to stimulate peristalsis Linzess
86
What is used to prevent diarrhea
Non euphoric opiates Such as Imodium Paragoric Lomotil
87
Dopamine blockers used for nausea control
Reglan Conpazine (risk of depression and movements )
88
Serotonin blockers to reduce nausea
Zofran Lotronex
89
Opiate adjuvants for nausea control
Phenergan (Promethazine) Vistaril (Hydroxyzine)
90
Bronchodilator/rescue meds with adrenergic effects Side effects
Albuterol Anxiousness and tremors Drops potassium
91
Calcium/tums (antacid) cause what side effect
Constipation
92
Acid suppressors Meds and what do they lead to
PPIs (prazoles) Tidines (H2 blockers) Diarrhea
93
Lining protective (meds) Compound type
sucralfate -carafate Adheres to gastric lining Aluminum compound
94
Bronchodilator/rescue meds with adrenergic and anticholinergic effects
Combination of and albuterol Combivent vs duoneb Use one or the other (never both)
95
Bronchodilator/rescue meds with anticholinergic effects
Ipratropium Increases heart rate Bad for glaucoma Increased UTI risk
96
Maintenance anticholinergic (dry) agents for resp
Spiriva Once a day Causes constipation Worsens glaucoma — Increased UTI Do not use with BPH—
97
Maintenance adrenergic agents for resp How often to take
Salmeterol (sevent) Twice a day Never for rescue
98
Maintenance anticholinergic and adrenic combo agents for resp What to watch for ??
Advir (erol,asone, nide) Breo Symbicort Watch for thrush!
99
How to treat thrush
Mycostatin
100
Steroid maintenance drugs What to do after inhaling
Fluticasone Beclonethasone Rinse after inhaling
101
What to watch for with anti-inflammatory resp steroids
Increased glucose Decrease potassium Take with food Hydrocort Medrol
102
Non steroid agents to prevent inflammation
Antihistamines Claritin Benedryl (dine)
103
Cough agent suppressors Best for COPD
Codiene Dextromethophan
104
Expectorant cough agent
Robitussin / tussin/ mucinex
105
Mucolytic cough agent also used to treat Tylenol overdose and cystic fibrosis
Acetylcystiene (mucomyst)
106
Digoxin does not decrease what
Blood pressure
107
Atropine side effects with eyes
Dialated eyes Dim lights
108
Normal PTT
60-80
109
INR normal lab
2-3
110
Platelet normal lab
150,000-450,000
111
What meds increase Coumadin levels
Antibiotics and steroids
112
Anitidote for Coumadin Stay away from what
Vitamin k or green leafy veggies Herbals
113
Stay away from what with statins
Grapefruit
114
Treatment with pulmonary embolism
Oxygen
115
Lung sound with farmers lung
Crackles
116
Statins (cholesterol) Zocor , Crestor , Lipitor , mevacor What labs to watch
Liver enzymes
117
When to hold antiplatelet meds (plavix , ticlid, baby ASA, persantin) Don’t give with what
Hold if PLatelets are low below 150k. Anticoagulants besides baby ASA
118
How long does it take for anticoagulants to come into full effect
A week
119
What enhances effects of Coumadin
Antibiotics , alcohol, herbs , garlic, cranberry
120
Alternative meds to no Coumadin No labs Report bruising
Pradaxa Xarelto Eliquis
121
Heparin works how fast How to give? how not to give why? Diet?
Quickly No diet restrictions Given subQ when stable Never give IM!!! Hematoma will occur
122
This dissolves clots so it can cause bleeding Effect lasts how long
TPA 2-3 hours
123
Beta blockers (vasodialator) Used for Side effects When to hold
Arrhythmias Hold if pulse below 60 or if systolic below 100 Unless doctor says otherwise Olols Mask hypoglycemia Cause wheezing
124
What to do before giving calcium channel blockers (vasodilator)
Check pulse and BP Hold if either is low
125
Vasolating Anti arrhythmics do what Side effects What not to take with
Block sodium and potassium and calcium Constipation and edema No grapefruit
126
Anti arrhythmic rhythm rx that does not drop BP What does it do? When to hold Target level? Side effect of toxicity What indicates toxicity
Digoxin (Slows and strengthens pulse) Hold if HR is below 60 0.8-1.8 Toxicity green halos Electrolyte increase or decrease may indicate toxicity along with rhythm
127
Atropine is what type Of med What to know
Anticholinergic Increased HR Don’t feed after giving watch for Bladder distension Dialate pupils Dim lights
128
Anti hypertensive diuretics
Loop and thiazides Potassium sparing Dyazide
129
Loop and thiazides (lasix, HCTZ) Do what? How to give What to eat with
Reduces edema/fluids, decreases HTN Give in AM Give with food Dissolve in water, never crush Never push IV Encourage bananas , oranges (replace potassium) that is lost with fluid
130
Potassium sparing diuretic (antihypertensive) Aldactone , angiotension, prils, Sartans May cause what ? Dietary restrictions ?
Arrythmias if potassium is greater than 5 No salt substitutes
131
When will a patient be NPO
Epigastric pain, acute pancreatitis, bloody vomit , gag reflux diminished
132
What med will heal the stomach over time
PPIs
133
When to take protonix and how many times a day
30 min before meals up to 4 x a day
134
Phenergan EPS causes
Distonia
135
When to take montelulaskt why?
Evening Can prevent asthma while asleep
136
What antacid is safest for renal failure
Tums because aluminum and magnesium are bad for renal failure
137
Calcium lab
8-10
138
Normal potassium
3.5-5
139
Sodium levels
135-145
140
Magnesium levels
1.5-2.5
141
PTT LEVELS
25-35 seconds?
142
Digoxin
0.5-2

Pharmacology-RN (3 decks)

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