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Pharmacology I > Test 4 - key points only > Flashcards

Test 4 - key points only Flashcards

1
Q

What is an inotropic effect?

A

INCREASES RATE & FORCE OF CONTRACTION

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2
Q

Does digoxin have a negative or positive chronotropic effect?

A

Negative

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3
Q

What are the key reason digoxin is used?

A

o HEART FAILURE

o DECREASES HEART RATE

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4
Q

If someone is experiencing digoxin toxicity, what will it cause?

A

HYPOKALEMIA.

SOME DUIRETICS CAN CAUSE LOW K+

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5
Q

WHAT ARE THE ADVERSE EFFECTS OF DIGOXIN?

A

o SEEING GREEN YELLOW PURPLE HALOS
o BRADYCARDIA
o HYPOKALEMIA

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6
Q

WHAT IS USED FOR DIG TOXICITY?

A

• DIGIBIND FOR DIG TOXICITY

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7
Q

DIGOXIN IS HELD FOR WHAT REASON?

A

o HOLD IF HR <60

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8
Q

IF HF WAS GETTING WORSE HOW WOULD YOU KNOW?

A

o EDEMA
o WEIGHT GAIN
o RESPIRATORY RATE INCREASED
o INCREASED ACTIVITY INTOLERANCE

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9
Q

WHAT IS MILRINONE USED FOR?

A

IT IS USED FOR SHORT-TERM MANAGEMENT OF HEART FAILURE

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10
Q

WHAT IS THE MOST COMMON ROUTE OF MILRINONE?

A

IT IS USUALLY GIVEN AS A WEEKLY 6-HOUR IV INFUSION

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11
Q

WHAT MUST BE MONITORED WHEN GIVING MILRINONE?

A

INTAKE, OUTPUT, HEART RATE, BP, WEIGHT (DAILY), RESPIRATIONS

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12
Q

WHAT ARE ANTIDYSRHYTHMIC DRUGS USED FOR?

A

THEY ARE USED FOR CARDIAC RHYTHMS

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13
Q

HOW DO MOST DRUGS USED FOR RHYTHM WORK?

A

MOST DRUGS THAT WORK FOR RHYTHM WILL SLOW HEART RATE AND POSSIBLY DROP BP QUICKLY

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14
Q

WHICH DRUG IS USED FOR VENTRICULAR DYSRHYTHMIAS?

A

LIDOCANE

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15
Q

WHEN TAKING ANTIDYSRHYTHMIAS, WHAT ARE PEOPLE AT HIGH RISK FOR

A

o RISK OF FALLS
o ORTHOSTATIC HYPERTENSION
-BECAUSE THEY SLOW THE HEART RATE AND POSSIBLY DROP B/P QUICKLY

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16
Q

WHAT ANTIDYSRHYTHMIA IS THE DRUG OF CHOICE FOR IV DRUG TREATMENT?

A

LIDOCANE

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17
Q

WHAT IS AN EXPECTED EFFECT OF ADENOSINE?

A

ADENOSINE MAY CAUSE ASYSTOLE FOR A FEW SECONDS (LITERALLY STOPS THE HEART, AND A NORMAL SINUS NODE KICKS IN MAKING IT FUNCTION NORMAL AGAIN)

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18
Q

WHAT IS AN ANTIANGINAL THAT CAN BE PROVIDED SUBLINGUAL, TOPICAL, AND IV?

A

• NITROGLYCERIN

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19
Q

NITROGLYCERIN MUST BE PROTECTED FROM?

A

LIGHT AND KEEP IN ITS ORIGINAL PACKAGING

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20
Q

WHEN ADMINISTERING NITROGLYCERIN TOPICALLY, YOU MUST: (3 POINTS)

A

WEAR GLOVES OR YOULL GET A HEADACHE

ALTERNATE LOCATION

DO NOT PUT OVER HEART

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21
Q

WHAT IS A CONTRAINDICATION WHEN TAKING NITROGLYCERIN?

A

ANEMIA IS A CONTRAINDICATION TO NITRO

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22
Q

WHAT ARE THE RECOMMENDATIONS FOR TAKING NITROGLYCERIN WHEN A CLIENT IS HAVING CHEST PAIN?

A

(NEW RECOMMANDATIONS)
IF THE PERSON IS STILL HAVING CHEST PAIN AFTER 1 DOSE OF SUBLINGUAL NITRO AFTER 5 MIN., 911 SHOULD BE CALLED IMMEDIATELY
OR
(OLD RECOMMANDATIONS)
Take an SL tablet, and wait 5 minutes
If no relief in 5 minutes, take a second SL tablet
If no relief in 5 minutes, take a third SL tablet
After three tablets, or 15 minutes, if no relief of chest pain, call 911 immediately

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23
Q

WHAT EFFECT DOES GRAPEFRUIT JUICE HAVE ON calcium channel blockers?

A

Grapefruit juice can reduce the metabolism of calcium channel blockers

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24
Q

WHAT DRUG IS CONTRAINDICATED WHEN TAKING NITROGLYCERIN?

A

VIAGRA

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25
Q

BECAUSE NITRO IN IV IS POISON AND HAS A DYNAMITE EFFECT WE SHOULD NOT:

A

SMOKE AND IT MUST BE PROTECTED FROM LIGHT

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26
Q

WHY MUST A CLIENT USING NITROGLYCERIN TAKE IT OFF AT NIGHT FROM THE DRUG?

A

To reduce tolerance, the patient may be instructed to remove topical forms at bedtime and apply new doses in the morning, allowing for a nitrate-free period

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27
Q

BETA BLOCKERS- METROPOLOL

HOW DOES IT WORK

A

IT SLOWS THE HEART RATE WAY DOWN

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28
Q

BETA BLOCKERS- METROPOLOL

WHAT SHOULD YOU ALWAYS TAKE BEFORE GIVING IT?

A

• MAKE SURE TO TAKE A PULSE

o HOLD IF HR <60

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29
Q

BETA BLOCKERS- METROPOLOL

WHAT IS A NEGATIVE SIDE EFFECT

A

CONSTIPATION

BRADYCARDIA

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30
Q

BETA BLOCKERS- IS ALSO USED FOR:

A

o ALSO USED FOR STAGE FRIGHT & MIGRAINE HEADACHES

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31
Q

WHAT EFFECT DO BETA BLOCKERS HAVE ON PEOPLE?

A

• FLAT AFFECT – CALMING

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32
Q

b-blockers and angiotensin-converting enzyme (ACE) inhibitors have been found to be more effective in what race?

A

more effective in white patients than in Black patients

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33
Q

Calcium channel blockers (CCBs) and diuretics have been shown to be more effective in what race?

A

more effective in Black patients than in white patients

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34
Q

WHAT IS THE RANGE FOR PRE-HYPERTENSION

A

(130–139/85–89 mm Hg)

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35
Q

WHAT IS THE RANGE FOR Stage 1 hypertension

A

Stage 1 hypertension 140/90–159/99

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36
Q

WHAT IS THE RANGE FOR Stage 2 hypertension

A

Stage 2 hypertension 160+/100+

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37
Q

WHY DO PEOPLE OFTEN STOP TAKING ACE INHIBITORS BECAUSE OF A?

A

NAGGING COUGH

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38
Q

WHAT ARE THE FIRST LINE DRUG FOR DIABETICS WITH HYPERTENSION

A

ACE INHIBITORS BECAUSE OF THE RENAL PROTECTIVE EFFECTS

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39
Q

WHAT IS THE TARGET BLOOD PRESSURE RANGE FOR DIABETICS?

A

BELOW 130

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40
Q

ANTIHYPERTENSIVE DRUGS CAN HAVE WHAT NEGATIVE EFFECT ON MEN?

A

IMPOTENCE

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41
Q

WHAT IS THE MOST COMMONLY USED DIURETIC FOR HYPERTENSION

A

THIAZIDE DIURECTICS- SPIRANOLACTONE, AND ALDACTONE

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42
Q

WILL AN ANTICOAGULANT PREVENT CLOTS OR DISSOLVE THEM

A

• PREVENTS CLOTS! DOES NOT DISSOLVE CLOTS!!!

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43
Q

WHAT ARE TWO COMMON ANTICOAGULANTS?

A
  • HEPARIN/LOVENOX

* COUMADIN

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44
Q

WHEN ADMINISTERING HEPARIN/LOVENOX (SC) WHAT ARE SOME KEY STEPS?

A

o DON’T RUB IN
o DON’T ASPIRATE
o STAY AWAY FROM UMBILICUS
o ROTATE SITES

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45
Q

WHAT IS THE ANTIDOTE FOR HEPARIN

A

PROTAMINE SULFATE

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46
Q

WHAT IS THE ANTIDOTE FOR COUMADIN

A

VIT K

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47
Q

HEPARIN Is monitored by

A

activated partial thromboplastin times (aPTTs)

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48
Q

COUMADIN Is monitored by

A

International Normalized Ratio (I&R)

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49
Q

WHAT IS THE SAFEST OTC PAIN MED TO TAKE WHEN ON A ANTICOAGULANT (COUMADIN AND HEPARIN)

A

Tylenol is the safest

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50
Q

ARE HEPARIN AND COUMADIN SAFE TO OVERLAP?

A

Heparin and Coumadin (warfarin) work in different places on the cascade. They are safe to overlap because they work in different places

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51
Q

WHAT IS THE BIGGEST RISK WITH ANTICOAGULANTS (HEPARIN & COUMADIN)?

A

• RISK OF BOTH DRUGS IS BLEEDING

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52
Q

WHAT KIND OF FOOD MUST A PERSON WATCH WHEN TAKING COUMADIN?

A

o PEOPLE WHO TAKE COUMADIN NEED TO WATCH HOW MUCH VEGGIES WITH VITAMIN K THEY CONSUME

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53
Q

WHAT DRUG CAN BE USED FOR PEOPLE WHO HAVE A RISK FOR CLOTS (LOW DOSE)

A

ASPIRIN (DOES NOT DISSOLVE CLOTS)

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54
Q

ASPIRIN SHOULD NEVER BE GIVEN TO?

A

o NEVER GIVE TO CHILDREN

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55
Q

WHAT ARE SOME SYMPTOMS OF ASPIRIN TOXICITY?

A

 VISION CHANGES

 TINITUS

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56
Q

WHAT IS THE DRUG KNOWN AS THE CLOT BUSTER?

A

• STREPTOKINASE - ONLY GIVEN AS A ONE TIME THING

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57
Q

ANTILIPEMIC DRUGS

THE HMG-CoA INHIBITORS ARE ALSO CALLED THE?

A

STATINS (atorvastatin, Lipitor)

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58
Q

ANTILIPEMIC DRUGS ARE USED TO?

A

LOWER CHOLESTEROL

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59
Q

HOW LONG DO ANTILIPEMIC DRUGS TAKE TO WORK?

A

6-8 WEEKS

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60
Q

Which drug stops the absorption from the small intestine (works in the gut) safer medication

A

EZEOTROL – ABSORBED IN THE GUT

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61
Q

ANTILIPEMIC DRUGS Nicotinic acid is available OTC as what type of drug?

A

Nicotinic acid is vitamin B3

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62
Q

ANTILIPEMIC DRUGS Nicotinic acid causes flushing (due to histamine release), what OTC drug prevents flushing in small doses?

A

ASPIRIN

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63
Q

When taking any statins, what must any patient report

A

o RHABDOMYOLYSIS (muscle pain, myopathy) – EVENTUALLY LEADS TO KIDNEY FAILURE.

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64
Q

When taking any statins what must be avoided?

A

CANT TAKE WITH GRAPEFRUIT JUICE because it Interacts with the following and may (although rarely) lead to the development of rhabdomyolysis:

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65
Q

ANTILIPEMIC DRUGS ESPECIALLY THE HMG–CoA Reductase Inhibitors (statins): Adverse Effects

A

Elevations in liver enzymes or liver disease

LIVER DYSFUNCTION AND BILIARY OBSTRUCTION

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66
Q

ANTILIPEMIC DRUGS WORK IN THE GUT & CAUSE CONSTIPATION. EXCEPT FOR?

A

FIBRIC ACID DERIVATIVES (GEMFIBROZIL, LOPID)

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67
Q

FIBRIC ACID DERIVATIVES (GEMFIBROZIL, LOPID) HAVE AN ADVERSE EFFECT OF

A

THE SHITTY SHITS

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68
Q

NON-DRUG MEANS OF CONTROLLING BLOOD CHOLESTEROL LEVELS SHOULD BE TRIED FRIST, HOW IS THIS DONE?

A

LIFE STYLE MODIFIATION EG. DIET, EXERCISE

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69
Q

HOW DO SEDATIVES EFFECT THE CNS?

IN LOW DOSES:

A

At low doses, they calm the CNS without inducing sleep

THEY REDUCE NERVOUSNESS, EXCITABILITY, & IRRITABIITY

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70
Q

HOW DO SEDATIVES EFFECT THE CNS?

IN HIGH DOSES:

A

At high doses, they calm the CNS to the point of causing sleep AND BECOME A HYPNOTIC

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71
Q

WHEN TAKING SEDATIVES OR HYPNOTICS THERE ARE TWO MAJOR SAFETY ISSUES:

A

o NO DRIVING

o DROWSINESS RISK FOR FALLS AND STUFF

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72
Q

HOW DO Hypnotics EFFECT THE CNS?

A

THEY INDUCE SLEEP

A sedative can become a hypnotic if it is given in large enough doses

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73
Q

WHAT DRUG IS LONG ACTING:

Sedative–hypnotic and control of convulsive conditions

A

pentobarbital

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74
Q

Barbiturates: Adverse Effects

Reduced REM sleep, resulting in

A

Because you have less rem you are quick to get angry, irritable, Agitated
and the inability to deal with normal stress

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75
Q

Barbiturates & benzodiazepines cannot be used in combination with:

A

ALCOHOL

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76
Q

Barbiturates (Phenobarb) cannot be used much today because:

A

benzodiazepines are safer and have a higher efficacy

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77
Q

What adverse effects do benzodiazepines have?

A

they have a hangover effect -> make you really tired & high risk for falls

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78
Q

When benzodiazepines are stopped this can cause:

A

rebound insomnia may occur for a few nights after 3-4 weeks the regimen has been discontinued

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79
Q

Interactions with benzodiazepines are:

A

other CNS depressants because this may lead to further CNS depression (including decreased B/P and respiratory rate, sedation, confusion, and diminished reflexes)

80
Q

Is there an antidote to benzodiazepines?

A

no narcan does not work

81
Q

If an overdose occurs when taking benzodiazepines this is severe, what interventions may be needed?

A

o OVERDOSE – SEVERE CNS DEPRESSION WILL NEED BREATHING SUPPORT

82
Q

Why is Phenobarb used in 3RD WORLD COUNTRIES

A

BECAUSE IT IS CHEAP

83
Q

PHENYTOIN/DILANTIN SHOULD NOT BE USED WHEN:

A

o SHOULD NOT BE USED PREGNANT BECAUSE IT IS A TERATOGEN

84
Q

LONG TERM USE OF PHENYTOIN/DILANTIN CAN CAUSE:

A

DILANTIN FACIES, GINGIVITAL HYPERPLASIA, HIRSUTISM AND ACNE

85
Q

WHEN TAKING PHENYTOIN/DILANTIN A DOSE SHOULD NEVER BE SKIPPED BECAUSE OF:

A

A NARROW THERAPEUTIC INDEX

86
Q

WHAT IS DIAZEPAM/VALIUM USED FOR:

A

STATUS EPILEPTICUS

87
Q

WHAT IS GABAPENTIN USED FOR?

A

o USED FOR SEIZURES

88
Q

WHAT CAN DEVELOP WHEN GABAPENTIN IS STOPPED?

A

o CAN DEVELOP WITHDRAWAL SEIZURES

89
Q

WHAT IS AN OFF LABELED USE FOR GABAPENTIN?

A

NEUROPATHIC OR NERVE PAIN AFTER SURGERY

90
Q

WHEN TAKING TOPIMAX THE DRUG CAN NEVER BE CRUSHED BECAUSE:

A

THEY ARE AN EXTENDED RELEASE FORM

91
Q

LYNN SAID TO LOOK UP TOPAMAX: HERE’S THE BLUE BOX INFO

A

Topiramate (Topamax) is a structurally unique drug chemically related to fructose, classified as a sulfamate substituted monosaccharide. Topiramate is indicated for management of patients (adults and children over 6 years of age) with newly diagnosed epilepsy and as adjunctive therapy for partial seizures in adults and children 2 years of age and older. It is also indicated for the prophylaxis of migraine headache in adults. Its exact mechanism of action is unknown. However, it is believed to work by blocking sodium channels in neurons, blocking glutamate activity, and enhancing GABA activity

92
Q

Cholinergic Drugs:
Stimulate pupils
Constriction (miosis)
Reduced intraocular pressure

A

AND ARE CONTRAINDICATED WITH GLUCOMA

93
Q

Cholinergic Drugs: Problematic in people with:

A

asthma, obstructions, Bradycardia

Defects in cardiac impulse conduction

94
Q

Cholinergic Drugs:

Used to arrest or slow the progression of Alzheimer’s disease if done at an early enough stage

A

donepezil (Aricept)

95
Q

Cholinergic Drugs:

bethanechol (Duvoid):

A

Increases tone and motility of bladder and gastrointestinal (GI) tract
Relaxes sphincters in bladder and GI tract, allowing them to empty
Is helpful for postsurgical atony of the bladder and GI tract
Is administered orally

96
Q

Cholinergic Drugs:

Adverse effects are a result of overstimulation of the PSNS

A

Effects of the drug are the side effects of the drug

97
Q

Cholinergic Drugs: Interactions

A

Anticholinergics, antihistamines, sympathomimetics

98
Q

Cholinergic Drugs:
Encourage patients with myasthenia gravis to take medication ____ ________before eating to help improve chewing and swallowing

A

30 minutes

99
Q

What is the antidote for cholinergics?

A

Atropine is the antidote for cholinergics*** ; it should be available in the patient’s room for immediate use if needed

100
Q
  1. The two types of cholinergic receptors are _______________________ and __________________________.
A

The two types of cholinergic receptors are muscarinic and nicotinic.

101
Q

The blood–brain barrier does not allow exogenously supplied dopamine to enter, but it does allow _______ __ ______.

A

levodopa to enter

102
Q

There is an imbalance of neurotransmitters and the drug therapy is aimed at balancing these two neurotransmitter:

A

Is caused by an imbalance of two neurotransmitters:
Dopamine
Acetylcholine (ACh)

103
Q

drug therapy is aimed at increasing levels of dopamine as long as there are functioning nerve terminals remaining, Anticholinergic can block ___________

A

Anticholinergic can block acetylcoline

104
Q

Selective MAOI Therapy: selegiline

Adverse Effects

A

Can’t eat aged cheese, red wine, baked yeast, a ton of food reactions. LEADS TO HYPERTENSIVE CRISIS.

105
Q

which drug causes release of dopamine from the storage sites at the end of nerve cells that are still intact
Blocks the reuptake of dopamine into the nerve endings, allowing more to accumulate both centrally and peripherally
Does not stimulate dopamine receptors directly

A

amantadine (Symmetrel)

Blue Box info
Amantadine (Symmetrel) is believed to work in the CNS by eliciting the release of dopamine from nerve endings, resulting in higher concentrations of dopamine in the CNS. It is most effective in the earlier stages of PD when there are still significant numbers of nerves to act on and dopamine to be released. As the disease progresses, however, the population of functioning nerves diminishes, and so does amantadine’s effect. Amantadine is usually effective for only 6 to 12 months. After amantadine fails to relieve the hypokinesia and rigidity, a dopamine agon- ist such as bromocriptine is usually tried next. Amantadine is contraindicated in patients who have shown a hypersensitivity reaction to it, women who are lactating, and children younger than 1 year of age (amantadine is also an antiviral drug).

106
Q

why is the combination of levodopa or levodopa–carbidopa and selegiline

A

AUGMENTS LEVADOPA THERAPY.

Carbidopa helps levodopa get to the blood brain barrier.

107
Q

selegiline: Adverse Effects

Doses higher than ___ mg/day may cause more severe adverse effects, such as hypertensive crisis

A

10 mg/day

108
Q

LEVADOPA is given with___________ which does not cross the blood–brain barrier, prevents levodopa breakdown in the periphery

A

Carbidopa,

109
Q

Enhanced CNS depressant effects with __________, CNS depressants, amantadine (Symmetrel), phenothiazines, tricyclic antidepressants, and antihistamines

A

alcohol

110
Q

When starting dopaminergic drugs, assist patient with __________ because dizziness may occur

A

walking

111
Q

Teach patient to avoid foods high in vitamin B6 because it can?

A

reverse the effects of the levadopa

112
Q

levodopa preparations may darken the patient’s __________ & _________– NORMAL EFFECT*

A

urine and sweat

113
Q

A “drug holidays” must be used with patients using levodopa long term because:

A

NOT WANTING TO BURN OUT RECEPTORS

114
Q

WHAT ARE THE EXPECTED THERAPEUTIC RESPONSES TO LEVODOPA?

A

Levodopa is converted to dopamine and helps supplement the deficient amounts of dopamine in the brain. In PD, there is an imbalance between dopamine and Ach. Levodopa helps restore this balance. Improvement in activities of daily living and other symptoms of the disease is the result.

115
Q

What is the concept of half life?

A

is the time it takes for one half of a given amount of a drug in the body to be removed and is a measure of the rate at which the drug is eliminated from the body. For instance, if the maximum level that a particular dosage could achieve in the body is 100 mg/L and in 8 hours the measured drug level is 50 mg/L, then the estimated half- life for that drug is 8 hours.

116
Q

Why is grapefruit often contraindicated?

A

Because it has clinically significant grapefruit juice–drug interactions

117
Q

What is the concept of first-pass effect?

A

If the drug is metabolized in the liver or excreted in the bile, some of the active drug will be inactivated or diverted before it can reach the general circulation and its intended sites of action. This is known as the first-pass effect, and it reduces the bio- availability of the drug to less than 100%.

118
Q

___________ is the movement of a drug from its site of administration into the bloodstream for distribution to the tissues.

A

Absorption (GI or skin problems)

119
Q

Why is parental route medications faster?

A

Medications given by the parenteral route also have the advantage of bypassing the first-pass effect of the liver..

120
Q

___________ refers to the transport of a drug in the body by the bloodstream to its site of action

A

Distribution (CV system)

121
Q

______________is also referred to as biotransformation because it involves the biochemical alteration of a drug can alter the biotransformation of a drug, including genetics, diseases, and the concurrent use of other medication

A

Metabolism (liver)

122
Q

_________ is the process through which drugs are eliminated; the primary organ responsible for this is the kidney. Two other organs that play an important role in the excretion of drugs are the liver and the bowel.

A

Excretion (kidneys)

123
Q

The ratio of a drug’s toxic level to the level that provides therapeutic benefits is referred to as the drug’s __________ ___________

A

therapeutic index.

124
Q

What is the preferred site for injections in children?

A

Generally, the vastus lateralis muscle is well developed and not located near major nerves or blood vessels. It is the preferred site of injection of drugs such as immunizations for infants

125
Q

What are diuretics used for?

A

CHF, kidney failure, HTN

126
Q

Where does furosemide (Lasix) work?

A

Works in the loop of Henle

127
Q

Loop Diuretics: Drug Effects

Decreased fluid volume, which causes

A 
Reduced blood pressure (BP)
Reduced pulmonary vascular resistance
Reduced systemic vascular resistance
Reduced central venous pressure
Reduced left ventricular end-diastolic pressure
*Potassium and sodium depletion
128
Q

What are indications of Loop Diuretics

A

Edema associated with heart failure or hepatic or renal disease
Control of hypertension
Hypercalcemia (increase renal excretion of calcium)
Certain cases of heart failure resulting from diastolic dysfunction

129
Q

Loop Diuretics:Contraindications

A

Known drug allergy
Allergy to sulfonamide antibiotics
Hepatic coma
Severe electrolyte loss-

130
Q

Loop Diuretics:what is a major concern with diuretics

A

Hypokalemia

131
Q

With which diuretic is potassium-sparing?

A

spironolactone (Aldactone)

132
Q

Patients taking ____________ along with a_____________preparation should be taught to monitor for digitalis toxicity

A

diuretics , digitalis

133
Q

Liver function tests to determine hepatotoxicity:

A

Bilirubin

134
Q

what tests are done to determine nephrotoxicity?

A

BUN & creatinine

135
Q

Growth hormone has what effect on the body?

A

Regulates anabolic processes related to growth and adaptation to stressors; promotes skeletal and muscle growth

136
Q

The drug that mimics growth hormone (GH) is?

A

Somatropin Hormone

137
Q

____________ ______________has the function of increasing water absorption

A

Antidiuretic Hormone

138
Q

Antidiuretic Hormone

It concentrates the __________ and causes potent vasoconstriction

A

urine

139
Q 
In which of the following conditions is somatropin contraindicated? In clients with:
A.	Dwarfism
B.	Acromegaly
C.	Hypopituitarism
D.	Addison’s disease
A

B. Acromegaly

Acromegaly is caused by excessive growth hormone, and thus this drug would be contraindicated,

140
Q 
The nurse admitting a client with acromegaly anticipates administering which of the following medications?
A.	octreotide
B.	somatropin
C.	corticotropin
D.	desmopressin
A

A. octreotide

Octreotide suppresses growth hormone, the culprit of acromegaly.

141
Q

Where is the target for adrenocorticotropic hormone?

A

adrenal gland

142
Q

Which drug is used for bedwetting?

A

desmopressin (DDAVP)

143
Q

Patients on antithyroid medications should be advised that:

A

they should never be stopped abruptly without physician’s permission or even switch brands

144
Q

signs and symptoms of _________ _________ , or what is often called _________ ________These include tachycardia, heart irregularities, fever, heart failure, flushed skin, con- fusion, apathetic attitude, behavioural changes, possible hypotension, and vascular collapse.

A

thyroid crisis, “thyroid storm.”

145
Q

Hyperthyroid symptoms are:

A

sweating, tachycardia, anxiety, and weight loss

146
Q

Hypothyroid symptoms are:

A

lethargy, fatigue, weight gain, (eg. cretinism and myxedema)

147
Q

what is a hyperthyroid treatment?

A

surgery or radiation

148
Q

what is a hypothyroid treatment?

A

thyroid replacement which is usually synthroid

149
Q

What are the signs of hyperglycemia?

A

Polyuria
Polydipsia
Polyphagia

150
Q

what is the drug of choice for type 2 diabetes?

A

metformin - because it is the safest and less likely to cause hypoglycemia

151
Q

Why is a sliding scale used in the hospital?

A

Sliding scale is typically used for hospitalized diabetic patients due to the unpredictability and the effect illness can have on blood sugars

152
Q

What is the month test used for diabetics?

A

Hemoglobin A1C is the test used to tell the 3 month scale

153
Q

When drawing up two types of insulin in one syringe, always withdraw the _________ or ____ _________insulin first

A

regular or rapid-acting

154
Q

NPH (Humulin-N, Novolin ge NPH)

A

Has a cloudy appearance

Is slower in onset and has a more prolonged duration than endogenous insulin

155
Q 
Which insulin is used for continuous intravenous infusions?
A.	insulin glargine
B.	insulin aspart
C.	insulin Regular
D.	insulin Ultralente
A

C. insulin Regular

156
Q

A long-acting insulin?

A

insulin glargine

157
Q

A rapid-acting insulin?

A

lispro insulin

158
Q

Clients with diabetes mellitus should avoid alcohol consumption because ________________.

A

Clients with diabetes mellitus should avoid alcohol consumption because alcohol is broken down in the body to simple carbohydrates, which leads to increases in blood glucose. In addition, alcohol can increase insulin’s hypoglycemic effects.

159
Q

Which rapid-acting insulin starts working in less than 15 minutes after administration?

A. insulin aspart
B. insulin glargine
C. insulin Regular
D. insulin Ultralente

A

insulin aspart

Insulin aspart is a rapid-acting insulin. Insulin glargine and Ultralente insulin are long-acting. Regular insulin is short-acting.

160
Q

Which of the following should the nurse do when administering 30 units regular insulin and 70 units NPH insulin?
A. Rotate sites at least once weekly and label the sites used on a diagram
B. Inform the client that mixing insulins will help increase insulin production
C. Draw up the regular insulin into the syringe first, followed by the cloudy NPH insulin
D. Use a 23- to 25-gauge syringe with a 1-inch needle for maximum absorption

A

C. Draw up the regular insulin into the syringe first, followed by the cloudy NPH insulin

161
Q

The nurse would include which of the following statements when teaching a client about insulin glargine?
A. “You can mix this insulin with Lente insulin to enhance its effects.”
B. “You should inject this insulin just before meals because it is fast-acting.”
C. “You cannot mix this insulin with regular insulin and thus will have to take two injections.”
D. “The duration of action for this insulin is approximately 8 to10 hours, so you will need to take it twice a day.”

A

C. “You cannot mix this insulin with regular insulin and thus will have to take two injections.”

162
Q

Insulin glargine is a long-acting insulin with duration of action up to 24 hours. It should not be mixed with any other insulins.
24. Which of the following methods of administration would achieve the most beneficial effect when the nurse plans to administer glipizide?
A. With food
B. At bedtime
C. 15 minutes post-prandial
D. 30 minutes before a meal

A

D. 30 minutes before a meal

163
Q

What should be cautioned in DM patients because it can cause hyperglycemia?

A

corticosteriods

164
Q

What are some uses of steroids?

A

they are used to prevent rejection in organ transplant, asthma, and arthritis

Any condition where inflammation or over active immune system plays a role

165
Q

Too much adrenal causes?

A

cushings

166
Q

Too little adrenal causes?

A

addisons

167
Q

Abrupt withdrawal from adrenal drugs is not recommended because this may precipitate an

A

adrenal crisis

168
Q

Some side effect to adrenal corticosteroids drugs may be?

A

weight gain and moon facies

169
Q

when taking corticosteroids drugs you have to be careful with _______, ______, &__________ because of risk for bleeding

A

alcohol, NSAIDS, and ASA

170
Q

Oral contraceptives are contraindicated with?

A

antibiotics, antivirals, and anti-tb

171
Q

why is it important to finish taking antibiotics until the prescription is finished?

A

to prevent the infection from coming back

172
Q

Explain the rationale for not taking dairy products, iron, or calcium with tetracycline. What would be recommended if these products are not taken out of the diet?

A

Milk, calcium, iron, and cheeses chelate or bind up the tetracycline, resulting in decreased levels of tetracycline. Tetracycline should be taken 2 hours before or after eating the foods listed above to help alleviate this problem.

173
Q

Ms. S. is taking an aminoglycoside for the treatment of a recurrent UTI. What conditions should be assessed for or laboratory studies performed before the initiation of therapy?

A

Aminoglycosides are nephrotoxic and ototoxic. It is important to assess renal functioning prior to therapy because these antibiotics may worsen renal dysfunction. A hearing assessment is also important before initiation of therapy because vestibular function may be impaired as well. BUN, creatinine clearance, serum creatinine, and audiometric testing should all be assessed, when indicated.

174
Q

Is the treatment of choice for MRSA and other Gram-positive infections but causes red man syndrome

A

vancomycin

175
Q

what drug turns tears and urine orange?

A

Rifampin

176
Q

Compliance issues are a big concern for TB drugs because

A
  • Non-adherence increases the incidence of drug-resistant organisms
  • Stress importance of strict adherence to regimen
177
Q

Why is multiple drug therapy often used for TB?

A

this reduces chances of developing resistance

178
Q

Antivirals need to be started within ___hrs before viral replication

A

48hrs

179
Q

Combination therapy is used for antiretroviral HIV

Antiretroviral therapy (ART) includes at least three medications

A

Because these medications work in different ways to reduce the viral load

180
Q

WHEN TAKING AMPHOTERICIN B (FUNGIZONE) AKA “AMPHOTERRIBLE” PRE-TX IS USUALLY DONE WITH AN ANTIPYRETIC, ANTIHISTAMINE, ANTIEMETIC AND STEROID TO

A

REDUCE SEVERITY OF THE INFUSION RELATED REACTION

181
Q

DOES NOT KILL ORGANISM, USED ON SKIN

A

ANTISEPTICS

182
Q

KILLS ORGANISM, NOT USED ON SKIN

A

DISINFECTANTS

183
Q

Amphotericin B (Fungizone) ADVERSE EFFECTS ARE?

A

o Renal toxicity

o Neurotoxicity: seizures and paraesthesias

184
Q

TRUE OR FALSE

SUPPRESSING A COUGH CAN BE DANGEROUS

A

TRUE

185
Q

WHY IS IT NECESSARY TO TAKE LOTS OF WATER WITH ANTITUSSIVES?

A

TO THIN SECRETIONS

186
Q

 fexofenadine (Allegra)
 loratadine (Claritin)
 cetirizine (Reactine)

A

o Nonsedating (peripherally acting)

187
Q

 diphenhydramine (Benadryl)

 chlorpheniramine (Chlor-Tripilon)

A

o Sedative – May cause drowsiness

188
Q

ANTIHISTAMINES SHOULD BE TAKEN BEFORE___________ ___________

A

SYMPTOMS START

189
Q

WHICH WOULD YOU TAKE FIRST THE BRONCHODILATOR OR THE STEROID

A
  • BRONCHODILATOR SHOUD BE USED FIRST TO OPEN THE AIRWAYS, THEN CORTICOSTEROIDS
190
Q

ANTI-INFLAMMATORY PUFFERS ARE TAKEN?

A

DAILY

191
Q

BRONCHODILATORS ARE TAKEN?

A

AS NEEDED

192
Q

ADVERSE EFFECT TO NASAL DECONGESTANTS?

A

REBOUND CONGESTION

193
Q

ORAL DECONGESTANTS DO NOT CAUSE REBOUND CONGESTION BUT THEY CAN CAUSE ____________

A

EXCITABILITY

194
Q

DO NOT DRINK OR EAT ANYTHING WITH CAFFINE IF TAKING THIS MEDICATION

A

XANTHINE DERIVATIVES

195
Q

WHICH DRUG WOULD YOU TEST BY PUTTING IT IN WATER?

A

VENTOLIN - IT WILL FLOAT WHEN EMPTY

Pharmacology I (13 decks)

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