Final Exam Drugs PT. 1

Question 1

Heparin: MOA

Answer 1

-Indirectly inactivates thrombin and factors Xa

Question 2

Heparin: Indications

Answer 2

-Needs prompt anticoagulant activity. (Evolving stroke, PE, massive DVT)

-Adjunct therapy for patient having open heart surgery or dialysis where blood is leaving the body

Question 3

Heparin: Adverse reactions

Answer 3

-Bleeding

-Hematoma with spinal epidural

-Thrombocytopenia

Question 4

Heparin: What do you monitor?

Answer 4

-Bleeding - Vitals - Bruising - Petechiae - Black tarry stools

Question 5

Heparin: Nursing Considerations

Answer 5

-High risk medication: Need nurse to double check calculations

-Starts working within 20-30 min

-Protamine sulfate is antidote

Question 6

Heparin: Labs

Answer 6

Anti-xa

aPTT

make sure to stop IV for 15 min and flush throughly before drawing lab

Question 7

Enoxaparin: Class

Answer 7

LMW Heparin

Question 8

Enoxaprin: MOA

Answer 8

Indirectly inactivates factors Xa

Prevent clotting

Question 9

Enoxaparin: Indications

Answer 9

Given Prophylaxis and for treatment

Home use if needed

Question 10

Enoxaparin: Adverse reactions

Answer 10

-Can cause HIT

-Thrombocyopenia and bleeding

Question 11

Enoxaparin: BBW

Answer 11

Potential Spinal hematoma if patient has epidural catheter

Question 12

Enoxaparin: Nursing considerations

Answer 12

-Do not give with other anti coags

-Can give with warfarin to treat PE or DVT

-Slower onset and longer half life than heparin

Question 13

Warfarin: Class

Answer 13

Anticoagulant

Question 14

Warfarin: MOA

Answer 14

-Vitamin - K inhibitor

Prevent synthesis of VII - IX - X and II (prothrombin)

Question 15

Warfarin: Indications

Answer 15

-Prevention of VTE - DVT - PE

-Patients with A-fib

-Reduce recurrence of MI

Question 16

Warfarin: Adverse Reactions

Answer 16

-Muscle pain

-Purple toes

Question 17

Warfarin: Antidote

Answer 17

-Give IV vitamin K

-Give fresh frozen plasma

-Give whole blood

Question 18

Warfarin: Nursing considerations

Answer 18

-HOLD before surgeries

-AVOID foods high in Vit K because they will reduce the effects

-Wear medical alert bracelet and use soft tooth brush and electric razor

Question 19

Warfarin: Labs

Answer 19

-Monitor PT/INR –> prothrombin time, international normalized ration

-Once therapeutic range is hit patients must monitor monthly

Question 20

Normal INR without warfarin

Answer 20

1

Question 21

Therapeutic INR with warfarin

Answer 21

2-3.5

Question 22

Apixaban
&
Rivaroxaban: Class

Answer 22

Anticoagulant

Question 23

Apixaban
&
Rivaroxaban: MOA

Answer 23

Direct inhibitor of factor Xa

Question 24

Apixaban
&
Rivaroxaban: Indications

Answer 24

-Prevent stroke with patient with AFIB

-Post op thrombo-prophylaxis

Question 25

Apixaban & Rivaroxaban: BBW

Answer 25

1. Spinal hematoma with epidural catheter 2. Risk of thrombosis if drugs abruptly stopped

Question 26

Apixaban & Rivaroxaban: Nursing considerations

Answer 26

-Decrease effect if taking phenytoin, carbamazepine, rifampin, and st johns wart -Increase effect: CYP3A4 inhibitors (GRAPEFRUIT JUICE) -No monitoring -Heavily envolved in liver so watch liver labs

Question 27

Apixaban & Rivaroxaban antidote

Answer 27

-Andexxa

Question 28

Aspirin: Class

Answer 28

NSAID

Question 29

Aspirin: MOA

Answer 29

-Blocks prostaglandin synthesis through the COX enzyme pathways (blocks platelet aggregation)

Question 30

Aspirin: Indications

Answer 30

-Prevent/Treat MI -Prevent ischemic (blood clot in brain) stroke

Question 31

Aspirin: Nursing indications

Answer 31

-In an acute event, chew a baby aspirin (cannot be enteric coated) (Chew white not orange)

Question 32

Aspirin: Antidote

Answer 32

DDAVP Desmopressin

Question 33

Clopidogrel & Ticagrelor: Class

Answer 33

Anti-platelet

Question 34

Clopidogrel & Ticagrelor: MOA

Answer 34

-Antiplatelet ADP inhibitor -Alters platelet membrane so the do not receive signal to aggregate

Question 35

Clopidogrel & Ticagrelor: Adverse Reactions

Answer 35

-Chest pain -Flu Like symptoms -Abdominal Pain -Epistaxis -Purities

Question 36

Contraindications for all antiplatelets

Answer 36

Thrombocytopenia and Bleeding Disorders

Question 37

Clopidogrel & Ticagrelor: BBW

Answer 37

-Patient with certain genetic abnormalities may have higher rate of CV events due to reduced conversion to the active metabolite

Question 38

Clopidogrel: Nursing consideration

Answer 38

-Effectiveness reduced by CCB's, NSAIDS, and PPI's

Question 39

Ticagrelor: Nursing consideration

Answer 39

-Increased bleeding risk with aspirin doses of 100 mg

Question 40

Clopidogrel & Ticagrelor: Antidote

Answer 40

DDAVP

Question 41

Argatroban & Bivalirudin: Class

Answer 41

Direct Thrombin Inhibitors

Question 42

Argatroban & Bivalirudin: MOA

Answer 42

-Inhibit Thrombin factor IIA

Question 43

Argatroban & Bivalirudin: Indications

Answer 43

Treat HIT and for patients undergoing procedures who are at high risk of HIT

Question 44

Argatroban & Bivalirudin: Nursing considerations

Answer 44

IV only Watch for heptaic dyfunction Labs: Anti-Xa, H&H, Platlets

Question 45

DDAVP desmopressin

Answer 45

Antidote for Aspirin Antidote for Clopidogrel and Ticagrelor

Question 46

Andexxa

Answer 46

Antidote for Apixaban and Rivaroxaban

Question 47

Vitamin K

Answer 47

Antidote for warfarin

Question 48

Protamine Sulfate

Answer 48

Antidote for heparin and enoxaparin

Question 49

Why do we give steriods

Answer 49

-Replacement (problem with adrenal gland) (over stress) -Anti-inflammatory (Systemic inflammatory response) -Immunosuppression (Organ transplant) (trying to depress immune system)

Question 50

Steroids given for

Answer 50

-Allergies (decrease immune response) -Asthma (inhaled steroids) -COPD exacerbation (trying to lessen inflammatory disorder) -Post transplant (wean patient off)

Question 51

Hydrocortisone: ALL

Answer 51

GCC -Same as endogenous cortisol -Not many side effects in small doses -Oral or IV

Question 52

Prednison

Answer 52

GCC Used for chronic disease states like COPD

Question 53

Dexamethasone

Answer 53

GCC Used when we need to monitor the adrenal functions. This steroids doesn't show up as cortisol in blood

Question 54

Fludrocortisone

Answer 54

-Mineralocortocoid -Only MCC replacement Used with Prednisone and Dexamethasone to prevent salt waisting

Question 55

Short Term Glucocorticoid Adverse Reactions

Answer 55

Increase intraocular pressure Fluid retention HTN Mood swing Weight gain (always hungry)

Question 56

Long Term Glucocorticoid Adverse reactions

Answer 56

High blood sugar Increase risk of WBC suppression -Thinning of bones and skin -Suppressed adrenal gland hormone production

Question 57

Glucocorticoid: Nursing implications

Answer 57

-Do not abruptly stop taking -Tell patient to take at same time -Increase steroids when stressed -Wear medical alert bracelet -Monitor weight and blood sugar

Question 58

Trimethorpim-suflamethozaole

Answer 58

First line antibiotic to treat UTI's

Question 59

Ciprofloxacin

Answer 59

Antibiotic used for UTI's

Question 60

Nitrofurantoin

Answer 60

Antibiotic used for recurring lower UTI's

Question 61

Phenazopyridine: Class

Answer 61

Analgesic

Question 62

Phenazopyridine: MOA

Answer 62

-Unknown but exerts topical analgesic effect on the mucosa of urinary tract to relieve pain

Question 63

Phenazopyridine: Indicaitons

Answer 63

-Relief of PAIN due to UTI

Question 64

Phenazopyridine: Adverse Reactions

Answer 64

Well tolerated: Reddish Orange

Question 65

Mirabegron: Class

Answer 65

Antispasmodic

Question 66

Mirabegron: MOA

Answer 66

-Seleticitevly stimulates beta-3 adrenergic receptors, relaxing bladder smooth muscle

Question 67

Mirabegron: Adverse effects

Answer 67

-HTN - UTI

Question 68

Oxybutynin: Class

Answer 68

Anti-cholinergic

Question 69

Oxybutynin: MOA

Answer 69

-Block the action of acetylcholine. Acetylcholine activates smooth muscle contractions

Question 70

Oxybutynin: Indications

Answer 70

Overactive bladder and incontinence

Question 71

Oxybutynin: Adverse Effects

Answer 71

-Dry mouth -Constipation