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Pharm > Week 8 > Flashcards

Week 8 Flashcards

1
Q

What is the prototype drug of Adrenergic Agents or Sympathometics?

A

phenylephrine (Neo-Synephrine)

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2
Q

How should the nurse explain to the patient that has increased HR and a strong pulse?

A

You might be in cardiac arrest, shock, heart failure

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3
Q

What will a patient feel if they are taking Beta1 receptor adrenergic agent?

A

increased HR and a strong pulse

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4
Q

What are three actions to take with phenylephrine to avoid extravasation?

A

Dilute drug before administering
Use an infusion pump
Assess for blanching at the infusion site

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5
Q

What are is something to assess when someone is taking phenylephrine?

A

Extravasation, so look for blanching

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6
Q

What should you ask if a patient will take phenylephrine?

A

Do you wear contacts?
Are you pregnant?

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7
Q

What type of patient should you be careful about when giving phenylephrine parentally?

A

Used with caution in patients with advanced coronary artery disease, hypertension, or hyperthyroidism

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8
Q

What is the prototype drug for Adrenergic Agents?

A

phenylephrine (Neo-Synephrine)

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9
Q

What will you see if a patient is taking phenylephrine parenterally?

A

Anxiety, restlessness, and tremor may occur due to the drug’s stimulation effect on the C N S

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10
Q

What might a patient say if they are taking phenylephrine parenterally?

A

I am so nervous.
I cannot sleep.
I really want to walk around the room
How much coffee did you drink.
Did you eat chocolate

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11
Q

What will we see if a patient takes too much sympathomimetics? (2)

A

Tachycardia, HTN

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12
Q

What findings should the nurse expect about HR and HTN of OD on sympathomimetics?

A

HR from above 84 bpm to 120 bpm
HTN from above 120/80 mmHg to 200/110 mmHg

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13
Q

What are some treatments to a patient who has HR from above 84 bpm to 120 bpm
HTN from above 120/80 mmHg to 200/110 mmHg
after taking sympathomimentics?

A

Alpha blocker such as phentolamine (Regitine)

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14
Q

What would you review before administering Sympathomimetics?

A

MOAIs – hypertensive crisis
Tricyclic antidepressants – potentiate the effect of Phenylephrine
Digoxin - dysrhythmias
Iron supplements – incompatible with phenylephrine

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15
Q

What information should you give to the provider when they are giving sympathomimetics?

A

MOAIs – hypertensive crisis
Tricyclic antidepressants – potentiate the effect of Phenylephrine
Digoxin - dysrhythmias
Iron supplements – incompatible with phenylephrine

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16
Q

What is a drug that will give you a hypertensive crisis with MAOIs?

A

sympathomimetics

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17
Q

What drug will potentiate the effect of phenylephrine?

A

Tricyclic antidepressants

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18
Q

What drug will give dysrhythmias when taken with sympathomimetics?

A

digoxin

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19
Q

What drug is incompatible with phenylephrine?

A

Iron supplements

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20
Q

What are some things to teach the patient when taking intranasal sympathomimetics? (5)

A

Do not share spray with anyone
Sit upright when using the spray
Only use for 3-5 days
Assess breathing patterns
Assess for rhinorrhea and epistaxis

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21
Q

What are some things to teach the patient when taking eye drops of sympathomimetics? (4)

A

Do not drive until the effect of the eye drop wear off
Wear sunglasses when in bright light
You may be more comfortable in a dark room
Observe patient’s responsiveness to light

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22
Q

How will you know if a patient is affected by eye drops of sympathomimetics?

A

Observe patient’s responsiveness to light

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23
Q

What is the prototype drug for Adrenergic-Blocking Agents?

A

Prazosin (Minipress)

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24
Q

What is the MOA for adrenergic-blocking agents?

A

to inhibit the sympathetic nervous system

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25
Q

What are some adrenergic-blocking agents uses? (7)

A

hypertension, dysrhythmias, angina, heart failure, benign prostatic hypertrophy, narrow-angle glaucoma

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26
Q

What are some adrenergic-blocking agents ADR? (6)

A

dizziness, drowsiness, headache, loss of energy and strength, palpitations, dry mouth

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27
Q

What actions should the nurse take to avoid unconsciousness about 30 minutes after the first dose?

A

the first dose should be very low and given at bedtime.

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28
Q

What may happen with prazosin administration?

A

Reflex tachycardia may result from the rapid fall in blood pressure.
Alpha blockade may cause nasal congestion or inhibition of ejaculation.

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29
Q

What actions should the nurse take to reduce dizziness, drowsiness, or light-headedness that may occur with Prazosin?

A

To avoid give at bedtime.

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30
Q

Who should not take prazosin?

A

Safety during pregnancy and lactation is not established.
Alcoholics

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31
Q

What should a patient not eat when on prazosin?

A

Palmetto or nettle roots

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32
Q

Why should a patient not take palmetto or nettle roots?

A

Saw palmetto blocks alpha1 receptors, resulting in the dilation of blood vessels and a hypotensive response.

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33
Q

What are some drug-drug interactions of prazosin?

A

antihypertensives and diuretics results in extremely low blood pressure. Alcohol should be avoided.

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34
Q

What are signs that a patient has ADHD?

A

Distractible in school
Can’t complete assignments
Interrupts other when they are speaking

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35
Q

What would you do if a patient is easily distractible in school, cannot complete assignments, interrupts other while they are speaking?

A

Nsg Action – Have child tested, could be ADHD

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36
Q

What is the outcome of medications for ADHD?

A

Impulsiveness, hyperactivity, and disruptive behavior usually reduced within a few weeks.
Promote improved

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37
Q

What is the priority outcome for children on Ritalin?

A

They can focus in school, avoid altercations, and interact with peers appropriately

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38
Q

How long will it take to see effects of methylphenidate?

A

A few weeks

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39
Q

What is the prototype drug for ADHD drugs?

A

Methylphenidate (Ritalin)

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40
Q

What are some things to tell the patient about epilepsy drugs?

A

Medications must be continued indefinitely
Take the medication at the same time every day
Avoid taking kava products
keto

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41
Q

What are some things to avoid taking when on epilepsy drugs?

A

Kava because it adds to the sedating effects

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42
Q

What kind of drug should an epileptic take?

A

keto

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43
Q

What kind of patients should not take epileptic levels?

A

Pregnant if you want to have a baby

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44
Q

What happens if you take kava with epilepsy drugs?

A

Adds to sedating effects

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45
Q

What drugs do phenytoin interact with?

A

Oral hyperglycemics, insulin, etc

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46
Q

What may happen with phenytoin and serum glucose?

A

Hyperglycemia and need to increase insulin

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47
Q

What is the prototype drug for epileptics?

A

Phenytoin (Dilantin)

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48
Q

How should Dilantin be taken and not taken?

A

Taken orally, or IV, not IM

49
Q

What is the purpose of Ethosuximide?

A

used to control absence (petit mal) seizures in patients with epilepsy

49
Q

What might happen if you administer phenytoin IM?

A

Extravasation and local tissue damage

49
Q

Why should you avoid hand veins when giving phenytoin?

A

causes purple glove syndrome and local vasoconstriction

49
Q

What are three considerations when giving Dilantin IV?

A

Use large vein like aortic
Need a filter in an IV line
Flush line with NS

49
Q

What are some symptoms of parkinson’s?

A

Pill rolling
Tremor
Bradykinesia, slow speech, difficulty chewing, shuffling

49
Q

What aere some symptoms of toxicity of Stalevo?

A

Muscle twitching and spasmodic winking are early signs of toxicity.

50
Q

What is the prototype drug of Parkinsons?

A

Stalevo

50
Q

What is Stalevo contradindcations?

A

Contraindicated in narrow-angle glaucoma

50
Q

What are symptoms of Alzheimers?

A

Impaired memory and judgment
Confusion and disorientation
Inability to recognize family and friends
Aggressive behavior
Depression
Psychoses, including paranoia and delusions
Anxiety

51
Q

What are some medications for Alzheimers?

A

Donepezil (Aricept)

51
Q

What are some general adverse effects of zarontin? (4)

A

Impair mental and physical activities
Psychosis
Behavioral changes
CNS effects include dizziness

51
Q

Wha is the primary use of Donepezil (Aricept)

A

slow progression of the disease
Will only help symptoms for a little while

51
Q

Why must a patient on Zarontin avoid activities?

A

may impair mental and physical abilities.

51
Q

What are three classic signs of Parkinson’s?

A

Pill rolling
Termor
Bradykinesia

52
Q

What happens when a patient as Parkinson’s bradykinesia?

A

Slow speech
Difficulty chewing
Shuffling the feet when walking

52
Q

What is the prototype drug of to control petit mal seizures?

A

Ethosuximide (Zarontin)

52
Q

What is the prototype drug for Parkinson’s?

A

Levodopa, Carbidopa, and Entacapone (Stalevo)

53
Q

What are the three drugs that make up Stelevo?

A

Levodopa, Carbidopa, and Entacapon

54
Q

What are the signs of Stalevo toxicity?

A

Muscle twitching and spasmodic winking are early signs of toxicity.

55
Q

What type of patients should not take Stalevo?

A

Narrow-angle glaucoma patients

56
Q

What are some administration instruction to tell a patient on Stalevo?

A

Increase fluids and fiber in diet.
Take on empty stomach for better absorption
Avoid multivitamins – decrease the effects of Stalevo
Avoid foods high is Vit B6

57
Q

What are some foods to avoid when on Stalevo?

A

Multivitamins because they decrease effect of Stalevo
Avoid goods with high Vit B6-banana, wheat germ, fortified cereals

58
Q

What are two signs that the drug Stalevo is wearing off?

A

Twitching of the eyes
Increased tremors

59
Q

What are the actions to take if you see Twitching of the eyes and Increased tremors from taking Stalevo with Parkinson’s?

A

Increase the dose of the medication
Change the interval between doses of the medication
Add an adjunctive therapy

60
Q

What is a bad reaction to Donepezil?

A

Hepatotoxicity – Assess LFTs.

61
Q

What are the two main goals of MS pharmacotherapy?

A

Modify the progression of the disease
Treat acute exacerbation

62
Q

What are some positive effects of Schizophrenia?

A

Neologism- creating words
Hitting
Grossly disorganized thinking/thoughts

63
Q

What is the prototype drug of first-gen antipsychotics?

A

Chlorpromazine (Thorazine)

64
Q

What is the priority plan of a complication from Chlorpromazine (Thorazine)?

A

Agranulocytosis – If infection occurs (fever, sore throat), obtain CBC and notify provider

65
Q

What would you see and do if you saw a complication of Thorazine?

A

Agranulocytosis
infection occurs (fever, sore throat), obtain CBC and notify provider

66
Q

What should you do if WBC falls below < 3,000/µL when taking first-gen antipsychotics?

A

discontinue

67
Q

What are some general side effects of Thorazine?

A

Anticholinergic effects, Sedation, Hypotension
High EPS, Low AE (extrapyramidal symptoms)

68
Q

What would you do if a patient is on Thorazine and has some sedation/hypotention from anticholinergic effects??

A

Sit for a few minutes before taking vital signs.
Urinate prior to taking the medication.
Give sugar free candy or gum.

69
Q

What would you do if a patient on first-gen antipsychotics has High EPS, Low AE?

A

Give benztropine (Cogentin)
Prevent EPS except TD

70
Q

What are some types of high potency first gen antipsychotics?

A

Haloperidol (Haldol) (1 – 30 mg/d)
Fluphenazine (Prolixin) (0.5 – 40 mg/d)
Thiothixene (Navane) (2 – 30 mg/d)
Trifluoperazine (Stelazine) (1 – 40 mg/d)
Perhenazine (Trilafon) (8-60 mg/d)
Loxapine (Loxitane) (20 – 250 mg/d)
Pimozide

71
Q

What is the prototype drug of Conventional (Typical)/ Nonphenothiazines?

A

haloperidol (Haldol) or other antipsychotics

72
Q

What is the use of of Nonphenothiazines

A

severe mental illness

73
Q

What might it mean when a patient is on nonphenothiazides and has relapse?

A

Relapses with the medication
If patient stops taking the medication

74
Q

What does 2nd Generation treat?

A

Treat both negative and positive symptoms

75
Q

What does 1st Generation do?

A

Treat just positive symptoms

76
Q

What is the gold standard for atypical antipsychotics?

A

Clozapine (Clozaril, FazaClo)

77
Q

What are some types of EPS?

A

Acute dystonia, tardive dyskinesia, akathisia, pseudoparkinsonism

78
Q

What is tardive dyskinesia?

A

Unusual tongue and face mvmts
Lipe smacking and worklike motions
Puffing check

79
Q

What is acute dystonia?

A

Dancing, twitching, tongue, and facial muscles

80
Q

What is the outcome of 2nd gen antipsychotics?

A

Patient will not hear voices anymore and other symptoms are reduced

81
Q

What are some signs of akathisia?

A

Can’t relax with rep and compulsions

82
Q

Pseudoparkinsonism?

A

Tremor, muscle rigidity, stooped posture, and shuffling

83
Q

What should a nurse look for when someone is on Clozapine?

A

Vitals
ES- report
+/- symptoms

84
Q

What are some signs that patients on Clozapine have changed up their routine?

A

Patient exhibits positive symptoms

85
Q

What are some actions the patient might have taken when taking Clozapine?

A

Changed fluid used to mix meds like caffeine
Changed pharmacies
Started smoking

86
Q

What is the diagnosis of a depressive disorder?

A

a depressed affect plus five of the following symptoms for a minimum of two weeks
Difficulty sleeping or sleeping too much
Extremely tired; without energy
Abnormal eating patterns
Vague physical symptoms

87
Q

What can cause a hypertensive crisis in MAOI’s?

A

food containing tyramine

88
Q

What foods should be avoided with MAOI’s

A

Fermented/cured/aged/pickled/processed foods

89
Q

If a patient on Nardil comes in with hypotension, what might they be doing?

A

Eating foods containing tyramine

90
Q

What is a prototype for mood stabilizers?

A

Lithium (Eskalith)

91
Q

What is the range for litium toxicity?

A

Lithium Toxicity: ≥ 1.5 – hold dose and notify provider

92
Q

What is the range for litium toxicity?

A

Lithium Toxicity: ≥ 1.5 – hold dose and notify provider

93
Q

What might it mean if a patient
has diarrhea, vomiting, stomach pain and lithium level is 2.1
?

A

Lithium toxicity, hold dose and notify provider

94
Q

What are some things a patient should avoid when taking lithium?

A

Avoid increased salt/caffeine

95
Q

What are some meds for glaucoma?

A

Glucocorticoids, antihypertensives
Antidepressants, antihistamines

95
Q

What symptoms would you see with a patient who as a level of 0.5 of lithium? And what would you do?

A

Signs of mania and hyperactive and pressured speech, and ask for dose adjustment

95
Q

What is open-angle glaucoma?

A

Aqueous humor builds up and there is excessive production of blockage of outflow

95
Q

What is the indication of starting glaucoma pharmacotherapy treatment? (2)

A

When IOP is between 21 and 30 mm Hg***
When signs of optic nerve damage or visual-field changes are present regardless of IOP

96
Q

For how long do you use glaucoma pharmacotherapy?

A

Until you die

96
Q

What might you tell the patient if they are taking multiple meds for their glaucoma?

A

Combination therapy may be necessary to achieve goal

97
Q

What are two additional expected ADR for Latanoprost (Xalatan) besides dryness, burning, and photophobia?

A

Thicker eyelashes and changes in color of the iris and periocular skin

98
Q

What should you say to the patient who reports a darker iris when taking Latanoprost (Xalatan) for their glaucoma?

A

Keep taking it. It’s normal

99
Q

What are some administrations teaching for Latanoprost (Xalatan)?

A

Remove contacts before using eyedrops and don’t reinsert until after 15 minutes
Wait 5 minutes for additional eyedrops
Don’t get pregnant

100
Q

What is the prototype drug for glaucoma?

A

Latanoprost (Xalatan)

101
Q

What should you do to administer ceruminolytics?

A

Assess for excess cerumen
Instil an earwax softener and irrigate with tepid water

Pharm (10 decks)

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