Exam 4 Drugs

Question 1

What drug class is alendronate?

Answer 1

Bisphosphonate

Question 2

What is the MOA of alendronate?

Answer 2

Binds permanently to surfaces of bones to inhibit osteoclast activity

Question 3

What are the common side effects of alendronate?

Answer 3

N/V/D, esophageal ulcerations

Question 4

What education should be given to a patient prescribed alendronate?

Answer 4

Take with small sip of water, do not lie down for 30 minutes after taking, do not take with other foods/drinks/calcium/vitamins

Question 5

What medication class is raloxifene?

Answer 5

Selective estrogen receptor modulator

Question 6

What is the MOA of raloxifene?

Answer 6

Mimics estrogen by increasing bone density and inhibits bone resorption

Question 7

What is the indication for raloxifene?

Answer 7

Prevention and treatment of postmenopausal osteoporosis

Question 8

What are the side effects of raloxifene?

Answer 8

Hot flashes, leg cramping

Question 9

What type of fractures does raloxifene reduce the risk for and by how much?

Answer 9

Spinal fractures only - 50 %

Question 10

What does a patient need to have enough of to have raloxifene work?

Answer 10

Calcium and vitamin D

Question 11

How long before a procedure should raloxifene be discontinued?

Answer 11

At least 72 hours

Question 12

Does raloxifene increase or decrease clotting risk?

Answer 12

Increase

Question 13

What is the MOA of calcitonin-salmon?

Answer 13

Inhibits bone removal by osteoclasts

Question 14

What is the indication of calcitonin-salmon?

Answer 14

Treatment of osteoporosis

Question 15

What is the side effect of calcitonin-salmon if given intranasally?

Answer 15

Nasal irritation

Question 16

What type of fracture does calcitonin-salmon reduce the risk for, by how much, and how long does it take to see this?

Answer 16

Spinal fractures, by 50%, have to take for at least 5 years to see

Question 17

What class is methotrexate?

Answer 17

DMARD

Question 18

What is the MOA of methotrexate?

Answer 18

Acts as an immunosppressive

Question 19

What are the side effects of methotrexate?

Answer 19

N/V, bone marrow suppression

Question 20

Methotrexate is a first line therapy - true or false?

Answer 20

True

Question 21

What supplement can you anticipate taking while on methotrexate?

Answer 21

Folate

Question 22

What labs should the nurse monitor for a patient on methtrexate?

Answer 22

Liver enzymes, WBC, RBC

Question 23

What are the major contraindications of methotrexate?

Answer 23

Kidney and liver disease
Pregnancy - this is extremely teratogenic

Question 24

What is the concern of taking NSAIDS with methotrexate?

Answer 24

Aplastic anemia

Question 25

What class is hydroxychloroquine?

Answer 25

Anti-rheumatic, antimalarial

Question 26

What is the MOA of hydroxychloroquine?

Answer 26

Unknown but does have anti-inflammatory processes like decreased macrophage, T-helped cells, and inflammatory cytokine activity

Question 27

What are the side effects of hydroxychloroquine?

Answer 27

Rare - retinopathy (encourage reporting vision changes)

Question 28

What medication is commonly used with hydroxychloroquine?

Answer 28

Methotrexate for early or mid level RA

Question 29

What class is allopurinol?

Answer 29

Xanthine oxidase inhibitor

Question 30

What is the MOA of allopurinol?

Answer 30

Inhibits the xanthine enzyme which prevents uric acid production

Question 31

What are the indications of allopurinol?

Answer 31

Prophylactic for patients whose gout is related to hyperuricemia

Question 32

What are the side effects of allopurinol?

Answer 32

Agranulocytosis = worried about infection aplastic anemia can cause steven johnson syndrome

Question 33

How can allopurinol affect glucose?

Answer 33

Can make the patient hypoglycemia

Question 34

How does allopurinol affect INR?

Answer 34

Can increase INR with warfarin

Question 35

What labs are important to monitor while taking allopurinol?

Answer 35

WBC, CBC

Question 36

What is the MOA of colchicine?

Answer 36

Reduces inflammatory response to the deposits of urate crystals in the joints

Question 37

What are the indications for colchicine?

Answer 37

Gout flares and prophylaxis

Question 38

What are the side effects of colchicine?

Answer 38

GI bleeding and urinary bleeding

Question 39

Colchicine is a first line therapy - true or false?

Answer 39

False, it is a second line therapy

Question 40

How can colchicine affect the bone marrow?

Answer 40

Can suppress it and cause short term leukopenia

Question 41

What are the contraindications for colchicine?

Answer 41

Anybody with severe renal, GI, hepatic, or cardiac / bleeding disorders

Question 42

What class is probenecid?

Answer 42

Uricosuric agent

Question 43

What is the MOA of probenecid?

Answer 43

Inhibits resorption of uric acid in the kidney and promotes the excretion of it

Question 44

What is the indication of probenecid?

Answer 44

Treats hyperuricemia with gout

Question 45

What are the side effects of probenecid?

Answer 45

GI upset, dizziness, headache, liver impairment, many drug drug interations

Question 46

What is probenecid usually used in combination with?

Answer 46

Allopurinol

Question 47

What is the MOA of cytotoxic agents?

Answer 47

Disrupts DNA synthesis and mitosis

Question 48

What type of growth fraction does cytotoxic agents work the best against?

Answer 48

High cell growth fraction

Question 49

How are cytotoxic agents usually given?

Answer 49

Through a CVC

Question 50

What class is cylcophosphamide?

Answer 50

Alkylating agent

Question 51

What is the MOA of cyclophosphamide?

Answer 51

Disrupts DNA synthesis and mitosis

Question 52

What are the side effects of cyclophosphamide?

Answer 52

Normal chemo SE + vesicant, hemorrhagic cystitis, sterility, discoloration of skin and nails

Question 53

Is cyclophosphamide cell cycle specific or non-specific?

Answer 53

Non specific

Question 54

When methotrexate is used against leukemia and some lymphomas is it cell cycle specific or non-specific?

Answer 54

Specific, usually S phase

Question 55

What class is methotrexate when being used for leukemia and some lymphomas?

Answer 55

Antimetabolite

Question 56

What class is doxorubicin?

Answer 56

Anti tumor antibiotic

Question 57

What is the MOA of doxorubicin?

Answer 57

Disrupts DNA synthesis and mitosis

Question 58

What are the side effects of doxorubicin?

Answer 58

Normal chemo SE + cardiotoxic Can have acute or delayed reactions Harmless red color to urine and sweat

Question 58

What are the side effects of vincristine?

Answer 58

No bone marrow suppression, peripheral neuropathy, vesicant

Question 58

What is the MOA of vincristine?

Answer 58

Disrupts cell DNA and mitosis

Question 58

Is doxorubicin cell cycle specific or non-specific?

Answer 58

Non specific

Question 58

What is the class of vincristine?

Answer 58

Mitotic inhibitors - vinca alkaloids

Question 59

Is viscristine cell cycle specific or non-specific?

Answer 59

Specific - usually M

Question 60

Which route is preferred with promethazine?

Answer 60

IVPB

Question 61

What is the MOA of biologics as chemo?

Answer 61

Uses the body's immune system to kill cancer cells

Question 62

What are the side effects of biologics?

Answer 62

Pain, swelling, soreness, flu-like symptoms, weight gain, diarrhea, increased risk for infection