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Pharmacology II > Exam 5 > Flashcards

Exam 5 Flashcards

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1
Q

Early sign of Vitamin A deficiency

The deficiency can progress to:

A

night blindness: aids in the formation of visual pigment needed for night vision

it can progress to dryness and ulceration of the cornea to blindness

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2
Q

Excessive Vitamin D can cause:

A

toxicity with s/s secondary to hypercalcemia

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3
Q

Newborns are low in what vitamin?

A

Newborns are low in vitamin K because the placenta does not supply enough and their intestines do not contain bacteria

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4
Q

Disruption in bacteria in the gut in infants can result in:

A

Disruption from antibiotic use or diarrhea in infants can result in vitamin K deficiency

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5
Q

Vitamin K reverses:

A

Vitamin K reverses the bleeding caused by excessive warfarin (Coumadin)

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6
Q

What vitamin is recommend for all infants immediately after delivery?

A

Vitamin K

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7
Q

What vitamin deficiency occurs frequently in alcoholics?

A 
Vitamin B (Thiamine)
Alcohol impairs the absorption of thiamine.
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8
Q

Thiamine deficiency manifests as:

A

Wernicke-Korsakoff syndrome

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9
Q

What vitamin deficiency causes pellagra which is characterized by scaling cracking skin in sun-exposed area?

A

Vitamin B2 (Niacin)

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10
Q

What is niacin used for?

A

Niacin is used to reduce cholesterol levels.

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11
Q

What are the most frequent adverse effects with high doses of vitamin B2 (niacin)?

A

Adverse effects: itching and intense flushing of the face, neck, and ears.

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12
Q

How can flushing caused by high doses of niacin be reduced?

A

By taking 325 mg of aspirin 30 minutes after each dose.

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13
Q

Vitamin B6 (Pyridoxine) deficiency results from:

A

Poor diet, use of isoniazid (a drug used in the treatment of TB), and inborn errors of metabolism

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14
Q

What are the symptoms of vitamin B6 (Pyridoxine) deficiency?

A

Peripheral neuropathy

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15
Q

What can deficiency of folic acid cause in early pregnancy?

A

It can cause neural tube defects in the fetus such as anencephaly (failure of the brain to develop) and spina bifida (defective closure of the bony structures of the spinal cord).

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16
Q

The parietal cells in the stomach secrete:

A

intrinsic factor which is necessary for Vitamin B12 absorption in the intestine, mainly in the ileum.

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17
Q

Vitamin B12 deficiency can be caused by:

A

gastrectomy and Crohn’s disease

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18
Q

What does Vitamin C in large doses cause:

A

Vitamin C can cause a decrease the effects of oral anticoagulants.

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19
Q

Megadoses of vitamin C taken with aspirin or sulfonamides (antibacterial agents) may cause:

A

crystallization in the urine

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20
Q

Iron absorption is increased when:

A

vitamin C is give concurrently

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21
Q

Liquid iron preparations can:

A

stain teeth
It can be prevented by mixing with water or juice, administering through a straw, and rinsing the mouth after administration.

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22
Q

Parental nutrition is given through:

A

large veins and consists of high-calorie nutrients

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23
Q

When should patients receive parenteral nutrition?

A

When patients are high risk of aspiration or have inadequate oral intake.

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24
Q

Enteral nutrition is preferred over parenteral nutrition if the GI tract is functioning because:

A

It promotes effective GI integrity, hepatic function, and body weight gain.

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25
Bolus enteral feeding method:
gives 250-400 ml of solution rapidly (in about 10 minutes) through a large syringe.
26
During bolus enteral feeding, the patient may experience:
n/v, abd cramping, and diarrhea due to rapid infusion
27
Intermittent infusions involve:
giving 300-400 ml every 3-6 hours over 30-60 minutes
28
How can you prevent aspiration during feeding?
Elevate the head of the bed at least 30 degrees during the tube feeding and 30 minutes after the tube feeding.
29
What should be done before the next feeding administration?
The tube should be aspirated to check for residual before administering the next feeding.
30
When should the tube feeding held and the health care provider should be notified?
If more than 50% of the amount of the last feeding is aspirated.
31
What is the usual residual for tube feeding?
0 to 100 ml
32
Drugs cannot be dissolved:
time-release forms, enteric-coated forms, sublingual forms, and bulk-forming laxatives.
33
How can tube clogging, abdominal cramping, vomiting, and diarrhea be prevented?
Diluted liquid medications followed by water.
34
What medication is effective for the treatment of peptic ulcers, but is not effective if the feeding is not held for 30 minutes after the medication is given?
Sucralfate (Carafate)
35
What are the complications of parenteral nutrition?
Air embolism, infection, hyperglycemia, hypoglycemia, and fluid overload.
36
What is black cohosh used for?
To relieve the symptoms of menopause.
37
What can decrease platelet aggregation and poses a risk for bleeding if taken with anti platelet medications (aspirin) or anticoagulants (warfarin, heparin)?
Feverfew
38
What lowers cholesterol and blood pressure?
garlic
39
What decreases morning sickness, motion sickness, and nausea after surgery?
Ginger root
40
What can decrease pain in patients with peripheral vascular disease of the legs?
Ginkgo biloba
41
What, in large doses and with chronic use, can cause liver damage including sever liver failure?
Kava
42
What is used to decrease symptoms of benign prostatic hyperplasia (BPH)?
Saw palmetto
43
What herbal supplement has a risk of physical dependence?
Valerian
44
What should you do immediately after eye medication instillation?
Apply gentle pressure to the nasolacrimal duct for 30-60 seconds to prevent or minimize absorption and possible systemic effects.
45
What medications are not nonselective beta adrenergic blocking agents?
betaxolol (Betopic) and levobetaxolol (Betaxon)
46
What can beta-1 blockade cause?
Bradycardia and AV heart block
47
What can beta-2 blockade cause?
bronchoconstriction
48
What medication can absorbed into soft contact lenses (so eye drops should be administered 15 minutes before contact lenses are placed in the eye)?
brimonidine (Alphagan)
49
What medication can cause a harmless increase in brown pigmentation of the iris in patients with brown eyes, which may be irreversible? Increase in pigmentation of the eyelid and increase growth and pigmentation of the eyelashes may also occur.
latanoprost (Xalatan)
50
What medication produces two effects that lower intraocular pressure: pupillary constriction (miosis) and contraction of the cilliary muscle?
Pilocarpine
51
What is the most concerning adverse effect with Echothiophate (Phospholine Iodide)?
Development of cataracts
52
What medication can cause pupillary dilation (mydriasis), so it can only be used in primary open-angle glaucoma (POAG) and not angle-closure glaucoma?
Dipivefrin (Propine)
53
What medication can dilate the pupil and aggravate angle-closure glaucoma by further preventing drainage of aqueous humor?
Dipivefrin (Propine)
54
Inhibition of carbonic anhydrase causes...
increased excretion of sodium, potassium, and bicarbonate. This can cause fluid loss and metabolic acidosis.
55
acetazolamide (Diamox)
acetazolamide (Diamox) is a carbonic anhydrase inhibitor and reduces intraocular pressure by decreasing the production of aqueous humor.
56
Mannitol
Mannitol is used for the treatment of primary open-angle glaucoma. It may be used to reduce intraocular pressure before eye surgery.
57
What aids in cataract removal during intraocular surgery?
mydriasis (excessive dilation of the pupil)
58
What medication is an anticholinergic agent used as eye drops?
Atropine (Isopto Atropine)
59
What ocular decongestant reduces redness and congestion by activating alpha-1 receptors in the eye causing vasoconstriction?
naphazoline (Clear Eyes)
60
Topical ear medications will have the word...
"otic" or "ear" on the label
61
How should the patient sit with ear medications?
Head tilted toward the unaffected side
62
Care with ear medication applicator...
avoid contamination from touching the outer ear
63
When should the auricle be pulled down and back?
Children 3 years and younger
64
How do you prevent otitis externa?
Foreign bodies (cotton swabs) should be kept out of the ear canal, cerumen should not be manually removed, the ear canal should be dried using a towel or tilting the head to promote drainage after swimming/bathing, and earplugs should be used when swimming.
65
Otitis media
inflammation of the middle ear and often associated with upper respiratory infections and allergies
66
What is the drug of choice unless the patient has a penicillin allergy?
Amoxicillin (Amoxil)
67
What cephalosporins can be used if the penicillin allergy is not severe?
cefdinir (Omnicef) or cefaclor (Ceclor)
68
What can be used if the penicillin allergy is severe?
azithromycin (Zithromax) or clarithromycin (Biaxin)
69
What nondrug measures can minimize lesions especially in mild acne?
Gentle cleansing 2-3 times per day can reduce oiliness of the skin and avoiding oil-based moisturizers, but dietary measures are not helpful.
70
What adverse effects can occur with tretinoin (Retin-A), a topical retinoid?
localized reactions since it is insufficient to cause systemic toxicity and increased susceptibility to sunburn so patients should use sunscreen with a SPF of 15 or greater
71
isotretinoin (Amnesteem)
used for severe nodulocystic acne vulgaris. It can cause hair loss and skin peeling from the palms and soles. Patients should be advised to wear sunscreen due to sensitivity to ultraviolet light. Adverse effects can be intensified with Vitamin A, so Vitamin A supplements should be discontinued prior to therapy. Pregnancy should be avoided, so two effective forms of birth control, even if one is tubal ligation or vasectomy of the male partner.
72
What adverse effects can occur with spironolactone (Aldactone)?
hyperkalemia from the blocking of aldosterone receptors
73
What is the most common side effect with calcipotriene (Dovonex)?
local irritation
74
tazarotene (Tazorac)
sensitizes the skin to sunlight, so sunscreen is advised
75
Anthralin (Psoriatec)
can stain clothing, skin, and hair
76
acitretin (Soriatane)
inhibits proliferation of epidermal cells and reduces inflammation in psoriasis. contraception should begin one month prior to treatment and continue for at least 3 years after treatment has stopped. It can reduce the efficacy of progestin-only contraceptives, so other forms of contraception should be used. Women of the reproductive age should be warned against drinking alcohol.
77
What should be done for first degree burns (moderately severe sunburn)?
cold wet compress applied to the burned area to constrict blood vessels, decrease swelling, and decrease the pain. A greasy ointment, butter, or greasy dressing should not be applied because they inhibit heat loss and cause more tissue damage.
78
bacitracin with polymyxin B (Polysporin)
antibiotics should not be used separately because they do not have a broad spectrum of antibacterial activity.
79
What should be done for second and third degree burns?
IV fluids are started immediately and pain medication is given as needed. Burned areas are cleansed with sterile saline and an antiseptic such as povidone-iodine (Betadine). Before using povidone-iodine, the nurse must ascertain if the patient is allergic to iodine or seafood.
80
mafenide acetate (Sulfamylon)
Causes inhabitation of carbonic anhydrase and causes increased excretion of sodium, potassium, and bicarbonate with possible fluid loss and metabolic acidosis
81
silver sulfadiazine (Silvadene)
contraindicated at or near term pregnancy due to the possibility of kernicterus in newborns.
82
silver nitrate
if used extensively, can cause hypokalemia

Pharmacology II (2 decks)

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