Exam 3 Yellow Packet Flashcards
(154 cards)
1
Q
MAOIsWhat are the two main cerebral centers that cause vomiting?
A
Vomiting center in medulla
CTZ
2
Q
What are some nonpharmacological remedies to nausea and vomiting? (6)
A
Weak tea
Dry toast
Crackers
Gatorade
Pedialyte
IV fluids if severely dehydrated
3
Q
What are some OTC drugs prescribed for nausea/vomiting? (4)
A
Diphenhydramine
Dramamine (motion sickness)
Meclizine - antihistamine
Pepto-bismol
4
Q
What are some side effects that Antihistamines and Anticholinergics have in common?
A
Drowsiness
Dry mouth - can’t spit
Tachycardia
Blurred vision - can’t see
Constipation - can’t shit
5
Q
You should avoid taking antihistamines and anticholinergics if you have what medical diagnosis?
A
Glaucoma
6
Q
Very high doses of dopamine antagonists can treat what?
A
Psychiatric illness
Psychotic break
Schizophrenia
7
Q
Dow do dopamine antagonists work?
A
Block dopamine 2 receptors in the CTZ
Promethazine
Prochlorperazine
Thorazine
IV or IM
8
Q
What antiemetic is used for severe nausea from surgery, anesthesia, chemo, and radiation?
A
Phenothiazines
9
Q
What are some common side effects/adverse reactions of dopamine antagonists? (7)
A
Hypotension
Sedation
EPS
CNS effects
Dry mouth
Constipation
Urinary retention
10
Q
What is the most used Serotonin receptor antagonist used for nausea/vomiting?
A
Ondansetron (Zofran) - does not cause EPS
11
Q
Benzodiazepines are a sedative hypnotic, but can indirectly be used as a what?
A
Antiemetic - not first choice
Indirectly control N/V with chemo - lorazepam, diazepam
12
Q
What use do glucocorticoids and cannabinoids have in common?
A
N/V associated with cancer treatment
13
Q
What are some side effects of cannabinoids?
DO NOT GIVE WITH PSYCHIATRIC DISORDERS
A
Mood changes
Euphoria
Drowsiness
Headache
Dry mouth
Confusion
Nightmares
Orthostatic hypotension
14
Q
What is the antidote for acetaminophen overdose?
A
Mucomyst
15
Q
When should you not take antidiarrheals?
A
You’ve already taken them for two days.
Fever is present
16
Q
What do we use Somostatin Analog Sandostatin to treat?
A
Severe diarrhea r/t metastatic cancer
17
Q
What is the use of adsorbents?
A
To coat the wall of the GI tract.
Kaopectate, Pepto-Bismol, Questran
18
Q
What are some nonpharmaceutical solutions to constipation?
A
High fiber diet
Increased water intake
Exercise
19
Q
When should you NOT use laxatives/cathartics? (4)
A
Intestinal obstruction
Appendicitis
Ulcerative colitis
Diverticulitis
20
Q
What are the four types of laxatives?
A
Osmotics (saline) - Do not use if poor renal function or CHF
Stimulants (contact or irritant)
Bulk forming
Emollients (stool softeners)
21
Q
Where in the GI tract can you get peptic ulcers?
A
Esophagus
Stomach (gastric)
Duodenum
Upper GI
22
Q
What is the GMB?
A
Gastric Mucosal Barrier that helps to protect the lining against corrosive substances.
23
Q
What are some nonpharmacological treatments for peptic ulcers/GERD? (7)
A
No smoking
Avoid alcohol
Weight loss
Avoid hot, spicy, greasy foods
NSAIDs/Glucocorticoids should be taken with food or decrease the dose
Avoid eating before hs
Loose fitting clothes
24
Q
Name the seven antiulcer drugs.
A
Tranquilizers - decrease vagal activity
Anticholinergics - decrease acetylcholine
Antacids - neutralizes gastric acid
H2 Blockers - block h2 receptors
PPI’s - inhibits gastric acid secretion
Sucralfate - mucosal protectant
Prostaglandin E1 analogue misoprostol - inhibits gastric acid secretion and protects the mucosa
25
What are the pros and cons of antacids?
Pro: promote ulcer healing
Cons: decreases absorptions of all other medications/nutrients
Should take 1-3 hours after meals
26
What are you assessing with antacids? (3)
Calcium
Phosphate
Renal function
27
What ending to all protein pump inhibitors have?
~prazole
omeprazole
pantaprazole
28
What enzymes do you monitor for PPIs?
Liver
29
Which antiulcer drug decreases absorption of tetracyclines, dilantin, fat-soluble vitamins?
Sucralfate (Carafate) - Mucosal Protectant
30
Which antiulcer drug prevents NSAID induced gastric ulcers?
Prostaglandin Analogue (misoprostol)
31
Should oral hypoglycemic meds be taken by all diabetics?
No, they are for type 2 diabetics only
32
What are the two types of oral hypoglycemic medications?
Sulfonylureas
Nonsulfonylureas
33
What are common side effects of Glipizide (sulfonylurea)?
Insulin reaction (nervousness, tremors, confusion)
GI effects
34
What are common adverse effects of sulfonylureas (glipizide)?
Blood dyscrasias (anemia, leukopenia, thrombocytopenia)
35
What lab test will you order when taking oral hypoglycemic medication?
CBC - frequently
36
What type of medication is glucophage (metformin)?
Nonsulfonylurea
37
Which medication must be stopped prior to and two days after any radiological test using contrast?
Metformin (glucophage)
38
What is the criteria for use of oral hypoglycemic medication? (6)
Onset of diabetes mellites after adolescence
Diagnosed with diabetes for <5 years
Normal or overweight
Fasting glucose <=200mg/dl
<40 U insulin required per day
Normal renal and hepatic function
39
What are the four types of insulin?
Rapid (~log)
Short-Acting - Regular
Intermediate Acting - NPH or Lente
Long Acting - Glargine
40
When should rapid insulin be given?
Should be given within 5 minutes before eating, with the tray in front of them. Peak 30 minutes.
41
What is the only insulin given IV?
Regular/Short-Acting
42
What are the onset/peak times for short-acting insulin?
Onset - 30 minutes
Peak - 1-2 hours
43
What are the onset/peak times for intermediate acting insulin?
Onset - 2-4 hours
Peak - 4-6 hours
44
What are the onset/peak times for long acting insulin?
Onset - 4-6 hours
Peak - 6-8 hours
45
What are some common signs and symptoms of diabetes? (10)
Always tired
Always thirsty
Frequent urination
Always hungry
Unexplained weight loss
Blurred vision
Numbness/tingling
Wounds that won't heal
Infections
Sexual dysfunction
46
Polyuria, polydipsia (thirst), polyphagia (hunger) are signs of?
Hyperglycemia
47
Glucagon is an IM injection used to treat?
Hypoglycemia
48
What nursing interventions are there for diabetes mellitis?
Monitor A1C 3-4 times a year
Monitor blood glucose
Periodic lipid profiles
49
What are the three pituitary hormones?
ADH - Antidiuretic Hormone
ACTH - Corticotropin
GH - Growth Hormone
50
What is caused when there is an excess of ADH (antidiuretic hormone)?
Demeclocycline
SIADH
Hypervolemia (excess fluid)
51
What is caused when there is a deficient amount of ADH (antidiuretic hormone)?
Desmopressin
Hypovolemia - Blood pressure bottoms out (check peripheral pulses and cap refill)
Diabetes insipidus
52
ACTH - corticotropin mimics steroids, so what is important to know?
Taper dose
Monitor electrolytes
Assess for weight gain, edema, hair growth
53
When would you NOT give medication for GH - growth hormone (~tropin)?
Already overweight
Already diabetic/hyperglycemic
54
Why do patients with hypothyroidism go to see the doctor?
Lethargy
Tough, dry skin
Memory problems
Myxedema
Weight gain
55
What are Levothyroxine (Synthroid, levothyroid) used to treat?
Hypothyroidism
56
What is another name for Hyperthyroidism?
Grave's Disease
57
What are signs and symptoms of grave's disease (hyperthyroidism)? (6)
Weight loss
Bulging eyes
Rapid pulse
Irritable
Nervous
Heat intolerance
58
Which thyroid disease can be fatal?
Hyperthyroidism
59
What is the main purpose of the parathyroid?
Maintains calcium levels
60
Which parathyroid disease can cause renal failure?
Hyperparathyroid = hypercalcemia
~dronate, calcitonin, biphosphonates
61
Which parathyroid disease can cause lock jaw?
Hypoparathyroid = hypocalcemia
Calcium, Calcitrol, Vitamin D
62
Cushings is an adrenal disorder, what would you expect to see?
High cortisol, high Na, low K
Too much steroids
Moon face
Hair growth
Hump back
Excess fluid volume
Hyperglycemia
63
Addison's is an adrenal disorder, what would you expect to see?
Mineralcorticoids (florinef) maintain electrolytes
Hydrocortisone to restore
Low cortisol, low NA, high K
Decreased fluid volume
Hypoglycemia
Withdrawal of steroids
64
Herbal remedies can be marketed, but they cannot....?
Claim to cure.
65
What are some uses for aloe vera? (5)
Burns
Insect bites
Sunburn
Laxative - if ingested
Increased menstral flow - if ingested
66
What are two uses for Black Cohosh? (2)
Menopause symptoms (hot flashes, irritability)
Heart palpitations
67
What herbal remedy should you avoid if allergic to daisy and ragweed?
Chamomile - causes bronchoconstriction
68
What are two uses of chamomile?
GI relief (IBS and colic)
Sedative (sleepy time tea)
69
What are two uses of Dong quai?
Treatment of menstrual cramps
Regulates menstrual cycle
70
What are the two rare adverse reactions to dong quai?
Fever
Excessive menstrual bleeding
71
You should NOT use echinacea if you have these three diagnosed diseases?
HIV
AIDS
TB
72
What are the three uses for Echinacea?
Immune enhancer
Leaf - respiratory and UTI
Root - flu-like symptoms
73
What are the six uses of Evening Primrose?
Cirrhosis
Eczema
PMS
Hypertension
Hardening of the arteries - may lower cholesterol
Heart Disease
74
You should not use this herbal remedy if pregnant or lactating?
Also, use cautiously with anticonvulsants?
Evening Primrose
75
What are the two uses of feverfew?
Migraines - seratonin antagonist
N/V from headache/migraines
76
What are the five uses of the "herb of endurance" Garlic?
Lower cholesterol
Decrease BP
Antibiotic to treat wounds
Earache - warmed
Lower triglyceride levels
77
What two herbs act as an immune system booster?
Echinacea and Ginger
78
What are the five uses of Ginger?
Immune booster
GI disorders
Motion sickness
Nausea
Relief of pain from OA and RA
79
What are the four uses of gingko?
Dementia syndromes - improves cognition
Intermittent Claudication
Vertigo
Tinnitus
80
What are the three uses of ginseng?
Short term relief of stress
Energy boost
Digestive support
81
What are the two uses of Goldenseal?
Ward off infection/promote wound healing
Congestion
82
What herb can be used in combo with Goldenseal?
Echinacea
83
What are the two uses for Kava Kava?
Promotes sleep
Muscle relaxation
84
What are the four uses of Licorice?
Chronic fatigue syndrome
Ulcers
Heartburn
Indigestion
85
What is the main use of Milk Thistle?
Prevent damage of liver cells and regenerate liver cells
86
What are the uses of peppermint internally? (3)
Stimulates appetite
Aids in digestion
Treats bowel disorders
87
What are the uses of peppermint in tea? (4)
Stimulates circulation
Reduces fever
Clears congestion
Restores energy
88
What is the main use of peppermint oil?
Tension Headache
89
What are the three uses of the "herbal prozac" St. John's Wort?
Mild depression
Anxiety
Insomnia
90
Which herb has the potential side effect of seratonin syndrome (massive diarrhea)?
St. John's Wort
91
What are the 7 uses of the "plant catheter" Saw Palmetto?
BPH
Urinary conditions
Expectorant
Colds
Asthma
Bronchitis
Thyroid deficiency
92
What are the two uses of the "herbal valium" Valerian?
Mild sedative
Sleep inducing agent
93
The following herbs interfere with what medications?
Bilberry, cats claw, chamomile, dong quai, feverfew, garlic, ginseng, ginger, gingko, licorice
Anticoagulants
94
What does the label of herbal supplements require?
Scientific name
Manufacturer's name & address
Batch and lot number
Date of manufacture & expiration
95
Describe the adverse effect of antipsychotic meds called neuroleptic malignant syndrome?
Malignant hyperthermia - a fever that will not go away. Can be fatal.
Can also be caused by 'miracle cures'
Stop meds
96
What are the three types of antipsychotic agents?
Phenothiazines
Non-phenothiazines
Atypical (seratonin-dopamine antagonists)
97
What are signs of positive psychosis?
Lose contact with reality
Delusions
Hallucinations
Aggressive or violent behaviors
Schizophrenia
98
What are signs of negative psychosis?
Withdrawal
Depression
Catatonic
Poor self-care
99
What hormone do antipsychotics interfere with?
Dopamine
100
What is the maid side effect of antipsychotic drugs?
EPS - Extrapyramidal symptoms
"Parkinsonsism"
101
What is EPS (Extrapyramidal symptoms)
Parkinsonism
Shuffling gait
mask-like facial expression
Tremors
Rigidity in extremity movement
102
What is the adverse effect of antipsychotic drugs that include restless, pacing, rocking back and forth called?
Akasthisia
Treat with Beta Blockers or benzos
103
What is the adverse effect of antipsychotic drugs that include gum smacking, tongue rolling, chewing motion, involuntary movements called?
Tardive Dyskinesia
104
How long can it take for Tardive Dyskinesia to show up?
Up to a year or later after treatment initiation.
Will have to stop meds
105
What is the adverse effect of antipsychotic drugs that include facial grimacing, upward eye movement, muscle spasms of next, back, trunk, face and tongue?
Acute Dystonia
Treat with Cogentin (Antiparkinsons/anticholinergic)
106
What type of antipsychotic medication is Thorazine?
Phenothiazine
107
What type of antipsychotic medication is Haldol?
Non-phenothiazine
Very large dose needed.
108
What are the side effects of phenothiazines and nonphenothiazines?
Low blood pressure
EPS
Sedation
109
Which antipsychotic is less likely to cause EPS or Tardive Dyskinesia?
Atypical
Clozapine
Risperdone
110
What may someone taking antipsychotics use to help dry mouth?
Lozenges
111
What is the small therapeutic range of lithium, which is used for bipolar disorder?
0.5-1.5mEq/L
112
How much fluid should you be taking when on lithium?
1-2L daily
113
Are isolated seizures permanent?
Typically they are not. They are caused by an underlying issue like fever, hypoglycemia, electrolyte imbalance, acid-base imbalance, alcohol/drug withdrawal. Correct the problem and the seizures cease.
114
How long do patients need to take anticonvulsants?
Usually lifelong, may possibly stop after 3-5 years seizure free
115
What are the two phases of a Grand Mal seizure?
Tonic - back raised
Clonic - clenched
116
Suppressing sodium influx, suppressing calcium influx, and increasing action of GABA are the 3 ways to prevent what?
Seizures
117
What are the common anticonvulsant medications? (6)
Phenytoin
Barbituates
Benzodiazepines
Valproate
Gabapentin
Levetiracetam
118
Phenytoin is the most commonly used medication for seizures, why is that? (2)
Least addictive
Least toxic effects
119
What are some common side effects of phenytoin? (5)
Gingival hyperplasia
Neurologic/psychiatric effects
Leukopenia
Hyperglycemia
Teratogenic
120
Phenytoin is highly protein bound, so what other medications will it interact with? (6)
Anticoagulants
ASA
Sulfonamides
Tagamet
Antacids
Antineoplastics
121
What barbituate is also used for seizures?
Phenobarbital
Grand mal and acute episodes of status epilepticus, meningitis, toxic reactions, eclampsia
Gradual discontinuance
122
Diazepam (valium) is used to treat acute status epilepticus - IV
Clonazepam is used to treat absence (petit mal) seizures.
What drug category do these fall in?
Benzodiazepines
123
Valproate treats petit mal, grand mal, and mixed types of seizures. What is the one main adverse effect from it?
Hepatotoxicity
Monitor liver enzymes
DO NOT give to children
124
What is the narrow therapeutic range of phenytoin?
10-20ug/ml
125
What are some risks for pregnant women that have epilepsy? (7)
Seizures increase 25%
Hypoxia
Teratogenic properties of meds
Decreases folate
Inhibits vitamin K
Cardiac defects, cleft lip/palate - phenytoin/carbamazapine
Neural tube defects - valproic
126
What is status epilepticus?
Continuous seizure state
127
Diazepam (Valium) or lorazepam (Ativan) followed by Phenytoin should be given IV for status epilepticus. Over what time should you push the IV meds?
2 minutes to avoid respiratory depression
128
What are some symptoms of Parkinson's disease?
Involuntary tremors
Rigidity of muscles
Slow movement (bradykinesia)
129
What is happening pathologically for Parkinson's disease?
Increased Gaba
Decreased dopamine
130
What are the five agents for Parkinson's?
Anticholinergics
Dopaminergics
Dopamine agonists
MAO-B inhibitors (~gilline)
COMT inhibitors (~capone)
131
When it comes to seizures, when would you take anticholinergics?
Drug induced or pseudo-parkinsons
132
Why must you take Carbidopa and Levadopa together when taking dopaminergics
Carbidopa helps the medication get to the brain.
133
What is a common side effect of dopaminergics that you would want to educate your patient about so they do not worry?
It can discolor your urine
134
What foods would you administer dopaminergics with?
Low protein
135
The CNS Stimulant Methylphenidate has a black box warning, why?
Very high abuse potential!
These calm people with ADD/ADHD
136
What are some common side effects of methylphenidate (parkinsons agent)? (7)
Weight loss
Unsteadiness
High heart rate
High blood pressure
Decreased growth
Priapism - long erection
Psychiatric episodes
137
Which herbal remedies should you avoid if taking antidepressants?
St. John's Wort
Ginseng
Can lead to seratonin syndrome when taking SSRI's
138
What do all Tricyclic antidepressants have in their name?
~triptyline
139
Which two antidepressants can cause insomnia?
SSRI
MAOI
140
Most SSRIs end in ~xetine, what is one exception?
paroxetine paxil
fluoxetine - prozac
duloxetine - cymbalta
Sertraline (zoloft)
141
What antidepressant has major food interactions including caffeine, aged cured meats, aged cheese, wine, beer, bread with yeast?
MAOIs
142
Which antidepressants cause orthostatic hypotension?
Tricyclic
MAOIs
143
Which antidepressent can be used to help with hot flashes?
Atypical
144
Which antidepressent should you avoid grapefruit juice?
SSRIs
145
Buspirone, bupropion, and venlafaxine are all what type of medication?
Atypical antidepressant
146
Marplan, nardil, and parnate are all what type of medication?
MAOI Antidepressent
147
Which antidepressent has the most interactions? Including OTC cold medicines, cns stimulants, and vasoconstrictors?
MAOIs
148
Which antidepressants should NOT be taken at the same time as MAOIs?
Tricyclic
Atypical
149
What side effect do all antidepressants have?
Dry mouth
150
Which antidepressant is used for neuropathic pain?
Tricyclic
151
Which antidepressant is used for OCD and migraine headache prevention?
SSRIs
152
Which antidepressants are also used to treat anxiety?
SSRI
Atypical
153
Which antidepressant should you watch for an increase in suicidal thoughts?
SSRIs
154
What is the typical timeframe until antidepressants are therapeutic?
1-4 weeks
