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Final Flashcards

1
Q

What age do you start change how you pull the ear to an adult direction from child direction? What else do you do when administering ear drops?

A

around age 8

massage the tragus

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2
Q

Ear drops are best for what type of infection? example?

A

otitis externa

ciproflaxacin w/dexamethasone

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3
Q

Why do you occlude tear duct when adminstering eye drops?

A

reduce systemic reactions. For example a beta bocker can cause cholinergic effects so keeping them in the eye will help prevent the effects

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4
Q

What is the main indication for timolol? does it take a while to take effect? Side effects?

A

open-angle glaucoma

yes, it’s gradual

hypotension, bradycardia

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5
Q

What are physical symptoms of bone marrow suppression?

A

anemia
infection
bleeding

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6
Q

What are the 4 immunostimulant classes and drug examples for each?

A

interferons: interferon alpha 2b

interleukins: aldesleukin

conony-stimulating factors: filgrastim

vaccines: hep B vaccine

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7
Q

What are the 4 immunosuppressant classes and drug examples for each?

A

calcineurin inhibitors: cyclosporine

cytotoxic/antimetabolites: azathioprine

antibodies: basiliximab

corticosteroids: hydrocortisone

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8
Q

What is the drug class for aldesleukin? what does it treat and how? What are the AE? Nursing considerations?

A

interleukin

cancer, it increases T, B and WBC activity like they’re on caffeine

capillary leak (anemia, low BP), low platelets, flu-like

Watch CBS, diet, platelet count, elevate legs and ted hose for capillary leak, only given IV and IM

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9
Q

What is the main purpose of prescibing filgrastim? What is it’s worst AE?

A

stimulates neutrophil production to offset the effects of drugs that have suppressed the immune system

bone pain

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10
Q

What med is used for both cancer and the treatment of hepatitis C? Why is it not given PO? How is it going to make the client feel?

A

interferon alpha 2b

the proteins would be metabolized

Crappy–flu-like, hair loss, bone marrow suppression

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11
Q

What immunosuppressants are used as a prophylaxis for transplant rejection? What else are they indicated for? What are the AEs? Why is a difficulty for clients with this med?

A

cyclosporine/tacrolimus
azathioprine

IBD, Crohn’s

increased risk of cancer/lymphoma, bone marrow supression, resistant HTN

must be on it for life, compliance

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12
Q

What is a med in the monoclonal antibody class of immunosupressants? Is it a broad or targeted therapy? What is it indicated for?

A

basiliximab

targeted

prophylaxis of kidney transplant rejection

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13
Q

Which vaccines should be avoided in immunosuppressed clients?

A

attenuated live vaccines

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14
Q

How long does it take for immunoglobulins to take effect? Immunizations? How long do they last?

A

passive immunity that takes effect immediatley, only lasts a few months

active immunity that takes effect in a few weeks, can last years or a lifetime, may need a booster

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15
Q

What are the live vaccines (3)?

A

rotavirus
MMR
varicella

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16
Q

What are inactive vaccines (3)?

A

tatanus
hepatitis B
polio

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17
Q

what are the recombinant vaccines (4)?

A

meningococcal
pneumococcal
herpes zoster
HPV

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18
Q

What is the immunoglobulin vaccine highlighted this term? When is it used?

A

Rhogam

used in rH-negative pregnant women to prevent hemolytic anemia in subsequent pregnancies

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19
Q

What are the 5 highlighted antineoplastic drugs? CVTDM

A

cyclophosphamide
vincristine
tamoxifin
doxorubicin
methotrexate

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20
Q

What antineoplastic is used specifically for breast cancer? What AE must be monitored? Clients are at an increased risk for what? What should they report?

A

tamoxifen

DVT, menopausal symptoms

uterine cancer

unusual uterine bleeding

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21
Q

What is the MOA of methotrexate? what must be given to offset this? What are the 4 big AEs of methotrexate?

A

blocks folic acid conversion

leukovorin (folic acid)

hepatotoxicity, bone marrow suppression, GI bleeds, teratogenic

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22
Q

What antineoplastic med is known to cause neuropathies? What are 3 ways neuropathies can present?

A

vincristine

hypoesthesia (reduced sensation)
hyperesthesia (over sensation)
paraesthesia (pins and needles)

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23
Q

What is the antineoplastic known to cause congestive heart failure? As a result, what must be followed with this med? Along with typical AE, what would be good for the patient to know about one of the side effects?

A

doxorubicin

has a total lifetime amount a person can receive. Must be monitored for lifetime use

will turn the urine red/orange

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24
Q

What antineoplast med can cause hemmorraghic cystitis? What should the nurse watch for?

A

cyclophosphamide

cystitis, blood in urine

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25
What occurs in the body when the alpha 1 receptor is acted upon (agonist)?
vasoconstriction increased peripheral resistance (in terms of blood flow) increased blood pressure mydriasis (dilated pupil) bladder sphincters close
26
What occurs the the alpha 2 receptors are acted upon (agonist)?
inhibits norepinephrine release inhibits ACh release inhibits insulin release
27
What occurs when the beta 1 receptors are acted upon (agonist)? *Remember 1 heart
increased heart rate increased contractility increased renin increased lyposysis
28
What occurs when the beta 2 receptors are acted upon (agonist)? *Remember 2 lungs
vasodilation decreased peripheral resistance bronchodilation increased glycogenolysis and glucagon release relaxes uterine muscle
29
What are the functions of the neurotransmitter Ach? Epinephrine? Norepinephrine? Dopamine?
parasympathetic response memory skeletal muscle sympathetic response vasoconstriction increase BP treats heart failure increased inotropy increased chronotropy
30
What are alpha 1 agonist meds? Antagonist? What are the major tissues affected?
phenylephrine norepinephrine epinephrine prazosin smooth muscle sphincters
31
What are alpha 2 agonist meds? What is the main tissue they act upon?
epinephrine clonidine nerve endings
32
What is the beta 1 agonist med? Antagonist? What are the main tissues acted upon?
epinephrine propranolol cardiac muscle, kidney
33
What are beta 2 agonists? Antagonist? What are the mains tissues acted upon?
epinephrine terbutaline propranolol smooth muscle, bronchi, liver skeletal muscle
34
What are AEs for alpha 1 agonist phenylephrine? What should be instructed then? What is the drug class?
rebound nasal congestion, hypotension only use nasal spray 3-5 days to prevent rebound congestion vasoconstrictor
35
What is the 1-generation nonselective Beta antagonist (1 and 2)? What are the AEs of note? Who should not be using this type of med? Why?
propranolol bradycardia and fatgue asthmatics/COPD and DM it is nonselective and restricts bronchi masks hypoglycemia symptoms
36
What is the apha 1 antagonist? What is it used for? Why? AEs of note?
prazosin HTN, BPH, Raynaud's vasodilator, opens the vessels OH, 1st dose phenomenon, reflex tachycardia
37
What anticholinergiti is used for bladder control? What patient teaching would be helpful? Who would this med be contrainticated for? Why?
oxybutynin increase fiber and fluids because of anticholinergic effects such a constipation paralytic ileus, GI obstruction It slows down the body's response and can aggravate a symptom where motility is already affected
38
What helps relieve urinary retention? Why/how does it do that?
bethanechol it is a cholinergic agonist so it relaxes the bladder muscle
39
What is the anticholinergic med used as an antidote for nerve gas and insecticides? Who is it contraindicated in? Why?
atropine acute closed-angle glaucoma the relaxing of vessels can exasperate the problem
40
What is an Ach inhibitor used to treat myasthenia gravis?
pyridostigmine
41
What cholinergic drug blocks neuromuscular receptors? How is it used then? Does it have antichoinergic AEs? In addition to what?
succinylcholine as a surgical muscle relaxant in conjunction with an pain killer manage secretions in palliative patients yes malignant hypothermia
42
What is the chemical nature of ammonium chloride? What does that make it useful to treat? If too much is adminishter what is the risk?
it's an acid metabolic alkalosis to restore pH, acidifying urine acidosis
43
What is used to treat metabolic acidosis in the duodenum? What electrolyte imbalance can it help to correct as well?
sodium bircarbonate hyperkalemia
44
What is the high-pressure, osmotic diuretic mannitol good for? What are AE?
high-pressure issues such as intracranial pressure intraocular pressure hypovolemia, electrolyte imbalances, dizziness, shock, HF
45
What is the loop diuretic? does it cause hypo or hypervolemia (AE)? What is it indicated for? What is the significant AE to consider?
furosemide HYPOvolemia CHF, pulmonary edema, edema from cirrhosis, CKD tinnitis, hearing loss, ototoxicity
46
What is hydrochlorothiazide diuretic most commonly indicated for? What is a contraindication of note? Can this med cause hypo or hypervolemia and sunsequent effects such as OH, electrolyte imbalances, etc.?
HTN sulfa sensitivity, gout HYPOvolemia
47
What is the potassium sparing diuretic? What diuretic does it most commonly counteract? What is it's AE of note? What organ are we worried about when we're messing with potassium?
spironolactone furosimide hyperkalemia heart
48
What is the big thing to remember when administering potassium chloride?
DO NOT PUSH
49
What is given with low magnesium levels and preclampsia or preterm labor? AEs? Who is it contraindicated in?
magnesium sulfate DTR, diarrhea, hypotension cardiac and CKD
50
What are 4 meds for gestational HTN? MNHL
methyldopa nifedipine hydralazine labetalol
51
What is albuterol indicated for? What receptor does it affect? SE
asthma, COPD Beta 2 agonist like taking an energy drink--palpitations, tachycardia, increased BP, HA
52
What med can help with bronchodilation but acts a lot like caffeine? Why is it rarely used?
theophylline Has a narrow therapeutic window and can quickly cause N/V and tachycardia
53
What is an anticholinergic used for bronchospasms and emphysema? AEs?
ipratropium Dry mouth, constipation, blurry vision (dilation), urinary retention, tachycardia,
54
When cromolyn is added to athma treatment, what does it do in the body?
stabilizes mast cells and calms the bronchospasms
55
What is the reason for addind a steriod to asthma treatment? What are two med examples? Is this a daily treatment or PRN? What can is cause? How can you prevent it? What else can it cause?
antiinflammatory fluticasone, beclomethasone daily oral candidiasis wash the mouth out hoarse voice (dysphonia)
56
How is monteleukast used as a supplemental med for COPD and asthma? is it used acutly or daily? What is the concerning risk with this med?
it blocks the leukotriene receptors to block inflammation daily SI, psychiatric events
57
Why is fexfofenidine (allegra) a better choice than diphenhydramine for seasonal allergies?
does not have sedating effects because it is second generation and does not cross the blood-brain barrier
58
acetylcysteine is the antidote for acetminphen, but what else is it good for? What is gross about it?
breaking up thick viscous secretions with cystic fibrosis rotten egg odor
59
In terms of cholesterol, which needs to be lower? Higher (good)?
LDL HDL
60
What is the first-line med to lower LDL? What is the biggest risk? Which organ are we especially concerned about monitoring? What food must you avoid?
atorvastatin muscle breakdown leading to rhabsomyolysis liver, LFTs grapefruit juice
61
What vitamin/med is good to add to lower triglycerides? What is added 30 minutes before to prevent GI side effects?
Vit B3: nicotinic acid or niacin aspirin 30 minutes before
62
What meds affect gout?
hydrochlorithiazide niacin (B3)
63
How does cholestyramine help lower the amount of cholesterol? What else is affected? What other drug works similarly?
blocks it from being absorbed by increasing bile production and removing it through feces fat soluble vitamins ezetimibe
64
What is ACE inhibotr the acronym for? What does it block? What does that do?
angiotensin converting inhibitor it block angiotensin from converting to angiotensin II opens up the vessels
65
What are HTN ACE inhibitor durgs? What is the notable AE? What happens if this AE gets worse? Who is it contraindicated in? What electrolyte imbalance does it cause?
captopril, "pril"s cough from increased bradykinin angioedema (similar to anaphylaxis) hyperkalemia pregnancy
66
Which HTN meds block the angiotensin receptor rather than inhibit the angiotensin itself (like the "pril"s do)? What AE does this prevent? Are the other AEs similar to the "pril"s? What are they?
losartan (the ARBs, "sartan"s) the cough from "prils"s yes hyperkalemia, angioedema, contraindicated in pregancy, fatigue, dizziness, HA
67
What are 3 Beta 1 blockers? What organ do the affect? MAE
metoprolol atenolol esmolol heart (remember: 1 heart, beta 1)
68
What are 2 nonselective beta blockers (beta 1 and 2)?
propranolol nadolol
69
What are 2 alpha and beta blockers?
carvedilol labetalol
70
What is the primary ability of metroprolol? If you have reduced the hear rate what AEs would you then expect?
reduce HR in HTN a fib, angina, reflex tachycardia fatigue, dizziness, bradycardia, reduced contractility
71
What is the calcium channel blocker that aids in a fib, angina and HTN control? why?
verapamil it affects both the blood vessels and the heart because it is a nondihydropyradine
72
Clonidine is similar to what 2 other meds? What receptor does it affect? How? What else would happen if you took away norepinephrine?
guanfacine, methydopa alpha 2 agonist turns OFF the norepinephrine, which decreases heart rate OH, bradycardia, depression, sedation, dry mouth
73
What is the reason to use hydralazine? How does it work? As a result, what are the AEs from the vasodilation?
HTN crisis or gestational HTN (not a first line drug so it is for persistant HTN conditions) It is a tremendous vasodilator reflex tachycardia, hypotension, HA, flushing, peripheral edema, palpitation, lupus-like syndrome
74
What is another med used for HTN crisis? What is it similar to with it's MOA and AEs? What is the 1 unique SE that must be monitired?
nitroprusside hydralazine risk of thiocyanate poisoning
75
What is the treatment for a heart attack?
oxygen aspirin nitroglycerin morphine
76
What is nitroglygerin for? What cannot be taken with it?
angina sildenafil (viagra)
77
What does an inotrope affect? What med is an inotrope for advanced CHF?
inotrope: contractility milrinone
78
What drug class can be used as an antidysrhythmic? Examples? How does it affect the heart?
beta blockers atenolol it is a negatave inotrope, chromotrope and dromotrope
79
amiodarone is used for what? What is the strange effect?
atrial and ventricular dysrythmias ventricular tachycardia and fib blue face
80
What are the 2 CCBs good for a fib and arrythmias? How do they affect other smooth muscle besides the heart
verapamil ditiazam GI: constipating
81
What is used in emergency situations for supraventricular tachycardia? What are the AEs of note? Is it short acting or long?
adenosine sense of impending doom, flushing, dyspnea very short while it resets the heart
82
What is digoxin used for? What is the risk with this med? What is used if there is a digoxin toxicity? What are the S/S of the toxicity?
afib, decreased CO and HF tanking potassium and causing hypokalemia digibind halos and vision changes
83
What med helps to decrease the production of aqueous humor with open-angle glaucoma? What is the drug class? How long does it take before improvement?
timolol beta blocker 4-6 weeks
84
What medication opens of the canels to let more aquesous humor out with open angle glaucoma? What is the weird side effect?
lantanaprost pigmentation of eyelashes and eyelids
85
dorzolamide
86
What happens if clients are not compliant with glaucoma eye drops?
risk of permanent blindness #1 cause of blindness in people over 65
87
What med is used for otitis media? Otitis exyerna
amoxacillin ciprofloxacin/dexamethasone drops
88
What is the med for metal toxicity? What is the route?
dimercaprol IM, multiple times
89
What is the contraindication with vitamin A?
pregnancy
90
That is vitamin B1? What is an AE of B1 deficiency? Who is at risk?
thiamine Warrneke Korsikoff syndrome alcoholics
91
What is vitamin B12? What is its use? Whose at risk for deficiency?
cyanocobalamin RBC production and nervous system vegans, alcoholics, upper GI issues (not lower GI, absorption doesn't happen there), Crohn's, stomach surgery
92
What is the rule of administration with iron? What does it do to stool? If liquid what do they use to consume? why?
wants to be absorbed with vitamin C do not give with other food or meds constipations, dark and black and hard (not tarry) straw, it can discolor teeth
93
What is used for weight loss? What absorption does it block? What are AE?
orlistat fat soluble vitamins diarrhea, greasy stool, wet farts
94
What is the term for heartburn like sysptoms?
dyspepsia
95
What are 3 types of antacids? What are the side effect for each? Are they PRN? What does it do to other meds?
aluminum, magnesium and calcium-based mag based: diarrhea aluminum or calcium based: constipation yes, they do not affect the stomach in any way, they just neutralize the acid affects their absorption. Do not take them together
96
What drug class is omeprazole and other "azole"s? What do they treat? What are the SE?
PPI GERD, PU, h. pylori (with antibiotics) risk for nutritional deficiencies with calcium and iron, infections
97
What is metoclopramide used for? How does it work? What is the concerning AE and contraindication ?
persistent nausea and vomiting, the type with chemotherapy and post-op, hyperemesis stimulates the muscles of the GI tract to push food through more quickly dystonia symptoms, Parkinson's
98
Who is ondansetron contraindicated in?
heart issue and dysrhythmias, QT prolongation
99
Whatis pancrelipase used for? Who cannot use it?
cystic fibrosis helps break down food pork sensitivity
100
What can reintroduce good bacteria into the GI tract? What can it help protect against? Who is it contraindicated in?
probiotic C Diff immunocompromised
101
What is sucralfate used for? What does it do? When should it be taken?
ulcers, GERD stimulates a coating to protect the stomach 1 hour before eating
102
What is used for infertility? By doing what?
clomiphene increase egg release
103
What is used for ulcers and inducing labor?
misoprostol
104
What is the big contraindication with estrogen?
breast cancer, DVT
105
Is testonterone a schedule drug? Why?
yes potential for abuse
106
What is used for BPH and alopecia? What is in contraindicated in? Will it affect blood pressure?
finasteride pregnancy no, does not affect pressure
107
What drug is good for HTN and BPH? What class is the med? Does it affect the heart rate? Will it cause hypotension?
tamsulosin alpha 1 antagonist, causes vasodilation no, it only affects the vessels does not affect changes in the heart yes, this is the only way it will affect the heart
108
Does sildenafil cause vasodilation? Who should not use it?
yes nitroglycerin use and low blood pressure
109
What blocks H2 receptors to decrease stomach acid production to treat GERD, h. pylori and PU?
famotidine
110
What is the risk of smoking and contraceptions?
DVT

Pharm II (8 decks)

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