ATI Pharmacology Review Flashcards
(158 cards)
1
Q
Antipsychotic Medications
A
Risperidone (Risperdal)
Olanzapine (Zyprexa)
Quetiapine (Seroquel)
2
Q
What should the nurse monitor for in a patient receiving antipsychotic medications?
A
- seizures
- extrapyramidal symptoms
- neuroleptic malignant syndrome
3
Q
Neuroleptic Malignant Syndrome
A
Reaction to antipsychotic drugs -fever -tremors -elevated blood pressure -tachycardia (If untreated it is potentially fatal)
4
Q
What should the nurse monitor for in a patient receiving olanzapine?
A
The nurse should monitor for orthostatic hypotension.
5
Q
Bipolar Disorder Medications
A
Lamotrigine (Lamictal)
Lithium (Lithobid)
Divalproex (Depakote)
6
Q
What should the nurse monitor in a patient receiving lithium?
A
The nurse should monitor lithium levels. Therapeutic range is 0.5 - 1.5 mEq/L.
The nurse should monitor intake/output.
Monitor sodium levels. If sodium levels rise, it increases risk for toxicity.
Monitor for seizures and arrhythmias.
7
Q
What are the signs of lithium toxicity?
A
- vomiting
- diarrhea
- drowsiness
- decreased coordination
- muscle weakness
8
Q
Selective Serotonin Reuptake Inhibitors (SSRIs)
A
Citalopram (Celexa) Escitalopram (Lexapro) Paroxetine (Paxil) Fluoxetine (Prozac) Sertaline (Zoloft)
9
Q
What are SSRIs used to treat?
A
Depression
10
Q
What should the nurse monitor in patients taking SSRIs?
A
- insomnia
- drowsiness
- constipation
- nausea, sweating
- tremors
- headache
- sexual dysfunction.
11
Q
MAOIs Inhibitors
A
Phenelzine (Nardil)
Tranylcypromine (Parnate)
12
Q
What are MAOIs used to treat?
A
Depression
13
Q
What should the nurse monitor for in patients receiving MAOIs?
A
-seizures and hypertensive crisis.
14
Q
What foods must a patient receiving MAOIs avoid?
A
These patients must avoid foods that contain tyramine.
Patients cannot eat cheeses, processed meats, wine, yogurt, beer, chocolate.
15
Q
NSAIDs
A
Ibuprofen (Advil; Motrin)
Acetominiphen (Tylenol)
16
Q
What should the nurse monitor in a patient receiving NSAIDS?
A
- GI irritation
- GI bleeding
- Renal failure
17
Q
What should the nurse monitor for in a patient receiving acetaminophen?
A
- s/s of hepatotoxicity such as
- sweating
- nausea, vomiting
- diarrhea
- anorexia
- abdominal pain
18
Q
What is the antidote for acetaminophen overdose?
A
acetylcysteine (Mucomyst)
19
Q
How much acetaminophen can be given in 24 hours?
A
Do not administer more than 4g of acetaminophen per 24 hours.
20
Q
What is the general antidote for oral non-narcotic analgesics?
A
Activated charcoal.
21
Q
Narcotic Analgesics (Opioids)
A
Codeine Morphine Oxycodone (OxyContin) Hydromorphone (Dilaudid) Fentanyl (Duragesic)
22
Q
What should the nurse monitor for in patients receiving opioid analgesics?
A
- hypotension
- respiratory depression
- nausea, vomiting
- constipation.
23
Q
What is the antidote to opioid overdose?
A
Naloxone (Narcan)
24
Q
Antimigraine Medications
A
Usually end in -triptan.
Sumatriptan (Imitrex)
Eletriptan (Replax)
Zolmitriptan (Zomig)
25
What should the nurse monitor for in patients receiving antimigraine medications?
- dizziness
- vertigo
- paresthesias
- myalgias
- chest tightness
26
What can occur when taking Sumatriptan (Imitex)
MI
27
Antiparkinson Medications
- Benztropine mesylate (Cogentin)
- Carbidopa/levodopa (Sinemet)
- Pramipexole (Mirapex)
28
When is carbidopa/levodopa (Sinemet) given?
It needs to be given before meals and at bedtime for the best effects.
29
What should the nurse monitor in patients receiving Sinemet?
- constipation
- dry mouth
- dizziness, drowsiness
- confusion
- insomnia
30
Sleeping Agents
Zolpidem (Ambien)
Temazepam (Restoril)
Eszopiclone (Lunesta)
Ramelteon (Rozerem)
31
What side effects can occur from sleeping agents?
Daytime drowsiness, dizziness.
Use cautiously in older adults.
32
What should the nurse teach to patients taking sleeping agents?
The nurse should teach alternative sleep aids such as keeping the room dark and quiet. Avoiding alcohol/caffeine/nicotine, and don't exercise before bedtime.
33
Antiseizure Medications
- Divalproex (Depakote): Bipolar disorder
- Phenytoin (Dilantin)
- Gabapentin (Neurontin): neuropathic pain treatment
- Carbamazepine (Tegretol)
- Diazepam (Valium):
34
What should the nurse monitor in patients taking antiseizure medications?
- confusion
- drowsiness
- ataxia
The nurse should monitor carbamazepine and phenytoin levels and CBC for toxicity or aplastic anemia and agranulocytosis.
35
What are the therapeutic levels of carbamazepine?
6-12mcg/ml.
36
What are the therapeutic levels of phenytoin?
10-20mcg/ml.
37
What adverse effects can phenytoin cause?
Phenytoin can cause gingival hyperplasia.
38
Toxicity symptoms of phenytoin
- nystagumus
- ataxia
- confusion, dizziness
- nausea
- Stevens-Johnson syndrome
39
If phenytoin is given IV, what should the nurse watch for?
The nurse should monitor for dysrhythmias.
40
When should phenytoin be given if given PO?
Phenytoin should be given before or after tube feedings.
41
Anti-Tuberculosis Agents
- Isonicotinic acid (Isoniazid)
- Ethambutol (Myambutol
- Nicotinamide (Pyrazinamide)
- Rifampin (Rifadin)
42
What are the adverse effects of isonicotinic acid (Isoniazid)?
-pyridoxine deficiency
43
What should patients taking isonicotinic acid (isonizaid) be prescribed to avoid pyridoxine deficiency
Patients should be prescribed vitamin B6 to avoid this.
44
What adverse effects does ethambutol have?
-decreases in color vision
45
What adverse effects does rifampin cause?
-body fluids such as urine, sweat, and saliva to be red/orange color
46
What should the nurse monitor for in a patient receiving antituberculosis agents?
The nurse should monitor for signs of gout and hepatitis.
Check LFTs and uric acid levels.
47
How long are antituberculosis medications used for?
These medications are used in combination for 12 to 18 months.
48
Bacteriostatic/Bactericidal Medications
```
Gentamycin (Garamycin)
Vancomycin (Vancocin)
Metronidazole (Flagyl)
Ampicillin/clavulanate (Augmentin)
Azithromycin (Zithromax)
Cefazolin (Ancef)
Cephalexin (Keflex)
Erythromycin (E-Mycin)
Levofloxacin (Levaquin)
Penicillin V (Pen-Vee-K)
Trimethorpim/sulfamethoxazole (Bactrim)
Tetracycline (Tetracap)
```
49
What are general adverse effects of antibiotics?
Antibiotic use can result in bacterial overgrowth resulting in yeast infections or GI disturbances.
50
What can occur when antibiotics are administered too rapidly?
increase risk of hypotension
51
What adverse effects do gentamycin and vancomycin have?
They are nephrotoxic and ototoxic
Monitor for ringing of the ears
52
What adverse effects can metronidazole have?
Seizures
-patient should avoid alcohol
53
What adverse effects does tetracycline have?
Patients should avoid sun exposure due to increased photosensitivity.
54
Antihistamines
Diphenhydramine (Benadryl)
55
What is diphenhydramine used for?
It is used to treat anaphylaxis, seasonal allergies, and allergic skin rashes.
It is also used as a mild sleep sedative and for motion sickness.
56
What should the nurse monitor for in a patient taking diphenhydramine?
- drowsiness
- anorexia
- dry mouth
-may causes falls in elderly patients
57
Antitussive
A type of medication used to relieve coughing. (Dextromethorphan)
58
Expectorant
A type of medication used to help remove mucous from airways. (Guafenesin:)
59
Decongestant
Decongestant
| Reduces nasal congestion and swelling. (Pseudoephedrine)
60
Glucocorticoids
Prednisone (PO)
| Methylprednisolone (IV)
61
When are glucocorticoids used?
Glucocorticoids produce anti-inflammatory and immunosuppressive effects.
62
What are the adverse effects of glucocorticoids?
- hyperglycemia
- poor wound healing
- decreased immune function
- increased risk of infection
- -osteoporosis
- sodium/water retention
63
Can glucocorticoids be stopped abruptly?
No, glucocorticoid treatment needs to be tapered off prior to discontinuing.
64
Inhaled Glucocorticoids
- Albuterol (beta 2 agonist adrenergic)
- Proventil (Salbutamol)
- Ipratropium (Atrovent)
65
What should the nurse teach the patient after taking inhaled glucocorticoids?
The nurse should teach the patient to rinse their mouth after each use to reduce risk for candidiasis.
In addition, they should dry the chamber after each use.
66
What should the nurse monitor in a patient receiving Proventil (Salbutamol)?
increased heart rate and tremors.
67
How does ipratropium work as a respiratory agent?
Ipratropium relaxes bronchial smooth muscle. It is slower acting than albuterol and does not produce tachycardia.
68
What is levothyroxine (Synthroid) used for?
It is used to improve symptoms of hypothyroidism.
69
How long must patients receive levothyroxine?
LIFE
70
What should the nurse and patient monitor for when receiving levothyroxine?
symptoms of hyperthyroidism, insomnia, irritability, nervousness, tachycardia, and cardiovascular collapse.
TSH levels should be monitored peridocally
71
At what time should levothyroxine be taken?
Levothyroxine should be taken before breakfast.
72
Rapid Acting Insulin
Lispro (Humalog)
73
When should a patient take lispro?
The patient should take lispro 15 minutes prior to eating.
74
Regular Insulin
Humulin R
75
How long does it take for humulin R to peak?
2-4 hours
76
NPH Insulin
Humulin N
77
How long does it take for humulin N to peak?
6-12 hours
78
Long Acting Insulin
Glargine (Lantus)
79
How often is glargine given?
Glargine is given once a day. This insulin lasts for 24 hours.
80
What are the signs and symptoms of hypoglycemia?
- cool, clammy
- confused
- weakness
- palpitations
- hunger
81
What are the signs and symptoms of hyperglycemia?
- dry, flushed skin
- polyuria
- polydipsia
82
What should the nurse monitor and teach the patient about when taking insulin?
about blood glucose monitoring
83
What is the antidote to hypoglycemia?
- dextrose tab under the tongue or eat something contain sugar
- dextrose 50% IV
- glucagon IM
84
Oral Hypoglycemics
Metformin (Glucophage)
Glipizide (Glucotrol)
Glyburide (Micronase)
85
What are the adverse effects of oral hypoglycemics?
-diarrhea, bloating
- liver dysfunction
- photosensitivity
- hypoglycemia
- aplastic anemia
86
What allergies should the nurse assess for prior to administering oral hypoglycemic?
sulfonamide allergys
87
What should the nurse monitor when administering oral hypoglycemic?
The nurse should monitor CBC and Hg A1C
88
Cholesterol Absorption Inhibitors
Ezetimibe (Zetia)
| works in small intestine by decreasing cholesterol absorption in digestive tract
89
What should the nurse monitor for in patients receiving ezetimibe?
angioedema
90
Hyperlipidemics
Usually end in -statin.
Atorvastatin (Lipitor)
Simvastatin (Zocor)
Lovastatin (Mevacor)
These medications lower cholesterol levels.
91
What food should patients receiving hyperlipidemics avoid?
-anything containing grapefruit as it decreases metabolism
92
What should the nurse monitor in patients receiving hyperlipidemics?
- muscle pain (myalgia)
- rhabdomyolysis
-liver function test should be checked before and during therapy
93
Rhabdomyolysis
Breakdown of muscle tissue that leads to release of muscle fiber into the blood.
Causes muscle pain and dark red or cola colored urine.
If untreated it can lead to kidney failure and death.
94
Anticoagulants
Heparin
| Warfarin (Coumadin)
95
What are the indications for heparin?
- pulmonary embolisms
- MI
- DVT
- CVA
96
What are therapeutic blood levels for heparin?
Therapeutic levels are generally 1.5 - 2.5 times normal control level
aPTT (1.5-2.5)
97
What are the adverse effects of heparin?
- bleeding
- anemia
- thrombocytopenia
98
What should the nurse monitor in patients receiving heparin?
- aPTT
- PTT
- hematocrit
99
What is the antidote of heparin?
protamine sulfate
100
What is enoxaparin (Lovenox)?
Enoxaparin is a low molecular weight heparin. It is similar to heparin but has a longer half-life and causes less thrombocytopenia.
101
What are the indications for warfarin?
- venous thrombus
- pulmonary embolism
- MI
- A-fib
- prosthetic valve replacement
102
What are the therapeutic levels of warfarin?
INR 0.7-1.8
| 2.0-3.0
103
What should the nurse monitor in patients receiving warfarin?
- PT (11-12.5 sec)
| - INR
104
What is the antidote to warfarin?
Vitamin K
105
Antidysrhythmics
Digoxin (Lanoxin)
Calcium channel blockers and beta blockers are also used to treat dysrhythmias.
106
What does Digoxin treat
- chronic HF
- A-fib
- proxysmal atrial tachycardia
107
What is the digoxin therapeutic level?
0.5-2
108
What are the signs and symptoms of digoxin toxicity?
- abdominal pain
- anorexia
- nausea, vomiting
- visual disturbances
- bradycardia
109
What must the nurse do before administering digoxin?
The nurse must take the patient's apical heart rate.
110
When would a nurse hold administering digoxin?
If the patient's apical HR is below 60 or above 100.
111
What should the nurse monitor in a patient receiving digoxin?
-potassium level
a decrease in potassium precipitates digoxin toxicity
112
What is given if the patient is suffering from digoxin toxicity?
The patient receives digoxin immune fab (Digibind)
113
What are nitrates used for?
They are used to decrease angina pain.
114
Nitrates
Nitroglycerin
115
When would a patient take nitroglycerin?
A patient experiencing angina, MI (given IV), or suffering from chronic heart failure.
116
How do nitrates work?
Nitrates lower blood pressure which improves blood flow to the myocardium.
117
When a patient is having an angina episode, what is the protocol for taking sublingual nitroglycerin?
The patient should take one tab under the tongue every 5 minutes up to three times.
If no relief is acquired, they should immediately call 911 and get transported to the ER.
118
What should the nurse monitor in patients receiving nitrates?
- hypotension
- headache
- rebound tachycardia due to vasodilation
119
What teaching should the nurse include in patients taking cardiac medications?
Education should include having the patients changing position slowly, reporting
-facial swelling
-dyspnea
-dizziness
-signs of digoxin toxicity, weight loss or gain
and change in mental status
120
What is an indication that nitroglycerin is working
A headache or tingling under the tongue confirms that nitroglycerin in is working.
121
Where should nitroglycerin be stored?
A dark container and replaced every 6 months.
122
Diuretics
These are used for both antihypertensive effects and to control edema.
123
What should the nurse monitor in a patient receiving diuretics?
- digoxin and lithium toxicity
- hyperglycemia
- electrolytes
- dehydration
- orthostatic hypotension
124
In what type of patient should diuretics be used cautiously?
Patients with renal impairment
125
Thiazide Diuretics
Hydrochlorothiazide (HCTZ)
126
Loop Diuretics
Furosemide (Lasix)
| Bumetanide (Bumex)
127
What should the nurse monitor in patients receiving loop diuretics?
- hypotension
- ototoxicity
- potassium depletion
128
What allergy should the nurse check for in a patient receiving loop diuretics?
if they are allergic to sulfa based medications
129
Potassium-Sparing Diuretics
Spironolactone (Aldactone)
130
What are potassium-sparing diuretics used for?
They are used to treat edema.
131
What should the nurse monitor for in patients receiving potassium-sparing diuretics?
Signs of hyperkalemia.
132
Osmotic Diuretics
Mannitol (Osmitrol)
133
What are osmotic diuretics used for?
patients with increased intracranial pressure
| -acute renal failure
134
What route are osmotic diuretics given in?
Osmotic diuretics are given IV with a filter.
135
What should the nurse monitor for in patients receiving osmotic diuretics?
monitor IV site and for CONFUSION
136
Potassium Replacement
Potassium (K-Dur) is a supplement given with loop diuretics to prevent hypokalemia.
137
Hyperkalemia Treatment
Sodium polystyrene sulfonate (Kayexalate) is given to treat hyperkalemia.
138
ACE Inhibitors
Usually end in -pril.
Enalapril (Vasotec)
Lisinopril (Zestril)
Captopril (Capoten)
139
What are adverse effects of ACE Inhibitors?
- hypotension
- dry cough
- angioedema
140
What should the nurse monitor for in patients receiving ACE Inhibitors?
renal function
141
Treatment for angioedema
epinephrine
142
ARB Inhibitor
Usually end in -artan.
Losartan (Cozaar)
Valsartan (Diovan)
Irbesartan (Avapro)
143
How do ARB Inhibitors work?
These work by blocking angiotensin II receptors in the angiotensin loop.
144
What should the nurse monitor in a patient receiving ARB Inhibitors?
- potassium level
| - renal function
145
What adverse effect may occur from ARB Inhibitors?
Angioedema
146
Calcium Channel Blockers
Verapamil (Calan)
Dilitiazem (Cardizem)
Amlodipine (Norvasc)
Nifedipine (Procardia)
147
What is a common adverse effect caused by verapamil (Calan)?
Constipation
148
What should the nurse monitor in a patient receiving calcium channel blockers?
Edema and hypotension
149
Alpha 1 blocker
Clonidine (Catapres)
150
What affects do alpha 1 blockers cause?
They cause systemic vasodilation by directly acting on smooth muscle of arteries.
151
What adverse effects can alpha 1 blockers cause?
hypotension
dizziness
sedation
152
In what form are alpha 1 blockers usually administered?
Alpha 1 blockers are generally administered as a patch and are changed once a week.
153
Betablockers
Usually end in -olol.
Propranolol (Inderal)
Atenolol (Tenormin)
Metoprolol (Lopressor)
154
What additional effects of betablockers should the nurse monitor?
broncho constriction and bronchospasms
155
In what population should betablockers be used cautiously in?
asthma patients
Beta blockers can mask tachycardia in patients suffering from hypovolemia and hypoglycemic symptoms seen in diabetic patients.
156
Antihypertensives
- Betablockers
- Alpha 1 Blockers
- Calcium Channel blockers
- ACE Inhibitors
- ARB Inhibitors
- Diuretics
157
What do antihypertensives do
Affect both the blood pressure and the rhythm of the heart.
| lowers BP
158
Common side effect of antihypertensives
orthostatic hypotension
