EXAM 3 Flashcards
(561 cards)
1
Q
What is the use of Aspirin (NSAID)?
A
Reduce pain, inflammatory symptoms, fever. Decreases inflammation for osteoarthritis and rheumatoid arthritis; arterial thromboembolism, MI, TIA, stroke prophylaxis.
2
Q
How is Aspirin administered?
A
Oral.
3
Q
What is the mechanism of action (MOA) of Aspirin?
A
Inhibits prostaglandin synthesis, hypothalamic regulator center, and platelet aggregation.
4
Q
What are the signs/symptoms of Aspirin toxicity?
A
Tinnitus, vertigo, and bronchospasm—especially in asthmatic patients.
5
Q
What foods contain salicylates?
A
Prunes, raisins, paprika, and licorice.
6
Q
Who should avoid Aspirin?
A
Patients with asthma (aspirin-exacerbated respiratory disease (AERD) or aspirin-induced asthma).
7
Q
What are the side effects of Aspirin?
A
Drowsiness, tinnitus, headaches, flushing, dizziness, GI distress, GI bleeding, visual changes, and seizures.
8
Q
What are the adverse reactions to Aspirin?
A
Tinnitus, hearing loss.
9
Q
What are the life-threatening reactions associated with Aspirin?
A
Reye syndrome, angioedema, bronchospasm.
10
Q
What should patients avoid when taking Aspirin?
A
Taking it with alcohol or with drugs that are highly protein bound, such as warfarin.
11
Q
What should patients inform their dentist about when taking Aspirin?
A
If they are taking high doses of aspirin.
12
Q
When should patients discontinue Aspirin before surgery?
A
Approximately 7 days before surgery to reduce risk of bleeding.
13
Q
What are the signs associated with GI bleeding that can be caused by aspirin?
A
lower BP, tachycardia
14
Q
How long may it take to experience the desired therapeutic effect of high dose Aspirin?
A
Several weeks for some NSAIDs and disease-modifying antirheumatic drugs (DMARDs).
15
Q
What warning is given regarding Aspirin and children?
A
Do not administer Aspirin for virus or flu symptoms in children younger than 19 years of age due to the risk of Reye syndrome.
16
Q
What should not be given to children with flu or cold symptoms for relief?
A
Any salicylate containing medications, e.g., Pepto–Bismol (Bismuth subsalicylate).
17
Q
What gastrointestinal effect can Aspirin tablets cause?
A
GI distress.
18
Q
What is the primary use of Ibuprofen?
A
Reduce inflammatory process, relieve pain, anti-inflammatory effect for arthritic conditions, reduce fever, dysmenorrhea, headache
19
Q
How is Ibuprofen administered?
A
Oral
20
Q
What is the mechanism of action (MOA) of Ibuprofen?
A
Inhibits COX-1 and COX-2 by blocking arachidonate binding, thus relieving pain and inflammation
21
Q
What interactions can NSAIDs have with other medications?
A
Increase the effects of phenytoin, sulfonamides, and warfarin
22
Q
In which conditions are NSAIDs contraindicated?
A
Severe renal or liver disease, peptic ulcer, bleeding disorder
23
Q
What signs should be assessed for to determine bleeding issues in patients taking NSAIDs?
A
Bleeding gums, petechiae, ecchymoses, or black, tarry stools
24
Q
What can happen to bleeding time when taking NSAIDs?
A
Bleeding time can be prolonged, especially with highly protein-bound drugs like warfarin
25
What should patients report when taking NSAIDs?
GI discomfort
26
When should NSAIDs be administered to prevent GI upset?
At mealtime or with food
27
What should patients with GERD take with Ibuprofen?
Ranitidine (H2 receptor blocker)
28
List some side effects of Ibuprofen.
* GI distress
* Peripheral edema
* Purpura or petechiae
* Dizziness
29
What are some adverse reactions of Ibuprofen?
* Hearing loss, tinnitus, seizure
* GI bleeding/perforation/ulcer
30
What are some life-threatening reactions associated with Ibuprofen?
* Anaphylaxis
* Angioedema
* Blood disorders
31
Should patients take aspirin and acetaminophen with NSAIDs?
No, it could cause GI upset and possibly GI bleeding
32
What should patients avoid when taking NSAIDs?
Alcohol
33
Why should patients inform their dentist or surgeon about NSAID use?
They are taking ibuprofen or other NSAIDs for a continuous period and can have prolonged bleeding
34
What should female patients avoid taking 1 to 2 days before menstruation?
NSAIDs to avoid heavy menstrual flow
35
What is Celecoxib classified as?
COX-2 Inhibitor
36
List the primary uses of Celecoxib.
* Treats osteoarthritis
* Treats rheumatoid arthritis
* Relieves dysmenorrhea
* Manages moderate to severe pain
* Treats ankylosing spondylitis
* Treats migraine
37
How is Celecoxib administered?
Oral
38
What is the mechanism of action (MOA) of Celecoxib?
Inhibits COX-2
39
What are the recommendations for administering Celecoxib?
* Use the lowest effective dose for the shortest period of time
* May administer without regard to meals
40
What are common side effects of Celecoxib?
* Headache
* Dizziness
* Drowsiness
41
What are some potential adverse reactions to Celecoxib?
* GI bleeding, obstruction, ulcer, perforation
* Hypertension, dyspnea
* Hearing loss, tinnitus
* Tendon rupture
* Hypo-hypernatremia
* Thromboembolism
42
What are life-threatening reactions associated with Celecoxib?
* Anaphylaxis, angioedema, bronchospasm
* Renal failure, hepatic failure
* blood disorders
* Stevens-Johnson syndrome
43
What precautions should patients take when using Celecoxib?
* Do not exceed prescribed dose
* Increasing doses do not increase effectiveness
* Avoid using more than one NSAID or aspirin at a time
* Inform of increased risk of MI and stroke
* Not safe for pregnancy, especially in the 3rd trimester
44
What type of medication is Infliximab?
Immunomodulator, TNF blocker
45
What conditions does Infliximab treat?
* Psoriasis
* Rheumatoid arthritis
* Psoriatic arthritis
* Ankylosing spondylitis
* Ulcerative colitis
* Crohn's disease
46
How is Infliximab administered?
IV
47
What is the mechanism of action (MOA) of Infliximab?
Binds to tumor necrosis factor alpha (TNF-alpha) and blocks it from attaching to TNF receptors on synovial cell surfaces
48
What is the effect of Infliximab on inflammation?
Reduces infiltration of inflammatory cells and delays inflammatory process
49
What should be assessed for in patients receiving Infliximab?
Signs and symptoms of systemic infections
50
List some signs and symptoms of systemic infections to assess in patients on Infliximab.
* Fever
* Malaise
* Weight loss
* Sweats
* Cough
* Dyspnea
* Pulmonary infiltrates
* Serious systemic illness with or without concomitant shock
51
What are some common side effects of Infliximab?
* Chills
* Flushing
* Fever
52
What are the adverse reactions associated with Infliximab?
Severe infections
53
What is a life-threatening condition associated with Infliximab?
Neutropenia
54
What advice should be given to patients regarding live vaccines while on Infliximab?
Avoid live vaccines due to potential interference with the immune response
55
What symptoms should patients report immediately while taking Infliximab?
* Dizziness
* Chills
* Depression
* Dyspnea
* Severe infections
* Seizures
* Fatigue
* Rash
56
True or False: Patients taking Infliximab should report severe infections immediately.
True
57
What is the mechanism of action of Febuxostat?
Blocks hypoxanthine and xanthine metabolism to reduce uric acid synthesis.
58
What are the contraindications for Febuxostat?
Hypersensitivity.
59
What caution should be taken when prescribing Febuxostat?
Hepatic/renal disorder.
60
What medical history should be obtained before administering Febuxostat?
Any gastric, renal, cardiac, or liver disorders.
61
Why is sufficient renal function important for antigout drugs?
Antigout drugs are excreted via kidneys.
62
What laboratory tests should be checked for patients on Febuxostat?
BUN, serum creatinine, alkaline phosphatase (ALP), aspartate aminotransferase (AST), alanine aminotransferase (ALT), and lactate dehydrogenase (LDH).
63
What is expected in a patient with gout regarding serum uric acid levels?
An increased serum uric acid level.
64
What side effects are associated with Febuxostat?
Anorexia, nausea, vomiting, diarrhea, stomatitis, dizziness, rash, pruritus, and metallic taste.
65
What should patients be encouraged to do while on Febuxostat?
Keep medical appointments and have regular laboratory tests.
66
What is a slight change in blood tests that may be expected with Febuxostat?
Slight increased WBC.
67
What substances should patients avoid while taking Febuxostat?
Alcohol and caffeine.
68
Fill in the blank: Febuxostat is administered _______.
Oral.
69
What should patients do if they experience gastric distress while taking Febuxostat?
Report any gastric distress.
70
What is the significance of monitoring laboratory tests for renal and liver function?
To detect potential adverse effects from antigout drugs.
71
What is the primary use of Acetaminophen?
To decrease pain and fever
## Footnote
Acetaminophen is classified as a non-opioid analgesic.
72
What is the mechanism of action (MOA) of Acetaminophen?
Inhibition (weak) of prostaglandin synthesis, inhibition of hypothalamic heat regulator center
73
How can Acetaminophen be administered?
Orally, IV
74
What are the contraindications for Acetaminophen?
Hypersensitivity
75
What should be ascertained before administering Acetaminophen?
The severity of pain
76
What types of medications might be necessary to relieve pain if Acetaminophen is insufficient?
Nonopioid nonsteroidal antiinflammatory drugs (NSAIDs), such as ibuprofen, or an opioid
77
What are some adverse reactions of Acetaminophen?
Oliguria, hearing loss, hypomagnesemia, elevated hepatic enzymes
78
List some common side effects of Acetaminophen.
* Headache
* Insomnia
* Anxiety
* Fatigue
* Anorexia
* Nausea
* Vomiting
* Constipation
* Peripheral edema
79
What can high doses of Acetaminophen cause?
Hepatotoxicity, hepatic failure, and death
80
What is the suggested safe maximum adult dosage of Acetaminophen to avoid hepatic damage?
4 g/day
81
What should patients be taught regarding Acetaminophen dosages?
To check acetaminophen dosages on the label of over-the-counter (OTC) drugs and not to exceed the recommended dosage
82
What is the antidote for Acetaminophen overdose?
Acetylcysteine
83
How does Acetylcysteine help in cases of Acetaminophen overdose?
It reduces liver injury by converting toxic metabolites to a nontoxic form
84
What makes Acetaminophen safer for patients with peptic ulcers and hemophilia?
Safer use for peptic ulcers and hemophilia
85
Is Acetaminophen recommended for children with the flu?
Yes
86
True or False: Patients should combine aspirin and Acetaminophen with NSAIDs.
False
87
What risks are associated with taking an NSAID with aspirin?
GI upset and possibly GI bleeding
88
What is the primary use of morphine?
To relieve moderate to severe pain
## Footnote
Morphine is indicated for pain levels ranging from 7 to 10.
89
What is the mechanism of action (MOA) of morphine?
Depression of the CNS; depression of pain impulses by binding with opiate receptors in the CNS
90
What are the routes of administration for morphine?
*Orally
*IM
*Subcut
*Rectal
*IV
*Epidural
*Intrathecal
91
What are the contraindications for using morphine?
CNS or respiratory depression
92
What vital signs should be assessed before administering morphine?
*Rate and depth of respirations
*Pupil size
93
What are common side effects of opioids like morphine?
*Respiratory depression
*Orthostatic hypotension
*Constipation
*Drowsiness
*Dizziness
*Urinary retention
94
What should be monitored to detect respiratory changes when administering morphine?
Vital signs at frequent intervals
95
What is a potential sign of morphine overdose?
Pinpoint pupils
96
What should be available as an antidote for morphine overdose?
Naloxone
97
What is the minimum urine output expected for patients taking morphine?
At least 600 mL/day
98
What are the symptoms of opioid withdrawal?
*Flu-like symptoms
*Muscle aches
*Sweating
*Runny nose
*Watery eyes
*Fever
*Dilated pupils
*Increased pain sensitivity
99
True or False: Opioids are contraindicated for patients with head injuries.
True
100
What adverse reactions can result from morphine use?
*Orthostatic hypotension
*Bradycardia
*Tachycardia
*Dyspnea
*Respiratory depression
101
What should patients be advised against while taking morphine?
Using alcohol or central nervous system (CNS) depressants
102
What can continuous use of opioids like morphine lead to?
Substance use disorder
103
What are the properties of methadone in treating opioid addiction?
*Agonist
*Antagonist
104
What might dizziness while taking morphine indicate?
Orthostatic hypotension
105
Fill in the blank: Morphine is classified as a _______.
Controlled Substance Schedule II
106
What is nalbuphine classified as?
Opioid-agonist-antagonist
107
What is the main use of nalbuphine?
To relieve moderate to severe pain and for anesthesia induction and maintenance
108
What is the mechanism of action (MOA) of nalbuphine?
Inhibits pain impulses transmitted in the CNS by binding with opiate receptors and increasing pain threshold
109
How is nalbuphine administered?
IM, Subcut, IV
110
What condition can nalbuphine help decrease?
Substance use disorder
111
Why is nalbuphine not given for cancer pain?
Risk of potential CNS toxicity from the high doses required
112
What should be obtained from the patient before administering nalbuphine?
A drug history
113
What can CNS depressants cause when taken with nalbuphine?
Respiratory depression
114
List three adverse reactions of nalbuphine.
* Bradycardia
* Hypo/hypertension
* Dyspnea
115
What are two life-threatening effects of nalbuphine?
* Respiratory depression
* Seizures
116
Name three common side effects of nalbuphine.
* Respiratory depression
* Dizziness
* Drowsiness
117
What should patients avoid while taking nalbuphine?
Alcohol
118
What side effects should patients report when taking nalbuphine?
* Dizziness
* Headaches
* Constipation
* Dysuria
* Rash
* Blurred vision
119
What is Fentanyl primarily used for?
Moderate to severe chronic pain and anesthesia induction and maintenance
## Footnote
Not for acute pain, post-op pain, or intermittent pain.
120
What are the routes of administration for Fentanyl?
Transdermal, IV, IM, Buccal, Transmucosal
121
What is the mechanism of action (MOA) of Fentanyl?
Binds to opiate receptors in the CNS, altering the response to and perception of pain
122
How does the potency of Fentanyl compare to other opioids?
Significantly more potent than other opioids like morphine or oxycodone
123
What vital signs should be assessed before administering opioids?
Rate and depth of respirations, and pupil size
124
What common effects do opioids have on vital signs?
Decrease respirations, cough reflex, and systolic blood pressure
125
What should be monitored to detect respiratory changes and hypotension?
Vital signs at frequent intervals
126
What urine output should be recorded before administering opioids?
At least 600 mL/day
127
What side effect may require checking bowel sounds?
Constipation
128
What pupil changes may indicate an overdose?
Pinpoint pupils
129
What should be available as an antidote for opioid overdose?
Naloxone
130
What is a key precaution to take before administering Fentanyl?
Validate the dose before administration
131
What should be checked in older adults before administering opioids?
Alertness and orientation
132
What are common side effects of Fentanyl?
* Drowsiness
* Dizziness
* Euphoria
* Headache
* Confusion
* Fatigue
* Weakness
* Hypokalemia
* Vomiting
* Nausea
* Constipation
* Rash
* Tolerance
133
What should patients be advised regarding alcohol and CNS depressants?
Not to use them with any opioid analgesics
134
What can continuous use of opioids lead to?
Substance use disorder
135
What is Methadone's role in opioid addiction treatment?
Has agonist and antagonist properties to help reduce dependence on opioids
136
What should patients report while taking opioids?
Dizziness
137
What condition might dizziness indicate when taking morphine?
Orthostatic Hypotension
138
Fill in the blank: Fentanyl patches should have the old patch _______ before applying a new one.
removed
139
What is Sumatriptan classified as?
5-HT selective serotonin receptor agonist (SSRAs)
## Footnote
Sumatriptan is specifically used for treating migraine and cluster headaches.
140
What is the primary use of Sumatriptan?
To treat migraine and cluster headaches
## Footnote
Sumatriptan is effective for acute migraine attacks and cluster headaches.
141
What is the mechanism of action (MOA) of Sumatriptan?
Causes vasoconstriction of cranial arteries to relieve migraine attacks
## Footnote
This action helps reduce the symptoms associated with migraines.
142
What are the routes of administration for Sumatriptan?
Orally, Subcutaneously, Nasally
## Footnote
These routes allow for flexibility based on patient needs.
143
What is a significant risk associated with Sumatriptan that must be reported?
Risk of vasospasm and elevated BP
## Footnote
Patients should notify their provider immediately if they experience these symptoms.
144
What are common side effects of Sumatriptan?
Dizziness, Headache
## Footnote
These are generally mild but should be monitored.
145
What are serious adverse reactions associated with Sumatriptan?
Hypotension, Hypertensive crisis
## Footnote
These reactions require immediate medical attention.
146
When should Sumatriptan be used?
Only during a migraine attack
## Footnote
It is important to use it specifically for active migraine symptoms.
147
When should a second injection of Sumatriptan be administered?
If migraine returns, with 1 hour between subcutaneous injections
## Footnote
Proper timing is crucial to avoid overdose and ensure effectiveness.
148
What is the maximum number of Sumatriptan injections allowed in 24 hours?
No more than 2 injections
## Footnote
This limit helps prevent potential side effects and complications.
149
What should patients taking SSRI or SNRI notify their provider about?
Signs of serotonin syndrome
## Footnote
Symptoms include mental status changes, agitation, hallucinations, coma, tachycardia, labile BP, hyperthermia, hyper-reflexia, nausea, vomiting, diarrhea.
150
What is the primary use of Methylphenidate?
CNS Stimulant for ADHD and narcolepsy
## Footnote
Methylphenidate is used to help control uncontrollable episodes of falling asleep.
151
What is the mechanism of action (MOA) of Methylphenidate?
Increases norepinephrine and dopamine at the synaptic cleft by inhibiting reuptake
## Footnote
This results in increased focus and attention while decreasing impulsivity.
152
How is Methylphenidate administered?
Orally and transdermal
## Footnote
It is available in different formulations for patient convenience.
153
What controlled substance schedule is Methylphenidate classified under?
CSS II
## Footnote
This classification is due to its potential for abuse and dependence.
154
List three contraindications for Methylphenidate.
* Glaucoma
* Angina
* Acute MI
## Footnote
Other contraindications include heart failure, hyperthyroidism, and MAOI therapy.
155
What precautions should be taken when administering Methylphenidate to children?
Caution in children <6, peripheral vascular disease, psychosis, depression
## Footnote
Monitoring is essential to prevent adverse outcomes.
156
What vital signs should be monitored when a patient is on Methylphenidate?
Blood pressure
## Footnote
Irregularities in blood pressure should be reported.
157
What are common side effects of Methylphenidate?
* Anorexia
* Insomnia
* Irritability
* Weight loss
## Footnote
These side effects can impact the patient's quality of life.
158
What are potential adverse reactions to Methylphenidate?
* Tachycardia
* Hypertension
* Bradycardia
* Growth suppression
* Palpitations
* Seizures
* Psychosis
## Footnote
These reactions require immediate medical attention.
159
What life-threatening conditions can result from Methylphenidate use?
* Blood dyscrasias
* Hepatotoxicity
* Ocular hypertension
## Footnote
These conditions can have severe consequences if not addressed promptly.
160
True or False: Patients should abruptly discontinue Methylphenidate.
False
## Footnote
The dose must be tapered to avoid withdrawal symptoms.
161
What should patients avoid while taking Methylphenidate?
* Alcohol
* Caffeine-containing foods
## Footnote
High plasma caffeine levels could be fatal, and alcohol can exacerbate side effects.
162
How often should patients monitor their weight while on Methylphenidate?
Twice a week
## Footnote
Patients should report any significant weight loss.
163
What should parents ensure for children taking Methylphenidate?
Provide a nutritious breakfast
## Footnote
This helps mitigate the anorexic effects of the drug.
164
What is the primary use of anorexiants?
Short term treatment of obesity in conjunction with dietary restriction and exercise
## Footnote
Anorexiants are intended for short-term use to aid in weight loss efforts.
165
How do anorexiants work in the body?
They cause a stimulant effect on the hypothalamic and limbic regions of the brain to suppress appetite.
## Footnote
This mechanism helps reduce hunger and promote weight loss.
166
What age group should avoid anorexiants?
Children younger than 12 years
## Footnote
Anorexiants are not recommended for young children due to safety concerns.
167
What should be discouraged regarding anorexiants?
Self-medication with anorexiants
## Footnote
It is important to seek medical advice before using these medications.
168
What is a significant risk of long-term use of anorexiants?
Severe side effects
## Footnote
Anorexiants are recommended for short-term use only due to potential complications.
169
List some side effects associated with anorexiants.
* Euphoria
* Restlessness
* Insomnia
* Palpitations
* Tachycardia
* Hypertension
* Erectile dysfunction
## Footnote
These side effects can impact the quality of life for users.
170
True or False: Most anorexiants have serious side effects similar to amphetamines.
False
## Footnote
Most anorexiants do not have the serious side effects associated with amphetamines.
171
What type of medication is Zolpidem?
Non-benzodiazepine sedative hypnotic
172
What is the primary use of Zolpidem?
Short term treatment for insomnia (< 10 days)
173
How is Zolpidem administered?
Orally, Sublingual
174
What is the mechanism of action (MOA) of Zolpidem?
CNS depression, neurotransmitter inhibition. Enhances the inhibitory effects of GABA.
175
What effects does Zolpidem produce?
Sedative, anxiolytic, and muscle-relaxant effects
176
What precaution should be taken for older adults or first-time users of non-benzodiazepines?
Use a bed alarm
177
What side effects should be observed in patients taking non-benzodiazepines?
Hangover, lightheadedness, dizziness, confusion
178
What should be obtained prior to administering non-benzodiazepines?
A drug history
179
What vital signs should be monitored when a patient is on non-benzodiazepines?
Signs of respiratory depression
180
List some side/adverse effects of Zolpidem.
* Dizziness
* Ataxia
* Visual impairment
* Amnesia
* Memory impairment
181
What are the life-threatening conditions associated with Zolpidem?
* Pulmonary edema
* Renal failure
182
What should patients notify their provider about regarding Zolpidem?
If pregnancy is planned or suspected or if breastfeeding
183
What substances should patients avoid while taking non-benzodiazepines?
* Alcohol
* Antidepressants
* Antipsychotics
* Narcotic drugs
184
What suggestion is made to prevent sleep disruption when taking non-benzodiazepines?
Urinate before taking the medication
185
When should Zolpidem be taken in relation to meals?
Not with dinner, take at bedtime
186
True or False: Patients should be warned about drowsiness when taking non-benzodiazepines.
True
187
What is Alprazolam classified as?
Benzodiazepine sedative hypnotic
188
What are the primary uses of Alprazolam?
Anxiety and insomnia
189
How is Alprazolam administered?
PO (by mouth)
190
What is the mechanism of action (MOA) of Alprazolam?
Increase the action of the inhibitory neurotransmitter, GABA to the GABA receptors
191
What should be assessed before administering Alprazolam?
Renal function
192
What urine output is considered normal when assessing renal function for Alprazolam?
1500 mL/day
193
What precautions should be taken for older adults receiving Alprazolam?
Use a bed alarm due to potential confusion and injury
194
When should Alprazolam be taken for optimal effect?
15 to 30 minutes before bedtime
195
What are common side effects of Alprazolam?
Lethargy, drowsiness, dizziness, headache, constipation, rash
196
What are some adverse reactions associated with Alprazolam?
Depression, tolerance, dependence, withdrawal, hypotension, tachycardia, seizures
197
What should patients avoid drinking during Alprazolam therapy?
Grapefruit juice
198
What substances should patients avoid while taking Alprazolam?
Alcohol, antidepressants, antipsychotics, and opioids
199
What risk may occur when combining Alprazolam with certain substances?
Respiratory depression
200
What should patients be advised against doing while using Alprazolam?
Driving a motor vehicle or operating machinery
201
What should patients do regarding over-the-counter (OTC) sleeping aids while on Alprazolam?
Check with a health care provider
202
What is the recommended approach for discontinuing Alprazolam after long-term use?
Gradually taper the dose
203
What symptoms may occur with abrupt cessation of Alprazolam?
Tremors and muscle twitching
204
What is Phenytoin used for?
To treat seizure
## Footnote
Treatment of tonic-clonic and partial seizures and status epilepticus
205
What is a tonic-clonic seizure?
Also called grand mal seizure; characterized by tonic phase (muscle contraction for 3–5 seconds) and clonic phase (dysrhythmic contraction lasts 2–4 minutes)
## Footnote
Most common form of seizure
206
What defines a partial seizure?
Involves one hemisphere of the brain; can be simple (no loss of consciousness) or complex (loss of consciousness)
## Footnote
Simple partial seizures do not cause loss of consciousness, but complex partial seizures do
207
What is status epilepticus?
A medical emergency with prolonged seizures or series of seizures without regaining consciousness
## Footnote
Can be life-threatening and lead to brain damage if untreated
208
What is the mechanism of action (MOA) of Phenytoin?
Reduces motor cortex activity and alters ion transport by acting on sodium channels on neuronal cell membranes
209
How is Phenytoin administered?
Orally or IV
210
What should be determined before administering Phenytoin?
Whether the patient is receiving adequate nutrients
## Footnote
Phenytoin may cause anorexia, nausea, and vomiting
211
What are common side effects of Phenytoin?
Dizziness, gingival hyperplasia, nausea, vomiting
212
What should patients be advised regarding driving while taking Phenytoin?
Not to drive or perform hazardous activities due to potential drowsiness
213
What should female patients contemplating pregnancy do before taking Phenytoin?
Consult with a health care provider due to potential teratogenic effects
214
What should patients avoid while taking Phenytoin?
Alcohol and other CNS depressants
## Footnote
They can cause an added depressive effect
215
What should patients not do abruptly when on Phenytoin therapy?
Stop drug therapy to prevent seizure rebound and status epilepticus
216
What happens if the Phenytoin drug level is below the desired range?
The patient may experience a recurrence of seizures
217
What should patients with diabetes do while taking Phenytoin?
Monitor serum glucose levels more closely
## Footnote
Phenytoin may inhibit insulin release, increasing glucose levels
218
How should antiseizure drugs be taken?
At the same time every day with food or milk
219
What color may the urine turn while taking Phenytoin?
Harmless pinkish-red or reddish-brown
220
What oral hygiene advice should be given to patients on Phenytoin?
Maintain good oral hygiene and use a soft toothbrush to prevent gum irritation and bleeding
221
What should patients inform health care providers about while on Phenytoin?
Adverse reactions such as gingivitis, nystagmus, rash, and dizziness
222
True or False: Stevens-Johnson syndrome begins with a rash.
True
223
What is the primary use of Carbidopa-Levodopa?
Parkinsonism – adds more dopamine to brain
## Footnote
Carbidopa-Levodopa is primarily used to manage symptoms of Parkinson's disease.
224
What is the mechanism of action (MOA) of Carbidopa?
Prevents levodopa from breaking in blood by inhibiting dopa decarboxylase in the peripheral nervous system
## Footnote
This action allows more levodopa to reach the brain.
225
How is Carbidopa-Levodopa administered?
Orally
## Footnote
It is important to monitor vitals and EKG during administration.
226
What should be monitored when administering Carbidopa-Levodopa?
Vitals, EKG
## Footnote
Additionally, observe for weakness, dizziness, or syncope.
227
Why should Carbidopa-Levodopa be administered with low protein foods?
High protein diets interfere with drug transport to the CNS
## Footnote
This ensures better absorption and effectiveness of the medication.
228
What are some common side effects of Carbidopa-Levodopa?
* Excess dark sweating
* Urine discoloration (red, brown, or black)
* Dyskinesias
* Orthostatic Hypotension
* Constipation
* Dry mouth
* N/V
* Insomnia
## Footnote
Dyskinesias are abnormal involuntary movements that may occur with long-term use.
229
What should patients be informed about urine discoloration when taking Carbidopa-Levodopa?
Urine may be discolored and will darken, black or red with exposure to air
## Footnote
This discoloration is harmless but may stain clothes.
230
True or False: It is safe to abruptly discontinue Carbidopa-Levodopa.
False
## Footnote
Abrupt discontinuation can lead to rebound Parkinson's disease symptoms.
231
What are the 'Wearing-off' and 'On-off' phenomena associated with Carbidopa-Levodopa?
Fluctuations in the effectiveness of carbidopa-levodopa over time
## Footnote
Some individuals may experience varying levels of symptom control.
232
What is the primary use of Benztropine?
To decrease involuntary symptoms of Parkinson disease, tremor, and drug-induced parkinsonism
## Footnote
Benztropine is an anticholinergic medication that helps manage symptoms related to Parkinson's disease.
233
What is the mechanism of action (MOA) of Benztropine?
By blocking Ach (excitatory) and blocking cholinergic activity in the CNS
## Footnote
Ach refers to acetylcholine, which is a neurotransmitter involved in muscle control and other functions.
234
How is Benztropine administered?
Orally, IM, IV
## Footnote
IM stands for intramuscular, and IV stands for intravenous.
235
What are common side effects of Benztropine?
* Dizziness
* Tachycardia
* Dry mouth
* Photophobia
* Urinary retention
* Blurred vision
* Constipation
## Footnote
These effects are primarily due to its anticholinergic properties.
236
What should be monitored when a patient is on Benztropine?
* Dry mouth
* Constipation
* Blurred vision
* Urinary retention
* Confusion
* Increased heart rate
## Footnote
Monitoring helps to manage potential side effects effectively.
237
Is Benztropine safe for patients with glaucoma?
No, it is not for glaucoma
## Footnote
Benztropine can increase intraocular pressure, which is harmful for glaucoma patients.
238
What can be recommended to alleviate dry mouth caused by Benztropine?
* Ice chips
* Sugarless candy
* Good oral hygiene
## Footnote
These measures can help improve comfort and oral health.
239
What should patients do to minimize orthostatic hypotension while taking Benztropine?
Position slowly
## Footnote
Orthostatic hypotension can cause dizziness and falls when standing up quickly.
240
What preventive measure should be taken to avoid constipation while on Benztropine?
High fiber diet
## Footnote
A high fiber intake can help maintain regular bowel movements.
241
When should patients void before taking Benztropine?
To minimize urinary retention
## Footnote
This recommendation helps reduce the risk of discomfort and complications.
242
What is one important annual health check for patients taking Benztropine?
Annual eye exams
## Footnote
Regular eye exams are crucial for monitoring any potential changes in vision or eye health.
243
What type of inhibitor is Rivastigmine?
Acetylcholinesterase inhibitor
244
What is the mechanism of action (MOA) of Rivastigmine?
Elevates acetylcholine concentrations
245
How is Rivastigmine administered?
PO, Transdermal
246
What is the primary use of Rivastigmine?
Improve cognitive function for patients with mild to moderate Alzheimer's
247
What is the onset time for Rivastigmine to show effects?
Within 2 weeks
248
How often should Rivastigmine be administered?
Twice daily (morning and evening)
249
What are common side effects of Rivastigmine?
* GI distress
* Nausea/Vomiting
* Dizziness
* Headache
* Fatigue
* Peripheral edema
* Nystagmus
* Photophobia
250
What are serious adverse effects of Rivastigmine?
* Bradycardia
* Orthostatic hypotension
* Hepatotoxicity
251
Should Rivastigmine be taken with or without food?
With or without food; food delays absorption
252
What should be avoided when taking Rivastigmine due to potential interaction?
NSAIDs
253
What risks are associated with the interaction of Rivastigmine and NSAIDs?
* Increased GI issues
* Renal function problems
* Bleeding risk
254
Fill in the blank: Rivastigmine is used to improve cognitive function for patients with _______.
mild to moderate Alzheimer's
255
What type of drug is Pyridostigmine?
Acetylcholinesterase inhibitor
## Footnote
Intermediate-acting
256
What is the mechanism of action (MOA) of Pyridostigmine?
Promotes transmission of neuromuscular impulses across myoneural junction by preventing Acetylcholine destruction
257
What are the primary uses of Pyridostigmine?
* Increases muscle strength in patients with myasthenia gravis
* Neuromuscular blockade reversal
* Nerve gas (soman) exposure prophylaxis
258
How is Pyridostigmine administered?
* Orally
* IM
* IV
259
What are the contraindications for Pyridostigmine?
* GI obstructions
* GU obstructions
* Ileus
* Bladder obstruction
260
What cautions should be taken when prescribing Pyridostigmine?
* Asthma
* Bradycardia
* Seizure disorder
* Peptic ulcer
* Cardiac arrhythmias
* Renal impairment
* Hyperthyroidism
* Pregnancy
* Breastfeeding
261
What should be assessed in patients taking Pyridostigmine?
* Signs of overdosing/underdosing
* Muscle strength
* Depth and rate of respirations
262
What are common side effects of Pyridostigmine?
* Abdominal pain
* Confusion
* Depression
* Diarrhea
* Blurred vision
* Hyperesthesia
* Fecal incontinence
* Urinary incontinence
* Seizures
263
What adverse reactions may occur with Pyridostigmine?
* Bradycardia
* Cardiac dysrhythmias
* COPD
* Hypertension
* Seizures
264
When should patients take Pyridostigmine for best absorption?
Before meals
265
Fill in the blank: Pyridostigmine is used to increase muscle strength in patients with _______.
myasthenia gravis
266
True or False: Pyridostigmine can be taken with food if gastric irritation occurs.
True
267
What is the primary use of Interferon beta-1a?
Used for the treatment of RRMS to slow physical disability and decrease the frequency of clinical exacerbations
## Footnote
Also prevents or slows the development of CIS in patients with a first MS episode and MRI features consistent with MS.
268
What is the primary use of Interferon beta-1b?
Used for RRMS to decrease the frequency of clinical exacerbations and for SPMS to delay neurologic deterioration.
269
What are the administration routes for Beta Interferon?
IM, Subcut
270
What is the mechanism of action (MOA) of Beta Interferon?
Antiviral and immune-regulatory properties produced by interacting with specific receptor sites on cell surfaces.
271
How does Beta Interferon suppress the inflammatory response?
Controls the secretions of proinflammatory and anti-inflammatory cytokines and suppresses T-cell activation.
272
What should be monitored for injection site reactions with Beta Interferon?
Injection site abscesses, cellulitis, and injection site necrosis.
273
What should be done to minimize the risk of injection site reactions?
Rotate sites with each injection.
274
What symptoms should be monitored in patients receiving Beta Interferon?
Dyspnea or new/increased fatigue.
275
What condition should be assessed if dyspnea or increased fatigue develops?
Pulmonary arterial hypertension.
276
What mental health signs should be monitored during Beta Interferon therapy?
Signs of depression and suicidal tendencies.
277
What are common adverse reactions associated with Beta Interferon?
Thrombocytopenia, large bruises.
278
What flu-like symptoms may occur during Beta Interferon therapy?
Fever, chills, myalgia, sweating, malaise.
279
What can be used for relief of flu-like symptoms during Beta Interferon therapy?
Acetaminophen.
280
What should patients notify their provider about during therapy?
Shortness of breath, difficulty breathing, fatigue, injection site reaction, rash, necrosis, or liver problem symptoms.
281
Fill in the blank: Interferon beta-1a is used to _______ the development of CIS in certain patients.
prevent or slow
282
What is the primary use of Cyclobenzaprine?
For short-term treatment of muscle spasms
## Footnote
Cyclobenzaprine is a central muscle relaxant.
283
How is Cyclobenzaprine administered?
Orally
284
What is the mechanism of action (MOA) of Cyclobenzaprine?
Relieves muscle spasms through a central action, possibly at the brain stem level
285
List three contraindications for Cyclobenzaprine.
* AV block
* Acute myocardial infarction
* Hyperthyroidism
286
What caution should be taken when prescribing Cyclobenzaprine?
In patients with seizure disorder, alcohol use, prostatic hypertrophy, urinary retention, hepatic disease, and geriatric patients
287
Cyclobenzaprine is contraindicated in patients taking which type of medication?
Monoamine oxidase inhibitors (MAOIs)
288
What anticholinergic effects should be assessed in patients taking Cyclobenzaprine?
Increased intraocular pressure and pupil dilation (mydriasis)
289
What central nervous system side effects should be observed for in patients taking Cyclobenzaprine?
* Dizziness
* Fatigue
* Confusion
290
What should be evaluated to determine the effectiveness of Cyclobenzaprine?
Whether the patient’s muscular pain or spasms have decreased or disappeared
291
What is a potential serious adverse reaction of Cyclobenzaprine?
Angioedema
292
Name three common side effects of Cyclobenzaprine.
* Nausea
* Dizziness
* Confusion
293
What is a significant risk associated with the use of Cyclobenzaprine that can cause dizziness and fainting?
Orthostatic (postural) hypotension
294
What should patients be taught regarding the discontinuation of Cyclobenzaprine?
The drug should be tapered over 1 week to avoid rebound spasms
295
What advice should be given to patients regarding activities requiring alertness while taking Cyclobenzaprine?
Not to drive, operate dangerous machinery, or make important life-changing decisions
296
How long are centrally acting muscle relaxants like Cyclobenzaprine usually taken?
For no longer than 3 weeks
297
Patients should avoid which substances while taking Cyclobenzaprine?
Alcohol and CNS depressants
298
What is Fluphenazine used for?
Schizophrenia – Acute and chronic psychoses
299
How is Fluphenazine administered?
Orally (Onset 1 hour), IM
300
What is the mechanism of action (MOA) of Fluphenazine?
Blocking Dopamine Receptors in the CNS
301
What symptoms do typical antipsychotics like Fluphenazine primarily treat?
Positive symptoms
302
List the positive symptoms of psychosis.
* Delusions
* Hallucinations
* Disorganized speech and behavior
* Catatonic behavior
303
What vital sign should be monitored when administering Fluphenazine?
Vital signs; orthostatic hypotension is likely to occur
304
What should be done to ensure patients take their medication?
Remain with patients while medication is taken and swallowed
305
What are the symptoms of ExtraPyramidal Syndrome (EPS)?
* Acute Dystonia
* Akathisia
* Pseudo-parkinsonism
* Tardive Dyskinesia
306
Define Acute Dystonia.
Involuntary muscle contractions, repetitive or twisting movement leading to abnormal movements or postures
307
What is Akathisia characterized by?
Inner restlessness and a constant urge to move
308
What is a key sign of Tardive Dyskinesia?
Protrusion and rolling of the tongue
309
What should be assessed to monitor for Neuroleptic Malignant Syndrome (NMS)?
Increased fever, pulse, blood pressure; muscle rigidity; altered mental status
310
What metabolic side effects can Fluphenazine cause?
* Weight gain
* Dyslipidemia
* Glucose dysregulation
311
List some common side effects of Fluphenazine.
* Drowsiness
* Dizziness
* Headache
* Dry mouth
* Blurred vision
* Urinary retention
* Peripheral edema
312
What is a life-threatening adverse reaction to Fluphenazine?
Neuroleptic Malignant Syndrome (NMS)
313
Why is adherence to the drug regimen important?
To ensure effective management of symptoms
314
How long may it take for Fluphenazine to achieve full clinical effect?
6 weeks or longer
315
What should patients avoid while taking Fluphenazine?
Alcohol and other CNS depressants
316
What should patients be advised regarding discontinuation of Fluphenazine?
Not to abruptly discontinue the drug
317
Why is smoking cessation recommended for patients taking Fluphenazine?
Smoking increases the metabolism of some antipsychotics
318
What laboratory tests should patients obtain on schedule?
WBCs monitored for 3 months during the start of drug therapy
319
What symptoms indicate agranulocytosis that patients should be alert for?
Malaise, fever, and sore throat
320
What should patients be informed about urine discoloration while on Fluphenazine?
Urine might be pink or red-brown; this discoloration is harmless
321
What is Haloperidol?
A typical antipsychotic (non-phenothiazine) used for schizophrenia with positive symptoms such as delusions and hallucinations.
322
What is the mechanism of action (MOA) of Haloperidol?
Alters the effects of dopamine in the CNS, anticholinergic and alpha adrenergic blocking activity.
323
Name three contraindications for Haloperidol.
* Parkinsonism
* CNS depression
* Coma
324
How is Haloperidol administered?
Orally or IM.
325
What vital sign should be monitored due to the risk of orthostatic hypotension with Haloperidol?
Blood pressure.
326
What should be observed for in patients taking Haloperidol?
ExtraPyramidal Syndrome (EPS) symptoms.
327
List four symptoms of ExtraPyramidal Syndrome (EPS).
* Acute Dystonia
* Akathisia
* Pseudo-parkinsonism
* Tardive Dyskinesia
328
What are the symptoms of Tardive Dyskinesia?
Abnormal, involuntary movement, protrusion and rolling of the tongue.
329
What is Neuroleptic Malignant Syndrome (NMS)?
A serious condition with symptoms such as increased fever, pulse, blood pressure, muscle rigidity, and altered mental status.
330
What metabolic side effects can Haloperidol cause?
* Weight gain
* Dyslipidemia
* Glucose dysregulation
331
What are common side effects of Haloperidol?
* Anticholinergic effects
* Blurred vision
* Dry mouth
* Constipation
* Urinary retention
332
What are some life-threatening adverse reactions of Haloperidol?
* Laryngeal edema
* Bronchospasm
* Dysrhythmias
* Blood disorders
* NMS
333
Why is adherence to a drug regimen important for patients taking Haloperidol?
To ensure the effectiveness of treatment and reduce the risk of complications.
334
How long may it take for Haloperidol to achieve full clinical effect?
6 weeks or longer.
335
What should patients be cautioned against consuming while on Haloperidol?
Alcohol or other CNS depressants.
336
What should patients be advised regarding the discontinuation of Haloperidol?
Not to abruptly discontinue the drug.
337
What should patients be informed about regarding smoking and Haloperidol?
Smoking increases the metabolism of some antipsychotics.
338
How often should laboratory tests for WBCs be monitored during Haloperidol therapy?
Every 3 months, especially during the start of drug therapy.
339
What symptoms may indicate agranulocytosis in patients on Haloperidol?
Malaise, fever, and sore throat.
340
What should patients avoid until drug dosing of Haloperidol has been stabilized?
Potentially dangerous situations, such as driving.
341
What harmless discoloration might occur in urine due to Haloperidol?
Pink or red-brown urine.
342
What is the primary use of Aripiprazole?
Manage symptoms of Schizophrenia, Bipolar disorder, autism, depression, Tourette syndrome
## Footnote
Aripiprazole is an atypical antipsychotic medication.
343
What is the mechanism of action (MOA) of Aripiprazole?
Partially activates dopamine and serotonin receptors in the brain
## Footnote
This helps stabilize dopamine and serotonin levels.
344
How is Aripiprazole administered?
Orally, IM
## Footnote
IM stands for intramuscular.
345
What are the positive symptoms of schizophrenia treated by Aripiprazole?
* Delusions of Control
* Delusions of reference
* Hallucination
* Disorganized speech
* Disorganized behavior
* Catatonic behavior
## Footnote
Positive symptoms reflect an excess or distortion of normal functions.
346
What are the negative symptoms of schizophrenia treated by Aripiprazole?
* Decreased emotions
* Impaired social interaction
* Loss of interests
* Flat affect
* Alogia
* Avolition
## Footnote
Negative symptoms reflect a decrease or loss of normal functions.
347
What vital sign must be monitored when administering Aripiprazole?
Vital signs
## Footnote
Orthostatic hypotension is likely to occur.
348
What is ExtraPyramidal Syndrome (EPS)?
A set of symptoms including Acute Dystonia, Akathisia, Pseudo-parkinsonism, and Tardive Dyskinesia
## Footnote
EPS symptoms require prompt reporting to the healthcare provider.
349
What are the symptoms of Neuroleptic Malignant Syndrome (NMS)?
* Increased fever
* Muscle rigidity
* Altered mental status
* Acute renal failure
* Tachycardia
* Diaphoresis
## Footnote
NMS is a life-threatening reaction to antipsychotic medications.
350
What metabolic side effects are associated with Aripiprazole?
* Weight gain
* Dyslipidemia
* Glucose dysregulation
## Footnote
These effects can lead to diabetes or impaired glucose tolerance.
351
What are some common side effects of Aripiprazole?
* Blurred vision
* Dry mouth
* Constipation
* Urinary retention
## Footnote
Adverse reactions can also include diabetes and EPS.
352
What is a critical consideration regarding drug adherence with Aripiprazole?
Adherence to a drug regimen is extremely important
## Footnote
Patients should be informed of the medication's full effect time.
353
True or False: Patients should abruptly discontinue Aripiprazole.
False
## Footnote
Abrupt discontinuation can lead to withdrawal symptoms.
354
What should patients be advised regarding alcohol while taking Aripiprazole?
Avoid consuming alcohol or other CNS depressants
## Footnote
These substances can intensify the depressant effect.
355
What laboratory tests should patients on Aripiprazole obtain on schedule?
WBCs
## Footnote
Monitoring is crucial for detecting leukopenia.
356
What symptoms should patients report that may indicate agranulocytosis?
* Malaise
* Fever
* Sore throat
## Footnote
Agranulocytosis is a serious blood dyscrasia associated with some antipsychotics.
357
What can cause urine discoloration in patients taking Aripiprazole?
Urine might be pink or red-brown
## Footnote
This discoloration is harmless.
358
What is the primary use of Lorazepam?
*Anxiolytic
*Antiseizure
*Insomnia
*Sedation-Induction
*Status Epilepticus
## Footnote
Lorazepam is used for various conditions including anxiety and seizures.
359
What is the mechanism of action (MOA) of Lorazepam?
Enhances effect of Gamma-aminobutyric acid (GABA) in the CNS, producing a calming effect.
## Footnote
GABA is an inhibitory neurotransmitter that helps reduce neuronal excitability.
360
How is Lorazepam administered?
Orally, IV, IM
## Footnote
Different routes of administration may affect onset and duration of action.
361
What are the risks associated with short-term use of Lorazepam?
Risk of developing tolerance, dependence, and potential for abuse.
## Footnote
These risks necessitate careful monitoring and management.
362
What is the antidote for Lorazepam overdose?
Flumazenil (benzodiazepine antagonist, IV)
## Footnote
Flumazenil is used to reverse the effects of benzodiazepines.
363
What vital signs should be monitored while a patient is on Lorazepam?
Blood pressure and pulse
## Footnote
Monitoring is crucial due to the risk of orthostatic hypotension.
364
List some side effects of Lorazepam.
*Sedation
*Amnesia
*Blurred vision
*Constipation
## Footnote
Awareness of side effects is important for patient safety.
365
What life-threatening conditions can occur with Lorazepam use?
*NMS
*Respiratory depression
## Footnote
These conditions require immediate medical attention.
366
True or False: Patients can drive or operate dangerous equipment while taking anxiolytics.
False
## Footnote
Sedation is a common side effect that impairs motor skills.
367
Why should patients avoid alcohol while taking Lorazepam?
Alcohol and CNS depressants can enhance sedative effects.
## Footnote
This increases the risk of respiratory depression and other side effects.
368
Fill in the blank: An effective response to Lorazepam may take _______.
1 to 2 weeks
## Footnote
This is important for patient expectations regarding treatment.
369
What should patients do when discontinuing Lorazepam after prolonged use?
Taper the drug dose
## Footnote
Abrupt cessation can lead to withdrawal symptoms.
370
What should patients be advised to do to prevent dizziness from orthostatic hypotension?
Rise slowly from sitting to standing positions
## Footnote
This helps mitigate the risk of falls.
371
What is the primary use of Fluoxetine?
Major Depression Disorder, Obsessive Compulsive Disorder (OCD), Bulimia Nervosa, Panic Disorder, Bipolar, Premenstrual dysphoric disorder (PMDD), Diabetic Neuropathy, Fibromyalgia
## Footnote
Fluoxetine is an SSRI (Selective Serotonin Reuptake Inhibitor) used for various mental health conditions and physical disorders.
372
How is Fluoxetine administered?
Orally
## Footnote
The onset of action is typically between 1 to 4 weeks, with a duration of approximately 2 weeks.
373
What is the mechanism of action (MOA) of Fluoxetine?
Serotonin action is enhanced due to selective serotonin reuptake blockade at neuronal membranes.
374
What vital sign monitoring is recommended for patients on Fluoxetine?
Monitor vital signs for orthostatic hypotension and check for anticholinergic-like symptoms
## Footnote
Symptoms include dry mouth, increased heart rate, urinary retention, and constipation.
375
How often should weight be checked for patients on Fluoxetine?
Two to three times per week.
376
What should be monitored in patients for suicidal tendencies?
When marked depression is present.
377
What rare syndrome should be monitored for in patients taking SSRIs?
Neuroleptic Malignant Syndrome
## Footnote
Symptoms include fever and severe muscle stiffness, and it is more commonly linked to antipsychotic use.
378
What is Serotonin Syndrome?
A condition characterized by mental changes such as agitation, hallucination, and coma.
379
List some common side effects of Fluoxetine.
* Headache
* Nausea
* Nervousness
* Dry mouth
* Urinary retention
* Sexual dysfunction
380
What are some transient side effects of Fluoxetine?
Nausea, drowsiness, headaches, and nervousness.
381
What is a potential life-threatening reaction associated with Fluoxetine?
Serotonin syndrome.
382
When might the full effectiveness of Fluoxetine be evident?
1 to 2 weeks after the start of therapy.
383
What should patients be warned about regarding complementary and alternative therapy products?
Many interact with antidepressants, especially MAOIs and SSRIs.
384
What should patients be advised against doing abruptly?
Stopping the drug.
385
What should patients be informed about regarding the sedative effect of Fluoxetine?
Antidepressants may be taken at bedtime to decrease dangers from this effect.
386
True or False: Patients on Fluoxetine should drive until the drug dose is stabilized.
False.
387
What is the mechanism of action (MOA) of Venlafaxine?
Potent inhibitor of neuronal serotonin and norepinephrine uptake, weak inhibitor of dopamine
## Footnote
Venlafaxine is classified as a serotonin-norepinephrine reuptake inhibitor (SNRI).
388
List three uses of Venlafaxine.
* Prevention/treatment of major depression
* Depression at the end of life
* Long-term treatment of general anxiety disorder, panic disorder, social anxiety disorder (Effexor XR only)
## Footnote
Effexor XR is an extended-release formulation of Venlafaxine.
389
What are the contraindications for Venlafaxine?
* Hypersensitivity
* MAOIs
## Footnote
MAOIs refer to monoamine oxidase inhibitors, which can cause serious interactions with Venlafaxine.
390
What precautions should be taken when administering Venlafaxine?
* Pregnancy
* Breastfeeding
## Footnote
Use during pregnancy and breastfeeding should be considered only if the benefits outweigh the risks.
391
How is Venlafaxine administered?
Per oral
## Footnote
This means it is taken by mouth.
392
What are some common side effects of Venlafaxine?
* Headache
* Insomnia
* Nausea
* Dry mouth
* Increased blood pressure
## Footnote
These side effects may vary in intensity among different individuals.
393
What are the potential life-threatening effects of Venlafaxine?
* Suicidal ideation (in children/adolescents)
* Seizures
* Neuroleptic malignant syndrome (NMS)-like reaction
* Stevens-Johnson syndrome
* QTc prolongation
## Footnote
These effects require immediate medical attention.
394
What are the withdrawal symptoms associated with Venlafaxine?
* Flulike symptoms
* Headache
* Nervousness
* Agitation
* Nausea
* Vomiting
* Muscle pain
* Weakness
## Footnote
Withdrawal symptoms are not usual unless the medication is discontinued abruptly.
395
True or False: Venlafaxine can cause peripheral edema.
True
## Footnote
Peripheral edema is a potential side effect that should be monitored.
396
Fill in the blank: Venlafaxine should be taken as prescribed, and the contents of the capsule may be sprinkled on _______ if unable to swallow whole.
applesauce
## Footnote
This can help patients who have difficulty swallowing capsules.
397
What should patients be notified of regarding rash and allergic reactions while taking Venlafaxine?
To notify prescriber of rash, hives, allergic reactions, bleeding
## Footnote
Immediate reporting of these symptoms is crucial for patient safety.
398
What should be monitored during long-term therapy with Venlafaxine?
* CBC
* Differential
* Leukocytes
* Cardiac enzymes
* Hepatic studies (AST, ALT, bilirubin)
* Weight
* Blood pressure
## Footnote
Regular monitoring helps ensure the patient's safety and medication effectiveness.
399
What lifestyle advice should be given to patients taking Venlafaxine regarding alcohol?
To avoid alcohol ingestion
## Footnote
Alcohol can increase the risk of side effects and complications.
400
What is a key instruction regarding the discontinuation of Venlafaxine?
Not to discontinue medication abruptly after long-term use; may cause nausea, headache, malaise; taper over 14 days
## Footnote
Gradual tapering helps prevent withdrawal symptoms.
401
What symptoms indicate serotonin syndrome that patients should report immediately?
* Shivering
* Sweating
* Tremors
* Fever
* Dilated pupils
## Footnote
Serotonin syndrome is a serious condition that can occur with medications affecting serotonin levels.
402
What are the effects of St. John’s wort and tryptophan when taken with Venlafaxine?
Increase the risk of serotonin syndrome
## Footnote
These substances can potentiate the effects of Venlafaxine.
403
What should patients be cautious about when driving while on Venlafaxine?
Drowsiness, dizziness, blurred vision
## Footnote
These side effects can impair alertness and reaction times.
404
What is the primary use of Lithium?
Bipolar disorder
## Footnote
Lithium is a mood stabilizer primarily prescribed for managing bipolar disorder.
405
What is the mechanism of action (MOA) of Lithium?
Increased receptor sensitivity to serotonin
## Footnote
This mechanism helps stabilize mood in individuals with bipolar disorder.
406
What is the therapeutic drug range for Lithium?
0.8–1.2 mEq/L
## Footnote
Maintaining lithium within this range is crucial to avoid toxicity.
407
When should blood samples for lithium levels be drawn?
Immediately before the next dose (8 to 12 hours after the previous dose)
## Footnote
This timing helps prevent lithium toxicity.
408
List signs of lithium toxicity.
* Coarse hand tremors
* Confusion
* Hypotension
* Seizure
* Tinnitus
## Footnote
Recognizing these symptoms early is essential to manage lithium toxicity effectively.
409
What should be done if serum lithium levels exceed 1.5 mEq/L?
Hold the dose and report to a health care provider
## Footnote
High levels of lithium can lead to severe toxicity.
410
What are expected tremors when taking Lithium?
Fine and gross motor tremors
## Footnote
These tremors are commonly observed and are not necessarily a sign of adverse reaction.
411
What cardiovascular parameters should be monitored in patients taking Lithium?
* Cardiac monitor
* Blood pressure
* Heart rate
## Footnote
Monitoring these parameters is important due to potential electrolyte imbalances.
412
What is the relationship between sodium and lithium levels?
Inverse relationship
## Footnote
If sodium levels decrease, lithium levels may increase, leading to toxicity.
413
Name common side effects of Lithium.
* Dry mouth
* Fatigue
* Tremor
* Polyuria
* Weight gain/loss
## Footnote
These side effects can affect patient compliance with the medication.
414
List some adverse reactions associated with Lithium.
* Thyroid disease (hypothyroidism)
* Goiter
* Hyperglycemia
* Leukocytosis
* Nephrotoxicity
## Footnote
Nephrotoxicity is particularly concerning in patients with renal disease.
415
What medications are contraindicated for patients taking Lithium?
* Diuretics
* NSAIDs
## Footnote
These medications can increase the risk of lithium toxicity.
416
What should patients be advised to maintain while taking Lithium?
Adequate fluid intake
## Footnote
This helps prevent dehydration and maintains stable lithium levels.
417
How should Lithium be taken to minimize gastric irritation?
With meals
## Footnote
Taking lithium with food can reduce gastrointestinal side effects.
418
When might the effectiveness of Lithium become evident?
1 to 2 weeks after the start of therapy
## Footnote
Patients should be informed that it may take time to see therapeutic effects.
419
What are early symptoms of lithium toxicity?
* Diarrhea
* Drowsiness
* Loss of appetite
* Muscle weakness
* Nausea
* Vomiting
* Slurred speech
* Trembling
## Footnote
Recognizing early symptoms is crucial for timely intervention.
420
What are late symptoms of lithium toxicity?
* Blurred vision
* Confusion
* Increased urination
* Convulsions
* Severe trembling
* Unsteadiness
## Footnote
Late symptoms indicate severe toxicity and require immediate medical attention.
421
What type of drug is Selegiline hydrochloride?
Monoamine oxidase inhibitor (MAOI)
422
What is the primary use of Selegiline hydrochloride?
Depression
423
What is the mechanism of action (MOA) of Selegiline hydrochloride?
Inhibiting monoamine oxidase (MAOI) which increases levels of dopamine, epinephrine, norepinephrine, and serotonin
424
How is Selegiline hydrochloride administered?
PO (oral) or transdermal
425
What should be monitored when administering Selegiline hydrochloride?
Drug-drug and food-drug interactions
426
Which types of drugs should be avoided when taking Selegiline hydrochloride?
Sympathomimetic-like drugs (CNS stimulants or vasoconstrictors and cold medications containing phenylephrine and pseudoephedrine)
427
What dietary restrictions must be observed when taking MAOIs like Selegiline?
Strict dietary restrictions to avoid foods containing tyramine
428
What is a potential side effect of taking Selegiline hydrochloride?
Hypertensive crisis
429
Fill in the blank: Foods that should be avoided when taking MAOIs include aged cheese, smoked meat, __________, red wine, and chocolate.
avocado
430
True or False: Foods rich in tyramine can cause a hypertensive crisis when taking Selegiline hydrochloride.
True
431
What is the primary use of iron supplements?
Treatment and prevention of iron deficiency anemia
## Footnote
Iron supplements are essential for individuals with low iron levels, particularly during pregnancy.
432
What is the mechanism of action (MOA) of iron?
Essential component of hemoglobin
## Footnote
Hemoglobin is crucial for oxygen transport in the blood.
433
How is iron administered?
Oral, IM
## Footnote
IM refers to intramuscular administration.
434
What is the CDC's recommendation for iron supplementation during pregnancy?
Starting a low dose (30 mg per day) iron supplement with the first prenatal appointment
## Footnote
Increased iron is necessary to meet fetal and maternal requirements.
435
What method should be used for IM injection of iron dextran?
Z tract method
## Footnote
This method helps prevent leakage into subcutaneous tissue.
436
What are common side effects of iron supplements?
* Teeth staining (drink with straw)
* Harmless black tarry stools
* Discoloration of urine
## Footnote
Side effects can vary based on the form of iron taken.
437
What dietary sources are rich in iron?
* Red meat
* Nuts and seeds
* Wheat germ
* Spinach
* Broccoli
* Prunes
* Iron-fortified cereal
## Footnote
Including these foods can help increase dietary iron intake.
438
When is it suggested to take supplemental iron for increased absorption?
1 hour before meals (empty stomach)
## Footnote
Taking iron with orange juice enhances absorption due to high ascorbic acid content.
439
What should not be taken with iron supplements due to absorption interference?
Milk or antacids
## Footnote
These substances can decrease the effectiveness of iron absorption.
440
What lifestyle changes can help prevent constipation when taking iron supplements?
Increase fiber and fluid intake
## Footnote
Adequate hydration and fiber can mitigate gastrointestinal side effects.
441
Why should iron supplements be kept out of reach of children?
Due to risk of fatal toxicity
## Footnote
Iron overdose can be extremely dangerous for children.
442
How should liquid iron preparations be taken to prevent tooth discoloration?
Dilute and take through a plastic straw
## Footnote
This method helps protect tooth enamel from staining.
443
True or False: Calcium increases iron absorption.
False
## Footnote
Calcium actually decreases iron absorption.
444
What is Folic Acid?
Anti-anemic, water-soluble vitamin
## Footnote
Folic Acid is the synthetic form of folate.
445
What conditions is Folic Acid used to treat?
Megaloblastic and macrocytic anemia, Cyanocobalamin B12 deficiency
446
What is the recommended daily intake of Folic Acid according to the CDC?
400 mcg daily
447
How is Folic Acid administered?
PO, IM, Subcut, IV
448
What is the mechanism of action (MOA) of Folic Acid?
Stimulates production of RBCs, WBCs, and platelets
449
What should be ingested to meet the recommended amount of Folic Acid?
Folate-enriched foods and supplementation
450
Name some examples of folate-enriched foods.
* Bread
* Cornmeal
* Rice
* Pasta
* Cereal
451
What can higher doses of Folic Acid mask?
Vitamin B12 deficiency
452
What are potential side effects of Folic Acid?
* Flushing
* Malaise
* Erythema
* Pruritus
* Skin rash
* Allergic bronchospasm (rare)
453
True or False: Folic Acid is part of preconception planning.
True
454
What can result from inadequate Folic Acid intake during early pregnancy?
Spontaneous abortion or birth defects, especially neural tube defects
455
What is Terbutaline classified as?
Bronchodilator, beta-adrenergic agent, tocolytic
456
What is the primary use of Terbutaline?
Preterm Labor (tocolytic) and COPD, asthma
457
How is Terbutaline administered?
PO, Subq
458
What is the mechanism of action (MOA) of Terbutaline?
Relaxation of the uterus, bronchodilation
459
What initial assessments should be performed when a patient has preterm uterine contractions?
History, complete physical assessment, vital signs, fetal heart rate (FHR), urine specimen for screening
460
What should be monitored if Terbutaline is used for more than 48-72 hours?
Maternal and Fetal Distress
461
What is the gestational age limit for using Terbutaline?
Less than 37 weeks gestation
462
What is the recommended duration of Terbutaline use?
Short term use ONLY
463
In what position should the patient be maintained to facilitate uteroplacental perfusion?
Left lateral position
464
What daily monitoring is recommended for patients on Terbutaline?
Daily weight and strict intake and output (I&O) measurement
465
What should be reported regarding fetal heart rate (FHR) when using Terbutaline?
Baseline FHR over 180 beats/min or any significant increase in uterine contractions
466
What maternal conditions should be assessed for while administering Terbutaline?
Maternal hyperglycemia and hypokalemia
467
What are common side/adverse effects of Terbutaline?
Tachycardia, Angina, Hypokalemia, Dysrhythmias, Restlessness, Tremor
468
What should a patient experiencing preterm labor contractions do initially?
Void, recline on her left side, and drink extra fluids
469
What is Magnesium Sulfate used for?
Treatment for severe pre-eclampsia and eclampsia
## Footnote
Severe pre-eclampsia is characterized by high blood pressure and organ damage during pregnancy. Eclampsia involves seizures in pregnant women associated with high blood pressure.
470
What is the mechanism of action (MOA) of Magnesium Sulfate?
Decreases acetylcholine from motor nerves, blocking neuromuscular transmission and decreasing incidence of seizures
471
What is the antidote for Magnesium Sulfate?
Calcium Gluconate
472
What are the routes of administration for Magnesium Sulfate?
IV (most common route), IM
473
What condition is characterized by high blood pressure and organ damage during pregnancy?
Severe pre-eclampsia
474
List some symptoms of Severe pre-eclampsia.
* High blood pressure
* Edema
* Headache
* Vision changes
* Abdominal pain
475
What are the symptoms of Eclampsia?
Seizures in pregnant women associated with high blood pressure
476
What should be monitored continuously during Magnesium Sulfate administration?
Electronic fetal monitoring
477
What are signs of maternal toxicity from Magnesium Sulfate?
* Lethargy
* Weakness
478
What are the signs of Magnesium toxicity?
* Diaphoresis
* Flushing
* Feelings of warmth
* Nasal congestion
479
What vital signs should be monitored during Magnesium Sulfate treatment?
* Blood pressure
* Pulse
* Respiratory rate
480
What reflexes and outputs should be monitored every hour?
* Deep tendon reflexes (DTRs)
* Clonus
* Intake and output (I&O)
481
True or False: A systolic BP of 160 mm Hg or more is a reason to notify the healthcare provider.
True
482
What fetal heart rate (FHR) baseline should be maintained?
110 to 160 beats/min
483
What are some side/adverse effects of Magnesium Sulfate?
* Increased pulse rate
* Hypotension
* Decreased fetal heart rate (FHR) variability
484
What are potential side effects of Magnesium Sulfate on the neonate?
* Respiratory depression
* Slight hypotonia with diminished reflexes
* Lethargy for 24 to 48 hours
485
What is a secondary effect of Magnesium Sulfate?
Reduction in BP as magnesium sulfate relaxes smooth muscle
486
Fill in the blank: Magnesium Sulfate _______ deep tendon reflexes and respiration.
depresses
487
What is the primary use of Oxytocin?
Induction or enhancement of labor, postpartum hemorrhage
## Footnote
Oxytocin is an oxytocic agent used in obstetric care.
488
How is Oxytocin administered?
IV, IM
## Footnote
Intravenous and intramuscular routes are common for this medication.
489
What should be monitored continuously during an Oxytocin infusion?
Maternal pulse and BP, uterine activity, and Fetal Heart Rate
## Footnote
Continuous monitoring ensures safety during the infusion.
490
What position should the patient be maintained in during Oxytocin infusion?
Sitting or lateral recumbent position
## Footnote
This position promotes placental infusion.
491
What is the recommended method of Oxytocin administration?
Continuous infusion (IV pump)
## Footnote
This allows for better control of uterine activity.
492
Is walking allowed during an Oxytocin infusion for labor induction?
No
## Footnote
Walking is not allowed to monitor contractions and fetal heart rate closely.
493
What are signs of uterine rupture to monitor for during Oxytocin infusion?
Fetal Heart Rate decelerations, sudden increased pain, loss of uterine contractions, hemorrhage, hypovolemic shock
## Footnote
These signs indicate a potential emergency situation.
494
How does uterine inertia affect responsiveness to Oxytocin?
Patients with uterine inertia may be more responsive than those who have not begun labor
## Footnote
A lower starting dose is often needed for these patients.
495
What are common side effects of Oxytocin?
Hypertension, dysrhythmias, uterine hyperstimulation, tachysystole
## Footnote
These effects require careful monitoring during treatment.
496
What are potential adverse reactions to Oxytocin?
Seizures, fetal jaundice, hypoxia
## Footnote
These serious reactions necessitate immediate attention.
497
How is the Oxytocin dosage adjusted during infusion?
In response to the uterine contraction pattern
## Footnote
The dosage may be decreased as contractions become effective.
498
What should the contraction pattern be during Oxytocin administration?
60 – 90 seconds, every 2 – 3 minutes
## Footnote
This pattern indicates effective labor stimulation.
499
What vital signs should be closely monitored during Oxytocin administration?
Maternal and fetal vital signs
## Footnote
Monitoring is crucial for the safety of both mother and baby.
500
What is the primary use of Beractant?
Treatment and prophylaxis of respiratory distress syndrome in premature infants
## Footnote
Respiratory distress syndrome (RDS) is a common condition in premature infants due to immature lung development.
501
What is the mechanism of action (MOA) of Beractant?
Improve Oxygenation by decreasing the surface tension of the alveoli
## Footnote
This helps the lungs fill with air and prevents alveoli from deflating.
502
What is a key requirement for administering exogenous surfactants like Beractant?
A patent endotracheal (ET) tube
## Footnote
Proper administration involves specific positioning alterations to ensure even drug dispersion.
503
What must be done to ensure equal distribution of surfactant throughout the lungs?
Position and reposition the patient as needed
## Footnote
This is crucial for effective treatment.
504
What causes respiratory distress syndrome (RDS) in infants?
Immature lung development, decreased airway muscle tone, and low surfactant levels
## Footnote
These factors contribute to the difficulty in breathing.
505
What transient findings may occur after the administration of Beractant?
Crackles and moist breath sounds
## Footnote
These sounds are particularly noted after administering surfactants.
506
What are some side effects of Beractant administration?
Transient bradycardia and oxygen desaturation
## Footnote
These effects may occur as a result of the administration process.
507
What do combined hormonal contraceptives (CHC) contain?
Both estrogen and progestin hormones.
508
Name three examples of combined hormonal contraceptives.
* Combination birth control pills
* Contraceptive patches
* Vaginal rings
509
What is the primary use of combined hormonal contraceptives?
Preventing pregnancy.
510
What is the mechanism of action (MOA) of combined hormonal contraceptives?
* Suppress the release of eggs from the ovaries
* Thicken cervical mucus
* Change the uterine lining
511
What does the BRAIDED method stand for?
* Benefits
* Risks
* Alternatives
* Inquiries
* Decision
* Explanation
* Documentation
512
What does the ACHES acronym help patients report?
Dangerous cardiovascular side effects.
513
What does each letter in ACHES represent?
* A: Abdominal pain (severe)
* C: Chest pain or shortness of breath
* H: Headaches (severe), dizziness, weakness, numbness, or speech difficulties
* E: Eye disorders (blurring or loss of vision)
* S: Severe leg pain or swelling in the calf or thigh
514
When is it suggested for non-nursing mothers to begin CHCs postpartum?
4 to 6 weeks postpartum.
515
What is a common side effect of taking Combined Hormonal Contraceptives?
Breakthrough bleeding.
516
What are some rare but serious adverse effects of CHCs?
* Venous Thromboembolism (VTE)
* Myocardial Infarction (MI)
* Cerebral Vascular Accident (CVA)
* Retinal Vein Thrombosis
517
Should breakthrough bleeding be reported immediately to a healthcare provider?
No, it is a common occurrence.
518
What should patients be advised about menstrual changes when starting CHCs?
Changes can occur at the start of combined estrogen-progestin contraception use, when changing types of hormonal contraception products, and with progestin contraceptives.
519
What is the primary use of Clomiphene Citrate?
To stimulate ovarian follicle growth
## Footnote
Indicated for infertility treatment for polycystic ovarian syndrome
520
How is Clomiphene Citrate administered?
Oral
521
What is the mechanism of action (MOA) of Clomiphene Citrate?
Stimulates release of follicle-stimulating hormone (FSH) and luteinizing hormone (LH)
522
What should a patient report immediately when taking Clomiphene Citrate?
Adverse effects such as abdominal pain or visual disturbances
523
What should a patient do if they miss a dose of Clomiphene Citrate?
Call the infertility specialist
524
List some side effects of Clomiphene Citrate.
* Breast discomfort
* Fatigue
* Dizziness
* Depression
* Anxiety
* Nausea
* Vomiting
* Constipation
* Increased appetite
* Headache
* Flatulence
* Multiple gestation
* Hot flashes
* Fluid retention
525
What is a notable adverse reaction of Clomiphene Citrate?
Visual disturbances
526
What temperature change predicts ovulation?
A 0.5°F drop in basal body temperature, followed by a 1°F rise
527
When should a couple engage in coitus to increase chances of conception?
Frequently from 4 days before to 3 days after ovulation
528
What is the recommended time for the female partner to take Clomiphene Citrate?
At the same time each day
529
When is a pregnancy test typically conducted after ovulation?
Around two weeks after ovulation
530
Why should a pregnancy test be conducted two weeks after ovulation?
To allow adequate time for a potential embryo to implant and for hCG levels to rise
531
What is the primary use of Conjugated Estrogen?
For moderate to severe vasomotor symptoms of menopause and vaginal dryness/atrophy, urinary incontinence in women
## Footnote
Conjugated Estrogen is a form of hormone replacement therapy (HRT) used to alleviate menopausal symptoms.
532
What are the routes of administration for Conjugated Estrogen?
Oral, Vaginal, Transdermal patch, Topical
## Footnote
These methods allow for various options based on patient preference and clinical considerations.
533
What is the mechanism of action (MOA) of Conjugated Estrogen?
Binds to estrogen receptors to decrease hot flashes and vaginal dryness. Inhibits bone resorption.
## Footnote
This action helps to mitigate menopausal symptoms and protects bone density.
534
List the contraindications for Conjugated Estrogen.
* Smoking
* Hypertension
* High risk for embolic events
* Estrogen-dependent cancer
## Footnote
These factors can increase the risk of serious side effects associated with hormone therapy.
535
Do current guidelines support the use of hormone therapy (HT) for the prevention of cardiovascular disease?
No
## Footnote
Current guidelines do not support the use of HT for cardiovascular disease prevention, osteoporosis, or dementia.
536
What does the FDA boxed warning state regarding hormone therapy?
HT should be used only for the treatment of menopausal symptoms, at the lowest dose possible, for the shortest duration possible, usually less than 5 years.
## Footnote
This warning emphasizes the need for careful management of hormone therapy to minimize risks.
537
What are some common side effects of Conjugated Estrogen?
* Nausea
* Vomiting
* Fluid retention (edema)
* Breast tenderness
* Leg cramps
* Breakthrough bleeding
* Chloasma
* Weight gain
* Hypertension
## Footnote
These side effects can vary in intensity and may affect patient adherence to therapy.
538
What are some adverse effects associated with Conjugated Estrogen?
Thromboembolic disorders (e.g., DVT, PE, MI, Stroke)
## Footnote
These adverse effects can be serious and are a critical consideration in the risk-benefit analysis of hormone therapy.
539
True or False: After discontinuing hormone therapy, menopausal signs and symptoms may recur.
True
## Footnote
Patients should be advised about the possibility of recurrence of symptoms such as hot flashes after stopping HT.
540
What is the primary use of Androgen Therapy?
Androgen replacement therapy in treatment of delayed male puberty, male hypogonadism
## Footnote
Androgen therapy is specifically aimed at addressing hormonal deficiencies in males.
541
What is the mechanism of action (MOA) of Androgen Therapy?
Binds to androgen receptors, producing multiple anabolic and androgenic effects
## Footnote
This leads to the promotion of male sex organ development and maintenance of male secondary sex characteristics.
542
What must be monitored every 6 months when treating a prepubertal child with Androgen Therapy?
Skeletal maturation by x-ray of the hand and wrist
## Footnote
This is crucial to ensure that skeletal growth is appropriate during treatment.
543
Where should testosterone gel be applied?
To clean dry skin of shoulders or upper arms daily
## Footnote
It should not be applied to the genitals, and hands should be washed after application.
544
What parameters should be monitored during Androgen Therapy?
*Weight
*Blood pressure
*Liver function
*Thyroid function
## Footnote
Regular monitoring helps to manage potential side effects and complications.
545
True or False: Androgens decrease the effects of oral anticoagulants.
False
## Footnote
Androgens potentiate the effects of oral anticoagulants, requiring dosage adjustments.
546
How can androgens affect blood glucose levels in diabetic patients?
They can decrease blood glucose, necessitating a reduction in insulin or other antidiabetic agents
## Footnote
Monitoring blood glucose levels is essential for diabetic patients receiving androgen therapy.
547
What medications decrease the effects of androgens?
*Barbiturates
*Phenytoin
*Phenylbutazone (NSAIDs)
## Footnote
These drugs can interfere with the efficacy of androgen therapy.
548
List some common side effects of Androgen Therapy.
*Abdominal pain
*Nausea
*Diarrhea
*Constipation
*Urinary urgency
*Gynecomastia
## Footnote
Side effects may vary in severity among individuals.
549
What are some adverse effects of Androgen Therapy?
*Acne
*Edema
*Liver dysfunction
*Increased hematocrit and hemoglobin
*Premature epiphyseal closure
*Elevated cholesterol
## Footnote
These effects require monitoring and potential intervention.
550
What are life-threatening effects associated with Androgen Therapy?
*Priapism
*Jaundice
*Severe liver dysfunction
## Footnote
Immediate medical attention is necessary for these conditions.
551
What should men undergoing androgen therapy report promptly?
Priapism
## Footnote
Prompt reporting can help avoid subsequent erectile dysfunction (ED).
552
What should men report if they experience a decreased urinary stream?
They should report it promptly to evaluate for prostatic hypertrophy
## Footnote
This is important for managing potential complications related to urinary function.
553
What is the recommended fluid intake for patients with elevated serum calcium during Androgen Therapy?
2 L per day or more to prevent kidney stones
## Footnote
Adequate hydration is critical for preventing complications.
554
What is Finasteride classified as?
5-alpha-reductase inhibitor
555
What are the primary uses of Finasteride?
* Benign Prostatic Hypertrophy (BPH)
* Male pattern baldness (MPB)
556
What is the mechanism of action (MOA) of Finasteride?
Decreases the concentration of dihydrotestosterone (DHT) in plasma and in the prostate without elevated plasma concentrations of LH or testosterone
557
What condition is 5-alpha dihydrotestosterone (DHT) partially responsible for?
* Prostatic hyperplasia
* Hair loss
558
How is Finasteride administered?
Oral
559
What precautions should women of childbearing age take when handling Finasteride?
Must not handle crushed or broken tablets due to possible absorption and potential risk to male fetuses
560
What should be done if contact with crushed or broken Finasteride tablets occurs?
Immediately wash contact area with soap and water
561
What are some side effects of Finasteride?
* Decreased libido
* Orthostatic hypotension
* Gynecomastia
