Top 40 Meds

Question 1

What are some examples of inhaled anticholinergics?

Answer 1

• ipratropium

- tiotopium

Question 2

What is the expected pharmacological action of inhaled anticholinergics?

Answer 2

block muscarinic receptors of the bronchi, resulting in bronchodilation

Question 3

What are the therapeutic uses of inhaled anticholinergics?

Answer 3

• relieve bronchospasm associated with COPD

- prevention of allergen-induced and exercise-induced asthma

Question 4

What are the contraindications of inhaled anticholinergics?

Answer 4

• pregnancy category B
• people who have allergies to peanuts (med preparations may contain soy lecithin)
• use cautiously with narrow-angle glaucoma and BPH

Question 5

What should you inform patients of when they take anticholinergics?

Answer 5

• advise clients to sip fluids and sugar free hard candies to control dry mouth (anticholinergic effects)
• rinse mouth after inhalation to decrease unpleasant taste
• usual adult dosage is two puffs
• wait directed length of time between puffs
• wait 5 minutes between use of other inhaled meds

Question 6

What are some examples of antivirals?

Answer 6

• acyclovir (oral, topical, IV)

- ganciclovir (oral, IV)

Question 7

What is the expected pharmacological action of antivirals?

Answer 7

prevent the reproduction of viral DNA and thus interrupting cell replication

Question 8

What are the adverse effects of acyclovir?

Answer 8

• phlebitis and inflammation at the site of infusion//rotate injection sites, monitor
• nephrotoxicity//infuse slowly over 1 hr, hydrate during and 2 hours after infusion therapy
• mild discomfort associated with oral therapy (nausea, headache, diarrhea)//observe and notify the provider

Question 9

What are the contraindications/precautions with acyclovir?

Answer 9

• renal impairment
• dehydration
• taking other nephrotoxic meds
• pregnancy category c
• neutrophil count below 500/mm^3
• platelet count less than 25,000/mm^3
• probenecid (decreases elimination of med)
• zidovudine (causes drowsiness)

Question 10

Nursing Administration of acyclovir

Answer 10

• for topical, put on rubber gloves to avoid transfer of virus to other areas of the body
• administer IV infusion slowly over 1 hr
• expect symptom relief, not cure
• wash affected are with soap and water three to four times daily
• keep lesions dry after washing
• avoid sexual contact when lesions are present

Question 11

What are some examples of antimitotics (Vinca Alkaloids)?

Answer 11

• vincristine
• vinblastine
• vinorelbine

Question 12

What is the expected pharmacological action of vinca alkaloids?

Answer 12

• used in combination with other chemotherapy meds
• stops cell division during mitosis
• not bone marrow toxic
• Mphase specific

Question 13

What are the adverse effects of vincristine?

Answer 13

• peripheral neuropathy (weakness, paresthesia)//report manifestations
• severe tissue damage due to extravasation of vesicants//stop meds, only trained professionals administer, use central lines for infusion
• alopecia//hair loss occurs within 7-10 days and lasts 2 months after stopping, select a hairpiece before hair loss occurs

Question 14

What are the contraindications of vincristine?

Answer 14

• pregnancy category d
• charcot-marie-tooth syndrome
• liver disease
• neuromuscular disease
• may reduce effects of digoxin (monitor digoxin level and ECG)
• may increase risk for bronchospasm
• decrease level of phenytoin

Question 15

What are the nursing administration considerations with vincristine?

Answer 15

• assess for neuropathy
• reduce doses w/ patients w/ liver disease
• assess breath sounds for bronchospasm
• monitor for bleeding and infection
• monitor CBC and liver enzymes
• give antiemetic for n/v
• advise clients to use good mouth care
• stop chemotherapy meds if extravasation occurs
• clients should be using birth control