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NSG 318 > Final Exam > Flashcards

Final Exam Flashcards

1
Q

transdermals

A

provides more consistent blood levels with no GI upset

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2
Q

pharmacogenetics

A

the study of genetic factors that influence an individuals response to a specific drug

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3
Q

pharmacokinetics

A

the process of drug movement throughout the body that is necessary to achieve drug action

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4
Q

pharmacology

A

study or science of drugs

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5
Q

6 rights of medication administration

A

right patient right drugright doseright route right time right documentation

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6
Q

OTC drugs

A

over the counter drugs: drugs that have been found safe and appropriate for use without the need of a health care provider

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7
Q

Pharmacodynamics

A

the study of the effects of drugs on the body

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8
Q

What are the 3 types of medications that need to be recorded for a patients medication list?

A

prescription drugsOTC drugs CAMs

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9
Q

What are the things that OTC drugs must provide on their label?

A

active and inactive ingredientspurpose of productuse of product warnings dosage instructions (who can use it and how often)

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10
Q

drug

A

any chemical that affects the physiological process of a living organism

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11
Q

What must a patient do before taking CAMs?

A

check with their HCP if the CAM can be mixed with their prescription drugs

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12
Q

chemical name of a drug

A

describes the chemical structure of the drug

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13
Q

generic name of a drug

A

official, nonproprietary name (acetaminophen)

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14
Q

brand/trade name of drug

A

proprietary name (Tylenol)

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15
Q

generic brand drugs

A

contain the same active ingredients, but may have inactive/inert ingredients to change the tablet shape and control release time

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16
Q

What is important when using a generic drug?

A

the health care provider needs to say on the prescription if using the generic brand is okay, or if the patient needs to use name brand

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17
Q

extended release, enteric coated, time release capsules/tablets

A

should NEVER be crushed or split in half, they must be swallowed whole

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18
Q

What are the rules for sublingual and buccal drugs?

A

the drug should remain in place until it is fully absorbeddo not let patient eat or drink when the medication is in place

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19
Q

What are the pharmacokinetic phases?

A

absorption distributionmetabolism excretion

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20
Q

absorption

A

movement of the drug from the GI tract into the bloodstream after administration

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21
Q

distribution

A

movement of drugs from circulation into body tissues

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22
Q

metabolism (biotransformation)

A

body chemically changes drugs to a form that can be excreted

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23
Q

potency

A

Amount of drug necessary to elicit a specific physiological response to a drug

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24
Q

excretion

A

elimination of drugs from the body

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25
Q

What is the first pass effect?

A

After oral administration, many drugs are absorbed intact from the small intestine and transported first via the portal system to the liver, where they undergo extensive metabolism, therefore usually decreasing the bioavailability of certain oral medications.

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26
Q

bioavailability

A

bioavailability
percent of administered drug available for activity what reaches systemic circulation (blood stream)

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27
Q

What happens when 2 highly protein bound drugs are administer together?

A

the drugs will compete for protein binding sites and this will lead to an increase in the free drugs of the drug that had the lower percent of protein binding

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28
Q

free drugs

A

can exit blood vessels and reach their site of action causing pharmacological response (too high of free drug accumulation can cause side effects, adverse effects, or toxicity)

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29
Q

half life (t1/2)

A

time it takes for the amount of drug in the body to be reduced by half

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30
Q

loading dose

A

a large initial dose given to achieve a rapid minimum effective concentration in the plasmatherapeutic effects can be obtained while steady state is reached

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31
Q

What lab test help determine if liver function is good?

A

aspirate transaminase (AST)alanine aminotransferase (ALT) alkaline phosphate (ALP)

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32
Q

What helps determine kidney function?

A

creatinine clearance BUNGFR

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33
Q

What labs are taken to test kidney function?

A

creatinine (CR)blood urea nitrogen (BUN)

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34
Q

therapeutic index

A

relationship between therapeutic and toxic dose

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35
Q

onset

A

time it takes for drug to reach minimum effective concentration (therapeutic response)

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36
Q

peak

A

highest concentration in the blood

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37
Q

duration

A

length of time for a drug to exert a therapeutic effect

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38
Q

peak drug level

A

the highest plasma concentration of a drug at a specific timeindicates the rate of absorption

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39
Q

trough drug level

A

the lowest plasma concentration of a drugmeasures the rate at which the drug is eliminated

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40
Q

drug toxicity

A

occurs when drug levels exceed the therapeutic range

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41
Q

tolerance

A

decreased responsiveness of a drug over the course of therapy (this individual would require a higher dosage of a drug to achieve the same therapeutic response)

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42
Q

additive effects

A

sum of the effects of the two drugs

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43
Q

synergistic effect

A

effect of the two drugs given together is much greater than effects of either drug alone

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44
Q

drug induced photosensitivity

A

skin reaction caused by exposure to sunlight

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45
Q

genomics

A

study of all the genes in the human genome together, including their interactions with one another with one another, their interactions with the environment and the influence of other cultural and psychosocial factors

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46
Q

What is the purpose of knowing a patients genomic information?

A

so that treatments can be tailored/personalized per patient

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47
Q

people of European descent

A

poor metabolizers of antidepressants, anti psychotics, cardiovascular agents, and isoniazid which can lead to toxicity

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48
Q

people of African descent

A

diminished therapeutic effects from beta blockers, Ace inhibitors and warfarin

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49
Q

people of Native American descent

A

increased vasomotor response to alcohol

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50
Q

people of Asian descent

A

diminished therapeutic effects of codeine; rapid metabolizers of isoniazid

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51
Q

people of Middle Eastern descent

A

many genetic diseases such as thalassemia

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52
Q

What do you document after administering a medication/drug?

A

name of the drugdoseroutetime and date nurse initials or signature

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53
Q

When should you check your drug label and how many times?

A

3 times:at contact with the dug bottlebefore measuring the drugafter measuring the drug

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54
Q

What is the culture of safety?

A

ANA encourages organizations to avoid punitive approaches in drug error reporting

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55
Q

What is Just Culture?

A

fair and not punitive encourages reporting of errorsgoal is to repair system

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56
Q

What is the focus of the Joint Commission? What did they develop

A

focuses on healthcare safety problems and resolutions TJC developed National Patient Safety Goals

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57
Q

What is the strongest form of warning?

A

Black box warning label

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58
Q

What is the first thing you think about when a medication error is made?

A

THE PATIENTS SAFETY! do not leave the patient

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59
Q

informed consent

A

clients have right to be informed and participation is voluntary

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60
Q

autonomy

A

right to self-determination

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61
Q

beneficence

A

obligation of RN to protect the client from harm (do good to patient)

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62
Q

justice

A

equitability or equal selection of research participants

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63
Q

the Federal Food, Drug, Administration Cosmetic Act

A

act that empowered the FDA to ensure a medication is safe prior to marketing

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64
Q

the Harrison Act

A

increased record keeping for narcotics and requires a prescription for a client to be administered narcotics

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65
Q

Pediatric Research Equity Act

A

act that authorized the FDA to require drug manufactures to test drugs and biological products for safety and effectiveness in children”children are NOT small adults

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66
Q

Tuskegee Experiment

A

Infamous historical study in which core values of research (respect for persons, beneficence, and justice) were violated - studied the effects of syphilis in african-american men if left untreated

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67
Q

Nuremberg Trials

A

Trials of the Nazi leaders, showed that people are responsible for their actions, even in wartime, cannot use prisoners of war for experiments NUREMBERG CODE OF ETHICS

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68
Q

Thalidomide

A

drug was marketed to help with nausea “safely” in pregnancy, can produce a variety of malformations of the limbs (stunted limbs) , eyes, ears, and heart.

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69
Q

epinephrine classification

A

Sympathomimetic: adrenergic agonist

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70
Q

epinephrine action

A

alpha 1: increases BP
beta 1: increases HR
Beta 2: promotes bronchodialation

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71
Q

epinephrine uses

A

anaphylactic shock and cardiac arrest

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72
Q

epinephrine adverse effect

A

tissue necrosis at IV site

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73
Q

epinephrine lab interactions

A

increase blood glucose

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74
Q

epinephrine food interactions

A

caffeine containing herbs (cola nut, guanara, mate, tea, coffee) increase stimulant effect

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75
Q

epinephrine nursing implications

A

watch IV sites and monitor blood glucose in diabetic patients

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76
Q

epinephrine drug interactions

A

increased effects with TCAs and MAOIs

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77
Q

albuterol classification

A

B2 adrenergic agonist

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78
Q

albuterol action and uses

A

causes bronchodialation
treatment of asthma

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79
Q

albuterol lab interactions

A

may increase glucose levels (stimulates gluconeogenesis in the liver)

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80
Q

albuterol nursing implications

A

monitor pulmonary function

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81
Q

bethanechol

A

Urecholine

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82
Q

Bethanechol (Urecholine) classification

A

cholinergic agonist: parasympathomimetic

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83
Q

Bethanechol (Urecholine) uses

A

Urinary retention and neurogenic bladder

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84
Q

Bethanechol (Urecholine) contraindications

A

intestinal and urinary tract obstruction, IBS, peptic ulcer
pt w asthma (as it causes bronchoconstriction

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85
Q

Bethanechol (Urecholine) nursing implications

A

baseline VS (IF BP IS LOW, CANNOT ADMINISTER)
monitor AST, bilirubin, amylase, lipase

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86
Q

atropine classification

A

anticholinergic

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87
Q

atropine uses

A

pre-op to reduce salivation so that you do not aspirate
increase HR for Bradycardia

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88
Q

atropine side effects

A

anticholinergic SE (dry mouth, photophobia, urinary retention)

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89
Q

atropine contraindications

A

glaucoma, obstructive GI disorders

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90
Q

atropine nursing implications

A

provide mouth care, tell pt, to wear sunglasses, chew gum or suck on candies to help with dry mouth

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91
Q

alprazolam

A

Xanax

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92
Q

Alprazolam (Xanax) classification

A

Benzodiazepine anxiolytic sedative hypnotic

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93
Q

Alprazolam (Xanax) use

A

anxiety and panic disorder

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94
Q

Alprazolam (Xanax) food and CAMs

A

food: grapefruit increases effects, green tea decreases effect
CAMs: do not combine with kava kava, valerian, chamomile

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95
Q

antidote for Alprazolam (Xanax)

A

Flumazenil

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96
Q

Alprazolam (Xanax) nursing implications

A

gradually withdrawal/wean off
antidote: flumenazil
instruct not to drive

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97
Q

lorazepam

A

Ativan

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98
Q

Lorazepam (Ativan) classification

A

Benzodiazepine anxiolytic sedative hypnotic

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99
Q

Lorazepam (Ativan) use

A

anxiety
status epilepticus
sedation induction for insomnia

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100
Q

antidote for Lorazepam (Ativan)

A

flumazenil

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101
Q

Lorazepam (Ativan) nursing implications

A

taper off
no driving or operating machinery
no alcohol (will further depress CNS)

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102
Q

Zolpidem

A

Ambien

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103
Q

Zolpidem (Ambien) classification

A

nonbenzo
sedative hypnotic

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104
Q

Zolpidem (Ambien) use

A

insomnia

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105
Q

Zolpidem (Ambien) side effects

A

hangover (residual sedation)
anterograde amnesia, nightmares, binge eating

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106
Q

Zolpidem (Ambien) nursing implications

A

teach patient to use non-harm method for sleep first
take medication 15-30 mins before bedtime
suggest patient to urinate before bed to prevent sleep disruption
do not drive

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107
Q

phenytoin

A

Dilantin

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108
Q

Phenytoin (Dilantin) classification

A

Anticonvulsant or antiepileptic drug/ anti seizure

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109
Q

Phenytoin (Dilantin) side effects

A

GINGIVAL HYPERPLASIA

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110
Q

Phenytoin (Dilantin) therapeutic range

A

10-20 mcg/mL

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111
Q

Phenytoin (Dilantin) contraindication

A

pregnancy (teratnogenic)

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112
Q

Phenytoin (Dilantin) drug interactions

A

decreased effects with antacids, folic acid, calcium

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113
Q

Phenytoin (Dilantin) CAMs interaction

A

ginkgo decreases effect

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114
Q

Phenytoin (Dilantin) nursing implications

A

monitor therapeutic serum levels (10-20 mcg/mL)
tell pt. to use extra contraceptive method
must be taken at the same time everyday, lifelong

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115
Q

fluoxetine

A

Prozac

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116
Q

Fluoxetine (Prozac) classification

A

SSRI

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117
Q

Fluoxetine (Prozac) use

A

depression

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118
Q

Fluoxetine (Prozac) food interaction

A

grapefruit juice can lead to toxicity

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119
Q

Fluoxetine (Prozac) CAMs interactions

A

St. Johns Wort can increase risk of serotonin syndrome

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120
Q

Fluoxetine (Prozac) drug interactions

A

alcohol and other CNS depressants increase respiratory depression
MAOIs and TCAs increase risk of serotonin syndrome

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121
Q

Venlafaxine

A

Effexor

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122
Q

Venlafaxine (Effexor) classification

A

SNRI

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123
Q

Venlafaxine (Effexor) use

A

depression, generalized anxiety, social and panic anxiety

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124
Q

Venlafaxine (Effexor) drug interaction

A

SSRI (may increase risk of NSM)
MAOIs (hypertensive crisis and death
St. Johns Wort (serotonin syndrome)

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125
Q

Tricyclic Antidepressants (TCAs) use

A

major depression
if it doesn’t work, then use an MAOI

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126
Q

Monoamine Oxidase Inhibitors (MAOIs) food interactions

A

hypertensive crisis from tyramine (aged cheeses, coffee, yogurt, red wine, sausage, cream, chocolate, bananas, beer)

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127
Q

Monoamine Oxidase Inhibitors (MAOIs) CAMs

A

FATAL w St. Johns Wort

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128
Q

Cyclobenzaprine

A

Flexeril

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129
Q

Cyclobenzaprine (Flexeril) classification and use

A

muscle relaxant
used for short term treatment of muscle spasm

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130
Q

Salicylate

A

aspirin

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131
Q

Salicyclate (aspirin) classification and action

A

nalgesic- antiinflammatory; NSAID
inhibits COX 1 and COX 2

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132
Q

Salicyclate (aspirin) therapeutic serum level

A

15-30 mg/mL

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133
Q

Salicyclate (aspirin) adverse effects

A

tinnitus
GI ulceration and bleeding w prolonged use
increase bleeding risk

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134
Q

Salicyclate (aspirin) contraindications

A

do not give to pt who is below the age of 19 if they have flu symptoms- can cause Reyes syndrome

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135
Q

Ibuprofen

A

Motrin

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136
Q

Ibuprofen (Motrin) dose level

A

3200mg/day

137
Q

Ibuprofen (Motrin) adverse effect

A

hearing loss and tinnitus

138
Q

what is the most widely used NSAID

A

Ibuprofen

139
Q

Ibuprofen (Motrin) CAM interactions

A

dong quai, fever few, garlic, ginger, ginkgo may cause bleeding w NSAID

140
Q

Ibuprofen (Motrin) nursing implication

A

observe pt. for bleeding gums, petechiae, ecchymoses, black tarry stool

141
Q

when should Ibuprofen (Motrin) not be used

A

2 days before menstrual cycle

142
Q

Celecoxib

A

Celebrex

143
Q

Celecoxib (Celebrex) classification and action

A

selective COX 2 inhibitor NSAID (so there will be no GI distress)

144
Q

Celecoxib (Celebrex) uses

A

Osteoarthritis
Rheumatoid arthritis

145
Q

Celecoxib (Celebrex) CAM interaction

A

ginkgo increase bleeding risk

146
Q

Celecoxib (Celebrex) nursing implications

A

Assess for skin rash

147
Q

Remicade

A

Infliximab

148
Q

Remicade (infliximab) use

A

treat psoriasis, RA, UC Chrons, autoimmune type disorders

149
Q

Remicade (infliximab) drug interactions

A

may decrease effectiveness of live vaccines

150
Q

Remicade (infliximab) administration

A

IV over 2 hours

151
Q

Remicade (infliximab) nursing implications

A

med supresses immune system
NEED NEGATIVE TB SKIN TEST

152
Q

what is the difference between allopurinol and colchicine?

A

colchicine: only for initial inflammation and pain
allopurinol: prevention of gout attacks

153
Q

Allopurinol action

A

Inhibits uric acid production (but doesn’t help w inflammation)

154
Q

Allopurinol use

A

lowers serum uric acid levels, prevent gout attacks

155
Q

Allopurinol adverse effects

A

urticaria (FIRST SIGN OF RASH DISCONTINUE)

156
Q

Allopurinol Nursing Implications

A

increase fluid intake (so kidney stones don’t form)
DO NOT eat foods w purines (beer, yeast, organ meats, deli meats)

157
Q

acetaminophen

A

Tylenol

158
Q

Acetaminophen (Tylenol) classification and action

A

Non-opioid analgesic, NOT AN NSAID
inhibits prostaglandin synthesis

159
Q

Acetaminophen (Tylenol) use

A

muscular aches and pain, fever, NOT FOR INFLAMMATION

160
Q

Acetaminophen (Tylenol) max dose

A

4000mg/day
4g/day

161
Q

Acetaminophen (Tylenol) side effects

A

rash, HA, insomnia, low incidence of GI distress

162
Q

Acetaminophen (Tylenol) adverse effects

A

hepatotoxicity and renal failure (nurse would see uligaria/ really low UO)

163
Q

Acetaminophen (Tylenol) nursing implications

A

check liver/hepatic enzymes as toxicity can occur

164
Q

Indomethacin

A

Indocin

165
Q

Indomethacin (Indocin) use

A

relieve mild to severe pain, gut, tendinitis, OA, RA

166
Q

Indomethacin (Indocin) contraindications

A

avoid if allergic to aspirin

167
Q

Indomethacin (Indocin) nursing implications

A

check hepatic and renal labs
PO: DO NOT BREAK CRUSH OR CHEW

168
Q

Ketorolac

A

Toradol

169
Q

Ketorolac (Toradol) use

A

SHORT TERM management (5 days or less)

170
Q

Tramadol

A

Ultram

171
Q

Tramadol (Ultram) use

A

moderate to severe pain

172
Q

Tramadol (Ultram) side effects

A

anxiety, agitation, drowsiness

173
Q

Tramadol (Ultram) nursing implications

A

educate patient not to operate have machinery or drive because of the sedative effect

174
Q

morphine classification and action

A

opioid
decreases severity of pain by altering perception of a response to painful stimuli while producing generalized CNS depression

175
Q

morphine side effect

A

CONSTIPATION, respiratory depression

176
Q

morphine drug interactions

A

EXTREME caution with MAOIs

177
Q

morphine CAM interaction

A

decreased effects with St. johns wort

178
Q

morphine nursing implications

A

antidote: Naloxone (Narcan)
monitor RR
if BP is elevate hold e med and contact HCP
pinpoint pupils may indicate OD
do not give in patient who have a head injury

179
Q

opioid antidote

A

Naloxone (Narcan)

180
Q

Naloxone (Narcan) nursing implications

A

monitor vitals, RR, repeat doses may be necessary if respiratory depression shows again
antidote to opioids
nasal spray

181
Q

Fentanyl side effect

A

constipation, dry mouth, N/V

182
Q

Fentanyl nursing implications

A

MUST BE DISPOSED IN A SAFETY CONTAINER WITH A LOCK ON IT AT A PHARMACY.
more potent Han morphine by 100x

183
Q

Hydromorphone

A

Dilaudid

184
Q

Hydromorphone (Dilaudid) action

A

binds to opiate receptors in the CNS alters perception of and response to painful stimuli while producing CNS depression
suppresses cough reflex

185
Q

Hydromorphone (Dilaudid) drug interaction

A

EXTREME caution with MAOId

186
Q

Hydromorphone (Dilaudid) CAM interaction

A

kava kava, valerian, chamomile, increase CNS depression
st. johns wort

187
Q

Oxycodone

A

Oxycontin

188
Q

Oxycodone (Oxycontin) side effects

A

unusual dreams, confusion dizziness, floating feeling, HA

189
Q

Oxycodone (Oxycontin) drug interactions

A

EXTREME caution w MAOIs

190
Q

Oxycodone (Oxycontin) nursing implications

A

take w food to avoid GI distress
TAPER OFF!!! (do not abruptly discontinue)
BROKEN, CHEWED, CRUSHED TABLETS GET ABSORBED TOO FAST AND MAY BE FATAL

191
Q

Oxycodone with Acetaminophen

A

Percocet

192
Q

Percocet nursing implications

A

take w food
watch for dependence and tolerance

193
Q

Nalbuphine

A

Nubain

194
Q

Nalbuphine (Nubain) classification and action and use

A

opioid agonist-antagonist (helps decrease opioid abuse)
increases pain threshold
pain and anesthesia induction and maintenance

195
Q

Nalbuphine (Nubain) adverse effects

A

respiratory depression

196
Q

Nalbuphine (Nubain) nursing implications

A

DO NOT use alcohol, VS, UO, bowel movements for constipation

197
Q

Sumatriptan

A

Imitrex

198
Q

Sumatriptan (Imitrex) classification, action, and use

A

anti-migraine, 5-HT agonist
causes vasoconstriction of cranial arteries
to treat migraine and cluster HA

199
Q

sumatriptan (Imitrex) adverse effects

A

hypo/hypertension, AV block, angina, dysrhythmias, stroke, thromboembolism

200
Q

Digoxin classifications and use

A

cardiac glycoside
use for heart failure

201
Q

Digoxin Therapeutic Serum Level

A

0.5-1 ng/mL (for heart failure)

202
Q

Digoxin toxicity S/S

A

Digitalis toxicity: green to yellow halos, blurred vision, anorexia, vomiting, diarrhea, Bradycardia, abnormal heart rhythms

203
Q

Digoxin antidote

A

digoxin immune FAB

204
Q

digoxin nursing implications

A

check vitals BEFORE ADMIN if HR is below 60 BOM DO NOT ADMINISTER
report hypokalemia and tell patient to heat foods high in potassium (hypokalemia increases the risk of digoxin toxicity)

205
Q

Nitroglycerin classification, action, and use

A

antianginal
decreases myocardial demand for oxygen
to control angina

206
Q

nitroglycerin nursing implications

A

3 doses every 5 minutes, call 911 after 1st dose if anginal pain hasn’t subsided then administer second dose
remove nitro patch nightly to prevent tolerance

207
Q

atenolol

A

Tenormin

208
Q

Atenolol (Tenormin) classification and use

A

beta-adrenergic blocker
used for HTN, angina, prophylaxis and treatment of acute MI

209
Q

Atenolol (Tenormin) side effects

A

cool extremities, erectile dysfunction (impotence), GI and CNS

210
Q

Atenolol (Tenormin) adverse effect

A

Bradycardia, hypotension, bronchospasm

211
Q

Atenolol (Tenormin) nursing implications

A

WATCH BUN AND CREATININE
should be weaned off
do not drive until patient knows reaction to drug
orthostatic hypertension so help with ambulation

212
Q

Diltiazem

A

Cardizem

213
Q

Diltiazem (Cardizem) classification and use

A

CCB
used for atrial dysrhythmias and HTN

214
Q

Diltiazem (Cardizem) side effects

A

edema of ankles and feet , Brady cardia, hypotension, ABRUPT WITHDRAWAL CAN CAUSE ACUTE ANGINA EPISODE

215
Q

Diltiazem (Cardizem) CAM interactions

A

Parsley can decrease effect

216
Q

Hydrochlorothiazide

A

Hydrodiuril

217
Q

Hydrocholorothiazide (HydroDiuril) classification, action, and use

A

thiazide diuretic
excretes sodium, chloride, and water, but KEPPS calcium
used to increase UO and treat HTN

218
Q

Hydrocholorothiazide (HydroDiuril) side effects

A

hyperglycemia, rash, photosensitivity, blurred vision, muscle cramps

219
Q

Hydrocholorothiazide (HydroDiuril) adverse effects

A

hyponatremia, hypokalemia, hypercalcemia

220
Q

Hydrocholorothiazide (HydroDiuril) nursing implications

A

DAILY WEIGHTS, watch electrolytes
TAKE IN MORNING TO PREVENT NOCTURIA
change positions slowly

221
Q

Furosemide

A

Lasix

222
Q

Furosemide (Lasix) classification, action and use

A

loop diuretic
sodium water, potassium, magnesium and calcium excreted
for heart failure, HTN, used in pt w renal failure

223
Q

Furosemide (Lasix) side effects

A

electrolyte imbalances, blurred vision, photosensitivity

224
Q

Furosemide (Lasix) adverse effects

A

ectrolyte imbalances, hearing loss, BUN, creatinine

225
Q

Furosemide (Lasix) drug interaction

A

aminoglycosides increase ototoxicity

226
Q

Furosemide (Lasix) food and CAM interactions

A

food: licorice may increase potassium loss
CAM: Hawthorne may potentiate hypotension
ginseng decrease effects

227
Q

Furosemide (Lasix) nursing implications

A

daily weights, watch electrolytes, UO
administer IV slowly or hearing loss may happen
instruct potassium replacement w food

228
Q

Spironolactone classification, action and use

A

potassium sparing diuretic
excrete sodium and water, keeps potassium
used for peripheral and pulmonsry edema, HTN, circulation overload, heart failure

229
Q

Spironolactone adverse effect

A

severe hyperkalemia, hepatotoxicity

230
Q

Spironolactone drug interactions

A

LIFE THREATENING WITH ACE INHIBITOR (they both spare potassium)

231
Q

Spironolactone nursing implications

A

avoid food high in potassium, and watch serum potassium levels

232
Q

Metoprolol

A

Lopressor

233
Q

Metoprolol (Lopressor) classification and use

A

beta 1 blocker
treat HTN acute MI and heart failure

234
Q

Metoprolol (Lopressor) side effects

A

dry mouth, HA, blurred vision, insomnia, tinnitus, peripheral edema, ED, depression BRADYCARDIA

235
Q

Metoprolol (Lopressor) nursing implications

A

instruct patient to comply w drug regimen and DO NOT abruptly stop as it can cause rebound HTN

236
Q

Prazosin

A

Minipress

237
Q

Prazosin (Minipress) classifcation and use

A

antihypertensive: alpha-adrenergic blocker
control HTN

238
Q

Prazosin (Minipress) side effects

A

tinnitus, depression, dry mouth, peripheral edema, ED, urinary incontinence

239
Q

Prazosin (Minipress) nursing implications

A

educate pt to not take OTC cold cough or allergy meds without consuming HCP first
DO NOT ABRUPTLY STOP TAKING MEDICATION CAN CAUSE REBOUND HTN
take weekly BP at home
decrease salt intake

240
Q

Lisinopril

A

Prinvil

241
Q

Lisinopril (Prinivil) classification and use

A

ACE inhibitor for HTN

242
Q

Lisinopril (Prinivil) side effects

A

“ACE cough” CNS, orthostatic hypotension

243
Q

Lisinopril (Prinivil) adverse effects

A

angioedema

244
Q

Lisinopril (Prinivil) contraindications

A

hyperkalemia, pregnancy

245
Q

Lisinopril (Prinivil) Drug and food interaction

A

drug: hyperkalemia with potassium sparing diuretics
food: hyperkalemia with foods high in potassium

246
Q

Valsartan classification and use

A

ngiotensin II receptor blocker (ARB)
for HTN and heart failure

247
Q

Valsartan side effects

A

abdominal and back pain, arthralgia, fatigue, ED, diarrhea, blurred vision

248
Q

Valsartan advert effects

A

hyperkalemia, ,rhabdomyolysis, elevated hepatic enzymes

249
Q

Heparin classification, action and use

A

anticoagulant
inhibits thrombin preventing conversion of fibrinogen to fibrin
prevent thrombosis assoc. w PE, MI, treat DIC

250
Q

Heparin route use

A

IV: for acute thrombosis
SQ: prophylactically

251
Q

Heparin antidote

A

protamine sulfate

252
Q

Heparin nursing implications

A

monitor PTT/aPTT
antidote: protamine sulfate

253
Q

Warfarin

A

Coumadin

254
Q

Warfarin (Coumadin) classification action use

A

anticoagulant
depresses vitamin K clotting factors
thrombosis assoc. w PE MI,treat a-fib

255
Q

Warfarin (Coumadin) adverse effects

A

purple toe syndrome

256
Q

Warfarin (Coumadin) antidote

A

Vitamin K

257
Q

Warfarin (Coumadin) nursing implications

A

monitor INR and PT
antidote: vitamin K
watch client for bleeding, soft tooth brushed, electric razor
watch foods rich in vitamin K

258
Q

Clopidogrel

A

Plavix

259
Q

Clopidogrel (Plavix) classification and use

A

antiplatelet
prevent thrombosis assoc, with unstable angina, acute MI stroke

260
Q

Clopidogrel (Plavix) side effects

A

flulike symptoms, bleeding, bronchospasms

261
Q

Clopidogrel (Plavix) CAMs

A

ginger garlic gingko, feverfew, green tea may increase bleeding risk

262
Q

Clopidogrel (Plavix) nursing implications

A

check BP before admin
watch for excessive bleeding

263
Q

Alteplase

A

tPA

264
Q

Alteplase (tPA) classification action and use

A

thrombolytic agent
promotes conversion of plasminogen to plasmin
clot bluster
promote fibrinolysis with thrombosis, MI, PE< ischemic stroke, occluded IV catheter

265
Q

Alteplase (tPA) antidote

A

aminocaproic acid

266
Q

Alteplase (tPA) nursing implications

A

ONLY USE FOR ISCHEMIC STROKE NOT HEMORHAGIC
monitor client 24 hours after therapy discontinues
watch fro bleeding

267
Q

Rosuvastatin

A

Crestor

268
Q

Rosuvastatin (Crestor) classification and use

A

antihyperlipidemic: HMG-CoA Reductase inhibitor
decrease cholesterol levels especially LDL and triglycerides

269
Q

Rosuvastatin (Crestor) nursing implications

A

take with sufficient water or with meal to alleviate GI upset
DO NOT ABRUPTLY STOP as rebound effects may occur could lead to acute MI and possible death
tell pt to report unexplained muscle tenderness (may be rhabdomyolysis)

270
Q

Cilostazol

A

Pletal

271
Q

Cilostazol (Pletal) classification and use

A

direct acting vasodilator
treat PBD and intermittent claudication

272
Q

Cilostazol (Pletal) side effects

A

melena, back and abd. rain, peripheral edema, increases susceptibility to infection TACHYCARDIA

273
Q

Cilostazol (Pletal) contraindications

A

tobacco smokers and pregnancy

274
Q

Cilostazol (Pletal) Drug interactions

A

decrease effects w St. johns wort
increase bleedingitme with gingko

275
Q

Cilostazol (Pletal) nursing implications

A

educate pt. therapeutic response may take 1.5-3 months
NO SMOKING can cause vasospasms
NO ALCOHOL
take with meals to alleviate GI distress

276
Q

amoxicillin classification and use

A

antibacterial: broad spectrum penicillin
treats OM, tonsilitis, sinusitius, skin, respiratory and UTI

277
Q

amoxicillin side effects

A

stomatitis, tongue and tooth discoloration, edema
can cause C diff

278
Q

amoxicillin adverse effects

A

superinfection (vaginitis)
anaphylaxis

279
Q

amoxicillin contraindications

A

allergic to penicillins

280
Q

amoxicillin drug interaction

A

antibiotics decrease effects of contraceptives (use extra contraceptive method)

281
Q

amoxicillin nursing implications

A

watch for superinfection and anaphylaxis (have epi available for severe reaction)
TAKE ENTIRE ANTIBIOTIC
WBC LEVELS
increase fluid intake

282
Q

ceftriaxone

A

Rocephin

283
Q

Ceftriaxone (Rocephin) classification and uses

A

third generation cephalosporin
OM, meningitis, appendicitis, gonorrhea, septicemia, surgical infection prophylaxis, skin respiratory and UTI infection

284
Q

Ceftriaxone (Rocephin) side effects

A

injection site reaction and stomatits (mouth sore)

285
Q

Ceftriaxone (Rocephin) drug interaction

A

alcohol- may cause disulfiram like reaction
gout drugs (uricosurics)- decrease cephalosporin excretion

286
Q

Ceftriaxone (Rocephin) nursing implications

A

culture the infected are
tell patient to report signs of superinfection
TAKE W FOOD to prevent GI irritation
watch for a temp, decreased UO, increase fluid outake

287
Q

azithromycin

A

Zithromax, Zmax

288
Q

Azithromycin (Zithromax, Zmax) classification and use

A

antibacterial macrolides
bacterial conjuntivitis, STI, skin and respiratory infection

289
Q

Azithromycin (Zithromax, Zmax)side effects

A

ocular irritation, tinnitus, tongue discoloration, pruritus, conjunctivitis
c diff

290
Q

Azithromycin (Zithromax, Zmax) adverse affection

A

superinfection (c diff)
hearing loss

291
Q

Azithromycin (Zithromax, Zmax) works well for

A

those allergic to penicillin

292
Q

Azithromycin (Zithromax, Zmax) trig interaction

A

levels reduced by antacids (administer two hours before or after)

293
Q

Azithromycin (Zithromax, Zmax) nursing implications

A

obtain sample
monitor labs and for LIVER DANAGE
report side effects of loose stools (c diff)

294
Q

doxycycline classification and use

A

antibiotic Tetracycline
acne, anthrax, gingivitis, STI, Ricketts, respirator and UTO and skin infection

295
Q

doxycycline side effects

A

tooth/ nail discoloration
glossitis (tongue discoloraition)

296
Q

doxycycline drug and food interactions

A

MILK products and antacids- decrease absorption
decreases oral contraceptive
decrease penicillins
aminoglycosides (increase nephrotoxicity)

297
Q

doxycycline nursing implications

A

can cause teratogenic effects in pregnancy so warn patients
WOMEN IN LAST TRIMESTER AND KIDS UNDER THE AGE OF 8 SHOULDN’T TAKE BECAUSE PERMANENT TOOTH DISCOLORATION

298
Q

gentamicin classification and use

A

amino glycoside antibaterial
endocarditis, meningitis, bacteremia, septicemia
bone/joint skin

299
Q

gentamicin side effects

A

ototoxicity and nephrotoxicity
tinnitus
photosensitivity

300
Q

gentamicin drug interactions

A

loop diuretics increase risk for ototoxicity and nephrotoxixty

301
Q

amino glycoside toxic effects

A

ototoxicity and nephrotoxicity

302
Q

gentamicin lab interactions

A

decrease serum potassium nd magnesium level

303
Q

gentamicin nursing implications

A

CHECK HEARING AND RENAL FUNCTION
NEED TO DRAW PEAK AND TROUGH LEVELS BECAUSE OF TOXICITY

304
Q

Levofloxacin

A

Levaquin

305
Q

Levofloxacin (Levaquin) classification and use

A

fluoroquinolone antibacterial
sinusitis cellucitis, impetigo, plague , anthrax
respiratory skin and UT

306
Q

Levofloxacin (Levaquin) side effects

A

nightmares, insomnia, tremor rash, injection side tinnitus photosensitivity

307
Q

Levofloxacin (Levaquin) drug interactions

A

decrease absorption with antacids and iron
can increase effects of warfarin

308
Q

Levofloxacin (Levaquin) nursignimplications

A

monitor I&Os
check renal and lab values
use sun protection
FLUID INTAKE IS IMPORTANT

309
Q

Trimethoprim/Sulfamethoxazole TMPSMZ

A

Bactrim

310
Q

TMP-SMZ (Bactrim) classification and use

A

sulfonamide antibacterial
OM gastroenteritis, MRDA
respiratory and UTI

311
Q

TMP-SMZ (Bactrim) side effects

A

rash tinnitus photosensitivity vertigo

312
Q

TMP-SMZ (Bactrim) lab interactions

A

may increase BUN CR, AST ALT ALP

313
Q

TMP-SMZ (Bactrim) nursing implications

A

ADMINISTER W A FULL GLASS OF WATER
do not take with antacids
tell patient about proper sun protection
CBC

314
Q

Isoniazid (INH) classification and use

A

antitubercular
treat and prophylaxis for TB

315
Q

Isoniazid (INH) side effects

A

injection side reaction with IM admin

316
Q

Isoniazid (INH) adverse effects

A

vitamin b6 deficiency

317
Q

Isoniazid (INH) food interactions

A

foods high in histamine (aged cheese, tuna)
tyramine (aged cheese, bananas, avocados, smokes meat, fish, soy sauce, yeast)
caffeine
increase effects

318
Q

Isoniazid (INH) CAM interactions

A

green tea, guaranan and ginseng count increase effects

319
Q

Isoniazid (INH) nursignimplication

A

`TB skin test required if in contact w person w TB
1 hour before or 2 hours after meal
PYRIDOXINE (vitamin B 6 ) prescribed to prevent peripheral neuropathy
take for like or (24 mots ) until sputum is negative for acid bacilli for 2-3 moths

320
Q

nystatin

A

Mycostatin

321
Q

Nystatin (Mycostatin) classifaction and use

A

antifungal antibiotic
to treat candiasis THRUSH

322
Q

Nystatin (Mycostatin) nursing implications

A

monitor UP check BUN and CR

323
Q

fluconazole

A

Diflucan

324
Q

Fluconazole (Diflucan) classifcation and use

A

azalea antifungal
candida infections and cryptococcal meningitis
prophylaxis fro client undergoing bone marrow transplant and radiation therapy

325
Q

Fluconazole (Diflucan) CAMS

A

NO CAFFIENE (green tea, soft drink, guarna)

326
Q

acyclovir

A

Zovirax

327
Q

Acyclovir (Zovirax) classification and use

A

antiviral
treat HSV and VZV

328
Q

Acyclovir (Zovirax) side effects

A

Philebitis at iv site
gi distress prurtis

329
Q

Acyclovir (Zovirax) nursing implications

A

check renal and hepatic
sed ed
fluid intake to increase UO

330
Q

chloroquine phosphate classification and use

A

antimalarial
treat and prophylaxis for malaria

331
Q

chloroquine phosphate nursing implications

A

use prophylactically if going to malaria endemic countries
take w food if GI dust happens
dont drive and avoid sun

332
Q

Ivermectin

A

Stromectol

333
Q

Ivermectin (Stromectol) classification and use

A

amtihelmintic
parasitic worms

334
Q

Ivermectin (Stromectol) drug lab food

A

take on empty stomach w water
monitor opthalamic exams
follow up with stool exams

335
Q

Ivermectin (Stromectol) nursing implications

A

trach importance of hand washing
peds dose not determined
take on empty stomach w water

336
Q

Metronidazole

A

Flagyl

337
Q

Metronidazole (Flagyl) classification and use

A

peptide amebicide
bacterial anaerobic infections

338
Q

Metronidazole (Flagyl) nursing implications

A

NO ALCOHOL
may cause disulfiram like reaction

NSG 318 (11 decks)

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